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Biomedical subjects

K J Connolly

Publications and source records attributed to K J Connolly.

At least 19 recordsLinked to original sources

Variability and the development of skilled actions.

Consistency and invariance in movements have been seen as the essential features of motor skill development. This emphasis on the stabilisation of action has led to the neglect of the processes whereby skills are modified and reorganised into new and more complex acts, that is the process of adaptation. It is argued that variability of motor behaviour has a major role to play in this process and hence in the development of skilled actions. The significance of variability for open systems and its implications for development are examined. A distinction is made between error variability and functional variability, the latter being used in the solution of motor problems. Two experiments on the acquisition of a skilled action by children are reported. A sequential coincident timing task which permitted an operational distinction between the macrostructure and microstructure of the task was used. The results support the argument that with development the action becomes increasingly consistent at the macrostructure level and that this is achieved by maintaining variability at the microstructure level.

Adolescent

Coping strategies and psychological adjustment of couples presenting for IVF.

The study was designed to examine the extent to which the psychological profiles of couples entering an IVF programme were influenced by evidence of previous fertility, the history of fertility investigations, the diagnosis made, and the coping strategies adopted. A sample of 152 couples was administered a number of standardized psychological instruments and a coping strategies questionnaire. They showed little variation from the normative range on the standardized measures. There was little evidence of differences between couples referred for primary or secondary infertility, between those with some evidence of fertility and those with none, or between different diagnostic groups. In relation to coping strategy, for women at least, taking direct action appears to be effective if it is associated with some degree of acceptance of one's position. For males, the picture is less clear, though direct action and acceptance again appear to be effective coping strategies.

Adaptation, Psychological

Attentional difficulties in hyperactive and conduct-disordered children: a processing deficit.

A random population sample of 1479 Chinese boys from Hong Kong was screened and diagnosed in a two-stage epidemiological study. Four groups, age 7-8, were distinguished: (1) a pure hyperactive group (HA), (2) a mixed hyperactive/conduct-disordered group (HA+CD), (3) a pure conduct-disordered group (CD), and (4) a normal control group (N). On a visual search task, only the HA children showed a specific processing deficit in performance. This confirms the diagnostic value of such a deficit for hyperactivity, differentiating it from conduct disorder. The failure to find a similar deficit in the HA+CD group raises questions concerning the clinical identity of these children. Each group showed a performance decrement over time in the visual search task but the decrement did not differ between the four groups. This observation is not congruent with the reports of a short attention span in hyperactive children; explanations of this apparent contradiction are considered.

Attention

Infection, nutrition and cognitive performance in children.

The paper considers briefly the nature of cognition and its relationship to intelligence. The information processing model of human cognition is outlined and IQ and DQ are explained. The literature dealing with the effects of malnutrition and parasitic infection on cognitive performance and development in children is selectively reviewed. A speculative hypothesis concerning the psychological effects of parasitic infection is sketched and brief consideration is given to models and measures in research on development.

Adult

Key issues in generating a psychological-testing protocol.

An individual's behavior is created by an amalgam of genetic, environmental, cultural, and historical variables working in concert and changing over time. Variations in nutrition are one class of environmental factors. Linking these to outcome effects requires carefully designed studies. Many considerations are involved, and this paper draws attention to some of the fundamental ones. Psychological and behavioral functions tend to be complex, in part because they are affected by a wide range of variables. Almost any given state--a particular constellation of psychological characteristics displayed by an individual at a given time--can be produced in a variety of ways.

Behavior

Long-term follow-up of didanosine administered orally twice daily to patients with advanced human immunodeficiency virus infection and hematologic intolerance of zidovudine.

This phase 1 trial was conducted to evaluate the safety and tolerance of didanosine (ddI) in subjects with AIDS or AIDS-related complex (ARC) who previously had demonstrated hematologic intolerance of zidovudine. Thirty subjects, 21 with AIDS and nine with ARC, were enrolled. Initially, didanosine was administered orally twice daily for a total daily dose of either 750 mg or 1,500 mg. Subsequently, the dosage for those receiving 1,500 mg/d was reduced to a maximum of 750 mg/d (375 mg twice daily) when data from this and other phase 1 studies showed that the dosage of 1,500 mg/d (750 mg twice daily) was associated with an unacceptable risk of developing neuropathy. The subjects were studied for 46 weeks (mean time; range, 7-122 weeks). The dose-limiting toxic effect observed was peripheral neuropathy, which occurred in eight patients. Other significant toxic effects included pancreatitis in three patients and xerostomia in eleven. In general, didanosine was well tolerated from a hematologic standpoint by the majority of patients during prolonged administration.

Administration, Oral

An evaluation of counselling for couples undergoing treatment for in-vitro fertilization.

Fertility difficulties, along with their investigation and treatment, are widely believed to cause significant psychological problems. This study was designed to investigate the efficacy of a non-directive counselling intervention with couples undertaking their first cycle of in-vitro fertilization treatment. Couples were randomly assigned to either a control group, given information about the treatment programme, or to an experimental group, given the same information plus three sessions of counselling before, during and on conclusion of the first treatment cycle. Psychological assessments were made at three points in the treatment process. Ratings were also obtained from the couples on the stress engendered by different parts of the treatment, the effects on their relationship and satisfaction with counselling. The results showed the patients to be generally well adjusted and anxiety levels dropped over the course of treatment. Counselling compared to information alone did not lead to any enhanced reduction in levels of anxiety or depression. The implications of the findings for service provision are discussed.

Adult

The impact of infertility on psychological functioning.

To explore the impact of infertility on psychological functioning 130 couples presenting with primary infertility were assessed at their initial visit to an infertility clinic. Of these, 116 couples were assessed on a second occasion some 7-9 months later when in most cases the medical tests were complete. Measures of personality, psychopathology, perceived social support, sex role identity and marital state were obtained from both partners. The set was subsequently divided into five subgroups on the basis of the diagnosis made or the outcome (female cause, male cause, female and male cause, unexplained and pregnant). The results show little evidence of psychopathology in the sample, depression scores remained low throughout the period of investigation. The results also indicated stable marital relationships. Scores on tests of anxiety and psychiatric morbidity declined between the first and second assessment except in the case of men who were diagnosed with a fertility problem. The implications of these findings are discussed in the increased use of donor insemination which circumvents rather than treats the problem of male infertility.

Adaptation, Psychological

The measurement of handedness: a cross-cultural comparison of samples from England and Papua New Guinea.

Handedness was compared in 125 English children and 185 young people from Papua New Guinea (PNG). Many of the latter were unfamiliar with implements such as pencils and spoons. The PNG subjects showed strong hand preferences, usually for the right, and on some items were more consistent in hand use than the English subjects. However, they had smaller hand differences on peg-moving and tapping than the English children. A factor analysis identified one factor with high loadings from items involving precise motor control, and another with positive loadings from only card-dealing, block-building and threading. The first factor was impervious to cultural influences, whereas the second showed considerable cultural variation.

Adolescent

Phase I study of 2'-3'-dideoxyinosine administered orally twice daily to patients with AIDS or AIDS-related complex and hematologic intolerance to zidovudine.

PURPOSE: To evaluate the safety and hematologic tolerance of 2'-3'-dideoxyinosine (didanosine, ddI) in subjects with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex and prior hematologic intolerance to zidovudine. PATIENTS AND METHODS: A Phase I trial with two dose groups at a single-center, university-affiliated hospital ambulatory care center. Of 30 subjects enrolled, 21 had AIDS and nine had AIDS-related complex. All had CD4 lymphocyte counts less than 0.2 x 10(9)/L at entry. Didanosine was administered orally twice daily at a total daily dose of 750 mg or 1,500 mg for 12 weeks. Subjects who completed the 12-week study continued to receive ddI at the lower dose. All subjects were monitored for toxicity. Virologic and immunologic response markers were also measured. RESULTS: For the group as a whole, there was no significant decrease in mean hemoglobin level or leukocyte or platelet counts. The dose-limiting toxicity was peripheral neuropathy. Other significant toxicities included pancreatitis and hypocalcemia. Uric acid elevations were common but were without clinical consequence. A sustained decrease in serum p24 antigen of at least 50% was noted in 42% of subjects who were p24 antigen-positive at entry. The mean CD4 lymphocyte count showed an initial increase that was not sustained over the 12-week study. All subjects remained anergic to skin testing. CONCLUSIONS: Didanosine is well tolerated hematologically in some patients with prior significant hematologic intolerance to zidovudine. The toxicity profile for ddI differs from that of zidovudine and includes peripheral neuropathy and pancreatitis. Changes in CD4 lymphocyte number and HIV p24 antigen levels in some patients suggest antiviral activity of ddI in this population.

AIDS-Related Complex

The effects of parasite infections on cognitive processes in children.

Two studies were carried out in the Nyuswa area of Natal to investigate the effects of parasitic infection on cognitive function in children. In the first study, children infected with intestinal helminths were given tests of information processing and perceptual speed before and after treatment with a single 500 mg dose of Mebendazole. The pattern of results was consistent with the hypothesis that parasitic infections combine with nutritional deficits to impair the efficiency of cognitive processes. There was, however, some confounding of variables, and the single drug treatment reduced but did not eliminate the parasites. The second study removed the confounding effects due to age and nutrition and employed a more comprehensive drug-treatment programme. A memory task and a test of sustained attention were administered. Poor performance on the attention task showed a significant association with parasite status, but no association was observed with educational attainment or memory function. The study also examined various ways of assessing parasite load, and an index weighted for estimated pathogenicity was found to give the best estimate. The results provide evidence of the effects of parasitic infection on attentional processes.

Age Factors

Effects of maternal iodine supplementation during pregnancy.

Reduced maternal thyroid hormone concentrations during pregnancy can adversely affect fetal neurological development. In the context of national iodine supplementation programmes, concern has been expressed over the theoretical possibility that iodine supplementation during pregnancy might adversely affect fetal development as a result of maternal thyroid inhibition from the Wolff-Chaikoff effect. In a double blind controlled trial in five villages in Papua New Guinea, several measures of motor and cognitive function showed no significant differences at either age 11 or 15 years between those children whose mothers had received supplementary iodine during pregnancy and the control children whose mothers had received the placebo.

Adolescent

The acute aseptic meningitis syndrome.

The acute aseptic meningitis syndrome is an entity that presents a diagnostic challenge to the clinician. Although many infectious and noninfectious etiologies exist for this syndrome, viruses, especially nonpolio enteroviruses, are the classic and most important agents encountered. The incidence of polio and mumps meningitis has declined dramatically in the vaccine era, but recently described pathogens, such as human immunodeficiency virus and Borrelia burgdorferi (Lyme disease agent) are now important considerations in the differential diagnosis. Specifically treatable entities (eg, mycobacterial or fungal meningitis, herpes simplex encephalitis, parameningeal infection) that may mimic aseptic meningitis in their initial presentations must not be overlooked. A careful approach to the patient and a rational use of laboratory studies are the basis for establishing a specific diagnosis and assuring a favorable outcome.

Acute Disease