Relationship between lung function values and air pollution data, in Budapest schoolchildren.
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Adolescent↗
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Results for “school functioning”
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The pharmacological management of childhood anxiety disorders: a review.
RATIONALE: Pediatric anxiety is a prevalent psychiatric disorder that may have important implications for school, social, and academic function. Psychopharmacological approaches to the treatment of pediatric anxiety have expanded over the past 20 years and increasing empirical evidence helps guide current clinical practice. OBJECTIVE: To review studies which examine the pharmacological treatment of pediatric anxiety disorders, including obsessive-compulsive disorder and to summarize treatment implications. METHODS: All relevant studies were searched using MEDLINE and PsycINFO search engines, supplemented by a manual bibliographical search; studies published between 1985 and 2006 that met inclusion criteria were examined. RESULTS: This article provides a systematic review of the psychopharmacological treatment of pediatric anxiety disorders based on available empirical evidence, with a focus on randomized controlled trials. General treatment principles and pharmacological management of specific pediatric anxiety disorders are also reviewed. CONCLUSION: There is good evidence to support the efficacy of several pharmacological agents including the selective serotonin reuptake inhibitors to treat pediatric anxiety and obsessive-compulsive disorder, although there are still many unanswered questions.
Adolescent↗
Development of a nurse-instructor preparation program in China.
Preparation of nurses to function as instructors in schools of nursing has proved a continuing problem in the effort to upgrade nursing and nursing education in third-world nations. Development of a nurse-instructor preparation program in China is discussed. Methods of adapting the program to local and national needs, abilities and resources are described along with the use of the counterpart concept to assure program continuation once foreign nurse-experts are no longer available. Use of a Phase Model program is seen as a method of maximizing use of nurse-consultants while alleviating their recruitment problems and preserving the continuity and integrity of the program.
China↗
The Serbian QOLIE-AD-48: translation, cultural adaptation, and preliminary psychometric evaluation.
PURPOSE: The goals of the work described in this article were to translate and adapt into Serbian the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48), and to evaluate the psychometric properties of the translation. METHODS: Translation/backtranslation, cultural adaptation, and pretesting were performed first. For validity, internal consistency, and sensitivity testing, the Serbian version was administered to a sample of 67 adolescents with epilepsy. RESULTS: All subscales (Epilepsy Impact, Memory/Concentration, Attitudes toward Epilepsy, Physical Functioning, Stigma, Social Support, School Behavior, and Health Perceptions) contributed significantly to the summary measure. Mean scores for the subscales ranged from 75.4 to 91.3, and showed a tendency to decrease as illness severity increased. Internal consistency reliability (Cronbach's alpha) was 0.92 for the entire questionnaire. CONCLUSIONS: The QOLIE-AD-48 Serbian version is a valid and reliable instrument for health-related quality-of-life assessment in youths with epilepsy. It can be administered in 15 minutes, and can be used in clinical practice, as well as in quality-of-life research.
Adaptation, Psychological↗
Empirical fear profiles among American youth.
Fears among children can range from relatively innocuous fears of simple objects to significant phobias that affect youths' everyday functioning in the home, school, or community environments. This study investigated empirically derived fear profiles among American youth ages 7-19 (N=556). Based upon youths' scores on the 5 factors of the Fear Survey Schedule for Children-II (FSSC-II; Burnham & Gullone (Behav Res Ther, 35, 1997)), multistage Euclidean grouping was applied and produced 5 replicable fear cluster profiles with unique contours. Logistic regression odds ratios revealed specific associations of profile group membership with demographic characteristics such as child age, sex, and ethnicity.
Adolescent↗
Health-related quality of life in childhood disorders: a modified focus group technique to involve children.
OBJECTIVES: Qualitative methodology has been under-utilized in child health research due to lack of a specific set of instruments. The objective of this study was to develop a child-centred qualitative research methodology to facilitate direct exploration of health-related quality of life (HRQL) issues and to identify the quality of life elements in pre-adolescent children with a chronic medical condition. STUDY DESIGN: Purposeful stratified sampling of children, ages 6-12, who function in a regular school class, with active epilepsy who were assembled in small focus groups. The groups met in four phases and were led by moderators who probed preset open questions and activities. RESULTS: The study demonstrated that our modified focus groups process was a powerful exploratory experience eliciting meaningful and important issues in quality of life beyond what parents and health professionals expected, and helped identify HRQL elements in childhood epilepsy. CONCLUSION: Modified focus groups are appropriate and suitable to explore quality of life issues in pre-adolescent children with a chronic medical condition. The process is feasible and trustworthy.
Child↗
Childhood farm environment and asthma and sensitization in young adulthood.
BACKGROUND: Farm environment in childhood may protect against sensitization, allergic rhinitis, and asthma. METHODS: Subjects were obtained from 10 667 Finnish first-year university students who responded to a questionnaire survey on IgE-mediated diseases. Two random samples were selected from 1631 respondents in Turku: subjects with asthma or wheezing, and subjects without asthmatic symptoms. A total of 296 subjects (72%) participated. Skin prick tests (SPT), measurements of IgE-antibodies, methacholine challenge, and bronchodilation tests were performed. Weighted occurrence of current asthma and sensitization among students from "childhood farm" and "childhood nonfarm" environments were analyzed. RESULTS: Current asthma was found in 3.1% of subjects with childhood farm environment, and in 12.4% with nonfarm environment (odds ratio (OR) 0.22; 95% confidence interval (CI) 0.07-0.70). There were fewer positive SPT to birch (8.3 vs. 24.2%, OR 0.28, 95% CI 0.07-1.15) and timothy pollen (12.6 vs. 30.3%, OR 0.33, 95% CI 0.09-1.20) among subjects with childhood farm environment, but more sensitization to house-dust mite (22.0 vs. 4.9%, OR 5.43, 95% CI 1.60-18.46). Sensitization to cat (RAST class >/= 3) was less common in subjects with farm compared to nonfarm environments in childhood (1.5 vs. 13.1%; OR 0.10, 95% CI 0.02-0.47). CONCLUSIONS: Farm environment in childhood protects against adult asthma and sensitization-especially to cat-the most important asthma related allergen. In contrast, sensitization to house-dust mite was more common in farming subjects.
Adolescent↗
The impact of student-generated learning issues on individual study time and academic achievement.
OBJECTIVES: The aim of this study was twofold. The first question concerns the way students make use of the learning issues they generate (as strict guidelines or as global guidelines) and whether this changes across years of training. The second question concerned the relationship between the way students make use of learning issues and the time spent on individual study and achievement on two tests of knowledge. DESIGN: A questionnaire was developed, containing seven items that measured to what extent students study strictly according to the student-generated learning issues and six items that measured to what extent students study beyond the student-generated learning issues. The questionnaire also contained one question in which students had to estimate the mean time spent on individual study. Achievement was measured by two forms of tests of knowledge, a block test assessing course content and a progress test assessing long-term functional knowledge. SETTING: Medical School of Maastricht University, the Netherlands. SUBJECTS: Medical students (response=69%) from the problem-based curriculum at the Maastricht University. RESULTS: During their first year students study strictly according to the content of the learning issues, whereas in later years students studied more according to their own learning needs and interests. In addition, students who tended to study beyond the generated learning issues spent more time on individual study and achieved better on both tests. CONCLUSIONS: Students in a problem-based curriculum seem to become better self-directed learners during the years of training.
Education, Medical, Undergraduate↗
Workspace for disabled people.
The paper aims at determining the workspace for disabled young people. The investigation embraced a group of young people with motor dysfunction of lower extremities. Seventeen measurements were taken of 32 boys and 45 girls aged 15-18. There are significant differences in functional dimensions of the arm between the healthy and the disabled populations. The differences clearly indicate that there is a need for different shaping of space in which people of limited motor efficiency must function. A method based on Das and Grady's concept was used in determining workspace. This method was modified by the author. The method allows determination of workspace by means of several simple anthropometric measurements. Workspace for young people investigated was determined for the sitting position in transverse and sagittal planes. The results of the investigation constitute data for design and estimation of workplaces for disabled young people with motor dysfunction of lower extremities. The results can also be used to determine functional space in classrooms, school workshops, educational and rehabilitation centres.
Adolescent↗
Growth and development four years after treatment for the Trichuris dysentery syndrome.
A follow-up study is reported of 18 children 4 y after treatment for the Trichuris dysentery syndrome (TDS) and matched control children. The TDS children were initially severely stunted and had extremely low developmental levels. They showed catch-up in height of 1.9 z-scores even though they remained in very poor environments. Their intelligence quotients, school achievement and cognitive function remained significantly lower than those of the controls. Controlling for their earlier developmental levels, the TDS children showed a small improvement in mental development relative to the controls.
Antinematodal Agents↗
Association between radical generation by urban particles and lung function in schoolchildren?
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Air Pollutants↗
Toward an optimal healing environment in pediatric rehabilitation.
Although recent scientific advances have enabled us to minimize disability and improve the quality of life for people with disabilities and their families, cure is still not possible for many rehabilitation patients. This inability to cure renders the field of rehabilitation medicine particularly well-suited to the philosophy of healing. In contrast to curing, which is aimed at removing or reversing a disease process, both rehabilitation and healing are meant to enhance all aspects of well-being, restore integrity to the person, and facilitate the creation of meaning. Pediatric rehabilitation represents the interface of rehabilitation medicine and pediatrics, and is associated with unique characteristics that provide a natural context for exploring the optimal healing environment. This paper describes those characteristics and argues for the systematic integration and evaluation of healing interventions among children with developmental disabilities and their caregivers (parents, health care practitioners, and teachers). The ultimate aim of these interventions would be to improve all levels of the children's functioning in their homes, schools, and community environments by reducing impairment and increasing activity and participation. The paper concludes with a discussion of research priorities and the challenges imposed by different research strategies.
Child↗
Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.
Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction.
Adult↗
Depression in young people: initial presentation and clinical course.
OBJECTIVE: This project was designed to provide prospective data on the clinical presentation and longitudinal course of depression in children and adolescents. METHOD: Children and their parent(s) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School Age Children) at intake, and then yearly for 3 years. Collateral data were collected on school, social, and family functioning. RESULTS: Mean length of initial depressive episode was 35.6 weeks, SD of 26 weeks. Of the 65 depressed youths who completed the 3-year follow-up, 35 (54%) disclosed another episode of depression. Demographic, family-environment, and diagnostic variables were explored as predictors of characteristics of initial episode, recurrence of depression, and psychosocial competence at follow-up. Female gender and presence of a coexisting anxiety disorder were significantly related to severity of initial depression. Family environment was the only predictor significantly related to overall psychosocial competence over 3 years. CONCLUSIONS: The findings confirm depression in youth as a valid clinical phenomenon, with substantial risk of recurrence. Increased levels of stress in the family environment were associated with poorer overall outcomes.
Anxiety Disorders↗
Diagnostic continuity between child and adolescent ADHD: findings from a longitudinal clinical sample.
OBJECTIVE: To determine whether there are differences in the clinical expression and correlates of attention-deficit hyperactivity disorder (ADHD) between children and adolescents. METHOD: Subjects were 6- to 17-year old Caucasian, non-Hispanic boys with and without ADHD. DSM-III-R structured diagnostic interviews, psychometric measures, and blind raters assessed psychiatric diagnoses, intellectual performance, social disability, school failure, and family functioning. RESULTS: Children and adolescents with ADHD had an almost identical pattern of correlates in multiple domains of assessment including psychosocial adversity and comorbidity with conduct, mood, and anxiety disorders. Although the rate of substance abuse differed in comparison between child and adolescent subjects, this was independent of ADHD status. CONCLUSIONS: These findings document the diagnostic continuity of ADHD between childhood and adolescence and support the inclusion of adolescent samples in ADHD research protocols.
Adolescent↗
Treating attention deficit hyperactivity disorder.
Attention deficit hyperactivity disorder (ADHD) is a chronic childhood disorder characterized by inattention, distractibility, impulsivity, and restlessness. ADHD symptoms impair the child's ability to function at home, in school, and in the community. When ADHD is untreated, the child is at increased risk for school failure, substance abuse, and psychiatric disorders. New clinical practice guidelines from the American Academy of Pediatrics specify diagnosis and treatment for childhood ADHD, including psychosocial interventions, psychopharmacology, educational modifications, skill training, and social support.
Attention Deficit Disorder with Hyperactivity↗
Long term survivors of childhood leukemia.
Changes in therapy, primarily intensification, for childhood leukemias have significantly improved cure rates during the past 30 years. The increasing number of survivors has led to a heightened appreciation of the late complications of treatment caused by both radiation and chemotherapy. Important late effects include decreased growth, poor school performance, altered cardiac function, infertility, and second malignant neoplasms. The long term outcome of children and adolescents suffering from the most recently recognized acute complication of treatment, avascular necrosis of weight-bearing bones, is still not known. These, and all patients treated on clinical trials, should be followed throughout their lives. Many of the complications of treatment are often not realized until years after the completion of therapy; some have been found to be related to dose intensity, emphasizing the importance of clinical trials that examine reduction of therapy for diseases with excellent cure rates. A successful example of this strategy is the elimination or reduction of radiation dose for the prevention of central nervous system acute lymphocytic leukemia. This has resulted in fewer long term central nervous system complications without a decrease in survival rates. As knowledge of late effects increases, design of future trials will need to focus on striking a balance between cure and long term toxicity.
Adolescent↗
Where to go? Strategic modelling of access to emergency shelters in Mozambique.
This paper, through spatial-analysis techniques, examines the accessibility of emergency shelters for vulnerable populations, and outlines the benefits of an extended and permanently established shelter network in central Mozambique. The raster-based modelling approach considers data on land cover, locations of accommodation centres in 2000, settlements and infrastructure. The shelter analysis is a two-step process determining access for vulnerable communities first, followed by a suitability analysis for additional emergency shelter sites. The results indicate the need for both retrofitting existing infrastructure (schools, health posts) to function as shelters during an emergency, and constructing new facilities - at best multi-purpose facilities that can serve as social infrastructure and shelter. Besides assessing the current situation in terms of availability and accessibility of emergency shelters, this paper provides an example of evaluating the effectiveness of humanitarian assistance without conventional mechanisms like food tonnage and number of beneficiaries.
Community Networks↗