Determinants of cognitive outcomes of perinatal and childhood stroke: A review

Our understanding of cognitive and behavioral outcomes of perinatal and childhood stroke is rapidly evolving. A current understanding of cognitive outcomes following pediatric stroke can inform prognosis and direct interventions and our understanding of plasticity in the developing brain. However, our understanding of these outcomes has been hampered by the notable heterogeneity that exists amongst the pediatric stroke population, as the influences of various demographic, cognitive, neurological, etiological, and psychosocial variables preclude broad generalizations about outcomes in any one cognitive domain. We therefore aimed to conduct a detailed overview of the published literature regarding the effects of age at stroke, time since stroke, sex, etiology, lesion characteristics (i.e., location, laterality, volume), neurologic impairment, and seizures on cognitive outcomes following pediatric stroke. A key theme arising from this review is the importance of interactive effects among variables on cognitive outcomes following pediatric stroke. Interactions particularly of note include the following: (a) age at Stroke x Lesion Location; (b) Lesion Characteristics (i.e., volume, location) x Neurologic Impairment; (c) Lesion Volume x Time Since Stroke; (d) Sex x Lesion Laterality; and (e) Seizures x Time Since Stroke. Further, it appears that these relationships do not always apply uniformly across cognitive domains but, rather, are contingent upon the cognitive ability in question. Implications for future research directions are discussed.     

Comparison of Informed Consent Preferences for Multiplex Genetic Carrier Screening among a Diverse Population

Multiplex genetic carrier screening is increasingly being integrated into reproductive care. Obtaining informed consent becomes more challenging as the number of screened conditions increases. Implementing a model of generic informed consent may facilitate informed decision-making. Current Wayne State University students and staff were invited to complete a web-based survey by blast email solicitation. Participants were asked to determine which of two generic informed consent scenarios they preferred: a brief versus a detailed consent. They were asked to rank the importance of different informational components in making an informed decision and to provide demographic information. Comparisons between informational preferences, demographic variables and scenario preferences were made. Six hundred ninety three participants completed the survey. When evaluating these generic consents, the majority preferred the more detailed consent (74.5 %), and agreed that it provided enough information to make an informed decision (89.5 %). Those who thought it would be more important to know the severity of the conditions being screened (p?=?.002) and range of symptoms (p?=?.000) were more likely to prefer the more detailed consent. There were no significant associations between scenario preferences and demographic variables. A generic consent was perceived to provide sufficient information for informed decision making regarding multiplex carrier screening with most preferring a more detailed version of the consent. Individual attitudes rather than demographic variables influenced preferences regarding the amount of information that should be included in the generic consent. The findings have implications for how clinicians approach providing tailored informed consent.     

The Simulation Theory,the Theory Theory and Folk Psychological Explanation

Philosophical Studies -     

Effects of neonatal cyproterone acetate administration on isolation-induced fighting behavior and mounting behavior in male and female TO strain albino mice

The effects of a single dose (1 mg) of cyproterone acetate administered on either day 1 or day 20 of life on the adult behaviors of male and female TO strain albino mice were studied. The mice were tested both in a “standard opponent”-type situation and in a similar test using a hormonally primed receptive female, after being gonadectomized and maintained with testosterone propionate as adults. Neonatal treatment with this compound had little effect on subsequent fighting behavior in either sex, but clear evidence was produced that this treatment masculinized the sexual behavioral potentialities of the females, an effect which was apparent in animals which had been injected on either day 1 or day 20 of life. Indications were obtained that females treated neonatally with cyproterone acetate were capable of differentiating between the male and female “opponents” in a manner similar to the male. The effects of this treatment on fighting behavior consequently appear to be dissimilar to the effects of neonatal castration in this species. However, the effects on mounting behavior in the females, evidenced in adulthood, seem Likely to be a consequence of the weak androgenic properties of the antiandrogen. The administration of cyproterone acetate neonatally appears to have a more dramatic effect on the adult weights of endocrine organs in females than in mates.     

The role of endocrines in isolation-induced intermale fighting in albino laboratory mice. I: PITUITARY-ADRENOCORTICAL INFLUENCES

Recent experiments concerning the possible role of components of the pituitary–adrenocortical axis (ACTH and glucocorticoids) in isolation-induced intermale fighting behavior in laboratory strains of mice are reviewed. A series of experiments which investigate factors that may influence the successful demonstration of this relationship are described. Differences in performances in standard-opponent tests of some outbred strains of albino mice are indicated, as well as an interesting positive correlation between the aggressiveness and the relative adrenal weights of the strains employed. Long-acting preparations of both ACTH and ACTH 4–10, injected throughout a period of isolation, suppressed fighting behavior in intact TO-strain mice in subsequent standard-opponent and trained-fighter tests. After it had been confirmed that vigorous isolation-induced fighting could be obtained in bilaterally castrated mice which had been subcutaneously implanted with testosterone pellets, the effects of long-acting preparations of ACTH, ACTH 4–10, ACTH 1–10, and ACTH 4–10 D-phe on the fighting behavior of such animals were studied. A significant suppression of fighting behavior was evident only with respect to ACTH, suggesting that ACTH 4–10 may have its action on this behavior in a manner rather different from that of the parent molecule. Some evidence was also obtained indicating that the zinc used in the preparation of long-acting injections of ACTH and its analogs may also cause a decline in the level of fighting behavior, in a standard-opponent test, in TO-strain mice which had been castrated and testosterone implanted. While such a finding does not affect the validity of the recorded behavioral influences of ACTH and ACTH 4–10 described earlier, it does seem likely that the presence of this substance in placebo injections would make the demonstration of the actions of the pep tides difficult, as there would be a low level of fighting in all categories. Rather less impressive results were obtained with respect to the influences of ACTH preparations and zinc on castrated—implanted CFW mice. The studies identify a number of the factors which may influence the successful demonstration of a relationship between the functioning of the pituitary—adrenocortical axis and isolation-induced agonistic behavior in the mouse. A number of general, if tentative, conclusions may also be listed. It seems likely, in spite of the interpretational difficulties caused by what seems to be a complex and rather unstable relationship, that ACTH and glucocorticoids may have profound influences on this type of fighting behavior in this species. One may also conclude that the evidence for an extraadrenal influence of ACTH on this behavior appears stronger as a result of these and related studies and that the actions of ACTH and its analogs on murine fighting behavior may be logically related to the actions of these compounds on the acquisition and extinction of conditioned avoidance reactions in hypophysectomized rats. The possible utility of such actions to the natural territorial habit of the adult male mouse is also indicated.     

The effects of divided attention on auditory priming

Traditional theorizing stresses the importance of attentional state during encoding for later memory, based primarily on research with explicit memory. Recent research has begun to investigate the role of attention in implicit memory but has focused almost exclusively on priming in the visual modality. The present experiments examined the effect of divided attention on auditory implicit memory, using auditory perceptual identification, word-stem completion and word-fragment completion. Participants heard study words under full attention conditions or while simultaneously carrying out a distractor task (the divided attention condition). In Experiment 1, a distractor task with low response frequency failed to disrupt later auditory priming (but diminished explicit memory as assessed with auditory recognition). In Experiment 2, a distractor task with greater response frequency disrupted priming on all three of the auditory priming tasks as well as the explicit test. These results imply that although auditory priming is less reliant on attention than explicit memory, it is still greatly affected by at least some divided-attention manipulations. These results are consistent with research using visual priming tasks and have relevance for hypotheses regarding attention and auditory priming.     

Post-conventional moral reasoning and reputation

Kohlberg’s theory of moral development conceives conventional and post-conventional moral reasoning as consecutive levels in a developmental sequence. This claim was examined in terms of the relationship between preference for these two styles of reasoning on the one hand and moral identity as perceived by others (reputation) and as self-perceived and on the other. Participants (n = 172), in groups of four mutual acquaintances, provided ratings of one another’s standing, and estimates of their own standing and reputation, on four trait dimensions (moral responsibility, consideration for others, respect for authority, and political orientation). Post-conventional moral reasoning, assessed using the Defining Issues Test, was not significantly related either to reputation or to self-rating on any dimension except political orientation. Conventional reasoning was related to politics though in the opposite direction, but additionally to both self- and other-ratings of moral responsibility and to the corresponding ratings of respect for authority. Findings do not support the view that the conventional/post-conventional distinction in moral reasoning is a developmental difference. An alternative proposed is that these are independent domains of moral thought, related to quite different aspects of social behaviour and political attitudes.