Informing the development of the coaching online and community health (COACH) program: a qualitative study of clubhouse members living with serious mental illness.

Health and wellness interventions addressing risk factors for early mortality among individuals with serious mental illness have demonstrated success and can be further augmented with digital technology. These programs may be suitable for delivery in psychosocial rehabilitation clubhouses, especially given many services have transitioned to digital platforms during the pandemic. This qualitative study aimed to: (a) explore clubhouse members' experiences engaging with the virtual clubhouse platform, and their preferences for accessing digital wellness and health promotion content; and, (b) gauge members' interest in an online peer-driven lifestyle intervention and their suggestions for program design. This study was guided by a community-based participatory action research framework. Ten focus groups were conducted with clubhouse members. Focus groups were coded and analyzed thematically by trained clubhouse members and the research team. Thirty-three members participated in the focus groups. Participants expressed the importance of having technical support from staff; that one-on-one support and consistent communication are important to keep them engaged in health and wellness programming; and described mixed views about use of the virtual platform, but generally were open to engaging in lifestyle intervention programming virtually. Participants who joined the clubhouse during the pandemic expressed feeling overwhelmed by in-person gatherings, and were especially interested in opportunities for remote participation. This study can inform health and wellness programming for delivery on the virtual clubhouse platform for members. The taxonomy of codes, created to generate a framework with recommendations, will inform the design of a virtual health and wellness intervention.

This study investigates people with mental illness's interest in an online program to improve their heart health and fitness through a clubhouse which they are a member of. Previous programs have had success improving the heart health and fitness of people with mental illness and adapting these programs to be accessible online can expand their impact. Thirty-three individuals participated in 10 focus groups and expressed the importance of having help from when accessing technology; that one-on-one support and communication would increase their participation in these programs; and described mixed views about use of online programs, but generally were open to an online program to increase heart health and fitness.

Bone morphogenetic protein 6 drives both osteogenesis and chondrogenesis in murine adipose-derived mesenchymal cells depending on culture conditions.

Bone morphogenetic proteins (BMPs) play a dual role as a factor in both bone and cartilage development and correspondingly have the therapeutic potential to regenerate both tissues. Given this dual nature, previous in vitro research using BMPs has relied on distinct media formulations and culture conditions to drive undifferentiated cells to the osteogenic or chondrogenic lineage. To isolate the impact of culture conditions and to explore the effect of BMP-6 on murine adipose-derived mesenchymal cells (ASCs), ASCs were seeded in either monolayer or pellets in an identical medium containing BMP-6. Results indicate that BMP-6 differentially promotes osteogenesis and chondrogenesis in ASCs depending on culture conditions. BMP-6 potently induced alkaline phosphatase activity and mineralization in ASCs cultured in monolayer conditions. In contrast, BMP-6 enhanced proteoglycan accumulation in ASCs seeded in chondrogenic pellet culture. A comparison of gene expression suggests that the differentiating effect of BMP-6 is specific to the particular culture condition. This study highlights the importance of the interactions between chemical signaling and microenvironmental cues in directing cell fate.

A semi-autonomous model of endochondral ossification for developmental tissue engineering.

Bone tissue engineering is currently undergoing a paradigm shift regarding the concepts used to develop cell-based therapies for skeletal repair. In place of the "trial and error" approach, researchers aim at developing cellular concepts that mirror developmental and postnatal processes. Herein, we describe a model for in vivo endochondral remodeling of an in vitro derived cartilaginous intermediate and its applicability to bone engineering. In vitro differentiation of the continuous cell line, ATDC5, in pellet culture was enhanced in a medium containing ascorbic acid, insulin-transferrin-selenium, dexamethasone, and transforming growth factor ß1, when compared with other tested preparations. This differentiation was characterized by the elevated expression of Collagen type II and X along with glycosaminoglycan (GAG) accumulation and the onset of hypertrophy. On combination with NuOss™, a clinically used bone void filler, and implantation in nude mice, the differentiated pellets further matured into GAG rich cartilaginous intermediates after 4 weeks. This was subsequently partially remodeled into osteocalcin-positive bone tissue after 8 weeks without further external manipulation, indicating the semi-autonomous nature of this implant. Mineralized tissue along with active osteoclast resorption and neo-angiogenesis was apparent throughout the implant. The bone volume was approximately eightfold higher (10.70%±0.99%) when using a cartilaginous intermediate (based on differentiated cell pellets) than when observed with cell-seeded scaffolds (1.19%±0.24% and 1.48%±0.35%), in both a differentiated and an undifferentiated state. This study highlights the potential of endochondral strategies for bone tissue engineering and allows the identification of the key cellular parameters for this process.