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PubMed2003

Hypertension and the brain: vulnerability of the prefrontal regions and executive functions.

Untreated hypertension negatively affects brain anatomy and cognitive functions, but the effects of medically treated hypertension are unclear. The authors compared 40 middle-age and older adults diagnosed with essential hypertension to demographically matched normotensive peers. Volumes of 7 brain regions and deep and periventricular white-matter hyperintensities (WMH) were measured on magnetic resonance imaging scans. Performance in 4 cognitive domains (perseveration, working memory, fluid reasoning, and vocabulary knowledge) was evaluated. Persons with hypertension had smaller prefrontal cortex and underlying white matter volumes and increased frontal WMH. No group differences were found in other examined brain regions. Among examined cognitive variables, hypertensive patients committed significantly more perseverative errors. Thus, even controlled hypertension may be associated with deficits in brain structure and cognition, warranting further study.

Aged↗
PubMed1996

Personal and familial characteristics of resilient sons of male alcoholics.

This study compared sons of male alcoholics (SOMAs) who had no problems with those who were abusing substances, those who had school problems, those who were delinquent and those who were multiproblem. Corresponding groups of non-SOMAs were also included. Groups were compared at ages 6, 10, 12 and 14 years on teacher- and peer-rated aggressiveness, hyperactivity, inattention, anxiety and prosociality; parent-rated temperament; parents' disciplinary practices; school performance; family socio-economic status; self-reported substance (ab)use and delinquency; and school performance (from school records). Differences between SOMAs and non-SOMAs were small. According to teachers and peers, no problem SOMAs and non-SOMAs were less aggressive-oppositional, inattentive and hyperactive than problem SOMAs and non-SOMAs. These effects differed as a function of age, however. Also, no problem SOMAs and non-SOMAs performed better in school than boys in the problem groups. We discuss the relevance of these findings for identifying factors that render children resilient and for early screening to select truly at risk SOMAs for prevention programs.

Achievement↗
PubMed2002

Social processes and outcomes of in-school contact between deaf and hearing peers.

Studies of social processes and outcomes of the placement of deaf students with hearing peers cannot be easily summarized, but can be grouped into a least four major categories of focus: social skills, interaction and participation, sociometric status and acceptance, and affective functioning. We review 33 studies available since 1980 in which a mainstreamed or included deaf sample was compared to another group. Studies indicated (1) that hearing students were more socially mature than deaf students in public schools, (2) that deaf students interacted with deaf classmates more than hearing ones, (3) that deaf students were somewhat accepted by their hearing classmates, and (4) that self-esteem was not related to extent of mainstreaming. There was a tendency for studies to use observational methods with very young children, teacher evaluations with middle school children, and questionnaires with older children. Three major areas of methodology limit general conclusions: samples, measurements of variables, and experimental manipulations. The reviewed studies provide a basis for understanding the social processes and outcomes in these placement situations; however, it is not possible to make broad generalizations about effects of placement.

Journal Article↗
PubMedDate not supplied

Analgesic drug prescription and use in cognitively impaired nursing home residents.

BACKGROUND: Prior research has documented the high prevalence of pain in elderly adults and the difficulties associated with properly assessing and treating pain in elders with cognitive impairment. OBJECTIVES: To investigate the prescription and administration of analgesic medications to treat pain in cognitively impaired nursing home residents. METHOD: The current sample consisted of 339 nursing home residents (295 women and 44 men) with a mean age of 87 years (range 66-104). Forty-six percent of the sample had diagnosed cognitive impairment, and 55% had at least one diagnosed painful condition. Data for this correlational study were drawn from four nursing homes in Western Pennsylvania. The Multidimensional Observation Scale for Elderly Subjects was used to assess behavioral indicators of cognitive impairment, and chart review was used to obtain demographic, medication, and diagnostic data. RESULTS: The results indicated that cognitively impaired nursing home residents are prescribed and administered significantly less analgesic medication, both in number and in dosage of pain drugs than their more cognitively intact peers. In multiple regression analyses holding the presence of painful conditions constant, more disoriented and withdrawn residents were prescribed significantly less analgesia by physicians; more disoriented, withdrawn, and functionally impaired residents were administered significantly less analgesia by nursing staff. CONCLUSIONS: The findings highlight the difficulties of assessing pain in cognitively impaired elders and the lack of knowledge among health care providers about effective pain management.

Activities of Daily Living↗
PubMed1990

Treatment of meningeal relapse in childhood acute lymphoblastic leukemia: II. A prospective study of intellectual loss specific to CNS relapse and therapy.

Changes in intellectual function during the course of treatment for acute lymphocytic leukemia were studied. Twenty-four children had baseline psychological evaluations and annual reevaluations for 3-6 years postdiagnosis. Treatment in all patients included combination chemotherapy, 2,400 cGy prophylactic cranial irradiation, and intrathecal methotrexate. Central Nervous System (CNS) relapse occurred in eight of these children. It was then treated with 3,000 cGy cranial plus 1,800 cGy spinal irradiation. Patients who remained in continuous complete remission showed no decline in global intelligence quotient (IQ). Patients who experienced CNS relapse had a mean decline of 16 IQ points by 3 years postdiagnosis and the long-term survivors displayed a mean loss of 25 IQ points 5-6 years postdiagnosis. Three of the five long-term survivors of CNS relapse function within the retarded range of mental ability and require special education. The other two have learning problems and display poor academic performance relative to same-age peers. There was no association noted between age at diagnosis and ultimate loss of IQ points. This prospective study suggests that children who receive a second course of cranial irradiation for treatment of CNS relapse are at high risk for significant and progressive intellectual loss.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Social functioning and adjustment in Chinese children: the imprint of historical time.

This study examined, in 3 cohorts (1990, 1998, and 2002) of elementary school children (M age=10 years), relations between social functioning and adjustment in different phases of the societal transition in China. Data were obtained from multiple sources. The results indicate that sociability-cooperation was associated with peer acceptance and teacher-rated competence, whereas aggression was associated with social and school difficulties in all 3 cohorts. The effect of different social contexts was reflected mainly in the relations between shyness-sensitivity and adjustment. Whereas shyness was associated with social and academic achievement in the 1990 cohort, the associations became weaker or nonsignificant in the 1998 cohort. Furthermore, shyness was associated with peer rejection, school problems, and depression in the 2002 cohort.

Achievement↗
PubMedDate not supplied

Influence of cognitive status on the sexual life of 352 elderly Italians aged 65-105 years.

BACKGROUND: Various factors are considered to influence sexual behavior in the elderly, but the role played by preservation of adequate cognitive functioning has not been adequately explored. OBJECTIVE: The aim of this research, conducted on 352 older adults aged between 65 and 105 years, was to identify the specific role played by cognitive functioning in sexual activity and sexual interest in the elderly. METHODS: The data were collected from elderly people attending the surgeries of 21 general practitioners in the city of Padua (Italy). Analysis of sexual functioning was based on two items, from the LEIPAD questionnaire: 'Are you interested in sex?' and 'Do you have sexual relations?'. Subjects cognitive status was assessed objectively through the Mini Mental State Examination (MMSE) and subjectively by the LEIPAD subscale on cognitive functioning. RESULTS: Subjects who were sexually active and interested in sex were more highly represented among the married elderly. The elderly who reported being active and interested in sex were significantly younger and had a significantly superior educational level and MMSE score. Mean scores for cognitive functioning and all quality-of-life indicators were in general significantly better for the active and interested. Univariate logistic regression analysis indicated that a higher MMSE score and cognitive functioning score influenced the maintenance of sexual interest. CONCLUSIONS: One third of the subjects reported being still sexually active and 40% being still interested in sex. This study seems to suggest that a significant role may be played by cognitive functioning in the maintenance of sexual interest in the elderly, especially older females in whom this dimension is evidently linked to far more diversified experiences than their male peers.

Aged↗
PubMed1999

Report describes benchmarks for administrative expenses.

How does your HMO stack up against its peers where administrative costs are concerned? Data from a survey conducted by Sherlock Company of six large HMOs was broken out into six product lines and 15 major functions, and then analyzed three ways. Check out the results.

Accounting↗
PubMed2002

A terrorism response plan for hospital security and safety officers.

Security and Safety managers in today's healthcare facilities need to factor terrorism response into their emergency management plans, separate from the customary disaster plans and the comparatively recent security plans. Terrorism incidents will likely be security occurrences that use a weapon of mass destruction to magnify the incidents into disasters. Facility Y2K Plans can provide an excellent framework for the detailed contingency planning needed for terrorism response by healthcare facilities. Tabbed binder notebooks, with bulleted procedures and contact points for each functional section, can provide security and safety officers with at-a-glance instructions for quick 24/7 implementation. Each functional section should focus upon what activities or severity levels trigger activation of the backup processes. Network with your countywide, regional, and/or state organizations to learn what your peers are doing. Comprehensively inventory your state, local, and commercial resources so that you have alternate providers readily available 24/7 to assist your facility upon disasters.

Disaster Planning↗
PubMedDate not supplied

Nursing students in an expanded charge nurse role: a real clinical management experience.

Ensuring that baccalaureate nursing students obtain a measure of management and leadership proficiency is a challenge for nurse educators. Having senior students manage juniors in a clinical course modeled in a peer hierarchal pattern that emulates advanced beginner practice is a creative approach that is both realistic and achievable. Through specific learning experiences, students are exposed to typical management functions and asked to demonstrate management and leadership skills at an expanded charge nurse level.

Attitude of Health Personnel↗
PubMed1992

Gait analysis in pediatric lower extremity amputees.

Walking function in 56 children with lower extremity amputations was assessed using a questionnaire and gait analysis. Children with prosthetic lower extremities can be very functional in society, often participating in sports. Limitations are proportional to the extent of the missing limbs. As a group, pediatric amputees walk more slowly than their normal peers with a slower cadence and a longer stride length. Pediatric amputees have higher heart rates when walking than normal children, but they seem willing to pay a higher physiologic price for ambulation.

Adolescent↗
PubMed1994

Executive summary of the surgeon general's report: preventing tobacco use among young people.

Smoking and smokeless tobacco use are almost always initiated and established in adolescence. Besides its long-term effects on adults, tobacco-use produces specific health problems for adolescents. Since nicotine addiction also occurs during adolescence, adolescent tobacco users are likely to become adult tobacco users. Smoking and smokeless tobacco use are associated with other problem behaviors and occur early in the sequence of these behaviors. The outcomes of adolescent smoking and smokeless tobacco use continue to be of great public health importance, since one out of three US adolescents uses tobacco by age 18. The social environment of adolescents, including the functions, meanings, and images of smoking that are conveyed through cigarette advertising sets the stage for adolescents to begin using tobacco. As tobacco products are available and as peers begin to try them, these factors become personalized and relevant, and tobacco use may begin. This process most affects adolescents who, compared with their peers, have lower self-esteem and self-images, are less involved with school and academic achievement, have fewer skills to resist the offers of peers, and come from homes with lower socioeconomic status. Tobacco-use prevention programs that target the larger social environment of adolescents are both efficacious and warranted.

Adolescent↗
PubMed2003

Descriptive functional analysis of behavioral excesses shown by adults with Down syndrome and dementia.

OBJECTIVES: The study examined the hypothesis that a functional relationship exists between social environmental events and behavioral excesses in individuals with Down syndrome and dementia. DESIGN: A case-series design was employed (n = 4) using an direct observation-based descriptive functional assessment procedure. METHODS: Observations were conducted in the natural environments of four participants over periods ranging from 11 to 15.4 hours. Data were collected on non-verbal and verbal behavioral excesses, appropriate engagement and verbal interaction with others. Social environmental events observed including both staff and peer behavior. RESULTS: Analysis of co-occurrence for behavioral excesses and social environmental events indicated significant relationships for some behaviours consistent with operant reinforcement processes. Sequential analysis showed that changes in the probability of social contact occurred in the period directly preceding and following verbal behaviors. CONCLUSIONS: Results support the hypothesis that, consistent with literature for older adults with dementia in the general population, some behavioral excesses were functional in nature and not randomly occurring events. No relationship was found between appropriate engagement and staff contact. Evidence of the functional nature of target behavioral excesses indicates that behavioral interventions have potential for this client group.

Adult↗
PubMed1997

Peer assessment of social reputation in community samples of disruptive and nondisruptive children: utility of the revised class play method.

Examined the psychometric properties of the Revised Class Play (RCP), a peer assessment measure of social reputation, in epidemiological samples of disruptive (n = 220) and nondisruptive (n = 104) children in Grades 2 through 5. Principal components analyses yielded a four-factor solution that was similar for disruptive and nondisruptive children and to previous research with this instrument. Discriminative function analyses demonstrated that the four RCP dimensions were each successful in predicting group membership, with the leadership and social etiquette dimensions best able to differentiate disruptive and nondisruptive groups. Regression modeling showed that the variance accounted for by the four RCP dimensions was large and varied for specific dimensions based on the criterion variable chosen. The advantages of the RCP as a devise for tracking social competence and peer reputation in high-risk disruptive children are discussed.

Child↗
PubMed2006

PAL2NAL: robust conversion of protein sequence alignments into the corresponding codon alignments.

PAL2NAL is a web server that constructs a multiple codon alignment from the corresponding aligned protein sequences. Such codon alignments can be used to evaluate the type and rate of nucleotide substitutions in coding DNA for a wide range of evolutionary analyses, such as the identification of levels of selective constraint acting on genes, or to perform DNA-based phylogenetic studies. The server takes a protein sequence alignment and the corresponding DNA sequences as input. In contrast to other existing applications, this server is able to construct codon alignments even if the input DNA sequence has mismatches with the input protein sequence, or contains untranslated regions and polyA tails. The server can also deal with frame shifts and inframe stop codons in the input models, and is thus suitable for the analysis of pseudogenes. Another distinct feature is that the user can specify a subregion of the input alignment in order to specifically analyze functional domains or exons of interest. The PAL2NAL server is available at http://www.bork.embl.de/pal2nal.

Codon↗
PubMed2006

Development of macrophages with altered actin organization in the absence of MafB.

In the hematopoietic system the bZip transcription factor MafB is selectively expressed at high levels in monocytes and macrophages and promotes macrophage differentiation in myeloid progenitors, whereas a dominant-negative allele can inhibit this process. To analyze the requirement of MafB for macrophage development, we generated MafB-deficient mice and, due to their neonatal lethal phenotype, analyzed macrophage differentiation in vitro, in the embryo, and in reconstituted mice. Surprisingly we observed in vitro differentiation of macrophages from E14.5 fetal liver (FL) cells and E18.5 splenocytes. Furthermore we found normal numbers of F4/80(+)/Mac-1(+) macrophages and monocytes in fetal liver, spleen, and blood as well as in bone marrow, spleen, and peritoneum of adult MafB(-/-) FL reconstituted mice. MafB(-/-) macrophages showed intact basic macrophage functions such as phagocytosis of latex beads or Listeria monocytogenes and nitric oxide production in response to lipopolysaccharide. By contrast, MafB(-/-) macrophages expressed increased levels of multiple genes involved in actin organization. Consistent with this, phalloidin staining revealed an altered morphology involving increased numbers of branched protrusions of MafB(-/-) macrophages in response to macrophage colony-stimulating factor. Together these data point to an unexpected redundancy of MafB function in macrophage differentiation and a previously unknown role in actin-dependent macrophage morphology.

Actins↗
PubMed1999

Evolution of CT findings in patients with cystic fibrosis.

OBJECTIVE: The aim of our study was to assess the evolution of pulmonary CT findings in cystic fibrosis patients. MATERIALS AND METHODS: Serial CT examinations were performed in four different follow-up periods on 107 patients with cystic fibrosis. Lung images of the initial and follow-up CT were reviewed and scored for specific morphologic findings. CT findings were correlated with the results of the pulmonary function tests and clinical (Shwachman-Kulczycki) scores. RESULTS: Morphologic changes were minor within the first 18 months of follow-up compared with the period after 18 months. The increase of the overall score was significantly higher in groups with follow-up periods longer than 18 months compared with groups with follow-up periods shorter than 18 months. Various components of morphologic changes contributed to the sequential changes seen on the CT scans. All morphologic changes and the CT scores correlated significantly (p < .0001) with pulmonary function tests and clinical score. CONCLUSION. Serial CT scans allow assessment of the evolution of pulmonary abnormalities in patients with cystic fibrosis. CT seems to have advantages over pulmonary function tests and clinical scoring in the depiction of pulmonary changes over time.

Adolescent↗
PubMed1993

Monitoring of investigational adverse drug experiences.

A number of different facets of the task of monitoring adverse experiences in clinical trials of investigational drugs are considered. Key responsibilities of the monitoring process are identified as warning, observation, and management. The relationship of regulatory needs to organizational culture is reviewed. A number of specific areas of interest relating to the monitoring process are examined, including event capture at the investigational site, unblinding, and causality assessment. The importance of an independent quality assurance oversight of the adverse experience monitoring function is touched on, as is the essential role of data management in the functioning of the safety monitoring effort.

Consumer Product Safety↗