Long-Term Consequences of Adolescent Gang Membership for Adult Functioning

Objectives. We examined the possible public health consequences of adolescent gang membership for adult functioning.Methods. Data were drawn from the Seattle Social Development Project, a longitudinal study focusing on the development of positive and problem outcomes. Using propensity score matching and logistic regression analyses, we assessed the effects of adolescent gang membership on illegal behavior, educational and occupational attainment, and physical and mental health at the ages of 27, 30, and 33 years.Results. In comparison with their nongang peers, who had been matched on 23 confounding risk variables known to be related to selection into gang membership, those who had joined a gang in adolescence had poorer outcomes in multiple areas of adult functioning, including higher rates of self-reported crime, receipt of illegal income, incarceration, drug abuse or dependence, poor general health, and welfare receipt and lower rates of high school graduation.Conclusions. The finding that adolescent gang membership has significant consequences in adulthood beyond criminal behavior indicates the public health importance of the development of effective gang prevention programs.Research has consistently shown that gang membership has proximal adverse consequences during adolescence that, in turn, lead to significant social and economic costs.1–3 Active gang members are much more likely than their nongang peers to engage in criminal behavior,2,4,5 especially serious and violent offending6; in addition, they are more likely to be involved in drug use and selling,5 have more difficulties in school,4 and are more likely to be violently victimized.3 However, with few exceptions, there is scant research on possible broader, long-term public health consequences of gang membership.7–9Levitt and Vankatesh,8 in a 10-year follow-up of a sample of Chicago youths, found that those who reported being in a gang during adolescence were more likely to be arrested and incarcerated as adults, were more likely to rely on illegal income, and had obtained less formal education than their nongang peers. When they controlled for background characteristics such as home environment and early school performance, only the relationship between adolescent gang membership and illegal income in adulthood remained significant.In an ethnographic study, Hagedorn10 conducted follow-up interviews of 228 Milwaukee-based founding male gang members several years after his initial study. Two thirds of the sample did not have a high school diploma or general equivalency diploma (GED), fewer than 32% were employed, and more than 63% had been incarcerated.In a quantitative study involving a community sample, Thornberry et al.9 examined the extent to which gang membership negatively affected the timeliness of developmental transitions into adulthood, such as completion of schooling and establishment of a career. They found that, after control for individual and environmental risks, male respondents who had been short-term or long-term gang members in adolescence had a greater likelihood of cohabitation before marriage at the age of 22 years than male respondents who had not been gang members. Long-term gang members also had significantly higher rates of unstable employment, school dropout, early pregnancy, and teenage parenthood at the follow-up. Female gang members were more likely to experience untimely or problematic transitions, including unstable employment, teenage pregnancy, and early motherhood. Both male and female former gang members were more likely to report adult arrests.Recently, Krohn et al.11 found that there was an indirect positive relationship between adolescent gang membership and engagement in street crime and arrest in adulthood. Specifically, gang membership was related to precocious transitions into adulthood that then predicted disrupted family relationships and economic instability. They found that this path eventually led to criminal behaviors at the age of 30 years. In our study, we extended these investigations by assessing the effects of gang membership on adult functioning holistically, examining possible later adult outcomes.Life course theory12–14 provides a framework to understand how gang membership in adolescence may affect illegal behavior, educational and occupational attainment, and physical and mental health in adulthood. This theory emphasizes the strong connection between childhood events and experiences in adulthood (trajectories), as well as significant events that create a disruption in a trajectory (turning points). Although we did not directly test a trajectory change model in this study, life course theory would suggest that joining a gang during adolescence may initiate a negative developmental cascade into both criminal and noncriminal domains, including decreased educational and occupational attainment and poor physical and mental health.15,16 Indeed, Melde and Esbensen reported that “youth who join gangs experience noteworthy changes in their emotions, attitudes, and behavior,”17^(p539) suggesting that gang membership may serve as a significant turning point in an individual’s life course.One such life course theory, the social development model,18 provides specific mechanisms through which these consequences may operate. This model articulates the mechanisms of socialization and identifies parallel but separate causal paths for prosocial and antisocial processes consisting of opportunities for involvement, actual involvement, skills, rewards, bonding, and adoption of beliefs. Participation in the prosocial path is seen to increase subsequent positive outcomes and decrease risk behaviors. By contrast, participation in the antisocial path is seen to decrease positive outcomes and increase problem behaviors. From the perspective of this model, gang membership in adolescence may serve as a turning point, drastically changing the opportunity structure for young people. As gang-involved youths move through subsequent cycles of socialization, they are likely to experience reduced prosocial functioning across several domains and escalated problem behaviors as they transition into adulthood, even if they are no longer members of a gang.According to Krohn and Thornberry,

it is reasonable to expect that being a member of a gang during adolescence will be associated with disrupted transitions from adolescence to adulthood and, ultimately, will adversely impact life chances.7^(p149)

They noted that the challenge is to discover empirically to what extent gang membership contributes to negative outcomes in adulthood over and above general delinquency and other risk factors in adolescence. This was precisely the aim of our study.     

Taenia solium cysticercosis

The larval stage of the pork tapeworm (Taenia solium) infects the human nervous system, causing neurocysticercosis. This disease is one of the main causes of epileptic seizures in many less developed countries and is also increasingly seen in more developed countries because of immigration from endemic areas. Little information is available on the natural evolution of taeniasis or cysticercosis. Available therapeutic measures include steroids, treatments for symptoms, surgery, and, more controversially, antiparasitic drugs to kill brain parasites. Efforts to control and eliminate this disease are underway through antiparasitic treatment of endemic populations, development of pig vaccines, and other measures.     

Validation of string test for diagnosis of Helicobacter pylori infections

The method of recovering Helicobacter pylori DNA or viable cells absorbed on a string that a person has swallowed and that is retrieved an hour later (string test) should be a useful alternative to traditional analysis of cells or DNA obtained by endoscopy, which is invasive, uncomfortable, relatively costly, and ill-suited for community-based and pediatric studies. Here we assayed the sensitivity and validity of the string test versus conventional endoscopic biopsy for detecting and analyzing H. pylori infection. Forty-four people with gastric complaints were studied using both H. pylori culture and urease gene (ureB) PCR. H. pylori organisms cultured from strings and biopsy specimens from the same patients were fingerprinted by the randomly amplified polymorphic DNA (RAPD) method. Biopsy sections were also hematoxylin and eosin and silver stained for H. pylori detection. H. pylori was cultured from 80% of strings and detected by PCR from 91% of strings from participants whose biopsies had been H. pylori positive by culture, PCR, and/or histology. Strains recovered from strings and biopsy specimens yielded identical or closely related RAPD profiles in each of the 24 cases tested. We conclude that the string test is a useful method for H. pylori recovery and analysis when relatively noninvasive procedures are needed.     

Factor V Quebec revisited

Factor V Quebec has been described as a bleeding disorder that exhibits an autosomal dominant inheritance pattern and presents severe bleeding after trauma. Two members of a fourth-generation (IV.13 and IV.15) Canadian family have been studied in detail and are the subject of this report. Their clinical presentations and histories have been described previously (Tracy et al: J Clin Invest 74:1221, 1984). Persistent abnormalities include mild thrombocytopenia and defective platelet factor V. Plasma factor V is present at near normal concentration and is fully functional. Thus, the bleeding diathesis appears to reflect the absence of platelet factor V activity. The recent report (Hayward et al: Blood 84:110a, 1994 [suppl, abstr]) of multimerin deficiency in these individuals led us to reevaluate these patients. Western blot analyses of platelet lysates developed with a variety of monoclonal antibodies show that the alpha-granule proteins, fibrinogen, von Willebrand factor, factor V and osteonectin are decreased in concentration and significantly degraded in the platelets of these patients. Thrombospondin, while not degraded, is substantially decreased. In contrast, platelet factor 4 and beta-thromboglobulin do not appear to be affected. These observations suggest that the alpha- granules are correctly assembled but the contents are subsequently subjected to proteolytic degradation. The results indicate that factor V Quebec disorder is probably associated with a generalized defect that leads to degradation of most proteins of the alpha-granules.     

Effects of excitotoxic striatal lesions on single unit activity in globus pallidus and entopeduncular nucleus of the cat

Striatal projections to the globus pallidus and entopeduncular nucleus are thought to be GABAergic and inhibitory. Thus, striatal lesions might be expected to increase the spontaneous discharge rate of neurons in these nuclei. To test this prediction, we recorded spontaneous single unit activity from awake cats sitting quietly before and 7-160 days after striatal lesions. Striatal lesions were produced by injecting ibotenic acid into the caudate nucleus and putamen. Median, standard deviation, mean, and coefficient of variation of the interspike intervals were calculated for each unit. In globus pallidus the striatal lesion resulted in a significant decrease in median interval length, i.e. an increase in the discharge rate. The prelesion median of 36 ms (S.E.M. = 2.3) decreased 11% to a postlesion value of 32 ms (S.E.M. = 2.1). The lesion also resulted in a significant decrease in the variability of interspike intervals. The coefficient of variation, 1.31 (S.E.M. = 0.08) before the lesion, decreased 25% to 0.97 (S.E.M. = 0.06) after the lesion. In entopeduncular nucleus, the lesion had no statistically significant effect on the rate of activity, but a significant decrease in the variability of activity occurred. The median interval was 33 ms (S.E.M. = 3.3) before the lesion and decreased 2% to 32 ms (S.E.M. = 2.4). The coefficient of variation decreased 48% from 1.44 (S.E.M. = 0.1) to 0.73 (S.E.M. = 0.03). These observations support the hypothesis that loss of GABAergic inputs to the globus pallidus results in disinhibition. The discharge rate in entopeduncular nucleus was not affected by the striatal lesion, suggesting that striatal substance P or subthalamic excitatory inputs may have a role in regulating discharge rate in the entopeduncular nucleus.     

The effects of exposure of incubating adult and young herring gulls to a simulated no. 2 fuel oil slick

Naturally incubating herring gulls (Larus argentatus) were exposed to No. 2 fuel oil. The gulls were treated either early (seven to ten days after clutch completion) or late (when the second egg of the clutch reached the pip stage) in incubation. Hatching success of eggs of adults oiled early in incubation was reduced at 321 ml oil/m² and survival of young to seven days post-hatch was reduced at both 107 and 321 ml/m². This decrease in survival at 107 ml/m² suggests that a concentration of oil which is not lethal to the embryos may have a sublethal effect which reduces chick viability. When adults were oiled late in incubation, the only effect noted was decreased hatching success at 321 ml/m². Chicks between five and nine days of age which were exposed to an artificial slick of 321 ml No. 2 fuel oil/m² exhibited decreased survival to seven days post-treatment. Since 107 ml/m² is more than 20 times the maximum thickness of No. 2 fuel oil slicks which have been measured on the Great Lakes, a single exposure of an adult at the incubation stages tested or of a young chick to a free-floating oil slick would probably not cause a significant reduction in hatching success or survival of young. The effects of repeated exposure to a fresh fuel oil slick are unknown.     

Malignant fibrous histiocytoma manifesting as a cavitary lung metastasis

Exploration prompted by acute abdominal symptoms in a 29-year-old woman discovered to have an asymptomatic right upper lobe cavitary lesion disclosed a malignant fibrous histiocytoma, the primary lesion of which was in the duodenum. At autopsy, the lung lesion was found to be metastatic. We believe this is the first recorded instance of cavitary lung metastasis from this type of tumor.     

Phase II study of rituximab in combination with chop chemotherapy in patients with previously untreated, aggressive non-Hodgkin's lymphoma.

PURPOSE: To determine the safety and efficacy of the combination of the chimeric anti-CD20 antibody Rituxan (rituximab, IDEC-C2B8; Genentech Inc, South San Francisco, CA) and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy in patients with aggressive non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS: Thirty-three patients with previously untreated advanced aggressive B-cell NHL received six infusions of Rituxan (375 mg/m2 per dose) on day 1 of each cycle in combination with six doses of CHOP chemotherapy given on day 3 of each cycle. RESULTS: The ORR by investigator assessment confirmed by the sponsor was 94% (31 of 33 patients). Twenty patients experienced a complete response (CR) (61%), 11 patients had a partial response (PR) (33%), and two patients were classified as having progressive disease. In the 18 patients with an International Prognostic Index (IPI) score > or = 2, the combination of Rituxan plus CHOP achieved an ORR of 89% and CR of 56%. The median duration of response and time to progression had not been reached after a median observation time of 26 months. Twenty-nine of 31 responding patients remained in remission during this follow-up period, including 15 of 16 patients with an IPI score > or = 2. The most frequent adverse events attributed to Rituxan were fever and chills, primarily during the first infusion. Rituxan did not seem to compromise the ability of patients to tolerate CHOP; all patients completed the entire six courses of the combination. The bcl-2 translocation of blood or bone marrow was positive at baseline in 13 patients; 11 patients had follow-up specimens obtained (eight CR, three PR), and all had a negative bcl-2 status after therapy. Only one patient has reconverted to bcl-2 positivity, and all patients remain in clinical remission. CONCLUSION: This is the first report to demonstrate the safety and efficacy of the Rituxan chimeric anti-CD20 antibody in combination with standard-dose CHOP in the treatment of aggressive B-cell lymphoma. The clinical responses are at least comparable to those achieved with CHOP alone with no significant added toxicity. The presence or absence of the bcl-2 translocation did not affect the ability of patients to achieve a CR with this regimen. The ability to achieve sustained remissions in patients with an IPI score > or = 2 warrants further investigation with a randomized study.     

The interactions of adenylate cyclases with P-site inhibitors.

Recent kinetic, binding and crystallographic studies using P-site inhibitors of mammalian adenylate bases provide new insights into the catalytic mechanism of these highly regulated enzymes. Here, Carmen Dessauer and colleagues discuss the conformational states of adenylate cyclase, the structural determinants of inhibitor binding and the potential uses of these inhibitors as pharmacological agents.