Long-term course of lung clearance index between infancy and school-age in cystic fibrosis subjects

Multiple breath washout (MBW) measurements have recently been shown to be sensitive for detection of early cystic fibrosis (CF) lung disease, with the lung clearance index (LCI) being the most common measure for ventilation inhomogeneity. The aim of this observational study was to describe the longitudinal course of LCI from time of clinical diagnosis during infancy to school-age in eleven children with CF. Elevated LCI during infancy was present in seven subjects, especially in those with later clinical diagnosis. Tracking of LCI at follow-up was evident only in the four most severe cases. We provide the first longitudinal data describing the long-term course of LCI in a small group of infants with CF. Our findings support the clinical usefulness of MBW measurements to detect and monitor early lung disease in children with CF already present shortly after clinical diagnosis.

Effect of bacterial filter on measurement of interrupter resistance in preschool and school-aged children

BACKGROUND: The interrupter technique is increasingly used in preschool children to assess airway resistance (Rint). Use of a bacterial filter is essential for prevention of cross-infection in a clinical setting. It is not known how large an effect this extra resistance and compliance exert upon interrupter measurements, especially on obstructive airways and in smaller children. We aim to determine the contribution of the filter to Rint, in a sample of children attending lung function testing at an asthma clinic. METHODS: Interrupter measurements were performed according to ATS/ERS guidelines during quiet normal breathing at an expiratory flow trigger of 200 ml s(-1), with the child seated upright with cheeks supported and wearing a nose clip. A minimum of 10 interrupter measurements was made with and without a bacterial filter. Spirometric and plethysmographic tests were also performed. RESULTS: A small but significant difference (0.12 (95% CI 0.06-0.17) kPa s L(-1), P = 0.0002) with 2x SD of 0.34 kPa s L(-1) was observed between Rint with and without filter in 39 children, with a large spread. This difference was not dependent on Rint magnitude, age or height, nor on lung function parameters (effective resistance, forced expiratory volume in 1 sec, and maximal expiratory flow at 50% of expired vital capacity). CONCLUSIONS: A bacterial filter causes a small difference but is not clinically significant, with a wide spread comparable to the variability of the technique and recommended cut-offs for assessing repeatability and bronchodilation. Age, height or severity of obstruction need not be corrected for in general.

Modular training in vascular and endovascular surgery exemplified by the Vascular International Foundation and School

The partial shift from patient to model is a reasonable and necessary paradigm shift in surgery in order to increase patient safety and to adapt to the reduced training time periods in hospitals and increased quality demands. Since 1991 the Vascular International Foundation and School has carried out many training courses with more than 2,500 participants. The modular build training system allows to teach many open vascular and endovascular surgical techniques on lifelike models with a pulsatile circulation. The simulation courses cannot replace training in operating rooms but are suitable for supporting the cognitive and associative stages for achieving motor skills. Scientific evaluation of the courses has continually shown that the training principle established since 1991 can lead to significant learning success. They are extremely useful not only for beginners but also for experienced vascular surgeons. They can help to shorten the learning curve, to learn new techniques or to refine previously used techniques in all stages of professional development. Keywords Advanced training · Advanced training regulations · Training model · Vascular International · Certification

High-school students' need for cognition, self-control capacity, and school achievement: testing a mediation hypothesis

In the present article, we examine the hypothesis that high-school students' motivation to engage in cognitive endeavors (i.e., their need for cognition; NFC) is positively related to their dispositional self-control capacity. Furthermore, we test the prediction that the relation between NFC and school achievement is mediated by self-control capacity. A questionnaire study with grade ten high-school students (N = 604) revealed the expected relations between NFC, self-control capacity, and school achievement. Sobel tests showed that self-control capacity mediated the relation between NFC and school grades as well as grade retention.

University and school students' motivation for effortful thinking: Factor structure, reliability, and validity of the German Need for Cognition Scale

Need for cognition (NFC) reflects a relatively stable trait regarding the degree to which one enjoys and engages in cognitive endeavors. We examined whether the previously demonstrated one-dimensional structure of the German NFC Scale could be replicated in three samples of undergraduates and secondary school students. Moreover, we investigated the test-retest reliability of the German NFC Scale, which has not yet been tested. Further, we investigated whether the scale would be valid in a sample of secondary school students. Multigroup confirmatory factor analyses established the one-dimensional factor structure of the long form as well as the short form of the German NFC Scale for undergraduates (N = 559), students of academic track secondary schools (German Gymnasium; N = 555), and students of vocational track secondary schools (German Realschule; N = 486). The scale proved to have a high test-retest reliability in a university student sample (N = 43). For secondary school students, we again found a high test-retest reliability (N = 157), and also found the scale to be valid (N = 181).