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PubMed1995

School attainment, cognitive ability and motor function in a total Scottish very-low-birthweight population at eight years: a controlled study.

The prevalence of learning problems and of cognitive and motor impairment in a total geographically based very-low-birthweight population (N = 324) was compared at eight years of age with that in a population comprising two classroom peers, matched for gender and age (N = 590). 15 per cent of those with birthweights less than 1000g and 6 per cent of those weighing 1000 to 1499 g attended special schools. Index children in main-stream schools performed significantly less well in tests of neuromotor function than their comparison groups. Their mean IQs were 90.4 and 93.7 for those below and above 1000 g, respectively, while their comparison groups' IQs were 102.5 and 101.2. In all cognitive subscales apart from that testing short-term auditory sequential memory, both index groups were less competent. They were also less able in Word Reading and Basic Number Skills. These children placed heavy demands on mainstream schools, with 52 per cent and 37 per cent of the index groups, respectively, requiring learning support compared with 16 per cent in both comparison groups.

Achievement↗
PubMed1990

Pulmonary function and respiratory morbidity in school-age children born prematurely and ventilated for neonatal respiratory insufficiency.

We examined 72 children aged 6-9 years to assess the effects of prematurity and ventilator treatment on subsequent lung function and respiratory morbidity. The preterm study group (n = 42) was divided into children with a history of bronchopulmonary dysplasia (BPD) (n = 10), children who had had neonatal respiratory treatment but no BPD (n = 19), and children without severe neonatal respiratory problems (n = 13). The BPD children as a group had markedly lower specific airway conductance and larger residual volume than did the full-term control group, but there were no significant differences in spirometric measurements. The BPD group also had higher respiratory morbidity requiring hospitalizations, particularly during the first 2 years of life, than did the children in the other study groups. Therefore, BPD may improve but does not disappear as age increases. Non-BPD children who had had ventilator treatment as neonates recovered well and suffered no severe respiratory problems after infancy. Pulmonary function parameters in prematurely born children without neonatal ventilator treatment did not differ from those in the full-term control group. Thus, neonatal lung disease seems to be a more important determinant of abnormal pulmonary function at a later age than is prematurity alone.

Aging↗
PubMed2005

Spirometry in the pre-school age group.

Spirometry is a widely used lung-function test in school-aged children and adults. It can also be used to test lung function in the pre-school population, provided that they are tested in a child-friendly setting, by experienced paediatric-orientated personnel and in a way that is congruent with their development. Accurate results can be obtained provided care and attention are paid to applying quality-control criteria suitable for this age group. The biggest challenge is to make the testing fun.

Child, Preschool↗
PubMed1979

Proximal femoral focal deficiency: a clinical appraisal.

In patients with unilateral proximal femoral focal deficiency, the leg length inequality is almost always greater than five inches at skeletal maturity. Consequently, prosthetic management should be planned before the patient walks. A standard plan of treatment of the patient with unilateral PFFD is not possible at this time, primarily because of the varying percentage of femur missing and the controversy of management of the hip in patients with type A or B deformity. However, we found that ankle disarticulation with Syme flap closure combined with arthrodesis of the knee is a reasonable plan in many patients with unilateral PFFD. This allows correction of the knee and hip flexion contractures and gives the patient a functional, cosmetic stump. By the time he begins school, he is functioning as an above-knee amputee. This is not an undesirable goal, as one of us (E.G.R.) recently examined an above-knee amputee, a Captain in the United States Army, who continued his hobby of sky diving.

Adolescent↗
PubMed2007

Rigid external fixation and condylar remodeling.

Condylar fractures, instead of other mandibular fractures, play a primary importance role because their high incidence and the historic controversy existent in literature regarding their treatment. Recent studies prove that conservative treatment of condylar fractures, although not determining perfect alignment of the fractured segments, leads to a series of histologic and morphologic healing processes ending with consolidation of the fracture and functional recovery of the TMJ (temporo-mandibular joint). In this study, we observed long-term results of 2 cases of bicondylar fracture treated with surgical reduction and rigid external fixation. Rx orthopantomography control 1 year after surgery showed condylar remodeling bilaterally with good functional recovery. Our school affirms that semirigid fixation system allows optimal function between the articular head and the glenoid fossa, with good tridimensional repositioning of the fractured segments.

Adult↗
PubMed1997

Utilization of advanced hygienist skills in the private practice.

PURPOSE: The purpose of this study was to survey dental hygiene graduates to determine utilization in the private practice setting of expanded functions taught in school. METHOD: A questionnaire was sent to 90 dental hygiene graduates from the classes of 1990-1994, of Indiana University-Purdue University, Fort Wayne. Analysis was done on utilization of specific expanded functions taught in school. Frequency tabulations of procedures performed and adequacy of preparation were done using the SAS software. The results were graphically represented in tables. RESULTS: Equal response from each class resulted in the total response rate of 74%. The expanded functions most frequently performed by dental hygienists were placing sealants followed by making cast impressions. Placing temporary and amalgam restorations were rarely performed. The majority of graduates felt adequately trained to perform these skills. CONCLUSION: Skills being required and taught in school are not being delegated in private practice. This survey shows the need for curriculum revisions and discrepancies between educational requirements and utilization.

Dental Hygienists↗
PubMed2002

Cognitive development in school-age children with vertically transmitted HIV infection.

We examined a broad range of neuropsychological functioning in school-age children with vertically transmitted HIV infection and a control group made up of siblings of children with HIV infection. Fourteen children with HIV (2 asymptomatic, 8 mildly symptomatic, and 4 with AIDS) and 11 control children were administered a battery of neuropsychological tests assessing intelligence, receptive language, expressive language, visual and verbal memory, visual-motor speed and coordination, visual-motor and visual-spatial processing, fine motor skill, and academic achievement. Results revealed that school-age children with vertically transmitted HIV infection show many areas of cognitive function within the normal range. Despite normal cognitive development, subtle motor impairments were documented in children with vertically transmitted HIV infection. Our results are the first report of fine motor and motor strength deficits in school-age children with vertically transmitted HIV. Lastly, computed tomography (CT) results suggest that children with HIV who have documented structural anomalies in the brain may be at risk for deficits in visual-motor and visual-spatial processing. This finding should be explored with larger samples and other measures to determine its generalizability.

Adolescent↗
PubMed1985

School-age children's conceptions of the heart and its function: Part I: Review of literature.

A study was conducted to learn more about school-age children's conceptions of the heart and its function (kotchabhakdi, 1984). This report presents the review of literature pertinent to the study. The review includes three areas: congenital heart disease in children, cognitive development and cognitive function of school-age children, and children's conceptions of body organs. Part II, namely, methodology and findings of the study will be reported in Monograph 15, the Winter 1985 issue of this Journal.

Body Image↗
PubMed1991

Present status of ethics committees of the medical schools in Japan.

Present features and functions of ethics committees in 80 Japanese medical schools were surveyed through inquiries to those institutes by the author. Seventy nine schools have already started their own committees in each campus by the end of 1990, and the remaining one is preparing for its start in near future. The major role of the ethics committee may be said to roughly correspond to that of the Institutional Review Boards (IRB) in the USA, although a role of the hospital ethics committee has been played in addition to its proper functions in many schools. Among many problems two major drawbacks seem necessary to be removed urgently. The first one is an inappropriate composition of the committee in the majority of schools. More members from the outside of the campus, younger generations, and female reviewers should be added to the committee. The second point is the essentially closed review systems in most schools. The process of the review has not been effectively opened to the public yet, even in case in which no privacy of the patients or volunteers appears in the discussion. Several schools are preparing for opening now and the situation will be improved gradually. It was fortunate that the ethics committees in Japanese medical schools were founded by wills and efforts of members of each campus without having any suggestions, recommendations, or orders from the national government or other officials.

Bioethical Issues↗
PubMed2001

Impact of tic disorders on ADHD outcome across the life cycle: findings from a large group of adults with and without ADHD.

OBJECTIVE: The impact of tic disorders on the outcome of attention deficit hyperactivity disorder (ADHD) remains a subject of high scientific and clinical interest. To evaluate the impact of comorbid ADHD and tic disorders from a lifespan perspective, the authors systematically examined data from adults with and without ADHD. METHOD: They comprehensively evaluated 312 consecutively referred adults with ADHD and 252 comparison subjects without ADHD. Tic disorders were characterized along with a wide range of neuropsychiatric correlates, including other comorbid disorders as well as indexes of function in the domains of school, cognition, and interpersonal functioning. RESULTS: A significantly greater proportion of adults with ADHD (12%) than those without ADHD (4%) had tic disorders. Tic disorders followed a mostly remitting course and had little impact on functional capacities. In addition, tic disorders were not associated with stimulant use. CONCLUSIONS: These findings in adults with ADHD confirm and extend previous findings in young subjects with ADHD, documenting that although individuals with ADHD are at greater risk for tic disorders, the presence of tic disorders has a limited impact on ADHD outcome.

Adolescent↗
PubMed1998

[A new organization of school health services: its twilight or renaissance?].

Starting from the beginning of January 1998, school health service in Croatia became exclusively a preventive activity. This change provoked a lot of controversial discussions among general public and medical profession. This paper gives an outline of the historic course, the aims and content of school health in different countries. From its very beginning in the middle of the 19th century, school health started to develop as a preventive activity directed primarily towards organic etiology dominant in the morbidity of school children at that time (infectious diseases, tuberculosis, malnutrition). The morbidity has changed over time. Nowadays, the problems of psychosocial etiology have emerged into the first plane. Moreover, schooling has been prolonged. It covers a great part of childhood and almost the entire adolescence. The problems of adolescents are different and complex. Health care of school children and adolescents is functionally bound to the school as their natural environment. The most efficient health care is provided in close cooperation between medical personnel and teachers. Besides, the classical model of school health offers, particularly with respect to current problems, large possibilities for health promotion of children and adolescents, and in the long run, of the whole population. Health care of school children is not equally organized in different countries. The main difference depends on whether the school health team is directed only towards preventive and specific activities or towards comprehensive primary health care. In Croatia, traditionally, the integrated health care has developed. Beside preventive health care, the school doctors provided curative care for students in their schools. Within the reorganization of health care a new situation has arisen. Compulsory integration of preventive and curative activities at the school level is completely incompatible with the right to a free choice of primary care physician. However, by the strict interpretation of the principle of indivisibility of preventive and curative care, one school should cooperate with numerous personal doctors for its students. The essential principle of school health would be lost. The school represents a community which is exposed to the same health risks but keeps a great potential for health promotion. So, if this advantage is to be utilized, preventive care must be organized at the school level. This is the very nature of the reorganization in school health service which is performed in Croatia under the auspices of the Ministry of Health. Providing the preventive and specific health care for all school children and adolescents is the responsibility of school doctors who have become the employees of the Institutes of Public Health, while the curative care is provided by the personal physician of a student's or his parents' choice.

Adolescent↗
PubMed2005

Outcomes at school age of preschool children with developmental language impairment.

In a prospective study, preschool children diagnosed with developmental language impairment were systematically reassessed during the early school years with standardized developmental (Battelle Developmental Inventory) and functional measures (Vineland Adaptive Behavior Scale). Of an original cohort of 70 children assessed and diagnosed at a mean age of 3.6 +/- 0.7 years, 43 were reassessed at a mean age of 7.4 +/- 0.7 years. Group performance on the Battelle overall was 71.9 +/- 8.2 with the lowest sub-domain score in communication at 69.5 +/- 8.9. On the Battelle, 67% of children fell below the 1.5 standard deviation (S.D.) cutoff signifying significant developmental concerns. Between 36% (gross motor) and 83% (communication) of the cohort performed at least 1.5 S.D. below the normative mean on the individual domains of the Battelle. Seventy-four percent were impaired in two or more domains of the Battelle. The group mean on the Vineland overall was 81.1 +/- 16.9 with between 19% (socialization) to 48% (communication) of the cohort scoring more than 1.5 S.D. below the mean on each of the sub-domains. Almost half of the cohort (20/42, 48%) manifested functional impairment in at least two domains of the Vineland. Univariate and multivariate analysis of potential predictor variables identified only female sex as being predictive of significantly poorer performance on the Vineland communication sub-domain and the Vineland total score. Children with early developmental language impairment demonstrate persistent impairments in developmental and functional skills at school entry not limited to language. Deficits remain especially evident in the communication sub-domain. These results have implications with respect to later prognostication, family counseling, and devising a programmatic approach to this group of children.

Child↗
PubMed2004

Health-related quality of life and its relationship to neurological outcome in child survivors of stroke.

BACKGROUND: Ischemic stroke during infancy and childhood has the potential to result in neurological impairments and affect a child's ability to function at home, school, and play. There are limited data on the effect of ischemic stroke on quality of life (QOL) of child survivors of ischemic stroke. OBJECTIVE: To examine parent and child perspectives on QOL and examine factors that correlate with reduced QOL for child survivors of stroke. METHODS: A prospective single-center cohort design was used. Participants included children 2-18 years of age surviving ischemic stroke. The Pediatric Quality of Life 4.0 Generic Inventory Scale (PedsQL) parent proxy-report (2-18 years of age) and child self-report (5-18 years of age) were completed by participants. Scores were compared with standardized normative data of healthy children and those with chronic medical conditions. Neurological deficits were measured with the Pediatric Stroke Outcome Measure, a standardized evaluation for children. The relationships between stroke type, neurological deficit, and health-related quality of life (HRQOL) were examined. RESULTS: We assessed the QOL in 84 children with arterial ischemic stroke and 16 with cerebral sinovenous thrombosis at a mean age of 8.4 (4.12) years; 4.4 (2.93) years after their stroke. Results showed that both the parent-proxy and child self-report HRQOL scores were significantly reduced (P>.01) compared with normative data of healthy children. Of greatest concern for both parents and children was the effect of stroke on school, followed by its impact on emotional and social functions. In contrast to other studies, scores in physical domain were better than those in the psychosocial domain. Multivariate analysis showed that of neurological deficits after stroke was a significant predictor of poor HRQOL (P>.05). The children with poor neurological recovery had the lowest mean PedsQL scores and their QOL was significantly poorer compared with normative data of children with chronic health conditions (ie, diabetes, cancer). CONCLUSION: The PedsQL appears to be a promising assessment tool of HRQOL for children following stroke. Both parent and child perspectives should be included because of the potential for there to be significant differences in perspectives. Although severity of neurological outcome is a significant predictor of reduced HRQOL, it accounted for a small proportion of variance in QOL scores. Further research is required to delineate other factors that are significant predictors of outcome.

Adolescent↗
PubMed1986

Adult age differences in spatial memory: effects of distinctiveness and repeated experience.

Young (mean age = 25.0) and elderly (mean age = 65.0) women's memory for buildings in a large model town was assessed. Participants viewed and constructed the town on two trials. Building distinctiveness was manipulated by showing differentiated buildings with unique physical and functional properties (e.g., school, gas station), or nondifferentiated buildings that were not functionally distinct and only somewhat physically distinct (e.g., red cube-like structure with curved roof, yellow cube-like structure with flat roof). Building distinctiveness was further manipulated by verbally labeling or not labeling each building type. On Trial 1 young adults were more accurate than elderly adults only on the differentiated buildings; on Trial 2 this age difference was evident on differentiated and nondifferentiated buildings. Verbal labeling did not significantly affect construction accuracy. It was concluded that age differences occurred because elderly adults have more difficulty utilizing encoding strategies than young adults.

Adult↗
PubMed1995

Treatment of school refusal. Strategies for the family physician.

Although school refusal is not a common problem, it causes extreme turmoil in families and affects psychological and social development of the growing child. Causes for school refusal are diverse. Careful assessment to clarify the function of the school refusal is critical for successful intervention. Effective management strategies have been developed and are described in more detail in a recent book by King, Ollendick, and Tonge.

Age Distribution↗
PubMed1993

[Liver transplantation in Denmark. First-year experiences].

During the first 12 months of the Danish Liver Transplantation program, which began in October 1990, 21 transplantations were performed in 11 women, six men and three children. One patient required a retransplant. Fourteen operations were performed electively and six patients were transplanted for acute and subacute fulminant liver failure and coma, two patients had reduced size livers because of large donor liver. There were no peroperative deaths. One of the elective patients died after three weeks from multiorgan failure and sepsis. Two of the emergency patients died after 20 and 22 days. One from graft dysfunction due to stenosis of the celiac trunk and the other of exudative pericarditis. One patient died from chronic rejection and CMV-infection after seven months. Complications were relatively few and acute rejection occurred in 40% of the patients. Fifteen patients are discharged with normal liver function and 11 of these were back at work, school or previous functions in the home. It is concluded that these results are comparable to the best results from other centres but that 21 transplants in 12 months must be a minimum activity.

Adolescent↗
PubMed2000

Predicting elementary school participation in children with disabilities.

OBJECTIVE: To identify predictors of participation in school activities from two sets of functional variables using classification and regression tree analysis. DESIGN: Relational study. PARTICIPANTS: A nationwide sample of 341 children with various disabling conditions, including physical and cognitive/behavioral types of impairment and various severity levels. Children attended public elementary school in 40 states in the United States. MAIN OUTCOME MEASURE: Overall participation in elementary school, combining children's participation in six different environments (transportation, transitions, classroom, cafeteria, bathroom, and playground), as measured by the newly developed School Function Assessment. The children were dichotomized into full (n = 117) and limited (n = 224) participation categories. RESULTS: Two classification trees were developed identifying a small set of predictors from variables measuring performance of functional tasks and discrete activities. Final predictive models included physical and cognitive-behavioral variables, suggested important interactions among predictors, and identified meaningful cut-off points that classified the sample into the outcome categories with about 85% accuracy. CONCLUSIONS: Limited participation was predicted by information about children's physical capabilities. Full participation was predicted by a combination of physical and cognitive-behavioral variables. Findings underscore the relative utility of functional performance compared with impairment information to predict the outcome, and suggest pathways of influence to consider in future research and intervention efforts.

Child↗