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Sample records for early years centres

  1. The Child at the Centre: Self-Evaluation in the Early Years

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2007

    2007-01-01

    This revised edition of "The Child at the Centre" replaces all previous versions. Along with a revised edition of "How good is our school?," this document forms the third part of "How good is our school? The Journey to Excellence." Early education centres are now part of a wider partnership of professionals, all of…

  2. Early cardioversion of atrial fibrillation and atrial flutter guided by transoesophageal echocardiography: a single centre 8.5-year experience.

    PubMed

    Corrado, G; Santarone, M; Beretta, S; Tadeo, G; Tagliagambe, L M; Foglia-Manzillo, G; Spata, M; Miglierina, E; Acquati, F; Santarone, M

    2000-04-01

    To analyse the safety and impact on maintenance of sinus rhythm of transoesophageal echocardiographically guided early cardioversion associated with short-term anticoagulation in a large series of patients with atrial fibrillation and atrial flutter. Patients who were candidates for cardioversion were eligible for inclusion if they had atrial fibrillation or atrial flutter lasting longer than 2 days or of unknown duration. Patients received short-term anticoagulation with warfarin or heparin and underwent transthoracic echocardiography followed by transoesophageal echocardiography. Early cardioversion was performed if no thrombus was seen on the transoesophageal study. Warfarin was maintained for 1 month after cardioversion. In patients with atrial thrombi, cardioversion was deferred and prolonged anticoagulation was prescribed. The study population included 183 patients. One hundred and sixty nine patients without atrial thrombi underwent early cardioversion. Fourteen patients with atrial thrombi (7.6%) underwent a second transoesophageal echocardiogram after a median of 4 weeks of oral warfarin, and cardioversion was performed if clot regression was documented. No patient in our study population had a clinical thromboembolic event at 1 month follow-up (95% C.I. 0-0.016). The immediate success rate of cardioversion was better among patients with atrial fibrillation < 4 weeks duration compared with patients with atrial fibrillation of longer or of unknown duration: 96.6% vs 85%, respectively (P = 0.014). At 1 month follow-up, the percentage of arrhythmia relapses in patients with initially successful cardioversion was similar in the two groups (29% vs 26%, P = ns); thus the initial better outcome in patients with recent-onset arrhythmia was not lost. Transoesophageal echocardiography-guided early cardioversion in concert with short-term anticoagulation is safe. This approach permits abbreviation of the overall duration of atrial fibrillation and has a better impact

  3. Leading and Managing in the Early Years: A Study of the Impact of a NCSL Programme on Children's Centre Leaders' Perceptions of Leadership and Practice

    ERIC Educational Resources Information Center

    Ang, Lynn

    2012-01-01

    Research has shown that the quality of early years provisions is directly linked to the quality of leadership and management of early years settings. The extant research also shows that the quality of preschool settings are almost always characterised by strong leadership, where leaders and practitioners share a clear vision of the setting's…

  4. Early Years Centres for Pre-School Children with Primary Language Difficulties: What Do They Cost, and are They Cost-Effective?

    ERIC Educational Resources Information Center

    Law, J.; Dockrell, J. E.; Castelnuovo, E.; Williams, K.; Seeff, B.; Normand, C.

    2006-01-01

    Background: High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children's needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about…

  5. A SDMS Model: Early Warning Coordination Centres

    NASA Astrophysics Data System (ADS)

    Santos-Reyes, Jaime

    2010-05-01

    Following the tsunami disaster in 2004, the General Secretary of the United Nations (UN) Kofi Annan called for a global early warning system for all hazards and for all communities. He also requested the ISDR (International Strategy fort Disaster Reduction) and its UN partners to conduct a global survey of capacities, gaps and opportunities in relation to early warning systems. The produced report, "Global survey of Early Warning Systems", concluded that there are many gaps and shortcomings and that much progress has been made on early warning systems and great capabilities are available around the world. However, it may be argued that an early warning system (EWS) may not be enough to prevent fatalities due to a natural hazard; i.e., it should be seen as part of a ‘wider' or total system. Furthermore, an EWS may work very well when assessed individually but it is not clear whether it will contribute to accomplish the purpose of the ‘total disaster management system'; i.e., to prevent fatalities. For instance, a regional EWS may only work if it is well co-ordinated with the local warning and emergency response systems that ensure that the warning is received, communicated and acted upon by the potentially affected communities. It may be argued that without these local measures being in place, a regional EWS will have little impact in saving lives. Researchers argued that unless people are warned in remote areas, the technology is useless; for instance McGuire [5] argues that: "I have no doubt that the technical element of the warning system will work very well,"…"But there has to be an effective and efficient communications cascade from the warning centre to the fisherman on the beach and his family and the bar owners." Similarly, McFadden [6] states that: "There's no point in spending all the money on a fancy monitoring and a fancy analysis system unless we can make sure the infrastructure for the broadcast system is there,"… "That's going to require a lot

  6. Creativity: The Early Years

    ERIC Educational Resources Information Center

    Shade, Rick; Shade, Patti Garrett

    2016-01-01

    There is a myth that some people are creative and others are not. However, all children are born creative. They love to explore, ask questions, and are incredibly imaginative. Parents are key in nurturing their child's creativity in the early years. This article offers resources and strategies parents can use at different ages and stages (newborn,…

  7. Understanding Early Years Policy

    ERIC Educational Resources Information Center

    Baldock, Peter; Fitzgerald, Damien; Kay, Janet

    2005-01-01

    The book is about policy in the area of early years services and that phrase may need some clarification. For the most part, therefore, this book deals with nursery schools and classes and with services provided by full day care nurseries, pre-schools, creches, childminders, after-school clubs and holiday play schemes. This book begins with…

  8. PHOBOS, the Early Years

    NASA Astrophysics Data System (ADS)

    Stephans, George S. F.; Back, B. B.; Baker, M. D.; Barton, D. S.; Betts, R. R.; Ballintijn, M.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; Garcia, E.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Holynski, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Michalowski, J.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steadman, S. G.; Steinberg, P.; Stephans, G. S. F.; Stodulski, M.; Sukhanov, A.; Tang, J.-L.; Teng, R.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Wadsworth, B.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wuosmaa, A. H.; Wyslouch, B.

    2002-06-01

    The PHOBOS detector, one of the two small experiments at RHIC, focuses on measurements of charged particle multiplicity over almost the full phase space and identified particles near mid-rapidity. Results will be presented from the early RHIC gold--gold runs at nucleon--nucleon center of mass energies of 56 and 130 GeV as well as the recently concluded run at the full RHIC energy of 200 GeV.

  9. Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

    PubMed

    Morris, N; Campbell, J; Biro, M A; Lumley, J; Rao, J; Spensley, J

    1986-06-09

    A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

  10. Perceived, Expressed and Observed Prosociality among Four-Year-Old Girls and Boys in Childcare Centres

    ERIC Educational Resources Information Center

    Bouchard, Caroline; Coutu, Sylvain; Bigras, Nathalie; Lemay, Lise; Cantin, Gilles; Bouchard, Marie-Claire; Duval, Stéphanie

    2015-01-01

    This article examines the prosociality of four-year-old girls and boys in childcare centres. More specifically, it aims to measure gender differences in prosociality among children, based on three sources and methods of evaluation: (1) the early childhood educator's (ECE) perception (perceived prosociality), (2) the children's own responses to…

  11. EARLY: a pilot study on early diagnosis of atrial fibrillation in a primary healthcare centre.

    PubMed

    Benito, Luisa; Coll-Vinent, Blanca; Gómez, Eva; Martí, David; Mitjavila, Joan; Torres, Ferran; Miró, Òscar; Sisó, Antoni; Mont, Lluís

    2015-11-01

    Atrial fibrillation (AF) is associated with high morbidity and mortality. Early diagnosis is likely to improve therapy and prognosis. The study objective was to evaluate the usefulness of a programme for early diagnosis of AF in patients from an urban primary care centre. Participants were recruited from a randomized sample of patients not diagnosed with AF but having relevant risk factors: age ≥ 65 years, ischaemic and/or valvular heart disease, congestive heart failure, hypertension, and/or diabetes. Patients were randomly assigned to the intervention group (IG) or control group (CG). The intervention included (i) initial visit with clinical history, electrocardiogram, and instruction about pulse palpation and warning signs and (ii) electrocardiogram every 6 months during a 2-year follow-up. The main endpoint of the study was the proportion of new cases diagnosed at 6 months. Secondary endpoints were number of new AF diagnoses and complications associated with the arrhythmia in both groups. A total of 928 patients were included (463 IG and 465 CG). At 6 months, AF was diagnosed in 8 IG patients and 1 CG patient (1.7 vs. 0.2%, respectively, P = 0.018). After 2 years of follow-up, 11 IG patients and 6 CG patients had newly diagnosed AF (2.5 vs. 1.3%, respectively, P = 0.132). Time to first diagnosis of AF was shorter in IG patients [median (inter-quartile range): 7 (192) days vs. 227 (188.5) days in CG, P = 0.029]. The simple screening proposed could be useful for the early detection of AF in primary care. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  12. Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study.

    PubMed

    Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H

    2017-03-01

    To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.

  13. Early Intervention Services for Early-Phase Psychosis - Centre for integrative psychiatry in Psychiatric Hospital "Sveti Ivan", Croatia.

    PubMed

    Matić, Katarina; Gereš, Natko; Gerlach, Josefina; Prskalo-Čule, Diana; Zadravec Vrbanc, Tihana; Lovretić, Vanja; Librenjak, Dina; Vuk Pisk, Sandra; Ivezić, Ena; Šimunović Filipčić, Ivona; Jeleč, Vjekoslav; Filipčić, Igor

    2018-06-01

    There is a growing body of evidence suggesting that early and effective management in the critical early years of schizophrenia can improve long-term outcomes. The objective of this study was to evaluate time to relapse of the patients with early-phase psychosis treated in the Centre for integrative psychiatry (CIP). We performed a retrospective cohort study on the sample of 373 early-phase psychosis patients admitted to Psychiatric Hospital "Sveti Ivan", Zagreb Croatia: from January 1, 2015 to December 31, 2017. The primary outcome was time to relapse. Patients who were admitted to group psychotherapeutic program after the end of acute treatment had 70% lower hazard for relapse (HR=0.30; 95% CI 0.16-0.58). Patients who were included first in the psychotherapeutic program and then treated and controlled in the daily hospital had 74% lower hazard for relapse (HR=0.26; 95% CI 0.10-0.67). In early-phase psychosis, integrative early intervention service has relevant beneficial effects compare to treatment as usual. These results justified the implementation of multimodal early intervention services in treatment of patients with early-phase psychosis.

  14. 1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations

    ERIC Educational Resources Information Center

    Hannikainen, Maritta

    2010-01-01

    This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…

  15. Suicides in the Centre of Portugal: seven years analysis.

    PubMed

    Dias, Daniel; Mendonça, M Cristina; Real, Francisco Corte; Vieira, Duarte Nuno; Teixeira, Helena M

    2014-01-01

    As one of the more specific and distinctive problems of human beings, suicide has been investigated with increasing attention all over the world. Several risk factors have been described as well as limitations arising from their study. The World Health Organization estimates that this scourge affects one million people annually, which corresponds to one death every 40s worldwide. According to recent studies, Portugal, despite the good rates (10 suicide deaths per 100,000 inhabitants), had shown an increasing trend among younger people. This work aims to characterize the evolution of the suicidal profile autopsied at the Forensic Pathology Department of the Centre Branch of the National Institute of Legal Medicine and Forensic Sciences of Portugal, analyzing several variables: age, gender, marital status, employment status, suicidal methodology, toxicological analysis and some conditions/behaviors regarding personal history (alcoholism, suicidal ideation, suicide attempts, physical illness, psychiatric disorder). All the autopsies from the 1 January, 2003 to 31 December, 2009 were analyzed. The suicide profile achieved corresponded to a man (77%), aged between 65 and 74 years old (20.4%), married (54.5%), employed, who committed suicide by hanging, in September, May or February. Clinical records include an organic health problem or psychiatric one, in addition to risk behaviors such as alcoholism, suicidal thoughts or suicide attempts. The number of suicides autopsied at the Centre Branch has increased, resembling the profile to the result of many other authors. However, new medical and social developments place hanging as the favorite suicide method in our study. Many barriers remain to overthrow but several prevention programs begin to be designed and implemented. Future evaluations and interventions at the social and medical level, including the death certification process, will be fundamental to a better realistic understanding of this phenomenon. Copyright

  16. The Early Years: "Life" Science

    ERIC Educational Resources Information Center

    Ashbrook, Peggy

    2013-01-01

    Talking about death as part of a life cycle is often ignored or spoken about in hushed tones in early childhood. Books with "life cycle" in the title often do not include the death of the living organism in the information about the cycle. The concept of a complete life cycle does not appear in "A Framework for K-12 Science…

  17. The Early Years: Integrating Design

    ERIC Educational Resources Information Center

    Ashbrook, Peggy; Nellor, Sue

    2015-01-01

    Engineering is such a common part of children's work in early childhood programs that teachers can simply look around the room to identify examples where students have engaged in engineering practices. This article presents a classroom activity that integrates engineering design by building on the everyday problems that young children encounter in…

  18. The Early Years: Mixing Materials

    ERIC Educational Resources Information Center

    Ashbrook, Peggy

    2017-01-01

    Engaging children's interest, inspiring active exploration of materials, and fostering cooperation between children and adults is the best way to promote the construction of knowledge. Some popular early childhood activities can be expanded to provide experiences and time for children to build on their prior knowledge. This column discusses…

  19. Measuring family-centred practices of professionals in early intervention services in Taiwan.

    PubMed

    Kang, L-J; Palisano, R J; Simeonsson, R J; Hwang, A-W

    2017-09-01

    Family-centred practices emphasize professional supports for forming partnerships with families in early intervention. The Measure of Processes of Care for Service Providers (MPOC-SP) measures the perceptions of paediatric service providers in supporting children and families. This study aimed to establish reliability of the Chinese version of the MPOC-SP (C-MPOC-SP) and to examine professional perceptions of family-centred practices in relation to professional discipline and years of experience. A convenience sample of 94 physical therapists, occupational therapists, speech-language pathologists, social workers and early childhood educators completed the C-MPOC-SP. Thirty-seven professionals completed the measure a second time within 2-4 weeks for test-retest reliability. Internal consistency and test-retest reliability were examined by Cronbach's α and intra-class correlation coefficient. Comparisons were made across professional disciplines by multivariate analyses of variance followed by analyses of variance. Relationships between years of experience and ratings of family-centred practices were examined by Pearson's correlation coefficients (r). Cronbach's α for items on each of the four scales of the C-MPOC-SP ranged from 0.80 to 0.92, indicating adequate internal consistency. Intra-class correlation coefficient between the initial and repeat completion of the C-MPOC-SP for each scale ranged from 0.56 to 0.77, indicating adequate to excellent test-retest reliability. Mean ratings for the Communicating Specific Information were significantly higher for physical therapists, occupational therapists and speech-language pathologists than for social workers (P = 0.001). The C-MPOC-SP scores were positively correlated with years of experience for all four scales (r = 0.23-0.38; P < 0.05). This study established adequate internal consistency and adequate to excellent test-retest reliability of the C-MPOC-SP in measuring perceptions of family centeredness of early

  20. Paediatric percutaneous nephrolithotomy: single-centre 10-year experience.

    PubMed

    Bhageria, Anand; Nayak, Brusabhanu; Seth, Amlesh; Dogra, Prem Nath; Kumar, Rajeev

    2013-08-01

    Percutaneous nephrolithotomy (PCNL) is a standard management option for complex and large renal calculi. In children, there is some concern over potential perioperative complications. We reviewed our 10 years of experience of PCNL in children and present our data. Data for paediatric patients who underwent PCNL at our centre in the last decade were retrieved. PCNL was performed in standard prone position under fluoroscopic guidance. Patient characteristics, outcomes and complications were reviewed. Complications were graded according to the modified Clavien system. A comparison was also made between supracostal and infracostal accesses. 95 children underwent PCNL in our institute in the last decade. 7 patients had bilateral PCNL. The most common presentation was flank pain (85%). 83% patients were stone-free after first PCNL and overall 94% were stone free after second-look PCNL and auxillary procedures. 6 cases had clinically insignificant residual fragments. Supracostal puncture was performed in 32 cases. Complications were higher in the supracostal puncture group (16 (50%)) and included fever in 11, sepsis in 2 and hydrothorax in 3 patients. There were 7 (10%) complications in the infracostal group: fever in 5 and perinephric collection in 2 patients. 16 patients had grade 1, 9 had grade 2 and another 2 cases developed grade 3 complications. PCNL is a safe and effective procedure in children. It enables excellent stone clearance with minimal number of interventions. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  1. An Ecological Footprint for an Early Learning Centre: Identifying Opportunities for Early Childhood Sustainability Education through Interdisciplinary Research

    ERIC Educational Resources Information Center

    McNichol, Heidi; Davis, Julie Margaret; O'Brien, Katherine R.

    2011-01-01

    In this study, engineers and educators worked together to adapt and apply the ecological footprint (EF) methodology to an early learning centre in Brisbane, Australia. Results were analysed to determine how environmental impact can be reduced at the study site and more generally across early childhood settings. It was found that food, transport…

  2. Ten years of the European Astronaut Centre (EAC).

    PubMed

    Messerschmid, E; Haignere, J P; Damian, K

    2000-11-01

    The European Astronaut Centre, the home base of ESA's Astronaut Corps, celebrated its 10th anniversary on 17 May 2000 with a media event highlighting the past, present and future of the Agency's manned space programme.

  3. Early Years Students' Relationships with Mathematics

    ERIC Educational Resources Information Center

    Takeuchi, Miwa Aoki; Towers, Jo; Plosz, Jennifer

    2016-01-01

    Early years mathematics experiences have been shown to be a significant predictor for students' school readiness and future mathematics achievement. Previous research also indicates an important connection between emotion and mathematics learning. How do students in early years education in Alberta describe their emotional relationship with…

  4. Leadership of Learning in Early Years Practice: A Professional Learning Resource [Includes DVD

    ERIC Educational Resources Information Center

    Hallet, Elaine

    2014-01-01

    This book focuses upon effective pedagogical leadership and practice in the leadership of learning within early years settings and children's centres. The book and accompanying DVD, containing real-life examples of early years leaders, provides a framework for reflective thinking and learning for those leading practice and working with children,…

  5. "We All Share a Common Vision and Passion": Early Years Professionals Reflect upon Their Leadership of Practice Role

    ERIC Educational Resources Information Center

    Hallet, Elaine

    2013-01-01

    Early Years Professionals are graduate leaders working with children below 5 years of age, their families and practitioners in early years settings in the private, voluntary and independent sectors and children's centres in England. Their leadership of practice role is central to raising the quality of early years provision and practice. In this…

  6. Proton Therapy for Craniopharyngioma - An Early Report from a Single European Centre.

    PubMed

    Ajithkumar, T; Mazhari, A-L; Stickan-Verfürth, M; Kramer, P-H; Fuentes, C-S; Lambert, J; Thomas, H; Müller, H; Fleischhack, G; Timmermann, B

    2018-05-01

    Proton beam therapy (PBT) is being increasingly used for craniopharyngioma. We describe our early outcome of patients treated with PBT. Between August 2013 and July 2016, 18 patients with craniopharyngiomas were treated with 54 Cobalt Gray Equivalent (CGE) in 30 fractions over 6 weeks at our centre. The early outcome of 16 patients included in a registry study was analysed. Radiological response was assessed by RECIST criteria and the disease- and treatment-related toxicities were scored according to the CTCAE 4.0. All patients are alive at a median follow-up of 32.6 months (range 9.2-70.6 months) from initial diagnosis. The median age at PBT was 10.2 years (range 5.4-46.9 years). One patient progressed 8.7 months after PBT and subsequently had complete resection of the tumour. At a median follow-up of 18.4 months after PBT, five patients remained in complete remission, four in partial remission and seven with stable disease. The most common adverse effects during PBT were grade 1 (cutaneous in seven patients and fatigue in six patients). There were no treatment-related grade 3 toxicities. Our early results are encouraging and comparable with the limited literature on PBT for craniopharyngioma. Copyright © 2018. Published by Elsevier Ltd.

  7. Understanding the Early Years (UEY) Initiative

    ERIC Educational Resources Information Center

    Human Resources and Social Development Canada, 2007

    2007-01-01

    Internal Audit Services conducted an Early Implementation Review of the Understanding the Early Years (UEY) Initiative in 2006-07. This review is intended to provide assurance to senior management that program delivery has been established appropriately in order to meet its objectives and highlight any areas that require focused management…

  8. Problem Solving in the Early Years

    ERIC Educational Resources Information Center

    Diamond, Lindsay Lile

    2018-01-01

    Problem solving is recognized as a critical component to becoming a self-determined individual. The development of this skill should be fostered in the early years through the use of age-appropriate direct and embedded activities. However, many early childhood teachers may not be providing adequate instruction in this area. This column provides a…

  9. [Usefulness of serological studies for the early diagnosis of Lyme disease in Primary Health Care Centres].

    PubMed

    Vázquez-López, María Esther; Fernández, Gonzalo; Díaz, Pablo; Díez-Morrondo, Carolina; Pego-Reigosa, Robustiano; Coira-Nieto, Amparo

    2018-01-01

    The main aim of this study was to determine the usefulness of an early diagnosis of Lyme disease (LD) in Primary Health Care Centres (PHCC) using the ELISA test as serological screening technique. A retrospective study (2006-2013) was performed in order to determine the anti-Borrelia seropositivity in 2,842 people at risk of having LD. The possible relationship between the environment and the area of residence with anti-Borrelia seropositivity was also studied according to the origin of the specimens (PHCC/Hospital). Overall, 15.2% of samples were positive to Borrelia spp. Seropositivity was significantly higher in samples sent by PHCC doctors than those sent by Hospital doctors. Seropositivity was significantly higher in rural than in urban populations and in those who live in mountainous or flat areas. The percentage of seropositivity has increased over the years. The role of the PHCC doctor is essential for achieving an early diagnosis of Lyme disease, as a higher percentage of seropositives was detected in samples submitted from PHCC. Furthermore, most early localised LD patients were diagnosed in PHCC, avoiding the appearance of sequelae. Therefore, detection of Borrelia specific antibodies using an ELISA assay is a useful screening test for patients at risk of LD. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Investigating the Impact of Working in Multi-Agency Service Delivery Settings in the UK on Early Years Practitioners' Beliefs and Practices

    ERIC Educational Resources Information Center

    Anning, Angela

    2005-01-01

    In the UK Centres of Excellence were funded by the DfES to model high quality, multi-agency, early years services for young children and their families. They were precursors to Children's Centres to be established across the UK. Early Excellence Centres were evaluated at national and local levels. This article will draw on data from local…

  11. Children of Two to Three Years of Age in France: Early Childhood Settings and Age Divisions

    ERIC Educational Resources Information Center

    Garnier, Pascale; Rayna, Sylvie; Brougère, Gilles; Rupin, Pablo

    2017-01-01

    In a French early childhood care and education system that is strongly divided by age and institution, the current research studies the collective life of children at the pivotal age of two to three years of age in four different early childhood settings: (1) a group of "grands" (nursery) in a "crèche" (daycare centre), (2) a…

  12. Early childhood development: the role of community based childcare centres in Malawi.

    PubMed

    Munthali, Alister C; Mvula, Peter M; Silo, Lois

    2014-01-01

    Somatic changes including growth and development of the brain of a human being occur very early in life. Programmes that enhance early childhood development (ECD) therefore should be part of the national agenda. Cognizant of this fact, the Malawi Government together with development partners facilitated the establishment of community-based child care centres (CBCCs) which are owned and managed by community members. This study was aimed at understanding how CBCCs operated and their core functions. Using information from databases kept by the District Social Welfare Officers from all the 28 districts in Malawi, coupled with snowballing, all functioning CBCCs were enumerated. A questionnaire was administered to the head of the CBCC or a care giver. Highly trained Research Assistants also carried our observations of the structures around the centres and the activities that actually happened. Data was analysed using a Statistical Package for Social Sciences. Communities provide structures, support for care givers, food, utensils, labour and play materials for the children in CBCCs. The first ECD centre was established in 1966 but the real surge in establishing these happened towards the end of the 1990s and by 2007 there were 5,665 CBCCs in Malawi caring for 407,468 children aged between 3 and 5 years. CBCCs were established to provide pre-primary school learning, and in some cases provide special care to orphans and other vulnerable. Despite the fact that most CBCC premises and structures fell short of the standards laid down by the CBCC profile, the activities and services provided were mostly to the book. Children were provided with nutritious foods and subjected to play that stimulated their cognitive and mental development. Despite the fact that some members of the community do not realize the value of the CBCCs, the existence of these institutions is an opportunity for the community to take care of their children communally, a task that has become imperative as a

  13. Can We Have an International Approach to Child-Centred Early Childhood Practice?

    ERIC Educational Resources Information Center

    Georgeson, Jan; Campbell-Barr, Verity; Bakosi, Éva; Nemes, Magdolna; Pálfi, Sándor; Sorzio, Paolo

    2015-01-01

    Increasing interest in the provision of early childhood education and care services as a social investment strategy has been accompanied by worldwide concerns to identify appropriate pedagogical practices for working with young children. Here, we trace the developing interest in child-centred approaches, before considering whether there can be…

  14. Pesticide intoxications in the Centre of Portugal: three years analysis.

    PubMed

    Teixeira, Helena; Proença, Paula; Alvarenga, Margarida; Oliveira, Margarida; Marques, Estela P; Vieira, Duarte Nuno

    2004-07-16

    Pesticides are used in most countries around the world to protect agricultural and horticultural crops against damage. Poisoning by these toxicant agents occurs as a result of misuse or accidental exposure, and also by oral ingestion (voluntary or not). In Portugal, pesticide intoxications are still a cause of death, found in a considerable number of cases. The authors retrospectively examined the cases of pesticide poisoning in the Centre of Portugal, from autopsies performed in the Forensic Pathology Service of Coimbra's Delegation of the National Institute of Legal Medicine (NILM) and from other autopsies carried out in the Centre of Portugal, as well as some samples taken in hospitals in cases of suspected intoxication. In this study, the positive cases have been especially studied, in order to identify the pesticide used, as well as the etiology. The frequency of intoxications and its distribution by sex and age were also analyzed. Between January 2000 and December 2002, the Forensic Toxicology Laboratory received 639 pesticide analysis requests. In 2000, in a total of 149 analysis requests, 30 cases were positive, 63.3% from male individuals and 36.7% from female. In 2001, the analysis requests increased to 240 as well as the positive cases (43), 74.4% from male individuals and 25.6% from female and in 2002, the total cases analyzed also increased to 250, with 38 positive (73.6% from male individuals and 26.4% from female). Among the pesticides, organophosphorus insecticides still constitute the most important class detected in forensic intoxications, representing 63% of the total positive cases, followed by herbicides, with 33% of the positive results. Quinalphos is the most important organophosphorus insecticide, present in 32 of the 111 positive cases, followed by the herbicide paraquat, detected in 31 cases. The study emphasizes the increasing number of pesticide analyses, particularly relevant for the organophosphorus compounds and herbicides

  15. The Early Years: Development, Learning and Teaching.

    ERIC Educational Resources Information Center

    Boulton-Lewis, Gillian, Ed.; Catherwood, Di, Ed.

    Designed for teachers, students, caregivers, and health professionals who work with children from birth to age 8, this book provides a review of recent research and theories of development and learning in the early childhood years, with an emphasis on implications for effective teaching. Where appropriate, the book takes an Australian perspective,…

  16. Geometry in the Early Years: A Commentary

    ERIC Educational Resources Information Center

    Dindyal, Jaguthsing

    2015-01-01

    The primary goal of this paper is to provide a commentary on the teaching and learning of geometry in the early years of schooling with the set of papers in this issue as a guiding factor. It is structured around issues about geometry education of young learners, such as: what should we teach in geometry and why; representation of geometrical…

  17. Folliculitis decalvans--a retrospective study in a tertiary referred centre, over five years.

    PubMed

    Chandrawansa, P H; Giam, Y C

    2003-02-01

    Folliculitis decalvans is a rare condition affecting mainly the scalp leading to scarring alopecia. Aetiology of the condition is still unknown, abnormal host response to Staphylococcus aureus has been postulated. We present a retrospective analysis of six cases of folliculitis decalvans presented to National Skin Centre (NSC), Singapore for the past five years, 1995-2000. The mean age of presentation was 39 years and ages ranged from 17 to 62 years. There were five male patients and one female patient. Duration of symptoms at presentation varied from six months to seven years. Occipital and vertex areas of the scalp were the only regions involved. Staphylococcus aureus was isolated in three patients; in one patient culture yielded negative results and no culture was done in the other two patients. All our patients were treated with several separate courses of systemic antibiotics which include doxycycline, erythromycin, minocycline, co-trimoxazole, cloxacillin, erythromycin, rifampicin and clindamycin. In addition one patient was treated with fucidic acid and zinc sulphate. The disease ran a protracted course with temporary improvement while on antibiotic and flare up of disease when antibiotics were stopped. The effectiveness of early treatment with rifampicin has been highlighted in some case reports in the past. We did use rifampicin in one of our patients. Our concern over emergence of antibiotic resistance, if used widely, may not permit us to use rifampicin on a wide scale.

  18. Teleconsultation in vascular surgery: a 13 year single centre experience.

    PubMed

    Schmidt, Christian A P; Schmidt-Weitmann, Sabine H; Lachat, Mario L; Brockes, Christiane M

    2014-01-01

    The University Hospital of Zurich has provided an email-based medical consultation service for the general public since 1999. We examined the enquiries in a 13-year period to identify those related to vascular surgery (based on 22 ICD-10 codes specific for vascular surgery). There were 40,062 questions, of which 643 (2%) were selected by ICD-10 codes. After exclusion of diagnoses not relevant to vascular surgery, 139 questions remained, i.e. an average rate of about one per month. The mean age of the users was 43 years (range 19-88). Most users (61%) were women. The majority of users asked questions about their own health problems (79%) with varicose veins and spider veins accounting for 63% of all questions. Arterial diseases accounted for 30%. The patient's intention in contacting the service was to obtain advice on treatment options (37%), information about a diagnosis or symptoms (27%), or a second opinion (15%). The online service responded with detailed information and advice (87%) and suggested a referral to the family doctor or a specialist in 75%. Most patients (82%) rated the service overall as good or very good. It appears likely that telemedicine and in particular email teleconsultations will increase in vascular surgery in the future.

  19. Renovascular hypertension: ten years' experience in a regional centre.

    PubMed

    Sellars, L; Siamopoulos, K; Hacking, P M; Proud, G; Taylor, R M; Essenhigh, D M; Wilkinson, R

    1985-07-01

    In a unit serving a population of three million, 60 hypertensive patients with renovascular disease were identified over a 10-year period. The presence of renovascular disease was usually suggested by intravenous urography (IVU), although this was falsely negative in 21 per cent of cases; isotope renography (IR) was normal in a similar proportion of patients (25 per cent). Eight patients were treated medically and 52 underwent surgical procedures; nephrectomy in 32, autotransplantation in 10, by pass graft in six and percutaneous transluminal angioplasty in four. Twenty-three per cent of patients were cured, 37 per cent improved and 40 per cent unchanged one year after surgery, but the response could not be accurately predicted. Clinical features were of some value in that those patients most likely to benefit from surgery were younger, had less severe hypertension of shorter duration, smoked less, had less severe retinopathy and less cardiomegaly. There was also a trend for those with better renal function and less electrocardiographic evidence of left ventricular hypertrophy to benefit from surgery. The IVU and IR did not predict response to surgery but arteriographic appearances of fibromuscular dysplasia indicated there should be a favourable response. The renal vein renin ratio, basal or stimulated, was of no prognostic value since approximately two-thirds of patients with ratios above or below the threshold value had some benefit from surgery. We conclude that the surgical treatment of renovascular hypertension is worthwhile but the number of patients suitable for surgery is small. Clinical features and the results of simple investigations provided the best guide to surgical outcome in our patients.

  20. 'Stepping in' or 'stepping back': how first year nursing students begin to learn about person-centred care.

    PubMed

    Currie, Kay; Bannerman, Samantha; Howatson, Val; MacLeod, Fiona; Mayne, Wendy; Organ, Christine; Renton, Sarah; Scott, Janine

    2015-01-01

    The concept of person-centred care has gained international recognition over the last decade and forms one of the key concepts of our Nursing Quality Improvement Curricular Framework. This study aimed to investigate nursing students' learning about person-centred care during the first-year of their programme. Qualitative thematic analysis of a section of placement learning documents from two consecutive cohorts of students from all fields of nursing (n=405), supplemented by three focus group discussions. Two conceptual categories of student approaches to learning emerged. Firstly, 'stepping back', or learning from a distance about how nurses provide care, often through reading case notes and care plans; second, 'stepping in', learning about the patient as a person by direct interaction with service users. Evidence of reflection on the patient's experience of care was limited. These results have resonance with existing pedagogical theories around preferences for active or passive styles of learning. The potential for clinical mentors to build student confidence and encourage direct engagement with patients was highlighted. Students are aware of the concepts, principles and professional values of person-centred care from early in their programme; however, the majority tend to be preoccupied by learning about what nurses 'do', rather than 'how patients experience care'. Development towards a more person-centred approach may require targeted support from mentors to help students gain confidence and begin reflecting on how patients experience care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Critiquing Child-Centred Pedagogy to Bring Children and Early Childhood Educators into the Centre of a Democratic Pedagogy

    ERIC Educational Resources Information Center

    Langford, Rachel

    2010-01-01

    Child-centred pedagogy is both an enduring approach and a revered concept in Western-based teacher preparation. This article weaves together major critiques of child-centred pedagogy that draw on critical feminist, postmodernist and post-structural theories. These critiques have particular relevance for conceptualizing what it can mean to be, and…

  2. Aistear vis-à-vis the Primary Curriculum: The Experiences of Early Years Teachers in Ireland

    ERIC Educational Resources Information Center

    Gray, Colette; Ryan, Anna

    2016-01-01

    Launched in 2009, the Aistear early years curriculum framework sought to complement and extend the primary school curriculum (PSC) at infant class level in the Republic of Ireland. While Aistear focuses on the development of attitudes, values and learning dispositions and is neither statutory nor inspected, the PSC centres on the acquisition of…

  3. Exploring Diversity: Reflections Ten Years On. Australian Early Childhood Resource Booklets, No. 2.

    ERIC Educational Resources Information Center

    Schurch, Pam; Hopson, Elizabeth

    This booklet reflects the past 10 year's thoughts and experiences and presents the current debate concerning multicultural early childhood education, as experienced by the Lady Gowrie Child Centre, in Sydney, New South Wales, Australia. The booklet describes how the center experienced the satisfying process of change and growth with such a program…

  4. Literacy as a Social Practice in the Early Years and the Effects of the Arts: A Case Study

    ERIC Educational Resources Information Center

    Theodotou, Evgenia

    2017-01-01

    Literacy as a social practice has a fundamental role in children's lives especially in the early years context, in which social interactions are in the centre of knowledge achievement. Several pieces of research investigate the positive contribution of the arts in children's literacy development in the early years settings. However, most of them…

  5. Sinonasal papillomas in a private referral otorhinolaryngology centre: Review of 22 years experience.

    PubMed

    de Sousa Fontes, Aderito; Sandrea Jiménez, Minaret; Urdaneta Lafée, Nelson; Abreu Durán, Perfecto A; Quintana Páez, Liwven E; de Sousa de Abreu, Andreina Carmina

    To evaluate the clinical presentation, treatment outcome and follow-up of all patients managed with sinonasal papillomas (SP), at a tertiary private otorhinolaryngology centre in Caracas (Venezuela). We reviewed 94 patients with SP that were treated at our otolaryngology center, from July 1st 1993 to June 31st 2015. The demographic data, clinical features, radiological findings, anatomical origin, disease extension into the adjacent structures, surgical approaches performed, histopathology outcomes, recurrent risk, malignant transformation rate and coadjuvant therapies were assessed. Sixty-five patients (69.1%) were male and 29 (30.9%) female with an average age of 44.5 years (range 9-80 years). All patients underwent endoscopic sinus surgery. The most commont histologic subtypes of SP were inverted papilloma (58 patients; 61.7%), fungiform papilloma (35 patients; 37.2%) and oncocytic papilloma (one patient; 1.1%). SP was associated in 2 patients with undifferentiated squamous cell carcinoma. Twelve patients (12.8%) had disease with extension beyond the sinus without associated malignancy. All these patients received adjuvant treatment with advanced techniques of radiotherapy. The mean duration of the follow-up period was 9 years and 2 months. Eighteen patients (19.1%) had recurrent disease during the entire course of follow-up. Complete endoscopic surgical removal of SP is the treatment of choice. In less endoscopically accessible tumours, with peripheral extension or incompletely resected, Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy may be indicated. Timely post-operative endoscopic follow-up with biopsy of suspected lesions is important for early detection of recurrences and associated malignancy. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  6. Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong.

    PubMed

    Wong, Carol W Y; Chan, Ivy H Y; Chung, Patrick H Y; Lan, Lawrence C L; Lam, Wendy W M; Wong, Kenneth K Y; Tam, Paul K H

    2015-12-01

    To review all paediatric patients with intussusception over the last 17 years. Retrospective case series. A tertiary centre in Hong Kong. Children who presented with intussusception from January 1997 to December 2014 were reviewed. The duration of symptoms, successful treatment modalities, complication rate, and length of hospital stay were studied. A total of 173 children (108 male, 65 female) presented to our hospital with intussusception during the study period. Their median age at presentation was 12.5 months (range, 2 months to 16 years) and the mean duration of symptoms was 2.3 (standard deviation, 1.8) days. Vomiting was the most common symptom (76.3%) followed by abdominal pain (46.2%), per rectal bleeding or red currant jelly stool (40.5%), and a palpable abdominal mass (39.3%). Overall, 160 patients proceeded to pneumatic or hydrostatic reduction, among whom 127 (79.4%) were successful. Three (1.9%) patients had bowel perforation during the procedure. Early recurrence of intussusception occurred in four (3.1%) patients with non-operative reduction. No recurrence was reported in the operative group. The presence of a palpable abdominal mass was a risk factor for operative treatment (relative risk=2.0; 95% confidence interval, 1.8-2.2). Analysis of our results suggested that duration of symptoms did not affect the success rate of non-operative reduction. Non-operative reduction has a high success rate and low complication rate, but the presence of a palpable abdominal mass is a risk factor for failure. Operative intervention should not be delayed in those patients who encounter difficult or doubtful non-operative reduction.

  7. The GNSS-based component for the new Indonesian tsunami early warning centre provided by GITEWS

    NASA Astrophysics Data System (ADS)

    Falck, C.; Ramatschi, M.; Bartsch, M.; Merx, A.; Hoeberechts, J.; Rothacher, M.

    2009-04-01

    Introduction Nowadays GNSS technologies are used for a large variety of precise positioning applications. The accuracy can reach the mm level depending on the data analysis methods. GNSS technologies thus offer a high potential to support tsunami early warning systems, e.g., by detection of ground motions due to earthquakes and of tsunami waves on the ocean by GNSS instruments on a buoy. Although GNSS-based precise positioning is a standard method, it is not yet common to apply this technique under tight time constraints and, hence, in the absence of precise satellite orbits and clocks. The new developed GNSS-based component utilises on- and offshore measured GNSS data and is the first system of its kind that was integrated into an operational early warning system. (Indonesian Tsunami Early Warning Centre INATEWS, inaugurated at BMKG, Jakarta on November, 11th 2008) Motivation After the Tsunami event of 26th December 2004 the German government initiated the GITEWS project (German Indonesian Tsunami Early Warning System) to develop a tsunami early warning system for Indonesia. The GFZ Potsdam (German Research Centre for Geosciences) as the consortial leader of GITEWS also covers several work packages, most of them related to sensor systems. The geodetic branch (Department 1) of the GFZ was assigned to develop a GNSS-based component. Brief system description The system covers all aspects from sensor stations with new developed hard- and software designs, manufacturing and installation of stations, real-time data transfer issues, a new developed automatic near real-time data processing and a graphical user interface for early warning centre operators including training on the system. GNSS sensors are installed on buoys, at tide gauges and as real-time reference stations (RTR stations), either stand-alone or co-located with seismic sensors. The GNSS data are transmitted to the warning centre where they are processed in a near real-time data processing chain. For

  8. Using Action Research to Support Quality Early Years Practice

    ERIC Educational Resources Information Center

    Bleach, Josephine

    2013-01-01

    This article examines the effectiveness of action research as a continuous professional development (CPD) tool. The aim of the CPD programme was to support 14 community-based Early Childhood Care and Education (ECCE) centres in Ireland to improve quality in their settings through the implementation of the national quality and curriculum frameworks…

  9. Using "Slowmation" for Intentional Teaching in Early Childhood Centres: Possibilities and Imaginings

    ERIC Educational Resources Information Center

    Fleer, Marilyn; Hoban, Garry

    2012-01-01

    Increased national and international attention towards early childhood education has resulted in the development of an Australian "Early Years Learning Framework" (EYLF) called "Belonging, Being and Becoming" (DEEWR, 2009) for realising agreed practice, principles and outcomes. The EYLF highlights the importance of educators…

  10. An Exploratory Study of Gender and Male Teachers in Early Childhood Education and Care Centres in China

    ERIC Educational Resources Information Center

    Xu, Yuwei; Waniganayake, Manjula

    2018-01-01

    This paper explores the impact of gender on the employment of men in early childhood education and care (ECEC) centres through the voices of male and female early childhood teachers (ECTs) working in China. Gender imbalance in the ECEC workforce is a global phenomenon, and there has been little research about it in countries such as China. This…

  11. Septic arthritis in haemodialysis patients: a seven-year multi-centre review.

    PubMed

    Al-Nammari, S S; Gulati, V; Patel, R; Bejjanki, N; Wright, M

    2008-04-01

    To determine relevant demographics, clinical features, and outcomes for septic arthritis in patients on haemodialysis for end-stage renal failure. A multi-centre retrospective review was performed from 1999 to 2005. 15 cases were identified. The mean age of the patients at diagnosis was 67 (range, 23-89) years and 11 were male. All had multiple co-morbidities and additional risk factors for sepsis. The primary sources of sepsis were dialysis access-related (n=12), unknown in 2, and unrelated soft tissue infection in one. All patients presented with acute monoarticular symptoms; the knee joint was affected in 11 patients. The white cell count, neutrophil count, and C-reactive protein concentration were elevated in 10, 10, and 15 patients, respectively. All patients had positive synovial fluid cultures and blood cultures were positive in 14. Organisms isolated were all skin commensals, being staphylococcal in 13 and streptococcal in 2. Six patients had concomitant rheumatological disease (gout in 4, pseudogout in one, and rheumatoid arthritis in one). Two had urate crystals in the synovial fluid (noted by microscopy). All patients underwent antimicrobial therapy for a mean of 36 days, together with joint washouts and debridement. 12 patients were cured of infection; 2 developed chronic sepsis secondary to localised osteomyelitis; and one died of sepsis. Septic arthritis is a potentially devastating condition. Early and aggressive joint lavage and debridement combined with appropriate antimicrobial therapy is imperative. A high index of suspicion is necessary in haemodialysis patients; the diagnosis of septic arthritis must be presumed until proven otherwise.

  12. Informing Transitions in the Early Years

    ERIC Educational Resources Information Center

    Dunlop, Aline-Wendy; Fabian, Hilary

    2006-01-01

    An increased emphasis on an early start in group day care and educational settings for young children means that by the time children enter statutory education, they may already have had several transitional experiences: each will have an impact. This book explores early transitions from a variety of international perspectives. Each chapter is…

  13. Infectious morbidity and resource use in children under 2 years old at childcare centres.

    PubMed

    Del Castillo-Aguas, Guadalupe; Gallego-Iborra, Ana; Gutiérrez-Olid, Mario; Pérez-González, Olga; Moreno-Muñoz, Ginesa; Ledesma-Albarrán, Juana M

    2017-02-01

    To analyse the associations between childcare centres and infectious morbidity and resource consumption. Cohort study from birth to 2 years. number and types of infections, drug consumption and medical visits. Exposure variable: attending or not attending a childcare centre. School age: 6-12, >12-18, >18-24 months. The initial cohort comprised 445 children, and the final cohort comprised 419 children. The mean number of recurrent infections and wheezing was higher in children attending childcare centres in all age groups with significant differences. Recurrent acute otitis media was observed in the 12- to 18-month group with an odds ratio of 6.04 (95% confidence interval, 1.3-27.6; P = 0.001) in the children attending childcare centres. In children older than 6 months, there was greater consumption of antibiotics, inhaled bronchodilators, oral and inhaled corticosteroids and montelukast. Attending a childcare is associated with an increased frequency of recurrent infections and wheezing, as well as the consumption of antibiotics, bronchodilators, corticosteroids and montelukast. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  14. High School Biology: The Early Years.

    ERIC Educational Resources Information Center

    Rosenthal, Dorothy B.; Bybee, Rodger W.

    1988-01-01

    Discusses the emergence of the biology curriculum which replaced physiology, zoology, and botany in high school science courses and supplanted an early form of general science known as natural history. (RT)

  15. Information and professional support: key factors in the provision of family-centred early childhood intervention services.

    PubMed

    Fordham, L; Gibson, F; Bowes, J

    2012-09-01

    Much has been written on the principles of family-centred practice and on the service delivery methods and skills required of its practitioners. Far less has been written from the perspective of families whose children have a disability. The aims of this study were twofold: firstly to understand families' experiences of family-centred early childhood intervention services and secondly to explore other factors that might impact on these experiences. One hundred and thirty families attending two established early childhood intervention services in New South Wales, Australia completed a survey incorporating the Measure of Processes of Care-56, the Family Empowerment Scale, the Family Support Scale and the Parenting Daily Hassles Scale. Consistent with previous research using the Measure of Processes of Care-56, 'respectful and supportive care' was the domain of care families rated to occur most and 'provision of general information' was the domain they rated to occur least. Significant positive relationships existed between families' ratings of family-centred care and feelings of empowerment. Being provided with general information was strongly correlated with family empowerment. Families' social support networks played an important role but support from professionals was most strongly correlated with families' experiences of family-centred care. Finally, families whose children's early intervention services were co-ordinated by a professional experienced significantly better care. The provision of general information and professional support are key components of family-centred early childhood intervention services. © 2011 Blackwell Publishing Ltd.

  16. Total aortic arch replacement with the elephant trunk technique: single-centre 30-year results.

    PubMed

    Shrestha, Malakh; Martens, Andreas; Krüger, Heike; Maeding, Illona; Ius, Fabio; Fleissner, Felix; Haverich, Axel

    2014-02-01

    The combined disease of the aortic arch and the descending aorta (aneurysms and dissection) remains a surgical challenge. Various approaches have been used to treat this complex pathology. In the two-stage operation, at the first-stage operation, the aortic arch is replaced through a median sternotomy. Later, at the second-stage operation, the descending thoracic aorta is replaced through a lateral thoracotomy. The elephant trunk (ET) technique was introduced by H.G. Borst at our centre in March 1982, greatly simplifying the second-phase operation. We present our 30-year experience. From March 1982 to March 2012, 179 patients (112 males, age 56.4±12.6 years) received an ET procedure for the combined disease of the aortic arch and the descending aorta (91 aneurysms, 88 dissections (47 acute)). Fifty-six of these patients had undergone previous cardiac operations. Concomitant procedures were performed if necessary. The cerebral protection was done either by deep (till 1999) or moderate hypothermic circulatory arrest and selective antegrade cerebral perfusion (SACP, after 1999). Cardiopulmonary bypass (CPB) and X-clamp times were 208.5±76.5 min and 123.7±54.8 min, respectively. The intraoperative mortality and 30-day mortality during the first-stage operation were 1.7% (3/179) and 17.3% (31/179, 15 with AADA), respectively. Perioperative stroke was 7.9% (n=14/176). Postoperative recurrent nerve palsy was present in 18.2% (32/176) and paraplegia in 5.6% (10/176). The second-stage completion operation was performed as early as possible. Fifty-seven second-stage completion procedures were performed, either surgically (n=50) or through interventional techniques (n=7). The intraoperative and 30-day mortality after the second-stage completion procedures were 5.2% (3/57) and 7.0% (4/57), respectively. The stroke, recurrent nerve palsy and paraplegia rates were 0, 0 and 7% (4/54), respectively. The ET technique has greatly facilitated the two-stage approach to the surgical

  17. Building a Model of Early Years Professionalism from Practitioners’ Perspectives

    ERIC Educational Resources Information Center

    Brock, Avril

    2013-01-01

    Practitioner voice has been absent from debates regarding what constitutes professional behaviour and practice in the early years. This research identifies and uses the professional knowledge of a group of early years educators to create a typology of professionalism. The typology comprises seven inter-related dimensions of early years…

  18. The GNSS data processing component within the Indonesian tsunami early warning centre provided by GITEWS

    NASA Astrophysics Data System (ADS)

    Bartsch, M.; Merx, A.; Falck, C.; Ramatschi, M.

    2010-05-01

    Introduction Within the GITEWS (German Indonesian Tsunami Early Warning System) project a near real-time GNSS processing system has been developed, which analizes on- and offshore measured GNSS data. It is the first system of its kind that was integrated into an operational tsunami early warning system. (Indonesian Tsunami Early Warning Centre INATEWS, inaugurated at BMKG Jakarta on November, 11th 2008) Brief system description The GNSS data to be processed are received from sensors (GNSS antenna and receiver) installed on buoys, at tide gauges and as real-time reference stations (RTR stations), either stand-alone or co-located with seismic sensors. The GNSS data are transmitted to the warning centre in real-time as a stream (RTR stations) or file-based and are processed in a near real-time data processing chain. The fully automatized system uses the BERNESE GPS software as processing core. Kinematic coordinate timeseries with a resolution of 1 Hz (landbased stations) and 1/3 Hz (buoys) are estimated every five minutes. In case of a recently occured earthquake the processing interval decreases from five to two minutes. All stations are processed with the relative technique (baseline-technique) using GITEWS-stations and stations available via IGS as reference. The most suitable reference stations are choosen by querying a database where continiously monitored quality data of GNSS observations are stored. In case of an earthquake at least one reference station should be located on a different tectonic plate to ensure that relative movements can be detected. The primary source for satellite orbit information is the IGS IGU product. If this source is not available for any reason, the system switches automatically to other orbit sources like CODE products or broadcast ephemeris data. For sensors on land the kinematic coordinates are used to detect deviations from their normal, mean coordinates. The deviations or so called displacements are indicators for land mass

  19. People-centred landslide early warning systems in the context of risk management

    NASA Astrophysics Data System (ADS)

    Haß, S.; Asch, K.; Fernandez-Steeger, T.; Arnhardt, C.

    2009-04-01

    In the current hazard research people-centred warning becomes more and more important, because different types of organizations and groups have to be involved in the warning process. This fact has to be taken into account when developing early warning systems. The effectiveness of early warning depends not only on technical capabilities but also on the preparedness of decision makers and their immediate response on how to act in case of emergency. Hence early warning systems have to be regarded in the context of an integrated and holistic risk management. Disaster Risk Reduction (DRR) measures include people-centred, timely and understandable warning. Further responsible authorities have to be identified in advance and standards for risk communication have to be established. Up to now, hazard and risk assessment for geohazards focuses on the development of inventory, susceptibility, hazard and risk maps. But often, especially in Europe, there are no institutional structures for managing geohazards and in addition there is a lack of an authority that is legally obliged to alarm on landslides at national or regional level. One of the main characteristics within the warning process for natural hazards e.g. in Germany is the split of responsibility between scientific authorities (wissenschaftliche Fachbehörde) and enforcement authorities (Vollzugsbehörde). The scientific authority provides the experts who define the methods and measures for monitoring and evaluate the hazard level. The main focus is the acquisition and evaluation of data and subsequently the distribution of information. The enforcement authority issues official warnings about dangerous natural phenomena. Hence the information chain in the context of early warning ranges over two different institutions, the forecast service and the warning service. But there doesn't exist a framework for warning processes in terms of landslides as yet. The concept for managing natural disasters is often reduced to

  20. Early-Years Absenteeism Seen as Critical

    ERIC Educational Resources Information Center

    Sparks, Sarah D.

    2010-01-01

    While efforts to reduce chronic absenteeism typically focus on adolescents, experts say that the early grades are the place to start. Statistics show that rates of absenteeism in kindergarten and 1st grade can rival those in high school. An average of one in 10 pupils in grades K-12 nationwide is considered chronically absent, defined as missing…

  1. The Early Years: Composting with Children

    ERIC Educational Resources Information Center

    Ashbrook, Peggy

    2016-01-01

    "Composting" is a way to purposefully use the process of decay to break down organic materials in a location where the resulting mixture can be harvested for enriching garden soil. The large body of literature about the science of composting provides many options for early childhood educators to choose from to incorporate into their…

  2. The Early Years: Integrating Digital Tools

    ERIC Educational Resources Information Center

    Ashbrook, Peggy

    2017-01-01

    This column discusses resources and science topics related to students in grades preK to 2. This month's issue discusses how digital media and robotics fit into the early childhood curriculum, and how time on devices supports learning goals and developmentally appropriate practice.

  3. The Early Years: Becoming Attuned to Sound

    ERIC Educational Resources Information Center

    Ashbrook, Peggy

    2014-01-01

    Exploration of making and changing sounds is part of the first-grade performance expectation 1-PS4-1, "Plan and conduct investigations to provide evidence that vibrating materials can make sound and that sound can make materials vibrate" (NGSS Lead States 2013, p. 10; see Internet Resource). Early learning experiences build toward…

  4. Weaknesses and Strengths in Assessing Early Childhood Programmes: An Assessment of an Early Childhood Spanish Trilingual Programme in Two- to Three-Year-Old Children

    ERIC Educational Resources Information Center

    Rivas, Sonia; Sobrino, Angel; Peralta, Felisa

    2010-01-01

    This article gives an account of the results from an assessment of an early childhood education programme, conducted over the course of two academic years (1999-2000 and 2000-2001), in a centre in northeastern Spain. The purpose of the assessment was to discover how a particular educational programme contributed to the short-term competency levels…

  5. Effective Leadership and Management in the Early Years

    ERIC Educational Resources Information Center

    Moyles, Janet

    2006-01-01

    There has recently been an unprecedented focus on early years care and education, particularly on the impact of the various adults who work and play with children in the birth to five/six-years age range. Staff in early years settings have had to adapt to many changes and demands, locally and nationally, from local authorities and national…

  6. Early Years Learning, Play Pedagogy and Social Class

    ERIC Educational Resources Information Center

    Stirrup, Julie; Evans, John; Davies, Brian

    2017-01-01

    Despite 50 years and more of "progressive education" in the United Kingdom, classed patterns of educational success and failure stubbornly prevail. So how, where and when does it all go wrong for the many children who continue to fail or underachieve? Drawing on the work of Basil Bernstein, this article centres processes within early…

  7. Early Years Education Resource Guide. Early Education Support Series.

    ERIC Educational Resources Information Center

    Dunlop, Aline-Wendy, Comp.

    The aim of this resource guide is to provide practitioners in preschool settings with information to help them plan, implement, augment with resources, and review practice based on the "Curriculum Framework for Children in Their Pre-School Year" issued by the Scottish Office Education and Industry Department. The guide presents a…

  8. Tasmania's Child and Family Centres: A Place-Based Early Childhood Services Model for Families and Children from Pregnancy to Age Five

    ERIC Educational Resources Information Center

    Taylor, Catherine L.; Jose, Kim; van de Lageweg, Wietse I.; Christensen, Daniel

    2017-01-01

    Tasmania's child and family centres (Centres) provide a single entry point to early childhood services (ECS) for children and families living in amongst the most disadvantaged communities in Australia. This study investigated the impact of Centres on parents' use and experiences of ECS using a mixed methods approach. The results showed that Centre…

  9. Beliefs Associated with Support for Child-Centred Learning Environment among Hong Kong Pre-Service Early Childhood Teachers

    ERIC Educational Resources Information Center

    Cheung, Sum Kwing; Ling, Elsa Ka-wei; Leung, Suzannie Kit Ying

    2017-01-01

    The physical, social and temporal dimensions of the classroom environment have an important role in children's learning. This study examines the level of support for child-centred learning, and its associated beliefs, that is provided by Hong Kong's pre-service early childhood teachers. Two hundred and seventy-five students from a pre-service…

  10. Making an Impression: Portfolios as Instruments of Impression Management for Teachers in Early Childhood Education and Care Centres

    ERIC Educational Resources Information Center

    Knauf, Helen

    2017-01-01

    The study presented here examines the contribution of portfolios to the communication between parents and early childhood education and care centres. Using content analysis techniques, 2104 portfolio entries are examined with a view to establishing what impression they are intended to create. While the actual purpose of portfolios emphasizes the…

  11. Parental Concerns Regarding a Centre-Based Early Intervention Programme for Down Syndrome in Malaysia: A Case Study

    ERIC Educational Resources Information Center

    Kunagaratnam, Nagasangari; Loh, Sau Cheong

    2010-01-01

    This qualitative study provides information on the concerns faced by parents having children with Down syndrome in a centre-based Early Intervention Programme in Malaysia and how they coped with these concerns. Semi-structured interviews were conducted with a total of five parents and two special educators. The interview and observation findings…

  12. Government's Involvement in Safety Management in Public Early Childhood Education Centres (ECECs) in Rivers State, Nigeria

    ERIC Educational Resources Information Center

    Igbinedion, Doye Angela; Abraham, N. M.; Nwogu, U. J.

    2016-01-01

    The study examined Governments' Involvement in Safety Management in Public Early Childhood Education Centres (ECECs) in Rivers State. Two research questions and two hypotheses guided the study which adopted the descriptive survey design. The population of the study comprised of five hundred and ten (510) ECECs in the twenty three (23) Local…

  13. [Centre of the state sanitary and epidemiological surveillance of Black Sea Fleet celebrates 75 years].

    PubMed

    Goncharov, G V; Brashkov, A A

    2010-08-01

    The history of the Centre of the state sanitary and epidemiological surveillance of Black Sea Fleet begun in the 1 April 1935 when the sanitary-epidemiological laboratory was founded. The article is concerned with the different stages of vivid development of this institute during 75 years. During this period organization, establishment and the name were changed many times. Since 2002 it got the current name and represents the scientific-methods institution which can solve the issues of sanitary-hygienic and antiepidemic supply of military personnel of the navy. Special attention is given to the high-readiness force.

  14. Evaluation of family-centred practices in the early intervention programmes for infants and young children in Singapore with Measure of Processes of Care for Service Providers and Measure of Beliefs about Participation in Family-Centred Service.

    PubMed

    Tang, H N; Chong, W H; Goh, W; Chan, W P; Choo, S

    2012-01-01

    The primary purpose of this study was to report on an evaluation of the perceptions and beliefs of service providers towards family-centred practices in 11 early intervention programmes for infants and young children in Singapore. The Measure of Processes of Care for Service Providers (MPOC-SP) and Measure of Beliefs about Participation in Family-Centred Service (MBP-FCS) were administered to 213 service providers made up of teachers, therapists, psychologists and social workers providing centre-based therapy to children with special needs who were below the age of 6 years. Exploratory factor analyses were performed with both scales. Nineteen of the 27 MPOC-SP items were retained and supported the original four-factor structure model. The exploratory factor analyses on MBP-FCS provided a less satisfactory outcome. Fourteen of the 28 items were retained and these loaded onto four factors. The two factors relating to Beliefs about benefits of FCS and Beliefs about the absence of negative outcomes from FCS failed to emerge as separate factors. Further multiple regressions indicated that more direct work with families and positive self-efficacy in implementing FCS contributed significantly to explaining service providers' positive perception towards family-centred practice in service delivery. This is the first time MPOC-SP and MBP-FCS were administered to a population in an Asian context. While MBP-FCS would benefit from further development work on its construct, MPOC-SP offered important insights into service providers' perspectives about family-centred practices that would have useful implications for professional and service development. © 2011 Blackwell Publishing Ltd.

  15. Impact of national smokefree environments laws on teachers, schools and early childhood centres.

    PubMed

    Watson, Donna; Glover, Marewa; McCool, Judith; Bullen, Chris; Adams, Brian; Min, Sandar

    2011-12-01

    New Zealand's (NZ) smokefree legislation, implemented on 1 January 2004, requires that all school and early childhood centre buildings and grounds are 100% smokefree; one aim being to prevent young people being influenced by seeing people (including teachers) smoke there. This study, conducted in 2008, investigated teachers'smoking behaviour and perceived adherence to the legislation. A national NZ cross-sectional survey of 2,004 teachers (oversampling Māori), who were randomly selected from the electoral roll of registered voters and sent postal invitations to complete an anonymous survey. The response rate was 70%. Current smokers numbered 7%, and proportionately more Maori and Pacific Island teachers (12% each) smoked than European/Other teachers (7%). Of current smokers, 37% smoked non-daily. Smokers smoked less on work than non-work days. Introducing smokefree legislation was associated with teachers changing when they smoked, cutting down, quitting or trying to quit. Perceived compliance with the legislation was high, although 30% of teachers reported seeing staff smoking. Proportionately, significantly more teachers from low than from high socioeconomic schools perceived poor compliance and staff visibly smoking. Smokefree legislation affects people's smoking behaviour. Smoking in NZ is becoming confined to population subgroups defined by socioeconomic status and ethnicity. Our findings argue for supporting cessation among those who work with children and young people, and for targeting support at school communities in areas of low socioeconomic status or with large populations of Māori or Pacific peoples.

  16. The last 10 years in a burn centre in Ankara, Turkey: an analysis of 5264 cases.

    PubMed

    Türegün, M; Sengezer, M; Selmanpakoglu, N; Celiköz, B; Nişanci, M

    1997-01-01

    This is a retrospective study analysing 5264 patients treated in the burn centre at Gülhane Military Medical Academy from 1 January 1986 to 31 December 1995. Our burn centre is not only the first, but one of the best established and supported in Turkey. Our present study has the largest patient group of other previously published studies from Turkey. Of the total patients studied, 4464 patients had minor burns and were treated on an outpatient basis and 800 patients had moderate to major burns. Although our centre is in a military area in Ankara, only 1047 (20 per cent) patients were military personnel and the military-related burn causes comprised only 6 per cent of the total. The remaining 4217 (80 per cent of the total patients) were civilians. Flame injuries were also more frequent in military patients than civilians. Minor burns were most common in the age group 0-10 years old (40 per cent) and moderate to major burns in the age group 21-30 years (54 per cent). Scalds were the main cause of paediatric burns. Male patients were dominant. The overall mortality among inpatients was 18.2 per cent and mean total body surface area (TBSA) was 57.6 per cent in patients who died. 134 patients demonstrated inhalation injury and 82 per cent of these patients died. The epidemiological pattern of our patients is similar to that in other studies from developed countries, although some ethnic causative factors could be found. Our study indicates that emergency measures should be taken to prevent flame injuries at military barracks and industrial workplaces and scalding accidents to children at home and throughout the country.

  17. Centre-based day care for children younger than five years of age in low- and middle-income countries.

    PubMed

    Brown, Taylor W; van Urk, Felix C; Waller, Rebecca; Mayo-Wilson, Evan

    2014-09-25

    Because of poverty, children and families in low- and middle-income countries often face significant impediments to health and well-being. Centre-based day care services may influence the development of children and the economic situation of parents by providing good quality early childhood care and by freeing parents to participate in the labour force. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development, health and well-being of children and families in low- and middle-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, ERIC and 16 other sources, including several World Health Organization (WHO) regional databases. We also searched two trials registers, websites of government and non-government agencies and reference lists of relevant studies. We included randomised and quasi-randomised controlled trials and prospective non-randomised studies with contemporaneous control groups and assessments both before and after intervention. We considered non-randomised controlled trials, as centre-based care in low- and middle-income countries is unlikely to be studied using randomised controlled trials (Higgins 2011). We included the following outcomes: child intellectual development, child psychosocial development, maternal and family outcomes and incidence of infectious diseases. Two review authors independently assessed risk of bias and extracted data from the single included study. Only one trial, involving 256 children, met the inclusion criteria for this review. This study was assessed as having high risk of bias because of non-random allocation, incomplete outcome data and insufficient control of confounding factors. Results from this study suggest that centre-based day care may have a positive effect on child cognitive ability compared with no treatment (care at home) (assessed using a modified

  18. Early Intervention and AAC: What a Difference 30 Years Makes.

    PubMed

    Romski, MaryAnn; Sevcik, Rose A; Barton-Hulsey, Andrea; Whitmore, Ani S

    2015-01-01

    This article provides an overview of early intervention and AAC over the 30-year period since the founding of the journal Augmentative and Alternative Communication in 1985. It discusses the global context for early intervention and addresses issues pertaining to young children from birth to 6 years of age. It provides a narrative review and synthesis of the evidence base in AAC and early intervention. Finally, it provides implications for practice and future research directions.

  19. Computer Use within a Play-Based Early Years Curriculum

    ERIC Educational Resources Information Center

    Howard, Justine; Miles, Gareth E.; Rees-Davies, Laura

    2012-01-01

    Early years curricula promote learning through play and in addition emphasise the development of computer literacy. Previous research, however, has described that teachers feel unprepared to integrate Information and Communication Technology (ICT) and play. Also, whereas research has suggested that effective computer use in the early years is…

  20. Learning to Teach in the Early Years Classroom

    ERIC Educational Resources Information Center

    Blaise, Mindy; Nuttal, Joce

    2011-01-01

    "Learning to Teach in the Early Years Classroom" helps teacher education students understand the complexities of teaching in early years' classrooms. It integrates research and theory with practice through vignettes, based on authentic classroom case studies, in order to show students how educators make decisions and achieve expected outcomes.…

  1. Positioning in Relationships between Parents and Early Years Practitioners

    ERIC Educational Resources Information Center

    Sims-Schouten, Wendy

    2016-01-01

    Early years care and education have been high on British political agendas. This includes partnership working between early years practitioners and parents. Yet, more research is needed to examine how childcare staff engage with parents and vice versa. This study addresses the role of position and positioning in parent-practitioner relationships,…

  2. Early Years Education and the Value for Money Folklore

    ERIC Educational Resources Information Center

    Campbell-Barr, Verity

    2012-01-01

    This article is intended as a contribution to the debate on the role of human capital in determining value for money in early years education. The article explores how the idea that early years education offers value for money has become folklore amongst policymakers and more widely. However, drawing on both interview data and existing literature…

  3. Parent Partnership and "Quality" Early Years Services: Practitioners' Perspectives

    ERIC Educational Resources Information Center

    Cottle, Michelle; Alexander, Elise

    2014-01-01

    This article begins by outlining the historical and political context of "parent partnership" within the UK. It locates the perspectives of early years' practitioners within this context, drawing on data from an Economic and Social Research Council (ESRC)-funded study of eighteen English early years settings, including interviews and…

  4. [Five years of ROM in substance abuse treatment centres in the Netherlands].

    PubMed

    Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

    2012-01-01

    Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

  5. General practice--reflection on five years of multidisciplinary training at Medical Centre Gütersloh.

    PubMed

    van den Heuvel, H G J

    2011-12-01

    Medical Centre Gütersloh is a primary care setting which provides the full range of general practice care for British Forces Germany Health Service (BFG HS). The aim of this article is to evaluate the multidisciplinary training organised by the author there, to exchange information and to provide suggestions for improvement and development. Description of the training scheme and analysis of routinely collected management data. The training scheme is based on adult education principles with a focus on interactive learning. Over the period November 2005-July 2010 a total of 1201 members of staff from various disciplines participated in 86 documented training sessions. The majority of the attending staff considered the training to be relevant, interesting and well presented. A substantial proportion indicated that they would change their practice as a result of the training. These views remained stable over time. The majority of facilitators consisted of medical centre employees. This article provides an overview onfive years of multidisciplinary training in a general practice setting. Overall feedback from staff suggests that the training has been highly valued over those years. However, it is recognised that this evaluation has its limitations and suggestions are made regarding how these types of training schemes can be improved and developed further.

  6. The Ancona Early Warning Centre, Instrumentation and Continuous Monitoring of the Landslide

    NASA Astrophysics Data System (ADS)

    Cardellini, S.

    2013-12-01

    have been preassembled and installed in site with DMS REELER, connecting the required number of modules, each containing one or more geotechnical-geophysical sensors and the electronic boards for data collection and transmission. Transmission system The transmitted data coming from different sensors, are collected according to the two following procedures: a) I and II Level Net: data transmission in real time through a WiFi Standard HyperLan to the Town Monitoring Centre. b) III Level Net and, DMS system, wheatear station: data transmission through periodic GSM in CSD mode. Early Warning Management Inside the Monitoring Room of the Ancona Early Warning Centre a staff of 8 people control the monitoring data, verify the data flow, cross-check carefully the SMS warnings from the surface and borehole monitoring systems, verifying and comparing the data also with the rain events and potential triggers. Personal on duty control the data also during the night and weekend 365day/y. The staff was trained specifically for the overall instrumentation allowing in this way to be ready in case of transmission, maintenance to the software and remote control unit in all wheatear conditions.

  7. "It's Just More in the Real World Really": How Can a Local Project Support Early Years Practitioners from Different Settings in Working and Learning Together?

    ERIC Educational Resources Information Center

    Cotton, Lizzie

    2013-01-01

    This article describes how early years practitioners working in different settings, with different experiences and qualifications, can work and learn together. It is a small-scale case study of an eight-month project, with a grass-roots approach, involving early years settings within the reach area of an inner-London Children's Centre. The data…

  8. Family-centred care for hospitalised children aged 0-12 years.

    PubMed

    Shields, Linda; Zhou, Huaqiong; Pratt, Jan; Taylor, Marjory; Hunter, Judith; Pascoe, Elaine

    2012-10-17

    This is an update of the Cochrane systematic review of family-centred care published in 2007 (Shields 2007). Family-centred care (FCC) is a widely used model in paediatrics, is thought to be the best way to provide care to children in hospital and is ubiquitous as a way of delivering care. When a child is admitted, the whole family is affected. In giving care, nurses, doctors and others must consider the impact of the child's admission on all family members. However, the effectiveness of family-centred care as a model of care has not been measured systematically. To assess the effects of family-centred models of care for hospitalised children aged from birth (unlike the previous version of the review, this update excludes premature neonates) to 12 years, when compared to standard models of care, on child, family and health service outcomes. In the original review, we searched up until 2004. For this update, we searched: the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library, Issue 12 2011); MEDLINE (Ovid SP); EMBASE (Ovid SP); PsycINFO (Ovid SP); CINAHL (EBSCO Host); and Sociological Abstracts (CSA). We did not search three that were included in the original review: Social Work Abstracts, the Australian Medical Index and ERIC. We searched EMBASE in this update only and searched from 2004 onwards. There was no limitation by language. We performed literature searches in May and June 2009 and updated them again in December 2011. We searched for randomised controlled trials (RCTs) including cluster randomised trials in which family-centred care models are compared with standard models of care for hospitalised children (0 to 12 years, but excluding premature neonates). Studies had to meet criteria for family-centredness. In order to assess the degree of family-centredness, we used a modified rating scale based on a validated instrument, (same instrument used in the initial review), however, we decreased the family-centredness score for

  9. The evolving role of data scientist during 20 years of the British Atmospheric Data Centre (Invited)

    NASA Astrophysics Data System (ADS)

    Pascoe, S.; Parton, G.; Pascoe, C.; Guillory, A.; da Costa, E. D.

    2013-12-01

    In 2014 The British Atmospheric Data Centre (BADC), now part of the Centre of Environmental Data Archival (CEDA), will celebrate its 20th anniversary. During its lifetime, most BADC staff have defined themselves as data scientists by virtue of being scientists by background and "data workers" by practice. However, the definition of data scientist has been ill defined until recently. As the term has become popularised in the world of business and general information technology, we ask ourselves to what extent the popular definition fits our profession. We observe that data science, as practised at CEDA, encompasses several roles which overlap and compliment each other as we strive to be enablers of data exploitation. For us a data scientist's skills include elements of data curation, software engineering, data infrastructure management and data-intensive research. As data science has evolved the balance between these roles has shifted in response to changes in technology, demands of the research community and funding drivers. We have had to balance our role as enablers of data exploitation, by providing services and infrastructure to the geo-science community, with our role as pioneers of data exploitation itself. By telling the story of how these roles have evolved during the 20 year history of the BADC, we aim to explore the maturing role of data scientist as practised within the geo-sciences and contrast that role with its recently popularised usage. Looking forward we will address questions about how centres of expertise, such as CEDA, can best increase the data capabilities of geo-science research as a whole in order to facilitate the transition to data-intensive science.

  10. Carotid endarterectomy: the change in practice over 11 years in a stroke centre.

    PubMed

    Tse, Gabrielle T W; Kilkenny, Monique F; Bladin, Chris; Grigg, Michael; Dewey, Helen M

    2017-11-13

    Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome. There were 510 CEAs performed during 2004-2014 and 95 CASs during 2003-2008. The proportion of patients undergoing CEA compared to CAS increased from 60% to 90% from 2004 to 2008 (P < 0.001). CAS patients were more likely to have cardiac co-morbidities. From 2004 to 2014, the proportion of CEA patients aged ≥80 years increased (P = 0.001) and the proportion of asymptomatic patients decreased (P = 0.003) over time. Median time from symptom onset to surgery decreased from 52 days (Q1: 25, Q3: 74) in 2004 to 8 days (Q1: 5, Q3: 37) in 2014 (P < 0.001). Use of preoperative ultrasonography decreased whilst CT angiography and the number of imaging modalities applied to each patient increased over time (P < 0.001). Overall, 5.9% of CEAs were complicated by death, stroke or acute myocardial infarction with no significant change over time. The trends in CEA practice at our centre align with international trends and guidelines. This study provides a representative indicator of Australian hospital practice, and illustrates how evidence from research is translated into clinical care. © 2017 Royal Australasian College of Surgeons.

  11. The National Poisons Information Centre in Sri Lanka: the first ten years.

    PubMed

    Fernando, Ravindra

    2002-01-01

    Poisoning is a major health concern in Sri Lanka, which has a very high morbidity and mortality from pesticide poisoning. Poisoning, which continues to be in the first five leading causes of death, accounts for about 80,000 hospitalizations and over 3,000 deaths per year. The National Poisons Information Centre in Sri Lanka, thefirst such centre to be established in South Asia, completed 10 years service in 1997. The 4,070 calls received in thefirst 10 years are analyzed and compared with the national hospitalization pattern. The recorded data sheets of all enquiries received from 1988 to 1997 were analyzed retrospectively to study (1) purpose of enquiry, (2) category of enquirer, (3) circumstances of poisoning, (4) gender of victim, (5) age of victim, (6) type of poison, and (7) outcome. Items (6) and (7) were compared with the national hospital statistics for 1998. Of the 4,070 enquiries, 92% concerned specific patients and 6% were for information on poisons. Almost 90% of the enquiries were from medical or paramedical personnel, 5% from relatives or friends, and 3% from the victims. Nearly 38% of enquiries concerned pesticides compared to 27% of poisoning hospitalizations. Medicinal agents were the subject of 20% of enquiries compared to 13% of hospitalizations. The major discrepancy was for snake bites, accounting for only 6% of enquiries but 42% of hospitalizations. Sex distribution of enquiries showed more males than females. Thirty-seven percent of the victims were young adults-15-29years age group. Nearly 49% of the enquiries were for suicidal attempts. Seventy-one percent of the victims recovered. Although enquiries to the NPIC averaged only 0.5% of poisoning hospitalizations, they were sufficiently representative of the national pattern to predict that increasing utilization of the NPIC would offer a much needed service, both for

  12. An Assessment of Nutritional Patterns in Early Childhood Centres in Zimbabwe: A Quest for Dietary Quality

    ERIC Educational Resources Information Center

    Runyowa, Julius; Podzo, Barbara Zvisinei; Kanyume, Patience

    2014-01-01

    The study explored the experiences of ECD centres in Masvingo district in terms of the quality of meals with regards to diversity and size of portions and WASH provisions. One school was purposively sampled. The research adopted a qualitative paradigm and used one ECD centre in Masvingo district as a case study. Data were gathered through…

  13. Valuing Children's Expression: A First Attempt at Displaying Preschool Art in an Early Childhood Centre

    ERIC Educational Resources Information Center

    Itzkowitz, Selina

    2013-01-01

    A local childcare centre embarks on a first-time project to exhibit preschool children's artworks, acknowledging the importance of art-based activities in the development of young children. In the planning and implementation of a successful afternoon event, the centre's children, along with parents, other family members, friends, and educators,…

  14. Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study

    PubMed Central

    Jakhmola, C.K.; Kumar, Ameet

    2015-01-01

    Background Surgery for inguinal hernia continues to evolve. The most recent development in the field of surgery for inguinal hernia is the emergence of laparoscopic inguinal hernia surgery (LIHS) which is challenging the gold standard Lichtenstein's tension free mesh repair. Our centre has the largest series of LIHS from any Armed Forces hospital. The aim of this study was to analyze the short and long term outcomes at our center since its inception. Methods Retrospective review of prospectively maintained data base of 501 LIHS done in 434 patients by a single surgeon between April 2008 and October 2013. Preoperative, intraoperative, postoperative and follow-up data was analyzed with emphasis on the recurrence rates and the incidence of inguinodynia. Results 402 (92.6%) patients had primary hernias and 367 (84.6%) patients had unilateral hernias. Of the 501 repairs, 453 (90.4 %) were done totally extraperitoneal approach and 48 (9.6 %) were done by the transabdominal preperitoneal approach. The mean operative time for unilateral and bilateral repairs was 40.9 ± 11.2 and 76.2 ± 15.0 minutes, respectively. The conversion rate to open surgery was 0.6%. The intraoperative, and early and late postoperative complication rates were 1.7%, 6.2% and 3%, respectively. The incidence of chronic groin pain was 0.7% and the recurrence rate was 1.6%. The median hospital stay was 1 day (1–5 days). Conclusion We, in this series of over 500 repairs have demonstrated that feasibility as well as safety of LIHS at our centre with good short and long term outcomes. PMID:26663957

  15. Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study.

    PubMed

    Jakhmola, C K; Kumar, Ameet

    2015-10-01

    Surgery for inguinal hernia continues to evolve. The most recent development in the field of surgery for inguinal hernia is the emergence of laparoscopic inguinal hernia surgery (LIHS) which is challenging the gold standard Lichtenstein's tension free mesh repair. Our centre has the largest series of LIHS from any Armed Forces hospital. The aim of this study was to analyze the short and long term outcomes at our center since its inception. Retrospective review of prospectively maintained data base of 501 LIHS done in 434 patients by a single surgeon between April 2008 and October 2013. Preoperative, intraoperative, postoperative and follow-up data was analyzed with emphasis on the recurrence rates and the incidence of inguinodynia. 402 (92.6%) patients had primary hernias and 367 (84.6%) patients had unilateral hernias. Of the 501 repairs, 453 (90.4 %) were done totally extraperitoneal approach and 48 (9.6 %) were done by the transabdominal preperitoneal approach. The mean operative time for unilateral and bilateral repairs was 40.9 ± 11.2 and 76.2 ± 15.0 minutes, respectively. The conversion rate to open surgery was 0.6%. The intraoperative, and early and late postoperative complication rates were 1.7%, 6.2% and 3%, respectively. The incidence of chronic groin pain was 0.7% and the recurrence rate was 1.6%. The median hospital stay was 1 day (1-5 days). We, in this series of over 500 repairs have demonstrated that feasibility as well as safety of LIHS at our centre with good short and long term outcomes.

  16. Results from a pediatric surgical centre justify early intervention in disorders of sex development.

    PubMed

    Crawford, Jennifer M; Warne, Garry; Grover, Sonia; Southwell, Bridget R; Hutson, John M

    2009-02-01

    Controversy persists surrounding early management of disorders of sex development. We assessed genital appearance, gender identity, and quality of life in prepubertal children who have had early surgical intervention. Children treated for disorders of sex development who were 5 to 10 years of age were eligible (n = 54). Children were scored (modified Creighton scale) for anatomical and cosmetic outcome, and both patients and parents completed PedsQL quality-of-life and gender identity questionnaires, with ethics approval. Of 54 patients, 41 presented for review. Treatment began at 13.2 (1.8-250.1) months (median; range) and were reviewed at 7.5 +/- 2.1 (mean +/- SD) years of age. Nineteen were raised as girls and 22 as boys. Girls had good (85%) or satisfactory (15%) anatomical/cosmetic outcome, whereas 52% boys had good, 38% satisfactory, and 10% poor cosmetic outcomes. On gender identity questionnaire, boys scored 3.9 +/- 0.4 (mean +/- SD) and girls 3.6 +/- 0.5; 1 of 19 boys and 3 of 19 girls had lower scores, suggesting risk of gender identity disorder. Quality-of-life scores were 80+ for physical and 65 to 80 for psychosocial scores. Early intervention is generally associated with positive outcomes for patients and parents. Girls had better anatomical outcomes than boys, and gender dysphoria risks were low in both sexes.

  17. Paediatric cervical spine injures. Nineteen years experience of a single centre.

    PubMed

    Ribeiro da Silva, Manuel; Linhares, Daniela; Cacho Rodrigues, Pedro; Monteiro, Eurico Lisboa; Santos Carvalho, Manuel; Negrão, Pedro; Pinto, Rui Peixoto; Neves, Nuno

    2016-06-01

    This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. Seventy-five cases of C-spine injuries (nine SCIWORA) were identified. Group A included 23 patients and group B 52. In group A, skeletal injuries at the upper C-spine were more common than injuries at the lower C-spine, whereas in group B, injuries of the lower C-spine were more frequent (p = 0.035). Motor vehicle accidents were the main cause of injury (44 %); 25.3 % of patients were surgically treated. Thirty-nine patients presented neurologic deficits, 16 of which improved. The overall mortality rate was 18.7 % and significantly higher in patients with neurological damages (p < 0.001) CONCLUSIONS: This study revealed a low incidence of cervical spine injuries in the paediatric population. As in previous reports younger children mainly sustained injuries at the upper C-spine, higher incidence of spinal injuries, and higher risk of death than older children.

  18. Changing characteristics of a Psychiatric Emergency Care Centre. An eight year follow-up study.

    PubMed

    Seymour, Joanne; Chapman, Tristan; Starcevic, Vladan; Viswasam, Kirupamani; Brakoulias, Vlasios

    2018-05-01

    The objective of this study was to report changes in characteristics of admissions to an established Psychiatric Emergency Care Centre (PECC) eight years after its opening. Key clinical characteristics of admissions to the PECC were documented for 327 patients in 2015 and compared with the 477 patients in 2007, which is when the centre first opened. The characteristics of admission were evaluated using an audit of medical records from June to December in both 2007 and 2015. Statistically significant differences ( p<0.05) between 2007 and 2015 were: a reduction in the numbers of patients admitted with depression; a reduction in the numbers of patients diagnosed with adjustment disorder; an increase in the numbers of patients diagnosed with borderline personality disorder; a reduction in pro re nata (prn) use, including a reduction in the need for chemical restraint with midazolam and a decrease in the length of admission in the PECC. The significant reduction in aggression, the use of prn medication and the number of people with longer stays within the PECC support the usefulness of PECCs in relation to patient satisfaction and adherence to admission criteria policy. These factors may be considered as indicators of the efficiency of a PECC.

  19. First-episode psychosis at the West Bologna Community Mental Health Centre: results of an 8-year prospective study.

    PubMed

    Tarricone, I; Mimmi, S; Paparelli, A; Rossi, E; Mori, E; Panigada, S; Carchia, G; Bandieri, V; Michetti, R; Minenna, G; Boydell, J; Morgan, C; Berardi, D

    2012-11-01

    Research mostly conducted in the UK and northern Europe has established that there are high rates of first-episode psychosis (FEP) in large cities and immigrant populations; moreover, psychosis has been found to be associated with cannabis use and early trauma. The present study aimed to evaluate the incidence rate of FEP and the distribution of several risk factors (e.g. age, ethnicity, substance abuse) in Bologna, Italy. The Bologna FEP (BoFEP) study is an 8-year prospective study. All FEP patients, 18-64 years old, consecutively referred to the West Bologna Community Mental Health Centre (CMHC) from 2002 to 2009 were evaluated. Sociodemographic information, migration history and clinical data were collected through an ad-hoc schedule. Psychiatric diagnoses were recorded using the Schedule for Clinical Assessment of Neuropsychiatry (SCAN). The overall incidence rate (IR) in the BoFEP study was 16.4 per 100 000 person-years [95% confidence interval (CI) 13.9-18.9]. The incidence was higher in young people, men and migrants (MI). The IR of FEP found by the Bologna study is lower than that found by other European studies. However, as in other studies, the incidence was higher in certain groups. This heterogeneity has implications for policy and mental health service development, and for understanding the aetiology of psychosis.

  20. Re-operative thyroid surgery: a 20-year prospective cohort study at a tertiary referral centre.

    PubMed

    Hardman, John C; Smith, J A; Nankivell, P; Sharma, N; Watkinson, J C

    2015-06-01

    Re-operative thyroid surgery is a relatively uncommon procedure complicated by distorted anatomy and post-operative tissue changes. Surgery may follow initial benign or malignant pathology. Published outcomes vary widely in the literature. This study aims to report our outcomes from re-operative thyroid surgery. Patient demographics and complication rates for consecutive thyroidectomies performed by a single surgeon at a tertiary centre were collected between 1993 and 2013. Outcomes in re-operative surgery are analysed and compared with local and national data. Cases of re-operative surgery following benign disease are further analysed for histology, re-presenting symptoms and time between procedures. Our cohort comprised 1,657 cases including 164 re-operative procedures (101 malignant, 63 benign). Within our cohort re-operative cases were on average 4 years older (mean 49.9 vs 45.9 years, p = 0.001) and had a higher incidence of haematoma formation (4.3 vs 1.7 %, p = 0.033) and transient recurrent laryngeal nerve palsy (5.5 vs 2.5 %, p = 0.044) compared to primary surgery. Rates of permanent hypocalcaemia (2.4 vs 1.8 %, p = 0.540) and permanent RLN palsy (1.8 vs 0.4 %, p = 0.051) were higher in the re-operative group but did not reach significance. Comparison of complications following re-operation for benign and malignant disease revealed no significant differences. Mean interval to re-operation for benign cases was 17.4 years with 74.6 % found to have multinodular goitre at repeat procedure. Re-operative procedures comprised around 10 % of thyroid surgery at our centre. Re-operative cases experienced more complications than primary surgery but permanent rates were low. Re-operative surgery may therefore be safely considered in experienced hands.

  1. Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre.

    PubMed

    Lane, Thirusha; Pinney, Jennifer H; Gilbertson, Janet A; Hutt, David F; Rowczenio, Dorota M; Mahmood, Shameem; Sachchithanantham, Sajitha; Fontana, Marianna; Youngstein, Taryn; Quarta, Candida C; Wechalekar, Ashutosh D; Gillmore, Julian D; Hawkins, Philip N; Lachmann, Helen J

    2017-09-01

    Systemic AA amyloidosis is a serious complication of chronic inflammation; however, there are relatively few published data on its incidence. We investigated the changing epidemiology of AA amyloidosis over a 25-year period at a single national referral centre. We conducted a retrospective study of all patients diagnosed with AA amyloidosis who had attended the centre between 1990 and 2014 inclusive. Six hundred and twenty-five patients were studied in three cohorts: C1: 1990-1997; C2: 1998-2006; C3: 2007-2014. Mean age at presentation increased from 46 in C1 to 56 in C3 (p < .0001). The proportion of South Asian patients increased from 4% in C1 to 17% in C3 (p = .0006). Comparison of underlying diseases between C1 and C3 revealed a reduction in patients with juvenile idiopathic arthritis from 25% to 2% (p < .0001), but an increase in patients with chronic infection due to intravenous recreational drug use from 1% to 13% (p < .0001), and uncharacterized inflammatory disorders from 10% to 27% (p <.0001). More patients were in end-stage renal failure at presentation in C3 (29%) than C1 (15%) (p = .0028). Median age at death was later in C3 (62 years) than C1 (54 years) (p = .0012). These data suggest both falling incidence and better outcome in AA amyloidosis over a quarter of a century, reflecting advances in therapeutics and overall management of complex chronic disease in an ageing population. AA amyloidosis of uncertain aetiology presents an emerging major problem. Newer techniques such as next-generation sequencing may aid diagnosis and effective treatment, thereby improving overall survival.

  2. Making the best of the early years: the Tambellup way.

    PubMed

    Clark, Kim D; Oosthuizen, Jacques; Beerenfels, Susan; Rowell, Anne-Marie C

    2010-01-01

    -knit community, where adults looked out for and supported both their own and others' children. The primary school played a key role in supporting children's development even before children started school. Good relations generally existed between Aboriginal and non-Aboriginal residents, contributing to the stability of the population and providing many role models in successful cross-cultural relationships. Aboriginal people in Tambellup played significant but often under-recognised roles in promoting child and youth wellbeing in the community. The community had the capacity to respond to local needs and challenges. Communication channels were effective and there was a sense of belonging, pride and 'connectedness' in the community that promoted and supported a safe environment for children. High quality services and staff (eg school and community health centre) reinforced children's developmental opportunities. The results suggest that small rural communities offer significant and untapped resources for enhancing the health and wellbeing of children in the critical early years of life.

  3. Early Years Practitioners' Views on Early Personal, Social and Emotional Development

    ERIC Educational Resources Information Center

    Aubrey, Carol; Ward, Karen

    2013-01-01

    Current policy guidance stresses the need for early identification of obstacles to learning and appropriate intervention. New standards for learning (Early Years Foundation Stage) place personal, social and emotional development (PSED) as central to learning and development. This paper reports a survey and follow-up interviews with early years…

  4. Factors influencing mothers' decisions on whether to provide seafood during early years' feeding: A qualitative study.

    PubMed

    Carstairs, Sharon A; Craig, Leone C A; Marais, Debbi; Kiezebrink, Kirsty

    2017-01-01

    The first year of a child's life is a key period of transition from an exclusive milk diet to solid foods to meet growing nutritional demands. An increased requirement for nutrients includes the introduction of protein-rich solid foods, such as seafood, which additionally provides valuable omega-3 fatty acids. However, consumption of seafood is low in the British child population. The aim of this study was to identify maternal perceptions of the factors that can influence the decision on whether to provide seafood during early years' feeding using a multi-method qualitative study design. A total of 26 discussions posted by mothers on parenting websites; Mumknowsbest, Mumsnet and Netmums, accessed July 2013, together with discussions from six focus groups (February-July 2014) in the North East of Scotland were included for thematic qualitative analysis. Discussions on the inclusion of seafood during the early years were centred across four interrelating themes; - food-related attributes, mother-centred aspects, family-centred aspects, and external information sources. Concerns regarding safety and mothers' limited knowledge and skills on seafood were apparent from discussions; however, the practicalities of providing a cost effective family meal were also issues raised by mothers. An understanding of the numerous and sometimes contradictory influences on mothers' decisions to include seafood during early years' period could be used to develop strategies to help increase regular seafood consumption. In particular, ensuring formal information and guidance clearly addresses the safety concerns of mothers and the development of practical education schemes to encourage and teach cooking skills should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Early and mid-term outcome of the arterial switch operation in 114 consecutive patients : A single centre experience.

    PubMed

    Prandstetter, C; Hofer, A; Lechner, E; Mair, R; Sames-Dolzer, E; Tulzer, G

    2007-10-01

    The arterial switch operation (ASO) has become the treatment of choice in patients with simple or complex transposition of the great arteries (TGA). The purpose of this study was to assess early and mid-term outcome after ASO in a single centre. Between 1995 and December 2005, 114 consecutive patients underwent an ASO at our institution, performed by one single surgeon. Patients charts, surgical reports and echocardiograms were retrospectively reviewed. Patients were analyzed in 3 different groups: Group I consisted of 77 neonates with TGA and intact ventricular septum, group II of 13 patients with TGA and ventricular septal defect which had to be closed surgically and group III of 24 patients with various forms of TGA in a complex setting. The patient's median weight was 3.23 kg (1.65-8.30). Twenty-five neonates were born preterm, 18 were diagnosed prenatally. Median follow-up time was 20.7 months (0.3-128.6). The thirty day mortality was 1.75% (2/114), late mortality 0.88% (1/112) accounting for an overall mortality of 2.63%. There was only one early coronary event and so far no late events. Ten of 111 survivors required reoperation, all but 1 from group III. Prevalence of supravalvular pulmonary stenosis was 4.7%. Freedom from reoperation at 5 years of follow-up time was 87.5%. One patient required permanent pacing, no other late arrhythmias occurred. In our series the only risk factor for increased mortality and morbidity was a body weight of less than 2500 g at the time of operation. No better outcome could be demonstrated in the prenatally diagnosed patients. The ASO can be performed safely and with low mortality and morbidity even in patients with complex TGA. Follow-up of these patients is required to detect residual problems like supravalvular pulmonary stenosis, coronary problems, arrhythmias and aortic valve dysfunction.

  6. Dyslexia in the Early Years: A Handbook for Practice

    ERIC Educational Resources Information Center

    Reid, Gavin

    2017-01-01

    Research has shown that early identification and intervention is crucial and can in fact minimise, and may even prevent, the challenges of dyslexia from becoming too detrimental at later stages of education. This book offers both research insights and practical guidance for teachers working in Early Years settings on how to create resource…

  7. Segments and Stutters: Early Years Teachers and Becoming-Professional

    ERIC Educational Resources Information Center

    Fairchild, Nikki

    2017-01-01

    There has been extensive research and analysis of the professionalization of early childhood educators/teachers. The recent promotion of a teacher-led workforce in England has further focused discussions on the modelling of early years teachers as professionals. In this article, the author develops an alternative analysis using the concepts of…

  8. Early Adolescence: Understanding the 10 to 15 Year Old.

    ERIC Educational Resources Information Center

    Caissy, Gail A.

    Early adolescence, the period from 10 to 15 years, is a significant transitional period in human development, marking the crossroads between childhood and young adulthood. This book is designed as a guide for parents, teachers, or anyone else who has contact with and who would like to better understand early adolescent children. The chapters in…

  9. The Littlest Historians: Early Years Programming in History Museums

    ERIC Educational Resources Information Center

    Leftwich, Mariruth; Haywood, Clare

    2016-01-01

    Working with children under five years old and the adults that accompany them is a rapidly growing area within the museum and wider cultural sector, with important emphasis being placed on early learning in both the United Kingdom and United States. For history museums in particular, early learning offers a unique set of questions and challenges,…

  10. Early Predictors of Adolescent Depression: A 7-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Mazza, James J.; Abbott, Robert D.; Fleming, Charles B.; Harachi, Tracy W.; Cortes, Rebecca C.; Park, Jisuk; Haggerty, Kevin P.; Catalano, Richard F.

    2009-01-01

    This study examined the longitudinal relationship of early elementary predictors to adolescent depression 7 years later. The sample consisted of 938 students who have been part of a larger longitudinal study that started in 1993. Data collected from parents, teachers, and youth self-reports on early risk factors when students were in 1st and 2nd…

  11. The First Three Years: Experiences of Early Career Teachers

    ERIC Educational Resources Information Center

    Fenwick, Ashley

    2011-01-01

    This study considers two discourses of current relevance to national and international educators--early professional learning (EPL) and curriculum change. Induction arrangements for early career teachers (ECTs), EPL and informal learning have received considerable attention in the past few years. Changes to induction inevitably have knock-on…

  12. Gender and psychiatric diagnosis: a 5-year retrospective study in a Nigerian Federal Medical Centre.

    PubMed

    Agbir, T M; Oyigeya, M; Audu, M; Dapap, D D; Goar, S G

    2010-01-01

    The role of gender in psychiatry disorders is becoming increasingly important. This study is therefore, aimed at identifying gender pattern of admissions to a public mental health centre with regards to demographic characteristic, psychiatry diagnosis and length of stay on admission. In this retrospective study Hospital records of 388 patients admitted at the psychiatric section of the Federal Medical Centre (FMC) Makurdi, between January, 2004 and December, 2008 were studied for gender differences regarding demographic attributes, length of stay and psychiatry diagnoses. Findings revealed that more men than women were admitted overall. Most men (56%) were less than 30 years old whereas 60.6% of women were within 30-59 years aged bracket. For men the main diagnosis was schizophrenia (30.5%), followed by substance related disorders (16.5%) then depression (14.0%); for women the main diagnosis was also schizophrenia (30.3%), this was followed by depression (24.5%), only one woman was diagnosed with substance related disorder. A statistically significant association was also found between having a personality disorder and being a male (p = 0.009). Most female were single and belong to the lowest occupational group. There was no significant difference in the gender distribution of patients with respect to length of stay on admission (p = 0.161). The results revealed how psychiatry diagnosis is significantly influence by gender issues. We therefore recommend that; for a more effective psychiatry formulation, it is imperative to pay attention to gender issues that may affect the development of psychopathology.

  13. Clinical features, microbiology and surgical outcomes of infective endocarditis: a 13-year study from a UK tertiary cardiothoracic referral centre.

    PubMed

    Marks, D J B; Hyams, C; Koo, C Y; Pavlou, M; Robbins, J; Koo, C S; Rodger, G; Huggett, J F; Yap, J; Macrae, M B; Swanton, R H; Zumla, A I; Miller, R F

    2015-03-01

    Infective endocarditis (IE) causes substantial morbidity and mortality. Patient and pathogen profiles, as well as microbiological and operative strategies, continue to evolve. The impact of these changes requires evaluation to inform optimum management and identify individuals at high risk of early mortality. Identification of clinical and microbiological features, and surgical outcomes, among patients presenting to a UK tertiary cardiothoracic centre for surgical management of IE between 1998 and 2010. Retrospective observational cohort study. Clinical, biochemical, microbiological and echocardiographic data were identified from clinical records. Principal outcomes were all-cause 28-day mortality and duration of post-operative admission. Patients (n = 336) were predominantly male (75.0%); median age 52 years (IQR = 41-67). Most cases involved the aortic (56.0%) or mitral (53.9%) valves. Microbiological diagnoses, obtained in 288 (85.7%) patients, included streptococci (45.2%); staphylococci (34.5%); Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella (HACEK) organisms (3.0%); and fungi (1.8%); 11.3% had polymicrobial infection. Valve replacement in 308 (91.7%) patients included mechanical prostheses (69.8%), xenografts (24.0%) and homografts (6.2%). Early mortality was 12.2%, but fell progressively during the study (P = 0.02), as did median duration of post-operative admission (33.5 to 10.5 days; P = 0.0003). Multivariable analysis showed previous cardiothoracic surgery (OR = 3.85, P = 0.03), neutrophil count (OR = 2.27, P = 0.05), albumin (OR = 0.94, P = 0.04) and urea (OR = 2.63, P < 0.001) predicted early mortality. This study demonstrates reduced post-operative early mortality and duration of hospital admission for IE patients over the past 13 years. Biomarkers (previous cardiothoracic surgery, neutrophil count, albumin and urea), predictive of early post-operative mortality, require prospective evaluation to refine algorithms, further improve

  14. [Study of polymedicated patients over 65 years-old in an urban primary care centre].

    PubMed

    Garrido-Garrido, E M; García-Garrido, I; García-López-Durán, J C; García-Jiménez, F; Ortega-López, I; Bueno-Cavanillas, A

    2011-01-01

    To identify and characterise the polymedicated population over 65 years-old; and to determine the prevalence of drugs and the diseases in this population subgroup. Cross-sectional study. A primary care centre Zaidín-Centro in Granada. Andalusian Public Health Service. A total of 305 patients over 65 years-old taking polypharmacy (defined as use of five or more drugs, during a period equal to or greater than six months by any route) selected by stratified sampling by sex, age and number of drugs consumed. The analysed variables were sex, age, number of diseases, number of drugs and medical doctor. The prevalence of polypharmacy in patients over 65 years-old was 33.77%. These patients were using an average number of drugs of 8.7±2.5 and had an average number of diseases of 5.56±1.89. The prevalence of polypharmacy was greater among women, but differences decreased in people more than 85 years old. The antihypertensive pharmacological group was the most commonly used, in accordance with the most frequent disease, arterial hypertension. We found a strong relationship between the number of drugs and the number of diseases (p=0.05). Chronic use of drugs in the elderly is of considerable magnitude, affecting one out of every three. Polypharmacy in the elderly is a common and serious problem that needs to be reviewed and evaluated continuously. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  15. Couples as Partners and Parents over Children's Early Years

    ERIC Educational Resources Information Center

    Carlson, Marcia J.; Pilkauskas, Natasha V.; McLanahan, Sara S.; Brooks-Gunn, Jeanne

    2011-01-01

    We used data from the Fragile Families and Child Wellbeing Study to examine how couple relationship quality and parental engagement are linked over children's early years--when they are infants, toddlers, and preschoolers. Our sample included 1,630 couples who were coresident over Years 1-3 and 1,376 couples who were coresident over Years 3-5…

  16. Children at Play: Learning Gender in the Early Years

    ERIC Educational Resources Information Center

    Martin, Barbara

    2011-01-01

    This captivating book illuminates our understanding of how young children develop gender identities. A two year longitudinal research project on children's own understandings of gender casts new light on how 3 and 4 year old newcomers in early years classes learn rules for gendered behaviour from older children, in their imaginative and…

  17. Bacterial Chemotaxis: The Early Years of Molecular Studies

    PubMed Central

    Hazelbauer, Gerald L.

    2014-01-01

    This review focuses on the early years of molecular studies of bacterial chemotaxis and motility, beginning in the 1960s with Julius Adler's pioneering work. It describes key observations that established the field and made bacterial chemotaxis a paradigm for the molecular understanding of biological signaling. Consideration of those early years includes aspects of science seldom described in journals: the accidental findings, personal interactions, and scientific culture that often drive scientific progress. PMID:22994495

  18. Delusional Infestation: Perspectives from Scottish Dermatologists and a 10-year Case Series from a Single Centre.

    PubMed

    Wong, Yee Ling; Affleck, Andrew; Stewart, Alexander M

    2018-04-16

    Perceptions of the clinical management of delusional infestation (DI) were compared with clinical outcomes in this 10-year case series from a single centre in Dundee, UK. An online questionnaire (survey-monkey, a TM brand of online survey available for free for basic use) was sent to Scottish Dermatologists to gauge their opinions and confidence in the management of DI. Also, a retrospective review of medical case notes of patients seen by dermatologists in one institution was undertaken and clinical outcomes were reported by patients' general practitioners (GP). The survey showed that 61% of responding dermatologists encountered 1-5 cases of DI per year. Twenty-four percent respondees were 'confident' in managing patients with DI, 54% were 'somewhat confident'. Forty-seven patients (62% female, 70% single) were seen over the 10 years; 43% brought a self-collected specimen to clinic, 68% of patients had a psychiatric comorbidity, 23% of patients had primary DI and 11/47 (23%) were seen by a psychiatrist. Clinical outcomes as rated by patients' GPs were reasonable or good in 2/3 patients. A poor outcome was seen in 12 patients and associated with chronic pain in 50% (p < 0.01) and psychiatric comorbidity in 100% (p < 0.01). We conclude that good outcomes can be achieved in some patients with DI without psychiatric input and without psychoactive treatment.

  19. Forty years of referrals and outcomes to a UK Child Development Centre (CDC): Has demand plateaued?

    PubMed

    Williams, A N; Mold, B; Kilbey, L; Naganna, P

    2018-05-01

    To explore 40 years of Child Development Centre (CDC) activity and outcomes at Northampton General Hospital 1974-2014. The study comprises 3 data sets: a published report from 1974 to 1999, an internal audit from 2001 to 2004, and more recent data collected from 2005 to 2014. The medical notes of all children who were assessed by the CDC in 2014 were reviewed, along with referral data collected by the CDC manager from this year and the preceding 10 years. From January 1, 1974 to December 31, 2014, 3,786 children were assessed. The male to female ratio is 2.8:1 from 2005 to 2014. Referrals for behavioural difficulties increased from 10% (10/100 referrals) in 1999-2004 to 17.8% (18/101 referrals) in 2014. Similarly, referrals for social and communication problems, "interaction" increased two and a half fold from 10% (10/100 referrals) in 1999-2004 to 26.7% (27/101 referrals) in 2014. Between 2004 and 2014, numbers of referrals for "developmental delay" halved (22.2% to 12%). We are aware of no other comparable extant UK CDC database. Services should plan for a referral rate of 6.5 per 1,000 preschool children. Between 1974 and 2014, there has clearly been a change in recorded assessment outcomes. From the mid-1980s, this reflects the change to a preschool assessment role and a shift away from purely educational outcome to include medical conditions. Covering 1974-2014, we demonstrate a clear increase in the number of referrals together with an increasing demand for assessments for social interaction and behavioural difficulties. This reflects the increased awareness of these neurodevelopmental difficulties and the changing diagnostic criteria which will now more likely result in an Autistic Spectrum Disorder diagnosis than previously. Together, these two features are most likely to have considerable implications for service development within Child Development Centres (CDCs) and Child Development Teams (CDTs). © 2018 John Wiley & Sons Ltd.

  20. Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review.

    PubMed

    Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S

    2017-12-01

    Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.

  1. Autism and Early Years Practice: A Guide for Early Years Professionals, Teachers and Parents

    ERIC Educational Resources Information Center

    Wall, Kate

    2004-01-01

    In this book the author discusses the field of Early Childhood Education and Care (ECEC) as one in which practitioners are highly committed, dedicated and willing to learn. Generally, they try to do their very best for the children with whom they work. However, the author also shows that the field has hitherto been neglected in the areas of…

  2. Seventeen years of Kasai portoenterostomy for biliary atresia in a single Southeast Asian paediatric centre.

    PubMed

    Chiang, Li Wei; Lee, Chuan Yaw; Krishnaswamy, Gita; Nah, Shireen Anne; Kader, Ajmal; Ong, Christina; Low, Yee; Phua, Kong Boo

    2017-04-01

    Biliary atresia (BA) has preponderance in Asian populations with Kasai portoenterostomy (KP) regarded as the first-line standard of care. Yet reports from Southeast Asia remain scant. This study reviews the demographics, short- and medium-term outcomes for our cohort, and evaluates prognostic factors for outcome. All patients diagnosed with BA between January 1997 and December 2013 were included. Clinical data were obtained from medical records. Jaundice clearance was defined as total bilirubin < 20 µmol/L within 6 months after KP. Two-year and 5-year native liver survival (NLS) were determined. Prognostic factors examined included gender, ethnicity, associated anomalies, age at KP, post-KP cholangitis and clearance of jaundice within 6 months. Of 58 patients studied, 31(53.4%) were male. Median age at time of KP was 53 days (range: 28-127). Ethnic distribution showed 32 (55.2%) Chinese, 16 (27.6%) Malays and 10 (17.2%) others. Twenty-one (36.2%) patients achieved jaundice clearance by 6 months. Two-year NLS rate was 36 out of 50 (72%), while 5-year NLS rate was 16 out of 35 (45.7%). Only clearance of jaundice within 6 months had a significant association with NLS (P = 0.006). All other factors showed no significant impact on outcome. Our short- and medium-term outcomes after KP for BA are comparable with those reported by most international centres. However, prognostic factors such as age at KP, cholangitis episodes and associated anomalies did not show significant correlation; only clearance of jaundice within 6 months was significantly predictive of NLS. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  3. Early Years Swimming: A Way of Supporting School Transitions?

    ERIC Educational Resources Information Center

    Jorgensen, Robyn

    2016-01-01

    Informal learning contexts may provide opportunities for adding capital to young children in their years prior to schooling. This paper explores the potential of the early-years swim context to add capital to young children that may position them favourably for the transition to school. Using Bourdieu's notion of capital, the paper discusses the…

  4. Practitioner Perspectives: Children's Use of Technology in the Early Years

    ERIC Educational Resources Information Center

    Formby, Susie

    2014-01-01

    This research, a collaboration between Pearson and the National Literacy Trust, was designed to explore the use of technology by children in the early years. In 2013 Pearson and the National Literacy Trust invited practitioners who work with three to five-year-olds to take part in an online survey to explore how they support children's language…

  5. The Role of Parents' Educational Level and Centre Type in Parent Satisfaction with Early Childhood Care Centres: A Study in Greece

    ERIC Educational Resources Information Center

    Kelesidou, Sofia; Chatzikou, Maria; Tsiamagka, Evmorfia; Koutra, Evangelia; Abakoumkin, Georgios; Tseliou, Eleftheria

    2017-01-01

    This research examines specific facets of parent satisfaction with childcare centres, namely satisfaction with parent-centre communication and the educational services they provide, as well as respective parent beliefs. These were investigated in relation to centre type (private vs public) and parents' education. Parents of different educational…

  6. Causes of prolonged jaundice in infancy: 3-year experience in a tertiary paediatric centre.

    PubMed

    Andre, Margaret; Day, Andrew S

    2016-01-29

    Although prolonged jaundice (PJ) commonly occurs in infancy, there is not yet agreement as to the appropriate extent of investigations, particularly in otherwise well children. Significant pathologies may present with PJ in this age group and need to be considered. The aim of this retrospective study was to ascertain the causes of PJ in infants referred to a single tertiary paediatric centre. Infants referred with PJ over a 3-year period were identified. Clinical documentation, electronic notes and results of investigations performed prior to and after referral were reviewed. One hundred and sixty-seven infants with PJ were seen. Fifty-eight percent were over 28 days of age. Four patients had conjugated hyperbilirubinaemia. Eighteen percent of patients were found to have a specific medical diagnosis causing or contributing to PJ, almost half of whom had normal clinical examination. The single most common pathological cause for PJ was hypothyroidism found in six patients. This study demonstrates that normal clinical examination and exclusion of conjugated hyperbilirubinaemia are insufficient to exclude pathological causes of PJ. Overall, these children were referred late. Guidelines, in conjunction with education initiatives, are required to optimise the management of prolonged jaundice in infancy.

  7. Wilson's Disease: a challenge of diagnosis. The 5-year experience of a tertiary centre.

    PubMed

    Gheorghe, Liana; Popescu, Irinel; Iacob, Speranta; Gheorghe, Cristian; Vaidan, Roxana; Constantinescu, Alexandra; Iacob, Razvan; Becheanu, Gabriel; Angelescu, Corina; Diculescu, Mircea

    2004-09-01

    Because molecular diagnosis is considered impractical and no patognomonic features have been described, diagnosis of Wilson's disease (WD) using clinical and biochemical findings is still challenging. We analysed predictive factors for the diagnosis in 55 patients with WD diagnosed in our centre between 1st January 1999 and 1st April 2004. All patients presented predominant liver disease classified as: 1) asymptomatic, found incidentally, 2) chronic hepatitis or cirrhosis, or 3) fulminant hepatic failure. Diagnosis was considered as classic (two out of the three following criteria: 1) serum ceruloplasmin < 20 mg/dl, 2) the presence of Kayser-Fleischer rings and/or 3) hepatic copper > 250 mg/g dry weight liver tissue), and non-classic (clinical manifestations plus laboratory parameters suggesting impaired copper metabolism). The association between the predictive factors and non-classic diagnosis was assessed based on the level of statistical significance (p value<0.05) associated with the chi-squared test in contingency tables. Multivariate analysis was performed by logistic regression using SPSS 10. There were 31 males (56.3%) and 24 females (43.7%) with the mean age at diagnosis of 20.92 +/- 9.97 years (4-52 years); 51 patients (92.7%) were younger than 40 years. Asymptomatic WD was diagnosed in 14 patients (25.4%), chronic liver disease due to WD in 29 patients (52.8%) and fulminant hepatic failure in 12 patients (21.8%). The classic diagnosis was made in 32 patients (58.18%). In the univariate analysis the non-classic diagnosis was associated with: age>18 years (p=0.03), increased copper excretion (p<0.0001), Coombs-negative hemolysis (p=0.03), absence of neurological manifestations (p<0.0001). Multivariate analysis identified age over 18 years, increased urinary copper, and isolated hepatic involvement as independent predictors. In clinical practice, WD should be considered also in patients who do not fulfil classic criteria. Independent factors associated

  8. Parents as Discerning Consumers at Three Types of Early Childhood Centres.

    ERIC Educational Resources Information Center

    Farquhar, Sarah-Eve

    Parents' views on the goals of early childhood programs and on characteristics of a high quality center were examined in a study that also investigated parents' understandings of quality in three different types of early childhood services. The study was part of a major project on the quality of early childhood centers, which was funded by the New…

  9. Ten-year surveillance of nosocomial bloodstream infections: trends of aetiology and antimicrobial resistance in a comprehensive cancer centre.

    PubMed

    Passerini, R; Ghezzi, Tl; Sandri, Mt; Radice, D; Biffi, R

    2011-01-01

    Bloodstream infections (BSIs) are one of the major life-threatening infectious conditions in cancer patients and are responsible for prolonged hospital stays, high healthcare costs and significant mortality. Several clinical trials have reported an improved survival in patients treated with appropriate empirical broad-spectrum antibiotic therapy. Early detection of pathogens and determination of their susceptibility are essential for the optimization of treatment. Variability between hospitals is substantial and requires the individual analysis of local trends. The aim of this study is to assess the local epidemiology of BSI in a single cancer centre over a 10-year period. Retrospective microbiological surveillance of all febrile/infective episodes occurring in oncological and surgical patients in a high-volume cancer centre between January 1999 and December 2008 were considered. Patients' data were collected, processed and analyzed using the epidemiological resource of the Virtuoso Plus software (Metafora Informatica Srl, Milano, Italy). Spearman's rank correlation coefficient, including the two-tailed test of significance, was used to investigate trends of incidence and rate of antibiotic resistance over the 10-year period. A total of 13,058 blood cultures (BCs) were performed in 2,976 patients. BCs were positive in 2,447 tests, representing 740 infective/febrile episodes: 358 (48%) in medical oncology and 382 (52%) in surgical wards. Gram-positives were responsible for the majority of episodes in oncological and surgical divisions (about 63% and 55%, respectively). Gram-positives were also the most common organism in non-catheter-related BSIs (CRBSIs) both in medical oncology (75%) and in surgical divisions (50%). Enterococci showed an increased resistance to levofloxacin, from 5.6% to 25.7% (p = 0.02) and to erythromycin, from 41.7% to 61.4%, (p = 0.05). Similarly, coagulase negative staphylococci (CoNS) developed resistance to levofloxacin and ciprofloxacin

  10. Surgical treatment of chronic pancreatitis using Frey's procedure: a Brazilian 16-year single-centre experience.

    PubMed

    Gestic, Martinho Antonio; Callejas-Neto, Francisco; Chaim, Elinton Adami; Utrini, Murillo Pimentel; Cazzo, Everton; Pareja, Jose Carlos

    2011-04-01

    Surgical treatment of chronic pancreatitis is indicated for intractable pain. Frey's procedure is an accepted treatment for this disease. The aim of the present study was to describe a single-centre experience in the treatment of chronic pancreatitis using Frey's procedure. A retrospective analysis of 73 patients who underwent a Frey's procedure between 1991 to 2007 and had at least 1 year of follow-up. Demographics, indication for surgery, peri-operative complications and late outcomes were analysed. The median age was 39.9 years. Seventy out of the 73 (95.8%) patients were male. The median pre-operative body mass index (BMI) was 19.1 kg/m(2). All patients had abdominal pain, 34 (46.6%) of them daily and 13 (17.8%) weekly, with moderate or severe intensity in 98.6% (n= 72). The aetiology was secondary to alcohol in 70 patients (95.9%), with a median consumption of 278 g per day. The surgical morbidity rate was 28.7%; there were no deaths. Median post-operative follow-up was 77.0 months; 64 patients (91.4%) had complete pain relief and post-operative BMI was 22.4 kg/m(2) (P<0.001). All patients with pre-operative endocrine and exocrine insufficiencies showed no reversal of the situation. New onset insufficiencies appeared late. Frey's procedure was a safe and effective therapeutic option for the surgical treatment of patients with intractable pain caused by chronic pancreatitis. © 2011 International Hepato-Pancreato-Biliary Association.

  11. Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study

    PubMed Central

    Poggioli, Michela; Minichilli, Fabrizio; Bononi, Tiziana; Meghi, Pasquina; Andre, Paolo; Crecchi, Alessandra; Rossi, Bruno; Carboncini, Maria Chiara; Ottolini, Alberto

    2016-01-01

    Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years' corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months' corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant's developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps. PMID:28090357

  12. Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study.

    PubMed

    Poggioli, Michela; Minichilli, Fabrizio; Bononi, Tiziana; Meghi, Pasquina; Andre, Paolo; Crecchi, Alessandra; Rossi, Bruno; Carboncini, Maria Chiara; Ottolini, Alberto; Bonfiglio, Luca

    2016-01-01

    Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years' corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months' corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant's developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps.

  13. Sowing the Seeds of Science Understanding in the Early Years

    ERIC Educational Resources Information Center

    Roach, Joanne

    2010-01-01

    For practitioners in the Early Years Foundation Stage (EYFS) in English schools (ages 3-5), the ethos of learning by "investigating and doing" is a major component of the pleasure of teaching very young children. The "Knowledge and understanding of the world" area of the EYFS (where scientific learning is mainly anchored)…

  14. Efficacy of Language Intervention in the Early Years

    ERIC Educational Resources Information Center

    Fricke, Silke; Bowyer-Crane, Claudine; Haley, Allyson J.; Hulme, Charles; Snowling, Margaret J.

    2013-01-01

    Background: Oral language skills in the preschool and early school years are critical to educational success and provide the foundations for the later development of reading comprehension. Methods: In a randomized controlled trial, 180 children from 15 UK nursery schools ("n" = 12 from each setting; M[subscript age] = 4;0) were randomly…

  15. Computing Education in Children's Early Years: A Call for Debate

    ERIC Educational Resources Information Center

    Manches, Andrew; Plowman, Lydia

    2017-01-01

    International changes in policy and curricula (notably recent developments in England) have led to a focus on the role of computing education in the early years. As interest in the potential of computing education has increased, there has been a proliferation of programming tools designed for young children. While these changes are broadly to be…

  16. Building Language Throughout the Year: The Preschool Early Literacy Curriculum

    ERIC Educational Resources Information Center

    Lybolt, John; Armstrong, Jennifer; Techmanski, Kristin Evans; Gottfred, Catherine

    2007-01-01

    For children from low-resource backgrounds, a literacy-rich preschool experience with a skilled and engaged teacher can offset risk factors and lay the groundwork for lifelong academic success. Now schools can ensure effective early literacy instruction with this field-tested, research-based curriculum for children 3 to 5 years of age. These 41…

  17. Multimodal Transcription of Video: Examining Interaction in Early Years Classrooms

    ERIC Educational Resources Information Center

    Cowan, Kate

    2014-01-01

    Video is an increasingly popular data collection tool for those undertaking social research, offering a temporal, sequential, fine-grained record which is durable, malleable and sharable. These characteristics make video a valuable resource for researching Early Years classrooms, particularly with regard to the study of children's interaction in…

  18. Assessing the Quality of Early Years Learning Environments

    ERIC Educational Resources Information Center

    Walsh, Glenda; Gardner, John

    2005-01-01

    This article describes a means of evaluating early years classrooms from the perspective of the child's experience. Nine key themes, such as motivation and independence, are identified as representing significant aspects of a high-quality environment for learning. The manner in which these manifest themselves in relation to the three elements of…

  19. Mathematics in Early Years Education. 3rd Edition

    ERIC Educational Resources Information Center

    Montague-Smith, Ann; Price, Alison

    2012-01-01

    This third edition of the best-selling "Mathematics in Nursery Education" provides an accessible introduction to the teaching of mathematics in the early years. Covering all areas of mathematics learning--number and counting, calculation, pattern, shape, measures and data handling--it summarises the research findings and underlying key concepts…

  20. Early Identification System: Year Two. Research Report 80-15.

    ERIC Educational Resources Information Center

    Stennett, R. G.; Earl, L. M.

    During the academic year 1978-79, school teams implemented a newly developed early identification system in all kindergarten and grade one classes in London, Ontario schools. After analysis and revision of the system, the internal consistency and concurrent validity of the process and a test of its short-term predictive validity were investigated.…

  1. Exploring Pedagogical Leadership in Early Years Education in Saudi Arabia

    ERIC Educational Resources Information Center

    Alameen, Lubna; Male, Trevor; Palaiologou, Ioanna

    2015-01-01

    The empirical research for this paper was undertaken with leaders of early years setting in the Kingdom of Saudi Arabia (KSA). The investigation sought to establish to what extent it was possible to behave in line with the concept of pedagogical leadership in the twenty-first century in an Arab Muslim monarchy, dominated by Islam, where directive…

  2. Eliciting Systematic Rule Use in Covariation Judgment [the Early Years].

    ERIC Educational Resources Information Center

    Shaklee, Harriet; Paszek, Donald

    Related research suggests that children may show some simple understanding of event covariations by the early elementary school years. The present experiments use a rule analysis methodology to investigate covariation judgments of children in this age range. In Experiment 1, children in second, third and fourth grade judged covariations on 12…

  3. Math Anxiety and Math Ability in Early Primary School Years

    ERIC Educational Resources Information Center

    Krinzinger, Helga; Kaufmann, Liane; Willmes, Klaus

    2009-01-01

    Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported…

  4. Developing Early Undergraduate Research at a Two-Year College

    ERIC Educational Resources Information Center

    Sibbernsen, Kendra

    2013-01-01

    Two-year college (TYC) physics teachers are not often required to provide student research experiences as a part of their contracted duties. However, some TYC physics faculty members are interested in developing research opportunities for their freshman- and sophomore-level students, often called "early undergraduate research" (EUR).…

  5. The Third Year of the Brookline Early Education Project.

    ERIC Educational Resources Information Center

    Pierson, Donald E.

    This is the third progress report of the Brookline Early Education Project (BEEP) which is a program designed to provide diagnostic and educational services to the family through their child's preschool years. This document provides information on (1) the BEEP center, (2) playgroups: transition phase of the education program, (3) dental screening…

  6. Approaches to Developing Health in Early Years Settings

    ERIC Educational Resources Information Center

    Mooney, Ann; Boddy, Janet; Statham, June; Warwick, Ian

    2008-01-01

    Purpose: The purpose of the paper is to consider the opportunities and difficulties in developing health-promotion work in early years settings in the UK. Design/methodology/approach: As the first study of its kind conducted in the UK, a multi-method approach was adopted involving: an overview of health-related guidance and of effective…

  7. Barriers and Solutions to HE Progression for Early Years' Practitioners

    ERIC Educational Resources Information Center

    Kendall, Alexandra; Carey, Danielle; Cramp, Andy; Perkins, Helen

    2012-01-01

    Shifts in UK social and economic policy have focused on education and care in the Early Years as key to improving social inclusion, skills acquisition and longer term social and economic prosperity. The implications for practitioners in the sector have been significant as roles, functions and foci have been renegotiated through the processes of…

  8. Monsters under the Bed: Critically Investigating Early Years Writing

    ERIC Educational Resources Information Center

    Melrose, Andrew

    2012-01-01

    "Monsters Under the Bed" is an essential text focussing on critical and contemporary issues surrounding writing for "early years" children. Containing a critically creative and a creatively critical investigation of the cult and culture of the child and childhood in fiction and non-fictional writing, it also contains a wealth of ideas and critical…

  9. Child Participation in the Early Years: Challenges for Education

    ERIC Educational Resources Information Center

    Theobald, Maryanne; Danby, Susan; Ailwood, Jo

    2011-01-01

    The view that children should have a say in and participate in the decision making of matters that affect them is now an accepted position when considering research and policy in the early years. This paper reviews the field of child participation in the Australian context to show that, despite growing evidence of support within policy and…

  10. Being a Manager in the English Early Years Sector

    ERIC Educational Resources Information Center

    Preston, Diane

    2013-01-01

    This article draws on interviews with 29 managers and deputy managers within 15 nurseries in the private sector in England. The author argues that, whilst there is a growing literature on management and professionalism within the Early Years (EY) sector, there is less known about the actual experiences of being a manager in this context. Many of…

  11. 34. THE CROW'S NEST. IN THE EARLY YEARS OF THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. THE CROW'S NEST. IN THE EARLY YEARS OF THE INN MUSICIANS SAT AND PLAYED FOR THE GUESTS IN THE LOBBY BELOW. THE EARTHQUAKE IN 1959 CAUSED SOME STRUCTURAL DAMAGE AND NOW THE CROW'S NEST IS NOT ACCESSIBLE TO THE PUBLIC. - Old Faithful Inn, 900' northeast of Snowlodge & 1050' west of Old Faithful Lodge, Lake, Teton County, WY

  12. Investigating Early Years Teachers' Understanding and Response to Children's Preconceptions

    ERIC Educational Resources Information Center

    Kambouri, Maria

    2016-01-01

    This paper focuses on young children's scientific preconceptions and discusses teachers' identification of these preconceptions when teaching science in the early years, on which research is still limited. This paper is based on the theoretical framework of constructivism and it defines preconceptions as children's erroneous concepts prior to…

  13. Repeat liver resection for recurrent colorectal metastases: a single-centre, 13-year experience.

    PubMed

    Battula, Narendra; Tsapralis, Dimitrios; Mayer, David; Isaac, John; Muiesan, Paolo; Sutcliffe, Robert P; Bramhall, Simon; Mirza, Darius; Marudanayagam, Ravi

    2014-02-01

    Isolated intrahepatic recurrence is noted in up to 40% of patients following curative liver resection for colorectal liver metastases (CLM). The aims of this study were to analyse the outcomes of repeat hepatectomy for recurrent CLM and to identify factors predicting survival. Data for all liver resections for CLM carried out at one centre between 1998 and 2011 were analysed. A total of 1027 liver resections were performed for CLM. Of these, 58 were repeat liver resections performed in 53 patients. Median time intervals were 10.5 months between the primary resection and first hepatectomy, and 15.4 months between the first and repeat hepatectomies. The median tumour size was 3.0 cm and the median number of tumours was one. Six patients had a positive margin (R1) resection following first hepatectomy. There were no perioperative deaths. Significant complications included transient liver dysfunction in one and bile leak in two patients. Rates of 1-, 3- and 5-year overall survival following repeat liver resection were 85%, 61% and 52%, respectively, at a median follow-up of 23 months. R1 resection at first hepatectomy (P = 0.002), a shorter time interval between the first and second hepatectomies (P = 0.02) and the presence of extrahepatic disease (P = 0.02) were associated with significantly worse overall survival. Repeat resection of CLM is safe and can achieve longterm survival in carefully selected patients. A preoperative knowledge of poor prognostic factors helps to facilitate better patient selection. © 2013 International Hepato-Pancreato-Biliary Association.

  14. Person-centred positive emotions, object-centred negative emotions: 2-year-olds generalize negative but not positive emotions across individuals.

    PubMed

    Vaish, Amrisha; Grossmann, Tobias; Woodward, Amanda

    2015-09-01

    Prior work suggests that young children do not generalize others' preferences to new individuals. We hypothesized (following Vaish et al., 2008, Psychol. Bull., 134, 383-403) that this may only hold for positive emotions, which inform the child about the person's attitude towards the object but not about the positivity of the object itself. It may not hold for negative emotions, which additionally inform the child about the negativity of the object itself. Two-year-old children saw one individual (the emoter) emoting positively or negatively towards one and neutrally towards a second novel object. When a second individual then requested an object, children generalized the emoter's negative but not her positive emotion to the second individual. Children thus draw different inferences from others' positive versus negative emotions: Whereas they view others' positive emotions as person centred, they may view others' negative emotions as object centred and thus generalizable across people. The results are discussed with relation to the functions and implications of the negativity bias. © 2015 The British Psychological Society.

  15. Sociocultural Perspectives on Transition to School from Pacific Islands Early Childhood Centres.

    ERIC Educational Resources Information Center

    Podmore, Valerie N.; Sauvao, Le'Autuli'ilagi M.; Mapa, Lia

    2003-01-01

    Summarizes research investigating children's transition to primary school from Pacific early childhood centers in New Zealand. Key issues emerging from the review include continuity of Pacific Islands languages and culture between home, early childhood center, and school; home-school partnership; teachers' and parents' expectations regarding…

  16. Towards Collaborative Professional Learning in the First Year Early Childhood Teacher Education Practicum: Issues in Negotiating the Multiple Interests of Stakeholder Feedback

    ERIC Educational Resources Information Center

    Brown, Alice; Danaher, Patrick

    2008-01-01

    This paper analyses data from two sources of stakeholder feedback--first year pre-service teachers and supervising teachers/centre directors--about the issues involved in creating more collaborative approaches to the first year early childhood teacher education practicum at an Australian regional university. The collection of this feedback was…

  17. Analysis of fatal accidents with tractors in the Centre of Portugal: Ten years analysis.

    PubMed

    Antunes, Soraia M; Cordeiro, Cristina; Teixeira, Helena M

    2018-06-01

    Tractors have been described as one of the deadliest farming implements concerning agricultural activity. In Portugal, the scientific investigations about this problem are practically non-existent, with only statistical studies performed by entities related to road traffic safety, not in accordance to the study now performed, pinpointing the possibility of an underreporting of these accidents. This work aims to characterize the fatal tractor accidents in Portugal, autopsied at the Forensic Pathology Department of the Centre Branch of the National Institute of Legal Medicine and Forensic Sciences of Portugal, analysing several variables: gender, age, occupation, survival time, the victim position in the tractor, cause of death, toxicological and histological exams, year/month/day of the week, type of agricultural machine, existence of rollover protective structures (ROPS), type of accident, ground conditions, circumstantial information and geographic distribution of the accidents. All the autopsies between 2005 and 2014 were analysed. The victim profile corresponded to a man (89.5%), between 61 and 70 years old (33.3%), retired (43.9%), being the tractor driver (45.6%). In most of the cases, death occurred in less than 24h after the accident. These fatalities arose mainly in May and October. Rollover in sloping land was the most common type of accident, and cranioencephalic, thoracic and abdominal traumatic injuries were the main cause of death. In 16.2% of the cases, blood alcohol concentration was above the lower limit established in our road traffic law (<0.5g/L). There was lack information about the use of ROPS (95.9%), and even when existent, the protections were not used or were incorrectly used. This is the first national study involving the description of the forensic achievements in each autopsy related to tractor accidents, and the corresponding circumstances that contributed to the death. Many barriers remain about this matter, but the Portuguese

  18. Management of febrile children under five years in hospitals and health centres of rural Ghana.

    PubMed

    Webster, Jayne; Baiden, Frank; Bawah, Justina; Bruce, Jane; Tivura, Mathilda; Delmini, Rupert; Amenga-Etego, Seeba; Chandramohan, Daniel; Owusu-Agyei, Seth

    2014-07-09

    The case management of febrile children in hospitals' and health centres' pre-roll out of the new WHO policy on parasitological diagnosis was assessed. The delivery of artemisinin combination therapy (ACT) at these two levels of the health system was compared. Structured observations and exit interviews of 1,222 febrile children attending five hospitals and 861 attending ten health centres were conducted in six districts of the Brong Ahafo Region of Ghana. Effectiveness of delivery of case management of malaria was assessed. Proportions of children receiving ACT, anti-malarial monotherapy and antibiotics were described. Predictors of: a febrile child being given an ACT, a febrile child being given an antibiotic and of carers knowing how to correctly administer the ACT were assessed using logistic regression models stratified by hospitals and health centres. The system's effectiveness of delivering an ACT to febrile children diagnosed with malaria (parasitologically or clinically) was 31.4 and 42.4% in hospitals and health centres, respectively. The most ineffective process was that of ensuring that carers knew how to correctly administer the ACT. Overall 278 children who were not given an ACT were treated with anti-malarial monotherapy other than quinine. The majority of these children, 232/278 were given amodiaquine, 139 of these were children attending hospitals and 93 attending health centres. The cadre of health staff conducting consultation was a common predictor of the outcomes of interest. Presenting symptoms and examinations conducted were predictive of being given an ACT in hospitals and antibiotic in hospitals and health centres but not of being given an ACT in health centres. Treatment-seeking factors were predictive of being given an ACT if it was more than seven days since the fever began and an antibiotic in hospitals but not in health centres. Interventions to improve adherence to negative parasitological tests are needed, together with guidance on

  19. The Early Years: Embracing the Challenges. 1997 Early Years of Schooling Conference Proceedings (Melbourne, Australia, July 20-21, 1997).

    ERIC Educational Resources Information Center

    Victoria Education Dept. (Australia).

    These conference proceedings comprise 19 papers and the plenary session presented at the Early Years Schooling Conference held in Melbourne, Australia. The plenary session was "A Developmental Approach to Teaching Young Children" conducted by Lilian Katz. The keynote addresses and breakout sessions were: (1) "Developmental Learning:…

  20. Tinnitus and psychiatric comorbidities in liaison psychiatry analysis of three years in an audiophonology centre.

    PubMed

    Jacques, Denis; Nozeret, Yves; Zdanowicz, Nicolas; Reynaert, Christine; Garin, Pierre; Gilain, Chantal

    2013-09-01

    Patients who are suffering from tinnitus are rarely directly referred to an audiophonology centre. Often, they have tried several medications and met with several doctors. Sometimes, they are also referred too quickly to a psychiatrist without a complete ENT assessment. Nevertheless, they frequently develop psychiatric comorbidities in regard to the tinnitus. On the basis of structured interviews with the "Mini International Neuropsychiatric Interview" and on a review of records, we assessed the associated psychiatric diagnoses in patients who consulted for tinnitus as their main complaint at the audiophonology centre from the University Hospital Centre of Mont-Godinne-Dinant between 2009 and 2012. Of the 80 patients who consulted for tinnitus, 28% suffered from a major depressive disorder, 27.5% from a somatoform disorder, 23.7% from sleep disorder, 22.5% from an anxiety disorder and 16% from alcoholic dependence. On the basis of these results, we developed clinical considerations concerning the treatment approach and options for patients suffering from tinnitus with psychiatric comorbidities. The interdisciplinary approach (ENT and liaison psychiatry) in an audiophonology centre seems to be a factor for better treatment adherence for patients with severe and chronic tinnitus.

  1. Factors predicting haematopoietic recovery in patients undergoing autologous transplantation: 11-year experience from a single centre.

    PubMed

    Bai, Lijun; Xia, Wei; Wong, Kelly; Reid, Cassandra; Ward, Christopher; Greenwood, Matthew

    2014-10-01

    Engraftment outcomes following autologous transplantation correlate poorly to infused stem cell number. We evaluated 446 consecutive patients who underwent autologous transplantation at our centre between 2001 and 2012. The impact of pre-transplant and collection factors together with CD34(+) dosing ranges on engraftment, hospital length of stay (LOS) and survival endpoints were assessed in order to identify factors which might be optimized to improve outcomes for patients undergoing autologous transplantation using haemopoietic progenitor cells-apheresis (HPC-A). Infused CD34(+) cell dose correlated to platelet but not neutrophil recovery. Time to platelet engraftment was significantly delayed in those receiving low versus medium or high CD34(+) doses. Non-remission status was associated with slower neutrophil and platelet recovery. Increasing neutrophil contamination of HPC-A was strongly associated with slower neutrophil recovery with infused neutrophil dose/kg recipient body weight ≥3 × 10(8)/kg having a significant impact on time to neutrophil engraftment (p = 0.001). Higher neutrophil doses/kg in HPC-A were associated with days of granulocyte colony stimulation factor (G-CSF) use, HPC-A volumes >500 ml and higher NCC in HPC-A. High infused neutrophil dose/kg and age >65 years were associated with longer hospital LOS (p = 0.002 and 0.011 respectively). Only age, disease and disease status predicted disease-free survival (DFS) and overall survival (OS) in our cohort (p < 0.005). Non-relapse mortality was not affected by low dose of CD34(+) (<2 × 10(6)/kg). In conclusion, our study shows that CD34(+) remains a useful and convenient marker for assessing haemotopoietic stem cell content and overall engraftment capacity post-transplant. Neutrophil contamination of HPC-A appears to be a key factor delaying neutrophil recovery. Steps to minimize the degree of neutrophil contamination in HPC-A product may be associated with more rapid neutrophil engraftment and

  2. The early dynamical evolution of star clusters near the Galactic Centre

    NASA Astrophysics Data System (ADS)

    Park, So-Myoung; Goodwin, Simon P.; Kim, Sungsoo S.

    2018-07-01

    We examine the dynamical evolution of both Plummer sphere and substructured (fractal) star-forming regions in Galactic Centre (GC) strong tidal fields to see what initial conditions could give rise to an Arches-like massive star cluster by ˜2 Myr. We find that any initial distribution has to be contained within its initial tidal radius to survive, which sets a lower limit of the initial density of the Arches of ˜600 M⊙ pc-3 if the Arches is at 30 pc from the GC, or ˜200 M⊙ pc-3 if the Arches is at 100 pc from the GC. Plummer spheres that survive change little other than to dynamically mass segregate, but initially fractal distributions rapidly erase substructure, dynamically mass segregate and by 2 Myr look extremely similar to initial Plummer spheres, therefore it is almost impossible to determine the initial conditions of clusters in strong tidal fields.

  3. The early dynamical evolution of star clusters near the Galactic Centre

    NASA Astrophysics Data System (ADS)

    Park, So-Myoung; Goodwin, Simon P.; Kim, Sungsoo S.

    2018-04-01

    We examine the dynamical evolution of both Plummer sphere and substructured (fractal) star forming regions in Galactic Centre (GC) strong tidal fields to see what initial conditions could give rise to an Arches-like massive star cluster by ˜2 Myr. We find that any initial distribution has to be contained within its initial tidal radius to survive, which sets a lower limit of the initial density of the Arches of ˜ 600 M⊙ pc-3 if the Arches is at 30 pc from the GC, or ˜ 200 M⊙ pc-3 if the Arches is at 100 pc from the GC. Plummer spheres that survive change little other than to dynamically mass segregate, but initially fractal distributions rapidly erase substructure, dynamically mass segregate and by 2 Myr look extremely similar to initial Plummer spheres, therefore it is almost impossible to determine the initial conditions of clusters in strong tidal fields.

  4. Math Anxiety and Math Ability in Early Primary School Years.

    PubMed

    Krinzinger, Helga; Kaufmann, Liane; Willmes, Klaus

    2009-06-01

    Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported evaluation of mathematics, and math anxiety in 140 primary school children between the end of first grade and the middle of third grade. Structural equation modeling revealed a strong influence of calculation ability and math anxiety on the evaluation of mathematics but no effect of math anxiety on calculation ability or vice versa-contrasting with the frequent clinical reports of math anxiety even in very young MLD children. To summarize, our study is a first step toward a better understanding of the link between math anxiety and math performance in early primary school years performance during typical and atypical courses of development.

  5. Math Anxiety and Math Ability in Early Primary School Years

    PubMed Central

    Krinzinger, Helga; Kaufmann, Liane; Willmes, Klaus

    2010-01-01

    Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported evaluation of mathematics, and math anxiety in 140 primary school children between the end of first grade and the middle of third grade. Structural equation modeling revealed a strong influence of calculation ability and math anxiety on the evaluation of mathematics but no effect of math anxiety on calculation ability or vice versa—contrasting with the frequent clinical reports of math anxiety even in very young MLD children. To summarize, our study is a first step toward a better understanding of the link between math anxiety and math performance in early primary school years performance during typical and atypical courses of development. PMID:20401159

  6. Early T-cell precursor acute lymphoblastic leukaemia in children treated in AIEOP centres with AIEOP-BFM protocols: a retrospective analysis.

    PubMed

    Conter, Valentino; Valsecchi, Maria Grazia; Buldini, Barbara; Parasole, Rosanna; Locatelli, Franco; Colombini, Antonella; Rizzari, Carmelo; Putti, Maria Caterina; Barisone, Elena; Lo Nigro, Luca; Santoro, Nicola; Ziino, Ottavio; Pession, Andrea; Testi, Anna Maria; Micalizzi, Concetta; Casale, Fiorina; Pierani, Paolo; Cesaro, Simone; Cellini, Monica; Silvestri, Daniela; Cazzaniga, Giovanni; Biondi, Andrea; Basso, Giuseppe

    2016-02-01

    Early T-cell precursor acute lymphoblastic leukaemia was recently recognised as a distinct leukaemia and reported as associated with poor outcomes. We aimed to assess the outcome of early T-cell precursor acute lymphoblastic leukaemia in patients from the Italian Association of Pediatric Hematology Oncology (AIEOP) centres treated with AIEOP-Berlin-Frankfurt-Münster (AIEOP-BFM) protocols. In this retrospective analysis, we included all children aged from 1 to less than 18 years with early T-cell precursor acute lymphoblastic leukaemia immunophenotype diagnosed between Jan 1, 2008, and Oct 31, 2014, from AIEOP centres. Early T-cell precursors were defined as being CD1a and CD8 negative, CD5 weak positive or negative, and positive for at least one of the following antigens: CD34, CD117, HLADR, CD13, CD33, CD11b, or CD65. Treatment was based on AIEOP-BFM acute lymphoblastic leukaemia 2000 (NCT00613457) or AIEOP-BFM acute lymphoblastic leukaemia 2009 protocols (European Clinical Trials Database 2007-004270-43). The main differences in treatment and stratification of T-cell acute lymphoblastic leukaemia between the two protocols were that in the 2009 protocol only, pegylated L-asparaginase was substituted for Escherichia coli L-asparaginase, patients with prednisone poor response received an additional dose of cyclophosphamide at day 10 of phase IA, and high minimal residual disease at day 15 assessed by flow cytometry was used as a high-risk criterion. Outcomes were assessed in terms of event-free survival, disease-free survival, and overall survival. Early T-cell precursor acute lymphoblastic leukaemia was diagnosed in 49 patients. Compared with overall T-cell acute lymphoblastic leukaemia, it was associated with absence of molecular markers for PCR detection of minimal residual disease in 25 (56%) of 45 patients; prednisone poor response in 27 (55%) of 49 patients; high minimal residual disease at day 15 after starting therapy in 25 (64%) of 39 patients (bone marrow

  7. Family-centred interventions by primary healthcare services for Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the United States: a systematic scoping review.

    PubMed

    McCalman, Janya; Heyeres, Marion; Campbell, Sandra; Bainbridge, Roxanne; Chamberlain, Catherine; Strobel, Natalie; Ruben, Alan

    2017-02-21

    Primary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families. This scoping review assesses the quality of the evidence base and identifies the published literature on family- centred interventions for Indigenous early childhood wellbeing. Fourteen electronic databases, grey literature sources and the reference lists of Indigenous maternal and child health reviews were searched to identify relevant publications from 2000 to 2015. Studies were included if the intervention was: 1) focussed on Indigenous children aged from conception to 5 years from the abovementioned countries; 2) led by a primary healthcare service; 3) described or evaluated; and 4) scored greater than 50% against a validated scale for family-centredness. The study characteristics were extracted and quality rated. Reported aims, strategies, enablers and outcomes of family-centredcare were identified using grounded theory methods. Eighteen studies (reported in 25 publications) were included. Three were randomised controlled studies; most were qualitative and exploratory in design. More than half of the publications were published from 2012 to 2015. The overarching aim of interventions was to promote healthy families. Six key strategies were to: support family behaviours and self- care, increase maternal knowledge, strengthen links with the clinic, build the Indigenous workforce, promote cultural/ community connectedness and advocate for social determinants of health. Four enablers were: competent and compassionate program deliverers, flexibility of access, continuity and integration of healthcare, and culturally supportive care. Health outcomes were reported for Indigenous children (nutritional status; emotional/behavioural; and prevention of injury and illness); parents/caregivers (depression and substance abuse; and

  8. Educating for Sustainability in the Early Years: Creating Cultural Change in a Child Care Setting

    ERIC Educational Resources Information Center

    Davis, Julie

    2005-01-01

    The early childhood education field has been slow to take up the challenge of sustainability. However, Brisbane's Campus Kindergarten is one early education centre that is making serious efforts in this regard. In 1997, Campus Kindergarten initiated its "Sustainable Planet Project" involving a variety of curriculum and pedagogical…

  9. Transitional Practice: Teachers and Children In-between Classrooms in One Early Childhood Centre

    ERIC Educational Resources Information Center

    Fincham, Emmanuelle N.; Fellner, Amanda R.

    2016-01-01

    Transitions from one classroom to the next as children reach a certain age or achieve certain milestones seem inevitable; however, this taken-for-granted practice in early childhood centers has not been looked at closely in research. This article considers what happens when we look more in depth at these day-to-day experiences of teachers and…

  10. Supporting Parental Involvement in Children's Early Learning: Lessons from Community Childcare Centres in Dublin's Docklands

    ERIC Educational Resources Information Center

    Share, Michelle; Kerrins, Liz

    2013-01-01

    Recently in Ireland attention has been placed on the importance of parental involvement in early childhood care and education settings as seen in the Síolta Quality Standards and Aistear Curriculum Framework. Yet there is little Irish empirical evidence on parental involvement in childcare settings; on the involvement models being used, or on the…

  11. Quality and Impact of Centre-Based Early Childhood Education and Care. Research Report

    ERIC Educational Resources Information Center

    Janta, Barbara; van Belle, Janna; Stewart, Katherine

    2016-01-01

    There is a strong association between the quality of Early Childhood Education and Care (ECEC) provision and the outcomes for children, with high quality ECEC being associated with better child outcomes later in life. This brief reviewed the broad range of indicators that have been linked to quality, with a focus on understanding how these…

  12. Lunch Time at the Child Care Centre: Neoliberal Assemblages in Early Childhood Education

    ERIC Educational Resources Information Center

    Nxumalo, Fikile; Pacini-Ketchabaw, Veronica; Rowan, Mary Caroline

    2011-01-01

    In this article we interrogate neoliberal assemblages within the context of eating and feeding practices in early childhood education. We consider how neoliberal assemblages are enacted and created through multiple linkages between micro and macro regulations and policies, and everyday food routines. We attend to the embodied intensities, desires…

  13. Conditions for Implementation of the Science Curriculum in Early Childhood Development and Education Centres in Kenya

    ERIC Educational Resources Information Center

    Shaji, Milimu Gladys; Indoshi, Francis C.

    2008-01-01

    Cognitive development and teaching have highlighted the importance of learning based on the relationship among individuals and the learning environment. Teaching and learning of science in early childhood development and education (ECDE) can only be effective if adequate facilities, materials, equipment and activities are put in place. Teaching of…

  14. Placement Supervision of Pedagogue Students in Denmark: The Role of University Colleges and Early Childhood Centres

    ERIC Educational Resources Information Center

    Jensen, Jytte Juul

    2015-01-01

    The article examines Danish pedagogue students' supervision during their placement periods in early childhood settings. Throughout the long history of Danish pedagogue education, discourses relating to the placement element have been located either within a "work" paradigm or a "scholastic" paradigm. These two understandings of…

  15. Five years' experience at a single centre of craniocerebral injury from winnowing fan blades.

    PubMed

    Kumar, Apoorva; Shankar, Ravi; Pandey, Rajendra P; Keshri, Virendra; Singh, Kulwant; Sharma, Vivek

    2010-02-01

    India, an agriculture-based country, relies heavily on indigenous farm machinery. In our study we present 31 patients with winnowing fan blade head injury, operated on at our centre between 2004 and 2008. The mechanism and nature of the injuries, operative methods, outcome and methods of prevention are discussed with special reference to the occurrence of this type of injury in the pediatric population. Copyright 2009 Elsevier Ltd. All rights reserved.

  16. Dengue fever in Czech travellers: A 10-year retrospective study in a tertiary care centre.

    PubMed

    Trojánek, Milan; Maixner, Jan; Sojková, Naděžda; Kynčl, Jan; Roháčová, Hana; Marešová, Vilma; Stejskal, František

    2016-01-01

    Dengue fever is a frequent cause of morbidity in travellers. The objective was to describe the epidemiological and clinical characteristics of dengue fever in Czech travellers. This descriptive study includes patients with acute dengue fever diagnosed at Hospital Na Bulovce during 2004-2013. Data were collected and analysed retrospectively. A total of 132 patients (83 males and 49 females) of median age 33 years (IQR 29-40) were included. Diagnosis was established by NS1 antigen detection in 87/107 cases (81.3%) and/or RT-PCR in 50/72 (69.4%) and by serology in 25 cases (18.9%). Dengue was acquired in South-East Asia in 69 cases (52.3%), followed by South Asia (48 cases; 36.3%), Latin America (14; 10.6%) and Sub-Saharan Africa (1; 0.8%). The most frequent symptoms included fever, rash and headache. Initial leukocyte and lymphocyte counts were lower in patients who presented in the early phase (0-4 days), however, platelet count was lower and AST, ALT and LDH activity higher in patients with a longer symptoms duration (≥5 days). The clinical course was mostly uncomplicated. Dengue fever is becoming a frequent cause of fever in Czech travellers. Clinicians should be familiar with the typical clinical findings and novel diagnostic methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Learning from Children: Learning from Caroline Pratt (1867-1954). Early Progressives in Early Years Education

    ERIC Educational Resources Information Center

    Drummond, Mary Jane

    2014-01-01

    This review of Caroline Pratt's life and work in early years education includes an account of how a six-year-old boy taught a woman in her thirties what she needed to know in order to open a school--in 1914--that continues to this day, a school that was, in the founder's own words, fitted to the child and not the other way around. It finds a clear…

  18. Early Childhood Development in the Montreal Study Area (Quebec). Understanding the Early Years

    ERIC Educational Resources Information Center

    Human Resources Development Canada, 2003

    2003-01-01

    Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

  19. Early Childhood Development in Abbotsford, British Columbia. Understanding the Early Years

    ERIC Educational Resources Information Center

    Human Resources Development Canada, 2003

    2003-01-01

    Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

  20. Early Childhood Development in Niagara Falls, Ontario. Understanding the Early Years

    ERIC Educational Resources Information Center

    Wilms, Douglas J.

    2003-01-01

    Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

  1. Early Childhood Development in the Dixie Bloor Community of Mississauga, Ontario. Understanding the Early Years.

    ERIC Educational Resources Information Center

    Human Resources Development Canada, 2003

    2003-01-01

    Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

  2. Early Childhood Development in Hampton/Sussex, New Brunswick. Understanding the Early Years

    ERIC Educational Resources Information Center

    Willms, J. Douglas

    2003-01-01

    Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

  3. Turkish Early Childhood Teachers' Emotional Problems in Early Years of Their Professional Lives

    ERIC Educational Resources Information Center

    Kotaman, Hüseyin

    2016-01-01

    The purpose of this study is to elaborate on the emotional problems faced by Turkish early childhood teachers in their interaction with students, parents, administrators and colleagues in the first three years of their professional lives. Data for this research consists of in-depth interviews with Turkish kindergarten teachers, where these…

  4. Early Tracking or Finally Leaving? Determinants of Early Study Success in First-Year University Students

    ERIC Educational Resources Information Center

    Brouwer, Jasperina; Jansen, Ellen; Hofman, Adriaan; Flache, Andreas

    2016-01-01

    Two theoretical approaches underlie this investigation of the determinants of early study success among first-year university students. Specifically, to extend Walberg's educational productivity model, this study draws on the expectancy-value theory of achievement motivation in a contemporary university context. The survey data came from 407…

  5. Application of an incident taxonomy for radiation therapy: Analysis of five years of data from three integrated cancer centres.

    PubMed

    Greenham, Stuart; Manley, Stephen; Turnbull, Kirsty; Hoffmann, Matthew; Fonseca, Amara; Westhuyzen, Justin; Last, Andrew; Aherne, Noel J; Shakespeare, Thomas P

    2018-01-01

    To develop and apply a clinical incident taxonomy for radiation therapy. Capturing clinical incident information that focuses on near-miss events is critical for achieving higher levels of safety and reliability. A clinical incident taxonomy for radiation therapy was established; coding categories were prescription, consent, simulation, voluming, dosimetry, treatment, bolus, shielding, imaging, quality assurance and coordination of care. The taxonomy was applied to all clinical incidents occurring at three integrated cancer centres for the years 2011-2015. Incidents were managed locally, audited and feedback disseminated to all centres. Across the five years the total incident rate (per 100 courses) was 8.54; the radiotherapy-specific coded rate was 6.71. The rate of true adverse events (unintended treatment and potential patient harm) was 1.06. Adverse events, where no harm was identified, occurred at a rate of 2.76 per 100 courses. Despite workload increases, overall and actual rates both exhibited downward trends over the 5-year period. The taxonomy captured previously unidentified quality assurance failures; centre-specific issues that contributed to variations in incident trends were also identified. The application of a taxonomy developed for radiation therapy enhances incident investigation and facilitates strategic interventions. The practice appears to be effective in our institution and contributes to the safety culture. The ratio of near miss to actual incidents could serve as a possible measure of incident reporting culture and could be incorporated into large scale incident reporting systems.

  6. Open randomised prospective comparative multi-centre intervention study of patients with cystic fibrosis and early diagnosed diabetes mellitus

    PubMed Central

    2014-01-01

    Background Diabetes mellitus may be present in patients with cystic fibrosis starting in the second decade of life. The prevalence increases rapidly with increasing age. As life-expectancy increases in cystic fibrosis, cystic fibrosis related diabetes will be diagnosed more frequently in the future. Up to date, no data are available to answer the question if cystic fibrosis related diabetes should always initially be treated by insulin therapy. Missing data regarding oral antidiabetic treatment of newly diagnosed cystic fibrosis related diabetes are an important reason to recommend insulin treatment. Several centres report the successful management of cystic fibrosis related diabetes using oral anti-diabetic drugs at least for some years. Oral therapies would be less invasive for a patient group which is highly traumatized by a very demanding therapy. Based on an initiative of the German Mukoviszidosis-Foundation, the present study tries to answer the question, whether oral therapy with repaglinide is as effective as insulin therapy in cystic fibrosis patients with early diagnosed diabetes mellitus. Methods/Design In all cystic fibrosis patients with an age of 10 years or older, an oral glucose tolerance test is recommended. The result of this test is classified according to the WHO cut off values. It is required to have two diabetes positive oral glucose tolerance tests for the diagnosis of diabetes mellitus. This study is a multi-national, multicentre, open labelled, randomized and prospective controlled parallel group’s trial, with 24 months treatment. The primary objective of this trial is to compare the glycaemic control of oral therapy with Repaglinide with insulin injections in patients with cystic fibrosis related diabetes after 2 years of treatment. The trial should include 74 subjects showing cystic fibrosis related diabetes newly diagnosed by oral glucose tolerance test during annual screening for cystic fibrosis related diabetes. Patients are

  7. Surgical intervention for paediatric liver injuries is almost history - a 12-year cohort from a major Scandinavian trauma centre.

    PubMed

    Koyama, Tomohide; Skattum, Jorunn; Engelsen, Peder; Eken, Torsten; Gaarder, Christine; Naess, Pål Aksel

    2016-11-29

    Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed. Data were compiled from the institutional trauma registry and medical records. A total of 66 children were included. The majority was severely injured as reflected by a median injury severity score of 20.5 (mean 22.2). NOM was attempted in 60 (90.9%) patients and was successful in 57, resulting in a NOM success rate of 95.0% [95% CI 89.3 to 100]. Only one of the three NOM failures was liver related, occurred in the early part of the study period, and consisted in operative placement of drains for bile leak. Two (3.0%) patients underwent angiographic embolization (AE). Complications occurred in 18 (27.3% [95 % CI 16.2 to 38.3]) patients. Only 2 (3.0%) patients had liver related complications, in both cases bile leak. Six (9.1%) patients underwent therapeutic laparotomy for non-liver related injuries. Two (3.0%) patients died secondary to traumatic brain injury. This single institution paediatric liver injury cohort confirms high attempted NOM and NOM success rates even in patients with high grade injuries and multiple accompanying injuries. AE can be a useful NOM adjunct in the treatment of paediatric liver injuries, but is seldom indicated. Moreover, bile leak is the most common liver-related complication and the need for liver-related surgery is very infrequent. NOM is the treatment of choice in almost all liver injuries in children, with operative management and interventional radiology

  8. Evolution of cystic fibrosis lung function in the early years.

    PubMed

    Bush, Andrew; Sly, Peter D

    2015-11-01

    Most treatment of newborn screening-diagnosed cystic fibrosis is not evidence-based; there are very few randomized controlled trials (RCTs). Furthermore, the advent of novel molecular therapies, which could be started at diagnosis, mandates performing RCTs in very young children. However, unless the natural history of early cystic fibrosis lung disease is known, RCTs are impossible. Here, we review the results of two large prospective cohorts of these infants - London Cystic Fibrosis Collaboration (LCFC) (London, UK) and Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST-CF) (Australia). Nutritional status remained excellent in both the cohorts. Both cohorts reported abnormal lung function aged at 3 months. AREST-CF, which previously reported rapidly declining preschool lung function, now report good conventional school-age spirometry. LCFC reported improvement between 3 months and 1 year, and stability in the second year. AREST-CF also reported a high prevalence of high resolution computed tomographic abnormalities related to free neutrophil elastase in bronchoalveolar lavage; LCFC reported high resolution computed tomographic changes at 1 year, which were too mild to be scored reproducibly. At least in the first 2 years of life, lung function is not a good end-point for RCTs; routine bronchoalveolar lavage and HRCT cannot be justified. Newborn screening has greatly improved outcomes, but we need better point-of-care biomarkers.

  9. Global early warning systems for natural hazards: systematic and people-centred.

    PubMed

    Basher, Reid

    2006-08-15

    To be effective, early warning systems for natural hazards need to have not only a sound scientific and technical basis, but also a strong focus on the people exposed to risk, and with a systems approach that incorporates all of the relevant factors in that risk, whether arising from the natural hazards or social vulnerabilities, and from short-term or long-term processes. Disasters are increasing in number and severity and international institutional frameworks to reduce disasters are being strengthened under United Nations oversight. Since the Indian Ocean tsunami of 26 December 2004, there has been a surge of interest in developing early warning systems to cater to the needs of all countries and all hazards.

  10. The Centre for Early Human Behaviour (EHB) at the University of Bergen: A transdisciplinary exploration into the evolution of homo sapiens behaviour

    NASA Astrophysics Data System (ADS)

    Sobolowski, Stefan; Henshilwood, Christopher; Jansen, Eystein

    2017-04-01

    Homo sapiens was anatomically modern by 200 000 years ago in Africa, but there is no archaeological evidence to demonstrate that behaviour was modern at the time. Attributes of modern behaviour, perhaps inspired by changes in the human brain, are only recognizable after 100 000 years ago. Before we can study the process, we must critically define the criteria for the term 'modern behaviour' and then find a means to recognize such behavior in the record. This seemingly simple research statement involves complex exploration by a team of specialists. In this highly competitive research field our centre will, for the first time, be able to rise to the challenge by combining the skills of cutting-edge scientists in archaeology, climate reconstruction and modelling, and the cognitive and social sciences. Over the next decade we will integrate knowledge and methods from different disciplines to synthesize approaches and contribute to a sophisticated understanding of early human behaviour. Our highly ambitious research program will focus explicitly on rare, well preserved archaeological sites occupied in the period between 100-50 000 years ago because these contain the 'keys' for unlocking the past. A major competitive edge is the EHB Director's 25 years of archaeological experience and his long-term exclusive access, with permits, to a number of the best-preserved sites in the southern Cape, South Africa - a region regarded as a major locus for vital evidence that could inform on the behaviour of early humans. Our planned excavations at existing and new sites and our ground-breaking and innovative interdisciplinary approaches, including climate (The Bjerknes Centre for Climate Research) and cognitive research, to understanding the processes that shaped human cultures. Primarily, EHB will directly address unanswered, first order questions about Homo sapiens: a) what defines the switch to 'modern behaviour', exactly how should this term be defined and then, when, why and

  11. Sacral neurostimulation for urinary retention: 10-year experience from one UK centre.

    PubMed

    Datta, Soumendra N; Chaliha, Charlotte; Singh, Anubha; Gonzales, Gwen; Mishra, Vibhash C; Kavia, Rajesh B C; Kitchen, Neil; Fowler, Clare J; Elneil, Sohier

    2008-01-01

    To report our 10-year experience of sacral neurostimulation (SNS) for women in urinary retention, comparing the original one-stage with the newer two-stage technique, as SNS therapy is a well-established treatment for urinary retention secondary to urethral sphincter overactivity (Fowler's syndrome). Between 1996 and 2006, 60 patients with urinary retention had a SNS device inserted; their case records were reviewed and data on efficacy, follow-up, need for continued clean intermittent self-catheterization (CISC), complications and operative revision rate were assessed. Overall, 43 of 60 (72%) women were voiding spontaneously, with a mean postvoid residual volume of 100 mL; 30 (50%) no longer needed to use CISC. During a total of 2878 months of SNS experience, adverse event episodes included lead migration in 20, 'box-site' pain in 19, leg pain/numbness in 18 and loss of response/failure in 18 patients; 53% of the women required a surgical revision related to their implanted stimulator. The efficacy of the two-stage was similar to that of the one-stage procedure (73% vs 70%). Women with a normal urethral sphincter electromyogram had worse outcomes than women with an abnormal test (43% vs 76%). Although the efficacy was no different in those taking analgesia/antidepressant medication, this group of women had a higher surgical revision rate. Failure and complications for the one-stage procedure were not restricted to the early follow-up period. The mean battery life of the implant was 7.31 years. SNS has sustained long-term efficacy but the procedure has a significant complication rate. At present, the two-stage technique has comparable efficacy to the one-stage technique but a longer-term follow-up is required. The National Institute of Clinical Excellence recommended the use of SNS in women with urinary incontinence who fail to respond adequately to anticholinergic therapy, but patients choosing this treatment should be made aware of the high complication rate

  12. Narrowing the Gap in Outcomes: Early Years (0-5 Years)

    ERIC Educational Resources Information Center

    Springate, Ian; Atkinson, Mary; Straw, Suzanne; Lamont, Emily; Grayson, Hilary

    2008-01-01

    This report was commissioned by the Local Government Association (LGA) to inform the Department for Children, Schools and Families (DCSF) and LGA work on "Narrowing the Gap." It focuses on early years' provision and presents findings from a review of the best evidence on narrowing the gap in outcomes across the five Every Child Matters…

  13. Centre d'Observacio de l'Univers: first year of activities

    NASA Astrophysics Data System (ADS)

    Ribas, S. J.

    2011-11-01

    The Centre d'Observacio de l'Univers is one of the parts of the Parc Astronomic Montsec (PAM). PAM is an initiative of the Catalan government, through the Consorci del Montsec (Montsec Consortium), to take advantage of the capabilities and potential of the Montsec region to develop scientific research, training, and outreach activities, particularly in the field of astronomy. The choice of the Montsec mountains to install the PAM was motivated by the magnificent conditions for observing the sky at night; the sky above Montsec is the best (natural sky free of light pollution) in Catalonia for astronomical observations. The PAM has two main parts: the Observatori Astronomic del Montsec (OAdM) and the Centre d'Observacio del'Univers (COU). The OAdM is a professional observatory with an 80 cm catadioptric telescope (Joan Oro Telescope). The COU is a large multipurpose center which is intended to become an educational benchmark for teaching and communicate astronomy and other sciences in Catalonia. Since the opening more than 50000 visitors went to this center to enjoy science with Montsec dark skies and an special natural environment.

  14. Centre-based day care for children younger than five years of age in high-income countries.

    PubMed

    van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

    2014-09-23

    A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR

  15. Comparison of endoscopic and microscopic trans-sphenoidal pituitary surgery: early results in a single centre.

    PubMed

    Razak, Adam A; Horridge, Michelle; Connolly, Daniel J; Warren, Daniel J; Mirza, Showkat; Muraleedharan, Vakkat; Sinha, Saurabh

    2013-02-01

    Pituitary surgery has seen a recent shift from a microscopic to an endoscopic trans-sphenoidal approach. We present our early experience with endoscopic surgery and compare the outcome with our recent microscopic experience. From January 2008 until present time, 80 consecutive patients underwent trans-sphenoidal pituitary surgery in our institution. Until September 2009, all patients had a microscopic trans-septal approach. After this time, the patients underwent endoscopic trans-sphenoidal surgery. All patients underwent pre- and post-operative MRI and full endocrinological evaluation. Data was collected prospectively including tumour volume, endocrine function, visual function, length of stay and complications. There were 40 patients in each group. In the microscopic group, there were 26 non-functioning tumours and 14 functioning tumours. In the endoscopic group, there were 24 non-functioning and 16 functioning tumours. There were significantly better results in terms of tumour resection (p = 0.002) and remission (p = 0.018) in the endoscopic group. In this group there was also a lower incidence of CSF leaks and a shorter length of stay for secreting tumours (p = 0.005). 1 patient in the endoscopic group died at day 43 post-operatively, having initially presented in a poor clinical state with pituitary apoplexy. Microscopic trans-sphenoidal surgery remains the benchmark for future surgical techniques. Our early results suggest that endoscopic trans-sphenoidal surgery provides favourable results in both tumour resection and control of secreting tumours in comparison with microscopic surgery. Further longer-term evaluation is required to ensure the outcome of endoscopic surgery.

  16. Outpatient follow-up after treatment for early breast cancer: updated results after 5 years.

    PubMed

    Churn, M; Kelly, V

    2001-01-01

    The value of frequent outpatient follow-up in the first few years after primary treatment for early breast cancer is a controversial issue. Schedules involving 3-4 monthly visits in the first 2-3 years and 6-monthly from years 3-5 are still commonplace. In this study we audited such a policy from a single cancer centre, identifying a cohort of all 612 patients with early breast cancer (pT(1-3)pN(0-1)NxM0) referred for adjuvant therapy in 1993. The hospital records were reviewed to ascertain patient and tumour characteristics, the surgical and adjuvant treatment received, the timing and sequencing of recurrences and their mode of detection. Five hundred and five patients had breast conservation surgery. The actuarial local recurrence-free survival rate at 5 years in this group was 94.5%. Twenty-five of the 31 local recurrences that occurred were the first site of relapse. Eight (32%) of these were detected at routine clinic appointments, seven (28%) by routine mammography, and nine (36%) were interim referrals. Significant risk factors for local recurrence identified were lymph node status (P = 0.03) and tumour grade (P = 0.04). One hundred and four patients underwent mastectomy. The actuarial local recurrence-free survival at 5 years in this group was 85.4%. Nine of the 13 local recurrences were the first site of relapse. Six (66.7%) of these were detected at routine appointments. The significant risk factor for local recurrence identified was tumour grade (P = 0.03). Overall, 60.1% of metastases presented as interim referrals. Nodal status, tumour grade and tumour stage were confirmed as significant risk factors for metastasis (P < or = 0.001). Hazard rate analysis demonstrated a peak incidence of both local and metastatic recurrences in the second year, diminishing thereafter. This peak was largely confined to patients with tumours with poor prognostic features. We identified only eight patients out of a total of 612 followed up as outpatients for 5 years who had

  17. Characteristics of clients to a suicide prevention centre--an epidemiological analysis of the users over a 10-year period.

    PubMed

    Qin, Ping; Madsen, Bente Hjorth; Mortensen, Preben Bo

    2009-06-01

    Suicide prevention centres play an important role on suicide prevention in communities. A better understanding of clients to these centres is essential and informative to suicide prevention. This study aimed to document the referral pattern of clients to a suicide prevention centre over a 10-year period and to capture their characteristics. All suicidal clients during 1996 to 2005 were included and compared with the regional population. Data were retrieved from longitudinal registers. There were in total 4274 contacts from 3505 individuals because of suicide attempt (38%) or suicide ideation (62%). Source of referral included self-initiation or family (25.4%), psychiatric hospitals (23.5%), general practitioners (21.7%), and somatic hospitals (15.1%). The clients were more likely females and persons at young ages. Compared with regional sex-age-matched counterparts, suicidal clients significantly more often had a history of psychiatric contact, were born by young parents, had no recorded link to a mother or father, had lost a parent, and had a parental psychiatric history. Also, they were often frequent movers and residents with a foreign citizenship. This study provided insights about the referral pattern of suicidal clients as well as client characteristics on selected variables at the birth and during upbringing, which may be informative to suicide intervention targeting at this group of population.

  18. The Impact of the Mathematics Support Centre on the Grades of First Year Students at the National University of Ireland Maynooth

    ERIC Educational Resources Information Center

    Mac an Bhaird, Ciaran; Morgan, Tadhg; O'Shea, Ann

    2009-01-01

    In this article, we consider the mathematics grades of first year students at the National University of Ireland Maynooth and the influence that the Mathematics Support Centre (MSC) has on these grades. We will consider the evidence to suggest that the MSC has a positive effect on the grades of the students who attend the centre. It seems to be…

  19. Changing trend of viral hepatitis--"A twenty one year report from Pakistan Medical Research Council Research Centre, Jinnah Postgraduate Medical Centre, Karachi".

    PubMed

    Ahmed, Waquaruddin; Qureshi, Huma; Arif, Ambreen; Alam, Syed Ejaz

    2010-02-01

    To determine the frequency and pattern of Hepatitis B and C over the past twenty one years, in a liver research unit of Karachi. Retrospective analysis of the records of PMRC, Research Centre, Jinnah Postgraduate Medical Centre, Karachi, from 1987 to 2007 were reviewed. A special flow sheet was made where information of all patients with viral liver disease was entered. Patients having complete information of viral markers were included in the analysis. Cases with HBsAg, Anti HBc IgM positive and raised ALT were considered as acute Hepatitis B. HBs Ag/Anti HBc IgG positive were considered as chronic Hepatitis B. Delta antibody positive with or without HBsAg were considered as Delta Hepatitis. Anti HCV positive and raised ALT more than ten times for less than 6 months were considered as acute Hepatitis C, whereas Anti HCV and HCV-RNA positive with or without raised ALT for more than six months were considered as chronic Hepatitis C. Anti HEV IgM and Anti HAV IgM positive were considered as acute Hepatitis E and A respectively. A total of 5193 cases fulfilling all criteria of viral hepatitis were seen in the past 21 years. Of the total 3247 (62.5%) were males and 1946 (37.5%) females giving a male to female ratio of 1.7 : 1. Hepatitis C was the most common infection seen in 2896 cases (55.8%), followed by Hepatitis B in 1691 cases (32.6%). Seventy five percent cases of Hepatitis B were males and 25% females while 55% Hepatitis C cases were males and 45% females. Hepatitis B was seen a decade earlier in different age groups than hepatitis C. Overall, out of the total 5193 cases, 2294 (44.2%) were of chronic hepatitis, 1430 (27.5%) cirrhosis, 1083 (20.8%) carriers and 346 (6.7%) had acute hepatitis (hepatitis B; 214 (61.8%), hepatitis C; 21 (6.0%). While hepatitis B and hepatitis C both were present in 3 (1.3%). Hepatitis E was 70 (20.2%), hepatitis A 12 (3.5%) and all markers were negative in 26 (7.5%) cases). Forty cases (0.8%) were of Hepatocellular carcinoma. Year

  20. A Gossip or a Good Yack? Reconceptualizing Parent Support in New Zealand Early Childhood Centre Based Programmes

    ERIC Educational Resources Information Center

    Duncan, Judith; Bowden, Chris; Smith, Anne B.

    2006-01-01

    Parental support has been an increasingly essential part of New Zealand early childhood (EC) education services over the last 20 years. This support has taken many shapes and forms over this time period, and has depended on the differing philosophies of the EC education services. What this support "looks like" and how it is delivered is…

  1. Talking Everyday Science to Very Young Children: A Study Involving Parents and Practitioners within an Early Childhood Centre

    ERIC Educational Resources Information Center

    Lloyd, Eva; Edmonds, Casey; Downs, Celony; Crutchley, Rebecca; Paffard, Fran

    2017-01-01

    The acquisition of everyday scientific concepts by 3-6-year-old children attending early childhood institutions has been widely studied. In contrast, research on science learning processes among younger children is less extensive. This paper reports on findings from an exploratory empirical study undertaken in a "stay and play" service…

  2. Review of Kinemax total knee replacements performed at the NHS treatment centre, Weston-Super-Mare: five-year results.

    PubMed

    Hickey, B A; Kempshall, P J; Metcalfe, A J; Forster, M C

    2012-04-01

    As part of the national initiative to reduce waiting times for joint replacement surgery in Wales, the Cardiff and Vale NHS Trust referred 224 patients to the NHS Treatment Centre in Weston-Super-Mare for total knee replacement (TKR). A total of 258 Kinemax TKRs were performed between November 2004 and August 2006. Of these, a total of 199 patients (232 TKRs, 90%) have been followed up for five years. This cohort was compared with 258 consecutive TKRs in 250 patients, performed at Cardiff and Vale Orthopaedic Centre (CAVOC) over a similar time period. The five year cumulative survival rate was 80.6% (95% confidence interval (CI) 74.0 to 86.0) in the Weston-Super-Mare cohort and 95.0% (95% CI 90.2 to 98.2) in the CAVOC cohort with revision for any reason as the endpoint. The relative risk for revision at Weston-Super-Mare compared with CAVOC was 3.88 (p < 0.001). For implants surviving five years, the mean Oxford knee scores (OKS) and mean EuroQol (EQ-5D) scores were similar (OKS: Weston-Super-Mare 29 (2 to 47) vs CAVOC 29.8 (3 to 48), p = 0.61; EQ-5D: Weston-Super-Mare 0.53 (-0.38 to 1.00) vs CAVOC 0.55 (-0.32 to 1.00), p = 0.79). Patients with revised TKRs had significantly lower Oxford knee and EQ-5D scores (p < 0.001). The results show a higher revision rate for patients operated at Weston-Super-Mare Treatment Centre, with a reduction in functional outcome and quality of life after revision. This further confirms that patients moved from one area to another for joint replacement surgery fare poorly.

  3. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    ERIC Educational Resources Information Center

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  4. Digital Disconnect or Digital Difference? A Socio-Ecological Perspective on Young Children's Technology Use in the Home and the Early Childhood Centre

    ERIC Educational Resources Information Center

    Edwards, Susan; Henderson, Michael; Gronn, Donna; Scott, Anne; Mirkhil, Moska

    2017-01-01

    A digital disconnect perspective is founded on an assumption that technology use in the home is frequent, creative and generative, and that technology use in the early childhood centre should be the same as that found in the home. However, such arguments divert our attention from understanding the nature of the setting and thereby from an…

  5. Comparing Quality of Childcare and Kindergarten Centres: The Need for a Strong and Equal Partnership in the Greek Early Childhood Education System

    ERIC Educational Resources Information Center

    Gregoriadis, A.; Tsigilis, N.; Grammatikopoulos, V.; Kouli, O.

    2016-01-01

    The purpose of this study was to examine whether kindergartens and childcare centres differ in terms of educational and caregiving components. More specifically, two aspects of the process quality of the early childhood education and care were examined regarding the "Activities" and the "Programme Structure." A multi-stage…

  6. Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

    PubMed

    Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

    2012-04-01

    The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). Evidence from the review was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from extensive on-line consultations with input from >900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged <1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

  7. Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families.

    PubMed

    Hollar, T Lucas; Cook, Nicole; Natale, Ruby; Quinn, David; Phillips, Teina; DeLucca, Michael

    2018-05-01

    We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards. We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design. ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA. Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre. We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01). Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.

  8. Early years of Radio Astronomy in the U.S.

    NASA Astrophysics Data System (ADS)

    Burke, B. F.

    Radio Astronomy in the U.S. went through two distinct phases, the pioneering phase before the Second World War, when Karl Jansky and Grote Reber were the only two radio astronomers in the world, and the post-WWII era, when the subject blossomed throughout the world, especially in England and Australia, while U.S. radio astronomy languished at a relatively low level, until its resurgence a decade later. Here in Budapest we are celebrating the 70th anniversary of Jansky's discovery, and I shall start with a review of his work, and the subsequent work of Grote Reber, who died, regrettably, in December 2002. Two historical references will be cited frequently: Serendipitous Discoveries in Radio Astronomy (Kellermann & Sheets, eds. 1983, referred to as Paper 1) and the two historical collections edited by W.T. Sullivan, Classics in Radio Astronomy (1982, referred to as Paper 2) and The Early Years of Radio Astronomy (1984, Paper 3).

  9. Early American sunspot drawings from the "year without a summer"

    NASA Astrophysics Data System (ADS)

    Denig, W. F.; McVaugh, M. R.

    2017-07-01

    A set of sunspot drawings from the early nineteenth century were discovered in the journals of the Reverend Jonathan Fisher. These drawings were made during a time when abnormally cold weather caused crops in New England to fail due to intermittent frost throughout the summer months of 1816, normally referred to as the "year without a summer." Global changes in weather patterns were the result of the Mount Tambora volcano eruption. Since this association was unknown at the time, there was speculation that the Sun was the cause inspiring the Reverend Fisher to monitor changes in sunspots during the summer of 1816 and continuing into 1817. These sunspot drawings for the summer of 1816 overlap the solar observations of Sir William Hershel.

  10. Ten years of barcoding at the African Centre for DNA Barcoding.

    PubMed

    Bezeng, B S; Davies, T J; Daru, B H; Kabongo, R M; Maurin, O; Yessoufou, K; van der Bank, H; van der Bank, M

    2017-07-01

    The African Centre for DNA Barcoding (ACDB) was established in 2005 as part of a global initiative to accurately and rapidly survey biodiversity using short DNA sequences. The mitochondrial cytochrome c oxidase 1 gene (CO1) was rapidly adopted as the de facto barcode for animals. Following the evaluation of several candidate loci for plants, the Plant Working Group of the Consortium for the Barcoding of Life in 2009 recommended that two plastid genes, rbcLa and matK, be adopted as core DNA barcodes for terrestrial plants. To date, numerous studies continue to test the discriminatory power of these markers across various plant lineages. Over the past decade, we at the ACDB have used these core DNA barcodes to generate a barcode library for southern Africa. To date, the ACDB has contributed more than 21 000 plant barcodes and over 3000 CO1 barcodes for animals to the Barcode of Life Database (BOLD). Building upon this effort, we at the ACDB have addressed questions related to community assembly, biogeography, phylogenetic diversification, and invasion biology. Collectively, our work demonstrates the diverse applications of DNA barcoding in ecology, systematics, evolutionary biology, and conservation.

  11. Renal diseases in adults with cystic fibrosis: a 40 year single centre experience.

    PubMed

    Wilcock, M J; Ruddick, A; Gyi, K M; Hodson, M E

    2015-10-01

    There is a sizable literature describing renal disease in patients with cystic fibrosis. Previous studies have focused on single disease processes alone, most commonly renal stone disease or acute kidney injury. In this study we report for the first time on the prevalence of all forms of renal disease in a cystic fibrosis population. A retrospective review of adult patients with cystic fibrosis attending the Adult Cystic Fibrosis Department at the Royal Brompton Hospital was carried out by searching the department's database to identify patients with renal problems and subsequently retrieving clinical information from medical notes. The prevalence of all renal diseases in our population was 5.1 %. The most commonly identified problem was renal stones. At 2.0 % the prevalence of renal stones in adult patients with cystic fibrosis was comparable to the general population. A range of other renal diseases were identified, the next most common being drug-induced acute kidney injury. A range of cystic fibrosis independent and attributable diseases has been identified but no cystic fibrosis specific disease. In contrast to other cystic fibrosis centres no increased prevalence of renal stones was found.

  12. Treating TTP/HUS with plasma exchange: a single centre's 25-year experience.

    PubMed

    Forzley, Brian R; Sontrop, Jessica M; Macnab, Jennifer J; Chen, Salina; Clark, William F

    2008-10-01

    Thrombotic thrombocytopenic purpura/Haemolytic uremic syndrome (TTP/HUS) is a thrombotic microangiopathy with a 6-month mortality rate of 16-29%. The present study described the clinical features, treatment regime and 6-month all-cause mortality rate of TTP/HUS patients at the London Health Sciences Centre (LHSC), Canada. Data for this retrospective cohort study were obtained from inpatient and outpatient records for all patients referred for plasma exchange therapy at LHSC, Canada between 1981 and 2006. Patients (n = 110) were categorized as: idiopathic primary (38%) or relapsed (16%), and secondary responsive (30%) or non-responsive (16%). Mortality data were available for all but three patients. The all-cause 6-month mortality rate was 19% overall and was 12% and 26% among idiopathic and secondary TTP/HUS patients, respectively. No mortality events occurred among the 17 idiopathic patients who relapsed. Relapsed patients had the least severe presenting characteristics, the fastest response time, and experienced significant improvement in the severity of clinical features between the first and final presentation. These findings suggest an excellent outcome for relapsed TTP/HUS patients. Patient education, surveillance, and aggressive plasma exchange therapy are hypothesized to improve the likelihood of survival: these hypotheses should be tested in a randomized controlled trial.

  13. A 10 year epidemiological study of paediatric burns at the Welsh Centre for burns and plastic surgery.

    PubMed

    Sanyaolu, Leigh; Javed, Muhammad Umair; Eales, Micheal; Hemington-Gorse, Sarah

    2017-05-01

    Paediatric burns make up a significant proportion of burn injured patients seen within the hospital setting and worldwide account for a significant proportion of unintentional deaths. Currently there is limited data on severe paediatric burns requiring intensive care support. Our study aimed primarily to describe the epidemiology of severe burns admitted to the intensive care unit at our centre receiving fluid resuscitation over a 10 year period. A secondary aim was to describe the referrals patterns in general over the same time period. A retrospective analysis was performed for paediatric patients referred to our centre receiving fluid resuscitation and intensive care support from 2003 to 2013. We also analysed the patterns of referrals, admissions and need for surgical intervention over the same time period retrospectively. Children less than 5 years old made up 65% of admissions to intensive care and scald injuries (56%) were the commonest aetiology. Both total length of stay (25 days in 2003 to 10 days in 2013) and intensive care length of stay (7.2 days in 2003 to 3 days in 2013) decreased during the study and less patients underwent operative intervention. Referrals to our centre increased from 261 in 2003 to 366 in 2013, however admission rates declined from 145 to 85 during that time period. Currently there is limited data on severe burns within the paediatric population. Our study provides epidemiological data in this area, an important step for developing future prevention strategies. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  14. Fungal infections in children in the early postoperative period after cardiac surgery for congenital heart disease: a single-centre experience.

    PubMed

    Jaworski, Radoslaw; Haponiuk, Ireneusz; Irga-Jaworska, Ninela; Chojnicki, Maciej; Steffens, Mariusz; Paczkowski, Konrad; Zielinski, Jacek

    2016-09-01

    Postoperative infections are still an important problem in cardiac surgery, especially in the paediatric population, and may influence the final outcome of congenital heart disease treatment. Postoperative infections with fungi are uncommon. The aetiology is poorly understood, and the proper diagnosis and treatment is unclear. In this single-centre study, the frequency of invasive fungal disease in children who underwent surgical management of congenital heart diseases was determined along with the risk factors for infection, treatment options and outcomes. All consecutive paediatric patients (<18 years of age) who underwent cardiac surgery for congenital heart disease between September 2008 and December 2015 in a paediatric cardiac centre in Poland were identified. Those who developed invasive fungal disease in the early postoperative period (30 days) were identified. Of the 1540 cardiosurgical procedures for congenital heart disease, 6 were complicated by fungal infection (0.39%). One patient had a high probability of fungal infection, but the diagnosis was unproved. Nevertheless, the patient was successfully treated with antifungal treatment. Five had proven invasive fungal disease. Of these, 3 were diagnosed with candidaemia. All had undergone cardiopulmonary bypass. Of the remaining 2 patients, 1 was a preterm newborn with complete atrioventricular septal defect who developed rib fungal invasion. The remaining patient had pulmonary atresia with ventricular septal defect and developed Fournier's gangrene after surgery. None of the patients died due to infection in the early postoperative period. However, the child with rib fungal invasion died 39 days after surgery as a result of multiorgan failure. Fungal infections in paediatric patients after cardiac surgery may markedly influence morbidity and mortality. Fungal infection prophylaxis in this specific group of children may reduce morbidity, whereas early empirical treatment followed by a targeted approach may

  15. A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions.

    PubMed

    Abbott, Tom E F; Torrance, Hew D T; Cron, Nicholas; Vaid, Nidhi; Emmanuel, Julian

    2016-11-01

    The utility of an early warning score may be improved when used with near patient testing. However, this has not yet been investigated for National Early Warning Score (NEWS). We hypothesised that the combination of NEWS and blood gas variables (lactate, glucose or base-excess) was more strongly associated with clinical outcome compared to NEWS alone. This was a prospective cohort study of adult medical admissions to a single-centre over 20days. Blood gas results and physiological observations were recorded at admission. NEWS was calculated retrospectively and combined with the biomarkers in multivariable logistic regression models. The primary outcome was a composite of mortality or critical care escalation within 2days of hospital admission. The secondary outcome was hospital length of stay. After accounting for missing data, 15 patients out of 322 (4.7%) died or were escalated to the critical care unit. The median length of stay was 4 (IQR 7) days. When combined with lactate or base excess, NEWS was associated with the primary outcome (OR 1.18, p=0.01 and OR 1.13, p=0.03). However, NEWS alone was more strongly associated with the primary outcome measure (OR 1.46, p<0.01). The combination of NEWS with glucose was not associated with the primary outcome. Neither NEWS nor any combination of NEWS and a biomarker were associated with hospital length of stay. Admission NEWS is more strongly associated with death or critical care unit admission within 2days of hospital admission, compared to combinations of NEWS and blood-gas derived biomarkers. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Sperm banking for male reproductive preservation: a 6-year retrospective multi-centre study in China

    PubMed Central

    Ping, Ping; Zhu, Wen-Bing; Zhang, Xin-Zong; Yao, Kang-Shou; Xu, Peng; Huang, Yi-Ran; Li, Zheng

    2010-01-01

    Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple centres in China from January 2003 to December 2008. The collected data included urogenital history, indication for cryopreservation, semen parameters, use rate, type of assisted reproductive technique (ART) treatment and pregnancy outcome. The study population included 1 548 males who had banked their semen during the study period at one of the clinics indicated above. Approximately 1.9% (30/1 548) of the cryopreserved semen samples were collected from cancer patients; about 88.8% (1 374/1 548) of the patients had banked their semen for ART and 8.6% (134/1 548) had a male infertility disease (such as anejaculation, severe oligozoospermia and obstructive azoospermia). The total use rate of cryopreserved semen was 22.7% (352/1 548), with 119 live births. The cancer group use rate was 6.7% (2/30), with one live birth by intracytoplasmic single sperm injection (ICSI). The ART group use rate was 23.2% (319/1 374), with 106 live births. The reproductive disease group use rate was 23.1% (31/134), with 12 live births. The semen parameters in each category varied; the cancer patient and infertility disease groups had poor semen quality. In vitro fertilization (IVF) and ICSI were the most common ART treatments for cryopreserved sperm. Semen cryopreservation as a salvage method is effective, but in many conditions it is underutilized, especially in cancer patients. Lack of awareness, urgency of cancer treatment and financial constraints are the main causes of the low access rate. The concept of fertility preservation should be popularized to make better use of this medical service in China. PMID:20348941

  17. Empowering Teachers to Teach Science in the Early Years in Mauritius

    ERIC Educational Resources Information Center

    Kamudu Applasawmy, B.; Naugah, J.; Maulloo, A. K.

    2017-01-01

    Children act as emergent scientists through active involvement with their environment and adults. Science forms an important component of early childhood education curriculum in Mauritius. Since 2015, The Rajiv Gandhi Science Centre (RGSC), has initiated a new project: empowering educators to teach science in pre-primary schools. One-day workshop…

  18. Studio Design Work in First Year Architectural Education. Advisory Centre Occasional Papers in University Education.

    ERIC Educational Resources Information Center

    Claridge, Philip George Brian

    A course for first-year architectural students is described. The approach concentrated on developing an understanding of the nature of design activity through exploration of the kind of thinking that may be applied in order to improve the first-year studio work. The course is based on the following premises: (1) it is possible and educationally…

  19. Glomerular diseases outcome at one year in a tertiary care centre

    PubMed Central

    Mahmud, Huma Mamun; Kumar, Darshan; Irum, Humera; Farman Ali, Syed

    2015-01-01

    Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow up. Methods: Study design is observational cohort, done in out-patient department, Dow Iinternational Medical College, DUHS. All information gathered on a proforma. All patients with dipstick positive proteinuria and clinical glomerular disease were included in study. Patients with no proteinuria were excluded so were patients with stage 5 CKD. Patients were followed for proteinuria and renal insufficiency at completion of one year follow up. Statistical analysis was done on SPSS version 16. Result: Total number of patients who completed one year follow up was 173. Mean age of patients was 51.67+ 10.16 (range 15 to 75 years). Ninety two (53.2%), were males and 81(46.8%) were females, ratio being 1.1: 1.0. Mean weight of our patients was 67.43+ 14.13 Kg, (35 to 107 kg). Commonest cause of glomerular disease in our patient was diabetic nephropathy which was seen in 94.2% patients. Commonest associated problem with glomerular disease was hypertension seen in 66.5% of patients. Four out of 173 patients had stage 5 CKD at end of follow up at one year while quantitativ proteinuria remained same at one year follow up. Conclusion: One year follow up is critical for patients with glomerular disease associated with stage 4 CKD as progression to end stage renal failure may be seen within one year in these patients. PMID:26101512

  20. Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study.

    PubMed

    Hodgson, Carol; Bellomo, Rinaldo; Berney, Susan; Bailey, Michael; Buhr, Heidi; Denehy, Linda; Harrold, Megan; Higgins, Alisa; Presneill, Jeff; Saxena, Manoj; Skinner, Elizabeth; Young, Paul; Webb, Steven

    2015-02-26

    The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work. We studied 192 patients (mean age 58.1 ± 15.8 years; mean Acute Physiology and Chronic Health Evaluation (APACHE) (IQR) II score, 18.0 (14 to 24)). Mortality at day 90 was 26.6% (51/192). Over 1,351 study days, we collected information during 1,288 planned early mobilization episodes in patients on mechanical ventilation for the first 14 days or until extubation (whichever occurred first). We recorded the highest level of early mobilization. Despite the presence of dedicated physical therapy staff, no mobilization occurred in 1,079 (84%) of these episodes. Where mobilization occurred, the maximum levels of mobilization were exercises in bed (N = 94, 7%), standing at the bed side (N = 11, 0.9%) or walking (N = 26, 2%). On day three, all patients who were mobilized were mechanically ventilated via an endotracheal tube (N = 10), whereas by day five 50% of the patients mobilized were mechanically ventilated via a tracheostomy tube (N = 18). Early mobilization of patients receiving mechanical ventilation was uncommon. More than 50% of patients discharged from the ICU had developed ICU-acquired weakness, which was associated with death between ICU discharge and day-90. ClinicalTrials.gov NCT01674608. Registered 14 August 2012.

  1. Early experience with open heart surgery in a pioneer private hospital in West Africa: the Biket medical centre experience.

    PubMed

    Onakpoya, Uvie Ufuoma; Adenle, Adebisi David; Adenekan, Anthony Taiwo

    2017-01-01

    More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study. The medical records of the patients were examined and data on age, sex, diagnosis, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted and the data was analysed using SPSS version 16. Eighteen patients comprising of 12 males and 6 females with ages ranging between 8 months and 52 years (mean= of 15.7 +/- 15 years) were studied. Pericardial patch closure of isolated ventricular septal defect was done in 7 patients (38.9%) while total correction of isolated tetralogy of Fallot was carried out in 5 patients (27.8%). Two patients had mitral valve repair for rheumatic mitral regurgitation. Sixty day mortality was 0%. Safe conduct of open heart surgery in the private hospital setting is feasible in Nigeria. It may be our only guarantee of hitch free and sustainable cardiac surgery.

  2. Ten years single-centre experience with intra-aortic balloon pump.

    PubMed

    Vandenplas, Guy; Bové, Thierry; Caes, Frank; Van Belleghem, Yves; François, Katrien; De Somer, Filip; Taeymans, Yves; Van Nooten, Guido

    2011-12-01

    The objective of this study was to investigate the patient characteristics and outcomes in 1406 patients undergoing intra-aortic balloon pump (IABP) counterpulsation. Between 1998 and 2008, 1406 consecutive patients were recorded in a prospective database. Based on the main clinical indication for IABP use, we defined 3 groups: group A, 630 cases of coronary ischaemia or infarction without serious left ventricular (LV) dysfunction; group B, 466 patients with left ventricular failure or cardiogenic shock; group C, 310 patients where IABP was used for miscellaneous procedures such as weaning from cardiopulmonary bypass or during high-risk angioplasty or surgery. Global mortality was 28% (n = 390), with a significant difference between group A (15%, n = 95) and group B (41%, n = 191) (P < 0.001). Mortality in group C was 34% (n = 104). Most insertions were done in the catheterization laboratory (n = 943) with subsequent mortality of 23% whereas 199 balloons were inserted in the operation room with 34% mortality. 170 balloons inserted in the intensive care unit resulted in 46% mortality (P < 0.001). Major IABP-induced complications were 6.8% with no statistical differences between the three groups. Advanced age, left ventricular failure and low BMI were identified as prognostic risk factors for early mortality. IABP deployed at an early clinical stage yields the best results, especially for acute coronary patients with preserved LV function whereas LV failure and late insertion result in worse outcome.

  3. Invisible to Visible: Mapping the Continuum of Literacy Learning Experiences in an Early Years Setting

    ERIC Educational Resources Information Center

    Kervin, Lisa; Turbill, Jan; Harden-Thew, Kathryn

    2017-01-01

    The face of early childhood education continues to change. In Australia, the national early childhood guidelines, "Early Years Learning Framework" (2009) and the "National Quality Framework" have articulated and defined the work of early years' educators in a range of areas, including literacy. Both frameworks state that their…

  4. Environmental characteristics of early childhood education and care centres and young children's weight status: A systematic review.

    PubMed

    Zhang, Zhiguang; Pereira, João R; Sousa-Sá, Eduarda; Okely, Anthony D; Feng, Xiaoqi; Santos, Rute

    2018-01-01

    The aim of this systematic review was to summarize ECEC environmental correlates of weight status in children under the age of 6years. Six databases (PubMed, PsycINFO, CINAHL, SPORTDiscus, Scopus, and Web of Science) were searched until March 2017. Observational studies examining the relationship between ECEC environmental characteristics and weight status in children aged 0-6years were included. Data was extracted using a predesigned form. Eight studies, representing 4862 children, met the inclusion criteria. Twenty-two environmental characteristics were identified and classified into four domains (physical, political, economic, and sociocultural); of these, six correlates were found. 'Active environment' 'sedentary opportunities', 'active play time', 'high sugar and high fat served', 'educators' weight' and 'educators' habitual physical activity level' were associated with weight status in young children. However, for most environmental characteristics examined, strong evidence is not available yet, due to variations across studies on the measures of environmental characteristics and analytical methodologies. Stronger empirical evidence in greater quantity is needed. Future studies in this area are recommended to investigate the environmental influence using an ecological approach and to examine the potential mediators, with a focus on the settings of family-based centres and samples representing toddlers and/or infants. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Trends in Pulmonary Hypertension Over a Period of 30 Years: Experience From a Single Referral Centre.

    PubMed

    Quezada Loaiza, Carlos Andrés; Velázquez Martín, María Teresa; Jiménez López-Guarch, Carmen; Ruiz Cano, María José; Navas Tejedor, Paula; Carreira, Patricia Esmeralda; Flox Camacho, Ángela; de Pablo Gafas, Alicia; Delgado Jiménez, Juan Francisco; Gómez Sánchez, Miguel Ángel; Escribano Subías, Pilar

    2017-11-01

    Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary vascular resistance, right ventricular dysfunction and death. Despite scientific advances, is still associated with high morbidity and mortality. The aim is to describe the clinical approach and determine the prognostic factors of patients with PAH treated in a national reference center over 30 years. Three hundred and seventy nine consecutive patients with PAH (January 1984 to December 2014) were studied. Were divided into 3 periods of time: before 2004, 2004-2009 and 2010-2014. Prognostic factors (multivariate analysis) were analyzed for clinical deterioration. Median age was 44 years (68.6% women), functional class III-IV: 72%. An increase was observed in more complex etiologies in the last period of time: Pulmonary venooclusive disease and portopulmonary hypertension. Upfront combination therapy significantly increased (5% before 2004 vs 27% after 2010; P < .05). Multivariate analysis showed prognostic significance in age, sex, etiology and combined clinical variables as they are independent predictors of clinical deterioration (P < .05). Survival free from death or transplantation for the 1st, 3rd and 5th year was 92.2%, 80.6% and 68.5% respectively. The median survival was 9 years (95% confidence interval, 7.532-11.959) CONCLUSIONS: The PAH is a heterogeneous and complex disease, the median survival free from death or transplantation in our series is 9 years after diagnosis. The structure of a multidisciplinary unit PAH must adapt quickly to changes that occur over time incorporating new diagnostic and therapeutic techniques. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Deaths in childhood from cystic fibrosis: 10-year analysis from two London specialist centres.

    PubMed

    Urquhart, Donald S; Thia, Lena P; Francis, Jackie; Prasad, S Ammani; Dawson, Charlie; Wallis, Colin; Balfour-Lynn, Ian M

    2013-02-01

    Death in childhood from cystic fibrosis (CF) is now an uncommon event in the U.K. We wished to assess the circumstances surrounding deaths (and lung transplantation) in the modern era of CF care. A retrospective review was carried out pooling data from two large paediatric specialist CF units in London for the 10-year period 2000-2009 inclusive. There were 11 deaths and eight children who had a lung transplant out of 1022 children cared for in this period. Median age of death was 14.2 years and transplant 13.0 years, with a female preponderance (82% deaths and 75% transplants). Apart from one child (forced expiratory volume in 1 s (FEV1) 69%), lung function indicated severe lung disease (median FEV1 33%, range 12%-69%). Values 5 years prior to death were not predictive (median FEV1 62%, range 32%-96%), and those 1 year prior were similar to the last recorded levels. Almost all (10/11) died in hospital and 5/11 (45%) were ventilated. Respiratory failure was the commonest mode of death (64%). Only four children (36%) were receiving palliative care, and in six cases (55%) care was withdrawn. The number of deaths in children with CF was small but often unpredictable, so active management was continued until late in the majority, reflected by the fact that almost all were in hospital, and more than half were ventilated. If death from respiratory failure is anticipated following a steady decline, palliative care should be instituted well in advance, with attention to appropriate end of life care.

  7. Characteristics of children under 6 years of age treated for early childhood caries in South Africa.

    PubMed

    Mohamed, Nadia; Barnes, Jo

    2008-01-01

    This retrospective survey highlighted the characteristics of children less than six years of age presenting with early childhood caries (ECC) who had two or more teeth extracted under intravenous sedation at the Tygerberg Oral Health Centre in Cape Town, South Africa. This survey was carried out in order to plan a community-appropriate intervention strategy. Records of 140 patients kept by the pediatric Dentistry Division met the inclusion criteria and were included in this survey. Most of the patients originate from economically disadvantaged areas. Diet, feeding and oral hygiene habits were shown to be the most significant factors that contributed to the development of ECC in these patients. All the children were either breast- or bottle-fed past one year of age. 93.6% of the children went to sleep with the bottle or while on the breast and 90% of them were fed on demand during the night. On average, breastfeeding was stopped at 9 months of age compared to bottle-feeding that, on average, was stopped at a much later mean age of 23 months. Where oral hygiene practices were concerned, 52.6% of children brushed their own teeth without supervision. Frequency of brushing varied between subjects. The results of this study have demonstrated that there is a need for culturally appropriate education campaigns to inform parents (especially those in disadvantaged communities) about the importance of oral health and the prevention of oral disease.

  8. The Datafication of Early Years Education and Its Impact upon Pedagogy

    ERIC Educational Resources Information Center

    Roberts-Holmes, Guy; Bradbury, Alice

    2016-01-01

    This article raises important questions about whether the increasing control of early years education through performance data is genuinely a means for school improvement. This composite article, examines the pervasiveness of attainment data in early years education professional activity, its impact on early years teachers' consciousness and…

  9. Children's Early Literacy Practices at Home and in Early Years Settings: Second Annual Survey of Parents and Practitioners

    ERIC Educational Resources Information Center

    Formby, Susie

    2014-01-01

    This report outlines findings from Pearson and the National Literacy Trust's second annual early years literacy survey, conducted in May to July 2014. 1,012 parents of children aged 3 to 5 and 567 early years practitioners who work with this age group participated. Attainment data in the form of vocabulary abilities were available for a subsample…

  10. Merkel Cell Carcinoma: 27-Year Experience at the Peter MacCallum Cancer Centre

    SciT

    Hui, Andrew C., E-mail: achui@bigpond.net.au; Stillie, Alison L.; Seel, Matthew

    2011-08-01

    Purpose: To retrospectively evaluate the treatment outcome of patients with Merkel cell carcinoma after local and/or regional treatment. Methods and Materials: Patients presenting to our center between January 1980 and July 2006 with Merkel cell carcinoma and without distant metastases were reviewed. The primary endpoint was locoregional control. Secondary endpoints were distant recurrence, survival and treatment toxicity. Results: A total of 176 patients were identified. The median age was 79 years. The median follow-up was 2.2 years for all patients and 3.9 years for those alive at the last follow-up visit. The most common primary site was the head andmore » neck (56%), and 62 patients(35%) had regional disease at presentation. The initial surgery to the primary tumor involved (wide) local excision in 140 patients and biopsy only in 28 patients (8 patients had no identifiable primary tumor); 33 patients underwent nodal surgery. Of the 176 patients, 165 (94%) underwent radiotherapy (RT) and 29 of them also underwent concurrent chemotherapy. The median radiation dose was 50 Gy (range, 18-60). Locoregional recurrence developed in 33 patients(19%), with a median interval to recurrence of 8 months. Distant metastases developed in 43 patients(24%). Age, primary tumor size, and RT (no RT vs. <45 Gy vs. {>=}45 Gy) were predictive of locoregional control on univariate analysis. However, only RT remained significant on multivariate analysis. The estimated 5-year actuarial rate for locoregional control, progression-free survival, and overall survival was 76%, 60%, and 45%, respectively. Conclusion: The locoregional control rate for Merkel cell carcinoma in our study was comparable to those from other series using combined modality treatment with RT an integral part of treatment.« less

  11. Burns in patients over 90: a fifteen-year series from a regional burns centre.

    PubMed

    Shariff, Zakir; Rodrigues, Jeremy N; Anwar, Umair; Austin, Orla; Phipps, Alan

    2015-03-01

    The elderly constitute an expanding subgroup within society, and may have differences in health needs compared to younger patients. The specific needs and outcomes of elderly patients with burns have been widely studied. However, the definition of elderly often used in previous studies is a cut off of 65 years old. Within this broadly defined group, the very elderly may have distinct health care needs and issues. This study investigated aetiology, management and outcome of burns in those over 90 years treated at a single UK burns service over a period of 15 years between 1998 and 2013, and compares these data to published data describing 'younger' elderly burns patients. Twenty two patients were included, with a 2:1 female:male ration, and a mean 9%TBSA burn. Six of the 22 died during their admission, and those who survived averaged 8 days inpatient stay per %TBSA. The very elderly with burns may fare worse than younger elderly patients. Although burns in the very elderly are relatively infrequent events, they require significant resource. Further work to optimise their outcome is required. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  12. Prognostic indicators associated with early mortality of wild raptors admitted to a wildlife rehabilitation centre in Spain.

    PubMed

    Molina-López, Rafael A; Casal, Jordi; Darwich, Laila

    2015-03-01

    Assessment of the prognostic indicators of wildlife casualties is critical in wildlife rehabilitation practice, to optimize the use of economical resources, and to protect animal welfare. Few studies have been conducted in this field. To identify the prognostic indicators associated with raptor mortality during the first week of hospitalization. Complete medical records of 1722 wild raptor cases admitted to a wildlife rehabilitation centre from 1995 to 2007 were used. Regression models were created to determine mortality-related factors for different variables (order, sex, body condition (BC), clinical signs, and available haematological and biochemical parameters). In the bivariate analysis, the presence of nervous (OR = 11.9, 95%CI:5.1-27.6) or musculoskeletal (OR = 12.1, 95%CI:5.8-25.3) signs, a poor BC (OR = 32.9, 95%CI:19-81.2), and low values of packed cell volume (PCV), haemoglobin or total solids (TS), were all associated with early mortality. After adjusting variables in the multivariate model, BC was excluded due to co-linearity with other variables, and alteration of the nervous system was the only significant risk factor (OR = 4.0; 95%CI:1.9-8.8). In species specific analysis, poor prognosis was related to neurological signs in Athene noctua, poor BC in Strix aluco, trauma in Acciptiter nisus and Tyto alba, low PCV in Buteo buteo and Falco tinnunculus and low TS in Falco tinnunculus. Raptors with a poor BC, low values of PCV and those presenting with neurological signs, had the highest risk of dying in the first days of admittance. Thus, either medical care or humane euthanasia for poor prognosis should be performed to address animal welfare.

  13. The Importance of Effective Behaviour Screening in the Early Years

    ERIC Educational Resources Information Center

    Tyler-Merrick, Gaye; Church, John

    2013-01-01

    Early intervention for children with behavioural difficulties can be effective in terms of outcomes for both the children and their families. Early intervention can save a child from long-term outcomes such as school failure, peer rejection and later offending. However, in terms of accurate assessment of young children's behavioural difficulties,…

  14. Supporting Child Participation in the Early Years of Education

    ERIC Educational Resources Information Center

    Sturges, Marion

    2015-01-01

    This paper aims to contribute to conversations around child participation within early childhood settings in Australia. Ethnographic approach was used for this study to explore child participatory workshops in Early Childhood Centers. The center in which this study took place was chosen as one of the sites of analysis for a broader PhD research…

  15. [A juvenile nasopharyngeal angiofibroma: our 10-year experience in a tertiary centre].

    PubMed

    Şahin, Bayram; Çomoğlu, Şenol; Sönmez, Said; Polat, Beldan; Değer, Kemal

    2016-01-01

    This study aims to evaluate the demographic characteristics, tumor stage, surgical treatment and recurrence rate among patients operated with a juvenile nasopharyngeal angiofibroma. This retrospective study included 45 patients (44 males, 1 female; mean age 21 years, range 9 to 55 years) who underwent surgery at Istanbul University, Istanbul Medical Faculty, Department of Otorhinolaryngology clinic between March 2006 and July 2015. The patients were classified according to age, sex, presenting symptom, tumor stage, surgical procedure applied, preoperative embolization, perioperative blood transfusion, complications, and the presence of recurrence. The most common presenting symptoms were epistaxis (78%) and nasal obstruction (73%). Preoperative angiography was performed on all patients and embolization was applied in eligible patients (69%). Transnasal endoscopic approach in 31 patients, midfacial degloving in six patients, and lateral rhinotomy approach in three patients were applied. The overall recurrence rate was 31% (n=14). The most important factor in determining the risk of postoperative recurrence is the preoperative tumor stage. Preoperative embolization reduces the amount of perioperative bleeding. Endoscopic transnasal approach decreases the rate of complications and length of hospitalization.

  16. Haematopoietic stem cell transplantation for primary immunodeficiency syndromes: A 5-year single-centre experience.

    PubMed

    Norman, Melissa; David, Clementine; Wainstein, Brynn; Ziegler, John B; Cohn, Richard; Mitchell, Richard; O'Brien, Tracey; Russell, Susan; Trahair, Toby; Trickett, Annette; Frith, Katie; Gray, Paul

    2017-10-01

    Haematopoietic stem cell transplantation (HSCT) is a central therapy in the treatment of primary immunodeficiency diseases (PIDs). Over the past 5 years, outcomes have been greatly improved due to earlier diagnosis, improved donor availability, advancements in graft manipulation and the use of less toxic preparative regimens. We present a 5-year audit of HSCT for PID at a single Australian tertiary hospital. Retrospective case note review identified diagnosis, pre-transplant medical morbidity, transplant protocol, engraftment, adverse events, post-transplant immune reconstitution and general health. A total of 22 patients with PID underwent 24 HSCTs at our institution between 2012 and 2016. The most common indications were severe combined immunodeficiency, chronic granulomatous disease and familial haemophagocytic lymphohistiocytosis, with a genetic diagnosis in all but two patients. Reduced intensity or reduced toxicity conditioning was used in 91% of cases, and 75% of the donors were unrelated. Transplant-related mortality at day +100 was 9.5%, and cumulative overall survival was 86%. There were three mortalities, all secondary to viral infection, one of which occurred in the context of graft failure. Two patients remained on immune support, with the remainder achieving adequate immune reconstitution. The outcomes for HSCT for PIDs performed at Sydney Children's Hospital were in line with the world's best practice. HSCT should be considered a potential therapeutic option for all Australian PID patients with a valid disease indication. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  17. Pitfalls in diagnosis and management of distal vaginal agenesis: 10-year experience at a single centre.

    PubMed

    Ugur, M G; Balat, O; Ozturk, E; Bekerecioglu, M; Dikensoy, E

    2012-07-01

    To discuss common pitfalls in diagnosis and management of distal vaginal agenesis, and summarize 10 years of experience among 11 patients using an interposition full-thickness graft and fibrin glue. Eleven patients with distal vaginal agenesis were evaluated and managed with an interposition full-thickness graft to bridge the gap between the upper vagina and the introitus. Associated renal abnormalities and complications including infection, total lack of skin graft take, stress urinary incontinence, partial graft loss, vaginal stricture and graft uptake were all investigated. The mean age of the patients was 12.91 (standard deviation 1.22) years. All patients had primary amenorrhoea, cryptomenorrhea, and cyclical or constant pelvic pain. None of the patients had associated urological abnormalities, and there were no cases of infection, total lack of skin graft take, stress urinary incontinence, partial graft loss or vaginal stricture. Graft uptake was 100% in 10 of the 11 patients. Four patients have subsequently married and report a satisfactory sex life. Accurate diagnosis of distal vaginal agenesis and careful pre-operative set-up, including evaluation of associated anomalies, bowel preparation, available vaginal stents and a multidisciplinary approach for the potential need for grafts, may be key to success. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. The early years of retroviral protease crystal structures.

    PubMed

    Miller, Maria

    2010-01-01

    Soon after its discovery, the attempts to develop anti-AIDS therapeutics focused on the retroviral protease (PR)-an enzyme used by lentiviruses to process the precursor polypeptide into mature viral proteins. An urgent need for the three-dimensional structure of PR to guide rational drug design prompted efforts to produce milligram quantities of this enzyme. However, only minute amounts of PR were present in the HIV-1 and HIV-2 viruses, and initial attempts to express this protein in bacteria were not successful. This review describes X-ray crystallographic studies of the retroviral proteases carried out at NCI-Frederick in the late 1980s and early 1990s and puts into perspective the crucial role that the total protein chemical synthesis played in unraveling the structure, mechanism of action, and inhibition of HIV-1 PR. Notably, the first fully correct structure of HIV-1 PR and the first cocrystal structure of its complex with an inhibitor (a substrate-derived, reduced isostere hexapeptide MVT-101) were determined using chemically synthesized protein. Most importantly, these sets of coordinates were made freely available to the research community and were used worldwide to solve X-ray structures of HIV-1 PR complexes with an array of inhibitors and set in motion a variety of theoretical studies. Publication of the structure of chemically synthesized HIV-1 PR complexed with MVT-101 preceded only by six years the approval of the first PR inhibitor as an anti-AIDS drug. Copyright (c) 2010 Wiley Periodicals, Inc.

  19. Heart lesion after the first attack of the rheumatic Fever 22 years experience in single centre.

    PubMed

    Bejiqi, Ramush A; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber

    2015-02-01

    Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded.

  20. Heart Lesion After the First Attack of the Rheumatic Fever 22 Years Experience in Single Centre

    PubMed Central

    Bejiqi, Ramush A.; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber

    2015-01-01

    Background: Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. Aims: In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. Methods: To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. Conclusion: In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded. PMID:25870479

  1. The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country.

    PubMed

    Bee, Ping Chong; Sekaran, Veera; Ng, Richard Rui Jie; Kweh, Ting Yi; Gan, Gin Gin

    2017-03-01

    The prognosis of patients with chronic myeloid leukaemia (CML) has improved since the introduction of imatinib. However, patients who do not achieve complete cytogenetic response (CCyR) and major molecular response (MMR) have poorer prognosis. Recent clinical trials have demonstrated that early and deeper cytogenetic and molecular responses predict a better long-term outcome. This study aimed to analyse the relationship between early molecular response and clinical outcome in a real-life setting. This retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia. A total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients. Our data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients. Copyright: © Singapore Medical Association

  2. India-Based Knee Osteoarthritis Evaluation (iKare): A Multi-Centre Cross-Sectional Study on the Management of Knee Pain and Early Osteoarthritis in India.

    PubMed

    Sancheti, Parag; Shetty, Vijay D; Dhillon, Mandeep S; Sprague, Sheila A; Bhandari, Mohit

    2017-09-01

    Access to early knee osteoarthritis treatment in low and middle income nations is often believed to be limited. We conducted a cross-sectional study in India to assess prior access to treatment among patients presenting with knee pain to specialist orthopaedic clinics. The multi-centre, cross-sectional study included patients presenting with knee pain at 3 hospitals in India. Patients who met the inclusion criteria and provided informed consent completed a questionnaire designed to assess patient demographics, socioeconomic status, knee pain, treatment method, and patient's knowledge on osteoarthritis (OA). Their orthopaedic surgeons also completed a questionnaire on the severity of patient's OA and their recommended treatments. The impact of demographic characteristics on the prescription of treatment options was analyzed using logistic regression. A total of 714 patients met the eligibility criteria and participated in this study. The majority of patients had been experiencing pain for less than 1 year (64.8%) and had previously been prescribed medications (91.6%), supplements (68.6%), and nonpharmacological (81.9%) treatments to manage their knee OA. Current treatment recommendations included oral medications (83.3%), intra-articular injections (29.8%), and surgical intervention (12.7%). Prescription of oral medications was related to younger age, lack of deformities, and lower Kellgren-Lawrence grades ( p < 0.01). Patients treated in private hospital settings were more likely to have been previously treated with medications (range, 84.3% to 92.6%; p < 0.01) and physical treatments (range, 61.8% to 84.8%; p < 0.01) than patients treated at government hospitals. Contrary to the perception, our findings suggest a similar proportion of early knee OA treatment between India and North America.

  3. Seafood inclusion in commercial main meal early years' food products.

    PubMed

    Carstairs, Sharon A; Marais, Debbi; Craig, Leone C A; Kiezebrink, Kirsty

    2016-10-01

    Seafood consumption is recommended as part of a healthy, balanced diet. Under-exposure to seafood during early years feeding, when taste and food acceptance is developed, may impact on the future development of a varied diet. This study aimed to investigate the availability and nutritional content of seafood in commercial infant meals compared to the other food types. A survey was conducted of all commercial infant main meal products available for purchase in supermarkets, high street retailers and online stores within the United Kingdom. The primary food type (seafood, poultry, meat and vegetables) within each product, nutritional composition per 100 g, and ingredient contribution were assessed. Of the original 341 main meal products seafood (n = 13; 3.8%) was underrepresented compared to poultry (103; 30.2%), meat (121; 35.5%) and vegetables (104; 30.5%). The number of the seafood meals increased three years later (n = 20; 6.3%) vegetable meals remained the largest contributor to the market (115; 36.4%) with meat (99; 31.3%) and poultry (82; 26.0%) both contributing slightly less than previously. Seafood-based meals provided significantly higher energy (83.0 kcal), protein (4.6 g), and total fat (3.2 g) than vegetable (68 kcal, 2.7 g, 1.9 g), meat (66 kcal, 3.0 g, 2.1 g) and poultry-based meals (66 kcal, 3.0 g, 2.1 g) and higher saturated fat (1.3 g) than poultry (0.4 g) and vegetable-based (0.6 g) meals (all per 100 g) which may be attributed to additional dairy ingredients. Parents who predominantly use commercial products to wean their infant may face challenges in sourcing a range of seafood products to enable the introduction of this food into the diet of their infant. © 2015 John Wiley & Sons Ltd.

  4. HDR brachytherapy of prostate cancer – two years experience in Greater Poland Cancer Centre

    PubMed Central

    Skowronek, Janusz; Chicheł, Adam

    2009-01-01

    Purpose The aim of this work was to analyze the results and complications of three treatment schemes of patients with initially localized prostate cancer after two years of observation time. Material and methods Sixty-three patients were enrolled into the study and divided into groups according to radiation schemes (I group – EBRT 50 Gy/BRT 15 Gy, II – EBRT 46 Gy/BRT 2 × 10 Gy, III group – BRT 3 × 15 Gy). Group I, II and III consisted of 46 (73%), 14 (22.2%), 3 (4.8%) patients, respectively. The low-, intermediate- and high risk groups consisted of 23 (36.5%), 18 (28.5%) and 22 (35%) men, respectively. Results and tolerance of the treatment and acute complications in analyzed groups were discussed. Results Median observation time was 24 months. Complete remission was observed in 43 patients (68.3%) out of the whole group. Locoregional and distal metastases progression were noted in 4 patients (6.4%). Partial remission was observed in low-, intermediate- and high risk group: 7.9%, 9.5% and 9.5% of all men. Nadir of PSA results were estimated as mean value of 0.094 ng/ml, average 0.0-0.63. The mean value for the complete group decreased from 0.98 ng/ml (range 0.0-9.7) in the third months to 0.32 ng/ml after one year (0.0-3.34) of the end of treatment time. Urologic and gastrointenstinal side effects were noted in different rates according to 1 month observation (dysuria – 22.2%, urinary incontinence – 7.9%, frequency – 58.7%, weak stream – 68.3%, rectal bleeding – 15.9%). Conclusions 1. HDR brachytherapy of prostate cancer can be used as a boost after or before the external beam radiation therapy in different treatment schemes. 2. In selected groups under investigation trials, sole HDR-BRT is a suitable method of treatment. 3. To confirm superiority of analyzed modality treatment a prospective investigation with larger groups of patients would be required. PMID:27807455

  5. Rural health care in New Zealand: the case of Coast to Coast Health Centre, Wellsford, an early Integrated Family Health Centre.

    PubMed

    Raymont, Antony; Boyd, Mary-Anne; Malloy, Timothy; Malloy, Nancy

    2015-12-01

    Primary health care is critical, particularly in rural areas distant from secondary care services. To describe the development of Coast to Coast Health Centre (CTCHC) at Wellsford, north of Auckland, New Zealand and reflect on its achievements and ongoing challenges. Interviews were conducted with staff and management of CTCHC and with other health service providers. Surveys of staff and a sample of enrolled patients were undertaken. Numerical data on service utilisation were obtained from the practice and from national datasets. The CTCHC provides a wide range of services, including after-hours care, maternity and radiology, across a network of electronically connected sites, as well as interdisciplinary training for a range of health students. General practitioner (GP) recruitment is problematic and nursing roles have been expanded. Staff report positively on the work environment. Consultation rates are higher than in comparable practices, especially consultations with nurses. Rates of hospital admission are relatively low. The development of the CTCHC was assisted by formation of a local primary health organisation (PHO) and by recognition by the local district health board (DHB). Issues with poor coordination of local services, and less service provision than is characteristic in urban areas, remain. Contracting processes with the DHB were complex and time-consuming. The merging of the local PHO into a larger PHO within the Waitemata DHB catchment inhibited progression towards more complete locality planning. A dedicated and locally controlled provider was able to generate a more than usually complete community health service for Wellsford and area.

  6. Robotic-assisted coronary artery bypass surgery: an 18-year single-centre experience.

    PubMed

    Giambruno, Vincenzo; Chu, Michael W; Fox, Stephanie; Swinamer, Stuart A; Rayman, Reiza; Markova, Zarina; Barnfield, Rebecca; Cooper, Mitchell; Boyd, Douglas W; Menkis, Alan; Kiaii, Bob

    2018-06-01

    Minimally invasive robot-assisted direct coronary artery bypass (RADCAB) has emerged as a feasible minimally invasive surgical technique for revascularization that might offer several potential advantages over conventional approaches. We present our 18-year experience in RADCAB. Between February 1998 and February 2016, 605 patients underwent RADCAB. Patients underwent post-procedural selective graft patency assessment using cardiac catheterization. The mortality rate was 0.3%. The rate of conversion to sternotomy for any cause was reduced from 16.0% of the first 200 cases to 6.9% of the last 405 patients. The patency rate of the LITA-to-LAD anastomosis was 97.4%. Surgical re-exploration for bleeding occurred in 1.8% of patients, and the transfusion rate was 9.2%. Average ICU stay was 1.2 ± 1.4 days, and average hospital stay was 4.8 ± 2.9 days. Robot-assisted coronary artery bypass grafting is safe, feasible and it seems to represent an effective alternative to traditional coronary artery bypass grafting in selected patients. Copyright © 2018 John Wiley & Sons, Ltd.

  7. Family-centred care for hospitalised children aged 0-12 Years: A systematic review of quasi-experimental studies.

    PubMed

    Shields, Linda; Zhou, Huaqiong; Taylor, Marjory; Hunter, Judith; Munns, Ailsa; Watts, Robin

    Family-centred care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. It is a widely used model in paediatrics, and is felt instinctively to be the best way to provide care to children in hospital. However, its effectiveness has not been established. The objective of this review was to identify the effectiveness of family-centred models of care for children (excluding premature neonates) when compared to standard models of care. The review considered quasi-experimental studies of children aged 0-12 years, their families and/or attending health professionals. Interventions for inclusion were family-centred polices, family support, communication, educational and environmental. Outcomes of interest covered three categories: the child, parent and staff. These included psychological, behavioural, physical, developmental, knowledge, satisfaction and attitudinal outcomes. The degree of family-centredness for eligible studies was scored using a modified rating scale based on that developed by Trivette.This review considered studies that included hospitalised children aged 0-12 years (excluding premature neonates), their family and/or health care professionals.The review considered studies that evaluated the effectiveness of family-centred models of care for hospitalised children when compared to standard models of care.The review considered quasi-experimental studies for inclusion to enable the identification of current best evidence regarding the effectiveness of family-centred models of care on child, family and health service outcomes. Quasi-experimental design includes experimental studies in which participants are not randomly assigned to treatment conditions.This review considered studies that included the following outcome measures: SEARCH STRATEGY: The search strategy identified published and unpublished studies dated from 2004 to December

  8. Outcome in chronic inflammatory demyelinating polyneuropathy from a Malaysian centre over sixteen years.

    PubMed

    Hiew, Fu Liong; Ong, Jun-Jean; Viswanathan, Shanthi; Puvanarajah, Santhi

    2018-04-01

    Long-term outcome in Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is very limited, especially from Asian countries. We aimed to determine the outcome of our cohort of CIDP patients and to define the relevant clinical, electrophysiological and laboratory determinants of disease activity, progression and treatment response. We retrospectively reviewed records of 23 CIDP patients attending our Neurology service at Kuala Lumpur Hospital, Malaysia between January 2000 and December 2016. We analysed data on neurological deficits, electrophysiological and laboratory parameters to determine diagnostic characteristics, correlation with disease activity and clinical outcomes following treatment. Included were 15 (65%) males and 8 (35%) females with a mean age of 42.7 years (SD 14.4). Mean duration of follow-up visit was 66 months (range 6-134 months). The cohort consists of 19 classical (sensory-motor) CIDP and 4 MADSAM. Large majority of patients (66%) had either stable active disease (CDAS 3, 44%) or were in remission (CDAS class 2, 22%) following treatment with standard immunotherapies (Intravenous Immunoglobulins, steroids or immunosuppressants). The proportion of CIDP patients in each CDAS class was comparable to published cohorts from North America and Europe. Medical Research Council (MRC) sum score was the only clinical score that differed across CDAS classes (p = .010) with significant inverse correlation (Spearman's rho -0.664, p = .001). In conclusion, treatment outcomes of our CIDP cohort was comparable to those of published series. Further studies with larger cohort of patients from other parts of Asia are important to determine the long-term outcome of this heterogenous disease in this region. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Primary vesicoureteral reflux: A 26-year experience in a single centre.

    PubMed

    Vachvanichsanong, Prayong; Dissaneewate, Pornsak; McNeil, Edward

    2016-04-01

    To determine the nature of primary vesicoureteral reflux (VUR) and the association of VUR with hydronephrosis and renal damage. The medical records of children ≤ 15 years diagnosed with VUR, attending the Department of Pediatrics, Prince of Songkla University, Thailand between 1987 and 2013 were reviewed. Renal ultrasound and technetium-99m dimercaptosuccinic acid renal scan (DMSA) results were examined to determine the severity of hydronephrosis and renal damage, respectively. There were 177 boys and 211 girls. 350 (90.2%) were diagnosed following urinary tract infection (UTI). The median (IQR) age at diagnosis of first VUR was 7.6 (4.3-12.2) months in boys and 18.6 (9.0-46.6) months in girls (P < 0.001). Renal ultrasound was performed in 340 patients. Hydronephrosis was found in 105 patients and 135 kidneys and 22.5% VUR kidneys and 11.0% non-VUR kidneys (P = 0.01). The severity of hydronephrosis was associated with VUR grade (44.2% of grades IV and V VUR had hydronephrosis vs 11.9% of grades I-III VUR, P < 0.001). DMSA was performed in 332 patients. Abnormalities were found in 30.1% VUR kidneys and 4.1% non-VUR kidneys (P < 0.001). Abnormal DMSA results were strongly associated with VUR grade (17.8% for VUR grades I-III vs 60.5% for VUR grades IV and V, P < 0.001). Primary VUR in this group was most commonly diagnosed following investigation of UTI and detected during infancy, earlier in boys. Hydronephrosis and renal damage were associated with severity of VUR. © 2015 Asian Pacific Society of Nephrology.

  10. Management for the anterior combined with posterior urethral stricture: a 9-year single centre experience

    PubMed Central

    Deng, Tuo; Liao, Banghua; Luo, Deyi; Liu, Bing; Wang, Kunjie; Liu, Jiaming; Jin, Tao

    2015-01-01

    Objective: Therapy for anterior combined with posterior urethral stricture is difficult and controversial. This study aims to introduce a standard process for managing anterior combined with posterior urethral stricture. Patients and methods: 19 patients with anterior combined with posterior urethral stricture were treated following our standard process. Average (range) age was 52 (21-72) years old. In this standard process, anterior urethral stricture should be treated first. Endoscopic surgery is applied for anterior urethra stricture as a priority as long as obliteration does not occur, and operation for posterior urethral stricture can be conducted in the same stage. Otherwise, an open reconstructive urethroplasty for anterior urethral is needed; while in this condition, the unobliterated posterior urethra can also be treated with endoscopic surgery in the same stage; however, if posterior urethra obliteration exists, then open reconstructive urethroplasty for posterior urethral stricture should be applied 2-3 months later. Results: The median (range) follow-up time was 25.8 (3-56) months. All 19 patients were normal in urethrography after 1 month of the surgery. 4 patients (21.1%) recurred urethral stricture during follow-up, and the locations of recurred stricture were bulbomembranous urethra (2 cases), bulbar urethra (1 case) and bladder neck (1 case). 3 of them restored to health through urethral dilation, yet 1 underwent a second operation. 2 patients (10.5%) complaint of dripping urination. No one had painful erection, stress urinary incontinence or other complications. Conclusions: The management for anterior combined with posterior urethral stricture following our standard process is effective and safe. PMID:26064293

  11. The effect of nitisinone on homogentisic acid and tyrosine: a two-year survey of patients attending the National Alkaptonuria Centre, Liverpool.

    PubMed

    Milan, Anna M; Hughes, Andrew T; Davison, Andrew S; Devine, Jean; Usher, Jeannette; Curtis, Sarah; Khedr, Milad; Gallagher, James A; Ranganath, Lakshminarayan R

    2017-05-01

    Background Alkaptonuria is a rare, debilitating autosomal recessive disorder affecting tyrosine metabolism. Deficiency of homogentisate 1,2-dioxygenase leads to increased homogentisic acid which is deposited as ochronotic pigment. Clinical sequelae include severe early onset osteoarthritis, increased renal and prostate stone formation and cardiac complications. Treatment has been largely based on analgaesia and arthroplasty. The National Alkaptonuria Centre in Liverpool has been using 2 mg nitisinone (NTBC) off-license for all patients in the United Kingdom with alkaptonuria and monitoring the tyrosine metabolite profiles. Methods Patients with confirmed alkaptonuria are commenced on 2 mg dose (alternative days) of NTBC for three months with daily dose thereafter. Metabolite measurement by LC-MS/MS is performed at baseline, day 4, three-months, six-months and one-year post-commencing NTBC. Thereafter, monitoring and clinical assessments are performed annually. Results Urine homogentisic acid concentration decreased from a mean baseline 20,557 µmol/24 h (95th percentile confidence interval 18,446-22,669 µmol/24 h) by on average 95.4% by six months, 94.8% at one year and 94.1% at two year monitoring. A concurrent reduction in serum homogentisic acid concentration of 83.2% compared to baseline was also measured. Serum tyrosine increased from normal adult reference interval to a mean ± SD of 594 ± 184 µmol /L at year-two monitoring with an increased urinary excretion from 103 ± 81 µmol /24 h at baseline to 1071 ± 726 µmol /24 h two years from therapy. Conclusions The data presented represent the first longitudinal survey of NTBC use in an NHS service setting and demonstrate the sustained effect of NTBC on the tyrosine metabolite profile.

  12. Breast cancer scenario in a regional cancer centre in Eastern India over eight years--still a major public health problem.

    PubMed

    Datta, Karabi; Choudhuri, Maitrayee; Guha, Subhas; Biswas, Jaydip

    2012-01-01

    In spite of screening and early diagnostic tests, the upward trend of breast cancer has become a matter of great concern in both developed and developing countries. The data collected by Population Based Cancer Registry in Chittaranjan National Cancer Institute, a regional cancer centre in Kolkata, from 1997 to 2004 gives an insight about the scenario of breast cancer in this part of Eastern India. The total no of female breast cancer cases were steadily increasing from 1997 to 2001 and only slightly lower from 2002 to 2004. and majority were in the 40-49 year old age group during this period. The next most commonly affected age group was 50-59 years. Regarding the distribution according to treatment, the main modality was surgery and radiotherapy followed by combined surgery, chemotherapy and radiotherapy and then combined surgery and chemotherapy. The commonest type was ductal followed by lobular cancer. In this eight year study in CNCI, status of patients on last day of the respective year was assessed. Number of patients alive was 43.5% in 1997. The percentage gradually increased up to 2000 and then gradually decreased to 47.4% in 2004. Also with every passing year, percentage mortality gradually decreased from 25.7% in 1997 to 16.8% in 2004. Better pattern of care (diagnosis and treatment) was reflected in this picture. However, lost to follow up, which also implies non compliance to treatment, increased to 30.8% in 1997 to 35.8% in 2004. Due to the small number of male breast cancers, only female cases were considered. In conclusion, breast cancer continues to be a major problem in Kolkata, India.

  13. Haemodialysis in an emerging centre in a developing country: a two year review and predictors of mortality

    PubMed Central

    2011-01-01

    Background Haemodialysis is the most common form of renal replacement therapy in Nigeria. The high cost of haemodialysis has made optimal therapy of end-stage renal disease difficult in Nigeria. This paper is a review of data collected over two years of provision of dialysis services in a new tertiary hospital in Southern Nigeria. Methods This retrospective analysis is done on data obtained from the patient case files and dialysis records in the first two years of provision of dialysis services in our centre. A gender comparison of the patients' baseline sociodemographic, clinical and biochemical was performed and a logistic regression model used to assess the predictors of mortality. Results A total of 98 patients had 471 sessions in the two years under review. Males and females had similar characteristics at baseline except for a higher median serum urea in the males. The commonest causes of end-stage renal disease were chronic glomerulonephritis (34.5%), hypertension (32.1%) and diabetes mellitus (17.9%). The main predictor of mortality was under treatment with haemodialysis due to inability to pay for more than a few dialysis sessions. Conclusions This study has highlighted the unchanging demographics of our advanced kidney failure patients. Efforts should be aimed at subsidizing the cost of dialysis for our teeming population of dialysis dependent chronic kidney disease patients. PMID:21962220

  14. Surgical Management of Head and Neck Soft Tissue Sarcoma: 11-Year Experience at a Tertiary Care Centre in South India.

    PubMed

    Sharma, Nivedita; George, Nebu Abraham; Singh, Rajesh; Iype, Elizabeth Mathew; Varghese, Bipin T; Thomas, Shaji

    2018-06-01

    Head and neck soft tissue sarcoma (HNSTS) is a rare neoplasm accounting for 1% of all head and neck tumours. Because of rarity and varied biological behaviour among various subtypes, knowledge about these tumours is limited. This study aimed at analysing clinicopathological, recurrence and survival pattern of surgically treated HNSTS. Case records of 28 patients of HNSTS who underwent surgery at the Regional Cancer Centre (RCC), Trivandrum (India) between 2002 and 2012 were analysed retrospectively for demographic profile, clinical features, treatment given, recurrence pattern and outcome. The median age of patients was 37 years (range, 3-79) with male:female ratio of 3:2. Majority of patients presented with painless lump in the neck as the most common subsite affected followed by scalp and face. One patient had nodal disease, while none had distant metastasis at presentation. The most frequent histological subtypes were synovial sarcoma and fibrosarcoma followed by malignant fibrous histiocytoma, angiosarcoma and rhabdomyosarcoma. Majority (78.5%) of patients received adjuvant therapy in the form of radiation, chemotherapy or chemo-radiation. After mean follow-up of 49 months, four patients had died, and six developed local recurrence and four distant metastasis. The overall 5-year survival was 82.7% while 5-year disease-free survival was 55.3%. HNSTS is a rare entity that requires multimodality treatment to achieve optimum locoregional control and survival.

  15. A single-centre 10-year experience with Candida bloodstream infections

    PubMed Central

    Labbé, Annie-Claude; Pépin, Jacques; Patiño, Carlos; Castonguay, Stéphanie; Restieri, Christiane; Laverdiere, Michel

    2009-01-01

    OBJECTIVE: To describe the clinical and microbiological features associated with Candida bloodstream infections observed at Hôpital Maisonneuve-Rosemont (Montreal, Quebec) between August 1996 and July 2006. METHODS: Episodes were retrieved from the microbiology laboratory. Different patient episodes and different isolate episodes in the same patient were selected. Antifungal susceptibility was determined by the Clinical and Laboratory Standards Institute’s (USA) M27A2 method. RESULTS: A total of 190 different episodes of candidemia in 185 patients were identified. Eleven (6%) episodes occurred in outpatients. Candida albicans was identified in the majority of episodes (57%). Its frequency remained stable over the years. The proportion of Candida krusei candidemia episodes increased between 2003 and 2006, but this was not statistically significant. A central venous indwelling catheter or a peripherally inserted central catheter line was present in the majority of patients (167 [88%]). Of the indwelling catheters removed at the time of diagnosis, 39% were positive for Candida species on culture. Overall, voriconazole was the most active agent (the minimum inhibitory concentration required to inhibit the growth of 90% of organisms was 0.5 mg/L). Resistance to fluconazole was observed in 26 (14%) isolates (C albicans, 4%; versus non-albicans Candida species, 27%; P<0.001). Being on the hematology-oncology unit at the time of diagnosis (adjusted OR 7.8; 95% CI 2.3 to 27.1; P=0.001) and having received fluconazole or itraconazole within the past three months (adjusted OR 8.3; 95% CI 2.8 to 24.4; P<0.001) were significantly associated with resistance to fluconazole in multivariate analysis. CONCLUSIONS: At Hôpital Maisonneuve-Rosemont, the frequency and species distribution of blood isolates of Candida remained stable over the past decade. In vitro resistance of C albicans to fluconazole and itraconazole remained minimal; resistance of non-albicans Candida species to

  16. Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study

    PubMed Central

    2011-01-01

    Background Dental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises. Methods/Design This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence. Discussion This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney. PMID:21223601

  17. Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study.

    PubMed

    Arora, Amit; Scott, Jane A; Bhole, Sameer; Do, Loc; Schwarz, Eli; Blinkhorn, Anthony S

    2011-01-12

    Dental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises. This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence. This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney.

  18. Influence of social deprivation on provision of bariatric surgery: 10-year comparative ecological study between two UK specialist centres.

    PubMed

    Bhanderi, Shivam; Alam, Mushfique; Matthews, Jacob Henry; Rudge, Gavin; Noble, Hamish; Mahon, David; Richardson, Martin; Welbourn, Richard; Super, Paul; Singhal, Rishi

    2017-10-12

    To investigate the effect of residential location and socioeconomic deprivation on the provision of bariatric surgery. Retrospective cross-sectional ecological study. Patients resident local to one of two specialist bariatric units, in different regions of the UK, who received obesity surgery between 2003 and 2013. Demographic data were collected from prospectively collected databases. Index of Multiple Deprivation (IMD 2010) was used as a measure of socioeconomic status. Obesity prevalences were obtained from Public Health England (2006). Patients were split into three IMD tertiles (high, median, low) and also tertiles of time. A generalised linear model was generated for each time period to investigate the effect of socioeconomic deprivation on the relationship between bariatric case count and prevalence of obesity. We used these to estimate surgical intervention provided in each population in each period at differing levels of deprivation. Data were included from 1163 bariatric cases (centre 1-414, centre 2-749). Incidence rate ratios (IRRs) were calculated to measure the associations between predictor and response variables. Associations were highly non-linear and changed over the 10-year study period. In general, the relationship between surgical case volume and obesity prevalence has weakened over time, with high volumes becoming less associated with prevalence of obesity. As bariatric services have matured, the associations between demand and supply factors have changed. Socioeconomic deprivation is not apparently a barrier to service provision more recently, but the positive relationships between obesity and surgical volume we would expect to find are absent. This suggests that interventions are not being taken up in the areas of need. We recommend a more detailed national analysis of the relationship between supply side and demand side factors in the provision of bariatric surgery. © Article author(s) (or their employer(s) unless otherwise stated in the

  19. Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review.

    PubMed

    Rashid, Mohd Radzniwan A; Aziz, Aznida Firzah Abdul; Ahmad, Saharuddin; Shah, Shamsul Azhar; Sagap, Ismail

    2009-01-01

    Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records. A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45). Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.

  20. Cholangiocarcinoma and dominant strictures in patients with primary sclerosing cholangitis: a 25-year single-centre experience.

    PubMed

    Chapman, Michael H; Webster, George J M; Bannoo, Selina; Johnson, Gavin J; Wittmann, Johannes; Pereira, Stephen P

    2012-09-01

    Dominant biliary strictures occur commonly in patients with primary sclerosing cholangitis (PSC), who have a high risk of developing cholangiocarcinoma (CC). The natural history and optimal management of dominant strictures remain unclear, with some reports suggesting that endoscopic interventions improve outcome. We describe a 25-year experience in patients with PSC-related dominant strictures at a single tertiary referral centre. A total of 128 patients with PSC (64% men, mean age at referral 49 years) were followed for a mean of 9.8 years. Eighty patients (62.5%) with dominant biliary strictures had a median of 3 (range 0-34) interventions, compared with 0 (0-7) in the 48 patients without dominant strictures (P<0.001). Endoscopic interventions included the following: (i) stenting alone (46%), (ii) dilatation alone (20%), (iii) dilatation and stenting (17%) and (iv) none or failed intervention (17%, of whom most required percutaneous transhepatic drainage). The major complication rate for endoscopic retrograde cholangiopancreatography was low (1%). The mean survival of those with dominant strictures (13.7 years) was worse than that for those without dominant strictures (23 years), with much of the survival difference related to a 26% risk of CC developing only in those with dominant strictures. Half of those with CC presented within 4 months of the diagnosis of PSC, highlighting the importance of a thorough evaluation of new dominant strictures. Repeated endoscopic therapy in PSC patients is safe, but the prognosis remains worse in the subgroup with dominant strictures. In our series, dominant strictures were associated with a high risk of developing CC.

  1. Comparison of Environmental Attitudes and Experiences of Five-Year-Old Children Receiving Preschool Education in the Village and City Centre

    ERIC Educational Resources Information Center

    Durkan, Nazmi; Güngör, Hande; Fetihi, Leyla; Erol, Ahmet; Gülay Ogelman, Hülya

    2016-01-01

    The purpose of the study is to compare environmental attitudes and experiences of five-year-old children receiving preschool education in the village and city centre. The first group comprised 54 five-year-old children who received preschool education and attended kindergartens of two primary schools in the Karateke and Kocabas villages of Honaz…

  2. Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

    SciT

    Raupach, J., E-mail: janraupach@seznam.cz; Lojik, M., E-mail: miroslav.lojik@fnhk.cz; Chovanec, V., E-mail: chovanec.v@seznam.cz

    2016-02-15

    PurposeRetrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methodsFrom 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.ResultsWe achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due tomore » a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.ConclusionPrimary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.« less

  3. Frequency of Six Early Childhood Education Approaches: A 10-Year Content Analysis of Early Childhood Education Journal

    ERIC Educational Resources Information Center

    Walsh, Bridget A.; Petty, Karen

    2007-01-01

    The frequency of early childhood education approaches spanning 10 years of publications was investigated. A content analysis of publications (N = 492) from "Early Childhood Education Journal" was conducted. From a previous content analysis six approaches or search words were identified: Bank Street, Head Start, High/Scope, Montessori, Reggio…

  4. Music in the Early Years: Pathways into the Social World

    ERIC Educational Resources Information Center

    Ilari, Beatriz

    2016-01-01

    Two assumptions that underlie much research in early childhood music education are that music is a social endeavor and musical participation is beneficial to children's overall social development. As members of cultural and social groups, young children engage with music in a multitude of ways and with different companions. This article examines…

  5. iPads: Improving Numeracy Learning in the Early Years

    ERIC Educational Resources Information Center

    Spencer, Peta

    2013-01-01

    The concept of mobile technologies is now an emergency theme in educational research, yet the playing of these edutainment applications and their impact on early childhood learning needs to be fully explored. This study highlights current research and explores how iPads improve student learning. It also examines how the introduction of iPads,…

  6. Introducing First-Year Medical Students to Early Diagnostic Hypotheses

    ERIC Educational Resources Information Center

    Taylor, P. J.; And Others

    1978-01-01

    A method of instruction in gynecology is described that encouraged the formulation of early diagnostic hypotheses, an important part of clinical problem-solving. Students were given a set of clinical clues to help them make broad diagnostic hypotheses. Student ability, results, and student perceptions of the course are provided. (Author/LBH)

  7. Sustaining Care: Cultivating Mindful Practice in Early Years Professional Development

    ERIC Educational Resources Information Center

    Taggart, Geoff

    2015-01-01

    The practitioner's own self is a resource in early childhood education and care (ECEC). It is proposed that an experiential training focusing on the "professional self" helps to raise awareness of how psychological dispositions may impair or enhance quality of provision. A key concept in such training is emotional labour, explored with…

  8. Children's Use of Objects in an Early Years Playground

    ERIC Educational Resources Information Center

    Bateman, Amanda; Church, Amelia

    2017-01-01

    Early childhood research has investigated children's use of objects largely focusing on cognitive and motor development. Yet members of a particular culture, such as young children's peer groups, use objects that have cultural relevance as "conversational" items, as a means to interacting with other members of the group. This article…

  9. Fostering a Sense of Wonder during the Early Childhood Years.

    ERIC Educational Resources Information Center

    Wilson, Ruth A.

    This book is based on the understanding that fostering a sense of wonder and appreciation for the natural world is important to the development of young children and the preservation of planet Earth. It is also based on the belief that experiences children have early in life impact the attitudes and behaviors they carry with them throughout their…

  10. Early Numeracy Indicators: Examining Predictive Utility Across Years and States

    ERIC Educational Resources Information Center

    Conoyer, Sarah J.; Foegen, Anne; Lembke, Erica S.

    2016-01-01

    Two studies using similar methods in two states investigated the long-term predictive utility of two single-skill early numeracy Curriculum Based Measures (CBMs) and the degree to which they can adequately predict high-stakes test scores. Data were drawn from kindergarten and first-grade students. State standardized assessment data from the…

  11. Othered Voices: Asylum-Seeking Mothers and Early Years Education

    ERIC Educational Resources Information Center

    Whitmarsh, Judy

    2011-01-01

    Strengthening the home-school partnership is a strategy to raise achievement levels and to engage "hard-to-reach" parents with education in the UK, however this political ideal has been critiqued as exclusive and based on a white, middle class model. This article explores how six asylum-seeking mothers manage their children's early years…

  12. SKIPing with Teachers: An Early Years Motor Skill Intervention

    ERIC Educational Resources Information Center

    Brian, Ali; Goodway, Jacqueline D.; Logan, Jessica A.; Sutherland, Sue

    2017-01-01

    Background: Fundamental motor skill (FMS) interventions when delivered by an expert can significantly improve the FMS of young children with and without developmental delays. However, there is a gap in the literature as few early childhood centers employ experts with the professional background to deliver FMS intervention. Purpose: The primary…

  13. Prevalence of ethanol and illicit drugs in road traffic accidents in the centre of Portugal: An eighteen-year update.

    PubMed

    Costa, Nádia; Silva, Rosário; Mendonça, M Cristina; Real, Francisco Corte; Vieira, Duarte Nuno; Teixeira, Helena M

    2012-03-10

    This study presents the prevalence of ethanol and illicit drugs in fatal road traffic accident victims in the Centre of Portugal between January 1990 and December 2007. Among the violent deaths, road traffic accidents presented the highest percentage (around 35%; n=3095), but decreasing throughout the years. Accidents were preponderant in males (about 80%; n=2402), between 21 and 30 years-old. Accidents involving drivers (55%; n=1310) were of the most common, being the car the main vehicle (45%), followed by the motorcycle (40%). An alcohol analysis request was present in 50% of the cases (n=1687), but increasing each year. Ethanol concentrations >1.2g/L, the legal limit in Portugal, were found in 55% (n=283) of the cases. Concerning drugs of abuse requests, only 4.4% (n=137) and 17.3% (58 cases) of the cases included the analysis at the Forensic Pathology Department (FPD) and at the Medico-Legal Office (MLO), respectively. Among the road accident cases analysed, 18 were positive, mainly in men (84%), between 21 and 30 years-old; opiates (47.1%; n=8) and cannabinoids (50%; n=4) were the most found, at the FPD and at the MLO, respectively. In conclusion, ethanol was identified as a key factor to traffic accidents, which explains the definition of specific legislation and methods of enforcement to prohibit this form of impairing. Nevertheless, ethanol still remains the psychoactive substance most frequently identified in the blood of divers killed in road-traffic crashes, recommending additional actions of supervision and control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. A qualitative examination of the perceptions of parents on the Canadian Sedentary Behaviour Guidelines for the early years

    PubMed Central

    2014-01-01

    Background Minimizing sedentary behavior, in particular screen-based sedentary behavior, during the early years is important for healthy growth and development. Consequently, new Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0–4 years) were recently released. Researchers are unclear what messages should supplement the guidelines when disseminating them to parents and when using the guidelines in behaviour-change interventions to increase adoption. The objective of this study was to qualitatively examine parents’ perceptions of the new Canadian Sedentary Behaviour Guidelines for the Early Years. Methods Parents with a child ≤4 years who attended a child care centre were purposefully recruited from child care centres. A total of 7 semi-structured focus groups with 2 to 5 parents were conducted from August to November, 2013 by a trained and experienced moderator. Participants were asked a series of open-ended questions pertaining to the Sedentary Behaviour Guidelines information sheet. Initial themes were identified followed by further review and analysis. Results For the most part parents thought the guidelines were clear and did not disagree with the recommendations per se. However, some confusion arose around the value of some sedentary activities, such as reading and coloring, for social and cognitive development. Many parents described feeling guilty after reading the guidelines and perceived several barriers in meeting the daily recommendations. Common barriers included the need to balance multiple demands of family life, the prevalence and accessibility of screen technology, and the weather and built environment where families live. Parents expressed the importance of communicating the guidelines early enough for good habits to be established and the need for realistic strategies and ideas to help them meet the recommendations. Conclusions Overall the findings indicate that gain-framed messages around the role of screen-based and non

  15. A qualitative examination of the perceptions of parents on the Canadian Sedentary Behaviour Guidelines for the early years.

    PubMed

    Carson, Valerie; Clark, Marianne; Berry, Tanya; Holt, Nicholas L; Latimer-Cheung, Amy E

    2014-05-17

    Minimizing sedentary behavior, in particular screen-based sedentary behavior, during the early years is important for healthy growth and development. Consequently, new Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years) were recently released. Researchers are unclear what messages should supplement the guidelines when disseminating them to parents and when using the guidelines in behaviour-change interventions to increase adoption. The objective of this study was to qualitatively examine parents' perceptions of the new Canadian Sedentary Behaviour Guidelines for the Early Years. Parents with a child ≤4 years who attended a child care centre were purposefully recruited from child care centres. A total of 7 semi-structured focus groups with 2 to 5 parents were conducted from August to November, 2013 by a trained and experienced moderator. Participants were asked a series of open-ended questions pertaining to the Sedentary Behaviour Guidelines information sheet. Initial themes were identified followed by further review and analysis. For the most part parents thought the guidelines were clear and did not disagree with the recommendations per se. However, some confusion arose around the value of some sedentary activities, such as reading and coloring, for social and cognitive development. Many parents described feeling guilty after reading the guidelines and perceived several barriers in meeting the daily recommendations. Common barriers included the need to balance multiple demands of family life, the prevalence and accessibility of screen technology, and the weather and built environment where families live. Parents expressed the importance of communicating the guidelines early enough for good habits to be established and the need for realistic strategies and ideas to help them meet the recommendations. Overall the findings indicate that gain-framed messages around the role of screen-based and non-screen-based sedentary behavior for children

  16. Role models and professional development in dentistry: an important resource: The views of early career stage dentists at one academic health science centre in England.

    PubMed

    Mohamed Osama, O; Gallagher, J E

    2018-02-01

    The importance of role models, and their differing influence in early, mid- and late careers, has been identified in the process of professional development of medical doctors. There is a paucity of evidence within dentistry on role models and their attributes. To explore the views of early career dentists on positive and negative role models across key phases of professional development, together with role models' attributes and perceived influence. This is a phenomenological study collecting qualitative data through semi-structured interviews based on a topic guide. Dentists in junior (core training) hospital posts in one academic health science centre were all invited to participate. Interviews were recorded, transcribed verbatim and analysed using framework analysis. Twelve early career stage dentists, 10 of whom were female, reported having role models, mainly positive, in their undergraduate and early career phases. Participants defined role models' attributes in relation to three distinct domains: clinical attributes, personal qualities and teaching skills. Positive role models were described as "prioritising the patient's best interests", "delivering learner-centred teaching and training" and "exhibiting a positive personality", whilst negative role models demonstrated the converse. Early career dentists reported having largely positive dentist role models during- and post-dental school and report their impact on professional values and aspirations, learning outcomes and career choice. The findings suggest that these early career dentists in junior hospital posts have largely experienced and benefitted from positive role models, notably dentists, perceived as playing an important and creative influence promoting professionalism and shaping the career choices of early career stage dentists. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Showing up Matters: Newark Chronic Absenteeism in the Early Years

    ERIC Educational Resources Information Center

    Chen, Peter; Rice, Cynthia

    2016-01-01

    Based on a 180-day school year, any student who misses 18 days or more per year--or about two days per month--is considered chronically absent. An alarming 4,328 Newark students in grades kindergarten through 3rd grade were chronically absent during the 2013-14 school year. When young students miss too much school, they will likely struggle…

  18. Where Are the Early Years of School in Contemporary Early Childhood Education Reforms? An Historical Perspective

    ERIC Educational Resources Information Center

    Krieg, Susan; Whitehead, Kay

    2015-01-01

    Although international definitions of early childhood repeatedly refer to a birth-8 age span, there are complex, institutional divides within this age range. This paper explores the divide between pre-compulsory and compulsory early childhood institutions. In countries such as Finland this divide is not such an issue because children do not begin…

  19. The status of occupational blood and infectious body fluids exposures in five blood centres in China: a 5-year review.

    PubMed

    Wang, Y J; Meng, Z H; Zheng, X F; Tang, X X; Sang, L Y; Du, X-M; Cheng, Y-Z

    2015-12-01

    Little information about the occupational exposures to blood and body fluid (BBF) among blood service workers (BSWs) in blood stations in China is available currently. To assess current status of occupational exposure to BBF and assess the knowledge about occupational blood-borne pathogen exposures and universal precaution among BSWs in blood donations in China. To understand the incidence of occupational exposure in five blood centres in China. A cross-sectional study was conducted from January 2008 to December 2013. There were a total of 99 BBF exposures reported during the study period. The total incidence of BBF exposures was 4.4 per 100 person-years. Higher rates were observed for persons employed less than five years and persons less than 45 years old. Nurses have the highest percentage (49.5%) of BBF exposures. BBF exposures occurred most commonly during the afternoon (62.7%). Percutaneous injuries were the most common BBF exposures. Most incidents occurred during sharps use (73.4%). The major cause of occupational exposure was that there was no continuous training (48.4%) and improper use of equipment (23.2%). Only 56.6% of BBF exposures had appropriate first aid measures. During this research work, one staff member was reported to have seroconverted to syphilis after BBF exposure. To reduce BBF exposures, it is urgent to take several effective actions in China, including improved occupational health systems, adequate education, administrative support, increased use of standard precautions, better safety devices/products and work practices. © 2015 British Blood Transfusion Society.

  20. The Early Risers Preventive Intervention: Testing for Six-year Outcomes and Mediational Processes

    ERIC Educational Resources Information Center

    Bernat, Debra H.; August, Gerald J.; Hektner, Joel M.; Bloomquist, Michael L.

    2007-01-01

    We examined effects of the Early Risers "Skills for Success" early-age-targeted prevention program on serious conduct problems following 5 years of continuous intervention and one year of follow-up. We also examined if intervention effects on proximally-targeted variables found after 3 years mediated intervention effects on conduct…

  1. Can Early Years Professionals Determine Which Preschoolers Have Comprehension Delays? A Comparison of Two Screening Tools

    ERIC Educational Resources Information Center

    Seager, Emily; Abbot-Smith, Kirsten

    2017-01-01

    Language comprehension delays in pre-schoolers are predictive of difficulties in a range of developmental domains. In England, early years practitioners are required to assess the language comprehension of 2-year-olds in their care. Many use a format based on the Early Years Foundation Stage Unique Child Communication Sheet (EYFS:UCCS) in which…

  2. Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance.

    PubMed

    Schmidt, C; Potter, N; Porceddu, S; Panizza, B

    2017-07-01

    Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up. Cases treated with curative intent (2000-2014) were included. Data were collected, and overall and disease-free survival rates were calculated. Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively. Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.

  3. Personnel training experience in the radioactive waste management: 10 years of Moscow SIA 'RADON' international education training centre

    SciT

    Batyukhnova, Olga; Dmitriev, Sergey; Arustamov, Artur

    Available in abstract form only. Full text of publication follows: The education service for specialists dealing with radioactive waste was established in Russia (former USSR) in 1983 and was based on the capabilities of two organisations: the Moscow Scientific and Industrial Association 'Radon' (SIA 'Radon') and the Chemical Department of Lomonosov's Moscow State University. These two organizations are able to offer training programs in the science fundamentals, applied research and in practical operational areas of the all pre-disposal activities of the radioactive waste management. Since 1997 this system was upgraded to the international level and now acts as International Educationmore » Training Centre (IETC) at SIA 'Radon' under the guidance of the IAEA. During 10 years more than 300 specialists from 26 European and Asian countries enhanced their knowledge and skills in radioactive waste management. The IAEA supported specialized regional training courses and workshops, fellowships, on-the-job training, and scientific visits are additional means to assure development of personnel capabilities. Efficiency of training was carefully analysed using the structural adaptation of educational process as well as factors, which have influence on education quality. Social-psychological aspects were also taken into account in assessing the overall efficiency. The analysis of the effect of individual factors and the efficiency of education activity were carried out based on attestation results and questioning attendees. A number of analytical methods were utilised such as Ishikawa's diagram method and Pareto's principle for improving of training programs and activities. (authors)« less

  4. Credentialing of radiotherapy centres in Australasia for TROG 09.02 (Chisel), a Phase III clinical trial on stereotactic ablative body radiotherapy of early stage lung cancer.

    PubMed

    Kron, Tomas; Chesson, Brent; Hardcastle, Nicholas; Crain, Melissa; Clements, Natalie; Burns, Mark; Ball, David

    2018-05-01

    A randomised clinical trial comparing stereotactic ablative body radiotherapy (SABR) with conventional radiotherapy for early stage lung cancer has been conducted in Australia and New Zealand under the auspices of the TransTasman Radiation Oncology Group (NCT01014130). We report on the technical credentialing program as prerequisite for centres joining the trial. Participating centres were asked to develop treatment plans for two test cases to assess their ability to create plans according to protocol. Dose delivery in the presence of inhomogeneity and motion was assessed during a site visit using a phantom with moving inserts. Site visits for the trial were conducted in 16 Australian and 3 New Zealand radiotherapy facilities. The tests with low density inhomogeneities confirmed shortcomings of the AAA algorithm for dose calculation. Dose was assessed for a typical treatment delivery including at least one non-coplanar beam in a stationary and moving phantom. This end-to-end test confirmed that all participating centres were able to deliver stereotactic ablative body radiotherapy with the required accuracy while the planning study demonstrated that they were able to produce acceptable plans for both test cases. The credentialing process documented that participating centres were able to deliver dose as required in the trial protocol. It also gave an opportunity to provide education about the trial and discuss technical issues such as four-dimensional CT, small field dosimetry and patient immobilisation with staff in participating centres. Advances in knowledge: Credentialing is an important quality assurance tool for radiotherapy trials using advanced technology. In addition to confirming technical competence, it provides an opportunity for education and discussion about the trial.

  5. ERCP in a cohort of 759 cases: A 6-year experience of a single tertiary centre in Libya.

    PubMed

    Tumi, Ali; Magadmi, Masoud; Elfageih, Salah; Rajab, Abdul-Fatah; Azzabi, Masoud; Elzouki, Abdel-Naser

    2015-03-01

    The aim of this study was to review the indications, findings, technical success, and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures in a large cohort of patients admitted to a single tertiary centre in Libya. A total of 759 consecutive ERCP procedures were performed in 704 patients from January 2005 through December 2010 at the Endoscopy Unit of Central Hospital, Tripoli, Libya. The patients' demographic characteristics, clinical information, ERCP indications, laboratory parameters, and post-ERCP complications were reviewed. Formal written consent was obtained from all patients prior to each procedure. The study included 280 (36.9%) males and 479 (63.1%) females with mean age ± standard deviation (SD) of 56.8 ± 18.7 years. Papillotomy was performed in 670 (88.3%) cases of the ERCP procedures. Common bile duct (CBD) stones were reported in 389 (51.3%) cases and were more frequent in females (234 cases, 60.1%) than males (155, 39.9%) (p = 0.01). The majority of the CBD stones were successfully retrieved with balloon extraction (304 cases, 78.2%), while mechanical lithotripsy (67 cases, 17.2%) and Dormia basket (11 cases, 2.8%) were used for difficult stones. Only seven (1.8%) cases were referred for surgery. Malignancy was found in 151 (19.9%) of the cases and was significantly more common in males than females (102, 67.5% vs. 49, 32.5%, respectively, p = 0.001). Stents for bile drainage were inserted in 26 (17.2%) of these cases. The complications encountered were acute pancreatitis in 30 cases (3.9%), minor bleeding in nine cases (1.2%), major bleeding in one case (0.15%), cholangitis in four cases (0.52%), and perforation in one case (0.15). Mortality was reported in three cases (0.4%). The ERCP indications and the related complications, in our centre in Libya, are comparatively consistent with those reported data in other countries. Successful biliary cannulation was achieved in most of the patients, and post-ERCP complications

  6. Is it too early to recommend patent foramen ovale closure for all patients who suffer from migraine? A single-centre study.

    PubMed

    Chessa, Massimo; Colombo, Chiara; Butera, Gianfranco; Negura, Diana; Piazza, Luciane; Varotto, Leonardo; Bussadori, Claudio; Fesslova, Vlasta; Meola, Giovanni; Carminati, Mario

    2009-05-01

    To evaluate the course of migraine in migraine headache patients undergoing patent foramen ovale (PFO) transcatheter closure. Migraine has an important impact on the quality of life, and it seems to be one of the most disabling medical illnesses. In several studies, a high prevalence of right-to-left shunt has been described in patients with migraine, especially migraine with aura. The presence of right-to-left shunt, whatever the mechanism, may be the most potent trigger of migraine attacks in both migraine with aura and migraine without aura and the main determinant of aura in migraine with aura. A cohort of 42 patients (nine men/33 women; mean age 39 +/- 11.2 years), current migraineurs, underwent PFO percutaneous closure in our centre between January 2004 and December 2007. All patients rated the severity of their migraine preoperatively and 6 months postoperatively, indicating the frequency, duration, and intensity of the attacks and the occurrence of the aura in the prodromal phase, during the past 6 months, according to the migraine severity score. Baseline severity of migraine was higher in migraine with aura patients than in migraine without aura ones (8.8 vs. 7.5; P = 0.037). The resolution of migraine was verified in 11 patients (26%) after the closure of the PFO. A reduction in the frequency of the attacks (>=50%) was observed in 22 patients (52%). Multiple logistic regression analysis showed that the improvement in migraine with aura and migraine without aura was independent of migraine type, sex, age, cerebrovascular risk factors and cerebrovascular events, type of cardiac defect, and thrombophilic conditions. The consistent observations of this and other studies are provocative and worthy of evaluation with a prospective randomized trial using objective measures of migraine frequency and severity. However, it seems too early to recommend PFO closure for all patients who suffer from migraine until the results of ongoing large randomized trials are

  7. Ocular trauma injuries: a 1-year surveillance study in the University of Malaya Medical Centre, Malaysia. 2008.

    PubMed

    Soong, Terrence Kwong-Weng; Koh, Alan; Subrayan, Visvaraja; Loo, Angela Voon Pei

    2011-12-01

    To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008. A total of 603 eyes of 546 patients were recruited for the study. All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet. Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries. A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.

  8. Science and Technology in the Early Years. An Equal Opportunities Approach. Gender and Education Series.

    ERIC Educational Resources Information Center

    Browne, Naima, Ed.

    During the early 1980s there was a lack of research regarding gender issues for early childhood and elementary education. This document attempts to fill this chasm by addressing gender issues in science and technology for primary education schooling and early-years education. The following chapters are included: (1) "Science and Technology in the…

  9. Science in the Early Years. The Progress of Education Reform. Volume 15, Number 2

    ERIC Educational Resources Information Center

    Brenneman, Kimberly

    2014-01-01

    Recent research suggests early math, science, and social studies knowledge may boost achievement for the nation's youngest students and provides a better chance at future reading success--more so even than early reading skills. This issue explores the benefits of including a strong science curriculum in the early years and includes recommendations…

  10. Early Years of Neutron Scattering and Its Manpower Development in Indonesia

    SciT

    Marsongkohadi

    In this paper I shall give a short history of the development of neutron scattering at the Research Centre for Nuclear Techniques (PPTN), in Bandung, and the early development of a more advanced facilities at the Neutron Scattering Laboratory (NSL BATAN), Centre of Technology for Nuclear Industrial Materials, in Serpong. The first research reactor in Indonesia was the TRIGA MARK II in Bandung, which became operational in 1965, with a power of 250 KW, upgraded to 1 MW in 1971, and to 2 MW in 2000. The neutron scattering activities was started in 1967, with the design and construction ofmore » the first powder diffractometer, and put in operation in 1970. It was followed by the second instrument, the filter detector spectrometer built in 1975 in collaboration with the Bhabha Atomic Research Centre (BARC), India. A powder diffractometer for magnetic studies was built in 1980, and finally, a modification of the filter detector spectrometer to measure textures was made in 1986. A brief description of the design and construction of the instruments, and a highlight of some research topics will be presented. Early developments of neutron scattering activities at the 30 MW, RSG-GAS reactor in Serpong in choosing suitable research program, which will be mainly centred around materials testing/characterization, and materials/condensed matter researches has been agreed. Instrument planning and layout which were appropriate to carry out the program had been decided. Manpower development for the neutron scattering laboratory is a severe problem. The efforts to overcome this problem has been solved. International Cooperation through workshops and on the job trainings also support the supply of qualified manpower.« less

  11. The changing spectrum of primary glomerular diseases within 15 years: a survey of 3331 patients in a single Chinese centre.

    PubMed

    Zhou, Fu-de; Zhao, Ming-hui; Zou, Wan-zhong; Liu, Gang; Wang, Haiyan

    2009-03-01

    Primary glomerular disease (PGD) is the leading cause of end-stage renal disease (ESRD) in China. With the development of socioeconomic status of Chinese people in the last two decades, PGD in ESRD is intent to decrease. However, whether this affects the spectrum of PGD is not clear. The aim of the current study is to investigate the changing spectrum of PGD in China. The records of 5398 consecutive native renal biopsies performed in adults (>or=14 years of age) in our centre between 1993 and 2007 were retrospectively analysed. The criteria for renal biopsy and pathologic diagnosis were kept unchanged. The patients were grouped according to a 5-year interval, 1993-97 (period 1), 1998-2002 (period 2) and 2003-07 (period 3). Then they were divided into four groups according to age for stratified analysis: 14-24 years, 25-44 years, 45-59 years and the elderly (>or=60 years). Three thousand, three hundred and thirty-one patients were diagnosed with PGD. PGD remained the most common renal disease, accounting for 65.9%, 57.7% and 63.2% in period 1, 2 and 3, respectively, without any significant difference. The proportion of elder patients increased significantly from 0% in 1993 to 9.1% in 2007 (P < 0.001). Within 1993-97, the leading PGD was IgA nephropathy (50.7%), followed by non-IgA MsPGN (19.9%), membranous nephropathy (MN) (13.3%) and minimal change disease (MCD) (6.3%), while within 2003-07, the most common PGD was still IgAN (58.2%), but followed by MN (14.3%), MCD (13.4%) and non-IgA MsPGN (7.0%). The age-adjusted frequency of IgAN and MCD increased significantly from period 1 to period 3 (P < 0.01 and P < 0.001, respectively), while that of non-IgA MsPGN, EnPGN and MPGN decreased significantly (P < 0.001, P < 0.01 and P < 0.05, respectively). There was no significant change in the age-adjusted frequency of FSGS, MN and CreGN during the study period. However, when patients were stratified by age, a sixfold increase in frequency of FSGS was identified in the 14

  12. Understanding Cognitive Development: Automaticity and the Early Years Child

    ERIC Educational Resources Information Center

    Gray, Colette

    2004-01-01

    In recent years a growing body of evidence has implicated deficits in the automaticity of fundamental facts such as word and number recognition in a range of disorders: including attention deficit hyperactivity disorder, dyslexia, apraxia and autism. Variously described as habits, fluency, chunking and over learning, automatic processes are best…

  13. The Portraiture of Nick: Scene One, the Early Years

    ERIC Educational Resources Information Center

    Bicehouse, Vaughn L.

    2012-01-01

    In 2007, the Autism Society of America (ASA) estimated that 1.5 million Americans and their families were affected by autism. As the current ASD prevalence rates continue to rise (10%-17% each year) so does the awareness that ASD is no respecter of persons. ASD touches children of every racial, ethnic, and socioeconomic background. Additionally,…

  14. Assessment of the mental health status of a one year cohort attending a two Sexual Assault Referral Centres in England.

    PubMed

    Brooker, Charlie; Tocque, Karen; Paul, Sheila

    2018-02-01

    A one year audit was undertaken of the mental health (MH) status of adult attendees to the Thames Valley Sexual Assault Centres (SARC). There were 301 relevant referrals over the twelve month period of whom 126 (42%) either fully or partially completed the mental health assessments. 38% (n = 66) of the population did not consent to the research. Participation in the study was felt inappropriate by the case clinician in the rest of the cases. To summarise the findings: 36% were moderately or severely depressed; 30% experienced moderate to severe anxiety; 28% were drinking at hazardous/harmful levels; and 12% had a drug problem that was moderate to severe. Self harm affected 45% of the sample with the greater majority cutting themselves and self-harming before the age of 17. Admission to a psychiatric in-patient unit was not uncommon and 19% had been admitted an average of three times each. The figure of 19% admitted to a psychiatric hospital is 90 times higher than for the general female population. 42% of the total sample were being prescribed medication for their mental health problem. The paper concludes that: there should be agreement nationally on the use of a standardised set of mental health outcome measures which are used in all assessments; there should be a move towards the commissioning of expert psychological support that is offered in a SARC and the pathways for specialist mental health care out of the SARCs. Finally, forensic physicians and general practitioners needs a greater awareness of the mental health sequalae of sexual assault and they then need to make prompt referrals to the appropriate services. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  15. Coeliac disease in a 15-year period of observation (1997 and 2011) in a Hungarian referral centre.

    PubMed

    Kocsis, Dorottya; Miheller, Pál; Lőrinczy, Katalin; Herszényi, László; Tulassay, Zsolt; Rácz, Károly; Juhász, Márk

    2013-07-01

    The aim of this study is to evaluate the experience of a single coeliac centre over a 15-year-long study period (between November of 1997 and September of 2011). Charts of 178 patients (139 females) with coeliac disease were retrospectively evaluated. Tests performed: multiple duodenal biopsies, anti-tissue transglutaminase and anti-endomysium antibodies, body mass index calculation, osteodensitometry, evaluation of disorders associated with coeliac disease, and implementation of family screening. Histological samples were available in 133 cases, distribution according to Marsh-Oberhuber classification: M0 in 7%, M1-M2 in 4%, M3a in 26%, M3b in 13%, and M3c in 50% of cases, respectively. Anti-tissue transglutaminase and anti-endomysium antibody tests were available in 158 cases, 132/158 showed seropositivity. Mean body mass index values were 23.05kg/m(2) for males, and 21.07kg/m(2) for females, respectively. Osteodensitometry showed normal values in 46%, osteopenia in 36%, and osteoporosis in 18% of cases, respectively. Coeliac disease associated disorders was present in 63/178 (35%) patients. Ninety coeliacs brought 197 first degree relatives for screening, with 47/197 (23%) relatives proving to have coeliac disease. Correlations between anti-tissue transglutaminase antibody titres and Marsh-Oberhuber classification, and anti-tissue transglutaminase antibody titres and bone mineral density values were found to be statistically significant (p=0.0011, and p=0.001, respectively). Coeliac disease can become overt at any age. Female predominance is significant. Histology usually showed advanced villous atrophy. Mean body mass index values were within normal range. The high prevalence of associated disorders is also noted. The prevalence of 24% of coeliac disease among first degree relatives underlines the necessity of family screening. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Signature Pedagogy in Early Years Education: A Role for COTS Game-Based Learning

    ERIC Educational Resources Information Center

    Miller, David; Robertson, Derek; Hudson, Alison; Shimi, Jill

    2012-01-01

    In this article we look at the links between early years pedagogy and the use of digital game-based learning. Early years education is a distinctive phase of the education system in many countries, generally covering the age range from 3-6 or 7 years. In the United Kingdom, it tends to bridge preschool and the first two years in primary school.…

  17. Early-Years Swimming: Creating Opportunities for Adding Mathematical Capital to Under 5s

    ERIC Educational Resources Information Center

    Jorgensen, Robyn

    2013-01-01

    Drawing on survey data from over 2000 parents, this paper explores the possibility of early-years swimming to add mathematical capital to young children. Using developmental milestones as the basis, it was found that parents reported significantly earlier achievement on many of these milestones. Such data suggest that the early years swim…

  18. Becoming Professional? Exploring Early Years Professional Status and Its Implications for Workforce Reform in England

    ERIC Educational Resources Information Center

    Simpson, Donald

    2010-01-01

    Across the "European learning space" (Lawn, 2006) professionalisation of early years workforces has become a key priority and there has been a flow of this policy between borders (Oberhuemer, 2005). Early Years Professional Status (EYPS) is central to these developments in England. Within what is regarded as a traditionally…

  19. Early Years Teachers' Perspectives on Teaching through Multiple Metaphors and Multimodality

    ERIC Educational Resources Information Center

    Mildenhall, Paula

    2015-01-01

    Recent research findings indicate that using multiple metaphors in multimodal learning experiences are effective teaching approaches in early years mathematics. Using a social semiotic lens this paper reports on eight early years teachers' perceptions of this approach whilst engaging in a small collaborative professional learning group. This group…

  20. Reversing the Real Brain Drain: Early Years Study--A Response.

    ERIC Educational Resources Information Center

    Killoran, Isabel

    2001-01-01

    Presents concerns over the "Early Years Study" (McCain & Mustard). Focuses on diversity issues related to the readiness measure used, parenting styles, and the importance of first language development. Questions the report's definition of "developmentally-attuned." Concludes by expressing hope that the Early Years Study…

  1. How Can the Skills of Early Years Leaders Support Other Leaders in a Primary School Setting?

    ERIC Educational Resources Information Center

    Mistry, Malini; Sood, Krishan

    2017-01-01

    This study investigated the leadership skills Early Years leaders demonstrated through their daily practice of teaching, assessing and teamwork within their setting. It explored how revealing the potential of Early Years leaders could have a positive impact on the leadership practice of other leaders in the same setting to improve pupil outcomes.…

  2. Strategies, Systems and Services: A Northern Ireland Early Years Policy Perspective

    ERIC Educational Resources Information Center

    McMillan, Dorothy J.; McConnell, Barbara

    2015-01-01

    Following a lengthy consultation process across Northern Ireland (NI), 2013 saw the publication of Learning to Learn: A Framework for Early Years Education and Learning [DE (Department of Education). 2013. "Learning to Learn: A Framework for Early Years Education and Learning." Accessed July 15, 2014.…

  3. Science of Materials: A Case Study of Intentional Teaching in the Early Years

    ERIC Educational Resources Information Center

    Hackling, Mark; Barratt-Pugh, Caroline

    2012-01-01

    Australia's Early Years Learning Framework and leading international researchers argue for more intentional and purposeful teaching of science in the early years. This case study of exemplary practice illustrates intentional teaching of science materials which opened-up learning opportunities in literacy and number. Student-led hands-on…

  4. Disrupting Communities of Practice? How "Reluctant" Practitioners View Early Years Workforce Reform in England

    ERIC Educational Resources Information Center

    Payler, Jane K.; Locke, Rachel

    2013-01-01

    This article reports on the views of early years practitioners in England from settings that were identified as "reluctant to engage" with one of the government's key policies, the introduction of Early Years Professional Status (EYPS), to drive forwards workforce reform. Focus groups, interviews and a survey were undertaken in 2009 with…

  5. Typical Didactical Activities in the Greek Early-Years Science Classroom: Do They Promote Science Learning?

    ERIC Educational Resources Information Center

    Kallery, Maria; Psillos, Dimitris; Tselfes, Vassilis

    2009-01-01

    This paper presents an epistemological analysis of typical didactical activities noted in early-years science lessons, which was carried out in an attempt to diagnose the extent to which the teaching practices adopted by early-years educators are successful in supporting young children's understanding in science. The analysis of didactical…

  6. Teachers' Voice, Power and Agency: (Un)Professionalisation of the Early Years Workforce

    ERIC Educational Resources Information Center

    Tesar, Marek; Pupala, Branislav; Kascak, Ondrej; Arndt, Sonja

    2017-01-01

    This article examines Slovak early years teachers' concerns with conceptions of teacher professionalism. It suggests that there is a mismatch between understandings of professionalism, policy aspirations and the attitudes of teachers to their own professionalism, and that this mismatch fuels early years teachers' sense of agency. These tensions…

  7. Earthquake Early Warning in Japan - Result of recent two years -

    NASA Astrophysics Data System (ADS)

    Shimoyama, T.; Doi, K.; Kiyomoto, M.; Hoshiba, M.

    2009-12-01

    Japan Meteorological Agency(JMA) started to provide Earthquake Early Warning(EEW) to the general public in October 2007. It was followed by provision of EEW to a limited number of users who understand the technical limit of EEW and can utilize it for automatic control from August 2006. Earthquake Early Warning in Japan definitely means information of estimated amplitude and arrival time of a strong ground motion after fault rupture occurred. In other words, the EEW provided by JMA is defined as a forecast of a strong ground motion before the strong motion arrival. EEW of JMA is to enable advance countermeasures to disasters caused by strong ground motions with providing a warning message of anticipating strong ground motion before the S wave arrival. However, due to its very short available time period, there should need some measures and ideas to provide rapidly EEW and utilize it properly. - EEW is issued to general public when the maximum seismic intensity 5 lower (JMA scale) or greater is expected. - EEW message contains origin time, epicentral region name, and names of areas (unit is about 1/3 to 1/4 of one prefecture) where seismic intensity 4 or greater is expected. Expected arrival time is not included because it differs substantially even in one unit area. - EEW is to be broadcast through the broadcasting media(TV, radio and City Administrative Disaster Management Radio), and is delivered to cellular phones through cell broadcast system. For those who would like to know the more precise estimation and smaller earthquake information at their point of their properties, JMA allows designated private companies to provide forecast of strong ground motion, in which the estimation of a seismic intensity as well as arrival time of S-wave are contained, at arbitrary places under the JMA’s technical assurance. From October, 2007 to August, 2009, JMA issued 11 warnings to general public expecting seismic intensity “5 lower” or greater, including M=7.2 inland

  8. Leaving Education Early: Putting Vocational Education and Training Centre Stage. Volume II: Evaluating Policy Impact. Cedefop Research Paper. No 58

    ERIC Educational Resources Information Center

    Cedefop - European Centre for the Development of Vocational Training, 2016

    2016-01-01

    This Cedefop study focuses on the contribution that vocational education and training (VET) can make to reducing early leaving from education and training (ELET). Published in two volumes, the first is dedicated to understanding better the learning pathways of young students, providing measurements of early leaving in VET, and understanding the…

  9. Practice versus Politics in Danish Day-Care Centres: How to Bridge the Gap in Early Learning?

    ERIC Educational Resources Information Center

    Clasen, Line Engel; Jensen de López, Kristine

    2016-01-01

    It is essential that early educators in day-care services possess adequate pedagogical tools for supporting children's communicative development. Early literacy programmes (ELPs) are potential tools. However, studies investigating the effects of ELPs seldom address implementation processes or the programme users' perspectives. This study sheds…

  10. Design and internal validation of an obstetric early warning score: secondary analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database.

    PubMed

    Carle, C; Alexander, P; Columb, M; Johal, J

    2013-04-01

    We designed and internally validated an aggregate weighted early warning scoring system specific to the obstetric population that has the potential for use in the ward environment. Direct obstetric admissions from the Intensive Care National Audit and Research Centre's Case Mix Programme Database were randomly allocated to model development (n = 2240) or validation (n = 2200) sets. Physiological variables collected during the first 24 h of critical care admission were analysed. Logistic regression analysis for mortality in the model development set was initially used to create a statistically based early warning score. The statistical score was then modified to create a clinically acceptable early warning score. Important features of this clinical obstetric early warning score are that the variables are weighted according to their statistical importance, a surrogate for the FI O2 /Pa O2 relationship is included, conscious level is assessed using a simplified alert/not alert variable, and the score, trigger thresholds and response are consistent with the new non-obstetric National Early Warning Score system. The statistical and clinical early warning scores were internally validated using the validation set. The area under the receiver operating characteristic curve was 0.995 (95% CI 0.992-0.998) for the statistical score and 0.957 (95% CI 0.923-0.991) for the clinical score. Pre-existing empirically designed early warning scores were also validated in the same way for comparison. The area under the receiver operating characteristic curve was 0.955 (95% CI 0.922-0.988) for Swanton et al.'s Modified Early Obstetric Warning System, 0.937 (95% CI 0.884-0.991) for the obstetric early warning score suggested in the 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the UK, and 0.973 (95% CI 0.957-0.989) for the non-obstetric National Early Warning Score. This highlights that the new clinical obstetric early warning score has an excellent ability to

  11. Attachment change processes in the early years of marriage.

    PubMed

    Davila, J; Karney, B R; Bradbury, T N

    1999-05-01

    The authors examined 4 models of attachment change: a contextual model, a social-cognitive model, an individual-difference model, and a diathesis-stress model. Models were examined in a sample of newlyweds over the first 2 years of marriage, using growth curve analyses. Reciprocal processes, whereby attachment representations and interpersonal life circumstances affect one another over time, also were studied. On average, newlyweds became more secure over time. However, there was significant within-subject variability on attachment change that was predicted by intra- and interpersonal factors. Attachment representations changed in response to contextual, social-cognitive, and individual-difference factors. Reciprocal processes between attachment representations and marital variables emerged, suggesting that these factors influence one another in an ongoing way.

  12. Implementation of Early Childhood Development Education Service Standard Guidelines on Physical Facilities in Public and Private Early Childhood Education Centres Kakamega County, Kenya

    ERIC Educational Resources Information Center

    Sitati, Emmily M.; Ndirangu, Mwangi; Kennedy, Bota; Rapongo, George S.

    2016-01-01

    In 2006, the Kenyan Ministry of Education (MoE) developed an early childhood development education (ECDE) service standard guidelines to guide the ECDE stakeholders in provision of early childhood education (ECE) programmes. The study sought to investigate the implementation of the ECDE service standard guidelines on provision of physical…

  13. Building a Student-Centred Learning Framework Using Social Software in the Middle Years Classroom: An Action Research Study

    ERIC Educational Resources Information Center

    Casey, Gail

    2013-01-01

    This article discusses the development of the online spaces that were used to create a learning framework: a student-centred framework that combined face-to-face teaching with online social and participatory media. The author, as part of her Doctoral research study, used action research as a mechanism for continual improvement as she redesigned…

  14. Extracardiac findings at cardiac MR imaging: a single-centre retrospective study over 14 years.

    PubMed

    Sokolowski, Felix C; Karius, Philipp; Rodríguez, Alejandra; Lembcke, Alexander; Wagner, Moritz; Hamm, Bernd; Dewey, Marc

    2018-04-30

    To determine the prevalence and significance of extracardiac findings (ECF) in a large set of cardiac magnetic resonance (MR) imaging examinations. The institutional review board (IRB) of the Charité approved this retrospective, single-centre study. A total of 4376 cardiac MR imaging reports of 3553 patients (age 37.4 ± 20 years, 60.8 % male) examined from 2000 to 2014 were included. Findings with a recommendation for follow-up were considered "major ECF". To analyse the association of indication, age and gender with ECF, Poisson regression and computed incidence rate ratios (IRR) were evaluated. The overall prevalence of ECF was 34% (95% confidence interval [CI] 32.5-35.6%). Major ECF were present in 3.4% (95% CI 2.9-4.1%) while findings that changed patient management were found in 0.9% (95% CI 0.7-1.3%). In the cases of congenital heart disease, ECF prevalence was higher compared to myocarditis (IRR, 6.0; 95% CI 5.1-7.1%; p < 0.001), while the prevalence of major ECF was lower (IRR, 0.2; 95% CI 0.02-0.51%; p < 0.05). Older patient age was associated with more nonvascular ECF (p < 0.001). Female patients had the same probability of having an ECF as male patients (IRR, 1.04; 95% CI 0.95-1.1%; p = 0.43). ECF in cardiac MR imaging are present in about every third patient while relevant ECF that change patient management can be found in about one out of 100 patients. Our data suggest that it is important to involve well-trained radiologists in reading cardiac MR images, which often reveal ECF if congenital heart disease is the clinical indication. • Extracardiac findings are present in about every third patient. • Relevant ECF changing patient management are found in one out of 100 findings. • Chance of ECF is high in patients with CHD and vascular indications.

  15. Bottled water, spas, and early years of water chemistry

    Back, William; Landa, Edward R.; Meeks, Lisa

    1995-01-01

    Although hot springs have been used and enjoyed for thousands of years, it was not until the late 1700s that they changed the course of world civilization by being the motivation for development of the science of chemistry. The pioneers of chemistry such as Priestley, Cavendish, Lavoisier, and Henry were working to identify and generate gases, in part, to determine their role in carbonated beverages. In the 18th century, spas in America were developed to follow the traditional activities of popular European spas. However, they were to become a dominant political and economic force in American history on three major points: (1) By far the most important was to provide a place for the leaders of individual colonies to meet and discuss the need for separation from England and the necessity for the Revolutionary War; (2) the westward expansion of the United States was facilitated by the presence of hot springs in many locations that provided the economic justification for railroads and settlement; and (3) the desire for the preservation of hot springs led to the establishment of the National Park Service. Although mineral springs have maintained their therapeutic credibility in many parts of the world, they have not done so in the United States. We suggest that the American decline was prompted by: (1) the establishment of The Johns Hopkins School of Medicine in 1893; (2) enactment of the Pure Food and Drug Act of 1907; and (3) the remarkable achievement of providing safe water supplies for American cities by the end of the 1920s. The current expanding market for bottled water is based in part on bottled water being an alternative beverage Ito alcohol and sweetened drinks and the inconsistent palatability and perceived health hazards of some tap waters.

  16. College Student Persistence in the Two-Year Setting: Identifying Risk Early to Guide Early Integration

    ERIC Educational Resources Information Center

    Keys, Margo A.

    2013-01-01

    College student persistence is examined. The unique nature of the students and environment of the two-year college setting warrant concentrated research effort. The purpose of the study is to examine student variables associated with persistence and program completion to develop a pre-entrance risk assessment in the two-year college setting.…

  17. Febrile neutropaenia and chemotherapy discontinuation in women aged 70 years or older receiving adjuvant chemotherapy for early breast cancer.

    PubMed

    Adjogatse, D; Thanopoulou, E; Okines, A; Thillai, K; Tasker, F; Johnston, S R D; Harper-Wynne, C; Torrisi, E; Ring, A

    2014-11-01

    Low rates of adjuvant chemotherapy use are frequently reported in older women with early breast cancer. One of the reasons for this may be the risk of febrile neutropaenia or the perception that older patients will probably not complete the chemotherapy course prescribed. There are no data regarding these adverse outcomes in routine clinical practice. We identified 128 patients aged 70 years or over who received neoadjuvant or adjuvant chemotherapy for early breast cancer in seven UK cancer centres between 2006 and 2012. Data were collected regarding standard clinical and pathological variables and treatment toxicity and outcomes. Twenty-four patients (19%) had an episode of febrile neutropaenia. Overall, 27 patients (21%) did not complete their planned therapy. Chemotherapy discontinuation was more common in those patients with an episode of febrile neutropaenia (46% versus 16%, P = 0.004). Thirty patients (23%) were admitted with chemotherapy-related complications. There were no treatment-related deaths. The rates of febrile neutropaenia and treatment discontinuation are high in women aged 70 years or over receiving adjuvant chemotherapy for breast cancer. Close attention should be paid to the choice or regimen and the use of supportive therapies in this patient population. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  18. Five years of specialised early intervention versus two years of specialised early intervention followed by three years of standard treatment for patients with a first episode psychosis: randomised, superiority, parallel group trial in Denmark (OPUS II).

    PubMed

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Emborg, Charlotte; Jepsen, Jens Richardt Mollegaard; Fagerlund, Birgitte; Gluud, Christian; Mors, Ole; Hjorthøj, Carsten; Nordentoft, Merete

    2017-01-12

    To compare the effects of five years of specialised early intervention (SEI) treatment for first episode schizophrenia spectrum disorder with the standard two years of SEI plus three years of treatment as usual. Randomised, superiority, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. Participants were recruited from six OPUS teams in Denmark between 2009 and 2012. OPUS teams provide SEI treatment to all patients diagnosed with a schizophrenia spectrum disorder in Denmark. 400 participants (51% women) with a mean age of 25.6 (standard deviation 4.3) were randomised to five years of SEI (experimental intervention; n=197) or to two years of SEI plus three years of treatment as usual (control; n=203). OPUS treatment consists of three core elements-modified assertive community treatment, family involvement, and social skill training-with a patient-case manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group were mostly referred to community health centres after two years of SEI treatment. Follow-up assessments were conducted five years after start of OPUS treatment. Primary outcome was negative symptoms measured on the scale for assessment of negative symptoms (avolition-apathy, anhedonia, alogia, and affective blunting). Secondary outcomes were remission of both negative and psychotic symptoms, psychotic symptoms, suicidal ideation, substance abuse, compliance with medical treatment, adherence with treatment, client satisfaction, days in hospital care, and labour market affiliation. Levels of negative symptoms did not differ between the intervention group and control group (1.72 v 1.81 points; estimated mean difference -0.10 (95% confidence interval -0.33 to 0.13), P=0.39). Participants receiving five years of OPUS treatment

  19. The English Early Years Professional Status (EYPS) and the "Split" Early Childhood Education and Care (ECEC) System

    ERIC Educational Resources Information Center

    Roberts-Holmes, Guy

    2013-01-01

    In England, the overwhelming majority (78%) of under fives' nursery places, remains in the private, voluntary and independent (PVI) sector where there is no requirement to employ a qualified teacher. Compared to the maintained state sector early years workforce, this dominant PVI sector tends to be staffed by a poorly qualified workforce. From…

  20. Goal-oriented cognitive rehabilitation in early-stage dementia: study protocol for a multi-centre single-blind randomised controlled trial (GREAT)

    PubMed Central

    2013-01-01

    Background Preliminary evidence suggests that goal-oriented cognitive rehabilitation (CR) may be a clinically effective intervention for people with early-stage Alzheimer’s disease, vascular or mixed dementia and their carers. This study aims to establish whether CR is a clinically effective and cost-effective intervention for people with early-stage dementia and their carers. Methods/design In this multi-centre, single-blind randomised controlled trial, 480 people with early-stage dementia, each with a carer, will be randomised to receive either treatment as usual or cognitive rehabilitation (10 therapy sessions over 3 months, followed by 4 maintenance sessions over 6 months). We will compare the effectiveness of cognitive rehabilitation with that of treatment as usual with regard to improving self-reported and carer-rated goal performance in areas identified as causing concern by people with early-stage dementia; improving quality of life, self-efficacy, mood and cognition of people with early-stage dementia; and reducing stress levels and ameliorating quality of life for carers of participants with early-stage dementia. The incremental cost-effectiveness of goal-oriented cognitive rehabilitation compared to treatment as usual will also be examined. Discussion If the study confirms the benefits and cost-effectiveness of cognitive rehabilitation, it will be important to examine how the goal-oriented cognitive rehabilitation approach can most effectively be integrated into routine health-care provision. Our aim is to provide training and develop materials to support the implementation of this approach following trial completion. Trial registration Current Controlled Trials ISRCTN21027481 PMID:23710796

  1. Early College High School Initiative. Evaluation Year End Report: 2003?2004

    ERIC Educational Resources Information Center

    Berger, Andrea R.; Cole, Susan; Melton, Janet; Safran, Stephanie; Vogel, Tyler; Walton, Laura; Adelman, Nancy; Hall, Catherine; Keating, Kaelie Knowles; Murray, Samantha; Nielsen, Natalie; Schaffner, Monika

    2005-01-01

    This is the first year-end report produced as part of the on-going evaluation of the Bill & Melinda Gates Foundation's Early College High School Initiative. The program provides funding and support for the establishment of Early College High Schools, which are organized to allow all enrolled students the opportunity to earn a high school diploma…

  2. Paths to Empowerment. Ten Years of Early Childhood Work in Israel.

    ERIC Educational Resources Information Center

    Paz, Ruth

    In this book, Bernard van Leer Foundation programs in Israel that combined early childhood education and community development approaches across a 10-year period are described. Chapter (1) provide an introduction; (2) discuss the evolution of this combined approach, its theoretical roots in the separate disciplines of early childhood education and…

  3. Reframing Leadership as a Participative Pedagogy: The Working Theories of Early Years Professionals

    ERIC Educational Resources Information Center

    Murray, Janet; Clark, Rory McDowall

    2013-01-01

    Traditional notions of leadership are at odds with the pedagogy and ethos of Early Childhood Education and Care (ECEC), prompting increasing international concern to develop new understandings which are better suited and create greater leadership capacity. The introduction of the Early Years Professional (EYP) in England, as a leader of practice…

  4. Formative Evaluation of the Understanding the Early Years Initiative. Final Report

    ERIC Educational Resources Information Center

    Human Resources and Skills Development Canada, 2009

    2009-01-01

    This report presents the findings of the formative evaluation of the Understanding the Early Years (UEY) Initiative. The evaluation was conducted to examine issues of implementation and design, early progress in achieving immediate objectives, and issues related to accountability. The evaluation team was also asked to provide preliminary guidance…

  5. My Body. Developing an Early Interest in Science: A Preschool Science Curriculum. (4-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This teaching guide on the body for 4-year-olds is based on a modification of the "Plan, Do, Review" approach to education devised by High Scope in Ypsilanti, Michigan. First implemented as an outreach early childhood program in North Carolina, the science activities described in this guide can be adapted to various early childhood environments.…

  6. Interrogating "Belonging" in Belonging, Being and Becoming: The Early Years Learning Framework for Australia

    ERIC Educational Resources Information Center

    Sumsion, Jennifer; Wong, Sandie

    2011-01-01

    In this article, the authors interrogate the use of "belonging" in "Belonging, Being and Becoming: the Early Years Learning Framework for Australia" (EYLF), Australia's first national curriculum for early childhood education and care settings and, from the authors' interrogation, possibilities are offered for thinking about and…

  7. Understanding the HighScope Approach: Early Years Education in Practice. Understanding the... Approach

    ERIC Educational Resources Information Center

    Wiltshire, Monica

    2011-01-01

    "Understanding the HighScope Approach" is a much needed source of information for those wishing to extend and consolidate their understanding of the HighScope Approach. It will enable the reader to analyse the essential elements of the HighScope Approach to early childhood and its relationship to quality early years practice. Exploring…

  8. Maternal Psychopathology and Early Child Temperament Predict Young Children's Salivary Cortisol 3 Years Later

    ERIC Educational Resources Information Center

    Dougherty, Lea R.; Smith, Victoria C.; Olino, Thomas M.; Dyson, Margaret W.; Bufferd, Sara J.; Rose, Suzanne A.; Klein, Daniel N.

    2013-01-01

    Neuroendocrine dysfunction is hypothesized to be an early emerging vulnerability marker for depression. We tested whether the main and interactive effects of maternal psychopathology and early child temperamental vulnerability for depression assessed at age three predicted offspring's basal cortisol function at age 6 years. 228 (122 males)…

  9. Schoolification or Early Years Democracy? A Cross-Curricular Perspective from Denmark and England

    ERIC Educational Resources Information Center

    Brogaard Clausen, Sigrid

    2015-01-01

    International comparisons strongly influence national policy agendas in the early years. However, an appreciation of details and national context and differences is imperative to promote democracy. From the perspective of a Danish social pedagogue lecturing in Early Childhood Studies in England, the author presents a cross-national comparison to…

  10. Educational Disadvantage in the Early Years: How Do We Overcome It? Some Lessons from Research

    ERIC Educational Resources Information Center

    Siraj-Blatchford, Iram

    2004-01-01

    This paper draws upon the findings of a body of recent research in early childhood education to explore the possibilities that may be available to overcome structural inequalities associated with socio-economic class, gender and ethnicity in the early years. Research has shown that preschool education makes a real difference for all children and…

  11. Early Childhood Education, The Year in Review: A Look at 1988.

    ERIC Educational Resources Information Center

    Hymes, James L., Jr.

    This is a report on the happenings in early childhood education in the United States in 1988. Contents focus on: (1) the week, the year, and the decade of the young child; (2) the proposed Act for Better Child Care Services; (3) other child care developments; (4) other early childhood programs; (5) growth of pre-kindergarten programs; (6) the need…

  12. Earth Science. Developing an Early Interest in Science: A Preschool Science Curriculum. (4-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This teaching guide on earth sciences for 4-year-olds is based on a modification of the "Plan, Do, Review" approach to education devised by High Scope in Ypsilanti, Michigan. First implemented as an outreach early childhood program in North Carolina, the science activities described in this guide can be adapted to various early childhood…

  13. Earth Science. Developing an Early Interest in Science: A Preschool Science Curriculum. (3-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This teaching guide on earth sciences for 3-year-old children is based on a modification of the "Plan, Do, Review" approach to education devised by High Scope in Ypsilanti, Michigan. First implemented as an outreach early childhood program in North Carolina, the science activities described in this guide can be adapted to various early childhood…

  14. Social Identity, Autism and Visual Impairment (VI) in the Early Years

    ERIC Educational Resources Information Center

    Dale, Naomi; Salt, Alison

    2008-01-01

    This article explores how visual impairment might impact on early social and emotional development including self-awareness and communication with others. Some children show a "developmental setback" and other worrying developmental trajectories in the early years, including autistic related behaviours and autistic spectrum disorders.…

  15. Integrated Practice in the Early Years in Australia: The Assumptions, Omissions and Contradictions of Policy Reform

    ERIC Educational Resources Information Center

    Macfarlane, Kym; Nolan, Andrea; Cartmel, Jennifer

    2016-01-01

    The aim of this article is to examine current national early years' policy reform, which emphasises the importance of service integration, national quality standards and a quality knowledge base for educators concerning the provision of early childhood education and care. Using Queensland, Australia, as an example, a policy discourse analysis…

  16. Teaching Children with down Syndrome in the Early Years of School

    ERIC Educational Resources Information Center

    McFadden, Amanda; Tangen, Donna; Spooner-Lane, Rebecca; Mergler, Amanda

    2017-01-01

    We explored 3 general classroom teachers' experiences of including a child with Down syndrome in their early years classrooms. Located at 3 different Australian school settings, 1 teacher was the head of a Preparatory class, 1 was a Year 3 teacher, and the third was a teacher of a split Preparatory/Year 1 class. Interview data were drawn from a…

  17. THE RELATIONSHIP OF CHILD PERCEPTIONS TO ACHIEVEMENT AND BEHAVIOR IN THE EARLY SCHOOL YEARS.

    ERIC Educational Resources Information Center

    COMBS, ARTHUR W.; SOPER, DANIEL W.

    THIS RESEARCH EXPLORED CERTAIN RELATIONSHIPS BETWEEN THE PERCEPTIONS OF CHILDREN AND THEIR BEHAVIOR DURING EARLY SCHOOL YEARS. SPECIFIC OBJECTIVES WERE--(1) TO DETERMINE IF CHANGING PERCEPTIONS OF SELF AND THE WORLD ARE ACCOMPANIED FROM YEAR TO YEAR BY CHANGES IN BEHAVIOR AND ACHIEVEMENT AND (2) TO SEE IF A KNOWLEDGE OF A CHILD'S PERCEPTIONS CAN…

  18. The history of the early years of metamaterials in USA and UK defense agencies

    NASA Astrophysics Data System (ADS)

    Derov, John S.; Hammond, Richard; Youngs, Ian J.

    2017-08-01

    This article discusses the historical events that occurred in the early years of metamaterials leading to the current development of metamaterials in the Defense Advanced Research Projects Agency, Department of Defense, and Ministry of Defence.

  19. Using Arrays to Build towards Multiplicative Thinking in the Early Years

    ERIC Educational Resources Information Center

    Jacob, Lorraine; Mulligan, Joanne

    2014-01-01

    In this article, Lorraine Jacob and Joanne Mulligan discuss how arrays can be used to promote students' early learning in relation to multiplication and division. They provide examples of activities that can be used from Foundation to Year 5.

  20. Multiple Perspectives on Integrated Education for Children with Disabilities in the Context of Early Childhood Centres in Hong Kong

    ERIC Educational Resources Information Center

    Lai, Yuk Ching; Gill, Judith

    2014-01-01

    The integration of children with disabilities in mainstream early childhood settings is a common practice in many developed and developing countries world-wide. A number of key points have been raised concerning such integration, including the increased attention to civil education about the rights of persons with disabilities, training for…

  1. Five-year evolution of reperfusion strategies and early mortality in patients with ST-segment elevation myocardial infarction in France.

    PubMed

    El Khoury, Carlos; Bochaton, Thomas; Flocard, Elodie; Serre, Patrice; Tomasevic, Danka; Mewton, Nathan; Bonnefoy-Cudraz, Eric

    2017-10-01

    To assess 5-year evolutions in reperfusion strategies and early mortality in patients with ST-segment elevation myocardial infarction. Using data from the French RESCUe network, we studied patients with ST-segment elevation myocardial infarction treated in mobile intensive care units between 2009 and 2013. Among 2418 patients (median age 62 years; 78.5% male), 2119 (87.6%) underwent primary percutaneous coronary intervention and 299 (12.4%) pre-hospital thrombolysis (94.0% of whom went on to undergo percutaneous coronary intervention). Use of primary percutaneous coronary intervention increased from 78.4% in 2009 to 95.9% in 2013 ( P trend <0.001). Median delays included: first medical contact to percutaneous coronary intervention centre 48 minutes; first medical contact to balloon inflation 94 minutes; and percutaneous coronary intervention centre to balloon inflation 43 minutes. Times from symptom onset to first medical contact and first medical contact to thrombolysis remained stable during 2009-2013, but times from symptom onset to first balloon inflation, and first medical contact to percutaneous coronary intervention centre to first balloon inflation decreased ( P<0.001). Among patients with known timings, 2146 (89.2%) had a first medical contact to percutaneous coronary intervention centre delay ⩽90 minutes, while 260 (10.8%) had a longer delay, with no significant variation over time. Primary percutaneous coronary intervention use increased over time in both delay groups, but was consistently higher in the ⩽90 versus >90 minutes delay group (83.0% in 2009 to 97.7% in 2013; P trend <0.001 versus 34.1% in 2009 to 79.2% in 2013; P trend <0.001). In-hospital (4-6%) and 30-day (6-8%) mortalities remained stable from 2009 to 2013. In the RESCUe network, the use of primary percutaneous coronary intervention increased from 2009 to 2013, in line with guidelines, but there was no evolution in early mortality.

  2. Dementia service centres in Austria: A comprehensive support and early detection model for persons with dementia and their caregivers – theoretical foundations and model description

    PubMed Central

    Span, Edith; Reisberg, Barry

    2015-01-01

    Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. PMID:24339114

  3. Dementia service centres in Austria: A comprehensive support and early detection model for persons with dementia and their caregivers - theoretical foundations and model description.

    PubMed

    Auer, Stefanie R; Span, Edith; Reisberg, Barry

    2015-07-01

    Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. © The Author(s) 2013.

  4. The Professional Identity of Early Years Educators in England: Implications for a Transformative Approach to Continuing Professional Development

    ERIC Educational Resources Information Center

    Lightfoot, Sarah; Frost, David

    2015-01-01

    This article examines the professional identity of nine early years educators currently working in the early years sector of education in England. These educators include teachers, teaching assistants, nursery practitioners and nursery nurses working with children three to five years old in the Early Years Foundation Stage in state-maintained…

  5. Developing Children's Self Initiated Music Making through the Creation of a Shared Ethos in an Early Years Music Project

    ERIC Educational Resources Information Center

    Naughton, Christopher; Lines, David

    2013-01-01

    The three-month "Changing Places" project involved early childhood student teachers working with music students in developing children's music in centres in Auckland, New Zealand. The project set out to challenge the calculative aspect in music learning (Heidegger, 1993). The term calculative in this instance describes learning seen as…

  6. The management of open tibial fractures in children: a retrospective case series of eight years' experience of 61 cases at a paediatric specialist centre.

    PubMed

    Nandra, R S; Wu, F; Gaffey, A; Bache, C E

    2017-04-01

    Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture. Their mean age was nine years (2 to 16) and the median follow-up was ten months (interquartile range 5 to 18). Management involved IV antibiotics, early debridement and combined treatment of the skeletal and soft-tissue injuries in line with standards proposed by the British Orthopaedic Association. There were 36 diaphyseal fractures and 25 distal tibial fractures. Of the distal fractures, eight involved the physis. Motor vehicle collisions accounted for two thirds of the injuries and 38 patients (62%) arrived outside of normal working hours. The initial method of stabilisation comprised: casting in nine cases (15%); elastic nailing in 19 (31%); Kirschner (K)-wiring in 13 (21%); intramedullary nailing in one (2%); open reduction and plate fixation in four (7%); and external fixation in 15 (25%). Wound management comprised: primary wound closure in 24 (39%), delayed primary closure in 11 (18%), split skin graft (SSG) in eight (13%), local flap with SSG in 17 (28%) and a free flap in one. A total of 43 fractures (70%) were Gustilo-Anderson grade III. There were four superficial (6.6%) and three (4.9%) deep infections. Two deep infections occurred following open reduction and plate fixation and the third after K-wire fixation of a distal fracture. No patient who underwent primary wound closure developed an infection. All the fractures united, although nine patients required revision of a mono-lateral to circular frame for delayed union (two) or for altered alignment or length (seven). The mean time to union was two weeks longer

  7. Single-centre experience with the frozen elephant trunk technique in 251 patients over 15 years.

    PubMed

    Shrestha, Malakh; Martens, Andreas; Kaufeld, Tim; Beckmann, Erik; Bertele, Sebastian; Krueger, Heike; Neuser, Julia; Fleissner, Felix; Ius, Fabio; Abd Alhadi, Firas; Hanke, Jasmin; Schmitto, Jan D; Cebotari, Serghei; Karck, Matthias; Haverich, Axel; Chavan, Ajay

    2017-11-01

    Our goal was to present our 15-year experience (2001-2015) with the frozen elephant trunk (FET) technique. A total of 251 patients (82 with aortic aneurysms, 96 with acute aortic dissection type A, 4 with acute type B dissections, 52 with chronic aortic dissection type A, 17 with chronic type B dissection and 67 redo cases) underwent FET implantation with either the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 31) or the Vascutek Thoraflex hybrid (n = 154) prosthesis. The cases were assigned to an early period (2001-2011) and a contemporary period (2012-present). Mean cardiopulmonary bypass time, aortic cross-clamp time, circulatory arrest time and selective antegrade cerebral perfusion time were 241 ± 72, 125 ± 59, 56 ± 30 and 81 ± 34 min, respectively. Incidence of rethoracotomy for bleeding, stroke, spinal cord injury, prolonged ventilatory support (>96 h) and long-term dialysis were 18, 14, 2, 24 and 2%, respectively. The in-hospital mortality rate was 11% (in acute aortic dissection type A, 12%). Of the 2 patients with graft infections, 1 died and the other had a protracted hospital stay. There were 49 second-stage procedures in the downstream aorta: either open surgical [n = 25 (thoraco-abdominal, n = 15; descending, n = 6; infrarenal, n = 4)] or transfemoral endovascular (n = 23). Elective thoracic endovascular aneurysm repair R implantation was successful in all 23 cases. FET results are comparable with those of the published results of the conventional elephant trunk technique. FET is an ideal landing zone for subsequent transfemoral endovascular completion. Patients with graft infections may have dismal results. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  8. Clinical Analysis of Ectopic Pregnancies in a Tertiary Care Centre in Southern India: A Six-Year Retrospective Study.

    PubMed

    Tahmina, S; Daniel, Mary; Solomon, Preethy

    2016-10-01

    Ectopic Pregnancy (EP) is a life-threatening emergency commonly encountered by medical practitioners where diagnosis can often be missed. Any woman in the reproductive age group, presenting with lower abdominal pain or vaginal bleeding must raise the suspicion of an ectopic pregnancy to prevent mortality and morbidity. To review all cases of EP and determine the incidence of EP. To study the high risk factors and know the types of clinical presentation, methods of diagnosis, outcome and complications. This was a retrospective cohort study, conducted at a tertiary care medical teaching hospital in Pondicherry, India. Medical records of all women with an EP between 2009 and 2015 were retrieved. Demographic data, parity, risk factors, clinical features, mode of management and need for blood transfusion was noted. Main outcome measures studied were the incidence of EP, risk factors, mortality and morbidity in these women. Data was entered in Microsoft Excel spreadsheet and analysed using SPSS software version 19.0. For categorical variables, data was compiled as frequency and percent. For continuous variables, data was calculated as mean ± SD. Seventy-two EP were diagnosed during the six-year period with an incidence of 9.1/1000 pregnancies. Majority of women were aged 21-30years (51.39%), 27.8% women were nulliparous. The most common risk factors were previous abortion (36.1%) and pelvic surgery (37.50%). Fifteen cases (20.8%) were diagnosed in women who had tubectomy. The classic triad of lower abdominal pain, amenorrhoea and vaginal bleeding was seen in 29(40.3%) cases. Ultrasonography was required to arrive at a diagnosis in 28(38.9%) cases. Urine pregnancy test was positive in 100% of cases. Majority (94.4%) were tubal ectopic pregnancies. Medical management with methotrexate alone benefitted 10(13.89%) of patients while another four required surgery for failed medical management. More than half of the patients (59.7%) required blood transfusion and two (2

  9. Early assessment of the 10-step patient engagement framework for patient-centred outcomes research studies: the first three steps.

    PubMed

    Sofolahan-Oladeinde, Yewande; Newhouse, Robin P; Lavallee, Danielle C; Huang, Jennifer C; Mullins, C Daniel

    2017-06-01

    A key principle of patient-centred outcomes research (PCOR) is the engagement of patients and other stakeholders in the research process, but the evidence is still emerging on the impact patient engagement has on the research process. A 10-step framework has been developed to provide methodological guidance for patient engagement throughout the research process. However, the utility of the framework for patient engagement has not been tested in actual research studies. To describe researcher's overall experiences with engaging patients at the beginning of their PCOR research process. Twelve in-depth interviews were conducted face-to-face and by telephone with PCOR researchers between November 2014 and January 2015 at an Academic Health Center in the eastern USA. All data were audiotaped and transcribed, and NVivo 10 software was used for data analysis. Four major themes emerged (i) the importance of patient engagement and how it provides 'a perspective you can't get unless you talk to the patient'; (ii) the impact of patient engagement; (iii) challenges and barriers of engagement; and (iv) the realities of patient engagement. Researchers' views illustrate the need to re-evaluate patient engagement in PCOR based on current realities. Given the many challenges to engagement that researchers encounter, it may be more productive to redefine the process of patient engagement so that the issues researchers now face are taken into account in future funding announcements, engagement rubrics and methodology frameworks developed. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Developing Peer Mentoring Support for TAFE Students Entering 1st-Year University Early Childhood Studies

    ERIC Educational Resources Information Center

    Heirdsfield, Ann; Walker, Sue; Walsh, Kerryann

    2005-01-01

    At Queensland University of Technology (QUT, Australia), in the Bachelor of Education (BEd) (Early Childhood) (EC), Technical and Further Education (TAFE) students with a diploma enroll with advanced standing (1 year's credit). These students share many challenges faced by 1st-year university students--workload, technology, academic orientation,…

  11. Otitis Media in Early Childhood and Cognitive, Academic, and Behavior Outcomes at 12 Years of Age.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; And Others

    1995-01-01

    Examined the association between otitis media with effusion (OME) during the first 3 years of life and cognitive, academic performance, and behavior outcomes at 12 years of age. Results indicated that OME during early childhood was not related to intellectual performance, academic achievement, behavior, and attention. Suggests that generalizations…

  12. Language Development in the Early School Years: The Importance of Close Relationships with Teachers

    ERIC Educational Resources Information Center

    Spilt, Jantine L.; Koomen, Helma M. Y.; Harrison, Linda J.

    2015-01-01

    This longitudinal study examined developmental links between closeness in teacher-child relationships and children's receptive language ability from the end of the preschool years into the early elementary years, while controlling for changes in peer interaction quality and child behavioral functioning. The sample included children and their…

  13. Early Cognitive and Linguistic Profiles of Different Types of 7- to 8-Year-Old Readers

    ERIC Educational Resources Information Center

    Potocki, Anna; Ecalle, Jean; Magnan, Annie

    2017-01-01

    The aim of this study was to investigate the early characteristics of four profiles of readers established in second grade (7-8 years of age): good readers, specific poor decoders, specific poor comprehenders and general poor readers. These profiles were compared retrospectively on a range of measures administered 2 years earlier, in kindergarten.…

  14. "Sounds of Intent in the Early Years": A Proposed Framework of Young Children's Musical Development

    ERIC Educational Resources Information Center

    Voyajolu, Angela; Ockelford, Adam

    2016-01-01

    "Sounds of Intent in the Early Years" explores the musical development of children from birth to five years of age. Observational evidence has been utilised together with key literature on musical development and core concepts of zygonic theory (Ockelford, 2013) to investigate the applicability of the original "Sounds of…

  15. The early years of single photon emission computed tomography (SPECT): an anthology of selected reminiscences.

    PubMed

    Jaszczak, Ronald Jack

    2006-07-07

    The origin of SPECT can be found in pioneering experiments on emission tomography performed approximately 50 years ago. This historical review consists of a compilation of first person recollections from nine trailblazing scientists who shaped the early years of SPECT instrumentation during the 1960s and 1970s.

  16. REVIEW: The early years of single photon emission computed tomography (SPECT): an anthology of selected reminiscences

    NASA Astrophysics Data System (ADS)

    Jaszczak, Ronald Jack

    2006-07-01

    The origin of SPECT can be found in pioneering experiments on emission tomography performed approximately 50 years ago. This historical review consists of a compilation of first person recollections from nine trailblazing scientists who shaped the early years of SPECT instrumentation during the 1960s and 1970s.

  17. The Race to the Top--Early Learning Challenge Year Two Progress Report

    ERIC Educational Resources Information Center

    US Department of Education, 2014

    2014-01-01

    The human brain develops rapidly in the first five years of life. High-quality early learning experiences can have a profound and lasting positive effect on young children during these years, setting the stage for success in kindergarten and beyond. This is especially true for young children with high needs who are from low-income families; who…

  18. Playful Structure: A Novel Image of Early Years Pedagogy for Primary School Classrooms

    ERIC Educational Resources Information Center

    Walsh, Glenda; Sproule, Liz; McGuinness, Carol; Trew, Karen

    2011-01-01

    Playful structure is a new pedagogic image representing a more balanced and integrated perspective on early years pedagogy, aiming to blend apparent dichotomies and contradictions and to sustain and evolve play-based practice beyond Year 1. Playful structure invites teachers and children to initiate and maintain a degree of playfulness in the…

  19. Contributions of Early Work-Based Learning: A Case Study of First Year Pharmacy Students

    ERIC Educational Resources Information Center

    Ting, Kang Nee; Wong, Kok Thong; Thang, Siew Ming

    2009-01-01

    Generally work-based learning opportunities are only offered to students in their penultimate year of undergraduate study. Little is known about the benefits and shortcomings of such experiential learning for students in the early stages of their undergraduate education. This is a mixed method study investigating first year undergraduate pharmacy…

  20. "It's the Bread and Butter of Our Practice": Experiencing the Early Years Foundation Stage

    ERIC Educational Resources Information Center

    Roberts-Holmes, Guy

    2012-01-01

    This article presents the experiences of nursery and primary head teachers (n = 12) on the English Early Years Foundation Stage (EYFS) after its first year of implementation in 2010. Findings are drawn from a subset of data (head teachers of primary and nursery schools) which forms part of a larger Department for Children, Schools and Families…

  1. Under-Representation of Males in the Early Years: The Challenges Leaders Face

    ERIC Educational Resources Information Center

    Mistry, Malini; Sood, Krishan

    2013-01-01

    This article investigates why there appears to be an under-representation of males in comparison to their female colleagues in the Early Years (EY) sector, and the perception of male teachers progressing more quickly to leadership positions when they do enter this context. Using case studies of final year male students on an Initial Teacher…

  2. Social Strategies during University Studies Predict Early Career Work Burnout and Engagement: 18-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Salmela-Aro, Katariina; Tolvanen, Asko; Nurmi, Jari-Erik

    2011-01-01

    This longitudinal study spanning 18 years examined the role of social strategies in early career adaptation. The aim was to find out whether individuals' social strategies measured during their university studies had an impact on work burnout and work engagement measured 10-18 years later. A sample of 292 university students completed the SAQ…

  3. Perceptions of the characteristics of the Alberta Nutrition Guidelines for Children and Youth by child care providers may influence early adoption of nutrition guidelines in child care centres.

    PubMed

    Nikolopoulos, Hara; Farmer, Anna; Berry, Tanya R; McCargar, Linda J; Mager, Diana R

    2015-04-01

    In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination. © 2012 Blackwell Publishing Ltd.

  4. Does early-life family income influence later dental pain experience? A prospective 14-year study.

    PubMed

    Ghorbani, Z; Peres, M A; Liu, P; Mejia, G C; Armfield, J M; Peres, K G

    2017-12-01

    The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45; 95% confidence interval = 1.27-1.66). Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions. © 2017 Australian Dental Association.

  5. Early treatment improves urodynamic prognosis in neurogenic voiding dysfunction: 20 years of experience.

    PubMed

    Costa Monteiro, Lucia M; Cruz, Glaura O; Fontes, Juliana M; Vieira, Eliane T R C; Santos, Eloá N; Araújo, Grace F; Ramos, Eloane G

    To evaluate the association between early treatment and urodynamic improvement in pediatric and adolescent patients with neurogenic bladder. Retrospective longitudinal and observational study (between 1990 and 2013) including patients with neurogenic bladder and myelomeningocele treated based on urodynamic results. The authors evaluated the urodynamic follow-up (bladder compliance and maximum bladder capacity and pressure) considering the first urodynamic improvement in two years as the outcome variable and early referral as the exposure variable, using a descriptive and multivariate analysis with logistic regression model. Among 230 patients included, 52% had an early referral. The majority were diagnosed as overactive bladder with high bladder pressure (≥40cm H 2 O) and low bladder compliance (3mL/cmH 2 O) and were treated with oxybutynin and intermittent catheterization. Urodynamic follow-up results showed 68% of improvement at the second urodynamic examination decreasing bladder pressure and increasing bladder capacity and compliance. The percentage of incontinence and urinary tract infections decreased over treatment. Early referral (one-year old or less) increased by 3.5 the probability of urodynamic improvement in two years (95% CI: 1.81-6.77). Treatment onset within the first year of life improves urodynamic prognosis in patients with neurogenic bladder and triplicates the probability of urodynamic improvement in two years. The role of neonatologists and pediatricians in early referral is extremely important. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  6. Early Years Educators' Perceptions of Professional Development in England: An Exploratory Study of Policy and Practice

    ERIC Educational Resources Information Center

    Ingleby, Ewan

    2018-01-01

    This article explores the perceptions of professional development held by a selection of early years educators who have experience of working in statutory and private early years settings in the north of England. The research participants (n = 20) reflected on their experiences of professional development in early years. The research process is…

  7. Early and late menarche are associated with oligomenorrhea and predict metabolic syndrome 26 years later.

    PubMed

    Glueck, Charles J; Morrison, John A; Wang, Ping; Woo, Jessica G

    2013-11-01

    We determined whether simple, clinical information on late and early menarche could help identify adult women with metabolic syndrome (MetS) and oligomenorrhea. We carried out a 26-year prospective follow-up of 272 suburban schoolgirls from ages 5-22 to 30-46. Early menarche (≤10 years, 5.2% of girls) and late menarche (≥16 years, 6.7% of girls) were both associated with oligomenorrhea (≥42 days) in adulthood, 29% and 11%, vs. 5% for normal menarche (11-15 years), p=.004. Early menarche was characterized by high childhood BMI (LS mean±SE: 21.2 ±1.0 kg/m2) and by high childhood and adult MetS (15%, 36%). Girls with late menarche had the lowest childhood BMI (18.1±1.0), no childhood MetS, and the highest adult MetS (47%). Increasing age at menarche was associated with uniformly decreasing childhood BMI and MetS, but with a U-shaped pattern of BMI (p = .05), MetS (p=.008), and oligomenorrhea (p=.02) in adulthood. Change to MetS from median ages 13 to 38 was associated with early-late menarche (OR=3.11, 95% CI 1.37-7.07, p=.007). MetS in adulthood was associated with childhood MetS (OR=8.03, 95% CI 2.57-25.08, p=.0003) and with early-late menarche (OR =3.43, 95% CI 1.44-8.15, p=.005). Menarche age had a curvilinear ('U' shaped) relationship with MetS and oligomenorrhea in adulthood. Late menarche and early menarche are risk factors for adult oligomenorrhea, MetS, and cardiometabolic abnormalities. Girls with early (≤ age 10) and with late menarche (≥ 16) represent a group at high risk for adult cardiometabolic abnormalities and oligomenorrhea that is easily identifiable by physicians. © 2013.

  8. Eradication of early P. aeruginosa infection in children <7 years of age with cystic fibrosis: The early study.

    PubMed

    Ratjen, Felix; Moeller, Alexander; McKinney, Martha L; Asherova, Irina; Alon, Nipa; Maykut, Robert; Angyalosi, Gerhild

    2018-04-20

    Antibiotic eradication treatment is the standard-of-care for cystic fibrosis (CF) patients with early Pseudomonas aeruginosa (Pa)-infection; however, evidence from placebo-controlled trials is limited. This double-blind, placebo-controlled trial randomised CF patients <7 years (N = 51) with early Pa-infection to tobramycin inhalation solution (TOBI 300 mg) or placebo (twice daily) for 28 days with an optional cross-over on Day 35. Primary endpoint was proportion of patients having throat swabs/sputum free of Pa on Day 29. On Day 29, 84.6% patients in the TOBI versus 24.0% in the placebo group were Pa-free (p < 0.001). At the end of the cross-over period, 76.0% patients receiving TOBI in the initial 28 days were Pa-free compared to 47.8% receiving placebo initially. Adverse events were consistent with the TOBI safety profile with no differences between TOBI and placebo. TOBI was effective in eradicating early Pa-infection with a favourable safety profile in young CF patients. NCT01082367. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  9. Epidemiology of fungal infections in liver transplant recipients: a six-year study of a large Brazilian liver transplantation centre.

    PubMed

    Zicker, Michelle; Colombo, Arnaldo Lopes; Ferraz-Neto, Ben-Hur; Camargo, Luis Fernando Aranha

    2011-05-01

    Liver transplant seems to be an effective option to prolong survival in patients with end-stage liver disease, although it still can be followed by serious complications. Invasive fungal infections (ifi) are related to high rates of morbidity and mortality. The epidemiology of fungal infections in Brazilian liver transplant recipients is unknown. The aim of this observational and retrospective study was to determine the incidence and epidemiology of fungal infections in all patients who underwent liver transplantation at Albert Einstein Israeli Hospital between 2002-2007. A total of 596 liver transplants were performed in 540 patients. Overall, 77 fungal infections occurred in 68 (13%) patients. Among the 77 fungal infections, there were 40 IFI that occurred in 37 patients (7%). Candida and Aspergillus species were the most common etiologic agents. Candida species accounted for 82% of all fungal infections and for 67% of all IFI, while Aspergillus species accounted for 9% of all fungal infections and for 17% of all IFI. Non-albicans Candida species were the predominant Candida isolates. Invasive aspergillosis tended to occur earlier in the post-transplant period. These findings can contribute to improve antifungal prophylaxis and therapy practices in Brazilian centres.

  10. Early speech perception in Mandarin-speaking children at one-year post cochlear implantation.

    PubMed

    Chen, Yuan; Wong, Lena L N; Zhu, Shufeng; Xi, Xin

    2016-01-01

    The aim in this study was to examine early speech perception outcomes in Mandarin-speaking children during the first year of cochlear implant (CI) use. A hierarchical early speech perception battery was administered to 80 children before and 3, 6, and 12 months after implantation. Demographic information was obtained to evaluate its relationship with these outcomes. Regardless of dialect exposure and whether a hearing aid was trialed before implantation, implant recipients were able to attain similar pre-lingual auditory skills after 12 months of CI use. Children speaking Mandarin developed early Mandarin speech perception faster than those with greater exposure to other Chinese dialects. In addition, children with better pre-implant hearing levels and younger age at implantation attained significantly better speech perception scores after 12 months of CI use. Better pre-implant hearing levels and higher maternal education level were also associated with a significantly steeper growth in early speech perception ability. Mandarin-speaking children with CIs are able to attain early speech perception results comparable to those of their English-speaking counterparts. In addition, consistent single language input via CI probably enhances early speech perception development at least during the first-year of CI use. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Early endocrine alterations reflect prolonged stress and relate to 1-year functional outcome in patients with severe brain injury.

    PubMed

    Marina, Djordje; Klose, Marianne; Nordenbo, Annette; Liebach, Annette; Feldt-Rasmussen, Ulla

    2015-06-01

    Severe brain injury may increase the risk of developing acute and chronic hypopituitarism. Pituitary hormone alterations developed in the early recovery phase after brain injury may have implications for long-term functional recovery. The objective of the present study was to assess the pattern and prevalence of pituitary hormone alterations 3 months after a severe brain injury with relation to functional outcome at a 1-year follow-up. Prospective study at a tertiary university referral centre. A total of 163 patients admitted to neurorehabilitation after severe traumatic brain injury (TBI, n=111) or non-TBI (n=52) were included. The main outcome measures were endocrine alterations 3.3 months (median) after the brain injury and their relationship to the functioning and ability of the patients at a 1-year follow-up, as measured by the Functional Independence Measure and the Glasgow Outcome Scale-Extended. Three months after the injury, elevated stress hormones (i.e. 30 min stimulated cortisol, prolactin and/or IGF1) and/or suppressed gonadal or thyroid hormones were recorded in 68 and 32% of the patients respectively. At 1 year after the injury, lower functioning level (Functional Independence Measure) and lower capability of performing normal life activities (Glasgow Outcome Scale-Extended) were related to both the elevated stress hormones (P≤0.01) and the reduced gonadal and/or thyroid hormones (P≤0.01) measured at 3 months. The present study suggests that brain injury-related endocrine alterations that mimic secondary hypogonadism and hypothyroidism and that occur with elevated stress hormones most probably reflect a prolonged stress response 2-5 months after severe brain injury, rather than pituitary insufficiency per se. These endocrine alterations thus seem to reflect a more severe disease state and relate to 1-year functional outcome. © 2015 European Society of Endocrinology.

  12. The relationship of otitis media in early childhood to attention dimensions during the early elementary school years.

    PubMed

    Hooper, Stephen R; Ashley, Timothy A; Roberts, Joanne E; Zeisel, Susan A; Poe, Michele D

    2006-08-01

    This study examined the impact of otitis media with effusion (OME) and associated hearing loss between 6 and 48 months of age on attention dimensions (i.e., selective/focus, sustained) during the elementary school years. A prospective cohort design in which 74 African American infants were recruited between ages 6 and 12 months. Ear examinations were done repeatedly using both otoscopy and tympanometry, and hearing was assessed using standard audiometric procedures between 6 and 48 months. Multiple measures of attention (i.e., direct assessment, behavioral observations, parent/teacher ratings) were administered from kindergarten through second grade to assess two theoretical dimensions of attention: selective/focused and sustained. The home environment was assessed annually. Results indicated that neither early childhood OME nor hearing loss showed significant correlations with any of the longitudinal or cross-sectional measures of selective/focused attention and sustained attention. In contrast, children with mothers who had fewer years of education and who lived in less responsive and supportive home environments scored higher on both parent and teacher ratings of sustained attention (i.e., hyperactivity) through the second grade of elementary school. For NEPSY Auditory Attention in second grade, a significant interaction between the Home Observation for Measurement of the Environment and hearing loss was uncovered. This interaction showed that children with hearing loss from poor home environments experienced greater difficulties on the NEPSY Auditory Attention task than those with hearing loss from good home environments. These findings do not support a direct linkage of a history of OME and associated hearing loss to difficulties in selective/focused attention or sustained attention in early elementary school children. Relationships between sociodemographic variables and attention-related functions appear stronger and should be considered as mediators in any

  13. Early Family Ties and Marital Stability Over 16 Years: The Context of Race and Gender

    PubMed Central

    Orbuch, Terri L.; Bauermeister, José A.; Brown, Edna; McKinley, Brandyn-Dior

    2016-01-01

    Spouses’ emotional ties to family early in marriage are linked to marital outcomes, but little is known about how these ties affect marital stability and whether these effects vary by race and gender. The present study examines the links between emotional ties to family of origin and in-laws in the first year of marriage and marital stability over the first 16 years of marriage. Data were collected as part of a longitudinal study following Black American (n=199) and White American (n=174) married couples. Analyses revealed that perceptions of closeness to in-laws early in marriage were associated with odds of divorce over time, but the results varied by race and gender. Findings are discussed in terms of couples’ ties to family early in marriage and the role that in-law bonds play for marital stability. We also offer insights for practitioners who provide premarital and marital education and counseling services to couples. PMID:27594724

  14. Language Outcomes at 7 Years: Early Predictors and Co-Occurring Difficulties.

    PubMed

    McKean, Cristina; Reilly, Sheena; Bavin, Edith L; Bretherton, Lesley; Cini, Eileen; Conway, Laura; Cook, Fallon; Eadie, Patricia; Prior, Margot; Wake, Melissa; Mensah, Fiona

    2017-03-01

    To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties METHODS: A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non-English speaking background,family history of speech/language difficulties); maternal factors (mental health, vocabulary, education, and age); and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life). Almost 19% of children (22/1204;18.9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68-0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85-0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning. Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties. Copyright © 2017 by the American Academy of Pediatrics.

  15. The nitrogen-vacancy colour centre in diamond

    NASA Astrophysics Data System (ADS)

    Doherty, Marcus W.; Manson, Neil B.; Delaney, Paul; Jelezko, Fedor; Wrachtrup, Jörg; Hollenberg, Lloyd C. L.

    2013-07-01

    The nitrogen-vacancy (NV) colour centre in diamond is an important physical system for emergent quantum technologies, including quantum metrology, information processing and communications, as well as for various nanotechnologies, such as biological and sub-diffraction limit imaging, and for tests of entanglement in quantum mechanics. Given this array of existing and potential applications and the almost 50 years of NV research, one would expect that the physics of the centre is well understood, however, the study of the NV centre has proved challenging, with many early assertions now believed false and many remaining issues yet to be resolved. This review represents the first time that the key empirical and ab initio results have been extracted from the extensive NV literature and assembled into one consistent picture of the current understanding of the centre. As a result, the key unresolved issues concerning the NV centre are identified and the possible avenues for their resolution are examined.

  16. A star in a 15.2-year orbit around the supermassive black hole at the centre of the Milky Way.

    PubMed

    Schödel, R; Ott, T; Genzel, R; Hofmann, R; Lehnert, M; Eckart, A; Mouawad, N; Alexander, T; Reid, M J; Lenzen, R; Hartung, M; Lacombe, F; Rouan, D; Gendron, E; Rousset, G; Lagrange, A-M; Brandner, W; Ageorges, N; Lidman, C; Moorwood, A F M; Spyromilio, J; Hubin, N; Menten, K M

    2002-10-17

    Many galaxies are thought to have supermassive black holes at their centres-more than a million times the mass of the Sun. Measurements of stellar velocities and the discovery of variable X-ray emission have provided strong evidence in favour of such a black hole at the centre of the Milky Way, but have hitherto been unable to rule out conclusively the presence of alternative concentrations of mass. Here we report ten years of high-resolution astrometric imaging that allows us to trace two-thirds of the orbit of the star currently closest to the compact radio source (and massive black-hole candidate) Sagittarius A*. The observations, which include both pericentre and apocentre passages, show that the star is on a bound, highly elliptical keplerian orbit around Sgr A*, with an orbital period of 15.2 years and a pericentre distance of only 17 light hours. The orbit with the best fit to the observations requires a central point mass of (3.7 +/- 1.5) x 10(6) solar masses (M(*)). The data no longer allow for a central mass composed of a dense cluster of dark stellar objects or a ball of massive, degenerate fermions.

  17. Promoting Equity in an Early Years Context: The Role of Participatory Educational Teams

    ERIC Educational Resources Information Center

    Formosinho, João; Figueiredo, Irene

    2014-01-01

    This article presents an alternative participatory pedagogy in Early Years as a contribution to the promotion of equity and social justice for children, particularly those from ethnic minorities and low income families, enhancing their chances of educational success. The development of mass education was implemented in many countries by…

  18. Gender and Schooling in the Early Years. Research on Women and Education

    ERIC Educational Resources Information Center

    Koch, Janice, Ed.; Irby, Beverly, Ed.

    2005-01-01

    In this volume, gender and schooling in the early years addresses a broad range of issues including, but not limited, to gender equity in education. We explore, for example, the complex world of play in Fromberg's chapter and are reminded that for young children, play involves issues of power and hierarchy in ways that parallel the role of gender…

  19. Role of Early Family Configuration and Hours Worked on Student Success in Two-Year Colleges

    ERIC Educational Resources Information Center

    Boswell, Robert A.; Passmore, David L.

    2013-01-01

    The purpose of this study was to examine factors that influence student success in two-year colleges, community colleges, or junior colleges. In determining the purpose of the study, a research framework is established to review the relationships between student success and biological children, marriage/co-habitation, early family configuration,…

  20. Men Managing, Not Teaching Foundation Phase: Teachers, Masculinity and the Early Years of Primary Schooling

    ERIC Educational Resources Information Center

    Moosa, Shaaista; Bhana, Deevia

    2017-01-01

    In this article we argue that eliminating the divisions of labour between men and women could work towards counteracting gender inequality within professions. Globally women are over-represented in the teaching of young children in the early years of primary school, or Foundation Phase (FP), as it is known in South Africa. We are concerned to go…

  1. Gifted and Talented in the Early Years: Practical Activities for Children Aged 3 to 5

    ERIC Educational Resources Information Center

    Sutherland, Margaret

    2005-01-01

    After a preface, the first chapter of this book sets out to explore the nature of intelligence. It considers the labels used to describe gifted and talented children and looks at how the adult's beliefs about intelligence will impact on what they do, say and look for in the early years setting. It challenges educators to think about the nature of…

  2. Minimal Brain Dysfunction in Childhood: 1. Outcome in Late Adolescence and Early Adult Years. Final Version.

    ERIC Educational Resources Information Center

    Milman, Doris H.

    Seventy-three patients, diagnosed in childhood as having either maturational lag or organic brain syndrome, were followed for an average of 12 years into late adolescence and early adult life for the purpose of discovering the outcome with respect to ultimate psychiatric status, educational attainment, social adjustment, and global adjustment. At…

  3. Improving Your Reflective Practice through Stories of Practitioner Research. Pen Green Books for Early Years Educators

    ERIC Educational Resources Information Center

    Arnold, Cath, Ed.

    2012-01-01

    "Improving Your Reflective Practice through Stories of Practitioner Research" shows how research has informed and created effective and valuable reflective practice in early years education, and offers depth to the arguments for a research-orientated stance to this vital field of study. This thought-provoking text explores and documents a variety…

  4. Superheroes v Demons: Constructing Identities of Male Student Teachers in the Early Years

    ERIC Educational Resources Information Center

    Jones, Deborah

    2008-01-01

    This article presents research undertaken among male teachers and it explores their perceptions and experiences of working in early years contexts. It examines prevalent, contrary discourses and their impact on the construction of male teachers' identities. Public discourses in relation to male teachers reveal contradictions and ambiguities…

  5. Early-Years Teachers' Professional Upgrading in Science: A Long-Term Programme

    ERIC Educational Resources Information Center

    Kallery, Maria

    2018-01-01

    In this paper, we present a professional development/upgrading programme in science for early-years teachers and investigate its impact on the teachers' competencies in relation to their knowledge and teaching of science. The basic idea of the programme was to motivate the teachers by making them members of an action research group aimed at…

  6. "Intensive Mothering" in the Early Years: The Cultivation and Consolidation of (Physical) Capital

    ERIC Educational Resources Information Center

    Stirrup, Julie; Duncombe, Rebecca; Sandford, Rachel

    2015-01-01

    Growing pressure on parents to equip their children with the skills required for future success, coupled with an increased focus on providing quality learning experiences in the early years, has contributed to an upsurge in the enrolment of young children in formal (often privatised) activities. Moreover, in response to growing societal concerns…

  7. Early-Years Teachers' Concept Images and Concept Definitions: Triangles, Circles, and Cylinders

    ERIC Educational Resources Information Center

    Tsamir, Pessia; Tirosh, Dina; Levenson, Esther; Barkai, Ruthi; Tabach, Michal

    2015-01-01

    This study investigates practicing early-years teachers' concept images and concept definitions for triangles, circles, and cylinders. Teachers were requested to define each figure and then to identify various examples and non-examples of the figure. Teachers' use of correct and precise mathematical language and reference to critical and…

  8. Co-Producing Early Years Policy in England under the Coalition Government

    ERIC Educational Resources Information Center

    Lloyd, Eva

    2014-01-01

    During the first half of the current Coalition Government, co-production--a form of participatory governance--was implemented widely in the conceptualization, design and implementation of early years policies. Seen as a revolutionary approach to public service reform, resulting in more effective and more cost-effective public services, the joint…

  9. Making and Being Made: Wise Humanising Creativity in Interdisciplinary Early Years Arts Education

    ERIC Educational Resources Information Center

    Chappell, Kerry Anne; Pender, Tamsin; Swinford, Elizabeth; Ford, Katherine

    2016-01-01

    This paper focuses on how wise humanising creativity (WHC) is manifested within early years interdisciplinary arts education. It draws on Arts Council-funded participatory research by Devon Carousel Project and University of Exeter's Graduate School of Education. It is grounded in previous AHRC-funded research, which conceptualised WHC in the face…

  10. Gender in the Early Years: Boys and Girls in an African Working Class Primary School

    ERIC Educational Resources Information Center

    Bhana, Deevia; Nzimakwe, Thokozani; Nzimakwe, Phumzile

    2011-01-01

    Understanding the ways in which young boys and girls give meaning to gender and sexuality is vital, and is especially significant in the light of South Africa's commitment to gender equality. Yet the, gendered cultures of young children in the early years of South African primary schools remains a, marginal concern in debate, research and…

  11. Watching, Creating and Achieving: Creative Technologies as a Conduit for Learning in the Early Years

    ERIC Educational Resources Information Center

    McDonald, Susan; Howell, Jennifer

    2012-01-01

    This paper describes the use of robotics in an Early Years classroom as a tool to aid the development of technological skills in a creative environment rich with literacy and numeracy opportunities. The pilot project illustrates how a three-phase process can result in the development of: (1) emergent literacy and numeracy, (2) digital access for…

  12. Extending the Research on the Tests of Early Numeracy: Longitudinal Analyses over Two School Years

    ERIC Educational Resources Information Center

    Baglici, Stephanie Petreshock; Codding, Robin; Tryon, Georgiana

    2010-01-01

    The purpose of this study was to extend the research on the "Tests of Early Numeracy" (TEN) by following a cohort of 61 students from kindergarten through first grade. Specifically, this study examined the relationship between kindergarten and first-grade TEN measures built within and across school years and their predictive validity of a math…

  13. Using Strengths-Based Approaches in Early Years Practice and Research

    ERIC Educational Resources Information Center

    Fenton, Angela; Walsh, Kerryann; Wong, Sandie; Cumming, Tamara

    2015-01-01

    Strengths-based approaches draw upon frameworks and perspectives from social work and psychology but have not necessarily been consistently defined or well articulated across disciplines. Internationally, there are increasing calls for professionals in early years settings to work in strengths-based ways to support the access and participation of…

  14. The Genetic and Environmental Origins of Learning Abilities and Disabilities in the Early School Years

    ERIC Educational Resources Information Center

    Kovas, Yulia; Haworth, Claire M. A.; Dale, Philip S.; Plomin, Robert

    2007-01-01

    Despite the importance of learning abilities and disabilities in education and child development, little is known about their genetic and environmental origins in the early school years. We report results for English (which includes reading, writing, and speaking), mathematics, and science as well as general cognitive ability in a large and…

  15. A Healthy Start: Promoting Mental Health and Well-Being in the Early Primary School Years

    ERIC Educational Resources Information Center

    Cefai, Carmel; Camilleri, Liberato

    2015-01-01

    Mental health problems in children represent a significant international health concern, with up to one in five children using mental health services during the course of any given year. Identifying the processes of what prevents social, emotional and behaviour difficulties (SEBD) and promotes healthy development from an early age can make a…

  16. Power and Identity in Immigrant Parents' Involvement in Early Years Mathematics Learning

    ERIC Educational Resources Information Center

    Takeuchi, Miwa Aoki

    2018-01-01

    This study examined immigrant parents' involvement in early years mathematics learning, focusing on learning of multiplication in in- and out-of-school settings. Ethnographic interviews and workshops were conducted in an urban city in Japan, to examine out-of-school practices of immigrant families. Drawing from sociocultural theory of learning and…

  17. Early Recovery of an Eastern Sierra Nevada Riparian System After 40 Years of Stream Diversion

    Julie C. Stromberg; Duncan T. Patten

    1989-01-01

    Rush Creek, which feeds Mono Lake, has been diverted below Grant Lake, totally or in part, for over 40 years. In the early 1980's, because of above normal snow packs, runoff was released into the creek. Minimum flow releases have also been established. The riparian vegetation has responded to these releases. In a few areas, riparian trees and shrubs (e.g., black...

  18. Early Years Teachers and the Influence of Piaget: Evidence from Oral History

    ERIC Educational Resources Information Center

    Cunningham, Peter

    2006-01-01

    In studying the historical development of early years provision, a clear factor in raising its profile was the growth in scientific study of children, especially the reception and interpretation of Piaget's research. For an understanding of how the mediation of new thinking and new discoveries influenced students and teachers, textbooks provide an…

  19. Pedagogical Documentation and Its Relation to Everyday Activities in Early Years

    ERIC Educational Resources Information Center

    Rintakorpi, Kati; Reunamo, Jyrki

    2017-01-01

    Documentation in early childhood education and care (ECEC) institutions has been developed for decades in various contexts. Today, documentation is preferred as an inclusive method of evaluating, planning, and developing ECEC in the curricula of many countries. Qualitative research on documentation has increased in past years, but quantitative…

  20. Gender and Power: Male and Female Teachers' Interactions in Early Years Contexts. Research Article

    ERIC Educational Resources Information Center

    Jones, Deborah

    2006-01-01

    This article presents research on female teachers exploring their perceptions and experiences of male teachers in the early years and it also examines the views of male teachers in relation to this environment. It considers the dominant UK public discourse calling for more men in primary teaching and it shows how this affects both male and female…

  1. An Ecological Perspective on Early Years Workforce Competences in Italian ECEC Settings

    ERIC Educational Resources Information Center

    Migliorini, Laura; Rania, Nadia; Tassara, Tatiana

    2016-01-01

    Based on an ecological perspective on competence, this study analyzed the attitudes, skills, and knowledge of practitioners in educational services for 0-6-years-old children in Italy, examining competence profiles in the Early Childhood Education and Care (ECEC) workforce. Our study considered three areas of competence, which previously have…

  2. Building a Stable Workforce: Recruitment and Retention in the Child Care and Early Years Sector

    ERIC Educational Resources Information Center

    Rolfe, Heather

    2005-01-01

    The paper presents findings from research aimed at identifying effective approaches to the recruitment and retention of child care workers, conducted to assist the UK Government's Childcare Strategy. The paper explores the practices and views of child care employers, Early Years Development and Childcare Partnerships (EYDCPs) and child care…

  3. Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

    2014-01-01

    This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants were…

  4. Early Years Teachers' Epistemic Beliefs and Beliefs about Children's Moral Learning

    ERIC Educational Resources Information Center

    Walker, S.; Brownlee, J.; Whiteford, C.; Cobb-Moore, C.; Johansson, E.; Ailwood, J.; Boulton-Lewis, G.

    2012-01-01

    There is strong political and social interest in values education both internationally and across Australia. Investment in young children is recognised as important for the development of moral values for a cohesive society; however, little is known about early years teachers' beliefs about moral values teaching and learning. The aim of the…

  5. Governance, Accountability and the Datafication of Early Years Education in England

    ERIC Educational Resources Information Center

    Roberts-Holmes, Guy; Bradbury, Alice

    2016-01-01

    In this paper we attempt to critically "make visible the flow and circulation of data" through analysing the datafication of the early years education sector in England (children aged 2-5). The concept of datafication is used to understand the processes and impacts of burgeoning data-based governance and accountability regimes. This…

  6. K-3 Policymakers' Guide to Action: Making the Early Years Count. Special Report

    ERIC Educational Resources Information Center

    Atchison, Bruce; Diffey, Louisa; Workman, Emily

    2016-01-01

    High-quality early elementary years offer a critical opportunity for child development and academic learning for all children, regardless of their race, family-income level, or culture and home language. All students deserve access to high-quality teachers and leaders trained in how to effectively support their learning. They deserve to attend…

  7. Early Transition and Adjustment and Children's Adjustment after Six Years of Schooling

    ERIC Educational Resources Information Center

    Margetts, Kay

    2009-01-01

    Researchers have made convincing arguments for the benefits of a smooth transition to school. The passage through this significant social change may have a lasting influence on children's progress. For example, social, emotional and academic difficulties in the early years of schooling have been shown to persist through school and into…

  8. Symbolic Representation in Early Years Learning: The Acquisition of Complex Notions

    ERIC Educational Resources Information Center

    Veraksa, Aleksander; Veraksa, Nikolay

    2016-01-01

    This article defines the concepts related to symbolic and sign representations, cognition and learning in the early years. The first study experiment of teaching 33 preschool children (19 boys and 14 girls; M = 68, 5 months) the notion of rainbow phenomenon proved the equal effectiveness of the use of both sign and symbolic tools. The second study…

  9. Children under Five and Digital Technologies: Implications for Early Years Pedagogy

    ERIC Educational Resources Information Center

    Palaiologou, Ioanna

    2016-01-01

    This project aimed to investigate the types of digital technologies children under the age of five are using at home and assess the possible implications for early years pedagogy. The research, carried out between 2010 and 2012, was based in four European countries: England, Greece, Malta and Luxemburg. A mixed methods approach was employed to…

  10. The Role of Computer Technology in Supporting Children's Learning in Jordanian Early Years Education

    ERIC Educational Resources Information Center

    Alkhawaldeh, Mustafa; Hyassat, Mizyed; Al-Zboon, Eman; Ahmad, Jamal

    2017-01-01

    The current research investigated early years teachers' perspectives regarding the role of computer technology in supporting children's learning in Jordanian kindergartens. Thirty semistructured interviews were conducted with preschool teachers. The sample of kindergartens in this study was purposefully selected from the targeted population of…

  11. The "Brave" Man in the Early Years (0-8): Defining the "Role Model"

    ERIC Educational Resources Information Center

    Brownhill, Simon

    2015-01-01

    The call for more "brave" male early years practitioners and primary classroom teachers remains prevalent as boys' underachievement continues to dominate education agendas. There is a recognised need, backed by government policy and public discourse in England, for more men to work in settings and schools (0-11) and act as "role…

  12. Giving Fathers a Voice: Towards Father Involvement in Early Years Settings

    ERIC Educational Resources Information Center

    Ihmeideh, Fathi Mahmoud

    2014-01-01

    It has been widely recognised that fathers can play a key role in the development and well-being of young children. In many cases, however, fathers still have limited involvement in the early years education of their children and their voices are as yet unheard. This study examined the beliefs and practices of Jordanian fathers of kindergarten…

  13. Two-Year Diagnostic Stability in Early-Onset First-Episode Psychosis

    ERIC Educational Resources Information Center

    Castro-Fornieles, Josefina; Baeza, Immaculada; de la Serna, Elena; Gonzalez-Pinto, Ana; Parellada, Mara; Graell, Montserrat; Moreno, Dolores; Otero, Soraya; Arango, Celso

    2011-01-01

    Background: Only one study has used a prospective method to analyze the diagnostic stability of first psychotic episodes in children and adolescents. The Child and Adolescent First-Episode Psychosis Study (CAFEPS) is a 2-year, prospective longitudinal study of early-onset first episodes of psychosis (EO-FEP). Aim: To describe diagnostic stability…

  14. Investigating Key Psychometric Properties of the French Version of the Early Years Evaluation-Teacher Assessment

    ERIC Educational Resources Information Center

    Laurie, Robert; Sloat, Elizabeth

    2016-01-01

    This research investigates key psychometric properties of the French Early Years Evaluation-Teacher Assessment measure designed to systematically assess kindergarten children across five social and academic developmental domains: awareness of self and environment, social skills and behaviour, cognitive abilities, language and communication, and…

  15. Geometry in Early Years: Sowing Seeds for a Mathematical Definition of Squares and Rectangles

    ERIC Educational Resources Information Center

    Bartolini Bussi, Maria G.; Baccaglini-Frank, Anna

    2015-01-01

    In early years schooling it is becoming common to propose activities that involve moving along paths, or programming robots to do so. In order to promote continuity towards the introduction of geometry in primary school, we developed a long-term teaching experiment (with 15 sessions) carried out over 4 months in a first grade classroom in northern…

  16. Learning How to Do Up Buttons: Professionalism, Teacher Identity and Bureaucratic Subjectivities in Early Years Settings

    ERIC Educational Resources Information Center

    Pupala, Branislav; Kascak, Ondrej; Tesar, Marek

    2016-01-01

    Early years education in Europe and elsewhere around the world is currently in the spotlight due to political and economical changes and subsequent promises of effective investment into its provision. In this article we analyse everyday preschool practices in Slovakia in terms of tensions between policies, the teachers workforce and the concept of…

  17. Kindergarten Program for Four-Year-OIds: An Early intervention Strategy.

    ERIC Educational Resources Information Center

    Klentschy, Michael P.; Hoge, Suzi

    The Pasadena Unified School District, in northwest Los Angeles County, recognized that an early intervention program for economically disadvantaged children should be part of its comprehensive district revitalizing and restructuring plan. Consequently, staff developed the Kindergarten Program for Four-Year-Olds, which was designed to provide: (1)…

  18. The Potential Impact of Undiagnosed Vision Impairment on Reading Development in the Early Years of School

    ERIC Educational Resources Information Center

    Thurston, Allen

    2014-01-01

    This article presents a critical review of the literature surrounding the potential impact of undiagnosed and untreated vision impairment on reading development in the early years of primary school. Despite pre-school screening programmes, it is still possible for children to enter school with undiagnosed, uncorrected vision impairments. This can…

  19. Responding to the Challenges of Active Citizenship through the Revised UK Early Years Foundation Stage Curriculum

    ERIC Educational Resources Information Center

    Baker, Fiona S.

    2013-01-01

    The revised UK Early Years Foundation Stage (EYFS) now places a stronger emphasis on personal, social and emotional development (PSED) as one of its three prime areas. PSED has three characteristics of learning: active learning, creating and thinking critically, and playing and exploring. These aspects of the revised EYFS closely align with the…

  20. How Silent Is the "Silent Period" for Young Bilinguals in Early Years Settings in England?

    ERIC Educational Resources Information Center

    Drury, Rose

    2013-01-01

    During the first decade of the twenty-first century there have been increasing numbers of bilingual children entering early years settings, many of whom are new to English. Twelve percent of school children in the UK are identified as having a mother tongue other than English and this number rises to 50% in urban areas such as inner London. In…

  1. Exploring the Continuing Professional Development Needs of Pedagogical Practitioners in Early Years in England

    ERIC Educational Resources Information Center

    Ingleby, Ewan; Hedges, Clive

    2012-01-01

    This article is based on quantitative and qualitative data that have been generated since 2009 on the study skills needs of early years practitioners working in England. The research has identified that developing information technology skills appears to be a particular professional development need for these practitioners. The practitioners are…

  2. The Educational Psychologist in the Early Years: Current Practice and Future Directions

    ERIC Educational Resources Information Center

    Shannon, Deborah; Posada, Susan

    2007-01-01

    Following suggestions for updated models of service within the early years educational psychologist (EP) role, the study aimed to provide exploratory research evidence of current models of service delivery and EP attitudes. Questionnaires were completed by 32 EPs. Interviews were conducted with three EPs. Quantitative data obtained were analysed…

  3. A National Study of Student Early Alert Models at Four-Year Institutions of Higher Education

    ERIC Educational Resources Information Center

    Simons, Jill M.

    2011-01-01

    The purpose of this study was to explore the state of student early alert models at nonprofit, four-year institutions of higher education through both quantitative and qualitative lenses. The use of these retention initiatives has become a much heralded practice on college campuses (Kuh, 2007a; Kuh 2007b; Seidman, 2005; Tinto, 2008). However,…

  4. Factors influencing career progress for early stage clinician-scientists in emerging Asian academic medical centres: a qualitative study in Singapore

    PubMed Central

    Yoon, Sungwon; Koh, Woon-Puay; Ong, Marcus E H; Thumboo, Julian

    2018-01-01

    Objectives To explore the factors that influence career progress for early stage clinician-scientists and to identify ways to mitigate these factors in the context of emerging Asian academic medical centres (AMCs). Design Qualitative interviews and thematic data analysis based on grounded theory. Setting and participants Five focus group interviews comprising 29 early career clinician-scientists who have received their first national-level career development award in Singapore. Results Clinical priorities represented an overarching concern with many reporting the difficulty in delineating responsibilities between clinical care and research. Additionally, there was a prevailing perception of the lack of support for research at the institutional level. Participants tended to identify mentors through their own efforts in a relatively haphazard manner, often owing to the dearth of role models and perceived inadequacy of reward systems for mentoring. Support from mentors was thought to be limited in terms of targeted scientific guidance and long-term commitments to the relationship. Most of the participants expressed concerns about how they could secure the next level of funding with diminishing confidence. Notably, the work-life balance was neither conceptualised as a ‘barrier’ to successful pursuit of research career nor was it translated into the reason for leaving the dual clinical-research career pathway. Conclusions Results revealed specific limitations presented by the research environment in newly emerging Asian AMCs. To retain a vibrant clinician-scientist workforce, additional measures are needed, aiming to improve institutional culture of research, build mentoring networks, adopt effective tools for tracking career progress and provide a clear and viable career progression path for clinician-scientist. Further research might explore the cross-cultural differences in managing work-life balance in academic medicine. PMID:29502093

  5. Factors influencing career progress for early stage clinician-scientists in emerging Asian academic medical centres: a qualitative study in Singapore.

    PubMed

    Yoon, Sungwon; Koh, Woon-Puay; Ong, Marcus E H; Thumboo, Julian

    2018-03-03

    To explore the factors that influence career progress for early stage clinician-scientists and to identify ways to mitigate these factors in the context of emerging Asian academic medical centres (AMCs). Qualitative interviews and thematic data analysis based on grounded theory. Five focus group interviews comprising 29 early career clinician-scientists who have received their first national-level career development award in Singapore. Clinical priorities represented an overarching concern with many reporting the difficulty in delineating responsibilities between clinical care and research. Additionally, there was a prevailing perception of the lack of support for research at the institutional level. Participants tended to identify mentors through their own efforts in a relatively haphazard manner, often owing to the dearth of role models and perceived inadequacy of reward systems for mentoring. Support from mentors was thought to be limited in terms of targeted scientific guidance and long-term commitments to the relationship. Most of the participants expressed concerns about how they could secure the next level of funding with diminishing confidence. Notably, the work-life balance was neither conceptualised as a 'barrier' to successful pursuit of research career nor was it translated into the reason for leaving the dual clinical-research career pathway. Results revealed specific limitations presented by the research environment in newly emerging Asian AMCs. To retain a vibrant clinician-scientist workforce, additional measures are needed, aiming to improve institutional culture of research, build mentoring networks, adopt effective tools for tracking career progress and provide a clear and viable career progression path for clinician-scientist. Further research might explore the cross-cultural differences in managing work-life balance in academic medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All

  6. Physical self-esteem--a ten-year follow-up study from early adolescence to early adulthood.

    PubMed

    Raustorp, Anders; Lindwall, Magnus

    2015-02-01

    One variable that has been consistently associated with adolescents' physical activity is perceived activity competence. Perceived physical (or sport) competence is considered a sub-domain to the physical self-esteem or self-worth (i.e., a person's valuation of what is good and worthy in their self-description). This study aimed to describe levels of and inter-correlations among physical self-esteem, physical activity, and body mass index in a longitudinal design spanning adolescence to early adulthood. At mean ages of 12.7, 15.7, 17.7 and 22.7 years, we measured perceived physical self-esteem in 39 (22 boys) Swedish adolescents. Physical activity (steps/day) for four consecutive schooldays, height, and weight were also measured. No significant difference between the four time points for any variable of perceived physical self-esteem was seen, neither in boys nor girls. In general, all physical self-variables revealed non-linear trajectories across time, where the general trend was an increase during the younger ages followed by a decrease during older ages. At ages 12 and 15 years in boys and girls physical condition and physical strength as well as body attractiveness and physical strength, respectively, had the strongest correlations to physical self-esteem. At age 17 and 22 years sports competence had the strongest correlation to self-esteem in girls, while body attractiveness and physical strength had the strongest correlation to self-esteem in boys. An overall stability in physical self-esteem was found. However the impact of a sub-domain upon physical self-esteem vary during adolescence and early adulthood. Such information may be useful when creating physical activity programs that support and develop physical self-esteem.

  7. Development of early communication skills in the first two years of life.

    PubMed

    Beuker, Karin T; Rommelse, Nanda N J; Donders, Rogier; Buitelaar, Jan K

    2013-02-01

    The first two years of life is a crucially important period for the development of communication skills. In this study joint attention and language development were monthly assessed between 8 and 24 months of age in a sample of 23 typically developing children to establish the developmental trajectory of specific joint attention skills, to investigate the developmental interrelations of these different joint attention skills with vocabulary size, and to examine whether the order of development of following and directing attention influences the development of other early communication skills such as language. All joint attention skills emerged between 8 and 15 months of age and responsive joint attention skills tend to emerge before initiative joint attention. Early joint attention skills influenced later language development, but not the other way around. Children in whom directing attention with gaze alternation developed early (in age or order) showed a relatively larger early vocabulary growth. A fine grained mapping of the normal development of early communication skills can be helpful in the early detection of abnormalities in these skills. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Depression and anxiety in women with early breast cancer: five year observational cohort study

    PubMed Central

    Burgess, Caroline; Cornelius, Victoria; Love, Sharon; Graham, Jill; Richards, Michael; Ramirez, Amanda

    2005-01-01

    Objective To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Design Observational cohort study. Setting NHS breast clinic, London. Participants 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Main outcome measures Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Results Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Conclusion Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support. PMID:15695497

  9. Active Early: one-year policy intervention to increase physical activity among early care and education programs in Wisconsin.

    PubMed

    LaRowe, Tara L; Tomayko, Emily J; Meinen, Amy M; Hoiting, Jill; Saxler, Courtney; Cullen, Bridget

    2016-07-20

    Early childcare and education (ECE) is a prime setting for obesity prevention and the establishment of healthy behaviors. The objective of this quasi-experimental study was to examine the efficacy of the Active Early guide, which includes evidenced-based approaches, provider resources, and training, to improve physical activity opportunities through structured (i.e. teacher-led) activity and environmental changes thereby increasing physical activity among children, ages 2-5 years, in the ECE setting. Twenty ECE programs in Wisconsin, 7 family and 13 group, were included. An 80-page guide, Active Early, was developed by experts and statewide partners in the fields of ECE, public health, and physical activity and was revised by ECE providers prior to implementation. Over 12 months, ECE programs received on-site training and technical assistance to implement the strategies and resources provided in the Active Early guide. Main outcome measures included observed minutes of teacher-led physical activity, physical activity environment measured by the Environment and Policy Assessment and Observation (EPAO) instrument, and child physical activity levels via accelerometry. All measures were collected at baseline, 6 months, and 12 months and were analyzed for changes over time. Observed teacher-led physical activity significantly increased from 30.9 ± 22.7 min at baseline to 82.3 ± 41.3 min at 12 months. The change in percent time children spent in sedentary activity decreased significantly after 12 months (-4.4 ± 14.2 % time, -29.2 ± 2.6 min, p < 0.02). Additionally, as teacher led-activity increased, percent time children were sedentary decreased (r = -0.37, p < 0.05) and percent time spent in light physical activity increased (r = 0.35, p < 0.05). Among all ECE programs, the physical activity environment improved significantly as indicated by multiple sub-scales of the EPAO; scores showing the greatest increases were the

  10. Early life factors and dental caries in 5-year-old children in China.

    PubMed

    Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer E; Zheng, Shuguo

    2017-09-01

    This study aimed to explore the association between early life factors and dental caries among 5-year-old Chinese children. Data from 9722 preschool children who participated in the third National Oral Health Survey of China were analysed. Information on early life (birth weight, breastfeeding and age when toothbrushing started), child (sex, ethnicity, birth order and dental behaviours) and family factors (parental education, household income, place of residence, number of children in the family, respondent's age and relation to the child) were obtained from parental questionnaires. Children were also clinically examined to assess dental caries experience using the decayed, missing and filled teeth (dmft) index. The association of early life factors with dmft was evaluated in negative binomial regression models. We found that birth weight was not associated with dental caries experience; children who were exclusively and predominantly formula-fed had lower dmft values than those exclusively breastfed; and children who started brushing later in life had higher dmft values than those who were brushing within the first year. Only one in seven of all children received regular toothbrushing twice per day, and only 34.7% had commenced toothbrushing by the age of 3 years. This study shows certain early life factors play a role in dental caries among Chinese preschool children and provides important insights to shape public health initiatives on the importance of introducing early toothbrushing. The early environment, especially the age when parents introduce toothbrushing to their children, can be an important factor to prevent childhood dental caries. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Early, structured disease modifying anti-rheumatic drug (DMARD) therapy reduces cardiovascular risk in rheumatoid arthritis--a single centre study using non-biologic drugs.

    PubMed

    Chatterjee, Sumit; Sarkate, Pankaj; Ghosh, Sudip; Biswas, Monodeep; Ghosh, Alakendu

    2013-08-01

    Rheumatoid arthritis, being a chronic disease requires long-term management of patients with drugs. The increasing cost of biologics in this era of disease management led us to devise a treatment regime, optimal for use in a developing country like India, which was economical as well as effective in controlling disease activity. To investigate if combination therapy with DMARDs can reduce cardiovascular risk in early Rheumatoid Arthritis, besides controlling disease activity. A small cohort of early Rheumatoid subjects with disease duration less than 1 year were treated with a structured DMARD regime and were followed up over a year. Disease activity score, C-reactive protein (CRP) and cardiac risk markers like lipid panel and carotid intima-medial thickness were monitored at 6 months and 1 year. A significant reduction (p < 0.001) of disease activity as well as cardiac risk parameters were observed. Our study showed that treatment of early rheumatoid arthritis with a combination regime of traditional DMARDs is highly effective in controlling disease activity as well as cardiovascular risk.

  12. Symptoms to pollen and fruits early in life and allergic disease at 4 years of age.

    PubMed

    Mai, X-M; Neuman, A; Ostblom, E; Pershagen, G; Nordvall, L; Almqvist, C; van Hage, M; Wickman, M

    2008-11-01

    The predictive value of reported early symptoms to pollen or fruits on later allergic disease is unclear. Our aim is to evaluate if symptoms to pollen and/or to fruits early in life are associated with allergic disease and sensitization to pollen at 4 years. The study included 3619 children from the Barn (Children), Allergy, Milieu, Stockholm, Epidemiology project (BAMSE) birth cohort. Reported symptoms of wheeze, sneeze or rash to birch, grass or weed, symptoms (vomiting, diarrhea, rash, facial edema, sneeze, or wheeze) to fruits including tree-nuts at 1 or 2 years of age, and definitions of asthma, rhinitis and eczema at 4 years were derived from questionnaire data. Sensitization to pollen allergens was defined as allergen-specific IgE-antibodies to any pollen (birch/timothy/mugwort) > or =0.35 kU(A)/l. At 1 or 2 years of age, 6% of the children were reported to have pollen-related symptoms, 6% had symptoms to fruits, and 1.4% to both pollen and fruits. Children with symptoms to both pollen and fruits at 1 or 2 years of age had an increased risk for sensitization to any pollen allergen at age 4 (OR(adj) = 4.4, 95% CI = 2.1-9.2). This group of children also had a substantially elevated risk for developing any allergic disease (asthma, rhinitis, or eczema) at 4 years irrespective of sensitization to pollen (OR(adj) = 8.6, 95% CI = 4.5-16.4). The prevalence of reported symptoms to pollen and fruits is very low in early childhood. However, children with early symptoms to both pollen and fruits appear to have a markedly elevated risk for allergic disease.

  13. Dispersing Waves: Innovation in Early Childhood Education

    ERIC Educational Resources Information Center

    Meade, Anne, Ed.

    2010-01-01

    Early childhood education Centres of Innovation (COI) were established in 2002 as part of the 10-year plan for early childhood education, "Pathways to the Future/Nga Huarahi Arataki." In COI projects, innovative early childhood teaching teams reflect on and investigate their practices through action research, and share their findings…

  14. Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe.

    PubMed

    Patel, Diana; Matyanga, Priscilla; Nyamundaya, Tichaona; Chimedza, Delia; Webb, Karen; Engelsmann, Barbara

    2012-07-11

    Early diagnosis of children living with HIV is a prerequisite for accessing timely paediatric HIV care and treatment services and for optimizing treatment outcomes. Testing of HIV-exposed infants at 6 weeks and later is part of the national prevention of mother to child transmission (PMTCT) of HIV programme in Zimbabwe, but many opportunities to test infants and children are being missed. Early childhood development (ECD) playcentres can act as an entry point providing multiple health and social services for orphans and vulnerable children (OVC) under 5 years, including facilitating access to HIV treatment and care. Sixteen rural community-based, community-run ECD playcentres were established to provide health, nutritional and psychosocial support for OVC aged 5 years and younger exposed to or living with HIV, coupled with family support groups (FSGs) for their families/caregivers. These centres were located in close proximity to health centres giving access to nurse-led monitoring of 697 OVC and their caregivers. Community mobilisers identified OVC within the community, supported their registration process and followed up defaulters. Records profiling each child's attendance, development and health status (including illness episodes), vaccinations and HIV status were compiled at the playcentres and regularly reviewed, updated and acted upon by nurse supervisors. Through FSGs, community cadres and a range of officers from local services established linkages and built the capacity of parents/caregivers and communities to provide protection, aid psychosocial development and facilitate referral for treatment and support. Available data as of September 2011 for 16 rural centres indicate that 58.8% (n=410) of the 697 children attending the centres were tested for HIV; 18% (n=74) tested positive and were initiated on antibiotic prophylaxis. All those deemed eligible for antiretroviral therapy were commenced on treatment and adherence was monitored. This community

  15. Year 12 Students' Mathematical Performance on the 1980 and 1981 External Examinations. Mathematics Education Centre Report No. 25.

    ERIC Educational Resources Information Center

    Clarkson, P. C.

    Descriptions of Papua New Guinea's national high schools, grade 12 major/minor mathematics courses, and an analysis of the 1980 and 1981 major/minor course examination results are presented. The analysis is intended for use by post year 12 lecturers/instructors planning their courses. Findings indicate that topic scores were far too low for these…

  16. Pesticide poisoning trend analysis of 13 years: a retrospective study based on telephone calls at the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

    PubMed

    Peshin, Sharda Shah; Srivastava, Amita; Halder, Nabanita; Gupta, Yogendra Kumar

    2014-02-01

    The study was designed to analyze the incidence and pattern of pesticide poisoning calls reported to the National Poisons Information Centre (NPIC), AIIMS, New Delhi and highlight the common classes of pesticides involved in poisoning. The telephone calls received by the Centre during the thirteen year period (1999-2012) were entered into a preset proforma and then into a retrievable database. A total of 4929 calls of pesticide poisoning were recorded. The data was analyzed with respect to age, gender, mode and type of poisoning. The age ranged from 1 to 65 years with the preponderance of males (M = 62.19%, F = 37.80%). The age group mainly involved in poisoning was 18-35 years. While 59.38% calls pertained to household pesticides, 40.61% calls related to agricultural pesticides. The common mode of poisoning was intentional (64.60%) followed by accidental (34.40%) and unknown (1%). Amongst the household pesticides, the highest number of calls were due to pyrethroids (26.23%) followed by rodenticides (17.06%), organophosphates (6.26%), carbamates (4.95%) and others (4.86%). In agricultural pesticides group, the organophosphates (9.79%) ranked the first followed by, aluminium phosphide (9.65%), organochlorines (9.31%), pyrethroids (3.87%), herbicides, weedicides and fungicides (3.20%), ethylene dibromide (2.82%), and others (1.70%). The data analysis shows a high incidence of poisoning due to household pesticides as compared to agricultural pesticides, clearly emphasizing the need for creating awareness and education about proper use and implementation of prevention programmes. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  17. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.

    PubMed

    Lalani, Tahaniyat; Chu, Vivian H; Park, Lawrence P; Cecchi, Enrico; Corey, G Ralph; Durante-Mangoni, Emanuele; Fowler, Vance G; Gordon, David; Grossi, Paolo; Hannan, Margaret; Hoen, Bruno; Muñoz, Patricia; Rizk, Hussien; Kanj, Souha S; Selton-Suty, Christine; Sexton, Daniel J; Spelman, Denis; Ravasio, Veronica; Tripodi, Marie Françoise; Wang, Andrew

    2013-09-09

    There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias. Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum. Valve replacement during index hospitalization (early surgery) vs medical therapy. In-hospital and 1-year mortality. Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21

  18. Early years neurosurgical training in the era of the European Working Time Directive.

    PubMed

    Kirkman, Matthew A; Watkins, Laurence D; Kitchen, Neil D; Sethi, Huma

    2013-10-01

    The past decade has seen significant changes to the face of neurosurgical training in the United Kingdom, driven in part by an increasing focus on patient safety and the introduction of Modernising Medical Careers and the European Working Time Directive (EWTD). Recent reforms to neurosurgical training over the past few years have resulted in creation of an 8-year 'run-through' training programme. In this programme, early years (ST1 and ST2) trainees often lack dedicated time for elective theatre lists and outpatient clinics. Further, any time spent in theatre and clinics is often with different teams. Here we describe a training model for early years trainees at the National Hospital for Neurology and Neurosurgery, who are given the responsibilities traditionally associated with a more senior trainee including dedicated weekly theatre and clinic time under the supervision of a single consultant, in addition to out of hours experience. The advantages and considerations for implementing this model are discussed, including the benefit of guidance under a single consultant in the early stages of training, along with key educational concepts necessary for understanding its utility. We feel that this is an effective model for junior neurosurgical training in the EWTD era, expediting the trainee's development of key technical and non-technical skills, with potentially significant rewards for patient, trainee and trainer. National implementation of this model should be considered.

  19. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India.

    PubMed

    Jeevarajan, Sakthiushadevi; Duraipandian, Amudhan; Kottayasamy Seenivasagam, Rajkumar; Shanmugam, Subbiah; Ramamurthy, Rajaraman

    2017-01-01

    Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

  20. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India

    PubMed Central

    Duraipandian, Amudhan; Shanmugam, Subbiah; Ramamurthy, Rajaraman

    2017-01-01

    Background Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Materials and Methods Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. Results The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. Conclusion The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence. PMID:29387486

  1. Outcome of lupus nephritis in childhood onset SLE in North and Central India: single-centre experience over 25 years.

    PubMed

    Srivastava, P; Abujam, B; Misra, R; Lawrence, A; Agarwal, V; Aggarwal, A

    2016-04-01

    Childhood SLE (cSLE) has a higher prevalence of lupus nephritis (LN), and there are ethnic variations in response to treatment as well as outcome of LN. There are limited data on long-term outcome of LN in cSLE from the Indian subcontinent. Retrospective analysis of case records of patients with cSLE (satisfying revised American College of Rheumatology (ACR) 1997 criteria for diagnosis) and age of onset <18 years was conducted from 1989 to 2013. Data on clinical features, renal involvement and biopsy findings, treatment, renal outcome, damage accrual and mortality were collected. End-stage renal disease (ESRD) was defined as the need for renal replacement therapy. Actuarial ESRD-free survival was studied as the primary outcome measure using Kaplan-Meier analysis. Among 205 children with cSLE, 134 (121 girls) had evidence of LN. The mean age at disease onset was 13.7 ± 3.5 years and the mean disease duration at presentation was 1.9 ± 2.5 years. Kidney biopsy was available for 92 patients, and histology included: 13 (14.2%) Class II, 24 (26%) Class III, 43 (46.7%) Class IV and 12 (13.1%) Class V LN. The mean follow-up period was 6.75 ± 5.7 years. At last visit, 81 (60.4%) children were in complete remission, 28 (20.9%) were in partial remission, 15 (11.2%) still had active nephritis and 10 (7.4%) had progressed to ESRD. Almost two-thirds (62.9%) of patients experienced lupus flares, and mean flare rate was 0.09 flares/patient follow-up year. Fifty-six (43.8%) children accrued damage and the mean Systemic Lupus International Collaborating Clinics (SLICC)/ACR damage score was 0.79 ± 1.13. Actuarial ESRD-free survival at five, 10 and 15 years was 91.1%, 79% and 76.2%, and five-, 10- and 15-year renal survival was 93.8%, 87.1% and 84%, respectively. Although multiple factors individually predicted poor outcome (death/ESRD), only raised serum creatinine at onset (R square = 0.65, p ≤ 0.0001) and damage accrual (R square = 0.62, p

  2. An early and enduring advanced technology originating 71,000 years ago in South Africa.

    PubMed

    Brown, Kyle S; Marean, Curtis W; Jacobs, Zenobia; Schoville, Benjamin J; Oestmo, Simen; Fisher, Erich C; Bernatchez, Jocelyn; Karkanas, Panagiotis; Matthews, Thalassa

    2012-11-22

    There is consensus that the modern human lineage appeared in Africa before 100,000 years ago. But there is debate as to when cultural and cognitive characteristics typical of modern humans first appeared, and the role that these had in the expansion of modern humans out of Africa. Scientists rely on symbolically specific proxies, such as artistic expression, to document the origins of complex cognition. Advanced technologies with elaborate chains of production are also proxies, as these often demand high-fidelity transmission and thus language. Some argue that advanced technologies in Africa appear and disappear and thus do not indicate complex cognition exclusive to early modern humans in Africa. The origins of composite tools and advanced projectile weapons figure prominently in modern human evolution research, and the latter have been argued to have been in the exclusive possession of modern humans. Here we describe a previously unrecognized advanced stone tool technology from Pinnacle Point Site 5-6 on the south coast of South Africa, originating approximately 71,000 years ago. This technology is dominated by the production of small bladelets (microliths) primarily from heat-treated stone. There is agreement that microlithic technology was used to create composite tool components as part of advanced projectile weapons. Microliths were common worldwide by the mid-Holocene epoch, but have a patchy pattern of first appearance that is rarely earlier than 40,000 years ago, and were thought to appear briefly between 65,000 and 60,000 years ago in South Africa and then disappear. Our research extends this record to ~71,000 years, shows that microlithic technology originated early in South Africa, evolved over a vast time span (~11,000 years), and was typically coupled to complex heat treatment that persisted for nearly 100,000 years. Advanced technologies in Africa were early and enduring; a small sample of excavated sites in Africa is the best explanation for any

  3. Socio-economic patterning in early mortality of patients aged 0-49 years diagnosed with primary bone cancer in Great Britain, 1985-2008.

    PubMed

    Blakey, Karen; Feltbower, Richard G; James, Peter W; Libby, Gillian; Stiller, Charles; Norman, Paul; Gerrand, Craig; McNally, Richard J Q

    2018-04-01

    Studies have shown marked improvements in survival between 1981 and 2000 for Ewing sarcoma patients but not for osteosarcoma. This study aimed to explore socio-economic patterning in early mortality rates for both tumours. The study analysed all 2432 osteosarcoma and 1619 Ewing sarcoma cases, aged 0-49 years, diagnosed in Great Britain 1985-2008 and followed to 31/12/2009. Logistic regression models were used to calculate risk of dying within three months, six months, one year, three years and five years after diagnosis. Associations with Townsend deprivation score and its components were examined at small-area level. Urban/rural status was studied at larger regional level. For osteosarcoma, after age adjustment, mortality at three months, six months and one year was associated with higher area unemployment, OR = 1.05 (95% CI 1.00, 1.10), OR = 1.04 (95% CI 1.01, 1.08) and OR = 1.04 (95% CI 1.02, 1.06) respectively per 1% increase in unemployment. Mortality at six months was associated with greater household non-car ownership, OR = 1.02 (95% CI 1.00, 1.03). For Ewing sarcoma, there were no significant associations between mortality and overall Townsend score, nor its components for any time period. For both tumours increasing mortality was associated with less urban and more remote rural areas. This study found that for osteosarcoma, early mortality was associated with residence at diagnosis in areas of higher unemployment, suggesting risk of early death may be socio-economically determined. For both tumours, distance from urban centres may lead to greater risk of early death. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. [Analysis of population characteristics of infants affected by necrotizing enterocolitis in a tertiary centre in the last 12 years].

    PubMed

    García-González, Miriam; Pita-Fernández, Salvador; Caramés-Bouzán, Jesús

    Necrotizing enterocolitis is the most lethal gastrointestinal emergency in the neonatal period. Incidence and mortality have remained stable in recent years despite advances in neonatal intensive care. The aim of this study is to show the general characteristics of patients diagnosed with necrotizing enterocolitis at Teresa Herrera's Hospital (La Coruna, Spain) in the last 12years. This study makes a retrospective and prospective descriptive analysis, evaluating the medical records and collecting radiological demographic variables, gestational data, perinatal history, clinical, analytical and perinatal therapeutic management and events in patients diagnosed with and treated for necrotizing enterocolitis between 2003 and 2015. A total of 124 patients met the criteria for inclusion in the study. The mean gestational age of our patients was 33 weeks and remained stable compared with other studies. The average weight of our patients was 1,873g. In our series of cases there was a progressive and significant increase in maternal age and the rate of artificial pregnancies and multiple births. In our series 38.7% of our patients required surgical treatment and the fatality rate was 11.4%. Despite advances in pre- and perinatal care necrotizing enterocolitis represents the leading cause of premature mortality. Incidence has remained unchanged in recent decades. More studies are required to identify both, risk and protective factors to reduce the morbidity and mortality of this entity. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  5. Mortality in bullous pemphigoid and prognostic factors in 1st and 3rd year of follow-up in specialized centre in Poland.

    PubMed

    Kalinska-Bienias, Agnieszka; Lukowska-Smorawska, Katarzyna; Jagielski, Pawel; Kowalewski, Cezary; Wozniak, Katarzyna

    2017-11-01

    Bullous pemphigoid (BP) is associated with higher mortality and coexisting comorbidities, some of them affecting poor prognosis. The aim of the study was to identify prognostic factors causing greater mortality both in the 1st and 3rd year of follow-up and to determine the 1-, 2-, 3-year mortality rates, standardized mortality ratio (SMR) in Polish BP patients. All patients with BP (a cohort of 205 patients, mean age 76.2 years) diagnosed between 5 January 2000 and 10 December 2013 in a referral unit for autoimmune bullous diseases at the university hospital in Poland were included retrospectively. Mortality data were obtained from the Centre for Document Personalization at the Minister of Interior and Administration. Our original observation was that prednisone in moderate dose (0.5 mg kg -1 ) in monotherapy was an independent risk factor of fatal prognosis in the 1st year of follow-up, assessed using multivariate analysis. We confirmed the strong correlation between neurological diseases and greater mortality. Both in the 1st and 3rd year of follow-up, dementia and Parkinson disease resulted in increased mortality. We also found that arrhythmias significantly increased mortality in the 1st and 3rd year of follow-up. The prognostic factors in BP changed over time of follow-up. In the 3rd year of observation, the age above 77, longer hospitalization and BP severity were associated with greater mortality. We observed poorer prognosis in BP patients than age-matched general Polish population. The 1-, 2-, 3-year mortality rates were 22.4, 31.2, 39.5% and SMR was 3.8 (95% CI 3.4-3.7).

  6. Short- and long-term outcomes following pelvic exenteration for gynae-oncological and colorectal cancers: A 9 year consecutive single-centre cohort study.

    PubMed

    Katory, Mark; McLean, Ross; Paez, Edgar; Kucukmetin, Ali; Naik, Raj

    2017-07-01

    Radical pelvic exenteration can be undertaken for locally invasive or recurrent disease in both colorectal and gynaecological malignancies. In the UK this procedure is usually undertaken by the respective surgical specialties who have undergone divergent surgical training. This study describes and compares outcomes between colorectal and gynae-oncological teams following pelvic exenteration for primary and recurrent gynaecological and colorectal cancers in a single-centre multi-disciplinary team. A retrospective review of consecutive pelvic exenteration patients undertaken over a nine-year period in a tertiary referral centre. Analyses comparing short- and long-term morbidity and mortality outcomes were undertaken by chi-square test for categorical variables and Mann-Whitney U for continuous variables. Cumulative survival rates were calculated according to the Kaplan-Meier method and factors associated with recurrence and survival determined using a Cox regression model. Thirty-four exenterations were undertaken; fourteen colorectal and twenty gynae-oncological. Morbidity was seen in 50% of colorectal and 75% of gynae-oncological patients. Recurrence was seen earlier and with greater frequency in the gynaeoncology group (44.4% and median time 11 months) than the colorectal group (21.4%, median time 41 months; p > 0.05). Survival in the gynae-oncology group was also lower than the colorectal group at 1-year (69.6% vs. 92.9%) and 5-years (58.0% vs. 92.9%; p = 0.115). The majority of gynae-oncological mortality occurred within 3-years of surgery, whilst the majority of mortality in the colorectal group was after 5-years. Long-term patient outcome measures, including disease recurrence and 5-year survival, for colorectal exenteration appear better than for gynaeoncology patients, however, no statistical significant difference exists between short-term outcome measures between specialties. This is likely to be caused by different baseline pathologies and disease

  7. Changes in the management of liver trauma leading to reduced mortality: 15-year experience in a major trauma centre.

    PubMed

    Suen, Kary; Skandarajah, Anita R; Knowles, Brett; Judson, Rodney; Thomson, Benjamin N

    2016-11-01

    Worldwide, the evolution of management of liver injury has resulted in improved outcomes. The aim of this study was to examine the trend in the management and outcomes of patients with liver injury. Primary outcomes were defined as mortality and hospital length of stay. The secondary aim was to identify independent predictors of mortality. This study utilized hospital trauma registry data of all trauma patients with liver injuries admitted from 1999 to 2013. Patients in this 15-year period were divided into three periods of 5 years each and compared in terms of demographics, management and outcomes. A total of 725 patients with hepatic trauma were included. Patient demographics were similar, except for an increase in patient transfers from rural locations. Non-operative management increased significantly. There was a significant increase in the use of damage control surgery with perihepatic packing in high-grade liver injuries managed operatively. Hepatic angioembolization commenced midway through the study period. The overall mortality decreased by approximately threefold (P < 0.001) and mortality within 24 h of arrival to hospital by approximately fivefold (P < 0.001). Controlling for independent predictive factors of mortality, the mortality within 24 h reduced from 18.8% in period 1 to 3.6% in period 3 (P = 0.001). At this institution, an integrated trauma service has led to an evolution in the management of hepatic trauma, favouring non-operative management, damage control surgery and the use of hepatic angioembolization. We experienced a significantly improved mortality within 24 h of arrival to hospital in patients with liver trauma. © 2015 Royal Australasian College of Surgeons.

  8. From red star rising to rocket's red glare: space travel, the early years

    NASA Astrophysics Data System (ADS)

    Chapman, Steven

    2007-07-01

    'We choose to go to the Moon in this decade and do the other things, not because they are easy, but because they are hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win, and the others, too.' President John Fitzgerald Kennedy, 12 September 1962. It is now 50 years since the first artificial satellite was launched. This article looks at the early years of space travel and some of the key moments during that time.

  9. Total aortic arch replacement with the frozen elephant trunk technique: 10-year follow-up single-centre experience.

    PubMed

    Ius, Fabio; Fleissner, Felix; Pichlmaier, Maximilian; Karck, Matthias; Martens, Andreas; Haverich, Axel; Shrestha, Malakh

    2013-11-01

    Since August 2001, the frozen elephant trunk (FET) technique has been used at our institution to treat degenerative or dissecting aneurysms involving the aortic arch and descending aorta as a potential 'single-stage' procedure. The aim of this study was to review our FET experience and to present the 10-year results. Between August 2001 and January 2012, 131 patients underwent FET implant with three different prostheses: the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 30) and the Vascutek Thoraflex (n = 35) prostheses. Concomitant procedures included aortic valve-sparing operations (David, n = 17) and aortic root replacement (Bentall, n = 25). Patient records and the first postoperative and last available computer tomography (CT) were retrospectively reviewed. Incidence of rethoracotomy for bleeding, stroke, spinal cord injury, prolonged ventilatory support (>96 h) and acute renal failure requiring dialysis were 18, 11, 1, 41 and 16%, respectively. In-hospital mortality was 15%. The mean follow-up was 42 ± 37 (range 1-134 months). At 1, 5 and 10 years, survivals were 82 ± 3, 72 ± 5 and 58 ± 8%, respectively. Freedoms from distal aortic operation were 81 ± 4, 67 ± 5 and 43 ± 13%, respectively. Thirty-six patients underwent 40 distal aortic operations, either open surgical (n = 22, 55%) or endovascular (n = 18, 45%). Chronic aortic dissection was identified as an independent risk factor for distal aortic operation (odds ratio = 3.8; 95% confidence interval 1.5-9.3; P = 0.004). At last CT control, false-lumen thrombosis rates up to 93% were achieved around the stent graft. An FET concept adds to the armament of the surgeon in the treatment of complex and diverse aortic arch pathologies. The preoperative patient risk profile explains the postoperative morbidity and in-hospital mortality. The FET can potentially be still a 'one-stage' procedure in selected patients. However, the extension of FET to patients with extensive aortic aneurysms has led

  10. Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience.

    PubMed

    Tang, I P; Lee, S C; Shashinder, S; Raman, R

    2009-06-01

    This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.

  11. UK Renal Registry 17th Annual Report: Chapter 10 2013 Multisite Dialysis Access Audit in England, Northern Ireland and Wales and 2012 PD One Year Follow-up: National and Centre-specific Analyses.

    PubMed

    Rao, Anirudh; Pitcher, David; Fluck, Richard; Kumwenda, Mick

    2015-01-01

    Dialysis access should be timely, minimize complications and maintain functionality. The aim of the second combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on incident vascular and peritoneal dialysis access outcome measures in patients from England, Wales and Northern Ireland (EW&NI), including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. Centres who had reported data on incident PD patients for the previous 2012 audit were additionally asked to provide one year follow up data for this group. The findings were compared to the audit measures stated in Renal Association clinical practice guidelines for dialysis access. Fifty-seven centres in EW&NI (representing 92% of all centres) returned data on first access from 3,663 incident HD patients and 1,022 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Twenty-four centres were at least two standard deviations below the 65% target for incident patients starting haemodialysis on AVF and only eight centres (14%) were within two standard deviations of the 85% target for prevalent haemodialysis patients on AVF. There was wide practice variation across the UK in provision of both HD and PD access which requires further exploration.

  12. Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical Study.

    PubMed

    Meissner, H O; Mscisz, A; Reich-Bilinska, H; Kapczynski, W; Mrozikiewicz, P; Bobkiewicz-Kozlowska, T; Kedzia, B; Lowicka, A; Barchia, I

    2006-12-01

    This was a double-blind, randomized, placebo-corrected, outpatient, multi-centre (five sites) clinical study, in which a total of 168 Caucasian early-postmenopausal women volunteers (age>49 years) participated after fulfilling the criteria: follicle stimulating hormone (FSH) >30 IU/ml and estrogen (E2) <40 pg/ml levels at admission. They were randomly allocated to Placebo and Pre-Gelatinized Organic Maca (Maca-GO) treatment, according to different monthly treatment sequences scheduled for each site. Two 500 mg vegetable hard gel capsules with Maca-GO or Placebo powder were self-administered twice daily with meals (total 2 g/day) during three (Trial I; n=102) or four (Trial II; n=66) months study periods. At the baseline and follow- up monthly intervals, blood levels of FSH, E2, progesterone (PRG) and lutinizing hormone (LH), as well as serum cholesterol (CHOL), triglycerides (TRG), high- and low density lipoproteins (HDL and LDL) were measured. Menopausal symptoms were assessed according to Greene's Score (GMS) and Kupperman's Index (KMI). Data were analyzed using multivariate technique on blocs of monthly results in one model and Maca versus Placebo contrast in another model. A total of 124 women concluded the study. Maca-GO significantly stimulated production of E2 (P<0.001) with a simultaneous suppression (P<0.05) of blood FSH, increase (P<0.05) in HDL. Maca-GO significantly reduced both frequency and severity of individual menopausal symptoms (hot flushes and night sweating in particular) resulting in significant (P<0.001) alleviation of KMI (from 22 to 10), thus, offering an attractive non-hormonal addition to the choices available to early-postmenopausal women in the form of a natural plant alternative to Hormone Replacement Therapy (HRT) - hence, reducing dependence on hormone therapy programs.

  13. Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical Study

    PubMed Central

    Meissner, H. O.; Mscisz, A.; Reich-Bilinska, H.; Kapczynski, W.; Mrozikiewicz, P.; Bobkiewicz-Kozlowska, T.; Kedzia, B.; Lowicka, A.; Barchia, I.

    2006-01-01

    This was a double-blind, randomized, placebo-corrected, outpatient, multi-centre (five sites) clinical study, in which a total of 168 Caucasian early-postmenopausal women volunteers (age>49 years) participated after fulfilling the criteria: follicle stimulating hormone (FSH) >30 IU/ml and estrogen (E2) <40 pg/ml levels at admission. They were randomly allocated to Placebo and Pre-Gelatinized Organic Maca (Maca-GO) treatment, according to different monthly treatment sequences scheduled for each site. Two 500 mg vegetable hard gel capsules with Maca-GO or Placebo powder were self-administered twice daily with meals (total 2 g/day) during three (Trial I; n=102) or four (Trial II; n=66) months study periods. At the baseline and follow- up monthly intervals, blood levels of FSH, E2, progesterone (PRG) and lutinizing hormone (LH), as well as serum cholesterol (CHOL), triglycerides (TRG), high- and low density lipoproteins (HDL and LDL) were measured. Menopausal symptoms were assessed according to Greene’s Score (GMS) and Kupperman’s Index (KMI). Data were analyzed using multivariate technique on blocs of monthly results in one model and Maca versus Placebo contrast in another model. A total of 124 women concluded the study. Maca-GO significantly stimulated production of E2 (P<0.001) with a simultaneous suppression (P<0.05) of blood FSH, increase (P<0.05) in HDL. Maca-GO significantly reduced both frequency and severity of individual menopausal symptoms (hot flushes and night sweating in particular) resulting in significant (P<0.001) alleviation of KMI (from 22 to 10), thus, offering an attractive non-hormonal addition to the choices available to early-postmenopausal women in the form of a natural plant alternative to Hormone Replacement Therapy (HRT) – hence, reducing dependence on hormone therapy programs. PMID:23675005

  14. Malignancy and chemotherapy induced haemophagocytic lymphohistiocytosis in children and adolescents-a single centre experience of 20 years.

    PubMed

    Strenger, Volker; Merth, Gerald; Lackner, Herwig; Aberle, Stephan W; Kessler, Harald H; Seidel, Markus G; Schwinger, Wolfgang; Sperl, Daniela; Sovinz, Petra; Karastaneva, Anna; Benesch, Martin; Urban, Christian

    2018-06-01

    Haemophagocytic lymphohistiocytosis (HLH) is a possibly life-threatening syndrome of immune dysregulation and can be divided into primary (hereditary) and secondary forms (including malignancy-associated HLH (M-HLH)). We retrospectively analysed epidemiological, clinical, virological and laboratory data from patients with M-HLH treated at our department between 1995 and 2014. Out of 1.706 haemato-/oncologic patients treated at our department between 1995 and 2014, we identified 22 (1.29%) patients with secondary HLH (1.3-18.0, median 10.1 years; malignancy induced n = 2; chemotherapy induced n = 20). Patients with acute myeloblastic leukaemia (AML) developed HLH significantly more often than patients with acute lymphoblastic leukaemia (ALL) (10/55, 18.2% vs. 6/148, 4.1%, p = 0.0021). As possible viral triggers, we detected BKV (53.8% of the tested patients), HHV-6 (33.3%), EBV (27.8%), CMV (23.5%), ADV (16.7%) and PVB19 (16.7%) significantly more frequently than in haemato-/oncologic patients without HLH. Despite lacking evidence of concurrent bacterial infection, C-reactive protein (CRP) and procalcitotnin (PCT) were elevated in 94.7 and 77.7% of the patients, respectively. Ferritin and sIL2R were markedly elevated in all patients. HLH-associated mortality significantly (p = 0.0276) decreased from 66.6% (1995-2004) to 6.25% (2005-2014), suggesting improved diagnostic and therapeutic management. Awareness of HLH is important, and fever refractory to antibiotics should prompt to consider this diagnosis. Elevated ferritin and sIL2R seem to be good markers, while inflammatory markers like CRP and PCT are not useful to discriminate viral triggered HLH from severe bacterial infection. Re-/activation of several viruses may play a role as possible trigger.

  15. Percutaneous nephrolithotomy of bilateral staghorn renal calculi in pediatric patients: 12 years experience in a tertiary care centre.

    PubMed

    Purkait, Bimalesh; Kumar, Manoj; Sokhal, Ashok Kumar; Bansal, Ankur; Sankhwar, Satya Narayan; Gupta, Ashok Kumar

    2017-08-01

    To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (<15 years) of bilateral staghorn calculi from 2004 to 2015. Staged PCNL was done after 2-3 days if needed and opposite side PCNL was performed after 10-14 days. Fifty-one patients with bilateral staghorn renal calculi underwent PCNL. The mean age of the study group was 10.25 ± 2.13 (range 3-15). Mean stone burden was 778.3 + 613.4 (range 231-3850 mm 2 ). Forty-five patients underwent single puncture, twenty-two patients underwent double punctures whereas six patients underwent triple punctures during first session PCNL procedure. Most common puncture location was through the superior calyx (58.82 %). The mean operating time was 77.25 + 30.21 (range 58-145). After the first session PCNL, the success rate was 76.47 %. Thirteen patients (17 renal units) underwent relook PCNL and seven patients underwent ESWL. Overall complication noted in twenty-four (47.05 %) cases. Most of the complications were minor grade. Percutaneous nephrolithotomy for staghorn calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.

  16. Institutional resuscitation protocols: do they affect cardiopulmonary resuscitation outcomes? A 6-year study in a single tertiary-care centre.

    PubMed

    Sodhi, Kanwalpreet; Singla, Manender Kumar; Shrivastava, Anupam

    2015-02-01

    Despite advances in cardiopulmonary resuscitation and widespread life-support trainings, the outcomes of resuscitation are variable. There is a definitive need for organizational inputs to strengthen the resuscitation process. Our hospital authorities introduced certain changes at the organizational level in our in-house resuscitation protocol. We aimed to study the impact of these changes on the outcomes of resuscitation. The hospital code blue committee decided to reformulate the resuscitation protocols and reframe the code blue team. Various initiatives were taken in the form of infrastructural changes, procurement of equipment, organising certified training programs, conduct of mock code and simulation drills etc. A prospective and retrospective observational study was made over 6 years: a pre-intervention period, which included all cardiac arrests from January 2007 to December 2009, before the implementation of the program, and a post-intervention period from January 2010 to December 2012, after the implementation of the program. The outcomes of interest were response time, immediate survival, day/night survival and survival to discharge ratio. 2,164 in-hospital cardiac arrests were included in the study, 1,042 during the pre-intervention period and 1,122 during the post-intervention period. The survival percentage increased from 26.7 to 40.8 % (p < 0.05), and the survival to discharge ratio increased from 23.4 to 66.6 % (p < 0.05). Both day- and night-time survival improved (p < 0.05) and response time improved from 4 to 1.5 min. A strong hospital-based resuscitation policy with well-defined protocols and infrastructure has potential synergistic effect and plays a big role in improving the outcomes of resuscitation.

  17. Twenty-eight-year review of childhood renal diseases from renal biopsy data: A single centre in China.

    PubMed

    Jiang, Mengjie; Xiao, Zizheng; Rong, Liping; Xu, Yuanyuan; Chen, Lizhi; Mo, Ying; Sun, Liangzhong; Sun, Wei; Jiang, Xiaoyun

    2016-12-01

    The aim of the present study was to investigate the clinicopathologic characteristics of biopsy-proven childhood renal diseases and to compare the trends and changes during two different time intervals between 1984 and 2011 at the First Affiliated Hospital of Sun Yat-sen University in China. We retrospectively analyzed kidney biopsy data from children with renal diseases and compared the data during two time intervals, namely 1984-1997 and 1998-2011. A total of 1313 children were enrolled in the present study. There were 921 children with primary glomerular disease (PGD) and 312 children with secondary glomerular disease (SGD), accounting for 70.1% and 23.8% of participants, respectively. The major clinical manifestation of PGD was nephrotic syndrome (NS), which accounted for 31.2% of cases, while the main aetiology of SGD was lupus nephritis (40.7%). The main biopsy patterns of PGD were IgA nephritis (27.6%), minimal change disease (24.0%), and mesangial proliferative glomerulonephritis (16.9%). PGD was the major class of disease in both time intervals, but the ratio of PGD decreased over time, while the ratio of SGD and other glomerular diseases increased. PGD was also the major class of disease in each age group; however, the incidence of PGD decreased with increasing age. The incidence patterns of paediatric renal diseases changed over the 28-year period of this study. Our results show that different renal diseases characterize different age intervals. Furthermore, there are several associations between clinical presentation and biopsy features in childhood renal disease. © 2015 Asian Pacific Society of Nephrology.

  18. Changing patterns and trends of multidrug-resistant tuberculosis at referral centre in Northern India: a 4-year experience.

    PubMed

    Maurya, A K; Singh, A K; Kumar, M; Umrao, J; Kant, S; Nag, V L; Kushwaha, R A S; Dhole, T N

    2013-01-01

    India has a high burden of drug-resistant tuberculosis (TB), although there is little data on multidrug-resistant tuberculosis (MDR-TB). Although MDR-TB has existed for long time in India, very few diagnostic laboratories are well-equipped to test drug sensitivity. The objectives of this study were to determine the prevalence of MDR-TB, first-line drug resistance patterns and its changing trends in northern India in the 4 years. This was a prospective study from July 2007 to December 2010. Microscopy, culture by Bactec460 and p-nitro-α-acetylamino-β-hydroxypropiophenone (NAP) test was performed to isolate and identify Mycobacterium tuberculosis (M. tb) complex (MTBC). Drug sensitivity testing (DST) was performed by 1% proportional method (Bactec460) for four drugs: Rifampicin, isoniazid, ethambutol and streptomycin. Various clinical and demographical profiles were evaluated to analyse risk factors for development of drug resistance. We found the overall prevalence rate of MDR-TB to be 38.8%, increasing from 36.4% in 2007 to 40.8% in 2010. we found that the prevalence of MDR-TB in new and previously treated cases was 29.1% and 43.3% ( P < 0.05; CI 95%). The increasing trend of MDR-TB was more likely in pulmonary TB when compared with extra-pulmonary TB ( P < 0.05; CI 95%). we found a high prevalence (38.8%) of MDR-TB both in new cases (29.1%) and previously treated cases (43.3%).This study strongly highlights the need to make strategies for testing, surveillance, monitoring and management of such drug-resistant cases.

  19. Early versus late tracheostomy in pediatric intensive care unit: does it matter? A 6-year experience.

    PubMed

    Pizza, Alessandro; Picconi, Enzo; Piastra, Marco; Genovese, Orazio; Biasucci, Daniele G; Conti, Giorgio

    2017-08-01

    The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of ventilator-associated pneumonia (VAP). This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six-year period. Data collection included PICU length of stay, days of intubation, days of mechanical ventilation, primary indication for tracheostomy, information about VAP and decannulations. The early tracheostomy group was defined as patients who had ten or fewer days of continuous ventilation, whereas the late tracheostomy group had more than ten days of continuous ventilation. A significant decrease in the rate of VAP incidence was noticed in the early tracheostomy group vs. late group (P=0.004, OR=0.39, 95% CI: 0.18-0.85). No differences were observed about decannulation, need of long-term ventilation and death rate. Significant decreases of days of mechanical ventilation and PICU stay were found in subgroup of patients who underwent early tracheostomy and were decannulated within 18 months. No standard timing for tracheostomy placement has been established in the pediatric population. Early tracheostomy can shorten the days of ventilation and hospitalization in PICU and reduce the incidence of VAP, but further studies are needed to identify patient categories in which it can be of benefit.

  20. Endoscopic tri-modal imaging for detection of early neoplasia in Barrett's oesophagus: a multi-centre feasibility study using high-resolution endoscopy, autofluorescence imaging and narrow band imaging incorporated in one endoscopy system.

    PubMed

    Curvers, W L; Singh, R; Song, L-M Wong-Kee; Wolfsen, H C; Ragunath, K; Wang, K; Wallace, M B; Fockens, P; Bergman, J J G H M

    2008-02-01

    To investigate the diagnostic potential of endoscopic tri-modal imaging and the relative contribution of each imaging modality (i.e. high-resolution endoscopy (HRE), autofluorescence imaging (AFI) and narrow-band imaging (NBI)) for the detection of early neoplasia in Barrett's oesophagus. Prospective multi-centre study. Tertiary referral centres. 84 Patients with Barrett's oesophagus. The Barrett's oesophagus was inspected with HRE followed by AFI. All lesions detected with HRE and/or AFI were subsequently inspected in detail by NBI for the presence of abnormal mucosal and/or microvascular patterns. Biopsies were obtained from all suspicious lesions for blinded histopathological assessment followed by random biopsies. (1) Number of patients with early neoplasia diagnosed by HRE and AFI; (2) number of lesions with early neoplasia detected with HRE and AFI; and (3) reduction of false positive AFI findings after NBI. Per patient analysis: AFI identified all 16 patients with early neoplasia identified with HRE and detected an additional 11 patients with early neoplasia that were not identified with HRE. In three patients no abnormalities were seen but random biopsies revealed HGIN. After HRE inspection, AFI detected an additional 102 lesions; 19 contained HGIN/EC (false positive rate of AFI after HRE: 81%). Detailed inspection with NBI reduced this false positive rate to 26%. In this international multi-centre study, the addition of AFI to HRE increased the detection of both the number of patients and the number of lesions with early neoplasia in patients with Barrett's oesophagus. The false positive rate of AFI was reduced after detailed inspection with NBI.

  1. Low Rates of Major Complications for Radiofrequency Ablation of Atrial Fibrillation Maintained Over 14 Years: A Single Centre Experience of 2750 Consecutive Cases.

    PubMed

    Voskoboinik, Aleksandr; Sparks, Paul B; Morton, Joseph B; Lee, Geoffrey; Joseph, Stephen A; Hawson, Joshua J; Kistler, Peter M; Kalman, Jonathan M

    2018-02-03

    Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter. Double transseptal puncture was performed under TEE guidance. All patients underwent wide antral circumferential isolation of the pulmonary veins (30W anteriorly, 25W posteriorly) with substrate modification at operator discretion. Of 2255 initial and 495 redo procedures, ablation strategies were: pulmonary vein isolation (PVI) only 2097 (76.3%), PVI+lines 368 (13.4%), PVI+posterior wall 191 (6.9%), PVI+cavotricuspid isthmus 277 (10.1%). There were 23 major (0.84%) and 20 minor (0.73%) complications. Cardiac tamponade (five cases - 0.18%) and phrenic nerve palsy (one case - 0.04%) rates were very low. Major vascular complications necessitating surgery or blood transfusion occurred in five patients (0.18%). There were no cases of death, permanent disability, atrio-oesophageal fistulae or symptomatic pulmonary vein (PV) stenosis, although there were five TEE probe-related complications (0.18%). Female gender (OR 2.14; 95% CI 1.07-4.26) but not age >70 (OR 1.01) was the only multivariate predictor of complications. Atrial fibrillation ablation performed at a high-volume centre using RF can be achieved with a low major complication rate in a representative AF population over a sustained period of time. Copyright © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights

  2. Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years.

    PubMed

    Deierlein, A L; Siega-Riz, A M; Herring, A H; Adair, L S; Daniels, J L

    2012-04-01

    To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length z-scores (WLZ) between early infancy and 3 years. Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n = 476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ and WLZ associated with GWG. In early infancy, compared with infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ and WLZ. Excessive GWG ≥ 200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. GWG is associated with significant differences in offspring anthropometrics in early infancy that persisted to 3 years of age. More longitudinal studies that utilize maternal and paediatric body composition measures are necessary to understand the nature of this association. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  3. Three year outcomes in an early intervention service for psychosis in a multicultural and multiethnic population.

    PubMed

    Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Persaud, Albert; Murphy, Suzanne; Zaman, Rashid

    2008-12-01

    Concern has been expressed that it may be difficult to provide certain interventions to some ethnic groups in an Early Intervention Service for Psychosis, and that as a consequence, three-year outcomes for the different Ethnic Groups may be different in different groups. To test whether there are differences between the three year outcomes of different ethnic groups represented in the patient population of an Early Intervention service for Psychosis. The three-year outcomes for the first group of 62 Patients to receive three years treatment in the Early Intervention Service in Luton, Bedfordshire were examined. This group well represented the ethnic mix of the population of Luton. It does not appear that there are major differences between the three-year outcomes of any one of the three groups studied. However the South Asian Patients appear to present earlier, with shorter DUPs, seemed more likely to marry, live with their families, and seem more likely to return to higher education after a first psychotic episode of psychosis compared to the Caucasians. Afro-Carribeans and South Asians were more likely to be unemployed, but many South Asians were employed, as were Caucasians. The fewest persons employed were in the Afro-Caribbean group. While slightly more South Asians and Afro-Carribeans were admitted compulsorily under the mental health act over the three years, 60% of each of the two non-white groups were never admitted compulsorily. This is different from the reported national trends of the Mental Health act being used excessively with the Afro-Caribbean population. No previous study has looked at the outcomes of Early Intervention Services for First Psychotic Episodes according to the Ethnic Origin of the Clients. The better outcomes seen with South Asians are probably due to cultural factors among the South Asians born in this country, rather than to issues related to the Psychotic Illness itself. These findings are important in planning services in areas

  4. Early-Years Teachers' Professional Upgrading in Science: a Long-Term Programme

    NASA Astrophysics Data System (ADS)

    Kallery, Maria

    2017-04-01

    In this paper, we present a professional development/upgrading programme in science for early-years teachers and investigate its impact on the teachers' competencies in relation to their knowledge and teaching of science. The basic idea of the programme was to motivate the teachers by making them members of an action research group aimed at developing and implementing curriculum activities to which they would contribute and thus meaningfully engaging them in their own learning. The programme used a `collaborative partnership' model for the development of the activities. In this model, the collaborative notion is defined as an act of `shared creation': partners share a goal and members bring their expertise to the partnership. Within this context, the partners were a researcher in science education with a background in physics, who also served as a facilitator, and six in-service early-years teachers with a background in early-years pedagogy and developmental sciences, who had many years of experience (classroom experts). These teachers participated in the programme as co-designers, but were involved to a significantly lesser degree than the researcher. The programme procedures comprised group work and individual teachers' class work. Data sources included teachers' essays, field-notes, lesson recordings and group-work records. Data were qualitatively analysed. The main results indicate improvement of teachers' `transformed' knowledge of the subject matter, development/improvement of knowledge of instructional strategies, including factors related to quality of implementation of the activities, knowledge of the pupils and improvement of the teachers' efficacy.

  5. The Interplay of Early Adolescents' Depressive Symptoms, Aggression and Perceived Parental Rejection: A Four-Year Community Study

    ERIC Educational Resources Information Center

    Hale, William W., III; VanderValk, Inge; Akse, Joyce; Meeus, Wim

    2008-01-01

    This study of early adolescents from the general population examined the direction of effects adolescents' depressive symptoms, aggression, and perceived parental rejection have on one another in a longitudinal study. Over a four-year period, data were collected yearly from 940 early adolescents (50.6% boys and 49.4% girls) who completed…

  6. Science Learning and Graphic Symbols: An Exploration of Early Years Teachers' Views and Use of Graphic Symbols When Teaching Science

    ERIC Educational Resources Information Center

    Kambouri, Maria; Pampoulou, Eliada Salowm; Pieridou, Myria; Allen, Michael

    2016-01-01

    The study investigated early years teachers' understanding and use of graphic symbols, defined as the visual representation(s) used to communicate one or more "linguistic" concepts, which can be used to facilitate science learning. The study was conducted in Cyprus where six early years teachers were observed and interviewed. The results…

  7. Language development in the early school years: the importance of close relationships with teachers.

    PubMed

    Spilt, Jantine L; Koomen, Helma M Y; Harrison, Linda J

    2015-02-01

    This longitudinal study examined developmental links between closeness in teacher-child relationships and children's receptive language ability from the end of the preschool years into the early elementary years, while controlling for changes in peer interaction quality and child behavioral functioning. The sample included children and their parents and teachers (N = 4,983) participating in the Longitudinal Study of Australian Children (LSAC) at ages 4-5, 6-7, and 8-9 years (3 waves). Teachers reported on levels of closeness in relationships with individual children. Independent assessments of receptive language were employed. Parents and teachers reported on peer interaction problems and child conduct problems. Results indicated reciprocal associations between close teacher-child relationships and receptive language development above and beyond associations with peer interaction quality and child behavioral functioning. However, the effects were only modest. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  8. Typologies of family functioning and children's adjustment during the early school years.

    PubMed

    Sturge-Apple, Melissa L; Davies, Patrick T; Cummings, E Mark

    2010-01-01

    Guided by family systems theory, the present study sought to identify patterns of family functioning from observational assessments of interparental, parent-child, and triadic contexts. In addition, it charted the implications for patterns of family functioning for children's developmental trajectories of adjustment in the school context across the early school years. Two-hundred thirty-four kindergarten children (129 girls and 105 boys; mean age = 6.0 years, SD = 0.50 at Wave 1) and their parents participated in this multimethod, 3-year longitudinal investigation. As expected, latent class analyses extracted 3 primary typologies of functioning including: (a) cohesive, (b) enmeshed, and (c) disengaged families. Furthermore, family patterns were differentially associated with children's maladaptive adjustment trajectories in the school context. The findings highlight the developmental utility of incorporating pattern-based approaches to family functioning.

  9. Exploring Parental Involvement in Early Years Education in China: Development and Validation of the Chinese Early Parental Involvement Scale (CEPIS)

    ERIC Educational Resources Information Center

    Lau, Eva Yi Hung; Li, Hui; Rao, Nirmala

    2012-01-01

    This study developed and validated an instrument, the Chinese Early Parental Involvement Scale (CEPIS), that can be widely used in both local and international contexts to assess Chinese parental involvement in early childhood education. The study was carried out in two stages: (1) focus group interviews were conducted with 41 teachers and 35…

  10. Influences on Turkish Early Childhood Teachers' Science Teaching Practices and the Science Content Covered in the Early Years

    ERIC Educational Resources Information Center

    Olgan, Refika

    2015-01-01

    The first rationale of the study was not only to determine the topics taught in Turkish early childhood settings but also to define the frequency and time allocation for teaching science (n?=?382). In the second phase, through semi-structured interview questions, the aim was to gain detailed information about Turkish early childhood teachers'…

  11. Bottle-feeding practices during early infancy and eating behaviors at 6 years of age.

    PubMed

    Li, Ruowei; Scanlon, Kelley S; May, Ashleigh; Rose, Chelsea; Birch, Leann

    2014-09-01

    Evidence suggests an association of breastfeeding with a maternal feeding style (MFS) that is less controlling than formula feeding, which, in turn, may improve a child's self-regulation of eating. This study examines associations of bottle-feeding practices during infancy with MFS and children's eating behavior (CEB) at 6 years old. We linked data from the Infant Feeding Practices Study II to the Year 6 Follow-Up, which include 8 MFS and CEB measures adapted from previous validated instruments. Bottle-feeding practices during the first 6 months estimated by using the Infant Feeding Practices Study II were bottle-feeding intensity (BFI), mother's encouragement of infant to finish milk in the bottle, and infant finishing all milk in the bottle. Adjusted odds ratios (aORs) for associations of bottle-feeding practices with MFS and CEB at 6 years old were calculated by using multivariable logistic regressions controlling for sociodemographic characteristics and other feeding practices (N = 1117). Frequent bottle emptying encouraged by mothers during infancy increased odds of mothers encouraging their child to eat all the food on their plate (aOR: 2.37; 95% confidence interval [CI]: 1.65-3.41] and making sure their child eats enough (aOR: 1.62; 95% CI: 1.14-2.31) and of children eating all the food on their plate at 6 years old (aOR: 2.01; 95% CI: 1.05-3.83). High BFI during early infancy also increased the odds of mothers being especially careful to ensure their 6-year-old eats enough. Bottle-feeding practices during infancy may have long-term effects on MFS and CEB. Frequent bottle emptying encouraged by mothers and/or high BFI during early infancy increased the likelihood of mothers pressuring their 6-year-old child to eat and children's low satiety responsiveness. Copyright © 2014 by the American Academy of Pediatrics.

  12. Celebrating 10 Years of Undergraduate Medical Education: A Student-Centered Evaluation of the Princess Margaret Cancer Centre--Determinants of Community Health Year 2 Program.

    PubMed

    Fernando, E; Jusko-Friedman, A; Catton, P; Nyhof-Young, J

    2015-06-01

    Between 2000 and 2011, over 170 second-year medical students participated in a Determinants of Community Health (DOCH 2) project at Princess Margaret Hospital (PMH). Students undertook community-based research projects at the hospital or with PMH community partners involving activities such as producing a literature review, writing a research proposal, obtaining ethics approval, carrying out data collection and analysis, presenting their data to classmates and supervisors, and production of a final report. An electronic survey consisting of both quantitative and qualitative questions was developed to evaluate the PMH-DOCH 2 program and was distributed to 144 past students with known email addresses. Fifty-eight students responded, a response rate of 40.3%. Data analysis indicates that an increase in oncology knowledge, awareness of the impact of determinants of health on patients, and knowledge of research procedures increased participants' satisfaction and ability to conduct research following DOCH 2. Furthermore, the PMH-DOCH 2 program enhanced the development of CanMEDS competencies through career exploration and patient interaction as well as through shadowing physicians and other allied health professionals. In addition, some students felt their PMH-DOCH 2 projects played a beneficial role during their residency matching process. The PMH-DOCH 2 research program appeared to provide a positive experience for most participants and opportunities for medical students' professional growth and development outside the confines of traditional lecture-based courses.

  13. Early and late complications of stapled haemorrhoidopexy: a 6-year experience from a single surgical clinic.

    PubMed

    Grigoropoulos, P; Kalles, V; Papapanagiotou, I; Mekras, A; Argyrou, A; Papageorgiou, K; Derian, A

    2011-10-01

    Introduction of stapled hemorrhoidopexy (SH) brought a radical change in the treatment of haemorrhoidal disease. The aim of this study is to evaluate the results and the complications (early and late) from the use of this technique. During the last 6 years (2005-2011), 123 patients underwent a SH in our ward. Our sample consists of 79 male and 44 female patients with an average age of 48.2 years (range 22-83 years). Of them, 83 had third-degree haemorrhoidal disease, 34 had fourth-degree and 6 had second-degree bleeding haemorrhoids. The follow-up period was 6-72 months. Pain was minimal or even not existent. Additional sutures or use of adrenaline 1:200.000 for haemostasis were required in 6 patients (4.8%). The bleeding has been diminished with the use of this new haemorrhoidectomy stapler PPH03. Urinary retention, which was observed in 3 patients (2.4%), was temporary and the use of catheter was not needed. As a late complication, 'faecal urgency' occurred in 8 patients (6.5%), and disappeared after some months. No recurrent haemorrhoidal disease occurred. No cases of chronic pain were reported. Average hospital stay was 1 day, except for 2 patients who remained for 2 days for bleeding observation. The correct application of SH reduces the possible complications. The advantages of the stapled procedure are reduced postoperative pain, the minimal hospital stay and early return to work.

  14. Early age exposure to moisture damage and systemic inflammation at the age of 6 years.

    PubMed

    Karvonen, A M; Tischer, C; Kirjavainen, P V; Roponen, M; Hyvärinen, A; Illi, S; Mustonen, K; Pfefferle, P I; Renz, H; Remes, S; Schaub, B; von Mutius, E; Pekkanen, J

    2018-05-01

    Cross-sectional studies have shown that exposure to indoor moisture damage and mold may be associated with subclinical inflammation. Our aim was to determine whether early age exposure to moisture damage or mold is prospectively associated with subclinical systemic inflammation or with immune responsiveness in later childhood. Home inspections were performed in children's homes in the first year of life. At age 6 years, subclinical systemic inflammation was measured by serum C-reactive protein (CRP) and blood leukocytes and immune responsiveness by ex vivo production of interleukin 1-beta (IL-1β), IL-6, and tumor necrosis factor alpha (TNF-α) in whole blood cultures without stimulation or after 24 hours stimulation with phorbol 12-myristate 13-acetate and ionomycin (PI), lipopolysaccharide (LPS), or peptidoglycan (PPG) in 251-270 children. Moisture damage in child's main living areas in infancy was not significantly associated with elevated levels of CRP or leukocytes at 6 years. In contrast, there was some suggestion for an effect on immune responsiveness, as moisture damage with visible mold was positively associated with LPS-stimulated production of TNF-α and minor moisture damage was inversely associated with PI-stimulated IL-1β. While early life exposure to mold damage may have some influence on later immune responsiveness, it does not seem to increase subclinical systemic inflammation in later life. © 2018 National Institute for Health and Welfare, Finland Indoor Air published by John Wiley & Sons Ltd.

  15. Good-quality diet in the early years may have a positive effect on academic achievement.

    PubMed

    Nyaradi, Anett; Li, Jianghong; Foster, Jonathan K; Hickling, Siobhan; Jacques, Angela; O'Sullivan, Therese A; Oddy, Wendy H

    2016-05-01

    The aim of this study was to investigate the associations between early diet and academic performance during childhood. Participants were from the Western Australian Pregnancy Cohort (Raine) Study (n = 2287). Frequency of consumption of food and beverages was collected at the one-, two- and three-year follow-ups, using a 24-hour food recall. Diet scores were developed from the number of eating occasions. The Western Australian Literacy and Numeracy Assessment (WALNA) data from grades five (age 10) and seven (age 12) were linked to the Raine study using The Western Australian Data Linkage System. The association between diet scores and WALNA scores was assessed using multivariate linear regression models. A higher (i.e. better quality) diet score at one year of age was associated with significantly higher scores in mathematics, reading, writing and spelling at both grades five and seven. Associations were observed between a higher diet score at two years and academic scores for mathematics, writing and spelling at grade seven. Higher dairy consumption at ages one, two and three, and higher fruit consumption at age one were associated with higher academic scores at all ages. Quality of early diet may be a predictor for later academic achievement. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  16. Leading Highly Performing Children's Centres: Supporting the Development of the "Accidental Leaders"

    ERIC Educational Resources Information Center

    Coleman, Andy; Sharp, Caroline; Handscomb, Graham

    2016-01-01

    There is wide recognition that early childhood experiences are critical to a child's development and their subsequent life chances. However, little research has been undertaken into leadership in early years settings, which is so influential in this regard. This article summarizes research into the leadership of Sure Start Children's Centres,…

  17. Defining Smallness for Gestational Age in the Early Years of the Danish Medical Birth Registry

    PubMed Central

    Rogvi, Rasmus á.; Mathiasen, Rene; Greisen, Gorm

    2011-01-01

    Background Being born small for gestational age (SGA) is associated with decreased insulin sensitivity and increased blood pressure in childhood, but the association with clinical disease in early adulthood is less certain. The Danish Medical Birth Registry has registered all births in Denmark since 1973, but due to variable data quality, data is most often used only from 1981 onwards, and birth registers in other countries may have similar problems for the early years. We wanted to examine whether the data can be used for identification of children born SGA and used in future research. Methodology/Principal Findings All persons born between 1974 and 1996 were identified in the Danish Medical Birth Registry (n = 1.704.890). Immigrants and children without data on gestational age and birth weight were excluded, and a total of 1.348.106 children were included in the analysis. The difference between the different variables used in the history of the registry were examined, and the quality of data in the birth registry from 1974-1981 was examined and compared to subsequent years. Data on birth weight and gestational age in the early years of the registry is inconsistent, and the identification of children born SGA is inaccurate, with 49% false-positives. The biggest source of error is due to the rough and inaccurate intervals used for gestational age. By using –3 standard deviations as a cut-off for the identification of children born SGA, the number of false-positives was reduced to 9%, while the amount of false-negatives were increased. Conclusion Choosing –3 standard deviations for identifying children born SGA is a viable, though not optimal solution for identifying children born SGA. Overall the data in the registry is of sufficient quality to be used in further medical research. PMID:21304958

  18. The development of executive function and language skills in the early school years.

    PubMed

    Gooch, Debbie; Thompson, Paul; Nash, Hannah M; Snowling, Margaret J; Hulme, Charles

    2016-02-01

    The developmental relationships between executive functions (EF) and early language skills are unclear. This study explores the longitudinal relationships between children's early EF and language skills in a sample of children with a wide range of language abilities including children at risk of dyslexia. In addition, we investigated whether these skills independently predict children's attention/behaviour skills. Data are presented from 243 children at four time points. Children were selected for being at risk of reading difficulties either because of a family history of dyslexia (FR; N = 90) or because of concerns regarding their language development (LI; N = 79) or as typically developing controls (TD; N = 74). The children completed tasks to assess their executive function and language skills at ages 4, 5 and 6 years. At 6 (T4) and 7 years (T5) parents and teachers rated the children's attention/behaviour skills. There was a strong concurrent relationship between language and EF at each assessment. Longitudinal analyses indicated a considerable degree of stability in children's language and EF skills: the influence of language on later EF skills (and vice versa) was weak and not significant in the current sample. Children's EF, but not language, skills at T3 predicted attention/behaviour ratings at T4/T5. There is a strong concurrent association between language and EF skills during the preschool and early school years, when children with language impairment show persistent EF deficits. Latent variables measuring language and EF show high longitudinal stability with little evidence of significant or strong reciprocal influences between these constructs. EF, but not language, skills predict later ratings of children's attention and behaviour. © 2015 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

  19. The female dragons awake: women, sport and society in the early years of the new China.

    PubMed

    Dong, J

    2001-01-01

    This article, based on archival records, published documents, interviews with elite sportswomen and three regional case studies, deals with the radical social, economic, cultural and political changes in the early years of the Communist China, the consequent changes in women's lives and the eventual extraordinary impact on elite women's sport. It analyses the complicated relations between the communist system, gender ideology, sports policy, international politics and elite women's sport. With the establishment of a variety of sports institutions, systems and structures women in increasing numbers took part in competitive sport and produced even increasingly remarkable achievements.

  20. Astigmatism Progression in the Early Treatment for Retinopathy of Prematurity Study to 6 years of age

    PubMed Central

    Davitt, Bradley V.; Quinn, Graham E.; Wallace, David K.; Dobson, Velma; Hardy, Robert J.; Tung, Betty; Lai, Dejian; Good, William V.

    2011-01-01

    Purpose To examine the prevalence of astigmatism (≥1.00 diopter (D)) and high astigmatism (≥2.00 D) from 6 months post term due date to 6 years postnatal, in preterm children with birth weight ≤ 1251g who developed high-risk prethreshold retinopathy of prematurity (ROP) and participated in the Early Treatment for ROP (ETROP) Study. Design Observational Cohort Study Participants 401 infants who developed high-risk prethreshold ROP in one or both eyes and were randomized to early treatment (ET) versus conventional management (CM). Refractive error was measured by cycloplegic retinoscopy. Eyes were excluded if they received additional retinal, glaucoma, or cataract surgery. Intervention Eyes were randomized to receive laser photocoagulation at high-risk prethreshold ROP or to receive treatment only if threshold ROP developed. Main Outcome Measures Astigmatism and high astigmatism at each study visit. Results For both ET and CM eyes, there was a consistent increase in prevalence of astigmatism over time, increasing from 42% at 4 years to 52% by 6 years for the group of ET eyes and from 47% to 54% in the CM eyes. There was no statistically significant difference between the slopes (rate of change per month) of the ET and CM eyes for both astigmatism and high astigmatism. (P=0.75) Conclusions By 6 years of age, over 50% of eyes with high-risk prethreshold ROP developed astigmatism ≥ 1.00 D, and nearly 25% of such eyes had high astigmatism (≥ 2.00 D). Presence of astigmatism was not influenced by timing of treatment, zone of acute-phase ROP, or presence of plus disease. However, there was a trend toward higher prevalence of astigmatism and high astigmatism in eyes with ROP residua. Most astigmatism was with-the-rule (75º –105º). More eyes with Type 2 than Type 1 had astigmatism by 6 years. These findings reinforce the need for follow-up eye examinations through early grade school years in infants with high risk prethreshold ROP. PMID:21872933

  1. Self-referral psychological treatment centre for young adults: a 2-year observational evaluation of routine practice before and after treatment

    PubMed Central

    Halje, Karin; Timpka, Toomas; Tylestedt, Petra; Adler, Anna-Karin; Fröberg, Lena; Schyman, Tommy; Johansson, Kristoffer; Dahl, Katarina

    2015-01-01

    Objectives To examine a self-referral psychological service provided to young adults with regard to effects on anxiety, depression and psychological distress and to explore client factors predicting non-adherence and non-response. Design Observational study over a 2-year period. Setting Young Adults Centre providing psychological services by self-referral (preprimary care) to Linköping, Åtvidaberg, and Kinda municipalities (combined population 145 000) in Östergötland county, Sweden. Participants 607 young adults (16–25 years of age); 71% females (n=429). Intervention Individually scheduled cognitive behavioural therapy delivered in up to six 45 min sessions structured according to an assessment of the client's mental health problems: anxiety, depression, anxiety and depression combined, or decreased distress without specific anxiety or depression. Primary outcome measures Pre–post intervention changes in psychological distress (General Health Questionnaire-12, GHQ-12), Hospital Anxiety and Depression Scale Anxiety/Depression (HADS-A/D). Results 192 clients (32.5%) discontinued the intervention on their own initiative and 39 clients (6.6%) were referred to a psychiatric clinic during the course of the intervention. Intention-to-treat analyses including all clients showed a medium treatment effect size (d=0.64) with regard to psychological distress, and small effect sizes were observed with regard to anxiety (d=0.58) and depression (d=0.57). Restricting the analyses to clients who adhered to the agreed programme, a large effect size (d=1.26) was observed with regard to psychological distress, and medium effect sizes were observed with regard to anxiety (d=1.18) and depression (d=1.19). Lower age and a high initial HADS-A score were the strongest risk factors for non-adherence, and inability to concentrate and thinking of oneself as a worthless person increased the risk for discontinuation. Conclusions We conclude that provision of psychological

  2. Disruptive behaviour disorders: a systematic review of environmental antenatal and early years risk factors.

    PubMed

    Latimer, K; Wilson, P; Kemp, J; Thompson, L; Sim, F; Gillberg, C; Puckering, C; Minnis, H

    2012-09-01

    Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables. © 2012 Blackwell Publishing Ltd.

  3. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability.

    PubMed

    Bartels, Ronald H M A; Hosman, Allard J F; van de Meent, Henk; Hofmeijer, Jeannette; Vos, Pieter E; Slooff, Willem Bart; Öner, F Cumhur; Coppes, Maarten H; Peul, Wilco C; Verbeek, André L M

    2013-01-31

    Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treatment was propagated with good clinical results. Proponents for early surgery as well those favoring conservative treatment are still in debate. The proposed trial will contribute to the discussion and hopefully also to a decrease in the variability of clinical practice. A randomized controlled trial is designed to compare the clinical outcome of early surgical strategy versus a conservative approach. The primary outcome is clinical outcome according to mJOA. This also measured by ASIA score, DASH score and SCIM III score. Other endpoints are duration of the stay at a high care department (medium care, intensive care), duration of the stay at the hospital, complication rate, mortality rate, sort of rehabilitation, and quality of life. A sample size of 36 patients per group was calculated to reach a power of 95%. The data will be analyzed as intention-to-treat at regular intervals, but the end evaluation will take place at two years post-injury. At the end of the study, clinical outcomes between treatments attitudes can be compared. Efficacy, but also efficiency can be determined. A goal of the study is to determine which treatment will result in the best quality of life for the patients. This study will certainly contribute to more uniformity of treatment offered to patients with a special sort of spinal cord injury. Gov: NCT01367405.

  4. Snoring during early childhood and academic performance at ages thirteen to fourteen years.

    PubMed

    Gozal, D; Pope, D W

    2001-06-01

    Obstructive sleep apnea syndrome in young children is associated with an adverse effect on learning. However, the long-term impact of sleep-disordered breathing (SDB) during early childhood on learning remains unknown. Questionnaires were mailed to seventh and eighth graders attending public schools whose class ranking was either in the top 25% (high performance [HP]) or bottom 25% of their class (low performance [LP]), and who were matched for age, gender, race, school, and street of residence. Snoring frequency and loudness at 2 to 6 years of age, tonsillectomy and adenoidectomy (T&A) for snoring or recurrent infection, school grades, and parental smoking and snoring were assessed. The questionnaire response rate was 82.8%. Because of ongoing ring, 13 responders were excluded, such that 1588 questionnaires could be analyzed (797 in LP and 791 in HP group). Frequent and loud snoring during early childhood was reported in 103 LP children (12.9%) compared with 40 HP children (5.1%; odds ratio: 2.79; confidence interval: 1.88-4.15). Furthermore, 24 LP and 7 HP children underwent T&A for snoring (odds ratio: 3.40; confidence interval: 1.47-7.84), while 21 LP and 19 HP children required surgery for recurrent tonsillitis. Children with lower academic performance in middle school are more likely to have snored during early childhood and to require T&A for snoring compared with better performing schoolmates. These findings support the concept that SDB-associated neurocognitive morbidity may be only partially reversible or that a "learning debt" may develop with SDB during early childhood and hamper subsequent school performance.

  5. Compliance with the Australian 24-hour movement guidelines for the early years: associations with weight status.

    PubMed

    Santos, Rute; Zhang, Zhiguang; Pereira, João R; Sousa-Sá, Eduarda; Cliff, Dylan P; Okely, Anthony D

    2017-11-20

    For effective public health and surveillance it is important to document the proportion of young children who meet the new Australian Integrated 24 h Movement Guidelines for the Early Years and how these associate with health outcomes. We aimed to (i) assess compliance with the new Integrated 24 h Movement Guidelines for the Early Years in a sample of Australian toddlers; and (ii) ascertain whether compliance with the guidelines associates with weight status. The sample comprised 202 toddlers (104 girls) aged 19.74 ± 4.07 months from the GET UP! Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity, sedentary time and sleep. Parents reported participants' screen time. Weight and height were measured and body mass index (BMI) z-scores by age and sex were calculated. Analysis of Covariance (ANCOVA) was performed to test differences in BMI z-scores between participants complying with (i) none or any individual guideline, (ii) any combination of meeting two guidelines, and (iii) those who met all three guidelines, adjusting for child age, gender and socioeconomic status. Only 8.9% of the sample met the overall 24 h movement guidelines. Most of the sample met the physical activity (96.5%) and sleep (79.7%) guidelines but only 11.4% met the sedentary behavior guideline. Average BMI Z-scores did not significantly differ between children who complied with none or any individual guideline, any combination of meeting two guidelines, and those who met all three guidelines (p > 0.05). Although the lack of significant differences, participants who accomplished any combination of two guidelines or all three guidelines appear to have had a lower BMI Z-score than those complying with one of the guidelines or none. Just under 9% of our sample met the overall Australian 24 h Movement Guidelines for the Early Years. BMI was not associated with the accomplishment of any of the 24-h Movement Guidelines. Strategies to

  6. Family and Peer Predictors of Substance Use From Early Adolescence to Early Adulthood: An 11-Year Prospective Analysis

    PubMed Central

    Van Ryzin, Mark J.; Fosco, Gregory M.; Dishion, Thomas J.

    2012-01-01

    The focus of this study was social (i.e., family and peer) influences on substance use from early adolescence to early adulthood. A large, ethnically diverse sample of early adolescents (N = 998) was followed from age 12 to age 23. We tested direct and indirect effects of parental monitoring, family relationship quality, and association with deviant peers on change in substance use across time. Outcomes for tobacco, alcohol, and marijuana use were analyzed as separate pathways within the same overall model. The results suggest that a significant shift in the nature of family influence occurred across adolescence and into early adulthood, but deviant peer influence was relatively consistent across this period. Specifically, parental monitoring and deviant peer association were predictive of substance use in early adolescence, but family relationship quality was a significant predictor across the transition to high school and generally continued to predict use into later adolescence, as did association with deviant peers. Deviant peers were the only significant predictor in early adulthood. Our results also suggested that parental monitoring and family relationship quality indirectly predicted later substance use by way of deviant peers, implying that an important aspect of the family context is its influence on choice of friends and peer group composition. Implications for family-based prevention and intervention are discussed. PMID:22958864

  7. A Grounded Theory of Mothering in the Early Years for Women Recovering From Substance Use.

    PubMed

    Marcellus, Lenora

    2017-08-01

    Women in recovery from addiction experience significant sociostructural barriers to reestablishing self, family, and home after having a baby. The aim of this grounded theory study was to describe pathways that women and their families followed and how transitions were experienced in the early years after receiving services through an integrated community-based maternity program. Eighteen women completed questionnaires and participated in a series of semistructured interviews over 2 years. The overall process women experienced was that of holding it together, which women did by restoring their sense of self during recovery, becoming a strong center for their family, and creating a sense of home no matter what the circumstances. Key elements supporting women in their transition to recovery and parenthood included longer term health, social, and recovery programs and services that addressed determinants of health (in particular, gender, housing, and income), and receiving support provided from strengths-based perspectives.

  8. Recollection of the early years of the research on cytochrome P450

    PubMed Central

    OMURA, Tsuneo

    2011-01-01

    Since the publication of the first paper on “cytochrome P450” in 1962, the biochemical research on this novel hemoprotein expanded rapidly in the 1960s and the 1970s as its principal roles in various important metabolic processes including steroid hormone biosynthesis in the steroidogenic organs and drug metabolism in the liver were elucidated. Establishment of the purification procedures of microsomal and mitochondrial P450s in the middle of the 1970s together with the introduction of molecular biological techniques accelerated the remarkable expansion of the research on P450 in the following years. This review paper summarizes the important developments in the research on P450 in the early years, for about two decades from the beginning, together with my personal recollections. PMID:22156409

  9. Is trauma in Switzerland any different? epidemiology and patterns of injury in major trauma - a 5-year review from a Swiss trauma centre.

    PubMed

    Heim, C; Bosisio, F; Roth, A; Bloch, J; Borens, O; Daniel, R T; Denys, A; Oddo, M; Pasquier, M; Schmidt, S; Schoettker, P; Zingg, T; Wasserfallen, J B

    2014-01-01

    Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide. Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders. Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS >15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥ 3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS >15 was 26.2%. This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by >50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.

  10. Clinical and demographic features of burn injuries in karachi: a six-year experience at the burns centre, civil hospital, Karachi

    PubMed Central

    Ali, S.A.; Hamiz-ul-Fawwad, S.; Al-Ibran, E.; Ahmed, G.; Saleem, A.; Mustafa, D.; Hussain, M.

    2016-01-01

    Summary Burn injuries are a leading cause of morbidity and mortality, with 195,000 deaths annually. This study was conducted to identify the demographics of burn victims and the effect of different variables on the outcome of their injuries. 4016 patients admitted to the Burns Centre, Civil Hospital Karachi from January 2006 to December 2011 were retrospectively analyzed. Demographics, burn injury details and their outcome were recorded in a pre-designed questionnaire. Injuries were categorized as: fire, chemical, scald or electrical. To estimate total body surface area (TBSA) burned in adults, the rule of nines was used. For children and infants, the Lund-Browder chart was employed. SPSS v16.0 software was used for analysis. Frequencies and percentages of all variables, and the measure of central tendencies and dispersion for continuous variables were calculated. Cross tabs were used to assess mortality. Mean age was 28.13 years. More than half of the cases (n=2337, 58.2%) were aged between 16-30 years. Labourers, housewives and students were the most commonly affected groups. Burn injuries by flame/fire and electricity were most common. Most cases were accidental, followed by suicide attempts and homicides. Mean percentage of TBSA affected was 35.49%. Mean duration of hospital stay was 16.45 days. 50.6% of the expired cases were females. The mean age of expired patients was 30.07 while for patients who survived it was 27.01 years. The outcome of burn injuries is related to various demographic factors. Female gender, increasing age, burn injuries following suicide attempts and greater surface area involvement predict poor outcome. PMID:27857643

  11. Arterial stiffness in 10-year-old children: current and early determinants.

    PubMed

    Schack-Nielsen, Lene; Mølgaard, Christian; Larsen, Dorthe; Martyn, Christopher; Michaelsen, Kim Fleischer

    2005-12-01

    It has been suggested that CVD has its origins in early life. An impairment of fetal growth and early postnatal nutrition may have programming effects on cardiovascular physiology. In addition, traditional risk factors for CVD may initiate the atherosclerotic process during childhood. We explored the effect of fat intake, physical activity and lipid profile in childhood, and birth weight, growth during infancy and breast-feeding on arterial stiffness in a cohort study of ninety-three 10-year-old children followed during infancy and re-examined at the age of 10 years. Arterial stiffness in two arterial segments (aorto-radial and aorto-femoral) was measured as pulse wave velocity. Arterial stiffness was inversely associated with physical activity (a regression coefficient in cm/s (95 % CI) of -6.8 (-11.2, -2.4) and -3.9 (-6.9, -0.8) per h of high physical activity/d in the aorto-radial and aorto-femoral segments, respectively). Arterial stiffness was also positively associated with dietary fat energy percentage (3.1 (95 % CI 0.9, 5.2) and 1.8 (95 % CI 0.2, 3.2) per fat energy percentage in the aorto-radial and aorto-femoral segments, respectively) but was not related to body composition, insulin resistance or lipid profile. Arterial stiffness was also positively associated with duration of breast-feeding for the aorto-femoral segment only (2.1 (95 % CI 0.4, 3.7) per month) but was not associated with growth in early life. In conclusion, patterns of physical activity and diet, and history of breast-feeding in infancy, have an influence on the stiffness of the large arteries in children. The long-term effects of this are unknown.

  12. The one-year impact of an emotion regulation intervention on early adolescent health risk behaviors

    PubMed Central

    Houck, Christopher D.; Barker, David; Hadley, Wendy; Brown, Larry K.; Lansing, Amy; Almy, Brandon; Hancock, Evan

    2016-01-01

    Objective Sexual activity often begins in early adolescence, and adolescents with mental health symptoms are at greater risk for sexual activity and other health risks. This study aimed to evaluate a developmentally targeted intervention designed to enhance early adolescents’ emotion regulation competencies as a strategy for reducing health risk behaviors, including sexual initiation. Method Adolescents 12 to 14 years old (N = 420; 53% male) with mental health symptoms participated in either an Emotion Regulation (ER) or Health Promotion (HP) intervention consisting of twelve after-school sessions. Participants completed questionnaires on laptop computers at baseline, 2-, 6-, and 12-month follow-ups. Results Time to event analyses were used to compare intervention conditions on rate of initiation to vaginal sex. Results showed that participants in the Emotion Regulation (ER) condition were less likely to transition into vaginal sexual activity by one-year follow-up than those in the Health Promotion (HP) condition (adjusted hazard ratio = 0.58, 95% CI: 0.36 to 0.94, p = .01). However, those who were sexually active did not report differences in sexual risk behaviors (e.g., condomless sex). Participants in the ER condition were significantly less likely to report violence behaviors and showed improvement on a behavioral measure of emotion identification, however they did not differ from HP participants on self-reports of emotional competence. Conclusions Emotion regulation strategies can be used to delay sexual initiation among early adolescents with mental health symptoms and may have an important role in health education. PMID:27175579

  13. Maternal hypothyroxinaemia in early pregnancy and problem behavior in 5-year-old offspring.

    PubMed

    Oostenbroek, Maurits H W; Kersten, Remco H J; Tros, Benjamin; Kunst, Anton E; Vrijkotte, Tanja G M; Finken, Martijn J J

    2017-07-01

    There is evidence, though not consistent, that offspring born to mothers with subtle decreases in thyroid function early in their pregnancies may be at risk of cognitive impairments and attention problems. However, other types of problem behavior have not been addressed thus far. We tested whether maternal thyroid function in early pregnancy is associated with several types of problem behavior in offspring at age 5-6 years. This was a longitudinal study that included the data of 2000 mother-child pairs from the Amsterdam Born Children and their Development study. At a median gestational age of 12.9 (interquartile range: 11.9-14.1) weeks, maternal blood was sampled for assessment of free T4 and TSH. Overall problem behavior, hyperactivity/inattention, conduct problems, emotional problems, peer relationship problems and prosocial behavior were measured at age 5-6 years using the Strengths and Difficulties Questionnaire, which was filled out by both parents and teachers. Maternal hypothyroxinaemia <5th percentile was associated with a 1.70 (95% confidence interval (CI): 1.01-2.86) increased odds of teacher-reported hyperactivity/inattention after adjustment for confounders. By increasing the cut-off level to <10th percentile, the odds ratio became 1.47 (95% CI: 0.99-2.20). There were no associations between maternal thyroid function parameters and hyperactivity/inattention as reported by parents, nor with teacher or parent reports of other types of problem behavior. Our results partially confirm previous observations, showing that early disruptions in the maternal thyroid hormone supply may be associated with ADHD symptoms in offspring. Our study adds that there is no evidence for an effect on other types of problem behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The cross-lagged relationship between father absence and child problem behaviour in the early years.

    PubMed

    Flouri, E; Narayanan, M K; Midouhas, E

    2015-11-01

    Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross-lagged relationship between father absence (non-residence) and child problem behaviour in the early years. We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2-4). The sample was 15,293 families in which both biological parents were co-resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut-offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Father absence at age 3 predicted a higher probability of the child scoring above cut-off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross-lagged relationships were similar for boys and girls. Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. © 2015 John Wiley & Sons Ltd.

  15. The cross‐lagged relationship between father absence and child problem behaviour in the early years

    PubMed Central

    Narayanan, M. K.; Midouhas, E.

    2015-01-01

    Abstract Background Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross‐lagged relationship between father absence (non‐residence) and child problem behaviour in the early years. Methods We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2–4). The sample was 15 293 families in which both biological parents were co‐resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut‐offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Results Father absence at age 3 predicted a higher probability of the child scoring above cut‐off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross‐lagged relationships were similar for boys and girls. Conclusions Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. PMID:25708874

  16. Investigating teacher and student effects of the Incredible Years Classroom Management Program in early elementary school.

    PubMed

    Murray, Desiree W; Rabiner, David L; Kuhn, Laura; Pan, Yi; Sabet, Raha Forooz

    2018-04-01

    The present paper reports on the results of a cluster randomized trial of the Incredible Years® Teacher Classroom Management Program (IY-TCM) and its effects on early elementary teachers' management strategies, classroom climate, and students' emotion regulation, attention, and academic competence. IY-TCM was implemented in 11 rural and semi-rural schools with K-2 teachers and a diverse student sample. Outcomes were compared for 45 teachers who participated in five full day training workshops and brief classroom consultation and 46 control teachers; these 91 teachers had a total of 1192 students. A high level of teacher satisfaction was found and specific aspects of the training considered most valuable for early elementary teachers were identified. Hierarchical linear modeling indicated a statistically significant intervention effect on Positive Climate in the classroom (d=0.45) that did not sustain into the next school year. No main effects on student outcomes were observed, although a priori moderator analyses indicated that students with elevated social-behavioral difficulties benefitted with regard to prosocial behavior (d=0.54) and inattention (d=-0.34). Results highlight potential benefits and limitations of a universal teacher training program for elementary students, and suggest strategies for future delivery of the IY-TCM program and areas for future research. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  17. The Role of Language Skill in Child Psychopathology: Implications for Intervention in the Early Years.

    PubMed

    Salmon, Karen; O'Kearney, Richard; Reese, Elaine; Fortune, Clare-Ann

    2016-12-01

    In this narrative review, we suggest that children's language skill should be targeted in clinical interventions for children with emotional and behavioral difficulties in the preschool years. We propose that language skill predicts childhood emotional and behavioral problems and this relationship may be mediated by children's self-regulation and emotion understanding skills. In the first sections, we review recent high-quality longitudinal studies which together demonstrate that that children's early language skill predicts: (1) emotional and behavioral problems, and this relationship is stronger than the reverse pattern; (2) self-regulation skill; this pattern may be stronger than the reverse pattern but moderated by child age. Findings also suggest that self-regulation skill mediates the relation between early language skill and children's emotional and behavioral problems. There is insufficient evidence regarding the mediating role of emotion understanding. In subsequent sections, we review evidence demonstrating that: (1) particular kinds of developmentally targeted parent-child conversations play a vital role in the development of language skill, and (2) some current clinical interventions, directly or indirectly, have a beneficial impact on children's vocabulary and narrative skills, but most approaches are ad hoc. Targeting language via parent-child conversation has the potential to improve the outcomes of current clinical interventions in the preschool years.

  18. Getting Ready for School: The Early Childhood Cluster Initiative of Palm Beach County, Florida. Program Implementation and Early Outcomes: Year 3 Report

    ERIC Educational Resources Information Center

    Spielberger, Julie; Baker, Stephen; Winje, Carolyn; Mayers, Leifa

    2009-01-01

    Chapin Hall has been conducting an implementation and evaluability study of the ECCI (Early Childhood Cluster Initiative) project since the midway point of its first year. As described in the authors' first report (Spielberger & Goyette, 2006), the initiative made considerable progress in its initial year, particularly in implementing the…

  19. Comparison of clinical outcomes in diabetic and non-diabetic burns patients in a national burns referral centre in southeast Asia: A 3-year retrospective review.

    PubMed

    Low, Zhao-Kai; Ng, Wai-Yee; Fook-Chong, Stephanie; Tan, Bien-Keem; Chong, Si-Jack; Hwee, Jolie; Tay, Sook-Muay

    2017-03-01

    Diabetic burns patients may be at risk of worse clinical outcomes. This study aims to further investigate the impact of diabetes mellitus on clinical outcomes in burns patients in Singapore. A 3-year retrospective review was performed at the Singapore General Hospital Burns Centre (2011-2013). Pure inhalational burns were excluded. Diabetic (N=53) and non-diabetic (N=533) patients were compared, and the impact of diabetes on clinical outcomes, adjusting for confounders, was investigated using multivariate logistic regression. The diabetic group had a significantly higher incidence of wound infection and severe renal impairment, as well as a longer length of stay, higher number of operations and higher rate of unplanned readmission. ICU admission was significantly associated with hyperglycaemia (OR 5.44 [2.61-11.35], p<0.001) and a higher total body surface area of burn (OR per 1% TBSA 1.07 [1.05-1.09], p<0.001). Unplanned readmission was significantly associated with wound infection (OR 4.29 [1.70-10.83], p=0.002), and mortality associated with a higher TBSA (OR per 1% TBSA 1.1 [1.07-1.14], p<0.001). After adjusting for confounders, diabetes mellitus was not significantly associated with unplanned readmission or mortality. Diabetic burns patients have an increased risk of worse clinical outcomes, including wound infections, renal impairment and longer length of stay. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  20. Regulatory effects on particulate pollution in the early hours of Chinese New Year, 2015.

    PubMed

    Lai, Yonghang; Brimblecombe, Peter

    2017-08-23

    Human activities are a key driver of air pollution, so it is hardly surprising that celebrations affect air quality. The use of fireworks contributes to high particulate concentrations in many parts of the world, with the Chinese Lunar New Year (spring festival) particularly noticeable, as firecrackers are traditionally used to drive off evil spirits. Fireworks lead to short-term peaks in the concentration of PM10, PM2.5 and SO 2 . Regulatory actions that restrict the use of fireworks have been evident in China since the 1990s. This paper investigates the particulate concentrations in nine Chinese cities (Beijing, Chengdu, Chongqing, Tianjin, Xi'an, Nanjing, Shanghai, Guangzhou and Shenzhen, along with Hong Kong (a Special Administrative Region) and Taipei and Kaohsiung (Taiwan) with a particular focus on the celebrations of 2015. Extremely high concentrations of particulate matter were observed, with some sites revealing peak PM10 concentrations in excess of 1000 μg m -3 in the early hours of the New Year. In Beijing, Tianjin and Chongqing, the activities caused high particulate matter concentrations at most sites throughout the city. These peaks in particulate load in the early hours of Chinese New Year do not appear to be closely related to meteorological parameters. However, in cities where fireworks appear to be better regulated, there are fewer sharp pollution peaks just after midnight, although lowered air quality can still be found in the outer parts of some cities, remote from regulatory pressures. A few cities seem to have been effective at reducing the impact of the celebrations on air quality, with Nanjing a recent example. An increasing focus on light displays and electric lanterns also seems to offer a sense of celebration with much reduced impacts on air quality.