Time Of First Test Research Articles

1452A Cohort Study of Comorbidities of Diabetes in Regional Australia

Abstract Background Epidemic of diabetes mellitus and its complications poses a major global threat and the burden of type 2 DM (T2DM) is also a worldwide phenomenon. However, data to rationalize continuous health promotion at local context such as regional New South Wales are lacking, and this underscores the need for continued epidemiological study. This study investigated if poorly controlled T2DM coexists with comorbidities more than those with good glycaemic control. Methods This was a cohort study at a private General Practice in Orange NSW, Australia. The study involved 137 de-identified adults living with T2DM. HbA1c and other biochemical and haematological records were reviewed. Other data included clinical notes including comorbidities, and complications. The cohort was separated into 2 groups: well-controlled versus poor glycaemic control. The resulting data were analysed for frequency, using the statistical software for Microsoft Excel. Results There were 37/137 of the T2DM cohort with baseline HbA1c of ≤ 6.5%, implying 73% poor glycaemic control in the region, at first time of testing. According to the clinical notes, the well-controlled group showed 29.7% comorbidities, including 2.7% queried infection. Among the 100 cases with abnormal HbA1c, comorbidities were observed in 22% including 4% who had infections. Conclusions Our observation implies no less comorbidities in well-controlled diabetes. However, the higher percentage of infection among the poorly controlled group is confirmation of need for continuous health promotion among people living with diabetes. Key messages This primary health statistic suggests the need to monitor for comorbidities equally, whether poor or well-controlled diabetes

Iron Deficient Anemia May Obscure a Diagnosis of Low VWF, VWD or Mild Hemophilia a in Biological Females with Heavy Menstrual Bleeding

INTRODUCTION Heavy menstrual bleeding (HMB) is one of the most common disease manifestations of biological females with inherited bleeding disorders and is often accompanied by iron deficient anemia (IDA). The most common bleeding disorders identified in biological females are von Willebrand Disease (VWD)/low von Willebrand Factor levels (low VWF) and heterozygosity for factor VIII genetic defects. Several pre-analytical variables including elevated adrenergic stress and estrogen-states can make it challenging to accurately diagnose these conditions as these variables are known to influence VWF and factor VIII activity levels. We sought to investigate whether an iron depleted state impacts the results of a laboratory assessment for VWD/low VWF or mild hemophilia A. METHODS Subjects were recruited from the Spots and Dots clinic (female-identifying bleeding disorder clinic) through the University of Colorado's Hemophilia and Thrombosis Center. Eligible subjects included biological females of any age who had at least two sets of laboratory assessments for von Willebrand levels (VWF antigen, VWF activity, and factor VIII activity level) and markers for total body iron stores (complete blood count and ferritin). Age at time of first testing, iron prescriptions, and underlying bleeding disorder diagnoses were also recorded. IDA was defined as a ferritin less than 20ng/mL with accompanying anemia (Hb <14.3 g/dL). Descriptive statistics and Fisher's exact tests were used to evaluate the association of factor VIII/VWF activity levels and iron stores. RESULTS Thirty-seven subjects were included in the final analysis. The average age at time of first testing was 21.5 years (range 9-50 years). IDA was present in 22 patients at the time of first assessment and in 20 patients at follow up. Serum ferritin improved overall in 23 patients between assessments. Oral iron was prescribed in 20 patients and intravenous iron was prescribed in three. An improvement in serum ferritin predicted a decrease in factor VIII activity (p = 0.0092) on follow-up assessment but did not predict a significant decrease in VWF activity levels (p = 0.0819) (Figure 1). Retesting factor VIII and VWF activity levels after iron repletion led to a diagnosis of low VWF in 4 cases (10.8%) and VWD in 2 cases (5.4%) that would have otherwise been classified as normal without retesting. CONCLUSIONS IDA is frequent in women with HMB and may be insufficiently managed with oral iron therapy in adolescents and those with an underlying bleeding disorder. The fact that many patients remained iron deficient at the time of follow up testing may have blunted the results of this analysis. Despite this limitation, this study still suggests that iron deficient anemia may be a significant enough biological stressor to increase factor VIII and possibly VWF activity levels to a point that may obscure an underlying diagnosis of VWD, low VWF, or hemophilia A. Further investigations are warranted to confirm if universal retesting of VWF and factor VIII activity levels are diagnostically imperative after correction of IDA. Such a recommendation may have a significant impact on this patient population as discovery of an underlying bleeding disorder diagnosis can not only provide an explanation for a patient's HMB but also can identifying individuals who may be at increased risk for bleeding at other sites or during invasive procedures. Disclosures No relevant conflicts of interest to declare.

Quantifying the HIV treatment cascade in a South African health sub-district by gender: retrospective cohort study.

To quantify the HIV care cascade in a Cape Town sub-district to understand rates of linkage to and engagement in HIV care. We used routinely collected data to reconstruct the treatment cascade for 8382 infected individuals who tested HIV+in 2012/2013. We obtained data on patient gender, year of initial HIV-positive test, age at testing and initial CD4 cell count and defined five stages of the HIV care cascade. We quantified attrition across cascade stages. Two-thirds of the sample (5646) were women. Men were older at time of first testing (36.5 vs. 31.3years) and had more advanced HIV disease at diagnosis (298 vs. 404 CD4 cells/µL for women). The median duration of follow-up was 818days. Among women, 90.5% attended an initial HIV care visit, 54.6% became eligible for antiretroviral therapy under local guidelines during follow-up, 49.3% initiated ART and 45.6% achieved a therapeutic response. Among men, 88.0% attended an initial HIV care visit, 67.4% became ART eligible during follow-up, 48.0% initiated ART and 42.4% achieved a therapeutic response. Approximately 3% of women and 5% of men died during follow-up. We were able to reconstruct the HIV treatment cascade using routinely collected data. In this setting, rates of engagement in care differ by gender in key stages of the cascade, with men faring worse than women at each cascade point. This highlights the need for interventions aimed at encouraging earlier testing, linkage, ART initiation and retention among men.

Expressive Vocabulary Predicts Nonverbal Executive Function: A 2-year Longitudinal Study of Deaf and Hearing Children.

Numerous studies suggest an association between language and executive function (EF), but evidence of a developmental relationship remains inconclusive. Data were collected from 75 deaf/hard-of-hearing (DHH) children and 82 hearing age-matched controls. Children were 6-11years old at first time of testing and completed a battery of nonverbal EF tasks and a test of expressive vocabulary. These tasks were completed again 2years later. Both groups improved their scores on all tasks over this period. DHH children performed significantly less well than hearing peers on some EF tasks and the vocabulary test at both time points. Cross-lagged panel models showed that vocabulary at Time 1 predicted change in EF scores for both DHH and hearing children but not the reverse.

The Minimal and Short-Lived Effects of Minority Language Exposure on the Executive Functions of Frisian-Dutch Bilingual Children.

Various studies have shown that bilingual children need a certain degree of proficiency in both languages before their bilingual experiences enhance their executive functioning (EF). In the current study, we investigated if degree of bilingualism in Frisian-Dutch children influenced EF and if this effect was sustained over a 3-year period. To this end, longitudinal data were analyzed from 120 Frisian-Dutch bilingual children who were 5- or 6-years-old at the first time of testing. EF was measured with two attention and two working memory tasks. Degree of bilingualism was defined as language balance based on receptive vocabulary and expressive morphology scores in both languages. In a context with a minority and a majority language, such as the Frisian-Dutch context, chances for becoming proficient in both languages are best for children who speak the minority language at home. Therefore, in a subsequent analysis, we examined whether minority language exposure predicted language balance and whether there was a relationship between minority language exposure and EF, mediated by language balance. The results showed that intensity of exposure to Frisian at home, mediated by language balance, had an impact on one of the attention tasks only. It predicted performance on this task at time 1, but not at time 2 and 3. This partially confirms previous evidence that the cognitive effects of bilingualism are moderated by degree of bilingualism and furthermore reveals that substantial minority language exposure at home indirectly affects bilingual children’s cognitive development, namely through mediation with degree of bilingualism. However, the findings also demonstrate that the effect of bilingualism on EF is limited and unstable.

Controlling response dependence in the measurement of change using the Rasch model.

The advantages of using person location estimates from the Rasch model over raw scores for the measurement of change using a common test include the linearization of scores and the automatic handling of statistical properties of repeated measurements. However, the application of the model requires that the responses to the items are statistically independent in the sense that the specific responses to the items on the first time of testing do not affect the responses at a second time. This requirement implies that the responses to the items at both times of assessment are governed only by the invariant location parameters of the items at the two times of testing and the location parameters of each person each time. A specific form of dependence that is pertinent when the same items are used is when the observed response to an item at the second time of testing is affected by the response to the same item at the first time, a form of dependence which has been referred to as response dependence. This paper presents the logic of applying the Rasch model to quantify, control and remove the effect of response dependence in the measurement of change when the same items are used on two occasions. The logic is illustrated with four sets of simulation studies with dichotomous items and with a small example of real data. It is shown that the presence of response dependence can reduce the evidence of change, a reduction which may impact interpretations at the individual, research, and policy levels.

A longitudinal investigation of repressive coping and ageing

Objectives: Two studies investigated the possibility that repressive coping is more prevalent in older adults and that this represents a developmental progression rather than a cohort effect. Study 1 examined repressive coping and mental health cross-sectionally in young and old adults. Study 2 examined whether there was a developmental progression of repressive coping prevalence rates in a longitudinal sample of older adults.Method: Study 1 compared younger adults (mean age 27.6 years) with older adults (mean age 74.2 years) on inventories of mental health and well-being and examined the prevalence of repressive coping in both samples. Study 2 re-tested a sample of older adults previously reported following an interval of 7 years.Results and conclusion: Study 1 – in line with previous research older adults demonstrated greater psychological well-being and had a higher prevalence of repressive coping than younger adults (at 30% vs. 12% respectively). Study 2 – the data indicated that the prevalence of repressive coping rose from 41% at the first time of testing (2002) to 56.4% at the second testing interval (2009). These results suggest that repressive coping may increase across the lifespan in certain individuals and continue to increase throughout older adulthood. Furthermore, this increase in repressive coping with age appears to result in better well-being in those older adults who become repressive copers.

Effectiveness of Early Infant Diagnosis (EID) in Detecting the Serostatus of HIV-Exposed Infants and Children.

Although interventions to prevent mother-to-child transmission of HIV infection are being increasingly implemented as a part of national guideline, the prevalence of pediatric HIV remains high. There is remarkable increase in survival if HIV-infected children have access to early infant diagnosis (EID) and treatment. The study was conducted in the Department of Obstetrics and Gynecology Medical College, Kolkata from July 2011 to February 2014 after obtaining approval from the institutional ethics committee. All the infants of HIV-positive mothers who came for EID between 6weeks to 18months of age during the study period were included in the study. A total number of 151 infants were included in the study and divided into Group A and B according to the time of first testing. It was a prospective observational longitudinal study. Data were collected from the EID register of PPTCT unit Medical College Kolkata. EID was done as laid out in the pediatric ART (anti-retroviral therapy) guidelines of the National AIDS Control Organization. Effectiveness of EID is judged by the corroboration of results at 6week, 6 and 18 months. Comparing the results in group A, we found that 10.26, 8.41, and 7.29% were positive at 6weeks, 6 and 18months, respectively, and with p value of 0.5828 the differences were not statistically significant. In group B, we observed that 47.06 and 45.45% were positive at 6 and 18months, respectively. Analysis revealed a p value of 0.9072 indicating no significant statistical difference between the results of testing in different periods. This reflects a good correlation between the 6weeks, 6 and 18 months value, thus establishing the integrity of the EID. Ultimate integrity of the PPTCT is judged by testing the child. EID is a novel procedure which aims at earlier diagnosis and initiation of treatment in the children.

Does Menstrual Cycle Phase Influence the Gender Specificity of Heterosexual Women’s Genital and Subjective Sexual Arousal?

Unlike men, heterosexual women's genital arousal is gender nonspecific, such that heterosexual women show relatively similar genital arousal to sexual stimuli depicting men and women but typically report greater subjective arousal to male stimuli. Based on the ovulatory-shift hypothesis-that women show a mid-cycle shift in preferences towards more masculine features during peak fertility-we predicted that heterosexual women's genital and subjective arousal would be gender specific (more arousal towards male stimuli) during peak fertility. Twenty-two naturally-cycling heterosexual women were assessed during the follicular and luteal phases of their menstrual cycle to examine the role of menstrual cycle phase in gender specificity of genital and subjective sexual arousal. Menstrual cycle phase was confirmed with salivary hormone assays; phase at the time of first testing was counterbalanced. Women's genital and subjective sexual arousal patterns were gender nonspecific, irrespective of cycle phase. Cycle phase at first testing session did not influence genital or subjective arousal in the second testing session. Similar to previous research, women's genital and subjective sexual arousal varied with cues of sexual activity, but neither genital nor subjective sexual arousal varied by gender cues, with the exception of masturbation stimuli, where women showed higher genital arousal to the stimuli depicting male compared to female actors. These data suggest that menstrual cycle phase does not influence the gender specificity of heterosexual women's genital and subjective sexual arousal.

Predictors of future mathematical performance in children: cognition, behaviour and brain structure

Event Abstract Back to Event Predictors of future mathematical performance in children: cognition, behaviour and brain structure Megan Spencer-Smith1*, Rita Almeida1, Fahimeh Darki1 and Torkel Klingberg1 1 Karolinska Institutet, Department of Neuroscience, Sweden Background: Mathematical underachievement at school age has detrimental consequences for academic success and future employment status. We aimed to extend understanding of the predictive ability of cognitive abilities (reasoning, working memory, speed of processing), behavioural symptoms (inattentive, anxious/ depressed) and brain structure (cortical thickness in the intra-parietal sulcus, IPS) for future mathematical performance. We tested mediating models to determine the association of these cognitive abilities and behavioural symptoms with children’s future mathematical performance. Methods: Included in this study were school age children 6-16 years at the first time of testing who completed neuropsychological testing (n=243) and brain MRI (n=53), and were tested again two years later. Latent variables for cognitive abilities and inattentive symptoms were created and used in all analyses. Mediation models were tested using a series of regression analyses. Results: Regression analyses revealed that although cognitive abilities (p=.000) and inattentive symptoms (p=.003) (but not anxious/depressed symptoms) were predictive of future mathematics, the inattentive symptoms prediction reduced to almost zero after accounting for baseline cognitive abilities (p=.083). Thus cognitive abilities was a full mediator. The cognitive abilities prediction did not change with sex (p=.327) but did change with age (p=.001), and persisted even after accounting for both baseline inattentive symptoms and mathematics (p=.000). Cortical thickness in the left IPS (p=.000) (but not right IPS) was predictive of future mathematics and this did not change with sex (p=.527) or age (p=.465), and persisted even after accounting for baseline cognitive abilities (p=.000). Discussion: Cognitive abilities and cortical thickness in the left IPS, but not behavioural symptoms, are unique predictors of future mathematical performance in school age children. Cognitive abilities have a causal role in the development of mathematical performance in school age children. Keywords: Mathematics, inattention, cortical thickness, Intraparietal sulcus, Cognition, Children Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Oral Topic: Other Citation: Spencer-Smith M, Almeida R, Darki F and Klingberg T (2013). Predictors of future mathematical performance in children: cognition, behaviour and brain structure. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00054 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 25 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Dr. Megan Spencer-Smith, Karolinska Institutet, Department of Neuroscience, Stockholm, Sweden, megan.spencer-smith@mcri.edu.au Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Megan Spencer-Smith Rita Almeida Fahimeh Darki Torkel Klingberg Google Megan Spencer-Smith Rita Almeida Fahimeh Darki Torkel Klingberg Google Scholar Megan Spencer-Smith Rita Almeida Fahimeh Darki Torkel Klingberg PubMed Megan Spencer-Smith Rita Almeida Fahimeh Darki Torkel Klingberg Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Anti-Angiotensin II Type 1-Receptor Antibodies Accelerate Late Renal Allograft Failure in the Absence or Presence of HLA Antibodies

Antibodies directed against Angiotensin II type 1-repector (AT1R) are implicated in humoral rejection and inferior short-term outcomes. However, the impact of AT1R antibodies on renal allograft outcome and their interaction with anti-HLA antibodies late after transplantation is not well understood. Here we report on a longitudinal follow-up of anti-HLA and AT1R antibodies among kidney transplant patients and their impact on long-term clinical outcome. A total of 189 renal transplant recipients were monitored for the presence of HLA and AT1R antibodies by Luminex Single Antigen beads and ELISA, respectively. Antibody testing was initiated on a median of 4.5 years posttransplant and at least two sera were analyzed. Mean follow-up after the first and last testing was 8 and 3 years, respectively. HLA antibodies were detected in 12% (22/189) which was associated with a decreased 8-year graft survival of 60% vs. 81% as compared to HLA negative patients. There was a significant additive negative impact on graft survival when AT1R antibodies were simultaneously detected with HLA antibodies, resulting in only 33% graft survival. Among HLA antibody negative patients AT1R antibody concentration at the time of first testing was not predictive for graft outcome. However, an increase of AT1R antibody titer over time negatively impacted allograft survival (64% vs. 88%) in otherwise HLA-antibody negative patients. Our data implicate importance of screening for AT1R antibodies in predicting velocity of late allograft failure. The dynamic of AT1R antibodies in the absence of HLA antibodies rather than the antibody concentration at a certain time point late after transplantation is predictive for renal allograft outcome. The coincidence of HLA and AT1R antibodies revealed the most detrimental effect on graft survival.

A developmental study of the own-age face recognition bias in children.

The own-age bias is one in which people recognize faces of people their own age more accurately than faces of other ages (e.g., Anastasi & Rhodes, 2005, 2006) and appears to be, at least, partially based on experience (Harrison & Hole, 2009). Indeed, Hills and Lewis (2011a) have shown that 8-year-old faces are more accurately recognized by 8-year-old children than by 6- or 11-year-old children, suggesting the own-age bias develops rapidly. The present study explores the own-age bias in a developmental study in participants aged 6-10 years. Ninety participants (divided into 3 groups of 30 on the basis of their age at the first time of testing) undertook a standard old/new recognition paradigm in which their recognition accuracy was measured for 8- and 20-year-old faces. Results showed that when the participants were 8 years old, they recognized 8-year-old faces more accurately than when they were 7 or 9 years old. This effect was found to be based on mechanisms that differ from simple developmental improvement. This is the first study to show the development of the own-age bias in face recognition using a longitudinal design. These results show that the face recognition system is updated on the basis of recent experience and/or motivation to process faces, creating recognition biases.

HIV-Infected Late Presenter Patients

HIV-Infected Late Presenter Patients

Improvements in cognition in patients converting from thrice weekly hemodialysis to nocturnal hemodialysis: A longitudinal pilot study

Cognitive impairment has been documented in uremia with partial improvement after dialysis. Nocturnal daily hemodialysis (NHD) is a novel dialysis modality with multiple benefits. Previous reports have shown marked improvements in quality of life, cardiac function, resolution of peripheral vascular disease, and reversal of central sleep apnea. We hypothesized that patients maintained on NHD would have better cognitive functioning than those receiving conventional therapy. Using a longitudinal study design, patients were tested at baseline and again after >or=6 months NHD. At each of the two time points, a battery of 10 neuropsychological tests were used to evaluate three domains of cognitive functioning--attention and working memory skills, psychomotor efficiency and processing speed, and learning efficiency. Clinical subjective symptoms for cognitive functioning and depression were measured using the Patients Assessment of Own Functioning inventory and the Beck Depression Index. Twelve patients (six males, six females) were recruited. Patients were aged 39.6+/-3.3 years at the time of first testing. Thirty-three percent were diabetic, with a mean Charlson comorbidity score of 3.5+/-2.0. Depression (defined as >16 on the Beck Depression Index score) was not seen in any patient. Over the 6-month period, a 22% reduction in cognitive symptoms (P=0.01), 7% improvement in psychomotor efficiency and processing speed (P=0.02), and 32% improvement in attention and working memory (P=0.04) was seen. Learning efficiency scores were unchanged. NHD may be associated with improved general cognitive efficiency as measured by psychomotor efficiency and attention and working memory.

Precursors of metamemory in young children: the role of theory of mind and metacognitive vocabulary

This paper describes findings of a longitudinal study that was carried out to examine relationships among different aspects of young children's cognitive development, namely, theory of mind, metacognitive vocabulary, and metamemory, which seem theoretically connected but so far have not been studied simultaneously. In total, 174 children were included in the present analyses who were about 4;6 years of age at the first measurement point. Children were tested at four time points, separated by a testing interval of approximately half a year. At the first time of testing, children completed a set of theory of mind tasks. At each of the following measurement points, measures of metacognitive vocabulary and general vocabulary as well as metamemory were given. Overall, the findings show that theory of mind performance assessed at the age of 4;6 predicts metacognitive knowledge assessed about one and a half years later. Furthermore, they point to a reciprocal relationship between metacognitive vocabulary and metamemory in that comprehension of metacognitive vocabulary predicted later metamemory and, conversely, metamemory significantly predicted later comprehension of metacognitive verbs.

Adaptive behavior and cognitive function of adults with down syndrome: modeling change with age.

Fifty-eight adults with Down syndrome (ages 31 to 56 years at time of first testing, mean age, 43.5) were assessed longitudinally over 10 years for the purpose of modeling aging-related change in cognitive function and adaptive behavior. Cognitive function was assessed seven times using the Woodcock-Johnson Tests of Cognitive Ability-Revised Early Development Battery. Adaptive behavior was evaluated five times using the Inventory for Client and Agency Planning. Multi-level (hierarchical linear) modeling procedures were used to model change with age. Findings provided further evidence of changes in performance with age and included selected effects for participants who completed the 10 years of study and those who were lost to follow-up as well as for age cohorts.

Reproductive effects of feeding gossypol and vitamin E to bulls.

An experiment was conducted to determine the effects of long-term feeding of cottonseed meal on the reproductive traits of Holstein bulls. Holstein bulls approximately 6 mo of age were placed on the following treatments: 1) soybean meal + corn (CON); 2) cottonseed meal + corn (GOS); and 3) cottonseed meal + 4,000 IU vitamin E x bull(-1) x d(-1) (G+4E). The GOS and G+4E diets were formulated to supply 14 mg of free gossypol x kg(-1) BW x d(-1). These bulls had been in a previous experiment that evaluated the effects of feeding the same type of diets, but from 2 wk to 6 mo. of age. Percentage of motility, percentage of normal and live sperm, and daily sperm production were less (P<.05) in the GOS than in the other two treatments. Percentages of primary abnormalities and abnormal midpieces were greater (P<.05) in the GOS group than in the other two groups. At 12 and 16 mo. of age, bulls were given two assessments for sex drive traits. Bulls that received gossypol exhibited less sexual activity (P<.05) at the first test than bulls in other treatments. Vitamin E supplementation in bulls that received gossypol improved the number of mounts in the first test and the time to first service in the second test. There was a trend of gossypol to decrease and vitamin E to improve libido score. The results of the GOS first libido test may indicate lack of sexual maturity, which agrees with sperm production data. At the time of first test (12 mo. of age), none of GOS, two of CON, and six of G+4E bulls had reached puberty on the basis of experimental protocol. Long-term feeding of gossypol to Holstein bulls negatively affected some reproductive traits; however, vitamin E supplementation countered these adverse effects and even improved these traits.

Adjustment after spinal cord injury: A 9-Year longitudinal study

Objective: To generate longitudinal data on the stability of life adjustment over a 9-year period among a sample of participants with spinal cord injury (SCI). Design: A field study was conducted by surveying the adjustment of a sample of participants with SCI in 1985 and again in 1994. Setting: Outpatient files of a large, university hospital in the Midwest. Participants: All 235 participants had traumatic onset SCI, were a minimum of 18 years of age at the time of first testing, and were no less than 2 years postinjury. The average age was 46.7yrs at the time of the 1994 study, with an average of 23.4yrs having passed since injury. Main Outcome Measures: The Life Situation Questionnaire (LSQ) was the outcome measure used. It was developed in 1973 to measure mostly objective information on adjustment and quality of life after SCI. It contains 7 scales and 40 individual items that were of interest in the current study. Results: Declines were identified over the 9-year period in several aspects of subjective well-being, even though there were no declines in overall activity level and some limited increases in participation in employment related activities. Conclusions: The results of this study were in contrast to previous longitudinal follow-ups that identified positive changes over time in both subjective and objective aspects of quality of life. These changes suggest that participants had a less optimistic outlook in 1994 than they did in 1985.

HIV media campaigns and HIV-1 testing trends at London genitourinary medicine clinic, 1985-1993.

To describe HIV-related media events in the context of first-time HIV-1-antibody testing trends at a London genitourinary medicine clinic. Demographic and behavioural data were collected prospectively for individuals tested for HIV-1 antibodies between September 1985 and September 1993, at the genitourinary medicine clinic of St Mary's Hospital, London. A total of 19,242 individuals were tested of whom 37% were women. Of the men tested 60% were heterosexual. The women at first time of testing were significantly younger [29.3 years; 95% confidence interval (CI), 28.8-29.7] than the men (32.5 years; 95% CI, 29.2-35.8); mean ages for both sexes did not change significantly over time. Overall, 199 women and 1539 men tested HIV-antibody-positive. The proportions of women testing positive increased significantly over time (chi 2 = 21.7, degrees of freedom = 1; P < 0.001), whereas the proportion of HIV-positive men remained constant for all sexual orientation groups. The proportion of heterosexual women testing positive (2.8%) was similar to the proportion of HIV-positive heterosexual men (2.9%). HIV-positive individuals were significantly older for both sexes. Throughout the study period numerous education campaigns were run using a variety of media complemented by a number of other HIV-related media events. Peak periods of attendance for HIV testing generally corresponded with increased HIV-related media activity and the greatest testing rates were observed when various HIV media events occurred concurrently. The increase in the number of heterosexuals tested suggests that the risk of heterosexual transmission of HIV has been recognized, at least among older individuals. The exact role of HIV-related media events, including celebrities disclosing their HIV-positive status, remains to be elucidated. Whether the relative under-representation of younger people is due to a lack of awareness, increased use of safer sex practices or reluctance to use the service also remains to be addressed. Given the increasing number of HIV-positive women and the relatively constant rate of HIV-positive tests in the male attendees an urgent need exists to assess the impact and effectiveness of specific HIV media campaigns.

Discrepancies in serological tissue typing revealed by DNA techniques

Abstract. DNA techniques were applied to typing a population of renal patients in order to assess the number of discrepancies between this technique and the serological technique. Five patients had been given an incorrect type by serology, and in 22 instances allogenotypes were found where previously there had been a serological blank. DNA typing was also able to determine allogenotypic subtypes that correlated with DR antigens difficult to split by serology and to determine allogenotypic subtypes correlating with DR antigens not known to have a split by serology. Whereas DNA typing provided a result first time of testing on all but 3 patients, the average number of serological testings for each patient was 1.9.