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Low exhaled nitric oxide in school-age children with bronchopulmonary dysplasia and airflow limitation.

Bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity, may be associated with long-term airflow limitation. Survivors of BPD may develop asthma-like symptoms in childhood, with a variable response to beta(2)-agonists. However, the pathologic pathways underlying these respiratory manifestations are still unknown. The aim of this study was to measure exhaled nitric oxide (FE(NO)) and lung function in a group of 31 school-age survivors of BPD. They showed variable degrees of airflow obstruction (mean FEV(1) 77.8 +/- 2.3% predicted) unresponsive to beta(2)-agonists in 72% of the subjects. Their FE(NO) values (geometric mean [95% confidence interval]: 7.7 [+/- 1.1] ppb) were significantly lower than in a group of healthy matched control subjects born at term (10.7 [+/- 1.1] ppb, p < 0.05) and a group of preterm children without BPD (9.9 [+/- 1.1] ppb, p < 0.05). The children with BPD were also compared with a group of 31 patients with asthma with a comparable airflow limitation (FEV(1) 80.2 +/- 2.1% predicted) and showed FE(NO) values four times lower than in those with asthma (24.9 [+/- 1.2] ppb, p < 0.001). In conclusion, unlike children with asthma, school-age survivors of BPD have airflow limitation associated with low FE(NO) values and lack of reversibility to beta(2)-agonists, probably as a result of mechanisms related to early life structural changes in the airways.

Adrenergic beta-Agonists↗

The clinical pathway for fast track recovery of school activities in children after minimally invasive cardiac surgery.

BACKGROUND: Minimally invasive cardiac surgery is now becoming standard in the correction of simple congenital cardiac malfbrmations. We introduced a clinical pathway for fast track recovery of school activities in children after minimally invasive cardiac surgery, and assessed the function of the pathway in children with atrial or ventricular septal defects, comparing minimally invasive surgery to repair through a conventional full sternotomy. METHODS: We studied 15 children of school age who underwent repair of an atrial or ventricular septal defect through a lower midline sternotomy, and 10 children undergoing repair through a full sternotomy. The clinical pathway was for extubation to take place in the operating room, echocardiographic evaluation on the 5th postoperative day, and discharge home on the 7th postoperative day, with return to school within 2 weeks, and resumption of all gymnastic activity within 6 weeks of the minimally invasive surgery. RESULTS: In those having a lower midline sternotomy, postoperative hospital stay was 7.4 +/- 0.8 days, with return to school 8.0 +/- 2.4 days after discharge. They resumed gymnastics 41 +/- 11 days after the minimally invasive surgery. In those having a full sternotomy, in contrast, these parameters were 13.5 +/- 2.7, 23.1 +/- 8.4, and 95 +/- 43 days, respectively. Of the 15 children undergoing a minimally invasive approach, 12 (80%) fulfilled the criterions of our clinical pathway. CONCLUSIONS: We conclude that minimally invasive cardiac surgery can safely be performed in children. In addition to its cosmetic role, the technique has added value in promoting early return to normal school life, including gymnastics.

Adolescent↗

[Ability of a child with Pierre-Robin syndrome to attend school].

A boy with Pierre Robin syndrome and his capability to attend elementary school are presented. In addition to basic features of the syndrome (micrognathia, glossoptosis, cleft palate), the boy had a congenital heart anomaly (atrial and ventricular septal defect) and hearing impairment. Results of the testing before enrollment in the elementary school showed motor deficit, lover than average level of intellectual functioning (IQ = 80-85), hyperactivity and attention deficit. The boy was enrolled in the regular elementary school, with adapted teaching program.

Child↗

Skin surface pH, stratum corneum hydration, trans-epidermal water loss and skin roughness related to atopic eczema and skin dryness in a population of primary school children.

Non-invasive investigations of skin morphology and function are standard tools to study the pathophysiology of several cutaneous disorders, yet they have not been used in population-based epidemiological studies. Here we examined skin surface pH, stratum corneum hydration, trans-epidermal water loss (TEWL) and skin roughness by profilometry in a study population comprising 377 primary school children (8-9 years old) as part of a multicentre survey on risk factors for allergic diseases in school children. Skin surface pH showed significant higher values (p=0.029) in the group with atopic eczema (n=45) compared with the group without atopic eczema; all other parameters did not differ significantly between children with and without atopic eczema. With increasing skin dryness there was a significant increase in pH values (p=0.004). Stratum corneum hydration showed a significant decrease with increasing dryness (p<0.001). Measurement of skin roughness also revealed a significant linear relationship with skin dryness (p=0.02). It is concluded that measurement of skin surface pH, corneometry and profilometry are useful non-invasive techniques to objectively assess skin dryness in epidemiological studies regarding atopic skin disease.

Body Water↗

An examination of the environmental attributes associated with pedestrian-vehicular crashes near public schools.

This paper examines pedestrian-vehicular crashes in the vicinity of public schools, the severity of injuries sustained, and their relationship to the physical and social attributes near the schools. Multivariate models of crash severity and crash risk exposure were estimated as a function of social and physical characteristics of the area immediately surrounding schools in Baltimore City, Maryland. Results show that the presence of a driveway or turning bay on the school entrance decreases both crash occurrence and injury severity. Conversely, the presence of recreational facilities on the school site is positively associated with crash occurrence and injury severity of crashes. Findings related to neighborhood characteristics were mixed but the significant variables - transit access, commercial access, and population density - are generally associated with increased pedestrian demand and should be interpreted with care. The results of this study are relevant for Safe Routes to School projects and point to areas meriting further study.

Accidents, Traffic↗

Parental cancer: characteristics of parents as predictors for child functioning.

BACKGROUND: The vulnerability of children when a parent is diagnosed with cancer may depend on a variety of variables. The current study examined the impact of characteristics of 180 parents diagnosed with cancer, along with 145 spouses, on the prevalence of emotional and behavioral problems in children. METHODS: Ill parents provided information on sociodemographics and illness-related variables and on the prevalence of problems in children by using the Child Behavior Checklist (CBCL). Both parents completed the two subscales that measure physical functioning and mental health of the RAND-36. RESULTS: The family situation (single parents, no or few siblings, oldest child) was one of the most important predictors of reported problems in primary school children, whereas adolescents were reported as having more problems when parents experienced treatment complications. A decrease in ill parents' physical functioning affected primary school daughters and adolescents, and both age groups were affected by the mental health of ill parents. Problems of ill fathers did not have a different impact on children from those of ill mothers. Spouses' physical limitations were indicative for problems in primary school children, whereas a worsening parental mental health was indicative for problems in adolescents. CONCLUSIONS: Findings illustrated that parents' characteristics must be taken into account when assessing vulnerability of children in this situation. Which variables particularly heighten the risk for problems depend on children's ages.

Adult↗

Maternal smoking during pregnancy as a predictor of lung function in children.

Recent studies have suggested that prenatal exposure to environmental tobacco smoke may lead to lower lung function in infants. The authors examined the relation of maternal smoking during pregnancy to persistent deficits in the lung function of older children. Subjects were 8,863 nonsmoking white children aged 8-12 years from 22 North American communities. Information on maternal smoking was provided by the child's mother. Pulmonary function testing of the children was conducted at school in 1988-1991. Children whose mothers smoked during pregnancy, whether or not they still smoked in the year prior to the study, had significantly lower lung function than did children whose mothers did not smoke in either period. On average, forced expiratory flow between 65 and 75 percent of forced vital capacity (FEF65-75%), forced expiratory flow between 25 and 75 percent of forced vital capacity (FEF25-75%), and forced expiratory volume in 3/4 of a second (FEV0.75) were 5.7%, 4.9%, and 1.7% lower, respectively, for children whose mothers smoked during pregnancy. After adjusting for maternal smoking during pregnancy, the authors found that current maternal smoking was not associated with significant differences on any lung function measure. These results show a persistent deficient in lung function associated with maternal smoking during pregnancy that is not explained by current maternal smoking alone. The strongest effects were observed with pulmonary function measures of flow in the small airways. The authors conclude that the effects of exposure to tobacco smoking by the mother during pregnancy and/or environmental tobacco smoke exposure in the first few years of life persist into childhood and may affect the pulmonary function attained throughout the child's life.

Child↗

School nurses: improve the reception and sharpen the image.

Many educators and community members misunderstand the present-day school nurses. These nurses' roles encompass a much broader range of health-related activities than did their predecessors' roles. Continued education and professional autonomy have enabled school nurses to direct their attention to primary and secondary prevention and to the maintenance of health. By utilizing a systems approach, school nurses can plan strategies that promote visibility and clarify their images. The outcome could result in better understanding and cooperation between the nurses and other school personnel, resulting in an ultimate benefit to children. The organization of a city school district's health service program and the functions of some of its team members are described. Pertinent statistics regarding the district and the nurses working within it are provided. Examples are given of typical school nurses experiences and responsibilities. Numerous suggestions are made for establishing networks with those persons having formal and informal power in order to achieve visibility and credibility. Some of the suggestions include participation at parent association meetings, presidents' council, teacher-faculty meetings, community council meetings and spreading the message via school and local newspapers.

New York City↗

Safety words inventory and literacy screener: standardization and validation.

When evaluating a school-aged patient, particularly for such issues as attention deficit disorder, or learning disabilities, health-care providers are encouraged to appraise children's school performance. Although some clinicians seek teachers' comments, recent research suggests that teachers' appraisals have limited value. As a consequence, health-care providers need brief methods, functional for busy primary care clinics, for detecting school problems. Because well-visits also include other services such as anticipatory guidance and safety and injury counseling, it would be helpful for detection tools to facilitate delivery of more than one aspect of well-child care. This study was undertaken to develop a brief method for evaluating school performance for elementary-age children and test its accuracy in identifying children with reading and other academic problems. By using common safety signs as the test stimuli, such a tool should also serve as a springboard to injury prevention counseling. Data were drawn from the standardization and validation data of an individually administered wide-range diagnostic achievement test using a geographically diverse, nationally representative sample of 934 children between 5 and 13 years of age. Children were administered the Comprehensive Inventory of Basic Skills-Revised (CIBS-R), which includes among its 10 subtests a 57-item measure of safety word recognition. Data were collected from previously administered measures of academics and intelligence. Forty-one children were administered the measure twice to assess inter-rater reliability. Logistic regression analyses were deployed using children's performance on the nine other subtests of the CIBS-R as the grouping variable, and as predictors, recognition of 57 safety words/phrases. Of these, 22 safety signs (e.g., "Keep out," "No Trespassing," "Danger") were significant predictors of overall academic performance. An additional seven safety words were added due to their ecological significance (e.g., "High Voltage," "Beware of Dog," "Poison," etc.). Receiver operating characteristic was used to determine cut scores based on children's ages in relation to overall academic performance. Cut scores increased with age and produced sensitivity of 78% (range, 73%-88%) and specificity of 84% (range, 77%-87%) to academic performance above and below the 25th percentile--the point where children typically fail to benefit from group instruction and become eligible for remedial reading programs (such as Title I). Children with performance below cut scores were 11 times more likely to have been retained in grade and five times more likely to receive a teacher rating of below average than were children performing above cut scores. Nevertheless, 72% of children with poor performance were not receiving special education or Title I services. Interrater reliability coefficients were high and ranged from .64 to .98. Extrapolating administration times from data on the CIBS-R as a whole suggests the reduced safety words measure takes 3 to 4 minutes to administer and score. The new measure, called the Safety Word Inventory and Literacy Screener (SWILS), consists of 29 words, takes little time to administer and score, and has a high degree of sensitivity and specificity to academic deficits. Use of the SWILS in primary care should enable clinicians to provide focused safety counseling while also screening for school problems.

Adolescent↗

Health effects of passive smoking. 9. Parental smoking and spirometric indices in children.

BACKGROUND: A systematic quantitative review was conducted of the evidence relating parental smoking to spirometric indices in children. METHODS: An electronic search of the Embase and Medline databases was completed in April 1997 and identified 692 articles from which we included four studies in neonates, 42 cross-sectional studies in school aged children (22 were included in a meta-analysis), and six longitudinal studies of lung function development. RESULTS: In a pooled analyses of 21 surveys of school aged children the percentage reduction in forced expiratory volume in one second (FEV1) in children exposed to parental smoking compared with those not exposed was 1.4% (95% CI 1.0 to 1.9). Effects were greater on mid expiratory flow rates (5.0% reduction, 95% CI 3.3 to 6.6) and end expiratory flow rates (4.3% reduction, 95% CI 3.1 to 5.5). Adjustment for potential confounding variables had little effect on the estimates. A number of studies reported clear evidence of exposure response. Where exposure was explicitly identified it was usually maternal smoking. Two studies in neonates have reported effects of prenatal exposure to maternal smoking. Of five cross sectional studies that compared effects of perinatal exposure (retrospectively assessed) with current exposure to maternal smoking in later childhood, the three largest concluded that the major effect was in utero or neonatal exposure. Longitudinal studies suggest a small effect of current exposure on growth in lung function, but with some heterogeneity between studies. CONCLUSIONS: Maternal smoking is associated with small but statistically significant deficits in FEV1 and other spirometric indices in school aged children. This is almost certainly a causal relationship. Much of the effect may be due to maternal smoking during pregnancy.

Adolescent↗

Adaptive behavior in autism and Pervasive Developmental Disorder-Not Otherwise Specified: microanalysis of scores on the Vineland Adaptive Behavior Scales.

The purpose of this study is to provide a microanalysis of differences in adaptive functioning seen between well-matched groups of school-aged children with autism and those diagnosed as having Pervasive Developmental Disorder-Not Otherwise Specified, all of whom functioned in the mild to moderate range of intellectual impairment. Findings indicate that the major area of difference between children with autism and those with Pervasive Developmental Disorder-Not Otherwise Specified, was expressive communication; specifically, the use of elaborations in syntax and morphology and in pragmatic use of language to convey and to seek information in discourse. Linear discriminant function analysis revealed that scores on just three of these expressive communication item sets correctly identified subjects in the two diagnostic categories with 80% overall accuracy. Implications of these findings for both diagnosis and intervention with children with Autism Spectrum Disorders will be discussed.

Activities of Daily Living↗

Community dentistry in Nordic dental schools.

Approximately a decade after the first plans for the teaching of community dentistry were made in the Nordic countries, a questionnaire survey of Nordic dental schools was conducted to find out to what extent community dentistry subjects had been introduced in undergraduate curricula. Replies were received from the 12 dental schools in Denmark, Finland, Norway and Sweden. These schools admitted 915 students in 1982-83. Seven had a department of community dentistry, and at least two others had plans to start one. About 100 h of teaching were given on community dentistry subjects during the 5-yr course of study, mostly on the traditional subjects of epidemiology, statistics, law and ethics. In some schools health education and other behavioral sciences subjects received a large amount of curriculum time. Decisionmaking theory and political science were not reported taught at any school. Three departments had attached clinics, with widely differing functions. The Nordic textbook in community dentistry was widely used, and separate examinations were held in community dentistry at most schools. Full-time postgraduate courses were offered at three schools. Although schools in all four countries expected the number of dental students to decrease in coming years, several schools expected community dentistry to expand with regard to curriculum time and staff, in keeping with trends in other countries.

Community Dentistry↗

Low levels of air pollution induce changes of lung function in a panel of schoolchildren.

In search of sensitive screening parameters for assessing acute effects of ambient air pollutants in young schoolchildren, the impact of 8-h average air pollution before lung function testing was investigated by oscillatory measurements of resistance and spirometry with flow-volume loops. At a central elementary school in Linz, the capital of Upper Austria, 163 children aged 7-10 yrs underwent repeated examinations at the same time of day during 1 school year, yielding a total of 11-12 lung function tests per child. Associations to mass concentrations of particulate matter and nitrogen dioxide (NO(2)) measured continuously at a nearby monitoring station were tested, applying the Generalised Estimating Equations model. Reductions per 10 microg.m(-3) (both for particles and for NO(2)) were in the magnitude of 1% for most lung function parameters. The most sensitive indicator for acute effects of combustion-related pollutants was a change in maximal expiratory flow in small airways. NO(2) at concentrations below current standards reduced (in the multipollutant model) the forced expiratory volume in one second by 1.01%, maximal instantaneous forced flow when 50% of the forced vital capacity remains to be exhaled (MEF(50%)) by 1.99% and MEF(25%) by 1.96%. Peripheral resistance increased by 1.03% per 10 microg.m(-3) of particulate matter with a 50% cut-off aerodynamic diameter of 2.5 mum (PM(2.5)). Resistance is less influenced by the child's cooperation and should be utilised more often in environmental epidemiology when screening for early signs of small airway dysfunction from urban air pollution, but cannot replace the measurement of MEF(50%) and MEF(25%). In the basic model, the reduction of these parameters per 10 microg.m(-3) was highest for NO(2), followed by PM(1), PM(2.5) and PM(10), while exposure to coarse dust (PM(10)-PM(2.5)) did not change end-expiratory flow significantly. All acute effects of urban air pollution found on the lung function of healthy pupils were evident at levels below current European limit values for nitrogen dioxide. Thus, planned reduction of nitrogen dioxide emission (Euro 5; vehicles that comply with the emission limits as defined in Directive 99/96/EC) of 20% in 2010 would seem to be insufficient.

Air Pollution↗

Out-of-school settings as a developmental context for children and youth.

Since the 1990s, there has been a growing recognition of the importance of the out-of-school context for children and adolescents. Fueled in part by family demographics that include substantial numbers of employed mothers and single mothers, in part by concerns about poor academic performance and problem behaviors, and in part by intensified efforts to find ways to promote positive youth development, researchers and practitioners have focused their attention on two particular out-of-school settings: after-school programs and structured activities. The research findings pertaining to full-time (i.e., 5 days a week) after-school programs are mixed, which may reflect the substantial heterogeneity of the programs in terms of children being served, the types of activities offered, and the training and background of the staff. The federal funding of the 21st Century CLCs and various state and local initiatives has increased the numbers of low-income and English-learning students participating in after-school programs. A substantial number of programs are becoming more school-like. The available research suggests that (under some conditions) attending after-school programs is linked to improved social and academic outcomes. Children are more likely to show academic and social benefits when staff-child relationships are positive and nonconflictual, when programs offer a variety of age-appropriate activities from which children can select those of interest, and when children attend on a regular basis. The research findings about voluntary structured activities are more straightforward. Participation in these activities has been consistently linked to positive academic and social developmental outcomes in numerous studies. What appears to be key is that the activities are voluntary, are characterized by sustained engagement and effort, and provide opportunities to build or develop skills. Although the available research has begun to inform our understanding of the out-of-school context, further research is sorely needed. First, there is a need for research to identify the social, cognitive, and linguistic processes by which participation in programs and structured activities influences child and youth developmental outcomes. For example, researchers need to consider the competitiveness of sport activities in relation to children's social and emotional functioning. Researchers also might examine after-school experiences as settings in which complex thought processes can develop. Heath (1999) has conducted initial work in the area of language development by obtaining language samples during voluntary structured activities and analyzing their content. In the initial samples, students engaged in few sustained conversations on a topic and they frequently changed topics. After 3-4 weeks at the program, however, Heath noted substantial changes in the students' conversations and language. The use of conditionals (should, would, could) increased. She also noted increases in strategies to obtain clarifications from others and increases in the use of shifted registers and genres. Heath's (1999) linguistic analyses in conjunction with research that considers social and motivational processes underscore the broader point that the out-of-school context is complex and multi-layered and likely to be of substantial importance in the lives of children and youth. Research is needed to identify other important developmental processes in programs and structured activities. A promising procedure for identifying these processes is experience sampling (Csikszentmihalyi & Larson, 1987; Larson, 1989). Experience sampling methodology allows researchers to collect systematic data about an individual's activities, thoughts, and affective states by obtaining reports from participants at multiple randomly sampled points in time. Participants are signaled to provide a report in a variety of ways, such as with beepers or alarm watches. This record of experiences is not usually captured by other data collection methods. For example, program observations provide data on observed activities, interactions, and program climate, but do not offer insights into students' feelings and experiences within the after-school environment. Questionnaire and survey data are retrospective, asking respondents to recall past experiences and feelings regarding their after-school activities. Experience sampling could be used to examine any number of processes in after-school programs and structured activities. A better understanding of the effects of program content also is needed. Whether after-school programs should focus exclusively on enrichment activities or exclusively on academic activities, or include both enrichment and academic components, is the subject of heated debate. Some after-school scholars (Halpern, 1999; Heath, 1999; Eccles, in press) have argued forcefully that a focus on academics undermines the unique strengths and role of programs, and that programs should emphasize extracurricular enrichment activities. Others (Noam, 2004) have supported the move by policy makers and educators to make programs more academic, with an emphasis on homework help, tutoring, and preparation for academic achievement tests. The effects of different approaches to after-school programming have not been evaluated systematically. Research that describes, compares, and then tests effects of different program content models is needed to determine which types of programs are successful in attracting and keeping students (a necessary condition for programs to effect change), and to determine whether different types of programs are differentially associated with improvements in student outcomes such as school attendance, academic achievement, social competencies, and behavioral adjustment. A related question is whether structured activities that are obligatory or required have the same effects as voluntary structured activities do. Researchers also should further examine the impact of different attendance patterns on child developmental outcomes. We do not have solid information about optimal intensity and duration of attendance in terms of outcomes. There are suggestions in the literature that long-term, frequent attendance at programs is associated with positive outcomes for low-income children. Research needs to examine whether these results hold for middle-income children and youth as well. Finally, experimental studies should be conducted in which children and adolescents are randomly assigned to after-school programs and structured activities. All of the research to date on structured activities, and most of the research on after-school programs, has been nonexperimental, so questions about selection bias remain. Experimental studies in which children and adolescents are randomly assigned to participation in programs and activities would be a valuable next step in understanding relations between participation and child and youth outcomes. Such research should not be conducted until we have more information about the components of high-quality programming in terms of program content and developmental processes, however.

Adolescent↗

Residual goitre in the postiodization phase: iodine status, thiocyanate exposure and autoimmunity.

OBJECTIVE: This study was done to assess goitre prevalence, thyroid functional status and cause of residual goitre among school children in the postsalt iodization phase in India. DESIGN: A cross-sectional study in which, 14762 school children in the age group of 6-18 years, from different States and Union territories of India, were evaluated for goitre prevalence, urinary iodine and thiocyanate excretion, functional status of the thyroid as well as serological and cytopathological markers for thyroid autoimmunity. MEASUREMENTS: Urinary iodine (wet ashing method), urinary thiocyanate (colourimetric method), serum thyroxine [in-house radioimmunoassay (RIA)], serum TSH (IRMA), antithyroid microsomal and antithyroglobulin antibodies (haemagglutination method) were estimated. Fine-needle aspiration cytology was performed in all goitrous subjects giving consent. RESULTS: The overall goitre prevalence was 23% (27.1% girls; 17.8% boys, P < 0.001). Subjects belonging to poor socio-economic strata had significantly higher goitre prevalence. Median urinary iodine excretion (UIE) in goitrous subjects (2-53 micromol/l) was significantly higher than in controls (2-24 micromol/l; P < 0.001). Levels of UIE observed among goitrous subjects showed no relationship with the presence or absence of thyroid dysfunction or with thyroid antibody status. High titres (> or = 1:1600) of TMA were present more often in goitrous subjects (6.08%) than nongoitrous controls (0.34%; P < 0.001) and in girls (7.3%) than boys (2.35%; P < 0.001). TMA positivity were significantly more among goitrous subjects with thyroid dysfunction than in euthyroid subjects. Significantly higher median urinary thiocyanate (USCN) excretion was observed in goitrous subjects (0.75 mg/dl) compared to controls (0.64 mg/dl; P < 0.001) and goitrous girls compared to goitrous boys. USCN excretion of goitrous subjects and controls showed no relationship with functional or thyroid antibody status in various groups. CONCLUSIONS: Persistent, albeit reduced prevalence of goitre, despite adequate iodine prophylaxis, suggests existence of additional factors in goitrogenesis in India. Thyroid autoimmunity can explain only a part of the goitre prevalence. The role of goitrogens in residual goitre prevalence is brought forth.

Adolescent↗

[Alcoholism in school-age children].

Curiosity motivated consumption of illegal drugs by young people decreased during the last 5 years. At the same time the problem of school-children abusing alcohol increased. This has to be seen against the background of more general epidemiological data of alcohol consumption in the Federal Republic of Germany: --between 1961 and 1974 the expenditure for alcoholic beverages more than doubled; --according to serious estimations there are between 700,000 and 1 million of alcoholics in this country (from these about 8-10% being minors); --the average age of inmates of clinics for alcoholics dropped considerably during the last decade. Main findings of a follow-up survey conducted (size of sample: about 10,000 school-children in Hamburg, age 13-20, representative of a total of 110,000) are: --more than 25% of the above mentioned 110,000 school-children showed a rather excessive drinking behaviour (i.e. having been drunk 1-5 or more than 5 times during a period of 2 months prior to the interviews); --positive correlations were found to exist between excessive drinking habits and certain psycho-social variables (i.e. broken home, suicide-attempts, excessive consumption of alcohol by the parents, etc.); --the subgroup of those school-children who were users of illegal drugs: about 60% of them belong also to the category of "excessive alcohol user". Reasons for the general increase of alcohol consumption in Western Germany are for instance: --a change of drinking habits (more frequently, drinking at home and alone); --a shift of preferances (from relatively low percentage-beverages like beer and wine to so-called hard liquors); --an increase of alcohol consumption among those societal groups--the young and women--who formerly were almost abstinent. Some reasons and causes for the increase of alcohol consumption among school-children are: --being exposed to negative model-behaviour of adults and especially of parents; --peer-group pressure; --the discovery of school-children by the industry as an important consumer group, i.e. shape of images through advertisement (for example "drinking makes you appear strong" etc.); --the increasing loss of functions of traditional agents of socialization (i.e. family, school and religion).

Adolescent↗

[Evaluation of school milieu as an aspect of conditions for realizing health promotion. I].

Data collected in 1990 by workers of children and youth hygiene section of the Sanitary Epidemiological Station were analysed in randomly chosen elementary schools of 41 districts. In elaboration of the data negative observations were singled out. There were differences between schools of various milieus. A regularity was noted: the smaller the locality, the more there are shortcomings and neglect. Teaching in shifts was general: in at least two relays in 90% of town schools and 50% of village ones. Many shortcomings were noted in the functioning of WC and washing equipment (lighting, heating, ventilation), besides 10% of village schools had no washing facilities. About 60% of town schools had showers bath but they were hardly utilised; 1/4 of village schools had shower baths but did not profit of them. In the sanitary-hygienic state frequent negligence was visible. For instance in 1/4 of what used to be communal schools the WC were dirty, without toilet paper, and less than half of them had neither soap nor towels. Lousiness indexes were as follows: 1.6% (if 140,000 individuals examined) in town schools and 2.5% (of 65,000 examined). Lousiness was recorded in more than 60% of schools. The staff of the schools health service may be described by the following data: in 85% of village schools the physician appeared at most several times in the course of the year, in town schools he was present at most several times in a month; in 50% of village schools a nurse was seen less frequently than one a week, and in 85% of town schools three or more times weekly.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗

Sex differences in neuropsychological performance for children with reading deficits.

This study examined sex differences in neuropsychological functioning for a large sample of public school children with reading deficits. Specifically, scores on the Weschsler Intelligence Scale for Children--Revised (Wechsler, 1974), the Halstead-Reitan Neuropsychological Battery for older children (Reitan, 1969) and the Wide Range Achievement Test (Jastak and Jastak, 1978) were compared for males and females in a multivariate fashion. Significant sex differences were found in motor, verbal and nonverbal functioning. Females seemed to be more aberrant than males in expected neuropsychological performance.

Achievement↗