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PubMedDate not supplied

Lack of short-latency-potentials in the VEP reflects immature extra geniculate visual function in delayed visual maturation (DVM).

PURPOSE: To investigate children with delayed visual maturation (DVM) and correlate the electrophysiological findings to visual development. METHODS: Three children, one from each of the DVM-classification groups, were subjected to routine ophthalmological examinations and electrophysiological examinations: flash visual evoked potential (VEP) and skin electrode electroretinography (ERG). RESULTS: All three children had normal ERGs but initially abnormal VEP-recordings with marked delay of latency or grossly altered VEPs. When visual interest developed with responsive smiling at 4, 4.5 and approximately 12 months of age, a maturation in the VEPs also appeared, with development of a short-latency complex (approximately 70 ms). In the normal neonatal development of the VEP, a negativity at approximately 60-70 ms (N1) emerged at four to six weeks of postnatal life when the child started responsive smiling and showing raised visual interest. According to animal experimental research and human studies, the development of the specific response (the short-latency complex) represents the gradual onset of cortical activity mediated via the specific retino-geniculo-striatal pathway. Thus, when the short-latency complex of the VEP cannot be identified, the visual function is mainly of subcortical origin. Since the VEP developed in the same way in the children with DVM as in normal subjects, the pathophysiological dysfunction and origins of DVM can partly be understood. CONCLUSIONS: The results show that i) children with DVM has a period of visual inattentiveness at a time when normal children show visual interest, ii) the VEP is abnormal in children with DVM at the time of visual inattentiveness, iii) the improvement of vision in DVM can be measured with VEP and iiii) the extra-geniculate system(s) provides for the visual function early neonatally in the normal child and in a prolonged period in the DVM-child as long as the VEPs are abnormal.

Electroretinography↗
PubMed2000

Children's acceptance of xylitol-based foods.

UNLABELLED: Daily consumption of xylitol (5-10 g/day) added to chewing gum and confectionary foods has been previously shown to prevent dental caries in children. METHODS: Snack foods containing xylitol were developed and tested for acceptability in a convenience sample of 31 children ages 3 to 6 years. In order to mimic an after-meal snack, all children were tested during mid-morning, approximately 1 h after eating. Preference testing was based on the methodology of Birch et al. (J Nutr Educ, 1979; 11: 77-80). In the first phase, each child was presented with a tray of six xylitol-based foods (popsicles, pudding, gum drops, gelatin dessert, cookies, popcorn) and asked to taste each item in any desired order. Immediately after tasting a food, the child was asked to place it in front of one of three cartoon faces (smile, frown or neutral) representing the child's response to the taste of that particular food. In the second phase, the child was asked to rank order the foods in each face category (smile, frown or neutral). Ranks within categories were then combined to obtain a rank ordering for all of the foods. RESULTS: Non-parametric data analysis indicated significant differences in ranking between the foods when they were compared to each other (Friedman ANOVA by ranks, P<0.01). Pudding was significantly less preferred than the other foods (sign tests, P<0.04). At least 84% of the children found five of the six foods very good or satisfactory, when considered individually. CONCLUSIONS: These results suggest that snack foods developed with xylitol are generally well accepted by children.

Analysis of Variance↗
PubMed2003

Evaluation of motivation methods used to obtain appropriate oral hygiene levels in schoolchildren.

The aim of the present study is to assess the behaviour of different motivation methods on levels of oral hygiene among schoolchildren aged from 7 to 9 years in Araraquara, SP, Brazil. The methods tested were: indirect instruction using 'The Smiling Robot' (group I), indirect instruction through class presentation (group II) and direct instruction with macromodels (group III). A control group was also constituted, which received no kind of motivation (group IV). The O'Leary Plaque Index was used as the evaluation method, applied before the instruction and 30 days after application of the different methods. It was noted that the plaque index had not decreased in group IV only. In conclusion, all the motivation methods promoted significant decrease of plaque index and among these methods, the 'The Smiling Robot' was the one that provided the best results.

Audiovisual Aids↗
PubMed1999

Emerging sensitivity to the timing and structure of protoconversation in early infancy.

Thirty-six 2-, 4-, and 6-month-old infants were videotaped while interacting with a female adult stranger engaging in either organized or disorganized 1-min peekaboo games. Two-month-old infants gazed and smiled equally at the stranger, regardless of the relative organization of the peekaboo game. In contrast, 4- and 6-month-old infants smiled significantly more and gazed significantly less in the organized peekaboo condition than in the disorganized peekaboo condition. These results suggest that from a diffuse sensitivity to the presence of a social partner, infants by 4 months develop a new sensitivity to the narrative envelope of protoconversation, in particular the timing and the structure of social exchanges scaffolded by adults. These observations are interpreted as evidence of developing social expectations in the first 6 months of life. This early development is viewed as announcing and preparing the communicative competence that blossoms by the end of the 1st year.

Adult↗
PubMed2002

Physical therapists' nonverbal communication predicts geriatric patients' health outcomes.

Two studies explored the link between health care providers' patterns of nonverbal communication and therapeutic efficacy. In Study 1, physical therapists were videotaped during a session with a client. Brief samples of therapists' nonverbal behavior were rated by naive judges. Judges' ratings were then correlated with clients' physical, cognitive, and psychological functioning at admission, at discharge, and at 3 months following discharge. Therapists' distancing behavior was strongly correlated with short- and long-term decreases in their clients' physical and cognitive functioning. Distancing was expressed through a pattern of not smiling and looking away from the client. In contrast, facial expressiveness, as revealed through smiling, nodding, and frowning, was associated with short- and long-term improvements in functioning. In Study 2, elderly subjects perceived distancing behaviors of therapists more negatively than positive behaviors.

Activities of Daily Living↗
PubMed2006

Increasing occlusal vertical dimension--why, when and how.

Cosmetic dentistry has evolved with the advent of more robust porcelain materials and ever-stronger bonding agents. This series of three articles aims to provide a practical overview of what is now possible both functionally and cosmetically from the preparation of a small number of teeth, through a whole smile, to full mouth rehabilitation. A complete diagnosis is the starting point to planning any cosmetic or functional changes. Guidance is given on the techniques used but adequate training must be considered essential before embarking upon modification in occlusal schemes or even minor adjustments in smile design. Understanding vertical dimension and how and when it can be changed has always been a challenging prospect for the general dental practitioner. This article aims to discuss the rationale behind changes in vertical dimension and demonstrate how it can be achieved in general practice assuming adequate hands-on postgraduate training has been completed.

Centric Relation↗
PubMed1996

A comparison of three-dimensional and two-dimensional analyses of facial motion.

The purpose of this study was to compare the amplitude of facial motion obtained using three-dimensional (3-D) and two-dimensional (2-D) methods. The amplitude of motion of fifteen facial landmarks during five maximal animations (smile, lip-purse, grimace, eye closure, and cheek-puff) was quantified in 3-D and 2-D using a video-based system. Results showed that the 3-D amplitudes were significantly larger than the 2-D amplitudes, especially for landmarks on the lower face during the smile animation. In the latter instance, the 2-D amplitudes underestimated the 3-D amplitudes by as much as 43%. The difference between 3-D and 2-D amplitudes was greater for 2-D amplitudes obtained from one camera rather than from multiple cameras. The results suggest that a 2-D analysis may not be adequate to assess facial motion during maximal animations, and that a 3-D analysis may be more appropriate for detecting clinical differences in facial function.

Adult↗
PubMed2005

A mini-implant for orthodontic anchorage in a deep overbite case.

This article describes the orthodontic treatment of a 19-year-old female patient with anterior crowding. There was a moderate arch length discrepancy in the lower dental arch, a significant deep overbite, and a "gummy smile." We inserted an orthodontic mini-implant as anchorage for the intrusion of the upper incisor segment, followed by alignment of the upper and lower dental arches with an edgewise appliance without tooth extraction. The overbite was corrected from +7.2 mm to +1.7 mm by upper incisor intrusion, and the gummy smile was improved. Good occlusion and facial esthetics were achieved, and these results have been maintained for two years after completion of the active treatment.

Adult↗
PubMed1999

Non-verbal behaviour in nurse-elderly patient communication.

This study explores the occurrence of non-verbal communication in nurse-elderly patient interaction in two different care settings: home nursing and a home for the elderly. In a sample of 181 nursing encounters involving 47 nurses a study was made of videotaped nurse-patient communication. Six non-verbal behaviours were observed: patient-directed eye gaze, affirmative head nodding, smiling, forward leaning, affective touch and instrumental touch. With the exception of instrumental touch these non-verbal behaviours are important in establishing a good relationship with the patient. To study the relationship between non-verbal and verbal communication, verbal communication was observed using an adapted version of Roter's Interaction Analysis System, which distinguishes socio-emotional and task-related communication. Data were analysed in hierarchical linear models. The results demonstrated that nurses use mainly eye gaze, head nodding and smiling to establish a good relation with their patients. The use of affective touch is mainly attributable to nurses' personal style. Compared to nurses in the community, nurses in the home for the elderly more often display non-verbal behaviours such as patient-directed gaze and affective touch.

Aged↗
PubMed2000

Statistical models for predicting response to interferon-alpha and spontaneous seroconversion in children with chronic hepatitis B.

To develop prognostic models for identifying children with hepatitis B who are likely to respond to interferon-alpha (IFN-alpha) or to spontaneously seroconvert, we evaluated results of a multinational controlled trial comprising 70 children with chronic hepatitis B who received IFN-alpha and 74 children who did not receive therapy. Prognostic models were developed using SMILES (similarity of least squares), which is a data analysis network that incorporates multidimensional relationships in the clinical data of complex diseases. Commonly collected clinical data included age, gender, serum aminotransferase (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) and hepatitis B virus (HBV) DNA levels, and IFN-alpha dose. Additional data included pretreatment directional information (e.g. increases or decreases in serum aminotransferase and HBV DNA levels), liver biopsy results, race and transmission mode. Using data available prior to initiation of treatment, the SMILES models achieved prospective predictions of 89% for responders, 96% for non-responders, 100% for seroconverters and 93% for non-seroconverters. Although not predictive by themselves, the variables that had the greatest impact on predictions for IFN-alpha response were HBV DNA pretreatment direction, baseline HBV DNA, IFN-alpha dose and gender. The variables that had the greatest impact on predictions for spontaneous seroconversion were ALT pretreatment direction, baseline HBV DNA level, age and AST pretreatment direction. Therefore, these models may be useful in determining, in children with hepatitis B, the likelihood of response to IFN-alpha and spontaneous seroconversion.

Adolescent↗
PubMed2001

Botulinum-A toxin treatment of the lower eyelid improves infraorbital rhytides and widens the eye.

Botulinum-A exotoxin (BTX-A) can be used cosmetically to improve rhytides, particularly of the upper one-third of the face. In this study, fifteen women had BTX-A (BOTOX, Allergan, Inc.) injected into the orbicularis oculi muscle. One lower eyelid received two units just subdermally in the midpupillary line three millimeters below the ciliary margin. The opposite periocular area received two units BTX-A in the lower eyelid with 12 units BTX-A injected into the lateral orbital ("crow's foot") area. Three injections of four units each were placed 1.5 cm from the lateral canthus, each 1 cm apart. Patients and physicians independently evaluated the degree of improvement (grade 0 = no improvement, grade 1 = mild improvement, grade 2 = moderate improvement, and grade 3 = dramatic improvement). An independent photographic analysis was performed. Patients reported a grade of 0.73 when two units were injected alone into the lower lid, and a grade of 1.9 when the lower eyelid and the lateral orbital areas were injected. Physician assessment was grade 0.7 with injection of the eyelid alone and grade 1.8 with injection of the lower eyelid and lateral orbital area. Single investigator photographic analysis demonstrated that 40% of the subjects who had injection of the lower eyelid alone had an increased palpebral aperture (IPA), while 86% of the subjects who had injection of the lower eyelid and lateral orbital area had an IPA. Subjects receiving two units alone had an average 0.5 mm IPA and a mean 1.3 mm IPA at full smile. Concomitant treatment of the lateral orbital area produced a mean 1.8 mm IPA at rest and a mean 2.9 mm IPA at full smile. The results were more notable in the Asian eye. Two units of BTX-A injected into the lower eyelid orbicularis oculi muscle improves infraorbital wrinkles, particularly when used in combination with BTX-A treatment of the lateral orbital area.

Adolescent↗
PubMed2002

Hyperventilation-induced high-amplitude rhythmic slowing with altered awareness: a video-EEG comparison with absence seizures.

PURPOSE: Hyperventilation-induced high-amplitude rhythmic slowing (HIHARS) in children may be associated with clinical episodes of altered awareness. The presence of automatisms has been proposed as a distinguishing feature that helps to differentiate absence seizures from nonepileptic causes of decreased responsiveness. This retrospective, controlled, video-EEG study compared the clinical characteristics of episodes of HIHARS with loss of awareness with those of absence seizures. METHODS: The database of a tertiary Children's Hospital was searched for patients studied between April 1993 and April 1997 who had at least one episode of HIHARS with loss of awareness. The absence control group was obtained by selecting the next patient, after an HIHARS study subject, who met the following criteria: (a) had at least one absence seizure occurred during hyperventilation in the EEG recording, and (b) had a diagnosis of idiopathic generalized epilepsy. The video-EEG and medical histories of all patients were reviewed and summarized. RESULTS: We reviewed video-EEG recordings of 77 episodes of HIHARS with loss of awareness from 22 children and 107 absence seizures during hyperventilation from 22 children. Eye opening and eyelid flutter were seen more frequently in absence seizures, whereas fidgeting, smiling, and yawning occurred more frequently during HIHARS episodes. Arrest of activity, staring, and oral and manual automatisms were observed in both groups. CONCLUSIONS: Automatisms are common in both HIHARS and absence seizures. Yawning, smiling, and particularly fidgeting occur more commonly and eye opening and eyelid flutter less commonly in HIHARS. However, episodes of HIHARS with loss of awareness clinically mimic absence seizures, and these conditions can be distinguished reliably only by EEG.

Awareness↗
PubMed2003

A detailed analysis of symptomatic posterior cortex seizure semiology in children younger than seven years.

PURPOSE: To analyze the semiology of seizure onset and evolution in young children with posterior cortex epilepsy (PCE), compare this with adult reports, and assess age-related differences. METHODS: We videotaped and analyzed 110 seizures from 18 patients with PCE, aged 3-81 months. All had a good prognosis after posterior epileptogenic zone removal. Ictal events were categorized by behavioral, consciousness, autonomic, and sensory features, as well as motor patterns, which included myoclonic, tonic, clonic, unclassified motor seizures, and epileptic spasm. A time-scaled data sheet was developed to record each epileptic event as onset, very early, early, or late manifestation. RESULTS: Patients had a high seizure frequency with < or =100 attacks/day; one third of them showed a cluster tendency. The mean duration of seizures was 67 s. The most common seizure components were motor manifestations (with myoclonic and tonic seizures), but psychomotor (automotor), hypomotor attacks, and isolated auras also were frequently observed. Clinical seizure spread was frequent; auras and visual sensory signs were difficult to record in this age. Typical phenomena during seizures included behavioral changes, ictal vocalization, smile, flush, head nod, oculomotor features, and late-appearing oral automatisms, whereas hypermotor and secondarily generalized tonic-clonic seizures were not seen. CONCLUSIONS: Our results suggest that PCE in infants and young children is very heterogeneous but shows important age-related features. Compared with adults, children with PCE have shorter but more frequent seizures; they rarely report aura or visual sensory signs, only sporadically develop hypermotor and secondarily generalized tonic-clonic seizures, whereas ictal smile, flush, head nod, and behavioral change are typical features at this age. Because of frequent subtle ictal phenomena, long-term video-EEG monitoring is a useful diagnostic tool with infants and young children with PCE.

Child↗
PubMed2000

Elderly pain assessment and pain management knowledge of long-term care nurses.

The purpose of this study was to determine the knowledge base of long-term care nurses regarding pain assessment and management in the elderly. Three specific themes related to long-term care nurses were investigated: personal beliefs regarding patients' self-reports of pain, documentation of patients' self-reports of pain, and choice of pain medication and dose. Eighty-nine long-term care nurses, from 6 rural counties in California, responded to a questionnaire that consisted of 2 patient scenarios. The scenarios portrayed 1 patient as smiling and showing no objective signs of pain and the other patient as grimacing. Three questions followed up the scenarios related to elder pain assessment and management. Nurses were asked to indicate their pain assessment on a 0 to 10 scale and to choose the correct pain medication and dose. Frequencies and means were used to analyze demographic data; frequencies, t tests, and chi 2 testing compared nurse responses with the different questions. Results indicated that nurses were more likely to believe and document the grimacing patient's self-report of pain than the smiling patient. Older nurses with more experience were less likely to believe or document their patient's self-report of pain than younger nurses with fewer years of experience. Less than half of the nurses would increase the analgesic dose for either patient scenario. Nursing implications include the importance of ongoing pain assessment and management education tailored to the geriatric population and long-term care.

Adult↗
PubMed1985

Thatcher and the Cheshire cat: context and the processing of facial features.

As has been noted before, a face made gruesome by the inversion of its mouth will not be so perceived when the entire construction is inverted. Results are presented which suggest that this is because the mouth and eye features are evaluated individually (although each feature may influence the evaluation of the other) and the mouth, whether normal or inverted, tends to have its uppermost part assigned as 'top', providing for either a pleasant smiling-mouth expression or a gruesome 'biting-intention' expression. However, the gruesomeness of an inverted mouth is attenuated when eyes are shown below it (producing an inverted smiling face) which suggests that the location of other facial features can also influence the assignments of 'top'.

Eye↗
PubMed1993

The reaction of 9- to 10-month-old infants to an unfamiliar animal.

In an attempt to assess infants' reactions to one particular class of animate objects (animals), as opposed to persons and inanimate objects, 57 babies between 9 and 10 months old were divided into three equal groups and assigned to three experimental conditions, involving (a) a living unfamiliar dwarf rabbit, (b) a novel toy, or (c) an adult stranger. The same infant-controlled procedure was used in all conditions, and the infants' reactions were measured in terms of approach and stimulus- as well as mother-directed looks, smiles, and vocalizations. Results showed that the animal provoked an intermediate reaction, consisting of a combination of behaviors elicited by the inanimate object (i.e., quick proximity seeking, contact, and scarcity of smiles) and by the person (i.e., strong and lasting attention). Implications of these results for clarification of the infant's concept of animal was discussed.

Concept Formation↗
PubMed1988

The effects of service dogs on social acknowledgments of people in wheelchairs.

Able-bodied people often exhibit behaviors that show them to be socially uncomfortable upon encountering a physically disabled stranger. These behaviors include less eye contact, gaze avoidance, greater personal distance, and briefer social interactions. This study examined whether persons in wheelchairs with service dogs receive more frequent social acknowledgement from able-bodied strangers than people in wheelchairs without dogs receive. Behaviors of passersby were recorded by an observer who followed a person in a wheelchair at a distance of 15 to 30 feet. Observations were made in public areas amid pedestrian traffic, areas such as shopping malls and a college campus. The behaviors of passersby to the person in a wheelchair, with or without a service dog, were recorded, including smiles, conversation, touch, gaze aversion, path avoidance, or no response. Results indicated that both smiles and conversations from passersby increased significantly when the dogs were present. These findings suggest that the benefits of service dogs for their owners extend beyond working tasks to include enhanced opportunities for social exchange. The service dogs substantially reduced the tendency of able-bodied people to ignore or avoid the disabled person.

Adult↗
PubMed1998

Interpersonal interactions in individuals with schizophrenia: individual differences among patients and their partners.

We examined 60 face-to-face ten-minute interactions between individuals with schizophrenia and college students. We studied patient responses to the students and student responses to the patients. Following each interaction, participants provided reports of their current mood and how well they liked their interaction partner. The interactions were audio- and video-taped, which allowed us to measure the frequency of patient and student smiles and eye contact, patient strangeness, and the pleasantness of the conversational content. We found individual differences among patients in the degree to which they were liked by students. Patient strangeness was associated with interaction partner negative responses to patients. In addition, the pleasantness of the conversational content was associated with how well patient and student were liked by one another. Sixteen percent of the variance in patient smiling was accounted for by the particular student with whom the patient interacted. The results of this study highlight the importance of attending to both intrapersonal and interactional factors for understanding patient interpersonal functioning.

Adult↗