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PubMed2005

Categorical perception of speech by children with specific language impairments.

Previous research has suggested that children with specific language impairments (SLI) have deficits in basic speech perception abilities, and this may be an underlying source of their linguistic deficits. These findings have come from studies in which perception of synthetic versions of meaningless syllables was typically examined in tasks with high memory demands. In this study, 20 children with SLI (mean age = 9 years, 3 months) and 20 age-matched peers participated in a categorical perception task. Children identified and discriminated digitally edited versions of naturally spoken real words in tasks designed to minimize memory requirements. Both groups exhibited all hallmarks of categorical perception: a sharp labeling function, discontinuous discrimination performance, and discrimination predicted from identification. There were no group differences for identification data, but children with SLI showed lower peak discrimination values. Children with SLI still discriminated phonemically contrastive pairs at levels significantly better than chance, with discrimination of same-label pairs at chance. These data suggest that children with SLI perceive natural speech tokens comparably to age-matched controls when listening to words under conditions that minimize memory load. Further, poor performance on speech perception tasks may not be due to a speech perception deficit, but rather to a consequence of task demands.

Child↗

PubMed1997

Development, use, and evaluation of clinical practice guidelines.

The development and use of practice guidelines, if framed as recommendations for best practices in the prevention, diagnosis, treatment, and management of occupationally related health concerns and disability, can improve the quality of occupational medical practice and worker health and well being. Adherence to guidelines should improve the efficiency and effectiveness of prevention, care, and disability management by reducing the present wide variance in practices and then by moving the mean or median of process and outcome statistics toward recommended levels. The information developed for guidelines can also be used for patient discussion and expectation management. Practicing in evidence-based, agreed-upon ways should also make occupational medical practices more defensible. Guidelines should be explicit, be based on a review of the available evidence and benefits vs risks, have clear medical logic, link findings to diagnosis to treatment ot prevention, be time-based, and avoid recommending unproven approaches as a last resort. If possible, they should be reviewed and tested for usability. Guidelines that start with common occupational health concerns are best suited to prevention and outpatient care, because patients present in this way. The contents of a useful occupational health guideline would include a statement of purpose and scope, the method of development; the authors' and reviewers names and affiliations; an analysis of the specificity, sensitivity, and predictive power of mechanisms of illness or injury, symptoms, signs and tests; findings that point to a serious or emergent condition requiring immediate referral or treatment; diagnostic criteria; and initial treatment, including work with the patient in a therapeutic partnership. The guideline should also present information on factors known to be associated with work, and predictors of delayed recovery. Disability-duration statistics and methods of matching job requirements with worker abilities are also helpful. Guidelines should then outline reassessment of those patients whose health concerns remain after a reasonable recovery period. The recommendations should again be evidence-based and conform to the other attributes listed above. A discussion of management after reassessment, including behavioral referral, further testing, and procedures, is also quite useful. Recommendations for restoration of function and return to work complete guidelines focused on diagnosing, treating, and resolving activity limitations among workers. Simply developing and publishing guidelines has not resulted in improvement in practice. However, if used as the basis for peer-group interactions and actions by occupational health opinion leaders, guidelines can contribute to marked improvements in quality, worker satisfaction, and worker health.

Cost-Benefit Analysis↗

PubMed2001

The Functional Magnetic Resonance Imaging Data Center (fMRIDC): the challenges and rewards of large-scale databasing of neuroimaging studies.

The Functional Magnetic Resonance Imaging Data Center (fMRIDC) (http://www.fmridc.org) was established in the Autumn of 1999 with the objective of creating a mechanism by which members of the neuroscientific community may more easily share functional neuroimaging data. Examples in other sciences offer proof of the usefulness and benefit that sharing data provides through encouraging growth and development in those fields. By building a publicly accessible repository of raw data from peer-reviewed studies, the Data Center hopes to create a similarly successful environment for the neurosciences. In this article, we discuss the continuum of data-sharing efforts and provide an overview of the scientific and practical difficulties inherent in managing various fMRI data-sharing approaches. Next, we detail the organization, design and foundation of the fMRIDC, ranging from its current capabilities to the issues involved in the submitting and requesting of data. We discuss how a publicly accessible database enables other fields to develop relevant tools that can aid in the growth of understanding of cognitive processes. Information retrieval and meta-analytic techniques can be used to search, sort and categorize study information with a view towards subjecting study data to secondary 'meta-' and 'mega-analyses'. In addition, we detail the technical and policy challenges that have had to be addressed in the formation of the Data Center. Among others, these include: human subject confidentiality issues; ensuring investigator's rights; heterogeneous data description and organization; development of search tools; and data transfer issues. We conclude with comments concerning the future of the fMRIDC effort, its role in promoting the sharing of neuroscientific data, and how this may alter the manner in which studies are published.

Brain↗

PubMed2000

Comparison of conduct-disordered behavior in crack-dealing versus nondealing juvenile offenders.

Currently, little research has investigated psychosocial functioning among juvenile crack dealers, and there appear to be few studies comparing dealers to nondealing juvenile offenders. The current study examined whether juvenile crack dealers display more severe conduct-disordered behavior than their nondealing delinquent peers. The records of 130 adolescent males committed to a residential training school were studied. Analyses indicated that crack dealers were younger when first arrested, had more arrests and commitments, and met more DSM-III-R conduct-disorder criteria than their nondealing delinquent peers. In addition, the DSM-III-R conduct-disorder criteria met by dealers were more severe, and dealers were more likely to be rearrested within six months following release. Overall, significant differences between crack dealers and nondealing juvenile offenders were found; dealers displayed a more delinquent history and a more serious and violent conduct disorder than their nondealing yet delinquent peers.

Adolescent↗

PubMed2005

The effects of benzodiazepines on cognition.

Initially thought to be virtually free of negative effects, benzodiazepines are now known to carry risks of dependence, withdrawal, and negative side effects. Among the most controversial of these side effects are cognitive effects. Long-term treatment with benzodiazepines has been described as causing impairment in several cognitive domains, such as visuospatial ability, speed of processing, and verbal learning. Conversely, long-term benzodiazepine use has also been described as causing no chronic cognitive impairment, with any cognitive dysfunction in patients ascribed to sedation or inattention or considered temporary and associated with peak plasma levels. Complicating the issue are whether anxiety disorders themselves are associated with cognitive deficits and the extent to which patients are aware of their own cognitive problems. In an attempt to settle this debate, meta-analyses of peer-reviewed studies were conducted and found that cognitive dysfunction did in fact occur in patients treated long term with benzodiazepines, and although cognitive dysfunction improved after benzodiazepines were withdrawn, patients did not return to levels of functioning that matched benzodiazepine-free controls. Neuroimaging studies have found transient changes in the brain after benzodiazepine administration but no brain abnormalities in patients treated long term with benzodiazepines. Such findings suggest that patients should be advised of potential cognitive effects when treated long term with benzodiazepines, although they should also be informed that the impact of such effects may be insignificant in the daily functioning of most patients.

Activities of Daily Living↗

PubMed1985

Factors governing the effective remediation of negative affect and its cognitive and behavioral consequences.

The present experiment tested the hypothesis that the remediation of negative emotion will be most effective when the remedial procedure matches the experience or cognition that induced the negative state--process-specificity hypothesis. Other hypotheses examined were that negative states induced by cognitive reflection related to the self would be resistant to remediation, even by a same-process positive procedure, and that changes in emotional expressions may make it appear that a negative state has been effectively remediated when lingering effects on behavior and cognition indicate that it has not. Negative emotional states were induced in second-grade children by one of four processes, all of which involved social rejection content: cognition that focused on (a) the self (thinking about oneself being rejected by a peer) or (b) another person (thinking about a peer being rejected); or experience that related to (c) oneself (actually being socially rejected) or (d) observing another (vicarious: seeing a peer be socially rejected). These inductions were then followed by a positive, remedial induction whose content was the reverse (social acceptance) and whose process did or did not match that of the negative induction. As predicted, except for negative self-cognitions, it was found that the behavioral (altruism) and cognitive (performance on a block design task) consequences of negative emotion were alleviated when the positive remediation was of the same type as the original induction. Emotional expressions were consistently positive following remediation, regardless of their type. The results are discussed in terms of differing processes for maintaining negative emotion as a function of the character of induction, and the implications for the understanding of clinical depression in children are noted.

Affect↗

PubMedDate not supplied

The fate of neuroradiologic abstracts presented at national meetings in 1993: rate of subsequent publication in peer-reviewed, indexed journals.

BACKGROUND AND PURPOSE: Abstract presentations are a valuable means of rapidly conveying new information; however, abstracts that fail to eventually become published are of little use to the general medical community. Our goals were to determine the publication rate of neuroradiologic papers originally presented at national meetings in 1993 and to assess publication rate as a function of neuroradiologic subspecialty and study design. METHODS: Proceedings from the 1993 ASNR and RSNA meetings were reviewed. A MEDLINE search encompassing 1993-1997 was performed cross-referencing lead author and at least one text word based on the abstract title. All ASNR and RSNA neuroradiologic abstracts were included. Study type, subspecialty classification, and sample size were tabulated. Publication rate, based on study design and neuroradiologic subspecialty, was compared with overall publication rate. Median duration from meeting presentation to publication was calculated, and the journals of publication were noted. RESULTS: Thirty-seven percent of ASNR abstracts and 33% of RSNA neuroradiologic abstracts were published as articles in indexed medical journals. Publication rates among neuroradiologic subspecialty types were not significantly different. Prospective studies presented at the ASNR were published at a higher rate than were retrospective studies. There was no difference between the publication rate of experimental versus clinical studies. Neuroradiologic abstracts were published less frequently than were abstracts within other medical specialties. Median time between abstract presentation and publication was 15 months. CONCLUSION: Approximately one third of neuroradiologic abstracts presented at national meetings in 1993 were published in indexed journals. This rate is lower than that of abstracts from medical specialties other than radiology.

Abstracting and Indexing↗

PubMed1995

Transduction of chemostimuli by the type I carotid body cell.

The postulated mechanisms for hypoxic and acidic chemotransduction by type I cells that we have described here are summarized in the diagrams of Fig. 4. Most if not all of these require more complete evaluation and, as we have described, there are obvious points of contention that need to be resolved. Nevertheless, it is apparent that studies of isolated type I cell preparations carried out over the last six years have provided significant advancements in our understanding of chemotransduction in the type I cell. Only when the functioning of these cells has been fully described can we hope to understand the mechanisms underlying the responses of the intact organ to chemostimuli.

Animals↗

PubMed2003

Genomewide structural annotation and evolutionary analysis of the type I MADS-box genes in plants.

The type I MADS-box genes constitute a largely unexplored subfamily of the extensively studied MADS-box gene family, well known for its role in flower development. Genes of the type I MADS-box subfamily possess the characteristic MADS box but are distinguished from type II MADS-box genes by the absence of the keratin-like box. In this in silico study, we have structurally annotated all 47 members of the type I MADS-box gene family in Arabidopsis thaliana and exerted a thorough analysis of the C-terminal regions of the translated proteins. On the basis of conserved motifs in the C-terminal region, we could classify the gene family into three main groups, two of which could be further subdivided. Phylogenetic trees were inferred to study the evolutionary relationships within this large MADS-box gene subfamily. These suggest for plant type I genes a dynamic of evolution that is significantly different from the mode of both animal type I (SRF) and plant type II (MIKC-type) gene phylogeny. The presence of conserved motifs in the majority of these genes, the identification of Oryza sativa MADS-box type I homologues, and the detection of expressed sequence tags for Arabidopsis thaliana and other plant type I genes suggest that these genes are indeed of functional importance to plants. It is therefore even more intriguing that, from an experimental point of view, almost nothing is known about the function of these MADS-box type I genes.

Amino Acid Motifs↗

PubMed2005

Auxin transport.

Polar transport of auxin is essential for normal plant growth and development. On a cellular level, directional auxin transport is primarily controlled by an efflux carrier complex that is characterized by the PIN-FORMED (PIN) family of proteins. Detailed developmental studies of PIN distribution and subcellular localization have been combined with the analysis of changes in localized auxin levels to map PIN-mediated auxin movement throughout Arabidopsis tissues. Plant orthologs of mammalian multidrug-resistance/P-glycoproteins (MDR/PGPs) also function in auxin efflux. MDR/PGPs appear to stabilize efflux complexes on the plasma membrane and to function as ATP-dependent auxin transporters, with the specificity and directionality of transport being provided by interacting PIN proteins.

Biological Transport↗

PubMed2002

A complex prediction: three-dimensional model of the yeast exosome.

We present a model of the yeast exosome based on the bacterial degradosome component polynucleotide phosphorylase (PNPase). Electron microscopy shows the exosome to resemble PNPase but with key differences likely related to the position of RNA binding domains, and to the location of domains unique to the exosome. We use various techniques to reduce the many possible models of exosome subunits based on PNPase to just one. The model suggests numerous experiments to probe exosome function, particularly with respect to subunits making direct atomic contacts and conserved, possibly functional residues within the predicted central pore of the complex.

Amino Acid Sequence↗

PubMed2000

[Allergen-specific immune therapy in the treatment of asthma].

OBJECTIVES: 1. To identify all published randomised controlled trials of allergen specific immunotherapy in asthma. 2. To estimate the overall efficacy of allergen specific immunotherapy upon asthmatic symptoms, medication requirements, lung function, nonspecific bronchial hyperreactivity (BHR) and allergen specific BHR. SEARCH STRATEGY: A search of the asthma database by the Cochrane Airways Group at St. Georges Hospital Medical School, London identified 660 nonunique citations with the keywords Immunotherapy* or Hyposensitive or Desensiti*. This database included all studies published up to 1997 with the keywords Asthma or Wheez* from the Medline, Embase and Cinahl databases, together with other studies identified by handsearching. SELECTION CRITERIA: The review was restricted to randomised controlled trials (RCT). Only studies which focussed upon asthma were included. Allergen specific immunotherapy was defined as the subcutaneous administration of extracts of house dust mites, pollens, animal danders or moulds, chemically modified allergoids or antigen-antibody complexes. Although placebo controlled trials were methodologically stronger, studies which administered house dust or other relatively antigenically inactive preparations to the control group were also considered. Double blinded trials were preferred, but single blind and open studies were also reviewed for possible inclusion. At least one of the following clinical outcomes had to be reported: asthmatic symptoms, asthma medication requirements, lung function, nonspecific BHR or allergen specific BHR. Inclusion of studies in the review was decided by a simple majority of all three reviewers, who independently read the methods sections of papers identified by the search strategy and applied the stated criteria. Quality assessment was performed by 2 reviewers, who independently assessed the concealment of allocation. DATA COLLECTION AND ANALYSIS: The comparisons were: Allergen immunotherapy v placebo, Allergen immunotherapy v antigenically inactive control, House dust v placebo and Allergen immunotherapy v untreated control. These comparisons were performed separately for each outcome, whenever these results were reported. Outcome data were extracted and entered into RevMan 3.0.1 for statistical analysis. Categorical outcomes were analysed as odds ratios (OR) and 95% confidence intervals (95% CI) calculated by Peto's method. Continuous outcomes were analysed as standardised mean differences (SMD). Fixed effects models were used to obtain summary statistics for the overall efficacy of allergen immunotherapy and x2 tests were performed to assess heterogeneity between studies. MAIN RESULTS: Fifty four randomised controlled trials published between 1954 and 1997 satisfied the inclusion criteria. There were 25 studies reporting immunotherapy for mite allergy, 13 studies of pollen allergy, eight studies of animal dander allergy, two studies of allergy to the mould Cladosporium and six studies which attempted simultaneous immunotherapy for multiple aeroallergens. Concealment of allocation was assessed as clearly adequate in only 11 studies. The adequacy or otherwise of 40 studies could not be determined from the details published in the papers. Only three studies used a clearly inadequate method for concealment of allocation. There was a significant overall improvement in asthma symptom scores following immunotherapy (combined SMD -0.52; 95% -0.70 to -0.35). Patients randomised to immunotherapy were also significantly less likely to report a deterioration in asthma symptoms than those randomised to placebo (OR 0.27; 95% CI 0.21 to 0.35). Asthma medication requirements were significantly reduced (SMD -0.51; 95% CI -0.74 to -0.28). Patients randomized to immunotherapy were also significantly less likely to require medication than those randomised to placebo (OR 0.28; 95% CI 0.19 to 0.42). There was no overall improvement in lung function following immunotherapy and marked hete

Asthma↗

PubMed1992

A comparison of the psychological profiles of teenage mothers and their nonmother peers: II. Responses to a set of TAT cards.

In Part I of this investigation (Oz, Tari, & Fine, 1992), it was found that, in comparison with nonmother peers, teenage mothers demonstrated a higher degree of ego development. This was in contradiction to most of the literature on the subject. In the second part of the study, the Thematic Apperception Test was employed to examine defenses and motivations which may impact upon the young girls' functioning within family and heterosexual relationships. Results confirmed reports in the literature which have indicated that adolescent mothers attempt to resolve autonomy-dependence conflicts in heterosexual relationships, whereas nonmothers do so within the family of origin. Consistent with their enhanced ego maturity, teenage mothers were more likely to confront their conflicts than were nonmothers. However, whereas nonmothers reacted to environmental stressors by rejecting the source of the stress, teenage mothers tended to react with self-abasement. It is recommended that further research be directed toward uncovering the emotional and cognitive resources of teenage mothers rather than focusing on their more obvious weaknesses.

Adolescent↗

PubMed2003

Peer support via video-telephony among frail elderly people living at home.

We evaluated the effect of a video-phone network on peer support among frail elderly people living at home. We conducted a one-year trial of network formation among 14 people (five men and nine women, age range 78-85 years) through coordinator intervention and the use of ISDN video-phones. The purpose of the intervention was to support and improve the functional independence of frail elderly people at home and to widen their social network. During the study, the subjects made 1400 video-calls, lasting a total of 25,867 min. One subject made no calls. There was greater use of video-phones by those living outside the central city area. Calls between men and women were infrequent. The men generally had shorter call times and made fewer calls. The participants could be categorized into three groups: those using video-phones every day; those using them once per week; and those using them once per month. All subjects in the first group clearly expressed their satisfaction with the video-phone. A video-phone network appears to be helpful for elderly people in their peer support relationships.

Aged↗

PubMed2003

Rites of passage: understanding participation of children with developmental coordination disorder.

Children with developmental coordination disorder (DCD) experience difficulty participating in the typical activities of childhood and are known to have a more sedentary pattern of activities than their peers. Little research has been done to investigate the impact of these deficits on the lives of children with DCD and the importance of their participation in the typical activities of childhood. This qualitative study explored the impact of the disorder and the importance of participation for children with DCD from the perspective of the parent. Twelve in-depth interviews were conducted with parents of children with DCD who attended a university clinic specializing in using the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, a cognitive-based intervention. Findings revealed that incompetence in everyday activities had serious negative effects for the children. Conversely, intervention that was focused on enablement at the activity and participation level had a significant positive impact on the children's quality of life. Emerging themes highlighted the notion that performance competency played an important role in being accepted by peers and being able "to be part of the group". As well, parents reported that successful participation built confidence in their children and allowed them to try other new activities. The World Health Organization's International Classification of Functioning, Disability, and Health provides a unique framework for analyzing and understanding the impact of the physical disability on the lives of families with children with DCD. Results illustrate how intervention that focuses on enabling children to choose their own functional goals in the area of physical activity has important implications for enabling participation and building the social networks of children with DCD.

Activities of Daily Living↗

PubMed2002

A pre-employment programme for overseas-trained doctors entering the Australian workforce, 1997-99.

OBJECTIVES: Overseas-trained doctors (OTDs) have limited access and formal interaction with the Australian health care system prior to joining the Australian medical workforce. A pre-employment programme was designed to familiarize OTDs with the Australian health care system. METHOD: All OTDs who had passed their Australian Medical Council (AMC) exams and were applying for a pre-registration year in New South Wales were invited to participate in the voluntary, free programme. A 4-week full-time programme was developed consisting of core group teaching and a hospital attachment. The curriculum included communication, health and workplace skills; and sessions on culture shock and the role of junior doctors. A pilot programme was run in 1997. The programme was repeated in 1998 and 1999. The OTDs' confidence regarding the general duties of internship, and attitudes towards hospital workplace skills were examined. RESULTS: The 66 OTDs reported greater understanding of staff and communication issues and familiarization with the hospital environment. They reported a more realistic understanding of the role of a junior doctor, the need for separation of workplace and personal responsibilities and knowledge of pathways for future professional development. The course structure, with a focus on hospital attachments, establishment of a peer network, and workplace familiarization facilitated entry into the hospital workforce. CONCLUSION: The pre-employment programme enabled the OTDs to have a more equitable entry into the public hospital system, resulting in a more integrated, confident and functional workforce.

Australia↗

PubMed2001

Verbal fluency deficits in children with specific language impairment: slow rapid naming or slow to name?

This study examined aspects of verbal fluency performance of children with Specific Language Impairment (SLI) and typically developing children matched on age and Block Design scores. While children with SLI showed deficits in verbal fluency compared to their peers, they showed the same pattern of performance on phonemic compared to semantic fluency trials. Children with SLI and normally developing children also demonstrated equivalent rates of clustering and switching, measures hypothesized to reflect aspects of frontal lobe functioning, when the overall number of exemplars was taken into account. The absence of a condition by group effect supports general processing limitation accounts of SLI, while the absence of group differences on cluster size and switches supports language-based processing accounts of SLI.

Child↗

PubMedDate not supplied

Integration.

The problems of intergrating the disabled child in the ordinary school are examined. The child's adaptation and adjustment are briefly discussed and the influence on these of the home, medical and educational services is considered. Handicap is seen to be created by a combination of the functional limitations imposed by the disability and by the reaction of society to it. Successful integration is considered to be in some way dependent upon efforts which will reduce both this secondary socially induced handicap and also any peer group stigmatization. Positive professional attitudes and intensive family centered support and guidance are considered essential to the successful habilitation of the disabled child.

Adaptation, Psychological↗