bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for language delay in the United Arab Emirates
Authors: Eapen V. , Zoubeidi T. , Yunis F. 
Published: August 2004

AbstractBackground  Developmental language delay (DLD) is frequent among two‐ and three‐year‐olds but little is known about this condition in the Arabian Peninsula. This paper forms part of a multipurpose community psychiatric survey conducted in the United Arab Emirates (UAE). The findings regarding the prevalence and psychosocial correlates of DLD are reported here.Methods  A total of 694 children, representative of the UAE 3‐year‐old population were screened using the Denver Developmental Screening Test (DDST) and the language screening procedure as used by Westerlund and Sundelin.Results  Of the 694 children screened for DLD at 3 years of age, 69 children (9.9%; CI 7.8–12.4) were found to have delays in the language sector of DDST. A total of 45 (6.5%; CI 4.3–8.7) were identified as having general language disability, both in comprehension and expression as per the language screening procedure. Language delay was found to be associated with rural living, mother being from a different nationality, non‐involvement of domestic help in child care, family history of language delay, obstetric and perinatal problems and presence of behavioural problems in the child. Using stepwise multiple logistic regression analysis, two factors emerged as important with regard to general language delay, which were previous non‐UAE nationality of the mother and total monthly income of the family.Conclusion  The pattern and correlates of DLD found in this survey are in line with those reported by other surveys, but some unique socio‐cultural risk factors specific to this community were identified. The implications of these findings to screening and referral for further evaluation and intervention are discussed.
Quality of motor performance in preterm and full‐term 3‐year‐old children
Authors: Hemgren E. , Persson K. 
Published: August 2004

AbstractBackground  A combined assessment of motor performance and behaviour (CAMPB) was introduced previously for use in a longitudinal study of children who needed neonatal intensive care (NIC) and were born very preterm (n = 68), moderately preterm (n = 81) and full‐term (n = 77) and in a reference group of neonatally healthy full‐term children (n = 72).Aim  To follow up the quality of motor performance at 3 years of age in the above groups of children.Method  A detailed assessment of motor performance and an assessment of co‐ordination were performed according to the CAMPB protocol. The results were compared between the different groups of children, and the relation between the two ways of assessing quality of motor performance was examined.Results  The detailed assessment showed that the very preterm children had a significantly higher total score of deviations than any of the other gestational age groups of children. Also, some types of deviations were much more frequently observed in the very preterm children than in the other three groups. Some types of deviations were more often seen in children with pronounced incoordination than in children with no incoordination. The results from the two ways of assessing motor performance were strongly correlated.Conclusion  At 3 years of age, NIC children born very preterm have a lower quality of motor performance than NIC children born at a higher gestational age and healthy children born at term. The two ways of assessing quality of motor performance proved useful in identifying children with deviations indicating minor motor impairments.
Good practices that address continuity during transition from child to adult care: synthesis of the evidence
Authors: While A. , Forbes A. , Ullman R. , Lewis S. , Mathes L. , Griffiths P. 
Published: August 2004

AbstractBackground  Effective transition to adult services is required by an increasing number of children with ongoing needs.Aim  To identify practices that promote continuity at transition between child and adult services.Methods  Systematic examination of the evidence from two search strategies yielding 5319 items.Results  Only three of the 126 appraised items had strong external validity. A large range of different practices, which focused on the service, the young person and the family, were identified. Practices within the service addressed structural, process and outcome components.Conclusion  Four transition models are proposed for testing.
Evaluating children's rehabilitation services: an application of a programme logic model
Authors: Stewart D. , Law M. , Russell D. , Hanna S. 
Published: August 2004

AbstractObjectives  To apply a programme logic model to evaluate the effectiveness of a new therapy service for children with special needs who were in transition from pre‐school to kindergarten.Setting  A children's outpatient rehabilitation centre in Ontario, Canada.Main outcomes  The short‐term outcomes included parents’ perceptions of the transition process itself and the information they required, the children's skill development for the transition to kindergarten, and parents’ perceptions of services and satisfaction with resources.Methods  A combination of quantitative methods [Goal Attainment Scaling (GAS), Measure of Processes of Care (MPOC), Client Satisfaction Questionnaire (CSQ)] and qualitative interviews were used to evaluate both the process (‘Outputs’) and outcomes (‘Short‐term objectives’) of the new therapy service.Results  The children involved in the evaluation met or exceeded goals that were set by therapists and parents. Parents’ perceptions of, and satisfaction with, the new service were higher than the provincial average. Qualitative data from interviews with parents and service providers supported the findings from standardized measures, and provided suggestions for future service delivery.Conclusions  The programme logic model provided researchers and service providers a collaborative and systematic approach to conducting programme evaluation in a relatively short‐time frame. It appears to be a useful option for evaluation of other children's services.
Provision for children with developmental co‐ordination disorder (DCD): audit of the service provider
Authors: Peters J. M. , Henderson S. E. , Dookun D. 
Published: August 2004

AbstractBackground  The aim of this study was to conduct an audit of parent/carer satisfaction with the service provided for children presenting with movement difficulties [developmental co‐ordination disorder (DCD)/dyspraxia] at the out‐patient physiotherapy clinic of a specialist tertiary referral paediatric hospital.Method  A postal questionnaire was used to obtain objective and subjective data on the service offered. Factual information on aspects such as waiting time for first appointment, type of intervention offered, etc. was checked against clinical records. Satisfaction with the service was assessed using ratings and open‐ended comment.Results  Forty‐five families completed the questionnaire. The results showed that the service was generally rated highly. The opportunity to discuss the child's problems and its implications was considered valuable. Among families offered 1 : 1 intervention, a statistically significant correlation emerged between the number of sessions attended and perceived effectiveness. Among families offered a home programme, perceived effectiveness was related to the number of times per week the child practised the programme.Conclusions  This study showed that many children from mainstream schools with co‐ordination problems continued to find it difficult to obtain a clear diagnosis. Once a referral and assessment had been achieved, however, parents/carers were shown to be satisfied with the package offered by this service provider.
Gender in discourse behaviour in parent–child dyads: a literature review
Authors: Lanvers U. 
Published: August 2004

AbstractBackground  This literature review on gender differences in child–parent interaction links two types of research bodies gathered over the last decades, on the one hand early between‐child and within‐child differences, and, on the other hand, parental discourse differences with children.Method  Relevant individual studies, as well as two meta‐analyses investigating gender in child–parent dyadic interaction, are evaluated, addressing differences in parental gender and child gender, early evidence of child gender differences in discourse, and child adaptations to interlocutors in general. Methodological problems of data gathering of both child and parental language are discussed, as well as the logical caveats of linking input to acquisition patterns.Result  The findings allow no final conclusion regarding the issue of early gender socialization through language but indicate two contrasting hypotheses concerning the importance of early gendered linguistic interaction.Conclusion  The paper concludes with a discussion of research designs which might allow further differentiation between existing theoretical accounts of early gender socialization through language.
National survey of Patient Advice and Liaison Services (PALS) in England: children, young people and parents’ access to and use of PALS
Authors: Heaton J. , Sloper P. 
Published: August 2004

AbstractBackground  Patient Advice and Liaison Services (PALS) have been set up in the National Health Service (NHS) in England to enable patients and the public to access information and raise issues they are concerned about their health care. The aim of this study was to examine to what extent, and how, PALS have promoted children’s, young people's and parents’ access to and use of the service.Methods  A postal questionnaire was sent to PALS in 553 NHS Trusts and Primary Care Trusts (PCTs). PALS in Ambulance Trusts, and Specialist Trusts that were known not to provide services for children and young people, were excluded.Results  Questionnaires were returned by 320 respondents representing 369 trusts – a response rate of 67%. Seventy‐seven responses were not valid, giving a final sample of 243 PALS. This included 122 PALS serving PCTs, 101 serving NHS Trusts, 15 serving a mix of both PCTs and NHS Trusts, and five serving children's hospitals. The responses suggest that, to date, most PALS have been developed as a generic service, with some making special efforts to target specific groups of patients and sections of the public. However, where such efforts have been made, they have tended to focus most of all on older people and least of all on children.Conclusions  PALS are intended to serve all sections of the community and accordingly need to be developed in ways that ensure the service is accessible to hard‐to‐reach groups such as children and young people. The remainder of the research will examine children, young people and parents’ perspectives on how PALS can involve them, and will provide associated guidelines for trusts.
Primary care clinicians’ use of standardized psychiatric diagnoses
Authors: Gardner W. , Kelleher K. J. , Pajer K. A. , Campo J. V. 
Published: August 2004

AbstractObjective  Treatment of child mental health (MH) problems should be informed by psychiatric diagnosis. Whether primary care clinicians (PCCs) use standardized psychiatric diagnostic criteria to direct the treatment of child MH problems is unknown. This study investigated PCCs’ use of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria during office visits.Methods  The data were obtained from 3674 children ages 4–15 years who were recognized as having one or more MH problems during office visits by clinicians participating in the Child Behaviour Study. Parents completed questionnaires before seeing the clinician. Clinicians completed a survey after the visit. The primary outcome was whether PCCs used standardized criteria to generate a diagnosis for children with recognized MH problems.Results  Clinicians used DSM criteria in 23% of visits in which a psychosocial problem was recognized, and 57% of PCCs reported no use of DSM. DSM criteria were used most frequently (38% of visits) when PCCs reported attention problems. Medications were much more likely to be prescribed during visits when PCCs diagnosed using DSM criteria (63% of visits vs. 19% when criteria were not used). However, only 51% of psychotropic medication prescriptions were based on a DSM diagnosis.Conclusions  Clinicians used standardized criteria infrequently, and primarily to diagnose attention problems.
Learning and behavioural difficulties but not microcephaly in three brothers resulting from undiagnosed maternal phenylketonuria
Authors: Shaw‐Smith C. , Hogg S. L. , Reading R. , Calvin J. , Trump D. 
Published: August 2004

AbstractUniversal screening introduced in the 1960s has reduced the incidence of learning disability resulting from phenylketonuria (PKU), which is a treatable condition. Nonetheless, PKU may still be having an impact on the paediatric‐age population. We report a woman with previously undiagnosed PKU who was born before the onset of universal screening. She is of normal intelligence, and so the diagnosis was not suspected until after the birth of her three children. Her serum phenylalanine concentration was found to be in excess of 1 mmol/L, well into the toxic range. She has had three sons, all of whom have a significant degree of learning disability resulting from intrauterine exposure to toxic levels of phenylalanine. None of the sons had microcephaly, a physical sign that, if present, might have helped to point towards the correct diagnosis. We suggest that maternal PKU should be suspected where there is sibling recurrence of cognitive impairment, particularly where the mother was born before the initiation of the neonatal screening programme for PKU.
A national evaluation of school breakfast clubs: evidence from a cluster randomized controlled trial and an observational analysis
Authors: Shemilt I. , Harvey I. , Shepstone L. , Swift L. , Reading R. , Mugford M. , Belderson P. , Norris N. , Thoburn J. , Robinson J. 
Published: August 2004

AbstractStudy objective  To measure the health, educational and social impacts of breakfast club provision in schools serving deprived areas across England.Design  A cluster randomized controlled trial and an observational analysis.Setting  England, the UK. Intervention: funding to establish a school‐based breakfast club vs. control (no funding).Main results  Intention to treat analysis showed improved concentration (Trail Making Test Part A) amongst the intervention group at 3 months. Fewer pupils within the intervention group reported having skipped classes within the last month and fewer pupils within the intervention group reported having skipped 1 or more days of school within the last month at 1 year. Observational analysis at 1 year showed a higher proportion of primary‐aged breakfast club attendees reported eating fruit for breakfast in comparison to non‐attendees. A higher proportion of breakfast club attendees had borderline or abnormal conduct and total difficulties scores (primary‐aged pupils) and prosocial score (secondary‐aged pupils).Conclusions  Analyses revealed a mixed picture of benefit and apparent disbenefit. This study illustrated the challenges of evaluating a complex intervention in which the evaluators had less control than is usual in randomized trials over recruitment, eligibility checking and implementation. If the impact of new policy initiatives is to be assessed using the most robust forms of evaluation, social policy needs to be organized so that evaluations can be constructed as experiments. This is likely to prove most difficult where the perceived value of implementing an intervention rapidly is high.
A national evaluation of school breakfast clubs: where does economics fit in?
Authors: Shemilt I. , Mugford M. , Moffatt P. , Harvey I. , Reading R. , Shepstone L. , Belderson P. 
Published: August 2004

AbstractStudy objective  To describe the economics of UK school breakfast clubs, to estimate costs resulting from clubs and to investigate relationships between costs and outcomes.Design  A postal survey of schools with a 1‐year follow‐up, a cluster randomized controlled trial, case studies, semi‐structured interviews with parents and a secondary econometric analysis.Setting  England, the UK.Main results  Key economic differences were identified between clubs based in primary schools and those based in secondary schools in terms of both funding levels and cost structures. However, funding levels were not a significant determinant of the observed outcomes in either type of school.Conclusions  For formal economic evaluation to succeed during implementation of a new initiative, a clearer understanding of relevant outcomes and the distinction between short‐ and long‐term outcomes and potential individual, institutional and societal benefits are required from an early stage.
CD40–CD154 interactions between macrophages and natural killer cells during sepsis are critical for macrophage activation and are not interferon gamma dependent
Authors: SCOTT M J , HOTH J J , STAGNER M K , GARDNER S A , PEYTON J C , CHEADLE W G 
Published: August 2004

SUMMARYNatural killer (NK) cell interactions with macrophages have been shown to be important during bacterial sepsis in activating macrophages to improve bacterial clearance. The mechanism for this increased activation, however, is unclear. This study determines the relative roles of interferon (IFN)-γ and CD40/CD154 direct cell interactions on macrophage and NK cell activation in an experimental model of sepsis. Splenic NK cells and peritoneal macrophages were isolated and cultured alone or in coculture, with and without LPS. CD69 expression on NK cells, phagocytosis ability of macrophages, and cell cytokine production was assessed at 24 and 48 h. Coculture of NK cells and macrophages significantly increased activation levels of both cell types, and through experiments culturing NK cells with supernatants from stimulated macrophages and macrophages with supernatants from stimulated NK cells, this activation was determined to be cell-contact-dependent. Similar experiments were conducted using NK cells from IFN-γ deficient (–/–) mice, as well as anti-IFN-γ neutralizing antibody. These experiments determined that IFN-γ is not required for NK or macrophage activation, although it did augment activation levels. Experiments were again repeated using peritoneal macrophages from CD40-/– mice or splenic NK cells from CD154-/– mice. CD40/CD154 interactions were important in the ingestion of bacteria by macrophages, but did not affect NK cell activation at 24 h. There was, however, a protective effect of CD40/CD154 interactions on NK cell activation-induced cell death that occurred at 48 h. CD40/CD154 interactions between macrophages and NK cells are therefore important in macrophage phagocytosis, and are not dependent on IFN-γ.
Decreased interferon-αproduction and impaired T helper 1 polarization by dendritic cells from patients with chronic hepatitis C
Authors: MURAKAMI H , AKBAR S M F , MATSUI H , HORIIKE N , ONJI M 
Published: August 2004

SUMMARYPatients with chronic hepatitis C (CHC) are unable to prime and maintain vigorous T cell responses that are initiated during the acute phase of hepatitis C virus (HCV) infection. As dendritic cells (DCs) induce and regulate both innate and adaptive immune responses, the aim of this study was to analyse two critical functions of DCs: firstly, production of interferon (IFN)-α and, secondly, polarization of T helper 1 lymphocytes. The frequencies of plasmacytoid DC (PDC) and myeloid DC (MDC) were estimated in 63 patients with CHC and 34 normal controls using four-colour flow cytometry. Circulating DCs were isolated from peripheral blood of CHC patients (n = 10) and normal controls (n = 10). These DCs were cultured with herpes simplex virus-1 to evaluate their capacity to produce IFN-α. The capacity of DCs to induce polarization of autologous naive CD4+ T lymphocytes to IFN-γ-producing effector T lymphocytes was also assessed. The frequencies of PDCs producing intracellular IFN-α (P &lt; 0·01) and the levels of IFN-α in culture supernatant of PDCs (P &lt; 0·01) were significantly lower in patients with CHC compared to those of normal controls. The numbers of MDC were significantly lower in patients with CHC (8·2 (6·0)/µl, median (interquartile range), n = 63) compared to normal control (11·7 (7·8)/µl, n = 34) (P &lt; 0·01). Moreover, DCs from patients with CHC induced significantly lower numbers of IFN-γ-producing effector T lymphocytes compared to that of controls (P &lt; 0·01). This study indicates that the low IFN-α-producing capacity and impaired T helper 1 polarization ability of DCs from patients with CHC might be responsible for the typical low anti-HCV immune responses in these patients.
Correlation of virulence, lung pathology, bacterial load and delayed type hypersensitivity responses after infection with different Mycobacterium tuberculosis genotypes in a BALB/c mouse model
Authors: DORMANS J , BURGER M , AGUILAR D , HERNANDEZ-PANDO R , KREMER K , ROHOLL P , AREND S M , VAN SOOLINGEN D 
Published: August 2004

SUMMARY
One of the most intriguing aspects of tuberculosis is that the outcome of an infection with M. tuberculosis (TB) is highly variable between individuals. The possibility of differences in virulence between M. tuberculosis strains or genotypes has only recently been studied. There is evidence of multifactorial genetic predisposition in humans that influences the susceptibility to tuberculosis. A better understanding of differences in virulence between M. tuberculosis genotypes could be important with regard to the efforts at TB control and the development of improved antituberculosis vaccines. Survival, lung pathology, bacterial load and delayed type hypersensitivity (DTH) responses of BALB/c mice after intratracheal infection with any of 19 different M. tuberculosis complex strains of 11 major genotype families were studied. The results indicate that among genetically different M. tuberculosis strains a very broad response was present with respect to virulence, pathology, bacterial load and DTH. ‘Low’-responders were the H37Rv, Canetti, Beijing-1 strains, while Beijing-2,3, Africa-2 and Somalia-2 strains were ‘high’-responders. A severe pathological response correlates with a high mortality and a high CFU counts in lungs, but poorly with the degree of the DTH response.