Disseminating a smokeless tobacco cessation intervention model to dental hygienists: a randomized comparison of personalized instruction and self-study methods.

This study evaluated 2 methods of disseminating an empirically validated smokeless tobacco intervention delivered during routine dental care. Twenty cities within 12 states were stratified and then randomized to 1 of 3 groups: personalized instruction (PI), self-study (SS), or delayed training (DT) control. Dental hygienists in the SS condition were sent a manual and video. Those in the PI condition were recruited to attend a workshop. Thirty-seven percent of eligible hygienists agreed to participate. At 12 months postenrollment, hygienists in the SS and PI conditions significantly increased their "Assist" behaviors (discuss cessation techniques, help patient set a quit date, and provide cessation materials) and reported fewer perceived barriers to delivering the intervention as compared with hygienists in DT. An economic analysis suggests that SS is more cost-effective than PI.     

Adults with dyslexia demonstrate space-based and object-based covert attention deficits: shifting attention to the periphery and shifting attention between objects in the left visual field

Performance on a covert visual attention task is compared between a group of adults with developmental dyslexia (specifically phonological difficulties) and a group of age and IQ matched controls. The group with dyslexia were generally slower to detect validly-cued targets. Costs of shifting attention toward the periphery when the target was invalidly cued were significantly higher for the group with dyslexia, while costs associated with shifts toward the fovea tended to be lower. Higher costs were also shown by the group with dyslexia for up-down shifts of attention in the periphery. A visual field processing difference was found, in that the group with dyslexia showed higher costs associated with shifting attention between objects in they LVF. These findings indicate that these adults with dyslexia have difficulty in both the space-based and the object-based components of covert visual attention, and more specifically to stimuli located in the periphery.     

Field reliability of comprehensive system scoring in an adolescent inpatient sample

The extent to which the Comprehensive System for the Rorschach is reliably scored has been a topic of some controversy. Although several studies have concluded it can be scored reliably in research settings, little is known about its reliability in field settings. This study evaluated the reliability of both response-level codes and protocol-level scores among 84 adolescent psychiatric inpatients in a clinical setting. Rorschachs were originally administered and scored for clinical purposes. Among response codes, 87% demonstrated acceptable reliability(> .60), and most coefficients exceeded .80. Results were similar for protocol-level scores, with only one score demonstrating less than adequate reliability. The findings are consistent with previous evidence, indicating reliable scoring is possible even in field settings.     

Coantagonism of glutamate receptors and nicotinic acetylcholinergic receptors disrupts fear conditioning and latent inhibition of fear conditioning

The present study investigated the hypothesis that both nicotinic acetylcholinergic receptors (nAChRs) and glutamate receptors (alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptors (AMPARs) and N-methyl-d-aspartate glutamate receptors (NMDARs)) are involved in fear conditioning, and may modulate similar processes. The effects of the nAChR antagonist mecamylamine administered alone, the AMPAR antagonist NBQX administered alone, and the NMDAR antagonist MK-801 administered alone on cued fear conditioning, contextual fear conditioning, and latent inhibition of cued fear conditioning were examined. In addition, the effects of coadministration of either mecamylamine and NBQX or mecamylamine and MK-801 on these behaviors were examined. Consistent with previous studies, neither mecamylamine nor NBQX administered alone disrupted any of the tasks. However, coadministration of mecamylamine and NBQX disrupted both contextual fear conditioning and latent inhibition of cued fear conditioning. In addition, coadministration of mecamylamine with a dose of MK-801 subthreshold for disrupting either task disrupted both contextual fear conditioning and latent inhibition of cued fear conditioning. Coadministration of mecamylamine and NBQX, and coadministration of mecamylamine with a dose of MK-801 subthreshold for disrupting fear conditioning had little effect on cued fear conditioning. These results suggest that nAChRs and glutamate receptors may support similar processes mediating acquisition of contextual fear conditioning and latent inhibition of fear conditioning.     

Missing sights: consequences for visual cognitive development

The effects of early-onset blindness on the development of the visual system have been explained traditionally by the stabilization of transient connections through Hebbian competition. Although many of the findings from congenital cataract and congenital blindness are consistent with that view, there is inconsistent evidence from studies of visual cognition in children treated for visual deprivation from cataract, case reports of recovery of vision in adults, and studies of visual reorganization after late-onset blindness. Collectively, the data from congenital cataract and congenital blindness indicate that early visual experience sets up the infrastructure for later learning involving both the dorsal ("where") and ventral ("what") streams. Nevertheless, there is surprising residual plasticity in adulthood that can be revealed if vision is lost either temporarily or permanently. This has important implications for understanding the role of early visual experience in shaping visual cognitive development.     

Becoming symbol-minded

No facet of human development is more crucial than becoming symbol-minded. To participate fully in any society, children have to master the symbol systems that are important in that society. Children today must learn to use more varieties of symbolic media than ever before, so it is even more important to understand the processes involved in symbolic development. Recent research has greatly expanded what we know about early symbol use. We have learned, for example, that infants initially accept a wide range of entities as potential symbols and that young children are often confused about the nature of symbol-referent relations. During the first few years of life, however, children make rapid progress towards becoming competent symbol users.     

Environmental complexity and central nervous system development and function

Environmental restriction or deprivation early in development can induce social, cognitive, affective, and motor abnormalities similar to those associated with autism. Conversely, rearing animals in larger, more complex environments results in enhanced brain structure and function, including increased brain weight, dendritic branching, neurogenesis, gene expression, and improved learning and memory. Moreover, in animal models of CNS insult (e.g., gene deletion), a more complex environment has attenuated or prevented the sequelae of the insult. Of relevance is the prevention of seizures and attenuation of their neuropathological sequelae as a consequence of exposure to a more complex environment. Relatively little attention, however, has been given to the issue of sensitive periods associated with such effects, the relative importance of social versus inanimate stimulation, or the unique contribution of exercise. Our studies have examined the effects of environmental complexity on the development of the restricted, repetitive behavior commonly observed in individuals with autism. In this model, a more complex environment substantially attenuates the development of the spontaneous and persistent stereotypies observed in deer mice reared in standard laboratory cages. Our findings support a sensitive period for such effects and suggest that early enrichment may have persistent neuroprotective effects after the animal is returned to a standard cage environment. Attenuation or prevention of repetitive behavior by environmental complexity was associated with increased neuronal metabolic activity, increased dendritic spine density, and elevated neurotrophin (BDNF) levels in brain regions that are part of cortical-basal ganglia circuitry. These effects were not observed in limbic areas such as the hippocampus.     

Identifying environmental contributions to autism: provocative clues and false leads

The potential role of environmental factors in autism spectrum disorders (ASD) is an area of emerging interest within the public and scientific communities. The high degree of heritability of ASD suggests that environmental influences are likely to operate through their interaction with genetic susceptibility during vulnerable periods of development. Evaluation of the plausibility of specific neurotoxicants as etiological agents in ASD should be guided by toxicological principles, including dose-effect dependency and pharmacokinetic parameters. Clinical and epidemiological investigations require the use of sufficiently powered study designs with appropriate control groups and unbiased case ascertainment and exposure assessment. Although much of the existing data that have been used to implicate environmental agents in ASD are limited by methodological shortcomings, a number of efforts are underway that will allow more rigorous evaluation of the role of environmental exposures in the etiology and/or phenotypic expression of the disorder. Surveillance systems are now in place that will provide reliable prevalence estimates going forward in time. Anticipated discoveries in genetics, brain pathology, and the molecular/cellular basis of functional impairment in ASD are likely to provide new opportunities to explore environmental aspects of this disorder.     

Australian lawyers' views on competency issues in older adults

Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions.