ZIEL: Ermittlung der Stichtagsprävalenz von Insomnie und anderen Schlafstörungen in deutschen Allgemeinarztpraxen sowie Bestimmung hausärztlicher Erkennensraten. METHODIK: Bundesweite Zufallsauswahl von 539 Arztpraxen. Charakterisierung der Arzt- und Praxismerkmale mittels initialer Vorstudie. Darauf folgend eine Stichtagsbefragung aller Hausarzt-Patienten mittels Schlaffragebogen (PSQI) und klinischen Fragen (N = 19155 Fälle) sowie klinisch-ärztliche Beurteilung durch den behandelnden Artz mittels CGI und Fragebogen. ERGEBNISSE: 1. Trotz nur moderater Kompetenzeinschätzungen hinsichtlich Diagnose und Therapie behandeln Hausärzte Insomnien und andere Schlafstörungen vorwiegend selbst, auch wenn diese einen hohen Behandlungsaufwand erfordern. 2. Die Stichprobe kann als typisch für die Hausarzt-Klientel angesehen werden. 3. Schlafstörungen sind der dritthäufigste Konsultationsanlass. Nahezu jeder zweite Patient berichtete, in den vergangenen 2 Wochen unter Schlafbeschwerden gelitten zu haben, 26,5% erfüllten aufgrund der subjektiven Angaben die Studienkriterien (DSM-IV) für Insomnie. 4. Auch die Ärzte beurteilten 46,4% aller ihrer Patienten mittels CGI zumindest als Grenzfälle einer Schlafstörung, 85,6% wurden als chronisch eingeordnet. Die ärtzlich beurteilte Insomnieprävalenz betrug 25,9%, die anderer Schlafstörungen 13,7%. 5. Nur 54,3% aller Insomniepatienten wurden auch als solche vom Hausarzt diagnostiziert. DISKUSSION: Die Studie liefert erstmals bundesrepräsentative, differenzierte epidemiologische Daten zu der Prävalenz, dem Schweregrad, den Einschränkungen und den Verlaufsmustern von Insomnien und Schlafstörungen. Die außerordentlich große Häufigkeit und die zum Teil markanten Defizite hinsichtlich Erkennen und Diagnostik in der primärärztlichen Versorgungen werden diskutiert. / AIM: To estimate the point prevalence of insomnia, recognition and prescription behavior in primary care. METHODS: Nationwide sample of 539 primary care settings along with their characterization (stage 1). Standardized assessment of all attenders (N = 19.155 patients) on the NISAS target day using a sleep questionnaire (PSQI) and additional questions to cover psychosocial and additional clinical variables. All patients were evaluated by the primary care doctors using a standardized clinical appraisal questionnaire, including a CGI-rating. RESULTS: Prevalence insomnia according to DSM-IV was 26.5%. Recognition of presence of any clinically significant sleep disorder was 72%, recognition of insomnia was poor 54.3%. 85.6% of insomnia patients were rated as chronic. Close to 50% of all insomnia cases did not receive a specific insomnia therapy. Herbals, followed by hypnotics and sedatives and antidepressants were the three most frequent treatments applied, psychotherapy was only seldomly indicated. DISCUSSION: NISAS provides for the first time nationally representative estimates of interventions for insomnia in primary care. The relatively low treatment rates and the high proportion of chronic patients receiving longterm prescription of benzodiazepines seem to be critical. Priorities for future agenda to improve this situation are discussed.

Decrements in selective attention are a commonly experienced phenomenon that has practical implications for many industries. Two causes of such deficits are mental fatigue and alcohol intoxication, which impair selective attention by decreasing the efficiency of inhibitory processes. The present research examined the effects of these two factors on the selective attention subtest of the Useful Field of View test in both a baseline and an experimental session. Participants in the mental fatigue condition (n = 14) were tested while performing a divided attention task for two hours to induce mental fatigue. Those in the alcohol condition (n = 10) were tested while achieving a peak blood alcohol content of 0.05%. No differences between the two groups were observed, nor was a significant decline in selective attention observed as a result of either manipulation. The results indicate three possible explanations for this lack of a difference including a floor effect on the selective attention task, a pop-out effect in switching from the divided to the selective attention task, and an increase in attentional effort regulation due to the contrast in difficulty of the divided and selective attention tasks.

<p>Semantic memory is part of the long-term memory system, and there are several theories concerning this type of memory. Some of these will be described in this essay. There are also several types of neuropsychological semantic memory deficits. For example, test results have shown that patients tend to have more difficulties naming living than nonliving things, and one probable explanation is that living things are more dependent on sensory than on functional features. Description of concrete concepts is a new test of semantic memory, in which cueing is used, both to capture the maximum performance of patients, and to give insight into the access versus storage problem. The theoretical ideas and empirical results relating to this new test will be described in detail. Furthermore, other tests of semantic memory that have been commonly used will also be briefly described. In conclusion semantic memory is a complex cognitive system that needs to be studied further.</p>

我國財務會計準則委員會於2004年7月1日發佈財務會計準則第35號公報《資產減損之會計處理準則》，此號公報允許公司可選擇於2004年提前認列資產減損，且公司擁有認列資產減損金額之裁量權。當公司擁有認列資產減損時點與金額的裁量權時，資產減損之認列可能成為一項新的盈餘管理工具。由於我國公司的代理問題是起因於控制股東剝削外部股東之財富，故本研究擬探討控制股東之股權結構與公司提前認列資產減損之關聯性。 / 本研究以2004年年報與2005年第一季季報宣告資產減損的上市櫃公司為研究對象。研究目的有三，首先探討控制股東之控制權偏離現金流量權引發的代理問題，是否會影響公司提前認列資產減損的可能性與金額。其次探討公司的控制股東持股質押的現象，是否會加深公司的代理問題，因而影響公司提前認列資產減損的可能性與認列減損的金額。最後本研究將探討市場對於宣告資產減損資訊的反應，是否會受到公司治理結構不同所影響。 / 研究結果發現，控制股東之控制權偏離現金流量權幅度愈大的公司，提前認列資產減損的可能性愈大，但是與提前認列資產減損的金額無顯著的關聯性。其次，控制股東有持股質押的公司，提前認列資產減損的可能性與金額皆愈大。最後，本研究並未發現股票市場對於不同公司治理結構的公司宣告資產減損的訊息有不同的反應。 / Statement of Financial Accounting Standards (SFAS) No.35 “Accounting for Assets Impairments” was released on July first of 2004. The provision of this Statement should be effective for quarterly financial statements ending on or after first quarter of 2005, but earlier application on the forth quarter of 2004 is encouraged. In Taiwan, the agency problem arises from the divergence between controlling owner’ voting right and cash flow right. Thus the regulation on the early adoption provides controlling owner with stronger incentive to manage reported earnings by manipulating the recognition timing and amount of write-off of impaired assets. / The primary objective of this paper is examine the association ownership structures, measured as the control divergence and the percentage of collateralized stock by controlling owners, and the likelihood of the early adoption of SFAS No. 35 and amount of assets impairments. Second, we further examine whether market valuation on assets impairment systematically varies depending on the agency problem level. / The results show that, as predicted, firms with greater control divergence and greater percentage of collateralized stock by controlling owners are more likely to early recognize impartment of assts. In addition, we find that the amount of asset impairment is associated with the percentage of collateralized stock by controlling owners, as predicted, but is not related to the control divergence. Finally, contrary to our prediction, we find no evidence that the market reaction to the announcement of asset impairments is significantly associated with the corporate governance structures.

Individuals with various lower-limb neuromuscular and musculoskeletal impairments are often prescribed passive-dynamic ankle-foot orthoses (PD-AFOs) to compensate for impaired ankle muscle weakness. Several studies have demonstrated the beneficial effects of PD-AFOs on pathological gait, but few studies have examined the influence of the AFO stiffness characteristics on gait performance. One challenge to performing such studies is the difficulty of manufacturing custom AFOs with a wide range of controlled stiffness levels. However, selective laser sintering (SLS) is a well-suited additive manufacturing technique for generating subject-specific PD-AFOs of varied stiffness. Therefore, the overall goal of this study was to use SLS manufactured PD-AFOs to identify the relationships between AFO stiffness and gait performance in patients with various lower-limb neuromuscular and musculoskeletal impairments. Six subjects with unilateral impairments were enrolled in this study. For each subject, one subject-specific PD-AFO equivalent to the subject’s clinically prescribed carbon fiber PD-AFO (nominal), one 20% more compliant and one 20% more stiff were manufactured using SLS. Three-dimensional kinematic and kinetic data were collected from each subject while ambulating with each PD-AFO at two different speeds to allow a comprehensive biomechanical analysis to assess the influence of PD-AFO stiffness on gait performance. The results showed that in the compliant AFO condition, the AFO limb vertical ground reaction force (GRF) impulse during loading and the non-AFO limb medial GRF impulse during push-off decreased. In addition, the AFO limb braking GRF impulse during loading and the non-AFO limb braking GRF impulse in early single-limb stance decreased. Furthermore, in the compliant AFO condition, negative knee work during early single-limb stance increased while positive hip work in early swing decreased in the AFO limb. Overall, as AFO stiffness decreased, the AFO limb contributed less to body support and braking. In addition, a decreased medial GRF impulse coupled with an increased vertical GRF impulse during non-AFO single-limb stance suggests that walking stability may be compromised as AFO stiffness decreases. Thus, a tradeoff may exist between preserving stability and increasing net propulsion, which should be considered when assessing the mobility needs of individuals prescribed PD-AFOs as a result of various neuromuscular and musculoskeletal impairments. / text

This study examined the characteristics of 14 English Language Learners classified as having learning disabilities (LD) who were also identified as having speech and language impairments (SI) prior to, at, or after initial identification as LD. Data were collected under the auspices of a longitudinal study, Bilingual Exceptional Students: Effective Practices for Oral Language and Reading Instruction, conducted by multicultural special education faculty at the University of Texas at Austin between 1999 and 2002. Participants were served in bilingual education and bilingual special education programs in a large, central Texas school District. Archival data from students’ cumulative, bilingual and special education records were analyzed to profile student characteristics at the point of their initial LD and SI eligibility determinations. A clinical judgment panel comprised of bilingual special education experts analyzed student data and made independent eligibility recommendations for each participant. These recommendations were compared to the multidisciplinary teams (MDTs’) eligibility decisions. Findings revealed that MDTs based eligibility primary on the presence of an IQ-achievement discrepancy and did not adequately consider factors, other than the presence of LD that could explain student difficulties. When data other than the IQ-achievement discrepancy were considered, the clinical judgment panel classified 4 participants as LD and 9 as having disabilities other than LD; the panel felt that data for one student were insufficient to make an eligibility recommendation. Findings related to identification of SI for this population were limited because students were assessed using a Spanish translation of an English speech and language assessment developed by the district. Test results corroborated parents’ and teachers’ concerns that these students had significant communication problems. Implications for improving practices related to early intervention, referral, assessment, and eligibility determinations for ELLs are presented and suggestions for future research are delineated. / text

Αντικρουόμενα συμπεράσματα παρουσιάζονται στη βιβλιογραφία σχετικά με την υγεία των καλλιεργητών. Στην παρούσα μελέτη η επίδραση της ενασχόλησης με τις αγροτικές καλλιέργειες διερευνήθηκε με κλινικά και εργαστηριακά ευρήματα, συγκρίνοντας αγρότες με μη αγρότες που διαμένουν στις ίδιες αγροτικές περιοχές. Δείγμα 328 αγροτών και 347 μη αγροτών, σταθμισμένα κατά ηλικία και φύλο, επελέγησαν με τυχαίο τρόπο σε αγροτικές περιοχές του νομού Αιτωλοακαρνανίας στη Δυτική Ελλάδα. Στα μέλη και των δύο ομάδων έγινε αιμοληψία για διενέργεια γενικής εξέτασης αίματος και βιοχημικών εξετάσεων ενώ εφαρμόστηκαν δύο νευροψυχιατρικές δοκιμασίες, η MMSE και η MADRS για την εκτίμηση της μνήμης και της διάθεσης αντίστοιχα και δύο νευρομυϊκές δοκιμασίες, η MRCS και η MAS για την εκτίμηση του μυϊκού τόνου και της μυϊκής κινητικότητας αντίστοιχα. Έγινε καταγραφή των δημογραφικών στοιχείων, διατροφικών και άλλων συνηθειών και του ατομικού ιατρικού ιστορικού. Από τους αγρότες ζητήθηκαν πληροφορίες σχετικά με τις καλλιέργειες, τα χρησιμοποιούμενα φυτοφάρμακα και τα λαμβανόμενα προστατευτικά μέσα. Οι αγρότες ανέφεραν συχνότερα αρτηριακή υπέρταση και κάποιες καρδιαγγειακές νόσους, ορθοπεδικά και ΩΡΛ προβλήματα. Στους αγρότες παρατηρήθηκαν χαμηλότερες τιμές αιματοκρίτη, αιμοσφαιρίνης και χολινεστεράσης πλάσματος και υψηλότερες τιμές καλίου, ασβεστίου, SGOT, LDH, χολερυθρίνης, ολικών λευκωμάτων, CRP και τριγλυκεριδίων. Στους αγρότες νεότερων ηλικιών παρατηρήθηκαν χαμηλότερες τιμές αρτηριακής υπέρτασης και καλύτερες επιδόσεις στις δοκιμασίες MMSE και MADRS σε σχέση με τους μη αγρότες, ενώ στις μεγαλύτερες ηλικίες συνέβαινε το αντίθετο. Κανένας νέος αγρότης δεν εμφάνιζε παθολογικά αποτελέσματα στις δοκιμασίες MRCS και MAS, ενώ οι ηλικιωμένοι αγρότες είχαν μεγαλύτερη συχνότητα παθολογικών αποτελεσμάτων σε σχέση με τους ηλικιωμένους μη αγρότες. Οι αγρότες είναι περισσότερο ευάλωτοι σε διάφορα προβλήματα υγείας. Οι παράγοντες που σχετίζονται με αυτή την τάση δεν είναι απολύτως σαφείς. Χρειάζονται περισσότερες αποδείξεις για να συνδεθεί η έκθεση στα φυτοφάρμακα με τα παρατηρούμενα προβλήματα υγείας. / Contradictory outcomes concerning the farmers’ health are reported in the literature. In this study the effect of “farming” is investigated by comparing farmers versus non-farmers living in the same rural area with regard to certain clinical and neurobehavioral health outcomes. 328 farmers and 347 non-farmers, matched per age and sex, were selected randomly in an agricultural area in West Greece. Both groups underwent haematological and biochemical examinations and were administered two neurobehavioral tests, namely the Mini-Mental State Examination (MMSE) and the Montgomery-Åsberg Depression Rating Scale (MADRS) as well as two neuromuscular tests, the Medical Research Council Scale (MRCS) and the Modified Ashworth Scale (MAS). Sociodemographic, personal medical, nutritional data and lifestyle were recorded. Farmers also gave details concerning cultivations, application of pesticides and protective measures taking. According to personal statements, farmers suffered from hypertension, cardiovascular, orthopaedic and ENT problems in higher frequency. Haematocrit, haemoglobin and serum cholinesterase’s activity were found to be lower among farmers. Potassium, calcium, SGOT, LDH, bilirubin, albumin, CRP and triglycerides levels are higher among farmers. Lower prevalence of hypertension and better performances on MMSE and MADRS tests were recorded in young farmers in relation to young non farmers, while these findings were reversed in older ages. Noone young farmer has abnormal results in MRCS and MAS tests, while in older ages farmers present abnormal results in higher frequency than non farmers in those scales. Farmers are susceptible to potential impairments on their health status. Factors affecting these impairments remain to be clarified. The pesticides’ exposure needs further investigation and evidence in order to be correlated with the observed effects.

This study analyzes the changes in disability-specific curriculum that took place in one specialized school for the blind driven by academic priorities from 1995 to 2005. The framework used in this case study approach analyzed the school's past and present (1) Artifacts - visible organizational structures and materials, (2) Expressed Values- explicitly written or stated beliefs and policies, and (3) Underlying Assumptions- unspoken attitudes and beliefs. Variables for change among the areas of teacher training, team teaching, evaluation systems, IEP's, state standards, the school improvement plan, short term and summer programming, as well as the residential program were all targeted to balance academics with an Expanded Core curriculum. The results indicate a balanced curriculum for some of the variables while other areas continue to reflect the struggle of mandates.

Šio darbo tikslas – išanalizuoti kalbos sutrikimų turinčių vaikų rišliuosius pasakojimus, taigi darbo objektas yra vaikų, turinčių kalbos sutrikimų, rišlieji pasakojimai. Šiame darbe buvo išanalizuoti dvidešimt trys priešmokyklinio amžiaus vaikų, turinčių kalbos sutrikimų, rišlieji pasakojimai. Darbą sudaro teorinė dalis, kurioje apžvelgiama kalbos sutrikimų klasifikaciją ir rišliojo pasakojimo metodika, bei tiriamoji dalis. Darbe buvo naudojami aprašomasis, teorinis ir analizės metodai. Tiriamojoje dalyje priešmokyklinio amžiaus vaikų, turinčių kalbos sutrikimų, rišlieji pasakojimai buvo išanalizuoti pirmiausiai pagal paveikslėlių sekos metodą. Išanalizavus rišliuosius pasakojimus pagal šį metodą, buvo pastebėta, kad papildomų klausimų uždavimas padeda vaikams geriau suprasti pasakojimo siužetą, todėl pasakojimai po užduotų papildomų klausimų tapo rišlesni, nuoseklesni ir ilgesni. Be to, vaikų pasakojimuose, kuriuose buvo rasta gramatinių netikslumų, po klausimų analizės šių gramatinių netikslumų neliko. Tolimesniuose teorinės dalies poskyriuose pasakojimai buvo analizuojami mikrostruktūros ir makrostruktūros lygmenyse. Šiose dalyse buvo tiriamas pasakojimų produktyvumas, sintaksės sudėtingumas, struktūrinių dalių subalansuotumas, pagrindinės minties atskleidimas ir teksto junglumas. Kalbos sutrikimų turinčių vaikų rišliojo pasakojimo darbo rezultatais galėtų pasinaudoti kalbininkai ir kiti mokslininkai, kurie domisi vaikų kalbos tyrimais. Tęsiant šį darbą, būtų galima... [toliau žr. visą tekstą] / The aim of this work is to analyse fictional narratives of children with specific language impairments (SLI), therefore, the fictional narratives of children with SLI is object of this paper work. Twenty three fictional narratives were analysed of pre-school children with SLI. This paper work consists of two main parts: theory and analysis. Classification of language disorders and methods of narratives were described in the theory part. Analytic, descriptive and theoretic methods have been used in the paper. First, pre-school children with SLI narratives were analysed by pictures sequence’s method. The results showed of this method analysis that additional questions help children to understand the main idea of the story. For this reason, children stories became more coherent, connected and longer after the additional questions’ analysis. Besides, grammatical imprecision disappeared in the children stories, which were told after the additional questions’ analysis. Second, pre-school children with SLI narratives were analysed by the microstructure and macrostructure levels. Narratives’ productivity, syntax complexity, balance of structural parts, the main idea of the story and text combinability were analysed in these sections. Results of the Fictional narratives of children with specific language impairments could be used by linguists and other scholars, who are interested in the children language analysis. Fallowing this work, this work results could be compared with... [to full text]

Each live organism is made to adapt to the constantly changing environment. The success of child’s integration into society, his conduct in society depends on the family and school. Frequently, excessive care by their parents prevents a disabled child from developing independency skills. One of the most important tasks for the school is to prepare an individual for independent life and seek his integration into society. The issue of developing independency of a disabled individual has not been studied in detailed yet. The object of this study is independency of the pupils with hearing impairments. The paper contains an analysis of the reference sources and findings of the study, which disclose the peculiarities of developing independency of the deaf and hard of hearing pupils during technology classes. The respondents were surveyed by test-interview methods and the data obtained were processed with the help of SPSS software. When summarizing the academic, professional and methodical literature, a model of the pupils’ independency was drafted by dividing independency into three groups of its manifestation (inquisitiveness, initiative and organization skills) and by defining technological skills by three types of skills ( planning, information collection and use, technology activities). Analysis of individual programs revealed that the teachers of technologies devote attention to the development of the pupils’ independency at the schools for deaf and heard to hear students... [to full text]