bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of music therapy for children and adolescents with psychopathology: a meta‐analysis
Authors: Gold Christian , Voracek Martin , Wigram Tony 
Published: July 2004

Background:  The objectives of this review were to examine the overall efficacy of music therapy for children and adolescents with psychopathology, and to examine how the size of the effect of music therapy is influenced by the type of pathology, client's age, music therapy approach, and type of outcome.Method:  Eleven studies were included for analysis, which resulted in a total of 188 subjects for the meta‐analysis. Effect sizes from these studies were combined, with weighting for sample size, and their distribution was examined.Results:  After exclusion of an extreme positive outlying value, the analysis revealed that music therapy has a medium to large positive effect (ES = .61) on clinically relevant outcomes that was statistically highly significant (p < .001) and statistically homogeneous. No evidence of a publication bias was identified. Effects tended to be greater for behavioural and developmental disorders than for emotional disorders; greater for eclectic, psychodynamic, and humanistic approaches than for behavioural models; and greater for behavioural and developmental outcomes than for social skills and self‐concept.Conclusions:  Implications for clinical practice and research are discussed.
Postpartum maternal moods and infant size predict performance on a national high school entrance examination
Authors: Galler Janina R. , Ramsey Frank C. , Harrison Robert H. , Taylor John , Cumberbatch Glenroy , Forde Victor 
Published: July 2004

Background: In an earlier series of studies, we documented the effects of feeding practices and postnatal maternal mood on the growth and development of 226 Barbadian children during the first few months of life. In this report, we extend our earlier studies by examining predictive relationships between infant size, feeding practices and postpartum maternal moods and scores on a national high school examination, the Common Entrance Examination (CEE), at 11 to 12 years of age.Methods: Feeding practices, anthropometry, and maternal moods, using Zung depression and anxiety scales and a morale scale, were assessed at 7 weeks (n = 158), 3 months (n = 168), and 6 months (n = 209) postpartum. Background variables including sociodemographic and home environmental factors were also assessed during infancy. CEE scores on 169 of the children in the original study were obtained from the Ministry of Education of Barbados.Results: In our sample of 86 boys and 83 girls, we found that reduced infant lengths and weights at 3 and 6 months of age were predictive of lower CEE, especially math scores. Children who were smaller at these early ages had significantly lower scores on the examination than did larger children. Postpartum maternal moods, including reports of despair and anxiety, were also found to be significant predictors of lower CEE scores, especially English scores. However, breast‐feeding and other feeding practices were not directly associated with the CEE scores. Background variables, which significantly predicted lower CEE scores, included young maternal age at the time of her first pregnancy, more children in the home, less maternal education, and fewer home conveniences. Significant associations between infant anthropometry, maternal moods and CEE scores were all significant even when these background variables were controlled for.Conclusions: These findings have important implications for developing interventions early in life to improve academic test scores and future opportunities available to children in this setting.
Cognitive appraisals in young people with obsessive‐compulsive disorder
Authors: Libby Sarah , Reynolds Shirley , Derisley Jo , Clark Sarah 
Published: July 2004

Background:  A number of cognitive appraisals have been identified as important in the manifestation of obsessive‐compulsive disorder (OCD) in adults. There have, however, been few attempts to explore these cognitive appraisals in clinical groups of young people.Method:  This study compared young people aged between 11 and 18 years with OCD (N = 28), young people with other types of anxiety disorders (N = 28) and a non‐clinical group (N = 62) on three questionnaire measures of cognitive appraisals. These were inflated responsibility (Responsibility Attitude Scale; Salkovskis et al., 2000), thought–action fusion – likelihood other (Thought–Action Fusion Scale; Shafran, Thordarson & Rachman, 1996) and perfectionism (Multidimensional Perfectionism Scale; Frost, Marten, Luhart & Rosenblate, 1990).Results:  The young people with OCD had significantly higher scores on inflated responsibility, thought–action fusion – (likelihood other), and one aspect of perfectionism, concern over mistakes, than the other groups. In addition, inflated responsibility independently predicted OCD symptom severity.Conclusions:  The results generally support a downward extension of the cognitive appraisals held by adults with OCD to young people with the disorder. Some of the results, however, raise issues about potential developmental shifts in cognitive appraisals. The findings are discussed in relation to implications for the cognitive model of OCD and cognitive behavioural therapy for young people with OCD.
Contributions of phonological memory, language comprehension and hearing to the expressive language of adolescents and young adults with Down syndrome
Authors: Laws Glynis 
Published: July 2004

Background: Expressive language constitutes a major challenge to the development of individuals with Down syndrome. This paper investigates the relationships between expressive language abilities, language comprehension and the deficits in verbal short‐term memory and hearing which are also associated with the syndrome.Methods: Tests of nonverbal ability, expressive language, verbal short‐term memory, visuo‐spatial memory, language comprehension and hearing were administered.Results: Phonological memory, measured by nonword repetition, was significantly correlated with expressive language abilities measured by MLU and sentence recall. Adjusting for word repetition skills did not reduce this correlation, suggesting that the relationship did not depend on the fact that both tests required spoken output. Hearing did not contribute significantly to expressive language scores of participants who provided an intelligible narrative. However, level of hearing loss as well as other language and memory measures did differentiate these participants from those who were unable to produce an intelligible narrative.Conclusion: Phonological memory was closely associated with the expressive language abilities of individuals with Down syndrome. Hearing loss appeared to be less closely related except that individuals with uncorrected mild to moderate hearing loss had difficulty with the narrative task. Further research is necessary to establish the nature of these relationships.
Theory‐of‐mind development in oral deaf children with cochlear implants or conventional hearing aids
Authors: Peterson Candida C. 
Published: July 2004

Background: In the context of the established finding that theory‐of‐mind (ToM) growth is seriously delayed in late‐signing deaf children, and some evidence of equivalent delays in those learning speech with conventional hearing aids, this study's novel contribution was to explore ToM development in deaf children with cochlear implants. Implants can substantially boost auditory acuity and rates of language growth. Despite the implant, there are often problems socialising with hearing peers and some language difficulties, lending special theoretical interest to the present comparative design.Methods: A total of 52 children aged 4 to 12 years took a battery of false belief tests of ToM. There were 26 oral deaf children, half with implants and half with hearing aids, evenly divided between oral‐only versus sign‐plus‐oral schools. Comparison groups of age‐matched high‐functioning children with autism and younger hearing children were also included.Results: No significant ToM differences emerged between deaf children with implants and those with hearing aids, nor between those in oral‐only versus sign‐plus‐oral schools. Nor did the deaf children perform any better on the ToM tasks than their age peers with autism. Hearing preschoolers scored significantly higher than all other groups. For the deaf and the autistic children, as well as the preschoolers, rate of language development and verbal maturity significantly predicted variability in ToM, over and above chronological age.Conclusions: The finding that deaf children with cochlear implants are as delayed in ToM development as children with autism and their deaf peers with hearing aids or late sign language highlights the likely significance of peer interaction and early fluent communication with peers and family, whether in sign or in speech, in order to optimally facilitate the growth of social cognition and language.
Speech‐in‐noise perception in high‐functioning individuals with autism or Asperger's syndrome
Authors: Alcántara José I. , Weisblatt Emma J.L. , Moore Brian C.J. , Bolton Patrick F. 
Published: July 2004

Background:  High‐functioning individuals with autism (HFA) or Asperger's syndrome (AS) commonly report difficulties understanding speech in situations where there is background speech or noise. The objective of this study was threefold: (1) to verify the validity of these reports; (2) to quantify the difficulties experienced; and (3) to propose possible mechanisms to explain the perceptual deficits described.Method:  Speech‐in‐noise perception abilities were measured using speech reception thresholds (SRTs), defined as the speech‐to‐noise ratio (SNR) at which approximately 50% of the speech is correctly identified. SRTs were measured for 11 individuals with HFA/AS and 9 age/IQ‐matched normal‐hearing control subjects, using an adaptive procedure, in a non‐reverberant sound‐attenuating chamber. The speech materials were standardised lists of everyday sentences spoken by a British male speaker. The background sounds were: (1) a single female talker; (2) a steady speech‐shaped noise; (3) a speech‐shaped noise with temporal dips; (4) a steady speech‐shaped noise with regularly spaced spectral dips; and (5) a speech‐shaped noise with temporal and spectral dips.Results:  SRTs for the HFA/AS group were generally higher (worse) than those for the controls, across the five background sounds. A statistically significant difference in SRTs between the subject groups was found only for those background sounds that contained temporal or spectro‐temporal dips. SRTs for the HFA/AS individuals were 2 to 3.5 dB higher than for the controls, equivalent to a substantial decrease in speech recognition. Expressed another way, the HFA/AS individuals required a higher SNR, whenever there were temporal dips in the background sound, to perform at the same level as the controls.Conclusions:  The results suggest that the speech‐in‐noise perception difficulties experienced by individuals with autism may be due, in part, to a reduced ability to integrate information from glimpses present in the temporal dips in the noise.
Autism and attachment: a meta‐analytic review
Authors: Rutgers Anna H. , Bakermans‐Kranenburg Marian J. , van Ijzendoorn Marinus H. , van Berckelaer‐Onnes Ina A. 
Published: July 2004

Method:  Sixteen studies on attachment in children with autism were reviewed, and ten studies with data on observed attachment security (N = 287) were included in a quantitative meta‐analysis.Results:  Despite the impairments of children with autism in reciprocal social interaction, the majority of the studies found evidence for attachment behaviours in these children. In four samples using the Strange Situation procedure the average percentage of secure attachments amounted to 53% (n = 72). Meta‐analytic results showed that children with autism were significantly less securely attached to their parents than comparison children, and the combined effect size for this difference was moderate (r = .24). Children with autism displayed less attachment security than comparisons without autism, but this difference disappeared in samples with children with higher mental development, and in samples in which autism was mixed with less severe symptoms of autistic spectrum disorders.Conclusions:  It is concluded that attachment security is compatible with autism, and can be assessed with Strange Situation type of procedures. The co‐morbidity of autism and mental retardation appears to be associated with attachment insecurity.
Effects of Provider Practice on Functional Independence in Older Adults
Authors: Phelan Elizabeth A. , Williams Barbara , LaCroix Andrea Z. , Grothaus Lou , LoGerfo James P. , Wagner Edward H. 
Published: July 2004

Objectives: To examine provider determinants of new‐onset disability in basic activities of daily living (ADLs) in community‐dwelling elderly.Design: Observational study.Setting: King County, Washington.Participants: A random sample of 800 health maintenance organization (HMO) enrollees aged 65 and older participating in a prospective longitudinal cohort study of dementia and normal aging and their 56 primary care providers formed the study population.Measurements: Incident ADL disability, defined as any new onset of difficulty performing any of the basic ADLs at follow‐up assessments, was examined in relation to provider characteristics and practice style using logistic regression and adjusting for case‐mix, patient and provider factors associated with ADL disability, and clustering by provider.Results: Neither provider experience taking care of large numbers of elderly patients nor having a certificate of added qualifications in geriatrics was associated with patient ADL disability at 2 or 4 years of follow‐up (adjusted odds ratio (AOR) for experience=1.29, 95% confidence interval (CI)=0.81–2.05; AOR for added qualifications=0.72, 95% CI=0.38–1.39; results at 4 years analogous). A practice style embodying traditional geriatric principles of care was not associated with a reduced likelihood of ADL disability over 4 years of follow‐up (AOR for prescribing no high‐risk medications=0.56, 95% CI=0.16–1.94; AOR for managing geriatric syndromes=0.94, 95% CI=0.40–2.19; AOR for a team care approach=1.35, 95% CI=0.66–2.75).Conclusion: Taking care of a large number of elderly patients, obtaining a certificate of added qualifications in geriatrics, and practicing with a traditional geriatric orientation do not appear to influence the development of ADL disability in elder, community dwelling HMO enrollees.
A Randomized, Controlled Trial of an Intensive Community Nurse–Supported Discharge Program in Preventing Hospital Readmissions of Older Patients with Chronic Lung Disease
Authors: Kwok Timothy , Lum Chor Ming , Chan Hok Shum , Ma Hon Ming , Lee Diana , Woo Jean 
Published: July 2004

Objectives: To evaluate the effectiveness of an intensive community nurse (CN)‐supported discharge program in preventing hospital readmissions of older patients with chronic lung disease (CLD).Design: Randomized, controlled trial.Setting: Two acute hospitals in the same health region in Hong Kong.Participants: One hundred fifty‐seven hospitalized patients aged 60 and older with a primary diagnosis of CLD and at least one hospital admission in the previous 6 months.Intervention: CNs made home visits within 7 days of discharge, then weekly for 4 weeks and monthly until 6 months. CNs coordinated closely with a geriatric or respiratory specialist in hospital. Subjects had telephone access to CNs during normal working hours from Monday to Saturday.Measurements: The primary outcome was the rate of unplanned readmission within 6 months. The secondary outcomes were the rate of unplanned readmission within 28 days, number of unplanned readmissions, hospital bed days, accident and emergency room attendance, functional and psychosocial status, and caregiver burden.Results: One hundred forty hospitalized patients completed the trial. Intervention group subjects had a higher rate of unplanned readmission within 6 months than control group subjects (76% vs 62%, P=.080, χ2 test). There was no significant group difference in any of the secondary outcomes except that intervention group subjects did better on social handicap scores.Conclusion: There was no evidence that an intensive CN‐supported discharge program can prevent hospital readmissions in older patients with CLD.
Site of Death in the Hospital Versus Nursing Home of Medicare Skilled Nursing Facility Residents Admitted Under Medicare's Part A Benefit
Authors: Levy Cari R. , Fish Ron , Kramer Andrew M. 
Published: July 2004

Objectives: To determine factors that predict site of death (hospital vs nursing home (NH)), related costs, and geographic variation in site of death of NH residents admitted under the Medicare Part A Benefit.Design: Retrospective cohort study.Setting: NHs located in the United States (N=13,146).Participants: All persons admitted to skilled nursing facilities (SNFs) in 2001 who died in a SNF (n=101,307) or hospital (n=51,187).Measurements: Patient, facility, and geographic characteristics associated with death in a hospital and receipt of Medicare payment.Results: Absence of a do‐not‐resuscitate order, non‐Caucasian ethnicity, greater functional independence, and higher cognitive status correlated with hospital as the site of death. Rural, hospital‐based, and government‐owned facilities had the lowest in‐hospital death rates. Site of death varied widely from state to state. Of those who died in a hospital, 24.2% (12,410) died within 24 hours of transfer. The average daily combined stay Medicare payment for those who died in the hospital was $969, versus $300 for those who died in a NH.Conclusion: Patient and facility characteristics predict site of death of Medicare NH patients, but in‐hospital death rather than NH death varies geographically and is associated with higher daily Medicare payment.
The Effect of a Cognitive Task on Voluntary Step Execution in Healthy Elderly and Young Individuals
Authors: Melzer Itshak , Oddsson Lars I. E. 
Published: July 2004

Objectives: To investigate voluntary step behavior of healthy elderly individuals during single‐ and dual‐task conditions and to compare it with those of young subjects.Design: Laboratory‐based study.Setting: Tests of healthy elderly and young individuals from senior community centers and from the university population in Boston, Massachusetts.Participants: Sixty‐six elderly and 12 young subjects.Measurements: Forward, sideways, and backward rapid voluntary stepping performed as a reaction time task while standing on a force platform and (1) awaiting a cutaneous cue (single task) and (2) awaiting a cutaneous cue while performing an attention‐demanding Stroop task (dual task). Step initiation phase, foot‐off time, foot contact time, and preparatory and swing phases were extracted from center‐of‐pressure and ground reaction force data.Results: Elderly subjects were significantly slower than young in all step parameters under both conditions. For dual compared with single task, the initiation phase increased 108% in the elderly group and 34% in the young. There was a short‐term learning effect during the dual task in elderly subjects but not in the young.Conclusion: The disproportional increase in step initiation time during the dual task in the elderly group suggests that they lacked neural processing resources required for swift multitasking during a voluntary postural task. This may be a factor contributing to balance loss and the large number of falls in elderly persons. Training may improve this skill. Clinical tests of postural function should incorporate multitask conditions to capture a more complete assessment of an individual's ability.
Prevalence and Outcomes of Low Mobility in Hospitalized Older Patients
Authors: Brown Cynthia J. , Friedkin Rebecca J. , Inouye Sharon K. 
Published: July 2004

Objectives: To estimate the prevalence of different levels of mobility in a hospitalized older cohort, to measure the degree and rate of adverse outcomes associated with different mobility levels, and to examine the physician activity orders and documented reasons for bedrest in the lowest mobility group.Design: A prospective cohort study.Setting: An 800‐bed university teaching hospital.Participants: Four hundred ninety‐eight hospitalized medical patients, aged 70 and older.Measurements: Using average mobility level, scored from 0 to 12, the low‐mobility group was defined as having a score of 4 or less, intermediate as a score of higher than 4 to 8, and high as higher than 8. Outcomes were functional decline, new institutionalization, death, and death or new institutionalization.Results: Low and intermediate levels of mobility were common, accounting for 80 (16%) and 157 (32%) study patients, respectively. Overall, any activity of daily living (ADL) decline occurred in 29%, new institutionalization in 13%, death in 7%, and death or new institutionalization in 22% of patients in this cohort. When compared with the high mobility group, the low and intermediate groups were associated with the adverse outcomes in a graded fashion, even after controlling for multiple confounders. The low‐mobility group had an adjusted odds ratio (OR) of 5.6 (95% confidence interval (CI)=2.9–11.0) for ADL decline, 6.0 (95% CI=2.5–14.8) for new institutionalization, 34.3 (95% CI=6.3–185.9) for death, and 7.2 (95% CI=3.6–14.4) for death or new institutionalization. The intermediate group had adjusted ORs of 2.5 (95% CI=1.5–4.1), 2.9 (95% CI=1.4–6.0), 10.1 (95% CI=1.9–52.9), and 3.3 (95% CI=1.8–5.9) for ADL decline, new institutionalization, death, and death or new institutionalization, respectively. Bedrest was ordered at some point during hospitalization in 165 (33%) patients. For most patients, mobility was limited involuntarily (bedrest orders), and almost 60% of bedrest episodes in the lowest mobility group had no documented medical indication.Conclusion: Low mobility and bedrest are common in hospitalized older patients and are important predictors of adverse outcomes. This study demonstrated that the adverse outcomes associated with low mobility and bedrest may be viewed as iatrogenic events leading to complications, such as functional decline.
The Health Status of Elderly Veteran Enrollees in the Veterans Health Administration
Authors: Selim Alfredo J. , Berlowitz Dan R. , Fincke Graeme , Cong Zhongxiao , Rogers William , Haffer Samuel C. , Ren Xinhua S. , Lee Austin , Qian Shirley X. , Miller Donald R. , Spiro Avron , Selim Bernardo J. , Kazis Lewis E. 
Published: July 2004

Objectives: To examine the health status of elderly veteran enrollees, stratified by age group, and compare with nonveteran populations.Design: Cross‐sectional study.Setting: Outpatient.Participants: A total of 1,406,049 veteran enrollees were surveyed, and 887,775 returned the questionnaire (63.1%). Of these, 663,729 (74%) were aged 65 and older.Measurements: Patient demographics, comorbid conditions, and health status, which was assessed using the Veterans 36‐item short form (SF‐36), a reliable and valid measure of health‐related quality of life (HRQoL).Results: Elderly veteran enrollees are a group with poor health status across all scales of the Veterans SF‐36. Significant decline in HRQoL was found in patients grouped by increasing age (65–74, 75–84, and ≥85). Of the Veterans SF‐36 scales, the role physical and role emotional scales and physical functioning presented the largest decrements by age group. The elderly veteran enrollees had poorer health status than older people enrolled in Medicare managed care, ranging from 0.5 to 1 standard deviations worse.Conclusion: Elderly veteran enrollees have substantial disease burden, as reflected by major impairments across multiple dimensions of HRQoL. These findings bear important implications for use of services, suggesting that the Veterans Health Administration will require considerable resources to provide care for its aging population.