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Purpose: In this study, the authors sought to determine whether a combination of English-language measures and a parent questionnaire on first-language development could adequately discriminate between English-language learners (ELLs) with and without language impairment (LI) when children had diverse first-language backgrounds., Method: Participants were 152 typically developing (TD) children and 26 children with LI; groups were matched for age (M = 5;10 [years;months]) and exposure to English (M = 21 months). Children were given English standardized tests of nonword repetition, tense morphology, narrative story grammar, and receptive vocabulary. Parents were given a questionnaire on children's first-language development., Results: ELLs with LI had significantly lower scores than the TD ELLs on the first-language questionnaire and all the English-language measures except for vocabulary. Linear discriminant function analyses showed that good discrimination between the TD and LI groups could be achieved with all measures, except vocabulary, combined. The strongest discriminator was the questionnaire, followed by nonword repetition and tense morphology., Conclusion: Discrimination of children with LI among a diverse group of ELLs might be possible when using a combination of measures. Children with LI exhibit deficits in similar linguistic/cognitive domains regardless of whether English is their first or second language.

Background: Prescribing antibiotics to patients with a history of penicillin allergy is common in clinical practice. Opting for non-beta-lactam antibiotics has its inconveniences and is often unnecessary, because most of these patients are in fact not allergic., Objective: This study aimed to determine how physicians in a large Canadian tertiary-care academic hospital without allergists on staff treat patients with a history of penicillin allergy., Methods: A retrospective study was conducted during a 1-year period among all patients hospitalized in the intensive care unit, coronary care unit, and internal medicine wards. Files of patients with a record of penicillin allergy were reviewed to assess the need for antibiotics during their hospitalization and the decision-making process underlying the choice of antibiotic. The additional costs of alternative antibiotics were calculated., Results: The files of 1738 patients admitted over a 1-year period were hand reviewed. A history of penicillin allergy was found in 172 patients (9.9%). The allergic reaction was described in only 30% of cases and left unmentioned in 20.7%. Beta-lactam antibiotics were used on 56 occasions despite a history of penicillin allergy. The use of alternative antibiotics in place of the beta-lactam standard of care carried an additional cost of $15,672 Canadian., Conclusion: Alleged penicillin allergy is common among hospitalized patients and leads to substantial additional costs. Poor documentation of penicillin allergy likely reflects a lack of knowledge on this issue in the medical community, which impairs optimal treatment of these patients. Increased education on this matter is needed, and allergists on staff could be part of the solution., (Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Purpose: This study investigated whether past tense use could differentiate children with language impairment (LI) from their typically developing (TD) peers when English is children's second language (L2) and whether L2 children's past tense profiles followed the predictions of Bybee's (2007) usage-based network model., Method: A group of L2 children with LI (L2-LI) and a matched group of L2-TD peers were administered the past tense probe from the Test of Early Grammatical Impairment (Rice & Wexler, 2001) and the Peabody Picture Vocabulary Test (Dunn & Dunn, 1997). A representative input corpus provided distributional information for each verb used. Background information was obtained via parent questionnaire., Results: The L2-LI group used fewer tense-marked verbs than did the L2-TD group. In both groups, vocabulary size and word frequency predicted accuracy with regular and irregular verbs. Children omitted regular past tense marking most often after alveolar stops, dropping the allomorph /Id/; L2-TD children omitted /t/ more often than /d/. Finally, first language typology predicted past tense accuracy., Conclusions: Past tense use could potentially differentiate between English L2 children with and without LI. The impact of vocabulary, frequency, and phonological factors supported the network model and indicated profile differences between L2-LI and L2-TD children.

A major challenge faced by Forensic Program management teams is to balance their budgets due to the unpredictability of the forensic patient population, particularly in the context of managing staffing costs where the hospital is not the "gatekeeper" and does not have control over who is admitted and when. In forensic mental health, the justice system, either via the courts, or review boards, determines who is ordered for admission to hospital for assessment or treatment and rehabilitation. Hospitals have little, if any, recourse but to admit these mentally disordered offenders. This typically results in increased levels of staffing with concomitant overtime costs. The literature suggests that clustered float pool nurses develop enhanced relationships with staff and patients, thereby enabling them to attain specialized clinical expertise to treat specific patient populations, promoting safer, high quality care, and overall are more cost effective. Forensic nursing is recognized as a mental health subspecialty. The "Forensic Float Nurse" concept was piloted to provide readily available, highly adaptable, skilled forensic nurses to assist in times of unpredictably heavy workloads and/or unplanned staffing shortages. A significant reduction approaching 50% in overtime was achieved. Heuristic implications of this finding are presented., (© 2012 International Association of Forensic Nurses.)

We previously observed the lungs of naive BALB/cJ Cftr(tm1UNC) mice to have greater numbers of lymphocytes, by immunohistochemical staining, than did BALB wild type littermates or C57BL/6J Cftr(tm1UNC) mice. In the present study, we initially investigated whether this mutation in Cftr alters the adaptive immunity phenotype by measuring the lymphocyte populations in the lungs and spleens by FACS and by evaluating CD3-stimulated cytokine secretion, proliferation, and apoptosis responses. Next, we assessed a potential influence of this lymphocyte phenotype on lung function through airway resistance measures. Finally, we mapped the phenotype of pulmonary lymphocyte counts in BALB × C57BL/6J F2 Cftr(tm1UNC) mice and reviewed positional candidate genes. By FACS analysis, both the lungs and spleens of BALB Cftr(tm1UNC) mice had more CD3(+) (both CD4(+) and CD8(+)) cells than did littermates or C57BL/6J Cftr(tm1UNC) mice. Cftr(tm1UNC) and littermate mice of either strain did not differ in anti-CD3-stimulated apoptosis or proliferation levels. Lymphocytes from BALB Cftr(tm1UNC) mice produced more IL-4 and IL-5 and reduced levels of IFN-γ than did littermates, whereas lymphocytes from C57BL/6J Cftr(tm1UNC) mice demonstrated increased Il-17 secretion. BALB Cftr(tm1UNC) mice presented an enhanced airway hyperresponsiveness to methacholine challenge compared with littermates and C57BL/6J Cftr(tm1UNC) mice. A chromosome 7 locus was identified to be linked to lymphocyte numbers, and genetic evaluation of the interval suggests Itgal and Il4ra as candidate genes for this trait. We conclude that the pulmonary phenotype of BALB Cftr(tm1UNC) mice includes airway hyperresponsiveness and increased lymphocyte numbers, with the latter trait being influenced by a chromosome 7 locus.

The practice of elective penicillin skin testing could be compromised by the fact that patients, their parents, or their physicians remain reluctant to reuse penicillin-class antibiotics (PCAs) despite a negative evaluation by an allergist. This study addresses reuse of PCAs in a pediatric population after negative penicillin skin testing and drug challenge and factors associated with its reluctance. All children evaluated for a history of penicillin allergy at the CHU Sainte-Justine Allergy Clinic between January 1998 and June 2000 with negative skin testing and drug challenge were included in the study. A telephone survey was conducted between May and October 2002 to assess the perception of the initial reaction by the parents, subsequent use of antibiotics, and antibiotic-related adverse reactions. Among the 200 children selected, parents of 170 (85%) children completed the survey. Since the allergist evaluation, 130 (76%) children had received antibiotics. PCA was used in 59 (45%) children. Parents of 24 (18%) children refused PCAs because they still feared an adverse reaction. They were more likely to have been very frightened by their child's allergic reaction than other parents whose children had used PCAs (p = 0.008). Although elective penicillin skin testing is useful and safe in the pediatric population, a significant proportion of parents still refuse PCAs even though they are needed. Identification of parents that were very frightened by their children's allergic reactions and additional reassurance could improve this situation.

Liaison and elision in French are phonological phenomena that apply across word boundaries. French-speaking children make errors in contexts where liaison/elision typically occurs in adult speech. In this study, we asked if acquisition of French liaison/elision can be explained in a constructivist framework. We tested if children's liaison/elision was sensitive to co-occurrence and meaning. We expected children's use of liaison/elision to correlate with their experience with French (estimated by vocabulary). Thirty-one French-speaking children (twenty-five bilingual) between three and five years old produced familiar vowel-initial words, following four words: (1) un, (2) deux, (3) un petit and (4) beaucoup de. The children with smaller French vocabularies produced many vowel-initial words and some consonant-initial chunks. The children with larger French vocabularies produced liaison/elision correctly across several frames while associating a number interpretation with liaised consonants. These results suggest that children use a variety of cues to construct the appropriate use of liaison/elision.

Bilingual and monolingual children's (mean age=4;10) elicited production of the past tense in both English and French was examined in order to test predictions from Usage-Based theory regarding the sensitivity of children's acquisition rates to input factors such as variation in exposure time and the type/token frequency of morphosyntactic structures. Both bilingual and monolingual children were less accurate with irregular than regular past tense forms in both languages. Bilingual children, as a group, were less accurate than monolinguals with the English regular and irregular past tense, and with the French irregular past tense, but not with the French regular past tense. However, bilingual children were as accurate as monolinguals with the past tense in their language of greater exposure, except for English irregular verbs. It is argued that these results support the view that children's acquisition rates are sensitive to input factors, but with some qualifications.

Background: A deviated septum can be corrected by either a conventional "open" or endoscopic approach. Controversy exists regarding comparative outcomes between these two techniques. Our objective was to compare the two according to subjective and objective criteria., Study Design: Prospective, single-blinded, randomized, controlled trial., Methods: Over a 6-month period, all patients diagnosed with a septal deviation meeting strict inclusion/exclusion criteria were recruited. Patients were randomly assigned to either the conventional or the endoscopic group. Outcome measures included surgical time, intraoperative complications, and pre- and postoperative data from the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Chi-square and t-tests were used for statistical analyses., Results: Sixty-three patients were enrolled in the study: 32 in the endoscopic group and 31 in the conventional group. There were subjective postoperative improvements in the NOSE scores across all participants and within both groups (endoscopic: preoperative mean score  =  14.7, postoperative mean score  =  7.4, p < .05; conventional: preoperative mean score  =  15.2, postoperative mean score  =  6.3, p < .05), with no differences found between groups (p  =  .61). However, objective outcomes such as operative time (p < .001) and intraoperative complications (p  =  .01) favoured the endoscopic group., Conclusion: The endoscopic approach for septoplasty may be considered superior to the traditional approach for the correction of septal deviation.

Purpose: Obtaining information on both languages of English language learners for assessment can be a challenge in a multilingual context. It is often difficult or impossible to observe a child's first language directly due to the absence of resources available in every language spoken. The objectives of this study were (1) to develop a parent questionnaire on the first language development of English language learners that is not specific to a particular language/cultural group: the Alberta Language and Development Questionnaire (ALDeQ), and (2) to test how well scores on the ALDeQ differentiated between English language learners with typical development and those with language impairment., Method: Participants were 139 typically developing children and 29 children with language impairment, aged 69 months with 18 months of exposure to English through preschool or school, on average. The ALDeQ consists of four sections: early milestones, current first language abilities, behaviour patterns and activity preferences, and family history. ALDeQ total scores are proportions calculated across all sections., Results: t-test analyses revealed robust between-group differences for ALDeQ total scores, and for each section score, with medium to very large effect sizes. Linear discriminant function analysis showed the ALDeQ total scores to be a significant and moderate discriminator between the typically developing and language impaired group, but with better specificity than sensitivity. The early milestones section scores emerged as the strongest discriminator among the four section scores. Parent responses showed that both the typically developing and language-impaired groups included children experiencing first language loss, but nevertheless, the current first language abilities section was the second strongest between-group discriminator., Conclusion: The ALDeQ would be useful to speech-language pathologists for obtaining information on English language learners' first language development, in particular where the first language cannot be examined directly. The information provided by the ALDeQ could be used in conjunction with other measures in order to identify children with language impairment among English language learners. The complete ALDeQ and score interpretation information are given in Appendix A., Learning Outcomes: Readers will (1) have a general understanding of how parent report could be useful for assessment in a multilingual context; (2) be aware of how first language loss in minority language children could impact assessment, and (3) have specific knowledge of a particular parent questionnaire and how it can be used to assist in identifying English language learners with language delay/impairment., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Background: Mice with the cystic fibrosis transmembrane conductance regulator (Cftr) gene knocked out develop osteopenia. To determine whether this phenotype is present in cystic fibrosis mouse models with the DeltaF508 Cftr mutation we assessed the femora of adult FVB/N Cftr(tm1Eur) and C57BL/6 Cftr(tm1Kth) mice., Methods: Bone disease, relative to littermate controls, was measured using histology, densitometry and quantitative imaging., Results: C57BL/6 Cftr(tm1Kth) mice had shorter femurs and bones of lower volume due to thinner trabeculae, compared to wild type littermates. FVB/N Cftr(tm1Eur) mice also presented a lower bone volume which was due to significantly fewer trabeculae in this strain. Osteoblast and osteoclast numbers did not differ between CF and controls, for either of FVB/N Cftr(tm1Eur) or C57BL/6 Cftr(tm1Kth) mice. The bone architecture of FVB/N Cftr(tm1Eur) mice did not significantly differ from that of C57BL/6 Cftr(tm1Kth) mice., Conclusions: An osteopenic bone disease is evident in adult DeltaF508-Cftr cystic fibrosis mouse models., (Copyright 2010 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.)

Hox genes encode transcription factors of crucial importance in the pattern formation of a large spectrum of species. Several studies have now proposed a role for these developmental genes in cancer biology. It has been suggested that HOXA5 possesses growth-suppressive properties through activation of p53 expression in human breast tissue. To assess the genetic cooperation that may exist between Hoxa5 and p53 in tumorigenesis, we generated Hoxa5/p53 compound mutant mice. The presence of Hoxa5 null alleles increased the susceptibility of p53(-/-) mice to develop tumors with a high prevalence for thymic lymphoma, suggesting that the loss of function of the two genes collaborate in tumor formation. To extend our analysis to mammary tumorigenesis, we performed Hoxa5/p53 whole mammary gland transplantations into wild-type hosts. In the p53(-/-) background, the presence of one Hoxa5 mutant allele had no impact on mammary tumor formation. In contrast, the complete loss of Hoxa5 function influenced the tumorigenic outcome of p53(+/-) mammary glands. However, the collaborative nature of this interaction did not depend on the transcriptional regulation of p53 by Hoxa5. Altogether, our data establish that Hoxa5 and p53 cooperate in mammary tumorigenesis in vivo.

Background: Peanut allergy is an important public health problem in western countries. However, the risk factors associated with this allergy remain uncertain., Objective: To determine whether the consumption of peanuts during pregnancy and breastfeeding is a risk factor for peanut allergy in infants., Methods: We enrolled 403 infants in a case-control study. The cases were infants aged 18 months or less with a diagnosis of peanut allergy based on a history of clinical reaction after exposure to peanuts and the presence of peanut-specific immunoglobulin E. Controls were age-matched infants with no known clinical history or signs of atopic disease. The mothers of the children filled out a detailed questionnaire about maternal diet during pregnancy and breastfeeding, the infant's diet, the presence of peanut products in the infant's environment, and family history of atopy., Results: The mean (SD) age of cases was 1.23 (0.03) years. The groups were comparable in terms of the rate and duration of breastfeeding. However, the reported consumption of peanuts during pregnancy and breastfeeding was higher in the case group and associated with an increased risk of peanut allergy in offspring (odds ratio [OR], 4.22 [95% confidence interval [CI], 1.57-11.30 and OR, 2.28 [95% CI, 1.31-3.97] for pregnancy and breastfeeding, respectively). Overall, the infants with peanut allergy did not seem to be more exposed to peanut products in their environment than the controls., Conclusion: Early exposure to peanut allergens, whether in utero or through human breast milk, seems to increase the risk of developing peanut allergy.

Objective: This study investigated the effects of a high-sympathetic stimulus environment (high-altitude hypoxia) on limb-specific systolic blood pressure (sBP) and ankle-brachial index (ABI) in normal volunteers. We hypothesized that currently accepted normal values for ABI may in fact not reflect an actual normal vascular state in all patients., Methods: Twenty climbers (17 males, 3 females) from Gatineau-Hull (Québec, Canada) participated in this study and ascended Mount Kilimanjaro, Africa. Ankle-brachial index measurements were performed at sea level and on Mount Kilimanjaro at approximately 4100 m. The data were analyzed using predictive analytics software SPSS 14.0. Data obtained at sea level were compared to those obtained at approximately 4100 m, with participants serving as their own controls., Results: Ankle-brachial indices measured at approximately 4100 m (mean = 1.20) were greater than those measured at sea level (mean = 0.97) (n = -6.23; 95% CI: -.32 to -.17; P < .001). There were no significant differences between the systolic brachial pressures at approximately 4100 m when compared to those at sea level (P = .814). Contrarily, systolic ankle pressures at sea level (mean = 132) were significantly greater than those measured at approximately 4100 m (mean = 152) (t = -3.5, 95% CI: -29 to -7.4; P = .002)., Conclusions: This study is the first to physiologically demonstrate that in response to a high adrenergic stimulus in healthy volunteers there is a greater increase in sBP in the legs vs the arms.

Objective: In this article, we compared the costs of testing meconium for alcohol exposure in newborns with the lifetime benefits of early detection and intervention., Method: A decision analytic model was developed to assess the cost-effectiveness of testing meconium for two scenarios: (1) all infants in the Canadian province of Ontario and (2) infants who have an older sibling diagnosed with fetal alcohol spectrum disorder (FASD). The model incorporated the costs of early screening, early intervention, and the lifetime societal benefits of early intervention., Results: The cost of the meconium test is Can. $150. The lifetime societal cost of the disease is Can. $1.3 million per incident case. The benefit of early intervention is an improvement in literacy, which improves the quality of life parameter by 0.17 and increases adult lifetime earnings by $26,400 per year. The ratio of the incremental cost to the incremental benefits results in an incremental cost-effectiveness ratio for mandating a universal screen of all newborns in Ontario of $65,874 per quality-adjusted life years. When considering targeted screening, there is a cost savings for society and improvements in quality of life., Conclusions: Depending on society's willingness-to-pay threshold for improving infants' lives in a setting of considerable equity concerns, universal screening and targeted screening of infants who have an older sibling diagnosed with FASD both represent policies that are good value for the money.

Technological developments in percutaneous coronary interventions (PCI) allow the possibility for less invasive revascularization in an increasing number of patients with atherosclerotic coronary artery disease. Bare-metal stents (BMS) have considerably improved the efficacy of PCI in addition to greatly reducing restenosis. However, even with standard stents, restenosis has remained a significant limitation of this revascularization technique. The advent of drug-eluting stents (DES) has dramatically reduced in-stent restenosis and, as a result, the need for repeat revascularization. However, their potential thrombogenicity has raised concerns about their clinical utility and long-term safety. Indeed, there is a possible higher rate of late stent thrombosis (LST) with DES compared with BMS. Antiplatelet therapy has been shown to be efficient in preventing DES thrombosis. Nevertheless, in the future, significant improvement will occur to improve the safety and efficacy of this therapy. This article will summarize the pathophysiology and the epidemiology of stent thrombosis (ST). Definitions of definite, probable and possible ST will be described. Furthermore, clinical risk factors for ST will be clearly enumerated. Then, the various antiplatelet therapeutic strategies used to prevent ST will be taken in consideration. Finally, a summary of the major recommendations about antiplatelet therapy made by some of the most prestigious learned societies will be presented.

This study reports on a comparison of the use and knowledge of tense-marking morphemes in English by first language (L1), second language (L2) and specifically language-impaired (SLI) children. The objective of our research was to ascertain whether the L2 children's tense acquisition patterns were similar or dissimilar to those of the L1 and SLI groups, and whether they would fit an (Extended) Optional Infinitive profile, or an L2-based profile, e.g., the Missing Surface Inflection Hypothesis. Results showed that the L2 children had a unique profile compared with their monolingual peers, which was better characterized by the Missing Surface Inflection Hypothesis. At the same time, results reinforce the assumption underlying the (Extended) Optional Infinitive profile that internal constraints on the acquisition of tense could be a component of L1 development, with and without SLI.

Raman microspectroscopy has been used to quantitatively study the effect of a mechanical deformation on the conformation and orientation of Samia cynthia ricini (S. c. ricini) silk fibroin. Samples were obtained from the aqueous solution stored in the silk gland and stretched at draw ratios (lambda) ranging from 0 to 11. Using an appropriate band decomposition procedure, polarized and orientation-insensitive spectra have been analyzed to determine order parameters and the content of secondary structures, respectively. The data unambiguously show that, in response to mechanical deformation, S. c. ricini fibroin undergoes a cooperative alpha-helix to beta-sheet conformational transition above a critical draw ratio of 4. The alpha-helix content decreases from 33 to 13% when lambda increases from 0 to 11, while the amount of beta-sheets increases from 15 to 37%. In comparison, cocoon silk is devoid of alpha-helical structure and always contains a larger amount of beta-sheets. Although the presence of isosbestic points in different spectral regions reveals that the conformational change induced by mechanical deformation is a two-state process, our results suggest that part of the glycine residues might be incorporated into beta-poly(alanine) structures. The beta-sheets are initially isotropically distributed and orient along the fiber axis as lambda increases, but do not reach the high level of orientation found in the cocoon fiber. The increase in the orientation level of the beta-sheets is found to be concomitant with the alpha --> beta conformational conversion, whereas alpha-helices do not orient under the applied strain but are rather readily converted into beta-sheets. The components assigned to turns exhibit a small orientation perpendicular to the fiber axis in stretched samples, showing that, overall, the polypeptide chains are aligned along the stretching direction. Our results suggest that, in nature, factors other than stretching contribute to the optimization of the amount of beta-sheets and the high degree of orientation found in natural cocoon silk.

Purpose: This study was conducted to examine whether the expressive language characteristics of typically developing (TD) children learning English as a second language (ESL) have similarities to the characteristics of the English that is spoken by monolingual children with specific language impairment (SLI), and whether this could result in the erroneous assessment of TD English-language learners (ELLs) as language impaired., Method: Twenty-four TD language-minority children who had been learning ESL for an average of 9.5 months participated in the study. The children's accuracy and error types in production of the following grammatical morphemes were examined in spontaneous and elicited speech: third person singular [-s], past tense [-ed], irregular past tense, BE as a copula and auxiliary verb, DO as an auxiliary verb, progressive [-ing], prepositions in and on, plural [-s], and determiners a and the. The elicitation probes were part of a recently developed standardized test for identifying language impairment, the Test of Early Grammatical Impairment (TEGI; M. Rice & K. Wexler, 2001)., Results: The ELLs' accuracy rates and error patterns with the grammatical morphemes were similar to those that have been reported for same-age monolingual children with SLI, in both spontaneous and elicited speech. In addition, the ELL's elicitation probe scores were compared to the criterion scores and group means from the sample of monolingual children used to develop the TEGI and their performance on the TEGI was in the range of the clinical population even though there is no reason to suspect that any of these children is language impaired. Both analyses point to the possibility that TD ELLs could be mistaken as language impaired., Clinical Implications: The results provide information that can be used to set appropriate expectations of error patterns and rate of grammatical development in the early stages of ESL learning. The results also emphasize how the use of English standardized tests with nonnative English-speakers is not a good practice, and suggestions are given for points to consider when assessing ELLs.

This study investigated whether crosslinguistic interference occurs in the domain of subject realization in Spanish in a bilingual acquisition context. We were also interested in exploring whether the source of the interference is due to child-internal crosslanguage contact between English and Spanish, as is commonly assumed, or due to the nature of the language input in a bilingual family, a factor which has not typically been considered in studies of crosslinguistic influence. The use of subjects in a null subject language like Spanish is a phenomenon linked to the pragmatics/syntax interface of the grammar, and thus, is a domain where crosslinguistic interference is predicted to be likely to occur in bilingual acquisition (Müller & Hulk, 2001). Using spontaneous language data available from CHILDES (www.childes.psy.cmu.edu), we examined the use of overt subjects in Spanish by two Spanish monolingual children (ages: 1;8-2;7 and 1;8-1;11) one Spanish-English bilingual child (age 1;9-2;6) and their parental interlocutors. We looked at the proportions of overt versus null subjects as well as the discourse-pragmatic contexts of overt subject use by the children in order to uncover bilingual/monolingual differences in the distributional properties and the functional determinants of subject realization. We also looked at identical variables in the speech of the children's parental interlocutors to investigate the potential influence of the input on the children's output. Our results suggest that the bilingual child showed patterns in her subject realizations in Spanish that could be interpreted as due to crosslinguistic effects from English; however, there is also evidence that these effects may have a source in the input, rather than resulting from internal crosslanguage contact. While our data do not permit us to distinguish conclusively between these two possible sources, they indicate that future research on crosslinguistic influence in bilingual acquisition should take input into account.

The goal of this study was to determine whether bilingual children with specific language impairment (SLI) are similar to monolingual age mates with SLI, in each language. Eight French-English bilingual children with SLI were compared to age-matched monolingual children with SLI, both English and French speaking, with respect to their use of morphosyntax in language production. Specifically, using the extended optional infinitive (EOI) framework, the authors examined the children's use of tense-bearing and non-tense-bearing morphemes in obligatory context in spontaneous speech. Analyses revealed that the patterns predicted by the EOI framework were borne out for both the monolingual and bilingual children with SLI: The bilingual and monolingual children with SLI showed greater accuracy with non-tense than with tense morphemes. Furthermore, the bilingual and monolingual children with SLI had similar mean accuracy scores for tense morphemes, indicating that the bilingual children did not exhibit more profound deficits in the use of these grammatical morphemes than their monolingual peers. In sum, the bilingual children with SLI in this study appeared similar to their monolingual peers for the aspects of grammatical morphology examined in each language. These bilingual-monolingual similarities point to the possibility that SLI may not be an impediment to learning two languages, at least in the domain of grammatical morphology.

A procedure developed for soybean protein precipitation which was based on electrodialysis was tested for the production of acid casein from reconstituted skim milk. In a previous paper, the performance of bipolar membrane electroacidification (BMEA) was evaluated under different conditions of ionic strength (micro(added) = 0, 0.25, 0.5, or 1.0 M) and added salt (CaCl(2), NaCl, or KCl) (1). The aim of this study, which is the complement of the work on evaluation of BMEA performance, was to evaluate the functionality of the protein isolates produced by BMEA and to compare the BMEA isolates to commercial isolates and an isolate produced by chemical acidification. It was not possible to show differences between the functional properties of isolates produced by BMEA, except at 1 M CaCl(2) micro(added), due to the variability of the isolates. However, the results showed that it is possible to obtain isolates similar to commercial isolates and that the addition of salt during the process does not induce variations in functional properties. From results on mineral concentrations, it appeared that the addition of monovalent cations did not influence the retention of monovalent or divalent cations in the BMEA isolates, while addition of divalent cations (CaCl(2)) influenced the retention of magnesium. According to previous results on evaluation of BMEA performances under different conditions of ionic strength and added salt, the difference observed for the BMEA isolate produced at 1.0 M CaCl(2) was confirmed.

Recent studies in our laboratories have focused on the reliability of direct-reading instruments for the determination of airborne isocyanate concentrations. The evaluation of airborne isocyanates is complicated because these substances exist as diisocyanate monomers and polyisocyanate oligomers, both in the vapor and aerosol phases. The studies showed that a number of direct-reading instruments, including the SureSpot test kit, do not allow an accurate determination of isocyanates in the aerosol phase. Using a test chamber, concentrations of various commercial polymeric methylenediphenyl diisocyanates (PMDI) were generated in the aerosol phase to examine the correlation between the SureSpot monitor and two laboratory methods. The results obtained with the SureSpot and laboratory methods correlated poorly. More precisely, the results indicated that the SureSpot direct-reading instrument had a distinctive response to each commercial PMDI and, in addition, it was not accurate for the determination of total PMDI in the aerosol phase. It seemed that the analytical response of the SureSpot is based on a calibration curve only reliable for MDI and not for the determination of PMDIs in the aerosol phase. Further investigation also indicated that the calibration provided by the manufacturer could not be converted into a linear curve over the suggested MDI concentrations range. An appropriate calibration procedure was developed in our laboratories for the SureSpot to accurately determine all commercial PMDIs without great variability.

The aim of this study was to evaluate the effect of decreasing the mineral content of skim milk by electrodialysis (ED) prior to electroacidification with bipolar membrane (BMEA) on the performance of the process, the chemical composition, and the physicochemical and functional properties of the isolates produced. ED used to demineralize the skim milk solution was very efficient. However, the electroacidification parameters were influenced by the demineralization level of the skim milk solution: the energy efficiency was decreased with an increase in demineralization, but it was still possible to perform BMEA at a very low conductivity level. Moreover, the isolates produced by BMEA after electrodialysis demineralization at different rates showed similar chemical composition, except on potassium and lactose contents for 75% demineralized isolate. These isolates, except on protein load for 75% demineralization rate, showed similar physicochemical and functional properties, whatever the demineralization rate.

Resistance to macrolides among group A streptococci is an increasing problem worldwide. We examined 496 strains phenotypically and genotypically for resistance to erythromycin and clindamycin. Strains were isolated in five different geographical areas representing about 45% of the total Quebec population. The overall resistance rate was 4.6% but varied from 0% in rural areas to 9.4% in Montreal. Of the 23 strains showing resistance to erythromycin, 15 (65%) had an identical pulsed-field gel electrophoresis pattern, were of serotype M28T28 and harboured the erm(TR) gene, suggesting the spread of a single clone. Of the remaining eight strains, two strains had the erm(B) gene, five had the mef gene and one with a different serotype also had the erm(TR) gene.

This study compares the morphosyntax of children with SLI to the morphosyntax of children acquiring a second language (L2) to determine whether the optional infinitive phenomenon (M. Rice, K. Wexler, & P. Cleave, 1995; K. Wexler, 1994) is evident in both learner groups and to what extent cross-learner similarities exist. We analyzed spontaneous production data from French-speaking children with SLI, English-speaking L2 learners of French, and French-speaking controls, all approximately 7 years old. We examined the children's use of tense morphology, temporal adverbials, agreement morphology, and distributional contingencies associated with finiteness. Our findings indicate that the use of morphosyntax by children with SLI and by L2 children has significant similarities, although certain specific differences exist. Both the children with SLI and the L2 children demonstrate optional infinitive effects in their language use. These results have theoretical and clinical relevance. First, they suggest that the characterization of the optional infinitive phenomenon in normal development as a consequence of very early neurological change may be too restrictive. Our data appear to indicate that the mechanism underlying the optional infinitive phenomenon extends to normal (second) language learning after the primary acquisition years. Second, they indicate that tense-marking difficulty may not be an adequate clinical marker of SLI when comparing children with impairment to both monolingual and bilingual peers. A more specific clinical marker would be more effective in diagnosing disordered populations in a multilingual context.

Nectar-carbohydrate production and composition were investigated by high-performance liquid chromatography and enzymology in nine species from five tribes of the Brassicaceae. In six species (Arabidopsis thaliana (L.) Heynh., Brassica napus L., B. rapa L., Lobularia maritima (L.) Desv., Raphanus sativus L., Sinapis arvensis L.) that produced nectar from both lateral nectaries (associated with the short stamens) and median nectaries (outside the long stamens), on average 95% of the total nectar carbohydrate was collected from the lateral ones. Nectar from these glands possessed a higher glucose/fructose ratio (usually 1.0-1.2) than that from the median nectaries (0.2-0.9) within the same flower. Comparatively little sucrose was detected in any nectar samples except from Matthiola bicornus (Sibth. et Sm.) DC., which possessed lateral nectaries only and produced a sucrose-dominant exudate. The anatomy of the nectarial tissue in nectar-secreting flowers of six species, Hesperis matronalis L., L. maritima, M. bicornus, R. sativus, S. arvensis, and Sisymbrium loeselii L., was studied by light and scanning-electron microscopy. Phloem alone supplied the nectaries. However, in accordance with their overall nectar-carbohydrate production, the lateral glands received relatively rich quantities of phloem that penetrated far into the glandular tissue, whereas median glands were supplied with phloem that often barely innervated them. All nectarial tissue possessed modified stomata (with the exception of the median glands of S. loeselii, which did not produce nectar); further evidence was gathered to indicate that these structures do not regulate nectar flow by guard-cell movements. The numbers of modified stomata per gland showed no relation to nectar-carbohydrate production. Taken together, the data on nectar biochemistry and nectary anatomy indicate the existence of two distinct nectary types in those Brassicacean species that possess both lateral and median nectaries, regardless of whether nectarial tissue is united around the entire receptacle or not. It is proposed that the term "nectarium" be used to represent collectively the multiple nectaries that can be found in individual flowers.

The U.S. Healthcare Fellowship in Quality Management at Hahnemann University was developed by a managed health care organization and health science university in order to train physicians in the theory and practice of quality management and clinical outcomes measurement. This article describes in detail the program content and the characteristics of applicants.

It has been claimed that children simultaneously acquiring two languages go through an initial stage when they are unable to differentiate between their two languages. Such claims have been based on the observation that at times virtually all bilingual children mix elements (e.g. lexical, morphological) from their two languages in the same utterance. That most, if not all, children acquiring two languages simultaneously mix linguistic elements in this way is widely documented. Although such code-mixing is not well understood or explained, there are a number of explanations unrelated to lack of language differentiation that may explain it. Moreover, while language differentiation is widely attested among bilingual children once functional categories emerge, usually during the third year, there is still some question as to how early in development differentiation is present. In this study, we examined language differentiation in five bilingual children prior to the emergence of functional categories (they ranged in age from 1;10 to 2;2 and in MLU from 1.23 to 2.08). They were observed with each parent separately and both together, on separate occasions. Our results indicate that while these children did code mix, they were clearly able to differentiate between their two languages. We also examine the possibility that the children's mixing is due to (a) their language dominance, and (b) their parents' rate of mixing. We could find no evidence that their mixing was due to parental input, but there was some evidence that language dominance played a role.

An exploratory strategy was used to investigate why 55% of patients with farmer's lung (FL) disease quit farming. Three groups were recruited: 47 patients with FL disease who quit farming because of the disease (FLq), 76 patients with FL disease who continued farming (FLc), and 123 control farmers without a history of FL disease. The severity of FL disease at diagnosis was similar in both groups of patients. For example, single-breath carbon monoxide diffusion capacity predicted for FLq and FLc was 64.4 +/- 28.2 and 63.9 +/- 22.0, respectively. Relying on a cognitive-behavior theory, numerous physiological, behavioral, cognitive, affective, and social variables were assessed. Results showed that the decision to quit farming was based on cognitive and behavioral motives rather than physiological factors. Subjects in the FLq group showed more negative beliefs toward FL and had more fears of FL disease. FLq subjects also reported that family members, friends, and family doctors were more inclined to consider that FL disease could stop them from farming. However, self-efficacy to continue farming despite having FL disease and perceived hindrance caused by FL disease played the most important roles in the decision to quit farming.