School-related experience and performance with inflammatory bowel disease: results from a cross-sectional survey in 675 children and their parents

Objective We describe school performance and experience in children with inflammatory bowel disease (IBD) across Germany and Austria. Predictors of compromised performance and satisfaction were evaluated to identify subgroups of increased risk. Design This cross-sectional analysis was based on a postal survey in children aged 10-15 with Crohn's disease, ulcerative colitis or unclassified IBD and their families. Multivariate regression analysis was used to assess influential factors on parental satisfaction with school, attending advanced secondary education (ASE), having good marks and having to repeat a class. Satisfaction was assessed based on the Child Healthcare-Satisfaction, Utilisation and Needs instrument (possible range 1.00-5.00). Results Of 1367 families contacted, 675 participated in the study (49.4%). Sixty-eight participants (10.2%) had repeated a year, 312 (46.2%) attended ASE. The median school satisfaction score was 2.67 (IQR 2.00-3.33). High socioeconomic status (SES) and region within Germany were predictive for ASE (OR high SES 8.2, 95% CI 4.7 to 14.2). SES, female sex and region of residence predicted good marks. Grade retention was associated with an active disease course (OR 2.7, 95% CI 1.4 to 5.3) and prolonged periods off school due to IBD (OR 3.9, 95% CI 1.8 to 8.6). Conclusions A severe disease course impacted on the risk of grade retention, but not on type of school attended and school marks. Low satisfaction of parents of chronically ill children with the school situation underlines the need for a more interdisciplinary approach in health services and health services research in young people

Removal of hydrogen from Ti VT 1-0 under action of accelerated electrons

The process of hydrogen removal from titanium of VT1-0 grade under the action of accelerated electrons has been studied experimentally. The irradiation was carried out by an electron beam with energies of 25-40 keV during 15-60 min. The information on the hydrogen content in samples from titanium of VT1-0 grade has been obtained both before and after irradiation with accelerated electrons. The activation energy of hydrogen desorption from titanium has been calculated. It was found that the increase of the time and the energy of an irradiation lead to the decrease of the residual hydrogen content in the titanium samples

Transition from pediatric to adult medical care – A survey in young persons with inflammatory bowel disease

BACKGROUND: Transition to adult health services is a vulnerable phase in young persons with chronic disease. We describe how young persons with inflammatory bowel disease in Germany and Austria experience care during the transitional age, focusing on differences by type of provider (pediatric vs. adult specialist, no specialist). METHODS: This was a follow up survey in patients previously registered with a pediatric IBD registry. Patients aged 15 to 25 received a postal questionnaire, including a measure of health care experience and satisfaction. Descriptive analyses were stratified by age. Sub-analyses in the 18–20 year age group compared health care experience by type of provider. Determinants of early or late transfer were examined using multinomial logistic regression. RESULTS: 619 patients responded to the survey; 605 questionnaires were available for analysis. Usual age of completing transition was 18. Earlier transfer was more common with low parental SES (OR 1.8, 95% CI 0.7 to 4.6), and less common with advanced schooling (OR 0.5, 95% CI 0.2 to 1.2). Structured transition was uncommon. 48% of the respondents had not received any preceding transition advice. Overall satisfaction with IBD care was high, especially with respect to interpersonal aspects, but less so in aspects of continuity of care. CONCLUSIONS: Despite high overall patient satisfaction, relevant deficiencies in transitional care were documented. Some of these were associated with lower parental social status. Differences in health care satisfaction by type of provider (adult vs. pediatric) were small

Single item performance, details: Items in need of improvement (n = 583).

<p>Single item performance, details: Items in need of improvement (n = 583).</p

Determinants of early and late transfer (multinomial regression) (OR with 95% CI).

<p>Reference categories: male sex, intermediate schooling, age of onset 14+, middle region, middle SES, ulcerative colitis + not specified.</p

Patient satisfaction: Single item performance, overview (n = 583).

<p>Patient satisfaction: Single item performance, overview (n = 583).</p

Potential determinants of age at transfer (n, row percent; only cases aged > 18).

<p>Potential determinants of age at transfer (n, row percent; only cases aged > 18).</p

Measures taken by IBD doctor to prepare for transition (transferred patients only).

<p>Measures taken by IBD doctor to prepare for transition (transferred patients only).</p

Correlation grid.

<p>Correlation grid.</p

Patient characteristics by current age (n, column percent).

<p>Patient characteristics by current age (n, column percent).</p