bluuebunny/crossref_metadata_2025 huggingface dataset:
Examiner Errors on the Wechsler Scales
Authors: Slate John R. , Hunnicutt Larry C.
Published: November 2009

Numerous studies have indicated that graduate students and professionals alike make errors on Wechsler intelligence test protocols, which decreases the reliability and, thus, the validity of obtained test scores. This paper analyzed literature on Wechsler protocol scoring errors and proposed several hypotheses for consistent findings of examiner errors. Poor instructional preparation of students and ambiguity of scoring criteria in test manuals were cited as two probable explanations. Carelessness on the examiner's part as evidenced by incorrect mathematical calculations and incorrect scores on more objective subtests (such as Coding and Digit Span) was mentioned as another probable hypothesis. The examiner-examinee relationship and job-related factors (such as stress and excessive caseloads) also may be contributing factors. Empirical research is needed to determine more clearly the degree to which these hypotheses explain examiner difficulties in Wechsler test scoring.
Demographic Distribution of Third Factor Deficits in the Standardization Sample of the Wechsler Intelligence Scale for Children-Revised
Authors: Silver Stephen J. , Clampit Michael K.
Published: November 2009

Clampit and Silver (in press) reported that girls from the West appeared twice as often as nonwestern girls in a subset of children with Third Factor deficits, drawn from the standardization sample of the Wechsler Intelligence Scale for Children-Revised (WISC-R). We sought to replicate these findings for the entire WISC-R standardization sample, using the discrepancy between deviation quotients as a measure of Third Factor deficits. Regression analysis showed that, even after controlling for other demographic factors, children in the western region had significantly larger Third Factor discrepancies than their cohort population elsewhere. Furthermore, most of this difference was accounted for by unusually large discrepancies among girls from the West. In addition to these regional differences, sex, occupational class, and urban/rural differences were significant in explaining discrepancies.
Comparison of Hispanic and Anglo Graduate Record Examination Scores and Academic Performance
Authors: Whitworth Randolph H. , Barrientos Guido A.
Published: November 2009

The Graduate Record Examination (GRE) Verbal, Quantitative, and Analytic scores and undergraduate and graduate grade-point averages (U-GPA and G-GPA) for 320 Hispanics and 632 Anglos admitted to graduate school at the University of Texas at El Paso over the past 5 years were evaluated. Multivariate analyses revealed that Anglos scored significantly higher than Hispanics on both U-GPA and G-GPA and all three GRE scores. Multiple regression analyses for the ethnic group, with U-GPA and GRE scores used to predict G-GPA, showed higher correlations for the Anglos compared to Hispanics, although both had relatively poor predictive validity. The regression coefficients for all three GRE scores for the Hispanic group were zero, which reflects no relationship between the GRE and graduate grades; this makes the use of the GRE in selection of Hispanics for graduate school questionable.
Differential Effects of Socioeconomic Status and Gender on the Matrix Analogies Test-Expanded Form and the Wide Range Achievement Test-Revised with Above-Average Elementary School Students
Authors: Haddad Frederick A. , Bardos Achilles N.
Published: November 2009

The study examined the relationship between the Matrix Analogies Test-Expanded Form (MAT-EF), a recently available nonverbal cognitive ability measure, and the Wide Range Achievement Test Revised (WRAT-R). The sample was comprised of 65 male and 100 female elementary school age children of various socioeconomic levels who were referred by their parents for possible placement in a school program for the academically talented. Results revealed moderate statistically significant correlations between the MAT-EF and WRAT-R. MANOVA tests indicated no significant differences between the sample's various socioeconomic level groups and between males and females. Discriminant analysis findings indicated that use of the MAT-EF and the WRAT-R resulted in a correct classification of 92.7% of the subjects in the study's sample.
Stability of the Stanford-Binet Fourth Edition and K-ABC for Young Black and White Children from low Income Families
Authors: Lamp Robert E. , Krohn Emily J.
Published: November 2009

The stability of the Stanford-Binet: Fourth Edition and Kaufman Assessment Battery for Children was investigated by administering the tests to a sample of 71 low SES children at age 4 and again at age 6. Data were analyzed by comparing group mean scores, computing correlation coefficients, and determining individual change scores from time one to time two. The SB:FE mean composite scores for the group were very similar at both ages, correlation coefficients between the two sets of scores were high, and the difference scores were within acceptable limits. However, the area scores of the SB:FE were somewhat less stable. The correlation coefficients for the K-ABC Global scales were also high, but mean scores for this test increased significantly. Difference scores for the K-ABC scales also were within acceptable limits. Thus, both the SB:FE and K-ABC were highly stable from ages 4 to 6 for this sample of children from low income families. No significant differences were found between the Black and White subgroups, and the tests were found to be equally stable for both groups.
The Effects of Vocal Intonation in Digit Span Testing
Authors: Thomas M. G. , Hutchens Teresa A.
Published: November 2009

”Digit Span” subtests appear on many individual measures of intellectual and cognitive functioning and typically are interpreted as a reflection of individual skills. However, variations in the presentation of stimuli may affect results on these measures. Intonation, the drop in pitch of the examiner's voice, may influence performance by serving to signal the end of a digit series and to cue initiation of recall strategies. Eighty-two normal adults responded to two equivalent digit span sets. The recorded sets differed in presentation: continued monotone vs. a drop in pitch for final digits. Repeated measures ANOVA revealed a main effect for the experimental condition of intonation. The level of recall was significantly greater in the presence of a drop in voice at the end of a digit series (p < .0006). A comparison of marginal means revealed significantly better performance on digits forward vs. reversed (p < .0001). Precision in assessment practices and implications for the significance of cuing in intervention strategies are discussed.
Origins of Intelligence and its Measurement
Authors: Thorndike Robert M.
Published: November 2009

The climate in psychology at the turn of the present century was right for the development of measures of intelligence. Many researchers were involved in efforts to find effective measures, most of which were based on empirical relationships rather than theories of human abilities. During the first quarter of the century, Terman's Stanford-Binet became the dominant instrument, but the debate over the nature of intelligence was carried out between Charles Spearman and E. L. Thorndike. There are clear antecedents of modern measurement methods and theories in the work of this period.
Theoretical Foundations of the Wj-R Measures of Cognitive Ability
Authors: Woodcock Richard W.
Published: November 2009

The WJ-R provides a wide age range and comprehensive set of cognitive measures. A major interpretation feature of the battery is the provision of eight factor scores, each based on two measures. The theoretical basis for the tests is founded in Gf-Gc theory, work that is often associated with Raymond Cattell and John Horn, although other scholars think and write about intelligence in a similar vein. This report is a brief review of the theory followed by the results of several factor analytic studies. Nine data sets drawn from the 1977 and 1989 norming and concurrent validity studies have been analyzed. In the concurrent studies, the WJ-R cognitive tests were administered in conjunction with other major batteries including the K-ABC, the SB-IV, the WISC-R, and the WAIS-R. Altogether, 15 sets of exploratory and confirmatory factor analyses that included a total of 68 variables were completed. The results of all studies provide support for the WJ-R eight-factor model of Gf-Gc theory. As a byproduct of the procedure, comparative information was observed for the congruence of other cognitive batteries to the Gf-Gc theory. It is suggested that the other cognitive batteries often have been underfactored, which has led to misinterpretation of their factorial structures. This report demonstrates the need for factor analytic studies in which the set of variables is not constrained to the limited set of subtests that have been published together as a battery. It is indicated that the set of variables to be included in a factor study must include enough breadth and depth of markers to ensure that the presence of all major factor effects can be identified.
Review of the K-ABC: Reflecting the Unobservable
Authors: Conoley Jane Close
Published: November 2009

In response to Dr. Randy Kamphaus' paper on the theoretical origins of the Kaufman Assessment Battery for Children (Kaufman & Kaufman, 1983), an argument is made that relates to the lack of factor analytic support for the independence of simultaneous and sequential mental processing, the tenuous claim that the K-ABC's mental processing and achievement scales are measuring different constructs, and that meaningful measures of intelligence can be considered as content free.
The Nature and Structure of the Das: Questioning the Test's Organizing Model and Use
Authors: Elliott Stephen N.
Published: November 2009

The Differential Ability Scales (DAS) is a scale developed in the British empirical tradition and is purported to be useful in making educational decisions for children. This reaction focuses on and questions the DAS factor structure, the developmental theme of differentiation of abilities, and the role of the achievement subtests in the model of human abilities espoused in the DAS. The reaction concludes with a discussion of five areas of practical concern. These areas of concern are framed as questions: the racial differences question, the classification/diagnostic utility question, the ability-achievement discrepancy question, the profile development and use question, and the treatment validity question. Significant information relative to each of these questions is needed for the DAS before consumers can use the instrument meaningfully.
Determining the Factor Structure of the Stanford-Binet: Fourth Edition-The Right Choice
Authors: McCallum R. Steve
Published: November 2009

In an invited address, R. M. Thorndike recently provided a critical review of several factor analytic studies that address the construct validity of the Stanford-Binet: Fourth Edition. After reviewing the studies, he characterizes a particular set of factor analytic strategies he used as representing the “right” choice. In this article I briefly review techniques for establishing construct validity in general and his arguments in particular. I conclude by recommending consideration of a confirmatory factor analysis followed by related hypotheses testing procedures (e.g., the LISREL program) for the purpose of establshing model-specific construct validity.
Construct Validity of the Halstead-Reitan Neuropsychological Battery for Children with Learning Disorders
Authors: Batchelor Ervin , Sowles Gregory , Dean Raymond S. , Fischer Wyman
Published: November 2009

The underlying constructs of the Halstead-Reitan Neuropsychological Battery for Older Children (HRNB-C; Reitan, 1969) were examined for a large sample of learning-disabled children. Scores on the HRNB-C, the Wechsler Intelligence Scale for Children-Revised, and the Wide Range Achievement Test were factor analyzed separately for 9- to 10-year-olds, 11- to 12-year-olds, and 13- to 14-year-olds and then the overall group. Like factors were identified across age levels and compared using coefficients of congruence. A six-factor solution emerged for the 9- to 10-year-old group, whereas a seven-factor solution was interpreted for the older groups. Factors appeared to represent Simple Motor Skills, Visually Guided Motor Activities, Verbal Organization and Verbal Concept Formation, Symbolic Langauge Integration, Spatial Organization, and Integration across age. Factors that related to Visual-Spatial Organization and Spatial Memory were less stable. These data were interpreted as suggesting an increase in complexity of neuropsychological functioning with age.
Frequency of Verbal and Performance IQ Discrepancies on the WPPSI-R at Various Levels of Ability
Authors: Gyurke James S. , Prifitera Aurelio , Sharp Stephanie A.
Published: November 2009

The issue of Verbal-Performance IQ discrepancy has been investigated with the Wechsler Preschool and Primary Scale of Intelligence (Wechsler, 1967) and, given the recent revision of this scale (WPPSIR; Wechsler, 1989), determining the average expectable scatter would be useful for the clinician. The present study examined the incidence of VIQ-PIQ discrepancies and subtest variation by ability level in the standardization sample of the WPPSIR. Cumulative frequency distributions were constructed for the overall sample of 1,700 children and for five ability levels (<79, 80-89, 90-109, 110-119, and 120+) within this sample. The average PIQ > VIQ was 11.54 points (SD = 9.10) and the average VIQ > PIQ was 10.69 (SD = 7.87). The average difference tended to increase with ability level. Subtest scatter also was examined and found to increase with ability level. These results are consistent with previous studies on both the WPPSI and the WISC-R.
A Comparison of the WPPSI-R and WPPSI with HIGH-IQ Children
Authors: Milrod Robert J. , Rescorla Leslie
Published: November 2009

Eighty 4-to 6-year-old children expected to be highly intelligent were administered the WPPSI and the WPPSI-R in counterbalanced order. Overall, findings from this study of high-IQ preschoolers replicated results from the WPPSI-R standardization sample in terms of correlations between the two measures, factor structure, and score differences. WPPSI-R Full Scale, Performance, and Verbal IQs were 6.0, 9.2, and 3.5 points lower, respectively, than their WPPSI counterparts. The most notable finding of the study was a higher rate of significant Verbal > Performance discrepancies on the WPPSI-R than on the WPPSI, with discrepancies of 15 points or more on the WPPSI-R found in 26% of the sample.
Attributions for Academic Success and Failure: An Individual Difference Investigation of Academic Achievement and Gender
Authors: Bell Sherry Mee , McCallum R. Steve , Bryles Janna , Driesler Karla , McDonald Jama , Park Soo Hee , Williams Audrey
Published: November 2009

Ability, effort, and external attributions for academic success/failure as a function of achievement and gender were investigated for 237 elementary school children. Six attributions were the dependent measures for two 2 (achievement) × 2 (gender) MANOVAs. Groups were formed by Total Reading and Total Math scores on the Comprehensive Test of Basic Skills/4; for both MANOVAs results yielded significant main effects for achievement, but not for the gender and interaction effects. Follow-up ANOVAs revealed that high achievers attributed success to ability to a significantly greater extent than did low achievers. Low achievers attributed math failure to ability to a significantly greater extent than did high achievers; for reading, the difference in reading failure to ability attributions approached significance. Finally, low achievers attributed reading success to external factors to a greater extent than did high achievers. No differences in effort attributions were noted for high and low achievers.
Children's and Adolescents' Interpersonal Relations: Do Age, Race, and Gender Define Normalcy?
Authors: Bracken Bruce A. , Crain R. Michelle
Published: November 2009

This study investigated age, gender, and race trends in the development of children's and adolescents' interpersonal relations with their mothers, fathers, male peers, female peers, and teachers. A nation-wide sample of 1,724 White, Black, and Hispanic children and adolescents rated their relationships on the Assessment of Interpersonal Relations scale. Results showed significant variability in relationship type as a function of age, race, and gender characteristics of the students. The analyses depicted children's and adolescents' relationship development as a complex multidimensional phenomenon and suggest that understanding the sequence and nature of children's relationship development should be the foundation upon which clinical practice and further research are based.
The Development and Investigation of a Graphic Scoring System for Obtaining Derived Scores for the WJ-R and Other Tests
Authors: McGrew Kevin S. , Murphy Suzanne R. , Knutson Dana J.
Published: November 2009

A recent revision of the Woodcock-Johnson Psychoeducational Battery (WJ-R) has been published for use by practitioners in the field of psychoeducational assessment. One criticism of the WJ-R is the lengthy scoring process that must be used to derive standard scores or percentile ranks for multiple tests and clusters. This scoring process limits the use of select portions of the WJ-R in screening programs, where immediate derived scores frequently are needed. Thus, the WJ-R was determined to be a good instrument for field testing a prototypical graphic scoring system designed to reduce scoring complexity. Participants were 25 undergraduate students from a large midwestern university who had no prior experience with the administration and scoring of psychoeducational assessment instruments. After a 10-minute standardized training experience, each of the participants scored 20 different hypothetical scores using a graphic scoring system. Analysis of interrater reliability and mean scores suggested that the prototype graphic scoring system was a generally efficient, reliable, and accurate method for obtaining standard scores for the WJ-R and other tests.
A Comparison of Referred Students' Performance on the WISC-III and the Stanford-Binet Intelligence Scale: Fourth Edition
Authors: Prewett Peter N. , Matavich Mark A.
Published: November 2009

The WISC-III and the S-B:IV were administered in counterbalanced order to 73 low socioeconomic status inner city referred students. The WISC-III Full Scale IQ averaged 9.4 points lower than the S-B:IV Test Composite, and the WISC-III Verbal IQ averaged 13.1 points lower than the Stanford-Binet Verbal Reasoning Area score. The nonverbal scales (Performance IQ and Abstract/Visual Reasoning Areas) differed by an average of 8.1 points. The .81 correlation between the two tests indicated, however, that performance on one test cannot be predicted reliably by the performance on the other. The results suggest that the two tests do not always give similar diagnostic impressions. Additional research is needed to determine the generalizability of the findings.
Examiner Errors in Administering and Scoring the WPPSI-R
Authors: Whitten Janice , Slate John R. , Jones Craig H. , Shine Agnes E. , Raggio Donald
Published: November 2009

We investigated administration and scoring errors on 57 WPPSI-R protocols completed by 7 examiners. These examiners made frequent errors, such as failing to record examine responses, assigning incorrect point values to examinee responses, and determining incorrect basals and/or ceilings. When examiner errors were corrected, Full Scale IQs were changed on 53% of protocols. The incorrect IQs assigned by examiners resulted in one potential diagnostic error. Examiner errors appeared to stem from three sources: examiner carelessness, inadequate training, and complex scoring procedures.
Why Do Deaf Children Score Differently on Performance vs. Motor-Reduced Nonverbal Intelligence Tests?
Authors: Braden Jeffery P. , Kostrubala Christine E. , Reed Jocelyn
Published: November 2009

Children who are deaf and hard of hearing (DC) and children with normal hearing (HC) have similar Performance IQs. However, DC score lower than HC on motor-reduced nonverbal intelligence tests (e.g., figural matrices tests). The difference between motor-reduced and motor-intensive (i.e., performance) nonverbal tests may be affected by psychomotor speed. This issue was investigated by comparing DC and HC on motor-intensive and motor-reduced nonverbal intelligence tests and on tests of psychomotor speed. Results show similar WISC-III Performance IQs for DC and HC and lower motor-reduced scores (from the Matrix Analogies Test-Short Form) for DC. This similar performance of HC and DC on an experimental motor-intensive nonverbal test, and on psychomotor speed measures, suggests that speed does not influence intelligence test results. We suspect that impulsivity, not speed per se, leads to the difference between motor-intensive and motor-reduced nonverbal test scores.
Comparison of the Slosson Full-Range Intelligence Test and Teacher Judgments as Predictors of Students' Academic Achievement
Authors: Eaves Ronald C. , Campbell-Whatley Gloria , Dunn Caroline , Reilly AmySue , Tate-Braxton Carbestha
Published: November 2009

This study investigated the use of teacher judgments and the Slosson Full-Range Intelligence Test to estimate the academic achievement of 89 students who were attending a small, private school. The results indicated that the validity coefficients for teacher judgments were moderate and comparable in magnitude to those found in existing literature. Validity coefficients for the Slosson Full-Range Intelligence Test were generally higher than those typically seen in the literature. When the unique contributions of teacher judgments and the Slosson Full-Range Intelligence Test were compared via multiple regression analyses, the intelligence test was the superior predictor for three of five predictions. Teacher judgments were superior for predicting spelling achievement. No substantial differences between the teacher judgments and the Slosson Full-Range Intelligence were noted in the prediction of reading. When the mean standard scores of the Slosson Full-Range Intelligence Test and the Peabody Individual Achievement Test-Revised were compared, 12 significant differences were found among the 66 comparisons. Possible explanations for these differences were discussed.
An Evaluation of Gender Differences in Self-Reported Internalizing Symptoms of Elementary-Age Children
Authors: Merrell Kenneth W. , Dobmeyer Anne C.
Published: November 2009

Gender differences in self-reported internalizing symptoms of children in grades 3-6 were investigated. Using the Internalizing Symptoms Scale for Children (ISSC), and normative data from a large, nationwide sample, self-reported internalizing symptom scores of boys (n = 876) were compared to those of girls (n = 840). Total internalizing scores of girls were significantly (p < .001) larger than those of boys, indicating a higher degree of self-reported internalizing symptoms. The average scores of the girls were approximately one third of a standard deviation higher than the average scores of the boys. Using a discriminant function analysis, the ISSC item scores were found to be reasonably effective in classifying subjects by gender. Seven critical self-report items that contributed the most to the separation of subjects by gender were identified. Implications of this study for psychoeducational assessment practice, early identification of internalizing problems, and subsequent intervention efforts are discussed.
The WAIS-R Comprehension and Picture Arrangement Subtests as Measures of Social Intelligence: Testing Traditional Interpretations
Authors: Campbell Jonathan M. , McCord David M.
Published: November 2009

This study tested the hypothesis that the WAIS-R Comprehension (C) and Picture Arrangement (PA) subtests measure social intelligence. Fifty subjects' C, PA, and estimated Full Scale IQ scores were compared to scores on the Chapin Social Insight Test (SIT) and the Interpersonal Perception Task (IPT). C scores did not significantly predict social information-processing abilities. Regression results supported the notion that PA scores reveal information about subjects' ability to interpret the nonverbal behavior of others. However, further analysis cautioned against interpreting PA as a measure of social intelligence. Sample size and participant characteristics may limit the generalizability of the study; recommendations for future studies are briefly mentioned.
Validation of the Snijders-Oomen Nonverbal Intelligence Test - Revised 2½-7 for Australian Children with Disabilities
Authors: Jenkinson Josephine , Roberts Susan , Dennehy Shirley , Tellegen Peter
Published: November 2009

One hundred and fifty-five preschool children (59 with hearing impairment, 37 with developmental delay, and 59 nondisabled children) were tested with the Snijders-Oomen Nonverbal Intelligence Test - Revised (2½-7) (SON-R 2½-7) and the Wechsler Preschool and Primary Scale of Intelligence - Revised (WPPSI-R). The aim of the study was to examine the suitability of the SON-R 2½-7 for Australian children. Within each group, the two tests were counterbalanced. Children with hearing impairment or developmental delay were given only the Performance Scale of the WPPSI-R. Correlations between SON-R 2½-7 IQ and WPPSI-R Performance IQ averaged around .73 for the three groups. In the nondisabled group, the SON-R 2½-7 IQ correlated .52 with the Verbal IQ of the WPPSI-R and .75 with the Full Scale IQ. The SON-R 2 ½-7 appeared to provide a satisfactory test of general intelligence for Australian preschool children, but IQs obtained on the SON-R 2½-7 tended to underestimate those obtained on the WPPSI-R.
Analytic Review: Disorders of Temperature Control: Part I. Hyperthermia
Authors: Curley Frederick J. , Irwin Richard S.
Published: November 2009

After a review of the normal physiology of temperature regulation, one of the three hyperthermic syndromes— heat stroke—is discussed in detail with respect to its pathogenesis, pathophysiology, diagnosis, differential diagnosis, and treatment. The other syndromes— malignant hyperthermia and neuroleptic malignant syndrome—are discussed in Part II. Heat stroke is a syndrome of acute thermoregulatory failure in warm environments; malignant hyperthermia is a drug or stress-induced hypermetabolic syndrome characterized by vigorous muscular contractions; and the neuroleptic malignant syndrome results primarily from an imbalance of central neurotransmitters, usually due to neuroleptic drug use and characterized by muscular rigidity. Knowledge of the normal physiology of temperature regulation and the causes and pathophysiology of heat stroke are keys to understanding the other two syndromes.
Dermatologic Problems in the Intensive Care Unit: Part I
Authors: Berman Rita S. , Silvestri Dianne L.
Published: November 2009

Skin disorders are present in many patients hospitalized in the intensive care unit. They range in severity from being the reason for admission to being a nuisance acquired during care These cutaneous problems have been categorized into four groups: (1) serious skin diseases that may incur life-threatening complications; (2) subtle skin findings associated with systemic disorders that may be characterized by critical events; (3) prominent cutaneous manifestations that accompany life-threatening systemic diseases: and (4) skin disorders that develop as complications during intensive care. Diseases in the first category are discussed in this article. Diseases in the second category will be discussed in Part II. The remaining disorders will be covered in Parts III and IV.
The Treatment of Acute Acetaminophen Poisoning
Authors: Hall Alan H. , Rumack Barry H.
Published: November 2009

Accidental or intentional overdose with acetaminophen is a relatively common occurrence. Few patients ingesting an overdose of acetaminophen will develop a fulminant clinical course resulting in death. Some are at risk for developing acetaminophen-induced hepatotoxicity unless properly treated with the prophylactic antidote N-acetylcysteine within the first 24 hours after ingestion. Intensive supportive care will allow an excellent prognosis for those patients developing hepatotoxicity or other, more rare, sequelae of acetaminophen poisoning.
Recognition and Treatment of Acute Aortic Regurgitation
Authors: O'Rourke Robert A. , Walsh Richard A.
Published: November 2009

Acute aortic regurgitation usually results from infective endocarditis, but is also caused by aortic dissection and trauma to the heart. Most of the left ventricular stroke volume is regurgitated back into the left ventricle; thus, the forward stroke volume to the body and the cardiac output may be severely compromised. An acute increase in left ventricular end-diastolic volume results in a marked increase in left ventricular end-diastolic pressure, and the mitral valve usually closes prematurely. Compensatory tachycardia is the rule and helps to shorten diastole; thus, the time available for aortic regurgitation to occur is reduced, and the cardiac output is often maintained.

On physical examination, there is tachycardia; the peripheral arterial pulse shows a rapid rise, but the systolic pressure is normal; the diastolic pressure is normal or even reduced; and the pulse pressure is often normal. The electrocardiogram (ECG) may be normal except for sinus tachycardia and often for nonspecific ST-T changes. The chest roentgenogram usually shows signs of pulmonary venous hypertension or even pulmonary edema. Echocardiography may show vegetations on the aortic valve, prolapse of an aortic leaflet into the left ventricle, and premature mitral valve closure. Doppler echocardiography is useful in detecting the presence of aortic regurgitation.

In cases of infective endocarditis, the appropriate antibiotic therapy must be given. Aortic regurgitation due to dissection of the aorta is usually an indication for surgery. In patients with severe aortic regurgitation, available medical therapy includes digitalis, diuretics, and vasodilators. When patients respond dramatically to the use of digitalis, diuretics, and arterial dilators, surgical therapy can be delayed until heart failure and infection are controlled and the patient is more stable. If the patient does not respond immediately and dramatically to therapy, then valve replacement should not be delayed, even if the infection is uncontrolled or the patient has had little antibiotic therapy.
Outcome of Intensive Care in Patients with the Acquired Immunodeficiency Syndrome
Authors: Rosen Mark J. , Cucco Robert A. , Teirstein Alvin S.
Published: November 2009

The prognosis of patients who become critically ill due to complications of the acquired immunodeficiency syndrome (AIDS) is generally believed to be poor, but no detailed studies have substantiated this impression. We performed a retrospective analysis of patients with AIDS admitted to the Medical Special Care Unit (MSCU) at Mount Sinai Medical Center in New York over a 42-month period. Of 910 patients admitted to the MSCU, 35 (4% ) had AIDS. An additional patient admitted to the pediatric intensive care unit was included in the analysis.

Respiratory failure occurred in 31 patients (86% ) and was the most common problem necessitating admission. Twenty-five of these patients (69% ) had Pneumocystis carinii pneumonia. All 31 patients with respiratory failure required endotracheal intubation and mechanical ventilation, and 27 (87%) died during the same hospitalization. Pneumothorax requiring tube thoracostomy occurred in 6 of 31 patients receiving mechanical ventilatory support. Among the 4 mechanically ventilated survivors, only 2 patients remain alive. Intensive care unit intervention in patients with AIDS and respiratory failure is associated with a poor outcome and probably does not alter the ultimate course in most cases.
Dermatologic Problems in the Intensive Care Unit: Part II
Authors: Berman Rita S. , Silvestri Dianne L.
Published: November 2009

Skin disorders are present in many patients hospitalized in the intensive care unit. They range in severity from being the reason for admission to being a nuisance during care. These cutaneous problems have been categorized into four groups: (1) serious skin diseases that may incur life-threatening complications; (2) subtle skin problems associated with systemic disorders that may be characterized by critical events; (3) prominent cutaneous manifestations that accompany life-threatening systemic diseases; and (4) skin disorders that develop as complications during intensive care. Diseases in the first category were discussed in Part I of this article [1]. In Part II, we discuss diseases in the second category. The remaining disorders will be covered in Parts III and IV.
Analytic Review: Blunt Chest Trauma: The Intensivist's Perspective
Authors: Shackford Steven R.
Published: November 2009

An overview of blunt chest injuries of particular interest to the intensivist is presented. These include injuries of the thoracic cage, pulmonary parenchyma, tracheobronchial tree, thoracic aorta, and heart. The discussion focuses on pathophysiological factors, diagnosis, and treatment.
Extrapulmonary Causes of Respiratory Failure
Authors: Pratter Melvin R. , Irwin Richard S.
Published: November 2009

The causes of respiratory failure can be divided into two main groups: extrapulmonary and pulmonary. Extrapulmonary causes of respiratory failure include conditions that exclusively or primarily cause respiratory failure by their effect on structures other than the lungs (i.e., the extrapulmonary compartment). To place the topic of extrapulmonary respiratory failure into perspective, we briefly review normal and abnormal gas exchange and then examine how one can use this information to suspect or confirm the diagnosis of an extrapulmonary cause of respiratory failure. We then review the individual causes of extrapulmonary respiratory failure. These have been divided into two main functional categories: (1) those that involve a decrease in normal force generation, and (2) those that involve an increase in resistance to (bulk flow) ventilation. We then briefly consider the treatment of these disorders from a respiratory point of view.
Analytic Review: Right Ventricular Infarction
Authors: Dell'Italia Louis J.
Published: November 2009

Right ventricular myocardial infarction (RVMI) usually occurs after occlusion of a dominant right coronary artery, and the amount of right ventricular necrosis depends on whether this occlusion occurs proximal or distal along the length of the coronary artery. In patients who have a considerable amount of right ventricular necrosis, the physical examination reveals an elevated jugular venous pressure and Kussmaul's sign. Acute hemodynamic monitoring demonstrates a disproportionate elevation of the right atrial pressure (RAP) when compared with the pulmonary artery wedge pressure (PAWP). Previously validated hemodynamic criteria for identifying hemodynamically important RVMI include an RAP greater than or equal to 10 mm Hg and a RAP: PAWP ratio greater than or equal to 0.8. These hemodynamic findings can be seen in approximately 10% of patients who are seen with acute inferior transmural myocardial infarction; the findings can be produced in another 10% of patients after volume loading.

Radionuclide angiography accurately assesses right ventricular systolic function using either the first pass or equilibrium technique. When the right ventricular ejection fraction is less than 40% and there is evidence of right ventricular wall motion abnormalities, the presence of hemodynamically important RVMI is highly likely. When a patient presents with hypotension and low cardiac index, volume therapy should be instituted initially. However, if cardiac index does not improve after RAP and PAWP have increased to greater than 20% above control values, intravenous dobutamine should be instituted without delay to restore circulatory stability. The acute and long-term prognosis of patients with RVMI is excellent as long as extensive left ventricular necrosis does not occur concomitantly. Furthermore, right ventricular systolic function has been shown to improve significantly in the recovery period so that the patient's functional capacity is not imparied.
High-Frequency Ventilation in Newborn Infants
Authors: Boynton Bruce R. , Buckley Barbara G. , Frantz Ivan D.
Published: November 2009

In the past mechanical ventilation always mimicked the tidal volumes and ventilatory frequencies of normal breathing. Recently, there has been great interest in techniques that use rapid rates (60 to 3,000 per minute) and tidal volumes approximating dead space. These techniques are known collectively as high-frequency ventilation, although they differ in circuit design, use, potential complications, and mechanism of gas transport. High-frequency ventilation can be divided into four categories: (1) high-frequency positive pressure ventilation, (2) high-frequency jet ventilation, (3) high-frequency oscillatory ventilation and high-frequency flow interruption, and (4) high-frequency chest wall oscillation. In this review we discuss the similarities and differences of these high-frequency techniques, their clinical applications, and some physiological mechanisms involved in gas transport.
Acute Gastrointestinal Bleeding
Authors: Schaffner John Alan
Published: November 2009

A greater understanding of the pathophysiology of gastrointestinal bleeding has been accompanied by a rapid advancement in therapeutic technology. Newer endoscopic and radiologic techniques are being tested to determine their appropriate uses, but pharmacologic therapy has yet to be proved beneficial. A discussion of the newer as well as some traditional therapies is presented.
Analytic Review: Thrombolytic Therapy in Acute Myocardial Infarction
Authors: Zwerner Peter L. , Gore Joel M.
Published: November 2009

The salvage of myocardium in the setting of acute myocardial infarction has long been a goal of physicians involved in the care of patients with coronary artery disease. Understanding the role of thrombosis in the pathogenesis of acute myocardial infarction has led the way to an entirely new approach to the treatment of this entity. Thrombolytic therapy has now become a widely used form of treatment with encouraging results. Both intravenous and intracoronary administration of thrombolytic agents have been shown to promote recanalization of acutely occluded coronary arteries. Results of studies using the clot-specific agent, tissue plasminogen activator, intravenously have been most encouraging; successful reperfusion has been obtained in approximately 70% of patients treated. In addition, a recent large-scale trial has shown a reduction in morbidity and mortality with the early use of thrombolytic agents.

Ongoing trials should help delineate the precise role and timing of these agents as the initial form of therapy for acute myocardial infarction. Other issues that remain unresolved are the frequency of restenosis and the role of percutaneous transluminal coronary angioplasty in addition to thrombolytic therapy in the treatment of acute myocardial infarction.
Post Sexual Abuse Trauma
Authors: Briere John , Runtz Marsha
Published: November 2009

The incidence and long-term effects of childhood sexual abuse were studied in a clinical sample of 152 adult women. Approximately 44% of female clients presenting to a health center crisis service reported a childhood history of sexual victimization. Prior victimization was associated with increased dissociation, sleep disturbance, tension, sexual problems, and anger on a Crisis Symptom Checklist, as well as greater current use of psychoactive medications, and more frequent histories of suicide attempts, substance addiction, and revictimization. Long-term psychological effects of sexual abuse are interpreted within both a developmental context and in terms of Post Traumatic Stress Disorder. Implications of the current data and related literature for mental health workers are briefly discussed.
The Effects of Sexual Abuse on Children
Authors: Conte Jon R. , Schuerman John R.
Published: November 2009

Data were collected at the Sexual Assault Center in Seattle on 369 sexually abused children and a community comparison sample of 318 not-abused children. Data describing the behavior of these children were collected from the child's parent and for the abused children from the social worker. Samples differed on a number of variables and these variables were used as control variables in the analysis. Results indicate that abused and not-abused children appear behaviorally different on a set of factors and clinical dimensions constructed from the parent-completed measure. Suggestions for future research are provided.
Treating the Effects of Sexual Abuse on Children
Authors: Berliner Lucy , Wheeler J. Robert
Published: November 2009

Effects of child sexual abuse are conceptualized as the result of conditioned anxiety and as socially learned responses to the victimization experience. This conceptualization is used to link existing psychological theory and research to therapeutic interventions. Strategies are proposed to alleviate anxiety, modify maladaptive beliefs and cognitions, restore or instate expectations of self-efficacy, and mitigate disturbed sexual attitudes or behaviors.
Influence of Milkweed Fiber Length on Textile Product Performance
Authors: Cox Crews Patricia , Rich Wendelin
Published: November 2009

Farmers and scientists joined forces in the late 1980s to develop milkweed as an alternative crop and source offiber. Efforts continue to develop milkweed floss fiber as an insulative fill material. A major barrier to increased utilization is its tendency to form mats during laundering or drycleaning. This research sought to evaluate the effect of fiber length on matting that occurs during cleaning. Milkweed floss in three lengths (full, half, and quarter), milkweed floss in three lengths blended 50l50 with down, plus 100% down, were used as loose fill in comforter samples. Trained judges rated hand (smoothnesslrQUghness) before and after laundering. Results showed that reducing fiber length produced significantly softer and smoother fill materials prior to and following laundering. Although shortened fibers did not entirely eliminate the matting problem associated with laundering, they did form smaller and less noticeable mats. Nevertheless, blending milkweed fibers with down remains the best way to improve smoothness ratings; reducing fiber length did not reduce matting as much as the blending of down with milkweed fibers. Consequently, milkweed floss used as a loose fill material should always be blended with down and producers should continue to subject milkweed floss to vigorous processing since no product advantage is gained by maintaining maximum fiber length.
Differences in Attitudes Toward Catalog Retailers of Apparel Among Social/Economic Risk Orientation Groups
Authors: Eastlick Mary Ann , Feinberg Richard A.
Published: November 2009

This research examined whether perceived social/economic risk related to apparel products influenced attitudes about attributes of apparel catalog retailers, overall attitude toward apparel catalog retailers, and actual purchase of apparel from catalogs. Self administered questionnaires were mailed to a random sample of catalog shoppers resulting in 458 respondents. Data were collected on levels of economic and social risks perceived for purchasing apparel, the importance of various apparel shopping needs and wants, and the belief that catalog retailers possessed attributes that met apparel shopping needs and wants. Results revealed that level of social/ economic risk did influence attitudes toward catalog attributes of economic utility, home environment, merchandise assortment, catalog clientele, and interaction with catalog personnel. Levels of socialleconomic risk also influenced annual apparel expenditures from catalogs but did not affect overall attitude toward catalog retailers and number of annual apparel purchases from catalogs.
The Retail Environment: Relationship of Tension and Social Support
Authors: Wolken Wendy S. , Good Linda K.
Published: November 2009

Sales associates and managers from branches of two department stores were surveyed (n = 193) to determine to what extent tension exists and what source (or combination of sources) of social support is perceived to influence the interaction of life domains. Role theory was used to guide the study. Study variables included: tension, sources of social support (supervisors, family, coworkers), role stressors (role conflict, role ambiguity, role overload), and selected demographic characteristics. Results indicated that role conflict, role overload, number of children, and role ambiguity were significant predictors of tension. Social support from supervisors and coworkers was found to be significantly related to tension. Specifically, for employees experiencing low levels of tension, there were no differences in the level of social support from supervisors and coworkers; for those experiencing high levels of tension, there was significantly more coworker support than supervisor support. Support from familylfriends was not found to be significant in influencing tension for either of the two groups. No difference was identified between men and women as to sources of social support.
Reflecting on Ethics, Power, and Privilege
Authors: Townsend Brenda L. , Patton James M.
Published: November 2009

It is clear that immediate and deliberate actions must be taken to respond to the issues facing African American children and youth in school settings. Teachers, administrators, and teacher educators are called upon to examine school practices and subsequent outcomes experienced by African American learners and their families. To evenly distribute power and privileges in school and university settings, we must engage in self-reflection and critique processes, and understand more about African American culture and incorporate that understanding in interactions with those learners and families. Strategies presented by the authors in this special issue are logical and can be implemented independent of financial resources. What are needed are more "human" resources—the continual willingness and commitment to critique self, other professionals, and school practices and to seek understandings of African American culture that will alter teacher, administrator, and counselor practices.
General and Special Educators' Perceptions of Teaching Strategies for Multicultural Students
Authors: Utley Cheryl A. , Delquadri Joseph C. , Obiakor Festus E. , Mims Victoria A.
Published: November 2009

This article focuses on a recent study that investigated perceptions of regular and special educators working with multicultural students with and without disabilities throughout the State of Kansas. The Multicultural Special Education Survey was distributed to 403 general and special educators who represented geographical areas, as well as school districts with an enrollment equal to or greater than 10 percent. This instrument consisted of items related to categories of demographics, professional development, cultural knowledge, linguistics, and teaching strategies. In the area of professional development, the most noteworthy and frequently cited response was "no training" in multicultural education course work. The highest percentage of respondents reported that cultural knowledge would help them understand the influence of their students' verbal and nonverbal learning/behavioral styles. The highest percentage of respondents reported that knowledge about the language of multicultural students and child language development were the most important areas of training. Respondents indicated that teacher-student discussion, cooperative learning, and peer tutoring were useful teaching strategies with multicultural students with and without disabilities. These results are discussed relative to the knowledge base of general and special educators and the future direction of teacher preparation programs.