This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-based distance learning technology. The purposes of this program were to provide training and to establish a regional cadre of researchers and clinicians; to increase disaster mental health research capacity and collaboration; and to improve the scientific rigor of research investigations of disaster mental health in children and families. Despite a number of obstacles encountered in development and implementation, outcomes of this program included increased team member awareness and knowledge of child and family disaster mental health issues; improved disaster and public health instruction and training independent of the UWDRT program; informed local and state disaster response preparedness and response; and contributions to the child and family disaster mental health research literature.

BACKGROUND: The nature and characteristics of the peer social networks of young children with Down syndrome in classroom settings were examined within a developmental framework. METHOD: Comparisons were made with younger typically developing children matched on mental age and typically developing children matched on chronological age. RESULTS: Similar patterns were found for all three groups for most peer social network measures. However, group differences were obtained for measures of teacher assistance and peer interactions in unstructured situations. CONCLUSIONS: Positive patterns appeared to be related to the social orientation of children with Down syndrome and the special efforts of teachers to support children's peer social networks. Findings also suggested that fundamental peer competence problems for children with Down syndrome remain and may best be addressed within the framework of contemporary models of peer-related social competence.

The peer-related social competence of children with Down syndrome was examined in an observational study. Dyadic interactions with peers of children with Down syndrome were compared with the dyadic interactions of matched groups of typically developing children and with playmates differing in both familiarity and social skills. Results suggested that both risk and protective factors influenced the peer interactions of children with Down syndrome. Recommendations are made for applying contemporary models of peer-related social competence to etiologic subgroups to better understand the mechanisms involved and to provide direction for the design of intervention programs.

Difficulty interpreting facial expressions has been reported in autism spectrum disorders (ASD) and is thought to be associated with amygdala abnormalities. To further explore the neural basis of abnormal emotional face processing in ASD, we conducted an fMRI study of emotional face matching in high-functioning adults with ASD and age, IQ, and gender matched controls. In addition, we investigated whether there was a relationship between self-reported social anxiety and fMRI activation. During fMRI scanning, study participants were instructed to match facial expressions depicting fear or anger. The control condition was a comparable shape-matching task. The control group evidenced significantly increased left prefrontal activation and decreased activation in the occipital lobes compared to the ASD group during emotional face matching. Further, within the ASD group, greater social anxiety was associated with increased activation in right amygdala and left middle temporal gyrus, and decreased activation in the fusiform face area. These results indicate that level of social anxiety mediates the neural response to emotional face perception in ASD.

Recent evidence suggests that a rapid, automatic face detection system is supported by subcortical structures including the amygdala, pulvinar, and superior colliculus. Early-emerging abnormalities in these structures may be related to reduced social orienting in children with autism, and subsequently, to aberrant development of cortical circuits involved in face processing. Our objective was to determine whether functional abnormalities in the subcortical face processing system are present in adults with autism spectrum disorders (ASD) during supraliminal fearful face processing. Participants included twenty-eight individuals with ASD and 25 controls group-matched on age, IQ, and behavioral performance. The ASD group met diagnostic criteria on the ADI-R, ADOS-G, and DSM-IV. Both the ASD and control groups showed significant activation in bilateral fusiform gyri. The control group exhibited additional significant responses in the right amygdala, right pulvinar, and bilateral superior colliculi. In the direct group comparison, the controls showed significantly greater activation in the left amygdala, bilateral fusiform gyrus, right pulvinar, and bilateral superior colliculi. No brain region showed significantly greater activation in the ASD group compared to the controls. Thus, basic rapid face identification mechanisms appear to be functional in ASD. However, individuals with ASD failed to engage the subcortical brain regions involved in face detection and automatic emotional face processing, suggesting a core mechanism for impaired socioemotional processing in ASD. Neural abnormalities in this system may contribute to early-emerging deficits in social orienting and attention, the putative precursors to abnormalities in social cognition and cortical face processing specialization.

This study explored the role of culture in shaping music perception and memory. We tested the hypothesis that listeners demonstrate different patterns of activation associated with music processing—particularly right frontal cortex—when encoding and retrieving culturally familiar and unfamiliar stimuli, with the latter evoking broader activation consistent with more complex memory tasks. Subjects (n = 16) were right-handed adults born and raised in the USA (n = 8) or Turkey (n = 8) with minimal music training. Using fMRI procedures, we scanned subjects during two tasks: (i) listening to novel musical examples from their own culture and an unfamiliar culture and (ii) identifying which among a series of brief excerpts were taken from the longer examples. Both groups were more successful remembering music of their home culture. We found greater activation for culturally unfamiliar music listening in the left cerebellar region, right angular gyrus, posterior precuneus and right middle frontal area extending into the inferior frontal cortex. Subjects demonstrated greater activation in the cingulate gyrus and right lingual gyrus when engaged in recall of culturally unfamiliar music. This study provides evidence for the influence of culture on music perception and memory performance at both a behavioral and neurological level.

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Brain activity patterns during face processing have been extensively explored with functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs). ERP source localization adds a spatial dimension to the ERP time series recordings, which allows for a more direct comparison and integration with fMRI findings. The goals for this study were (1) to compare the spatial descriptions of neuronal activity during face processing obtained with fMRI and ERP source localization using low-resolution electromagnetic tomography (LORETA), and (2) to use the combined information from source localization and fMRI to explore how the temporal sequence of brain activity during face processing is summarized in fMRI activation maps. fMRI and high-density ERP data were acquired in separate sessions for 17 healthy adult males for a face and object processing task. LORETA statistical maps for the comparison of viewing faces and viewing houses were coregistered and compared to fMRI statistical maps for the same conditions. The spatial locations of face processing-sensitive activity measured by fMRI and LORETA were found to overlap in a number of areas including the bilateral fusiform gyri, the right superior, middle and inferior temporal gyri, and the bilateral precuneus. Both the fMRI and LORETA solutions additionally demonstrated activity in regions that did not overlap. fMRI and LORETA statistical maps of face processing-sensitive brain activity were found to converge spatially primarily at LORETA solution latencies that were within 18 ms of the N170 latency. The combination of data from these techniques suggested that electrical brain activity at the latency of the N170 is highly represented in fMRI statistical maps.

Numerous dimensions of the peer social networks of children with Down syndrome were examined within a developmental framework. Results revealed that for many key measures, particularly involvement in play, linkages to other settings, and control of play, children with Down syndrome have less well-developed peer networks even in comparison to a mental age matched group of typically developing children. This suggests both an absence of any social advantage in the peer context for children with Down syndrome and the existence of unusual difficulties that may be traced to underlying problems in peer-related social competence. The need for future observational studies of peer interactions for this group of children was emphasized.

Opposing theories of striatal hyper- and hypodopaminergic functioning have been suggested in the pathophysiology of externalizing behavior disorders. To test these competing theories, the authors used functional MRI to evaluate neural activity during a simple reward task in 12- to 16-year-old boys with attention-deficit/hyperactivity disorder and/or conduct disorder (n = 19) and in controls with no psychiatric condition (n = 11). The task proceeded in blocks during which participants received either (a) monetary incentives for correct responses or (b) no rewards for correct responses. Controls exhibited striatal activation only during reward, shifting to anterior cingulate activation during nonreward. In contrast, externalizing adolescents exhibited striatal activation during both reward and nonreward. Externalizing psychopathology appears to be characterized by deficits in processing the omission of predicted reward, which may render behaviors that are acquired through environmental contingencies difficult to extinguish when those contingencies change.

OBJECTIVE:Amygdala dysfunction has been proposed as a critical component in social impairment in autism spectrum disorders. This study was designed to investigate whether abnormal habituation characterizes amygdala dysfunction in autism spectrum disorders and whether the rate of amygdala habituation is related to social impairment.METHOD:Using functional MRI, the authors measured change over time in activation of the amygdala and fusiform gyrus to neutral facial stimuli in adults with autism spectrum disorders and healthy comparison adults.RESULTS:The comparison group evidenced significantly greater amygdala habituation bilaterally than the autism spectrum group. There were no group differences in overall fusiform habituation. For the autism spectrum group, lower levels of habituation of the amygdala to the face stimuli were associated with more severe social impairment.CONCLUSIONS:These results suggest amygdala hyperarousal in autism spectrum disorders in response to socially relevant stimuli. Further, sustained amygdala arousal may contribute to the social deficits observed in autism spectrum disorders.

Abnormalities in the interactions between functionally linked brain regions have been suggested to be associated with the clinical impairments observed in autism spectrum disorders (ASD). We investigated functional connectivity within the limbic system during face identification; a primary component of social cognition, in 19 high-functioning adults with ASD and 21 age-and IQ-matched control adults. Activation during identification of previously viewed faces and houses using a one-back paradigm was compared. The fusiform face area (FFA) was individually localized in each participant and used as the seed point for functional connectivity analyses. The degree of correlation between FFA and the extended neural circuitry involved in face identification was tested. A whole brain analysis was also conducted in order to determine whether connectivity from the FFA to aberrant brain locations was present in the ASD group. Measures of clinical severity (ADOS social score and ADI-R social score) were included as independent variables into the functional connectivity analyses. Significant FFA-amygdala and FFA-superior temporal sulcus functional connectivity was found in both the ASD and control participants. However, the control group had significantly increased connectivity to the left amygdala and the posterior cingulate compared to ASD. Post hoc analyses additionally found increased connectivity to the thalamus in the controls. A significant relationship between abnormal functional connectivity and clinical severity in the ASD group was observed. Specifically, greater social impairment was associated with reduced FFA-amygdala connectivity and increased FFA-right inferior frontal connectivity. These results suggest that abnormal neural connections within the limbic system may contribute to the social impairments observed in ASD.

BACKGROUND AND PURPOSE: Diffusion tensor imaging is a tool that can be used to study white matter microstructure in dyslexia. We tested the hypothesis that dyslexics have a white matter structural change (as measured by directional diffusion of water, which can be affected by disruption in white matter tracts) between brain regions that previous functional connectivity studies showed were associated with phonologic processing.MATERIALS AND METHODS: Diffusion tensor imaging (DTI) scans were acquired from 7 healthy adult normal readers and from 14 adults with dyslexia on a 1.5T scanner. Voxelwise statistical analysis of the fractional anisotropy data were carried out by using Tract-Based Spatial Statistics to compare dyslexic subjects versus control subjects in white matter tracts.RESULTS: Significant group difference map clusters (comparing adults with and without dyslexia) occurred in specific bilateral white matter tracts within the frontal lobe, temporal lobe, occipital lobe, and parietal lobe.CONCLUSION: The DTI fractional anisotropy results in the bilateral white matter showing higher fractional anisotropy in adult control subjects compared with adults with dyslexia (relating to white matter fiber tract integrity) are consistent with our previous functional connectivity results from seed points in the bilateral inferior frontal gyrus.

Objective: Based upon Damasio's "convergence zone" model of semantic memory, we predicted that epilepsy surgical patients with anterior temporal lobe (TL) seizure onset would exhibit a pattern of category-specific naming and recognition deficits not observed in patients with seizures arising elsewhere.Methods: We assessed epilepsy patients with unilateral seizure onset of anterior TL or other origin (n = 22), pre- or post-operatively, using a set of category-specific items and a conventional measure of visual naming (Boston Naming Test: BNT).Results: Category-specific naming deficits were exhibited by patients with dominant anterior TL seizure onset/resection for famous faces and animals, while category-specific recognition deficits for these same categories were exhibited by patients with nondominant anterior TL onset/resection. Patients with other seizure onset did not exhibit category-specific deficits. Naming and recognition deficits were frequently not detected by the BNT, which samples only a limited range of stimuli.Interpretation: Consistent with the "convergence zone" framework, results suggest that the nondominant anterior TL plays a major role in binding sensory information into conceptual percepts for certain stimuli, while dominant TL regions function to provide a link to verbal labels for these percepts. Although observed category-specific deficits were striking, they were often missed by the BNT, suggesting that they are more prevalent than recognized in both pre- and post-surgical epilepsy patients. Systematic investigation of these deficits could lead to more refined models of semantic memory, aid in the localization of seizures, and contribute to modifications in surgical technique and patient selection in epilepsy surgery to improve neurocognitive outcome. (C) 2007 Elsevier Ltd. All rights reserved.

This study of recidivism among Washington supermax prisoners used a retrospective matched control design, matching supermax prisoners one-to-one with nonsupermax prisoners on mental illness status and up to eight recidivism predictors. Supermax prisoners committed new felonies at a higher rate than nonsupermax controls, but the difference was not statistically significant. Prisoners released directly from supermax to the community, however, showed significantly higher felony recidivism rates than their nonsupermax controls and committed new offenses sooner than supermax prisoners who left supermax 3 months or more before prison release. Limitations, methodological issues, and policy implications are considered.

The potential for a novel influenza virus to cause a pandemic represents a significant threat to global health. Planning for pandemic flu, as compared to planning for other types of hazards, presents some unique challenges to businesses, communities, and education institutions. To identify and address the challenges that may be faced by major metropolitan universities during a flu pandemic, a tabletop exercise was developed, offered, and evaluated. Its purpose was to assess existing University of Washington ( UW) plans and policies for responding to an influenza pandemic. On May 31, 2006, more than 50 participants, including UW administrators and unit leaders and a number of key external partners, participated in a tabletop exercise designed to simulate all phases of an influenza pandemic. This exercise revealed existing gaps in university pandemic influenza plans and policies, including issues related to isolation and quarantine, continuity of operations, disaster mental health services, integration of volunteers into a disaster response, tracking travel of university students and personnel, communication problems, and ways to meet the needs of resident and foreign students and faculty during an outbreak. Policy and planning recommendations are offered that address each of these challenges faced by UW as well as other major research universities and colleges.

Interventions using a group format can be powerful treatment modalities. However, a review of nursing journals most likely to report the conduct of group research by nurses showed that less than 1% of nursing research reports used this approach and that none accounted for group-level effects in the analysis. This article discusses methodological issues inherent in group intervention research. We begin by offering examples of variables that can be incorporated into group research. We then present some challenges that researchers must address in collecting data when group formats are used. We end with recommendations for conducting group intervention research and by addressing issues associated with interpreting and reporting results. (c) 2006 Elsevier Inc. All rights reserved.

Functional magnetic resonance imaging (fMRI) is a powerful noninvasive neuroimaging technique nurse scientists can use to investigate the structure and cognitive capacities of the brain. A strong magnetic field and intermittent high-frequency pulses cause protons in body tissues to release energy, which can be recorded and processed into images that are sensitive to specific tissue characteristics. Although temporal and spatial resolution constraints define an upper limit to the precision of magnetic resonance (MR) scanners, the primary index of neuronal activity, hemodynamic response, can be efficiently estimated. Characteristics of the experimental environment, the hypothesis of interest, and the physiology of the cognitive process under investigation provide guidance for the design and limit available options. The processing of functional data to remove unwanted variability is briefly described as are the techniques used to estimate statistical effects and control for the rate of false positives in the results. A detailed applied example of nursing research is included to demonstrate the practical application of the theory, methods, and techniques being discussed. A glossary of key terms is also provided.