Changing Women: Mothers and Their Adolescent Daughters

Budding fecundity in the female child is a matter of family concern. The authors used the grounded theory method to explore the process of communication between mothers and their adolescent daughters concerning sexuality issues within the context of the age changes of both. A core category of changing women was identified along with three maternal and three daughter processes. Changes that occur during this time period can lead to lasting separation between the pair if they fail to develop insight as a way of protecting themselves and one another. The findings may assist health professionals to understand these changes and facilitate the process of communication in these dyads.     

Occupational Therapy Intervention for Residents in a Skilled Nursing Facility: A Focus on Atypical Patients

The 1990 implementation of the Omnibus Budget Reconciliation Act (OBRA) has expanded opportunities for occupational therapists to treat individuals with non-traditional illnesses. Therapists working in skilled nursing and long term care can benefit from gaining an understanding of the OBRA guidelines and patient's rights, especially regarding restraint reduction. Occupational therapists possess the necessary skills to assess and treat these individuals to help maximize their functioning as well as improve their quality of life (Moon-Sperling & Pinson, 1991). The premise of this article is to inform therapists about various types of ethical and legal intervention with atypical patients in skilled nursing facilities and to introduce therapists to the laws supporting provision of these services. [Article copies available for a fee from The Haworth Document Delivery Service: 1–800–342–9678. E-mail address: getinfo@haworth.com]     

Clinical assessment of freezing of gait in Parkinson's disease from computer-generated animation

The current ‘gold standard’ for clinical evaluation of freezing of gait (FOG) in Parkinson's disease (PD) is determination of the number of FOG episodes from video by independent raters. We have previously described a robust technique for objective FOG assessment from lower-limb acceleration. However, there is no existing method for validation of autonomous FOG measures in the absence of video documentation. In this study we compared the results of clinical evaluation of FOG from computer-generated animations (derived from body-mounted inertial sensors) during a timed up and go test with the ‘gold standard’ of clinical video assessment, utilizing a cohort of 10 experienced raters from four PD centers. Agreement between the 10 clinical observers for scoring of FOG from computer animations was more robust for the relative duration of freeze events (percent time frozen; intraclass correlation coefficient of 0.65) than number of FOG episodes, and was comparable with clinical evaluation of the patient from video (intraclass correlation coefficient 0.73). This result suggests that percent time frozen should be considered (along with number of FOG events) to better convey FOG severity. The ability of clinical observers to quantify FOG from computer-generated animation derived from lower-limb motion data provides a potential approach to validation of accelerometry-based FOG identification outside of the clinic.     

Functional significance of evolving protein sequence in dihydrofolate reductase from bacteria to humans

With the rapidly growing wealth of genomic data, experimental inquiries on the functional significance of important divergence sites in protein evolution are becoming more accessible. Here we trace the evolution of dihydrofolate reductase (DHFR) and identify multiple key divergence sites among 233 species between humans and bacteria. We connect these sites, experimentally and computationally, to changes in the enzyme’s binding properties and catalytic efficiency. One of the identified evolutionarily important sites is the N23PP modification (∼mid-Devonian, 415–385 Mya), which alters the conformational states of the active site loop in Escherichia coli dihydrofolate reductase and negatively impacts catalysis. This enzyme activity was restored with the inclusion of an evolutionarily significant lid domain (G51PEKN in E. coli enzyme; ∼2.4 Gya). Guided by this evolutionary genomic analysis, we generated a human-like E. coli dihydrofolate reductase variant through three simple mutations despite only 26% sequence identity between native human and E. coli DHFRs. Molecular dynamics simulations indicate that the overall conformational motions of the protein within a common scaffold are retained throughout evolution, although subtle changes to the equilibrium conformational sampling altered the free energy barrier of the enzymatic reaction in some cases. The data presented here provide a glimpse into the evolutionary trajectory of functional DHFR through its protein sequence space that lead to the diverged binding and catalytic properties of the E. coli and human enzymes.     

Cough Frequency in a Group of Males

An epidemiologic study by questionnaire was undertaken in Great Britain and the United States, to provide data on diabetes mellitus in Down’s syndrome. Among 20,362 patients with Down’s syndrome, 88 living diabetics were found.

A high prevalence of diabetes in the population with Down’s syndrome, particularly In the younger age groups, was noted. In these age groups the prevalence of diabetes in the population with Down’s syndrome exceeded that of the general population by factors 6.8, 3.3, and 3.0. Insufficient data exist to determine the exact statistical significance of these ratios. Further investigation is necessary. Nevertheless, a definitive association between Down’s Syndrome and diabetes mellitus is suggested. The role of prediabetes, autoimmunity and genetics in this association is discussed.