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Biomedical subjects

H Mohay

Publications and source records attributed to H Mohay.

At least 19 recordsLinked to original sources
PubMed2002

Non-anaemic iron deficiency identified by ZPP test in extremely premature infants: prevalence, dietary risk factors, and association with neurodevelopmental problems.

INTRODUCTION: The aims of this study were to determine, in a cohort of extremely premature infants, the prevalence of iron deficiency identified by zinc protoporphyrin/heme ratio (ZPP) testing, and its association with neurodevelopmental problems and dietary risk factors for iron deficiency. METHODS: Infants of less than 29 weeks' gestation or less than 1000 g birth weight were studied prospectively at a multidisciplinary follow-up clinic. Assessments were made at a corrected age of either 12 months (n=72) or 2 years (n=69). Physical examination, Griffiths Developmental Scale, and neurosensory-motor assessment were administered, information on diet and behaviour was obtained by questionnaire, and a fingerprick ZPP ratio was performed to identify iron deficiency. RESULTS: 18.4% of infants had positive ZPP tests. There was no significant association between a positive ZPP test result and dietary risk factors, or symptoms of lethargy, irritability or poor attention. In children without cerebral palsy, there was no difference on Griffiths scores or neurosensory-motor assessment between ZPP-positive and ZPP-negative groups. The diagnosis of cerebral palsy (n=12) was significantly associated with both a positive ZPP test and a lower Griffiths general quotient (GQ) score. CONCLUSIONS: Iron deficiency occurs commonly in extremely low birth weight (ELBW) children in early childhood, and is not predicted by dietary risk factors. The prevalence of iron deficiency is increased in ELBW children with cerebral palsy. Non-anaemic iron deficiency (NAID) does not impair development or significantly affect behaviour of ELBW subjects who do not have cerebral palsy.

Child, Preschool↗
PubMed2001

John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital.

AIMS: John Bowlby and James Robertson, two men who were extremely influential in the latter part of the 20th Century, combined scientific theory with evangelism to bring about changes in the way in which children were cared for in hospitals and other institutions. This paper discusses their work together, their theories and their influence on the care of children and paediatric nursing. BACKGROUND: Bowlby and Robertson collaborated early in their working relationship on research about separation of mother and child. Bowlby was the scientist who developed classic theories about maternal separation. Robertson focused his research on separation of mother and child due to hospital admission. Between the two of them, they derived a classic theory about the phases of 'protest', 'despair' and 'denial' (Bowlby called this last stage 'detachment') through which small children pass when isolated from their mothers for a length of time. DISCUSSION: Bowlby became an internationally recognized theorist, widely acclaimed and considered an expert in the field of maternal care and child development. Robertson, with his wife, Joyce, not only continued Bowlby's work investigating children separated from their mothers, but also took on the role of campaigner for the welfare of children in hospital. James Robertson, with his impressive speaking powers, established an international reputation proselytizing the need to admit parents to hospital with their children. The work of Bowlby and Robertson coincided with new knowledge about cross-infection, which had been one of the reasons for excluding parents from hospital wards. At the same time, and influenced by their work, community groups, which championed the idea of admitting parents with their children, developed. The combination of these factors provided a catalyst for changes within the health systems of many developed countries. Because of the theoretical work of Bowlby and Robertson's missionary zeal, government policies, staff attitudes and parents' expectations changed. Children's wards and hospitals in developed countries today admit parents as part of normal routine and actively involve them in the planning and implementation of their child's care.

Adolescent↗
PubMed2000

The measurement of quality of life in young children.

The purpose of this paper is to argue for a measure of quality of life (QoL) for children aged between 4 and 8 years, describe the obstacles in developing such a measure, and provide evidence that it is possible to elicit directly information from children. Finally we summarize and critique measures that are currently available for this purpose.

Child↗
PubMed1999

Executive function of children with extremely low birthweight: a case control study.

This study examines the executive function (EF) skills of extremely-low-birthweight (ELBW) children at school compared with their peers. Thirty children with ELBW and 50 control children (both with a mean age of 62+/-4 months) were administered tests of EF including the Tower of Hanoi task, Finger Sequencing task, and Tapping Test. Children with ELBW, including those who scored more than 1 SD below the mean on the Peabody Picture Vocabulary Test-Revised, scored significantly lower than their peers on all executive tasks. There was limited correlation between EF and previous general quotient index scores obtained at routine assessment using the McCarthy Scales of General Ability at 4 years of age for the children with ELBW. Results suggest that children with ELBW are at risk for deficits in 'executive' behaviours including planning, sequencing, and inhibition which may have implications for later learning.

Case-Control Studies↗
PubMed1999

The influence of growth on development outcome in extremely low birthweight infants at 2 years of age.

OBJECTIVE: To determine if weight < 3rd and < 10th centile at 2 years in extremely low birthweight (ELBW) infants is associated with problems of development and motor skills, and whether this association is explained by perinatal risk status. METHODOLOGY: One hundred and ninety-eight of 226 (88%) surviving ELBW infants born between January 1987 and December 1992 were assessed at 2 years corrected age. Children were classified as being at low perinatal risk (n = 128) or high perinatal risk (n = 70) for adverse developmental outcome based on perinatal risk factors. Weight at 2 years was classified as < 3rd, 3rd-9th or > or = 10th centile for age and gender. Development was assessed using the Griffiths Mental Developmental Scales and motor skills using the Neurosensory Motor Developmental Assessment (NSMDA). RESULTS: For the total study group weight centile was strongly related to General Quotient (GQ) and motor abilities. For children < 3rd percentile (n = 48) mean (GQ) was 90.4 (SD, 15.9), for children between the 3rd-9th percentile (n = 49) 91.5 (SD, 17.9), and for children > or = 10th percentile (n = 99) mean GQ was 99.8 (SD, 8.6). The association with mean GQ and NSMDA category occurred for the high-risk subgroup and became non-significant in the low-risk subgroup if neurologically abnormal children were excluded. Other perinatal risk factors, exposure to breast milk, level of maternal education, marital status and history of feeding problems or infections over the 2 years did not confound this association. CONCLUSION: Low weight percentile at 2 years was related to adverse developmental outcome in ELBW infants at high perinatal risk or with neurological impairment, though minimal association was present for neurologically normal infants at low perinatal risk.

Birth Weight↗
PubMed1998

Educating young children about asthma: comparing the effectiveness of a developmentally appropriate asthma education video tape and picture book.

Asthma self-management programmes have been shown to increase children's knowledge about asthma and improve their management practices and health status. However, existing programmes have rarely addressed the unique learning needs of very young children. This study aimed to develop and assess the effectiveness of a video tape and picture book designed to teach children about the prevention and management of acute episodes of asthma. The information content of the educational resources was determined by analysis of relevant medical information and asthma management skills. Social Learning Theory and consideration of the developmental stage of the target population informed the format and style of presentation of the resources. Eighty children aged between 2 and 5 years who had been diagnosed with asthma by their medical practitioner and who required daily asthma medication participated in a controlled experimental study. The study evaluated the impact of the asthma education resources on children's knowledge about asthma, compliance with medication regimens and health status. Children were randomly allocated to one of three experimental groups. Children in these groups were exposed to either the video tape alone, the book alone or both the video tape and book, or to a control group who viewed materials unrelated to asthma. The results for the three experimental groups were compared with the control group who did not receive exposure to any of the asthma education resources. The results showed that children in each experimental group had significantly greater gains in asthma-related knowledge than children in the control group and children exposed to both resources showed the greatest increases in knowledge. Children in each of the three experimental groups also had better compliance and health than children in the control group. These findings indicate that carefully designed asthma education resources are useful for providing even the youngest children with information about asthma and its management.

Asthma↗
PubMed1997

Learning to look in the right place: a comparison of attentional behavior in deaf children with deaf and hearing mothers.

Eleven 18-month-old children with profound prelingual hearing loss were video-recorded in a free-play session with their mothers. Five of the mothers were profoundly deaf and fluent users of British Sign Language (BSL) or Auslan. The other six were hearing and had enrolled in a signing program. Ten-minute segments from each session were analyzed to determine the number of switches in attention shown by each child. Switches in attention were subdivided into three categories: spontaneous (where the child spontaneously looked to the mother); responsive (where the child responded to some maternal action such as moving an object); and elicited (where the mother made a direct attempt to gain the child's attention. Failed attempts to gain attention were also noted. A comparison of deaf and hearing mothers revealed no difference in the proportion of spontaneous or responsive switches in attention shown by their children. Responsive switches were by far the most frequent category for both groups, but these most commonly focused on objects and did not provide an opportunity for maternal signing. Successful perception of signing typically followed from spontaneous or elicited attentional switches. Deaf mothers were generally more insistent on their children turning to look at them, and they were more successful in eliciting attentional switches although they also had more failed attempts. These overall differences between the two groups were overshadowed by large individual differences within the groups. Within the sample there were both deaf and hearing mothers who achieved successful signed communication with their children.

Journal Article↗
PubMed1996

School performance of ELBW children: a controlled study.

This paper examines the prevalence of learning difficulty in reading, spelling, mathematics and writing and the prevalence of attention deficit disorder (ADD) in extremely low-birthweight (ELBW) children at school compared to their peers. Parents of 87 eligible ELBW children completed an educational questionnaire and questionnaire for ADD. Teachers of the ELBW children completed a detailed educational and ADD questionnaire for the study child and two control children in the same class, matched for age and nearest in birth date to the study child. Parents reported that 4% of the ELBW children born between 1977 and 1986 were in a special education unit, 46% received remedial help and 21% repeated a grade. Teacher assessment of six aspects of reading and spelling and five aspects of mathematics and writing skills indicated that the ELBW children experienced marked problems in all areas compared to control children and were approximately 3 times more likely to be delayed by more than a year in all areas. Prevalence of ADD was not increased in the ELBW children compared to the control group, though males in both groups had a higher prevalence of symptoms. Early intervention and special education resources must be available for ELBW children attending school.

Adolescent↗
PubMed1993

The long-term neurodevelopmental outcome for very low birthweight (VLBW) infants with 'dystonic' signs at 4 months of age.

As very low birthweight (VLBW) infants are at a high risk of developmental handicap, it is important to establish predictors of long-term adverse outcome at an early age so that early intervention can be instituted. Longitudinal neurodevelopmental assessments were performed in 107 VLBW infants at 1, 4, 8 and 12 months corrected age. Eighteen were diagnosed as 'dystonic' at 4 months of age. This study compared the outcomes at 4 and 6 years for 15 of the 18 dystonic with 75 of the 89 non-dystonic VLBW infants, respectively. At 9 years of age, nine dystonic and 54 non-dystonic infants were assessed on the Rutter Behaviour Questionnaire. Dystonic children had a lower mean General Cognitive Index (GCI; P = 0.001) and a higher incidence of disability as measured by the Burns Neuro-Sensori-Motor Developmental Assessment Scale (P = 0.0005) and Kitchen disability grading (P = 0.001). Even if the minor neurological aberrations of the premature dystonia syndrome in VLBW infants abate by one year of life, these infants still constitute a high-risk group for subsequent neurodevelopmental disability and therefore require close observation and probably early intervention.

Case-Control Studies↗
PubMed1993

Speech and language outcomes 3 years after neonatal intensive care.

Although major handicap rates have been documented in children who required neonatal intensive care, minor handicap rates, including speech and language problems, have received less attention. This paper reports the first stage of a longitudinal study of 118 children, which investigated the speech and language outcomes at 3 years of age. Differences from the normal population were found for the articulation measure, but not for the language comprehension and expression measures used. A major overall communication problem was determined to exist in 13% of the children. The impact of perinatal, medical and environmental variables was investigated. Variables such as low birthweight, short gestational age and mechanical ventilation, found to be important in other studies, had no significant impact on the speech and language outcomes of this cohort of 3 years old. However, for children who had experienced respiratory distress syndrome, there was an effect on articulation and language expression. Paediatric complications and maternal education level had the largest effects on language comprehension and expression, suggesting they were the persistent variables which most contributed to speech and language outcomes at 3 years of age.

Articulation Disorders↗
PubMed1993

Speech and language outcomes in preschool-aged survivors of neonatal intensive care.

This paper reports on the second stage of a longitudinal follow-up of the speech and language outcomes in a cohort of children who required neonatal intensive care. From 3 years of age, when the first stage was completed, to preschool age, the rate for major overall communication problems rose from 13% to 17%. However, when children with frank neurological or intellectual problems were excluded, this figure dropped to 8%. The impact of perinatal, medical and environmental variables on speech and language outcomes was again investigated. Differences were found between those that were important at 3 years of age and those that were important at preschool age. New variables emerged as contributing to language expression, including gender and the perinatal variables, gestational age and respiratory distress syndrome. Maternal education level was even more important to language comprehension at preschool age than at 3 years of age. Factors that might explain improvement, or lack of improvement, in speech and language skills are discussed.

Child, Preschool↗
PubMed1990

A comparison of the health knowledge of hearing-impaired and hearing high school students.

A health knowledge questionnaire was administered to 139 hearing and 66 hearing-impaired high school students from 12 to 18 years of age. The level of health knowledge of the normally-hearing students was found to be superior to that of hearing-impaired students at all ages but appeared not to improve with increasing school grade. In contrast, the health knowledge of the hearing-impaired students increased markedly from Grade 8 to Grade 12, so that by Grade 12 they were achieving only marginally below their hearing grade mates. Some of this apparent increase in health knowledge probably was due to the fact that only academically able hearing-impaired students continue at school in Australia after Grade 10. Deficits in the health knowledge of hearing-impaired students were distributed uniformly over all areas investigated.

Adolescent↗
PubMed1989

Neonatal cranial ultrasonography as predictor of 2 year outcome of very low birthweight infants.

Real time ultrasound scans using an ATL 300C sector scanner with 5-7.5 MHz transducer were performed on days 1, 4, 7 and thereafter as clinically necessary on 153 consecutively discharged very low birthweight (VLBW) infants. One hundred and forty-six long-term survivors were assessed fully at 2 years. The prevalence of cerebroventricular haemorrhage (CVH) in these survivors was 34.2% (grade 1-21.2%; grade 2-4.8%; grade 3-3.4%; grade 4-4.8%), ventricular dilatation 19.9% (including 4.1% with ventriculoperitoneal shunt), and ischaemia 9%. Impairments at 2 years were classified as nil, mild, moderate, severe or multiply severe, based on the criteria of Kitchen et al. Overall, 120 infants (82.2%) were unimpaired and 6.2% had mild, 3.4% had moderate, 4.1% had severe and 4.1% had multiply severe impairment. The major factors associated with impairment were gestational age less than 28 weeks, birthweight less than 1000 g, vaginal delivery, respiratory distress syndrome, mechanical ventilation, pulmonary air leaks and CVH. When these factors were reanalysed in a logistic regression model for odds ratios, only CVH (P less than 0.005) and birth by spontaneous vaginal delivery (P less than 0.05) were significant. The prevalence of impairment was 11.4% with no CVH, 6.5% grade 1, 71% grade 2, 20.0% grade 3 and 100.0% grade 4 CVH. The sensitivity of CVH of grade 2 or greater as a screening test was 64.7% for impairment, 78.6% for cerebral palsy and 70% for severe intellectual handicap. The mean general quotient (GQ) (Griffiths) at 2 years for infants with CVH was 89.1, and 97.5 for those without CVH (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Ischemia↗
PubMed1986

Apnoea in very low birthweight infants: outcome at 2 years.

Follow-up data to 2 years are reported for 164 of an initial cohort of 172 consecutively, surviving very low birth-weight infants. The 13 infants who suffered apnoeic episodes at home were not predicted at discharge from hospital. The mean (s.d.) general developmental quotient at 2 years for the total group was 97.3 (12.0), compared with 99.0 (10.2) for the 72 infants who had nil-mild apnoea in the newborn period and 96.0 (13.4) for the 92 infants with moderate-severe apnoea (P less than 0.1). All six infants with general quotients less than 76 had sustained moderate-severe apnoea (P less than 0.05). Multivariate analysis to assess the influence of confounding variables showed that the presence of chronic lung disease decreased the general quotient by 4.0 units, birthweight less than 1000 g 3.3 units, mechanical ventilation 2.2 units and moderate-severe apnoea only 0.1 unit. Moderate-severe apnoea occurred in six of eight babies with neurological handicap and all eight with sensory handicaps (P less than 0.01). Overall, of the 12 (7.3%) handicapped children, two had no apnoea and 10 moderate-severe apnoea (P = 0.07). Moderate or severe apnoea occurred in 58% of very low birthweight infants and was associated with the smallest and sickest infants who had the most handicaps at 2 years. However, when correction for birthweight less than 1000 g, mechanical ventilation and chronic lung disease is made, apnoea per se, as it was detected and managed between 1978-80, had no additional deleterious effect on average intellectual performance though it may have been an important causative factor in functional handicap.

Analysis of Variance↗