The protein domains of vertebrate species in which selection is more effective have greater intrinsic structural disorder

The nearly neutral theory of molecular evolution posits variation among species in the effectiveness of selection. In an idealized model, the census population size determines both this minimum magnitude of the selection coefficient required for deleterious variants to be reliably purged, and the amount of neutral diversity. Empirically, an "effective population size" is often estimated from the amount of putatively neutral genetic diversity and is assumed to also capture a species' effectiveness of selection. A potentially more direct measure of the effectiveness of selection is the degree to which selection maintains preferred codons. However, past metrics that compare codon bias across species are confounded by among-species variation in %GC content and/or amino acid composition. Here we propose a new Codon Adaptation Index of Species (CAIS), based on Kullback-Leibler divergence, that corrects for both confounders. We demonstrate the use of CAIS correlations, as well as the Effective Number of Codons, to show that the protein domains of more highly adapted vertebrate species evolve higher intrinsic structural disorder.

A qualitative study of primary care clinician's approach to ending cervical cancer screening in older women in the United States

The United States Preventive Services Task Force (USPSTF) recommends that cervical cancer screening end in average-risk patients with a cervix at 65 years of age if adequate screening measures have been met, defined as having 1) at least three normal consecutive cytology (Pap) tests, or 2) two normal cytology tests and/or two negative high-risk human papillomavirus tests between ages 55-65; the last test should be performed within the prior 5 years. Up to 60 % of all women aged 65 years and older who are ending screening do not meet the criteria for adequate screening. The objective of this study was to understand the process and approach that healthcare clinicians use to determine eligibility to end cervical cancer screening. In 2021 we conducted semi-structured interviews in San Francisco, CA with twelve healthcare clinicians: two family medicine physicians, three general internal medicine physicians, two obstetrician/gynecologists and five nurse practitioners. Thematic analysis, using inductive and deductive coding, was utilized. Three major themes emerged: following guidelines, relying on self-reported data regarding prior screening, and considering sexual activity as a factor in the decision to end screening. All interviewees endorsed following the USPSTF guidelines and they utilized self-report to determine eligibility to end screening. Clinicians' approach was dependent in part on their judgement about the reliability of the patient to convey their screening history. Sexual activity of the patient was considered when making clinical recommendations. Shared decision-making was often utilized. Clinicians voiced a strong reliance on self-reported screening history to end cervical cancer screening.

"Good luck, social distance": rapid decarceration and community care for serious mental illness and substance use disorder during the COVID-19 pandemic

The COVID-19 pandemic inspired calls for rapid decarceration of prisons and jails to slow the spread of disease in a high-risk congregate setting. Due to the rarity of intentionally-decarcerative policies, little is known about the effects of rapid decarceration on individuals with serious mental illness (SMI) substance use disorder (SUD), a population who receive many services via the criminal legal system (CLS). We conducted interviews with 13 key informants involved in CLS in San Francisco, CA to better understand the implication of the decarcerative policies put into practice in early 2020. Participants described a tension between the desire to have fewer people incarcerated and the challenges of accessing services and support - especially during the lockdown period of the pandemic - outside of the CLS given the number of services that are only accessible to those who have been arrested, incarcerated, or sentenced. These findings emphasize the need for investing in community social services rather than further expanding the CLS to achieve the goal of supporting individuals with SMI and SUD shrinking the US system of mass incarceration.

Hospice Quality, Race, and Disenrollment in Hospice Enrollees With Dementia

Background: Racial and ethnic minoritized people with dementia (PWD) are at high risk of disenrollment from hospice, yet little is known about the relationship between hospice quality and racial disparities in disenrollment among PWD. Objective: To assess the association between race and disenrollment between and within hospice quality categories in PWD. Design/Setting/Subjects: Retrospective cohort study of 100% Medicare beneficiaries 65+ enrolled in hospice with a principal diagnosis of dementia, July 2012-December 2017. Race and ethnicity (White/Black/Hispanic/Asian and Pacific Islander [AAPI]) was assessed with the Research Triangle Institute (RTI) algorithm. Hospice quality was assessed with the publicly-available Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey item on overall hospice rating, including a category for hospices exempt from public reporting (unrated). Results: The sample included 673,102 PWD (mean age 86, 66% female, 85% White, 7.3% Black, 6.3% Hispanic, 1.6% AAPI) enrolled in 4371 hospices nationwide. Likelihood of disenrollment was higher in hospices in the lowest quartile of quality ratings (vs. highest quartile) for both White (adjusted odds ratio [AOR] 1.12 [95% confidence interval 1.06-1.19]) and minoritized PWD (AOR range 1.2-1.3) and was substantially higher in unrated hospices (AOR range 1.8-2.0). Within both low- and high-quality hospices, minoritized PWD were more likely to be disenrolled compared with White PWD (AOR range 1.18-1.45). Conclusions: Hospice quality predicts disenrollment, but does not fully explain disparities in disenrollment for minoritized PWD. Efforts to improve racial equity in hospice should focus both on increasing equity in access to high-quality hospices and improving care for racial minoritized PWD in all hospices.

"Prison life is very hard and it's made harder if you're isolated": COVID-19 risk mitigation strategies and the mental health of incarcerated women in California

PURPOSE

This study aims to describe the COVID-19 risk mitigation strategies implemented in California prisons and the impact of these policies on the mental health of incarcerated women.

DESIGN/METHODOLOGY/APPROACH

The authors conducted semi-structured qualitative interviews with ten women who were over the age of 50 and/or had a chronic illness and had been incarcerated in California prisons during the COVID-19 pandemic. The authors also interviewed ten health-care providers working in California jails or prisons during the pandemic. Interviews were analyzed using a grounded theory coding framework and triangulated with fieldnotes from ethnographic observations of medical and legal advocacy efforts during the pandemic.

FINDINGS

Participants described being locked in their cells for 23 hours per day or more, often for days, weeks or even months at a time in an effort to reduce the spread of COVID-19. For many participants, these lockdowns and the resulting isolation from loved ones both inside and outside of the prison were detrimental to both their physical and mental health. Participants reported that access to mental health care for those in the general population was limited prior to the pandemic, and that COVID-19 risk mitigation strategies, including the cessation of group programs and shift to cell-front mental health services, created further barriers.

ORIGINALITY/VALUE

There has been little qualitative research on the mental health effects of the COVID-19 pandemic on incarcerated populations. This paper provides insight into the mental health effects of both the COVID-19 pandemic and COVID-19 risk mitigation strategies for the structurally vulnerable older women incarcerated in California prisons.

COVID-19 and the reimaging of compassionate release

PURPOSE

The purpose of this paper is to provide a historical overview of compassionate release policies in the USA and describe how these policies have been used during the COVID-19 pandemic. The authors then describe how these programs have been shaped by COVID-19 and could be reimagined to address the structural conditions that make prisons potentially life limiting for older adults and those with chronic illness.

DESIGN/METHODOLOGY/APPROACH

This paper is primarily descriptive, offering an overview of the history of compassionate release policies before and during the COVID-19 pandemic. The authors augmented this description by surveying state Departments of Corrections about their utilization of compassionate release during 2019 and 2020. The findings from this survey were combined with data collected via Freedom of Information Act Requests sent to state Departments of Corrections about the same topic.

FINDINGS

The findings demonstrate that while the US federal prison system saw a multifold increase in the number of individuals released under compassionate release policies in 2020 compared to 2019, most US states had modest change, with many states maintaining the same number, or even fewer, releases in 2020 compared with 2019.

ORIGINALITY/VALUE

This paper provides both new data and new insight into compassionate release utilization during the COVID-19 pandemic and offers new possibilities for how compassionate release might be considered in the future.

Inferring genome-wide correlations of mutation fitness effects between populations

The effect of a mutation on fitness may differ between populations depending on environmental and genetic context, but little is known about the factors that underlie such differences. To quantify genome-wide correlations in mutation fitness effects, we developed a novel concept called a joint distribution of fitness effects (DFE) between populations. We then proposed a new statistic w to measure the DFE correlation between populations. Using simulation, we showed that inferring the DFE correlation from the joint allele frequency spectrum is statistically precise and robust. Using population genomic data, we inferred DFE correlations of populations in humans, Drosophila melanogaster, and wild tomatoes. In these species, we found that the overall correlation of the joint DFE was inversely related to genetic differentiation. In humans and D. melanogaster, deleterious mutations had a lower DFE correlation than tolerated mutations, indicating a complex joint DFE. Altogether, the DFE correlation can be reliably inferred, and it offers extensive insight into the genetics of population divergence.

Corrigendum: Creativity, Resilience and Resistance: Black Birthworkers' Responses to the COVID-19 Pandemic

[This corrects the article DOI: 10.3389/fsoc.2021.636029.].

Universal and taxon-specific trends in protein sequences as a function of age

Extant protein-coding sequences span a huge range of ages, from those that emerged only recently to those present in the last universal common ancestor. Because evolution has had less time to act on young sequences, there might be 'phylostratigraphy' trends in any properties that evolve slowly with age. A long-term reduction in hydrophobicity and hydrophobic clustering was found in previous, taxonomically restricted studies. Here we perform integrated phylostratigraphy across 435 fully sequenced species, using sensitive HMM methods to detect protein domain homology. We find that the reduction in hydrophobic clustering is universal across lineages. However, only young animal domains have a tendency to have higher structural disorder. Among ancient domains, trends in amino acid composition reflect the order of recruitment into the genetic code, suggesting that the composition of the contemporary descendants of ancient sequences reflects amino acid availability during the earliest stages of life, when these sequences first emerged.

Creativity, Resilience and Resistance: Black Birthworkers' Responses to the COVID-19 Pandemic

This article documents the experiences of Black birthworkers supporting pregnant and birthing people and new mamas during the first six months of the COVID-19 pandemic. Building on the methodology and outcomes of Battling Over Birth-a Research Justice project by and for Black women about their experiences of pregnancy and childbirth-the authors utilized a "community-based sheltered-in-place research methodology" to collect the narratives of Black birthworkers, including doulas, certified nurse-midwives (CNMs), homebirth midwives, lactation consultants, community health workers and ob/gyns. The article examines the impact of restrictions put in place by hospitals and clinics, including inadequate or inconsistent care, mandatory testing, separation from newborns, and restrictions on attendance by birth support people, including doulas. Birthworkers shared the innovative approaches that they have devised to continue to offer care and the ways that they have expanded the care they offer to make sure the needs of Black birthing people and new parents are being met during this uncertain time. The article also explores the threats to health, safety, and financial security faced by Black birthworkers as a result of the pandemic, and the overt and subtle forms of racism they had to navigate. Finally, it documents the sources of strength that Black birthworkers have found to sustain them at the frontlines of a maternal health care system in crisis.

Selective sweeps on novel and introgressed variation shape mimicry loci in a butterfly adaptive radiation

Natural selection leaves distinct signatures in the genome that can reveal the targets and history of adaptive evolution. By analysing high-coverage genome sequence data from 4 major colour pattern loci sampled from nearly 600 individuals in 53 populations, we show pervasive selection on wing patterns in the Heliconius adaptive radiation. The strongest signatures correspond to loci with the greatest phenotypic effects, consistent with visual selection by predators, and are found in colour patterns with geographically restricted distributions. These recent sweeps are similar between co-mimics and indicate colour pattern turn-over events despite strong stabilising selection. Using simulations, we compare sweep signatures expected under classic hard sweeps with those resulting from adaptive introgression, an important aspect of mimicry evolution in Heliconius butterflies. Simulated recipient populations show a distinct 'volcano' pattern with peaks of increased genetic diversity around the selected target, characteristic of sweeps of introgressed variation and consistent with diversity patterns found in some populations. Our genomic data reveal a surprisingly dynamic history of colour pattern selection and co-evolution in this adaptive radiation.

Molecular Evolutionary Consequences of Island Colonization

Island endemics are expected to have low effective population sizes (Ne), first because some may experience population bottlenecks when they are founded, and second because they have restricted ranges. Therefore, we expect island species to have reduced genetic diversity, inefficient selection, and reduced adaptive potential compared with their mainland counterparts. We used both polymorphism and substitution data to address these predictions, improving on the approach of recent studies that only used substitution data. This allowed us to directly test the assumption that island species have small values of Ne We found that island species had significantly less genetic diversity than mainland species; however, this pattern could be attributed to a subset of island species that appeared to have undergone a recent population bottleneck. When these species were excluded from the analysis, island and mainland species had similar levels of genetic diversity, despite island species occupying considerably smaller areas than their mainland counterparts. We also found no overall difference between island and mainland species in terms of the effectiveness of selection or the mutation rate. Our evidence suggests that island colonization has no lasting impact on molecular evolution. This surprising result highlights gaps in our knowledge of the relationship between census and effective population size.

The rate of adaptive evolution in animal mitochondria

We have investigated whether there is adaptive evolution in mitochondrial DNA, using an extensive data set containing over 500 animal species from a wide range of taxonomic groups. We apply a variety of McDonald-Kreitman style methods to the data. We find that the evolution of mitochondrial DNA is dominated by slightly deleterious mutations, a finding which is supported by a number of previous studies. However, when we control for the presence of deleterious mutations using a new method, we find that mitochondria undergo a significant amount of adaptive evolution, with an estimated 26% (95% confidence intervals: 5.7-45%) of nonsynonymous substitutions fixed by adaptive evolution. We further find some weak evidence that the rate of adaptive evolution is correlated to synonymous diversity. We interpret this as evidence that at least some adaptive evolution is limited by the supply of mutations.

In vitro exposure of preimplantation porcine embryos to porcine parvovirus

Early porcine embryos at the four- to eight-cell stage can be infected with either the virulent (NADL-8) or avirulent KBSH strain of porcine parvovirus (PPV) by microinjection or by incubation of embryos with virus. Treatment of embryos by microinjection of virus or incubation in media with virus did not significantly inhibit in vitro development of the embryos when compared with untreated controls. RNA-DNA hybridization was used to identify the presence of virus associated with embryos. It was found that PPV-DNA was present in viable embryos after microinjection of embryos with KBSH and NADL-8 strains of PPV and after incubation of embryos with KBSH strain. The data indicated the presence of replicative virus associated with viable porcine embryos.

Psychophysiological effects of habitual caffeine consumption

Caffeine is the most widely consumed pharmacologically active substance in the world, and a key issue concerning its possible implications for human health is whether it has persistent (i.e., chronic) physiological effects on habitual consumers. This study examined blood pressure, heart rate (HR), electromyogram (EMG), and skin conductance level (SCL) in 36 healthy men and women exposed to a pattern of moderate intake. A double-blind placebo-controlled crossover design with counterbalancing was used in which all subjects participated in four experimental conditions involving the ingestion of placebo or caffeine three times daily for 6 days followed by a seventh ("challenge") day of placebo or caffeine ingestion. Results confirmed that caffeine has significant pressor effects, and these were found to he additive to the pressor action of a laboratory stressor. Following habitual consumption of the drug. pressor effects were diminished (indicative of tolerance) but not eliminated. Effects of caffeine on other parameters were either modest (HR and EMG) or negligible (SCL). Considering (he near-universal use of caffeine. the persistent pressor effects observed in this study have important implications for clinical practice and public health.

Acute and chronic effects of caffeine on performance, mood, headache, and sleep

Despite being the most widely consumed psychoactive substance in the world, there is considerable confusion regarding the effects of caffeine. This study examined objective indices of performance, and self-reported mood, headache, and sleep in 36 healthy male and female habitual caffeine consumers exposed to a pattern of moderate intake. A double-blind placebo-controlled cross-over design with counterbalancing was employed in which all subjects participated in four experimental conditions involving the ingestion of placebo or caffeine 3 times daily for 6 days followed by a 7th (challenge) day of placebo or caffeine ingestion. No evidence was found that caffeine improved performance, either in the context of acute or habitual use. On the contrary, performance was found to be significantly impaired when caffeine was withdrawn abruptly following habitual use. Participants reported feeling more alert and less tired following acute ingestion of caffeine, but feeling less alert in conjunction with chronic exposure to the drug. In addition, caffeine withdrawal was associated with reported increases in frequency and severity of headache, and with reports of sleeping longer and more soundly.

Hemodynamic profile of stress-induced anticipation and recovery

Systolic and diastolic blood pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance were measured in 100 healthy men and women with the aim of investigating hemodynamic profile during anticipation of, and recovery from, exposure to active and passive laboratory stressors. A 5-min anticipatory period preceded two tasks, both of which lasted 2.5 min. The tasks were mental arithmetic ('beta-adrenergic' stress) and the cold pressor test ('alpha-adrenergic' stress). Each task was followed by a 5-min recovery period. Blood pressure and heart rate were measured with a FinaPres 2300e, and stroke volume, cardiac output, and total peripheral resistance were computed from these parameters. Salivary cortisol was measured in relation to both tasks, and participants completed tests of state and trait anxiety, locus of control, and hostility. As expected, mental arithmetic and the cold pressor test elicited myocardial and vascular patterns of reactivity, respectively. However, contrary to expectations, anticipatory and recovery hemodynamic profile involved essentially vascular responding for both stressors. Salivary cortisol increased in response to both tasks but only weakly correlated with hemodynamic changes. None of the subjective measurements was a strong predictor of physiological reactivity. The findings suggest that stress-induced anticipatory and recovery reactivity may be generally vascular rather than myocardial. This could have important implications in light of suggestions that anticipatory and recovery responses may be better predictors of subsequent cardiovascular disease than direct stress-induced reactivity.

Effects of video-relayed social support on hemodynamic reactivity and salivary cortisol during laboratory-based behavioral challenge

The authors tested the effects of a laboratory analogue of social support on reactivity to laboratory-based behavioral challenge. Video-relayed supportive commentary was provided by a same-sex confederate while participants (40 healthy men and women assigned to support and no-support groups) performed a demanding computer task, and their heart rate, systolic and diastolic blood pressure, and salivary cortisol were measured. The authors found that heart rate and cortisol level (but not blood pressure) were attenuated in the support condition for both genders. Objective performance on the task was similar in both groups, but the social support group reported higher levels of perceived support and rated the task as easier than did participants in the no-support condition. Video presentation offers new opportunities for systematically examining social support and its effects.

Effects of video-relayed social support on hemodynamic reactivity and salivary cortisol during laboratory-based behavioral challenge

The authors tested the effects of a laboratory analogue of social support on reactivity to laboratory-based behavioral challenge. Video-relayed supportive commentary was provided by a same-sex confederate while participants (40 healthy men and women assigned to support and no-support groups) performed a demanding computer task, and their heart rate, systolic and diastolic blood pressure, and salivary cortisol were measured. The authors found that heart rate and cortisol level (but not blood pressure) were attenuated in the support condition for both genders. Objective performance on the task was similar in both groups, but the social support group reported higher levels of perceived support and rated the task as easier than did participants in the no-support condition. Video presentation offers new opportunities for systematically examining social support and its effects.

The psychological and emotional impact of living with an automatic internal cardioverter defibrillator (AICD): how can nurses help?

The introduction of the Automatic Internal Cardioverter Defibrillator (AICD) has greatly improved the mortality rates associated with sudden cardiac events (Moss et al 1996, McCarthy 1997, Trappe et al 1997). Little is known about the consequences of living with this device for patients and their families. Biomedical influences have resulted in the devices's success being measured on physical adaptation, with data on suitability, reliability, and efficiency of AICDs as a therapeutic measure. What seems to be of equal priority now is to obtain insights as to the emotional and psychological consequences of such treatment, and the effects these may have on outcomes and utilization of health-care resources. AICD patients have described many powerful emotions arising from receiving this device, which are often heightened at discharge, yet little is known of the reasons for this (James 1997a). It is essential that individuals' and their families' perceptions of their experiences are understood so that clinical staff can not only meet the technological and safety needs of this group, but also assist them to adjust to living with an AICD. Families of AICD patients report significant emotions arising from their support of AICD patients, and describe their own needs and problems. Nevertheless, the influence of, and the effects on the family are often underestimated within AICD patient care. A shift away from a purely individualistic approach towards a more family-centred approach is suggested, arguably enabling the role of family members to be recognized, supported and developed. Qualitative research in this area is needed to inform clinical nursing practice and assist in development of clinical expertise to address the important issues for patients and families. This should enable them to return to their everyday lives with appropriate support. Education of healthcare professionals in a wide variety of clinical areas is needed to ensure a sound body of knowledge, as a basis for development of a more holistic approach to care which encompasses and recognizes the feelings and emotions evoked from receiving this device.

A comparison of fluorescence versus chemiluminescence detection for analysis of the fluorescamine derivative of histamine by HPLC

Fluorescence and chemiluminescence detection were compared for HPLC analysis of the fluorescamine derivative of histamine. The kinetic behaviour of the chemiluminescent response for the derivative was characterized in a static system. An HPLC method was optimized for the derivative using fluorescence detection. Fluorescence detection was linear over the range of 166-1666 pg on column for the fluorescamine-histamine derivative with a limit of detection of 13 pg on column. Using a detector designed for optimal use with chemiluminescence, the chemiluminescence response of the fluorescamine derivative was linear over a range of 1.66-16.6 ng on column with a limit of detection of 1.0 ng on column. These results exemplify a case in which superior detectibility is provided by fluorescence over chemiluminescence, and contradicts many reports comparing fluorescence to chemiluminescence. The authors conclude that chemiluminescence should be considered when indicated by conditions established for separation that are favourable for the observation of chemiluminescence. These conditions include sufficiently low excitation energies corresponding to an excitation maximum greater than 400 nm, favourable dipole character of analytes, mobile phases of high organic content, and an appropriate pH of the mobile phase.

Chronic effects of habitual caffeine consumption on laboratory and ambulatory blood pressure levels

BACKGROUND

Uncertainty continues to surround the role of habitual caffeine consumption as a cardiovascular risk factor. The present study examined the effects of moderate caffeine intake on 24h blood pressure and heart rate in normotensive men and women.

METHODS

A double-blind, placebo-controlled, crossover design with counterbalancing was used, in which 36 healthy men and women participated in four experimental conditions involving the ingestion of placebo or caffeine three times daily for 6 days, followed by a seventh ('challenge') day of placebo or caffeine ingestion.

RESULTS

When caffeine was consumed on the challenge day, blood pressure was found to be elevated immediately after caffeine ingestion and was either unchanged or decreased (hypotensive effect) after a period of abstinence from the drug. Some diminution of the peak pressor effects was found when participants ingested caffeine after habitual use of the drug (6.0/5.2 mmHg) compared with when they had been abstinent before the challenge day (7.7/6.8 mmHg). This diminution in the reaction was comparatively small, however, and pressor effects persisted on caffeine-challenge days even when caffeine was consumed on preceding days.

CONCLUSION

Habitual consumption diminished, but did not eliminate, the pressor effects of caffeine. Considering the almost universal consumption of caffeine beverages, the persistent pressor effects of the drug could have important implications for cardiovascular health.

Pressor effects of caffeine and cigarette smoking

Pressor effects of caffeine and cigarette smoking were examined in 15 normotensive young men and women. A cross-over design was used in which all subjects participated in four separate conditions: placebo alone, caffeine alone, placebo plus smoking, and caffeine plus smoking. Caffeine and smoking produced independent increases in systolic and diastolic blood pressure, and these effects were additive in the caffeine-plus-smoking condition. Heart rate was significantly increased by smoking but was essentially unaffected by caffeine.

The influence of user status and anxious disposition on the hypertensive effects of caffeine

The present study examined the influence of consumer status and anxious disposition on the hypertensive effects of caffeine. A secondary aim of the study was to investigate possible gender differences in response to caffeine. Sixty normotensive subjects were assigned to 4 groups representing high and low scorers on the variables of habitual caffeine consumption and anxious disposition. A randomized double-blind crossover design was used in which all subjects received a placebo (lactose) at one of two 120-min laboratory sessions and caffeine (6 mg/kg) at the other. Systolic and diastolic blood pressure, heart rate, hand steadiness, and EMG were monitored before and after exposure to a psychological stressor. Caffeine produced significant elevations in systolic and diastolic blood pressure, and these effects were additive to the pressor effects of stress and anxiety. While the general pattern of results was similar for both sexes, reactions to caffeine were more pronounced in males than in females. Notwithstanding the need for clarification of the chronic effects of caffeine, present findings add further weight to current concerns about the acute hypertensive effects of the drug.

Virtue rewarded: reinforcement and punishment in an acute psychiatric admission ward

This study evaluated the naturally occurring behaviour of psychiatric patients in an acute psychiatric setting. Direct behavioural observations were carried out to determine the amount of time patients spent in interaction, with whom they interacted, and the nature of the interaction. Also examined were each respondent group's type and rate of interactive behavior. For much of the time no interactive behaviour was observed to occur, but much of the behaviour exhibited by patients was socially appropriate. When social interactions did occur, both fellow patients and staff tended to reinforce appropriate behaviour. However, nurses reinforced inappropriate crazy behaviour much less than did fellow-patients or non-nursing staff. Treatment implications are discussed.

Lumbar zygapophyseal joint meniscoids: evidence of their role in chronic intersegmental hypomobility

Meniscoid bodies of the zygapophyseal joints are considered by some to be a cause of the Acute-Locked Back Syndrome. These meniscoid bodies have been identified anatomically and histologically, but not yet in a formal clinical investigation. The authors provide a brief review of the zygapophyseal meniscoid-related literature, present new documentation of histological variations and offer some possible consequences of the presence of mechanically pathological meniscoids. It is herein proposed that an important sequela to the pathophysiology of these structures is that of chronic intersegmental hypomobility. We invite the scientific community to pursue further investigations of these meniscoids. Magnetic resonance imaging is one method suggested to investigate the meniscoid in vivo.

Relative efficacy of intensive and spaced behavioral treatment of stuttering

Twenty adult and adolescent stutterers were randomly assigned to two treatment formats consisting of either 16 two-hour sessions of fluency training administered within a concentrated period of four consecutive days (intensive treatment), or two two-hour sessions per week for eight weeks (spaced treatment). Frequency of stuttering and rate of speaking were repeatedly assessed from speech samples obtained in six different clinic and extra-clinic speech settings. The efficiency of treatment, subject compliance, and communication "attitudes" were also measured. Fluency training produced significant reductions in stuttering frequency, and significant improvements in speaking rate and communication attitudes for both treatment formats. Both formats were found equivalent on all measures. In addition, generalization of treatment effects was observed in all settings. However, maintenance of generalization effects was uneven across settings, suggesting the possible need for differential levels of training for different speaking situations.

Self-report reliability and symptomatology of habitual caffeine consumption

1. A large body of research on the demography of caffeine use and its potential health consequences has been undermined by the absence of empirical data on the reliability of retrospective self-reports of caffeine consumption. 2. The principal aim of the present study was to use standard bioanalytic method to assess the reliability of subjects' self-reported caffeine use. Saliva samples were obtained from 142 first-and second-year medical students and assayed for caffeine and paraxanthine. 3. Self-reported caffeine use was found to be significantly correlated with salivary caffeine (r = 0.31, P less than 0.001) and paraxanthine (r = 0.42, P less than 0.001), thereby providing qualified support for use of questionnaires to estimate patterns of caffeine consumption. 4. A secondary aim of the study was to extend previous research concerning the symptomatology of caffeine use by examining the association between caffeine exposure and a variety of measures of somatic and psychological health. Caffeine consumption was reliably associated with the self-reported occurrence of somatic symptoms, but not psychological well-being.

Biochemical validation of self-reported caffeine consumption during caffeine fading

Increasing concern about caffeine as a drug with potential for abuse has resulted in the development of procedures for effecting reductions in caffeine consumption among heavy users. However, the reliability of reported findings may be questioned, since previous studies have relied on subject self-report as the principal measure of caffeine use. The present study employed bioanalytic methods for assessing the reliability of self-reported caffeine intake during a caffeine-fading regime. Twelve subjects, each with a history of heavy caffeine use, provided baseline, treatment, and follow-up blood samples which were assayed for caffeine and its major metabolites. General support was provided for the reliability of self-report as a measure of caffeine consumption. The general efficacy of caffeine fading was also supported, although there were indications that maintenance effects may have been over-estimated in previous studies.

Desensitization treatment of agoraphobia

Clinical literature on desensitization treatment of agoraphobia is reviewed. The popular belief that in vivo desensitization is generally superior to imaginal exposure is critically examined. Studies which do not support this belief are reviewed, and the implications for clinical practice are considered.

Embryo transfer in swine

Embryo transfer is used to propagate genetically superior swine while minimizing disease risks. Embryos are harvested through a ventral midline incision in the anesthetized sow 4-6 days after estrus, using a glass tube or Foley catheter. Embryos are transferred to similarly prepared sows by injection directly into the uterus through a tomcat catheter or glass pipette. Embryos typically are transferred within a few hours of collection but may be stored in culture medium at 37 C for up to 30 hours.

The relative efficacy of imaginal and in vivo desensitization in the treatment of agoraphobia

Claims have often been made that in vivo procedures are generally superior to imaginal approaches in the clinical management of anxiety and avoidance behavior. Such claims seem unwarranted in that the relevant clinical research appears only to have involved either flooding or rapid exposure techniques. The aim of the present study was specifically to examine the relative efficacy of imaginal and in vivo desensitization in the clinical management of debilitating phobia. Six agoraphobic women participated in the study which employed a multiple-baseline single-subject methodology. Severity of phobia was repeatedly assessed on measures of avoidance behavior and subjective distress, and subjects self-monitored pulse rate. Significant reductions in phobic behavior were observed during both imaginal and in vivo desensitization, but neither treatment was found to be more effective than the other. Moreover, the same pattern of results was observed for both treatment and generalization settings. As such, the results do not support previous suggestions that in vivo exposure is necessarily superior to imaginal desensitization in the treatment of agoraphobia. Encouraging follow-up results provided some confirmation of previous findings indicating the effectiveness of self-management procedures in the long-term control of agoraphobia.

Embryo transfer for conserving valuable genetic material from swine herds with pseudorabies

Embryo transfer was used to conserve genetic material from 2 swine herds seropositive for pseudorabies virus (PRV). Embryos (n = 805) were recovered from 38 PRV-seropositive Duroc sows in Iowa and, after 4 to 10 hours' culture and shipment to Illinois, were transferred to 34 recipients from a herd seronegative for PRV. All recipients remained seronegative for PRV, and 22 of the recipients farrowed 208 pigs (189 alive) that also were seronegative for PRV. There was no evidence of PRV in the embryo recovery medium or in the uterine and oviductal cells recovered with the embryos. Transfer of morulae resulted in higher (P less than 0.02) farrowing rates than did transfer of 4- to 8-cell embryos, but litter size was not affected.

Parameters of the influence of self-initiated time-out from speaking on stuttering

The influence of two parameters of self-initiated time-out from speaking were investigated with 33 adolescent and adult stutterers. Subjects were assigned at random to one of three conditions which compared experimenter-administered time-out of fixed duration, experimenter-administered time-out of duration determined by the subject, and self-initiated time-out of fixed duration. When given the opportunity to determine time-out duration, subjects chose a relatively brief period. In addition, when given responsibility for self-initiating time-out contingent on stuttering, subjects were significantly less reliable than was the experimenter in administering the procedure. Nevertheless, significant improvements in fluency were observed during all three time-out conditions, and the improvements were comparable across the three conditions.

The modification of parent behavior. A review of generalization and maintenance

This article reviews the literature on the extratraining effects of behavioral family intervention relating to parent behavior. The review classifies generalization and maintenance into several distinct categories suggested by Drabman, Hammer, and Rosenbaum (1979). The authors conclude that only limited aspects of generalization and maintenance questions in parent training have been addressed and highlight several persisting methodological deficiencies that have hampered the development and evaluation of effective generalization programming technologies.