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PubMed2005

Dental faculty recruitment at Loma Linda University School of Dentistry.

This article addresses the dental faculty shortage as reported by the American Dental Association in its publication The Future of Dentistry and the Journal of Dental Education report on the demand nationally for dental school faculty. Budgeted full-time faculty vacancies in U.S. dental schools stand between 300 and 400 with present and anticipated state and federal shortfalls forecasting even further cuts or at least lack of government support. Acknowledging various reasons for, and responses to, the shortage, the School of Dentistry at Loma Linda University is seeking to deal creatively with a faculty shortage. A survey of newly hired full-time faculty indicates the issues that concern them and their colleagues. Loma Linda University School of Dentistry's response to the shortage includes a routine invitation to students, particularly seniors and residents, to consider teaching at the school. In addition, a simple alumni recruitment form is used for personal relationship building with alumni. A student loan reimbursement program for new faculty is a successful program in recruiting new, young full-time faculty. To provide for the long-term future of the research function of the school, a new program focusing on hiring doctoral (PhD)-prepared individuals who will be trained in the predoctoral DDS program at the expense of the school is in place. This article suggests further steps that can be taken to enhance the cause and reputation of the school's educational program.

California↗
PubMedDate not supplied

Conversational repair in speakers with autism spectrum disorder.

BACKGROUND: The ability to repair communicative breakdown is an important pragmatic language skill, yet very little is known about it in the population of children with autism spectrum disorder (ASD). Previous investigations have shown that people with ASD, across a variety of ages and language levels, recognized communicative breakdown and responded to requests for clarification (RQCLs) with a wide variety of repair strategies. No previous work has assessed the repair abilities of speakers with ASD when faced with a persistent communicative breakdown indicated by a stacked series of RQCLs. AIMS: The present paper aimed to determine whether school-aged, high-functioning children with ASD responded to a stacked series of RQCLs in a way similar to children matched for language age. METHODS & PROCEDURES: Nine school-aged, high-functioning children with ASD were recruited and matched to nine control group children based on language level. During conversation, an unfamiliar examiner engineered 10 episodes of communicative breakdown. Each consisted of a stacked series of three RQCLs ('What?', 'I don't understand', 'Tell me another way'). Verbal and non-verbal responses to each RQCL were coded. Responses were analysed by a series of repeated measures analyses of variance with diagnostic group and RQCL type/position as independent variables and type of repair as the dependent variable. OUTCOMES & RESULTS: Children with ASD were similar to language age-matched control children in responding to RQCLs and employing a variety of repair strategies. In addition, their pattern of responding over the series of RQCLs was very similar to the controls in varying the repair strategy by adding increasingly more information as the breakdown persisted, i.e. as the sequence of RQCLs progressed. Children with ASD, however, were significantly more likely than language age-matched controls to respond to an RQCL with an inappropriate response. CONCLUSIONS: The ability to repair communicative breakdown successfully raises questions about some of the currently popular theories about the source and nature of social and communicative deficits in autism. In addition, the presence of significantly more inappropriate utterances in the group with ASD poses both theoretical and clinical challenges. In theoretical terms, several possible explanations are proposed, but future work will need to test these hypotheses. Clinically, it is important to focus on utterances that disrupt the conversational flow and that generate severe social penalties for the speaker with ASD.

Analysis of Variance↗
PubMed1985

Personality and neuropsychological performance of high-risk children.

The present article reports findings on intelligence and personality functioning during the school period and at adolescence in a sample of kibbutz and urban Israeli children at risk for schizophrenia, as measured by a standard psychological test battery. On the first round of testing it was found that the index subjects, when compared with their controls, showed a significantly lower level in arithmetic proficiency, perceptual-motor functioning, and several specific verbal and thought patterns. These findings suggest an overall pattern of attentional dysfunctioning and a basic distortion in cognitive integration. Followup data did not show intergroup differences in perceptual-motor functioning, but did indicate a consistent picture of a significantly lower overall intelligence level and several indices of clear personality problems. No consistent sex or kibbutz-city differences were found. Findings are interpreted in the framework of a developmental model of vulnerability in subjects at risk for schizophrenia.

Adolescent↗
PubMed1994

Chest illness in infancy and chronic respiratory disease in later life: an analysis by month of birth.

BACKGROUND: Cohorts born at different times of year differ in their risk of exposure to seasonal respiratory infections in early life, but are likely to have similar socioeconomic status and lifestyle thereafter. METHODS: We investigated the long-term consequences of acute chest illness in infancy for later development of chronic respiratory disease by analysing variations by month of birth in hospital admissions for respiratory illness (total n = 49,866), chronic respiratory symptoms and ventilatory function among British school children (n = 11,482) and middle-aged adults (total n = 55,829). RESULTS: Admission for bronchiolitis in the first year of life was three times more common for infants born September to November (autumn) than those born March to May, yet people born in the autumn experienced fewer respiratory symptoms and had better ventilatory function. In two surveys of middle-aged men, forced expiratory volume in one second/forced ventilatory capacity (FEV1/FVC) was significantly (P = 0.025) higher among autumn births. Hospital admissions for chronic bronchitis/emphysema and pneumonia varied little with season of birth. Admissions for asthma were significantly (P < 0.05) more common among children and young adults born in the autumn. CONCLUSIONS: These findings do not support the hypothesis of a causal link between chest illness in infancy and the later development of chronic bronchitis and emphysema. The variation in asthma admissions with month of birth deserves further investigation.

Adult↗
PubMed1996

Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?

OBJECTIVE: To evaluate the psychiatric, cognitive, and functional correlates of attention-deficit hyperactivity disorder (ADHD) children with and without comorbid bipolar disorder (BPD). METHOD: DSM-III-R structured diagnostic interviews and blind raters were used to examine psychiatric diagnoses at baseline and 4-year follow-up in ADHD and control children. In addition, subjects were evaluated for cognitive, academic, social, school, and family functioning. RESULTS: BPD was diagnosed in 11% of ADHD children at baseline and in an additional 12% at 4-year follow-up. These rates were significantly higher than those of controls at each assessment. ADHD children with comorbid BPD at either baseline or follow-up assessment had significantly higher rates of additional psychopathology, psychiatric hospitalization, and severely impaired psychosocial functioning than other ADHD children. The clinical picture of bipolarity was mostly irritable and mixed. ADHD children with comorbid BPD also had a very severe symptomatic picture of ADHD as well as prototypical correlates of the disorder. Comorbidity between ADHD and BPD was not due to symptom overlap. ADHD children who developed BPD at the 4-year follow-up had higher initial rates of comorbidity, more symptoms of ADHD, worse scores on the CBCL, and a greater family history of mood disorder compared with non-BPD, ADHD children. CONCLUSIONS: The results extend previous results documenting that children with ADHD are at increased risk of developing BPD with its associated severe morbidity, dysfunction, and incapacitation.

Adolescent↗
PubMed2006

Effect of anxiety reduction on children's school performance and social adjustment.

This study tested the effect of reductions in children's anxiety over time on improvements in school performance and social functioning in the context of participation in a cognitive-behavioral intervention program. Participants included 40 children with high anxiety (6-13 years of age). Independent evaluators, children, and parents rated child anxiety; parents rated school performance; and children and parents rated social functioning. Measures were completed at preintervention, midintervention, and postintervention. Fixed-effects regression analyses and random-effects regression analyses indicated that decreased anxiety was predictive of improved school performance and social functioning over the course of the intervention. These findings suggest that changes in anxiety influence trajectories of children's scholastic and social functioning.

Achievement↗
PubMed2002

Effects of glutathione-S-transferase M1, T1, and P1 on childhood lung function growth.

The effects of glutathione-S-transferase (GST) M1, GSTT1, and GSTP1 genotypes on lung function growth were investigated in 1,940 children enrolled in the Children's Health Study as fourth graders (aged 8-11 years) in two cohorts during 1993 and 1996 and were followed annually over a 4-year period. Genotypes for GSTM1 and GSTT1 and GSTP1 codon 105 variants (ile105 and val105) were determined using DNA from buccal cell specimens. We used two-level regression models to estimate the effects of GSTM1, GSTT1, and GSTP1 genotypes on the adjusted annual average lung function growth. GSTM1 null was associated with deficits in annual growth rates for FVC (-0.21%; 95% confidence interval [CI], -0.40, -0.03) and FEV(1) (-0.27%; 95% CI, -0.50, -0.04). Children who were homozygous for the GSTP1 val105 allele had slower lung function growth (FVC -0.35%; 95% CI, -0.62, -0.07; and FEV(1) -0.34%; 95% CI, -0.68, 0.00) than children with one or more ile105 alleles. Children with asthma who were homozygous for the GSTP1 val105 allele had substantially larger deficits in FVC, FEV(1), and maximal mid-expiratory flow than children without asthma. The deficits in FVC and FEV(1) growth associated with both GSTM1 null and the GSTP1 val105 allele were largest and were statistically significant in non-Hispanic white children. We conclude that GSTM1 and GSTP1 genotypes are associated with lung function growth in school children.

Case-Control Studies↗
PubMedDate not supplied

[State of the visual organ in pupils of a secondary school and a general education school].

The impact of school loads on visual function was studied in 845 pupils from two general educational schools and two lyceums of Izhevsk. The studies confirmed the negative impact of school teaching on the children's vision. Negative trends were most noticeable in junior (1st-5th-form), girls, and children having additional classes, in the lyceums in particular.

Accommodation, Ocular↗
PubMed2001

Methodological complexities in the diagnosis of major depression in youth: an analysis of mother and youth self-reports.

OBJECTIVE: Considering the well-documented low level of agreement between youth and parent reports on the diagnosis of major depressive disorder (MDD), uncertainties remain as to the informativeness of discrepant youth and parent reports in clinical studies. To this end we evaluated whether morbidity and functional correlates on the diagnosis of MDD in youth vary by informant source. METHODS: The sample consisted of 186 pairs of independently assessed mother and youth self-reports on the diagnosis of MDD using structured diagnostic interviews ascertained in a large study of youth with and without attention deficit hyperactivity disorder of both genders. Subjects were also assessed on measures of interpersonal, school, and family functioning as well as prior treatment history. RESULTS: The diagnosis of MDD endorsed by youth self-report only when compared with that reported by the mother was characterized by significantly: shorter duration episode, later age at onset, milder depression-associated impairment, less impairment in interpersonal functioning, lower rates of comorbid disorders, and decreased likelihood to receive any course of treatment for depression. The morbidity and dysfunction associated with MDD varied significantly by informant source, and followed a dose-response association with the highest morbidity associated with the concurrent reports of the youth and the mothers, followed by mother report alone, with the least morbidity and dysfunction when endorsed by youth alone. CONCLUSIONS: These findings suggest that exclusive reliance on youth self-reports may identify a mild form of depression associated with limited morbidity and disability compared with that identified by parental reports.

Adolescent↗
PubMed1999

Risk factors for poor health-related quality of life in adolescents with epilepsy.

PURPOSE: To examine potential risk factors for poor health-related quality of life (HRQOL) among adolescents with epilepsy by using the newly developed QOLIE-AD-48. Risk factors were derived from sociodemographic, social, academic, and epilepsy- and health-related domains. METHODS: The QOLIE-AD-48 was administered to 197 English-speaking adolescents (age 11-17 years from >20 sites in the United States and in Canada). The self-report instrument yields an overall HRQOL score and eight subscale scores. Other data were obtained from family interviews, physician reports, and health records. Multiple regression analyses were conducted to study risk factors for impairment of HRQOL. RESULTS: Older adolescents (age 14-17 years), those with more severe epilepsy and more symptoms of neurotoxicity, and those living in households with lower socioeconomic status were more likely to report poor overall HRQOL. Risk factors in the eight HRQOL domains were found as follows: (a) Epilepsy Impact: older age in adolescence, more severe epilepsy and neurotoxicity, more hospitalizations during the past year, and fewer hours of extracurricular activities; (b) Memory and Concentration: longer duration of epilepsy, special education classes, and history of repeating a grade in school; (c) Attitude Toward Illness: older age, female gender, and more severe epilepsy and neurotoxicity; (d) Social Support: younger age, male gender, and fewer hospitalizations in the last year; (e) Stigma: lower socioeconomic status and special-education classes; and (f) Health Perceptions: older age, female gender, and lower socioeconomic status. None of the factors examined was significantly associated with HRQOL in (g) Physical Functioning or (h) School Behavior subscales. CONCLUSIONS: We identified several risk factors for poor HRQOL outcomes in adolescents with epilepsy. Age, increased seizure severity, and neurotoxicity were most consistently associated with poor HRQOL across domains. Older adolescents, independent of epilepsy severity, reported worse overall HRQOL than did their younger counterparts. Older adolescents also were more likely to perceive a greater negative impact on life and general health, and had more negative attitudes toward epilepsy. Adolescent boys and girls may show different sensitivities to various quality-of-life domains.

Achievement↗
PubMed2004

Predictors of smoking development in a population-based sample of adolescents: a prospective study.

PURPOSE: To study the development of smoking behavior in adolescents using a longitudinal, multivariate design. METHODS: Adolescents (n = 14,133, age range 12 to 18 years) took part in the longitudinal Add Health study (two waves, separated by 1 year, 56% smokers and 44% nonsmokers at Wave 1). Eight risk factor domains were established at Wave 1 (daily activities, psychological health, personality, school situation, family functioning, rough living, religion, and neighborhood status), which were further separated into subdomains by factor analysis. Subdomains were used to predict risk at Wave 2 of smoking initiation, progression, or failure to discontinue, using logistic regression analysis. Analyses were performed for boys and girls separately and results corrected for age, race, urbanicity, and socioeconomic status. RESULTS: Use/abuse of other substances by self and peers influenced most stages of smoking, whereas trouble in school was associated with initiation and progression of smoking. Poor family relations predicted initiation of experimental smoking for girls, whereas low involvement in active pastimes predicted failure to discontinue experimental smoking. For boys, low religiosity predicted progression to regular smoking and failure to quit regular smoking, whereas delinquency also reduced success of regular smoking discontinuation. CONCLUSIONS: These findings may direct efforts for prevention and intervention of adolescent smoking behavior and may also provide guidance for future studies.

Adolescent↗
PubMedDate not supplied

School-based youth health nurses: roles, responsibilities, challenges, and rewards.

A case study and focus-group discussions were conducted with 10 youth health nurses (nurses) employed in the recently introduced School-Based Youth Health Nurse Program (SBYHNP) to identify their roles, responsibilities, and professional development needs. Major roles are support, referral, health promotion, and marketing. Clients include high school students, teachers, and parents; the majority of whom are female and aged 13-16 years. Health issues addressed during individual consultations are predominantly psychosocial but also include medical, sexual health and sexuality issues, health surveillance, and risk-taking behaviors. Nurses also provide clients with health information and promote enhanced personal skill development during these consultations. Health promotion strategies undertaken by nurses were predominantly health education and health information displays. Nurses reported marketing their role and function within the school to be an essential and often difficult aspect of their role. Professional development through the SBYHNP was excellent; however, there was concern relating to the availability of future educational opportunities. The SBYHNP provides nurses with a new, challenging, autonomous role within the school environment and the opportunity to expand their role to incorporate all aspects of the health-promoting schools' framework.

Adolescent↗
PubMed2006

Postsurgical outcome in pediatric patients with epilepsy: a comparison of patients with intellectual disabilities, subaverage intelligence, and average-range intelligence.

PURPOSE: Intellectual disabilities are often associated with bilateral or diffuse morphologic brain damage. The chances of becoming seizure free after focal surgery are therefore considered to be worse in patients with intellectual disabilities. The risk of postoperative cognitive deficits could increase because diffuse brain damage lowers the patient's ability to compensate for surgically induced deficits. Several studies in adult patients have indicated that IQ alone is not a good predictor of postoperative cognitive and seizure outcome. Our study evaluated this subject in children and adolescents. METHODS: Pediatric patients with intellectual disabilities (IQ < or = 70), subaverage intelligence (IQ between 71 and 85), or average-range intelligence (IQ > 85) were matched according to several clinical and etiologic criteria to determine the influence of IQ (N = 66). RESULTS: No dependency of seizure outcome, postoperative cognitive development, and behavioral outcome on the IQ level was found. All groups slightly improved in attention while memory functions tended to decrease and executive functions were stable. School placement remained unchanged for the majority of patients. Between 67 and 78% were seizure free 1 year after surgery (Engel outcome class I). CONCLUSIONS: IQ alone is not a good predictor of postoperative outcome in pediatric patients with epilepsy. As with patients of average-range intelligence, the decision to operate on patients with a low level of intelligence should depend on the results of the presurgical diagnostics. If the results of the neuropsychological examination indicate diffuse functional impairment, this should not hinder further steps, if all other findings are consistent.

Achievement↗
PubMed1994

Left ventricular structure and function by echocardiography in childhood swimmers.

The purpose of this study was to determine the differences in the left ventricular dimensions, mass index and function in school-aged swimmers by echocardiography. The study group consisted of 82 swimmers who participated in a systematic swimming training for at least six months, and the control group consisted of 41 sedentary children of similar age, sex and weight. In the study group, left ventricular dimensions and wall thicknesses, aortic root and left atrium diameters, and left ventricle mass index were significantly greater than the normal children (p < 0.05). However, there was no difference in the left ventricular systolic function (ejection fraction, shortening fraction) or in the left ventricular filling characteristics (p > 0.05). In conclusion, in childhood swimmers there was a significant increase in left ventricular dimensions, wall thicknesses and mass index, but no differences in the systolic function and filling characteristics of the left ventricle. Thus, information on endurance training participation is necessary to interpret quantitative echocardiographic data.

Adolescent↗
PubMed1994

Changes of physical performance as indicators of the response to enhanced physical education.

The value of field performance tests in the assessment of a programme of enhanced physical education has been examined in a 3-factor study of students over all 6 primary school grades. The enhanced programme under review offered a one hour of required physical education daily from age 7 to 12 years, taught by a specialist physical educator. Control students from immediately preceding and succeeding classes continued with the standard programme, a standard single period of physical education per week taught by a nonspecialist. Subjects were classed by gender, environment (urban vs rural school) and the experimental intervention to allow analysis by MANOVA. Students in the experimental programme showed small but statistically significant gains in laboratory measures of aerobic power and muscle strength relative to controls. In general, these responses were mirrored by gains in scores on the Canadian Association for Health Physical Education and Recreation (CAHPER) field performance test battery. The latter tests also suggested gains of anaerobic power, coordination and muscular endurance. It is concluded that an enhanced programme of physical education can enhance function in primary school students, but the size of gains is not a strong argument for such programmes. Further, gains in performance test scores indicate the direction, but not necessarily the magnitude of programme responses.

Anaerobic Threshold↗
PubMedDate not supplied

The impact of an emotional self-management skills course on psychosocial functioning and autonomic recovery to stress in middle school children.

Unmanaged emotional reactions to stress not only lead to behavior problems in young people but also create physiological conditions that inhibit learning and potentially increase the risk of disease later in life. For these reasons, the integration of emotional self-management skills training programs has become an increased priority in some schools. In this study, middle school students enrolled in a course in emotional competence skills learned techniques designed to intercept stressful responses during emotionally challenging situations. Behavioral outcomes were assessed using the Achievement Inventory Measure and autonomic function was measured by heart rate variability (HRV) analysis during and after a stressful interview. Following the program, students exhibited significant improvements in areas including stress and anger management, risky behavior, work management and focus, and relationships with family, peers and teachers. These improvements were sustained over the following six months. Students using the skills taught in the course to recover from acute emotional stress were also able to positively modulate their physiological stress responses. As compared to a control group, trained students demonstrated significantly increased HRV and more rhythmic, sine wave-like heart rhythm patterns during recovery. This response pattern reflects increased parasympathetic activity, heart rhythm coherence, and entrainment of other biological oscillatory systems to the primary heart rhythm frequency. Increased physiological coherence is associated with improved cognitive performance, emotional balance, mental clarity and health outcomes. These physiological shifts could promote the sustained psychological and behavioral improvements associated with the use of emotional management skills. It is suggested that learning emotional competence skills in childhood establishes healthier physiological response patterns which can benefit learning and long-term health. Results provide support for the integration in school curricula of courses designed to teach effective self-management skills to children.

Acute Disease↗
PubMed1986

Young adolescents' perception of their peers who wear hearing aids.

In order to evaluate the perceptions of young adolescents of their peers who wear hearing aids, observers were selected from four types of schools: rural, suburban, inner city, and a self-contained classroom for the hearing impaired. Observers made semantic differential ratings of two teen-aged peers, one of whom had normal hearing and one of whom had a moderately severe sensorineural hearing loss. Both boys spoke under three conditions: wearing a postauricular hearing aid, wearing a body aid, and wearing no aid at all. Results indicated at least partial support for the "hearing aid effect" (Blood and Blood, 1977) as evidenced by the differential perceptions of the observers as a function of the school they attended, differential reactions to the hearing impaired speaker and the one with normal hearing, and the absence, presence, and type of hearing aid worn. This study reports the perceptual similarities and differences among observer groups and between the two speakers. Further, it is suggested that the overall speech quality, in addition to the absence, presence, and type of hearing aid, is important to peer perceptions.

Adaptation, Psychological↗
PubMed2004

Contextualism and the development of effective prevention practices.

Widespread and effective implementation of research-based prevention practices will be facilitated by the explicit adoption of a functional contextualist framework for prevention research. Such a framework has as its central goal predicting and influencing behavior and cultural practices. Research within this framework is evaluated in terms of its ability to contribute to that goal. As a result, it contributes directly to the ultimate goals of prevention science-affecting the incidence and prevalence of problems in populations. The approach contrasts with the mechanist framework, which is implicit in much behavioral science research. The mechanist framework has as its truth criterion the predictive verification of models of the interrelationships among variables. Such models can-but need not-identify manipulable variables that can be exploited to affect problems of interest. Such models require the inclusion of multiple cases for testing and this requirement may impede the tendency of scientists to work with a single school or community. Functional contextualism is suited to the study of the individual case. It provides a framework within which researchers can more readily collaborate with practitioners in the development and further evaluation of practices within the settings where practitioners will ultimately use those practices.

Models, Organizational↗