Anesthesia for pediatric stereotactic radiosurgery.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
M Edwards
Publications and source records attributed to M Edwards.
Staff attitudes that impede the implementation of behavioral treatment programs.
Staff who have negative attitudes about behavioral treatments are less likely to implement them. Previous research suggests that negative attitudes are associated with staff burnout and perceived collegial support. A path analysis is conducted in this study to determine the direction of these effects. Ninety staff members who work in treatment programs for severely mentally ill adults completed measures of attitudes about behavior therapy, experience with behavior therapy, burnout, and collegial support. Results of the path analysis yielded a model with good fit that confirmed our hypotheses; namely, burnout leads to negative attitudes and experience with behavior therapy yields positive attitudes. Insufficient collegial support leads to negative attitudes through burnout. Implications of these findings for improving the use of behavior treatments in real-world programs are discussed.
Adult↗
Mutation analysis of the MEN1 gene in multiple endocrine neoplasia type 1, familial acromegaly and familial isolated hyperparathyroidism.
Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant disease characterized by neoplasia of the parathyroid glands, the endocrine pancreas, and the anterior pituitary gland. In addition, families with isolated endocrine neoplasia, notably familial isolated hyperparathyroidism (FIHP) and familial acromegaly, have also been reported. However, whether these families constitute MEN 1 variants or separate entities remains speculative as the genetic bases for these diseases are unclear. The gene for MEN 1 has recently been cloned and characterized. Using single strand conformation analysis (SSCA) and sequencing, we performed mutation analysis in: a) a total of 55 MEN 1 families from 7 countries, b) 13 isolated MEN 1 cases without family history of the disease, c) 8 acromegaly families, and d) 4 FIHP families. Mutations were identified in 27 MEN 1 families and 9 isolated cases. The 22 different mutations spread across most of the 9 translated exons and included frameshift (11), nonsense (6), splice (2), missense mutations (2), and in-frame deletions (1). Among the 19 Finnish MEN 1 probands, a 1466del12 mutation was identified in 6 families with identical 11q13 haplotypes and in 2 isolated cases indicating a common founder. One frameshift mutation caused by 359del4 (GTCT) was found in 1 isolated case and 4 kindreds of different origin and haplotypes; this mutation therefore represents a common "warm" spot in the MEN1 gene. By analyzing the DNA of the parents of an isolated case one mutation was confirmed to be de novo. No mutation was found in any of the acromegaly and small FIHP families, suggesting that genetic defects other than the MEN1 gene might be involved and that additional such families need to be analyzed.
Acromegaly↗
A window on regional cerebral blood flow via voluntary hand activity using a whole hand input in a virtual environment.
Explore the source record for details and available documents.
Brain Mapping↗
Algorithms for the treatment of cleft lip and palate.
Developing standardized outcomes and algorithms of treatment is a constantly evolving task. This article examines four variables in this process: cleft type, operative technique, surgical experience, and timing. Input from international cleft lip and palate programs regarding techniques and treatment modalities provide a dynamic tool for assessment and the development of guidelines in the treatment of the cleft lip and palate patient.
Adolescent↗
Supernumerary ring chromosome 17 identified by fluorescent in situ hybridization.
We present a patient with multiple anomalies and severe developmental delay. A small supernumerary ring chromosome was found in 40% of her lymphocyte cells at birth. The origin of the marker chromosome could not be determined by GTG banding, but fluorescent in situ hybridization (FISH) later identified the marker as deriving from chromosome 17.
Abnormalities, Multiple↗
Collegial support and barriers to behavioral programs for severe mental illness.
Previous investigations have identified staff beliefs about barriers to implementing behavioral interventions in programs for persons with severe mental illness. One of these barriers, institutional constraints, was found to be associated with collegial support; i.e., staff who report more collegial support were less likely to endorse institutional constraints. The purpose of this study was to determine how the components of collegial support were associated with beliefs about institutional constraints. Fifty-six staff members completed measures of staff opinions about barriers to implementing behavior therapy, satisfaction with collegial support, source of support, and functions of support. Results suggested that collegial support is significantly associated with co-worker and supervisor support, but not the support of family and friends. Endorsing institutional constraints was inversely associated with the support of co-workers and supervisors; institutional constraints were positively associated with the support of family and friends. Endorsing institutional constraints was also inversely associated with the sense that others rely upon the individual for their well-being. Implications of these findings for diminishing barriers to behavioral interventions are discussed.
Behavior Therapy↗
Simultaneous motion contrast across space: involvement of second-order motion?
A static or counterphase (target) grating surrounded by drifting (inducer) gratings is perceived to move in the direction opposite that of the inducers. We compared the relative magnitudes of these simultaneous motion contrasts generated by both first-order and second-order stimuli. The first-order stimuli were sinusoidal luminance-modulations of a uniform field, and the second-order stimuli were sinusoidal contrast-modulations of a random-dot field. When the target was a static grating, the second-order stimuli induced little motion contrast, while the first-order stimuli of the same effective contrast produced clear motion contrast. When the target was a counterphase grating, both first- and second-order stimuli produced clear motion contrast. These results are discussed in relation to the involvement of second-order motion pathways in the relative-motion processing, and the two types of motion aftereffects obtained with static and dynamic test stimuli.
Contrast Sensitivity↗
Dual multiple-scale processing for motion in the human visual system.
A number of psychophysical and physiological studies have suggested that first- and second-order motion signals are processed, at least initially, by independent pathways, and that the two pathways both consist of multiple motion-detecting channels that are each narrowly tuned to a different spatial scale (spatial frequency). However, the precise number and nature of the mechanisms that subserve first- and second-order motion perception in human vision remain both controversial and speculative. We sought to clarify this issue by conducting selective adaptation experiments, in which modulation-depth thresholds for identifying the direction of stimulus motion of first-order (luminance-defined) and second-order (contrast-defined) drifting gratings were measured both prior to and following adaptation to motion. The drift direction, spatial frequency and stimulus type (either first- or second-order) of the adaptation and test stimuli were systematically manipulated. When the adaptation and test stimuli were either both first-order gratings or both second-order gratings, robust elevations of direction-identification thresholds were found and, importantly, these aftereffects exhibited both direction-selectivity and spatial-frequency selectivity. Cross-over-adaptation effects between first- and second-order gratings were also sometimes observed, but were very weak and not spatial-frequency selective. These findings give direct support for the existence of multiple-scale processing for first- and second-order motion in the human visual system and provide additional evidence that the two varieties of motion are initially processed by independent pathways.
Adaptation, Ocular↗
Discharging routine phacoemulsification patients at one week.
The reduction of surgically induced astigmatism and rapid refractive stabilisation after phacoemulsification have been well studied and often lead to reduced follow-up. In this prospective study we reviewed a cohort of 100 patients discharged with a refractive prescription at their 1 week post-operative appointment following routine sutureless phacoemulsification through a corneal or scleral section. The aim was to assess the incidence of late pathology and need for review. Eighty-eight patients attended for review between 3 and 4 months post-operatively, of whom 8 (9.1%) who had been symptomatic had already visited ophthalmic casualty. Nine (10.2%) benefited from the follow-up appointment: 4 were given a new refractive prescription that increased their Snellen visual acuity by 1 line; the other 5 were all symptomatic or had incidental findings. We feel that provided there is easy access to the eye department, early discharge with or without refraction is justifiable as those with surgically related pathology at any stage are symptomatic.
Emergency Service, Hospital↗
The nurses' aide: past and future necessity.
Popular images of nursing, largely based on Victorian ideals, have tended to ignore the role played by the unqualified nurse. Yet nurses' aides have been described as providing the backbone of health services and in many clinical areas have traditionally performed the greater part of basic nursing care. Demographic pressures, including increased numbers of elderly people with health care needs and the reduction in the number of school leavers entering nursing, together with reforms in nurse education, will mean that the demand for nurses is likely to continue to outstrip supply. The nurses' aide is likely to remain indispensible to nursing provision in the United Kingdom. Despite the contribution of unqualified nurses, little attention has been paid historically to their training needs. Studies have attempted to compare the effectiveness of qualified staff with that of nurses' aides, even though the latter have received little or on training. The validity of such approaches is questionable since 'unqualified' and 'untrained' have been accepted as synonymous by the nursing profession. Other studies which have looked at the caring abilities of unqualified staff suggest that despite their lack of training they have the potential to deliver therapeutic care as long as trained nurses provide appropriate role models within a therapeutic unit philosophy. The value of the qualified nurse may in fact involve the organization of care rather than hands on care alone.
Forecasting↗
Initial human experience with MK-462 (rizatriptan): a novel 5-HT1D agonist.
AIMS: We evaluated the pharmacokinetics and pharmacodynamics of oral MK-462 in comparison with oral sumatriptan in healthy male volunteers. METHODS: Sixteen healthy male volunteers were studied in a rising, single dose, alternating panel design with eight subjects per panel. Matching placebo was administered to two of eight study subjects at each dose level of MK-462 in a randomized, double-blind fashion. RESULTS: MK-462 was rapidly absorbed with a median tmax of 1.3 h (range 1-3 h) vs a tmax for sumatriptan of 2.5 h (range 1-4 h, P < 0.001). Administration of either MK-462 or sumatriptan produced maximal mean elevations of 5-10 mmHg in systolic and diastolic blood pressures without effect on heart rate; the changes occurred sooner following MK-462, consistent with more rapid absorption. Both MK-462 and sumatriptan provoked mild increases in serum growth hormone without any effect on serum prolactin concentrations. The most commonly reported symptom following MK-462 was drowsiness. CONCLUSIONS: These results indicate that the novel 5-HT1D agonist, MK-462, is rapidly absorbed following oral administration and warrants further investigation of its utility in the treatment of acute migraine.
Administration, Oral↗
Staff training to improve implementation and impact of behavioral rehabilitation programs.
Staff who provide services for persons with severe mental illness often have pessimistic attitudes about adopting behavioral innovations for their programs. Thirty-five staff members in psychiatric residential programs participated in eight months of interactive staff training, an organizational development strategy that helps the rehabilitation team develop behavioral approaches to changing clients' behavior. After the training, staff members reported significant improvement in their attitudes about behavioral interventions and increased perceptions of collegial support. Direct care staff reported significantly less emotional exhaustion. Interactive staff training may facilitate implementation of behavioral strategies by improving attitudes toward these interventions.
Adult↗
Being present: experiential connections between Zen Buddhist practices and the grieving process.
The Zen Buddhist contemplative tradition involves several meditation and instructional techniques that have strong phenomenological and theoretical connections with the experience of loss and the process of grief. From experiences which occurred during personal encounters with individuals (three of whom had a disability) in a grief counselling setting, several points of connection were identified. These included a heightened awareness of the embodied nature of experience, the importance of dialogue and relationship for both healing and transformation, the focus on process as opposed to outcome, the importance of the process of life review, a confrontation with the nature of absence and emptiness, and being present to what is experienced rather than focusing on the need for change. These findings are discussed in terms of Ken Wilber's full-spectrum model of human development, as well as their implications for professional and non-professional support persons of people experiencing grief.
Buddhism↗
Variation of the multifocal visual evoked potential with eccentricity in isometropic amblyopes.
PURPOSE: To investigate the variation of visual function in different eccentricities of the visual field in isometropic amblyopes. METHOD: The stimulus matrix containing 61 hexagons was generated on a monitor. The diameter of the entire stimulating field was approximately 13.6 deg of arc; the frame rate of the monitor was 67 Hz. Every hexagon of the display contained a number of black and white small hexagonal patches which reversed during stimulation. These hexagons were simultaneously but independently modulated in time by the controlling computer program. The flashed elements were selected differently on each frame according to a computer-generated binary pseudo-random time series (m-sequence); the response contributions from each of the individual stimulus elements could be extracted from the cross corre-ation function. Subjects were asked to maintain fixation at the center of the stimulus pattern while each of the hexagons of the display reversed. The VERIS system extracted the local responses by cross-correlating the input (binary m-sequence) and output (evoked response) signals. The latencies and amplitudes of the responses from the central 8.6 deg of arc in the visual field were analyzed. RESULT: Mean latency is about 22 ms longer at the fovea, and 10 ms longer in the first ring for the isometropic amblyopes than for the normal (control) subjects. The differences are highly significant at the fovea and in the first ring. In the second ring and the third ring, the difference have reduced to 3 to 4 ms. The latencies at the second ring and the third ring are not significantly different. In isometropic amblyopes, the P1-N2 amplitude is about half of that in the normal subjects for the fovea and is similar to that for the normal subjects in the third ring. The P1-N2 amplitudes in the isometropic amblyopes are significant lower than the normal values from the center to the second ring. CONCLUSION: In isometropic amblyopia, the prolongation of latencies and the attenuation of the amplitudes of topographic VEPs are marked in the central region of the visual field and diminished in the periphery. The topographic VEP can objectively reflect the variation of visual response with eccentricity in the visual field.
Adolescent↗
The road to worldwide sexuality education.
Explore the source record for details and available documents.
Adolescent↗
Most germ-line mutations in the nevoid basal cell carcinoma syndrome lead to a premature termination of the PATCHED protein, and no genotype-phenotype correlations are evident.
The human homologue of the Drosophila segment polarity gene patched is implicated in the development of nevoid basal cell carcinoma syndrome (NBCCS) and in the genesis of sporadic basal cell carcinomas. In order to examine the phenotypic variability in NBCCS and to highlight functionally important domains of the PTCH protein, we have now screened 71 unrelated NBCCS individuals for mutations in the PTCH exons. We identified 28 mutations that are distributed throughout the entire gene, and most (86%) cause protein truncation. As part of this analysis, we demonstrate that failure of one NBCCS family to show clear linkage to chromosome 9q22.3-31 is most likely due to germinal mosaicism. We have identified three families bearing identical mutations with variable phenotypes, suggesting phenotypic variability in NBCCS is a complex genetic event. No phenotype genotype correlation between the position of truncation mutations and major clinical features was evident. Two missense mutations have been identified, and their location within transmembrane domains supports the notion that PTCH may have a transport function. The preponderance of truncation mutants in the germ line of NBCCS patients suggests that the developmental defects associated with the disorder are most likely due to haploinsufficiency.
Basal Cell Nevus Syndrome↗
Partially Molten Middle Crust Beneath Southern Tibet: Synthesis of Project INDEPTH Results
INDEPTH geophysical and geological observations imply that a partially molten midcrustal layer exists beneath southern Tibet. This partially molten layer has been produced by crustal thickening and behaves as a fluid on the time scale of Himalayan deformation. It is confined on the south by the structurally imbricated Indian crust underlying the Tethyan and High Himalaya and is underlain, apparently, by a stiff Indian mantle lid. The results suggest that during Neogene time the underthrusting Indian crust has acted as a plunger, displacing the molten middle crust to the north while at the same time contributing to this layer by melting and ductile flow. Viewed broadly, the Neogene evolution of the Himalaya is essentially a record of the southward extrusion of the partially molten middle crust underlying southern Tibet.
Journal Article↗