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Behaviour/mental health problems in young adults with intellectual disability: the impact on families.

BACKGROUND: The present authors studied the impact of dual diagnosis [i.e. intellectual disability (ID) and mental disorder] in young adults on their mothers' perceived levels of stress and decisions about placement. METHODS: The mothers of 103 young adults with severe ID were interviewed using a 2-3-h in-depth protocol of measures designed to assess their child's adaptive functioning, maladaptive behaviour, mental health problems and negative impact on the family, as well as their own thoughts on out-of-home placement. The Scales of Independent Behavior--Revised Problem Behavior Scale assessed problem behaviours and the Reiss Screen assessed mental disorder. RESULTS: These measures were highly correlated (r = 0.64), but tapped some different domains of maladaptive behaviour and proved to be most predictive when employed together. Behaviour and/or mental health (B/MH) problems significantly predicted the mothers' perceived negative impact of the young adult on the family, even after controlling for other young adult characteristics. These problems also predicted the family's steps toward seeking out-of-home placement, as did better young adult health and the mother's higher educational attainment; stress did not predict additional variance in placement once these variables were accounted for. CONCLUSIONS: The discussion focuses on the implications for service provision to families of young adults with B/MH problems.

Activities of Daily Living↗

Fighting back: promoting emancipatory nursing actions.

Poverty, education, and social problems are inextricably linked to health concerns and cannot be addressed in isolation from each other. Nurses are being challenged to care for clients who are socially, politically, and economically disadvantaged. The model of emancipatory nursing actions is derived from the work of Freire, Habermas, and Katz and presented as a practice model in guiding nurses to begin choosing actions that seek to help people fight back from the depths of their despair, rather than helping people cope and adapt to their oppression. Emancipatory interventions are provided to help nurses launch a new direction toward freeing their clients, rather than herding them through an uncaring and disjointed health and social service system.

Adaptation, Psychological↗

Modeling gunshot bruises in soft body armor with an adaptive fuzzy system.

Gunshots produce bruise patterns on persons who wear soft body armor when shot even though the armor stops the bullets. An adaptive fuzzy system modeled these bruise patterns based on the depth and width of the deformed armor given a projectile's mass and momentum. The fuzzy system used rules with sinc-shaped if-part fuzzy sets and was robust against random rule pruning: Median and mean test errors remained low even after removing up to one fifth of the rules. Handguns shot different caliber bullets at armor that had a 10%-ordnance gelatin backing. The gelatin blocks were tissue simulants. The gunshot data tuned the additive fuzzy function approximator. The fuzzy system's conditional variance V[Y/X = x] described the second-order uncertainty of the function approximation. Handguns with different barrel lengths shot bullets over a fixed distance at armor-clad gelatin blocks that we made with Type 250 A Ordnance Gelatin. The bullet-armor experiments found that a bullet's weight and momentum correlated with the depth of its impact on armor-clad gelatin (R2 = 0.881 and p-value < 0.001 for the null hypothesis that the regression line had zero slope). Related experiments on plumber's putty showed that highspeed baseball impacts compared well to bullet-armor impacts for large-caliber handguns. A baseball's momentum correlated with its impact depth in putty (R2 = 0.93 and p-value < 0.001). A bullet's momentum similarly correlated with its armor-impact in putty (R2 = 0.97 and p-value < 0.001). A Gujarati-Chow test showed that the two putty-impact regression lines had statistically indistinguishable slopes for p-value = 0.396. Baseball impact depths were comparable to bullet-armor impact depths: Getting shot with a .22 caliber bullet when wearing soft body armor resembles getting hit in the chest with a 40-mph baseball. Getting shot with a .45 caliber bullet resembles getting hit with a 90-mph baseball.

Computer Simulation↗

Sensory adaptations in Duane's retraction syndrome.

Knowledge of the sensory status of patients with Duane's retraction syndrome is limited. Fourteen patients with type A Duane's retraction syndrome, aged 6 to 22 years, were assessed prospectively and their sensory findings and the nature of their sensory symptoms detailed. All 14 patients had corrected monocular Snellen acuities of 6/9 or better. Six patients were asymptomatic and 5 of these had dense suppression on lateral versions, were free of diplopia and had variable stereopsis. The 5 bilateral cases were among the asymptomatic group. The remaining 8 patients had weak or absent suppression on lateral versions, variable horizontal diplopia and relatively normal stereopsis. Six were aware of diplopia but were never bothered by it and two spontaneously complained of symptoms related to abnormal binocularity (diplopia in one and asthenopia at near in both). It was not [corrected] possible to differentiate the 2 symptomatic cases from the former 6 on the basis of their sensory findings. Patients with type A Duane's retraction syndrome spontaneously complained of symptoms related to abnormal binocularity. The patients least likely to suffer sensory symptoms were bilateral cases or patients with dense suppression on lateral versions, irrespective of their stereoacuity levels.

Adaptation, Ocular↗

In situ determination of sulfide turnover rates in a meromictic alpine lake.

A push-pull method, previously used in groundwater analyses, was successfully adapted for measuring sulfide turnover rates in situ at different depths in the meromictic Lake Cadagno. In the layer of phototrophic bacteria at about 12 m in depth net sulfide consumption was observed during the day, indicating active bacterial photosynthesis. During the night the sulfide turnover rates were positive, indicating a net sulfide production from the reduction of more-oxidized sulfur compounds. Because of lack of light, no photosynthesis takes place in the monimolimnion; thus, only sulfide formation is observed both during the day and the night. Sulfide turnover rates in the oxic mixolimnion were always positive as sulfide is spontaneously oxidized by oxygen and as the rates of sulfide oxidation depend on the oxygen concentrations present. Sulfide oxidation by chemolithotrophic bacteria may occur at the oxicline, but this cannot be distinguished from spontaneous chemical oxidation.

Bacteria↗

Objective evaluation of sensorial and sensorimotorial status in esotropia: their importance in surgical prognosis.

Appropriate use of base-out prisms may be useful objective test for detecting persistence of normal binocular vision (4-dioptre prism test). By prolonged observation of prismatic correction of an esotropic patient one may infer the presence of an anomalous sensorial status. This can be done when the prismatic correction is compensated for by an increase of the angle of esotropia (prism adaptation test). The increase in the angle of esotropia induced by base-out prisms, here called anomalous movements, is probably related to a type of anomalous movement fusional in nature. When anomalous movements are present, it is important to realise how powerfully they have developed. This may be inferred by determining what amount of prism overcorrection of the esotropic angle the patient is capable of compensating for (progressive prism compensation test). This has important implications for surgery. It has been statistically demonstrated that esotropia with strong anomalous movements tends to respond less effectively to surgery than esotropia without or with weak anomalous movements.

Adaptation, Ocular↗

Perception.

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Adaptation, Ocular↗

Endocrine function and emergency contraception: physiology and society.

Relating emergency contraception, commonly referred to as "the morning-after pill," to the menstrual cycle can be used both to teach endocrine function and to show how physiology relates to the world outside the undergraduate classroom. The menstrual cycle is an excellent topic for teaching many features of the physiology of the human endocrine system. Relating emergency contraception to the menstrual cycle makes this topic relevant to both male and female students, provides opportunities for discussions that require the students' understanding of endocrine functions, and illustrates how physiology is connected to social economic, and political issues. The overview of emergency contraception and literature survey provided here are meant to be adapted for use in a variety of teaching contexts. The depth of coverage and the extent of consideration of issues beyond physiology would depend on many factors including the level fo the course and the size of enrollment.

Contraception↗

Intermittent exotropia: stimulus characteristics affect tests for retinal correspondence and suppression.

BACKGROUND AND PURPOSE: Prior studies have reported various sensory responses in subjects with intermittent exotropia [X(T)]. These varying responses have been proposed due to differences in stimulus targets, backgrounds, or even a lack of control of binocular alignment. This study investigated the effects of varying target and background stimuli while controlling binocular alignment. METHODS: Eight X(T)s of the divergence excess or basic type were presented dichoptic computer generated visual stimuli while an infra red eye movement monitoring system determined horizontal eye position of each eye. Target and background were varied to assess their effect on sensory responses during latent and manifest exotropia. RESULTS: Most of our X(T)s demonstrated, while tropic, a consistent, i.e., dominant, type of retinal correspondence, i.e. a response that occurred on most tests, independent of the stimulus or background used for testing. Four subjects demonstrated harmonious anomalous retinal correspondence (HARC) while three subjects demonstrated normal retinal correspondence (NRC) with three out of four of the tests. In two out of four stimuli used for testing, one subject demonstrated NRC and another HARC. CONCLUSIONS: Complex backgrounds resulted in the largest number of suppressions, whereas blank backgrounds decreased the number of reported suppressions.

Adaptation, Ocular↗

Perceptual adaptation to spectrally shifted vowels: training with nonlexical labels.

Although normal-hearing (NH) and cochlear implant (CI) listeners are able to adapt to spectrally shifted speech to some degree, auditory training has been shown to provide more complete and/or accelerated adaptation. However, it is unclear whether listeners use auditory and visual feedback to improve discrimination of speech stimuli, or to learn the identity of speech stimuli. The present study investigated the effects of training with lexical and nonlexical labels on NH listeners' perceptual adaptation to spectrally degraded and spectrally shifted vowels. An eight-channel sine wave vocoder was used to simulate CI speech processing. Two degrees of spectral shift (moderate and severe shift) were studied with three training paradigms, including training with lexical labels (i.e., "hayed," "had," "who'd," etc.), training with nonlexical labels (i.e., randomly assigned letters "f," "b," "g," etc.), and repeated testing with lexical labels (i.e., "test-only" paradigm without feedback). All training and testing was conducted over 5 consecutive days, with two to four training exercises per day. Results showed that with the test-only paradigm, lexically labeled vowel recognition significantly improved for moderately shifted vowels; however, there was no significant improvement for severely shifted vowels. Training with nonlexical labels significantly improved the recognition of nonlexically labeled vowels for both shift conditions; however, this improvement failed to generalize to lexically labeled vowel recognition with severely shifted vowels. Training with lexical labels significantly improved lexically labeled vowel recognition with severely shifted vowels. These results suggest that storage and retrieval of speech patterns in the central nervous system is somewhat robust to tonotopic distortion and spectral degradation. Although training with nonlexical labels may improve discrimination of spectrally distorted peripheral patterns, lexically meaningful feedback is needed to identify these peripheral patterns. The results also suggest that training with lexically meaningful feedback may be beneficial to CI users, especially patients with shallow electrode insertion depths.

Adaptation, Physiological↗

[Light absorption by carotenoid peridinin in zooxanthellae cell and setting down of hermatypic coral to depth].

Carotenoid peridinin absorbs ocean light which could penetrate deep into the water. Absolute and relative contents of symbiotic dinoflagellatae zooxanthellae are increased with depth of habitat of germatypic corals. To estimate whether the presence of peridinin in corals is chromatic adaptation or not, the absorbance of solar radiation by different amounts of peridinin and chlorophyll in natice zooxanthellae cells was evaluated. Calculations have shown that at the great depths the peredinin absorbance corresponds to 42% of total cell absorbance and that the increase of light absorbance correlating with changes of its spectral characteristics is entirely determined by presence of this carotenoid. The increase of amount of peridinin in cell is as much important as important the increase of all other pigments taken together. However, at the same time selective and preferential accumulation of peridinin and the change of its native state in the limits naturally occurred in zooxanthellae cells have only low impact on the light absorbance. The presence of peridinin could be considered as manifestation of chromatic adaptation of organism. The comparison of light absorption by zooxanthellae with different content of peridinin (or without peridinin) reveals that this pigment expands the habitat of hermatypic corals in ocean waters at 8-17 meters into the deep.

Adaptation, Physiological↗

Multiwindow scatter correction techniques in single-photon imaging.

We studied the performance of linear scatter correction methods for single-photon imaging with Tc-99m and Tl-201, using a numerical model of the Rollo phantom and measurements with a gamma camera modified to record position and energy information in list mode form. We compared the performance of these methods to per-image optimized linear methods and to locally adaptive linear methods, and developed estimates of the limits on accuracy of scatter correction imposed by the presence of Poisson noise. For both Tc-99m and Tl-201 imaging at a fixed depth, particularly at low count rates, the performance of dual-window methods, or of adaptive methods, is near the best possible for linear methods. Smoothing of the scatter estimate results in minor improvement for Tl-201. Substantial gaps between the performance of any of these linear methods and the limits imposed by Poisson noise remain and are due primarily to bias, with the gap for Tl-201 being larger than that for Tc-99m.

Algorithms↗

Small-scale navigation in the honeybee: active acquisition of visual information about the goal

In a series of behavioural studies we found that bees use depth information extracted from self-induced image motion in several visual tasks involving pin-pointing the goal. Some of the results are reviewed here in an attempt to emphasise the active nature of this performance. They show that bees acquire depth information during free flight by employing two different strategies. One is to adapt flight behaviour, upon arrival at the food source, to the requirements of the task, a performance that is based on a learning process. The other is based on a stereotyped, innate flight pattern performed upon departure from the food source. The latter has probably evolved specifically for the acquisition of depth information.

Journal Article↗

Epidermal growth factor stimulates the recovery of glucose absorption after small bowel transplantation.

Epidermal growth factor (EGF) has been reported to enhance adaptation in damaged intestines following massive intestinal resection. Studies were performed to determine whether EGF influences the recovery of intestinal function after small bowel transplantation in rats. Recipient Lewis rats underwent resection of the distal 80% of the small bowel, which was replaced with a 20-cm isograft. EGF (30 microg/kg/day) or its vehicle (control) was infused intraperitoneally for 3 days after transplantation. After 7 days, the graft was isolated for morphologic studies and was used for analysis of glucose and water absorption and the expression of sodium glucose cotransporter (SGLT1). These were used as indicators of functional adaptation. The EGF-treated group exhibited significantly increased mucosal villous height, crypt cell proliferation, glucose and water absorption, and expression of SGLT1 protein compared to the control group. No significant differences were found in body weight change or crypt depth between the two groups. These results demonstrate that EGF augments structural and functional adaptation of intestinal grafts in rats. EGF may be useful after intestinal transplantation in patients with short bowel syndrome.

Animals↗

Total parenteral nutrition inhibits intestinal adaptive hyperplasia in young rats: reversal by feeding.

To determine whether the inhibition of intestinal adaptation by total parenteral nutrition (TPN) in young growing animals is reversible, 130 7-week-old rats with 70% resection of the midportion of the small bowel were given an amino acid and glucose TPN solution parenterally or orally or a chow diet for 10 days. After TPN administration, villous height, crypt depth, DNA and RNA content, RNA:DNA ratio, and sucrase activity were decreased. After returning to 4 weeks of chow feeding, rats given TPN achieved similar body weight and 15% greater intestinal length as compared with rats fed chow from the start, although their jejunal villous height, ileal crypt depth, and RNA:DNA were decreased. Therefore, the inhibition by TPN of intestinal adaptation after intestinal resection in young growing rats is largely reversible. Furthermore, oral feeding of a high-calorie, high-protein liquid diet before feeding of a normal diet appears to promote adaptation after intestinal resection in immature, growing rats.

Adaptation, Physiological↗

Psychosocial responses to spinal cord injury.

Spinal cord injury (SCI) is devastating both physiologically and psychologically. The psychosocial responses to SCI are the focus of this article. The following nursing diagnoses as they relate to the acute SCI population are examined in detail: disturbance in self-concept (body image, self-esteem, and role performance); powerlessness; functional grieving; and alteration in family process. Each nursing diagnosis will be explored in depth.

Adaptation, Psychological↗