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PubMed1998

The development of memory.

This article reviews recent advances in understanding the changes in memory function that take place during the childhood years. Development of the following aspects of memory are considered: short-term memory, comprising phonological memory, visuospatial memory, and executive function; autobiographical memory; episodic memory, including eyewitness memory; and metamemory. Each of these aspects of memory function shows substantial qualitative change from infancy, through the preschool period, to the early school years. Beyond about 7 years of age, however, memory function appears adult-like in organisation and strategies, and shows only a gradual quantitative improvement through to early adolescence.

Child↗
PubMed1994

Graduate medical education consortia: expectations and experiences.

Graduate medical education (GME) consortia are formal associations of medical schools, teaching hospitals, and other organizations involved in residency training, with central support, direction, and coordination allowing members to function collectively. GME consortia are not well documented in the literature, although they are included in many GME reform proposals. Proponents expect consortia to improve the organizational structure and governance of residency training programs and, through local coordination and possibly the allocation of resources, to help members meet national workforce goals regarding both numbers and practice locations for generalist and specialist physicians. The authors contrast the expectations of educators and policymakers for the future performance of GME consortia with the experiences of 36 functioning consortia, gathered in a 1993 national survey conducted by the Maine Medical Center and the Association of American Medical Colleges. Respondents account for nearly 10% of all residency training programs and 17% of all residents nationwide. The participating consortia differ markedly in their structures, functions, and other features, although nearly 85% have been convened by medical schools and closely affiliated hospitals. Fewer than half function with governing boards; 40% offer a single integrated residency training program in each discipline; and 58% allocate resources. A common concern of consortium members was physician distribution by specialty, but only 31% identified "increasing the number of generalist physicians" as a major accomplishment to date. To improve their performance, consortium participants call for greater commitment and leadership from the medical school and university, better definition of the community's GME needs, more information about the flow of GME funds locally, greater authority to allocate resources, and incentives for shifting allegiances from individual institutions to the consortium community as a whole.

Data Collection↗
PubMed1988

Psychologic and neurologic function following treatment for childhood temporal lobe astrocytoma.

Seven school-aged children treated for temporal lobe astrocytomas with surgical resection and irradiation were prospectively tested to evaluate their intellectual, academic, personality, and neurologic status after therapy. At their most recent follow-up examination, neuropsychologic functioning was adequate in only two patients. The other five children manifested either intellectual deterioration, learning disability, mental retardation, or psychopathology. These deficits were associated with poor postoperative performance status, inadequate seizure control, tumor recurrence, and younger age at diagnosis. No pattern of intellectual, academic, or personality dysfunction emerged in association with left- versus right-hemisphere tumors.

Achievement↗
PubMed1997

Influence of information related to child physical abuse on professional ratings of adjustment and prognosis.

The study investigates the influence of access to information of a history of physical maltreatment on the evaluative responding of social service and clinical psychology professionals. Written vignettes were used in a 2 x 2 x 2 factorial design to manipulate the: (a) presence/absence of abuse history; (b) presence/absence of behavior problems; and (c) gender of the child. Professionals rated children presented in 12 case vignettes along five treatment-related dimensions: (a) overall adjustment; (b) predicted 6 months temporal stability of behavior; (c) likelihood of treatment referral; (d) expected home intervention success; and (e) expected school intervention success. Four dimensions related to social functioning were also rated, including likelihood of the child being: (a) recommended to serve as assistant to teacher; (b) elected as a school activity team leader; (c) elected as a class officer; and (d) nominated as a candidate for successful completion of a summer camp program. The findings verified the influence of information related to a history of maltreatment of professional judgments, despite matched vignette content for all factors other than maltreatment status. The results suggests a possible failure to recognize that some children have been buffered from the negative effects of abuse and point to the risk of erroneous judgments that may be directed toward maltreated children.

Adult↗
PubMed1998

[Thyroid function in a population with an extra iodine intake].

BACKGROUND: After 20 years of iodine salt fortification, the prevalence of goiter has decreased significantly in the rural area of Pirque, central Chile. In this location, equipment has been installed that efficiently and economically adds 0.5 mg of elemental iodine per liter of water to render it potable. AIM: To study thyroid function and urinary iodine excretion in school age children of this zone, after two years of extra iodine intake. MATERIAL AND METHODS: One hundred thirty four children aged 6 to 12 years old were examined. In 56 randomly chosen children a morning urine sample was obtained to measure iodine excretion. In 45 children without goiter, a blood sample was drawn to measure TSH and thyroxin. RESULTS: In nine children (7%) a diffuse goiter was found. Median urinary iodine excretion was 158 micrograms/dl. Thyroxin and TSH levels were within normal limits (8.4 +/- 1.1 micrograms/dl and 2.2 +/- 1.5 microU/ml respectively). During the period of iodine water supplementation there were 47 births in the zone. All newborns had normal TSH values and none had goiter. CONCLUSIONS: When present results are compared with the period before water iodination (when the prevalence of goiter was 9.6% and mean urinary iodine excretion was 57.6 micrograms/dl), it can be concluded that extra iodine intake in this rural population has not caused additional thyroid problems.

Child↗
PubMed2003

Effect of left- or right-handedness on nursing practice.

The aim of the present study was to evaluate the association of hand preference of nursing and the success of the nursing practice. The study included 24 students, all of whom attend different classes in the School of Nursing. The status of left- or right-handedness of the students included in the research was determined using Oldfield (Edinburgh Handedness Inventory) Index. The students were divided into two equal groups according to their right or left hand use. Then the students were categorized in four groups (Very good: 81-100, Average: 61-80, Pass: 50-60, and Fail: <50) according to the scores they received from the practice and theory tests of the lesson "Fundamentals of Nursing" the lesson requiring hand skills most. The test for the difference between two population proportions was used for statistical analysis. Left-handed nurses were found to be more successful than right-handed nurses in nursing practice. The difference between them was found significant (p < .01). It was concluded that left-handed nurses should never be forced to convert into right-handedness; instead they should be supported both verbally and in terms of equipment, and they should be motivated, because the data obtained proved that left-handedness means success.

Adolescent↗
PubMed2000

Return to work after sickness absence due to back disorders--a systematic review on intervention strategies.

OBJECTIVES: The aim was to review the literature with regard to the effectiveness of intervention programmes for the prevention of aggravation of back disorders or prolonged duration of sickness absence. METHODS: A systematic search of the literature was performed using three groups of key words and inclusion/exclusion criteria. Effectiveness was evaluated using two measures: the difference between intervention and referent groups in return to work, and the fraction of sickness absence among referent groups that could be prevented if these referents had undergone the same intervention (preventable fraction). RESULTS: Twelve articles with quantitative information on the effect of ergonomic interventions on return to work were included. In eight studies, introduction of a back-school programme was the preferred intervention, combining exercise and functional conditioning, and training in working methods and lifting techniques. In seven out of eight back-school studies, return to work was significantly better in the intervention group. Intervention after 60 days, in the subacute phase of back pain, showed the most promising results. In these studies the preventable fraction varied between -11% and 80%, largely depending on the stage and phase of back disorders and the time of follow-up. The success of intervention also depended on the profile of the referents when left untampered. In all studies compliance during the intervention was fairly good, but there was a lack of information on sustainability of the intervention during the follow-up and on recurrence of back complaints and consequent sickness absence. CONCLUSIONS: Few studies were performed to assess the outcome return to work after ergonomic intervention. However, there is evidence that intervention in the subacute phase of back pain is preferable. Future intervention studies should address intervention sustainability and recurrence of sickness absence due to back pain over at least a 1-year follow-up period.

Absenteeism↗
PubMed1990

[Morphological and functional parameters of the left ventricle (mass, wall thickness and end-systolic stress) in school children with different levels of blood pressure, at rest and during maximal exercise].

Echocardiographically determined left ventricular mass, diastolic septal and posterior wall thickness and end-systolic wall stress, as well as electrocardiographic indexes of left ventricular enlargement (Sokolow-Lyon index and Romhilt-Estes score) and of left atrial enlargement (P terminal index) were correlated with resting and exercise systolic and diastolic blood pressures, and with several parameters of body size (weight, height, body surface area, Quetelet index), in 130 school children (61 boys, 69 girls) 6 to 15 years of age. Parameters of body size had a positive correlation both with systolic and diastolic blood pressures and with parameters of left ventricular size. Thus, the latter were adjusted for body surface area, for correlation with blood pressure. Left ventricular mass and diastolic septal and posterior wall thickness had a very poor correlation with resting and exercise diastolic blood pressures. Left ventricular mass and diastolic posterior wall thickness had a significantly higher correlation with peak exercise systolic blood pressure than with resting systolic blood pressure. End-systolic wall stress had a positive correlation with resting diastolic and systolic blood pressures. Electrocardiographic parameters of left ventricular and left atrial enlargement had a very poor correlation with resting and exercise blood pressure. Our findings suggest that early in life left ventricular mass and wall thickness are more closely related to maximal systolic blood pressure during physical exercise than to blood pressure in basal conditions. The electrocardiogram is an insensitive method to detect early modifications of left ventricular size in relation to different levels of blood pressure. The echocardiogram is the method of choice for this purpose.

Adolescent↗
PubMedDate not supplied

[Determinants of self-rated health among elderly persons in São Paulo, Brazil].

OBJECTIVES: To investigate the influence that demographic determinants, socioeconomic determinants, chronic diseases, and functional capacity have on self-rated health among elderly persons (60 years and older) living in the city of São Paulo, São Paulo, Brazil, and to investigate the existence of differences between men and women in terms of their self-rated health. METHODS: The study was carried out using data collected in the city of São Paulo as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). We analyzed data on 2,135 elderly individuals (58.6% women; mean age, 69.4 years; median age, 68.0 years). The dependent variable was self-rated health (good or poor). The following independent variables were considered: (1) demographic ones (age, sex, marital status, and living arrangements (whether the elderly person lived alone or with others)), (2) socioeconomic ones (schooling and income), (3) the number of chronic diseases (hypertension, arthritis or rheumatism, cardiovascular disease, diabetes, asthma, bronchitis or emphysema, embolism or stroke, and cancer), and (4) functional capacity. To estimate the association between self-rated health and the independent variables and to study gender differences, a multiple binary logistic regression analysis was performed. RESULTS: The presence of chronic diseases in association with gender was the strongest determinant of self-rated health among the elderly in São Paulo. Among men with four or more chronic diseases, they were 10.53 times as likely to characterize their health as poor; among women with four or more chronic diseases, the ratio was 8.31. Functional capacity, schooling, and income were also strongly associated with self-rated health, and the influence of age was significant. The elderly women were more likely to report good self-rated health than were men when the women or men either had no chronic diseases or had two or more. CONCLUSIONS: Our results indicate the need for simultaneous, comprehensive actions in the health sector, social services, and the economic sector to address the main determinants of self-rated health in order to promote well-being and quality of life among the elderly.

Aged↗
PubMed1993

The use of speech-based recoding in reading by prelingually deaf children.

We evaluated the extent to which prelingually deaf school children who were educated orally made functional use of speech-based codes in reading processes. The study involved two experimental reading tasks: (1) memorizing written words in association with meaning and (2) serial order recall of written word strings. The subjects were 78 school children 6 to 13 years of age. The results revealed a developmental change in the use of coding strategies: up to 9 years of age, most children seem to process written words by means of visual codes; older children tend to differentiate and appear to prefer either a visual or a speech-based strategy. The latter was found to be associated with better performance in reading tasks.

Child↗
PubMed2005

Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group.

STUDY DESIGN: A systematic review within the Cochrane Collaboration Back Review Group. OBJECTIVES: To assess the effectiveness of back schools for patients with nonspecific low back pain (LBP). SUMMARY OF BACKGROUND DATA: Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating patients with LBP. However, the content of back schools has changed and appears to vary widely today. METHODS: We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials to November 2004 for relevant trials reported in English, Dutch, French, or German. We also screened references from relevant reviews and included trials. Randomized controlled trials that reported on any type of back school for nonspecific LBP were included. Four reviewers, blinded to authors, institution, and journal, independently extracted the data and assessed the quality of the trials. We set the high-quality level, a priori, at a trial meeting six or more of 11 internal validity criteria. Because data were clinically and statistically too heterogeneous to perform a meta-analysis, we used a qualitative review (best evidence synthesis) to summarize the results. The evidence was classified into four levels (strong, moderate, limited, or no evidence), taking into account the methodologic quality of the studies. We also evaluated the clinical relevance of the studies. RESULTS: Nineteen randomized controlled trials (3,584 patients) were included in this updated review. Overall, the methodologic quality was low, with only six trials considered to be high-quality. It was not possible to perform relevant subgroup analyses for LBP with radiation versus LBP without radiation. The results indicate that there is moderate evidence suggesting that back schools have better short- and intermediate-term effects on pain and functional status than other treatments for patients with recurrent and chronic LBP. There is moderate evidence suggesting that back schools for chronic LBP in an occupational setting are more effective than other treatments and placebo or waiting list controls on pain, functional status, and return to work during short- and intermediate-term follow-up. In general, the clinical relevance of the studies was rated as insufficient. CONCLUSION: There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain and improve function and return-to-work status, in the short- and intermediate-term, compared with exercises, manipulation, myofascial therapy, advice, placebo, or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodologic quality and clinical relevance and evaluate the cost-effectiveness of back schools.

Humans↗
PubMed1998

Objective interpretation of bovine clinical biochemistry data: application of Bayes law to a database model.

With the advent of animal-side biochemistry analysers in veterinary practice, the requirement for ready access to reliable means for interpretation of the results is of increasing importance. At the University of Glasgow Veterinary School (GUVS), a large computerised hospital database containing extensive clinical, laboratory, and pathological information has been maintained. A retrospective study was undertaken to investigate plasma biochemistry results and corresponding post mortem diagnosis data from 754 unwell cattle which had presented to GUVS over the study period. Initial analysis of the clinical biochemistry data from this unwell population revealed that the parameters did not follow a normal distribution. This finding suggested that the accepted reference range method for the interpretation of clinical biochemistry data may provide limited information about the unwell animal. By applying a combination of percentile analysis and conditional probability techniques to the hospital data, the development of a means of clinical biochemistry interpretation was developed whereby a clinician could determine whether a value was abnormal, the degree of abnormality, and the most likely associated diseases. For example, a urea value of 30 mmol/l lay within the top 5% of results, and one of the most common diseases associated with this urea value was pyelonephritis. Furthermore, a Bayesian approach allowed the quantification of the relationship between any plasma biochemistry value and disease through the generation of a ratio termed the 'biochemical factor'. Using the same example, given a urea value of 30 mmol/l, pyelonephritis was eight times more likely than before any biochemistry information was known. The results from the study were used to form the basis of a software system which may ultimately be used by the clinical to aid in the recognition, treatment and prevention of disease in the veterinary domain.

Animals↗
PubMed1993

Psychological functioning of children with craniofacial anomalies and their mothers: follow-up from late infancy to school entry.

Twenty-three mothers and their 5- to 7-year-old children with craniofacial anomalies (CFA) who were assessed during the child's infancy were followed. Three types of CFA were included: cleft lip and palate (CLP), isolated cleft palate (CP), and sagittal synostosis. Measures of child status focused on behavior-problem frequency and self-concept. Mothers completed self-report measures of emotional well-being, marital satisfaction, and social support. Results indicated that (1) a sizable minority (18%) of the children with CFA had clinically significant behavior-problem scores shown in concordant reports by parent and teacher of behavior problems; (2) individual differences in child functioning within the CFA group were predicted by observational measures of earlier mother-infant interaction during play and teaching situations; (3) mothers of children with CLP reported less favorable social support than mothers of children with CP or sagittal synostosis.

Analysis of Variance↗
PubMed2004

Back schools for non-specific low-back pain.

BACKGROUND: Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating patients with low-back pain (LBP). However, the content of back schools has changed and appears to vary widely today. OBJECTIVES: To assess the effectiveness of back schools for patients with non-specific LBP. SEARCH STRATEGY: We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials to May 2003 for relevant trials reported in English, Dutch, French or German. We also screened references from relevant reviews and included trials. SELECTION CRITERIA: Randomized controlled trials (RCTs) that reported on any type of back school for non-specific LBP were included. DATA COLLECTION AND ANALYSIS: Four reviewers, blinded to authors, institution and journal, independently extracted the data and assessed the quality of the trials. We set the high quality level, a priori, at a trial meeting six or more of 11 internal validity criteria. As data were clinically and statistically too heterogeneous to perform a meta-analysis, we used a qualitative review (best evidence synthesis) to summarize the results. The evidence was classified into four levels (strong, moderate, limited or no evidence), taking into account the methodological quality of the studies. We also evaluated the clinical relevance of the studies. MAIN RESULTS: Nineteen RCTs (3584 patients) were included in this updated review. Overall, the methodological quality was low, with only six trials considered to be high quality. It was not possible to perform relevant subgroup analyses for LBP with radiation versus LBP without radiation. The results indicate that there is moderate evidence suggesting that back schools have better short and intermediate-term effects on pain and functional status than other treatments for patients with recurrent and chronic LBP. There is moderate evidence suggesting that back schools for chronic LBP in an occupational setting, are more effective than other treatments and placebo or waiting list controls on pain, functional status and return to work during short and intermediate-term follow-up. In general, the clinical relevance of the studies was rated as insufficient. REVIEWERS' CONCLUSIONS: There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain, and improve function and return-to-work status, in the short and intermediate-term, compared to exercises, manipulation, myofascial therapy, advice, placebo or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodological quality and clinical relevance and evaluate the cost-effectiveness of back schools.

Exercise↗
PubMedDate not supplied

[Hygienic advantages of teaching girls of same sex schools].

The paper comparatively analyzes the impact of teaching on the health and functional parameters of girls in the same sex classes. The hygienic and educational advantages of girls' separate schooling at primary and secondary stages are substantiated. The right to separate schooling of girls is recognized as one of its variations, which realizes a gender line in pedagogy and lowers the unfavourable impact of schooling on girls' health.

Child↗
PubMed2000

School absenteeism after upper gastrointestinal endoscopy in children.

BACKGROUND AND AIMS: To examine the functional impact of upper gastrointestinal endoscopy as a day procedure, particularly in relation to subsequent school attendance. METHODS: Symptoms and morbidities were prospectively recorded from school-aged children during observation in hospital and for 3 days at home after endoscopy by using a structured questionnaire. Reasons for school absence were identified. RESULTS: Sixty children (31 boys, 29 girls) were enrolled in the study (mean age 10.6 +/- 2.8 years, range 6.1-16.2 years). Following the procedure, symptoms were reported at home in 68.3% (same day), 56.7% (day 1) and 20% (day 2).The commonest symptoms were sore throat, tiredness and dizziness. Twenty-nine children (48.3%) did not attend school on the day following the procedure but most (26 of 29) had returned to school by the second day. The main reason for their absence was residual physical discomfort related to the procedure (55.2%). CONCLUSIONS: Persisting physical discomfort and school absenteeism are common following upper gastrointestinal endoscopy in children.

Absenteeism↗
PubMed1985

Congenital heart disease: functional abilities in young adults.

Muscular endurance, motor abilities, childhood activities, school experiences, work plans, and social behaviors of 188 young adults aged 16 to 23 years with congenital heart disease were examined. The subjects had isolated aortic stenosis, pulmonary stenosis, or tetralogy of Fallot. Overall, physical function scores were slightly below average. Childhood activities had been affected in about 30% of the cases, but seriously disrupted in only 17%. School experiences had been positive, and 68% of the students in school planned to continue on to college or university or were already there. Normal social behavior was much more common than antisocial behavior. Subjects had few specific health worries, although many wanted more information about lifestyle implications of their heart disease.

Adolescent↗