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PubMed2006

Racial and ethnic differences in unmet need for vision care among children with special health care needs.

OBJECTIVE: To examine racial and ethnic differences in unmet need for vision care among children with special health care needs. METHODS: Cross-sectional data from the National Survey of Children with Special Health Care Needs were analyzed. The analytic sample was 14,070 children with special health care needs who needed eyeglasses or vision care in the previous year. Children who did not receive all the eyeglasses or vision care they needed were considered to have unmet need for vision care. RESULTS: Of the sample, 5.8%, representing approximately 198,600 children with special health care needs in the United States, had unmet need for vision care. Rates of unmet need ranged from 2.5% to 14.3% across the 7 racial and ethnic groups studied. Relative to whites, children of African American, Latino, and multiracial backgrounds had approximately twice the adjusted risk of unmet need, whereas American Indian or Alaskan Native children had a lower adjusted risk. Health care providers, school personnel, insurance coverage, and other factors also contributed to differences in the risk of unmet need, independently of child race/ethnicity. CONCLUSION: Further research is needed to explain and address the causes of racial and ethnic differences in unmet need for vision care among children with special health care needs.

Adolescent↗
PubMed2005

Responding to persons with mental illnesses: police perspectives on specialized and traditional practices.

Persons with mental illnesses increasingly come into contact with police in the community due to changes in local and national policies and police responsibility for maintaining order. Recently, specialized intervention strategies have been advanced to ensure that persons with mental illnesses are not inappropriately arrested and moved into the criminal justice system. This study builds on previous research undertaken on police perceptions of dealing with persons with mental illnesses in the community and effectiveness of response (see Borum et al., 1998). A subsample of 182 officers from the Newark, NJ, Police Department was surveyed and added to a sample of 452 officers from three agencies with specialized responses to persons with mental illnesses. The authors conclude that, despite a non-specialized response to this population, the actual and perceived effectiveness of Newark's strategy is similar to (and in some cases better than) that which is observed in the agencies with specialized response programs. Implications for implementing specialized responses for persons with mental illnesses are discussed.

Adult↗
PubMed2005

Moringua edwardsi (Moringuidae: Anguilliformes): cranial specialization for head-first burrowing?

The order Anguilliformes forms a natural group of eel-like species. Moringua edwardsi (Moringuidae) is of special interest because of its peculiar fossorial lifestyle: this species burrows head-first. Externally pronounced morphological specializations for a fossorial lifestyle include: reduced eyes, lack of color, low or absent paired vertical fins, elongated, cylindrical body, reduced head pores of the lateral line system, etc. Many fossorial amphibians, reptiles, and even mammals have evolved similar external specializations related to burrowing. The present study focuses on osteological and myological features of M. edwardsi in order to evaluate the structural modifications that may have evolved as adaptations to burrowing. Convergent evolutionary structures and possible relations with head-first burrowing, miniaturization, feeding habits, etc., were investigated. Body elongation, reduction of the eyes, modified cranial lateral line system, and modified skull shape (pointed though firm) can be considered specializations for head-first burrowing. Hyperossification can probably be regarded more as a specialization to both head-first burrowing and feeding, even though an impact of miniaturization cannot be excluded. Hypertrophied adductor mandibulae muscles and the enlarged coronoid process can be associated with both feeding requirements (it enhances bite forces necessary for their predatory behavior) and with a burrowing lifestyle, as well as miniaturization.

Adaptation, Biological↗
PubMed1994

Specialized ribosomes allow for the study of mutations in functionally important regions in 16 S rRNA, without affecting cell growth. The identification of functional regions in the central domain of 16S rRNA.

In order to identify the sequences in the central domain of 16 S rRNA of Escherichia coli that are important for ribosome function, we have generated random mutations using a PCR-based mutagenesis technique. We show that the effects of such mutations on ribosomal activity can be analyzed in vivo utilizing the specialized ribosome system. With this system the effect of rRNA mutations on ribosomal activity can be studied by measuring the translation of a modified CAT-mRNA by specialized ribosomes. Specialized ribosomes do not translate the endogenous mRNAs and, therefore, are expected to constitute a non-essential pool of ribosomes within the cell. In total, we have isolated 28 different clones harboring specialized ribosomes with single or multiple point mutations. We demonstrate that for none of these clones was cell growth retarded, even though some of the mutations severely impaired the activity of the specialized ribosomes, to as low as 3% of the wild-type level. For all mutants, their individual activities ranged between 3% and 100% of that of the wild-type activity. Comparison of several mutants indicates that mutations within the hairpin loops 787-795 and 898-901 strongly reduce the ribosomal activity. We also present evidence that the single-stranded region centered around residue A815 may be involved in maintaining translational accuracy.

Base Sequence↗
PubMed1997

Evolutionary advantages of cell specialization: save and protect DNA.

As the transcribed regions of nuclear DNA are in a more open state, they are liable to be damaged by naturally or environmentally produced mutagens. Cell specializations make it possible to express fewer genes in individual cells of multicellular organisms, thus protecting genes from the damage of mutagens. We propose that this might account for the advantage of cell specialization, as an alternative to the traditional conception that cell specializations result in increased efficiency. The most efficient cell specialization to protect DNA is in the segregation of germ cell(s) and somatic cell(s). But in optimal environments, such specialization is expected to reduce the rate of reproduction, which might counteract its advantage of protecting DNA.

Animals↗
PubMed1985

Self-labeling by educably mentally retarded high school students in their mainstream and special education classes.

Educably mentally retarded (EMR) students and nonhandicapped students from their mainstream classes completed semantic differential ratings of a stereotypic popular teen-ager, juvenile delinquent, and special education student. Subjects also rated their global self-concepts and situation-specific self-concepts within the mainstream and the special class settings. Ratings were done at the beginning (Time 1) and the end (Time 2) of a semester. Results showed that mainstream classes did not "de-label" EMR students. Within the mainstream class, the number of EMR students who saw themselves as similar to a special education student significantly increased over time. Moreover, at Time 2, EMR students were more likely to think of themselves as similar to a special education student in their mainstream class than in their special education class. However, EMR subjects' global self-concepts did not change. Implications for mainstreaming are discussed.

Adolescent↗
PubMed1984

Membrane specialization and axo-glial association in the rat retinal nerve fibre layer: freeze-fracture observations.

The ultrastructure of non-myelinated ganglion cell axolemma within the retinal nerve fibre layer of adult rats was examined by thin section and freeze-fracture electron microscopy. Most of the axolemma within the nerve fibre layer does not exhibit any membrane specializations; intramembranous particles are partitioned with a density of approximately 1750 microns-2 on the P-fracture face and approximately 225 microns-2 on the E-face of the non-specialized axolemma. The nerve fibres also exhibit specialized foci of axolemma, at which the axons are abutted by the tips of blunt, radially oriented processes from Müller cells. At such sites of axo-glial association, an electron-dense undercoating is present beneath the axon membrane. Freeze-fracture analysis revealed a substantial increase in the density of E-face particles (greater than 500 microns-2) at sites of association between the tips of blunt glial processes and the axon. These findings demonstrate that non-myelinated axolemma of the retinal nerve fibre layer can exhibit spatial heterogeneity, with patches of node-like membrane at regions of specialized association with glial cell processes. On the basis of their morphological similarity to nodes of Ranvier, we suggest that these specialized axon regions represent foci of inward ionic current.

Animals↗
PubMed2006

Mitochondrial cytochrome b sequence variation and phylogenetics of the highly specialized Schizothoracine fishes (Teleostei: Cyprinidae) in the Qinghai-Tibet plateau.

The complete 1140 bp mitochondrial cytochrome b sequences were obtained from 39 individuals representing five species of all four genera of highly specialized schizothoracine fishes distributed in the Qinghai-Tibet plateau. Sequence variation of the cytochrome b gene was surveyed among the 39 individuals as well as three primitive schizothoracines and one outgroup. Phylogenetic analysis suggested that the group assignment based on 1140 bp of the cytochrome b sequence is obviously different from previous assignments, and the highly specialized schizothoracine fishes (Schizopygopsis pylzovi, Gymnocypris przewalskii, G. eckloni, Chuanchia labiosa, and Platypharodon extremus) form a monophyletic group that is sister to the clade formed by the primitive schizothoracine fishes (Schizothorax prenanti, S. pseudaksaiensis, and S. argentatus). The haplotypes of Schizopygopsis pylzovi and G. przewalskii were paraphyletic based on cytochrome b data, which most likely reflected incomplete sorting of mitochondrial DNA lineages. The diploid chromosome numbers of Schizothoracinae were considered in phylogenetic analysis and provided a clear pattern of relationships. Molecular dating estimated for highly specialized schizothoracine fishes suggested that the highly specialized schizothoracine fishes diverged in the late Miocene Pliocene to Pleistocene (4.5 x 10(4)-4.05 x 10(6 ) years BP). The relationship between the cladogenesis of highly specialized schizothoracine fishes and geographical events of the Qinghai-Tibet plateau is discussed.

Animals↗
PubMed2005

Comparing environmental issues in Cuba before and after the Special Period: balancing sustainable development and survival.

Following the Earth Summit in 1992, Cuba designed and implemented a variety of programs, administrative structures, and public awareness activities to promote sound environmental management and sustainable development. This came shortly after the fall of the Soviet Union and the strengthening of the US blockade in 1990, which resulted in a 35% drop in Cuban GDP. This period, referred to as the Special Period, witnessed a decrease in many environmentally damaging activities both by choice and by necessity, but also resulted in many decisions to resuscitate the Cuban economy. The purpose of this work was to compare and rank the environmental risks Cuba faced before and during the Special Period (1990-2000) using two Comparative environmental risk assessments (CERAs). To do so, an ecosystem integrity risk assessment matrix was constructed with 42 risk end points. The matrix assessed the risk posed by 17 problem areas including air pollution, water contamination, solid waste sites, pesticides and ecosystem degradation. The risks were calculated using five criteria: area affected, vulnerability of affected population, severity of impact, irreversibility of effect and uncertainty. To construct this matrix, both literature reviews and expert interviews in Cuba were conducted in 2000. The results showed a general decrease in risk scores during the Special Period. Before the Special Period, high risks were posed by: terrestrial degradation and industrial wastewater and sludge, followed by freshwater degradation, surface water stressors, and pesticides. After the Special Period, industrial wastewater and sludge and pesticides were no longer high-risk areas, but municipal wastewater and marine coastal degradation ranked higher than previously. Also, the risk endpoints most stressed after 1990 were affected by activities controlled by the government, such as mining and tourism, and lack of infrastructure. Therefore, the claims that public environmental education is the main pathway to sustainable development in Cuba seem uninformed and other management practices should be evaluated.

Cuba↗
PubMed2004

Specialization within the ventral stream: the case for the visual word form area.

Is there specialization for visual word recognition within the visual ventral stream of literate human adults? We review the evidence for a specialized "visual word form area" and critically examine some of the arguments recently placed against this hypothesis. Three distinct forms of specialization must be distinguished: functional specialization, reproducible localization, and regional selectivity. Examination of the literature with this theoretical division in mind indicates that reading activates a precise subpart of the left ventral occipitotemporal sulcus, and that patients with pure alexia consistently exhibit lesions of this region (reproducible localization). Second, this region implements processes adequate for reading in a specific script, such as invariance across upper- and lower-case letters, and its lesion results in the selective loss of reading-specific processes (functional specialization). Third, the issue of regional selectivity, namely, the existence of putative cortical patches dedicated to letter and word recognition, cannot be resolved by positron emission tomography or lesion data, but requires high-resolution neuroimaging techniques. The available evidence from single-subject fMRI and intracranial recordings suggests that some cortical sites respond preferentially to letter strings than to other categories of visual stimuli such as faces or objects, though the preference is often relative rather than absolute. We conclude that learning to read results in the progressive development of an inferotemporal region increasingly responsive to visual words, which is aptly named the visual word form area (VWFA).

Dyslexia↗
PubMed2005

Intact hemispheric specialization for spatial and shape working memory in schizophrenia.

OBJECTIVE: Using functional MRI, we investigated whether, like healthy subjects, patients with schizophrenia show a relative hemispheric specialization in ventrolateral prefrontal cortex (PFC) for spatial and shape working memory (WM). We hypothesized that reduced specialization in schizophrenia would reflect a failure to adopt optimal domain-specific strategies and would contribute to WM deficits. METHODS: Twelve healthy subjects and 16 schizophrenia patients performed spatial and shape WM tasks and a non-WM control task. Direct comparisons of the spatial and shape WM tasks assessed specialization. RESULTS: Despite deficient WM performance, both patients and controls showed a relative hemispheric specialization in ventrolateral PFC for spatial (right) and shape (left) WM and did not differ in this regard. CONCLUSIONS: The finding of intact hemispheric specialization in ventrolateral PFC suggests that patients employ the same domain-specific strategies as healthy subjects during spatial and shape WM. Rather than reflecting a failure to adopt the optimal strategy, we hypothesize that WM deficits in schizophrenia reflect impairments of executive processes that are required for WM performance regardless of domain. These processes are associated with activity in the dorsolateral PFC, a region that has been repeatedly implicated in studies of WM.

Adult↗
PubMed1979

Is hemispheric specialization important to scholastic achievement?

Scholastic achievement in both reading and mathematics were examined as a function of hemispheric specialization for visually presented words and pictures. Two groups of subjects (mean ages = 8.8 and 13.3) were included so that hemispheric specialization at an early and later phase of reading sophistication could be monitored. The results indicated that a lack of specialization for words is associated with higher reading achievement in both age groups and that right hemispheric specialization for words is likely to be accompanied by less reading skill. The results were discussed in terms of developmental changes in hemispheric processing and the need to investigate a variety of hemispheric specialization patterns and a variety of acquired skills (music, mathematics, art).

Achievement↗
PubMed1997

Loss of heterozygosity in usual and special variant carcinomas of the endometrium.

Endometrial carcinoma is the most common invasive malignancy of the female genital tract, and it exists as two different clinicopathologic forms: an estrogen-dependent, "usual" type and an estrogen-independent "special variant" type. Despite the frequency of endometrial cancer, little is known about the molecular genetic events that contribute to its pathogenesis. The accumulation of genetic alterations identified through the study of loss of heterozygosity (LOH), gene mutation, and gene activation in tumor DNA has been associated with the establishment and progression of a variety of human malignancies. A relatively low incidence of LOH has been reported in usual type endometrial cancers; however, special variant tumors have rarely been included in the reported studies. To understand the molecular events that contribute to both forms of endometrial cancer, 31 tumors have been surveyed for events of LOH on all chromosomes. The study groups included 18 tumors of the usual type and 13 special variant tumors. Polymorphic loci were studied by Southern blot analysis and polymerase chain reaction (PCR) of microsatellite loci. Normal tissue in each case served as a control. Both frequency and patterns of LOH differed greatly between the two tumor types. Although LOH was frequently detected in the special variant tumors, it was rare in the usual type tumors. LOH was detected in only 8 of the 18 usual tumors, with chromosomes 17, 13, and 2 being the most frequently affected (22%, 20%, and 19%, respectively). In contrast, LOH was detected in all cases of special variant tumors, with chromosomes 17p, 14, and 12 showing the highest LOH (83%, 77%, and 40%, respectively). Two cases of microsatellite instability (MI) were detected among the usual type tumors. These findings suggest that the clinicopathologic phenotypes observed in these tumor types are likely caused by different tumorigenic pathways that reflect alterations of different cancer-controlling genes.

Blotting, Southern↗
PubMedDate not supplied

Effects of specialized community nursing care in patients with chronic obstructive pulmonary disease.

OBJECTIVE: To investigate the effects of specialized respiratory home nursing care after discharge from a pulmonary rehabilitation center. DESIGN: Pretest-posttest control group design. Patients in the experimental group were visited by a nurse who specializes in respiratory care, whereas the control group received care from nurses who did not specialize in respiratory care. SETTING: Data were collected on admission, at program discharge, and 4 months and 9 months after discharge from a pulmonary rehabilitation center. PATIENTS: One hundred fifteen patients were included in the study and observed for 1 year. OUTCOME MEASURES: Health-related quality of life (HRQL), coping strategies, compliance, hospitalization, and satisfaction with the care provided. RESULTS: Complete data sets were obtained from 78 patients with severe airflow obstruction (FEV1 = 41%; predicted +/- SD = 15). Corrections were made for the selective nonresponse, but did not lead to adjustments in outcome scores. In both groups, HRQL scores improved between admission and discharge, but deteriorated 4 months and 9 months after discharge. The only statistically significant short-term effect was found on the "activities" component of HRQL in favor of the control group. No differences were found between groups regarding coping, compliance, and hospitalization. Patients in the experimental group, however, were more satisfied with the care provided by the specialized community nurses. CONCLUSIONS: The treatment intervention of specialized respiratory home nursing might not have been specific or intensive enough to result in outcome benefits. Secondly, the initial benefits from baseline pulmonary rehabilitation alone may have led to positive outcomes in both patient groups.

Adult↗
PubMed2002

Transient evoked otoacoustic emissions in children studying in special schools.

OBJECTIVES: The present study aimed to investigate the feasibility and practicalities of testing children in special school settings using transient evoked otoacoustic emissions (TEOAE) and tympanometry. Children studying in special schools, particularly those with intellectual impairment, may be highly susceptible to hearing pathologies and can be difficult to assess using traditional test batteries. Researchers have recently suggested the possible applicability of TEOAE testing, in lieu of conventional behavioral methods, as a hearing screening device for persons with intellectual impairment. However, to date, few publications have detailed the particulars and results of such testing. METHODS: A total of 489 children, with a mean age of 9.6 years, were tested in 15 special schools. Case information was obtained regarding birth history, medical history and type/degree of impairment, for later comparison with screening results. TEOAEs were collected using Quickscreen mode of the ILO292 Otodynamics Analyzer, whilst tympanometry was performed utilizing a Madsen Zodiac 901 Middle Ear Analyzer. RESULTS: In total, 80% of students were able to be tested using TEOAEs. Average test time per ear was 2 min. However, a large proportion (40% of those able to be tested) failed TEOAE testing in at least one ear. No significant effects were found between could-not-test (CNT) cases and case history factors. A significant difference in TEOAE failure rates was found across history of neonatal special care nursery residency and history of parental concern regarding possible hearing impairment. Failure rates were higher for those who indicated positive histories. A total of 74% of subjects could be tested using tympanometry, with 25% of those able to be tested failing in at least one ear. Notably, neither type nor degree of impairment had any significant bearing on CNT or failure rates for tympanometry or TEOAE screening. CONCLUSIONS: Findings of the present investigation lend support to the review of hearing screening programs for children in special schools, with TEOAEs presenting as a potential alternative procedure. Further examination of the performance measures of protocols incorporating TEOAEs would now be advantageous.

Acoustic Impedance Tests↗
PubMed2002

[Smoking cessation in primary and specialized care: a real opportunity and a public health necessity].

AIM: To determine whether primary care provides a suitable framework for integrated treatment aimed at smoking cessation with systematic minimal intervention or pharmacological treatment with nicotine replacement therapy (NRT). To compare the results with those obtained in a specialized pneumology unit. DESIGN: Prospective, quasi-experimental study. SETTING: Primary and specialized care services. PARTICIPANTS: 357 smokers who were followed at a health center (166) or a specialized clinic (191) during a 6-month period. INTERVENTIONS: Two types of intervention were used depending on the patients' degree of nicotine dependence: systematic minimal intervention for those with low dependence or who were still in the contemplation or precontemplation phase, and NRT for those with high dependence, in the preparation phase. MAIN OUTCOME MEASURES: Twelve months after the start of the study, abstinence among participants who received systematic minimal intervention was 36.5% in primary care patients and 41.8% in specialized care patients (P>.05). Among participants who received NRT abstinence was 37.1% in the former group and 35.5% in the latter (P>.05). The percentage of patients lost to follow-up was 8.6% in specialized care and 6.3% in primary care. CONCLUSIONS: The results lead us to recommend smoking cessation treatment integrated in the primary care setting, either with systematic minimal intervention or NRT.

Adult↗
PubMed2003

Complementary hemispheric specialization for word and accent detection.

When we hear a familiar word pronounced in a foreign accent, which parts of the brain identify the word and which identify the accent? Here we present converging evidence from PET blood flow, event-related scalp potentials, and behavioral responses during dichotic listening, showing homologous and complementary hemispheric specialization for word and accent detection. Accuracy of detecting target words was greater when stimuli were presented to the right ear, indicating left hemisphere specialization, with no ear advantage for detecting target accents. Detection of words also produced increased blood flow in a left frontal area associated with motor and phonetic processing, and a left temporal area associated with semantic memory. Homologous areas of the right hemisphere, together with right prefrontal and precuneus regions, showed increased blood flow during detection of accents. Separate analyses for each detection task indicated that voxels whose activity maximally correlated with accuracy were in the left hemisphere for word detection, but in the right hemisphere for accent detection. Voxels whose activity maximally correlated with inaccuracy were in the opposite hemisphere for both tasks, strengthening the interpretation that between-task differences in brain activation are related to lateralized specializations for task performance. ERP waveforms and reaction times suggested that greater left hemisphere activation during word detection preceded greater right hemisphere activation during accent detection. The results are interpreted as supporting left hemisphere specialization for extraction of the linguistic, phonetic, and semantic information contained in speech, and right hemisphere specialization for pragmatics, the social context of linguistic communication.

Adult↗
PubMed2004

How children with special health care needs affect the employment decisions of low-income parents.

OBJECTIVES: To better understand the impact of having a child with special health care needs (CSHCN), on low-income parents' employment decisions. METHODS: Using data from the 1999 and 2000 National Health Interview Survey (NHIS), we estimate multivariate statistical regressions (logit and tobit models) to estimate the relationship between having a CSHCN and the likelihood of employment and hours of employment for a sample-of low-income single parents. RESULTS: Controlling for differences in demographic and family characteristics, we find no significant association between having a CSHCN and the probability of work or the number of hours worked among low-income single-parent families. Separate analysis of different dimensions of special health care needs shows that parents of children with activity limitations are significantly less likely to work and work fewer hours. This result does not hold true for the group of children defined based on elevated or special service use, or for the group of children with specific chronic conditions. CONCLUSIONS: These results indicate that only a specific subset of children with special needs present difficulties for low-income parents' work. This suggests that policies to help low-income single parents of children with disabilities move into work should target this specific subset of children with special health care needs.

Adolescent↗