Aortic isthmus stenosis from a neurological viewpoint

The etiology, pathogenesis, and clinical treatment of stenoses of the isthmus aortae are outlined. Following this, the particular case of a 41-year-old patient with typical stenosis of the isthmus of the aorta is reported. The course of disease required the need for a surgical operation, which had not initially been taken into consideration, to be reexamined. The patient, after performance on him of vascular restoration, is now on a part-time job. Using age as the sole circumstance indicating the inadvisability of performing a surgical operation in the case of stenosis of the isthmus aortae cannot any longer be considered justifiable.     

Adverse caregiving in early life: The trauma and deprivation distinction in young children

Knowledge and understanding about the impact of cumulative adverse experiences on the health and wellbeing of children, adolescents, and adults has rapidly expanded over the past 30 years. Despite the invaluable attention and support this proliferation has drawn to the importance of early childhood experiences, we believe that it is time to move beyond broad indices of risk and toward more specific and individualized understanding of how risk exposures are linked to clinical outcomes in young children. Within infant and early childhood mental health, there is a need for greater specificity in linking adverse caregiving experiences in early life to psychopathology in children. We highlight a framework distinguishing experiences of trauma from experiences of deprivation and use the examples of posttraumatic stress disorder and reactive attachment disorder to demonstrate how greater specificity in our understanding of early adverse caregiving can lead to more accurate and targeted diagnosis and treatment for young children. Both researchers and clinicians benefit from an approach to gain a greater appreciation of the links between specific types of experiences and outcomes in the children that we serve.     

The Persistence of Priming: Exploring Long-lasting Syntactic Priming Effects in Children and Adults

The implicit learning account of syntactic priming proposes that the same mechanism underlies syntactic priming and language development, providing a link between a child and adult language processing. The present experiment tested predictions of this account by comparing the persistence of syntactic priming effects in children and adults. Four-year-olds and adults first described transitive events after hearing transitive primes, constituting an exposure phase that established priming effects for passives. The persistence of this priming effect was measured in a test phase as participants described further transitive events but no longer heard primes. Their production of passives was compared to a baseline group who described the same pictures without any exposure to primes. Neither immediate nor long-term priming effects differed between children and adults but both children and adults showed significant immediate and persistent effects of the priming when the test phase occurred immediately after the exposure phase and when a short delay separated the exposure and test phase. The implications of these results for an implicit learning account of syntactic priming are discussed.     

Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.