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Strategies to promote activity and participation in children and youths with acquired brain injuries.

Strategies used by hospital and community-based rehabilitation and educational professionals and parents for promoting activity performance and participation of children and youths with acquired brain injuries (ABI) in the hospital, at home, at school and in the community are described in this article. Semi-structured interviews with interdisciplinary staff from a pediatric rehabilitation hospital in the Northeast USA and focus groups comprised of hospital and community-based educational and rehabilitation professionals and parents were conducted. Interviews and focus groups were audiotaped, transcribed verbatim and qualitatively analyzed. The strategies described fell into three categories: Routine, Repetition, and Consistency; Supports and Models; and Curriculum and Environmental Modifications. In addition, three broader factors emerged related to the use of strategies: Communication; Age, Development and Recovery Time; and Attitudes and Expectations. Findings may provide insights to professionals and families to promote activity performance and participation in children and youth with acquired brain injuries across the continuum of care.

Adolescent↗

Evaluation of the Centers for Disease Control and Prevention's chronic disease state-based epidemiology for public health program support (STEPPS) program.

To identify effective strategies for improving epidemiology capacity in state chronic disease programs, staff epidemiologists and program directors from 25 states were interviewed using a structured questionnaire by phone or in person. Respondents reported three chief barriers to chronic disease epidemiology capacity: lack of institutional commitment and support for chronic disease epidemiology; lack of professional opportunities to engage with peers, colleagues, and scientists; and lack of trained epidemiology staff and resources to support chronic disease functions and activities. Epidemiology capacity in states would be improved by expanding the role and scope of staff placement programs; assisting states in establishing formal collaborations with academic institutions; and providing technical assistance to staff currently employed in states through training, consultation, and networking.

Centers for Disease Control and Prevention, U.S.↗

Short-term efficacy of methylphenidate: a randomized, double-blind, placebo-controlled trial among survivors of childhood cancer.

PURPOSE: Children surviving acute lymphoblastic leukemia (ALL) and malignant brain tumors (BTs) have a higher incidence of attention and learning problems in school than do their healthy peers. The present study tests the hypothesis that the psychostimulant methylphenidate (MPH) improves cognitive and social functioning among these patients. PATIENTS AND METHODS: We report on 83 long-term survivors of ALL and BT identified as having attentional deficits on behavioral testing and parent or teacher report, and problems with academic achievement. The 47 male and 36 female patients ranged from 0.6 to 14.3 years (median, 5.4 years) of age at diagnosis and 6.7 to 17.9 years (median, 11.9 years) of age at participation. The patients (40 ALL, 43 BT) participated in a randomized, double-blind, 3-week home cross-over trial of placebo (bid), low-dose MPH (0.3 mg/kg; maximum dose, 10 mg bid), and moderate-dose MPH (0.6 mg/kg; maximum dose, 20 mg bid). The primary end points were weekly teacher and parent reports on the Conners' Rating Scales and Social Skills Rating System. RESULTS: Compared to placebo, significant improvement with MPH was reported by teachers and parents on the Conners' Rating Scales and by teachers on the Social Skills Rating System. However, no consistent advantage of moderate dose over low dose was observed. Of those participating, 66 (79.5%) of the 83 patients continued on best clinical management. CONCLUSION: Treatment with MPH can at least temporarily reduce some attentional and social deficits among survivors of childhood ALL and BT. Long-term follow-up will reveal those subsets of patients who are more likely to benefit from MPH.

Adolescent↗

Physical function in sedentary and exercising older veterans as compared to national norms.

We examined the associations between sedentary older veterans, those regularly involved in an outpatient exercise program and physical function. Sedentary and currently exercising older veterans performed a 30 s chair-stand test and 6 min walk test as part of an exercise program. Test results were then compared to national norms. The exercisers' test scores were not significantly different from the national averages. However, their mean 6 min walk score approached being significantly better than the national average (p = 0.095). The sedentary group's scores were significantly lower (p < or = 0.05) than the exercisers' scores and the national averages for both tests. In this cohort, older veterans who maintain a regular program of physical activity function at a level considered average or slightly above average compared to their age-matched peers, while sedentary veterans are significantly below average. Healthcare providers need to stress the importance of regular exercise to their older veteran patients.

Aged↗

Hospital accreditation in Australia evaluating health care.

The paper examines in detail the accreditation process, the accreditation process, the accreditation decision, as well as the membership, structure, function and standards of The Australian Council on Hospital Standards. It demonstrates that the concept of peer review of hospital professionals is an important and increasingly accepted method of evaluating the standards of hospital care in Australia.

Accreditation↗

Sleep patterns in children and adolescents with functional recurrent abdominal pain: objective versus subjective assessment.

AIM: To document objective sleep patterns of children and adolescents with functional recurrent abdominal pain (RAP), and to compare them with subjective sleep assessments and sleep patterns of healthy controls. METHODS: Subjective sleep reports and sleep habit assessments were obtained from 25 adolescents with functional RAP and from 15 age- and gender-matched healthy volunteers, and were compared with continuous movement monitoring using the Actigraph for 7 consecutive days. RESULTS: Abdominal pain before falling asleep was a unanimous complaint in the RAP group, with 29% reporting awakening from sleep by the pain. Only 25% of RAP patients assessed their sleep quality as good, compared with 87% of the control group. Objective sleep patterns measurements of the RAP patients were similar to those of the control group as well as to measurements observed in a large population of school-aged children and adolescents. CONCLUSION: This study of a small group of children and adolescents with functional RAP provides objective evidence that their sleep patterns do not differ from those of normal peers, despite their subjective complaints.

Abdominal Pain↗

Chalmers J. Lyons memorial lecture: Metal implants and the mandibular staple bone plate.

To briefly summarize our results, two of the five three-pin staples (40%) have survived and have functioned well for more than six years. Four of the five four-pin staples (80%) have survived five years or longer and are functioning well. Twenty-four of the 25 seven-pin staples (96%) are functioning well, some for a period of 4-1/2 years; a few in this group have been used a little less than a year. Our total percentage of survival with good function is 30 of 35, or 86%, which includes our pilot study of the three- and four-pin staples. A more significant statistic, however, might be those patients with staples who we feel have been free of any significant trouble; these are 27 of 35, or 77%. All of our patients have been subjected to peer review examination and grading by members of the oral surgery staff at Sinai Hospital. They were examined and graded according to three criteria. The first was clinical appearance which included firmness of the staple and clinical appearance of the gingiva (Fig 16). The second was radiographic evidence of bone loss along the transosteal pins and retentive pins (Fig 17). The third category was patient evaluation of improved function and stability of the lower denture (Fig 18). The peer review group used marks A, B, C, D, as excellent, good, fair, and failure. Four points were assigned to A, 3 points to B, 2 points to C, and 1 point to D, so that the grade averages for all three categories were as follows: clinical appearance, 3.6; radiographic appearance, 3.5; and patient evaluation, 3.9. The conclusion of the review group was that the mandibular staple was functioning well and that it was clinically useful. I have presented an overview of some of the characteristics of metallic implants that make them implantable devices, and some of the qualities of the host tissues that will allow placement of foreign material. We do not yet understand all of the factors that make alloplastic materials biocompatible or some of the reasons for rejection by the host. We need continued research in animal models to study new devices and new materials that might permit biologic attachments of the host to implant. We also need controlled clinical studies with peer review to establish reliability of those devices that are clinically useful. The mandibular staple has had an initial clinical trial that seems very promising and is worthy of continued clinical study and clinical application.

Atrophy↗

The British version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the British language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. A total of 440 subjects were enrolled: 219 patients with JIA (17% systemic onset, 41% polyarticular onset, 33% extended oligoarticular subtype, and 9% persistent oligoarticular subtype) and 221 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the British version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗

The Korean version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Korean language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. A total of 221 subjects were enrolled: 87 patients with JIA (18% systemic onset, 37% polyarticular onset, 12% extended oligoarticular subtype, and 33% persistent oligoarticular subtype) and 134 healthy children. The CHAQ clinically discriminated between healthy subjects and the four JIA subtypes of patients, with the JIA patients having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the JIA patients having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Korean version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗

Olfactory toxicity: long-term effects of occupational exposures.

OBJECTIVE: To present and discuss the results of research on olfactory function impairments related to chronic occupational exposure to industrial chemicals. METHODS: This review is mainly focused on the results of epidemiological studies on olfactory function, evaluated using quantitative testing methods, in workers chronically exposed to airborne industrial chemicals. Papers published in peer-reviewed scientific journals were mainly considered. RESULTS: The prevalence of olfactory impairments related to occupational exposure to chemicals is unknown: frequencies ranging 0.5-5% of all olfactory dysfunctions have been proposed, considering both exposure to chemicals and the use of pharmaceutical drugs, but the real relevance of this problem is possibly overlooked, especially considering that occupational exposure may account for a significant part of "idiopathic" smell disorders, i.e., the 10-25% of all olfactory problems within the general population. An adverse effect has been reported in workers chronically exposed to some metals as cadmium, chromium, manganese, arsenic, mercury, and organic lead, and to other chemicals as acrylates, styrene, and solvent mixtures. The results of relevant studies are discussed. A problem in the evaluation of data is that different methods have been applied in different studies, affecting the comparability of results. CONCLUSIONS: To date, knowledge of the effect of chronic occupational exposure to industrial chemicals on olfactory function is largely incomplete, but supports the hypothesis that olfactory neuroepithelium is susceptible to environmental exposures to chemicals. Occupational-related olfactory impairment is usually sub-clinical, and can be only detected using adequate quantitative olfactory function testing procedures. Available data show the need for further good quality research in this field.

Air Pollutants, Occupational↗

The changing face of peer review at the National Institutes of Health.

OBJECTIVE: To discuss the new peer review system at the National Institutes of Health (NIH) and to present the process undertaken to accomplish these changes, with an emphasis on the reproductive sciences. DESIGN: A discussion of the many NIH committees and their composition and reports leading to the changes in peer review affecting the reproductive sciences. RESULT(S) AND CONCLUSION(S): The Center for Scientific Review (CSR), which reviews grants for all NIH Institutes, will initiate the Cellular, Molecular, and Integrative Reproduction, the Integrative and Clinical Endocrinology and Reproduction, and the Pregnancy and Neonatology study sections in February 2004. The National Institute of Child Health and Human Development (NICHD)'s Division of Scientific Review has the following subcommittees, which started review in July 2003: Pediatrics; Developmental Biology; Biobehavior and Behavior Sciences; Population Science; Obstetrics and Maternal-Fetal Biology; Reproduction, Andrology, and Gynecology; and Function, Integration, and Rehabilitation Science.

National Institutes of Health (U.S.)↗

Does whom you work with matter? Effects of referent group gender and age composition on managers' compensation.

Much research has examined gender and age effects on compensation, concluding that a wage gap exists favoring men and negative stereotypes against older workers persist. Although the effect of an employee's gender or age has been widely studied, little work has examined the impact of the demographic characteristics of a focal employee's immediate referent groups (e.g., subordinates, peers, or supervisors) on pay. The effect of the gender and age composition of a focal manager's subordinates, peers, and supervisor on the manager's compensation levels was investigated in a sample of 2,178 managers across a wide range of organizations and functional areas. After controlling for a number of human capital variables, results indicated that not only does a wage gap favoring men exist, but also managerial pay is lower when managers' referent groups are largely female, when subordinates are outside the prime age group, and when peers and supervisors are younger.

Adult↗

The Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Turkish language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Turkish CHAQ CHQ were fully validated with 3 forward and 3 backward translations. A total of 145 subjects were enrolled: 85 patients with JIA (35% systemic onset, 41% polyarticular onset, and 24% persistent oligoarticular subtype) and 60 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, and polyarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, and polyarticular onset having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Turkish version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗

The Bulgarian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Bulgarian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Bulgarian CHAQ CHQ were fully validated with 1 forward and 1 backward translations. 137 subjects were enrolled: 77 patients with JIA (36% systemic onset, 30% polyarticular onset, 4% extended oligoarticular subtype, and 30% persistent oligoarticular subtype) and 60 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Bulgarian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗

Cognitive and social cognitive development of depressed children and adolescents.

Depressed juveniles show evidence of functional impairment in various cognitive and social domains. Actual school performance seems to be more consistently affected by depression than cognitive and intellectual abilities. In addition, depressed youth appear to be less socially adept than nondepressed peers, although depression does not consistently impair social-cognitive abilities. Indications that depressed youth show mild declines in tested verbal performance over time and that residual problems in social functioning persist after symptomatic recovery suggest that major depression may have negative effects on development in childhood.

Adolescent↗

The Portuguese version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Portuguese language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well being of children independently from the underlying disease. The Portuguese CHAQ CHQ were fully validated with 3 forward and 3 backward translations. A total of 130 subjects were enrolled: 69 patients with JIA (32% systemic onset, 19% polyarticular onset, 26% extended oligoarticular subtype, and 23% persistent oligoarticular subtype) and 61 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well being when compared to their healthy peers. In conclusion the Portuguese version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗

The Croatian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Croatian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Croatian CHAQ-CHQ were fully validated with 3 forward and 3 backward translations. A total of 139 subjects were enrolled: 75 patients with JIA (19% systemic onset, 20% polyarticular onset, 17% extended oligoarticular subtype, and 44% persistent oligoarticular subtype) and 64 healthy children. CHAQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Croatian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗

The Latvian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Latvian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Latvian CHAQ CHQ were fully validated with 1 forward and 1 backward translations. A total of 141 subjects were enrolled: 80 patients with JIA (16% systemic onset, 32.5% polyarticular onset, 19% extended oligoarticular subtype, and 32.5% persistent oligoarticular subtype) and 61 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Latvian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗