Spatial vision deficits in infants and children with Down syndrome

PURPOSE: Infants and children with Down syndrome show reduced visual acuity and contrast sensitivity when tested with conventional behavioral techniques. These results may reflect sensory deficits of optical or neural origin or a loss of performance in mechanisms responsible for generating the behavioral response. The purpose of this study was to compare objective acuity and contrast sensitivity measurements recorded with visual-evoked potentials (VEPs), with behavioral clinical test results in a group of children with Down syndrome and a group of control subjects. The goal was to determine whether children with Down syndrome still have a sensory deficit when tested using a procedure that is less cognitively demanding than conventional tests. METHODS: The subject group comprised 58 children with Down syndrome and 44 control subjects, aged 3 months to 14.15 years. Visual acuity and contrast sensitivity were measured with steady state, swept VEPs and behavioral techniques. VEP acuity was obtained from 36 children with Down syndrome and 40 control subjects, and behavioral acuity from 54 children with Down syndrome and 35 control subjects. VEP contrast sensitivity was measured in 24 children with Down syndrome and 34 control subjects, and behavioral contrast sensitivity in 42 children with Down syndrome and 25 control subjects. Group differences in visual acuity and contrast sensitivity were analyzed with an analysis of covariance (ANCOVA), with age as a covariate. RESULTS: Visual acuity thresholds were significantly lower in the group with Down syndrome than in the control group. This was true for both VEP (P < 0.01) and behavioral measures (P < 0.01). The Down syndrome group also had reduced contrast sensitivity when compared with the control subjects, for VEP contrast sensitivity (P < 0.01) and behavioral contrast sensitivity (P < 0.01). The group differences remained when children with ophthalmic anomalies were excluded from the analysis. CONCLUSIONS: The reduced visual acuity and contrast sensitivity in the Down syndrome group support the idea of an underlying sensory deficit in the visual system in Down syndrome.     

Differences between estimated caloric requirements and self-reported caloric intake in the women's health initiative

PURPOSE: To compare energy intake derived from a food frequency questionnaire (FFQ) with estimated energy expenditure in postmenopausal women participating in a large clinical study. METHODS: A total of 161,856 women aged 50 to 79 years enrolled in the Women's Health Initiative (WHI) Observational Study (OS) or Clinical Trial (CT) [including the Diet Modification (DM) component] completed the WHI FFQ, from which energy intake (FFQEI) was derived. Population-adjusted total energy expenditure (PATEE) was calculated according to the Harris-Benedict equation weighted by caloric intakes derived from the National Health and Nutrition Examination Survey. Stepwise regression was used to examine the influence of independent variables (e.g., demographic, anthropometric) on FFQEI-PATEE. Race, region, and education were forced into the model; other variables were retained if they increased model explanatory ability by more than 1%. RESULTS: On average, FFQEI was approximately 25% lower than PATEE. Regression results (intercept=-799 kcal/d) indicated that body mass index (b=-23 kcal/day/kg.m(-2)); age (b=15 kcal/day/year of age); and study arm (relative to women in the OS, for DM women b=169 kcal/d, indicating better agreement with PATEE) increased model partial R(2)>.01. Results for CT women not eligible for DM were similar to those of women in the OS (b=14 kcal/d). There also were apparent differences by race (b=-152 kcal/d in Blacks) and education (b=-67 kcal/d in women with相似文献   

Anorexia nervosa and the efficacy of an eating disorder service

Anorexia nervosa is often a chronic and severe disorder in which morbidity and mortality are high. This article describes the treatments used at The Priory Hospital's eating disorder service. The findings of an audit and follow-up study found that 85 per cent of the anorexic patients were successfully helped to gain weight (up to their normal weight) at a rate of about 1 kg per week. In a follow-up study four years later 80 per cent were doing reasonably well.     

Hopelessness and Violence Among Inner-City Youths

Objectives: Ethnographic literature on inner-city life argues that adolescents react to their uncertain (and objectively bleak) future by abandoning hope; this, in turn, leads them to engage in risk behaviors, including violence, with considerable frequency. This study empirically measures the pervasiveness of hopelessness and uncertainty about the future among inner-city adolescents and documents the link between hopelessness, uncertainty, and risk behavior. Methods: We surveyed a sample of 583 adolescents (aged 9–19) living in public housing in Huntsville, AL; this constitutes 80% of the eligible population. Each participant in the survey received $10. Their responses yielded empirical distributions for hopelessness, uncertainty about the future, and four violent behaviors. Using OLS regression, we examined the effect of hopelessness on these violent behaviors. Results: Hopelessness about the future was relatively rare, affecting only 20–30% of the respondents. However, it was a strong predictor of fighting and carrying a knife for females, and of carrying a knife, carrying a gun, and pulling a knife or gun on someone else for males. Uncertainty about the future was more prevalent, but unrelated to the violent behaviors. Conclusions: These results suggest that the conclusions of the ethnographic literature are only partially valid: While hopelessness is, in fact, strongly related to risk behavior, it is not nearly so prevalent as is generally assumed.     

The characterisation and impact of 'fluctuating' cognition in dementia with Lewy bodies and Alzheimer's disease

BACKGROUND: Case reports and clinical observations suggest that fluctuating cognition (FC) is common in all the major dementias, particularly dementia with Lewy bodies (DLB) where it is one of three core clinical diagnostic features. The purpose of this study was to characterise FC and determine its impact upon activities of daily living. METHODS: Forty matched subjects (15 DLB, 15 AD, 10 elderly controls) were assessed using the activities of daily living scale (ADLD), the cognitive drug research (CDR) computerised neuropsychological test battery and a semi-standardised assessment of FC. The CDR battery was completed three times across a 1-week period, to evaluate variability in attention, visuospatial ability, working memory and delayed recall. RESULTS: There was a strong positive correlation between clinical FC scores and total mean ADLD. Measures of cognitive variability also demonstrated strong significant correlations with independent clinical severity ratings of FC across several cognitive domains. These associations were most powerful between attentional measures and clinical FC ratings. CONCLUSIONS: Although attention is the cognitive domain which fluctuates most markedly, other cognitive domains are also affected. FC also has a significant independent impact on activities of daily living.     

Emotions and psychopathology

Few psychological assessment instruments exist for Jamaicans. Studies that address the appropriateness of foreign instruments for Jamaicans are sparse and empirical focus on psychopathology and its aetiology in Jamaican adults is virtually nonexistent. The present study addressed these deficits via Confirmatory Factor Analyses (CFA) which revealed that factors on the Toronto Alexithymia Scale (TAS-20) and Brief Symptom Inventory (BSI) were not replicated for a Jamaican sample (N = 352). Exploratory Factor Analyses (EFA) on the TAS-20 revealed one factor labelled Unawareness and Confusion Regarding Emotions (UCRE). Also, EFA yielded six BSI dimensions labelled Somatic Complaints, Paranoia, Hostility, Mild Depression/Dysthymia, Major Depression with Psychotic Features, and Agoraphobia with Panic. Regression analyses on the Jamaican-based TAS-20 and BSI factors revealed a positive relationship between UCRE and each BSI factor and total BSI score. Mild Depression, Agoraphobia with Panic, Paranoia, Hostility, Mild Depression and Major Depression were higher for women and younger Jamaicans, respectively, but younger Jamaicans with higher UCRE scores had higher scores on Paranoia, Major Depression, and total score. The findings suggest that Jamaican mental health policy and programmes should focus on the difficulties some Jamaicans experience in recognising and expressing their emotions.