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The impact of severe asthma on schoolchildren.

Episodic airway obstruction and hypoxia are potentially life-threatening to children with asthma and may account for neuropsychological impairment. Moreover, living with this chronic disease may severely disrupt children's emotional functioning. The general functioning of 25 children with severe asthma aged 10-13 years was tested by a comparison with 25 matched normal controls. Testing included variables with relevance to normal daily functioning: memory, concentration, school performance, physical condition, subjective symptoms after exercise, and negative emotions. The results showed that children with asthma did not significantly deviate from controls. They reported more dyspnea after physical exercise, which could not be attributed to lung function. Differences in school performance were not significant. It was concluded that children may generally adapt well to living with asthma.

Activities of Daily Living↗

Participation and activity performance of students with cerebral palsy within the school environment.

PURPOSE: The aims of this study were to investigate the levels of participation and activity performance of students with cerebral palsy within the inclusive school context, to explore the relationships between these two aspects of function and to identify predictors of participation among the various school activities. METHOD: Two hundred and forty-eight elementary school students were divided into three groups: 100 fully included (FI) students with CP, 100 matched by class and gender typical students (TS) and 48 students with CP in self-contained classes (SC). The School Function Assessment (SFA) was used as the main measurement for assessing the levels of participation and functional performance profiles. RESULTS: Significant differences (P<0.0001) in levels of participation were evident across the three study groups using MANOVA and ANOVAs analyses, where the TS level was the highest and the SC was the lowest. Comparison of the mean score of the physical and the cognitive/behavioural tasks performance revealed similar results among the three groups. Positive Pearson correlations were obtained between participation and both motor and cognitive/behavioural activity performance in the FI and the SC groups. Regression models for the FI and the SC groups were found significant (P<0.0001) and explained above 69% of the participation variance with physical activity performance as the most predictive variable. CONCLUSIONS: Significant differences exist between participation and activity performance of typical students and students with CP included in regular schools. Moreover, activity performance limitations were found to impact on school participation. These findings stress the continuing need to provide rehabilitative intervention towards removing existing barriers within the inclusive environment.

Activities of Daily Living↗

Muscular, functional and orthodontic changes in pre school children with enlarged adenoids and tonsils.

INTRODUCTION: Hypertrophy of the adenoids and palatine tonsils is the second most frequent cause of upper respiratory obstruction and, consequently, mouth breathing in children. Prolonged mouth breathing leads to muscular and postural alterations which, in turn, cause dentoskeletal changes. OBJECTIVE: The aim of this study was to determine muscular, functional and dentoskeletal alterations in children aged 3-6 years. MATERIALS AND METHODS: Seventy-three children, including 44 with tonsil hypertrophy and 29 controls, were submitted to otorhinolaryngologic, speech pathologic and orthodontic assessment. RESULTS: Otorhinolaryngologic evaluation revealed a higher incidence of nasal obstruction, snoring, mouth breathing, apneas, nocturnal hypersalivation, itchy nose, repeated tonsillitis and bruxism in children with tonsils hypertrophy. Speech pathologic assessment showed a higher incidence of open lip and lower tongue position, and of hypotonia of the upper and lower lips, tongue and buccinator muscle in these children, accompanied by important impairment in mastication and deglutition. Orthodontic evaluation demonstrated a higher incidence of lower mandible position in relation to the cranial base, a reduction in lower posterior facial height, transverse atresia of the palate, and a dolicofacial pattern. CONCLUSION: Postural and functional alterations anticipate dentoskeletal changes, except for the facial pattern. Postural alterations and the skeletal pattern seem to play an important role in infant dentofacial growth.

Adenoids↗

General internal medicine units in academic medical centers: their emergence and functions.

By 1979, 77% of medical school primary teaching hospitals had functioning general internal medicine units; less than 5% had existed before 1970. These units were established to meet institutional needs for primary care internal medicine teachers and clinicians. By the end of the decade they had achieved major administrative and staffing responsibility for a wide variety of general education and service activities. The scope of general internal medicine units goes beyond the narrow definition of primary care internal medicine, to include activities traditionally considered those of the entire department of medicine.

Academic Medical Centers↗

School-year employment among high school students: effects on academic, social, and physical functioning.

This study describes the effects of different weekly work intensity levels on adolescent functioning in a sample of 3,083 high school students in rural South Texas, where economically disadvantaged and Hispanic youth are heavily represented. Anonymous surveys were conducted in 10th- and 12th-grade students' classrooms in 1995. The following effects were associated with long hours of weekly employment during the school year: (1) decreased performance/engagement in school and satisfaction with amount of leisure time, and (2) increased health risk behaviors and psychological stress. The effects of school-year work on academic factors and health behaviors differed by grade, but not by race/ethnicity, parent education, or race/ethnicity and parent education considered together. It was concluded that parents and professionals should continue to monitor the number of weekly hours that students work during the school year.

Adolescent↗

Enhanced schooling performance in lateralized fishes.

The occurrence of functional left-right cerebral asymmetries has been documented in a wide range of animals, suggesting that the lateralization of cognitive functions enjoys some kind of selective advantage over the bilateral control of the same functions. Here, we compared schooling performance of fishes with high or low degree of lateralization, which were obtained through selective breeding. Schools of lateralized fishes moving in a novel environment showed significantly more cohesion and coordination than schools of non-lateralized (NL) fishes. Pairs of fishes lateralized in opposite directions were as efficient as pairs of same laterality, suggesting that the performance of lateralized fishes derives from a computational advantage rather than being the consequence of a behavioural similarity among schoolmates. In schools composed of both lateralized and NL fishes, the latter were more often at the periphery of the school while lateralized fishes occupied the core, a position normally safer and energetically less expensive.

Analysis of Variance↗

Renal transplantation: experience in Australia.

OBJECTIVE: Outcome of renal transplantation in children under the age of 15 years, who received a renal allograft at The New Children's Hospital between January 1983 to June 1997 was studied. METHODS: Retrospective review of patients records and access to data collected from Renal Registry of the Hospital. 64 renal transplants were undertaken in 57 children during this period. Prednisone and Azathioprine were the mainstay of the immunosuppressive regimen up to 1983, then Cyclosporine A was introduced. Median age of first grafts was 10 years (range 1 month-14 years). There were 41 living related and 23 cadaveric grafts. 37 (64%) children had a congenital disorder as the cause of renal failure. Among them 14 (37%) had congenital renal dysplasia/hypoplasia, 20 (36%) had primary glomerular disorder as the cause of renal failure. RESULTS: Survival analysis at 12 month, 5 yr and 10 yr showed functioning grafts in 85%, 67% and 64% case respectively. Longest surviving transplant was 14 years. 6 children had died. Cumulative patient survival was 92.9% at 1 year, 90% at 5 year and 87% at 10 year. Sixteen primary grafts were lost with most common cause being chronic rejection accounting for 68% of all transplant lost. Recurrence of primary disease was the second most common cause of graft failure. There was one malignancy in this series. 25 of the 29 children of school age with functioning transplant attended school full time in a class appropriate for their age and nine of 13 years older patients were working full time, two worked part time. CONCLUSION: Renal transplantation is a successful treatment of end stage renal failure in children with high survival and normally functioning life. Chronic rejection remains a major cause of graft loss.

Adolescent↗

Psychiatric comorbidity and functioning in clinically referred preschool children and school-age youths with ADHD.

OBJECTIVE: Although the literature documents that attention-deficit/hyperactivity disorder (ADHD) commonly onsets prior to age 6, little is known about the disorder in preschool children. We evaluated the clinical characteristics, psychiatric comorbidity, and functioning of preschool children and school-age youths with ADHD referred to a pediatric psychiatric clinic for evaluation. METHOD: Structured psychiatric interviews assessing lifetime psychopathology by DSM-III-R criteria were completed with parents about their children. Family, social, and overall functioning were also assessed at intake. RESULTS: We identified 165 children with ADHD aged 4 to 6 years (preschool children) and 381 youths aged 7 to 9 years (school-age) with ADHD. Despite being younger, preschool children had similar rates of comorbid psychopathology compared with school-age youths with ADHD. There was an earlier onset of ADHD and co-occurring psychopathology in the preschool children compared to school-age youths. Both preschool children and school-age youths had substantial impairment in school, social, and overall functioning. CONCLUSIONS: The results of this study suggest that despite being significantly younger, clinically referred preschool children with ADHD are reminiscent of school-age youths with ADHD in the quality of ADHD, high rates of comorbid psychopathology, and impaired functioning. Follow-up of these clinically referred preschool children with ADHD to evaluate the stability of their diagnoses, treatment response, and their long-term outcome are necessary.

Attention Deficit Disorder with Hyperactivity↗

Children's mental health and school success.

An integrative review of literature was undertaken to examine the impact of children's mental health on their school success. The literature confirmed a confluence of problems associated with school performance and child and adolescent mental health. Poor academic functioning and inconsistent school attendance were identified as early signs of emerging or existing mental health problems during childhood and adolescence. Among the goals of school nursing is to provide a process for identification and resolution of students' health needs as they affect educational achievement. Thus, it is within the scope of practice and goals of school nursing to also address children's mental health needs, as they affect school performance. This review of literature supports the conclusion that school nursing is well positioned to respond to the need for mental health promotion, illness prevention, and early intervention related to children's mental health.

Adolescent↗

Differences in lung function and chest dimensions in school-age girls and boys.

The present analysis was undertaken to find out whether differences in the performance of the lungs of boys and girls of the same height are explicable by differences in thoracic size. We measured forced vital capacity (FVC), peak expiratory flow (PEF) and forced expiratory flows (FEFs), when 50% and 75% of FVC had been exhaled (FEF50, FEF75), and standing height, chest width and depth and biacromial diameter in 1187 schoolchildren aged 6-18 years. Thoracic dimensions were usually greater in boys than in girls of the same height, except for the height range of 150.0-164.9 cm. For this height range, the pulmonary function variables (PEF, FEF50, FEF75 and PEF/FVC) were significantly higher in girls, and for FVC almost as high as the male values. For FEF50/FVC and FEF75/FVC, the female values were larger over the whole height range (115.0-184.9 cm), but even for these parameters the differences were greatest for the height range 150.0-164.9 cm. In conclusion, very similar growth patterns of lung function and thoracic parameters can suggest that differences in the lung function parameters of boys and girls of the same height may be explained by differences in the thorax size.

Child↗

Fatigue, depression, and social adjustment in chronic fatigue syndrome.

The aims of this study were to determine the characteristics and perceived levels of fatigue and the prevalence of depression in children with chronic fatigue syndrome and to assess the effects of illness on schooling and social functioning. Twelve children with chronic fatigue syndrome were compared with a matched group of children with cystic fibrosis and matched healthy controls. Levels of fatigue (fatigue questionnaire), depression (children's depression inventory), and social adjustment (semistructured interview with parents) were compared between groups. Children with chronic fatigue syndrome had significantly higher median scores for physical and mental fatigue and depressive symptomatology than either comparison group and five children scored as depressed on the children's depression inventory. Schooling and social functioning were seriously disrupted. Children with chronic fatigue syndrome reported high levels of fatigue affecting both physical and mental functioning, the association with depression found in adult studies was confirmed, and social adjustment was poor.

Absenteeism↗

[Studies of voice stress in teachers with functional voice disorders caused by teaching activity].

30 female teachers of ten-years technical schools-15 with functional voice-disturbance an 15 with healthy voice-have been examined while teaching in respect of their strain. Duration of speech, intensity of their teachers voice an background noise, the frequency of heart rate and the arterial blood pressure were measured on the teaching day. Between both research groups no statistically significant differences were shown. There were no correlations between the durations of speech, intensity and vegetative parameters.

Adult↗

Can the Family Assessment Device (FAD) be used with school aged children?

This article examines the usefulness of the Family Assessment Device(FAD) in assessing family functioning with school-aged children (under 12 years of age) compared to children 12 and older and mothers. FAD reports from 194 children with asthma (132 under 12 years; 62 12 years and older) were evaluated in comparison to mothers' FAD reports as well as mothers' reports on two other family functioning measures: the Family Inventory of Life Events (FILE) and the Impact on Family (IOF) scale, both relevant to functioning in families with children with asthma. Although FAD scale reliabilities were lowest in younger children (alpha = 48-.79), good concurrent validity was found with mothers' reports on the three different measures of family functioning. Older childrens' FAD scales showed good reliability (> .70) but poorer agreement with the various maternal measures. With modifications to make items more structured and simplified, the FAD could be tried with younger children, although documentation of improved reliability is needed before more widespread use with school-aged children is advocated. The measure already shows good agreement with maternal report in this younger age group, which likely would be strengthened with improved reliability. FAD reports in older children correlated less well with maternal measures, but may represent nonredundant information on family health from an independent perspective and are worth considering in addition to mothers' perspectives.

Adaptation, Psychological↗

Evaluation of lung function in male population from vocational mining schools of the Lublin Coal Basin.

Occupational exposure to dust and other environmental factors in coal miners may impair the lung function of workers. Besides the coal workers' pneumoconiosis, the inhaled dust may cause decreased ventilatory capacity as a due to chronic bronchitis (9, 13). The same diseases, especially chronic bronchitis, are common in general population and may arise not only from occupational reasons (11, 12). The involvement of the genetic factors, environmental pollutions and cigarette smoking should be considered.

Adolescent↗

Behavior pattern (innate action) of individuals in fish schools generating efficient collective evasion from predation.

The schooling of fishes is one typical animal social behavior. One primary function of fish school is to protect members when attacked by predators. One main way that the school reduces the predator's chance of making a successful kill is to confuse the predator as it makes its strike. This may be accomplished by collective evasion behaviors organized through integration of motions of individual fish made based on their innate actions (behavior patterns). In order to investigate what kind of behavior pattern of individuals can generate the efficient collective evasion of a school, we present a model of evasion behavior pattern which consists of three component behavior patterns, schooling, cooperative escape, and selfish escape behavior patterns and the rule for choice of one among them with proper timing. Each fish determines its movement direction taking into account simultaneously three kinds of elemental motions, mimicking its neighbors, avoiding collisions with its nearest neighbors, and escaping from an approaching predator. The weights of three elemental motions are changed depending on which component behavior pattern the fish carries out. The values of the weights for three component behavior patterns can be definitively determined under the condition that the collective evasion of the school becomes the most efficient, that is, the probability that any member is eaten by the predator becomes minimum.

Animals↗

Attention deficit hyperactivity disorder: assessment and treatment of children from culturally different groups.

Attention deficit hyperactivity disorder (ADHD) is now thought to affect from 3 to 7% of school-age children. Children with ADHD will often experience serious problems functioning in the school environment. More and more children from culturally diverse groups are being diagnosed as having ADHD. Research shows that culture can directly affect both assessment and treatment of ADHD. This article provides an overview of the effects of cultural differences on the assessment and treatment of ADHD. Children from diverse cultural groups may be overidentified as having ADHD. Cultural difference may also have an impact on access to treatment and compliance with treatment programs. Recommendations for practitioners are included.

Attention Deficit Disorder with Hyperactivity↗