Citations

One in eight children in the United States grows up in a household with parental substance use disorder (SUD). The purpose of this study was to explore the needs of children and kinship caregivers affected by SUD, as perceived by 23 professionals who interact with these families. A community-based participatory research approach with exploratory and descriptive qualitative methods was utilized. Results indicated that (a) children need relationships and connections, stability, emotional and health care support, and protection from risks associated with SUD; (b) caregivers need community resource and navigation supports, skills development, and understanding of the caregiver’s role; and (c) there is a lack of existing comprehensive resources and services to support families affected by SUD. This study adds to existing literature by identifying key professionals’ perceptions and examining various types of kin relationships. Future research and practice implications are discussed.

Known gaps exist between what patients value and institutions prioritize. We sought to incorporate patients’ reasons for valuing family medicine into a new Mission and Vision statement by deploying brief surveys to a convenience sample of patients. We conducted descriptive quantitative analyses of demographics and inductive content analysis of written responses. Patients returned 92 (20%) of 450 questionnaires. Responders were 63% female, mean age of 47 years. Patients noted distinguishing features of family medicine were (1) continuity of care, (2) all-encompassing care, and (3) trusted referrals. Some patients reported not knowing there was a distinction between family medicine and other primary care.

Background The causes of obesity are multifactorial, with genetic, environmental, behavioural and societal contributions. These factors also affect adherence to diet and exercise after bariatric surgery. The objective of this study was to evaluate changes in perceived obesity-related stigma, exercise and dietary adherence perioperatively as well as what demographic factors most influence the magnitude of these changes. Methods Validated questionnaires regarding perception of stigma and adherence to diet and exercise regimens were administered to 104 bariatric surgery patients preoperatively and postoperatively at three, six and 12 months. Scoring was compared for improvement, and concomitant factors were analysed for effect on magnitude of improvement. Results Our study found overall improvement in perception of stigma as well as adherence to diet and exercise regimens. Those with a family history of obesity had less robust improvement compared to those without a family history of obesity. Those who were Caucasian also did not have as robust of an improvement in their scores. Conclusions Patient perception of obesity-related stigma and adherence to diet and exercise regimens improve after bariatric surgery. However, a patient with a family history of obesity and/or a Caucasian ethnicity may have a less robust improvement in these facets.

Background Compelling evidence links obstructive sleep apnea (OSA), a prevalent sleep disorder, to heightened morbidity and mortality. Individuals with family history (FH) of OSA exhibit increased risk of developing this sleep disorder, suggesting that genetics, in addition to demographic and lifestyle factors, are likely implicated in the pathogenesis of OSA. However, it is unclear whether a positive FH of OSA predisposes to other unfavorable health outcomes. In this regard, data on its impact on vulnerability to obesity, both a precursor and a consequence of OSA, are lacking. Objective We sought to assess the association between FH of OSA and risk of obesity. Methods The study population consisted of 612 individuals (66% male, age 48.1±17.3 years) who took part in research studies performed in the Cardiovascular/Sleep Laboratory at Mayo Clinic and had complete family history data. FH of OSA and obesity were determined from questionnaires. Demographics and medical comorbidities including OSA diagnosis were obtained from self‐reports. Body mass index (BMI, kg/m 2 ) was calculated from height and weight measures and used to determine obesity status as follows: normal weight (BMI <25 kg/m 2 ), overweight (BMI 25–29.9 kg/m 2 ), and obese (BMI ≥30 kg/m 2 ). Measurements of waist circumference were obtained to determine central obesity (defined as waist circumference ≥88 cm in women and ≥102 cm in men). Results FH of OSA was reported by twelve percent of the sample (n=72). Individuals with FH of OSA were younger and more likely to be female than those without (age: 40.8±12.6 years vs 49.1±17.6 years, P<0.0001; sex: 48.6% vs 32.2%, P=0.008). Those with positive FH had higher BMI (31.5±6.8 kg/m 2 vs 29.2±7 kg/m 2 , P=0.009), were more frequently obese (59.7% vs 39.8%, P=0.007), and had higher prevalence of central obesity (67.7% vs 53.8%, P=0.036). Multivariable regression models showed the FH of OSA was associated with 3.2‐times greater risk of obesity (95% CI 1.7–5.9, P=0.0002) and with 2.3‐times greater risk of central obesity (95% CI 1.2–4.5, P=0.011) after correcting for age, sex, OSA diagnosis, and FH of obesity. Conclusion Family history of OSA is accompanied by an increased likelihood of obesity, especially central obesity, even if subjects with FH of OSA are much younger. This relationship is independent of conventional risk factors, including OSA diagnosis, suggesting that comorbid OSA in the offspring is unlikely to be implicated. Research addressing the potential pathophysiological mechanisms underlying our findings is warranted. Support or Funding Information Research support: VKS and PS are supported by NIH HL65176. NC is supported by American Heart Association grant 16SDG27250156, and Mayo Clinic CCaTS grant Marie Ingalls Cardiovascular Research Career Development Fund. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

The RAS signal transduction cascade is a pivotal signaling pathway that controls numerous fundamental cellular processes, such as cell proliferation, differentiation, motility, and apoptosis. Oncogenic K‐RAS pathway activation is detected in approximately 30% of all human cancers. Seven‐IN‐Absentia (SINA) is an evolutionarily conserved E3 ubiquitin ligase that is the most downstream signaling module identified in the RAS signaling pathway. Underscoring the importance of SINA is its high evolutionary conservation with over 83% amino acid identity shared between Drosophila SINA and its human SINA homologs (SIAHs). As a major signaling hub and the downstream signaling “gatekeeper” in the RAS pathway, SIAHs are uniquely positioned to inhibit “undruggable” oncogenic K‐RAS activation that is prevalent in high‐grade metastatic cancer. Thus, it is important to delineate the enzymatic activity, molecular regulation, and substrate targeting mechanism(s) of this highly conserved family of SINA/SIAH E3 ligases. By deploying the elegant and powerful Drosophila photoreceptor cell development system, we conducted a genetic modifier screen and identified 28 new sina mutant alleles that exhibit a range of mutant phenotypes. For example, sina complete loss of function (null alleles) is cell lethal, suggesting that SINA is an essential gene in development. All other sina mutant alleles exhibit stronger phenotypes than the previously published sina 2 and sina 3 alleles, providing us with an opportunity to study sina loss‐of‐function mutant phenotypes. Sequencing analysis of these newly identified mutant alleles reveals the critical roles of several immutatable amino acid residues essential for SINA function. To demonstrate the functional conservation of SINA/SIAH proteins, we have generated a collection of transgenic fly lines that carry either wild‐type (WT) or dominant negative (DN) Dm SINA and human SIAH. The altered Dm SINA/hSIAH expression under the control of sev ‐, GMR ‐, and dpp ‐ and salivary gland ‐GAL4 drivers revealed the biological consequences of gain of function and/or loss of function of Dm SINA/hSIAH1/2 in transmitting RAS signaling in central nervous system (CNS) and peripheral nervous system (PNS) development. Immunofluorescent staining of developing imaginal discs and electron micrographs of adult tissues show that ectopic expression of SINA WT/DN /SIAH WT/DN in neurons resulted in dramatic changes in neuronal cell fate in the developing eye and notum. Furthermore, immunofluorescent staining of larval salivary glands revealed a critical role for SINA family E3 ligases in regulation of cell shape, focal adhesions, and cellular junctions. The results from these transgenic animals suggested that Drosophila SINA and human SIAH1/SIAH2 are evolutionarily conserved and functionally interchangeable. Through this developmental neurobiology and cellular biology‐based study, we aim to dissect the molecular action of SINA/SIAH1/2 in RAS signaling. Furthermore, we hope to translate these findings to demonstrate the anticancer efficacy of the next‐generation anti‐SIAH‐based anti‐K‐RAS strategy against high‐grade metastatic human cancer in the future. Support or Funding Information Extramural funding support provided by NIH NIGMS R01 GM069922Z‐05S1 and NCI R01 CA140550. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

The American Academy of Pediatrics (AAP) recommends that all breastfed infants be supplemented with 400 IU of vitamin D daily, beginning soon after birth. We surveyed all Family Medicine providers at a single, academic medical institution regarding their perceptions and practices of infant vitamin D supplementation. Of 99 surveys solicited, 56 (57%) responded. Respondents were aware of the AAP recommendation with 52 (93%) correctly identifying the AAP’s recommended dose. The self‐reported median (interquartile range) proportion of visits in which the provider recommended supplementation to exclusively or partially breastfed infants were 80% (50 ‐ 97%) and 50% (25 ‐ 80%), respectively. The most common reason (82%) for recommending supplementation was “to follow the AAP recommendations.” Thirty (54%) reported recommending vitamin D supplementation within the first two weeks of life. Of all respondents, 49 (88%) recommend infant vitamin D drops as the route of supplementation. Finally, 49 (88%) respondents would prefer to supplement the mother instead of the infant or offer the parents a choice if this were an adequate and safe option for vitamin D supplementation, and 17 (30%) would prefer monthly to daily supplementation. In conclusion, Family Medicine providers are aware of current AAP recommendations, but vary in their practices; they are open to maternal vitamin D supplementation as an alternative option.