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Biomedical subjects

S Connell

Publications and source records attributed to S Connell.

13 recordsLinked to original sources

Self-directed behavioral family intervention for parents of oppositional children in rural and remote areas.

Twenty-four parents of oppositional preschoolers were randomly assigned to either a self-directed behavioral family intervention condition (SD) or to a waitlist control group (WL). The self-directed parent training program, based on self-regulation principles, consisted of a written information package and weekly telephone consultations for 10 weeks. At posttest, in comparison to the WL group, children in the SD group had lower levels of behavior problems on parent report measures of child behavior. At posttreatment, parents in the SD condition reported increased levels of parenting competence and lower levels of dysfunctional parenting practices as compared to parents in the WL condition. In addition, mothers reported lower levels of anxiety, depression, and stress as compared to mothers in the WL condition at posttreatment. Using mother's reports, gains in child behavior and parenting practices achieved at posttreatment were maintained at 4-month follow-up.

Adult↗

Screening potential corneal donors for HIV-1 by polymerase chain reaction and a colorimetric microwell hybridization assay.

PURPOSE: Current screening of potential corneal donors for human immunodeficiency virus type 1 (HIV-1) involves serologic detection of antibodies to the virus. However, this approach cannot detect infection during the seronegative window period of the disease. We therefore evaluated the polymerase chain reaction (PCR) assay for viral nucleic acid as a possible alternative to screening cadaveric blood for HIV-1. METHODS: Blood specimens from cadavers diagnosed at autopsy with acquired immunodeficiency syndrome (AIDS) (n = 21), at high risk for HIV-1 infection (n = 47), and at no known risk (n = 350) were screened by PCR for HIV-1 proviral DNA and human leukocyte antigen (HLA)-DQ alpha sequences, and for HIV antibodies. RESULTS: All AIDS group samples were seropositive; of these, 18 (86%) and 20 (95%) of 21 were positive for HIV by PCR of proteinase K- and Chelex-extracted pellets, respectively. The seropositive samples negative by PCR testing were shown to inhibit PCR amplification. Nine (19%) of 47 high-risk specimens were HIV-positive. The no-known-risk group yielded negative results. The overall sensitivities for PCR in the proteinase K- and Chelex-treated groups were 90% and 97%, respectively, compared with Western blot reactivity. If PCR-inhibitory samples and HLA-DQ alpha-negative samples had been eliminated, sensitivity would have been 100%. Specificity was 100% for each group. CONCLUSIONS: Screening cadaveric blood by PCR may be feasible, but further refinement of the assay and blood specimen collection practices will be necessary for it to become routine. Future studies should focus on optimizing specimen procurement and preparation to reduce or eliminate specimens that inhibit PCR.

AIDS Serodiagnosis↗

The spatial coding strategies of one-year-old infants in a locomotor search task.

The ability of 1-year-old infants to remember the location of a nonvisible target was investigated in 3 experiments. Infants searched for a toy hidden in one of many possible locations within a circular bounded space. The presence, number, and spatial arrangement of local cues or "landmarks" within this space were varied. The results of Experiment 1 showed that search performance was highly successful when a landmark was coincident with the location of the toy ("direct"), but less successful when a landmark was adjacent to the target location ("indirect"). The results of Experiment 2 suggested that search with an indirect landmark may be more fragile than search with no landmarks at all. In Experiments 3a and 3b, 2 different configurations of indirect landmarks were employed; search performance was equally poor with both of these and was inferior to search with no landmarks. It is concluded that infants of this age are able to associate a nonvisible target with a direct landmark and are able to code the distance and direction of a target with respect to themselves or with respect to the larger framework. However, there was no evidence that they can code the distance and direction of a target relative to another object. The difficulty of coding with indirect landmarks is interpreted in terms of cognitive complexity and conflict between spatial strategies.

Child Development↗

Escherichia coli O157:H7 generates a unique biochemical profile on MicroScan conventional gram-negative identification panels.

More than 90% of the strains of Escherichia coli O157:H7 that were identified on a MicroScan gram-negative dried conventional (overnight) panel gave one of two unique biochemical profile numbers that were not detected in other d-sorbitol-negative E. coli or in other strains isolated from pathogenic processes. This suggests that the panel has the capability of being used as a preliminary screening tool for O157:H7 strains involved in hemorrhagic colitis when MacConkey-sorbitol agar is not available.

Bacterial Typing Techniques↗

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Continuity of Patient Care↗

Diagnostic concordance in functional psychosis revisited: a study of inter-relationships between alternative concepts of psychotic disorder.

More than a decade ago, a series of retrospective studies examined the concordance between proliferating definitions of severe psychiatric disorder. The European response has been a poly-diagnostic one, which has attempted to maintain interest in a broad range of psychiatric phenomena in the psychoses. In North America a more convergent approach has emerged, resulting in a series of operational definitions evolving from one another, and a correspondingly limited capacity to allow alternative perspectives to co-exist. The present study uses a prospective design as well as recent improvements in the clinical validity of psychopathology assessment to re-evaluate the relationships between competing concepts of psychotic illness in a broad sample (N = 176) of recent-onset psychotic patients. In the schizophrenic group, concordance was predictably highest among recent North American 'cousins', and lowest among various historical concepts. There was a moderately high concordance between selected schizoaffective and atypical psychosis definitions, indicating that this component is an important area for further studies of descriptive validity. These interrelationships may be used as a starting point to explore latent classes underlying the phenomena of functional psychosis.

Adult↗

A two-part quality assurance project addressing infection rates of wounds sutured in the emergency department.

The process and outcome of our QA program suggest many areas for further examination; a study featuring a larger sample and more rigorous experimental research could address these. Our immediate goals, however--to examine the quality of wound care in our emergency department and to improve it--were accomplished. What is perhaps more important, this QA project made us look at our practice and realize that we could change things. We identified a problem, studied it, and did something about it.

Adolescent↗

Do infants use their own images to locate objects reflected in a mirror?

The ability of infants to locate a toy from a mirror reflection was investigated in 3 experiments. In the first, it was found that a minority of 22-month-old infants turned to locate the toy that was the source of the reflection, and that localization of the toy occurred regardless of whether the infants' own image was visible in the mirror. The results of 2 further experiments indicated that younger infants aged 14 and 18 months rarely use mirror information to locate a toy. When they do so, they also turn whether or not images of themselves are visible. It is concluded that tasks involving the localization of objects or events from mirror images are not direct indices of self-recognition. Rather, they indicate the skill of infants in using the mirror as a perceptual tool.

Arousal↗

Ultrastructure of the myocardium during development from early fetal life to adult life in sheep.

The ultrastructure of the developing fetal lamb myocardium was studied in a series of animals spanning 29 days of gestation to term, and compared with newborn and adult animals. All major ultrastructural features which characterise the adult myocyte were found in early fetal life, although with considerably different degrees of development of specific features. Notably, myofibrils at 29 days of gestation are sparse and show little organisation. With advancing gestation there is an increasing number of myofibrils and the development of well defined striations. Thus, at term, the fetal tissue is not substantially different from the adult myofibril in the appearance of sarcomere structure. The observation of contractile tissue paucity and disorder in early fetal lamb myocardium is difficult to reconcile with available physiological data, which show an extraordinary pumping performance of the heart in vivo, and requires further investigation.

Animals↗

The nosology and prognosis of puerperal psychosis: a review.

Functional psychosis in the puerperal period is a dramatic phenomenon that presents a unique set of diagnostic and therapeutic challenges. Despite its omission from modern classificatory systems such as DSM-III and DSM-III-R, the concept of puerperal psychosis continues to receive support from clinicians on the basis of the apparently distinctive clinical picture that characterizes psychoses occurring at this time. The range of possible nosological models is considered in light of relevant studies of puerperal illness, and the evidence for and against each model is presented. The question of the prognosis of puerperal psychosis is reviewed and guidelines for its estimation in the individual case proposed. The heuristic importance of puerperal psychosis in terms of basic research and preventive psychiatry is also stressed.

Adult↗

Determining the utility and effectiveness of the NeoPath AutoPap 300 QC System used routinely.

OBJECTIVE: To evaluate routine use of the NeoPath AutoPap 300 QC System (AP 300) as it influences diagnostic quality and operations in a large cytology laboratory. STUDY DESIGN: During a three-month period, 35,143 conventionally prepared consecutive cervical cytologic smears taken from non-high-risk women and evaluated as negative by our staff of 25 cytotechnologists were selected for processing by four AP 300 instruments. Slides flagged for review by the AP 300 were reevaluated by our five quality control (QC) cytotechnologists. False negative (FN) results were compared with results of our current practice (CP), random-selection QC method, used during the preceding six months. RESULTS: A 240% increase was seen in the FN detection rate for atypical squamous cells of undetermined significance (ASCUS) and squamous intraepithelial lesions (SIL) (n AP = 65 FN in 5,034 QC, n CP = 77 FN in 22,052 QC) and a 744% increase in the FN detection rate for low and high grade SIL (n AP = 24 FN/5,034 QC, n CP = 12 FN/22,052 QC). The rate of overcall by cytotechnologists did not increase. The QC ASCUS/SIL ratio improved. FN biopsy correlation increased from 45% to 85% (n CP = 17/38 agreement, n AP = 23/27 agreement). Turnaround time increased by one or more days for negative and 1.5 days for QC result reporting. Sensitivity varied among instruments. CONCLUSION: More FN results and greater specificity were seen using the AP 300 than using CP. As with other instrumentation, each laboratory should establish acceptable ranges of performance and baseline values for sensitivity and specificity.

Biopsy↗