Rewards and Lessons Learned From Implementation of a Healthy Homes Research Project in a Midwestern Public Health Department.

Marion County Public Health Department (MCPHD) in Indianapolis, Indiana, was awarded funding in 2009 from the U.S. Department of Housing and Urban Development through the Healthy Homes Demonstration Grant Program as a part of the American Recovery and Reinvestment Act. This funding is currently supporting activities addressing health and safety hazards in homes of low- and very low-income residents living in an urban community within Marion County with an extensive history of heavy industry and lead smelting. One portion of this grant is being used to fund IRB-approved research conducted by MCPHD for the period of the grant. Development and implementation of this study has provided both unique challenges and positive opportunities for study participants, MCPHD, and community stakeholders. The following commentary provides insight into the benefits and rewards of implementing a successful study process, as well as challenges in implementing a community-based research study for the first time in a preexisting Healthy Homes Demonstration Grant Program health department.

The mediating role of organizational subcultures in health care organizations.

PURPOSE: This study aims to investigate the mediating role of organizational subculture between job satisfaction, organizational commitment (dependent variables) and leadership, culture (independent variables) in health care organizations. DESIGN/METHODOLOGY/APPROACH: A survey on nurses from 26 wards from various types of hospital was used. A total of 251 usable returns were collected for the analysis (i.e. response rate of 63 per cent). Structural equation analysis was conducted to obtain the best fit model and to determine the direction of the causal effect between job satisfaction and commitment, and the role of subculture as a mediating variable, between commitment of its other antecedents. FINDINGS: Comparisons with alternative models confirmed satisfaction as an antecedent of commitment and the role of subculture as a mediating variable. The results of this study contribute to the clarification of the causal relations of the antecedents of commitment, and highlight the important role of local leadership and subculture in determining employees' job satisfaction and commitment. RESEARCH LIMITATIONS/IMPLICATIONS: The results of this study should not be generalized to other industries and other national cultural context. Furthermore, a longitudinal study may be necessary to determine the causal relationship of variables used in this study. PRACTICAL IMPLICATIONS: The findings could provide managers with valuable insight to focus their limited resources on improving the level of organizational commitment via the mediating role of organizational culture. ORIGINALITY/VALUE: The research findings provide managers with a new lens to examine organizational culture using the three perspectives of: bureaucratic, supportive, and innovative. Furthermore, the results could renew interest in developing other organizational subculture models that determine the relationship between organizational subculture and commitment

The antianginal agent trimetazidine does not exert its functional benefit via inhibition of mitochondrial long-chain 3-ketoacyl coenzyme A thiolase.

Trimetazidine acts as an effective antianginal clinical agent by modulating cardiac energy metabolism. Recent published data support the hypothesis that trimetazidine selectively inhibits long-chain 3-ketoacyl CoA thiolase (LC 3-KAT), thereby reducing fatty acid oxidation resulting in clinical benefit. The aim of this study was to assess whether trimetazidine and ranolazine, which may also act as a metabolic modulator, are specific inhibitors of LC 3-KAT. We have demonstrated that trimetazidine and ranolazine do not inhibit crude and purified rat heart or recombinant human LC 3-KAT by methods that both assess the ability of LC 3-KAT to turnover specific substrate, and LC 3-KAT activity as a functional component of intact cellular beta-oxidation. Furthermore, we have demonstrated that trimetazidine does not inhibit any component of beta-oxidation in an isolated human cardiomyocyte cell line. Ranolazine, however, did demonstrate a partial inhibition of beta-oxidation in a dose-dependent manner (12% at 100 micromol/L and 30% at 300 micromol/L). Both trimetazidine (10 micromol/L) and ranolazine (20 micromol/L) improved the recovery of cardiac function after a period of no flow ischemia in the isolated working rat heart perfused with a buffer containing a relatively high concentration (1.2 mmol/L) of free fatty acid. In summary, both trimetazidine and ranolazine were able to improve ischemic cardiac function but inhibition of LC 3-KAT is not part of their mechanism of action. The full text of this article is available online at http://www.circresaha.org.