A Systematic Review and Meta-Analysis of the Language Skills of Youth Offenders.

PURPOSE: This systematic review and meta-analysis estimates the overall language skills of youth offenders involved with the juvenile justice system. Given the importance of this population, identifying avenues through which we can increase the likelihood of successful interventions is a necessary societal effort. METHOD: Eighteen studies, representing data from 3,304 individuals, contributed 82 effect sizes to the current analytic sample. We used random-effects models to estimate the overall mean effect size metric to address each research question and fit meta-regression models for each moderator analysis. RESULTS: Results yielded that youth offenders presented with significantly lower language skills than their nonoffending peers (g = -1.26). Furthermore, high proportions of the present meta-analytic sample were classified as youth with moderate (50%) and severe (10%) language disorders. In general, differences in language skills did not vary as a function of age, gender, or language measure type. We did detect significant differences as a function of sample country and type of peer comparison group. CONCLUSIONS: This meta-analysis reports on the significantly compromised language skills of youth offenders. We conclude with a discussion of the findings and consideration of the implications for research and practice.

New Zealand Policy on Frozen Embryo Disputes.

Disputes between separated couples over whether frozen embryos can be used in an attempt to create a child create a moral dilemma for public policy. When a couple create embryos intending to parent any resulting children, New Zealand's current policy requires the consent of both people at every stage of the ART process. New Zealand's Advisory Committee on Assisted Reproductive Technology has proposed a policy change that would give ex-partners involved in an embryo dispute twelve months to come to an agreement before the embryos are destroyed. New Zealand's current policy and the proposed policy both favour the person who wishes to avoid procreation. Two alternative policy approaches that do not favour procreative avoidance are considered. Using pre-fertilisation contracts to determine the decision reached in embryo disputes allows the couple's wishes at the time the embryos are created to determine what happens to the embryos if they separate. However, pre-fertilisation contracts are agreements about healthcare and personal relationships, and changing circumstances can make enforcing such agreements unjust. Finally, it is argued that New Zealand's Family Court system should be used to reach decisions that balance the interests of those involved in the dispute.

Correlates of Sustained Volunteering: Advocacy for Students with Disabilities.

Parents of students with disabilities often receive support from special education advocates, who may be trained through a variety of programs. Using a web-based survey, this study examined the post-graduation advocacy activities of 83 graduates of one such volunteer advocacy training program. In the 1-4 years after program graduation, 63.8% (53 of 83) of the graduates advocated for one or more families; these sustained advocates reported stable rates of advocacy over time, and advocates performed activities that were either family-focused or school-focused. For graduates who advocated post-training, amounts of advocacy were positively related to satisfaction with advocating and with higher levels of involvement with other advocates and with the broader disability community. Compared to those not advocating after graduating, sustained advocates reported greater advocacy-role identities, increased involvement in disability groups, and higher likelihood to advocate in the upcoming year. Future research and practice implications are discussed.

Three cases of intentional isoniazid overdose - a life-threatening condition.

Currently, isoniazid (INH) overdose seems to be a growing and life-threatening problem, partly due to the recent national roll-out of INHpreventive therapy (IPT) for HIV-positive adults. We present three cases, two of which were fatal, seen at Frere and Cecilia Makiwanehospitals, East London, South Africa over the past 16 months.

The competence gap.

A study of HCAs' skills shows in-house training may be inadequate, and should be a priority for employers.

Improving services for people with alcohol-related problems.

From March 2007 to April 2008 the Royal College of Nursing supported a project to improve services for people with alcohol-related problems by demonstrating and publicising the effectiveness of nursing interventions. The project team included representation from England, Northern Ireland, Wales and Scotland. This article presents a framework that can be adapted and used by nurses to promote the development of specialist nursing services by health and social care commissioners and policy makers to improve care for people who misuse alcohol.

Signaling of grasp dimension and grasp force in dorsal premotor cortex and primary motor cortex neurons during reach to grasp in the monkey.

A fundamental question is how the CNS controls the hand with its many degrees of freedom. Several motor cortical areas, including the dorsal premotor cortex (PMd) and primary motor cortex (M1), are involved in reach to grasp. Although neurons in PMd are known to modulate in relation to the type of grasp and neurons in M1 in relation to grasp force and finger movements, whether specific parameters of whole hand shaping are encoded in the discharge of these cells has not been studied. In this study, two monkeys were trained to reach and grasp 16 objects varying in shape, size, and orientation. Grasp force was explicitly controlled, requiring the monkeys to exert either three or five levels of grasp force on each object. The animals were unable to see the objects or their hands. Single PMd and M1 neurons were recorded during the task, and cell firing was examined for modulation with object properties and grasp force. The firing of the vast majority of PMd and M1 neurons varied significantly as a function of the object presented as well as the object grasp dimension. Grasp dimension of the object was an important determinant of the firing of cells in both PMd and M1. A smaller percentage of PMd and M1 neurons were modulated by grasp force. Linear encoding was prominent with grasp force but less so with grasp dimension. The correlations with grasp dimension and grasp force were stronger in the firing of M1 than PMd neurons and across both regions the modulation with these parameters increased as reach to grasp proceeded. All PMd and M1 neurons that signaled grasp force also signaled grasp dimension, yet the two signals showed limited interactions, providing a neural substrate for the independent control of these two parameters at the behavioral level.

Integrated media presentation in multidisciplinary head and neck oncology meetings.

Multidisciplinary meetings (MDMs) are an essential part of the management of head and neck cancer. Practice care guidance set up by the British Association of Head and Neck Oncologists has recommended that MDMs should have appropriate projection equipment for computer-generated images so that all members of group have access to the same information. The aim of this paper is to review our experience with the integrated visual presentation of head and neck oncology patients and to demonstrate its advantages over conventional approaches. Digital photographs are taken of patients and of their index tumour at presentation or at the time of diagnostic endoscopy. All relevant pre-treatment digitised images from tumour sites and radiological images and histological slides are incorporated into a single presentation using Microsoft PowerPoint software. During the past 2 years, on-line radiological scans have also become accessible for the meeting to aid treatment planning. Subsequently, all peri-operative pictures and post-surgical macroscopic and microscopic histopathological images are added to each patient's presentation, which is then hyperlinked into the agenda. The Guy's and St Thomas' Head and Neck Cancer Centre treats over 400 patients a year, and since 2002, all new cancer diagnoses have been discussed in the weekly MDM as described above. A total of 1,638 presentations have been incorporated in a centralized database that is updated in the event of recurrence, further primary tumours or other clinical developments. Satisfactory documentation and staging of head and neck tumours must include a verbal description, accurate measurement, diagrammatic representation, photographic recording and appropriate radiological imaging. Integrated presentation at MDM collates all relevant findings for clinical management decisions on patients with head and neck cancer. This approach is also an extremely valuable adjunct to long-term clinical monitoring.

Clients with mental illness and their children: implications for clinical practice.

The problem of adults with severe mental illness parenting minor children is a growing concern. These clients suffer from concerns that negatively affect them and their children. This study showed many clients seeking services at public mental health agencies are parents of minor children and have had a history of family dysfunction. Prevalence rates, demographic characteristics, types of mental illness diagnoses, family background variables, and some current issues regarding these clients were examined. The study concludes with clinical implications for clients and their families and calls for a family focused approach.

Developing an international learning experience in The Gambia, West Africa: the rewards and challenges of a complex partnership.

An international educational program that engages students in healthcare in another culture is a wonderful way to immerse students in diversity issues. However, developing these types of international programs are challenging for many reasons. It takes a great deal of time, financial resources, and ongoing commitment from all involved. Even with the known benefits of developing international educational partnerships many nursing programs lack the personnel and/or financial resources to develop and/or to sustain these programs overtime. By partnering with other universities and local hospitals extra financial and personnel resources become available to develop and help sustain these international educational programs.

Spiritual care: practical guidelines for rehabilitation nurses.

Spiritual care has long been recognized as an essential component in providing holistic care to patients. However, many nurses have acknowledged that their education lacked practical guidelines on how to provide culturally competent spiritual care. Although all nurses are required to provide spiritual care, rehabilitation nurses are particularly challenged to be competent in this area, due to the lengthy recovery time and special needs often presented by rehabilitation patients. This article provides practical guidelines for rehabilitation nurses, to assist patients in meeting their spiritual needs.

Purkinje cells signal hand shape and grasp force during reach-to-grasp in the monkey.

The cerebellar cortex and nuclei play important roles in the learning, planning, and execution of reach-to-grasp and prehensile movements. However, few studies have investigated the signals carried by cerebellar neurons during reach-to-grasp, particularly signals relating to target object properties, hand shape, and grasp force. In this study, the simple spike discharge of 77 Purkinje cells was recorded as two rhesus monkeys reached and grasped 16 objects. The objects varied systematically in volume, shape, and orientation and each was grasped at five different force levels. Linear multiple regression analyses showed the simple spike discharge was significantly modulated in relation to objects and force levels. Object related modulation occurred preferentially during reach or early in the grasp and was linearly related to grasp aperture. The simple spike discharge was positively correlated with grasp force during both the reach and the grasp. There was no significant interaction between object and grasp force modulation, supporting previous kinematic findings that grasp kinematics and force are signaled independently. Singular value decomposition (SVD) was used to quantify the temporal patterns in the simple spike discharge. Most cells had a predominant discharge pattern that remained relatively constant across object grasp dimensions and force levels. A single predominant simple spike discharge pattern that spans reach and grasp and accounts for most of the variation (>60%) is consistent with the concept that the cerebellum is involved with synergies underlying prehension. Therefore Purkinje cells are involved with the signaling of prehension, providing independent signals for hand shaping and grasp force.

Finger movements during reach-to-grasp in the monkey: amplitude scaling of a temporal synergy.

To reduce the complexity of controlling hand-shaping, recent evidence suggests that the central nervous system uses synergies. In this study, two Rhesus monkeys reached-to-grasp 15 objects, varying in geometric properties, at five grasp force levels. Hand kinematics were recorded using a video-based tracking system. Individual finger movements were described as vectors varying in length and angle. Inflection points (i.e., stereotypic minima/maxima in the temporal profile of each finger vector) exhibited a temporal synchrony for individual fingers and in the coupling across fingers. Inflection point amplitudes varied significantly across objects grasped, scaling linearly with the object grasp dimension. Thus, differences in the vectors as a function of the objects were in the relative scaling of the vector parameters over time rather than a change in the temporal structure. Mahalanobis distance analysis of the inflection points confirmed that changes in inflection point amplitude as a function of objects were greater than changes in timing. Inflection points were independent of the grasp force, consistent with the observation that reach-to-grasp kinematics and grasp force are controlled independently. In summary, the shaping of the hand during reach-to-grasp involves scaling the amplitude of highly stereotypic temporal movements of the fingers.

Helping parents with mental illnesses and their children: a call for family-focused mental health care.

1. Large numbers of individuals with mental illnesses are parents to minor children. 2. Recommendations to improve services suggest that services provided by the adult mental health system and child service agencies be coordinated. 3. Nursing care intersects both the adult and child systems, and nurses have the expertise to offer a variety of services. 4. There is an urgent need to improve family-focused mental health nursing care to benefit parents with mental illnesses, their children and families, and the overall community and society.

Addressing complex health issues: developing contextual knowing through sequenced writing and presentations.

When students discuss possible solutions for health problems they tend to form quick opinions, rush to conclusions, and suggest answers that do not address all the factors or stakeholders involved. Therefore, teaching the complexity of community health issues can be challenging. A series of learning activities applying Baxter-Magolda's model of four stages of college students' intellectual development is used to help students address complex health problems. Two written assignments and two presentations involving role playing are sequenced throughout the semester. This project has been well received by students and other faculty.

Monkey hand postural synergies during reach-to-grasp in the absence of vision of the hand and object.

Understanding how the CNS controls reach-to-grasp will require behavioral and neurophysiological studies of reach-to-grasp in the monkey, including the evaluation of whole-hand grasp with explicit force requirements. In this study, monkeys performed a reach-to-grasp task in which the size, shape, and orientation of the objects were varied. The monkeys were required to grasp each object at five force levels based on visual feedback. Seventeen positions on the wrist and hand were monitored to quantify kinematics. Hand shaping began with initiation of reach and continued throughout the reach, matching object properties even without vision of the hand or object. Grasp aperture scaled to object size. Singular value decomposition analysis of the marker positions identified two dominant hand postures. The first eigenvector or "eigenposture" consisted of an open hand configuration midway between flexion and extension that explained >93% of the variance. The second eigenposture consisted of hyperextension of all joints that accounted for another 4-5% of the variance. The two eigenpostures were similar across force levels and between monkeys. Reach kinematics consisted of a U-shaped hand path with a bell-shaped velocity profile. Trajectory and speed were independent of grasp force and object properties. In summary, hand shaping during the reach occurred without vision of the hand or object, and hand kinematics were not dependent on grasp force. Furthermore, the reach was independent of grasp force and object properties. These observations imply that the kinematics of reach-to-grasp and grasp force are controlled independently. Similar to humans, monkeys may use a simplifying strategy to reduce the degrees of freedom of the hand during reach-to-grasp.