Breaking bad news to people with a learning disability

Schilder's diffuse myelinoclastic sclerosis is a rare demyelinating disease which often mimics intracranial neoplasm or abscess. We have treated 3 patients with this disorder in the past 5 years and followed their postoperative course. Certain distinct features of this disease will allow neurosurgeons to preoperatively entertain this diagnosis. We discuss postoperative treatment and propose a new hypothesis regarding the variable prognoses of this disorder. Schilder's disease constitutes an important diagnosis for any neurosurgeon to be aware of (especially those treating the pediatric age group) which has not received adequate coverage in the neurosurgical literature.     

Offenders who have a learning disability

This article examines aspects of the criminal justice system in relation to offenders with learning disabilities. Questions relating to the vulnerability and responsibility of suspects are explored in the light of recent literature. The legal rights of detainees are considered with reference to the Police and Criminal Evidence Act 1984. The role of the 'appropriate adult' is reviewed and implications for service workers are explored. Future directions are considered with reference to innovative developments in services. Victims and witnesses will be considered in a subsequent article.     

Health care for women with learning disabilities

This article describes a research project exploring the basic health education ow women with learning disabilities. It demonstrated that preventive and well-woman needs were not being met. In response a joint venture was developed between a community learning disabilities team and local well woman and family planning services. The article describes how an informal and accessible clinic was established for women with learning disabilities.     

Teaching phonological awareness to young children with learning disabilities

This study examined the feasibility of teaching phonological manipulation skills to preschool children with disabilities. Forty-seven children, 4-6 years old, enrolled in a special education preschool, were randomly assigned to receive training in one of three categories of phonological tasks (rhyming, blending, and segmenting) or a control group. Results indicated that children were able to make significant progress in each experimental category, but that they demonstrated little or no generalization either within a category (e.g., from one type of blending task to another type of blending task) or between categories (e.g., from blending to segmenting). Although the children's level of cognitive development significantly predicted some learning outcomes, it did not appear to limit the learning of phonological tasks.     

Prognosis of learning disability.

This article reviews earlier and recent studies about the long-term and adult outcomes of children with learning disabilities (LDs). Although some results are contradictory or inconclusive because of the many methodological problems in the conduct of such studies, there is agreement that LDs persist into adulthood to some degree. Outcome is dependent on the severity of the LD at school age, on intelligence, on the socioeconomic status of parents, and on the presence or absence of neurological impairment. Intervention has not been clearly related to improved outcome. Some evidence has suggested that a language-deficit subtype of LD may show poorer outcome. The prognosis of outcome in the strict sense is limited at this time and has little validity for the individual child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Agatha Christie's learning disability.

Evidence is reviewed suggesting that Agatha Christie, the prolific and popular author, had a learning disability. In spite of excellent reading and problem solving skills, she had difficulty with spelling, arithmetic, the mechanical aspects of writing, and foreign language learning. This disability, variously called developmental output failure, dysgraphia, writing backwardness, and/or arithmetic/writing disability, obviously did not prevent her from becoming one of the most popular writers in the English language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of a safety awareness group intervention for women with diverse disabilities: A pilot study.

Objective: Describe the development and preliminary evaluation of a safety awareness program for women with disabilities. Design: Baseline and postintervention questionnaires administered to a sample of women who completed a safety awareness program. Participants: Seven women with diverse disabilities. Intervention: Eight interactive sessions designed to increase protective factors. Setting: Community site for persons with disabilities. Main Outcomes: Safety self-efficacy, safety skills, social support/isolation, and safety promoting behaviors. Results: Significant increases from baseline to postintervention were found on measures of self-efficacy and safety skills. Although not statistically significant, improvements were also found in safety promoting behavior. Conclusion: Despite the small sample, findings suggest that participation in a safety awareness program may improve protective factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working memory in learning disability subgroups

The purpose of this study was to investigate (a) the degree to which working memory differences between learning-disabled and nondisabled children reflect a specific or generalized deficit, and (b) whether limitations in the enhancement of learning-disabled student's working memory performance are attributable to process or storage functions. To this end, performances of reading-disabled, math-disabled, chronological age (CA)-matched, and achievement-matched children were compared on verbal and visual-spatial working memory measures under initial, gain, and maintenance conditions. The results indicated that: (a) learning-disabled subtypes were not differentiated by their performance on verbal and visual-spatial working memory measures; and (b) learning-disabled children's working memory performance was inferior to CA-matched and superior to achievement-matched counterparts across initial, gain, and maintenance conditions. The results suggest that learning-disabled children suffer generalized working memory deficits, possibly due to storage constraints in the executive system.     

Supported employment for adults with psychiatric disability: Results of an innovative demonstration project.

Describes an innovative 3-yr research and demonstration project evaluating a supported employment program on a university campus designed specifically for persons with psychiatric disability. The vocational status, job satisfaction, work integration, symptomatology, and social supports of 20 Ss were assessed during the project, and a 2-yr follow-up of employment status was conducted. While a university setting was ideal for providing supported employment services for persons with psychiatric disabilities, the university itself was not a particularly receptive or compatible employer. The 2-yr follow-up showed that 10 Ss were employed an average of 17.5 hrs per week with mean earnings of $156 per week, representing a modest increase in percentage of Ss employed, and a substantial increase in average hours worked and average wages earned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is there a relationship between child abuse and learning disability?

Reviews 7 studies on the possible relationship between child abuse and learning disability. It is concluded that despite case reports linking child abuse with learning disability in some cases, there is no evidence either that abused children are more likely than nonabused children to have a learning disability or that learning disabled children are more likely than children without learning disabilities to be abused. The studies that have been done included diverse definitions, a variety of small and unrepresented samples, an absence group, and a lack of information about the children's pre-abuse characteristics. It is suggested that case studies may be the most useful method. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of traumatic brain injury on children with learning disability

In Argentina, there is rather little information about the natural occurrence of mycotoxins in feedstuffs. The aim of this work was to determine the fungal flora and natural incidence of aflatoxin B1 (AFB1), zearalenone (ZEA) and deoxynivalenol (DON) in poultry feeds from 5 factories of Río Cuarto, Córdoba. Three hundred samples were taken from May 1995 to May 1996. Fungal counts of poultry feeds ranged 10(4) to 10(6) CFU g-1. The lowest counts were obtained on the first months from the sampling (May to September 1995) with mean values significantly different from those found at the last of the sampling (October 1995 to April 1996). The most prevalent species isolated of poultry feed samples belonged to the genera Penicillium that was present in 98% of the samples, Fusarium (87%) and Aspergillus (52%). Fusarium species isolated were: F moniliforme in 73% of the samples, F subglutinans (35%), F graminearum (20%) and within Aspergillus species: A. parasiticus (33%) and A. flavus (8%) were identified. In poultry feeds aflatoxin B1 (AFB1) was the most significant mycotoxin with levels ranging from 17 to 197 ng/g. For deoxynivalenol (DON) the levels ranged from 240 to 410 ng/g. Only three out of 300 samples were contaminated with zearalenone (ZEA) in concentrations of 30, 120 and 280 ng/g. These are preliminary data on this subject in our region.     

Research utilization: the continence for women project

The RU3 is in process and is in its second year. Project sites are implementing the protocol and are screening women and implementing behavioral interventions. Data analysis and project evaluation is scheduled for early 1998 and will be presented at the AWHONN conference in June, 1998.     

Memory, awareness and learning in general anesthesia

Enough information concerning memory and other cognitive functions in total anesthesia is available in the literature. Some basic theories about neuronal mechanisms of memory and consciousness are known. An attempt trying to bridge the gap between psychological and biologic levels is the usage of anesthetics in pharmacologic tests enabling the study of their influence on awareness and memory in humans. With the help of this approach it is possible to inquire into the psychological mechanisms and to demonstrate the influence of anesthetics on them. 44 patients were included in the study, operated on in inhalation anesthesia. The effects of anesthesia on awareness, consciousness, learning and memory in our study sample were following: 1. No episode of awareness was observed during the study; 2. There was an improvement of the memory quotient (MQ) following total inhalation anesthesia (p < 0.05); 3. The pain threshold significantly decreased after anesthesia (p < 0.001); 4. There exists a learning mechanism in total anesthesia more efficient in the group of patients auditively learning pain related words (p < 0.05) comparing to the control group of patients auditively learning pain nonrelated words; 5. Statistical analysis of the number of remembered pain related words and pain nonrelated words revealed significantly higher number of words in the first group of pain related words (p < 0.001). (Tab. 3, fig. 6, Ref. 22.)     

Breast cancer in older women

The American Geriatric Society currently recommends screening mammography for women up to 85 years of age whose life expectancy is three years or longer. The value of clinical breast examinations in older women needs further study. Total mastectomy and partial mastectomy with postoperative radiation therapy yield similar results in localized breast cancer. Postoperative irradiation may be avoided in women with small tumors (2.5 cm or less in diameter) who have undergone quadrantectomy. Lymph node dissection is important for tumor staging but significantly increases the risks and morbidity of surgery. Lymph node mapping may obviate the need for lymphadenectomy in many older women. Adjuvant hormonal therapy for at least two years appears to be beneficial in all women with hormone-receptor-rich tumors. Adjuvant chemotherapy is indicated in women with lymph node involvement or high-risk tumors with no lymph node involvement. Unless life-threatening metastases are present, hormonal therapy is the first approach to metastatic cancer. Chemotherapy is indicated if endocrine therapy is unsuccessful or life-threatening metastases are present. Most chemotherapy regimens appear to be well tolerated, even by women over 70 years of age. Special treatment should be employed for metastases to tumor sanctuaries (i.e., brain, eyes), the long bones, the spine and the chest wall.     

Breast cancer in older women

Successful laser treatment of haemangiomas requires selective photocoagulation of subsurface targeted blood vessels without thermal damage to the overlying epidermis. We present an in vivo experimental procedure, using a chicken comb animal model, and an infrared feedback system to deliver repetitive cryogen spurts (of the order of milliseconds) during continuous Nd:YAG laser irradiation. Gross and histologic observations show deep-tissue photocoagulation is achieved, while superficial structures are protected from thermal injury due to cryogen spray cooling. Experimental observation of epidermis protection in chicken comb animal models suggests selective photocoagulation of subsurface targeted blood vessels for successful treatment of haemangiomas can be achieved by repetitive applications of a cryogen spurt during continuous Nd:YAG laser irradiation.     

Severe childhood sexual abuse and nonverbal learning disability

Sexual addiction has received increasing attention in the past decade. We review existing literature on (a) competing conceptualizations of this syndrome as constituting an addictive, obsessive-compulsive, or impulse control disorder; (b) symptomatology and progression; (c) etiological models; and (d) treatment approaches. Based on this review, we conclude by identifying questions requiring resolution via empirical investigation.     

An impairment model of learning disability diagnosis.

This review of the literature and available evidence attempts to clarify the debate surrounding the learning disability (LD) diagnosis by offering a diagnostic model based on the principles of academic and functional impairment. The authors briefly review the strengths and weaknesses of current LD diagnostic approaches. Next, they propose a method for diagnosing LD that presumes core symptoms of below average academic achievement and associated impairment in other domains of functioning, including behavior and emotion, interpersonal relations, and self-care and fulfillment, which is modeled on the successful decades old approach to mental retardation diagnosis. The authors contend that this approach may help ameliorate the diagnostic problems plaguing the LD field. Finally, they present a rationale for future research efforts aimed at determining a level of low achievement that is associated with functional impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epilepsy, learning disability and anti-convulsant drug status

We describe the isolation of crotoxin, a presynaptic B-neurotoxin, as well as its subunits B (crotactine) and A (crotapotin) from lyophilized Crotalus durissus terrificus venom by a single-step preparative isoelectric focusing procedure. From 98 mg of dried venom protein 20.1 mg of crotactine and 13.1 mg of crotapotin were recovered in the first step of focalization and 4.2 mg in a second run. These values correspond to 35.7% of the total venom protein applied. Crotactine separated in the 9.3-7.0 pH range (tubes 1-6) and crotapotin in the 1.8-2.8 pH range (tubes 15-19) and both were homogeneous by SDS-PAGE and N-terminal amino acid analysis. Crotactine, a 12-kDA protein, presented hemolytic and phospholipase A2 activity. Thus, using isoelectric focusing we simultaneously purified both toxins in high yields. This method can be used as an alternative for the purification and characterization of proteins from other snake venoms under conditions in which biological activity is retained.