86 research outputs found
Motor and executive function at 6 years of age after extremely preterm birth
BACKGROUND. Studies of very preterm infants have demonstrated impairments in multiple neurocognitive domains. We hypothesized that neuromotor and executive-
function deficits may independently contribute to school failure.
METHODS.We studied children who were born at 25 completed weeks’ gestation in the United Kingdom and Ireland in 1995 at early school age. Children underwent
standardized cognitive and neuromotor assessments, including the Kaufman Assessment Battery for Children and NEPSY, and a teacher-based assessment of academic achievement.
RESULTS. Of 308 surviving children, 241 (78%) were assessed at a median age of 6 years 4 months. Compared with 160 term classmates, 180 extremely preterm children without cerebral palsy and attending mainstream school performed less
well on 3 simple motor tasks: posting coins, heel walking, and 1-leg standing. They more frequently had non–right-hand preferences (28% vs 10%) and more associated/
overflow movements during motor tasks. Standardized scores for visuospatial and sensorimotor function performance differed from classmates by 1.6 and 1.1 SDs of the classmates’ scores, respectively. These differences attenuated but remained significant after controlling for overall cognitive scores. Cognitive, visuospatial
scores, and motor scores explained 54% of the variance in teachers’ ratings of performance in the whole set; in the extremely preterm group, additional variance was explained by attention-executive tasks and gender.
CONCLUSIONS. Impairment of motor, visuospatial, and sensorimotor function, including planning, self-regulation, inhibition, and motor persistence, contributes excess
morbidity over cognitive impairment in extremely preterm children and contributes independently to poor classroom performance at 6 years of age
The EPICure study : growth and blood pressure at 6 years of age following extremely preterm birth
Background: Preterm children are at risk for reduced growth in early childhood, which may predispose them to later changes in blood pressure. We studied growth and blood pressure (BP) in extremely preterm (EP) children at age 6 years.
Methods: We evaluated children who were born at 25 completed weeks of gestation or less in the United Kingdom and Ireland in 1995 when they reached early school age. Children underwent standardized assessments, including auxology and sitting blood pressure.
Results: Of 308 surviving children, 241 (78 percent) were assessed at a median age of 6 years 4 months; 160 full term classmates acted as a comparison group. Compared to classmates, EP children were 1.2 standard deviations (SD) lighter, 0.97SD shorter, BMI was 0.95SD lower and head circumference 1.3SD lower. Compared to 2.5 years of age, EP children showed catch up in terms of weight by 0.37SD, height by 0.42SD and head circumference by 0.13SD. Systolic
and diastolic BP were lower by 2.3mmHg and 2.4mmHg respectively in EP children but these differences were accounted for by differences in height and BMI. Maternal smoking in pregnancy was associated with lower BP, children born before 24 weeks had higher systolic and children given postnatal steroids higher diastolic pressures.
Conclusions: Poor postnatal growth seen after birth and at in the third year persists into school age. Catch up growth reduces some of the early deficit but is least for head growth.
Despite serious postnatal growth restriction blood pressure appears similar in both EP and term classmates
Screening for autism in preterm children : diagnostic utility of the Social Communication Questionnaire
Objective Preterm survivors are at high risk for autism
spectrum disorders (ASD). The diagnostic utility of the
Social Communication Questionnaire (SCQ) in screening
for ASD was assessed in extremely preterm children at
11 years of age.
Design All babies born at <26 weeks gestation
in UK and Ireland from March through December
1995 were recruited to the EPICure Study. Of 307
survivors, 219 (71%) were assessed at 11 years.
Parents of 173 children completed the SCQ to screen
for autistic features and the Development and Well
Being Assessment (DAWBA) psychiatric interview.
A consensus diagnosis of ASD was assigned by two
child psychiatrists following review of the DAWBA
parental interview and corresponding DAWBA teacher
questionnaire.
Setting Community-based follow-up.
Results Using the established SCQ cut-off (scores
≥15), 28 (16%) extremely preterm children screened
positive for ASD. Eleven (6%) were assigned a
diagnosis of ASD. Using this cut-off, the SCQ had 82%
sensitivity and 88% specifi city for identifying ASD in this
population. Using a receiver operating characteristic
curve, SCQ scores ≥14 had optimal diagnostic utility
(area under curve: 0.94; sensitivity: 91%; specifi city:
86%). Positive predictive value was relatively low
(31%) resulting in numerous over-referrals. However,
children with false positive screens had signifi cantly
worse neuro-developmental, cognitive and behavioural
outcomes than those with true negative screens.
Conclusion The SCQ has good diagnostic utility for
identifying ASD in extremely preterm children and
is a useful screening tool in this population. Children
with false positive screens represent a high-risk group
in whom further diagnostic assessment would be
benefi cial
Academic attainment and special educational needs in extremely preterm children at 11 years of age : the EPICure Study
Aim: To assess academic attainment and special educational needs (SEN) in extremely preterm (EP) children in middle childhood.
Methods: Of 307 EP (=25 weeks) survivors born in the UK and Ireland in 1995, 219 (71%) were re-assessed at 11 years, with a comparison group of 153 classmates born at term, using standardised tests of cognitive ability and academic attainment and teacher reports of school performance and special educational needs (SEN). Multiple imputation was used to correct for selective dropout.
Results: EP children had significantly lower scores than classmates for cognitive ability (-20 points; 95%CI: -23,-17), reading (-18 points; -22,-15) and mathematics (-27 points; -31,-23). Twenty-nine (13%) EP children attended special school. In mainstream schools, 105 (57%) EP children had SEN (OR: 10; 6, 18) and 103 (55%) required SEN resource provision (OR: 10; 5, 18). Teachers rated 50% of EP children with attainment below the average range compared with 5% of classmates (OR: 18; CI: 8, 41). EP children who are entered for mainstream education an academic year early due to preterm birth had similar academic attainment but required more SEN support (OR: 2; 1.1,3.8).
Conclusions: EP survivors remain at high risk for learning impairments and poor academic attainment in middle childhood. A significant proportion require full-time specialist education and over half of those attending mainstream schools require additional health or educational resources in order to access the national curriculum. The prevalence and impact of SEN is likely to increase as these children approach the transition to secondary school.
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Educational outcomes in extremely preterm children : neuropsychological correlates and predictors of attainment
This study assessed the impact of extremely preterm birth on academic attainment at 11 years of
age, investigated neuropsychological antecedents of attainment in reading and mathematics, and
examined early predictors of educational outcomes. Children born extremely preterm had significantly
poorer academic attainment and a higher prevalence of learning difficulties than their term
peers. General cognitive ability and specific deficits in visuospatial skills or phoneme deletion at 6
years were predictive of mathematics and reading attainment at 11 years in both extremely preterm
and term children. Phonological processing, attention, and executive functions at 6 years were also
associated with academic attainment in children born extremely preterm. Furthermore, social factors,
neonatal factors (necrotizing enterocolitis, breech delivery, abnormal cerebral ultrasound, early
breast milk provision), and developmental factors at 30 months (head circumference, cognitive development),
were independent predictors of educational outcomes at 11 years. Neonatal complications
combined with assessments of early cognitive function provide moderate prediction for educational
outcomes in children born extremely preterm
What's wrong with the scrum laws in rugby union? - Judgment, truth and refereeing
Officiating and the role of officials in sport are crucial and often decisive factors in sports contests. Notable contributions in philosophy of sport include Collins (2012), Russell (1997; 1999), McFee (2011) & Mumford (2006) have brought a sharp philosophical focus to highlight that justice and desert of sport contests, in part, rely on officiating truths (performances) that arise from an appropriate admixture of epistemic (judgments) and metaphysical (actions) ingredients. This paper provides a rigorous and original philosophical analysis of the problems of obeying the rules and of applying the rules of sport. The paper focuses on a particular phase of play in rugby union, namely the scrum. It is fair to say that the scrum has become a focus of criticism and bewilderment. Elite televised rugby is damaged as a spectacle because too much time is wasted setting and re-setting scrums. Furthermore, our trust in the fairness of games is eroded because the scrum is a ‘lottery’ when it comes to officiating. In this paper, we identify two fundamental structural problems which contribute to the scrum controversy. First, drawing on Mumford (2006) and Collins (2012) we argue that officials cannot make reliable judgments about scrums because they cannot see what they need to see. Secondly, we argue that players cannot follow the laws of the scrum even if they have a strong desire to do so. Laws which can’t be followed are, according to Fuller (2000) defective. Consequently, the scrum is not only potentially dangerous but also flawed in terms of its capacity to actualize an intended part of the game
Autism spectrum disorders in extremely preterm children
Objectives
To investigate the prevalence, correlates, and antecedents of autism spectrum disorders (ASD) in extremely preterm children.
Study design
We conducted a prospective study of all births <26 weeks gestation in the United Kingdom and Ireland in 1995. Of 307 survivors at 11 years, 219 (71%) were assessed and compared with 153 term-born classmates. Parents completed the Social Communication Questionnaire (SCQ) to assess autism spectrum symptoms, and ASD were diagnosed by using a psychiatric evaluation. An IQ test and clinical evaluation were also administered. Longitudinal outcome data were available for extremely preterm children.
Results
Extremely preterm children had significantly higher SCQ scores than classmates (mean difference, 4.6 points; 95% CI, 3.4-5.8). Sixteen extremely preterm children (8%) were assigned an ASD diagnosis, compared with none of the classmates. By hospital discharge, male sex, lower gestation, vaginal breech delivery, abnormal cerebral ultrasound scanning results, and not having had breast milk were independently associated with autism spectrum symptoms. By 6 years, independent associates were cognitive impairment, inattention and peer problems, withdrawn behavior at 2.5 years, and not having had breast milk.
Conclusions
Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood. These symptoms and disorders were associated with neurocognitive outcomes, suggesting that ASD may result from abnormal brain development in this population
The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe
The preponderance of matter over antimatter in the early Universe, the
dynamics of the supernova bursts that produced the heavy elements necessary for
life and whether protons eventually decay --- these mysteries at the forefront
of particle physics and astrophysics are key to understanding the early
evolution of our Universe, its current state and its eventual fate. The
Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed
plan for a world-class experiment dedicated to addressing these questions. LBNE
is conceived around three central components: (1) a new, high-intensity
neutrino source generated from a megawatt-class proton accelerator at Fermi
National Accelerator Laboratory, (2) a near neutrino detector just downstream
of the source, and (3) a massive liquid argon time-projection chamber deployed
as a far detector deep underground at the Sanford Underground Research
Facility. This facility, located at the site of the former Homestake Mine in
Lead, South Dakota, is approximately 1,300 km from the neutrino source at
Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino
charge-parity symmetry violation and mass ordering effects. This ambitious yet
cost-effective design incorporates scalability and flexibility and can
accommodate a variety of upgrades and contributions. With its exceptional
combination of experimental configuration, technical capabilities, and
potential for transformative discoveries, LBNE promises to be a vital facility
for the field of particle physics worldwide, providing physicists from around
the globe with opportunities to collaborate in a twenty to thirty year program
of exciting science. In this document we provide a comprehensive overview of
LBNE's scientific objectives, its place in the landscape of neutrino physics
worldwide, the technologies it will incorporate and the capabilities it will
possess.Comment: Major update of previous version. This is the reference document for
LBNE science program and current status. Chapters 1, 3, and 9 provide a
comprehensive overview of LBNE's scientific objectives, its place in the
landscape of neutrino physics worldwide, the technologies it will incorporate
and the capabilities it will possess. 288 pages, 116 figure
The Habitable Exoplanet Observatory (HabEx) Mission Concept Study Final Report
The Habitable Exoplanet Observatory, or HabEx, has been designed to be the Great Observatory of the 2030s. For the first time in human history, technologies have matured sufficiently to enable an affordable space-based telescope mission capable of discovering and characterizing Earthlike planets orbiting nearby bright sunlike stars in order to search for signs of habitability and biosignatures. Such a mission can also be equipped with instrumentation that will enable broad and exciting general astrophysics and planetary science not possible from current or planned facilities. HabEx is a space telescope with unique imaging and multi-object spectroscopic capabilities at wavelengths ranging from ultraviolet (UV) to near-IR. These capabilities allow for a broad suite of compelling science that cuts across the entire NASA astrophysics portfolio. HabEx has three primary science goals: (1) Seek out nearby worlds and explore their habitability; (2) Map out nearby planetary systems and understand the diversity of the worlds they contain; (3) Enable new explorations of astrophysical systems from our own solar system to external galaxies by extending our reach in the UV through near-IR. This Great Observatory science will be selected through a competed GO program, and will account for about 50% of the HabEx primary mission. The preferred HabEx architecture is a 4m, monolithic, off-axis telescope that is diffraction-limited at 0.4 microns and is in an L2 orbit. HabEx employs two starlight suppression systems: a coronagraph and a starshade, each with their own dedicated instrument
The Habitable Exoplanet Observatory (HabEx) Mission Concept Study Final Report
The Habitable Exoplanet Observatory, or HabEx, has been designed to be the
Great Observatory of the 2030s. For the first time in human history,
technologies have matured sufficiently to enable an affordable space-based
telescope mission capable of discovering and characterizing Earthlike planets
orbiting nearby bright sunlike stars in order to search for signs of
habitability and biosignatures. Such a mission can also be equipped with
instrumentation that will enable broad and exciting general astrophysics and
planetary science not possible from current or planned facilities. HabEx is a
space telescope with unique imaging and multi-object spectroscopic capabilities
at wavelengths ranging from ultraviolet (UV) to near-IR. These capabilities
allow for a broad suite of compelling science that cuts across the entire NASA
astrophysics portfolio. HabEx has three primary science goals: (1) Seek out
nearby worlds and explore their habitability; (2) Map out nearby planetary
systems and understand the diversity of the worlds they contain; (3) Enable new
explorations of astrophysical systems from our own solar system to external
galaxies by extending our reach in the UV through near-IR. This Great
Observatory science will be selected through a competed GO program, and will
account for about 50% of the HabEx primary mission. The preferred HabEx
architecture is a 4m, monolithic, off-axis telescope that is
diffraction-limited at 0.4 microns and is in an L2 orbit. HabEx employs two
starlight suppression systems: a coronagraph and a starshade, each with their
own dedicated instrument.Comment: Full report: 498 pages. Executive Summary: 14 pages. More information
about HabEx can be found here: https://www.jpl.nasa.gov/habex
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