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A study of neonatal deaths in the tea gardens of Dibrugarh district of upper Assam.

A total of 2432 live births and 46 stillbirths were studied in some of the tea gardens of Dibrugarh district of upper Assam. The neonatal mortality rate was 46.5 per 1000 live births per year. Immaturity (21.2%), fever/sepsis (13.3%), breathing disorder (12.4%), neonatal tetanus (11.5%) and neonatal diarrhoea (8.8%) accounted for most of the neonatal deaths. There were 42.9% low birth weight infants and this was associated with 92.8% of total neonatal deaths and 34.3% of preterm babies were associated with 90.7% of neonatal deaths. The case fatality rate among low birth weight and preterm babies was 9% and 11% respectively. High risk of neonatal deaths had been found among the neonates in case of no maternal immunisation, delivery attended by untrained person and newborn care at home.

Cause of Death↗

[Ego development in the transition from adolescence to young adulthood: an empirical comparative study of psychiatric patients and healthy control probands].

The model of ego development by Loevinger describes an epigenetic series of successive stages comprising increasingly complex styles of impulse control, interpersonal relationships, moral and cognitive reasoning. This model offers an opportunity to explore the structural premises young adults rely on solving their developmental tasks. Controls compared to patients show a significantly superior intrapsychic coping, awareness of social rules and knowledge of interpersonal relations. Except non-psychotic patients who seem to dispose of slightly more mature ego capacities than psychotic patients there prevails a dominant psychosocial immaturity among all patient subgroups however. The results are discussed in relation to psychopathological syndromes, the actual status of a psychiatric illness, and differently favourable patterns of psychosocial adaptation defined by results in the Offer-Self-Image-Questionnaire.

Adolescent↗

Psychodynamic and cognitive mechanisms of change in adult therapy: a pilot study.

To examine the effects of the patient-level mechanisms of change postulated by cognitive-behavioral theory and psychodynamic theory, thirty-three patients in eclectic therapy completed questionnaires at two time points. Decreases in automatic thoughts and immature defenses were each associated with lower symptoms, and were correlated with one another at the level of a trend. The theorized patient mechanisms of cognitive-behavioral therapy and psychodynamic therapy are independently active in eclectic therapy. Implications for research and clinical practice are discussed.

Adult↗

Comparison of ego defenses among physically abused children, neglected, and non-maltreated children.

The nature and level of ego functioning were assessed in 41 recently detected physically abused children, and in two control groups of 38 neglected and 35 non-abused/non-neglected children (aged 6 to 12 years), using the Child Suicidal Potential Scales (CSPS). The results obtained in this study support the hypothesis that the influences of parental violence on the child's ego functions are detrimental, as reflected by significantly higher impairments in affect regulation (like irritability, anger, passivity, depression), low levels of impulse control, distortions in reality testing, and extensive operation of immature defense mechanisms in the physically abused children in comparison to the controls. Significant differences between the physically abused and the non-abused/non-neglected children were found for all mechanisms except displacement. The differences between the physically abused and neglected children for regression, denial and splitting, projection, and introjection (high scores for the physically abused children), and for compensation and undoing (higher scores for the neglected children) were also significant. It is suggested that physically abused children should be distinguished as a high-risk population for future personality disorders.

Case-Control Studies↗

PMN heterogeneity: long-term stability of fluorescent membrane potential responses to the chemoattractant N-formyl-methionyl-leucyl-phenylalanine in healthy adults and correlation with respiratory burst activity.

Polymorphonuclear neutrophils (PMNs) were isolated from 24 healthy adults 20 to 61 years of age and the proportion of cells that demonstrated depolarization responses to the synthetic chemotaxin N-formyl-methionyl-leucyl-phenylalanine (FMLP) were enumerated using the lipophilic fluorescent cyanine dye 3,3'-di-pentyl-oxacarbocyanine [di-O-C(5)(3)] and flow cytometry. The membrane potential responses were correlated to the cells' respiratory burst capabilities as measured by nitroblue tetrazolium (NBT) reduction and/or superoxide production in response to FMLP; 40.2% +/- 15.1% (mean +/- SD) of cells depolarized to FMLP. The mean SE for duplicate determinations 1 hour apart was 3.8% (range 0.4% to 13.6%, n = 15). There was no correlation between the percentage of depolarizing PMNs and the yield of cells, the percentage of immature cells, or the circulating WBC count. There was no difference in the average age of men (34.9 +/- 9.9 years, n = 11) v women (33.8 +/- 8.5, n = 13) (mean +/- SD) studied, or in the percentage of depolarizing PMNs when men and women were compared (42.2 +/- 10.6% v 43.1 +/- 13.3%, respectively). However, there was a significant increase in the percentage of depolarizing PMNs with increasing age of women (r = .61, P less than .025) but not men (r = .03, P greater than .05). Analysis of variance revealed significantly greater person-to-person variability in the membrane potential response than in day-to-day variability in the same person (P less than .0005). The percentage of depolarizing PMNs in response to FMLP was significantly correlated with the percentage of NBT-positive cells from both purified PMNs and from whole blood (r = .849, P less than .0005, r = .857, P less than .05, respectively), and with the amount of superoxide produced, expressed as a percentage of that amount produced by cytochalasin B (cyto-B)-pretreated cells (r = .565, P less than .01). The data indicate that PMNs from healthy adults demonstrate a heterogeneous membrane potential response to the chemotaxin FMLP that correlates with the cells' oxidative responsiveness and that intersubject differences can be detected. In addition, the proportion of responsive PMNs increases with increasing age in women.

Adult↗

Mathematical model of CD4+ lymphocyte depletion in HIV infection.

The CD4+ lymphocyte depletion in human immunodeficiency virus (HIV)-infected persons seems to be affected by HIV products. As the dynamics of the concentration of HIV products is reciprocal to that of non-replicating antigen used for induction of tolerance, the mathematical model of immunological tolerance can be used to describe the dynamics of CD4+ lymphocyte depletion. To stimulate the clinically observed dynamics, it is necessary to include the limitation of HIV growth by the corresponding cytotoxic T cells and their dependence on the helper effect of CD4+ lymphocytes. Simulation analysis suggests that qualitatively similar results are obtained if immature, mature, or both categories of CD4+ lymphocytes considered in the model are depleted by the HIV products.

Acquired Immunodeficiency Syndrome↗

Antibody prevalence to HBLV (human herpesvirus-6, HHV-6) and suggestive pathogenicity in the general population and in patients with immune deficiency syndromes.

Detailed serologic screening showed an antibody prevalence to HBLV (HHV-6) in the general population of 26% if very strict criteria for antibody positivity were applied. Lower and borderline antibody titers yet may be found in up to 63% of the population. Only 17% of these persons have clinical symptoms; in the majority infection remains silent. HHV-6 infection apparently occurs already quite early in life, and initial symptoms can occur, such as short-term high fever, sore throat, local lymphadenopathy and skin rash. Lesions disappear without specific treatment. The frequency of positive antibody tests at higher titers rises in patients with immune deficiency and with atypical lymphoproliferative diseases to 60 and 75%. The rise in antibody titers is associated in patients with immune deficiency by characteristic shifts of blood lymphocyte populations, essentially by increase in immature T-lymphocytes. Highest titers are found in patients with lymphoproliferative syndromes, yet the percentage of atypical lymphoid cells harboring the viral genome is low (about 2% of seropositive patients). Thus it appears, that HBLV, similar to other herpesviruses such as Epstein-Barr virus, usually causes a silent seroconversion, yet may be associated with variable clinical pathology when persisting in an active state. Its pathogenic effect might be rather a cofactor contributing to immune disturbance than overt oncogenicity.

Acquired Immunodeficiency Syndrome↗

The evolution and function of adult attachment: a comparative and phylogenetic analysis.

Although the evolutionary functions of attachment in infant-caregiver relationships are undisputed, it is unclear what functions--if any--attachment serves in adult romantic relationships. The objective of this research was to examine the evolution and function of adult attachment (i.e., pair bonding) by applying comparative and phylogenetic methods to archival data collected on 2 diverse samples of mammalian species. The authors found that species exhibiting adult attachment were more likely than others to be characterized by paternal care, developmental immaturity or neoteny, small social groups, and small body sizes. The authors also used phylogenetic techniques to reconstruct the evolution of adult attachment and test alternative evolutionary models of the comparative correlates of pair bonding. Phylogenetic analyses suggested that the relationship between paternal care and adult attachment may be a functional one (i.e., due to convergent evolution) but that the relationship between neoteny and adult attachment may be due to homology (i.e., shared ancestry). Discussion focuses on the potential of comparative and phylogenetic methods for advancing the science of social and personality psychology.

Adult↗

Developmental aspects of psychological defenses: their relation to self-complexity, self-perception, and symptomatology in adolescents.

This study investigated developmental aspects of psychological defenses in relation to self-complexity, self-perception, and symptomatology through a comparison of two groups of adolescents characterized by defense maturity level (i.e., immature versus mature defenses). The Defense Style Questionnaire (DSQ-78), the Self-Complexity Inventory (SCI), the Self-Perception Profile for Adolescents, and the Youth Self Report behavior checklist (YSR) were completed by 79 high school students ranging in age from 15 to 18 years. Subjects were characterized as either employing predominantly mature or immature defensive strategies based on median splits of the two defense factors. Dependent variables included the Self-Complexity Inventory, The Youth Self Report and the Self-Perception Profile for Adolescents. The mature defense group (N = 26) reported significantly higher self-complexity than the immature defense group (N = 26), supporting a developmental approach to defense mechanisms. In general, mature defense mechanisms seem to be more adaptive in late adolescence than immature defenses as indicated by higher global self-worth and fewer internalizing and externalizing symptoms. The findings lend support to the developmental approach to the self and highlight the importance of examining psychological indices of development independent of chronological age.

Adaptation, Psychological↗

Effect of amphetamines on speech defects in the mentally retarded.

In a double-blind study, 106 mentally retarded patients with speech defects were given 15 mg. of d-Amphetamine daily, or a placebo, for a three-month period. Speech defect types were: Stuttering, immature production, oral inaccuracy, lisp, psychotic, mongoloid, aphasia, deafness, and cleft palate. Only the stutterers showed obvious improvement in comparison with the placebo group. Three severe, long-term stutterers showed such dramatic improvement that their whole course in life has been changed.

Amphetamine↗

[Psychological aspects of Prader-Willi syndrome. Results of a parent survey].

Forty-six parents of children and adolescents with Prader-Willi syndrome reported on the social and emotional behavior of their children and on parenting stress. Standardized questionnaires were used, e.g. a German behavioral questionnaire for preschool children and the Child Behavior Checklist. The results showed a high frequency of problem behaviors, including stubbornness, temper tantrums, obsessions and underactivity. In comparison to age norms, 40% of the preschool children were socially immature and 20% had social adaptation problems. Among the school-age children 70% had social adaptation problems. More than 70% of the mothers reported a high level of parenting stress and are in need of psychological counseling.

Adaptation, Psychological↗

Trauma and defense style as response predictors of pharmacological treatment in panic patients.

BACKGROUND: As panic disorder (PD) has a chronic course, it is important to identify predictors that might be related to non-remission. The aim of this study is to verify whether history of trauma and defense style are predictors to pharmacological treatment response in PD patients. METHOD: The sample was composed by 47 PD patients according to DSM-IV who were treated with sertraline for 16 weeks. Evaluations were assessed by the C.G.I. (Clinical Global Impression), the Hamilton-Anxiety Scale, the Hamilton-Depression Scale, the Panic Inventory and the DSQ-40 (Defense Style Questionnaire) at baseline and after treatment. RESULTS: Full remission was observed in 61.7% of the sample. The predictors significantly associated with non-remission were: severity of PD (p=0.012), age of onset (p=0.02) and immature defenses (p=0.032). In addition, the history of trauma was associated with early onset of PD (p=0.043). CONCLUSION: Panic patients had as predictors of worse response to pharmacological treatment the early onset and the severity of PD symptoms as well as the use of immature defenses at baseline. This finding corroborates the relevance of the evaluation of factors that might affect the response so as to enable the development of appropriate treatment for each patient.

Adult↗

Perfectionism, ego defense styles, and depression: a comparison of self-reports versus informant ratings.

The present study examined the associations among perfectionism, defense styles, and depression in an Israeli community sample of young adults. This study involved a comparison of self-reports and informant ratings on all measures. A community sample of 210 pairs of same-sex best friends from Israel completed the Multidimensional Perfectionism Scale, the Defense Styles Questionnaire - 40, and a depression measure. Analyses confirmed that socially prescribed perfectionism is associated with depression, not only in terms of self-reports but also in terms of informant ratings. In addition, informant ratings revealed a link between other-oriented perfectionism and depression. Both self-reports and informant ratings also indicated that socially prescribed perfectionism is associated with immature defense styles and neurotic defense styles. Further simultaneous Structural Equation Modeling (SEM) analyses of self-reports and informant ratings showed that maladaptive defense styles mediate the link between socially prescribed perfectionism and depression. The practical and theoretical implications of these findings are discussed.

Adaptation, Psychological↗

Pubertal growth and sexual maturation for adolescents with chronic illness or disability.

In adolescents with chronic illness or disability, the progress of puberty may be abnormal. Growth or sexual maturation may be delayed. In some cases, adulthood may be characterized by short stature or sexual immaturity. Genetic endowment, nutritional deficiency, or concomitants of treatment all may contribute to disordered growth; frequently the basis of abnormal physical development in adolescence is multifactorial. This paper reviews the major mechanisms by which chronic conditions may interfere with puberty and discusses the effects of common chronic conditions on the pubertal process.

Adolescent↗

A rapid method of estimating the abundance of immature blackflies (Diptera: Simuliidae).

A ten-point visual method of estimating the abundance of immature blackflies in the field is proposed and tested. The method is based on the comparison of larvae and pupae found on natural substrates, with ten diagrammatically prepared abundance classes. When estimates were based on the abundance of blackflies within a 4 x 4 cm area of highest density, there were no significant differences between estimates based on the ten-point visual method and those based on actual counts (P > 0.05). The time taken to assess the abundance of larval blackflies on 30 substrates was about 15 min, depending on substrate accessibility. Personal bias was assessed independently by four people, and was negligible when estimates were based on the highest densities within a 4 x 4 cm quadrat. The method tends to overlook very small larvae, and is not recommended for estimating overall population densities. However, the method provides a reliable, practical and rapid index of blackfly abundance suitable for use in blackfly control programmes.

Animals↗

[Lymph node tuberculosis in HIV-1 seropositive patients in Central Africa. A characteristic histopathologic picture].

Sixty two patients fulfilling the definition established by the Centers for Disease Control in 1982 for persistent lymphadenopathy syndrome, thought to be related to the human immunodeficiency virus (HIV) infection, were selected at the Butare university hospital, in Rwanda, between 1987 and 1988. Forty-five (73%) of them were indeed seropositive. Fifteen patients of sixty two (24%) presented unexpectedly evidence of tuberculous adenitis on biopsy. Three of them, found HIV-1 seronegative, showed a classical follicular adenitis, whereas the twelve other seropositive patients presented unusual histologic features, consisting of more or less immature tuberculoid granulomas with an abundant caseating and often granular necrosis, containing acid fast bacilli. Numerous blood vessels and abundant plasmacytosis were found in non-necrotic areas. Semi-quantitative evaluation of the granulomatous reaction components provided a histological spectrum probably related to the degree of impairment of the cellular immune response, which could be of prognostic significance. In areas where populations are exposed to both HIV and M. tuberculosis, it appears that lymph node biopsy with mycobacterial culture should be recommended in order to detect occult tuberculosis among HIV-seropositive persons, allowing accurate medical care and adequate public health surveillance.

AIDS-Related Opportunistic Infections↗

Sex differences in the relationship between interpersonal problems and defensive style.

Horowitz, et al.'s Inventory of Interpersonal Problems and Bond, et al.'s Defensive Style Questionnaire were completed by 42 women and 35 men. Significant correlations emerged between most interpersonal problems and the tendency for both men and women to use immature and intermediate defense mechanisms in both work and intimate relationships. However, women were more likely than men to employ immature defenses when dealing with issues of "control" in intimate relationships while men were more likely to employ intermediate defenses in response to problems with "intimacy" in work relationships. Data support further inquiry into sex differences in interpersonal problems and defensive style.

Adult↗

The Revised Behavior Problem Checklist and severely emotionally disturbed adolescents: relationship to intelligence, academic achievement, and sociometric ratings.

This study explored the relationship among the subscales of the Revised Behavior Problem Checklist and intelligence, academic achievement, and sociometric ratings for a sample of 62 severely emotionally disturbed adolescents enrolled in a special school. A relationship of the Attention Problems-Immaturity subscale with intelligence scores and mathematics achievement was found. Four of six subscales were found to be related to peer sociometric ratings of social acceptance, while only one subscale was related to sociometric ratings of peer acceptance of his/her classmates. These findings are discussed within the context of previous research.

Achievement↗