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PubMed2003

A complication of an unusual sexual practice.

A patient presented with scrotal cellulitis as a complication of infusing 900 ml saline into his scrotum. He had obtained a kit along with explicit instructions for performing the infusion through the Internet. This practice may be more widespread than expected. An Internet search revealed many references to this procedure, but a MEDLINE search showed virtually no information in the medical literature. Patients who are considering scrotal inflation, as it is called in the lay literature, should be warned of the potential complications of this procedure.

Adult↗

PubMed1996

FES standing: control by handle reactions of leg muscle stimulation (CHRELMS).

Many paraplegics can stand using functional electrical stimulation (FES) of their extensor muscles without any modulation of the stimulus intensity by feedback. This is possible because, using handles and the intact upper-body muscles, the position of the pelvis can be controlled and this determines the positions of the two legs. Nevertheless, it is highly desirable that some practical method of modulating the stimulus intensities is used to reduce muscle fatigue and improve posture. We propose that the goal of the controller should be the minimization of the handle reaction forces by referring these forces to the equivalent leg joint moments and, as far as possible, making corresponding changes to the stimulation of the leg muscles. If force sensors are used only at the handles, the joint moments in the two legs are indeterminate. We hypothesize that in some patients acceptable results may still be obtained if we treat the two legs as one. This method will control standing up, standing, and sitting down; the user will be able to "feel" that his leg muscles are tiring and will be able to "posture switch" without any explicit instruction to the controller to change mode.

Arm↗

PubMed2002

Probability cuing of target location facilitates visual search implicitly in normal participants and patients with hemispatial neglect.

We explored how variability in the probability of target locations affects visual search in normal individuals and in patients with hemispatial neglect, a deficit in attending to the contralesional side of space. Young and elderly normal participants responded faster when targets appeared in the more probable region than when targets appeared in the less probable region. Similarly, patients were sensitive to the distribution of targets, even in the neglected field. Although the attentional gradient that characterizes neglect was not eliminated, the response facilitation due to the probability distribution was proportionate to that of control participants and equal in magnitude across the neglected field. All participants exploited the uneven distribution of targets to enhance task performance without explicit instructions to do so or awareness of biases in their behavior. These results suggest that attentional orientation and sensitivity to external probabilities are possibly dissociable. An early sensory and a late motor mechanism are postulated as possibly being involved in the observed probability-matching behavior of participants.

Adolescent↗

PubMedDate not supplied

Is a picture worth a thousand words? The flexible nature of modality dominance in young children.

When presented simultaneously with equally discriminable, but unfamiliar, visual and auditory stimuli, 4-year-olds exhibited auditory dominance, processing only auditory information (Sloutsky & Napolitano, 2003). The current study examined factors underlying auditory dominance. In 6 experiments, 4-year-olds (N=181) were presented with auditory and visual compounds in which (a) the complexity and familiarity of stimuli were systematically varied (Experiments 1-5) and (b) participants were explicitly instructed to attend to a particular modality (Experiment 6). Results indicate that auditory dominance is a special case of flexible modality dominance, which may stem from automatic pulls on attention. Theoretical implications of these results for understanding the development of attention and cross-modal processing, as well as linguistic and conceptual development, are discussed.

Acoustic Stimulation↗

PubMed1998

An intervention programme for children with moderate learning difficulties.

BACKGROUND: Children with learning difficulties typically demonstrate problems generalising what they have learned in specific contexts to new situations. Intervention programmes that teach children regulatory skills have been shown to overcome these problems for children with reading difficulties. This study applies the principles that underlie such interventions to the design of a programme for children with more general learning difficulties. AIM: The aim of the study reported here was to design and evaluate an intervention programme which would facilitate the transfer of skills learned over the course of the intervention to different types of task. SAMPLE: A total of 41 children (aged 13-16 yrs; 14 females, 27 males) with moderate learning difficulties participated in the intervention programme. METHOD: The children participated in a twelve-week intervention programme designed to promote regulatory strategies over a range of activities. The children worked in pairs and were guided by an adult who provided explicit instruction and modelled appropriate strategies. The children were assessed before and after the programme to determine whether improvements in strategic behaviour were evident and whether this generalised to new situations. RESULTS: Gains made in regulatory skills over the course of the intervention were accompanied by improvements in other performance measures such as reading and IQ. CONCLUSIONS: Even after a relatively short intervention, which focused on the development of regulatory skills, significant improvements on a range of tasks were observed for a group of children with moderate learning difficulties.

Adolescent↗

PubMed1989

Mode of processing and hemisphere differences in the judgement of musical stimuli.

The relationship between processing strategy and ear asymmetry was examined in two experiments in which subjects were required to make judgements about monoaurally presented musical chords. In the first experiment, subjects without musical training showed a significant left ear advantage while in those with musical training a significant shift towards a right ear advantage was observed. Performance on the Embedded Figures Test (EFT) suggested a strong relationship between analytic processing style and right ear advantage which was significant in the musician groups. The effect of musical training status on ear asymmetry continued to be significant when the scores were adjusted for analytic processing. There was also a clear relationship between self-reported listening strategies and direction of ear asymmetry, with musicians generally reporting a much greater use of analytic strategies. The second experiment failed to demonstrate a significant influence of explicit instructions in how to carry out a chords task on the direction of ear advantages in musically untrained subjects. The results partially confirm earlier studies comparing subjects with and without musical training, and extend them by demonstrating a clear relationship between ear advantage and a separate measure of processing strategy. The findings of the second experiment, however, do not support clearly the hypothesis that differences in ear asymmetry are produced through the use of different processing strategies.

Adolescent↗

PubMed1976

Medicines and elderly people: a general practice survey.

All 151 patients of 75 years and over in one practice were visited at home to survey their health and how they managed their medicines. Altogehter 87% were on regular treatment, 34% taking three or four different drugs each day. Most were responsible for their own drugs and managed them well, but many left their drugs in exposed places and were uncertain about how to dispose of unwanted medicines. Overall they were prescribed about three times the number of drugs prescribed for the general population, and women took twice as many drugs regularly as men. Although many drugs were obtained directly from a pharmacist, his advice was rarely sought. Most were labelled, but more explicit instructions about indications for taking the drug would have been helpful, and information about hoarded drugs would have been enhanced by dispensing and expiry dates. Treatment was facilitated when patients brought their drugs to the consultation and careful records were made of repeat prescriptions. As so many patients take three or more different types of drugs each day a container in which a day's supply could be laid out would be useful.

Aged↗

PubMed1992

Spatiomotor cueing in unilateral left neglect: three case studies of its therapeutic effects.

Limb activation contralateral to a cerebral lesion seems to reduce visual neglect, though whether this is due to perceptual cueing or hemispheric activation is controversial. Three case studies are presented which attempt to use this experimental finding therapeutically in the rehabilitation of unilateral left neglect. The first study used a combination of perceptual anchoring training with left arm activation procedures and produced improvements. The second used the same method, but stimulated left arm activation using an avoidance conditioning procedure, again with positive results. The third case treatment focused on cueing for left arm activation without explicit instructions for perceptual anchoring, with positive results.

Adult↗

PubMed2006

Activity of tonically active neurons in the monkey putamen during initiation and withholding of movement.

Tonically active neurons (TANs) of the primate striatum are putative interneurons that respond to events of motivational significance, such as primary rewards, and to sensory stimuli that predict such events. Because TANs influence striatal projection neurons, TANs may play a role in the initiation and control of movement. To examine this issue, we recorded from putaminal TANs in macaque monkeys trained to make the same arm movement in two ways--in reaction to an external cue and also after a variable delay without an explicit instruction to move (self-timed movements). On other trials, the animals had to withhold movement following an external cue. The task design ensured that the three types of trials were effectively randomly interleaved, equally frequent, and similar in overall timing. Separately, we presented "playback" trials in which the same sequence of visual stimulation and reward was presented while the animals fixated without making the arm movement. We found that TAN responses were strongly affected by behavioral context. In particular, TAN responses were strikingly stronger when the animals actively withheld movements than on the corresponding playback trials, even though the stimulus sequence and reward timing were identical and no movement was made in either case. Many TANs also became active in the absence of a proximate sensory cue on self-timed movements, suggesting that TANs may reflect internal processes that are specific to self-timed movements. These results suggest that TANs may directly participate in, or monitor the motivational significance of, an animal's actions as well as external events.

Action Potentials↗

PubMed1989

Organizing principles for single-joint movements. II. A speed-sensitive strategy.

1. Normal human subjects made discrete flexions of the elbow over a fixed distance in the horizontal plane from a stationary initial position to a visually defined target. We measured joint angle, acceleration, and electromyograms (EMGs) from two agonist and two antagonist muscles. 2. Changes in movement speed were elicited either by explicit instruction to the subject or by adjusting the target width. Instructions always required accurately stopping in the target zone. 3. Peak inertial torques and accelerations, movement times, and integrated EMGs were all highly correlated with speed. We show that inertial torque can be used as a linking variable that is almost sufficient to explain all correlations between the task, the EMG, and movement kinematics. 4. When subjects perform tasks that require control of movement speed, they adjust the rate at which torque is developed by the muscles. This rate is modulated by the way in which the muscles are activated. The rate at which joint torque develops is correlated with the rate at which the agonist EMG rises as well as with integrated EMG. 5. The antagonist EMG shows two components. The latency of the first is 30-50 ms and independent of movement dynamics. The latency of the second component is proportional to movement time. The rate of rise and area of both components scale with torque. 6. We propose organizing principles for the control of single-joint movements in which tasks are performed by one of two strategies. These are called speed-insensitive and speed-sensitive strategies. 7. A model is proposed in which movements made under a speed-sensitive strategy are executed by controlling the intensity of an excitation pulse delivered to the motoneuron pool. The effect is to regulate the rate at which joint torque, and consequently acceleration, increases. 8. Movements of variable distance, speed, accuracy, and load are shown to be controlled by one of two consistent sets of rules for muscle activation. These rules apply to the control of both the agonist and antagonist muscles. Rules of activation lead to distinguishable patterns of EMG and torque development. All observable changes in movement kinematics are explained as deterministic consequences of these effects.

Elbow Joint↗

PubMed1996

Coordinating movement at two joints: a principle of linear covariance.

1. Six subjects performed fast, "single-joint" flexions at either the elbow or shoulder over three angular distances in a sagittal plane. Movement endpoints were located to require flexion of only a single, "focal" joint, without any external, mechanical constraint on the other, "nonfocal" joint. Three subjects performed another series of movements between two targets while moving along different paths and in which both joints were flexed. 2. We compared the torque patterns that were produced at the two joints. For single-joint movements, they were both biphasic pulses that accelerated and then decelerated the limb. 3. The torque at the nonfocal joint of a single joint movement was very close to linearly proportional to that at the focal joint throughout the movement. Elbow and shoulder torques differed by a linear scaling constant and went through extrema and zero crossings almost simultaneously. 4. In contrast, during movements in which subjects were explicitly instructed to use a hand path they would not naturally, use the linear interjoint torque scaling rule did not apply. This demonstrated that when we wish to move along a path between two targets that is not produced by linear torque covariation, we are able to modify that rule at will. 5. We speculate that linear, dynamic covariation of the torque patterns across two joints may be an important principle for reducing the number of degrees of freedom that the nervous system must independently control in performing unconstrained limb movements over naturally chosen paths.

Analysis of Variance↗

PubMed2004

Neural correlates of detecting pretense: automatic engagement of the intentional stance under covert conditions.

Typically developing children begin to produce and understand pretend play between 18 and 24 months of age, and early pretense has been argued to be a candidate ''core'' capacity central to the deployment of representations of other peoples' mental states-''theory of mind.'' In a functional magnetic resonance imaging study, 16 healthy adult volunteers were imaged while watching short (5 sec) clips of actors who either performed simple everyday actions or pretended to perform a similar set of actions, under covert conditions (e. g., participants were not directed to attend to actors' mental states). There was increased activity in the medial prefrontal areas (Brodmann's areas [BA] 9/6/32, 9, and 10), inferior frontal gyrus bilaterally (BA 44, 47), temporo-parietal regions (BA 21 and 22), and parahippocampal areas, including the amygdala, when subjects viewed pretend actions as compared with real actions. This result suggests that at least some areas previously implicated in making explicit mental state judgments are also strongly activated in response to actions that call for mental state interpretation (e. g., pretense) even when there is no explicit instruction for ''mind reading.'' This outcome is discussed in terms of accounts that propose ''theory of mind'' to be underwritten by automatic specialized mechanisms for the interpretation of the behavior of social agents.

Adolescent↗

PubMed1986

The reliability of axis V of DSM-III.

The authors studied the reliability of axis V of DSM-III by analyzing ratings of 97 psychiatric inpatients made by a multidisciplinary team of clinicians. The intraclass correlation coefficient for ratings of the overall sample was .49, lower than the figure found during the DSM-III field trials. The psychiatric diagnosis, age, ethnicity, marital status, and sex of the patient did not significantly influence reliability. The authors recommend more explicit instructions in the administration of the scale, the use of a standardized interview, and more training for raters as ways of increasing reliability.

Adaptation, Psychological↗

PubMedDate not supplied

A synthesis of spelling and reading interventions and their effects on the spelling outcomes of students with LD.

Previous research studies examining the effects of spelling and reading interventions on the spelling outcomes of students with learning disabilities (LD) are synthesized. An extensive search of the professional literature between 1995 and 2003 yielded a total of 19 intervention studies that provided spelling and reading interventions to students with LD and measured spelling outcomes. Findings revealed that spelling outcomes were consistently improved following spelling interventions that included explicit instruction with multiple practice opportunities and immediate corrective feedback after the word was misspelled. Furthermore, evidence from spelling interventions that employed assistive technology aimed at spelling in written compositions indicated positive effects on spelling outcomes.

Child↗

PubMedDate not supplied

On the relation among speech errors, disfluencies, and self-repairs.

In this study the relationship between speech errors (deviations from a speech plan), disfluencies (interruptions in the execution of a speech plan), and self-repairs (corrections of speech errors) was examined. Two hypotheses were formulated: Either disfluencies are special types of speech errors, or they resemble self-repairs (i.e., they are corrective actions applied to anticipated, internal errors). To test these two hypotheses, patterns of speech errors, disfluencies, and self-repairs were compared in a task in which speakers recited stimulus sentences four times in succession under time pressure. Subjects in one condition were explicitly instructed to pay close attention to accuracy of speaking. In another condition subjects were told that speech accuracy was not important. A much lower speech error rate was found in the higher-accuracy condition, but rates of disfluencies and self-repairs did not differ significantly between the two accuracy conditions. This is regarded as support for the self-repair account of disfluencies. When accuracy of speaking is stressed, speakers tend to avoid and repair speech errors at the cost of reduced speech fluency.

Adolescent↗

PubMed2004

Reliability of a structured interview scoring instrument for a Canadian postgraduate emergency medicine training program.

OBJECTIVES: To determine the reliability of scores assigned to interviews of medical students applying to an emergency medicine program. METHODS: A scoring instrument was derived based on faculty and resident input, institutional and national documents, and previous application procedures. Candidates were interviewed by four pairs of interviewers. Interviewers were asked to score the candidates on five visual analog scales (VASs) with objective anchors. Each interview assessed a unique candidate characteristic. All interviewers were given explicit instructions on scoring procedures and instrument use. The data were entered into an Excel database and transferred to SPSS, and reliabilities were measured with a two-way mixed-effect Cronbach's alpha. RESULTS: Forty applications were received for the 2002 residency entry year. Thirty-eight application packages were complete, and 16 candidates were interviewed. Data collection was complete for all 16. The average measure intraclass correlations for each individual interviewer across the five VASs ranged from 0.72 to 0.92 (mean, 0.85). The interrater reliability within the four interviews (personal characteristics, trainability, suitability for emergency medicine, and suitability for the specific training program) were low at 0.36, 0.59, 0.69, and 0.49. The overall reliability of the four interview scores was 0.83, and for the eight interviewer scores it was 0.86. CONCLUSIONS: The reliability of the overall interview scores was very high. The intraclass correlations for each interviewer's VAS scores were also high, but interrater correlations within interview teams were moderate and not higher than those across interview teams. This study suggests that an interview assessment instrument can be highly reliable overall and that interviewers base scores on an overall global impression.

Canada↗

PubMed2004

The relation between disinhibition and emotion regulation in boys with attention deficit hyperactivity disorder.

This study examined group differences of 49 boys ages 6 to 11 years with and without attention deficit hyperactivity disorder (ADHD) in emotion regulation during frustrating peer competition. Half of all boys in each group were explicitly instructed to hide their feelings if they became upset during the competition. Behavioral inhibition, both before and after the competitive task, was examined using the Stop Signal Task (SST), and emotion regulation was assessed via structured observation data. Effect sizes indicated that impulsive ADHD boys displayed greater disinhibition and were less effective at emotion regulation than comparison boys. In addition, boys with ADHD were unsuccessful in masking their emotions even when instructed to do so. In contrast, comparison boys were more successful at emotion regulation when given instruction to self-regulate, and these regulatory attempts predicted later inhibitory control. Findings are discussed in the context of current ADHD-related theories of inhibitory deficit, and suggestions for future research are provided.

Attention Deficit Disorder with Hyperactivity↗

PubMed1970

The control of "classroom attention": a group contingency for complex behavior.

Cumulative time measures of classroom attention, as delineated by the teacher, were taken of four elementary classes (kindergarten, third, fifth, and sixth grades) and of 16 randomly chosen students in these same classes. Each class of students was viewed as an individual responding organism. Base rates showed considerable variability. Explicit instructions alone concerning student attention produced temporary increase for some students and for some grades. Adding group contingencies (i.e., contingencies dependent on the attention of every student in the class) and token-mediated reinforcement to class achievement of a gradually increasing attention criterion raised group measures to a consistent 70 to 85% level of time attending to task as instructed, and raised individual student measures to a stable 90 to 100% level. Reversals and other data indicate that the elementary teacher can, by herself and with little effort, maximize what she considers the "paying-attention behavior" of all her students by her less-than-precise measure and consequation of the attention of the class as a whole.

Journal Article↗