Does Cognitive Remediation Therapy (CRT) Improve the Neuropsychological Function in Patients With Anorexia Nervosa?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cognitive remediation therapy (CRT) improves the neuropsychological function in patients with anorexia nervosa. STUDY DESIGNS: Review of two randomized controlled trials and one non-randomized case series, published in 2012, 2013 and 2014. DATA SOURCES: The three studies used in this review were published in English and found in PubMed. OUTCOMES MEASURED: For all studies, neuropsychological function, such as memory, attention, and cognitive flexibility, were measured using pre- and post-treatment questionnaires. One study used a computerized task-shifting paradigm to determine cognitive flexibility. RESULTS: Brockmeyer et al. and Lock et al. compared CRT to other forms of treatment, and Abbate-Daga et al. investigated the effects of CRT pre- and post-CRT. All three studies revealed statistically significant improvements in patient’s neuropsychological function following CRT. Brockmeyer et al. measured patients’ reaction times as an indication for cognitive flexibility during computerized exercises and found that reaction times were decreased in the CRT group compared to the group receiving non-neuropsychological therapy. In the study conducted by Lock et al., patients who received 8 sessions of CRT as compared to those who received cognitive behavioral therapy, showed enhanced cognitive flexibility and central coherence. Abbate-Daga et al. demonstrated an improvement in patient decision making from baseline measurements. CONCLUSIONS: The results presented in these three studies suggest that cognitive remediation therapy is an effective treatment approach to improving the neuropsychological function in patients with anorexia nervosa

Preventing the Selection of "Deaf Embryos" Under the Human Fertilisation and Embryology Act 2008:Problematizing Disability?

Section 14(4) of the Human Fertilisation and Embryology Act 2008 imposes – within the general licensing conditions listed in the Human Fertilisation and Embryology Act 1990 – a prohibition to prevent the selection and implantation of embryos for the purpose of creating a child who will be born with a “serious disability.” This article offers a perspective that demonstrates the problematic nature of the consultation, review, and legislative reform process surrounding s 14(4). The term “serious disability” is not defined within the legislation, but we highlight the fact that s 14(4) was passed with the case of selecting deaf children in mind. We consider some of the literature on the topic of disability and deafness, which, we think, casts some doubt on the view that deafness is a “serious disability.” The main position we advance is that the lack of serious engagement with alternative viewpoints during the legislative process was unsatisfactory. We argue that the contested nature of deafness necessitates a more robust consultation process and a clearer explanation and defence of the normative position that underpins s 14(4)

X chromosome-wide analyses of genomic DNA methylation states and gene expression in male and female neutrophils

The DNA methylation status of human X chromosomes from male and female neutrophils was identified by high-throughput sequencing of HpaII and MspI digested fragments. In the intergenic and intragenic regions on the X chromosome, the sites outside CpG islands were heavily hypermethylated to the same degree in both genders. Nearly half of X chromosome promoters were either hypomethylated or hypermethylated in both females and males. Nearly one third of X chromosome promoters were a mixture of hypomethylated and heterogeneously methylated sites in females and were hypomethylated in males. Thus, a large fraction of genes that are silenced on the inactive X chromosome are hypomethylated in their promoter regions. These genes frequently belong to the evolutionarily younger strata of the X chromosome. The promoters that were hypomethylated at more than two sites contained most of the genes that escaped silencing on the inactive X chromosome. The overall levels of expression of X-linked genes were indistinguishable in females and males, regardless of the methylation state of the inactive X chromosome. Thus, in addition to DNA methylation, other factors are involved in the fine tuning of gene dosage compensation in neutrophils

Academic attainment in deaf and hard-of-hearing students in distance education

This study compared outcomes in deaf and hard-of-hearing (DHH) students and nondisabled students taking courses by distance learning with the UK Open University in 2012. DHH students who had no additional disabilities were more likely to complete their courses than nondisabled students, and they were just as likely to pass the courses that they completed and to obtain good grades on the courses that they passed. DHH students who had additional disabilities were less likely to complete their courses, less likely to pass the courses that they completed, and less likely to obtain good grades on the courses that they pass than were nondisabled students. It is concluded that hearing loss per se has no effect on academic attainment, but that additional disabilities may have an impact on DHH students’ academic performance

Sentence Repetition in Deaf Children with Specific Language Impairment in British Sign Language

Children with specific language impairment (SLI) perform poorly on sentence repetition tasks across different spoken languages, but until now, this methodology has not been investigated in children who have SLI in a signed language. Users of a natural sign language encode different sentence meanings through their choice of signs and by altering the sequence and inflections of these signs. Grammatical information is expressed through movement and configurational changes of the hands and face. The visual modality thus influences how grammatical morphology and syntax are instantiated. How would language impairment impact on the acquisition of these types of linguistic devices in child signers? We investigated sentence repetition skills in a group of 11 deaf children who display SLI in British Sign Language (BSL) and 11 deaf controls with no language impairment who were matched for age and years of BSL exposure. The SLI group was significantly less accurate on an overall accuracy score, and they repeated lexical items, overall sentence meaning, sign order, facial expressions, and verb morphological structures significantly less accurately than controls. This pattern of language deficits is consistent with the characterization of SLI in spoken languages even though expression is in a different modality. We conclude that explanations of SLI, and of poor sentence repetition by children with this disorder, must be able to account for both the spoken and signed modalities

The epistemological model of disability, and its role in understanding passive exclusion in eighteenth and nineteenth century protestant educational asylums

This article examines how the process of constructing knowledge on impairment has affected the institutional construction of an ethic of disability. Its primary finding is that the process of creating knowledge in a number of historical contexts was influenced more by traditions and the biases of philosophers and educators in order to signify moral and intellectual superiority, than by a desire to improve the lives of disabled people through education. The article illustrates this epistemological process in a case study of the development of Protestant asylums in the latter years of the nineteenth century

A look at the other 90 per cent: Investigating British Sign Language vocabulary knowledge in deaf children from different language learning backgrounds

In this study we present new data on deaf children's receptive and expressive vocabulary knowledge in British Sign Language (BSL) from a sample consisting of children with deaf parents, children with hearing parents, and children with additional needs. Their performance on three BSL vocabulary tasks was compared with (previously reported findings from) a sample of deaf fluent signers. We use these data to assess the effects of some key demographic/ child variables on deaf signing children's vocabulary and discuss findings in the relation to the meaning of 'normative' data and samples for this heterogeneous population. Findings show no effect of the presence of additional disabilities on participants' scores for any of the three tasks. As expected, chronological age is the most significant factor in performance on all vocabulary tasks while the number of deaf relatives only becomes statistically significant for the form recall task. This study contributes to the field of sign language assessment by seeking to identify key variables in heterogeneity and how these variables affect signed vocabulary acquisition with the long-term objective of informing intervention

Colorectal Cancer Video for the Deaf Community: A Randomized Control Trial

The Deaf community experiences multiple barriers to accessing cancer information. Deaf participants (n = 144) were randomly assigned to view a colorectal cancer education video or another program in American Sign Language. They completed surveys pre- and post-intervention and at 2 months post-intervention. By using a crossover model, control group participants were offered the option of seeing the intervention video. The experimental group gained and retained significantly more colorectal cancer knowledge than the control group, and the control group demonstrated the greatest knowledge gain after crossing into the experimental arm. This video effectively informed the Deaf community about colorectal cancer

Exploration of Deaf people’s health information sources and techniques for information delivery in Cape Town: A qualitative study for the design and development of a mobile health application

BACKGROUND: Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sign Language interpreters (SASLIs) is also insufficient to meet the demand of the Deaf population in the country. Our research team, in collaboration with the Deaf communities in Cape Town, devised a mobile health app called SignSupport to bridge the communication gaps in health care contexts. We consequently plan to extend our work with a Health Knowledge Transfer System (HKTS) to provide Deaf people with accessible, understandable, and accurate health information. We conducted an explorative study to prepare the groundwork for the design and development of the system. OBJECTIVES: To investigate the current modes of health information distributed to Deaf people in Cape Town, identify the health information sources Deaf people prefer and their reasons, and define effective techniques for delivering understandable information to generate the groundwork for the mobile health app development with and for Deaf people. METHODS: A qualitative methodology using semistructured interviews with sensitizing tools was used in a community-based codesign setting. Twenty-three Deaf people and 10 health professionals participated in this study. Inductive and deductive coding was used for the analysis. RESULTS: Deaf people currently have access to 4 modes of health information distribution through: Deaf and other relevant organizations, hearing health professionals, personal interactions, and the mass media. Their preferred and accessible sources are those delivering information in signed language and with communication techniques that match Deaf people’s communication needs. Accessible and accurate health information can be delivered to Deaf people by 3 effective techniques: using signed language including its dialects, through health drama with its combined techniques, and accompanying the information with pictures in combination with simple text descriptions. CONCLUSIONS: We can apply the knowledge gained from this exploration to build the groundwork of the mobile health information system. We see an opportunity to design an HKTS to assist the information delivery during the patient-health professional interactions in primary health care settings. Deaf people want to understand the information relevant to their diagnosed disease and its self-management. The 3 identified effective techniques will be applied to deliver health information through the mobile health app