Personality differences among patients with chronic aphasia predict improvement in speech-language therapy.

BACKGROUND: Negative affectivity and neurocognitive deficits including executive dysfunction have been shown to be detrimental to rehabilitation therapies. However, research on the relationship between neuropsychological deficits and improvement in speech-language therapy (SLT) for aphasia is sparse. OBJECTIVE: To examine the relationships among neurocognitive and psychological functioning and improvement in SLT following aphasia due to stroke. METHODS: Fifty patients who were ≥ 9 months post stroke and enrolled in outpatient SLT to treat aphasia participated. Using standard language assessment measures, the authors evaluated language functioning at initiation of the study and after participants completed various SLT protocols. Executive functioning, visuospatial skills, attention, and memory also were assessed to provide indices of convergent and discriminant validity. Participants' mood and affectivity were evaluated by self-report, and their functional abilities and recovery of function since stroke were assessed via caregiver report. RESULTS: A multiple regression model testing the combined powers of neurocognitive and psychological variables was significant (P = .004, R2 = 0.33), with psychological and neurocognitive functioning accounting for 15% of the variance in relative language change beyond that accounted for by stroke severity and gross cognitive functioning. Negative affectivity expressed on the Positive and Negative Affectivity Scale made unique contributions to the model. CONCLUSIONS: Improvement in SLT is substantially related to neurocognitive and psychological functioning, particularly affectivity. Assessment of these characteristics may assist in identifying patients who are likely to improve and in tailoring treatment programs to yield optimal outcomes.

Cladophora in the Great Lakes: impacts on beach water quality and human health.

Cladophora in the Great Lakes grows rapidly during the warm summer months, detaches, and becomes free-floating mats as a result of environmental conditions, eventually becoming stranded on recreational beaches. Cladophora provides protection and nutrients, which allow enteric bacteria such as Escherichia coli, enterococci, Shigella, Campylobacter, and Salmonella to persist and potentially regrow in the presence of the algae. As a result of wind and wave action, these microorganisms can detach and be released to surrounding waters and can influence water quality. Enteric bacterial pathogens have been detected in Cladophora mats; E. coli and enterococci may populate to become part of the naturalized microbiota in Cladophora; the high densities of these bacteria may affect water quality, resulting in unnecessary beach closures. The continued use of traditional fecal indicators at beaches with Cladophora presence is inadequate at accurately predicting the presence of fecal contamination. This paper offers a substantial review of available literature to improve the knowledge of Cladophora impacts on water quality, recreational water monitoring, fecal indicator bacteria and microorganisms, and public health and policy.

Food production and the energy crisis.

The principal raw material of modern U.S. agriculture is fossil fuel, whereas the labor input is relatively small (about 9 hours per crop acre). As agriculture is dependent upon fossil energy, crop production costs will also soar when fuel costs increase two- to fivefold. A return of 2.8 kcal of corn per 1 kcal of fuel input may then be uneconomical. Green revolution agriculture also uses high energy crop production technology, especially with respect to fertilizers and pesticides. While one may not doubt the sincerity of the U.S. effort to share its agricultural technology so that the rest of the world can live and eat as it does, one must be realistic about the resources available to accomplish this mission. In the United States we are currently using an equivalent of 80 gallons of gasoline to produce an acre of corn. With fuel shortages and high prices to come, we wonder if many developing nations will be able to afford the technology of U.S. agriculture. Problems have already occurred with green revolution crops, particularly problems related to pests (57). More critical problems are expected when there is a world energy crisis. A careful assessment should be made of the benefits, costs, and risks of high energy-demand green revolution agriculture in order to be certain that this program will not aggravate the already serious world food situation (58). To reduce energy inputs, green revolution and U.S. agriculture might employ such alternatives as rotations and green manures to reduce the high energy demand of chemical fertilizers and pesticides. U.S. agriculture might also reduce energy expenditures by substituting some manpower currently displaced by mechanization. While no one knows for certain what changes will have to be made, we can be sure that when conventional energy resources become scarce and expensive, the impact on agriculture as an industry and a way of life will be significant. This analysis is but a preliminary investigation of a significant agricultural problem that deserves careful attention and greater study before the energy situation becomes more critical.

A case of developmental deep dyslexia: what's left is right.

Cases of acquired deep dyslexia have not clearly and consistently supported any of the theoretical models. We report on a case of a 51-year-old right-handed female, L.S., with a developmental history of deep dyslexia in order to test the neuropsychological models using a visual half-field semantic priming paradigm. Word targets were primed either by a highly associated word (e.g., CLEAN-DIRTY), a weakly associated word (e.g., CLEAN-TIDY), or an unrelated word (e.g., CLEAN-FAMILY) projected to either the same or opposite visual field (VF) as the target. In normals, RVF-left hemisphere primes result in high associate priming regardless of target location (ipsilateral or contralateral to the prime), whereas LVF-right hemisphere primes produce both high and low associate priming across both target location conditions (Hutchinson, Whitman, Abeare & Raiter, 2003). In contrast, L.S. showed hyperpriming to both high and low associates only in the left hemisphere with inhibition of high associates in the right hemisphere. This case represents a variation of developmental deep dyslexia in which the patient's left hemisphere functions like a normal right hemisphere. However, the lack of exclusively high associate priming in the opposite (right) hemisphere may not provide the necessary narrowing of semantic activation necessary for normal reading and thus, may lead to semantic reading errors. Theoretical implications are discussed.

Pilot- and bench-scale testing of faecal indicator bacteria survival in marine beach sand near point sources.

AIM: Factors affecting faecal indicator bacteria (FIB) and pathogen survival/persistence in sand remain largely unstudied. This work elucidates how biological and physical factors affect die-off in beach sand following sewage spills. METHODS AND RESULTS: Solar disinfection with mechanical mixing was pilot-tested as a disinfection procedure after a large sewage spill in Los Angeles. Effects of solar exposure, mechanical mixing, predation and/or competition, season, and moisture were tested at bench scale. First-order decay constants for Escherichia coli ranged between -0.23 and -1.02 per day, and for enterococci between -0.5 and -1.0 per day. Desiccation was a dominant factor for E. coli but not enterococci inactivation. Effects of season were investigated through a comparison of experimental results from winter, spring, and fall. CONCLUSIONS: Moisture was the dominant factor controlling E. coli inactivation kinetics. Initial microbial community and sand temperature were also important factors. Mechanical mixing, common in beach grooming, did not consistently reduce bacterial levels. SIGNIFICANCE AND IMPACT OF THE STUDY: Inactivation rates are mainly dependent on moisture and high sand temperature. Chlorination was an effective disinfection treatment in sand microcosms inoculated with raw influent.

Faecal indicator bacteria enumeration in beach sand: a comparison study of extraction methods in medium to coarse sands.

AIMS: The absence of standardized methods for quantifying faecal indicator bacteria (FIB) in sand hinders comparison of results across studies. The purpose of the study was to compare methods for extraction of faecal bacteria from sands and recommend a standardized extraction technique. METHODS AND RESULTS: Twenty-two methods of extracting enterococci and Escherichia coli from sand were evaluated, including multiple permutations of hand shaking, mechanical shaking, blending, sonication, number of rinses, settling time, eluant-to-sand ratio, eluant composition, prefiltration and type of decantation. Tests were performed on sands from California, Florida and Lake Michigan. Most extraction parameters did not significantly affect bacterial enumeration. anova revealed significant effects of eluant composition and blending; with both sodium metaphosphate buffer and blending producing reduced counts. CONCLUSIONS: The simplest extraction method that produced the highest FIB recoveries consisted of 2 min of hand shaking in phosphate-buffered saline or deionized water, a 30-s settling time, one-rinse step and a 10 : 1 eluant volume to sand weight ratio. This result was consistent across the sand compositions tested in this study but could vary for other sand types. SIGNIFICANCE AND IMPACT OF THE STUDY: Method standardization will improve the understanding of how sands affect surface water quality.

Assault on the therapist.

The authors conducted a questionnaire survey among psychotherapists in psychiatry, psychology and social work to determine how many patients posed a threat to others or to the therapist and how many actually assaulted the therapist. They found that 9.2% of all patients seen by 101 therapists in one year presented a threat to others, 1.9% posed a physical threat to the therapist, and .63% actually assaulted the therapist. The authors conclude that attacks on a therapist are infrequent but almost inevitable and suggest the development of techniques for coping with assaultive patients that therapists can use in crisis situations.

Separation anxiety in panic disorder.

OBJECTIVE: A number of researchers have provided evidence that separation anxiety is an important antecedent or current affect in panic disorder. The objective of this pilot study was to test this hypothesis by comparing dreams, screen memories, and life situations of panic disorder patients with those of comparison patients. METHOD: A recent dream with associations, screen memories with associations, and life situations at onset of symptoms were recorded verbatim during semistructured interviews with 20 patients with DSM-III-R panic disorder and 20 comparison subjects upon referral to a private outpatient practice. A judge blind to the diagnoses rated each of the dreams, screen memories, and life situations separately on each of the 10 Gottschalk-Gleser Content Analysis Scales, thereby measuring manifest and latent death, mutilation, separation, guilt, and shame anxiety and overt and covert hostility in each group. RESULTS: mean separation anxiety scores were significantly higher in both the dreams and screen memories of the panic disorder patients than in the comparison patients. Mean scores for covert hostility directed outward were significantly higher in the dreams of the panic disorder patients than in the comparison patients. CONCLUSIONS: The hypothesis that separation anxiety is a prevalent affective undercurrent in the dreams and screen memories of panic disorder patients was supported. Significantly higher covert hostility in the panic disorder patients' dreams may support Bowlby's observation that people with high separation anxiety tend to disavow their anger.

Empathy and outcome in brief focal dynamic therapy.

In an attempt to test the hypothesis that therapist empathy is an important variable in successful dynamic therapy, the authors collected outcome measures and empathy ratings in the brief focal dynamic therapy of 59 patients. There was no significant agreement among patients, therapists, and clinical supervisors when they used the same scale to rate therapist empathy for the same sessions. Only the patients' ratings correlated significantly with some of the outcome measures, and they added modest but statistically significant predictive variance on multiple regression analysis. The authors discuss the implications of these findings for the traditional mode of supervision of dynamic therapy.

Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro-oesophageal reflux in patients with oesophagitis: a double-blind, placebo-controlled study.

AIM: To investigate the effect of cisapride, a selective 5-hydroxytryptamine-4 receptor agonist, on the frequency of nocturnal transient lower oesophageal sphincter relaxations and oesophageal acid exposure in patients with gastro-oesophageal reflux disease. METHODS: In a double-blind, placebo-controlled study, 10 patients with gastro-oesophageal reflux disease (six male and four female; mean age, 54 +/- 10.4 years) were randomly assigned to 5-day treatments with cisapride, 10 mg q.d.s., or placebo, separated by a 2-day washout period before the treatment crossover. Sleep stages, lower oesophageal sphincter tone and oesophageal pH were monitored overnight at the end of each treatment regimen. Gastric emptying was assessed before treatment. RESULTS: Cisapride decreased the frequency of transient lower oesophageal sphincter relaxations during sleep (1.2 +/- 0.2/h vs. 2.7 +/- 0.5/h with placebo; P=0.004) and oesophageal acid exposure (17.2 +/- 9.9% with placebo vs. 7.2 +/- 4.2% with cisapride; P=0.4). Cisapride increased lower oesophageal sphincter tone from 12.7 +/- 2.8 mmHg with placebo to 16.9 +/- 3.9 mmHg (P=0.03), and decreased heartburn episodes and antacid consumption. All patients had normal gastric retention data over 4 h. CONCLUSIONS: In patients with gastro-oesophageal reflux disease, cisapride significantly decreased the frequency of transient lower oesophageal sphincter relaxations during sleep and increased lower oesophageal sphincter pressure without changing gastric emptying. We hypothesize, therefore, that 5-hydroxytryptamine-4 mechanisms are important in the control of transient lower oesophageal sphincter relaxations in humans.

Selective attention and laterally in good and poor readers.

Good and poor readers recalled lists of three pairs of competing digits presented either Dichotically (separated by ear) or Spectral-Monotically (separated by voice frequency) and at different rates of presentation. Poor readers showed a reduced ability to attenuate unattended channels and, unlike good readers, showed poorest performance at the fast rate. These results suggest a specific attentional deficit, not merely representative of the poor readers' general tendency to do poorly on difficult language related tasks.

Role of subvocal motor activity in dichotic speech perception and selective attention.

Twenty right-handed male and female subjects were asked for ear-by-ear recall of dichotically presented consonant--vowel syllables. Stimuli within each dichotic pair were contrasted on the features on voicing and/or place, or were differentiated by manner of production. While listening to the stimuli, the subjects were required to concurrently reduce the electromyographic subvocal activity recorded from the lips and throat or from a control site, the frontalis muscle. A right-ear advantage was observed during the control condition, the largest advantage occurring when the pairs were contrasted on both voicing and place. In contrast, a left-ear advantage was observed when subvocal articulatory activity was voluntarily reduced. These results suggest that subvocal articulatory activity contributes to the observed right-ear advantage for speech by affecting attentional bias and not phonetic processing. Possible underlying mechanisms for this effect are discussed.

Memory deficits in workers suffering from hard metal disease.

This study examined memory functioning on the Wechsler Memory Scale-Revised in a group of adult tungsten carbide workers with hard metal disease and a group of matched controls. The hard-metal-exposed group of workers showed memory deficits related to difficulties in attention and verbal memory, with an apparent sparing of visual-spatial memory. Implications of this finding for future research are discussed.

Neuropsychological sequelae of hard metal disease.

To evaluate the memory complaints of a group of patients with hard metal disease, 12 adult, former tungsten carbide workers with hard metal disease and 26 healthy, unexposed control subjects matched for age, race, sex, occupational status and education were administered the Wechsler Memory Scale-Revised (WMS-R), the Peterson Word Triad Test, Squire's Current Events Test (including both the recall and recognition forms), and Squire's Television Title Recognition Test. The exposed group demonstrated deficits in short-term verbal memory, allocation of central processing resources, and remote verbal memory compared to the control group. Visual memory was spared. Comparisons were made to previous investigations of memory functioning within the toxicology literature.

The unification of mind: Integration of hemispheric semantic processing.

Seventy-six participants performed a visual half-field lexical decision task at two different stimulus onset asynchronies (50 or 750 ms). Word targets were primed either by a highly associated word (e.g., CLEAN-DIRTY), a weakly associated word (e.g., CLEAN-TIDY), or an unrelated word (e.g., CLEAN-FAMILY) projected to either the same or opposite visual field (VF) as the target. In the short SOA, RVF-left hemisphere primes resulted in high associate priming regardless of target location (ipsilateral or contralateral to the prime) whereas LVF-right hemisphere primes produced both high and low associate priming across both target location conditions. In the long SOA condition, contralateral priming patterns converged, demonstrating only high associate priming in both VF locations. The results of this study demonstrate the critical role of interhemispheric transfer in semantic processing and indicate a need to elaborate current models of semantic processing.

The utility of novelty seeking, harm avoidance, and expectancy in the prediction of drinking.

To test the hypothesis that two temperament scales (Novelty Seeking and Harm Avoidance) are differentially related to alcohol expectancies and drinking patterns, 140 adolescents from an inpatient psychiatric facility completed several self-report questionnaires measuring temperament, alcohol expectancies, and alcohol consumption. Moderated multiple regression analyses indicated that Novelty Seeking was significantly related to frequency of drinking and problem drinking, but that Harm Avoidance was not related to these variables. Results of the MANOVA indicated that high novelty seeking and low harm avoidant (Type 2) individuals had a significantly higher frequency of drinking than did individuals who were high on Harm Avoidance and low on Novelty Seeking (Type 1). Results also showed that expectancy and Novelty Seeking contributed significant independent and overlapping variance in the prediction of amount of drinking. Although Novelty Seeking was related to expectations of social functioning, other hypothesized relationships between temperament and expectancy were not supported.

Continuous positive airway pressure: patients' and caregivers' learning needs and barriers to use.

OBJECTIVE: To identify learning needs and factors related to postdischarge use of continuous positive airway pressure (CPAP) ventilation. DESIGN: Exploratory descriptive correlational. SETTING: Metropolitan and rural clinics. SUBJECTS: Adult patients (N = 21) and family caregivers, one half 60 years or older. INSTRUMENTS: Family interviews, life satisfaction and quality, family function and relationship, depression and learning preparedness. RESULTS: There were numerous learning needs related to CPAP machine management, monitoring illness severity, and recognizing depressive symptomology, oxygen deficits, and cardiovascular sequelae. Family members are involved in overcoming barriers interfering with nightly CPAP use. Interview and questionnaire data clearly indicate life satisfaction improves after CPAP treatment. CONCLUSION: Predischarge and teaching programs coordinated by expert nurses are needed to address families' learning needs and support habitual long-term CPAP use. Family problem solving and depression interventions, instruction on recognizing symptoms of cardiovascular complications, and long-term follow-up programs are currently being studied.

Influence of biostimulation by mature bulls on occurrence of puberty in beef heifers.

The objective of this study was to determine if biostimulation of prepuberal beef heifers by mature bulls would alter proportions of heifers exhibiting puberty, or age or weight at puberty. Angus (A), A X Hereford (H) and Tarentaise X HA heifers (n = 103) were stratified by age and weight within breed-type and location of birth and allotted randomly to the following treatments: 1) heifers exposed to mature bulls (T1; n = 52) or 2) heifers isolated from bulls (T2; n = 51). At the start of the experiment, heifers in T1 and T2 were 287 +/- 2 and 286 +/- 2 d of age, respectively. Male-to-female ratio for T1 was 1:26. Heifers in T1 and T2 were maintained in drylots separated by .5 km. Heifers were observed for estrus twice daily for 152 d. Puberty was characterized by the following criteria: 1) behavioral estrus, 2) presence of a palpable corpus luteum (d 9; estrus = d 0) and 3) a rise in serum progesterone above 1 ng/ml (d 9). Proportions of heifers reaching puberty by 11, 12, 13, 14 and 15 mo of age did not differ (P greater than .10) between treatments. Percentages of heifers reaching puberty by the end of the experiment were 84 and 89% for T1 and T2, respectively. Age and weight at puberty did not differ (P greater than .10) between treatments and averaged 370 +/- 7 d and 293 +/- 4 kg, respectively. Results from this experiment indicated that presence of mature bulls did not alter proportions of beef heifers reaching puberty, or age and weight at puberty.

Estimating the impact of management decisions on the occurrence of puberty in beef heifers.

Age and weight at puberty in beef heifers were hypothesized to be jointly dependent random variables with the joint distribution conditional upon values of exogenous variables such as breed, date of birth and postweaning rate of gain. A statistical model was specified that tested the joint dependency hypothesis and measured the impact of variation in the explanatory variables on puberty. Model parameters were estimated by two-stage least-squares procedures from data on 556 beef heifers: 190 raised at the Northern Agricultural Research Center (NARC), Havre, Montana and 366 raised at the Livestock and Range Research Station (LARRS), Miles City, Montana. Results did not support the hypothesis that age and weight at puberty were jointly dependent; weight at puberty did depend upon age at puberty, but age at puberty did not depend upon weight at puberty when postweaning level of nutrition was known. Thus, the appropriate probability distribution was a conditional univariate probability distribution on age. Results were consistent with past research in that breed and breed-cross differences existed, and heifers heavier at weaning and fed higher levels of postweaning nutrition reached puberty at an earlier age and heavier weight.

The pediatrician's approach to the preschool child with language delay.

A systematic approach to the child with suspected language disorder includes screening of expressive language, receptive language, general development, and hearing. Various screening approaches and tools are discussed. Diagnostic categories and associated referral patterns are recommended.