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Objective Traumatic brain injury (TBI) is thought to be a risk factor for Parkinson’s disease (PD) but results are conflicting. Many studies do not account for confounding or reverse-causation. We sought to address these concerns by quantifying risk of PD after TBI compared to non-TBI trauma (NTT, defined as fractures). Methods Using inpatient/emergency department (ED) ICD-9 code data for California hospitals from 2005–2006, we identified patients age ≥55 with TBI (n=52,393) or NTT (n=113,406) and without baseline PD or dementia who survived hospitalization. Using Kaplan-Meier estimates and Cox proportional hazards models (adjusted for age, sex, race/ethnicity, income, comorbidities, healthcare use, trauma severity), we estimated risk of PD after TBI during follow-up ending in 2011. We also assessed interaction with mechanism of injury (fall vs. non-fall) and effect of TBI-severity (mild vs. moderate/severe) and TBI-frequency (1 TBI vs. >1 TBI). Results TBI patients were significantly more likely to be diagnosed with PD compared to NTT patients (1.7% versus 1.1%, p<0.001, adjusted hazard ratio (HR) 1.44, 95% CI 1.31–1.58). Risk of PD was similar for TBI sustained via falls versus non-falls (interaction p=0.6). Assessment by TBI-severity (mild TBI HR 1.24, 95% CI 1.04–1.48; moderate/severe TBI HR 1.50, 95% CI 1.35–1.66) and TBI-frequency (1 TBI HR 1.45, 95% CI 1.30–1.60; >1 TBI HR 1.87, 95% CI 1.58–2.21) revealed a dose-response. Interpretation Among patients age ≥55 presenting to inpatient/ED settings with trauma, TBI is associated with a 44% increased risk of developing PD over 5–7 years that is unlikely due to confounding or reverse-causation.

Background Previous work examining normal controls from the Alzheimer's Disease Neuroimaging Initiative (ADNI) identified substantial biological heterogeneity. We hypothesized that ADNI mild cognitive impairment (MCI) subjects would also exhibit heterogeneity with possible clinical implications. Methods 138 ADNI subjects diagnosed with amnestic MCI were clustered based on baseline MRI, cerebrospinal fluid, and serum biomarkers. The clusters were compared with respect to longitudinal atrophy, cognitive trajectory, and time to conversion. Results Four clusters emerged with distinct biomarker patterns: The first cluster was biologically similar to normal controls and rarely converted to Alzheimer's disease (AD) during follow-up. The second cluster had characteristics of early Alzheimer’s pathology. The third cluster showed the most severe atrophy but barely abnormal tau levels and a substantial proportion converted to clinical AD. The fourth cluster appeared to be pre-AD and nearly all converted to AD. Conclusions Subjects with MCI who were clinically similar showed substantial heterogeneity in biomarkers.

Gender-based violence, which includes sexual and intimate partner violence against women, is prevalent worldwide, prompting calls for primary prevention programs which engage men and boys in changing social norms that condone violence against women. Bystander intervention efforts which encourage males to say something to stop peers from enacting disrespectful and abusive behaviors toward females are a promising strategy for promoting non-violent, gender-equitable attitudes and behaviors. An evaluation of "Parivartan"--a U.S. program called "Coaching Boys Into Men" adapted for urban India cricket teams--was conducted in Mumbai, India. Baseline and 12 month follow-up surveys were administered to 309 male cricket athletes aged 10 to 16 years in 46 urban middle schools in Mumbai, India (27 intervention, 19 control). Athletes whose coaches were trained in the program demonstrated greater improvements in gender-equitable attitudes compared to athletes whose coaches provided standard coaching only. Marginally significant improvements were seen in reduction of negative bystander behavior. Violence prevention programs which utilize coaches as positive messengers for respect and non-violence may be a useful addition to global prevention efforts to reduce violence against women.

Background: Although women receive nearly half of all doctoral degrees and show a high interest in academic careers, the pipeline is leaky. The challenge of balancing life course events with career trajectory is an important determinant leading to premature dropout or slower career advancement. This report describes the findings of the first phase of a National Institute of Health Office of Research on Women's Health (NIH ORWH)-funded study using survey and academic data for exploring satisfaction and awareness of/intent to use specific career flexibility options at the University of California, Davis (UCD). Methods: All men and women faculty in the UCD's Schools of Medicine (SOM) and Veterinary Medicine (SVM) and College of Biological Science (CBS) were surveyed. Data also were obtained from deans' offices on use of family-friendly benefits by faculty. Results: Three hundred twenty-five total survey responses were received from the SOM, 83 from SVM, and 64 from CBS, representing 42%, 46%, and 52% of their total faculty, respectively. In each school, large percentages of men (32%-60%) and women (46%-53%) faculty have children under 18 and a moderately high level of demand of family care responsibilities. Women were significantly more likely to be childless, particularly in the SOM (35% vs. 14%, p < 0.001). For all schools, documented use of any family-friendly policy was low (0%-11.5%), as was awareness of policies, although both were significantly higher for women than for men. Significantly more women than men wanted to use policies or chose not to, particularly in the SOM (51% vs. 28%, p < 0.001, and 37% vs. 23%, p = 0.016, respectively), because of multiple barriers. Faculty in all schools agreed/ highly agreed that policies were important to recruitment, retention, and career advancement. Conclusions: Family-friendly policies are pertinent to men and women, as both demonstrate interest and need, linked to increased career satisfaction. A family-friendly policy is important, particularly for women in the biomedical sciences.

SMCs are associated with cognitive impairment nearly 2 decades later among older women. SMCs may be a very early symptom of an insidious neurodegenerative disease process, such as Alzheimer disease.

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Background-Cerebrospinal fluid (CSF) and structural magnetic resonance imaging (MRI) show patterns of change in Alzheimer's disease (AD) that precede dementia. The Alzheimer's Disease Neuroimaging Initiative (ADNI) studied normal controls (NC), subjects with mild cognitive impairment (MCI) and AD to identify patterns of biomarkers to aid in early diagnosis and effective treatment of AD.Methods-222 NC underwent baseline MRI and clinical examination at baseline and at least one follow-up. 112 also provided CSF at baseline. Unsupervised clustering based on initial CSF and MRI measures was used to identify clusters of participants with similar profiles. Repeated measures * Data used in the preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (www.loni.ucla.edu\ADNI). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators is available at www.loni.ucla.edu\ADNI\Collaboration\ADNI_Manuscript_Citations.pdf. © 2010 Elsevier Inc. All rights reserved.Correspondence to: Laurel Beckett, labeckett@ucdavis.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflict of interestNone reported for JN, JB, LB, DH. regression modeling assessed the relationship of individual measures, and of cluster membership, to cognitive change over three years. NIH Public AccessResults-Most individuals showed little cognitive change. Individual biomarkers had limited predictive value for cognitive decline, but membership in the cluster with the most extreme profile was associated with more rapid decline in ADAS-COG.Conclusions-Subtypes among NC based on multiple biomarkers may represent the earliest stages of subclinical cognitive decline and AD.