Erginel, Basak; Gun Soysal, Feryal; Keskin, Erbug; Celik, Alaaddin; Salman, Tansu
Introduction The aim of this study was to review a single institution's experience with surgical interventions in children with achalasia and to determine treatment strategies for this rare disorder. Patients and methods This study is a retrospective analysis of 22 cases of childhood achalasia from 1991 to 2013. The patients were evaluated in terms of age, symptoms, interventions, intraoperative complications, and recurrent dysphagia. Results There were 13 boys and nine girls (7 months to 17 years old). The clinical symptoms were vomiting (68%), dysphagia (36%), wheezing (18%), coughing (13%), and weight-loss (13%). The mean duration of symptoms was 2.4 years (1 month to 6 years). A barium contrast X-ray study was performed in all of the patients. Oesophageal manometry was performed in eight patients. Six patients underwent multiple oesophageal dilatations (ED) as a first intervention. A Heller myotomy (HM) and fundoplication were performed in all the patients except two patients who recovered with dilatation. In the long term, one patient had a stricture due to the operation and had to undergo a reoperation. Of the Heller myotomy patients, one had a recurrent stricture that responded to dilatation. No other complications were present. All the patients are now asymptomatic. Conclusion Early diagnosis and prompt surgical treatment is important to prevent growth impairment in childhood achalasia cases. A Heller myotomy followed by a partial anti-reflux procedure is an effective treatment for achalasia in children. Based on our experience, it is superior to oesophageal dilatation therapy.
Following the tsunami disaster in 2004, the General Secretary of the United Nations (UN) Kofi Annan called for a global early warning system for all hazards and for all communities. He also requested the ISDR (International Strategy fort Disaster Reduction) and its UN partners to conduct a global survey of capacities, gaps and opportunities in relation to early warning systems. The produced report, "Global survey of Early Warning Systems", concluded that there are many gaps and shortcomings and that much progress has been made on early warning systems and great capabilities are available around the world. However, it may be argued that an early warning system (EWS) may not be enough to prevent fatalities due to a natural hazard; i.e., it should be seen as part of a ‘wider' or total system. Furthermore, an EWS may work very well when assessed individually but it is not clear whether it will contribute to accomplish the purpose of the ‘total disaster management system'; i.e., to prevent fatalities. For instance, a regional EWS may only work if it is well co-ordinated with the local warning and emergency response systems that ensure that the warning is received, communicated and acted upon by the potentially affected communities. It may be argued that without these local measures being in place, a regional EWS will have little impact in saving lives. Researchers argued that unless people are warned in remote areas, the technology is useless; for instance McGuire  argues that: "I have no doubt that the technical element of the warning system will work very well,"…"But there has to be an effective and efficient communications cascade from the warning centre to the fisherman on the beach and his family and the bar owners." Similarly, McFadden  states that: "There's no point in spending all the money on a fancy monitoring and a fancy analysis system unless we can make sure the infrastructure for the broadcast system is there,"… "That's going to require a lot
The Hannan Crusaid Treatment Centre – early beginnings and lessons learnt. R Kaplan, C Orrell, SD Lawn, L-G Bekker, R Wood. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.7196/sajhivmed.1040 · AJOL African ...
Payler, Jane; Georgeson, Jan
Research and development with regard to interprofessional practice have extended over recent decades to early years services in children's centres (CCs). However, most children in England attend private and voluntary settings, rather than CCs. where early years practitioners have varying amounts of opportunity, training and experience to work…
Family-centred practice has been included in the Victoria, Australia Early Years Learning and Development Framework as a key practice principle for professionals working across all early years programs in that state. While this model of partnership for engaging and collaborating with families has long been used in the early intervention sector,…
Nachaliel, N; Re'Em-Kalma, Y; Eshed, O; Elias, S; Frank, D
Bone morphogenetic protein (BMP) plays an important role in mesoderm patterning in Xenopus. The ectopic expression of BMP-4 protein hyperventralizes embryos, whereas embryos expressing a BMP-2/4 dominant-negative receptor (DNR) are hyperdorsalized. Mesoderm is initially induced in the marginal zone by cells in the underlying vegetal pole. While much is known about BMP's expression and role in patterning the marginal zone, little is known about its early role in regulating vegetal mesoderm induction centre formation. The role of BMP in regulating formation of vegetal mesoderm inducing centres during early Xenopus development was examined. Ectopic BMP-4 expression in vegetal pole cells inhibited dorsal mesoderm induction but increased ventral mesoderm induction when recombined with animal cap ectoderm in Nieuwkoop explants. 32-cell embryos injected with BMP-4 RNA in the most vegetal blastomere tier were not hyperdorsalized by LiCl treatment. The ectopic expression of Smad or Mix.1 proteins in the vegetal pole also inhibited dorsal mesoderm induction in explants and embryos. Expression of the BMP 2/4 DNR in the vegetal pole increased dorsal mesoderm induction and inhibited ventral mesoderm induction in explants and embryos. These results support a role for BMP signalling in regulating ventral vegetal and dorsal vegetal mesoderm induction centre formation during early Xenopus development.
Vernal keratoconjunctivitis at Guinness eye centre, Luth (A five year study). FB Akinsola, AT Sonuga, OT Aribaba, AO Onakoya, AO Adefula-Ositelu. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/nqjhm.v18i1.44945.
This paper explores how early childhood development practitioners running centre-based programmes with children aged 3-6 years address the needs of an increasing number of children from diverse cultural backgrounds in their care. This is important as early childhood is a critical moment in which to create a positive awareness about diversity. A…
Blamires, M.; Estrada, C.
This paper considers inclusion in the early years from the perspective of a social model of learning articulated by Wenger (1998). This model is used to highlight key areas of teaching and learning in the early years that enhance participation and achievement. Implications for change in early years settings are considered alongside some priorities for professional development.
Research purpose: This study explored whether call centre agents’ sense of coherence significantly influences their career adaptability and whether their burnout levels significantly moderate the sense of coherence–career adaptability relationship. The research also investigated whether age, gender and years of service (as control variables, along with sense of coherence, predicted career adaptability. Motivation for the study: The positive psychological construct of career adaptability and its association with call centre agents’ sense of coherence, burnout, age, gender and years of service have not yet been investigated in the call centre environment. Research design, approach and method: A cross-sectional quantitative survey design was used. The Orientation to Life, Career Adapt-Abilities Scale and Maslach Burnout Inventory General Scale were administered to a non-probability purposive sample of 409 early-career Black staff employed in three of the largest outsourced financial call centres in Africa. Main findings: Multiple regression analyses revealed that age, gender and meaningfulness significantly predicted call centre agents’ career adaptability, but that their burnout levels do not significantly moderate the sense of coherence–career adaptability relationship. Practical/managerial implications: Enhancing call centre agents’ sense of meaningfulness will increase their levels of career adaptability and career wellbeing. Contribution/value-add: This research is the first to investigate the construct of career adaptability in the call centre environment and adds new knowledge and insights to the existing wellness and positive psychology literature.
McNichol, Heidi; Davis, Julie Margaret; O'Brien, Katherine R.
In this study, engineers and educators worked together to adapt and apply the ecological footprint (EF) methodology to an early learning centre in Brisbane, Australia. Results were analysed to determine how environmental impact can be reduced at the study site and more generally across early childhood settings. It was found that food, transport…
Takeuchi, Miwa Aoki; Towers, Jo; Plosz, Jennifer
Early years mathematics experiences have been shown to be a significant predictor for students' school readiness and future mathematics achievement. Previous research also indicates an important connection between emotion and mathematics learning. How do students in early years education in Alberta describe their emotional relationship with…
Human Resources and Social Development Canada, 2007
Internal Audit Services conducted an Early Implementation Review of the Understanding the Early Years (UEY) Initiative in 2006-07. This review is intended to provide assurance to senior management that program delivery has been established appropriately in order to meet its objectives and highlight any areas that require focused management…
Full Text Available The British Atmospheric Data Centre (BADC has existed in its present form for 20 years, having been formally created in 1994. It evolved from the GDF (Geophysical Data Facility, a SERC (Science and Engineering Research Council facility, as a result of research council reform where NERC (Natural Environment Research Council extended its remit to cover atmospheric data below 10km altitude. With that change the BADC took on data from many other atmospheric sources and started interacting with NERC research programmes. The BADC has now hit early adulthood. Prompted by this milestone, we examine in this paper whether the data centre is creaking at the seams or is looking forward to the prime of its life, gliding effortlessly into the future. Which parts of it are bullet proof and which parts are held together with double-sided sticky tape? Can we expect to see it in its present form in another twenty years’ time? To answer these questions, we examine the interfaces, technology, processes and organisation used in the provision of data centre services by looking at three snapshots in time, 1994, 2004 and 2014, using metrics and reports from the time to compare and contrasts the services using BADC. The repository landscape has changed massively over this period and has moved the focus for technology and development as the broader community followed emerging trends, standards and ways of working. The incorporation of these new ideas has been both a blessing and a curse, providing the data centre staff with plenty of challenges and opportunities. We also discuss key data centre functions including: data discovery, data access, ingestion, data management planning, preservation plans, agreements/licences and data policy, storage and server technology, organisation and funding, and user management. We conclude that the data centre will probably still exist in some form in 2024 and that it will most likely still be reliant on a file system. However, the
Vázquez-López, María Esther; Fernández, Gonzalo; Díaz, Pablo; Díez-Morrondo, Carolina; Pego-Reigosa, Robustiano; Coira-Nieto, Amparo
The main aim of this study was to determine the usefulness of an early diagnosis of Lyme disease (LD) in Primary Health Care Centres (PHCC) using the ELISA test as serological screening technique. A retrospective study (2006-2013) was performed in order to determine the anti-Borrelia seropositivity in 2,842 people at risk of having LD. The possible relationship between the environment and the area of residence with anti-Borrelia seropositivity was also studied according to the origin of the specimens (PHCC/Hospital). Overall, 15.2% of samples were positive to Borrelia spp. Seropositivity was significantly higher in samples sent by PHCC doctors than those sent by Hospital doctors. Seropositivity was significantly higher in rural than in urban populations and in those who live in mountainous or flat areas. The percentage of seropositivity has increased over the years. The role of the PHCC doctor is essential for achieving an early diagnosis of Lyme disease, as a higher percentage of seropositives was detected in samples submitted from PHCC. Furthermore, most early localised LD patients were diagnosed in PHCC, avoiding the appearance of sequelae. Therefore, detection of Borrelia specific antibodies using an ELISA assay is a useful screening test for patients at risk of LD. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Michel, M.C.; Kuiken, F.
Over the past few decades early years education throughout Europe has experienced many changes due to higher numbers of children attending centres for early childhood education and care (ECEC), a growing linguistic and cultural diversity in society and a shift from care to education with the focus
The primary goal of this paper is to provide a commentary on the teaching and learning of geometry in the early years of schooling with the set of papers in this issue as a guiding factor. It is structured around issues about geometry education of young learners, such as: what should we teach in geometry and why; representation of geometrical…
Judy Van Heerden
Full Text Available This study investigated how quality in early learning centres (preschools in South Africa was experienced and perceived by mothers and teachers. A theoretical framework, based on a model of quality development by Woodhead (1996, informed the study. This framework that consists of input (structural, process and outcome quality indicators is a well-established model for quality development, which has been used in developing countries. The findings generated from a thematical analysis of interview data showed that aspects perceived by mothers and teachers as quality indicators in early learning centres were predominantly process indicators and hard to ‘measure’ in a quantitative way. For mothers and teachers, children’s social-emotional well-being, holistic development, a normative foundation for values and respect, effective infrastructure and accountable learning indicated quality. A quality school climate enhances emotional and social well-being, and the findings suggest that for mothers and teachers quality concerns were not about that which the early learning centres have provided in terms of facilities (input indicators, but rather about the process indicators where centres promote children’s holistic well-being. The only outcome indicator that was regarded as extremely important by mothers and important, but not to the same extent, by teachers, is whether children are happy and content and enjoying school.
Sandrini, Massimo; Vizzardi, Valerio; Valerio, Francesca; Ravera, Sara; Manili, Luigi; Zubani, Roberto; Lucca, Bernardo J A; Cancarini, Giovanni
Incremental dialysis consists in prescribing a dialysis dose aimed towards maintaining total solute clearance (renal + dialysis) near the targets set by guidelines. Incremental peritoneal dialysis (incrPD) is defined as one or two dwell-times per day on CAPD, whereas standard peritoneal dialysis (stPD) consists in three-four dwell-times per day. Single-centre cohort study. Enrollement period: January 2002-December 2007; end of follow up (FU): December 2012. incident patients with FU ≥6 months, initial residual renal function (RRF) 3-10 ml/min/1.73 sqm BSA, renal indication for PD. Median incrPD duration was 17 months (I-III Q: 10; 30). There were no statistically significant differences between 29 patients on incrPD and 76 on stPD regarding: clinical, demographic and anthropometric characteristics at the beginning of treatment, adequacy indices, peritonitis-free survival (peritonitis incidence: 1/135 months-patients in incrPD vs. 1/52 months-patients in stPD) and patient survival. During the first 6 months, RRF remained stable in incrPD (6.20 ± 2.02 vs. 6.08 ± 1.47 ml/min/1.73 sqm BSA; p = 0.792) whereas it decreased in stPD (4.48 ± 2.12 vs. 5.61 ± 1.49; p peritonitis incidence and slower reduction of renal function.
One of the biggest challenges in early childhood development (ECD) centres in rural districts is that teachers are not trained adequately and therefore they cannot create learning environments in which young children can develop to their optimal potential. In many cases a large group of children is placed in a classroom and no stimulation is given to them, because the ECD practitioner does not have the knowledge or skills to use what is available in the classroom to stimulate t...
Kaske, Sigune; Lefering, Rolf; Trentzsch, Heiko; Driessen, Arne; Bouillon, Bertil; Maegele, Marc; Probst, Christian
Trauma related injuries are a main cause for long-lasting morbidity and disability especially in younger patients with their productive years ahead. On a routine basis, we assessed health related quality of life two years after trauma of severely injured patients at our level-I trauma centre via posted survey. The posted survey included (1) POLO-Chart questionnaire with European Quality of Life (EuroQoL), Short Form Health Survey-36 (SF 36) and the recently developed and validated Trauma Outcome Profile (TOP) combined with (2) single centre data according to TraumaRegister DGU(®) data sets including trauma mechanism, injuries and initial treatment. Inclusion criteria were severely injured patients ≥ 18 years, treated between 2008 and 2010. Exclusion criteria were death, cognitive impairment, lack of German language and denial of participation. 129 datasets were eligible for analysis reflecting a typical trauma collective with mean age 44 years, predominantly male (67%), mean ISS 22 and 98% blunt trauma. Two years after trauma, 62% of the patients reported of relevant remaining pain and 64% of severe functional deficit in at least one body region. Sixty-four percent of the patients suffered from decreased overall quality of life (EuroQoL≤0.8). Additionally, all domains of SF-36 were impaired compared to an age and gender adjusted cohort of healthy individuals, especially domains of pain and activity of daily living. These impairments were associated with decreased 'social functioning' and 'emotional role functioning'. TOP results confirmed these findings: Quality of life was decreased in almost every dimension. TOP additionally identified sequels especially in domains of "Mental Functioning" and impairments in psychological recovery including post-traumatic stress disorder, depression and anxiety. Socioeconomic impairments were frequent including further hospitalisations (62%), duration of inability to work ≥ 6 month (54%), financial disadvantages (45%) and
Bennett, Jessica; Burridge, Peter
This paper explores the successful mentoring of Timor-Leste early years teachers by Australian teachers to expand their knowledge and practice of child-centred play-based pedagogy. The mentoring programme for the Timorese teachers occurred through an extended visit to a school in Victoria, Australia, for eight weeks to work with mentor teachers in…
Agrawal, P.P.; Bahadur, A.K.; Mohanta, P.K.; Singh, K.; Rathi, A.K.
Nine patients with a histologically proven diagnosis of chordoma seen at the Department of Radiation Oncology, Maulana Azad Medical College and Lok Nayak Hospital between January 1999 and December 2004 were retrospectively reviewed with respect to age, sex, presentation, location of tumour, treatment, response, recurrence, metastasis and follow up. Chordoma constituted 0.07% of total cancer cases registered over 6 years. Out of nine patients, eight were males and one was female with median age at time of diagnosis 52 years (range 34-68 years). All had sacrococcygeal lesions except one who had a spheno-occipital lesion. Seven patients had undergone either subtotal or gross total resection whereas only biopsy had been carried out in two of them. All patients received radiation therapy, seven in a postoperative setting and two for palliation. Follow-up period ranged from 2 to 50 months. Four patients died - the first after fourth fraction of radiation, second after 10 days of treatment, third of progressive lesion in sphenoidal region despite resection and radiation and fourth of local recurrence in the sacrococcyx. One patient developed distant metastases in the lungs and subcutaneous tissue over the scalp along with local recurrence; he is still alive. Two patients are locally free of disease whereas the other two were lost to follow up. The present analysis was undertaken to review our institutional experience with an aim to provide a practical approach to these tumours. In this report, these cases are discussed and the published works have been reviewed for the optimal management of patients with chordoma Copyright (2006) Blackwell Publishing Asia Pty Ltd
Hussein, Khetam; Raz-Pasteur, Ayelet; Shachor-Meyouhas, Yael; Geffen, Yuval; Oren, Ilana; Paul, Mical; Kassis, Imad
Campylobacter bacteraemia (CB) is rare and usually occurs in immune-compromised patients. In this study we examined the incidence and epidemiology of CB in one institution over 15.5 years. The medical records of all the consecutive patients with CB admitted to our hospital from 2000 to 2015 were retrospectively reviewed. Clinical characteristics, microbiologic and outcome data were collected. During the study period, 65 patients with CB were identified. The majority of the patients were middle aged and immune-compromised. Campylobacter jejuni was the most commonly identified species (33/47, 70%). The main underlying conditions were haematological malignancies (43%) and chronic liver disease (14%). Fifty-seven percent of the patients were receiving immunosuppressive therapy at the time of bacteraemia. The most common presenting symptoms were fever (85%), diarrhoea (40%), abdominal pain (40%), and nausea and vomiting (40%). Of the isolates tested, 97% were susceptible to macrolides, and only 35% were susceptible to quinolones. Susceptibility to quinolones decreased over the years. Most patients did not receive adequate empiric antibiotic treatment (81.5%) and about 20% never received directed therapy. Mortality and relapse rates were low (5% each). There was no association between adequate empirical or definitive antibiotic therapy and adverse outcomes. The main predisposing factor for Campylobacter bacteraemia in our cohort was immunosuppression. Prognosis was generally favourable regardless of appropriateness of antibiotic therapy.
Full Text Available Background: Mesenteric cysts are rare intra-abdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal symptoms. Patients and Methods: Seventeen patients (age less than 10 years with mesenteric cysts were managed in our hospital. The age ranged from 15 days to 10 years. Patients were admitted with acute or chronic symptoms. They were evaluated with complete history, clinical examination, blood investigations and radiological investigations (x-ray abdomen erect, ultrasound abdomen (USG and computed tomography (CT scan in selected cases to reach a provisional diagnosis. The diagnosis was proven on laparotomy and histologically confirmed. Results: The main presenting symptoms were abdominal pain or lump. The most common mode of presentation was acute small intestinal obstruction. USG was not conclusive in all. Abdominal CT scan with intravenous contrast was diagnostic in nine patients. Five patients had volvulus on exploration. Cysts were located in small intestinal mesentery in 14 cases and three were in the sigmoid mesentery. Seven patients had complete excision, intestinal resection was required in four and marsupialisation with cauterisation of margins was done in six patients. Histologically, all were lymphangiomatous mesenteric cysts. Conclusion: The diagnosis of mesenteric cysts should be kept in mind in any patient presenting with acute abdominal symptoms. Small bowel volvulus with mesenteric cyst constituted a significant number in children with acute abdominal symptoms. Early diagnosis and treatment yields excellent outcome.
Pope, Sue; Vickerstaff, A L; Wareham, A P
During the recent conflicts in Iraq and Afghanistan, substantial numbers of service personnel survived devastating injuries, presenting significant challenges for early rehabilitation at Queen Elizabeth Hospital Birmingham. Royal Centre for Defence Medicine personnel augmented NHS therapy provision, gaining significant experience in rehabilitating complex trauma. Multidisciplinary working was key to delivering this service, with a unique rehabilitation coordinating officer position established to manage the rehabilitation pathway. A military exercise rehabilitation instructor provided daily gym-based rehabilitation, developing exercise tolerance. Emphasis was placed on early independence, reducing pain, eliminating complications and optimising function. Innovative solutions and non-standard combinations of rehabilitation were required, with therapy working practices redesigned that, we believe, exceed provision elsewhere, including novel applications such as unique patient transfers, specialist seating, additional equipment, problem-solving teaching and early upper limb prosthetic provision. Active pain management allowed engagement in rehabilitation. With limited evidence available, therapeutic modalities attempting to alleviate phantom limb pain centred on patients' ability to engage in treatment. Finally, the requirement to measure change in early trauma rehabilitation was identified, leading to the development of the preprosthetic functional outcome measure. This article aims to document advances made, lessons learned, encourage debate and identify priorities for future research for military complex trauma rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Full Text Available Background: Precocious puberty, as early physical development and low final height might lead to psychosocial problems.Objective: To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children.Materials and Methods: In this case-series study, 44 girls and 8 boys with precocious puberty referred to Endocrine Reserch Centre (Firouzgar, Institute of Endocrinology and Metabolism (Hemmat Campus, were examined in a 10 years period of time. Results: Mean age of girls and boys was 7.43±1.4 years and 5.8±2.1 years respectively. Most of the patients fell within the age category of 7-7.9 years old (40.9% for girls and 50% for boys. Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP, including idiopathic CPP (87.5% and neurogenic CPP (12.5%. 23.3% of patients had peripheral precocious puberty (PPP, including congenital adrenal hyperplasia (CAH (42.8%, ovarian cysts (28.4%, McCune-Albright syndrome (14.2% and adrenal carcinoma (14.2%. 34.1% of girls and 25% of boys had normal variant puberty including premature thelarche (57%, premature adrenarche (38% as well as premature menarche (4.7%l. Conclusion: The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH. Therefore precocious puberty in girls is usually benign. In boys, CNS anomalies should first be considered in the differential diagnosis of CPP. Therefore brain Magnetic Resonance Imaging (MRI is mandatory in all cases.
In the course of your day, when you interpret or count a radioimmunoassay or a sample of blood or body fluid, you will probably use a variant of the well counter invented by Hal O. Anger in the early 1950s. If you obtain or read a patient image, it probably came from some type of his gamma camera. If yoy do or see a single photon emission computed tomography study, Hal Anger showed the feasibility. Even if you are working with positrons, some of the early imaging work was done by devices Hal Anger invented. This article deals primarily with the years I spent with Hal, 1962 to 1964. I was fortunate to have the opportunity to spend this time with him when he had just completed the development of his 11-in gamma camera, the first multipurpose camera suitable for diverse clinical examinations. In retrospect, it is easy to see why Hal was honored by the Society of Nuclear Medicine as one of its pioneers and why he was the first recipient of the Ben Cassen Prize. However, it was not always clear that Hal's creative road would lead to such deserved distinction. I have tried to portray the beginnings of this journey to the best of my recollections.
Mueck, K.; Steger, F.; Hefner, A.
The radiation protection control report for the Research Centre Seibersdorf comprises the results of all measurements which have been performed during the year 1988 by the radiation protection control department to protect the employees and the environment of the Research Centre Seibersdorf. Personnel monitoring was carried out by TL-dosimetry to control the external dose, by body counting and excretion analysis for the surveillance of internal exposure. Monitoring of working places was performed by smear tests and measurements of the activity concentration in the air. The result of the environmental surveillance proves that in the year of 1988 no employee of the centre or any other firms was exposured to a dose above the limits set in the Austrian code of regulations. The net dose, amounted to less than 1% of the annual limit of 50 mSv for occupationally exposed workers. For a collective of 345 employees actually occupied in radiation areas the average annual dose amounted to 1,47 mSv/a (147 mrem/a) which is less than 3 % of the maximum value. The releases to the environment were also below the limits set by the authorities, is many cases by orders of magnitude. In accordance with this, the measurements in the environment of the research centre prove that no influence of the research centre on the environment is observable. 23 tabs., 14 figs. (Author, shortned by qui)
Payler, Jane Katherine; Georgeson, Janet
This paper reports on case study research in the UK analysing the participation of early years staff in interprofessional practice to provide effective care and education for children, primarily those with special educational needs. Even though case study staff in different "outstanding" settings had equivalent qualifications and similar…
Eight-year follow up result of the OTOASOR trial: The Optimal Treatment Of the Axilla - Surgery Or Radiotherapy after positive sentinel lymph node biopsy in early-stage breast cancer: A randomized, single centre, phase III, non-inferiority trial.
Sávolt, Á; Péley, G; Polgár, C; Udvarhelyi, N; Rubovszky, G; Kovács, E; Győrffy, B; Kásler, M; Mátrai, Z
The National Institute of Oncology, Budapest conducted a single centre randomized clinical study. The OTOASOR (Optimal Treatment Of the Axilla - Surgery Or Radiotherapy) trial compares completion of axillary lymph node dissection (cALND) to regional nodal irradiation (RNI) in patients with sentinel lymph node metastasis (pN1sn) in stage I-II breast cancer. Patients with primary invasive breast cancer (cN0 and cT ≤ 3 cm) were randomized before surgery for cALND (standard treatment) or RNI (investigational treatment). Sentinel lymph nodes (SN) were investigated with serial sectioning at 0.5 mm levels by hematoxylin-eosin staining. Investigational treatment arm patients received 50 Gy RNI instead of cALND. Adjuvant treatment and follow up were performed according to the actual guidelines. Between August 2002 and June 2009, 1054 patients were randomized for cALND and 1052 patients for RNI. SN was evaluated in 2073 patients and was positive in 526 patients (25.4%). 474 cases were evaluable (244 in the cALND and 230 in the RNI arm), and in the cALND group 94 of 244 patients (38.5%) who underwent completion axillary surgery has additional positive nodes. The two arms were well balanced according to the majority of main prognostic factors. Primary endpoint was axillary recurrence and secondary endpoints were overall survival (OS) and disease-free survival (DFS). Mean follow-up was 97 months (Q1-Q3: 80-120). Axillary recurrence was 2.0% in cALND arm vs. 1.7% in RNI arm (p = 1.00). OS at 8 years was 77.9% vs. 84.8% (p = 0.060), and DFS was 72.1% in cALND arm and 77.4% after RNI (p = 0.51). The results show that RNI is statistically not inferior to cALND treatment. The long term follow-up results of this prospective-randomized trial suggest that RNI without cALND does not increase the risk of axillary failure in selected patients with early-stage invasive breast cancer (cT ≤ 3 cm, cN0) and pN1(sn). Axillary radiotherapy should be an alternative treatment for
Falck, C.; Ramatschi, M.; Bartsch, M.; Merx, A.; Hoeberechts, J.; Rothacher, M.
Introduction Nowadays GNSS technologies are used for a large variety of precise positioning applications. The accuracy can reach the mm level depending on the data analysis methods. GNSS technologies thus offer a high potential to support tsunami early warning systems, e.g., by detection of ground motions due to earthquakes and of tsunami waves on the ocean by GNSS instruments on a buoy. Although GNSS-based precise positioning is a standard method, it is not yet common to apply this technique under tight time constraints and, hence, in the absence of precise satellite orbits and clocks. The new developed GNSS-based component utilises on- and offshore measured GNSS data and is the first system of its kind that was integrated into an operational early warning system. (Indonesian Tsunami Early Warning Centre INATEWS, inaugurated at BMKG, Jakarta on November, 11th 2008) Motivation After the Tsunami event of 26th December 2004 the German government initiated the GITEWS project (German Indonesian Tsunami Early Warning System) to develop a tsunami early warning system for Indonesia. The GFZ Potsdam (German Research Centre for Geosciences) as the consortial leader of GITEWS also covers several work packages, most of them related to sensor systems. The geodetic branch (Department 1) of the GFZ was assigned to develop a GNSS-based component. Brief system description The system covers all aspects from sensor stations with new developed hard- and software designs, manufacturing and installation of stations, real-time data transfer issues, a new developed automatic near real-time data processing and a graphical user interface for early warning centre operators including training on the system. GNSS sensors are installed on buoys, at tide gauges and as real-time reference stations (RTR stations), either stand-alone or co-located with seismic sensors. The GNSS data are transmitted to the warning centre where they are processed in a near real-time data processing chain. For
This report contains the titles of the publications which appeared during the year 1986. Lectures which have not been printed yet are listed separately from the literature. All the patents awarded or published in 1986 are given; i.e. patents and publications of patents. Summarising lectures and practical instructions from the courses at the College for Nuclear Technology are not included in the list. The list of publications is arranged according to Institutes. Among the projects, only the published project reports and publications by members of the staff of the project are listed. The publications printed at the Nuclear Research Centre from the research and development projects of the Manufacturing Technique Project (PFT) and the project on the 'European Research Centre for Measures for Keeping the Air Clean' (PEF), which are being carried out by the Nuclear Research Centre in collaboration with firms and institutions, are also included in the list. The list also contains publications by the external office of the West German Institute of Food resident in the Nuclear Research Centre. The last chapter of the list contains publications on guest experiments at the Nuclear Research Centre. The list has an alphabetical index, which gives page and registry numbers. (orig./GG) [de
Dhadda, A S; Martin, A; Killeen, S; Hunter, I A
Contact radiotherapy for early rectal cancer uses 50 kV X-rays to treat rectal cancers under direct vision. We present data of a series of patients treated at a single centre with prospective follow-up and functional assessment. All patients were treated at the Queen's Centre for Oncology, Hull, UK between September 2011 and October 2015. Patients received a biopsy, magnetic resonance imaging (MRI) of the liver/pelvis, computed tomography of the chest and endorectal ultrasound. Patients were deemed to be either unfit for radical surgery or refused it due to the need for a permanent stoma. Follow-up consisted of 3 monthly flexible sigmoidoscopy and MRI of the liver/pelvis and 12 monthly computed tomography of the chest. In total, 42 patients were treated with contact radiotherapy ± external beam chemo/radiotherapy without any primary surgical excision. The median age was 78 years (range 50-94 years). Local recurrence-free survival was 88%, disease-free survival was 86% and overall survival was 88% with a median follow-up of 24 months (range 5-54 months). The median time to recurrence was 12 months (range 4-14 months). The estimated 30 day surgical mortality for this cohort with radical surgery was 12%. Mortality from the contact radiotherapy procedure was 0%. Functional outcomes as investigated by the Low Anterior Resection Syndrome (LARS) score were good, with 65% having no LARS. Contact radiotherapy for early rectal cancer is a safe, well-tolerated outpatient procedure, allowing organ preservation, with excellent oncological and functional outcomes. For elderly co-morbid patients with suitable rectal cancers this should be considered as a standard of care. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Hughes, Kathleen; Bullock, Amanda; Coplan, Robert J
Previously, the nature of teacher-child relationships (TCRs) has been explored through dimensions of close, conflicted, and dependent. However, this variable-centred approach is limited, as many relationships can be characterized by more than one characteristic or trait. A person-centred approach would allow for a greater understanding of the types of relationships that are formed and improved interpretation of the students' socio-emotional outcomes associated with that relationship. The primary goal of this study was to examine the socio-emotional functioning of young children who formed distinct types of TCRs. Participants were n = 202 kindergarten children (98 girls, 104 boys, Mage = 64.12 months, SD = 4.86). Multi-source assessment was employed with data collected from parent ratings, teacher reports, child interviews, and naturalistic observations in the classroom. Using quartile cut-offs, we identified children who formed conflicted, dependent, and 'combined' (conflicted and dependent) TCRs. Results indicated distinct patterns of socio-emotional functioning for each TCR group. For example, whereas children in conflicted TCRs evidenced greater externalizing difficulties, children with dependent TCRs had greater internalizing difficulties. Children who evidenced high levels of both conflicted and dependent TCRs displayed the most pervasive socio-emotional difficulties. Children who form TCRs characterized by high levels of both conflict and dependency displayed the most pervasive adjustment difficulties. Further investigation is needed to improve our understanding of this group and to assess the plausibility of early intervention strategies. © 2013 The British Psychological Society.
Fordham, L; Gibson, F; Bowes, J
Much has been written on the principles of family-centred practice and on the service delivery methods and skills required of its practitioners. Far less has been written from the perspective of families whose children have a disability. The aims of this study were twofold: firstly to understand families' experiences of family-centred early childhood intervention services and secondly to explore other factors that might impact on these experiences. One hundred and thirty families attending two established early childhood intervention services in New South Wales, Australia completed a survey incorporating the Measure of Processes of Care-56, the Family Empowerment Scale, the Family Support Scale and the Parenting Daily Hassles Scale. Consistent with previous research using the Measure of Processes of Care-56, 'respectful and supportive care' was the domain of care families rated to occur most and 'provision of general information' was the domain they rated to occur least. Significant positive relationships existed between families' ratings of family-centred care and feelings of empowerment. Being provided with general information was strongly correlated with family empowerment. Families' social support networks played an important role but support from professionals was most strongly correlated with families' experiences of family-centred care. Finally, families whose children's early intervention services were co-ordinated by a professional experienced significantly better care. The provision of general information and professional support are key components of family-centred early childhood intervention services. © 2011 Blackwell Publishing Ltd.
Exploration of making and changing sounds is part of the first-grade performance expectation 1-PS4-1, "Plan and conduct investigations to provide evidence that vibrating materials can make sound and that sound can make materials vibrate" (NGSS Lead States 2013, p. 10; see Internet Resource). Early learning experiences build toward…
Bartsch, M.; Merx, A.; Falck, C.; Ramatschi, M.
Introduction Within the GITEWS (German Indonesian Tsunami Early Warning System) project a near real-time GNSS processing system has been developed, which analizes on- and offshore measured GNSS data. It is the first system of its kind that was integrated into an operational tsunami early warning system. (Indonesian Tsunami Early Warning Centre INATEWS, inaugurated at BMKG Jakarta on November, 11th 2008) Brief system description The GNSS data to be processed are received from sensors (GNSS antenna and receiver) installed on buoys, at tide gauges and as real-time reference stations (RTR stations), either stand-alone or co-located with seismic sensors. The GNSS data are transmitted to the warning centre in real-time as a stream (RTR stations) or file-based and are processed in a near real-time data processing chain. The fully automatized system uses the BERNESE GPS software as processing core. Kinematic coordinate timeseries with a resolution of 1 Hz (landbased stations) and 1/3 Hz (buoys) are estimated every five minutes. In case of a recently occured earthquake the processing interval decreases from five to two minutes. All stations are processed with the relative technique (baseline-technique) using GITEWS-stations and stations available via IGS as reference. The most suitable reference stations are choosen by querying a database where continiously monitored quality data of GNSS observations are stored. In case of an earthquake at least one reference station should be located on a different tectonic plate to ensure that relative movements can be detected. The primary source for satellite orbit information is the IGS IGU product. If this source is not available for any reason, the system switches automatically to other orbit sources like CODE products or broadcast ephemeris data. For sensors on land the kinematic coordinates are used to detect deviations from their normal, mean coordinates. The deviations or so called displacements are indicators for land mass
Haß, S.; Asch, K.; Fernandez-Steeger, T.; Arnhardt, C.
In the current hazard research people-centred warning becomes more and more important, because different types of organizations and groups have to be involved in the warning process. This fact has to be taken into account when developing early warning systems. The effectiveness of early warning depends not only on technical capabilities but also on the preparedness of decision makers and their immediate response on how to act in case of emergency. Hence early warning systems have to be regarded in the context of an integrated and holistic risk management. Disaster Risk Reduction (DRR) measures include people-centred, timely and understandable warning. Further responsible authorities have to be identified in advance and standards for risk communication have to be established. Up to now, hazard and risk assessment for geohazards focuses on the development of inventory, susceptibility, hazard and risk maps. But often, especially in Europe, there are no institutional structures for managing geohazards and in addition there is a lack of an authority that is legally obliged to alarm on landslides at national or regional level. One of the main characteristics within the warning process for natural hazards e.g. in Germany is the split of responsibility between scientific authorities (wissenschaftliche Fachbehörde) and enforcement authorities (Vollzugsbehörde). The scientific authority provides the experts who define the methods and measures for monitoring and evaluate the hazard level. The main focus is the acquisition and evaluation of data and subsequently the distribution of information. The enforcement authority issues official warnings about dangerous natural phenomena. Hence the information chain in the context of early warning ranges over two different institutions, the forecast service and the warning service. But there doesn't exist a framework for warning processes in terms of landslides as yet. The concept for managing natural disasters is often reduced to
Lane, Thirusha; Pinney, Jennifer H; Gilbertson, Janet A; Hutt, David F; Rowczenio, Dorota M; Mahmood, Shameem; Sachchithanantham, Sajitha; Fontana, Marianna; Youngstein, Taryn; Quarta, Candida C; Wechalekar, Ashutosh D; Gillmore, Julian D; Hawkins, Philip N; Lachmann, Helen J
Systemic AA amyloidosis is a serious complication of chronic inflammation; however, there are relatively few published data on its incidence. We investigated the changing epidemiology of AA amyloidosis over a 25-year period at a single national referral centre. We conducted a retrospective study of all patients diagnosed with AA amyloidosis who had attended the centre between 1990 and 2014 inclusive. Six hundred and twenty-five patients were studied in three cohorts: C1: 1990-1997; C2: 1998-2006; C3: 2007-2014. Mean age at presentation increased from 46 in C1 to 56 in C3 (p AA amyloidosis over a quarter of a century, reflecting advances in therapeutics and overall management of complex chronic disease in an ageing population. AA amyloidosis of uncertain aetiology presents an emerging major problem. Newer techniques such as next-generation sequencing may aid diagnosis and effective treatment, thereby improving overall survival.
Stirrup, Julie; Evans, John; Davies, Brian
Despite 50 years and more of "progressive education" in the United Kingdom, classed patterns of educational success and failure stubbornly prevail. So how, where and when does it all go wrong for the many children who continue to fail or underachieve? Drawing on the work of Basil Bernstein, this article centres processes within early…
The topography of the Bhabha Atomic Research Centre, Trombay site, where all major components of nuclear fuel cycle activities are located is very complex in nature. The assessment of the radiological impact, if any, due to atmospheric releases from these facilities within BARC site is being carried out by using a Local Area Network (LAN) based Radiation Early Warning System and meteorological parameters. The upgraded system is aimed at providing data during normal operation of the various facilities at site and for providing early warning to decision makers in case of any onset of an emergency. It is carried out by acquiring both on-line and off-line data on releases from the plants, the environmental radiation dose rate at selected locations and other related parameters. The monitors placed at these selected locations including strategic point around the BARC site can also help in detecting any attempt of unauthorized trafficking of the radioactive sources. This paper explains different aspects of the system operating at BARC
Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.
Fisker, Ane B; Nebie, Eric; Schoeps, Anja
Background: Besides protecting against measles, measles vaccine (MV) may have beneficial non-specific effects. We tested the effect of an additional early MV on mortality and measles antibody levels. Methods: Children aged 4-7 months in two rural health and demographic surveillance sites in Burkina...... home visits and compared mortality from enrolment to 3 years of age in Cox proportional hazards models, censoring for subsequent non-trial MV. Subgroups of participants had blood sampled at enrolment, before the 9 months MV and in the second year of life to assess measles antibody level. Results: Among......% (90/422) in Guinea-Bissau had protective measles antibody levels. By 9 months of age, no measles-unvaccinated/unexposed child had protective levels, while 92% (306/333) of early MV recipients had. At final follow-up, 98% (186/189) in the early MV group and 97% (196/202) in the control group had...
Cheung, Sum Kwing; Ling, Elsa Ka-wei; Leung, Suzannie Kit Ying
The physical, social and temporal dimensions of the classroom environment have an important role in children's learning. This study examines the level of support for child-centred learning, and its associated beliefs, that is provided by Hong Kong's pre-service early childhood teachers. Two hundred and seventy-five students from a pre-service…
Igbinedion, Doye Angela; Abraham, N. M.; Nwogu, U. J.
The study examined Governments' Involvement in Safety Management in Public Early Childhood Education Centres (ECECs) in Rivers State. Two research questions and two hypotheses guided the study which adopted the descriptive survey design. The population of the study comprised of five hundred and ten (510) ECECs in the twenty three (23) Local…
Goncharov, G V; Brashkov, A A
The history of the Centre of the state sanitary and epidemiological surveillance of Black Sea Fleet begun in the 1 April 1935 when the sanitary-epidemiological laboratory was founded. The article is concerned with the different stages of vivid development of this institute during 75 years. During this period organization, establishment and the name were changed many times. Since 2002 it got the current name and represents the scientific-methods institution which can solve the issues of sanitary-hygienic and antiepidemic supply of military personnel of the navy. Special attention is given to the high-readiness force.
This article is intended as a contribution to the debate on the role of human capital in determining value for money in early years education. The article explores how the idea that early years education offers value for money has become folklore amongst policymakers and more widely. However, drawing on both interview data and existing literature…
Brown, Taylor W; van Urk, Felix C; Waller, Rebecca; Mayo-Wilson, Evan
Because of poverty, children and families in low- and middle-income countries often face significant impediments to health and well-being. Centre-based day care services may influence the development of children and the economic situation of parents by providing good quality early childhood care and by freeing parents to participate in the labour force. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development, health and well-being of children and families in low- and middle-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, ERIC and 16 other sources, including several World Health Organization (WHO) regional databases. We also searched two trials registers, websites of government and non-government agencies and reference lists of relevant studies. We included randomised and quasi-randomised controlled trials and prospective non-randomised studies with contemporaneous control groups and assessments both before and after intervention. We considered non-randomised controlled trials, as centre-based care in low- and middle-income countries is unlikely to be studied using randomised controlled trials (Higgins 2011). We included the following outcomes: child intellectual development, child psychosocial development, maternal and family outcomes and incidence of infectious diseases. Two review authors independently assessed risk of bias and extracted data from the single included study. Only one trial, involving 256 children, met the inclusion criteria for this review. This study was assessed as having high risk of bias because of non-random allocation, incomplete outcome data and insufficient control of confounding factors. Results from this study suggest that centre-based day care may have a positive effect on child cognitive ability compared with no treatment (care at home) (assessed using a modified
Dodds, L J; Murphy, D; Neerhut, G; Leggatt, R
During a 15-year period from 1980 to 1995, 63 patients from the Geelong region of Victoria presented with germ cell neoplasm. In this retrospective review performed by studying hospital records, treating specialists' notes and by telephone interviews, 61 of 63 patients were identified. A tumour incidence of four cases per 100,000 male population per year with an overall cancer-specific survival of 95% is demonstrated. Follow-up ranged from 18 months to 15 years. The incidence of seminoma was 30%; patients with seminoma presented at a later stage than those with non-seminoma. The present study demonstrates the increasing incidence of testicular tumour in the Geelong region, and the excellent prognosis of this disease with management outside of the tertiary referral centre.
Gelin, Élodie; Marquis, Marie; Côté, Stéphanie; Deschamps, Julie; Brochu, Mylène Duplessis; Grand, Philippe; Leblanc, Marie-Josée
A review of the literature reveals that there are currently no tools available to analyze the quality of the menus provided in daycare centres. An analysis grid has been developed for this purpose, specifically targeting the food served to preschool children aged 18 months and over. The tool was produced on the basis of findings from recent scientific research. The final version of the grid features 25 statements that cover types of menus, the food groups and recommendations of Canada's Food Guide, sources of protein, the supply of beverages,processed foods, cariogenic products, nutritional variety,allergens and sensory properties of foods. The data gathered using this grid will help establish recommendations for daycare administrators and kitchen managers with respect to various considerations that are key to promoting healthy eating habits in early childhood. The limitations to its use stem from the need to complement these recommendations by conducting an analysis of the recipes and ingredients used, the beverages served and the portion sizes offered.
Teh, C L; Wan, S A; Cheong, Y K; Ling, G R
We performed a retrospective study of all systemic lupus erythematosus (SLE) pregnancies during a 10-year period (2006-2015) to describe the clinical features, maternal and foetal outcomes in our centre. There were 115 pregnancies in 86 women with SLE. Our patients had a mean age of 29.1 years (SD 5.80) and a mean disease duration of 44.63 months (SD 41.17). Fifteen patients had antiphospholipid syndrome (APS). Our patients had complicated pregnancies: 26.1% had SLE flares, 13.9% had pre-eclampsia and 45.1% needed caesarean sections. There were 23.3% foetal losses and 25% preterm deliveries in our patients. There was a higher rate of unplanned pregnancies and lupus flare among pregnancies with active SLE at conception. Pregnancies in lupus nephritis have higher incidence of lupus flares during pregnancy but similar maternal and foetal outcomes compared to those without nephritis. The prognostic indicators for adverse foetal outcome in our patients were flare of SLE (HR 4.08 [CI 95% 1.65-10.13, p Lupus pregnancies in our centre remained as high-risk pregnancies with significant maternal and foetal complications.
Recent policy in England has created a new status of "Early Years Professional", thus imposing professionalisation of the early years workforce. There has been an increase in policy focus on those working with young children, and such a focus raises questions about practitioners' own responses to the debate about their training,…
have been preassembled and installed in site with DMS REELER, connecting the required number of modules, each containing one or more geotechnical-geophysical sensors and the electronic boards for data collection and transmission. Transmission system The transmitted data coming from different sensors, are collected according to the two following procedures: a) I and II Level Net: data transmission in real time through a WiFi Standard HyperLan to the Town Monitoring Centre. b) III Level Net and, DMS system, wheatear station: data transmission through periodic GSM in CSD mode. Early Warning Management Inside the Monitoring Room of the Ancona Early Warning Centre a staff of 8 people control the monitoring data, verify the data flow, cross-check carefully the SMS warnings from the surface and borehole monitoring systems, verifying and comparing the data also with the rain events and potential triggers. Personal on duty control the data also during the night and weekend 365day/y. The staff was trained specifically for the overall instrumentation allowing in this way to be ready in case of transmission, maintenance to the software and remote control unit in all wheatear conditions.
Mueck, K.; Steger, F.; Hefner, A.
The radiation protection control report for the Research Centre Seibersdorf comprises the results of all measurements which have been performed during the year 1989 by the radiation protection control department to protect the employees and the environment of the Research Centre Seibersdorf. Personnel monitoring was carried out by TL-dosimetry to control the external dose, by body counting and excretion analysis for the surveillance of internal exposure according to the Austrian Radiation Protection Law. Monitoring of working places and laboratories was performed by external dose rate measurements, by smear tests and by measurements of the activity concentration in air. The radioactivity emissions from the ASTRA-reactor, the SAL, the waste-incineration plant and other institutes as well as the radioactive effluents from the water treatment plant were monitored. The environmental surveillance was supplemented by measurements of the activity content of surface air, tap- and surface water, soil and vegetation samples. The net dose amounted to less than 1% of the annual limit of 50 mSv for occupationally exposed workers. For a collective of 345 employees actually occupied in radiation areas the average annual dose including natural background radiation amounted 1,31 mSv/a (131 mrem/a) which is also less than 1% of the maximum value. 24 tabs., 14 figs. (Authors)
National Gallery of Art, Washington, DC.
This teachers' guide investigates three National Gallery of Art paintings included in the exhibition "Picasso: The Early Years, 1892-1906." The guide is intended for teachers of middle school and high school students. It includes background information on Pablo Picasso's life and early career, discussion questions, and suggested…
There has been extensive research and analysis of the professionalization of early childhood educators/teachers. The recent promotion of a teacher-led workforce in England has further focused discussions on the modelling of early years teachers as professionals. In this article, the author develops an alternative analysis using the concepts of…
Research has shown that early identification and intervention is crucial and can in fact minimise, and may even prevent, the challenges of dyslexia from becoming too detrimental at later stages of education. This book offers both research insights and practical guidance for teachers working in Early Years settings on how to create resource…
Mazza, James J.; Abbott, Robert D.; Fleming, Charles B.; Harachi, Tracy W.; Cortes, Rebecca C.; Park, Jisuk; Haggerty, Kevin P.; Catalano, Richard F.
This study examined the longitudinal relationship of early elementary predictors to adolescent depression 7 years later. The sample consisted of 938 students who have been part of a larger longitudinal study that started in 1993. Data collected from parents, teachers, and youth self-reports on early risk factors when students were in 1st and 2nd…
Leftwich, Mariruth; Haywood, Clare
Working with children under five years old and the adults that accompany them is a rapidly growing area within the museum and wider cultural sector, with important emphasis being placed on early learning in both the United Kingdom and United States. For history museums in particular, early learning offers a unique set of questions and challenges,…
Oliver, M; Inaba, K; Tang, A; Branco, B C; Barmparas, G; Schnüriger, B; Lustenberger, T; Demetriades, D
Spinal injuries secondary to trauma are a major cause of patient morbidity and a source of significant health care expenditure. Increases in traffic safety standards and improved health care resources may have changed the characteristics and incidence of spinal injury. The purpose of this study was to review a single metropolitan Level I trauma centre's experience to assess the changing characteristics and incidence of traumatic spinal injuries and spinal cord injuries (SCI) over a 13-year period. A retrospective review of patients admitted to a Level I trauma centre between 1996 and 2008 was performed. Patients with spinal fractures and SCI were identified. Demographics, mechanism of injury, level of spinal injury and Injury Severity Score (ISS) were extracted. The outcomes assessed were the incidence rate of SCI and in-hospital mortality. Over the 13-year period, 5.8% of all trauma patients suffered spinal fractures, with 21.7% of patients with spinal injuries having SCI. Motor vehicle accidents (MVAs) were responsible for the majority of spinal injuries (32.6%). The mortality rate due to spinal injury decreased significantly over the study period despite a constant mean ISS. The incidence rate of SCI also decreased over the years, which was paralleled by a significant reduction in MVA associated SCI (from 23.5% in 1996 to 14.3% in 2001 to 6.7% in 2008). With increasing age there was an increase in spinal injuries; frequency of blunt SCI; and injuries at multiple spinal levels. This study demonstrated a reduction in mortality attributable to spinal injury. There has been a marked reduction in SCI due to MVAs, which may be related to improvements in motor vehicle safety and traffic regulations. The elderly population was more likely to suffer SCI, especially by blunt injury, and at multiple levels. Underlying reasons may be anatomical, physiological or mechanism related. Copyright © 2012 Elsevier Ltd. All rights reserved.
Carlson, Marcia J.; Pilkauskas, Natasha V.; McLanahan, Sara S.; Brooks-Gunn, Jeanne
We used data from the Fragile Families and Child Wellbeing Study to examine how couple relationship quality and parental engagement are linked over children's early years--when they are infants, toddlers, and preschoolers. Our sample included 1,630 couples who were coresident over Years 1-3 and 1,376 couples who were coresident over Years 3-5…
van Halsema, Clare; Whitfield, Thomas; Lin, Naomi; Ashton, Kathryn; Torkington, Adele; Ustianowski, Andrew
Raltegravir was the first licensed integrase inhibitor. Real-life experience is informative and complements trial data. We therefore evaluated raltegravir use in adults in a large HIV treatment centre. From pharmacy and departmental HIV database records, we identified all adults taking ≥1 dose of raltegravir from first availability to the end of November 2012. Data were collected using a standardised case report form. Two hundred and fifteen individuals provided 502 patient-years (median 2.6 years/person) of raltegravir use. Of 215 individuals, 166 (77%) were male, median age 43 years; 189 (88%) were antiretroviral therapy (ART)-experienced and 26 (12%) ART-naive, with median baseline CD4 counts of 324 and 54 cells/µL, respectively. Of ten individuals using once-daily raltegravir, four, with good adherence remained virologically suppressed after a median 28 months, four stopped against medical advice, one stopped to simplify and one failed virologically. In hepatitis co-infection, 35 individuals (92 patient-years) took raltegravir without evidence of hepatotoxicity. Six women started raltegravir during pregnancy for intensification (5/6) or switch for tolerability without complications. Of ten individuals stopping raltegravir after virological failure, 2/4 with successful sequencing showed resistance. Raltegravir appears safe and effective, without evidence of toxicity above that in published trials, including in pregnancy and co-infections. Once-daily dosing seems effective where adherence is good. © The Author(s) 2015.
E. V. Shlyakhto
Full Text Available Aim. To estimate the results of 6-year experience of heart transplantation (HT in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old. We used biventricular assist device (BIVAD, Berlin Heart Excor support in 7 heart transplant candidates before HT. 19 patients (29% received thymoglobulin, whereas 46 patients (71% had basiliximab to induce immunosuppression.Results. Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7% after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure for tricuspid valve repair was carried out in 3 cases (4.6%. Venovenous hemodiafi ltration was used in 11 patients (16.9%. A total of 598 endomyocardial biopsies (EMB were performed after HT. Evidence of cellular rejection (R1 and R2 was presented in 286 biopsies (48%. The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months.Conclusions. The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.
Informal learning contexts may provide opportunities for adding capital to young children in their years prior to schooling. This paper explores the potential of the early-years swim context to add capital to young children that may position them favourably for the transition to school. Using Bourdieu's notion of capital, the paper discusses the…
Ferris, J D
In 2001, the NHS plan concluded that there was a significant lack of capacity within current NHS structures to deliver adequate volumes of cataract surgery for England and Wales. The initial central 'solution' for this was to invite in overseas surgical teams to existing NHS centres for short-term surgical initiatives. However, with the advent of the Waiting, Booking and Choice Strategy, a target was set for treatment centers (TCs) to be carrying out an additional 250 000 inpatient/day-case episodes, across all specialties, by 2005. This paper outlines how these Ophthalmology TCs were commissioned, and some of the policy and medical agendas that surrounded their evolution. The concept of 'take or pay' contracts, which placed the onus on local Primary Care Trust organisations to provide the promised number of suitable cataract patients for the TCs, and the 'additionality' of medical and nursing staff are discussed. In September 2003, Netcare was awarded the contract to carry out 41 600 cataract procedures over a 5-year period in a mixture of mobile and fixed site units. Netcare's proposed patient care pathways are examined, as is the reality of its interaction with local Ophthalmology Departments and the response of the Royal College of Ophthalmologists to its standards of patient care. Although Netcare TCs may have contributed to reduced waiting times for cataract surgery in some districts, the quality of care provided by the Netcare TCs has yet to be established. There are ongoing concerns about both the continuity of care and the management of postoperative complications, as well as the economics of neighbouring NHS units.
E. García Vicente
Full Text Available Introduction. The results of the recent DECRA study suggest that although craniectomy decreases ICP and ICU length of stay, it is also associated with worst outcomes. Our experience, illustrated by these two striking cases, supports that early decompressive craniectomy may significantly improve the outcome in selected patients. Case Reports. The first patient, a 20-year-old man who suffered severe brain contusion and subarachnoid haemorrhage after a fall downstairs, with refractory ICP of 35 mmHg, despite maximal medical therapy, eventually underwent decompressive craniectomy. After 18 days in intensive care, he was discharged for rehabilitation. The second patient, a 23-year-old man was found at the scene of a road accident with a GCS of 3 and fixed, dilated pupils who underwent extensive unilateral decompressive craniectomy for refractory intracranial hypertension. After three weeks of cooling, paralysis, and neuroprotection, he eventually left ICU for rehabilitation. Outcomes. Four months after leaving ICU, the first patient abseiled 40 m down the main building of St. Mary’s Hospital to raise money for the Trauma Unit. He has returned to part-time work. The second patient, was decannulated less than a month later and made a full cognitive recovery. A year later, with a titanium skull prosthesis, he is back to part-time work and to playing football. Conclusions. Despite the conclusions of the DECRA study, our experience of the use of early decompressive craniectomy has been associated with outstanding outcomes. We are currently actively recruiting patients into the RESCUEicp trial and have high hopes that it will clarify the role of the decompressive craniectomy in traumatic brain injury and whether it effectively improves outcomes.
Billiet, T; Cleynen, I; Ballet, V; Ferrante, M; Van Assche, G; Gils, A; Vermeire, S
The long-term efficacy of infliximab in patients with Crohn's disease is suboptimal. To study prognostic factors for real-life long-term effcacy of infliximab in Crohn's disease. All consecutive Crohn's disease patients treated with infliximab at a tertiary centre were retrospectively analysed. Only patients who received scheduled infliximab maintenance treatment were considered. Patient- and disease-related factors were used to identify independent predictors of infliximab failure-free survival using Cox proportional hazards regression. Of 1031 patients with Crohn's disease, 261 were eligible for inclusion. Median time on infliximab was 2.4 [IQR 1.4-4.7] years, and 65 (24.9%) patients experienced infliximab failure. Estimated 5-year infliximab failure-free survival was 65.9% (95% CI 58.3-73.5). Multivariate Cox regression identified disease duration ≥1 year (HR 2.5 (95% CI 1.2-5.2), P = 0.02), L1 disease location [HR 2.0 (1.1-3.5), P = 0.02], prior anti-TNF use [HR 2.3 (1.1-4.8), P = 0.03], haemoglobin infliximab failure-free survival. Stratifying patients into risk groups resulted in estimated 3-year infliximab failure-free survival rates ranging from 95.3% (94.2-96.4) to 26.3% (8.6-44.0) depending on the number of risk factors (P = 8 × 10(-13) ). This study identified several easy to obtain predictors of infliximab failure in patients with Crohn's disease, and these are in line with previous reports. Those with a high-risk profile for infliximab failure in whom infliximab initiation is considered, should be treated as early as possible making use of therapeutic drug monitoring. © 2016 John Wiley & Sons Ltd.
Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S
Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.
Full Text Available This paper examines the early language development of children with particular reference to the importance of personal multilingualism and the reasons why this should be promoted in early years education. It is argued that such an objective is best achieved by building multilingual learning environments at the level of nursery and infant schools. The characteristics of such environments are described and ways of evaluating projects designed to build them are presented.
Pelclová, D.; Navrátil, Tomáš; Křenová, M.
Roč. 45, č. 4 (2007), s. 345-345 ISSN 0731-3810. [European Association of Poisons Centres and Clinical Toxicologists International Congress /27./. 01.05.2007-04.05.2007, Athens] Institutional research plan: CEZ:AV0Z40400503 Keywords : Czech Toxicological Information Centre * amanita phalloides Subject RIV: CF - Physical ; Theoretical Chemistry
Kajal, Pradeep; Rattan, Kamal Nain; Bhutani, Namita; Yadav, Poonam
Pyloric atresia may occur as an isolated or pure atresia or may be associated with other anomalies like those involving skin, renal or gastrointestinal systems etc. The most frequent association is with junctional epidermolysis bullosa, a rare autosomal recessive disorder affecting the skin and mucosa. We present a prospective evaluation of three patients of pyloric atresia at our institute over last 2 years (2012-2014)-one of them presenting at 5th day of life and the other two at 5 and 6 years of age, respectively. Two of them did not have any other associated anomaly whereas one patient had incidental finding of Meckel's diverticulum at the time of surgery for pyloric atresia plus he had been operated upon for right-sided pelvioureteric junction obstruction at 1 year of age. All patients underwent laparotomy after stabilization. The two patients presenting late had type 1 pyloric atresia with a pyloric membrane having a central hole in both the patients. So, excision of the membrane with Heineke Mikulicz pyloroplasty was done in both of them. The neonate who presented early had type 2 pyloric atresia and underwent Finney's pyloroplasty.
Jensen, Bente; Holm, Anders; Bremberg, Sven
A significant number of studies indicate that early year preschool programs lead to positive long-term effects. Systematic quality improvement of early year preschool may enhance these outcomes. The ASP Program was built on this principle. In this program preschool staff are supported...... in their efforts to critically reflect on current practices and to change these. A randomized controlled study was carried out in Denmark from September 2006 to May 2008. The study encompassed 2323 children in 59 preschools in two municipalities. Children were assessed using the Strength and Difficulties...
Sapey, T; Py, J-Y; Barnoux, M; Tessier, M; Dehaut, F
The French Establishment of Blood Centre Atlantique (EFSCA) is one of the French regional blood transfusion centers. Donor's biobank is a mandatory activity leading to the storage of biological samples taken from the blood donor. Samples of each blood donation are preserved for a 5-year period at Châteauroux in the form of two straws of 500microliters stored in liquid nitrogen. The aim of this study was to analyze the samples usage by studying quantitative, qualitative and economic criteria. We analyzed all the requests of stored blood samples from 2005 to 2014. They were coming either from the blood donor qualification laboratory (BDQL), in order to perform complementary tests, or from hemovigilance inquiry. Among the blood donation samples, 2,144,636 (whole blood, plasma or platelets apheresis) were preserved during these ten years. During this period, 548 (0.025%) requests for samples were received; 78% were in relation with a request of the BDQL and 22% in relation with a request of hemovigilance. For the straws, the mean exit delay with regard to the blood donation date was 11.5 months (2-55). The cost of samples exit includes only working hours of a laboratory technician. On average, the annual working time dedicated to this activity was 23h. Also, the average price for one-year issuing activity was 620.31 euros. In our study, the donor's biobank was little used. The part of hemovigilance was weak but essential for the blood safety. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Passerini, R; Ghezzi, Tl; Sandri, Mt; Radice, D; Biffi, R
Bloodstream infections (BSIs) are one of the major life-threatening infectious conditions in cancer patients and are responsible for prolonged hospital stays, high healthcare costs and significant mortality. Several clinical trials have reported an improved survival in patients treated with appropriate empirical broad-spectrum antibiotic therapy. Early detection of pathogens and determination of their susceptibility are essential for the optimization of treatment. Variability between hospitals is substantial and requires the individual analysis of local trends. The aim of this study is to assess the local epidemiology of BSI in a single cancer centre over a 10-year period. Retrospective microbiological surveillance of all febrile/infective episodes occurring in oncological and surgical patients in a high-volume cancer centre between January 1999 and December 2008 were considered. Patients' data were collected, processed and analyzed using the epidemiological resource of the Virtuoso Plus software (Metafora Informatica Srl, Milano, Italy). Spearman's rank correlation coefficient, including the two-tailed test of significance, was used to investigate trends of incidence and rate of antibiotic resistance over the 10-year period. A total of 13,058 blood cultures (BCs) were performed in 2,976 patients. BCs were positive in 2,447 tests, representing 740 infective/febrile episodes: 358 (48%) in medical oncology and 382 (52%) in surgical wards. Gram-positives were responsible for the majority of episodes in oncological and surgical divisions (about 63% and 55%, respectively). Gram-positives were also the most common organism in non-catheter-related BSIs (CRBSIs) both in medical oncology (75%) and in surgical divisions (50%). Enterococci showed an increased resistance to levofloxacin, from 5.6% to 25.7% (p = 0.02) and to erythromycin, from 41.7% to 61.4%, (p = 0.05). Similarly, coagulase negative staphylococci (CoNS) developed resistance to levofloxacin and ciprofloxacin
Andre, Margaret; Day, Andrew S
Although prolonged jaundice (PJ) commonly occurs in infancy, there is not yet agreement as to the appropriate extent of investigations, particularly in otherwise well children. Significant pathologies may present with PJ in this age group and need to be considered. The aim of this retrospective study was to ascertain the causes of PJ in infants referred to a single tertiary paediatric centre. Infants referred with PJ over a 3-year period were identified. Clinical documentation, electronic notes and results of investigations performed prior to and after referral were reviewed. One hundred and sixty-seven infants with PJ were seen. Fifty-eight percent were over 28 days of age. Four patients had conjugated hyperbilirubinaemia. Eighteen percent of patients were found to have a specific medical diagnosis causing or contributing to PJ, almost half of whom had normal clinical examination. The single most common pathological cause for PJ was hypothyroidism found in six patients. This study demonstrates that normal clinical examination and exclusion of conjugated hyperbilirubinaemia are insufficient to exclude pathological causes of PJ. Overall, these children were referred late. Guidelines, in conjunction with education initiatives, are required to optimise the management of prolonged jaundice in infancy.
Brown, Alice; Danaher, Patrick
This paper analyses data from two sources of stakeholder feedback--first year pre-service teachers and supervising teachers/centre directors--about the issues involved in creating more collaborative approaches to the first year early childhood teacher education practicum at an Australian regional university. The collection of this feedback was…
Van Kalleveen, Michael W; de Meij, Tim; Plötz, Frans B
This study was undertaken to gain insight in the clinical spectrum of paediatric coeliac disease (CD) in a Dutch teaching hospital. We retrospectively compared the frequency of CD in children with a wide spectrum of complaints with and without CD antibodies in serum and were interested if certain complaints are more pathognomonic for CD. Furthermore, we expected that over a period of 10-year incidence rates of CD would have increased and shifted towards an atypical presentation with more non-gastrointestinal symptoms with increasing age. A retrospective, single-centre, case-control study was performed. All patients who presented at the Department of Paediatrics, Tergooi Hospital, with symptoms suspected for CD were eligible for inclusion during the study period from 1 January 2007 till 31 December 2016. Children were diagnosed with CD according to the 2005 and 2012 ESPGHAN guideline between 2007 and 2016, respectively. Demographic data, presenting symptoms, prevalence of associated conditions and serology results were examined. A total of 105 new cases of paediatric CD were observed, with an average of 10 new cases each year. The calculated incidence was 21.09 (CI 17.49-25.22)/100,000 under 18 years of age. About 40% were infants and toddlers, predominantly presenting with gastrointestinal symptoms. Primary and high school children had more display of atypical symptoms (p = 0.001, p = 0.017) and non-gastrointestinal symptoms (p = 0.009, p = 0.009) than infants and toddlers. In 8.6% of the CD patients, mostly primary school aged female patients, the serology was repeated at least once in time to become positive. The median time for serology to become positive was 609 days (range 140-1054). As it is well known, our study supports the increasing notion of a shift in the clinical spectrum of presenting symptoms in paediatric CD towards an atypical presentation, with more non-gastrointestinal symptoms and a diagnosis at a later age in a Dutch
Full Text Available Background: The aim of the study was to review the cases of all children who had gastric volvulus from 2002 to 2007 at a tertiary care centre in India and to compare the outcome of management with the reported series on gastric volvulus in a paediatric age group. Materials and Methods: This was a retrospective study of eight children with an age range between 10 days and 2 years who were managed for gastric volvulus between 2002 and 2007. The records of these patients were reviewed for clinical features, investigations, management and outcome. Results: All patients were less than 3 years of age with female preponderance (n = 5. Three patients had acute presentation and three had acute-on-chronic symptoms, while two had chronic gastric volvulus. The commonest symptom was abdominal distension. Two patients were diagnosed by barium studies and six had clinical suspicion because of their symptoms and were confirmed intra-operatively. Seven had secondary gastric volvulus of organo axial type with associated pathologies as congenital diaphragmatic hernia (n = 5, Para oesophageal hiatus hernia (n = 2, and one had primary gastric volvulus in a postoperative period in an operated case for a tracheo-oesophageal fistula (n = 1. Seven patients were symptom free at follow-up; one patient succumbed due to septicaemia in the immediate post-operative period which was not related to the pathology of gastric volvulus. Conclusion: Gastric volvulus is a rare condition in children and requires prompt diagnosis and urgent intervention in acute presentation where it mimics acute abdomen and strong clinical suspicion.
Gestic, Martinho Antonio; Callejas-Neto, Francisco; Chaim, Elinton Adami; Utrini, Murillo Pimentel; Cazzo, Everton; Pareja, Jose Carlos
Surgical treatment of chronic pancreatitis is indicated for intractable pain. Frey's procedure is an accepted treatment for this disease. The aim of the present study was to describe a single-centre experience in the treatment of chronic pancreatitis using Frey's procedure. A retrospective analysis of 73 patients who underwent a Frey's procedure between 1991 to 2007 and had at least 1 year of follow-up. Demographics, indication for surgery, peri-operative complications and late outcomes were analysed. The median age was 39.9 years. Seventy out of the 73 (95.8%) patients were male. The median pre-operative body mass index (BMI) was 19.1 kg/m(2). All patients had abdominal pain, 34 (46.6%) of them daily and 13 (17.8%) weekly, with moderate or severe intensity in 98.6% (n= 72). The aetiology was secondary to alcohol in 70 patients (95.9%), with a median consumption of 278 g per day. The surgical morbidity rate was 28.7%; there were no deaths. Median post-operative follow-up was 77.0 months; 64 patients (91.4%) had complete pain relief and post-operative BMI was 22.4 kg/m(2) (P<0.001). All patients with pre-operative endocrine and exocrine insufficiencies showed no reversal of the situation. New onset insufficiencies appeared late. Frey's procedure was a safe and effective therapeutic option for the surgical treatment of patients with intractable pain caused by chronic pancreatitis. © 2011 International Hepato-Pancreato-Biliary Association.
Describes the history, curriculum, and methodology of elementary school foreign-language (FL) learning within Waldorf schools, using information from Waldorf FL teachers, class observations, and research readings. Waldorf students study two FLs. An oral/choral method is used in the early years. Reading, writing, and formal grammar are introduced…
Swick, Kevin J.
This book provides early childhood educators with perspectives and tools that will enable them to strengthen parents and families during the child's earliest year of development. The 25 chapters are divided into 6 parts or themes. Part one focuses on understanding families as learners from an ecological and empathetic perspective, with the premise…
Alameen, Lubna; Male, Trevor; Palaiologou, Ioanna
The empirical research for this paper was undertaken with leaders of early years setting in the Kingdom of Saudi Arabia (KSA). The investigation sought to establish to what extent it was possible to behave in line with the concept of pedagogical leadership in the twenty-first century in an Arab Muslim monarchy, dominated by Islam, where directive…
This paper will explore arts-based educational research (ABER) as an effective and appropriate research method in the early years. It has been noted that the arts play an increasingly important role in the development of the child (Boone, 2008; Twigg, 2011a, 2011b; Twigg & Garvis, 2010; Wright, 2012). In fact McArdle and Wright (2014) call the…
Two-year college (TYC) physics teachers are not often required to provide student research experiences as a part of their contracted duties. However, some TYC physics faculty members are interested in developing research opportunities for their freshman- and sophomore-level students, often called "early undergraduate research" (EUR).…
Full Text Available Several studies showed the close relationship between Rheumatoid Arthritis (RA and cerebro-cardiovascular events (CVEs and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis.We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis.We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH, type 2 diabetes mellitus and metabolic syndrome (MS, at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis.Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors.
Full Text Available Abstract Background Fixation of trochanteric hip fractures using the Gamma Nail has been performed since 1988 and is today well established and wide-spread. However, a number of reports have raised serious concerns about the implant's complication rate. The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other obvious advantages, when this implant is employed. Through access to a uniquely large patient data base available, which is available for analysis of trochanteric fractures; we have been able to evaluate the performance of the Gamma Nail over a twelve year period. Methods 3066 consecutive patients were treated for trochanteric fractures using Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l'Orthopedie (CTO, Strasbourg, France. These patients were retrospectively analysed. Information on epidemiological data, intra- and postoperative complications and patients' outcome was retrieved from patient notes. All available radiographs were assessed by a single reviewer (AJB. Results The results showed a low complication rate with the use of the Gamma Nail. There were 137 (4.5% intraoperative fracture-related complications. Moreover 189 (6.2% complications were detected postoperatively and during follow-up. Cut-out of the lag screw from the femoral head was the most frequent mechanical complication (57 patients, 1.85%, whereas a postoperative femoral shaft fracture occurred in 19 patients (0.6%. Other complications, such as infection, delayed healing/non-union, avascular femoral head necrosis and distal locking problems occurred in 113 patients (3.7%. Conclusions The use of the Gamma Nail in trochanteric hip fractures is a safe method with a low complication rate. In particular, a low rate of femoral shaft fractures was reported. The low complication rate reported in this series can probably be explained by strict adherence to a proper
Vaish, Amrisha; Grossmann, Tobias; Woodward, Amanda
Prior work suggests that young children do not generalize others' preferences to new individuals. We hypothesized (following Vaish et al., 2008, Psychol. Bull., 134, 383-403) that this may only hold for positive emotions, which inform the child about the person's attitude towards the object but not about the positivity of the object itself. It may not hold for negative emotions, which additionally inform the child about the negativity of the object itself. Two-year-old children saw one individual (the emoter) emoting positively or negatively towards one and neutrally towards a second novel object. When a second individual then requested an object, children generalized the emoter's negative but not her positive emotion to the second individual. Children thus draw different inferences from others' positive versus negative emotions: Whereas they view others' positive emotions as person centred, they may view others' negative emotions as object centred and thus generalizable across people. The results are discussed with relation to the functions and implications of the negativity bias. © 2015 The British Psychological Society.
Biasco, Luigi; Cristoforetti, Yvonne; De Backer, Ole; Castagno, Davide; Giustetto, Carla; Orzan, Fulvio; Gaita, Fiorenzo
For more than 70 years, early repolarization has been considered to be a common normal variant. In the general population, the prevalence ranges between 5 and 13%, and in athletes, a rising trend is observed from 20 to 90%. Nevertheless, from the latter half of the 1990s, a growing number of case reports, series, observational and prospective studies reported that the presence of various electrocardiographic patterns attributed to early repolarization may constitute a potential marker for the increased risk of sudden death in otherwise normal individuals, casting a dark shadow on this ECG peculiarity. This review provides a historical summary of the evolution of the concept of early repolarization from its original description to the latest works and a guide to help physicians in evaluating individuals with this common electrocardiographic pattern.
Twenty early childhood student educators were surveyed on their teaching practices when working with children learning English as a second language in early childhood centres in New Zealand. The bilingual and trilingual participants stated that their practices were based on their own language learning experiences, theories learned in class and…
Koh, Hoey; McSorley, Stephen; Hunt, Sarah; Quinn, Martha; MacKay, Graham; Anderson, John
Sacral nerve stimulation (SNS) is increasingly popular in the management of faecal incontinence. This paper reports the first 10-year experience of SNS in the management of faecal incontinence at a tertiary referral centre. Data was collected in a prospectively maintained database. In total 130 patients were referred. The majority were women (94%) under 75-year-old (98%). Seven patients were found to have full-thickness rectal prolapse at the initial work-up and proceeded to rectopexy. Eighty-three patients underwent temporary SNS testing with 73.5% positive outcome, of which 52 patients had permanent implant insertion. There were four failures of SNS (7%) following implantation despite successful temporary testing, seven infection, one lead migration and three post-operative pain/numbness. One patient subsequently developed colorectal cancer requiring SNS removal. A higher frequency of episodes of incontinence was associated with positive SNS outcome (p = 0.007). There was no significant association between age, sex, type of faecal incontinence, previous anorectal/pelvic surgery, colonoscopic or USS findings and the likelihood of successful SNS. Of the 52 patients with SNS implants, 27 patients were seen only once for follow-up; the remaining 25 patients were seen more than once - five of these were part of our initial cases of routine 6- and 12-monthly follow-up, 6 patients were seen for adjustment of voltages, whereas the remaining 14 patients were seen for complications of the implants. If the initial five patients were excluded, only 38% of patients would have been seen more frequently on an as-required basis. SNS is a safe and effective option in the management of faecal incontinence. Of the initial work-up, endoscopy and examination-under-anaesthesia (EUA) or proctogram are essential and more likely to influence the likelihood of suitability of SNS testing. A patient-led drop-in approach to follow-up is feasible to allow patients to be seen on an as
Full Text Available Sheppard Frere was Professor of the Archaeology of the Roman Empire at Oxford from 1967 to his retirement in 1983, but most of his early career as a university teacher and scholar was spent at the Institute, where he was the first full-time Professor of the Archaeology of the Roman Provinces. Here he recalls his years at the Institute, from 1955 to 1966, first at St John’s Lodge and later in Gordon Square.
Lesny, Peter; Luknar, Milan; Matejka, Martin; Varga, Ivan; Solik, Peter; Wimmerova, Sona; Goncalvesova, Eva
Patients with advanced heart failure (HF) represent a pool of candidates for heart transplantation and long-term mechanical circulatory support devices. The aim of our study was to determine simple and reliable markers of one-year mortality for selection of the most suitable patients for heart replacement therapy. One thousand consecutive patients with HF (mean age 49 ± 10.9 years; 86.8% males) referred to a single tertiary centre from January 1998 to January 2010 in order to assess the indication for heart transplantation were enrolled. Kaplan-Meier survival analysis was performed. Independent mortality predictors were established using logistic regression analysis. The mean follow-up was 4.3 ± 2.7 years (range 1-12 years). Cumulative survival was as follows: 1-year survival 83%, 3-year 63%, 5-year 50%, 7-year 39%, and 10-year 23%. Independent predictors of 1-year mortality included coronary artery disease, left ventricular diastolic diameter >79 mm, plasma sodium 240 mg/day. Short-term prognosis of HF patient can be estimated based on simple parameters. Patients with signs of poor prognosis should be referred to tertiary centres to be considered for heart replacement therapy.
Anfinan, Nisrin; Sait, Khalid; Ghatage, Prafull; Nation, Jill; Chu, Pam
The aim of this study was to review the clinical outcomes of patients with borderline ovarian tumors (BOTs) at Tom Baker Cancer Centre (TBCC) and to assess the value of surgical staging. This retrospective study included 138 patients treated for BOTs at TBCC between January 1994 and December 2005. Patients were divided into two groups: group I with complete surgical staging (n = 89) and group II with incomplete surgical staging (n = 49). This population-based study identified patients using the Alberta Cancer Registry. Charts were reviewed by a single person. Data extracted included demographic information and prognostic factors such as age, histological type, laterality of the cyst, presence of microinvasion, and the type of surgical procedure. Data were extracted and entered into a study database for analysis. Overall survival and overall recurrence-free survival of both groups were calculated using the Kaplan-Meier method. Risk factors for recurrence were analyzed using Cox regression analysis. A total of 138 patients were enrolled, with a mean age of 46 years. The median follow-up time was 37 months. The most common histological type of BOT was the serous type found in 70 (50.7%) patients. Microinvasion was identified in four (2.9%) patients. Twelve patients were found to have implants as result of the staging procedure; two of them were invasive implants and both required chemotherapy. Forty-three (31%) patients had conservative surgery and 95 (68.8%) patients had non-conservative surgery. Nine (6.5%) patients experienced recurrence: five (5.6%) patients in group I versus four (8.2%) patients in group II. The presence of microinvasion is the risk factor for recurrence (P = 0.013). The indications for restaging surgery remain controversial, as there was no difference in recurrence rates observed between the study groups. However, surgical staging is important for identifying invasive extraovarian implants that need to be treated with chemotherapy. For patients
Anna Klimek; Anna Górska; Marzenna Radecka; Emilia Podgórska; Ewa Zarzecka
Aim of the study: The analysis of the types of developmental disorders in early childhood. Material and methods: Seventy-one children at the age from 7 days to 3 years who came to The Early Intervention Centre for Handicapped Children “Give the Chance” at University Children’s Clinical Hospital in Bialystok in 2010 were examined. There were 46 (65%) boys and 25 (35%) girls in that group. The most common reason for coming to the Centre was the psychomotor retardation – 38 (54%) sub...
Carlsson, Lars; Englund, Lars; Hallqvist, Johan; Wallman, Thorne
Abstract Objective To study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre. Design Randomized controlled trial. Setting Patients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapi...
Brouwer, Jasperina; Jansen, Ellen; Hofman, Adriaan; Flache, Andreas
Two theoretical approaches underlie this investigation of the determinants of early study success among first-year university students. Specifically, to extend Walberg's educational productivity model, this study draws on the expectancy-value theory of achievement motivation in a contemporary university context. The survey data came from 407…
Kumar, Apoorva; Shankar, Ravi; Pandey, Rajendra P; Keshri, Virendra; Singh, Kulwant; Sharma, Vivek
India, an agriculture-based country, relies heavily on indigenous farm machinery. In our study we present 31 patients with winnowing fan blade head injury, operated on at our centre between 2004 and 2008. The mechanism and nature of the injuries, operative methods, outcome and methods of prevention are discussed with special reference to the occurrence of this type of injury in the pediatric population. Copyright 2009 Elsevier Ltd. All rights reserved.
Jensen, Jytte Juul
The article examines Danish pedagogue students' supervision during their placement periods in early childhood settings. Throughout the long history of Danish pedagogue education, discourses relating to the placement element have been located either within a "work" paradigm or a "scholastic" paradigm. These two understandings of…
Fincham, Emmanuelle N.; Fellner, Amanda R.
Transitions from one classroom to the next as children reach a certain age or achieve certain milestones seem inevitable; however, this taken-for-granted practice in early childhood centers has not been looked at closely in research. This article considers what happens when we look more in depth at these day-to-day experiences of teachers and…
Underwood, Kathryn; Trent-Kratz, Marion
Increasingly, governments are seeking ways to integrate early childhood education and care services as a social policy strategy to maximize child and family outcomes. This study examines the role of a school-based parenting and family literacy program to a system of services in one community in Ontario, Canada. Using an appreciative inquiry…
Full Text Available This article considers what the migration circuits to and from Suriname can tell us about Dutch early modern colonisation in the Atlantic world. Did the Dutch have an Atlantic empire that can be studied by treating it as an integrated space, as suggested by New Imperial Historians, or did colonisation rely on circuits outside Dutch control, stretching beyond its imperial space? An empire-centred approach has dominated the study of Suriname’s history and has largely glossed over the routes taken by European migrants to and from the colony. When the empirecentred perspective is transcended it becomes possible to see that colonists arrived in Suriname from a range of different places around the Atlantic and the European hinterland. The article takes an Atlantic or global perspective to demonstrate the choices available to colonists and the networks through which they moved.
Trojánek, Milan; Maixner, Jan; Sojková, Naděžda; Kynčl, Jan; Roháčová, Hana; Marešová, Vilma; Stejskal, František
Dengue fever is a frequent cause of morbidity in travellers. The objective was to describe the epidemiological and clinical characteristics of dengue fever in Czech travellers. This descriptive study includes patients with acute dengue fever diagnosed at Hospital Na Bulovce during 2004-2013. Data were collected and analysed retrospectively. A total of 132 patients (83 males and 49 females) of median age 33 years (IQR 29-40) were included. Diagnosis was established by NS1 antigen detection in 87/107 cases (81.3%) and/or RT-PCR in 50/72 (69.4%) and by serology in 25 cases (18.9%). Dengue was acquired in South-East Asia in 69 cases (52.3%), followed by South Asia (48 cases; 36.3%), Latin America (14; 10.6%) and Sub-Saharan Africa (1; 0.8%). The most frequent symptoms included fever, rash and headache. Initial leukocyte and lymphocyte counts were lower in patients who presented in the early phase (0-4 days), however, platelet count was lower and AST, ALT and LDH activity higher in patients with a longer symptoms duration (≥5 days). The clinical course was mostly uncomplicated. Dengue fever is becoming a frequent cause of fever in Czech travellers. Clinicians should be familiar with the typical clinical findings and novel diagnostic methods. Copyright © 2015 Elsevier Ltd. All rights reserved.
Sobolowski, Stefan; Henshilwood, Christopher; Jansen, Eystein
Homo sapiens was anatomically modern by 200 000 years ago in Africa, but there is no archaeological evidence to demonstrate that behaviour was modern at the time. Attributes of modern behaviour, perhaps inspired by changes in the human brain, are only recognizable after 100 000 years ago. Before we can study the process, we must critically define the criteria for the term 'modern behaviour' and then find a means to recognize such behavior in the record. This seemingly simple research statement involves complex exploration by a team of specialists. In this highly competitive research field our centre will, for the first time, be able to rise to the challenge by combining the skills of cutting-edge scientists in archaeology, climate reconstruction and modelling, and the cognitive and social sciences. Over the next decade we will integrate knowledge and methods from different disciplines to synthesize approaches and contribute to a sophisticated understanding of early human behaviour. Our highly ambitious research program will focus explicitly on rare, well preserved archaeological sites occupied in the period between 100-50 000 years ago because these contain the 'keys' for unlocking the past. A major competitive edge is the EHB Director's 25 years of archaeological experience and his long-term exclusive access, with permits, to a number of the best-preserved sites in the southern Cape, South Africa - a region regarded as a major locus for vital evidence that could inform on the behaviour of early humans. Our planned excavations at existing and new sites and our ground-breaking and innovative interdisciplinary approaches, including climate (The Bjerknes Centre for Climate Research) and cognitive research, to understanding the processes that shaped human cultures. Primarily, EHB will directly address unanswered, first order questions about Homo sapiens: a) what defines the switch to 'modern behaviour', exactly how should this term be defined and then, when, why and
Springate, Ian; Atkinson, Mary; Straw, Suzanne; Lamont, Emily; Grayson, Hilary
This report was commissioned by the Local Government Association (LGA) to inform the Department for Children, Schools and Families (DCSF) and LGA work on "Narrowing the Gap." It focuses on early years' provision and presents findings from a review of the best evidence on narrowing the gap in outcomes across the five Every Child Matters…
To be effective, early warning systems for natural hazards need to have not only a sound scientific and technical basis, but also a strong focus on the people exposed to risk, and with a systems approach that incorporates all of the relevant factors in that risk, whether arising from the natural hazards or social vulnerabilities, and from short-term or long-term processes. Disasters are increasing in number and severity and international institutional frameworks to reduce disasters are being strengthened under United Nations oversight. Since the Indian Ocean tsunami of 26 December 2004, there has been a surge of interest in developing early warning systems to cater to the needs of all countries and all hazards.
Nestel, Debra; Kidd, Jane
Peer tutoring is a potentially valuable resource in higher education. There are few published accounts of the impact of peer tutoring in medical education. College-wide experience of peer tutoring together with difficulties recruiting medical teachers for a communication programme led to the development of a peer-tutoring project. This paper reports the impact on first-year medical students of peer tutoring in patient-centred interviewing. After attending a preparatory workshop, third-year medical students co-facilitated their first-year colleagues in a session:Interviewing a Simulated Patient. First-year students completed written evaluations immediately after the session and two months later randomly selected students were assessed in patient-centred interviews. The impact of the peer-tutoring experience was evaluated by comparing these outcomes for students in groups co-facilitated by peer tutors with those who worked in groups facilitated by medical teachers. The eight learning objectives were completely met by more than 56% of students. However, there were statistically significant differences for four objectives with more students in groups facilitated by medical teachers completely meeting these objectives. Although the seven educational techniques used in the session were rated favourably by all students, two were rated as more effective in achieving the learning objectives by students in groups facilitated by medical teachers. Free-text comments revealed no differences between groups. Two months after the session, there were no differences between students in terms of interviewing skills as rated by trained observers and simulated patients, whilst simulated patients were more satisfied with interviews from students facilitated by peer tutors (p Peer tutors can support the acquisition of basic patient-centred interviewing skills in first-year medical students when contributing to one session of a structured programme. First-year students were receptive and
Goldie, John; Dowie, Al; Cotton, Phil; Morrison, Jillian
Despite the growing literature on professionalism in undergraduate medical curricula, few studies have examined its delivery. This study investigated tutors' and students' perspectives of the delivery of professionalism in the early years of Glasgow's learner-centred, problem-based learning (PBL), integrated medical curriculum. A qualitative approach was adopted involving semistructured interviews, on a 1 in 6 sample of tutors involved in teaching in the early curricular years, and 3 student focus groups. The findings were subjected to between-method triangulation. Involvement in teaching raised students' and tutors' awareness of their professionalism. Learning activities promoting critical reflection were most effective. The integration of professionalism across the domains of Vocational Studies (VS) was important for learning; however, it was not well integrated with the PBL core. Integration was promoted by having the same tutor present throughout all VS sessions. Early patient contact experiences were found to be particularly important. The hidden curriculum provided both opportunities for, and threats to, learning. The small-group format provided a suitable environment for the examination of pre-existing perspectives. The portfolio was an effective learning tool, although its assessment should be formalised. Reflection is integral to professional development. Early clinical contact is an important part of the process of socialisation, as it allows students to enter the community of practice that is the medical profession. Role models can contribute powerfully to students' learning and identity formation. As students move towards fuller participation, the clinical milieu should be controlled to maximise the influence of role models, and opportunities for guided reflection should be sustained.
Gerety, E.L.; Hopper, M.A. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Grant, I. [Cambridge University Hospitals NHS Foundation Trust, Department of Plastic Surgery, Cambridge (United Kingdom)
Congenital hand anomalies present a rare but important physical and emotional challenge for children and parents. Radiological imaging is important for accurate diagnosis, to aid decision making and to monitor changes in the growing hand. The goal of any treatment is to help the child achieve his/her maximum potential, to provide a useful hand with attention to cosmesis. We investigated the range of congenital hand anomalies imaged in a tertiary referral centre. We examined the timing of imaging and the key clinical questions. The radiology imaging system was searched retrospectively for radiographs of congenital hand anomalies over a 6-year period. The images were reviewed and patient demographics, diagnosis and other imaging recorded. Over 6 years, 85 patients had imaging. Twenty-three patients had bilateral problems and 11 had recognised syndromes. The most common abnormalities imaged were duplicated thumbs (28 %), followed by syndactyly (18 %). Children were first imaged as early as 1 day old, with the median age of initial imaging 12 months. Thumb duplication and syndactyly are the most common conditions for which radiographs are requested at our hospital, although overall syndactyly is considered the most common congenital hand anomaly. For a variety of reasons, children are often imaged very early, before review by the Specialist in Children's Hand Surgery (despite surgery being unlikely before 1 year of age.) We discuss the classification systems and specific issues that hand surgeons want to know from the radiologists. (orig.)
Full Text Available Laparoscopic colon resection has established its role as a minimally invasive approach to colorectal diseases. Better long-term survival rate is suggested to be achievable with this approach in colon cancer patients, whereas some doubts were raised about its safety in rectal cancer. Here we report on our single centre experience of rectal laparoscopic resections for cancer focusing on short- and long-term oncological outcomes. In the last 13 years, 248 patients underwent minimally invasive approach for rectal cancer at our centre. We focused on 99 stage I, II, and III patients with a minimum follow-up period of 5 years. Of them 43 had a middle and 56 lower rectal tumor. Laparoscopic anterior rectal resection was performed in 71 patients whereas laparoscopic abdomino-perineal resection in 28. The overall mortality rate was 1%; the overall morbidity rate was 29%. The 5-year disease-free survival rate was 69.7%, The 5-year overall survival rate was 78.8%.
Ahmed, W.; Qureshi, H.; Arif, A.; Alam, S.E.
To determine the frequency and pattern of Hepatitis B and C over the past twenty one years, in a liver research unit of Karachi. Retrospective analysis of the records of PMRC, Research Centre, Jinnah Postgraduate Medical Centre, Karachi, from 1987 to 2007 were reviewed. A special flow sheet was made where information of all patients with viral liver disease was entered. Patients having complete information of viral markers were included in the analysis. Cases with HBsAg, Anti HBc IgM positive and raised ALT were considered as acute Hepatitis B. HBs Ag/ Anti HBc IgG positive were considered as chronic Hepatitis B. Delta antibody positive with or without HBsAg were considered as Delta Hepatitis. Anti HCV positive and raised ALT more than ten times for less than 6 months were considered as acute Hepatitis C, whereas Anti HCV and HCV-RNA positive with or without raised ALT for more than six months were considered as chronic Hepatitis C. Anti HEV IgM and Anti HAV IgM positive were considered as acute Hepatitis E and A respectively. A total of 5193 cases fulfilling all criteria of viral hepatitis were seen in the past 21 years. Of the total 3247 (62.5 %) were males and 1946 (37.5 %) females giving a male to female ratio of 1.7:1 Hepatitis C was the most common infection seen in 2896 cases (55.8 %), followed by Hepatitis B in 1691 cases (32.6 %). Seventy five percent cases of Hepatitis B were males and 25 % females while 55% Hepatitis C cases were males and 45 % females. Hepatitis B was seen a decade earlier in different age groups than hepatitis C. Overall, out of the total 5193 cases, 2294 (44.2%) were of chronic hepatitis, 1430 (27.5%) cirrhosis, 1083 (20.8%) carriers and 346 (6.7%) had acute hepatitis (hepatitis B; 214 (61.8%), hepatitis C; 21 (6.0%). While hepatitis B and hepatitis C both were present in 3 (1.3%). Hepatitis E was 70 (20.2%) hepatitis A 12 (3.5%) and all markers were negative in 26 (7.5%) cases). Forty cases (0.8%) were of Hepatocellular carcinoma
Edwards, Susan; Henderson, Michael; Gronn, Donna; Scott, Anne; Mirkhil, Moska
A digital disconnect perspective is founded on an assumption that technology use in the home is frequent, creative and generative, and that technology use in the early childhood centre should be the same as that found in the home. However, such arguments divert our attention from understanding the nature of the setting and thereby from an…
Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families.
Hollar, T Lucas; Cook, Nicole; Natale, Ruby; Quinn, David; Phillips, Teina; DeLucca, Michael
We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards. We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design. ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA. Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre. We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01). Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.
Galina P. Lavrentieva
Full Text Available The article highlights the propaedeutic of information culture in the early school years. It reveals the principles, conceptual frameworks of continuous development of information culture of a pupil. It investigates the processes and characteristics of the use and application of ICT in the educational process of children of primary school age. The factors that influence the effectiveness of training and safe use of computer technology that essential for information culture formation are identified. Methodological advice and psychological and pedagogical requirements for the educational environment, providing psychological comfort of a child being essential for propaedeutic of information culture are outlined. The main trends of teacher’s information culture formation are identified.
The early years of molecular biology were characterized by a strong interaction between theory and experiment. This included the elucidation of the structure of DNA itself; genetic fine structure, recombination and repair; DNA replication; template-directed protein synthesis; the universality of the triplet genetic code, and the co-linearity of the DNA sequence of structural genes and the sequence of amino acids in proteins. The principle of co-linearity was later modified when split genes were discovered. It is suggested that accurate splicing of gene transcripts might also be template directed. In 1958 Crick proposed a 'central dogma' of molecular biology stating that information could not be transmitted from proteins to DNA. Nevertheless, proteins can chemically modify DNA, and this is now known to have strong effects on gene expression.
Hammond, C.J. [Leeds General Infirmary, Leeds (United Kingdom)], E-mail: email@example.com; Bakshi, D.R. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Currie, R.J. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); Patel, J.V. [Leeds General Infirmary, Leeds (United Kingdom); Kinsella, D. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); McWilliams, R.G. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Watkinson, A. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); Nicholson, A.A. [Leeds General Infirmary, Leeds (United Kingdom)
Aim: To audit the use of inferior vena cava (IVC) filter insertions at three UK centres over 12 years to assess whether trends in filter use in the UK mirrored those seen elsewhere. Materials and methods: Radiology department databases were interrogated for IVC filter insertions and removals between 1994 and 2006. Reports for these interventions, along with prior and subsequent imaging reports, were analysed. Follow-up data were obtained when available. Results: Five hundred and sixteen filters were placed with a significant year-on-year trend towards increasing use. Fifty-seven percent of filters placed were for absolute indications and 37% for relative indications. The filters were used for prophylaxis in 6% of patients in the absence of proven pulmonary embolism (PE) or deep vein thrombosis (DVT). A retrievable filter was used in 74% of cases with retrieval attempted in 40% of these and no evidence of an increasing rate of retrieval over time. A significant complication related to insertion or retrieval was encountered in 0.4 and 1% of procedures, respectively. Mean 24 h and 30 day mortalities were 1 and 8%, respectively. There was an absence of organized follow-up at all three centres. Conclusion: IVC filter use in the UK is increasing. The use of retrievable filters has not resulted in increased filter retrieval. Filter insertion and retrieval is associated with a low risk of significant complication, but lack of systematic follow-up limits conclusions regarding safety and efficacy.
Cheng, Chi-Hung; Shu, Kuo-Hsiung; Chuang, Ya-Wen; Huang, Shih-Ting; Chou, Ming-Chih; Chang, Horng-Rong
Peritoneal dialysis (PD) is an alternative treatment for elderly patients with end-stage renal disease (ESRD). In Taiwan, non-professional personnel are employed to provide assisted care for elderly patients. Whether assisted care is appropriate for elderly patients is unknown. The aim of this paper is to evaluate the outcomes of assisted care in a single centre. This is a retrospective cohort study in a single medical centre. The outcomes were derived from the assessment of patient survival, technique survival and peritonitis incidence between self-care patients and assisted-care patients. From 1984 to 2010, there were 138 elderly PD patients at Taichung Veterans General Hospital, of which 70% were assisted-care patients and 30% self-care patients. The mean duration of PD survival was 49.2 months in self-care patients, which was significantly longer than the 17.0 months of assisted-care patients (P self-care patients had a lower risk in both patient survival (Hazard Ratio 0.15; 95% confidence interval (CI) 0.2-0.94, P care patients. Type of assistance was not a risk factor for PD-related peritonitis. Our elderly assisted care had patients had a poorer survival and technique survival rates than those of the self-care patients. We argue that this is because early recognition of medical deterioration and early medical intervention are necessary for a better outcome for elderly PD patients. © 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.
Sanyaolu, Leigh; Javed, Muhammad Umair; Eales, Micheal; Hemington-Gorse, Sarah
Paediatric burns make up a significant proportion of burn injured patients seen within the hospital setting and worldwide account for a significant proportion of unintentional deaths. Currently there is limited data on severe paediatric burns requiring intensive care support. Our study aimed primarily to describe the epidemiology of severe burns admitted to the intensive care unit at our centre receiving fluid resuscitation over a 10 year period. A secondary aim was to describe the referrals patterns in general over the same time period. A retrospective analysis was performed for paediatric patients referred to our centre receiving fluid resuscitation and intensive care support from 2003 to 2013. We also analysed the patterns of referrals, admissions and need for surgical intervention over the same time period retrospectively. Children less than 5 years old made up 65% of admissions to intensive care and scald injuries (56%) were the commonest aetiology. Both total length of stay (25 days in 2003 to 10 days in 2013) and intensive care length of stay (7.2 days in 2003 to 3 days in 2013) decreased during the study and less patients underwent operative intervention. Referrals to our centre increased from 261 in 2003 to 366 in 2013, however admission rates declined from 145 to 85 during that time period. Currently there is limited data on severe burns within the paediatric population. Our study provides epidemiological data in this area, an important step for developing future prevention strategies. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
Cornelius, Amajuoyi C; Onyegbule, A; Onyema; Uchenna, Ejelonu T; Duke, Onyeabochukwu A
Ectopic pregnancy remains a leading cause of maternal morbidity and mortality in the first trimester of pregnancy in developing countries. To determine the incidence, pattern of presentation and management of ectopic pregnancies at Federal Medical Centre (FMC) Owerri. This was a retrospective descriptive study of all cases of ectopic gestations managed at FMC Owerri between 1st January 2009 and 31st December, 2013. The case notes were retrieved from the hospital's Records Department and information on socio-demographic characteristics, age, and parity, clinical presentation, findings at laparotomy, estimated blood loss and the need for blood transfusion were obtained. Data were entered into SPSS 17.0 and analysed descriptively. There were 382 cases of ectopic gestations out of the total 9880 total deliveries within the study period. The incidence of ectopic pregnancy was 38.66 per 1,000 live births or I in 26 deliveries. Nulliparous women were 132 (34.5%). At presentation, 99.47% of patients had rupture with haemoperitoneum, with the commonest site being the ampulla of the fallopian tube as seen in 338 (88.4%). Salpingectomy was done in majority of cases, accounting for 355 (93%), while 248 (65%) had blood transfusion. Five (1.3%) maternal deaths occurred during period of study. Ectopic pregnancy presents a major public health challenge among women of reproductive age groups in Nigeria. Efforts should be directed to public awareness on sex education, contraception, prevention and treatment of common risk factors for ectopic pregnancy.
Tang, T Y; Kam, J W; Gaunt, M E
Objectives This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. Methods A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment. Postoperative complications were recorded along with patient satisfaction. Results All 393 procedures were completed successfully under local anaesthetic. Complete occlusion of the treated vein was initially achieved in all the patients, but at eight weeks' follow-up, there was only partial obliteration in 13/393 (3.3%) veins. These were all successfully treated with ultrasound-guided foam sclerotherapy. Procedures were well tolerated with a mean pain score of 0.8 (0-10). No significant complications were reported. Conclusions ClariVein® can be used to ablate long and short saphenous varicose veins on a walk-in-walk-out basis. Bilateral procedures can be successfully performed, and these are well tolerated as can multiple veins in the same leg. Early results are promising but further evaluation and longer term follow-up are required.
Durante-Mangoni, Emanuele; Andini, Roberto; Agrusta, Federica; Iossa, Domenico; Mattucci, Irene; Bernardo, Mariano; Utili, Riccardo
Infective endocarditis (IE) due to gram-negative (GN) bacilli is uncommon. Although multi- and extensively-drug resistant (MDR/XDR) GN infections are emerging, very few data are available on IE due to these microrganisms. In this study, we describe the clinical characteristics, course and outcome of five contemporary, definite, MDR/XDR GNIE cases seen at our centre. All patients had been admitted to a hospital during the 6months before IE onset, 2 were on hemodialysis and 3 on intravenous medications. Three of the 5 cases were hospital-acquired. Intracardiac prosthetic devices were present in all cases (3 central venous lines, 2 prosthetic heart valves, 2 pacemakers). Mean Charlson comorbidity index was 5.8. Causative pathogens were XDR Pseudomonas aeruginosa (2 cases), XDR Acinetobacter baumannii, MDR Burkolderia cepacia and MDR Escherichia coli (1 case each). Concomitant pathogens with a MDR/XDR phenotype were isolated in 4 patients. Both valves and intracardiac devices and left and right sides of the heart were involved. The rate of complications was high. Antibiotic treatment hinged on the use of colistin, a carbapenem or both. Cardiovascular surgical procedures were performed in 3 patients. Despite aggressive therapeutic regimens, outcomes were poor. Clearance of bacteremia was obtained in 3 patients, in-hospital death occurred in 3 patients, only 1 patient survived during follow up. MDR/XDR GN are emerging as a cause of IE in carriers of intracardiac prostheses with extensive healthcare contacts and multiple comorbidities. Resistant GNIE has a complicated course and shows a dismal prognosis. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Ping, Ping; Zhu, Wen-Bing; Zhang, Xin-Zong; Yao, Kang-Shou; Xu, Peng; Huang, Yi-Ran; Li, Zheng
Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple centres in China from January 2003 to December 2008. The collected data included urogenital history, indication for cryopreservation, semen parameters, use rate, type of assisted reproductive technique (ART) treatment and pregnancy outcome. The study population included 1 548 males who had banked their semen during the study period at one of the clinics indicated above. Approximately 1.9% (30/1 548) of the cryopreserved semen samples were collected from cancer patients; about 88.8% (1 374/1 548) of the patients had banked their semen for ART and 8.6% (134/1 548) had a male infertility disease (such as anejaculation, severe oligozoospermia and obstructive azoospermia). The total use rate of cryopreserved semen was 22.7% (352/1 548), with 119 live births. The cancer group use rate was 6.7% (2/30), with one live birth by intracytoplasmic single sperm injection (ICSI). The ART group use rate was 23.2% (319/1 374), with 106 live births. The reproductive disease group use rate was 23.1% (31/134), with 12 live births. The semen parameters in each category varied; the cancer patient and infertility disease groups had poor semen quality. In vitro fertilization (IVF) and ICSI were the most common ART treatments for cryopreserved sperm. Semen cryopreservation as a salvage method is effective, but in many conditions it is underutilized, especially in cancer patients. Lack of awareness, urgency of cancer treatment and financial constraints are the main causes of the low access rate. The concept of fertility preservation should be popularized to make better use of this medical service in China. PMID:20348941
Onakpoya, Uvie Ufuoma; Adenle, Adebisi David; Adenekan, Anthony Taiwo
More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study. The medical records of the patients were examined and data on age, sex, diagnosis, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted and the data was analysed using SPSS version 16. Eighteen patients comprising of 12 males and 6 females with ages ranging between 8 months and 52 years (mean= of 15.7 +/- 15 years) were studied. Pericardial patch closure of isolated ventricular septal defect was done in 7 patients (38.9%) while total correction of isolated tetralogy of Fallot was carried out in 5 patients (27.8%). Two patients had mitral valve repair for rheumatic mitral regurgitation. Sixty day mortality was 0%. Safe conduct of open heart surgery in the private hospital setting is feasible in Nigeria. It may be our only guarantee of hitch free and sustainable cardiac surgery.
Salazar, Gabriela; Vásquez, Fabián; Rodríguez, Maria P; Andrade, Ana M; Anziani, Maria A; Vio, Fernando; Coward, Williams
the doubly labelled water (DLW) method has an accuracy of 1% and within-subject precision of 5-8%, depending on subject's age and environments issues. Energy intake assessment is prone to errors (>15- 20%) depending in the method utilized. to quantify DLW methodology errors in four to five year olds that could affect the comparison with energy intake. energy expenditure (TEE, by DLW), was assessed during 14 days in 18 preschool children, who attended eight hours daily to day-care centres. Energy intake was determined by a combined method: food weighing during weekdays and recall after leaving the Centre (17h to sleep time) plus 24 h recall, during the weekend. Several assumptions affecting DLW total error were assessed to determine their influence in the comparison to energy intake (i.e. background variability, space ratio, proportion of water subject to fractionation, food quotient value). the individual mean energy expenditure was 1 373 ± 177 kcal and the energy intake (1 409 ± 161 kcal). The overall difference between intake and expenditure was 42.9 kcal/day (limits of agreement + 259.1 to -112.3 kcal/day). TEE measurement error only explained a minor quantity (2.4%), between both measurements, and the observed mean isotope dilution space was 1.030 ± 0.010 confirming the value utilized in adults studies. energy expenditure data is similar to other studies in preschool children. The small difference found between energy intake and expenditure may be attributed to the applied energy intake methodology, the homogeneous diet at care centres during the week-days and the lower DLW methodology error. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
It has been 54 years already, ever since the Nursery school was founded in March 1961, that the Staff Association together with the teachers, the managerial and the administrative staff, welcomes your children at the start of the school year. On Tuesday, 30 August 2016, the Children’s Day-Care Centre (EVE) and School opened its doors again for children between four months and six years old. The start of the school year was carried out gradually and in small groups to allow quality interaction between children, professionals and parents. This year, our structure will accommodate about 130 children divided between the nursery, the kindergarten and the school. Throughout the school year, the children will work on the theme of colours, which will be the common thread linking all our activities. Our team is comprised of 38 people: the headmistress, the deputy headmistress, 2 secretaries, 13 educators, 4 teachers, 11 teaching assistants, 2 nursery assistants and 4 canteen workers. The team is delighted...
Albert, Nikolai; Melau, Marianne; Jensen, Heidi
of three core elements-modified assertive community treatment, family involvement, and social skill training-with a patient-case manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group......OBJECTIVE: To compare the effects of five years of specialised early intervention (SEI) treatment for first episode schizophrenia spectrum disorder with the standard two years of SEI plus three years of treatment as usual. DESIGN: Randomised, superiority, parallel group trial with blinded outcome...... assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. SETTING: Participants were recruited from six OPUS teams in Denmark between 2009 and 2012. OPUS teams provide SEI treatment to all patients diagnosed with a schizophrenia spectrum...
Albert, Nikolai; Melau, Marianne; Jensen, Heidi
of three core elements-modified assertive community treatment, family involvement, and social skill training-with a patientcase manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group......Objective To compare the effects of five years of specialised early intervention (SEI) treatment for first episode schizophrenia spectrum disorder with the standard two years of SEI plus three years of treatment as usual. Design Randomised, superiority, parallel group trial with blinded outcome...... assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. Setting Participants were recruited from six OPUS teams in Denmark between 2009 and 2012. OPUS teams provide SEI treatment to all patients diagnosed with a schizophrenia spectrum...
Therkildsen, Ole Roland; Balsby, Thorsten Johannes Skovbjerg; Groom, Geoffrey Brian
The Department of Bioscience, Aarhus University was commissioned by the DanishNature Agency to undertake a bird monitoring programme of a national testcentre for wind turbines near Østerild in Thy, Denmark. Here we present the results from the first year of the post-construction studies. Whooper ...
Full Text Available Background: This study aimed to evaluate congenital diaphragmatic hernia (CDH patients in our department during a 4-year period. Patients and Methods: A retrospective study of 10 cases of CDH patients managed in the Neonatology and Pediatric Surgery Units of Goztepe Teaching Hospital from 2000 to 2004. Results: The mean birth weight of the patients was 2,600 g and the mean gestational age was 37.6 weeks. The mean admission time for the patients was 10.4 h. The mortality rate was 50%, comprising two deaths before operation and one during operation. The surviving infants followed for 1 year are free of any symptoms and complications. Conclusion: Conventional ventilation is an other treatment modality, especially in order to gain time before surgical operation for newborns with CDH.
Bejiqi, Ramush A.; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber
Background: Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was estab...
Full Text Available Abstract Background Infection with varicella-zoster virus (VZV contemporaneously with malignant disease or immunosuppression represents a particular challenge and requires individualized decisions and treatment. Although the increasing use of varicella-vaccines in the general population and rapid initiation of VZV-immunoglobulins and acyclovir in case of exposure has been beneficial for some patients, immunocompromised individuals are still at risk for unfavourable courses. Methods In this single center, 6-year analysis we review incidence, hospitalization and complication rates of VZV-infections in our center and compare them to published data. Furthermore, we report three instructive cases. Results Hospitalization rate of referred children with VZV-infections was 45%, among these 17% with malignancies and 9% under immunosuppressive therapy. Rate of complications was not elevated in these two high-risk cohorts, but one ALL-patient died due to VZV-related complications. We report one 4-year old boy with initial diagnosis of acute lymphoblastic leukemia who showed a rapidly fatal outcome of his simultaneous varicella-infection, one 1.8-year old boy with an identical situation but a mild course of his disease, and an 8.5-year old boy with a steroid-dependent nephrotic syndrome. This boy developed severe hepatic involvement during his varicella-infection but responded to immediate withdrawl of steroids and administration of acyclovir plus single-dose cidofovir after nonresponse to acyclovir after 48 h. Conclusion Our data show that patients with malignant diseases or immunosuppressive therapy should be hospitalized and treated immediately with antiviral agents. Despite these measures the course of VZV-infections can be highly variable in these patients. We discuss aids to individual decision-making for these difficult situations.
Douglas, C M; Poole-Cowley, J; Morrissey, S; Kubba, H; Clement, W A; Wynne, D
The aim of this paper was to review the indications, complications and outcomes for tracheostomy at a Scottish paediatric tertiary referral hospital. All patients undergoing tracheostomy between January 2001 and September 2012 were identified. A retrospective case note analysis was performed. 111 tracheostomies were done in the study period. The mean number per year was 11 (3-12). Full data was available for 95 patients. There were 56 (59%) males and 39 (41%) females. Age at time of tracheostomy ranged from one day to 15 years, the mean age of tracheostomy insertion was 69 weeks. The majority of patients, 75 (79%), were under one year old when they had their tracheostomy. The most common indication was long-term ventilation (20%), followed by craniofacial abnormality causing airway obstruction (18%), followed by subglottic stenosis (14%). 37% of patients were decannulated. This series reflects current trends in the indications for paediatric tracheostomy, with chronic lung disease of prematurity being the most common indication. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
The Department of Bioscience, Aarhus University was commissioned by the Danish Nature Agency to undertake a bat and bird monitoring programme of a national test centre for wind turbines near Østerild in Thy, Denmark. Here we present the results from the first year of the post-construction studies....... Bats were recorded in August, September and October 2013. A total of nine species were recorded. Species composition and occurrence were comparable to the results during summer and autumn 2011. Bats were recorded on 67-85% of survey nights at turbine sites and on every survey night at all ponds...... and lakes. High activities were recorded throughout the monitoring period at ponds and lakes. Overall, the bat activity level was higher in 2013 than in 2011 at ponds and lakes. Bat activity was higher near the wind turbines than at nearby forest edges. These differences suggest that bats exploit the food...
Valayatham, Vijayan; Subramaniam, Raman; Juan, Yap Moy; Chia, Patrick
Analyze indications and type of prenatal diagnostic procedures performed. This retrospective audit was conducted at a dedicated fetal medicine center in Petaling Jaya. All invasive prenatal diagnosis procedures performed from 2003 up until 2010 (amniocentesis, chorionic villous sampling and fetal blood sampling) were analyzed. A total of 1560 invasive prenatal diagnostic procedures were performed during the 8 year period. Advanced maternal age is the leading indication for invasive prenatal diagnostic procedures followed by fetal abnormalities. The fetal loss rate was 0.2% for amniocentesis and 1.2% for CVS. Advanced maternal age is the leading indication for invasive prenatal diagnostic procedures at this centre but is on a declining trend. The fetal loss rates are comparable to auditable standards set by professional bodies, in this case, the Royal College of Obstetricians & Gynecologists of London.
Borstlap, W. A. A.; Tanis, P. J.; Koedam, T. W. A.; Marijnen, C. A. M.; Cunningham, C.
Rectal cancer surgery is accompanied with high morbidity and poor long term functional outcome. Screening programs have shown a shift towards more early staged cancers. Patients with early rectal cancer can potentially benefit significantly from rectal preserving therapy. For the earliest stage cancers, local excision is sufficient when the risk of lymph node disease and subsequent recurrence is below 5 %. However, the majority of early cancers are associated with an intermediate risk of lymph node involvement (5–20 %) suggesting that local excision alone is not sufficient, while completion radical surgery, which is currently standard of care, could be a substantial overtreatment for this group of patients. In this multicentre randomised trial, patients with an intermediate risk T1-2 rectal cancer, that has been locally excised using an endoluminal technique, will be randomized between adjuvant chemo-radiotherapylimited to the mesorectum and standard completion total mesorectal excision (TME). To strictly monitor the risk of locoregional recurrence in the experimental arm and enable early salvage surgery, there will be additional follow up with frequent MRI and endoscopy. The primary outcome of the study is three-year local recurrence rate. Secondary outcomes are morbidity, disease free and overall survival, stoma rate, functional outcomes, health related quality of life and costs. The design is a non inferiority study with a total sample size of 302 patients. The results of the TESAR trial will potentially demonstrate that adjuvant chemoradiotherapy is an oncological safe treatment option in patients who are confronted with the difficult clinical dilemma of a radically removed intermediate risk early rectal cancer by polypectomy or transanal surgery that is conventionally treated with subsequent radical surgery. Preserving the rectum using adjuvant radiotherapy is expected to significantly improve morbidity, function and quality of life if compared to completion
Simonetti, Giovanni; Gandini, Roberto; Pampana, Enrico; Fabiano, Sebastiano; Stefanini, Matteo; Spinelli, Alessio; Reale, Carlo Andrea; Di Primio, Massimiliano; Gaspari, Eleonora; Versaci, Francesco
Carotid artery stenting (CAS) may be an alternative to surgical endoarterectomy not only in high-risk patients. We report results in the endovascular treatment of carotid artery disease with up to 8 years' follow-up. In this retrospective study, we analysed data from 853 consecutive patients (946 arteries) treated for carotid artery stenosis between April 1999 and March 2007; 491 (52%) arteries were symptomatic and 455(48%) were asymptomatic. Preprocedural evaluation of the patients was performed with echo Doppler, magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) and a neurological examination. A cerebral protection device was used in 879 (92.9%) procedures. Anti-platelet therapy was administered before and after the procedure. All patients were included in a follow-up of up to 8 years. Technical success was achieved in 943 (99.6%) lesions. At 30 days, there was a 0.21% (n 2) death rate, a 0.42% major stroke rate, a 1.69% minor stroke/transient ischaemic attack (TIA) rate and a combined 2.32% TIA/stroke and death rate. During follow-up, echo Doppler evidenced restenosis in 39 (4.85%) cases; of these, only five, presenting restenosis >80%, were treated with an endovascular reintervention. At the long-term follow-up, two strokes (0.23%) were reported, which both occurred within the first 2 years. In our experience, carotid artery stenting seems to be a safe and effective treatment, providing satisfactory long-term clinical results. (orig.)
Almodumeegh, Abdulaziz; Heidekrueger, Paul I; Ninkovic, Milomir; Rubenbauer, Johannes; Hadjipanayi, Ektoras; Broer, P Niclas
Extensive full-thickness burns pose a great challenge to the burn surgeon. Lack of autograft donor sites is an important limiting factor to achieving wound closure. To overcome this problem, various methods of treatment have been suggested in the past, including the MEEK technique. This study was carried out at the Bogenhausen Hospital Burn Unit, Munich, Germany from 2006 to 2015. There were a total of 148 skin grafting operations. The modified MEEK technique was performed on 67 patients. Patients included 34 males and 33 females, with an average age of 39·6 years. The mean percentage body surface burned was 65%, and full-thickness injury occurred in 52%. The mean area graft per procedure was 20%. The viability of the graft as assessed between the 7th and 10th day was generally in the range of 60-90%. The average number of operations required was 2·21. The mean length of stay was 27 days. Infection was documented in five patients, and seven deaths occurred. The mean follow-up was 3·2 years. When faced with large surface area burns and limited donor sites, the MEEK technique is a satisfactory method for coverage. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Zeilstra, Dick J; Staartjes, Victor E; Schröder, Marc L
Our aim was to evaluate mid- and long-term results in a cohort of patients who underwent minimally invasive transaxial lumbosacral fixation and to identify clinical and other parameters that can aid in proper patient selection. Over a period of ten years, we assessed 164 patients who had a complete follow-up of a minimum of one year (average 54 months). On follow-up, we recorded clinical status, fusion status, visual analogue scale (VAS), Oswestry Lower Back Pain Disability Index (ODI) scores and patient satisfaction. There were no intra- or peri-operative complications. Overall clinical success rate was 73.8 %. Only sex (female), working status (still working), body mass index (BMI) (lower) and presence of Modic II changes (absent) were correlated with a good result. Transaxial fixation is a safe, minimally invasive technique that can offer good results in patients with single-level degenerative disc disease (DDD) at the lumbosacral level, with minimal operative risk.
Lindholt, Jes S.; Juul, Svend; Fasting, Helge
to treat" from the date of randomisation. RESULTS: The attendance rate was 76.6% and 191 (4.0%) had an AAA. The median observation time was 9.58 years. In the invited group 13 subjects were acutely operated on compared to 40 in the control group (Risk ratio: 0.32 (95% C.I. 0.17-0.60, P...,333 were invited to an abdominal ultrasound scan at their district hospital. Information on all deaths until 15.3.2005 was obtained from the Office of Civil Registration. Information on AAA related deaths was obtained from the national registry of Causes of Deaths from 1.4.1994 to 31...
Bejiqi, Ramush A; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber
Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded.
Iselin, K C; Baenninger, P B; Schmittinger-Zirm, A; Thiel, M A; Kaufmann, C
Background This review reports the epidemiology, laboratory results, treatment regimens and costs of fungal keratitis at a tertiary referral center in Lucerne, Switzerland. Patients and Methods Culture-proven fungal infections between January 2010 and December 2015 were reviewed retrospectively. Results Seventeen patients with a mean age of 52 years were identified. Contact lens wear was the most important risk factor (n = 11) (65 % of all cases), with filamentous fungi being identified as the most common fungus type (n = 10) (91 % of all cases of contact lens-associated fungal keratitis). All non-contact lens-associated fungal infections (n = 6) (35 % of all cases) were related to Candida spp. Six patients (35 %) were treated on an outpatient basis; 11 cases (65 %) required hospitalisation. Systemic voriconazole was the treatment regimen prescribed most often (n = 12) (71 %), followed by topical natamycin 5 % (n = 11) (65 %). Corneal crosslinking and penetrating keratoplasty were required in 4 cases each (24 %). One case ended up in enucleation (6 %). Average costs per case were EUR 15 952 for hospitalised patients if surgical intervention was required, and EUR 7415 if no intervention was performed. Average costs for outpatients were EUR 7079. In a majority of cases, visual acuity could be improved (n = 9) (53 %) or preserved (n = 2) (12 %). Conclusion Despite the relatively low incidence of culture-proven keratitis (17 cases in 6 years), a clear pattern with regard to risk factors and fungus species was noted. In the absence of a gold standard for the treatment of fungal keratitis, the combination of systemic voriconazole and topical natamycin seems to be one of the most commonly used antifungal treatment regimens. The costs of outpatient versus inpatient non-surgical treatment were approximately the same. Georg Thieme Verlag KG Stuttgart · New York.
Bejiqi, Ramush A.; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber
Background: Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. Aims: In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. Methods: To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. Conclusion: In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded. PMID:25870479
Young, Stephanie M; Lim, Lee-Hooi; Seah, Lay-Leng; Choo, Chai-Teck; Chee, Elaine W L; Shen, Sunny Y; Lang, Stephanie S; Looi, Audrey L G
To evaluate the demographics, presentation, and surgical outcomes of patients undergoing ptosis surgery in an Asian population in a prospective manner. A prospective ptosis audit was conducted over a 2-year period from January 2010 to December 2011 in a tertiary eye hospital in Singapore. All patients undergoing ptosis surgery by, or under the supervision of, an oculoplastic-trained consultant in the institution were included. Institutional Review Board approval was obtained for the study. This study comprises 302 patients, of which 236 were acquired and 66 were congenital ptosis cases. Levator repair (77.2%) was the most commonly performed procedure, followed by levator resection (13.9%) and brow suspension (8.9%). Forty-seven (10.1%) eyes had readjustment within 2 weeks, the reasons for readjustment being eyelid height undercorrection (n = 35), eyelid height overcorrection (n = 9), and unsatisfactory eyelid contour (n = 4). Postoperatively, 93.8% of patients showed an increase in marginal reflex distance-1 (MRD1), 91.3% achieved symmetry or MRD1, 98.5% had good eyelid contour, and 74.3% had symmetric eyelid crease. On a scale of 1 to 10, 83.1% of patients gave a subjective grade of 7 or better. This study is the first prospective ptosis surgery audit in an Asian population and takes a leading step in assessing both subjective and objective surgical outcomes in a prospective manner. With the continuation of this audit in years to come, it will allow us to generate clinical outcomes in a robust manner and allow for more reliable benchmarking with major centers elsewhere.
Full Text Available The burns intensive care unit (BICU staff observed an increasing number of pediatric scald burn admissions as a result of increase injuries associated with the scald burns. A retrospective study was conducted to identify scalds demographics, etiologies, and mortality risk factors. This descriptive study comprised a total of 166 patients aged 0-5 years, who were admitted to the BICU of the Reconstructive Plastic Surgery and Burns Unit (RPSBU through the Accident and Emergency (A and E Centre of the Komfo Anokye Teaching Hospital (KATH from May 1 st 2009 to April 30 th 2012. Source of information was the BICU Computerized Database System. Data extracted included demographics as well as treatment methods and outcomes. The study population was 166; 92 (55.4% males and 74 (44.6% females. Scalds admissions were 141 (84.9%; 13 (9.2% of them died, 83 (58.9% discharged, and 45 (31.9% transferred-out to another burn ward and pediatric surgery ward in the hospital. Scald patients' demographics included 78 males (55.3% and 63 females (44.7%; mean age was 2.18 years. Mortality risk factors identified were age <3 years (P = 0.044; scalds from hot water (P = 0.033, total burns surface area >30% (P = 0.017, and multiple body parts affected (P = 0.049. The current study showed age, hot water, and Total Burns Surface Area (TBSA as risk factors of early childhood scalds. Education on scalds prevention targeting mothers/caregivers is needed to create awareness of the frequency, severity, and danger associated with pediatric scalds.
Sarginson, Julia H; Estela, Catalina; Pomeroy, Shirin
Hair straighteners have become a popular and common household appliance. The incidence of burns from these devices is rising, and is of particular concern given that the main casualties are infants. We present the largest case series in the literature of paediatric burns from hair straightening devices. Retrospective data collection of all burns by hair straightening devices presenting to our unit between 2007 and 2011. Details on demographics, time and mechanism of injury, size and depth of injury and treatment received were recorded. There were 155 cases in the five-year period. The mean age was 19 months. The majority of the burns were caused by a 'touch/grab' (49%) or 'stepped-into' (14%) mechanism. The area most frequently burnt was the hand with 60% of the injuries. 8 out of the 155 required excision and grafting. Hair straightening devices can reach temperatures of over 220°C and can cause significant full thickness injuries. Our study shows that infants and toddlers are at most risk. These are preventable burns that warrant our attention, and we would advocate the use of heat-resistant pouches and closure clips on the devices to help minimise the risk of injury. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.
Ikpeme Enobong E
Full Text Available Abstract Background Haemodialysis is the most common form of renal replacement therapy in Nigeria. The high cost of haemodialysis has made optimal therapy of end-stage renal disease difficult in Nigeria. This paper is a review of data collected over two years of provision of dialysis services in a new tertiary hospital in Southern Nigeria. Methods This retrospective analysis is done on data obtained from the patient case files and dialysis records in the first two years of provision of dialysis services in our centre. A gender comparison of the patients' baseline sociodemographic, clinical and biochemical was performed and a logistic regression model used to assess the predictors of mortality. Results A total of 98 patients had 471 sessions in the two years under review. Males and females had similar characteristics at baseline except for a higher median serum urea in the males. The commonest causes of end-stage renal disease were chronic glomerulonephritis (34.5%, hypertension (32.1% and diabetes mellitus (17.9%. The main predictor of mortality was under treatment with haemodialysis due to inability to pay for more than a few dialysis sessions. Conclusions This study has highlighted the unchanging demographics of our advanced kidney failure patients. Efforts should be aimed at subsidizing the cost of dialysis for our teeming population of dialysis dependent chronic kidney disease patients.
Bywater, T; Hutchings, J; Linck, P; Whitaker, C; Daley, D; Yeo, S T; Edwards, R T
the incidence of conduct disorder in young children is 10% in the general population and 37% among fostered children. Up to 40% of untreated children diagnosed with conduct disorder develop problems later in life including drug misuse, criminal and violent behaviour. There are more than 80,000 looked after children in the UK, with 5000 in Wales. Challenging child behaviour is the main reason for placement breakdown and has huge cost implications as challenging children cost up to 10 times more in service use than children without conduct disorder. The Incredible Years (IY) evidence-based parenting programme is an effective, low cost solution in improving child behaviour and social competence in 'conventional' families and thus has the potential to support foster carers in managing difficult behaviours. Our main aims were to establish: • The feasibility of delivery and the effectiveness of the IY parenting programme in supporting carers in managing difficult behaviour in looked after children. • Service use costs for foster carers and looked after child. This was a 12-month trial platform study with 46 foster carers in three authorities in Wales. Carers were allocated 2:1 intervention to waiting-list control. Validated measures were used to assess 'parenting' competency, carers' depression levels, child behaviour and service use. Measures were administered at baseline and 6-month follow-up. Intervention carers received the programme between baseline and follow-up. Analyses showed a significant reduction in child problem behaviour and improvement in carers' depression levels for intervention families at follow-up, compared with control. Unexpectedly, there was a significant improvement in control carers' self-reported 'parenting' strategies. Special education was the greatest service cost for looked after children. Initial foster carer training could incorporate the IY programme to support carers in establishing positive relationships and managing difficult child
Deng, Tuo; Liao, Banghua; Luo, Deyi; Liu, Bing; Wang, Kunjie; Liu, Jiaming; Jin, Tao
Objective: Therapy for anterior combined with posterior urethral stricture is difficult and controversial. This study aims to introduce a standard process for managing anterior combined with posterior urethral stricture. Patients and methods: 19 patients with anterior combined with posterior urethral stricture were treated following our standard process. Average (range) age was 52 (21-72) years old. In this standard process, anterior urethral stricture should be treated first. Endoscopic surgery is applied for anterior urethra stricture as a priority as long as obliteration does not occur, and operation for posterior urethral stricture can be conducted in the same stage. Otherwise, an open reconstructive urethroplasty for anterior urethral is needed; while in this condition, the unobliterated posterior urethra can also be treated with endoscopic surgery in the same stage; however, if posterior urethra obliteration exists, then open reconstructive urethroplasty for posterior urethral stricture should be applied 2-3 months later. Results: The median (range) follow-up time was 25.8 (3-56) months. All 19 patients were normal in urethrography after 1 month of the surgery. 4 patients (21.1%) recurred urethral stricture during follow-up, and the locations of recurred stricture were bulbomembranous urethra (2 cases), bulbar urethra (1 case) and bladder neck (1 case). 3 of them restored to health through urethral dilation, yet 1 underwent a second operation. 2 patients (10.5%) complaint of dripping urination. No one had painful erection, stress urinary incontinence or other complications. Conclusions: The management for anterior combined with posterior urethral stricture following our standard process is effective and safe. PMID:26064293
Kiefer, Philipp; Seeburger, Jörg; Noack, Thilo; Schröter, Thomas; Linke, Axel; Schuler, Gerhard; Haensig, Martin; Vollroth, Marcel; Mohr, Friedrich-Wilhelm; Holzhey, David Michael
European guidelines recommend to perform transcatheter aortic valve implantation (TAVI) within a multidisciplinary heart team. However, there is a strong drive--despite existing guidelines--to perform TAVI outside of specialized centres. The aim of this study was to clarify the necessity of on-site cardiac surgery by providing a clear insight into the complications during/after TAVI that needed surgical management. A total of 2287 (1523 transfemoral, 752 transapical and 12 transaortic) patients, with a mean age of 84.5 ± 5.3 years, and a mean log EuroSCORE of 21.7 ± 16.3, of which 205 were female (84%), underwent TAVI since February 2006 at our institution. All procedure-related complications that required surgical interventions, whether immediate or delayed but within the initial hospital stay, were recorded and retrospectively analysed. Out of this cohort, 245 (10.7%) patients required surgical treatment due to major complications. A total of 42 patients (1.8%) underwent conversion to full sternotomy and 27 (1.2%) were dependent on the short-term use of the heart-lung machine. Vascular complications with surgical intervention were seen in 85 patients (3.7%), 54 patients (2.4%) had to have a rethoracotomy within their initial stay and 15 (0.7%) required a cardiac reoperation. Severe complications during TAVI that can only be resolved surgically will continue to occur. Therefore, each TAVI procedure should be conducted or accompanied by a cardiac surgeon and an experienced team within a specialized centre. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Carson, Valerie; Clark, Marianne; Berry, Tanya; Holt, Nicholas L; Latimer-Cheung, Amy E
Minimizing sedentary behavior, in particular screen-based sedentary behavior, during the early years is important for healthy growth and development. Consequently, new Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years) were recently released. Researchers are unclear what messages should supplement the guidelines when disseminating them to parents and when using the guidelines in behaviour-change interventions to increase adoption. The objective of this study was to qualitatively examine parents' perceptions of the new Canadian Sedentary Behaviour Guidelines for the Early Years. Parents with a child ≤4 years who attended a child care centre were purposefully recruited from child care centres. A total of 7 semi-structured focus groups with 2 to 5 parents were conducted from August to November, 2013 by a trained and experienced moderator. Participants were asked a series of open-ended questions pertaining to the Sedentary Behaviour Guidelines information sheet. Initial themes were identified followed by further review and analysis. For the most part parents thought the guidelines were clear and did not disagree with the recommendations per se. However, some confusion arose around the value of some sedentary activities, such as reading and coloring, for social and cognitive development. Many parents described feeling guilty after reading the guidelines and perceived several barriers in meeting the daily recommendations. Common barriers included the need to balance multiple demands of family life, the prevalence and accessibility of screen technology, and the weather and built environment where families live. Parents expressed the importance of communicating the guidelines early enough for good habits to be established and the need for realistic strategies and ideas to help them meet the recommendations. Overall the findings indicate that gain-framed messages around the role of screen-based and non-screen-based sedentary behavior for children
Five years of specialised early intervention versus two years of specialised early intervention followed by three years of standard treatment for patients with a first episode psychosis: randomised, superiority, parallel group trial in Denmark (OPUS II).
Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Emborg, Charlotte; Jepsen, Jens Richardt Mollegaard; Fagerlund, Birgitte; Gluud, Christian; Mors, Ole; Hjorthøj, Carsten; Nordentoft, Merete
To compare the effects of five years of specialised early intervention (SEI) treatment for first episode schizophrenia spectrum disorder with the standard two years of SEI plus three years of treatment as usual. Randomised, superiority, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. Participants were recruited from six OPUS teams in Denmark between 2009 and 2012. OPUS teams provide SEI treatment to all patients diagnosed with a schizophrenia spectrum disorder in Denmark. 400 participants (51% women) with a mean age of 25.6 (standard deviation 4.3) were randomised to five years of SEI (experimental intervention; n=197) or to two years of SEI plus three years of treatment as usual (control; n=203). OPUS treatment consists of three core elements-modified assertive community treatment, family involvement, and social skill training-with a patient-case manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group were mostly referred to community health centres after two years of SEI treatment. Follow-up assessments were conducted five years after start of OPUS treatment. Primary outcome was negative symptoms measured on the scale for assessment of negative symptoms (avolition-apathy, anhedonia, alogia, and affective blunting). Secondary outcomes were remission of both negative and psychotic symptoms, psychotic symptoms, suicidal ideation, substance abuse, compliance with medical treatment, adherence with treatment, client satisfaction, days in hospital care, and labour market affiliation. Levels of negative symptoms did not differ between the intervention group and control group (1.72 v 1.81 points; estimated mean difference -0.10 (95% confidence interval -0.33 to 0.13), P=0.39). Participants receiving five years of OPUS treatment
Full Text Available Children with primary Tslymphocyte deficiency arc more ."I/."'clptihfe to infection hy organisms such (15: bacteria, fungi. prolo:o(J lind virus, 1711.' isniatian oj all opponuniuic ory;ani."m or an IImallally severe infection with higher grade pathogens, provide a clue (0 diagnosis of immunodeficiency, To determine the microorganisms causing recurrent or severe infections in children with T•(rmpllOcy!e doflcicncy, we carried out II retrospective case review oj H5 patients with 1'../ympllOC'te deficiency who wuc investigated at the Great Ormond Street Hospital for Children, NHS Trust, OH'r the 5 year period between June I, 1188 and June I, 1193. Tuc /:mllp of patients included 53 mules anti 32 [cmales, among which 23 and 62 were diagnosed to prewnt SClf (/",1 elf subtypes respectively, Among the 174 organisms isolated. these included bacteria (97 isolates], viruses (43 isolates}, funJ:i (25 isolates] and parasites (9 isolates}, 17lC predominant ."ites of infections were mainly the gll. rointe. itwl (60 out of 174 and respiratory tracts (49 out of 174. 171£' most common bacterial infections, were with aerobic gram negative organisms (28 isolatcs, P.H'UdOmOnllS aeruginosa (17 isolates], Enterococcus (/2 isolates, C. difficile (10 isolates], Analysis: of 43 viral infection showed that Homvirus (10 isolates], Adenovirus (9 isolates], Herpes simplex (6 isolates], am!"nC}loml'!:altH'iTlH (6 isalatcs, Wi'rl! prrdominutu pathogens. Candida albicans was IIII' most commonly isolated fungi. Parasitic infections included P. curini and Cryp(o."poridillm, 3 and (j opt of 9 cases. In our }iTOUp of pmients 16 patients' died before hone maTOOW transplantation, due to infectimu complication. Based on this . lldy. we ,wgge.lt thai pronytaxis aJjllin.rt bacterial, viral, Jllngal ami protozoa agents is a necessity to minimize infectious complication." in 7~/ympilOcyte deficient patients, awaiting a hone
This paper reviews the past quantum mechanical history of the dual resonance model which is an early string theory. The content of this paper is listed as follows: historical review, the Veneziano amplitude, the operator formalism, the ghost story, and the string story
The practitioner's own self is a resource in early childhood education and care (ECEC). It is proposed that an experiential training focusing on the "professional self" helps to raise awareness of how psychological dispositions may impair or enhance quality of provision. A key concept in such training is emotional labour, explored with…
The concept of mobile technologies is now an emergency theme in educational research, yet the playing of these edutainment applications and their impact on early childhood learning needs to be fully explored. This study highlights current research and explores how iPads improve student learning. It also examines how the introduction of iPads,…
Strengthening the home-school partnership is a strategy to raise achievement levels and to engage "hard-to-reach" parents with education in the UK, however this political ideal has been critiqued as exclusive and based on a white, middle class model. This article explores how six asylum-seeking mothers manage their children's early years…
Bleses, Dorthe; Makransky, Guido; Dale, Philip
We use a longitudinal design to examine associations for 2,120 16-30 months old children between early expressive vocabulary and later reading and math outcomes in the 6th Grade based on a large and diverse sample of Danish children. Educational outcomes, in particular decoding and reading compre...
Simonsen, Erik; ten Velden Hegelstad, Wenche; Haahr, Ulrik Helt
years, 50% of patients were in symptomatic remission. Non-remission was predicted by positive symptoms at inclusion and during the first year of treatment. Of individual symptoms only hallucinations were significantly predictive of ten-year non-remission. Early symptom differences were not reflected...
Durkan, Nazmi; Güngör, Hande; Fetihi, Leyla; Erol, Ahmet; Gülay Ogelman, Hülya
The purpose of the study is to compare environmental attitudes and experiences of five-year-old children receiving preschool education in the village and city centre. The first group comprised 54 five-year-old children who received preschool education and attended kindergartens of two primary schools in the Karateke and Kocabas villages of Honaz…
Marina, Djordje; Klose, Marianne; Nordenbo, Annette
OBJECTIVE: Severe brain injury poses a risk of developing acute and chronic hypopituitarism. Pituitary hormone alterations developed in the early recovery phase after brain injury may have implications for long-term functional recovery. The objective was to assess the pattern and prevalence...... of pituitary hormone alterations three months after severe brain injury with relation to functional outcome at one year follow-up. DESIGN: Prospective study at a tertiary university referral centre. METHODS: A total of 163 patients admitted to neurorehabilitation after severe traumatic (N=111) or non......-traumatic (N=52) brain injury were included. Main outcome measures were endocrine alterations 3.3 months (median) after the brain injury and their relationship to functioning and ability of the patients at one year follow-up, as measured by Functional Independence Measure and Glasgow Outcome Scale...
Chen, Peter; Rice, Cynthia
Based on a 180-day school year, any student who misses 18 days or more per year--or about two days per month--is considered chronically absent. An alarming 4,328 Newark students in grades kindergarten through 3rd grade were chronically absent during the 2013-14 school year. When young students miss too much school, they will likely struggle…
Raupach, J.; Lojik, M.; Chovanec, V.; Renc, O.; Strýček, M.; Dvořák, P.; Hoffmann, P.; Guňka, I.; Ferko, A.; Ryška, P.; Omran, N.; Krajina, A.; Čabelková, P.; Čermáková, E.; Malý, R.
PurposeRetrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methodsFrom 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.ResultsWe achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.ConclusionPrimary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %
Raupach, J., E-mail: firstname.lastname@example.org; Lojik, M., E-mail: email@example.com; Chovanec, V., E-mail: firstname.lastname@example.org; Renc, O., E-mail: email@example.com [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Strýček, M., E-mail: firstname.lastname@example.org [Faculty of Medicine at Charles University (Czech Republic); Dvořák, P., E-mail: email@example.com; Hoffmann, P., E-mail: firstname.lastname@example.org [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Guňka, I., E-mail: email@example.com; Ferko, A., E-mail: firstname.lastname@example.org [Faculty of Medicine at Charles University and University Hospital, Department of Surgery (Czech Republic); Ryška, P., E-mail: email@example.com [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Omran, N., E-mail: firstname.lastname@example.org [Faculty of Medicine at Charles University and University Hospital, Department of Cardiac Surgery (Czech Republic); Krajina, A., E-mail: email@example.com; Čabelková, P., E-mail: firstname.lastname@example.org [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Čermáková, E., E-mail: email@example.com [Faculty of Medicine at Charles University, Computer Technology Center (Czech Republic); Malý, R., E-mail: firstname.lastname@example.org [Faculty of Medicine at Charles University and University Hospital, Department of Medicine (Czech Republic)
PurposeRetrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methodsFrom 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.ResultsWe achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.ConclusionPrimary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.
Seager, Emily; Abbot-Smith, Kirsten
Language comprehension delays in pre-schoolers are predictive of difficulties in a range of developmental domains. In England, early years practitioners are required to assess the language comprehension of 2-year-olds in their care. Many use a format based on the Early Years Foundation Stage Unique Child Communication Sheet (EYFS:UCCS) in which…
Mohamed Osama, O; Gallagher, J E
The importance of role models, and their differing influence in early, mid- and late careers, has been identified in the process of professional development of medical doctors. There is a paucity of evidence within dentistry on role models and their attributes. To explore the views of early career dentists on positive and negative role models across key phases of professional development, together with role models' attributes and perceived influence. This is a phenomenological study collecting qualitative data through semi-structured interviews based on a topic guide. Dentists in junior (core training) hospital posts in one academic health science centre were all invited to participate. Interviews were recorded, transcribed verbatim and analysed using framework analysis. Twelve early career stage dentists, 10 of whom were female, reported having role models, mainly positive, in their undergraduate and early career phases. Participants defined role models' attributes in relation to three distinct domains: clinical attributes, personal qualities and teaching skills. Positive role models were described as "prioritising the patient's best interests", "delivering learner-centred teaching and training" and "exhibiting a positive personality", whilst negative role models demonstrated the converse. Early career dentists reported having largely positive dentist role models during- and post-dental school and report their impact on professional values and aspirations, learning outcomes and career choice. The findings suggest that these early career dentists in junior hospital posts have largely experienced and benefitted from positive role models, notably dentists, perceived as playing an important and creative influence promoting professionalism and shaping the career choices of early career stage dentists. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available Background: Initiating a National Poisoning Information Centre (PIC in Estonia took about 12 years of challenging work on research, training and attracting governmental support and funding. In this study we described the establishment process and the profile of phone calls in the first year which the PIC started to be available full time (24h/day 7days/week. Methods: This was a descriptive retrospective study. Relevant documents from 2000-2012 were reviewed. The documents were categorized into 5 main issues against establishment of PIC. Data of all inquiries related to toxic agent exposures regarding patient’s demographic, intention of poisoning and type of toxic substances in 2012 were collected. The data were reported with frequency and percentage. Results: During establishment process, 386 documents including governmental regulations and contracts, memorandums from meetings, professional e-mails, newspaper articles, interviews, annual reports and program sheets of other poison centres and conference presentations were collected. Funding was provided form PHARE and BTox projects (2000-2003, and government of Estonia (2004-2012. Educational programs were held to train specialists in clinical toxicology and poisoning information to direct the PIC. The active phase of establishment started in 2004; however, the services of PIC became available at the beginning of 2008. In 2012, total number of calls was 1118. 20% of calls were related to general questions about pharmaceuticals and non-toxic agents. 894 calls were related to acute poisoning cases. Most of them (87.9% were due to accidental poisoning. The most common types of substances responsible for poisoning were pharmaceutical products (30.2%, household products (29.5% and plant toxins (11.1%. Conclusion: To establish a stable PIC, it is crucial to have a wide range data backbone, clear support and direct funding from the government, assistance from collaborative PICs, active international
Zhang, Hong-yun; Sun, Qun-ying; Yang, Kun-peng; Chen, Yu-xia; Wang, Qi; Wang, Xi; Liu, Yuan
To study the clinical effect of development theory based acupuncture on early cerebral palsy (CP) infants with parafunctional sitting position. Totally 120 early CP infants were randomly assigned to two groups equally, the treatment group and the control group. All received acupuncture combined with training rehabilitation. Patients in the treatment group adopted acupuncture based on infants development theory, while those in the control group were treated by head acupuncture. Sitting functional points in Gross motor function measure (GMFM) 88 were observed in different groups and infant patients of various types before and after treatment. Root mean square (RMS) signals of sitting correlated muscles (latissimus dorsi, erector spinae, rectus abdominis) were recorded by surface electromyography (sEMG). The effective rate was evaluated by Nimodipine method. Compared with before treatment, sitting functional points were significantly improved in the two groups (Pvs. 77.78%, Pacupuncture could effectively elevate dorsi-extensor muscles force, improve sitting position of 8 months to 1 year old CP infants with parafunctional sitting position.
Hoff, M.; Haugeberg, G.; Odegård, S.; Syversen, S.; Landewé, R.; van der Heijde, D.; Kvien, T. K.
To examine 1-year hand bone loss in early rheumatoid arthritis (RA) as a predictor of radiographic damage at 5-year and 10-year follow-up A total of 136 patients with RA (disease duration 0-4 years) were followed for 10 years with clinical data and hand radiographs. Joint damage was scored according
Kron, Tomas; Chesson, Brent; Hardcastle, Nicholas; Crain, Melissa; Clements, Natalie; Burns, Mark; Ball, David
A randomised clinical trial comparing stereotactic ablative body radiotherapy (SABR) with conventional radiotherapy for early stage lung cancer has been conducted in Australia and New Zealand under the auspices of the TransTasman Radiation Oncology Group (NCT01014130). We report on the technical credentialing program as prerequisite for centres joining the trial. Participating centres were asked to develop treatment plans for two test cases to assess their ability to create plans according to protocol. Dose delivery in the presence of inhomogeneity and motion was assessed during a site visit using a phantom with moving inserts. Site visits for the trial were conducted in 16 Australian and 3 New Zealand radiotherapy facilities. The tests with low density inhomogeneities confirmed shortcomings of the AAA algorithm for dose calculation. Dose was assessed for a typical treatment delivery including at least one non-coplanar beam in a stationary and moving phantom. This end-to-end test confirmed that all participating centres were able to deliver stereotactic ablative body radiotherapy with the required accuracy while the planning study demonstrated that they were able to produce acceptable plans for both test cases. The credentialing process documented that participating centres were able to deliver dose as required in the trial protocol. It also gave an opportunity to provide education about the trial and discuss technical issues such as four-dimensional CT, small field dosimetry and patient immobilisation with staff in participating centres. Advances in knowledge: Credentialing is an important quality assurance tool for radiotherapy trials using advanced technology. In addition to confirming technical competence, it provides an opportunity for education and discussion about the trial.
Batyukhnova, Olga; Dmitriev, Sergey; Arustamov, Artur; Ojovan, Mikhael
Available in abstract form only. Full text of publication follows: The education service for specialists dealing with radioactive waste was established in Russia (former USSR) in 1983 and was based on the capabilities of two organisations: the Moscow Scientific and Industrial Association 'Radon' (SIA 'Radon') and the Chemical Department of Lomonosov's Moscow State University. These two organizations are able to offer training programs in the science fundamentals, applied research and in practical operational areas of the all pre-disposal activities of the radioactive waste management. Since 1997 this system was upgraded to the international level and now acts as International Education Training Centre (IETC) at SIA 'Radon' under the guidance of the IAEA. During 10 years more than 300 specialists from 26 European and Asian countries enhanced their knowledge and skills in radioactive waste management. The IAEA supported specialized regional training courses and workshops, fellowships, on-the-job training, and scientific visits are additional means to assure development of personnel capabilities. Efficiency of training was carefully analysed using the structural adaptation of educational process as well as factors, which have influence on education quality. Social-psychological aspects were also taken into account in assessing the overall efficiency. The analysis of the effect of individual factors and the efficiency of education activity were carried out based on attestation results and questioning attendees. A number of analytical methods were utilised such as Ishikawa's diagram method and Pareto's principle for improving of training programs and activities. (authors)
Type 1 diabetes (T1D) symptoms are subtle and easily overlooked. Delayed diagnosis can result in Diabetic ketoacidosis (DKA), a life threatening complication with lasting consequences. We sought to define the presenting features of T1D and DKA frequency, in children <15 years diagnosed in a single national tertiary centre, and identify predictive factors for DKA. A review of T1D incident cases was undertaken from 2008-2012 using the National Diabetes Register (ICDNR) and clinical case notes. Data were compared with a 1997\\/8 national study. We found DKA at presentation in 28.7 % of children and 15.5% had moderate\\/severe DKA. Commonest symptoms were polydipsia, polyuria, weight loss, and lethargy. Median symptom duration was 17 days. Clinical presentation was similar and frequency of DKA at T1D diagnosis remains high. The proportion with moderate\\/severe DKA is lower than the 25% previously reported (p=0.038). National monitoring and targeted action to reduce DKA at diagnosis is required.
In this paper I shall give a short history of the development of neutron scattering at the Research Centre for Nuclear Techniques (PPTN), in Bandung, and the early development of a more advanced facilities at the Neutron Scattering Laboratory (NSL BATAN), Centre of Technology for Nuclear Industrial Materials, in Serpong. The first research reactor in Indonesia was the TRIGA MARK II in Bandung, which became operational in 1965, with a power of 250 KW, upgraded to 1 MW in 1971, and to 2 MW in 2000. The neutron scattering activities was started in 1967, with the design and construction of the first powder diffractometer, and put in operation in 1970. It was followed by the second instrument, the filter detector spectrometer built in 1975 in collaboration with the Bhabha Atomic Research Centre (BARC), India. A powder diffractometer for magnetic studies was built in 1980, and finally, a modification of the filter detector spectrometer to measure textures was made in 1986. A brief description of the design and construction of the instruments, and a highlight of some research topics will be presented. Early developments of neutron scattering activities at the 30 MW, RSG-GAS reactor in Serpong in choosing suitable research program, which will be mainly centred around materials testing/characterization, and materials/condensed matter researches has been agreed. Instrument planning and layout which were appropriate to carry out the program had been decided. Manpower development for the neutron scattering laboratory is a severe problem. The efforts to overcome this problem has been solved. International Cooperation through workshops and on the job trainings also support the supply of qualified manpower.
In this paper I shall give a short history of the development of neutron scattering at the Research Centre for Nuclear Techniques (PPTN), in Bandung, and the early development of a more advanced facilities at the Neutron Scattering Laboratory (NSL BATAN), Centre of Technology for Nuclear Industrial Materials, in Serpong. The first research reactor in Indonesia was the TRIGA MARK II in Bandung, which became operational in 1965, with a power of 250 KW, upgraded to 1 MW in 1971, and to 2 MW in 2000. The neutron scattering activities was started in 1967, with the design and construction of the first powder diffractometer, and put in operation in 1970. It was followed by the second instrument, the filter detector spectrometer built in 1975 in collaboration with the Bhabha Atomic Research Centre (BARC), India. A powder diffractometer for magnetic studies was built in 1980, and finally, a modification of the filter detector spectrometer to measure textures was made in 1986. A brief description of the design and construction of the instruments, and a highlight of some research topics will be presented. Early developments of neutron scattering activities at the 30 MW, RSG-GAS reactor in Serpong in choosing suitable research program, which will be mainly centred around materials testing/characterization, and materials/condensed matter researches has been agreed. Instrument planning and layout which were appropriate to carry out the program had been decided. Manpower development for the neutron scattering laboratory is a severe problem. The efforts to overcome this problem has been solved. International Cooperation through workshops and on the job trainings also support the supply of qualified manpower
Soong, Terrence Kwong-Weng; Koh, Alan; Subrayan, Visvaraja; Loo, Angela Voon Pei
To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008. A total of 603 eyes of 546 patients were recruited for the study. All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet. Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries. A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.
Full Text Available In the 1998/99 issue of Archaeology International, Geoffrey Dimbleby reflected on the period, from 1964 to 1979, when he was head of the Institute's former Department of Human Environment. Here Joan Sheldon (Fig. 1, who joined the Institute in 1948 as assistant to Frederick Zeuner, recalls how environmental archaeology developed during her 35 years on the staff.
In the 1998/99 issue of Archaeology International, Geoffrey Dimbleby reflected on the period, from 1964 to 1979, when he was head of the Institute's former Department of Human Environment. Here Joan Sheldon (Fig. 1), who joined the Institute in 1948 as assistant to Frederick Zeuner, recalls how environmental archaeology developed during her 35 years on the staff.
Jan 20, 1973 ... E. P. Stibbe was appointed to the Chair of Anatomy, and. Professor E. H. Cluver to the Chair of Physiology. Thirteen students enrolled for the second year. Anatomy was taught in a wood and iron converted stable in the north-east corner of the grounds of the. South African Institute for Medical Research, ...
The first-year teaching experiences of urban teachers were studied to conceptualize the reality faced by urban teachers and to determine the implications of the urban environment for teacher education. Subjects were four graduates of a teacher education program that gave no particular attention to the urban context beyond placement for student…
Mistry, Malini; Sood, Krishan
This study investigated the leadership skills Early Years leaders demonstrated through their daily practice of teaching, assessing and teamwork within their setting. It explored how revealing the potential of Early Years leaders could have a positive impact on the leadership practice of other leaders in the same setting to improve pupil outcomes.…
Drawing on survey data from over 2000 parents, this paper explores the possibility of early-years swimming to add mathematical capital to young children. Using developmental milestones as the basis, it was found that parents reported significantly earlier achievement on many of these milestones. Such data suggest that the early years swim…
Recent research findings indicate that using multiple metaphors in multimodal learning experiences are effective teaching approaches in early years mathematics. Using a social semiotic lens this paper reports on eight early years teachers' perceptions of this approach whilst engaging in a small collaborative professional learning group. This group…
Hackling, Mark; Barratt-Pugh, Caroline
Australia's Early Years Learning Framework and leading international researchers argue for more intentional and purposeful teaching of science in the early years. This case study of exemplary practice illustrates intentional teaching of science materials which opened-up learning opportunities in literacy and number. Student-led hands-on…
Presents concerns over the "Early Years Study" (McCain & Mustard). Focuses on diversity issues related to the readiness measure used, parenting styles, and the importance of first language development. Questions the report's definition of "developmentally-attuned." Concludes by expressing hope that the Early Years Study…
Tesar, Marek; Pupala, Branislav; Kascak, Ondrej; Arndt, Sonja
This article examines Slovak early years teachers' concerns with conceptions of teacher professionalism. It suggests that there is a mismatch between understandings of professionalism, policy aspirations and the attitudes of teachers to their own professionalism, and that this mismatch fuels early years teachers' sense of agency. These tensions…
Shimoyama, T.; Doi, K.; Kiyomoto, M.; Hoshiba, M.
Japan Meteorological Agency(JMA) started to provide Earthquake Early Warning(EEW) to the general public in October 2007. It was followed by provision of EEW to a limited number of users who understand the technical limit of EEW and can utilize it for automatic control from August 2006. Earthquake Early Warning in Japan definitely means information of estimated amplitude and arrival time of a strong ground motion after fault rupture occurred. In other words, the EEW provided by JMA is defined as a forecast of a strong ground motion before the strong motion arrival. EEW of JMA is to enable advance countermeasures to disasters caused by strong ground motions with providing a warning message of anticipating strong ground motion before the S wave arrival. However, due to its very short available time period, there should need some measures and ideas to provide rapidly EEW and utilize it properly. - EEW is issued to general public when the maximum seismic intensity 5 lower (JMA scale) or greater is expected. - EEW message contains origin time, epicentral region name, and names of areas (unit is about 1/3 to 1/4 of one prefecture) where seismic intensity 4 or greater is expected. Expected arrival time is not included because it differs substantially even in one unit area. - EEW is to be broadcast through the broadcasting media(TV, radio and City Administrative Disaster Management Radio), and is delivered to cellular phones through cell broadcast system. For those who would like to know the more precise estimation and smaller earthquake information at their point of their properties, JMA allows designated private companies to provide forecast of strong ground motion, in which the estimation of a seismic intensity as well as arrival time of S-wave are contained, at arbitrary places under the JMA’s technical assurance. From October, 2007 to August, 2009, JMA issued 11 warnings to general public expecting seismic intensity “5 lower” or greater, including M=7.2 inland
Brooker, Charlie; Tocque, Karen; Paul, Sheila
A one year audit was undertaken of the mental health (MH) status of adult attendees to the Thames Valley Sexual Assault Centres (SARC). There were 301 relevant referrals over the twelve month period of whom 126 (42%) either fully or partially completed the mental health assessments. 38% (n = 66) of the population did not consent to the research. Participation in the study was felt inappropriate by the case clinician in the rest of the cases. To summarise the findings: 36% were moderately or severely depressed; 30% experienced moderate to severe anxiety; 28% were drinking at hazardous/harmful levels; and 12% had a drug problem that was moderate to severe. Self harm affected 45% of the sample with the greater majority cutting themselves and self-harming before the age of 17. Admission to a psychiatric in-patient unit was not uncommon and 19% had been admitted an average of three times each. The figure of 19% admitted to a psychiatric hospital is 90 times higher than for the general female population. 42% of the total sample were being prescribed medication for their mental health problem. The paper concludes that: there should be agreement nationally on the use of a standardised set of mental health outcome measures which are used in all assessments; there should be a move towards the commissioning of expert psychological support that is offered in a SARC and the pathways for specialist mental health care out of the SARCs. Finally, forensic physicians and general practitioners needs a greater awareness of the mental health sequalae of sexual assault and they then need to make prompt referrals to the appropriate services. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
What happens to children in their earliest years is critical for their development throughout the life course. The years from zero to school age are foundational for brain and biological development. Attachment and face recognition; impulse control and regulation of physical aggression; executive function in the prefrontal cortex and focused attention; fine and gross motor functions and coordination; receptive and expressive language; and understandings of quantitative concepts are all established during this time and become embedded in the architecture and function of the brain (Doherty 1997; Kolb 2009; McCain and Mustard 1999). Brain and biological development are in turn expressed through three broad domains of development of the whole child: physical, social-emotional and language-cognitive, which together are the basis of "developmental health" (Keating and Hertzman 1999). Developmental health influences many aspects of well-being, including obesity and stunting, mental health, heart disease, competence in literacy and numeracy, criminality and economic participation throughout life (Irwin et al. 2007). Accordingly, developmental health is the central concern of this article.
Pavlović Biljana M.
Full Text Available The paper discusses choral singing as a form of extracurricular activity and teaching in elementary school. It considers the historical development of choral singing in order to highlight the continuity of its existence and importance in society and reviews the importance of choral singing in musical and overall upbringing and education of elementary school students. Authors analyze the curricula of grades I to IV in order to determine how much attention is given to choral singing. Didactic and methodological issues related to the formation of the choir in elementary school are reviewed, together with methodical approach for working with early grades choir, proper selection of the musical compositions and the role of teachers. Listed is the recommended choral literature to supplement the current curricula. Special attention was given to literature containing the Kosovo-Metohija folk songs, suitable for choral arrangement. Performing of these songs in a choral arrangement will contribute to stimulating the interest of students towards musical folklore of Kosovo and Metohija, and therefore its preservation and fostering. It is highlighted that singing in the choir contributes to the development of hearing, voice, harmonic feeling, a sense of rhythm, melody and group play. By mastering different compositions, students become familiar with valuable achievements of artist, spiritual and folk music. The significant meaning and importance of this kind of work is reflected in the possibilities of achieving the tasks of socio-moral education. Choral singing develops a sense of collective responsibility, conscious discipline, perseverance, endurance, helps establish a sense of understanding, mutual respect and tolerance, friendship and a sense of teamwork. Singing in the choir develops aesthetic attitude and taste in music. Students are trained to perceive and to value the true qualities of beauty, grace, harmony and authenticity in music. The value of
Steger, F.; Etzersdorfer, E.; Sorantin, H.
The monitoring system of the Seibersdorf Research Centre is described in outline. Aspects mentioned include 1) permanent monitoring of the air within the centre (the ASTRA reactor is the main emitter of short-lived radionuclides such as 41 Ar, 3 H, fission gas, aerosols 88 Rb, 138 Cs, 131 I), 2) monitoring and disposal of rainwater, domestic waste such as sewerage etc., 3) radioactive, and potentially radioactive water such as drinking water, wells etc., 4) soil sampling, 5) measurements in the agricultural area immediately surrounding the centre, including the river Leitha. The overall system has proved adequate up until now. A filter pump unit to collect 5000 m 3 /h on a charcoal filter is under construction. (U.K.)
Full Text Available Abstract Background Pregnancy in adolescents is a worldwide health problem and has been mostly common in poor populations. It is not clear if socioeconomic or biological factors are the main determinants of perinatal adverse outcomes in pregnant adolescents. Adolescents under 15 years old may present a high growth rate which may contribute to impair fetal growth. Our aim is to compare perinatal characteristics among early (aged 10 to 14 years and late (aged 15 to 19 years pregnant adolescents. Methods A cross-sectional study was performed using data from Pernambuco State 2009, obtained from DATASUS/SISNAC, a Brazilian Government, open-access public health database. Maternal and neonatal outcomes were compared between early (aged 10–14 years and late (aged 15–19 years pregnant adolescents. Family income was compared between early and late pregnant adolescents using a sample of 412 subjects evaluated at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP during 2011. Statistical comparisons were made using the chi-square test was used with a significant level of 0.05; bivariate and multivariate analysis were performed. This project was approved by the Institutional Ethics Review Board. Results Data from 31,209 pregnant adolescents were analyzed. 29,733 (95.2% were aged 15 to 19 years and 1,476 (4.7% were aged 10 to 14 years. There were significant differences with respect to marital status, education level and number of prenatal visits of mothers aged 10 to 14 years compared to 15 to 19 years. Of importance, early adolescents had a greater rate of neonates born premature and with low birth weight. Prematurity and low birth weight remained statistically significant after multivariate analysis. Conclusions Early aged adolescents may have an increased risk of prematurity and low birth weight. These findings highlight the potential role of biological factors in newborn outcomes in pregnant adolescents.
Carlsson, Lars; Englund, Lars; Hallqvist, Johan; Wallman, Thorne
To study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre. Randomized controlled trial. Patients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapist, a psychotherapist, and an occupational therapist or to "standard care". The therapists used methods and tools they normally use in their clinical work. Proportion of patients still sick-listed three months after randomization, total and net days on sick leave, and proportion who were on part-time sick leave. Results. At follow-up after three months, in contrast to the pre-trial hypothesis, there was a trend toward a higher proportion of patients still sick-listed in the intervention group (7/18) as compared with the control group (3/15). The intervention group also had significantly longer sick-listing periods (mean 58 days) than the control group (mean 36 days) (p = 0.038). The proportion of patients who were part time sick-listed was significantly higher in the intervention group (10/18) than in the control group (2/15) (p = 0.027). In this study an early multidisciplinary assessment was associated with longer periods on sick leave and more individuals on part-time sick leave.
Four of the eight Millennium Development Goals highlight the importance of adequate nutrition for human health and development. The IAEA is assisting Member States in their efforts to achieve these goals by providing technical support for strategies to combat undernutrition. In particular, the IAEA contributes technical expertise in the use of stable isotope techniques in the development and evaluation of nutrition interventions. Stable isotope techniques have been used as research tools in nutrition for many years. However, the application of stable isotope techniques in programme development and evaluation is a relatively new approach, where the IAEA has a unique opportunity to contribute. As only stable (non-radioactive) isotopes are used, the techniques can be applied in the most vulnerable population groups, i.e., infants and children. The use of stable isotope techniques adds value by increasing the sensitivity and specificity of measurements as compared to conventional techniques. This brief overview highlights selected activities in infant nutrition where stable isotope techniques have been used. They include projects to measure human milk intake in breast-fed infants, lean body mass (muscle mass) in lactating mothers, and bioavailability of iron in infants and young children
Cedefop - European Centre for the Development of Vocational Training, 2016
This Cedefop study focuses on the contribution that vocational education and training (VET) can make to reducing early leaving from education and training (ELET). Published in two volumes, the first is dedicated to understanding better the learning pathways of young students, providing measurements of early leaving in VET, and understanding the…
Carle, C; Alexander, P; Columb, M; Johal, J
We designed and internally validated an aggregate weighted early warning scoring system specific to the obstetric population that has the potential for use in the ward environment. Direct obstetric admissions from the Intensive Care National Audit and Research Centre's Case Mix Programme Database were randomly allocated to model development (n = 2240) or validation (n = 2200) sets. Physiological variables collected during the first 24 h of critical care admission were analysed. Logistic regression analysis for mortality in the model development set was initially used to create a statistically based early warning score. The statistical score was then modified to create a clinically acceptable early warning score. Important features of this clinical obstetric early warning score are that the variables are weighted according to their statistical importance, a surrogate for the FI O2 /Pa O2 relationship is included, conscious level is assessed using a simplified alert/not alert variable, and the score, trigger thresholds and response are consistent with the new non-obstetric National Early Warning Score system. The statistical and clinical early warning scores were internally validated using the validation set. The area under the receiver operating characteristic curve was 0.995 (95% CI 0.992-0.998) for the statistical score and 0.957 (95% CI 0.923-0.991) for the clinical score. Pre-existing empirically designed early warning scores were also validated in the same way for comparison. The area under the receiver operating characteristic curve was 0.955 (95% CI 0.922-0.988) for Swanton et al.'s Modified Early Obstetric Warning System, 0.937 (95% CI 0.884-0.991) for the obstetric early warning score suggested in the 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the UK, and 0.973 (95% CI 0.957-0.989) for the non-obstetric National Early Warning Score. This highlights that the new clinical obstetric early warning score has an excellent ability to
Baykal, C; Atci, T; Polat Ekinci, A; Buyukbabani, N
Information on frequency of melanoma and its clinicopathological subtypes derived from dermatology clinics in Turkey is limited. As data about melanoma show clear differences due to geographic and ethnic distribution, we scrutinized the rich data of our dermatology centre in Istanbul. Consecutive patients diagnosed with melanoma in a tertiary dermatology clinic during the last 19 years were retrospectively investigated about the clinical presentation of the skin lesions during admission, frequency of subtypes and localization of the tumour. There were 227 patients with melanoma showing five different clinical presentations: 200 of them had totally 207 primary cutaneous melanoma (PCM) lesions, nine had PCM lesions associated with metastatic skin lesions, three presented with local recurrence, eight with only skin metastases and seven with regressed skin melanoma following systemic melanoma metastases. Histologically, 23.19% of the PCM lesions were intraepidermal (in situ) and Breslow thickness was less than 1 mm in 30.9% of the patients with invasive melanoma. The most common subtype was superficial spreading melanoma (SSM) (37.19%), followed by lentigo malignant melanoma (LMM) (31.4%), acral lentiginous melanoma (ALM) (19.32%) and nodular melanoma (NM) (6.76%). Head and neck region was the most common (34.78%) localization of PCM lesions. Different clinical presentations, including various types of cutaneous melanoma metastases, were seen. However, a great proportion of our patients were relatively early diagnosed, either having an in situ or an invasive PCM with a Breslow thickness ≤1 mm. Even though SSM was the most common subtype of PCM in our series, its rate was lower compared to many European countries. Furthermore, the rate of NM subtype was also low, while LMM and ALM rates were higher in comparison to studies originating from European countries. This striking discrepancy requires further studies to explain the probable causes. © 2016 European Academy of
Back, William; Landa, Edward R.; Meeks, Lisa
Although hot springs have been used and enjoyed for thousands of years, it was not until the late 1700s that they changed the course of world civilization by being the motivation for development of the science of chemistry. The pioneers of chemistry such as Priestley, Cavendish, Lavoisier, and Henry were working to identify and generate gases, in part, to determine their role in carbonated beverages. In the 18th century, spas in America were developed to follow the traditional activities of popular European spas. However, they were to become a dominant political and economic force in American history on three major points: (1) By far the most important was to provide a place for the leaders of individual colonies to meet and discuss the need for separation from England and the necessity for the Revolutionary War; (2) the westward expansion of the United States was facilitated by the presence of hot springs in many locations that provided the economic justification for railroads and settlement; and (3) the desire for the preservation of hot springs led to the establishment of the National Park Service. Although mineral springs have maintained their therapeutic credibility in many parts of the world, they have not done so in the United States. We suggest that the American decline was prompted by: (1) the establishment of The Johns Hopkins School of Medicine in 1893; (2) enactment of the Pure Food and Drug Act of 1907; and (3) the remarkable achievement of providing safe water supplies for American cities by the end of the 1920s. The current expanding market for bottled water is based in part on bottled water being an alternative beverage Ito alcohol and sweetened drinks and the inconsistent palatability and perceived health hazards of some tap waters.
Keys, Margo A.
College student persistence is examined. The unique nature of the students and environment of the two-year college setting warrant concentrated research effort. The purpose of the study is to examine student variables associated with persistence and program completion to develop a pre-entrance risk assessment in the two-year college setting.…
Community-based early childhood education and development programs can serve a geographical community, but may also serve a group not necessarily from the same community but who have a deep interest in one or more community-based schools. This set of booklets provides a proposal and program characteristics for a community-based early childhood…
De Chiffre, Leonardo; Andreasen, Jan Lasson; Christensen, Lars Bager
as a centre of excellence for industrial CT scanning, both nationally and internationally. A network with approx. 40 participants has been established, and a total of 22 students have been educated. Dissemination activities have encompassed: a web page www.cia-ct.mek.dtu.dk , 8 newsletters, 4 topical...
Thornton, Linda; Brunton, Pat
"Understanding the Reggio Approach" is a much needed source of information for those wishing to extend and consolidate their understanding of the Reggio Approach. Analysing the essential elements of the Reggio Approach to early childhood and its relationship to quality early years practice, this new edition is fully updated with the…
Dougherty, Lea R.; Smith, Victoria C.; Olino, Thomas M.; Dyson, Margaret W.; Bufferd, Sara J.; Rose, Suzanne A.; Klein, Daniel N.
Neuroendocrine dysfunction is hypothesized to be an early emerging vulnerability marker for depression. We tested whether the main and interactive effects of maternal psychopathology and early child temperamental vulnerability for depression assessed at age three predicted offspring's basal cortisol function at age 6 years. 228 (122 males)…
Jacob, Lorraine; Mulligan, Joanne
In this article, Lorraine Jacob and Joanne Mulligan discuss how arrays can be used to promote students' early learning in relation to multiplication and division. They provide examples of activities that can be used from Foundation to Year 5.
Veen, Christa A; van Kasteren, Marjo E E; Fiedeldeij, Cora A; Kuipers, Marien H J; van Dijken, Pim J; Obihara, Charles C
To evaluate the neonatal outcomes of the policy for the prevention of vertical HIV transmission in a non-university HIV centre. Retrospective, descriptive study. We analysed the HIV status of newborns of HIV-positive mothers during pregnancy in the period between 1 January 1995 and 31 December 2010 in St. Elisabeth Hospital, Tilburg, the Netherlands and compared these results with the Dutch HIV monitoring foundation (SHM) registration data. Eighty-seven children from 84 pregnancies and their 71 HIV-positive mothers were included. Compared with SHM data, more women were African, younger at HIV diagnosis and had less resistance to the usual combination antiretroviral therapy (cART). In line with SHM data, the percentage of elective caesarean sections declined in the study period. There were fewer preterm births than in SHM data. There were no significant differences between preterm birth (p = 0.18), SGA (p = 0.25) or congenital abnormality (p = 0.45) and detectable HIV-RNA or cART use during pregnancy. During 10 (12%) pregnancies the mother presented to the HIV centre too late. At the age of 18 months, all 72 tested children were HIV negative. Of the 15 children lost to follow-up, 8 (9%) left to an unknown destination. All newborns of HIV-positive mothers were HIV negative, 12% of the HIV-positive mothers presented too late and 9% of the children disappeared from medical control. These results emphasize the importance of better communication between HIV centres, medical services of asylum centres and first-line obstetric care for female asylum seekers and their children.
Conclusion: Family-centred practice, play therapy, and individually tailored programmes are identified as key practice areas for this population. The important role occupational therapists play in early intervention teams is highlighted; however, further research is needed to develop the evidence base for best practice with particular rare developmental conditions.
Lightfoot, Sarah; Frost, David
This article examines the professional identity of nine early years educators currently working in the early years sector of education in England. These educators include teachers, teaching assistants, nursery practitioners and nursery nurses working with children three to five years old in the Early Years Foundation Stage in state-maintained…
Auer, Stefanie R; Span, Edith; Reisberg, Barry
Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. © The Author(s) 2013.
Anderloni, Andrea; Ballarè, Marco; Pagliarulo, Michela; Conte, Dario; Galeazzi, Marianna; Orsello, Marco; Andorno, Silvano; Del Piano, Mario
Endoscopic ultrasonography is accurate, safe, and cost-effective in diagnosing common bile duct stones, thus suggesting the possibility to avoid invasive endoscopic retrograde cholangiopancreatography. To prospectively evaluate the diagnostic and therapeutic performance of early endoscopic ultrasonography in suspected choledocholithiasis. All consecutive patients presenting to the Emergency Department with suspicion of choledocholithiasis between January 2010 and January 2012 were evaluated and categorized as low, moderate, or high probability of choledocholithiasis, according to accepted criteria. Endoscopic endosonography was carried out within 48 h from the admission and endoscopic retrograde cholangiopancreatography was performed soon in case of confirmed choledocholithiasis. Overall 179 patients were included: 48 (26.8%) were classified as low, 65 (36.3%) as moderate, and 66 (36.9%) as high probability of choledocholithiasis. Of the 86 patients with common bile duct stones at endoscopic endosonography, endoscopic retrograde cholangiopancreatography confirmed the finding in 79 (92%). By multivariate analysis only the common bile duct diameter proved an independent predictor of common bile duct stones. Early endoscopic endosonography is accurate in identifying choledocholithiasis allowing immediate endoscopic treatment and significant spare of unnecessary endoscopic retrograde cholangiopancreatography. This approach can be useful as a triage test to select patients not needing endoscopic retrograde cholangiopancreatography, allowing, in selected cases, their early discharge. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
This article presents the experiences of nursery and primary head teachers (n = 12) on the English Early Years Foundation Stage (EYFS) after its first year of implementation in 2010. Findings are drawn from a subset of data (head teachers of primary and nursery schools) which forms part of a larger Department for Children, Schools and Families…
Salmela-Aro, Katariina; Tolvanen, Asko; Nurmi, Jari-Erik
This longitudinal study spanning 18 years examined the role of social strategies in early career adaptation. The aim was to find out whether individuals' social strategies measured during their university studies had an impact on work burnout and work engagement measured 10-18 years later. A sample of 292 university students completed the SAQ…
Voyajolu, Angela; Ockelford, Adam
"Sounds of Intent in the Early Years" explores the musical development of children from birth to five years of age. Observational evidence has been utilised together with key literature on musical development and core concepts of zygonic theory (Ockelford, 2013) to investigate the applicability of the original "Sounds of…
Spilt, Jantine L.; Koomen, Helma M. Y.; Harrison, Linda J.
This longitudinal study examined developmental links between closeness in teacher-child relationships and children's receptive language ability from the end of the preschool years into the early elementary years, while controlling for changes in peer interaction quality and child behavioral functioning. The sample included children and their…
Spilt, J.L.; Koomen, H.M.Y.; Harrison, L.J.
This longitudinal study examined developmental links between closeness in teacher-child relationships and children’s receptive language ability from the end of the preschool years into the early elementary years, while controlling for changes in peer interaction quality and child behavioral
US Department of Education, 2014
The human brain develops rapidly in the first five years of life. High-quality early learning experiences can have a profound and lasting positive effect on young children during these years, setting the stage for success in kindergarten and beyond. This is especially true for young children with high needs who are from low-income families; who…
Sofolahan-Oladeinde, Yewande; Newhouse, Robin P; Lavallee, Danielle C; Huang, Jennifer C; Mullins, C Daniel
A key principle of patient-centred outcomes research (PCOR) is the engagement of patients and other stakeholders in the research process, but the evidence is still emerging on the impact patient engagement has on the research process. A 10-step framework has been developed to provide methodological guidance for patient engagement throughout the research process. However, the utility of the framework for patient engagement has not been tested in actual research studies. To describe researcher's overall experiences with engaging patients at the beginning of their PCOR research process. Twelve in-depth interviews were conducted face-to-face and by telephone with PCOR researchers between November 2014 and January 2015 at an Academic Health Center in the eastern USA. All data were audiotaped and transcribed, and NVivo 10 software was used for data analysis. Four major themes emerged (i) the importance of patient engagement and how it provides 'a perspective you can't get unless you talk to the patient'; (ii) the impact of patient engagement; (iii) challenges and barriers of engagement; and (iv) the realities of patient engagement. Researchers' views illustrate the need to re-evaluate patient engagement in PCOR based on current realities. Given the many challenges to engagement that researchers encounter, it may be more productive to redefine the process of patient engagement so that the issues researchers now face are taken into account in future funding announcements, engagement rubrics and methodology frameworks developed. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
Ricks, Timothy L; Phipps, Kathy R; Bruerd, Bonnie
The purpose of this study was to assess a national initiative's effect on prevalence of early childhood caries and untreated decay in zero- to five-year-old Indian/Alaska Native preschool children. The Indian Health Service (IHS) conducted a five-year Early Childhood Caries Collaborative from October 1, 2009 to September 30, 2014. The program used educational materials and routine communication with the 322 IHS and United States tribal dental programs, with an emphasis on early access to care, dental sealanth, fluoride varnish, and interim therapeutic restorations (ITRs). Prevalence and untreated decay data were obtained through the nationwide oral health survey (2010 and 2014). Data were also collected on access to care, sealants, fluoride, and ITRs. The number of zero- to five-year-olds with a dental visit increased seven percent: dental sealants placed increased 65 percent; and fluoride varnish applications increased 161.2 percent. Between 2010 and 2014, the percentage of one- to two-year-olds with decay experience and untreated decay declined, but the difference was not statistically significant. Early childhood caries prevention strategies, such as early access to dental care, sealants, fluoride varnish, and interim therapeutic restorations, demonstrated some initial improvement in the oral health status of zero- to five-year-old Indian/Alaska Native children.
Spjut Jansson B
Full Text Available Birgitta Spjut Jansson,1–3 Carmela Miniscalco,1,4 Joakim Westerlund,1,5 Anne-Katrin Kantzer,1,6 Elisabeth Fernell,1 Christopher Gillberg1 1Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, 2Unit of Child and Adolescent Habilitation, 3Department of Psychology, University of Gothenburg, 4Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, 5Department of Psychology, University of Stockholm, Stockholm, 6Department of Child and Adolescent Psychiatry, NU Hospital Organization, Trollhättan, Sweden Background: Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods: Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL – in two settings, which included home- and preschool-based (IL Regular and only home-based (IL Modified and eclectic interventions.Results: There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion: The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. Keywords: autism spectrum disorder, preschool children, early intervention, ABA, cognitive function, follow-up
Full Text Available Physical activity (PA and body mass index (BMI are consistently associated with motor coordination (MC in children. However, we know very little how BMI in early childhood associates with MC later in childhood. This study investigated associations between BMI in early childhood and BMI, PA, and MC in middle childhood. Children aged 5 to 7 years (n = 64, 32 girls were measured for MC using Körperkoordinationstest für Kinder (KTK and for moderate-to-vigorous PA (MVPA using triaxial accelerometers. Prevailing body weight and height were measured, and information on weight and height in early years was based on parental report of child health care report cards. Age-adjusted BMIz scores were calculated on the basis of international growth curve references. Associations and the explained variability of MC were investigated by Pearson correlations and a hierarchical multiple regression analysis. Age and MVPA were found to be significantly associated with MC at middle childhood, in general. BMIz at middle childhood and at ages 4 and 5 years inversely explained 12% (p < 0.05, 6% (p > 0.05, and 7% (p > 0.05 of the variation in MC in girls after adjusting for covariates, respectively. In boys, BMIz scores did not show any trend of association with MC. This study suggests sex-specific mechanisms in the interplay between BMI and motor development in childhood.
RTO-MP-HFM-134 6 - 1 Guideline for Early Interventions Maaike de Vries Impact Foundation, Dutch Knowledge & Advice Centre for Post...assistance, also referred to as ‘ early interventions ’ or ‘debriefing’, is offered following shocking events. These may be large scale disasters or...calamities, but also military deployment and individual incidents. During the last years, the demand for early interventions has been increasing
Joshi, K; Nair, S; Khade, C; Rajan, M G R
Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age deficiency was 91%. Screening programme for iodine deficiency during early gestation should be implemented along with the existing programme of haemoglobin estimation at first prenatal visit. This would help prevent damage to the developing brain and growth of the foetus and also to trace at-risk pregnant women.
Cheng, Mina; Lee, Kin-Yan; Chang, Annice-M L; Ho, Hiu-Fai; Chan, Lily-P S; Lee, Kin-Bong; Kwok, Philip-C H; Lee, Alexander-C W; Wong, Kevin-Y K; Kam, Chak-Wah; Leung, Gilberto-K K; Wong, John-K S; Cheung, Nai-Kwong; Yeung, Janice-H H; Tang, Ning; Choi, Shing-Hing; Lau, Tak-Wing; Wong, Heidi-H T; Leung, Ming
The mortality rate in patients with haemodynamically unstable pelvic fractures is as high as 40-60%. Despite the new advances in trauma care which are in phase in trauma centres in Hong Kong, the management of haemodynamically unstable pelvic fracture is still heterogeneous. The aim of this study is to review the results of management of haemodynamically unstable pelvic fracture patients in Hong Kong over a five year period. This is a retrospective multi-centred cohort study of patients with haemodynamic and mechanically unstable pelvic fractures from 1 January 2010 to 31 December 2014. The primary outcome investigated is mortality of patients (including overall, 30-day, 7-day and 24-hour mortalities). Implementation of three-in-one pelvic damage control protocol was identified to be a significant independent predictive factor for overall, 30-day, seven-day and 24-hour mortalities. The overall in-hospital and 30-day mortality rates for patients managed with three-in-one protocol was 12.5%, while it was 11% for seven day mortality and 6% for 24 hour mortality. There were no significant differences in demographic characteristics, physiological measurements, types of pelvic fracture, severity and mechanism of injury between patients managed with or without three-in-one protocol. Implementation of the multidisciplinary three-in-one pelvic damage control protocol reduces mortality and therefore should be highly recommended. The results are convincing as it has eliminated the limitations of our previous single-centred trial.
Kirkegaard, Henriette Schultz; Valentin, Finn
Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic and organi......Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic...... their performance....
Christiansen, Elisabeth Soegaard; Kjaer, Henrik Fomsgaard; Eller, Esben
BACKGROUND: Sensitization to both inhalant and food allergens has been shown to be risk factors for development of asthma and rhinoconjunctivitis (RC). However, few studies have addressed the role of transient or persistent IgE sensitization to specific allergens in early life for later developme......'s egg was associated with asthma and RC at 14 years. Furthermore, sensitization to HDM was associated with asthma at 14 years. This article is protected by copyright. All rights reserved....... to groups of and to individual allergens and asthma and RC at 6 and 14 years compared to a reference group with no sensitization. RESULTS: Both transient and persistent early-life sensitization to cow's milk or hen's egg proteins were associated with asthma (aOR 3.99(1.41-11.32) and 5.95(1.78-19.92)) and RC...... (aOR 2.94(1.19-7.28) and 6.18(1.86-20.53)) at 14 years, this association being driven mainly by sensitization to hen's egg. Transient early-life sensitization to HDM had increased risk of asthma (aOR 3.80(1.17-12.41)) at 14 years. CONCLUSIONS: Early transient and persistent IgE sensitization to hen...
Full Text Available The main aim of the study is to examine effects of bombing on development of early maladaptive schemas in children who live in directly bombed towns in comparison with children who live in towns not directly exposed to bombing. The subjects were twelve years old at the moment of testing (February 2005 meaning that they were at the age of seven during the bombing. Additional aim was to examine gender differences in development of early maladaptive schemas. The theory of Young (1990 provided framework for the study. According to the theory, early maladaptive cognitive schemas, which present basis for psychological disorder later in life, begin to develop in childhood in connection with traumatic experiences and/or other aversive circumstances. The results showed that the early maladaptive schemas are more frequent in children from directly exposed towns; and in male subjects comparing with females.
Jakobsen, Ida Skytte; Fergusson, David; Horwood, John L.
independent additive contributions to crime. The important applied implication of these observations is that interventions that increase the eucational attainment of young people with early onset conduct problems may reduce the longer-term risks of antisocial behaviour faced by these young people. Further......This study used dato from a 30-year longitudinal study to esamine the associations between early conduct problems, school achievement and later crime. The analysis showed that, even following extensive adjustment for confounding, both early conduct problems and later educational achievement made...... experimental research is required to ascertain the extent that: a) the educational achievement of young people with early-onset conduct problems can be improved; and b) the extent to which any such improvements translate into reductions in subsequent antisocial behviour....
Leary, S D; Lawlor, D A; Davey Smith, G; Brion, M J; Ness, A R
Previous studies have demonstrated associations between some early-life exposures and later obesity, but most have used body mass index in childhood or adulthood as the outcome. The objective of this study was to investigate whether early-life exposures were associated with directly measured fat and lean mass in adolescence. This study used data on 4750 mother-offspring pairs, collected as a part of the Avon Longitudinal Study of Parents and Children, Bristol, UK between 1991 and 1992; associations between behavioural exposures occurring from conception up to 5 years of age (maternal and paternal smoking during pregnancy, breastfeeding, age at introduction to solids, dietary patterns and physical inactivity during early childhood) and offspring body composition measured by dual-energy X-ray absorptiometry at ~15 years were assessed. After full adjustment for potential confounders, maternal smoking during pregnancy, having a junk food diet and spending more time watching television in early childhood were all associated with higher fat mass at age 15, whereas maternal smoking, having a healthy diet and playing computer games more frequently in early childhood were all associated with a higher lean mass at age 15. Associations with paternal smoking were generally weaker for both fat and lean mass, but as there was no strong statistical evidence for maternal vs paternal differences, confounding by social factors rather than a direct effect of maternal smoking cannot be ruled out. Early feeding was not associated with fat or lean mass at age 15. This study does not provide compelling evidence for associations between most early-life factors and body composition in adolescence. However, possible associations with dietary patterns and physical inactivity in early childhood require further investigation in other cohorts that have direct measurements of adolescent body composition.
Friis, Svein; Melle, Ingrid; Johannessen, Jan Olav
OBJECTIVE: Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first...... psychotic episode. METHODS: Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two......, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years...
Christensen, Martin; Kronborg, Camilla Skovhus; Carlsen, Rasmus Kirkeskov; Eldrup, Nikolaj; Knudsen, Ulla Breth
Women with a history of preeclampsia have increased risk of cardiovascular disease later in life. However, it is unclear whether early gestational age at preeclampsia onset is associated with higher cardiovascular disease risk. This study aimed to test the association between gestational age at preeclampsia onset (including the early-onset/late-onset preeclampsia distinction) and subclinical atherosclerosis and arterial stiffness in age-matched women 12 years after index pregnancy. Eligible participants were identified in two Danish registries. Main outcome measures were carotid plaque presence, carotid intima-media thickness, aortic pulse wave velocity, and augmentation index adjusted for heart rate. Twenty-four women with previous early-onset preeclampsia, 24 with previous late-onset preeclampsia and 24 with previous normotensive pregnancies were included after matching on age (±2 years) and time since delivery (±1 year). In all outcome measures, the early-onset group had the highest percentage or mean value. In the adjusted analysis, the early-onset group significantly differed from the late-onset group in all outcome measures except aortic pulse wave velocity. The early-onset group also had significantly higher carotid intima-media thickness (average and left) compared with the normotensive group. Gestational age at preeclampsia onset as a continuous variable was significantly associated to both carotid plaque presence and carotid intima-media thickness (average and right). Gestational age at preeclampsia onset is negatively associated with markers of subclinical atherosclerosis 12 years after delivery. Potentially, gestational age at preeclampsia onset might be helpful in directing cardiovascular disease prevention after preeclampsia. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.
Stirrup, Julie; Duncombe, Rebecca; Sandford, Rachel
Growing pressure on parents to equip their children with the skills required for future success, coupled with an increased focus on providing quality learning experiences in the early years, has contributed to an upsurge in the enrolment of young children in formal (often privatised) activities. Moreover, in response to growing societal concerns…
Laurie, Robert; Sloat, Elizabeth
This research investigates key psychometric properties of the French Early Years Evaluation-Teacher Assessment measure designed to systematically assess kindergarten children across five social and academic developmental domains: awareness of self and environment, social skills and behaviour, cognitive abilities, language and communication, and…
Atchison, Bruce; Diffey, Louisa; Workman, Emily
High-quality early elementary years offer a critical opportunity for child development and academic learning for all children, regardless of their race, family-income level, or culture and home language. All students deserve access to high-quality teachers and leaders trained in how to effectively support their learning. They deserve to attend…
Alkhawaldeh, Mustafa; Hyassat, Mizyed; Al-Zboon, Eman; Ahmad, Jamal
The current research investigated early years teachers' perspectives regarding the role of computer technology in supporting children's learning in Jordanian kindergartens. Thirty semistructured interviews were conducted with preschool teachers. The sample of kindergartens in this study was purposefully selected from the targeted population of…
Sayler, Michael F.
The University of North Texas's Texas Academy of Mathematics and Science began admitting students to its 2-year early college entrance science, technology, engineering, and mathematics (STEM) program in the fall of 1988. This program provided accelerated entry for top students in Texas in the areas of mathematics and science. Approximately 200…
Bartolini Bussi, Maria G.; Baccaglini-Frank, Anna
In early years schooling it is becoming common to propose activities that involve moving along paths, or programming robots to do so. In order to promote continuity towards the introduction of geometry in primary school, we developed a long-term teaching experiment (with 15 sessions) carried out over 4 months in a first grade classroom in northern…
Pupala, Branislav; Kascak, Ondrej; Tesar, Marek
Early years education in Europe and elsewhere around the world is currently in the spotlight due to political and economical changes and subsequent promises of effective investment into its provision. In this article we analyse everyday preschool practices in Slovakia in terms of tensions between policies, the teachers workforce and the concept of…
This article presents research undertaken among male teachers and it explores their perceptions and experiences of working in early years contexts. It examines prevalent, contrary discourses and their impact on the construction of male teachers' identities. Public discourses in relation to male teachers reveal contradictions and ambiguities…
Moosa, Shaaista; Bhana, Deevia
In this article we argue that eliminating the divisions of labour between men and women could work towards counteracting gender inequality within professions. Globally women are over-represented in the teaching of young children in the early years of primary school, or Foundation Phase (FP), as it is known in South Africa. We are concerned to go…
Ihmeideh, Fathi Mahmoud
It has been widely recognised that fathers can play a key role in the development and well-being of young children. In many cases, however, fathers still have limited involvement in the early years education of their children and their voices are as yet unheard. This study examined the beliefs and practices of Jordanian fathers of kindergarten…
Since the introduction of the Early Years Foundation Stage (EYFS) in England in 2008, assessment of children has taken a formal and standardized measurable approach. Such an approach goes against most findings of play-oriented research. Thus, the project reported here employed participatory action research with practitioners in order to identify…
Miller, Peggy J.; Chen, Eva Chian-Hui; Olivarez, Megan
Although very young children are unable to formulate a personal narrative of the life course, their everyday lives are steeped in narratives. Drawing on ethnographic studies in diverse sociocultural worlds, we argue that the early years of life form a vital preamble to the personal narrative. In this phase of life, the universal predisposition to…
Arguments about the modalities to teach reading effectively in the early years have been a subject of discourse among literacy teachers. Phonics has been adjudged as a significant approach in teaching how to read and write. Two perspectives of teaching phonics, synthetic and analytic, have been found to dominate the ...
The Independent Review of the Primary Curriculum and the independent Cambridge Primary Review both highlight the need to re-think children's educational experiences in English classrooms between the ages of five and seven. Recent government initiatives have led to experiences in these early primary years being adult-directed and often in…
Bhana, Deevia; Nzimakwe, Thokozani; Nzimakwe, Phumzile
Understanding the ways in which young boys and girls give meaning to gender and sexuality is vital, and is especially significant in the light of South Africa's commitment to gender equality. Yet the, gendered cultures of young children in the early years of South African primary schools remains a, marginal concern in debate, research and…
Chappell, Kerry Anne; Pender, Tamsin; Swinford, Elizabeth; Ford, Katherine
This paper focuses on how wise humanising creativity (WHC) is manifested within early years interdisciplinary arts education. It draws on Arts Council-funded participatory research by Devon Carousel Project and University of Exeter's Graduate School of Education. It is grounded in previous AHRC-funded research, which conceptualised WHC in the face…
Groen, SE; de Blecourt, ACE; Postema, K; Hadders-Algra, M
Assessment of the quality of general movements (GMs) in early infancy is a powerful instrument to predict cerebral palsy (CP). The aim of the present study is to explore the value of GM assessment in predicting minor neurological dysfunction (MND) at 9 to 12 years of age. Two groups of infants were
Moffatt, H. Keith
The origins of the Journal of Fluid Mechanics, of which the first volume was published in 1956, are discussed, with reference to editorial correspondence during the early years of the Journal. This paper is based on a lecture given at the colloquium: A Century of Fluid Mechanics, 1870-1970, IMFT, Toulouse, France, 19-21 October 2016.
Castro-Fornieles, Josefina; Baeza, Immaculada; de la Serna, Elena; Gonzalez-Pinto, Ana; Parellada, Mara; Graell, Montserrat; Moreno, Dolores; Otero, Soraya; Arango, Celso
Background: Only one study has used a prospective method to analyze the diagnostic stability of first psychotic episodes in children and adolescents. The Child and Adolescent First-Episode Psychosis Study (CAFEPS) is a 2-year, prospective longitudinal study of early-onset first episodes of psychosis (EO-FEP). Aim: To describe diagnostic stability…
Neal, Arthur G.; And Others
Examined attitudes of ambivalence and hostility toward children by drawing on a random sample of 600 couples in the early years of marriage. Based on a scale that measured perceived advantages and disadvantages of children, results showed that several alienation variables were associated with negative attitudes toward children, while several…
Takeuchi, Miwa Aoki
This study examined immigrant parents' involvement in early years mathematics learning, focusing on learning of multiplication in in- and out-of-school settings. Ethnographic interviews and workshops were conducted in an urban city in Japan, to examine out-of-school practices of immigrant families. Drawing from sociocultural theory of learning and…
Aim: To determine the differences in prevalence of early childhood caries among underprivileged and privileged children aged 2 to 6 years at different institutions in Dar es Salaam. Design: A cross sectional study. Study participants and methods: Intra oral examination was done to assess the children's caries status scored ...
Kovas, Yulia; Haworth, Claire M. A.; Dale, Philip S.; Plomin, Robert
Despite the importance of learning abilities and disabilities in education and child development, little is known about their genetic and environmental origins in the early school years. We report results for English (which includes reading, writing, and speaking), mathematics, and science as well as general cognitive ability in a large and…
Full Text Available Liver transplant seems to be an effective option to prolong survival in patients with end-stage liver disease, although it still can be followed by serious complications. Invasive fungal infections (ifi are related to high rates of morbidity and mortality. The epidemiology of fungal infections in Brazilian liver transplant recipients is unknown. The aim of this observational and retrospective study was to determine the incidence and epidemiology of fungal infections in all patients who underwent liver transplantation at Albert Einstein Israeli Hospital between 2002-2007. A total of 596 liver transplants were performed in 540 patients. Overall, 77 fungal infections occurred in 68 (13% patients. Among the 77 fungal infections, there were 40 IFI that occurred in 37 patients (7%. Candida and Aspergillus species were the most common etiologic agents. Candida species accounted for 82% of all fungal infections and for 67% of all IFI, while Aspergillus species accounted for 9% of all fungal infections and for 17% of all IFI. Non-albicans Candida species were the predominant Candida isolates. Invasive aspergillosis tended to occur earlier in the post-transplant period. These findings can contribute to improve antifungal prophylaxis and therapy practices in Brazilian centres.
S. V. Alekseenko
Full Text Available Background: Amblyopia related to congenital strabismus belongs to neurological disorders since it is caused by structural and functional remodeling of the visual parts of the brain without any baseline retinal pathology. Although a large number of animal studies on experimentally induced strabismus, as well as clinical cases have been published, the mechanisms and time course of the processes within the brain structures are not fully understood. Aim: To study the time course of abnormalities in the dorsal lateral geniculate nucleus (LGNd in animals with surgically induced convergent strabismus. LGNd is the structure through which the information from the retina goes to the visual cortex separately for each eye. Materials and methods: 14 strabismic and 17 intact kittens of four age groups were studied. Histochemical method was used to identify cytochrome oxidase which is a mitochondrial respiratory chain enzyme whose activity correlates with neuronal functional activity. Optical density in eye-specific layers A and A1 was measured on the images of stained LGNd sections, with calculation of the contrast difference between them. Results: In strabismic kittens, there were changes in activity of A and A1 layers in the projection of the central part of visual field in LGNd of both hemispheres. At early stages of their formation, a relative decrease in activity was found in both hemispheres in the LGNd layers innervated through non-crossed pathways from both retinae. Thereafter, the time course of abnormalities in LGNd of both hemispheres was different. In the hemisphere ipsilateral to the squinting eye, the difference in layer activity was highest at the age from 3 to 5 months. However, in the opposite hemisphere the same difference indicating a decreased activity in the layer of the squinting eye were observed only at the age of 5 months. Conclusion: The process of amblyopia development during congenital convergent strabismus is
Raustorp, Anders; Lindwall, Magnus
One variable that has been consistently associated with adolescents' physical activity is perceived activity competence. Perceived physical (or sport) competence is considered a sub-domain to the physical self-esteem or self-worth (i.e., a person's valuation of what is good and worthy in their self-description). This study aimed to describe levels of and inter-correlations among physical self-esteem, physical activity, and body mass index in a longitudinal design spanning adolescence to early adulthood. At mean ages of 12.7, 15.7, 17.7 and 22.7 years, we measured perceived physical self-esteem in 39 (22 boys) Swedish adolescents. Physical activity (steps/day) for four consecutive schooldays, height, and weight were also measured. No significant difference between the four time points for any variable of perceived physical self-esteem was seen, neither in boys nor girls. In general, all physical self-variables revealed non-linear trajectories across time, where the general trend was an increase during the younger ages followed by a decrease during older ages. At ages 12 and 15 years in boys and girls physical condition and physical strength as well as body attractiveness and physical strength, respectively, had the strongest correlations to physical self-esteem. At age 17 and 22 years sports competence had the strongest correlation to self-esteem in girls, while body attractiveness and physical strength had the strongest correlation to self-esteem in boys. An overall stability in physical self-esteem was found. However the impact of a sub-domain upon physical self-esteem vary during adolescence and early adulthood. Such information may be useful when creating physical activity programs that support and develop physical self-esteem.
The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial
Lindholt, J S; Gottschalksen, B; Johannesen, N
To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study.......To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study....
Beuker, Karin T; Rommelse, Nanda N J; Donders, Rogier; Buitelaar, Jan K
The first two years of life is a crucially important period for the development of communication skills. In this study joint attention and language development were monthly assessed between 8 and 24 months of age in a sample of 23 typically developing children to establish the developmental trajectory of specific joint attention skills, to investigate the developmental interrelations of these different joint attention skills with vocabulary size, and to examine whether the order of development of following and directing attention influences the development of other early communication skills such as language. All joint attention skills emerged between 8 and 15 months of age and responsive joint attention skills tend to emerge before initiative joint attention. Early joint attention skills influenced later language development, but not the other way around. Children in whom directing attention with gaze alternation developed early (in age or order) showed a relatively larger early vocabulary growth. A fine grained mapping of the normal development of early communication skills can be helpful in the early detection of abnormalities in these skills. Copyright © 2012 Elsevier Inc. All rights reserved.
Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer E; Zheng, Shuguo
This study aimed to explore the association between early life factors and dental caries among 5-year-old Chinese children. Data from 9722 preschool children who participated in the third National Oral Health Survey of China were analysed. Information on early life (birth weight, breastfeeding and age when toothbrushing started), child (sex, ethnicity, birth order and dental behaviours) and family factors (parental education, household income, place of residence, number of children in the family, respondent's age and relation to the child) were obtained from parental questionnaires. Children were also clinically examined to assess dental caries experience using the decayed, missing and filled teeth (dmft) index. The association of early life factors with dmft was evaluated in negative binomial regression models. We found that birth weight was not associated with dental caries experience; children who were exclusively and predominantly formula-fed had lower dmft values than those exclusively breastfed; and children who started brushing later in life had higher dmft values than those who were brushing within the first year. Only one in seven of all children received regular toothbrushing twice per day, and only 34.7% had commenced toothbrushing by the age of 3 years. This study shows certain early life factors play a role in dental caries among Chinese preschool children and provides important insights to shape public health initiatives on the importance of introducing early toothbrushing. The early environment, especially the age when parents introduce toothbrushing to their children, can be an important factor to prevent childhood dental caries. Copyright © 2017 Elsevier Ltd. All rights reserved.
Tara L. LaRowe
Full Text Available Abstract Background Early childcare and education (ECE is a prime setting for obesity prevention and the establishment of healthy behaviors. The objective of this quasi-experimental study was to examine the efficacy of the Active Early guide, which includes evidenced-based approaches, provider resources, and training, to improve physical activity opportunities through structured (i.e. teacher-led activity and environmental changes thereby increasing physical activity among children, ages 2–5 years, in the ECE setting. Methods Twenty ECE programs in Wisconsin, 7 family and 13 group, were included. An 80-page guide, Active Early, was developed by experts and statewide partners in the fields of ECE, public health, and physical activity and was revised by ECE providers prior to implementation. Over 12 months, ECE programs received on-site training and technical assistance to implement the strategies and resources provided in the Active Early guide. Main outcome measures included observed minutes of teacher-led physical activity, physical activity environment measured by the Environment and Policy Assessment and Observation (EPAO instrument, and child physical activity levels via accelerometry. All measures were collected at baseline, 6 months, and 12 months and were analyzed for changes over time. Results Observed teacher-led physical activity significantly increased from 30.9 ± 22.7 min at baseline to 82.3 ± 41.3 min at 12 months. The change in percent time children spent in sedentary activity decreased significantly after 12 months (−4.4 ± 14.2 % time, −29.2 ± 2.6 min, p < 0.02. Additionally, as teacher led-activity increased, percent time children were sedentary decreased (r = −0.37, p < 0.05 and percent time spent in light physical activity increased (r = 0.35, p < 0.05. Among all ECE programs, the physical activity environment improved significantly as indicated by multiple sub-scales of
LaRowe, Tara L; Tomayko, Emily J; Meinen, Amy M; Hoiting, Jill; Saxler, Courtney; Cullen, Bridget
Early childcare and education (ECE) is a prime setting for obesity prevention and the establishment of healthy behaviors. The objective of this quasi-experimental study was to examine the efficacy of the Active Early guide, which includes evidenced-based approaches, provider resources, and training, to improve physical activity opportunities through structured (i.e. teacher-led) activity and environmental changes thereby increasing physical activity among children, ages 2-5 years, in the ECE setting. Twenty ECE programs in Wisconsin, 7 family and 13 group, were included. An 80-page guide, Active Early, was developed by experts and statewide partners in the fields of ECE, public health, and physical activity and was revised by ECE providers prior to implementation. Over 12 months, ECE programs received on-site training and technical assistance to implement the strategies and resources provided in the Active Early guide. Main outcome measures included observed minutes of teacher-led physical activity, physical activity environment measured by the Environment and Policy Assessment and Observation (EPAO) instrument, and child physical activity levels via accelerometry. All measures were collected at baseline, 6 months, and 12 months and were analyzed for changes over time. Observed teacher-led physical activity significantly increased from 30.9 ± 22.7 min at baseline to 82.3 ± 41.3 min at 12 months. The change in percent time children spent in sedentary activity decreased significantly after 12 months (-4.4 ± 14.2 % time, -29.2 ± 2.6 min, p < 0.02). Additionally, as teacher led-activity increased, percent time children were sedentary decreased (r = -0.37, p < 0.05) and percent time spent in light physical activity increased (r = 0.35, p < 0.05). Among all ECE programs, the physical activity environment improved significantly as indicated by multiple sub-scales of the EPAO; scores showing the greatest increases were the
Light, John M.; Rusby, Julie C.; Nies, Kimberley M.; Snijders, Tom A. B.
Antisocial behavior typically increases during early adolescence, but the possibility of seasonal variation has not been examined. In this study, trajectories of antisocial behavior were estimated for early adolescent boys and girls. Data were obtained from a 3-year longitudinal study of 11 middle schools in the western U.S. (n = 5,742), with assessments completed four times per academic year. Antisocial behavior increased steadily throughout 6th grade, but beginning in 7th grade for boys and 8th grade for girls, it declined during the school year. Significant increases between grades 6–7 and 7–8 were found for both genders. Trajectories varied by contextual and individual-level social victimization and gender. Implications for theoretical development and future studies are discussed. PMID:25346587
Yoshida, Ken; Koizumi, Masahiko; Inoue, Takehiro; Yamazaki, Hideya; Imai, Atsushi; Shiomi, Hiroya; Yoshioka, Yasuo; Tanaka, Eiichi; Shimizutani, Kimishige; Furukawa, Souhei; Inoue, Toshihiko
Purpose: To evaluate the results of treatment for early mobile tongue cancer in patients less than 40 years. Methods and Materials: Between January 1967 and September 1992, 70 patients less than 40 years old (young age group) with early tongue cancer (T1-2N0M0) were treated with low-dose-rate (LDR) interstitial radiotherapy at the Osaka University Hospital (OUH). All patients had a minimum 2-year follow-up (median: 13 years). External radiotherapy (median: 30 Gy) was combined in 25 cases. The treatment results were compared with those for two older age groups (middle age: 40-64 years old; old age: 65 years old or more). Results: The 5-year probability of cause-specific survival (CSS) rate for the young age group was 80%, which was not significantly different from the two older groups: 81% for middle age and 71% for old age. However, male patients of young age showed significantly worse rates than those of middle and old age (p = 0.02). The 5-year local control rate for the young age group was 78%. It was not significantly different from the two older groups: 81% for middle age and 70% for old age. The incidence of regional lymph node metastasis was 32% for T1, 48% for T2, 56% for males, and 24% for females. The regional failure rate of young males was significantly higher than those of the two older groups: 32% for middle and 22% for old age (p = 0.001). Conclusion: The overall treatment results for patients with early tongue cancer less than 40 years old were not worse than those of older age groups. However, male gender was a risk factor for lymph node metastasis and CSS
Full Text Available Aim of the study: The analysis of the types of developmental disorders in early childhood. Material and methods: Seventy-one children at the age from 7 days to 3 years who came to The Early Intervention Centre for Handicapped Children “Give the Chance” at University Children’s Clinical Hospital in Bialystok in 2010 were examined. There were 46 (65% boys and 25 (35% girls in that group. The most common reason for coming to the Centre was the psychomotor retardation – 38 (54% subjects. In the Centre the diagnosis included: developmental interview, psychological, pedagogical and speech-therapy research. The evaluation of the psychomotor development in the psychological investigation was made using the Brunet-Lézine Scale of Psychomotor Development. The opinion on the symptoms of pervasive developmental disorder was based on diagnostic criteria contained in ICD-10. Results: The delayed development of the active speech was diagnosed in 71 (100% subjects. Forty-one (58% patients had psychomotor retardation without the features of the pervasive developmental disorder. Pervasive developmental disorder was diagnosed in 19 (27% subjects. The quotient of the psychomotor development was 77. Therapeutic influences included: psychoeducation – 65 (92% subjects, pedagogical therapy and speech-therapy – 13 (18% subjects, emotional support – 65 (92% subjects, systematic group classes for parents – 10 (14% subjects. Conclusions: 1 The developmental disorder was diagnosed in the majority of the examined children – 41 (58% subjects. 2 Pervasive developmental disorder was diagnosed in 19 (27% subjects, which is in accordance with the worldwide tendency for the growth of the number of diagnosis connected with this disorder (“autism epidemics”.
Kirkman, Matthew A; Watkins, Laurence D; Kitchen, Neil D; Sethi, Huma
The past decade has seen significant changes to the face of neurosurgical training in the United Kingdom, driven in part by an increasing focus on patient safety and the introduction of Modernising Medical Careers and the European Working Time Directive (EWTD). Recent reforms to neurosurgical training over the past few years have resulted in creation of an 8-year 'run-through' training programme. In this programme, early years (ST1 and ST2) trainees often lack dedicated time for elective theatre lists and outpatient clinics. Further, any time spent in theatre and clinics is often with different teams. Here we describe a training model for early years trainees at the National Hospital for Neurology and Neurosurgery, who are given the responsibilities traditionally associated with a more senior trainee including dedicated weekly theatre and clinic time under the supervision of a single consultant, in addition to out of hours experience. The advantages and considerations for implementing this model are discussed, including the benefit of guidance under a single consultant in the early stages of training, along with key educational concepts necessary for understanding its utility. We feel that this is an effective model for junior neurosurgical training in the EWTD era, expediting the trainee's development of key technical and non-technical skills, with potentially significant rewards for patient, trainee and trainer. National implementation of this model should be considered.
Barczak, Katarzyna; Szmidt, Monika; Buczkowska-Radlińska, Jadwiga
The aim of this study was to determine the relationship between the masticatory apparatus functionality and a sense of depression in patients over 55 years of age living in a family environment and the Social Care Centres (SCC). Shortened version of the Geriatric Depression Scale (GDS) was used to assess the wellbeing of patients and their state/sense of depression. The clinical evaluation of masticatory function was performed during one appointment in the natural light. The clinical criterion for the retention of masticatory function, adopted by the World Health Organization was a contact between at least 20 opposing teeth, natural or artificial. Among patients with a low number of GDS points (0-5), statistically significantly higher proportion of people living in family houses (69.4%) maintained functionality of masticatory apparatus than of people living in SCC (23.5%). In contrast, among patients with a higher number of GDS points (6-15), statistically significantly higher proportion of patients living in SCC (70.8%) did not maintain functionality of masticatory apparatus than of those living in family houses (41.7%). Patients with a sense of depression living in Social Care Centres were more likely to report lack of functionality of masticatory apparatus than patients with a sense of depression living in family houses. The presence of a growing sense of depression significantly affected a lower rate of preserved functionality of masticatory apparatus or vice versa.
Blakey, Karen; Feltbower, Richard G; James, Peter W; Libby, Gillian; Stiller, Charles; Norman, Paul; Gerrand, Craig; McNally, Richard J Q
Studies have shown marked improvements in survival between 1981 and 2000 for Ewing sarcoma patients but not for osteosarcoma. This study aimed to explore socio-economic patterning in early mortality rates for both tumours. The study analysed all 2432 osteosarcoma and 1619 Ewing sarcoma cases, aged 0-49 years, diagnosed in Great Britain 1985-2008 and followed to 31/12/2009. Logistic regression models were used to calculate risk of dying within three months, six months, one year, three years and five years after diagnosis. Associations with Townsend deprivation score and its components were examined at small-area level. Urban/rural status was studied at larger regional level. For osteosarcoma, after age adjustment, mortality at three months, six months and one year was associated with higher area unemployment, OR = 1.05 (95% CI 1.00, 1.10), OR = 1.04 (95% CI 1.01, 1.08) and OR = 1.04 (95% CI 1.02, 1.06) respectively per 1% increase in unemployment. Mortality at six months was associated with greater household non-car ownership, OR = 1.02 (95% CI 1.00, 1.03). For Ewing sarcoma, there were no significant associations between mortality and overall Townsend score, nor its components for any time period. For both tumours increasing mortality was associated with less urban and more remote rural areas. This study found that for osteosarcoma, early mortality was associated with residence at diagnosis in areas of higher unemployment, suggesting risk of early death may be socio-economically determined. For both tumours, distance from urban centres may lead to greater risk of early death. Copyright © 2018 Elsevier Ltd. All rights reserved.
Farhana, F; Jamaiah, I; Rohela, M; Abdul-Aziz, N M; Nissapatorn, V
This is a ten year (1999-2008) retrospective study of amebiasis in patients admitted to UMMC. A total of 34 cases were analyzed. The most common were amebic liver abscess 22(65%) and the rest were amoebic dysentery 12(35%). Majority of the cases occurred among Malaysians 29(85%), with Chinese 14(41%), followed by the Malays 9(26%) and the Indians 6(18%). Foreigners made up of one Indonesian, one Pakistani and three Myanmarese and constituted 5(15%) of the total cases. Males 24(71%) were more commonly affected. Most of the cases occurred between the age group of 40-49 years, 8(23%) and 60 years and above, 8(23%). Age group of 20-50 years constituted 20(60%) of the cases. The most common clinical presentations were fever with chills and rigors 26(76%), diarrhoea 20 (59%), right hypochondrium pain 17(50%), abdominal pain 17(50%), hepatomegaly 16 (47%) and jaundice 7(20%). All were discharged well after treatment except for one case of death in a 69-year-old Chinese male with amebic liver abscess.
Peshin, Sharda Shah; Srivastava, Amita; Halder, Nabanita; Gupta, Yogendra Kumar
The study was designed to analyze the incidence and pattern of pesticide poisoning calls reported to the National Poisons Information Centre (NPIC), AIIMS, New Delhi and highlight the common classes of pesticides involved in poisoning. The telephone calls received by the Centre during the thirteen year period (1999-2012) were entered into a preset proforma and then into a retrievable database. A total of 4929 calls of pesticide poisoning were recorded. The data was analyzed with respect to age, gender, mode and type of poisoning. The age ranged from 1 to 65 years with the preponderance of males (M = 62.19%, F = 37.80%). The age group mainly involved in poisoning was 18-35 years. While 59.38% calls pertained to household pesticides, 40.61% calls related to agricultural pesticides. The common mode of poisoning was intentional (64.60%) followed by accidental (34.40%) and unknown (1%). Amongst the household pesticides, the highest number of calls were due to pyrethroids (26.23%) followed by rodenticides (17.06%), organophosphates (6.26%), carbamates (4.95%) and others (4.86%). In agricultural pesticides group, the organophosphates (9.79%) ranked the first followed by, aluminium phosphide (9.65%), organochlorines (9.31%), pyrethroids (3.87%), herbicides, weedicides and fungicides (3.20%), ethylene dibromide (2.82%), and others (1.70%). The data analysis shows a high incidence of poisoning due to household pesticides as compared to agricultural pesticides, clearly emphasizing the need for creating awareness and education about proper use and implementation of prevention programmes. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Wigen, Tove I; Wang, Nina J
The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 years of age and having caries experience at 5 years of age. This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 years of age having the teeth brushed less than twice daily (OR = 2.1, CI = 1.3-3.6) and being offered sugary drinks at least once a week (OR = 1.8, CI = 1.1-2.9) when controlled for family characteristics and oral health behavior at 5 years of age. Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during pre-school age, independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long-term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children's first years of life should receive special attention from health personnel.
Giselly Rosa Modesto Pereira
Full Text Available Abstract Introduction/objective: We evaluated the predictability of early changes in serum albumin (sAlb on the two-year mortality of incident hemodialysis patients. Methods: Observational, longitudinal retrospective study using the database of Fresenius Medical Care of Latin America. Adult patients starting dialysis from January/2000 to June/2004, from 25 centers were included. Changes in sAlb during the first 3 months on hemodialysis were used as the main predictor. The outcome was death from any cause. Results: 1,679 incident patients were included. They were 52 ± 15 years old, 58.7% male and 21.5% diabetic, with a median sAlb of 38 g/L (bromocresol green. 923 patients had sAlb 38.0 g/L (Adequate sAlb Group. The mortality was significantly higher in Low sAlb Group (17% vs. 11%, p < 0.001. Early changes in sAlb significantly affected two-year mortality. Factoring the Kaplan Meier curve of Low sAlb Group by the presence of an increase in sAlb uncovered of a statistically significant difference in mortality favoring the ones whose sAlb went up (19% vs. 15%, p = 0.043. Differently, patients from Adequate sAlb Group with a decrease in their sAlb had a statistically higher mortality rate (13% vs. 8%, p = 0.029. Conclusions: Early sAlb changes showed a significant predictive power on mortality at 2 years in incident hemodialysis patients. Those with low initial sAlb may have a better prognosis if their sAlb rises. In contrast, patients with satisfactory initial levels can have a worsening of their prognosis in the case of an early reduction in sAlb.
Lawson, J.; Brianti, G.
In the first report, 'Early synchrotrons in Britain, and early work for CERN', John Lawson gives an extended account of the material presented at the John Adams lecture, and at the same time a revised and shortened version of RAL report 97-011, which contains fuller archival references and notes. During the period covered by this report there was extensive work in Russia, where the principle of phase stability had been discovered in 1944 by Veksler. Unfortunately, all experimental work was kept secret until Veksler's talk at the first 'Atoms for Peace' conference at Geneva in August 1955. In the second lecture, 'The CERN Synchrotrons', Giorgio Brianti outlines the history of alternating-gradient synchrotrons from 1953/54 until today. In preparing this lecture he was confronted with a vast amount of material, while the time at his disposal was not even one minute per year, implying a time compression factor close to one million. Therefore, he had to exercise drastic choices, which led him to concentrate on CERN hadron synchrotrons and colliders and leave aside the Large Electron-Positron storage ring (LEP). Indeed, LEP was the subject of the John Adams Memorial Lecture in 1990, and it may be treated again in the future in connection with its energy upgrade. Even with these severe limitations, it was impossible to do justice to the number and variety of events and to the ingenuity of the people who have carved the history of CERN and of particle physics on the magnets, radiofrequency cavities, vacuum etc., and on the record performance of our machines. (orig./WL)
'We choose to go to the Moon in this decade and do the other things, not because they are easy, but because they are hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win, and the others, too.' President John Fitzgerald Kennedy, 12 September 1962. It is now 50 years since the first artificial satellite was launched. This article looks at the early years of space travel and some of the key moments during that time.
Dijkstal, Johanna M; Cooley, San-San; Holleschau, Ann M; King, Richard A; Summers, C Gail
To determine whether binocular best-corrected visual acuity (B-BCVA) improves in the early school years in patients with albinism and whether this is related to type of albinism, ocular pigment, or appearance of the macula. Patients with albinism seen between 5.5 and 9 years (Visit A) and 9.5 and 14 years of age (Visit B), with visits separated by at least 2.5 years, were included. Type of albinism, B-BCVA, glasses wear, iris pigment and macular transparency grade, and presence or absence of an annular reflex and melanin in the macula were recorded. Mean B-BCVA was 20/84 at Visit A and 20/61 at Visit B (P albinism in the early school years and this observation should be included in counseling. The etiology is unknown but may be related to change in nystagmus, use of precise null point, developmental maturation, and/or some of the ocular characteristics evaluated in this study. Copyright 2012, SLACK Incorporated.
Franz, T; Hasler, R M; Benneker, L; Zimmermann, H; Siebenrock, K A; Exadaktylos, A K
To analyse the epidemiological data, injury pattern, clinical features and mechanisms of severe spinal injuries related to alpine skiing and snowboarding. A six-year review of all adult patients with severe spinal injuries sustained from alpine skiing or snowboarding. Tertiary trauma centre in Bern, Switzerland. All adult patients (over 16 years of age) admitted to a tertiary trauma centre from 1 July 2000, through 30 June 2006, were reviewed using a computerised database. From these records, a total of 728 patients injured from snow sports were identified. Severe spinal injuries (defined as spinal fractures, subluxations, dislocations or concomitant spinal cord injuries) were found in 73 patients (17 female, 56 male). The clinical features of these patients were reviewed with respect to epidemiological factors, mechanism of injury, fracture pattern, and neurological status. The majority of severe spinal injuries (n = 63) were related to skiing. Fatal central-nervous injuries and transient or persistent neurological symptoms occurred in 28 patients (23 skiers, 5 snowboarders). None of the snowboarders suffered from persistent neurological sequelae. Snowboarders with severe spinal injuries (n = 10) were all male (p<0.05), and were significantly younger than skiers (p<0.001). The most commonly affected site was the lumbar spine. However, 39 patients (53.4%) suffered from injury pattern at two or more levels. With advances in technology and slope maintenance, skiers and snowboarders progress to higher skill levels and faster speeds more rapidly than ever before. Great efforts have been focused on reducing extremity injuries in snow sports, but until recently very little attention has been given to spinal injury prevention on the slopes. Suggestions for injury prevention include the use of spine protectors, participation on appropriate runs for ability level, proper fit and adjustment of equipment, and taking lessons with the goal of increasing ability and learning
Nwosu, Emmanuel C; Robertson, Frances C; Holmes, Martha J; Cotton, Mark F; Dobbels, Els; Little, Francesca; Laughton, Barbara; van der Kouwe, Andre; Meintjes, Ernesta M
Even with the increased roll out of combination antiretroviral therapy (cART), paediatric HIV infection is associated with neurodevelopmental delays and neurocognitive deficits that may be accompanied by alterations in brain structure. Few neuroimaging studies have been done in children initiating ART before 2 years of age, and even fewer in children within the critical stage of brain development between 5 and 11 years. We hypothesized that early ART would limit HIV-related brain morphometric deficits at age 7. Study participants were 7-year old HIV-infected (HIV+) children from the Children with HIV Early Antiretroviral Therapy (CHER) trial whose viral loads were supressed at a young age, and age-matched uninfected controls. We used structural magnetic resonance imaging (MRI) and FreeSurfer ( http://www.freesurfer.net/ ) software to investigate effects of HIV and age at ART initiation on cortical thickness, gyrification and regional brain volumes. HIV+ children showed reduced gyrification compared to controls in bilateral medial parietal regions, as well as reduced volumes of the right putamen, left hippocampus, and global white and gray matter and thicker cortex in small lateral occipital region. Earlier ART initiation was associated with lower gyrification and thicker cortex in medial frontal regions. Although early ART appears to preserve cortical thickness and volumes of certain brain structures, HIV infection is nevertheless associated with reduced gyrification in the parietal cortex, and lower putamen and hippocampus volumes. Our results indicate that in early childhood gyrification is more sensitive than cortical thickness to timing of ART initiation. Future work will clarify the implications of these morphometric effects for neuropsychological function.
Jedrychowski, Wieslaw; Perera, Frederica P.; Jankowski, Jeffery; Maugeri, Umberto; Mrozek-Budzyn, Dorota; Mroz, Elzbieta; Flak, Elzbieta; Skarupa, Anita; Edwards, Susan; Lisowska-Miszczyk, Ilona
The main purpose of the study was to answer the question whether young children without clinical diagnosis of asthma but experiencing early wheezing disorders and therefore being at high risk of developing asthma may have cognitive deficits. In the ongoing birth cohort study wheezing symptoms were recorded postpartum over two first years of age and subsequently cognitive status of children at the age of 3 years was assessed with the Bayley Mental Development Index (MDI). In the statistical analysis a wide range of modifying and confounding factors (maternal education, gender of children, prenatal exposure to lead and environmental tobacco smoke (ETS) were considered to assess the independent effect of early wheezing phenotypes on cognitive development of children. The MDI score correlated inversely with the number of wheezing days recorded over 24 months (r = −0.13, p=0.007), lead cord blood concentration (r = − 0.12, p = − 0.02), number of siblings (r = − 0.17, p = 0.0006) and the number of cigarettes smoked daily by other household members at home over the pregnancy period (r = − 0.18, p = 0.0002). While the children who experienced wheezing over the first year of age showed deficit of 2 MDI scores (beta coeff. = −2.31, 95%CI: −4.63 to 0.02), those with persistent wheezing had the score deficit of 4 points (beta coeff. = − 4.41, 95%CI: −8.27 to −0.55). To our knowledge, it is the first report in the literature showing that early wheezing is associated the cognitive deficit in a community-recruited very young children. Observed cognitive deficit in early wheezers may be caused by RSV infections or can be related to lower lung function attributed to persistent wheezing, which reducing oxygen supply would affect rapidly developing brain. PMID:19548966
Simonetti, Giovanni; Gandini, Roberto; Pampana, Enrico; Fabiano, Sebastiano; Stefanini, Matteo; Spinelli, Alessio; Reale, Carlo Andrea; Di Primio, Massimiliano; Gaspari, Eleonora [University Hospital ' ' Tor Vergata' ' , Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Rome (Italy); Versaci, Francesco [University Hospital ' ' Tor Vergata' ' , Department of Internal Medicine, Unit of Cardiology, Rome (Italy)
Carotid artery stenting (CAS) may be an alternative to surgical endoarterectomy not only in high-risk patients. We report results in the endovascular treatment of carotid artery disease with up to 8 years' follow-up. In this retrospective study, we analysed data from 853 consecutive patients (946 arteries) treated for carotid artery stenosis between April 1999 and March 2007; 491 (52%) arteries were symptomatic and 455(48%) were asymptomatic. Preprocedural evaluation of the patients was performed with echo Doppler, magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) and a neurological examination. A cerebral protection device was used in 879 (92.9%) procedures. Anti-platelet therapy was administered before and after the procedure. All patients were included in a follow-up of up to 8 years. Technical success was achieved in 943 (99.6%) lesions. At 30 days, there was a 0.21% (n = 2) death rate, a 0.42% major stroke rate, a 1.69% minor stroke/transient ischaemic attack (TIA) rate and a combined 2.32% TIA/stroke and death rate. During follow-up, echo Doppler evidenced restenosis in 39 (4.85%) cases; of these, only five, presenting restenosis >80%, were treated with an endovascular reintervention. At the long-term follow-up, two strokes (0.23%) were reported, which both occurred within the first 2 years. In our experience, carotid artery stenting seems to be a safe and effective treatment, providing satisfactory long-term clinical results. (orig.)
Chiat, Shula; Roy, Penny
Purpose: In this study, the authors aimed to evaluate hypotheses that early sociocognition will predict later social communication and early phonology will predict later morphosyntax in clinically referred preschoolers. Method: Participants were 108 children ages 9-11 years who had been referred to clinical services with concerns about language at…
Perez-Abalo, M C; Gaya, J A; Savio, G; Ponce de Leon, M; Perera, M; Reigosa, V
Infant hearing loss is a highly prevalent disorder which untreated can severely disrupt normal brain development. As a result there is a significant delay in language acquisition as well as many cognitive and emotional problems in the child. Over the last decades important advances have occurred in the available technology for early detection and assessment of hearing impairment. Therefore many countries worldwide have become aware of the need for hearing screening programs. The optimal protocols depending on the local conditions of health care as well as the availability of technological and human resources. To summarize the results obtained over the last 20 years by an ongoing hearing screening protocol. Data on the coverage program, sensitivity and specificity, age of identification of hearing losses, diagnostic and intervention stages will be summarized and discussed. Also the long terms effects of early detection on the child cognitive and language development are analyzed. Finally, the possible role of a new technique based on the recording of multiple auditory steady state potentials with Cuban equipment (AUDIX system) was evaluated within this context. The Cuban targeting multiple high risk hearing screening program is a useful alternative to early detection of hearing losses. The average detection age of hearing loss was 10 months during the period of optimal functioning. Cognitive, emotional and linguistic development are improved by early detection and intervention. The multiple auditory steady state responses can provide valuable audiometric information within a screening context.
Srivastava, P; Abujam, B; Misra, R; Lawrence, A; Agarwal, V; Aggarwal, A
Childhood SLE (cSLE) has a higher prevalence of lupus nephritis (LN), and there are ethnic variations in response to treatment as well as outcome of LN. There are limited data on long-term outcome of LN in cSLE from the Indian subcontinent. Retrospective analysis of case records of patients with cSLE (satisfying revised American College of Rheumatology (ACR) 1997 criteria for diagnosis) and age of onset Collaborating Clinics (SLICC)/ACR damage score was 0.79 ± 1.13. Actuarial ESRD-free survival at five, 10 and 15 years was 91.1%, 79% and 76.2%, and five-, 10- and 15-year renal survival was 93.8%, 87.1% and 84%, respectively. Although multiple factors individually predicted poor outcome (death/ESRD), only raised serum creatinine at onset (R square = 0.65, p ≤ 0.0001) and damage accrual (R square = 0.62, p ≤ 0.0001) remained significant on multivariate analysis. Eleven (8.2%) children died during the follow-up period, and infections were the leading cause of mortality. Long-term outcome of LN in cSLE in our cohort was better than previous reports from India. However, a high rate of major infection still remains the leading cause of mortality. © The Author(s) 2015.
Sinha, C K; Pallewatte, A; Easty, M; De Coppi, P; Pierro, A; Misra, D; Biassoni, L
To review our practice of Meckel's Tc-99m pertechnetate scans over 18 years with regard to indications for the test, sensitivity and specificity in our particular referral patients' population. This is a retrospective review of Meckel's scans performed in two paediatric tertiary care teaching hospitals from April 1993 to March 2011 and followed up till October 2011. The scan was performed according to published international guidelines. 183 patients were included in this study. We classified the patients into two groups: group 1, which included 77 patients (42 %) presenting with painless per rectum bleeding, and group 2, which included 106 patients (58 %) presenting with other non-specific symptoms (e.g. abdominal pain, possibly associated with nausea and/or vomiting, failure to thrive). Data were analysed using Chi square test, considering P value less than 0.05 as significant. The age of the patients ranged from 4 days to 16.5 years (median 3 years). 161 of the total 183 children on the study (88 %) had a negative Meckel's scan, and 22 children (12 %) had a positive scan. In the group with a positive Meckel's scan (22 children), all patients underwent surgical exploration and ectopic gastric mucosa was found in 17 cases (77 %, true positives). In the remaining 5 cases (23 %), there was no evidence of ectopic gastric mucosa (false positives). Within the group with a negative scan, 8 children (5 %) underwent surgery; only 1 child had a ectopic gastric mucosa detected following surgery (false negative). In other 52 children (32 %) of the group with a negative Meckel's scan, an endoscopy was done, which showed a normal result in 21 children and was abnormal in 31 children. Of the remaining 101 (63 %) children with a negative Meckel's scan, 74 children (46 %) improved without any further intervention. In 13 cases (8 %), other pathologies were identified. The sensitivity and specificity of the Meckel's scan for ectopic gastric mucosa were 94 and 97 %, respectively. The
Full Text Available While our multimedia world, with rapid advances in technologies, now challenges educators to consider new pedagogies that expand cultural and linguistic diversity, the potential for information and communication technologies (ICT to support literacy learning in the early years remains a seriously under-researched area. There is an urgency to address a range of questions raised by teacher practitioners such as what new literacies will look like in their programs, how ICT can be used to learn in new ways, and which pedagogies of multiliteracies are relevant for early childhood education. This paper explores these questions in relation to knowledge management initiatives and e-learning opportunities. The Willy Wagtail Tale presents a case study of how knowledge management and e-learning is socially constructed to enrich multiliteracies experiences in the early years. The study occurred in a small Western Australian school committed to the Reggio Emilia teaching approach. Implications for educational research are that multiliteracies experiences occur inadvertently through children’s play, are integral to The Hundred Languages of Children, and are dramatically enriched through social constructivist knowledge management and child-centered e-learning.
Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical Study.
Meissner, H O; Mscisz, A; Reich-Bilinska, H; Kapczynski, W; Mrozikiewicz, P; Bobkiewicz-Kozlowska, T; Kedzia, B; Lowicka, A; Barchia, I
This was a double-blind, randomized, placebo-corrected, outpatient, multi-centre (five sites) clinical study, in which a total of 168 Caucasian early-postmenopausal women volunteers (age>49 years) participated after fulfilling the criteria: follicle stimulating hormone (FSH) >30 IU/ml and estrogen (E2) Maca (Maca-GO) treatment, according to different monthly treatment sequences scheduled for each site. Two 500 mg vegetable hard gel capsules with Maca-GO or Placebo powder were self-administered twice daily with meals (total 2 g/day) during three (Trial I; n=102) or four (Trial II; n=66) months study periods. At the baseline and follow- up monthly intervals, blood levels of FSH, E2, progesterone (PRG) and lutinizing hormone (LH), as well as serum cholesterol (CHOL), triglycerides (TRG), high- and low density lipoproteins (HDL and LDL) were measured. Menopausal symptoms were assessed according to Greene's Score (GMS) and Kupperman's Index (KMI). Data were analyzed using multivariate technique on blocs of monthly results in one model and Maca versus Placebo contrast in another model. A total of 124 women concluded the study. Maca-GO significantly stimulated production of E2 (PMaca-GO significantly reduced both frequency and severity of individual menopausal symptoms (hot flushes and night sweating in particular) resulting in significant (P<0.001) alleviation of KMI (from 22 to 10), thus, offering an attractive non-hormonal addition to the choices available to early-postmenopausal women in the form of a natural plant alternative to Hormone Replacement Therapy (HRT) - hence, reducing dependence on hormone therapy programs.
Walker Kate F
Full Text Available Abstract Background British women are increasingly delaying childbirth. The proportion giving birth over the age of 35 rose from 12% in 1996 to 20% in 2006. Women over this age are at a higher risk of perinatal death, and antepartum stillbirth accounts for 61% of all such deaths. Women over 40 years old have a similar stillbirth risk at 39 weeks as women who are between 25 and 29 years old have at 41 weeks. Many obstetricians respond to this by suggesting labour induction at term to forestall some of the risk. In a national survey of obstetricians 37% already induce women aged 40–44 years. A substantial minority of parents support such a policy, but others do not on the grounds that it might increase the risk of Caesarean section. However trials of induction in other high-risk scenarios have not shown any increase in Caesarean sections, rather the reverse. If induction for women over 35 did not increase Caesareans, or even reduced them, it would plausibly improve perinatal outcome and be an acceptable intervention. We therefore plan to perform a trial to test the effect of such an induction policy on Caesarean section rates. This trial is funded by the NHS Research for Patient Benefit (RfPB Programme. Design The 35/39 trial is a multi-centre, prospective, randomised controlled trial. It is being run in twenty UK centres and we aim to recruit 630 nulliparous women (315 per group aged over 35 years of age, over two years. Women will be randomly allocated to one of two groups: Induction of labour between 390/7 and 396/7 weeks gestation. Expectant management i.e. awaiting spontaneous onset of labour unless a situation develops necessitating either induction of labour or Caesarean Section. The primary purpose of this trial is to establish what effect a policy of induction of labour at 39 weeks for nulliparous women of advanced maternal age has on the rate of Caesarean section deliveries. The secondary aim is to act as a pilot study for a trial to
Batyukhnova, O.G.; Dmitriev, S.A.; Agrinenko, V.V.; Ojovan, M.I.; Sabol, J.; Efremenkov, V.M.
The experience gained during last 8 years of educational and training activities of the IETC under the IAEA guidance was described in this paper. For that period more than 160 specialists from 26 European and Asian countries enhanced their skills. The education-training programmes were developed accounting both for the IAEA recommendations and gained experience and attendees' requests. Efficiency of education was carefully analysed using the structural adaptation of educational process as well as factors, which have influence on education quality. Social-psychological aspects were also taken into account in assessing the overall efficiency. The analysis of the effect of individual factors and the efficiency of education activity were carried out based on attestation results and questioning attendees of training courses. A number of analytical methods were utilised such as Ishikawa's diagram method and Pareto's principle for improving of training programmes and activities. (authors)
Pai, Varadraj Vasant; Naveen, Kikkeri Narayanshetty; Athanikar, S B; Dinesh, U S; Divyashree, A; Gupta, Gaurang
Lupus vulgaris is the most common form of cutaneous tuberculosis in adults. Lupus vulgaris is caused by hematogenous, lymphatic, or contiguous spread from elsewhere in the body. histologically it is charecterised by typical tubercles with or without caseation, surrounded by epitheloid histiocytes and multinucleate giant cells in the superficial epidermis with prominent peripheral lymphocytes. All cases of clinically and histopathologicaly diagnosed lupus vulgaris over the previous five years were included in the study. Fourteen cases of lupus vulgaris cases reported during the study period with eaqual incidence among males and females. Plaque type of lupus vulgaris was the most common type. Histopathologically tubercular granulomas were seen in all cases as compared to other studies. Different patterns of lupus vulgaris are reported.
Varadraj Vasant Pai
Full Text Available Background: Lupus vulgaris is the most common form of cutaneous tuberculosis in adults. Lupus vulgaris is caused by hematogenous, lymphatic, or contiguous spread from elsewhere in the body. histologically it is charecterised by typical tubercles with or without caseation, surrounded by epitheloid histiocytes and multinucleate giant cells in the superfi cial epidermis with prominent peripheral lymphocytes. Materials and Method: All cases of clinically and histopathologicaly diagnosed lupus vulgaris over the previous five years were included in the study. Results: Fourteen cases of lupus vulgaris cases reported during the study period with eaqual incidence among males and females. Discussion: Plaque type of lupus vulgaris was the most common type. Histopathologically tubercular granulomas were seen in all cases as compared to other studies. Conclusion: Different patterns of lupus vulgaris are reported
Pescatore, Claudio; Buser, Marcos; Kallenbach-Herbert, Beate; Brazier, David; Molina, Mariano; Blom, Catharina; Simic, Eva; Coadou, Jean; ); Beule, Karina de; Kotra, Janet P.; LE BARS, Yves; Gonzalez Hermosilla, Fernando; Heriard Dubreuil, Gilles; Zeleznik, Nadja; O'Connor, Martin; Lezaun, Javier; Hietanen, Leena; Koivisto, Katarina; Gas, Serge; Mathieu Carey; Massart, Cecile
The OECD Nuclear Energy Agency (NEA) and its Radioactive Waste Management Committee (RWMC) proudly celebrate the 10. anniversary of the Forum on Stakeholder Confidence with a one-day open Colloquium in Paris. The Colloquium takes stock of FSC achievements, conducts a multi-stakeholder discussion of important themes in the governance of radioactive waste management, and gathers guidance on new directions to be taken by the FSC in coming years. The Colloquium welcomes some 80 participants: local and national opinion leaders and stakeholder representatives, government policy and regulatory officials, R and D specialists, implementers and industry representatives from 16 countries, and journalists. This report brings together the presentations (slides) given at this colloquium: 1 - Update since September 2009, The 10-year Anniversary Colloquium; Review of the RWMC and its working parties; Review of countries' input and RWMC project vision (C. Pescatore); 2 - State-of-the-art Report on Marker Systems for Radioactive Waste Repositories (M. Buser); 3 - Consideration of Social Scientific Aspects in a Safety Case for a Geological Repository in Germany, Results of a Research Project (B. Kallenbach-Herbert); 4 - Interplay Among Stakeholders for the Definition of the Detailed Geological Survey Zone in the Meuse/Haute-Marne (Andra); 5 - Regulatory Guidance on Retrievability (D. Brazier); 6 - Sogin engagement process 2010, Focus on involvement of economic operators as a part of the local community (Sogin); 7 - The role of the Government in territorial development of Meuse/Haute-Marne (Andra); 8 - Cooperating with regional elected authorities, some cases in Spain (M. Molina); 9 - Regional development and economic growth (C. Blom); 10 - Seeking transparency, Collective Action... (C. Pescatore); 11 - Introduction and overview of country responses to the transparency questionnaire (E. Simic); 12 - EC initiatives/support towards enhanced transparency and citizens participation
Juliana Pinto Viecheneski
Full Text Available This article presents the results of a research professional, which was developed in the context of the early years of elementary school, from the application of a didactic sequence, with a view to initiation of scientific literacy of students in the literacy process of language. The methodological approach was qualitative, interpretative nature. The subjects were the students of 1st year 1st Cycle of Basic Education in a public school in Ponta Grossa - PR. The data were collected through observation, application of diagnostic testing, audio recordings, photographs, written records, illustrations and posttest. The theory History Cultural Development made the analysis of pedagogical actions and reflections on them. The main results indicate that the activities of the instructional sequence, contributed to the progressive advancement of the students' knowledge in relation to the area of science and basic scientific literacy, and also contributed to make learning the language more contextualized and interdisciplinary. It is noted that this work requires a teacher to assume the role of mediator between the scientific and the children, as well as requires the understanding that, as the subject entered the technological means, students in the early years have a right to access scientific culture. In this perspective, respecting the level of development of the children, the teacher can provide challenges and mediations necessary for the gradual construction of scientific knowledge, the first years of elementary school.
In this paper, we present a professional development/upgrading programme in science for early-years teachers and investigate its impact on the teachers' competencies in relation to their knowledge and teaching of science. The basic idea of the programme was to motivate the teachers by making them members of an action research group aimed at developing and implementing curriculum activities to which they would contribute and thus meaningfully engaging them in their own learning. The programme used a `collaborative partnership' model for the development of the activities. In this model, the collaborative notion is defined as an act of `shared creation': partners share a goal and members bring their expertise to the partnership. Within this context, the partners were a researcher in science education with a background in physics, who also served as a facilitator, and six in-service early-years teachers with a background in early-years pedagogy and developmental sciences, who had many years of experience (classroom experts). These teachers participated in the programme as co-designers, but were involved to a significantly lesser degree than the researcher. The programme procedures comprised group work and individual teachers' class work. Data sources included teachers' essays, field-notes, lesson recordings and group-work records. Data were qualitatively analysed. The main results indicate improvement of teachers' `transformed' knowledge of the subject matter, development/improvement of knowledge of instructional strategies, including factors related to quality of implementation of the activities, knowledge of the pupils and improvement of the teachers' efficacy.
In a center for the processing of irradiated fuels, as in any other factory, continuity of production can only be achieved through constant effort to maintain the standard of safety. The authors examine the safety elements inherent in the design of the installations, from the point of view of both radioactive and conventional protection. It is clear that in the nuclear industry it is not sufficient merely to adopt the usual precautions against the risks of explosion, fire, etc...; but great attention must be paid to the problems arising from the confinement of materials, radioactivity and the risks of criticality. The general principles of the technical prevention of radioactive risks are now well known. They must be applied as soon as the plans are drawn up for the installations, by taking into account : - the design and construction of the installations with respect to the risks mentioned above - the division of the plant into zones - the circulation of personnel and material - ventilation and purification of the air. The technical safety factors however, are not sufficient in themselves. However good the material and the degree of automation achieved, the smooth running of a factory depends on the man responsible for supervision and repair work or who takes initiatives. Technical safety is never definitive and must be continually maintained. The collaboration of the workers is necessary to its efficiency. Psychological measures must thus be taken as an addition to the technical precautions. This psychological prevention is based on: - education of the personnel - organization of the work and definition of the safety rules - checking on obedience to the rules and behaviour of the personnel - constant reminders of the necessity for the prevention of radioactive risks. Six years operation of the irradiated fuel processing plant at Marcoule have shown the importance of close collaboration between workers and technique. The authors analyse the results obtained from
Early years professionals wrote about changes in their settings as part of their MA studies, and reflected on the use of theories of leadership in implementing these changes. This article describes a documentary analysis of the scripts produced. Initially basing the study in current knowledge of leadership and change in Early Years settings, the…
Kambouri, Maria; Pampoulou, Eliada Salowm; Pieridou, Myria; Allen, Michael
The study investigated early years teachers' understanding and use of graphic symbols, defined as the visual representation(s) used to communicate one or more "linguistic" concepts, which can be used to facilitate science learning. The study was conducted in Cyprus where six early years teachers were observed and interviewed. The results…
Tang, I P; Lee, S C; Shashinder, S; Raman, R
This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.
Aggarwal, Munish; Banerjee, Anindya; Singh, Shubh Mohan; Mattoo, S K; Basu, D
The relationship between substance use and psychotic disorder has been complex. Alcohol, cannabis, amphetamines, hallucinogens, and phencyclidine have been implicated as a causative factor for psychotic disorders. It is important to differentiate substance induced psychotic disorders (SIPDs) from primary psychotic disorders as management of the two conditions is different. There is paucity of research in the area of SIPD particularly from Asia. The present study was a retrospective study and it determines retrospectively the incidence rate and clinical characteristics of the SIPDs over a period of 13 years. The incidence of SIPDs was found to be 1.4% and all the subjects were males. In the present study, only alcohol and cannabis were implicated as causative agents for SIPDs. The most common type of psychosis was schizophrenia like psychosis, being more common in the cannabis group. The other forms of psychosis included delusional type, hallucinatory type and affective psychosis. 20% of the subjects had a change in diagnosis to either schizophrenia or affective psychosis on follow-up. The present study showed that the presentation of SIPDs is similar to the primary psychotic disorder and this has management implication. Copyright © 2011 Elsevier B.V. All rights reserved.
Keskin, Serkan; Ekenel, Meltem; Basaran, Mert; Kilicaslan, Isin; Tunc, Murat; Bavbek, Sevil
We report our experience with 8 consecutive adults treated for paratesticular rhabdomyosarcoma (RMS) at a single institution between 2000 and 2010. After primary surgical excision, 7 patients were classified into group I according to the Intergroup Rhabdomyosarcoma Study Group (IRSG) Postsurgical Grouping Classification, and 1 patient into group IIB. Retroperitoneal node dissection was not a required staging procedure. Adjuvant chemotherapy was administered to 7 of the 8 patients. No additional radiotherapy was administered. The median age at diagnosis was 24 years (range: 18-60). Embryonal histology was the most common (75%) subtype. During follow-up, 3 patients experienced local relapse and 5 distant relapse. The median progression-free and overall survival times were 17.0 ± 9.9 months (range: 5-31) and 27.3 ± 1.3 months (range: 16-58), respectively. Paratesticular RMS is an uncommon malignancy in adults. We confirm that patients with localized paratesticular RMS may have different prognoses. Retroperitoneal lymphadenectomy can be avoided as a treatment for paratesticular RMS after radical inguinal orchiectomy.
Sarikaya, Baran; Sipahioglu, Serkan; Sarikaya, Zeynep B; Bozkurt, Celal; Altay, Mehmet A; Isikan, Ugur E
We aimed to investigate the early radiological effects of Dega and Pemberton iliac osteotomies that were performed in patients aged 4-8 years with developmental dysplasia of the hip on development of hip joint. Dega osteotomy or Pemberton osteotomy was performed in 76 hips of 58 patients because of developmental dysplasia of the hip between September 2011 and June 2015 and were evaluated retrospectively. Of a total of 76 hips, Pemberton osteotomy was performed on 39 (19 unilateral) and Dega osteotomy was performed on 37 (21 unilateral). In all hips, the acetabular index, acetabular depth ratio, centre-edge angle of Wiberg, and Reimer's index values were recorded preoperatively and at the final follow-up. We measured the surface areas of the femoral head ossific nucleus in patients with unilateral dysplastic hips and compared results before both osteotomy procedures and at the final follow-up. There were no statistically significant differences between the groups in terms of the acetabular index and acetabular depth ratio values (P>0.05) preoperatively and at the final follow-up, but the mean centre-edge angle of Wiberg and Reimer's index values showed significant statistical differences in favor of the Dega procedure (Phips. Although Dega and Pemberton osteotomies produce satisfactory radiological outcomes at early stages in children aged 4-8 years with developmental dysplasia of the hip, a higher rate in the surface area of the femoral head ossific nucleus was observed in the Pemberton osteotomy group, which also had a lower mean age than the Dega osteotomy group.
Jeszke, M; Jeszke, J
Within the discipline as such, among Polish scientists of the period of twenty years of independence after the World War I, there was no agreement as to the understanding of the area of hygiene interests and as to the role of it. On one poend it was placed a concept of hygiene as the remedy towards the basic sanitary inadvertences, covering only narrow segments of relationship between the organism condition and individual environment elements of positive or negative importance for health. This depiction was bringing a hygienist closer to such disciplines as physiology, pathophysiology, toxicology, bacteriology etc., it imposed typically natural point of view and research workshop. On the second end the issue of health has been considered within the broad social and cultural context. In such a meaning hygiene goes beyond the narrow concept of medicine, since the latter has not been able to replace the shortages of civilisation and it has not been interested in issues of cultural adaptation of desired sanitary behaviour. As a matter of fact, both views have been excluding each other, adopting different and "incommensurate" visions of the "world and human being" as well as methodological depictions. In the time under discussion, within Polish territories, a thesis, that individual health has a social dimension, makes a considerable economic value, decides on the defence abilities of state, so it is in the interest of the whole society the care for health of all members of society - was still having virtues of uniqueness. It was going like that despite earlier activity of many outstanding Polish hygienists, giving fruits both in information campaigns planned on a wide scale and civilisation experiments. ...
Stewart, Jane; Benford, Penny; Wynn, Persephone; Watson, Michael Craig; Coupland, Carol; Deave, Toity; Hindmarch, Paul; Majsak-Newman, Gosia; Kendrick, Denise
To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. Multicentre matched case-control study in acute hospitals, minor injury units and GP practices in four study centres in England. Cases comprised 338 children under 5 presenting with a scald, and 1438 control participants matched on age, gender, date of event and study centre. Parents/caregivers completed questionnaires on safety practices, safety equipment use, home hazards and potential confounders. Odds ratios were estimated using conditional logistic regression. Parents of cases were significantly more likely than parents of controls to have left hot drinks within reach of their child (adjusted odds ratio (AOR) 2.33, 95%CI 1.63 to 3.31; population attributable fraction (PAF) 31%). They were more likely not to have taught children rules about climbing on kitchen objects (AOR 1.66, 95%CI 1.12 to 2.47; PAF 20%); what to do or not do when parents are cooking (AOR 1.95, 95%CI 1.33 to 2.85; PAF 26%); and about hot things in the kitchen (AOR 1.89, 95%CI 1.30 to 2.75; PAF 26%). Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
The first rationale of the study was not only to determine the topics taught in Turkish early childhood settings but also to define the frequency and time allocation for teaching science (n?=?382). In the second phase, through semi-structured interview questions, the aim was to gain detailed information about Turkish early childhood teachers'…
Kamel Abd Elaziz Mohamed
Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.
Karvonen, A M; Tischer, C; Kirjavainen, P V; Roponen, M; Hyvärinen, A; Illi, S; Mustonen, K; Pfefferle, P I; Renz, H; Remes, S; Schaub, B; von Mutius, E; Pekkanen, J
Cross-sectional studies have shown that exposure to indoor moisture damage and mold may be associated with subclinical inflammation. Our aim was to determine whether early age exposure to moisture damage or mold is prospectively associated with subclinical systemic inflammation or with immune responsiveness in later childhood. Home inspections were performed in children's homes in the first year of life. At age 6 years, subclinical systemic inflammation was measured by serum C-reactive protein (CRP) and blood leukocytes and immune responsiveness by ex vivo production of interleukin 1-beta (IL-1β), IL-6, and tumor necrosis factor alpha (TNF-α) in whole blood cultures without stimulation or after 24 hours stimulation with phorbol 12-myristate 13-acetate and ionomycin (PI), lipopolysaccharide (LPS), or peptidoglycan (PPG) in 251-270 children. Moisture damage in child's main living areas in infancy was not significantly associated with elevated levels of CRP or leukocytes at 6 years. In contrast, there was some suggestion for an effect on immune responsiveness, as moisture damage with visible mold was positively associated with LPS-stimulated production of TNF-α and minor moisture damage was inversely associated with PI-stimulated IL-1β. While early life exposure to mold damage may have some influence on later immune responsiveness, it does not seem to increase subclinical systemic inflammation in later life. © 2018 National Institute for Health and Welfare, Finland Indoor Air published by John Wiley & Sons Ltd.
Nyaradi, Anett; Li, Jianghong; Foster, Jonathan K; Hickling, Siobhan; Jacques, Angela; O'Sullivan, Therese A; Oddy, Wendy H
The aim of this study was to investigate the associations between early diet and academic performance during childhood. Participants were from the Western Australian Pregnancy Cohort (Raine) Study (n = 2287). Frequency of consumption of food and beverages was collected at the one-, two- and three-year follow-ups, using a 24-hour food recall. Diet scores were developed from the number of eating occasions. The Western Australian Literacy and Numeracy Assessment (WALNA) data from grades five (age 10) and seven (age 12) were linked to the Raine study using The Western Australian Data Linkage System. The association between diet scores and WALNA scores was assessed using multivariate linear regression models. A higher (i.e. better quality) diet score at one year of age was associated with significantly higher scores in mathematics, reading, writing and spelling at both grades five and seven. Associations were observed between a higher diet score at two years and academic scores for mathematics, writing and spelling at grade seven. Higher dairy consumption at ages one, two and three, and higher fruit consumption at age one were associated with higher academic scores at all ages. Quality of early diet may be a predictor for later academic achievement. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
This article, based on archival records, published documents, interviews with elite sportswomen and three regional case studies, deals with the radical social, economic, cultural and political changes in the early years of the Communist China, the consequent changes in women's lives and the eventual extraordinary impact on elite women's sport. It analyses the complicated relations between the communist system, gender ideology, sports policy, international politics and elite women's sport. With the establishment of a variety of sports institutions, systems and structures women in increasing numbers took part in competitive sport and produced even increasingly remarkable achievements.
Kar, Maitreyee; Kar, Chinmaya; Roy, Hironmoy; Goyal, Parmod
Context: Early clinical exposure (ECE) is one of the important tools to teach basic science to the MBBS students. It is one form of vertical integration between basic science and clinical subjects. This study is an effort at exploring the use of ECE as a motivational tool toward better learning in neuroanatomy for first year MBBS students. Aim: This study aims to make the students interested and motivated to study neuroanatomy by using ECE as learning tool in neuroanatomy and to make the stud...
Brenner, Hermann; Altenhofen, Lutz; Stock, Christian; Hoffmeister, Michael
Screening colonoscopy was introduced in Germany in October 2002. We aimed to quantify its effects on prevention, early detection, and overdiagnosis of colorectal cancer (CRC) in the 10 years since its introduction. We analyzed data from more than 4.4 million screening colonoscopies (conducted on individuals 55-79 years old from 2003 through 2012) available through the national screening colonoscopy registry. CRCs prevented, detected earlier than they would have been without screening, and overdiagnosed (cancers detected at screening colonoscopy that would not have become clinically manifest during the patient's lifetime) were estimated by Markov models. Model parameters included sex-specific and age-specific findings at screening colonoscopy; mortality; rates of transition from nonadvanced to advanced adenoma, advanced adenoma to preclinical cancer, or preclinical cancer to clinically manifest cancer; and protection from screening colonoscopy. Overall, approximately 180,000 CRCs (1/28 screening colonoscopies) were estimated to have been prevented, and more than 40,000 CRCs (1/121 screening colonoscopies) were detected earlier than they would have been without screening, compared with approximately 4500 overdiagnoses (1/1089 screening colonoscopies). Almost all CRCs prevented or detected earlier than they would have been without screening resulted from screening colonoscopies performed on individuals up to 75 years old (97% and 89%, respectively), whereas 28% of overdiagnoses occurred from screening colonoscopies of individuals older than 75 years old. On the basis of a 10-year analysis of data from a national registry in Germany, screening colonoscopies have large potential for prevention and early detection of CRC, with low risk of overdiagnosis. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
Antti O. Tanskanen
Full Text Available Previous studies show that in many pre-modern and traditional populations the presence of a grandmother correlates with increased child survival rates, maybe as a result of improved child nutrition. Grandmaternal investment aimed at improving grandchildren's nutritional status in subsistence societies may have different outcomes in contemporary affluent societies. Using the British Millennium Cohort Study I investigate the association between maternal and paternal grandmothers' childcare and early years overweight in the UK. Results show that children who were cared for mainly by their grandmothers between the ages of 9 months and 3 years were more likely overweight at age 3 than children who were cared for by their parents. My results are in line with Pearce, Abbas, Ferguson, Graham, and Law (2010, although they did not distinguish grandmothers by lineage. Grandmothers may influence children's nutritional status in contemporary societies, but as with many evolved behavioral strategies the outcome may be no longer beneficial.
Squarza, Chiara; Picciolini, Odoardo; Gardon, Laura; Ravasi, Maura; Giannì, Maria L; Porro, Matteo; Bonzini, Matteo; Gangi, Silvana; Mosca, Fabio
Infants born preterm are at high risk for the onset of cognitive dysfunctions at school age. The aim of this study was to investigate the association between early neurodevelopmental assessment and the risk of adverse cognitive outcome in extremely low birth weight children. We enrolled all newborns (January 2002 - April 2007) consecutively admitted to our Institution, with a birthweight age using the Griffiths Mental Development Scales Revised. The same children were re-assessed at school age through the Wechsler Intelligence Scale for Children. Children with impaired Griffiths General Quotient (i.e., age showed a significantly lower Full Scale Intelligence Quotient at 7 years of chronological age when compared to children who scored in the normal range at 1 year ( p Eye and Hand Coordination Sub-quotients were specifically associated with poorer Performance or Verbal Intelligence Quotients, respectively ( p age. Larger confirmation studies are needed.
Jamshid Yazdani Charati
Full Text Available Background and purpose: Disasters and traffic accidents as the leading causes of disability and death throughout the world are the most significant health problems which have usually been predictable and, therefore, possible to prevent. The present study, as the first attempt, was conducted to calculate the burden of life years lost due to early death caused by traffic accidents in Mazandaran Province. Materials and Methods: The current study was cross-sectional, and the data was collected from the center of Mazandaran Legal Medicine. The number of years of life lost due to premature death was calculated by using the instructions GBD2010 age and gender composition of the province was taken in the last census in 2012 from the Statistical Center. Then the SPSS Software was used to key in all the collected information in order to perform the analysis. Results: Of the total population in 2015, 729 deaths were recorded due to car accidents with 77.9 percent of them being male. Mean age was 43.07±21.18 and 44.67±23.34 in women. The number of years of life lost due to premature death was 24972.7 years in men, 6965.3 years in women, and the total of two genders was 31938 years (10.6 years per thousand people which were calculated, and it was the highest in the age group ranging from 20 to 24 years old. Discussion: According to the high rate of deaths from traffic accidents and damages resulted from it, and in order to reduce these losses, it is necessary to take appropriate preventive measures.
Thomas, Peter W; Thomas, Sarah; Kersten, Paula; Jones, Rosemary; Slingsby, Vicky; Nock, Alison; Davies Smith, Angela; Baker, Roger; Galvin, Kathleen T; Hillier, Charles
Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS). The aim was to evaluate the effectiveness at 1-year follow-up of a manualised group-based programme ('FACETS') for managing MS-fatigue. One-year follow-up of a pragmatic multi-centre randomised controlled trial. People with MS and significant fatigue were randomised to FACETS plus current local practice (FACETS) or current local practice alone (CLP), using concealed computer-generated randomisation. Participant blinding was not possible. Primary outcome measures were fatigue severity (Global Fatigue Severity subscale of the Fatigue Assessment Instrument), self-efficacy (MS-Fatigue Self-Efficacy) and disease-specific quality of life (MS Impact Scale). Between May 2008 and November 2009, 164 participants were randomised. Primary outcome data were available at 1 year for 131 (80%). The benefits demonstrated at 4-months in the FACETS arm for fatigue severity and self-efficacy largely persisted, with a slight reduction in standardised effect sizes (SES) (-0.29, p = 0.06 and 0.34, p = 0.09, respectively). There was a significant difference on the MS Impact Scale favouring FACETS that had not been present at 4-months (SES -0.24, p = 0.046). No adverse events were reported. Improvements in fatigue severity and self-efficacy at 4-months follow-up following attendance of FACETS were mostly sustained at 1 year with additional improvements in MS impact. The FACETS programme provides modest long-term benefits to people with MS-fatigue. ISRCTN76517470.
Pikwer, Mitra; Nilsson, Jan-Åke; Bergström, Ulf; Jacobsson, Lennart T H; Turesson, Carl
We aimed to investigate whether recognized hormonal predictors of rheumatoid arthritis (RA) also influence the severity of RA. One hundred thirty-four incident RA cases identified by four different local and national registers, who had participated in a community-based health survey between 1991 and 1996, were included. By a retrospective structured review of the medical records, information on the use of disease-modifying antirheumatic drugs (DMARDs), erosions on radiographs, rheumatoid factor (RF) status, and disability measured by using the health assessment questionnaire (HAQ) were collected. The variables were added to the SPSS TwoStep Cluster Analysis to reveal natural groupings of RA severity. Known hormonal predictors analyzed were breastfeeding history, history of oral contraceptive (OC) use, and menopausal age. The mean age at RA diagnosis was 63.4 years; 72% were RF positive, and 28% had received biological treatment. Three clusters were identified, one with severe RA, one with mild/moderate RF-positive RA, and one with mild/moderate RF-negative RA. A significant difference (P = 0.005) was found in the distribution of clusters between patients with a history of early menopause compared with those with menopause after 45 years, with a higher proportion with mild/moderate RF-negative RA in the early-menopause subset. No major difference in severity of the disease was noted depending on OC use or history of breastfeeding. Early menopause was associated with a milder form of RA. Hormonal changes may influence pathways that are distinct from those leading to severe, progressive disease.
Flouri, E; Narayanan, M K; Midouhas, E
Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross-lagged relationship between father absence (non-residence) and child problem behaviour in the early years. We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2-4). The sample was 15,293 families in which both biological parents were co-resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut-offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Father absence at age 3 predicted a higher probability of the child scoring above cut-off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross-lagged relationships were similar for boys and girls. Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. © 2015 John Wiley & Sons Ltd.
Salmon, Karen; O'Kearney, Richard; Reese, Elaine; Fortune, Clare-Ann
In this narrative review, we suggest that children's language skill should be targeted in clinical interventions for children with emotional and behavioral difficulties in the preschool years. We propose that language skill predicts childhood emotional and behavioral problems and this relationship may be mediated by children's self-regulation and emotion understanding skills. In the first sections, we review recent high-quality longitudinal studies which together demonstrate that that children's early language skill predicts: (1) emotional and behavioral problems, and this relationship is stronger than the reverse pattern; (2) self-regulation skill; this pattern may be stronger than the reverse pattern but moderated by child age. Findings also suggest that self-regulation skill mediates the relation between early language skill and children's emotional and behavioral problems. There is insufficient evidence regarding the mediating role of emotion understanding. In subsequent sections, we review evidence demonstrating that: (1) particular kinds of developmentally targeted parent-child conversations play a vital role in the development of language skill, and (2) some current clinical interventions, directly or indirectly, have a beneficial impact on children's vocabulary and narrative skills, but most approaches are ad hoc. Targeting language via parent-child conversation has the potential to improve the outcomes of current clinical interventions in the preschool years.
Halje, Karin; Timpka, Toomas; Tylestedt, Petra; Adler, Anna-Karin; Fröberg, Lena; Schyman, Tommy; Johansson, Kristoffer; Dahl, Katarina
To examine a self-referral psychological service provided to young adults with regard to effects on anxiety, depression and psychological distress and to explore client factors predicting non-adherence and non-response. Observational study over a 2-year period. Young Adults Centre providing psychological services by self-referral (preprimary care) to Linköping, Åtvidaberg, and Kinda municipalities (combined population 145,000) in Östergötland county, Sweden. 607 young adults (16-25 years of age); 71% females (n=429). Individually scheduled cognitive behavioural therapy delivered in up to six 45 min sessions structured according to an assessment of the client's mental health problems: anxiety, depression, anxiety and depression combined, or decreased distress without specific anxiety or depression. Pre-post intervention changes in psychological distress (General Health Questionnaire-12, GHQ-12), Hospital Anxiety and Depression Scale Anxiety/Depression (HADS-A/D). 192 clients (32.5%) discontinued the intervention on their own initiative and 39 clients (6.6%) were referred to a psychiatric clinic during the course of the intervention. Intention-to-treat analyses including all clients showed a medium treatment effect size (d=0.64) with regard to psychological distress, and small effect sizes were observed with regard to anxiety (d=0.58) and depression (d=0.57). Restricting the analyses to clients who adhered to the agreed programme, a large effect size (d=1.26) was observed with regard to psychological distress, and medium effect sizes were observed with regard to anxiety (d=1.18) and depression (d=1.19). Lower age and a high initial HADS-A score were the strongest risk factors for non-adherence, and inability to concentrate and thinking of oneself as a worthless person increased the risk for discontinuation. We conclude that provision of psychological services to young people through a self-referral centre has potential to improve long-term mental health in
Full Text Available Infants born preterm are at high risk for the onset of cognitive dysfunctions at school age. The aim of this study was to investigate the association between early neurodevelopmental assessment and the risk of adverse cognitive outcome in extremely low birth weight children. We enrolled all newborns (January 2002 – April 2007 consecutively admitted to our Institution, with a birthweight < 1000 g. Exclusion criteria were genetic abnormalities, severe neurofunctional impairment, and/or neurosensory disabilities. Ninety-nine children were assessed at 1 year of corrected age using the Griffiths Mental Development Scales Revised. The same children were re-assessed at school age through the Wechsler Intelligence Scale for Children. Children with impaired Griffiths General Quotient (i.e., <1 SD at 1 year of corrected age showed a significantly lower Full Scale Intelligence Quotient at 7 years of chronological age when compared to children who scored in the normal range at 1 year (p < 0.01. Considering the Griffiths Sub-quotients separately, a poor score in the Performance or in the Personal-Social Sub-quotients at 1 year was associated with significantly worse cognitive outcomes both in the Verbal and in the Performance Intelligence Quotients at 7 years (p < 0.01 and p < 0.05, respectively. A score <1 SD in the Locomotor or in the Eye and Hand Coordination Sub-quotients were specifically associated with poorer Performance or Verbal Intelligence Quotients, respectively (p < 0.05. Our findings suggest that a poor score on the Griffiths Scales at 1 year is associated with a higher risk of cognitive impairment at school age. Larger confirmation studies are needed.
Background Physical activity and sedentary behavior habits are established during early childhood, yet only recently has objectively measured data been available on children aged 5 years and younger. This study presents data on the physical activity and sedentary behaviors of Canadian children aged 3–5 years. Methods Data were collected as part of the Canadian Health Measures Survey between 2009 and 2011. A nationally-representative sample (n = 459) of children aged 3–5 years wore Actical accelerometers during their waking hours for 7 consecutive days. Data were collected in 60-sec epochs and respondents with ≥4 valid days were retained for analysis. Parents reported their child’s physical activity and screen time habits in a questionnaire. Results Eighty-four percent of 3–4 year old children met the physical activity guideline of 180 minutes of total physical activity every day while 18% met the screen time target of physical activity guideline of 60 minutes of daily moderate-to-vigorous physical activity (MVPA) while 81% met the screen time target of physical activity and 66 minutes of MVPA while 5 year old children accumulated an average of 342 min/d of total physical activity and 68 minutes of MVPA. Children were sedentary for approximately half of their waking hours and spent an average of 2 hours per day in front of screens. Only 15% of 3–4 year olds and 5% of 5 year olds are meeting both the physical activity and sedentary behavior guidelines. Conclusions Promoting physical activity while reducing sedentary behavior is important at all stages of life. The findings of the present study indicate that there remains significant room for improvement in these behaviors among young Canadian children. PMID:23642258
Bartels Ronald HMA
Full Text Available Abstract Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treatment was propagated with good clinical results. Proponents for early surgery as well those favoring conservative treatment are still in debate. The proposed trial will contribute to the discussion and hopefully also to a decrease in the variability of clinical practice. Methods/Design A randomized controlled trial is designed to compare the clinical outcome of early surgical strategy versus a conservative approach. The primary outcome is clinical outcome according to mJOA. This also measured by ASIA score, DASH score and SCIM III score. Other endpoints are duration of the stay at a high care department (medium care, intensive care, duration of the stay at the hospital, complication rate, mortality rate, sort of rehabilitation, and quality of life. A sample size of 36 patients per group was calculated to reach a power of 95%. The data will be analyzed as intention-to-treat at regular intervals, but the end evaluation will take place at two years post-injury. Discussion At the end of the study, clinical outcomes between treatments attitudes can be compared. Efficacy, but also efficiency can be determined. A goal of the study is to determine which treatment will result in the best quality of life for the patients. This study will certainly contribute to more uniformity of treatment offered to patients with a special sort of spinal cord injury. Trial Registration Gov: NCT01367405
Mac Donald, Christine L; Barber, Jason; Jordan, Mary; Johnson, Ann M; Dikmen, Sureyya; Fann, Jesse R; Temkin, Nancy
The long-term clinical effects of wartime traumatic brain injuries (TBIs), most of which are mild, remain incompletely described. Current medical disability cost estimates from world conflicts continually surpass projections. Additional information regarding long-term functional trajectory is needed to reduce this extensive public health burden. To examine 5-year clinical outcomes leveraging existing clinical data collected at 1 year after injury in the same patients and to identify early risk factors for long-term disability. This prospective, longitudinal study enrolled active-duty US military after concussive blast injury (n = 50) in the acute to subacute stage and combat-deployed control individuals (n = 44) in Afghanistan or after medical evacuation to Germany from November 1, 2008, through July 1, 2013. One- and 5-year clinical evaluations were completed in the United States. All concussive blast injuries met the Department of Defense definition of mild, uncomplicated TBI. In-person clinical evaluations included standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden that were essentially identical to the evaluations completed at 1-year follow-up. Data were analyzed from October 1 through November 30, 2016. Changes in the in-person standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden from the 1- to 5-year follow-up. Predictive modeling was used to identify early risk factors for long-term disability. Among the 94 participants (87 men [93%] and 7 women [7%]; mean [SD] age, 34  years), global disability, satisfaction with life, neurobehavioral symptom severity, psychiatric symptom severity, and sleep impairment were significantly worse in patients with concussive blast TBI compared with combat-deployed controls, whereas performance on cognitive measures was no different between groups at the 5-year evaluation. Logistic regression on the dichotomized Extended
Full Text Available Abstract Background The study examines differences regarding quality of life (QoL, mental health and illness beliefs between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (CAPD/PD patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a 77 in-centre haemodialysis (HD and 58 continuous ambulatory peritoneal dialysis (CAPD/PD patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment ( 4 years. Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a 41 in-centre haemodialysis (HD and b 48 continuous ambulatory peritoneal dialysis (CAPD/PD patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Results Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas
Ginieri-Coccossis, M; Theofilou, P; Synodinou, C; Tomaras, V; Soldatos, C
The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a) 77 in-centre haemodialysis (HD) and 58 continuous ambulatory peritoneal dialysis (CAPD/PD) patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment ( 4 years). Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a) 41 in-centre haemodialysis (HD) and b) 48 continuous ambulatory peritoneal dialysis (CAPD/PD) patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas of mental health. With regards to illness
1 juin 2009 ... 31 (1) Every copy of a consolidated statute or consolidated regulation ... Assimilation à organisme de bienfaisance enregistré. Financial. Dispositions financières. 20. International Development Research Centre Account. 20. Compte du ...... cal year, including the financial statements of the Centre and the ...
Betz, Nicolas; Ott, Oliver J.; Sauer, Rolf; Fietkau, Rainer; Adamietz, Boris; Keilholz, Ludwig
Background and Purpose: In early-stage Dupuytren's contracture, radiotherapy is applied to prevent disease progression. Long-term outcome and late toxicity of the treatment were evaluated in a retrospective analysis. Patients and Methods: Between 12/1982 and 02/2006, 135 patients (208 hands) were irradiated with orthovoltage (120 kV; 20 mA; 4-mm Al filter), in two courses with five daily fractions of 3.0 Gy to a total dose of 30 Gy; separated by a 6- to 8-week interval. The extent of disease was described according to a modified classification of Tubiana et al. Long-term outcome was analyzed at last follow-up between 02/2008 and 05/2008 with a median follow-up of 13 years (range, 2-25 years). Late treatment toxicity and objective reduction of symptoms as change in stage and numbers of nodules and cords were evaluated and used as evidence to assess treatment response. Results: According to the individual stages, 123 cases (59%) remained stable, 20 (10%) improved, and 65 (31%) progressed. In stage N 87% and in stage N/I 70% remained stable or even regressed. In more advanced stages, the rate of disease progression increased to 62% (stage I) or 86% (stage II). 66% of the patients showed a long-term relief of symptoms (i.e., burning sensations, itching and scratching, pressure and tension). Radiotherapy did not increase the complication rate after surgery in case of disease progression and only minor late toxicity (skin atrophy, dry desquamation) could be observed in 32% of the patients. There was no evidence for a second malignancy induced by radiotherapy. Conclusion: After a mean follow-up of 13 years radiotherapy is effective in prevention of disease progression and improves patients' symptoms in early-stage Dupuytren's contracture (stage N, N/I). In case of disease progression after radiotherapy, a ''salvage'' operation is still feasible. (orig.)
Harper, Peter S
The European Society of Human Genetics (ESHG) was founded on 15 March 1967, after preliminary discussions at the International Human Genetics Congress in Chicago the previous year and in Copenhagen in early 1967. Its initial meeting was held on 18-19 November 1967, also in Copenhagen, and annual meetings have been held from that time until the present, apart from years in which the International Congress of Human Genetics was also being held. The character of the Society during its early years was strongly influenced by its founding and permanent Secretary, Jan Mohr, head of the Copenhagen Institute of Medical Genetics, whose records are archived in the Tage Kemp/Jan Mohr Archive, now part of the Danish National Archives. These records show Jan Mohr's determination to keep the activities of the Society limited to the holding of an annual meeting to enhance contacts between European human geneticists, and to resist expansion to other activities. Pressures for a wider role of ESHG became irresistible in the late 1980s and a revised constitution, adopted in 1991, reshaped the Society into a more conventional and less restrictive structure. This has allowed it to play a wider and increasingly influential role in the development of human and medical genetics across Europe, with its own Journal, a range of committees covering different aspects of the field and a series of valuable reports on specific important topics, to be described in a forthcoming article on the Society's more recent history.European Journal of Human Genetics advance online publication, 10 May 2017; doi:10.1038/ejhg.2017.34.
Lall, S B; Peshin, S S
The Poisons Information Centre (PIC) is a specialized unit providing information on prevention, early diagnosis and treatment of poisoning and hazard management. Most of the developed and many developing countries have well established poison control centres with poisons information service, patient management facility and analytical laboratory. In India, the National Poisons Information Centre (NPIC) was established in February, 1995 in the Department of Pharmacology at the All India Institute of Medical Sciences, New Delhi. The centre provides toxicological information and advice on the management of poisoned patients adopted to the level of the enquirer. The basis of this service are the databases on poisoning, drug reactions and also the continuous and systematic collection of data from the library. This information service is available round the clock. The PIC has the training responsibility extending to medical and other health professionals and community. The NPIC organized two successive training courses for medical professionals and para professionals at all health levels. Further, NPIC is a participant of INTOX project of IPCS/WHO, receiving regular yearly training on the use of INTOX database. Laboratory service is an essential component of a poisons control programme, providing analytical services on emergency basis to help in diagnosis and management. The NPIC is developing facilities for quick diagnosis of poisoning cases. Toxicovigilance and prevention of poisoning is another major function of PIC. The Centre has prepared manuals and leaflets on prevention and management cards on treatment of various poisonings. Thus the Centre provides a service with considerable health benefits, reducing morbidity and mortality from poisoning and gives significant financial savings to the community.
Riaño-Galán, Isolina; Fernández-Somoano, Ana; Rodríguez-Dehli, Cristina; Valvi, Damaskini; Vrijheid, Martine; Tardón, Adonina
To determine lipid profiles in early childhood and evaluate their association with weight status at 4 years of age. Additionally, we evaluated whether the risk of overweight or having an altered lipid profile was associated with parental weight status. Five hundred eighty two mothers and their 4-year-old children from 2 Spanish population-based cohorts were studied. Weight status in children at 4 years of age was classified as overweight or obese using the International Obesity Task Force criteria. Plasma total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were determined in children and lipid ratios were calculated. A proatherogenic lipid profile was defined as having the 3 lipid ratios in the third tertile. A total of 12.9% of children were overweight and 6.4% were obese. Weight status at 4 years of age was related to maternal prepregnancy body mass index, paternal body mass index, gestational diabetes, and birth weight, but not with other sociodemographic characteristics of the mother. We found no association with gestational age, sex of the child, or breastfeeding. The risk of overweight/obesity was increased 4.17-fold if mothers were overweight/obese (95% CI 1.76-9.88) and 5.1-fold (95% CI 2.50-10.40) if both parents were overweight/obese. There were 133 children (22.8%) with a proatherogenic lipid profile. The risk of a proatherogenic lipid profile was increased 2.44-fold (95% CI 1.54-3.86) if they were overweight/obese at 4 years of age and 2-fold if the father was overweight/obese (95% CI 1.22-3.35). Four-year-old overweight/obese children have higher lipid risk profiles. Offspring of overweight/obese parents have an increased risk for obesity and a proatherogenic lipid profile. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
Full Text Available The purpose of this article is to show how attention on ‘place’ can be productive in methodology concerning the bodily relations, movements and expressions of children up to three years of age who are enrolled in kindergarten. While research that has adopted a hermeneutic and phenomenological approach has contributed to important knowledge concerning young children, we propose re-thinking methodology that takes children’s bodily relations, movements and expressions into concern. Using ‘place’ as a lens, we show how power relations are interrupted and allow for alternative ways for the researcher to relate to data. Inspired by Somerville (2010, elements of place are situated at the centre of the research analysis. The three key elements of place that are put to work are as follows: our relationship to place is constituted in stories and other representations; place learning is local and embodied; and place is a contact zone for cultural contact. The paper is part of a research project which explores how place can be more explicit in educational practices to strengthen kindergarten as a learning arena. We seek to explore how place relations work and what they have the possibility of producing in the analyzing process.
Howard, Jane S; Stanislaw, Harold; Green, Gina; Sparkman, Coleen R; Cohen, Howard G
In a previous study, we compared the effects of just over one year of intensive behavior analytic intervention (IBT) provided to 29 young children diagnosed with autism with two eclectic (i.e., mixed-method) interventions (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005). One eclectic intervention (autism programming; AP) was designed specifically for children with autism and was intensive in that it was delivered for an average of 25-30 h per week (n = 16). The other eclectic intervention (generic programming; GP) was delivered to 16 children with a variety of diagnoses and needs for an average of 15-17 h per week. This paper reports outcomes for children in all three groups after two additional years of intervention. With few exceptions, the benefits of IBT documented in our first study were sustained throughout Years 2 and 3. At their final assessment, children who received IBT were more than twice as likely to score in the normal range on measures of cognitive, language, and adaptive functioning than were children who received either form of eclectic intervention. Significantly more children in the IBT group than in the other two groups had IQ, language, and adaptive behavior test scores that increased by at least one standard deviation from intake to final assessment. Although the largest improvements for children in the IBT group generally occurred during Year 1, many children in that group whose scores were below the normal range after the first year of intervention attained scores in the normal range of functioning with one or two years of additional intervention. In contrast, children in the two eclectic treatment groups were unlikely to attain scores in the normal range after the first year of intervention, and many of those who had scores in the normal range in the first year fell out of the normal range in subsequent years. There were no consistent differences in outcomes at Years 2 and 3 between the two groups who received eclectic interventions
Hawley, Carol; Sakr, Magdy; Scapinello, Sarah; Salvo, Jesse; Wrenn, Paul
Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma. We determined age, gender, mechanism of injury, Injury Severity Score, presenting Glasgow Coma Scale (GCS) and Mayo Score, and the association of outcome (Glasgow Outcome Scale (GOS)) with age and clinical presentation. 4413 patients were admitted with trauma meeting TARN criteria: 1389 were ≥65 years and 45% (624) had TBI. For patients ≥65 years with TBI, mean age was 79 (range 65-99); 56% were men. Falls accounted for 85% of all TBIs. Most TBIs were moderate/severe (80%) by the Mayo criteria. Of the 279 patients with subdural haematoma, 28% had neurosurgery. Most patients survived TBI (78%); 57% had a good outcome on GOS at discharge (not requiring care package). Mortality was associated with increased age (17% in ages 65-74 years, 19% in 75-84 years, 30% in ≥85 years, p=0.03). Outcome was significantly associated with injury severity (p=0.0001). Patients with TBI represented 45% of all trauma cases meeting TARN inclusion criteria. Falls at home accounted for most TBIs. Most had moderate/severe TBI, yet over half made a good recovery on GOS. Our data indicate that injury prevention initiatives should focus on home safety. Further research is needed to examine rehabilitation and follow-up after hospital discharge. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a
Proctor, Laura J.; Skriner, Laura C.; Roesch, Scott; Litrownik, Alan J.
Objective: To identify trajectories of behavioral adjustment from age 6 through 14 years for youth placed in early foster care, and to examine links between trajectories and early cognitive ability and social competence, caregiver stability, and frequency, timing, and type of maltreatment. Method: Participants were 279 youth from the Southwest…
In this paper, I examine the claim that teachers' subjective experiences can lead to social change through the perspective of the early years teacher in Quebec. Fourteen early childhood teachers participated in memory writing and individual interviews. Data were inductively coded and analysed in terms of the teachers' subjective experiences of:…
Perry, Bob; Hampshire, Ann; Gervaxoni, Ann; O'Neill, Will
"Let's Count" is a preschool mathematics intervention implemented by The Smith Family from 2012 to the present in "disdvantaged" communities across Australia. It is based on current mathematics and early childhood education research and aligns with the Early Years Learning Framework. Let's Count has been shown to be effective…
Full Text Available OBJECTIVE: To determine how early musculoskeletal disorders (MSDs develop in dental professionals and to explore the potential differences among distinct dental specialties. MATERIAL AND METHODS: 271 dental postgraduates majoring in five dental specialties were recruited, i.e., orthodontics, prosthodontics, endodontics, periodontics and alveolar surgery. 254 age-matched non-dental postgraduates served as the control. The standardized Nordic questionnaire on MSDs and a self-report questionnaire regarding correlative factors (only for dental postgraduates were answered through emails. Reliability of responses was assessed applying test-retest method. RESULTS: The intraclass correlation coefficient of participants' answers ranged from 0.89 to 0.96. Dental postgraduates had significantly higher prevalence of MSDs than the control group, especially at neck, upper back and lower back. In all dental specialties included, high prevalence of MSDs was reported at neck (47.5%-69.8%, shoulders (50.8%-65.1%, lower back (27.1%-51.2% and upper back (25.6%-46.5%, with lower prevalence at elbows (5.1%-18.6%, hips (3.4%-16.3% and ankles (5.1%-11.6%. Periodontics students reported the worst MSDs in most body regions except wrists and knees, which were more prevalent for prosthodontic and alveolar surgery students, respectively. Furthermore, year of clinical work, clinical hours per week and desk hours per week were found as risk factors for MSDs, whereas physical exercise and rest between patients as protective factors. CONCLUSIONS: High and specialty-related MSDs afflict dental professionals even since very early stage of careers. Prevention aimed at the specialty-related characteristics and the risk/protective factors revealed in this study should be introduced to dental personnel as early as possible.
Green, Bart N.; Johnson, Claire D.
Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and
Despite their success in boosting cereals production overall, the Green Revolution programs of the 1950s and 1960s were often criticized for failing to achieve their declared aim of alleviating world hunger. Most critics argued that the programs had produced a technology unsuited to the needs of small peasant farmers. This paper explores why such inappropriate technology might have been developed, focusing on the early years of the Rockefeller Foundation's Mexican Agricultural Program (MAP). It shows that some foundation officers as well as agricultural advisors had prior experience of the problems faced by small farmers in the United States and elsewhere. Moreover, the foundation's expressed concern for rural poverty does not appear to have been mere posturing by an organization anxious to be seen as an agent of philanthropy. Furthermore, the program's early work in maize-breeding was well tailored to the conditions of Mexican agriculture. Once the MAP was up and running, however, it became apparent that the task of getting new varieties and cultivation practices to small farmers was going to be difficult. Needing to make some kind of impact quickly, MAP staff chose to concentrate upon projects that were likely to find a rapid uptake. This meant setting aside the needs of peasant farmers to develop high-yielding varieties suited to large commercial farms.
Fostering Effective Early Learning (FEEL) through a professional development programme for early childhood educators to improve professional practice and child outcomes in the year before formal schooling: study protocol for a cluster randomised controlled trial.
Melhuish, Edward; Howard, Steven J; Siraj, Iram; Neilsen-Hewett, Cathrine; Kingston, Denise; de Rosnay, Marc; Duursma, Elisabeth; Luu, Betty
A substantial research base documents the benefits of attendance at high-quality early childhood education and care (ECEC) for positive behavioural and learning outcomes. Research has also found that the quality of many young children's experiences and opportunities in ECEC depends on the skills, dispositions and understandings of the early childhood adult educators. Increasingly, research has shown that the quality of children's interactions with educators and their peers, more than any other programme feature, influence what children learn and how they feel about learning. Hence, we sought to investigate the extent to which evidence-based professional development (PD) - focussed on promoting sustained shared thinking through quality interactions - could improve the quality of ECEC and, as a consequence, child outcomes. The Fostering Effective Early Learning (FEEL) study is a cluster randomised controlled trial for evaluating the benefits of a professional development (PD) programme for early childhood educators, compared with no extra PD. Ninety long-day care and preschool centres in New South Wales, Australia, will be selected to ensure representation across National Quality Standards (NQS) ratings, location, centre type and socioeconomic areas. Participating centres will be randomly allocated to one of two groups, stratified by centre type and NQS rating: (1) an intervention group (45 centres) receiving a PD intervention or (2) a control group (45 centres) that continues engaging in typical classroom practice. Randomisation to these groups will occur after the collection of baseline environmental quality ratings. Primary outcomes, at the child level, will be two measures of language development: verbal comprehension and expressive vocabulary. Secondary outcomes at the child level will be measures of early numeracy, social development and self-regulation. Secondary outcomes at the ECEC room level will be measures of environmental quality derived from full
It can be argued that globalisation brings change for children and their families in the guise of increased poverty and inequality; for example, for the world's poorest populations and communities. Students undertaking Early Childhood Studies degrees in the United Kingdom are likely to encounter modules with a focus on childhood in a variety of…
year-old science and technology research centre at Maseno University in western Kenya. The Centre focuses on science and technology research to influence both national policies and development practices at the community level. Currently ...
Miller, Jodie; Warren, Elizabeth
Students living in disadvantaged contexts and whose second language is English (ESL) are at risk of not succeeding in school mathematics. It has been internationally recognised that students' socioeconomic background and their achievements in mathematics is more pronounced for Australian students (Thomson et al. 2011). This gap is even more prominent for students who also have English as their second language (ESL). This paper explores the impact of the representations, oral language and engagement in mathematics (RoleM) learning experiences on ESL students' performance in mathematics in the early years (foundation-year 2). All students participating in the study are from disadvantaged contexts ( n = 461). The sample comprised 328 students who identified themselves as having English as a second language (ESL) and 133 mainstream students. Pre- and post-tests were conducted at the commencement and completion of each school year. All students demonstrated a significant improvement on their post-test scores, with ESL students displaying greater gains than the mainstream students. Additionally, students' results were meeting norm-referenced expectations for students of the same age. A hypothesised taxonomy was developed to further investigate which types of test items foundation ESL students displayed greatest gains. ESL students again outperformed the mainstream cohort on all levels of test categorisation, including questions that were linguistically and conceptually challenging for foundation students.
Norman, Kasih; Inglis, Josha; Clarkson, Chris; Faith, J. Tyler; Shulmeister, James; Harris, Daniel
Colonisation of Sahul 70-60 thousand years ago (kya) represents the first great maritime migration undertaken by anatomically modern humans in one of the final phases of the Out of Africa dispersal. Visual connectivity network analyses, agent-based simulations and ocean current modelling reveal that modern humans could follow numerous northern and southern migration pathways into Sahul. Our results support a southern route out of Africa through South Asia with entry into ISEA through the Banda Arc, culminating in an early colonisation of Sahul on the northwest shelf. Our results show multiple colonisation events through other entry points were also probable, and raise interesting possibilities for complex regional migration and population histories.
V. N. Poptsov
Full Text Available Introduction. Increase in the number of older patients with terminal CHF results in increase in their proportion among potential recipients requiring mechanical circulatory support and/or heart transplantation (HT [Abecassis M., Bridges N.D. et al., 2012].Aim. To analyze our own experience of HT in recipients of older 60 years.Materials and methods. The study included 63 patients (56 men (93.3% and 4 (6.7% women aged 60–74 years (63.0 ± 0.8 with body weight of 76.6 ± 1.4 kg, body surface area of 1.7 ± 0.02 m2, and body mass index of 23.4 ± 0.6. Indications for heart transplantation: dilated cardiomyopathy – 24 (38.1%, coronary heart disease – 34 (54.0%, hypertrophic cardiomyopathy – 2 (3.2%, irreversible cardiac graft dysfunction – 3 (4.7%. 46 (73.0% patients had NYHA functional Class III and 17 (23.0% patients – Class IV. Transpulmonary pressure gradient was 11.2 ± 2.7 mmHg, pulmonary vascular resistance – 3.5 ± 1.3 Wood units. According to UNOS algorithm 10 (15.9% patients were listed as Status 1A of urgency of orthotopic cardiac transplantation (VA ECMO, n = 8, and implantable left ventricular assist device, n = 2, 21 (33.3% patients as Status 1B, and 32 (50.8% patients as Status 2. Recipients had the following comorbidities: arterial hypertension (n = 51; 81.0%, diabetes mellitus (n = 6; 9.5%, cerebrovascular disease (n = 13; 20.6%, history of stroke (n = 9; 14.3%, dialysisindependent renal dysfunction (n = 21; 33.3%. Before cardiac transplantation 9 (14.2% recipients underwent various thoracic surgeries, 2 (3.2% recipients – brain surgery. Heart donors (49 (77.8% men and 14 (22.2% women were aged 18–59 (34.3 ± 10.4 years.Results. ICU hospitalization lasted for 4–15 (8.2 ± 0.5 days. In 61.9% of cases (n = 39 early postoperative and hospital periods were uncomplicated. Early on-table postoperative activation («early» tracheal extubation was performed in 32 (50.8% patients in 48 ± 6 minutes after
Hung, Y W; Ko, W S; Liu, W H; Chow, C S; Kwok, Y Y; Wong, Clara W Y; Tse, W L; Ho, P C
To evaluate the treatment outcomes of enchondroma of the hand with artificial bone substitute versus autologous (iliac) bone graft. Historical cohort study. Tertiary referral centre, Hong Kong. A total of 24 patients with hand enchondroma from January 2001 to December 2013 who underwent operation at the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong were reviewed. Thorough curettage of the tumour was performed in all patients, followed by either autologous bone graft impaction under general anaesthesia in 13 patients, or artificial bone substitute in 11 patients (10 procedures were performed under local or regional anaesthesia and 1 was done under general anaesthesia). The functional outcomes and bone incorporation were measured by QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire) scores and radiological appearance, respectively. The mean follow-up period was 59 months. There were eight men and 16 women, with a mean age of 40 years. Overall, 17 cases involved phalangeal bones and seven involved metacarpal bones. Among both groups of patients, most of the affected digits had good range of motion and function after surgery. One patient in each study group had complications of local soft tissue inflammation. One patient in the artificial bone substitute group was suspected to have recurrence 8 years after operation. Among the autologous bone graft group, four patients had persistent donor site morbidity at the last follow-up. In all patients, radiographs showed satisfactory bone incorporation. Artificial bone substitute is a safe and effective treatment option for hand enchondroma, with satisfactory functional and radiographic outcomes. Artificial bone substitute offers the additional benefits of enabling the procedure to be done under local anaesthesia on a day-case basis with minimal complications.
Walley, S; Bailey, J R; Albadri, S; Mackie, I C; Gilchrist, F; Rodd, H D
A variety of educational approaches exist within U.K. dental schools, and institutions are constantly striving to improve the quality of their graduates. This study aimed to evaluate the self-reported confidence in, and clinical exposure to, paediatric dentistry at three U.K. dental schools (Liverpool, Manchester and Sheffield) over a three year period. Seventy-five percent of final year BDS undergraduates at the three dental schools completed an anonymous questionnaire capturing student self-reported clinical experience in seven core paediatric dentistry treatment skills, both in hospital and outreach settings. Visual analogue scales were used to record self-assessed confidence levels in aspects of paediatric dentistry and students were also asked to provide a written reflection of both their hospital and outreach placements. The results revealed that despite the variety of educational approaches taken, undergraduates reported very similar levels of clinical experience and confidence. Significant interschool differences in student experience were found with respect to the management of carious primary molars, believed to be a result of individual schools favouring different treatment regimes. Although outreach placements were seen as essential for gaining adequate student experience, the need to improve the consistency of teaching between hospital and outreach centres was highlighted. The study also emphasises the need to take care when using clinical targets in undergraduate teaching and identifies the potential benefits of undergraduate training in inhalation sedation. Finally, despite changes to the paediatric programmes with respect to dental trauma management, students remained lacking in confidence suggesting the need for further development.
Full Text Available Abstract Background Movement skill competence (e.g. the ability to throw, run and kick is a potentially important physical activity determinant. However, little is known about the long-term impact of interventions to improve movement skills in early childhood. This study aimed to determine whether intervention preschool children were still more skill proficient than controls three years after a 10 month movement skill focused intervention: ‘Tooty Fruity Vegie in Preschools’. Methods Children from 18 intervention and 13 control preschools in NSW, Australia were assessed at ages four (Time1, five (T2 and eight years (T3 for locomotor (run, gallop, hop, leap, horizontal jump, slide and object control proficiency (strike, bounce, catch, kick, overhand throw, underhand roll using the Test of Gross Motor Development-2. Multi-level object control and locomotor regression models were fitted with variables time, intervention (yes/no and a time*intervention interaction. Both models added sex of child and retained if significant, in which case interactions of sex of child with other variables were modelled and retained. SPSS (Version 17.0 was used. Results Overall follow-up rate was 29% (163/560. Of the 137 students used in the regression models, 53% were female (n = 73. Intervention girls maintained their object control skill advantage in comparison to controls at T3 (p = .002, but intervention boys did not (p = .591. At T3, there were no longer intervention/control differences in locomotor skill (p = .801. Conclusion Early childhood settings should implement movement skill interventions and more intensively target girls and object control skills.
Background High television exposure time at young age has been described as a potential risk factor for developing behavioral problems. However, less is known about the effects of preschool television on subsequent bullying involvement. We examined the association between television viewing time through ages 2-5 and bullying involvement in the first grades of elementary school. We hypothesized that high television exposure increases the risk of bullying involvement. Method TV viewing time was assessed repeatedly in early childhood using parental report. To combine these repeated assessments we used latent class analysis. Four exposure classes were identified and labeled “low”, “mid-low”, “mid-high” and “high”. Bullying involvement was assessed by teacher questionnaire (n = 3423, mean age 6.8 years). Additionally, peer/self-report of bullying involvement was obtained using a peer nomination procedure (n = 1176, mean age 7.6 years). We examined child risk of being a bully, victim or a bully-victim (compared to being uninvolved in bullying). Results High television exposure class was associated with elevated risks of bullying and victimization. Also, in both teacher- and child-reported data, children in the high television exposure class were more likely to be a bully-victim (OR = 2.11, 95% CI: 1.42-3.13 and OR = 3.68, 95% CI: 1.75-7.74 respectively). However, all univariate effect estimates attenuated and were no longer statistically significant once adjusted for maternal and child covariates. Conclusions The association between television viewing time through ages 2-5 and bullying involvement in early elementary school is confounded by maternal and child socio-demographic characteristics. PMID:24520886
Taha Ghada RA
Full Text Available Abstract Background There were few studies on the outcome of schizophrenia in developing countries. Whether the outcome is similar to or different from developed world is still a point for research. The main aim of the current study was to know if patients with early onset non affective psychosis can behave and function properly after few years from start of the illness or not. Other aims included investigation of possible predictors and associated factors with remission and outcome. Method The study prospectively investigated a group of 56 patients with onset of psychosis during childhood or adolescence. Diagnosis made according to DSM-IV criteria and included; schizophrenia, psychotic disorder not otherwise specified and acute psychosis. Severity of psychosis was measured by PANSS. Measures of the outcome included; remission criteria of Andreasen et al 2005, the children's global assessment scale and educational level. Results Analysis of data was done for only 37 patients. Thirty patients diagnosed as schizophrenia and 7 with Psychotic disorder not otherwise specified. Mean duration of follow up was 38.4 +/- 16.9 months. At the end of the study, 6 patients (16.2% had one episode, 23(62.1% had multiple episodes and 8 (21.6% continuous course. Nineteen patients (51.4% achieved full remission, and only 11(29.7% achieved their average educational level for their age. Twenty seven percent of the sample had good outcome and 24.3% had poor outcome. Factors associated with non remission and poor outcome included gradual onset, low IQ, poor premorbid adjustment, negative symptoms at onset of the illness and poor adherence to drugs. Moreover, there was tendency of negative symptoms at illness start to predict poor outcome. Conclusion Some patients with early onset non affective psychosis can behave and function properly after few years from the start of the illness. Although remission is a difficult target in childhood psychosis, it is still achievable.
Verlinden, Marina; Tiemeier, Henning; Veenstra, René; Mieloo, Cathelijne L; Jansen, Wilma; Jaddoe, Vincent W V; Raat, Hein; Hofman, Albert; Verhulst, Frank C; Jansen, Pauline W
High television exposure time at young age has been described as a potential risk factor for developing behavioral problems. However, less is known about the effects of preschool television on subsequent bullying involvement. We examined the association between television viewing time through ages 2-5 and bullying involvement in the first grades of elementary school. We hypothesized that high television exposure increases the risk of bullying involvement. TV viewing time was assessed repeatedly in early childhood using parental report. To combine these repeated assessments we used latent class analysis. Four exposure classes were identified and labeled "low", "mid-low", "mid-high" and "high". Bullying involvement was assessed by teacher questionnaire (n=3423, mean age 6.8 years). Additionally, peer/self-report of bullying involvement was obtained using a peer nomination procedure (n=1176, mean age 7.6 years). We examined child risk of being a bully, victim or a bully-victim (compared to being uninvolved in bullying). High television exposure class was associated with elevated risks of bullying and victimization. Also, in both teacher- and child-reported data, children in the high television exposure class were more likely to be a bully-victim (OR=2.11, 95% CI: 1.42-3.13 and OR=3.68, 95% CI: 1.75-7.74 respectively). However, all univariate effect estimates attenuated and were no longer statistically significant once adjusted for maternal and child covariates. The association between television viewing time through ages 2-5 and bullying involvement in early elementary school is confounded by maternal and child socio-demographic characteristics.
Kambouri, Maria; Allen, Michael; Pampoulou, Eliada; Pieridou, Myria
The study investigated early years teachers’ understanding and use of graphic symbols, defined as the visual representation(s) used to communicate one or more “linguistic” concepts, which can be used to facilitate science learning. The study was conducted in Cyprus where six early years teachers were observed and interviewed. The results indicate that the teachers had a good understanding of the role of symbols, but demonstrated a lack of understanding in regards to graphic symbols specifical...
Hansen, Kristina; Mangrio, Elisabeth; Lindström, Martin; Rosvall, Maria
Earlier studies have shown an association between secondhand tobacco smoke and allergy development in children. Furthermore, there is an increased risk of developing an allergy if the parents have an allergy. However, there are only few studies investigating the potential synergistic effect of secondhand tobacco smoke and allergic heredity on the development of an allergy. The study was population-based cross-sectional with retrospective information on presence of secondhand tobacco smoke during early life. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmö for their 4-year health checkup during 2006-2008 and whose parents answered a self-administered questionnaire (n = 4,278 children). The questionnaire was distributed to parents of children registered with the CHC and invited for the 4-year checkup during the study period. There was a two to four times increased odds of the child having an allergy or having sought medical care due to allergic symptoms if at least one parent had an allergy, while there were rather small increased odds related to presence of secondhand smoke during the child's first month in life or at the age of 8 months. However, children with heredity for allergies and with presence of secondhand tobacco smoke during their first year in life had highly increased odds of developing an allergy and having sought medical care due to allergic symptoms at 4 years of age. Thus, there was a synergistic effect enhancing the independent effects of heredity and exposure to secondhand tobacco smoke on allergy development. Children with a family history of allergies and early exposure to secondhand tobacco smoke is a risk group that prevention and intervention should pay extra attention to. The tobacco smoke effect on children is an essential and urgent question considering it not being self chosen, possibly giving life lasting negative health effects and being possible to reduce.
Full Text Available Abstract Background Earlier studies have shown an association between secondhand tobacco smoke and allergy development in children. Furthermore, there is an increased risk of developing an allergy if the parents have an allergy. However, there are only few studies investigating the potential synergistic effect of secondhand tobacco smoke and allergic heredity on the development of an allergy. Methods The study was population-based cross-sectional with retrospective information on presence of secondhand tobacco smoke during early life. The study population consisted of children who visited the Child Health Care (CHC centres in Malmö for their 4-year health checkup during 2006-2008 and whose parents answered a self-administered questionnaire (n = 4,278 children. The questionnaire was distributed to parents of children registered with the CHC and invited for the 4-year checkup during the study period. Results There was a two to four times increased odds of the child having an allergy or having sought medical care due to allergic symptoms if at least one parent had an allergy, while there were rather small increased odds related to presence of secondhand smoke during the child's first month in life or at the age of 8 months. However, children with heredity for allergies and with presence of secondhand tobacco smoke during their first year in life had highly increased odds of developing an allergy and having sought medical care due to allergic symptoms at 4 years of age. Thus, there was a synergistic effect enhancing the independent effects of heredity and exposure to secondhand tobacco smoke on allergy development. Conclusions Children with a family history of allergies and early exposure to secondhand tobacco smoke is a risk group that prevention and intervention should pay extra attention to. The tobacco smoke effect on children is an essential and urgent question considering it not being self chosen, possibly giving life lasting negative health
Elhabashy, Safinaz Adel; Elbarbary, Nancy Samir; Nageb, Karim Magdy; Mohammed, Mai Mostafa
Optical coherence tomography (OCT) has been proven useful in measuring retinal thickness and volumes in patients with diabetes. To test whether OCT is able to identify early retinal changes and its potential correlations with metabolic parameters and other microvascular complications. Thirty patients with type 1 diabetes without minimal diabetic retinopathy (MDR) (17 males, 13 females, aged 14.3±2.4 years) compared with age-matched healthy volunteers were examined with OCT. Diabetes duration, anthropometric measurements, HbA1c, other microvascular complications (nephropathy, autonomic and peripheral neuropathy) and total serum cholesterol were determined. No statistically significant differences were found between patients with (n=15) and without microvascular complications (n=15) compared to controls regarding retinal volume, nerve fibre layer volume (temporal and nasal quadrants) and ganglion cell layer area in both eyes. No correlation was found between the ganglion cell layer area and the clinical and laboratory characteristics of the patients, except a negative correlation with total serum cholesterol (r=-0.369, p=0.049). The best cut-off value of ganglion cell layer area to detect the level at which thinning of this layer occurs was >1900 pixels. Our study suggests that there is no advantage in performing OCT routinely in patients with type 1 diabetes mellitus without MDR. OCT did not show changes in retinal thickness in those patients compared to control. So OCT did not seem to be useful in the preclinical stages of diabetic retinopathy. Therefore, the conventional diagnostic methods are mandatory to detect early diabetic retinopathy.
Early childhood education and care (ECEC) has become a national priority in many countries. Governments across Europe and the Asia-Pacific region have placed considerable emphasis on the development of policy documents and national initiatives to improve the quality of services for young children and families. This paper presents findings from a…
Schneider, William H; Drucker, Ernest
Blood transfusions transmit HIV more effectively than other means, yet there has been little examination of their role in the origins and early course of AIDS in sub-Saharan Africa. We review historical data in archives, government reports, and medical literature from African and European sources documenting the introduction, establishment, use, and growth of blood transfusions in sub-Saharan Africa. These data allow estimation of the geographic diffusion and growth of blood transfusions between 1940 and 1990. By 1955, 19 African colonies and countries reported transfusion programs-with national rates of 718 to 1372 per 100 000 by 1964, and urban rates similar to those in developed countries. We estimated 1 million transfusions per year in sub-Saharan Africa by 1970 and 2 million per year by the 1980s, indicating that transfusions were widely used throughout sub-Saharan Africa during the crucial period of 1950-1970, when all epidemic strains of HIV first emerged in this region.
Terezinha da Conceição Costa-Hübes
Full Text Available The analysis of students’ texts requires from the teacher scientific knowledge about language which provides him subsidies for the diagnosis of the writings. Thus, this paper aims to present some reflections on the possibilities of using a diagnostic table, designed with the purpose of guiding the teacher – when assessing the student’s text – in the identification of the mastered and non-mastered aspects in writing. The designing of the table is the result of studies carried out by a study group on Portuguese language, consisting of teachers of the early years and supported by the theories of speech genres (BAKHTIN, 2003 and text genres (BRONCKART, 2003, the concept of text as a teaching unit (GERALDI, 1984 and, more specifically, the discussions on practices of linguistic analysis (GERALDI, 1984 and 1997. In order to test the use of the table, we will take texts of the genre ‘note’ produced by students of the 3rd year of elementary school, considering genre, text and spelling aspects.
Ejlerskov, Katrine Tschentscher; Christensen, Line Brinch; Ritz, Christian
on body composition at 3 years, and whether infant feeding modified the relationship between early growth and body composition at 3 years. We studied 233 children from the prospective cohort study, SKOT (in Danish: Småbørns Kost og Trivsel). Birth weight z-scores (BWZ) and change in weight-for-age z......Early excessive weight gain is positively associated with later obesity, and yet the effect of weight gain during specific periods and the impact of infant feeding practices are debated. The objective of the present study was to examine the impact of weight gain in periods of early childhood...... of infant feeding was found for FFMI. In conclusion, high birth weight and rapid growth from 0 to 5 months were associated with increased FMI and FFMI at 3 years. Longer duration of full breastfeeding reduced the effect of birth weight and early weight gain on fat mass....
Busse, William W; Pedersen, Søren; Pauwels, Romain A
BACKGROUND: The Inhaled Steroid Treatment as Regular Therapy in Early Asthma (START) study enrolled 7241 patients aged 5 to 66 years with recent-onset, mild persistent asthma to assess early intervention with the inhaled corticosteroid budesonide on long-term asthma control. OBJECTIVE: The open......-label phase of the START study was included to determine the effect on lung function and asthma control of adding budesonide to the reference group patients who had not initially received inhaled corticosteroids. METHODS: Patients were randomized to double-blind treatment with budesonide, 200 mug (those aged...... asthma therapy for 3 years, after which all patients received 2 years of open-label treatment with budesonide once daily. RESULTS: During the full 5-year study period, postbronchodilator FEV(1) percent predicted decreased, irrespective...
Hansen, C.R.; Pressler, T.; Høiby, Niels
BACKGROUND: Since 1989, CF-patients intermittently colonized with Pseudomonas aeruginosa have been treated with inhaled colistin and oral ciprofloxacin in the Copenhagen CF-centre. The study evaluates 15 years results of this treatment. METHODS: All isolates of P. aeruginosa from CF-patients inte......BACKGROUND: Since 1989, CF-patients intermittently colonized with Pseudomonas aeruginosa have been treated with inhaled colistin and oral ciprofloxacin in the Copenhagen CF-centre. The study evaluates 15 years results of this treatment. METHODS: All isolates of P. aeruginosa from CF...... to 80% of patients for up to 15 years. 613 colistin/ciprofloxacin treatments were given. There was no difference in pseudomonas-free interval comparing 3 weeks (5 months) and 3 months (10.4 months) of colistin and ciprofloxacin, but a significant difference compared to no treatment (1.9 months......) was a strong risk factor for development of chronic infection after 3-4 years, OR 5.8. 1093 pseudomonas-isolates were evaluated (86.6% non-mucoid). No colistin-resistance was found. Ciprofloxacin-resistance was found in 4% of isolates. CONCLUSION: Treatment of intermittent P. aeruginosa colonization in CF...
Gadre, Kiran S; Halli, Rajshekhar; Joshi, Samir; Ramanojam, Shandilya; Gadre, Pushkar K; Kunchur, Ranjit; Bhosale, Gururaj; Kaul, Deepak
This study aims to retrospectively analyze the incidence and pattern of cranio-maxillofacial injuries in the developing world in a hope to emphasize on authorities the need of improvising infrastructural facilities, medical and other. Hospital medical records with available radiographs of 6,872 patients treated for cranio-maxillofacial injuries at major trauma centres in Pune, India over a 22 year period (from July 1989 to June 2010) were reviewed. Relevant data pertaining to patients' age, sex, cause of injury, sites of injury, associated injuries, anaesthesia, various treatment modalities and complications were recorded and analyzed statistically. A total of 6,872 patients sustained maxillofacial injuries of which 5,936 (86.4 %) were caused by road traffic accidents (RTA), followed by fall in 608 cases. Distribution pattern of sex revealed male predominance (M:F-2.5:1) and the third decade age group (2,416) sustained maximum cranio-maxillofacial injuries. Of 12,503 cranio-maxillofacial sites involved, mandible (6,456) predominated, while there was middle third involvement in 5,024 cases. Most of the patients (4,856) were treated with open reduction and internal fixation without maxillo-mandibular fixation and complications were noted in 320 patients. In comparison to similar recent studies reported in the literature, our findings show that RTA remains the most common cause of cranio-maxillofacial injuries with male preponderance. Also RTA remains the major preventable etiological factor of cranio-maxillofacial injuries, which should prompt authorities to take "Herculean effort" to implement rules and educate people.
Branco, Bernardino C; Inaba, Kenji; Barmparas, Galinos; Schnüriger, Beat; Lustenberger, Thomas; Talving, Peep; Lam, Lydia; Demetriades, Demetrios
Compartment syndrome is a devastating complication after trauma to the extremities. Prompt fasciotomy is essential for avoiding disability and limb loss. The purpose of this study was to determine the incidence and predictors for the need for fasciotomy after extremity trauma. All trauma patients sustaining extremity injuries admitted to the LAC+USC Medical Centre during a 10-year period ending in December 2007 were identified. Demographics, clinical data, blood requirements and outcomes were abstracted. Patients who required an extremity fasciotomy were compared with those who did not. Stepwise logistic regression analysis was used to identify independent predictors of the need for fasciotomy. During the study period, 288 (2.8%) of a total of 10,315 patients who sustained extremity trauma required a fasciotomy. Despite a stable ISS and extremity AIS over the study period, fasciotomy rates decreased significantly from 3.2% in 1998 to 2.5% in 2002 to 0.7% in 2007 (pinjury (from 0.9% after motor vehicle accident to 8.6% in GSWs, pinjury (from 2.2% in closed fracture to 41.8% in combined vascular injury, pupper: 8.3% vs. 5.2%, p=0.031 and lower: 28.5% vs. 11.8%, pinjuries (15.3% vs. 0.4%, pinjury, need for PRBC transfusion, male gender, open fracture, elbow or knee dislocation, GSW, ISS≥16 and ageextremity trauma, approximately 1% of patients will require a fasciotomy. The need for fasciotomy varied widely by injury mechanism and type reaching 42% in patients who sustained a combined arterial and venous injury. The above risk factors were identified as independent predictors for the need for fasciotomy. Copyright © 2010 Elsevier Ltd. All rights reserved.
Evans, A.J. [Breast Institute, Nottingham City Hospital, Nottingham (United Kingdom)]. E-mail: firstname.lastname@example.org; Kutt, E. [Avon Breast Cancer Screening Unit, Central Health Clinic, Tower Hill, Bristol, Avon (United Kingdom); Record, C. [Breast Screening Service, Stoke Mandeville Hospital, Aylesbury (United Kingdom); Waller, M. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom); Bobrow, L. [Histopathology, Addenbrookes Hospital, Cambridge (United Kingdom); Moss, S. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom)
Aim: The aim of this study was to analyse the radiographic findings of the screening mammograms of women with interval cancer who participated in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-48 years. Materials and methods: The screening and diagnostic mammograms of 208 women with interval cancers were reviewed. Abnormalities were classified as malignant, subtle and non-specific. Results: Eighty-seven (42%) of women had true, 66 (32%) occult and 55 (26%) false-negative interval cancers. The features most frequently missed or misinterpreted were granular microcalcification (38%), asymmetric density (27%) and distortion (22%). Thirty-seven percent of abnormal previous screens were classified as malignant, 39% subtle change and 21% as non-specific. Granular calcifications were significantly more common on the diagnostic mammograms of false-negative interval cancers than those of true interval cancers (28 versus 14%, p = 0.04). Occult interval cancers were more likely to be <10 mm and <15 mm in invasive pathological size than other interval cancers (p = 0.03 and 0.005, respectively). True interval cancers were more likely to be histologically grade 3 than other interval cancers (p = 0.04). Women who developed true and false-negative interval cancers had similar background patterns, but women with occult cancers had a higher proportion of dense patterns (p < 0.05). Conclusion: Interval cancers in a young screening population have a high proportion of occult lesions that are small and occur in dense background patterns. The proportion of interval cancers that are false negative is similar that seen in older populations and granular microcalcification is the commonest missed mammographic feature.
Evans, A.J.; Kutt, E.; Record, C.; Waller, M.; Bobrow, L.; Moss, S.
Aim: The aim of this study was to analyse the radiographic findings of the screening mammograms of women with interval cancer who participated in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-48 years. Materials and methods: The screening and diagnostic mammograms of 208 women with interval cancers were reviewed. Abnormalities were classified as malignant, subtle and non-specific. Results: Eighty-seven (42%) of women had true, 66 (32%) occult and 55 (26%) false-negative interval cancers. The features most frequently missed or misinterpreted were granular microcalcification (38%), asymmetric density (27%) and distortion (22%). Thirty-seven percent of abnormal previous screens were classified as malignant, 39% subtle change and 21% as non-specific. Granular calcifications were significantly more common on the diagnostic mammograms of false-negative interval cancers than those of true interval cancers (28 versus 14%, p = 0.04). Occult interval cancers were more likely to be <10 mm and <15 mm in invasive pathological size than other interval cancers (p = 0.03 and 0.005, respectively). True interval cancers were more likely to be histologically grade 3 than other interval cancers (p = 0.04). Women who developed true and false-negative interval cancers had similar background patterns, but women with occult cancers had a higher proportion of dense patterns (p < 0.05). Conclusion: Interval cancers in a young screening population have a high proportion of occult lesions that are small and occur in dense background patterns. The proportion of interval cancers that are false negative is similar that seen in older populations and granular microcalcification is the commonest missed mammographic feature
Ten Velden Hegelstad, Wenche; Haahr, Ulrik; Larsen, Tor K
Poor symptom outcome remains a challenge in psychosis: At least 50% of first-episode patients continue to have positive and/or negative symptoms after ten years.......Poor symptom outcome remains a challenge in psychosis: At least 50% of first-episode patients continue to have positive and/or negative symptoms after ten years....
The role of integrating natural and social science concepts for risk governance and the design of people-centred early warning systems. Case study from the German-Indonesian Tsunami Early Warning System Project (GITEWS)
Gebert, Niklas; Post, Joachim
The development of early warning systems are one of the key domains of adaptation to global environmental change and contribute very much to the development of societal reaction and adaptive capacities to deal with extreme events. Especially, Indonesia is highly exposed to tsunami. In average every three years small and medium size tsunamis occur in the region causing damage and death. In the aftermath of the Indian Ocean Tsunami 2004, the German and Indonesian government agreed on a joint cooperation to develop a People Centered End-to-End Early Warning System (GITEWS). The analysis of risk and vulnerability, as an important step in risk (and early warning) governance, is a precondition for the design of effective early warning structures by delivering the knowledge base for developing institutionalized quick response mechanisms of organizations involved in the issuing of a tsunami warning, and of populations exposed to react to warnings and to manage evacuation before the first tsunami wave hits. Thus, a special challenge for developing countries is the governance of complex cross-sectoral and cross-scale institutional, social and spatial processes and requirements for the conceptualization, implementation and optimization of a people centered tsunami early warning system. In support of this, the risk and vulnerability assessment of the case study aims at identifying those factors that constitute the causal structure of the (dis)functionality between the technological warning and the social response system causing loss of life during an emergency situation: Which social groups are likely to be less able to receive and respond to an early warning alert? And, are people able to evacuate in due time? Here, only an interdisciplinary research approach is capable to analyze the socio-spatial and environmental conditions of vulnerability and risk and to produce valuable results for decision makers and civil society to manage tsunami risk in the early warning context
Schonhaut B, Luisa; Pérez R, Marcela; Castilla F, Ana María; Castro M, Sonia; Salinas A, Patricia; Armijo R, Iván
The Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. Diagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation RESULTS: 123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. ASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Rachel and Margaret McMillan created an open-air nursery in Deptford, London that has influenced early years education for 100 years. Their vision for young children living in poverty and deprivation to have access to fresh air through outdoor learning, nutritious meals, and an enriching environment to explore and develop has been embraced and…
Tiago Henrique da Silva Ramos
This study is based on a Master’s research in progress thataims to analyze that formative relationships are established betweenbeginning young teachers, recently graduated or with a maximum of fiveyears of teaching experience - and experienced teachers - aged forty yearsor more and about fifteen or more years of teaching, within an elementaryschool (early years, conceived as a training space. It has been hypothesized
This research paper reports on phase one of an investigation of video recorded intensive one-to-one teaching interactions with 6-7-year-old students who were in their second year of schooling in Australia and identified by the their teacher as low attaining in early number. The two-phased study from which this paper emerges was originally…
This paper considers the implications of UK policy approaches to ICT (Information Communication Technology) in education by exploring the views of early years (0-8 years) educators about their ICT CPD (continuing professional development) needs. UK policy approaches to ICT may be visualised as a "house that Jack built." The policies are…
Brach, Michael; Nieder, Frank; Nieder, Ulrike; Mechling, Heinz
There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and
Full Text Available Abstract Background There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL, the organisational-institutional level (OIL and the political-cultural level (PCL. Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. Methods The intervention consisted of (a two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL, (b a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL, (c informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL. Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL, number of groups continued without external financial
Background There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. Methods The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end
Biering-Sørensen, Sofie; Andersen, Andreas; Ravn, Henrik
BACKGROUND: Randomised trials have shown that early Bacille Calmette-Guérin (BCG) vaccine reduces overall neonatal and infant mortality. However, no study has examined how BCG affects growth. We investigated the effect on infant growth of early BCG vaccine given to low-birth-weight (LBW) infants...... A supplementation (VAS) or placebo. Anthropometric measurements were obtained 2, 6, and 12 months after enrolment. RESULTS: Overall there was no effect of early BCG on growth in the first year of life. The effect of early BCG on weight and mid-upper-arm circumference at 2 months tended to be beneficial among girls...... but not among boys (interaction between "early BCG" and sex: weight p = 0.03 and MUAC p = 0.04). This beneficial effect among girls was particularly seen among the largest infants weighing 2.0 kg or more at inclusion. CONCLUSION: Though BCG vaccination is not recommended to be given to LBW infants at birth...
Lozoff, Betsy; Smith, Julia B; Kaciroti, Niko; Clark, Katy M; Guevara, Silvia; Jimenez, Elias
To evaluate adulthood function following chronic iron deficiency in infancy. At 25 years, we compared 33 subjects with chronic iron deficiency in infancy to 89 who were iron-sufficient before and/or after iron therapy. Outcomes included education, employment, marital status, and physical and mental health. Adjusting for sex and socioeconomic status, a higher proportion of the group with chronic iron deficiency did not complete secondary school (58.1% vs 19.8% in iron-sufficient group; Wald value = 8.74; P = .003), were not pursuing further education/training (76.1% vs 31.5%; Wald value = 3.01; P = .08; suggestive trend), and were single (83.9% vs 23.7%, Wald value = 4.49; P = .03). They reported poorer emotional health and more negative emotions and feelings of dissociation/detachment. Results were similar in secondary analyses comparing the chronic iron-deficient group with subjects in the iron-sufficient group who had been iron-deficient before treatment in infancy. Path analysis showed direct paths for chronic iron deficiency in infancy and being single and more detachment/dissociation at 25 years. There were indirect paths for chronic iron deficiency and not completing secondary school via poorer cognitive functioning in early adolescence and more negative emotions via behavior problems in adolescence, indicating a cascade of adverse outcomes. The observational nature of this study limits our ability to draw causal inference, even when controlling for background factors. Nonetheless, our results indicate substantial loss of human potential. There may be broader societal implications, considering that many adults worldwide had chronic iron deficiency in infancy. Iron deficiency can be prevented or treated before it becomes chronic or severe. Copyright © 2013 Mosby, Inc. All rights reserved.
Walsh, B H
AIMS: Hypoxic Ischaemic Encephalopathy (HIE) causes characteristic changes of the electroencephalogram (EEG), and a raised Nucleated Red Blood Cell (NRBC) count compared to controls. We wished to examine whether combining these markers could improve their ability to predict HIE severity in the first 24h. METHODS: Term infants with HIE were recruited. NRBC count and continuous multi-channel EEG were recorded within the first 24h. Neurological assessment was carried out at 24 months. A control population with NRBC counts in the first 24h was recruited. RESULTS: 44 infants with HIE and 43 control infants were recruited. Of the HIE population 39 completed a 2 year follow-up. The median NRBC count differed significantly between the controls and those with HIE (3\\/100 WBC [range of 0-11] vs 12.3\\/100 WBC [0-240]) (p<0.001). Within the HIE population the median NRBC count was significantly greater in infants with moderate\\/severe HIE than mild (16\\/100 WBC [range of 0-240] vs 8\\/100 WBC [1-23]) (p=0.016), and among infants with abnormal outcome compared to normal (21.3\\/100 WBC [1-239.8] vs 8.3\\/100 WBC [0-50])(p=0.03). The predictive ability of EEG changed with time post-delivery, therefore results are given at both 12 and 24h of age. At both time points the combined marker had a stronger correlation than EEG alone; with HIE severity (12h: r=0.661 vs r=0.622), (24h: r=0.645 vs r=0.598), and with outcome at 2 years (12h: r=0.756 vs r=0.652), (24h: r=0.802 vs r=0.746). CONCLUSION: Combining early EEG and NRBC count to predict HIE severity and neurological outcome, improved the predictive ability of either in isolation.
Valtonen, Hannu J; Qvarnberg, Yrjö H; Nuutinen, Juhani
Ventilation tubes in the treatment of otitis media in young children remain controversial. Despite abundant research, few prospective long-term follow-up studies have included even a minority of patients under 1 year old. We investigated long-term otological and audiological outcomes in children with recurrent acute otitis media and otitis media with effusion, who were treated early with ventilation tubes. Prospective follow-up. Three hundred five children under 17 months of age received a primary tympanostomy in the Central Hospital of Central Finland (Jyväskylä, Finland), and those 281 (92.1%) who were monitored prospectively for 5 years made up the study group. At the final examination, pneumatic otoscope and otomicroscope were used and pure-tone audiometric thresholds of air and bone conduction were measured to define the hearing levels (mean of 0.5, 1.0, and 2.0 KHz thresholds). Of ears, 67.3% were healed, 7.1% had a retraction of tympanic membrane in pars flaccida and 9.6% in pars tensa, 7.5% had an ongoing otitis media with effusion, 3.9% had a ventilation tube in place, and 4.6% had a tympanic membrane perforation with mean hearing levels of 7.6, 9.0, 16.0, 18.5, 10.5, and 17.7 dB, respectively. Hearing in general was well preserved, and no ear presented with adhesive otitis media or cholesteatoma. Adverse otological and audiological outcomes of these young children did not exceed those presented by others for older counterparts. Tympanic membrane perforations, ongoing otitis media with effusion, and pars tensa retractions were causes of mild conductive hearing loss. Because one third of ears continued to have middle ear disease or sequelae, we emphasize the proper follow-up and restoration of middle ear ventilation with repeat ventilation tubes if not otherwise achieved.
Ishiwata, Akiko; Kitamura, Shin; Nomura, Toshiaki; Nemoto, Rumi; Ishii, Chika; Wakamatsu, Naoki; Katayama, Yasuo
The community consultation center was established as the core facility for a project entitled "Community Support Network for Citizens with Mild Cognitive Impairment (MCI) and Dementia." This study reports on our center's activity and user outcomes. Users consulted with medical staff regarding their memory problems and were self-screened using a touch-panel computer assisted screening tool (TPST). Dementia was suspected when the TPST score was 12 points or below, and the Mini-Mental State Examination (MMSE) was conducted by our onsite clinical psychologists, which served as the gold standard. All reports were provided to user's primary care physicians, or a nearby medical institute if users did not have a primary care physician. Patient outcomes were obtained from participating medical institutes. Informed consent was obtained for all users. In the four-year period, 2802 users visited the center. Of them, 1565 registered (men/women=519/1046; mean age, 74 years). Of 1354 people who used TPST, 622 (45.9%) scored 12 points or below. 409 confirmed diagnoses from the medical institutes revealed MCI in 11.2%, Alzheimer's disease in 37.1%, and vascular dementia in 8.0%. Among the 207 users who had no primary care physicians at consultation, 43 (20.8%) were diagnosed with MCI or dementia. Approximately half of the users who took the TPST were suspected of dementia following interview by a clinical psychologist. Both MCI and dementia were confirmed by the medical institutes in 59.6% of users. We conclude that our consultation center plays a pivotal role in early diagnosis of MCI and dementia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
White, E. Jayne; Peter, Mira; Sims, Margaret; Rockel, Jean; Kumeroa, Maureen
This article reports on a project, "Collaboration of Universities Pedagogies of Infants' and Toddlers' Development-'down under' (CUPID)," in which the practicum experiences of 1st-year preservice initial teacher education (ITE) students at five universities across Australia and New Zealand (NZ) engaging in early childhood education (ECE)…
Full Text Available Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies. However, to date there are insufficient data to determine a universally acceptable opinion on early loading of implants for single-tooth replacement. This case report involves early loading, combined with construction of a restoration, inserted directly after 6 weeks of implant surgery and followup of one year.
Beldar, Amol; Bhongade, Manohar L.; Byakod, Girish; Buregoni, Chandrashekar
Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies. However, to date there are insufficient data to determine a universally acceptable opinion on early loading of implants for single-tooth replacement. This case report involves early loading, combined with construction of a restoration, inserted directly after 6 weeks of implant surgery and followup of one year. PMID:23710375
Pioneer Women was an AHRC-funded project based on archives held at the National Resource Centre for Dance, University of Surrey. Two of the largest collections, those on Madge Atkinson and Natural Movement, and Ruby Ginner’s Revived (later Classical) Greek Dance, are categorized and interrogated for not only what they reveal of the work of these two dance artists, but also for how they resonate with dominant cultural trends in the arts. The research privileges a much under-explored or theoriz...
A prospective, single-centre, randomised study evaluating the clinical, imaging and immunological depth of remission achieved by very early versus delayed Etanercept in patients with Rheumatoid Arthritis (VEDERA).
Dumitru, Raluca B; Horton, Sarah; Hodgson, Richard; Wakefield, Richard J; Hensor, Elizabeth M A; Emery, Paul; Buch, Maya H
Rheumatoid arthritis (RA) is a chronic inflammatory arthritis, with significant impact on quality of life and functional status. Whilst biologic disease modifying anti-rheumatic drugs (bDMARD) such as tumour necrosis factor-inhibitor (TNFi) agents have revolutionised outcomes in RA, early diagnosis with immediate conventional therapy, titrated in a treat to target approach is also associated with high remission rates. The main aim of the VEDERA study (Very Early versus Delayed Etanercept in Rheumatoid Arthritis) is to assess the depth of remission, sustainability of remission and immunological normalisation induced by very early TNFi with etanercept (ETN) or standard of care +/- delayed ETN. VEDERA is a pragmatic, phase IV single-centre open-label randomised superiority trial of 120 patients with early, treatment-naive RA. Patients will be randomised 1:1 to first-line ETN and methotrexate (MTX) or MTX with additional synthetic disease modifying anti-rheumatic drugs (sDMARDs) according to a treat to target (TT) protocol with further step up to ETN and MTX after 24 weeks if remission is not achieved. Participants will have regular disease activity assessments and imaging evaluation including musculoskeletal ultrasound and MRI. The main objective of this study is to assess the proportion of patients with early RA that achieve clinical remission at 48 weeks, following either treatment strategy. In addition, the participants are invited to take part in a cardio-vascular sub-study (Coronary Artery Disease in RA, CADERA), which aims to identify the incidence of cardiovascular abnormalities in early RA. The hypothesis underlining this study is that very early treatment with first-line ETN increases the proportion of patients with rheumatoid arthritis achieving clinical remission, in comparison to conventional therapy. NCT02433184 , 23/04/2015.
Daniel D. Bingham
Full Text Available Measuring physical activity (PA and sedentary time (ST in young children (<5 years is complex. Objective measures have high validity but require specialist expertise, are expensive, and can be burdensome for participants. A proxy-report instrument for young children that accurately measures PA and ST is needed. The aim of this study was to assess the reliability and validity of the Early Years Physical Activity Questionnaire (EY-PAQ. In a setting where English and Urdu are the predominant languages spoken by parents of young children, a sample of 196 parents and their young children (mean age 3.2 ± 0.8 years from Bradford, UK took part in the study. A total of 156 (79.6% questionnaires were completed in English and 40 (20.4% were completed in transliterated Urdu. A total of 109 parents took part in the reliability aspect of the study, which involved completion of the EY-PAQ on two occasions (7.2 days apart; standard deviation (SD = 1.1. All 196 participants took part in the validity aspect which involved comparison of EY-PAQ scores against accelerometry. Validty anaylsis used all data and data falling with specific MVPA and ST boundaries. Reliability was assessed using intra-class correlations (ICC and validity by Bland–Altman plots and rank correlation coefficients. The test re-test reliability of the EY-PAQ was moderate for ST (ICC = 0.47 and fair for moderate-to-vigorous physical activity (MVPA(ICC = 0.35. The EY-PAQ had poor agreement with accelerometer-determined ST (mean difference = −87.5 min·day−1 and good agreement for MVPA (mean difference = 7.1 min·day−1 limits of agreement were wide for all variables. The rank correlation coefficient was non-significant for ST (rho = 0.19 and significant for MVPA (rho = 0.30. The EY-PAQ has comparable validity and reliability to other PA self-report tools and is a promising population-based measure of young children’s habitual MVPA but not ST. In situations when objective methods are not
Helm, M; Bitzl, A; Klinger, S; Lefering, R; Lampl, L; Kulla, M
The trauma register of the German Society of Trauma Surgery (TraumaRegister DGU®/TR-DGU) has been proven to be a valuable tool for external assessment of quality in the treatment of patients with major trauma. This publication shows for the first time how the quality of trauma treatment in a level I trauma centre could be improved over a period of almost ten years with the help of continuous quality management, i.e. recognizing a problem, developing a solution and evaluating its effect. Tracer parameters and indicators of quality are presented in four periods over a total study period from 1st January 1989 to 31st March 2007. The division into four periods is due to major changes in the trauma treatment algorithms or structural changes in the trauma room. The results are displayed for all patients treated in the trauma room and for those patients with an injury severity score (ISS)≥16. Over all four periods a total number of n=2,239 patients were admitted to the trauma room. Based on the results of the trauma register a number of changes were made, not only structural changes, such as the introduction of point-of-care diagnostics, initially conventional X-ray, then digital X-ray and finally multislice computed tomography (CT) scanning in the trauma room but also changes in the way personnel participating in the trauma treatment are trained. Advanced trauma life support (ATLS®) has become the standard training for doctors and prehospital trauma life support (PHTLS®) for nurses. Time efficient treatment algorithms were introduced. All measures led to changes in several parameters which are chosen as indicators for good treatment quality. It was for instance possible to reduce the average total trauma treatment time for patients with an ISS≥16 from initially 90.9±48.6 min to 37.4±18. min in the final study period. The external quality management performed by the TR-DGU has proved to be a constant source of inspiration. The effects of the changes made can
Malla, Ashok; Joober, Ridha; Iyer, Srividya; Norman, Ross; Schmitz, Norbert; Brown, Thomas; Lutgens, Danyael; Jarvis, Eric; Margolese, Howard C; Casacalenda, Nicola; Abdel-Baki, Amal; Latimer, Eric; Mustafa, Sally; Abadi, Sherezad
This study aimed to determine if, following two years of early intervention service for first-episode psychosis, three-year extension of that service was superior to three years of regular care. We conducted a randomized single blind clinical trial using an urn randomization balanced for gender and substance abuse. Participants were recruited from early intervention service clinics in Montreal. Patients (N=220), 18-35 years old, were randomized to an extension of early intervention service (EEIS; N=110) or to regular care (N=110). EEIS included case management, family intervention, cognitive behaviour therapy and crisis intervention, while regular care involved transfer to primary (community health and social services and family physicians) or secondary care (psychiatric outpatient clinics). Cumulative length of positive and negative symptom remission was the primary outcome measure. EEIS patients had a significantly longer mean length of remission of positive symptoms (92.5 vs. 63.6 weeks, t=4.47, pyears has a positive impact on length of remission of positive and negative symptoms compared to regular care. This may have policy implications for extending early intervention services beyond the current two years. © 2017 World Psychiatric Association.
Ho, Dora; Campbell-Barr, Verity; Leeson, Caroline
With a growing awareness of the importance of early childhood education, the governments of Hong Kong and England have both increased investment through providing fee assistance to parents for buying services and providing funding to providers for offering "free" places, respectively. Alongside the increased funding of early childhood…
Nicol, Janni; Taplin, Jill
Understanding the Steiner Waldorf Approach is a much needed source of information for those wishing to extend and consolidate their understanding of the Steiner Waldorf High Scope Approach. It will enable the reader to analyse the essential elements of the Steiner Waldorf Approach to early childhood and its relationship to quality early years…
Edwards, Susan; Bird, Jo
Early childhood education settings are characterized by the use of play-based learning and the assessment of children's play by teachers to promote further learning. A problem with technology use in early childhood settings is that little is known about how children learn to use technologies through play. This lack of knowledge makes it difficult…
Just over a decade ago, an OECD "Starting Strong" team reviewed the system of early childhood education and care (ECEC) in Germany. Regarding the staffing of early childhood provision and referring in particular to resistance at the political level to raise the formal qualification level of educators in alignment with European trends,…
Tierney, Adrienne L.; Nelson, Charles A., III
Research over the past several decades has provided insight into the processes that govern early brain development and how those processes contribute to behavior. In this article, the authors provide an overview of early brain development beginning with a summary of the prenatal period. They then turn to postnatal development and examine how brain…
Berger, Andrea; Adelman, Nancy; Cole, Susan
In 2002, the Bill & Melinda Gates Foundation started the Early College High School Initiative (ECHSI). Through this initiative, more than 200 Early College Schools (ECSs) opened by fall 2009. All of the schools aim to provide underserved students access to college classes while in high school. This article will provide an overview of the first 6…
The international trend to increase the cognitive achievement of early childhood children has generated a need for better understanding how concept formation occurs within play-based programs. Yet the theories of play for supporting early childhood professionals were originally not conceptualized with this need in mind. In this article, concepts…
McClung, Michael R; Wasnich, Richard D; Hosking, David J
We report the effect of continuous treatment with alendronate for 6 yr vs. placebo in the Early Postmenopausal Intervention Cohort study. A total of 1609 healthy, early postmenopausal women were recruited; we describe results for the 585 women who received continuous placebo or alendronate (2...
Sandra Smidt takes the reader on a journey through the key concepts of Jerome Bruner, a significant figure in the field of early education whose work has spanned almost a century. His wide-ranging and innovative principles of early learning and teaching are unpicked here using everyday language and the links between his ideas and those of other…
Schwartz, Heather L.; Karoly, Lynn A.; Le, Vi-Nhuan; Tamargo, Jennifer; Setodji, Claude Messan
Delaware was in the first group of states to receive a federal grant in 2012 to improve early care and education services and increase the number of infants, toddlers, and preschool-age children in high-quality programs. One component of the state's grant is a rigorous validation process for Delaware Stars for Early Success, a voluntary quality…
Food allergies are common in preschool children. This study’s aims are to establish prevalence, to clarify management practices, levels of preparedness and the perceived role of General Practitioners amongst Early Years Services providers. This study is an anonymous, quantitative, cross sectional study. An online questionnaire was distributed to 282 Early Years Service providers. Data were analysed using SPSS. Response rate was 35% (n=98). Prevalence of food allergy was 3% (n=119). Allergic reactions to food had occurred on site in 16% (n=15). Written emergency action plans were available in 47% of facilities (n=46). Medications were not kept on site in 63% (n=62) of facilities. General practitioners were felt to have an important role in the management of food allergies by 76% of respondents (n=61). This study identifies significant areas for improvement in the management of food allergic child in Early Years Services
Idelmo Rangel Garcia Junior
Full Text Available Objective: After a period of five years, evaluate the use of early load in 24 patients at a private clinic. Methods: One hundred and three fixations and prosthetic rehabilitations were performed in 24 patients, with a mean age of 38 years (minimum of 23 and maximum of 72 years, eleven being women and 13 men, in whom 50 and 53 fixations respectively, were performed. Results: The success obtained among single dentures and splinted implant supported dentures was similar, around 92%. Conclusion: The predictability between the protocol of two separate stages and the protocol of immediate or early functional load is similar; the initial stability of the implant plays a fundamental role in the immediate or early functional load protocol.
Kalfa, David; Mohammadi, Siamak; Kalavrouziotis, Dimitri; Kharroubi, Mounir; Doyle, Daniel; Marzouk, Mohamed; Metras, Jacques; Perron, Jean
The optimal prosthesis option for aortic valve replacement in adult patientsreplacement (n=190; 86%) or the subcoronary technique (n=31; 14%). There were 169 patients with bicuspid valves and 33 redo operations including previous aortic valve repair (n=6) and replacement (n=9) for severe AS. Demographic, preoperative, postoperative and longitudinal clinical and echocardiographic data were collected prospectively. The median and mean follow-up were 11.4 years (range: 1-20.1 years) and 10.1±5.9 years, respectively. The follow-up was complete in all patients. Kaplan-Meier actuarial survival analysis was performed to assess long-term survival, freedom from reoperation for autograft and/or homograft failure and freedom from autograft valve insufficiency. Cox regression risk analysis was performed to identify factors associated with autograft or homograft reoperations. The perioperative mortality rate was 0.9% (n=2). The incidence rate of early reoperation for bleeding was 5.9%. The actuarial survival rate at 10 and 15 years following surgery was 92.1 and 90.5%, respectively. Ross-related reoperations occurred in 21 patients during follow-up: autograft dysfunction (n=9), homograft dysfunction (n=6) and both (n=6). The rate of freedom from Ross-related reoperation was 94.7 and 87.7% at 10 and 15 years, respectively. The rate of freedom from reoperation for autograft failure was 97.6 and 91.5%, the rate of freedom from reoperation for homograft failure was 95.7 and 90.8%, and the rate of freedom from moderate or severe autograft regurgitation was 94.1 and 85.6% at 10 and 15 years, respectively. Compared with available aortic bioprosthetic alternatives in young adults with severe AS, the Ross procedure provides an excellent long-term option for patients with predominant severe AS who seek a durable operation without anticoagulation. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights
In 1998, the Association Togolaise Pour le Bien Etre Familiale launched a youth centre in Lomé, Togo. To evaluate the centre, a three-year panel study was undertaken. Three years after being launched, about 10% of surveyed youth had visited the centre. Youth who lived close to the centre had contact with a peer ...
Radhika, A G; Chawla, Sonia; Bhaskaran, Sruthi
Prevention of Parent To Child Transmission (PPTCT) of HIV/AIDS is an integral component of AIDS control programme. PPTCT is an ongoing programme since last 15 years. The aim of the study was to evaluate the reduction in the burden of disease in newborn and infants by prevention of parents to child transmission of HIV/AIDS. This retrospective study was conducted at Department of Obstetrics and Gynecology in a tertiary care hospital of Delhi from May 2002 to May 2015. The data was collected from records of maternal details registered at PPTCT clinic as well as list of infants undergoing Early Infant Diagnosis (EID) recorded in the standard format as per instructions from National AIDS Control Organization (NACO) of India. The Programme performance was assessed against performance indicators stated by NACO, India. Evaluation was done by dividing study period into two halves of seven years each. Out of 2,52,447 new antenatal case registration, overall, 43% received pretest of which, 91% were tested. Antenatal seropositivity rate varied from 0.1%-0.25%. Of 243 seropositive antenatal women 187 partners tested positive. While 25 women opted for MTP, 15 had still births. There were 17 neonatal deaths at 3-12 months attributable to respiratory infections and diarrheal diseases. Operative delivery rates declined from 50% to 31% over the years. Most women opted for breast feeding. The lost to follow up rate of newborns was quite high with details of only 43.5% being available at 18 months of infant's age. A total of three infants tested HIV positive at 18 months of age. The study highlights the practical aspects of policy implementation and operational issues involved in low resource country.
Sabiston, Catherine M; Jewett, Rachel; Ashdown-Franks, Garcia; Belanger, Mathieu; Brunet, Jennifer; O'Loughlin, Erin; O'Loughlin, Jennifer
The purpose of this study was to examine the longitudinal and unique association between number of years of team sport and individual sport participation during adolescence and depressive symptoms during early adulthood. Adolescents (n = 860) reported team sport and individual sport participation in each year of secondary school for five years. Participants reported depressive symptoms using the Major Depression Inventory three years after secondary school. Multivariate linear regression was performed to model the associations of sport participation with depressive symptoms while controlling for sex, age, parent education, and baseline depressive symptoms. In the final model, adolescents who consistently participated in team sport during high school reported lower depression scores in early adulthood (β = -.09, p = .02). Number of years of individual sport participation was not statistically significantly associated with depressive symptoms in early adulthood. Based on these findings, team sport participation may protect against depressive symptoms in early adulthood. If this finding is replicated, strategies should be implemented to encourage and maintain team sport participation during adolescence. Further research is needed to understand the mechanisms that link team sport participation to lower depression.
Noten, Anna M. E.; Loomans, Eva M.; Vrijkotte, Tanja G. M.; van de Ven, Peter M.; van Trotsenburg, A. S. Paul; Rotteveel, Joost; van Eijsden, Manon; Finken, Martijn J. J.
Overt hypothyroidism in pregnant women is associated with a lower intelligence quotient in their children. More recently, subtle decreases in maternal thyroid function have also been associated with neurodevelopmental impairment in offspring. We tested the effect of hypothyroxinaemia during early
Jonville-Béra, Annie-Pierre; Mallaret, Michel; Sgro, Catherine
In 1976, the Regional Pharmacovigilance Centres were created in France to collect and analyze adverse drug reactions. Even if they have, to date, managed and transmitted more than 583,000 adverse drug reactions to the French and international health authorities, the missions of these university hospital structures supervised by clinical pharmacologists are not limited to this activity. They also provide a consulting and diagnostic aid for drug diseases. Their other main mission is information about drugs and their proper use for health professionals and patients on any matter relating to medicines. These queries are used to adjust and focus the training of health professionals in prevention of drug risks and improvement of drug use. Beside signal detection and identification of alerts, the 31 Regional Pharmacovigilance Centres collaborate with the French Drug Agency (Agence nationale de sécurité du medicament et des produits de santé [ANSM]) by achieving expertise on drugs and participation in various working groups and committees. Finally, Regional Pharmacovigilance Centres participate in scientific advancement through research and publication activities. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.
Pía Santelices, María; Olhaberry, M; Paz Pérez-Salas, C; Carvacho, C
Bowlby developed the concept of 'caregiver' to refer to significant adults with whom young children interact daily. Not only parents are considered significant caregivers but also the care centre staff where the child attends regularly. Within caregiver-infant interactions, sensitive response on the part of the adult is a key concept in the assessment of the quality of the relationship, as it integrates the experiences and emotions that will influence the attainment of a secure attachment and a favourable emotional, social and cognitive development in the child. This study is a comparative analysis between the dyadic interactions between a child and its principal caregivers in the home and in the crèche; it is based on a group of 185 children between 8 and 24 months old, who attend a crèche regularly. The Care-Index instrument was used to assess interaction between children and adults, analysing sensitive response in the adults and cooperativeness in the children. The sensitive response of adults to children was complementary; mothers and primary caregivers showed greater sensitivity in the affective aspects of the interaction, while the care centre staff showed greater sensitivity in the cognitive aspects. The fact that caregivers show significant differences in response sensitivity is consistent with existing studies, as are corresponding significant differences in the children's cooperativeness, which demonstrates that a child could benefit from interacting with adults whose different skills could strengthen diverse aspects of health child development. The presence of children in the crèche can be a positive experience in that it favours quality exchanges with the child, developing cognitive aspects of the interaction which are cultivated to a lesser degree by mothers or primary caregivers who principally develop affective aspects.
Reddy, Arathi; Graves, Crista; Augustyn, Marilyn
increasingly challenging because he does not like the sensation of soap and the water temperature must be "just right." You refer the child to a Developmental and Behavioral Pediatrician for evaluation and at 28 months he is seen. During his testing visit, he had decreased eye contact and followed his own agenda but improved significantly as testing progressed. As he got more comfortable, he began making good eye contact, social referenced, and exhibited joint attention with his parents and the examiner. He did not meet criteria for an autism spectrum disorder or specifically pervasive developmental disorder-not otherwise specified (PDD-NOS). He was given a diagnosis of mixed receptive and expressive language delay and disruptive behavior disorder with sensory processing problems.The parents come to you a month after their evaluation visit asking you to give him a "listed diagnosis of PDD-NOS" that could be removed when he turns 3 years so that he may qualify for increased hours of services-up to 15 hours per week-as well as applied behavioral analysis therapy. A behavioral therapist through early intervention has told the family that he would benefit from this increased intervention, specifically applied behavioral analysis but the only way he can receive it is with a "medical diagnosis" on the autism spectrum. What do you do next?
Carson, Valerie; Tremblay, Mark S; Spence, John C; Timmons, Brian W; Janssen, Ian
OBJECTIVES To assess the proportion of children meeting the new Canadian Sedentary Behaviour Guidelines for the Early Years (zero to four years of age) and to describe parental attitudes toward and barriers to reducing screen time. METHODS: Participants included 657 children zero to four years of age from the Kingston, Ontario, area. From May to September 2011, parents completed a questionnaire regarding their child’s screen time and their attitudes toward and barriers to reducing their child’s screen time. RESULTS AND CONCLUSIONS: Approximately 32% of children younger than two years of age engaged in no screen time and approximately 46% of children two to four years of age engaged in child did not engage in excessive screen time. Physicians and other health professionals should inform parents of these new guidelines and provide strategies to help their children meet targets. PMID:24381488
Hepatitis B vaccination in haemodialysis patients: an underestimated problem. Factors influencing immune responses in ten years of observation in an Italian haemodialysis centre and literature review.
Cordova, E; Miglia, I; Festuccia, F; Sarlo, M G; Scornavacca, G; Punzo, G; Menè, P; Fofi, C
Despite universal infection control precautions, the risk of hepatitis B virus (HBV) infection in patients on chronic haemodialysis (HD) remains high. For this reason anti-HBV vaccination is recommended in these subjects. In hemodialyzed patients vaccinal response is often suboptimal and it's not clear what factors may influence it. The aim of our study is to assess the influence of some clinical and laboratory factors on seroconversion rate after anti HBV vaccination in a cohort of patients on maintenance HD. We analysed 60 patients on regular HD, 40 men and 20 women (age 64±12 years, range 40-88 years), immunized with Engerix B ® vaccine, followed for an average time of 62 month (12-120 months). For each patient the following data were collected: age, serum albumin (sAlb), Blood urea nitrogen before HD session (BUN), age at vaccination, dialysis vintage, presence of systemic disease, type of vascular access, dialysis modality. Correlation between these factors and anti Hbs titer was estimated with multiple regression analysis. Anti-Hbs seroconversion rate ( Anti Hbs > 10 IU/l) was 77%. Better rate of seroconversion (86%) was observed in patients with arteriovenous fistula (AVF) and serum albumin > 3,5 g/dL (93%), while higher rate of not responders (50%) in patients with systemic diseases. The only parameter correlated to anti Hbs titer was sAlb (p =0,0012). sAlb was correlated to age in all patients (p=0,01) and age was correlated to higher anti Hbs titer in the responder group (p=0,018). In our experience an early vaccination, when patients on chronic HD are younger and in better nutritional conditions, improves anti-HBV response.
Tomayko, Emily J.; Prince, Ronald J.; Hoiting, Jill; Braun, Abbe; LaRowe, Tara L.; Adams, Alexandra K.
Physical activity is a critical component of obesity prevention, but few interventions targeting early childhood have been described. The Active Early guide was designed to increase physical activity in early care and education (ECE) settings. The purpose of Active Early 2.0 was to evaluate the effectiveness of Active Early along with provider training, microgrant support, and technical assistance over 2 years (2012–2014) to increase physical activity and related behaviors (e.g., nutrition) i...
Lunn Brownlee, Jo; Johansson, Eva; Cobb-Moore, Charlotte; Boulton-Lewis, Gillian; Walker, Sue; Ailwood, Joanne
While investment in young children is recognised as important for the development of moral values for a cohesive society, little is known about early years teaching practices that promote learning of moral values. This paper reports on observations and interviews with 11 Australian teachers, focusing on their epistemic beliefs and beliefs about…
Ruocco, Sylvia; Gordon, Jocelynne; McLean, Louise A.
Early manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the "Get Lost Mr. Scary" programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn…
Mrozek-Budzyn, Dorota; Majewska, Renata; Kiełtyka, Agnieszka
The controversial topic of the early exposure to mercury is regarding ethylmercury, which is present in the thimerosal-containing vaccines (TCVs). The objective of this study was to determine the relationship between the early exposure to TCVs and cognitive development in children during the first 9 years of life. The cohort included 318 children vaccinated in an early period (neonatal and up to 6 months) against hepatitis B and diphtheria-tetanus-pertussis (DTP) using formulation with or without thimerosal. The children's development was assessed using the Fagan test (6th month of life), the Bayley Scales of Infant Development (BSID)-II (12th-36th month), the Raven test (5th, 8th year), and the Wechsler Intelligence Scale for Children (WISC-R) (6th, 7th, 9th year). Results were determined by multivariable linear and logistic regression, adjusted to potential confounders. Children exposed and not exposed to TCVs in the neonatal period had similar outcomes of cognitive-developmental tests; only the results of BSID-II at the 36th month and WISC-R at the 9th year were significantly higher for those exposed to TCVs. Developmental test results in children exposed to TCVs up to the 6th month of life also did not depend on thimerosal dose. TCV administration in early infancy did not affect children's cognitive development.
Cremin, Teresa; Glauert, Esme; Craft, Anna; Compton, Ashley; Stylianidou, Fani
In the light of the European Union's interest in creativity and innovation, this paper, drawing on data from the EU project Creative Little Scientists (2011-2014), explores the teaching and learning of science and creativity in Early Years education. The project's conceptual framework, developed from detailed analysis of relevant literatures,…
Reynolds, Meree; Wheldall, Kevin; Madelaine, Alison
An analysis of large and influential published reviews of research pertaining to the reading acquisition of young struggling readers in the early years of schooling was undertaken. The reviews were selected on the basis that they either had been commissioned by federal governments or had been conducted by reputable research institutions and had…
Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.
This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…
This article is an exploration of the possibilities encountered through shifting from a "logic of quality" to a "space of meaning-making" within early years education. Focusing on ideas of "readiness", this discussion aims to challenge normative understandings that relate this concept to the predictable achievement of…
Stirrup, Julie; Evans, John; Davies, Brian
Drawing on the theoretical work of the British sociologist Basil Bernstein, this paper documents how learning is structured and organised through play in three Early Years Education (EYE) settings catering for children aged three to five in England, UK. Its data address current issues raised within EYE research relating to "quality and high…
Maree, Jacobus G.
The article discusses the changing world of work and the attendant uncertainty and loss of work-life identity. Little research has been done on career development and life design in the early years of a person's life, especially in developing countries characterized by disadvantage. The underlying theoretical models of career development are…
Sakr, Mona; Connelly, Vince; Wild, Mary
Digital technologies have the potential to offer new opportunities for children's expressive arts practices. Although adult expectations surround and shape children's visual art making on paper in the early years classroom, such expectations are not so established in relation to digital art making. So how do children make sense of digital art…
Yan Yan Chen
Full Text Available The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance.To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood.424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later.Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight. Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001 in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001 in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR and triglycerides at 10 years of age.Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin.
Verschuur, Constant V. M.; Suwijn, S. R.; Post, B.; Dijkgraaf, M.; Bloem, B. R.; van Hilten, J. J.; van Laar, T.; Tissingh, G.; Deuschl, G.; Lang, A. E.; de Haan, R. J.; de Bie, R. M. A.
Background: The aim of this study is to investigate if early treatment with levodopa has a beneficial disease modifying effect on Parkinson's disease (PD) symptoms and functional health, improves the ability to (maintain) work, and reduces the use of (informal) care, caregiver burden, and costs.
Verschuur, Constant V. M.; Suwijn, S. R.; Post, B.; Dijkgraaf, M.; Bloem, B. R.; van Hilten, J. J.; van Laar, T.; Tissingh, G.; Deuschl, G.; Lang, A. E.; de Haan, R. J.; de Bie, R. M. A.
The aim of this study is to investigate if early treatment with levodopa has a beneficial disease modifying effect on Parkinson's disease (PD) symptoms and functional health, improves the ability to (maintain) work, and reduces the use of (informal) care, caregiver burden, and costs. Additionally,
Dankert-Roelse, J E; te Meerman, G J
BACKGROUND: A study was undertaken to evaluate whether an early diagnosis by neonatal screening may improve the long term prognosis of patients with cystic fibrosis and to assess the influence of expert management started immediately after the diagnosis. METHODS: Comparative clinical follow up in
Bristow, Katie; Capewell, Simon; Abba, Katharine; Goodall, Mark; Lloyd-Williams, Ffion
To determine the extent to which national and local UK guidelines for the early years sector address key recommendations for encouraging healthy eating based on best available evidence. Phase 1 comprised a literature review to identify new evidence to assess current relevance of the Caroline Walker Trust (CWT) 'Eating well for under-5 s in child care' guidelines. Phase 2 assessed the completeness of seven local to national-level government guidelines by comparison with the 'gold standard' CWT guidelines. Desk-based review using secondary data. Research literature and statutory guidelines on healthy eating in early years settings. Phase 1 retrieved seventy-five papers, of which sixty were excluded as they addressed compliance with nutritional and food-based standards only. One report examined a social marketing tool and was deemed too narrow. The remaining fourteen documents assessed interventions to encourage healthy eating in early years settings. Following quality assessment, seven documents were included. Nine key recommendations were identified: (i) role of government; (ii) early years setting policy/guidelines; (iii) training; (iv) menu planning; (v) parents; (vi) atmosphere and encouragement; (vii) learning through food; (viii) sustainability; and (ix) equal opportunities. Phase 2 identified that all seven guidelines included the nine key recommendations but sporadic cover of sub-key recommendations. More detail is needed on how early years settings can encourage children to eat healthily. Research is required to develop second-layer guidance for interactive materials. Clear processes of communication and support for parents are required. Ways food relates to children's wider learning and social development need further thought, requiring collaboration between the Department of Health and the Department for Education.
Nicola J. Pitchford
Full Text Available Fine motor skills have long been recognised as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the U.K. Two key findings were revealed. First, despite being in the first two years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the U.K. that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.
Pitchford, Nicola J.; Papini, Chiara; Outhwaite, Laura A.; Gulliford, Anthea
Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills. PMID:27303342
Pitchford, Nicola J; Papini, Chiara; Outhwaite, Laura A; Gulliford, Anthea
Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.
Full Text Available Abstract Background Rising rates of obesity and overweight is an increasing public health problem all over the world. Recent research has shown the importance of early life factors in the development of child overweight. However, to the best of our knowledge there are no studies investigating the potential synergistic effect of early life factors and presence of parental overweight on the development of child overweight. Methods The study was population-based and cross-sectional. The study population consisted of children who visited the Child Health Care (CHC centers in Malmö for their 4-year health check during 2003-2008 and whose parents answered a self-administered questionnaire (n = 9009 children. Results The results showed that having overweight/obese parents was strongly associated with the child being overweight or obese. Furthermore, there was an association between unfavorable early life factors (i.e., mother smoking during pregnancy, presence of secondhand tobacco smoke early in life, high birth weight and the development of child overweight/obesity at four years of age, while breastfeeding seemed to have a protective role. For example, maternal smoking during pregnancy was associated with an odds ratio (OR of 1.47 (95% CI: 1.22, 1.76 for overweight and 2.31 (95% CI: 1.68, 3.17 for obesity. The results further showed synergistic effects between parental overweight and exposure to unfavourable early life factors in the development of child overweight. Conclusions The present study shows the importance of early life factors in the development of child overweight and obesity, and thus puts focus on the importance of early targeted interventions.
Eriksen, Hanne-Lise Falgreen; Mortensen, Erik Lykke; Kilburn, Tina R.
the Danish National Birth Cohort. Methods Participants were sampled based on maternal alcohol consumption during pregnancy. At 5 years of age, children were tested with the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R). Parental education, maternal IQ, maternal smoking in pregnancy......Please cite this paper as: Falgreen Eriksen H, Mortensen E, Kilburn T, Underbjerg M, Bertrand J, Støvring H, Wimberley T, Grove J, Kesmodel U. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IQ in 5-year-old children. BJOG 2012;119:1191-1200. Objective To examine...... the effects of low to moderate maternal alcohol consumption during early pregnancy on children's intelligence (IQ) at age 5 years. Design Prospective follow-up study. Setting Neuropsychological testing in four Danish cities 2003-2008. Population A cohort of 1628 women and their children sampled from...
Gohy, Bérangère; Ali, Engy; Van den Bergh, Rafael; Schillberg, Erin; Nasim, Masood; Naimi, Muhammad Mahmood; Cheréstal, Sophia; Falipou, Pauline; Weerts, Eric; Skelton, Peter; Van Overloop, Catherine; Trelles, Miguel
In Afghanistan, Médecins Sans Frontières provided specialised trauma care in Kunduz Trauma Centre (KTC), including physiotherapy. In this study, we describe the development of an adapted functional score for patient outcome monitoring, and document the rehabilitation care provided and patient outcomes in relation to this functional score. A descriptive cohort study was done, including all patients admitted in the KTC inpatient department (IPD) between January and June 2015. The adapted functional score was collected at four points in time: admission and discharge from both IPD and outpatient department (OPD). Out of the 1528 admitted patients, 92.3% (n = 1410) received at least one physiotherapy session. A total of 1022 patients sustained either lower limb fracture, upper limb fracture, traumatic brain injury or multiple injury. Among them, 966 patients received physiotherapy in IPD, of whom 596 (61.7%) received IPD sessions within 2 days of admission; 696 patients received physiotherapy in OPD. Functional independence increased over time; among patients having a functional score taken at admission and discharge from IPD, 32.2% (172/535) were independent at discharge, and among patients having a functional score at OPD admission and discharge, 79% (75/95) were independent at discharge. The provision of physiotherapy was feasible in this humanitarian setting, and the tailored functional score appeared to be relevant. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Владимир Петрович Литвинов
Full Text Available The article deals with one of the aspects of the history of the Russian-Turkish relations in the period under consideration. The evidence suggests there was a high level of tension in the Russian-Turkish relations throughout its development. They often escalated into open military conflicts. The Russian penetration into Turkestan in the second half of the 19th century angered the Ottoman Empire’s ruling circles and forced them to send their agents to the Caspian region. Russia’s annexation of Central Asia by the 1860-1870s strengthened Turkey’s anti-Russian policy. As a result, the number of Turkish agents increased in Russian Turkestan. The Ottoman Empire’s intelligence service actively used the “holy places” of Islam in Turkestan as the centres of the largest concentration of Muslims of the region with the view of anti-Russian propaganda. Virtually all anti-Russian uprisings in the region began at the graves of Islamic "righteous." Despite serious countermeasures the tsarist authorities did not manage to eradicate the Turkish agents from the state and political life of the region and completely destroy all its subversive activities.
á Rogvi, Rasmus; Mathiasen, Rene; Greisen, Gorm
Being born small for gestational age (SGA) is associated with decreased insulin sensitivity and increased blood pressure in childhood, but the association with clinical disease in early adulthood is less certain. The Danish Medical Birth Registry has registered all births in Denmark since 1973, b...
Kemmler, Wolfgang; Engelke, Klaus; Lauber, Dirk; Weineck, Juergen; Hensen, Johannes; Kalender, Willi A.
Investigated the effect of intense exercise training on physical fitness, coronary heart disease, bone mineral density (BMD), and parameters related to quality of life in early postmenopausal women with osteopenia. Data on woman in control and exercise training groups indicated that the intense exercise training program was effective in improving…
BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should raise a suspicion of bowel obstruction. The objective of this study was to determine pattern of presentation, diagnosis and outcome of management of intestinal obstruction in the early neonatal period in the Neonatal Care Unit ...
Askins, Billy E.; And Others
This report describes and evaluates a bilingual early education intervention program, designed to provide children with successful experiences, using the concept of responsive environment in language development (English and Spanish) and in cognitive and affective development. Instructional, community-parental involvement, staff development, and…
The occurrence increased with age. Privileged children were more affected by caries than the underprivileged. The mandibular posterior teeth were the most affected and mandibular anterior teeth the least affected. Keywords: Early childhood caries, privileged, underprivileged, children. Tanzania Dental Journal Vol. 14 (2) ...
In early childhood education and care, Nordic social pedagogy approach is challenged by a learning orientation that often results in unproductive "either/or" thinking. Therefore, based on the two approaches and by analysing several dimensions of Froebel's ideas and prevailing social-historical activity (play) theory, the author deduces…
This paper argues that early childhood education and care (ECEC) has a legitimate aspiration to be a "caring profession" like others such as nursing or social work, defined by a moral purpose. For example, practitioners often draw on an ethic of care as evidence of their professionalism. However, the discourse of professionalism in…
Jepsen, Jens Richardt Møllegaard; Fagerlund, Birgitte; Pagsberg, Anne Katrine
Only few prospective longitudinal studies have assessed the course of intelligence deficits in early onset schizophrenia (EOS), and these have used different age appropriate versions of Wechsler Intelligence Scales and age appropriate norms. The post-psychotic development of intelligence in EOS has...
Edwards, S.; Skouteris, H.; Rutherford, L.; Cutter-Mackenzie, A.
In today's fast food, fast-paced consumer society, too few questions are asked about the influence of digital media on young children's health and sustainability choices, and indeed how such choices are expressed in children's play (and early childhood classrooms). By interviewing children and parents, and using such data to prompt teacher…
Recent research has shown that young children are capable of engaging in data modeling and making informed judgments, an aspect of the mathematics curriculum not previously considered integral to early numeracy. In an Australian study, a sample of 21 highly able Grade 1 students was engaged in a series of investigations where they developed their…
Walker, Karen E.
In 2002, The Robert Wood Johnson Foundation launched an early childhood initiative in Trenton, NJ, called "Children's Futures" (CF) to determine if focused efforts to bring about community change could make measurable differences in children's health and well-being and help ensure their readiness to enter school. The Foundation engaged…
Blanden, Jo; Hansen, Kirstine; McNally, Sandra
Childcare quality is often thought to be important for influencing children's subsequent attainment at school. The English Government regulates the quality of early education by setting minimum levels of qualifications for workers and grading settings based on a national Inspectorate (OfSTED). This paper uses administrative data on over two…
Davis, Julie M.
"Young Children and the Environment" is intended for tertiary students in Early Childhood Education and as a reference for child care practitioners and primary school teachers to promote education for sustainability (EfS) from birth to 8 years. The focus is on early education services, including day care centres, kindergartens, preschools,…
1 in 20 first time pregnancies is complicated by pre-eclampsia, the leading cause of maternal death in Europe. No clinically useful early pregnancy screening test exists, consequentially clinicians are unable to offer targeted surveillance or preventative strategies. IMPROVED Consortium members have pioneered a personalised medicine approach in identifying blood-borne biomarkers through recent technological advancements, involving mapping of the blood metabolome and proteome. The Consortium recently received funding under the auspices of the 7th Framework Programme of the European Union under the call: HEALTH- 2012-INNOVATION-1.2-1 (Grant Agreement no. Health-F5-2012-305169). The objective is to develop a sensitive, specific, high-throughput and economically viable early pregnancy screening test for pre-eclampsia. We report the design of a multicentre, phase IIa clinical study to assess and refine innovative prototype tests based on emerging metabolomic and proteomic technologies. Participation involves serial maternal phlebotomy, collection of clinical data, and pregnancy outcome data. Participants will attend essential visits at 15 and 20 weeks' gestation, with optional 11 and 34 weeks' gestation. Blood samples will undergo a combination of proteomic and metabolomic tests, and diagnostic performance will be assessed in accord with a pre-approved statistical analysis plan which will report Receiver Operating Curves, and Positive Predictive Values. The study is expected to refine proteomic and metabolomic panels, combined with clinical parameters, and evaluate clinical applicability as an early pregnancy predictive test for pre-eclampsia. If 'at risk' patients can be identified, this will allow stratified care with personalised fetal and maternal surveillance, early diagnosis, timely intervention, and significant health economic savings. The IMPROVED biobank will be accessible to the European scientific community for high quality research into the cause and
Maria Lidia Bueno Fernandes
Full Text Available This article presents reflections on the teaching of geography and history in the early years of schooling, considering the possibilities of establishing pedagogical dialogue between them. Related to this the paper reports the experience developed in the Faculty of Education at the University of Brasilia. The Federal District became the object of teaching in the classroom. Considering this it proposes that the pedagogical approach - field work - is incorporated into the apprenticeship of the future teachers in their professional performance. Thus addresses the challenge of working with everyday reality of professional training from the perspective of its approach to concepts of Geography and History. The theoretical background bases on the works of: Santos, Cavalcanti and Callai with regard to the discussion of the geographic knowledge, Revel and Pesavento about reflections about micro-history and Alarcão and Brzezinski on teacher education. As a summary, one can recognize the transformative potential of the subjects that establish dialogue with the prior knowledge of the students and their everyday life. It can be seen to the survey, the potential of the field work as an ally in the classroom. O presente artigo apresenta reflexões a respeito do Ensino da Geografia e da História nos anos iniciais da escolarização, considerando as possibilidades de estabelecer diálogo de natureza pedagógica entre ambas. Nesse sentido, relata a experiência desenvolvida na Faculdade de Educação da Universidade de Brasília, em que o Distrito Federal tornou-se objeto de ensino em sala de aula. Para tanto propõe que a abordagem pedagógica denominada estudo do meio seja incorporada à formação do futuro pedagogo em sua atuação profissional. Dessa forma, considera o desafio de trabalhar com a realidade cotidiana do profissional em formação na perspectiva de sua aproximação com conceitos da Geografia e da História. Em termos teóricos a pesquisa
The 'Centre de la Manche', first French low-level waste disposal site opened in 1969 and will enter the institutional control period around 1994. A creation process for a new disposal was initiated in 1981 when ANDRA prepared a general radioactive waste management Program and presented it to the High Council for Nuclear Safety and Information. After acceptance of the Program, a national site screening was made, based on a conceptual geological model designed from the experience. In 1984, the Minister of Industry announced the pre-selection of 3 counties out of the inventory for preliminary studies that allowed to select l' Aube as a potential site for the new French disposal 'Centre de l'Aube'. The different steps of the process and procedure that brought to the acceptance of the first packages in January 1992 is presented in the paper, as well as the experience recently gained since that date. This additional know-how and expertise is made available by Andra through agreements already existing with various Countries like, among others, Spain, the United States, and Mexico
Bohun, L.; Kapisovsk y, M.
This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed
Davies, G.R.; Gress, M.U.
A study of tiny mineral 'inclusions' within diamonds from Botswana has shown that diamond crystals can take billions of years to grow. One diamond was found to contain silicate material that formed 2.3 billion years ago in its interior and a 250 million-year-old garnet crystal towards its outer rim,
de Wilde, Amber; Koot, Hans M; van Lier, Pol A C
This study assessed the developmental links between children's working memory development and their relations with teachers and peers across 2 years of kindergarten and early elementary school. Kindergarten and first grade children, N = 1109, 50% boys, were followed across 2 school-years. Children were assessed across 3 waves, in the fall and spring of the first school-year (within school-year), and finally in the spring of the second school-year. Working memory was assessed using a visuo-spatial working memory task. The developmental links between working memory and child-reported teacher-child relationship quality (warmth and conflict) and peer-nominated likeability and friendedness were assessed using autoregressive cross-lagged models. Lower working memory scores were related to increases in teacher-child conflict and decreases in teacher-child warmth one school-year later, in addition to decreases in likeability by peers within the same school-year. Conversely, teacher-child conflict was negatively associated with the development of working memory across the studied period. Path estimates between working memory and social relational factors were similar for boys and girls. Findings show developmental links between working memory and social-relational factors and vice versa. These results suggest that children's working memory development can be fostered through pro-social relations with teachers in early elementary school children.
Gyenes, G.; Rutqvist, L.E.; Fornander, T.; Carlens, P.
The purpose of this study was to assess the cardiac side effects, primarily the occurrence of ischemic heart disease, in symptom-free patients with early breast cancer treated with radiotherapy. Thirty-seven survivors of a former randomized study of early breast cancer were examined. Twenty patients irradiated pre- or postoperatively for left sided disease (study group patients) were compared with 17 controls who were either treated for right sided disease, or were nonirradiated patients. Radiotherapy was randomized in the original study; either tangential field 60 Co, or electron-therapy was delivered. Echocardiography and bicycle ergometry stress test with 99m Tc SestaMIBI myocardial perfusion scintigraphy were carried out and the patients' major risk factors for ischemic heart disease were also listed. Our results showed a significant difference between the scintigraphic findings of the two groups. Five of the 20 study group patients (25%), while none of the 17 controls exhibited some kind of significant defects on scintigraphy, indicating ischemic heart disease (p < 0.05). No deterioration in left ventricular systolic and/or diastolic function could be detected by echocardiography. Radiotherapy for left sided breast cancer with the mentioned treatment technique may present as an independent risk factor in the long-term development of ischemic heart disease, while left ventricular dysfunction could not be related to the previous irradiation. The authors emphasize the need to optimize adjuvant radiotherapy for early breast cancer by considering the dose both to the heart as well as the cancer. 39 refs., 4 tabs
In this paper, the early warning signals of abrupt temperature change in different regions of China are investigated. Seven regions are divided on the basis of different climate temperature patterns, obtained through the rotated empirical orthogonal function, and the signal-to-noise temperature ratios for each region are then calculated. Based on the concept of critical slowing down, the temperature data that contain noise in the different regions of China are preprocessed to study the early warning signals of abrupt climate change. First, the Mann–Kendall method is used to identify the instant of abrupt climate change in the temperature data. Second, autocorrelation coefficients that can identify critical slowing down are calculated. The results show that the critical slowing down phenomenon appeared in temperature data about 5–10 years before abrupt climate change occurred, which indicates that the critical slowing down phenomenon is a possible early warning signal for abrupt climate change, and that noise has less influence on the detection results of the early warning signals. Accordingly, this demonstrates that the model is reliable in identifying the early warning signals of abrupt climate change based on detecting the critical slowing down phenomenon, which provides an experimental basis for the actual application of the method. (geophysics, astronomy, and astrophysics)
Adolfsen, Frode; Strøm, Henriette Kyrrestad; Martinussen, Monica; Natvig, Henrik; Eisemann, Martin; Handegård, Bjørn Helge; Koposov, Roman
Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth-graders with a mean age of 13.5 years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30 days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
Brownhill, Simon; Oates, Ruby
This paper provides an exploratory discussion surrounding the views and experiences of women and men who work/train in the early years (0-8 years) by bringing together select findings from two independent doctoral research projects. In an effort to weave together the voices of females and males working/training in the early years sector, this…
Navaratnam, Kate; Alfirevic, Zarko; Baker, Philip N; Gluud, Christian; Grüttner, Berthold; Kublickiene, Karolina; Zeeman, Gerda; Kenny, Louise C
5% of first time pregnancies are complicated by pre-eclampsia, the leading cause of maternal death in Europe. No clinically useful screening test exists; consequentially clinicians are unable to offer targeted surveillance or preventative strategies. IMPROvED Consortium members have pioneered a personalised medicine approach to identifying blood-borne biomarkers through recent technological advancements, involving mapping of the blood metabolome and proteome. The key objective is to develop a sensitive, specific, high-throughput and economically viable early pregnancy screening test for pre-eclampsia. We report the design of a multicentre, phase IIa clinical study aiming to recruit 5000 low risk primiparous women to assess and refine innovative prototype tests based on emerging metabolomic and proteomic technologies. Participation involves maternal phlebotomy at 15 and 20 weeks' gestation, with optional testing and biobanking at 11 and 34 weeks. Blood samples will be analysed using two innovative, proprietary prototype platforms; one metabolomic based and one proteomic based, both of which outperform current biomarker based screening tests at comparable gestations. Analytical and clinical data will be collated and analysed via the Copenhagen Trials Unit. The IMPROvED study is expected to refine proteomic and metabolomic panels, combined with clinical parameters, and evaluate clinical applicability as an early pregnancy predictive test for pre-eclampsia. If 'at risk' patients can be identified, this will allow stratified care with personalised fetal and maternal surveillance, early diagnosis, timely intervention, and significant health economic savings. The IMPROvED biobank will be accessible to the European scientific community for high quality research into the cause and prevention of adverse pregnancy outcome. Trial registration number NCT01891240The IMPROvED project is funded by the seventh framework programme for Research and Technological development of the EU
van Lunteren, Miranda; Ez-Zaitouni, Zineb; Fongen, Camilla; Landewé, Robert; Ramonda, Roberta; van der Heijde, Désirée; van Gaalen, Floris A
To assess if a change in disease activity is associated with a change in work productivity loss (WPL) over 1 year in early axial SpA (axSpA) patients. Baseline and 1 year data of axSpA patients in the SPondyloArthritis Caught Early cohort were analysed. Linear regression models were built explaining the change in the Ankylosing Spondylitis Disease Activity Score (ASDAS) over time by the change in absenteeism, presenteeism, WPL and activity impairment over time. Effect modification and confounding were tested for age, gender, arm of Assessment of SpondyloArthritis international Society classification criteria, HLA-B27, duration of chronic back pain, profession and medication. At baseline, in 105 axSpA patients (48% female, mean age 30.8 years, mean symptom duration 13.6 months, 92% HLA-B27 positive, 24% radiographic sacroiliitis), the mean ASDAS was 2.4 (s.d. 1.0), absenteeism 9% (s.d. 23), presenteeism 33% (s.d. 28), WPL 36% (s.d. 30) and activity impairment 37% (s.d. 25). After 1 year, the mean ASDAS decreased to 2.0 (s.d. 0.8) and absenteeism, presenteeism, WPL and activity impairment improved to 6% (s.d. 22), 26% (s.d. 26), 27% (s.d. 29) and 27% (s.d. 26), respectively. Models showed that if ASDAS decreased 1 unit, absenteeism, presenteeism, WPL and activity impairment improved by 5, 17, 16 and 18%, respectively. The impact of disease activity on work productivity was higher in patients with shorter symptom duration and the impact on absenteeism was higher in patients starting pharmacological treatment. In early axSpA patients, work productivity and daily activities are seriously impacted at baseline and 1 year. However, decreasing disease activity is associated with marked improvements in work productivity and daily activities. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: email@example.com
After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)
Peres, Karen Glazer; De Oliveira Latorre, Maria Do Rosário Dias; Sheiham, Aubrey; Peres, Marco Aurélio; Victora, César Gomes; Barros, Fernando Celso
Little is known about the effects of social and biological risk factors for open bite on the primary dentition. The aim of this study was to assess the early-life risk factors affecting anterior open bite. A cross-sectional study using a birth cohort was carried out in Pelotas, Brazil. A sample of 400, 6-year-old children was employed. The Foster and Hamilton criteria were used to classify open bite. Data concerning social conditions, and perinatal and childhood health and behaviour were obtained from birth to 12 months of age and during the fifth year of the children's lives. Unconditional bivariate and multiple logistic regression analysis were performed. The prevalence of anterior open bite was 46.3%. Risk factors included: a maternal age of between 30 and 39 years, as compared with children whose mothers were younger; breast-feeding for pacifier sucking between 12 months and 5 years, as compared to no sucking or a shorter duration of sucking; and the presence of finger-sucking at 6 years of age. Open bite in the primary dentition was associated with older mothers, early weaning, dental caries occurrence, long-term use of a pacifier and finger-sucking at 6 years of age. These findings support the common risk approach for intervention to prevent open bite in the primary dentition.
One hundred years ago, Pierre and Marie Curie reawakened the topic of uranic rays and discovered two radioelements, polonium in July 1898 and radium in December. The circumstances of these events which announced the beginning of radiochemistry are reviewed at the light of the laboratory notebooks and the publications of the authors. The role of radium in the early history of radioactivity and nuclear sciences is emphasized. (author)
Adloff, J.P. [University Louis Pasteur, 63 Rue Saint Urbain 67100 Strasbourg (France)
One hundred years ago, Pierre and Marie Curie reawakened the topic of uranic rays and discovered two radioelements, polonium in July 1898 and radium in December. The circumstances of these events which announced the beginning of radiochemistry are reviewed at the light of the laboratory notebooks and the publications of the authors. The role of radium in the early history of radioactivity and nuclear sciences is emphasized. (author)
Wamalwa, Dalton; Benki-Nugent, Sarah; Langat, Agnes; Tapia, Kenneth; Ngugi, Evelyn; Moraa, Helen; Maleche-Obimbo, Elizabeth; Otieno, Vincent; Inwani, Irene; Richardson, Barbra A; Chohan, Bhavna; Overbaugh, Julie; John-Stewart, Grace C
Treatment interruption has been well tolerated and durable in some pediatric studies but none have compared treatment interruption with continued antiretroviral treatment (ART) following ART initiation in early HIV. The objective of this study was to compare outcomes in treatment interruption versus continued ART among early-treated infants. Randomized trial (OPH-03; NCT00428116). The trial included HIV-infected infants who initiated ART at less than 13 months of age, received ART for 24 months, and, if eligible (CD4% >25%, normal growth), were randomized to treatment interruption versus continued ART. Children in the treatment interruption group restarted ART if they met WHO ART-eligibility criteria. During 18-months postrandomization, primary outcomes were incidence of serious adverse events and growth. CD4%, viral load, morbidity, and growth were compared. Of 140 infants enrolled, 121 started ART, of whom 75 completed at least 24 months ART and 42 were randomized (21 per arm). ART was initiated at median age 5 months and randomization at 30 months. Among 21 treatment interruption children, 14 met ART restart criteria within 3 months. Randomization was discontinued by Data and Safety Monitoring Board due to low treatment interruption durability. At 18 months postrandomization, growth and serious adverse events were comparable between arms; hypercholesteremia incidence was higher in the continued arm (P = 0.03). CD4% and viral load did not differ between arms [CD4% 35% and median viral load undetectable (<150 copies/ml) in both arms, P = 0.9 for each comparison]. No infants had post-treatment viral control. Short treatment interruption did not compromise 18-month CD4%, viral control, growth, or morbidity compared with continued ART among infants who started ART in early HIV infection.
Full Text Available Background: Congenital lobar emphysema (CLE is characterised by over distension of one lobe and pressure on the adjacent lobe and mediastinum. In this study, we review the pathological results of our paediatric patients with CLE, highlighting the early and late complications that occurred in these patients. Patients and Methods: In a prospective study from 1996 to 2008, we evaluated 30 patients with CLE diagnosis. Variables collected included sex, age at the time of diagnosis, radiological diagnostic method, type of treatment, pathological analysis, surgical findings and early postoperative complications. Parents were asked to refer to our clinic for follow-up and evaluation of late complications. Results: Thirty patients and males accounted for majority of the study population (n = 20, 67%. The mean age of male and female patients (at admission was 7.2 ± 2.3 and 4.7 ± 1.2 months respectively (P = not significant. The main diagnostic method was chest x-ray (CXR in all patients. Abnormal bronchial cartilage was found in 71% of patients. The most affected lobe was left upper lobe (50%. Associated anomalies were seen in four patients. Early postoperative periodhadtwo cases of pneumothoraces. At six month follow up, five (25% males and four females (40% had delayed weight gain. Permanent oxygen dependency was seen in two patients. Twenty- six patients underwent thoracotomy. Mortality rate was 13%. Base deficit at the time of admission was greater in those patients who eventually died, (-8.6 ± 1.2 versus -3.1 ± 0.4 (P = 0.0003. There were two deaths in the bilobar involvement group and two in the unilobar involvement group (P = 0.07, near significant. Conclusion: This study confirms that the number of affected lobes and base deficit at the time of admission were associated with significantly increased mortality.
Jordan, A Rainer; Becker, Natascha; Jöhren, Hans-Peter; Zimmer, Stefan
In Germany, caries of young people has been declining since the late 1980s, while the prevalence of early childhood caries has remained steady. Data from a number of regional studies suggest a current prevalence between 10% and 15%. However, there is a dearth of longitudinal observational study data on the risk of caries in the permanent teeth of persons who as children had to undergo comprehensive treatment for caries under intubation general anesthesia. The aim of this study was to compare caries experience in the permanent teeth of patients who had to undergo surgical treatment under general anesthesia as a result of non-compliance with caries treatment in early childhood with the experience of patients who did not develop caries at a young age. Analysis of the data revealed that severe caries experience during early childhood resulted in a more severe caries experience during adulthood (difference: 14.8 DMFS; p = 0.001). This increase in caries experience applied to both untreated and treated carious surfaces, and was also apparent in relation to tooth extractions. When compared with persons whose first teeth had been caries-free, patients with severe childhood caries experience tended to show poorer dental hygiene in relation to smooth (p < 0.06) and interproximal (p < 0.04) surfaces. Patients who had been non-compliant as young children were not found to suffer from dental anxiety as young adults. Patients in the treatment and control groups differed with regard to dental health. Aside from being statistically relevant, these differences also have implications for clinical dental practice.
Baars, G. J. A.; Arnold, I. J. M.
At Erasmus School of Economics about 40% of the students in the bachelor program Economics and Business drop out in the first academic year. We examined whether it is feasible (a) to identify on the basis of their participation and achievement in the first 2 (out of 10) examinations students who drop out in the first year, and (b) to characterize…
Stalpers, L. J.; van Vierzen, P. B.; Brouns, J. J.; Bruaset, I.; Manni, J. J.; Verbeek, A. L.; Ruys, J. H.; van Daal, W. A.
In a study of 213 patients with oral cancer, we investigated the incidence and prognosis of lung malignancies in patients offered a yearly chest radiography in the follow-up. Three conclusions can be drawn. (1) Metastatic or primary lung cancer was diagnosed in 22 (10.3%) patients. The 2-year
Yu, Jennifer W; Buka, Stephen L; McCormick, Marie C; Fitzmaurice, Garrett M; Indurkhya, Alka
1) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children. 2) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities (LD). This is a secondary data analysis of the Infant Health and Development Program (IHDP), a randomized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature. The findings are based on a prospective follow-up of these children at 8 years of age. Compared to children without verbal LD (VLD), those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89% more likely to exhibit externalizing behavior problems. Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors, as well as an increased likelihood of attention problems among children with VLD. No significant association was found between nonverbal LD (NVLD) and any type of behavior problem. Furthermore, there was a significant interaction between VLD and the intervention, in which the odds of internalizing behavior problems were greater among children with VLD. No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD. These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children.
Krátká, Z; Bártová, J; Krejsa, O; Otcenásková, M; Janatova, T; Dusková, J
Our 10-year study of early-onset periodontitis (EOP) patients includes repeated clinical observations, microbiological characteristics and analysis of genetic polymorphism of IL-1A and IL-1B genes. Twenty patients (age 15-26 years) were divided according to the clinical status in the 4th year into a group with mean number of teeth with bleeding on probing (BP) 9.8 and mean number of teeth with periodontal pocket (PP) 2.23, and a group with mean number of teeth with BP 5.37 and no PP. Significantly higher values of mean BP and PP were found among the groups during the study but a strong progression of disease was found only in 3 patients. The risk IL-1A allele-2 and IL-1B allele-2 genotype and bacterial presence were analyzed by DNA hybridization methods. No significant differences of bacteria composition (Treponema denticola, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans) were found between the groups. A higher prevalence of composite IL-1 genotype was detected in the group of EOP patients with progressive disease. Early finding of the disease followed by conservative therapy could positively influence the disease progression. EOP treated in early stages may, but need not, develop into the aggressive form in the presence of risk genotype IL-1.
This research paper reports on phase one of an investigation of video recorded intensive one-to-one teaching interactions with 6–7-year-old students who were in their second year of schooling in Australia and identified by the their teacher as low attaining in early number. The two-phased study from which this paper emerges was originally conducted in 1998 as part of my Bachelor of Teaching Honours (Research) program at Southern Cross University Lismore, New South Wales. That study identified...
Full Text Available To evaluate body composition, metabolism and growth as well as their interaction with early nutrition in former extremely low birth weight infants (ELBW, we assessed qualitative and quantitative nutritional intake during initial hospitalization and infantile growth parameters in 61 former ELBW infants with a birth weight <1000 g. In two follow-up exams, physical and biochemical development were measured at 5.7 and at 9.5 years. At the second follow-up, in addition to biochemical reassessment, body composition was analyzed by dual-energy x-ray absorptiometry (DEXA. Protein intake between birth and discharge was associated with weight gain in the first six months of life (r = 0.51; p < 0.01. Weight catch-up preceded height catch-up. Protein intake in early infancy correlated highly significantly with abdominal fat mass (r = 0.49; p < 0.05, but not with lean body mass at 9.5 years (r = 0.30; not significant (n.s.. In contrast to nutrient intake, birth weight was associated with lean body mass (r = 0.433; p < 0.001. Early protein and carbohydrate intake were associated with high-density lipoprotein (HDL-cholesterol, and early catch-up growth correlated with fasting insulin at follow-up. Stepwise linear regression demonstrated that protein intake predicted fat mass (p < 0.05, whereas only gender and birth weight standard deviation score (SDS contributed significantly to lean body mass variation (p < 0.05. Our results suggest an important impact of early nutrient intake on body composition and metabolism in later childhood in ELBW children.
Bar-On, Elhanan; Abargel, Avi; Peleg, Kobi; Kreiss, Yitshak
To propose strategies and recommendations for future planning and deployment of field hospitals after earthquakes by comparing the experience of 4 field hospitals deployed by The Israel Defense Forces (IDF) Medical Corps in Armenia, Turkey, India and Haiti. Quantitative data regarding the earthquakes were collected from published sources; data regarding hospital activity were collected from IDF records; and qualitative information was obtained from structured interviews with key figures involved in the missions. The hospitals started operating between 89 and 262 hours after the earthquakes. Their sizes ranged from 25 to 72 beds, and their personnel numbered between 34 and 100. The number of patients treated varied from 1111 to 2400. The proportion of earthquake-related diagnoses ranged from 28% to 67% (P earthquakes, patient caseload and treatment requirements varied widely. The variables affecting the patient profile most significantly were time until deployment, total number of injured, availability of adjacent medical facilities, and possibility of evacuation from the disaster area. When deploying a field hospital in the early phase after an earthquake, a wide variability in patient caseload should be anticipated. Customization is difficult due to the paucity of information. Therefore, early deployment necessitates full logistic self-sufficiency and operational versatility. Also, collaboration with local and international medical teams can greatly enhance treatment capabilities.
Bonny, Justin W; Lourenco, Stella F
Humans rely on two main systems of quantification; one is nonsymbolic and involves approximate number representations (known as the approximate number system or ANS), and the other is symbolic and allows for exact calculations of number. Despite the pervasiveness of the ANS across development, recent studies with adolescents and school-aged children point to individual differences in the precision of these representations that, importantly, have been shown to relate to symbolic math competence even after controlling for general aspects of intelligence. Such findings suggest that the ANS, which humans share with nonhuman animals, interfaces specifically with a uniquely human system of formal mathematics. Other findings, however, point to a less straightforward picture, leaving open questions about the nature and ontogenetic origins of the relation between these two systems. Testing children across the preschool period, we found that ANS precision correlated with early math achievement but, critically, that this relation was nonlinear. More specifically, the correlation between ANS precision and math competence was stronger for children with lower math scores than for children with higher math scores. Taken together, our findings suggest that early-developing connections between the ANS and mathematics may be fundamentally discontinuous. Possible mechanisms underlying such nonlinearity are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.
Full Text Available The present study aimed at examining the development of conservatories which started to become institutionalized under the leadership of Mustafa Kemal in the early period of the Republic and which have brought polyphony to musical culture in our country. In line with this purpose, the following research questions were directed: • When did Interaction between Classical Western Music and Turkish Music start in our country? • What were the attitudes towards artistic activities in the early period of the Republic? • What are the contributions of Turkish composers to Modern Turkish Music who have an important place in the history of Turkish Music in our country? In the study, the interaction between Turkish Music and Western Music in our country in the 17th century was examined. In addition, the present study also focused on related Turkish composers who became expert in their fields as well as on other related composers who came to Turkey from various European countries. The present study is limited to these data, and the purpose is to present the collected data to today’s musicians and to contribute to their professional developments.
Musumeci, Giuseppina; Magnani, Giacomo; Bon, Isabella; Longo, Serena; Bertoldi, Alessia; Degli Antoni, Anna Maria; Rossi, Maria Rita; Ruggeri, Alessandro; Sambri, Vittorio; Semprini, Simona; Sighinolfi, Laura; Ursitti, Maria Alessandra; Zerbini, Alessandro; Colangeli, Vincenzo; Calza, Leonardo; Finarelli, Alba Carola; Massimiliani, Erika; Re, Maria Carla
It is crucial to establish the timing of infection and distinguish between early and long-lasting HIV-1 infections not only for partner notification and epidemiological surveillance, but also to offer early drug treatment and contain the spread of infection. This study analyzed serum and/or plasma samples with a first positive HIV antibody/antigen result coming from different Medical Centers in the Emilia Romagna Region, North East Italy, using the avidity assay, Western Blotting, RNA viral load, CD4 cell counts and genotyping assay. From May 2013 to May 2016, we certified 845 new HIV-1 infections, 18.7% of which were classified on the basis of avidity index as recent infections and 81.3% as long-lasting infections, with an estimated conversion time exceeding six months at the time of study. Western Blotting showed reactivity to only one or two HIV-1 proteins in recently infected patients (RIPs), while a complete pattern to gag, env and pol proteins was observed in most long-lasting infected patients (LLIPs). The median age, gender, nationality and risk transmission factors were comparable in RIPs and LLIPs. Phylogenetic analysis performed in available plasma disclosed B strains, non-B subtypes and circulating recombinant forms (CRFs) in both groups of patients, with a major presence of CRFs in non-Italian HIV subjects. The large number of patients unaware of their HIV status makes it crucial to discover hidden epidemics and implement appropriate targeted public health interventions.
Full Text Available Currently many children in early childhood education cannot be accommodated in provincial department schools. Consequently, different non-governmental institutions offer Grade R programmes in an attempt to support the DBE. Pre-primary schools that traditionally took responsibility for early childhood education also offer Grade R education. The recent policy decision to include Grade R in the primary school is an innovation, which is still in its infancy. It is against this background that the national South African Curriculum (NCS has to be implemented. This paper focuses on the teaching of natural science in Grade R and attempts to determine if the teaching and learning of natural science has different outcomes in the different contexts described above. An oral questionnaire was administered to capture children’s understanding of natural science phenomena, while interviews provided data with regard to teachers’ understanding of natural science in the foundation phase. The results show that there are differences in children’s understanding of natural phenomena in the different contexts and these differences are related to teachers’ understanding of the curriculum, as well as their views of the nature of science.
López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes
There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Full Text Available Abstract Background While feasibility of new health technologies in well-resourced healthcare settings is extensively documented, it is largely unknown in low-resourced settings. Uganda's decision to deploy and scale up malaria rapid diagnostic tests (mRDTs in public health facilities and at the community level provides a useful entry point for documenting field experience, acceptance, and predictive variables for technology acceptance and use. These findings are important in informing implementation of new health technologies, plans, and budgets in low-resourced national disease control programmes. Methods A cross-sectional qualitative descriptive study at 21 health centres in Uganda was undertaken in 2007 to elucidate the barriers and facilitators in the introduction of mRDTs as a new diagnostic technology at lower-level health facilities. Pre-tested interview questionnaires were administered through pre-structured patient exit interviews and semi-structured health worker interviews to gain an understanding of the response to this implementation. A conceptual framework on technology acceptance and use was adapted for this study and used to prepare the questionnaires. Thematic analysis was used to generate themes from the data. Results A total of 52 of 57 health workers (92% reported a belief that a positive mRDT result was true, although only 41 of 57 (64% believed that treatment with anti-malarials was justified for every positive mRDT case. Of the same health workers, only 49% believed that a negative mRDT result was truly negative. Factors linked to these findings were related to mRDT acceptance and use, including the design and characteristics of the device, availability and quality of mRDT ancillary supplies, health worker capacity to investigate febrile cases testing negative with the device and provide appropriate treatment, availability of effective malaria treatments, reliability of the health commodity supply chain, existing national
Maryod, Waleed Hamed; Ali, Samer Mostafa; Shawky, Ahmad Fathalla
The aim of this preliminary clinical report was to evaluate and compare the clinical outcomes of immediate and early loaded mini-implants (MIs) supporting mandibular overdentures. Thirty-six completely edentulous patients (20 men and 16 women) complaining of insufficient retention of their mandibular dentures were randomly assigned to two groups. Each patient received four MIs in the interforaminal area of the mandible using the nonsubmerged flapless surgical approach. In group 1 (G1), MIs were loaded with mandibular overdentures using the immediate loading protocol, while in group 2 (G2), MIs were loaded with overdentures using the early loading protocol. The cumulative survival rate was calculated using Kaplan-Meier analysis. Peri-implant health indices (Plaque Index/Bleeding Index), probing depths, and marginal bone levels were recorded for both groups after MI insertions and 6, 12, 24, and 36 months thereafter. The cumulative implant survival rates were 91.7% and 96.7% for G1 and G2, respectively. G1 recorded significantly higher Plaque Index, Bleeding Index, and probing depths than G2 after 12 months, while other observation times demonstrated no significant difference between groups. Most of the recorded marginal bone loss occurred in the first year, and no significant bone loss was noted in subsequent years. After 6 months, marginal bone loss was significantly higher in G1 compared to G2, but no significant differences between groups were noted thereafter. Within the limitations of this study's research design and duration of follow-up outcome analyses, immediate and early loading protocols showed good clinical results with favorable peri-implant tissue response 3 years after implant insertion. Early loading of MIs supporting a mandibular overdenture appears to be preferable to immediate loading.
Postma, Froukje M; Ågren, Jon
Incomplete information regarding both selection regimes and the genetic basis of fitness limits our understanding of adaptive evolution. Among-year variation in the genetic basis of fitness is rarely quantified, and estimates of selection are typically based on single components of fitness, thus potentially missing conflicting selection acting during other life-history stages. Here, we examined among-year variation in selection on a key life-history trait and the genetic basis of fitness covering the whole life cycle in the annual plant Arabidopsis thaliana. We planted freshly-matured seeds of >200 recombinant inbred lines (RILs) derived from a cross between two locally-adapted populations (Italy and Sweden), and both parental genotypes at the native site of the Swedish population in three consecutive years. We quantified selection against the nonlocal Italian genotype, mapped quantitative trait loci (QTL) for fitness and its components, and quantified selection on timing of germination during different life stages. In all three years, the local Swedish genotype outperformed the non-local Italian genotype. However, both the contribution of early life stages to relative fitness, and the effects of fitness QTL varied among years. Timing of germination was under conflicting selection through seedling establishment vs. adult survival and fecundity, and both the direction and magnitude of net selection varied among years. Our results demonstrate that selection during early life stages and the genetic basis of fitness can vary markedly among years, emphasizing the need for multi-year studies considering the whole life cycle for a full understanding of natural selection and mechanisms maintaining local adaptation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Maurer, Christian; Hammerl, Christa; Koch, Elisabeth; Hammerl, Teresa; Pokorny, Elfriede
Detection and quantification of extreme weather conditions in the past is important for correctly assessing the significance of today's extremes. We defined a list of 40 extreme years (1540-2007), where two or more of several parameters (phenological records or mean temperatures) available at that time exceed the double standard deviation with regard to a 105-years lasting reference period. As vine flowering, grape mellowness and grape harvest dates are on hand, the term "extreme" adverts to anomalous temperature conditions during spring and early summer time, i.e. to mean temperatures which correlate highly significantly to these phenological records. By analyzing the phenological data of the region of Vienna, Burgundy and the Swiss Plateau Region on one hand as well as the temperature series of Vienna, Basel, Geneva and Strasbourg on the other, we tried to extend extreme events to an inter-regional scale. Apart from these data we used independent descriptive sources from the municipal archive of the town Retz in Lower Austria for affirming and amending these results. For instance in Western Europe 1542, 1718, 1811, 1821, 1822, 2003 and 2007 did have extreme spring to early summer temperatures and/or exceptional phenological dates; four out of only seven cold extremes cluster between 1816 and 1879. Not a single mean temperature extreme at Vienna (according to our definition of double standard deviation) is present between 1874 and 1983 and no extreme positive grape harvest date anomalies arise after 1980.
Julie Langham Grilly was interviewed by representatives of the US DOE Office of Human Radiation Experiments (OHRE) being the widow of Dr. Wright Langham, an investigator of principal interest of the committee. Her extensive experience with research at LANL was also of interest to the committee. Following a brief biographical sketch, Ms. Grilly relates her early postwar experience and her knowledge of Wright Langham's involvement in animal research at Los Alamos, radiolanthanum tests on monkeys, Eniwetok tissue examinations, research on tritium uptake in humans, plutonium injections, tritium injections, EDTA, and etc. In addition to illuminating her former husband as a researcher and as an individual, she also relates her remembrances of Louis Hempelman, Enrico Fermi, Oppenheimer, Edward Teller, and many others
Julie Langham Grilly was interviewed by representatives of the US DOE Office of Human Radiation Experiments (OHRE) being the widow of Dr. Wright Langham, an investigator of principal interest of the committee. Her extensive experience with research at LANL was also of interest to the committee. Following a brief biographical sketch, Ms. Grilly relates her early postwar experience and her knowledge of Wright Langham`s involvement in animal research at Los Alamos, radiolanthanum tests on monkeys, Eniwetok tissue examinations, research on tritium uptake in humans, plutonium injections, tritium injections, EDTA, and etc. In addition to illuminating her former husband as a researcher and as an individual, she also relates her remembrances of Louis Hempelman, Enrico Fermi, Oppenheimer, Edward Teller, and many others.
Simonsen, Dorthe Gert
The paper examines the embodiment of aviation in its earliest decades. Drawing on theories of enactment and affect in recent studies of technology and mobility, I investigate the entanglements between airplanes and human bodies as well as the relations between aerial and earthbound bodies....... At a time when airplanes were little more than cloth wings attached to motors, their assembly with the body of the aviator was highly visible and essential in the practice and perception of powered flight. Perhaps less visible, but no less essential in this perception, was the embodied experience...... of aviation from the ground. By exploring how the early airplane ‘choreographed’ and reconfigured aerial as well as earthbound bodies, this paper tries to grasp the transformative and non-representational interactions between technology and the human embodiment of aerial mobility. As an introduction...
Abstract Background To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. Methods Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg\\/dL (2.6 mmol\\/L)] and hyperglycaemia [> 150 mg\\/dL (8.3 mmol\\/L)] were correlated to neurodevelopmental outcome at 24 months of age. Results Four fifths of the 468 blood samples were in the normoglycaemic range (392\\/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11\\/39) and a third of the hyperglycaemic samples (32.4%:12\\/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol\\/L and 5.02(2.35) mmol\\/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. Conclusion During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.
BACKGROUND: To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. METHODS: Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg\\/dL (2.6 mmol\\/L)] and hyperglycaemia [> 150 mg\\/dL (8.3 mmol\\/L)] were correlated to neurodevelopmental outcome at 24 months of age. RESULTS: Four fifths of the 468 blood samples were in the normoglycaemic range (392\\/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11\\/39) and a third of the hyperglycaemic samples (32.4%:12\\/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol\\/L and 5.02(2.35) mmol\\/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. CONCLUSION: During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.
The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial.
Lindholt, J S; Gottschalksen, B; Johannesen, N; Dueholm, D; Ravn, H; Christensen, E D; Viddal, B; Flørenes, T; Pedersen, G; Rasmussen, M; Carstensen, M; Grøndal, N; Fasting, H
To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study. Eleven Scandinavian centres enrolled 569 patients with chronic functional or critical lower limb ischaemia who were scheduled to undergo femoro-femoral bypass or femoro-poplitaeal bypass. The patients were randomised 1:1 stratified by centre. Patency was assessed by duplex ultrasound scanning. A total of 546 patients (96%) completed the study with adequate follow-up. Perioperative bleeding was, on average, 370 ml with PTFE grafts and 399 ml with Heparin-bonded PTFE grafts (p = 0.32). Overall, primary patency after 1 year was 86.4% for Hb-PTFE grafts and 79.9% for PTFE grafts (OR = 0.627, 95% CI: 0.398; 0.989, p = 0.043). Secondary patency was 88% in Hb-PTFE grafts and 81% in PTFE grafts (OR = 0.569 (0.353; 0.917, p = 0.020)). Subgroup analyses revealed that significant reduction in risk (50%) was observed when Hb-PTFE was used for femoro-poplitaeal bypass (OR = 0.515 (0.281; 0.944, p = 0.030)), and a significant reduction in risk (50%) was observed with Hb-PTFE in cases with critical ischaemia (OR = 0.490 (0.249; 0.962, p = 0.036)). The Hb-PTFE graft significantly reduced the overall risk of primary graft failure by 37%. Risk reduction was 50% in femoro-poplitaeal bypass cases and in cases with critical ischaemia. Copyright © 2011. Published by Elsevier Ltd.
Do, Loc G; Miller, Jenifer; Phelan, Claire; Sivaneswaran, Shanti; Spencer, A John; Wright, Clive
It is important to evaluate concurrently the benefit for dental caries and the risk for dental fluorosis from early exposure to fluoride among children. To evaluate associations of different levels of exposure to fluoride in early childhood with dental caries and dental fluorosis experience in school children. A Child Dental Health Survey (CDHS) was conducted among school children in the Australian state of New South Wales (NSW) in 2007. Trained and calibrated examination teams conducted oral epidemiologic examinations to assess caries experience as decayed, missing or filled tooth surfaces of the primary and permanent dentitions (dmfs/DMFS) and fluorosis using the Thylstrup & Fejerskov (TF) index on the maxillary central incisors only. A parental questionnaire collected information on residential histories and tap water usage to enable calculation of percentage of 3-year lifetime exposure to fluoride in water. Use of dietary fluoride supplements was also collected. Dental caries and fluorosis experience were compared among groups by levels of exposure to fluoride from water and fluoride supplements in bivariate and multivariable analysis, controlling for socioeconomic factors. Exposure to different fluoride sources varied in the group of 2611 children aged 8-12 years. Lower household income was significantly associated in both bivariate and multivariable analyses with the greater prevalence and severity of primary tooth caries among 8-10-year-old children and permanent tooth caries among 8-12 year old. Exposure to fluoride in water during the first 3 years of life was associated with both caries and fluorosis experience observed at age 8-12 years. Having higher percentage of 3-year lifetime exposure to fluoride in water was associated with higher prevalence of mostly mild fluorosis, but significantly lower prevalence and severity of caries in the primary and permanent dentitions. There were significant associations of dental caries and fluorosis experience with
S. Syed Shaheed Ahamed
Full Text Available Introduction : The premature loss of primary teeth may reduce arch length required for the succeeding tooth and, hence, predisposes crowding, rotation and impaction of the permanent teeth. There are only limited studies carried out about the prevalence of early loss of primary teeth. Aim : The present study was performed to evaluate the prevalence of early loss of primary teeth in school children in Chidambaram town in Tamilnadu, India. Settings and Design : A total of 1121 school children (561 boys and 560 girls between 5 and 10 years of age were selected for the study. Materials and Methods : An experienced examiner performed all clinical examinations under natural light. Data including age and missing tooth was collected. Statistical Analysis Used : Microsoft Excel/2000 (Microsoft Office XP data spreadsheet was used and later exported to the Statistical Package for Social Science (SPSS for Windows (version 10.0. Descriptive statistics was applied and, from the results, chi-square tests were applied at a level of significance of 5% (P 0.05. The greatest prevalence was found among the 8-year olds (5.08%, and the most commonly missing teeth were the right lower primary first molars (16.82%. It can be concluded that the prevalence of early loss was high and that the lower primary molars were the most commonly missing teeth in the present study
Ahamed, S Syed Shaheed; Reddy, Venugopal N; Krishnakumar, R; Mohan, Muthu G; Sugumaran, Durai K; Rao, Arun P
The premature loss of primary teeth may reduce arch length required for the succeeding tooth and, hence, predisposes crowding, rotation and impaction of the permanent teeth. There are only limited studies carried out about the prevalence of early loss of primary teeth. The present study was performed to evaluate the prevalence of early loss of primary teeth in school children in Chidambaram town in Tamilnadu, India. A total of 1121 school children (561 boys and 560 girls) between 5 and 10 years of age were selected for the study. An experienced examiner performed all clinical examinations under natural light. Data including age and missing tooth was collected. Microsoft Excel/2000 (Microsoft Office XP) data spreadsheet was used and later exported to the Statistical Package for Social Science (SPSS) for Windows (version 10.0). Descriptive statistics was applied and, from the results, chi-square tests were applied at a level of significance of 5% (P 0.05). The greatest prevalence was found among the 8-year olds (5.08%), and the most commonly missing teeth were the right lower primary first molars (16.82%). It can be concluded that the prevalence of early loss was high and that the lower primary molars were the most commonly missing teeth in the present study.
Shiratsuchi, T; Takahashi, N; Suzuki, T; Abe, K
Depressive (or depression-like) episodes are the most common manifestations of bipolar affective disorder in early teenage years. The present paper analyses the clinical features and their changes over time in these episodes. By a prospective study on children who had their first affective or psychotic episodes between the ages of ten and fifteen, those who eventually met the ICD 10 diagnostic criteria for bipolar disorder were selected and followed up. There were three boys and nine girls. Their early depressive episodes were characterised by psychotic features and clinging to the mother in most cases, and in some by brief episodes and/or a good response to sulpiride. However, these characteristics tended to disappear with increasing age. Five children (42%) had an IQ of 61-75. Generalisability of the results is limited because of the small number of patients and the lack of control groups. Bipolar disorder in early teenage years may show clinical features and a drug response that are different from those in adulthood. Low IQ may expedite the onset of bipolar disorder.
Ali M. El-Sheikh
Full Text Available Purpose. To investigate the predictability of simplifying mandibular overdenture treatment using one-stage surgery and early prosthetic loading of a single implant. Materials and Methods. Twenty edentulous patients with problematic existing mandibular dentures were treated. A single implant with a chemically modified surface (SLActive, Straumann AG, Basel, Switzerland was placed into the mandibular midline. The patients were recalled at 3, 6 and 12 months. Clinical assessments and marginal bone loss using standardized radiographs were recorded. All complications, failures and maintenance were noted. Visual analog-scale questionnaires were used to record patient satisfaction in five categories. ANOVA was used to determine differences between means of marginal bone loss and different categories of patient staisfaction (=0.05. Results. The 20 early loaded implants were all surviving at the 12-month recall. All implants showed less than 1 mm of marginal bone loss by the end of the 1-year with a significant increase during the follow-up period. Few prosthetic problems were reported. Patient satisfaction was high with a significant increase in all comfort and functional parameters. Conclusions. These preliminary 1-year results indicate that early loading of a single chemically modified surface implant used to retain a mucosa-borne mandibular overdenture is a safe, reliable, and cost-effective treatment.
Wilson, Suzanne J; Davie, Gabrielle; Derrett, Sarah
To determine, in a cohort with injuries classified anatomically as mainly minor or moderate and for which only 25% were hospitalised acutely, the prevalence of ongoing problems attributed by participants to their injury 2 years prior, and to examine whether three-month post-injury experiences and expectations predict such problems. Participants (N = 2231; 18-64 years at injury) were those in the Prospective Outcomes of Injury Study who completed the initial three-month and final two-year interviews. The outcome measure was whether participants reported ongoing injury-related problems at 2 years. Possible early post-injury predictors were identified from the first interview; pre-injury and injury-related potential confounders from the first interview, insurer records and hospital discharge records. Multivariable models estimated relative risks. Almost half the participants reported injury-related problems at 2 years. Participants reporting non-recovery at 3 months were more likely than those reporting recovery to have ongoing problems at 2 years, ranging from participants expecting to get better soon [adjusted RR 2.2, 95% CI (1.7,2.8)) to those expecting to never get better (aRR 3.1, 95% CI (2.4,4.0)]. Several three-month post-injury experiences also predicted ongoing problems at 2 years. Participants at highest risk included those with extreme pain [aRR 2.1, 95% CI (1.7,2.5)], and less involvement in usual activities [aRR 1.7, 95% CI (1.5,1.9)]. Findings indicate that early post-injury characteristics predict longer-term recovery among this cohort, most of who were not classified as seriously injured, and provide guidance for future studies on interventions to reduce poor outcome prevalence, particularly focussing on pain management and enabling return to independence and social participation.
Technology in education is considered in empirical and theoretical literature as both beneficial and harmful to children’s development. In the field of the early years settings there is a dilemma whether or not early childhood teachers should use technology as a teaching and learning resource. This paper has a pedagogical focus, discussing the advantages and the potential problems of computer practice to children’s learning and behaviour in the early years settings and also suggests teaching ...
This study investigated Korean children's cultural adjustment during transition to South Australian junior primary school settings. Using case-study methodology to provide a sociocultural perspective, data were collected during interviews with a sample of South Korean international students aged five to eight years, their mothers and teachers. All…
Verkerk, Gijs; Jeukens-Visser, Martine; Houtzager, Bregje; Wassenaer-Leemhuis, Aleid van; Koldewijn, Karen; Nollet, Frans; Kok, Joke
To compare attention skills of children with a very low birth weight (VLBW) with children with a normal birth weight (NBW) when entering primary school, and explore the association of attention skills with school career 2 years later. Participants were 151 children with VLBW and 41 with NBW.
Purpose: This study aimed to determine the relative strengths and weaknesses in language and verbal short-term memory abilities of school-age children who were adopted from Eastern Europe. Method: Children adopted between 1;0 and 4;11 (years;months) of age were assessed with the Clinical Evaluation of Language Fundamentals-Preschool, Second…
Zhang, Linlin; Eggum-Wilkens, Natalie D.; Eisenberg, Nancy; Spinrad, Tracy L.
In this two-wave longitudinal study, concurrent and longitudinal relations among teacher-reported shyness, peer acceptance, and academic achievement were examined (Ns = 162 and 155; and Ms[subscript age] = 6.09 and 7.07 years). Concurrently, at both times, shyness was negatively related to peer acceptance and academic achievement, and peer…
Engelen, A. M.; Stalpers, L. J.; Manni, J. J.; Ruijs, J. H.; van Daal, W. A.
In a retrospective study of 556 patients (505 men, 51 women) with laryngeal cancer the incidence and prognosis of lung malignancies was studied in patients who were examined yearly by chest radiography. In 69 patients (12.4%) a lung malignancy was diagnosed, with 28 having a histologically confirmed
Sullivan, Debra Ren-Etta
There has been much attention given to the opportunity gap between white and minority students, especially African American children. Using research and years of experience "Cultivating the Genius of Black Children" is able to break down the cultural influences on learning style and provides a practical approach to helping Black children…
Using a lighthearted and simple approach, this 23-minute videotape in English and Spanish versions presents interactions between parents and children while reading books. The children in the videotape range in age from 0 to 5 years. The video is introduced by scenes of children enjoying books while narration discussing the impact of reading to…
Mackenzie, Noella M.; Hemmings, Brian; Kay, Russell
Teachers bring a complex array of beliefs and attitudes to the teaching of literacy. The purpose of the study reported in this article was to investigate the nature of teacher attitudes towards the learning and teaching of writing in the first year of school and to identify any broad underlying attitudinal dimensions. The secondary aim was to…
Cohen, Sanford N.
SUMMARY During the decade of the 1960s, the epidemiology of a new dengue disease, dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS), was described by collaborative research performed by Thai scientists from many institutions and by workers at the U.S. Army's SEATO Medical Research Laboratory in Bangkok, Thailand. Careful clinical and physiological studies provided the initial description of DSS. DSS cases were caused by each of the four dengue viruses (DENV) and not chikungunya (CHIK) virus or DENV 5 and 6, were associated with a secondary-type dengue antibody response in children over the age of 1 year, were associated with a primary antibody response in infants less than 1 year old whose mothers had neutralizing antibodies to all four DENV, were associated more frequently with secondary DENV 2 infections than those due to DENV 1 and 3, and were more common in females than males over the age of 3 years. Robust laboratory methods for growth and recovery of DENV in tissue cultures were introduced. In addition, life-saving principles of fluid and plasma protein resuscitation of hypovolemia were described. Most epidemiological observations made during the decade of the 1960s have been confirmed in the succeeding 45 years. Much contemporary research on pathogenesis fails to address the two distinct immunological antecedents of DHF/DSS. PMID:26085471
Forman, Helen; Mantyla, Timo; Carelli, Maria G.
In this longitudinal study, we examined time keeping in relation to working memory (WM) development. School-aged children completed two tasks of WM updating and a time monitoring task in which they indicated the passing of time every 5 min while watching a film. Children completed these tasks first when they were 8 to 12 years old and then 4 years…
Aspects of preschoolers' ecological understandings were explored in a cross-age, quantitative study that utilised a sample of seventy-five 3- to 5-year-old children. Specifically, their concepts of feeding relationships were determined by presenting physical models of three-step food chains during structured interviews. A majority of children,…
Webster-Stratton, Carolyn; Herman, Keith C.
The Incredible Years (IY) Series is a well-established set of parent, teacher, and child programs for treating and preventing conduct problems and promoting social competence and emotional regulation in young children. The purpose of this article is to describe the development of this evidence-based series within the context of a prevention…
Halstead, Scott B; Cohen, Sanford N
During the decade of the 1960s, the epidemiology of a new dengue disease, dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS), was described by collaborative research performed by Thai scientists from many institutions and by workers at the U.S. Army's SEATO Medical Research Laboratory in Bangkok, Thailand. Careful clinical and physiological studies provided the initial description of DSS. DSS cases were caused by each of the four dengue viruses (DENV) and not chikungunya (CHIK) virus or DENV 5 and 6, were associated with a secondary-type dengue antibody response in children over the age of 1 year, were associated with a primary antibody response in infants less than 1 year old whose mothers had neutralizing antibodies to all four DENV, were associated more frequently with secondary DENV 2 infections than those due to DENV 1 and 3, and were more common in females than males over the age of 3 years. Robust laboratory methods for growth and recovery of DENV in tissue cultures were introduced. In addition, life-saving principles of fluid and plasma protein resuscitation of hypovolemia were described. Most epidemiological observations made during the decade of the 1960s have been confirmed in the succeeding 45 years. Much contemporary research on pathogenesis fails to address the two distinct immunological antecedents of DHF/DSS. Copyright © 2015, American Society for Microbiology. All Rights Reserved.