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Evaluation of preschool children with Down's syndrome in Cape Town using the Griffiths Scale of Mental Development.

Fifty-five preschool children with Down's syndrome were assessed using the Griffiths Scale of Mental Development. They were all the children with Down's syndrome living in Cape Town who spoke English or Afrikaans as their home language. There was a significant decrease in developmental quotient with increasing age and the hearing and speech subscore was lower than the other subscores. No significant associations were found between maternal age, sex, social class or race of the child and development. There was a negative association between developmental quotient and the number of siblings. The additional stimulation of a playgroup or preschool centre was associated with improved developmental functioning when compared to the children cared for at home during the day.

Child Development↗
PubMed1996

Assessing right to die attitudes: a conceptually guided measurement model.

This article discusses the current status of research regarding the assessment of attitudes toward euthanasia and other right to die constructs with a focus on conceptual and methodological issues hindering advancement in this area. Two models are presented: a conceptual model for differentiating the various right to die constructs, and a measurement model to guide scale development and refinement. The conceptual model defines the right to die constructs as a function of locus of decision and locus of action. Health status and age are hypothesized as important factors that in some instances are defining attributes in right to die constructs and in other instances are factors influencing people's attitudes toward the right to die. The measurement model considers the importance of construct specificity, individual characteristics, and conviction in the assessment of right to die attributes. An extant euthanasia attitude scale is presented and evaluated in terms of the models to demonstrate how they may be useful for advancing attitude research in this important area.

Age Factors↗
PubMed1987

Appropriateness of antibiotic therapy in long-term care facilities.

The objective of this study was to examine the appropriateness of antibiotic therapy in nursing homes. Information was abstracted from infection control reports and patients' charts for a three-month period at two nursing homes in Portland, Oregon. A panel of two board-certified infectious disease specialists and one hospital pharmacist reviewed the information and rated the appropriateness of each prescription using a previously developed scale. Among the 120 infections, treatment was rated as appropriate in 49 percent, as inappropriate in 42 percent, and as unjustified in 9 percent. Cephalosporins received the lowest percent of appropriate ratings (27 percent). The primary reason for an inappropriate rating was that a more effective drug was recommended for empiric therapy of gram-negative bacillary infections. These bacteria are often resistant to oral antibiotics. There were no significant differences in appropriateness by type of organism, infection site, or clinical outcome. Physician education and the development of systems and guidelines for optimal management in this population are appropriate actions for the future.

Aged↗
PubMed2006

Timing of menarche and the origins of conduct disorder.

CONTEXT: Precocious onset of menses (ie, age < or =11 years) has repeatedly been identified as a risk factor for higher rates of delinquency or conduct disorder (CD) in girls. Although this association is often conceptualized as environmentally mediated (via processes such as affiliation of early-menstruating youth with older, more deviant peers), such conclusions are premature as biological and genetic explanations have yet to be fully considered. OBJECTIVE: To uncover the origins of the association between CD and timing of menarche. DESIGN, SETTING, AND PARTICIPANTS: The sample consisted of a population-based birth cohort of 708 mid-adolescent female twins assessed as part of the ongoing Minnesota Twin Family Study. We conducted 2 sets of analyses: standard bivariate analyses to uncover possible common genes and moderator analyses to evaluate possible moderation of genetic influences on CD by timing of menarche. MAIN OUTCOME MEASURES: Conduct disorder was assessed via individual semistructured interviews with mothers and adolescents. Menarcheal status and age at menarche were assessed via the Pubertal Development Scale. RESULTS: The results argued against common genetic influences but did provide evidence of etiological moderation of CD by timing of menarche. The heritability of CD was strongest (67%) in girls with average timing of menarche (ie, age 12-13 years) and substantially weaker (8%) in those with early onset. Those with late initiation of menses (ie, age >13 years) similarly exhibited weaker genetic influences (29%). Shared environmental influences showed the opposite pattern, as they were far stronger for those with precocious and delayed onset vs those with average onset. CONCLUSIONS: Our findings provide indirect support for psychosocial interpretations of the impact of precocious menarche and, to a lesser extent, delayed menarche on CD development. Further, they lend support to the notion that in some cases, genetic influences on psychopathology may be strongest in the "average, expectable" environment.

Age Factors↗
PubMed1998

Preliminary development of the Children's Physical Self-Concept Scale.

The development of a healthy eating style and physical fitness regimen in adolescence or adulthood might be contingent on physical self-concept in childhood. Most available measures of physical self-concept are inappropriate for use with 1st and 2nd grade children, so the present study developed, piloted, and partially validated the 27-item Children's Physical Self-Concept Scale (CPSS), which assesses Global physical self-concept and subscales of Physical Performance, Physical Appearance, and Weight Control behaviors in children 6 to 11 years of age. The test exhibits adequate test-retest reliability and internal consistency. A comparison of 316 normal and overweight children indicated that normal-weight children obtained higher Global physical self-concept scores and higher subscale scores. In addition, the CPSS distinguished test groups of diabetic, overweight, and normal-weight children in a contrasted-groups analysis.

Body Image↗
PubMed2005

Zinc supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children.

BACKGROUND: Undernourished children have poor levels of development that benefit from stimulation. Zinc deficiency is prevalent in undernourished children and may contribute to their poor development. OBJECTIVE: We assessed the effects of zinc supplementation and psychosocial stimulation given together or separately on the psychomotor development of undernourished children. DESIGN: This was a randomized controlled trial with 4 groups: stimulation alone, zinc supplementation alone, both interventions, and control (routine care only). Subjects were 114 children aged 9-30 mo and below -1.5 z scores of the National Center for Health Statistics weight-for-age references who were recruited from 18 health clinics. Clinics were randomly assigned to receive stimulation or not; individual children were randomly assigned to receive zinc or placebo. The stimulation program comprised weekly home visits during which play was demonstrated and maternal-child interactions were encouraged. The supplementation was 10 mg Zn as sulfate daily or placebo. Development (assessed by use of the Griffiths Mental Development Scales), length, and weight were measured at baseline and 6 mo later. Weekly morbidity histories were taken. RESULTS: Significant interactions were found between zinc supplementation and stimulation. Zinc benefited the developmental quotient only in children who received stimulation, and benefits from zinc to hand and eye coordination were greater in stimulated children. Zinc supplementation alone improved hand and eye coordination, and stimulation alone benefited the developmental quotient, hearing and speech, and performance. Zinc supplementation also reduced diarrheal morbidity but did not significantly improve growth. CONCLUSION: Zinc supplementation benefits development in undernourished children, and the benefits are enhanced if stimulation is also provided.

Child Development↗
PubMed1995

Relationships between physical growth, mental development and nutritional supplementation in stunted children: the Jamaican study.

The relationship between physical growth and change in mental development on the Griffiths mental development scales was investigated in 127 stunted Jamaican children over a 2-year period. The role of nutritional supplementation in this relationship was examined. There were no consistent associations between changes in weight-for-height or head circumference and developmental change. Height gain over 2 years was significantly associated with change in mental age, and locomotor and hearing and speech subscale scores. Height gain in the first year predicted change in mental age, and hearing and speech in the second year. Some of the effect of supplementation on development was shared with linear growth. Therefore, nutrition probably explains part of the relationship between growth and development. However, supplementation also had effects on development independent of growth. The benefits of supplementation on development and the extent to which they were shared with growth varied among the subscales.

Body Height↗
PubMed1994

The "little five": exploring the nomological network of the five-factor model of personality in adolescent boys.

The California Child Q-set (CCQ) was used to explore the structure of personality in early adolescence and to develop scales to measure the "Big Five" dimensions: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. Mothers provided Q-sorts of 350 ethnically diverse boys between 12 and 13 years old. Analyses of the construct validity of the scales provided a nomological network relating the Big Five to theoretically and socially important criterion variables, such as juvenile delinquency, Externalizing and Internalizing disorders of childhood psychopathology, school performance, IQ, SES, and race. These effects were obtained using diverse methods, including self-reports from the boys, ratings by their mothers and their teachers, and objective-test data. In addition to the Big Five, analyses also suggested 2 possibly age-specific dimensions of personality in early adolescence. Discussion is focused on the changing manifestations of personality traits throughout development.

Achievement↗
PubMed2004

[Follow-up study of mental developments in high-risk children].

OBJECTIVE: To study the mental developments in high risk children and the impact of the high risk factors on neurologic abnormalities, mental defect and long-term outcome. METHODS: The mental development of 122 children who had been exposed to high-risk factors and treated between March 1994 to May 1995 during their newborn periods was evaluated. Gesell development scales were performed when they were at 6 and 12 months old. And Wechsler intelligence scales for children (Chinese version) were performed at 6 approximately 7 years old. RESULTS: The children exposed to hypoglycemia during their newborn period and preterm labor had significantly lower IQ, VIQ and PIQ scores (P <0.05). The other risk factors in order were low birth weight, severe anoxia, asphyxia at birth, erythrocythemia, hyperbilirubinemia. There was significant difference between the children exposed to one risk factor and those exposed to two or more risk factors (P <0.05). And there was significant correlation between developmental assessment at 6 and 12 months and mental development at 6 approximately 7 years old (P<0.01). CONCLUSION: The impact of the high risk factors at birth on children's mental development is not negligible. And the risk of development abnormalities will increase if the children were exposed to multiple risk factors. The evaluation of development at 6 approximately 12 months is of predictive value for long-term outcome.

Apgar Score↗
PubMed1995

Prevalence and risk factors of psychopathology in Ethiopian children.

OBJECTIVE: To determine the prevalence and risk factors associated with psychopathology in Ethiopian children aged 6 to 11 years living in Jimma town. METHOD: The mothers of 611 randomly selected children (317 boys and 294 girls) were interviewed to determine the presence of 64 child problem behaviors. Scores on the Child Behavior Problem Questionnaire were normed and reduced to eight subscales using responses to a second scale developed by the World Health Organization (the Reporting Questionnaire for Children). Measures of maternal psychopathology, family stress, and child disability were included. RESULTS: Separate analyses conducted for boys and girls yielded prevalence rates of 21.45% for boys and 25.17% for girls. Principal-components analyses identified common syndromes such as aggressive, anxious, delinquent, depressed, hyperactive, uncommunicative, and immature. Two additional syndromes, hostile/withdrawn and insecure, were particularly prevalent. Children whose mothers reported more psychiatric symptoms for themselves tended to score higher on at least one of the pathology subscales. CONCLUSIONS: On a measure developed for Ethiopian children, the prevalence and risk factors were similar to those found in other countries. Several differences in syndromes indicate the need for culture-specific analyses of psychopathology in children.

Adolescent↗
PubMed2004

Developmental and behavioral status of infants and young children awaiting heart or heart-lung transplantation.

OBJECTIVE: Research into cognitive development and behavior in children undergoing heart or heart-lung transplantation has focused mainly on older children, with investigation of children undergoing transplantation as infants or toddlers being largely retrospective. This study was conducted, therefore, to obtain pretransplant baseline measures of development and behavior for preschool-aged children. METHODS: Children <3.5 years old were assessed before transplantation (n = 35) and compared with a group of children awaiting conventional cardiac surgery, a group undergoing bone marrow transplantation, and a group of healthy children. Development was measured by using the Ruth Griffiths Mental Development Scales, and behavior was measured with the Achenbach Child Behavior Checklist. RESULTS: Within the transplant group, 17 had congenital heart disease (CHD), and 18 had cardiomyopathy (CM). Although the overall mean developmental scores were within the normal range for the transplant, conventional cardiac surgery, and bone marrow transplantation groups, scores were significantly lower than those of the healthy group. Within the transplant group, those with CHD had a significantly lower mean developmental quotient than those with CM. Furthermore, the CHD patients obtained significantly lower scores than those with CM on areas of development covering locomotor abilities, speech and hearing, eye-hand coordination, and performance. CONCLUSIONS: In common with other groups of ill children, patients awaiting heart or heart-lung transplantation are at risk for developmental delay. Diagnosis is a salient factor in determining outcome in most areas of development. Psychosocial interventions need to be targeted to maximize developmental potential before transplantation.

Child Behavior↗
PubMed1989

Teen Advocate Program: a unique assessment of case management.

The Teen Advocate Program is a case management demonstration project developed with a block grant from the Maternal and Child Health Section of the Louisiana Department of Health. Family Counseling of East Baton Route Parish, a community-based agency, was contracted to develop outreach services for high risk adolescents. The purpose of the program is to provide structure, advocacy, and coordination, empowering teens to use primary and preventive health care providers. The initial referral base of clients was provided from a clinic of teen mothers and their infants, and an adolescent family planning clinic, both located at the East Baton Rouge Parish Health Unit. This interdisciplinary case management outreach services makes this model unique because it offers an organized, structured preventive health care intervention to teens at high risk of becoming pregnant. Goal attainment scales developed revealed that 96% of the study population improved. Sixty-seven percent have good attendance at clinics. Among the client population of teen mothers, there has only been a 4% repeat pregnancy rate. For the first six months of existence, there were no documented pregnancies among the adolescent seeking contraceptive counseling. The study results confirmed the positive influence of case management in preventing adolescent pregnancy. This model is being expanded to address other high risk adolescent behaviors.

Adolescent↗
PubMed1990

Language learning in a prospective study of otitis media with effusion in the first two years of life.

We report cross-sectional findings on children's early experience with otitis media with effusion (OME) related to hearing over time and emerging receptive and expressive language skills on the Sequenced Inventory of Communication Development Scale (SICD). Tympanometry and otoscopy on the same day are combined to diagnose OME. Hearing from 6 to 12 months is significantly related to scores on the SICD beginning with receptive language at 12 months. At 18 and 24 months, both receptive and expressive language are significantly related to average hearing from 6 to 18 months. Better language is associated with better average hearing levels. These findings suggest that the relationship between OME and language is mediated by hearing. It remains to be seen whether these relationships persist as the children continue to develop language.

Child, Preschool↗
PubMed2006

Controlled DNA-templated metal deposition: towards ultra-thin nanowires.

In this paper, we report the metallization of a dsDNA template using a novel photography-derived two-step strategy in which dsDNA is first complexed with Ag(I) ions and then irradiated with UV light at 254 nm. The nucleobases act as light harvesters and sensitizers, triggering the photoreduction of the complexed silver ions. This process yields a silver nanoparticles blueprint along the DNA strand. The silver latent image is then developed by depositing metallic nickel through an electroless plating process. This photography-derived procedure generates very homogeneous and evenly distributed strings of silver-core/nickel-shell nanoparticles. Although still discontinuous, we believe that such chains can serve as the base for obtaining continuous metal nanowires. Furthermore, this process can most likely be extended to other plating metals, resulting in a broadly general procedure for metallizing DNA with a variety of different materials. Because of the intrinsic simplicity in using light as the key step, this methodology might be amenable to large-scale development, eventually leading to a very efficient molecular-photolithography process.

Aluminum Silicates↗
PubMed1996

Measuring visual function and quality of life in patients with cytomegalovirus retinitis. Development of a questionnaire. Studies of Ocular Complication of AIDS Research Group.

OBJECTIVE: To develop and test a brief questionnaire designed to assess visual symptoms, visual function in daily activities, and impact of treatment administration in patients with cytomegalovirus retinitis related to acquired immunodeficiency syndrome. DESIGN: Observational cross-sectional study. Patients were recruited in June and July 1992. SETTING: Seven university-based sites participating in the Studies of Ocular Complications of AIDS. PATIENTS: Twenty-six subjects enrolled in a randomized trial that compared foscarnet and ganciclovir for the treatment of cytomegalovirus retinitis. MAIN OUTCOME MEASURES AND ANALYSIS: Distributions of scores, reliability, and validity of newly developed scales to assess visual function, visual symptoms, and global vision. Spearman rank correlations with 95% confidence intervals were used to test hypothesized relationships between scale scores, visual acuity, visual field, and findings from visual examination. RESULTS: The final 18-item self-administered questionnaire required 5 minutes to complete. The new scales had high internal consistency (Cronbach alpha = .81 to .94). As hypothesized, patient-reported vision scores decreased with greater abnormalities found on ophthalmologic examination. Visual symptoms were most strongly related to findings in the worse eye. Visual function and global vision scores were moderately correlated with findings from visual testing and examination, and less strongly related to general health perceptions. Patients reported considerable impairment: 42% reported blurred vision; 40%, difficulty reading; 44%, difficulty driving; and 40%, that treatment interfered with social activities; 50% reported substantial trouble with their vision. CONCLUSIONS: The brief questionnaire developed to assess patient-reported visual function in cytomegalovirus retinitis appears reliable and valid as a measure of performance of vision-related activities, visual symptoms, and the impact of treatment administration. Further research is needed to test its utility as an outcome measure in longitudinal studies of cytomegalovirus retinitis.

AIDS-Related Opportunistic Infections↗
PubMed1999

The Dysphagia Outcome and Severity Scale.

The Dysphagia Outcome and Severity Scale (DOSS) is a simple, easy-to-use, 7-point scale developed to systematically rate the functional severity of dysphagia based on objective assessment and make recommendations for diet level, independence level, and type of nutrition. Intra- and interjudge reliabilities of the DOSS was established by four clinicians on 135 consecutive patients who underwent a modified barium swallow procedure at a large teaching hospital. Patients were assigned a severity level, independence level, and nutritional level based on three areas most associated with final recommendations: oral stage bolus transfer, pharyngeal stage retention, and airway protection. Results indicate high interrater (90%) and intrarater (93%) agreement with this scale. Implications are suggested for use of the DOSS in documenting functional outcomes of swallowing and diet status based on objective assessment.

Adult↗
PubMed1994

Nonintellective intelligence and personality: variance shared by the Constructive Thinking Inventory and the Myers-Briggs Type Indicator.

The Constructive Thinking Inventory (CTI; Epstein & Meier, 1989), a recently developed scale assessing patterns of habitual everyday thoughts, was compared with the Myers-Briggs Type Indicator (MBTI; Myers & McCaulley, 1985) to ascertain areas of common variance. CTI and MBTI data from 65 men and 109 women were evaluated. A series of standard multiple regression procedures indicated that, in most instances, CTI scales were predictive of MBTI continuous scores, although gender mediated several of the effects. The results suggest that the variance assessed by the CTI is similar to that addressed by traditional measures of personality but that the CTI partitions the variance in an atypical, yet coherent, manner.

Adolescent↗