Biomedical subjects

Sandra Hale

Publications and source records attributed to Sandra Hale.

8 recordsLinked to original sources

PubMed2006

Corticosteroid therapy in the age of infliximab: acute and 1-year outcomes in newly diagnosed children with Crohn's disease.

BACKGROUND & AIMS: The aim of this study was to describe 3-month and 1-year outcomes of children with Crohn's disease (CD) treated with corticosteroids within 30 days of diagnosis, with particular emphasis on the influence of infliximab on these outcomes. We also aimed to determine whether there are clinical or laboratory characteristics associated with corticosteroid therapy outcomes. METHODS: Data from 109 children were drawn from a multicenter observational registry that was started in 2002. Clinical characteristics and data on corticosteroid and other therapies were recorded prospectively. Corticosteroid therapy outcomes at 3 months were defined as complete acute response, partial response, or corticosteroid resistance. At 1 year, corticosteroid responsiveness, dependence, and surgical rates were determined. Infliximab's influence on short- and long-term outcomes also was investigated. RESULTS: At 3 months, 65 of 109 (60%) patients had a complete acute response to corticosteroids, 26 (24%) had a partial response, and 18 (17%) were corticosteroid resistant. At 1 year, 61% were corticosteroid responsive, 31% were corticosteroid dependent, and 8% required surgery. Irrespective of the duration of corticosteroid treatment, 16 of 24 of corticosteroid-dependent/resistant patients rapidly discontinued corticosteroids after starting infliximab. No clinical or laboratory characteristics at diagnosis predicted short-term outcome. Growth impairment at diagnosis increased risk for corticosteroid dependence or surgery at 1 year. CONCLUSIONS: At 3 months, 84% of children had a complete or partial response to corticosteroids. However, despite concomitant immunomodulators, at 1 year 31% were corticosteroid dependent and 8% required surgery. Infliximab improves outcomes of corticosteroid-dependent/resistant patients because the duration of corticosteroid use can be controlled by initiating treatment with infliximab.

Adolescent↗

PubMed2006

Are there age differences in intraindividual variability in working memory performance?

It has been suggested, primarily based on response time (RT) data, that there is an age-related increase in intraindividual variability. To determine whether older adults show more intraindividual variability in working memory (WM) performance, we had younger and older adults perform three verbal WM tasks of varying complexity as well as a same-different judgment RT task. For both groups, individual performance tended to be more variable on the two complex span tasks than on the simple span task. Although older adults showed greater variability on the RT task, consistent with previous studies, they did not show greater variability on any of the WM tasks. These findings fail to support theories of frontal lobe aging that predict greater moment-to-moment fluctuations in the performance of older adults.

Adolescent↗

PubMed2006

Saying versus touching: age differences in short-term memory are affected by the type of response.

We examined whether the type of response used to report items recalled from short-term memory affects the age difference in verbal and spatial memory spans. Younger and older adults viewed either a series of letters or a series of locations in a grid, and then they reported their memory for the items either vocally or by using a touch screen. Overall, age differences were larger for spatial memory spans than for verbal memory spans, replicating previous results. Changing the response modality affected only older adults' verbal spans, which were approximately one item higher with a vocal response than with a manual response. This resulted in a smaller age difference for verbal items reported vocally than for any other condition. The results can best be explained by age-related difficulties in both spatial processing and in dealing with stimulus-response incongruity.

Age Factors↗

PubMed2006

Health-related quality of life in the first year after a diagnosis of pediatric inflammatory bowel disease.

BACKGROUND AND AIMS: Assessment of health-related quality of life (HRQOL) is of increasing importance in the evaluation of new therapies for inflammatory bowel disease (IBD). Available data concerning HRQOL in pediatric patients are sparse and uniformly cross-sectional. The aim of this study was to describe HRQOL and influential factors in newly diagnosed pediatric patients with Crohn's disease and ulcerative colitis during the first 12 months after diagnosis. MATERIALS AND METHODS: Participants were drawn from a large, prospectively derived observational IBD registry of pediatric patients studied through 18 U.S. and Canadian centers. Patients who had completed a baseline IMPACT questionnaire and for whom there were 12 months of follow-up data available were included. In addition to description of cohort, factors that were believed to influence HLQOL were assessed during the course of the year from diagnosis. RESULTS: Two hundred eighteen children met inclusion criteria (77% Crohn's disease, 23 % ulcerative colitis, mean age 12.7 +/- 1.9 years). Mean total IMPACT score at baseline was 154, 181 at 6 months, and 191 at 1 year (possible range 0-238, with increasing scores representing better quality of life). Repeated measures analysis showed that age and disease severity significantly negatively affected the IMPACT scores during the course of the year. CONCLUSIONS: In this large prospective pediatric IBD cohort, significant improvement in HRQOL is noted during the year from diagnosis. Mean IMPACT scores varied significantly depending on the disease severity and also decreased with increasing age.

Adolescent↗

PubMed2005

It's the activity that counts: what clients value in psycho-educational groups.

BACKGROUND: This qualitative pilot research study provides client-centred outcomes by evaluating psycho-educational groups from the clients'perspective. PURPOSE: This study was designed to determine what clients value in three psycho-educational groups offered in an acute inpatient psychiatric setting. METHODS: Interviews lasting 30 to 60 minutes relating to the 8 participants group experiences were recorded and transcribed verbatim. A constant comparative approach was used to analyze data allowing for both expected and emergent themes to be integrated into later interviews. RESULTS: Identified themes were group structure, readiness to attend groups and process information, and group milieu. Participants valued voluntary attendance and supportive milieu of groups. Insertion of relevant activity into groups to promote interaction, learning and information retention was also valued. PRACTICE IMPLICATIONS: Occupational therapists offering mental health groups should consider a number of factors. These include the importance of transitioning clients from activity groups to psycho-educational groups, as well as the value clients place in determining their readiness to attend a group and having a supportive milieu with limits to emotional disclosure.

Canada↗

PubMed2003

Analysis of group differences in processing speed: Brinley plots, Q-Q plots, and other conspiracies.

Researchers in a growing number of areas (including cognitive development, aging, and neuropsychology) use Brinley plots to compare the processing speed of different groups. Ratcliff, Spieler, and McKoon (2000) argued that a Brinley plot is a quantile-quantile (Q-Q) plot and that therefore Brinley plot regression slopes measure standard deviation ratios rather than relative speed of processing. We show that this argument is incorrect. Brinley plots, by definition, are not Q-Q plots; the former are based on unranked data and the latter are based on ranked data. Furthermore, the relationship between standard deviation ratios and slopes is a general property of regression lines and has no implications for the use of Brinley plot regression slopes as processing speed measures. We also show that the relative speed interpretation of Brinley plot slopes is strongly supported by converging evidence from a metaanalysis of visual search, mental rotation, and memory scanning in young and older adults. As to Ratcliff et al.'s hypothesis that age differences in response time are attributable to greater cautiousness on the part of the elderly, rather than true processing speed differences, this hypothesis has been extensively tested in previous studies and found wanting.

Adult↗

PubMed2003

The difference engine: a model of diversity in speeded cognition.

A theory of diversity in speeded cognition, the difference engine, is proposed, in which information processing is represented as a series of generic computational steps. Some individuals tend to perform all of these computations relatively quickly and other individuals tend to perform them all relatively slowly, reflecting the existence of a general cognitive speed factor, but the time required for response selection and execution is assumed to be independent of cognitive speed. The difference engine correctly predicts the positively accelerated form of the relation between diversity of performance, as measured by the standard deviation for the group, and task difficulty, as indexed by the mean response time (RT) for the group. In addition, the difference engine correctly predicts approximately linear relations between the RTs of any individual and average performance for the group, with the regression lines for fast individuals having slopes less than 1.0 (and positive intercepts) and the regression lines for slow individuals having slopes greater than 1.0 (and negative intercepts). Similar predictions are made for comparisons of slow, average, and fast subgroups, regardless of whether those subgroups are formed on the basis of differences in ability, age, or health status. These predictions are consistent with evidence from studies of healthy young and older adults as well as from studies of depressed and age-matched control groups.

Cognition↗

PubMed2002

Age-related dedifferentiation of visuospatial abilities.

Forty-eight older adults were tested on a battery of seven speeded visuospatial tasks that were developed by Chen et al. to measure the functions of the ventral and dorsal neural processing streams. Principal components analysis revealed only one factor with an eigenvalue greater than 1.0, and all of the tasks loaded heavily on this general factor. These results are in contrast to those reported in a previous study of young adults in which principal components analysis revealed two factors with eigenvalues greater than 1.0. Importantly, for young adults the second principal component was a bipolar factor which grouped the tasks based on the neural processing stream (i.e. ventral versus dorsal) whose function they had been designed to assess. The age-related difference in the factor structure of visuospatial abilities apparent from the present results may be interpreted as reflecting an age-related dedifferentiation of the neural processing streams consistent with the results of recent neuroimaging studies.

Aged↗