Exploring self-care practices of African American informal kinship caregivers.

African American caregivers providing informal kinship care are vulnerable to chronic stress. Research has indicated stress increases individuals' risk for many adverse physical and mental health outcomes, including cardiovascular disease, Alzheimer's disease and depression. Given the adverse outcomes related to stress, identifying mechanisms to help these caregivers lower and manage their stress is critical to their overall health and well-being. This pilot qualitative study aimed to explore the self-care practices of 12 African Americans providing informal kinship care using a phenomenological approach. Three themes emerged: (a) behaviours to manage stress levels, (b) support network reminding caregivers to take care of themselves and (c) prioritizing my own needs. Specifically, our findings indicate that some caregivers have high-stress levels and engage in maladaptive coping behaviours. The children they cared for reminded them to take care of themselves by attending doctors' appointments or getting their nails done. Nevertheless, some caregivers prioritized their needs by participating in positive self-care behaviours, such as listening to jazz and gospel music and exercising. Prevention and intervention programs that focus on improving caregivers' health should consider the role of self-care practices.

Antigen Geometry Tunes Mast Cell Signaling Through Distinct FcεRI Aggregation and Structural Changes.

Immunoreceptor tyrosine-based activation motif (ITAM)-containing Fc receptors are critical components of the innate and adaptive immune systems. FcεRI mediates the allergic response via crosslinking of IgE-bound receptors by multivalent antigens. Yet, the underlying molecular mechanisms that govern the response of FcεRI to specific antigens remain poorly understood. We compared responses induced by two antigens with distinct geometries, high valency DNP-BSA and trivalent DF3, and found unique secretion and receptor phosphorylation profiles that are due to differential recruitment of Lyn and SHIP1. To understand how these two antigens can cause such markedly different outcomes, we used direct stochastic optical reconstruction microscopy (dSTORM) super-resolution imaging combined with Bayesian Grouping of Localizations (BaGoL) analysis to compare the nanoscale characteristics of FcεRI aggregates. DF3 aggregates were found to be smaller and more densely packed than DNP-BSA aggregates. Using lifetime-based Förster resonance energy transfer (FRET) measurements, we discovered that FcεRI subunits undergo structural rearrangements upon crosslinking with either antigen, and in response to interaction with monovalent antigen presented on a supported lipid bilayer. The extent of conformational change is positively correlated with signaling efficiency. Finally, we provide evidence for forces in optimizing FcεRI signaling, such that immobilizing DF3 on a rigid surface promoted degranulation while increasing DNP-BSA flexibility lowered degranulation. These results provide a link between the physical attributes of allergens, including size, shape, valency, and flexibility, and FcεRI signaling strength. Thus, the antigen modulates mast cell outcomes by creating unique aggregate geometries that tune FcεRI conformation, phosphorylation and signaling partner recruitment.

Nutrition education and counselling as strategic interventions to improvehealth outcomes in adult outpatients with HIV: a literature review.

Malnutrition poses a significant risk for people living with HIV and accelerates disease progression. This is because adequate nutrition is essential for optimal immune function. This article discusses research on the role and use of nutrition education or counselling as a strategic intervention to improve health outcomes through better health behaviour in adult outpatients with HIV. Ten studies (five quantitative and five qualitative) met the inclusion criteria of the literature review. The findings of the studies related to the following outcomes of nutrition interventions: increases in fat-free and lean body mass; offsetting the adverse effects of HIV infection in patients with a low CD4 cell count; significant improvement in dietary patterns with resultant greater adherence to HIV medications and fewer side effects; and agreement on the importance of addressing the nutrition concerns. The article discusses the five prominent themes that emerged from the literature review: 1) ethical issues in HIV/AIDS research; 2) the role of health and culture in nutrition interventions; 3) HIV stigma and its impact on nutrition interventions; 4) the socioeconomics of HIV and AIDS; and 5) food security and emotional wellbeing among persons with HIV. Although the evidence base is limited and raises questions about key aspects of the quality of the research conducted to date, the overall results show that providing HIV-positive adults with culturally relevant and practical nutrition strategies can improve health outcomes, health behaviour and quality of life. Current and future nutrition interventions for persons with HIV disease should be targeted, sustainable, and rigorously evaluated. There is an urgent need for research on this topic in developing countries, particularly African ones, which are some of the most affected by HIV.