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PubMed2003

Consequences of children's exposure to community violence.

Much has been learned over the past decade about the way children respond to experiences of violence in their community. The goal of this paper is to review what is known about the effects of community violence on children's development. In addition to main effects, factors that mediate these effects, as well as factors that moderate children's response to community violence are discussed. Special attention is paid to developmental differences in children's responses to community violence and the factors that may promote resilient functioning.

Blood Pressure↗
PubMed2003

Chronic hypoxia potentiates capacitative Ca2+ entry in type-I cortical astrocytes.

Prolonged hypoxia exerts profound effects on cell function, and has been associated with increased production of amyloid beta peptides (A beta Ps) of Alzheimer's disease. Here, we have investigated the effects of chronic hypoxia (2.5% O2, 24 h) on capacitative Ca2+ entry (CCE) in primary cultures of rat type-I cortical astrocytes, and compared results with those obtained in astrocytes exposed to A beta Ps. Chronic hypoxia caused a marked enhancement of CCE that was observed after intracellular Ca2+ stores were depleted by bradykinin application or by exposure to thapsigargin (1 microM). Exposure of cells for 24 h to 1 microM A beta P(1-40) did not alter CCE. Enhancement of CCE was not attributable to cell hyperpolarization, as chronically hypoxic cells were significantly depolarized as compared with controls. Mitochondrial inhibition [by FCCP (10 microM) and oligomycin (2.5 microg/mL)] suppressed CCE in all three cell groups, but more importantly there were no significant differences in the magnitude of CCE in the three astrocyte groups under these conditions. Similarly, the antioxidants melatonin and Trolox abolished the enhancement of CCE in hypoxic cells. Our results indicate that chronic hypoxia augments CCE in cortical type-I astrocytes, a finding which is not mimicked by A beta P(1-40) and appears to be dependent on altered mitochondrial function.

Amyloid beta-Peptides↗
PubMed2003

The PAM domain, a multi-protein complex-associated module with an all-alpha-helix fold.

BACKGROUND: Multimeric protein complexes have a role in many cellular pathways and are highly interconnected with various other proteins. The characterization of their domain composition and organization provides useful information on the specific role of each region of their sequence. RESULTS: We identified a new module, the PAM domain (PCI/PINT associated module), present in single subunits of well characterized multiprotein complexes, like the regulatory lid of the 26S proteasome, the COP-9 signalosome and the Sac3-Thp1 complex. This module is an around 200 residue long domain with a predicted TPR-like all-alpha-helical fold. CONCLUSIONS: The occurrence of the PAM domain in specific subunits of multimeric protein complexes, together with the role of other all-alpha-helical folds in protein-protein interactions, suggest a function for this domain in mediating transient binding to diverse target proteins.

Amino Acid Sequence↗
PubMed1990

Structural interpretation of the amino acid sequence of a second domain from the Artemia covalent polymer globin.

Artemia has a complex extracellular hemoglobin of Mr 260,000 comprising two globin chains (Mr 130,000) each of which is a polymer of eight covalently linked domains of Mr 16,000. The primary structure of this polymeric globin was studied to understand how globin folded domains are ordered within a globin chain and, in turn, how the latter associate into a functional hemoglobin molecule. Here we report the amino acid sequence of a second domain, E7 (Mr 16,081, excluding the heme), and interpretations of sequence data by computer-assisted alignment and modeling. This clearly shows that, as with domain E1 (Moens, L., Van Hauwaert, M.-L., De Smet, K., Geelen, D., Verpooten, G., Van Beeumen, J., Wodak, S., Alard, P., & Trotman, C. (1988) J. Biol. Chem. 263, 4679-4685), domain E7 is compatible with a globin folded structure of the beta-type chain. Several specific differences of domains E7 and E1 from the classic globins are identified. They possibly can be interpreted in terms of specific requirements for a double octameric functional molecule.

Amino Acid Sequence↗
PubMed2004

A multisite randomized trial of the effects of physician education and organizational change in chronic-asthma care: health outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study.

BACKGROUND: Traditional primary care practice change approaches have not led to full implementation of national asthma guidelines. OBJECTIVE: To evaluate the effectiveness of 2 asthma care improvement strategies in primary care. DESIGN: Two-year randomized controlled clinical trial. SETTING: Forty-two primary care pediatric practices affiliated with 4 managed care organizations. PARTICIPANTS: Children aged 3 to 17 years with mild to moderate persistent asthma enrolled in primary care practices affiliated with managed care organizations. INTERVENTIONS: Peer leader education consisted of training 1 physician per practice in asthma guidelines and peer teaching methods. Planned care combined the peer leader program with nurse-mediated organizational change through planned visits with assessments, care planning, and self-management support, in collaboration with physicians. Analyses compared each intervention with usual care. MAIN OUTCOME MEASURES: Annualized asthma symptom days, asthma-specific functional health status (Children's Health Survey for Asthma), and frequency of brief oral steroid courses (bursts). RESULTS: Six hundred thirty-eight children completed baseline evaluations, representing 64% of those screened and eligible. Mean +/- SD age was 9.4 +/- 3.5 years; 60% were boys. Three hundred fifty (55%) were taking controller medication. Mean +/- SD annualized asthma symptom days was 107.4 +/- 122 days. Children in the peer leader arm had 6.5 fewer symptom days per year (95% confidence interval [CI], - 16.9 to 3.6), a nonsignificant difference, but had a 36% (95% CI, 11% to 54%) lower oral steroid burst rate per year compared with children receiving usual care. Children in the planned care arm had 13.3 (95% CI, - 24.7 to -2.1) fewer symptom days annually (-12% from baseline; P =.02) and a 39% (95% CI, 11% to 58%) lower oral steroid burst rate per year relative to usual care. Both interventions showed small, statistically significant effects for 2 of 5 Children's Health Survey for Asthma scales. Planned care subjects had greater controller adherence (parent report) compared with usual care subjects (rate ratio, 1.05 [95% CI, 1.00 to 1.09]). CONCLUSIONS: Planned care (nurse-mediated organizational change plus peer leader education) is an effective model for improving asthma care in the primary care setting. Peer leader education on its own may also serve as a useful model for improving asthma care, although it is less comprehensive and the treatment effect less pronounced.

Administration, Oral↗
PubMed2002

Prevalence and description of selective mutism in a school-based sample.

OBJECTIVE: To examine the prevalence of selective mutism (SM) in a public school sample and compare the functioning and symptoms of children with SM to age- and gender-matched unaffected children. METHOD: Kindergarten, first, and second grade teachers in a large district were asked to identify pupils who met DSM-IV criteria for SM and to complete ratings of speaking behavior, social anxiety, other internalizing and externalizing symptoms, and overall functioning for these and comparison youngsters. Teachers completed the same ratings on the SM children 6 months later. RESULTS: A participation rate of 94% (125 of 133 teachers) was obtained, and the prevalence of SM was .71% (16/2,256). Measures were completed for 12 (75%) of 16 identified children. Compared with peers, children with SM were more symptomatic on measures of frequency of speech, social anxiety, and other internalizing symptoms. As a group, children with SM had improved 6 months later but remained impaired and symptomatic when compared with the comparison group. CONCLUSIONS: SM may not be as rare as previously thought. The functioning of children with SM is impaired, and although there is some improvement over time, notable impairment remains, suggesting that intervention is preferable to waiting for SM to remit spontaneously.

Child↗
PubMed1998

Benefit of early Class II treatment: progress report of a two-phase randomized clinical trial.

Preadolescent children with overjet greater than 7 mm were randomly assigned to observation only, headgear (combination), or functional appliance (modified bionator) and were monitored for 15 months. Of the 166 patients who completed this first phase of the trial, 147 continued to a second phase of treatment. The data from the first 107 patients to complete phase 2 are available and form the basis of this progress report. During phase 1, on average there was no change in the jaw relationship of untreated children, but 5% showed considerable improvement and 15% demonstrated worsening. Both early-treatment groups had a significant average reduction in ANB angle, more by change in maxillary dimensions in the headgear group and mandibular growth in the functional appliance group. There were wide variations in response, however, with only 75% of the treated children showing favorable skeletal response. Failure to respond favorably could not be explained by lack of cooperation alone. The preliminary results from phase 2 show that, on average, time in fixed appliances was shorter for children who underwent early treatment, but the total treatment time was considerably longer if the early phase of treatment was included. Only small differences were noted in anteroposterior jaw position between the groups at the completion of treatment, and the changes in dental occlusion, judged on the basis of Peer Assessment Rating scores, were similar between groups. Neither the severity of the initial problem nor the duration of treatment was correlated with the occlusal result. The number of patients who required extraction of permanent teeth was greater in the early functional appliance group than in the headgear or control group. The option of orthognathic surgery was presented more often in the cases of children who did not undergo early treatment, but surgery was accepted or was still being considered almost as frequently in the previous headgear group as in the controls, less often in the patients previously treated with functional appliances.

Activator Appliances↗
PubMedDate not supplied

Respiratory effects of inhaled sulfuric acid on senior asthmatics and nonasthmatics.

The objective of this study was two-fold: (1) to investigate the response of asthmatic subjects who were 60 to 75 y of age to inhaled sulfuric acid, and (2) to compare that response to findings from healthy subjects in the same age group. Nine subjects who had asthma and eight healthy subjects participated. Each subject was exposed to clean air, an inert ammonium sulfate aerosol, or 70 micrograms/m3 sulfuric acid during a 40-min exposure period composed of 30 min at rest and 10 min of light exercise on a treadmill. The sulfuric acid was delivered twice, one preceded by a lemonade drink to neutralize oral concentrations of ammonia. Exposures were separated by at least 1 wk. Oral ammonia levels and pulmonary function parameters (forced expiratory volume in one second, forced vital capacity, and total respiratory resistance) were measured before and after each exposure. None of the functional parameters in either group showed significant changes. However, total respiratory resistance changes from baseline after sulfuric acid exposure were significantly higher (+16%) in the asthmatic subjects, compared with the healthy subjects (-6%). These data suggest that older subjects are not at increased risk for adverse respiratory effects from inhalation of sulfuric acid by virtue of age alone, and older subjects with asthma are slightly more vulnerable than are their healthy peers.

Adolescent↗
PubMed1976

Exercise performance in children and adolescents after surgical repair of tetralogy of Fallot.

Cardiopulmonary function studies at rest and during submaximal and maximal exercise were performed in 21 children and adolescents who had undergone surgical correction of tetralogy of Fallot. Maximal oxygen uptake of the patients was 84.6% of healthy peers matched for age and height. The reduced aerobic capacity can mainly be attributed to a reduction in stroke volume. In the presence of a reduced stroke volume normal cardiac output during submaximal exercise was achieved and maintained by an increase in heart rate. During maximal exercise, however, the heart rate did not exceed that of the healthy controls and the results for the children in this series are about 20% higher than those reported in the literature for adults who had undergone surgical repair of a tetralogy. Persistent impairment of cardiac function in patients with tetralogy of Fallot who have undergone corrective surgery may represent a residual outflow tract obstruction in the right ventricle, impaired function of the left ventricle or the result of restricted physical activity.

Adolescent↗
PubMed1990

Child care and the family: complex contributors to child development.

In a state with minimal child care standards, we found pervasive differences in third graders associated with earlier child care histories. More extensive child are predicted children receiving more negative ratings from parents and teachers, poorer academic and conduct grades, lower standardized test scores, and more negative sociometric nominations. In addition, for some variables (IQ, work habits negative peer nominations, and compliance ratings) there was evidence of interactive effects in which both extensive infant care and exclusive maternal care were associated with more problematical functioning, depending on parental marital status, social class, and child gender. We found no evidence of negative effects associated with part-time care. This study has several important limitations that should be acknowledged. The first is the danger of generalizing these results to states and communities with higher-quality child care standards than those imposed in Texas. They may, unfortunately, be generalizable to the twenty states with child care regulations similar to those in Texas. This study has another important limitation. It did not examine the underlying processes that might contribute to the effects of child care history. For example, we do not know if the differences in children who were in part-time versus extensive child care are owing to (1) differences in the children's experiences while they are in the child care settings, or (2) differences in the quality of interactions that occur when the two groups of children are at home, or (3) some combination of children's experiences in child care and the family.

Analysis of Variance↗
PubMed2004

Word length effect in early reading and in developmental dyslexia.

Vocal reaction times were measured in Italian dyslexics and in proficient readers while they read single words. Three groups of control participants (for a total of 79) were tested. All were in the first, second or third grade of elementary school. Nine third graders with a low level of reading ability when assessed by standard reading procedures were also tested. Results indicated that vocal RTs of control participants were faster and less sensitive to word length as a function of age; also, there was a particularly marked change between first and second graders. Dyslexics' vocal RTs and errors were much worse than those of peer control participants and resembled those of first grade controls. It is suggested that normal readers in an orthographically transparent language (Italian) adopt a lexical strategy quite early in their learning. On the contrary, dyslexics seem unable to learn this mode of processing and continue to use a sub-lexical reading procedure.

Child↗
PubMed2006

Young adult stimulant users' increased striatal activation during uncertainty is related to impulsivity.

BACKGROUND: Young adults who use stimulants (e.g., cocaine, amphetamines) are at particular risk of transitioning to dependence. Previously, we demonstrated increased risk-taking in young adults who had used stimulants (Leland, D.S., Paulus, M.P., 2005. Increased risk-taking decision-making but not altered response to punishment in stimulant-using young adults. Drug. Alcohol Depend. 78, 83-90). Since outcome uncertainty is a critical element of risk, we investigated whether such individuals have different neural responses to uncertainty than their stimulant-naive peers. METHOD: Eleven young adults (age 18-25) who had used stimulants were compared with 11 age- and education-matched stimulant-naive controls using functional magnetic resonance imaging and a card prediction task with relatively certain/uncertain outcome conditions. RESULTS: The caudate, an area involved in processing salient events, was among those regions more active in users than controls in response to uncertainty. Personality measures revealed that users were more impulsive than controls, and that neural response to uncertainty in a number of areas, including the thalamus/caudate, was positively correlated with impulsivity. CONCLUSIONS: These results are consistent with the idea that young adults who have used stimulants find uncertainty particularly salient, due in part to preexisting differences in impulsivity, and may be subject to more "action pressure" when making decisions under uncertainty. This neural and personality profile may constitute a marker for increased risk of stimulant use.

Adult↗
PubMed2002

Individual and environmental influences on adolescent eating behaviors.

Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).

Adolescent↗
PubMed2001

Quality of life in adults and children with allergic rhinitis.

Quality of life, when referring to an individual's health, is called health-related quality of life (HRQL). HRQL focuses on patients' perceptions of their disease and measures impairments that have significant impact on the patient. Similar symptoms may vary in their effect on different individuals; the goal of therapy should be to reduce impairments that patients consider important. HRQL can be measured with generic or specific questionnaires. Specific questionnaires may be more sensitive and are much more likely to detect clinically important changes in patients' impairments. Specific questionnaires used to assess HRQL in rhinitis are the Rhinoconjunctivitis Quality of Life Questionnaire, the Adolescent Rhinoconjunctivitis Quality of Life Questionnaire, and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire. HRQL issues in adult rhinitis patients include fatigue, decrease in energy, general health perception, and social function; impairment of HQRL generally increases with increasing degree of symptoms and severity of disease. In children, HRQL issues include learning impairment, inability to integrate with peers, anxiety, and family dysfunction. Comorbid disorders often associated with rhinitis, including sinusitis, otitis media, and frequent respiratory infections, can further compromise HRQL. Pharmacologic treatments can have both positive and negative effects on HRQL. Agents that have troublesome adverse effects such as sedation can have a negative impact, whereas nonsedating antihistamines and intranasal cortico-steroids can significantly improve HRQL in patients of all ages with rhinitis.

Administration, Intranasal↗
PubMed2006

Pain sensitivity and fMRI pain-related brain activity in Alzheimer's disease.

People with Alzheimer's disease are administered fewer analgesics and report less clinical pain than cognitively intact peers with similar painful diseases or injuries, prompting speculation about the likely impact of neurodegeneration on central pain processing. The present study measured pain ratings and functional MRI (fMRI) brain responses following mechanical pressure simulation in 14 patients with Alzheimer's disease and 15 age-matched controls. Contrary to the prevailing hypothesis that this disease is likely to differentially reduce emotional responses to pain, we show that activity in both medial and lateral pain pathways is preserved. Moderate pain was evoked with similar stimuli in both groups, and was associated with a common network of pain-related activity incorporating cingulate, insula and somatosensory cortices. Between-group analyses showed no evidence of diminished pain-related activity in Alzheimer's disease patients compared with controls. In fact, compared with controls, patients showed greater amplitude and duration of pain-related activity in sensory, affective and cognitive processing regions consistent with sustained attention to the noxious stimulus. The results of this study show that pain perception and processing are not diminished in Alzheimer's disease, thereby raising concerns about the current inadequate treatment of pain in this highly dependent and vulnerable patient group.

Aged↗
PubMed2003

Analysis of the evolutionary relationships of HIV-1 and SIVcpz sequences using bayesian inference: implications for the origin of HIV-1.

The most plausible origin of HIV-1 group M is an SIV lineage currently represented by SIVcpz isolated from the chimpanzee subspecies Pan troglodytes troglodytes. The origin of HIV-1 group O is less clear. Putative recombination between any of the HIV-1 and SIVcpz sequences was tested using bootscanning and Bayesian-scanning plots, as well as a new method using a Bayesian multiple change-point (BMCP) model to infer parental sequences and crossing-over points. We found that in the case of highly divergent sequences, such as HIV-1/SIVcpz, Bayesian scanning and BMCP methods are more appropriate than bootscanning analysis to investigate spatial phylogenetic variation, including estimating the boundaries of the regions with discordant evolutionary relationships and the levels of support of the phylogenetic clusters under study. According to the Bayesian scanning plots and BMCP method, there was strong evidence for discordant phylogenetic clustering throughout the genome: (1) HIV-1 group O clustered with SIVcpzANT/TAN in middle pol, and partial vif/env; (2) SIVcpzGab1 clustered with SIVcpzANT/TAN in 3'pol/vif, and middle env; (3) HIV-1 group O grouped with SIVcpzCamUS and SIVcpzGab1 in p17/p24; (4) HIV-1 group M was more closely related to SIVcpzCamUS in 3'gag/pol and in middle pol, whereas in partial gp120 group M clustered with group O. Conditionally independent phylogenetic analysis inferred by maximum likelihood (ML) and Bayesian methods further confirmed these findings. The discordant phylogenetic relationships between the HIV-1/SIVcpz sequences may have been caused by ancient recombination events, but they are also due, at least in part, to altered rates of evolution between parental SIVcpz lineages.

Animals↗
PubMed1996

Risk factors of psychosis: identifying vulnerable populations premorbidly.

This article reviews premorbid indicators of psychosis that may be relevant to primary intervention. These risk markers are divided into two categories: (1) precursors related to early etiological factors (family psychiatric history, perinatal and obstetric complications, neurobehavior deficits, early parental separation, institutionalization, and poor family function) and (2) precursors signaling latent mental illness (personality measurements indicating proneness to psychosis, and teacher ratings indicating emotional lability, social anxiety, social withdrawal, passivity, poor peer relations, and disruptive and aggressive behavior). Because teacher ratings have been shown to be powerful predictors of adult mental breakdown, part of this article focuses on a specific study that assesses such ratings as predictors of psychosis in a high-risk population. Risk indicators may also provide clues about protective factors relevant for primary prevention.

Adolescent↗
PubMed2005

Asymmetric deterioration of spatial awareness with diminishing levels of alertness in normal children and children with ADHD.

BACKGROUND: There is growing literature suggesting that some children diagnosed with attention deficit hyperactivity disorder (ADHD) can show a significant bias in attention away from left space. Here we examine mechanisms that may underpin these effects in both clinical and non-clinical child populations. Unilateral spatial inattention (unilateral neglect) is a commonly reported consequence of stroke in adults. Although for most patients the problem is relatively transient, persistent forms of neglect are almost exclusively associated with right hemisphere lesions. It has been suggested that this chronicity may result from co-existing disruption to right hemisphere dominant systems that mediate alertness. Here we present two studies examining the relationship between sustained attention and left spatial awareness in childhood. METHOD: In the first, normal children without the ADHD diagnosis were administered a non-spatial test of sustained attention/alertness. Children who performed poorly at this task, relative to their more attentive peers, showed a modest but reliable delay in awareness of left-sided visual information. Furthermore, attention towards the left declined for both groups as a function of time-on-task, suggesting a significant within-subject modulatory effect of alertness on spatial awareness. The second study examines this relationship in children referred to clinical services for attention problems. Irrespective of their final diagnosis, children were divided into two groups according to their performance in sustained attention/alertness tasks. RESULTS: The results suggest that, regardless of the children's clinical diagnosis, diminished sustained attention/alertness levels formed the strongest predictor of relatively delayed awareness of information presented within left visual space. Two children within this group exhibited signs of hitherto undetected spatial neglect as severe as that observed in some brain-injured adults. CONCLUSIONS: Clinical and theoretical implications are discussed.

Attention Deficit Disorder with Hyperactivity↗