Search PubMed⌕ Search

Biomedical subjects

David W Evans

Publications and source records attributed to David W Evans.

12 recordsLinked to original sources
PubMed2006

Profiles and development of adaptive behavior in children with Down syndrome.

The profiles and developmental trajectories of adaptive behavior were cross-sectionally examined in 80 children with Down syndrome ages 1 to 11.5 years using the Vineland Adaptive Behavior Scales. Profile findings indicated a significant weakness in communication relative to daily living and socialization skills. Within communication itself, expressive language was significantly weaker than receptive skills, especially when children's overall communicative levels were above 24 months. One to 6-year-old children showed significant age-related gains in adaptive functioning, but older subjects showed no relation between age and adaptive behavior. There was, however, increased variability within this older group, implying that not all children plateau in adaptive development during the middle childhood years. Implications for development in Down syndrome and intervention programs were discussed.

Adaptation, Psychological↗
PubMed2005

Testing the effectiveness of an innovative information package on practitioner reported behaviour and beliefs: the UK Chiropractors, Osteopaths and Musculoskeletal Physiotherapists Low back pain ManagemENT (COMPLeMENT) trial [ISRCTN77245761].

BACKGROUND: Low back pain (LBP) is a common and costly problem. Initiatives designed to assist practitioner and patient decisions about appropriate healthcare for LBP include printed evidence-based clinical guidelines. The three professional groups of chiropractic, osteopathy and musculoskeletal physiotherapy in the UK share common ground with their approaches to managing LBP and are amongst those targeted by LBP guidelines. Even so, many seem unaware that such guidelines exist. Furthermore, the behaviour of at least some of these practitioners differs from that recommended in these guidelines. Few randomised controlled trials evaluating printed information as an intervention to change practitioner behaviour have utilised a no-intervention control. All these trials have used a cluster design and most have methodological flaws. None specifically focus upon practitioner behaviour towards LBP patients. Studies that have investigated other strategies to change practitioner behaviour with LBP patients have produced conflicting results. Although numerous LBP guidelines have been developed worldwide, there is a paucity of data on whether their dissemination actually changes practitioner behaviour. Primarily because of its low unit cost, sending printed information to large numbers of practitioners is an attractive dissemination and implementation strategy. The effect size of such a strategy, at an individual practitioner level, is likely to be small. However, if large numbers of practitioners are targeted, this strategy might achieve meaningful changes at a population level. METHODS: The primary aim of this prospective, pragmatic randomised controlled trial is to test the short-term effectiveness (six-months following intervention) of a directly-posted information package on the reported clinical behaviour (primary outcome), attitudes and beliefs of UK chiropractors, osteopaths and musculoskeletal physiotherapists. We sought to randomly allocate a combined sample of 1,800 consenting practitioners to receive either the information package (intervention arm) or no information above that gained during normal practice (control arm). We collected questionnaire data at baseline and six-months post-intervention. The analysis of the primary outcome will assess between-arm differences of proportions of responses to questions on recommendations about activity, work and bed-rest, that fall within categories previously defined by an expert consensus exercise as either 'guideline-consistent' and 'guideline-inconsistent'.

Chiropractic↗
PubMed2005

The fears, phobias and anxieties of children with autism spectrum disorders and Down syndrome: comparisons with developmentally and chronologically age matched children.

This study compared the fears and behavior problems of 25 children with an autism spectrum disorder (ASD), 43 children with Down syndrome (DS), 45 mental age (MA) matched children, and 37 chronologically age (CA) matched children. Children's fears, phobias, anxieties and behavioral problems were assessed using parent reports. Significant differences emerged across the diagnostic groups on a variety of fears. Children with ASD were reported to have more situation phobias and medical fears, but fewer fears of harm/injury compared to all other groups. The groups also differed in terms of the pattern of correlations between fears, phobias, anxieties and behavior problems. For children with ASD, fears, phobias and anxieties were closely related to problem behaviors, whereas fears, phobias, and anxieties were less related to behavioral symptoms for the other groups of subjects. Such findings suggest that children with ASD exhibit a distinct profile of fear and anxiety compared to other mental age and chronologically age-matched children, and these fears are related to the symptoms associated with ASD.

Anxiety Disorders↗
PubMed2004

The role of the orbitofrontal cortex in normally developing compulsive-like behaviors and obsessive-compulsive disorder.

Mounting evidence concerning obsessive-compulsive disorders points to abnormal functioning of the orbitofrontal cortices. First, patients with obsessive-compulsive disorder (OCD) perform poorly on tasks that rely on response suppression/motor inhibition functions mediated by the orbitofrontal cortex relative to both normal and clinical controls. Second, patients with OCD exhibit functional hyperactivity in lateral orbitofrontal and related structures corresponding with symptom severity. In this article, we compare these neurocognitive correlates of OCD with the executive and neural underpinnings of "compulsive-like" behaviors that are common in normal childhood. We discuss the phenomenology and natural history of normative compulsive-like behaviors as well as the behavioral, emotional, and cognitive continuities between typical and pathological obsessive-compulsive behaviors. We then examine associations between children's executive performance deficits and their observed compulsive-like characteristics. We relate these patterns to executive deficits shown by adults with OCD. Finally, we speculate on the developmental neurobiology of children's compulsive-like behaviors, with particular attention to orbitofrontal functions including behavioral and emotional regulation, and we suggest similarities and differences with the neurobiology of OCD. In making these comparisons, we hope to open a dialogue between researchers who study underlying brain pathologies associated with OCD and those who explore the neurocognitive bases of normal development.

Adolescent↗
PubMed2002

Spectral content of the intraocular pressure pulse wave: glaucoma patients versus normal subjects.

BACKGROUND: Many studies have found that the intraocular pressure (IOP) is lower in glaucomatous populations than in normal groups. An alternative method of analysis, commonly used in the investigation of arterial blood pressure, is to reduce the pulse waveform to its component Fourier parts. The purpose of this study, therefore, was to determine whether such a technique is applicable to the IOP pulse and to investigate whether it was superior at differentiating diseased from healthy eyes. METHODS: Using a pneumatonometer, continuous 10-s IOP recordings were taken from 10 glaucoma patients and 10 normal subjects. The IOP recordings were then analysed using the fast Fourier transform (FFT) to determine their spectral components. In addition, standard IOP parameters (pulse amplitude, pulse volume, and pulsatile ocular blood flow) were measured to allow comparison with the waveform analysis technique. RESULTS: Analysis by FFT successfully determined the IOP pulse's higher spectral components up to the fourth harmonic. In addition, although standard measurements of the IOP pulse (such as pulse amplitude) were insignificant, the second ( P=0.034), third ( P=0.015) and fourth ( P=0.013) harmonics of the waveform successfully differentiated between the glaucoma and normal groups. CONCLUSION: Spectral analysis of the IOP pulse appears to be a promising technique in the investigation of ocular vascular disease.

Blood Pressure↗
PubMed2002

Waking the dead.

Explore the source record for details and available documents.

Brain Death↗
PubMed2002

Magical beliefs and rituals in young children.

Thirty-one children were administered a structured interview that assessed their beliefs about magic, tricks and wishes. Children were also presented with demonstrations of magic tricks/illusions, and asked to offer explanations as to how they worked. Parents completed the Childhood Routines Inventory (CRI), a 19-item parent report measure that assesses children's rituals, habits and sensory-perceptual experiences that we have termed "compulsive-like" behavior. Results indicated that children's rituals and compulsions were positively related to their magical beliefs, and inversely related to their uses of concrete, physical explanations to describe various phenomena. In particular, children's beliefs about the effects of wishing were most consistently correlated with their compulsive-like rituals and routines. The findings extended the work on magical beliefs and obsessive-compulsive phenomena to the normative manifestation of compulsive behaviors found in typical development.

Child↗
PubMed2002

Mechanisms and effects of spinal high-velocity, low-amplitude thrust manipulation: previous theories.

OBJECTIVES: When the clinical efficacy of spinal manipulative treatment for spinal pain has been assessed, high-velocity low-amplitude thrust (HVLAT) manipulation and mobilization have been regarded as clinical interventions giving identical and equivalent biologic effects. The objective of this review is to critically discuss previous theories and research of spinal HVLAT manipulation, highlighting reported neurophysiologic effects that seem to be uniquely associated with cavitation of synovial fluid. DATA SOURCE: The biomedical literature was searched for research and reviews on spinal manipulation. MEDLINE and EMBASE databases were used to help find relevant articles. STUDY SELECTION: All articles relevant to the objectives were selected. DATA EXTRACTION: All available data were used. DATA SYNTHESIS: The main hypotheses for lesions that respond to HVLAT manipulation were critically discussed: (1) release of entrapped synovial folds or plica, (2) relaxation of hypertonic muscle by sudden stretching, (3) disruption of articular or periarticular adhesions, and (4) unbuckling of motion segments that have undergone disproportionate displacements. RESULTS: There appear to be 2 separate modes of action from zygapophyseal HVLAT manipulation. Intra-articular "mechanical" effects of zygapophyseal HVLAT manipulation seem to be absolutely separate from and irrelevant to the occurrence of reported "neurophysiologic" effects. Cavitation should not be an absolute requirement for the mechanical effects to occur but may be a reliable indicator for successful joint gapping. CONCLUSIONS: It is hoped that identification of these unique neurophysiologic effects will provide enough theoretical reason for HVLAT manipulation and mobilization to be assessed independently as individual clinical interventions.

Cervical Vertebrae↗