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Biomedical subjects

E Gibson

Publications and source records attributed to E Gibson.

At least 37 records · Page 2Linked to original sources
PubMed1996

Recency preference in the human sentence processing mechanism.

Cuetos and Mitchell (1988) observed that in constructions in which a relative clause can attach to one of two possible sites, English speakers prefer the more recent attachment site, but Spanish speakers prefer the least recent attachment site, in violation of the proposed universal principle Late Closure (Recency Preference), which favors attachments to the most recent sites. Based on this evidence, Cuetos and Mitchell concluded that Late Closure is not a universal principle of the human sentence processing mechanism. In this paper, we provide new evidence from Spanish and English self-paced reading experiments on relative clause attachment ambiguities that involve three possible attachment sites. The results of our experiments suggest that a principle like Late Closure is in fact universally operative in the human parser, but that it is modulated by at least one other factor in the processing of relative clause attachment ambiguities. We propose that the second factor involved in the processing of these and related constructions is the principle of Predicate Proximity, according to which attachments are preferred to be as structurally close to the head of a predicate phrase as possible, and we further consider the origins and predictions of the theory combining these two factors.

Cognition↗
PubMed1996

Effects of sweet taste stimulation on growth and sucking in preterm infants.

OBJECTIVE: To evaluate the effect of sweet taste stimulation in augmenting the reported growth-enhancing effects of nonnutritive sucking in preterm infants who are gavage-fed. DESIGN: Random assignment of preterm infants to receive stimulation by one of three methods during each feeding until totally orally fed. SETTING: Hospital intensive-care and infant transitional units. PATIENTS: Eligibility criteria included body weight greater than or equal to 1,250 g, gestational age younger than 34 weeks, growth parameters appropriate for gestational age, tolerating at least 100 kcals/kg/day by gavage feeding with evidence of weight gain, and no clinical evidence of health complications. Data are presented for 42 infants who completed 14 days of treatment. INTERVENTIONS: Exposure to a sweet pacifier, a latex pacifier, or maternal heartbeat sounds during gavage feedings. MAIN OUTCOME MEASURES: Growth, time to total oral feeding, and sucking responses. RESULTS: No significant differences in sucking measures were noted among treatment groups. Differences in progression time to total oral feedings and weight gain favored the sweet-pacifier group but were not statistically significant. CONCLUSIONS: Oral stimulation of gavage-fed, preterm infants during a 2-week hospitalization was not sufficient to elicit a significant improvement in growth efficiency, progression to total oral feedings, or sucking maturation. Additional studies may show a beneficial effect of chemosensory stimulation in preterm infants.

Child Development↗
PubMed1996

Documented home apnea monitoring: effect on compliance, duration of monitoring, and validation of alarm reporting.

The objectives of this study were to: (1) measure patient compliance with monitoring, (2) validate parental reports of alarms at home, (3) examine monitoring duration, and (4) compare documented monitor records with the traditional pneumogram to evaluate patients for monitor discontinuation. During the 1-year period from January through December, 1992, 114 infants were followed up with documented monitoring. Simultaneously, 113 infants were followed up with conventional monitors. Infants were premature, or victims of apparent life-threatening episodes (ALTE), or siblings of SIDS victims. Monitors recorded all episodes of apnea greater than 15 seconds and bradycardia less than 80 beats per minute. All families were contacted biweekly by telephone. Downloads were performed at regular intervals. Monitor downloads were compared with simultaneous pneumograms to assess the accuracy of a long-term, intermittent event-recording system versus short-term (6- to 12-hour) continuous recording. All families were highly compliant with the use of home monitoring. Although Caucasian families used the monitors more often than non-Caucasian families, all groups used the monitor > 75% of the time. True episodes were verified in 38% of patients by monitor downloads. Only 7.4% of all recorded events were true events. Of the real events, 51.2% were apneas of 16-20 seconds. No significant differences were found in overall duration of monitoring between documented and nondocumented monitors. In the premature infants, the duration of monitoring was significantly reduced in those infants found to have no true episodes over those with real events at home. Readmission for ALTE was reduced in infants with documented monitors. Premature infants without events were monitored an average of 24 fewer days (P = 0.03). Computerized monitor downloads were found to be equally, if not more, sensitive than pneumograms in evaluating infants for monitor discontinuation. Documented monitoring offers a viable alternative to traditional monitoring and pneumograms in assisting clinicians and families in evaluating their infant's progress. By accurately assessing compliance, distinguishing true from false alarms, and decreasing the need for pneumograms, these devices provide valuable information to clinicians and families.

Apnea↗
PubMed1995

The timing of SIDS deaths in premature infants in an urban population.

Previous reports have demonstrated that premature infants are at greatly increased risk for sudden infant death syndrome (SIDS). Although only 9% of infants are born at less than 36 weeks' gestation, 20% of SIDS victims are former premature infants. The objective of this study was to characterize the time course of SIDS in premature infants and to determine why SIDS occurs at such a high rate in this patient population. A database of all cases of SIDS in Philadelphia from 1987 through 1991 was used to establish the time course for SIDS deaths in term and preterm infants. Gestational age was established by Dubowitz exam. To evaluate distinctly different age groups, infants from 32-36 weeks were excluded from analysis. Age at death and postconceptional age of death were compared for both groups. Data are described in weeks (mean +/- SEM), and analyzed using unpaired t-test and log-rank test to compare survival rate between term and preterm infants. A significant difference (P < 0.01) was noted in age at death of term versus preterm infants. No difference was found in postconceptional age of death. The survival rates were also different (P < 0.001). Preterm infants showed a much wider distribution in age of death from SIDS. The term infants followed the classic SIDS curve. By 32 weeks' postnatal age, 95% of all SIDS had taken place in the term group, but only 75% in the preterm group. The age at death for SIDS differs in the preterm infant.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1995

Infant sleep position following new AAP guidelines. American Academy of Pediatrics.

OBJECTIVE: This report examines the response of families to the American Academy of Pediatrics June 1992 recommendation that healthy term infants be put to sleep on their back or side to decrease the risk of sudden infant death syndrome. Parents at two clinics and private practices were interviewed to ascertain sleep position practices. METHODS: Parents of infants from 1 to 6 months of age who were in the waiting room for a well-child visit were eligible for study. A total of 760 interviews were conducted using a closed-ended questionnaire. Parents were asked about sleep position, positional changes during sleep, and factors that influenced their decision to position their infant prone, side, or supine. Interviews were conducted from September 1993 through April 1994. This interval was divided into two equal, 4-month time intervals. Sleep practices were compared during the first and second time periods. Differences between practice and clinic groups were measured. Groups were compared using the chi-square test, with results considered significant at P < .05. RESULTS: The number of infants placed side or supine for sleep increased significantly since the inception of the study, from 38.1% to 59.1%. Despite this increase, parents reported that the impetus for changing position came from family or the media, rather than from health professionals. Initially, the proportion of infants in private practices placed side or supine was greater than that of clinic patients. That difference disappeared by the end of the study. Prone positioning continued to be more prevalent in the 3- to 6-month-old infants than in the 1- to 3-month-old group. The majority of infants at all ages awoke in the same position that they were put to sleep. CONCLUSIONS: Side and supine positioning for sleep increased in all socioeconomic groups. A small number of infants placed side or supine for sleep are found prone on awakening. Health professionals need to increase their role in providing sleep position guidance. As the proportion of the population positioning their infants side or supine for sleep increases, it should be possible to examine the effect on the sudden infant death syndrome rate.

Cross-Sectional Studies↗
PubMed1995

Recent advances in home infant apnea monitoring.

Appropriate and effective nursing intervention is an essential element in determining how the family responds to the monitor in the home. Accurate assessment of the family system and dynamics provides the basis for a plan of care. The family's and infant's specific needs must be addressed. Careful implementation of the plan allows for changes and unexpected outcomes. Frequent evaluation of monitoring is necessary to determine if a change in the plan of care is needed. Recent changes in home apnea monitoring technology are rapidly altering the care of infants at risk for apnea and SIDS. The advent of the documented or recording monitor has the potential to demystify the events occurring while the infant is being monitored. Parents can get answers about their infant as quickly as a telephone call. The clinician can differentiate between a true and a false alarm and reassure the parents accordingly. Documenting false events and shallow-breathing alarms will potentially reduce the duration of monitoring, decreasing costs to the entire health care system. Documented monitoring is a valuable tool for nurses. For the staff nurse, clinical observation can be validated through trending and print out of events can be done at the bedside. For the advanced practice nurse, management of care can become more efficient through remote monitoring via modem. Patient teaching can be followed with immediate feedback. Monitors may assist in allaying anxiety in families who have lost children to SIDS or had an unexpected death in a previous sibling. Families may feel less anxious about having an "at risk" child in the home if the events are continuously being recorded. Length of hospital stay may decrease initially, with fewer rehospitalizations. Nursing research in these areas is necessary. Evaluating events occurring in the home may also help shed light on the enigma of SIDS. Several SIDS deaths have been recorded on documented monitors. If we can pinpoint exactly what takes place prior to and immediately after a SIDS episode, the enigma that has had physicians puzzled for so long may finally begin to unravel.

Apnea↗
PubMed1993

Hypertension, diabetes, and obesity in Barbados: findings from a recent population-based survey.

A stratified random sample of 464 persons aged 40 to 79 years, drawn from enumeration registers in the Bridgetown area of Barbados, participated in this survey. The prevalence of hypertension (defined as systolic blood pressure of at least 160 mm Hg, diastolic blood pressure of at least 95 mm Hg, or use of antihypertensive medication) was 47% and 43% for women and men, respectively. Diabetes was present in 17% of all subjects (18% of women and 15% of men). Of the 209 hypertensive subjects, 82% were aware of their blood pressure status. The proportion of previously diagnosed hypertensive subjects on medication was 72% for men and 68% for women. Fifty-three percent of men and 42% of women were overweight (body mass indices [weight in kilograms divided by height in meters squared] between 25 and 30). However, 30% of women and 10% of men were obese (body mass indices over 30), supporting the growing recognition of the marked gender disparity in obesity among persons of African origin in the Caribbean. Body mass index was positively associated with hypertension (OR = 1.33; 95% CI: 1.1-1.6). Obese persons experienced a 2.6 times greater risk of hypertension compared to those with body mass indices below 25. Similar statistically significant associations were observed between diabetes and body mass index: OR comparing body mass index over 30 with body mass index under 25 was 2.5 (95% CI: 1.3-5.1) for all subjects, 1.0 (0.3-4.1) for men only, and 5.2 (1.9-14) for women only. Preventing obesity in this population could reduce the incidence of hypertension and diabetes by approximately 30% and 33% among men and women, respectively.

Adult↗
PubMed1992

Home monitoring.

This article addresses the controversies surrounding home monitoring for the treatment of infant apnea and in the prevention of sudden infant death syndrome. A program for the use of monitoring is outlined for the practicing physician, and the benefits and deficiencies of home cardiorespiratory recording are discussed.

Hemodynamics↗
PubMed1991

Pseudoreflux syndrome-increased periodic breathing during the neonatal period presenting as feeding-related difficulties.

Sixteen infants who presented with symptoms suggestive of gastroesophageal reflux (GER)-associated apnea were evaluated at the Breathing Disorder Center of the Children's Hospital of Philadelphia. These neonates had a history of occasional emesis and an apparent life-threatening event (ALTE) that occurred while awake which was similar to the presentation of a group of infants previously described. Evaluation of the present group of infants however, revealed increased periodic breathing (12.1 +/- 1.8 SEM% of total sleep time) as opposed to the obstructive apnea that was typically seen with GER. Pathologic gastroesophageal reflux could not be diagnosed in relationship to apneic events. Infants who present during the first month of life with symptoms suggestive of GER-associated apnea should have careful evaluation of reflux and respiratory patterns to confirm the correct diagnosis. Because of the similarities of these infants to the GER group, we have called their disorder pseudoreflux.

Diagnosis, Differential↗
PubMed1990

An evaluation of four different measures of abdominal muscle strength: patient, order and instrument variation.

We compared 4 measures of abdominal muscle strength in 24 male subjects aged 20-52 years, 12 without low back pain (LBP) and 12 with LBP. The manometer to knee and manometer to sternum methods involved 2 positions of testing abdominal muscle strength using the adapter sphygmomanometer, a 3rd method was a scheme of graduated sit-ups, and the 4th had the sphygmomanometer bladder replaced by a disposable plastic tube and the subject blowing into the manometer. Order of methods was controlled with knee 4 x 4 latin squares. Analysis of variance showed that order of measurement was not significant [F (3,60) = 0.24, P2 = 0.725], but methods were different [F (3,60) = 86.80, P2 less than 0.01], and subjects without LBP had higher abdominal muscle strength than subjects with LBP [F (1.60) = 89.29, P2 less than 0.001]. The manometer to knee and manometer to sternum methods were equally sensitive and more sensitive than the graduated sit-up and blow into manometer methods. The manometer to sternum method was best as it was not painful and exercised the abdominals well.

Abdominal Muscles↗
PubMed1985

Controlling weight by purgation and vomiting: a comparative study of bulimics.

This study assessed the efficacy of self-induced vomiting and purgation, respectively, in attempts at preventing weight gain in patients with bulimia. It was found that the vomiters ate significantly more yet weighed less: the purgers ate less but weighed significantly more. Such findings strongly suggest that excess purgation has little impact on intestinal absorption even at the doses used in bulimia. Weight control appears to be exercised by dietary restraint not by the pharmacological action of the laxatives used.

Adolescent↗
PubMed1985

Does laxative abuse control body weight? A comparative study of purging and vomiting bulimics.

This study examines the daily food intake and eating habits of 30 bulimia nervosa patients of normal weight; 20 vomited daily and 10 purged daily. The aim was to measure and compare food intakes and to examine the belief that laxative abuse is an effective means of controlling body weight. The results indicate that the purgers control their weight by overall dietary restraint, not by the pharmacological action of the laxatives. The purgers' eating patterns were bulimic, but not gross: mean daily energy intake being in a normal range (2210 +/- 210 kcal/day). Binge-eating by the vomiters was of a different order: mean energy intake was very large (6025 kcal/day), nearly three times that recommended and significantly greater (P less than 0.01) than that eaten by the purgers. There was major daily variation (s.d. = 3605) and, on occasions, huge amounts were recorded, up to 30 000 kcal in a day. Despite this, vomiting was highly effective in preventing weight gain, the mean weights of the vomiters being similar (mean = 98 per cent) to their matched population mean weight (MPMW). In contrast, purging was relatively ineffective, for despite smaller energy intakes, all the purgers were above (mean = 114 per cent)--and some markedly above--their MPMW. This difference between the two groups was significant (P less than 0.01). Reasons for persisting with laxative abuse are discussed.

Adolescent↗