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Neurological sequelae in children surviving mechanical ventilation in the neonatal period.

The incidence of mental defect, visual and hearing disability, major neurological handicap, and such minor neurological handicap as can be detected on examination at 2--9 years without formal intelligence testing, is presented among survivors of neonatal mechanical ventilation at Hammersmith Hospital between the years 1966--1973 inclusive. 77(21%) of 367 children survived, over three-quarters of them being born elsewhere. 3 died before the age of 6 months, 2 suddenly and unexpectedly at home, the third accidentally. 1 child was lost to follow up. 11 (15%) of the remaining 73 children had neurological sequelae as defined. In two-thirds this was moderate to severe. Spastic diplegia may no longer be the commonest form of cerebral palsy among those of low birthweight, particularly those surviving severe neonatal illness.

Child↗

Psychological effects of sodium valproate and carbamazepine in epilepsy.

Information from standardised tests of intelligence, school attainments, attention, memory and visuomotor function, together with parent and teacher questionnaire information about various aspects of behaviour, was obtained for 63 schoolchildren with newly diagnosed epilepsy before treatment with sodium valproate or carbamazepine, and again at intervals for a total period of 12 months. The same information was collected on 47 matched controls. The children with epilepsy represented those under non-specialised paediatric care. The result showed that both drugs were effective in most cases at modest dosage without causing notable psychological effects 12 months into treatment. Modest and temporary adverse cognitive effects seen earlier in treatment could have been the result of uncontrolled seizure discharge. Improved function was the same in children with epilepsy and controls. Some psychological abnormalities in the children with epilepsy were evident before treatment suggesting early unwanted effects of the epileptic process itself.

Carbamazepine↗

Reading attainment and physical development after whooping cough.

Anthropometric measurements were made on 360 primary school children with a history of whooping cough and on 711 controls. Altogether 245 (68%) cases and 469 (66%) controls had taken tests of reading attainment and a smaller number had taken tests of intelligence. No significant differences were found between cases and controls in any of the anthropometric measurements nor in reading age or intelligence quotient after controlling for social class and parental smoking. Whooping cough is, in general, unlikely to cause subsequent deficiency in physical or mental development.

Adolescent↗

Cognitive recovery after severe head injury. 1. Serial testing on the Wechsler Adult Intelligence Scale.

The Wechsler Adult Intelligence Scale was administered serially to 40 severely head-injured adults, and the results compared with a matched group of 40 non-injured men. The scores on the verbal subtests showed less initial impairment and were faster to recover to the level of the comparison group than were the non-verbal subtest scores. Verbal IQ of the head-injury group approached that of the comparison group within about one year of injury, while recovery of Performance IQ continued over about three years.

Adolescent↗

Memory disorder related to coma duration after head injury.

The relationship of memory and intelligence test performances to coma duration was studied in 51 head injured patients who had not been operated on for intracranial haematoma. Memory defect was related to coma duration, and was not secondary to impaired perceptual or conceptual analysis of the material to be remembered.

Adult↗

Deficits on self ordered tasks associated with hyperostosis frontalis interna.

A 74 year old patient, EW, with dorsolateral frontal cortical compression due to hyperostosis frontalis interna, in the absence of the Morgagni or Stewart-Morel syndromes, is described. In addition to conventional neuropsychological measures EW was administered one nonspatial and two spatial self ordered working memory tasks, as well as a standard measure of fluid intelligence or g. She showed impaired performance on all three self ordered working memory tasks compared with a normal control group of 10 subjects matched for age, education, sex, and IQ. By contrast, her performance on the fluid intelligence test was comparable with that of the controls. It is concluded that the compression of dorsolateral frontal cortex accompanying hyperostosis frontalis interna may produce selective cognitive impairment.

Aged↗

Platelets and glomerulonephritis.

There is evidence derived from both experimental studies and from observation of human nephritis that platelets are important in the glomerular injury of chronic soluble-complex disease. It is not yet clear if platelets are involved in the events initiating endothelial damage, in perpetuating and amplifying injury, or both. Antiplatelet agents appear to have a role in the treatment of chronic forms of glomerulonephritis; but more knowledge of platelet involvement in nephritis and more readily available tests for platelet involvement are necessary before this suggestion can be tested intelligently.

Blood Platelets↗

Cognitive functioning as measured by the WISC-R: do children with learning disabilities have distinctive patterns of performance?

Patterns of performance on the Wechsler Intelligence Scale for Children-Revised (WISC-R) have been proposed as useful tools for the identification of children with learning disabilities (LD). However, most of the studies of WISC-R patterns in children with LD have been plagued by the lack of a typically achieving comparison group, by failure to measure individual patterns, and by the lack of a precise definition of LD. In an attempt to address these flaws and to assess the presence of patterns of performance on the WISC-R, we examined data from 121 children with typical achievement (TA), 143 children with reading disabilities (RD), and 100 children with a specific arithmetic disability (AD), ages 6 to 16 years. The results indicated that the RD and AD groups had significantly lower scores than the TA group on all the Verbal IQ subtests. Many of the children with AD and RD showed a significant difference between Verbal and Performance IQ scores, but so did many of the typically achieving children. Although there were some children with LD who showed the predicted patterns, typically, 65% or more of the children with LD did not. Furthermore, a proportion of the TA group-generally not significantly smaller than that of the RD and AD groups-showed discrepancy patterns as well. Our results indicate that the patterns of performance on intelligence tests are not reliable enough for the diagnosis of LD in individual children. Therefore, it might be more profitable to base the detection of an individual's LD on patterns of achievement test scores.

Adolescent↗

Spontaneous talkers among students with learning disabilities: implications of right cerebral dysfunction.

Experimental studies and clinical observations have indicated that right-hemisphere lesions produce impulsive talkative behavior. An exploratory study was conducted to investigate whether right-cerebral dysfunction would be evident in the intelligence test scores of talkative students with learning disabilities. Limitations and implications of the study are discussed.

Attention↗

The effectiveness of Irlen filters for improving reading performance: a pilot study.

The objectives of this pilot study were to investigate the effectiveness of Irlen filters for improving comfort and reading performance and to determine whether traditional optometric intervention would be effective in relieving the symptoms commonly reported by people seeking help through the use of Irlen filters. Thirty subjects were included in the study: 12 males and 18 females. The ages of the subjects ranged from 9 to 51 (mean = 23.6). They were randomly placed in either an Irlen filter treatment group (n = 11), a vision therapy treatment group (n = 11), or a control group (n = 8). Pre- and posttesting on all subjects included a vision evaluation, reading and intelligence testing, the Irlen scotopic sensitivity screening test, and a symptom questionnaire. Results revealed that subjects in both treatment groups were more comfortable after treatment, although only the vision therapy group showed improvement in vision functioning. The subjects in the Irlen filter group did not show any significant gains in reading rate, word recognition in context, or comprehension.

Adolescent↗

Methodological issues and learning disabilities diagnosis in clinical populations.

Previous research suggests that the diagnosis of a comorbid learning disability is dependent on the method used for making the LD diagnosis. This study investigated that proposition by studying the effects of using three approaches to the assessment of learning disabilities in a sample of 177 six- to thirteen-year-old boys referred to outpatient mental health clinics for behavior problems. The use of these three procedures to diagnose comorbid learning problems produced significantly different results. All methods identified significant numbers of children in the clinical population as learning disabled; however, each method identified children with differing characteristics. Consistent with predictions from measurement theory, the commonly used simple standard score discrepancy method was more likely to identify children with above-average IQs as learning disabled, whereas a regression approach identified learning disabilities more consistently across the ability range. These results were interpreted as supporting the use of regression approaches to diagnose co-occurring learning disabilities, as that method is less likely to be biased by the child's intelligence test score. The implications of the use of each method in research investigations is also discussed.

Adolescent↗

Do nutrient supplements and dietary changes affect learning and emotional reactions of children with learning difficulties? A controlled series of 16 cases.

Detailed dietary and biochemical analyses were done on 16 consecutive cases of children aged 5-15 years referred for a combined remedial reading/behaviour modification program. Each child was given an individually designed vitamin and mineral supplement. Diets were also changed to reduce sugars and refined foods and toxic metals contamination. Cases were matched in pairs with 16 other cases on the program who were given no dietary changes but who received a one-a-day vitamin/mineral capsule as part of standard procedure at the clinic. Over 22 weeks on the program, the experimental group showed significantly greater improvements than the control group in behaviour assessed at school, at home and in the clinic. The experimental group also made significantly greater gains in reading skills. Routine Stanford-Binet intelligence tests given at week 2 and week 20 or 21 showed increased IQ scores of 5 to 35 points (mean = 17.9) for the experimental group. Increases for the control group were 0-21 points (mean = 8.4). Results suggest that subtle nutritional variables exert a substantial influence on learning and behaviour.

Adolescent↗

A critical assessment of the European Commission's proposals for the risk assessment and registration of chemical substances in the European Union.

In May, 2003, the European Commission published detailed proposals relating to its 2001 White Paper - Strategy for a Future Chemicals Policy. The White Paper described a new registration system called the REACH (Registration, Evaluation and Authorisation of Chemicals) system, for both new and existing chemicals. Subsequently, these detailed proposals were available for an eight-week consultation period for stakeholders to voice their views and concerns. In this paper, we describe our reactions to the Commission's more-detailed proposals. These include the creation of a European Chemicals Agency to implement the REACH system in conjunction with Competent Authorities (CAs) in Member States and the Commission itself. Unfortunately, many of our concerns and suggestions, previously voiced and shared with several other key stakeholders, remain unanswered, but are as relevant as when the White Paper was published. In particular, we are concerned about the lack of a clear and coherent strategy. There is no guidance for registrants on intelligent testing to maximise the use of non-animal approaches to safety testing, based on a combination of factors for estimating exposure levels, rather than mainly on production volumes. We are also concerned about the absence of a clear programme for the development, improvement and validation of new alternative methods, in conjunction with the Commission's own unit, the European Centre for the Validation of Alternative Methods, as well as other organisations with relevant expertise and experience, including FRAME. Finally, we explain why such measures should be introduced, together with clearer guidelines for the respective roles of the Agency, the CAs and the Commission in implementing and harmonising the REACH system at the European Union and Member State levels. A series of recommendations are made, to improve the situation and to improve the risk assessment process.

Animal Use Alternatives↗

Gender differences in the human cerebral cortex: more neurons in males; more processes in females.

This study's objective was to investigate morphometric gender differences of the cerebral cortex in six males and five females, 12 to 24 years old. Though human brains lack sexual dimorphism on routine neuropathologic examinations, gender-specific brain weight, functional, and morphologic differences exist, suggesting that cortical differences may be found. Yet the cerebral cortex may be exempt from gender differences, as demonstrated by the fact that normal males and females perform comparably on intelligence tests. Stereologic morphometry on standardized histologic sections from 30 bilateral cortical loci determined cortical thickness, neuronal density, and derived neuronal number estimates. The mean +/- SD cortical thickness of the 60 loci examined was similar in males and females with right and left hemispheric gender ratios being balanced. In contrast, the average neuronal density of the same 60 loci was significantly higher in the male group than in the female group, and the corresponding mean male-to-female ratios were 1.18 in the right and 1.13 in the left hemisphere, which differ significantly from each other and from the balanced cortical thickness ratios. Estimates of neuronal numbers -- the product of neuronal thickness times density -- were 13% higher in males than in females, with mean male-to-female ratios of 1.13 in both hemispheres. The data provide morphologic evidence of considerable cerebral cortical dimorphism with the demonstration of significantly higher neuronal densities and neuronal number estimates in males, though with similar mean cortical thickness, implying a reciprocal increase in neuropil/neuronal processes in the female cortex.

Adolescent↗

Psychiatry beyond the asylum: the origins of German military psychiatry before World War I.

This study examines the co-operation between psychiatry and the army in Germany between 1870 and 1914, leading to the establishment of military psychiatry as an independent discipline. Arguing that military psychiatry played a key role in the history of modern clinical psychiatry, the paper points out how the first generation of military psychiatrists developed innovative diagnostic technologies, such as the intelligence test, and established crucial institutional alliances between psychiatric clinics, military authorities, and local and national administrations. The early history of military psychiatry marks the transition of psychiatry from a medical sub-discipline to a more generally applicable "social technology" assessing the borderline between normality and abnormality in multiple social contexts.

Germany↗

Internship training in psychological assessment: has managed care had an impact?

Training directors of 84 APA-approved internship programs in psychology responded to a survey on the current status and recent changes in internship training in psychological assessment. There appears to be a slight decline in emphasis on assessment in general, although it is still considered to be an important component of training. There was a surprising endorsement of traditional assessment instruments as important for clinical practice, in spite of a trend toward decreased emphasis on projective methods. The majority of programs have maintained the same degree of emphasis on objective measures, intelligence tests, behavioral methods, and the interview, while increasing emphasis on neuropsychological assessment. Less than half (43%) of the training directors reported that their programs have been significantly affected by managed care, suggesting that the majority of internship sites are somewhat insulated from present trends in marketplace pressures regarding reimbursement for psychological testing. The implications of potential future trends are discussed.

Administrative Personnel↗

Social, personality and environmental determinants of smoking in young Finnish men.

The study was based on 471 males, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. Of these subjects 48% smoked regularly and had smoked in the past three weeks. The correlation between the reported number of cigarettes smoked a day and serum thiocyanate was 0.60. Seventy-four per cent of the subjects whose best friend smoked, were current smokers compared with 24% of the others. Proportion of smokers was higher in urban areas than in rural areas. Among the 14 explanatory variables in the multivariate logistic analysis, family members' and friends' smoking, the place of residence, strenuousness of leisure-time physical activities, number of friends, rebelliousness, intelligence test score, and general pessimism were most strongly associated with the likelihood of being a current smoker. The model explained 87% of the smoking variance.

Adult↗