Working Memory Training for Children with Attention Problems or Hyperactivity: A School-Based Pilot Study

We piloted a computer program to train working memory for children with attention problems or hyperactivity who attended an urban public school serving economically disadvantaged neighborhoods. Training was conducted daily for 5 weeks during school hours. Teachers rated children’s behaviors before and after the intervention, and standardized assessments of verbal and visuo-spatial working memory were also conducted. No attrition occurred due to an inability or unwillingness on the part of children to complete the training. Overall, children’s behavior and working memory improved following training, compared to baseline. Our findings suggest that school-based working memory training may be a viable means for treating children with attention problems or hyperactivity that warrants further investigation. This approach may also overcome barriers to care delivery for economically disadvantaged children who are known to be at higher risk for poor school outcomes.     

Lactation and weaning effects on physiological and behavioral response to stressors

Two experiments tested the effects of lactation and weaning on heart rate (HR), corticosterone, and behavioral responses to stress in Wistar rats. In Experiment 1, HRs in lactating, weaning, and control animals were recorded for 10-min periods before, during, and after immobilization stress. Compared with control animals, lactating and weaning animals showed a diminished initial HR response. In addition, HRs of weaning animals failed to habituate and showed a delayed decline after stress termination. In Experiment 2, behaviors, HRs, and corticosterone levels in the elevated plus maze (EPM) were compared among lactating, weaning, and control animals. Compared with control animals, weaning animals exhibited more anxiety behaviors. Contrary to expectation, compared to the other two groups, lactating animals exhibited more closed-arm entries, although they may have been motivated by maternal behavior, rather than anxiety. Initial HR responses to the plus maze were attenuated in lactating animals. Corticosterone levels after the plus maze were lowest in the lactating dams and highest in the control animals. The results from these two experiments are consistent with effects of breast-feeding and weaning observed in humans. In general, lactation is associated with an attenuated initial HR response to stress, while weaning is associated with exacerbated response to stressors.     

The effects of epinephrine administration on impedance cardiographic measures of cardiovascular function.

The effects of epinephrine administration on cardiovascular function were examined in 26 men who were given a bolus injection of either 1:10,000 epinephrine hydrochloride or physiological saline. Impedance cardiographic and continuous blood pressure measures were recorded during a 2-min pre-injection baseline and in the post-injection period. Compared to a saline control, epinephrine elicited greater shortening of heart period, pre-ejection period, and the R-B interval; greater increases in cardiac output, stroke volume, dZ/dt amplitude, Heather Index, and systolic and diastolic pressures; and greater decreases in total peripheral resistance (all P < 0.05). Left ventricular ejection time and the Q-R interval were not affected. The results indicate that inotropic indices that are readily measured by impedance cardiography should be considered as important non-invasive indices of adrenergically mediated responses to stress.     

Gastric emptying in premature newborns with acute respiratory distress

OBJECTIVES: The authors hypothesized that acute respiratory distress (ARD) delays gastric emptying. The objective was to test this hypothesis by assessing gastric emptying on the second and seventh days of life in premature infants with ARD resulting from pulmonary disease. METHODS: Thirty-nine newborns with ARD starting on the first day of life were selected and paired with 39 healthy control newborns matched by weight (within 250 g). Gestational age was 相似文献   

Sinonasal primitive neuroectodermal tumor arising in a long-term survivor of heritable unilateral retinoblastoma.

BACKGROUND. Patients who survive retinoblastoma (RB) are at risk for having second nonocular tumors, usually osteosarcomas, which often are fatal. Such patients almost always have bilateral RB. METHODS. This article reports a woman who, at the age of 1 year had been cured of a unilateral RB by radiation therapy and enucleation. Eighteen years later, she had a sinonasal small cell tumor that rapidly recurred and proved fatal 2 months after surgical debulking. The tumor was studied by immunohistochemistry and electron microscopic (EM) examination. RESULTS. It showed diffuse neuron-specific enolase staining, focal weak staining for chromogranin, synaptophysin, and Leu-7 monoclonal antibodies in paraffin-embedded, B5-fixed tissue (Great Lakes Diagnostics, Troy, MI). EM study showed an undifferentiated primitive neuroectodermal tumor with many polyribosomes, simple cell junctions, few microtubules, and rare dense core granules. CONCLUSIONS. The combined immunohistochemical, ultrastructural, and clinical features of the tumor were interpreted as a sinonasal primitive neuroectodermal tumor with early neuronal differentiation. The tumor was pathologically indistinguishable from poorly differentiated olfactory neuroblastoma (ONB) and Ewing sarcoma.     

Imaging evaluation of children after falls from a height: review of 45 cases

The injury pattern in the child who falls from a height is markedly different from that in the adult, so a different imaging protocol is needed. To help establish such a protocol, the authors reviewed the charts and imaging records of 45 children and infants 12 years of age and younger who had fallen one to six stories. Extremity fractures were the most common injury, occurring in 20 patients. Head injuries (including skull fractures) occurred in 19 patients. Abdominal injuries were present in only one patient. Pneumothoraces were seen in four patients and lung contusions in two patients. Fractures of the pelvis, spine, and os calcis were uncommon. The height of the fall did not enable prediction of either the severity or type of injury. The authors recommend radiography of the cervical spine and chest alone in the initial evaluation of the injured child and greater willingness to obtain computed tomographic (CT) scans of the head in children than in adults. Radiographs of the pelvis, thoracolumbar spine, and lower extremities, as well as CT scans of the head and abdomen, should be obtained on a case-by-case basis, and not according to protocol, as is often the situation in adults.     

A competency-based model for research training during psychiatry residency

The Institute of Medicine recently identified a critical shortage of psychiatrist-researchers and highlighted the need for competency-based curricula that promote research training during psychiatry residency as a way to address that shortage. In this article we review extant approaches to research training during psychiatry residency. We then identify five core elements necessary for promoting research training: (1) mentoring, (2) education, (3) experience, (4) time, and (5) support. We describe six interrelated domains of core research competencies that can be mastered gradually over the course of residency training: (1) research literacy, (2) content mastery of specific research topics, (3) principles of research design and methods, (4) principles of biostatistics, (5) presentation and writing skills, including grant writing, and (6) principles of responsible conduct of research. Finally, we propose a broadly applicable, developmental, competency-based framework for applying these core elements to research training during psychiatry residency.