Search

A group of 347 children who had been classed as 'at risk' in the neonatal period were examined by means of academic attainment tests and teacher ratings at the end of their first year in primary school. Matched classroom controls were also examined to estimate the prevalence of reading, spelling and mathematics difficulties. Preterm birth and low birthweight appeared to be significant antecedents of poorer outcome in all three subjects. The attributable risk of low birthweight to academic handicap was estimated to be 29 per cent. There was no additional effect of time to spontaneous respiration (short and long) on academic outcome for the preterm low-birthweight group. In contrast, poor outcome for the low-birthweight children who had not been preterm was associated with longer time to spontaneous respiration. Graduates of neonatal intensive care with normal birthweights performed comparably with their low-risk controls. These results are discussed in relation to other longitudinal studies of the outcome for 'at-risk' infants.

Forty-four patients at risk for Huntington's disease and seventeen diagnosed as having the disease were studied longitudinally over a nine-year period to assess the evolution of cognitive impairment. Results showed that there were measurable changes in sensory-perceptual functions well in advance of the emergence of the movement disorder. Discrimination between patients with Huntington's disease and those at risk for the disease based on tests of sensory-perceptual functioning resulted in a correct classification rate of 95.1%. Subjects who had changed from being at risk to having the disease nearly all had discriminant scores from their first test sequence lying in either the disease range or the pre-symptomatic disease range. The present organic model of Huntington's disease is discussed in light of these findings and implications of the mathematical model underlying prediction are discussed.

This paper describes an extensive study of the parameters of saccadic eye movement in a group of 28 poor-reading children and a comparative normally reading group of 31 children. Ages ranged from 6.0 to 16.9 yr. Poor readers had normal intelligence but were lagging by at least two years in reading ability as compared to their peer age group. Parameters studied in refixation eye movements included saccadic latency, accuracy, velocity, and acceleration, as well as differences in latency for abduct and adduct movements. Shapes of saccades were also studied. It was shown that eye-movement performance in simple saccadic refixation was not distinguishably different for poor readers and normal readers, even though in reading, which requires higher processing, eye-movement characteristics are quite different. Maturational changes for various saccadic eye-movement parameters were also examined for the normal and poor reading groups.

The impact of a drug bulletin on prescribing oral analgesics in a teaching hospital was studied. Using an abbreviated time-series design, prescriptions for oral analgesics for all inpatients were surveyed one, three, and five weeks before and one, three, five, and seven weeks after the distribution of one of the hospital's regular drug bulletins. This bulletin contained guidelines for the treatment of minor, moderate, and severe pain. The 493 patients included in the study were classified by drug category, pain severity, and timer period. The drug categories were: (1) propoxyphene, (2) aspirin or acetaminophen alone or with codeine 8 mg or less, and (3) codeine alone or in combination products with more than codeine 8 mg, or other oral narcotic drugs. Each patient's pain severity was determined by interviewing attendant nursing staff; the validity of this approach was confirmed by correlating nurse and physician perception of pain at one time point. Multivariate contingency table analysis revealed that the drug bulletin significantly (p less than or equal to 0.05) reduced the prescribing of propoxyphene hydrochloride across both the minor and moderate pain categories. An increased use of aspirin and acetaminophen was significant three weeks after the release of the drug bulletin. This effect, however, was not significant at other time points. Drug bulletins can be used to achieve a temporary change in physician prescribing patterns of oral analgesics. For a sustained effect, alternative strategies are needed.

We asked 28 registered nurses with varying degrees of experience in working with neurological and neurosurgical patients to fake results on 10 neuropsychological tests in such a way as to be congruent with a history of trauma to the left fronto-temporal cortex. We compared these data to those obtained from 21 patients who had been referred with verified cerebral injury and who had a diagnosis of left fronto-temporal dysfunction. The overall hit rate of classification for the two groups was 85.7% and 89.8%, depending on the way in which test scores were combined. Results showed that a knowledgeable group of informed fakers had great difficulty reproducing the test performance of individuals with left fronto-temporal impairment.