Is Down syndrome a risk factor for poor outcome after repair of congenital heart defects?

Down syndrome is commonly associated with significant congenital heart disease with the potential for early development of pulmonary hypertension. As such, children with Down syndrome may be at increased risk for both perioperative and long-term mortality. The purpose of this study, using data collected from a population-based outcomes study, is to analyze the potential role that Down syndrome plays in the outcome of surgically "corrected" congenital heart disease. Data were collected from a registry of all Oregon residents who, in the period 1958 to the present, had a reparative operation for one of 14 congenital cardiac malformations when younger than 18 years (N = 3965 patients). Down syndrome was present in 289 (7%) of the total registry patients. In evaluating the cardiac mortality associated with Down syndrome for each of the repaired cardiac malformations, only complete atrioventricular septal defect was associated with significantly higher perioperative (13% vs 5%) as well as higher overall late cardiac mortality through 20 years after the operation (20% vs 5%; p = 0.04). The survival outcomes for each of the other cardiac malformations were similar for children with and without Down syndrome.     

Is ABH nonsecretor status a risk factor for obstructive lung disease?

In a multidisciplinary study of risk factors for chronic obstructive pulmonary disease (COPD), a significantly more impairment of forced expiration was observed in ABH nonsecretors than in ABH secretors among 1017 white adults. (ABH refers to the "A" and "B" antigens of the ABO blood group system and "H", the heterogenetic substance which is found in persons of all ABO types including type "O".) Nonsecretors had significantly lower mean values of forced expiratory volume in one second as a percentage of forced vital capacity (FEV1/FVC%) and a significantly larger proportion of them had aberrant values, defined as FEV1/FVC% less than 68. These differences remained when mean values or rates of aberrancy were adjusted for other factors reported to alter risk of airway obstruction. In view of the known COPD-peptic ulcer and nonsecretor-duodenal ulcer associations, these findings suggest that the ability to secrete ABH antigens into secretions of the respiratory and gastrointestinal tract may have a protective effect on epithelialized organs in general, or on the lung and portions of the gut specifically.     

A reexamination of the factor structure of the Center for Epidemiologic Studies Depression Scale: Is a one-factor model plausible?

The Center for Epidemiologic Studies Depression Scale (CES–D) is one of the most widely used measures of depressive symptoms in research today. The original psychometric work in support of the CES–D (Radloff, 1977) described a 4-factor model underlying the 20 items on the scale. Despite a long history of evidence supporting this structure, researchers routinely report single-number summaries from the CES–D. The research described in this article examines the plausibility of 1-factor model using an initial sample of 595 subjects and a cross-validation sample of 661. After comparing a series of models found in the literature or suggested by analyses, we determined that the good fit of the 4-factor model is mostly due to its ability to model excess covariance associated with the 4 reverse-scored items. A 2-factor model that included a general depression factor and a positive wording method factor loading only on those 4 items had fit that was nearly as good as the original 4-factor model. We conclude that although a 1-factor model may not be the best model for the full 20-item CES–D, it is at least plausible. If a unidimensional set of items is required (e.g., for a unidimensional item response theory analysis), by dropping 5 items, we were able to find a 1-factor model that had very similar fit to the 4-factor model with the original 20 items. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is the flow in the giraffe's jugular vein a "free" fall?

There is controversy as to whether or not the heart works against gravity in the arteries to the head in the upright position. One view is that the gravitational effects in the neck arteries are counterbalanced by the gravitational effects in the veins of the neck and the heart does not do extra pressure work. This concept has been challenged by others who claim that the heart works against gravity based on the notion that the jugular vein is collapsed and gravitational effects on jugular blood are inoperative, similar to the "free" fall of liquids. The present study supports the view that blood flow in the collapsible jugular vein of the giraffe is not a "free" fall and that the heart does not spend extra energy to raise the blood to the head.     

Is there still a role for functional radionuclide study of the liver?

Clinical applications of radionuclide methods for the study of liver hemodynamics and hepatocyte function are examined. In particular, as for hemodynamic studies, perfusion assessment with radiocolloids, 99mTc-IDA scintigraphy or 99mTc-labeled red blood cells, is underlined; they allow characterization of the different cellular component of space-occupying liver processes. The use of hepatic perfusion index (HPI) is reconsidered both as prognostic parameter in cirrhotic patients and as predictor of liver metastasis from colorectal cancer. The diagnostic role of recent procedures, as those based on endorectal radiopharmaceuticals in the evaluation of portosystemic shunts in cirrhosis, is analyzed. Studies of hepatocyte function of practical concern are essentially devoted to the "excretory function" and "asialoglycoprotein metabolism". In the first case, a major role is played by IDA halogenated derivatives and functional parameters drawn from them by mathematico-statistical evaluations of radiohepatogram (simple or applied to compartmental models). For metabolic studies, at present an artificial glycoprotein, 99mTc-galactosylneoglycoalbumin (99mTc-NGA) that binds with hepatocellular receptors is used. Information on the rate of blood plasma clearance and liver uptake, receptor density (altered in some pathologic conditions) and plasmic hepatic flow, is supplied.     

Is epsilon-aminocaproic acid as effective as aprotinin in reducing bleeding with cardiac surgery?: a meta-analysis

Infection of BALB/c mice with Trypanosoma cruzi resulted in up-regulated expression of Fas and Fas ligand (FasL) mRNA by splenic CD4+ T cells, activation-induced CD4+ T cell death (AICD), and in Fas: FasL-mediated cytotoxicity. When CD4+ T cells from infected mice were co-cultured with T. cruzi-infected macrophages, onset of AICD exacerbated parasite replication. CD4+ T cells from T. cruzi-infected FasL-deficient BALB gld/gld mice had no detectable AICD in vitro and their activation with anti-TCR did not exacerbate T. cruzi replication in macrophages. However, infection of BALB gld/gld mice with T. cruzi resulted in higher and more prolonged parasitemia, compared to wild-type mice. Secretion of Th2 cytokines IL-10 and IL-4 by CD4+ T cells from infected gld mice was markedly increased, compared to controls. In addition, in vivo injection of anti-IL-4 mAb, but not of an isotype control mAb, reduced parasitemia in both gld and wild-type mice. These results indicate that, besides controlling CD4+ T cell AICD and parasite replication in vitro, an intact Fas: FasL pathway also controls the host cytokine response to T. cruzi infection in vivo, being required to prevent an exacerbated Th2-type immune response to the parasite.     

Is a gay Oedipus a Trojan horse? Commentary on Lewes's "A special Oedipal mechanism in the development of male homosexuality."

K. Lewes's (see record 1998-10061-002) article is seen as an effort to locate the psychopathology and desiring patterns of some gay men in a variant of the Oedipus complex. This commentary questions the value of the Oedipus complex as a theoretical tool in the psychoanalytic formulation of male same-sex eroticism both on clinical and political grounds. It argues that the embedded primary of evaluation and reproduction in the theory of the Oedipal complex inevitably devalues same-sex desire. Equally, it argues that the Oedipus complex's tendency to reinforce gender norms and stereotypes is especially distorting when applied to sample-sex desiring men, in that it may contribute to the analyst's clinical neglect of the role of gender conflict in pathogenesis. The author tries to show this through some examination of K. Lewes's (1998) clinical examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is criminal behavior a central component of psychopathy? Conceptual directions for resolving the debate.

The development of the Psychopathy Checklist—Revised (PCL–R; R. D. Hare, 2003) has fueled intense clinical interest in the construct of psychopathy. Unfortunately, a side effect of this interest has been conceptual confusion and, in particular, the conflating of measures with constructs. Indeed, the field is in danger of equating the PCL–R with the theoretical construct of psychopathy. A key point in the debate is whether criminal behavior is a central component, or mere downstream correlate, of psychopathy. In this article, the authors present conceptual directions for resolving this debate. First, factor analysis of PCL–R items in a theoretical vacuum cannot reveal the essence of psychopathy. Second, a myth about the PCL–R and its relation to violence must be examined to avoid the view that psychopathy is merely a violent variant of antisocial personality disorder. Third, a formal, iterative process between theory development and empirical validation must be adopted. Fundamentally, constructs and measures must be recognized as separate entities, and neither reified. Applying such principles to the current state of the field, the authors believe the evidence favors viewing criminal behavior as a correlate, not a component, of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual attention in the rat: A role for the prelimbic cortex and thalamic nuclei?

The behavioral effects of lesions of the prelimbic cortex (PL), mediodorsal nucleus of the thalamus (MD), and anterior thalamic nuclei (ANT) were investigated in 2 attentional tasks in rats: the 5-choice serial reaction time task and a vigilance task. Although there was no lesion effect on accuracy in the 5-choice task, PL lesions enhanced perseverative responding during baseline performance and when stimulus duration was reduced. In contrast, MD lesions increased premature responding during baseline performance and when the intertrial interval was varied unpredictably, In the vigilance paradigm, PL lesions also impaired rats' ability to detect the light signal at baseline and at the reduced stimulus duration. ANT lesions did not substantially disrupt performance. The results suggest that different aspects of attention may be attributable to the PL and the MD and that the mechanisms underlying inhibitory control of behavior may be attributable to functionally different thalamocortical circuits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rotary International—A private partner in a public health battle: A model for psychology?

This article describes an effort by Rotary International, involving a partnership of public and private health providers and voluntary organizations in the worldwide eradication of polio. The authors cite this effort as a successful private–public partnership model for psychologists and/or psychological organizations attempting to improve public mental health on a mass scale. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is aggression the same for boys and girls? Assessing measurement invariance with confirmatory factor analysis and item response theory.

Gender differences in aggression have typically been based on studies utilizing a mean difference method. From a measurement perspective, this method is inherently problematic unless an aggression measure possesses comparable validity across gender. Stated differently, establishing measurement invariance on the measure of aggression is prerequisite to making any inferences about gender differences. This paper investigated whether aggression functions in the same way across gender using teacher-rated aggression scales from the Behavior Assessment System for Children (BASC). The samples for this study consisted of the BASC standardization samples, including 1,223 children (628 boys, 595 girls) and 788 adolescents (379 boys, 409 girls). The measurement invariance of the BASC aggression scales was examined with both confirmatory factor analysis (CFA) and item response theory (IRT). CFA results showed that there was not enough evidence to support the measurement invariance of the scales across gender at a scale level; IRT results found that only a few items were significantly different across gender. The two methods have similarities and differences in studying measurement invariance, so they can be complementary to each other. The implications of the findings for research and practice in school psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial variability in the UDP-glucuronosyltransferase 1 (UGT1A1) promoter: a balanced polymorphism for regulation of bilirubin metabolism?

A polymorphism in the promoter of the UDP-glucuronosyltransferase 1 (UGT1A1) gene has been shown to cause Gilbert syndrome, a benign form of unconjugated bilirubinemia. Promoters containing seven thymine adenine (ta) repeats have been found to be less active than the wild-type six repeats, and the serum bilirubin levels of persons homozygous or even heterozygous for seven repeats have been found to be higher than those with the wild-type six repeats. We have now examined the genotypes in persons of Asian, African, and Caucasian ancestry. Although within the Caucasian ethnic group there is a strong correlation between promoter repeat number and bilirubin level, between ethnic groups we found that this relationship to be inverse. Among people of African ancestry there are, in addition to those with six and seven repeats, also persons who have five or eight repeats. Using a reporter gene we show that there is an inverse relationship between the number of ta repeats and the activity of the promoter through the range of 5-8 ta repeats. An incidental finding was a polymorphism at nucleotide -106, tightly linked to the (ta)5 haplotype. Serum bilirubin levels are influenced by many factors, both genetic and environmental. We suggest that the unstable UGT1A1 polymorphism may serve to "fine-tune" the plasma bilirubin level within population groups, maintaining it at a high enough level to provide protection against oxidative damage, but at a level that is sufficiently low to prevent kernicterus in infants.     

Doctor in the lab: what is it like for a doctor to work with scientists?

As clinical academic medical departments strive to improve the quality of their research, clinicians and scientists are forced into closer liaison. In many cases, clinical departments now have research laboratories directed by "basic scientists" but often staffed, in part at least, by doctors. To someone who has not worked in one, these laboratories may seem uncompromising and forbidding work environments. This article presents a "case report" written from the viewpoints of the doctor, the scientist, and the professor.     

Psychopathic traits from the perspective of self and informant reports: Is there evidence for a lack of insight?

It has been suggested that psychopathic individuals are incapable of providing valid reports on their own personality functioning because they are either unwilling (i.e., pathologically lie) or unable (i.e. lack insight) to do so. Despite the long-standing nature of this suggestion, almost no empirical research exists on this topic. In the current study, the authors examined the issue of psychopathy and insight by testing self and informant convergence and mean level differences across 3 indices of psychopathy in a community sample (N = 64). Self- and informant-report psychopathy scores were also examined in relation to self and informant reports on traits from the Five-Factor Model (FFM). Convergence was strong across the 3 psychopathy indices and their respective factors (i.e., median r = .64), and there was only modest evidence that individuals rated themselves as less psychopathic than did informants. In addition, the same FFM domains—low Agreeableness and Conscientiousness—characterized individuals with psychopathic traits regardless of reporter. Psychopathic individuals appear capable of reporting accurately on psychopathic traits when there are no direct consequences to accurate reporting (i.e., sentencing). It may be that the lack of concern for the consequences of these traits has been mistaken for a lack of insight into them. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A psychometric analysis of the Positive and Negative Affect Schedule for Children–Parent Version in a school sample.

The current study was the 1st to examine the psychometric properties of the Positive and Negative Affect Schedule for Children–Parent Version (PANAS-C-P) using a large school-based sample of children and adolescents ages 8 to 18 (N = 606). Confirmatory factor analysis supported a 2-factor (correlated) model of positive affect (PA) and negative affect (NA). The PANAS-C-P scale scores also demonstrated acceptable internal consistency and convergent and divergent validity. The PANAS-C-P PA and NA scale scores also related to measures of anxiety and depression in a manner consistent with the tripartite model. Scale means and standard deviations were reported by grade and sex to provide normative data for the PANAS-C-P scales. Results from the present study provide initial support for the PANAS-C-P as a parent-reported perspective of youth PA and NA among school-based youths. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Is authoritative teaching beneficial for all students? A multi-level model of the effects of teaching style on interest and achievement.

This study examined the effects of the two facets of authoritative teaching—high academic press and caring for students—on student interest and achievement in mathematics for middle and high school students (N = 3,602 in 198 classrooms), and whether those effects are moderated by students' ethnicity (Hispanic, Vietnamese, and Caucasian Non-Hispanic). Tested with hierarchical modeling, a trend suggested that the authoritative teaching style predicted higher levels of interest for Hispanic students; however, the trend for caring was approaching significance, which suggests that future research should be conducted to determine whether authoritative and authoritarian teaching styles truly have different effects on interest for this group. Authoritarian teaching (high press and low caring) was positively related to interest for Vietnamese students. Results for Caucasian students did not differ from Hispanic students, but should be interpreted with caution due to small sample size. For all students, authoritarian teaching was positively associated with achievement gains. Results are discussed in terms of the relationships between teaching style and different academic outcomes among particular student groups, as informed by the parenting style and teaching style literatures. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Is the dissociability of working memory systems for name identity, visual-object identity, and spatial location maintained in old age?

The dissociability of working memory for name identity (verbal information), visual objects, and spatial location was explored in 3 experiments. Consistent with previous results, the 3 working memory systems were dissociable in younger adults. Both younger and older adults showed involvement of name identity in an object identity task, and older adults showed this involvement in a spatial memory task. Results were interpreted as showing that the systems are generally separable but that involvement of 1 with another is possible and more likely in older adults. A 4th, correlational study showed that there is generalized decline in working memory systems in old age, with the age differences in memory mediated to a moderate extent by age-related differences in speed of processing. It was speculated that the specific, possibly strategic changes are independent of and take place against a backdrop of generalized loss of nervous system integrity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is the breast best for children with a family history of atopy? The relation between way of feeding and early childhood morbidity

BACKGROUND: Previous studies reported that breast-feeding protects children against a variety of diseases, but these studies were generally conducted on "high-risk" or hospitalized children. This paper describes the results of our study on the effects of breast-feeding on rate of illness in normal children with a family history of atopy. METHODS: A historic cohort approach of 794 children with a family history of atopy was used to assess the effects of breast-feeding on illness rates. Family history of atopy was based on allergic diseases in family members as registered by the family physician. Illness data from birth onwards were available from the Continuous Morbidity Registration of the Department of Family Medicine. Information on breast-feeding was collected by postal questionnaire. We then compared rates of illness between children with a family history of atopy who were and who were not breast-fed. RESULTS: Breast-feeding was related to lower levels of childhood illness both in the first and the first three years of life. In the first year of life they had fewer episodes of gastroenteritis, lower respiratory tract infections, and digestive tract disorders. Over the next three years of life they had fewer respiratory tract infections and skin infections. CONCLUSIONS: Our results suggest a protective effect of breast-feeding among children with a family history of atopy that is not confined to the period of breast-feeding but continues during the first three years of life. Breast-feeding should be promoted in children with a family history of atopy.     

Can it be predicted which patients with chronic low back pain should be offered tertiary rehabilitation in a functional restoration program? A search for demographic, socioeconomic, and physical predictors

STUDY DESIGN: A prospective clinical trial was conducted that involved six groups of patients with chronic low back pain selected from a large cohort (N = 816). OBJECTIVES: To correlate pretreatment baseline variables with outcome parameters after treatment in a functional restoration program or in control programs, to identify possible factors predictive of the need for functional restoration. SUMMARY OF BACKGROUND DATA: Since the functional restoration program was first described, research has focused on identifying patients who will or will not benefit from such a program. The value of previous studies is limited, however, because predictive factors from a control group were not "subtracted." METHODS: Eight hundred sixteen patients with chronic low back disability were included. All had a structured medical examination, including various physical tests before participation in either a functional restoration program (n = 621) or shorter "control" outpatient programs (n = 144). A smaller group of the cohort (n = 51) had no treatment and served as a pure control group. Six groups were selected from the cohort: Three underwent an identical functional restoration program and three underwent different outpatient control programs. Several baseline demographic, physical, and socioeconomic variables were correlated to 1-year outcome parameters. RESULTS: Age, days of sick leave, connection to the work force, and back pain intensity, were significantly correlated to success 1 year after entry into the study in all groups, no matter what kind of treatment was administered. Back muscle endurance, sports activity, activity of daily living scores, and vibrations were of importance in some outcome parameters for success after functional restoration. Smoking was positively correlated to disability pension. Days of sick leave and, in functional restoration, ability to work were the only factors that were correlative with statistics for people who withdrew. CONCLUSIONS: Different factors can be identified as predictive of outcome in a functional restoration program, but most of these factors were also shown to predict success for shorter control outpatient programs or of no treatment.     

Molecular Biology to Radiation Oncology: A Model for Translational Research? Opportunities in basic and translational research. From a workshop sponsored by the National Cancer Institute, Radiation Research Program, January 26-28, 1997, Bethesda, Maryland

Many exciting discoveries are being made that are providing new insights into how molecules, cells and tissues respond to ionizing radiation. There remains a need, however, to translate these findings into more effective treatments for cancer patients, including those treated with radiation therapy. This complex task will require the collaboration of scientists studying molecular, cellular and tissue responses, and those performing clinical trials of emerging therapies. The Radiation Research Program of the National Cancer Institute sponsored a workshop entitled "Molecular Biology to Radiation Oncology: A Model for Translational Research?" to bring together basic scientists and clinicians to exchange ideas and fundamental concepts and to identify opportunities for future research and collaboration. Four broad topics were addressed: signal transduction and apoptosis, the cell cycle, repair of radiation damage, and the microenvironment. The development, selection and use of appropriate experimental models is crucial to finding and developing new therapies, and opportunities exist in this area as well. This paper and the accompanying paper by Coleman and Harris that provides the viewpoint of radiation oncologists (Radiat. Res. 150, 134-147, 1998) summarize the background concepts and opportunities for translational research identified by the workshop participants.