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PubMed1994

Analysis of environmental deprivation: cognitive and social development in Romanian orphans.

The cognitive and social developmental status of a representative group of Romanian orphans between the ages of 23 and 50 months living in the Leagan de Copii in Timisoara, Romania was assessed using a variety of traditional and nontraditional measures. Results indicated that the orphanage sample all exhibited deficits in cognitive and social functioning; the majority were severely delayed. Correlations between the traditional and nontraditional measures indicated that children's delays occurred across domains. Deficits were not related to length of time in the orphanage, age at entrance, Apgar scores, or birthweight. The children's greatest capability was in peer social interaction.

Child, Abandoned↗
PubMed2003

Health maintenance throughout the life span for individuals with Down syndrome.

PURPOSE: To describe the routine health maintenance needs of individuals with Down syndrome who have specialized health needs associated with the multi-system impact of the diagnosis. DATA SOURCES: Review of scientific literature including peer-reviewed articles, books, and online resources. CONCLUSION: In addition to the routine health maintenance needs of all persons, those with Down syndrome have specialized needs. Failure to address these specific health maintenance concerns may lead to misdiagnoses and failure to reach the highest level of function possible. IMPLICATIONS FOR PRACTICE: Patients with Down syndrome who have legitimate, treatable diagnoses may be misdiagnosed as having behavior problems or dementia. Failure to identify abnormalities such as cardiac problems or sleep apnea may shorten life and interfere with ability to live life to the fullest.

Adolescent↗
PubMed1983

Gifted children benefit from health classes accelerated to their needs.

Health education is an optimal route for informing individuals and groups about their bodies and preserving and protecting health. Gifted children have the same health needs regarding health as all children, but because of their accelerated intellectual abilities, their need for information may out-distance those of peers. This article reflects the experience of a nurse-educator who taught a special summer health course to a group of academically talented fourth and fifth graders. The children chose this class on their own and were enthusiastic with "hands-on" experiences of human functioning. Not only were these youngsters a challenge to work with, but their ability to master concepts quickly made the course a truly dynamic learning experience.

Child↗
PubMed2006

Season of birth and childhood intelligence: findings from the Aberdeen Children of the 1950s cohort study.

BACKGROUND: In this study, 2 main hypotheses have been put forward to explain the variation in childhood intelligence or school performance by season of birth. In the first hypothesis, it is suggested that it is due to school policy concerning school entry, whereas the second suggests that a seasonally patterned exposure such as temperature, maternal nutrition, or infection during critical periods of brain development have a lasting effect on intelligence. AIMS: To determine whether childhood performance on tests of different domains of intelligence is patterned by season of birth and to examine possible mechanisms for any associations. SAMPLE: 12,150 individuals born in Aberdeen, Scotland between 1950 and 1956. METHODS: Birth cohort study in which the variation in different domains of childhood intelligence measured at ages 7, 9, and 11 by season of birth were examined. RESULTS: Reading ability at age 9 and arithmetic ability at age 11 varied by season of birth, with lowest scores among those born in autumn or early winter (September-December) and highest scores among those born in later winter or spring (February-April); p=.002 for joint sine-cosine functions for reading ability at age 9 and p=.05 for sine-cosine function for arithmetic ability at age 11. The child's perception and understanding of pictorial differences at age 7, verbal reasoning at 11, and English language ability at 11 did not vary by season of birth. Age at starting primary school and age relative to class peers were both associated with the different measurements of childhood intelligence and both attenuated the association between month of birth and reading ability at age 9 and arithmetic ability at age 11 towards the null. Both adjusted and unadjusted differences in reading ability at age 9 and arithmetic ability at age 11 between those born from September to December compared with other times of the year were less than 0.1 of a standard deviation of the test scores. Ambient temperature around the time of conception, during gestation, and around the time of birth did not affect intelligence. CONCLUSION: Any variation in mean childhood intelligence by season of birth is weak and largely explained by age at school entry and age relative to class peers.

Achievement↗
PubMed2003

Alcohol abuse and dependence: psychopathology, medical management and dental implications.

BACKGROUND: The authors review the clinical features, epidemiology, pathophysiology, medical management, dental findings and dental treatment of patients with alcoholism. LITERATURE REVIEWED: The authors conducted a MEDLINE search for 1995 through 2001 using the key terms of alcoholism, epidemiology, pathophysiology, treatment and dentistry. Reports selected for further review included those published in English in peer-reviewed journals. The authors gave preference to articles reporting randomized, controlled trials. CONCLUSIONS: Alcoholism is a chronic and progressive psychiatric illness that afflicts more than 14 million Americans. It is characterized by a loss of control over the use of alcohol, resulting in impaired social functioning, and the consequent development of medical illnesses. The disease arises in genetically vulnerable people when they are overwhelmed by their cravings for the alcohol-associated euphoria that results from the actions of several neurotransmitter systems in the brain's pleasure center. New medications to counteract alcohol-induced neurotransmission imbalance may assist patients in reducing their craving. CLINICAL IMPLICATIONS: The prevalence of dental disease usually is extensive because of a disinterest in performing appropriate oral hygiene techniques and diminished salivary flow. Concurrent abuse of tobacco products worsens dental disease and heightens the risk of developing oral cancer. Identification of the alcohol-abusing patient, a cancer-screening examination, preventive dental education, and use of saliva substitutes and anticaries agents are indicated. Special precautions must be taken when performing surgery and when prescribing or administering analgesics, antibiotics or sedative agents that are likely to have an adverse interaction with alcohol or psychiatric medications.

Alcohol Deterrents↗
PubMed2001

Procalcitonin in critical illness.

OBJECTIVE: To detail the biology and diagnostic usefulness of serum procalcitonin in critical illness. DATA SOURCES: A review of articles published in peer reviewed journals from 1990 to 2001 and identified through a MEDLINE search on procalcitonin. SUMMARY OF REVIEW: Procalcitonin (PCT) is a prohormone of calcitonin. Serum levels are elevated during sepsis and have been identified as a potential marker of infection in critical illness. However, its function and precise source of origin during sepsis remain unclear. The value of estimating serum PCT appears to be in the differentiation of infectious from non-infectious forms of systemic inflammatory response syndrome. A number of studies also point to its usefulness in distinguishing between bacterial and viral meningitis. However, there are a number of non-infectious conditions, where elevations in serum PCT occur, reducing its specificity. Its superiority as a marker of sepsis compared with other acute phase reactants continues to be debated. CONCLUSIONS: The utility of serum procalcitonin as a diagnostic test of sepsis is still under evaluation. Moreover, a number of unanswered questions remain regarding the biological role of PCT during sepsis, its target receptors and its protective value to the patient.

Journal Article↗
PubMed1996

Growth curves of Dutch children with Down's syndrome.

Two thousand and forty-five observations on height and weight were collected from 295 healthy Dutch children with Down's syndrome. In a cross-sectional analysis, means and standard deviations were calculated per age-class, and subsequently smoothed, resulting in age references between 0 and 20 years. Each child contributed only once in every age class. In a subgroup in whom more than four measurements were available before puberty, quadratic regression functions were determined on the basis of the full data set, as well as for individual children separately (54 boys and 25 girls). The average coefficients of the individual regression functions were almost identical to the coefficients of the regression line through all data, indicating that the reference curve for the mean height based on cross-sectional analysis adequately represents longitudinal growth during childhood. Dutch children with Down's syndrome are taller than their US peers (P50 equals P75) but more than 2 SD shorter than normal Dutch children. Above the age of 10 years, the mean weight for height is above the P90 of normal children.

Adolescent↗
PubMed2005

Sex differences in how older students influence younger student smoking behaviour.

The purpose of this study was to examine sex differences in how the smoking behaviour of close friends and older peers at school influence smoking onset and progression among 10,843 grade 9, 10 and 11 students from 29 secondary schools in Ontario, Canada. In lower-risk student populations (i.e., students with no smoking friends or one smoking friend), males and females were both at a similar level of risk for occasional smoking as a function of the smoking rate of older students at their school. Among higher-risk student populations (i.e., students with three or more close friends who smoke), the smoking rate of older students at school did not influence the risk of occasional smoking. The odds of a female student being a regular smoker increased as the prevalence of smoking among older students at her school increased regardless of her close friends' smoking behaviour. However, among male students, the influence of older student smoking at school on the odds of regular smoking was moderated by the number of close friends who smoke. It appears that the prevalence of older student smoking at a school is more influential among younger female students, whereas the smoking behaviour of close friends appears to be more influential among younger male students. This new finding provides unique insight for tailoring and targeting future school-based smoking prevention initiatives.

Adolescent↗
PubMed1981

Women's perceptions of their important dyadic relationships during pregnancy.

This study examined women's perceptions of important relationships during pregnancy. Fourteen women were interviewed at approximately monthly intervals from the third through the last month of their pregnancies. During these interviews, each woman (a) identified relationships which were important to her; (b) described each important relationship as either changing or stable; and (c) evaluated each important relationship as either satisfactory or unsatisfactory. Study results indicate that the women identified important relationships with their husbands, children, parental figures, and peers. Important relationships were described as more changing than stable throughout pregnancy. These relationships were experienced, over all, as more satisfactory than unsatisfactory. An analysis of the perceived satisfactory and unsatisfactory relationships reveals the woman's expectations for important relationships and indicates major considerations for the acceptance and accommodation process. The woman's expectations for her important relationships indicate the presence of two major systems of relationships within her social space. Each of these systems is characterized by a dominant function. One system of relationships has as its primary function, differentiation; the other, support. Within the differentiation system, the woman helps important others to reorganize for the addition of the expected baby to the family system. Within the supportive system, the pregnant woman is the recipient of the nurturing and caring actions of others. The interplay between these interdependent systems reflects the workings of the task of accommodation and acceptance.

Adult↗
PubMed2002

Differences in antimicrobial drug exposure in patients with various degrees of renal function based on recommendations from dosing references.

STUDY OBJECTIVE: To calculate and compare 24-hour area under the unbound drug concentration-time curves (AUC(0-24)) of antimicrobials with dosing recommendations from six commonly used dosing references. INTERVENTION: Unbound plasma concentration-time profiles of 13 antimicrobial agents (4 penicillins, 3 cephalosporins, 2 carbapenems, aztreonam, 3 fluoroquinolones) were simulated at steady state using a one-compartment open model for a 70-kg adult based on pharmacokinetic parameters obtained from peer-reviewed literature. Simulations were performed at five levels of creatinine clearance (Cl(cr)). MEASUREMENTS AND MAIN RESULTS: Differences in AUC(0-24) for each antimicrobial agent were noted among the six references at each level of Cl(cr) as well as within references across the range of Cl(cr). In addition, up to 16-fold and 3-fold ranges in AUC(0-24) values were observed for beta-lactams and fluoroquinolones, respectively, in one reference based on dosing recommendations at a single level of Cl(cr) (due to more than one dose and/or dosing interval). CONCLUSION: Clinicians should be aware of differences among common references when selecting dosages of antimicrobial agents, especially for patients with moderate-to-severe renal impairment.

Adult↗
PubMed1975

In vitro immunological studies on East African cancer patients. II. Increased sensitivity of blood lymphocytes from untreated Burkitt lymphoma patients to inhibition of spontaneous rosette formation.

Frozen aliquots of peripheral blood mononuclear cells from patients with Burkitt's lymphoma (BL) at various stages of the disease have been compared with samples from East African children who were healthy or who suffered from non-malinant disorders. Using the sheep-cell rosette test (which is believed to identify T-lymphocytes), we found a significant reduction in the proportion of rosette-forming cells (RFC) in the samples from untreated BL patients. After reduction of remission the difference between BL patients and controls was abolished. Rosette formation was more readily inhibited by anti-lymphocyte globulin (ALG) in samples from untreated BL patients than in controls. On induction of remission the rosette inhibition curve shifted towards the control values. The findings are compatible with the presence, in untreated BL, of a circulating factor which impairs the capacity of T-lymphocytes to form rosettes with sheep erythrocytes. It remains to be established whether the functional capacity of T-cells to protect the host against tumour proliferation is also impaired.

Africa, Eastern↗
PubMed2006

Brief report: individual social-multi-modal intervention for HFASD.

This research is the first part of a 2-year cognitive-behavioral-ecological (CB-E) social skills training for high-functioning children with autism spectrum disorder (HFASD). Current study examined efficacy of an individual CB-E intervention in facilitating children's dyadic interactions (immediately after treatment and 4 months later) and their social cognition capabilities (e.g., emotion understanding and recognition, social problem solving). Participants were 19 HFASD children aged 7 years and 7 months to 11 years and 6 months. Results demonstrated improvement in children's social cognition and positive dyadic interaction and decrease in children's low-level social interaction behavior. Long-term evaluation revealed maintenance of improvement. Progress in children's cooperation, self-control, and assertiveness was reported by their teachers. Discussion focused on CB-E intervention efficacy in promoting integral social functioning for HF children with ASD.

Asperger Syndrome↗
PubMed1983

A simple operation for correction of chronic lateral instability of the ankle.

Twenty-two patients underwent a simple operation for correction of chronic lateral instability of the ankle. During the procedure the function of the peroneus brevis was preserved and the anterior talofibular ligament was reconstructed. At follow-up only one patient reported that the ankle still felt unstable.

Adult↗
PubMed2006

The detrusor muscle: an innocent victim of bladder outlet obstruction.

OBJECTIVES: Benign prostatic hyperplasia (BPH) is considered a frequent cause of bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS), although the physiopathologic mechanism through which BPH causes LUTS is not clear. Several morphologic and functional modifications of the bladder detrusor have been described in patients with BPH and could play a direct role in determining symptoms. The opinion is spreading that the enlarged prostates in patients with LUTS is nothing more than a mere bystander. Evidence has accumulated, however, supporting the role of BPH-related BOO as the direct cause determining bladder dysfunction and indirectly causing urinary symptoms. The present review addresses the bladder response to BOO, particularly focusing on the physiopathologic cascade that links obstructive BPH to bladder dysfunction. METHODS: A literature review of peer-reviewed articles has been performed, including both in vivo and in vitro studies on human tissue and animal model experiments. RESULTS: Epithelial and smooth muscle cells in the bladder wall are mechanosensitive, and in response to mechanical stretch stress caused by BOO, undergo modifications of gene expression and protein synthesis. This process involves several transduction mechanisms and finally alter the ultrastructure and physiology of cell membranes, cytoskeleton, contractile proteins, mitochondria, extracellular matrix, and neuronal networks. CONCLUSIONS: BOO is the initiator of a physiopathologic cascade leading to deep changing of bladder structure and function. Before being a direct cause of storing-phase urinary symptoms, the bladder is the first innocent victim of prostatic obstruction.

Humans↗
PubMed1993

Inhibition of interferon-gamma by an interferon-gamma receptor immunoadhesin.

Interferon-gamma (IFN-gamma) is an important cytokine which regulates inflammatory and immune response mechanisms. IFN-gamma enhances the presentation and recognition of antigens by inducing the expression of major histocompatibility complex (MHC) proteins, by activating effector T cells and mononuclear phagocytes, and by modulating immunoglobulin production and class selection in B cells. Inappropriate production of IFN-gamma has been implicated in the pathogenesis of several autoimmune and inflammatory diseases and in graft rejection. Here, we describe a recombinant inhibitor of IFN-gamma, termed murine IFN-gamma receptor immunoadhesin (mIFN-gamma R-IgG). We constructed this immunoadhesin by linking the extracellular portion of the mouse IFN-gamma R to the hinge and Fc region of an IgG1 heavy chain. Murine IFN-gamma R-IgG is secreted by transfected cells as a disulphide-bonded homodimer which binds IFN-gamma bivalently, with high affinity and in a species-specific manner. In vitro, mIFN-gamma R-IgG can block mIFN-gamma-induced antiviral activity and expression of the class I MHC antigen H-2Kk in cultured cells. In vivo, mIFN-gamma R-IgG can block the function of endogenous mIFN-gamma in mouse models of infection with Listeria monocytogenes and of contact sensitivity. These results show that mIFN-gamma R-IgG is an effective and specific inhibitor of mIFN-gamma both in vitro and in vivo. Thus, in general, IFN-gamma receptor immunoadhesins may be useful for investigating the biological functions of IFN-gamma as well as for preventing deleterious effects of IFN-gamma in human disease.

Animals↗
PubMed2001

The assessment of the situational specificity of children's problems behaviour in peer-peer context.

In both theory and research the general issue of the extent to which children's problem behaviour is generalised across situations, and to what extent it is situation specific, has been neglected. In the clinical assessment of disordered children, too, little attention has been paid to the specific situations in which these children display their inappropriate behaviour. In this study the Taxonomy of Problematic Social Situations (TOPS) (Dodge, McClaskey, & Feldman, 1985) was employed. This is a questionnaire in which the child's teacher is asked to rate the likelihood of a child responding in an inappropriate manner in a specific situation. Characteristics of TOPS were investigated both in randomly selected normal school children and in boys with a conduct disorder. Four factors appeared to underlie the TOPS scores from 652 randomly selected boys and girls from grades 1 to 6, these being: teachers' scores for the types of problem situation Being Disadvantaged, Coping with Competition, Social Expectations of Peers, and Teacher Expectations. Because of the high internal consistency of the four factors, TOPS was abbreviated to a TOPS-Short Form (18 instead of 44 items). The four-factor model was cross-validated by means of a second sample of 326 boys and girls. A model with only one general problem behaviour factor did not fit the data of both samples. When the four specific factors were added a satisfactory fit resulted. Moreover, it was found that in the first sample 52% of the variance was explained by the general factor, whereas 18% of the variance was explained by the four specific factors together. Thus, the extent to which problem behaviour is situation specific should not be disregarded. In all four types of problem situation, boys showed more inappropriate behaviour than girls. With increasing age, children were rated as being more competent in dealing with the problem situation Being Disadvantaged. Teachers rated the four types of problem situation as more problematic for boys with a conduct disorder (N = 42) than for normal control boys (N = 67). Conduct disordered boys also differed individually in the number of situational types that were problematic for them. With respect to clinical implications, the identification of the particular social context in which a conduct disordered child displays his or her inappropriate behaviour may help refine treatment goals: more adequate social functioning should be aimed at specifically in those situations that are problematic.

Aggression↗
PubMed2005

Evidence-based considerations for removable prosthodontic and dental implant occlusion: a literature review.

The dental literature is filled with discussions of dental occlusion, occlusal schemes, philosophies, and methods to correct and restore the diseased, worn, or damaged occlusion. Traditionally, these discussions have been empirical in nature and not based on scientific evidence. Due to the empirical nature of the literature, the study of occlusion has been extremely complex and troublesome to both pre- and post-doctoral students. The introduction of osseointegrated implants has further complicated the situation. Dentists may apply the principles of occlusion for the natural dentition directly to implant-supported and retained restorations. Although this may be successful, this rationale may result in overly complex or simplified treatment protocols and outcomes. There is an emerging body of scientific literature related to dental implant therapy that may be useful in formulating treatment protocols and prosthesis designs for implant-supported restorations. This review focuses on some of the "classic" removable prosthodontic literature and the currently available scientific literature involving removable prosthodontic occlusion and dental implant occlusion. The authors reviewed the English peer-reviewed literature prior to 1996 in as comprehensive manner as possible, and material after 1996 was reviewed electronically using MEDLINE. Electronic searches of the literature were performed in MEDLINE using key words-animal studies, case series, clinical trials, cohort studies, complete denture occlusion, dental implant function, dental implant occlusion, dental implant occlusion research, dental implant functional loading, dental implants, dental occlusion, dental occlusion research, denture function, denture occlusion, dentures, implant function, implant functional loading, implant occlusion, occlusion, and removable partial denture occlusion-in various combinations to obtain potential references for review. A total of 5447 English language titles were obtained, many of which were duplicates due to multiple searches. Manual hand searching of the MEDLINE reference list was performed to identify any articles missed in the original search.

Animals↗
PubMedDate not supplied

Is recovery planning any different from treatment planning?

Using process evaluation data, this paper compares the "recovery" planning process of the social model programs with the "treatment" planning process in a comparison medical model program. We consider how the planning process is actually conducted, the role of staff versus clients in the planning process, and how the implementation of the planning process is monitored and evaluated at the programs. Results point to major differences in the actual process of treatment planning and recovery planning. Professional staff at medical model programs generally direct and control the planning process and its implementation. In social model programs, clients are directly responsible for developing their own recovery plans, within a context of help from peers and recovering staff; the latter oversee the process. We conclude that both treatment planning and recovery planning are distinct and defining features of medical and social model philosophies. Treatment planning in medical model programs and recovery planning in social model programs serve similar administrative and programmatic functions. However, the impact on patients/residents is likely to be significantly different. Recovery planning becomes a skill acquired by clients, part of the experiential education characterizing social model programs. Future research is needed to assess whether these planning skills actually aid social model clients in structuring a sober lifestyle in aftercare, and whether differences are obtained by the more passive client role in planning taken at the medical model program.

Humans↗