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PubMed2000

Behavioural treatments for sleep problems in children and adolescents with physical illness, psychological problems or intellectual disabilities.

Young people with physical, psychological or intellectual disabilities or disorders are reported to have more frequent and persistent problems with sleep than their peers without <<< >>>. Sleep disorders affecting the quantity or quality of sleep have effects on a child's daytime functioning and the functioning of their families. Many children with special needs have learning and behaviour problems and their parents (particularly mothers) have increased levels of stress and poorer mental health. This relationship between sleep disorders and learning, and behaviour and family functioning makes it particularly important that children with special needs receive appropriate intervention for their sleep disorders. This may be one way of mitigating these other problems. This review considers the case reports and experimental trials which have used behavioural treatments for sleep problems in children and adolescents with special needs. Behavioural treatments for sleep-wake cycle disorders, sleeplessness, parasomnias and excessive sleepiness are reported. These preliminary reports do suggest that behavioural approaches can be rapidly successful for treating sleep problems, even where the sleep problems are long-standing, severe and associated with physical, psychological or intellectual problems. The parent and the clinician should not be deterred from treating the sleep problem in isolation using behavioural treatments. Methodological issues, however, highlight the importance of further and better research. Not all children responded to the behavioural interventions and some needed re-implementation of therapy to maintain improvements; the use of heterogeneous groups make the findings and choice of treatment for individuals difficult to interpret. Finally, there are few studies overall, and the majority are case studies rather than controlled studies using multiple baseline designs or randomization and a control group. Careful studies are required in order to establish the relative efficacy of the behavioural techniques and their suitability with homogeneous subgroups of children with special needs.

Journal Article↗

PubMed2004

Detection of 91 potential conserved plant microRNAs in Arabidopsis thaliana and Oryza sativa identifies important target genes.

MicroRNAs (miRNAs) are an extensive class of tiny RNA molecules that regulate the expression of target genes by means of complementary base pair interactions. Although the first miRNAs were discovered in Caenorhabditis elegans, >300 miRNAs were recently documented in animals and plants, both by cloning methods and computational predictions. We present a genome-wide computational approach to detect miRNA genes in the Arabidopsis thaliana genome. Our method is based on the conservation of short sequences between the genomes of Arabidopsis and rice (Oryza sativa) and on properties of the secondary structure of the miRNA precursor. The method was fine-tuned to take into account plant-specific properties, such as the variable length of the miRNA precursor sequences. In total, 91 potential miRNA genes were identified, of which 58 had at least one nearly perfect match with an Arabidopsis mRNA, constituting the potential targets of those miRNAs. In addition to already known transcription factors involved in plant development, the targets also comprised genes involved in several other cellular processes, such as sulfur assimilation and ubiquitin-dependent protein degradation. These findings considerably broaden the scope of miRNA functions in plants.

Arabidopsis↗

PubMed2001

Probiotics: future directions.

Clinical studies have shown that certain probiotics may be useful in treating a variety of diarrheal disorders, including rotavirus diarrhea, antibiotic-associated diarrhea, Clostridium difficile diarrhea, and traveler's diarrhea. New data suggest that probiotics might be useful in controlling inflammatory diseases, treating and preventing allergic diseases, preventing cancer, and stimulating the immune system, which may reduce the incidence of respiratory disease. Different modes of administering probiotics are currently being investigated, which may ultimately lead to the widespread use of probiotics in functional foods. It is important that such practices be directed by carefully controlled clinical studies published in peer-reviewed journals.

Animals↗

PubMed1995

Quality assurance in medical education.

Many people have an interest in the quality of medical education. Students have the right to as good an education as possible, and the public has the right to well-educated and well-trained general physicians and specialists. Therefore, a medical school or faculty must ensure its quality and is accountable for the quality of the training it provides. This paper emphasizes that the best way to ensure quality is by continuous attention to it. Quality depends not on measurement instruments and tools but rather on the spread of quality awareness among faculty, staff, and students. A tool for safeguarding quality is the design of a well-functioning quality assessment system, based on two pillars: a system of internal quality control and external assessment by peers. The connection between the internal and external assessments is the self-evaluation by the school. On the one side, this self-evaluation is a critical self-analysis and an agenda for improvement. On the other side, it contains information for the external reviewers. The peer review also provides input for the process of improvement.

Clinical Competence↗

PubMed2005

Multigenerational challenges in academic medicine: UCDavis's responses.

Academic medicine is a unique work environment, one of the few where members of four different generations regularly interact and where multigenerational teams are key to fulfilling its missions, particularly education. This can lead to increased creativity, but also to intergenerational conflict, since each generation has different values and expectations. The authors describe multigenerational challenges confronted at the University of California, Davis, School of Medicine, and that school's responses to them. These challenges include issues related to work hours, workload, compensation, evaluation for advancement, recruitment and retention, and attendance at required meetings. Awareness of the different generational qualities and values allowed the school of medicine to identify the multigenerational origin of many of these ongoing issues and challenges and to plan appropriate solutions within the Office of Academic Affairs. These include policy changes related to work-life balance, utilizing multiple faculty tracks with different roles, allowing part-time faculty appointments, creating a variety of faculty development programs geared toward different generational needs (which utilize flexible modules, menus of options, and alternative technologies for presentation), defining appropriate reward and incentives through compensations plans, and creating peer-reviewed awards. The authors conclude that these efforts mitigate conflict, promote diversity, and allow multigenerational teams to function more effectively and creatively in education, research, and clinical care. Ongoing evaluation will further refine this approach.

Academic Medical Centers↗

PubMed2005

Social anxiety predicts amygdala activation in adolescents viewing fearful faces.

The amygdala is critically involved in the processing of anxiety in adults, but little is known about the neurogenesis of trait-anxiety during adolescence. We correlated amygdala activity during visual presentations of fearful and happy faces with scores on the Multidimensional Anxiety Scale for Children in 16 adolescents undergoing functional magnetic resonance imaging. During fear perception, amygdala activity positively correlated with several social dimensions of anxiety, including peer rejection, humiliation, performing in public, and being separated from loved ones, but was not correlated with most measured nonsocial dimensions of anxiety. Amygdala responses during happy face presentations correlated positively only with tension/restlessness. During adolescence, amygdala activity appears to be more strongly related to social/interpersonal than nonsocial dimensions of anxiety.

Adolescent↗

PubMed2005

Structural similarity to bridge sequence space: finding new families on the bridges.

Structures for protein domains have increased rapidly in recent years owing to advances in structural biology and structural genomics projects. New structures are often similar to those solved previously, and such similarities can give insights into function by linking poorly understood families to those that are better characterized. They also allow the possibility of combing information to find still more proteins adopting a similar structure and sometimes a similar function, and to reprioritize families in structural genomics pipelines. We explore this possibility here by preparing merged profiles for pairs of structurally similar, but not necessarily sequence-similar, domains within the SMART and Pfam database by way of the Structural Classification of Proteins (SCOP). We show that such profiles are often able to successfully identify further members of the same superfamily and thus can be used to increase the sensitivity of database searching methods like HMMer and PSI-BLAST. We perform detailed benchmarks using the SMART and Pfam databases with four complete genomes frequently used as annotation benchmarks. We quantify the associated increase in structural information in Swissprot and discuss examples illustrating the applicability of this approach to understand functional and evolutionary relationships between protein families.

Protein Conformation↗

PubMedDate not supplied

Competent kids: children and adolescents with a chronic illness.

The social and personal competence of children and adolescents with a seizure disorder or an orthopaedic condition was assessed by parents and teachers. The contributions to these assessments of characteristics of the child, the intensity of the illness, and the child's temperament were explored using a hierarchical regression model. Parents and teachers rated all children as functioning fairly well. Children with a seizure disorder were perceived as significantly less competent than were their healthy peers (P less than 0.05). Across health status groups, children received higher competence scores from their parents than they did from their teachers (P less than 0.05). Competence scores did not differ according to the age of the child. The patterns of variables that predicted ratings of competence differed according to illness type and rater. Indicators of illness intensity explained a larger share of the variance in competence ratings for children with a seizure disorder (25%) than for children with an orthopaedic condition (5%). For children in this latter group, temperament explained a much larger proportion of the variance in both parents' (29%) and teachers' (42%) ratings of competence than did the illness intensity variables.

Adolescent↗

PubMed1989

Assessing child symptom severity and stress in parents of autistic children.

Parents of 44 autistic children rated their children's symptom severity and their own stress on a 14-item symptom scale. Thirteen child and family characteristics were also examined to assess how they affected symptom perception and stress. Preschoolers were rated less symptomatic by their parents than by clinicians. Lower functioning, nonverbal, odd-looking, self-abusive, seizuring and hyperirritable children were rated more symptomatic than their peers. Best predictor of stress for both parents was a child's self-abuse; for mothers hyperirritability and older age were also associated with elevated stress scores. Compared with parents of matched normal children, mothers of autistic children reported the most aggravations and expressed the need for additional support from their spouses.

Adaptation, Psychological↗

PubMed1997

Pulmonary endocrine cells in anthracosilicotic lungs.

It has been suggested by some studies of human and animal lungs that the products of pulmonary endocrine cells, particularly gastrin-releasing peptide, might play a role in fibrogenesis, but more recent detailed studies of fibrotic human lungs have failed to confirm this. We have made a detailed quantitative examination of a series of fibrotic human lungs to see if we could determine whether there was any relationship between endocrine cells and fibrosis. Using immunocytochemistry, we investigated the morphology, content, distribution and number of pulmonary endocrine cells in 15 pairs of fibrotic lungs from coal miners, and compared their features with those of equivalent cells in age-matched controls. Proliferation of endocrine cells was seen in the lungs of just two miners, in which it was focal and associated with acute bronchitis and bronchopneumonia. There was no difference between the miners and controls in the appearance (mostly solitary cells), content (predominantly gastrin-releasing peptide and calcitonin), distribution (mainly in small bronchi and bronchioles), or number (4.5 vs 4.1 cells per 10,000 epithelial cells, respectively) of endocrine cells. It seems unlikely that the substances secreted by these cells play any role in stimulating fibrosis in human lungs, but rather that they have a function in the inflammatory response to pulmonary injury.

Aged↗

PubMed1998

The interdisciplinary team's approach to lupus nephritis.

The interdisciplinary team approach in assessment and treatment of patients with chronic disease in general and lupus nephritis in particular provides a global format for identifying the multiple problem areas that retard or prevent optimal patient functioning. These areas include the physical, emotional, economic, psychosocial, and functional. Benefits to the individual patient include a thorough multifaceted assessment by professionals who have the benefit of peer collaboration and validation. This increases the likelihood that the whole patient is considered, not just the problem of nephritis. For example, how does the patient and her or his family cope with the impact of such a disease and how, in turn, do the coping abilities of the patient and family affect the disease. The interdisciplinary team also assesses how the treatment strategies for each problem area influence each other. Finally, the interdisciplinary team serves as a positive role model for effective collaboration among health professionals and for students in their respective disciplines.

Adult↗

PubMed2002

Training family medicine residents for assessment and advocacy of older adults.

A review of the Basic Standards for Residency Training in Osteopathic Family Practice and Manipulative Treatment by the American Osteopathic Association and the American College of Osteopathic Family Physicians revealed that the family medicine residency curriculum in place at Riverside Osteopathic Hospital in Trenton, Mich, lacked formal didactic and clinical teaching in geriatric medicine. Therefore, a geriatric curriculum focusing on functional assessment strategies was developed and implemented. A three-part, 6-hour educational series was delivered to family medicine residents, interns, and medical students at Riverside Osteopathic Hospital. Content for the sessions addressed a variety of assessment and screening tools; concepts of abuse, neglect, and guardianship; available community resources to support the independent functioning of older adults; and, application of knowledge and skills. The geriatric medicine series concluded with a working session to prepare an individualized management plan for each of the patients evaluated. Each family medicine resident, the target learners, demonstrated his skill at performing a functional assessment of a geriatric patient at the community-based Horizon Family Medical Center in Taylor, Mich. Peers and faculty provided feedback. Family medicine residents were able to transfer knowledge and skills from the classroom to a geriatric patient. This teaching curriculum is the starting point for further development of clinical and community-based geriatric experiences for the family medicine residents at Riverside Osteopathic Hospital.

Aged↗

PubMed1990

Peer social skills in toddlers: competencies and constraints illustrated by same-age and mixed-age interaction.

One important aspect of social competence is the ability to accommodate social behavior to different contexts. Can children who are just beginning to acquire peer interactional skills adjust their social behavior to the age of their partner? 18- and 24-month-old children were paired in same-age or mixed-age dyads, and their spontaneously occurring peer interactions were observed. Previously documented age differences in peer skills were replicated. Additionally, toddlers in mixed-age dyads adjusted both the behavioral content and the complexity of their social behavior to the age of their partners. For initiations the effects were interactive. That is, children's adjustments in social behavior were a function of both the child's age and the partner's age. There also were age-related constraints on the accommodations that children made to one another. Speculations are offered about potential contributions to these developments during the second year. Results support arguments for the uniqueness of the mixed-age context, and show that by the second year children possess rudimentary skills to permit functional accommodations to this context.

Age Factors↗

PubMed1994

Being alone, playing alone, and acting alone: distinguishing among reticence and passive and active solitude in young children.

3 forms of solitude were studied in young children--reticence (onlooker and unoccupied behavior), solitary-passive behavior (solitary-constructive and -exploratory play), and solitary-active behavior (solitary-functional and -dramatic play). 48 4-year-old children grouped in quartets of same-sex unfamiliar peers were observed in several situations. Mothers completed the Colorado Temperament Inventory. Results indicated that (1) solitary-passive, solitary-active, and reticent behaviors were nonsignificantly intercorrelated; (2) reticence was stable and associated with the demonstration of anxiety and hovering near others, whereas solitary-passive and solitary-active play were stable yet unrelated to anxiety and hovering; (3) reticence during free play was generally associated with poor performance and displays of wariness in several other social situations, while solitary-passive and -active play were not; (4) reticence was associated with maternal ratings of child shyness, while solitary-active behavior was associated with maternal ratings of impulsivity. Results are discussed in terms of the underlying mechanisms associated with reticence and passive and active withdrawal.

Anxiety↗

PubMed2004

PeerGAD: a peer-review-based and community-centric web application for viewing and annotating prokaryotic genome sequences.

PeerGAD is a web-based database-driven application that allows community-wide peer-reviewed annotation of prokaryotic genome sequences. The application was developed to support the annotation of the Pseudomonas syringae pv. tomato strain DC3000 genome sequence and is easily portable to other genome sequence annotation projects. PeerGAD incorporates several innovative design and operation features and accepts annotations pertaining to gene naming, role classification, gene translation and annotation derivation. The annotator tool in PeerGAD is built around a genome browser that offers users the ability to search and navigate the genome sequence. Because the application encourages annotation of the genome sequence directly by researchers and relies on peer review, it circumvents the need for an annotation curator while providing added value to the annotation data. Support for the Gene Ontology vocabulary, a structured and controlled vocabulary used in classification of gene roles, is emphasized throughout the system. Here we present the underlying concepts integral to the functionality of PeerGAD.

Computational Biology↗

PubMed2002

The development of romantic relationships and adaptations in the system of peer relationships.

In this review, it is proposed that a systems approach to the study of the development of romantic relationships might enhance our understanding of the nature of social relationships, and the links between social relationships and individual psychosocial functioning. First, a selected literature review is provided on the normative development of romantic relationships during adolescence, antecedents of different romantic involvement pathways, and positive and negative qualities of these relationships. Second, the focus is placed on the how the development of romantic relationships occurs within existing systems of relationships including peer networks and close friendships. It is suggested that the development of romantic relationships may change the peer network and nature of relationships with friends and others, and particular types of transitions in social relationships will likely occur. The timing of these transitions and an understanding of the entire peer system as romantic relationships develop will likely improve our understanding of individual developmental processes such as identity formation and the development of externalizing and internalizing problems. Finally, it is proposed that adolescents are faced with a complicated task that includes developing romantic interests and relationships but managing their changing social networks.

Adolescent↗

PubMed1993

A mathematical model for fundamental regulation processes in the cardiovascular system.

Based on the four compartment model by Grodins we develop a model for the response of the cardiovascular system to a short term submaximal workload. Basic mechanisms included in the model are Starling's law of the heart, the Bowditch effect and autoregulation in the peripheral regions. A fundamental assumption is that the action of the feedback control is represented by the baroceptor loop and minimizes a quadratic cost functional. Simulation results show that the model provides a satisfactory description of data obtained in bicycle ergometer tests.

Blood Pressure↗

PubMed2001

Executive function deficits in non-retarded autistic children.

The purpose of this study was to examine differences between Taiwanese children with autism and their typically developing peers on the Wisconsin Card Sorting Test (WCST). Twenty-six children with autism of normal IQ were included, and matched for chronological age with 52 controls. The WCST scores of the typically developing children were significantly higher for categories completed and percent conceptual level than in the autism group. Scores on perseverative responses, perseverative errors, the number of trials to complete the first category and non-perseverative errors were significantly higher in the autism group. The implications of these findings are discussed.

Attention↗