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PubMed2003

Long-term follow-up and outcome of extremely-low-birth-weight (ELBW) infants.

INTRODUCTION: Modern day obstetric and neonatal care has dramatically increased the survival of the extremely-low-birth-weight (ELBW) neonates. As the limits of viability decrease, it is of paramount importance to have reliable data on long-term morbidity. Long-term follow-up of these high-risk survivors is thus becoming an integral part of neonatal intensive care units. METHODS: Detailed Medline search and review of leading journal articles were done to assess the current data on long-term outcome of ELBW infants. RESULTS: The developmental outcome of the ELBW infant is determined by a complex interaction of medical and environmental factors acting on a developmentally vulnerable premature brain. In early childhood, 13% to 37% of ELBW survivors have a significant delay in cognitive function while 7% to 17% have neurosensory impairment viz. cerebral palsy. Advances have been made in measuring functional outcome to assess the impact of ELBW births on long-term quality of life and skills for independent living. Measuring school age outcome is an important landmark in the longitudinal follow-up of ELBW infants and most reports show high rates of cognitive impairment as well as increased incidence of learning disability and school difficulties as well as behavioural problems. The ELBW adolescent and young adult continue to lag behind in academic achievement and cognitive score. However, more than half of the ELBW survivors function within the normal range of variability and their self-reported quality of life in adolescence continues to be comparable to that of their peers. CONCLUSION: In managing ELBW infants, a holistic, systematic approach is needed to assess the degree and impact of impairment on their daily function and issues related to quality of life.

Activities of Daily Living↗
PubMed2002

Islet yield remains a problem in islet autotransplantation.

For patients with chronic pancreatitis whose pain is inadequately controlled with opiate analgesia, surgical resection offers a good chance of symptomatic relief. However, the inevitable sequela is type 1 diabetes mellitus and its attendant long-term complications. Islet cell autotransplantation offers a theoretical "cure" for this iatrogenic diabetes but this end point has not been produced consistently in clinical practice. The main factor determining the likelihood of insulin independence after islet autotransplantation is the islet mass that is transplanted. This review examines the factors that affect the functional islet mass available for transplantation. Original articles and reviews from peer-reviewed journals were analyzed following a computer search of the MEDLINE database from 1966 to the present, we extracted mainly level 2 and level 3 data. Although improvements in collagenase consistency and purification techniques and reductions in cold ischemic times have all been shown to improve islet yield, there is still the need to optimize every stage in the islet isolation process. Increasing the proportion of potential islets in the final isolate is of particular importance in chronic pancreatitis because the total mass of islets initially available in the gland might be just sufficient to produce insulin independence after islet autotransplantation. We believe that reducing the warm ischemic time might significantly increase the likelihood of insulin independence after islet autotransplantation.

Chronic Disease↗
PubMed2004

The Strengths and Difficulties Self-Report Questionnaire as a screening instrument in Norwegian community samples.

This study reports on the application of the Norwegian self-report version of the Strengths and Difficulties Questionnaire (SDQ-S). The application of the SDQ-S was not motivated by a wish to reveal the prevalence of psychiatric disorders, but rather to set the stage for routine screening as part of schools' efforts to inform themselves about the life of adolescents at school. The survey included 4167 young people aged 11 to 16 years, attending 66 primary and secondary schools in Northern Norway. The respondents comprised 80.2% of the total population in these grades in the target area. Structural analysis of the instrument, including confirmatory factor analysis, internal consistency and intra- and cross-scale correlations revealed somewhat variable psychometric properties. Model modification suggested several ways of improving the structural psychometric properties of the SDQ-S. Norwegian cut-off points were similar to those found in other Scandinavian studies. About one third of the subjects reported at least minor perceived difficulties, while about 5% reported definite or severe difficulties. These difficulties were strongly associated with all symptom scales. Girls reported a significantly higher level of emotional problems and better prosocial functioning. Boys reported significantly higher scores on the externalising scales and on peer problems. The SDQ-S may be judged as an efficient and economical screening instrument for preventive research on large community samples. However, efforts should be made to improve its psychometric structure.

Adolescent↗
PubMed1994

Factors influencing self-esteem and self-consciousness in adolescents with spina bifida.

PURPOSE: To identify the demographic, personal, familial, attitudinal, and social factors that influence the self-esteem of adolescents with spina bifida. METHODS: A structured face-to-face interview, that included the Rosenberg Self-Esteem Inventory, was conducted with 107 adolescents with spina bifida. Discriminant analyses were performed to identify the factors that discriminate between adolescents with spina bifida who have low vs. high self-esteem and low vs. high self-consciousness. The discriminant functions included variables from the following domains: sociodemographics, personal biography, family interaction, peer relationships and activities, school and work experiences, attitudes toward spina bifida, sexuality and sexual education, and future aspirations. RESULTS: The factors contributing most positively to adolescents' self-esteem were age-appropriate treatments by parents and parental permissiveness in social participation, as perceived by the adolescents. Factors negatively associated with self-esteem included school problems, a perception of disability by others, and living in a medium-sized town (i.e., population 10,000-49,999). The discriminant models correctly identified 57.8% of adolescents who had low self-esteem and 50.4% of those with high self-consciousness, and accurately classified 92.6% and 88.4% of those who had high self-esteem and low self-consciousness, respectively. CONCLUSION: Parents' relationships with their adolescents have important associations with the self-image of the youth.

Adolescent↗
PubMed2004

Plantar- and dorsiflexor strength in prepubertal girls with juvenile idiopathic arthritis.

OBJECTIVE: To compare lower-leg strength of young girls with polyarticular juvenile idiopathic arthritis (JIA) with that of healthy, age-matched controls. DESIGN: Isometric and isokinetic strength tests of the plantar- and dorsiflexors. All strength measures were made at an ankle angle of 90 degrees. Isokinetic plantar- and dorsiflexor measures were made at 15 degrees/s during shortening (concentric) and lengthening (eccentric) actions. SETTING: Strength testing laboratory. PARTICIPANTS: Ten prepubertal girls diagnosed with JIA and 10 healthy girls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Isometric and isokinetic plantar- and dorsiflexor strength. RESULTS: Isometric plantar- and dorsiflexion torques were significantly lower (48% and 38% respectively; P<.05) for the children with JIA than for the controls. The JIA group also produced lower shortening plantarflexion torques (52%, P<.05). Lengthening plantarflexor torques did not differ significantly between the 2 groups (P<.05). Controls were stronger than the JIA group for both shortening and lengthening maximal dorsiflexor actions (P<.05). All children were 4 to 5 times stronger in plantarflexion than in dorsiflexion. CONCLUSIONS: Girls with JIA had significantly less plantar- and dorsiflexor strength than age-matched, healthy peers. The reduced strength of children with JIA is likely to affect function in daily activities and probably contributes to reduced levels of physical activity.

Activities of Daily Living↗
PubMed2004

Peer support. An under-recognized resource in cardiac recovery.

BACKGROUND: Cardiovascular disease remains the leading cause of mortality and premature death in western societies. Thus, rates of interventions such as coronary artery bypass surgery are continuing to grow. Health care reform and initiatives to reduce health care expenditures have resulted in early patient discharge from hospital following cardiac surgery. With subsequent cutbacks in nursing support and community-based care, patients are leaving hospital less prepared and supported to deal with the changes that occur during the first weeks of recovery. AIMS: To examine the theoretical assumptions that support the contention that peer support is an under-utilized resource for patients who are recovering from cardiac surgery and the challenges to evaluating peer support interventions. METHODS: A review of current literature, which focuses on cardiac surgery recovery, transitions, social support, and peer support interventions. RESULTS: Peer support (lay assistance from individuals who possess experiential knowledge and similar characteristics), a form of social support, is a viable and potentially sustainable mechanism to put in place during transitional life events such as recovery from cardiac surgery. CONCLUSIONS: Further investigation is needed of peer support interventions for cardiac surgery patients. Specifically, investigations of the influence of peer support interventions on recovery and health outcomes are necessary in this patient population. Yet, challenges exist to undertaking well-designed investigations of social interventions such as peer support.

Aftercare↗
PubMed2006

Factors associated with depressive symptoms in Nigerian adolescents.

PURPOSE: To evaluate the factors associated with depressive symptoms in a sample of Nigerian 13-18-year-olds attending senior secondary schools. METHOD: Adolescents aged 13 to 18 years (n = 1095) attending senior secondary schools completed the Beck Depressive Inventory (BDI) as a measure of their depressive symptoms. The adolescents and their parents also completed various questionnaires regarding related demographic, psychosocial and family factors. RESULTS: There were 99 (9.0%) adolescents with clinically significant depressive symptoms. The factors significantly associated with adolescents' depressive symptoms include parental depressive symptoms (odds ratio [OR] 5.21, 95% confidence interval [CI] 3.48-7.81), adolescents' perception of family functioning as poor (OR 6.79, 95% CI 3.46-12.23), adolescents' problems with peers (OR 4.69, 95% CI 3.06-7.19), adolescents' low self-esteem (OR 6.63, 95% CI 2.59-16.96), adolescents' drinking (OR 3.98, 95% CI 2.37-6.69), female gender (OR 1.74, 95% CI 1.11-2.72), and large family size (OR 2.83, 95% CI 1.15-7.74). CONCLUSIONS: Child and adolescent health policy-makers should consider these factors when planning healthcare services or formulating a predictive model for adolescents' depression in low-income countries. Clinical assessment should focus on identification of these variables and nonpharmacological interventions may be of relevance in addressing some of the associated factors.

Adolescent↗
PubMed2002

Protein domain analysis in the era of complete genomes.

Domains present one of the most useful levels at which to understand protein function, and domain family-based analysis has had a profound impact on the study of individual proteins. Protein domain discovery has been progressing steadily over the past 30 years. What are the realistically achievable goals of sequence-based domain analysis, and how far off are they for the sequences encoded in eukaryotic genomes? Here we address some of the issues involved in better coverage of sequence-based domain annotation, and the integration of these results within the wider context of genomes, structures and function.

Amino Acid Sequence↗
PubMed2003

Attachment characteristics and behavioural problems in rural and urban juvenile delinquents.

Self-reported attachment characteristics, substance use and behavioural problems were assessed in 68 male juvenile delinquents from rural and urban areas. As was predicted, insecure attachment characteristics were related to behavioural problems, substance use, and poor family functioning. Urban delinquents reported more substance use and more interpersonal problems with peers and family members than their rural counterparts. Contextual influences on adolescent attachment relationships and adjustment problems may have implications for the administration and delivery of psychological treatments in youth correctional settings.

Adolescent↗
PubMed2005

The relation between social problems and substance use in adolescent boys: an investigation of potential moderators.

This study investigated the relation between social problems and adolescent male substance use in the context of other potential moderating variables. Two hundred eighty adolescent boys completed measures of social problems, cognitive distortions, constructive thinking, affiliation with delinquent peers, and multiple aspects of substance use. Results revealed that social problems were not directly related to most substance use variables. Cognitive distortions moderated the relation between social problems and substance use in social situations, such that the relation was significant only at high levels of cognitive distortions. Constructive thinking and affiliation with delinquent peers were both related to substance use, but neither served a moderating function. It is concluded that the widely accepted relation between social difficulties and adolescent male substance use may be better understood in the context of cognitive variables.

Adolescent↗
PubMedDate not supplied

Drug use and associated factors among rural adolescents in Costa Rica.

The objectives of this study, carried out in 1995, were to assess both licit and illicit substance use among rural male and female Costa Rican adolescents, and associated health, psychological, and psychosocial problems. A sample of 304 students from rural schools was randomly selected. The mean age for females was 14.7 years (S.D. = 1.71), and for males was 14.4 years (S.D. = 1.62). The data were collected using the Latin-American version of Drug Use Screening Inventory (DUSI). Results showed a high prevalence of past-year alcohol use for both males and females (56.6% and 47.4%, respectively), and a lower prevalence of past-year tobacco use (44.0% and 7.7%). There results also showed a low level of use of solvent inhalants and benzodiazepines. In terms of illicit drugs, males preferred cocaine and marijuana, while females only reported amphetamine use. An analysis of adolescent functioning showed differences among alcohol users and nonusers in behavior patterns and peer relationships. However, no significant differences were found regarding rebellion, depression, and social isolation. The implications of these results are discussed, along with the importance of enhancing prevention, as well as early detection and intervention.

Adolescent↗
PubMed1994

Impact of parental substance use on adolescents: a test of a mediational model.

Tested a mediational model of the relationship between parental substance use and adolescents' substance (tobacco, alcohol, marijuana) use with data from a sample of 1,775 adolescents, mean age 13.3 years, who completed a questionnaire including constructs from three theories of substance use. Mediational analyses identified five constructs involved in the relationship of parental and adolescent use. A structural model with latent constructs for substance use showed indirect effects of parental substance use through greater tolerance for deviance, lower behavioral control, greater perceived coping function of substance use, more negative life events, and more affiliation with peer users, plus a direct effect. Implications for the theory of transmission of risk are considered.

Adaptation, Psychological↗
PubMed2004

Functional clues for hypothetical proteins based on genomic context analysis in prokaryotes.

Three integrated genomic context methods were used to annotate uncharacterized proteins in 102 bacterial genomes. Of 7853 orthologous groups with unknown function containing 45,110 proteins, 1738 groups could be linked to functionally associated partners. In many cases, those partners are uncharacterized themselves (hinting at newly identified modules) or have been described in general terms only. However, we were able to assign pathways, cellular processes or physical complexes for 273 groups (encompassing 3624 previously functionally uncharacterized proteins).

Bacterial Proteins↗
PubMed2000

Enhanced cardiovascular hemodynamics in endurance-trained postmenopausal women athletes.

PURPOSE: We sought to determine whether older women athletes who had habitually performed vigorous endurance exercise training had higher stroke volumes and cardiac outputs than sedentary postmenopausal women during maximal exercise. METHODS: Seventeen endurance-trained, postmenopausal women athletes (age 65 +/- 4 yr; VO2max 2.11 +/- 0.31 L x min(-1), 38.3 mL x kg(-1) x min(-1)) and 14 sedentary, postmenopausal women (age 63 +/- 5 yr; VO2max 1.41 +/- 0.22 L x min(-1), 23.7 +/- 3.5 mL x kg(-1) x min(-1)) performed maximal treadmill exercise while cardiac output (via acetylene rebreathing) and other cardiovascular hemodynamics were measured. Approximately half of the subjects in each group were on hormone replacement therapy (HRT). RESULTS: The greater VO2max of the athletes was the result of a greater cardiac output (12.8 +/- 1.6 vs. 9.3 +/- 1.4 L x min(-1)) resulting from their significantly larger stroke volume (80 +/- 10 vs 57 +/- 10 mL) at maximal exercise. There were no significant differences in maximal cardiac output or maximal stroke volume related to HRT status in the sedentary women or athletes. CONCLUSIONS: These data indicate that endurance-trained, competitive, postmenopausal women have higher stroke volumes and cardiac outputs during maximal exercise, than their sedentary peers. However, these data suggest that HRT may not affect maximal CV function in sedentary or endurance-trained postmenopausal women.

Aged↗
PubMed2005

Firearm violence exposure and serious violent behavior.

To estimate the cause-effect relationship between exposure to firearm violence and subsequent perpetration of serious violence, we applied the analytic method of propensity stratification to longitudinal data on adolescents residing in Chicago, Illinois. Results indicate that exposure to firearm violence approximately doubles the probability that an adolescent will perpetrate serious violence over the subsequent 2 years.

Adolescent↗
PubMed1998

The substance use system: social and neighborhood environments associated with substance use and misuse.

Substance use theory and practice have traditionally focused on individuals who misuse substances or who are at risk for substance misuse, but this emphasis is shifting. The present study views both substance use and misuse systematically, assessing the relationships between the physical and social environments and substance use and misuse in dynamic interplay. This substance use system was examined through a survey of approximately 10,000 persons, aged 22-44, from primarily inner-city neighborhoods in the United States. Individual indicators such as race, sex, age, socioeconomic status, education, and religious service attendance relate to both the physical and interpersonal environments, even when each is controlled for the others. Qualities of both environments are strongly associated with substance dependency, even after individual indicators are controlled. These findings suggest the difficulty of bringing about change in drug and alcohol use without fundamental change in the environments where use takes place.

Adult↗
PubMed1999

Drinking moderately and pregnancy. Effects on child development.

Children exposed to moderate levels of alcohol during pregnancy show growth deficits and intellectual and behavioral problems similar to, although less severe than, those found in children with fetal alcohol syndrome. Research has begun to examine the extent to which these problems affect the child's ability to function on a day-to-day basis at school and with peers. Findings indicate that "moderate" drinking has much more impact on child development when the mother consumes several drinks in a single day than when she drinks the same quantity in doses of one to two drinks per day over several days.

Alcohol Drinking↗