A modified version of the BSID-II scales for cognitive matching of infants with and without Down syndrome

Background Many measures of infants’ early cognitive development, including the BSID-II, mix together test items that assess a number of different developmental domains including language, attention, motor functioning and social abilities, and some items contribute to the assessment of more than one domain. Consequently, the scales may lead to under- or over-estimates of cognitive abilities in some clinical samples and may not be the best measure to use for matching purposes. Method To address this issue we created a modified form of the BSID-II (the BSI-M) to provide a ‘purer’ assessment of the general cognitive capacities in infants with DS from 6 through to 18 months of age. We excluded a number of items that implicated language, motor, attentional and social functioning from the original measure. This modified form was administered to 17 infants with Down's syndrome when 6-, 12- and 18-months-old and to 41 typically developing infants at 4-, 7- and 10-months. Results The results suggested that the modified form continued to provide a meaningful and stable measure of cognitive functioning and revealed that DS infants may score marginally higher in terms of general cognitive abilities when using this modified form than they might when using the standard BSID-II scales. Conclusions This modified form may be useful for researchers who need a ‘purer’ measure with which to match infants with Down syndrome and other infants with IDs on cognitive functioning

STUDIES ON THE NONSPECIFIC DEPRESSION OF THE IMMUNE RESPONSE

Calf serum has been shown to suppress the primary immune response to erythrocytes and some bacterial antigens in mice if administered prior to and not after immunization. The importance of the route of iniection of antigens and immunosuppressant is indicated. It is suggested that immunosuppression is achieved by phagocytosis and enyzmatic destruction of the injected antigen by peritoneal macrophages. A similar mechanism is probably involved in the type of immunosuppression induced by PHA

Cognitive and social factors in the development of infants with Down syndrome

Infants and young children with Down syndrome can be engaging and affectionate. It seems that in the early months of life their personal relations may be relatively 'spared' the effects of limitations in their capacities for information-processing. Yet how far is this the case as development proceeds? In this paper we discuss some ways in which social and cognitive development interact and mutually influence one another over the first year or so of life, and present preliminary findings from a longitudinal study of infants with and without Down syndrome. The evidence suggests that the development of 'triadic'(person-person-world) social interactions may be affected by limited information-processing capacities in infants with Down syndrome, through a complex socially-mediated developmental trajectory

Behaviour of infants with Down syndrome and their mothers in the still-face procedure

There has been limited study of how the constitutional characteristics of infants with Down syndrome (DS) influence the patterning of their relations with caregivers. To assess natural and perturbed interactions between infants with DS and their mothers, we tested ten 6-month-old infants with DS and 20 typically developing (TD) 4-month-old of similar mental age. Participants were videotaped with their mothers in a natural face-to-face interaction, a brief period when the mothers adopted a still-face, and a subsequent reengagement phase. There was little to distinguish the infants in the initial phase of natural interaction, but the mothers of infants with DS were more likely to show assertive warmth, and unlike in the case of mothers of TD infants, high maternal directiveness tended to be associated with lower levels of infant looking and lack of fussing. During the still-face episode, infants of both groups showed reduced looking and smiling, although infants with DS tended to show lower levels of fussing and fewer in this group showed fussing in the reengagement phase. Therefore DS infants were somewhat similar to TD infants of comparable mental age in being responsive to the still-face procedure, but showed indications of group differences in intense emotional reactivity

Electrophysiologic actions of high plasma concentrations of propranolol in human subjects

The authors have previously shown that 40% of patients whose ventricular arrhythmias respond to propranolol require plasma concentrations in excess of those producing substantial beta-receptor blockade (> 150 ng/ml). However, the electrophysiologic actions of propranolol have only been examined in human beings after small intravenous doses achieving concentrations of less than 100 ng/ml. In this study, the electrophysiologic effects of a wider concentration range of propranolol was examined in nine patients. Using a series of loading and maintenance infusions, measurements were made at baseline, at low mean plasma propranolol concentrations (104 ± 17 ng/ml) and at high concentrations (472 ± 68 ng/ml). Significant (p < 0.05) increases in AH interval and sinus cycle length were seen at low concentrations of propranolol, with no further prolongation at the high concentrations; these effects are typical of those produced by beta-blockade. However, progressive shortening of the endocardial monophasic action potential duration and QTc interval were seen over the entire concentration range tested (p < 0.05). At high concentrations, there was significant (p < 0.05) further shortening of both the QTc and monophasic action potential duration beyond that seen at low propranolol concentrations, along with a progressive increase in the ratio of the ventricular effective refractory period to monophasic action potential duration. No significant changes were seen in HV interval, QRS duration or ventricular effective refractory period.In summary, the concentration-response relations for atrioventricular conductivity and sinus node automat-icity were flat above concentrations of 150 ng/ml. On the other hand, the durations of the monophasic action potential and the QTc interval shortened at high concentrations. It is concluded that propranolol, in addition to blocking beta-receptors, produces other beta-receptor independent electrophysiologic effects in human beings

Primates in peril: The world's 25 most endangered primates, 2006-2008

From first paragraph: Here we report on the fourth iteration of the biennial listing of a consensus of 25 primate species considered to be amongst the most endangered worldwide and the most in need of urgent conservation measures. The first was drawn up in 2000 by the IUCN/SSC Primate Specialist Group, together with Conservation International (Mittermeier et al. 2000). The list was subsequently reviewed and updated in 2002 during an open meeting held during the 19th Congress of the International Primatological Society (IPS) in Beijing, China (Mittermeier et al. 2002). That occasion provided for debate among primatologists working in the field who had first-hand knowledge of the causes of threats to primates, both in general and in particular with the species or communities they study

Primates in peril: The world's 25 most endangered primates, 2006-2008

From first paragraph: Here we report on the fourth iteration of the biennial listing of a consensus of 25 primate species considered to be amongst the most endangered worldwide and the most in need of urgent conservation measures. The first was drawn up in 2000 by the IUCN/SSC Primate Specialist Group, together with Conservation International (Mittermeier et al. 2000). The list was subsequently reviewed and updated in 2002 during an open meeting held during the 19th Congress of the International Primatological Society (IPS) in Beijing, China (Mittermeier et al. 2002). That occasion provided for debate among primatologists working in the field who had first-hand knowledge of the causes of threats to primates, both in general and in particular with the species or communities they study

The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle

Background: Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research). Methods: With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013. Results: The findings show an increase in both the single and repeated use of outcome measures from the time of the original audit, with repeated use (baseline and follow-up) of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) scale increasing from 10% to 50% of cases. Re-audited case-notes contained more combined use of different outcome measures, with greater consensus on which measures to use. Outcome measures that were applicable across a wide range of clinical conditions were more likely to be used than symptom-specific measures, and measures that were completed by the clinician were found more often than measures completed by the service user. Conclusions: The findings show a substantial improvement in the use of outcome measures within CAMHS. These increases in use were found across different service organisations which were subject to different types of local service priorities and drivers

Primates in Peril: The world's 25 most endangered primates 2008-2010

Introduction Here we report on the fifth iteration of the biennial listing of a consensus of 25 primate species considered to be amongst the most endangered worldwide and the most in need of urgent conservation measures. The first was drawn up in 2000 by the IUCN/SSC Primate Specialist Group, together with Conservation International (Mittermeier et al. 2000). The list was subsequently reviewed and updated in 2002 during an open meeting held during the 19th Congress of the International Primatological Society (IPS) in Beijing, China (Mittermeier et al. 2002). That occasion provided for debate among primatologists working in the field who had first-hand knowledge of the causes of threats to primates, both in general and in particular with the species or communities they study. The meeting and the review of the list of the World’s 25 Most Endangered Primates resulted in its official endorsement by the IPS, and became as such a combined endeavor of the Primate Specialist Group, the IPS, and Conservation International. A third revision was carried out at a meeting in August 2004, at the 20th Congress of the IPS in Torino, Italy (Mittermeier et al. 2006). The fourth, covering the biennium 2006–2008, was the result of a meeting held during the 21st Congress of the International Primatological Society (IPS), in Entebbe, Uganda, 26–30 June 2006 (Mittermeier et al. 2007)

2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation

Heart failure (HF) is a major and growing public health problem in the United States. Approximately 5 million patients in this country have HF, and over 550,000 patients are diagnosed with HF for the first time each year. The disorder is the primary reason for 12 to 15 million office visits and 6.5 million hospital days each year. From 1990 to 1999, the annual number of hospitalizations has increased from approximately 810,000 to over 1 million for HF as a primary diagnosis and from 2.4 to 3.6 million for HF as a primary or secondary diagnosis. In 2001, nearly 53 000 patients died of HF as a primary cause. The number of HF deaths has increased steadily despite advances in treatment, in part because of increasing numbers of patients with HF due to better treatment and “salvage” of patients with acute myocardial infarctions (MIs) earlier in life. Heart failure is primarily a condition of the elderly, and thus the widely recognized “aging of the population” also contributes to the increasing incidence of HF. The incidence of HF approaches 10 per 1000 population after age 65, and approximately 80% of patients hospitalized with HF are more than 65 years old. Heart failure is the most common Medicare diagnosis-related group (i.e., hospital discharge diagnosis), and more Medicare dollars are spent for the diagnosis and treatment of HF than for any other diagnosis. The total estimated direct and indirect costs for HF in 2005 were approximately $27.9 billion. In the United States, approximately$2.9 billion annually is spent on drugs for the treatment of HF