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PubMed1996

Drug effects: a search for outcomes.

In order to best understand the developmental and behavioral effects of prenatal cocaine exposure, two important activities must occur. The first is the continuing development and refinement of research methodologies. Information-sharing activities such as conferences support this goal. Second, agencies such as NIDA need to support longitudinal followup of prenatally drug-exposed child cohorts and controls to identify outcomes beyond infancy and toddler years. Without support for information exchange and longitudinal followup, researchers will still be in the dark regarding the effects of prenatal drug exposure on school functioning when the next drug epidemic occurs. This message was not heeded in the 1970s and early 1980s, leaving researchers in the 1990s in the uncomfortable position of saying they do not know the longer term effects of prenatal drug exposure.

Animals↗

PubMed1998

Disentangling the overlap between Tourette's disorder and ADHD.

OBJECTIVE: To identify similarities and differences in neuropsychiatric correlates in children with Tourette's syndrome (TS) and those with ADHD. METHOD: The sample consisted of children with Tourette's syndrome with ADHD (N = 79), children with Tourette's syndrome without ADHD (N = 18), children with ADHD (N = 563), psychiatrically referred children (N = 212), and healthy controls (N = 140). RESULTS: Disorders specifically associated with Tourette's syndrome were obsessive compulsive disorder (OCD) and simple phobias. Rates of other disorders, including other disruptive behavioral, mood, and anxiety disorders, neuropsychologic correlates, and social and school functioning were indistinguishable in children with Tourette's and ADHD. However, children with Tourette's syndrome plus ADHD had more additional comorbid disorders overall and lower psychosocial function than children with ADHD. CONCLUSIONS: These findings confirm previously noted associations between Tourette's syndrome and OCD but suggest that disruptive behavioral, mood, and anxiety disorders as well as cognitive dysfunctions may be accounted for by comorbidity with ADHD. However, Tourette's syndrome plus ADHD appears to be a more severe condition than ADHD alone.

Adolescent↗

PubMed1996

Socioeconomic status and lung function among primary school children in Canada.

We examined the relationship of lung function level to socioeconomic status (SES) using a cross-sectional design among 989 primary school children selected from 18 Montreal schools and studied between April 1990 and November 1992. Information on each child's health, demographics, home exposure to tobacco smoke, pets, and cooking and heating fuel used in the child's home was collected by questionnaire. Spirometry was performed at school. Parental occupation was used to establish SES. After adjusting for personal, familial, and environmental factors, in boys but not in girls, FEV1 and FVC were progressively larger in higher categories of SES (p < 0.001 for linear trend). After taking into account the effect of multiple comparisons and adjusting for personal, familial, and environmental factors, boys from families in the lowest category of SES were found to have an FEV1 lower by 8.2% (95% CI, -13.8 to -2.1) and an FVC lower by 8.1% (95% CI, -13.4 to -2.6) when compared with the most advantaged. These results provide evidence that socioeconomic status, independent of common indoor exposures, is a risk factor for lower FEV1 and FVC among boys.

Canada↗

PubMed2002

The functional relationships of medical schools and health services.

Medical schools need good functional relationships with the health systems in which their students, graduates and staff will learn and work. With increasing complexity and rising costs of health delivery the 2 types of organisation have become more interdependent but not always as collaborating partners. Recent changes in the organisation of undergraduate medical education have been reactive to re-structuring of health services. For example, traditional teaching hospitals have become more specialised and less suitable for general medical education. While this has helped to decentralise medical education into appropriate clinical environments, these and other changes have generally been adaptive to the health systems rather than being instigated by the medical schools for educational reasons. This discussion paper examines the nature of the relationships and their contributory elements. A taxonomy of functional relationships is proposed with primary categories of (i) autonomy (ii) contiguity (iii) interdependence (iv) collaboration, and (v) obligation. It is suggested that medical schools should become more assertive in application of their creative talents and educational resources throughout the environment in which their graduates will use their medical skills, and in which they will work with other health care professionals.

Alberta↗

PubMed1990

Effects of indoor air pollution on lung function of primary school children in Kuala Lumpur.

In a cross-sectional study of 7-12 year-old primary school children in Kuala Lumpur city, lung function was assessed by spirometric and peak expiratory flow measurements. Spirometric and peak expiratory flow measurements were successfully performed in 1,214 and 1,414 children, respectively. As expected, the main predictors of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and peak expiratory flow rate (PEFR) were standing height, weight, age, and sex. In addition, lung function values of Chinese and Malays were generally higher than those of Indians. In multiple regression models which included host and environmental factors, asthma was associated with significant decreases in FEV1, FEF25-75, and PEFR. However, family history of chest illness, history of allergies, low paternal education, and hospitalization during the neonatal period were not independent predictors of lung function. Children sharing rooms with adult smokers had significantly lower levels of FEF25-75. Exposures to wood or kerosene stoves were, but to mosquito repellents were not, associated with decreased lung function.

Air Pollutants↗

PubMed2005

The effect of voluntary dehydration on cognitive functions of elementary school children.

AIMS: (1) To describe the occurrence of voluntary dehydration in two classes of elementary school students as expressed by their morning and noon-time urine osmolality; and (2) to determine the relationship between the children's scores on cognitive tests and their state of hydration. METHODS: Group comparison among fifty-eight sixth-grade students (age range 10.1-12.4 y old) during mid-June at two schools in a desert town. Morning and noon-time urine samples were collected in school, and five cognitive tests were scored in the morning and at noon-time. MAIN OUTCOME MEASURES: (1) morning and noon-time urine osmolality; (2) scores of five cognitive tests (hidden figures, auditory number span, making groups, verbal analogies, and number addition) that were applied in the morning and at noon-time. RESULTS: Thirty-two students were dehydrated (urine osmolality above 800 mosm/kg H(2)O) in the morning. An individual's noon-time urine osmolality was highly related to morning osmolality (r=0.67, p=0.000). The morning cognitive scores were similar in the hydrated and dehydrated students (p=0.443). The adjusted mean scores of the noon-time tests, with the morning test scores as covariates, demonstrated an overall positive trend in four of the five tests in favor of the hydrated group (p=0.025). The effect was mainly due to the auditory number span test (p=0.024). CONCLUSION: Voluntary dehydration is a common phenomenon in school-aged children that adversely affects cognitive functions.

Child↗

PubMed1992

Moderate to heavy infections of Trichuris trichiura affect cognitive function in Jamaican school children.

A double-blind placebo trial was conducted to determine the effect of moderate to high loads of Trichuris trichiura (whipworm) infection on the cognitive functions of 159 school children (age 9-12 years) in Jamaica. Infected children were randomly assigned to Treatment or Placebo groups. A third group of randomly selected uninfected children were assigned to a Control for comparative purposes. The improvement in cognitive function was evaluated using a stepwise multiple linear regression, designed to control for any confounding variables. The expulsion of worms led to a significant improvement in tests of auditory short-term memory (P less than 0.02; P less than 0.01), and a highly significant improvement in the scanning and retrieval of long-term memory (P less than 0.001). After 9 weeks, treated children were no longer significantly different from an uninfected Control group in these three tests of cognitive function. The removal of T. trichiura was more important than Ascaris lumbricoides in determining this improvement. The results suggest that whipworm infection has an adverse effect on certain cognitive functions which is reversible by therapy.

Albendazole↗

PubMed1984

[A change of attitude among health personnel: a function of the schools of public health].

This presentation examines the problem of certain attitudes of persons employed in health and other sectors, and of the beneficiary population itself which, though not blocking, at least make it difficult to promote the attainment of health for all based on primary care. The author describes the changes of attitude and behavior patterns needed both in the whole population, for whose sake the changes are needed, and in those charged with establishing policies and providing health care. At the same time, he identifies the functions that schools of public health may have to perform in order to promote and bring about those changes. With a precise idea of what the desirable changes are and what they consist of, the article examines in detail the principal areas of interest, which it distinguishes as follows: the meaning of health; the meaning of health care and health development; the scope of policy-making; intersectoral and multidisciplinary collaboration; community involvement and self-care; cost-containment of medical care; health system organization and operation; health management training, and health manpower development. The author concludes by underscoring the vital importance of understanding the meaning of health for all and of taking cognizance of the current deficiencies of the health education and service systems, but states that it is just as important to keep an optimistic and positive attitude.

Attitude of Health Personnel↗

PubMed2002

Chinese adolescents' perceptions of family functioning: personal, school-related, and family correlates.

The author used two translated measures (Self-Report Family Inventory; D. T. L. Shek, 1998); and Family Assessment Device; N. B. Epstein, L. M. Baldwin, & D. S. Bishop, 1983) and a locally developed scale (Chinese Family Assessment Instrument; D. T. L. Shek, in press-a) to assess 3,649 Chinese adolescents' perceptions of how well their families function. He found that boys perceived their families to function worse than did girls and that younger adolescents perceived their families to function better than did older adolescents. Perceived family functioning was negatively related to grade level; students attending schools with higher academic standards perceived their families to function better than did students attending schools with lower academic standards; and students attending government and aided schools had higher levels of family functioning than did students attending private schools. Family types (intact vs. nonintact families) and the duration of parents' stay in Hong Kong were also related to the adolescents' perceptions of family functioning. Findings for the personal, school-related, and family correlates of perceived family functioning were statistically significant and stable across different measures of family functioning, but the practical significance of the findings was not high.

Adolescent↗

PubMed2003

Normative data and developmental characteristics of hand function for elementary school children in Suwon area of Korea: grip, pinch and dexterity study.

This study was designed to establish norms of hand function, and to identify developmental characteristics of hand function among the Korean children. 712 elementary school children participated in measurement of grip strength, three kinds of pinch strength, and dexterity. The hand strength of the Korean children appeared to be weaker than that of western children. The grip strength of boys was significantly stronger than that of girls in all ages for both hands. The order of magnitude of three kinds of pinch strength was, in descending order, lateral pinch, palmar pinch and tip pinch for both boys and girls. There was no significant difference of hand function according to the type of hand dominance in boys. However, girls with left hand dominance showed weakness of bilateral grip, right tip pinch, and bilateral lateral pinch strength compared with girls with right hand dominance. In conclusion, this study provided normative data of hand functions including dexterity, and enabled us to identify some developmental characteristics of hand functions for the Korean elementary school children.

Age Factors↗

PubMed2005

Dietary fat intake is associated with psychosocial and cognitive functioning of school-aged children in the United States.

Using cross-sectional data from the Third National Health and Nutrition Survey, 1988-1994, we examined whether dietary fat intake is associated with cognitive and psychosocial functioning in school-aged children. Based upon 24-h diet recall interviews, dietary intakes of total fat, SFA, monounsaturated fatty, PUFAs, and cholesterol were estimated in 3666 participants aged 6 to 16 y. Psychosocial functioning was evaluated in interviews of each child's mother. Cognitive functioning was measured using achievement and intelligence tests. Overall, total fat and saturated fat were unrelated to measures of cognitive and psychosocial functioning. Compared with equivalent energy intake from saturated fat or carbohydrate, each 5% increase in energy intake from PUFAs was associated with lower risks of poor performance on the digit span test (replacing SFA, OR = 0.58, 95% CI = 0.37-0.91; replacing carbohydrate, OR = 0.61, 95% CI = 0.43-0.88). Cholesterol intake was associated with an increased risk of poor performance on the digit span test (OR = 1.25, 95% CI = 1.11-1.42 for each 100-mg increment intake of cholesterol). The associations were independent of socioeconomic status, maternal education and marital status, and children's nutrition status and were consistent across different methods of energy adjustment in regression models. We conclude that high intake of PUFAs may contribute to an improved performance on the digit span test. In contrast, increased intake of cholesterol may be associated with a poorer performance.

Adolescent↗

PubMed1979

Departmental review in medical schools: focus and functions.

Approximately two-thirds of all U.S. and Canadian medical schools have provisions for the evaluation of their departments on a periodic or ad hoc basis. Most of these institutions have initiated the departmental review process since 1970. It appears that use of the practice is increasing and is becoming an important tool in providing guidance for departmental activities, programs, and leadership. Departmental review may be conducted in a variety of ways with varying levels of intensity, flexibility, and skill, depending on the environment, resources, dean, department chairmen, faculty, and attitudes of university administrators. Departmental review may be employed to identify, elaborate, document, and/or contribute to the resolution of current and potential organizational concerns. When carefully administered, the process can be a stabilizing rather than a disruptive force; however, by itself, it does not solve major institutional problems.

Canada↗

PubMed1997

The impact of the classroom environment on defining function in school-based practice.

OBJECTIVE: Whether the environment is stressed in function-dysfunction decisions appears to depend on where in the hierarchy of components of complex tasks and of role skills the evaluating therapist is focused. This study examined the intervention planning decisions of occupational therapists who used the Model of Student Role Adaptation, which emphasizes the complex tasks involved in the student role. The purpose of the study was to determine whether these therapists were responding to environmental demands in planning their interventions. METHOD: Special education teachers selected tasks that they believed were the most essential for student functioning within their classroom environments. These selections were compared with the goals and objectives developed by occupational therapists who serve children in these settings. RESULTS: Chi square analysis indicated a significant relationship between tasks designated by the teacher participants as environmental demands and those included in occupational therapy intervention planning. CONCLUSION: The results suggest that the occupational therapist participants were responding to the environmental demands of the classroom when constructing their intervention plans.

Activities of Daily Living↗

PubMed2002

[Studies of psychophysiological functions of middle school age students after prolonged physical training].

Longitudinal researches of neurodynamical functions of pupils 11-15 y. of control and sport classes were executed. The comparative analysis of the study's materials has shown that the research objects with the high level of properties of the basis nervous processes are characterized by faster and more intensive changes of the neurodynamical functions. Long-lasting physical loadings in dependence on typological gradation provide more intensive sensomotor reactions' activation of some functions of attention. At the boys of sports classes the higher functional mobility of the basic nervous processes provide a shorter latent period of the complex sensomotor reactions of a choice, more intensive activation of speed of processing of the information and switching of attention. All parameters (which were analysed) of neurodynamical functions undergo changes, which character depends on duration of influence of physical loadings.

Adolescent↗

PubMed1993

Effects of aircraft noise on hearing and auditory pathway function of school-age children.

This study was conducted to investigate the influence of high-frequency aircraft noise on the function of the auditory system of school-age children. A total of 228 students attending a school near an airport (school A) and 151 students attending a school far from an airport (school B) were analyzed. Audiometry and brainstem auditory evoked potential (BAEP) detection were performed in all subjects to evaluate cochlear and retrocochlear function. The results of audiometry indicated that hearing ability was significantly worse in the children of school A, which was located under the flight paths. The values of pure tone average, high pure tone average, and threshold at 4 kHz were all higher in children who were frequently exposed to aircraft noise. There was no consistent difference in BAEP latencies between the two schools. These results indicate that central transmission is not affected in children who have been exposed to aircraft noise for several years. The results of the present study showed a significant association between aircraft noise exposure and prevalence of noise-induced hearing loss. Although damage to peripheral cochlear organs was confirmed in school-age children, involvement of the central auditory pathway could not be verified.

Aircraft↗

PubMed2006

Executive functions in school-age children born very prematurely.

BACKGROUND: School-age preterm children are at risk for cognitive difficulties including Executive Dysfunction and low average IQ. AIM: The aim of this study was to determine the performance of very preterm, school-age children on three components of Executive Function (EF), two components of Executive Attention and a measure of IQ. STUDY DESIGN: Cross-sectional, independent samples comparison. METHODS: A UK sample of 40 very preterm (<32 weeks gestational age, Mean 28.43, SD 2.41) children and 41 term born control children aged between 6 and 12 years (mean ages 8 years 5 months in both groups) was assessed on IQ, EF (inhibition, working memory and set shifting) and attention (sustained and selective). Between group comparisons were made using multivariate analysis of variance and covariance. RESULTS: Multivariate analyses indicated that preterm children scored significantly lower than their term born peers across Executive Function and executive attention tasks. As expected, the preterm group achieved IQ scores at the low end of the average range. Univariate analyses indicated some difficulties with shifting and inhibition components of EF, although covariate analysis revealed that only shifting was independent of IQ. CONCLUSIONS: Preterm children showed mild executive function and executive attention difficulties in the context of average IQ scores. The findings highlight the benefit of using multivariate assessments of executive skills rather than general intellectual outcome alone, to obtain a better distinction of the specific cognitive weaknesses associated with preterm birth.

Attention↗

PubMed2005

Family functioning in school-age children with cystic fibrosis: an observational assessment of family interactions in the mealtime environment.

OBJECTIVE: To examine, using direct observation methodology, differences in family functioning at mealtime between families of school-age children with cystic fibrosis (CF) and families of school-age children without a chronic illness. METHOD: Family functioning was rated using the McMaster Mealtime Interaction Coding System (MICS) during a videotaped dinner among 28 families of children with CF and 27 families of non-ill, age-matched peers. Families were rated on overall family functioning and on six dimensions of the MICS: task accomplishment, communication, affect management, interpersonal involvement, behavior control, and role allocation. RESULTS: Ratings for families of a child with CF were significantly lower than they were for comparison families on overall family functioning and on four of the six MICS dimensions: communication, affect management, interpersonal involvement, and behavioral control. Moreover, a significantly greater percentage of families of children with CF were rated in the unhealthy range on overall family functioning and on five of six MICS dimensions. There was no relationship between family functioning and child weight status for children with CF. CONCLUSIONS: The current study suggests that for families of school-age children with CF, the family system is negatively affected during mealtime. Dietary interventions need to address family-centered, as well as child-centered, interventions to help families manage challenges presented during the family meal.

Child↗

PubMed2003

Animal source foods improve dietary quality, micronutrient status, growth and cognitive function in Kenyan school children: background, study design and baseline findings.

A previous longitudinal three-country study in Egypt, Kenya and Mexico found significant positive associations between intake of animal source foods (ASF) and growth, cognitive development and physical activity. To test for a causal relationship, a controlled school feeding intervention study was designed to test the hypotheses that ASF would improve micronutrient status, growth and cognitive function in Kenyan primary school children. Twelve rural Kenyan schools with 554 children were randomized to four feeding interventions using a local vegetable stew as the vehicle. The groups were designated as Meat, Milk, Energy and Control, who received no feedings. Feeding was carried out on school days for seven terms during 21 mo. Preintervention baseline measures included nutritional status, home food intake, anthropometry, biochemical measures of micronutrient status, malaria, intestinal parasites, health status and cognitive and behavioral measures. The measurements of each child were repeated at intervals over 2 y. Baseline data revealed stunting and underweight in approximately 30% of children and widespread inadequate intakes and/or biochemical evidence of micronutrient deficiencies, particularly of iron, zinc, vitamins A and B-12, riboflavin and calcium. Little or no ASF were eaten and fat intake was low. Malaria was present in 31% of children, and hookworm, amebiasis and giardia were widely prevalent. The outcomes measured were rates of change or increase during the intervention in cognitive function, growth, physical activity and behavior and micronutrient status. Hierarchical linear random effects modeling was used for analysis of outcomes.

Animals↗