What matters,and what matters most,for change in life satisfaction in the oldest-old? A study over 6 years among individuals 80+

Objectives: The study investigates whether markers of life satisfaction identified in a cross-sectional study–quality of social network, self-rated health, depressive symptoms, locus of control and widowhood, in addition to financial satisfaction and the personality traits of extraversion and neuroticism–predict change in life satisfaction (LSI-Z) across four measurement occasions during a 6-year period in individuals aged 80+.

Method: Data were drawn from the Swedish OCTO-Twin-study of individuals aged 80 and older.

Results: Growth curve analysis showed a relatively consistent significant linear decline in life satisfaction, but certain markers predicted change in life satisfaction. The loss of spouse, in particular in men, and higher levels of depressive symptoms were related to lower levels of life satisfaction over time.

Conclusion: The results from the study question the notion of a life-long stability of life satisfaction.     

Successful strategy to improve the specificity of electronic statin–drug interaction alerts

Purpose  

A considerable weakness of current clinical decision support systems managing drug–drug interactions (DDI) is the high incidence of inappropriate alerts. Because DDI-induced, dose-dependent adverse events can be prevented by dosage adjustment, corresponding DDI alerts should only be issued if dosages exceed safe limits. We have designed a logical framework for a DDI alert-system that considers prescribed dosage and retrospectively evaluates the impact on the frequency of statin–drug interaction alerts.     

Validation of a resolution-independent method for the quantification of 123I-FP-CIT SPECT scans

OBJECTIVE: To verify the applicability of a recently described resolution-independent method for the semi-quantification of 123I-FP-CIT scans. METHODS: Visual interpretation, 'conventional' and resolution-independent semi-quantification was performed on 60 123I-FP-CIT scans. Using ROC analysis, the results were compared to the final clinical diagnosis after a follow-up of at least 18 months. Sensitivity and specificity values were calculated and a cut-off value of the specific binding, which differentiated between normal and abnormal scans with high sensitivity and specificity, was given. RESULTS: Application of the resolution-independent method to a new set of 123I-FP-CIT SPECT data yielded a cut-off value of the specific striatal binding of 55 ml. Corresponding values of sensitivity and specificity were 95% and 72%, respectively. Further, based on the values of the area under the ROC curve and the 95% confidence interval of different semi-quantitative methods, the resolution-independent semi-quantification agreed best with the final clinical diagnosis. CONCLUSION: We found a similar value of the specific 123I-FP-CIT binding as the one previously described in the literature, which proved the validity of the resolution-independent method. Further, this method, among other 'conventional' semi-quantitative methods, agreed best with the final clinical diagnosis. For this reason we recommend its use to aid in the diagnostic process.     

Human papillomavirus 16 E6 variants differ in their dysregulation of human keratinocyte differentiation and apoptosis

L83V-related variants of human papillomavirus (HPV) 16 E6, exemplified by the Asian-American variant Q14H/H78Y/L83V, were shown to be more prevalent than E6 prototype in progressing lesions and cervical cancer. We evaluated functions relevant to carcinogenesis for the E6 variants L83V, R10/L83V and Q14H/H78Y/L83V as well as the prototype in a model of human normal immortalized keratinocytes (NIKS). All E6 expressing NIKS equally abrogated growth arrest and DNA damage responses. Organotypic cultures derived from these keratinocytes demonstrated hyperplasia and aberrantly expressed keratin 5 in the suprabasal compartment. In contrast, differentiation and induction of apoptosis varied. The E6 variant rafts expressed keratin 10 in nearly all suprabasal cells while the prototype raft showed keratin 10 staining in a subset of suprabasal cells only. In addition, E6 variant NIKS expressing R10G/L83V and Q14H/H78Y/L83V were more prone to undergo cell-detachment-induced apoptosis (anoikis) than NIKS expressing E6 prototype. The combined differentiation and apoptosis pattern of high-risk E6 variants, especially of Q14H/H78Y/L83V, may reflect a phenotype beneficial to carcinogenesis and viral life cycle.     

Childrearing Style in Families of Anxiety-Disordered Children: Between-Family and Within-Family Differences

This study examined whether (1) parents of anxiety-disordered (AD) children differed from those of non-clinical controls in their childrearing style, and whether (2) the child-rearing style of parents towards AD children is different from that towards their siblings. A clinical sample of 25 AD children, age range 8–13 years, was compared with 25 siblings and a non-clinical control group (n = 25). Childrearing was assessed by means of parental self-report, child report and through an expressed emotion interview measure. AD children perceived more parental rejection than non-clinical control children or the AD children’s siblings. High-expressed emotion was scored significantly more often towards AD children than non-clinical control children, or their siblings. On ‘care’ and ‘control’ parental self-report showed some differences regarding AD children on the one hand and non-clinical control children or siblings of AD children on the other. These results suggest that the rearing of AD children differs significantly both from the rearing of their siblings and that of non-clinical control children. I. E. Lindhout and F. Boer were with the Academic Centre for Child and Adolescent Psychiatry Curium, Oegstgeest, and Leiden University Medical Centre, Leiden, The Netherlands, at the time of the study.     

Early and intensive behavioral intervention for autism: A survey of clinical practices

Early and intensive behavioral intervention (EIBI) has been demonstrated to be a highly effective treatment for early childhood autism. As EIBI programs have proliferated, they have also begun to mutate and evolve such that between-program differences in specific practices are quite common. Unfortunately, the extent of this procedural variability is unknown. The purpose of the present investigation was to begin documenting the specific practices of EIBI programs. A 43-question Internet survey was distributed to professional supervisors of EIBI programs who provided information regarding their program’s characteristics and practices. A total of 211 program supervisors provided information on a number of practices, including curriculum, program size, therapist expertise and training, supervision, data collection, trial interspersal, consequence delivery, prompt fading, skill maintenance, and problem behavior assessment and treatment. The results indicate considerable variation in a number of EIBI practices. The implications of these findings are discussed.