Outcomes of child sexual contacts: patterns of incarcerations from a national sample.

OBJECTIVE: In a test of the relationships between sexual touching before puberty and later incarcerations during adolescence and adulthood, two theoretical models were examined. These models focus on examination of crime from the developmental origins of criminals and the adaptive and maladaptive outcomes of early experiences. METHOD: Data were taken from the National Health and Social Life Survey to study the sexual touching and social origin variables in childhood and incarceration variable during teen years. The sample was a stratified, random sample of 3,362 adults (18 to 59 years of age) throughout the United States. RESULTS: Data support inferences from the two interrelated models. Respondents reporting touching before puberty were significantly more likely to experience incarceration. They were also more likely to engage in behaviors as teenagers that were associated with an increased probability of jailing. Such behaviors include sexual promiscuity and early departure from the parental family. CONCLUSIONS: These findings are consistent for first jailing as a teenager and as an adult, as well as for those with short (less than a week) or longer (a week or more) spells of incarceration. Prepubertal sexual touching has a significant and enduring effect on later adolescent and adult incarcerations.

Prospective, randomized trial of template-assisted versus undirected written recording of physician records in the emergency department.

STUDY OBJECTIVE: To determine whether use of the T-System (Emergency Services Consultants, Irving, TX) template-generated medical documentation system (1) decreases physician evaluation time in the emergency department, (2) increases gross billing under the 1997 Health Care Financing Administration guidelines by minimizing downcoding caused by inadequate documentation, and (3) increases physician satisfaction with the documentation process, compared with the undirected written narrative format. METHODS: A prospective, randomized, unblinded, controlled, convenience trial of documentation with the T-System of ED templates versus undirected written documentation was conducted in the ED of a county-owned, university-affiliated hospital. All patients seen between the hours of 7 AM and 10 PM during a 16-day period were included. The intervention was varying the method of documentation of the emergency physician. Adequacy of randomization to the 2 documentation groups was assessed by comparing ED triage classification, patient disposition, level of training of the evaluating physician, and whether ED consultation with other services occurred. Outcome measurements included emergency physician total evaluation and treatment time, professional bill, and satisfaction, as evaluated by a questionnaire completed after the study period. The 2 documentation groups were compared by an intention-to-treat analysis and by Student's t test and the median test as appropriate. RESULTS: A total of 1,228 patient encounters were included. Emergency physician total evaluation and treatment time with template-directed documentation was 4.6 minutes less than with undirected recording, a difference that was not significant (95% confidence interval [CI], -9.2 to 18.3). Gross billing was $29. 60 more per patient (95% CI, $22.20 to $37.00) with the T-System, as assessed by our hospital coders. This difference was caused by a mean.50 (95% CI,.39 to.60) higher level of evaluation and management coding. Physicians preferred the T-System (P <.0005). CONCLUSION: Use of template-assisted documentation in the ED was associated with higher gross billing and physician satisfaction but no significant decrease in emergency physician total evaluation time.

Illegal drug use, alcohol and aggressive crime among Mexican-American and white male arrestees in San Antonio.

This research explores the relationship between use of certain drugs and aggressive crimes among Mexican-American and White male arrestees in San Antonio, Texas, for 1992. This is based on a Drug Use Forecasting (DUF) sample of 534 male arrestees administered a drug urine analysis test and questionnaire by the Department of Justice and the city of San Antonio. Using a four-way asymmetrical analysis, logit-models were tested to examine the relationships between the response variable, the types of crimes charged (nonaggressive versus aggressive) and a set of exploratory variables, ethnicity (White versus Hispanic), drug test results (positive versus negative), and alcohol use (infrequent versus frequent). The logit-analysis allows the specification of a subset of relevant models to be tested for their adequacy of fit. Findings indicate a complex but interpretable pattern between drug use, alcohol use patterns, and aggressive crimes. A surprising finding was that more aggressive crimes were committed by all men testing negative for drugs. Mexican-Americans with frequent alcohol use and testing positive for drugs were twice as likely to commit an aggressive crime (a crime associated with violence) than Whites in the same subgroup. The implication of these findings for prevention strategies aimed at alcohol and other drug users involved in violent behavior is discussed.

Wallerian degeneration in the optic nerve of the wabbler-lethal (wl/wl) mouse.

Optic nerve pathology was studied in C57BL/6J wabbler-lethal (wl/wl) and control (+/+) mice at postnatal age of 4 weeks (P28). Qualitative light and ultrastructural pathology in wl/wl animals conformed to the criteria of primary axonal (Wallerian) degeneration. Most optic nerve axons in mutant animals appeared normal, as did oligodendroglia, the degree of myelination, the integrity and maturity of vascular elements, astroglia, and most myelin. Still, degenerating axons surrounded by somewhat normal myelin and axons with thickened myelin sheaths were prevalent in wl/wl mice. Dysmyelination or hypomyelination was not evident. At P28, pathology appeared more prominent in large diameter fibers. In the optic nerve of wl/wl mice, axonal degeneration preceded myelin disruption, adding this nerve to other previously reported systems undergoing Wallerian degeneration in this mutant.

Systematic distribution of muscle fiber types in the medial gastrocnemius of the laboratory mouse: a morphometric analysis.

Midbelly cross sections of the medial gastrocnemius muscle of young adult male laboratory mice were subjected to ATPase histochemistry with preincubation at pH 4.6. Through the use of a sampling grid and computer-assisted morphometric analysis, 26 to 35% of the total muscle fibers were sampled and classified as type I, IIa, or IIb. Photomicrographs (16 X 20 in.) of five muscles were divided into octants according to a standardized procedure. Total fiber counts and percent of fibers sampled were determined. Variability of sample size per octant was noted, but when averaged across entire muscles, it was in all instances greater than 33%. Fiber type frequency per octant was tested for goodness of fit to a random model by means of a chi-square statistic for equal expected frequencies. Deviation from random fiber type frequency was significant at the P = 0.001 level for every muscle. More importantly, when these data were pooled and again tested using the same method, the probability estimate was less than P = 0.001. This established that the variations in the fiber type proportions found in each mouse followed a common pattern. The systematic fiber type distribution confirmed by these morphometric and statistical methods supports the impression expressed by many muscle biologists that this muscle displays a consistent and complex intramuscular organization.

Gastroesophageal reflux and Barrett's esophagus in developmentally disabled patients.

Twenty-seven patients from an institution for the developmentally disabled underwent endoscopy for evaluation of vomiting, regurgitation, rumination, or upper gastrointestinal bleeding. The presence of gastroesophageal reflux and Barrett's esophagus was determined retrospectively. Twenty-three patients had an IQ less than 20, 19 were nonambulatory, and 14 were taking at least one neuroleptic drug daily. Seven patients (26%) had histologically documented Barrett's esophagus of the specialized-columnar type. Two patients with Barrett's esophagus had benign esophageal strictures, but no cases of adenocarcinoma were found. There were no significant differences (p greater than 0.05) between patients with or without Barrett's esophagus in regard to symptoms, age, sex, IQ, medications, or ambulatory status. The present data suggest that Barrett's esophagus may frequently occur in developmentally disabled patients with symptoms and signs of gastroesophageal reflux.

Flounder intestinal absorptive cells have abundant gap junctions and may be coupled.

We noted that, unlike mammalian intestinal absorptive cells, cells of the winter flounder (Pseudopleuronectes americanus) displayed abundant gap junctions on the lateral plasma membrane. We compared the distribution of gap junctions in winter flounder to that in rabbit intestinal epithelium. We also examined for evidence of gap junction-mediated intercellular coupling by comparing the cell-to-cell variation of electrical potential difference across winter flounder intestinal cell apical membranes with that in rabbit small intestinal epithelium in which gap junctions are rare. Gap junctions were seen in 95% of flounder absorptive cells and were localized largely to the apical third of the lateral membrane. Individual gap junctions often contained several hundred uniform 9-nm intramembrane particles. Gap junction size and structure was independent of the position of individual absorptive cells on mucosal folds. These findings sharply contrasted flounder intestinal absorptive cells with rabbit small intestinal absorptive cells, in which gap junctions were rarely detected and when present consisted of few intramembrane particles. Correlating with this distribution of morphologically detectable gap junctions, rabbit small intestinal epithelial cells demonstrated marked variability in potential difference across their apical membranes, whereas those in flounder small intestine showed little variation in apical membrane potential difference. Thus, in contrast to intestinal epithelium of rabbits, flounder intestinal epithelium demonstrates morphological and functional characteristics, suggesting a substantial degree of electrical coupling.

Voltage threshold and excitability among variously sized cat hindlimb motoneurons.

Intracellular recording has been performed to examine whether any differences in apparent initial-segment voltage threshold exist between types F and S cat triceps surae motoneurons. Voltage threshold was estimated using orthodromic action potentials initiated by large, monosynaptic excitatory postsynaptic potentials (EPSPs) evoked by dorsal root stimulation. No significant differences in voltage threshold could be detected between types F and S motoneurons. Further, voltage thresholds did not covary with motoneuron input resistance, afterhyperpolarization duration, or the twitch contraction time of functionally isolated muscle units. Significant positive correlations were observed between voltage threshold and the motoneuron resting potential. Utilizing a compartmental neuron model, a theoretical analysis has been performed that examines the influence of specific passive membrane properties on current threshold for action potentials initiated by large, monosynaptic EPSPs. This analysis indicates that total membrane capacitance will be the primary determinant of these thresholds. Further analysis of available data suggests that active membrane properties will play a minimal role in setting these thresholds. Since specific membrane capacitance is likely to be similar among cat motoneurons, it is concluded that only size or surface area-related current threshold differences will exist among these cells for activation with brief currents such as those underlying large EPSPs. For motoneurons thus activated, it is suggested that variations in the excitatory/inhibitory balance or density of synaptic input would be the major mechanisms for producing differential recruitment thresholds among the motoneuron population. Other available evidence is discussed that indicates that factors intrinsic to the motoneurons themselves will contribute to the setting of functional recruitment thresholds for activation with longer duration currents.