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D Burge

Publications and source records attributed to D Burge.

At least 19 recordsLinked to original sources
PubMed2000

Incidence of RET mutations in patients with Hirschsprung's disease.

BACKGROUND: RET mutations have been reported variously to affect 7% to 41% of Hirschsprung's disease (HSCR) patients depending on familial or sporadic occurrence of the disease, length of aganglionosis and possible association with other disease phenotypes. The authors report a study of the incidence of RET mutations in unselected HSCR patients from two regional centers and correlate their genotypes and phenotypes. METHODS: The records of HSCR patients treated in 2 regional centers with a combined population of 5 million were reviewed, and blood samples were obtained from 57 patients. During the same period, 39 patients with similar demographic data refused or provided insufficient blood for study. DNA was extracted, and the 21 exons of the RET protooncogene were screened for mutations using denaturing gradient gel electrophoresis (DGGE). RESULTS: Of 57 patients, 48 were sporadic, and 9 were familial. Lengths of aganglionosis were total colonic, 4; long, 11; short, 39; ultrashort, 1; unclassified, 2. Associated anomalies were present in 20. Causative mutations were identified in 4 (7%): missense or "silent" in 3 (exons 5, 11, 13) and deletion in 1. The silent mutation of exon 11 recently has been shown to have effects on correct RET mRNA splicing. One mutation occurred in total colonic aganglionosis (25%), 1 in long segment dysganglionosis (9%), and 2 in short segment aganglionosis (5%). Surprisingly, all these mutations occurred in sporadic cases (10%). Five patients (9%) had rare polymorphic alleles at exon 14 (n = 1) and exon 18 (n = 4). Fifty patients (88%) showed common polymorphic alleles (sequence variants) in 1 or more exons (> 4, n = 5). CONCLUSIONS: RET mutation as a primary cause for Hirschsprung's disease in the general surgical population is less frequent than previously thought. This observation is compatible with the hypothesis that HSCR could be a polygenic disease caused by additive subclinical effects of more than one gene, including RET.

Drosophila Proteins↗
PubMed2000

Toward an interpersonal life-stress model of depression: the developmental context of stress generation.

The validity of a developmentally based life-stress model of depression was evaluated in 88 clinic-referred youngsters. The model focused on (a) the role of child-environment transactions, (b) the specificity of stress-psychopathology relations, and (c) the consideration of both episodic and chronic stress. Semistructured diagnostic and life-stress interviews were administered to youngsters and their parents. As predicted, in the total sample child depression was associated with interpersonal episodic and chronic stress, whereas externalizing disorder was associated with noninterpersonal episodic and chronic stress. However, the pattern of results differed somewhat in boys and girls. Youngsters with comorbid depression and externalizing disorder tended to experience the highest stress levels. Support was obtained for a stress-generation model of depression, wherein children precipitate stressful events and circumstances. In fact, stress that was in part dependent on children's contribution distinguished best among diagnostic groups, whereas independent stress had little discriminative power. Results suggest that life-stress research may benefit from the application of transactional models of developmental psychopathology, which consider how children participate in the construction of stressful environments.

Adolescent↗
PubMed2000

A pilot randomised controlled trial of medical versus nurse clerking for minor surgery.

BACKGROUND: Nurse led clerking is currently practiced in a growing number of UK centres, but there is a paucity of evidence to underpin the safety of this innovation. AIM: To assess the safety of nurse led clerking in paediatric day case and minor surgery. METHODS: Children aged 3 months to 15 years were randomly assigned to clerking by either a nurse or a senior house officer (SHO) (resident). All children were then independently reassessed by a specialist registrar anaesthetist to provide a "gold standard" against which practitioner performance could be judged. RESULTS: In 60 children studied, nurses identified a significantly greater proportion of the detectable abnormalities present in the sample (p = 0.16). This difference is attributable to nurses' greater accuracy in history taking (p = 0.04); no conclusions regarding the comparability of nurses' and SHOs' skills in physical examination can be derived from the current study. CONCLUSION: Evidence attests to the likelihood of nursing having superior skills in history taking to SHOs. Exploration of nursing safety in undertaking physical examination, however, requires the conduct of a large scale equivalence study. Only then can conclusions be drawn as to whether nurse led physical assessment offers children a standard of care equivalent to that which they currently receive from SHOs.

Adolescent↗
PubMed1999

The context of depression in clinic-referred youth: neglected areas in treatment.

OBJECTIVE: To review the empirical, methodological, and conceptual limitations of psychotherapy and pharmacotherapy for childhood and adolescent depression and to present descriptive data on key characteristics of a depressed sample to illustrate gaps in treatment. METHOD: Interview-based assessment of psychiatric features and psychosocial functioning, family psychopathology and marital adjustment, and child and parent stressful life events was performed in a sample of 43 depressed youngsters seeking outpatient treatment. RESULTS: The empirical and conceptual review indicated that treatments based on downward extensions of adult procedures are limited in number and success. Also, the treatments generally neglect the following characteristics revealed in the descriptive data: depressed youngsters have high rates of recurrent depression and comorbid conditions, impaired academic and social functioning, exposure to high rates of parental psychopathology, parental assortative mating, severe marital dysfunction, and high rates of severe stressors. CONCLUSIONS: Treatments need to be informed by and address the actual characteristics of depressed youngsters and their environments, which are highly dysfunctional.

Adolescent↗
PubMed1999

Depression and Axis II symptomatology in an adolescent community sample: concurrent and longitudinal associations.

The relationship between personality pathology and depression has been the focus of increasing attention, but few investigators have examined this issue prospectively or in adolescent community samples. The present study used both self report and interviewer assessments of personality disorder symptomatology and depression in a sample of 155 late adolescent women followed over three years. Personality pathology cluster and total scores demonstrated moderate to fairly high degrees of stability, indicating endurance of these traits in late adolescence. As predicted, Axis II symptoms were associated with concurrent depressive symptomatology. Overall, self-reported personality disorder symptoms, as well as those specifically in Clusters A and B, predicted interviewer-rated depression over two years beyond the contribution of initial depression, indicating that subclinical Axis II symptoms are a risk factor for subsequent depressive symptomatology.

Adolescent↗
PubMed1998

Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood.

This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner-reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported.

Adolescent↗
PubMed1997

The relationship between attachment cognitions and psychological adjustment in late adolescent women.

This longitudinal study of 137 female high school seniors investigated the relationship of attachment cognitions, current psychological functioning, and psychological functioning 12 months later. Attachment cognitions, assessed with the Revised Adult Attachment Scale and the Inventory of Parent and Peer Attachment, were significantly associated with current symptomatology. The Revised Adult Attachment Scale, in interaction with initial symptomatology, predicted depression, substance abuse, eating disorders, and personality disorders 12 months later. The Inventory of Parent and Peer Attachment parent subscales predicted eating disorder and personality disorder symptomatology, whereas the peer subscales predicted substance abuse, eating disorder, and personality disorder symptomatology.

Adaptation, Psychological↗
PubMed1997

A cognitive-interpersonal approach to depressive symptoms in preadolescent children.

Cognitive and interpersonal aspects of depressive symptoms were investigated in a community sample of children. Eighty-one 8- to 12-year-olds completed scales assessing cognitive representations of social relationships and symptoms of depression and anxiety. Teachers provided ratings of peer rejection. Children with elevated levels of depressive symptoms displayed increased negativity in their beliefs about self, family, and peers, as well as distinct patterns of interpersonal information processing. Anxiety symptoms did not make a unique contribution beyond depression to negative representations of family and peers; in contrast, symptom-specific profiles of self-representations were found. Structural equation analysis supported a model linking negative interpersonal representations, peer rejection, and depressive symptoms. The findings suggest that future studies may benefit from approaches that incorporate both cognitive and interpersonal variables as predictors of child depression.

Anxiety Disorders↗
PubMed1997

Predictors of the generation of episodic stress: a longitudinal study of late adolescent women.

The effects of depression and Axis I comorbidity on subsequent self-generated life stress were examined in a longitudinal sample of 134 late adolescent women. The results indicated that specific forms of psychopathology constitute a risk factor for future self-generated episodic stress, even when controlling for prior chronic stress. Comorbid depression had a particularly salient effect in the prediction of stress related to interpersonal conflicts. The effects of family psychopathology and sociotropy were mediated through participant psychiatric status, whereas autonomy made an independent contribution to the prediction of episodic stress. These results support C. Hammen's (1991b) stress generation model in a community sample, demonstrating how individuals with depression play a role in the creation of stress, and also refine prior work by showing that only the comorbid form of depression is associated with subsequent conflict-related stress.

Adolescent↗
PubMed1997

Why does attachment style change?

Adult attachment research has proceeded on the assumption that attachment style is relatively stable and affects future functioning. However, researchers have become interested in attachment instability and predictors of attachment style change. In this article, 2 conceptualizations of attachment style change were examined: Attachment style change is a reaction to current circumstances, and attachment style change is an individual difference in susceptibility to change that is associated with stable vulnerability factors. A total of 155 women were assessed after high school graduation, and 6 months and 2 years later. Results primarily supported the conceptualization of attachment style change as an individual difference. Specifically, some women may be prone to attachment fluctuations because of adverse earlier experiences, and women who show attachment fluctuations are similar to women with stably insecure attachments.

Adaptation, Psychological↗
PubMed1995

Gastroschisis and reduced fetal heart-rate variability.

Most liveborn babies with gastroschisis do well after surgical repair, although about one-eighth of affected cases die late in utero. Our practice is to use weekly computerised cardiotocograph (CTG) analysis after week 34 of gestation in cases of gastroschisis. In a look-back at the records in 18 such singleton pregnancies, CTG showed 7 to be highly abnormal or preterminal. All but 1 of these 7 had a normal fetal heart rate. In all 7 cases, delivery was expedited. Only 1 infant had neurological sequelae, and in all the abdominal defect was successfully repaired. Monitoring of these high-risk pregnancies with serial computerised CTG may be helpful in timing delivery.

Abdominal Muscles↗
PubMed1995

Poor interpersonal problem solving as a mechanism of stress generation in depression among adolescent women.

The authors examined C. Hammen's (1991) model of stress generation in depression and the role of interpersonal problem-solving strategies (IPS) in the stress generation process in a longitudinal sample of 140 young women who entered the study at ages 17-18. Structural equation modeling was used to test a model in which IPS and subsequent interpersonal stress mediated the relationship between initial and later depressive symptoms. Results supported the main prediction of the stress generation model: Interpersonal stress mediated the relationship between initial and later depressive symptoms. In addition, IPS predicted interpersonal stress. However, no association was found between depressive symptoms and IPS. An alternative model in which IPS moderated the relationship between stress and depressive symptoms was tested; it was not supported.

Adolescent↗
PubMed1995

Cognitive representations of self, family, and peers in school-age children: links with social competence and sociometric status.

Attachment and social-cognitive theories of interpersonal relations have underscored the integral role that internalized cognitive representations may play as mediators of the link between family and peer relationships. 3 predictions consistent with this conceptualization received support in the present study of 161 7-12-year-old school children. In Part 1 of the study, significant connections were found among different components of cognitive representations, including social perceptions, interpersonal expectancies, and schematic organization and processing of social information. Moreover, generalization was found among children's representations across 3 interpersonal domains--that is, family, peer, and self. In Part 2, negative representations of self and others were found to be associated with increased social impairment, including dysfunctional social behavior and less positive status in the peer group. Implications of the findings for theories of interpersonal competence and interventions with socially impaired children are discussed.

Child↗
PubMed1995

Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress.

The authors tested a cognitive-interpersonal hypothesis of depression by examining the role of interpersonal cognitions in the prediction of depression associated with interpersonal stressors. A measure of adult attachment assessed interpersonal cognitions about ability to be close to others and to depend on others and anxiety about rejection and abandonment. Participants were women who had recently graduated from high school; they were followed for 1 year with extensive interview evaluation of life events, depression, and other symptomatology. Generally, cognitions, interpersonal events, and their interactions contributed to the prediction of interview-assessed depressive symptoms, but the effects were not specific to depression and predicted general symptomatology measured by diagnostic interviews as well, and results also varied by attachment subscale. Results were discussed in terms of a developmental psychopathology approach to disorders in young women.

Cognition↗
PubMed1994

Interpersonal functioning and depressive symptoms in childhood: addressing the issues of specificity and comorbidity.

Research has supported linkages between depression and social impairment in youngsters, but has often focused on depressive symptoms in isolation. We collected data on depressive, anxiety, and externalizing symptoms in 161 school children. Information about interpersonal competence was gathered from several sources, including children, teachers, and behavioral observations. Depressive symptoms were found to be related to difficulties in multiple areas of competence, including maladaptive social problem-solving styles, conflict-negotiation and affect-regulation deficits, and peer rejection. Comparisons of the relative contributions made by depressive and anxiety symptoms to the prediction of functioning yielded some evidence for a specific relation between depressive symptoms and impairment. Children with cooccurring internalizing and externalizing symptoms generally suffered from the most social dysfunction. If replicated in clinical samples, findings such as these may help to guide intervention efforts with depressed children.

Analysis of Variance↗
PubMed1994

Diaphragmatic herniae and translocations involving 8q22 in two patients.

Two girls with congenital diaphragmatic herniae are reported. Both were discovered to have a balanced reciprocal translocation involving 8q22.3. In one girl the translocation was de novo, in the other it was maternally inherited. Uniparental disomy was excluded in both. 8q22.3 may be the location of a gene affecting development of the diaphragm.

Chromosomes, Human, Pair 8↗
PubMed1993

A new day.

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Centers for Medicare and Medicaid Services, U.S.↗