The effects of intranasal oxytocin on reward circuitry responses in children with autism spectrum disorder.

BACKGROUND: Intranasal oxytocin (OT) has been shown to improve social communication functioning of individuals with autism spectrum disorder (ASD) and, thus, has received considerable interest as a potential ASD therapeutic agent. Although preclinical research indicates that OT modulates the functional output of the mesocorticolimbic dopamine system that processes rewards, no clinical brain imaging study to date has examined the effects of OT on this system using a reward processing paradigm. To address this, we used an incentive delay task to examine the effects of a single dose of intranasal OT, versus placebo (PLC), on neural responses to social and nonsocial rewards in children with ASD. METHODS: In this placebo-controlled double-blind study, 28 children and adolescents with ASD (age: M = 13.43 years, SD = 2.36) completed two fMRI scans, one after intranasal OT administration and one after PLC administration. During both scanning sessions, participants completed social and nonsocial incentive delay tasks. Task-based neural activation and connectivity were examined to assess the impact of OT relative to PLC on mesocorticolimbic brain responses to social and nonsocial reward anticipation and outcomes. RESULTS: Central analyses compared the OT and PLC conditions. During nonsocial reward anticipation, there was greater activation in the right nucleus accumbens (NAcc), left anterior cingulate cortex (ACC), bilateral orbital frontal cortex (OFC), left superior frontal cortex, and right frontal pole (FP) during the OT condition relative to PLC. Alternatively, during social reward anticipation and outcomes, there were no significant increases in brain activation during the OT condition relative to PLC. A Treatment Group × Reward Condition interaction revealed relatively greater activation in the right NAcc, right caudate nucleus, left ACC, and right OFC during nonsocial relative to social reward anticipation during the OT condition relative to PLC. Additionally, these analyses revealed greater activation during nonsocial reward outcomes during the OT condition relative to PLC in the right OFC and left FP. Finally, functional connectivity analyses generally revealed changes in frontostriatal connections during the OT condition relative to PLC in response to nonsocial, but not social, rewards. CONCLUSIONS: The effects of intranasal OT administration on mesocorticolimbic brain systems that process rewards in ASD were observable primarily during the processing of nonsocial incentive salience stimuli. These findings have implications for understanding the effects of OT on neural systems that process rewards, as well as for experimental trials of novel ASD treatments developed to ameliorate social communication impairments in ASD.

The Ampere and Electrical Standards.

This paper describes some of the major contributions to metrology and physics made by the NIST Electricity Division, which has existed since 1901. It was one of the six original divisions of the National Bureau of Standards. The Electricity Division provides dc and low-frequency calibrations for industrial, scientific, and research organizations, and conducts research on topics related to electrical metrology and fundamental constants. The early work of the Electricity Division staff included the development of precision standards, such as Rosa and Thomas standard resistors and the ac-dc thermal converter. Research contributions helped define the early international system of measurement units and bring about the transition to absolute units based on fundamental principles and physical and dimensional measurements. NIST research has helped to develop and refine electrical standards using the quantum Hall effect and the Josephson effect, which are both based on quantum physics. Four projects covering a number of voltage and impedance measurements are described in detail. Several other areas of current research at NIST are described, including the use of the Internet for international compatibility in metrology, determination of the fine-structure and Planck constants, and construction of the electronic kilogram.

An examination of employer-provided benefits in the health care industry.

Organizations that depend on a highly-skilled, stable workforce must be attuned to the needs of their employees and provide adequate compensation and benefits that enhance job satisfaction and lessen job mobility. Hospitals, like other organizations that compete for hard-to-find workers, use both traditional and non-traditional benefits to attract and keep skilled employees. This nationwide survey of hospital human resource managers assesses the types of benefits offered to health care workers and gauges the perceived impact of those benefits on job satisfaction and employee retention. Survey findings reveal that certain basic benefits, such as health insurance, are provided to all hospital employees. Other benefits, such as signing bonuses and reimbursement of relocation costs, are used as inducements to attract individuals in hard-to-fill job categories.

Are hospitals facing a critical shortage of skilled workers?

A nationwide survey of health care human resource managers reveals that hospitals are experiencing a critical shortage of qualified job applicants in certain job categories. Computer systems personnel, registered nurses, pharmacists, and therapists are especially in short supply. Jobs that require only minimal training as well as those not directly involved in patient care are filled more easily. According to the survey respondents, shortages of qualified personnel negatively impact hospitals' operations in a variety of ways. To combat shortages of qualified job applicants, hospitals are employing a variety of tools to attract workers. Signing bonuses, above-market compensation, flexible work schedules, and myriad perks are being used to entice and retain qualified workers.

Short communication: Total craniofacial photon shell technique for radiotherapy of extensive angiosarcomas of the head.

Effective radiotherapy for extensive angiosarcomas of the face and scalp is technically difficult due to the complex shape of the volume at risk, which can consist of the superficial tissues of the entire head. This work reports the details of a rotational X-ray technique used to deliver a large part of the tumour dose. The technique consists of four consecutive 90 degree arcs with changing centre blocks to protect critical midline structures. Multilevel CT based treatment planning is carried out to determine the centre block dimensions and beam weights. As a result the radiation dose is delivered with acceptable uniformity over the entire shell of superficial tissues of the head. The overall treatment combines the rotational fields with large lateral field irradiation and/or local boosts with photons or electrons. Two of three patients treated with this technique had local control of the disease until their deaths at 13 and 18 months. A third patient responded well, with only a small region of stable disease at 9 months.

Sexual harassment in the hospital industry: an empirical inquiry.

A 1994 survey of hospital HRMs has revealed that charges of sexual harassment within the health care industry are increasing at an alarming rate. Most charges are filed by women who claim they were victims of "hostile environments." Nurses levy the largest number of complaints, followed by clerical/secretarial personnel, technicians, custodial workers, food service personnel, and therapists. Most charges are filed against coworkers. Approximately 10 percent of all charges of sexual harassment in hospitals are brought against physicians.

A study of substance abuse testing in patient care facilities.

Drug testing, once practically ignored as a health care management strategy in curbing legal liability potential, is now the norm rather than exception. Most hospitals today conduct drug tests involving employment considerations and "for cause" (e.g., accidents) involving most employees but excluding physicians. Random drug testing is recommended for health care institutions to consider as a strategy designed to reduce illicit drug abuse in such facilities. This recommendation is based on the nature and sensitivity of the health care institution's mission and purpose relative to patient care and safety.

The short-term effect of low-dose radiation on intracranial germinoma. A pathologic study.

A correlative pathologic and imaging (computed tomography and magnetic resonance imaging) study is reported of a pineal germinoma in a 35-year-old man who died unexpectedly of massive pulmonary embolism on the 8th day during the course of radiation therapy after receiving a total dose of only 1600 cGy. A histologic study of the entire lesion in serial sections revealed no viable tumor cells. The tumor bed was composed of stromal elements with a variable degree of proliferation. The lymphocytic component of the tumor was unaffected by the radiation. This case provided a rare opportunity to show total eradication of tumor cells in a germinoma after a small dose of radiation and supports the notion, based on imaging observations, that histologically proven intracranial pure germinomas may be treated successfully with a much smaller dose of radiation than previously thought.

Negligent hiring and retention: some evidence of hospital vulnerability.

Hospital human resource managers were surveyed to determine their understanding of negligent hiring employment law and the tools used in employment screening. This article describes the results, which indicate that hospital human resource managers understand the law but that there are gaps in the use of some employment screening tools. The authors make recommendations for future research.

Managing health care costs: strategies available to small businesses.

Although health care costs continue to rise at an alarming rate, small businesses can take steps to help moderate these costs. First, business firms must restructure benefits so that needless surgery is eliminated and inpatient hospital care is minimized. Next, small firms should investigate the feasibility of partial self-insurance options such as risk pooling and purchasing preferred premium plans. Finally, small firms should investigate the cost savings that can be realized through the use of alternative health care delivery systems such as HMOs and PPOs. Today, competition is reshaping the health care industry by creating more options and rewarding efficiency. The prospect of steadily rising prices and more choices makes it essential that small employers become prudent purchasers of employee health benefits. For American businesses, the issue is crucial. Unless firms can control health care costs, they will have to keep boosting the prices of their goods and services and thus become less competitive in the global marketplace. In that event, many workers will face a prospect even more grim than rising medical premiums: losing their jobs.

Substance abuse and mandatory drug testing in health care institutions.

Substance abuse in the workplace is a problem of enormous proportions. Hospitals, like other organizations, must recognize the potential risks posed by substance abuse and effectively deal with the problem. A nationwide study was conducted of hospital personnel managers' attitudes toward drug abuse and mandatory drug testing. The study focuses on the policies hospitals have formulated and reveals hospital administrators' concerns over the legality of mandatory testing.