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Biomedical subjects

Margaret Harris

Publications and source records attributed to Margaret Harris.

13 recordsLinked to original sources
PubMed2006

Concurrent correlates and predictors of reading and spelling achievement in deaf and hearing school children.

Seven- and eight-year-old deaf children and hearing children of equivalent reading age were presented with a number of tasks designed to assess reading, spelling, productive vocabulary, speechreading, phonological awareness, short-term memory, and nonverbal intelligence. The two groups were compared for similarities and differences in the levels of performance and in the predictors of literacy. Multiple regressions showed that both productive vocabulary and speechreading were significant predictors of reading for the deaf children after hearing loss and nonverbal intelligence had been accounted for. However, spelling ability was not associated with any of the other measures apart from reading. For hearing children, age was the main determinant of reading and spelling ability (due to selection criterion). Possible explanations for the role of speechreading and productive vocabulary in deaf children's reading and the differences between the correlates of literacy for deaf and hearing children are discussed.

Analysis of Variance↗
PubMed2006

Speech reading and learning to read: a comparison of 8-year-old profoundly deaf children with good and poor reading ability.

Nine children with severe-profound prelingual hearing loss and single-word reading scores not more than 10 months behind chronological age (Good Readers) were matched with 9 children whose reading lag was at least 15 months (Poor Readers). Good Readers had significantly higher spelling and reading comprehension scores. They produced significantly more phonetic errors (indicating the use of phonological coding) and more often correctly represented the number of syllables in spelling than Poor Readers. They also scored more highly on orthographic awareness and were better at speech reading. Speech intelligibility was the same in the two groups. Cluster analysis revealed that only three Good Readers showed strong evidence of phonetic coding in spelling although seven had good representation of syllables; only four had high orthographic awareness scores. However, all 9 children were good speech readers, suggesting that a phonological code derived through speech reading may underpin reading success for deaf children.

Child↗
PubMed2006

Successful management of lymphangiomatosis and chylothorax in a 7-month-old infant.

A 7-month old infant presented with an effusion and multiple lesions in his spleen. A diagnosis of lymphangiomatosis was made based on chylous effusion and an MRI demonstrating numerous enhancing lesions within the spleen on T2-weighed images. Conservative measures, including the withdrawal of feeds and octreotide, did not significantly reduce the rate of chyle production and increasing requirement for respiratory support. Resection of the patient's spleen and partial pleurectomy were associated with a dramatic improvement in his condition. At 27 months the patient was well with no evidence of further lymphangiomas or a recurrence of his chylothoraces.

Chylothorax↗
PubMed2005

Visual attention in deaf and hearing infants: the role of auditory cues.

BACKGROUND: Successful communication with profoundly deaf children is heavily dependent on visual attention. Previous research has shown that mothers of deaf children--notably those who are deaf themselves--use a variety of strategies to gain their children's attention. This study compares patterns of visual attention in deaf and hearing children to determine how they are affected by the absence of auditory cues, especially when looking to the mother's face. METHOD: The visual attention of 18-month-old infants to their mothers was examined in two groups of deaf children (6 with deaf mothers and 6 with hearing mothers) and two of hearing children (6 with deaf mothers and 8 with hearing mothers). Dyads were observed in free play and 10 minutes of videorecorded interaction was analysed. All looks to the mother were classified as Spontaneous, Responsive (Child turns in response to something done by mother) or Elicited (Mother actively seeks to gain child's attention by, e.g., tapping or waving). The kind of event that attracted the child's attention in Responsive and Elicited episodes was also determined (e.g., object movement, speech, physical contact), as was the focus of the child's attention (e.g., mother's face, mother's body). RESULTS: Responsive looks to the mother were the most frequent for all groups but on only about 25% of occasions were they directed to her face. Elicited and spontaneous looks occurred less often but were frequently directed to the mother's face. Spontaneous looking occurred in all groups but elicited looking very seldom occurred in Hearing-Hearing dyads. Overall, there were fewer looks to the mother in the two groups where mother and child had congruent hearing status, although the proportion of the looks to the mother's face was similar. CONCLUSIONS: Both spontaneous and elicited looks are likely to involve attention to the mother's face. However, while active elicitation of attention is an important part of successful communication with young deaf children, this does not appear necessary for typically developing hearing children who turn to look at their mother's face on hearing her voice. The implications of these findings for differences in the dynamics of communication with young deaf and hearing children are discussed.

Analysis of Variance↗
PubMed2005

Service utilization in 1896 and 1996: morbidity and mortality data from North Wales.

The 1896 and 1996 populations of North-West Wales are similar in number, ethnic and social mix and rurality, enabling a study of the comparative prevalence of service utilization, as well as the morbidity and mortality associated with mental illness in 1894-96 and 1996. The 1996 data reveal a 15 times greater prevalence of admissions for all diagnoses, and three times greater prevalence of admissions by detention, compared with 1896. Patients now spend more time in a service bed than they did 100 years ago. Death as a direct consequence of mental illness is commoner now than 100 years ago. There is therefore a major disjunction between the rhetoric and the reality of mental health service utilization. General factors related to changing health care and expectations and specific factors linked to the mental health appear to have led to an increased rate of service utilization in the modern period.

Bed Occupancy↗
PubMed2005

The impact of mood stabilizers on bipolar disorder: the 1890s and 1990s compared.

This study comparing patterns of service utilization by bipolar patients in North-West Wales found a greater prevalence of service utilization in the 1990s compared with the 1890s. In the pre-lithium era, admissions for bipolar disorders occurred at a rate of 4 every 10 years; they now occur at a rate of 6.3 every 10 years. Where 100 years ago, there were 16 bipolar patients per million population resident per day in hospital, there are now 24 per million resident in acute service beds and more in non-acute beds. These data are incompatible with simple claims that mood stabilizing drugs 'work'. An alternative is that these agents have treatment effects, and further research is needed to match treatments to patients in order to optimize outcomes.

Antimanic Agents↗
PubMed2005

Patellofemoral pain and functional outcome after anterior cruciate ligament reconstruction: an analysis of the literature.

We reviewed the literature for reports on anterior knee pain and function after endoscopic single-incision anterior cruciate ligament reconstruction. The risk for developing a range-of-motion extension deficit of more than 3 degrees 2 years after surgery was 62% higher for patients who underwent a patellar tendon procedure than for patients who underwent a hamstring graft procedure, and the risk for having an abnormal International Knee Documentation Committee score was 9% higher. There were no statistically significant functional differences between the 2 groups. We also concluded that studies done from "high-quality randomized trials" are insufficient alone; clinicians should evaluate results from meta-analyses to determine whether data from individual studies were properly combined.

Anterior Cruciate Ligament↗
PubMed2004

Deaf children's use of phonological coding: evidence from reading, spelling, and working memory.

Two groups of deaf children, aged 8 and 14 years, were presented with a number of tasks designed to assess their reliance on phonological coding. Their performance was compared with that of hearing children of the same chronological age (CA) and reading age (RA). Performance on the first task, short-term recall of pictures, showed that the deaf children's spans were comparable to those of RA controls but lower than CA controls. For the older deaf children, short-term memory span predicted reading ability. There was no clear evidence that the deaf children were using phonological coding in short-term memory when recall of dissimilar items was compared with recall of items with similarly sounding names. In the second task, which assessed orthographic awareness, performance of the deaf children was similar to that of RA controls although scores predicted reading level for the deaf children but not the hearing. The final task was a picture spelling test in which there were marked differences between the deaf and hearing children, most notably in the number of spelling refusals (which was higher for the deaf children in the older group than their RA controls) and the percentage of phonetic errors (which was considerably lower for both groups of deaf children than for any of the hearing controls). Overall these results provide support for the view that deaf children place little reliance on phonological coding.

Adolescent↗
PubMed2003

Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy.

Osteoporosis is a major public health concern. The combination of exercise, hormone replacement therapy, and calcium supplementation may have added benefits for improving bone mineral density compared to a single intervention. To test this notion, 320 healthy, non-smoking postmenopausal women, who did or did not use hormone replacement therapy (HRT), were randomized within groups to exercise or no exercise and followed for 12 months. All women received 800 mg calcium citrate supplements daily. Women who exercised performed supervised aerobic, weight-bearing and weight-lifting exercise, three times per week in community-based exercise facilities. Regional bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry. Women who used HRT, calcium, and exercised increased femoral neck, trochanteric and lumbar spine bone mineral density by approximately 1-2%. Trochanteric BMD was also significantly increased by approximately 1.0% in women who exercised and used calcium without HRT compared to a negligible change in women who used HRT and did not exercise. The results demonstrate that regional BMD can be improved with aerobic, weight-bearing activity combined with weight lifting at clinically relevant sites in postmenopausal women. The response was significant at more sites in women who used HRT, suggesting a greater benefit with hormone replacement and exercise compared to HRT alone.

Adult↗
PubMed2003

Mood-stabilizers: the archeology of the concept.

OBJECTIVE: To review the history of 'mood-stabilizing' treatments. METHOD: We have reviewed primary source data on the origin of the use of current mood-stabilizers. RESULTS: This historical record on the origins of the mood-stabilizers points to a more ambiguous picture as regards pharmacotherapeutic specificity to bipolar disorders than is commonly conceded. CONCLUSIONS: This review suggests a need for alternative formulations of the concept of a mood-stabilizer. An alternative to the currently dominant paradigm is that these agents have treatment effects, which need to be matched more precisely with patients' constitutional types in order to optimize outcomes.

Affect↗
PubMed2002

The relationship between insulin secretion, the insulin-like growth factor axis and growth in children with cystic fibrosis.

OBJECTIVE: Cystic fibrosis-related diabetes mellitus (CFRD) is an increasingly common complication of cystic fibrosis. CFRD is preceded by a progressive decline in insulin secretion but there is no accepted definition of the prediabetic state in CFRD. This prediabetic state appears to have adverse effects on clinical status, nutrition and lung function, but there is no direct evidence that the impaired glucose homeostasis is the cause of these deteriorations. This study examined the prevalence of glucose intolerance and impaired insulin secretion in a population of children with CF without CFRD. Severe CF lung disease is often associated with poor weight gain and slower growth but the mechanism for this is still unclear. The relationships between the current state of glucose homeostasis, insulin secretion and the insulin-like growth factor axis, height velocity, nutrition status and lung function were therefore studied. DESIGN AND PATIENTS: Eighteen children with cystic fibrosis aged 9.5-15 years had oral glucose tolerance tests and 14 of these also had intravenous glucose tolerance tests (four refused). Blood samples were collected for insulin, C-peptide, glucose, HbA1c, insulin-like growth factor (IGF)-I, IGF-II, IGF-binding protein (IGFBP)-1 and IGFBP-3. Data on height, weight, puberty status, clinical score (Shwachman score) and lung function were recorded. Height velocity, height and weight standard deviation scores (SDS) were calculated using WHO/CDC data. RESULTS: The mean height SDS (-0.52 +/- 0.17) was less than the normal population (P = 0.007) and the mean height velocity was 4.6 +/- 0.5 cm/year, 39% with a height velocity less than the third percentile for age. The weight SDS and body mass index (BMI) were similar to the normal population. Four children had impaired glucose tolerance. The first-phase insulin response (FPIR) was below the first percentile of normal population values in nine (65%). Impaired FPIR or impaired glucose tolerance did not correlate with the Shwachman score, nutritional status or pulmonary function. There was a significant positive correlation between insulin secretion (area under the curve) and height velocity (P = 0.001) and serum IGFBP-3 levels (P = 0.001). CONCLUSIONS: Impaired glucose tolerance was present in 20% of children with cystic fibrosis. Impaired insulin secretion was common (65%) even in children with normal glucose tolerance. The mean height SDS for the group was low and the height velocity was abnormally slow in 39%, yet nutritional status as measured by BMI was appropriate for age. Relative insulin deficiency rather than nutritional deprivation or poor clinical status thus appears to be implicated in the poor linear growth of these children with relatively stable lung disease. This was a small study and firm conclusions on this chronic suppurative disease as to the cause of poor growth are not possible. The causes of poor growth are likely to be complex; nevertheless, the apparent decrease in insulin secretion combined with the expected increased demands on insulin production during pubertal growth raises the question as to whether insulin therapy should be considered in children with cystic fibrosis before the onset of cystic fibrosis-related diabetes mellitus.

Adolescent↗
PubMedDate not supplied

Enabling students to develop confidence in basic clinical skills.

An increase in the number of nursing students is making it difficult to guarantee those on the common foundation programme the opportunity to practise basic nursing skills. In order to address this problem a nursing college developed a skills week that enabled students to practise their skills and develop confidence. Simulated clinical situations gave students the opportunity to relate these skills to practice while learning about teamwork and holistic patient care.

Attitude of Health Personnel↗