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PubMed1991

Manual laterality in nonhuman primates: a distinction between handedness and manual specialization.

This article examines individual and group manual lateralization in nonhuman primates as a function of task's demands. It is suggested to distinguish low- from high-level manual activities with respect to the novelty variable and to the spatiotemporal scale of the movements. This review shows that low-level tasks lead to (a) symmetrical distributions of hand biases for the group and (b) manual preferences that are not indicative of the specialization of the contralateral hemisphere. In contrast, behaviors expressed in high-level tasks (a) show asymmetrical distribution of hand biases for the group and (b) seem to be related to a specialization of the contralateral hemisphere. Two types of lateralization, handedness and manual specialization, correspond to the 2 levels of tasks that are distinguished.

Animals↗
PubMed2005

Is self special? A critical review of evidence from experimental psychology and cognitive neuroscience.

Varied research findings have been taken to support the claim that humans' representation of the self is "special," that is, that it emerges from systems that are physically and functionally distinct from those used for more general purpose cognitive processing. The authors evaluate this claim by reviewing the relevant literatures and addressing the criteria for considering a system special, the various operationalizations of self, and how the studies' findings relate to the conclusions drawn. The authors conclude that many of the claims for the special status of self-related processing are premature given the evidence and that the various self-related research programs do not seem to be illuminating a unitary, common system, despite individuals' subjective experience of a unified self.

Brain↗
PubMed2005

Methodology in family science: introduction to the special issue.

Methodology influences every facet of scientific inquiry including the processes of framing questions, operationalizing constructs, sampling individuals within populations and observations within persons, analyzing data, and bringing meaning to the results. This introduction to the special issue on methodology emphasizes the recursive interaction of research methodology and theories underlying family science. Because the science of family psychology is richly complex, so too must the methods for examining couple and family phenomena be equally diverse. Articles comprising this special issue vary in their emphasis on research design versus data-analytic techniques and on confirmatory versus discovery-oriented strategies. The special issue is intended to advance not only the conduct of family science but also the understanding and integration of an increasingly complex research literature by those engaged in education and clinical interventions. ((c) 2005 APA, all rights reserved).

Journal Article↗
PubMed2005

Introduction to the special section on developing guidelines for the evidence-based assessment (EBA) of adult disorders.

The goal of this special section is to encourage greater awareness of evidence-based assessment (EBA) in the development of a scientifically supported clinical psychology. In this introductory article, the authors describe the elements that authors in this special section were asked to consider in their focused reviews (including the scope of available psychometric evidence, advancements in psychopathology research, and evidence of attention to factors such as gender, age, and ethnicity in measure validation). The authors then present central issues evident in the articles that deal with anxiety, depression, personality disorders, and couple distress and in the accompanying commentaries. The authors conclude by presenting key themes emerging from the articles in this special section, including gaps in psychometric information, limited information about the utility of assessment, the discrepancy between recommended EBAs and current training and practice, and the need for further data on the process of clinical assessment.

Adult↗
PubMed2002

An unexpected specialization for horizontal disparity in primate primary visual cortex.

The horizontal separation of the eyes means that objects nearer or farther than the fixation point project to different locations on the two retinae, differing principally in their horizontal coordinates (horizontal binocular disparity). Disparity-selective neurons have generally been studied with disparities applied in only one direction (often horizontal), which cannot determine whether the encoding is specialized for processing disparities along the horizontal axis. It is therefore unclear if disparity selectivity represents a specialization for naturally occurring disparities. I used random dot stereograms to study disparity-selective neurons from the primary visual cortex (V1) of awake fixating monkeys. Many combinations of vertical and horizontal disparity were used, characterizing the surface of responses as a function of two-dimensional disparity. Here I report that the response surface usually showed elongation along the horizontal disparity axis, despite the isotropic stimulus. Thus these neurons modulated their firing rate over a wider range of horizontal disparity than vertical disparity. This demonstrates that disparity-selective cells are specialized for processing horizontal disparity, and that existing models of disparity selectivity require substantial revision.

Action Potentials↗
PubMed2005

Specialized staff and equipment for weight loss surgery patients: best practice guidelines.

OBJECTIVE: To provide evidence-based guidelines on the specialized personnel, equipment, and physical plant required for safe and effective care of severely obese weight loss surgery (WLS) patients. RESEARCH METHODS AND PROCEDURES: We examined MEDLINE (Ovid and PubMed) and the Cumulative Index of Nursing and Allied Health Literature for articles on facilities resources for care of WLS patients published in English between January 1980 and March 2004. We queried several web sites for appropriate references; these included the Agency for Healthcare Research and Quality and the American College of Surgeons. The majority of reference material was descriptive and not specific to facilities resources for WLS patients. We identified a substantial body of literature on the general subject of patient safety; three of these articles were used to develop recommendations on the use of technology for medical error reduction. All other recommendations are based on 11 expert opinion reports. RESULTS: We recommended adequate training and credentialing for all medical staff; dedicated support and administrative personnel; and specialized interventional, diagnostic, operating room, and transport equipment. We specified needed adaptations to the physical plant and developed evidence-based guidelines for medical error reduction and systems improvements. DISCUSSION: Specialized resources and dedicated staff are needed to protect the health of WLS surgery patients and staff. Adaptations include preoperative preparation for safe means of patient transport; techniques of anesthesia and intraoperative exposure; provisions for postoperative recovery; and measures to assure postoperative patient safety, hygiene, and comfort.

Credentialing↗
PubMed2000

Special postpartum dietary practices of Hong Kong Chinese women.

OBJECTIVE: A 'ginger vinegar soup' and other special dietary practices have been traditionally recommended for postpartum Chinese women. This paper describes these practices in the first 6 weeks postpartum, and details of the calcium and iron content of the 'ginger vinegar soup'. DESIGN AND SUBJECTS: Results of this paper were generated from a longitudinal study on the nutritional status of Hong Kong Chinese postpartum women. 'Ginger vinegar soup' samples were collected at the 2 week home visits. Calcium and iron content were measured by the combination of dry ashing method and atomic absorption spectrophotometry. Results were compared with other types of soup and food sources. A food frequency questionnaire was completed at the 6 week interview to assess the special dietary practices during this period. RESULTS: Fifty-one subjects completed the food frequency questionnaires. Twenty-two ginger vinegar soup samples and six other soup samples were collected. Consumption of special food items such as ginger, pig's trotters, egg and chicken varied greatly among subjects. More poultry and similar amounts of egg were consumed by our subjects as compared with the Hong Kong general population. Chicken soup and ginger vinegar soup were commonly consumed. Median calcium and iron contents of the ginger vinegar soup were 4.65 and 0.84 mg/dl, respectively. This calcium content was higher than that of the other six soup samples, but was low as compared with other calcium-rich foods. Iron content of ginger vinegar soup was higher than that of the other six samples and was comparable to some iron-rich foods. CONCLUSIONS: Hong Kong Chinese postpartum women followed traditional dietary practices to different degrees. These practices were characterized by an increased poultry consumption. Iron content of ginger vinegar soup was comparable to some iron-rich foods.

Adult↗
PubMed2002

Cohort study in South and West England of the influence of specialization on the management and outcome of patients with oesophageal and gastric cancers.

BACKGROUND: To evaluate specialization in National Health Service (NHS) cancer care, volume-outcome relationships were examined. METHODS: This was a cohort study of 1512 patients with oesophageal or gastric cancer in 23 acute NHS hospitals. Outcomes were survival time and operative (30 day) mortality. Multiple regression analysis was performed, adjusted for diagnoses, prognoses and treatments. RESULTS: For oesophageal cancer, the operative mortality rate decreased by 40 per cent (odds ratio 0.60 (95 per cent confidence interval (c.i.) 0.36 to 0.99 per cent); P = 0.047) for each increase of ten patients in doctors' annual surgical caseloads, and the risk of death decreased by 8 per cent (hazard ratio 0.92 (95 per cent c.i. 0.85 to 0.99); P = 0.021) for each increase of ten patients in doctors' annual caseloads. For gastric cancer, the operative mortality rate decreased by 41 per cent (odds ratio 0.59 (95 per cent c.i. 0.32 to 1.07)) for each increase of ten patients in doctors' annual surgical caseloads, and the risk of death decreased by 7 per cent (hazard ratio 0.93 (95 per cent c.i. 0.89 to 0.98); P = 0.009) for each increase of ten patients in hospitals' annual caseloads. Patients of higher-volume doctors were more likely to receive most investigations and treatments, independently of presenting features. CONCLUSION: The study supports concentration of services for oesophageal and gastric cancers. Specialization of doctors and their teams is at least as important as specialization of hospitals.

Cancer Care Facilities↗
PubMed1999

Caring for children with specialized health care needs in the community: the challenges for primary care.

People needing intensive and specialized health care are being cared for now in community settings; this has implications for both primary health care professionals and family carers. This paper draws on research investigating how services can be developed to support families caring for children with complex health care needs, to consider the challenges facing professionals working in the primary health care sector. Interviews conducted with parents, professionals and those who fund and commission specialized health services reveal particular problems in relation to the purchasing and provision of short-term care and specialist equipment/therapies in the community. These problems need to be addressed if people with specialized needs are to be cared for outside hospitals. The new Primary Care Groups (PCGs) will have the opportunity to enhance the provision of these services. Primary care professionals will also need to work in partnership with other sectors of the health service and with local authority services, at both strategic and operational levels, to develop integrated and coordinated services for this growing group of people.

Journal Article↗
PubMed1996

An exploration of parental perception of the nature and level of support needed to care for their child with special needs.

This paper is part of a study attempting to identify parental perception of support necessary to care for their child with special needs. The existing literature has been analysed, revealing a paucity of studies relating to the parents' perception. The study gathered data from questionnaires administered to 25 randomly selected parents who have children with special needs, exploring multi-disciplinary support. The other method used was conducting three semi structured interviews, with parents known to the paediatric team in the locality being studied. The health professionals input, respite care and overall level of support have been studied from the questionnaires. The interviews highlighted many areas where the paediatric community nurse could fulfil some of the parents' support needs. The response rate was 19 questionnaires returned, covering 21 children, as two families had two children with special needs. The results indicate that half the parents were satisfied with the support they received, with the main groups giving support being education and relatives, followed by health and social services.

Adolescent↗
PubMed2002

Dealing with uncertainty: parental assessment of pain in their children with profound special needs.

BACKGROUND: Despite advances in the assessment and management of children's pain, children with profound special needs are especially vulnerable to poor pain management. Their underpinning condition often severely compromises their ability to express pain through the usual verbal and behavioural routes. The lack of any appropriate framework for assessment results in a suboptimum and inaccurate approach to an important aspect of their care. PURPOSE: The purpose of the study was to explore the ways in which parents of children with profound special needs assess and manage their children's pain. METHODS: Qualitative case study design underpinned the study using guided interviews with the 15 parents/carers (of 12 children aged 5-16 years with profound special needs). ETHICAL APPROVAL: Ethics Committee approval was gained. FINDINGS: A number of themes emerged from the data including learning to live with pain, dealing with uncertainty, expression of pain and making decisions. CONCLUSIONS: Parents felt that their child had learned to live with significant levels of chronic and acute pain. Assessment of pain was an uncertain and complex process requiring parents to draw on skills and knowledge developed over a number of years. Parents used different strategies for both the assessment and management of pain based on an intimate knowledge of their child's usual nonpain state. Even with a limited repertoire of behaviours available to them, children were able to express pain. Parents often felt isolated in relation to pain management and under-used as a resource by health professionals.

Adolescent↗
PubMed1999

A home visit programme to teach medical students about children with special needs.

OBJECTIVES: During an 8-week clinical rotation in paediatrics and child health, fifth-year medical students at the University of Cape Town are required to visit children with special needs in their homes. The home visit allows students to learn, first-hand, from children with special needs and their families about living with chronic disease and disability. DESIGN: During 1998 students anonymously completed home visit evaluation questionnaires (90% response rate, 160/177). Through verbal presentations, students are assessed on their ability to make a comprehensive evaluation of the impact of chronic disease and disability on a child and family. SETTING: University of Cape Town Medical School. SUBJECTS: Fifth-year medical students. RESULTS: A content analysis of verbal presentations found students were more likely to identify medical, psychosocial and economic than spiritual and ethical issues. As a learning experience, 37% (n=57) of students rated the home visit as 'extremely worthwhile', 62% (n=100) found it 'worthwhile' and only 2% (n=3) felt it was 'a waste of time'. Most (97%, n=155) students felt the programme should continue in the future. CONCLUSIONS: As an educational tool, home visiting grounds learning in families' experience and encourages reflection beyond the medical aspects of care for children with special needs.

Child↗
PubMed2001

Preparing tomorrow's doctors: the impact of a special study module in medical informatics.

BACKGROUND: In response to the call for more informatics teaching in the medical curriculum, an elective special study module has been offered to first-year students at Queen's University since 1997. OBJECTIVES: To assess the impact of a medical informatics course in terms of the use of skills acquired and attitudes held about information technology (IT) in medicine. METHODS: A postal structured questionnaire was sent to all 30 students who took the medical informatics special study module in 1997 and to all 29 students who took the module in 1998, plus an age and sex-matched group of controls in each year. Main outcome measures included attitudes to the role of IT in medicine and declared frequency of use of various software packages. RESULTS: Compared with the control group, those taking the module felt less confident initially with computers. There was a high level of positive attitude to computers in medicine following the course, in both study and control groups. There was a significantly greater use of word-processing (P=0.001) and presentation packages (P=0.0005) amongst third-year students compared with second-year students, but there was no significant difference in this regard between those taking the module and controls. CONCLUSIONS: Students' use of computer technology and IT skills, is more influenced by the demands of the overall curriculum than by undertaking a single module in medical informatics. A special study module may, however, provide valuable support by performing a 'remedial function'. The authors found the module a useful first step in the process of introducing medical informatics to the core curriculum.

Attitude of Health Personnel↗
PubMed2002

Anatomical relationship between specialized astrocytes and leptin-sensitive neurones.

We have previously reported that a specialized subpopulation of astrocytes in the arcuate nucleus of the hypothalamus show an unusually intense immunoreactivity for brain fatty acid binding protein (bFABP). Since bFABP has been shown to regulate the activity of an enzyme, fatty acid synthase, that has a potent influence upon the regulation of feeding by the hypothalamus, it was of interest to determine if bFABP + astrocytes are positioned to potentially influence the activity of feeding-regulating neurones. In this study, we examined the anatomical relationship between specialized arcuate astrocytes immunoreactive for bFABP and feeding-regulating neurones that are responsive to leptin and which are immunoreactive for the transcription factor STAT3. The results show that both cell types are abundant in the arcuate nucleus of the hypothalamus and are frequently closely adjacent to each other. This study provides an anatomical basis for the possibility that specialized arcuate astrocytes regulate the function of leptin-sensitive, feeding-regulating neurones of the arcuate nucleus.

Animals↗
PubMedDate not supplied

Limitations of the Gail model in the specialized breast cancer risk assessment clinic.

The Gail model is a risk assessment tool that is accurate for general breast cancer risk screening. Because of the limited way that this model incorporates family history information, however, there are concerns that it may underestimate risk for many women attending specialized breast cancer risk assessment clinics. We collected comprehensive breast cancer risk factor information for 213 women attending a specialized breast cancer risk assessment clinic using a modified version of the CancerGene software. Breast cancer risk was calculated using the models of Gail and Claus as well as BRCAPRO and the tables of Bodian (for women with lobular neoplasia). Eighty-six percent of the women had a family history of breast cancer. Although 74% of women had risk factor histories that are thought to confound the Gail model (family history of breast cancer in second-degree relatives, family history of breast cancer before the age of 50, family history of bilateral breast cancer, family history of ovarian cancer, or personal history of lobular neoplasia), the inclusion of other models increased the risk level assignment in only 13% of the cases. We conclude that the Gail model is an appropriate risk assessment tool for most women attending specialized clinics, although the inclusion of models better able to account for family history information and personal history of lobular neoplasia is required to accommodate all women.

Adolescent↗
PubMed2003

Prevalence of obesity in International Special Olympic athletes as determined by body mass index.

The heights and weights of 1,749 Special Olympics athlete volunteers participating in the Special Olympics Games in 1999 and 2001 were measured, and body mass index (BMI) was computed. Results indicated that athletes from the United States (US) under 18 years of age had a significantly (P<.001) higher prevalence of being overweight or at risk of being overweight compared with athletes from other countries. Similarly, adult athletes from the United States were at least 3.1 times more likely to be overweight or obese compared with their non-US counterparts. The risk of obesity in US Special Olympic athletes parallels the prevalence of obesity in the general US population. There is a clear need for further research, surveillance, and treatment of the risky health behaviors that contribute to the development of obesity in this group.

Adolescent↗
PubMed2001

[Surgical rehabilitation of neuromuscular swallowing disorders with special regard to cricopharyngeal myotomy and glottopexy].

UNLABELLED: Surgical Rehabilitation of Neuromuscular Swallowing Disorders with Special Regard to Cricopharyngeal Myotomy and Glottopexy. BACKGROUND: The surgical rehabilitation of patients with swallowing disorders caused by neuromuscular insufficiency with life-threatening aspiration presents a special challenge to the ENT-surgeon. METHODS: In a period of 5 years we decided on a surgical treatment in altogether 12 patients with paralytical dysphagia. In 6 patients we combined a cricopharyngeal myotomy with a complete closure of the glottis, in 5 patients we performed a sole cricopharyngeal myotomy. In another patient we restricted ourselves to glottopexy only. RESULTS: In all cases the dysphagia giving rise to the surgical intervention was regredient so far that the removal of the percutan endoscopic gastrostomy postsurgically was possible. 3 special cases are presented in detail. DISCUSSION: The main part of the therapy is the subtle and complete cricopharyngeal myotomy. Particulary good results are available with a combination of the latter with a reversible glottopexy. CONCLUSIONS: After the failure of conservative therapy the indication for a surgical treatment should be made on a large scale.

Adult↗
PubMed2003

[Comparison of ward atmosphere between three specialized wards for patients with alcoholism, schizophrenia, and depression and a diagnostic heterogeneous satellite ward].

OBJECTIVE: Does the ward atmosphere differ between three specialized wards for patients with alcoholism, schizophrenia, and depression and a diagnostic heterogeneous satellite ward? METHODS: The ward atmosphere was assessed by patients and staff with the German version of the ward atmosphere scale (WAS). RESULTS: The data of 49 co-workers and 41 patients were evaluated. The satellite ward was rated significantly better than the specialized wards by both staff and patients (p < 0.01). CONCLUSIONS: If it is not possible to prove empirically, in future, that specialized wards have treatment advantages, our study suggests for atmospheric reasons that diagnostic heterogeneous wards should be recommended as standard care.

Adult↗