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Anne M. Connolly Julaine M. Florence Mary M. Cradock Elizabeth C. Malkus Jeanine R. Schierbecker Catherine A. Siener Charlie O. Wulf Pallavi Anand Paul T. Golumbek Craig M. Zaidman J. Philip Miller Linda P. Lowes Lindsay N. Alfano Laurence Viollet-Callendret Kevin M. Flanigan Jerry R. Mendell Craig M. McDonald Erica Goude Michelle Eagle 《Neuromuscular disorders : NMD》2013,23(7):529-539
Therapeutic trials in Duchenne Muscular Dystrophy (DMD) exclude young boys because traditional outcome measures rely on cooperation. The Bayley III Scales of Infant and Toddler Development (Bayley III) have been validated in developing children and those with developmental disorders but have not been studied in DMD. Expanded Hammersmith Functional Motor Scale (HFMSE) and North Star Ambulatory Assessment (NSAA) may also be useful in this young DMD population. Clinical evaluators from the MDA-DMD Clinical Research Network were trained in these assessment tools. Infants and boys with DMD (n = 24; 1.9 ± 0.7 years) were assessed. The mean Bayley III motor composite score was low (82.8 ± 8; p ? .0001) (normal = 100 ± 15). Mean gross motor and fine motor function scaled scores were low (both p ? .0001). The mean cognitive comprehensive (p = .0002), receptive language (p ? .0001), and expressive language (p = .0001) were also low compared to normal children. Age was negatively associated with Bayley III gross motor (r = ?0.44; p = .02) but not with fine motor, cognitive, or language scores. HFMSE (n = 23) showed a mean score of 31 ± 13. NSAA (n = 18 boys; 2.2 ± 0.4 years) showed a mean score of 12 ± 5. Outcome assessments of young boys with DMD are feasible and in this multicenter study were best demonstrated using the Bayley III. 相似文献
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Handedness for grasping objects and pointing and the development of language in 14-month-old infants
The goal of this study was to evaluate the relationship between object-related handedness and handedness for communicative gestures. We observed 22 infants aged 14 months on a baby laterality test consisting of grasping objects in different conditions, on a pointing task with targets placed out of reach at different spatial positions from left to right, and on word understanding and word production. Results show that 77% of infants pointed to the left, middle, and right targets. The majority of infants were right-handed for pointing—except for the far left target—and, to a lesser extent, for grasping objects, but there was no significant relation between the two measures of handedness. The frequency of pointing tended to be related to the number of words understood, and infants right-handed for pointing understood and produced significantly more words than non-right-handed pointers. These results are interpreted as confirming the link between pointing and language development, and as showing that communicative gesture lateralisation is not a mere consequence of object-related handedness, at least during development. Whether lateralised communicative gesture reinforces a pre-existing tendency to use the right hand to interact with objects remains an open question. 相似文献
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Background
Newly qualified and inexperienced nurses are at particular risk of suffering emotional exhaustion and burnout in unsupportive practice environments. Despite new nurses’ potential vulnerability, development of burnout after graduation has rarely been studied longitudinally and in relation to demographic and educational characteristics prior to working life entry, i.e. during education.Objectives
To identify and compare typical change trajectories (i.e. common patterns of intra-individual development) in burnout symptoms for new graduate nurses annually over a three-year period, during which there was reason to believe that this group was especially vulnerable.Design
A prospective longitudinal and national cohort of 1153 nurses within the population-based LANE study (Longitudinal Analyses of Nursing Education), where new graduate nurses were assessed four times annually, i.e. in their final year of nursing education and three times post graduation (after 1, 2 and 3 years).Participants
A longitudinal sample of 997 respondents was prospectively followed.Methods
Within-group changes in burnout levels were analysed using a repeated-measures analysis of variance, and cluster analytic techniques were used to identify typical trajectories of burnout.Results
At group level, mean levels of burnout were rather stable across time. However, underlying these levels we identified eight change trajectories, explaining 74% of all individual variation; seven of them reflected significant changes across time. Almost every fifth nurse reported extremely high levels of burnout at some point during their first three years after graduation. Changes in burnout levels were accompanied by concurrent changes in depressive symptoms and intention to leave the profession. This study also showed that negative development of burnout was predicted by not feeling well prepared for a nursing job, lacking study interest, high levels of performance-based self-esteem and depressive mood in the final year of education.Conclusions
An investigation of burnout symptoms over time disclosed numerous development patterns, some of which were stable while others changed significantly. Hence, this study gave a more nuanced picture of burnout development among new graduate nurses, highlighted by eight different trajectories. Regarding the time frame, nearly every second new graduate showed a significant increase in levels of burnout during their second year post graduation. 相似文献105.
《European journal of paediatric neurology》2019,23(3):525-536
Traumatic brain injury (TBI) is a heterogeneous disorder in which diffuse axonal injury (DAI) is an important component contributing to executive dysfunction. During adolescence, developing brain networks are especially vulnerable to acceleration-deceleration forces. We aimed to examine the correlation between DAI (number and localization) and executive functioning in adolescents with TBI.We recruited 18 adolescents with a mean age of 15y8m (SD = 1y7m), averaging 2.5 years after sustaining a moderate-to-severe TBI with documented DAI. Susceptibility Weighted Imaging sequence was administered to localize the DAI lesions. The adolescents performed a neurocognitive test-battery, addressing different aspects of executive functioning (working memory, attention, processing speed, planning ability) and their parents completed the Behavior Rating Inventory of Executive Function (BRIEF) – questionnaire. Executive performance of the TBI-group was compared with an age and gender matched control group of typically developing peers. Based on these results we focused on the Stockings of Cambridge test and the BRIEF to correlate with the total number and location of DAI. Results revealed that the anatomical distribution of DAI, especially in the corpus callosum and the deep brain nuclei, may have more implications for executive functioning than the total amount of DAI in adolescents. Results of this study may help guide targeted rehabilitation to redirect the disturbed development of executive function in adolescents with TBI. 相似文献
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