Developmental pathways to antisocial behavior: the delayed-onset pathway in girls

Recent research has suggested that there are two distinct trajectories for the development of antisocial behavior in boys: a childhood-onset pathway and an adolescent-onset pathway. After reviewing the limited available research on antisocial girls, we propose that this influential method of conceptualizing the development of severe antisocial behavior may not apply to girls without some important modifications. Antisocial girls appear to show many of the correlates that have been associated with the childhood-onset pathway in boys, and they tend to show impaired adult adjustment, which is also similar to boys in the childhood-onset pathway. However, antisocial girls typically show an adolescent-onset to their antisocial behavior. We have proposed that these girls show a third developmental pathway which we have labeled the "delayed-onset" pathway. This model rests on the assumption that many of the putative pathogenic mechanisms that contribute to the development of antisocial behavior in girls, such as cognitive and neuropsychological deficits, a dysfunctional family environment, and/or the presence of a callous and unemotional interpersonal style, may be present in childhood, but they do not lead to severe and overt antisocial behavior until adolescence. Therefore, we propose that the delayed-onset pathway for girls is analogous to the childhood-onset pathway in boys and that there is no analogous pathway in girls to the adolescent-onset pathway in boys. Although this model clearly needs to be tested in future research, it highlights the need to test the applicability of current theoretical models for explaining the development of antisocial behavior in girls.     

Characteristics of Natural Mentoring Relationships and Adolescent Adjustment: Evidence from a National Study

This research investigated characteristics of natural mentoring relationships (mentor role, frequency of contact, closeness, duration) as predictors of adjustment outcomes among older adolescents and young adults (N = 2,053) in the Add Health study. Outcomes were assessed in the domains of education/work, problem behavior, psychological well-being, and physical health. Mentoring relationships with persons in roles outside of the family predicted greater likelihood of favorable outcomes in all domains except psychological well-being, relative to mentoring relationships with family members. Greater reported closeness in relationships was predictive of several favorable outcomes, particularly those in the domain of psychological well-being. These findings indicate that strategies to promote mentoring of adolescents may be more effective if particular categories of adults are targeted and an effort is made to cultivate relationships with strong emotional bonds.Editors’ Strategic Implications: These data suggest that the cultivation of natural (especially non-familial) mentoring relationships during adolescence may be a promising strategy for prevention and health promotion. This study is impressive due to its large, nationally representative sample, the examination of relationship characteristics and multiple mentors, and the links to a variety of outcomes (controlling for earlier functioning). School officials and mentoring programs must consider how to capitalize on – and promote – naturally occurring mentor relationships.     

Postoperative complications necessitating right lower lobectomy in a heart-lung transplant recipient with previous sternotomy

Heart-lung transplantation for treatment of end-stage cardiopulmonary disease continues to be plagued by many problems. Three primary ones are the technical difficulties that can be encountered, particularly in those patients who have undergone previous cardiac operations, the additional restriction on donor availability imposed by the lack of satisfactory preservation techniques, and the need for lung size compatibility. Two of these difficulties and others surfaced postoperatively in a heart-lung transplant recipient who presented a series of unique operative and therapeutic challenges. A 42-year-old woman with chronic pulmonary hypertension and previous atrial septal defect repair underwent a heart-lung transplantation in August 1985. The operative procedure was expectedly complicated by bleeding from extensive mediastinal adhesions from the previous sternotomy and bronchial collateralization. Excessive chest tube drainage postoperatively necessitated reoperation to control bleeding from a right bronchial artery tributary. Phrenic nerve paresis, hepatomegaly, and marked abdominal distention caused persistent atelectasis and eventual right lower lobe collapse. Arteriovenous shunting and low oxygen saturation necessitated right lower lobectomy 15 days after transplantation, believed to be the first use of this procedure in a heart-lung graft recipient. Although oxygenation improved dramatically, continued ventilatory support led to tracheostomy. An intensive, psychologically oriented physical therapy program was initiated to access and retrain intercostal and accessory muscles. The tracheostomy cannula was removed after 43 days and gradual weaning from supplemental oxygen was accomplished. During this protracted recovery period, an episode of rejection was also encountered and successfully managed with steroid therapy. The patient continued to progress satisfactorily and was discharged 83 days after transplantation. She is well and active 20 months after discharge.     

The incidence of fracture of the proximal femur in two million Canadians from 1972 to 1984. Projections for Canada in the year 2006

Reported increases in the number of fractures of the proximal femur in Europe are greater than can be explained by demographic changes alone. This trend was assessed in Canada by examining hospital discharge records from the provinces of Saskatchewan and Manitoba from 1972 to 1984. The annual number of first fractures of the proximal femur in persons older than 50 years of age increased 59.7% in women and 42.2% in men during this time period. In most of the five-year age groups the percentage of increase in the number of fractures exceeded the percentage of increase in population of that age group. Annual age-specific incidences (by five-year age groups) increased exponentially with age, doubling every six years, and reached a maximum value of 4% in women older than 90 years of age. Annual age-adjusted incidences increased significantly over the study period in men and women. For the whole of Canada in 1987, it is estimated that there were 13,193 first fractures of the proximal femur in women and 4610 in men, and that in the year 2006 these will rise to 22,922 and 7846, respectively. The actual increase will be considerably greater if the age-specific incidences continue to increase as they have from 1972 to 1984. The gradual decline in physical activity, which contributes to bone loss, may be one etiological factor of this trend during the last half century.     

Tuberculous meningitis in children at Zaria, Nigeria:A review of 16 cases

Sixteen children with tuberculous meningitis seen in Zaria between January 1978 and December 1984 were studied. There was absence of neck rigidity in 11 of the 16 cases. Five of 9 patients who had chest X-ray done had either hilar and/or paratracheal lymph node enlargement, while one had miliary spread in the lungs. None of the patients had been vaccinated with BCG in infancy. The overall mortality was 75%. Extension of BCG vaccination of children beyond infancy to include all children aged 4 years and less may further reduce the frequency of tuberculous meningitis in this community.     

Localization of nerve growth factor (NGF) and low-affinity NGF receptors in touch domes and quantification of NGF mRNA in keratinocytes of adult rats

Touch doems are clearly delineated mechanoreceptors that are visible on the depilated skin of mammals. These structures consist of a sharply circumscribed disk of thickened epithelium surmounting a group of Merkel cells that are innervated by type I sensory neurons. These characteristic cutaneous structures provide an ideal opportunity for investigating whether the localization of nerve growth factor (NGF) in the skin related to sites of sensory axon termination. For these reasons, we have used immunocytochemistry to study the distribution of NGF and the low-affinity NGF receptor (p^75NGFR) in the touch domes of adult rat skin. Intense NGF-like immunoreactivity was sharply restricted to keratinocytes (excluding the stratum corneum) of the thickened epidermis of the touch domes. The epidermis immediately surrounding touch domes and the epidermis of the tylotrich hair follicle associated with touch domes were immunonegative for NGF but were immunopositive for p^75NGFR as werer the type I nerve endings innervating these cells. Quantitative Northern blotting revealed that the level of NGF mRNA was substantially higher in keratinocytes isolated from the stratum granulosum and stratum spinosum than in keratinocytes isolated from the stratum germinativum. These findings indicate that NGF synthesis in mature skin has a highly restricted regional distribution that is primarily associated with the innervation of a specialized touch receptor. © 1994 Wiley-Liss, Inc.