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Karin Luttropp, 1 Johan Dalén, 1 Axel Svedbom, 1 Mary Dozier, 2 Christopher M Black, 3 Amy Puenpatom 3 1ICON Clinical Research, Plc., Stockholm, Sweden; 2ICON Clinical Research, Plc., Boston, MA, USA; 3Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USACorrespondence: Amy PuenpatomCenter of Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ Tel +1 267 305 0620Fax +1 215 850 4549Email puenpatom.amy@merck.comPurpose: To obtain an up-to-date overview of the measurement of patient experience of switching biologic treatment in patients with inflammatory arthritis (IA) or ulcerative colitis (UC). Secondary objectives included summarizing the types of patient-reported outcomes (PROs) used (if any), and related findings; and summarizing medical and non-medical reasons for treatment switch and/or discontinuation.Methods: A systematic literature review (SLR) was performed, searching Medline and Embase for relevant publications.Results: In total, 70 relevant publications were identified. While the majority of these reported reasons for switching and/or discontinuing treatment, only four provided information explicitly regarding patient-reported experience of switching biologic treatment. All four utilized ranking tools to assess patient experience of switching biologic treatment. The most common reason for switching and/or discontinuing treatment was loss of efficacy, while the least common reason was patient preference.Conclusion: Although the number of available treatments in IA and UC have increased, there is a sparsity of information regarding patient-reported experience of switching biologic treatment. Further research regarding patient preference and/or experience would benefit this therapeutic area and help guide treatment choices.Keywords: arthritis, colitis, ulcerative, biological products, patient reported outcome measures, treatment switch

This study examined associations between foster mothers' emotional investment, assessed when foster children were age 2, and foster children's representations of self and others, assessed when children were age 5. Caregiver investment was assessed using a semi-structured interview called the ''This is My Baby'' interview (TIMB; Bates, B., & Dozier, M. (2002). The importance of maternal state of mind regarding attachment and infant age at placement to foster mothers' representations of their foster infants. Infant Mental Health Journal, 23, 417-431.) administered to foster mothers when their foster children were age 2. Self-representations were assessed using a projective puppet interview (Cassidy, J. (1988). Child-mother attachment and the self in six-year olds. Child Development, 59, 121-134.) when children were age 5. Children's ability to cope with separations from caregivers was examined using the Separation Anxiety Test (SAT; Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood and adulthood: A move to the level of representation. In I. Bretherton & E. Waters (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development, 50, (Serial No. 209), 66-104.). As predicted, foster mothers who were more accepting of their children early in the child-caregiver relationship had foster children who developed more positive self-representations than children whose foster mothers were less accepting. Additionally, caregiver acceptance was associated with children's quality of coping responses in response to caregiver separations, with high caregiver acceptance associated with effective solutions to separation scenarios.

Scientists and resource managers continue to have concerns regarding the potential negative water quality impact that may result from nonpoint additions of nutrients to watersheds. The greatest potential for nonpoint [...]

Early-life stress, such as maltreatment, institutionalization, and exposure to violence, is associated with accelerated telomere shortening. Telomere shortening may thus represent a biomarker of early adversity. Previous studies have suggested that responsive parenting may protect children from the negative biological and behavioral consequences of early adversity. This study examined the role of parental responsiveness in buffering children from telomere shortening following experiences of early-life stress. We found that high-risk children had significantly shorter telomeres than low-risk children, controlling for household income, birth weight, gender, and minority status. Further, parental responsiveness moderated the association between risk and telomere length, with more responsive parenting associated with longer telomeres only among high-risk children. These findings suggest that responsive parenting may have protective benefits on telomere shortening for young children exposed to early-life stress. Therefore, this study has important implications for early parenting interventions. [ABSTRACT FROM PUBLISHER]

AIMS: There is a proven and immediate need for a shared vocabulary for medical education in the United Kingdom, both to support the practice of medical education and the research of medical education practice. It would be inefficient to create a complete and independent vocabulary from scratch, the proposed alternative being to create differential terms between the MeSH and BET vocabularies. METHODS: Existing schemas were reviewed against the needs of stakeholders. Seed terms were submitted to the METRO work environment, discussed, scoped and voted upon. RESULTS: A set of procedures, initial terms and recommendations for further development are the principal deliverables from METRO's first phase, while the ongoing second phase will see the creation and testing of an essential branch of descriptors for assessment. CONCLUSIONS: Further work in a number of areas will be required and long-term issues of resourcing and sustainability have yet to be substantially addressed to allow for full adoption by the user community. [ABSTRACT FROM AUTHOR]

Reports that a hybrid poultry litter and inorganic N fertilization program can supply necessary crop nutrients without detrimental impacts on runoff water quality, but only if recommended best management practices are followed. Demonstration that a properly managed annual litter application of 1 to 2 tons per acre provides a sustainable alternative to disposal techniques and produces little or no negative water quality impact.

The concordance between foster mothers' attachment state of mind and foster infants' attachment quality was examined for 50 foster mother-infant dyads. Babies had been placed into the care of their foster mothers between birth and 20 months of age. Attachment quality was assessed between 12 and 24 months of age, at least 3 months after the infants' placement into foster care. The two-way correspondence between maternal state of mind and infant attachment quality was 72%, kappa = .43, similar to the level seen among biologically intact mother-infant dyads. Contrary to expectations, age at placement was not related to attachment quality. Rather, concordance between maternal state of mind and infant attachment was seen for relatively late-placed babies, as well as early placed babies. These findings have two major implications. First, following a disruption in care during the first year and a half of life, babies appear capable of organizing their behavior around the availability of new caregivers. Second, these data argue for a nongenetic mechanism for the intergenerational transmission of attachment. [ABSTRACT FROM AUTHOR]

Systematic review (SR) already makes a major contribution to evidence-based healthcare by making the review process transparent and by reducing bias. SR has been successfully applied to observational studies. Radiologists have already begun to make an impact in dentistry by using SR as a decision-making tool. Central to SR is establishment of a research question, selection criteria, a search plan, a literature search, an appraisal of the identified literature by the selection criteria; an analysis and a formulation of recommendations. With regard to the literature search, electronic databases (Medline, Embase, Science Citation Index, Lilacs), controlled subject headings, exploding and free-text searching, handsearching and the gray literature are discussed. [ABSTRACT FROM AUTHOR]

Over 170 flavoring ingredients commonly used in the manufacture of American-style blended cigarettes were evaluated in 4 subchronic nose-only smoke inhalation studies. Male and female Fischer 344 rats were exposed 1 h/ day, 5 days/ wk, for 13 wk to smoke from cigarettes containing mixtures of flavor ingredients at target mainstream smoke particulate concentrations between 150 and 1200 mg/m 3. For comparison, separate groups of rats were exposed to smoke from nonflavored reference cigarettes of similar construction and tobacco blend, or to filtered air. Internal dose biomarkers (carboxyhemoglobin, serum nicotine, and serum cotinine) were measured during the studies to monitor smoke exposure. Effects typically noted in rats exposed to mainstream tobacco smoke were similar for both flavored and non-flavored cigarette types. Dose-related reductions in body weights, increased organ-to-body weight ratios for the heart and lungs, and a trend toward decreased blood glucose concentrations in males were noted in the smoke-exposed groups. Exposure-related histopathologic changes occurred only in the respiratory tract. These changes were primarily associated with epithelial tissue, and presented as hyperplasia and/or metaplasia in the nose and larynx. The anterior sections of the nose were more severely affected than were the more posterior regions. Macrophages and areas of epithelial hyperplasia were observed in the lungs of smoke-exposed animals. All smoke-related histopathologic effects diminished significantly during a 6-wk postexposure recovery period. The results indicate that theaddition of these flavoring ingredients to cigarette tobacco had no discernible effect on the character or extent of the biologic responses normally associated with inhalation of mainstream cigarette smoke in rats. [ABSTRACT FROM AUTHOR]

Seasonal hyporesponsiveness and other immune system variations were observed in female B6C3F1 mice during routine screening tests for immunomodulation. In a retrospective assessment, 4 years of data from over 1200 naive, vehicle, and immunosuppressed (cyclophosphamide-treated) control mice were compiled and analyzed for uniformity and significant circannual pattern of immune response. Endpoints included body, spleen, and thymus weights and an immunotoxicity assessment which enumerates specific antibody plaque-forming cells (PFC) in the spleen following immunization with sheep red blood cells. Dosing vehicles were water, corn oil, or 1% methyl cellulose instilled by oral gavage in a 5–20 ml/kg volume once daily for 5 days. Four days later, terminal organ and body weights were recorded and PFC were quantitated. Upon analysis, individual datapoints were arrayed in consistent circannual and seasonal patterns. In naive mice, the yearly peak response in circannual rhythm (acrophase) for body weight and PFC parameters occurred in the summer, with acrophases for spleen and thymus weights located in the spring. Vehicle gavage modulated the circannual/seasonal means and acrophases of all measured endpoints in distinct patterns which varied by vehicle. Body weight was the endpoint least affected by vehicle treatment Corn oil was the vehicle resulting in the most dramatic effects on natural rhythm. As expected, the naive mice receiving an ip injection of cyclophosphamide exhibited significant decreases (p ≤ 0.05) in circannual mean values for PFC response and relative organ weights when compared to naive controls and the elimination of significant expression of rhythm for PFC parameters. Our results indicate that dosing vehicles alter normal seasonal patterns of biological responses in the mouse. These effects on natural rhythms should be considered in toxicity evaluations, especially when comparing datapoints collected at different times of the year. [ABSTRACT FROM AUTHOR]

The Medical Education Taxonomy Research Organization (METRO) was formed to map and create terms to comprehensively describe the processes, procedures and concepts of medical education. The terms will be used in a variety of purposes, such as describing content for retrieval from e-learning environments, indexing literature in databases, and extracting and exchanging data for research, such as for BEME systematic reviews. METRO has now completed an extensive set of descriptors for assessment, which are freely available at http://metro2.blogspot.com. The organization welcomes the response and participation of all medical education professionals. [ABSTRACT FROM AUTHOR]

Objective The Stroop Color and Word Test is a well-known measure of executive functioning. The aim of this study is to determine if Stroop performance is impacted by bilingualism. Method A clinic-referred sample of veterans (n = 245; Mage = 55.84; Medu = 13.87) in whom a cognitive disorder diagnosis was ruled out were selected for inclusion. Participants self-identified as monolingual English (n = 192) or bilingual English/Spanish (n = 53) and were deemed appropriate for completing neuropsychological evaluation in English. All participants were administered the Stroop as part of a larger battery of tests. Analysis of covariance (ANCOVA) was used to examine Stroop scores across monolingual/bilingual groups, controlling for age. Results Stroop Word (raw) was significantly lower among bilingual participants (M = 79.13, SD = 18.24) compared to monolingual participants (M = 85.22, SD = 16.7), F = 4.48, p =.035. Although Color (F = 3.01, p =.084) and Color-Word Interference trials (F = 2.36, p =.125) were not significantly different across groups, there was a trend. When scores on the Color-Word Interference subtest were corrected using the Golden Equation, there were no significant group differences (F =.002, p =.966). Conclusions Bilingualism was related to reduced performance on speeded word-reading. Although there were no statistical differences on color-naming or inhibition, the sample size may have impacted statistical power. Despite this, there was no evidence of even a trend towards significance when applying the Golden Equation to correct for speed of word-reading and color-naming. Findings indicate Stroop is a valid measure of inhibitory control among bilingual individuals who are appropriate for completing testing in English, so long as adjustments are made to account for speed on the Word, Color, and Color-Word trials. [ABSTRACT FROM AUTHOR]