Psychosocial factors and complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study. VIII.

OBJECTIVE--To investigate whether psychosocial factors are associated with diabetic complications. RESEARCH DESIGN AND METHODS--Questionnaires on quality of life, depressive symptomatology, and personality type were completed and a clinical assessment was performed. The study population was an incident cohort of childhood-onset insulin-dependent diabetic (IDDM) subjects whose duration of IDDM was greater than or equal to 25 yr (n = 175). RESULTS--Patients with macrovascular disease (P less than 0.01) or nephropathy (P less than 0.05) reported significantly poorer quality of life compared with those who were free from all complications. Patients with macrovascular disease also reported greater depressive symptomatology (P less than 0.05). Quality of life significantly deteriorated according to the presence of multiple (greater than or equal to 4) complications (P less than 0.001). Higher depression symptom scores were also related to the presence of greater than or equal to 4 complications (P less than 0.001). Those with multiple complications reported less type A behavior than those without any complications (P less than 0.05). CONCLUSIONS--This study shows that psychosocial differences exist according to both the number and the type of diabetic complications present. Because poorer quality of life and symptoms of depression may both result form complications, prospective follow-up is needed to clarify their temporal interrelationships, and to determine whether type A personality affords any protection against complications or is diminished as a result of developing complications.     

Structuring the documentation of nursing care on the basis of a theoretical process model

The aim of this study was to develop the documentation of the substance of nursing care on the basis of a theoretical caring process model. The theory is Eriksson's caring process model and her theory of health, suffering and caring. The approach of the research task was dialogue. As a research method Koski's adaptation of Gadamer's theory of hermeneutic experience was used, in which Gadamer's hermeneutic text interpretation is divided into four phases. The phases are the explicit analysis of preunderstanding, hermeneutic dialogue, the merging of horizons and active application. The dialogue is carried on between Eriksson's theory of health, suffering and caring and clinical nursing practice and between the caring process model and nursing practice. The goal is to achieve a new scientific view on which to base the documentation of nursing care. As a result of the dialogue a classification in accordance with Eriksson's caring-process model is presented. In the next phase of the study the classification is piloted in a clinical context. The purpose is to obtain knowledge of whether the suggested classification describes what, according to the theory, it should describe.     

Activity of 9-(1,3-dihydroxy-2-propoxymethyl)guanine compared with that of acyclovir against human, monkey, and rodent cytomegaloviruses.

The activities of the purine acyclic nucleoside 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG) against two human and five animal strains of cytomegalovirus were compared with those of acyclovir. DHPG was significantly more active than acyclovir against all but one (mouse cytomegalovirus) of the strains tested, with 50% effective doses ranging from 5 to 13 microM, as determined by plaque reduction assays in human embryonic lung (MRC-5) and human embryonic tonsil cells. Both DHPG and acyclovir inhibited virus replication at concentrations considerably lower than those necessary to inhibit cell proliferation. In mode-of-action studies, the triphosphates of DHPG and acyclovir inhibited human cytomegalovirus DNA polymerase. DHPG phosphorylation to the active triphosphate was enhanced in infected cells; however, this enzymatic activity was unrelated to thymidine kinase. In animal studies, DHPG was slightly more effective than acyclovir in reducing mouse cytomegalovirus-induced mortality.     

Longitudinal Risk and Protective Factors Associated with Internalizing and Externalizing Symptoms Among Male and Female Adolescents

Using ecological theory and the peer socialization model, the current study identified risk and protective factors associated with internalizing and externalizing symptoms across ecological domains. It was hypothesized that the constellation of risk and protective factors within the peer microsystem would vary by gender: future optimism and negative peer influence were expected to be significant risk/protective factors for males, whereas peer victimization was expected to be significant risk factors among females. Using four waves of data, three-level hierarchical linear models were estimated for males and females. Results revealed that negative peer influence was a particularly salient risk factor for both internalizing and externalizing behaviors among males, although future optimism did not emerge as a significant protective factor. In addition, as hypothesized, peer victimization indicators were significant risk factors for females. Parent–child conflict was also significantly and positively associated with both internalizing and externalizing symptoms for males and females. Implications are discussed.     

Transverse patterning,aging, and neuropsychological correlates in humans

Transverse patterning is a learning and memory adaptation of the ‘rock/paper/scissors’ problem that has been though to depend on the hippocampus, is sensitive to aging, and requires pattern separation to solve. Previous investigators dichotomized cognitively normal older adults who passed a cognitive screening into impaired and unimpaired subsets, and found that impaired older adults were disproportionately deficient in pattern separation abilities. However, this variability in pattern separation ability has not been examined using a transverse patterning task. Our aims, then, were two‐fold: First, to determine if impaired older adults were inferior on transverse patterning compared to unimpaired older adults and young adults; second, to identify the neuropsychological correlates of transverse patterning. Our findings revealed that impaired older adults required more trials to criterion on the transverse patterning task than both young adults and unimpaired older adults. Unimpaired older adults also required more trials to criterion than young adults. A detailed analysis of the transverse patterning task confirmed that the aforementioned group differences were only observed in high interference conditions when pattern separation demands were at their peak. Finally, regression analyses showed that both memory and executive functioning neuropsychological composite scores were related to different indices of transverse patterning performance. Consistent with the pattern separation literature, and despite passing a cognitive screening, we found disproportionate transverse patterning deficits in impaired older adults. Forthcoming work should determine if transverse patterning performance is similar between impaired older adults and patients with Mild Cognitive Impairment. © 2016 Wiley Periodicals, Inc.     

A preliminary study of the effects of working memory training on brain function

Working memory (WM) training improves WM ability in Attention-Deficit/Hyperactivity Disorder (ADHD), but its efficacy for non-cognitive ADHD impairments ADHD has been sharply debated. The purpose of this preliminary study was to characterize WM training-related changes in ADHD brain function and see if they were linked to clinical improvement. We examined 18 adolescents diagnosed with DSM-IV Combined-subtype ADHD before and after 25 sessions of WM training using a frequently employed approach (Cogmed?) using a nonverbal Sternberg WM fMRI task, neuropsychological tests, and participant- and parent-reports of ADHD symptom severity and associated functional impairment. Whole brain SPM8 analyses identified ADHD activation deficits compared to 18 non-ADHD control participants, then tested whether impaired ADHD frontoparietal brain activation would increase following WM training. Post hoc tests examined the relationships between neural changes and neurocognitive or clinical improvements. As predicted, WM training increased WM performance, ADHD clinical functioning, and WM-related ADHD brain activity in several frontal, parietal and temporal lobe regions. Increased left inferior frontal sulcus region activity was seen in all Encoding, Maintenance, and Retrieval Sternberg task phases. ADHD symptom severity improvements were most often positively correlated with activation gains in brain regions known to be engaged for WM-related executive processing; improvement of different symptom types had different neural correlates. The responsiveness of both amodal WM frontoparietal circuits and executive process-specific WM brain regions was altered by WM training. The latter might represent a promising, relatively unexplored treatment target for researchers seeking to optimize clinical response in ongoing ADHD WM training development efforts.