Release planning for inmates with mental illness compared with those who have other chronic illnesses

The authors evaluated the effort of New Jersey jails to plan for the postrelease treatment needs of inmates with mental illness compared with inmates with heart disease and HIV infection or AIDS. Seventy percent of interviewees expressed a belief that release planning for persons with serious mental illness is very or extremely important. However, virtually all the jails reported providing "no real release planning." A majority of the jails provide aftercare plans for fewer than 10 percent of inmates with serious mental illness. A lack of release planning was noted for the other chronic conditions. Release planning for particular chronic problems is most common and complete in facilities with special treatment programs, such as a mental health unit.     

Exposure to alcohol in utero: Influence on cognitive function and learning in a northern elementary school population

OBJECTIVES:

To establish the prevalence of fetal alcohol exposure; to compare physical, behavioural and learning patterns of children with significant alcohol exposure in utero with those of a group of children exposed to minimal alcohol; to assess the usefulness of a fetal alcohol syndrome (FAS)/fetal alcohol effect (FAE) score; and to provide feedback to parents, schools and communities.

DESIGN:

Parent questionnaire, complete physical examinations of children, psychometric tests of the children using elements of the Pediatric Early Elementary Examination (PEEX) and the Pediatric Examination of Educational Readiness (PEER), ADD-H comprehensive teachers rating scale (ACTeRS) score, the newly developed FAS/FAE Score, and the Brigance Comprehensive Inventory of Basic Skills to assess language and mathematical achievement. Testers were blinded to the results of the assessments and questionnaires.

SETTING:

Grades 1 to 3 at Sir Alexander MacKenzie School in Inuvik, Northwest Territories.

RESULTS:

Twenty-four per cent of mothers reported frequent or binge drinking, and 76% of mothers reported abstinence or moderate alcohol intake. There were significant ethnic differences; none of the Caucasian mothers reported frequent or binge drinking during pregnancy compared with 40% of Inuvialuit and 33% of Indian mothers. Children with exposure to frequent or binge drinking in utero had smaller palpebral fissures (2.3±0.1 cm versus 2.5±0.3 cm, P<0.01), smaller palpebral fissure to intercanthal distance ratios (0.77±0.05 versus 0.86±0.10, P<0.01) and smaller head circumferences (52.1±1.6 cm versus 53.6±1.6 cm, P<0.01) than those exposed to moderate drinking or abstinence. Children exposed to frequent or binge drinking in utero also demonstrated poorer coordination (P<0.005) and cortical function (P<0.01), attention problems, hyperactivity (ACTeRS), and poorer scholastic achievement in language (P<0.001) and mathematics (P<0.01) than their minimally exposed counterparts. In children in grades 2 and 3, a significant negative correlation was found between FAS/FAE scores and language (r=–0.55, P<0.001) and mathematical achievement (r=–0.28, P=0.20).

CONCLUSIONS:

The prevalence of drinking during pregnancy in the northern population studied was high, and exposure in utero was associated with physical abnormalities, difficulties with coordination and cortical function, and significant delays in language and mathematical achievement. The FAS/FAE score may be useful in predicting success or failure in language development.     

Pediatric brain tumors in Non-Hispanics,Hispanics, African Americans and Asians: differences in survival after diagnosis

Background Racial differences in survival for children with brain tumors have not been well studied, particularly in Hispanics and Asians. The objective of this study was to assess racial differences in survival of children with brain tumors, focusing on Hispanics, African Americans and Asians compared to Non-Hispanics.Methods Subjects identified through the SEER Program were 2799 children, ≤19 years old at diagnosis, newly diagnosed between 1973 and 1996 with primary, malignant brain tumors. Chi-square tests were used to evaluate prognostic variables by race. Kaplan–Meier models and Cox proportional hazards models were used to assess racial differences in overall survival and in survival by histological type of tumor.Results The distribution histological type of tumor varied significantly by race. Overall survival was similar for Hispanics, African Americans, Asians compared to Non-Hispanics, although trends of increased risk of death for the minority groups were noted when stratifying by histological type of tumor.Conclusions Racial differences in survival could exist by histological type of tumor, but further work is necessary for a more complete understanding of these differences.     

Array comparative genomic hybridisation (aCGH) analysis of premenopausal breast cancers from a nuclear fallout area and matched cases from Western New York

High-resolution array comparative genomic hybridisation (aCGH) analysis of DNA copy number aberrations (CNAs) was performed on breast carcinomas in premenopausal women from Western New York (WNY) and from Gomel, Belarus, an area exposed to fallout from the 1986 Chernobyl nuclear accident. Genomic DNA was isolated from 47 frozen tumour specimens from 42 patients and hybridised to arrays spotted with more than 3000 BAC clones. In all, 20 samples were from WNY and 27 were from Belarus. In total, 34 samples were primary tumours and 13 were lymph node metastases, including five matched pairs from Gomel. The average number of total CNAs per sample was 76 (range 35-134). We identified 152 CNAs (92 gains and 60 losses) occurring in more than 10% of the samples. The most common amplifications included gains at 8q13.2 (49%), at 1p21.1 (36%), and at 8q24.21 (36%). The most common deletions were at 1p36.22 (26%), at 17p13.2 (26%), and at 8p23.3 (23%). Belarussian tumours had more amplifications and fewer deletions than WNY breast cancers. HER2/neu negativity and younger age were also associated with a higher number of gains and fewer losses. In the five paired samples, we observed more discordant than concordant DNA changes. Unsupervised hierarchical cluster analysis revealed two distinct groups of tumours: one comprised predominantly of Belarussian carcinomas and the other largely consisting of WNY cases. In total, 50 CNAs occurred significantly more commonly in one cohort vs the other, and these included some candidate signature amplifications in the breast cancers in women exposed to significant radiation. In conclusion, our high-density aCGH study has revealed a large number of genetic aberrations in individual premenopausal breast cancer specimens, some of which had not been reported before. We identified a distinct CNA profile for carcinomas from a nuclear fallout area, suggesting a possible molecular fingerprint of radiation-associated breast cancer.     

Perceptions regarding preventive sexual practices and communication with sexual partners among Chinese college students

PURPOSE: To assess the relation between Chinese college students' perceptions and attitudes regarding preventive sexual behaviors, their sexual knowledge, and their use of protective sexual behaviors. METHODS: A subsample of 133 sexually active college students (18-25 years old) was obtained to identify factors related to protective sexual behaviors (e.g., knowledge of partner's sexual history, condom use). RESULTS: Seventy-five percent of the sexually active students were male. Significantly more females had discussed AIDS and sexually transmitted diseases (STDs) issues with their partners and had asked their partners about their sexual histories than males. Students endorsing the use of preventive behaviors were more likely to have discussed AIDS issues with their partners, used condoms, and known their partner's sexual history. CONCLUSIONS: Student perceptions about preventive behaviors have a significant impact on their knowledge of their sexual partners and their own sexual behaviors. These findings, as well as the presence of significant gender differences in perceptions and communications with their partners, have major implications for risk reduction programs.     

Qualitative teamwork issues and strategies: coordination through mutual adjustment

Multidisciplinary research teams that include faculty, students, and volunteers can be challenging and enriching for all participants. Although such teams are becoming commonplace, minimal guidance is available about strategies to enhance team effectiveness. In this article, the authors highlight strategies to guide qualitative teamwork through coordination of team members and tasks based on mutual adjustment. Using a grounded theory exemplar, they focus on issues of (a) building the team, (b) developing reflexivity and theoretical sensitivity, (c) tackling analytic and methodological procedures, and (d) developing dissemination guidelines. Sharing information, articulating project goals and elements, acknowledging variation in individual goals, and engaging in reciprocity and respectful collaboration are key elements of mutual adjustment. The authors summarize conclusions about the costs and benefits of the process.     

Dominant negative selection of vaccinia virus using a thymidine kinase/thymidylate kinase fusion gene and the prodrug azidothymidine

The Escherichia coli thymidine kinase/thymidylate kinase (tk/tmk) fusion gene encodes an enzyme that efficiently converts the prodrug 3'-azido-2',3'-dideoxythymidine (AZT) into its toxic triphosphate derivative, a substance which stops DNA chain elongation. Integration of this marker gene into vaccinia virus that normally is not inhibited by AZT allowed the establishment of a powerful selection procedure for recombinant viruses. In contrast to the conventional vaccinia thymidine kinase (tk) selection that is performed in tk-negative cell lines, AZT selection can be performed in normal (tk-positive) cell lines. The technique is especially useful for the generation of replication-deficient vaccinia viruses and may also be used for gene knock-out studies of essential vaccinia genes.     

Cigarette smoking among rural-to-urban migrants in Beijing, China

BACKGROUND: Tobacco use remains a substantial public health challenge in China. The rapidly growing rural-to-urban migrant population currently numbering approximately 121 million individuals may be especially vulnerable to tobacco use. METHODS: Cigarette smoking levels and associated factors were examined among 2,201 subjects using cross-sectional data from the Migrant Health Behavior Survey (MHBS), conducted in 2002, Beijing, China. RESULTS: Respondents (39.3% females) were 18-30 years old with a mean age of 22.7 years; 77.3% were single and 35.6% had at least attended high school for education. Migrants reported an average of 4 years of migratory experience; 28.8% had worked in at least three cities and 36.8 had held at least four jobs. Males (51.7%) and females (10.9%) reported 30-day cigarette use. Smoking levels were positively associated with age, education, income, migration years, number of cities in which the migrants had worked, living in rental properties, and number of jobs held. Smoking levels were negatively associated with job and life satisfaction and living with relatives in Beijing. Smoking levels were not associated with marital status. CONCLUSIONS: Female migrants had disproportionately high rate of cigarette smoking. Several conditions and experiences common to the migratory lifestyle were associated with increased levels of smoking. Tobacco control measures are needed to protect migrant populations in China.     

Methodological Issues in Group-Matching Designs: α Levels for Control Variable Comparisons and Measurement Characteristics of Control and Target Variables

Group-matching designs are commonly used to identify the diagnosis-specific characteristics of children with developmental disabilities. In this paper, we address three issues central to the use of this design. The first concerns the alpha level to be used for considering groups to be matched on the control variable(s). The second involves the measurement characteristics of the control and target variables. We discuss the properties of standard scores, raw scores, and age equivalents and argue against the use of age equivalents. In addition, we consider the appropriateness of the commonly made prediction that groups that are matched for a control variable such as language ability or nonverbal reasoning ability but are not matched for chronological age should perform at equivalent levels on the target variable. Finally, we discuss issues related to the interpretation of significant between-group differences on the target variable, assuming groups are well-matched on the control variables, and describe the benefits of a method that focuses on characterizing a disorder on a case-by-case basis and then aggregating the cases, using the measures of sensitivity and specificity from signal detection theory.