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Predictors of retention of participants in a longitudinal study and heterogeneity between communities were investigated using a multilevel logistic regression model. Data from the longitudinal outcome study of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families program and information on communities participating in the evaluation were used to examine retention of participants at 6-, 12-, 18-, and 24-month follow-up interviews. Findings revealed that both child and family characteristics and community characteristics significantly influenced participation for up to 24-month follow-up. Specifically, behavioral and emotional problems at intake, referral source, proportion of total staff devoted to interviewers, and total amount of incentive paid out at baseline influenced retention of participants. In addition, significant random effects at both Level 2 and Level 3 indicated that retention varied significantly between communities and among children even after controlling for child and family characteristics.

The longitudinal comparison study of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program assesses factors in service delivery systems that may shape the impact of systems of care. We evaluated the extent to which services embodying the principles of a system of care, as measured by the System-of-Care Practice Review (SOCPR), affect clinical outcomes for children being served in federally-funded systems of care and matched comparison communities. The participants included 75 children and families selected for participation in the SOCPR. Results indicated that experience of services embodying system-of-care principles at a high level was associated with lower symptom and impairment scores one year after entry into services. Children in systems of care were rated to have experienced high levels of system-of-care principles implemented within their services, and their symptom severity and functional impairment did not vary as a function of their experiences. Children in matched comparison communities had more variable rated experiences of system-of-care principles within their services, and their symptom severity and functional impairment decreased as their experiences of the principles increased.

Youth suicide remains a significant public health problem in the United States. In 2004, the Garrett Lee Smith Memorial Act provided states and tribes with funding to implement and evaluate youth suicide prevention programs. The Tennessee Lives Count project was developed through a collaborative model at the state level and delivers an enhanced version of the Question, Persuade, Refer gatekeeper training program to individuals working with youth across the state. This article describes the development of the project and preliminary outcomes of 416 participants in child welfare, juvenile justice, health, and education systems at pretest, posttest, and 6-month follow-up. The findings suggest the training has an immediate and long-term impact on perceived knowledge of suicide prevention, self-efficacy, and attitudes about the inevitability of suicide. Policy and practice implications are presented. Keywords: suicide prevention, gatekeeper training, child welfare, juvenile justice, public health nursing, education

Visceral hypersensitivity is the leading complaint of functional bowel disorders. Central sensitization mediated by glutamate receptor activation is implicated in pathophysiology of visceral pain. The glial glutamate transporter EAAT2 is the principal mediator of glutamate clearance to terminate glutamate-mediated responses. Transgenic mice overexpressing human EAAT2 (EAAT2 mice), which exhibited a twofold enhanced glutamate uptake, showed 39% less writhing response to intraperitoneal acetic acid than nontransgenic littermates. Moreover, EAAT2 transgenic mice showed a 53-64% reduction in visceromotor response (VMR) to colorectal distension (CRD) in assessments of the response to graded increase in pressures. Corroborating the involvement of enhanced glutamate uptake, wild-type mice treated for 1 wk with ceftriaxone, an EAAT2 expression activator, showed a 49-70% reduction in VMR to CRD. Moreover, systemic pretreatment with the selective EAAT2 transporter blocker dihydrokainate reversed the ceftriaxone-blunted nociceptive response to CRD. However, the enhanced VMR to CRD produced by intracolonic ethanol was not significantly attenuated by 1-wk ceftriaxone pretreatment. The data suggest that enhanced glutamate uptake provides protective effects against colonic distension-induced nociception and represents an exciting new mechanistic approach leading to better therapeutic options to visceral pain disorders. colon; pain; gastrointestinal; excitatory amino acids

Background: eHealth interventions can help cancer survivors self‐manage their health outside the clinic. Little is known about how best to engage and assist survivors across the age and cancer treatment spectra. Methods: The American Cancer Society conducted a randomized controlled trial that assessed efficacy of, and engagement with, Springboard Beyond Cancer, an eHealth self‐management program for cancer survivors. Intent‐to treat analyses assessed effects of intervention engagement for treatment (on‐treatment vs completed) overall (n = 176; 88 control, 88 intervention arm) and separately by age (<60 years vs older). Multiple imputation was used to account for participants who were lost to follow‐up (n = 41) or missing self‐efficacy data (n = 1) at 3 months follow‐up. Results: Self‐efficacy for managing cancer, the primary outcome of this trial, increased significantly within the intervention arm and for those who had completed treatment (Cohen's d = 0.26, 0.31, respectively). Additionally, participants with moderate‐to‐high engagement in the text and/or web intervention (n = 30) had a significantly greater self‐efficacy for managing cancer‐related issues compared to the control group (n = 68), with a medium effect size (Cohen's d = 0.44). Self‐efficacy did not differ between the intervention and control arm at 3 months post‐baseline. Conclusions: Study results suggest that cancer survivors benefit variably from eHealth tools. To maximize effects of such tools, it is imperative to tailor information to a priori identified survivor subgroups and increase engagement efforts. This randomized controlled trial assessed the efficacy of the Springboard Beyond Cancer eHealth program in a sample of 176 cancer survivors. Results demonstrate significant improvement in self‐efficacy for managing cancer issues among the intervention group and no significant change among the control group. [ABSTRACT FROM AUTHOR]

The site specificity of the interactions between serotonin (5-HT) and thyrotropin-releasing hormone (TRH) was investigated using prototypical selective agonists of the serotonin to delineate the mechanisms of the interactions. The results suggested that an augmentation of the TRH-analog induced increment in the response to gastric acid through activation of 5-carboxyamidotryptamine and 5-HT2 receptors may have come from the 5-HT in the dorsal vagal complex (DVC). The results further suggested that the TRH analog behavior at the DVC may have been inhibited by the 5-HT4 receptor activation.

Systemic serotonin (5-HT) inhibits gastric acid secretion via a basolateral pathway that is not affected by the enteric and external autonomic nervous control. Prostaglandins, gastric mucosal blood flow and adrenal factors did not alter 5-HT-mediated inhibition of pentagastrin-stimulated gastric acid secretion. Furthermore, reductions in blood supply to the gastric mucosa did not alter the inhibitory action of 5-HT on the gastric mucosa.

5-hydroxytryptamine (5-HT) selectively alters gastric acid secretion, motility and cytoprotection by stimulating the thyrotropin releasing hormone (TRH) analogue in the dorsal vagal complex (DVC). The administration of 5-HT into the DVC enhances the secretion of gastric acid and inhibits gastric cytoprotection, but leaves the gastric antral contractility unaffected through its effect on the TRH receptors.

Rat pancreatic polypeptide (PP) strongly stimulates gastric emptying by rats. In comparison, the effects of bovine PP is small or non-existent, depending on the method of administration. Researchers injected rat PP, bovine PP, or placebo either intracisternally or into the dorsal vagal complex (DVC) of rats. When injected intracisternally, bovine PP had little or no effect, but that of rat PP was marked. Reaction to DVC injection was measurable but smaller for both rat and bovine PP, and the bovine PP response was much smaller. PP probably acts as a circulating hormone by stimulating gastric voiding through a vagal cholinergic-dependent mechanism.

Abstract Glutamate is a neurotransmitter critical for spinal excitatory synaptic transmission and for generation and maintenance of spinal states of pain hypersensitivity via activation of glutamate receptors. Understanding the regulation of synaptically and non-synaptically released glutamate associated with pathological pain is important in exploring novel molecular mechanisms and developing therapeutic strategies of pathological pain. The glutamate transporter system is the primary mechanism for the inactivation of synaptically released glutamate and the maintenance of glutamate homeostasis. Recent studies demonstrated that spinal glutamate transporter inhibition relieved pathological pain, suggesting that the spinal glutamate transporter might serve as a therapeutic target for treatment of pathological pain. However, the exact function of glutamate transporter in pathological pain is not completely understood. This report will review the evidence for the role of the spinal glutamate transporter during normal sensory transmission and pathological pain conditions and discuss potential mechanisms by which spinal glutamate transporter is involved in pathological pain.

Proposes that it is more useful for industrial arts/technology teacher education to adopt than to ignore the concept of liberal learning. Argues that the goals of liberal learning are not only compatible, they are complementary, useful, and necessary. Includes recommendations for selecting courses for industrial arts/technology teacher education programs. (JOW)

Background: Despite demonstrated utility of Bandura's social cognitive theory for increasing physical activity among cancer survivors, the validity of the originally hypothesized relationships among self-efficacy, outcome expectations, and physical activity behavior continues to be debated.Purpose: To explore the temporal ordering of outcome expectations and self-efficacy as they relate to moderate-to-vigorous physical activity behavior.Methods: Longitudinal data from cancer survivors (N = 1,009) recently completing treatment were used to fit six cross-lagged panel models, including one parent model, one model representing originally hypothesized variable relationships, and four alternative models. All models contained covariates and used full information maximum likelihood and weighted least squares mean and variance adjusted estimation. Tests of equal fit between the parent model and alternative models were conducted.Results: The model depicting Bandura's originally hypothesized relationships showed no statistically significant relationship between outcome expectations and physical activity (p = .18), and was a worse fit to the data, compared with the parent model [Χ2 (1) = 5.92, p = .01]. An alternative model showed evidence of a reciprocal relationship between self-efficacy and outcome expectations, and was statistically equivalent to the parent model [Χ2(1) = 2.01, p = .16].Conclusions: This study provides evidence against Bandura's theoretical assertions that (a) self-efficacy causes outcome expectations and not vice versa, and (b) outcome expectation has a direct effect on physical activity. Replication within population subgroups and for other health behaviors will determine whether the social cognitive theory needs modification. Future trials should test whether differential construct ordering results in clinically meaningful differences in physical activity behavior change. [ABSTRACT FROM AUTHOR]