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Selected AbstractsLevels of evidence available for techniques in antireflux surgeryDISEASES OF THE ESOPHAGUS, Issue 2 2007M. Neufeld SUMMARY., The objective of this study was to determine the levels of evidence and grades of recommendations available for techniques in antireflux surgery. Areas of technical controversy in antireflux surgery were identified and developed into eight answerable questions. The external evidence was surveyed using the databases Medline and EMBASE. Abstracts and appropriate articles were identified from January 1966 to December 2005. A set of search strategies was systematically employed to determine the levels of evidence available for each clinical question. Primary outcome measures included the determination of levels of evidence and grade of recommendation based on The Oxford Center for Evidence-Based Medicine. Secondary outcome measures included for randomized controlled trials were Jadad scores, noting the presence of a sample size calculation, and the determination of an effect estimate and the reporting of a confidence interval. Higher quality randomized controlled trials (mostly level 2b, occasional level 1b) existed to answer three questions: whether to complete a 360° or partial wrap; whether or not to divide the short gastric vessels; and whether to perform laparoscopic or open surgery. Lower quality randomized controlled trials were available to determine whether the use of mesh was helpful, whether or not to use a bougie catheter for calibration of the wrap, and whether an anterior or posterior wrap results in a superior outcome. This was deemed to be of inferior grade of recommendation due to the lack (< 2) of trials available and the sole presence of level 2b evidence. The final two questions: whether to complete fundoplication using a thoracic or abdominal approach and whether to use intraoperative manometry relied exclusively upon level 4 evidence and thus received a lower grade of recommendation. A higher Jadad score seemed to be associated with studies having a higher level of evidence available to answer the question. Sample size calculations were given to answer three questions. Effect estimate was difficult to interpret given inconsistent findings, composite outcomes and lack of reported confidence intervals. In conclusion, antireflux surgery has many randomized controlled trials available upon which to base clinical practice. Unfortunately, these are generally of poor quality. We recommend that esophageal surgeons determine consistent outcome measures and endeavor to improve the quality of randomized controlled trials they perform. [source] Low coronary driving pressure early in the course of myocardial infarction is associated with subendocardial remodelling and left ventricular dysfunctionINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 4 2007Marcia Kiyomi Koike Summary Subendocardial remodelling of the left ventricular (LV) non-infarcted myocardium has been poorly investigated. Previously, we have demonstrated that low coronary driving pressure (CDP) early postinfarction was associated with the subsequent development of remote subendocardial fibrosis. The present study aimed at examining the role of CDP in LV remodelling and function following infarction. Haemodynamics were performed in Wistar rats immediately after myocardial infarction (MI group) or sham surgery (SH group) and at days 1, 3, 7 and 28. Heart tissue sections were stained with HE, Sirius red and immunostained for ,-actin. Two distinct LV regions remote to infarction were examined: subendocardium (SE) and interstitium (INT). Myocyte necrosis, leucocyte infiltration, myofibroblasts and collagen volume fraction were determined. Compared with SH, MI showed lower CDP and LV systolic and diastolic dysfunction. Necrosis was evident in SE at day 1. Inflammation and fibroplasia predominated in SE as far as day 7. Fibrosis was restricted to SE from day 3 on. Inflammation occurred in INT at days 1 and 3, but at a lower grade than in SE. CDP correlated inversely with SE necrosis (r = ,0.65, P = 0.003, at day 1), inflammation (r = ,0.76, P < 0.001, at day 1), fibroplasia (r = ,0.47, P = 0.04, at day 7) and fibrosis (r = ,0.83, P < 0.001, at day 28). Low CDP produced progressive LV expansion. Necrosis at day 1, inflammation at days 3 and 7, and fibroplasia at day 7 correlated inversely with LV function. CDP is a key factor to SE integrity and affects LV remodelling and function following infarction. [source] Petrogenetic significance of orthopyroxene-free garnet + clinopyroxene + plagioclase ± quartz-bearing metabasites with respect to the amphibolite and granulite faciesJOURNAL OF METAMORPHIC GEOLOGY, Issue 1 2003D. R. M. Pattison Abstract Orthopyroxene-free garnet + clinopyroxene + plagioclase ± quartz-bearing mineral assemblages represent the paragenetic link between plagioclase-free eclogite facies metabasites and orthopyroxene-bearing granulite facies metabasites. Although these assemblages are most commonly developed under P,T conditions consistent with high pressure granulite facies, they sometimes occur at lower grade in the amphibolite facies. Thus, these assemblages are characteristic but not definitive of high pressure granulite facies. Compositional factors favouring their development at amphibolite grade include Fe-rich mineral compositions, Ca-rich garnet and plagioclase, and Ti-poor hornblende. The generalized reaction that accounts for the prograde development of garnet + clinopyroxene + plagioclase ± quartz from a hornblende + plagioclase + quartz-bearing (amphibolite) precursor is Hbl + Pl + Qtz=Grt + Cpx + liquid or vapour, depending on whether the reaction occurs above or below the solidus. There are significant discrepancies between experimental and natural constraints on the P,T conditions of orthopyroxene-free garnet + clinopyroxene + plagioclase ± quartz-bearing mineral assemblages and therefore on the P,T position of this reaction. Semi-quantitative thermodynamic modelling of this reaction is hampered by the lack of a melt model and gives results that are only moderately successful in rationalizing the natural and experimental data. [source] Rare Earth Deposits of North AmericaRESOURCE GEOLOGY, Issue 4 2008Stephen B. Castor Abstract Rare earth elements (REE) have been mined in North America since 1885, when placer monazite was produced in the southeast USA. Since the 1960s, however, most North American REE have come from a carbonatite deposit at Mountain Pass, California, and most of the world's REE came from this source between 1965 and 1995. After 1998, Mountain Pass REE sales declined substantially due to competition from China and to environmental constraints. REE are presently not mined at Mountain Pass, and shipments were made from stockpiles in recent years. Chevron Mining, however, restarted extraction of selected REE at Mountain Pass in 2007. In 1987, Mountain Pass reserves were calculated at 29 Mt of ore with 8.9% rare earth oxide based on a 5% cut-off grade. Current reserves are in excess of 20 Mt at similar grade. The ore mineral is bastnasite, and the ore has high light REE/heavy REE (LREE/HREE). The carbonatite is a moderately dipping, tabular 1.4-Ga intrusive body associated with ultrapotassic alkaline plutons of similar age. The chemistry and ultrapotassic alkaline association of the Mountain Pass deposit suggest a different source than that of most other carbonatites. Elsewhere in the western USA, carbonatites have been proposed as possible REE sources. Large but low-grade LREE resources are in carbonatite in Colorado and Wyoming. Carbonatite complexes in Canada contain only minor REE resources. Other types of hard-rock REE deposits in the USA include small iron-REE deposits in Missouri and New York, and vein deposits in Idaho. Phosphorite and fluorite deposits in the USA also contain minor REE resources. The most recently discovered REE deposit in North America is the Hoidas Lake vein deposit, Saskatchewan, a small but incompletely evaluated resource. Neogene North American placer monazite resources, both marine and continental, are small or in environmentally sensitive areas, and thus unlikely to be mined. Paleoplacer deposits also contain minor resources. Possible future uranium mining of Precambrian conglomerates in the Elliott Lake,Blind River district, Canada, could yield by-product HREE and Y. REE deposits occur in peralkaline syenitic and granitic rocks in several places in North America. These deposits are typically enriched in HREE, Y, and Zr. Some also have associated Be, Nb, and Ta. The largest such deposits are at Thor Lake and Strange Lake in Canada. A eudialyte syenite deposit at Pajarito Mountain in New Mexico is also probably large, but of lower grade. Similar deposits occur at Kipawa Lake and Lackner Lake in Canada. Future uses of some REE commodities are expected to increase, and growth is likely for REE in new technologies. World reserves, however, are probably sufficient to meet international demand for most REE commodities well into the 21st century. Recent experience shows that Chinese producers are capable of large amounts of REE production, keeping prices low. Most refined REE prices are now at approximately 50% of the 1980s price levels, but there has been recent upward price movement for some REE compounds following Chinese restriction of exports. Because of its grade, size, and relatively simple metallurgy, the Mountain Pass deposit remains North America's best source of LREE. The future of REE production at Mountain Pass is mostly dependent on REE price levels and on domestic REE marketing potential. The development of new REE deposits in North America is unlikely in the near future. Undeveloped deposits with the most potential are probably large, low-grade deposits in peralkaline igneous rocks. Competition with established Chinese HREE and Y sources and a developing Australian deposit will be a factor. [source] Oxidative/nitrosative stress and peroxiredoxin 2 are associated with grade and prognosis of human renal carcinoma,APMIS, Issue 5 2006Y. SOINI Peroxiredoxins (Prxs) 1,6 were assessed in 138 renal cell carcinomas (RCC) using immunohistochemistry and selected samples by Western blotting analysis. Oxidative/nitrosative damage was evaluated using nitrotyrosine immunoreactivity. The expressions of Prxs were correlated with tumor grade and survival and nitrotyrosine reactivity. Non-malignant kidney tubular cells showed positivity with variable intensity for all six Prxs. In RCCs, most cases were positive for Prxs 1 and 2, while only 15,20% of tumors showed expression for Prxs 3 and 4. Prx 2 was associated with tumors of a lower grade (p=0.009) and with a lower frequency of distant metastases (p=0.046). Patients with tumors expressing Prx2 had better prognosis (p=0.027). Instead, nitrotyrosine was significantly associated with high grade tumors (p=0.001). Compared with the non-malignant kidney tubular cells, low Prx expression in the tumor cells can make them more susceptible to oxidative damage. Prx 2 was more abundantly expressed in low grade tumors, suggesting that this protein could play a role in preventing the development of oxidative damage, which in turn can lead to the activation of pathways leading to aggressive tumors. [source] Superficial papillary urothelial carcinomas in young and elderly patients: a comparative studyBJU INTERNATIONAL, Issue 3 2004Mario Migaldi OBJECTIVE To compare the clinicopathological and immunohistochemical findings of superficial papillary transitional cell carcinomas in ,young' and ,elderly' patients, as the natural history and prognosis of bladder tumours in young patients remains a matter of debate. PATIENTS AND METHODS Tumours from 50 patients with superficial urothelial tumours of the bladder diagnosed before 45 years old (,young' group, follow-up 25,119 months) were compared with 90 similar tumours developed in patients aged >55 years (,elderly', follow-up 24,102 months). All the patients had a transurethral resection with curative intent, and none had received any therapy before surgery. After surgery only patients diagnosed with pT1 tumours were treated by intravesical bacille Calmette-Guérin (BCG) instillations; all received intravesical BCG if there was a recurrence. The clinicopathological variables, recurrence and disease-free interval to recurrence were assessed. Proliferative activity (MIB-1) and expression of cell-cycle regulation proteins cyclin D1, p53 and p27kip1 were detected by immunohistochemistry in the tumours of both groups. RESULTS There were statistically significant differences in tumour grade, stage and occurrence between the ,young' and ,elderly' groups. The ,young' group had a longer disease-free interval to recurrence. Among the immunohistochemical markers analysed, only MIB-1 and cyclin D1 were associated with an increased risk of recurrence in the ,young' group (P < 0.04 and <0.01, respectively) in a univariate analysis. CONCLUSIONS Superficial papillary urothelial tumours of the bladder in ,young' patients had a better prognosis than those in the ,elderly' group, showing a lower grade and stage at diagnosis, and a lower recurrence rate. Proliferative activity and cyclin D1 expression levels were of prognostic significance for the risk of recurrence in these patients. [source] 2262: Study of the role of P2Y receptors in the development of experimental autoimmune uveitisACTA OPHTHALMOLOGICA, Issue 20103Article first published online: 23 SEP 2010, L JUDICE DE MENEZES RELVAS Purpose During autoimmune uveitis (AU), retinal specific auto-reactive T lymphocytes (TL) are activated, alter blood retinal barrier(BRB) and penetrate the eye where they start an inflammatory reaction. Nucleotides, normally present at low concentration in extracellular media, can act as a danger signal, through P2 receptors activation and might be implicated in AU. In this work we would like to investigate if the expression of the nucleotide receptor P2Y2 has any role in experimental autoimmune uveitis (EAU). Methods EAU will be induced in WT and P2Y2 KO mice by IRBP peptide 1-20 injection. 12 days later, TL from spleen and lymph nodes will be purified and restimulated by IRBP. TL proliferation will be measured by thymidine incorporation and cytokines secretion by ELISA. TL from the 2 groups of mice will also be adoptively transfered in WT mice. Similarly, TL from WT mice will be adoptively transfered in WT and P2Y2 KO mice. EAU development will be graded by clinical and histological scores. Results TL generated in KO mice proliferate and produce less IFN, and IL-17, after IRBP restimulation than TL generated in WT mice. Accordingly, adoptive transfer of TL generated in KO mice induce significantly a lower grade of disease than those generated in WT mice. Finally, adoptive transfer of TL generated in WT mice induce disease of significantly lower grade in KO mice recipient than in WT mice recipient. Conclusion Our preliminary data shows that P2Y2 KO mice have a defective immune response after immunisation and develop lower intraocular inflammation following adoptive transfer with TL. Altogether this suggests that P2Y2, as danger receptor signals, play an important role in the development of uveitis. [source] The pen is mightier than the word: Object priming of evaluative standardsEUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 5 2010Abraham M. Rutchick Because red pens are closely associated with error-marking and poor performance, the use of red pens when correcting student work can activate these concepts. People using red pens to complete a word-stem task completed more words related to errors and poor performance than did people using black pens (Study 1), suggesting relatively greater accessibility of these concepts. Moreover, people using red pens to correct essays marked more errors (Study 2) and awarded lower grades (Study 3) than people using blue pens. Thus, despite teachers' efforts to free themselves from extraneous influences when grading, the very act of picking up a red pen can bias their evaluations. Copyright © 2010 John Wiley & Sons, Ltd. [source] Anxiety and the True Beginner,False Beginner Dynamic in Beginning French and Spanish ClassesFOREIGN LANGUAGE ANNALS, Issue 2 2005Diana Frantzen Abstract: This study considered true beginners and false beginners in first-semester university French and Spanish classes to: (a) determine whether true beginners and false beginners differ in anxiety, grades, and plans to continue language study; and (b) identify classroom factors that foster anxiety or comfort. Students completed a questionnaire that included the Foreign Language Classroom Anxiety Scale (Horwitz, Horwitz, & Cope, 1986), MacIntyre and Gardner Anxiety Subscales (1989, 1994), demographic information, grade expectations, and open-ended questions. Randomly selected students were interviewed about their experiences in the courses. Statistical analyses revealed that (a) although neither group was terribly anxious, true beginners were significantly more anxious overall and during processing and output stages than false beginners; (b) true beginners expected and received lower grades than false beginners; and (c) significantly more true beginners than false beginners planned to continue studying the language. Comments on one written open-ended question and in the interviews pointed to the key role of the instructor in reducing anxiety. [source] The initiation and development of metamorphic foliation in the Otago Schist, Part 1: competitive oriented growth of white micaJOURNAL OF METAMORPHIC GEOLOGY, Issue 6 2005A. STALLARD Abstract The 3D shape, size and orientation data for white mica grains sampled along two transects of increasing metamorphic grade in the Otago Schist, New Zealand, reveal that metamorphic foliation, as defined by mica shape-preferred orientation (SPO), developed rapidly at sub-greenschist facies conditions early in the deformation history. The onset of penetrative strain metamorphism is marked by the rapid elimination of poorly oriented large clastic mica in favour of numerous new smaller grains of contrasting composition, higher aspect ratios and a strong preferred orientation. The metamorphic mica is blade shaped with long axes defining the linear aspect of the foliation and intermediate axes a partial girdle about the lineation. Once initiated, foliation progressively intensified by an increase in the aspect ratio, size and alignment of grains, although highest grade samples within the chlorite zone record a decrease in aspect ratio and reduction in SPO strength despite continued increase in grain size. These trends are interpreted in terms of progressive competitive anisotropic growth of blade-shaped grains so that the fastest growth directions and blade lengths tend to parallel the extension direction during deformation. The competitive nature of mica growth is indicated by the progressive increase in size and resultant decrease in number of metamorphic mica with increasing grade, from c. 1000 relatively small mica grains per square millimetre of thin section at lower grades, to c. 100 relatively large grains per square millimetre in higher grade samples. Reversal of SPO intensity and grain aspect ratio trends in higher grade samples may reflect a reduction in the strain rate or reduction in the deviatoric component of the stress field. [source] A survey of treatment outcomes with removable partial denturesJOURNAL OF ORAL REHABILITATION, Issue 8 2003D. Knezovi, Zlatari summary The patient's satisfaction with removable partial denture (RPD) therapy has become an increasingly important factor in prosthetic treatment. This study examined patients' satisfaction with RPDs in relation to some socio-economic variables, patients' habits of wearing and cleaning RPDs, comfort of wearing RPDs and different RPDs characteristics. A questionnaire was devised for the purpose. Two hundred and five patients were required to assess satisfaction with RPDs. They graded RPDs, depending on the level of satisfaction, on scale ranging from 1 to 5. A dentist determined Kennedy classification, material and denture support, denture base shape, number of missing teeth and evaluated denture construction. Majority of the patients were satisfied with the prosthesis. The patients of a higher education level gave lower grades (P < 0·05) to aesthetics of maxillary RPDs. Almost half of the patients were wearing RPDs during the day. Most of the patients cleaned RPDs three times a day. A significant difference was found between the patients' grades for comfort of wearing mandibular RPDs and number of missing teeth and between hygiene of mandibular RPDs and habits of cleaning them. Majority of the patients treated with RPDs were satisfied with the prosthesis. Dissatisfaction was related to mastication, esthetics, number of missing teeth and maintenance of oral hygiene. [source] Prevalence and Patterns of Alcohol Consumption and Health-Risk Behaviors Among High School Students in ThailandALCOHOLISM, Issue 12 2009Sawitri Assanangkornchai Background:, Underage drinking is a significant social and public health problem in Thailand. We report the prevalence and patterns of alcohol consumption and associated health-risk behaviors using data from a 2007,2008 national school survey. Method: A cross-sectional survey using a self-administered questionnaire was conducted among 50,033 high school and vocational college students from 201 schools in 40 provinces between December 2007 and February 2008. Results: The prevalence rates of past-year drinking, past-30-day binge drinking, and drinking until intoxication were 25.5, 9.5, and 17.3% in boys and 14.5, 3.7, and 7.2% in girls, respectively. Higher school levels, lower grades, living with someone other than their own parents, and having family members with substance or alcohol problems were significantly associated with all kinds of drinking. Binge drinkers were significantly more likely to have drinking consequences, e.g., driving after drinking, nausea and vomiting, and having a hangover than were nonbinge drinkers. The rates of other behavior and emotional problems were 2.5 to 6.7 times as likely in drinkers as nondrinkers, including smoking (35.1% vs. 4.9%), prescription drug misuse (17.7% vs. 6.7%), illicit substance use (17.8% vs. 2.4%), carrying a weapon (6.5% vs. 1.8%), feeling depressed (23.2% vs. 10.9%), suicidal attempt (10.5% vs. 3.8%), and sexual intercourse (30.5% vs. 5.7%). Conclusion: Alcohol consumption is a serious problem among adolescents in Thailand and is strongly associated with various health-risk behaviors. Effective age- and gender-specific interventions should be implemented to discourage underage drinking and associated adverse health and social consequences. [source] Adolescents' Sleep Behaviors and Perceptions of SleepJOURNAL OF SCHOOL HEALTH, Issue 5 2009Heather Noland MEd ABSTRACT Background:, Sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents. This study extends our understanding of how adolescents perceive and deal with their sleep issues. Methods:, General education classes were randomly selected from a convenience sample of three high schools in the Midwest. Three hundred eighty-four ninth- to twelfth-grade students (57%) completed a self-administered valid and reliable questionnaire on sleep behaviors and perceptions of sleep. Results:, Most respondents (91.9%) obtained inadequate sleep (, 9 hours) on most school nights of the week, with 10% reporting less than 6 hours of sleep each week night. The majority indicated that not getting enough sleep had the following effects on them: being more tired during the day (93.7%), having difficulty paying attention (83.6%), lower grades (60.8%), increase in stress (59.0%), and having difficulty getting along with others (57.7%). Some students reported engaging in harmful behaviors to help them sleep: taking sleeping pills (6.0%), smoking a cigarette to relax (5.7%), and drinking alcohol in the evening (2.9%). Students who received fewer hours of sleep were significantly more likely to report being stressed (p = .02) and were more likely to be overweight (p = .04). Conclusions:, Inadequate sleep time may be contributing to adolescent health problems such as increased stress and obesity. Findings indicate a need for sleep hygiene education for adolescents and their parents. A long-term solution to chronic sleep deprivation among high school students could include delaying high school start times, such as was done successfully in the Minneapolis Public School District. [source] Age-related variations and sex differences in gender cleavage during middle childhoodPERSONAL RELATIONSHIPS, Issue 2 2001ROSANNE BURTON SMITH Gender cleavage, the segregation of the sexes, is a powerful phenomenon affecting socialization during childhood, but its developmental trajectory is far from clear. Sociometric responses by 299 boys and girls in Grades 3 to 6 from a group preference record were used to investigate age-related variations and sex differences in gender cleavage. Moreno's (1953) developmental model of gender cleavage was examined in the light of sociocultural changes, as well as advances in the theory and measurement of gender cleavage. Sex differences were found in same-gender preference, with older elementary girls showing greater same-gender preference than boys of the same age. However, this finding, plus the absence of gender differences in cross-gender evaluations, did not support more recent developmental accounts of gender cleavage. Linear trend analyses contradicted Moreno's basic precept of increasing same-gender preference between Grades 3 and 6. While same-gender acceptance and rejection were relatively similar regardless of grade level, cross-gender acceptance was greater in higher than in lower grades and the reverse was true for rejection. Furthermore, weaker gender cleavage effects in rejection data than in acceptance data suggested that strong same-gender liking does not infer equally robust cross-gender dislike. Gender cleavage appears to be relative rather than absolute. A more complex model is proposed incorporating sex differences as well as rejection evaluations [source] THE DETERMINANTS OF GRADE ATTAINMENT IN LOW-INCOME COUNTRIES: EVIDENCE FROM RURAL BANGLADESHTHE DEVELOPING ECONOMIES, Issue 4 2004Hayfa GRIRA This paper presents an econometric analysis of the effects of child health on school enrollment and grade attainment in Bungladesh. It improves on past studies in a number of ways mainly by incorporating into its analysis the endogenous nature of child health. The results challenge the conclusions found in the literature. First, it finds that in Bangladesh, a child's health and his/her probability of being enrolled in school are at best weakly related. Second, it shows that once enrolled, nutritional deficiencies retard substantially school progress: Underweight children tend to be in lower grades than well-fed children of the same age. It is estimated that a one standard deviation improvement in weight-for-age would be expected to reduce the grades behind by about 0.25 years or about 13.5 percent of the actual years completed. Finally, the estimates suggest that the weight-for-age indicator appears as the best predictor of nutritional status. [source] Association between laminin-8 and glial tumor grade, recurrence, and patient survival,CANCER, Issue 3 2004Julia Y. Ljubimova M.D., Ph.D. Abstract BACKGROUND The authors previously sought to identify novel markers of glioma invasion and recurrence. Their research demonstrated that brain gliomas overexpressed a subset of vascular basement components, laminins, that contained the ,4 chain. One of these laminins, laminin-8, was found to be present in highly invasive and malignant glioblastoma multiforme (GBM) (Grade 4 astrocytoma); its expression was associated with a decreased time to tumor recurrence, and it was found in vitro to promote invasion of GBM cell lines. METHODS In the current study, the authors studied glial tumors of different grades in an attempt to correlate laminin-8 expression with tumor recurrence and patient survival. Immunohistochemistry and Western blot analysis were used to detect laminin isoforms of interest. RESULTS Using immunohistochemistry and Western blot analysis, the authors confirmed high levels of laminin-8 expression in approximately 75% of the GBM cases examined and in their adjacent tissues, whereas astrocytomas of lower grades expressed for the most part a different isoform, laminin-9, which also was found in low amounts in normal brain tissue and benign meningiomas. Overexpression of laminin-8 in GBM was found to be associated with a statistically significant shorter time to tumor recurrence (P < 0.0002) and a decreased patient survival time (P < 0.015). CONCLUSIONS The data suggest that laminin-8, which may facilitate tumor invasion, contributes to tumor regrowth after therapy. Laminin-8 may be used as a predictor of tumor recurrence and patient survival and as a potential molecular target for glioma therapy. Cancer 2004. © 2004 American Cancer Society. [source] Follow-up of adolescents born extremely preterm: cognitive function and health at 18 years of ageACTA PAEDIATRICA, Issue 9 2010Anne-Li Hallin Abstract Aim:, To compare cognitive ability, school achievement and self-perceived health aspects in adolescents born extremely preterm and term born controls. Method:, Fifty-two, out of 61, extremely preterm born adolescents (mean age 18.4 years) and 54 matched controls (mean age 18.3 years) born at full term were investigated; intelligence quotient was measured with the Wechsler Adult Intelligence Scale; cognitive flexibility, i.e. a measure of visuomotor speed and attention, with the Trail Making Test; school achievement and choice of upper secondary programmes were reported. Health aspects were investigated in a semi structured interview. Result:, The adolescents born prematurely had significantly lower IQ than the controls, mean 93 (SD 15.4) vs 106 (12.5), p < 0.001; showed slower visuomotor speed; had lower grades from compulsory school (192.7 vs 234.8, p < 0.001); and chose to a greater extent practical upper secondary school programmes. There were no differences between the groups in health care consumption, prevalence of chronic disease, allergy or infectious diseases. Conclusion:, Poorer cognitive performance, in extremely preterm born individuals, seems to persist into late adolescence. Fewer prematurely born than control chose theoretical upper secondary school programmes. However, no difference was noted regarding self-perceived health aspects. [source] Borderline intellectual functioning in children and adolescents , insufficiently recognized difficultiesACTA PAEDIATRICA, Issue 5 2010Elisabeth Fernell Abstract Aim:, To draw attention to groups of children and adolescents with borderline intellectual functioning, especially with respect to their school-situation. Methods:, In one study, population-based, children with borderline intellectual functioning at age 10 years were followed until they finished compulsory school when their final certificates could be analysed. In a second study parents of 20 individuals in the upper secondary school for pupils with mild mental retardation were interviewed according to the Vineland adaptive scales and school health records were reviewed. In a third study pupils attending an individual programme in upper secondary school were assessed and we report one representative case. Results:, (1) Pupils with borderline intellectual functioning, assessed in grade 4, received significantly lower grades when finishing the compulsory school. (2) In the group of pupils in the upper secondary school for the mildly mentally retarded, compiled data indicated that a considerable number did not fulfil the combined IQ and adaptive criteria for mild mental retardation. (3) The subtle nature of borderline intellectual functioning may delay appropriate measures at school, which our case illustrates. Conclusion:, Borderline intellectual functioning seldom attracts attention. Our studies indicate that school and also society at large must be prepared to adapt educational and working conditions for the large minority of individuals with borderline intellectual functioning. [source] | |||||||||||||||||||