Areas Of Difficulty Research Articles

Time will tell: Deficits of temporal information processing in patients with visual field loss

Visual field loss after brain lesions is commonly determined using perimetric tests of light detection (perimetry). Many patients with visual field defects complain about perceptual difficulties in areas that are perimetrically normal. To look at a potential cause for such difficulties, we topographically determined temporal characteristics of visual information processing in those patients and compared them to those of healthy subjects. In nine patients with visual field loss we measured thresholds of double-pulse resolution (DPR), i.e., the minimum perceivable duration of a temporal gap between two light pulses, at eccentricities up to 20°. Furthermore, high-resolution maps of visual reaction times (RT) were obtained in a computer-based campimetric test. Performance was compared to healthy controls from a cross-sectional study of temporal perception across the life span (Toelz Temporal Topography Study). Compared to healthy subjects, DPR thresholds and RTs in patients are elevated in the entire visual field, including areas that are perimetrically intact. Performance on temporal variables depends on the degree of intactness of the respective visual field position. DPR thresholds correlate considerably with RTs, and both parameters increase with eccentricity. However, whereas DPR thresholds are increased around blind regions relative to the intact field, this is not the case for RTs. Temporal processing in patients with cerebral vision loss is impaired to a certain extent independently from perimetric light detection performance. This may partly explain reported subjective perceptual problems. The findings may have important implications for visual rehabilitation, i.e., the potential generalization of light detection training to temporal processing performance.

Characteristics of fetal anticonvulsant syndrome associated autistic disorder

The aim of this study was to evaluate the clinical features and frequency of autistic disorder or Asperger syndrome (AS; according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV] criteria) in children exposed to anticonvulsant medication in utero. During a 20-year study period, 626 children were born in Aberdeen to mothers taking antiepileptic drugs (AEDs). The study examined long-term effects of prenatal exposure to AEDs in 260 children (122 males, 138 females). Of these, 26 (16 males) were reported by parents to have social or behavioural difficulties. Eleven children (6 males, 5 females) fulfilled the DSM-IV criteria for autistic disorder and one (female) fulfilled the DSM-IV criteria for AS. These children comprised 4.6% of the exposed children studied, and 1.9% of all exposed children born during the study period. Mean age of these children at diagnosis was 5 years 4 months (SD 2y 11mo) and 9 years 10 months (SD 3y 10mo) at the time of this study. Other children from the group of 26 had difficulties in areas of speech and language development and social communication but did not meet the criteria for an autism spectrum disorder (ASD). Sodium valproate was the drug most commonly associated with autistic disorder, five of 56 (8.9%) of the study children exposed to sodium valproate alone had either autistic disorder or AS. It was concluded that prenatal exposure to anticonvulsant medication is a risk factor for the development of an ASD. Fetal anticonvulsant syndrome associated autistic disorder is characterized by an even sex ratio, absence of regression or skill loss, and language delay in the absence of global delay.

Characteristics of fetal anticonvulsant syndrome associated autistic disorder

The aim of this study was to evaluate the clinical features and frequency of autistic disorder or Asperger syndrome (AS; according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV] criteria) in children exposed to anticonvulsant medication in utero. During a 20-year study period, 626 children were born in Aberdeen to mothers taking antiepileptic drugs (AEDs). The study examined long-term effects of prenatal exposure to AEDs in 260 children (122 males, 138 females). Of these, 26 (16 males) were reported by parents to have social or behavioural difficulties. Eleven children (6 males, 5 females) fulfilled the DSM-IV criteria for autistic disorder and one (female) fulfilled the DSM-IV criteria for AS. These children comprised 4.6% of the exposed children studied, and 1.9% of all exposed children born during the study period. Mean age of these children at diagnosis was 5 years 4 months (SD 2y 11mo) and 9 years 10 months (SD 3y 10mo) at the time of this study. Other children from the group of 26 had difficulties in areas of speech and language development and social communication but did not meet the criteria for an autism spectrum disorder (ASD). Sodium valproate was the drug most commonly associated with autistic disorder, five of 56 (8.9%) of the study children exposed to sodium valproate alone had either autistic disorder or AS. It was concluded that prenatal exposure to anticonvulsant medication is a risk factor for the development of an ASD. Fetal anticonvulsant syndrome associated autistic disorder is characterized by an even sex ratio, absence of regression or skill loss, and language delay in the absence of global delay.

The acquisition of requests by second language learners of Spanish

This cross-sectional study in interlanguage pragmatics analyzes the requests employed by English-speaking learners of L2 Spanish, using data collected from university students at four different levels of language learning. The most common request strategies are first identified in a cross-linguistic analysis of Spanish and English and are then compared to the interlanguage data. The requests of lower-level students are found to be more idiosyncratic and pragmatically ambiguous than those of advanced learners, although not necessarily more direct. Advanced learners show signs of improvement, but still rely largely on L1 request behavior. Learners at all levels display more difficulties in areas in which there is cross-linguistic variation between the L1 and L2.

Factors associated with difficulties encountered by nurses in the care of terminally ill cancer patients in hospitals in Japan

To identify the factors associated with difficulties encountered by nurses working in general wards in hospitals in Japan. Questionnaires including items regarding difficulties in providing care to terminally ill cancer patients, the existence of a mentor regarding end-of-life issues, awareness of end-of-life issues, and demographic factors were administered to 375 staff nurses working in general in-patient wards. Multivariate regression analyses were employed to investigate correlations between factors. Multivariate regression analysis revealed that the existence of a mentor for end-of-life issues was associated with fewer difficulties in all areas other than "Knowledge and skill of nurses." Clinical experience was inversely related to difficulties in "Communication with patients and families" and "Personal issues." Greater awareness of end-of-life issues was related to higher difficulties in most areas. The existence of a mentor was correlated with fewer difficulties in most areas. Support by a palliative care team might be effective in reducing difficulties experienced by nurses and in improving care for terminally ill cancer patients. Basic communication training undertaken sooner after registration might be also useful.

Lèpre ostéoarticulaire

Leprosy remains an endemic infectious disease in many countries. Typical clinical manifestations involve skin and nerves, but bone and joint involvement can be observed. There are either classical rheumatic manifestations (directly due to Hansen bacillus or linked to complications due to nervous involvement), or inflammatory manifestations, which can be acute or chronic, occur during leprosy reactions or not, and which physiopathology remains unclear. Because of their clinical, radiological and biological features, these inflammatory manifestations may mimick some systemic diseases, raising diagnosis difficulties in areas where leprosy is rare.

Social Cognition and Verbal Learning Disabilities

Abstract Considerable research suggests that the greatest proportion of learning disabilities involve reading and writing. In a majority of these cases, investigators have documented the presence of underlying weaknesses in various verbal/linguistic processes. Professionals have invested heavily in the treatment of academic outcomes associated with verbal learning disabilities. However, less emphasis has been given to the way in which these verbal deficiencies impact an individual's ability to process language information in order to understand, interpret and manage social communication or mentally construct an understanding of the world. Evidence suggests that many students with learning disability (LD) also have difficulties in areas of psychosocial functioning. A “social cognition” perspective is offered so as to view verbal learning disabilities not only as an academic skill deficit, but rather as a developmental compromise in the verbal/language systems that may impact cognitive, academic, and social...

Learning disabilities associated with lesser brain damage

Summary In an habilitation program for brain-damaged children it has been found that children with little motor involvement merge with children who have no demonstrable motor handicap in presenting perceptual difficulty in areas of speech, hearing, writing, reading, memory, understanding, obeying oral commands, and in the control of activity. When not understood and dealt with properly, these deficits interfere with intellectual accomplishments. They cause emotional maladjustment and disturbance in socialization. This group is salvageable and deserve the combined efforts of physicians, psychiatrists, and educators as well as the ancillary discipline to help them attain their optimum development.