Assessing the use of the Family Affluence Scale (FAS) among Irish schoolchildren

The objective of this analysis was to examine the answering rates, internal reliability and external validity of the Family Affluence Scale (FAS) employing data from the 2002 Irish Health Behaviour in School-aged Children study HBSC; a cross-sectional survey of 8,424 Irish schoolchildren aged 10-18. Father's occupation was reported by 80.6% of the schoolchildren and 60.6% reported on mother's occupation, while over 96% reported on the FAS items. Lower answering rates on parental occupation were found among younger schoolchildren and among those with poorer material circumstances. Analysis of the FAS revealed a moderate internal reliability and FAS scores were significantly associated with reported parental occupation. The traditional SES measures suffer from poor answering rates that pose a serious methodological threat. The FAS has moderate internal reliability and does not capture the SES status in full, but it has high completion rates, and can be used as an additional measure of SES in late childhood and adolescence.     

Adolescents attending an adult emergency department: their utilisation characteristics and self-reported opinions of care provided

We aimed to examine the case mix of adolescents presenting to an adult Emergency Department (ED) and to survey a representative sample regarding their perceived care. Of the 323 visits reviewed, 215 (66.6%) were males. Presentations increased at the weekend (151/323, 46.7%). Most visits were non-urgent, 34 (10.5%) were admitted. Acute injuries accounted for 156/215 (72.6%) of male presentations. 12/17 (70.5%) of those with a psychosocial presenting problem registered between 9 p.m. and 9 a.m. 33 adolescents presented during the prospective study period. 6 were excluded, 3 were lost to follow-up. 10/24 (41.7%) described the time they were waiting to be seen by a doctor as unacceptable, 9 (37.5%) wanted more privacy and 11 (45.9%) reported a delay in receiving treatment. Adolescents represent a minority in the ED, but have specific needs. We recommend the availability of age specific health promotion information and training of staff in adolescent healthcare issues.     

The effects of electro-convulsive therapy on the speed of information processing in major depression

BACKGROUND: This study investigates whether cognitive impairment is evident in inpatients diagnosed with Major Depression (MD) following electro-convulsive therapy (ECT), and if so, whether it is independent from depressive symptomatology. METHODS: Speed of information processing was measured using the inspection time (IT) task. IT was compared between twelve inpatients diagnosed with MD receiving ECT and twelve age-, gender-, verbal IQ-, and depression and anxiety severity matched control inpatients diagnosed with MD not receiving ECT, over four testing sessions (prior to ECT, following one ECT session, following the completion of an ECT block, and 4 to 6 weeks after the ECT block (follow-up)). RESULTS: The mean IT score for the inpatients diagnosed with MD who received ECT slowed significantly from the first ECT to immediately after the ECT block, and was significantly faster at follow-up. The mean IT score of the inpatients diagnosed with MD not receiving ECT gradually but significantly became faster over the entire equivalent time period. LIMITATIONS: Small sample sizes. CONCLUSIONS: ECT temporarily slows information processing speed in MD patients, independent of depression symptomatology.     

Demolition experts: management of the parafunctional patient: 2. Restorative management strategies

The second part of this paper discusses strategies for providing restorative dental care for the parafunctional patient.These include direct composite resin restorations, cast metal resin-retained restorations and dentine-bonded crowns, design features for porcelain fused to metal crowns and denture design. Specific features can help enhance predictability in the hostile environment of increased occlusal loading and parafunction. CLINICAL RELEVANCE: Appropriate planning, design and execution of restorative procedures can reduce the chance of failure. Patients may have to accept a compromise between appearance and restoration survival/maintenance.     

Markers for faecal fat estimation in monitoring steatorrhoea in cystic fibrosis.

Polyethylene glycol (PEG) 4000 is one of numerous substances used as non-absorbable markers to correct for variable faecal output when assessing daily faecal losses of nutrients. The introduction of enteric coated micro-encapsulated pancreatic enzyme (EMPE) preparations has greatly improved the control of fat malabsorption in cystic fibrosis and chronic pancreatitis patients. Unfortunately, these enzyme preparations contain significant quantities of PEG 4000 or polyvinyl pyrrolidine (PVP) as components of the enteric coating and thus PEG 4000 cannot be used either as a faecal marker, or in intubation studies, if these enzyme preparations are being used.     

The HIV-1 proviral landscape reveals that Nef contributes to HIV-1 persistence in effector memory CD4+ T cells

Despite long-term antiretroviral therapy (ART), HIV-1 persists within a reservoir of CD4⁺ T cells that contribute to viral rebound if treatment is interrupted. Identifying the cellular populations that contribute to the HIV-1 reservoir and understanding the mechanisms of viral persistence are necessary to achieve an effective cure. In this regard, through Full-Length Individual Proviral Sequencing, we observed that the HIV-1 proviral landscape was different and changed with time on ART across naive and memory CD4⁺ T cell subsets isolated from 24 participants. We found that the proportion of genetically intact HIV-1 proviruses was higher and persisted over time in effector memory CD4⁺ T cells when compared with naive, central, and transitional memory CD4⁺ T cells. Interestingly, we found that escape mutations remained stable over time within effector memory T cells during therapy. Finally, we provided evidence that Nef plays a role in the persistence of genetically intact HIV-1. These findings posit effector memory T cells as a key component of the HIV-1 reservoir and suggest Nef as an attractive therapeutic target.     

Loss of leucine-rich repeat kinase 2 causes impairment of protein degradation pathways,accumulation of α-synuclein,and apoptotic cell death in aged mice

Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common genetic cause of Parkinson''s disease. LRRK2 is a large protein containing a small GTPase domain and a kinase domain, but its physiological role is unknown. To identify the normal function of LRRK2 in vivo, we generated two independent lines of germ-line deletion mice. The dopaminergic system of LRRK2^−/− mice appears normal, and numbers of dopaminergic neurons and levels of striatal dopamine are unchanged. However, LRRK2^−/− kidneys, which suffer the greatest loss of LRRK compared with other organs, develop striking accumulation and aggregation of α-synuclein and ubiquitinated proteins at 20 months of age. The autophagy–lysosomal pathway is also impaired in the absence of LRRK2, as indicated by accumulation of lipofuscin granules as well as altered levels of LC3-II and p62. Furthermore, loss of LRRK2 dramatically increases apoptotic cell death, inflammatory responses, and oxidative damage. Collectively, our findings show that LRRK2 plays an essential and unexpected role in the regulation of protein homeostasis during aging, and suggest that LRRK2 mutations may cause Parkinson''s disease and cell death via impairment of protein degradation pathways, leading to α-synuclein accumulation and aggregation over time.