Sorting it out: Eliciting consumer priorities for recovery in supportive housing

This study aims to understand participant priorities in their personal recovery journey and their perspectives of recovery domains. A card-sort data-gathering technique was employed to elicit priorities in recovery from consumers in supportive housing programs serving adults who were formerly homeless with severe mental illnesses in New York City. Participants (N = 38) were asked to sort 12 cards printed with recovery domains in order of importance and describe the meaning attached to each domain. Mental health (95%), physical health (89%), and housing (92%) were the domains most frequently included and prioritized in the top three rankings. Family (76%) and partner (74%) were also frequently included and endorsed as most important second only to mental health. Housing was prioritized yet rated most important less often (58%). Work, school, hobbies, program, friends, and neighborhood were less frequently endorsed. “Card-sort talk” revealed critical understanding of participants’ priorities and their reasons for endorsing other domains less frequently. Most important to participants was regaining functional independence through improved mental and physical health and access to housing. With underlying principles of efficiency and empowerment, card sort is a promising engagement technique for providers to elicit consumer priorities in their own recovery.     

Factors associated with the social competence and emotional well-being among young children in an Asian urban city

This cross-sectional observational study aims to examine the current status and familial factors associated with social competence and emotional well-being among young children in an urban city in the East Asia region. Early childhood teachers assessed the social competence and the emotional state of preschool children with the Social Competence and Behavioural Evaluation (SCBE-30) Scale. Data were analysed with multiple regression modelling. Results suggested few variables were significantly associated with social competence. These included being a boy, aged 5 years or older, had more than one sibling, whose mother spoke a language other than the local language, and whose carers were not biological parents. Being a male with a mother who spoke a language other than the local language was associated with anger–aggression, while parental work arrangement was the only variable associated with anxiety–withdrawal. Results have a direct implication on the individual and structural levels of child care and early childhood education.     

Clinical utility of emerging biomarkers in prostate cancer liquid biopsies

ABSTRACT

Introduction: Prostate cancer (PCa) is one of the most common malignancies in men and a major cause of cancer deaths among men worldwide. Prostate specific antigen (PSA) monitoring and histopathological examination of tumor biopsies remain gold standards in PCa diagnostics. These clinical parameters are not well suited for patient stratification, predicting and monitoring treatment response. On the other hand, liquid biopsies offer a unique opportunity to easily isolate tumor-derived material for longitudinal clinical assessment.

Areas covered: In this review we focus on the clinical application of novel liquid biomarkers that have the potential to monitor and stratify patients in order to achieve better therapeutic effects and improve clinical outcomes. Enumeration and characterization of circulating tumor cells (CTCs), tumor-educated platelets, exosomes, and cell-free nucleic acids have been studied for their clinical utility in PCa diagnostics, prognostics, monitoring treatment response and guiding treatment choice.

Expert opinion: Liquid biomarkers have high potential to be used for prognosis, monitoring treatment response and guiding treatment selection. Although there is a remarkable progress in PCa biomarker discovery, their clinical validation is very limited. Research should be focused on biomarker validation and the incorporation of these biomarkers in clinical practice.     

Antioxidant capacity and total phenolic content of Malaysian underutilized fruits

The purpose of this study was to evaluate the antioxidant capacity (AC) and total phenolic content (TPC) of selected Malaysian underutilized fruits. The 58 underutilized fruits of 32 different species from 21 genera were analyzed for AC and TPC. AC was measured using β-carotene bleaching, ferric reducing antioxidant potential (FRAP) and 2,2-diphenyl-1-picryl hydrazyl (DPPH) assays, and TPC was determined using the Folin–Ciocalteu reagent assay. Our findings showed that the fruits from genera of Pometia, Averrhoa, Syzygium, Sallacca, Phyllanthus, Garcinia, Sandoricum and Maipighia had higher AC compared to other studied genera. Among the underutilized fruits, Sandoricum and Phyllanthus fruits contained the highest TPC (>2000 mg/100 g edible portion). The correlation between AC and TPC varied. The study indicated that some of these underutilized fruits have the potential to be sources of antioxidant components.     

Bone marrow stem cells implantation with α-cyclodextrin/MPEG–PCL–MPEG hydrogel improves cardiac function after myocardial infarction

Cellular transplantation represents a promising therapy for myocardial infarction (MI). However, it is limited by low transplanted cell retention and survival within the ischemic tissue. This study was designed to investigate whether injectable α-cyclodextrin/poly(ethylene glycol)–b-polycaprolactone-(dodecanedioic acid)-polycaprolactone–poly(ethylene glycol) (MPEG–PCL–MPEG) hydrogel could improve cell transplant retention and survival, reduce infarct expansion and inhibit left ventricle (LV) remodeling. Bone marrow-derived stem cells (BMSCs) were encapsulated in α-cyclodextrin/MPEG–PCL–MPEG hydrogel and maintained their morphologies during the cell culturing. MTT assays were used for in vitro cell viability studies of the hydrogel and were shown to be non-cytotoxic. Seven days after MI, 100 μl of α-cyclodextrin solution containing 2 × 10⁷ BMSCs and 100 μl of MPEG–PCL–MPEG solution were injected into the infarcted myocardium simultaneously and the solutions solidified immediately. Injection of culture medium or cell alone served as controls. Four weeks after treatment, histological analysis indicated that the hydrogel was absorbed, and the injection of BMSCs with hydrogel had increased cell retention and vessel density around the infarct, and subsequently prevented scar expansion compared with BMSCs injection alone. Echocardiography studies showed that injection of BMSCs with hydrogel increased the LV ejection function and attenuated left ventricular dilatation. This study indicated that the injection of BMSCs with α-cyclodextrin/MPEG–PCL–MPEG hydrogel was an effective strategy which could enhance the effect of cellular transplantation therapy for myocardial infarction.     

Noncompliance in lifestyle intervention studies: the instrumental variable method provides insight into the bias

ObjectiveIn lifestyle intervention trials, participants of the control group often change their behavior despite the request to maintain their usual lifestyle pattern. These changes in the control group and changes in addition to the intended in the intervention group can lead to undesirable confounding effects.Study Design and SettingWe address several considerations for study design to prevent noncompliance or minimize its effects. Furthermore, we demonstrate how the instrumental variable method can give insight into the extent of bias introduced by noncompliance in randomized trials, within the context of the Sex Hormones and Physical Exercise study.ResultsNoncompliance can be prevented by measures taken in the design phase of a study, for example, limited duration of the study, clear recommendations, power calculation, intensity of the intervention, involvement of the control group, waiting-list control group, and single-consent design nested within an observational study. When nevertheless noncompliance does occur, the instrumental variable method estimates the intervention effect of treatment among the compliers.ConclusionNoncompliance can seriously affect validity of lifestyle trial results. Its occurrence should be prevented by taking measures during the design phase of a study. The instrumental variable method can give insight into confounding by noncompliance in randomized trials.     

Provider Views of Harm Reduction Versus Abstinence Policies Within Homeless Services for Dually Diagnosed Adults

Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two different approaches to homeless services: the traditional or “treatment first” approach that requires abstinence, and the more recent housing first approach that incorporates harm reduction. As part of a federally funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view harm reduction versus abstinence approaches. Themes included the following: (a) harm reduction as a welcomed alternative, (b) working with ambiguity, and (c) accommodating abstinence. Drawing on recovery principles, the authors consider the broader implications of the findings for behavioral health care with this population.     

Engagement of stakeholders in the development of a Theory of Change for handwashing and sanitation behaviour change

A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users/practitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice.