Analog language teaching versus natural language teaching: Generalization and retention of language learning for adults with autism and mental retardation

Examined the effects of two instructional methods on language generalization and longterm retention in 23 adults with autism and severe to profound mental retardation. Analog language teaching employed discrete trials in a controlled setting concentrating on discrimination and identification of materials. Natural language teaching emphasized instruction through interactions that occurred incidentally to training students in the use of materials to perform functional tasks. Assessments were conducted under conditions favoring analog teaching to assure against partiality toward natural language teaching. Under such disadvantageous conditions, the methods of natural language teaching would be supported by results showing either no difference or an advantage in their favor. Both techniques increased initial and long-term generalization though the results suggest no relative superiority for either method under these assessment conditions. A significant interaction was found between prior functioning level and sequence of instruction. Because natural language teaching has many strengths, few drawbacks, and produces equal generalization and retention under disadvantageous conditions, it is strongly supported as preferable for people with autism and mental retardation.The authors acknowledge the important assistance provided by the following people: the staff and management of the Behavior Development and Learning Center at CSH/DC directed by Israel Perel, Lisa Kramer, Steve Hafferkamp, James Lowdermilk, and, finally, and especially, to the participants themselves.     

Recovery from coma that results as a complication of cardiac arrest followed by cardiopulmonary bypass

Many possible complications are associated with cardiopulmonary bypass. They are similar to the risks accompanying most surgical procedures and include stroke, renal failure, and death. This potential for complication increases when bypass exceeds 2 hours and rises sharply when pump time is prolonged more than 3 to 4 hours. One group of serious complications is major neurologic disorders. The risk of significant cerebral dysfunction, that is, severe focal stroke or coma, is about 1%, and this risk increases with age and coexistent cardiovascular disease. This article focuses on the complication of coma and the possible role cardiopulmonary bypass plays in improving survival rates. A case study is presented illustrating the potential role of cardiopulmonary bypass in the unexpected neurologic recovery from coma.     

Exposure to pesticides in ambient air

Abstract: Ambient air was monitored for pesticides at four sites in Coffs Harbour, a coastal town (population about 50 000) surrounded by banana plantations. Air was sampled continuously for five consecutive months during the peak agricultural spraying period using vacuum pumps set to sample one litre per minute through ORBO-42 adsorption tubes. Six pesticides were detected: three organochlorines and three organophosphates. The most commonly detected pesticide (14 per cent of all samples) was chlor-pyrifos (maximum detected level 208.0 ng/m³, mean 3.6 ng/m³). Heptachlor was detected in 7.1 per cent of all samples (maximum detected level 133 ng/m³, mean 2.7 ng/m³). Other pesticides were only rarely detected. The only pesticide applied by air in the district (propiconazole) was not detected. If international health guidelines are used as a yardstick, these levels of exposure appear unlikely to present an appreciable health risk. Chlorpyrifos detection was associated with low wind speed (P = 0.012) and high temperature (P = 0.015), and detection at one site was associated with detection at another (P < 0.001). Chlorpyrifos detection was also associated with domestic applications within the town area as reported by pesticide applicators (P = 0.045). Peak agricultural use of chlorpyrifos did not coincide with peak detection periods. None of the detected organochlorines is registered for agricultural use, although at the time, heptachlor was permitted for use as a domestic termiticide. Even in a semirural town with nearby widespread use of agricultural chemicals, community exposures to pesticides in ambient air may largely relate to their nonagricultural use.     

Cytokines in anaesthesia

The scope of cytokine biology is fascinating with widespread applications anticipated in many areas of medical science. We have emphasized the fundamental roles that cytokines play in the control of normal immunological functions, defence mechanisms and normal cell growth, and how major surgery and trauma can affect these processes. It remains to be determined if morbidity and mortality may be improved after major illness and surgery by altering cytokine production and function.      

Fentanyl and the interleukin-6 response to surgery

It has been suggested that large doses of opioids may suppress the interleukin-6 response to surgery. We examined the effects of the supplementation of inhalational anaesthesia with either 3 or 15 μg.kg⁻¹ fentanyl on the circulating interleukin-6, interleukin-8, C-reactive protein, cortisol and glucose concentrations in 16 patients undergoing pelvic surgery. In both groups, surgery evoked the expected glucose, cortisol and interleukin-6 response but no increase in interleukin-8 was detected. There were no significant differences between the two groups. We conclude that the supplementation of inhalational anaesthesia with conventional doses of opioids does not modify the cytokine response to surgery.     

Modulation of human T cell functions by surface sulphydryl groups: differential effects on IL-2 production and responsiveness.

An impermeable thiol blocker has been used to investigate the role of sulphydryl (SH) groups in the production of and responsiveness to IL-2 by normal human T lymphocytes. Surface SH blockade of mononuclear cells prior to incubation with mitogen (phytohaemagglutinin, concanavalin A, CD3 MoAb) had no effect on production of IL-2 but markedly impaired cellular responsiveness to exogenous IL-2. Studies using MoAbs indicated that this effect was accompanied by decreased expression of both the CD25 and p75 subunits of the IL-2 receptor. Blocking surface SH groups did not affect binding of IL-2 to p75 on unstimulated mononuclear cells, but inhibited binding to high-affinity receptors on a T lymphoma cell line. The data are consistent with the hypothesis that sulphydryl groups on the IL-2 receptor are required for its function and may be involved in the interaction of the CD25 and p75 subunits leading to generation of the high-affinity binding site. The surface thiol identified on the IL-2 receptor may be a candidate for oxidation on cells from patients with chronic inflammatory diseases such as rheumatoid arthritis and thus contribute to the aberrant function of T cells in these patients.     

Keratan sulphate in rheumatoid arthritis, osteoarthritis, and inflammatory diseases.

Serum concentrations of antigenic keratan sulphate determined by an enzyme linked immunosorbent assay (ELISA) with a monoclonal antibody were studied in patients with rheumatoid arthritis (RA), osteoarthritis, ankylosing spondylitis, other inflammatory diseases, and a large control group of women without arthritis. Mean keratan sulphate concentrations were low in 117 women with RA compared with 227 female control subjects matched for age drawn from a community survey. There were significant correlations between serum keratan sulphate concentrations in patients with RA and serum C reactive protein and the erythrocyte sedimentation rate. Serum keratan sulphate concentrations were also low in 29 men and women with ankylosing spondylitis and 29 patients with arthritis and high concentrations of C reactive protein. In 98 women undergoing an operation for benign breast disease there were decreases in serum keratan sulphate concentrations after the operation which correlated with doses in serum C reactive protein. No differences were found in keratan sulphate concentrations in 137 women with osteoarthritis compared with controls. Within the group with osteoarthritis there were no differences for the various joint groups and there was no obvious correlation with radiographic severity or progression. These findings suggest serum keratan sulphate is unlikely to be useful as a diagnostic marker in osteoarthritis or RA but indicate a role for inflammation in the regulation of cartilage loss.