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At least 685 records · Page 38Linked to original sources
PubMed2003

Evaluating a practice-oriented service model to increase the use of respite services among minorities and rural caregivers.

PURPOSE: The goal of this study was to evaluate the practice-oriented model of service use (Yeatts, Crow, & Folts, 1992) relative to the more widely used behavioral model ( Andersen, 1968) in its ability to explain the use of respite services by caregivers of Alzheimer's patients. Unlike the behavioral model, which focuses primarily on characteristics of the service user, the practice-oriented model focuses primarily on characteristics of the service. DESIGN AND METHODS: Interview data from 1,158 caregivers participating in the Alzheimer's Disease Demonstration Grants to States program ( Montgomery, Kosloski, Karner, & Schaefer, 2002) were analyzed. Separate regression models were estimated for adult day care and in-home respite, using the full information maximum likelihood procedure described by Arbuckle (1996), and ordinary least squares regression with listwise deletion of missing data. RESULTS: The findings indicate that the factors related to respite use tapped by the practice-oriented model add significantly to explanatory models of service use over models that use only the factors typically represented by the behavioral model. Additional analyses, including a set of interactions with ethnicity, indicated that this improvement occurs primarily for White and Hispanic caregivers, and less so for African Americans. IMPLICATIONS: The findings are discussed in terms of their implications for enhancing the timely use of respite services and directions for future research.

Alzheimer Disease↗
PubMed1983

Clinically mild tularemia associated with tick-borne Francisella tularensis.

Between May 9 and July 3, 1979, 12 cases of glandular or ulceroglandular tularemia occurred in residents of the Crow Indian Reservation in southcentral Montana; only 13 cases had been reported from this geographic area in the preceding 25 years. The illness was mild, characterized by fever and cervical or occipital adenopathy. Systemic symptoms were self-limited although residual lymphadenopathy was common. Francisella tularensis was isolated from ticks (Dermacentor variabilis), the suspected vector. The strains of F tularensis did not ferment glycerol and thus were identified as type B rather than the more virulent type A. None of 83 adults hospitalized in an urban area 50 miles from the reservation had agglutination titers of antibody to F tularensis of greater than or equal to 1:40 compared with eight of 77 patients at the reservation hospital (P less than 0.01). Mild tularemia in reservation residents may have gone unrecognized; similar illness due to type B F tularensis may occur elsewhere.

Adult↗
PubMed2006

Psychiatry and race during World War II.

Although the American literature on "war neuroses" expanded during World War II, psychiatrists remained more interested in dramatic instances of "combat fatigue" than in the problems of soldiers who broke down far from the field of battle. This bias in the medical literature shaped both diagnosis and treatment. It had an especially powerful effect on African American soldiers who, in the "Jim Crow" army of World War II, were assigned in disproportionate numbers to service units. When military neuropsychiatrists did write about troubled young African Americans, many revealed a racial conservatism that was surprising given the liberal environmentalist paradigm of the day. (Here, a particularly useful source is the two-volume history of Neuropsychiatry in World War II, produced by the Medical Department of the U.S. Army.) The major challenge to such views came from the National Medical Association (NMA). Despite its many criticisms of military medicine, the NMA argued that African American soldiers and veterans needed more, not fewer, psychiatric services. NMA members also joined their white counterparts in the campaign to diminish the stigma of mental illness, especially among the families of soldiers returning home. We need more investigation of the subsequent history of race and psychiatry, especially within the Veterans Administration.

Black or African American↗
PubMed1993

Recovering phylogenetic signal from DNA sequences: relationships within the corvine assemblage (class aves) as inferred from complete sequences of the mitochondrial DNA cytochrome-b gene.

Phylogenetic analysis of cytochrome-b sequences and cranial osteological characters for nine genera of corvine passerine birds supports the hypothesis that the two major groups of birds of paradise, the manucodines and paradisaeinines, constitute a monophyletic group and that their postulated sister group is the Corvidae (crows, jays, and allies). The data are also consistent with the hypothesis that the bowerbirds are not closely related to the birds of paradise but instead lie near the base of the corvine assemblage. The corvine radiation exemplifies a case of multiple star phylogenies embedded within a major clade, with the branching pattern characterized by very short internodal divergence times. Such histories are difficult to resolve no matter what type of data is employed, because little change accumulates between branching events. With respect to sequence data, reconstructed tree topologies are sensitive to the choice of outgroup and to the method of analysis (e.g., transversion vs. global parsimony). In such cases, assessing the "reliability" of a best-fit or most-parsimonious tree inferred from any particular data set becomes problematic. Statistical tests of tree topologies that depend on random sampling of characters will generally be inconclusive in that all cladistic components will tend to be poorly supported because relatively few character-state changes will be recorded between branching events. It is suggested, on the other hand, that congruence in cladistic signal across different data sets may be a potentially more useful method for evaluating the reliability of the signal of any one data set. Resolution of star phylogenies will probably be possible only if DNA sequence and morphological characters are combined in a single analysis.

Animals↗
PubMed2001

Speech disorder in schizophrenia: review of the literature and exploration of its relation to the uniquely human capacity for language.

The language capacity of modern humans is thought by some to be clearly distinct from that of nonhuman primates (Bickerton 1990). Crow (1997, 1998a) has proposed that a disturbance in the uniquely human aspects of language is central to the genetic etiology of schizophrenia. A review of the literature on language disorder in schizophrenia provides evidence for widespread deficits in comprehension, production, attention, and cerebral lateralization of language. We focused here on those anomalies that are uniquely human aspects of language. Bickerton's five distinctly human language devices were examined in patients with schizophrenia and their families by using a structured scoring format on oral soliloquies. The chronic patients showed reduced use of clausal embedding and used fewer words than first episode patients or well family members. The amount of sentence complexity was found to be familial and to cosegregate with schizophrenia within families. These data are consistent with previous literature and additionally show a familial component to these measures, thus suggesting that deficits in specifically human aspects of language may be related to the genetics of schizophrenia.

Adult↗
PubMed2006

Effects of formalin feeding or administering into the crops of white leghorn cockerels on hematological and biochemical parameters.

Formalin administered (15 and 20 mL) into the crops of White Leghorn cockerels resulted in behavioral alterations, included depression, dullness, staggering, somnolence, anorexia, and decreased frequency of crowing. A significant decrease was observed in red blood cell counts, hemoglobin concentration, packed cell volume, and leukocyte counts in birds fed higher levels of formalin. Decreasing and increasing trends in concentrations of serum proteins and enzymes, respectively, were observed with increases in formalin doses. Significantly lower blood glucose and testosterone levels and significantly (P < 0.05) higher blood urea and creatinine concentrations were observed in birds fed higher formalin levels. No gross or microscopic lesions were observed in the birds fed different levels of formalin mixed in feed. These changes suggested that the formalin mixed in feed might have evaporated, and, hence, the amount ingested might have been too low to induce pathological changes. It was concluded from the present study that formalin mixed up to 5 mL/kg of feed, corresponding to 10 mL/bird of 3% formalin in drinking water by crop tube had no adverse effects on the health of White Leghorn cockerels.

Administration, Oral↗
PubMed1985

Positive and negative schizophrenic symptoms, attention, and information processing.

This study was concerned with the relationship between attentional and information-processing deficits and positive vs. negative symptoms in schizophrenia. Sixteen schizophrenic patients, rated for extent of positive and negative symptomatology, 17 depressed patients, and 31 normal control subjects were tested on a measure of distractibility and ability to process under information overload. To establish the validity of our measures, schizophrenic patients were compared with depressed patients and with normal control subjects. Lowered processing capacity appeared to be specific to schizophrenia, although the specificity of differential distractibility was less clear. For schizophrenic patients, positive symptoms were related to distractibility, whereas negative symptoms were associated with lowered processing capacity. These findings were interpreted as supporting Crow's (1981) hypothesis that the two clinical syndromes reflect independent pathological processes.

Adult↗
PubMed1988

The role of serotonin in schizophrenia.

Studies examining serotonin (5-hydroxytryptamine; 5HT) in schizophrenia show variable and inconsistent findings, which might reflect the heterogeneity of the disease. When these studies are reviewed in the light of Crow's "two-syndrome" paradigm of schizophrenia, a new trend emerges. It appears that 5HT findings may be related to certain features of Type II schizophrenia such as negative symptoms, degenerative brain changes, and chronicity in the following manner: (1) 5HT2 antagonists, which have recently become available, have been shown to have an antipsychotic effect, particularly on the negative symptom cluster. (2) Decreased levels of 5-hydroxyindoleacetic acid in cerebrospinal fluid have been found to be correlated with cortical atrophy or ventricular enlargement in schizophrenic patients. (3) A subgroup of chronic schizophrenic patients has been shown to have elevated levels of platelet or whole blood 5HT. We propose, then, that 5HT dysfunction might be related to Type II, or negative syndrome, schizophrenia, and that the nature of this dysfunction might involve 5HT postsynaptic receptor hypersensitivity. We further suggest that the pharmacotherapy of schizophrenia should include a 5HT-blocking component, as well as a dopamine-blocking component, and we propose that future research should address the role of selective 5HT receptor hypersensitivity in schizophrenia.

Brain↗
PubMed1991

Examining the underlying structure of schizophrenic phenomenology: evidence for a three-process model.

The present report examined the latent structure of schizophrenic phenomenology. Schizophrenic patient case histories (n = 192) were rated for positive symptoms, negative symptoms, and premorbid social adjustment and the observed covariation among these clinical features was evaluated using a model-based confirmatory factor analytic approach. Our results indicated that schizophrenic phenomenology was best characterized by three distinct underlying structures. These data provide empirical support for Strauss et al.'s (1974) three-process model, which suggests that positive symptoms, negative symptoms, and disordered premorbid personal-social relationships are three distinct classes of phenomenology possibly reflective of three relatively independent pathological processes in schizophrenia. The data are also consistent with Crow's (1980, 1985, 1987) model of schizophrenic symptomatology, differentiating social impairment from both positive and negative symptoms. The heuristic implications of these data for the development of schizophrenia are discussed and the utility of a replication of the present study is noted.

Adult↗
PubMed1996

Induction of anesthesia and tracheal intubation with sevoflurane in adults.

BACKGROUND: The speed, quality, and cost of mask induction of anesthesia and laryngeal mask airway insertion or tracheal intubation were studied in young non-premedicated volunteers given high inspired concentrations of sevoflurane (6 to 7%). METHODS: Twenty healthy persons who were 19 to 32 years old participated three times, received 6 l/min fresh gas flow, and were randomized to receive 6 to 7% sevoflurane in 66% nitrous oxide/28% oxygen by face mask until tracheal intubation (treatment 1) or until laryngeal mask airway insertion (treatment 3), or 6 to 7% sevoflurane without nitrous oxide to tracheal intubation (treatment 2). Participants exhaled to residual volume and took three vital capacity breaths of the gas mixture; thereafter ventilation was manually assisted. The time of exposure to the inhaled gas was varied for consecutive participants. It was either increased or decreased by 30-sec increments based on the failure or success of the preceding volunteer's response to laryngoscopy and intubation after a preselected exposure time. Failure was defined as poor jaw relaxation, coughing or bucking, or inadequate vocal cord relaxation. RESULTS: Loss of the lid-lash reflex in unpremedicated young volunteers was achieved in 1 min and did not differ among groups. Average time (and 95% confidence interval) for acceptable conditions for LMA insertion was achieved in 1.7 (0.7 to 2.7) min, and all participants had an immediate return of spontaneous ventilation. The time for acceptable tracheal intubating conditions after manual hyperventilation by mask was 4.7 (3.7 to 5.7) min and 6.4 (5.1 to 7.7) min in treatments 1 and 2, respectively. There were no cases of increased secretions or laryngospasm. The incidence of breath holding and expiratory stridor ("crowing") was 7.5% and 25%, respectively, during treatment 1 and 15% and 40%, respectively, during treatment 2. CONCLUSIONS: The induction of anesthesia to loss of lid reflex in young non-premedicated adults approaches the speed of intravenous induction techniques. No untoward airway responses were noted during mask induction of anesthesia with a three-breath technique. In response to intubation, no adverse airway responses, including jaw tightness, laryngospasm, and excessive coughing or bucking, occurred in participants whose duration of mask administration of sevoflurane met the appropriate times (as determined in this study).

Adult↗
PubMed1998

Failure of dominant left-hemispheric activation to right-ear stimulation in schizophrenia.

Schizophrenia is associated with an absence of the lateralizations that typify the human brain. Previous evidence emphasized structural changes, particularly reduced asymmetry in extension and surface of the planum temporale, although gross structural deviations occur only in a minority of patients. The present study describes an absence of lateralization on a robust functional measure that characterized schizophrenia patients: healthy subjects but not schizophrenics displayed a contralateral left-hemispheric dominance of the auditory evoked magnetic field to right-ear auditory stimulation. Absence of contralateral dominance in response to auditory stimuli among schizophrenia patients may indicate a failure to establish unequivocal left-hemispheric dominance of the phonological loop as hypothesized by Crow.

Acoustic Stimulation↗
PubMedDate not supplied

Review of the use of botulinum toxin for hyperhidrosis and cosmetic purposes.

This article reviews the current status of dermatological uses for botulinum toxin type A (Botox), recently approved in the United States for treatment of glabellar wrinkles, and type B (Myobloc), approved for cervical dystonia. The respective formulations of Botox and Myobloc are described, and injection techniques and special considerations for administration in the treatment of dermatologic conditions are also discussed. The use of botulinum toxin injections for cosmetic treatment of movement-related facial lines and platysmal bands in the neck is reviewed, including injection procedures, efficacy, and potential complications. Recent developments in the use of botulinum toxins for the treatment of palmar and axillary hyperhidrosis are also described, comparing type A and type B results. Although direct comparisons between botulinum toxins for dermatologic applications are complicated by the lack of functional equivalence of the standard potency assays, appropriate dosing strategies for obtaining satisfactory clinical results using type B are being established, which will add to the experience already gained with type A. The diffusion characteristics of type B appear to show different and potentially advantageous clinical profiles in the treatment of crows' feet and hyperhidrosis compared with type A.

Botulinum Toxins↗
PubMed1997

Environmental awareness and level-dependent hearing protection devices.

OBJECTIVE: The effect of level-dependent hearing protection devices (HPDs) on subjects' ability to identify real-life environmental sounds was investigated. DESIGN: Eighteen subjects with no hunting experience attempted to identify sounds (crow, duck, turkey, deer, owl, goose, and person) recorded at various distances in the presence of the SoundScope and Sonic II level-dependent HPDs as well as in an open ear condition. Knowles Electronic's Manikin for Auditory Research was employed in making the experimental recordings. The Sonic II accomplishes level-dependent attenuation via a passive mechanism, whereas the SoundScope employs active circuitry that attenuates loud sounds while providing a small amount of high frequency amplification for soft sounds. Both devices are commercially available and are advertised for hunters/shooters. Sound identification scores (SISs) were determined for each condition. RESULTS: Mean SISs differed significantly among the three earplug conditions, collapsed over type of sound and distance, with the best SIS obtained under the open ear condition (96.43%) and the worst under the Sonic II condition (84.13%). Further analysis revealed that the listening conditions differed significantly only at the 100 yard distance. CONCLUSIONS: Auditory awareness was not maintained by either device investigated during the 100 yard condition. However, auditory awareness was maintained by both devices at a distance of 75 yards or closer. These devices may be appropriate for use in certain hunting/shooting situations depending on several factors including type of game being hunted, environment, and shooting range of the weapon. Further support also is provided for the usage of level-dependent HPDs during recreational shooting activities (i.e., at a shooting range).

Adolescent↗
PubMed2003

BOTOX: a review.

BOTOX cosmetic is proving to be an affordable alternative for thousands of people looking to enhance their appearance without the cost, risks and downtime associated with surgical procedures. Botulinum toxin is a neuromuscular blocking agent produced by Clostridium Botulinum, an anaerobic bacterium. When first discovered BOTOX was pinpointed as the cause of severe paralysis acquired through the ingestion of contaminated food. Paralysis related to BOTOX is caused by chemodenervation, which is a result of blockage of the presynaptic release of acetylcholine at the neuromuscular junction. The corrugator (medial eyebrows), crow's feet, forehead, platysmal neckbands, and the jowl are frequently targeted areas for BOTOX injections. There are no current guidelines for physical limitations following the administration of BOTOX. Side effects associated with BOTOX infections appear to be either local, due to the paralysis of adjacent muscles, or mild flu-like symptoms lasting a few days in a small number of patients.

Botulinum Toxins, Type A↗
PubMed1994

Botulinum toxin A for hyperkinetic facial lines: results of a double-blind, placebo-controlled study.

Previous work on patients with muscular dystonia has shown that small intramuscular doses of botulinum toxin A eliminated hyperkinetic facial lines for approximately 6 months. The purpose of this study was to determine the efficacy of botulinum toxin A injections in eliminating facial wrinkles in aesthetic surgery patients who do not have muscular dystonia. Eleven healthy subjects were studied in a double-blind fashion. On both sides of the face, 0.2 cc of either normal saline or botulinum toxin A was injected into the forehead or into the periorbital wrinkles (crow's feet). Documentation of results was made by photographs taken of the patients during repose and during facial animation before and after injection. Assessment of facial wrinkles was done from a grading system in which the patient and the facial plastic surgeon were asked to judge the severity of the wrinkles on a scale from 0 to 3, with 0 reflecting no facial wrinkles and 3 reflecting severe facial wrinkling. Nine of 11 subjects injected with botulinum toxin A noted a significant improvement in the severity of their facial wrinkles in comparison with the side of the face injected with saline, with a rating improvement of 2 points. Two of 11 subjects noted a moderate improvement, with a rating improvement of 1 point. No patient injected with saline reported an improvement in the severity of the facial wrinkles on the control side. There were no serious complications. Botulinum toxin A is an efficacious method of nonsurgically eliminating facial wrinkles and may play a role in the cosmetic enhancement of the aging face.

Adult↗
PubMed1996

Brow lift by flap transposition in the glabrous brow area.

In brow lift, if a direct approach is utilized, the suture line medially is placed in a normal frontalis crease, and then the lateral part of the suture line, by lateral transfer of a small superiorly based flap, is caused to fall into a natural "laugh line" or "crow's feet" crease, three improvements result: 1. Greater control and predictability of shaping and position than with other techniques; 2. A more normal appearance, including better lateral lift and a much more inconspicuous scar than with supraciliary direct lift; 3. A longer-lasting result. In approximately 150 patients, scar appearance has been very gratifying indeed, with only 3 limited segmental scar revisions and 2 secondary midforehead elliptical excisions. It is believed that the principle exhibited in the tightening of the upper suture line by flap transfer, referred to by analogy as the worm principle, accounts for much of the improvement, especially in durability. This principle is seen as an aid in thinking through the mechanics of several other plastic surgical situations as well.

Aged↗
PubMed1999

Botox for the treatment of dynamic and hyperkinetic facial lines and furrows: adjunctive use in facial aesthetic surgery.

Our improved understanding of the pathophysiology of facial lines, wrinkles, and furrows has broadened the treatment options for a variety of facial cosmetic blemishes. The persistence or recurrence of certain facial rhytids after surgery has confirmed the lack of full comprehension of their origin. Glabellar forehead furrows (frown lines) and lateral canthal rhytids (crow's feet) have been the most popular facial lines that have been shown to be mostly the result of regional hyperkinetic muscles, and their eradication may be more suitable, at times, to chemodenervation than to soft-tissue fillers, skin resurfacing, or surgical resection. Aesthetic surgical procedures that have yielded suboptimal results may also occur from failure to recognize other causative factors including hyperkinetic or dynamic musculature, which may contribute to etiology of the visible soft-tissue changes and lack of persistent effect after surgery. Chemodenervation with botulinum toxin A (Botox) has proven to be useful both as a primary treatment for certain facial rhytids and as an adjunctive agent for a variety of facial aesthetic procedures to obtain optimal results.

Botulinum Toxins, Type A↗
PubMed2001

Treatment guidelines for botulinum toxin type A for the periocular region and a report on partial upper lip ptosis following injections to the lateral canthal rhytids.

Inactivation of the orbicularis oculi muscle by chemodenervation with botulinum toxin type A (Botox, Allergan, Inc., Irvine, Calif.) as a sole procedure or in conjunction with blepharoplasty has proved to be a reliable method to improve the appearance of the periocular area. Botox has the unique and ideal characteristic in that, with repeated use, there is potential for a prolonged clinical effect with smaller dosages. In addition, if a complication does arise--while not aesthetically acceptable and potentially untoward--it is time-limited, and the anatomical area will eventually return to its pretreatment baseline status. In this study, in three cases [in more than 1000 crow's feet treatment sessions (2000 sides)] over the course of 1 year, partial lip ptosis resulting from weakening of the zygomaticus major muscle after the injection of Botox into the periocular region are reported. This article reviews suggested treatment guidelines and anatomic considerations for the periocular region to maintain injection standardization and improve the safety profile of Botox as the aesthetic indications for its use expand and the number of individuals who inject it increases.

Botulinum Toxins, Type A↗