Telomerase and the aging heart

Telomeres are highly conserved structures that cap and protect the ends of linear chromosomes. The telomerase enzyme is present in germline cells as well as in many rapidly dividing tissues and serves to maintain chromosome length and integrity during cell division. Telomerase activity is typically reduced as an organism ages, and this phenomenon has been implicated in the aging process. In this Perspective, we focus on the effects of both gene knockout and gene replacement of telomerase in the heart and discuss the implications of these findings for potential cardiovascular therapeutics.     

Assistive technology outcomes in work settings

Successfully documenting the outcomes of assistive technology (AT) interventions in the workplace benefits people with disabilities, service providers and agencies. However, no work related system currently exists that comprehensively collects the data needed to analyze such outcomes. Part of the reason for this absence of an outcome system is that, while the concept is simple, the process is complex and depends on the acquisition of data that represent many outcomes related variables. This article describes the exploratory work of the NIDRR (National Institute on Disability and Rehabilitation Research) funded ATOMS Project (Assistive Technology Outcomes Measurement System) and its efforts to identify existing data that might be used as the basis for an outcomes measurement system. Sample records from four assistive technology service programs were acquired and evaluated for the data they housed. This study discovered that AT service programs fail to collect consistent or sufficient data for outcomes analysis. However, discussions with AT programs that provided services to State vocational rehabilitation agencies revealed an interesting potential. Assistive technology service data in combination with data collected by State vocational rehabilitation departments might coalesce the needed data. The Federal Rehabilitation Services Administration (RSA) 911 Report aggregates many variables of outcomes related information including employment status and the success of the vocational rehabilitation investment. This combined database could answer a range of assistive technology outcomes related questions of interest to service providers, people with disabilities, and vocational rehabilitation State agencies. This paper describes the data needed in an outcomes system, reviews the data that appear to be available today related to AT outcomes, and projects how data from two diverse programs might be used together to create a significant outcomes database.     

Knit Your Own Without a Pattern: Health Promotion Specialists in an Internal Market

The reforms of the National Health Service in England have given an emphasis to "strategic" approaches to health and health care, in that, ideally, purchasing decisions will be made on the basis of evidence from various forms of "needs assessment". Alongside these reforms a strategic approach to the promotion of health has been set out in the "Health of the Nation" (DoH 1992). However, although the promotion of health is high on the policy agenda, the occupational group of health promotion specialists, whose prime function it is to devise, develop and implement health promotion strategies, have been ignored. Drawing on qualitative interview data with these specialists in both provider and purchasing settings in England this paper argues that thus far the reforms have actually hindered the development of a strategic approach to the promotion of health by health promotion specialists. Three main reasons for this are suggested; a confusion over the most appropriate institutional location for health promotion specialists; a lack of clarity by key actors as to the role and function of health promotion specialists; and the emergence of a model of effectiveness and efficiency which is largely antithetical to the philosophy and practice of health promotion.     

The encounter with family violence and risky sexual activity among young adolescent females

In this article, we analyze the relationship between family violence and risky sexual activity for female adolescents (age 14 to 17). We examine two forms of family violence: experience (receiving physical abuse from a parent or parent-figure) and exposure (witnessing interparental physical violence). We hypothesize that either form of violence will predict greater odds of engaging in risky sexual behavior. We define risky sexual activity as any of the following: having multiple partners within the last 12 months or having sex with partners who are themselves engaging in risky behavior (e.g., having multiple partners of either sex, injecting unprescribed drugs, sharing unprescribed needles for injecting drugs). We analyzed data from 710 respondents taken from the National Survey of Family Growth, Cycle V, living with at least one biological parent. Results showed that experiencing violence from a parent greatly increased the likelihood of risky sex, even when controlling for the experience of forced sex, age, mother's age at first birth, race, socioeconomic status, and religiosity. Female adolescents who had experienced forced sex, those who were older (especially 17-year-olds), non-Hispanic Blacks (but not Hispanics), those living in a family with low educational attainment (less than a high school diploma), and those for whom religion was not or only somewhat personally important were more likely to report risky sex compared to others. These effects were not modified by whether the respondents lived in single- or two-parent families. An interaction between the two forms of physical violence suggests that either form is sufficient to increase significantly the odds of risky sex; an analysis in which respondents were differentiated by their experience of either form of violence showed a strong effect of experience on risky sex, net of the control variables.     

Gastrostomy and children: a review of the literature in learning disabilities

Children with developmental delays often suffer feeding difficulties. It has become common for those with a severe likelihood of malnutrition to be considered for alternative methods of nutritional intake, often a gastrostomy. As part of a pilot study investigating the effects of gastrostomy on the child and their family, we conducted a literature review in order to establish the current areas of research, progress and concern. This paper describes the method and findings of the literature review and concludes with a discussion of the topics raised. The main conclusion is that although the need for gastrostomy in this group of children has been shown to be effective in maintaining adequate weight gain and nutritional intake, the support given to the family prior to, and after the operation is inadequate. Greater emphasis needs to be placed on detailed family assessment as part of the early intervention package. Copyright © 2001 John Wiley & Sons, Ltd.     

Practical usage of O'Brien's OLS and GLS statistics in clinical trials

Multivariate techniques of O'Brien's OLS and GLS statistics are discussed in the context of their application in clinical trials. We introduce the concept of an operational effect size and illustrate its use to evaluate power. An extension describing how to handle covariates and missing data is developed in the context of Mixed models. This extension allowing adjustment for covariates is easily programmed in any statistical package including SAS. Monte Carlo simulation is used for a number of different sample sizes to compare the actual size and power of the tests based on O'Brien's OLS and GLS statistics.     

Parental structure experiences of children: Exposure,transitions, and type at birth

This paper examines parental structure experiences during childhood and adolescence of non-Hispanic whites, blacks, Mexicans, and Puerto Ricans born 1957 to 1964. The study shows that the parental structure types most commonly experienced are mother-father, mother only, and mother-stepfather. The study also finds that a significant proportion of children move into a mother-only family and do not leave it. Finally, the study shows that the parental structure experiences of children are strongly influenced by their parental structure at birth.A version of this paper was presented at the meetings of the American Sociological Association in Pittsburgh, Pennsylvania, August 1992.