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Biomedical subjects

C Penn

Publications and source records attributed to C Penn.

At least 19 recordsLinked to original sources
PubMed1999

Pragmatic assessment and therapy for persons with brain damage: what have clinicians gleaned in two decades?

Pragmatic competence comprises a number of interrelated skills which manifest in real-time in a range of adaptive behaviors and which are driven by underlying cognitive processes that appear to be variably compromised in brain damage. Differential neurological profiles reflect different pragmatic outcomes. The essence of pragmatic assessment and therapy for clinicians is therefore to capture accurately, measure, and, where possible, enhance the ability of the individual to adapt to a changing communicative environment. Assessment measures differ along a number of dimensions. A distinction is drawn between testing and assessment and the argument proposed that for clinical purposes, it is helpful to keep the notions of functional and pragmatic distinct.

Brain Diseases↗
PubMed1999

Contemporary results of radical radiotherapy for bladder transitional cell carcinoma in a district general hospital with cancer-centre status.

OBJECTIVE: To assess the current efficacy and safety of definitive external beam radiotherapy (EBRT) in the treatment of invasive bladder transitional cell carcinoma (TCC) in a district general hospital with cancer-centre status. PATIENTS AND METHODS: The case notes of all patients with bladder TCC undergoing EBRT with curative intent over an 8-year period (1988-95) were reviewed. Additional missing outcome data were collected. RESULTS: In all, 120 patients (109 men; median age 70 years, range 34-90) underwent radical EBRT (40-65 Gy; fraction median=20) over the 8-year period. Staging, as assessed by examination under anaesthesia and computed tomography, was T1 in 16%, T2 in 43%, T3 in 38% and T4 in 3%. In 96 patients (80%) the tumour was poorly differentiated (G3). The overall morbidity at 12 months was 12%; proctitis occurred in nine patients (8%) and cystitis in five (4%). Sixty-seven patients (59%) developed a local recurrence and in 36 (30%) this was invasive. The overall median survival was 60 months. Thirty-three patients underwent salvage cystectomy with a subsequent median survival of 12.5 months. CONCLUSION: Modern radical multifraction EBRT in invasive bladder TCC has a low morbidity, with an overall median survival of 5 years.

Adult↗
PubMed1998

The study of child language in South Africa.

This paper describes some of the research into child language that has been conducted in South Africa over the past 20 years. It is written from a clinical perspective and it describes the influence of changing demographic, social, educational and political variables on the study of child language. Specifically, the influence of the multilingual and multicultural nature of the society will be considered. Among issues discussed are the increasing research base on the acquisition of normal language, the adaptation of assessment tools and language in education.

Child↗
PubMed1997

The measurement of emotional reaction and depression in a South African stroke population.

The study evaluated the sensitivity of a newly devised scale for measurement of emotional reactions and depression, on a group of 25 stroke patients, with right or left hemisphere damage, and 15 age-matched controls. Four clusters were examined: communication, expression of emotions, sense of self and physical or psychomotor problems. Case history factors such as time since onset, gender, anti-depressant medication and severity of aphasia were related to performance on the scale. Results indicated that the scale allowed for expression of emotion in all three groups tested and that speech and communication items significantly differentiated right and left hemisphere subjects. A strong correlation was found between spouse reports and self reports on selected items of the scale. Time since onset was found to be important in predicting level of depression. These findings have implications for assessment and management of stroke.

Aphasia↗
PubMed1996

Toward a new psychometric definition of social disability in children with attention-deficit hyperactivity disorder.

OBJECTIVE: To investigate a new mechanism for identifying social disability in children with attention-deficit hyperactivity disorder (ADHD), employing psychometric methodology used in defining learning disabilities. METHOD: Two groups of index children were examined: 140 children with ADHD (referred from both psychiatric and pediatric sources) and 120 non-ADHD comparison children. Subjects were defined as socially disabled if they had a value greater than 1.65 on a standardized discrepancy score between observed and expected scores on a measure of social functioning (with expected scores derived as a function of the child's estimated Full Scale IQ). Children identified as socially disabled were compared with non-socially disabled probands on psychopathology, familiality, cognitive functioning, school history, and treatment history. RESULTS: Using this psychometric approach, 22% of the ADHD probands qualified as socially disabled, whereas none of the comparison probands qualified (p < or = .001). Socially disabled ADHD probands were significantly more impaired than were non-socially disabled ADHD probands in global and specific measures of social functioning and patterns of psychiatric comorbidity. CONCLUSIONS: The psychometrically defined construct of social disability may identify children with ADHD who are at very high risk for severe social dysfunction and whose course and prognosis may vary from those of other children with ADHD. This subgroup of children with ADHD may be at heightened risk for poor outcome, and their identification may facilitate the development of clinical interventions aimed at ameliorating their specific difficulties.

Adolescent↗
PubMed1996

The persisting communicative difficulties of 'remediated' language-impaired children.

This study addresses the effiacy of dismissal criteria used by speech and language pathologists by investigating communicative functioning in children declared 'remediated'. A battery of measures comprising the Language Assessment and Remediation Procedure (LARSP); the Behavioural inventory of Speech Act Performances (BISAP); the BISAP Addendum and the Devereux School Behaviour Rating Scale (DESB) was conducted on five children with language impairment who had been declared 'remediated'. Findings for certain 'remediated' subjects revealed persisting problems. The results suggest that decisions about dismissal from therapy may, in some cases, be premature and point to the need for a broad-based perspective concerning remediation dismissal decisions. An additional study on larger populations and the use of designs which investigate long term outcomes would further inform clinical decision-making concerning dismissal from therapy.

Child↗
PubMed1996

Assessment of urinary incontinence.

1. In the past, nursing practice toward incontinence has focused on urine containment and skin protection rather than on proactive treatment-oriented therapeutic care. 2. Accurate assessment and diagnosis of urinary incontinence determine the success of treatment. 3. Efforts directed at early identification, appropriate assessment and treatment, and linkage to community agencies should be initiated by the nurse.

Geriatric Assessment↗
PubMed1996

Speech-language evaluation of closed head injured subjects in South Africa: cultural applicability and ecological validity of a test battery.

This paper addresses the communicative outcome of a group of closed head injured (CHI) subjects in South Africa. Communicative outcome is evaluated on one test battery currently used for medico-legal assessments in South Africa. It was found that a number of the tests were sensitive to breakdown in this sample, but that the demographic factors of first language and pre-injury education significantly affected performance on some tests. Many test performances were significantly related to return to work, thus confirming the importance of communicative skills in the workplace, and the speech-language pathologist's role in vocational assessment and rehabilitation.

Adult↗
PubMed1994

Binding of plasma fibronectin to Candida albicans occurs through the cell binding domain.

Candida albicans yeast cells bind soluble human plasma fibronectin (Fn) through a glycoprotein receptor (adhesin) located on the cell surface. This work demonstrates that a 120 kDa proteolytic fragment of Fn encompassing the cell binding domain binds more avidly to the yeast cell adhesin than does the parent Fn molecule. The presence of binding of Fn fragments containing heparin- and gelatin-binding domains of Fn could not be detected. The binding of the 120 kDa fragment is inhibited by a monoclonal antibody to the cell binding domain containing the amino acid sequence, Arginine-Glycine-Aspartic acid (RGD) as well as by an RGD-containing approximately 23-mer Fn peptide, but not with heparin or GRGDSPL. The fact that the cell binding domain of soluble Fn binds more avidly than does the parent molecule may explain the difference in the interaction of soluble Fn and immobilized Fn with Candida. It is possible that, upon immobilization, Fn may expose domains of the molecule previously unexposed when the molecule is in the soluble state.

Bacterial Adhesion↗
PubMed1992

The communicative Effectiveness Index: its use with South African stroke patients.

The functional communication of a group of 28 South African stroke patients was examined using the Communicative Effectiveness Index (CETI). It was translated into Afrikaans, Sotho and Zulu and administered to the significant others of 22 aphasic patients with left hemisphere damage and 6 patients with right hemisphere damage. Results were related to the results of standardized language testing and to case history factors such as cultural factors and time since onset. The CETI was readministered in the case of eight of the aphasic subjects after a mean period of six months in order to assess its sensitivity to recovery. Results showed that the CETI seems applicable across different language groups, that it is sensitive to change across time as well as sensitive to the communication disorders resulting from both right and left hemisphere damage. Further it appears to correlate well with overall level of severity. It does not appear to differentiate patients in terms of time since onset. Its potential use as a relatively culture free assessment tool in the South African context is discussed.

Adult↗
PubMed1991

Toward a national policy for deaf education in the "new" South Africa.

In this article, it is suggested that there has been a lack of a clear, focused, cohesive and articulated sense of direction in areas related to deafness and the provision of services to the deaf in South Africa. As a means of rectifying this situation, policy proposals which were developed in a workshop conducted at the Thirteenth Biennial Conference of the South African National Council for the Deaf are presented and discussed, as is the underlying research base for the policy proposals.

Curriculum↗
PubMed1990

Stable expression of foreign antigens from the chromosome of Salmonella typhimurium vaccine strains.

A simple and versatile system has been developed using a new cloning vector which can serve as a vehicle for integrating DNA fragments, which direct the expression of heterologous antigens, into the aroC gene on the Salmonella chromosome. The system is based on Escherichia coli plasmid vectors which contain the DNA fragment, cloned from the chromosome of S. typhimurium C5, which encodes the aroC gene. The aroC gene was modified using synthetic oligodeoxyribonucleotides so that it contained several unique restriction sites into which DNA, directing the expression of heterologous antigens, could be cloned. DNA was integrated into the S. typhimurium chromosome at aroC by transferring the vectors into S. typhimurium polA mutants and allowing homologous recombination to occur between the cloned and chromosomal aroC genes. The vectors were used to integrate nucleotide sequences into the S. typhimurium chromosome which directed the expression of tetanus toxin fragment C and the Treponema pallidum lipoprotein. The expression of both antigens was detected by Western blotting.

Antigens, Bacterial↗
PubMed1990

Acquired childhood aphasia with convulsive disorder (Landau-Kleffner syndrome). A case report.

The Landau-Kleffner syndrome is a rare form of acquired childhood aphasia associated with convulsive disorder. These children are typically misdiagnosed. A 15-year-old girl whose aphasia was not diagnosed until the age of 13 is described. Pitfalls in diagnosis are discussed, particularly with regard to interpretation of the results of audiometric testing. Attention is drawn to the existence of this rare form of aphasia and to the lack of appropriate educational facilities for aphasic children in general.

Adolescent↗
PubMed1989

The role of RNA segment 1 in an in vitro host restriction occurring in an avian influenza virus mutant.

A temperature sensitive mutant, ts C47, derived from A/FPV/Rostock/34 and with a ts mutation in RNA segment 8, fails to form plaques in MDCK cells. From data obtained with reassortant viruses using the human influenza isolate A/FM/1/47 it was apparent that more than one mutation contributed to the temperature-sensitive (ts) and host range (hr) phenotypes of ts C47, and the phenotype of reassortants containing RNA segment 1 from A/FM/1/47 indicated that this segment was involved. A single nucleotide substitution at nucleotide 1961, resulting in valine instead of methionine in the predicted amino acid sequence of polypeptide PB2, was found in RNA segment 1 of ts C47, but this mutation did not segregate with the attenuated phenotype on gene reassortment. The following conclusions are drawn: (a) that ts C47 has at least two mutations in addition to that already known to exist in RNA segment 8, one of which (that in RNA segment 1) does not contribute to the observed ts hr phenotypes and (b) that the hr phenotype can be suppressed by substitution of RNA segment 1 by that of another strain.

Amino Acid Sequence↗