Showing papers by "University of Miami published in 1992"

Optical Coherence Tomography

Abstract: Optical coherence tomography (OCT) has developed rapidly since its first realisation in medicine and is currently an emerging technology in the diagnosis of skin disease. OCT is an interferometric technique that detects reflected and backscattered light from tissue and is often described as the optical analogue to ultrasound. The inherent safety of the technology allows for in vivo use of OCT in patients. The main strength of OCT is the depth resolution. In dermatology, most OCT research has turned on non-melanoma skin cancer (NMSC) and non-invasive monitoring of morphological changes in a number of skin diseases based on pattern recognition, and studies have found good agreement between OCT images and histopathological architecture. OCT has shown high accuracy in distinguishing lesions from normal skin, which is of great importance in identifying tumour borders or residual neoplastic tissue after therapy. The OCT images provide an advantageous combination of resolution and penetration depth, but specific studies of diagnostic sensitivity and specificity in dermatology are sparse. In order to improve OCT image quality and expand the potential of OCT, technical developments are necessary. It is suggested that the technology will be of particular interest to the routine follow-up of patients undergoing non-invasive therapy of malignant or premalignant keratinocyte tumours. It is speculated that the continued technological development can propel the method to a greater level of dermatological use.

Effects of optimism on psychological and physical well-being: Theoretical overview and empirical update

Abstract: The primary purpose of this paper is to review recent research examining the beneficial effects of optimism on psychological and physical well-being. The review focuses on research that is longitudinal or prospective in design. Potential mechanisms are also identified whereby the beneficial effects of optimism are produced, focusing in particular on how optimism may lead a person to cope more adaptively with stress. The paper closes with a brief consideration of the similarities and differences between our own theoretical approach and several related approaches that have been taken by others.

Revising Axis V for DSM-IV: A Review of Measures of Social Functioning

Abstract: Objective: Axis V, which uses the Global Assessment of Functioning Scale in the multiaxial system of DSM-III-R, is under review for DSM-IV. This article examines what is known about axis V and selectively reviews the literature on measures of social functioning to identify potential alternatives to the Global Assessment of Functioning Scale. Method: About 25 studies on the use, reliability, and validity of axis V in DSM-III and DSM-III-R are reviewed. In addition, nearly 30 measures of social functioning are reviewed and analyzed as potential substitutes for the Global Assessment of Functioning Scale. The analysis focuses on the strengths and weaknesses of each measure for assessing functioning on axis V. Results: Axis V measures are modestly reliable and valid but not widely used. The authors identify and discuss two particular limitations on the Global Assessment of Functioning Scale: 1) the combination of measures of symptoms and measures of social functioning on a single axis and 2) the exclusion of physical impairments from the rating of functioning. Conclusions: None of the measures of social functioning reviewed is clearly superior to the Global Assessment of Functioning Scale for use on axis V. A modified version of the Global Assessment of Functioning Scale, separating the measures of social and occupational functioning from the measures of symptoms and psychological functioning, is proposed for field testing, along with a new set of instructions permitting the rating of limitations due to both physical and mental impairments.

Mentorship and career mobility: An empirical investigation

Abstract: The literature on mentorship is briefly reviewed, revealing that many studies have documented the functions that mentors provide to proteges, including vocational and psychosocial support. This study investigates the link between these functions and the career mobility outcomes of proteges. Results from a random sample of 244 manufacturing managers supports previous research on the dimensions of mentoring. Further, vocational (coaching) and psycho-social (social support) were found to be related to managers' salary level and promotions. Implications of these results for future studies of mentoring are discussed.

Selective transmission of human immunodeficiency virus type-1 variants from mothers to infants

Abstract: Multiple human immunodeficiency virus type-1 sequences from the V3 and V4-V5 regions of the envelope gene were analyzed from three mother-infant pairs. The infants' viral sequences were less diverse than those of their mothers. In two pairs, a proviral form infrequently found in the mother predominated in her infant. A conserved N-linked glycosylation site within the V3 region, present in each mother's sequence set, was absent in all of the infants' sequence sets. These findings demonstrate that a minor subset of maternal virus is transmitted to the infant.

Cytokines and arachidonic metabolites produced during human immunodeficiency virus (HIV)-infected macrophage-astroglia interactions: implications for the neuropathogenesis of HIV disease.

Abstract: Human immunodeficiency virus (HIV) infection of brain macrophages and astroglial proliferation are central features of HIV-induced central nervous system (CNS) disorders. These observations suggest that glial cellular interactions participate in disease. In an experimental system to examine this process, we found that cocultures of HIV-infected monocytes and astroglia release high levels of cytokines and arachidonate metabolites leading to neuronotoxicity. HIV-1ADA-infected monocytes cocultured with human glia (astrocytoma, neuroglia, and primary human astrocytes) synthesized tumor necrosis factor (TNF-alpha) and interleukin 1 beta (IL-1 beta) as assayed by coupled reverse transcription-polymerase chain reaction, enzyme-linked immunosorbent assay, and biological activity. The cytokine induction was selective, cell specific, and associated with induction of arachidonic acid metabolites. TNF-beta, IL-1 alpha, IL-6, interferon alpha (IFN-alpha), and IFN-gamma were not produced. Leukotriene B4, leukotriene D4, lipoxin A4, and platelet-activating factor were detected in large amounts after high-performance liquid chromatography separation and correlated with cytokine activity. Specific inhibitors of the arachidonic cascade markedly diminished the cytokine response suggesting regulatory relationships between these factors. Cocultures of HIV-infected monocytes and neuroblastoma or endothelial cells, or HIV-infected monocyte fluids, sucrose gradient-concentrated viral particles, and paraformaldehyde-fixed or freeze-thawed HIV-infected monocytes placed onto astroglia failed to induce cytokines and neuronotoxins. This demonstrated that viable monocyte-astroglia interactions were required for the cell reactions. The addition of actinomycin D or cycloheximide to the HIV-infected monocytes before coculture reduced, > 2.5-fold, the levels of TNF-alpha. These results, taken together, suggest that the neuronotoxicity associated with HIV central nervous system disorders is mediated, in part, through cytokines and arachidonic acid metabolites, produced during cell-to-cell interactions between HIV-infected brain macrophages and astrocytes.

Sudden cardiac death. Structure, function, and time-dependence of risk.

Abstract: Sudden cardiac death (SCD) remains a major unresolved clinical and public health problem, accounting for more than 300,000 of the deaths in the United States annually. The ability to identify potential SCD victims is limited by the large size of the population subgroups that contain the majority of SCD victims and by the apparent time dependence of risk of sudden death. The latter refers to the tendency for SCD to follow other cardiovascular events within a high-risk period of 6-18 months after a primary cardiovascular event, with risk decreasing thereafter. The combination of time dependence and denominator pool size provides a basis for future studies to identify the higher risk individuals. Pathophysiologically, SCD can be viewed as an interaction between structural abnormalities of the heart, transient functional disturbances, and the specific electrophysiological events responsible for fatal arrhythmias. Structural abnormalities provide the anatomic substrate for chronic risk and include the myocardial consequences of coronary artery disease, left ventricular hypertrophy, myopathic ventricles, and specific electrophysiological anatomic abnormalities such as bypass tracts. The functional factors responsible for destabilizing a chronic electrophysiological abnormality include transient ischemia and reperfusion, systemic factors (e.g., electrolyte disturbances, acidosis, and hemodynamic dysfunction), autonomic fluctuations (both systemic and at a tissue level), and myocardial toxic influences such as proarrhythmic effects of various drugs. Each of these changes is able to destabilize myocardial membrane integrity, some regionally and some globally, making the heart susceptible to an electrical triggering event for ventricular tachycardia or fibrillation.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapeutic modulation of brain temperature: relevance to ischemic brain injury.

Abstract: Hypothermia was first applied therapeutically as a local anesthetic and later was used to achieve organ protection during procedures necessitating circulatory interruption. Profound whole-body hypothermia, typically carried out in conjunction with extracorporeal bypass, has long been employed during cardiac and neurosurgical operative procedures. More recently, studies in small-animal experimental models of cerebral ischemia have provided persuasive evidence that even small decreases in brain temperature confer striking protection against ischemic neuronal injury. By contrast, small elevations of brain temperature during ischemia accelerate and extend pathologic changes in the brain and promote early disruption of the blood-brain barrier. Hypothermia retards the rate of high-energy phosphate depletion during ischemia and promotes postischemic metabolic recovery. More importantly, mild intraischemic hypothermia markedly attenuates the release of glutamate into the brain's extracellular space and significantly diminishes the release of dopamine. Similarly, the inhibition of calcium-calmodulin-dependent protein kinase II triggered by normothermic ischemia is prevented by hypothermia, as is the ischemia-induced translocation and inhibition of the key regulatory enzyme protein kinase C. Hypothermia also appears to facilitate the resynthesis of ubiquitin following ischemia. Studies of potential clinical importance have shown that moderate hypothermia is capable of attenuating ischemic damage even if instituted early in the postischemic period. In the setting of focal cerebral ischemia, moderate brain hypothermia reduces the infarct size (particularly in the setting of reversible middle cerebral artery occlusion); conversely, hyperthermia markedly increases the infarct volume. These studies underscore the importance of monitoring and regulating the brain temperature during experimental studies of cerebral ischemia to insure a consistent pathologic outcome and to avoid the false attribution of "pharmacoprotection" to drugs that reduce the body temperature. The measurement of brain temperature is now practicable in neurosurgical patients requiring invasive monitoring, and human studies have shown that cortical and cerebroventricular temperatures may exceed systemic temperatures. Mild to moderate decreases in brain temperature are neuroprotective in cerebral ischemia, while mild elevations of brain temperature are markedly deleterious in the setting of ischemia or injury. It is anticipated that controlled clinical trials of therapeutic brain temperature modulation will be undertaken over the next several years.

The relationship of the superficial and deep facial fascias: relevance to rhytidectomy and aging

Abstract: Controversy persists regarding the relationship of the superficial facial fascia (SMAS) to the mimetic muscles, deep facial fascia, and underlying facial nerve branches. Using fresh cadaver dissection, and supplemented by several hundred intraoperative dissections, we studied facial soft-tissue anatomy. The facial soft-tissue architecture can be described as being arranged in a series of concentric layers: skin, subcutaneous fat, superficial fascia, mimetic muscle, deep facial fascia (parotidomasseteric fascia), and the plane containing the facial nerve, parotid duct, and buccal fat pad. The anatomic relationships existing within the facial soft-tissue layers are (1) the superficial facial fascia invests the superficially situated mimetic muscles (platysma, orbicularis oculi, and zygomaticus major and minor); (2) the deep facial fascia represents a continuation of the deep cervical fascia cephalad into the face, the importance of which lies in the fact that the facial nerve branches within the cheek lie deep to this deep fascial layer; and (3) two types of relationships exist between the superficial and deep facial fascias: In some regions of the face, these fascial planes are separated by an areolar plane, and in other regions of the face, the superficial and deep fascia are intimately adherent to one another through a series of dense fibrous attachments. The layers of the facial soft tissue are supported in normal anatomic position by a series of retaining ligaments that run from deep, fixed facial structures to the overlying dermis. Two types of retaining ligaments are noted as defined by their origin, either from bone or from other fixed structures within the face.(ABSTRACT TRUNCATED AT 250 WORDS)

Life-Threatening Ventricular Arrhythmias in Patients with Silent Myocardial Ischemia Due to Coronary Artery Spasm

Abstract: Background Silent myocardial ischemia in patients with coronary atherosclerosis is associated with an increased risk of adverse cardiac events, including sudden death. The relation between silent ischemia and the initiation of potentially fatal ventricular arrhythmias has not been defined, however. Methods As part of a long-term study of sudden cardiac death, data on arrhythmias, coronary anatomy, and responses to ergonovine testing to provoke coronary artery spasm were collected prospectively among survivors of out-of-hospital cardiac arrest who had no flow-limiting coronary artery lesions, prior myocardial infarctions, or other structural causes of cardiac arrest and no angina pectoris. Associations between silent myocardial ischemia due to coronary artery spasm and the occurrence and characteristics of life-threatening ventricular arrhythmias were studied by both invasive and noninvasive techniques. Results Silent ischemic events were associated with the initiation of life-threatening ventricu...

An outbreak of tuberculosis caused by multiple-drug-resistant tubercle bacilli among patients with HIV infection.

Abstract: ▪Objective:To evaluate a nosocomial outbreak of tuberculosis caused by multiple-drug-resistant bacilli among patients with tuberculosis and HIV infection. ▪Design:A case-control study. ▪Pa...

Infants of depressed mothers

Abstract: Literature is reviewed demonstrating the impact of maternal depression on early infant interactions and development. Infants of depressed mothers (a) develop a depressed mood style as early as 3 months; (b) this mood generalizes to interactions with nondepressed women; (c) it persists over the first year if the mother's depression persists; and (d) it affects growth and Bayley developmental scores by the end of the first year. Other data are reviewed on individual differences including maternal depression styles of withdrawal and intrusion, negative behavior matching, and distorted perceptions of behavior. Finally, genetic, intrauterine, and extrauterine environment effects are discussed and interventions are suggested for altering the mother's depressed behavior and distorted perceptions. The review concludes that a developmental psychopathology perspective is needed to better understand the development of early depression.

Heat shock gene regulation by nascent polypeptides and denatured proteins: hsp70 as a potential autoregulatory factor.

Abstract: Heat shock genes encode proteins (hsp's) that play important structural roles under normal cir- cumstances and are essential to the ceils' ability to survive environmental insults. Evidence is presented herein that transcriptional regulation of hsp gene ex- pression is linked with the regulation of overall protein synthesis as well as with the accumulation of proteins denatured by stressful events. The factor that connects the three processes appears to be one of the hsp's, pre- sumably a member(s) of the hsp70 family. Biochemical experiments demonstrate that complexes containing hsp70 and heat shock transcription factor, the specific regulator of hsp gene activity, are formed in the cells.

The Significance of Brain Temperature in Focal Cerebral Ischemia: Histopathological Consequences of Middle Cerebral Artery Occlusion in the Rat:

Abstract: The purpose of this study was to determine the effect of selective modulation of brain temperature in the experimental settings of permanent and reversible middle cerebral artery (MCA) occlusion in Sprague-Dawley rats. Three models of proximal MCA occlusion were used, in which the effect of brain-temperature modulations could be studied. These included (a) permanent MCA occlusion with an initial 30-min period of hypotension (30 or 36 degrees C x 4 h), (b) permanent MCA occlusion alone (30, 36, or 39 degrees C x 2 h), and (c) 2 h of reversible MCA occlusion (30, 36, or 39 degrees C x 2 h). In the transient MCA occlusion series, intra- and postischemic cortical blood flow was assessed using a laser-Doppler flowmeter placed over the dorsolateral cortex. After a 3-day survival, all rats were perfusion fixed for histopathological analysis and the determination of infarct volume. In animals with permanent MCA occlusion plus hypotension, no significant difference in infarct volume was demonstrated between the 30 and 36 degrees C groups. In rats with permanent MCA occlusion without hypotension, significant differences in infarct volume were again not demonstrable, but an interaction between infarct area and temperature class was shown by repeated-measures analysis, indicating that hypothermia altered the topographic pattern of the cortical infarct. With 2 h of reversible MCA occlusion, there was a statistically significant reduction in infarct volume in the 30 degrees C group compared to 39 degrees C rats. Although intra- and postischemic CBF were not significantly different among the three temperature groups, the cortical infarct volume was positively correlated with postischemic CBF. The postischemic CBF, in turn, was positively correlated to the intraischemic brain temperature and was negatively correlated to CBF during the ischemic period. These findings demonstrate that moderate manipulations of brain temperature have a greater influence on the resulting cortical infarction in the setting of transient focal ischemia than in the context of permanent vascular occlusion.

Drug abuse, dependence, and addiction in chronic pain patients.

Abstract: It is claimed that a significant percentage of chronic pain patients suffer from drug/alcohol abuse/dependency/addiction. To address this question, 24 articles alluding to chronic pain patient drug/alcohol dependence/addiction were reviewed according to the following criteria: method for dru

Measuring Bilingual Children's Receptive Vocabularies

Abstract: Receptive vocabulary of Hispanic children in Miami was tested in both English and Spanish with complementary standardized tests, the Peabody Picture Vocabulary Test (PPVT-R) and the Test de Vocabulario en Imagenes Peabody (TVIP-H). 105 bilingual first graders, of middle to high socioeconomic status relative to national norms, were divided according to the language(s) spoken in their homes. Both groups, whether they spoke only Spanish in the home (OSH) or both English and Spanish in the home (ESH), performed near the mean of 100 in Spanish receptive vocabulary (TVIP-H means 97.0 and 96.5); in contrast, ESH group children scored more than 1 SD higher in English than OSH group children (PPVT-R means 88.0 and 69.7, respectively). It appears, therefore, that learning 2 languages at once does not harm receptive language development in the language of origin, while it does lay the groundwork for superior performance in the majority language. Furthermore, an analysis of translation equivalents, items shared by both tests, shows that a statistically significant portion of bilingual children's lexical knowledge does not overlap in their 2 languages and is therefore not reflected in single-language scores.

Students' perceptions of teacher behaviors as motivating and demotivating factors in college classes

Abstract: This study coded and categorized 2404 motivators and demotivators freely listed by 308 college students prior to and following their being prompted to consider teacher behaviors as contributing to motivation level. Twenty categories of motivators and 20 categories of demotivators emerged; four of each reflected context factors, six of each structure/format factors, and ten of each teacher behavior factors. While teacher behaviors accounted for approximately 44% of both motivators and demotivators, negative teacher behaviors were perceived as more central to students' demotivation (i.e., were listed without prompting) than positive teacher behaviors were perceived as central to motivation. Structure/format factors were more frequently mentioned as demotivators and context factors, such as desire to know the material, grade or credit motivation, and personal desire for accomplishment, as motivators. It was concluded that motivation is perceived by students as a student‐owned state, while lack of motivation ...

Orthotopic corneal transplantation in mice—evidence that the immunogenetic rules of rejection do not apply

Abstract: The fate of orthotopic corneal transplants has been studied in inbred strains of mice. Using a surgical technique that achieves > 95% success of syngeneic cornea grafts, it was determined that a high proportion of orthotopic cornea allografts were accepted indefinitely, irrespective of the degree of immunogenetic disparity between graft donor and recipient. Grafts that succumbed to irreversible rejection developed extensive corneal edema and intrastromal neovascularization as harbingers of corneal opacity and endothelial cell failure. The highest rate of rejection occurred among grafts that confronted their hosts with multiple minor histocompatibility antigens, with or without major histocompatibility antigens. Much lower rates of rejection (< 35%) were observed when the donors of the grafts differed from recipients at class I and/or class II major histocompatibility loci. Corneal grafts that confronted their hosts with class II MHC alloantigens alone experienced early, acute inflammation, and eventually developed stomal neovascularization, but only a small minority of these grafts were eventually destroyed. Allogeneic corneas that were transplanted orthotopically into eyes of presensitized mice were uniformly subjected to an acute rejection process that produced opacity within three weeks; however, in a minority of instances, the inflammation and opacity subside, and after eight weeks the grafts displayed a clear, nonvascularized appearance. The high rate of success of even grossly histoincompatible orthotopic corneal allografts in mice resembles the extraordinary success of unmatched allogeneic corneas transplanted into human eyes. The results are discussed in terms of the possible mechanisms that permit orthotopic corneal allografts to enjoy significantly better survival than orthotopic grafts of other types of solid tissues.

Social anxiety and peer relationships in early adolescence: A prospective analysis.

Abstract: Examined relationships over time between social anxiety, friendship qualities, and rejection experiences for 68 early adolescents who had recently relocated. Prospective analyses provide evidence consistent with the view that social anxiety influences the emergence of companionship and intimacy in newly formed friendships but does not play a significant role in determining the frequency of rejection events. Social anxiety also appears to change over time in response to the degree of companionship and intimacy in friendships and to the frequency of rejection experiences.

A Cohort Study of Transcutaneous Oxygen Tension and the Incidence and Severity of Retinopathy of Prematurity

Abstract: Background. Retinopathy of prematurity is a disease affecting the blood vessels of the retina in premature infants that may result in scarring, retinal detachment, and loss of vision. An association between this condition and the exposure of premature infants to supplemental oxygen has been postulated, but the relation between retinopathy of prematurity and blood oxygen levels has not been defined. The purpose of this study of a cohort of preterm infants was to correlate the incidence and severity of retinopathy of prematurity with the duration of exposure to different ranges of oxygen tension as measured by transcutaneous monitoring (tcPO2). Methods. One hundred one premature infants (birth weight, 500 to 1300 g) requiring supplemental oxygen had continuous monitoring of tcPO2. The number of hours during which the tcPO2 was 80 mm Hg or higher was tabulated for each infant during the first four weeks of life. Results. There was a significant association between the amount of time that the tcPO2 w...

Massage Reduces Anxiety in Child and Adolescent Psychiatric Patients

Abstract: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.

Neuropsychological Impairment in Chronic Cocaine Abusers

Abstract: Twenty chronic cocaine abusers were compared with age and education matched controls using standardized neuropsychological assessment procedures to determine whether the cocaine abusers were impaired Fifty percent of the cocaine abusers in contrast to 15% of the controls scored in the impaired range on the summary index of the Neuropsychological Screening Exam The cocaine abusers also performed more poorly on the Halstead Category Test, the Symbol Digit Modalities Test, the WAIS-R Arithmetic Test, and a test of verbal memory (forgetting) In the cocaine abuser sample, neuropsychological performance was related to the amount and recency of cocaine use, suggesting a direct role of cocaine on cognitive functioning

Quality of attachment in the preschool years

Abstract: This is a theoretical paper about differences in quality of attachment in preschool-aged children with emphasis on the development of the goal-corrected partnership. Inferences are made about the processes underlying preschoolers' attachment behavior. Specifically, the notion of quality of attachment is expanded to explicitly include strategy, regulation of affect, negotiation, secure base behavior, and response to maternal behavior. The classificatory system is expanded by adding two additional defended patterns, that is, compulsive caregiving and compulsive compliance, to the infant avoidant pattern. Furthermore, at the preschool age, the infant ambivalent pattern is identified as having a coercive strategy. In addition, the disorganized infant category is reconceptualized in terms of complex organization, reorganization, and disorganization. Finally, the process of generating new theories and hypotheses through a “participant observer” methodology is considered from the perspective of developmental psychopathology.

Studies on the induction of anterior chamber-associated immune deviation (ACAID). III. Induction of ACAID depends upon intraocular transforming growth factor-beta.

Abstract: Delayed hypersensitivity (DH), the prototypical form of cell-mediated immune responsiveness, is mediated with the participation of considerable nonspecific inflammation which necessarily disrupts the anatomic integrity of involved and adjacent tissues. Damage of this type is of minor consequence to many visceral and cutaneous organs, but is of devastating consequence for organs such as the eye and the brain. At least in the case of the eye, the organ is remarkably adept at regulating the immune system's ability to respond to intraocular antigens by selectively down-regulating both the induction and expression of delayed hypersensitivity while leaving other effector modalities intact. This ability of the eye to selectivity down-regulate systemic DH responses to intracamerally inoculated antigens is known as anterior chamber-associated immune deviation (ACAID) and is mediated in part by antigen-specific regulatory T cells. Recent work suggests that macrophages (M phi) that reside in the iris and ciliary body can migrate out of an antigen-bearing eye and activate regulatory T cells within the spleen. In an effort to understand the mechanism by which intraocular M phi interact with antigen in the anterior chamber of the eye (AC) and subsequently induce splenic regulatory cells in ACAID, we have investigated what role, if any, the AC microenvironment itself plays in ACAID induction. The results reveal that CD45- parenchymal iris/ciliary cells secrete a soluble factor(s) locally and into the aqueous humor which endows resident, mature M phi with ACAID-inducing capabilities. Mice receiving infusions of these altered, antigen-pulsed M phi are incapable of mounting a significant DH response following immunization with antigen in adjuvant. Importantly, the ACAID-inducing effect is achieved when conventional, extraocular M phi are exposed in vitro to a soluble factor present in aqueous humor or culture SN from iris and ciliary body cells. Further investigations into the identity of this factor reveal it to be transforming growth factor-beta (TGF-beta). The role of TGF-beta in the generation of ACAID, as well as the implications of these findings to an understanding of immunologic privilege in general, are discussed.

The Effects of Cognitive and Metacognitive Strategy Instruction on the Mathematical Problem Solving of Middle School Students with Learning Disabilities

Abstract: This study investigated the effects of cognitive and metacognitive strategy instruction on the mathematical problem solving of six middle school students with learning disabilities. Conditions of the multiple baseline, across-subjects design included baseline, two levels of treatment, setting and temporal generalization, and retraining. For Treatment 1, subjects received either cognitive or metacognitive strategy instruction. Treatment 2 consisted of instruction in the complementary component of the instructional program so that all subjects eventually received both cognitive and metacognitive strategy instruction. This design allowed a componential analysis of the content as well as sequence of instruction. Generally, subjects improved their mathematical problem solving as measured by performance on one-, two-, and three-step word problems. Discussion focused on effectiveness of treatment, acquisition and application of strategic knowledge, error pattern analysis, and the need to tailor instruction to the learner's individual characteristics.