Use of response-contingent withdrawal of reinforcement in reducing inappropriate behavior of a retarded child.
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Gump in 2004 identified a positive significant relationship between awareness of daily class objectives and ratings of the instructor's overall teaching effectiveness. The idea that rating of teaching effectiveness can be related to other non-teaching related attributes of the lecturer was further examined. Correlations based on ratings of teaching effectiveness from 453 undergraduate students (M=21 yr., SD= 5.5; 73% women) showed that another nonteaching related variable, namely, how funny the instructor was perceived, was significantly related to indicators of teaching effectiveness.
OBJECTIVE: To review the clinical features, neurobiological correlates and treatment of pathological laughing and crying. METHOD: Selective literature review. RESULTS: Attacks of involuntary, irresistible laughing or crying have long been recognised as sequelae of brain damage. There is controversy about the clinical features of these attacks, the stimuli that provoke them and their relation to affective disorder. The pathophysiology of pathological laughing and crying is still unclear. It can occur in the presence of focal as well as diffuse brain disease. Treatment with antidepressant medications has been found to be of benefit in patients with cerebrovascular disease and multiple sclerosis. CONCLUSIONS: Clinicians should remain vigilant for these symptoms, and offer effective treatments, such as antidepressants, where indicated. Further research is needed to delineate the underlying neurobiological correlates of pathological laughing and crying. The efficacy of both pharmacological and non-pharmacological interventions requires critical evaluation.
Emotional lability or emotionalism is a relatively common phenomenon and frequently occurs following vascular or traumatic brain injury. It is distressing and embarrassing to sufferers and their families, and often interferes with rehabilitation. At present there is no satisfactory or reliable treatment for this condition. We describe an open trial using fluoxetine, a newer antidepressant with a specific serotonergic action, in the treatment of emotional lability due to brain injury. Six consecutive cases of emotional lability attending a rehabilitation unit were studied (five cases of cerebrovascular accident and one of traumatic brain injury). Response to treatment was measured using a modification of the scale described by Lawson and MacLeod [1]. All showed a marked improvement within one week of commencing fluoxetine and the drug was well tolerated with no reported side-effects. The speed of onset and degree of improvement suggest that fluoxetine may be a useful agent in the treatment of emotional lability due to brain injury. Our observations indicate that further investigation of the role of fluoxetine in the treatment of emotional lability is warranted.
Rabbit corneal endothelial fluxes of sodium, bicarbonate, inulin, and dextran have been measured in ambient solutions containing either 0.5 mM adenosine alone (A), 0.3 mM glutathione alone (G), both adenosine and glutathione, or neither adenosine nor glutathione. Addition of A alone to a solution lacking both additives caused a decrease in both Jstrendo and Jendostr sodium fluxes coupled with an increase in Jstrendo net. Addition of G alone caused no effect, whereas addition of A and G together caused a decrease in both Jstrendo and Jendostr sodium fluxes and a large increase in Jstrendo net. Addition of A or G caused an increase in Jstrendo bicarbonate flux, but no change in Jendostr flux. Addition of A and G caused an increase in both Jstrendo and Jendostr bicarbonate flux and a decrease in Jstrendo net. None of the solution variations caused an alteration in either inulin or dextran permeability. Since both A and G influence Jstrendo net bicarbonate and sodium transport, this may provide an explanation of the beneficial effects of these compounds on the endothelium to both enhance and prolong corneal thickness and hydration regulation.
The thymic leukemia cell line EL4 has been shown to produce the lymphokine Interleukin-2 (IL-2) following stimulation with phorbol ester (PMA). We investigated intracellular enzyme pathways triggered by phorbol stimulation using an EL4 cell line which responds to PMA with IL-2 synthesis (EL4r) and one which does not produce IL-2 following stimulation (EL4nr). By comparing these two cell lines we hoped to establish which enzyme activities were associated with IL-2 synthesis. The enzyme pathways studied included calcium/phospholipid dependent protein kinase (C-kinase) activity, the induction of polyamine synthesis, RNA, DNA and protein synthesis and finally IL-2 production. Our results indicate that both EL4 cell lines have a receptor for PMA, which can activate the C-kinase enzyme. Further, in both cell lines PMA activates the nuclear synthesis of polyamines as demonstrated by ornithine decarboxylase induction. Both RNA and protein synthesis measured by 3H-uridine and 3H-leucine uptake respectively appear comparable between EL4r and EL4nr. The only difference in cellular responsiveness between EL4r and EL4nr was in the 3H-thymidine uptake, and IL-2 production. IL-2 production or lack of production was established by 3H-uridine and 3H-thymidine incorporation as well as viable cell count using the IL-2 dependent cell line CTLL-2. We, therefore, conclude that EL4r and EL4nr cells show similar intracellular responses to phorbol ester except for 3H-thymidine uptake and detectable IL-2 production. Our results suggest that failure of PMA-stimulated EL4nr cells to produce IL-2 is either due to inability of this cell line to synthesize IL-2 or the production of defective IL-2. It is not due to failure of PMA to activate C-kinase or the subsequent nuclear events.
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OBJECT: The authors provide evidence that direct resection of hypothalamic hamartomas (HHs) can improve associated gelastic and nongelastic seizures. METHODS: Ten children younger than 17 years of age underwent resection of HHs (nine sessile and one pedunculated) that were causing refractory epilepsy. Lesions were approached from above transventricularly through a transcallosal anterior interforniceal approach in six cases, endoscopically through the foramen of Monro in one, and from below with a frontotemporal craniotomy including an orbitozygomatic osteotomy in three. Medical charts were reviewed retrospectively, and follow-up data were obtained through office records and phone calls. Follow-up periods ranged between 12 and 84 months (mean 16.8 months). All patients in whom the approach was from above had sessile HHs. Five were free from seizures at follow up and two had a reduction in seizures of at least 95%. The transventricular route allowed excellent exposure and visualization of the local structures during resection. Among the three patients in whom the approach was from below, one became free of seizure after two procedures and one had a 75% reduction in epilepsy; the latter two had sessile HHs. The exposure was inadequate, and critical tissue borders were not readily apparent. Although the HH was adequately exposed and resected, the epilepsy persisted in the third patient, who had a pedunculated lesion. The overall rate of major permanent hypothalamic complications appeared to be slightly lower for the orbitozygomatic osteotomy group. CONCLUSIONS: Sessile lesions are best approached from above. Approaches from below adequately expose pedunculated hamartomas. The likelihood of curing seizures seems to be higher when lesions are approached from above rather than from below.
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The nurse scholar, whether a supervisor, an educator, or a practitioner, has a lifetime of research opportunities as well as personal experiences related to the human need for humor. We need to develop the means to assess the individual's and group's response to humor. Nurse scholars, particularly the nurse supervisor, can make a significant contribution in the search to harness some of the energy we use in laughing and direct it toward helping us heal our human conditions.
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