Assessment of the regional economic impacts of catastrophic events: CGE analysis of resource loss and behavioral effects of an RDD attack scenario.

We investigate the regional economic consequences of a hypothetical catastrophic event-attack via radiological dispersal device (RDD)-centered on the downtown Los Angeles area. We distinguish two routes via which such an event might affect regional economic activity: (i) reduction in effective resource supply (the resource loss effect) and (ii) shifts in the perceptions of economic agents (the behavioral effect). The resource loss effect relates to the physical destructiveness of the event, while the behavioral effect relates to changes in fear and risk perception. Both affect the size of the regional economy. RDD detonation causes little capital damage and few casualties, but generates substantial short-run resource loss via business interruption. Changes in fear and risk perception increase the supply cost of resources to the affected region, while simultaneously reducing demand for goods produced in the region. We use results from a nationwide survey, tailored to our RDD scenario, to inform our model values for behavioral effects. Survey results, supplemented by findings from previous research on stigmatized asset values, suggest that in the region affected by the RDD, households may require higher wages, investors may require higher returns, and customers may require price discounts. We show that because behavioral effects may have lingering long-term deleterious impacts on both the supply-cost of resources to a region and willingness to pay for regional output, they can generate changes in regional gross domestic product (GDP) much greater than those generated by resource loss effects. Implications for policies that have the potential to mitigate these effects are discussed.

Assessment of visual-motor coordination in 6- to 11-yr.-olds.

The concurrent and content validity of the Rey-Osterrieth Complex Figure Test and the Beery Developmental Test of Visual-Motor Integration-Third Revision were investigated through correlational analysis. 432 children, ages 6 to 11 years, were administered both tests. Across age groups participants performed better on both measures, providing support for the similarity of the measures and their sensitivity to the development of visuomotor integration. Although analysis indicated considerable overlap in the content of the two scales, the shared variance ranged from 7% to 31%, depending on the age of the child. The Rey-Osterrieth figure is composed of overlapping squares, rectangles, triangles, and various other shapes. Given this complex combination, scores on this test reflect the examinees' visual organization and motor planning skills. On the other hand, the Beery test consists of a series of shapes which progress from simple figures to more complex ones. Because the figures become more difficult to copy, the score on this test reflects the examinees' developmental level of visuomotor ability. Despite these differences in test stimuli and interpretation of performance, the present study showed considerable shared variance in the scores of the examinees who took both tests. Finally, local norms for the Rey-Osterrieth figure using the scoring approach of E. M. Taylor (1959, adapted from Osterrieth, 1944) and including standard scores are presented for children ages 6 to 11 years.

Prospective study of the MMPI-2 correction factor after mild head injury.

Gass (1991) proposed a correction factor composed of 14 MMPI-2 items that were characteristically endorsed by patients with closed-head injury. Their frequency of occurrence suggested that the items reflected the neurological rather than emotional consequences of head injury. The current study was designed to evaluate the interpretive significance of correction factor items after mild head trauma. Patients were examined immediately upon hospitalization and followed prospectively for at least 3 months. Correction factor items were endorsed more frequently during acute hospitalization than in the MMPI-2 standardization sample. At follow-up, none of the items were endorsed more often by patients with chronic mild head injury than by uninjured controls. These results suggest that the correction factor is sensitive to the acute neurological consequences of mild head trauma, but that these symptoms can typically be expected to resolve. Chronic endorsement of the items in this population is therefore most likely related to psychological factors.

Computerized cognitive training for severely emotionally disturbed children with ADHD.

An experiment was conducted to investigate the influence of Captain's Log (a computerized cognitive-training system) on the behaviors and performance capabilities of 4 severely emotionally disturbed children with Attention Deficit Hyperactivity Disorder (ADHD), ages 7 to 11. Behavioral scales, spectral electroencephalograms, and intelligence and performance tests were assessed pre- and posttreatment. A behavioral point system and monitoring of progress on computer tasks were used throughout treatment to evaluate ongoing improvements. There were 64 training sessions administered over a 16-week period. Outcome of treatment was determined by computer advancement, changes in behavioral points, and pre- and postmeasures. Results support the expectation that children who were most successful in the training would demonstrate the highest levels of generalization of those skills that were the focus of treatment.

Relationship between the Millon Clinical Multiaxial Inventory-II and Coolidge Axis II Inventory in chronically mentally ill older adults: a pilot study.

The purpose of this study was to investigate the relationship between two self-report measures of personality disorders in older chronically mentally ill inpatients. A random sample of 30 chronically mentally ill (DSM-III-R schizophrenia, schizoaffective disorder, recurrent major depression) inpatients aged 55 and older completed the Millon Clinical Multiaxial Inventory-II (MCMI-II) and the Coolidge Axis II Inventory (CATI). The personality inventories were concurrently administered in counterbalanced fashion to assess concurrent validity of the CATI and MCMI in this older adult group. Data were submitted for correlational analysis. Median concurrent validity (raw score sums) between the CATI and MCMI-II for the 13 personality disorder scales was moderate (r = .55). Individual scale correlations ranged from -.13 for schizoid disorder to .88 for borderline disorder. Individual scale correlations were somewhat lower than previously reported values, but were above .54 for 7 of 13 disorders. Findings provide preliminary support for use of the CATI and MCMI with chronically mentally ill elders. Suggestions for future research are offered.

The early relationship of drug abusing mothers and their infants: an assessment at eight to twelve months of age.

Ten mother-infant dyads in which the mother abused drugs during pregnancy were compared to 10 matched drug-free dyads using a short form of the Parent-Child Early Relational Assessment to analyze videotaped mother-infant interactions. Interactions consisted of two five-minute segments: structured and unstructured play. Infants were 8-12 months of age. There was a consistent tendency for the drug abusing group mean scores to separate from the controls. Drug abusing dyads had significantly more (r = .71, Fisher's Exact Probability) ratings below 3.0 in the unstructured play situation for items that measured enthusiasm, responsivity to infant cues, and infant happiness. These categories provide preliminary evidence for those characteristics which may be most problematic in the relationship between drug abusing mothers and their infants, especially in situations in which mother is responsible for providing structure.

Influence of coronary atherosclerotic remodeling on the mechanism of balloon angioplasty.

OBJECTIVES: Intracoronary ultrasonography was used to assess coronary arteries before and after balloon percutaneous transluminal coronary angioplasty (PTCA) to determine whether the mode of coronary atherosclerotic remodeling affects the mechanism of balloon dilation. BACKGROUND: Coronary arteries may enlarge or shrink in response to atherosclerotic plaque development. The effect of coronary remodeling on the mechanism of balloon PTCA has not yet been studied. METHODS: Forty-one patients with 47 native de novo coronary artery lesions were studied with a 30 MHz intracoronary ultrasound catheter before and after balloon PTCA. Images were analyzed at the lesion site and the adjacent reference segments. At each site the lumen, vessel, and plaque area and the percent area stenosis were measured. Lesions were separated into two groups based on relative vessel area (lesion vessel area/reference vessel area). A relative vessel area >1.0 defines adaptive enlargement (group 1, n = 25), whereas a relative vessel area < or =1.0 reflects coronary shrinkage (group 2, n = 22). Regression analysis examined whether elastic recoil and the PTCA balloon/vessel area ratio correlated. RESULTS: After balloon PTCA was performed, both the enlargement and shrinkage groups had similar gains in luminal area (2.3 +/- 1.8 mm2 [mean +/- SD] vs 2.8 +/- 1.7 mm2, p = 0.32), reduction in percent stenosis (-19.2% +/- 11.5% vs -14.4 +/- 12.7, p = 0.18), and final lumen area (4.9 +/- 1.7 mm2 vs 4.7 +/- 1.9 mm2, p = 0.73). However, the mechanism of luminal enlargement was different in each group. Reduction in plaque area was significantly greater in the enlargement group (group 1, -2.0 +/- 1.7 mm2 vs group 2, 0.04 +/- 2.2 mm2; p = 0.001), whereas increased vessel area was more important in the shrinkage group (group 1, 0.8 +/- 1.5 mm2 vs group 2, 2.4 +/- 2.3 mm2; p = 0.009). Positive correlation was seen between elastic recoil and the balloon/vessel area ratio in lesions with vessel enlargement (r = 0.80, p < 0.0001). No such correlation was observed in shrinkage vessels (r = 0.28, p = 0.21 ). CONCLUSIONS: The acute luminal gain after balloon PTCA is similar regardless of the type of coronary remodeling. However, the mode of remodeling affects the mechanism of balloon dilation such that enlargement vessels exhibit plaque compression, whereas shrinkage arteries demonstrate vessel stretch. The post-PTCA elastic recoil correlates linearly to the balloon/vessel area ratio in arteries that have undergone adaptive enlargement.

Prediction of premorbid intellectual functioning of young children using demographic information.

Regression equations were developed for the estimation of Wechsler Preschool and Primary Scale of Intelligence - Revised (WPPSI-R) Verbal, Performance and Full Scale IQs from the demographic characteristics of the WPPSI-R standardization sample (N=1700) Parent's education level, child's ethnicity, parent's occupation, and geographic region were found to be most predictive of the IQs The three resultant models produced statistically significant Rs of 0 54, 0 52, and 0 44 for Full, Verbal and Performance scales, respectively All three models showed minimal shrinkage upon crossvalidation, but results of tests for similarity of magnitude, variation, and classification were considerably poorer Guidelines and cautions for the clinical use of these models are discussed Also, the results are discussed in the context of similar studies.

Base rates for the Selz-Reitan. Index of subtest scatter on the WPPSI-R.

Using the standardization sample of the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) an analysis was done to determine the base rates of occurrence of the Selz-Reitan Index (SRI) of unusual or abnormal scatter. Findings offered support for the use of the WPPSI-R to determine unusually or abnormally large SRIs in clinical practice. However, It was found that the clinical interpretation of obtained indexes depend upon the Full Scale IQ of the individual and the level of the SRI selected for interpretation. Further research on clinical neurological populations is encouraged.

Use of the Revised Developmental Test of Visual-Motor Integration with chronic mentally ill adult population.

From the Nova University Geriatric Institute, for 30 outpatients ranging in age from 55 to 80 years old, significant moderate Pearson correlations (.40 to .54) obtained between the raw scores of the Revised Developmental Test of Visual-motor Integration standardized for children ages 2 1/2 years through 19 years and the WAIS-R subscale IQs. Further, scores on the Recall administration of the Benton Revised Visual Retention Test were significantly correlated with the performance on Beery's developmental test. Also, scores on Beery's test were correlated with estimates of adaptive functioning made by the staff for each patient.

Correlations between antepartum maternal metabolism and intelligence of offspring.

BACKGROUND: It is not clear to what extent maternal metabolism during pregnancy affects the cognitive and behavioral function of the offspring by altering brain development in utero. To investigate this question, we correlated measures of metabolism in pregnant diabetic and nondiabetic women with the intellectual development of their offspring. METHODS: The study included 223 pregnant women and their singleton offspring: 89 women had diabetes before pregnancy (pregestational diabetes mellitus), 99 had the onset of diabetes during pregnancy (gestational diabetes mellitus), and 35 had normal carbohydrate metabolism during their pregnancy. We correlated measures of maternal glucose and lipid metabolism (fasting plasma glucose levels, hemoglobin A1c levels, episodes of hypoglycemia, episodes of acetonuria, and plasma beta-hydroxybutyrate and free fatty acid levels) with two measures of intellectual development in the offspring--the mental development index of the Bayley Scales of Infant Development, given at the age of two years, and the Stanford--Binet Intelligence Scale, given at the ages of three, four, and five years and expressed as an average of the three scores. RESULTS: After correction for socioeconomic status, race or ethnic origin, and patient group, the children's mental-development-index scores at the age of two years correlated inversely with the mothers' third-trimester plasma beta-hydroxybutyrate levels (r = -0.21, P less than 0.01); the average Stanford-Binet scores correlated inversely with third-trimester plasma beta-hydroxybutyrate (r = -0.20, P less than 0.02) and free fatty acid (r = -0.27, P less than 0.002) levels. No other correlations were significant. Including various perinatal events (e.g., prematurity and acidemia) in the analyses did not alter the results. CONCLUSIONS: Maternal diabetes during pregnancy may affect behavioral and intellectual development in the offspring. The associations between gestational ketonemia in the mother and a lower IQ in the child warrant continued efforts to avoid ketoacidosis and accelerated starvation in all pregnant women.

Dyadic disturbances in cocaine-abusing mothers and their infants.

A recently developed instrument for the quantification of mother-infant interaction, the Parent-Child Early Relationship Assessment (PCERA), was used to observe drug-abusing mothers and their infants. Compared to the standardization sample used in the development of the PCERA, these drug-abusing mothers (N = 5) showed a tendency toward rigidity and overcontrol in their parenting, a lack of enjoyment and pleasure in relating to their infants, and limited emotional involvement and responsivity in their interaction. An analysis of the dyadic behaviors showed an overall reduction in reciprocity, mutual enjoyment, and regulation of interaction between mother and infant.

Correlations between antepartum maternal metabolism and newborn behavior.

We suggested that antepartum maternal metabolism may affect later cognitive and behavioral function of progeny by impacting on developing brain cells in utero. This study reports on the observed relationships between serial characterizations of maternal fuels during pregnancy and Brazelton neonatal behavioral assessment scale ratings of offspring from 73 well-controlled pregestational diabetic patients, 112 gestational diabetic patients, and 24 nondiabetic patients. After controlling for the effects of premature birth on the Brazelton neonatal behavioral assessment scale, significant correlations were found between second- and third-trimester glycemic regulation (hemoglobin A1c and fasting plasma glucose levels) and three of four newborn behavioral dimensions of the Brazelton neonatal behavioral assessment scale. In each case, as maternal glucose increased, the newborns' Brazelton neonatal behavioral assessment scale responses were poor. Results were not substantially different when gestational and pregestational diabetic patients were analyzed separately, nor can they be attributed to various perinatal events (neonatal asphyxia, hypoglycemia) or differences in socioeconomic status or ethnicity. The presence of fuel-related neurobehavioral deficits in neonates of diabetic mothers suggests that such infants start their interactions with care givers from a modified base.

Early developmental progress of preterm twins discordant for birthweight and risk.

Studies of developmental progress in high-risk twins have disparate findings. In this study, we report the outcome of 45 twin pairs born between 26 and 37 weeks gestation, and whose birthweights ranged from 840 to 2000 g. No significant differences were found for weight, risk and birth order. However, earlier preterm infants were found to have significantly lower mental scores on the Bayley Scales of Infant Development at 24 months, and lower IQ scores on the Stanford Binet Intelligence Scale at 36 months. These findings imply that gestational age is a powerful variable in determining developmental outcome.

Cocaine use in pregnancy: perinatal morbidity and mortality.

With the increasing use of cocaine in the United States, there has been growing concern regarding its effects on the fetuses and neonates of pregnant cocaine abusers. Fifty-two cocaine-using women enrolled in a comprehensive perinatal addiction program were evaluated and compared with 73 women who had used narcotics in the past and were maintained on methadone during pregnancy. The groups were similar in maternal age, socioeconomic status, number of pregnancies and cigarette, marijuana and alcohol use. The cocaine-using women had a significantly higher rate of premature labor, precipitous labor, abruptio placentae, fetal monitor abnormality and fetal meconium staining than the women in the methadone group. Neonatal gestational age, birth weight, length and head circumference were not affected by cocaine use compared to methadone use. However, the Brazelton Neonatal Behavioral Assessment Scale revealed that infants exposed to cocaine had significant depression of organizational response to environmental stimuli (state organization) when compared to methadone-exposed infants. In another aspect of the study, an increased rate of SIDS (15%) was found for 66 cocaine-exposed infants as compared to a 4% rate of SIDS in 50 methadone-exposed infants.

Prenatal drug exposure: effects on neonatal and infant growth and development.

There is no question that the number of women using and abusing drugs other than opiates far exceeds the number who are addicted to narcotics. Data on four groups of drug-addicted pregnant women and their newborns are presented and compared to a drug-free control group. Group I women (N = 51) conceived while on heroin and were converted to low-dose methadone maintenance; Group II women were addicted to multiple licit or illicit nonnarcotic drugs (N = 22); Group III women abused a combination of pentazocine and tripelennamine (T's and blues) during pregnancy (N = 13); and Group IV women (N = 9) abused phencyclidine (PCP) throughout pregnancy. Group V women (N = 27) were selected from the clinic population of Prentice Women's Hospital and Maternity Center and had no history or evidence of substance use or abuse. Opiate-exposed newborns in Groups I and III were significantly smaller than control infants for all growth parameters, though by nine months of age they had caught up in weight and length to control infants. Head circumference remained significantly smaller than controls through two years of age. All four groups of drug-exposed infants exhibited abnormal neurobehavior in the newborn period, but mental and psychomotor development as evaluated with the Bayley Scales of Infant Development was comparable to control infants' development through two years of age.

Cocaine use in pregnancy.

With the increasing use of cocaine in the United States, there has been growing concern regarding its effects on the fetuses and neonates of pregnant cocaine abusers. Twenty-three cocaine-using women enrolled in a comprehensive perinatal-addiction program were divided into two groups: those using cocaine only and those using cocaine plus narcotics. These two groups were compared with a group of women who had used narcotics in the past and were maintained on methadone during pregnancy, and with a group of drug-free women. All four groups were similar in maternal age, socioeconomic status, number of pregnancies, and cigarette, marijuana, and alcohol use. Their medical histories indicated that the cocaine-using women had a significantly higher rate of spontaneous abortion than the women in the other two groups. In the pregnancies under study, four cocaine-using women had onset of labor with abruptio placentae immediately after intravenous self-injection of cocaine. Neonatal gestational age, birth weight, length, and head circumference were not affected by cocaine use. However, the Brazelton Neonatal Behavioral Assessment Scale revealed that infants exposed to cocaine had significant depression of interactive behavior and a poor organizational response to environmental stimuli (state organization). These preliminary observations suggest that cocaine influences the outcome of pregnancy as well as the neurologic behavior of the newborn, but a full assessment will require a larger number of pregnancies and longer follow-up.

Early language abilities of high-risk infants.

Ten children with a history of prematurity and respiratory distress syndrome (RDS) were matched with 10 full-term controls on the single-word stage of language. Eleven dependent variables probed for qualitative differences between the groups. Measures of receptive language were based on two assessment procedures specifically designed for this study. Expressive language measures were taken from a parent-elicited language sample. Control subjects demonstrated superior performance on all receptive language and child verbosity measures despite their younger age.