Cognitive functioning of adults with Noonan syndrome: a case-control study.

Noonan syndrome (NS) is a genetic disorder characterised by short stature, facial dysmorphia, congenital heart defects and mildly lowered intellectual abilities. Research has mainly focused on genetic and somatic aspects, while intellectual and cognitive functioning has been documented scarcely. Also, to date studies have been primarily performed in children. This is the first study in which functioning within the major cognitive domains is systematically evaluated in a group of adults with NS and compared with a control group. Extensive neuropsychological assessment, including the domains intelligence, speed of information processing, memory (working memory, immediate recall and delayed recall), executive function and visuoconstruction, was performed in a sample of 42 patients with NS and 42 healthy controls, matched on age, sex and education level. In addition, subjective cognitive complaints were assessed with self-report questionnaires. On the domain speed of information processing patients performed worse than controls (P < 0.05). Furthermore, except for slightly better results on delayed recall in the patients with NS (P < 0.05), none of the other cognitive domains showed between-group differences. On the questionnaires, patients reported substantially more complaints about their own cognitive abilities than controls (P < 0.05). A lowered speed of information processing and relatively intact functioning in other cognitive domains characterises the cognitive profile of adult patients, in contrast to previous findings in children with NS, who seem to have more generalised cognitive deficits.

Nurses' decision on seclusion: patient characteristics, contextual factors and reflexivity in teams.

While many characteristics of patients, professionals and facilities with relevance to seclusion rates have been investigated, their relative importance is unclear. Virtually no attention has been paid to team processes and reflexivity in relation to decision making on seclusion. The aim of this paper is to estimate the effects of these factors on nurse decision making on seclusion. Sixty Dutch psychiatric nurses of four closed wards reported team reflexivity and their tendency to seclude a theoretical patient. Approachability (whether there was a good or hardly any possibility to communicate with the patient), staffing level and confidence within the team had the greatest impact on the decision to seclude. Intra class correlation was 0.30. There was a large interaction effect of reflexivity with team 4, and team reflexivity was highly correlated with team tendency to avoid seclusion. In nurses' decision on seclusion, the effects of 'pure' patient characteristics are small as compared with the effects of interpersonal and contextual factors, and nurses vary widely in their judgement. Team reflexivity is related to the tendency to prevent seclusion.

Prey catching in archer fish: the role of posture and morphology in aiming behavior.

Archer fishes (Toxotidae) bring down aerial prey with a squirt of water from their mouth. How they aim, however, is not clear. Measurements of the angle between the squirt and the fish's body axis (the mouth angle) already yielded agreement that pointing the body plays a part in aiming, and it has been suggested that more accurate aiming would occur by means of lips and tongue. In a previous study, however, we found that the mouth angle is an individual property, with a much smaller range than reported by others. Moreover, we found that archer fishes do not possess movable lips, and that their tongue seems too short to direct the squirt. Presently, we found that the tongue cannot even reach the rostral part of the mouth cavity, that affects the squirt's direction, and that the mouth angle is an individual property remaining constant, even across a wide range of target distances. These findings suggest that aiming the body is the only way of aiming the squirt. We also found that during aiming, the body rotates around the eyeballs which remain fixed in space. The position of the eyeballs in the head (eye angle) at the moment of squirting was also found to be an individual property. However, the eye angle is less constant than the mouth angle. The systematic variance of the eye angle probably is related to the refraction effect.