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PubMedDate not supplied

Fecundity of daughters born after short, intermediate, or long birth intervals. An analysis of family reconstitutions from The Netherlands, late 19th-early 20th century.

In an historical cohort study, we compared the reproductive performances of women born after short (< 14 completed months), intermediate (21-32 completed months), and long (> 39 completed months) birth intervals. Of the initial study base, comprising family reconstitutions of 1,425 women born between 1873 and 1902 in or around Rotterdam (The Netherlands) and married before age 45, a large portion (data of 1,001 women born between 1888 and 1902) was uninformative because of (unintended) selection on birth control behavior. Among the remaining 424 women, those born after very short birth intervals (less than 1 year) showed higher likelihood of childlessness and stillbirth in the offspring than those born after intermediate intervals (adjusted odds ratios (OR) and 95%-confidence intervals: 7.7 [1.8-33.0] and 3.3 [1.3-8.3], respectively). The latter association, however, nearly disappeared after restriction to women whose preceding sibling lived at least 1 year. Women born after modestly short intervals (12-13 months) exhibited longer interpregnancy intervals. So did women born after long birth intervals, but this might well be attributable to intergenerational transmission of reproductive behavior. These results indicate that fecundability is reduced in women born after short birth intervals.

Adult↗
PubMed2005

Substance use disorders and Cluster B personality disorders: physiological, cognitive, and environmental correlates in a college sample.

Substance use disorders (SUDs) and Cluster B personality disorders (PDs) are both marked by impulsivity and poor behavioral control and may result in part from shared neurobiological or executive cognitive functioning deficits. To examine the potential utility of such models in explaining variance in SUDs and PDs at the lower end of symptom expression and impairment, 123 (73 female) volunteer college students were administered 2 measures of executive cognitive functioning; a task assessing autonomic reactivity to aversive noise blasts; a life events and a peer substance use measure; and structured clinical interviews to assess symptoms of substance abuse/dependence and antisocial, borderline, histrionic, and narcissistic PDs. As expected, symptoms of SUDs and PDs were significantly positively correlated. Antisocial PD, alcohol and cannabis use disorder symptoms were significantly positively related to proportion of friends who use alcohol and drugs regularly and drug use among romantic partners. Number of negative life events was positively related to PD symptoms and to alcohol use disorder symptoms. Executive cognitive functioning was not related to SUD and PD symptoms in the expected direction. Findings suggest that, among higher functioning young adults, environmental factors may be particularly relevant to our understanding of SUDs and certain PDs.

Adult↗
PubMed1998

How best to measure implementation of school health curricula: a comparison of three measures.

The impact of school health education programs is often attenuated by inadequate teacher implementation. Using data from a school-based nutrition education program delivered in a sample of fifth graders, this study examines the discriminant and predictive validity of three measures of curriculum implementation: class-room observation of fidelity, and two measures of completeness, teacher self-report questionnaire and post-implementation interview. A fourth measure, obtained during teacher observations, that assessed student and teacher interaction and student receptivity to the curriculum (labeled Rapport) was also obtained. Predictive validity was determined by examining the association of implementation measures with three study outcomes; health knowledge, asking behaviors related to fruit and vegetables, and fruit and vegetable intake, assessed by 7-day diary. Of the 37 teachers observed, 21 were observed for two sessions and 16 were observed once. Implementation measures were moderately correlated, an indication of discriminant validity. Predictive validity analyses indicated that the observed fidelity, Rapport and interview measures were significantly correlated with post-test student knowledge. The association between health knowledge and observed fidelity (based on dual observation only), Rapport and interview measures remained significant after adjustment for pre-test knowledge values. None of the implementation variables were significantly associated with student fruit and vegetable intake or asking behaviors controlling for pre-test values. These results indicate that the teacher self-report questionnaire was not a valid measure of implementation completeness in this study. Post-implementation completeness interviews and dual observations of fidelity and Rapport appear to be more valid, and largely independent methods of implementation assessment.

Child↗
PubMed2001

Observational assessment of family functioning at mealtime in preschool children with cystic fibrosis.

OBJECTIVE: To examine functioning during a dinner meal in families of a child with a chronic illness that requires dietary treatment recommendations, as compared to families of a child without a chronic illness. METHODS: Ratings of seven dimensions of family functioning on the McMaster Mealtime Family Interaction Coding System (MICS) were obtained on 29 families of children with CF and 29 families of children with no chronic illness, ages 2 to 6 years, during a videotaped dinner meal at home. RESULTS: Ratings of families with a child with CF were significantly lower than those for families of children without a chronic illness on Overall Family Functioning and five of the six MICS dimensions: Communication, Interpersonal Involvement, Affect Management, Behavior Control, and Role Allocation and approached significance on the Task Accomplishment dimension. The ratings of families of a child with CF were in the "clinically significant" range on all subcales, including Task ACCOMPLISHMENT. CONCLUSIONS: This study suggests that family functioning at mealtimes may be different in families of children with CF in which explicit dietary guidelines exist than in families of children with no illness or dietary guidelines. These results are discussed in terms of global family functioning and treatment approaches to dietary treatment recommendations.

Child, Preschool↗
PubMed1995

Reevaluation of the mesolimbic hypothesis of antipsychotic drug action.

Conventional neuroleptic drugs are thought to derive their antipsychotic efficacy through influences on the mesolimbic dopamine (DA) system. In contrast, motor side effects of these drugs are suggested to follow from influences on the nigrostriatal DA system. This conceptualization is based on the assumption that behaviors mediated by the mesolimbic DA system are involved in schizophrenia while behaviors controlled by the nigrostriatal system are not. In this article, it is argued that although assumptions about mesolimbic activities may indeed be correct, those concerning the nigrostriatal system certainly are not. This being the case, drugs with mesolimbic-specific activity may not have significant antipsychotic potency and probably will not be free of motor side effects. The current thrust of neuropharmacology, which emphasizes development of drugs with pharmacological specificity rather than anatomical selectivity, is more likely to generate new antipsychotic agents with a reduced risk of motor side effects.

Antipsychotic Agents↗
PubMed2003

Dramatic expansion of germinal stem cells by ectopically expressed human glial cell line-derived neurotrophic factor in mouse Sertoli cells.

Although the mammalian germinal stem cell (GSC) provides a good model to investigate the regulation of stem cells, the small number of these cells currently available hampers elucidation of the regulatory mechanism. Here, we show the dramatic amplification of GSCs in mouse testis following transfection of human glial cell line-derived neurotrophic factor cDNA into Sertoli cells using an efficient, in vivo electroporation technique. Transplantation analysis demonstrated not only GSC enrichment but also differentiation from stem cells into sperm. The GSC population, as estimated using a colony-formation assay, was approximately 20-fold greater than in cryptorchid testis, or approximately 500- to 1000-fold greater than in normal adult testis. This system should provide sufficient quantities of GSCs to accelerate our understanding of GSC properties, regulation mechanisms, and behavior control.

Animals↗
PubMed2006

3-Hydroxymorphinan, a metabolite of dextromethorphan, protects nigrostriatal pathway against MPTP-elicited damage both in vivo and in vitro.

We investigated the neuroprotective property of analogs of dextromethorphan (DM) in lipopolysaccharide (LPS) and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) models to identify neuroprotective drugs for Parkinson's disease (PD). In vivo studies showed that daily injections with DM analogs protected dopamine (DA) neurons in substantia nigra pars compacta and restored DA levels in striatum using two different models for PD. Of the five analogs studied, 3-hydroxymorphinan (3-HM), a metabolite of DM, was the most potent, and restored DA neuronal loss and DA depletion up to 90% of the controls. Behavioral studies showed an excellent correlation between potency for preventing toxin-induced decrease in motor activities and neuroprotective effects among the DM analogs studied, of which 3-HM was the most potent in attenuating behavioral damage. In vitro studies revealed two glia-dependent mechanisms for the neuroprotection by 3-HM. First, astroglia mediated the 3-HM-induced neurotrophic effect by increasing the gene expression of neurotrophic factors, which was associated with the increased acetylation of histone H3. Second, microglia participated in 3-HM-mediated neuroprotection by reducing MPTP-elicited reactive microgliosis as evidenced by the decreased production of reactive oxygen species. In summary, we show the potent neuroprotection by 3-HM in LPS and MPTP PD models investigated. With its high efficacy and low toxicity, 3-HM may be a novel therapy for PD.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1995

Preventing perioperative transmission of infection: a survey of anesthesiology practice.

Given the societal and economic impact of perioperative infection, it is essential that anesthesiologists and other operating room personnel use appropriate precautions to reduce the potential for transmission of infectious agents to the patients under their care. This study, therefore, was designed to evaluate the degree to which anesthesiologists utilize appropriate hygienic techniques for the prevention of infection in the perioperative period. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the membership of the American Society of Anesthesiologists (ASA). Of these, 493 (44%) were completed and returned. Forty-nine percent and 75.3% of respondents always used gloves and masks, respectively, in their everyday practice. Only 58% of respondents stated that they always washed their hands after every patient contact and 85% reported that they always used aseptic technique for placing indwelling catheters. Knowledge of universal precautions for prevention of occupational transmission of infection was associated with good hygienic practice. Twenty percent of the respondents reported frequently or always reusing syringes for more than one patient and 34.4% reported never or rarely disinfecting the septum of multidose vials prior to use. The practice of reusing syringes was significantly greater among private than university practitioners (P < 0.01). On a scale of 0-10 (10 = high) anesthesiologists rated their potential for transmitting or contributing to patient potential for transmitting or contributing to patient infection as 4.7 +/- 0.12 (mean +/- SE). Results of this study suggest that, whereas most responding anesthesiologists exhibit appropriate infection control behaviors, there are several potentially hazardous practices that continue.

Anesthesiology↗
PubMed1990

Obsessive compulsive disorder in children and adolescents: phenomenology and family history.

Phenomenology and family history in 21 clinically referred children and adolescents with obsessive compulsive disorder are described. Each child and family participated in a standard clinical psychiatric assessment. The most frequently reported symptoms were repeating rituals, washing, ordering and arranging, checking, and contamination concerns. Controlling behaviors involving other family members were seen in 57% of the patients. Associated psychopathology was common: 38% received an anxiety disorder diagnosis; 29% received a mood disorder diagnosis; tics were observed in 24%. Fifteen (71%) of the children had a parent with either obsessive compulsive disorder (N = 4) or obsessive-compulsive symptoms (N = 11). The clinical and research implications of these findings are discussed.

Adolescent↗
PubMed1993

Communication deficits in children undergoing temporal lobectomy.

OBJECTIVE: To examine formal thought disorder and discourse (cohesive) devices that make speech coherent prospectively in seven children, aged 5.7 to 16.7 years, before and after temporal lobectomy for intractable cut points determined from sensitivity and specificity analyses of formal thought disorder and discourse measures in 22 children with complex partial seizure disorder and 45 normal children. RESULTS: Before surgery, the mean illogical thinking and discourse scores of the surgical candidates were in the pathological range. After a mean postoperative follow-up period of 15.1 months, their illogical thinking (but not their discourse scores) decreased significantly to the normal range. CONCLUSIONS: These preliminary findings are discussed in terms of the possible role of postsurgical changes in seizure control, behavior, antiepileptic drugs, cognition, and prefrontal function.

Adolescent↗
PubMed1993

The Kids' Eating Disorders Survey (KEDS): a study of middle school students.

OBJECTIVE: Anorexia nervosa and bulimia nervosa are known to occur in children although prevalence studies are lacking. METHOD: Using a newly developed self-report instrument, the Kids' Eating Disorders Survey (KEDS), 3,175 students (1,610 females, 1,565 males) enrolled in grades 5 to 8 were surveyed. RESULTS: More than 40% of respondents reported feeling fat and/or the wish to lose weight. These frequencies of weight control behaviors were reported, many of which were significantly greater in girls than boys (*p < 0.05, chi-square): dieting (31.4%*), fasting (8.7%*), diet pill use (2.4%*), vomiting (4.8%), diuretic use (1.5%). The effects of age, grade, weight, and race on responses are reviewed. CONCLUSIONS: Findings demonstrate that development of prevention programs aimed at recognizing problem eating behavior in children is indicated.

Anorexia Nervosa↗
PubMedDate not supplied

Family factors related to alexithymia characteristics.

There is little empirical research on the familial and parental correlates of alexithymia. A two-part study explored how the affective and cognitive characteristics of alexithymia are related to family dysfunction and maternal alexithymia. In Part I, 127 young adults were evaluated for alexithymia with the Toronto Alexithymia Scale-20 (TAS-20), for impaired imagination with the Scored Archetypal Test with Nine Elements, and for family dysfunction with the McMaster Family Assessment Device. In Part II, 80 of their mothers completed the TAS-20 about themselves, and maternal alexithymia characteristics were correlated with those of their offspring. In Part I, general family pathology was associated with alexithymia. In particular, difficulty identifying feelings was related to dysfunctional family affective involvement, externally oriented thinking was related to deficient family behavior control, and impaired imagination was related to inadequate family problem solving; these relationships were independent of general family pathology and subjects' positive and negative affect. In Part II, maternal alexithymia characteristics were correlated significantly with the offsprings', controlling for both respondents' positive and negative affect. These findings implicate disturbed family functioning and maternal alexithymia in the development of alexithymia characteristics in children.

Adolescent↗
PubMedDate not supplied

University students' intention to seek medical care promptly if symptoms of sexually transmitted diseases were suspected.

The aim of this study was to identify the factors explaining intention to seek medical care promptly if STD symptoms were suspected. A random sample of 1617 undergraduate students completed a questionnaire assessing intention, attitude, perceived norm among friends, perceived behavioral control, and risk of disease, along with different socio-demographic variables. The regression of intention on all variables yielded an adjusted R2 of 0.32 (P < 0.0001). The factors explaining this variance were the perceived advantages, easiness, and social norm among friends regarding seeking medical care promptly, age, and gender. Perception of risk to delay seeking medical care and perceived personal risk of getting STDs were not significant variables. Overall, the results indicate the need to develop programs for male first-year students. These programs will have to influence the attitude, that is, the perceived advantages of seeking medical care promptly if STD symptoms are suspected. Seeking advice from students' friends, and perception of these friends as a significant reference source if STD symptoms are suspected, should also be promoted.

Adolescent↗
PubMed1996

Effect of multiple discrimination reversals on acquisition of a drug discrimination task in rats.

There are many similarities between exteroceptive stimuli and interoceptive stimuli. Nevertheless, it has been suggested that behavior maintained by drug stimuli might be more difficult to reverse than behavior controlled by exteroceptive stimuli. Once a discrimination is established with an exteroceptive stimulus, it can be reversed by switching the reinforcement contingencies, and repeated reversals result in progressively faster relearning of the discrimination. To determine whether faster relearning of successive discrimination reversals also occurs when the discrimination is controlled by an internal drug stimulus, we trained rats to discriminate 3.2mg/kg phencyclidine-(PCP) from saline, in a two-lever food-reinforced operant task. After this discrimination was acquired, the reinforcement contingencies were reversed. A number of such discrimination reversals were performed to determine whether fewer trials would be needed to reach criterion performance with each reversal. Each time the reinforcement contingencies were switched, fewer training sessions were required for the subjects to reach criterion. These results are similar to those observed when a discrimination has been established with exteroceptive stimuli. The present study provides further evidence of the similarity between interoceptive drug stimuli and exteroceptive sensory stimuli.

Journal Article↗
PubMed1997

Assessment of the multiple discriminative stimulus effects of ethanol using an ethanol-pentobarbital-water discrimination in rats.

Previous drug discrimination studies have elucidated the importance of gamma-aminobutyric acidA (GABAA), N-methyl-D-aspartate (NMDA) glutamate, and serotonin (5-HT) receptor systems in mediating the discriminative stimulus effects of ethanol. The present study used a three-choice operant drug discrimination procedure in an attempt to determine if salient GABAergic effects could be separated from other stimulus effects of 2.0 g/kg ethanol. Adult male Long-Evans rats (n = 7) were trained to discriminate pentobarbital (10.0 mg/kg; intragastrically (i.g.) from ethanol (2.0 g/kg; i.g.) from water (4.7 ml; i.g.) using food reinforcement. Stimulus substitution tests were conducted following the administration of allopregnanolone (1.0-17.0 mg/kg; intraperitoneally (i.p.)), diazepam (0.1-7.3 mg/kg; i.p.), midazolam (0.0056-17.0 mg/kg; i.p.), dizocilpine (0.01-0.56 mg/kg; i.p.), phencyclidine (1.0-5.6 mg/kg; i.p.), CGS 12066B (3-30 mg/kg; i.p.), RU 24969 (0.1-5.6 mg/kg; i.p.) and morphine (1 or 3.0 mg/kg; i.p.). Within the group, allopregnanolone and midazolam completely substituted (> 80%), and diazepam partly substituted (67%) for the discriminative stimulus effects of pentobarbital. Dizocilpine and phencyclidine partly substituted (58 and 57%, respectively) for ethanol without substantial pentobarbital-appropriate responding. RU 24969, CGS 12066B and morphine did not result in complete substitution for either ethanol or pentobarbital, although RU 24969 resulted in partial (68%) pentobarbital substitution. The ability to train the present three-choice discrimination in rats indicates that the discriminative stimulus effects of 10.0 mg/kg pentobarbital were separable from those of 2.0 g/kg ethanol. The results suggest that the pharmacological effects of ethanol, which can control behavior, may seemingly be modified by training conditions (two-versus three-choice discrimination procedures), to the extent that a receptor system prominently linked to the behavioral activity of ethanol (i.e. GABAA) appears no longer to be involved in the interoceptive effects of the drug.

Animals↗
PubMed2007

Association between exposure to childhood and lifetime traumatic events and lifetime pathological gambling in a twin cohort.

The present study seeks to estimate the strength of the association between exposure to lifetime traumatic events and gambling problems while accounting for the potential contribution of psychiatric disorders, genetic factors, and family environmental influences. In 2002, structured diagnostic interviews were conducted with 1675 male twins to obtain data on exposure to traumatic events and pathological gambling. Multinomial regression tested for associations between each traumatic event and three levels of problem gambling (1-2 symptoms, at risk; 3-4 symptoms, problem gambling, and 5 or more symptoms, pathological gambling). Analyses of data from twin pairs discordant for gambling behavior controlled for genetic and family environmental factors. After adjustment for covariates, child abuse (relative risk [RR]=2.31), child neglect (RR=5.53), witnessing someone badly hurt or killed (RR=2.83), and physical attack (RR=3.39) were associated with pathological gambling. Genetic and family environmental factors significantly contributed to the association between exposure to traumatic events and one or more symptoms of problem gambling. Exposure to childhood and lifetime traumatic events are significantly associated with problem and pathological gambling. These associations are partially accounted for by psychiatric covariates and genetic and family environmental factors.

Child↗
PubMed2006

Restraint use for psychiatric patients in the pediatric emergency department.

BACKGROUND: Restraint of children and adolescents with psychiatric problems has generated controversy. Restraint may be defined as methods used to restrict movement or normal access to one's body. Published data to guide restraint practice are limited. OBJECTIVE: To examine frequency of restraint use and patient demographics and chief complaints associated with restraint use in our pediatric emergency department. METHODS: We retrospectively reviewed the pediatric emergency department records of children (age <18 years) who underwent emergency psychiatric evaluation in an urban general hospital from January 2001 to December 2002. Factors associated with restraint use were determined using multivariate logistic regression. RESULTS: Data were available for 1125 (82%) of 1371 patients who underwent emergency psychiatric evaluation; 76 (6.8%) of 1125 patients were restrained: 37 physical, 19 with medication, and 20 both. Study patients were mean age 13.1 years, 50% girls, 54% blacks, 19% Latinos, and 18% whites; 80% had public insurance. Boys were restrained more often than girls (8.7% vs. 5.2%, P = 0.02). Age, insurance, and race were not associated with restraint use. Patients admitted for inpatient psychiatric care were restrained more frequently than those discharged home (9.9% vs. 3.9%, P < 0.001). In multivariate logistic regression, sex was not associated with restraint use. Restraint use was associated with chief complaints of visual hallucinations (odds ratio, 5.29), out-of-control behavior (odds ratio, 4.65), hyperactivity (odds ratio, 2.26), and admission to a psychiatric facility (odds ratio, 2.40). CONCLUSIONS: Approximately 1 in 15 children undergoing psychiatric evaluation were restrained. This is the first study to elucidate correlates of restraint practice in the pediatric emergency department. Further studies examining indications for restraint and comparing methods of restraint are needed.

Adolescent↗