Prospective Longitudinal Study (prospective + longitudinal_study)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


The Impact of Childhood Epilepsy on Neurocognitive and Behavioral Performance: A Prospective Longitudinal Study

EPILEPSIA, Issue 4 2000
Laura L. Bailet
Summary: Purpose: To assess neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE, n = 74), their siblings without epilepsy (control, n = 23), and children with migraine (CWM, n = 13), and to identify medical factors related to learning or behavioral problems in CWE. Methods: Subjects, ages 8,13 years with IQs of ,80, completed a neurocognitive test battery annually for ,3 years. For CWE, age at seizure onset, most recent EEG results, seizure type, seizure frequency, current antiepileptic drug (AED), and most recent AED serum levels were documented at each visit. Results: CWE and CWM had high rates of grade retention and placement in special education compared with sibling controls. CWE performed worse than controls on numerous neurocognitive variables. These differences persisted over time. CWE with abnormal EEGs scored lower than CWE with normal EEGs on reading and spelling measures, even with comparable IQs. Age at seizure onset, seizure type, and seizure frequency were not related to neurocognitive or behavioral test scores. CWE taking carbamazepine (CBZ) performed better than CWE taking valproate (VPA) on academic achievement measures, although the study lacked controls necessary to assess this finding thoroughly. CWM did not differ from CWE or controls in cognitive or academic achievement skills. Conclusions: Long-term risk of learning problems exists among CWE as compared with controls, even with normal IQs and well-controlled seizures. Predicting learning problems in CWE based on medical factors remains elusive. Monitoring of educational progress and neurocognitive screening may be most effective in assessing academic risk for CWE. [source]


A Prospective Longitudinal Study of Teen Court's Impact on Offending Youths' Behavior

JUVENILE AND FAMILY COURT JOURNAL, Issue 1 2005
ANDREW RASMUSSEN
ABSTRACT Although teen court is the fastest growing alternative processing model in juvenile justice, there has been little systematic investigation of offenders' impressions of the process and no attempt to measure changes in delinquent behavior. This study employed a prospective longitudinal design to measure several impressions of teen court using a questionnaire, and changes in self-reported delinquency using the YSR and CBCL. Impressions of teen court did not predict compliance with the teen court sentence or lower risk of recidivism once demographic and prior delinquency were taken into account, although delinquent behavior did decrease between intake and six months for boys, who reported more delinquent behavior at intake. Interpretation of these results involves teen court's location at the soft end of juvenile justice. Implications for net-widening and changing not-so-delinquent youths' behavior are central to this discussion. [source]


Maternal and fetal serum transformed alpha-fetoprotein levels in normal pregnancy

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2009
Fernando González-Bugatto
Abstract Aim:, To evaluate transformed alpha-fetoprotein (t-AFP) (a new molecular conformation of alpha-fetoprotein) levels in maternal serum and fetal serum in normal pregnancy. Methods:, Prospective longitudinal study. Fifty pregnant women were studied in two groups: 25 were evaluated in each trimester of pregnancy and near term (12, 20, 32 and 36 weeks) and the other 25 were evaluated at the time of planned cesarean section at term. In the first group, maternal serum t-AFP was measured and in the second group, maternal and fetal serum t-AFP were analyzed. Results:, Maternal serum t-AFP levels (medians) were 14.73 ng/mL in the first trimester, 28.29 ng/mL in the second trimester, 30.45 ng/mL in the early third trimester and 8.06 ng/mL in late pregnancy. t-AFP levels were significantly higher in maternal than in fetal serum (P < 0.001). There were no significant correlations between AFP and t-AFP levels in maternal versus fetal serum. Conclusions:, t-AFP increases during pregnancy until the early third trimester and then falls before delivery. t-AFP levels are higher in maternal than in fetal serum which suggests that native AFP is transformed to t-AFP either in the mother or in the placenta. [source]


Reference ranges for umbilical vein blood flow in the second half of pregnancy based on longitudinal data

PRENATAL DIAGNOSIS, Issue 2 2005
Ganesh Acharya
Abstract Objectives To construct new reference ranges for serial measurements of umbilical vein (UV) blood flow. Methods Prospective longitudinal study of blood flow velocities and diameter of the UV measured at four-weekly intervals during 19 to 42 weeks' gestation in 130 low-risk singleton pregnancies. Regression models and multilevel modeling were used to construct the reference ranges. Results On the basis of 511 sets of longitudinal observations, we established new reference percentiles of UV diameter, blood flow velocities, volume flow, and blood flow normalized for fetal weight and abdominal circumference. They reflected some of the developmental patterns of previous cross-sectional studies, but with important differences, particularly near term. The UV blood flow showed a continuous increase until term, whereas the flow normalized per unit fetal weight, a corresponding reduction. Calculating the blood flow on the basis of intensity-weighted mean velocity or 0.5 of the maximum velocity gave almost interchangeable results for most fetuses. Conclusion New reference ranges for UV blood flow based on longitudinal observations appear slightly different from cross-sectional studies, and should be more appropriate for serial evaluation of fetal circulation. Copyright © 2005 John Wiley & Sons, Ltd. [source]


Pregnancy and delivery: a urodynamic viewpoint

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2000
C. Chaliha Research Fellow (Urogynaecology)
Objective The aims of this study were to establish prospectively the prevalence of objective bladder dysfunction before and after delivery by means of urodynamic investigations and to assess the effect of obstetric variables on bladder function. Design Prospective longitudinal study. Twin channel subtracted cystometry was performed in the standing and sitting position, with a cough stress test at the end of filling. The investigations were repeated three months postpartum. Participants Two hundred and eighty-six nulliparae with singleton pregnancies who were delivered between April 1996 and November 1997 attended for antenatal assessment after 34 weeks of gestation and 161 who returned postpartum. Setting Department of Obstetrics and Gynaecology in a London teaching hospital. Results The mean urodynamic values both in pregnancy and postpartum lower than values defined in a non-pregnant population. The prevalence of genuine stress incontinence and detrusor instability were antenatally 9% and 8%, respectively, and postpartum 5% and 7%, respectively. Obstetric and neonatal factors were not related to urodynamic variables. Conclusions Despite the reported high prevalence of urinary incontinence related to pregnancy and childbirth, neither pregnancy nor delivery resulted in any consistent effects on objective bladder function. Postpartum urodynamic measurements were not related to either obstetric or neonatal variables, but were dependent on antenatal values. [source]


Searching for a developmental typology of personality and its relations to antisocial behaviour: a longitudinal study of an adjudicated men sample

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2003
Julien Morizot
The search for an empirically based personality typology has regained the interest of researchers. To date, however, empirical inquiries have mainly been cross-sectional. In this study, an empirically based developmental typology of personality was identified using data from a prospective longitudinal study of a sample of men adjudicated during their adolescence and assessed on four occasions until midlife. Cluster analyses were performed on measures of disinhibition, negative emotionality, and extraversion. Four developmental types of personality were identified. The first was characterized by average scores in the three traits in adolescence that decreased linearly until midlife (39%). The second type displayed very high scores in disinhibition and negative emotionality in adolescence that decreased rapidly during early adulthood (24%). The third type was characterized by very high scores in disinhibition and negative emotionality that remained stable until midlife, while extraversion was average during adolescence and then decreased rapidly until midlife (17%). The fourth type was characterized by high scores in disinhibition and negative emotionality in adolescence that was followed by cycles of decreases and increases until midlife (20%). These four developmental types of personality seemed to be related to known antisocial behaviour trajectories. Copyright © 2003 Whurr Publishers Ltd. [source]


Rumination in posttraumatic stress disorder

DEPRESSION AND ANXIETY, Issue 5 2007
Tanja Michael Ph.D.
Abstract Recent studies have shown that rumination is a powerful predictor of persistent posttraumatic stress disorder (PTSD). However, to date, the mechanisms by which rumination maintains PTSD symptoms are little understood. Two studies of assault survivors, a cross-sectional (N = 81) and a 6-month prospective longitudinal study (N = 73), examined several facets of ruminative thinking to establish which aspects of rumination provide the link to PTSD. The current investigation showed that rumination is not only used as a strategy to cope with intrusive memories but it also triggers such memories. Certain characteristics of rumination, such as compulsion to continue ruminating, occurrence of unproductive thoughts, and "why" and "what if" type questions, as well as negative emotions before and after rumination, were significantly associated with PTSD, concurrently and prospectively. These characteristics explained significantly more variance in PTSD severity than the mere presence of rumination, thereby indicating that not all ways of ruminative thinking are equally maladaptive. Depression and Anxiety 24:307,317, 2007. © 2006 Wiley-Liss, Inc. [source]


Longitudinal development of hand function in children with unilateral cerebral palsy

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2010
MARIE HOLMEFUR PHD REG OT
Aim The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years. Method A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y 8mo [SD 1y 1mo]). Children were assessed with the Assisting Hand Assessment (AHA) 3 to 11 times per child over a mean period of 4 years 6 months. Two models were used for grouping children: by AHA score at 18 months and by Manual Ability Classification System (MACS) levels. Estimated average motor development curves were fitted with a nonlinear mixed-effects model. Results Children with a high AHA score (high ability level) at 18 months reached a significantly higher ability level and at a higher progression rate than children with a low 18-month AHA score. Limits of development differed between the three MACS levels. Interpretation Results indicate that the AHA score at 18 months can be used to discuss future development of affected hand use in bimanual tasks in children with unilateral CP. [source]


Substance use and periodontal disease among Australian Aboriginal young adults

ADDICTION, Issue 4 2010
Lisa M. Jamieson
ABSTRACT Aim To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. Design Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. Participants Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. Measurements Clinical dental examination and self-report questionnaire. Findings Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06,2.40], marijuana (PR = 1.44, 95% CI = 1.05,1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08,3.11), but not alcohol (PR = 0.92, 95% CI = 0.67,1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03,2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. Conclusions This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation. [source]


Hypothalamic,pituitary,adrenal axis and smoking and drinking onset among adolescents: the longitudinal cohort TRacking Adolescents' Individual Lives Survey (TRAILS)

ADDICTION, Issue 11 2009
Anja C. Huizink
ABSTRACT Aims We examined within a prospective longitudinal study whether cortisol levels were associated with smoking or drinking behaviours, taking parental substance use into account. Design The influence of parental substance use on cortisol levels of their adolescent offspring at age 10,12 years was examined. Next, cortisol levels of adolescents who initiated smoking or drinking at the first data collection (age 10,12) were compared to non-users. Finally, we examined whether cortisol levels could predict new onset and frequency of smoking and drinking 2 years later. Setting and participants First and second assessment data of the TRacking Adolescents' Individual Lives Survey (TRAILS) were used, including 1768 Dutch adolescents aged 10,12 years, who were followed-up across a period of 2 years. Measurements Cortisol was measured in saliva samples at awakening, 30 minutes later, and at 8 p.m. at age 10,12. Self-reported substance use at age 10,12 and 13,14, and parental self-reported substance use were used. Findings Only maternal substance use was related to slightly lower adolescent cortisol levels at 8 p.m. Both maternal and paternal substance use were associated with adolescent smoking and drinking at age 13,14, although fathers' use only predicted the amount used and not the chance of ever use. Finally, higher cortisol levels were related moderately to current smoking and future frequency of smoking, but not to alcohol use. Conclusions In a general population, parental heavy substance use does not seem to affect cortisol levels consistently in their offspring. We found some evidence for higher, instead of lower, hypothalamic,pituitary,adrenal axis activity as a predictor of smoking in early adolescence. [source]


When Home Care Ends,Changes in the Physical Health of Informal Caregivers Caring for Dementia Patients: A Longitudinal Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2002
Elmar Gräsel MD
OBJECTIVES: To verify the change in health variables and parameters of health service utilization in a group of active caregivers for older persons with dementia in comparison with former caregivers who had ceased to provide home care for at least 6 months (death of the patient or institutionalized care). DESIGN: A prospective longitudinal study with 1-year follow-up. Active and former caregiver groups originated from a sample of active caregivers at baseline. SETTING: Participants were recruited mainly via advertisements placed in two magazines with large, nationwide circulation. The questionnaires were sent on request. PARTICIPANTS: Seven hundred twenty primary caregivers of dementia patients living in the community. All patients had a medical diagnosis of dementia and had a score of 20 or greater on the mental-mnestic disturbances factor of the Sandoz Clinical Assessment,Geriatric scale. Their care needs covered at least one of four activities of daily living (personal hygiene, eating, toilet use/excretion, mobility). After 12 months, 681 caregivers were reinterviewed. MEASUREMENTS: The physical complaints were assessed with the 24-item Giessen Symptom List (subscales: aching limbs, stomach complaints, heart complaints, physical exhaustion). Other key variables were the number of illnesses, number of somatic and psychotropic medications, and number of physician visits. RESULTS: Although the somatic symptoms of the active caregivers (n = 427) remained stable at a high level, they decreased significantly (24%) in the group of former caregivers (n = 121). Simultaneously, the number of visits former caregivers made to physicians almost doubled. The reason why home care was terminated (death or institutionalization) did not influence health variables or health service utilization. CONCLUSION: The physical health of former caregivers improves in the long term once they cease to provide home care. The fact that former caregivers go to the doctor much more frequently is to be interpreted as an indication that they take the time to attend to their own physical and medical needs. [source]


Mothers' Attachment Style, Their Mental Health, and Their Children's Emotional Vulnerabilities: A 7-Year Study of Children With Congenital Heart Disease

JOURNAL OF PERSONALITY, Issue 1 2008
Ety Berant
ABSTRACT The long-term contribution of mothers' attachment insecurities to their own and their children's psychological functioning was examined in a 7-year prospective longitudinal study of children with Congenital Heart Disease (CHD). Sixty-three mothers of newborns with CHD participated in a three-wave study, beginning with the CHD diagnosis (T1), then 1 year later (T2), and again 7 years later (T3). At T1, the mothers reported on their attachment style and mental health. At T2, the mental health measure was administered again, along with a marital satisfaction scale. At T3, participants completed these two measures again, and their children reported on their self-concept and completed the Children's Apperception Test. Maternal avoidant attachment at T1 was the best predictor of deterioration in the mothers' mental health and marital satisfaction over the 7-year period, especially in a subgroup whose children had severe CHD. In addition, mothers' attachment insecurities (both anxiety and avoidance) at the beginning of the study were associated with their children's emotional problems and poor self-image 7 years later. [source]


Joint generalized estimating equations for multivariate longitudinal binary outcomes with missing data: an application to acquired immune deficiency syndrome data

JOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2009
Stuart R. Lipsitz
Summary., In a large, prospective longitudinal study designed to monitor cardiac abnormalities in children born to women who are infected with the human immunodeficiency virus, instead of a single outcome variable, there are multiple binary outcomes (e.g. abnormal heart rate, abnormal blood pressure and abnormal heart wall thickness) considered as joint measures of heart function over time. In the presence of missing responses at some time points, longitudinal marginal models for these multiple outcomes can be estimated by using generalized estimating equations (GEEs), and consistent estimates can be obtained under the assumption of a missingness completely at random mechanism. When the missing data mechanism is missingness at random, i.e. the probability of missing a particular outcome at a time point depends on observed values of that outcome and the remaining outcomes at other time points, we propose joint estimation of the marginal models by using a single modified GEE based on an EM-type algorithm. The method proposed is motivated by the longitudinal study of cardiac abnormalities in children who were born to women infected with the human immunodeficiency virus, and analyses of these data are presented to illustrate the application of the method. Further, in an asymptotic study of bias, we show that, under a missingness at random mechanism in which missingness depends on all observed outcome variables, our joint estimation via the modified GEE produces almost unbiased estimates, provided that the correlation model has been correctly specified, whereas estimates from standard GEEs can lead to substantial bias. [source]


Kindergarten Predictors of Math Learning Disability

LEARNING DISABILITIES RESEARCH & PRACTICE, Issue 3 2005
Michčle M. M. Mazzocco
The aim of the present study was to address how to effectively predict mathematics learning disability (MLD). Specifically, we addressed whether cognitive data obtained during kindergarten can effectively predict which children will have MLD in third grade, whether an abbreviated test battery could be as effective as a standard psychoeducational assessment at predicting MLD, and whether the abbreviated battery corresponded to the literature on MLD characteristics. Participants were 226 children who enrolled in a 4-year prospective longitudinal study during kindergarten. We administered measures of mathematics achievement, formal and informal mathematics ability, visual-spatial reasoning, and rapid automatized naming and examined which test scores and test items from kindergarten best predicted MLD at grades 2 and 3. Statistical models using standardized scores from the entire test battery correctly classified ,80,83 percent of the participants as having, or not having, MLD. Regression models using scores from only individual test items were less predictive than models containing the standard scores, except for models using a specific subset of test items that dealt with reading numerals, number constancy, magnitude judgments of one-digit numbers, or mental addition of one-digit numbers. These models were as accurate in predicting MLD as was the model including the entire set of standard scores from the battery of tests examined. Our findings indicate that it is possible to effectively predict which kindergartners are at risk for MLD, and thus the findings have implications for early screening of MLD. [source]


Medical students' personality characteristics and academic performance: a five-factor model perspective

MEDICAL EDUCATION, Issue 11 2002
Filip Lievens
Objectives, This study investigates: (1) which personality traits are typical of medical students as compared to other students, and (2) which personality traits predict medical student performance in pre-clinical years. Design, This paper reports a cross-sectional inventory study of students in nine academic majors and a prospective longitudinal study of one cohort of medical students assessed by inventory during their first preclinical year and by university examination at the end of each pre-clinical year. Subjects and methods In 1997, a combined total of 785 students entered medical studies courses in five Flemish universities. Of these, 631 (80·4%) completed the NEO-PI-R (i.e. a measure of the Five-Factor Model of Personality). This was also completed by 914 Year 1 students of seven other academic majors at Ghent University. Year end scores for medical students were obtained for 607 students in Year 1, for 413 in Year 2, and for 341 in Year 3. Results, Medical studies falls into the group of majors where students score highest on extraversion and agreeableness. Conscientiousness (i.e. self-achievement and self-discipline) significantly predicts final scores in each pre-clinical year. Medical students who score low on conscientiousness and high on gregariousness and excitement-seeking are significantly less likely to sit examinations successfully. Conclusions, The higher scores for extraversion and agreeableness, two dimensions defining the interpersonal dynamic, may be beneficial for doctors' collaboration and communication skills in future professional practice. Because conscientiousness affects examination results and can be reliably assessed at the start of a medical study career, personality assessment may be a useful tool in student counselling and guidance. [source]


Attachment transfer among Swedish and German adolescents: A prospective longitudinal study

PERSONAL RELATIONSHIPS, Issue 3 2006
WOLFGANG FRIEDLMEIER
This prospective longitudinal study investigated whether and in what way different functions of attachment relationships are transferred from parents to reciprocal relationship partners in adolescence. Furthermore, the impact of nationality, romantic relationship status, and individual differences in perceived attachment history and current attachment orientation on the timing and extent of transfer was examined. Adolescents from Sweden and Germany were studied over a 12- to 15-month time span. As predicted, the transfer generally unfolded in a step-by-step process in cross-sectional analyses. However, the predicted direction of transfer from parents to peers could not be confirmed in the prospective analyses. Adolescents who had formed a romantic relationship between assessments showed a stronger transfer from parents to peers compared to those who had not. German adolescents had transferred to a larger extent at Time Point 1, but Swedish adolescents caught up by Time Point 2. Finally, the combination of an insecure history with mother and high current anxiety was linked to a particularly high degree of prospective attachment transfer, whereas an insecure history with mother combined with high current avoidance predicted a particularly low degree of prospective transfer. [source]


Sorting out successful failures: Exploratory analyses of factors associated with academic and behavioral outcomes of retained students

PSYCHOLOGY IN THE SCHOOLS, Issue 4 2001
Phillip Ferguson
This prospective longitudinal study followed a sample of 106 kindergarten students through 11th grade examining the effects of family characteristics, school readiness, socialization, and student demographics on academic achievement and behavioral adjustment outcomes. These educational outcomes were contrasted among four groups consisting of: 1) early grade retainees; 2) transitionally placed retained students; 3) students recommended for transitional placement, but promoted; and 4) regularly promoted students. While previous studies examining the efficacy of early grade retention focus exclusively on between-group comparisons, this study examines the family and individual characteristics of successful and unsuccessful retained students by including both between-group and within-group effects on academic and behavioral outcomes. The results of this study demonstrate that retained students' initial school readiness, socioeconomic status, mother's level of education, parental value of education, kindergarten personal-social functioning, and chronological age are distinctly associated with subsequent academic or behavioral outcomes. Variables associated with relative educational success following early failure are delineated and research implications are discussed. © 2001 John Wiley & Sons, Inc. [source]


Exercise participation after diagnosis of breast cancer: trends and effects on mood and quality of life

PSYCHO-ONCOLOGY, Issue 5 2002
Bernardine M. Pinto
Individuals treated for cancer often experience higher levels of emotional distress than the general population. Previous research has shown that exercise can have an ameliorating effect on these problems. This 12-month prospective longitudinal study investigated mood, quality of life, cancer-related symptoms, and exercise behavior of 69 women who had completed treatment for Stage 0,2 breast cancer. We studied the natural progression of exercise participation after cancer treatment. Effects on mood, quality of life, and cancer-related symptoms were assessed after controlling for demographic variables, disease variables, social support, and baseline values to test the hypothesis that women who exercised were more likely to report better mood, higher quality of life, and fewer cancer-related symptoms. Results indicated that women did not increase their exercise participation over time and that overall mean minutes of exercise participation were below recommended levels. Baseline demographic predictors of exercise participation included younger age, having a spouse or partner, increased time since diagnosis, higher social support, and higher depression. Exercise participation was associated with improved physical functioning, but not overall mood or cancer-related symptoms. We discuss implications of these findings towards the well-being of breast cancer survivors. Copyright © 2002 John Wiley & Sons, Ltd. [source]


Parenting and the development of conduct disorder and hyperactive symptoms in childhood: a prospective longitudinal study from 2 months to 8 years

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 4 2003
Julian Morrell
Background:, This study investigated the early processes involved in the development of symptoms of conduct disorder and hyperactivity. Method:, The study employed a prospective design, over a period from 2 months to 8 years. Detailed observational data of early and later mother,child interactions were collected, infant prefrontal function (the A not B task) was assessed, and symptoms of child conduct disorder and hyperactivity were rated by maternal report at age 5 and 8 years. Results:, The principal findings of the study were that emotional dysregulation on the A not B task at 9 months predicted symptoms of conduct disorder at 5 and 8 years, and delayed object reaching times on the same task predicted hyperactive symptoms at 5 years. These two developmental trajectories were associated with distinct patterns of early parenting that were strongly influenced by infant gender. Thus, in boys early emotional dysregulation was predicted by rejecting and coercive parenting, and delayed reaching on the A not B task by coercive parenting, whereas in girls only continuity from earlier infant behaviour could be demonstrated. There was strong continuity between these early infant behaviours and later child disturbance that was partially mediated by parenting for conduct disorder symptoms (maternal hostile parenting in boys, and maternal coercive parenting in girls), but not for hyperactive symptoms. Conclusions:, These data would suggest that only in boys was there evidence for the existence of a sensitive period for the development of hyperactive symptoms, and to a lesser extent, conduct disorder symptoms. [source]


Candidate's Thesis: Universal Newborn Hearing Screening in an Inner-City, Managed Care Environment ,

THE LARYNGOSCOPE, Issue 6 2000
Glenn Isaacson MD
Abstract Objectives/Hypothesis Universal neonatal hearing screening (UNHS) programs aim to identify and treat educationally significant hearing loss in the first months of life. Several states have mandated UNHS for all newborns. Such programs have been successful in small, homogeneous populations. As larger states attempt to implement such programs, important obstacles have arisen, particularly in sparsely populated rural environments and in the inner city, where poverty, unstable living situations, and inadequate access to health care make follow-up of infants failing initial testing difficult. Study Design We performed a prospective longitudinal study e-amining the effects of increasingly comple- and e-pensive interventions designed to ensure that children failing initial hearing screening returned for complete evaluation and habilitation. Methods A UNHS program based on transient evoked otoacoustic emissions testing was implemented at Temple University Hospital, with 2,000 births per year. At 6 months into the program, efficacy was assessed and modifications in follow-up methodology were made in an attempt to improved rate of return of infants failing newborn screening. The effect of these interventions was reassessed 6 months later. Results In its first 12 months, the Temple University Infant and Young Child Hearing Intervention Initiative successfully screened 95% (2,031) of all newborns using transient evoked otoacoustic emissions. Collecting a complete database profile for each newborn, establishing rapport with the family, and offering immediate follow-up appointments yielded a 61% return rate after discharge. The addition of a dedicated project secretary, free day-care for siblings, and cab vouchers for transportation and the elimination of a requirement for health maintenance organization referrals increased follow-up yield to 75%. Conclusion Given adequate resources and planning, UNHS can be successful, even in economically depressed environments. [source]


Airway Epithelial Cell Senescence in the Lung Allograft

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2008
S. M. Parker
Chronic lung allograft dysfunction, manifesting as bronchiolitis obliterans syndrome (BOS), is characterized by airway epithelial injury, impaired epithelial regeneration and subsequent airway remodeling. Increased cellular senescence has been reported in renal and liver allografts affected by chronic allograft dysfunction but the significance of cellular senescence in the airway epithelium of the transplanted lung is unknown. Thirty-four lung transplant recipients, 20 with stable graft function and 14 with BOS, underwent transbronchial lung biopsy and histochemical studies for senescence markers in small airways. Compared to nontransplant control lung tissue (n = 9), lung allografts demonstrate significantly increased airway epithelial staining for senescence-associated beta galactosidase (SA ,-gal) (p = 0.0215), p16ink4a (p = 0.0002) and p21waf1/cip (p = 0.0138) but there was no difference in expression of these markers between stable and BOS affected recipients (p > 0.05). This preliminary cross-sectional study demonstrates that cellular senescence occurs with increased frequency in the airway epithelium of the lung allograft but does not establish any association between airway epithelial senescence and BOS. A prospective longitudinal study is required to better address any potential causal association between airway epithelial senescence in stable allograft recipients and the subsequent development of BOS. [source]


Relation between neuritic plaques and depressive state in Alzheimer's disease

ACTA NEUROPSYCHIATRICA, Issue 1 2010
Gerben Meynen
Meynen G, Van Stralen H, Smit JH, Kamphorst W, Swaab DF, Hoogendijk WJG. Relation between neuritic plaques and depressive state in Alzheimer's disease. Background: To investigate for the first time in a prospective study the relationship between depressive state and the neuropathological hallmarks of Alzheimer's disease, using a scale for depressive symptoms in dementia, while controlling for clinical severity of dementia. Method: Within the framework of a prospective longitudinal study of depression in Alzheimer's disease, patients with dementia underwent a clinical evaluation every six months during the last years of their lives, using the Cornell scale for depression in dementia to assess depressive symptoms and using the Functional Assessment Staging scale to control for clinical severity of dementia. The brains of 43 Alzheimer patients were obtained. The last clinical evaluations prior to death together with post-mortem neuropathology measures were analysed. Results: We found a correlation between the Cornell scores and the sum score for the density of neuritic plaques in the entire cortex (p = 0.027), and even stronger in the temporal cortex (p = 0.012). The observed correlations were independent of sex, age of death, clinical dementia severity and duration of Alzheimer's disease. Conclusions: This study shows a positive relationship between depressive state at time of death and the presence of neuritic plaques in Alzheimer's disease, which is independent of the clinical severity of dementia. [source]


Are regulatory problems in infancy precursors of later hyperkinetic symptoms?

ACTA PAEDIATRICA, Issue 11 2004
K Becker
Aim: To examine whether regulatory problems in infancy predict later hyperkinetic symptoms in childhood and pre-adolescence. Methods: In a prospective longitudinal study of 319 children at risk of later developmental problems and psychopathology, hyperkinetic behaviour problems were assessed at the ages of 2, 4.5, 8 and 11 y by means of a standardized parent interview. Infant regulatory problems at the age of 3 mo were determined from multiple sources of information. An observational procedure was used to assess the quality of mother-infant interaction. Results: At the age of 3 mo, 17% of the infants (n= 55; 27 boys, 28 girls) suffered from multiple regulatory problems. Compared to a control group (n= 264), these children presented more hyperkinetic symptoms throughout childhood. Negativity in the mother-infant interaction and early family adversity each contributed to later hyperkinetic symptoms. When controlling for family adversity, the association between infant multiple regulatory problems and later hyperkinetic problems was rendered insignificant. Conclusions: These findings suggest that multiple regulatory problems may not be a key variable for later hyperkinetic problems. The impact of early family adversity factors clearly outweighed that of infant psychopathology on later behaviour disorder. [source]