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At least 19 recordsLinked to original sources
PubMed2002

Special olympics, special athletes, special needs?

Based upon the current study, the review of the literature, and our experience, the preparticipation physical examination for Special Olympics is an opportunity for physicians of all specialties to assist and encourage a group of athletes with special physical and emotional characteristics not found in other athletes. The physician should review the medical condition of the athlete (including prescribed medications and their potential side effects), the physical demands of the proposed activity, and the presence of volunteers to assist the athlete when necessary. Full or limited participation should be recommended in most cases. "No participation" should only apply to unstable medical conditions or situations that would place the athlete at risk for injury despite activity modification and close supervision.

Adolescent↗
PubMed1978

Bacteriophage P22-mediated specialized transduction in Salmonella typhimurium: identification of different types of specialized transducing particles.

The temperate bacteriophage P22 mediates both generalized and specialized transduction in Salmonella typhimurium. Specialized transduction by phage P22 is different from, and less restricted than, the well characterized specialized transduction by phage lambda, due to differences in the phage DNA packaging mechanism. Phage lysates produced by induction of lysogenic strains contain very high frequencies of supQ newD- and proA,B-specialized transducing particles (10(-2)/PFU and 10(-3)/PFU, respectively), most of which are produced by independent aberrant excision events of various types. In a model, 12 different modes of transduction mechanisms were characterized by: (i) the structure of the specialized transducing genomes after injection into a new host cell, i.e., linear or circular, and (ii) the requirements for the transduction process, i.e., host recombination functions, phage integration functions, or presence of a prophage. By using different recipient strains and phage helper strains, it was possible to show that most specialized transducing particles (ca. 99%) contain linear genomes that cannot circularize upon injection into a new host cell and that require the presence of an integrated prophage as a site for a recombinational event to give rise to a transductant. Only 0.1% of all specialized transducing particles were shown to transduce by integration, suggesting that transducing genomes containing terminally redundant ends represent only a minor fraction of all transducing particles that are produced. However, it should be pointed out that the frequency (approximately 10(-5)/PFU) of these specialized transducing genomes that can circularize upon injection into a new host cell is as high as or even higher than the frequency of specialized transducing particles of phage lambda. The remaining approximately 1% of all specialized transducing particles can transduce by any one of the other mechanisms described.

Adsorption↗
PubMed1993

What's so special about special visceral?

The brainstem is classically divided into functional columns including special and general subdivisions for somatic and visceral components. The term 'special visceral motor' is applied to branchiomotor nuclei, while 'special visceral sensory' refers to nuclei devoted to incoming gustatory and olfactory senses. The use of the term 'special visceral motor' is questioned in that the branchiomotor neurons function more like general somatic than general visceral motoneurons. The designation of taste and smell as 'special visceral sensory' systems seems inconsistent on several bases. First, taste and smell are not homologous systems: (1) the receptors are grossly dissimilar in morphology and relationship to other elements of the nervous system; (2) the two systems mediate very different behaviors and respond to different types of chemical stimuli, and (3) chemosensory systems are not 'special' (i.e. limited to cranial nerves) in that solitary chemoreceptor cells, which are distributed across the body surface, can be innervated by spinal or cranial nerves. Finally, taste is considered 'special' because it involves specialized chemosensory end organs; the visceral nerves also provide innervation to other specialized chemoreceptors (e.g. carotid body) which are considered part of the general visceral sensory system. Thus the term 'special visceral sensory' appears without solid foundation when applied to gustatory systems in contradistinction to nongustatory branchial and thoracic interoceptive systems. A reformulation of the functional columns of the brainstem is suggested in which six columns can be identified: (1) somatic motor; (2) branchial motor; (3) visceral motor; (4) visceral sensory; (5) somatic sensory, and (6) hair cell (dorsolateral placode) sensory.

Animals↗
PubMed2005

The structure and development of avian lumbosacral specializations of the vertebral canal and the spinal cord with special reference to a possible function as a sense organ of equilibrium.

The avian lumbosacral vertebral column and spinal cord show a number of specializations which have recently been interpreted as a sense organ of equilibrium. This sense organ is thought to support balanced walking on the ground. Although most of the peculiar structures have been described previously, there was a need to reevaluate the specializations with regard to the possible function as a sense organ. Specializations were studied in detail in the adult pigeon. The development of the system was studied both in the pigeon (semiprecocial at hatching) and in the chicken (precocial). Specializations in the vertebral canal consist of a considerable enlargement, which is not due to an increase in the size of the spinal nervous tissue, but to a large glycogen body embedded in a dorsal rhomboid sinus. The dorsal wall of the vertebral canal shows segmented bilateral dorsal grooves, which are covered by the meninges towards the lumen of the vertebral canal leaving openings in the midline and laterally. This results in a system of lumbosacral canals which look and may function similar to the semicircular canals in the inner ear. Laterally these canals open above ventrolateral protrusions or accessory lobes of the spinal cord which contain neurons. There are large subarachnoidal cerebrospinal fluid spaces, lateral and ventral to the accessory lobes. Movement of this fluid is thought to stimulate the lobes mechanically. As to the development of avian lumbosacral specializations, main attention was given to the organization of the lobes and the adjacent fluid spaces including the dorsal canals. In the pigeon the system is far from being adult-like at hatching but maturates rapidly after hatching. In the chicken the system looks already adult-like at hatching. The implications derived from the structural findings are discussed with regard to a possible function of the lumbosacral specializations as a sense organ of equilibrium. The adult-like organization in the newly hatched chickens, which walk around immediately after hatching, supports the assumed function as a sense organ involved in the control of locomotion on the ground.

Animal Structures↗
PubMed1997

What is so special about special education?

There is nothing special about special education. Educational methods have not changed significantly in at least 2,500 years. IQ tests were developed to identify those in need of special education, with the intention of developing appropriate educational methods. Effective special educational methods have yet to be developed. IQ tests are diagnostic but not prescriptive. Effective special educational methods will not be developed until (a) individual differences in student characteristics beyond IQ scores are recognized and understood and (b) educators focus on specific and realistic goals for outcome.

Adolescent↗
PubMedDate not supplied

Emergency medical services assessment and treatment of children with special health care needs before and after specialized paramedic training.

INTRODUCTION: This study evaluates whether a continuing education program for paramedics, focusing on Children with Special Health Care Needs, improved paramedics' assessment and management. METHODS: Emergency Medical Services responses for children, 21 years of age or younger, with a congenital or acquired condition or a chronic physical or mental illness, were identified. The responses before and after the specialized education program were reviewed by a multidisciplinary team to evaluate assessment and management of the children. Interreviewer agreement between the nurses on the team and between the physicians on the team was assessed. We also evaluated whether there was an improvement in assessment and care by paramedics completing our education program. RESULTS: Significant improvement was seen in appropriate assessment and overall care by paramedics who completed our specialized education program. Reviewers also noted an appropriate rating for the initial assessment category more often for responses involving paramedics who had the training. Agreement on whether assessment and treatment was appropriate for all five reviewers varied considerably, ranging from 32% to 93%. Overall there was a high percentage of agreement (>70%) between the nurses and between the physicians on most items. However, kappa statistics did not generally reflect good agreement except for most of the focused assessment items and some treatment and procedure items. CONCLUSION: Most of the documentation on the EMS records indicated appropriate assessment and treatment during all responses for Children with Special Health Care Needs. Nevertheless, the results indicate that paramedics may improve their assessment and management of these children after specialized continuing education.

Arizona↗
PubMed1989

Are special treatment facilities for female alcoholics needed? A controlled 2-year follow-up study from a specialized female unit (EWA) versus a mixed male/female treatment facility.

Women with alcohol problems constitute an increasing number of patients in medical service. Do they need special care? How should the treatment program be designed? The specialized female Karolinska Project for Early Treatment of Women with Alcohol Addiction (EWA) unit at the Karolinska Hospital in Stockholm, Sweden, was opened in 1981. The aim of the project is to reach women in an early stage of alcohol dependence behavior and to develop treatment programs specific to the needs of females alone. In order to investigate the value of such a specialized female unit a controlled 2-year follow-up study was carried out including 200 women. The probands were treated in the female only EWA-unit, whereas the controls were placed in the care of traditional mixed-sex alcoholism treatment centers. The 2-year follow-up study showed a more successful rehabilitation regarding alcohol consumption and social adjustment for the women treated in the specialized female unit (EWA). Improvement was noted also for the controls but to a lesser extent. Probably one of the most important achievements of a specialized female unit, such as EWA, is to attract women to come for help earlier.

Adolescent↗
PubMed2004

A national assessment of children with special health care needs: prevalence of special needs and use of health care services among children in the military health system.

OBJECTIVE: Children are frequently perceived to be healthy, low-risk individuals with a majority of clinical services devoted to health maintenance and preventive clinical services. However, a subset of children have unique needs that require specialized care to achieve optimal health outcomes. The purpose of this research was to use survey tools that have been developed to identify children with special health care needs (CSHCN) to measure prevalence and resource needs of these children in the military health system (MHS). METHODS: The US Department of Defense manages the MHS, which is one of the largest integrated health care systems in the world and provides care to almost 2,000000 children. We incorporated the CSHCN survey screener and assessment questions into the annual health care survey of beneficiaries who are eligible for benefits within the MHS. In addition, we used claims information available from inpatient and outpatient services. We used parent reports from the survey to estimate the prevalence of CSHCN. Incorporating claims data and restricting our analyses to those who were enrolled continuously in a military health maintenance organization (TRICARE Prime), we described utilization of different types of health care resources and compared CSHCN with their healthy counterparts. Finally, we examined alternative types of special needs and performed regression analyses to identify the major determinants of health needs and resource utilization to guide system management and policy development. RESULTS: CSHCN compose 23% of the TRICARE Prime enrollees who are younger than 18 years and whose parents responded to the survey. The needs of a majority of these children consist of prescription medications and services targeting medical, mental health, and educational needs. CSHCN experience 5 times as many admissions and 10 times as many days in hospitals compared with children without special needs. CSHCN are responsible for nearly half of outpatient visits for enrolled children and more than three quarters of inpatient days. Service utilization varies dramatically by type of special need and other demographic variables. CONCLUSION: CSHCN represent a major challenge to organized systems of care and our society. Because they represent a group of children who are particularly at risk with potential for improved health outcomes, efforts to improve quality, coordinate care, and optimize efficiency should focus on this target population.

Child↗
PubMed2001

Introduction to the final special section in the special series on the utility of the Rorschach for clinical assessment.

A special Series was organized to clarify the merits of the Rorschach for clinical assessment. Except for a neutral meta-analytic review, articles were solicited from scholars known to have opposing views on the Rorschach. The authors participated in a structured, sequential, evidence-based dialogue that focused on strengths and limitations when using the Rorschach for applied purposes. The debate has taken place over 4 iterations, with later articles building on and reacting to those generated earlier. The first 5 articles in the Special Series were published earlier (G. J. Meyer, 1999), and the final 6 articles are published in this issue of Psychological Assessment. This article provides a brief overview of the full Special Series and an introduction to the 6 articles contained in this Special Section. The Special Series provides clinicians, researchers, educators, and students with a thorough review of the evidence and logic that are critical for understanding the Rorschach's strengths and limitations in clinical assessment.

Humans↗
PubMed1970

Sub-specialization or super-specialization in surgery?

A special centre for prosthetic hip replacement set up 10 years ago has been successful in its primary objectives, producing high quality work at low cost and stimulating research. The project has not yet been successful in achieving a permanent staffing structure, but this is the effect of certain British ideologies in surgical training, with the result that craftsmanship and technology cannot be reconciled with pure intellectual attainment.The success of the project suggests the importance of isolating elective surgery from emergency surgery in the interests of cost-effectiveness. Problems of isolation from teaching hospitals are not insurmountable, but isolation to some degree is essential to achieve the minimum size necessary for efficiency and to ensure unbroken professional team-work among all levels of staff. While maximum efficiency in this field can be achieved only in special centres, too many primary operations will be required every year to insist that total hip replacement should be done only in special centres. A special feature of this field is the need for a permanent staffing structure to hand on technical expertise as an unbroken tradition.

Costs and Cost Analysis↗
PubMed2002

Hyperparathyroidism in hereditary syndromes: special expressions and special managements.

Hyperparathyroidism (HPT) in its hereditary variants assumes special forms, has special associations, and requires special managements. Familial hypocalciuric hypercalcemia (FHH or FBHH) and neonatal severe primary hyperparathyroidism (NSHPT) reflect heterozygous or homozygous mutations, respectively, in the calcium-sensing receptor. FHH and NSHPT represent the mildest and severest variants of HPT. Both cause hypercalcemia from birth and atypical HPT that always and uniquely persists after subtotal parathyroidectomy. Their HPT is likely polyclonal and nonneoplastic. In contrast, mono- or oligo-clonal parathyroid neoplasia underlays most other HPT variants: multiple endocrine neoplasia type 1 (MEN1), multiple endocrine neoplasia type 2A (MEN2A), and hyperparathyroidism-jaw tumor syndrome (HPT-JT). Familial-isolated HPT combines several diagnoses, including occult forms of the above syndromes. Each neoplastic variant has tumors in multiple parathyroids and a delayed, but still early age of onset for HPT (average age, 25-35 years). Each justifies special and similar approaches to parathyroidectomy: typically, identification of four glands, subtotal parathyroidectomy, rapid intraoperative parathyroid hormone (PTH) assays, and parathyroid cryopreservation. Outcomes of parathyroidectomy remain suboptimal in each. Each syndrome of parathyroid neoplasia associates with characteristic cancer(s): enteropancreatic neuroendocrine or foregut carcinoid tissues (MEN1), thyroidal C cells (MEN2A), or parathyroid (HPT-JT). HPT has promoted gene discovery more through its rare hereditary variants than through common adenoma; the main genes causing four of six hereditary variants are known. The RET mutation test became essential in management of MEN2A. The MEN1 test is less urgent, because it rarely guides a major patient benefit. The CASR test, perhaps least urgent, has largely been unavailable. Further progress in molecular genetics will enhance understandings, diagnosis, and therapy of HPT.

Calcium↗
PubMedDate not supplied

Do nurses see eye to eye on specialization? A look at the past, present, and future of the development of specialization.

1. Specialization in nursing is a complex topic that has significance for how nursing is practiced, how services are delivered, what research is done, and what educational programs are offered. 2. The movement toward specialization is driven by a genuine concern for the quality of care, a desire on the part of individual nurses for recognition of their knowledge and expertise, a psychological as well as an economic need, and a profession-wide pursuit of status and recognition. 3. The need for an identified framework or classification system for the orderly development of specialization in nursing is essential and urgent. The situation in the United States gives a picture of the fragmentation, duplication, and disorder created by the lack of a framework. The identification of a framework would facilitate and expedite the orderly development of specialization.

Eye Diseases↗
PubMed1985

Tourette syndrome in the classroom: special problems, special needs.

Tourette Syndrome (TS) is an uncommon developmental disability characterized by repetitive and involuntary verbal and motor tics. A survey of all known affiliates of the Tourette Syndrome Association of Ohio was conducted to document the special problems and needs of the TS student. A total of 431 questionnaires was returned, and the types and frequency of interpersonal and academic school problems were found to be pervasive. Problems did not differ by grade level, but students medicating their TS symptoms experienced more problems. In most cases, current students described similar problems to adults, suggesting that recent attempts to provide optimal educational opportunities to all handicapped children have not been successful where TS is involved. The presence of a behavioral or learning disability diagnosis indicated that substantial percentages of respondents were in need of specialized educational services, but not all those in need were receiving them. Parents were generally satisfied with their child's education, but less satisfied when specialized education was involved. Suggestions are offered for more effectively dealing with the TS child in the classroom.

Adolescent↗