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Biomedical subjects

S Dowling

Publications and source records attributed to S Dowling.

At least 37 records · Page 2Linked to original sources
PubMed1990

Fantasy formation: a child analyst's perspective.

Unconscious fantasy is the principal unit of psychoanalytic investigation. Though individual fantasies, either conscious or unconscious, may emphasize drive, defense, or superego interests, all fantasy life develops from a limited number of themes; these themes concern drive-related issues, experiences of helplessness, or combinations of both. Fantasy formation and fantasy content undergo developmental change. Sensorimotor, behavioral memories occur prior to fantasy and are influential in determining repetitive behavioral enactments. The complexities of infant behavior do not require the postulation of fantasy or representational memory. A complex, innate, instinctual organization of the newborn, similar in many respects to that of other newborn mammals, and distinct from the psychological organization of the older infant, is suggested as an explanation of these phenomena.

Adolescent↗
PubMed1990

Nutrition in the management of HIV antibody positive patients: a longitudinal study of dietetic out-patient advice.

The efficacy of a dietetic service was evaluated in an AIDS clinic; 17 asymptomatic (CDC II) and 17 symptomatic (CDC IV) patients participated in a 12 week evaluation of out-patient dietetic advice. The symptomatic group, classified as CDC stage IV according to the Centre for Disease Control classification, were significantly lighter (P less than 0.05) and had significantly lower values for usual weight, current body mass index, mid-upper arm and mid-arm muscle circumferences and triceps and subscapular skinfold thicknesses (P less than 0.05) at the outset of the study. There were no significant differences in nutrient intakes between the two groups. After 12 weeks of dietetic intervention which included personalised advice, prescription of food supplements and the provision of a special food allowance as social welfare payments for the unemployed, there were significant increases in the intakes of most nutrients, the effect being greater with the symptomatic CDC IV group. It is concluded that dietetic intervention has a significant role to play in the management of HIV antibody positive patients.

Adult↗
PubMed1989

The relationship between cluster and liquid simplification and sentence length, age, and IQ in Down's syndrome children.

Twenty-two Down's syndrome children who were 6 years, 6 months to 12 years, 7 months of age were tested to assess the relationships among cluster reduction, liquid simplification and sentence length, age, and IQ. Sentence length was found to be the primary predictor of cluster reduction and liquid simplification in the articulatory productions of Down's syndrome children. The liquid /r/ was generally more difficult than the liquid /l/ for the subjects.

Age Factors↗
PubMed1988

An analysis of potential biases in the loss of indigent infants to follow-up.

Loss to follow-up is a major problem in indigent inner-city populations. We evaluated a large, well-described, inborn indigent population of high-risk infants (HRI) and control infants (CI) to assess possible selection biases in loss to follow-up at one year adjusted age. Serial clinic visits, phone calls, and letters and payment of $20.00 for attending at 1 year was used to minimize patient loss. Yet, the 1 year loss rate was high, and among HRI, greater for ventilator-treated infants greater than 1500 g birthweight (71/114; 62%) than for ventilator-treated very-low-birthweight (VLBW; less than 1500 g) infants (39/108; 36%) or non-ventilated VLBW infants (62/145; 43%) (P less than 0.05). Multivariate analyses indicated that those lost to follow-up were at no greater risk of a poor outcome on the basis of prenatal and perinatal medical and socioeconomic findings than were those in the same risk group (HRI or CI) or subgroup of HRI who were examined at 1 year. In a review of hospital records, similar rates of hospitalization and neurologic problems during infancy were identified for HRI examined and HRI lost to follow-up. The identification of such morbidity during infancy may be less complete for HRI lost to follow-up than for those examined. Thus, the high frequency of deficits observed in follow-up evaluation of indigent HRI is unlikely to result from loss of unaffected infants.

Child Health Services↗
PubMed1987

Disappointing follow-up findings for indigent high-risk newborns.

Indigent populations have received little attention in neonatal follow-up studies. We conducted "blinded" evaluations one year past term for 204 indigent high-risk infants who were ventilator treated or had a very low birth weight (VLBW) (less than or equal to 1500 g) and 85 healthy term controls from families similar to those of the high-risk infants. Marked developmental delay (Bayley Mental Developmental Index, less than 70) or gross motor abnormality occurred in 2% of controls, 27% of VLBW infants, 33% of ventilator-treated infants, and 39% of ventilator-treated VLBW infants. Despite considerable effort to prevent attrition, 43% of high-risk survivors were unavailable for follow-up at the one-year visit. Even if all of these infants were assumed to be normal, the incidence of developmental delay exceeded that in 11 of 12 recent studies. Indigent high-risk infants deserve considerable follow-up attention because of their high rate of attrition and developmental delay.

Anthropometry↗
PubMed1987

Teaching clinic conferences: perceptions of supervisor and peer behavior.

Perceptions of supervisor and peer behavior during teaching clinic conferences, a group supervisory approach, were assessed. Four groups of graduate students participated in a total of 19 teaching clinics. Following each conference, they completed two Individual Conference Rating Scales to describe the supervisor and peer during the interaction. Peer behavior differed from that of supervisors. Differences were also found between supervisors and among groups of students participating in the conferences. A participant's role had no impact on the participants' perceptions of either the peers or supervisors. Variations in perceptions were noted as the number of clinics per group increased.

Education, Graduate↗
PubMed1986

A prospective comparison of selective and universal electronic fetal monitoring in 34,995 pregnancies.

We investigated the effects of using intrapartum electronic fetal monitoring in all pregnancies, as compared with using it only in cases in which the fetus is judged to be at high risk. Predominant risk factors included oxytocin stimulation of labor, dysfunctional labor, abnormal fetal heart rate, or meconium-stained amniotic fluid. This prospective alternate-month clinical trial took place over a 36-month period during which 34,995 women gave birth. In alternate months, either 7 (for "selective monitoring") or 19 (for "universal monitoring") fetal monitors were made available in the labor and delivery unit. During the "selective" months, 6420 of 17,409 women (37 percent) were electronically monitored, as compared with 13,956 of 17,586 women (79 percent) during the "universal months." Universal monitoring was associated with a small but significant increase in the incidence of delivery by cesarean section because of fetal distress, but perinatal outcomes as assessed by intrapartum stillbirths, low Apgar scores, a need for assisted ventilation of the newborn, admission to the intensive care nursery, or neonatal seizures were not significantly different. We conclude that not all pregnancies, and particularly not those considered at low risk of perinatal complications, need continuous electronic fetal monitoring during labor.

Adult↗
PubMed1986

Brainstem auditory evoked potentials in very-low-birth-weight neonates with intracranial hemorrhage.

A study was conducted in very-low-birth-weight (VLBW) neonates to correlate structural damage to the central nervous system due to intracranial hemorrhage (ICH) with electrophysiological function of the lower auditory system as measured by brainstem auditory evoked potentials (BAEP). BAEP testing of 61 VLBW neonates was completed at 36 weeks conceptional age. BAEP Wave III and V latencies significantly increased with increasing severity of ICH. Although significant at conventional levels (P less than 0.05), these correlations were of modest size. Furthermore, after adjusting for the effects of birthweight, hypoxia, lowest pH and associated pCO2 the correlation between ICH and BAEP was reduced in magnitude and no longer significant. Thus, there is little evidence that ICH shortly after birth affected functioning of the auditory brainstem pathways in VLBW neonates at 36 weeks conceptional age.

Brain Stem↗
PubMed1984

Cognitive complexity, rhetorical sensitivity: contributing factors in clinical skill?

Rhetorical sensitivity and cognitive complexity, measures of interpersonal sensitivity and complexity of interpersonal construct systems, were investigated in this study as they relate to clinical skill. A clinical evaluation tool was developed and validated in order to identify outstanding and failing clinicians. Cognitive complexity and rhetorical sensitivity data were collected and analyzed to compare two groups of clinicians representing the extremes of clinical ability. Outstanding and failing clinicians were not differentiated on the basis of these measures. The clinical implications of these findings were addressed.

Adult↗
PubMed1983

Teaching clinic conference participant interaction.

The purpose of this study was to analyze the talk behaviors that occur during teaching clinic supervisory conferences. Two matched groups of five clinicians participated in teaching clinic supervision for 4 wk. Two supervisors alternately supervised both groups. The teaching clinic conferences were videotaped at the end of the second and fourth week. Segments of the conferences were coded using the Multidimensional Observational System for the Analysis of Interactions in Clinical Supervision (MOSAICS). Supervisors, peers, and clinicians did not differ statistically in quantity or in categories of talk during conferences. The teaching clinics appeared to have characteristics of both direct and indirect conferencing. Teaching clinic supervision appeared to foster the development of selfsupervisory behaviors in student speech--language pathologists as reflected by their active conference participation, problem-solving, and strategy development. Participants, in general, expressed satisfaction with the process and its outcomes.

Attitude of Health Personnel↗
PubMed1983

Two Epstein-Barr viral nuclear neoantigens distinguished by gene transfer, serology, and chromosome binding.

We recently identified, by means of cotransformation of LTK- cells, a region of the Epstein-Barr virus (EBV) genome (the BamHI K fragment) that encodes or induces an EBV nuclear neoantigen (EBNA) serologically related to the EBNA found in lymphoid cells carrying the entire EBV genome. We now find that a second EBV DNA fragment, BamHI M, is also able to give rise to cotransformed LTK- cells with stable expression of a nuclear antigen. The BamHI K and M fragments have no apparent DNA homology. Many human sera that are reactive to EBNA in Raji cells detect both antigens; however, certain anti-EBNA-positive human sera are discordant and react only with the BamHI M or only with the BamHI K nuclear antigen. Every Raji cell appears to express both "M" and "K" antigens; D98 Raji cells, a somatic cell hybrid, express only "K" antigen. The K antigen is found on metaphase chromosomes of LTK cells and Raji cells. The M-induced antigen is not located on chromosomes when the cells are in metaphase but is present as granules within the nucleus.

Animals↗
PubMed1982

Culatta and Seltzer content and sequence analysis of the supervisory session: question of reliability and validity.

The Culatta and Seltzer (1976) Content and Sequence Analysis of the Supervisory Session was a pioneer effort in the evolution of an observation tool for use in charting the supervisory conference in speech-language pathology. The purpose of this study was to evaluate the reliability, validity, and practicality of data collected with this system. Supervisory conferences of three certified speech-language pathologists, each of whom supervised four students representing four experience levels, were audiotaped three times. Trained individuals coded specified segments of the conferences using the Culatta and Seltzer system. Data collected with the system was found to be unreliable. The observation system meets criteria for face validity but not content or construct validity. Criterion validity was not evaluated. The major strength of the system is practicality.

Clinical Competence↗
PubMed1982

Students' perceived supervisory needs.

One hundred and ninety-one students from six Michigan University speech-language pathology training programs completed a 43-item questionnaire concerning their perceived supervisory needs in five areas: lesson plan and report writing, supervisor observation, conferencing, professional responsibility, and general supervisory practices. Selection criteria for students were academic status, university attended, and earned clinical clock hours. Student's perceptions of positive and negative supervisory practices differed significantly as a function of earned clinical clock hours and site of training. However, there were no differences in perception between undergraduate and graduate students.

Analysis of Variance↗
PubMed1982

Dreams and dreaming in relation to trauma in childhood.

Mrs C experienced two types of repetitive dream linked with childhood trauma. The first type consisted of primal scene experience expressed in images utilizing typical primary process organization, i.e. condensation, displacement, symbolization and representation in visual or auditory imagery. Associated anxiety was intense but relieved with awakening. The second type of repetitive dream was an experience 'beyond anxiety', 'like being buried in a wave' and was without remembered imagery. The overwhelming anxiety did not dissipate with awakening and only gradually receded over succeeding days. It is hypothesized that these two types of dream are derived from quite different forms of mental organization. The former is linked to typical primary process organization, requiring representational thought, the capacity to manipulate mental images. Condensation, displacement, and symbolization are defining aspects of early forms of representational thought. Piaget has demonstrated that this capacity for manipulation of mental images begins at about 15-24 months. The second type of dream, with imageless terror and diffuse feelings of loss and emptiness, was derived from trauma Mrs C sustained at 2 years of age. It is suggested that this form of dream makes use of sensori-motor organization of mental experience and is similar to phenomena described by Lewin and Isakower. Vignettes from three additional analyses are presented as further examples of dream formation following childhood trauma. Piaget's findings concerning early forms of mental organization are briefly considered. These discoveries are helpful in understanding phenomena derived from early childhood experience.

Adaptation, Psychological↗
PubMed1981

A comparison of the effects of two supervisory styles, conventional and teaching clinic, in the training of speech and language pathologists.

This study compared the teaching clinic, a group form of supervision, to the conventional one-to-one method of supervision. The purpose was to determine if the conventional or teaching clinic method was more conducive to the development of self-supervisory behaviors in student speech pathologists as measured by the talk behaviors that occurred during the supervisory conference. Two matched groups of five clinicians participated in conventional supervision for 4 wk and in teaching-clinic supervision for 4 wk. Two supervisors alternately supervised both groups. The supervisory conferences were videotaped at 2-wk intervals. Segments of the conferences were coded using the Calutta/Seltzer supervisory observation system. The results indicated that the conventional and teaching clinic methods of supervision are viable supervisory methodologies which cannot be differentiated on the basis of talk behaviors occurring during the supervisory conference. Self-supervisory talk behaviors were generated with both methods.

Administrative Personnel↗
PubMed1980

Going forth to meet the environment: a developmental study of seven infants with esophageal atresia.

The development of seven esophageal atresia infants is described. These children differed in the quality of maternal care received and the amount of oral experience permitted during the first year of life. Observation of these infants suggest differences between effects of maternal depression and effects of abnormal oral experiences and provide additional insights on the early formation of motivated activity or intentionality.

Adolescent↗