Mother-Professional Agreement about Developmental Delay in Preschool Children: A Preliminary Report

Current practice prescribes that parents play an integral part in the assessment and management of their preschool child with suspected developmental delay. Multidisciplinary assessment aims to enhance parents' understanding of the nature and extent of the delay with a view to promoting parent-professional agreement about interventions. Serious mismatches between parents and therapists in their judgements of developmental status are potentially important markers of families at risk of sub-optimal use of intervention services. This study compared mothers' perceptions of their child's development with the results of standardised tests in key domains. A 14 item questionnaire, constructed to measure mothers' perceptions of current and future development, was administered pre- and post-developmental assessment. Preliminary results suggest that mothers recognised the existence of delayed development, but underestimated its severity. Levels of congruence varied with domain. Predictions about future development revealed that most mothers interpreted the delay as temporary. Implications for clinical practice are discussed.     

Modified Vaccination Technique for Prophylactic and Therapeutic Applications to Combat Endogenous Antigen–Induced Disorders

Public health can be protected most effectively through vaccination programmes. However, while presently available vaccination techniques protects the individual by provoking immune responses against exogenous antigens (ags), such as those associated with certain bacteria and viruses, they cannot protect against or treat mishaps caused by endogenous ag. Recently, Barabas and colleagues have developed a new vaccination method, called modified vaccination technique (MVT), which allows the presentation of disease causing agents in such a way as to initiate and maintain desired immune response outcomes even in the context of mishaps associated with endogenous ag. For example, in an experimental autoimmune kidney disease, the MVT downregulated/terminated pathogenic immune responses that were causing morphological and functional changes of the kidney. The MVT promises, with appropriate case‐specific modifications, both preventative and curative applications for ailments, such as endogenous ag initiated mishaps (i.e. autoimmune diseases and cancer) and diseases caused by chronic infection, that are presently only treatable with drugs. To achieve specific immune responses, purified components of the vaccine (ag and antibodies) must be produced and assembled into immune complexes having the potential of inducing predetermined corrective immune response outcomes.     

Definition and measurement of guilt: Implications for clinical research and practice

Research on the relation of guilt to psychopathology is highly inconsistent. Some studies suggest that guilt contributes to psychopathology; others suggest that guilt serves a protective role. This review of 23 theory-based definitions of guilt and 25 measures of guilt suggests that a lack of conceptual clarity may be to blame. Measures of guilt do not correspond well to the definitions from which they derive. Many definitions and measures reflect the intrusion of extraneous constructs that could confound guilt research. Furthermore, definitions and measures of guilt change with developmental level. Nevertheless, two broad conceptualizations of guilt emerge. Central to both is a focus on one's action or inactions involving real or imagined moral transgressions. Distinguishing the two conceptualizations is whether or not guilt is inherently adaptive construct, generating remorse, augmenting a sense of responsibility, and motivating reparation. Recommendations for the definition and measurement of guilt are discussed.     

Attributing Hardy-Weinberg Disequilibrium to Population Stratification and Genetic Association in Case-Control Studies

Loci exhibiting Hardy-Weinberg disequilibrium (HWD) are often excluded from association studies, because HWD may indicate genotyping error, population stratification or selection bias. For case-control studies, HWD can result from a genetic effect at the locus. We extend the modelling to accommodate both stratification and genetic effects. Theoretical genotype frequencies and HWD coefficients are derived under a general genetic model for a population with two strata. Maximum likelihood is used to estimate model parameters and a test for lack of fit identifies the models most consistent with the data. Simulations were used to assess the method.
The technique was applied to a group of ethnically and clinically heterogeneous kidney stone formers and controls, both exhibiting HWD for the R990G SNP of the CASR gene. Results indicate the best fitting model incorporates both stratification and genetic association. The ability of our method to apportion HWD to stratification and genetic effects may well be a significant advance in dealing with heterogeneity in case-control genetic association studies.     

FACIAL EXPRESSION RECOGNITION BY PEOPLE WITH MÖBIUS SYNDROME

We present an investigation of facial expression recognition by three people (BC, LP, and NC) with Mobius syndrome, a congenital disorder producing facial paralysis. The participants were asked to identify the emotion displayed in 10 examples of facial expressions associated with each of 6 basic emotions from the Ekman and Friesen (1976) series. None of the three people with Möbius syndrome was significantly impaired on this task. On a second test of facial expression recognition using computer-morphed facial expressions, NC showed a statistically significant impairment, BC a borderline deficit, and LP was unimpaired. However, even when impairments were found, people with Möbius syndrome still recognised many of the facial expressions shown to them. The recognition of facial expressions by people who have never been able to produce such signals on their own faces demonstrates that the ability to produce facial expressions is not a necessary prerequisite of their recognition.     

腹腔镜阑尾切除术Hem-o-lok夹闭法处理阑尾残端的临床效果分析

目的:评价腹腔镜阑尾切除术中Hem-o-lok夹闭法处理阑尾残端的临床效果.方法:选择82例行腹腔镜阑尾切除术的病人为研究对象,随机分为Hem-o-lok组与对照组,各41例.Hem-o-lok组阑尾残端采用Hem-o-lok夹闭,对照组采用丝线单纯结扎或结扎+缝扎.比较2组手术时间、手术相关并发症、住院时间及住院费用...     

Carotid sinus “irritability” rather than hypersensitivity: a new name for an old syndrome?

Carotid sinus hypersensitivity (CSH) is a well-described cause of syncope, resulting in bradycardia and/or hypotension in response to neck pressure. The authors hypothesized that (CSH) represents an inappropriate response of the baroreflex system to a nonphysiologic stimulus, rather than a truly hypersensitive carotid carotid sinus (ie, excessive vagotonia and sympathoinhibition in response to arterial hypertension). To test their hypothesis, the authors used a neck chamber to deliver stepped, R-wave-triggered changes in transmural carotid sinus pressure, from +40 to −60 mm Hg, during a single held expiration. The authors studied 7 men (age 69±8y; mean age ±SD) with carotid sinus syndrome and 10 age- and sex-matched controls. Seven repetitions of pressure changes were averaged, and the carotid sinus response described by changes in the R-R interval. There was no statistical difference in carotid-cardiac baroreflex gain (R-R interval/pressure change; mean gain ±SD, 3.0±2.1 msec/mm Hg and 2.2±3.0 msec/mm Hg, respectively) or other markers of carotid baroreflex responses between the subjects and controls. These preliminary results suggest that (CSH) may not be a “hypersensitive” reflex, but rather an inappropriate response, or “irritability,” of the baroreflex system to nonphysiologic deformation of the carotid sinus and/or surrounding tissues. Funding for this study was provided by an unrestricted grant from Cardiac Pacing Inc. (CPI), Minneapolis, Minnesota, and Engineering Development Lab (EDL), Newport News, Virginia.