All that glitters is not always gold: Medical offset effects and managed behavioral health care.

This article urges caution in using broadly predicted medical offset effects in marketing managed behavioral care services. Three analyses of a health maintenance organization population who were provided managed mental health services showed that the use of simple percentage change in cost and use of hospital care may give deceptively positive results. The use of such methods may eventually undermine rather than support the credibility of managed care contracts for professional psychology. Results are discussed in the context of professional psychology's future role in guiding quality assurance and cost-effectiveness studies in regional, multiprofessional primary practice groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Not that bad after all: Generation of random sequences.

People simulating a random generator fail in the rate of each event, which is too close to the theoretical rate, and in overalternation between events. It is suggested that both failures stem from attempts to produce within short-term memory (STM) limitations a typical sequence in the standard task. 398 Ss of 3 age groups performed 3 coin-tossing tasks: standard, guessing, and guessing with feedback. The proportion of events was more variable and alternation rate was higher in the guessing than in the standard task. High alternation rates are shown to be byproducts of typical sequences. An estimate of the window size within which people operate highly correlated with age (corresponding to changes in STM capacity), further supporting the typicality assumption. People's grasp of randomness is therefore concluded to be better than hitherto believed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cryopexy is not as bad as all that

PURPOSE: This report describes an extremely rare case of an infant with neuroblastoma involving MYCN amplification found through mass screening (MS). PATIENT: An 8-month-old boy was referred to our hospital after screening for neuroblastoma showed positive results. A firm tumor was found above his left kidney and completely resected. RESULTS: The tumor arose from the left adrenal gland. The disease was classified as stage I according to the International Neuroblastoma Staging System. Although the tumor showed a favorable histology, MYCN was amplified to 20 copies. After surgery, the infant underwent chemotherapy, but a new mass in the right adrenal gland was found. After chemotherapy, the tumor was excised. Despite several courses of chemotherapy, multiple metastases in both lung fields appeared. More intensive chemotherapy and allogenic peripheral blood stem cell transplantation were performed, but the infant died from pulmonary hemorrhage after the transplantation. CONCLUSIONS: The majority of patients with neuroblastoma found through MS have a good outcome. However, some patients have poor prognostic factors, like our patient with MYCN amplification. There is a need to develop a suitable protocol for babies with high risk features younger than 1 year of age found through MS.     

A new heat shock protein that binds nucleic acids

Familial acromegaly/gigantism occurring in the absence of multiple endocrine neoplasia type I (MEN-1) or the Carney complex has been reported in 18 families since the biochemical diagnosis of GH excess became available, and the genetic defect is unknown. In the present study we examined 2 unrelated families with isolated acromegaly/gigantism. In family A, 3 of 4 siblings were affected, with ages at diagnosis of 19, 21, and 23 yr. In family B, 5 of 13 siblings exhibited the phenotype and were diagnosed at 13, 15, 17, 17, and 24 yr of age. All 8 affected patients had elevated basal GH levels associated with high insulin-like growth factor I levels and/or nonsuppressible serum GH levels during an oral glucose tolerance test. GHRH levels were normal in affected members of family A. An invasive macroadenoma was found in 6 subjects, and a microadenoma was found in 1 subject from family B. The sequence of the GHRH receptor complementary DNA in 1 tumor from family A was normal. There was no history of consanguinity in either family, and the past medical history and laboratory results excluded MEN-1 and the Carney complex in all affected and unaffected screened subjects. Five of 8 subjects have undergone pituitary surgery to date, and paraffin-embedded pituitary blocks were available for analysis. Loss of heterozygosity on chromosome 11q13 was studied by comparing microsatellite polymorphisms of leukocyte and tumor DNA using PYGM (centromeric) and D11S527 (telomeric), markers closely linked to the MEN-1 tumor suppressor gene. All tumors exhibited a loss of heterozygosity at both markers. Sequencing of the MEN-1 gene revealed no germline mutations in either family, nor was a somatic mutation found in tumor DNA from one subject in family A. The integrity of the MEN-1 gene in this subject was further supported by demonstration of the presence of MEN-1 messenger ribonucleic acid, as assessed by RT-PCR. These data indicate that loss of heterozygosity in these affected family members appears independent of MEN-1 gene changes and suggest that a novel (tissue-specific?) tumor suppressor gene(s) linked to the PYGM marker and expressed in the pituitary is essential for regulation of somatotrope proliferation.     

Report of the Treasurer: 1977. Revenues, expenses, and all that jazz.

Presents a report from the American Psychological Association's treasurer for the year 1977. Because APA's activities and materials are largely in publications, and since these constitute over half of our annual revenues, the first part of this year's Treasurer's Report is devoted to a selective overview of our publication programs and operations. The financial portion of the report includes (a) a report of the 1976 audited results from operations; (b) a look at APA's financial condition as of December 31, 1976; (c) a prediction for 1977; (d) a review of the 1978 approved budget; and (e) a projection for 1979. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual and spatial working memory are not that dissociated after all: A time-based resource-sharing account.

Examinations of interference between visual and spatial materials in working memory have suggested domain- and process-based fractionations of visuo-spatial working memory. The present study examined the role of central time-based resource sharing in visuo-spatial working memory and assessed its role in obtained interference patterns. Visual and spatial storage were combined with both visual and spatial on-line processing components in computer-paced working memory span tasks (Experiment 1) and in a selective interference paradigm (Experiment 2). The cognitive load of the processing components was manipulated to investigate its impact on concurrent maintenance for both within-domain and between-domain combinations of processing and storage components. In contrast to both domain- and process-based fractionations of visuo-spatial working memory, the results revealed that recall performance was determined by the cognitive load induced by the processing of items, rather than by the domain to which those items pertained. These findings are interpreted as evidence for a time-based resource-sharing mechanism in visuo-spatial working memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of chronic morphine administration upon a modified Sidman avoidance schedule that utilizes response-independent shock

Six male squirrel monkeys were subjected to a Sidman nondiscriminated avoidance schedule (R-S, S-S-20 sec) that superimposed 3-min conditioned stimuli (CS) unavoidable shock pairings upon the ongoing avoidance behavior. Five of the 6 animals demonstrated facilitated avoidance response rates during the CS, while one animal demonstrated suppressed rates during the CS. Morphine sulfate (0.5, 1.0, 2.0, 3.0, 4.0 mg/kg) altered these patterns, causing the suppressor to facilitate, while the facilitators demonstrated reduced levels of response elevation during the aversive CS. Morphine also led to a reliable reduction in overall response rate and an increase in the number of shocks received. No consistent drug effects were noted with regard to general motor activity. These results were interpreted to suggest that a potent analgesic agent, such as morphine, was able to reduce the level of fear motivation normally generated by the aversive CS. Since changes in relative rate during the aversive CS were quite reliable both within and between animals, it was suggested that this behavioral schedule might prove useful in assaying the fear-reducing qualities of a variety of drugs. A cautionary note, however, indicated that other explanations, most notably, a rate dependent hypothesis, could account for the data without assuming the level of fear was altered.     

Inositol phospholipids: translocation, translocation, translocation..

The pleckstrin homology (PH) domains of a number of proteins have been found to interact in vitro with inositol phospholipids; recent experiments show that these interactions may be important in directing protein translocation to specific parts of the cell following stimulus-induced lipid breakdown or synthesis.