Prx1-expressing cells contributing to fracture repair require primary cilia for complete healing in mice.

Bone is a dynamic organ that is continuously modified during development, load-induced adaptation, and fracture repair. Understanding the cellular and molecular mechanisms for natural fracture healing can lead to therapeutics that enhance the quality of newly formed tissue, advance the rate of healing, or replace the need for invasive surgical procedures. Prx1-expressing cells in the periosteum are thought to supply the majority of osteoblasts and chondrocytes in the fracture callus, but the exact mechanisms for this behavior are unknown. The primary cilium is a sensory organelle that is known to mediate several signaling pathways involved in fracture healing and required for Prx1-expressing cells to contribute to juvenile bone development and adult load-induced bone formation. We therefore investigated the role of Prx1-expressing cell primary cilia in fracture repair by developing a mouse model that enabled us to simultaneously track Prx1 lineage cell fate and disrupt Prx1-expressing cell primary cilia in vivo. The cilium KO mice exhibited abnormally large calluses with significantly decreased bone formation and persistent cartilage nodules. Analysis of mRNA expression in the early soft callus revealed downregulation of osteogenesis, Hh signaling, and Wnt signaling, and upregulation of chondrogenesis and angiogenesis. The mutant mice also exhibited decreased Osx and Periostin but increased αSMA and PECAM-1 protein expression in the hard callus. We further used a Gli1LacZ reporter and found that Hh signaling was significantly upregulated in the mutant callus at later stages of healing. Interestingly, altered protein expression and Hh signaling did not correlate with labeled Prx1-lineage cells, suggesting loss of cilia altered Hh signaling non-autonomously. Overall, cilium KO mice demonstrated severely delayed and incomplete fracture healing, and our findings suggest Prx1-expressing cell primary cilia are necessary to tune Hh signaling for proper fracture repair.

Clients' satisfaction with HIV treatment and care services in Nigeria.

OBJECTIVE: Many Sub-Saharan Africa countries have witnessed rapid scale-up of HIV treatment and care services in recent years. However, there is increasing evidence suggestive of poor quality of services. In this study, we examined clients' satisfaction with quality of HIV treatment and care services in Nigeria. STUDY DESIGN: This was a cross-sectional survey of people living with HIV (PLHIV) receiving HIV treatment and care services. METHODS: The study included 1212 PLHIV receiving HIV treatment and care in 96 health facilities across 12 states. We collected data on clients' satisfaction with four quality domains (confidentiality, staff attitude, physical structure, and perceived improved health) and the overall quality of care, sociodemographic characteristics, type of facility, distance to facility, and time spent at facility. A logistic regression analysis was conducted with clients' satisfaction with the overall quality of care as the dependent variable. RESULTS: About 90% of the respondents were satisfied with the overall quality of care. Women, rural dwellers, and Muslims, public (government-owned) healthcare facility users, those unsatisfied with confidentiality, and those unsatisfied with staff attitude had statistically significant lower odds of being satisfied with the overall quality of care. After adjusting for sociodemographic characteristics and the type of facility, confidentiality (adjusted odds ratio [AOR] = 0.1, 95% confidence interval [CI] = 0.01-0.81, P = 0.031) and staff attitude (AOR = 0.24, 95% CI = 0.09-0.67, P = 0.006) remained statistically significant. CONCLUSIONS: Clients' satisfaction with the quality of HIV treatment and care services at health facilities in Nigeria appears high. HIV service provision should be in line with standard ethical principles and more patient centered and responsive to sociodemographic characteristics of PLHIV.

"Eat for Health": a supermarket intervention for nutrition and cancer risk reduction.

OBJECTIVES: The results of an evaluation of "Eat for Health," a supermarket nutrition intervention, are presented. The study tested whether such a program could be successfully carried out and whether it could effect changes in knowledge, attitudes, and food purchasing behavior in line with nutrition and cancer risk reduction guidelines. METHODS: The evaluation consisted of an in-store monitoring element, an in-store and telephone consumer survey, and an analysis of sales data on selected foods. A matched-pair design, using a total of 40 stores in the intervention and comparison groups, was used. RESULTS: The intervention was successfully implemented and had limited success in changing some food purchasing behaviors. There appeared to be no effect on knowledge and attitudes except for increased awareness of a link between diet and cancer and of the program itself. CONCLUSIONS: Despite the intervention's success, limitations of the consumer survey and sales data analyses and the continuing diffusion of nutrition messages throughout society make it difficult to specify the impact of this program on consumer nutrition knowledge and behaviors.

Eat for health: a nutrition and cancer control supermarket intervention.

The growing evidence linking dietary patterns to the incidence and prevention of chronic disease has prompted a number of prominent health and scientific agencies to publish dietary guidelines for the public. Some dietary guidelines address specific diseases, such as cancer or heart disease; others focus on overall health promotion. This situation has created a demand for nutrition education and information programs for the public. Increasingly, supermarkets are seen as potential sites for effective consumer education. Eat for Health is a joint research study by the National Cancer Institute (NCI) and Giant Food Inc., a regional supermarket chain in the Washington-Baltimore area. The study's goal was to test the feasibility of supermarkets as a site for consumer nutrition education. Eat for Health's educational focus was diet and cancer control issues in the context of dietary patterns that promote health. Particular attention was paid to reduction of fat intake and increases in consumption of dietary fiber from grains, vegetables, and fruits. Analysis of program results is currently underway; data should be available in early 1990.