Cerebral palsy in very preterm infants: new epidemiological insights

The focus of this review is on new insights from recent epidemiological research on cerebral palsy in preterm infants. These include: 1) a better understanding of issues related to diagnosis and classification; 2) new information about the brain abnormalities underlying cerebral palsy in preterm infants; and 3) a better understanding of biological mechanisms that may underlie previously described epidemiological associations. Ongoing efforts to improve the diagnosis and classification of cerebral palsy have been enhanced by findings from serial examinations of cohorts of very preterm infants. Cranial ultrasonography through the anterior fontanelle of very preterm infants has provided information about grossly evident brain damage, found in about one-half of preterm infants who develop cerebral palsy. Insights into the pathophysiologic basis for certain epidemiologic associations have come from studies of experimental brain damage in animals and clinical studies of neurologic disorders in adults. Much of the current epidemiological research into the causes of cerebral palsy in preterm infants has focused on two potential mechanisms of brain damage. One mechanism involves insufficient cerebral perfusion; the other, cytokine-mediated damage, potentially triggered by events such as maternal infection (e.g., intrauterine or periodontal infection), neonatal infection (e.g., sepsis and necrotizing enterocolitis), and neonatal oxygen- or ventilator-induced lung injury. In addition to the preterm infant's increased exposure to such damaging factors, the high frequency of cerebral palsy in these infants might be due, in part, to insufficient levels of developmentally regulated protective substances, such as thyroid hormone and glucocorticoids. Models of causation currently are being investigated using recently developed methods for quantifying, with small quantities of blood, biomolecules that are suspected to either promote or protect against brain damage in the neonate. Clinical investigations now under way can be expected to identify strategies to be tested in clinical trials that could lower the risk of cerebral palsy in very preterm infants.     

Primary care physicians attitude toward diagnosis and treatment of late-life depression

Underdiagnosis and undertreatment of late-life depression is common, especially in primary care settings. To help assess whether physicians attitude and confidence in diagnosing and managing depression serve as barriers to care, a total of 176 physicians employed in 18 primary care groups were administered surveys to assess attitudes towards diagnosis, treatment, and management of depression in elderly patients, (individuals over 65 years of age). Logistic regression was performed to assess the association of physician characteristics on attitudes. Nearly all of the physicians surveyed felt that depression in the elderly was a primary care problem, and 41% reported late-life depression as the most common problem seen in older patients. Physicians were confident in their ability to diagnose and manage depression, yet 45% had no medical education on depression in the previous three years. Physicians confidence in their ability to diagnose, treat, and manage depression, and their reported adequacy of training, do not appear to correspond to the amount of continuing medical education in depression, suggesting that physician overconfidence may potentially be serving as a barrier to care.     

Effects of task performance and contextual performance on systemic rewards

Evidence from 2 samples of Air Force mechanics supported the hypothesis that contextual performance affects employees' career advancement and rewards over time. Results of hierarchical regressions controlling for experience showed task performance and contextual performance each predicted systemic rewards. Each facet explained separate variance in promotability ratings over 2 years. In both samples, contextual performance explained separate variance in informal rewards but task performance did not. Task performance explained incremental variance in career advancement 1 year later but contextual performance did not. Analyses using correlations corrected for unreliability suggest these results cannot be attributed to measurement error. Contextual performance still explained separate variance in informal rewards, and task performance explained distinct variance in career advancement a year later.     

Test of the cross-cultural generalizability of a model of sexual harassment

Sexual harassment research has been primarily limited to examination of the phenomena in U.S. organizations; attempts to explore the generalizability of constructs and theoretical models across cultures are rare. This study examined (a) the measurement equivalence of survey scales in U.S. and Turkish samples using mean and covariance structure analysis and (b) the generalizability of the L. F. Fitzgerald, F. Drasgow, C. L. Hulin, M. J. Gelfand, and V. J. Magley (1997) model of sexual harassment to the Turkish context using structural equations modeling. Analyses used questionnaire data from 336 Turkish women and 455 women from the United States. The results indicate that, in general, the survey scales demonstrate measurement equivalence and the pattern of relationships in the Fitzgerald et al. model generalizes to the Turkish culture. These results support the usefulness of the model for explaining sexual harassment experiences in a variety of organizational and cultural contexts.     

Interpretation of a full-information item-level factor analysis of the MMPI-2: normative sampling and nonpathognomonic descriptors

An exploratory item-level full-information factor analysis was performed on the normative sample for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). This method of factor analysis, developed by Schilling and Bock (Bock & Schilling, 1997) and based on item response theory, works directly with the response patterns and avoids the artifacts associated with phi coefficients and tetrachoric coefficients. Promax rotation of the factor solution organizes the clinical scale items into 10 factors that we labeled Distrust, Self-Doubt, Fitness, Serenity, Rebelliousness, Instrumentality, Irritability, Artistry, Sociability, and Self-Reliance. A comparison was made to the results of Johnson, Butcher, Null, and Johnson (1984), who performed a principal-component analysis on an item set of 550 items from the previous version of the MMPI (Hathaway & McKinley, 1943). Along with version changes and sampling differences, the essential differences between Johnson et al.'s results and ours may be attributed to differences between the Schilling and Bock method, which uses all information in the item responses, and the principal-component analysis, which uses the partial information contained in pairwise correlation coefficients. This study included 518 of the complete 567 items of the MMPI-2, versus Johnson et al.'s retention of 309 of the initially included 550 items of the previous MMPI. The full-information analysis retained all 518 initially included items and more evenly distributed the items over the 10 resulting factors, all sharply defined by their highest loading items and easy to interpret. Sampling effects and factor label considerations are discussed, along with recommendations for research that would validate the clinical utility of the implied scales for describing normal personality profiles. The full-information procedure provides for Bayes estimation of scores on these scales.     

Assessing achievement, affiliation, and power motives all at once: the Multi-Motive Grid (MMG)

In this article, we introduce the Multi-Motive Grid (MMG), a new diagnostic tool to measure motives with respect to their hope and fear components. The MMG combines features of the Thematic Apperception Test (TAT) with features of self-report questionnaires. Similar to the TAT, a set of 14 pictures representing a balanced set of achievement-arousing, affiliation-arousing, and power-arousing situations is presented together with a set of statements representing important motivational states. Six motive scores can be calculated: hope of success (HS) and fear of failure (FF) for the achievement motive, hope of affiliation (HA) and fear of rejection (FR) for the affiliation motive, and hope of power (HP) and fear of power (FP) for the power motive. Results of factor analyses suggest a 3-factor solution, with a general fear factor (FF, FR, FP), a factor combining the hope components of achievement and power (HS and HP), and a third factor representing HA, but the 6 a priori factors also reflect a sound structural model. Reliability data show that the internal consistency and retest reliability of the MMG scales satisfy traditional standards. External validity of the MMG has been established in all 3 motive domains. Three separate studies document that (a) individuals high in resultant achievement motivation perform better and report more flow experience, (b) individuals high in resultant power motivation profit more from a leadership training program, and (c) individuals high in resultant affiliation motivation recollect more highly memorable affiliative themes.     

The personal-group discrepancy: Is there a common information basis for personal and group judgment?

In contrast to motivational accounts of the personal-group discrepancy, results from this article suggest that the discrepancy is explained by aggregating different sets of comparison outcomes for either personal or group ratings. Results from a longitudinal study with East German (the minority group) and West German (the majority group) samples confirm the personal-group discrepancy and support our approach. First, social comparisons influenced evaluations of economic situation at both group and personal levels. Second, ratings of group versus personal economic situation were based on different sets of comparisons. Third, the mean structure of both sets of comparison outcomes mirrored the personal-group discrepancy. Fourth, an interaction between personal-group discrepancy and group status supported the authors' suggestions-concerning the direction of the discrepancy.     

Comparison of the Trail Making and Color Trails Tests in a Chinese context: a preliminary report

The Color Trails Test developed as a culturally fair analogue of the Trail Making Test, was used to examine the relationship between the two tests with 35 undergraduate Chinese in Hong Kong recruited as the subjects. The scores on these two tests of the 12 men and 23 women were significantly correlated .71. The equivalence of the Trail Making and Color Trails Tests when applied to Chinese in Hong Kong was discussed.     

Use of photic feedback as an adjunct treatment in a case of Miller Fisher syndrome

Photic Feedback treatment of a patient diagnosed with Miller Fisher syndrome has resulted in the rapid and permanent remission of symptoms. During Photic Feedback treatment, the CD20 appeared to be slightly increased. This may have been associated with changes in humoral immunity. The present clinical observation of a single patient suggests that Photic Feedback treatment should be investigated as a possible adjunct therapy for patients who suffer from polyneuropathies, such as Miller Fisher syndrome, within a carefully controlled clinical trial.