Biomedical subjects
Publications and source records attributed to B Hart.
Taking a precise history from a patient who presents with a "bruised" toe in the absence of trauma requires sharp assessment skills and an investigative nature. Looking beyond the obvious in an otherwise healthy appearing individual calls for knowledge of many different disease processes including blue toe syndrome. Rapid identification, proper diagnosis, and correct medical and nursing management are essential for a positive outcome.
Plasma adrenocorticotropin hormone (ACTH), cortisol, heart rate, self-reported state anxiety and total reaction time responses in physically active (n = 8) and sedentary (n = 11) middle-aged men were compared during performance of a well-learned, psychologically challenging task. The groups were similar in age (active: 39.9 +/- 8.4 yr vs. sedentary: 44.4 +/- 7.2 yr) and trait anxiety (29.4 +/- 5.2 vs. 34.5 +/- 12.6), but they had different maximal oxygen consumption relative to lean body weight (68.6 +/- 7.1 vs. 44.7 +/- 4.6 ml.kg(-1).min(-1)). During performance of the psychological protocol, the total group had significant increases in heart rate and state anxiety, whereas both ACTH and cortisol remained near baseline levels. ACTH and cortisol were not different between the groups. The sedentary group exercise trained for 4 mo, which resulted in an 18% improvement in maximal aerobic capacity (vO2 max). Exercise intervention did not significantly alter the neuroendocrine response compared to pre-training values or compared to a corresponding control group. These findings suggest that enhanced cardiovascular fitness resulting from exercise training does not affect anterior pituitary-adrenocortical activity during performance of a practiced vigilance task.
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Obstructive jaundice occurred 3 years after cholecystectomy in a 49-year-old man. At surgery a large stone was discovered in the common bile duct. Pathologic examination showed that the stone had formed around an open vessel clip. Migration of an open vessel clip to the biliary system with subsequent stone formation has not been reported previously.
Personality development as measured by Loevinger's Washington University Sentence Completion Test, The Friedman Developmental Level Scoring System for the Rorschach, The Urist Mutuality of Autonomy Scale, The Thematic Apperception Test, and indexes from a structured interview were able to discriminate between teenagers at high- and low-risk for pregnancy. In addition, these measures correlated significantly with each other and enabled a description and comparison of the personality characteristics of adolescents who are at risk for pregnancy and those who are not.
A standard 6 MV linear accelerator X-ray beam has been adapted to produce a non-divergent and almost penumbra-free beam edge by a beam splitting and extended collimation system. Using a contact lens to provide the reference point on the front surface of the eye and an attached rod-and-scale measuring system that is linked to the sharp beam edge system, it has proved possible to place this field border with an exactitude of within 0.5 mm at a required distance behind the front surface of the eye. This system has been developed for the treatment of small retinoblastomas not amenable to focal treatment methods; the technique may have other applications. Data in this manuscript corroborate an earlier Dutch publication and extend the observations on the physics beam profile obtainable, the immobilization of the patient, the anaesthetic procedure, the contact lens system and the dose prescription. Both scanning densitometry and TLC measurements in an anthropomorphic head shell (with extractable eye) confirm the extreme precision and sharp beam profile obtainable by this technique.
We examine the lives and growth processes of women who have achieved considerable development of personality. Subjects of study are seven women in a longitudinal sample who, at ages 42-45, are classified by the Loevinger Sentence Completion Test at the highest ego-levels. As a way of describing their lives, all seven are analyzed in terms of Levinson's model of male development, one case is presented in terms of Gilligan's model of female development, another in terms of Loevinger's general model, and linkages among theories are observed. Characteristics of Loevinger's autonomous stage are illustrated and the extent to which they are gender-related is discussed. Findings show that women with very different personalities, problems, and ways of life can attain a high level of ego-development; that their lives tend not to have been orthodox or easy; and that theories of adult development are useful but uneven in application.
From 1973 to 1981, 75 patients with T1 N1 M0 and T2 N1 M0 disease had a complete, potentially curative resection with mediastinal lymph node dissection. Thirty-eight had adenocarcinomas, 36 epidermoid cancer and one large cell carcinoma. Surgical treatment consisted of lobectomy in 54, sleeve lobectomy in three, and pneumonectomy in 18. Two patients died postoperatively. Of 17 patients with T1 N1 disease, 14 had no further treatment and three received postoperative radiation and/or chemotherapy; the 5 year cumulative survival rate of these patients was 56%. There were 58 patients with T2 N1 disease. Forty-five had no further treatment and 13 received postoperative radiation and/or chemotherapy; the 5 year cumulative survival rate of these patients was 48%. The overall incidence of local and regional recurrence was low, and the brain was the most frequent site of recurrence. Factors influencing recurrence were histology and proximity of the tumor to hilum. The specific nodes involved, the number of nodes affected, and the extent of involvement within the nodes had no observed effect on survival. There was no observed improvement in survival with the use of adjuvants. However, survival was significantly poorer in patients with visceral pleural involvement.
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After observing the lack of generalization of language trained in highly structured training sessions using established behavior modification techniques, "incidental teaching" procedures were developed to change the use of specified language behaviors in the natural environment. This paper reports an analysis of the general changes in the language, other than that specifically targeted by the incidental teaching procedures, used by disadvantaged preschool children. The daily language samples of disadvantaged children involved in a previously reported experiment to increase compound sentence usage were reexamined and compared to comparable records of other disadvantaged children and of middle-class children of college parents in order to assess possible general effects of the intervention program. Whereas the language that both groups of comparison children used changed little across the preschool year, the amount of talking by the children in the experimental program increased markedly. Their use of more elaborate vocabulary and more elaborate sentences also increased in direct proportion to the increases in overall language use, such that both language use and language elaboration in the experimental group of children changed from a pattern simlar to the comparison group of disadvantaged children to a pattern similar to the comparison group of middleclass children. It is argued that some general features of the incidental teaching procedure--differentially attending to child overtures and responding relative to the child's selected topic (reinforcer)--contributed to the increase in overall language use beyond the specific language behavior targeted, and that this increase in the probability of children's talking itself resulted in the substantial increases in elaboration seen in the children's spontaneous language. Because, at least in children with fairly well-developed language repertoires, language use is contextually controlled, talking more involves talking in more varied and complex contexts, which inevitably produces the use of more elaborate language.
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"Incidental teaching" denotes a process whereby language skills of labelling and describing are learned in naturally occurring adult-child interactions. In the present study, 15-min daily samples of the spontaneous speech of 11 children were recorded during free play over eight months of preschool. After incidental teaching of compound sentences, increases in unprompted use of compound sentences were seen for all the children, first directed to teachers, and then to children, in accordance with who attended to the children's requests for play materials. The incidental teaching procedure also stimulated spontaneous variety in speech, and appears to have general applicability to child learning settings.
Although language remediation programs have generally been conducted with the use of special materials in structured group settings, traditional preschool practice emphasizes "incidental teaching" incorporated into children's free play. To determine if incidental teaching practices could be effective in improving children's speech, this study investigated the spontaneous speech of 12 disadvantaged children during free-play periods over eight months of a preschool program. Whenever the children selected a preschool play material, they were prompted and required to ask for it, first by name (noun), then by name plus a word that described the material (adjective-noun combination), then by use of a color adjuctive-noun combination, and finally by requesting the material and describing how they were going to use it (compound sentence). As each requirement was made, the children's general use of that aspect of language markedly increased, but little change was noted in the amount or nature of the children's interactions with teachers or their use of a set of materials to which they had free access. This study demonstrates that preschool free-play periods can be powerful "incidental teaching" periods by capitalizing on moments when children seek new play materials.
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Correspondence was developed between children's non-verbal and verbal behavior such that their non-verbal behavior could be altered simply by reinforcing related verbal behavior. Two groups of six children each were given food snack at the end of the day: for reporting use of a specific preschool material during free play (procedure A); and then only for reports of use which corresponded to actual use of that material earlier that day (procedure B). Initially, procedure A alone had little or no effect on the children's use of materials. Procedure B resulted in all of the children in one group actually using a specific material, and after repeating procedures A and B with this group across a series of different materials, procedure A alone was sufficient to significantly increase use of a specific material. Correspondence between verbal and non-verbal behavior was produced such that, in this group of 4-yr-old disadvantaged Negro children, "saying" controlled "doing" 22 or more hours later. In the second group, procedure B initially did not increase the use of a specific material; rather, the children's reports decreased so as to correspond to the intermittent use of the material. It appeared from subsequent procedures with this group that maintenance of a high level of reporting was crucial to the saying-then-doing correspondence seen in the first group.