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Biomedical subjects

J M Swanson

Publications and source records attributed to J M Swanson.

At least 19 recordsLinked to original sources
PubMed1992

Lateralized deficits in visual attention in males with developmental dopamine depletion.

Children with early treated phenylketonuria (ETPKU), a disorder associated with developmental dopamine depletion, were tested with a visual orienting paradigm to determine the existence of lateralized deficits in specific attentional operations. Male ETPKU subjects showed a right visual field impairment in disengaging attention, indicating left hemisphere dysfunction, and overall slowed reaction times. Female ETPKU and normal subjects did not differ. The results suggest that for males, dopamine depletion disrupts left hemisphere function. This finding has important implications for disorders with suspected developmental dopamine abnormalities, and may also illustrate how sex differences in functional lateralization develop in the normal brain.

Attention↗
PubMed1992

Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders.

The study examined the sustained effects of methylphenidate on reading performance in a sample of 42 boys, aged 8 to 11, with attention deficit-hyperactivity disorder (ADHD). Two subgroups were formed based on the presence or absence of co-occurring conduct disorders. Subjects were selected on the basis of their positive response to methylphenidate as determined in a series of original medication trials (Forness, Cantwell, Swanson, Hanna, & Youpa, 1991). For the purpose of this study, subjects were placed on their optimal dose of medication for a 6-week period and then tested on measures of oral reading and reading comprehension equivalent to those used in the original trials, retested after a week without medication (placebo), then tested again the following week after return to medication. Only the subgroup with conduct disorders responded, and this response was limited to reading comprehension improvement in only those subjects who also demonstrated improvement in oral reading on original trials. No response differences were found between subjects with or without learning disabilities.

Achievement↗
PubMed1991

Auditory attention switching in hyperactive children.

The ability to rapidly reorient attention in the auditory modality was studied in hyperactive children. Hyperactive and nonhyperactive subjects matched on age, sex, and IQ listened to dichotically presented lists for prespecified targets. Reorientation was studied by comparing performance on trials requiring subjects to reorient their attention during a list to performance on trials requiring no switching of attention. The results indicate that although nonhyperactive children were temporarily disrupted by the switch, they eventually reoriented to the cued ear. In contrast, once hyperactive children were disrupted by the switch, they did not reorient to the cued ear. As the pattern in performance comparing hyperactive and nonhyperactive subjects resembles the pattern previously found in comparing younger and older subjects, these results are consistent with the hypothesis that the auditory reorientation skills of hyperactive children are developmentally immature.

Acoustic Stimulation↗
PubMed1991

A divided attention analysis of the effects of methylphenidate on the arithmetic performance of children with attention-deficit hyperactivity disorder.

Thirteen boys with Attention-Deficit Hyperactivity Disorder (ADHD) completed 80 arithmetic problems presented on a computer screen by typing a two digit answer. On half the trials, a foot press was required to terminate a computer-generated tone presented 2 seconds before, 1 second before, 1 second after, and 2 seconds after arithmetic problem presentation. Compared to placebo, methylphenidate resulted in significantly faster reaction times (RTs) to tone probes and faster answers to arithmetic problems when the two tasks did not overlap in time, but not when simultaneous processing was required when the probe was presented 2 seconds after arithmetic problems. When dual processing taxed cognitive capacity, methylphenidate still improved accuracy on the primary arithmetic task relative to placebo, but at the expense of speed of performance on the secondary RT task. When ADHD children fail to allocate available resources to a primary cognitive task, treatment with methylphenidate may result in reallocation of existing cognitive capacity from a secondary task to the primary task.

Attention↗
PubMed1991

Effects of stimulant medication on learning in children with ADHD.

It is well established that stimulant medication improves classroom manageability and attention in terms of time on task, but does stimulant medication improve learning or long-term academic achievement in children with ADHD? There is no clear evidence that it does, but there are at least two reasons why beneficial effects may be obscured in research studies and clinical practice: (1) Higher-than-optimal doses may be prescribed if behavioral response (rather than cognitive response) is used to titrate the dose, and (2) treatment may be overinclusive if diagnostic groups are targeted in which a significant proportion of cases do not have favorable cognitive responses to medication. This article addresses these two issues and describes a large clinical series of patients who were evaluated using a double-blind medication assessment protocol designed to overcome some of the theoretical deficiencies suggested by these issues.

Achievement↗
PubMed1991

Differential effects of stimulant medication on reading performance of boys with hyperactivity with and without conduct disorder.

Controversy surrounding stimulant medication, particularly its effects on reading performance, continues to obscure the issue of the use of this drug in classroom situations. The present study emphasized careful differential diagnosis, double-blind and placebo approaches, and curriculum-based dependent measures to address these concerns. Methylphenidate was administered to two groups of boys, ages 8 through 11. The two groups included 27 subjects meeting criteria for attention deficit-hyperactivity disorder but not conduct disorder, known as hyperactive disorder (HD), and 28 subjects meeting criteria for both diagnostic categories, known as hyperactive-aggressive (HA). Only four subjects in each group met a discrepancy criterion for learning disabilities (LD). Methylphenidate was administered to both groups at three levels of dosage, along with baseline and placebo conditions. Dependent measures involved both reading recognition and reading comprehension, equivalent across all conditions. No significant results were found for the group with HD in either reading recognition or comprehension, due largely to unusual placebo reactions. Results were generally in the direction predicted for the group with HA, but only significantly so in reading comprehension, and no dose effect was found on this variable. Implications for reading as a dependent measure of medication effects are discussed.

Achievement↗
PubMed1991

Activating tasks for the study of visual-spatial attention in ADHD children: a cognitive anatomic approach.

The clinical label attention deficit hyperactivity disorder (ADHD) suggests that this syndrome is a disorder of attention. However, the presumed attentional deficits have not been linked either to specific cognitive operations or to specific neural systems. To provide this link, theories of the cognitive anatomy of attention were used to generate hypotheses about specific visual-spatial attentional deficits in children with ADHD. A cued reaction-time test was used to assess covert and overt shifts of attention theoretically linked to two neuroanatomically defined attentional systems in the posterior and anterior parts of the human brain. The early, posterior-based covert shift of attention was found to be normal in ADHD children, but a later, anterior-based overt shift of attention was abnormal as reflected by a significant lateral difference in reaction time. This was interpreted as a failure to sustain focused attention.

Analysis of Variance↗
PubMed1990

Readability of commercial versus generic health instructions for condoms.

Despite the fact that condoms are increasingly recommended for the prevention of acquired immune deficiency syndrome (AIDS) and other sexually transmitted diseases (STDs) and have long been used as a barrier method of contraception, little is known about the readability of the range of materials that have been written exclusively for consumers on how to use a condom. The authors described and compared the reading comprehension levels of condom patient package inserts (PPIs) prepared commercially and those generic instructions (GIs) prepared by health care providers. Fifteen sets of PPIs and 30 sets of GIs were analyzed using six standard readability formulas (Fry, Fog, Dale-Chall, Flesch, Flesch-Kincaid, SMOG). Readability levels of the instructions ranged from grade 6.3 to 13.7. The PPIs required a significantly higher grade level for comprehension (mean 10.32) than the GIs (mean 8.69). This study suggests that instructions prepared by both sources may require a reading level above that of many consumers who need information on how to use a condom.

Contraceptive Devices, Male↗
PubMed1990

Genetic latent structure analysis of dysmorphology in attention deficit disorder.

Dysmorphology--in the form of minor physical anomalies--has been frequently reported in children with attention deficit disorder (ADD). The authors report an overrepresentation of minor physical anomalies in both ADD probands and their first-degree relatives. Further, ADD probands who are not dysmorphic have non-ADD relatives who are dysmorphic; this familial pattern suggests that a single underlying factor may influence transmission of both traits. A genetic latent structure model was fit to these data to describe the factor's mode of transmission. In this analysis, an autosomal dominant model emerged. Successfully fitting this model is not equivalent to testing the validity of the model itself. Meaningful tests of the model will require larger samples than available at present, and would benefit from diagnostic refinement of the ADD and dysmorphic phenotypes.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Family factors associated with aggressive symptomatology in boys with attention deficit hyperactivity disorder: a research note.

This study tested whether parent and child affective attitudes and interactional behavior co-varied with the presence or absence of associated aggressive symptomatology in families with an attention deficit hyperactivity disorder (ADHD) child. Affective attitudes of both parents and their ADHD sons were studied using a modified measure of expressed emotion, the five minute speech sample (FMSS-EE), in 29 families. A direct interaction task was also used to measure verbal and non-verbal communication. FMSS-EE status predicted parental interactional behavior, but the degree of child aggressiveness did not. The child's behavior towards parents, however, was highly correlated with their aggressiveness but not their EE status regarding their parents, despite the fact that child and parent EE were highly correlated. The study supports the notion that aggressiveness and a negative family climate may be independent factors in determining the long-term course of ADHD children.

Adolescent↗
PubMed1990

Psychosocial aspects of genital herpes: a review of the literature.

Understanding the psychosocial aspects of genital herpes will enable community health nurses to be aware of the range of responses by young adults to the disease and of interventions suggested by research. Reviewed are the epidemiology of genital herpes infection; the knowledge, attitudes, and behavior related to it; the psychosocial consequences of and techniques for coping and adaptation to living with the disease; responses to treatment; and implications for community health nursing.

Adaptation, Psychological↗
PubMed1990

Readability of commercial and generic contraceptive instructions.

This study describes the readability levels of written instructions for methods of contraception. Materials studied include patient package inserts (PPIs) from commercial manufacturers and generic instructions (GIs) written by staff members in selected health agencies in the community and by health information publishers. Written materials were analyzed using Dale-Chall, Fry, Fog, Flesh, Flesch-Kincaid and SMOG formulas for readability. Readability levels ranged from elementary school (grade 5.5) to college (grade 13.6). Required comprehension levels of the PPIs were higher than those of the GIs for three of the four groups of contraceptives studied (diaphragms, pills, condoms).

Contraceptive Devices↗
PubMed1990

Community health nurses and family planning services for men.

Current concerns about sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS), as well as unintended pregnancy, have drawn increasing attention to reproductive health services for men. This report presents information about responses by 844 community health nurses (CHNs) to a self-administered mailed questionnaire that included questions about the extent of the nurses' involvement in delivering or administering family planning services to men, their knowledge and attitudes about men and family planning, and their preparation for working with men. Our sample included CHNs in practice in five states and a sample of CHNs belonging to a national organization of public health nursing, in order to gain information about CHNs in practice in the field and CHNs more likely to be in an educational or administrative position and thus able to influence or to set policy. Two thirds of the nurses surveyed work with men in their reproductive years but only 17.8% delivered or administered family planning services to men (23% of the state sample and 12.5% of the organization sample). Deficits in knowledge about male birth control methods were identified; for example, only 32% knew the use-effectiveness rate of the condom. However, 90% of the CHNs knew the condom has to be put on before any genital contact is made. The CHNs' attitudes were positive; more than 90% said they felt men had equal responsibility with their partners in preventing unwanted pregnancies, using contraception, and contraceptive decision making. Yet, only 9.6% of the CHNs felt men have as much knowledge about contraception as women do. Seventy percent of the nurses felt tha sex education in schools was directed more to female students than to male students. More than 90% said they believed that family planning providers have a responsibility to provide services to men; but two thirds felt that nurses are not as well prepared to work with male as with female clients. Increased educational preparation may improve CHNs' knowledge about men and family planning and enable them to feel professionally prepared to deliver and administer the services they feel are necessary for male as well as female clients. There are 101,430 CHNs in the United States, working in public health departments or other service agencies in almost every community across the country. These CHNs are a major resource for the family planning field.

Community Health Nursing↗
PubMed1989

Self-paced learning in children with attention deficit disorder with hyperactivity.

Attention deficit (ADDH) children self-paced the delivery of response pairs for paired-associate learning at about the rate previously shown to be conducive to relatively good learning in attention deficit. The self-pacing opportunity did not seem either to impair or to enhance the learning performance. On methylphenidate they paced themselves at about the same rate but learned much more. Stimulant therapy does not help by "slowing the child down" but permits more effective memorizing at the same presentation rate.

Attention↗
PubMed1989

The prevention and management of genital herpes: a community health approach.

The incidence of genital herpes, a sexually transmitted disease (STD) of epidemic proportions in the community, is increasing. Meeting the health needs of clients and the public concerning genital herpes is a challenge to community health nurses (CHNs). Little information is available concerning both the physical and psychosocial responses of young adults to genital herpes. This article reviews the changing epidemiology of genital herpes and the psychosocial consequences experienced by those living with the disease--emotional distress, stress associated with recurrences, sexual responses, alterations in interpersonal relationships, and coping and adaptation. The Permission-Limited Information-Specific Suggestion-Intensive Therapy (P-LI-SS-IT) model, a model for intervention and referral, can be used with clients who have the disease to prevent the disabling consequences of the disease. Educating the public is necessary to prevent transmission of this silent epidemic among the population.

Community Health Nursing↗
PubMed1989

Counseling clients with genital herpes.

The epidemic of genital herpes requires nurses to diagnose and treat human responses to this health problem (American Nurses' Association, 1980). It also creates many opportunities for nurses, particularly in the realm of counseling and education. Given the changing epidemiology of genital herpes and the psychosocial consequences, nurses need to keep abreast of new information so that they may assist people to live with the disease and teach the prevention of transmission of the disease. Recent information about mild and asymptomatic cases of herpes infections has serious implications for counseling and education of persons with genital herpes. The emergence of this "silent" dimension of herpes infections means more difficulty in diagnosis and treatment. All persons with genital herpes should be assessed for their physical and psychological responses to the disease and information should be given to combat misconceptions, to alleviate fear, and aid in preventing transmission. The most significant implication of mild or asymptomatic herpes is the greater risk of transmission. The public needs to be informed about the practice of "safer sex" as a routine measure to prevent herpes, as well as AIDS and other STDs. Given the widespread and epidemic proportions of herpes, persons should be counseled to use condoms whenever they engage in sexual activity with a partner. In addition, correct use of condoms must be taught. Nurses have an important role to play in counseling clients with genital herpes and in preventing the disease.

Adaptation, Psychological↗