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PubMed2004

Studying interactions, reactions, and perceptions: can genetic disorders serve as behavioral proxies?

Different genetic disorders predispose individuals to display specific, etiology-related profiles, personalities, and maladaptive behaviors. Using groups with genetic etiologies as stand-ins or proxies for a specific behavior or set of behaviors, one can then examine how others in the child's environment react and whether such reactions are limited to a particular disorder or occur generally to all individuals showing that behavior. Just as twins, adopted, and institutionalized children have all been used as natural experiments to tell us about typical development, so too can groups with specific genetic syndromes help us to understand the nature and mechanisms of the reactions and behaviors of others.

Child↗
PubMed2001

The validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. I. Psychiatric diagnoses.

OBJECTIVE: To investigate the validity of best-estimate methodology for making psychiatric diagnoses among individuals who attempted suicide. METHOD: Subjects were 80 patients admitted for treatment following a suicide attempt. Psychiatric diagnoses based on structured interviews with subjects were compared with diagnoses made based on interviews with proxy respondents. In both cases, interview information was supplemented with pre-admission psychiatric and medical records to inform diagnoses. RESULTS: Diagnostic agreement, based on kappa coefficients, was substantial for major depression and bipolar disorders, and moderate for non-affective psychoses, organic mood and anxiety disorders. Agreement was substantial for substance dependence but poor for substance abuse disorders. CONCLUSION: Results support best-estimate methodology for making mood and substance dependence diagnoses in research of suicidal behavior in this age group, with potential implications for interpreting postmortem research of completed suicide.

Aged↗
PubMed2004

Climate as a social-cognitive construction of supervisory safety practices: scripts as proxy of behavior patterns.

Organizational climate research has focused on prediction of organizational outcomes rather than on climate as a social-cognitive mediator between environmental attributes and relevant outcomes. This article presents a model specifying that supervisory safety practices predict (safety) climate level and strength as moderated by leadership quality. Using supervisory scripts as proxy of practices, it is shown that script orientation indicative of safely priority predicted climate level, whereas script simplicity and cross-situational variability predicted climate strength. Transformational leadership mitigated these effects because of closer leader-member relationships. Safety climate partially mediated the relationship between supervisory scripts and injury rate during the 6-month period following climate and script measurement. Theoretical and methodological implications are discussed.

Accidents, Occupational↗
PubMed2006

Educational attainment as a proxy for cognitive ability in selection: effects on levels of cognitive ability and adverse impact.

The authors examined the differences in mean level of cognitive ability and adverse impact that can be expected when selecting employees solely on educational attainment as a proxy for cognitive ability versus selecting employees directly on cognitive ability. Selection using cognitive ability worked as a more efficient cognitive screen. Imposing an educational attainment standard of at least 1 year of college, though, did result in noticeably higher levels of cognitive ability in potential applicant pools than did random selection, meaning that educational attainment does work as a cognitive screen. These results held not only in a nationally representative sample but also within and across 6 different occupational groups. Finally, adverse impact is examined for selection using educational attainment, compared with selection on the basis of cognitive ability.

Achievement↗
PubMed2003

Proxy evidence for an El Niño-like response to volcanic forcing.

Past studies have suggested a statistical connection between explosive volcanic eruptions and subsequent El Niño climate events. This connection, however, has remained controversial. Here we present support for a response of the El Niño/Southern Oscillation (ENSO) phenomenon to forcing from explosive volcanism by using two different palaeoclimate reconstructions of El Niño activity and two independent, proxy-based chronologies of explosive volcanic activity from ad 1649 to the present. We demonstrate a significant, multi-year, El Niño-like response to explosive tropical volcanic forcing over the past several centuries. The results imply roughly a doubling of the probability of an El Niño event occurring in the winter following a volcanic eruption. Our empirical findings shed light on how the tropical Pacific ocean-atmosphere system may respond to exogenous (both natural and anthropogenic) radiative forcing.

Journal Article↗
PubMed1998

Proxy activation of protein ErbB2 by heterologous ligands implies a heterotetrameric mode of receptor tyrosine kinase interaction.

The oncoprotein ErbB2 is frequently overexpressed in human tumours, but no activating ErbB2-specific ligand has yet been identified. Here we analyse the catalytic and oligomeric behaviour of ErbB2 using phosphorylation-state-specific antibodies which distinguish kinase-active and -inactive ErbB2 receptor subsets. Heregulin-alpha (HRG) activates ErbB2 in G8/DHFR 3T3 cells by selectively inducing hetero-oligomerization with kinase-defective ErbB3, indicating that heterologous transphosphorylation is an unlikely prerequisite for ErbB2 activation. HRG also triggers association of epidermal-growth-factor receptors (EGFR) with a kinase-inactive ErbB2 subset while reducing EGFR association with active ErbB2. Similarly, EGF treatment of A431 cells induces concomitant hetero-oligomerization of active ErbB2 with inactive EGFR, of active EGFR with inactive ErbB2, and of inactive ErbB2 with kinase-defective ErbB3. These combinatorial patterns of ligand-dependent oligomerization suggest a multivalent model of receptor tyrosine kinase interaction in which liganded homodimers provide stable oligomerization interfaces for unliganded ErbB2 or other bystander receptors. We submit that ErbB2 may be physiologically activated via a 'proxy' ligand-inducible heterotetrameric mechanism similar to that already established for transforming-growth-factor-beta type I receptors.

3T3 Cells↗
PubMed2001

Evaluating a community nursing service: listening to the voices of clients with an intellectual disability and/or their proxies.

The aim of this study was to evaluate a specialist nursing service programme for people with an intellectual disability residing in the community. It is important to correct the imbalance in the literature that has neglected the voices of the clients themselves or denied expression by their proxies. The aim of the study was to gain a better understanding of matters of importance for clients and their families and to involve them in the evaluation of a service that directly affects their care. Only three clients were able to participate; however, 17 parents (next of kin) agreed to be interviewed. In-depth interviews were audio-taped, transcribed and analysed relating to the questions asked and were checked against the domains of the nursing practice in the disability area: continuity of care, advanced nursing practice, education and credentialling, personal and professional attributes, primary health care, and normalization. The findings confirm the high regard in which the programme is held. Service evaluation is crucial in providing evidence for programme funders. The favourable outcome of this evaluation meant that the programme gained funding for another few years.

Adaptation, Psychological↗
PubMed2002

Race: predictor versus proxy variable? Outcomes after spinal cord injury.

OBJECTIVE: To examine the impact of race on acute, rehabilitation, and long-term outcomes after spinal cord injury (SCI). DESIGN: Two case control studies (study 1: acute and rehabilitation outcomes, study 2: long-term outcomes) in which white and nonwhite individuals were matched case for case on multiple demographic, medical, and geographic characteristics with the rationale being that a case-control methodology would increase the internal validity of the design, thereby increasing confidence in the assertion that any between-group differences observed may be specifically attributed to race. SETTING: Data drawn from the Spinal Cord Injury Model Systems. Institutional practice and general community. PARTICIPANTS: Study 1: 187 pairs of individuals, study 2: 158 pairs of matched individuals. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Outcome measures assessed included economic (eg, cost of care), treatment-related (eg, length of hospital stay), functional (eg, FIM instrument), and medical (eg, number of medical complications) variables, as well as self-reported life satisfaction, level of handicap, and mental and physical health. RESULTS: In study 1, none of the outcome measures differed significantly across racial groups. Similarly, study 2 failed to indicate significant differences in any of the outcome variables across racial groups, with the exception that nonwhites were at increased risk of greater self-reported handicap in the area of mobility. Power analyses indicated these finding were not merely the result of inadequate power. CONCLUSION: For the outcomes assessed in studies 1 and 2, race appeared to act primarily as a proxy for other variables (eg, injury severity, age, educational achievement), which in turn may be associated with poor outcome after SCI. Theoretical implications and recommendations are discussed.

Activities of Daily Living↗
PubMed2006

Consistent simulations of multiple proxy responses to an abrupt climate change event.

Isotope, aerosol, and methane records document an abrupt cooling event across the Northern Hemisphere at 8.2 kiloyears before present (kyr), while separate geologic lines of evidence document the catastrophic drainage of the glacial Lakes Agassiz and Ojibway into the Hudson Bay at approximately the same time. This melt water pulse may have been the catalyst for a decrease in North Atlantic Deep Water formation and subsequent cooling around the Northern Hemisphere. However, lack of direct evidence for ocean cooling has lead to speculation that this abrupt event was purely local to Greenland and called into question this proposed mechanism. We simulate the response to this melt water pulse using a coupled general circulation model that explicitly tracks water isotopes and with atmosphere-only experiments that calculate changes in atmospheric aerosol deposition (specifically (10)Be and dust) and wetland methane emissions. The simulations produce a short period of significantly diminished North Atlantic Deep Water and are able to quantitatively match paleoclimate observations, including the lack of isotopic signal in the North Atlantic. This direct comparison with multiple proxy records provides compelling evidence that changes in ocean circulation played a major role in this abrupt climate change event.

Atlantic Ocean↗
PubMed2002

Altered host plant volatiles are proxies for sex pheromones in the gall wasp Antistrophus rufus.

We describe a previously uncharacterized function for changes in plant chemistry induced by phytophagous insects: to provide cues for mate location. Larvae of the gall wasp Antistrophus rufus Gillette (Hymenoptera: Cynipidae) feed within inconspicuous galls inside the flowering stems of the prairie perennials Silphium laciniatum L. and Silphium terebinthinaceum Jacquin (Asteraceae). Adult male A. rufus emerge before females and are challenged with locating mates that are sequestered within dead plant stems that occur in a matrix of dead vegetation. Allozyme studies revealed complete reproductive isolation between wasp subpopulations in the two plant species. In laboratory bioassays, males responded only to their natal plant species, antennating the stem surface. Males from S. laciniatum also responded to hexane extracts of S. laciniatum stems, and extracts contained much higher concentrations of monoterpenes (alpha-pinene, beta-pinene, and camphene) than did S. terebinthinaceum. Ratios of "+" and "-" enantiomers of alpha- and beta-pinene approximated 50:50 for nongalled S. laciniatum stems but strongly differed from 50:50 in galled stems, with "+" and "-" enantiomers strongly dominant in different plants. In bioassays, male wasps from S. laciniatum responded to a synthetic blend of the monoterpenes in enantiomeric ratios characteristic of galled stems. Male A. rufus rely entirely on olfaction to locate females within stems in a complex prairie habitat, and gall wasps themselves apparently influence the plant to modify ratios of monoterpene enantiomers. These plant volatiles serve as a signal for males, acting as a sex pheromone proxy for females concealed within plant tissues.

Journal Article↗
PubMed2006

Basal metabolic rate as a proxy for overnight energy expenditure: the effect of age.

Recommendations for daily energy requirements use factorial calculations based on BMR. Expressing total energy requirements as a multiple of BMR is based on the assumption that BMR is equal to overnight metabolic rate (OMR). The objective of the present study was to determine if BMR is an appropriate proxy for OMR in children, young adults and elderly. Data are presented of thirty children (11 (SD 2) years), thirty young adults (25 (SD 5) years) and fifty-nine elderly (61 (SD 5) years). OMR was measured in a respiration chamber while sleep was not hindered and BMR was measured directly afterwards with a ventilated hood system under strictly controlled conditions. The mean ratio of OMR:BMR was 0.92 (SD 0.09) for children, which was significantly different from 1.00 (P<0.001), 1.00 (SD 0.07) for young adults and 1.06 (SD 0.09) for elderly which was also different from 1.00 (P<0.001). For adults, BMR is an appropriate measure of OMR. In children, the use of BMR to estimate OMR would introduce an overestimate and for elderly an underestimate.

Adult↗
PubMed1985

Forensic and family psychiatry in abuse dwarfism: Munchausen's syndrome by proxy, atonement, and addiction to abuse.

The syndrome of abuse dwarfism is characterized by gross impairment of statural and intellectual growth and social maturation while the abused child remains in the domicile of abuse. The parents collude as child abusers, and are medical impostors regarding the symptoms of abuse. The syndrome as a whole is appropriately named Munchausen's syndrome by proxy. Though the mother typically initiates abuse, she cannot give a rational explanation for doing so. In her own history there is a sin that is expiated or atoned for symbolically by the sacrifice of the child--explainable in terms of the theory of opponent-process learning. In the two cases presented, the sin was the mother's own birth out of wedlock, in one case as a sequel to incest. The child's addiction to abuse is a challenge to the program of rehabilitation. With respect to parents at risk, the data of this paper are relevant to the prevention of a predisposition toward, or the actual implementation of child abuse, though a program of prevention needs still to be formulated. The sexological relevance of this paper is that the data demonstrate that the effects of sexual abuse may be transmitted to the next generation and manifested as child abuse which is not necessarily sexual in content.

Adolescent↗
PubMed1990

A proxy approach to the determination of total caloric intake for use in cancer epidemiology.

In the absence of complete dietary information on a cohort of 472 early-stage breast cancer patients a caloric prediction technique was developed. Deriving an accurate caloric denominator would enable examination of individual nutrient effects by controlling for potential confounding by calories. Surrogate measures of mean daily caloric intake were generated from estimates of basal metabolic rate (BMR) predicted from age, height, weight, and physical activity. A validation study was undertaken to test the relationship between the BMR proxy terms and mean daily energy intake obtained from four-day food diaries for 51 subjects. Pearson correlation coefficients between the diary-derived and predicted values of caloric intake were computed (r = 0.43, p = 0.001). The results are in the range of what many researchers found when comparing self-reports of total caloric intake in validation and reliability studies of various dietary assessment tools. Because of the large heterogeneity of results across the ages represented in this study (25-77 yrs), it is recommended that small validation studies of this type be carried out in the subpopulations of interest.

Adult↗
PubMed2006

Interpersonal issues surrounding HIV counseling and testing, and the phenomenon of "testing by proxy".

This multimethod study explored challenges faced by women in close heterosexual relationships who decided to test for HIV, and their experiences with instituting safer sexual practices and partner testing. Eighty-one women who sought HIV counseling and testing and had a regular male sexual partner were interviewed on five occasions, and 18 of these women and 15 men later took part in one of four focus groups (women only, men only, or couples). Findings identified difficulty understanding the unpredictability of HIV transmission, gender differences in how partners interpret their susceptibility to HIV, and male resistance to safer sex and testing. We also identified a pervasive phenomenon of "testing by proxy"--the belief that if one partner tests negative for HIV after having unprotected intercourse, the untested partner's serostatus is deemed to be negative. This dangerous practice must be addressed in public health prevention efforts. Programs aiming to reduce heterosexual HIV risk for women must include their male partners and incorporate effective interpersonal communication skills.

Adolescent↗
PubMedDate not supplied

Sudden infant death syndrome and the age-cause proxy relationship in infancy.

Evidence from a longitudinal study of the relationship between socioeconomic status and infant mortality in metropolitan Ohio is presented in an effort to throw additional light on the continuing debate over the validity of the age-cause proxy relationship in infancy. The results indicate that while there is a fairly strong and consistent association between neonatal mortality and endogenous causes of death that is little affected by the classification of Sudden Infant Death Syndrome, the nature of the association between postneonatal mortality and exogenous causes of death varies from weak to moderate depending upon where this cause is included. Additional evidence pertaining to the role of SIDS in contributing to the long-standing inverse association between infant mortality and socioeconomic status is presented, thus further emphasizing the need for continued research to clarify the etiologic mechanisms of this poorly understood condition.

Age Distribution↗
PubMed2006

The effect of a web-based, patient-directed intervention on knowledge, discussion, and completion of a health care proxy.

OBJECTIVES: To examine the effect of patient-directed electronic messages on health care proxy (HCP) use. DESIGN: Randomized control trial using an electronic message intervention to encourage patients to complete an HCP document. SETTING: General medical practice at a large tertiary care teaching institution. PARTICIPANTS: Nine hundred twelve patients aged older than 50. MEASUREMENTS: We reviewed online medical records (OMRs) to assess for discussion and documentation of HCPs and to collect information on patient characteristics. We surveyed participants to determine knowledge, discussion, and completion of HCPs. RESULTS: Four hundred thirty participants were randomized to the intervention group and 482 to the control group. Only 1 HCP discussion (intervention group) and only 10 new HCPs (4 in intervention group versus 6 in control group, p = 0.649) were documented in the OMR. Among the 444 survey responders, 205 (46%) reported having an HCP, but only 74 (36%) of these had discussed the HCP with their doctors and only 9 (4%) had a documented HCP in the OMR. Patients in the intervention group were more likely to report knowledge of HCPs (adjusted risk ratio [RR] 1.07; 95% confidence interval [CI], 1.01-1.14) and having a plan to complete one in the future (adjusted RR 1.19; 95% CI, 1.05-1.36). CONCLUSION: This patient-directed intervention did not increase patient completion of an HCP but was associated with greater knowledge of an HCP and planning to complete one.

Aged↗
PubMed1991

Munchausen syndrome by proxy documented by discrepant blood typing.

The authors describe a case of Munchausen syndrome by proxy, a form of child abuse, documented by use of routine blood bank serologic procedures. While immunohematologic testing has been used in the legal arena to resolve issues of disputed paternity and to investigate instances of criminal acts, the authors believe this to be the first documented application to this clinical disorder.

ABO Blood-Group System↗
PubMed2026

SNPannotator: automated functional annotation of genetic variants and linked proxies.

SUMMARY: Genome-wide association studies (GWASs) have identified thousands of genetic variants associated with complex traits and diseases. However, explaining the mechanisms underlying phenotypic variation remains challenging. Here, we introduce SNPannotator, an automated post-GWAS analysis software package designed to streamline the interpretation of GWAS findings. Our pipeline implements a multi-step process that identifies proxy variants in high linkage disequilibrium (LD) with associated lead variants, then queries comprehensive resources (including Ensembl, the GTEx Portal, the eQTL Catalog, and STRING DB) for genomic position, deleteriousness, regulatory annotations, clinical significance, trait associations, expression (eQTLs) and splicing quantitative trait loci (sQTLs), and functional enrichment analyses and compiles the results into user-friendly reports. This package is implemented in the R programming language and includes auxiliary functions for variant lookup and LD exploration. SNPannotator provides a practical framework for efficiently deriving biologically meaningful insights from GWAS data and for assisting researchers in prioritizing candidate variants for functional validation. AVAILABILITY AND IMPLEMENTATION: The SNPannotator package is available from the Comprehensive R Archive Network (CRAN) at https://cran.r-project.org/web/packages/SNPannotator. The development version and tutorial is available on GitHub (https://github.com/omicslaboratory/SNPannotator). The online version of the package is available at https://omicslab.org/snpannotator.

Software↗