RESUMEN
The purpose of this study involving a cross-cultural group of single, pregnant adolescents was to examine the association of depression with self-esteem, social support, discomforts of pregnancy, and selected sociodemographic variables. The sample comprised 62 pregnant adolescents recruited from a residential maternity home. Subjects ranged in age from 14 to 20 years (mean 16.67 years) and were predominantly Hispanic and black. All subjects completed the Center for Epidemiological Studies Depression Scale, Coopersmith's Self-Esteem Inventory, a physical discomfort checklist, and a sociodemographic questionnaire. A high level of depression symptoms was reported by the majority of participants. Nearly two thirds of the young women reported adequate levels of emotional support; however, the remaining subjects claimed inadequate levels. Results of the multiple regression analyses revealed that, of the predictor variables investigated, only the total self-esteem score was statistically significant (p = 0.0001) and explained 32.6% of the variance. In further statistical analysis a multifactor analysis of variance found social support to be a significant variable influencing depression. On the basis of these results, several recommendations for assessment and intervention with similar groups of pregnant adolescents are suggested, including screening for depression symptoms and development of treatment programs for affected youth.
Asunto(s)
Depresión/etiología , Embarazo en Adolescencia/psicología , Adolescente , Análisis de Varianza , Comparación Transcultural , Femenino , Predicción , Humanos , Embarazo , Análisis de Regresión , Autoimagen , Padres Solteros , Apoyo SocialRESUMEN
The continuous high-intensity noise in the neonatal intensive care unit (NICU) is both stressful and harmful for the premature infant. Although some researchers have found evidence that loud noise can cause hearing loss and alter physiologic and behavioral responses, no study to date has investigated the benefits of noise reduction by the use of earmuffs. In this study earmuffs were placed over the premature infants' ears to reduce noise intensity in the NICU while physiologic and behavioral responses were measured. Two sites were used to collect data: in the first setting, 17 low birth weight infants were randomly assigned to an experimental and a control group, whereas 13 infants from a second hospital acted as their own controls and were tested with and without earmuffs. Earmuffs that reduced the intensity of noise by 7 to 12 dB were worn by infants in the experimental group only during the observation periods. Infants in the control group were exposed to the usual noise in the NICU. The infant's physiologic and behavioral responses were observed for four 2-hour intervals, morning and evening, on two consecutive days. Most of the significant results were from the site at which infants acted as their own controls. When infants wore the earmuffs, they had significantly higher mean oxygen saturation levels and less fluctuation in oxygen saturation. Furthermore, these infants had less frequent behavioral state changes, spent more time in the quiet sleep state, and had longer bouts in the sleep state. It is imperative that NICUs develop aggressive antinoise policies to substantially and consistently reduce noise.
Asunto(s)
Dispositivos de Protección de los Oídos , Conducta del Lactante/fisiología , Recien Nacido Prematuro/fisiología , Unidades de Cuidado Intensivo Neonatal , Ruido/efectos adversos , Análisis de Varianza , Estudios de Casos y Controles , Femenino , Pérdida Auditiva Provocada por Ruido/prevención & control , Frecuencia Cardíaca , Humanos , Recién Nacido , Masculino , Consumo de Oxígeno , RespiraciónRESUMEN
Using predefined guidelines, the California HMO Quality Management Coalition monitored access by HMO members to six different types of health services across provider groups. Results highlight regional differences and point to some significantly poorer scores in the urgent visits and specialty referrals. Design considerations are discussed and suggestions are made for follow-up quality improvement.
Asunto(s)
Sistemas Prepagos de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Análisis de Varianza , California , Guías como Asunto , Sistemas Prepagos de Salud/normas , Accesibilidad a los Servicios de Salud/normas , Evaluación de Resultado en la Atención de Salud , Derivación y Consulta , Administración del Tiempo , Listas de EsperaRESUMEN
BIO-1014 is an educational computer-based program written in TURBO PASCAL 3.01 which simulates experiments of antitumour activity. Basically, this program offers the user the possibility of checking the therapeutical efficiency of anticancer drugs as applied to different tumors, but many other types of experiment can be also performed with BIO-1014. Drugs such as methotrexate, cyclophosphamide and arabinosylcytosine can be tested on the following tumors: sarcoma, carcinoma, leukemia and melanoma. The dose, the number of treatments per day, the total number of treatments and the time interval between the treatments are the parameters to be adjusted for each therapeutical schedule. Tumoral growth, cause of death and survival are among the results that are generated after each simulation. These results are either tabulated or plotted. In addition, four statistical tests have also been integrated to the program in order to provide with a way to check whether or not there is a significant difference in terms of survival between two groups of mice differently treated. Furthermore, the program has been elaborated to also consider some physiological phenomena met within an anticancer drug screening programme. The potential and the performance of the program BIO-1014 is presented and discussed.
Asunto(s)
Antineoplásicos/uso terapéutico , Simulación por Computador , Instrucción por Computador , Modelos Biológicos , Modelos Educacionales , Neoplasias Experimentales/tratamiento farmacológico , Enseñanza/métodos , Animales , Antineoplásicos/administración & dosificación , Carcinoma/tratamiento farmacológico , Carcinoma/patología , Causas de Muerte , Ciclofosfamida/administración & dosificación , Ciclofosfamida/uso terapéutico , Citarabina/administración & dosificación , Citarabina/uso terapéutico , Esquema de Medicación , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Leucemia Experimental/tratamiento farmacológico , Leucemia Experimental/patología , Melanoma/tratamiento farmacológico , Melanoma/patología , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Ratones , Neoplasias Experimentales/patología , Sarcoma Experimental/tratamiento farmacológico , Sarcoma Experimental/patología , Programas Informáticos , Tasa de SupervivenciaRESUMEN
Primary nystagmus was evoked by constant angular acceleration at near-threshold levels (0.2, 0.4, and 0.6 degree/s2) in 34 normal human subjects (25 children aged 2-11 years and 9 young adults aged 17-21 years). Acceleration was carried out in complete darkness, and with subjects' eyes open. Analysis of response latencies showed that all subjects responded to acceleration magnitude as low as 0.2 degrees/s2. A decrease in response latency was associated with an increase in acceleration magnitude, and there was no significant effect of age on response latency or its relationship to acceleration. However, a relationship was found between age and the percentage of trials showing the presence of a set of three successive beats during acceleration: a significant increase in the frequency of such trials occurred with increasing age. The relationship of these findings to brainstem vestibular modulatory mechanisms is discussed.
Asunto(s)
Nistagmo Fisiológico/fisiología , Vestíbulo del Laberinto/fisiología , Aceleración , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Tiempo de Reacción/fisiologíaRESUMEN
Positive EEG deflections with the latency and scalp distribution of the P300 accompany startle in response to loud auditory stimuli in a non-task context. The purpose of this investigation is to determine if inhibitory and facilitatory prestimulation would have effects on the P300 similar to those on the startle blink. Prestimulation conditions were chosen to induce startle amplitude facilitation (4000 msec sustained tone), startle amplitude inhibition (120 msec prestimulation interval), and startle onset latency facilitation (60 msec prestimulation interval). Ninety-three boys (including normals and those with ADHD and/or enuresis) from a startle modulation study had EEG recordings of sufficient quality to provide data for the current study. Repeated measures analyses of variance demonstrated startle amplitude and P300 amplitude facilitation following the 4000 msec tone, startle amplitude and P300 amplitude inhibition following the 120 msec prestimulation interval, and startle onset latency and P300 peak latency facilitation (shorter latencies) following the 60 msec prestimulation interval. Hence, the vertex-recorded P300 elicited by startling stimuli was modulated by non-startling prestimulation in a manner that paralleled that of modulation of the brain-stem generated startle blink. Startle inhibition by prestimulation is mediated by an inhibitory pathway in the mesopontine lateral tegmentum. This brain-stem circuitry has a similar effect on the P300 even though the latter may be generated in more rostral structures. Alternatively, this automatically elicited P300 may represent a limbic or cortical reflection of the sensory processing taking place in the brain-stem. Either interpretation suggests a "bottom-up" as contrasted with a "top-down" mode of sensory processing. This P300 obeys the rules of startle modulation by brain-stem mechanisms rather than indexing cortical evaluation of stimuli for task relevance, stimulus probability, and prior uncertainty.
Asunto(s)
Encéfalo/fisiología , Potenciales Evocados/fisiología , Reflejo de Sobresalto/fisiología , Estimulación Acústica , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Parpadeo/fisiología , Niño , Electroencefalografía , Electromiografía , Enuresis/fisiopatología , Humanos , Masculino , Músculos/fisiología , Tiempo de Reacción/fisiologíaRESUMEN
We studied acoustic startle response and its modulation by prestimulation and by short-term and long-term habituation in 54 autistic patients and 72 normal age-matched controls. The startle response was measured as the amplitude and onset latency of the integrated orbicularis oculi EMG. There were no consistent significant differences between the autistic and control subjects in startle modulation by inhibitory or facilitatory prestimulation, short-term habituation of startle amplitude, long-term habituation of either startle amplitude or latency, or unmodulated startle amplitude. Differences between autistic and control subjects were limited to prolongation of unmodulated startle onset latencies in the autistics in all of the experimental paradigms (significant p = .005 only in the context of short-term habituation) and a statistically significant (p < .05) slower rate of short-term habituation of startle onset latency in the autistic patients, relative to the controls. Results provide only limited support for hypotheses of brainstem pathophysiology and no support for hypotheses of cerebellar pathophysiology in autism.
Asunto(s)
Nivel de Alerta/fisiología , Trastorno Autístico/fisiopatología , Reflejo de Sobresalto/fisiología , Estimulación Acústica , Adolescente , Adulto , Trastorno Autístico/diagnóstico , Trastorno Autístico/psicología , Parpadeo/fisiología , Daño Encefálico Crónico/fisiopatología , Tronco Encefálico/fisiopatología , Cerebelo/fisiopatología , Niño , Preescolar , Electromiografía , Femenino , Habituación Psicofisiológica/fisiología , Humanos , Masculino , Vías Nerviosas/fisiopatología , Tiempo de Reacción/fisiologíaRESUMEN
This study examined the presurgical 2-deoxy-2[18F]-fluoro-D-glucose positron emission tomography (PET) patterns of regional cerebral glucose metabolism in the non-resected hemisphere of 13 children who underwent hemispherectomy for early-onset intractable seizures. These patterns were compared with the rate of change in the children's non-verbal communication scores, measured before and after surgery. Irrespective of the side of surgery, the pre-operative glucose metabolism in the non-resected prefrontal cortex correlated significantly with the postoperative rate of change in the children's ability to focus the attention of an adult on an object or event (joint attention). These preliminary findings suggest that pre-operative PET patterns might be associated with certain aspects of the developmental outcome of children undergoing hemispherectomy.
Asunto(s)
Encéfalo/cirugía , Epilepsia/cirugía , Lateralidad Funcional , Glucosa/metabolismo , Comunicación no Verbal , Convulsiones/cirugía , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Corteza Cerebral/metabolismo , Niño , Preescolar , Epilepsia/diagnóstico por imagen , Femenino , Fluorodesoxiglucosa F18 , Humanos , Lactante , Masculino , Complicaciones Posoperatorias , Radiofármacos , Convulsiones/diagnóstico por imagen , Tomografía Computarizada de EmisiónRESUMEN
Startle modulation was induced by prestimulation in 43, 6-11 year old boys with attention-deficit hyperactivity disorder (ADHD), 13 of whom were or had been enuretic, 17 age-matched enuretic boys, and 42 age-matched normal boys, using 60-ms and 120-ms prestimulation intervals and a 4000-ms continuous tone. There was a significant multivariate effect of enuresis on startle amplitude modulation. This effect was attributed primarily to the reduction of amplitude inhibition following the 120-ms prestimulation interval regardless of whether or not enuresis was associated with ADHD. There was no effect of ADHD on startle modulation by prestimulation. The inhibition following the 120-ms prestimulation interval in the enuretic boys was reduced to the level of 5-year-old normal children, suggesting a maturational component of the deficient startle inhibition. The neurophysiologic dysfunction underlying the deficient startle inhibition in enuresis, but not ADHD, is discussed in terms of a possible dysfunction of mesopontine reticular mechanisms mediating preattentive processing of signals associated with spinal reflexes involved in urinary bladder control.