Patterns and correlates of drinking in offspring from the San Diego Prospective Study

BACKGROUND: The decision among young people to drink is complex and reflects multiple domains of influence. This paper applies the results from a previous test of an externalizing-based model predicting heavy drinking and alcohol problems in the probands from the San Diego Prospective Study to evaluate how similar characteristics relate to the decision to drink in their offspring. METHODS: Data were generated from multiple sources for 152 offspring with a mean age of 17.2 years. Information on the family histories, personal alcohol and other substance use, socioeconomic stratum, the child's gestational problems, and additional characteristics were gathered from face-to-face interviews with a parent approximately every 5 years between their mid-20s and mid-40s. Data regarding the drinking status and additional variables applicable to the offspring were extracted from the 25-year (T25) epoch of the family evaluations using data supplied directly by the offspring. The relationships of variables to the drinking status in that generation were determined through correlations, regression analyses, and an AMOS-based structural equation model (SEM). RESULTS: Significant correlations to the drinking status in offspring were observed for age, but not for sex. Using age-adjusted backgrounds and data supplied by the offspring at T25, the most robust correlations to the drinking status were seen for a disinhibition measure, peer drinking, expectations of the effects of alcohol, and the history of having worked outside the home. When placed into an SEM, the former 3 variables performed in a manner similar to that observed in the original probands in the prediction of the drinking status, in a model with good fit characteristics. CONCLUSIONS: These data from a prospective study support the importance of similar domains across 2 generations in characterizing age-appropriate alcohol-related outcomes.     

Systematic screen for tyrosine kinase rearrangements identifies a novel C6orf204-PDGFRB fusion in a patient with recurrent T-ALL and an associated myeloproliferative neoplasm

Gene fusions involving the catalytic domain of tyrosine kinases (TKs) are found in a variety of hematological and solid tumor malignancies. Clinically, TK fusions have emerged as prime targets for therapy with small molecule kinase inhibitors. Unfortunately, identification of TK fusions has been hampered by experimental limitations. Here, we developed version 2.0 of a genomically based systematic kinase fusion screen and used it to detect a novel imatinib-sensitive C6orf204-PDGFRB fusion in a patient with precursor T lymphoblastic lymphoma (T-ALL) and an associated myeloproliferative neoplasm with eosinophilia. These data validate the ability of this targeted capture-sequencing approach to detect TK fusion events in small amounts of DNA extracted directly from patient samples.     

Measuring quality: one hospice's process

This article describes the recent modifications to the Medicare Conditions of Participation as they relate to hospice programs' quality requirements. The process used by one hospice program in the Washington Metropolitan Area to implement the National Hospice and Palliative Care Organizations Quality Partners Self-Assessment Surveys is explained. Baseline survey results were used to identify and prioritize areas for improvement related to the standards of hospice care.     

Calcium balance in mature male rats with unloaded hindlimbs

BACKGROUND: Calcium balances, regulated by the calcium endocrine system, are negative during spaceflight but have not been reported in flight simulation models using fully mature small animals. METHODS: We conducted two calcium (Ca) balance studies in 6-mo-old male rats exposed to a model that unloads the hindlimbs (HU) for 4 wk. Control (C) and HU rats were fed diets with 0.5% Ca in the first and 0.1% Ca in the second study. Housing in metabolic cages enabled daily food and water intake measurements as well as collections of urine and fecal specimens. At necropsy, blood was obtained for measures of Ca-regulating hormones. RESULTS: Both C and HU rats adjusted to housing and diets with decreases in body weight and negative Ca balances during the first week of each experiment. Thereafter, averages of Ca balances were more negative in the unloaded rats than controls: -8.1 vs. -1.6 mg x d(-1) in rats fed 0.5% (p < 0.05). This difference was not due to urinary Ca excretion since it was lower in HU than C rats (1.27 +/- 0.51 mg x d(-1) vs. 2.35 +/- 0.82 mg x d(-1), p < 0.05). Fecal Ca in HU rats exceeded dietary Ca by 4-7%, Restricting dietary Ca to 0.1% was followed by an increase in serum 1,25-dihydroxyvitamin D (1,25-D) and greater intestinal Ca absorption than in rats fed 0.5% Ca. Ca balances in rats fed 0.1% Ca were also more negative in HU than C rats (-2.4 vs. -0.03 mg x d(-1), p < 0.05). Parathyroid hormone (PTH) was suppressed and 1,25-D increased in HU rats fed 0.5% Ca. C rats fed 0.1% Ca had increased PTH and 1,25-D was the same as in the HU group. CONCLUSION: After adaptation, Ca balances were more negative in mature male rats with unloaded hindlimbs than controls, an effect from increased secretion and loss of endogenous fecal Ca associated with increased 1,25-D in Ca-replete and Ca-restricted rats.     

An evaluation of the performance of the self-rating of the effects of alcohol questionnaire in 12- and 35-year-old subjects

OBJECTIVE: A low level of response (LR) to alcohol was originally established through evidence of less alcohol-related change in several parameters at a given blood alcohol level. This is a genetically influenced phenotype associated with an increased risk for alcoholism. When measured by a retrospective questionnaire (the Self-Rating of the Effects of Alcohol [SRE] scale), a lower LR (here indicated by a report that more drinks were historically needed for various effects) correlates with a family history of alcoholism and numerous alcohol use-related variables. The current analyses address the questions of how higher SRE scores (as indicators of a low LR) relate to alcohol use and problems across different age groups and when considered in the context of demography (e.g., age, gender, and weight), as well as the number of items endorsed on the questionnaire. METHOD: SRE data (scores and numbers of items endorsed), demography, and alcohol-related variables (quantity, frequency, and problems) were evaluated in two populations. The first population included 334 12-year-old children from the Avon Longitudinal Study of Parents and Children, and the second included more than 400 35-year-old men from the San Diego Prospective Study. In each group, Pearson correlations were established among all variables, and items that were significantly linked to alcohol-related outcomes were entered into regression analyses as predictors of these outcomes. RESULTS: In both samples, SRE scores correlated with all alcohol-related outcomes, with the highest values for the maximum quantity of alcohol consumed. Relationships between the SRE score and alcohol-related variables remained robust in both populations when entered into regression analyses incorporating demography and the number of SRE items answered by subjects. CONCLUSIONS: The SRE score appears to perform relatively similarly across the two populations regarding relationships with alcohol quantity, frequency, and problems. The most consistent results were observed for the maximum quantity of alcohol consumed.     

Enhancing generalized teaching strategy use in daily routines by parents of children with autism.

PURPOSE: The purpose of this study was to examine the effects of facilitating generalized use of teaching strategies by parents of children with autism within daily routines. METHOD: Five preschool children with autism participated in intervention with a parent within daily routines in the family's home. Parents learned to include 2 teaching strategies in target routines to address their child's communication objectives. Parent-child interactions in routines were videotaped for data coding and analysis. Proactive programming of generalization occurred by systematic selection of intervention routines and by embedding intervention in multiple routines. Generalization data were collected by measuring strategy use in untrained routines. A multiple baseline design across teaching strategies was used to assess experimental effects. RESULTS: All parents demonstrated proficient use of teaching strategies and generalized their use across routines. The intervention had positive effects on child communication outcomes. All parents perceived the intervention to be beneficial. CONCLUSION: Results from this study add to the limited body of evidence supporting parent-implemented interventions in natural environments with young children with autism spectrum disorder. Additional research that replicates this approach with children of varying ages and disabilities and families with diverse characteristics is needed to support the generality of these findings.     

Comparison of Inpatient Glycemic Control with Insulin Vials Versus Insulin Pens in General Medicine Patients

Background:

The Institute for Safe Medication Practices has recommended against routine use of insulin pen devices for inpatients, but the quality of inpatient glycemic control that is achieved with insulin pens versus insulin vials and syringes has not been compared.

Objective:

To evaluate the quality of glycemic control achieved with insulin vials versus insulin pens in type 2 diabetic general medicine patients.

Methods:

This retrospective cohort study compared glycemic control between 2 groups of patients on rapid-acting insulin protocols: those receiving insulin via patient-specific pen devices and those receiving insulin from patient-specific vials. Patients on a prespecified subacute care floor with a diagnosis of type 2 diabetes and at least 24 hours of glucose monitoring while on an insulin protocol with insulin lispro were included. Glycemic control was compared by area under the curve (AUC) estimations of average overall glucose and average glucose above, below, and within goal range (70-180 mg/dL). Percentages of time above, below, and within goal range were also compared.

Results:

The mean ± SD AUC-estimated average glucose for pens was 160 ± 39 mg/dL compared to 158 ± 45 mg/dL for vials (P = .752). The mean ± SD percentage time within goal range was 68.2% ± 28.1% in the pen group versus 69.4% ± 31.8% percent in the vial group (P = .825). No statistically significant differences were detected between those receiving pens or vials for any outcome before and after adjusting for baseline differences and significant covariates.

Conclusion:

Glycemic control did not differ based on insulin delivery system.