Children\u27s Time Outdoors: Results from a National Survey

Abstract In the past decade, much has been said and written about American children’s declining outdoor leisure time. These claims are confounded by the absence of a baseline for detecting trends in children’s activities and time spent outdoors. The USDA Forest Service initiated a general population telephone survey, the National Kids Survey, to address this issue. This paper summarizes data collected during the first phase of this project (2007-2009). Results suggest that most children across all demographic groups are spending a substantial amount of time outdoors daily. Interaction with the natural environment varies as playing/hanging out, physical activities, and technology-centered activities appear to be more popular than nature-based activities. Future research efforts should build on these initial data and continue to monitor children’s outdoor activities patterns across diverse populations

Space Station Engineering Design Issues

Space Station Freedom topics addressed include: general design issues; issues related to utilization and operations; issues related to systems requirements and design; and management issues relevant to design

Childhood intellectual disability and parents' mental health: integrating social, psychological and genetic influences.

BACKGROUND: Intellectual disability has a complex effect on the well-being of affected individuals and their families. Previous research has identified multiple risk and protective factors for parental mental health, including socioeconomic circumstances and child behaviour. AIMS: This study explored whether genetic cause of childhood intellectual disability contributes to parental well-being. METHOD: Children from across the UK with intellectual disability due to diverse genetic causes were recruited to the IMAGINE-ID study. Primary carers completed the Development and Well-being Assessment, including a measure of parental distress (Everyday Feeling Questionnaire). Genetic diagnoses were broadly categorised into aneuploidy, chromosomal rearrangements, copy number variants (CNVs) and single nucleotide variants. RESULTS: Compared with the UK general population, IMAGINE-ID parents (n = 888) reported significantly elevated emotional distress (Cohen's d = 0.546). Within-sample variation was related to recent life events and the perceived impact of children's difficulties. Impact was predicted by child age, physical disability, autistic characteristics and other behavioural difficulties. Genetic diagnosis also predicted impact, indirectly influencing parental well-being. Specifically, CNVs were associated with higher impact, not explained by CNV inheritance, neighbourhood deprivation or family structure. CONCLUSIONS: The mental health of parents caring for a child with intellectual disability is influenced by child and family factors, converging on parental appraisal of impact. We found that genetic aetiologies, broadly categorised, also influence impact and thereby family risks. Recognition of these risk factors could improve access to support for parents, reduce their long-term mental health needs and improve well-being of individuals with intellectual disability.This work was supported by the UK Medical Research Council (grant number G101400 to K.B.), UK Medical Research Council and Medical Research Foundation (grant number MR-N022572-1 to the IMAGINE-ID study; Principle Investigators: David H. Skuse, F Lucy Raymond, Jeremy Hall, Marianne Van den Bree, Michael J. Hall) and the Baily Thomas Charitable Trust (to K.B.)

The Effects of Foam Rolling on Hamstring Flexibility, Muscle Soreness and Power

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Litigation involving patients with slipped capital femoral epiphysis

Background Slipped capital femoral epiphysis (SCFE) is a hip disorder of late childhood and adolescence. Litigation involving SCFE may occur, as it is frequently diagnosed late, and/or may be temporally related to an injury. The purpose of this study was to review litigation cases involving SCFE in the US, focusing on the type of litigation (professional, premise, or product liability), the outcome of the litigation and indemnity payouts. Methods Cases of litigation involving SCFE were identified using 5 legal databases and Google Scholar searching for the term “slipped capital femoral epiphysis”. These databases originated as early as 1973. The data collected was the alleged complaint, type of defendant, outcome, state where filed, and amount of indemnity payout. Payout amounts were converted to 2020 US$. Statistical analyses were performed with SYSTAT® 10 software. Results There were 135 unique cases identified which involved professional liability (103), premise liability (30), both premise and professional liability (1), and product liability (1). Complaints for professional liability cases were alleged failure in diagnosis (71), inappropriate treatment (14), both diagnosis and treatment (12), and others (7). The delay in those with an alleged late diagnosis (37 cases) was 5.8 months. The three most common specialties named as defendant(s) were primary care (31$1.28 million. Payout was higher in the complaints for professional compared to premise liability ($1.5 vs.$0.9 million). The average payout for those with and without avascular necrosis was $2.97 million vs.$1.02 million. For the professional liability claims, indemnity payout was most frequent in the Western US. It must be remembered that this study only represents law suits filed in the US court system. It does not include cases that might have been resolved prior to any legal action as those cases are not publicly available. Conclusions Reported litigation involving SCFE patients involved claims of professional liability in 77% and premise liability in 22% of located cases. Due to significant exposure, this study should serve as a reminder to all health care providers to include SCFE in the differential diagnosis of knee/thigh pain in adolescents

The time-dependent localization of Ki 67 antigen-positive cells in human skin wounds

A total of 77 human skin wounds with a post-infliction interval between 3 h and 7 months were investigated and the proliferation marker antigen Ki 67 was visualized in paraffin sections using a specific monoclonal antibody (MIB). The re-built epidermal layer covering the former lesional area showed only a few basal cells positively staining for Ki 67 antigen. No enhanced reactivity was found when compared to uninjured skin. In basal cells of the epidermis adjacent to the wound area, however, varying numbers of positive cells occurred, but no information useful for a reliable time estimation of skin wounds could be obtained due to the considerable variability in the number of Ki 67 positive epidermal basal cells found in non-damaged skin. Fibroblastic cells in the wound area revealed an increased number of Ki 67-positive sites which could first be detected in a 1.5-day-old skin lesion. Positive results could be obtained in every specimen investigated after a post-infliction interval of 6 days up to 1.5 months. Only the scar tissue of the oldest wound examined (wound age 7 months) revealed no increase in the number of positively staining fibroblasts. Therefore, positive results indicate a wound age of at least approximately 1.5 days and the lack of an increased number of positive fibroblastic cells in a sufficient number of specimens indicates at a wound age of less than 6 days, but cannot totally exclude longer post-infliction intervals

Immunohistochemical localization of collagen types I and VI in human skin wounds

A total of 74 human skin wounds were investigated and collagen types I and VI were localized in the wound area by immunohistochemistry. Collagen type I appeared in the form of ramifying string-like structures after approximately 5–6 days, but positive reactions in the form of a spot-like staining around isolated fibroblasts also occurred in a skin wound aged 4 days. Collagen VI was detectable after a post-infliction interval of at least 3 days showing a strongly positive reacting network associated with fibroblasts in the wound area. Both collagens appeared almost constantly after a wound age of 6–7 clays and could also be found in wounds aged a few months. Therefore, although a positive reaction for collagen type I in the form of string-like and ramifying structures around wound fibroblasts indicates a wound age of at least 5–6 days, a spot-like positive staining for collagen type I cannot exclude a wound age of at least 4 days. A positive staining for collagen type VI represents a post-infliction time of 3 days or more. The almost constant appearance of these collagen types suggests that negative results in a sufficient number of specimens indicate a wound age of less than 6–7 days, but cannot completely exclude longer post-infliction intervals. Since collagen type I and VI are also found in the granulation/scar tissue of lesions with advanced wound age, the immunohistochemical analysis of these proteins provides no further information for an age determination of older skin wounds

Multivisceral intestinal transplantation: Surgical pathology

We report the diagnostic surgical pathology of two children who underwent multivisceral abdominal transplantation and survived for 1 month and 6 months. There is little relevant literature, and diagnostic criteria for the various clinical possibilities are not established; this is made more complicated by the simultaneous occurrence of more than one process. We based our interpretations on conventional histology, augmented with immunohistology, including HLA staining that distinguished graft from host cells in situ. In some instances functional analysis of T cells propagated from the same biopsies was available and was used to corroborate morphological interpretations. A wide spectrum of changes was encountered. Graft-versus-host disease, a prime concern before surgery, was not seen. Rejection was severe in 1 patient, not present in the other, and both had evidence of lymphoproliferative disease, which was related to Epstein-Barr virus. Bacterial translocation through the gut wall was also a feature in both children. This paper documents and illustrates the various diagnostic possibilities.. © 1989 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted