Autistic persons are known to have serious abnormalities in speech prosody. The present study attempted to ascertain whether autistic persons could discriminate and/or recognize prosodic contrasts in auditory stimuli. A group of 11 adult autistic subjects with normal IQ and an age-matched group of normal subjects were studied electrophysiologically and behaviorally during presentations of prosodic and phonemic stimuli. The cognitive P3 potential was recorded in response to rare (20%)/frequent (80%) presentations of phonemic stimuli, 'ba/pa,' linguistic-prosodic stimuli, 'Bob.' (statement)/'Bob?' (question), and emotional-prosodic stimuli, 'Bob' (happy)/'Bob' (angry). Behaviorally, auditory discrimination was tested by requiring a button-press response to each presentation of the rare target stimulus and cognitive association was tested by requiring a match between the verbalized stimulus and an appropriate picture/word. Contrary to our hypothesis, the autistic subjects generally showed normal P3 responses to all stimuli and performed at a normal level in all behavioral tests. However, a significant autistic P3 response to the phoneme 'pa' was not demonstrated. This surprising result was reexamined and shown to reflect an unusually large autistic response to 'pa' as the frequent stimulus in the first recording block, this initial hyper-reactivity prevented a 'frequent/rare' differential when 'pa' was presented as the rare stimulus in a later recording block. In the P3 latency window, both the autistic and control groups showed the largest amplitude responses to emotional-prosodic stimuli; neither the N1 nor P2 showed these stimulus effects. Thus, 'emotional sounds' appear to be particularly effective in activating the neural substrate of the P3 generator system. Overall, these data indicate remarkably normal P3 and behavioral processing of prosodic stimuli by the high-functioning autistic subjects of this study.

Acoustic Stimulation↗

PubMedDate not supplied

Midlatency auditory evoked responses: P1 abnormalities in adult autistic subjects.

MLR recordings from a group of 11 high-functioning adult autistic subjects were compared with those from a control group of 11 normal subjects. Components selected for analysis were "Pa", the maximum positivity in the 25-40 msec latency range following stimulus onset, "P1", the maximum positivity within the 50-65 msec latency range, and "Nb," the maximum negative deflection in the 40-50 msec latency range. Statistical analyses of amplitude and latency data were conducted using repeated measures analysis of variance and t test group comparisons. The Pa component showed no significant difference between autistic and control groups. However, 2 types of abnormality were noted in the P1 component: (1) the P1 component was significantly smaller in the autistic subjects at slow rates of stimulation, and (2) the autistic P1 did not change as rates of click stimulation increased from 0.5 to 10/sec, in contrast to the normally produced P1 decrement. Data from the P1 model in the cat, and complementary data from the human, closely link the generator substrate of the P1 potential to cholinergic components of the ascending reticular activating system (RAS) and their thalamic target cells. This is the first report of abnormal P1 responses in autism and strongly suggests that the RAS and/or its post-synaptic thalamic targets may be dysfunctional in this syndrome.

Acoustic Stimulation↗

PubMedDate not supplied

Parents' perceived benefits and barriers of adolescents' diabetes self-management: part 2.

Knowledge is limited about parents' decision making regarding adolescents' assumption of diabetes management. This study's purpose was to identify parents' perceived benefits and barriers about this process. We interviewed 17 parents of adolescents with type I diabetes. Questions were adapted from Janis and Mann's (1977) decisional balance sheet. Interviews were audiotaped and transcribed verbatim. Descriptive expressions were identified and categories inductively generated. Inter-rater agreement was initially 85% and was 100% after discussion of disagreements. Parents' perceived benefits for themselves were relief from burden and knowledge and confidence and/or pride in adolescents' abilities. Their perceived benefits for their sons and daughters were also twofold: knowledge and/or confidence in abilities and freedom, independence, and/or control. Parents perceived barriers for themselves were loss of control, authority, and supervision, dealing with consequences. and expression of lack of barriers. Their perceived barriers for their sons and daughters were burden of responsibility and also lack of barriers. Understanding parents' perceived benefits and barriers would be beneficial to health care professionals when working with parents, because decision making related to the transfer of diabetes management to their adolescent sons and daughters is crucial to the success of its management.

Adolescent↗

PubMedDate not supplied

Adolescents' perceived benefits and barriers related to diabetes self-management--Part 1.

Knowledge is limited about adolescents' decision making regarding their assumption of diabetes management from parents. This study's purpose was to identify adolescents' perceived benefits and barriers about this process. Sixteen adolescents with type 1 diabetes were interviewed. Questions were adapted from the Janis and Mann (1977) decisional balance sheet. Interviews were audiotaped and transcribed verbatim. Descriptive expressions were identified and categories inductively generated. Adolescents' perceived benefits for themselves were having knowledge of or confidence in self-management abilities, more freedoms, and approval of others. They perceived benefits for parents as relief from responsibility, stress, and worry. Burden of responsibility was perceived as a barrier to adolescents for self-management. Adolescents perceived barriers for parents as worry/guilt and loss of control. Interrater agreement was initially 74%. Categories with disagreements were recategorized by interraters and then there was 100% agreement. Understanding adolescents' perceptions would be beneficial to their health care professionals.

Adolescent↗

PubMedDate not supplied

Parents' and adolescents' perceptions of helpful and nonhelpful support for adolescents' assumption of diabetes management responsibility.

The study identified parents' and adolescents' perceptions of helpful and nonhelpful support, specific to adolescents' assumption of responsibility for diabetes management. Sixteen pairs of parents and adolescents with type 1 diabetes (11-18 years of age) were interviewed. The interviews were audiotaped and transcribed verbatim. Data were analyzed for manifest content according to social support dimensions identified by Barrera and Ainlay (1983). Inter-rater agreement between primary investigator and doctorally prepared diabetes nurse and educator was 100%. Both parents and adolescents describe directive guidance and tangible assistance as helpful and nonhelpful, depending on degree of directness and perceived need for help. Nurses can encourage parents to use subtle guidance and adolescents to communicate their needs.

Adolescent↗

PubMedDate not supplied

Ambulatory blood pressure, heart rate, and neuroendocrine responses in women nurses during work and off work days.

OBJECTIVE: This study examined women's cardiovascular and neuroendocrine responsiveness to work. METHODS: Ambulatory blood pressure (BP) and heart rate (HR) were recorded over 24-hour periods on 2 work and 2 off days during the luteal and follicular phases of the menstrual cycle in 138 registered nurses, aged 25 to 50 years. Urinary catecholamines and cortisol were measured for day and night periods. RESULTS: During waking hours systolic BP (SBP), HR, and epinephrine were higher on work than off days. Diastolic BP (DBP) and HR were highest at work. Nurses scoring high on job demands had elevations in daytime SBP, daytime HR only on work days, and nighttime epinephrine on work days. Compared with those with short work histories, nurses employed longer had consistently higher norepinephrine levels during days and nights, and higher nighttime DBP during off days. In unmarried nurses compared with married nurses, nighttime cortisol was lower during all 4 days and norepinephrine was lower during days off. All findings were independent of actigraph-recorded activity. CONCLUSIONS: Although the work environment leads to increased activity of the cardiovascular and sympathoadrenal medullary system in healthy women, the effects are modified by the woman's domestic role, by the length of her employment, and by the demands of her job.

Adaptation, Psychological↗

PubMedDate not supplied

Foot care: knowledge retention and self-care practices.

This study investigated the effectiveness of a "hands-on" foot care teaching/learning approach for adults with diabetes. By random assignment, the control group received a lecture presentation on foot care, while the experimental group participated in a hands-on session on foot care in addition to the lecture presentation. Data concerning the subjects' foot care knowledge and skills, the condition of their feet, and their level of HbA1c were gathered prior to and six months after the foot care educational sessions. No significant increases in knowledge about foot care were observed in the experimental group. The experimental group reported improvements in inspecting and washing their feet on a daily basis, and in care of the toenails. No significant differences were observed in the status of the subjects' feet. The HbA1c readings were significantly improved for both the experimental (t = 4.10, df = 10, p = 0.002) and control (t = 2.25, df = 9, p = 0.051) groups. A hands-on educational session may improve foot care practices temporarily. However, long term effects need to be studied to discern overall improvement of foot care practices and physical status of the feet.

Diabetes Mellitus↗

PubMedDate not supplied

Growth and maturation of children with insulin-dependent diabetes mellitus.

The purpose of this paper is to define criteria used for classifying patients into varying degrees of diabetic control and to verify that children with diabetes maintained in higher degrees of metabolic control do not have delayed growth and maturation. Growth records of 252 children with insulin-dependent diabetes who have been under continuous observation in our clinic at three- to five-month intervals for at least three years and up to 16 years have been individually reviewed and analyzed. All children received two daily injections of a mixture of two parts of an intermediate to one part of regular insulin and were instructed to eat structured meals of high-quality selected foods. An over-all rating for diabetic control based primarily on the frequency and degree of glycosuria was made for the time period between clinic visits. The over-all diabetic control rating and the size of the subgroups were "good"--20 per cent, "fair to good"--64 per cent, and "fair"--16 per cent. All children maintained in "good" and "fair to good" control (84 per cent), grew and matured at a normal rate regardless of the age at onset or duration of diabetes. All children in lower degrees of control coming under care for greater than 24 months after diagnosis had accelerated growth during the early months after attaining a higher degree of control.

Adolescent↗