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PubMed2001

The immune system gets nervous.

It is becoming increasingly apparent that there exists an intimate bidirectional communication between the immune system and the nervous system. However, the field of 'neuroimmunology' has--for both mainstream immunologists and neuroscientists alike--often seemed more a realm of anecdotal, if not somewhat quirky, observations made by enthusiastic amateurs working at the fringes of each of the 'serious' mainstream disciplines. This perception is gradually changing as the detailed taxonomy of the immune system reveals that the component cells are equipped to respond to a plethora of soluble chemical messengers including serotonin, catecholamines, neurotrophins, opioids and several neuropeptides that, conventionally, have been considered as restricted to the neuroendocrine axis.

Animals↗

PubMed2000

Epileptic syndromes, cognitive assessment and school placement: a study of 251 children.

Two-hundred and fifty-one children (98 girls and 153 boys, aged from 3 to 17 years) with documented diagnosis of epileptic syndrome, IQ measurement, and information on school placement were included in this retrospective study. The relations between these three parameters as well as effects of age at onset and duration of epilepsy, seizure frequency, and number of antiepileptic drugs (AEDs) were analysed. Both IQ and schooling were univariately related to epileptic syndrome, age at onset and duration of epilepsy, and number of AEDs; seizure frequency was related to IQ but not to school placement. Multiple regression showed that IQ was independently related to epileptic syndrome and AED; multiple logistic regression showed that type of school (mainstream versus adapted or special) was independently related to IQ and AED. Children with idiopathic generalised or with localisation-related epilepsy had higher IQ scores and higher probability of mainstream schooling than those with symptomatic or cryptogenic generalised epilepsies or epileptic syndromes which were undetermined. Subtests profile of intelligence scale in localisation-related epilepsies showed different specific cognitive deficits, according to the location of the epileptic focus.

Adolescent↗

PubMed1997

What should be the focus of emotion regulation in children? A nonlinear dynamic mathematical model of children's peer interaction in groups.

This paper questions the assumption that children's social and emotional competence be placed within the developing child, rather than in the interaction of the child with the range of peer social ecologies in which the children might function. This paper presents a new nonstatistical mathematical approach to modeling children's peer social interaction in small groups using nonlinear difference equations in which both an uninfluenced and an influenced regulatory set point of positive minus negative interaction can be separately estimated. Using this model and the estimation procedure, it is possible to estimate what a focal child and the group initially brings to the group interaction and also how these regulatory set points are influenced by the interaction to determine two influenced regulatory set points. Six-person mainstreamed and specialized groups were established involving three types of unacquainted preschool boys: children with and without developmental delays and a language disordered but intellectually normally functioning group, using a methodology that ensured appropriate matching of child and family characteristics. For each 2-week play group, the social interactions of each child were observed during a designated free play period. Handicapped children were observed in either a specialized or mainstreamed setting. The application made of this modeling process in this paper is generating theory to attempt to understand influence processes. Parameters are introduced that reflect uninfluenced target child and group set points, emotional inertia, and influence functions.

Child, Preschool↗

PubMed2006

An individualized psychosocial approach for "treatment resistant" behavioral symptoms of dementia among aged care residents.

BACKGROUND: Behavioral symptoms of dementia are common among residents in mainstream aged care settings, and have a substantial impact on residents and professional caregivers. This study evaluated the impact of individualized psychosocial interventions for behavioral symptoms through a small preliminary study. METHOD: Interventions were delivered to a patient group of 31 psychogeriatric aged care residents who presented with behavioral symptoms of dementia that had failed to respond to pharmacological treatment approaches. Outcome data on severity of behaviors, health service utilization and staff burden of care were collected. RESULTS: A modest but significant reduction in staff ratings of the severity of aggressive and verbally agitated behavioral symptoms was found, with an associated reduction in their perceptions of the burden of caring for these patients. Reduced behavioral disturbance was associated with a reduction in the requirement for primary care consultations, and all participants were able to continue to reside in mainstream aged care facilities, despite an increase in the severity of dementia. CONCLUSIONS: This study supported the use of individualized psychological strategies for behavioral symptoms at all stages of dementia. Methodological limitations of this preliminary study are discussed.

Aged↗

PubMed2000

Quantitation of flavor-related alkenylbenzenes in tobacco smoke particulate by selected ion monitoring gas chromatography-mass spectrometry.

Little is known about the possible health effects associated with inhaling alkenylbenzenes through cigarette smoking, even though these flavor-related compounds have known toxic effects in animals. We developed a rapid and sensitive solid-phase extraction (SPE) method to quantify seven alkenylbenzenes and piperonal in mainstream cigarette smoke particulate. The smoke particulate fraction of a single cigarette was collected on Cambridge filter pads, solvent extracted, concentrated, purified with SPE, and analyzed by selected ion monitoring gas chromatography-mass spectrometry. We positively identified and quantified five alkenylbenzenes compounds (eugenol, isoeugenol, methyleugenol myristicin, and elemicin) and piperonal in the smoke particulate from eight U.S. brands with mean levels (measured in triplicate) ranging from 6.6 to 4210 ng per cigarette. Additionally, complete blocking of nearly invisible ventilation holes in the cigarette filter increased 2- to 7-fold the percent transfer of alkenylbenzenes from tobacco to the particulate fraction of mainstream smoke.

Alkenes↗

PubMed2004

On the deposition of volatiles and semivolatiles from cigarette smoke aerosols: relative rates of transfer of nicotine and ammonia from particles to the gas phase.

The hypothesis that elevated levels of ammonia-releasing compounds in tobacco and ammonia in mainstream (MS) smoke increase the rate and amount of nicotine evaporation from the particles of MS smoke aerosol was examined by kinetic modeling and experiments with MS cigarette smoke. Computational simulation of a kinetic mechanism describing volatile loss of nicotine, ammonia, and acetic acid from an aqueous solution was used to compute the time-dependent concentration of all species in the model. Because of the high volatility of ammonia relative to that of nicotine, variation over a wide range of initial ammonia concentration had no significant effect upon the rate of loss of nicotine from the model system. The effects of a variation in the volatile loss rate constant for ammonia and for the acid were examined. The simulations show that ammonia is lost from the model solution at a greater rate than nicotine and acid, and the loss of volatile acid has a significant role in the rate and amount of nicotine loss. Simulations with a model system undergoing a continuous steady addition of ammonia showed that high rates of ammonia addition could significantly increase the rate of nicotine volatile loss from the model solution. A series of smoking experiments was performed using blended cigarettes connected to a denuder tube. Deposition of smoke constituents can occur directly from the gas phase and by the deposition of smoke aerosol particles themselves. As nicotine exists >99% in the particle phase of MS smoke, in the absence of particle deposition, denuder tube deposition of nicotine occurs via the evaporation-deposition pathway. Solanesol, a nonvolatile tobacco and smoke terpene, was used to quantify the amount of particle deposition onto the denuder tube. The amount of ammonia deposited on the denuder tube was an order of magnitude greater than that of nicotine, showing that ammonia evaporates from the MS smoke particles much faster than does nicotine. The experimental results were supported and explained by the aqueous model simulations. Included in these experiments are cigarettes that differ in their MS smoke ammonia content by a factor of ca. five. However, an increased amount of MS smoke ammonia does not increase the rate of nicotine loss from the particles. The combined results support the conclusion that ammonia in mainstream smoke has little effect, if any, upon the rate and amount of nicotine evaporation from MS smoke particles.

Aerosols↗

PubMed1998

Cultural barriers in oncology: issues in obtaining medical informed consent from Japanese-American elders in Hawaii.

In east-west cultural contexts medical decision-making by elderly Japanese-American oncology patients is made complex by cultural differences from mainstream service providers. Cultural, religious and practical factors thought to contribute to delays in obtaining informed consent for treatment in oncology from mentally competent Japanese-American elders in Hawai'i are identified in this study of health care professionals at Queen's Medical Center in Honolulu (n = 50). Circumstances under which Japanese-American elders sign informed consent documents without understanding them are also examined. Recommendations are offered by the participants and researchers for improvements to the informed consent process. Implications of the findings and recommendations are discussed for Health Care Practice with Japanese-American and other ethnic elderly patients in mainstream health care organizations.

Journal Article↗

PubMed2001

What feminism can do for bioethics.

Feminist criticism of health care and of bioethics has become increasingly rich and sophisticated in the last years of the twentieth century. Nonetheless, this body of work remains quite marginalized. I believe that there are (at least) two reasons for this. First, many people are still confused about feminism. Second, many people are unconvinced that significant sexism still exists and are therefore unreceptive to arguments that it should be remedied if there is no larger benefit. In this essay I argue for a thin, "core" conception of feminism that is easy to understand and difficult to reject. Core feminism would render debate within feminism more fruitful, clear the way for appropriate recognition of differences among women and their circumstances, provide intellectually compelling reasons for current non-feminists to adopt a feminist outlook, and facilitate mutually beneficial cooperation between feminism and other progressive social movements. This conception of feminism also makes it clear that feminism is part of a larger egalitarian moral and political agenda, and adopting it would help bioethics focus on the most urgent moral priorities. In addition, integrating core feminism into bioethics would open a gateway to the more speculative parts of feminist work where a wealth of creative thinking is occurring. Engaging with this feminist work would challenge and strengthen mainstream approaches: it should also motivate mainstream bioethicists to explore other currently marginalized parts of bioethics.

Bioethics↗

PubMedDate not supplied

The changing role of stereotaxis in surgical neuro-oncology.

PURPOSE: Evaluate evolution and time course of stereotactic neurosurgery within surgical neuro-oncology. METHODS: MEDLINE search 1966-2003 sub-stratified and analyzed for annual trends. AANS/CNS membership databases for Joint Sections. ACRC neuro-oncology program database 1998-2003. RESULTS: Tumor stereotaxis emerged in 1980 and became the dominant stereotactic publication topic by 1984. Frame-based tumor stereotaxis led publications through 1994, when supplanted by stereotactic radiosurgery (SR). Brachytherapy led SR 1982-1987, but then fell behind, reducing to pre-1983 levels by 1996. SR publications currently comprise 65% of stereotactic tumor articles and publication rate continues to rise at a steady rate. Frameless stereotaxis (FS) publications began to increase in 1993 and growth is larger than the corresponding fall in frame-based volumetric resection publications. Data suggest increased utilization for cases that would have otherwise utilized ultrasound or gone without image guidance. Intraoperative MR developed predominantly as complimentary technology to FS. Tumor diagnostic needle biopsy publications continue to be mostly frame-based, while FS techniques are largely resection focused. This may change as >80% of our tumors biopsied with frame-based techniques would be candidates for FS biopsy based solely on lesion size, location, and technique accuracy considerations. CNS parenchymal delivery of experimental therapies continues to be predominantly frame-based. CONCLUSION: The role of tumor stereotaxis in surgical neuro-oncology is important, but changing. SR is increasingly dominating the subspecialty. Stereotactic tumor resection has become a mainstream neurosurgical procedure due to FS, and this will likely occur with needle biopsy as well. Delivery of experimental therapies remains predominantly frame-based, but may need to transition to FS in order to gain wider mainstream acceptance and applicability once efficacy is demonstrated.

Brachytherapy↗

PubMed2002

Rapid detection of oesophageal intubation: take care when using colorimetric capnometry.

BACKGROUND: Rapid detection of a misplaced endotracheal tube in the esophagus is crucial, especially in emergency situations. Hence, we have compared the ability of a colorimetric CO2 indicator (Colibri technology, CO2ntrol 1) and a capnography to differentiate oesophageal and tracheal intubation, with and without CO2 air in the esophagus. METHODS: Fourteen otherwise healthy patients were intubated with an endotracheal tube in the trachea under general anesthesia. After a positive verification of this endotracheal tube and established mechanical ventilation a second endotracheal tube was placed in the esophagus. Both were initially ventilated four times, and expired CO2 was measured with a mainstream capnograph and a colorimetric indicator. In the remaining five patients CO2 containing air was inserted into the esophagus first and then ventilated four times. RESULTS: Both the colorimetric indicator and mainstream capnograph verified correct placement of the endotracheal tube from the first ventilation. When the tube was placed in the esophagus, both methods correctly showed that no CO2 was present. However, in patients (n=5) with CO2 installed in their esophagus, the colorimetric indicator, but not the capnograph, had readings showing that CO2 was present. This may cause a misinterpretation of correct tracheal placement. CONCLUSIONS: We found that in emergency situations where CO2 containing air may be present in the esophagus, capnography should be the preferred method of verifying endotracheal and not oesophageal intubation. The tested colorimetric CO2 indicator (Colibri technology, CO2ntrol 1) is very sensitive to low CO2 values. It may therefore falsely indicate correct endotracheal intubation, even when the tube is in the oesophageus.

Anesthesia↗

PubMed1999

An empirical analysis of trends in psychology.

The present research examined trends in the prominence of 4 widely recognized schools in scientific psychology: psychoanalysis, behaviorism, cognitive psychology, and neuroscience. The results, which replicated across 3 measures of prominence, showed the following trends: (a) psychoanalytic research has been virtually ignored by mainstream scientific psychology over the past several decades; (b) behavioral psychology has declined in prominence and gave way to the ascension of cognitive psychology during the 1970s; (c) cognitive psychology has sustained a steady upward trajectory and continues to be the most prominent school; and (d) neuroscience has seen only a modest increase in prominence in mainstream psychology, despite evidence for its conspicuous growth in general. The authors use these findings as a springboard for discussing different views of scientific prominence and conclude that psychologists should evaluate trends in the field empirically, not intuitively.

Behaviorism↗

PubMed1990

Adolescents' reference-group choices, self-esteem, and adjustment.

Three hundred thirty Black, Hispanic, Asian, and White high school students reported their reference-group label as mainstream, bicultural, or strongly ethnically identified. Compared with other groups, White students were significantly more likely to be mainstream. Across ethnic groups, students reporting a strong ethnic identification held attitudes that were significantly more separatist, reported more ethnic pride, engaged in less cross-ethnic contact out of school, reported more cross-ethnic conflict, and used English significantly less often than other reference groups. Reference-group label was not associated with significant ethnic differences in self-esteem, social competence, or grade point average. The generational status of minority students is discussed as a potential influence mediating the impact of reference group on adjustment.

Acculturation↗

PubMed2000

Is acculturation unidimensional or bidimensional? A head-to-head comparison in the prediction of personality, self-identity, and adjustment.

The unidimensional model of acculturation posits that heritage and mainstream culture identifications have a strong inverse relation, whereas the bidimensional model posits that the 2 identifications are independent. The authors compared these models in 3 samples of ethnic Chinese (ns = 164, 150, and 204), 1 sample of non-Chinese East Asians (n = 70), and one diverse group of acculturating individuals (n = 140). Although the unidimensional measure showed a coherent pattern of external correlates, the bidimensional measure revealed independent dimensions corresponding to heritage and mainstream culture identification. These dimensions displayed patterns of noninverse correlations with personality, self-identity, and psychosocial adjustment. The authors conclude that the bidimensional model is a more valid and useful operationalization of acculturation.

Acculturation↗

PubMed2004

Between the cup of principle and the lip of practice: ethnic minorities and American psychology, 1966-1980.

By 1980, the previously held dichotomy of Black and White racial identity in America had yielded to a mosaic of red, yellow, brown, black, and white. During the 1960s and 1970s, identity, and thus psychological knowledge, were articulated and differentiated in terms of gender, sexual orientation, and class in unprecedented ways. In this article, the author contextualizes efforts to make mainstream American psychology more receptive to ethnic minorities between 1966 and 1980. Advocacy and activism by ethnic minority psychologists forced American mainstream psychology to yield a place at the table to non-White, non-European individuals. He emphasizes the recruitment and retention of ethnic minority graduate students and faculty, and concludes that many individual psychologists were important in forcing changes in these areas.

Ethnicity↗

PubMed2026

Prevalence of BRCA1/2 variants in an Ovarian Cancer Cohort: outcomes from a Nationwide Testing Program.

Poly(ADP-ribose) polymerase inhibitors (PARPi) have revolutionized the management of BRCA1- and BRCA2-associated ovarian cancer (OC). In 2020, Ireland implemented a nationwide, oncology-led pathway for mainstreamed BRCA1/2 testing in patients with OC. This study evaluated the pathway and characterised the BRCA1/2 landscape in an Irish cohort of patients with OC. Samples collected between January 2020 and December 2023 were tested in two national molecular diagnostic laboratories. Single-molecule molecular inversion probe sequencing was used to detect single nucleotide variants, while multiplex ligation-dependent probe amplification assessed large genomic rearrangements. Variants were classified according to the American College of Medical Genetics and Genomics and Association for Clinical Genomic Science 2020 guidelines and CanVIG-UK specifications. In total, 535 patients were included, with a median age of 65.5 years (range, 27-89 years). Of these, 455/535 (85.0%) underwent germline BRCA1/2 (gBRCA) testing using peripheral blood, and 360/535 (67.2%) underwent tumour BRCA1/2 (tBRCA) testing, resulting in 292/535 (54.6%) patients having paired testing. Among gBRCA-tested patients, 10.3% (47/455) had a clinically actionable variant (CAV), while 2.1% (10/455) had a variant of uncertain significance. Of the 262 patients who underwent paired testing and had negative gBRCA results, 9.5% (25/262) had a somatic BRCA CAV. Recurrent germline BRCA CAVs were identified in regional clusters, including BRCA1 c.5266dup, BRCA1 c.1175_1214del, and BRCA2 c.4398_4402del. This nationwide real-world study demonstrates that mainstreamed germline and somatic BRCA1/2 testing is feasible in Ireland and reports the prevalence of BRCA CAVs in a cohort of patients with OC. Although the observed prevalence of germline BRCA CAVs was lower than anticipated, it is consistent with UK real-world data. The identification of recurrent, regionally clustered germline variants further enhances the characterisation of the Irish genomic landscape.

Journal Article↗

PubMed1986

Communicative interactions of mildly delayed and normally developing preschool children: effects of listener's developmental level.

The communicative interactions of mildly delayed and normally developing preschool children were recorded during free play as they interacted with children at different developmental levels in a mainstreamed program. Analyses of syntactic complexity, semantic diversity, functional aspects of speech, and the use of selected discourse devices indicated that mildly delayed children adjusted important characteristics of their speech in accordance with the cognitive and linguistic levels of their companions. Specifically, speech addressed to less developmentally advanced children was less complex, more diverse, and consisted of a greater proportion of behavior requests but contained proportionally fewer information requests or information statements. These adjustments appeared to be well suited for improving communicative effectiveness and were similar in magnitude and direction to those of normally developing children. In addition, both mildly delayed and normally developing groups were generally successful in obtaining responses to their behavior and information requests. The implications of these findings were discussed in relation to the communicative competence of young children and to early childhood mainstreaming.

Child Language↗

PubMed2003

An observational study investigating the health provision for children with epilepsy within secondary schools in the East Midlands, UK.

BACKGROUND: Epilepsy is a common medical condition affecting many children in mainstream education. The practice of local secondary schools and the health service with regard to pupils with epilepsy was examined. The extent to which these children had activities at schools restricted and the schools' perception of the health service with regard to epilepsy was explored. METHOD: A structured interview was conducted with selected staff members from mainstream secondary schools in East Midlands region, UK. RESULTS: Fourteen out of 17 schools participated. Fifty-seven children were identified from a total pupil population of 14 534. Seven schools used the DOH/DfEE (The Department of Health/Department for Education and Employment) 'Supporting Pupils with Medical Needs' publication as a resource. No schools created individual health care plans for children with epilepsy. Six out of seven schools reported appropriate provision for children during swimming activities. The commonest restriction was related to computer use. Nine schools stated a need for more training for staff members with regard to seizure management. CONCLUSIONS: Schools rely heavily on obtaining medical information from non-medical sources. Individual health care plans for children with epilepsy are not commonly undertaken. Few children had any restriction or special provision placed upon them because of their epilepsy except in the area of computer use. Further action is needed to consider how the system for providing for such children can be improved so that each child's individual health needs can be satisfactorily met.

Adolescent↗

PubMed2000

Exploration of the concept of hope in the Dominican Republic.

An ethnonursing study explored What is the meaning of hope (esperanza/esperar) to the Dominican people? What is the importance of the concept of hope to the people of the Dominican Republic? What are the universals and diversities in the meaning of hope for this cultural group and United States' (US) mainstream culture? Hope has been considered universal and recent research has demonstrated the effect of levels of hope or hopelessness on health. Nurse researchers have explored the meaning of hope to patients in the US and have developed instruments to measure levels of hope. However, little research has explored whether hope has different attributes in various cultural groups. From data gathered in a rural Dominican village, a definition of hope and its attributes were developed: 'Hope is an essential but dynamic life force that grows out of faith in God, is supported by relationships, resources and work, and results in the energy necessary to work for a desired future. Hope gives meaning and happiness'. This definition and its attributes were compared with definitions developed from research among mainstream US populations to propose universals and diversities of hope.

Adolescent↗