Is telomere length socially patterned? Evidence from the West of Scotland Twenty-07 study

Lower socioeconomic status (SES) is strongly associated with an increased risk of morbidity and premature mortality, but it is not known if the same is true for telomere length, a marker often used to assess biological ageing. The West of Scotland Twenty-07 Study was used to investigate this and consists of three cohorts aged approximately 35 (N = 775), 55 (N = 866) and 75 years (N = 544) at the time of telomere length measurement. Four sets of measurements of SES were investigated: those collected contemporaneously with telomere length assessment, educational markers, SES in childhood and SES over the preceding twenty years. We found mixed evidence for an association between SES and telomere length. In 35-year-olds, many of the education and childhood SES measures were associated with telomere length, i.e. those in poorer circumstances had shorter telomeres, as was intergenerational social mobility, but not accumulated disadvantage. A crude estimate showed that, at the same chronological age, social renters, for example, were nine years (biologically) older than home owners. No consistent associations were apparent in those aged 55 or 75. There is evidence of an association between SES and telomere length, but only in younger adults and most strongly using education and childhood SES measures. These results may reflect that childhood is a sensitive period for telomere attrition. The cohort differences are possibly the result of survival bias suppressing the SES-telomere association; cohort effects with regard different experiences of SES; or telomere possibly being a less effective marker of biological ageing at older ages

Systematic population screening, using biomarkers and genetic testing, identifies 2.5% of the U.K. pediatric diabetes population with monogenic diabetes

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.OBJECTIVE: Monogenic diabetes is rare but is an important diagnosis in pediatric diabetes clinics. These patients are often not identified as this relies on the recognition of key clinical features by an alert clinician. Biomarkers (islet autoantibodies and C-peptide) can assist in the exclusion of patients with type 1 diabetes and allow systematic testing that does not rely on clinical recognition. Our study aimed to establish the prevalence of monogenic diabetes in U.K. pediatric clinics using a systematic approach of biomarker screening and targeted genetic testing. RESEARCH DESIGN AND METHODS: We studied 808 patients (79.5% of the eligible population) <20 years of age with diabetes who were attending six pediatric clinics in South West England and Tayside, Scotland. Endogenous insulin production was measured using the urinary C-peptide creatinine ratio (UCPCR). C-peptide-positive patients (UCPCR ≥0.2 nmol/mmol) underwent islet autoantibody (GAD and IA2) testing, with patients who were autoantibody negative undergoing genetic testing for all 29 identified causes of monogenic diabetes. RESULTS: A total of 2.5% of patients (20 of 808 patients) (95% CI 1.6-3.9%) had monogenic diabetes (8 GCK, 5 HNF1A, 4 HNF4A, 1 HNF1B, 1 ABCC8, 1 INSR). The majority (17 of 20 patients) were managed without insulin treatment. A similar proportion of the population had type 2 diabetes (3.3%, 27 of 808 patients). CONCLUSIONS: This large systematic study confirms a prevalence of 2.5% of patients with monogenic diabetes who were <20 years of age in six U.K. clinics. This figure suggests that ∼50% of the estimated 875 U.K. pediatric patients with monogenic diabetes have still not received a genetic diagnosis. This biomarker screening pathway is a practical approach that can be used to identify pediatric patients who are most appropriate for genetic testing.This work presents independent research commissioned by the Health Innovation Challenge Fund, a parallel funding partnership between the Wellcome Trust and the Department of Health (grant HICF-1009-041); and was supported by the National Institute for Health Research (NIHR) Exeter Clinical Research Facility and the South West Peninsula Diabetes Research Network. M.S. is supported by the NIHR Exeter Clinical Research Facility. T.J.M. is funded by an NIHR CSO Fellowship. S.E. and A.T.H. are both Wellcome Trust Senior Investigators. E.R.P. is a Wellcome Trust New Investigator. A.T.H. is an NIHR Senior Investigator

Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis

Background Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy. Methods We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance. Results We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography. Conclusion Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data

Why nonsuicidal self-injury?: examining the validity of steps of a decisional model of nonsuicidal self-injury under distress

The most common reason for Nonsuicidal Self-Injury (NSSI) is to reduce distress (Klonsky, 2007), yet it is unclear why people decide to use NSSI to reduce distress on a specific occasion. This study tested separate steps of a decision making model (adapted from Janis &amp; Mann, 1977) about using NSSI to reduce distress. College students who have previously self-injured were administered 14-21 daily online questionnaires about coping behavior and decisions. Results supported each step of the model and indicated that NSSI was more likely when someone is more distressed, less hopeful to find another coping behavior, and can find solitude, amongst other findings. These results highlight potential areas of clinical intervention including specific cognitions to modify and improving social support. This study should be improved and replicated in future research

The Interaction of Temperament and Childhood Sexual Abuse in Predicting Symptoms of Borderline Personality Disorder

This study examined how two of Rothbart's temperament variables (Rothbart &amp; Derryberry, 1981), negative affect and effortful control, along with childhood sexual abuse, (CSA) predict borderline personality disorder (BPD) symptoms. It was hypothesized that increased negative affect, increased CSA, and their interaction would predict BPD symptoms. It was further hypothesized that this relationship would be mediated by lower levels of effortful control. Questionnaires assessing effortful control, negative affect, CSA, and BPD were administered to 215 female undergraduates. Structural equation modeling supported the first hypothesis, but not the second. The data indicated that the interaction was specific to BPD when compared to avoidant personality disorder. These results provide support for the theory that temperament interacts with the environment to produce BPD

The effect of media and beauty standards on the body image of women with a visual disability

“The twentieth century has seen a huge upsurge in the importance placed by western society on physical beauty, particularly for women” (Wood “Perceptions of Feminine Beauty,” n.d.). Fashion industries, cosmetics, and plastic surgeries have all flourished on the importance society has placed on physical beauty. Marketing ploys from these industries often show tall, slender, white women who suggest cosmetics, diet regimens, and other beauty enhancements to successfully transform one’s aesthetic. With the fashion and media industries heavy reliance on visuals, there have been a plethora of evaluations conducted to examine the media’s influence on women’s body image. Yet, there has been little research conducted with non-able-bodied women, specifically women with visual disabilities, and the effects that the media has on their self-image. To determine this, I conducted semi-structured, in-depth interviews, with six college-aged blind or visually impaired women which focused on their lived experiences and exposure to the media. Recruiting participants through convenience sampling, I interpreted the data based on participants’ race, culture, and other common themes in response to their lived experiences. Results demonstrated participants had a positive self-image; contributors included their family, self, and partners. Keywords: disability, visual disability, body-image, women, medi

The verbal behavior of the autistic child

Procedures were employed over a period of six months to develop communication in three non-verbal, emotionally-disturbed children who displayed autistic types of behavior as described by banner. The children were institutionalized, and, at the beginning of therapy, ranged in age from five years three months to eleven years seven months. The oldest was a girl with a hearing impairment who had been diagnosed at age four as schizophrenic (autistic type), and the two younger subjects were boys. The basic therapeutic method utilized was operant conditioning using food and social reinforcement. Negative reinforcement was a firm “No,” or immediate cessation of an activity

Crafting one’s brand to fit: an exploration of Black female principals’ construction and navigation of their leadership identities

African American female school leaders have a great responsibility and complex task before them. Not only are they charged with managing and improving schools, leading and empowering staff, and ensuring that the students under their care find academic success, they must also do this while managing their identity and navigating through various gender and race related social constructions. School leaders have multiple selves such as the identities they use when dealing with parents, district personnel, colleagues, students, etc. Effectively managing these selves is imperative to their successfulness as a school leader. This study examines how African American female principals construct and craft their leadership identities. Using the theoretical framework of critical race theory and black feminist thought, it discusses in depth the challenges Black females face based on their race and gender. This study also details their need to prove themselves and to change perceptions related to the stereotypes that plague women of color. It provides insight about how these women navigate and shift their identities in order to find and maintain success in their work spaces. This study recognizes that African American women are doubly marginalized; however, it appreciates their efforts to succeed despite the hurdles they face. The stories and voices of these women are seldom heard in the context of educational leadership and this study attempts to fill that void. Six women were selected and interviewed for this qualitative study which sought to answer the following questions: How do African American female principals construct and navigate their leadership identities? How do Black female administrators describe their experiences with identity navigation and shifting in terms of personality, behavior, and physical appearance? How do they use identity navigation and shifting to fit their work spaces? Also, this study uses autoethnographic data obtained from the author's own interview data, a daily log of events, excerpts from a reflective journal, relevant emails, and memories coupled with interview data from the six administrators to create a composite portrait illustrating a week in the life of a Black female school principal. In order to follow the tenets of critical race theory, the author's and the participants' authentic voice was honored through the use of powerful narratives and a composite counter-story. Themes that emerged related to the need for African American women to prove themselves professionally and to portray an image and identity that dispelled myths and negative perceptions related to their gender and/or race. Shifting strategies that are used such as changing communication styles, appearance, and behaviors are discussed. Concluding thoughts, implications for future research, and recommendations for educational practitioners are also presented