Hungry rats were trained to press a lever for food pellets prior to an assessment of the effect of a shift in their motivational state on instrumental performance in extinction. The first study replicated the finding that a reduction in the level of food deprivation has no detectable effect on extinction performance unless the animals receive prior experience with the food pellets in the nondeprived state (Balleine, 1992;. When tested in the nondeprived state, only animals that were reexposed to the food pellets in this state between training and testing showed a reduction in the level of pressing during the extinction test relative to animals tested in the deprived state. The magnitude of this reexposure effect depended, however, on the amount of instrumental training. Following more extended instrumental training, extinction performance was unaffected by reexposure to the food pellets in the nondeprived state whether or not the animals were food deprived at the time of testing. A second study demonstrated that the resistance to the reexposure treatment engendered by overtraining was due to the animals' increased experience of the food pellets in the deprived state during training rather than to the more extensive exposure to the instrumental contingency. In contrast to the results of the first two experiments, however, a reliable reexposure effect was detected after overtraining in a fmal study, in which the animals were given greater reexposure to the food pellets in the nondeprived state.

SummaryIt is paramount that any child or adolescent with a suspected disorder of sex development (DSD) is assessed by an experienced clinician with adequate knowledge about the range of conditions associated with DSD. If there is any doubt, the case should be discussed with the regional DSD team. In most cases, particularly in the case of the newborn, the paediatric endocrinologist within the regional team acts commonly as the first point of contact. This clinician should be part of a multidisciplinary team experienced in management of DSD and should ensure that the affected person and parents have access to specialist psychological support and that their information needs are comprehensively addressed. The underlying pathophysiology of DSD and the strengths and weaknesses of the tests that can be performed should be discussed with the parents and affected young person and tests undertaken in a timely fashion. Finally, in the field of rare conditions, it is imperative that the clinician shares the experience with others through national and international clinical and research collaboration.

Novel assays were used to assess inter alia whether the hippocampus is involved in detecting novelty per se or in an associative mismatch process. During training, rats received two audiovisual sequences (tone-left constant light and click-left flashing light). In both sham-operated control rats and those with excitotoxic hippocampal lesions, novel visual targets provoked an orienting response that habituated during training. Moreover, like sham-operated rats, rats with hippocampal lesions acquired associations between the elements of two audiovisual sequences. However, subsequent test trials in which the auditory stimuli preceding the visual targets were switched (click-left constant light and tone-left flashing light) provoked renewed orienting to the visual targets in sham-operated rats but not in hippocampal rats. These results support the view that hippocampal damage results in a failure to detect (or act on) mismatches that are generated when an auditory stimulus associatively evokes the memory of one visual stimulus and a different (familiar) visual stimulus is present in the environment.

No abstract

It is paramount that any child or adolescent with a suspected disorder of sex development (DSD) is assessed by an experienced clinician with adequate knowledge about the range of conditions associated with DSD. If there is any doubt, the case should be discussed with the regional team. In most cases, particularly in the case of the newborn, the paediatric endocrinologist within the regional DSD team acts as the first point of contact. The underlying pathophysiology of DSD and the strengths and weaknesses of the tests that can be performed should be discussed with the parents and affected young person and tests undertaken in a timely fashion. This clinician should be part of a multidisciplinary team experienced in management of DSD and should ensure that the affected person and parents are as fully informed as possible and have access to specialist psychological support. Finally, in the field of rare conditions, it is imperative that the clinician shares the experience with others through national and international clinical and research collaboration.