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Discrepancies between mother and adolescent perceptions of diabetes-related decision-making autonomy and their relationship to diabetes-related conflict and adherence to treatment.

OBJECTIVE: To document the relationship between discrepancies in mother and adolescent perceptions of diabetes-related decision-making autonomy, diabetes-related conflict, and regimen adherence. METHODS: The sample was composed of 82 mother-adolescent dyads. Measures included adolescent and mother reports of diabetes-related decision-making autonomy, diabetes-related conflict, and regimen adherence. Nurses' reports of adherence and number of glucose tests performed each day were also obtained. RESULTS: Discrepancies between mother and adolescent perceptions of decision-making autonomy were related to greater maternal report of diabetes-related conflict. In particular, when adolescents reported that they were more in charge of decisions than reported by their mothers, mothers reported more conflict. Discrepancies between mother and adolescent perceptions of decision-making autonomy were not related to regimen adherence. CONCLUSIONS: The findings suggest that discrepancies between mother and adolescent perceptions of diabetes-related decision-making autonomy may be a potentially important area for intervention.

Adolescent↗

The relation between ponderosity and coronary risk factors in children and their relatives. The Muscatine Ponderosity Family Study.

A family study was conducted in Muscatine, Iowa in 1984-1985 to evaluate the relation between ponderosity in children and coronary risk factor levels in these children and in their family members, and the genetic contribution to familial clustering of levels of ponderosity (body weight relative to height). Four groups of probands were selected from the 1,783 students who participated in three consecutive biennial school surveys. A random group (n = 70), a random sample of students from the entire pool; a lean group (n = 72), students in the lowest quintile of relative weight on all three surveys; a gain group (n = 70), students who gained at least two quintiles of relative weight over the four-year period; and a heavy group (n = 72), students in the highest quintile of relative weight on all three surveys. The parents, siblings, a related aunt or uncle, and a first cousin of these probands were also examined. The data show that levels of high density lipoprotein (HDL) cholesterol, apolipoproteins A-1 and B, and systolic blood pressure in heavy group probands are consistent with increased coronary risk. This same association exists among the relatives with excess ponderosity. Levels of body mass index in the mothers, fathers, and siblings cluster with the levels in the probands, and genetic differences among persons explain 36-52 per cent of the variability in body mass index across the range of ponderosity represented by the probands and their relatives. While the contribution from genes is strong, these data suggest that the contribution from environmental factors is equally as important.

Adolescent↗

Age-related changes in structure and relative collagen content of the human and feline sinoatrial node. A comparative study.

Age-related changes in the structure and size of the human and cat sinoatrial nodes were studied by light microscopy, with emphasis on changes in relative collagen volume. Sinoatrial nodes from 41 humans (aged 0-94 years) and 21 cats (aged 6 weeks-18 years) were used. It was found that there were no changes in the dimensions of the sinoatrial node during adult life in either species. In Sirius Red F3 Ba stained sections, the relative volume of collagen was measured using an interactive image analysis system. The relative volume of collagen in the human sinoatrial node increases from 38% during childhood to 70% during adulthood. Once adulthood is reached, there are no further changes in the relative volume of collagen. In the cat sinoatrial node the relative volume of collagen is only 27% and does not change with age. The organisation of collagen in the sinoatrial node, however, demonstrates an age-dependent change in both humans and cats. From coarse strands between clusters of nodal cells it gradually changes into a fine network of isolated collagen fibres which surround individual nodal cells. This process is more pronounced in humans. It is concluded that age-related changes in sinoatrial node function are not related to an increase in collagen content in the sinoatrial node.

Adolescent↗

Driving habits and health-related quality of life in patients with age-related maculopathy.

PURPOSE: To characterize the driving habits of persons with age-related maculopathy who present to a low-vision rehabilitation clinic and to examine how driving status relates to vision-specific health-related quality of life. METHODS: The Driving Habits Questionnaire, the National Eye Institute Vision Function Questionnaire-25, and the Life Space Questionnaire were administered via telephone interview to 126 patients with age-related maculopathy who presented to a low-vision clinic during the previous year and were either past or current drivers. RESULTS: Twenty-four percent of the sample reported being a current driver. Compared with those who stopped driving, current drivers were more likely to be male, younger, have better visual acuity and higher National Eye Institute Vision Function Questionnaire-25 scores. Drivers reported driving an average of 4 days and 10 miles per week. Over 50% of drivers reported that because of their vision, they had difficulty with or did not drive at all in rain, at night, on freeways or interstate highways, in heavy traffic areas, or during rush hour. Drivers and nondrivers did not differ in their life space, the spatial extent of their excursions into their environment. CONCLUSION: Some individuals who present to a low-vision clinic with age-related maculopathy do drive, although their driving exposure is low and they report avoiding challenging on-road situations. Driving status in age-related maculopathy appears to be related to better eye visual acuity and vision-specific health-related quality of life.

Activities of Daily Living↗

Food and Drug Administration surveillance of dermatology-related and nondermatology-related prescription drug advertising in the USA, 2000-2003.

BACKGROUND: Spending on advertising of prescription medicines in the U.S.A. is increasing by nearly a billion dollars yearly. The Food and Drug Administration (FDA) is legally mandated to regulate pharmaceutical advertising in the U.S.A. Prior studies have documented inaccuracies in pharmaceutical advertisements, in the U.S.A. and the rest of the world. OBJECTIVES: To assess trends in FDA surveillance of dermatology-related prescription drug advertising, and to investigate pharmaceutical companies' responses to FDA regulatory actions. METHODS: We analysed all FDA citations of prescription drug advertisements issued during 2000-2003, and responses from cited companies to our mailed requests for follow-up information. RESULTS: Twenty-four dermatology-related drugs from 21 companies accounted for 30 (15.2%) of the 198 letters sent by the FDA; of these, 18 letters cited advertisements or promotions of these medications for dermatology-related uses. The most common violation cited overall was insufficient communication of risk (32.4% overall, 33.9% dermatology-related). Most FDA letters cited physician-targeted advertising (71.6% overall, 62.1% dermatology-related). The number of dermatology-related letters sent declined by 69.2% from 2000 (n=13) to 2003 (n=4), paralleling the 69.6% decline in the total number of letters sent (n=79 in 2000, n=24 in 2003). Compared with 2000, the FDA took longer to issue citation letters in 2003 for advertisements overall [hazard ratio (HR) 0.47, 95% confidence interval (CI) 0.27-0.72, P=0.001], although this trend was not present for dermatology-related advertisements (HR 1.12, 95% CI 0.39-3.29, P=0.83). Eight of the 16 companies (50%) that received requests from the authors for information replied. Seven of the eight (87.5%) reported complying with FDA requests to discontinue the cited advertisements, while one (12.5%) reported disagreeing with the citation and successfully clarifying the issue with the FDA. CONCLUSIONS: Dermatology-related advertisements accounted for 15.2% of FDA citations of pharmaceutical advertisements between 2000 and 2003. Recent controversy over pharmaceutical advertising may lead to changes in pharmaceutical advertising practices and surveillance of pharmaceutical advertising in the U.S.A.

Advertising↗

Phenotypic correlations between oculomotor functioning and schizophrenia-related characteristics in relatives of schizophrenic probands.

Abnormalities of visual pursuit tracking are frequent in the first-degree relatives of probands with schizophrenia. The relationship between oculomotor abnormalities and schizophrenia-related characteristics in those family members, however, has received little attention. Fifty-three first-degree relatives of 24 probands with schizophrenia were evaluated for the presence of schizophrenia-related characteristics using both interview (Schedule for Schizotypal Personalities) and questionnaire (Chapman scales). The family members also had their eye movements recorded during pursuit tracking tasks and scored for gain in both the frequency and time domains, and saccadic intrusions. Social-interpersonal schizophrenia-related features were significantly related to both time- and frequency-domain gain calculations. It appears that abnormalities in the smooth-pursuit oculomotor system may be associated with symptoms conjectured to be most closely related to a genetic diathesis for schizophrenia. These findings provide further evidence that oculomotor abnormalities may be related to risk for this disorder.

Adult↗

Family burden and coping strategies in schizophrenia: are key relatives really different to other relatives?

Subjective and objective burden, psychiatric symptoms and coping strategies in a sample of 90 key relatives and other relatives of patients with schizophrenia, living in two European countries, were explored by means of well-validated questionnaires. The levels of burden on key relatives did not differ significantly from those on other relatives. Moreover, the risk of developing psychiatric symptoms was similar in the two subject groups at both centres. Significant correlations were found between key relatives and other relatives concerning the adoption of emotion-focused coping strategies. These data contrast with the current belief that family burden in schizophrenia is mainly a burden of key relatives, and they emphasize the need to provide supportive interventions for as many relatives as possible.

Adaptation, Psychological↗

Mucous membrane and lower respiratory building related symptoms in relation to indoor carbon dioxide concentrations in the 100-building BASE dataset.

UNLABELLED: Indoor air pollutants are a potential cause of building related symptoms and can be reduced by increasing ventilation rates. Indoor carbon dioxide (CO(2)) concentration is an approximate surrogate for concentrations of occupant-generated pollutants and for ventilation rate per occupant. Using the US EPA 100 office-building BASE Study dataset, we conducted multivariate logistic regression analyses to quantify the relationship between indoor CO(2) concentrations (dCO(2)) and mucous membrane (MM) and lower respiratory system (LResp) building related symptoms, adjusting for age, sex, smoking status, presence of carpet in workspace, thermal exposure, relative humidity, and a marker for entrained automobile exhaust. In addition, we tested the hypothesis that certain environmentally mediated health conditions (e.g., allergies and asthma) confer increased susceptibility to building related symptoms. Adjusted odds ratios (ORs) for statistically significant, dose-dependent associations (P < 0.05) for combined mucous membrane, dry eyes, sore throat, nose/sinus congestion, sneeze, and wheeze symptoms with 100 p.p.m. increases in dCO(2) ranged from 1.1 to 1.2. Building occupants with certain environmentally mediated health conditions were more likely to report that they experience building related symptoms than those without these conditions (statistically significant ORs ranged from 1.5 to 11.1, P < 0.05). PRACTICAL IMPLICATIONS: These results suggest that provision of sufficient per-person outdoor ventilation air, could significantly decrease prevalence of selected building related symptoms. The observed relationship between indoor minus outdoor CO(2) concentrations and mucous membrane and lower respiratory symptoms suggests that air contaminants are implicated in the etiology of building related symptoms. Levels of indoor air pollutants that are suspected to cause building related symptoms could be reduced by increasing ventilation rates, improving ventilation effectiveness, or reducing sources of indoor air pollutants, if known.

Adult↗

Guilt proneness and expressed emotion in relatives of patients with schizophrenia or related psychoses.

OBJECTIVE: Knowledge of what predicts relatives' expressed emotion (EE) may contribute to improved family work in schizophrenia. In the present study we examined guilt proneness as a determinant of EE components. METHOD: In a Norwegian sample of 46 recently hospitalized patients (schizophrenia or schizophreniform disorder) and 69 relatives, relatives' expressed emotion was assessed by means of the Camberwell Family Interview, and guilt proneness by means of the Revised Mosher Guilt Inventory. (RMGI). RESULTS: Confirmatory multiple regression analyses showed that hostility-guilt (RMGI) was negatively related to high levels of criticism and hostility and, for men, positively related to emotional overinvolvement. There was a strong positive relationship between relatives' guilty conscience (RMGI) and emotional overinvolvement if the patient had a diagnosis of schizophrenia. CONCLUSIONS: Our analyses indicate that relatives' guilt proneness may be a determinant of their criticism, hostility and emotional overinvolvement towards a schizophrenic family member. This personality trait should be taken into account in family work which aims at modifying relatives' expressed emotion.

Adolescent↗

Decline of the relative risk of death associated with low employment grade at older age: the impact of age related differences in smoking, blood pressure and plasma cholesterol.

STUDY OBJECTIVE: To explore whether the observed age related decline in the relative risk of death associated with low employment grade can be explained by the profiles of smoking, blood pressure and plasma cholesterol changing differently with age between the employment grades. DESIGN: Prospective cohort study with 25 years of mortality follow up. SETTING: Whitehall study. PARTICIPANTS: There were 16,984 men aged 40 to 69 years at baseline with complete information on smoking, blood pressure and plasma cholesterol. MAIN RESULTS: The relative risk of death associated with low employment grade decreased from 2.1 at 55-59 years of age to 1.3 at 85-89 years of age. Adjustment for smoking status and blood pressure, attenuated the age related decline of the relative risk by 18% and 3% respectively; adjustment for plasma cholesterol increased the decline by 3%. Taken together, these risk factors explain 20% of the observed age related decline. CONCLUSIONS: A small part of the observed age related decline in the relative risk of death associated with low employment grade can be explained by differential changes in the profiles of smoking, blood pressure and plasma cholesterol with age between the employment grades.

Adult↗

Characteristics of water skiing-related and wakeboarding-related injuries treated in emergency departments in the United States, 2001-2003.

BACKGROUND: Water skiing and wakeboarding are popular sports with high potential for injury due to rapid boat acceleration, lack of protective gear, and waterway obstacles. However, trends in water skiing- and wakeboarding-related injuries in the United States have not been described using national data. HYPOTHESIS: The number of injuries, injury diagnoses, and body regions injured vary by sport. STUDY DESIGN: Descriptive epidemiology study. METHODS: Data regarding water skiing- and wakeboarding-related injuries presenting to 98 hospital emergency departments in the United States between January 1, 2001, and December 31, 2003, were extracted from the National Electronic Injury Surveillance System. Data included demographics, injury diagnosis, and body region injured. RESULTS: Data were collected for 517 individuals with water skiing-related injuries and 95 individuals with wakeboarding-related injuries. These injuries represent an estimated 23 460 water skiing- and 4810 wakeboarding-related injuries treated in US emergency departments in 2001 to 2003. Head injuries represented the largest percentage of injuries for wakeboarders (28.8% of all injuries) and the smallest percentage for water skiers (4.3%) (P < .01; relative risk [95% confidence interval], 6.73 [3.89-11.66]). Analysis of injury diagnosis was consistent as wakeboarders had significantly more traumatic brain injuries (12.5% of all injuries) than did water skiers (2.4%) (P < .05; relative risk [95% confidence interval], 5.27 [2.21-12.60]). Strains or sprains were the leading injury diagnoses for water skiing (36.3% of all injuries), and the majority (55.7%) were to the lower extremity. Lacerations were the most common diagnoses for wakeboarders (31.1% of all injuries), and the majority (59.6%) were to the face. CONCLUSION: The analyses of water skiing- and wakeboarding-related injuries treated in US emergency departments in 2001 to 2003 highlight the differences in injury patterns for these 2 sports. The substantial number of head and facial injuries among wakeboarders underscores the need for research on the potential role of helmets or other protective gear to reduce these common injuries.

Adolescent↗

Relative binding affinity-serum modified access (RBA-SMA) assay predicts the relative in vivo bioactivity of the xenoestrogens bisphenol A and octylphenol.

We have developed a relative binding affinity-serum modified access (RBA-SMA) assay to determine the effect of serum on the access of xenoestrogens to estrogen receptors within intact cultured MCF-7 human breast cancer cells. We used this assay to predict low dose activity of two xenoestrogens in mice. In serum-free medium, bisphenol A, a component of polycarbonates and of resins used to line metal food cans, showed a lower relative binding affinity (RBA; 0.006%) than octylphenol (0.072%) and nonylphenol (0.026%), which are used as surfactants in many commercial products (all RBAs are relative to estradiol, which is equal to 100%). In 100% serum from adult men, bisphenol A showed a higher RBA (0.01%) than in serum-free medium and thus enhanced access to estrogen receptors relative to estradiol. In contrast, octylphenol showed a 22-fold decrease in RBA (0.0029%) and nonylphenol showed a 5-fold decrease in RBA (0.0039%) when measured in adult serum. This indicates that, relative to estradiol, serum had less of an inhibitory effect on the cell uptake and binding in MCF-7 cells of bisphenol A, while serum had a greater inhibitory effect on octylphenol and nonylphenol relative to estradiol. Extrapolation of these relative activities in adult serum predicted that the estrogenic bioactivity of bisphenol A would be over 500-fold greater than that of octylphenol in fetal mouse serum. Bisphenol A and octylphenol were fed to pregnant mice at 2 and 20 micrograms/kg/day. Exposure of male mouse fetuses to either dose of bisphenol A, but to neither dose of octylphenol, significantly increased their adult prostate weight relative to control males, which is consistent with the higher predicted bioactivity of bisphenol A than octylphenol in the RBA-SMA assay. In addition, our findings show for the first time that fetal exposure to environmentally relevant parts-per-billion (ppb) doses of bisphenol A, in the range currently being consumed by people, can alter the adult reproductive system in mice.

Animals↗

Sex-related differences in the relations of insulin resistance and obesity to left ventricular hypertrophy in Japanese hypertensive patients.

Echocardiographically determined left ventricular (LV) hypertrophy is a powerful, independent predictor of cardiovascular morbidity and mortality. Both insulin resistance and obesity have a well-known association with LV hypertrophy. However, whether or not there are sex-related differences in the relations of insulin resistance and obesity to LV hypertrophy has never been systematically explored in Japan. We enrolled 91 never-treated hypertensive patients (49 men and 42 women) to assess the possible relations of insulin resistance and obesity to LV geometry. Insulin resistance was estimated using the homeostasis model assessment (HOMA) formula. Echocardiographically determined LV mass and relative wall thickness were measured as markers of LV geometry. In addition, body mass index (BMI) was calculated as weight (kg) divided by height (m)2 as a marker of obesity. Independent determinants of LV mass in male hypertensive patients were HOMA value (p < 0.0001) and age (p = 0.034). BMI did not bear a significant relation to LV mass. In comparison, in female hypertensive patients BMI was an independent determinant of LV mass (p = 0.011). The HOMA value did not bear a significant relation to LV mass in the female hypertensive patients. In conclusion, these findings indicate the presence of sex-related differences in the relations of insulin resistance and obesity to LV hypertrophy in Japanese hypertensive patients. The effect of obesity on LV geometry was greater in female hypertensive patients than in male hypertensive patients.

Aged↗

Central vein catheter-related thrombosis in intensive care patients: incidence, risks factors, and relationship with catheter-related sepsis.

OBJECTIVE: To evaluate the incidence and risk factors for catheter-related central vein thrombosis in ICU patients. DESIGN: Observational prospective multicenter study. SETTING: An 8-bed surgical ICU, a 10-bed surgical cardiovascular ICU, and a 10-bed medical-surgical ICU. PATIENTS: During an 18-month period, 265 internaljugular or subclavian catheters were included. Veins were explored by duplex scanning performed just before or < 24 h after catheter removal. Suspected risk factors of catheter-related central vein thrombosis were recorded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-seven catheters were excluded from the analysis. Therefore 208 catheters were analyzed. Mean age of patients was 64+/-15 years, simplified acute physiologic score was 12+/-5, organ system failure score at insertion was 1+/-1, and mean duration of catheterization was 9+/-5 days. A catheter-related internal jugular or subclavian vein thrombosis occurred in 33% of the cases (42% [95% confidence interval (CI), 34 to 49%] and 10% [95% CI, 3 to 18%], respectively). Thrombosis was limited in 8%, large in 22%, and occlusive in 3% of the cases. Internal jugular route (relative risk [RR], 4.13; 95% CI, 1.72 to 9.95), therapeutic heparinization (RR 0.47; 95% CI, 0.23 to 0.99), and age >64 years (RR, 2.44; 95% CI, 2.05 to 3.19) were independently associated with catheter-related thrombosis. Moreover, the risk of catheter-related sepsis was 2.62-fold higher when thrombosis occurred (p=0.011). CONCLUSIONS: Catheter-related central vein thrombosis is a frequent complication of central venous catheterization in ICU patients and is closely associated with catheter-related sepsis.

APACHE↗

Epidemiology of terror-related versus non-terror-related traumatic injury in children.

OBJECTIVE: In the past 2 years hundreds of children in Israel have been injured in terrorist attacks. There is a paucity of data on the epidemiology of terror-related trauma in the pediatric population and its effect on the health care system. The objective of this study was to review the accumulated Israeli experience with medical care to young victims of terrorism and to use the knowledge obtained to contribute to the preparedness of medical personnel for future events. METHODS: Data on all patients who were younger than 18 years and were hospitalized from October 1, 2000, to December 31, 2001, for injuries sustained in a terrorist attack were obtained from the Israel National Trauma Registry. The parameters evaluated were patient age and sex, diagnosis, type, mechanism and severity of injury, interhospital transfer, stay in intensive care unit, duration of hospitalization, and need for rehabilitation. Findings were compared with the general pediatric population hospitalized for non-terror-related trauma within the same time period. RESULTS: During the study period, 138 children were hospitalized for a terror-related injury and 8363 for a non-terror-related injury. The study group was significantly older (mean age: 12.3 years [standard deviation: 5.1] v 6.9 years [standard deviation: 5.3]) and sustained proportionately more penetrating injuries (54% [n = 74] vs 9% [n = 725]). Differences were also noted in the proportion of internal injuries to the torso (11% in the patients with terror-related trauma vs 4% in those with non-terror-related injuries), open wounds to the head (13% vs 6%), and critical injuries (Injury Severity Score of 25+; 25% vs 3%). The study group showed greater use of intensive care unit facilities (33% vs 8% in the comparison group), longer median hospitalization time (5 days vs 2 days), and greater need for rehabilitative care (17% vs 1%). CONCLUSIONS: Terror-related injuries are more severe than non-terror-related injuries and increase the demand for acute care in children.

Adolescent↗

Derived stimulus relations, semantic priming, and event-related potentials: testing a behavioral theory of semantic networks.

Derived equivalence relations, it has been argued, provide a behavioral model of semantic or symbolic meaning in natural language, and thus equivalence relations should possess properties that are typically associated with semantic relations. The present study sought to test this basic postulate using semantic priming. Across three experiments, participants were trained and tested in two 4-member equivalence relations using word-like nonsense words. Participants also were exposed to a single- or two-word lexical decision task, and both direct (Experiment 1) and mediated (Experiments 2 and 3) priming effects for reaction times and event-related potentials were observed within but not across equivalence relations. The findings support the argument that derived equivalence relations provides a useful preliminary model of semantic relations.

Adolescent↗

Dynamic expression of apoptosis-related genes during development of laboratory hepatocellular carcinoma and its relation to apoptosis.

AIM: To explore the expression of p53, bcl-2, bax, survivin and the cell apoptosis during the development of tree shrew hepatocellular carcinoma (HCC), the relationship between expression of these genes, its impact on HCC development, and its relation to cell apoptosis. METHODS: Tree shrew HCC was induced with aflatoxin B1 (AFB1), and regular biopsy of liver tissues was carried out and the biopsy tissues were collected during cancer inducement. Liver biopsy tissue and HCC tissue were collected from 35 pre-cancerous experimental animals at wk 30 and 60 and at the 30th-, 60th-, and 90th-wk. Liver biopsy tissues were collected from 13 blank control animals at wk 30, 60, and 90. Expression of p53, bcl-2, bax, and survivin at each stage was examined by immunohistochemistry method. Apoptotic cells were detected in situ by the terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) technique. RESULTS: The apoptosis rate of normal hepatic cells was extremely low, whereas it increased during the formation of HCC. Expression of the apoptosis-related genes p53, bcl-2, bax, and survivin during the formation of HCC presented an increasing tendency. Expression of p53 did not noticeably relate to that of bcl-2, bax, and survivin, whereas expression of bcl-2 and bax was closely related. In HCC, p53 did not present a distinct relation to cell apoptosis, whereas its high level expression was probably related to liver cell proliferation. Survivin negatively correlated apoptosis index, and its overexpression could inhibit cell apoptosis. CONCLUSION: Apoptosis-related genes p53, bcl-2, bax, and survivin are all related to the occurrence of HCC. The anti-apoptosis effect of bcl-2 is influenced by bax, and ratio bcl/bax reflects more correctly the extent of cell apoptosis.

Aflatoxin B1↗

A meta-analytic review of occupational commitment: relations with person- and work-related variables.

Relations between occupational commitment (OC) and several person- and work-related variables were examined meta-analytically (76 samples; across analyses, Ns ranged 746-15,774). Major findings are as follows. First, OC was positively related to job-focused constructs such as job involvement and satisfaction, suggesting that attitudes toward the job itself may be a central concern in committing to one's occupation. Second, consistent with previous work, OC and organizational commitment were positively related. This relation was found to be moderated by the compatibility of the profession and the employing organization. Third, OC was positively related to job performance and had an indirect effect on organizational turnover intention through occupational turnover intention. This latter effect suggests that understanding of organizational turnover can be enhanced by incorporating occupation-related variables into turnover models.

Humans↗