Robert B. Williams

Excited delirium: Consideration of selected medical and psychiatric issues

Excited delirium, sometimes referred to as agitated or excited delirium, is the label assigned to the state of acute behavioral disinhibition manifested in a cluster of behaviors that may include bizarreness, aggressiveness, agitation, ranting, hyperactivity, paranoia, panic, violence, public disturbance, surprising physical strength, profuse sweating due to hyperthermia, respiratory arrest, and death. Excited delirium is reported to result from substance intoxication, psychiatric illness, alcohol withdrawal, head trauma, or a combination of these. This communication reviews the history of the origins of excited delirium, selected research related to its causes, symptoms, management, and the links noted between it and selected medical and psychiatric conditions. Excited delirium involves behavioral and physical symptoms that are also observed in medical and psychiatric conditions such as rhabdomyolysis, neuroleptic malignant syndrome, and catatonia. A useful contribution of this communication is that it links the state of excited delirium to conditions for which there are known and effective medical and psychiatric interventions.

REFLECTIONS ON ANONYMITY

Experiences of anonymity and the trends of a brief survey of research findings are discussed. It is proposed that notions and experiences of anonymity ought to be thought, taught and written about much more than they are at present.

Testing for Number Readiness: Application of the Piagetian Theory of the Child's Development of the Concept of Number

AbstractPiaget’s 3-stage theory of the child’s attainment of the concept of number was applied as a number readiness criterion to ninety-six kindergarten children. Two children were found to be at the initial stage of number development, eighty-six at the intermediate stage, and eight at the stage of attainment of number concept which is inclusive of operational ability. Results were applied to mathematics curriculum goals on the kindergarten level. Curriculum goals for mathematics on this level should not include operations (addition, subtraction). Socialization to number symbols may be established as a goal at this level, but it has nothing to do with the concept of number and does not appear to enhance attainment of the concept of number.

Observing the preservation and decline of abilities in dementias.

The Brief Cognitive Rating Scale facilitated observation of the preservation and decline of abilities due to dementias among 73 female and 52 male residents at nursing homes in a northeastern and southwestern state. They ranged in age from 41 to 102 years (M = 78, SD=10.5). Dementia diagnoses included presenile Alzheimers, senile Alzheimers, Vascular Dementia, Dementia secondary to Huntingtons Disease, Dementia due to Picks Disease, and Korsakoff Dementia secondary to chronic alcoholism. Their ratings on tasks of the scale were submitted to an order analysis procedure to explore the order of decline and preservation of abilities. Results for these nursing home residents show an apparent order: loss singly or concurrently of the abilities of concentration and recent memory, followed by past memory and functioning and self-care that also appeared to be unpredictably lost or preserved singly or concurrently by different individuals, and, finally, by orientation that was preserved in 82% of the subjects.

Adaptive estimation of single response evoked potentials.

A new adaptive filtering algorithm and structure is developed to estimate response-to-response variations in evoked responses. The evoked responses are modeled as the sum of three uncorrelated signal components: ensemble average, noise, and stochastic signal variation. A two stage time sequenced filter structure exhibiting improved convergence characteristics is developed along with a modified P-vector algorithm (mPa) which eliminates the need for a separate desired signal electrode. The mPa adaptive filter is tested with simulated and human EP data. The mPa filter is able to estimate signal variations from one response to the next.

RELATIONS AMONG TASKS ASSESSING YOUNG CHILDREN'S NUMBER CONCEPTS

Order analysis of responses by kindergarteners and first-graders did not support a linear order of task mastery as predicted by Brainerds ordinal theory of number development. A more complex structure of the relations among the tasks was noted with magnitude-same-density ordering a prerequisite to ordination and number, and both of these as prerequisites to cardination.