Biomedical subjects

R S Dean

Publications and source records attributed to R S Dean.

At least 37 records · Page 2Linked to original sources

PubMed1996

Underlying factor structure of perinatal events.

The underlying factor structure of perinatal events was examined for 847 children (272 normals, 117 developmentally disabled, 37 speech disordered, 221 learning disordered, 91 emotionally disturbed, and 109 Head Start children). Pertinent perinatal information from the Maternal Perinatal Scale was subjected to a principle-components factor analysis. Ten factors accounting for some 58% of the total variance were isolated. In general, these factors appeared to be consistent with clinical evidence. The results were discussed in terms of their implications for the utility of perinatal information.

Birth Weight↗

PubMed1996

Neuropsychological subgroups of dementia of the Alzheimer's type.

Neuropsychological aspects of Dementia of the Alzheimer's Type (DAT) was considered using the scores from the Cambridge Cognitive Examination (CAMCOG) portion of the Cambridge Index of Mental Disorders in the Elderly (CAMDEX). CAMCOG scores for 51 DAT patients and 79 normal subjects were cluster analyzed. Results showed that the CAMCOG was effective in separating normal from demented subjects. The four subgroups of DAT patients differed more in "level" of impairment than for specific neuropsychological function. However, each level was characterized by losses in specific neuropsychological functions. Higher functioning groups exhibited greatest losses in memory skills, while the lowest functioning group showed greater loss of language skills.

Adult↗

PubMed1996

An exploratory stepwise discriminant function analysis of malingered and nondistorted responses to the Neuropsychological Symptom Inventory.

Clinicians are often asked to evaluate a patient's potential for malingering during a neuropsychological examination. This problem is particularly crucial when financial gain may hinge on the results of the assessment. Response distortion may occur even when a head injury has been verified by radiological means (e.g., MRI). Research in the identification of malingering has yet to produce results that are effective in the clinical setting. The present study addressed several shortcomings of past research with the use of a self-report symptom inventory. The responses of 242 subjects told to distort symptomology were compared to 128 nonmalingerers. A discriminant function analysis of these data produced a 90% hit rate overall with 2.3% false positives. The results were discussed in terms of clinical utility.

Cognition Disorders↗

PubMed1995

Treatment of pancreatic pseudocysts with ductal communication by transpapillary pancreatic duct endoprosthesis.

BACKGROUND: Endoscopic treatment of pancreatic pseudocysts via cystenterostomy has been recognized as a successful treatment option in carefully selected patients. Pancreatic transpapillary stenting as an alternative treatment option in patients with pancreatic pseudocysts directly communicating with the main duct has received little consideration. The aim of the current study was to assess the safety and utility of transpapillary pancreatic endoprosthesis in the treatment of communicating pseudocysts. METHODS: Twenty-one patients underwent placement of 33 transpapillary endoprostheses for the treatment of symptomatic pancreatic pseudocysts. All pseudocysts communicated with the main pancreatic duct and ranged in size from 3 to 9 cm (mean 6 cm). Eight patients had associated pancreatic duct strictures. RESULTS: Stent placement was successful in all cases: 13 directly into the pseudocyst, 8 beyond the stricture but not into the pseudocyst. Initial resolution of pseudocysts was seen in 17 patients, with 16 patients free of pseudocyst recurrence at mean follow-up of 37 months. All patients with associated strictures were treated successfully. Factors predictive of success included presence of strictures, size of pseudocyst greater than or equal to 6 cm, location in the body of the pancreas, and duration of pseudocyst less than 6 months. Complications included one episode of mild pancreatitis. CONCLUSIONS: Endoscopic treatment of symptomatic pancreatic pseudocysts with ductal communication by transpapillary pancreatic duct stenting is a safe, effective modality and should be considered a first line therapy.

Adult↗

PubMed1995

Neuropsychological characteristics of learning disabled/gifted children.

The neuropsychological characteristics of 68 learning-disabled/gifted children (LD/Gifted) were studied using the Halstead-Reitan Neuropsychological Test Battery for Children (HRNB-C). The proportion of LD/Gifted children identified as impaired was low compared to previous research that has examined the proportion of school-identified learning-disabled students who scored within the impaired range on the HRNB-C. Consistent with previous research, the results of this study indicated that LD/Gifted children were also more likely to demonstrate impairment on the Tactual Performance Test-Memory, Tactual Performance Test-Localization, and Trails B-Errors components of the HRNB-C.

Adolescent↗

PubMed1995

Factor analysis of the Halstead-Reitan Neuropsychological Test Battery for Older Children.

Studies of the factor structure of the Halstead-Reitan Neuropsychological Test Battery for Older Children (HRNB-C) have reported solutions ranging from 5 to 7 constructs. The current study examined the underlying factor structure of the HRNB-C using only tests from the Battery itself with 800 learning disabled children. The results showed a four factor solution to be the most heuristic. These dimensions were identified as Speed of Operation, Tactile-Motor Integration, Attention, and Visuo-Spatial Memory. When ancillary tests are excluded it is argued that four factors provide the best description of the underlying structure of the HRNB-C.

Adolescent↗

PubMed1995

Utilization of maternal perinatal risk indicators in the differential diagnosis of ADHD and UADD children.

The purpose of this study was to differentiate between children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD), children with Undifferentiated Attention-Deficit Disorder (UADD) and a control group using maternal perinatal information. The sample consisted of 74 ADHD, 56 UADD, and 135 normal children between the ages of 6 years, 5 months and 13 years, 4 months. The results supported the use of maternal perinatal information in the diagnosis of attention disorders. More specifically, the greater the number of medical conditions prior or during their pregnancy the more likely a child was diagnosed with an attention deficit disorder. In addition, if the mother experienced moderate emotional stress or smoked cigarettes during pregnancy the child was more likely to be diagnosed with an attention deficit disorder.

Adolescent↗

PubMed1995

Survival of physician self-referral to physical therapy centers with physician-held owner interest.

Physician ownership of ancillary services has grown during recent years as a means of expanding financial security--as well as providing convenient access for patients and physicians. As these investments have spread, so too have concerns expressed by professional organizations and state and federal regulatory commissions. This professional paper will explore the historical perspective of federal and state regulatory impacts regarding physician ownership of ancillary services (specifically physical therapy centers), will develop a view of yesterday's regulatory impacts and help outline the necessity of change for tomorrow.

Alaska↗

PubMed1994

The modality effect: a result of methodology?

Modality differences for short-term (STM) and long-term memory (LTM) were investigated. Sixty-eight subjects participated in one of four conditions: Auditory STM, Verbal STM, Auditory LTM, and Verbal LTM. Analysis of the number of words correctly recalled showed a significant interaction between modality and store. Contrary to both Engle and Mobley's (1976) and Penney's (1975, 1989a, 1989b) findings, further analysis showed that the auditory mode was superior in STM and that no modality difference existed in LTM. It was concluded that the LTM modality effect is less robust than that found in STM. Possible methodological reasons for the conflicting results of the past as well as areas of potential future research were discussed.

Adolescent↗

PubMed1994

Perinatal risk factors as predictors of developmental functioning.

This study examined the relationship between perinatal risk factors and developmental functioning for a referred population of 216 children. A canonical correlation analysis indicated that 31% of the variability in developmental information could be predicted from perinatal events. The results were interpreted as lending support to a multivariate link between perinatal complications and developmental functioning for referred children.

Child↗

PubMed1994

Neuropsychological significance of IQ summary scores.

A canonical correlation between summary intelligence scores and neuropsychological tests for 423 learning-disabled children was performed. Results showed a significant relationship between WISC-R global intelligence scores and tests of the Halstead-Reitan's Neuropsychological Battery for Older Children (HRNB-C), Rc = .53, p < .001. While measures were found to share commonality, both were found to provide unique information. The clinical implications of these findings were discussed.

Child↗

PubMed1994

Investigation of possible cognitive, behavioral, and emotional heterogeneity in patients with Alzheimer's disease.

This study sought to examine whether subtypes of patients with Alzheimer's Disease (AD) existed as measured by seven scales of the Cognitive Behavior Rating Scale (CBRS). Wards' method of cluster analysis was used to group 104 AD patients into subgroups. Three clusters were identified: (a) Moderately Impaired, (b) Severely Impaired, and (c) Emotionally Intact. These clusters displayed more differences in symptom severity than type of symptom. Clusters could be partially defined by the amount of time since diagnosis, while differences in the clusters' profile of scores had little or no descriptive utility. Results failed to support the existence of AD subtypes and yet did not follow the traditional "stage" descriptions of AD progression either. Findings are discussed within a modified "phase" description of AD progression.

Journal Article↗

PubMed1993

Factor structure of emotional and cognitive behaviors for normals and neurologically impaired patients.

This study examined the factor structure of 68 affective, cognitive, and behavioral symptoms often reported with neurological impairment. The responses of 199 subjects to a behavioral inventory were submitted to an exploratory factor analysis. The results demonstrated that the instrument could be reduced to 16 homogeneous factors, which were able to explain 67% of the instrument's total variability. These factors were entered into a discriminant analysis that examined neurologically impaired patients and normal controls. Eleven of the 16 factors formed a linear composite that discriminated between these two groups with approximately 94% accuracy.

Adolescent↗

PubMed1993

Empirical derivation and classification of subgroups of children with learning disorders at separate age levels.

This study classified subgroups of learning disabled (LD) children while considering the effects of age. Specifically, scores on the Halstead-Reitan Neuropsychological Battery (HRNB) for older children, the Wechsler Intelligence Scale for Children-Revised (WISC-R), and Wide Range Achievement Test (WRAT) were clustered for a large sample of public school LD children at the age levels 9-10, 11-12, and 13-14 years old. Like clusters were then identified and collapsed across age groups. Discriminant analyses were performed at each age level, and for like clusters across ages as a measure of predictive validity. Results of this study suggested two distinct clusters at each age level; one showing diffuse deficits which varied little with age, and the other evidencing specific neuropsychological problems which may vary with age.

Journal Article↗

PubMed1992

Factor analysis and matrix invariance of the HRNB-C category test.

This study examined the factorial invariance of the six individual Halstead-Reitan Neuropsychological Battery for Older Children (HRNB-C) Category subtests. The test scores for two large samples of learning disabled children were factor analyzed. A three-factor solution emerged for each group with a clear pattern of variable loadings. Category subtests IV and V load on Factor 1, subtests III and VI on Factor 2, and subtests I and II on Factor 3. Variable loadings were not only of similar pattern, but also magnitude and sign for both samples. Moreover, comparison statistics indicate an excellent fit between the two factor matrices. Results support the conclusion that the HRNB-C Category Test measures more than a single underlying construct.

Journal Article↗

PubMed1990

MMPI differences for renal, psychiatric, and general medical patients.

Renal failure has both medical and psychological implications. Indeed, various psychiatric problems related to end-stage renal disease have been reported in the literature; however, the focus has been on anxiety and depression. While previous research has dealt with the comparisons of patients with renal failure, few studies have investigated the comparison of renal patients with psychiatric and general medical patients. The present study compared renal patients (N = 24) with a group of depressed psychiatric patients (N = 24) and a group of general medical patients (N = 24) on the MMPI. The results suggested that the renal group presented a psychological profile that more closely resembled that of the depressed psychiatric group than that of patients with other chronic medical conditions.

Adaptation, Psychological↗

PubMed1990

Empirical testing of a cognitive model to account for neuropsychological functioning underlying arithmetic problem solving.

The efficacy of a cognitive-based arithmetic problem-solving model (Dinnel, Glover, & Halpain, in press; Dinnel, Glover, & Ronning, 1984) was tested using 989 students with learning disabilities. Comprehensive neuropsychological test battery information was used to predict composite arithmetic test performance as a means of examining the utility of this model. Results of this study offer support for Dinnel et al.'s (Dinnel, Glover, & Halpain, in press; Dinnel, Glover, & Ronning, 1984) model in accounting for arithmetic performance under continuous visual stimulus conditions. However, these data indicate a more complex neuropsychological underpinning to arithmetic performance in both visual and aural stimulus conditions. The neuropsychological aspects of arithmetic problem solving were discussed in relationship to this cognitive-based model.

Adolescent↗

PubMed1990

Sex differences in neuropsychological performance for children with reading deficits.

This study examined sex differences in neuropsychological functioning for a large sample of public school children with reading deficits. Specifically, scores on the Weschsler Intelligence Scale for Children--Revised (Wechsler, 1974), the Halstead-Reitan Neuropsychological Battery for older children (Reitan, 1969) and the Wide Range Achievement Test (Jastak and Jastak, 1978) were compared for males and females in a multivariate fashion. Significant sex differences were found in motor, verbal and nonverbal functioning. Females seemed to be more aberrant than males in expected neuropsychological performance.

Achievement↗