Neurological abnormalities and cognitive ability in first-episode psychosis.

BACKGROUND: It remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis. AIMS: To investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ). METHOD: Evaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239). RESULTS: Primary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ. CONCLUSIONS: Higher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.

Cognitive therapy for the management of sickle cell disease pain: an evaluation of a community based intervention

Sickle cell disease [SCD] is the most prevalent haemoglobinopathy in Northern Europe [WHO, 1985]. It primarily affects the Caribbean and African population as well as small numbers of people from Mediterranean and India [NAHAT,19991]. SCD's most common symptoms is the vaso-occlusive cricis or "painful cricis". Painful crises are the principal cause of morbidity among patients with SCD and account for the second greatest number of hospital admissions with an average of seven days. Whilst numbers vary, most patient experience at least one severe episode per year requiring hospital admission for control. This inevitably causes severe disruption to educational and social aspects of patients' lives, which in turn, has consequences for achievement capabilities and psycho-social adjustment[Thomas and Westerdale,1996]. Nevertheless, traditionally the focus of treatment for SDC pain has been upon its physical aspects.This has been at the expense of consideration of the psycho-social and socio-cultural factors involved and may account for some of the difficulties fraught within the current treatment for SCD pain. [AU]

The prevalence of childhood disability in Clarendon, Jamaica - abstract

The experience of the epidemiological transition for developing countries is leading to a revision of paediatric priorities, with increasing concern for the problem of childhood disabilities. Their exists a lack of knowledge of the profile of disability occurrence in Caribbean communities. In a community-based study in the parish of Clarendon, Jamaica, done between 1986 and 1989, the prevalence of six types of childhood disabilities was sought. Within a defined area, data were collected on 5,468 children aged 2-9 years via household surveys. All children screening positive for disability, together with a sample of `normal' children, were assessed by a physician and a psychologist. Disabilities were categorised by types and levels. The prevalence rate for all types and degrees of disabilities was 93 per 1,000 children and for severe disability, 5.4 per 1,000 children. The rates for specific disabilities showed wide variation (cognitive - 81/1000, speech - 14/1000, visual - 10/1000, hearing - 9/1000, motor - 4/1000 and seizure -2.0/1000), with cognitive problems either singly or in combination accounting for a large segment of the disability profile. Seventy per cent of disabled children had only one disability, 23 per cent had two and 6 per cent had three and four. A literature review reveals no data on prevalence for the region that would make meaningful comparisons. International comparisons are difficult, due to conceptual and methodological dissimilarities. The prevalence of childhood disabilities for Clarendon suggests that this aspect of children's functioning should be given greater emphasis by planners and policy-makers. If disability is to be seen as the final outcome of a range of interacting factors, then these prevalence rates, taken with the specific aetiologies, would provide a framework for planning intervention (AU)

Early childhood supplementation and cognitive development, during and after intervention

Studies of the effects of supplementation during childhood have been reviewed previously and a meta-analysis of the concurrent effects on development was recently conducted. This review looks at five studies in Latin America and the Caribbean, in which the effects of supplementation have been assesses during the intervention period, as well as one or more years after the interventions ended. These studies are particularly relevant when considering the long-term effects of early childhood undernutrition and the policy implications for human resource development. The studies that will be reviewed were conducted in Mexico; Guatemala; Cali, Colombia; Bogota, Colombia; and Jamaica (AU)