Visual Abstract

What is already known on this topic? There is evidence that the use of community health workers (CHWs) can improve the health of patients. What is added by this report? This model offers a unique look at the process by which insurance companies offered their resources in support of a policy using CHWs that improves public health. What are the implications for public health practice? This report demonstrates a pathway to achieve sustainability for activities performed by CHWs and that they can become a permanent part of health care services.

Aging increases the risk of cardiovascular disease and metabolic syndrome. Alterations in epicardial fat play an important pathophysiological role in coronary artery disease and hypertension. We investigated the impact of normal aging on obesity-related genes in epicardial fat. Sex-specific changes in obesity-related genes with aging in epicardial fat (EF) were determined in young (6 months) and old (30/36 months) female and male, Fischer 344 × Brown Norway hybrid (FBN) rats, using a rat obesity RT2 PCR Array. Circulating sex hormone levels, body and heart weights were determined. Statistical significance was determined using two-tailed Student’s t test and Pearson’s correlation. Our results revealed sex-specific differences in obesity-related genes with aging. Dramatic changes in the expression profile of obesity-related genes in EF with aging in female, but not in male, FBN rats were observed. The older (30 months) female rats had more significant variations in the abundance of obesity-related genes in the EF compared to that seen in younger female rats or both age groups in male rats. A correlation of changes in obesity-related genes in EF to heart weights was observed in female rats, but not in male rats with aging. No correlation was observed to circulating sex hormone levels. Our findings indicate a dysfunctional EF in female rats with aging compared to male rats. These findings, with further functional validation, might help explain the sex differences in cardiovascular risk and mortality associated with aging observed in humans.

GABAergic inhibitory neurons in the prefrontal cortex (PFC) play a crucial role in higher cognitive functions. Although disruption of their normal development is linked to a number of psychiatric disorders, cellular and molecular mechanisms underlying the normal development of these neurons are poorly understood. Here we found that during postnatal mouse development, Cyp26b1, a gene encoding a retinoic acid-degrading enzyme, is strongly expressed in the PFC and that medial ganglionic eminence (MGE)- show that the thalamus regulates the development of PFC interneurons both by cortexwide and area-specific mechanisms.

The Affordable Care Act (ACA) has as one of its main objectives to reduce the number of uninsured Americans. The understanding of the ACA reforms by uninsured patients will likely influence the degree of success in achieving this objective. This study assessed the basic knowledge and opinions regarding the ACA of patients at a free clinic and the impact of a brief educational intervention on respondents' knowledge and opinions. One hundred uninsured adult patients completed a brief survey about the ACA before and after viewing a video outlining the major features of the act. The study cohort initially performed worse than national polls on all knowledge questions. Significant improvement was observed after the educational video. Our study suggests a need for educational efforts directed at those individuals most likely to benefit from the ACA. We demonstrated that a brief intervention during a routine office visit may improve knowledge of the ACA.