Autistic Adult Services Availability, Preferences, and User Experiences: Results From the Autism Spectrum Disorder in the European Union Survey

There is very little knowledge regarding autistic adult services, practices, and delivery. The study objective was to improve understanding of current services and practices for autistic adults and opportunities for improvement as part of the Autism Spectrum Disorder in the European Union (ASDEU) project. Separate survey versions were created for autistic adults, carers of autistic adults, and professionals in adult services. 2,009 persons responded to the survey and 1,085 (54%) of them completed at least one of the services sections: 469 autistic adults (65% female; 55% <35 years old), 441 carers of autistic adults (27% female; 6% <35 years old), 175 professionals in adult services (76% female; 67% in non-medical services). Top choices by autistic adults, carers or professionals for services best suiting their current needs were: residential services: "help in own home" (adults, carers of high independent adults, professionals), "fulltime residential facility" (carers of low independent adults); employment services: "job mentors" (adults, carers of high independent adults, professionals), "Sheltered employment" (carers of low independent adults); education services: "support in regular education setting" (all groups); financial services: financial support in lieu of employment ("Supplementary income for persons unable to have full employment" for adults, "full pension" for carers of low independent adults) or to supplement employment earnings for carers of high independent adults and professionals; social services: "behavior training" (adults) and "life skills training" (carers and professionals). Waiting times for specific services were generally < 1 month or 1-3 months, except for residential services which could be up to 6 months; most professionals were uninformed of waiting times (>50% responded "don't know"). Five of seven residential services features recommended for autistic adults were experienced by <50% of adults. The knowledge of good local services models that work well for autistic adults was generally low across all services areas. The variation in services experiences and perceptions reported by autistic adults, carers, or professionals underscore the need to query all groups for a complete picture of community services availability and needs. The results showed areas for potential improvement in autistic adult services delivery in the EU to achieve recommended standards.

Autistic Adult Health and Professional Perceptions of It: Evidence From the ASDEU Project

The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated the knowledge and health service experiences of users and providers to generate new hypotheses and scientific investigations that would contribute to improvement in health care for autistic adults. An online survey designed for autistic adults, carers of autistic adults, and professionals in adult services was translated into 11 languages and distributed electronically by organizations and in-country adult service facilities in 2017; 522 autistic adults, 442 carers, and 113 professionals provided answers to the health questions. Professionals, the majority in non-medical services, appeared to be poorly informed about whether certain co-occurring conditions were more frequent in autistic adults than typical adults-especially some medical conditions, suicide attempts, accidents, and pain. A minority of autistic adults reported preventive health behaviors such as routine health check-ups. The majority of users and providers expressed the desire to make health care services more user-friendly for autistic adults. Among the three groups, <20% of responders knew an organization or clinician which has developed a way to monitor health, and prevent poor health, that works well for adults on the autism spectrum. The results point to means for better management of co-occurring conditions associated with autism in adulthood in order to reduce hospital admissions and potential areas of improvement in health and social services for autistic adults. Specifically, efforts should be focused on (1) professionals' education on risks for co-occurring conditions in autistic adults; (2) promoting preventive health behaviors; (3) making services user-friendly for autistic adults and their families; and (4) encouraging knowledge of good local services.

Intervention Services for Autistic Adults: An ASDEU Study of Autistic Adults, Carers, and Professionals' Experiences

The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services’ use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Family interventions were experienced slightly more commonly by carers than adults or professionals. Less than the 26% of autistic adult responders who had experienced challenging behaviors reported receiving an intervention to change them. These results provide insights for improving gaps in service provision of interventions among autistic adults.

Real-World Experiences in Autistic Adult Diagnostic Services and Post-diagnostic Support and Alignment with Services Guidelines: Results from the ASDEU Study

Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and post-diagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals.

Anxiety and Depression in Cyberbullied College Students: A Retrospective Study

Cyberbullying is a worldwide phenomenon and its effects can be severe. To better understand the personal and situational factors in cyberbullying, we approach it from the perspective of the general aggression model. More specifically, we analyze the medium and long-term impact of past experiences of cyberbullying on university students. We also compare their psychological adjustment with peers who have not been cyberbullied by examining the recall of cyberbullying while attending secondary school of 1,593 university students. Participants from a Spanish University (N = 680) and a Bolivian University (N = 913) were invited to participate by filling in an online survey. It included the School Violence Questionnaire-Revised, CUVE-R, to assess school and classroom climate in relation to bullying and cyberbullying, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Results show that among the participants, 5.1% reported having suffered cyberbullying and 19.3% reported having been a bystander of cyberbullying, with similar percentages between universities. Canonical correlation suggests that variables related to school climate best explain the variability among participants who have and have not been cyberbullied. Those who have been cyberbullied scored significantly higher on anxiety and depression symptoms as well. Being a bystander of cyberbullying was not associated to significant differences on psychological adjustment (i.e., anxiety and depression). Results indicated that experiencing cyberbullying in secondary school is associated to lower psychological adjustment years later as university students. School climate variables contribute more strongly to identifying victims of cyberbullying. These results support the need for psychosocial interventions from a broader perspective, addressing the different dimensions of this phenomenon and its impact on victims.

A valid and reliable measure of nothing: disentangling the "Gavagai effect" in survey data

Background

In three recent studies, Maul demonstrated that sets of nonsense items can acquire excellent psychometric properties. Our aim was to find out why responses to nonsense items acquire a well-defined structure and high internal consistency.

Method

We designed two studies. In the first study, 610 participants responded to eight items where the central term (intelligence) was replaced by the term “gavagai”. In the second study, 548 participants responded to seven items whose content was totally invented. We asked the participants if they gave any meaning to “gavagai”, and conducted analyses aimed at uncovering the most suitable structure for modeling responses to meaningless items.

Results

In the first study, 81.3% of the sample gave “gavagai” meaning, while 18.7% showed they had given it no interpretation. The factorial structures of the two groups were very different from each other. In the second study, the factorial model fitted almost perfectly. However, further analysis revealed that the structure of the data was not continuous but categorical with three unordered classes very similar to midpoint, disacquiescent, and random response styles.

Discussion

Apparently good psychometric properties on meaningless scales may be due to (a) respondents actually giving an interpretation to the item and responding according to that interpretation, or (b) a false positive because the statistical fit of the factorial model is not sensitive to cases where the actual structure of the data does not come from a common factor. In conclusion, the problem is not in factor analysis, but in the ability of the researcher to elaborate substantive hypotheses about the structure of the data, to employ analytical procedures congruent with those hypotheses, and to understand that a good fit in factor analysis does not have a univocal interpretation and is not sufficient evidence of either validity nor good psychometric properties.

Influence of time to admission to a comprehensive stroke centre on the outcome of patients with intracerebral haemorrhage

Introduction

In patients with spontaneous intracerebral haemorrhage, it is uncertain if diagnostic and therapeutic measures are time-sensitive on their impact on the outcome. We sought to determine the influence of the time to admission to a comprehensive stroke centre on the outcome of patients with acute intracerebral haemorrhage.

Patients and methods

We studied a prospective database of consecutive patients with intracerebral haemorrhage attended at two comprehensive stroke centres (2005-2017). We excluded patients with an unwitnessed time of onset of the intracerebral haemorrhage, or previous modified Rankin Scale >3 or in those in whom withdrawal of life-sustaining interventions were decided <24 h from admission. We recorded the time from the intracerebral haemorrhage onset to admission, demographic, clinical, radiological data, the functional outcome (favourable when modified Rankin Scale ≤3) and mortality at 90 days. We conducted a propensity score-matching analysis to evaluate functional outcome and mortality.

Results

We included 487 patients (mean age 72.3 ± 13.9 years), and 53.2% were men. Compared to patients with an admission >110 min, patients who were admitted ≤110 min were significantly younger, and had higher National Institutes of Health Stroke Scale scores. Moreover, patients admitted ≤110 min were more likely to have basal ganglia intracerebral haemorrhage, and to show neurological deterioration. The propensity score groups were well matched. We did not find an association between time to admission and the favourable outcome (OR: 1.42 (95% CI: 0.93-2.16)) or mortality (OR: 0.64 (0.41-0.99)) at 90 days.

Conclusions

Our results suggest that in patients with intracerebral haemorrhage and known symptom onset who are admitted to a comprehensive stroke centre, an early admission (≤110 min) does not influence the outcome at 90 days.

E-Health Interventions for Adult and Aging Population With Intellectual Disability: A Review

To answer the question about which e-health and e-therapy applications are being used with people with intellectual disabilities, we searched the PsycINFO, Medline, PubMed, ERIC, CINAHL, Scopus, Web of Science, and Cochrane databases. This is an extensive search. Inclusion criteria were academic journals and any design type that addressed the topic of interest. Studies that do not include adults or elderly, and studies that do not focus on people with disabilities but on third parties, were excluded. After an initial selection of 515 articles, 32 full-text articles were subjected to in-depth analysis leading to the final selection of 18 articles. We used the AAID framework definition of intellectual disability to analyze the dimensions explored by the selected studies and found that the majority of studies focused on the use of technology as supports to instrumental activities of daily life. The ISO classification of assistive products allowed us to identify that many e-health products are aimed at providing psychological or medical treatment. In summary, this review suggests that there is a very small number of studies focusing on the use of technology by older persons with intellectual disabilities. The studies present substantial limitations regarding generalization and replication and pay little attention to the maintenance of cognitive abilities in this population. These aspects, together with premature aging generally associated with many conditions that lead to intellectual disability, underscore the need to pay more attention to and develop e-health interventions for cognitive stimulation for this group.

Resilience and social support as protective factors against abuse of patients with dementia: A study on family caregivers

OBJECTIVE

Scientific literature has identified different vulnerability factors associated to abuse in people with dementia (PWD), but little is known about the psychosocial protective variables against abuse. The main objective of this study is to investigate a set of caregiver and patient factors linked to abuse-related behavior of PWD.

METHODS

A total of 326 primary and family caregivers, residents of the Castilla and León community (Spain), were evaluated. All participants filled out a standardized protocol, which assessed the sociodemographic characteristics, patient and care-related variables, as well as the perceived burden, resilience, and social support. Abuse-related behavior was evaluated using the Caregiver Abuse Screen.

RESULTS

Results show that the severity of cognitive impairment and behavior disorders of PWD, a greater number of caregiving hours, a worse previous relationship with the caregiver, and perceived burden are positively related with abuse. However, resilience and social support showed a negative relationship with Caregiver Abuse Screen scores, suggesting a protective effect on abuse, even after controlling the effect of a number of covariates. Indeed, resilience was the only variable that remained significant after including the effect of burden.

CONCLUSIONS

This paper states the role of burden in abuse of PWD, while resilience and social support are abuse protective factors. These variables should be considered in future guidelines for the prevention of abuse against PWD.

Urinoma Formation Secondary to Ureteral Obstruction by Metastatic Squamous Cell Carcinoma of the Appendix. Case Report

We report a case of secondary squamous cell carcinoma of the appendix causing spontaneous extravasation of urine and urinoma formation. On the basis of clinical findings, we interpret this rare lesion as metastatic from a cervical carcinoma surgically resected 8 years earlier. Ureteral continuity was restored by retrograde catheterization and the urinoma was drained percutaneously. The final diagnosis was made at laparotomy.

Cavitation of Lung Metastases from Bladder Cancer. Report of two Cases

We describe 2 cases of cavitary lung metastasis from bladder cancer and retrospectively analyze the frequency of such an event in our environment. Although rare, this finding is not exceptional and should be taken into account when clinicians and oncologists face the differential diagnosis of pulmonary cavitation. Moreover, a cavitary pulmonary nodule may also be the presenting sign of bladder cancer.

Cyberbullying among adults with intellectual disabilities: Some preliminary data

BACKGROUND

Recent studies show that youth with disabilities are at risk of experiencing cyberbullying. Nevertheless, the nature of this phenomenon among adults with intellectual disabilities has not been investigated. Therefore, the purpose of this study is to analyze the frequency and characteristics of cyberbullying and its correlates in individuals with intellectual disabilities attending training centers for adults with intellectual disabilities.

METHODS AND PROCEDURES

A convenience sample of 269 participants (54.3% men and 35.7% women), aged 18-40 years was recruited from Chile (14.1%), Mexico (32%), and Spain (53.9%).

RESULTS

The findings showed that 15.2% have been cyberbullied 9.7% are currently being cyberbullied. Being different was the main reason (97.7%) for being cyberbullied. The behaviors happen in educational settings (46.67%), leisure/free time activities (31.11%), and associations for people with disabilities (15.56%). Verbal aggressions (74.53%) were the most common cyberbullying behaviors. Those who were cyberbullied reported more inadequate use of mobile phone and Internet, as well as more unhealthy behaviors and depressive mood.

CONCLUSIONS AND IMPLICATIONS

These findings support the need for further studies on adults with intellectual disabilities, as well as the need for implementing primary, secondary, and tertiary prevention programs.

ACTITUDES, BARRERAS Y OPORTUNIDADES PARA EL EMPLEO DE PERSONAS CON DISCAPACIDAD INTELECTUAL

Abstract.En nuestra sociedad el empleo representa uno de los aspectos más importantes que condicionan nuestra vida y relaciones e incluso nuestra salud. El trabajo constituye una de las actividades fundamentales de la vida. Sin embargo, el acceso al mismo se encuentra condicionado por una serie de variables personales y contextuales que, en interacción, se convierten en barreras para la participación en la sociedad. Un grupo tradicionalmente excluido es el compuesto por personas con discapacidad. El objetivo de este trabajo consistió en: 1) Evaluar las percepciones de los trabajadores con discapacidad intelectual sobre su calidad de vida laboral; 2) Conocer las principales actitudes, barreras y oportunidades que favorecen y/o dificultan el empleo en estos trabajadores; y 3) Identificar áreas de intervención para mejorar la calidad de vida laboral en los trabajadores y organizaciones. Para ello se analizaron las opiniones expresadas por 12 trabajadores con discapacidad intelectual que actualmente trabajaban en Empleo con Apoyo (ECA) utilizando metodologías cualitativas a través del procedimiento de grupos focales y mediante el análisis de fragmentos textuales. Los resultados obtenidos pusieron de manifiesto que la calidad de vida laboral es un constructo multidimensional formado por indicadores objetivos y subjetivos, y que las actitudes, barreras y oportunidades percibidas por los trabajadores impactan en su bienestar. Finalmente se proponen estrategias para mejorar los servicios orientados hacia el empleo normalizado de personas con discapacidad intelectual.Palabras Clave: calidad de vida laboral, discapacidad intelectual, actitudes, grupos focales

NECESIDADES EDUCATIVAS E INCLUSIÓN ESCOLAR: EL PESO DE LAS ACTITUDES

Abstract.Se presentan los resultados obtenidos tras evaluar las actitudes hacia la inclusión de alumnos con necesidades educativas especiales en aulas ordinarias. En este estudio preliminar la muestra está compuesta por 91 participantes, todos ellos estudiantes del grado de Maestro. , de los cuales un 22% son hombres y un 78% son mujeres, de edades comprendidas entre los 22 y los 45 años (M=28,13; Dt=6,4). Se aplicó el Cuestionario de Opiniones hacia la Integración, que está formado por 30 items con un formato de respuesta tipo Likert de 5 puntos y puntuaciones más altas denotan actitudes más favorables. Los resultados indicaron que las mujeres y quienes tienen contacto con el referente actitudinal consideran que el profesorado está mejor preparado para hacer frente a los retos de la inclusión. Sin embargo, no parece existir una relación lineal entre frecuencia de contacto y actitudes hacia la integración, por lo que es necesario profundizar en el tipo de contacto y en los tipos de necesidades educativas con los que se está familiarizado, para poder determinar el peso de estos factores en la conformación de unas actitudes más o menos favorables. Los presentes hallazgos así como la continuación del presente estudio nos permitirán establecer pautas para la intervención con maestros en formación, quienes serán elementos clave de la promoción de la inclusión en las aulas del futuro.Palabras Clave: Maestros, Integración educativa, Actitudes, Contacto, Frecuencia

Salud y calidad de vida de cuidadores familiares y profesionales de personas mayores dependientes: estudio comparativo

El trabajo que se presenta tiene como objetivo analizar las semejanzas y diferencias en la salud y en la calidad de vida de los cuidadores familiares y profesionales que atienden a personas mayores en situación de dependencia. Concretamente se presentan los resultados obtenidos tras la evaluación de 600 cuidadores de los cuales un 33,83% son familiares y un 66,17% son profesionales, a quienes se evaluó la carga o estrés experimentado, la salud física y psicológica y la calidad de vida general, laboral, familiar y social. Los resultados obtenidos indican que existen diferencias entre ambos grupos de cuidadores. Los familiares dedicados al cuidado presentan mayores niveles de sobrecarga y tienen una peor salud física y psicológica como consecuencia de la atención prestada al dependiente. Los cuidadores profesionales experimentan una mayor satisfacción con la vida en general y con otros factores como el trabajo, la familia y las relaciones sociales. Finalmente se justifica la necesidad de poner en marcha intervenciones de mejora de la salud de los cuidadores

Health and Quality of Life of Family and Professional Caregivers of Dependent Elderly: A Comparative Study

The work presented aims to analyze the similarities and differences in health and quality of life of family caregivers and professionals serving seniors in a position of dependency. Specifically, the results presented were obtained from the evaluation of 600 caregivers, of which 33.83% are family and 66.17% are professionals, to determine their burden or stress experienced, as well as their physical and psychological health and their overall, work, family and social quality of life. The results indicate that there are differences between the two groups of caregivers. The family caregivers have higher levels of overload and have poorer physical and psychological health as a result of their tasks. Professional caregivers experience greater satisfaction with life in general and in other factors such as work, family and social relationships. Finally, this justifies the need to implement interventions to improve the health of caregivers.

Síndrome de burnout y calidad de vida laboral en profesionales de servicios sanitarios

El objetivo de este trabajo consistió en analizar los factores asociados con la calidad de vida laboral y su relación con el síndrome de burnout en profesionales de servicios sanitarios. La muestra estuvo formada por 562 trabajadores pertenecientes al sector sanitario, a quienes se evaluaron los estresores o demandas laborales, el apoyo social percibido, el síndrome de burnout, diversos factores de salud biopsicosocial y la satisfacción y calidad de vida laboral percibida. Los instrumentos empleados fueron el Maslach Burnout Inventory-General Survey (MBI-GS), el Job Content Questionnarie (JCQ) y el Cuestionario General de Salud de Goldberg (GHQ-28). Los resultados obtenidos evidenciaron altas tasas de estrés percibido, así como la presencia de burnout o síndrome de “quemarse” por el trabajo. También se encontraron repercusiones en la salud física y psicológica de los profesionales. Los análisis de varianza pusieron de manifiesto la existencia de diferencias significativas en función de variables como la categoría profesional y los años de antigüedad en la profesión. Asimismo, los análisis de regresión confirmaron que la calidad de vida laboral experimentada por el personal sanitario es producto del equilibrio entre las demandas, los recursos y la ausencia de burnout. Los resultados justifican la necesidad de intervenir con estos profesionales para mejorar tanto su salud como la calidad de los servicios ofrecidos.

Identification of the support needs of individuals with severe mental illness using the Supports Intensity Scale

OBJECTIVE

To characterize the intensity of the support needs of individuals with severe mental illness.

METHODS

Quantitative and descriptive study that applied the Supports Intensity Scale to a sample comprising 182 individuals.

RESULTS

The supports intensity profile identifies groups, individuals, and areas with different needs of support relative to the domains of home living, health, community living, learning, employment, and social living. As a whole, the intensity level of support needs found was low, and the domains with greater needs were employment and social.

CONCLUSIONS

Identification of the intensity of support needs is helpful in planning integral care and detecting professional training needs. The support provision-centered approach, associated with the person-related outcomes perspective, has been sparsely applied to individuals with mental illness, and this represents the main contribution of the present study. In addition, this study introduces novel approaches to assessment that are both concordant and an innovation in nursing because they might provide a tool for understanding other disabilities.

Quality of services and quality of life from service providers' perspectives: analysis with focus groups

BACKGROUND

Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services.

METHOD

Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups.

RESULTS

Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services.

CONCLUSIONS

It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes.

Managing finances of shipping living donor kidneys for donor exchanges

Kidney donor exchanges enable recipients with immunologically incompatible donors to receive compatible living donor grafts; however, the financial management of these exchanges, especially when an organ is shipped, is complex and thus has the potential to impede the broader implementation of donor exchange programs. Representatives from transplant centers that utilize the National Kidney Registry database to facilitate donor exchange transplants developed a financial model applicable to paired donor exchanges and donor chain transplants. The first tenet of the model is to eliminate financial liability to the donor. Thereafter, it accounts for the donor evaluation, donor nephrectomy hospital costs, donor nephrectomy physician fees, organ transport, donor complications and recipient inpatient services. Billing between hospitals is based on Medicare cost report defined costs rather than charges. We believe that this model complies with current federal regulations and effectively captures costs of the donor and recipient services. It could be considered as a financial paradigm for the United Network for Organ Sharing managed donor exchange program.

Synergistic benefit in inflammatory arthritis by targeting I kappaB kinase epsilon and interferon beta

OBJECTIVES

The I kappaB kinase (IKK)-related kinase IKKepsilon regulates type I interferon expression and responses as well as proinflammatory mediator production. We examined the role of IKKepsilon in arthritis and its ability to enhance the therapeutic response to systemic interferon (IFN) beta therapy in passive murine K/BxN arthritis.

METHODS

IKKepsilon(-/-), IFN alpha(approximately)beta R(-/-) and wild type mice were given K/BxN serum and treated with polyinosinic polycytidylic acid (poly(I:C)), IFN beta, or normal saline. Clinical response and histological scores were assessed. Gene expression in the paws was measured by quantitative PCR. Serum interleukin 1a receptor agonist (IL1Ra) and IL10 were measured by ELISA and multiplex bead array.

RESULTS

Arthritis was almost completely blocked in wild type mice if arthritogenic K/BxN serum and the Toll-like receptor (TLR)3 ligand, poly(I:C), were coadministered at the onset of the model, but not in established disease. Mice deficient in IFN alpha(approximately)beta R had an accelerated course of arthritis, and did not respond to poly(I:C). IKKepsilon null mice had a modest decrease in clinical arthritis compared with heterozygous mice. Low doses of IFN beta that were ineffective in wild type mice significantly decreased clinical arthritis in IKKepsilon null mice. Articular chemokine gene expression was reduced in the IKKepsilon(-/-) mice with arthritis and secreted IL1Ra (sIL1Ra) mRNA was significantly increased. Serum levels of IL1Ra were increased in low dose IFN beta-treated IKKepsilon(-/-) mice.

CONCLUSIONS

Subtherapeutic doses of IFN beta enhance the anti-inflammatory effects of IKKepsilon deficiency, possibly by increasing production of IL1Ra and unmasking the antichemokine effects. Combination therapy with low dose IFN beta and an IKKepsilon inhibitor might improve efficacy of either agent alone and offers a novel approach to RA.

Vaccination with a neural-derived peptide plus administration of glutathione improves the performance of paraplegic rats

After damage to the central nervous system (CNS) the body is protected by an adaptive immune response which is directed against myelin-associated proteins. Active immunization with nonpathogenic derivatives of CNS-associated peptides (DCAP) reduces the degeneration of neurons and promotes motor recovery after spinal cord injury (SCI) in rats. In order to improve even more the neurological outcome obtained with this therapy, either a combination of DCAP immunization plus glutathione monoethyl ester (GSHE) or a double DCAP immunization were performed. GSHE is a cell-permeant derivative of glutathione, a potent antioxidant agent that significantly inhibits lipid peroxidation after SCI. After a contusive or compressive SCI, the combination of GSHE + DCAP immunization, induced better motor recovery, a higher number of myelinated axons and better rubrospinal neuron survival than immunization alone. On the other hand, double-DCAP immunization counteracted the protective effect of DCAP therapy. Motor recovery and neuronal survival of double-immunized rats were similar to those observed in control animals (PBS-treated). Further studies revealed that double immunization was not encephalitogenic but inhibited the proliferative response of T-cells specific to the DCAP-immunized peptide. This clonal dysfunction was probably secondary to anergy. GSHE improves the protective effect induced by DCAP immunization while double immunization, reverts it.

Evaluation of consumable household products for decontaminating retail skinless, boneless chicken breasts

The effect of 15 consumable products, including juices, wines, and vinegar, used as rinsing agents on microbial loads of retail skinless, boneless chicken breasts was evaluated in two studies. Ten breasts were rinsed for 1 min with each solution. Samples were swabbed before and after rinsing with a cellulose sponge and evaluated for total aerobic (APC), total coliform (TCC), and generic Escherichia coli counts by Petrifilm methods. No differences were found in initial APC or TCC in either study, with initial mean APC ranging from 5.30 to 7.05 log CFU/cm2 and initial mean TCC ranging from 2.21 to 3.36 log CFU/cm2. In study 1, the APC for breasts rinsed with distilled white vinegar (3.22 log CFU/cm2) was lower than for those rinsed with all other solutions except cranberry juice cocktail (3.86 log CFU/cm2). The TCC for breasts rinsed with distilled white vinegar (0.00 log CFU/cm2) and cranberry juice cocktail (0.20 log CFU/cm2) were lower than those for all other solutions except 10% NaCl (0.43 log CFU/cm2) and 10% NaHCO3 (0.48 log CFU/cm2). In study 2, APC values for breasts rinsed with red wine (5.29 log CFU/cm2) and white wine (5.32 log CFU/cm2) were lower than for breasts rinsed with the other three solutions. The TCC after rinsing with chicken broth (4.48 log CFU/cm2) was higher than for all other solutions except Italian dressing. Although distilled white vinegar was the most effective rinsing agent, all solutions produced lower counts after rinsing, indicating that consumers could use rinsing to remove microorganisms from chicken breast surfaces prior to cooking.

NFkappaB and AP-1 DNA binding activity in patients with multiple sclerosis

Current evidence suggests that multiple sclerosis (MS) results from an autoimmune response mediated by T lymphocytes, which would be activated in the peripheral blood and migrate into the central nervous system. NFkappaB and AP-1 are two main transcription factors involved in T-cell activation. To investigate possible alterations in the activity of these factors in MS individuals, we have assayed NFkappaB and AP-1 DNA binding activity in peripheral blood mononuclear cells (PBMC). Binding activity was analyzed by gel mobility shift assay in MS patients compared with controls. No significant differences were found between the two groups, indicating no evidence of abnormalities associated with MS in NFkappaB or AP-1 binding activities in PBMC, both basally and after PMA+anti-CD3 antibody induction.