Health-related quality of life of young adults with Turner syndrome following a long-term randomized controlled trial of recombinant human growth hormone

<p>Abstract</p> <p>Background</p> <p>There are limited long-term randomized controlled trials of growth hormone (GH) supplementation to adult height and few published reports of the health-related quality of life (HRQOL) following treatment. The present follow-up study of young adults from a long-term controlled trial of GH treatment in patients with Turner syndrome (TS) yielded data to examine whether GH supplementation resulted in a higher HRQOL (either due to taller stature or from the knowledge that active treatment and not placebo had been received) or alternatively a lower HRQOL (due to medicalization from years of injections).</p> <p>Methods</p> <p>The original trial randomized 154 Canadian girls with TS aged 7-13 years from 13 centres to receive either long-term GH injections at the pharmacologic dose of 0.3 mg/kg/week or to receive no injections; estrogen prescription for induction of puberty was standardized. Patients were eligible for the follow-up study if they were at least 16 years old at the time of follow-up. The instrument used to study HRQOL was the SF-36, summarized into physical and mental component scales (PCS and MCS); higher scores indicate better HRQOL.</p> <p>Results</p> <p>Thirty-four of the 48 eligible participants (71%) consented to participate; data were missing for one patient. Both groups (GH and no treatment) had normal HRQOL at this post-treatment assessment. The GH group had a (mean ± SD) PCS score of 56 ± 5; the untreated group 58 ± 4; mean score for 16-24 year old females in the general population 53.5 ± 6.9. The GH group had a mean MCS score of 52 ± 6; the untreated group 49 ± 13; mean score for 16-24 year old females in the general population 49.6 ± 9.8. Secondary analyses showed no relationship between HRQOL and height.</p> <p>Conclusions</p> <p>We found no benefit or adverse effect on HRQOL either from receiving or not receiving growth hormone injections in a long-term randomized controlled trial, confirming larger observational studies. We suggest that it remains ethically acceptable as well as necessary to maintain a long-term untreated control group to estimate the effects of pharmacological agents to manipulate adult height. Young adult women with TS have normal HRQOL suggesting that they adjust well to their challenges in life.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier <a href="http://www.clinicaltrials.gov/ct2/show/NCT00191113">NCT00191113</a>.</p

THE MEDIATING EFFECT OF SCHOOL CLIMATE ON THE RELATIONSHIP BETWEEN ACADEMIC SELF-CONCEPT AND STUDENT ENGAGEMENT

This study aimed to determine the mediating effect of school climate on the relationship between academic self-concept and student engagement in public secondary schools in Cateel I District that offer the Senior High School Program. The researcher used a quantitative, non-experimental design of research using correlational techniques to gather data from 224 senior high school student respondents, who were stratified randomly. The data was collected through a survey method using validated questionnaires. Further, the results were collated and statistically analyzed using mean, Pearson r, and regression utilizing Medgraph to determine the mediation. The study revealed that academic self-concept, student engagement, and school climate exhibited high mean scores. This study also showed a significant relationship between the level of academic self-concept and student engagement, a significant relationship between academic self-concept and school climate, and a significant relationship between student engagement and school climate. Lastly, the results of this study showed that there was a partial mediation of school climate on the relationship between academic self-concept and student engagement. It implies that the school climate conveys good academic self-concept and student engagement.  Article visualizations

Patterns of Classroom Organization in Classrooms Where Children Exhibit Higher and Lower Language Gains

Previous research suggests that the ways in which early childhood classrooms are organized may facilitate children’s language learning. However, different measures of classroom organization often yield inconsistent findings regarding child outcomes. In this study, we investigated multiple aspects of classroom organization across two time points in classrooms where children made varying language gains. Using a purposeful sample of 60 early childhood classrooms, 30 in which children made higher language gains and 30 in which children made lower language gains, we explored the organization of the physical classroom literacy environment, classroom management, classroom time, and classroom activities. Research Findings: Results indicated that the organization of classroom time and classroom activities, but not of the classroom literacy environment nor of classroom management, differed across classrooms. Differences between classrooms were particularly salient in the fall. Practice or Policy: Findings suggest similarities and differences in the organizational patterns of classrooms, both at the start of the school year and across time. This has implications for how early childhood classrooms are organized to facilitate children’s language learning and highlights the importance of supporting teachers with establishing classroom organization early in the school year. Furthermore, these results emphasize the value of using multiple measures when exploring classroom organization