High-resolution measurements of the DT neutron spectrum using new CD foils in the Magnetic Recoil neutron Spectrometer (MRS) on the National Ignition Facility.

The Magnetic Recoil neutron Spectrometer (MRS) on the National Ignition Facility measures the DT neutron spectrum from cryogenically layered inertial confinement fusion implosions. Yield, areal density, apparent ion temperature, and directional fluid flow are inferred from the MRS data. This paper describes recent advances in MRS measurements of the primary peak using new, thinner, reduced-area deuterated plastic (CD) conversion foils. The new foils allow operation of MRS at yields 2 orders of magnitude higher than previously possible, at a resolution down to ∼200 keV FWHM.

Breast cancer detection among Irish BRCA1 & BRCA2 mutation carriers: a population-based study.

BACKGROUND: High-risk breast cancer screening for BRCA1/2 mutation carriers with clinical breast exam, mammography and MRI has reported sensitivity of 100 %, but BRCA1/2 mutation carriers still present with interval cancers. AIMS: We investigated the presentation and screening patterns of an Irish cohort of BRCA1/2 mutation carriers with breast cancer. MATERIALS AND METHODS: BRCA1/2 mutation carriers with breast cancer were identified in this retrospective cohort study. Records were reviewed for BRCA1/2 mutation status, demographics, screening regimen, screening modality, stage and histology at diagnosis. RESULTS: Fifty-three cases of breast cancer were diagnosed between 1968 and 2010 among 60 Irish hereditary breast ovarian cancer (HBOC) families. In 50 of 53 women, the diagnosis of breast cancer predated the identification of BRCA1/2 mutations. Breast cancer detection method was identified in 47 % of patients (n = 25): 80 % (n = 20) by clinical breast exam (CBE), 12 % by mammography (n = 3), 8 % by MRI (n = 2). Fourteen women (26 %) developed a second breast cancer. Ten of these patients (71 %) were involved in regular screening; 50 % were detected by screening mammography, 20 % by MRI and 30 % by CBE alone. Six patients (43 %) had a change in morphology from first to second breast cancers. There was no change in hormone receptor status between first and second breast cancers. CONCLUSION: In this cohort of Irish BRCA1/2 mutation carriers, compliance with screening was inconsistent. There was a 30 % incidence of interval cancers occurring in women in high-risk screening. Preventive surgery may be a more effective risk reduction strategy for certain high-risk women.

Genetic testing and interpretive complexity: a BRCA1 gene mutation example.

Diagnosis and interpretation of hereditary breast cancer can be a complex and challenging dilemma. Advances in genetic testing have resulted in guidelines for clinical evaluation and recommendations. Here, we present a case of one family with multiple cases of early-onset breast cancer, some due to a familial BRCA1 mutation but others unrelated to this pathogenic E143X nonsense mutation. In this case report, we highlight the complexities associated with adhering strictly to guidelines and highlight the need for clinical experience in when to deviate from recommended protocols.

Multivariate analysis of MLH1 c.1664T>C (p.Leu555Pro) mismatch repair gene variant demonstrates its pathogenicity.

Genetic testing of an Irish kindred identified an exonic nucleotide substitution c.1664T>C (p.Leu555Pro) in the MLH1 mismatch repair (MMR) gene. This previously unreported variant is classified as a "variant of uncertain significance" (VUS). Immunohistochemical (IHC) analysis and microsatellite instability (MSI) studies, genetic testing, a literature and online MMR mutation database review, in silico phenotype prediction tools, and an in vitro MMR activity assay were used to study the clinical significance of this variant. The MLH1 c.1664T>C (p.Leu555Pro) VUS co-segregated with three cases of classic Lynch syndrome-associated malignancies over two generations, with consistent loss of MLH1 and PMS2 protein expression on IHC, and evidence of the MSI-High mutator phenotype. The leucine at position 555 is well conserved across a number of species, and this novel variant has not been reported as a normal polymorphism in the general population. In silico and in vitro analyses suggest that this variant may have a deleterious effect on the MLH1 protein and abrogate MMR activity. Evidence from clinical, histological, immunohistochemical, and molecular genetic data suggests that MLH1 c.1664T>C (p.Leu555Pro) is likely to be the pathogenic cause of Lynch syndrome in this family.

Informal roles and the stages of interdisciplinary team development.

After presenting a theory of team development, we propose that the informal role structure of a team is dependent upon the degree of anomie in the team culture, and we provide measures of anomie and informal roles that can be used in field settings. Then we test hypotheses on a national sample of 111 interdisciplinary health care teams in geriatrics in US Veterans Affairs medical centers. We find evidence that as teams develop from early to later stages, the interpersonal behavior of members becomes less differentiated on three dimensions: prominence, sociability, and task-orientation. In addition, we find that images of each member come into clearer focus, as evidenced by reduced variation in how each member is seen by other team members. Finally, we find that regardless of stage of team development, the more education the team members have, the more prominent and task-oriented they are. In general, physicians score highest in prominence and task-orientation, but relatively low in sociability.

Health values buffer social-environmental risks for adolescent alcohol misuse.

Data from a representative sample of 17- to 20-year-old adolescents were analyzed to investigate whether a health-valuing attitude could buffer the effects of social-environmental risk on adolescent alcohol misuse. A risk index was constructed for adolescents, based on variables such as friends' drinking, parental alcohol abuse, and poor parental monitoring and communication. The expected buffering interaction called for high environmental risk to lead to greater alcohol misuse for adolescents who placed low value on health, but not for those who placed high value on health. The expected interactions were obtained for 2 alcohol-related variables (total consumption and consuming 5 or more drinks at a time).

Tobacco use among high school athletes and nonatieletes: results of the 1997 youth risk behavior survey.

In the United States today, the use of tobacco has become an entrenched part of teenage culture. The present study used the 1997 Youth Risk Behavior Survey (YRBS), which collected data from a nationally representative sample of 16,262 students in public and private high schools, to compare the tobacco use patterns of athletes and nonathletes. The independent variable, athletic participation, differentiated between moderately involved (1 or 2 teams) and highly involved (3 or more teams) athletes. Frequency of cigarette and cigar smoking and smokeless tobacco use served as the operational measure of tobacco use. Age, race/ethnicity, parental education, and residence were controlled. Logistic regression was used to calculate odds ratios for female and male athletes and nonathletes for each of the tobacco use variables. It was found that both male and female athletes were less likely to have ever smoked regularly, the effect being stronger for more highly involved athletes of both genders. Cigar smoking was unrelated to athlete status. Both female and male athletes were more likely to have used smokeless tobacco, the effect being stronger for more highly involved athletes of both genders. The findings are discussed in terms of access to health information, performance considerations, social status factors, the salience of an athletic identity, and the influence of the athletic subculture on its members.

High school athletic participation, sexual behavior and adolescent pregnancy: a regional study.

PURPOSE: To determine whether high school athletic participation among adolescents in Western New York was associated with reduced rates of sexual behavior and pregnancy involvement. METHODS: A secondary analysis of data from the Family and Adolescent Study, a longitudinal study of a random sample of adolescents (ages 13-16 years) from 699 families living in households in Western New York. A general population sample was obtained with characteristics closely matching the census distributions in the area. Interview and survey methods provided data on athletic participation, frequency of sexual relations during the past year, and risk for pregnancy. Bivariate correlations were used to examine relationships among athletic participation, demographic and control variables, and measures of sexual behavior and pregnancy rates. Next, path analyses were done in order to test for hypothesized relationships between athletic participation, sexual behavior, and pregnancy involvement while controlling for age, race, income, family cohesion, and non-athletic forms of extracurricular activity. Variables that were significantly associated with sexual behavior and/or pregnancy involvement were presented for both sexes within the resulting multivariate models. RESULTS: Lower income and higher rates of sexual activity were associated with higher rates of pregnancy involvement for both sexes. Family cohesion was associated with lower sexual activity rates for both sexes. For girls, athletic participation was directly related to reduced frequency of sexual behavior and, indirectly, to pregnancy risk. Male athletes did not exhibit lower rates of sexual behavior and involvement with pregnancy than male non-athletes. Boys who participated in the arts, however, did report lower rates of sexual behavior and, indirectly, less involvement with pregnancy. CONCLUSIONS: Female adolescents who participated in sports were less likely than their non-athletic peers to engage in sexual activity and/or report a pregnancy. Among male adolescents, athletic participation was unrelated to sexual behavior and pregnancy involvement. Teen pregnancy prevention efforts for girls should consider utilizing sport as a strategic tool.

PIP: A longitudinal study using a random sample of adolescents, aged 13-16 years, was conducted in western New York to determine if athletic participation was associated with a reduced rate of sexual behavior and pregnancy. 699 families were interviewed and surveyed, and bivariate correlations were used to examine the relationships among athletic participation, demographic and control variables, and measures of sexual behavior and pregnancy rates. Findings showed that high rates of pregnancy involvement for both sexes were associated with low income and high sexual activity. Higher levels of family cohesion reduced rates of sexual activity for both sexes. Girls' athletic participation was directly proportional to reduced frequency of sexual behavior and, indirectly, to pregnancy risk. However, lower rates of sexual behavior and pregnancy involvement among adolescent male athletes were not discovered. Female adolescents who participated in sports were less likely than their nonathletic peers to engage in sexual activity and/or report a pregnancy. Among male adolescents, athletic participation was unrelated to sexual behavior and pregnancy involvement.

Development of an Attitudes Toward Health Care Teams Scale.

The authors describe the development and psychometric testing across three study phases of an Attitudes Toward Health Care Teams Scale. The measure contains two subscales: Quality of Care/Process (14 items) and Physician Centrality (6 items). The Quality of Care/Process subscale measures team members' perceptions of the quality of care delivered by health care teams and the quality of teamwork to accomplish this. The Physician Centrality subscale measures team members' attitudes toward physicians' authority in teams and their control over information about patients. Tests of reliability and validity demonstrate that each subscale is a strong measure of its respective underlying concept. The measure has potential for use as a research tool and as a pre- and posttest tool for educational interventions with teams and for evaluating clinically based team training programs for medical and health professions students and residents.

Sports, sexual behavior, contraceptive use, and pregnancy among female and male high school students: testing cultural resource theory.

PIP: This paper explores the relationship among athletic participation and sexual behavior, contraceptive use, and pregnancy in female and male high school students in the US. Using the 1995 Youth Risk Behavior Survey, the sexual behavior of 8979 high school students was analyzed using covariance and multiple covariance. After controlling for factors such as race and ethnicity, age, and maternal education, it was observed that girls who participated in sports activities had lower rates of sexual experience, fewer sex partners, later age of first intercourse, higher rates of contraceptive use, and lower rates of past pregnancies compared to girls who did not participate in sports. On the other hand, male high school athletes were reported to have higher rates of sexual experience and more partners than nonathletes, although higher prevalence of contraceptive use during their most recent intercourse was noted. Based on the cultural resource theory, it was suggested that athletic participation would most likely reduce the girls' adherence to conventional cultural scripts while providing them with additional social and personal resources on which to draw in the sexual bargaining process. In addition, sports provide boys with similar resources while strengthening their commitment to traditional masculine scripts.^ieng

Athletic participation and sexual behavior in adolescents: the different worlds of boys and girls.

Using multivariate analysis of covariance to test hypotheses about the effects of sports and sexual behavior on a sample of 611 Western New York adolescents, this study concludes that athletic participation and gender interact to influence adolescent sexual outcomes. Female athletes report significantly lower rates of sexual activity than female nonathletes; male athletes report slightly (though not significantly) higher rates than male nonathletes. The gender-specific effect of sports on sexual behavior remains, net of the impacts of race, age, socioeconomic status, quality of family relations, and participation in other extracurricular activities. This paper introduces cultural resource theory to explain how athletic participation influences both traditional cultural scripts and exchange resources, which, in turn, condition the sexual bargaining process and its outcomes for adolescents.

Parental and peer influences on the onset of heavier drinking among adolescents.

OBJECTIVE: Less is known about heavier drinking in adolescents than about alcohol initiation. The present study examined the emergence of regular (weekly) and heavy episodic (five or more drinks at a time) adolescent drinking as a function of social influence (modeling and social control) from parents and peers. METHOD: A three-wave study was conducted using a representative household sample of families in metropolitan Buffalo, New York (N = 612). Over half (54%) of the adolescent respondents were female. Black families made up 30% of the sample. Interviews were conducted at 1-year intervals. Adolescent drinking was dichotomized at each wave into abstinence/light drinking versus regular drinking. Logistic regression including only adolescents who were abstainers/light drinkers at Wave 1 was performed to assess which Wave- variables could predict regular-drinking onset by Wave 2; a similar analysis examined the onset of heavy episodic drinking by Wave 2. Parallel analyses using Wave-2 variables to predict the onset of the drinking outcomes by Wave 3 were also conducted. RESULTS: Across the different analyses, the strongest psychosocial predictors of advancement to heavier drinking were friend's drinking and low parental monitoring. Also, white adolescents were at greater risk than their black counterparts. CONCLUSIONS: A multidimensional approach to prevention that addresses different processes of influence (e.g., modeling and social control) involving both parental and peer domains is likely to be most successful in deterring the onset of heavier drinking in adolescents.

Family cohesion as a buffer against the effects of problem-drinking fathers on psychological distress, deviant behavior, and heavy drinking in adolescents.

In this paper we examine the degree to which family cohesion buffers the effects of fathers' problem drinking at Time 1 (T1) on adolescent distress, deviance, and heavy drinking at Time 2 (T2), one year later. Data from a representative sample of 658 families were used to test the hypotheses. Mothers, fathers (if present), and adolescent children were interviewed in the home. Fathers who were present completed self-report scales measuring problem drinking. When fathers were not available, mothers' reports on fathers' drinking were used to measure fathers' problem drinking. Results from regression analysis indicate that after controlling for the effects of race, SES, age, gender, and family structure: (1) the more cohesion in the family and the fever stressful events, the less distress, deviance, and heavy drinking shown by adolescents; (2) the fathers' problem drinking affects adolescent distress and deviance when cohesion is low; but as cohesion increases, the effects of the fathers' drinking are reduced. The findings support the hypothesis that cohesion in families buffers the effects of fathers' problem drinking on adolescents.

Evolution of host cell RNA into efficient template RNA by Q beta replicase: the origin of RNA in untemplated reactions.

Q beta replicase can replicate a single molecule of certain species of RNA to 10(14) copies in minutes. This replication ability has been used for in vitro studies of molecular evolution and is currently being utilized as a method of amplifying RNAs that contain probe sequences. It has been observed that Q beta replicase can produce replicatable RNA even in the absence of exogenously added template RNA. The origin of this RNA has been ascribed either to contamination with replicatable RNA or to an ability of Q beta replicase to synthesize RNA de novo from the nucleotides present in the reaction. Technologies that employ Q beta replicase require a thorough understanding of the conditions that lead to this so-called spontaneous RNA production. We have created an expression system and purification method with which we produce gram quantities of highly purified Q beta replicase, and we have identified reaction conditions that prevent the amplification of RNA in assays that do not contain added RNA. However, when these reaction conditions are relaxed, spontaneous RNA replication is seen in up to 100% of the assays. To understand the origin of this RNA, we have cloned several spontaneously produced RNAs. Sequence analysis of one of these RNAs shows that it arose by the evolution of Escherichia coli tRNA into a replicatable template and not by de novo synthesis from nucleoside triphosphates in the reaction.

Father's unemployment and adolescent's self-concept.

This study examined families in which fathers were affected by a steel mill shutdown, and tested hypotheses on the impact of unemployment on parent-child relations and adolescent self-concept. The hypotheses were tested by comparing convenience samples of three types of intact families with children between the ages of 12 and 18: continuously employed, unemployed with slight income loss, unemployed with significant income loss. As predicted, relationship with fathers were more negative when income loss was significant, but contrary to predictions, the relationship with mothers were not more positive, and adolescent self-concept was not directly affected by unemployment or income loss. However, a path analysis showed that income loss affected adolescent self-concept indirectly through its impact on parent-child relations.

Identification of human papillomavirus type 16 in primary and recurrent cervical cancer following radiation therapy.

Formalin-fixed, paraffin-embedded tissue blocks from 13 women with cervical carcinoma that recurred following radiation therapy were evaluated for the presence of human papillomavirus (HPV) by in situ hybridization using ribonucleic acid 35S-labeled probes for HPV types 6, 11, 16, and 18. Ten of thirteen patients also had pretreatment biopsies from their primary tumors available for analysis. HPV 16 was detected in both primary and recurrent lesions in 4 women. In 1 case, HPV was detected in the primary tumor and not in the recurrence. HPV 16 was also present in three recurrent cancers from which primary lesions were not available for probing. Radiation therapy did not alter the hybridization signal strength or pattern, suggesting that the HPV genome copy number was not significantly affected. The persistence of HPV 16 in recurrent cervical carcinoma is consistent with the theory that HPV plays a role in maintaining the malignant state.

Reasons for non-attendance at a child guidance clinic.

A consecutive group of children (n = 19) referred to a child guidance clinic who failed to attend an initial interview were followed-up. These 'non-attenders' did not differ from a matched group of 'attenders' with respect to duration or nature of their problems, waiting period for the appointment, type of referring agencies or socio-demographic variables, but were more likely to be living with their natural parents. Disinclination among the parents was the main reason for absenteeism and could be related to ignorance about the clinic. The problems leading to referral persisted in most cases and had not received further treatment.