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Programming for recognition and programming for response. Separate developmental subroutines in the murine thymus.

Pre-T cells become programmed with the capacity to make functional responses to activating stimuli in a process that occurs prior to, and independently of, T-cell receptor gene rearrangement and T-cell receptor-dependent positive selection. In spite of this early programming, as differentiation proceeds further the cells enter a stage in which they appear to be unable to make any functional responses. This 'eclipse' phase begins when the cells undergo successful T-cell receptor beta-chain rearrangement and ends, with the return of their functional competence, only when they successfully traverse positive selection. These results suggest that pre-T cells are subject to two distinct subroutines of differentiation, which cannot operate at the same time: one which confers function and one which confers and selects recognition specificity. To provide a possible molecular basis for the relationship between these two processes, we consider specific alterations in response-associated transcription factors that may cause the changes in responsiveness observed during programming for recognition. The interplay of the two differentiation subroutines is proposed to be a consequence of the use of common transcription factors in different combinatorial contexts for functional responses, assembly of T-cell receptor complexes, and selection.

Aging↗

Gang membership and student behavior: nursing's involvement with prevention, intervention, and suppression.

Gangs are alive, and growing stronger each day, as they infiltrate all socioeconomic levels of most towns, cities, and metropolitan areas. This is the first of two articles in this issue discussing students and gang membership and a school nurse's involvement with gang prevention, intervention, and suppression. It is also about a large metropolitan school district's proactive approach to gang prevention, which includes a meaningful partnership involving the family, community, and school. The program is a comprehensive developmental guidance program to promote pro-social behaviors, equip students with refusal skills, and encourage problem-solving strategies that enable students to avoid engaging in high-risk activities.

Adolescent↗

Development and implementation of a program for offenders with developmental disabilities.

The need for a comprehensive range of services for persons with mental retardation and other developmental disabilities who enter the criminal justice system has been well-established. However, such services are unavailable to most offenders with developmental disabilities. Here we describe the services of one agency devoted to this population. Established in 1990, this agency has provided education and training to over 1,500 professionals, answered over 1,000 information and referral questions, and provided direct services to over 600 offenders with developmental disabilities. Recommendations for developing and implementing similar programs are offered. Areas addressed include assessing need, funding, composition of boards of directors, program philosophy, selection of program services, staffing, the referral process, and program evaluation.

Adolescent↗

Developmental outcome, child behaviour and mother-child interaction at 3 years of age following Newborn Individualized Developmental Care and Intervention Program (NIDCAP) intervention.

The aim of the present pilot study was to investigate the impact of early intervention in the form of family-centred developmentally supportive care according to NIDCAP((R)) (Newborn Individualized Developmental Care and Assessment Program) on the development and behaviour of the child and on the mother-child interaction at 3 years of age. Two groups of very-low-birth-weight (VLBW) infants (< or = 1500 g) were studied. The control group (n=21) was born in 1990, i.e. prior to implementation of the NIDCAP. The intervention group, born in 1992-1993 (n=21), was subjected to formal NIDCAP observation once every 10 days. Development was assessed using the Griffiths' Developmental Scale II in conjunction with a neurological examination. Behaviour was assessed on the basis of a parental interview. Mother-child interaction was assessed according to the Parent-Child Early Relational Assessment Scale (ERA). There was no significant difference in motor development. The total developmental quotient (DQ) on the Griffiths' developmental scale was 109 (94-122) [median (range)] for the NIDCAP group and 108 (93-120) for the control group (n.s.). On the subscale hearing-speech, the intervention group scored 119 (72-157) and the control group 108 (84-130) (P=0.02). The total score with respect to the Behaviour Symptom Interview was 6 (0-20) for the NIDCAP group and 16 (0-54) for the control group (P=0.03). With respect to the mother-child interaction, there was a significant difference in the child cluster 'communication', the total score being 12 (11-13) for the NIDCAP group and 10 (9-13) for the control group (P=0.03). In conclusion, care of VLBW infants according to NIDCAP appears to have certain positive long-term effects on the child's behaviour and mother-child interaction.

Adult↗

Nonprofit ownership and quality in Medicaid's longterm care program for persons with developmental disabilities.

To assess ownership-related differences in the Intermediate Care Facility Program for persons with Mental Retardation (ICF/MR) Industry, this article analyzes a nationally representative sample of data on Medicaid certified facilities from the Health Care Financing Administration On-line Survey and Certification Reporting System. This study found that nonprofit providers provided a higher level of quality than for-profit facilities when organizational size and facility-mix were controlled. The size and case-mix composition of these facilities were also influenced by nonprofit ownership type. Nonprofit providers offered smaller facilities, on average, and were more likely to enroll heavy case-mix residents than their for-profit counterparts.

Adult↗

The Missouri Elks Mobile Dental Program--dental care for developmentally disabled persons.

This article describes the origins, funding, organization, operation, utilization, and outreach program of a statewide mobile dental program for the disabled in Missouri. The article includes information based on analysis of productivity reports and patient records. Comparisons are made between the utilization by mentally retarded (MR) and other disabled patients (MCCS), their county of residence, and the location where service was provided (rural vs urban). The mean number of dental procedures provided per client was 7.3. More procedures (8.35) were provided to urban clients than rural clients (5.81). The utilization rate of urban MR clients was 63.9 percent, compared to 60 percent for rural MR clients. Other findings show 10.7 percent urban MCCS clients utilized the mobile dental program, versus 13.5 percent of the rural MCCS clients. The budgeted expenditures for providing care to this underserved group were $46,000 less than the estimated value of dental care provided in a private practice setting.

Adolescent↗

Attentional stimuli and programming hand selection: a developmental perspective.

This experiment examined the use of attentional stimuli for reaching in hemispace by strong right-dominant adults and children. Driving the hypothesis was the notion that developmental factors associated with use of attentional information may affect the programming of reaching movements in hemispace. Although the general pattern of responses was similar for both samples, children did not use attentional cues to program reaching movements in contralateral hemispace as effectively as adults. This result suggests that motor dominance and perhaps other factors were pivotal in motor programming for children. One possible explanation for the general behavior observed underlies an attentional hemispheric bias for a tendency to use the hand that is on the same side as the stimulus.

Adult↗

[Individual developmental care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)].

The number of preterm deliveries is increasing. Major advances in neonatology now enable even infants with a very low gestational age to survive. These infants have to spend months in the intensive care unit, while they have to deal with a lot of painful medical procedures, nursing care units, excessive noise and light, all differing from the normal uterine environment. The immature preterm infant nervous system is in a vulnerable phase of development. Early exposure to stress, or the mismatch of the preterm infant brain with the unphysiologic intensive care environment, may be linked to long-term developmental impairments reported in these children. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is a systematic method of assessing the individual needs of preterm newborns. In an attempt to mimic uterine environment, care according to the NIDCAP principles is reducing infant distress and in the same way supporting the individual aibilities. Thus NIDCAP may have an effect on the preterm infant neurodevelopmental outcome.

Child Development↗

Developing an AIDS prevention education program for persons with developmental disabilities.

The AIDS epidemic poses a serious threat to people with developmental disabilities, the magnitude of which has not yet been fully realized by many professionals working with this population. Models for effective AIDS prevention education have been developed, however, within other populations. Key principles utilized in existing models were discussed and recommendations presented on how to adapt these models when designing programs for people who have developmental disabilities, most specifically, those in the mild/moderate range of mental retardation.

Acquired Immunodeficiency Syndrome↗

Designing and implementing a school-based dental program for students with developmental disabilities.

Students with developmental disabilities in Atlantic County Special Services School District (ACSSSD) receive on-site dental care through a program created by UMDNJ-New Jersey Dental School (NJDS). The program's goal was to coordinate dental school resources with those of a school district, county agencies and the Delta Dental Foundation to provide quality dental services to the students, aged 3-21 years. The University developed a Needs Assessment Survey and distributed 450 surveys to the students' parent/guardian(s). Completed surveys were returned by 131 respondents. Of the 131 children represented, 75 had not been seen by a dentist within the past year. In response to guardian reported access problems, UMDNJ-NJDS and ACSSSD developed a school-based dental care delivery system and a program for health promotion and disease.

Adolescent↗

TIGAR deficiency enhances cardiac resilience through epigenetic programming of Parkin expression.

Mitochondrial dysfunction devastates the heart in major cardiovascular diseases, yet the mechanisms governing mitochondrial quality control remain elusive. We discovered that TIGAR (TP53-induced glycolysis and apoptosis regulator) deficiency established profound cardiac protection through developmental epigenetic programming of Parkin expression. Using mice with whole-body and cardiomyocyte-specific TIGAR knockout, we demonstrated remarkable cardioprotection following myocardial infarction with maintained ejection fraction, and complete resistance to diet-induced cardiac hypertrophy despite comparable weight gain. TIGAR deficiency triggered dramatic increases in Parkin expression across all somatic tissues except testes, where Parkin levels remained extraordinarily high (100-fold greater than cardiac levels) regardless of TIGAR status, revealing tissue-specific regulatory mechanisms. This protection was entirely Parkin dependent, as double-knockout mice lost all cardioprotective benefits. Crucially, adult TIGAR manipulation failed to alter Parkin levels, demonstrating that this pathway operated exclusively during critical developmental windows to program lifelong cardiac resilience. Whole-genome bisulfite sequencing identified reduced DNA methylation in Prkn intron 10 as the key regulatory mechanism, with CRISPR deletion dramatically increasing Parkin expression in multiple cell lines. Our findings reveal how early cardiac metabolism programs lifelong cardiac function through epigenetic mechanisms, and identify developmental metabolic programming as a potential therapeutic target for preventing both ischemic heart disease and metabolic cardiomyopathy.

Animals↗

A comparison of behavioral interventions reported in treatment studies and programs for adults with developmental disabilities.

This study examined the frequency with which behavioral interventions reported in the research literature were being incorporated into residential treatment programs addressing identical skill deficits. A sample of 113 research articles involving 299 subjects and a corresponding sample of 299 adaptive skill programs implemented in state-funded facilities were reviewed. Information was collected about subject attributes, target behaviors, types of intervention, and alternative instructional techniques. Chi-square analyses revealed significant differences between researchers and clinicians in the categories of adaptive and maladaptive behavior targeted as well as the behavioral interventions reported. Disparities were also found in treatment implementation practices including the use of task analysis, instruction in the natural environment, teaching of replacement skills, and the functional analysis of behavior. These differences are discussed in light of federal regulations governing practices in state-funded facilities as well as current research trends.

Adult↗

Impact of developmental tests on ARRT examination scores.

This study evaluated the effectiveness of developmental tests by comparing the ARRT examination scores of radiography graduates who did and did not participate in their use. The study found a statistically significant relationship between participation in the developmental testing program and higher scores on the ARRT radiography certification exam. Recommendations include further validation of the developmental testing program.

Data Interpretation, Statistical↗

A mobility skills training program for adults with developmental disabilities.

Twenty-nine adults with developmental disabilities were trained by an occupational therapist to use city buses for leisure outings to local shopping malls. Program evaluation was based on the number of times each program participant used his or her mobility skills to make an independent leisure outing. These data were collected for 1 year after each person left the program and were analyzed with the use of multiple regression procedures. The results revealed that the participants maintained their mobility skills for 1 year. Older women who shared common leisure interests as well as persons who were afforded more intensive individualized training were especially likely to use the city bus for leisure outings after the treatment program ended. This study demonstrates the long-term effectiveness of occupational therapy when specific treatment goals are matched with individualized training sequences for persons with developmental disabilities.

Activities of Daily Living↗

Behavioral evaluation of a state program of deinstitutionalization of the developmentally disabled.

The purpose of this study was to evaluate one phase of a statewide program of deinstitutionalizing developmentally disabled individuals. Forty adults who had spent a minimum of six months in community placements were evaluated with respect to changes in behavior associated with movement out of state institutions and into community settings such as group homes and day activity centers. Pre- and post-deinstitutionalization measures were taken with the Behavior Development Survey. Post-deinstitutionalization measures on Cataldo and Risley's Resident Activity Manifest were compared to the same measures obtained on 159 developmentally disabled individuals scheduled for deinstitutionalization. A consistent pattern of positive changes on both instruments favored deinstitutionalization, but changes could not be unequivocally attributed to movement out of the institutions per se.

Adult↗

Genetic background influences developmental airway smooth muscle program and susceptibility to airway hyperresponsiveness in mice.

Airway structural remodeling and hyperresponsiveness (AHR), hallmarks of asthma, are influenced by genetic variations and adverse exposures. While intrauterine perturbations in lung development have been linked to adult pulmonary disease, the developmental origins of these abnormalities remain poorly understood. Here, we provide evidence of genetic background playing a key role in this process. Using A/J and C57BL/6J mice known for their distinct susceptibility to AHR, we show that A/J embryos selectively develop an aberrant airway smooth muscle (SM) program and AHR in adulthood when exposed transiently to a vitamin A/retinoic acid (RA)-disrupted intrauterine environment in vivo by maternal BMS493 administration. Single-nucleus multiomics identified a mesenchymal cell population overactivating TGF-&#x3b2; targets in response to BMS493 selectively in A/J lungs. These cells, localized to sites of airway SM initiation and p-SMAD2- and -3, exhibited robust BMS493-mediated upregulation of SMAD2/3 targets, including regulators of SM program Pdgfra and Tnc. Functional analyses in vivo and cultured lungs showed aberrant SM formation in areas of overactive TGF-&#x3b2; of BMS493-exposed lungs. These abnormalities were prevented by inhibiting TGF-&#x3b2; signaling in utero in RA-deficient embryos. These findings underscore how distinct genetic backgrounds respond to intrauterine perturbations that program airway structure and function, with potential lasting consequences in postnatal pulmonary function.

Animals↗