The effect of seated positioning quality on typical 6- and 7-year-old children's object manipulation skills.

OBJECTIVE: The purpose of this study was to examine the effect of optimal seated positioning in individually fitted furniture versus suboptimal seated positioning in standard classroom furniture on typical 6- and 7-year-old children's object manipulation skills as measured by the In-hand Manipulation Test (IMT). METHOD: An experimental research design was used to compare IMT performance of two groups of 20 children. One group was positioned in standard, too-large classroom furniture that did not support an optimal seated position, and one group was positioned optimally in furniture fitted to each child for tabletop activities, which allowed for hip flexion to 90 degrees, and foot placement on the floor, and the table to be at flexed elbow height. RESULTS: Independent groups' t tests indicated that children who were optimally positioned performed significantly better (t = -2.77, df = 38, p < .01) than children who were tested in the too-large standard classroom furniture. The difference between groups was greater on the more difficult object manipulation items (t = -3.29, df = 38, p = .001) than on the easier items (t = -1.38, df = 38, p = .08). Age and gender may have differentially affected the results. CONCLUSION: The study's results suggest that the fit of furniture relative to the child's size may have a significant impact on a young, typical child's object manipulation skills. Complex hand skills, such as those involving in-hand manipulation with stabilization, appear to be more affected by the quality of the child's seated position than are simpler, more well-established skills. Findings suggest that test administrators should strive to test young children in the most optimal seated position possible, particularly when the test involves complex hand skills. Further study is needed to assess the impact of the fit of furniture on hand skills in children with disabilities and on children's performance of other tasks.     

Assessment of quality of life in children with peanut allergy

Children with a peanut allergy (PA) are faced with food and social restrictions due to the potentially life-threatening nature of their disease, for which there is no cure or treatment. This inevitably impacts upon their quality of life (QoL). QoL of 20 children with PA and 20 children with insulin-dependent diabetes mellitus (IDDM) was measured using two disease-specific QoL questionnaires (higher scores correspond to a poorer QoL). One questionnaire was designed by us and the other was adapted from the Vespid Allergy QoL questionnaire. We gave subjects cameras to record how their QoL is affected over a 24-h period. Response rates for both questionnaires were 100%. Mean ages were 9.0 and 10.4 years for PA and IDDM subjects, respectively. Children with a PA reported a poorer quality of life than children with IDDM: mean scores were 54.85 for PA subjects and 46.40 for diabetics (p = 0.004) in questionnaire 1 and 54.30 and 34.50 (p≤0.001) in questionnaire 2. PA children reported more fear of an adverse event and more anxiety about eating, especially when eating away from home. Photographs fell into seven common categories: food, management, environment, away from home, physical activities, restaurant and people. Most photographs related to food and management issues and revealed difficulties for both groups regarding food restrictions. PA subjects felt more threatened by potential hazards within their environment, felt more restricted by their PA regarding physical activities, and worried more about being away from home. However, they felt safe when carrying epinephrine kits and were positive about eating at familiar restaurants. The QoL in children with PA is more impaired than in children with IDDM. Their anxiety may be considered useful in some situations, promoting better adherence to allergen avoidance advice and rescue plans.     

Do cancer patients fully understand clinical trial participation? A pilot study to assess informed consent and patient expectations

Background. Accepted practices of informed consent often result in suboptimal patient understanding of research studies.Methods. This pilot study aimed to assess trial-specific tailored materials, compared to a widely used generic booklet about clinical trials, randomly assigned to 118 candidates for cancer clinical trials. Study outcomes were: satisfaction with decision-making; satisfaction with materials; and subjective understanding of the clinical trial.Results. There were no major differences between groups. Participants rated tailored materials higher as a useful reference.Conclusions. Trial-specific materials hold utility for reference during clinical trials. Studies of informed consent are feasible, although important factors limit research.     

Zur Zulässigkeit der Verwendung menschlichen Körpermaterials für Forschungs- und andere Zwecke

Ohne Zusammenfassung     

Simultaneous measurement of intracellular pH and contraction in uterine smooth muscle

Changes in intracellular pH (pH_i) are thought to produce large changes in force production in the uterus. There have however, been no simultaneous measurements of pH_i and force in the uterus and therefore no direct information is available about the relation between the two. We have used carboxy-SNARF (a pH-sensitive fluorophore) in small strips of longitudinal myometrium and obtained simultaneous measurements of pH_i and force. SNARF did not alter contractile function, and continuous measurements of pH_i could be made for 2 hours. The mean resting pH_i (7.16) was similar to that reported previously. Application of weak bases rapidly raised pH_i, in a concentration-dependent manner, followed by a gradual restoration of pH_i to resting levels. Alkalinization greatly increased the frequency of contractions, often accompanied by a small increase in their amplitude. Removal of base produced a rebound acidification which transiently abolished contractions. Direct acidification of the cytoplasm, by application of weak acid, also abolished contractions. However the alkalinization which accompanied removal of acid, produced variable effects on force.Supported by the M.R.C.     

Benign giant cell tumour with metastases to bone and lung. One case studied over 20 years

We report a case of benign giant cell tumour which over a 20-year period has given rise to pulmonary and bony metastases. The indolent nature of these metastases is remarkable, with considerable implications for the long-term management of such cases.     

Immunohistochemical study of oral keratoses including lichen planus

Biopsies of non-ulcerated oral mucosa from 13 patients with oral lichen planus and 12 patients with leukoplakia were immunohistochemically stained using monoclonal antibodies to pan T, pan B, T helper and T suppressor/cytotoxic cells and the stained lymphocytes enumerated using an image analyser. The results show the preponderance of T cells infiltrating both oral lichen planus and leukoplakia. The T helper: T suppressor/cytotoxic cell ratio was the same (1:2) for both oral lichen planus and leukoplakia. A similar proportion of T suppressor/cytotoxic cells was found infiltrating the epithelium. These data indicate that T cell subset analysis is of no value in distinguishing oral lichen planus from other oral keratoses.