Search

Introduction: Community-based participatory research and animated video offer promising approaches to attenuate disparities in access to kidney transplant information. Project Aims: We refined an evidence-based animated video curriculum (Kidney Transplant and Donation Information Made Easy) designed for diverse individuals, that is currently being trialed to advance kidney transplant access among referred patients at a single transplant center, to further accommodate information needs in earlier stages of the path to transplant (pre-referral) and to enhance fit for Black and Hispanic people. Design: We describe formation of an academic-community partnership and the application of qualitative research methods and partnership discussions to refine the Kidney Transplant and Donation Information Made Easy videos. A simple content analysis was undertaken of intervention refinement transcriptions, minutes, and meeting notes. Results: We formed a community steering committee and advisory board of local members predominantly of minoritized race or ethnicity. Full engagement with community members is evident in the program's adaptation process. Essential refinement elements were adaptation of 17 original videos and iterative development of 8 new videos with the community, conducting parallel cognitive interviews of an expanded sample of stakeholders, maintaining the theoretical grounding of Elaboration Theory, communication/multimedia learning best practices, and self-efficacy framework, and doing Spanish-language translation. Conclusions: Applying community-based participatory research principles and qualitative methods, we produced a culturally grounded adaptation of the Kidney Transplant and Donation Information Made Easy videos that provides information about kidney transplantation from primary care to transplantation. This approach is likely to strengthen our community partnership and eventual community acceptance of the intervention during the implementation phase. Challenges were achieving consensus and adding Spanish-language translation.

Background: Referral for kidney transplantation is influenced by patient education; digital technologies can enhance broad information accessibility. This single-group study tested the feasibility and acceptability of patient-centered self-directed educational animated videos to improve mediators of kidney transplant referral., Methods: Community-based adults with chronic kidney disease stage ≥4 invited from a clinical registry or self-responding to flyers viewed eight sequential videos (19:36 min total duration) remotely on their own device. Change in kidney transplant knowledge, concerns, and confidence talking about kidney transplantation to doctors was assessed with self-report surveys before and immediately after viewing. Program feedback was assessed by survey and self-selected exit interview., Results: Viewers of the video set (n = 50) demonstrated increases in mean kidney transplantation knowledge by +22%, confidence discussing with their doctor by +6%, and reductions in concerns by -2%. Knowledge results were consistent across age, race, and literacy level. Over 90% indicated positive ratings on understanding, engaging, and helpfulness. In post-study interviews viewers indicated the videos promoted confidence in obtaining a kidney transplant and none reported that the 19-min duration of the home education was too long., Conclusion: The animated video education is promising to improve diverse individuals' knowledge, concerns, and communication confidence about kidney transplantation and is highly acceptable., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The adenylate cyclase activity of a particulate preparation of rat cerebral cortex is comprised of two contributing components, only one of which requires a CDR for activity. The CDR-dependent component was inhibited by high ratios of Mg2+ to Ca2+, responded in a biphasic manner (activation then inhibition) to increasing free Ca2+ concentrations, was inhibited by 0.1 to 0.4 mM chlorpromazine, and was activated by 1 to 100 micrometer cocaine. This enzyme form, which represented approximately 80% of tge basal activity of a cortex homogenate, was stable during pretreatment of homogenates at 45 degrees C but was completely deactivated by the removal of CDR during the preparation of the particulate fraction. Adenylate cyclase activity that did not depend on CDR was unaffected by the removal of CDR during the preparation of the particulate fraction, had elevated activity at high ratios of Mg2+ to Ca2+, was inhibited by Ca2+, was unaffected by 0.1 to 0.4 mM chlorpromazine and was slightly inhibited by 1 to 100 micrometer cocaine, and was not stable during pretreatment of homogenates at 45 degrees. The CDR-dependent component of adenylate cyclase activity was activated by 5 mM NaF to varying degrees depending on the concentration of CDR present in the assay. NaF decreased the concentration of CDR required to produce half-maximal velocity obtained at optimal concentrations of CDR. Activation by NaF required the presence of Ca2+ and was immediately and completely reversed by EGTA. In contrast, the component that did not respond to CDR was activated four- to fivefold by NaF. This activation was not influenced by Ca2+ or CDR and was not reversed by EGTA. The observed effects of effects of divalent cations on the CDR-dependent enzyme are discussed in relation to the cation-binding properties of CDR. The relationship of the CDR-dependent form of adenylate cyclase to other forms of this enzyme remains to be determined.

The frequency of miniature endplate potentials (mepps) in rat diaphragms was markedly increased by epinephrine and norepinephrine in preparations exposed to 15 mM K(+). The effect was rapid in onset but gradually declined during continued exposure to the catecholamines. N(6), O(2')-dibutyryl adenosine 3',5'-monophosphate (dibutyryl-cAMP) also caused transient frequency increases resembling in time-course those observed with catecholamines. Contrary to previous reports, catecholamines and dibutyryl-cAMP had little effect on mepp frequency in preparations not treated with K(+). Sustained increases with theophylline and decreases with adenosine were found in both K(+)-treated and untreated preparations. Analysis of the data obtained with catecholamines showed the intensity of the response to be a function of nerve terminal polarization. The inability of catecholamines and dibutyryl-cAMP to affect mepp frequency of untreated preparations argues against an obligatory role for cAMP in the neurosecretory mechanism. The findings are consistent with an action of catecholamines and cAMP in the regulation of transmitter release at fatigued preparations.

C-6 glial tumor cells treated with norepinephrine and sodium azide accumulated cyclic GMP to concentrations approximately 10-fold greater than the sum of the separate responses. Isoproterenol, but not phenylephrine, was an effective substitute for norepinephrine, and the response was blocked by propranolol and sotalol. Nitroprusside, but neither cyanide nor isobutyl-methylxanthine, replaced azide. The potentiation was not affected by removal of CA2+ OR Na+ from the extracellular medium and was not blocked by cocaine. The potentiative accumulation of cyclic GMP in C-6 cells differs from the recently described stimulation by catecholamines of soluble guanylate cyclase of renal cortex. The potentiative phenomenon is compared with the few known instances in which cyclic AMP augments cyclic GMP formation and may be associated with synergistic modifications of cellular functions.