Re-visiting the 'mysterious myth of attention deficit': A systematic review of the recent evidence.

Based on the inclusive and methodologically rigorous framework provided by Ed Zigler's developmental approach, we previously challenged what we called, 'the mysterious myth of attention deficit', the fallacy of attention as a universal deficit among persons with intellectual disability (ID). In this latest update, we conducted a systematic review of studies of essential components of attention among persons with ID published in the interim since the last iteration of the mysterious myth narrative was submitted for publication approximately a decade ago. We searched the databases PubMed and PsycINFO for English-language peer-reviewed studies published from 1 January 2011 through 5 February 2021. In keeping with the developmental approach, the two essential methodological criteria were that the groups of persons with ID were aetiologically homogeneous and that the comparisons with persons with average IQs (or with available norms) were based on an appropriate index of developmental level, or mental age. Stringent use of these criteria for inclusion served to control for bias in article selection. Articles were then categorised based on aetiological group studied and component of visual attention. Based on these criteria, 18 articles were selected for inclusion out of the 2837 that were identified. The included studies involved 547 participants: 201 participants with Down syndrome, 214 participants with Williams syndrome and 132 participants with fragile X syndrome. The findings from these articles call attention to the complexities and nuances in understanding attentional functioning across homogeneous aetiological groups and highlight that functioning must be considered in relation to aetiology; factors associated with the individual, such as developmental level, motivation, styles and biases; and factors associated with both the task, such as context, focus, social and emotional implications, and levels of environmental complexity.

Visual filtering in time and space among persons with Down syndrome.

BACKGROUND: Individuals with Down syndrome (DS) appear to perform at a level that is commensurate with developmental expectations on simple tasks of selective attention. In this study, we examine how their selective attention is impacted by target changes that unfold over both time and space. This increased complexity reflects an attempt at greater ecological validity in an experimental task, as a steppingstone for better understanding attention among persons with DS in real-world environments. METHODS: A modified flanker task was used to assess visual temporal and spatial filtering among persons with DS (n = 14) and typically developing individuals (n = 14) matched on non-verbal mental age (mental age = 8.5 years). Experimental conditions included varying the stimulus onset asynchronies between the onset of the target and flankers, the distances between the target and flankers, and the similarity of the target and flankers. RESULTS: Both the participants with DS and the typically developing participants showed slower reaction times and lower accuracy rates when the flankers appeared closer in time and/or space to the target. CONCLUSION: No group differences were found on a broad level, but the findings suggest that dynamic stimuli may be processed differently by those with DS. Implications of the findings are discussed in relation to the developmental approach to intellectual disability originally articulated by Ed Zigler.

Valorization of pretreated biogas digestate with black soldier fly (Hermetia illucens, L; Diptera: Stratiomyidae) larvae.

Increasing concerns related to the negative environmental impacts of food waste havemotivated the development of new solutions to complete the waste cycle of organic residues. One particular "waste" product, the solid digestate from anaerobic digestion, has been identified for further bioprocessing. Black soldier fly (BSF, Hermetia illucens) larvae are known for their great potential in the processing of organic waste. In this study, this potential was investigated to further process the digestate waste stream. Digestate is considered a low potential source of nutrients for larvae due to the presence of different fiber fractions. However, the lignocellulosic matter in this residue could be enzymatically hydrolyzed to release residual carbohydrates. For this study, digestate from a full-scale anaerobic digestion plant in Quebec (Canada) which processes a range of feedstocks (fruits, vegetables, garden wastes, sludge derived from dairy processing and wastewater treatment) was sourced. Digestate was treated with Accelerase® DUET enzyme complex to hydrolyze lignocellulosic matter and compared to a standard diet. For each treatment, 600 four-day old larvae were fed daily with 160 g (70% relative humidity) of diets for 6 days and harvested 3 days later. Although their growth and total biomass were significantly lower than the standard diet, larvae fed on hydrolyzed digestate were almost two times larger than the larvae fed on crude digestate. Furthermore, the content of organic matter, lipids and minerals in the diets and frass were analyzed. Finally, the feasibility of applying BSF treatment for digestate valorization is discussed. According to this study, enzyme-treated digestate does not allow efficient larval growth compared to the standard diet. The development of a more effective method of pretreatment is required for BSF larvae to become an eco-friendly solution for digestate valorization.

The v-ski oncogene encodes a truncated set of c-ski coding exons with limited sequence and structural relatedness to v-myc.

The nucleotide sequence of a biologically active v-ski gene from a cloned proviral segment shows that ski is a 1,312-base sequence embedded in the p19 region of the avian leukosis virus gag gene. The v-ski sequence contains a single open translational reading frame that encodes a polypeptide with a molecular mass of 49,000 daltons. The predicted amino acid sequence includes nuclear localization motifs that have been identified in other nuclear oncoproteins. It also contains a proline-rich region and a set of cysteine and histidine residues that could constitute a metal-binding domain. Two regions of the amino acid sequences of v-ski and v-myc are related, and the two proteins exhibit similar distributions of hydrophobic and hydrophilic amino acids. Cloned segments of the chicken c-ski proto-oncogene totaling 65 kilobases have been analyzed, and regions related to v-ski have been sequenced. The results indicate that v-ski is derived from at least five coding exons of c-ski, that it is correctly spliced, and that it is missing c-ski coding sequences at both its 5' and 3' ends. The c-ski and avian leukosis virus sequences that overlap the 5' virus/v-ski junction in Sloan-Kettering virus contain an 18-of-20-base sequence match that presumably played a role in the transduction of ski by facilitating virus/c-ski recombination.

The development of selective attention: a life-span overview.

This paper outlines research on selective attention within a life-span developmental framework. Findings obtained in both the infancy-child and adulthood-aging literatures are reviewed and discussed in relationship to four aspects of selective attention: orienting, filtering, search, and expecting. Developmental consistencies and inconsistencies are identified and integrative theories are evaluated. Although a single theory is unlikely to accommodate the diverse patterns of age effects, emergent themes are identifiable nonetheless and the essential ingredients of a life-span theory of attentional development are enumerated. Directions for future research and theory are suggested.

The development of selective attention in children with attention deficit hyperactivity disorder.

The influence of age on a selective attention task was studied in a sample of children with and without Attention Deficit Hyperactivity Disorder (ADHD). The impact of methylphenidate (MPH) treatment on selective attention was also investigated in the children with ADHD. Two age groups of children with ADHD and two age groups of control children were tested using a timed computer task. The task consisted of identifying visual target stimuli under various distracter conditions. Distracters varied on the basis of modality (i.e., visual, auditory, or both) and task relevance (i.e., meaningful or irrelevant). Reaction times and accuracy were measured. Children with ADHD were less efficient on the selective attention task than were children without ADHD, and older children were more efficient than younger children in both groups. Children without ADHD were influenced more by the nature of distracters than were children with ADHD. For children with ADHD, MPH improved performance overall.

Time perception: does it distinguish ADHD and RD children in a clinical sample?

This study used a double-dissociation design to evaluate whether children with ADHD demonstrated specific deficits relative to children with Reading Disorders. Recent theory suggests that ADHD children have deficits in time perception and working memory, whereas RD children have deficits in phonological decoding. The performance of 113 clinic-referred children aged 6-11 was examined using measures of working memory, phonological processing, and time perception. Respondents completed two time production tasks in which they were to judge when 30-s had elapsed, and another in which they were asked to estimate the duration of the Conners' CPT (CCPT). Time Perception and phonological processing variables were submitted to a 2 x 2 ANCOVA (ADHD vs. RD), covarying for age, SES, IQ, and working memory. Children with ADHD were more likely to overestimate the time taken for the CCPT than children without ADHD, but no group differences were found on the 30-s estimation tasks. Children with RD did not display deficits in time estimation, but showed deficits in auditory phonological processing. The lack of interaction effects supported an "etiological subtype" over the "phenocopy" model of ADHD and RD. No group differences were detected using the CCPT. Although our previous studies did not find an order effect for the Conners' CPT in a 1-hr battery, a fatigue effect was evident with a 1.5-hr battery. The implications for Barkley's behavioral inhibition theories (R. Barkley, 1997) are discussed.

Covert visual orienting across the lifespan.

Covert visual orienting was examined over a span of human life ranging from six to 73 years. The observer's task was the speeded discrimination of "X" from "O1" but of primary interest was the effect of a location cue that appeared prior to the target. Both an abrupt stimulus cue and a voluntary information cue were studied using response time (RT) measures. Eye movements were monitored to control for differences in the ability to maintain fixation. Experiment 1 showed that there were very few age differences in stimulus-cued orienting. In contrast, there were important differences when orienting was intentional. In comparison with young adults, children were less able to sustain orienting over time, and senior adults required more time to use the cue. Experiment 2 tested the relation between stimulus and information cues when they both occurred prior to a given target. All age groups were able to use information cues in the presence of conflicting stimulus cues, but young adults were better able to do so than either children or senior adults. These results are interpreted as support for the view that separate mechanisms underlie stimulus-based versus information-based spatial orienting.

Visual processing of verbal and nonverbal stimuli in adolescents with reading disabilities.

This study investigated whether a group of children with reading disabilities (RD) were slower at processing visual information in general (compared to a group of children of comparable age and a group of children of comparable reading level), or whether their deficit was specific to the written word. Computerized backward masking and temporal integration tasks were used to assess the speed of visual information processing. Stimulus complexity (simple, complex) and type (verbal, nonverbal) were varied, creating a 2 x 2 matrix of stimulus conditions: simple nonverbal, complex nonverbal, simple verbal, and complex verbal. Adolescents with RD demonstrated difficulties in processing rapidly presented verbal and nonverbal visual stimuli, although the effect was magnified when they were processing verbal stimuli. Thus, the results of this study suggest that some youth with reading disabilities have visual temporal processing deficits that compound difficulties in processing verbal information during reading.

Bishops' response to Act on Rights of Terminally Ill.

In August 1985 the National Conference of Commissioners on Uniform State Laws drafted a document entitled The Uniform Rights of the Terminally Ill Act, which it recommended for enactment by all U.S. states. The act attempts to set uniform, clear guidelines for advance directives, or living wills--written declarations made by a patient that are used to guide treatment decisions should the patient become incompetent and terminally ill. The act limits the scope of an advance directive to the withdrawal or withholding of "life-sustaining treatment," which is "any medical procedure or intervention that when administered to a qualified patient will serve only to prolong the process of dying." Qualified patients are those with a terminal condition, which is "an incurable or irreversible condition that without the administration of life-sustaining treatment will, in the opinion of the attending physician, result in death within a relatively short time." The National Conference of Catholic Bishops (NCCB) Committee for Pro-Life Activities responded to the act in July 1986. The NCCB wishes to narrow the act's scope to apply only to patients in the "final stage of a terminal condition." Other specific concerns are the withdrawal of artificial nutrition and hydration, the need for communication with the family in making decisions, and the protection of an unborn child's life when the mother fulfills the conditions of the act and her living will stipulates a desire for withdrawal of life-sustaining treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

The ethics of Cruzan. Families, not states, should make treatment termination decisions.

Although the U.S. Supreme Court justices frequently alluded to ethical concepts in delivering their opinions in the Cruzan decision, no clear or consistent ethical framework supported this jargon. The decision, in fact, resolves none of the ethical and professional questions that initially brought the case to the courts. The various arguments about whether and when it is ethical to terminate treatment are the first source of ethical confusion in questions about death and dying. Individuals arriving at the same conclusion can begin from significantly different ethical principles. An added complexity arises as a result of differences among medical professionals regarding what constitutes a fatal pathological condition. A resolution of these differences would clarify a number of ethical questions. The biggest problem with the Missouri Supreme Court's decision was that it gave absolute precedence to the state's interest in preserving life, excluding quality-of-life considerations and disregarding personal, familial, and professional values that should have affected the decision. In fact, since a medically well-informed family is in most cases in the best position to make a decision that would conform with a family member's wishes, applying the "clear and convincing" evidence standard in the Cruzan case shifts the burden of proof to the wrong party. Instead, the state should be obliged to give convincing evidence of why it has intervened in a decision for which the patient's family and physician should have authority.

The rights debate.

To date, no proposal for systemic healthcare reform directly addresses whether healthcare is a right for all Americans. In fact, some proposals have avoided the issue altogether. Typically, proponents of reform have been more comfortable approaching healthcare services as something society has a moral obligation to provide rather than something individuals have a right to. Such an approach is consistent with the liberal democratic tradition's understanding of rights, which stresses individual freedom and autonomy. According to the Catholic social teaching of the past century, however, the right to participate in society takes precedence over the right to be free of governmental intrusions. From the Catholic perspective, furthermore, lack of access to healthcare is tantamount to being denied full involvement in social life. This tradition has stressed repeatedly that each individual achieves dignity and fulfillment only by being actively involved in the social world. In debates over systemic healthcare reform, it is imperative that advocates of the Catholic perspective recognize the difference between the meaning of "rights" as it has developed in their tradition and the meaning that has emerged from the context of the liberal democratic tradition. Their challenge will be to give the debate's key term a meaning that better reflects the tradition of Catholic social teaching.

Feeding policy protects patients' rights, decisions.

In adopting a policy to guide patients and care givers in treatment decisions, the Carmelite Sisters for the Aged and Infirm, Davenport, IA, have taken an important step toward resolving issues related to force-feeding. The policy enables residents of Kahl Home for the Aged and Infirm to discuss their future health care with relatives and physicians while they are competent. It also establishes guidelines concerning the insertion of feeding tubes and provides for periodic evaluation of residents' feeding needs. Formulating such a policy, of course, requires consideration of the ethical assumptions underlying decisions to withdraw or withhold life-sustaining therapy. It requires an understanding of the difference between a diminished capacity to pursue life's ends and the complete inability to do so when a person is permanently comatose. this difference affects the decision as to whether it is time to allow one to die--a decision that should precede the medical decision to withhold or withdraw treatment. For example, to present as an option the removal of feeding tubes and intravenous equipment when a patient is brain dead is poor medicine and bad ethics. The patient is dead; thus no choice exists whether to end treatment. Despite objections to decision making based on quality-of-life criteria, this concept--when related to a person's ability to pursue life's temporal goals--is critical to good decision making and allows decision makers to avoid arbitrary judgments in determining when it is time to let a person die.

Guidance for a failing system. Catholic social teachings provide the needed principles.

Catholic healthcare has traditionally relied on four major ethical principles--nonmaleficence, beneficence, autonomy, and justice--to address conflicts between various goods. However, all healthcare now finds itself facing great changes. "Principleism" is too limited to guide the Church's health ministry through the current crisis. But the Church possesses a body of social justice teachings that may provide healthcare with the necessary guidance. Eight inseparable but distinct themes are found in the social teachings: human dignity, human solidarity, the option for the poor, the common good, human rights, social justice, stewardship, and liberation. The eight themes are here applied to five critical healthcare issues: the patient-physician relationship, the right to choose, healthcare as a communal good, rationing and limits, and work and its implications. The Church's social teachings may provide us with a basis for a structural reexamination of healthcare--including Catholic healthcare. In that analysis, we may find that Catholic healthcare has developed practices and standards that are at odds with its own teachings. Such an analysis will be painful, but it must be done.

Ethical principles in geriatric nephrology.

Seven principles are suggested to resolve ethical issues raised by medical developments affecting an aging society. First, there must be clear identification of the goals of medical treatment. Second, treatments must consider the whole person. Third, physiological concerns are more important than chronological age. Fourth, a patient's choice must be respected when choice is the result of an informed decision-making process. Fifth, access has to be equitable while respecting the sixth principle which requires allocation of resources. Finally, society must more clearly identify the appropriate principles to guide the care of the dying person.