Supportive care needs of adults living with a peripherally inserted central catheter (PICC) at home: a qualitative content analysis.

BACKGROUND: Peripherally inserted central catheters (PICCs) are common vascular access devices inserted for adults undergoing intravenous treatment in the community setting. Individuals with a PICC report challenges understanding information and adapting to the device both practically and psychologically at home. There is a lack of research investigating the supportive care needs of individuals with a PICC to inform nursing assessment and the provision of additional supports they may require to successfully adapt to life with a PICC. The aim of this study was to identify the supportive care needs of adults with cancer or infection living with a PICC at home. METHOD: Qualitative, semi-structured interviews were used to identify supportive care needs of adults living with a PICC at home. Participants were recruited from cancer and infectious diseases outpatient units. Two researchers independently analysed transcripts using content analysis. RESULTS: A total of 15 participants were interviewed (30-87 years old). There were 5 males and 10 females interviewed, 9 participants had a cancer diagnosis and most lived in a metropolitan area. Many participants lived with a partner/spouse at home and three participants had young children. Participants identified supportive care needs in the following eight categories (i (i) Adapting daily life (ii) Physical comfort (iii) Self-management (iv) Emotional impact (v) Information content (vi) Understanding information (vii) Healthcare resources and (viii) Social supports. CONCLUSIONS: Adults living with a PICC at home report a broad range of supportive care needs. In addition to practical and information needs, health consumers may also require support to accept living with a device inside their body and to assume responsibility for the PICC. These findings may provide nurses with a greater understanding of individual needs and guide the provision of appropriate supports.

Community-based Intravenous Treatment and Central Venous Access Devices: A Scoping Review of the Consumer and Caregiver Experience, Information Preferences, and Supportive Care Needs.

PURPOSE: Map existing research and describe the consumer/caregiver experience of community-based intravenous treatment, central venous access devices (CVADs), supportive care needs, and information preferences. DESIGN: Scoping review. METHODS: Five databases (Joanna Briggs Institute, Cochrane library, Emcare, Embase, and Medline) were searched. Screening and data extraction were performed independently by two reviewers. FINDINGS: Forty-eight studies were included. CONCLUSIONS: Although community-based intravenous treatment and CVADs have a significant impact on consumers and caregivers, there is scant research on their supportive care needs and information preferences. CLINICAL EVIDENCE: Some consumers and caregivers may require additional support while undergoing community-based intravenous treatment.

Adverse events associated with home blood transfusion: A retrospective cohort study.

AIMS AND OBJECTIVES: To determine the rate of individual and system adverse events associated with blood transfusion at home. BACKGROUND: Home or residential care facility based blood transfusion is beneficial for individuals requiring transfusion due to reduced disruption to daily life and the comfort of a familiar environment. However, blood transfusion may result in serious adverse events. There is a lack of research in this area, and there is a need to identify rates of adverse events and evaluate the system used for this service. DESIGN: Retrospective cohort study. METHODS: Existing data routinely collected for clinical care were used to determine client and system adverse events of medically stable adults with a chronic disease who underwent blood transfusion in a home setting provided by a nurse-led service. A STROBE EQUATOR checklist was used for this study (see Appendix S1). RESULTS: There were 1790 episodes of care involving 533 participants, with 13 cases of transfusion reaction (incident rate [IR] 0.7%; 95% CI 0.43-1.25). Only five of these were severe, resulting in the cessation of the blood transfusion and further medical review or hospital admission (IR 0.28%; 95% CI 0.12-0.68). There were no cases of tampered blood packaging, expired or visually damaged blood products. There were 10 cases of incorrect paperwork (0.6%) and nine cases of incorrect temperature (0.5%). There were 153 cases of vascular access device adverse events (IR 8.5% 95% CI 7.3-9.9), most commonly, difficulty cannulating the individual (n = 82, 54%). CONCLUSIONS: A nurse-led home blood transfusion service was associated with low rates of both individual and system adverse events. Further research is needed to explore the perception of those using this service and supports required to improve the experience. RELEVANCE TO CLINICAL PRACTICE: Blood transfusions may be associated with increased risk of morbidity and mortality. This risk may be increased in a home setting due to the distance from an acute care facility. This study has demonstrated that a nurse-led home blood transfusion service is safe (<1% adverse event rate) for those with a medically stable, chronic condition. There were few failures in the system used to provide this service. Adverse events associated with the vascular access device were the most common complication and the reason for most blood product wastage. Mainly, this was due to difficulty inserting the short-term peripheral intravenous catheter (PIVC). RNs should consider ultrasound to aid PIVC insertion to facilitate treatment provision and enhance the experience of the individual.

Transcatheter Aortic Valve Implantation (TAVI) Versus Surgical Aortic Valve Replacement for Aortic Stenosis (SAVR): A Cost-Comparison Study.

BACKGROUND: Comparative costing studies using real-world data stratified by patient case-mix, are valuable to decision makers for making reimbursement decisions of new interventions. This study evaluated real-world hospital admissions and short-term costs of transcatheter aortic valve implantation (TAVI) and isolated surgical aortic valve replacement (SAVR) for patients with aortic stenosis, stratified by the Society of Thoracic Surgeons (STS) risk scores. METHODS: Retrospective analysis of consecutive patients with a principal diagnosis of aortic stenosis who underwent isolated valve replacement at a single tertiary hospital, January 2012-December 2017. Patients were followed-up for 30 days post-procedure or until hospital discharge if index hospitalisation was greater than 30 days. Intensive care unit (ICU) and hospital length of stay (days), and costs in 2018 Australian dollars for the index procedure and 30-day follow-up were assessed. Multivariable generalised linear and two-part models with gamma distribution and log link function adjusting for Society of Thoracic Surgeons (STS) risk group and key sociodemographic characteristics were used. RESULTS: Of 488 patients, 61% males, median age 78 years (IQR 14 years), 221 (45%) received transcatheter aortic valve replacement (TAVI) and 267 (55%) received surgical aortic valve replacement (SAVR). STS risk scores were low (28%), intermediate (46%) and high (26%) for TAVI patients, and low (85%), intermediate (12%) and high (3%) for SAVR patients. When adjusted, TAVI length of stay was 57% shorter than SAVR (95% CI 31-83%, p<0.001) for intensive care unit (ICU) admission, and 64% shorter (95% CI 47-81%, p<0.001) for hospital admissions. TAVI costs were 13% lower than SAVR (95% CI 4-22%, p=0.005). CONCLUSION: This data suggests short-term health care costs are lower for patients with aortic stenosis undergoing TAVI than SAVR. A further roll-out of the TAVI program in hospitals across Australia may result in savings to the health system.

Eluxadoline for Irritable Bowel Syndrome with Diarrhea.

Background Effective and safe treatments are needed for patients who have irritable bowel syndrome (IBS) with diarrhea. We conducted two phase 3 trials to assess the efficacy and safety of eluxadoline, a new oral agent with mixed opioid effects (µ- and κ-opioid receptor agonist and δ-opioid receptor antagonist), in patients with IBS with diarrhea. Methods We randomly assigned 2427 adults who had IBS with diarrhea to eluxadoline (at a dose of 75 mg or 100 mg) or placebo twice daily for 26 weeks (IBS-3002 trial) or 52 weeks (IBS-3001 trial). The primary end point was the proportion of patients who had a composite response of decrease in abdominal pain and improvement in stool consistency on the same day for at least 50% of the days from weeks 1 through 12 and from weeks 1 through 26. Results For weeks 1 through 12, more patients in the eluxadoline groups (75 mg and 100 mg) than in the placebo group reached the primary end point (IBS-3001 trial, 23.9% with the 75-mg dose and 25.1% with the 100-mg dose vs. 17.1% with placebo; P=0.01 and P=0.004, respectively; IBS-3002 trial, 28.9% and 29.6%, respectively, vs. 16.2%; P<0.001 for both comparisons). For weeks 1 through 26, the corresponding rates in IBS-3001 were 23.4% and 29.3% versus 19.0% (P=0.11 and P<0.001, respectively), and the corresponding rates in IBS-3002 were 30.4% and 32.7% versus 20.2% (P=0.001 and P<0.001, respectively). The most common adverse events associated with 75 mg of eluxadoline and 100 mg of eluxadoline, as compared with placebo, were nausea (8.1% and 7.5% vs. 5.1%), constipation (7.4% and 8.6% vs. 2.5%), and abdominal pain (5.8% and 7.2% vs. 4.1%). Pancreatitis developed in 5 (2 in the 75-mg group and 3 in the 100-mg group) of the 1666 patients in the safety population (0.3%). Conclusions Eluxadoline is a new therapeutic agent that reduced symptoms of IBS with diarrhea in men and women, with sustained efficacy over 6 months in patients who received the 100-mg dose twice daily. (Funded by Furiex Pharmaceuticals, an affiliate of Allergan; IBS-3001 and IBS-3002 ClinicalTrials.gov numbers, NCT01553591 and NCT01553747 , respectively.).

Topical delivery of Avastin to the posterior segment of the eye in vivo using annexin A5-associated liposomes.

Effective delivery to the retina is presently one of the most challenging areas in drug development in ophthalmology, due to anatomical barriers preventing entry of therapeutic substances. Intraocular injection is presently the only route of administration for large protein therapeutics, including the anti-Vascular Endothelial Growth Factors Lucentis (ranibizumab) and Avastin (bevacizumab). Anti-VEGFs have revolutionised the management of age-related macular degeneration and have increasing indications for use as sight-saving therapies in diabetes and retinal vascular disease. Considerable resources have been allocated to develop non-invasive ocular drug delivery systems. It has been suggested that the anionic phospholipid binding protein annexin A5, may have a role in drug delivery. In the present study we demonstrate, using a combination of in vitro and in vivo assays, that the presence of annexin A5 can significantly enhance uptake and transcytosis of liposomal drug carrier systems across corneal epithelial barriers. This system is employed to deliver physiologically significant concentrations of Avastin to the posterior of the rat eye (127 ng/g) and rabbit retina (18 ng/g) after topical application. Our observations provide evidence to suggest annexin A5 mediated endocytosis can enhance the delivery of associated lipidic drug delivery vehicles across biological barriers, which may have therapeutic implications.

Romantic attachment, empathy, and the broader autism phenotype among college students.

Recent research suggests that mild autistic-like characteristics can be measured among relatives of individuals with autism and in the general population. These characteristics have been referred to as the broader autism phenotype (BAP), and include pragmatic language difficulties, aloofness, and rigidity. Evidence is growing to suggest that individuals with BAP encounter difficulties in their social interactions. Recent work demonstrates that college students scoring high on the BAP report more loneliness (Jobe & Williams White, 2007) and more interpersonal problems (Wainer, Ingersoll, & Hopwood, 2012). Because intimate relationships are important in development and are very salient in emerging adulthood, the authors examined the relation of the BAP to romantic attachment and empathy among young adults. Higher BAP scores were associated with lower empathy and higher attachment anxiety and avoidance. Specifically, pragmatic language difficulties were related to higher rates of avoidant attachment and this relationship was mediated by empathy. In contrast, pragmatic language deficits were directly related to anxious attachment.

Spatial transcriptomics reveals molecular dysfunction associated with cortical Lewy pathology.

A key hallmark of Parkinson's disease (PD) is Lewy pathology. Composed of α-synuclein, Lewy pathology is found both in dopaminergic neurons that modulate motor function, and cortical regions that control cognitive function. Recent work has established the molecular identity of dopaminergic neurons susceptible to death, but little is known about cortical neurons susceptible to Lewy pathology or molecular changes induced by aggregates. In the current study, we use spatial transcriptomics to capture whole transcriptome signatures from cortical neurons with α-synuclein pathology compared to neurons without pathology. We find, both in PD and related PD dementia, dementia with Lewy bodies and in the pre-formed fibril α-synucleinopathy mouse model, that specific classes of excitatory neurons are vulnerable to developing Lewy pathology. Further, we identify conserved gene expression changes in aggregate-bearing neurons that we designate the Lewy-associated molecular dysfunction from aggregates (LAMDA) signature. Neurons with aggregates downregulate synaptic, mitochondrial, ubiquitin-proteasome, endo-lysosomal, and cytoskeletal genes and upregulate DNA repair and complement/cytokine genes. Our results identify neurons vulnerable to Lewy pathology in the PD cortex and describe a conserved signature of molecular dysfunction in both mice and humans.

Ex Vivo Patient-Derived Explant Model for Neurofibromatosis Type 1-Related Cutaneous Neurofibromas.

Cutaneous neurofibromas (CNFs) are benign tumors that occur in the dermis of individuals with the inherited tumor predisposition disorder, neurofibromatosis type 1. CNFs cause disfigurement, pain, burning, and itching, resulting in substantially reduced QOL in patients with neurofibromatosis type 1. CNFs are benign tumors that exhibit cellular and molecular heterogeneity, making it difficult to develop tractable in vitro or in vivo models. As a result, CNF research and drug discovery efforts have been limited. To address this need, we developed a reproducible patient-derived explant (PDE) ex vivo culture model using CNF tumors from patients with neurofibromatosis type 1. CNF PDEs remain viable in culture for over 9 days and recapitulate the cellular composition and molecular signaling of CNFs. Using CNF PDEs as a model system, we found that proliferation was associated with increased T-cell infiltration. Furthermore, we identified a pattern of reciprocal inflammatory signaling in CNF PDEs in which tumors rely on prostaglandin or leukotriene-mediated signaling pathways. As proof of principle, we show that ex vivo glucocorticoid treatment reduced the expression of proinflammatory genes, confirming that CNF PDEs are a useful model for both mechanistic studies and preclinical drug testing.

Nf1 deficiency modulates the stromal environment in the pretumorigenic rat mammary gland.

Background: Neurofibromin, coded by the NF1 tumor suppressor gene, is the main negative regulator of the RAS pathway and is frequently mutated in various cancers. Women with Neurofibromatosis Type I (NF1)-a tumor predisposition syndrome caused by a germline NF1 mutation-have an increased risk of developing aggressive breast cancer with poorer prognosis. The mechanism by which NF1 mutations lead to breast cancer tumorigenesis is not well understood. Therefore, the objective of this work was to identify stromal alterations before tumor formation that result in the increased risk and poorer outcome seen among NF1 patients with breast cancer. Approach: To accurately model the germline monoallelic NF1 mutations in NF1 patients, we utilized an Nf1-deficient rat model with accelerated mammary development before presenting with highly penetrant breast cancer. Results: We identified increased collagen content in Nf1-deficient rat mammary glands before tumor formation that correlated with age of tumor onset. Additionally, gene expression analysis revealed that Nf1-deficient mature adipocytes in the rat mammary gland have increased collagen expression and shifted to a fibroblast and preadipocyte expression profile. This alteration in lineage commitment was also observed with in vitro differentiation, however, flow cytometry analysis did not show a change in mammary adipose-derived mesenchymal stem cell abundance. Conclusion: Collectively, this study uncovered the previously undescribed role of Nf1 in mammary collagen deposition and regulating adipocyte differentiation. In addition to unraveling the mechanism of tumor formation, further investigation of adipocytes and collagen modifications in preneoplastic mammary glands will create a foundation for developing early detection strategies of breast cancer among NF1 patients.

The potential of annexin-labelling for the diagnosis and follow-up of glaucoma.

Glaucoma is one of the leading causes of blindness in developed countries and is mainly attributable to the apoptosis of retinal ganglion cells (RGCs). Although several diagnostic tools have been developed to detect and monitor this disease, none has the requisite sensitivity to identify it at a preclinical stage or to perceive small changes in retinal health over short periods. Specifically, irreversible visual changes occur before neuronal damage is discovered. The most widely accepted in vitro assay for apoptotic cells involves the use of fluorescent annexin A5. The radiolabelling of this marker makes it possible to assess, in vivo and non-invasively, various diseases in which the apoptotic process is pivotal, such as myocardial infarction or tumour response to chemotherapy. Recently, a new technique has been developed to visualise directly individual RGCs undergoing apoptosis in the living eye. This DARC (detection of apoptosing retinal cells) technology uses fluorescently labelled annexin A5 to bind apoptosing retinal neurons and confocal scanning laser ophthalmoscopy to detect the marked dying cells. Based on experimental models, DARC has been suggested to offer a direct and quantitative assessment of the retinal condition of patients. A Phase I clinical trial in glaucoma patients is scheduled to start shortly. This technology has the potential to pre-empt the diagnosis of glaucoma prior to visual deterioration, to provide an accurate numeric evaluation highlighting even small retinal changes and to allow the rapid judgement of the efficacy of both current and new therapeutic strategies.

Parental Psychological Control and Self-Efficacy as Predictors of Romantic Relationship Power Dynamics.

In the current study, we utilized a person-centered approach to examine the relations of parental psychological control (PPC) and relationship self-efficacy (RSE) to power dynamics in emerging adults' romantic relationships. College student emerging adults (N = 312) completed measures assessing retrospective PPC, RSE, and perceived self and partner power in current relationships. Latent profile analysis uncovered four relationship types based on reported self- and partner-power: balanced-unified, balanced-interchanging, unbalanced-high self, and unbalanced-high partner. Increases in PPC were related to increased odds of being in an unbalanced relationship. Higher levels of RSE were associated with decreased odds of being in an unbalanced relationship. Further, even individuals in the balanced profile who reported average levels of both self and partner power (balanced-interchanging) reported higher levels of PPC and lower levels of RSE compared to those in the balanced group where levels of both self and partner power were low (balanced-unified). These findings suggest using a person-centered approach to relationship power may advance our conceptualization of power distribution in romantic relationships. Further, experienced family dynamics and one's sense of self may be especially important for young adults' tendency to form healthy relationships. The current findings encourage future investigation into the mechanisms by which parental factors predict both dominance and submissiveness in romantic relationships. Understanding predictors of power dynamics may contribute to intimate partner violence prevention and intervention.

Spatial transcriptomics reveals molecular dysfunction associated with Lewy pathology.

Lewy pathology composed of α-synuclein is the key pathological hallmark of Parkinson's disease (PD), found both in dopaminergic neurons that control motor function, and throughout cortical regions that control cognitive function. Recent work has investigated which dopaminergic neurons are most susceptible to death, but little is known about which neurons are vulnerable to developing Lewy pathology and what molecular changes an aggregate induces. In the current study, we use spatial transcriptomics to selectively capture whole transcriptome signatures from cortical neurons with Lewy pathology compared to those without pathology in the same brains. We find, both in PD and in a mouse model of PD, that there are specific classes of excitatory neurons that are vulnerable to developing Lewy pathology in the cortex. Further, we identify conserved gene expression changes in aggregate-bearing neurons that we designate the Lewy-associated molecular dysfunction from aggregates (LAMDA) signature. This gene signature indicates that neurons with aggregates downregulate synaptic, mitochondrial, ubiquitin-proteasome, endo-lysosomal, and cytoskeletal genes and upregulate DNA repair and complement/cytokine genes. However, beyond DNA repair gene upregulation, we find that neurons also activate apoptotic pathways, suggesting that if DNA repair fails, neurons undergo programmed cell death. Our results identify neurons vulnerable to Lewy pathology in the PD cortex and identify a conserved signature of molecular dysfunction in both mice and humans.

The efficacy of an intimate partner violence prevention program with high-risk adolescent girls: a preliminary test.

This study examined the efficacy of a brief (four session) intimate partner violence (IPV) prevention program (Building a Lasting Love, Langhinrichsen-Rohling et al. 2005) that was designed to reduce the relationship violence of predominantly African American inner-city adolescent girls (n = 72) who were receiving teen pregnancy services. These high-risk girls were randomly assigned to the prevention program (n = 39) or waitlist control (n = 33) conditions. Implementation fidelity was documented. As predicted, girls who successfully completed the program (n = 24) reported significant reductions in their perpetration of psychological abuse toward their baby's father as compared to the control (n = 23) participants. They also reported experiencing significantly less severe IPV victimization over the course of the program. Preliminary analyses indicated that avoidant attachment to one's partner may be associated with less program-related change. These findings support the contention that brief IPV prevention programs can be targeted to selected groups of high-risk adolescents.

Help From a Friend: Helicopter Parenting Predicts Empathy and Bystander Intervention.

Harassment toward others happens in many contexts with a myriad of negative impacts on victims, witnesses, and society. Although preventing harassment of others is ideal, it is also important to consider how bystanders may react in ways to defend the victim and reduce the harassment. Bystanders differ in their reactions to these events and the goal of this investigation is to better understand individual differences in college students' reported tendency to defend victims of harassment. We proposed a mediation model where higher rates of helicopter parenting would predict lower empathic concern and greater personal distress. In turn, lower empathic concern and greater personal distress would predict lower likelihood of defending the victim. College students (n = 305) completed self-report measures of helicopter parenting, empathic concern, personal distress, and bystander intervention to general harassment. Using the Hayes PROCESS program, we found the relation of helicopter parenting to bystander intervention was mediated by empathic concern, such that helicopter parenting predicted lower empathic concern, which predicted lower likelihood of intervening. Helicopter parenting predicted greater personal distress, but personal distress did not predict bystander intervention. In an exploratory analysis, we tested a moderated mediation model in which personal distress moderated the relation of empathic concern to bystander intervention. The moderated mediation model was statistically significant; for students with low to moderate personal distress, empathic concern predicted self-reported intervention. However, for students high in personal distress, empathic concern was not related to self-reported intervention. The current study explained a small amount of the variance in bystander intervention. These findings demonstrate the complex family and personal factors that may explain, to a small degree, individual differences in bystander intervention. Further studies should consider the complex contextual variables that may influence this relationship.

Models of cardiovascular surgery biobanking to facilitate translational research and precision medicine.

Biobanking in health care has evolved over the last few decades from simple biological sample repositories to complex and dynamic units with multi-organizational infrastructure networks and has become an essential tool for modern medical research. Cardiovascular tissue biobanking provides a unique opportunity to utilize cardiac and vascular samples for translational research into heart failure and other related pathologies. Current techniques for diagnosis, classification, and treatment monitoring of cardiac disease relies primarily on interpretation of clinical signs, imaging, and blood biomarkers. Further research at the disease source (i.e. myocardium and blood vessels) has been limited by a relative lack of access to quality human cardiac tissue and the inherent shortcomings of most animal models of heart disease. In this review, we describe a model for cardiovascular tissue biobanking and databasing, and its potential to facilitate basic and translational research. We share techniques to procure endocardial samples from patients with hypertrophic cardiomyopathy, heart failure with reduced ejection fraction, and heart failure with preserved ejection fraction, in addition to aortic disease samples. We discuss some of the issues with respect to data collection, privacy, biobank consent, and the governance of tissue biobanking. The development of tissue biobanks as described here has significant scope to improve and facilitate translational research in multi-omic fields such as genomics, transcriptomics, proteomics, and metabolomics. This research heralds an era of precision medicine, in which patients with cardiovascular pathology can be provided with optimized and personalized medical care for the treatment of their individual phenotype.

Exercise among commercial truck drivers.

This study examines the exercise habits and perceived barriers to exercise of a convenience sample of 300 commercial truck drivers. Participants reported minimal amounts of exercise, with nearly 20% not exercising in the past week. A high prevalence of obesity was found in this sample: 93.3% of study participants had a body mass index (BMI) of 25 or higher. Drivers with BMIs of greater than 30 were significantly more likely to rate the exercise environment as terrible/bad. Drivers who had at least one health condition engaged in significantly less aerobic exercise, used fewer strengthening exercises, did not exercise for 30 minutes continuously, and had a higher BMI. Drivers who spent most of their off-duty time in their truck while their partner drove were also significantly more likely to not exercise regularly. Most drivers cited lack of time and place as the primary barriers to exercising. This study adds to the limited knowledge about exercise behaviors among commercial truck drivers.

Parental Warmth and Interpersonal Empathy as Predictors of Sexual Assault Bystander Intervention Efficacy.

Sexual victimization rates of women in the United States remain worryingly high. Much research has focused on the reduction of sexual violence with varying levels of success. One promising avenue of sexual violence reduction research provides evidence that bystanders who intervene appropriately can effectively contribute to a reduction in sexual assault. The Ecological Model for Bystander Intervention provides a conceptual framework for investigating what motivates and what inhibits bystanders. Empirical evidence on various levels of the model has been garnered; however, little is known about the association between particular developmental variables and bystander intervention efficacy situated in the microsystem. The goal of this study was to explore developmental predictors of bystander intervention efficacy. We predicted perceived parental warmth would be related to bystander intervention efficacy and that the relation would be mediated by empathy. University students (mean age = 19.2 years) completed anonymous online self-report measures of perceived maternal and paternal warmth, empathy, and bystander efficacy. The mediation model was supported by the data. As predicted, the path from parental warmth to empathy was significant (p < .001) and the path from empathy to bystander intervention efficacy was significant (p < .001). The indirect effect of parental warmth on bystander efficacy through empathy was significant (p = .001). One implication of these findings is that characteristics that are related to bystander tendencies may develop early in the family environment. Efforts to increase bystander intervention may benefit from the recognition that empathy may be founded in earlier life experiences. Limitations and future directions are discussed.

Generation and Characterization of Mouse Models for Skeletal Disease.

Our laboratories have used genetically engineered mouse models (GEMMs) to assess genetic contributions to skeletal diseases such as osteoporosis and osteoarthritis. Studies on the genetic contributions to OA are often done by assessing how GEMMs respond to surgical methods that induce symptoms modeling OA. Here, we will describe protocols outlining the induction of experimental OA in mice as well as detailed descriptions of methods for analyzing skeletal phenotypes using micro-computerized tomography and skeletal histomorphometry.

Helicopter Parenting, Authenticity, and Depressive Symptoms: A Mediation Model.

Helicopter parenting is an overinvolved, overcontrolling parenting style that likely interferes with children's healthy development of authenticity. Authenticity refers to self-awareness and a genuine expression of the self and is important for college students as they traverse the opportunities and challenges of emerging adulthood. Authenticity appears to be a protective characteristic and is negatively related to depressive symptoms. The authors proposed and tested a model in which helicopter parenting was related to depressive symptoms through authenticity. In the present investigation, college students (n = 286) completed self-report instruments assessing perceptions of helicopter parenting, current states of authenticity (self-alienation, authentic living, external influence), and depressive symptoms. Path analysis was conducted with AMOS, and the data fit the model well (χ2(1) = .580, p = .446, TLI = 1.103, CFI = 1.000, RMSEA = .000). Helicopter parenting was related to higher levels of self-alienation and external influence and lower levels of authentic living. Self-alienation and authentic living were related to depressive symptoms (external influence was not related to depressive symptoms). These findings demonstrate the importance of considering developmental predictors of authenticity and depression. Helicopter parenting is likely to inhibit authenticity in ways that may contribute to difficulties in emerging adulthood.