Predicting developmental outcome at school age from infant tests of normal, at-risk and retarded infants

The predictive validity of developmental testing was investigated in term, preterm and retarded children. Verbal, performance and locomotor development were assessed at various ages and individual development curves constructed. Inter-age correlations between development tests at nine to 24 months and intellectual assessment at seven years revealed a strong effect on prediction for age at testing and level of mental performance. Categorisation by level of mental performance demonstrated that at seven years 98.6 per cent of the children with developmental quotients (DQs) greater than 85 at 24 months achieved IQs greater than 85, while 98.7 per cent of the seven- to eight-year-old children with DQs greater than 85 at nine to 24 months achieved IQs greater than 85. The Griffiths language and performance scores and their combination were the strongest predictors of later intellectual functioning. The social score was of moderate significance, while the locomotor score had no predictive value. Analysis of individual development curves revealed that prediction was hampered in some children by factors not detectable by statistical analysis, such as dissociations in development, organic impairment and major life events. Among the prenatal, perinatal and postnatal variables studied, only socio-economic status was of predictive significance; its effect depended on the level of mental performance and was most marked in term children, but it had no effect on retarded children.     

Minimally invasive, longitudinal monitoring of biomaterial-associated inflammation by fluorescence imaging

Implant-associated inflammation is a major cause for the reduced performance/lifetime and failure of numerous medical devices. Therefore, the ability to non-invasively and quantitatively monitor implant-associated inflammation is critically important. Here we show that implant-associated inflammation can be imaged via fluorescence imaging using near-infrared hydrocyanine dyes delivered either locally or intravenously in living mice. This imaging strategy allowed quantitative longitudinal monitoring of inflammation by detecting reactive oxygen species (ROS) released by inflammatory cells in response to implanted poly(ethylene terephthalate) (PET) disks or injected poly (lactic-co-glycolic acid) (PLGA) microparticles, and exhibited a strong correlation to conventional analysis of inflammation. Furthermore, modulation of inflammatory responses via controlled release of the anti-inflammatory agent dexamethasone was detected using this sensitive imaging approach. Thus, hydrocyanine-based fluorescence imaging of ROS could serve as a surrogate measure for monitoring implant-associated inflammation as well as evaluating the efficacy of therapeutic approaches to modulate host responses to implanted medical devices.     

Melanoma knowledge, perception, and awareness in ethnic minorities in Chicago: recommendations regarding education

Objectives: To assess the level of melanoma awareness and risk perception among ethnic minorities and to identify ways to enhance the relevance of melanoma educational materials for ethnic minorities. Methods: Twelve focus groups composed of participants from a single ethnicity [African‐American (n=40), Hispanic (n=40), and Asian (n=40)], participated in a 2 h discussion on melanoma and skin cancer and commented on an educational brochure by the American Cancer Society and reacted to photographs of melanoma on ethnic skin. Participants also evaluated the ability to sunburn and tan and the skin cancer risk of images of celebrities before and after the discussion. Additionally, participants assessed the skin tone of celebrities as very fair, fair, olive, light brown, dark brown, and very dark. The audiotape recordings of the 12 focus groups were transcribed and analyzed with the Non‐numerical Unstructured Data Indexing Searching and Theorizing software for common themes. Results: The common themes were (1) lack of relevance of skin cancer to ethnic people, (2) understanding of skin cancer risk terminology is based on personal experience and what is acquired from the media, and (3) sources of health information for ethnic minorities are fragmented and physicians are not the primary source of information. Celebrity images representing the six skin tones were selected. Conclusions: Relevance of melanoma education to ethnic people may be improved by using ‘melanoma skin cancer’, photographs of early melanoma in people with dark skin, and providing guidance on how to inspect hands and feet for suspicious moles. Copyright © 2010 John Wiley & Sons, Ltd.     

Simplifying paediatric immunization with a fully liquid DTP–HepB–Hib combination vaccine: Evidence from a comparative time-motion study in India

An observational time-motion study investigated logistic, programmatic and safety-related advantages and limits in the delivery of a fully liquid DTP–HepB–Hib combination vaccine versus a lyophilized combination vaccine requiring reconstitution. The study was conducted in 2006, observing 312 child vaccinations in a tertiary hospital setting in Kolkata, India. The time for vaccination was on average 46 s (35.12%) lower with the fully liquid vaccine (p < 0.05). In addition, the fully liquid combination was easier and potentially safer to handle and as well tolerated as the lyophilized formulation. Fully liquid combination vaccines have the potential to simplify immunization schedules, contribute to better resource management and improve efficiency of immunization programs.