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Respiratory health status of the roadside school children at Kolkata.

School students in metro cities are often exposed to vehicle exhausts as their schools are situated mostly on the high traffic roadside. Acute exposure to automobile exhaust is associated with increased respiratory symptoms and may decrease and impair lung function in children. The lung functioning performance of the city school children was compared with rural school children where there is no pollution and automobile exhausts. In Kolkata, two schools for boys (n = 210) and two schools for girls (n = 200) and in rural area one school for boys (n = 99) and the other school for girls (n = 95) were investigated. City schools are situated on the main roadside, nearer to the traffic junction. The detail histories about health status of children, if they have any subjective feelings of health related problems during the school hours or after returning from the school, and the family histories were taken by questionnaire method. The pulmonary function tests (PFT) were carried out by Spirometric method by Spirovit-Sp-10 and Wright's Peak flow meter. The mean PFT values of the students found in the normal range. Boys were having higher values compared to the girls in both city and rural schools. Lung volumes and flow rates were significantly higher in rural students. Symptomatic changes like breathlessness, cough and other problems (sneezing, eye irritation, running nose etc.) among city schoolboys found 13%, 7% and 15% and in girls found 12%, 6% and 7% respectively. In symoptomatic students, mean PFT values were significantly lowered compared to non-symptomatic. PFT values were presented in relation to age and height. It has been found that a number of city school students are having different types of respiratory symptoms. Long-term effect of exposure into such environment may develop lung functional impairments.

Adolescent↗

Cognitive effects of diarrhea, malnutrition, and Entamoeba histolytica infection on school age children in Dhaka, Bangladesh.

Cognitive function was assessed in 191 Bangladeshi children 6-9 years of age using verbal and nonverbal tests. These scores were added to a health surveillance database that was compiled over the four previous years that includes incidence of diarrhea and Entamoeba histolytica infection and nutritional status. The associations of diarrhea, malnutrition, and social factors with cognitive scores were analyzed statistically, and associations between diarrhea and test scores were controlled for the influence of social factors. Cognitive scores were negatively associated with stunting during school age, as well as the height-for-age and weight-for-age scores at study enrollment. Incidence of diarrhea was associated with nonverbal test scores before, but not after, controlling for socioeconomic factors. Generally E. histolytica infection was not found to independently influence scores, except that E. histolytica-associated dysentery was associated with lower test scores while dysentery of any etiology was not. Thus, malnutrition during the school age years, but not diarrhea or E. histolytica infection, was associated with a lower level of cognitive functioning. This suggested that intervention during school age years may be able to mitigate the cognitive deficiencies associated with malnutrition.

Animals↗

[Functional impact of hospitalization among elderly patients].

OBJECTIVE: To describe functional capacity changes of elderly during hospitalization and to assess the correlation of these changes at the time of hospital discharge and sociodemographics and clinical variables. METHODS: There were studied 94 patients aged 65 to 94 years admitted to a geriatric-gerontological hospital unit of a school hospital. The first functional capacity evaluation (number of daily living activities impaired) of the elderly patients was carried out up to 24 hours after admission and the last one immediately after discharge. Routine therapeutic interventions were performed by an interdisciplinary health care team in the study period. Data was analyzed using Chi-square test (alpha< or = 0.05). RESULTS: Of all patient studied, 25.6% improved their functional capacity, 34.0% had not had functional changes, 19.1% had worsened functionally, and 21.3% died during the study period. A significant correlation was seen between functional deterioration and cognitive deficits, delirium, and low functional capacity at admission. CONCLUSIONS: Functional capacity is an important marker of health in hospitalized elderly. Functional improvement during hospitalization is associated to lesser impairment in daily activities at the time of admission and better clinical conditions.

Activities of Daily Living↗

Short stature--the role of intelligence in psychosocial adjustment.

Short children are often described as having psychosocial problems. These reports may be inaccurate as former studies have relied largely on parental report. Psychosocial functioning of short children was assessed with the aim of using them and their peers as informants. Twenty two short (mean (SD) height -2.53 (0.28) SD score) prepubertal children aged between 6 and 11 years were recruited from growth clinics. Comparison children were recruited from each case child's class at school. Cognitive and psychosocial functioning was assessed. Peer relationships were measured using sociometry. There were no significant group differences in terms of peer acceptance, self perception, and social competence. Although cases described themselves as receiving less social support from teachers, no differences were evident in other areas of social support. Little evidence was found to suggest clinic referred prepubertal short children are psychosocially maladjusted. Further analysis revealed cognitive ability was a better predictor than height for most aspects of behavioural and emotional adjustment.

Anthropometry↗

Renal transplantation in the infant and young child.

Fourteen renal transplantations were performed in 13 children, aged 5 years or younger, including three infants. The mean duration of follow-up was 68 months, with a range of 14 to 203 months. Eleven children are alive; of these, nine had prolonged graft function. Graft survival rate was 92% at one year and 73% at two and five years following surgery. Sustained catch-up growth occurred in all growth-retarded children who underwent successful transplantation. At this writing, the oldest patient is 20 years of age and a junior in college; all school-age children are functioning at the appropriate grade level, except one, who is one year behind. The youngest child is 3 years old and is developing normally. Infants and young children appear to be good candidates for renal transplantation.

Child Development↗

Respiratory and cardiovascular functions among smoking and nonsmoking girls from two regions with different air pollution degree.

AIM: The aim of the present study was to analyze the respiratory and cardiovascular functions among smoking and nonsmoking girls attending two schools situated in regions with different levels of air pollution. The characteristic of air pollution is based on the data gathered by stations 1 and 2 belonging to the Uniform National System for Monitoring the Air Pollution in Bulgaria. The participants (n=108, 16.07+/-0.80 years) were separated in two groups: smokers (S1 - from school 1, S2 - from school 2) and nonsmokers (NS1 - from school 1, NS2 - from school 2). All of them performed pulmonary function testing and .cardiopulmonary exercise testing on a treadmill using our modification of the Balke protocol (Marinov et al., 2000). Reference values for European children, previously validated for the Bulgarian population, were used. RESULTS: There are no significant differences in mean levels of VC, IC, FEV1, MEF50 and MEF25 (as a percentage from the predicted value as well). The average level of the Tiffneau index is noticeably higher among nonsmokers from the two regions and is the lowest among smokers from the more polluted area, but a significant difference exists between S2 (88.7+/-5.9) and NS2 (92.6+/-4.7), p=0.047; T(L,CO)%pred: S1 (85.4+/-7.2) vs. S2 (86.7+/-8.2), p=0.048 and NS1 (88.3+/-8.2) vs. NS2 (92.8+/-14.5), p=0.037; V(E)%pred: S1 (127.5+/-9.6) vs. S2 (123.7+/-6.1), p=0.035; higher levels of total lung capacity (TLC%pred), S1 (107.3+/-9.2) vs. NS2 (104.3+/-9.1), p=0.009 and alveolar ventilation (VA), S1 (5.0+/-0.6) vs. NS2 (4.6+/-0.5), p=0.008. CONCLUSIONS: 1. The negative effects of the combined influence of tobacco smoking and air pollution on some respiratory and cardiovascular functions of adolescent girls are more pronounced than each influence alone. 2. The cardiopulmonary exercise test gives adequate information about the combined effect of air pollution and smoking and using it for preventive purposes is an advisable method.

Adolescent↗

Effect of exercise training on energy expenditure, muscle volume, and maximal oxygen uptake in female adolescents.

OBJECTIVES: American female adolescents are at high risk of a physically inactive lifestyle that likely leads to health problems later in life. We hypothesized that a brief program of endurance exercise training in female adolescents would result in increased energy expenditure and quantifiable structural and functional adaptations. STUDY DESIGN: Forty-four high school girls (aged 15 to 17 years, none were elite athletes) enrolled in a 5-day per week anatomy class for 5 weeks and were randomly assigned to control (n = 22) and training groups. All subjects participated in a 2-hour daily teaching program. During the remaining time (2 hours), the training group members underwent endurance-type training and control group subjects participated in a computer workshop. The intervention was assessed by (1) comparison of total energy expenditure between groups with the doubly labeled water technique, (2) determination of changes in thigh muscle volume by magnetic resonance imaging, and (3) determination of changes in maximal oxygen uptake by use of respiratory gas exchange responses. RESULTS: Total energy expenditure was significantly greater (15.3%) in the training group compared with the control subjects (p < 0.003). Five weeks of training led to a 4.3% +/- 1% increase in thigh muscle volume (p < 0.0002) and a 12.1% +/- 3.7% increase in maximal oxygen uptake (p < 0.004); there were no changes in the control group. The training effect was most pronounced in the least fit subjects. CONCLUSIONS: Exercise training programs for female adolescents can be successfully integrated into a high school summer curriculum. Quantifiable, substantial structural and functional responses occur with relatively short periods of training. Approximately 60% of the training response was related to factors independent of muscle size per se. These data may serve to better design physical activity programs for female adolescents.

Adolescent↗

School Breakfast Program and school performance.

To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children.

Absenteeism↗

Plethysmographic specific airway resistance.

sRaw measurements are feasible in children from 2 years of age. sRaw allows clinical monitoring and research during this critical period of growth and development in early life. sRaw measurements promise to bridge the gap of lung function measurements between infancy and school age.

Airway Resistance↗

Involuntary smoking and asthma severity in children: data from the Third National Health and Nutrition Examination Survey.

STUDY OBJECTIVES: We sought to determine the indicators of asthma severity among children in the United States with high and low levels of tobacco smoke exposure. DESIGN: Cross-sectional study. SETTING: Nationally representative survey of participants in the Third National Health and Nutrition Examination Survey (from 1988 to 1994). PARTICIPANTS: Five hundred twenty-three children with physician-diagnosed asthma. MEASUREMENTS AND RESULTS: We stratified the study participants into tertiles on the basis of serum levels of cotinine (a metabolite of nicotine that indicates tobacco smoke exposure). We used logistic and linear regression modeling, adjusting for known covariates, to determine the effect of high environmental tobacco smoke exposure on the following outcomes: asthma severity (determined using reported symptom and respiratory illness frequency); lung function; physician visits; and school absence. Among our study sample, 78.6% of children had mild asthma, 6.8% of children had moderate asthma, and 14.6% of children had severe asthma. Asthmatic children with high levels of smoke exposure, compared with those with low levels of exposure, were more likely to have moderate or severe asthma (odds ratio, 2.7 95% confidence interval [CI], 1.1 to 6.8) and decreased lung function, with a mean FEV(1) decrement of 213 mL or 8.1% (95% CI, -14.7 to -3.5). CONCLUSIONS: Involuntary smoke exposure is associated with increased asthma severity and worsened lung function in a nationally representative group of US children with asthma.

Adolescent↗

Forecasting veterinary school admission probabilities for undergraduate student profiles.

Increased competition for veterinary school admission has created a need to determine whether individual students are likely to be successful candidates for veterinary school admission early in their undergraduate careers. Students invest considerable time and money in pre-veterinary courses of study, hoping for acceptance into professional veterinary school. A forecasting model was developed to predict the likelihood of students with particular characteristics gaining acceptance. Characteristics such as gender, age, size of high school, and ACT, are known upon entrance into college and can be used to determine the likelihood of an individual's being accepted. Data were gathered from the Louisiana State University College of Veterinary Medicine (LSU-CVM) admissions for all students applying to veterinary school for the classes of 2006 through 2008 from the top two agricultural programs in the state in terms of quantity of applicants to veterinary school: Louisiana State University and Louisiana Tech University. A one-way ANOVA was used to examine whether there were any statistical differences between known demographic and performance variables and acceptance into veterinary school. A logit forecasting model was then estimated to predict the likelihood of gaining acceptance into veterinary school based only on variables known early in the student's undergraduate career. Age, gender, and ACT scores were determined to be important variables in determining the likelihood of gaining admission. Overall, the forecasting model is of use in assigning probabilities of acceptance into veterinary school for specific student profiles, which can assist in one-on-one assistance from advisor to student.

Analysis of Variance↗

School psychologists' knowledge of children's legal rights.

School psychologists need a working knowledge of laws affecting children. This investigation was done to discover whether members of Ohio's school psychological association, including intern school psychologists who were functioning in a supervised capacity, are as knowledgeable about law as they need to be to avoid lawsuits. Participants completed a custom-designed questionnaire. Survey of Children's Legal Rights, including questions assessing knowledge of children's rights in relation to child abuse, suspension and expulsion, corporal punishment, rights in juvenile court, special education, freedom of religion and speech, search and seizure within school, divorce and child custody, school vandalism, and school attendance. Analysis indicated significant misconceptions about legal decisions; however, these school psychology practitioners have adequate legal knowledge about most of the surveyed themes excepting provisions for special education.

Child↗

Thought disorder: A developmental disability in pediatric epilepsy.

This study compared thought disorder (i.e., impaired use of language to formulate and organize thoughts) in 93 children with complex partial seizures (CPSs) and 56 children with primary generalized epilepsy with absence (PGE) and its relationship to age, seizure, cognitive, and linguistic variables. By the use of psychopathology, social competence, academic achievement, and school problem measures, the functional implications of thought disorder in these two groups were compared. When demographic variables were controlled for, there were no significant differences in thought disorder scores between the CPS and PGE groups. However, the profile of age, gender, seizure, and cognitive variables related to thought disorder differed in the CPS and PGE groups. Within each group, different aspects of thought disorder were associated with different seizure variables. Thought disorder was related to psychopathology, school problems, decreased academic achievement, and poor peer interaction in the CPS group, but with school problems in the PGE group. These findings suggest that CPS and PGE affect the normal maturation of children's discourse skills, albeit through different mechanisms. The relationship of thought disorder to behavioral, academic, and social problems implies that these discourse deficits are one component of the developmental disabilities or comorbidities associated with pediatric CPS and PGE.

Adolescent↗

Asbestos-related disease in public school custodians.

A cross-sectional prevalence study of 120 public school custodians was carried out. The purposes were 1) to investigate the prevalence of asbestos-related disease in a group of custodians at risk for asbestos exposure in public schools and 2) to determine the proportion with disease attributable to exposures in school buildings. Medical and occupational histories, flow-volume loops, and posterior-anterior, lateral, and anterior oblique (AO) chest radiographs were obtained. Single breath DLCO was measured and chest auscultation performed. Mean age of subjects was 57 years and mean duration of work as a custodian, 27 years. Fifty-seven (47.5%) had no known or likely exposure to asbestos outside of their work as a school custodian (NOE). Pleural plaques (PP) occurred in 40 (33%) of the total group and 12 (21%) of the group with NOE. Pulmonary restriction (FVC less than 80% predicted, FEV1/FVC% greater than or equal to 70) occurred in 22 (18%) of the total group and 10 (17%) of those with NOE. DLCO was lower in the group with restriction. Multivariate analysis revealed significant associations (p less than 0.05) between both PP and restriction and duration of asbestos exposure. AO radiographs increased PP detection by a factor of 1.9. Our results reveal PP prevalence in excess of background and pulmonary restriction in the study population, and indicate that PP are attributable to asbestos in schools. Findings with regard to pulmonary restriction need further investigation. Prudent management of asbestos in buildings is indicated for the prevention of related disease.

Adult↗

Intervention approaches and children with developmental coordination disorder.

Children with Developmental Coordination Disorder (DCD) have a marked impairment in the performance of functional motor skills required to succeed at school. Longitudinal studies show that without intervention children with DCD often do not improve with development and the poor motor behaviour appears to have a detrimental effect on other aspects of functioning such as school achievement, behaviour and self esteem. Outside of clinical situations, there are only a small number of controlled empirical investigations, and from this small number two types of approaches emerge. The first concentrates on processes underlying motor skills and purports to improve areas such as kinesthesis or sensory motor processes. The second concentrates on teaching functional tasks aiming to specifically intervene in the deficient areas. Evaluations of these approaches show that they both work, producing significant improvements over control groups but show no differences between other approaches. It is hypothesized that more general learning principles are producing the effect, such as accurate assessment and tailoring activities to meet the needs of any individual child. Further, it is suggested that work with non-specialists in the motor area, such as teachers and parents, is a way forward with all but the most severely affected children.

Child↗

The 4-year course of tic disorders in boys with attention-deficit/hyperactivity disorder.

BACKGROUND: Despite long-standing clinical concerns, relatively little is known about the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and tic disorders. Therefore, we examined tic disorders in an ongoing prospective follow-up study of male subjects with ADHD, a sample unselected for any comorbid disorder. METHODS: One hundred twenty-eight male children and adolescents with ADHD and 110 male controls were comprehensively evaluated at baseline and 4 years later. We characterized tic disorders along with a wide range of neuropsychiatric correlates, including other comorbid disorders and indices of psychosocial function in multiple domains (school, cognitive, social, and family). RESULTS: Compared with controls, subjects with ADHD showed more tic disorders at baseline and more new onsets were reported at follow-up. Attention-deficit/hyperactivity disorder and tic disorders appeared to be independent in course: in contrast to low rates of ADHD remission, tic disorders mostly remitted. The age-adjusted rate of ADHD remission was 20% and that of tic remission, 65%. Tic disorders had little effect on the psychosocial functioning of subjects with ADHD. CONCLUSIONS: These findings suggest that comorbidity with a tic disorder has a limited effect on ADHD outcome. However, because of the relatively small sample of subjects with tic disorders, our conclusions should be considered preliminary until confirmed in larger studies of medicated and unmedicated children with ADHD with and without tic disorders.

Adolescent↗