Association Between Gross-Motor and Executive Function Depends on Age and Motor Task Complexity

The objective was to examine associations between motor and executive function across the adult lifespan and to investigate the role of motor complexity in these associations. Young, middle-aged and older adults (n = 82; 19–83y) performed two gross-motor tasks with different levels of complexity and a Stroop-like computer task. Performance was decreased in older adults. The association between motor and cognitive performance was significant for older adults in the complex motor task (p = 0.03, r_s = ?0.41), whereas no significant associations were found for young or middle-aged groups, suggesting that the link between gross-motor and executive function emerges with age and depends on motor complexity.     

RESIDENTIAL DISTANCE TO PUBLIC HOUSING AND ITS DIFFERENTIAL INFLUENCE ON INFANT MORTALITY ACROSS RACE

Infant mortality is a major problem in the United States. Understanding the relationship between geographic variation and birth outcomes is important to develop and implement targeted interventions. This study examined the relationship between contextual residential distance to public housing and infant mortality. All singleton births (N = 30,554) and infant deaths (N = 361) occurring between January 1, 1997 and December 31, 2007 in Richmond, VA were analyzed. Maternal race, education, smoking during pregnancy, method of payment, gestational age, and sex of the infant were significantly associated with infant mortality. African Americans were 1.6 times as likely to reside 1 to 2 miles or less closer to public housing (p<.0001) than European Americans. Residential contextual variables play a role in poor birth outcomes, and public health professionals should be aware of this association when developing interventions.     

Stepped early psychological intervention for posttraumatic stress disorder, other anxiety disorders, and depression following serious injury

The best approach for implementing early psychological intervention for anxiety and depressive disorders after a traumatic event has not been established. This study aimed to test the effectiveness of a stepped model of early psychological intervention following traumatic injury. A sample of 683 consecutively admitted injury patients were screened during hospitalization. High-risk patients were followed up at 4-weeks postinjury and assessed for anxiety and depression symptom levels. Patients with elevated symptoms were randomly assigned to receive 4-10 sessions of cognitive-behavioral therapy (n = 24) or usual care (n = 22). Screening in the hospital identified 89% of those who went on to develop any anxiety or affective disorder at 12 months. Relative to usual care, patients receiving early intervention had significantly improved mental health at 12 months. A stepped model can effectively identify and treat injury patients with high psychiatric symptoms within 3 months of the initial trauma.     

Five years of anti-resorptive activity after a single dose of zoledronate--results from a randomized double-blind placebo-controlled trial

Intravenous zoledronate 5 mg, administered annually, prevents fractures in people with osteoporosis, but the optimal dosing schedule is not known. Previously, we reported that a single dose of 5 mg zoledronate stably decreased bone turnover and increased bone mineral density (BMD) for 3 years in a randomized controlled trial in 50 postmenopausal women with osteopenia. We have now completed a 2-year double-blind extension of this trial, during which no additional treatment was administered. The primary endpoint was change in the bone turnover markers procollagen type-I N-terminal propeptide (P1NP) and β-C-terminal telopeptide of type I collagen (β-CTX); the secondary endpoint was change in BMD at lumbar spine, total hip and total body. Mean levels of the each of the bone turnover markers were lower in the zoledronate group throughout the study (P<0.0001 for each marker). After 5 years, mean (95% CI) levels of β-CTX and P1NP were 277 ng/L (150, 404) and 28 μg/L (16, 40) lower in the zoledronate group, corresponding to reductions of 48% and 45%, respectively. BMD was higher in the zoledronate group during the study (P<0.0001 for each site). After 5 years, BMD in the zoledronate group was higher by 4.2% (1.1, 7.2) at the lumbar spine, by 5.3% (2.7, 7.9) at the total hip, and by 2.7% (1.1, 4.2) at the total body. These findings suggest that the anti-resorptive effects of a single 5 mg dose of zoledronate persist for at least 5 years in postmenopausal women. Trials assessing the anti-fracture efficacy of dosing intervals of zoledronate of up to 5 years are justified.     

Neuropsychological Performance,Brain Imaging,and Driving Violations in Multiple Sclerosis

Objective

To examine the relationship between third ventricular width, a measure of thalamic brain atrophy, and motor vehicle violation type and frequency in a cohort of patients with multiple sclerosis (MS).

Design

Retrospective cohort study.

Setting

Tertiary care university hospital.

Participants

Thirty-five individuals with clinically confirmed relapsing-remitting multiple sclerosis and 35 age-, sex-, and education-matched community-dwelling healthy comparisons (N=70). Participants were aged between 25 and 65 years.

Interventions

Not applicable.

Main Outcome Measures

Data on motor vehicle violations were obtained from an online database (Iowa Courts Online). The violations were categorized as follows: (1) speeding, (2) nonmoving safety, (3) administrative, (4) alcohol-related offense, (5) moving safety, and (6) total violations. Neuropsychological performance in all major cognitive domains was obtained. Thalamic atrophy for the patients with MS was determined via third ventricular width measurement.

Results

The MS group had a greater number of overall violations, administrative violations, and nonmoving safety violations. The groups differed on neuropsychological tasks measuring visuospatial skills, speeded language, learning, and executive functioning, after controlling for affective symptoms. Third ventricular width was associated with total violations as well as moving safety violations. Finally, third ventricular width accounted for a significant variance in driving violation frequency above and beyond demographic variables and neuropsychological factors.

Conclusions

There is an increased frequency of motor vehicle violations among patients with multiple sclerosis, and the number of violations can be predicted by thalamic brain atrophy.     

The Rothmund-Thomson syndrome helicase RECQL4 is essential for hematopoiesis

Mutations within the gene encoding the DNA helicase RECQL4 underlie the autosomal recessive cancer-predisposition disorder Rothmund-Thomson syndrome, though it is unclear how these mutations lead to disease. Here, we demonstrated that somatic deletion of Recql4 causes a rapid bone marrow failure in mice that involves cells from across the myeloid, lymphoid, and, most profoundly, erythroid lineages. Apoptosis was markedly elevated in multipotent progenitors lacking RECQL4 compared with WT cells. While the stem cell compartment was relatively spared in RECQL4-deficent mice, HSCs from these animals were not transplantable and even selected against. The requirement for RECQL4 was intrinsic in hematopoietic cells, and loss of RECQL4 in these cells was associated with increased replicative DNA damage and failed cell-cycle progression. Concurrent deletion of p53, which rescues loss of function in animals lacking the related helicase BLM, did not rescue BM phenotypes in RECQL4-deficient animals. In contrast, hematopoietic defects in cells from Recql4^Δ/Δ mice were fully rescued by a RECQL4 variant without RecQ helicase activity, demonstrating that RECQL4 maintains hematopoiesis independently of helicase activity. Together, our data indicate that RECQL4 participates in DNA replication rather than genome stability and identify RECQL4 as a regulator of hematopoiesis with a nonredundant role compared with other RecQ helicases.     

Empowerment Through Rehabilitation Nursing Certification

Certification empowers nurses by validating their clinical competency and continued professional growth. This article discusses the current state of certification in the nursing profession. The potential benefits to the certified nurse and the costs in both time and money needed to achieve and maintain certification are addressed. The article also describes how the nursing department of a 284-bed rehabilitation hospital developed a program to promote specialty certification among its nursing staff. The process and outcome of this program revealed several potential research topics.     

Safety, tolerance, and pharmacokinetics of cefepime administered intramuscularly to healthy subjects

Steady state pharmacokinetics, absolute bioavailability, and dose proportionality of cefepime were evaluated in healthy male subjects after single (250, 500, 1000, or 2000 mg) and multiple (1000 mg every 12 hours for 10 days) intramuscular injections. Safety and tolerance were also monitored. High performance liquid chromatography/UV methodology was used to determine cefepime concentrations in plasma and urine. Key pharmacokinetic parameters were determined using noncompartmental methods. Cefepime was absorbed rapidly; mean peak times were 1.0-1.6 hours. Pharmacokinetics were linear over the 250-mg to 2000-mg dose range, with mean total body clearance ranging from 125 to 141 mL/min. The peak plasma concentration and area under the curve increased in a dose-proportional manner. The apparent elimination half-life (2 hours) did not appear to be influenced by dose or by duration of dosing. No accumulation of cefepime was observed during the multiple-dose study. More than 80% of the administered dose was excreted in the urine as unchanged cefepime, and absolute bioavailability after intramuscular dose was 100%. Cefepime was well tolerated. Most subjects experienced none to mild pain and only minimum discomfort at the site of injection.