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PubMed2000

Assessment of myocardial velocities in healthy children using tissue Doppler imaging.

The objective was to determine the normal range of tissue velocities in paediatric hearts as measured by tissue Doppler imaging. A prospective study was carried out involving 160 healthy children (mean age 10.8 y, range 4.0-17.9 y). Using tissue Doppler imaging (TDI) from parasternal long axis and apical views, peak velocities and peak myocardial velocity differences across the right ventricular anterior wall, interventricular septum and left ventricular posterior wall were assessed during systole, early and late diastole. The existence of transmyocardial velocity differences between the left and right side of the interventricular septum, as well as between the endocardium and epicardium of the left ventricular posterior wall was observed throughout the heart cycle. With range-gated TDI from apical four-chamber view, peak velocities were measured within the basal, mid and apical parts of the interventricular septum, and the left and right free ventricular walls. The highest peak systolic, early and late diastolic velocities were measured within the basal parts of all myocardial walls. The ranges of the calculated velocity ratios (early-to-late diastolic velocity and early diastolic-to-systolic velocity) for the various wall parts appeared to be overlapping. The correlations of peak myocardial tissue velocities and their ratios with age and weight were weak and practically irrelevant. These normal values of peak myocardial velocities, transmyocardial velocity differences and the ratios of peak wall velocities can be used as reference values in future investigations of ventricular dysfunction in this age group.

Adolescent↗
PubMed1999

Sexual behavior and AIDS-related knowledge among community college students in Orange County, California.

Whereas college students are not identified as a high-risk group for acquiring the HIV infection, they exhibit high-risk behaviors consistent with their age group, including multiple sexual partners and high rates of unprotected intercourse. This study was conducted to determine levels of HIV-related sexual behavior, along with knowledge and attitudes among students attending community colleges in a relatively affluent multiethnic community. This study used a random sample survey (N = 319) of students attending selected classes at four community colleges in Orange County, California, to assess HIV/AIDS knowledge, attitudes, and patterns of past and present sexual behavior. The level of student knowledge concerning HIV disease was found to be relatively high, and pronounced differences in knowledge and sexual permissiveness were identified as a function of ethnicity and religion, with Asians showing lower knowledge and lower concern about HIV, and religion/religiosity related to these variables and also to levels of sexual permissiveness. Respondents' comfort in asking a partner about his/her sexual history was positively associated with their level of self-esteem, and negatively related to peer pressure in this population. As in previous studies of college populations, HIV knowledge per se does not confer a protective effect against high-risk behavior. However, knowledge was found to be an enabling factor with regard to students' comfort levels in asking about their partner's sexual histories, and in requesting that partners take an AIDS test.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Verbal and spatial information processing constraints in children with specific language impairment.

A dual-processing paradigm was used to investigate information processing limitations underlying specific language impairment (SLI). School-age children with and without SLI were asked to recall verbal and spatial stimuli in situations that varied the number of tasks that were required and the speed at which stimuli were presented. Children recalled digits or locations of X's that were presented on a computer screen. In some conditions, they were asked to name or point to the color of the stimuli before completing the recall task. In comparison to their typically developing peers, children with SLI had generally poorer recall of digits and locations across all conditions. Typically developing children derived greater benefit than the children with SLI under conditions that enabled them to disperse processing efforts across verbal and spatial response modalities. It appears that limitations in general cognitive capacity and central executive functions in working memory work synergistically with response modality to constrain information processing in children with SLI.

Acoustic Stimulation↗
PubMed2005

Self-reported goals of older patients with type 2 diabetes mellitus.

OBJECTIVES: New diabetes mellitus guidelines from the American Geriatrics Society promote the individualization of treatment goals and plans for patients aged 65 and older. Communicating with older patients about such complex medical decisions presents new challenges for providers. The self-reported healthcare goals, factors influencing these goals, and self-care practices of older patients with diabetes mellitus were explored. DESIGN: Exploratory study involving semistructured interviews. SETTING: Four clinics of a midwestern, urban academic medical center. PARTICIPANTS: Patients aged 65 and older with type II diabetes mellitus (N=28). MEASUREMENTS: Semistructured, one-on-one interviews were conducted. Interviews were audiotaped, transcribed, and evaluated for recurring themes using a grounded theory approach. RESULTS: The majority of patients expressed their healthcare goals in a social and functional language, in contrast to the biomedical language of risk factor control and complication prevention, even when specifically asked about goals for diabetes mellitus care. Patient's predominant healthcare goals centered on maintaining their independence and their activities of daily living (71%). Medical experiences of friends and family (50%), social comparison with peers (7%), and medical professionals (43%) shaped patients' goals. Self-reported medication adherence and glucose monitoring was high, but more than one-quarter of patients failed to adhere to any dietary recommendations, and one-third failed to adhere to their exercise regimens. CONCLUSION: As diabetes mellitus care recommendations for older patients grow more complex, providers could enhance their communication about such medical decisions by exploring patients' specific circumstances and reframing diabetes mellitus treatment goals in patients' own language. These may be crucial steps to developing successful individualized care plans.

Activities of Daily Living↗
PubMed2005

Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis.

OBJECTIVE: The duration of untreated psychosis may influence response to treatment, reflecting a potentially malleable progressive pathological process. The authors reviewed the literature on the association of duration of untreated psychosis with symptom severity at first treatment contact and with treatment outcomes and conducted a meta-analysis examining these relationships. METHOD: English-language articles on duration of untreated psychosis published in peer-reviewed journals through July 2004 were reviewed. Studies that quantitatively assessed the duration of untreated psychosis; identified study subjects who met the criteria for nonaffective psychotic disorders at or close to first treatment; employed cross-sectional analyses of duration of untreated psychosis and of baseline symptoms, neurocognition, brain morphology, or functional measures or prospectively analyzed symptom change, response, or relapse; assessed psychopathology with clinician-rated instruments; and reported subjects' diagnoses (a total of 43 publications from 28 sites) were included in the meta-analysis. RESULTS: Shorter duration of untreated psychosis was associated with greater response to antipsychotic treatment, as measured by severity of global psychopathology, positive symptoms, negative symptoms, and functional outcomes. At the time of treatment initiation, duration of initially untreated psychosis was associated with the severity of negative symptoms but not with the severity of positive symptoms, general psychopathology, or neurocognitive function. CONCLUSIONS: Duration of untreated psychosis may be a potentially modifiable prognostic factor. Understanding the mechanism by which duration of untreated psychosis influences prognosis may lead to better understanding of the pathophysiology of schizophrenia and to improved treatment strategies.

Antipsychotic Agents↗
PubMed2001

Self-representations and socioemotional competence in young children: a 3-year longitudinal study.

In a longitudinal study, the connections between children's self-representations at age 5 and their self-perceptions, socioemotional competence according to the teacher, and peer acceptance at age 8 were examined. The sample consisted of 60 children (33 boys, 27 girls). Self-representations at age 5 were assessed by the Puppet Interview (J. Cassidy, 1988). Results generally revealed the expected connections between the positiveness of self at age 5 and self-perceptions and socioemotional functioning 3 years later. These findings support the predictive validity of the Puppet Interview. Moreover, they suggest that young children do possess at least a rudimentary sense of being generally worthy and lovable, which can be assessed by using adequate, age-appropriate interviews.

Age Factors↗
PubMed1998

Behavioral outcomes among children of alcoholics during the early and middle childhood years: familial subtype variations.

This study examined early behavioral outcomes among young children of alcoholics (COAs) as a function of differences in subtype of paternal alcoholism. Participants were 212 children (106 girls and 106 boys, ages 3 through 8) and both of their biological parents. Families were characterized as antisocial alcoholics, nonantisocial alcoholics, and nonalcoholic controls. There were significant familial subtype group differences on parent report measures of children's total behavior problems, externalizing behavior, and internalizing behavior, and on measures of children's intellectual functioning and academic achievement. In all instances, COAs had poorer functioning than controls. In the behavior problem domain, but not for the domain of intellectual functioning, children from antisocial alcoholic families had greater problems than children from nonantisocial alcoholic families. In addition to the subtype effects, boys had higher levels of behavior problems than girls in all three areas, and older children had more internalizing problems than younger children. Maternal functioning pertaining to lifetime alcohol problem involvement and antisocial behavior also contributed to child subtype differences in internalizing behavior. Results indicate that, even at very early ages, male and female COAs are heterogeneous populations that are distinguishable by way of familial subtype membership, as well as distinguishable from their non-COA peers. Thus, findings underscore the need to consider the heterogeneity of alcoholism when looking at its effects on child development.

Alcoholism↗
PubMed1999

Cognitive status, language attainment, and prereading skills of 6-year-old very preterm children and their peers: the Bavarian Longitudinal Study.

The prevalence of intellectual-, language-, and prereading-skill deficits was investigated in a geographically defined whole-population sample of very preterm children at 6 years of age in southern Germany. The sample consisted of the following: 264 very preterm children (75.6% of German-speaking survivors); 264 term controls (matched for sex, socioeconomic status [SES], marital status and age of mother); and a representative normative sample for Bavaria (N=311). Compared with term peers, very preterm children scored significantly lower (approximately -1SD) on the measures of cognitive and language skills and had major cognitive deficits (<-2 SD) 10 to 35 times more often than the controls. Deficits in speech articulation and prereading skills (<l0th centile) were three to five times more frequent in very preterm children. More than 18% of very preterm children had cognitive deficits in more than five areas of functioning, compared with no control children. The differences between very preterm children and controls remained highly significant when only very preterm children (N= 229) and controls (N= 261) without major neurosensory impairment were considered. Little evidence for specific cognitive deficits was found once mental processing measured in the Kaufman Assessment Battery for Children (K-ABC) was controlled for. The effect of preterm birth on cognitive abilities was found to be larger than the influence of SES. In conclusion, there was a high prevalence of long-term multiple cognitive problems in very preterm children. These persistent cognitive problems appear to be of pre- or neonatal (treatment) rather than postnatal social origin.

Aptitude Tests↗
PubMed2004

Hospital accreditation and the surgeon: the Canadian experience.

Accreditation is an internationally recognised process through which healthcare organisations are able to improve the safety and quality of services delivered to patients. The focus of accreditation is to help organisations understand what they are doing well and what opportunities are available for improvement. The Canadian approach to accreditation is a rigorous peer review process comprised of a self-assessment against a set of standards, an on-site survey and follow-up action on recommendations that arise from the survey. The accreditation standards can be used effectively to guide the surgical teams in the transformation of the specialty. The 17 standards that are used to evaluate surgical teams relate to the activities that represent the continuum of clinical care as well as aspects related to learning. Within the subsections and standards are opportunities for surgeons and surgical teams to use the standards to effectively deliver services and to continuously improve patient care. In 38 recent Canadian Accreditation AIM surveys, that included at least one surgical team, there were a total of 75 recommendations made to the teams. Most recommendations related to process as opposed to outcome issues, implying that surgeons need to become more proactive in the functioning of the surgical team and to participate more effectively in management issues related to surgical care. Attention to these details will position surgical programmes to effectively deal with the rapid pace of change that is inherent in a modern surgical practice.

Accreditation↗
PubMed1998

A problem-solving approach to nutrition education with Filipino mothers.

The study examined Filipino mothers' problem solving on issues related to child feeding, using a dyadic, peer-help approach. The participants were mothers of children under 6 yr of age from a village in the southern Philippines, where malnutrition among children is prevalent. Mothers were paired with a mutual friend (each nominated the other as a best friend) or a unilateral friend (only one nominated the other as a best friend) to discuss a feeding problem to which they initially gave similar solutions (agreed) and one to which they gave different solutions (disagreed). In the final step, they were asked to give privately the solutions they considered best for the problem. The number and quality of these final-step solutions were analyzed as a function of the friend relation, the level of initial agreement with their friend partner, and the source of the solution. Results indicated that the quantity and quality of solutions increased from before to after the dyadic discussion, especially among mothers paired with a mutual friend with whom they agreed. Most of their final-step solutions came from ones they themselves had generated during the discussion, not ones their friend partner had proposed. There was also evidence that high quality solutions were generated by mothers paired with a disagreeing unilateral friend. Implications for nutrition education concern the benefits of a peer-help, dyadic problem-solving approach, taking into account the role of a friend in facilitating a mother's production of new solutions to child feeding problems. The procedure may be used by health promoters who want to build capacities and self-reliance through collective problem solving.

Adult↗
PubMed2002

Lack of contribution of mitochondrial electron transport to acute O(2) sensing in model airway chemoreceptors.

We have recently reported that the model airway chemoreceptors, H146 cells, exhibit a significant component of their oxygen-sensing transduction pathway which cannot be explained by activity of NADPH oxidase. Using patch-clamp, we have studied the transduction system linking reduced O(2) to k(+) channel inhibition and report that, in complete contrast to recent suggestions in pulmonary vasculature, O(2) sensing by the model airway chemoreceptors, H146 cells, does not require functional mitochondria. These data show, for the first time, that mitochondrial production of reactive O(2) species is not the unifying mechanism in O(2) sensing.

Antimycin A↗
PubMed1996

Nitric oxide in ischaemic acute renal failure of streptozotocin diabetic rats.

Changes in nitric oxide (NO) levels were determined in ischaemic acute renal failure in streptozotocin-induced diabetes mellitus rats. Two weeks after streptozotocin administration and immediately after right nephrectomy, the left renal artery was occluded for 60 min. Similar procedures were carried out in non-diabetic rats. The nitrite (NO2) + nitrate (NO3) levels were measured in plasma and urine. The effects of chronic oral supplementation with L-arginine and an NO synthase inhibitor (N-omega-nitro-L-arginine) were also studied in both diabetic and non-diabetic rats before and after renal artery clamping. The rats with diabetic acute renal failure had a much lower creatinine clearance (90 +/- 22 microliters.min-1. 100g body weight-1, p < 0.005), and higher fractional excretion of sodium (FENa)% (10.90 +/- 4.2, p < 0.001) and protein excretion (2078 +/- 69 micrograms/ml creatinine clearance, p < 0.001) compared with the respective values in the non-diabetic groups (163 +/- 30; 1.46 +/- 86; 453.3 +/- 31). The plasma and urine NO2 + NO3 levels were significantly higher in the untreated diabetic rats compared with the untreated normal rats before ischaemia (p < 0.001). The ischaemic acute renal failure in non-diabetic rats increased the plasma and urinary NO2 + NO3 excretion after ischaemia. The urinary excretion of these metabolites decreased significantly and their plasma levels remained unchanged in the ischaemic diabetic rats. The L-arginine administration resulted in a small but significantly higher creatinine clearance after clamping in the non-diabetic rats. The NO synthase inhibitor caused deterioration in renal function in all ischaemic and non-ischaemic groups. In summary, the greater vulnerability to ischaemia of the diabetic kidney seems to be associated with both impaired response to and impaired production of NO.

Acute Kidney Injury↗
PubMed1982

Increased urinary excretion of total 16 alpha-hydroxypregnenolone in newborn infants with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

Urinary excretion of total 16 alpha-hydroxypregnenolone (16 alpha-OH-P'O), pregnanetriol (PT), and 11-oxopregnanetriol (11-O-PT) were determined by capillary gas chromatography in 32 healthy neonates and three newborn infants with congenital adrenal hyperplasia (CAH) during the first 4 weeks of life. In the 2nd and 3rd week of life, only the 16 alpha-OH-P'O excretion was pathognomonically elevated in infants with 21-hydroxylase deficiency. The values amounted to 1023, 1611 (age 1--2 weeks), and 2955 micrograms/day (3 weeks of life) compared to much lower levels in healthy peers (2nd week: mean 243, range 0--520 micrograms/day; 3rd week; mean 515, range 66--1541 micrograms/day).

17-alpha-Hydroxypregnenolone↗
PubMed2026

Plasmodium thiamine pyrophosphokinase is essential for sporozoite formation and activation of an antiplasmodial thiamine analogue.

Oxythiamine, a thiamine analogue, inhibits Plasmodium falciparum proliferation by acting as an antimetabolite of vitamin B1. To elucidate in more detail its underlying mechanism of action, in vitro drug pressure was employed to generate oxythiamine-resistant P. falciparum lines. Whole-genome sequencing revealed that resistance was conferred by a single-point mutation in the thiamine pyrophosphokinase (TPK) gene. The mutated TPK has reduced activity, thereby likely limiting the conversion of oxythiamine into its active toxic form. To investigate the functional role of TPK across the parasite life cycle, a TPK-knockout line was generated in Plasmodium berghei. TPK-knockout parasites displayed a minor fitness cost during intraerythrocytic proliferation that could be overcome by infecting reticulocytes, but their sensitivity to oxythiamine was reduced fivefold in vivo, consistent with the hypothesis that activation of oxythiamine via TPK is essential for its antiplasmodial activity. In the Anopheles vector, TPK-knockout parasites produced a similar number of oocysts as wild-type parasites, but oocyst maturation was impaired and sporozoite formation was completely inhibited. These findings underscore an essential role for TPK in mediating the antiplasmodial activity of oxythiamine and reveal its critical function in sporogony within the mosquito, supporting its potential as a transmission-blocking target for antimalarial intervention.

Animals↗
PubMed2003

STRING: a database of predicted functional associations between proteins.

Functional links between proteins can often be inferred from genomic associations between the genes that encode them: groups of genes that are required for the same function tend to show similar species coverage, are often located in close proximity on the genome (in prokaryotes), and tend to be involved in gene-fusion events. The database STRING is a precomputed global resource for the exploration and analysis of these associations. Since the three types of evidence differ conceptually, and the number of predicted interactions is very large, it is essential to be able to assess and compare the significance of individual predictions. Thus, STRING contains a unique scoring-framework based on benchmarks of the different types of associations against a common reference set, integrated in a single confidence score per prediction. The graphical representation of the network of inferred, weighted protein interactions provides a high-level view of functional linkage, facilitating the analysis of modularity in biological processes. STRING is updated continuously, and currently contains 261 033 orthologs in 89 fully sequenced genomes. The database predicts functional interactions at an expected level of accuracy of at least 80% for more than half of the genes; it is online at http://www.bork.embl-heidelberg.de/STRING/.

Algorithms↗
PubMed1977

Use of a crisis committee in a therapeutic community.

Described is the use of a patient crisis committee in an adult therapeutic community. The crisis committee is a function of the patient government and is called into action in situations formerly handled by physicians or nurses. This method appears to be highly successful in the therapeutic community described.

Humans↗
PubMed1996

Skeletal muscle microvascular and tissue injury after varying durations of ischemia.

The purpose of this study was to examine the effect of varying durations of ischemia on several microvascular parameters in the awake hamster chamber model. The goal was to characterize the microvascular damage that occurs in skeletal muscle as a result of ischemia and reperfusion. The chamber tissues were subjected to 1-5 h of ischemia, and then the following parameters were measured: vessel diameter, endothelial thickness, macromolecular leakage, red blood cell velocity, adherent leukocytes, rolling leukocytes, freely flowing leukocytes, functional capillary density, and propidium iodide-positive cell nuclei. In control animals there was no significant difference in any parameters over the entire observation period. After 1 or 2 h of ischemia an increase in rolling and adherent leukocytes was measured. After 3 h of ischemia there was a significant increase in the mean endothelial thickness and in the number of nonviable cells. After 4 h of ischemia a significant difference in the extent of macromolecular leakage and the functional capillary density was additionally observed. After 5 h of ischemia this damage was more pronounced and often so severe that approximately 50% of the vessels demonstrated no reflow.

Animals↗
PubMed2001

Levels of interpersonal concerns and social functioning in early adolescent boys and girls.

Previous research has shown that the Interpersonal Concerns factor of the Depressive Experiences Questionnaire (DEQ; Blatt, D'Affliti, & Quinlan, 1976, 1979; Depressive Experiences Questionnaire for Adolescent [DEQ-A]; Blatt, Schaffer, Bers, & Quinlan, 1992) assesses 2 levels of interpersonal relatedness in young adults and older adolescents: neediness and relatedness. However, studies investigating the relation of the DEQ and DEQ-A with social functioning have not used the Neediness and Relatedness subscales of the Interpersonal Concerns factor. This study investigated (a) whether the Neediness and Relatedness subscales can be differentiated in a sample of early adolescents and (b) how the 2 subscales are differentially associated with indexes of social functioning. Results indicate that this differentiation of Neediness and Relatedness, and their associations with social functioning, emerges in early adolescence, especially for girls.

Adolescent↗