Self-regulatory behaviors in children with Down syndrome and typically developing children measured using the Goodman Lock Box

Self-regulation has been identified as an area of difficulty for those with mental retardation. The Goodman Lock Box provides measures of two critical aspects of self-regulation-planfulness and maintenance of goal-directed behavior. In this study, the Lock Box performance of 25 children with Down syndrome was compared with that of 43 typically developing children, matched for mental age (24-36 months). Children in both groups showed similar levels of competence, planfulness and distractibility. However, children with Down syndrome displayed more task-avoidant behavior. Some issues related to the measurements obtained from the Lock Box are raised. (C) 2003 Elsevier Science Ltd. All rights reserved.

Reflections on the statistical analysis of personality and norms in war, peace, and prejudice: Are deviant minorities the problem?

The compelling quality of the Global Change simulation study (Altemeyer, 2003), in which high RWA (right-wing authoritarianism)/high SDO (social dominance orientation) individuals produced poor outcomes for the planet, rests on the inference that the link between high RWA/SDO scores and disaster in the simulation can be generalized to real environmental and social situations. However, we argue that studies of the Person × Situation interaction are biased to overestimate the role of the individual variability. When variables are operationalized, strongly normative items are excluded because they are skewed and kurtotic. This occurs both in the measurement of predictor constructs, such as RWA, and in the outcome constructs, such as prejudice and war. Analyses of normal linear statistics highlight personality variables such as RWA, which produce variance, and overlook the role of norms, which produce invariance. Where both normative and personality forces are operating, as in intergroup contexts, the linear analysis generates statistics for the sample that disproportionately reflect the behavior of the deviant, antinormative minority and direct attention away from the baseline, normative position. The implications of these findings for the link between high RWA and disaster are discussed.

The outcome in Australian children with hyperinsulinism of infancy: early extensive surgery in severe cases lowers risk of diabetes

AIMS Hyperinsulinism of infancy (HI) is characterized by unregulated insulin secretion in the presence of hypoglycaemia, often resulting in brain damage. Pancreatic resection for control of hypoglycaemia is frequently resisted because of the risk of diabetes mellitus (DM). We investigated retrospectively 62 children with HI from nine Australian treatment centres born between 1972 and 1998, comparing endocrine and neurological outcome in 28 patients receiving medical therapy alone with 34 who required pancreatic resection to control their hypoglycaemia. METHODS History, treatment and clinical course were ascertained from file audit and interview. Risk of DM (hazard ratio) attributable to age at surgery (< vs. greater than or equal to 100 days at last pancreatectomy) and extent of resection (< vs. greater than or equal to 95%) were calculated using Cox proportional hazards regression and categorical variables compared by the chi(2) -test. Neurological outcome (normal, mild deficit or severe deficit) was derived from the most authoritative source. RESULTS Surgically treated patients had a greater birthweight, earlier presentation and higher plasma insulin levels. Of 18 infants < 100 days and 16 greater than or equal to 100 days of age at surgery, four (all greater than or equal to 100 days) became diabetic as an immediate consequence of surgery and five (two < 100 days and three greater than or equal to 100 days) became diabetic 7-18 years later. Surgery greater than or equal to 100 days and pancreatectomy greater than or equal to 95% were associated with development of diabetes (HR = 12.61, CI 1.53-104.07 and HR = 7.03, CI 1.43-34.58, respectively). Neurodevelopmental outcome was no different between the surgical and medical groups with 44% overall with neurological deficits. Patients euglycaemic within 35 days of the first symptom of hypoglycaemia (Group A) had a better neurodevelopmental outcome than those still hypoglycaemic > 35 days from first presentation (Group B) (P = 0.007). Prolonged hypoglycaemia in Group B was due either to delayed diagnosis or to need for repeat surgery because of continued hypoglycaemia. Within Group A, medically treated patients (who presented later with apparently milder disease) had a higher incidence of neurodevelopmental deficit (n = 15, four mild, three severe deficit) compared with surgically treated patients (n = 18, two mild, none severe deficit) (P < 0.025). CONCLUSIONS Poor neurodevelopmental outcome remains a major problem in hyperinsulinism of infancy. Risk of diabetes mellitus with pancreatectomy varies according to age at surgery and extent of resection. Patients presenting early with severe disease have a better neurodevelopmental outcome and lower risk of diabetes if they are treated with early extensive surgery.

Serious lead poisoning in childhood: Still a problem after a century

Objective: To describe a series of patients with clinically significant lead poisoning. Methodology: A case series of nine patients with lead poisoning who required inpatient management, identified through a Clinical Toxicology Service. Results: Nine children presented with clinically significant lead poisoning. The median serum lead was 2.5 mumol/L (range 1.38-4.83). Eight of the children were exposed to lead-based paint, with seven due to dust from sanded lead paint during house renovations. Serial blood determinations suggested re-exposure in four of the patients, and in one of these patients the re-exposure was from a different source of lead. Eight of the patients required chelation therapy. Conclusions: Serious lead poisoning continues to occur and there appears to be complacency regarding the hazard posed by lead paint in old houses.

The prevalence of childhood obesity in primary school children in urban Khon Kaen, Northeast Thailand

Childhood obesity is a serious public health problem because of its strong association with adulthood obesity and the related adverse health consequences. The published literature indicates a rising prevalence of childhood obesity in both developed and developing countries. However no data exists on the prevalence in Northeast Thailand, one of the poorest regions of the country and one that has experienced a recent economic transition. The objective of this study was to estimate the prevalence of obesity in seven to nine year old children in urban Khon Kaen, Northeast Thailand. A cross-sectional school based survey was conducted to determine the prevalence of obesity in children of urban Khon Kaen, Thailand. Multi-staged cluster sampling was used to select 12 school clusters of 72 children each between the ages of 7 and 9 years, in primary school grades 1, 2 and 3 from government, private and demonstration schools. A total of 864 seven to nine year old school children were studied. Anthropometric measurements of standing height and weight were taken for all subjects to the nearest tenth of a centimetre and tenth of a kilogram respectively. Childhood obesity was defined as a weight-for-height Z-score above 2.0 standard deviations of the National Center for Health Statistics/World Health Organisation reference population median. The prevalence of childhood obesity was 10.8% (95% CI: 7.6, 13.9). Obesity was significantly more prevalent in boys than girls. The biggest difference was observed between the three school types, with the highest prevalence of obesity found at teacher training demonstration schools and the lowest at the government schools. This study provides the first data on childhood obesity prevalence in Northeast Thailand. The prevalence of 10.8 per cent is lower than that found in two other urban areas of Thailand but slightly higher than expected for this relatively poor region. If this prevalence rate increases, as observed in other countries in economic transition, the incidence of non-communicable diseases associated with obesity is also likely to increase, thus raising cause for concern and reason for intervention to both control and prevent obesity during childhood.

Cleaner fish use tactile dancing behavior as a preconflict management strategy

The most commonly asked question about cooperative interactions is how they are maintained when cheating is theoretically more profitable [1]. In cleaning interactions, where cleaners remove parasites from apparently cooperating clients, the classical question asked is why cleaner fish can clean piscivorous client fish without being eaten, a problem Trivers [2] used to explain reciprocal altruism. Trivers [2] suggested that predators refrain from eating cleaners only when the repeated removal of parasites by a particular cleaner results in a greater benefit than eating the cleaner. Although several theoretical models have examined cheating behavior in clients [3,4], no empirical tests have been done (but see Darcy [5]). It has been observed that cleaners are susceptible to predation [6, 7]. Thus, cleaners should have evolved strategies to avoid conflict or being eaten. In primates, conflicts are often resolved with conflict or preconflict management behavior [8]. Here, I show that cleaner fish tactically stimulate clients while swimming in an oscillating dancing manner (tactile dancing) more when exposed to hungry piscivorous clients than satiated ones, regardless of the client's parasite load. Tactile dancing thus may function as a preconflict management strategy that enables cleaner fish to avoid conflict with potentially dangerous clients.

Facilitating communication in children with multiple disabilities: three case studies of girls with Rett syndrome

Purpose: To investigate the effect of cueing on communicative responses of children with multiple disabilities in an educational setting. It was hypothesized that differences would exist in teacher interactional styles and the use of orienting cues would increase the communicative responses of the participants. Method: A naturalistic observation research method was employed in order to examine the interaction of three student-teacher dyads in three special schools. Three different activity types were videotaped from which interactions were coded and analysed. Results: Multi-modal cueing facilitated communicative responses of children with Rett syndrome. However, increased communication opportunities provided by caregivers did not elicit increased responses from the girls. Conclusion: There is a difference in cueing by teachers in their interactions with children with multiple disabilities. Also, more frequent communicative interactions did not necessarily lead to increased student responses. It is suggested that amount and type of cueing may need to be considered to be effective in generating student responses. The small number of participants, however, means findings should be viewed cautiously and that more research is indicated.

Seclusion use with children and adolescents: an Australian experience

Objective: To summarize the current state of knowledge on the use of seclusion and restraint with children and adolescents and to report the findings of an exploratory study to identify factors that place a child or adolescent at increased risk of seclusion during their admission. Method: Literature searches were undertaken on MEDLINE, CINAHL and PsycINFO databases. Articles were identified that focused specifically on seclusion and restraint use with children and adolescents or contained material significant to this population. The study reports findings from a retrospective review of patient charts, seclusion registers and staffing from an Australian acute inpatient facility. Results: The data available in regard to seclusion use in this population is limited and flawed. Further research is needed on the use and outcomes of seclusion and restraint and on alternative measures in the containment of dangerousness. Both the literature and this study find that patients with certain factors are at increased risk of being secluded during an inpatient stay. These factors include being male, diagnoses of disruptive behaviour disorder and a previous history of physical abuse. Staffing factors did not show a relationship to the use of seclusion. Conclusions: There are patient factors that predict increased risk of seclusion; these factors and their interrelationships require further elucidation. Further research is also needed on the outcomes, both positive and negative, of seclusion use and of alternatives to seclusion.

Parent management training and Asperger syndrome - A randomized controlled trial to evaluate a parent based intervention

This controlled trial of a parent management intervention aimed to increase parental competence in management of problem behaviours associated with Asperger syndrome. The intervention compared two formats, a 1 day workshop and six individual sessions. Measures were taken on three occasions: pre-intervention, at 4 weeks, and at 3 month follow-up. Variables of interest were number and intensity of problem behaviours, and parent evaluation of social interaction skills. Results showed parents reporting fewer and lower intensity of problem behaviours and increased social interactions at 4 weeks and 3 months. Results held across formats and suggest that parent management training can provide an effective intervention for parents of a child with Asperger syndrome. Group differences on outcome measures and in the use of strategies are discussed along with limitations of the study.

Ion beam modification and analysis of metal/polymer bi-layer thin films

A set of varying-thickness Au-films were thermally evaporated onto poly(styrene-co-acrylonitrile) thin film surfaces. The Au/PSA bi-layer targets were then implanted with 50 keV N+ ions to a fluence of 1 × 1016 ions/cm2 to promote metal-to-polymer adhesion and to enhance their mechanical and electrical performance. Electrical conductivity measurements of the implanted Au/PSA thin films showed a sharp percolation behavior versus the pre-implant Au-film thickness with a percolation threshold near the nominal thickness of 44 Å. The electrical conductivity results are discussed along with the film microstructure and the elemental diffusion/mixing within the Au/PSA interface obtained by scanning electron microscopy (SEM) and ion beam analysis techniques (RBS and ERD).

Community-based interventions for the prevention of burns and scalds in children

Background Burns and scalds are a significant cause of morbidity and mortality in children. Successful counter-measures to prevent burn and scald-related injury have been identified. However, evidence indicating the successful roll-out of these counter-measures into the wider community is lacking. Community-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to burn and scald injury in children. Objectives To assess the effects of community-based interventions, defined as coordinated, multi-strategy initiatives, for reducing burns and scalds in children aged 14 years and under. Search strategy We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, National Research Register and the Web of Knowledge. We also handsearched selected journals and checked the reference lists of selected publications. The searches were last updated in May 2007. Selection criteria Included studies were those that reported changes in medically attended burn and scald-related injury rates in a paediatric population (aged 14 years and under), following the implementation of a controlled community-based intervention. Data collection and analysis Two authors independently assess studies for eligibility and extracted data. Due to heterogeneity between the included studies, a pooled analysis was not appropriate. Main results Of 39 identified studies, four met the criteria for inclusion. Two of the included studies reported a significant decrease in paediatric burn and scald injury in the intervention compared with the control communities. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities. Authors' conclusions There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children. It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.

Getting the run around: accessing services for children with developmental co-ordination disorder

Background Accessing services for children with developmental co-ordination disorder (DCD) is frequently difficult for parents who have to navigate both health and education systems to find a diagnosis and appropriate interventions. Method A qualitative study design incorporating a phenomenological perspective was utilized to understand the nature of the experiences of these parents in attempting to access support for their children with DCD. Twelve parents, whose children attended the Kids Skills Clinic at the University of Western Ontario and were identified as having DCD, were interviewed by the second author. Interviews were transcribed verbatim and analysed using constant comparative method. Member checking, peer checking and code-recoding were carried out to enhance rigour in data analysis. Results A number of themes emerged focusing on the common problems experienced leading to occupational therapy referral. Parents' journeys to seek and access services for their children with DCD were characterized by a sense of maternal knowing, experience of frustration, trivialization of the problem, a sense of 'going it alone', and 'getting the run around'. Conclusions Implications for health and educational professionals working with children, in terms of recognition of DCD and referral for services, are described.

Vitamin A intake and factors influencing it amongst children and caretakers in Kosrae, Micronesia

A cross-sectional study was undertaken in Kosrae, Federated States of Micronesia to assess preschool children and caretaker dietary intake of vitamin A (VA) (including provitamin A carotenoids) and other nutrients contributing to VA status and to investigate relationships between VA intake and factors affecting dietary intake. Ethnography, food sample analysis, two dietary assessment methods (7-day food frequency questionnaire and quantitative 24-hour recall for three nonconsecutive days) administered by trained interviewers to a random sample group, and cultivar difference specification (yellow-fleshed versus white-fleshed bananas) contributed to the richness of the study. Vitamin A intake was low, approximately half of the estimated requirements for children (n = 65) and caretakers (n = 65), whereas protein intake was high. There were no clear significant relationships associated with gender, caretaker education, caretaker occupation, and socio-economic status with VA intake, indicating that a broad-based intervention over all population segments is needed to change dietary behavior, The ethnographic approach was critical for survey instrument development and data analysis.

Asthma and internalizing behavior problems in adolescence: A longitudinal study

Objective: Clinical studies of asthmatic children have found an association between lung disease and internalizing behavior problems. The causal direction of this association is, however, unclear. This article examines the nature of the relationship between behavior and asthma problems in childhood and adolescence. Methods: Data were analyzed on 5135 children from the Mater University Study of Pregnancy and its outcomes (MUSP), a large birth cohort of mothers and children started in Brisbane, Australia, in 1981. Lung disease was measured from maternal reports of asthma/bronchitis when the children were aged 5 and maternal reports of asthma symptoms when the children were aged 14. Symptoms of internalizing behaviors were obtained by maternal reports (Child Behavior Checklist) at 5 years and by maternal and children's reports at 14 years (Child Behavior Checklist and Youth Self Report). Results: Although there was no association between prevalence of asthma and externalizing symptoms, asthma and internalizing symptoms were significantly associated in cross-sectional analyses at 5 and 14 years. In prospective analyses, after excluding children with asthma at 5 years, internalizing symptoms at age 5 were not associated with the development of asthma symptoms at age 14. After excluding children with internalizing symptoms at 5 years, those who had asthma at 5 years had greater odds of developing internalizing symptoms at age 14. Conclusion: Children who have asthma/bronchitis by the age of 5 are at greater risk of having internalizing behavior problems in adolescence.

Application of the cross-entropy method to the buffer allocation problem in a simulation-based environment

The buffer allocation problem (BAP) is a well-known difficult problem in the design of production lines. We present a stochastic algorithm for solving the BAP, based on the cross-entropy method, a new paradigm for stochastic optimization. The algorithm involves the following iterative steps: (a) the generation of buffer allocations according to a certain random mechanism, followed by (b) the modification of this mechanism on the basis of cross-entropy minimization. Through various numerical experiments we demonstrate the efficiency of the proposed algorithm and show that the method can quickly generate (near-)optimal buffer allocations for fairly large production lines.