Substantial evidence indicates that triglyceride-rich lipoprotein remnants are atherogenic. Additional research has, however, been limited by available methods for separation and quantification of remnants. We have evaluated an immunoseparation assay developed to measure cholesterol in remnant-like particles (RLP-C). This method uses monoclonal antibodies to human apolipoproteins B-100 and A-I to remove most of the apolipoprotein B-100-containing lipoproteins (namely LDL and nascent VLDL) and apolipoprotein A-I-containing lipoproteins (namely chylomicrons and HDL), leaving behind a fraction of triglyceride-rich lipoproteins, including chylomicron and VLDL remnants, both of which are enriched in apolipoprotein E. Cholesterol in the unbound fraction is measured with a sensitive enzymatic assay. The RLP-C concentration was highly correlated with total triglyceride-rich lipoproteins (sum of VLDL-cholesterol and IDL-cholesterol) separated by ultracentrifugation and by polyacrylamide gel electrophoresis (r = 0.86 and 0.76, respectively). The within-run and run-to-run imprecision (CV) of the assay was ∼6% and 10%, respectively. The assay was not affected by hemoglobin up to 5000 mg/L (500 mg/dL), bilirubin up to 342 mmol/L (20 mg/dL), glucose up to 67 mmol/L (1200 mg/dL), or ascorbic acid up to 170 mmol/L (3.0 mg/dL). In 726 subjects (men, n = 364; women, n = 362) in the US, the 75th percentiles of RLP-C concentration were 0.17 mmol/L (6.6 mg/dL) and 0.23 mmol/L (8.8 mg/dL) in sera obtained after overnight fasting or randomly, respectively. A group of 151 patients from nine US centers and one Canadian center with coronary artery atherosclerosis established by angiography had higher median RLP-C concentrations than 302 gender- and age-matched controls (P <0.05). We conclude that the RLP-C assay compares favorably to ultracentrifugation and electrophoresis and provides a convenient and economical approach to measure triglyceride-rich lipoprotein remnants in routine clinical laboratories.
Abstract:The fundamental feature that distinguishes positive behavior support (PBS) from previous generations of applied behavior analysis is its focus on the remediation of deficient contexts that are determined to be the source of the problem. Determining this source involves conducting a functional assessment. This innovative practices article presents the argument that if professionals are to successfully address issues pertaining to the context of problem behaviors, they must incorporate the perspectives and knowledge of people receiving behavioral supports into the functional assessment process. The authors report the results of a pilot examination of a person-guided functional assessment and present ideas for enhancing consumer involvement in the functional assessment process.Promoting and enhancing the self-determination of people with disabilities has become an important focus of disability services and supports across the life span (Wehmeyer, 2001). A growing international literature base has documented that people with mental retardation or developmental disabilities in particular are not very selfdetermined (Robertson et al
This study examined the sleep patterns and prevalence of sleep problems in adults with mental retardation living in community settings. Information was gathered from 67 staff members regarding 237 individuals with mental retardation (focus persons). Staff members provided information about each focus person's (a) demographics, (b) sleep patterns, and (c) sleep problems encountered in the last month. Persons with severe or profound mental retardation and persons taking medications were more likely to experience sleep problems. These findings clearly identify sleep as a critical area of health support for persons with mental retardation, and suggest areas for future analysis.
The development of behavior support strategies in the homes and workplaces of persons with disabilities remains a challenge. This report presents a study of behavior support training for a residential and vocational support agency. Three training sessions were provided to managerial and direct-care staff, during which trainees worked in teams to plan or complete functional assessments and behavior support plans for focus persons supported by the agency. Before training, there were no complete functional assessments for the focus persons but there were behavior support plans for two of the focus persons. Posttraining, functional assessments and behavior support plans were either developed or improved to meet the standards for best practice for all focus persons. One behavior support plan was not written until approximately one year after the completion of the training sessions. The frequency of problem behavior was reduced for all focus persons. The limitations and strengths of this approach are described herein for clinicians and researchers.
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