Accommodative facility: Assessment of variables limiting performance

Evaluation of available normative data and protocols for accommodative facility testing in school aged children shows a lack of agreement among authors, and many studies failed to include or consider the unique conditions under which this age group must be tested. This study was designed to assess variables which have been implicated in previous research as having an impact upon testing in children, and ultimately limits their usefulness. Specifically, these variables are linguistic/cognitive processing (visual-verbal automaticity), and the motor response act of turning the lens flipper. The purpose of this study was to determine the potential impact these two variables have upon the measurement of relative accommodative response time during lens rock facility testing with school children. Methods include presentation of a new testing paradigm and a unique target (Modified Landolt C). Forty-nine fourth graders and twenty-two first graders participated in a within- subjects design where each subject\u27s response time was measured for each of five separate test conditions. These conditions were designed to assess both the impact and effect the above variables may have upon performance during accommodative facility testing at these two grade levels. Results indicate: (1) Use of a flipper slows performance at both first and fourth grade levels; (2) There was no significant difference in performance either when the examiner or the subject was manipulating the flipper. This was true for both our samples of first and fourth graders. Therefore, motor dexterity is not an issue in performance; (3) Although visual-verbal response time plays a significant role in lens rock performance, relative accommodative response is a major limiting variable with each grade level; and (4) Relative accommodative response time may improve between first and fourth grade

Systematic review: psychological morbidity in young people with inflammatory bowel disease - risk factors and impacts

BACKGROUND: Psychological morbidity in young people aged 10-24 years, with inflammatory bowel disease (IBD) is increased, but risk factors for and impacts of this are unclear. AIM: To undertake a systematic literature review of the risk factors for and impact of psychological morbidity in young people with IBD. METHODS: Electronic searches for English-language articles were performed with keywords relating to psychological morbidity according to DSM-IV and subsequent criteria; young people; and IBD in the MEDLINE, PsychInfo, Web of Science and CINAHL databases for studies published from 1994 to September 2014. RESULTS: One thousand four hundred and forty-four studies were identified, of which 30 met the inclusion criteria. The majority measured depression and anxiety symptoms, with a small proportion examining externalising behaviours. Identifiable risk factors for psychological morbidity included: increased disease severity (r(2) = 0.152, P < 0.001), lower socioeconomic status (r(2) = 0.046, P < 0.001), corticosteroids (P ≤ 0.001), parental stress (r = 0.35, P < 0.001) and older age at diagnosis (r = 0.28, P = 0.0006). Impacts of psychological morbidity in young people with IBD were wide-ranging and included abdominal pain (r = 0.33; P < 0.001), sleep dysfunction (P < 0.05), psychotropic drug use (HR 4.16, 95% CI 2.76-6.27), non-adherence to medication (12.6% reduction) and negative illness perceptions (r = -0.43). CONCLUSIONS: Psychological morbidity affects young people with IBD in a range of ways, highlighting the need for psychological interventions to improve outcomes. Identified risk factors provide an opportunity to develop targeted therapies for a vulnerable group. Further research is required to examine groups under-represented in this review, such as those with severe IBD and those from ethnic minorities

Evaluation of a psychoeducational intervention for adolescents with inflammatory bowel disease

OBJECTIVES: Inflammatory bowel disease (IBD), comprising Crohn's disease, ulcerative colitis, and indeterminate colitis, often has its onset in adolescence. The aim of this study was to evaluate whether a psychoeducational group intervention (aiming to enhance information seeking and giving about the disease, relaxation, social competence, and positive thinking) can strengthen the coping efforts of adolescents with IBD and have a positive effect on their Health-Related Quality of Life (HRQoL). METHODS: Adolescent IBD patients from the Emma Children's Hospital AMC and adolescent members of the Crohn and Ulcerative Colitis Association in The Netherlands, were invited to participate in The intervention study. Using reliable and valid self-report instruments the adolescent's coping styles, feelings of competence, and HRQoL were assessed before and 6-8 months after the intervention. The parents were asked to fill in the Child Behavior Check List. Linear regression analyses were performed to test whether group participation was predictive of the outcome measures while correcting for the first measurement occasion and sex. RESULTS AND CONCLUSION: Forty patients responded positively to invitation to the intervention. Eighteen adolescents, however, lived too far away to attend and served as a control group. Twenty-two children were enrolled and attended in groups of four to six children in six group sessions, supervised by two psychologists. The intervention seemed to have a positive effect on: coping (predictive control, P<0.01), feelings of competence (global self-worth, P<0.05 and physical appearance, P<0.01), and HRQoL (body image, P<0.05). These results give good reason to continue this intervention study with a larger population. © 2009 Lippincott Williams & Wilkins, Inc

Challenges and strategies of children and adolescents with inflammatory bowel disease: a qualitative examination

© 2007 Nicholas et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens