AIM: To evaluate a recruitment strategy to identify high risk toddlers for a programme of prevention of allergy. For screening, parents were asked to participate in our study by information form and screening questionnaire on the occasion of routine check-up visits of toddlers scheduled between 20 and 48 months of age in four paediatric practices. As a next step, readiness of parents for implementation of preventive measures was confirmed. METHOD: Inclusion criteria were age between 20 and 48 months and a positive atopic family history (evaluated by 5 questions regarding asthma, allergic rhino-conjunctivitis and atopic dermatitis) of parents or siblings. This was confirmed by sensitization to an environmental allergen (skin prick test (SPT)) in at least one parent. If these inclusion criteria were fulfilled, the toddlers were randomly allocated to the intervention and control group of the prevention programme. RESULTS: 111 of 175 screening questionnaires (63.4 %) were returned. In 76.6 % (n = 85) of these 111 questionnaires a positive atopic family history (mother, father, sibling) was noted. All inclusion criteria were fulfilled by only 43 toddlers (age: median 33.6 months, 5-95 % quantile: 21.6-48 months). Based on the positive screening questionnaire, history of atopy was confirmed by positive SPT in 70.0 % of fathers and 77.8 % of mothers. Despite a negative screening questionnaire, history of atopy was detected by a positive SPT in 11.1 % of mothers and 47.4 % of fathers. Detection of specific IgE against house-dust mite in 9 of 18 serum samples revealed the risk for allergy of the toddlers. A re-evaluation after three months showed that all the elements of the prevention programme as well as the recommendations for the control group had been almost completely accepted by all the families concerned practically without any reservations. CONCLUSION: The recruitment of toddlers with high risk for developing allergy turned out well and could be validated. The prevention programme was readily accepted by the families and thus can be used for a larger study.

Antigens, Dermatophagoides↗

PubMedDate not supplied

Perceptions of psychosocial adjustment to acquired communication disorders: applications of the Code-Müller Protocols.

The 'Code-Müller protocols' (CMP) were introduced in 1983 and originally aimed to compare perceptions of psychosocial adjustment to aphasia and related disorders from the separate perspectives of patients, relatives and speech and language therapists as a basis for counselling. In later studies the items of the CMP were also used to examine perceptions of their importance as possible therapy targets in the rehabilitation of people with communication disorders. This paper describes the development of the CMP and presents an overview of their application in aphasia, laryngectomy and acquired deafness and discusses some clinical implications. Studies published in the past 15 years show that aphasic people and their relatives or significant others are significantly more optimistic concerning psychosocial adjustment than their therapists. Furthermore, optimism changes during the course of illness. The relative weightings given for therapy or rehabilitation targets significantly differ between different professional groups concerned with aphasia rehabilitation (speech and language therapists/pathologists, physiotherapists, occupational therapists, psychologists and physicians) and are influenced by clinical experience.

Clinical Protocols↗

PubMedDate not supplied

Depressive changes in stroke patients.

The present state of research concerning depressive alterations following cerebrovascular infarcts is reviewed with special consideration of methodological issues, the course of depressive changes and interactions with neuropsychological and clinical parameters. The concepts of 'grief response', '(depressive)-catastrophic reactions' and 'post-stroke depression' are analysed and compared. An attempt is made at a theory of post-stroke depressive alterations that is based on neuroanatomical, pathophysiological and neurochemical models of depression and psychosocial changes and interactions. Therapeutic implications are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Morphological investigations of connective tissue structures in the region of the nervus occipitalis major.

The connective tissue lamellae surrounding the n. occipitalis major are arranged in such a way that they form at least two compartments. An outer epineurial, and an inner endoneurial one. The outer compartment is a shifting and sliding layer, the inner one is probably filled with fluid which means that it is relatively incompressible. This fluid could be drawn off and supplied through the widely branched arterial and venous reticulum, the vasa nervorum. Measurements of the connective tissue space area (perineurium, subperineurial space, endoneurium with axon and glia) on the n. occipitalis major showed a high correlation between measured values. In addition, lammellar corpuscles of the Paccini type are regularly found in both compartments. These receptors measure the local pressure and shearing forces. The design of the suspension network along with the course of the muscles in the area of the regio occipitalis, the interdependence of the connective tissue compartments, the diffusion barrier of the perineurium, the mighty vasa nervorum and the occurrence of lamellar corpuscles, all point to a probable connection with the symptom complex of occipital neuralgia.

Connective Tissue↗