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1.  A Research Mentor Training Curriculum for Clinical and Translational Researchers 
Purpose
To design and evaluate a research mentor training curriculum for clinical and translational researchers. The resulting eight hour curriculum was implemented as part of a national mentor training trial.
Method
The mentor training curriculum was implemented with 144 mentors at 16 academic institutions. Facilitators of the curriculum participated in a train-the-trainer workshop to ensure uniform delivery. The data used for this report were collected from participants during the training sessions through reflective writing, and following the last training session via confidential survey with a 94% response rate.
Results
88% of respondents reported high levels of satisfaction with the training experience, and 90% noted they would recommend the training to a colleague. Participants also reported significant learning gains across six mentoring competencies as well as specific impacts of the training on their mentoring practice.
Conclusions
The data suggest the described research mentor training curriculum is an effective means of engaging research mentors to reflect upon and improve their research mentoring practices. The training resulted in high satisfaction, self-reported skill gains as well as behavioral changes of clinical and translation research mentors. Given success across 16 diverse sites, this training may serve as a national model.
doi:10.1111/cts.12009
PMCID: PMC3572855  PMID: 23399086
2.  The anatomy, function, and development of mammalian Aβ low-threshold mechanoreceptors 
Frontiers in biology  2013;8(4):10.1007/s11515-013-1271-1.
Touch sensation is critical for our social and environmental interactions. In mammals, most discriminative light touch sensation is mediated by the Aβ low-threshold mechanoreceptors. Cell bodies of Aβ low-threshold mechanoreceptors are located in the dorsal root ganglia and trigeminal ganglia, which extend a central projection innervating the spinal cord and brain stem and a peripheral projection innervating the specialized mechanosensory end organs. These specialized mechanosensory end organs include Meissner’s corpuscles, Pacinian corpuscles, lanceolate endings, Merkel cells, and Ruffini corpuscles. The morphologies and physiological properties of these mechanosensory end organs and their innervating neurons have been investigated for over a century. In addition, recent advances in mouse genetics have enabled the identification of molecular mechanisms underlying the development of Aβ low-threshold mechanoreceptors, which highlight the crucial roles of neurotrophic factor signaling and transcription factor activity in this process. Here, we will review the anatomy, physiological properties, and development of mammalian low-threshold Aβ mechanoreceptors.
doi:10.1007/s11515-013-1271-1
PMCID: PMC3873732  PMID: 24376457
mechanoreceptor; Meissner’s corpuscle; Pacinian corpuscle; lanceolate ending; Merkel cell; Ruffini corpuscle; dorsal root ganglion
3.  Racial Disparities in Pain Management in Primary Care 
This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African Americans and Caucasians on pain management and QOL, with African Americans faring worse. The proposed mediational model, which included race, perceived discrimination, hopelessness, and pain management was supported: (1) African Americans compared to Caucasians had higher perceived discrimination, (2) perceived discrimination was positively associated with hopelessness, and (3) higher hopelessness was associated with worse pain management. Further, pain management predicted QOL. This is the first study in which an explanatory model for the racial disparities in pain management of primary care patients with chronic nonmalignant pain was examined. Perceived discrimination and hopelessness were implicated as explanatory factors for the disparities.
PMCID: PMC3827865  PMID: 24244911
Pain Management; Chronic nonmalignant pain; Model of racial disparities; racial and ethnic minorities; perceived discrimination
4.  Older adolescents’ views regarding participation in Facebook research 
Purpose
Facebook continues to grow in popularity among adolescents as well as adolescent researchers. Guidance on conducting this research with appropriate attention to privacy and ethics is scarce. To inform such research efforts, the purpose of this study was to determine older adolescents’ responses after learning that they were participants in a research study that involved identification of participants using Facebook.
Methods
Public Facebook profiles of older adolescents age 18 to 19 years from a large state university were examined. Profile owners were then interviewed. During the interview participants were informed that they were identified by examining publicly available Facebook profiles. Participants were asked to discuss their views on this research method.
Results
A total of 132 participants completed the interview (70% response rate), the average age was 18.4 years (SD=0.5) and our sample included 64 males (48.5%). Participant responses included: endorsement (19.7%), fine (36.4%), neutral (28.8%), uneasy (9.1%) and concerned (6.1%). Among participants who were uneasy or concerned, the majority voiced confusion regarding their current profile security settings (p=0.00).
Conclusion
The majority of adolescent participants viewed the use of Facebook for research positively. These findings are consistent with the approach taken by many US courts. Researchers may consider these findings when developing research protocols involving Facebook.
doi:10.1016/j.jadohealth.2012.02.001
PMCID: PMC3478668  PMID: 23084164
Adolescent; college student; social networking sites; research ethics; privacy; qualitative research
5.  Total Economic Cost and Burden of Dengue in Nicaragua: 1996–2010 
The burden of dengue in Nicaragua has been steadily rising during the last three decades; however, there have been few efforts to quantify the burden (measured in disability-adjusted life years [DALYs]) and cost to society. Using primary data from the Nicaraguan Ministry of Health (MINSA), the total cost and burden of dengue were calculated from 1996 to 2010. Total costs included both direct costs from medical expenditures and prevention activities and indirect costs from lost productivity. The annual disease burden ranged from 99 to 805 DALYs per million, with a majority associated with classic dengue fever. The total cost was estimated to be US$13.5 million/year (range: US$5.1–27.6 million). This analysis can help improve allocation of dengue control resources in Nicaragua and the region. As one of the most comprehensive analyses of its type to date in Nicaragua and Latin America, this study can serve as a model to determine the burden and cost of dengue.
doi:10.4269/ajtmh.2012.12-0146
PMCID: PMC3516309  PMID: 22890033
7.  Mentoring Translational Science Investigators 
doi:10.1001/jama.2012.14367
PMCID: PMC3767996  PMID: 23168821
8.  RCR Online Course: Build an Online Course to Augment RCR Training Using Evidenced-Based Learning Theory 
Accountability in research  2012;19(4):247-266.
This article demonstrates how to apply evidenced-based instructional design principles to develop a supplemental, online Responsible Conduct of Research (RCR) course. The supplement RCR course may serve to appropriately augment the National Institutes of Health (NIH) required RCR training. The way to ensure that an online RCR course is effective is to incorporate evidence-based learning theories into the development of the course content. This article specifically demonstrates application of Bloom’s taxonomy and Gagne’s Nine Instructional Events to a research misconduct course. At the conclusion, the reader will be able to apply evidence-based learning theories to the development of any online course.
doi:10.1080/08989621.2012.708637
PMCID: PMC3768005  PMID: 22861181
online; asynchronous; Responsible Conduct of Research training; Bloom’s taxonomy; Gagne’s Instructional Events; evidenced-based learning methodologies
9.  Changes in Association between Previous Therapeutic Abortion and Preterm Birth in Scotland, 1980 to 2008: A Historical Cohort Study 
PLoS Medicine  2013;10(7):e1001481.
Gordon C. Smith and colleagues used national databases to investigate the association between previous termination of pregnancy and preterm birth in Scotland between 1980 to 2008, and whether the type of procedure was an important factor.
Please see later in the article for the Editors' Summary
Background
Numerous studies have demonstrated that therapeutic termination of pregnancy (abortion) is associated with an increased risk of subsequent preterm birth. However, the literature is inconsistent, and methods of abortion have changed dramatically over the last 30 years. We hypothesized that the association between previous abortion and the risk of preterm first birth changed in Scotland between 1 January 1980 and 31 December 2008.
Methods and Findings
We studied linked Scottish national databases of births and perinatal deaths. We analysed the risk of preterm birth in relation to the number of previous abortions in 732,719 first births (≥24 wk), adjusting for maternal characteristics. The risk (adjusted odds ratio [95% CI]) of preterm birth was modelled using logistic regression, and associations were expressed for a one-unit increase in the number of previous abortions. Previous abortion was associated with an increased risk of preterm birth (1.12 [1.09–1.16]). When analysed by year of delivery, the association was strongest in 1980–1983 (1.32 [1.21–1.43]), progressively declined between 1984 and 1999, and was no longer apparent in 2000–2003 (0.98 [0.91–1.05]) or 2004–2008 (1.02 [0.95–1.09]). A statistical test for interaction between previous abortion and year was highly statistically significant (p<0.001). Analysis of data for abortions among nulliparous women in Scotland 1992–2008 demonstrated that the proportion that were surgical without use of cervical pre-treatment decreased from 31% to 0.4%, and that the proportion of medical abortions increased from 18% to 68%.
Conclusions
Previous abortion was a risk factor for spontaneous preterm birth in Scotland in the 1980s and 1990s, but the association progressively weakened and disappeared altogether by 2000. These changes were paralleled by increasing use of medical abortion and cervical pre-treatment prior to surgical abortion. Although it is plausible that the two trends were related, we could not test this directly as the data on the method of prior abortions were not linked to individuals in the cohort. However, we speculate that modernising abortion methods may be an effective long-term strategy to reduce global rates of preterm birth.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Therapeutic termination of pregnancy is relatively common, with an estimated 40 million procedures performed worldwide every year. Until two decades ago, most terminations were performed as a surgical procedure, but now the majority of terminations are medically induced with a combination of drugs—selective progesterone receptor antagonists, such as mifepristone, and prostaglandins—that cause less damage to the woman's cervix. Although surgical terminations are still performed, nowadays prostaglandins are also used to help prevent damage to the cervix. Protecting the woman's cervix can help to reduce the risk of spontaneous preterm birth (delivery before 37 weeks gestation) in subsequent pregnancies. As many women who have abortions go on to have subsequent births, the widespread use of termination may be a significant factor in the high global rates of preterm delivery.
Why Was This Study Done?
A previous meta-analysis (a study that combines information from several studies) showed that the risk of preterm delivery was higher in women who had had a previous termination compared to women who had not. Based on this meta-analysis, UK guidelines on the care of women requesting a termination currently recommend that they be informed of the increased risk of subsequent preterm birth. However, it is biologically plausible that women undergoing medical termination or current practice for surgical termination (using prostaglandins to protect and prepare the cervix) may not have an increased risk of subsequent preterm delivery, because such approaches may cause less trauma to the cervix than traditional surgical termination. So in this study, the researchers used a large dataset from Scotland with three decades of information about previous terminations and subsequent preterm deliveries to test this possibility.
What Did the Researchers Do and Find?
The researchers linked two national databases—the Scottish Morbidity Record 02 (SMR02), which records the clinical and demographic characteristics and outcomes of all patients giving birth in Scottish maternity hospitals, and the Scottish Stillbirth and Infant Death Survey (SSBIDS), which classifies all perinatal deaths in Scotland. SMR02 data were available from 1980 onwards and also recorded each woman's self-reported total number of previous abortions, and SSBIDS data were available from 1985. Then the researchers used information from NHS National Services Scotland to examine secular trends in terminations over the past few decades, specifically, whether a recorded termination was surgical or medical, and also whether surgical abortion was preceded by cervical preparation.
Using these methods, the researchers identified that there were 757,060 live, singleton first births between 1980 and 2008 and that 56,816 women reported one previous termination, 5,790 women reported two previous terminations, and 822 women reported three previous terminations. In their analysis (adjusted for maternal characteristics) the researchers found that there was an independent association of spontaneous preterm birth, but not induced preterm birth, with previous termination. The researchers calculated that the chance (odds) of spontaneous preterm birth for one, two, and three or more previous abortions was 1.17, 1.51, and 1.64, after adjusting for maternal characteristics, including smoking. Over the time period, the researchers found that the proportion of surgical terminations without use of cervical pre-treatment decreased from 31% in 1992 to 0.4% in 2008, and over the same period the proportion of medical terminations increased from 18% to 68%. These trends are important, because in their analysis by year of delivery, the researchers found that the association between preterm delivery and previous termination was strongest in 1980–1983, progressively declined between 1984 and 1999, and was no longer present from 2000 to 2008.
What Do These Findings Mean?
These findings support the established association between previous termination and preterm delivery. But most importantly, the changes in this association over the past two decades—from strong in 1980–1983 to nonexistent in 2000–2008—a period in which the use of medical termination and pre-treatment of the cervix for surgical termination increased dramatically in Scotland, suggest that surgical termination without cervical pre-treatment is responsible for the increased risk of spontaneous preterm birth: the decrease in the proportion of this procedure over the study period may have led to the disappearance of the established association between previous termination and preterm delivery from 2000 onwards. However, these findings are limited in that the researchers could not directly test whether the two trends were related because they did not have information on the method of previous termination linked to subsequent birth outcome for individual women. However, based on the findings of this study, it is possible that using modern methods of termination of pregnancy (rather than purely surgical methods) could be a factor in reducing global rates of spontaneous preterm delivery in the future.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001481.
Wikipedia gives more information about termination of pregnancy (note that Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
More information is available about the SMR02 dataset used in this study
The World Health Organization gives information on preterm birth
doi:10.1371/journal.pmed.1001481
PMCID: PMC3706322  PMID: 23874161
10.  College Students’ Alcohol Displays on Facebook: Intervention Considerations 
Objective
The purpose of this study was to investigate college freshmen’s views towards potential social networking site (SNS) screening or intervention efforts regarding alcohol.
Participants
Freshmen college students between February 2010 and May 2011.
Methods
Participants were interviewed, all interviews were audio recorded and transcribed. Qualitative analysis was conducted using an iterative approach.
Results
A total of 132 participants completed the interview (70% response rate), the average age was 18.4 years (SD 0.49) and 64 were males (48.5%). Three themes emerged from our data. First, most participants stated they viewed displayed alcohol content as indicative of alcohol use. Second, they explained they would prefer to be approached in a direct manner by someone they knew. Third, the style of approach was considered critical.
Conclusions
When approaching college students regarding alcohol messages on SNSs, both the relationship and the approach are key factors.
doi:10.1080/07448481.2012.663841
PMCID: PMC3375871  PMID: 22686361
Alcohol; Counseling; Health Education
11.  An Imperative: Patient-Centered Care for Our Aging Population 
The Ochsner Journal  2013;13(2):190-193.
PMCID: PMC3684326  PMID: 23789003
Case management; chronic disease; patient-centered care
12.  Evaluating and Giving Feedback to Mentors: New Evidence-Based Approaches 
A comprehensive mentoring program includes a variety of components. One of the most important is the ongoing assessment of and feedback to mentors. Scholars need strong active mentors who have the expertise, disposition, motivation, skills, and the ability to accept feedback and to adjust their mentoring style. Assessing the effectiveness of a given mentor is no easy task. Variability in learning needs and academic goals among scholars makes it difficult to develop a single evaluation instrument or a standardized procedure for evaluating mentors. Scholars, mentors, and program leaders are often reluctant to conduct formal evaluations, as there are no commonly accepted measures. The process of giving feedback is often difficult and there is limited empirical data on efficacy. This article presents a new and innovative six-component approach to mentor evaluation that includes the assessment of mentee training and empowerment, peer learning and mentor training, scholar advocacy, mentee–mentor expectations, mentor self-reflection, and mentee evaluation of their mentor.
doi:10.1111/j.1752-8062.2011.00361.x
PMCID: PMC3476454  PMID: 22376261
mentors; evaluation; outcomes
13.  Deriving Competencies for Mentors of Clinical and Translational Scholars 
Although the importance of research mentorship has been well established, the role of mentors of junior clinical and translational science investigators is not clearly defined. The authors attempt to derive a list of actionable competencies for mentors from a series of complementary methods. We examined focus groups, the literature, competencies derived for clinical and translational scholars, mentor training curricula, mentor evaluation forms and finally conducted an expert panel process in order to compose this list. These efforts resulted in a set of competencies that include generic competencies expected of all mentors, competencies specific to scientists, and competencies that are clinical and translational research specific. They are divided into six thematic areas: (1) Communication and managing the relationship, (2) Psychosocial support, (3) Career and professional development, (4) Professional enculturation and scientific integrity, (5) Research development, and (6) Clinical and translational investigator development. For each thematic area, we have listed associated competencies, 19 in total. For each competency, we list examples that are actionable and measurable. Although a comprehensive approach was used to derive this list of competencies, further work will be required to parse out how to apply and adapt them, as well future research directions and evaluation processes.
doi:10.1111/j.1752-8062.2011.00366.x
PMCID: PMC3476465  PMID: 22686206
mentoring; mentor; competencies; translational
14.  Identifying and Aligning Expectations in a Mentoring Relationship 
The mentoring relationship between a scholar and their primary mentor is a core feature of research training. Anecdotal evidence suggests this relationship is adversely affected when scholar and mentor expectations are not aligned. We examined three questions: (1) What is the value in assuring that the expectations of scholars and mentors are mutually identified and aligned? (2) What types of programmatic interventions facilitate this process? (3) What types of expectations are important to identify and align? We addressed these questions through a systematic literature review, focus group interviews of mentors and scholars, a survey of Clinical and Translational Science Award (CTSA) KL2 program directors, and review of formal programmatic mechanisms used by KL2 programs. We found broad support for the importance of identifying and aligning the expectations of scholars and mentors and evidence that mentoring contracts, agreements, and training programs facilitate this process. These tools focus on aligning expectations with respect to the scholar’s research, education, professional development and career advancement as well as support, communication, and personal conduct and interpersonal relations. Research is needed to assess test the efficacy of formal alignment activities.
doi:10.1111/j.1752-8062.2011.00356.x
PMCID: PMC3476480  PMID: 22212226
mentors; mentoring; career development; faculty development; staff development
15.  The majority of dorsal spinal cord gastrin releasing peptide is synthesized locally whereas neuromedin B is highly expressed in pain- and itch-sensing somatosensory neurons 
Molecular Pain  2012;8:52.
Background
Itch is one of the major somatosensory modalities. Some recent findings have proposed that gastrin releasing peptide (Grp) is expressed in a subset of dorsal root ganglion (DRG) neurons and functions as a selective neurotransmitter for transferring itch information to spinal cord interneurons. However, expression data from public databases and earlier literatures indicate that Grp mRNA is only detected in dorsal spinal cord (dSC) whereas its family member neuromedin B (Nmb) is highly expressed in DRG neurons. These contradictory results argue that a thorough characterization of the expression of Grp and Nmb is warranted.
Findings
Grp mRNA is highly expressed in dSC but is barely detectable in DRGs of juvenile and adult mice. Anti-bombesin serum specifically recognizes Grp but not Nmb. Grp is present in a small number of small-diameter DRG neurons and in abundance in layers I and II of the spinal cord. The reduction of dSC Grp after dorsal root rhizotomy is significantly different from those of DRG derived markers but similar to that of a spinal cord neuronal marker. Double fluorescent in situ of Nmb and other molecular markers indicate that Nmb is highly and selectively expressed in nociceptive and itch-sensitive DRG neurons.
Conclusion
The majority of dSC Grp is synthesized locally in dorsal spinal cord neurons. On the other hand, Nmb is highly expressed in pain- and itch-sensing DRG neurons. Our findings provide direct anatomic evidence that Grp could function locally in the dorsal spinal cord in addition to its roles in DRG neurons and that Nmb has potential roles in nociceptive and itch-sensitive neurons. These results will improve our understanding about roles of Grp and Nmb in mediating itch sensation.
doi:10.1186/1744-8069-8-52
PMCID: PMC3495671  PMID: 22776446
Gastrin releasing peptide; Neuromedin B; Itch; Dorsal root ganglion; Spinal cord
16.  Mentoring K scholars: Strategies to support research mentors 
The goal of this paper is to present strategies utilized to support K scholar research mentors. K scholars are generally assistant professors who are close to developing independent research programs. Of all the various types of mentees, K scholars offer the greatest challenges, as well as the greatest rewards, for research mentors. To see one's mentee achieve independent PI status and become an established investigator is one of the great joys of being a research mentor. Research mentors for K scholars, however, may not directly benefit from their mentoring relationship, neither in terms of obtaining data to support their research program or laboratory, nor in assistance with grants or scientific papers. There is a pressing need for the research community to address the workload, institutional expectations and reward system for research mentors. The dearth of research mentors and role models in clinical translational science parallels the decreasing number of physicians choosing careers in clinical research. While there is limited empirical information on the effectiveness of mentor support mechanisms, this white paper concludes that providing mentor support is critical to expanding the available pool of mentors, as well as providing training opportunities for K scholars.
doi:10.1111/j.1752-8062.2011.00286.x
PMCID: PMC3136377  PMID: 21707951
translational research; salary; protected time; resources
17.  Selection of Research Mentors for K Funded Scholars 
Mentoring is an important element in the training of new investigators, particularly for KL2, K12, K08, and K23 funded scholars who are often physicians or other clinicians with limited prior research experience. Matching K scholars with appropriate mentors who have the mentoring skills and available time is an ongoing challenge for most universities. The goal of this paper is to present a variety of strategies used to select mentors for K awardees. The information presented in this special communication is derived from the literature, a national survey of CTSA leaders, as well as K scholar and K mentor focus groups.
Some of the mentor selection methods discussed in this paper include a) having the scholar find a mentor as part of the application process for the award, b) selecting mentors post award, c) expecting the chair of the department to identify a mentor(s), d) using a committee to match the scholar and a mentor based on a pool of approved mentors e) selecting additional mentors as the scholar’s research program develops. The paper concludes that mentor selection requires an ongoing programmatic approach with the active participation of K scholars, CTSA program leaders, center directors, research deans and chairs.
doi:10.1111/j.1752-8062.2011.00273.x
PMCID: PMC3072229  PMID: 21463493
research mentor selection
18.  Alcohol-Induced Memory Blackouts as an Indicator of Injury Risk among College Drinkers 
Injury Prevention  2011;18(1):44-49.
Objective
An alcohol-induced memory blackout represents an amnesia to recall events but does not involve a loss of consciousness. Memory blackouts are a common occurrence among college drinkers, but it is not clear if a history of memory blackouts is predictive of future alcohol-related injury above and beyond the risk associated with heavy drinking episodes. This analysis sought to determine if baseline memory blackouts can prospectively identify college students with alcohol-related injury in the next 24 months after controlling for heavy drinking days.
Methods
Data were analyzed from the College Health Intervention Project Study (CHIPS), a randomized controlled trial of screening and brief physician intervention for problem alcohol use among 796 undergraduate and 158 graduate students at four university sites in the US and one in Canada, conducted from 2004 to 2009. Multivariate analyses used generalized estimating equations (GEE) with the logit link.
Results
The overall 24-month alcohol-related injury rate was 25.6%, with no significant difference between males and females (p=.51). Alcohol-induced memory blackouts at baseline exhibited a significant dose-response on odds of alcohol-related injury during follow-up, increasing from 1.57 (95% CI: 1.13–2.19) for subjects reporting 1–2 memory blackouts at baseline to 2.64 (95% CI: 1.65–4.21) for students acknowledging 6+ memory blackouts at baseline. The link between memory blackouts and injury was mediated by younger age, prior alcohol-related injury, heavy drinking, and sensation-seeking disposition.
Conclusions
Memory blackouts are a significant predictor of future alcohol-related injury among college drinkers after adjusting for heavy drinking episodes.
doi:10.1136/ip.2011.031724
PMCID: PMC3210864  PMID: 21708813
alcohol drinking; alcohol abuse; blackout; memory
19.  Depression and Suicide Ideation Among Students Accessing Campus Healthcare 
Depression and suicide are of increasing concern on college campuses. This article presents data from the College Health Intervention Projects on the frequency of depression and suicide ideation among 1,622 college students who accessed primary care services in 4 university clinics in the Midwest, Northwest, and Canada. Students completed the Beck Depression Inventory and other measures related to exercise patterns, alcohol use, sensation seeking, and violence. The frequency of depression was similar for men (25%) and women (26%). Thought of suicide was higher for men (13%) than women (10%). Tobacco use, emotional abuse, and unwanted sexual encounters were all associated with screening positive for depression. “Days of exercise per week” was inversely associated with screening positive for depression. Because the majority of students access campus-based student health centers, medical providers can serve a key role in early identification and intervention. With every 4th student reporting symptoms of depression and every 10th student having suicidal thoughts, such interventions are needed.
doi:10.1111/j.1939-0025.2010.01077.x
PMCID: PMC3057910  PMID: 21219281
university students; full and reduced-form logistic regression; randomized controlled trials; depression; suicidal ideation; university health clinics
20.  Alcohol Use in Students Seeking Primary Care Treatment at University Health Services 
OBJECTIVE
Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004 to February 15, 2007.
METHOD
Analyses were based on a Health Screening Survey (HSS) completed by 10,234 college students seeking general medical treatment.
RESULTS
Alcohol use was similar to other studies with 57% (n=5840) meeting the NIAAA criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco.
CONCLUSIONS
Our findings support the widespread implementation of alcohol screening and intervention in university health services.
doi:10.1080/07448481.2010.502413
PMCID: PMC3070440  PMID: 21186453
College drinking; alcohol; student health services; alcohol intervention
21.  Inside the Physician’s Black Bag: Critical Ingredients of Brief Alcohol Interventions 
Brief primary care interventions structured around patient workbooks have been shown to be effective in modifying hazardous drinking behavior. However, the critical ingredients of such interventions are not well understood, possibly contributing to their under-utilization. Seventeen campus-based clinicians trained in a brief, workbook-based alcohol intervention participated in a qualitative study to identify the most promising clinician-patient interaction components within this shared approach, utilizing a focus group with the clinicians and ranking of the 24 workbook ingredients. Based on the clinicians’ collective experience, consensus emerged around the perceived strength of five main components: (1) providing a summary of the patient’s drinking level, (2) discussing drinking likes and dislikes, (3) discussing life goals, (4) encouraging a risk-reduction agreement, and (5) asking patients to track their drinking (on cards provided for this purpose). This is the first paper to examine primary care physician perspectives on potentially critical components of effective brief alcohol intervention. (150 words)
doi:10.1080/08897077.2010.514242
PMCID: PMC3050497  PMID: 21038178
brief intervention; heavy alcohol use; high-risk drinking; motivational interviewing; alcohol counseling; critical ingredients
22.  A National Survey of Mentoring Programs for KL2 Scholars 
There is limited information on how academic institutions support effective mentoring practices for new investigators. A national semi-structured telephone interview was conducted to assess current “state of the art” mentoring practices for KL2 scholars among the 46 institutions participating in the Clinical Translational Science Awards (CTSA) Consortium. Mentoring practices examined included: mentor selection, articulating and aligning expectations, assessing the mentoring relationship, and mentor training. Telephone interviews were conducted in winter/fall 2009, with 100% of the CTSAs funded (n = 46) through 2009, participating in the survey. Primary findings include: five programs selected mentors for K scholars, 14 programs used mentor contracts to define expectations, 16 programs reported formal mentor evaluation, 10 offered financial incentives to mentors, and 13 offered formal mentoring training. The interviews found considerable variation in mentoring practices for training new investigators among the 46 CTSAs. There was also limited consensus on “what works” and what are the core elements of “effective mentoring practices. Empirical research is needed to help research leaders decide on where and how to place resources related to mentoring.
PMCID: PMC3159422  PMID: 21207765
mentoring; training; clinical and translational research
23.  Cigarette smoking and associated health risks among students at five universities 
Nicotine & Tobacco Research  2009;12(2):96-104.
Introduction:
While most college students and other young adults who smoke fall into the light and intermittent smoking (LITS) category, they remain at risk for tobacco dependence and other adverse health effects from their smoking. This study examines smoking patterns, tobacco dependence, and other health variables among students at five universities to better understand how to identify and address tobacco use and related risks in a college health clinic setting.
Methods:
A health screening survey was completed by 2,091 college and graduate student volunteers seeking routine care at their university health centers or participating in a health class. Independent health variables were analyzed descriptively and in regression analyses with three levels of smoking (none, non-daily, and daily) and tobacco dependence to determine predictors and associated risks.
Results:
Nearly a quarter of students reported any current smoking, 41% of whom reported smoking less than 1 cigarette/day (cpd). Of the daily smokers, 80% smoked less than 10 cpd but 45% met criteria for tobacco dependence. Any smoking was associated with high-risk alcohol use, risky driving, relational abuse, depression, less exercise, and utilization of emergency and mental health services. In regression analyses, students who experienced depression had more than double the odds of being dependent smokers (odds ratio [OR] = 2.32), as did those who reported abuse (OR = 2.07) or sought mental health counseling (OR = 2.09).
Discussion:
Student health providers should be alerted to the multiple risks and comorbidities that occur among all smokers, including LITS, and intervene concurrently to help prevent or mitigate adverse outcomes that result from these conditions and behaviors.
doi:10.1093/ntr/ntp182
PMCID: PMC2902913  PMID: 20018947
24.  Psychiatric Disorders in Smokers Seeking Treatment for Tobacco Dependence: Relations with Tobacco Dependence and Cessation 
Objective
The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes.
Method
Data were collected from 1504 smokers (58.2% women, 83.9% white, 44.67 [SD = 11.08] years old) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined using the Composite International Diagnostic Interview (CIDI) structured clinical interview. Tobacco dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM).
Results
Diagnostic groups included those who were never diagnosed, ever diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group (p’s < .05). At 8 weeks post-quit, strong associations were found between cessation outcome and both past-year mood disorder and ever-diagnosed anxiety disorder. At 6 months post-quit those ever diagnosed with an anxiety disorder (OR = .72, p = .02) and those ever diagnosed with more than one psychiatric diagnosis (OR = .74, p = .03) had lower abstinence rates. The diagnostic categories did not differ in smoking heaviness or the FTND, but they did differ in dependence motives assessed with the WISDM.
Conclusion
Information on recent or lifetime psychiatric disorders may help clinicians gauge relapse risk and may suggest dependence motives that are particularly relevant to affected patients. These findings also illustrate the importance of using multidimensional tobacco dependence assessments.
doi:10.1037/a0018065
PMCID: PMC2813467  PMID: 20099946
smoking cessation; psychiatric disorders; psychiatric comorbidity; nicotine dependence; depression; anxiety
25.  A forward genetic screen with a thalamocortical axon reporter mouse yields novel neurodevelopment mutants and a distinct emx2 mutant phenotype 
Neural Development  2011;6:3.
Background
The dorsal thalamus acts as a gateway and modulator for information going to and from the cerebral cortex. This activity requires the formation of reciprocal topographic axon connections between thalamus and cortex. The axons grow along a complex multistep pathway, making sharp turns, crossing expression boundaries, and encountering intermediate targets. However, the cellular and molecular components mediating these steps remain poorly understood.
Results
To further elucidate the development of the thalamocortical system, we first created a thalamocortical axon reporter line to use as a genetic tool for sensitive analysis of mutant mouse phenotypes. The TCA-tau-lacZ reporter mouse shows specific, robust, and reproducible labeling of thalamocortical axons (TCAs), but not the overlapping corticothalamic axons, during development. Moreover, it readily reveals TCA pathfinding abnormalities in known cortical mutants such as reeler. Next, we performed an unbiased screen for genes involved in thalamocortical development using random mutagenesis with the TCA reporter. Six independent mutant lines show aberrant TCA phenotypes at different steps of the pathway. These include ventral misrouting, overfasciculation, stalling at the corticostriatal boundary, and invasion of ectopic cortical cell clusters. An outcross breeding strategy coupled with a genomic panel of single nucleotide polymorphisms facilitated genetic mapping with small numbers of mutant mice. We mapped a ventral misrouting mutant to the Emx2 gene, and discovered that some TCAs extend to the olfactory bulbs in this mutant. Mapping data suggest that other lines carry mutations in genes not previously known for roles in thalamocortical development.
Conclusions
These data demonstrate the feasibility of a forward genetic approach to understanding mammalian brain morphogenesis and wiring. A robust axonal reporter enabled sensitive analysis of a specific axon tract inside the mouse brain, identifying mutant phenotypes at multiple steps of the pathway, and revealing a new aspect of the Emx2 mutant. The phenotypes highlight vulnerable choice points and latent tendencies of TCAs, and will lead to a refined understanding of the elements and interactions required to form the thalamocortical system.
See Commentary: http://www.biomedcentral.com/1741-7007/9/1
doi:10.1186/1749-8104-6-3
PMCID: PMC3024922  PMID: 21214893

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