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Biomedical subjects

A Vance

Publications and source records attributed to A Vance.

At least 19 recordsLinked to original sources
PubMed2006

Visuospatial working memory deficits in adolescent onset schizophrenia.

This study determines that visuospatial working memory (VSWM) deficits are evident in adolescent-onset schizophrenia, while the spatial strategy and spatial span components of VSWM are spared. These findings imply that frontal-striatal-parietal neural networks are dysfunctional in adolescent-onset schizophrenia, while mid-dorsolateral and ventrolateral PFC functions remain intact: the current conceptualisation of schizophrenia as a progressive neurodevelopmental disorder is consistent with these results.

Adolescent↗
PubMed2005

An investigation of visuospatial memory impairment in children with attention deficit hyperactivity disorder (ADHD), combined type.

BACKGROUND: Memory impairment is not considered a core cognitive feature of attention deficit hyperactivity disorder, combined type (ADHD-CT), although it is associated with impairments in attentional and executive functions. This study investigates visuospatial memory impairment, in particular encoding and retrieval aspects, in children with ADHD-CT who are stimulant-medication naive and medicated with stimulant medication. METHOD: A cross-sectional study of visuospatial memory in 6- to 12-year-old children with stimulant-medication-naive ADHD-CT (n = 62) and medicated ADHD-CT (n = 58) compared to an age- and gender-matched healthy control group (n = 39) was completed. RESULTS: Both medication-naive and medicated ADHD-CT groups demonstrated subtle yet significant impairment in visuospatial memory. The memory impairment was delay-independent, which, along with other factors, suggest dysfunction of the encoding rather than retrieval phase of visuospatial memory. CONCLUSIONS: Careful study of large ADHD-CT samples does detect deficits in a visuospatial memory task, but these reflect attentional deficits rather than being specifically due to dysfunction of the medial temporal lobe explicit memory system. Children with ADHD-CT may benefit from cognitive and behavioural strategies focused on improving encoding of relevant information rather than retrieval strategies.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

Fronto-parietal activation in attention-deficit hyperactivity disorder, combined type: functional magnetic resonance imaging study.

A functional magnetic resonance imaging mental rotation paradigm was used to investigate the patterns of activation of fronto-parietal brain areas in male adolescents with attention-deficit hyperactivity disorder, combined type (ADHD-CT) compared with age-, gender-, handedness- and performance IQ-matched healthy controls. The ADHD-CT group had (a) decreased activation of the 'action-attentional' system (including Brodmann's areas (BA) 46, 39, 40) and the superior parietal (BA 7) and middle frontal (BA10) areas and (b) increased activation of the posterior midline attentional system. These different neuroactivation patterns indicate widespread frontal, striatal and parietal dysfunction in adolescents with ADHD-CT.

Adolescent↗
PubMed2001

Contextual abnormalities of saccadic inhibition in children with attention deficit hyperactivity disorder.

Abnormalities of executive function are observed consistently in children with attention-deficit hyperactivity disorder (ADHD), and it is hypothesised that these arise because of disruption to a behavioural inhibition system. Executive and inhibitory functions were compared between unmedicated and medicated children with ADHD (combined type), age-matched healthy children and healthy adults. Executive functions were measured using a test of spatial working memory shown previously to be sensitive to ADHD and to stimulant medication. Inhibitory functions were measured using an ocular motor paradigm that required individuals to use task context to control the release of fixation. Context was set according to the probability that a target would appear at either of the two locations. In one block, targets appeared on 80% of trials. In the other block, targets appeared on 20% of trials. The ability to control the release of fixation was inferred from the fixation offset effect (FOE), or the difference in saccade latency when the current fixation is offset 200 ms prior to the onset of the saccade target (gap condition), compared with when there is no offset (overlap condition). Although the healthy children made more errors on the spatial working memory task than the healthy adults, there was no difference between the two groups in their ability to control fixation using context. Both showed a larger FOE when target probability was low. As expected, the unmedicated ADHD group made more errors on the spatial working memory test than the healthy children, although spatial working memory performance was normal in the medicated ADHD group. However, both the unmedicated and medicated ADHD groups were unable to modulate the FOE according to context, and this was due to their inability to voluntarily inhibit saccades when there was a low target probability. These data suggest that the context-based modulation of fixation release is not controlled by the same systems that control executive function. Furthermore, deficits in executive function and inhibitory control appear independent in children with ADHD.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Abnormal executive function in attention deficit hyperactivity disorder: the effect of stimulant medication and age on spatial working memory.

OBJECTIVE: This study sought to examine the factors associated with spatial working memory and the use of strategies to impairments in spatial working memory in children with attention deficit hyperactivity disorder (ADHD). The developmental trajectories for spatial working memory in medicated and medication naïve children with ADHD were investigated. In addition, the effect of psychostimulant medication on deficits in spatial working memory was examined. METHOD: A cross-sectional study compared performance between 21 psychostimulant medicated children with ADHD, 27 medication naïve children with ADHD and 26 matched control subjects on computerized tests of spatial memory and spatial working memory. RESULTS: Compared with the controls, performance in medication naïve children with ADHD was significantly worse on the spatial working memory task. There was no difference in performance between the medicated children with ADHD and the control subjects on this same task, despite the ongoing symptoms of ADHD in the former group. The pattern of normal and abnormal performance in the ADHD groups was age-independent. CONCLUSIONS: Deficits in executive functions related to spatial working memory do occur in children with ADHD, although the magnitude of these deficits is not related to the child's age or the level of ADHD symptoms. These deficits were not present in the current sample of children who were receiving psychostimulant medication.

Age Factors↗
PubMed1999

Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children.

BACKGROUND: Executive function deficits have been reported repeatedly in children with Attention Deficit Hyperactivity Disorder (ADHD). Stimulant medication has been shown to be effective in improving cognitive performance on most executive function tasks, but neuropsychological tests of executive function in this population have yielded inconsistent results. Methodological limitations may explain these inconsistencies. This study aimed to measure executive function in medicated and non-medicated children with ADHD by using a computerized battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which is sensitive to executive function deficits in older patients with frontostriatal neurological impairments. METHODS: Executive function was assessed in 30 children with ADHD: 15 were stimulant medication naive and 15 were treated with stimulant medication. These two groups were compared to 15 age, sex and IQ matched controls. RESULTS: The unmedicated children with ADHD displayed specific cognitive impairments on executive function tasks of spatial short-term memory, spatial working memory, set-shifting ability and planning ability. Impairments were also seen on spatial recognition memory and delayed matching to sample, while pattern recognition memory remained intact. The medicated children with ADHD were not impaired on any of the above executive function tasks except for deficits in spatial recognition memory. CONCLUSIONS: ADHD is associated with deficits in executive function. Stimulant medication is associated with better executive function performance. Prospective follow-up studies are required to examine these effects.

Adolescent↗
PubMed1999

Restructuring clinical time to professionalize the RN-BSN student.

The needs of the RN-BSN student are unique. If the RN-BSN student is to be successful in a degree completion program, it is important that the program be designed with the needs of the student in mind. It is important that the program be tailored to the needs of the student who may already possess expertise in nursing. This will enhance the likelihood that the student will stay in the program and that learning will occur.

Adult↗
PubMed1997

Strategies to assist students to be successful the next time around on the NCLEX-RN.

Not passing the NCLEX is traumatic for both the graduate and the nursing program's faculty and dean. The faculty need to look at the program and make some strengthening changes such as higher admission requirements, more time in some clinical course, or increased use of NLN tests for specialty areas. Additionally, a supportive faculty member needs to assist the graduate who has not passed to make an individualized plan for succeeding the second time. A variety of ways to assist the graduate in studying, that have been found useful at the author's school of nursing, have been suggested.

Adaptation, Psychological↗
PubMed1997

Motivating the paraprofessional in long-term care.

Motivating the paraprofessional employee in the long-term care setting is one of the biggest challenges facing health care supervisors. Unlike their counterparts in industry, whose work may produce tangible results and rewards, long-term care professionals often must face patients who show little or no change over time. Supervisors must have understanding and knowledge of motivational techniques that will involve and challenge paraprofessionals.

Aged↗
PubMed1997

Irritability in work relationships.

Irritability is a word that is not commonly found in management textbooks. However, it is a phenomenon that the manager may frequently encounter and should be understood if correct intervention is to occur. This paper explores the phenomenon of irritability as it relates to emotions, behavior, and physiology, in order to provide information for the manager to use in recognizing, understanding, and detecting irritability in one's self, peers, boss, or employees.

Adaptation, Psychological↗
PubMed1996

Overreacting: a manager's dilemma.

Time-proven strategies assist nurse managers to react confidently, coolly and effectively when others are overreacting. Each person is responsible for his/her own feelings. Nevertheless, managers can teach others better coping mechanisms so that overreactions are replaced with sophisticated coping strategies.

Adaptation, Psychological↗
PubMed1992

When your patient complains.

A caregiver's attitude and mood sets the tone for the interpersonal environment in which patients and caregivers relate. Caregivers should role model a positive attitude. When complaints are expressed, the caregiver should listen and make careful note not only of the content of what is expressed but the feelings behind the message. The caregiver should assess the meaning behind the complaint in order to be able to appropriately receive, investigate, and respond to complaints. It is the wise caregiver who accepts that complaints are an inevitable part of the care setting and works to develop expertise in ways of handling this human patient reaction.

Adaptation, Psychological↗
PubMed1992

The element of care in the operating room.

1. Perioperative nurses are experts in attending to imminent physiological needs of patients. However, when these needs seem paramount, focus on a patient's feelings often become a lower priority. 2. Being cared for is a basic human need. Just as perceptions of needs vary among individuals, so do caring needs. It is essential that nurses value the components of caring and demonstrate caring from a holistic perspective. 3. OR nurses can communicate caring by identifying staff to patients, providing reassuring information, monitoring self-talk, touching the patient, and responding to the patient as an individual.

Communication↗
PubMedDate not supplied

Oral and systemic effects of prolonged minocycline therapy.

The following case report shows the unfortunate side effects of minocycline therapy used in the management of facial acne. All three features of discoloration affecting the skin, bone and dentition were found. A 46-year-old patient presented with adult onset discoloration of the dentition following prolonged minocycline therapy. In addition, oral and cutaneous pigmentation were noted. Unfortunately, the undesirable cosmetic appearance of facial acne was exchanged for permanent discoloration of the dentition. When considering prolonged minocycline therapy, patients would benefit from dialogue between the medical and dental practitioners, so that the risk of this potential side effect can be assessed in a more informed way.

Acne Vulgaris↗