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PubMed2002

Referral rates for a functional vision screening among a large cosmopolitan sample of Australian children.

The aim of this study was to investigate the incidence of functional vision problems in a large unselected cosmopolitan population of primary school-age children and to investigate whether constant clinical criteria for functional vision problems would be implemented by the practitioners involved in the screening. Refractive errors, near point of convergence, stereopsis, strabismus, heterophoria and accommodative facility were assessed for 2697 children (3-12 years) of varying racial backgrounds living in Australia. The spherical component of the refractive error ranged from -7.75 to +9.50 D (mean +0.54 D, +/-0.79) with a distribution skewed towards hypermetropia; astigmatism ranged from 0 to 4.25 D (mean -0.16 D, +/-0.35). There was a trend towards less hypermetropia and slightly more astigmatism with age. Mean near point of convergence was 5.4+/-2.9 cm, heterophoria at far and near was 0.12+/-1.58delta exophoria and 1.05+/-2.53delta exophoria, respectively, 0.55% of children exhibited vertical phoria at near >0.5delta, accommodative facility ranged from 0 to 24 cycles per minute (cpm) (mean 11.2 cpm, +/-3.7), stereopsis varied from 20 to 800 s (") of arc with 50% of children having 40" or better. The prevalence of strabismus was particularly low (0.3%). Twenty percent of the children were referred for further assessment based on criteria of one or more of: stereopsis >70", accommodative facility <8 cpm, near point of convergence (NPC) >9 cm, near exophoria >10delta or near esophoria >5delta, shift in eso or exophoria > or = 4delta between distance and near, astigmatism > or = 1 D, myopia more than -0.75 D, or hyperopia >+1.50 D. Post-hoc analysis of the record cards seeking the reason for further assessment indicates that referrals appear to have been based upon clinical intuition rather than on a set number of borderline or unsatisfactory results.

Accommodation, Ocular↗
PubMed1997

Extremely premature (< or = 800 g) schoolchildren: multiple areas of hidden disability.

AIM: To examine the functional abilities of extremely low birthweight (ELBW, < or = 800 g) children at school age compared with full term children. METHODS: ELBW children (n = 115) in a geographically defined regional cohort born between 1974 and mid-1985 (comprising 96% of 120 survivors of 400 ELBW infants admitted to the Provincial Tertiary neonatal intensive care unit), were compared with (n = 50) children of comparable age and sociodemographic status. Each child was categorised by the pattern and degree of disability, using a system derived from the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM IV). Psycho-educational, behavioural, and motor results for ELBW children free of severe/multiple neurosensory disabilities (n = 90; 91% return rate) were compared with the term children. RESULTS: Severe/multiple neurosensory disabilities were present in 16 ELBW children (14%), and 15 (13%) had borderline intelligence. ELBW children of global IQ > or = 85 scored significantly lower in standardised tests of fine and gross motor control, visuo-motor pencil output, visual memory, and academic achievement (reading, arithmetic, written language). ELBW survivors were three times more likely to have learning disorders (47% vs 18%) and 22 (41%) of the 54 ELBW children with learning disorders had multiple areas of learning difficulty. Of the ELBW group, 30 (26%) were not disabled compared with 41 (82%) of the term group. Only five (12%) of the ELBW boys were not disabled, compared with 25 (35%) of the ELBW girls. Finally, ELBW children had significantly worse scores on ratings of behaviour during testing by the psychologist and behaviour by parental report. CONCLUSION: The most likely outcome for ELBW survivors at school age is a learning disorder, often multiple, or borderline intellectual functioning, combined with behavioural and motor risk factors rather than severe/multiple disability. Mean scores on psycho-educational testing showed poorer performance of the ELBW children, but grossly understated the complex nature of the individual degree of educational difficulty faced by these children.

Child↗
PubMed1997

Expressive pragmatic skills in pre-school children with and without Down's syndrome: parental perceptions.

Parental perceptions of the pragmatic skills of six pre-school children with Down's syndrome were compared to those of six children without cognitive impairment. Children were matched for language comprehension age on the Reynell Developmental Language Scale and parents were interviewed using the Pragmatics Profile of Early Communication Skills. Data from the parental interviews was analysed taking a qualitative approach, using the technique of content analysis. The results showed that the children with and without Down's syndrome had many similarities in reported behaviours and responses In addition, five out of the six children with Down's syndrome had some skills which were more advanced than their matched pairs. Possible reasons for these findings are discussed. The evidence suggests that children with Down's syndrome have a normal range of pragmatic skills and communicative intentions compared with children of similar levels of comprehension functioning at an early pre-school level.

Child, Preschool↗
PubMed1996

Clinical outcome and long-term quality of life after surgical correction of Hirschsprung's disease.

One hundred seventy-eight of 330 patients were recalled after undergoing surgery for histologically proven Hirschsprung's disease (HD). One hundred fifteen were older than 4 years at interview (Mean age, 10 years). This sample appeared to be representative of the whole in terms of demographic features such as ethnic group, sex, length of aganglionic segment, timing of presentation and surgery performed. Anthropomorphic indices for weight and height were comparable to norms, but many younger patients were below expected weight for age. In general, weight and height for age was regained with time. Nine patients had delayed developmental milestones, which were owing to specific causes in four. Nine patients had a poor functional outcome, of which two had neurological impairment. Satisfactory school performance was achieved in all but 19 (26%) of the remaining patients. Long-term functional results were comparable for the Soave and Duhamel procedures with less favorable results noted following the Swenson procedure. Assessment of complications demonstrated a significantly (P < .01) lower incidence of constipation, sexual dysfunction, and micturition disturbance following the Soave procedure when compared with the Duhamel and Swenson procedures. Neurological impairment and length of aganglionic segment beyond the rectosigmoid area appeared to influence functional outcome, as did persisting enterocolitis. Enterocolitis was observed in 16.6% of patients on presentation, but continued in only 6%. Constipation was particularly associated with the Duhamel procedure, and a higher incidence of micturition disturbance, abdominal distension, and cuff stricture was noted following the Swenson procedure. Functional assessment by three different scoring methods showed that 86 (74.7%) of the 115 patients over the age of 4 had excellent anorectal function and appeared to be well adjusted. Twenty-two patients (19.2%) had relatively minor long-term problems but seven (6.1%) had persistent fecal soiling with resulting psychosocial maladjustment.

Anal Canal↗
PubMed2002

Endometriotic haptoglobin binds to peritoneal macrophages and alters their function in women with endometriosis.

OBJECTIVE: To evaluate the effects of endometriotic haptoglobin on peritoneal macrophage function. DESIGN: Prospective laboratory study. SETTING: School of medicine. PATIENT(S): Twenty-three women with and without endometriosis. INTERVENTION(S): Peritoneal macrophages cultured without or with haptoglobin. MAIN OUTCOME MEASURE(S): Peritoneal macrophage haptoglobin immunoreactivity, adhesion, and interleukin-6 (IL-6) production. RESULT(S): In vivo, significantly more peritoneal macrophages from women with endometriosis bound haptoglobin and exhibited reduced adhesion compared to women without endometriosis. In vitro, haptoglobin treatment significantly decreased peritoneal macrophage adherence only in women without endometriosis; this effect was not seen in women with endometriosis, probably owing to in vivo haptoglobin saturation. Conversely, haptoglobin treatment robustly increased IL-6 production only by macrophages from women with endometriosis, suggesting differential immune response in these women. CONCLUSION(S): Endometriotic lesions synthesize and secrete a unique form of haptoglobin (endometriosis protein-I) that is up-regulated by IL-6. This study shows that haptoglobin adheres to peritoneal macrophages; decreases adhesion, which may influence phagocytic function; and up-regulates IL-6 production. Hence, a feed-forward loop is proposed whereby endometriotic lesion haptoglobin decreases macrophage phagocytic function while increasing IL-6 production, which in turn increases endometriotic haptoglobin and promotes establishment of endometriosis.

Adult↗
PubMed2006

Substance abuse prevention infrastructure: a survey-based study of the organizational structure and function of the D.A.R.E. program.

BACKGROUND: The only national drug abuse prevention delivery system that supports the rapid diffusion of new prevention strategies and includes uniform training and credentialing of instructors who are monitored for quality implementation of prevention programming is the Drug Abuse Resistance Education network (D.A.R.E.) linking community law enforcement to schools. Analysis of the organizational structure and function of D.A.R.E. provides an understanding of the essential parameters of this successful delivery system that can be used in the development of other types of national infrastructures for community-based prevention services. Information regarding organizational structure and function around funding issues, training, quality control and community relationships was gathered through telephone surveys with 50 state D.A.R.E. coordinators (including two major cities), focus groups with local D.A.R.E. officers and mentors, and interviews with national D.A.R.E. office staff. RESULTS: The surveys helped identify several strengths inherent in the D.A.R.E. program necessary for building a prevention infrastructure, including a well-defined organizational focus (D.A.R.E. America), uniform training and means for rapid dissemination (through its organized training structure), continuing education mechanisms (through the state and national conference and website), mechanisms for program monitoring and fidelity of implementation (formal and informal), branding and, for several states, predictable and consistent financing. Weaknesses of the program as currently structured include unstable funding and the failure to incorporate components for the continual upgrading of curricula reflecting research evidence and "principles of prevention". CONCLUSION: The D.A.R.E. organization and service delivery network provides a framework for the rapid dissemination of evidence-based prevention strategies. The major strength of D.A.R.E. is its natural affiliation to local law enforcement agencies through state coordinators. Through these affiliations, it has been possible for D.A.R.E. to become established nationally within a few years and internationally within a decade. Understanding how this structure developed and currently functions provides insights into how other such delivery systems could be developed.

Community-Institutional Relations↗
PubMed1991

The status of dental education at Stony Brook in 1991.

The School of Dental Medicine was planned and functions as an integral part of the Health Sciences Center at the State University of New York at Stony Brook. It has been in operation for almost 20 years. The mission of the school is multifaceted. It educates new dentists and scientists at the doctoral level. Its research advances the knowledge on which dental care is provided. Through its clinical activities, the school provides care to people in need and to special segments of the population that are underserved. And its faculty serves as a reservoir of expertise to the profession and the community.

Aged↗
PubMed1987

Children of depressed parents. Increased psychopathology and early onset of major depression.

Data on the psychiatric diagnosis, overall functioning, and treatment of 220 6- to 23-year-old subjects who were at high or low risk for major depression are presented. The subjects' diagnoses were made by a child psychiatrist based on best-estimate evaluation of diagnostic information derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Epidemiologic Version) with the subjects and separately with their mothers about their children. The major findings were an increased overall prevalence of major depression and substance abuse, psychiatric treatment, poor social functioning, and school problems in the children of depressed proband parents compared with children of normal proband parents. Overall prepubertal depression was uncommon and the sex ratios were equal. After 12 years of age, there was an increasing preponderance of female subjects in the group with major depression. The mean age at onset of major depression was similar for male and female subjects. However, it was significantly earlier in the children of depressed probands (mean age at onset, 12 to 13 years) compared with the children of normal probands (mean age at onset, 16 to 17 years). Symptom profiles and additional types of diagnoses in the depressed children from either proband parent group did not differ. These children are being followed up longitudinally to determine the prognostic significance, persistence, recurrence, and recall of their symptoms. Several research and clinical strategies are suggested by these data.

Adolescent↗
PubMed2001

Relationships between dietary intake and cognitive function level in Korean elderly people.

We examined the relationship between dietary intake and cognitive performance in Korean elderly people. Data for dietary intake, anthropometric measurements and cognitive function tests were collected and the relationships of the variables were analyzed. A random sample of 210 men and 239 women in Korea, aged 60 and over, was selected. Subjects were free-living elderly people who had not experienced major cognitive function impairment. Main outcome measures, 24 h dietary recall method, food behaviour variables, anthropometrics indices, health variables, and Kwon's Mini-Mental State Examination for Koreans (MMSE-K) for cognitive function test. The prevalence rate of poor cognitive function (MMSE-K score < or = 19) of Korean elderly was 22.3%: women with poor cognitive function had a higher rate (31.0%) than that in men (12.3%). Cognitive ability was related negatively with age and positively with school education level. Female subjects of poor cognitive function had significantly lower intakes of total amount of foods, cereals, vegetables, fruits, milk, spices, and also, energy, protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, and niacin than those of the normal cognitive score (> or = 24) group (P < 0.05). Male subjects of poor cognitive function had significantly lower intakes of fruits, fiber, and vitamin C than the normal subjects (P < 0.05). The MMSE-K score of female subjects showed a significant positive correlation with total amount of foods, cereals, beans, fruits, milk, oil, spices, and energy, protein, fat, carbohydrate, Ca, Fe, P, riboflavin and niacin intakes. The consumption of adequate nutrients, by taking sufficient amounts and variety of foods, may be important in maintaining adequate cognitive function in elderly Koreans.

Aged↗
PubMed1977

[Smoking in the childhood--results of the school study Berlin-Karow 1976 (author's transl)].

The smoking habits and the lung function of 369 boys and 340 girls aged 6-16 were examined in a school. The boys are beginning to smoke at the age of 9, the girls at the age of 13. 62 per cent of the children aged 16 are smoking (20 per cent of the girls and 30 per cent of the boys are smoking regularely more than 1 cigarette/day). 58 per cent of the children have a smoker in their family. Only 10 per cent of the parents have knowledge about the smoking of their child aged 12, and 59 per cent of the parents of their child aged 16. The lung function tests (ventilation, distribution, bodyplethysmography, single-breath-test, blood gases) of the healthy teen-agers dont show differences between smokers and non-smokers.

Adolescent↗
PubMed1998

Examination of the diagnostic value and estimation of the chaos phenomenon in masticatory movement using fractal dimension in patients with temporomandibular dysfunction syndrome.

The aim of this study was to estimate the chaos phenomenon (chaos) in masticatory movements using the fractal dimension (FD), and to examine the diagnostic value of the fractal dimension in comparing stomatognathic functional disturbances with normal stomatognathic function. The subjects were all high school students and included nine subjects presenting with acceptable normal occlusion, 18 subjects with TMJ dysfunction syndrome and seven subjects with tooth crowding. Masticatory movements were obtained during free, right side, and left side gum-chewing and were used to calculate the capacity dimension in the FD. Chaos in the masticatory movement was estimated by the FD saturated with some constant value to an increase of embedding dimension (approached a plateau). In the crowding group, the FD was also significantly high on the sagittal plane in comparison with the normal. In the patients with pain, the FD on the sagittal plane was significantly high. In the patients with pain and closed lock, the FD on the frontal plane was significantly high. However, in the patients with pain and with reduction of anterior disc displacement, the FD was significantly low on the horizontal plane. These findings suggest that chaos is present in masticatory movements and the difference in the FD are of diagnostic value in evaluation of the relationship between FD and stomatognathic functional disturbance.

Adolescent↗
PubMed1989

The PPVT-R as a measure of psycholinguistic functioning: a caution.

The present investigation was undertaken to evaluate the use of the PPVT-R as a measure of psycholinguistic functioning. The sample included 75 school-aged children referred for evaluation. The mean PPVT-R standard score (94.59, SD = 15.85) was not significantly different (p less than .01) than the WISC-R Full Scale IQ (95.36, SD = 16.29), Verbal IQ (94.36, SD = 16.17), or Performance IQ (97.75, SD = 15.61), or the mean ITPA PLQ. The PPVT-R correlated positively and significantly with the WISC-R Full Scale IQ (.77), Verbal IQ (.71) and Performance IQ (.74) and the WISC-R subtests, with coefficients that ranged from .42 (object assembly) to .69 (vocabulary). In addition, the PPVT-R correlated positively and significantly with the ITPA Psycho-Linguistic Quotient (PLQ) (.72) and the ITPA) subtests, with coefficients that ranged from .38 (auditory sequential memory) to .72 (grammatic closure). Regression analyses determined that the ITPA PLQ and the PPVT-R standard score were not predictive of one another. The data are interpreted to suggest that the PPVT-R is not more appropriately used as a measure of receptive language ability than as a screen for intellectual functioning.

Child↗
PubMed1998

A blueprint for linking academic oncology and the community.

The processes by which academic medicine will train the next generation of physicians and develop new knowledge have brought to the forefront the relationship between academic medical centers and community hospitals and practitioners. Over the past thirteen years, the Harvard Medical School Joint Center for Radiation Therapy (JCRT) has developed an integrated radiation oncology program designed to serve simultaneously the needs of the community, teaching hospitals, medical schools, and faculty. The structure and function of this program are described here, as are the challenges posed by the highly competitive health care marketplace. We believe that long-term vision should guide short-term goals. The success of academic-community collaborative programs depends not only on the good will and vision of the participants but also on the medical administration, academic leadership, policy makers, and politicians who define the principles and rules by which cooperation within the health care industry occurs.

Academic Medical Centers↗
PubMed2000

The development of normal feeding and swallowing: Showa University study of the feeding function.

Since the 1980s the Department of Hygiene and Oral Health at the Showa University School of Dentistry has focused its research efforts on the development of feeding function and disorders. In addition, we have treated dysphagic children and dysphagic elderly using our feeding training program approach. The developmental course of the feeding function includes the following steps: 1) Suckle feeding and prefeeding period; 2) Acquiring the ability to swallow with lips closed; 3) Acquiring the ability to take food with lips closed; 4) Acquiring the ability to push mashed food with the tongue and anterior hard palate; 5) Acquiring the ability to perform mastication; 6) Beginning self-feeding; 7) Beginning finger feeding; 8) Beginning using table ware.

Child Development↗
PubMed2004

Function transfer in human operant experiments: the role of stimulus pairings.

Although function transfer often has been studied in complex operant procedures (such as matching to sample), whether operant reinforcement actually produces function transfer in such settings has not been established. The present experiments, with high school students as subjects, suggest that stimulus pairings can promote function transfer in conditions that closely approximate those of matching to sample. In Experiment 1, the subjects showed transfer of operant responding from three geometric figures (C1, C2, C3) to three colored shapes (B1, B2, B3) when the latter were paired with the former. Experiment 2 involved two groups of subjects. In the matching group, subjects matched the colored shapes with the geometric figures; in the yoked group, the shapes were merely paired with the geometric figures, and the schedule of stimulus pairing was yoked to the performance of the subjects in the matching group. Both groups of subjects showed function transfer. Experiment 3 documented function transfer from C stimuli to B stimuli through indirect stimulus pairings (A-B, A-C). In Experiment 4, function transfer was obtained even though the subjects vocalized continuously during the pairing trials, presumably preventing covert verbalization that might mediate transfer effects. Our results are consistent with a Pavlovian account and raise difficulties for current operant theories of function transfer.

Adolescent↗
PubMed2003

Special school teachers require more goal-oriented collaboration with psychiatric professionals in Northern Finland.

BACKGROUND: The problems of children and adolescents have increased in number and severity during the last years. OBJECTIVE: The purpose of this study was to elicit the views of special school teachers in the Oulu Province in Finland concerning their pupils' problems and the need, use and adequacy of relevant psychiatric services. METHODS: The information was collected from the Northern Ostrobothnia Hospital District in 1998 in Finland and responses were obtained from the 37 (97.4%) special schools. The data were analysed using the content analysis method. RESULTS: Special-needs pupils had various behavioural and emotional problems that made it difficult for them to learn and for the teachers to teach. According to the teachers, the major obstacles in the process of helping special-needs pupils were the delayed admission for treatment and the lack of information necessary for the pupils' school work and goal-oriented aftercare, although there were also favourable experiences of functional co-operation and availability of useful information. Some schools lacked a reliable network for helping pupilsand supporting teachers. The Finnish legislation on basic education obliges the providers of education to provide rehabilitation in connection with special education and to arrange relevant development, counselling and support services. CONCLUSION: The rehabilitation of special-need pupils and the collaboration between school and mental health authorities is not optimally realised in spite of the legislation.

Adolescent↗
PubMedDate not supplied

[Effect of atmospheric pollution on respiratory function in children from Venice (author's transl)].

The respiratory function has been compared in two standard school populations. A sample, of 700 children from the industrial quarters of Venice (highly polluted) and 350 children from the Historic Center (not polluted), has been subjected to a respiratory questionnaire, clinical investigation and plethysmographic functional testing with measurement of airways resistance by the panting method. The changes in the airways resistance were related to the residing area and to the bronchitic episodes in the past, while the family's socio-economic situation and the living area did not play any role.

Air Pollution↗