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Immunoglobulin levels and function in pre-school children with recurrent respiratory infections.

Thirty pre-school children with recurrent respiratory infections had a higher age adjusted mean serum IgG level than their siblings or a reference group. One index child had persistently low serum IgA, but mean serum IgA and IgM levels for the index children were normal. All of the 23 index children and 17 siblings studied had a four-fold or greater rise in virus neutralizing antibody titre. There was no correlation between serum immunoglobulin levels and frequency of infections. There was, however, a significant inverse correlation between salivary IgA levels when healthy and the number of infections experienced by each child in the study year. Salivary IgA levels rose considerably during acute infections.

Child↗

Pre-competition anxiety and performance in female high school swimmers: a test of optimal function theory.

This investigation attempted to test Hanin's theory of optimal function in 15 female high school swimmers. Each swimmer completed the State Anxiety Inventory (STAI) and the Body Awareness Scale (BAS) under the following conditions: I) baseline; II) retrospective recall of "best", "usual", and "worst" performances; III) 24 h prior to an easy and difficult dual meet with instructions to respond as to "how you think you will feel 1 h before the meet"; and IV) 1 h before the meets utilizing the standard ("right now") instructional set. Success was determined in each meet by two methods: 1) objective ratings based on comparisons with the average of times from previous meets; and 2) subjective ratings of performance made by the coach. In the difficult meet significant (P less than 0.01) increases in precompetition anxiety and body awareness occurred, and the correlations between predicted and actual pre-competition were .95 (P less than 0.001) for both anxiety and body awareness. In the difficult meet swimmers subjectively classified as successful were more accurate (P less than 0.05) in predicting precompetition anxiety, and possessed pre-competition anxiety values that were closer to their recall of optimal pre-competition anxiety compared to the unsuccessful swimmers. No comparisons based on the objective classifications were significant, nor were any of the comparisons in the easy meet. The present findings support Hanin's optimal function theory.

Adolescent↗

Factors affecting the reliability of clinical judgments about the function of children's school-refusal behavior.

Conducted two studies to examine the interrater reliability, test-retest stability, and the effect of various clinician variables, such as years of clinical experience, theoretical orientation, and prior experience with children, on clinical judgments about the reinforcement functions of children's school-refusal behavior. Results indicated that the judgments by individual clinicians were of questionable reliability. Judgments aggregated across 3 clinicians yielded acceptable interrater and test-retest reliability in Study 1, but a greater number of clinicians were necessary to achieve acceptable reliability in Study 2. Years of clinical experience and training were the only clinician variables related to the reliability of judgments about reinforcement functions. Several recommendations for the clinical assessment of the function of children's school-refusal behavior are discussed.

Adolescent↗

Suicidal adolescents: factors in evaluation.

Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.

Adolescent↗

High, usual and impaired functioning in community-dwelling older men and women: findings from the MacArthur Foundation Research Network on Successful Aging.

The objective of this study is to determine the range of complex physical and cognitive abilities of older men and women functioning at high, medium and impaired ranges and to determine the psychosocial and physiological conditions that discriminate those in the high functioning group from those functioning at middle or impaired ranges. The subjects for this study were drawn from men and women aged 70-79 from 3 Established Populations for the Epidemiologic Study of the Elderly (EPESE) programs in East Boston MA, New Haven CT, and Durham County NC screened on the basis of criteria of physical and cognitive function. In 1988, 4030 men and women were screened as part of their annual EPESE interview. 1192 men and women met criteria for "high functioning". Age and sex-matched subjects were selected to represent the medium (n = 80) and low (n = 82) functioning groups. Physical and cognitive functioning was assessed from performance-based examinations and self-reported abilities. Physical function measures focused on balance, gait, and upper body strength. Cognitive exams assessed memory, language, abstraction, and praxis. Significant differences for every performance-based examination of physical and cognitive function were observed across functioning groups. Low functioning subjects were almost 3 times as likely to have an income of < or = $5000 compared to the high functioning group. They were less likely to have completed high school. High functioning subjects smoked cigarettes less and exercised more than others. They had higher levels of DHEA-S and peak expiratory flow rate. High functioning elders were more likely to engage in volunteer activities and score higher on scales of self-efficacy, mastery and report fewer psychiatric symptoms.

Activities of Daily Living↗

Return to school as an outcome measure after a burn injury.

Outcome measures have become an important tool to assist with monitoring the efficacy of burn care. One such measurement for children is the time required for them to return to school, as well as their behavior and academic performance in school after a burn injury. The purpose of this study was to relate demographic data with return-to-school time and school performance. Through medical record review and interviews with patients, parents, and school teachers, information was obtained regarding the patient's burn injury, as well as home and school status before and after the burn injury. School information before the burn injury was obtained after patient admission. Schools were contacted 6 months after hospital discharge for data after the burn injury. Thirty-four patients aged 6 to 16 years had their outcomes evaluated from September 1993 to June 1995. Average total body surface area burned was 25.9%; the mean area of full-thickness burn was 17.5%. Length of stay averaged 30.8 days. Sixty-five percent of patients were discharged with splints, and all were discharged with a pressure program. Children returned to school an average of 7.4 days after discharge, and the average number of missed school days was 22. Thirty-four percent of the children had a school reentry visit, and either a phone call, written material, or both were provided in lieu of a visit to the other schools. For this population, burn injury did not appear to impact outcome negatively as it related to a child's return or function in school. These children returned to school rather rapidly after discharge and functioned as well or better after injury. Little loss of grade was noted, and only those children with problems in school before the burn injury had problems after the burn injury. Contact with the child's school before reentry might have assisted with the smooth transition.

Adolescent↗