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Knowledge and attitudes of schoolteachers toward oral health programs and preventive dentistry.

Because teachers often take on major roles in school dental health programs, three surveys were completed between 1973 and 1981 to measure teachers' attitudes and knowledge about oral health and their own participation in school programs. The questionnaires were sent to teachers whose schools were included in major dental caries preventive programs and teachers whose schools were not included in such programs. Results showed that: Teachers were quite willing to teach oral health topics and were willing to take on a wide range of teaching, but not administrative, responsibilities. Teachers' acceptance of these responsibilities appeared to decrease during the surveys, possibly as a function of school budget difficulties, indicating a need for incentives and positive rein-forcement. However, their acceptance of responsibilities was not affected by their participation in preventive programs. Schoolteachers had basic misinformation about the purposes of personal oral hygiene, and about the relative effectiveness of measures such as oral hygiene and consumption of fluoridated water in preventing dental caries. The preventive knowledge of teachers was unaffected by either the passage of time or participation in school preventive programs. A series of recommendations is given for the inservice education of school-teachers.

Attitude to Health↗

Long-term follow-up of children with bacterial meningitis with emphasis on behavioural characteristics.

UNLABELLED: The sequelae and behaviour in children several years after an episode of bacterial meningitis were studied. All children in Sweden aged 0-4 years with bacterial meningitis between 1987 and 1989 caused by Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis were identified. After exclusion of 16 children who died, 12 with severe concomitant diseases, ten with severe neurological damage obvious already at discharge from hospital and 34 with unknown address, questionnaires were sent to the parents of the remaining 463 children The nearest-age siblings were used as a comparison group. The questionnaires included questions concerning general health, schooling, motor function, speech, hearing and behaviour (inattention, hyperactivity and impulsiveness). The children were 6-14 years old when the questionnaires were completed. Questionnaires were completed for 304 pairs of patients and siblings and for 154 patients without siblings. The majority of post-meningitic children were healthy and attended normal school but they had more hearing impairment, headaches and problems with balance than their siblings. When the distributions of answers regarding behaviour were compared, the post-meningitic children had significantly more symptoms in the fields of inattention, hyperactivity and impulsiveness than their siblings. CONCLUSION: Except for hearing impairment, severe sequelae after bacterial meningitis which are not discovered at discharge do not appear later. Children who appear well after bacterial meningitis have more non-specific symptoms like headache, and more signs and symptoms indicating inattention, hyperactivity and impulsiveness than their siblings.

Child Behavior Disorders↗

Family functioning and psychological well-being, school adjustment, and problem behavior in chinese adolescents with and without economic disadvantage.

Using an indigenously developed measure of family functioning, the author examined the association between family functioning and adolescent adjustment in 1,519 Chinese adolescents. Results showed that family functioning was significantly related to measures of adolescent psychological well-being (existential well-being, life satisfaction, self-esteem, sense of mastery, general psychiatric morbidity), school adjustment (perceived academic performance, satisfaction with academic performance, and school conduct), and problem behavior (delinquent and substance abuse behavior). Family functioning was generally more strongly related to measures of adolescent adjustment for adolescents with economic disadvantage than for adolescents without economic disadvantage.

Achievement↗

School-age outcomes in children with birth weights under 750 g.

BACKGROUND: Since the mid-1980s, increasing numbers of children with birth weights under 750 g have survived to school age. METHODS: We matched a regional cohort of 68 surviving children born from 1982 through 1986 with birth weights under 750 g (mean, 670 g; gestational age, 25.7 weeks) with 65 children weighting 750 to 1499 g at birth and 61 children born at term. Growth, neurosensory status, and functioning at school age in the three groups were compared. Associations of biologic and social risk factors with major developmental outcomes were examined by means of logistic-regression analyses. RESULTS: Children with birth weights under 750 g were inferior to both comparison groups in cognitive ability, psychomotor skills, and academic achievement. They had poorer social skills and adaptive behavior and more behavioral and attention problems. The mean (+/- SD) Mental Processing Composite score for the cohort was 87 +/- 15, as compared with 93 +/- 14 for children with birth weights of 750 to 1499 g and 100 +/- 13 for children born at term (P < 0.001). The rates of mental retardation (IQ < 70) in the three groups were 21, 8, and 2 percent, respectively; the rates of cerebral palsy were 9, 6, and 0 percent; and the rates of severe visual disability were 25, 5, and 2 percent. Major cerebral ultrasonographic abnormalities were associated with mental retardation (odds ratio, 5.4; 95 percent confidence interval, 1.8 to 15.8) and cerebral palsy (odds ratio, 15.2; 95 percent confidence interval, 3.0 to 77.4). Oxygen dependence at 36 weeks was associated with mental retardation (odds ratio, 4.5; 95 percent confidence interval, 1.2 to 10.7) and severe visual disability (odds ratio, 4.3; 95 percent confidence interval, 1.3 to 14.2). Social disadvantage, though associated with several neuropsychological outcomes, was not associated with major developmental impairment. CONCLUSIONS: Children with birth weights under 750 g who survive represent a subgroup of very-low-birth-weight children who are at high risk for neurobehavioral dysfunction and poor school performance.

Adaptation, Physiological↗

New library building: Mercer University School of Medicine, Macon, Georgia.

The Mercer University School of Medicine (MUSM) enrolled its charter class in 1982. The curriculum is problem-based and adaptable to the learning needs of each student. MUSM is housed in a new building designed to support this unique educational program. Its library is an example of a comparatively small, but fully functional, medical school library. The planning process, design, and layout of the new library facility are described. Among its unique features are an integrated print and non-print collection, current periodical display space, and extensive use of task lighting.

Facility Design and Construction↗

Rehabilitation of low back pain patients. A review.

Numerous methods have been developed for the rehabilitation of low back pain patients, including spinal flexion and extension exercises, lumbar spine locking in an intermediate position, enhancement of spinal and pelvic proprioceptive sensibility, swimming pool therapy, back schools, and functional restoration. Each seeks to achieve a goal assumed to be central to the prevention of a first or recurrent episode of low back pain. Goals include short-term pain relief, an improved ability to achieve self-sedation, abdominal and lumbar muscle strengthening, increased hip and lumbar spine mobility, improved lumbar and pelvic proprioceptive sensibility, intervertebral joint stabilization, lumbar posture modification and improved general fitness. Less than 30 studies meeting widely accepted validity and applicability criteria for therapeutic trials have addressed the clinical efficacy of rehabilitation in low back pain patients. Most studies of the back school approach have found no benefit. Spinal flexion and extension exercise programs have yielded short-lived improvements, with no differences across methods. There is evidence that functional restoration programs based on graded activity may provide long-term benefits including better social and occupational outcomes. We have evaluated the physical therapy methods most commonly taught to and used by physical therapists in France.

Back Pain↗

Schools' capacity to help low-income, minority children to manage asthma.

This article describes the challenges and strengths of asthma management in 14 low-income, predominantly African American urban elementary schools serving more than 5,000 students. Asthma prevalence was 24.5%. Teachers, school principals, parents, and children described how asthma was managed at school. Data from classmates of students with asthma showed that they had moderate to high levels of information about the disease. Data from teachers indicated the great need for practical instruction on how they might effectively support a child with asthma in the classroom and on the playground. Principals raised concerns about expectations for the functioning of school staff and implementation of school policies especially related to asthma emergencies. Parents reported a range of problems their children face at school. Data from children with asthma showed that 75% believed asthma affected their school work. Findings from this study should be useful to school personnel, health providers, and others who assist children and their families to manage asthma at school. Data suggest that making school nursing services available is warranted, given the impact of asthma on the school community.

Administrative Personnel↗

Health of the Nation targets: where school nurses find constraints on achievement.

A qualitative research methodology was used to investigate 73 school nurses' perceptions of their contributions towards Health of the Nation targets (1). The inquiry aimed to identify areas in which the school nurses felt that educational assistance was required. The study demonstrated that school nurses function well and have an enormous potential to affect positively the health of the nation's children. Four main areas of constraint, however, were identified by the nurses. These areas, pinpointed as the major obstacles for target achievement, are education, joint planning, resources and perceived value. The author highlights recommendations for the future role of the school nurse.

Attitude of Health Personnel↗

The relationship between dental aesthetic index (DAI) and perceptions of aesthetics, function and speech amongst secondary school children in Ibadan, Nigeria.

OBJECTIVE: The purpose of the study was to investigate the relationship between a professionally derived index, the Dental Aesthetic Index, and some indications for orthodontic treatment as perceived by potential patients. METHODS: An epidemiological survey of 614 secondary school students, 327 males (53.3%) and 287 females (46.7%) was carried out in Ibadan, Nigeria. Children aged 12-18 years (mean age, 14.9+/-2.9 SD) were randomly selected, none of them had received previous orthodontic treatment. One examiner assessed the students using the Dental Aesthetic Index (DAI). Subjects were also asked to complete a questionnaire consisting of three questions concerning appearance, function, and speech, using a 5-point Likert scale. RESULTS: Weak but statistically significant correlations were found for subjective assessments of appearance of teeth and the DAI (r=0.174; P<0.01) and between biting/chewing and appearance of teeth (r=0.095; P<0.05). Statistically significant correlations were found between appearance of teeth and speech (r=0.148; P<0.01) and biting/chewing and speech. The last showed the strongest correlation (r=0.268; P<0.01). CONCLUSION: The study has shown weak but significant correlation between DAI and children's perceptions of the appearance of their teeth. We recommend further study involving both DAI and Index of Orthodontic Treatment Need (IOTN) for comparison in the Nigerian population.

Adolescent↗

Parental and school correlates of binge drinking among middle school students.

OBJECTIVES: We examined the prevalence and dynamics of binge drinking among middle school students. METHODS: We analyzed data from the National Longitudinal Study of Adolescent Health. The sample was composed of approximately 5300 seventh-and eighth-grade students who were interviewed at 2 points in time. RESULTS: Approximately 8% of seventh graders and 17% of eighth graders reported engaging in binge drinking during the past 12 months. These rates varied as a function of school characteristics. Low scores on the parenting variables-communication quality, use of reasoning, and control and supervision-and binge drinking during middle school also were predictive of binge drinking during high school. CONCLUSIONS: Binge drinking among middle school students is an important phenomenon that for many students forecasts future binge drinking during high school.

Adolescent↗

[Depression in children and adolescents].

The prevalence of major depression in preschool is less than 1 procent, in school-age children about 2 percent, and in adolescents about 4.7 percent. While as no significant sex differences have been reported among preadolescents, studies of adolescents have reported 2 to 3 times higher rates of depression. The most frequent course of depression is chronic and persistent, the mean length of depressive episode being 30 weeks. Depressed children and adolescents have impaired psychosocial functioning and school problems. Relapse occurs at a high frequency for depressed patients. The high recurrence of depression in children and adolescents calls for a long-term management in these age-groups.

Adolescent↗

The relation between third graders' after-school care and social, academic, and emotional functioning.

Outcome differences associated with types of after-school care were explored among 150 white, predominantly middle-class third graders from a suburban school system. Children returned home to their mothers, attended day-care centers, stayed with sitters, or returned home alone or with siblings. No differences were found between latchkey and mother-care children in terms of their classroom sociometric nominations, academic grades, standardized test scores, conduct grades, self-reports of self-competence, or parent and teacher ratings of the children. Significant differences were found for children who attended day-care centers after school. These children received more negative peer nominations, made lower academic grades, and had lower standardized test scores than either mother-care or latchkey children. The children who stayed with sitters after school received more negative peer nominations than the latchkey and mother-care children but, in other areas, resembled these groups. These outcome differences were apparent in both divorced and intact families. Factors contributing to these differences are examined.

Achievement↗

Identification and impact of risk and protective factors for drug use among urban African American adolescents.

Identified 10 risk and 12 protective factors associated with drug use among African American 8th graders (N = 994) in an urban school system. Regression analyses identified 7 risk and 7 protective factors with minimal overlap. The total number of risk factors was significantly related to the prevalence of use for cigarettes, beer or wine, liquor, marijuana, and a composite measure of drug use. The Protective Factor Index (PFI) was a significant moderator of the relation between risk and use of beer or wine, liquor, marijuana, and the composite measure. Longitudinal analyses of data on 650 students across the transition from middle to high school indicated that the sum of risk factors predicted changes in all drug use categories except the composite. The PFI significantly predicted changes in beer or wine, liquor, and composite drug use over this 1-year period. It also moderated risk for cigarette use, but not for other drugs. Results replicated prior studies and highlighted the importance of protective factors such as adaptive functioning in school and family influences.

Adolescent↗

Neuropsychological differences between juvenile delinquents and functional adolescents: a preliminary study.

This study examines the neuropsychological differences between juvenile delinquents and functional high school adolescents by means of the Bender-Gestalt test and the Luria Neuropsychological Investigation. Forty-one subjects were examined, twenty-eight delinquent subjects (15 female, 13 male, mean age 15.5 years) and thirteen control subjects (8 female, 5 male, mean age 15 years). Of the nine subtests in the Luria Battery, eight were found statistically significant, with cutaneous and kinesthetic functions being the only subtest which did not prove significant (greater than .025). Overall t analysis between the groups displayed significance at the .01 level. As was expected the delinquent group performed significantly higher on those functions requiring complex problem-solving and language abilities. On the Bender-Gestalt test of visio-motor abilities group, significance was displayed at the .05 level.

Adolescent↗

Evolving collective behavior in an artificial ecology.

Collective behavior refers to coordinated group motion, common to many animals. The dynamics of a group can be seen as a distributed model, each "animal" applying the same rule set. This study investigates the use of evolved sensory controllers to produce schooling behavior. A set of artificial creatures "live" in an artificial world with hazards and food. Each creature has a simple artificial neural network brain that controls movement in different situations. A chromosome encodes the network structure and weights, which may be combined using artificial evolution with another chromosome, if a creature should choose to mate. Prey and predators coevolve without an explicit fitness function for schooling to produce sophisticated, nondeterministic, behavior. The work highlights the role of species' physiology in understanding behavior and the role of the environment in encouraging the development of sensory systems.

Animals↗

Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: clinical outcomes.

OBJECTIVE: The primary purpose of this study was to determine whether multisystemic therapy (MST), modified for use with youths presenting psychiatric emergencies, can serve as a clinically viable alternative to inpatient psychiatric hospitalization. METHOD: One hundred sixteen children and adolescents approved for emergency psychiatric hospitalization were randomly assigned to home-based MST or inpatient hospitalization. Assessments examining symptomatology, antisocial behavior, self-esteem, family relations, peer relations, school attendance, and consumer satisfaction were conducted at 3 times: within 24 hours of recruitment into the project, shortly after the hospitalized youth was released from the hospital (1-2 weeks after recruitment), and at the completion of MST home-based services (average of 4 months postrecruitment). RESULTS: MST was more effective than emergency hospitalization at decreasing youths' externalizing symptoms and improving their family functioning and school attendance. Hospitalization was more effective than MST at improving youths' self-esteem. Consumer satisfaction scores were higher in the MST condition. CONCLUSIONS: The findings support the view that an intensive, well-specified, and empirically supported treatment model, with judicious access to placement, can effectively serve as a family- and community-based alternative to the emergency psychiatric hospitalization of children and adolescents.

Activities of Daily Living↗

Glenohumeral joint laxity and stiffness in the functional throwing position of high school baseball pitchers.

CONTEXT: Repetitive overhead throwing has been theorized to result in chronic adaptations to the capsuloligamentous restraints of the glenohumeral joint. OBJECTIVE: To compare glenohumeral joint laxity and stiffness between the throwing and nonthrowing shoulders of high school baseball pitchers. DESIGN: Repeated measures. SETTING: High school athletic training facilities. PATIENTS OR OTHER PARTICIPANTS: Twenty-two asymptomatic high school baseball pitchers (age = 16.50 +/- 0.74 years, height = 178.51 +/- 7.66 cm, mass = 75.43 +/- 13.24 kg) from a sample of convenience. MAIN OUTCOMES MEASURE(S): We used computerized stress arthrometry to measure glenohumeral joint laxity and stiffness. Anterior glenohumeral joint laxity and stiffness measures were obtained with the shoulder in 90 degrees of abduction and both neutral rotation and 90 degrees of external rotation. Posterior laxity and stiffness measures were obtained with the shoulder in 90 degrees of abduction and neutral rotation. RESULTS: No clinically significant differences were found for glenohumeral laxity or stiffness between sides. However, a statistically significant main effect for position was present for both laxity and stiffness. Anterior glenohumeral joint laxity in the 90 degrees external rotation position was significantly decreased and stiffness was increased in this position compared with the anterior at neutral and posterior at neutral positions. CONCLUSIONS: Glenohumeral joint laxity decreases and stiffness increases in the functional throwing position of 90 degrees of abduction and 90 degrees of external rotation. No clinically significant side-to-side differences or directional differences were found in high school baseball pitchers.

Journal Article↗

Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources.

OBJECTIVE: The scientific literature about attention-deficit hyperactivity disorder (ADHD) is based almost exclusively on male subjects, and girls with ADHD may be underidentified and undertreated. The aim of this study was to examine clinical correlates of ADHD in females using comprehensive assessments in multiple domains of functioning. METHOD: Subjects were 140 girls with ADHD and 122 comparison girls without ADHD ascertained from pediatric and psychiatric referral sources of the same age and social class. Subjects were assessed with structured diagnostic interviews, psychometric tests assessing intellectual functioning and academic achievement, as well as standardized assessments of interpersonal, school, and family functioning by raters who were blind to clinical diagnosis. RESULTS: Compared with female controls, girls with ADHD were more likely to have conduct, mood, and anxiety disorders; lower IQ and achievement scores; and more impairment on measures of social, school, and family functioning. CONCLUSIONS: These results extend to girls previous findings in boys indicating that ADHD is characterized by prototypical core symptoms of the disorder, high levels of comorbid psychopathology, and dysfunction in multiple domains. These results not only support findings documenting phenotypic similarities between the genders but also stress the severity of the disorder in females.

Adolescent↗