Measuring health status using the Health Utilities Index: agreement between raters and between modalities of administration

The aim of this study was to evaluate interrater and intermodality agreement in assessing health status using the Health Utilities Index. A random sample from a Dutch cohort of 14-year-old Very Low Birth Weight children and their parents were invited to participate in a face-to-face (n = 150) or telephone (n = 150) interview. All 300 participants were also sent a questionnaire by mail. Response rate was 68%. Interrater and intermodality agreement were high for the physical HUI3 attributes and poor for the psychological attributes. Children and parents reported more dysfunction in the psychological attributes when interviewed than when completing the mailed questionnaire. High agreement on the physical attributes may have resulted from the fact that hardly any dysfunction was reported in these attributes, and poor agreement in the psychological attributes may have been a result of the fact that in these attributes much more dysfunction was reported. In measuring children's health status using the HUI3, the results and their interpretation vary with the source of information and the modality of administration. For maximum comparability between studies, written self-report questionnaires seem the preferred option.     

Cardio-metabolic risk in 5-year-old children prenatally exposed to maternal psychosocial stress: the ABCD study

Background  

Recent evidence, both animal and human, suggests that modifiable factors during fetal and infant development predispose for cardiovascular disease in adult life and that they may become possible future targets for prevention. One of these factors is maternal psychosocial stress, but so far, few prospective studies have been able to investigate the longer-term effects of stress in detail, i.e. effects in childhood. Therefore, our general aim is to study whether prenatal maternal psychosocial stress is associated with an adverse cardio-metabolic risk profile in the child at age five.     

Predicting trajectories of behavioral adjustment in children diagnosed with acute lymphoblastic leukemia

Purpose

Previous research showed that children with cancer are at risk for developing behavioral adjustment problems after successful treatment; however, the course of adjustment remains unclear. This study focuses on adjustment trajectories of children during treatment for acute lymphoblastic leukemia (ALL) and aims to distinguish subgroups of patients showing different trajectories during active treatment, and to identify sociodemographic, medical, and psychosocial predictors of the distinct adjustment trajectories.

Methods

In a multicenter longitudinal study, 108 parents of a child (response rate 80 %) diagnosed with ALL were assessed during induction treatment (T0), after induction/consolidation treatment (T1), and after end of treatment (T2). Trajectories of child behavioral adjustment (Child Behavior Checklist; CBCL) were tested with latent class growth modeling (LCGM) analyses.

Results

For internalizing behavior, a three-trajectory model was found: a group that experienced no problems (60 %), a group that experienced only initial problems (30 %), and a group that experienced chronic problems (10 %). For externalizing behavior, a three-trajectory model was also found: a group that experienced no problems (83 %), a group that experienced chronic problems (12 %), and a group that experienced increasing problems (5 %). Only parenting stress and baseline QoL (cancer related) were found to contribute uniquely to adjustment trajectories.

Conclusions

The majority of the children (77 %) showed no or transient behavioral problems during the entire treatment as reported by parents. A substantial group (23 %) shows maladaptive trajectories of internalizing behavioral problems and/or externalizing behavioral problems. Screening for risk factors for developing problems might be helpful in early identification of these children.

     

Current source density correlates of cerebellar Golgi and Purkinje cell responses to tactile input

The overall circuitry of the cerebellar cortex has been known for over a century, but the function of many synaptic connections remains poorly characterized in vivo. We used a one-dimensional multielectrode probe to estimate the current source density (CSD) of Crus IIa in response to perioral tactile stimuli in anesthetized rats and to correlate current sinks and sources to changes in the spike rate of corecorded Golgi and Purkinje cells. The punctate stimuli evoked two distinct early waves of excitation (at <10 and ～ 20 ms) associated with current sinks in the granular layer. The second wave was putatively of corticopontine origin, and its associated sink was located higher in the granular layer than the first trigeminal sink. The distinctive patterns of granular-layer sinks correlated with the spike responses of corecorded Golgi cells. In general, Golgi cell spike responses could be linearly reconstructed from the CSD profile. A dip in simple-spike activity of coregistered Purkinje cells correlated with a current source deep in the molecular layer, probably generated by basket cell synapses, interspersed between sparse early sinks presumably generated by synapses from granule cells. The late (>30 ms) enhancement of simple-spike activity in Purkinje cells was characterized by the absence of simultaneous sinks in the granular layer and by the suppression of corecorded Golgi cell activity, pointing at inhibition of Golgi cells by Purkinje axon collaterals as a likely mechanism of late Purkinje cell excitation.     

Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

Background  

Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL) and those in which the ligament is routinely sacrificed (posterior stabilized). In patients with a functional PCL the decision which design is chosen depends largely on the favour and training of the surgeon.     

The commissural transfer of the horizontal optokinetic signal in the rat: a c-Fos study

Using a precision grip, 12 participants horizontally oscillated a lightweight object at different movement frequencies (1.0, 1.5, and 2.0 Hz) under two types of elastic load. In the first (CENT), the center of oscillation coincided with the neutral position of the object in the elastic force field, leading to two peaks in load force (LF) per cycle of movement (2:1 frequency ratio). In the second (BACK and FRONT), the neutral elastic force position of the object was located outside the range of movement, thus leading to only one LF peak per cycle of movement (1:1 frequency ratio). Results showed that in BACK and FRONT the coupling between grip force (GF) and LF (as reflected by coefficients of correlations) remained strong for all movement frequencies. In contrast, this coupling decreased in CENT as movement frequency increased, with participants switching progressively from two to one GF modulation per cycle of movement. Specific evaluation of performance under conditions giving rise to comparable LF frequencies (CENT at 1.0 Hz vs. BACK/FRONT at 2.0 Hz) confirmed the effect of frequency ratio on GF–LF coupling. We conclude that the control of GF is more efficient when LF varies at the frequency of movement than when it varies at twice this frequency, especially when movement frequency is high. These results are interpreted in the context of coordination dynamics and forward modeling approach.     

Discontinuation of tube feeding in young children by hunger provocation - a randomized controlled trial

Tijdschrift voor Kindergeneeskunde -     

MCM-based microlaboratory for simultaneous measurement of several biochemical parameters by spectrophotometry

This paper reports on the concept, fabrication and characterization of a multi-chip module microlaboratory. The application is in the spectrophotometric analysis of human physiological fluids in a clinical setting. The system is composed of three stacked parts: (1) a central microfluidic system die containing the microchannels, which is fabricated by applying MEMS techniques to an SU-8 layer, (2) an optical filtering system on the top side, fabricated using a dielectric thin-films multilayer and (3) a detection and readout system on the bottom side, which is fabricated in a CMOS microelectronic process. The system modularity and emphasis on microfabrication provides potential for low unit cost. The application is the simultaneous and quantitative measurement of the concentration of four biochemical parameters in human physiological fluids by spectrally selective optical absorption. The intensity of the light transmitted through the physiological fluid results in an electrical output signal in the form of bit streams, which allows simple computer interfacing. A simple white light source is used for illumination, due to the optical filtering system, which makes the microlaboratory portable. The quantitative measurement of chloride, creatinine, total protein and uric acid in urine is successfully demonstrated.