ABSTRACT Over the last few years Bipolar Disorder has been associated with chronic neuropsychological deficits that remain even when episodes of depression, mania or hypomania remit. Furthermore Bipolar Disorder has been associated with progressive cognitive impairment, leading to the description of the illness as chronic and deteriorating, rather than as an illness with discreet episodes from which patients can fully recover. The results of neuropsychological studies have been criticized for methodological weaknesses however. The present study attempted to address these weaknesses. The aim was primarily to establish whether neuropsychological impairment exists in euthymic patients, and secondarily, to establish if neuropsychological functioning deteriorates with illness severity. Sixteen euthymic Bipolar I disordered patients were matched for age and sex to 16 controls and subjected to a battery of neuropsychological tests. Matched pair T-tests were used to identify if significant differences in neuropsychological functioning existed between the two groups. The ANOVA technique was used to determine if neuropsychological functioning deteriorated with illness severity. Markers of illness severity utilised in this study were number of depressive episodes, number of manic episodes, number of suicide attempts and number of hospitalisations. The results indicated that neuropsychological differences between the patient and control group were minimal and not clinically significant. The present study sample was medically and psychologically well managed and enjoyed good support structures and their neuropsychological functioning did not deteriorate with illness severity. It was concluded that the sample size and the nature of the sample selected could perhaps have affected the study outcome. It was therefore hypothesized that bipolar disorder is not a homogenous group and that protective factors may exist which affect the course and outcome of the illness. These protective factors should be the subject of further investigation as they are likely to significantly impact on the natural history of this disease process.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / This study was designed to examine dependency in a permanently and totally blind adult male population. This necessitated the use of measures of overt and covert dependency which examined (a) the differences in dependency levels for blind adults compared with a sighted adult comparison group, and (b) the dependency levels varying within the blind groups is a function of length of blindness. A distinction between Instrumental Dependency (ID) and Emotional Dependency {ED) was proposed. ID was defined as the activity of seeking support or overt help, and ED referred to behavior exhibited in gaining satisfaction of some covert need. It is generally accepted that blindness creates a state of helplessness and dependency. A physical disability, by its very nature, necessitates the disabled person to both seek out and accept help from others. Often times the assistance he receives is in areas of performance where he was formerly able to function independently. Generally, the more severe the disability, in this case, the degree of blindness, the higher the amount of dependent behavior required to function adequately. It is possible that generalization effects of this dependency result in a transfer of this behavior to new and different situations. Not only is there the possibility of ID transfer, but there also may be a transfer effect which would increase covert ED behavior. The following four hypotheses were tested: 1. Blind adults are higher in Instrumental Dependency than are sighted adults. 2. Instrumental Dependency is related to length of blindness among blind adults. 3. Blind adults are higher in Emotional Dependency than are sighted adults. 4. Emotional Dependencx is related to length of blindess among blind adults. Instrumental Dependency was reflected through the frequency with which Ss required the assistance of repeated anchor value sounds in the judgment of "slow" and "fast" audible stimuli. Emotional Dependency was measured through responses to the Rohde Sentence Completion Test. Subjects' ages ranged from 20-54 years, intelligence quotients were between "dull normal" and "bright normal". Seventy subjects were studied, fifty-six blind and a comparison group of fourteen sighted. The blind Ss were divided into four groups according to length of blindness, which ranged from four months to almost eleven years. Results indicated that blind adults are higher in ID, and that ID is related to length of blindness (r=.47). While the blind adults scored higher in ED than did sighted adults, results indicated that, contrary to the proposed hypothesis, ED decreases as the length of blindness increases (r= -.35). There is evidence that help-seeking ("dependency") is a concomitant of the condition of blindness that is generalized to behavior which would not ordinarily elicit differential responses. As noted in the results , this help seeking was significantly greater for blind adults. However, the lessening of ED over time seems to indicate the learning of coping behavior following the initial heightened dependency. The separate dynamics of ID and ED, and their relationship to length of blindness, were discussed within the framework of learning and ego psychology. / 2031-01-01

Thesis (M.S.)--Boston University / This study was carried on under the auspices of the Boston Guild for the Hard of Hearing and the Childrens' Aid Association, Department of Neighborhood Clubs. Its purpose has been to study the adjustment of a group of acoustically handicapped children in a protective group work setting. This study also seeks to explore the following questions: 1. What were the problems in group adjustment as related to the hearing handicap? 2. Vlhat methods were used by the group leader in helping the boys deal with the handicap? 3. Vlhat changes were there regarding the boys' attitude toward their handicap? 4. What was the nature of the cooperative relationship between the two agencies?

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Background: Elderly people who demonstrate memory impairment that falls short of dementia, are referred to as having amnestic Mild Cognitive Impairment (aMCI). AMCI patients have an elevated risk of developing dementia, although not all will do so. Clinical criteria for Alzheimer's Disease (AD) and aMCI do not specify how impairment of a cognitive nature should be defined. The process of differentially diagnosing these conditions can be improved, if knowledge of neuropsychological measures that best discriminate between neurodegenerative and non-neurodegenerative cognitive impairment is used to implement diagnostic criteria for aMCI and AD. Aims: We sought to 1) determine the frequency of aMCI referrals to our specialist memory clinic, 2) characterise the detailed neuropsychology of a group of patients with aMCI, 3) determine the utility in differential diagnosis and test-retest reliability of these neuropsychological measures, and 4) establish a subset of neuropsychological measures that were of prognostic utility in aMCI. Methods: The case notes of 187 consecutive referrals received by our Royal Edinburgh Hospital memory assessment service across an 18-month period were reviewed retrospectively and numbers of patients fulfilling aMCI criteria were recorded. The baseline neuropsychological performances of 46 patients with aMCI, 20 patients with very early stage AD, 20 elderly patients with depressive symptoms and 24 healthy elderly participants were compared in order to determine their usefulness in differential diagnosis. AMCI participants were followed-up across an average of 4 years. Baseline neuropsychological performances of the aMCI dementia converters and aMCI non-converters were compared. Logistic regression analysis was applied to ascertain the predictive accuracy of a combination of these. Results: One quarter of referrals received by our memory assessment service met criteria for aMCI, most of whom displayed additional neuropsychological impairments of a non-memory nature, all the while performing above the highest cut off points on even the most comprehensive dementia screening measures. A number of neuropsychological measures were highly sensitive and specific to early AD however, similar combinations of both high sensitivity and specificity to aMCI were not achieved. Forty one percent of patients presenting to our service who fulfilled criteria for aMCI, received a clinical diagnosis of dementia across an average 4-year period. Performances on a comprehensive cognitive screening measure and a measure of delayed word recognition accuracy at baseline, classified 74% of aMCI patients comprising our clinic sample in accordance with their prognostic fate. Conclusion: A significant proportion of patients presenting to specialist memory clinics display episodic and semantic memory or executive impairment that falls short of dementia and that is not detectable using traditional bedside screening measures. The vast majority of such patients (i.e. 72%) experience persisting or progressive cognitive impairment, and a significant proportion (41%) go on to receive a clinical diagnosis of dementia. The baseline neuropsychological performance of aMCI patients who do and do not develop dementia differs, and contributes over and above clinical information to the prediction of long-term diagnostic outcome. The high frequency with which aMCI is encountered in clinical practice, coupled with the minority of aMCI patients who experience resolution of their cognitive impairment, and the sensitivity and prognostic utility of several neuropsychological tasks, has implications for the clinical management of patients with aMCI.

ABSTRACT Visibility degradation has become one of the major problems of public concern in Kaohsiung City as well as in most of the urban areas of Taiwan in recent years due to the increasing severity of smog. This study investigated the different aspects of atmospheric visibility degradation problems in metro Kaohsiung. First of all, both the long-term and short-term variation trends of atmospheric visibility were interpreted by analyzing the past data of prevailing visibility. Secondly, the correlation of atmospheric visibility with its major causative factors (i.e. meteorological and pollutant parameters) was established. Thirdly, the relationship between visibility degradation and aerosol mass/composition was derived by using multiple linear regression techniques based on in-situ field measurements of ambient aerosols and light extinction coefficient. Finally, the effective strategies for improving the visual air quality of metro Kaohsiung were proposed based on the results of the receptor-oriented modeling. In metro Kaohsiung, the seasonal variation of atmospheric visibility from the highest to the lowest were found to be in the sequence of summer, spring, autumn and winter, with mean values of 9.1, 8.2, 5.4, and 3.4 km, respectively. A diurnal variation of visibility was observed and showed that the visibility was generally lower in the morning and higher in the afternoon. A mass light scattering efficiency of 3.6 m2 g-1 for PM2.5 and a much lower value (0.3 m2 g-1) for PM2.5-10 indicated that the visible light was mainly scattered by the fine aerosol particles. The derived multiple linear regression model of light scattering coefficient yielded the mass scattering efficiencies of 4.6 m2 g-1 for (NH4)2SO4, 6.7 m2 g-1 for NH4NO3, 3.3 m2 g-1 for total carbon, and 3.2 m2 g-1 for PM2.5-remainder with an R2 of 0.97. On average, the percentage contributions of the visibility-degrading species to the light scattering coefficient were 29% for sulfates, 28% for nitrates, 22% for total carbon, and 21% for PM2.5-remainder, respectively. Furthermore, the major component of light extinction coefficient (bext) was the scattering of light by particles (75% of bext), followed by the absorption of light by particles (20%), while the remaining 5% of bext was attributed to gases. An empirical regression model of visibility based on sulfates, nitrates, PM2.5-remainder, and relative humidity was developed. The results showed that the variation of sulfate in PM2.5 aerosols was most sensitive to visibility change among the parameters. In terms of visibility degradation sources, source apportionment results indicated that the major contributors to fine particles were motor vehicle exhaust and secondary aerosols, which contributed more than half of the visibility degradation in metro Kaohsiung. Meanwhile, the second largest contributor was secondary aerosols containing ammonium sulfate and ammonium nitrate. Additionally, the contribution of soil dust increased markedly from normally only 4% to 25%, owing to an impact of continental dust storm from Mainland China. The results strongly indicated that soil dust blown from the desert areas of Northern China could be transported across the Yellow Sea and the East China Sea and evidently deposited in metro Kaohsiung. Results of the correlation analysis between atmospheric visibility and emission sources revealed a similarity between the source contribution pattern for visibility impairment and the source apportionment of fine particles. It showed ammonium sulfate contributed approximately 46% of the logarithm of atmospheric visibility, while the ¡§remainders¡¨, ammonium nitrate, and elemental carbons contributed about 20%, 17%, and 17%, respectively. Accordingly, this study concluded that the most effective strategy for improving atmospheric visibility in metro Kaohsiung was to prevent the formation of secondary fine particles containing ammonium sulfate and ammonium nitrate.

Preschool children with Specific Language Impairment are at an increased risk for later reading difficulties (Watson, Layton, & Pierce, 1994; Catts et al., 1999; Johnston et al., 1999; Boudreau & Hedberg, 1999). Current emergent literacy intervention approaches have been discussed regarding typically developing children and children from lower incomes, but they lack efficacy data for preschoolers with SLI. The purpose of this article is to describe the current literature regarding emergent literacy intervention in preschoolers with SLI and reach an evidence-base decision as to the most effective intervention techniques to utilize in order to prevent later reading difficulties. / text

The purpose of this report is to explore whether listening comprehension difficulties are due to receptive language impairment or attention deficits in school-age children. This evidence-based practice brief analyzes research within this population and gives suggestions on clinical implications for practicing speech-language pathologists related to intervention. Results show that listening comprehension is impaired in children whether or not they have co-occurring language impairment. However, ADHD does not further impair a child with a language disorder. Intervention for this population should focus on increasing the child’s understanding of causal connections, making inferences, and effective ways to study. / text

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