Cognitive consequences of early phase of literacy.

The effect of the degree of illiteracy (complete or incomplete) on phonological skills, verbal and visual memory and visuospatial skills is examined in 97 normal Brazilian adults who considered themselves illiterate, and 41 Brazilian school children aged 7 to 8 years, either nonreaders or beginning readers. Similar literacy effects were observed in children and in adults. Tasks involving phonological awareness and visual recognition memory of nonsense figures distinguish the best nonreaders and beginning readers. Children performed better than adults at oral repetition of short items and figure recall, and adults better than children at semantic verbal fluency, digit span, and word list recall. A principal component analysis of the correlations between tasks showed that phonological awareness/reading, phonological memory/oral repetition, and semantic verbal memory/fluency tasks, generated different components. The respective role of culturally based preschool activities and literacy on the cognitive functions that are explored in this study is discussed.     

Pregnant Adolescents With Addictions

Adolescence is the most formative time in the lives of women. During this time girls are making choices that have implications for the rest of their lives. Adolescence also can be a time when the negative impact of sexual and physical abuse from childhood begins to take its toll, contributing to adolescent pregnancy and substance abuse. In the last decade the incidences of pregnancy and drug use in the adolescent population have increased, with 80% of teenagers reported being sexually active by the age of 19 years and 80% of high school seniors reporting use of alcohol; 64% reporting smoking; and 41 % reporting marijuana use in 1995. Nurses working with pregnant adolescents must screen for substance abuse problems and physical abuse. If problems are identified, the nurse should refer the adolescent for counseling.     

TREATMENT OF PSEUDALLESCHERIA BOYDII INFECTION WITH ORAL KETOCONAZOLE AND TOPICAL MICONAZOLE

Skin infection in a man immunosuppressed by corticosteroid treatment was found to be due to Pseudallescheria boydii. Although treatment is often unsatisfactory, infection in this patient responded well to oral ketoconazole and topical miconazole.     

Blastomycosis: a case study of a dimorphic fungal disease.

A 17-year-old male presented to a local hospital with symptoms of pneumonia and a hacking cough productive of yellow sputum. Direct examination of a bronchial lavage sample revealed organisms morphologically consistent with Blastomyces dermatitidis, which was confirmed by culture. The patient was placed on intravenous antifungal therapy and his condition improved dramatically. OBJECTIVES: to describe the gross and microscopic morphologies of both yeast and mold forms of B. dermatitidis; to identify B. dermatitidis given patient history, and microscopic and colony morphology; to describe the symptoms of primary pulmonary infections caused by B. dermatitidis, and to name additional tissues typically affected by the systemic pathogen.     

Rurality, remoteness and the change process: evidence from a study of maternity services in the north of Scotland.

There is a wealth of material on 'how to do' change plus empirical work revealing change process complexity. In health care, the relevance of context is highlighted, but studies of rural health-care change have focused on community impacts. There is little to inform health-care managers of how remoteness and rurality impact upon change processes. This study considered Scottish maternity units and aimed to identify issues in the change process associated with rurality and remoteness. Six units were purposively selected and 131 interviews were conducted with managers, staff and community members over 15 months. Analysis induced themes pertinent to remoteness and rurality. These included: perceived 'distance' between senior managers imposing change and the wider community of staff and residents; perceptions of community vulnerability; and tensions arising from working in small teams and living in small communities. The study provides useful insights for rural managers at a time of considerable service reconfiguration.