No abstract

Lower estimated insulin sensitivity was associated with risk for hyperfiltration over time, whereas increased albumin excretion was associated with hyperglycemia in youth-onset T2DM.

The nucleus accumbens, a site within the ventral striatum, plays a prominent role in mediating the reinforcing effects of drugs of abuse, food, sex, and other addictions. Indeed, it is generally believed that this structure mandates motivated behaviors such as eating, drinking, and sexual activity, which are elicited by natural rewards and other strong incentive stimuli. This article focuses on sex addiction, but we hypothesize that there is a common underlying mechanism of action for the powerful effects that all addictions have on human motivation. That is, biological drives may have common molecular genetic antecedents, which if impaired, lead to aberrant behaviors. Based on abundant scientific support, we further hypothesize that dopaminergic genes, and possibly other candidate neurotransmitter-related gene polymorphisms, affect both hedonic and anhedonic behavioral outcomes. Genotyping studies already have linked gene polymorphic associations with alcohol and drug addictions and obesity, and we anticipate that future genotyping studies of sex addicts will provide evidence for polymorphic associations with specific clustering of sexual typologies based on clinical instrument assessments. We recommend that scientists and clinicians embark on research coupling the use of neuroimaging tools with dopaminergic agonistic agents to target specific gene polymorphisms systematically for normalizing hyper- or hypo-sexual behaviors.

This investigation examined variables related to family adaptation to brain injury that may contribute to a more functional level of adaptation for family members using the family adjustment and adaptation response model. Participants were 123 family members of 65 brain-injured patients at the Shepherd Center, a rehabilitation hospital treating people with spinal cord injury, acquired brain injury, multiple sclerosis, and other neuromuscular problems. Hierarchical linear modeling was used to aggregate family data. Results of the test of this model indicate that a number of variables influenced adaptation, including increased financial resources, social support, reframing, and coping skills. Many factors combined to increase the level of distress for these families, including concerns with insurance and emotional and behavioral changes exhibited by the patient. Conclusions drawn from this study are that (a) family members of brain-injured patients experienced significantly more psychological distress when compared with nonpatient norms and (b) these family members were vulnerable to disruption in family functioning. Directions for future research are discussed.

The purpose of this article is to integrate science into clinical practice by introducing marriage and family therapists to the ideas of evidence-based practice (EBP). Evidence-based practice, which originated in the medical field, refers to the process of using research to make clinical decisions that best meet the needs of each client. Included in the description is a brief history of EBPs and ideas about learning EBPs. Suggestions are also made about the use of EBPs in MFT training programs, and resources are provided to enable clinicians to use EBPs in clinical practice.