Gastrointestinal tract symptoms and self-reported abuse: a population-based study

BACKGROUND/AIMS: A link between abuse and irritable bowel syndrome (IBS) has been reported in outpatients but remains controversial. No population-based studies have investigated this issue. The aim of this study was to determine the prevalence of abuse and its association with symptoms in a representative community sample. METHODS: An age- and sex-stratified random sample of residents of Olmsted County, Minnesota ranging in age from 30 to 49 years was mailed a valid self-report symptom questionnaire. Abuse was assessed by standard published criteria. RESULTS: Of the 919 responders (74%), the age-adjusted prevalence of any abuse was 41% in women and 11% in men, resulting in an age- and sex-adjusted prevalence of 26%. Symptoms of IBS, dyspepsia, and frequent heartburn were reported by 14%, 23%, and 12%, respectively. There was a significant association between IBS and sexual abuse, emotional or verbal abuse, and abuse in childhood and adulthood. Similarly, dyspepsia and heartburn were both significantly associated with abuse. In the population, 31% had visited a physician for gastrointestinal symptoms; the odds of visiting a physician were highest in those reporting abuse in adulthood and childhood. CONCLUSIONS: Self-reported abuse is common in middle-aged subjects; those who report abuse are more likely to have symptoms consistent with IBS, dyspepsia, or heartburn and to visit a physician for bowel symptoms.     

Neuroleptic use and behavioral disturbance in nursing homes: a 1-year study

This article discusses a longitudinal study of change in disruptive behaviors among nursing home residents treated with neuroleptics compared with those not treated with neuroleptics. Observations were made of 201 participants on admission to and after 1 year in eight skilled nursing facilities. Nine disruptive behaviors were measured using the Psychogeriatric Dependency Rating Scale with nursing assistants. Neuroleptic use was documented from medication records. Odds ratios are reported for the association of behavior at baseline and use of neuroleptics on nine problem behaviors. For those who received neuroleptics during the year, there was greater change in both developing and resolving disruptive behaviors than for those not receiving neuroleptics. For both groups, restless or pacing behavior and belligerent behavior manifested by refusing instructions changed the most, both in developing and in apparently resolving. Our results show that change in disruptive behaviors occurs among nursing home residents regardless of neuroleptic use, but it occurs more frequently among those who receive neuroleptic medication. Knowledge of which disruptive behaviors are most likely to resolve or develop is important in training nursing home staff to cope with the behaviors as well as in planning interventions that may modify such behaviors.     

New nonsteroidal androgen receptor modulators based on 4-(trifluoromethyl)-2(1H)-pyrrolidino[3,2-g] quinolinone

Typhoid fever is often associated with abnormal liver biochemical tests, but severe hepatic involvement with a clinical feature of acute hepatitis is a rare complication. There have been more than 150 cases of salmonella hepatitis reported from both developed and developing countries. The documented incidence varies widely from less than 1% to 26% patients with enteric fever. The possible associated factors for development of salmonella hepatitis are virulence of the organisms, delayed treatment and poor general health of the patients. The pathogenesis of severe hepatic involvement in salmonella infection may be multifactorial and includes endotoxin, local inflammatory and/or host immune reactions. Clinical jaundice in salmonella hepatitis usually occurs within the first 2 weeks of the febrile illness. Hepatomegaly and moderate elevation of transaminase levels are common findings. Extreme hepatic dysfunction with hepatic encephalopathy is a rare coexisting complication in salmonella hepatitis. A positive culture for salmonella from blood or stool is essential to differentiate salmonella hepatitis from other causes of acute hepatitis. Hepatic pathology is characterized by the presence of typhoid nodules with marked hyperplasia of reticuloendothelial cells. The prognosis is usually good as salmonella hepatitis responds well to a specific antibiotic therapy and juandice resolves with clinical improvement. The clinical course can be severe with a mortality rate as high as 20%, particularly with delayed treatment or in patients with other complications of salmonella infection. As enteric fever is a common infection, the recognition of salmonella hepatitis is of clinical importance.     

Latchkey children and susceptibility to peer pressure: An ecological analysis.

Data on adolescents' after-school experiences and their susceptibility to peer pressure were derived from surveys administered to a heterogeneous sample of 865 adolescents in Grades 5–9. Consistent with the findings of previous studies, the results show that Ss who reported home after school were not significantly different from those who were supervised by their parents at home during after-school hours. However, when a 2nd sample of latchkey children (n?=?594) was studied to include greater variation in after-school experiences, Ss who were more removed from adult supervision were found to be more susceptible to peer pressure to engage in antisocial activity. Ss who were home alone were less susceptible to peer pressure than are those who were at a friend's house after school, and those who were at a friend's house, in turn, were less susceptible than were those who describe themselves as "hanging out." Moreover, latchkey Ss whose parents knew their whereabouts and those who had been raised authoritatively were less susceptible to peer influence than were their peers, even if their afternoons were spent in contexts in which adult supervision was lax and susceptibility to peer pressure was generally high. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Function of sulfur dioxide in the kinetic mechanism of oxidation of carbon

Retardation of the gasification reaction of carbon with oxygen by SO₂ was observed. Rates of oxidation were determined by thermal gravimetric analysis (TGA) of a nuclear graphite in the temperature range of 550–700°C, and of a coconut charcoal in the temperature range of 400–505°C. The oxidant gases were dry air containing 0–6% SO₂. Reduction of the rate by SO₂ varied with burn-off. Differential thermal analysis (DTA) was also applied to detect the retardation effect of SO₂. The technique of infrared internal reflection spectroscopy (IRS) was used to examine the surface species of reacted charcoal samples. Absorption bands were assigned to surface carbonyls, lactones, and a chemisorbed SO₂ in the form of sulfate. Chemisorption of SO₂ was attributed to cause the retardation of the oxidation reaction.     

Dimerization/docking domain of the type Ialpha regulatory subunit of cAMP-dependent protein kinase. Requirements for dimerization and docking are distinct but overlapping

Based on increasing evidence that the type I R subunits as well as the type II R subunits localize to specific subcellular sites, we have carried out an extensive characterization of the stable dimerization domain at the N terminus of RIalpha. Deletion mutants as well as alanine scanning mutagenesis were used to delineate critical regions as well as particular amino acids that are required for homodimerization. A set of nested deletion mutants defined a minimum core required for dimerization. Two single site mutations on the C37H template, RIalpha(F47A) and RIalpha(F52A), were sufficient to abolish dimerization. In addition to serving as a dimerization motif, this domain also serves as a docking surface for binding to dual specificity anchoring proteins (D-AKAPs) (Huang, L. J., Durick, K., Weiner, J. A., Chun, J., and Taylor, S. S. (1997) J. Biol. Chem. 272, 8057-8064; Huang, L. J., Durick, K., Weiner, J. A., Chun, J., and Taylor, S. S. (1997) Proc. Natl. Acad. Sci. U. S. A. 94, 11184-11189). A similar strategy was used to map the sequence requirements for anchoring of RIalpha to D-AKAP1. Although dimerization appears to be essential for anchoring to D-AKAP1, anchoring can also be abolished by the following single site mutations: C37H, V20A, and I25A. These sites define "hot spots" for the anchoring surface since each of these dimeric proteins are deficient in binding to D-AKAP1. In contrast to earlier predictions, the alignment of the dimerization/docking domains of RIalpha and RII show striking similarities yet subtle differences not only in their secondary structure (Newlon, M. G., Roy, M., Hausken, Z. E., Scott, J. D., and Jennings. P. A. (1997) J. Biol. Chem. 272, 23637-23644) but also in the distribution of residues important for both docking and dimerization functions.     

Tennessee's failed managed care program for mental health and substance abuse services

In July 1996, Tennessee initiated a managed mental health and substance abuse program called TennCare Partners. This publicly funded "carve-out" experiment started chaotically and soon deteriorated into a crisis. Many patients did not receive care or lost continuity of care, and the traditional "safety net" mental health system nearly disintegrated. This qualitative case study sought to ascertain the impact of the TennCare Partners program. It points out that the program's difficulties stemmed directly from a flawed design that spread funds previously earmarked for severely mentally ill patients across the entire Medicaid population. States contemplating similar reforms should strive to protect vulnerable patients by risk-adjusting capitation payments and by focusing resources on care for severely mentally ill persons. States should also minimize program complexity and ensure the accountability of managed care networks for their patients' behavioral health care needs.     

Temporal processing of the pitch of complex tones

The effect of tone duration on fundamental frequency (F0) discrimination is greater for complexes containing unresolved harmonics than for those containing resolved harmonics [Plack and Carlyon, J. Acoust. Soc. Am. 98, 1355-1364 (1995)]. Three experiments explored this effect further. The first experiment measured sensitivity (as d') to fundamental frequency (F0) differences for two complexes, both with an F0 of 250 Hz. The first complex was low-pass filtered at 1875 Hz to create a resolved complex and the second was bandpass filtered between 5500 and 7500 Hz to create an unresolved complex. The harmonics for the resolved complex were selected so that no two harmonics were the same between the two observation intervals. Performance for both complexes was measured for tone durations of 20, 40, 80, and 160 ms. For the unresolved complex, the effect of duration was greater than that for the resolved complex and greater than the predictions of a "multiple-looks" model assuming either peripheral (before sampling) or central (after combining samples) sources of variance. The second experiment replicated these results using an F0 of 62.5 Hz with the cutoff frequencies of the bandpass filters divided by four, confirming that the effect is related to resolvability and not to spectral region. In the final experiment, F0 discrimination for pairs of complexes separated by a temporal gap was measured relative to that for one complex. Performance for the resolved and unresolved complexes was similar: Very little effect of gap duration was observed and the results were consistent with the predictions of the peripheral-variance multiple-looks model. Taken together, the results suggest that the pitch mechanism for resolved harmonics uses a relatively short sampling window of around 20 ms, while the mechanism for unresolved harmonics may use a more complex strategy for optimizing the combination of information over time, perhaps involving a flexible integration time.     

Evolution of the trappin multigene family in the Suidae

The purpose of the study was to examine the effects of manipulating lung volume (LV) on phonatory and articulatory kinematic behavior during sentence production in healthy adults. Five men and five women repeated the sentence "I sell a sapapple again" under five LV conditions. These included (1) speaking normally, (2) speaking after exhaling most of the air from the lungs, (3) speaking at end expiratory level (EEL), (4) speaking after a maximal inhalation, and (5) speaking after a maximal inhalation while attempting to maintain as normal a mode of speech as possible. From a multichannel recording, measures were made of LV, sound pressure level (SPL), fundamental frequency (F0) and semitone standard deviation (STSD), and upper and lower lip displacements and peak velocities. When compared with the reference condition, the sentence was spoken significantly more quickly at the lowest LV. SPL increased significantly for the high LV condition, as did the women's F0 and STSD. Upper lip displacements and peak velocities generally decreased for LVs other than the reference condition. Lower lip movements showed inconsistent changes as a function of LV. Adjustments to the LV for speech led to SPL and F0 changes consistent with a coordinated control of the respiratory system and the larynx. However, less consistent effects were observed in the articulatory kinematic measures, possibly because of a less direct biomechanical and neural control linkage between respiratory and articulatory structures.