Hutchinson–Gilford progeria syndrome (HGPS) is a rare, autosomal-dominant, and fatal premature aging syndrome. HGPS is most often derived from a de novo point mutation in the LMNA gene, which results in an alternative splicing defect and the generation of the mutant protein, progerin. Progerin behaves in a dominant-negative fashion, leading to a variety of cellular and molecular changes, including nuclear abnormalities, defective DNA damage response (DDR) and DNA repair, and accelerated telomere attrition. Intriguingly, many of the manifestations of the HGPS cells are shared with normal aging cells. However, at a clinical level, HGPS does not fully match normal aging because of the accelerated nature of the phenotypes and its primary effects on connective tissues. Furthermore, the epigenetic changes in HGPS patients are of great interest and may play a crucial role in the pathogenesis of HGPS. Finally, various treatments for the HGPS patients have been developed in recent years with important effects at a cellular level, which translate to symptomatic improvement and increased lifespan.
Objective: To describe development of the Positive Affect, Promoting Positive Engagement, and Adherence for Life (APPEAL) program. Method: APPEAL is intended to increase HIV medication adherence through promotion of positive affect, and was developed through an iterative process involving 6 focus groups (N ϭ 34) that elicited feedback on intervention content, followed by an individually administered prepilot of the entire intervention (N ϭ 7). Results: Participants provided feedback on important potential moderator variables, including depression, on mode of intervention administration, and on anticipated barriers and benefits to participation. Insights gained were used to finalize study procedures in preparation for a feasibility trial. For the feasibility trial, a total of 80 participants who, in the past 6 months have had at least one plasma HIV RNA Ͼ200 copies/mL, will be randomized to receive APPEAL or standard of care (N ϭ 40 per group). Intervention group participants will receive 3 monthly, individually administered sessions, and all participants will have their medication adherence monitored and complete structured interviews at baseline and at 3 and 6 months. Conclusion: The APPEAL program is innovative in that it focuses on promoting self-regulation of positive emotions, an understudied approach to promoting chronic disease self-management behaviors such as HIV medication adherence. Findings from the feasibility trial will gauge suitability of the APPEAL intervention and evaluation methods for subsequent testing in a confirmatory trial and will examine changes in positive affect, the primary mechanism of change targeted in the intervention.
Societal influences, such as beliefs and behaviors, and their increasing complexity add to the challenges of interactivity promoted by globalization. This study was developed during a virtual global educational exchange experience and designed for research and educational purposes to assess personal social and cultural risk factors for students’ COVID-19 personal prevention behavior and perceptions about life during the pandemic, and to inform future educational efforts in intercultural learning for healthcare students. We designed and implemented a cross-sectional anonymous online survey intended to assess social and cultural risk factors for COVID-19 personal prevention behavior and students’ perceptions about life during the pandemic in public health and healthcare students in two public universities (United States n = 53; Brazil n = 55). Statistically significant differences existed between the United States and Brazil students in degree type, employment, risk behavior, personal prevention procedures, sanitization perceptions, and views of governmental policies. Cultural and social differences, risk messaging, and lifestyle factors may contribute to disparities in perceptions and behaviors of students around the novel infectious disease, with implications for future global infectious disease control.
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