Impact of war on veteran life span: natural experiment involving combat versus non-combat exposed military personnel.

INTRODUCTION: There is still uncertainty around the impact of combat exposure on the life span of war veterans. Therefore we made use of a natural experiment to study the impact on veteran life span of combat versus non-combat exposure in World War II (WW2). METHODS: The combat-exposed military personnel were derived from a random (10%) sample of the military roll of the 28th (Maori) Battalion from New Zealand. One non-combat cohort was the 15th Reinforcements of this same Battalion, since the war ended before they reached the front line. The other non-combat cohort were Maori personnel who were only involved in Jayforce, which occupied Japan at the end of the WW2. Data on life span were mainly derived from an official repository of birth and death records, but supplemented with other sources, including military files. RESULTS: When comparing life spans of service veterans, there was no statistically significant reduction for the average life span of the 234 combat-exposed veterans in our sample from the 28th (Maori) Battalion (66.7 years), relative to the Maori veterans from two non-combat cohorts: the 132 personnel in the 15th Reinforcements (67.2 years) and the 147 personnel in Jayforce (66.9 years). CONCLUSIONS: Despite a very high level of wounding in the combat-exposed group (48%), there were no statistically significant reductions in life span between this group and comparable non-combat exposed veterans. This finding contrasts to life span reductions found in a similar study of New Zealand veterans of WW1.

Differential lifespan impacts on veterans by war exposure in the First World War.

INTRODUCTION: There remains uncertainty around the impact of war on the lifespan of First World War (WW1) veterans. In particular, study comparison groups do not typically consider the 'healthy soldier effect'. METHODS: We obtained lifespan data on a random sample of 857 war-exposed New Zealand WW1 veterans and compared this with lifespans of a non-war military cohort (n=1039). This comparison was possible as the non-war-cohort arrived in Europe too late to participate in the war, allowing a 'natural experiment' that avoided the 'healthy solider effect'. RESULTS: The lifespan comparisons indicated lower mean lifespan in the war-exposed veteran cohort compared with the non-war veteran cohort (69.7 vs 71.1 years; p=0.0405). This gap persisted (range: 0.8-1.1 years) but was no longer statistically significant when only considering the non-Maori ethnic grouping (nearly all European/Pakeha personnel), when excluding additional deaths in the immediate postwar period up to 31 December 1923, and when excluding participation in any other wars. This was the case in both analysis of variance and Cox proportional hazards regression adjusting for year of birth and occupational status. Within the war-exposed cohort, there were suggestive patterns of increasing lifespan with increasing occupational status and military rank (eg, 69.5, 70.0 and 70.7 mean years as group-level occupational status progressively increased). There were also stark differences in lifespan of 8.3 years between Maori (Indigenous) and non-Maori veterans (p=0.0083). CONCLUSIONS: The pattern of reduced lifespan in war-exposed versus non-war-exposed veterans was compatible with a smaller previous New Zealand study with comparable methodology. Veterans who were Maori had significantly lower lifespans than non-Maori veterans. There are a number of feasible avenues to further improve this type of work with existing data sources.

The quantitative measurement of family quality of life: a review of available instruments.

BACKGROUND: Family quality of life (FQOL) has emerged as an important outcome of service delivery for individuals with disabilities and their families. The purpose of this review was to explore the disparity of scale development approaches between families with children with disabilities and families from other populations and identify strengths to serve as a source of recommendations to improve the measurements of FQOL in the disability field. METHOD: We conducted a keyword search of 25 databases. Sixteen measurement tools on FQOL, family well-being and family satisfaction currently used in the disability field, healthcare field and general family studies published in journals from 1980 to 2009 were included in the analysis. RESULTS: Three themes emerged from the detailed analysis and comparisons of the instruments: (1) description of the primary purpose and theoretical basis; (2) identification of the tool's respondents, domains, response formats and scoring strategies to assess family systems; and (3) summarisation of available psychometric information. CONCLUSIONS: As family researchers continue their mission to conceptualise and theorise about FQOL, they should also promote the refinement of FQOL measurements and consider the implications from family instruments used in the healthcare and general family fields from the following aspects: (1) domains of FQOL; (2) units of analysis; (3) response format; (4) scoring choice; and (5) psychometric evaluation.

Family quality of life: adaptation to Spanish population of several family support questionnaires.

BACKGROUND: The concept of family quality of life has emerged as a decisive construct in the last decades to improve the capabilities of families and to assess the outcomes of the services and supports they get. The goal of this research is to adapt three instruments to the Spanish population: the 'Beach Center Family Quality of Life Scale', the 'Beach Center Family-Professional Partnership Scale' and the 'Service Inventory'. These tools were originally designed by researchers from the Beach Center on Disability, University of Kansas, in order to obtain some input from the families of people with intellectual disability (ID) with regard to the attention they get from the early childhood intervention services. METHOD: The sample included a total of 202 families of children with ID, between 0 and 6 years old, all of them cared for at 13 early childhood intervention centres. Based on a confirmatory factorial analysis, we have explored the psychometric properties of the three scales administered to respondents. Statistical analyses were conducted with the spss software version 17.0 and the EQS software version 6.1 for Structural Equation Models. RESULTS: The results confirm that the factor structure of the 'Beach Center Family Quality of Life Scale', the 'Beach Center Family-Professional Partnership Scale' and the 'Service Inventory' adapted for the Spanish population fit the factor models proposed by the authors of the surveys. Consequently, the scales are ready to be used. CONCLUSIONS: The developed measures may serve as a foundation for good decision-making from practices and policies.

High contrast, depth-resolved thermoreflectance imaging using a Nipkow disk confocal microscope.

We have developed a depth-resolved confocal thermal imaging technique that is capable of measuring the temperature distribution of an encapsulated or semi-obstructed device. The technique employs lock-in charge coupled device-based thermoreflectance imaging via a Nipkow disk confocal microscope, which is used to eliminate extraneous reflections from above or below the imaging plane. We use the confocal microscope to predict the decrease in contrast and dynamic range due to an obstruction for widefield thermoreflectance, and we demonstrate the ability of confocal thermoreflectance to maintain a high contrast and thermal sensitivity in the presence of large reflecting obstructions in the optical path.

Perspectives of fathers and mothers of children in early intervention programmes in assessing family quality of life.

BACKGROUND: Family quality of life (FQOL), as a family outcome measure of early intervention and other services, has increasingly drawn attention of researchers, policymakers and service providers. Developing an index of family QOL requires a measure suitable for use with multiple family members. The purpose of this study was to test whether mothers and fathers similarly view the conceptual model of FQOL embodied in one measure. METHOD: This study involved fathers and mothers of 107 families who have a young child (birth to five) with a disability enrolled in an early intervention programme. Data from couples completing the Beach Center FQOL measure were analysed using structural equation modelling (SEM) to determine similarities or differences between fathers and mothers with respect to their assessment of FQOL. RESULTS: The analysis of measurement invariance of the FQOL construct across the father and mother groups indicates that the Beach Center FQOL Scale measures equally the underlying FQOL construct across fathers and mothers in this sample. Fathers do not differ from mothers in perceived importance of factors related to FQOL items, nor did they differ in their overall satisfaction with FQOL. CONCLUSION: These results suggest that fathers and mothers respond similarly to the latent constructs within the Beach Center FQOL Scale; therefore, it holds promise for use with both fathers and mothers in assessing FQOL across multiple family members. Further implications for research and practice are discussed.

Conceptualizing and measuring family quality of life.

BACKGROUND: Increasing emphasis on family-centred approaches to services and supports for families of children with disabilities has surfaced the issue of accountability for family outcomes. We present a review of literature about the impacts of children with disabilities on families as a backdrop to proposing family quality of life as a concept that encompasses impacts of disability and one that can be used to assess the impact of supports and services on families. METHOD: We briefly introduce the Beach Center Family Quality of Life Scale, providing information about its factor structure, reliability and convergent validity. RESULTS: The Beach Center Family Quality of Life Scale contains 25 items assessing family ratings of importance and satisfaction with five domains: Family interaction, Parenting, Emotional well-being, Physical/material well-being and Disability-related supports. CONCLUSION: We present a framework for utilizing a measure of family quality of life as a long-term outcome in concert with other short-term measures of service outcomes for families.

Distinctive pattern of behavioral functioning in Angelman syndrome.

Angelman syndrome is a neurogenetic disorder that is characterized by impairments in neurological, motor, and intellectual functioning. This study compared 27 participants with Angelman syndrome to clinical and community participants with developmental disabilities of mixed etiology to determine whether Angelman syndrome is associated with a distinctive pattern of behavioral functioning. The groups with and without Angelman syndrome were matched on chronological age, gender, and level of intellectual functioning. The dependent measure was parent ratings of maladaptive behavior using the Aberrant Behavior Checklist. The Angelman syndrome group had significantly lower scores on measures of irritability and lethargy. Results contribute to the delineation of a behavior phenotype for the syndrome.

Behaviour problems in Angelman syndrome.

Angelman syndrome (AS) is a genetic disorder that is associated with a deletion on chromosome 15, and is characterized by abnormalities or impairments in neurological, motor and intellectual functioning. While behaviour problems have been reported in clients with AS, relatively little is known about their developmental course and outcome. In this study, data on the nature and prevalence of behaviour problems among clients with AS were gathered from two sources: (1) a review of published case reports; and (2) parent responses to a survey of behaviour problems in a small (n = 11) sample of children with AS. Data from both sources showed that behaviour problems were present in males and females of all ages, and included language deficits, excessive laughter, hyperactivity, short attention span, problems with eating and sleeping, aggression, noncompliance, mouthing of objects, tantrums, and repetitive and stereotyped behaviour. Identification and treatment of severe behaviour problems in clients with AS may improve their adaptive functioning.

Lipoxygenase inhibitory activity of U-66,858 and its deacetylated metabolite U-68,244 in human whole blood.

The inhibitory effects of the semi-quinone U-66,858 and its metabolite U-68,244 on the ionophore-induced formation of leukotriene B4 (LTB4) were examined in human whole blood (WB). Preincubation of U-66,858 and U-68,244 for 1 min prior to challenge of blood with calcium ionophore A23187 resulted in IC50 values of 1080 +/- 644 and 820 +/- 442 nmol/L, respectively (NS). After 60 min preincubation, values were 250 +/- 85 and 270 +/- 79 nmol/L (NS). The activity of the lipoxygenase inhibitor AA-861 in this system was similar to that of U-66,858, while vitamin K and the sulphate conjugate of U-66,858 showed significant inhibition of LTB4 release only at micromolar concentrations. U-66,858 exhibited significant inhibition of thromboxane A2 release (p < 0.02) in a comparative study with the known cyclooxygenase (CO) inhibitor flurbiprofen. The metabolism of U-66,858 in contact with WB at 37 degrees C was monitored for 70 min using [14C]-labelled drug and reverse-phase HPLC, the majority of recovered radioactivity no longer in the form of U-66,858 being accounted for by U-68,244 and polar conjugates of U-66,858. Thus, U-66,858 is a potent inhibitor of LTB4 production in human whole blood and undergoes deacetylation to an initial metabolite with similar pharmacological potency. However, other metabolites of U-66,858 such as the sulphate conjugate, are relatively weak inhibitors of 5-lipoxygenase (5-LO) under similar conditions.

Treatment of non specific dyssomnia with simple stimulus control procedures in a child with Down's syndrome.

Nonaversive behavioural interventions were used successfully to treat a disrupted sleep pattern in a child with Down's syndrome. A quasi-experimental single-case design was employed to evaluate the treatment efficacy. During the first phase of treatment, the mother implemented a structured bedtime routine and the child was no longer allowed to engage in activities while in bed. During the second phase, a stimulus control paradigm was employed in which a nearly life-sized rag doll was substituted for the mother in bed. Finally, the mother gradually withdrew from the child's bed and room. During baseline, the child spent an average of only six percent of the night sleeping alone. By the second phase, this rose to a mean of 26%. By the end of treatment this was increased to a mean of 78.2%. The increase was accompanied by collateral decreases in crying and distress. Improvements were maintained at follow-up.

Monoclonal antibodies specific for guinea pig eosinophil major basic protein: their use in an ELISA, immunocytochemistry and flow cytometry.

Eosinophil major basic protein (MBP), purified from guinea pig eosinophil granules was used to raise five monoclonal antibodies (MoAbs). Their reactivity with MBP was confirmed by immunoblotting and indirect ELISA. Two of the MoAbs were used to develop a sensitive and specific antigen capture (sandwich) ELISA for guinea pig eosinophil MBP which gives an accurate and reproducible standard curve over the range of 10-10,000 ng/ml. The specificity of the ELISA for MBP was confirmed and its suitability for testing biological samples ascertained by measurement of MBP in bronchoalveolar lavage fluid (BALF) and plasma from guinea pigs sensitized and challenged with ovalbumin. The ELISA was also capable of detecting MBP in culture supernatants from purified eosinophil preparations challenged with calcium ionophore in vitro. One of the monoclonals could be used to strongly and specifically stain guinea pig eosinophils in immunocytochemistry, whilst all five could be used to visualize eosinophils in suspension in BALF or peritoneal lavage fluid by flow cytometry. There was no staining of other guinea pig leucocyte types, nor crossreactivity with human eosinophils by immunocytochemistry or flow cytometry.

A combined behavioral/pharmacological treatment of sleep-wake schedule disorder in Angelman syndrome.

Angelman syndrome (AS) is a genetic disorder associated with a deletion on chromosome 15. Behavior problems among children with AS include sleep difficulties. Data are presented on the successful treatment of a sleep-wake schedule disorder (SWSD) in a 9-year-old boy with AS. The treatment program included behavioral and pharmacological components. During baseline, the child slept a mean of 1.9 hours per night and 1.3 hours during the day; night sleep was increased to a mean of 8.3 hours and day sleep was reduced to a mean of .08 hours after introduction of the full-treatment program. Medication was discontinued subsequently, and the child slept a mean of 7.8 hours during the night and .07 hours during the day. At 45-day follow-up, night sleep was maintained at 7.1 hours and day sleep remained stable at .29 hours. This is the first known report of an effective treatment of a SWSD in a child with AS.

Increased central immunoreactive beta-endorphin content in patients with Wernicke-Korsakoff syndrome and in alcoholics.

beta-endorphin, adrenocorticotrophin, and alpha-melanocyte stimulating hormone were measured by radioimmunoassay in three areas of human brain at necropsy in seven subjects with Wernicke-Korsakoff syndrome and in 52 controls. Thiamin concentration in six brain areas was also measured. Mamillary body beta-endorphin concentrations were significantly increased in those with the syndrome compared with controls, and those controls with high alcohol intake showed increased mamillary body beta-endorphin compared with controls with low alcohol intake. Brain thiamin concentration was similar in both groups, with the exception of the brainstem, where it was reduced in subjects with Wernicke-Korsakoff syndrome. Thalamic beta-endorphin in controls was inversely correlated with thiamin in frontal white matter, frontal cortex, parietal white matter and parietal cortex, while beta-endorphin in the hypothalamus of patients was inversely correlated with thiamin in frontal cortex, parietal white matter, thalamus and brainstem. These results suggest that there is a disturbance of the endorphinergic system in Wernicke-Korsakoff syndrome which may be related to alcohol intake.

Laypeople's attitudes toward drug treatment for behavioral control depend on which disorder and which drug.

One hundred four laypeople were asked to rate two vignettes describing the use of psychotropic medication to treat behavior problems in school-aged boys. These problems were described as a result of either an attention deficit disorder (ADD) with hyperactivity or a seizure disorder. Respondents considered the parents of the ADD child less justified in placing and continuing their child on medication than the parents of the epileptic child. They also thought that drug use would exacerbate the behavior problem more for the ADD child than for the epileptic child. It is suggested that by being aware of and acknowledging the existence of these attitudes, clinicians can better deal with concerns that parents may have regarding drug treatment for their children, possibly increasing the chances for a successful outcome.