Warburg's observation that cancer cells exhibit a high rate of glycolysis even in the presence of oxygen (aerobic glycolysis) sparked debate over the role of glycolysis in normal and cancer cells. Although it has been established that defects in mitochondrial respiration are not the cause of cancer or aerobic glycolysis, the advantages of enhanced glycolysis in cancer remain controversial. Many cells ranging from microbes to lymphocytes use aerobic glycolysis during rapid proliferation, which suggests it may play a fundamental role in supporting cell growth. Here, we review how glycolysis contributes to the metabolic processes of dividing cells. We provide a detailed accounting of the biosynthetic requirements to construct a new cell and illustrate the importance of glycolysis in providing carbons to generate biomass. We argue that the major function of aerobic glycolysis is to maintain high levels of glycolytic intermediates to support anabolic reactions in cells, thus providing an explanation for why in...

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Aerobic Glycolysis: Meeting the Metabolic Requirements of Cell Proliferation

New treatments for HIV can improve immune functioning and decrease mortality. However, lapses in adherence may render these complex regimens ineffective. Sixty-three men and 9 women on highly active antiretroviral therapy completed measures of medication adherence, psychological characteristics, and barriers to adherence. HIV viral load, a health outcome measure of virus amount present in blood, was also obtained. The sample was 36% African American and 56% Caucasian, with 35% reporting disability. Nearly one third of patients had missed medication doses in the past 5 days, and 18% had missed doses weekly over the past 3 months. Frequency of missed doses was strongly related to detectable HIV viral loads. Depression, side-effect severity, self-efficacy, and social support distinguished patients with good and poor adherence. Barriers also varied with adherence level. Implications for interventions promoting HIV treatment adherence are discussed.

Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease.

Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa.

Stress and coping theory has provided a foundation for a wide range of descriptive studies of the stress process. There is less evidence for its utility as a foundation for coping interventions. One of the impediments of the translation of stress and coping theory into intervention has to do with well-documented problems with the measurement of intervention-associated changes in coping (Folkman & Moskowitz, 2004). The present study describes a measure of coping self-efficacy (CSE), which provides an alternate approach to the measurement of coping for intervention studies. This measure focuses on changes in a person’s confidence in his or her ability to cope effectively, which, according to self-efficacy theory (Bandura, 1997), is an important prerequisite to changing coping behaviour. Stress and coping theory defines stress as a person-environment relationship that is evaluated as personally significant and as exceeding a person’s resources for coping. This process is referred to as ‘primary appraisal’. Coping is defined as behavioural or cognitive efforts to manage situations that are appraised as stressful (Lazarus & Folkman, 1984). Coping involves both emotion-focused coping (i.e. responses that focus on managing emotional responses to stressful events), and problem-focused coping (i.e. responses that focus on changing problematic aspects of stressful events). The choice of coping strategy is influenced by the appraisal of options for coping, referred to in stress and coping theory as ‘secondary appraisal’ (Lazarus & Folkman, 1984). Secondary appraisal refers to the question, ‘What can I do?’ A key aspect of secondary appraisal is the judgment concerning the extent to which the individual can control the outcome of the situation. Self-efficacy contributes to this judgment, which in turn influences coping (see Park & Folkman, 1997 for review). Maladaptive coping (e.g. coping that fails to regulate distress or manage the underlying problem) occurs when people respond to uncontrollable stressors primarily with problem-focused coping strategies, or when people respond to controllable stressors primarily with emotion-focused coping strategies (Strentz & Auerbach, 1988; Vitaliano, DeWolfe, Maiuro, Russo, & Katon, 1990). Adaptive coping refers to situations in which there is a fit between the controllability of the stressful situation and the choice of coping strategy (i.e. emotion-focused versus problem-focused). When people obtain a ‘fit’ between stressful events and their coping strategies, they experience fewer psychological symptoms than when there is a lack of fit (Park, Folkman, & Bostrom, 2001).

Cognitive behavioural interventions such as coping effectiveness training (CET; Chesney, Chambers, Taylor, & Johnson, 2003; Chesney, Chambers, Taylor, Johnson, & Folkman, 2003; Chesney, Folkman, & Chambers, 1996; Folkman & Chesney, 1995), which are based on social cognitive theory (Bandura, 1997) as well as stress and coping theory (Lazarus & Folkman, 1984), strive to increase adaptive coping, and, by doing so, reduce psychological distress and improve well-being. Perceived self-efficacy, defined as a belief about one’s ability to perform a specific behaviour, is a pivotal component of social cognitive theory in that beliefs of personal efficacy determine the acquisition of knowledge on which skills are founded (Bandura, 1997). Thus, beliefs about one’s ability to perform specific coping behaviours, or CSE, would be expected to influence outcomes of interventions designed to improve coping. This concept is also relevant to stress and coping theory and the secondary appraisal of controllability. Part of secondary appraisal is the judgment that an outcome is controllable through coping; another part addresses the question of whether or not the individual believes he or she can carry out the requisite coping strategy. Beliefs about self-efficacy are not a general disposition; a high level of efficacy in one domain does not necessarily correlate with high levels of self-efficacy in other domains (DiClemente, 1986; Hofstetter, Sallis, & Hovell, 1990).

To achieve predictive and explanatory power, measures of self-efficacy must be designed and tailored to the sphere of activity (Forsyth & Carey, 1998). For example, self-efficacy regarding diabetic self-care behaviours has been identified as a pivotal psychosocial variable in diabetes research (Glasgow & Osteen, 1992; Jenkins, 1995), with scores on self-efficacy significantly associated with self-care by diabetics in the areas of diet, exercise and blood glucose testing (Williams & Bond, 2002). Efficacy beliefs also predict adherence to habits that lower cardiovascular risk and prevent myocardial infarctions in persons with coronary heart disease (Ewart, 1992; Jensen, Banwart, Venhaus, Popkess-Vawter, & Perkins, 1993). These lines of clinical investigation each developed specialized efficacy scales.

The current study is designed to assess the reliability and validity of the CSE scale, a 26-item measure of perceived self-efficacy for coping with challenges or threats. The original instrument was developed by the authors, in collaboration with Dr Albert Bandura of Stanford University, for use in two randomized clinical trials investigating the efficacy of a theory-based CET intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness. In this paper, we subjected the CSE scale items to focused analyses with the specific goal of deriving a psychometrically sound and reduced form of the scale for use in future research. Analyses included assessing construct validity through exploratory and confirmatory factor analyses (EFA and CFA, respectively), assessing reliability through internal consistency coefficient alphas and test–retest correlations, and assessing concurrent and predictive validity through partial correlations and multiple regression analyses, respectively.

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A validity and reliability study of the coping self-efficacy scale

When learning of a positive HIV test, individuals face a host of psychological and social stresses. HIV-related stigma is associated with psychological distress and can interfere with coping, adjustment, and management of HIV disease. Effective management of HIV disease requires timely testing for HIV infection so that persons who are infected can learn of their serostatus and gain access to care, therefore benefiting from available treatment options. This article discusses the impact that HIV-related stigma has on HIV testing and care. Specifically, problems associated with delays in testing, disclosure of seropositive status, and implications for health care are presented.

Critical Delays in HIV Testing and Care The Potential Role of Stigma

The estimated 12 million people worldwide who are infected with HIV face a chronic and debilitating disease that can create profound psychological distress. Each individual living with HIV confronts uncertainties about their future personal health and prognosis. In the developed world, advances in medical management and treatment of HIV have altered the trajectory of this disease to one of longterm illness. As a result, many individuals with HIV disease live more than a decade with the threat of increasing disability, loss of employment, and premature death. Many HIV-infected persons cope effectively with their condition and continue to lead productive, meaningful lives. Unfortunately, others have dif® culty managing the stresses associated with their condition. The Of® ce of AIDS Research and the National Institute of Mental Health (NIMH), both at the National Institutes of Health, have called for research on interventions to assist HIV-infected individuals to cope with the distress that often accompanies HIV disease and that can interfere with quality of life and adherence to care. While the majority of behavioural research and interventions in the area of HIV/AIDS have focused on the primary prevention of HIV transmission, a number of investigators have been conducting research designed to develop and evaluate interventions to increase coping and decrease distress in persons living with HIV1± 5. This paper describes one such intervention, Coping Effectiveness Training6,7, and reports on preliminary data from a randomized clinical trial that is being conducted to evaluate the training’s impact on HIV-related distress. In the face of the worldwide epidemic, some might argue that interventions are a luxury that we cannot afford. We believe that there are a number of compelling reasons to help those who are infected. First and foremost, there is the humanitarian imperative. If we have the capacity to deliver treatments that can ease pain and suffering and provide support, we have a responsibility to make these available. Second, assisting HIV-infected persons to cope with their disease will reduce distress, which is associated with non-adherence to care. Thus, coping interventions may increase adherence and reduce health care costs associated with HIV. Third, to the extent that distress has been associated with high-risk sexual behaviour8, assisting HIV-infected persons to cope with distress may reduce high-risk behaviour and reduce the likelihood of HIV transmission.

Coping effectiveness training for men living with HIV: preliminary findings.

The feasibility of providing postexposure prophylaxis (PEP) after sexual or injection drug use exposures to human immunodeficiency virus (HIV) was evaluated. PEP was provided within 72 h to individuals with exposures from partners known to have or to be at risk for HIV infection. PEP consisted of 4 weeks of antiretroviral medications and individually tailored risk-reduction and medication-adherence counseling. Among 401 participants seeking PEP, sexual exposures were most common (94%; n=375). Among sexual exposures, receptive (40%) and insertive (27%) anal intercourse were the most common sexual acts. The median time from exposure to treatment was 33 h. Ninety-seven percent of participants were treated exclusively with dual reverse-transcriptase inhibitors, and 78% completed the 4-week treatment. Six months after the exposure, no participant developed HIV antibodies, although a second PEP course for a subsequent exposure was provided to 12%. PEP, after nonoccupational HIV exposure, is feasible for persons at risk for HIV infection.

Feasibility of Postexposure Prophylaxis (PEP) against Human Immunodeficiency Virus Infection after Sexual or Injection Drug Use Exposure: The San Francisco PEP Study

https://www.cell.com/cell/pdf/0092-8674(74)90053-1.pdf

The effect of cyclic nucleotides on purine biosynthesis and the induction of PRPP synthetase during lymphocyte activation.

This survey research conducted during a 3-year period was designed to describe the scope of practice and effectiveness of the geriatric nurse practitioner (GNP) in providing health care to older adults in a variety of settings The University of California, San Francisco, in collaboration with three other GNP programs surveyed graduates (n = 123) Also surveyed were administrators, directors of nursing, and the primary medical consultant where the GNPs were employed A high degree of agreement among the professional groups was found Some comparisons are made with the results of previous studies

Donald Chambers

Papers

Coping effectiveness training for men living with HIV: preliminary findings.

Feasibility of Postexposure Prophylaxis (PEP) against Human Immunodeficiency Virus Infection after Sexual or Injection Drug Use Exposure: The San Francisco PEP Study

The effect of cyclic nucleotides on purine biosynthesis and the induction of PRPP synthetase during lymphocyte activation.

Survey of geriatric nurse practitioners in the West: scope of practice and effectiveness.