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Children reared in impoverished environments are at risk for enduring psychological and physical health problems. Mechanisms by which poverty affects development, however, remain unclear. To explore one potential mechanism of poverty's impact on social–emotional and cognitive development, an experimental examination of a rodent model of scarcity-adversity was conducted and compared to results from a longitudinal study of human infants and families followed from birth (N = 1,292) who faced high levels of poverty-related scarcity-adversity. Cross-species results supported the hypothesis that altered caregiving is one pathway by which poverty adversely impacts development. Rodent mothers assigned to the scarcity-adversity condition exhibited decreased sensitive parenting and increased negative parenting relative to mothers assigned to the control condition. Furthermore, scarcity-adversity reared pups exhibited decreased developmental competence as indicated by disrupted nipple attachment, distress vocalization when in physical contact with an anesthetized mother, and reduced preference for maternal odor with corresponding changes in brain activation. Human results indicated that scarcity-adversity was inversely correlated with sensitive parenting and positively correlated with negative parenting, and that parenting fully mediated the association of poverty-related risk with infant indicators of developmental competence. Findings are discussed from the perspective of the usefulness of bidirectional–translational research to inform interventions for at-risk families.
The purpose of this study was to evaluate the short and intermediate term results of infants who have undergone balloon aortic valvotomy from the carotid arterial approach, and to identify risk factors in those infants who had a poor outcome.
Methods
Between 1988 and 1999, balloon aortic valvotomy was attempted at four centres in 95 infants with severe aortic stenosis. Echocardiographic and hemodynamic data, and outcome, were analysed retrospectively.
Results
Valvotomy was accomplished in 92 of the 95 infants, with a median age of 5 days, a range from 0 to 191 days, and weighing 3.4 kg, with a range from 1.0 to 6.5 kg. Major procedural complications occurred in 10 infants. Post-procedural aortic regurgitation was severe in 5 patients. There were 13 early deaths, and 4 late deaths. The period of mean follow-up has been 2.1 years, with a range from 0 to 9.3 years. The actuarial survival at 3 years was 76 ± 6%. Further interventions were needed in 19 patients, giving a 3-year freedom from reintervention of 67 ± 6%. The 51 infants who were duct-dependent were further analyzed, and found to have a higher mortality (38%) compared to those infants not dependent on the arterial duct (5%). Risk factors for a poor outcome in the duct-dependent infants were mitral stenosis (p<0.005), a left ventricle which did not form the cardiac apex (p<0.005), and an aortic valve with a diameter of less than 6 mm (p<0.05).
Conclusions
This multi-centric registry shows good results in the intermediate term for treating infants with severe aortic valvar stenosis with balloon valvotomy through a carotid arterial cutdown. Infants dependent on prostaglandin had a worse outcome, especially if they had any of the identified risk factors.
Milk supply response was estimated for Pennsylvania using three different levels of structural aggregation. The base level involved the estimation of milk production in a single equation. Under the second method, production was the product of two equations: milk per cow and number of milk cows. The third method factored production into three equations: milk per cow, number of dairy farms, and number of cows per farm. As expected, the greater the degree of disaggregation the more was learned about the structural aspects of milk production. At the same time, predictive accuracy generally decreased, but the differences among models was slight.
The depressive syndrome is very distressing and incapacitating for any patient who suffers from it, and wherever it occurs psychiatrists are faced with a serious problem more particularly because of the consequent risk of suicide. The incidence of depressive illnesses has in my experience certainly not decreased during recent years, on the contrary it has probably increased and there is still an urgent need for more effective therapy to counteract the dire suffering and suicidal rate involved.
It was Bleuler (1917) who introduced the conception of “schizophrenia” as a mental illness and described its characteristics. Since 1957 was the centenary of Bleuler's birth the attention of psychiatrists has been focused on the various problems and difficulties still confronting us today regarding the diagnostic, aetiological and therapeutic aspects of this disease.
In March, 1939. there was admitted under my care at the St. Pancras Hospital Mental Observation Unit a case of torulosis of the nervous system. This is a very rare disease in this country and the present case is only the third recorded in British medical history (Greenfield et al., 1938; Smith and Crawford, 1930), and the first one to have come under mental hospital supervision. Although such a rarity here, torulosis is more common in the United States, and cases have been reported from nearly every part of the world.
Epilepsy is as old as history. To the ancients it was a sacred disease, each convulsion signifying a visitation of its victim by one of the gods. Hippocrates first seriously attributed epilepsy to material causes, but the light of scientific approach which he momentarily kindled was soon extinguished, and for centuries the mysteries of epilepsy remained shrouded in a cloud of mysticism and religious cult, and if treatment was administered at all it usually consisted of incantations and spirit-exorcising rituals. In the modern era of medicine scientific battle has been joined with this disease in common with all others, and since the epileptic, like most other sufferers, is liable to an exacerbation of his disease in times of mental and physical stress, the present human warfare cannot but render more important than ever successes in the therapeutic field against epilepsy.
In the world of mental diseases schizophrenia may well be termed “the sickness that destroyeth in the noonday.” Although the replacement of Kraepelin's nomenclature of “dementia praecox” by Bleuler's term, “schizophrenia,” has carried with it a general recognition that the chance of recovery is better than had been originally anticipated, the doom of those who do not recover is amongst the most dreadful meted out by any disease. It so frequently means a body apparently fully alive with a mind permanently impaired or virtually dead. Despite the obvious desirability of assessing the prognostic chances of the individual case, the statistical works published up to date have failed to establish agreement as to how this may be done. The object of this paper is to combine a detailed examination of the literature with a personal study of the histories of over 100 cases of schizophrenia in an effort to reach a definite conclusion in this matter. The paper will be divided into the following parts: I, a detailed survey of the literature; II, the outcome of 120 cases studied by myself; III, a comparison of remission rates and prognostic factors in cases treated by cardiazol.
The outstanding successes claimed in the treatment of schizophrenia by two such apparently different forms of treatment as insulin and cardiazol lead to a comparison of their effects on body and mind. Amongst those who have studied the two methods individually are Angyal and Gyarfas (1937), and Georgi and Strauss (1937),
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