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PubMed2003

Respiratory symptoms and pulmonary function among school-age children in the Aral Sea region.

The saline Aral Sea in central Asia was once the 4th largest inland lake in the world. Desiccation of the Aral Sea as a result of diversion of inflow for irrigation has resulted in significant adverse health effects among residents of surrounding areas. This study was conducted to examine respiratory symptoms and function among children who lived in "the heavily affected disaster zone" (i.e., within 200 km of the Aral Sea), by comparing them with children who lived in "the slightly affected disaster zone" (i.e., located approximately 500 km from the Aral Sea). A questionnaire-based interview was conducted among 383 students 6-15 yr of age who lived in the study area and 432 students who lived in the reference area. Pulmonary function tests were completed by 337 children in the study area and 417 children in the reference area. Prevalence of current cough and current wheezing was higher among the study group participants. Percentage of predicted forced vital capacity (FVC% predicted) was lower in the study group (median = 96.6%) than in the reference group (median = 100.5%), and prevalence of restrictive pulmonary dysfunction was higher in the study group (10.6%) than in the reference group (2.6%). Multivariate analysis indicated that FVC% predicted was lower among females and in the study area, but was not associated with socioeconomic factors.

Adolescent↗
PubMed2004

The mechanisms of morphological-motor functioning in elementary school female first- to fourth-graders.

Four morphological and 7 motor variables were assessed in a sample of 2,235 female children (subdivided into 4 groups) aged 7-11 years, elementary school first- to fourth-graders from the Primorje-Gorski Kotar County, Republic of Croatia. The study objective was to analyze the morphological-motor structures according to age. Factor analysis was done for each of the four subject groups. Results clearly showed the morphological-motor functioning of the girls to change with age. Developmental processes lead to the formation of a general morphological factor defined as ectomesomorph and two general mechanisms responsible for motor efficiency in the form of strength regulation and speed regulation. The results obtained were found to be consistent with the existing relevant models related to the morphological, motor, functional and cognitive systems. The more so, these results allow for a supramodel to design, which will integrate relevant elements of all these models to define the function of the body as a whole.

Age Factors↗
PubMed2006

Cognitive functioning in school-aged children with vertically acquired HIV infection being treated with highly active antiretroviral therapy (HAART).

In today's era of highly active antiretroviral therapy (HAART), few children with HIV-1 infection experience severe central nervous system (CNS) manifestations indicative of encephalopathy. However, little is known about the neurocognitive strengths and weaknesses of HIV-infected children treated with HAART. This cross-sectional study is the first to systematically investigate the relation between cognitive functioning and medical markers in HIV-infected children and adolescents treated with HAART with varying levels of computed tomography (CT) brain scan abnormalities. The Wechsler Intelligence Scale for Children-Third Edition was administered to 41 vertically infected children (mean age = 11.2 years) treated with HAART for at least 1 year. Other procedures at the time of testing included CT brain scans and collection of CD4 cell counts and plasma HIV1 RNA PCR. Although global cognitive functioning among participants was in the Average range, children with minimal to moderate CT brain scan abnormalities scored significantly lower than children with normal scans on composite measures of cognitive functioning and five specific subtests, especially tasks involving executive functions. Furthermore, children with worse immune status (CD4+ counts < or = 500) scored lower on subtests measuring processing speed. Viral load was unrelated to cognitive test scores. Thus, children with HIV being treated with HAART remain at risk for developing CNS disease. Findings emphasize the importance of conducting neuropsychological assessments in this population, particularly for children with cortical atrophy and absolute CD4+ cell counts < or = 500.

Adolescent↗
PubMed2004

Executive functioning in school-aged children who were born very preterm or with extremely low birth weight in the 1990s.

OBJECTIVE: To determine the frequency, nature, and severity of executive dysfunction (EDF) at 8 years of age in extremely low birth weight (ELBW)/very preterm infants who were born in the 1990s, compared with normal birth weight (NBW) control subjects. METHODS: A geographically determined cohort study was conducted in Victoria, Australia. The ELBW/very preterm cohort comprised 298 consecutive survivors at 2 years of age who had gestational ages <28 completed weeks or birth weights <1000 g and were born during 1991-1992. The NBW cohort comprised 262 randomly selected children of birth weight >2499 g matched on date of birth, gender, ethnicity, and health insurance status. The participation rate was 92% (275 of 298) for the ELBW/very preterm cohort and 85% (223 of 262) for the NBW cohort. Cognitive and behavioral measures of executive functioning were administered. RESULTS: The ELBW/very preterm cohort exhibited significant EDF compared with their NBW peers in all areas assessed. The cognitive assessment revealed global impairment rather than deficits in specific executive domains. The ELBW/very preterm children also displayed more behavioral problems indicative of EDF than the NBW children. Severe impairments were exhibited in only a small minority of ELBW/very preterm children. No statistical conclusions were altered after adjustment for sociodemographic variables or when children with substantial neurosensory impairment were excluded. CONCLUSIONS: School-aged children who were born in the 1990s and were very preterm or had ELBW are at greater risk for developing EDF and require ongoing neuropsychological review throughout middle childhood.

Child↗
PubMed2004

Evaluation of the National School Health Coordinator Leadership Institute.

In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training sessions, and three, shorter midyear "booster" sessions, with the various sessions designed to assist one cohort of participants (n = 50) to build leadership capacities to coordinate school health. This evaluation examined the effects of the Institute as measured through a panel survey of participants - school health coordinators or their equivalents - over an 18-month period. Findings suggest that substantial progress was made in institutionalizing the school health coordination function in the target school districts. Specifically, in contrast to when the training began, clear, written position descriptions are common among program participants, most have functioning school health councils in their school districts, and program trainees appear to be moving aggressively to enhance the infrastructure for school health coordination through planning, setting priorities, and assessing needs. Program trainees report spending increased time on school health coordination, and they are active in spreading the word about coordinated school health programs. Trainees viewed the Institute as relevant to their needs, though not all aspects of the program are viewed as equally useful. As possible shortcomings, the training needed more emphasis on funding for school health coordination, and a low level of evaluation skills existed among coordinators.

American Cancer Society↗
PubMed2003

Absence of adverse effects of severe hypoglycemia on cognitive function in school-aged children with diabetes over 18 months.

OBJECTIVE: Some children with type 1 diabetes may be at risk of cognitive impairments, but mechanisms of this effect have not been confirmed. The objective of this study was to determine whether severe hypoglycemia (SH) in children with type 1 diabetes is associated with cognitive decline over 18 months. RESEARCH DESIGN AND METHODS: A sample of 142 6- to 15-year-old children with type 1 diabetes (mean age 11.6 +/- 2.7 years) enrolled in a trial of intensive therapy (IT) or usual care (UC) were tested with the Das-Naglieri Cognitive Assessment System at baseline and after 9 and 18 months. Episodes of SH were recorded by parents and reported promptly for verification by study nurses. HbA(1c) was measured quarterly. RESULTS: Over 18 months, 58 of 142 patients (41%) experienced 111 SH episodes, with a RR of SH of 1.12 for IT over UC. Neither occurrence nor frequency of SH was associated with decline in full-scale intelligence quotient (IQ), standard scores for planning, attention, simultaneous processing, or successive processing, or scaled scores on any of eight subtests. The same findings emerged when only patients who had experienced hypoglycemic seizures or coma were included in the SH group for analyses. These effects persisted when the child's age, sex, type 1 diabetes duration, and age at diagnosis were controlled statistically. HbA(1c) during the trial was not associated with cognitive changes. CONCLUSIONS: SH did not induce adverse changes in the measures of cognitive function administered to 6- to 15-year-old children with type 1 diabetes in this study. Although SH should be avoided in all children with diabetes, these episodes did not have adverse effects on cognition in this age-group over 18 months.

Adolescent↗
PubMed2001

[BREV: a new clinical scale for the evaluation of cognitive function in school-age and preschool-age children].

BREV (Batterie Rapide d'Evaluation des fonctions cognitives) is a new evaluation test for the screening of cognitive disorders in 4-9-year-old children, based on a neuropsychological process. It is made up of 17 subtests which have been carefully standardized. It is not an intelligence test but a tool for children' health professionals to use as a rapid neuropsychological screening test. It is particularly recommended for any child with a school learning disorder or neurological history with a high risk of cognitive disturbances such as epilepsy. It may also be used as a systematic screening test.

Child↗
PubMed1979

Evidence against a hydrodynamic function for fish schools.

THERE are numerous explanations for the formation of fish schools(1,2), one of the most popular being that the members gain hydrodynamic advantage over solitary individuals(3-6). The model proposed by Weihs(5,6) for the first time makes precise predictions about school structure which can be verified. We report here the first empirical test of this model, and demonstrate that three species of schooling fish do not swim in appropriate positions to gain hydrodynamic advantage.

Journal Article↗
PubMed2003

Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States.

OBJECTIVE: To evaluate the relationship between elevated blood pressure (BP) and cognitive test performance in a nationally representative sample of children. Study design The National Health and Nutrition Examination Survey III provides cross-sectional data for children 6 to 16 years, including BP and cognitive test scores. Elevated BP was defined as systolic or diastolic BP >or=90th percentile. Cognitive tests were compared for children with elevated and normal BP. Linear regression was used to evaluate the relation between elevated BP and decreased test scores. RESULTS: Among the 5077 children, 3.4% had systolic BP >or=90th percentile and 1.6% diastolic BP >or=90th percentile. Children with elevated systolic BP had lower average scores compared with normotensive children for digit span (7.9 vs 8.7, P=.01), block design (8.6 vs 9.5, P=.03), and mathematics (89.6 vs 93.8, P=.01). Elevated diastolic BP was associated with lower average scores on block design (9.5 vs 11, P=.01). Linear regression showed that elevated systolic BP was independently associated with lower digit span scores (P=.032). CONCLUSION: Children with elevation of systolic BP are at risk for central nervous system end-organ damage, as manifested by decreased digit span test scores.

Adolescent↗
PubMed2005

In utero exposure to background levels of polychlorinated biphenyls and cognitive functioning among school-age children.

Polychlorinated biphenyls (PCBs) are ubiquitous environmental contaminants. In utero exposure to background levels of PCBs has been associated with intellectual impairment among children in most, but not all, studies. The authors evaluated prenatal PCB exposure in relation to cognitive test (intelligence quotient (IQ)) scores on the Wechsler Intelligence Scale for Children at age 7 years. Pregnant women were recruited from 12 US study centers from 1959 to 1965, and their children were followed until age 7 years (the Collaborative Perinatal Project). Third trimester serum was analyzed for PCBs in 1997-1999 for 732 women selected at random and for an additional 162 women whose children had either a low or a high IQ score. The PCB-IQ association was examined in multivariate models. Among those in the lowest exposure category (<1.25 microg of PCB/liter of serum), the fully adjusted mean IQ score was 93.6 (standard error: 1.8); among those in the highest category (> or =5 microg of PCB/liter), the mean IQ was 97.6 (standard error: 1.2); and overall the increase in IQ per unit increase in PCB level (microg/liter) was 0.22 (95% confidence interval: -0.28, 0.71). In these data, in utero exposure to background levels of PCBs was not associated with lower IQ at age 7 years.

Abnormalities, Drug-Induced↗
PubMed1995

Preparing children with congenital heart disease for cardiac surgery.

Compared the effects of two methods of preparing children for cardiac surgery. Forty-eight child-caregiver dyads were assigned to a treatment group, receiving information and coping skills training, or a control group, receiving information as routinely provided. Treatment group children were more cooperative and less upset in the hospital; better adjusted at home after discharge; higher functioning in school; and their functional health status improved faster. Treatment group caregivers expressed greater confidence in their ability to care for their children in hospital and at home after discharge. Results are discussed in terms of the cognitive appraisal model of stress coping using a multidimensional assessment of treatment effects.

Adaptation, Psychological↗