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T Humphries

Publications and source records attributed to T Humphries.

18 recordsLinked to original sources

An open-label study of rabeprazole in patients with Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion.

BACKGROUND: Omeprazole and lansoprazole are both of proven efficacy in the treatment of Zollinger-Ellison syndrome and idiopathic gastric acid hypersecretion. Rabeprazole, which has a similar mechanism of action, has not previously been studied in these diseases. AIM: To determine the dose of rabeprazole that decreased basal acid output to safe levels in patients with Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion. METHODS: Patients with Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion were given rabeprazole 60 mg once daily for uncomplicated disease or 40 mg twice daily for complicated disease. Doses were titrated according to response and continued for 2 years. Efficacy was assessed primarily by measuring basal acid output. RESULTS: All patients had basal acid output before the next dose controlled to <10 mmol/h either at the starting dose or after minor dose titration. Control of acid output was maintained for 2 years. Consistent with this, most patients reported few gastrointestinal symptoms. Gastric biopsy showed no enterochromaffin-like cell dysplasia or neoplasia. CONCLUSIONS: Rabeprazole was an effective and well-tolerated treatment for Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion, which reliably reduced gastric acid output to safe levels. Although a dose of 60 mg once daily was appropriate for most patients in this study, doses may need adjustment according to individual response.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Pharmacokinetics of rabeprazole following single intravenous and oral administration to healthy subjects.

The study was designed to determine the absolute bioavailability of 20 mg rabeprazole tablets in normal, healthy subjects in comparison with intravenous administration of 20 mg rabeprazole. Twenty-eight healthy subjects were enrolled in this study. The study was a randomized, balanced, open-label, 2-period crossover study. Each subject was randomized at the beginning of the study to receive either a single 20 mg dose of rabeprazole intravenously or orally during Period 1. Following a 7-day washout period, all subjects received the alternate formulation during Period 2. Intravenous dose was given in constant infusion over five minutes. The absolute bioavailability of rabeprazole was 51.8%. The elimination half-life of rabeprazole sodium (1.47 +/- 0.82 h) after oral administration was significantly longer than the elimination half-life after intravenous administration (1.02 +/- 0.63 h), probably due to slower rate of absorption than that of elimination. The mean total body clearance was 283 +/- 98 ml/minutes following a 20 mg intravenous dose. The administration of rabeprazole sodium was safe as evidenced by the lack of serious adverse events and the rapid resolution of the mostly mild adverse events that occurred during the study. Both treatments were well-tolerated throughout the study. Rabeprazole was well-absorbed after oral administration.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Actigraphy and parental ratings of sleep in children with attention-deficit/hyperactivity disorder (ADHD).

STUDY OBJECTIVES: To assess various sleep parameters in latency-aged children with ADHD and their normally developing peers through the use of multiple sleep measures. DESIGN: Six sleep parameters were evaluated for two groups of children, ADHD and normal comparison. Each group consisted of 25 children (20 males, 5 females) who ranged in age from 7 to 11 years. All children underwent rigorous diagnostic procedures and the ADHD subjects were selected only if they displayed pervasiveness in their symptomatology and were medication naive. Parents completed a retrospective questionnaire which evaluated sleep problems over the past six months. Additionally, each child wore an actigraph for seven consecutive nights, and the child's parents completed a sleep diary during this time period. SETTING: N/A. PATIENTS OR PARTICIPANTS: N/A. INTERVENTIONS: N/A. RESULTS: Based on the findings from the questionnaire, parents of children with ADHD reported significantly more sleep problems than parents of normally developing children. However, the majority of these sleep differences were not verified through actigraphy or sleep diary data, with the exception of longer sleep duration for children with ADHD and parent reports that describe increased bedtime resistence. It was also found that child-parent interactions during bedtime routines were more challenging in the ADHD group. CONCLUSIONS: Despite the possibility of intrinsic sleep problems such as longer sleep duration, results indicate that many of the sleep problems of children with ADHD may be due to challenging behaviours during bedtime routines. The reason for discrepancies among sleep studies employing objective measures as well as between retrospective and prospective measures are discussed.

Attention Deficit Disorder with Hyperactivity↗

Theoretical and practical considerations in the psychological and educational assessment of the student with intractable epilepsy: dynamic assessment as an adjunct to static assessment.

Assessing the student with intractable epilepsy requires skill not only in evaluating cognitive problems, but also detecting seizures and discovering how to adapt instruction to minimize their negative impact on learning. Ironically, assessment efforts are seen as compromised by the occurrence of seizures during testing, when determining how seizure events may interfere with learning and the instructional modifications that are necessary to cope with them, should be a key part of assessment. A dual approach to assessment is recommended that combines the identification of cognitive deficits with an evaluation of how recurring seizures may prevent the student from engaging in instruction. Without also evaluating the student's response to instruction, teaching to specific cognitive needs is limited by insufficient knowledge about how to keep the student involved in instruction when seizures occur. Static assessment evaluates cognitive functioning at the time of testing, without changing the way that the student learns and responds. By engaging the student in teaching/learning sessions, dynamic assessment explores how the student best learns despite cognitive deficits and the disruptive effect of seizures. This paper includes a description of the authors'experience in using dynamic assessment as an adjunct to static assessment in evaluating a student with intractable epilepsy.

Child↗

Spatial and emotional aspects of language inferencing in nonverbal learning disabilities.

Although subtle linguistic deficits have been postulated for children identified with nonverbal learning disabilities (NLD), there is little empirical evidence to support this contention. Two experimental language inferencing measures that have been demonstrated to be problematic for individuals with right hemisphere brain damage (RHBD) and one norm-referenced inferencing task were examined in three groups of children aged 9-13: (1) children with NLD (n = 14), (2) children with verbal impairments (VI) (n = 14), and (3) children without learning disabilities who served as controls (n = 19). The NLD and VI groups did not differ from one another on any of the three measures, indicating a generalized language inferencing deficit in the NLD group. Relative to the control group, however, the NLD group experienced specific difficulties with spatial and emotional inferencing. The implications for right hemisphere involvement in the NLD profile are examined in relation to the effects of working memory on inferential abilities.

Adolescent↗

Effect of methylphenidate on attention in children with attention deficit hyperactivity disorder (ADHD): ERP evidence.

Methylphenidate is the most common treatment for attention deficit hyperactivity disorder (ADHD) and has been shown to improve attention and behaviour. However, the precise nature of methylphenidate on specific aspects of attention at different dose levels remains unclear. We studied methylphenidate effects in ADHD from a neurophysiological perspective, recording event-related potentials (ERPs) during attention task performance in normal controls and children with ADHD under different dose conditions. Twenty children with ADHD and 20 age matched controls were assessed with a continuous performance task requiring subjects to identify repeating alphabetic characters. ERPs and behavioural measures were recorded and analyzed for trials where a correct response was made. The ADHD group was assessed off drug (baseline) and on placebo, low (0.28 mg/kg) and high (0.56 mg/kg) dose levels of methylphenidate. The results showed that the ADHD group at baseline was more impulsive and inattentive than controls and had shorter P2 and N2 latencies and longer P3 latencies. Low dose methylphenidate was associated with reduced impulsivity (fewer false alarms) and decreased P3 latencies, whereas the higher dose level was associated with reduced impulsivity and less inattention (more hits), as well as increased P2 and N2 latencies and decreased P3 latencies. Amplitudes were unaffected and there were no adverse effects of the higher dose for any of the children. These results suggest differential dosage effects and a dissociation between dose levels and aspects of processing.

Attention↗

Sleep problems in children with attention-deficit/hyperactivity disorder: impact of subtype, comorbidity, and stimulant medication.

OBJECTIVE: To determine the relationship of sleep problems to attention-deficit/hyperactivity disorder (ADHD), diagnostic subtype, comorbid disorders, and the effects of stimulant treatment. METHOD: On the basis of clinical diagnostic interviews, children aged 6 to 12 years were assigned to 4 groups: unmedicated ADHD (n = 79), medicated ADHD (n = 22), clinical comparison (n = 35), and healthy nonclinical comparison (n = 36). These groups were compared on 2 sleep questionnaires completed by the parents that assessed current sleep problems and factors associated with sleep difficulties (i.e., sleep routines, sleep practices, child and family sleep history). RESULTS: Factor analysis revealed 3 sleep problem categories: dyssomnias, parasomnias, and sleep-related involuntary movements. Linear regression analyses showed that (1) dyssomnias were related to confounding factors (i.e., comorbid oppositional defiant disorder and stimulant medication) rather than ADHD; (2) parasomnias were similar in clinical and nonclinical children; and (3) the DSM-IV combined subtype of ADHD was associated with sleep-related involuntary movements. However, sleep-related involuntary movements were more highly associated with separation anxiety. CONCLUSIONS: The results suggest that the relationship between sleep problems and ADHD is complex and depends on the type of sleep problem assessed as well as confounding factors such as comorbid clinical disorders and treatment with stimulant medication.

Attention Deficit Disorder with Hyperactivity↗

Future value and patch choice in least chipmunks.

Animals subsisting on non-renewing patches confront a unique valuation problem, in which the objective value of a patch is inversely related to the amount already harvested. We investigated whether the subjective patch valuations of captive least chipmunks, Tamias minimus, reflected this environmental constraint as they foraged for buried patches of seeds. On the day following partial depletion of two patches, chipmunks spontaneously selected the least depleted patch, despite having no direct information about its former or present value. These findings held across experiments in which the order and extent of patch depletion were under the forager's control or experimental control. The animals consistently chose sites from which they had taken the fewest items, despite experiencing no difference in relative capture rate, suggesting that they discounted patch value on the basis of amount harvested or harvest time. Furthermore, the animals refused to return to patches they had completely depleted, and when induced to re-dig depleted patches by placing seeds above them, the animals chose randomly despite a three-fold difference in the number of items previously taken from each, suggesting that they disregarded rewards taken, attending only to the amount remaining. Subsequent experiments showed that chipmunks can take past reward history into account. When we refilled previously depleted patches and induced chipmunks to re-dig and deplete them again, they treated the patches as renewable types and represented their value in terms of the amount removed, not the amount left. Thus, the assessment mechanism of least chipmunks is facultative: they expect that patches will not replenish, but are prepared for exceptions. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.

Journal Article↗

Tissue-specific methylation differences and cognitive function in fragile X premutation females.

Tissue-specific variation in (CGG)n repeat size and methylation status of the FMR1 gene was investigated in 17 female premutation carriers. Minor variation in premutation repeat size among leukocyte, lymphoblast, and fibroblast tissues was noted in some subjects. One subject exhibited a premutation size allele of (CGG)64 in leukocyte and fibroblast tissues by polymerase chain reaction analysis but a normal-size allele of (CGG)46 in lymphoblast cells, suggesting low-level mosaicism in blood and clonality of the lymphoblast cell line. Six subjects exhibited differences in methylation pattern between leukocytes and lymphoblasts but not between leukocytes and fibroblasts, whereas 2 subjects showed large differences in methylation pattern between leukocytes and fibroblasts. Cognitive function was studied in 14 subjects using the Wechsler Adult Intelligence Scale-Revised. Mean Verbal and Performance IQs were well within the average range as was the mean Full Scale IQ; nevertheless, a trend toward lower Performance IQ compared with Verbal IQ was observed. No significant correlation was apparent between Full Scale IQ and (CGG)n repeat size; however, a significant positive correlation was observed between Full Scale IQ and the proportion of the active X carrying the normal FMR1 allele in fibroblasts but not in leukocytes or lymphoblasts.

Adult↗

Methylphenidate slows right hemisphere processing in children with attention-deficit/hyperactivity disorder.

To examine the effects and particularly, any potential detrimental effects of methylphenidate on right hemisphere processing in children with attention-deficit/hyperactivity disorder (ADHD), the performance of 26 children (aged 8-15 years) with ADHD was compared under methylphenidate and placebo on various cognitive tasks in a double-blind within-subjects design. Results indicated that reaction times on a tachistoscopic task were slower on methylphenidate for stimuli that produced a left visual field advantage (reflecting better right hemisphere functioning) but not for stimuli that produced a right visual field advantage (reflecting better left hemisphere functioning) or for bilateral stimuli. It is argued that methylphenidate induces a slower response on tasks involving right hemisphere processing, resulting in slower reaction times and unchanged accuracy rates. Findings on two tasks that more closely reflect classroom-type tasks revealed an improvement in performance on methylphenidate, suggesting that any stimulant-induced benefits on learning style may have overcome detrimental effects on unilateral processing. These findings may help understand the complex, diverse, and sometimes unpredictable effects of psychostimulants on cognitive functioning that are observed clinically in individuals treated for ADHD.

Adolescent↗

Evidence of nonverbal learning disability among learning disabled boys with sensory integrative dysfunction.

The presumed sensorimotor basis of the nonverbal learning disability syndrome was investigated among 90 learning disabled boys (M age = 6 yr., 8 mo., SD = 12.2 mo.) with sensory integrative dysfunction. The majority of the boys were Caucasian, lower to middle socioeconomic status, and from urban, English-speaking families. 14% (n = 13) of the boys satisfied core discrepancy criteria for nonverbal learning disability, including both a significantly higher Wechsler Verbal than Performance IQ and a higher standard score in Reading than Arithmetic on the Wide Range Achievement Test. Compared with a control group of 19 boys from the same sample who had no significant discrepancies, boys with nonverbal learning disability had significantly greater weaknesses in space visualization and visuomotor coordination. As predicted, rote verbal memory and syntactical strengths were also exhibited by boys with nonverbal learning disability, but the two groups did not differ significantly.

Child↗

Teacher-identified oral language difficulties among boys with attention problems.

Teachers evaluated the language functioning of 95 boys, aged 6.5 to 13.8 years, identified as having attention problems (AP, n = 30), learning disability (LD, n = 33), or average achievement (AA, n = 32). The three groups did not differ significantly (p > .05) in their frequency of articulation problems. Significantly (p < .05) more AP boys were rated as having pragmatics problems than both of the other groups. AP boys were also viewed as having a higher frequency of receptive/expressive language problems than were AA boys, but not compared with LD boys. LD and AA boys did not differ in their ratings for pragmatics problems, but more LD than AA boys were perceived as having receptive/expressive problems. The average incidence of all types of language problems was highest for the AP boys at 42% with poor pragmatics representing their most frequently rated language difficulty. AP boys' pragmatics difficulties seemed to be characterized by greater difficulty in maintaining than initiating a conversation compared with the other two groups. This difficulty was positively associated with the teachers' ratings of the AP boys' impulsivity.

Adolescent↗

Use of IQ criteria for evaluating the uniqueness of the learning disability profile.

Beyond predetermined Performance Scale differences, a group of 24 children with learning disabilities having a lower Verbal, higher Performance IQ profile on the WISC-R and 33 slow learners were not found to be otherwise distinguished by their individual WISC-R subtest scores or subtest scatter. The majority of children were males, white, of lower to middle socioeconomic status and ranged in age from 6 to 13 years.

Adolescent↗

A comparison of the effectiveness of sensory integrative therapy and perceptual-motor training in treating children with learning disabilities.

This study compared the effect of sensory integration therapy (SI), perceptual-motor training (PM) and no treatment (NT) on the performance of 103 children with learning disabilities and sensory integrative dysfunction, aged 58 to 107 months, who were randomly assigned to one of the two treatment groups or to no treatment. After receiving a total of 72 1-hour sessions of therapy for 3 hours per week, PM-treated subjects showed significant gains over the other two groups, primarily in gross motor performance. SI-treated subjects showed an advantage in motor planning. There were no accompanying group differences in visual perception, handwriting readiness, copying ability, cognitive, academic, language and attentional skills or in self-concept. These findings demonstrate motor gains resulting from motor treatments without carry-over to functional skills and abilities more directly associated with school performance.

Attention↗

Attention deficit hyperactivity disorder: does cognitive behavioral therapy improve home behavior?

This study evaluates the effectiveness of cognitive behavioral therapy (CBT) in improving the home behavior of children with attention deficit hyperactivity disorder (ADHD). Twenty-five boys (age 7 to 13) with a diagnosis of ADHD were randomized to a CBT or supportive therapy control group. Outcome measures included parent and teacher ratings of the child on the Behavior Problem Checklist-Attention Problem Subscale (BPC-AP), and the Self-Control Rating Scale (SCRS), parent ratings on the Modified Werry Weiss Activity Scale, and child ratings on the Piers Harris Self-Concept Scale and Matching Familiar Figures Task. Data were analyzed using a two-way analysis of variance for main effects. A significant improvement favoring CBT was found on the Werry Weiss Scale, which measures the parent's perception of the child's hyperactivity in the home, and the child's rating of his/her self-esteem on the Piers Harris Self-Concept Scale. Other outcome measures did not demonstrate statistical differences. This research provides support for the use of CBT in children with ADHD. CBT was found to improve the parent's perception of the child's hyperactivity in the home as well as the child's self-esteem.

Adolescent↗

A categorical analysis of the social attributions of learning-disabled children.

The social attributions of learning-disabled and control children with either similar or higher social acceptance ratings were assessed within an open-ended interview format. In addition, measures of social self-esteem and expectation of social success were obtained. The learning-disabled group used luck more frequently and personality interaction less frequently as explanations for social outcomes than did the other two groups. Learning-disabled children also had the lowest expectation of social success and, like the low acceptance group, had a poorer social self-image. Possible explanations for the development of these attributions and the implications for holding them were discussed.

Child↗

Mediators of the risk for problem behavior in children with language learning disabilities.

A developmental-organizational perspective was employed to explore underlying risk for problem behavior in children with language learning disabilities. The independent and relative influences of social discourse and social skills on problem behavior were examined in 50 children with language learning disabilities (LLD) and 50 control children (children without LLD) aged 8 to 12 years. Hierarchical regression analyses revealed that when examined independently, both impaired social discourse skill and poor social skills accounted for the negative effect of LLD status on children's problem behavior. When social discourse and social skills were examined simultaneously in relation to problem behavior, social discourse no longer retained its predictive value. This result suggests that children's impaired social interactional functioning is central to the development of behavioral symptomatology. However, the importance of social discourse cannot be overlooked, given the significant correlation between social discourse and social skills ratings. Though these results are correlational in nature, it is argued that the impaired communicative competence of some children with LLD may contribute to poor social skills that ultimately manifest themselves as more clinical problem behaviors characterized by internalizing and externalizing symptomatology. Finally, differences were confirmed in social discourse performance, social skills, and problem behaviors between the children with LLD and the control group children. Findings emphasize the importance of the routine assessment and monitoring of broader social discourse skills, in addition to social competence, in children with LLD.

Child↗