Current practices in sensory motor programming with developmentally delayed infants and young children

This study examined the current practices of sensory motor programming with developmentally delayed infants and young children. A survey was conducted of facilities listed as serving this population group. There were 625 facilities which responded (response rate 84%). The responses of these facilities showed that each modal facility served between 21-50 children in day settings, and that 95% of the facilities offered individualized sensory motor programmes. Responses indicated that the way sensory motor programming was developed, the activities used, and the expected benefits had a high degree of similarity. Differences, however, were reported in the professional background of the programme directors, in their theoretical orientation, and in the assessment instruments used for developing and evaluating sensory motor programmes. There are implications for future study.     

Age as a Variable in an Exercise Program for the Treatment of Simple Urinary Stress Incontinence

This study compared the effectiveness of biofeedback on pubococcygeal muscle strengthening and simple urinary stress incontinence in older and younger women. Women aged 55 years and older and women younger than 55 years of age were taught Kegel exercises, using biofeedback, for the treatment of simple urinary stress incontinence. Eighty percent of the younger group and 67% of the older group eliminated stress incontinence. Also, the younger women required less pubococcygeal strength than the older women to control incontinence.     

Precision and content range of a parent‐reported item bank assessing lower extremity and mobility skills in children with cerebral palsy

Aim The aim of this study was to determine the psychometric properties, content range, and measurement precision of a lower extremity physical functioning and mobility skills item bank (LE85) in children with cerebral palsy (CP). Method Lower extremity functioning and mobility skill items were administered to 308 parents of children (169 males, 139 females; mean age 10y 8mo, SD 4y) with spastic CP (145 diplegia, 73 hemiplegia, 89 quadriplegia; [for one person type of CP was unknown]) classified using the Gross Motor Function Classification System (75 level I, 91 level II, 79 level III, 37 level IV, 26 level V). Additional legacy measures were administered to assess concurrent validity. Psychometric characteristics, differential item functioning, content range, and score precision were examined. Results The LE85 had acceptable psychometric properties. Content range matched the ability range of the sample population and exceeded legacy measures with minimal differential item functioning. The LE85 had good correlation with the Paediatric Outcomes Data Collection Instrument, Functional Independence Measure for Children, Gillette Functional Assessment Questionnaire, and Paediatric Quality of Life Inventory – CP module (range r=0.63–0.86). Precision of the LE85 and 10‐item simulated computer adaptive test scores outperformed legacy measures. Interpretation The LE85 appears to be suitable to administer as a computer adaptive test to measure lower extremity physical functioning and mobility in children with CP.     

Changes in otoacoustic emissions and auditory brain stem response after cis-platinum exposure in gerbils

Ototoxicity associated with cis -platinum administration commonly presents as hearing loss and tinnitus. The hearing loss is usually an irreversible, high-frequency sensorineural loss. Histologic studies in humans and animals suggest that the outer hair cells (OHCs) are most susceptible to cis -platinum. Evoked otoacoustic emissions (EOAE), as a measure of outer hair cell function, are potentially useful in following ototoxic insults involving OHCs. Distortion-product otoacoustic emission (DPOAE) test frequency-specific regions of the cochlea and therefore may be particularly well suited for monitoring ototoxic injuries. We measured distortion product otoacoustic emissions, at f2 = 2, 4, 6, 8, 10, and 12 kHz, in gerbils after a single large dose of cis -platinum. Animals treated with saline served as controls. The findings were compared to auditory brain stem evoked response (ABR) thresholds, using tone pipe of the same frequencies. The DPOAE and ABR thresholds were measured before treatment and again 2, 5, and 14 days after drug administration. The changes in DPOAE were compared with the changes in ABR. No treatment effect was noted in the 2-day group. Animals treated with cis -platinum demonstrated significant elevation of DPOAE and ABR thresholds compared with control animals at 5 and 14 days. There was no significant difference between the threshold changes in the 5-and 14-day groups. (Otolaryngol Head Neck Surg 1997; 116:585-92.)     

Nursing in Child Psychiatric Milieus Part II: Mapping Conceptual Footholds

In the first part of this paper, child inpatient nursing practice was organized into five therapeutic processes (safety, structure, support, involvement and validation). Using this organization of nursing care, three specific practice question are now addressed. One, how will nursing blend their traditional psychosocial orientation with biological psychiatry? Two, how might nurses best respond to the pressure to reduce the length of hospitalization yet still effectively intervene with troubled children? Three, does the traditional milieu therapy model have clinical utility for child inpatient nurses in the 1990's. It is suggested that nursing practice is best supported by multiple midrange theories which clarify children's behavior and give theoretical support to specific nursing interventions.     

Ras-dependent maturation of Xenopus oocytes is blocked by modified peptides of GTPase activating protein (GAP)

Guanosine triphosphatase activating protein (GAP) is an important modulator of p21^ras (Ras)-dependent signal transduction in mammalian cells and in insulin-induced maturation of Xenopus oocytes. A synthetic octapeptide from the catalytic domain of GAP, residues 899-906 (F⁸⁹⁹VFLRLIC⁹⁰⁶), inhibited GAP-stimulated hydrolysis of GTP to GDP by Ras in an in vitro biochemical assay (IC₅₀= 12 μM). The peptide was assayed for its ability to block insulin- (Ras-dependent) and progesterone- (Ras-independent) induced maturation of stage VI Xenopus laevis oocytes, marked by germinal vesicle breakdown (GVBD). Microinjection of 50 pmol of the peptide inhibited insulin- but not progesterone-induced GVBD by 50%. A 7-residue peptide lacking F⁸⁹⁹, GAP(900-906)-NH₂, failed to inhibit GAP-stimulated GTPase activity and did not block GVBD. Replacement of the cysteine residue at position 906 with methionine resulted in a peptide with prolonged inhibitory activity in the oocyte. Moreover, sequential replacement of specific L-amino acid residues with the corresponding d -mino acids produced a peptide with a two-fold increased half-life after injection into oocytes. None of the peptides tested affected progesterone induced GVBD, suggesting that the modifications did not result in loss of specificity. These studies show that (a) peptides that were able to inhibit GAP-stimulated Ras GTPase activity in vitro were also able to block Ras-dependent GVBD in oocytes, and (b) specific substitutions in these peptides can result in improved stability in oocytes. © Munksgaard 1995.     

A Comparative Study of the Rates of in Vitro Percutaneous Absorption of Eight Chemicals Using Rat and Human Skin

In vitro percutaneous absorption studies were carried out foreight chemicals using full thickness rat skin and human stratumcorneum. The purpose of the studies was to compare the ratesof absorption for the two species. For each of the chemicals,the observed rate using full thickness rat skin was greaterthan that observed for human stratum corneum. The ratios ofthe rates (rat/human) varied from 1.7 to 5.8 with a mean valueof 3.1. The chemicals tested were tritiated water, 2-ethoxyethylacetate,diethylene glycol monobutyl ether, urea, di(2-ethylhexyl)phthalate,2-ethylhexanol, ethyl 3-ethoxypropionate, and 2-propoxyethanol.The chemicals were chosen to represent a wide range of physicalproperties and permeability constant values. It was concludedthat rat skin was more permeable than human skin for each ofthese eight chemicals. This conclusion is supported by similarfindings from studies in other laboratories and suggests thatresults from studies in the rat overestimate skin absorptionin man.     

MCL1 and MCL6 Compared to V1 and V6 in Distinguishing Aberrant Supraventricular from Ventricular Ectopic Beats

Use of V1 and V6 has been suggested for distinguishing aberrant supraventricular from ventricular ectopy. For two decades, "modified" leads MCL1 and MCL6 have been widely used as V1 and V6 substitutes for bedside monitoring, but their use has never been validated. To determine the value of MCL1 and MCL6, 81 morphologically distinct wide QRS ectopic beats were recorded from 46 patients during cardiac electrophysiological study. As determined by the His-bundle electrogram, 31 of the ectopics were aberrant supraventricular, 50 were ventricular. A new criterion, measurement of QRS onset to the predominant peak or nadir of the complex, was valuable in diagnosing wide complexes in MCL6 and V6. An interval of 50 msec or less predicted aberrant supraventricular ectopy; an interval of 70 msec or more predicted ventricular ectopy. There was agreement between the modified and conventional precordial leads regarding which QRS patterns were useful in distinguishing aberrant supraventricular from ventricular ectopy. A greater proportion of wide complexes in MCL1 and V1 exhibited patterns useful in making the diagnosis compared to MCL6 and V6. Using well-established criteria, the proportion of correct diagnoses that was made from individual leads was: MCL1 = 86%, V1 = 85%, MCL6 = 72%, V6 = 67%. The bedside leads (MCL1 and MCL6) were not statistically different in diagnostic accuracy from their conventional lead counterparts (V1 and V6); however, MCL1 and V1 were superior to MCL6 and V6. When the new criterion was added to make the diagnosis from MCL6 and V6, no difference in diagnostic accuracy was present between the four leads.     

Bv — A Sub-Group of B which Lacks Part of the Normal Human B Antigen

A sub-group of B, B_v is described which contains an anti-B reacting with a fraction of the B agglutinogen complex. The B_v sub-group appears to be inherited as a simple Mendelian dominant.

Résumé

Un sous-groupe de B appelé B_v est décrit qui contient un anti-B réagissant avec une fraction du complexe de l'agglutinogène B. Le sous-groupe B_v semble être hérité selon le mode Mendèlien dominant simple.

Zusammenfassung

Es wird eine Untergruppe von B, B_v beschrieben, welche ein Anti-B enthält, welches mit einer Fraktion des B-Agglutinogenkomplexes reagiert. Die B_v-Untergruppe scheint nach Mendel einfach dominant vererbt zu werden.