Attention Functions in Children with Pediatric Chronic Kidney Disease

Children with chronic kidney disease (CKD) can evidence a variety of general and specific neurocognitive deficits, but little is known regarding the effects of pediatric CKD on specific domains of attention. Using a variety of measures tapping specific domains (e.g., Focus/Execute, Sustain, Stability, Shift, Encode), the current study compared attention outcomes for school-age children with CKD to those of a typicallydeveloping control group. The study addressed the following research questions: 1) Do specific domains of attention in children and adolescents with CKD differ significantly from those measured in typically-developing children and adolescents? 2) Do pediatric patients with CKD differ significantly from typically-developing children in their observed proportion of attention problems? 3) What functional- (e.g., recent school absences, IQ), family- (e.g., socioeconomic status), and disease-related (e.g., disease severity, age of onset, duration of disease) characteristics predict attention domain scores? Significant differences on group means were revealed between the CKD (n = 30) and control (n = 41) groups on the Focus/Execute, Sustain, Stability, and Encode attention domains; no group differences were evident on the Shift domain. The CKD group also had a larger proportion of children with attention domain scores one standard deviation or more below the mean on the Shift and Encode domains. The CKD and iv control groups did not differ with respect to the proportion of scores falling one standard deviation or more below the mean on the Focus/Execute, Sustain, or Shift domains. Correlational data indicated that IQ scores and socioeconomic status were positively correlated with all five attention domains, while disease severity was negatively correlated with the attention domains. Exploratory regression analyses indicated that IQ scores were a significant predictor of the Stability and Encode attention domains. No predictors emerged for the Focus/Execute, Sustain, or Shift attention domains. In exploratory analyses with a subdivided CKD group, the end-stage renal disease (ESRD, i.e., kidney failure) group was found to have a higher proportion of attention scores one standard deviation or more below the mean on the Focus/Execute, Sustain, and Stability domains. Exploratory univariate comparisons of children with ESRD versus those with mild/moderate CKD further suggested a potential effect of disease severity on attention. Findings suggested that children with CKD may be vulnerable to subtle, specific deficits in domains of attention relative to their typically-developing peers. Results also suggested that this finding of specific attention problems may be particularly relevant for children with more severe levels of CKD. Facets of the current study, such as small sample size and other limitations, precluded broad generalizations of these findings to the pediatric CKD population as a whole. Future research should utilize regression analyses to develop a model of risk using predictor variables when screening for neurocognitive deficits. Using larger sample sizes and longitudinal analyses in future research may help to distinguish subtle attention problems in this population. Limitations and suggestions for future research are discussed

Fatigue crack growth and low cycle fatigue of two nickel base superalloys

The fatigue crack growth and low cycle fatigue behavior of two P/M superalloys, Rene 95 and Astroloy, in the hot isostatically pressed (HIP) condition, was determined. Test variables included frequency, temperature, environment, and hold times at peak tensile loads (or strains). Crack initiation sites were identified in both alloys. Crack growth rates were shown to increase in argon with decreasing frequency or with the imposition of hold times. This behavior was attributed to the effect of oxygen in the argon. Auger analyses were performed on oxide films formed in argon. Low cycle fatigue lives also were degraded by tensile hold, contrary to previous reports in the literature. The role of environment in low cycle fatigue behavior is discussed

The nervous system and chronic kidney disease in children

This paper provides a review of the literature on the nervous system involvement incurred by children and adolescents with chronic kidney disease (CKD), with a particular focus on neuropsychological functioning. In addition to an historical overview of earlier literature, published studies from the past 14 years that address both central and peripheral nervous system function in children with CKD are reviewed (1990–2003). These studies span work in neuroimaging, electrophysiology, and neuropsychology. A key focus for this review is on variables that might affect neurodevelopmental status in these children. The paper concludes with suggestions for achieving progress in the understanding of this complication of kidney disease in children

Initial validation of the Brief Assessment of Service Satisfaction in Persons with an Intellectual Disability (BASSPID)

Individuals with an intellectual disability often require intensive services to promote their social participation to the fullest extent. As such, measuring satisfaction with these services appears essential to enhance the quality of life of individuals with an intellectual disability and to improve service delivery within agencies. Thus, the purpose of the study was to conduct an initial validation of the Brief Assessment of Service Satisfaction in Persons with an Intellectual Disability (BASSPID), a 15-item questionnaire designed to assess service satisfaction. To examine the structure, reliability, and validity of the BASSPID, we interviewed 98 individuals with an intellectual disability and 23 parents. Overall, the BASSPID contained one scale, which had strong content and convergent validity as well as items easily understandable for individuals with an intellectual disability. Furthermore, the questionnaire had good internal consistency and adequate test-retest reliability. However, parents generally overestimated the perceived satisfaction of their child. The study suggests that the BASSPID may be useful to assess the satisfaction of individuals with an intellectual disability, but more research is needed to examine its potential impact on improving service quality