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PubMed1985

[Heart transplantation in cardiomyopathy].

Within the spectrum of presently accepted candidates for heart transplantation, end-stage heart failure in dilated cardiomyopathy has become the principle indication. Although several indicators of poor prognosis have been specified, the decision for heart transplantation is primarily made on clinical grounds. Expected long-term survival after transplantation is 60 to 80% at one year and more than 50% at five years. Since July, 1983, 50 patients underwent orthotopic heart transplantation, 38 of whom had been suffering from dilated cardiomyopathy. Ages ranged from nine to 54 years with a mean of 40 years. At present, 38 patients are alive, 34 are discharged from hospital, 14 have returned to work or school. Physical capacity and cardiac function are normal. There was no difference between the cardiomyopathy patients and the coronary artery disease patients with respect to rate and severity of rejection episodes, infection and long-term findings. Heart transplantation is considered a promising routine treatment for end-stage heart failure in particular in younger patients with dilated cardiomyopathy.

Adolescent↗
PubMed1982

[The leukemic child. Reflections from 5 years of psychological practice in a pediatric hematologic unit].

This report describes the psychological study of 130 children admitted to a paediatric haematology unit, where the personnel are sensitive to the needs of the infant and the parents also have their place. Taking several situations confronting the child with leukaemia, we try to stress the effect of the illness on schooling, family life and psychological function. The illness interrupt the psycho-affection development of the child and affects his relations to himself and others. Faced with childhood leukaemia, where somatic pathology and psychological difficulties interact, the psychologist has the role of listening to and supporting the child and the family as well as that of mediator with the personnel.

Activities of Daily Living↗
PubMed1984

Relationship between health status and psychological adjustment among children with chronic conditions.

The extent to which children's psychological adjustment is affected by the presence of chronic physical illness is a subject of controversy. Data obtained at entry to a study of children with chronic illness show that among the 81 children greater than or equal to 5 years of age there is little relationship between psychological adjustment and traditional morbidity measures such as days hospitalized and days in bed. There is, however, a moderate but significant relationship between psychological adjustment and both the number of days absent from school and the child's functional status: children who have more absences and those with poor functional status have poorer psychological adjustment. The data also suggest that these relationships may differ in size within demographic subgroups of the population, something that may explain current controversies over the relationship between the child's chronic condition and psychological adjustment.

Absenteeism↗
PubMed1995

Adolescents' intimacy with parents and friends.

Adolescents' perceived levels of intimacy with their mother, father, and close friend were examined as a function of demographic, family and school, and psychological variables. Students with same-sex friends and greater interest in school reported greater intimacy with their mothers. Students with higher self-esteem, lower depression, and lower risk-taking scores reported greater intimacy with their mothers and fathers. The greatest number of relationships with positive variables involved intimacy with mothers.

Adolescent↗
PubMed1997

[The "Illenau Psychiatric School"--on the significance of the "model institution" as an educational site].

The great importance of the "illenau", the so-called "first model asylum of the Germans" (letter) has been increasingly appreciated in recent years. This article describes the "illenau" especially as place of education for young psychiatrists. It seems legitimate to speak of the "illenau psychiatric school" in respect of its function for the practical education of young psychiatrists, but not as a special academic mode of teaching or research.

Education, Medical, Graduate↗
PubMed2003

The development of the LV Prasad-Functional Vision Questionnaire: a measure of functional vision performance of visually impaired children.

PURPOSE: To develop a reliable and valid questionnaire (the LV Prasad-Functional Vision Questionnaire, LVP-FVQ) to assess self-reported functional vision problems of visually impaired school children. METHODS: The LVP-FVQ consisting of 19 items was administered verbally to 78 visually impaired Indian school children aged 8 to 18 years. Responses for each item were rated on a 5-point scale. A Rasch analysis of the ordinal difficulty ratings was used to estimate interval measures of perceived visual ability for functional vision performance. RESULTS: Content validity of the LVP-FVQ was shown by the good separation index (3.75) and high reliability scores (0.93) for the item parameters. Construct validity was shown with good model fit statistics. Criterion validity of the LVP-FVQ was shown by good discrimination among subjects who answered "seeing much worse" versus "as well as"; "seeing much worse" versus "as well as/a little worse" and "seeing much worse" versus "a little worse," compared with their normal-sighted friends. The task that required the least visual ability was "walking alone in the corridor at school"; the task that required the most was "reading a textbook at arm's length." The estimated person measures of visual ability were linear with logarithm of the minimum angle of resolution (logMAR) acuity and the binocular high contrast distance visual acuity accounted for 32.6% of the variability in the person measure. CONCLUSIONS: The LVP-FVQ is a reliable, valid, and simple questionnaire that can be used to measure functional vision in visually impaired children in developing countries such as India.

Adolescent↗
PubMed1994

Effect of moderate NO2 air pollution on the lung function of children with asthmatic symptoms.

In the course of a 2 1/2-year longitudinal study, the influence of outdoor NO2 and of the heating device at home on lung function was investigated in 467 children of school age in the urban area of Freiburg. Data were gathered in three surveys using standardized interviews, lung function measurements, skin prick tests with inhalant allergens, and NO2 measurements from October to April near the child's home. Regarding the lung function of a subpopulation with asthmatic symptoms (n = 106) in the three consecutive surveys, multivariate regression analyses adjusted for confounders indicate negative associations between five dependent variables, FEV1%FVC (P = 0.004), FEV1% (P = 0.02), MEF75% (P = 0.038), MEF50% (P = 0.052), and MEF25% (P = 0.002), on the one hand, and outdoor NO2 for average NO2 concentrations exceeding 40 micrograms/m3 on the other. The use of individual room heaters is associated with decreased lung function and is significant only for FEV1%FVC (P = 0.033). Neither NO2 nor individual room heating is significantly associated with one of the lung function parameters in the subpopulation without asthmatic symptoms (n = 361). In conclusion, children with asthmatic symptoms are identified as being susceptible to having reduced lung function under outdoor air pollution where average NO2 concentrations exceed 40 micrograms/m3.

Air Pollutants↗
PubMed2006

Chronic conditions, functional limitations, and special health care needs in 10- to 12-year-old children born at 23 to 25 weeks' gestation in the 1990s: a Swedish national prospective follow-up study.

BACKGROUND: Children born extremely immature (gestational age < 26 weeks' gestation) increasingly reach school age. Information on their overall functioning and special health care needs is necessary to plan for their medical and educational services. This study was undertaken to examine neurosensory, medical, and developmental conditions together with functional limitations and special health care needs of extremely immature children compared with control subjects born at term. METHODS: We studied 11-year-old children born before 26 completed weeks of gestation in all of Sweden from 1990 through 1992. All had been evaluated at 36 months' corrected age. Identification of children with chronic conditions lasting > or = 12 months was based on a questionnaire administered to parents. Neurosensory impairments were identified by reviewing health records. Information regarding other specific medical diagnoses and developmental disabilities was obtained by standard parent and teacher questionnaires. RESULTS: Of 89 eligible children, 86 (97%) were studied at a mean age of 11 years. An equal number of children born at term served as controls. Logistic-regression analyses adjusting for social risk factors and gender showed that significantly more extremely immature children than controls had chronic conditions, including functional limitations (64% vs 11%, respectively), compensatory dependency needs (59% vs 25%), and services above those routinely required by children (67% vs 22%). Specific diagnoses or disabilities with higher rates in extremely immature children than in controls included neurosensory impairment (15% vs 2%), asthma (20% vs 6%), poor motor skills of > 2 SDs above the mean (26% vs 3%), poor visual perception of > 2 SDs above the mean (21% vs 4%), poor learning skills of > 2 SDs above the mean (27% vs 3%), poor adaptive functioning with T scores of < 40 (42% vs 9%), and poor academic performance with T score < 40 (49% vs 7%). CONCLUSIONS: Children born extremely immature have significantly greater health problems and special health care needs at 11 years of age. However, few children have severe impairments that curtail major activities of daily living.

Child↗
PubMed2006

A randomized, controlled trial of an interactive educational computer package for children with asthma.

OBJECTIVE: The purpose of this study was to evaluate the impact and acceptability of an educational multimedia program designed to promote self-management skills in children with asthma. METHODS: We conducted a randomized, controlled trial with measures at baseline and 1- and 6-month follow-up. The trial was conducted in pediatric outpatient respiratory clinics in 3 United Kingdom hospitals. Participants included 101 children aged 7 to 14 years under the care of hospital-based asthma services. The children were randomly assigned to receive an asthma information booklet alone or the booklet plus The Asthma Files, an interactive CD-ROM for children with asthma. Asthma knowledge was the primary outcome measure. Other measures included asthma locus of control, lung function, use of oral steroids, and school absence. RESULTS: At the 1-month follow-up (n = 99), children in the computer group had improved knowledge compared with the control group and a more internal locus of control. There were no differences in objective lung-function measures, hospitalizations, or oral steroid use. The study participants were positive in their evaluation of the intervention. At the 6-month follow-up (n = 90), significantly fewer children in the intervention group had required oral steroids and had had time off school for asthma in the previous 6 months. The difference did not reach statistical significance in the intention-to-treat analysis for both steroid use and school absence. CONCLUSION: The Asthma Files was found to be an effective and popular health education tool for promoting asthma self-management skills within pediatric care.

Asthma↗
PubMed1977

[Development of the comprehension of localization in deranged consciousness].

The controversy between narrow localisationism and equipotentialism which exists even nowadays shows that these two trends are not in a position to solve the localisation problem. The attempts to localize consciousness either in the cortex or in the subcortex and the area of the third ventricle should be considered groundless, as well as the assumption that the cortex only gives the contents of consciousness while the source of consciousness is found in the area of the third ventricle. Consciousness represents the synthesis of the psychical activity. The basic weak points of both trends arise from the very formulation of the question discussed, from the striving to find the solution of the localisation problem without bearing in mind the physiological processes which lie in the basis of the higher psychical functions, i.e. behind the processes of the higher nervous activity, as well as from the incorrect understanding of the conceptions of "function" and "centre". Thanks to the school of I. P Pavlov and his followers the prerequistions have been created of a new trend in the field of the localisation problem--the teaching of the dynamic localisation of the cerebral function.

Action Potentials↗
PubMed1989

Age versus schooling effects on intelligence development.

The effect of formal education, as opposed to chronological age, on intelligence development has suffered from inadequate empirical investigation. Most studies of this issue have relied on natural variation in exposure to school among children of the same age, thus confounding differences in schooling with differences in other intelligence-related variables. This difficulty can be overcome by a quasi-experimental paradigm involving comparison between children who differ in both chronological age and schooling. The present study applies this paradigm to the estimation of the independent effects of age and schooling in grades 5 and 6 on raw scores obtained on a variety of general ability tests. The sample included all students in Jerusalem's Hebrew-language, state-controlled elementary schools. The results unambiguously point to schooling as the major factor underlying the increase of intelligence test scores as a function of age and to the larger effect schooling has on verbal than nonverbal tests. These results contribute to our understanding of the causal model underlying intelligence development and call for reconsideration of the conceptual basis underlying the definition of deviation-IQ scores. Some implications of these results concerning the distinction between intelligence and scholastic achievement, the causal model underlying the development of "crystallized" and "fluid" abilities, and the notion of "culture-fair" tests are discussed.

Achievement↗
PubMed1967

The selection of medical students in Western Canada.

The methods employed in the selection of medical students for the 1964-65 class of freshmen at the four Western medical schools are described and recommendations are made for improving the procedure. The structure and functions of the various selection committees varied from school to school but their prime purpose was the same-the selection of "good students" who would later become "good physicians". Not surprisingly, academic achievement and confidence in estimating this ranked highest in importance, and while non-intellectual characteristics ranked almost as high, committee members had no confidence that they could evaluate these qualities.It is suggested that the ideal selection committee would be a "high-priority" committee consisting of six to eight members who would meet at least twice a year, have tenure of at least four years, be trained in interviewing applicants, consider Medical College Admission Test scores, review applications before each meeting, and establish research committees to investigate the students they choose.

Canada↗
PubMed1992

Factors affecting the school placement of children with spina bifida.

Integrating children with disabilities into mainstream schools has been an active policy in Britain since the 1981 Education Act. 26 children with spina bifida, 13 of whom were educated in mainstream schools, and 13 in special schools were assessed to clarify the relative importance of the following factors 1) IQ, 2) Mobility, 3) Hand function, 4) Bladder and bowel function, and 5) Behaviour. A marked difference was found between those attending mainstream and special schools. 11/13 of the former attained scores within the normal range as compared to only 2/13 of the latter. Neither mobility nor hand function alone were found to influence school placement and a marked correlation was found between the two. Whilst those educated in special schools had more marked problems, all children functioned poorly compared with the norms for able-bodied peers. Neither bladder nor bowel incontinence hindered attendance at mainstream school, but faecal soiling was considered the more serious problem. The frequency of behavioural problems showed a similar distribution amongst the two groups. Comments from parents highlighted their reservations about both special and mainstream schooling which indicates the policy for integration needs considerably more commitment from Government and Education Authorities in order to succeed.

Activities of Daily Living↗
PubMed1994

Measuring physical disablement: the contextual challenge.

Context is a fundamental consideration in physical therapy assessment and in the interpretation of physical disablement. Specification of context may include physical requirements of a task such as the demands for speed or a specific degree of accuracy, or the social context in which an activity is performed such as dressing for work versus dressing for leisure activities. Context also encompasses individual factors such as the importance of particular activities within the person's culture or value system, or the specific types of roles requiring physical functioning that a person resumes upon discharge from physical therapy. Data are presented to illustrate the differences in performance across related physical tasks and between self-care and mobility tasks in home and school settings in children with severe functional delays. These data highlight the potential impact of context on performance. Implications for future development of functional assessments are discussed, particularly in light of the importance of incorporating contextual information in the clinical interpretation of disablement outcomes for patient groups and individual patients.

Activities of Daily Living↗
PubMed1997

A preliminary investigation of high-school counseling resources on the Cape Peninsula.

In South Africa, counseling and guidance services remain marginalized. The aim of this study was to determine the structure and function of the counseling facilities in high schools on the Cape Peninsula. The first telephone survey comprising 68 representatively and randomly selected schools revealed that 26% of schools had no guidance department, and the mean full-time guidance teacher-pupil ratio was 1:897. The second survey involving 33 randomly selected full-time and part-time guidance teachers from the first sample showed that they could assign on average 14.4 minutes of counselling per pupil in one school year. Analysis of the full-time guidance teachers (N = 22) time allocation revealed that 23% of time was allocated to counseling, 32% to guidance, and 45% to formal teaching and administration. These results suggest that the allocation of personnel and time to counselling are deficient. An implication is that adolescents with psychological problems go undetected and therefore untreated.

Adolescent↗
PubMed2004

Educational disadvantage impairs functional recovery after hospitalization in older persons.

PURPOSE: To determine whether low educational level is associated with poor functional recovery after hospitalization in older adults. METHODS: We followed 862 patients (374 with low education, defined as <high school) for 6 months after hospitalization. Poor functional recovery was defined as an Activities of Daily Living score that was lower 6 months after hospitalization than 1 month before hospitalization. People who died were also considered to have poor recovery. RESULTS: Of the 862 participants, 351 (41%) experienced poor functional recovery: 124 died and 227 had declines in activities of daily living. There was a graded, statistically significant relation between level of education and poor functional recovery, regardless of impairment of activities of daily living at baseline. Poor functional recovery was more common in subjects with baseline impairment (50% [147/296]) than in those without baseline impairment (36% [204/566]). Independent predictors of poor functional recovery were low education, cognitive impairment, lack of social support, poor self-rated health, and high comorbidity. Sequential addition of demographic, economic, functional, psychosocial, and clinical factors to low education only modestly affected the association between low education and poor functional recovery. CONCLUSION: Educational disadvantage impairs functional recovery after hospitalization in older persons.

Activities of Daily Living↗
PubMedDate not supplied

Diagnosing the 'strange' child.

The diagnosis of children with a spectrum of autistic features, who do not qualify for the diagnosis of classical autism, has increased during the past decade. A case is reported of an 8-year-old child originally diagnosed as learning disabled with attention disorders and hyperactivity, who was later diagnosed as having an autistic spectrum disorder when abnormalities of social interaction and play activity became more obvious. The frequency of learning and attention problems in school-age children may obscure more significant psychiatric pathologies, such as autistic disorders. Improved awareness of disorders of social functioning and play activity in the school-age child and use of screening tools may lead to earlier detection, definitive diagnosis and treatment for these children. In addition, assessments from multiple sources, i.e. the school, the home and the clinic, are needed in the diagnostic process. Periodic re-evaluations of the school-age child with problem behaviour are necessary to insure that more significant pathologies, which were not clear on initial evaluation, are diagnosed at the earliest opportunity.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

Long-term effects of supervised physical training in secondary prevention of low back pain.

BACKGROUND AND OBJECTIVES: In the last few years, several studies have focused on short-term treatment effects of exercise therapy. However, there is a lack of knowledge concerning the long-term treatment effects recorded after several years. Hence, this study was performed to investigate the short- and long-term effects of supervised physical training on functional ability, self-rated pain and disability in secondary prevention of low back pain. METHODS: One hundred and eighty-three hospital employees with chronic low back pain were randomly assigned either to back school (comparison group), or three-months supervised physical training including a back school (exercise group). Various measurements of functional ability were performed and subjects completed questionnaires on self-rated pain, disability, and general well-being before treatment, immediately after intervention, and at six-months follow-up. At one-year and at ten-years follow-up participants evaluated treatment effectiveness. RESULTS: Out of 183 employees, 148 completed the program. Participation at follow-ups ranged from 66 to 96%. Supervised physical training significantly improved muscular endurance and isokinetic strength during a six-months follow-up, and effectively decreased self-rated pain and disability during a one-year follow-up. At ten-years follow-up the subjects' assessment of the effectiveness of treatment was significantly better in the exercise group. CONCLUSIONS: Supervised physical training effectively improved functional capacity and decreased LBP and disability up to one-year follow-up. The subjects' positive evaluation of the treatment effect at ten-years follow-up suggests a long-term benefit of training.

Adult↗