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Psychosocial support in the treatment of severely burned patients.

A psychosocial team took part in the total patient care program of a burn unit. Psychometric data were gathered during the treatment phase and at one-year followup. The treatment plan included adequate analgesics, major tranquilizers when indicated, attention to sleep requirements for patients, and active participation of family members in the treatment program, with supportive psychotherapy. Standardized psychological and intelligence tests were administered to adult patients during treatment and one year after discharge, and scores compared.

Adaptation, Psychological↗

Somatic versus nonsomatic shoulder and back pain experience in middle age in relation to body build, physical fitness, bone mineral content, gamma-glutamyltransferase, occupational workload, and psychosocial factors.

This study selected 205 subjects aged 55 years who had shoulder and/or back pain complaints to determine the relationship of somatic and nonsomatic pain experience to body build, physical fitness, bone mineral content, serum levels of gamma-glutamyltransferase, occupational workload and intelligence test, educational level, life success, social support, stress at work, monotonous work, and job decision latitude. Men with a somatic back pain drawing experienced more stress at work and had higher serum levels of gamma-glutamyltransferase, indicating a higher intake of alcohol and/or painkillers, but were more satisfied with their jobs compared with men who had a nonsomatic pain drawing. Women with obvious shoulder signs and symptoms and/or a somatic back pain drawing tended heavier than women without symptoms, had higher serum levels of gamma-glutamyltransferase, and found their jobs more mentally demanding than did women with shoulder and/or back pain experience but without obvious shoulder signs and symptoms and/or a nonsomatic back pain drawing.

Back Pain↗

Comorbidity of functional urinary incontinence and encopresis: somatic and behavioral associations.

PURPOSE: Functional urinary incontinence and encopresis are common comorbid disorders in childhood. We analyze the specific somatic and behavioral symptoms associated with functional enuresis/urinary incontinence and encopresis when they occur together. MATERIALS AND METHODS: A total of 167 consecutive children 5 to 10 year olds, with day and/or night wetting were examined prospectively with ultrasound, uroflowmetry, electroencephalography, the Child Behavior Checklist, Culture Fair Intelligence Test and ICD-10 child psychiatric diagnoses. RESULTS: The main findings for the comorbid group (20 patients) with wetting and soiling were a significantly higher rate of daytime incontinence and micturition problems, thickened bladder walls and pathological electroencephalography. There were higher, although not significant, rates of previous urinary tract infections, antibiotic prophylaxis, residual volume and abnormal uroflow curves in this group. Behaviorally, hyperkinetic syndromes, and emotional and conduct disorders (according to ICD-10) were more common. Of the 20 patients 65% had a Child Behavior Checklist total score (greater than 90th percentile) in the clinical range. The externalizing, internalizing, delinquent and anxious/depressed problem scales were also significantly higher. CONCLUSIONS: This risk group requires detailed assessment and specific treatment. In addition to the symptomatic treatment of the wetting and soiling, many of these children are in need of specific behavioral, psychotherapeutic and pharmacological treatment.

Behavioral Symptoms↗

Congenital arhinia: a case report and functional evaluation.

OBJECTIVES: Congenital arhinia is rare clinical entity. An unusual case of congenital arhinia with no surgical treatment is presented. STUDY DESIGN: Case report. METHODS: A 9-year-old with congenital arhinia was referred for treatment of otitis media with effusion. In addition to his undergoing imaging studies since birth, various functional evaluations regarding the nose were performed. Furthermore, the pathogenesis of arhinia is discussed. RESULTS: The imaging workup revealed the absence of nasal bones, the nasal septum, and turbinates, hypoxia of the maxilla, and a high-arched palate. Furthermore, magnetic resonance imaging clearly demonstrated the absence of olfactory bulbs and tracts, resulting in no response with olfactometry. Among the examinations performed, chromosomal analysis, polysomnography, and an intelligence test produced normal results. In the hearing assessment, he had a slight conductive hearing loss. A phonetic examination revealed the typical pattern of rhinophonia clausa. CONCLUSIONS: This study presents congenital arhinia associated with facial anomalies. Because there was no life-threatening complications and normal psychomotor development, the patient could not only be followed up long-term but could also have his nose functionally evaluated. It is highly likely that this case might have been the result of the failure of medial and lateral nasal processes to grow, which was the underlying pathogenesis.

Child↗

Facial deformity in childhood: severity and psychological adjustment.

This study examines the hypothesis that severe facial deformities may be less of a psychological burden than those that are more mild. Twenty-seven experimental children and 12 controls, plus 26 siblings of the experimental group and 12 control siblings, were assessed using tests of intelligence, self-concept and ratings of behaviour. The results provided some support for the hypothesis being considered.

Child↗

Cystinuria and mental deficiency.

Several studies have shown that the incidence of cystinuria in mentally retarded populations is higher than it is in the general population. The present study found that a group of cystinurics did not differ significantly in their intelligence from their normal siblings or intelligence test norms. Since cystinuria is a heterogeneous disease, the findings of the present study could be reconciled with previous findings by supposing that only certain genotypes for cystinuria lead to mental retardation.

Adolescent↗

Parental agreement on child rearing during early childhood and the psychological characteristics of adolescents.

In previous research, an index of parental agreement regarding child-rearing orientations was found to relate to the quality of children's psychological functioning from 3 to 7 years of age. For this study, the parental agreement index, derived when their children were 3 years old, was related to a variety of psychological measures and personality descriptions obtained when the children were adolescents. Reliable differences were found in the patterning of relations for boys and girls wherein parental agreement during early childhood was associated with tested intelligence, aspects of moral judgment, and dimensions of personality derived from self-reports for boys but not for girls. For adolescent girls, early parental agreement was associated with the congruence of "self" and "ideal-self" descriptions (i.e., self-esteem). For both girls and boys, parental agreement was associated with personality descriptions provided by observers; however, it was only in the sample of girls that early parental agreement significantly correlated with Q sort criterion scores referencing ego-undercontrol and ego-resiliency. These findings suggest that early family socialization experiences are importantly but differently salient for boys and girls with respect both to psychological content and the developmental timing of effects. The data suggest that socialization researchers consider the likelihood that developmental paths to competence differ markedly for girls and boys.

Adolescent↗

Long-term neurological sequelae following vacuum extractor delivery.

Two hundred and ninety-five children delivered by vacuum extractor (VE) 10 years ago were studied to determine if they had an increased incidence of neurological abnormality; 302 children delivered spontaneously in the same hospital looked after by the same doctors in the same year matched for maternal age, gestational age and birthweight were used as controls. Fine- and gross-motor control, perceptual integration and behavioural maturity were screened by 4 tasks selected from the Quick Neurological Screening Test. Intelligence assessment was based on scholastic performance, speech ability and ability of self-care as commented by teachers and parents. Similar scorings were found between the 2 groups. Mental subnormality or severe neurological abnormality was found in 3 children delivered by VE and in 3 children delivered spontaneously and there was no evidence that it was birth-related.

Child↗

Distinct genetic influences on grammar and phonological short-term memory deficits: evidence from 6-year-old twins.

Children with language impairments have limitations of phonological short-term memory (STM) and have distinctive problems with certain aspects of grammar. Both deficits have been proposed as phenotypic markers of heritable language impairment. We studied 173 twin pairs, selected to be over-representative of children with risk of developmental language impairment, using a battery of standardized language and intelligence tests, a test of nonword repetition to index phonological STM and two elicitation tasks to assess use of verb tense marking. As predicted, the phonological STM and the verb tense measures both discriminated children with risk of language impairment from low risk children, and DeFries-Fulker analysis showed that impairments on both tasks were significantly heritable. However, there was minimal phenotypic and etiological overlap between the two deficits, suggesting that different genes are implicated in causing these two kinds of language difficulty. From an evolutionary perspective, these data are consistent with the view that language is a complex function that depends on multiple underlying skills with distinct genetic origins.

Aging↗

Dieting in teenage schoolgirls. A longitudinal prospective study.

The aim of the present study was to demonstrate what far-reaching consequences dieting may produce in teenage girls and to determine whether there is a direct relation between dieting and the development of anorexia nervosa. The study took the form of a longitudinal prospective investigation of dieting teenage schoolgirls over a 10-year observation period, particularly as regards physical and mental state of health and general psychosocial development. The questionnaire study underlying the present work--entitled "The feeling of being fat and dieting in a school population"--was published in 1971 by Ingvar Nylander. With the aim of determining how often teenagers feel overweight, how often they diet and how often they develop disorders from dieting, Nylander interviewed 2370 students (1129 boys and 1241 girls). His study was published in Acta Socio-Medica Scand 1971, 1. In the present work a primary material of 130 girls was selected from the dieting schoolgirls and 111 of these were examined by the author. The methods included a personal interview, examination of physical and mental health, an EEG examination and an intelligence test. Moreover, information was obtained concerning the subjects from their parents and from school health records and hospital case records. A follow-up study was done 10 years later, in which 97 of the subjects were again examined by the author while 12 subjects merely answered a questionnaire. The methods used were very similar to the foregoing ones. The subjects' dieting behaviour was evaluated on the basis of an anorectic behaviour scale. Further information was obtained from hospital case records. The overall situation of the subjects was evaluated on the basis of case histories and of data from case records concerning heredity, environment, psychosocial adjustment, state of health and findings on examination. Some of the subjects had had a dieting problem for a long time; they had generally dieted for short but repeated periods, but, in most cases, with little effect on their weight. Some patients had developed anorectic behaviour, or even AN, others did not. The former group had shown such behaviour at an early stage--or other signs of mental insufficiency--while the latter group was healthy and during dieting periods developed neither anorectic behaviour nor anorexia nervosa. Thus no direct causal relation between dieting and anorexia nervosa could be demonstrated. If dieting is caused by mental insufficiency, this may lead to the development of anorectic behaviour and/or anorexia nervosa.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗

The understanding of counting in children with severe learning difficulties and nursery children.

BACKGROUND: Little is known about the development of counting in children with severe learning difficulties (SLD) although early research has stressed the rote nature of children's understanding. AIMS: We investigated the attainments of children with SLD both with regard to their skills and understanding of counting and compared performance with typically developing preschoolers. SAMPLES: Twenty-five children with SLD (aged 7-14 years) matched to one group of preschoolers on the basis of their receptive language scores and to a second group using a broader measure, performance on a non-verbal intelligence test. METHODS: Children were presented with a simple counting task and an error detection task. RESULTS: There were no differences between the SLD and preschool groups in the mean scores on either task. In each group more children were able to count than detect errors. However, analysis of their counting performance suggested a difference in the acquisition of counting skills. Furthermore, the SLD group included three transitional children-able to count competently but not able to detect errors. This pattern was not evident in the preschool groups: if the children were competent counters they were able to detect errors. CONCLUSION: The acquisition of procedures for counting is an important first step in developing an understanding of counting. There is some evidence to suggest that children with SLD may have difficulty learning the number words and producing them whilst pointing to count items. We cannot assume that children with SLD will move smoothly towards an understanding of counting. These aspects warrant further investigation and raise the important question of what experiences best promote the acquisition of procedures and understanding in children with SLD.

Adolescent↗

An audio-visual corpus for speech perception and automatic speech recognition.

An audio-visual corpus has been collected to support the use of common material in speech perception and automatic speech recognition studies. The corpus consists of high-quality audio and video recordings of 1000 sentences spoken by each of 34 talkers. Sentences are simple, syntactically identical phrases such as "place green at B 4 now". Intelligibility tests using the audio signals suggest that the material is easily identifiable in quiet and low levels of stationary noise. The annotated corpus is available on the web for research use.

Acoustic Stimulation↗

Evaluation of spectral enhancement in hearing aids, combined with phonemic compression.

In this study, the separate and combined effects on speech perception of compensation of the reduced dynamic range by compression and compensation of the reduced frequency resolution by spectral enhancement is investigated. The study has been designed to compare the effects of signal processing on monosyllabic consonant-vowel-consonant words for hearing-impaired listeners in conditions of quiet, fluctuating noise, and continuous noise. Speech perception of spectrally enhanced speech was compared with unprocessed speech. In addition, a comparison was made between combinations of spectrally enhanced speech and two types of phonemic compression. In the past, the definition "syllabic compressor" is often used to indicate fast compressors. However, the time constants of the fast compressors used in this study are so short that syllabic has become an inappropriate term. Moreover, intelligibility tests were performed in which scores were acquired of monosyllabic words, and their constituent "phonemic" parts. Therefore, the definitions "phoneme" and phonemic will be used throughout this paper. In one condition, spectral enhancement produced significant improvements for vowel perception. But, this was counteracted by deterioration of the consonant scores for all but one subject. In general, the best overall scores for consonant-vowel-consonant words were obtained in the unprocessed condition. After the spectral enhancement, a single-channel phonemic compressor added no improvement. There are indications that a multichannel phonemic compressor and spectral enhancement have opposite effects, because the scores for this combination are, in general, the lowest.

Adolescent↗

Native Italian speakers' perception and production of English vowels.

This study examined the production and perception of English vowels by highly experienced native Italian speakers of English. The subjects were selected on the basis of the age at which they arrived in Canada and began to learn English, and how much they continued to use Italian. Vowel production accuracy was assessed through an intelligibility test in which native English-speaking listeners attempted to identify vowels spoken by the native Italian subjects. Vowel perception was assessed using a categorial discrimination test. The later in life the native Italian subjects began to learn English, the less accurately they produced and perceived English vowels. Neither of two groups of early Italian/English bilinguals differed significantly from native speakers of English either for production or perception. This finding is consistent with the hypothesis of the speech learning model [Flege, in Speech Perception and Linguistic Experience: Theoretical and Methodological Issues (York, Timonium, MD, 1995)] that early bilinguals establish new categories for vowels found in the second language (L2). The significant correlation observed to exist between the measures of L2 vowel production and perception is consistent with another hypothesis of the speech learning model, viz., that the accuracy with which L2 vowels are produced is limited by how accurately they are perceived.

Adolescent↗

Soviet psychology and psychophysiology.

Pavlov's experiments, begun long before the revolution, have always been generously supported by the Soviet state. However, their far-reaching ontological and methodological implication gained an official and commanding position to Soviet biomedical and psychosocial (as distinct from socioeconomic) sciences only in 1950 with the Resolution of the 28 June-4 July Joint Pavlovian Session of the Soviet Academy of Sciences and Academy of Medical Sciences. In the biomedical sciences, present-day Soviet Pavlovianism may best be conceived of as (i) a doctrine of nervism (a Russian term)-the ubiquity of neural control of bodily reactions (neural, neurosomatic, neurovisceral, and neurohumoral) and (ii) a doctrine of what might be called concomitantism (my term )-the ready and radical modification of these reactions by concomitant reactions; or, viewed more generally and somewhat differently, as (iii) a far-reaching physicalistic psychosomaticism or, rather, a neuroviscerosomaticism. Psychophysiology-or higher nervous activity-is the key discipline here. With scores of research institutes, it is indeed a very well-established, wide-scoped, and faradvanced faradvanced science that, in both present achievements and future capabilities, is a challenge to American and Western equivalents. On the other hand, in the psychosocial sciences and the key discipline of psychology proper, unmitigated Pavlovian physicalism and objectivism is met head on by (i) the unbending postulate of dialectical materialism of "the specific emergent efficacy of consciousness and subjective conscious categories" as well as by (ii) the simple consideration that a consistent Pavlovianism is a fully autarchic psychology and needs no other science of psychology on top of it. A large portion of current Soviet psychological theory in psychology proper is thus primarily a textual and exegetic collation and conciliation of the views of Pavlov with those of Marx, Engels, and Lenin (until recently and, to some extent even now, also of Stalin), just as most current Soviet psychological experimentation in psychology proper is primarily a duplication of what Soviet psychophysiology could do as well, if not better. Moreover, there is the longstanding drastic ban on intelligence testing, psychoanalysis, Gestalt psychology, and other to-be-shunned "bourgeois-psychological" thought-and-practice systems, so that, in all, psychology proper is a much constricted and, per se, more ancilliary than basic discipline of Soviet empirical research-a state of affairs plainly reflected in the fact that the number of its research institutes and publications (as well as the number of psychologists proper) is but a small fraction of the number in psychophysiology. Yet, in evaluating our efforts in the area vis-à-vis those of the Soviets, we must, obviously, take full account of both disciplines, Soviet psychophysiology being in all respects a psychology in American terms (60). Indeed, it is Soviet psychophysiology, and not Soviet psychology proper, that is the homolog not only of American behavioristics but also, to a large extent, of all American experimental psychology.

Academies and Institutes↗

Neurodevelopmental outcome of hypoglycaemia in healthy, large for gestational age, term newborns.

AIMS: To evaluate the effects of transient hypoglycaemia on the first day of life in 75 healthy term large for gestational age (LGA) infants, born to non-diabetic mothers, on their neurodevelopmental outcome at the age of 4 years. METHODS: Screening for hypoglycaemia was performed 1, 3, and 5 hours after birth, and continued if blood glucose levels were low. Treatment with intravenous glucose for hypoglycaemia was started if hypoglycaemia was severe or symptomatic. Patients' development and behaviour was examined at the age of 4 years by the Denver Developmental Scale, a non-verbal intelligence test, and the Child Behaviour Check List. RESULTS: There were no significant differences between children with neonatal normoglycaemia (n = 15) and hypoglycaemia (plasma glucose <2.2 mmol/l 1 hour after birth, or <2.5 mmol/l subsequently; n = 60) in Denver developmental scale scores and child behaviour checklist scores. Although total IQ did not differ between hypoglycaemic and normoglycaemic children, one subscale (reasoning) did (mean difference 9.3, 95% CI 1.3 to 17.2). The correlation between reasoning IQ and neonatal blood glucose levels was weak and not statistically significant. When other definitions for hypoglycaemia were applied, the difference in reasoning IQ was not found. There were no differences in any of the test scores between hypoglycaemic children who had and who had not been treated with intravenous glucose. CONCLUSION: Transient mild hypoglycaemia in healthy, term LGA newborns does not appear to be harmful to psychomotor development at the age of 4 years.

Birth Weight↗