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The high cost of fruit and vegetables can be a barrier to healthy eating, particularly among lower-income households with children. We examined the effects of a financial incentive on purchases at a single supermarket by primary shoppers from low-income households who had at least one child. Participation in an in-store cooking Matters event was requested for incentivized subjects but optional for their nonincentivized controls. The sample included but was not limited to supplemental Nutrition Assistance Program participants. compared to the controls, incentivized shoppers-who were given an immediate 50 percent discount on qualifying fruit and vegetables-increased weekly spending on those items by 27 percent; this change was for fresh produce. There was no change in purchases of frozen and canned produce or unhealthful foods. Estimated annual average daily consumption of fruit and vegetables by the incentivized shoppers and by one designated child per incentivized household did not change. Attendance at Cooking Matters events was low. These findings support financial incentive programs to increase fruit and vegetable purchasing but suggest that effective complementary approaches are needed to improve diet quality.

It is currently poorly understood how hormones like oestrogen can elicit a rapid non-genomic response from cells via their traditional nuclear receptors. It has been known for some time that some cells, although lacking the canonical oestrogen receptors (ERs), still display rapid non-genomic signalling in response to oestrogen. Recently, a G protein coupled receptor; GPR30 (or GPER) and an alternative splice variant of the traditional ERα (ERα36) have been proposed as alternative oestrogen receptors that may mediate these non-genomic effects. This study investigated the presence and location of GPR30 and ERα36 in breast and endometrial cancer cells. We also investigated their possible roles in cancer cell migration. Using a combination of cell migration assays, gene silencing siRNAs, actin polymerisation measurements and immuno-fluorescence we have demonstrated that SKBr3 cells (a ER receptor negative, breast cancer cell line) migrate towards the GPR30/ERα36 agonist G-1; an effect that is attenuated by G-15, a GPR30/ERα36 antagonist and pERK inhibitors, but not by ROCK inhibitors. We have also demonstrated that G-1 activates a rapid signalling pathway involving changes in the actin cytoskeleton. A similar migration response is seen in endometrial cancer cells. However, we have also discovered that another breast cancer, ER receptor negative cell line, MDA-MB-231, although expressing both GPR30 and ERα36 does not display this migratory behaviour. We propose and provide evidence that the migratory signalling pathway via GPR30 and ERα36 involves the activation of the HER 2 receptor which the MDA-MB-231 cell line lacks. These findings may progress the development of new therapeutics targeting ER negative breast cancer tumors.

Educators working with English learners face challenges beyond teaching academic content in languages new to the students.The added layer of problem-solving for students who may have exceptional needs and providing the appropriate support can be a complex process that involves careful decision making.

After eleven years of instruction, a veteran pianist like me shouldn't have any problems teaching a few eager, budding musicians. Right? Not quite...

During the 1840's, my ancestors, who lived in County Carlow, Ireland, fled the potato famine for America. Determined never to forget the charms ol mist and Celtic customs, they tucked the traditions of the old country in with their meager belongings and tales of leprechauns, fairies, and St. Patrick.

'There are missing links in the recession argument,' he says. 'Inventories are very low, and they normally start to rise before a recession; exporters are performing well. The other uncertainty is the labour market. Normally in recessions, you get less hiring, and layoffs. We're seeing less hiring, but we're not yet seeing layoffs, or don't seem to be.' 'The difference between the Democratic nominee and [John McCain] on Iraq is going to be much bigger than the difference between [Barack Obama] and [Hillary Clinton], or McCain and Romney or Huckabee,' he adds. ' When you're talking about getting troops out within a year, compared to keeping them there for a hundred years, which is what McCain is saying, that's going to focus things. People think the economy's a big issue, but in their gut, I think they think the President can do more about Iraq than the economy.' Whether or not it's 'the economy, stupid' at the stump, whoever walks into the White House at the start of 2009 is likely to be haunted by the sub-prime crisis for a long time to come. 'I don't think it will be over by then,' says [Jason Furman]. 'Housing corrections take a pretty long time.'

Group B Streptococcus commonly colonises healthy adults without symptoms, yet under certain circumstances displays the ability to invade host tissues, evade immune detection and cause serious invasive disease. Consequently, Group B Streptococcus remains a leading cause of neonatal pneumonia, sepsis and meningitis. Here we review recent information on the bacterial factors and mechanisms that direct host–pathogen interactions involved in the pathogenesis of Group B Streptococcus infection. New research on host signalling and inflammatory responses to Group B Streptococcus infection is summarised. An understanding of the complex interplay between Group B Streptococcus and host provides valuable insight into pathogen evolution and highlights molecular targets for therapeutic intervention.

ObjectivesTo examine the effect of general practitioners (GPs) working in or alongside the emergency department (GPED) on patient outcomes and experience, and the associated impacts of implementation on the workforce.DesignMixed-methods study: interviews with service leaders and NHS managers; in-depth case studies (n=10) and retrospective observational analysis of routinely collected national data. We used normalisation process theory to map our findings to the theory’s four main constructs of coherence, cognitive participation, collective action and reflexive monitoring.Setting and participantsData were collected from 64 EDs in England. Case site data included: non-participant observation of 142 clinical encounters; 467 semistructured interviews with policy-makers, service leaders, clinical staff, patients and carers. Retrospective observational analysis used routinely collected Hospital Episode Statistics alongside information on GPED service hours from 40 hospitals for which complete data were available.ResultsThere was disagreement at individual, stakeholder and organisational levels regarding the purpose and potential impact of GPED (coherence). Participants criticised policy development and implementation, and staff engagement was hindered by tensions between ED and GP staff (cognitive participation). Patient ‘streaming’ processes, staffing and resource constraints influenced whether GPED became embedded in routine practice. Concerns that GPED may increase ED attendance influenced staff views. Our quantitative analysis showed no detectable impact on attendance (collective action). Stakeholders disagreed whether GPED was successful, due to variations in GPED model, site-specific patient mix and governance arrangements. Following statistical adjustment for multiple testing, we found no impact on: ED reattendances within 7 days, patients discharged within 4 hours of arrival, patients leaving the ED without being seen; inpatient admissions; non-urgent ED attendances and 30-day mortality (reflexive monitoring).ConclusionsWe found a high degree of variability between hospital sites, but no overall evidence that GPED increases the efficient operation of EDs or improves clinical outcomes, patient or staff experience.Trial registration numberISCRTN5178022.

Group B streptococci (GBSs) are the leading cause of neonatal meningitis. GBSs enter the CNS by penetrating the blood-brain barrier (BBB), which consists of specialized human brain microvascular endothelial cells (hBMECs). To identify GBS factors required for BBB penetration, we generated random mutant libraries of a virulent strain and screened for loss of hBMEC invasion in vitro. Two independent hypo-invasive mutants possessed disruptions in the same gene, invasion associated gene (iagA), which encodes a glycosyltransferase homolog. Allelic replacement of iagA in the GBS chromosome produced a 4-fold decrease in hBMEC invasiveness. Mice challenged with the GBS DeltaiagA mutant developed bacteremia comparably to WT mice, yet mortality was significantly lower (20% vs. 90%), as was the incidence of meningitis. The glycolipid diglucosyldiacylglycerol, a cell membrane anchor for lipoteichoic acid (LTA) and predicted product of the IagA glycosyltransferase, was absent in the DeltaiagA mutant, which consequently shed LTA into the media. Attenuation of virulence of the DeltaiagA mutant was found to be independent of TLR2-mediated signaling, but bacterial supernatants from the DeltaiagA mutant containing released LTA inhibited hBMEC invasion by WT GBS. Our data suggest that LTA expression on the GBS surface plays a role in bacterial interaction with BBB endothelium and the pathogenesis of neonatal meningitis.