Cereal weevils' antimicrobial peptides: at the crosstalk between development, endosymbiosis and immune response.

Interactions between animals and microbes are ubiquitous in nature and strongly impact animal physiology. These interactions are shaped by the host immune system, which responds to infections and contributes to tailor the associations with beneficial microorganisms. In many insects, beneficial symbiotic associations not only include gut commensals, but also intracellular bacteria, or endosymbionts. Endosymbionts are housed within specialized host cells, the bacteriocytes, and are transmitted vertically across host generations. Host-endosymbiont co-evolution shapes the endosymbiont genome and host immune system, which not only fights against microbial intruders, but also ensures the preservation of endosymbionts and the control of their load and location. The cereal weevil Sitophilus spp. is a remarkable model in which to study the evolutionary adaptation of the immune system to endosymbiosis owing to its binary association with a unique, relatively recently acquired nutritional endosymbiont, Sodalis pierantonius. This Gram-negative bacterium has not experienced the genome size shrinkage observed in long-term endosymbioses and has retained immunogenicity. We focus here on the sixteen antimicrobial peptides (AMPs) identified in the Sitophilus oryzae genome and their expression patterns in different tissues, along host development or upon immune challenges, to address their potential functions in the defensive response and endosymbiosis homeostasis along the insect life cycle. This article is part of the theme issue 'Sculpting the microbiome: how host factors determine and respond to microbial colonization'.

Sensory processing differences and urinary incontinence in school-aged children.

OBJECTIVE: Urinary Incontinence (UI) is a common problem among school-aged children (5-11 years). Symptoms such as urgency, diminished awareness of wetting, or apparent apathy may represent differences in sensory processing (SP). This study aims to describe the SP abilities of incontinent school-aged children with typical development to determine if they differ from established norms for continent children. MATERIALS AND METHODS: The SP abilities of 209 school-aged children with UI were evaluated using the short sensory profile (SSP), a judgment-based caregiver questionnaire, then compared with established norms using descriptive and inferential statistics. RESULTS: Forty-four percent of children showed significant differences in global SP with the greatest differences noted in tactile sensitivity. Higher section subscores were also noted in "seeks sensation/under responsive" and "auditory sensitivity". Children with dysfunctional voiding (DV) were more likely to show global differences (p = 0.015), differences in "seeks sensation" (p = 0.006), and auditory sensitivity (p = 0.041). The odds for low tactile sensitivity scores were five times greater for children with UI and DV (p = 0.006). CONCLUSION: These results suggest that differences in SP may be found among typical school aged children with UI. Continued research is indicated to understand the significance of the study results.

Five images of maturity in adolescence: what does "grown up" mean?

This study focussed on the subjective meanings of maturity in adolescence, or what it means to adolescents to be grown up. Younger (6th grade) and older (9th grade) adolescents' descriptions (n=236) of their "grown-up" peers were examined through content analysis. This qualitative analysis revealed five images of maturity portrayed by adolescents: balanced maturity (adolescents who show psychosocial and behavioural maturity, and ability to balance work and play); an image focussed on privileges (adolescents who engage in problem behaviour and present what may be a facade of adult-like behaviour); an image focussed on responsibility (adolescents who may be psychosocially mature, but may have taken on inappropriately high levels of responsibility); an image focussed on power and status (adolescents who seem to have usurped an older status, by being bossy and controlling); and an image focussed on physical development (adolescents who show advanced levels of physical maturity). There were some gender and age differences in the frequencies of these five images. Discussion is directed at understanding the hallmarks of each image relative to scholarly notions of adult maturity.

Congruence of diagnoses 2 years after a first-admission diagnosis of psychosis.

BACKGROUND: Diagnostic changes may reflect evolution of an illness, emergence of newly disclosed information, or unreliability of assessment. This study evaluates the stability of research diagnoses in a heterogeneous first-admission sample with psychosis. METHODS: A group of 547 subjects initially diagnosed with a psychosis were reassessed 6 and 24 months after enrollment. The DSM-IV consensus diagnoses were formulated by psychiatrists blind to previous research diagnoses. The analysis focuses on agreement over time and the effects of demographic, family history, and clinical variables on the shift from a nonschizophrenia diagnosis to schizophrenia. RESULTS: Seventy-two percent of 6- and 24-month diagnoses were congruent. The most temporally consistent 6-month categories were schizophrenia (92%), bipolar disorder (83%), and major depression (74%); the least stable were psychosis not otherwise specified (44%), schizoaffective disorder (36%), and brief psychosis (27%). The most frequent shift in diagnosis at 24 months was to schizophrenia spectrum (n=45). These 45 subjects had a similar illness course after 6 months as the 171 subjects in this category at both assessments, but their prior clinical functioning was better. Risk factors predicting change to a schizophrenia spectrum diagnosis include facility variables (schizophrenia diagnosis, longer stays, and given antipsychotic medication on hospital discharge); prehospital features (psychotic > or =3 months before admission, poorer adolescent adjustment, lifetime substance disorder); and negative symptoms. CONCLUSIONS: Changes in diagnosis, particularly to schizophrenia, are mostly attributable to the evolution of the illness. Rigid adherence to DSM-IV requirements may have led to underdiagnosis of schizophrenia. The findings support the need for a longitudinally based diagnostic process in incidence samples.

Coping with psychotic symptoms in the early phases of schizophrenia.

How people diagnosed with schizophrenia cope with positive symptoms after their first hospitalization is explored, along with the relationship of their coping strategies to their psychosocial functioning. The strategies most frequently endorsed were cognitive in type, while those considered most helpful were behavioral. Respondents identifying an active strategy as most helpful displayed better psychosocial functioning at 24-month follow-up.

Is there an association between duration of untreated psychosis and 24-month clinical outcome in a first-admission series?

OBJECTIVE: The authors examined the duration of untreated psychosis, defined as the interval from first psychotic symptom to first psychiatric hospitalization, in a county-wide sample of first-admission inpatients who had received no previous antipsychotic medication. Differences between diagnostic groups in 24-month illness course and clinical outcomes as well as relationships between outcomes and duration of untreated psychosis were evaluated. METHOD: The data were derived from subjects in the Suffolk County Psychosis Project who were diagnosed at 24-month follow-up according to DSM-IV as having schizophrenia or schizoaffective disorder (N=155), bipolar disorder with psychotic features (N=119), or major depressive disorder with psychotic features (N=75). Duration of untreated psychosis was derived from the Structured Clinical Interview for DSM-III-R, medical records, and information from significant others. Measures at 24-month follow-up included consensus ratings of illness course, Global Assessment of Functioning Scale scores for the worst week in the month before interview, and current affective and psychotic symptoms. RESULTS: The median duration of untreated psychosis was 98 days for schizophrenia, 9 days for psychotic bipolar disorder, and 22 days for psychotic depression. Duration of untreated psychosis was not significantly associated with 24-month illness course or clinical outcomes in any of the diagnostic subgroups. CONCLUSIONS: Although these findings require replication in other epidemiologically based first-admission samples, at face value they do not support the suggestion of a psychotoxic effect of prolonged exposure to untreated psychosis.

Multiple-risk behaviour in adolescents and young adults.

OBJECTIVES: This article examines the prevalence of four risk behaviours among teenagers and young adults: smoking, binge drinking, sex with multiple partners, and sex without a condom. DATA SOURCE: The data are from a Health Canada-sponsored supplement to the 1994/95 National Population Health Survey. The analysis is based on 905 respondents aged 15 to 19 and 1,055 respondents aged 20 to 24. ANALYTICAL TECHNIQUES: Prevalence estimates of the four risk behaviours were calculated for males and females in each age group. An index of multiple-risk behaviour was derived by summing the four risk behaviours. Hierarchical multiple regression was used to examine how sets of variables are related to multiple-risk behaviour. MAIN RESULTS: Multiple-risk behaviour was higher among young people who had never married, who were not students, and who did not live with a parent. Feeling distressed was positively linked with multiple-risk behaviour, while regular attendance at religious services was negatively linked with such conduct.

Adolescent development: challenges and opportunities for research, programs, and policies.

The basic process of adolescent development involves changing relations between the individual and the multiple levels of the context within which the young person is embedded. Variation in the substance and timing of these relations promotes diversity in adolescence and represents sources of risk or protective factors across this life period. The key risk factors of the contemporary American adolescent period are discussed. Behavioral risks involve drug, alcohol, and substance use and abuse; unsafe sex, teenage pregnancy, and teenage parenting; school underachievement, failure, and dropout; and delinquency, crime, and violence. Poverty among youth exacerbates these risks. The features of youth programs effective in preventing the actualization of risk or in promoting positive adolescent development are discussed, as are the characteristics of public policies that may enhance the life chances of the diverse youth of America and the world.

Clinical practice guidelines on depression: awareness, attitudes, and content knowledge among family physicians in New York.

BACKGROUND: In 1989, the federal government mandated that the Agency for Health Care Policy and Research (AHCPR) appoint expert panels to develop clinical practice guidelines to define standards for the provision and quality of health care. There is uncertainty about physicians' awareness and attitudes concerning guidelines. METHODS: We surveyed 992 members of the New York State Academy of Family Physicians. In addition to demographic data, respondents were questioned about awareness of AHCPR guidelines for depression in primary care, urinary incontinence, and pressure ulcers in adults; knowledge of the diagnosis and treatment of depression; and general attitudes about guidelines. RESULTS: Three mailings produced a response rate of 53.2%. While 90.5% of respondents treat depression in their primary care practices, only 33.6% are aware of the existence of the guidelines on depression 1 year after publication. Only 13.1% of respondents have a copy of the guidelines. Physicians are slightly less aware of the guidelines on urinary incontinence and pressure ulcers (30.0%). Respondents are generally knowledgeable about the diagnosis and treatment of depression, and board certification is correlated with increased knowledge about the treatment of recurrent depression. Logistic regression analyses demonstrate that female family physicians, those living in larger communities, and physicians with 3 or more years of training are most likely to have positive attitudes toward guidelines. CONCLUSIONS: The AHCPR guidelines failed to reach their targeted audience. Specific strategies derived from survey data can identify physicians who may most benefit from educational interventions.

Diagnosis and six-month stability of negative symptoms in psychotic disorders.

Negative symptoms were examined in 150 primarily first-admission patients diagnosed with schizophrenia, schizoaffective disorder, psychotic depression, psychotic bipolar disorder, and 'other' psychoses. The analysis focused on patients who were rated on the Scale for the Assessment of Negative Symptoms (SANS) within 45 days of admission and at follow-up 6 months later. Significantly more schizophrenics had moderate to severe negative symptoms at each time point compared with other psychotic patients. The SANS scores were found to be relatively stable over time in all five diagnostic groups. Although the DSM-IV includes alogia, affective flattening, and avolition in the A criterion for schizophrenia, only alogia and affective flattening were found to be specific to this disorder. Our results point to the existence and enduring quality of negative symptoms in the early phase of psychosis and its specificity to schizophrenia even at this early stage.

Gender, premorbid characteristics and negative symptoms in schizophrenia.

The interrelationships among gender, premorbid functioning, and negative symptoms were examined in a first-admission inpatient sample with DSM-III-R schizophrenia. Fifty-two subjects were assessed with the Schedule for the Assessment of Negative Symptoms (SANS) at baseline and 6-month follow-up. Three indicators of premorbid functioning were examined: the Premorbid Adjustment Scale, the Quick Test, and the GAF for the best month in the year prior to the baseline interview. Men and women had relatively similar ratings on each of the 5 SANS global subscales at both times; they were also relatively similar on most of the indicators of premorbid functioning. The men and women were categorized into low vs moderate-high negative symptom groups at baseline, and no differences in premorbid functioning were detected. When the sample was classified into those with and without consistent negative symptoms at baseline and 6-month follow-up, the enduring negative men and women had significantly poorer premorbid functioning in several areas than the consistently non-negative patients. Our findings support the importance of assessing negative symptoms longitudinally and suggest that gender is not strongly associated with negative symptoms and premorbid functioning in patients ascertained at early stages of schizophrenia.

Depressive disorders in three primary care populations: United States, Israel, Japan.

Primary care patients in the United States, Israel and Japan received the Inventory to Diagnose Depression and the Dartmouth COOP Functional Status Charts modified for international use. Patients were classified as having major depressive disorder or minor depression. Although demographic characteristics varied by country, the rank order and frequency of the depressive symptoms were similar for both major and minor depression. Functional impairment was most severe in patients with major depression, less severe in those with minor depression and was least impaired in those not depressed. The results suggest that depressive disorders have similar presentations in the three countries studied, although the separate cultures confer different consequences on patients receiving these diagnoses.

Minor depression and functional impairment.

OBJECTIVE: To describe a method of assessing minor depression and its effects on functional status, medical co-morbidity, seasonality, and demographic variables. DESIGN: A survey administered to a nonrandom sample of 302 patients. SETTING: A university-based family practice outpatient center. PATIENTS: Patients who were seen for routine ambulatory care were asked to complete the Inventory to Diagnose Depression scale and a modified version of the Dartmouth COOP Functional Assessment Charts, including a measure of seasonality. MAIN OUTCOME MEASURES: Six categories of functional impairment were examined across two categories of depression (major and minor) and the nondepressed. Major depression is defined strictly by criteria in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Minor depression is defined as depressed mood or anhedonia and one other of the nine depression symptoms. RESULTS: Forty-seven patients (15.6%) had minor depression. Using chi 2 analysis, significant differences were found among the three levels of depression for each functional status category. Logistic regression analysis showed patients with minor depression to have greater odds of more impairment in feelings (odds ratio [OR], 4.01; 95% confidence interval [CI], 1.75 to 9.19), pain (OR, 2.58; 95% CI, 1.18 to 5.63), and social activities (OR, 2.48; 95% CI, 1.19 to 5.17) compared with the nondepressed patient. The cluster of impairment distinguishing minor from major depression differed somewhat, with more impairment in daily activities (OR, 19.6; 95% CI, 3.45 to 112.00) and feelings (OR, 24.4; 95% CI, 1.78 to 333.00) and greater lung disease (OR, 13.7; 95% CI, 2.19 to 80.00) and seasonality (OR, 5.9; 95% CI, 1.10 to 32.1 for highest seasonality) in patients with major depression. CONCLUSIONS: There appears to be significant functional disability associated with the presence of minor depression. Seasonality was also present in those with minor depression, although it was of greater importance among those with major depression. Despite lack of national consensus on the definition of minor depression, limitations owing to sampling method, and statistical modeling, there is evidence that patients with minor depression reveal a different constellation of impairment than do those with major depressive disorder.

Marital status and timing of coronary artery surgery.

Women undergoing surgery for coronary artery disease are older and have greater impairment of functional status than their male counterparts, suggesting either gender differences or gender bias. Reduced willingness to accept risks of surgery and reduced reliability of non-invasive tests in women have been proposed as possible explanations of surgical intervention delay. Since women survive their husbands by 7 years, their role as a terminal caretaker may impede acceptance of recommended surgery. In a record review of 145 women who underwent coronary artery bypass surgery, widows, as compared with the general population, were over-represented in each of the 3 decades from age 45-74. A prospective study to assess the several variables contributing to poorer surgical outcome in women is warranted.

Masculinity, femininity, and sex role attitudes in early adolescence: exploring gender intensification.

This longitudinal study of 200 young adolescent girls and boys (mean age 11.6 years in sixth grade) investigated the hypothesis that differences in masculinity, femininity, and sex role attitudes would intensify across the sixth, seventh, and eighth grades (between 11 and 13 years of age) and that pubertal timing (early, on time, late) would play a role in this intensification. Analyses revealed that sex differences in masculinity and sex role attitudes increased across grades, but not sex differences in femininity. Pubertal timing was not associated with this gender divergence, although the evidence is equivocal for boys. The results provide support for gender intensification, but the role of pubertal timing may not be as strong as previously supposed.

Child characteristics and the employment of mothers with young children: a longitudinal study.

The present longitudinal study investigated the relative influence of child, maternal, and demographic characteristics on the labor force participation of 93 mothers with young children in the New York Longitudinal Study. Multiple regression analyses revealed that child characteristics such as temperamental difficulty and the presence of physical problems were as potent as demographic features in predicting the mother's labor market activities throughout the child's early years. Conclusions were that multiple aspects of the context, including child characteristics, must be addressed if a more comprehensive picture of the employment patterns of mothers is to be gained.

Adolescent abuse and the development of personal sense of control.

The link between adolescent abuse, the adolescent's psychological functioning, and locus of control orientation is explored. Maltreated adolescents experience such problems as low self-esteem, antisocial behavior, and suicidal tendencies. It is argued that the adolescent's locus of control orientation, deriving from his/her experiences in the home, may determine the extent to which the adolescent exhibits problematic behavior and personal maladjustment. Although locus of control in abused adolescents has not been investigated, studies show that individuals who experience the same types of problems evidenced by abused adolescents are more likely to have perceptions of external control. The nature of the relationship between locus of control and abuse may depend upon the duration of the abuse (i.e., long- versus short-term abuse). For example, adolescents who have experienced abusive behavior throughout childhood are expected to be more externally oriented than those adolescents who have been abused for a shorter time. Thus, long-term abused adolescents will be more likely to have perceptions of external control than nonabused adolescents, with short-term abused adolescents falling in the middle. The distinction between short- and long-term abuse in the context of locus of control may be important to consider when designing treatment programs for abused adolescents.