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Biomedical subjects

R S Dean

Publications and source records attributed to R S Dean.

At least 19 recordsLinked to original sources
PubMed2001

Comorbidity among individuals classified with attention disorders.

This study examined the frequency of comorbidity among ADHD and ADHD subtypes. Specific aspects of comorbidity were examined in the areas of learning disorders, disruptive behavior disorders, and affective disorders. Two analyses were performed. The first analysis compared the comorbid second and third diagnoses for 287 individuals with a primary diagnosis of ADHD (Predominately Inattentive Type or Predominately Hyperactive-Impulsive Type) with a comparison sample (n = 290) who did not have a primary diagnosis of ADHD. The second analysis examined the comorbidity with specific ADHD subtypes. This analysis compared the comorbid second and third diagnosis of individuals with a primary ADHD subtype diagnosis of Predominately Inattentive (n = 143) with individuals who have a primary ADHD subtype diagnosis of Predominately Hyperactive-Impulsive (n = 143). Results from the first analysis indicated significant overlap between the diagnosis of ADHD and the diagnosis of learning disorders and disruptive behavior disorders but not for affective disorders. Results from the second analysis indicated that only conduct disorders were comorbid with certain ADHD subtypes, with disruptive behavior disorders being more likely to be diagnosed with ADHD Hyperactive-Impulsive Type than with ADHD Inattentive Type.

Adolescent↗
PubMed2001

Integration of neuropsychological and cognitive theory in rehabilitation.

Clinical neuropsychology has focused on the diagnosis and localization of brain damage. Much of the early progress in the field relied upon an atheoretical-actuarial approach. Recently a link between neuropsychology and cognitive psychology has emerged. From the early focus upon brain-behavior relationships, neurocognitive theories have emerged to explain observed brain functions. Although many researchers have enjoyed the collaboration between neuropsychology and cognitive psychology, others continue to investigate functions without considering the merging of finds. This article reviews integrative elements of cognitive and neuropsychological research and the emergence of cognitive neuropsychology.

Brain↗
PubMed2001

Report of normative sensory and motor performance in children using a standardized battery.

This study provided normative data for sensory and motor functioning of children from 2-15 years of age. Two hundred eighty-eight children without a history of neurological or psychiatric evaluation, diagnosis, or treatment served as subjects. Each child was administered the Dean-Woodcock Sensory and Motor Battery. This measure consists of 18 individual subtests. Nine subtests reflect visual, auditory, or tactile perception. The remaining 9 subtests involve motor functioning, with 3 of the subtests devoted to subcortical functioning. The results showed that the most rapid development occurred between the ages of 4 and 7 years. Indeed, some 76% of the sensory-motor tasks administered reached a plateau by age 7.

Child↗
PubMed2001

Neuropsychological clusters within intelligence levels for learning disabled children.

The present study assessed 1142 learning disabled children with the Halstead Reitan Neuropsychological Battery and the Wechsler Intelligence Scale for Children-Revised. Subjects were divided into four groups based upon Full Scale IQ (i.e., 70-79; 80-89; 90-99 and 100-110). Subsequent clustering of the test data within each group suggested that while the students in the 70-79 IQ range were represented by a single Impaired Cluster, each of the other IQ groups had both an Impaired Cluster and a Non-Impaired Cluster.

Adolescent↗
PubMed2000

Constructs underlying measures of sensory-motor functions.

Many pathognomonic indicators of brain damage are characterized by deficits in sensory and/or motor functions. The strength of these pathognomonic signs has led to reliance on clinical administration and interpretation in the assessment of sensory and motor functions. Subsequently, the majority of measures designed to assess sensory and motor functions lack adequate reliability and psychometric confirmation of their utility. The Dean-Woodcock Sensory-Motor Battery (DWSMB) was designed to standardize the administration and interpretation of sensory-motor functions and has demonstrated satisfactory reliability. The present study further examined the psychometric properties of the DWSMB through factor analysis. It was hypothesized that at least two factors would emerge representing sensory and motor functions, respectively. A third possible factor that would reflect subcortical functioning was also hypothesized. Principal components analysis on data from over 600 participants supported a three-factor solution which accounted for 50.9% of the total variance. However, factor loadings revealed more dual loadings than expected, and factors emerged according to complexity rather than basic sensory, motor, and subcortical factors. Regardless, these data provide empirical evidence for the conceptualization of sensory-motor skills in a manner that incorporates subcortical abilities. These data also provide support for the underlying constructs of the DWSMB.

Journal Article↗
PubMed1999

Antimicrobial efficacy of endoscopic disinfection procedures: a controlled, multifactorial investigation.

BACKGROUND: Adequate disinfection of endoscopes is essential to prevent environmental and patient-to-patient transmission of infectious agents, but data from controlled studies are limited. Moreover, there is controversy regarding current guidelines for disinfection. We compared the antimicrobial efficacy of several endoscopic disinfection procedures controlling for multiple factors that affect reprocessing. METHODS: A colonoscope was contaminated with 10(8) CFU/mL of Enterococcus faecalis as a standardized inoculum. The colonoscope was passed through 1 of 16 study arms (5 reps/arm for a total of 80 runs) that were controlled for all possible combinations of the following variables: manual precleaning; 10-, 20-, or 45-minute glutaraldehyde exposure; air or ethanol drying; or automated reprocessing with peracetic acid (liquid sterilization system). Suction accessory channels and air-water channels were harvested for microbiologic culture. RESULTS: Control runs (no cleaning or disinfection) recovered more than 5 x 10(7) CFU/mL from each sampling site. When each processing variable was isolated independent of other variables, the benefits of manual precleaning, longer soak times, and ethanol drying were apparent. When factors were combined, manual precleaning followed by 20- and 45-minute glutaraldehyde exposure and ethanol drying removed all test organisms, as did processing with the liquid sterilization system. CONCLUSION: Although the initial cost is higher, the automated liquid sterilization system provides effective sterilization and minimizes worker exposure. In units where chemical disinfection is used, our results suggest that manual precleaning followed by at least 20-minute glutaraldehyde exposure and ethanol rinse drying are sufficient to achieve complete disinfection.

Colony Count, Microbial↗
PubMed1999

Parkinson's disease and neuropsychological assessment.

Neurological aspects of Parkinson's disease including symptomology, etiology, and chemotherapy are briefly reviewed. Recent developments in each area are also presented. Clinical considerations relevant to neuropsychological testing with the Parkinson's disease patient are discussed in terms of confounds that may hinder the accuracy of test result interpretation.

Humans↗
PubMed1999

Attribute-treatment interaction research using nonexperimental data and the allocation average.

Attribute-treatment interaction (ATI) research attempts to answer the question, "Which treatment is best for whom?" Recent critical reviewers of ATI methodology have cited numerous pragmatic and methodological shortcomings of traditional experimental designs and argued that successful ATI research will require an alternative approach. This manuscript describes a purely correlational ATI method that addresses the more serious criticisms of experimental ATI research. This paper also presents use of the allocation average for ATI research that is either experimental or correlational in nature. The allocation average estimates the clinical utility of differential treatment assignment based on ATI data in terms of improved treatment outcomes. The proposed method is illustrated with hypothetical psychotherapy data and data from a recent educational study.

Data Collection↗
PubMed1998

Utility of the Maternal Perinatal Scale (MPS) in distinguishing normal from learning disabled children.

This study examined perinatal complications and risk factors as predictors of learning disabilities in schoolaged children. Specifically, the Maternal Perinatal Scale (MPS) was used to distinguish between normal children and those classified as learning disabled (LD) by their school system. One hundred and eight participants, 54 in each classification, were selected from a small Midwestern area. A stepwise discriminant analysis demonstrated that all four factors of the MPS contribute significantly to the prediction. A linear composite of MPS factor scores correctly classified 93.5% of all participants, with only two normal and five LD children being misclassified. Repeating the results with other clinical populations, these results support the use of the MPS in assessing the perinatal history. More importantly, these data are consistent with the notion that perinatal complications increase the likelihood of future impairment. Moreover, the MPS shows promise as a screening device for use in early preventative programs which diminish the negative psychological, sociological, and neuropsychological outcomes for children with neurological disorders.

Adolescent↗
PubMed1998

Discriminant function analysis of malingerers' and neurological headache patients' self-reports of neuropsychological symptoms.

Interpretation of a patient's neuropsychological examination involves the determination of the role motivational and psychiatric factors may have played. The ability to detect malingering becomes crucial, particularly when the examination occurs as a result of litigation. Moreover, falsely identifying a performance as distorted has serious consequences for the patient. The present study was conducted to replicate previous research that discriminated between malingered and nonmalingered responses to a neuropsychological self-report inventory. An overall hit rate of 84% for malingerers and neurologic headache patients demonstrated replication of the inventory's ability to identify malingerers. Of those predicted to be malingerers, 27% were false positives indicating the need to use this inventory in conjunction with other neuropsychological measures.

Journal Article↗
PubMed1997

"Profile" analysis of the personality characteristics of child molesters using the MMPI-2.

Identification of child sexual molesters has been attempted for at least half a century without success. This is due, in part, to the heterogeneity of child molesters. Child sexual molesters were studied in three ways. First, a discriminant function analysis was conducted to evaluate how well the MMPI-2 would distinguish child molesters from controls. Hit rates of 81% and 88% were found for clinical scales alone and the clinical and supplemental scales, respectively. Second, a cluster analysis of MMPI-2 data identified four groups that resembled clusters found previously with the MMPI. Third, when followed in treatment, all subgroups achieved significant progress ratings and no significant difference in treatment progress was found between clusters.

Adolescent↗
PubMed1997

Cognitive processing and self-report of lateral preference.

Our knowledge of the human brain has increased more during the past 40 years than at any other time in history. Of particular interest have been the findings of a correspondence between cognitive functions and individual structures of the brain. Similar from a gross anatomical point of view, the hemispheres of the brain have been shown to serve specialized cognitive functions. This work offers an overview of the cognitive aspects of cerebral lateralization as a context for considering this issue, followed by a review of specific self-report techniques in the appraisal of lateral preference.

Brain↗
PubMed1997

The neuropsychological significance of lateral preference for complex visual activities in children with learning disabilities.

In the present study the relationship between neuropsychological functioning and lateral preference for visual activities was examined with learning disordered children. Specifically, the relationship between measures of the Lateral Dominance Exam (LDE), scores on the Halstead-Reitan Neuropsychological Battery (HRNB), and the Wechsler Intelligence Scale for Children-Revised (WISC-R) were explored. A canonical analysis suggested that composites of neuropsychological functioning and lateral preference shared 22% of variance. Learning disabled children with strong right or left preference for visually guided motor activities showed lower performance in spatial tasks on the ipsilateral side and in simple motor skills on the contralateral side. Children in the present study with strong right preference patterns for visually assisted motor activities also showed low performance on visual tracking tasks. These data offer some support for assessing lateral preference in learning disabled children.

Adolescent↗
PubMed1997

Developmental and sex differences in sensory and motor functioning.

The sensory and motor functioning of normal children (N = 119) ages 4 to 13 years old were examined for developmental and sex differences in relation to neuropsychological functioning. Sensory and motor subtests of the Dean-Woodcock Neuropsychological Assessment System (D-WNAS), a standardized instrument, were administered. Significant differences between the older and younger children were found, suggesting that developmental differences exist for sensory and motor functioning. The older children significantly outperformed the younger children on all subtests except for visual confrontation. Differences between males and females and the interaction between sex and age were not significant. The present findings coincide with previous research showing clear maturational differences in sensory and motor functions.

Adolescent↗
PubMed1997

Validity and reliability of rapidly alternating movement tests.

Two studies investigated the interrater reliability and concurrent validity of tests of rapidly alternating movement. Study I examined the interrater reliability of three different tests, "finger tapping" to the adjacent thumb, "table tapping," and "hand to thigh" alternating movements. Using normal participants the results indicated poor interrater agreement for the "hand to thigh" test and modest relationship for both types of finger tapping. However, for each test the number of recorded repetitions differed significantly between raters. Study 2 examined the concurrent validity of two mechanical measures of finger tapping. The scores of 36 normal participants was compared using a mechanical digital counter and a calculator. Results indicated that the use of the calculator as a counter was highly related to the results with a mechanical digital counter. Conclusions suggested the use of a mechanical apparatus is more reliable than human observations. In addition, the use of an inexpensive apparatus will produce results similar to the manual finger tapping apparatus commonly used in neuropsychological batteries.

Adult↗
PubMed1997

Prospective randomized comparison of stonetome combination catheter versus conventional endoscopic clearance of common bile duct.

OBJECTIVES: To assess the therapeutic efficacy and performance characteristics of a novel cannula that has recently become available for clearance of the common bile duct (CBD), combining a sphincterotome and retrieval balloon in a single instrument, and to compare it with the conventional approach. METHODS: Seventeen consecutive patients with signs of biliary obstruction were prospectively randomized to undergo evaluation and clearance of the CBD by combination catheter (Stonetome, Microvasive) or conventional sphincterotomy (Ultratome) with separate balloon sweep. In all cases, three sweeps of the CBD were made with an 11.5-mm retrieval balloon after sphincterotomy. Fluoroscopy time was measured, as was total time from initiation of sphincterotomy to removal of endoscope from the patient. The same endoscopist performed all procedures. RESULTS: Patient groups were matched with regard to age, gender, proportion with prior cholecystectomy, CBD diameter, and stone size. Patients were successfully treated by either approach. Use of the Stonetome combination catheter reduced mean fluoroscopy time by 52% (from 3.1 +/- 0.6 to 1.5 +/- 0.2 min), mean total time by 57% (from 11.3 +/- 2.2 to 4.9 +/- 1.1 min), and dosage of midazolam used for conscious sedation. CONCLUSIONS: The new combination catheter allows the elimination of one step in exchanging the sphincterotome for a retrieval balloon after sphincterotomy. Its efficacy in clearing the CBD is equal to that of our conventional approach. Use of the combined approach should minimize the risk of losing cannulation, reduce fluoroscopic exposure, and improve the overall efficiency of the procedure.

Adult↗
PubMed1996

Diagnostic agreement in the classification of headache using Ad Hoc Committee and IHS criteria.

This study examined the level of agreement between raters in the diagnosis of headache using the Ad Hoc Committee (AHC) on the Classification of Headache and the Headache Classification Committee of the International Headache Society (IHS) classification criteria. In addition, differences in classification of headache between the AHC and IHS classification systems were considered. Analyses indicated that both the AHC and IHS classification systems were adequate in allowing clinicians to reach 100% agreement in diagnosis of headache cases (N = 36). Additionally, there was 91.7% diagnostic agreement between the two sets of criteria as applied by the raters. Differences in diagnostic classification between the two sets of criteria were believed to be the result of IHS exclusionary criteria in the classification of Tension-type headache.

Adult↗