Real American children: The challenge for after-school programs

Several million American children are currently unsupervised during the hours between school and parents' leaving for and/or return from the workplace. Many families would prefer other arrangements, but cost or availability factors present insurmountable barriers. Although growing, the public response continues to fall far short of the need; in the meantime, private entrepreneurs are moving to fill the gaps in available services. But if these programs for school-aged children are to serve functions other than the aggrandizement of their sponsors, they must be focused on the real needs that exist among real American children. Among the real children in need of care are those who are impoverished, unsupervised, unfit physically, unprepared for the demands of school and workplace, hurried into premature adulthood, and/or disconnected from the social worlds around them. Professional child and youth care workers with experience in day care and residential settings have the preparation needed to take leadership roles in creating developmentally appropriate, effective programs to meet the emerging demands for school-age child care and to weave them into a fabric of youth-centered community services.     

Tc-99m HMPAO SPECT imaging of the central nervous system in tuberous sclerosis

Tc-99m HMPAO was used to evaluate cerebral perfusion in a patient with tuberous sclerosis. The SPECT images demonstrated reduced HMPAO uptake in regions corresponding with MRI-confirmed locations of cortical tubers. These results indicate that the lesions are characterized by vascular perfusion deficits and support the hypothesis that cortical tubers result from developmental abnormalities of the embryonic central nervous system.     

Isometric and isokinetic hip abductor strength in persons with above-knee amputations

Recently introduced prosthetic socket designs for the above-knee amputee (AKA) feature a narrow medial-lateral dimension and emphasize maintenance of the residual limb in full physiologic adduction. Quantitative data on the effect of frontal plane limb position on the isometric hip abductor strength of ten otherwise healthy AKAs were obtained in the standing position. Residual limb isometric and isokinetic abductor strength was also measured and compared with that of the intact limb and with that of ten healthy age-, sex-, and height-matched control subjects using an identical technique. The testing hardware consisted of a modified Cybex II Isokinetic Dynamometer with a custom-made pelvis and trunk stabilizing device. Anthropometric measurements were taken. Results showed an essentially linear increase in residual limb abduction strength with progressive adduction from 30 degrees abduction to 16 degrees adduction. The average increase in abduction torque was .97% (range .29 to 1.5) of the peak neutral position strength per degree of change in femur angle when corrected for the effect of gravity. Similar strength increases with adduction of the femur were found for intact and control limbs. Mean residual limb isometric abduction torque measured 30% less than the intact limb value (p = .0018). The difference between the intact and the control limb mean isometric abduction torques was less than 1%. Isokinetic testing was technically more difficult than isometric testing but revealed similar weakness of the residual limb abductors when compared to the intact and control limbs.     

Effects of niacin source on epinephrine stimulation of plasma nonesterified fatty acid and glucose concentrations, on diet digestibility and on rumen protozoal numbers in lactating dairy cows

Effects of niacin (nicotinic acid or nicotinamide) supplementation of dairy cow diets on apparent total tract nutrient digestibility, milk yield and milk composition were determined using six mid-lactation Holstein cows in a replicated 3 x 3 Latin square design arranged to test for residual treatment effects. Treatments were control, 12 g/d of nicotinic acid or 12 g/d of nicotinamide. Periods were 14 d long; d 1 to 4 served as an adaptation period before treatment administration commenced (d 5 to 14). Effects of supplemental niacin on plasma nonesterified fatty acid (NEFA) concentrations and plasma glucose concentrations were tested following saline injection on d 10. Blood was then sampled for 5.5 h at 15-min intervals. On d 13, cows were treated similarly except that epinephrine replaced saline. The area below d-10 curves was subtracted from the area below d-13 curves to serve as an indicator of niacin's effect on plasma NEFA and glucose concentration responses to epinephrine injection. Niacin treatments did not change the area differences for plasma glucose compared to the control treatment; however, there was a trend for niacin to reduce the area difference compared to the control treatment for plasma NEFA. Niacin treatments did not alter dry matter intake, nutrient digestibility, milk yield or composition. Niacin supplementation increased the number of entodinia protozoa in rumen fluid.     

Cognitive deficits among functionally psychotic patients: a rehabilitative perspective

Psychological and neuropsychological assessments of psychiatric patients are usually designed to contribute to or document psychiatric diagnoses. The present article suggests that reframing the task to focus on cognitive rehabilitation issues can contribute significantly to the treatment of the chronic patient. A test protocol is proposed and exemplary tests suggested.