Telephone counseling to implement best parenting practices to prevent adolescent problem behaviors.

There is considerable suggestive evidence that parents can protect their adolescents from developing problem behaviors if they implement recommended best parenting practices. These include providing appropriate limits on adolescent free time, maintaining a close personal relationship with the adolescent, and negotiating and providing incentives for positive behavior patterns. However, retention of the study samples has limited conclusions that can be drawn from published studies. This randomized controlled trial recruited and randomized a national population sample of 1036 families to an intensive parenting intervention using telephone counseling or to a no-contact control group. At enrollment, eligible families had an eldest child between the ages of 10-13 years. The intervention included an initial training program using a self-help manual with telephone counselor support. Implementation of best parenting practices was encouraged using quarterly telephone contacts and a family management check-up questionnaire. A computer-assisted structured counseling protocol was used to aid parents who needed additional assistance to implement best practices. This, along with a centralized service, enabled implementation of quality control procedures. Assessment of problem behavior is undertaken with repeated telephone interviews of the target adolescents. The study is powered to test whether the intervention encouraging parents to maintain best parenting practices is associated with a reduction of 25% in the incidence of problem behaviors prior to age 18 years and will be tested through a maximum likelihood framework.

Work rehabilitation for middle-aged and older people with schizophrenia: a comparison of three approaches.

We examined employment outcomes among middle-aged and older clients with schizophrenia in three work rehabilitation programs that varied in their emphasis on conventional vocational rehabilitation (train-then-place) versus supported employment principles (place-then-train). We analyzed retrospective data from 36 veterans receiving VA Wellness and Vocational Enrichment Clinic (WAVE) services and prospective data from a randomized controlled trial of 30 subjects receiving Department of Rehabilitation/Employment Services (DOR) or Individual Placement and Support (IPS). Across interventions, half the subjects obtained volunteer or paid work. IPS participants, those with schizophrenia (versus schizoaffective disorder), and those with more education were more likely to work or volunteer. Rates of volunteer or paid work were 81% in IPS, 44% in WAVE, and 29% in DOR. Rates of competitive/paid work only were highest in IPS (69%), followed by DOR (29%) and WAVE (17%). Middle-aged and older people with schizophrenia-spectrum disorders benefit most from a supported employment approach.

A combined (1)H NMR and HPLC-MS-based metabonomic study of urine from obese (fa/fa) Zucker and normal Wistar-derived rats.

(1)H NMR and HPLC-MS were used to generate metabolite fingerprints for the metabonomic analysis of urine obtained from both male and female Zucker obese (fa/fa) rats, used as a model of type II diabetes, and normal male Wistar-derived animals. The resulting data were subjected to chemometric analysis (principal components analysis and partial least squares discriminant analysis) to investigate the effects of strain, diurnal variation is strain, diurnal variation and gender and gender on metabolite profiles. In the case of strain, (1)H NMR spectroscopic analysis revealed increased taurine, hippurate and formate and decreased betaine, alpha-ketoglutarate, succinate and acetate in samples from Zucker-obese compared to Wistar-derived rats. HPLC-MS analysis detected increased hippurate and ions at m/z 255.0640 and 285.0770 in positive, and 245.0122 and 261.0065 in negative electrospray ionisation (ESI), respectively, for the Zucker obese samples. Both techniques enable the detection of diurnal variation in the urine of male and female Zucker rats, marked by increases in taurine, creatinine, allantoin and alpha-ketoglutarate by (1)H NMR, and ions at m/z 285.0753, 291.0536 and 297.1492 (positive ESI) and 461.1939 (negative ESI) using HPLC-MS, in the evening samples. Differences between male and female Zucker rats were also observed. Compared to samples from male rats hippurate, succinate, alpha-ketoglutarate and dimethylglycine ((1)H NMR) were elevated in the urine of female animals together with ions at, e.g., m/z 431.1047, 325.0655, 271.0635 and 447.0946 (positive ESI) and m/z 815.5495 and 459.0985 (negative ESI) by HPLC-MS. Both analytical techniques used in this study were able to detect differences between normal and Zucker obese rats, which may provide markers of metabolic disease.

1H NMR pattern recognition and 31P NMR studies with d-Serine in rat urine and kidney, time- and dose-related metabolic effects.

Proton NMR spectroscopy of urine has previously been used to gain insight into the site and mechanism of toxic injury to the kidney. d-Serine injures the rat kidney, causing selective necrosis of the proximal straight tubules. Damage is accompanied by proteinuria, glucosuria, and amino aciduria, the latter preceding the onset of necrosis. This study has employed (1)H NMR spectroscopy of urine and (1)H NMR and (31)P NMR spectroscopy of kidney extracts to examine the nephrotoxic action of d-serine. Urine was collected 0-8 h (all doses) and 8-24, 24-48, 48-72, 72-96, and 96-120 h (500 mg/kg only) postdosing from Alderley Park rats given d-serine (62.5, 125, 250, and 500 mg/kg ip). (1)H NMR spectra were monitored for markers of tubular damage. Additionally, ATP and ADP were quantitated in kidney perchloric acid extracts, prepared after 0.5, 1, 2, 4, and 8 h (500 mg/kg) to assess energy status; serine was also measured in these samples. At 500 mg/kg, glucosuria, amino aciduria, and reduced citrate, alpha-ketoglutarate, and succinate were observed in urine at 0-8 h. Furthermore, serine and pyruvate levels were elevated at this time. After 8-24 h, similar changes were observed; however, they were more severe reflecting the development of the lesion prior to recovery. These perturbations were dose-related, in particular, for serine and pyruvate, with no alterations seen at 62.5 mg/kg. Kidney serine concentration rapidly increased, where it was maximal after 30 min and cleared by 8 h. A decline in ATP, to approximately 60-70% of control, was observed within the kidney at 2-4 h postdosing, when necrosis first becomes evident suggesting that mitochondrial function might be impaired in the early stages of d-serine-induced nephrotoxicity. The use of NMR spectroscopy has given a comprehensive overview of the effects of d-serine in vivo. Information on the excretion of serine and its effect on renal energy metabolism provides insight into the possible mechanism of renal tubule injury.

1H-Nuclear magnetic resonance pattern recognition studies with N-phenylanthranilic acid in the rat: time- and dose-related metabolic effects.

N-Phenylanthranilic acid (NPAA) causes renal papillary necrosis (RPN) in the rat following repeated oral dosing. Non-invasive early detection of RPN is difficult, but a number of potential biomarkers have been investigated, including phospholipid and uronic acid excretion. This study used 1H-nuclear magnetic resonance (NMR) spectroscopic analysis of urine to investigate urinary metabolic perturbations occurring in the rat following exposure to NPAA. Male Alderley Park rats received NPAA (300, 500 or 700 mg kg(-1) day(-1) orally) for 7 days, and urine was collected on days 7-8, 14-15, 21-22 and 28-29. In a separate study, urine was collected on days 1-2, 3-4, 5-6 and 7-8 from rats receiving 500 mg kg(-1) day(-1). Samples were analysed by 1H NMR spectroscopy combined with multivariate data analysis and clinical chemistry. Histopathology and clinical chemistry analysis of terminal blood samples was carried out following termination on days 4, 6, 8 and 29 (4 week time course) and days 2, 4, 6 and 8 (8 day study). Urine analysis revealed a marked, though variable, excretion of beta-hydroxybutyrate, acetoacetate and acetone (ketone bodies) seen on days 3-4, 5-6 and 7-8 of the study. It is postulated that the ketonuria might be secondary to an alteration in fatty acid metabolism due to inhibition of prostaglandin synthesis. In addition, an elevation in urinary ascorbate was observed during the first 8 days of the study. Ascorbate is considered to be a biomarker of hepatic response, probably reflecting an increased hepatic activity due to glucuronidation of NPAA.

Effects of task structure on category priming in patients with Parkinson's disease and in healthy individuals.

Lexical decision tasks have been used to study both shifts of attention and semantic processing in Parkinson's Disease (PD). Whereas other laboratories have reported normal levels of semantic priming among PD patients, our laboratory has reported abnormally large levels. In this study, two experiments were performed to determine the influence of task structure on the extent of semantic priming during lexical decision-making and pronunciation tasks among PD patients and neurologically healthy controls. In Experiment 1, the effect of Prime Dominance (the ratio of category to neutral trials) on lexical decision-making was studied. Although equal numbers of word and nonword trials were presented, half of the PD patients and controls were studied under Category Prime Dominance (category : neutral prime ratio of 2:1) and half were studied under Neutral Prime Dominance (category : neutral prime ratio of 1:2). In Experiment 2, PD and control participants were studied on lexical decision-making and pronunciation tasks where twice as many words as nonword trials were presented, consistent with other studies from our laboratory. In Experiment 1, we found no group differences in the magnitude of priming and no effect of Prime Dominance. Moreover, the findings were similar in pattern and magnitude to results published by Neely (1977). In Experiment 2, we observed larger priming effects among PD patients than among controls, but only on the lexical decision (LD) task. These results support the hypothesis that abnormally large category-priming effects appear in LD studies of PD patients when the number of word trials exceeds the number of nonword trials. Furthermore, increased lexical priming in PD appears to be due to processes operating during the decision-making period that follows presentation of the lexical target.