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PubMed1986

Peer interactions of conduct-disordered, anxious-withdrawn, and well-adjusted black adolescents.

The relationship between behavior problems and adolescent peer relations was examined in 30 black male adolescents divided into three equal-sized groups on the basis of individual psychosocial functioning (conduct-disordered, anxious-withdrawn, well-adjusted). Groups were matched on age, IQ, and father absence. An observational method was used to evaluate dominance, conflict, affect, and social competence manifested with a friend and with a well-adjusted stranger. Conduct-disordered and anxious-withdrawn adolescents displayed less social competence and less positive affect than well-adjusted adolescents when interacting with both friends and strangers. Anxious-withdrawn adolescents evidenced more personal apprehension than their well-adjusted counterparts. All groups showed greater leadership ability, talked more, and showed less personal apprehension with friends than with strangers. The findings support the role of peer relations in the maintenance and exacerbation of adolescent psychosocial difficulties.

Adolescent↗
PubMed1999

Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays.

The aims of this longitudinal study were: (1) to assess the continuity and change in diagnosis, intelligence, and language skills in children with autism, Down syndrome, and other developmental delays, (2) to specify the deficits in social competence and language skills in these children, and (3) to identify precursors in the preschool period of gains in language skills and of peer engagement in the mid-school years. The initial sample consisted of 70 children with autism, 93 children with Down syndrome, 59 children with developmental delays, and 108 typically developing children, with the first three groups of children studied when they were between 2 and 6 years of age. At follow-up, 51 children with autism, 71 children with Down syndrome, and 33 children with developmental delays were assessed at mean ages around 10-13 years. The long-term follow-up showed little change in the diagnosis of autism but sizeable improvements in intellectual and language abilities within the autistic group, a pattern that was not seen in the children with Down syndrome. Unique deficits in joint attention, some forms of representational play, responsiveness to the emotions of others, and initiation of peer engagement were identified in the autistic children, whereas the children with Down syndrome seemed to have a specific deficit only in language. Joint attention skills were concurrently associated with language abilities in all groups and predicted long-term gains in expressive language for the children with autism. Children with autism, regardless of their level of functioning, were less socially engaged with classmates than the other developmentally disabled children because they infrequently initiated and accepted play bids, not because they were rebuffed by peers. Early nonverbal communication and play skills were predictors of the frequency of initiations of peer play for the children with Down syndrome as well as the extent of peer engagement of the children with autism. These results suggest that improvements in early communication and play skills may have long-term consequences for later language and social competence in these groups of children.

Adolescent↗
PubMedDate not supplied

Intravenous cyclophosphamide therapy for systemic sclerosis. A single-center experience and review of the literature with pooled analysis of lung function test results.

OBJECTIVE: Oral cyclophosphamide (CYC) is a promising therapy for Systemic Sclerosis (SSc)-related interstitial lung disease (ILD). The use of intravenous (i.v.) pulses has been considered as an alternative route of drug administration, possibly associated with reduced toxicity. Our objectives were to re-evaluate our experience with i.v. CYC, to review the literature, and to pool our results with those available from other groups, improving the statistical power of the analysis. METHODS: 1) Retrospective analysis of our center experience on 16 patients with SSc and active alveolitis, treated with i.v. CYC 750 mg + 6-methylprednisolone 125 mg every 3 weeks. 2) Pooled analysis of papers published in peer-reviewed journals reporting detailed data on each patient treated with i.v. CYC. The end-point was modification in the results of lung function tests (LFT) after 6 months. Piecewise regression analysis was performed using a linear mixed-effects model adjusted for baseline values to evaluate the changes in LFT. RESULTS: Retrospective analysis. In the period before therapy there was a significant deterioration in FVC (in 6 months: -4.3%; p=0.0009) and DLCO (-2.1%; p=0.018). After 6 months of treatment there was a modest improvement in the FVC (+2.7% p=0.08) and DLCO (+2.2%; p=0.08). Pooled analysis. In 53 evaluable patients, the improvement in LFT reached conventional statistical significance (FVC: +2.85%; 95% confidence intervals: +0.04, +5.66%; p=0.04. DLCO: +4.4%; 95% confidence intervals: +1.2%, +7.5%; p<0.001). CONCLUSION: i.v. CYC for 6 months can achieve a small, but significant improvement of LFT in patients with SSc and active alveolitis.

Adult↗
PubMed2006

Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor.

BACKGROUND: The improved prognosis of childhood cancer makes monitoring of functional outcome important. The purpose of this study was to evaluate behavioral and educational functioning in survivors of childhood acute lymphoblastic leukemia (ALL) or a Wilms tumor. In this study, children with ALL received central nervous system directed chemotherapy without cranial irradiation. METHODS: In a multicenter study, behavioral functioning and school performance was examined in 199 children age 4 to 18. Sixty-four children were at least 1 year from finishing treatment with chemotherapy for ALL (n = 28) or a Wilms tumor (n = 36). They were compared with siblings (n = 37) and with a control group of healthy schoolchildren (n = 98). RESULTS: A moderately increased risk of behavioral and educational problems was found in children with ALL but not in children with Wilms tumor. School performance was poorer in children with ALL attending primary school compared with same-age peers; however, the rate of utilization of special education services was low. Teacher-rated behavior and mathematics performance was correlated with attention function in children with ALL. An excess of problem behavior and underperformance at school was found in the ALL high-risk group compared with the standard-risk group. No differences were found between siblings and controls. CONCLUSION: Evidence is provided of subtle but significant behavioral and educational problems in survivors of childhood ALL, but no dysfunctions in survivors of a Wilms tumor. Careful follow-up of children with ALL treated with chemotherapy only is warranted.

Adolescent↗
PubMedDate not supplied

Exercise limitations and training for patients with cystic fibrosis.

Exercise has much to offer to cystic fibrosis patients. Overcoming the limits of decreased pulmonary function by increasing fitness has a considerable potential to improve patients' quality of life; decreased breathlessness allows greater mobility and participation with peers in social and sporting activities, improves confidence and self-esteem and creates a greater pleasure in life for the individual patient. There are also immediate therapeutic gains and potentially long-term gains with improved survival. Above all, cystic fibrosis patients enjoy and prefer exercise as a therapeutic option to most other forms of therapy.

Cystic Fibrosis↗
PubMedDate not supplied

The Belgian-Flemish 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 Belgian-Flemish 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 Belgian-Flemish CHAQ was fully validated with 3 forward and 3 backward translations, while the Belgian-Flemish CHQ was equal to the Dutch version and revalidated in this study. The French version of both CHAQ and CHQ was exactly the same as the one used in France. A total of 199 subjects were enrolled: 53 patients with JIA (11% systemic onset, 40% polyarticular onset, 13% extended oligoarticular subtype, and 36% persistent oligoarticular subtype) and 146 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular onset, 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 Belgian-Flemish version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗
PubMed2001

Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial.

OBJECTIVE: To determine the effect of a peer led programme for asthma education on quality of life and related morbidity in adolescents with asthma. DESIGN: Cluster randomised controlled trial. SETTING: Six high schools in rural Australia. PARTICIPANTS: 272 students with recent wheeze, recruited from a cohort of 1515 students from two school years (mean age 12.5 and 15.5 years); 251 (92.3%) completed the study. INTERVENTION: A structured education programme for peers comprising three steps (the "Triple A Program"). MAIN OUTCOME MEASURES: Quality of life, school absenteeism, asthma attacks, and lung function. RESULTS: When adjusted for year and sex, mean total quality of life scores showed significant improvement in the intervention than control group. Clinically important improvement in quality of life (>0.5 units) occurred in 25% of students with asthma in the intervention group compared with 12% in the control group (P=0.01). The number needed to treat was 8 (95% confidence interval 4.5 to 35.7). The effect of the intervention was greatest in students in year 10 and in females. Significant improvements occurred in the activities domain (41% v 28%) and in the emotions domain (39% v 19%) in males in the intervention group. School absenteeism significantly decreased in the intervention group only. Asthma attacks at school increased in the control group only. CONCLUSION: The triple A programme leads to a clinically relevant improvement in quality of life and related morbidity in students with asthma. Wider dissemination of this programme in schools could play an important part in reducing the burden of asthma in adolescents.

Absenteeism↗
PubMed1998

The nature of teacher talk in early childhood classrooms and its relationship to children's play with objects and peers.

The nature of teacher talk in early childhood classrooms as well as how such talk is related to children's level of play with objects and peers during free play was examined. The purpose of the study was to determine what levels of teacher talk were related to child functioning. Eighty-nine children (42 girls, 47 boys; age range = 31 through 63 months) enrolled in three early childhood programs participated in the study. Results demonstrated that when teachers are within 3 ft of a child, they do not talk to that child 81% of the time and they talk at high levels 18% of the time. Although previous research suggests that high-level teacher talk should be related to high-level play with objects, the results indicated that high-level teacher talk was related to lower levels of play with objects and unrelated to play with peers on the part of the children.

Analysis of Variance↗
PubMed2004

Biophysical characterization of ERp29. Evidence for a key structural role of cysteine 125.

ERp29 is a major resident of the endoplasmic reticulum (ER) that seemingly plays an important role in most animal cells. Although a protein-folding association is widely supported, ERp29's specific molecular function remains unknown. A chaperone activity was postulated from evidence that ERp29 forms multimers like the classical ER chaperones, but conflicting results have emerged from our recent studies. Here a biophysical approach was used to clarify this issue and also reveal a key structural role for ERp29's characteristic cysteine, Cys-125. Applying hydrodynamic parameters derived from sedimentation and dynamic light-scattering analyses, a model of ERp29's quaternary structure was assembled from existing tertiary substructures. Comparison with Windbeutel, an ERp29-like protein from fruit fly with specialized chaperone activity, revealed similar tri-lobar gross structures but some finer differences consistent with functional divergence. Solubility and hydrophobic probe assays revealed moderate surface hydrophobicity, which was reduced in mutant ERp29 in which serine replaced Cys-125. This mutant was also relatively labile to proteolytic degradation, providing two reasons for the strict conservation of Cys-125. No multimerization was observed with untagged ERp29, which existed as tight homodimers (K(d) < 50 nm), whereas His-tagged ERp29 artifactually formed 670-kDa oligomers. These findings distinguish ERp29 biophysically from its peers in the ER including Windbeutel, endorsing our postulate that ERp29 adds a distinct type of folding activity to the ER machinery. By invoking novel functional associations for Cys-125 and the adjoining linker, new clues about how ERp29 might work have also arisen.

Animals↗
PubMed1998

Social anxiety in children with anxiety disorders: relation with social and emotional functioning.

Investigated the psychometric properties of the Social Anxiety Scale for children-Revised (SASC-R) as well as relations between social anxiety and children's social and emotional functioning. Participants were a clinic sample of children, ages 6-11 with anxiety disorders (N = 154) who completed the SASC-R. For a subset of these children, parent ratings of social skills, and self-ratings of perceived competence and peer interactions were also obtained. Factor analysis of the SASC-R supported the original three-factor solution and internal consistencies were in the acceptable range. Among children with simple phobia, scores on the SASC-R differentiated those with and without a comorbid social-based anxiety disorder. Social anxiety was also associated with impairments in social and emotional functioning. Specifically, highly socially anxious children reported low levels of social acceptance and global self-esteem and more negative peer interactions. Girls with high levels of social anxiety were also rated by parents as having poor social skills, particularly in the areas of assertive and responsible social behavior.

Anxiety Disorders↗
PubMed1978

Determination of brain death via pulsatile echoencephalography.

For cerebral death to occur there must be many levels of cerebral function destroyed. Cortical and subcortical irreversible damage is evident by unresponsiveness to any stimuli. Brain stem and basal ganglia damage is indicated by absence of spontaneous respirations, cephalic reflexes, and thus cerebral circulation. All elements of the criteria for cerebral death must be met. The decision should be made by the attending physician in consultation with his peers. The life support mechanisms should be discontinued after the diagnosis of cerebral death has been made. Absence of pulsatile echoes means absence of cerebral circulation and cerebral function, or a definitive diagnosis of cerebral death. It is a final parameter in the criteria and allows definite measures to be taken. But it behooves one to remember that this phenomenon of cerebral death makes organ donation and transplantation possible. It has not been created in order to supply the needs for organ transplant!

Adult↗
PubMedDate not supplied

The Swiss German and Swiss French versions 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 Swiss German and Swiss French languages 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 Swiss German and Swiss French CHAQ-CHQ were adapted from the German and French versions of the CHAQ-CHQ, and revalidated in this study. A total of 147 subjects were enrolled: 85 patients with JIA (22% systemic onset, 31% polyarticular onset, 32% extended oligoarticular subtype, and 15% persistent oligoarticular subtype) and 62 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 Swiss German and Swiss French versions of the CHAQ-CHQ are reliable, and valid tools for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗
PubMed2003

Peer-group risk assessment: a post-traumatic management strategy for hierarchical organizations.

BACKGROUND: Organizations have moral and legal duties to consider the psychological needs of their workforce following exposure to potentially traumatic events related to the workplace. Additionally, it makes economic sense to avoid loss of valuable personnel to the effects of psychological trauma. There have been attempts to provide a range of psychological interventions for staff after exposure to potentially traumatizing events, but recent evidence-based medicine publications have questioned their effectiveness and, indeed, some studies show that single-session psychological debriefings may be harmful. AIM: This paper presents a post-traumatic management strategy based upon peer-group risk assessment which was developed by the British military and is in use with other hierarchical organizations. The presented model keeps employees functioning after traumatic events and provides support and education to those who require it. Additionally, the strategy aims to identify those who are unable to cope after potentially traumatizing events and aims to refer them for early intervention, which has been shown to be of benefit.

Adult↗
PubMed2002

Long-term neuropsychological effects of sagittal craniosynostosis on child development.

The link between cranial deformity and "functional" disability is not obvious in single-suture sagittal craniosynostosis. Physicians have anecdotally reported that children with simple craniosynostosis often seem to have a higher proportion of learning disabilities and cognitive problems than their nonafflicted peers. These problems have not been systematically studied, however. This study examined the long-term neuropsychological effects of single-suture sagittal craniosynostosis on selected aspects of neurological development. It did so by going beyond global measures of mental function (intelligence quotient) in an attempt to assess the incidence of subtle neuropsychological sequelae. Retrospective inspection of the Yale Department of Neurosurgery records between 1980 and 1990 was used to identify study subjects born with nonsyndromic sagittal suture craniosynostosis who were between 6 and 16 years of age at the time of the study. Of the 16 study subjects born with sagittal synostosis, which is thought to be among the most benign of the single-suture craniosynostoses, this study found that 50% had a reading and/or spelling learning disability. Although children with single-suture sagittal craniosynostosis fall within the normal range for intelligence, there is a significantly higher incidence of learning disabilities in this group than in the general population.

Adolescent↗
PubMed2005

Neural network estimation of balance control during locomotion.

Gait patterns of the elderly are often adjusted to accommodate for reduced function in the balance control system and a general reduction in skeletal muscle strength. Recent studies have demonstrated that measures related to motion of whole body center of mass (COM) can distinguish elderly individuals with balance impairment from healthy peers. Accurate COM estimation requires a multiple-segment anthropometric model, which may restrict its broad application in assessment of dynamic instability. Although temporal-distance measures and electromyography have been used in evaluation of overall gait function and determination of gait dysfunction, no studies have examined the use of gait measurements in predicting COM motion during gait. The purpose of this study was to demonstrate the effectiveness of an artificial neural network (ANN) model in mapping gait measurements onto COM motion in the frontal plane. Data from 40 subjects of varied age and balance impairment were entered into a 3-layer feed-forward model with back-propagated error correction. Bootstrap re-sampling was used to enhance the generalization accuracy of the model, using 20 re-sampling trials. The ANN model required minimal processing time (5 epochs, with 20 hidden units) and accurately mapped COM motion (R-values up to 0.89). As training proportion and number of hidden units increased, so did model accuracy. Overall, this model appears to be effective as a mapping tool for estimating balance control during locomotion. With easily obtained gait measures as input and a simple, computationally efficient architecture, the model may prove useful in clinical scenarios where electromyography equipment exists.

Age Factors↗
PubMed2000

A prospective study of familial and social influences on girls' body image and dieting.

OBJECTIVE: This study examines the emergence of body image concerns and dieting behaviors in early adolescence as a function of girls' perceptions of family relationships, maternal modeling of dieting behaviors and body image concerns, and familial and peer pressures to diet. METHOD: Self-report measures were obtained from 77 White girls and their mothers in early adolescence (mean age = 12.3 years) and 1 year later. RESULTS: Girls' perceptions of family relations and mothers' perceptions of daughters' weight at Time 1 significantly predicted girls' dieting behavior 1 year later over and above Time 1 dieting and body image. Only girls' previous body image and dieting behaviors significantly predicted more body dissatisfaction 1 year later. Girls' body image was found to mediate the relationship between family relations and dieting at Time 1 assessment, but not over time. DISCUSSION: The importance of implementing early prevention and interventions programs is discussed.

Adolescent↗
PubMed2005

[Digital teaching archive. Concept, implementation, and experiences in a university setting].

Film-based teaching files require a substantial investment in human, logistic, and financial resources. The combination of computer and network technology facilitates the workflow integration of distributing radiologic teaching cases within an institution (intranet) or via the World Wide Web (Internet). A digital teaching file (DTF) should include the following basic functions: image import from different sources and of different formats, editing of imported images, uniform case classification, quality control (peer review), a controlled access of different user groups (in-house and external), and an efficient retrieval strategy. The portable network graphics image format (PNG) is especially suitable for DTFs because of several features: pixel support, 2D-interlacing, gamma correction, and lossless compression. The American College of Radiology (ACR) "Index for Radiological Diagnoses" is hierarchically organized and thus an ideal classification system for a DTF. Computer-based training (CBT) in radiology is described in numerous publications, from supplementing traditional learning methods to certified education via the Internet. Attractiveness of a CBT application can be increased by integration of graphical and interactive elements but makes workflow integration of daily case input more difficult. Our DTF was built with established Internet instruments and integrated into a heterogeneous PACS/RIS environment. It facilitates a quick transfer (DICOM_Send) of selected images at the time of interpretation to the DTF and access to the DTF application at any time anywhere within the university hospital intranet employing a standard web browser. A DTF is a small but important building block in an institutional strategy of knowledge management.

Computer-Assisted Instruction↗
PubMed1989

West Indian adolescents' perceptions of family functioning.

A total of 424 Barbadians aged 13-15 years completed the Family Functioning in Adolescence Questionnaire, developed in Australia by Roelofse and Middleton (1985). Findings revealed most adolescents, like their Australian peers, reported fairly favourable perceptions of their families. However, neither total nor sub-scale scores served to discriminate between sub-groups based on sex, age or household structure to any great extent. A re-grouping of items based on results of Varimax analysis also failed to yield many significant group differences, although some directions for future research were indicated. Adolescents not living with their fathers seemed to have a somewhat lower sense of personal security, but in other respects did not report their family life any less favourably than did those living with both natural parents.

Adolescent↗