Behavioural flexibility in individuals with Angelman syndrome, Down syndrome, non-specific intellectual disability and Autism spectrum disorder.

BACKGROUND: Little is known about behavioural flexibility in children and adults with Angelman syndrome and whether people with this syndrome have more or less problems in being behaviourally flexible as compared with other people. METHOD: Behavioural flexibility scores were assessed in 129 individuals with Angelman syndrome using 11 items from the Behavioural Flexibility Rating Scale-Revised (Green et al. 2007). Level of behavioural flexibility scores in individuals with Angelman syndrome (N = 129) was compared with that of people with non-specific intellectual disability (ID) (N = 90), Down syndrome (N = 398) and Autism spectrum disorder (N = 235). RESULTS: Comparative analyses show that individuals with Angelman syndrome were more flexible than those with non-specific ID (P < 0.001) and those with Autism spectrum disorder (P < 0.01). There were no differences in behavioural flexibility scores between individuals with Angelman syndrome and those with Down syndrome (P = 0.94). CONCLUSION: It is concluded that individuals with Angelman syndrome are comparatively flexible in their behaviour.

Transferring AAC intervention to the home.

PURPOSE: To evaluate the acquisition of AAC skills during an initial clinical trial and assess subsequent transfer of the training to the home setting. METHOD: A 12-year-old male with autism was first seen in a clinical setting to establish the use of a voice-output communication device. After learning to use the device to request access to preferred objects in the clinical trial, the intervention was transferred to the home. Follow-up with the parent was conducted via e-mail and telephone. Videotapes were made of initial home-based sessions to enable evaluation of the participant's progress. RESULTS: The programme was successful in teaching the participant to use a portable AAC device to make requests during the clinical trial and then in two home-based activities. CONCLUSION: An initial clinical trial with follow-up support for parents may be an efficient method for beginning AAC intervention and transferring the training procedures to the home setting.

Nursing the patient with severe communication impairment.

BACKGROUND: Effective communication with patients is critical to effective nursing practice. Surprisingly, there is little information on nurses' experiences in caring for patients who are unable to speak. PURPOSE AND METHOD: This study provides descriptive information from interviews with 20 nurses who cared for patients with severe communication impairment. The interview protocol explored positive and negative experiences of nursing patients with severe communication impairment. Frequency counts and descriptive analyses were conducted to identify the major themes emerging from the interviews. RESULTS: The results suggest that nurse-patient communication is difficult when the patient has severe communication impairment, although some nurses discovered effective strategies to facilitate communication with such patients. Many of the difficulties could be viewed as a breakdown in understanding arising from the lack of a readily interpretable communication system that could be used by nurse and patient. CONCLUSIONS: The results suggest a need for training nurses in the use of alternative modes of communication. Nurses also need access to a variety of simple augmentative communication devices for use with patients who are unable to speak. Finally, nurses should collaborate with speech pathologists on the development of preadmission information and bedside training for people who are admitted to hospital with severe communication impairment.

American Indian adolescent inhalant use.

Inhalant use and use patterns, decision-making pertaining to inhalant use, cognitive capacity, cognitive egocentrism, and adherence to traditional ways were studied in a sample of male and female American Indian adolescents residing in a boarding home. Significant differences were not found for gender. Inhalant use group differences were found for only one variable, participation in tribal activities. For males, cognitive ability, cognitive egocentrism and participation in tribal activities were significant predictors of inhalant use/non-use. For females, tribal activities was the only significant predictor.

Self-focus, other-focus, and interpersonal needs as correlates of loneliness.

Residential college students (44 men, 51 women) participated in a questionnaire study to clarify the relationship between loneliness, self- or other-focus, and interpersonal needs. Contrary to predictions, loneliness was unrelated to self-focus, other-focus, or the ability to elicit disclosure from others. However, sex differences were found on interpersonal needs. Specifically, loneliness in men was predicted by a lack of expressed inclusion and a desire for control from others, while loneliness in women was predicted by a lack of expressed affection. These findings suggest that lonely men and women may benefit from different intervention strategies. Outcome studies are needed to ensure that such interventions actually reduce loneliness.

Luciferase from the east European firefly Luciola mingrelica: cloning and nucleotide sequence of the cDNA, overexpression in Escherichia coli and purification of the enzyme.

We have cloned cDNA encoding luciferase in Luciola mingrelica, fireflies living near the Black Sea in southern Russia, and obtained high level expression of the cloned sequences in Escherichia coli. The nucleotide sequences of two isolated clones were determined; five single base differences were observed, but none resulted in a change in the encoded amino acid residue. The cDNA encoded a protein of 548 amino acid residues. The overall amino acid sequence identity with the luciferase from Photinus pyralis, the North American firefly, was 67%, while comparison of the L. mingrelica luciferase with L. cruciata and L. lateralis, both indigenous to Japan, showed about 80% of the residues were strictly conserved. A novel overexpression system which employs the regulatory genes of the luminous bacterium Vibrio fischeri allowed growth of cultures to high cell density and high luciferase content, facilitating purification of the enzyme. Luciferase was purified to homogeneity in good yield from lysates of recombinant E. coli by ammonium sulfate fractionation and chromatography on columns of DEAE Sephadex and Blue Sepharose. The physicochemical properties of the luciferases from the available recombinant sources are significantly different and should allow detailed investigations into the mechanism of the bioluminescence reaction and the physical basis of the differences in the color of light emitted from the various enzymes.

Mineral seal oil excreted in urine--a case report.

There is a paucity of reported cases demonstrating the gastrointestinal absorption and renal excretion of mineral seal oil, a petroleum distillate. In 1972, a teenager attempted suicide by purposely ingesting an entire 8 oz bottle of furniture polish containing 99% mineral seal oil. She arrived in the ER two hours post-ingestion and was lavaged with two liters of normal saline, given 2 oz of mineral oil and 20 ml of 50% magnesium sulfate per gavage. The stomach contents were yellow, thick, oily and smelled like the furniture polish. She was admitted for psychiatric evaluation and observation for the ingestion. The patient did not suffer any respiratory or CNS complications. However, she excreted oil droplets which coalesced to form an oil layer in her urine. She suffered no kidney damage or abnormality as could be detected by routine renal function studies.

Mineral seal oil excreted in urine.

There is a paucity of reported cases demonstrating the gastrointestinal absorption and renal excretion of mineral seal oil, a petroleum distillate. In 1972, a teenager attempted suicide by purposely ingesting an entire 8 ounce bottle of furniture polish containing 99% mineral seal oil. She arrived in the F.R. two hours post-ingestion and was lavaged with two liters of normal saline and given two ounces of mineral oil and 20 ml of 50% magnesium sulfate by the tube. The stomach contents were yellow, thick, oily, and smelled like furniture polish. She was admitted for psychiatric evaluation and observation for the ingestion. The patient did not suffer any respiratory or CNS complications. However, she excreted oil droplets which coalasced to form an oil layer in her urine! She suffered no kidney damage or abnormality as could be detected by routine renal function studies. Pictures revealing oil in the urine will be shown.

Bites and stings of Hymenoptera, caterpillar and beetle.

Insects compose a very large group of creatures that bite or sting but only a few are truly venomous in the sense that they inject a venom into human victims. Anaphylaxis from a Hymenoptera sting is the most serious reaction from this group and is estimated to account for approximately half of the annual fatalities from venomous bites and stings in the United States. Epinephrine, Benadryl, steroids, hyposensitization, local tissue management and symptomatic and supportive care are discussed.

Lomotil ingestions in children.

Although the incidence of adverse reactions is relatively low in adults, Lomotil may result in serious toxicity in children. Early effects are often due to the atropine present in the compound, while the narcotic-like actions of diphenoxylate HCI tend to occur later. Respiratory depression is the most threatening reaction and should be treated with naloxone.

Development and evaluation of method for simultaneous determination of phenobarbital and diphenylhydantoin in plasma by high-pressure liquid chromatography.

A procedure for the simultaneous analysis of diphenylhydantoin and phenobarbital in plasma by high-pressure liquid chromatography was developed and evaluated. Separation is effected on a porous particle silicic acid column with chloroform dioxane-isopropanol-acetic acid (310:9.7:1.0:0.1 by volume) and is monitored at 254 nm. Results of the procedure were compared with results of a GLC assay.