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PubMed2002

Group for research in pathology education online resources to facilitate pathology instruction.

BACKGROUND: The Group for Research in Pathology Education (GRIPE) is an organization of pathology educators whose purpose is to promote and facilitate excellence in pathology education. One important function of GRIPE is the maintenance of image and multiple-choice test question data banks. These resources have recently been made available online via the GRIPE Digital Library Web site. The purpose of the GRIPE Digital Library project was to develop an online searchable database that would facilitate access to the GRIPE resources for pathology education. DESIGN: The GRIPE image bank--containing approximately 3000 peer-reviewed gross and microscopic pathologic images along with textual descriptions--was linked with the GRIPE test question bank using Gossamer Thread's DBMan Web database management program. The search and display templates create a functional user interface that integrates images, image descriptions, and test questions into a single online digital library. Using any Web browser, faculty can access the GRIPE Digital Library and search for images and/or test items that can be used in teaching. RESULTS: In the first 18 months (February 2000 through July 2001), users at 40 GRIPE member institutions signed up and used the GRIPE Digital Library to perform more than 6000 individual searches and view more than 37500 images. These digital images were used to produce lectures and laboratory modules that were posted on Web pages and made available to students remotely. CONCLUSIONS: The GRIPE Digital Library provides a unique resource that can facilitate development of educational materials for pathology instruction and helps to fulfill the educational mission of GRIPE.

Computer Communication Networks↗
PubMed1986

Vibrotactile stimulation for the adventitiously deaf: an alternative to cochlear implantation.

Acoustic correlates of the prosodic features identifying English contrastive stress, ie, fundamental frequency (Fo), duration and intensity, and listener perceptions were investigated in a profoundly adventitiously deaf subject (D) pre/postvibrotactile stimulation, and in an age-peer normally-hearing person as a control (N). Stimuli were a group of general American English words in which a change of function from noun to verb was associated with a shift of stress from initial to final syllable, eg, CON'test vs conTEST'. Prior to vibrotactile stimulation, D was unable to produce contrastive stress correctly. Only final syllable intensity differences were noted, but proved to be inadequate cues for contrastive stress. Vibrotactile stimulation resulted in changes, specifically significantly higher Fo for initial stressed vs unstressed syllables, significantly louder intensity for final stressed vs unstressed syllables, and significantly longer duration for final stressed vs unstressed syllables. Perceptually, listeners judged D's contrastive stress placement as always occurring on the final syllable previbrotactile stimulation and as 78% correct postvibrotactile stimulation. N's contrastive stress placement was always correct. It was concluded that use of vibrotactile stimulation enhanced D's production and resulted in listeners' perceptions of correct prosody.

Cochlear Implants↗
PubMed2006

Adult congenital heart disease: the patient's perspective.

This article presents the adult congenital heart disease (ACHD) patient "voice" by high-lighting issues and challenges commonly identified in peer support forums but rarely addressed in the existing literature. Representative patient quotations are provided, and relevant research on patient education and psychosocial function is referenced. Issues discussed include the provision of overly pessimistic and overly optimistic prognoses, common patient misperceptions and knowledge gaps, frustrations and dangerous encounters in the medical system, and living with invisible disabilities. Patient self-perception of congenital heart disease, the gifts of congenital heart disease, and the role of patient associations are also discussed. For each issue identified, implications for the ACHD health professional are outlined and recommendations for best practices are made.

Adult↗
PubMed2004

Parent-reported health status after pediatric thoracic organ transplant.

BACKGROUND: Thoracic organ transplantation is a life-changing event for a child and family from both a physical and a psychosocial perspective. Accurate pre-transplantation counseling and effective post-transplantation follow-up depend on a good understanding of post-transplantation health status, especially as perceived by families. METHODS: The Child Health Questionnaire-Parent Form 50 (CHQ-P50), an instrument that assesses parent-reported health status of pediatric patients, was administered to 47 pediatric thoracic organ transplant recipients (41 heart, 6 lung) 5 to 18 years of age. RESULTS: Transplant recipients scored lower on the Physical Health Summary (PhS) score than the general population, as evidenced by a lower median score (50.6 vs 55.1, p < 0.0001) and a difference in the distribution of quartiles (p = 0.001), skewed toward the lower quartiles of the general population. The distribution of PhS scores in transplant recipients was comparable to scores of 3 groups of pediatric patients with other chronic health conditions (juvenile rheumatoid arthritis, epilepsy and asthma). The distribution of the Psychosocial Health Summary (PsS) scores was similar to that of the general population, but the median score was lower (51.5 vs 53.2, p = 0.02). Transplant patients clearly scored lower than the general population on 4 of 12 sub-scales, including those assessing general health, physical functioning, family activities and parental emotional impact. No difference was found in sub-scales reflecting self-esteem, mental health, behavior, pain, peer interactions, family cohesion or parental time demands. CONCLUSIONS: Thoracic organ transplantation in children ages 5 to 18 years is associated with an ongoing deficit in parent-perceived physical health status.

Adolescent↗
PubMed1996

Toward tense as a clinical marker of specific language impairment in English-speaking children.

A critical clinical issue is the identification of a clinical marker, a linguistic form or principle that can be shown to be characteristic of children with Specific Language Impairment (SLI). In this paper we evaluate, as candidate clinical markers, a set of morphemes that mark Tense. In English, this includes -s third person singular, -ed regular past, BE, and DO. According to the Extended Optional Infinitive Account (EOI) of Rice, Wexler, and Cleave (1995), this set of morphemes is likely to appear optionally in the grammars of children with SLI at a rate lower than the optionality evident in younger controls. Three groups of preschool children participated: 37 children with SLI, and two control groups, one of 40 MLU-equivalent children and another of 45 age-equivalent children. Three kinds of evidence support the conclusion that a set of morphemes that marks Tense can be considered a clinical marker: (a) low levels of accuracy for the target morphemes for the SLI group relative to either of the two control groups; (b) affectedness for the set of morphemes defined by the linguistic function of Tense, but not for morphemes unrelated to Tense; and (c) a bimodal distribution for Tense-marking morphemes relative to age peers, in which the typical children are at essentially adult levels of the grammar, whereas children in the SLI group were at low (i.e., non-adultlike) levels of performance. The clinical symptoms are evident in omissions of surface forms. Errors of subject-verb agreement and syntactic misuses are rare, showing that, as predicted, children in an EOI stage who are likely to mark Tense optionally at the same time know a great deal about the grammatical properties of finiteness and agreement in the adult grammar. The findings are discussed in terms of alternative accounts of the grammatical limitations of children with SLI and implications for clinical identification.

Child↗
PubMed1997

Functional knee braces and dynamic performance: a review.

OBJECTIVE: The purpose of the present review was to examine current experimental research on the effectiveness of functional knee braces (FKBs) used by patients with anterior cruciate ligament injury during dynamic performance tests. DATA SOURCES: Twelve studies published in peer-reviewed journals and listed in the Excerpta Medica system were reviewed. STUDY SELECTION: All studies compared braced and unbraced tests performed by the same subjects, using tests characterized by weight bearing/axial loading. DATA EXTRACTION: Studies were reviewed independently by three investigators. DATA SYNTHESIS: Tests included one-leg hop, figure-of-eight run, stair climbing, walking, cutting, agility runs, straight running, and bicycle ergometry. Experimental situations were classified as follows: (a) maximal effort tests, which compared overall measures of performance such as the distance hopped and the time to run a specific distance; and (b) matched submaximal effort tests, which compared specific variables such as electromyography, range of motion, ground reaction forces, and energy costs. Bracing was found to be advantageous in three of the 16 maximal effort situations, disadvantageous in two, and of no measurable effect in 11. Six of the 10 matched effort situations reported differences in the criterion measurements when braced, while four reported no differences. CONCLUSIONS: If FKB prescription is to be based solely on empirical evidence of efficacy from performance tests, then further investigation is required to provide this evidence. Future research needs to examine the subjective and psychological aspects of FKB usage along with the results of objective performance tests.

Braces↗
PubMed1990

The staff psychiatrist and the Joint Commission survey.

The psychiatrist on a hospital's medical staff has a major role in maintaining the quality standards established by the Joint Commission on Accreditation of Healthcare Organizations and in preparing for its accreditation survey. The authors review the medical staff's role in quality assurance activities, including development of clinical indicators, monitoring of clinical data, peer review of problems, and planning for improved care. Other areas of hospital operation requiring the attention of the medical staff are the functioning of the medical executive committee, hospital bylaws, and procedures for granting, denying, and amending clinical privileges.

Accreditation↗
PubMed1999

Too little, too late: primary vs. secondary interventions for adolescents with sickle cell disease.

The cognitive, biological, and psychological characteristics of adolescents affect their adaptation to a chronic medical condition. This article reviews the literature on how sickle cell disease alters the normal developmental challenges facing adolescents. Examples of these challenges include delayed maturation, neurologic complications, sequelae of pain episodes, and prolonged financial and family dependence. These challenges are also discussed within the context of family and peer relationships, as well as cultural norms. Using the principles of anticipatory guidance, interventions into the psychological development may help to preserve normal functioning. These interventions need to be provided in a manner acceptable to the adolescent within the community context. The education, counseling, and medical services provided by the multidisciplinary team in the Comprehensive Sickle Cell Program at Children's Hospital in Columbus, Ohio are used to highlight these intervention strategies.

Adolescent↗
PubMed2004

Therapeutic applications of citicoline for stroke and cognitive dysfunction in the elderly: a review of the literature.

Citicoline (CDP-choline; cytidine 5'-diphosphocholine), a form of the essential nutrient choline, shows promise of clinical efficacy in elderly patients with cognitive deficits, inefficient memory, and early-stage Alzheimer's disease. Citicoline has also been investigated as a therapy in stroke patients, although the results of trials to date are inconclusive. Produced endogenously, citicoline serves as a choline donor in the metabolic pathways for biosynthesis of acetylcholine and neuronal membrane phospholipids, chiefly phosphatidylcholine. The principal components of citicoline, choline and cytidine, are readily absorbed in the GI tract and easily cross the blood-brain barrier. Exogenous citicoline, as the sodium salt, has been researched in animal experiments and human clinical trials that provide evidence of its cholinergic and neuroprotective actions. As a dietary supplement, citicoline appears useful for improving both the structural integrity and functionality of the neuronal membrane that may assist in membrane repair. This review, while not intended to be exhaustive, highlights the published, peer-reviewed research on citicoline with brief discussions on toxicology and safety, mechanisms of action, and pharmacokinetics.

Alzheimer Disease↗
PubMed1979

[A report on studies on the child's adaptation to school and family environment after neoplastic disease].

The objective of this study was to learn the course of child's adaptation process to school and family environment following the neoplastic disease. The study also aimed select the environment and personality factors influencing adaptation effect. The study pertains to the child's personality and how it works at home and at school. It also tries to get to know the child's environment. 65 children of different social environment were studied. Motor functions of these children were limited as the result of tumour disease. Special scale of adaptation was prepared when the research was over. By means of this sale two groups of children were distinguished: those who were well adapted to the environment and those who were not. Statistical analysis was used to compare the groups on account of the following factors: health factors including: a kind of tumour, duration of the disease, prevalence of pain, manipulation and locomotive abilities, visibility of handicap; sociological factors including: age and sex of studied persons, the place of residence and education of parent's, living standard of the family, a degree of family participation in cultural life of the society, mother's attitude towards the insane child. These factors allow to formulate the following dependences: The more a level of the child's locomotive functions, following neoplastic disease approaches to the standard, the more favourable course takes the process of child's adaptation to the family and peers. If a neoplastic disease leaves permanent and always visible handicap then child's adaptation effect to the environment is not favourable. An active participation of the family in socially life is beneficial for regular adaptation of a child. Personality development as the result of participation in cultural life allows socially accepted defence mechanism to work in stress situations connected with the disease. Parent's rational attitude towards an insane child correlates with a beneficial child's adaptation to an environment. Other factors did not differentiate the two groups statistically. During clinicalontgenetic analysis concerning particular studied cases, 3 models of nonfunctional adaptation were distinguished: maladjustment of aggressive type prevailing among the children with permanent physical handicap coming of families characteristic for socially nonaccepted standard of behaviour; maladjustment of neurotic type prevailing among the children coming of compliant families whose adult members manifest neurotic vegetative reactions in difficult situations.(ABSTRACT TRUNCATED AT 400 WORDS)

Activities of Daily Living↗
PubMed1993

The relations of emotionality and regulation to preschoolers' social skills and sociometric status.

The purpose of this study was to examine the relations of emotionality (intensity and negative emotion) and regulation (coping and attentional regulation) to preschoolers' social skills (as rated by adults) and sociometric status. Teachers' ratings of children's constructive coping and attentional control were positively related to boys' social skills and peer status, whereas negative affect was negatively related. Acting out (vs. avoidant) coping and emotional intensity were negatively related to girls' and boys' social skills and boys' peer status. In addition, mothers' reports of boys' coping by seeking social support and low emotional intensity were associated with boys' positive social functioning, whereas avoidant coping was positively related to girls' rated social skills. The results are discussed in relation to research on emotion regulation and coping with emotion in interpersonal contexts.

Adaptation, Psychological↗
PubMed1999

Impact of osteoarthritis and analgesic treatment on quality of life of an elderly population.

UNLABELLED: To determine the quality of life of elderly patients with osteoarthritis (OA) compared with that of their peers with no chronic illnesses and to investigate the associations between analgesic use and quality of life. SUBJECTS: Patients >65 years of age with OA taking analgesics with (n = 33) and without (n = 26) comorbidities, and control patients with no chronic illness and not taking analgesics (n = 37). METHODS: Quality of life was assessed by the SF-36 and level of pain was measured by a visual analog scale. Multiple regression analysis was used to determine the medication characteristics and additional patient factors significantly associated with SF-36 scores. RESULTS: OA patients had significantly (p < 0.05) lower scores than control patients in all quality-of-life domains. OA patient scores were lowest for the domains of role-physical, bodily pain, and physical functioning. OA patients with comorbidities also had poorer general and mental health. Pain- and analgesic-related factors were significantly (p < 0.05) associated with physical health status, reduced vitality, general health, and social functioning. A better quality of life was associated with noncompliance, fewer visits to the physician, and taking oral nonsteroidal antiinflammatory agents. Presence of adverse drug reactions and sleep disturbance did not influence SF-36 scores significantly. CONCLUSIONS: Quality of life of elderly OA patients with and without additional comorbidities was significantly poorer than that of their healthy peers, particularly in the domains associated with physical status, but also affecting vitality, social functioning, and general health. Level of pain suffered and perceived effectiveness of analgesic medication in pain control were important factors associated with quality of life.

Aged↗
PubMed1995

Phenytoin and carbamazepine: differential effects on cognitive function.

This review summarizes the studies on the cognitive side-effects of two important antiepileptic drugs: phenytoin and carbamazepine. A large literature database was compiled through the DIMDI computer database and the inspection of recent reviews. Only scientific articles published in peer-reviewed journals during the last 25 years were selected. Of the 358 potentially relevant papers on cognitive effects of AEDs, a total of 16 studies have been found that have studied both carbamazepine and phenytoin. After excluding studies with designs that do not permit valid inferences regarding the cognitive effects of AEDs, only five studies remained. The evaluation of these studies reveal that our current knowledge allows us to draw conclusions about the cognitive side-effects of phenytoin and carbamazepine only with great caution. The claim in reviews that 'both drugs have an impact on cognitive function, PHT to a larger degree than CBZ' is simply not supported by valid 'high quality' data. The same is true for the overall conclusion in more recent reviews that 'drug-induced cognitive effects of these AEDs on cognitive function are probably mild or even negligible'. Apparently, the only information that we have is that the differential impact of PHT and CBZ on cognitive function is not extremely different. No conclusive and reconfirmed data are available on the absolute effects of CBZ and PHT (differences between the two drugs and a no-treatment condition). Our review summarizes some recommendations for future studies.

Carbamazepine↗
PubMed1998

Measurement of gastrointestinal motility in the GI laboratory.

Current tests of gastric and small intestinal motor function provide relevant physiological information, but their clinical utility is controversial. This article reviews the current procedures, indications, significance, pitfalls, and guidelines for gastrointestinal motility measurements by scintigraphy, gastroduodenojejunal manometry, and surface electrogastrography in humans. Methods included review of literature and discussions in closed and open fora among investigators, including presentations for peer review at focused (Iowa City American Motility Society Symposium, December 1995) and national meetings (American Gastroenterological Association, May 1996, and American Motility Society, September 1996). The current tests are generally complementary; scintigraphy is typically the first test in the evaluation of gastric motor function and often confirms the clinical suspicion of dysmotility. Manometry identifies patterns suggestive of myopathy, neuropathy, or obstruction but may be most helpful when it shows entirely normal findings, because manometry helps in part to exclude dysmotility as a cause of symptoms. Electrogastrography may identify dysrhythmias or failure of signal power to increase postprandially; rhythm abnormalities may be independent of impaired emptying among dyspeptic patients. The best validated and clinically most significant results pertain to transit tests; manometry may contribute importantly to the diagnostic process; and the significance of electrogastrography remains to be fully elucidated.

Digestive System↗
PubMed2002

Paper-and-pencil or online? Evaluating mode effects on measures of emotional functioning and attachment.

The viability of using the World Wide Web to collect data from three widely used instruments by clinicians and researchers was investigated. The instruments were the Inventory of Parental and Peer Attachment, the Negative Mood Regulation Scale, and the Trait Meta-Mood Scale. Data were collected from two comparable groups of college students, and differences in response patterns on paper-and-pencil and World Wide Web versions of the measures, at both the item level and scale score level, were documented. Although mode of administration effects were statistically significant, the magnitude of the effects was in general very small. The basic similarity of the properties of the measures using paper-and-pencil and online Internet modes of administration suggests the viability of the Internet for assessing these and other psychological phenomena.

Adolescent↗
PubMed1990

Effects of collateral peer supportive behaviors within the classwide peer tutoring program.

A classwide peer tutoring procedure was implemented in an urban elementary school classroom to improve students' spelling performance. Three students combined untrained or collateral tutoring behaviors with the core behaviors initially taught. To explore the function of these natural and spontaneous behaviors, a multielement single-subject experiment with replications was conducted. Results indicated that the additional tutoring behaviors increased (a) the academic response frequencies of 3 tutees and (b) the weekly spelling achievement of 1 target tutee. The remaining class members were successfully taught and continued to use these behaviors over the final 3 weeks of the school year. These findings are discussed with regard to academic instruction, natural communities of peer reinforcement, and the social validation of intervention procedures.

Achievement↗
PubMed2004

Adopted children's problem behavior is significantly related to their ego resiliency, ego control, and sociometric status.

BACKGROUND: Many studies have documented that adopted children are at higher risk for behavior problems, but less is known about the correlates of their problem behavior. METHOD: The correlates of parent-reported and teacher-reported problem behavior in 7-year-old internationally adopted children (N = 176) were investigated by examining these children's ego resiliency, ego control, and sociometric status, and exploring possible risks factors in the home and racial influences. RESULTS: Using the 25th percentiles lowest and highest scores on ego resiliency and ego control as cut-off criteria, we found that: (1) resilient children were almost free of behavior problems; (2) overcontrolling children showed predominantly internalizing behavior problems (33% at school, and 28% at home); (3) undercontrolling children showed high rates of externalizing behavior problems (50% at school, and 34% at home), and an elevated rate of comorbidity (21% at school, and 21% at home). Adopted children identified by peer report as controversial or rejected had significantly higher externalizing problem scores than popular, average or neglected adopted children. The adopted children did not experience much (racial) discrimination. Nevertheless, children who wished to be white (46%) presented more mother-reported behavior problems. CONCLUSIONS: Our findings replicate R.W. Robins et al.'s (1996) work on three types of personality functioning: resilients, overcontrollers and undercontrollers (identified by J. Block, 1971), extending the model from adolescent boys to school-aged boys and girls, adopted from Asia and South America. The wish to identify with white parents and white peers may constitute a potential risk factor for internationally adopted children in middle childhood.

Adoption↗
PubMed2006

The concepts of remission and recovery in schizophrenia.

OBJECTIVE: To examine the past and current research into the concepts of remission and recovery in schizophrenia. DATA SOURCES: An electronic literature search of studies published between January 1990-April 2005 examining the concepts of remission and recovery in schizophrenia and the treatment of schizophrenia with antipsychotic agents was performed using Medline and EMBASE. Primary research parameters were 'schizophrenia', 'remission', 'recovery', 'meta-analysis', 'antipsychotics', 'atypicals', 'conventional', 'cognition', 'function' and 'quality of life'. STUDY SELECTION: English language articles, original research articles, reviews and other articles of interest were reviewed. DATA EXTRACTION: Data quality was determined by publication in the peer-reviewed literature and the most important information was identified. DATA SYNTHESIS: A number of different definitions of remission and recovery have been previously used, which has made comparison of study results problematic. Recently, the first operational definition of remission, based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria (DSM-IV) for schizophrenia, was developed. It is hoped that this will provide a standard tool for assessing the effectiveness of treatments for schizophrenia. Recovery, which encompasses both symptom remission and more functional aspects of patient's well being, such as cognition, social functionality and quality of life, is still to be satisfactorily defined. Although recent studies on new generation antipsychotics have examined some proxy outcomes related to recovery, further research is required. CONCLUSIONS: Until the definition for 'recovery' is further elucidated, factors such as symptom control and remission, and functional aspects of recovery such as improvements in cognition and social functioning, which are quantifiable, should be used as measures of treatment outcome and markers of recovery.

Antipsychotic Agents↗