Which clinical signs are valid indicators for speech language disorder?

Presentatie in werkgroep richtlijnontwikkeling taalontwikkelin

The role of social cognitions in the social gradient in adolescent mental health: A longitudinal mediation model

Purpose. The social gradient in adolescent mental health is well established: adolescents’ socioeconomic status (SES) is negatively associated with their mental health. However, de-spite changes in social cognition during adolescence, and theory and evidence that SES, so-cial cognitions, and adolescent mental health are associated, little is known about whether social cognitions mediate this gradient. Methods. This study used three data waves, each six months apart, from a socioeconomi-cally diverse sample of 1,429 adolescents (Mage = 17.9) in the Netherlands. With a longitu-dinal mediation model, we examined whether three social cognitions (self-esteem, sense of control, and optimism) mediated the associations between perceived family wealth and four indicators of adolescent mental health problems (emotional symptoms, conduct prob-lems, hyperactivity, and peer problems). Results. Adolescents with lower perceived family wealth reported more emotional symp-toms and peer problems concurrently and an increase in peer problems six months later. Adolescents with lower perceived family wealth reported a decrease in sense of control six months later, and lower sense of control predicted increases in emotional symptoms and hyperactivity six months later (though not in the multivariate model with all three social cognitions). Perceived family wealth predicted neither later self-esteem nor optimism, though we found concurrent positive associations between perceived family wealth and all three social cognitions, and concurrent negative associations between social cognitions and mental health problems. Conclusion. Our findings indicate that social cognitions may be an overlooked mediator of the social gradient in adolescent mental health. Future research on this social gradient may benefit from incorporating a focus on social cognition

A 'short walk' is longer before radiotherapy than afterwards: a qualitative study questioning the baseline and follow-up design

<p>Abstract</p> <p>Background</p> <p>Numerous studies have indirectly demonstrated changes in the content of respondents' QoL appraisal process over time by revealing response-shift effects. This is the first known study to qualitatively examine the assumption of consistency in the content of the cognitive processes underlying QoL appraisal over time. Specific objectives are to examine whether the content of each distinct cognitive process underlying QoL appraisal is (dis)similar over time and whether patterns of (dis)similarity can be discerned across and within patients and/or items.</p> <p>Methods</p> <p>We conducted cognitive think-aloud interviews with 50 cancer patients prior to and following radiotherapy to elicit cognitive processes underlying the assessment of 7 EORTC QLQ-C30 items. Qualitative analysis of patients' responses at baseline and follow-up was independently carried out by 2 researchers by means of an analysis scheme based on the cognitive process models of Tourangeau et al. and Rapkin & Schwartz.</p> <p>Results</p> <p>The interviews yielded 342 comparisons of baseline and follow-up responses, which were analyzed according to the five cognitive processes underlying QoL appraisal. The content of comprehension/frame of reference changed in 188 comparisons; retrieval/sampling strategy in 246; standards of comparison in 152; judgment/combinatory algorithm in 113; and reporting and response selection in 141 comparisons. Overall, in 322 comparisons of responses (94%) the content of at least one cognitive component changed over time. We could not discern patterns of (dis)similarity since the content of each of the cognitive processes differed across and within patients and/or items. Additionally, differences found in the content of a cognitive process for one item was not found to influence dissimilarity in the content of that same cognitive process for the subsequent item.</p> <p>Conclusions</p> <p>The assumption of consistency in the content of the cognitive processes underlying QoL appraisal over time was not found to be in line with the cognitive processes described by the respondents. Additionally, we could not discern patterns of (dis)similarity across and within patients and/or items. In building on cognitive process models and the response shift literature, this study contributes to a better understanding of patient-reported QoL appraisal over time.</p

The role of social cognitions in the social gradient in adolescent mental health: A longitudinal mediation model

The social gradient in adolescent mental health is well established: adolescents' socioeconomic status is negatively associated with their mental health. However, despite changes in social cognition during adolescence, little is known about whether social cognitions mediate this gradient. Therefore, this study tested this proposed mediational path using three data waves, each 6 months apart, from a socioeconomically diverse sample of 1,429 adolescents ( M age = 17.9) in the Netherlands. Longitudinal modeling examined whether three social cognitions (self-esteem, sense of control, and optimism) mediated associations between perceived family wealth and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). There was evidence of a social gradient: adolescents with lower perceived family wealth reported more concurrent emotional symptoms and peer problems and an increase in peer problems 6 months later. Results also showed evidence of mediation through social cognitions, specifically sense of control: adolescents with lower perceived family wealth reported a decrease in sense of control (though not self-esteem nor optimism) 6 months later, and lower sense of control predicted increases in emotional symptoms and hyperactivity 6 months later. We found concurrent positive associations between perceived family wealth and all three social cognitions, and concurrent negative associations between social cognitions and mental health problems. The findings indicate that social cognitions, especially sense of control, may be an overlooked mediator of the social gradient in adolescent mental health

The social gradient in adolescent mental health: mediated or moderated by belief in a just world?

PURPOSE: A social gradient in adolescent mental health exists: adolescents with higher socioeconomic status (SES) have fewer mental health problems than their peers with lower SES. Little is known about whether adolescents' societal beliefs play a role in this social gradient. Belief in a just world (BJW) may be a mediator or moderator of the social gradient in adolescent mental health. METHODS: Using data from 848 adolescents (Mage = 17) in the Netherlands, path analyses examined whether two indicators of BJW (general and personal) mediated or moderated the associations between two indicators of SES (family affluence and perceived family wealth), and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). RESULTS: Adolescents with lower family affluence and lower perceived family wealth reported more emotional symptoms, and the association between perceived family wealth and emotional symptoms was mediated by lower personal and general BJW. Furthermore, higher personal BJW amplified the negative association between SES and peer problems. CONCLUSION: This study suggests BJW may both mediate and amplify the social gradient in adolescent mental health. Adolescents' beliefs about society may be important to include in research aimed at understanding this social gradient

Efficacy of cleansing agents in killing microorganisms in mixed species biofilms present on silicone facial prostheses-an in vitro study

The purpose of this study was to assess the efficacy of different cleansing agents in killing mixed species biofilms on silicone facial prostheses. Two bacterial and three yeast strains, isolated from silicone facial prostheses, were selected for the mixed species biofilms. A variety of agents used to clean facial prostheses were employed, viz., antibacterial soap, essential-oil-containing mouth rinse, ethanol 27 %, chlorhexidine mouth rinse, and buttermilk. Colony forming units (CFUs) and live/dead staining were analyzed to assess the efficacy of these cleansing agents against 24-h and 2-week biofilms and regrown biofilms on silicone samples. Chlorhexidine was the most effective cleansing agent. Chlorhexidine killed 8 log unit CFUs (> 99.99 % killing) in a 24-h biofilm and 5 log unit CFUs (> 99.99 % killing) in 2-week biofilms. Also, after regrowth and repeated treatment of the biofilm, chlorhexidine was the most effective cleansing agent showing no detectable CFUs. The essential-oil-containing mouth rinse (containing 26.9 % ethanol) showed a similar efficacy as ethanol (27 %) alone. Antibacterial soap and buttermilk were the least effective agents tested. Chlorhexidine showed the highest reduction in CFUs in 24-h, 2-week, and regrown mixed species biofilm of microorganisms isolated from silicone facial prostheses. Chlorhexidine mouth rinse (easy obtainable and relatively cheap) is very effective in killing bacteria and yeast present in biofilms on silicone facial prostheses. When applied on a regular basis, cleansing a facial prosthesis with chlorhexidine will presumably increase its lifetime and reduce skin irritations

Serious complications after button battery ingestion in children

Serious and fatal complications after button battery ingestion are increasing worldwide. The aim of this study is to describe serious complications after battery ingestion in children in the Netherlands. All pediatric gastroenterologists in the Netherlands performing upper endoscopies were asked to report all serious complications after battery ingestion in children (0–18 years) between 2008 and 2016 retrospectively. Sixteen serious complications were reported: death after massive bleeding through esophageal-aortal fistula (n = 1), esophageal-tracheal fistula (n = 5), stenosis after (suspected) perforation and mediastinitis (n = 5), (suspected) perforation and mediastinitis (n = 3), vocal cord paralysis (n = 1), and required reintubation for dyspnea and stridor (n = 1). The median time interval between ingestion and presentation was 5 (IQR 2–258) h. All children were ≤ 5 (median 1.4; IQR 0.9–2.1) years. Vomiting (31.3%), swallowing/feeding problems (31.3%), and fever (31.3%) were the most common presenting symptoms; however, 18.8% of the patients were asymptomatic (n = 1 missing). All batteries were button batteries (75% ≥ 20 mm; 18.8% < 20 mm; n = 1 missing). The batteries were removed by esophagogastroduodenoscopy (50%) and rigid endoscopy (37.5%) or surgically (12.5%). Conclusion: Sixteen serious complications occurred after small and large button batteries ingestion between 2008 and 2016 in both symptomatic and asymptomatic children in the Netherlands. Therefore, immediate intervention after (suspected) button battery ingestion is required.(Table presented.

Reduced Vitamin K Status as a Potentially Modifiable Risk Factor of Severe Coronavirus Disease 2019

BACKGROUND: Respiratory failure and thromboembolism are frequent in SARS-CoV-2-infected patients. Vitamin K activates both hepatic coagulation factors and extrahepatic endothelial anticoagulant protein S, required for thrombosis prevention. In times of vitamin K insufficiency, hepatic procoagulant factors are preferentially activated over extrahepatic proteins. Vitamin K also activates matrix Gla protein (MGP), which protects against pulmonary and vascular elastic fiber damage. We hypothesized that vitamin K may be implicated in coronavirus disease 2019 (COVID-19), linking pulmonary and thromboembolic disease. METHODS: 135 hospitalized COVID-19 patients were compared with 184 historical controls. Poor outcome was defined as invasive ventilation and/or death. Inactive vitamin K-dependent MGP (dp-ucMGP) and prothrombin (PIVKA-II) were measured, inversely related to extrahepatic and hepatic vitamin K status, respectively. Desmosine was measured to quantify the rate of elastic fiber degradation. Arterial calcification severity was assessed by computed tomography. RESULTS: Dp-ucMGP was elevated in COVID-19 patients compared to controls (p<0.001), with even higher dp-ucMGP in patients with poor outcomes (p<0.001). PIVKA-II was normal in 82.1% of patients. Dp-ucMGP was correlated with desmosine (p<0.001), and coronary artery (p=0.002) and thoracic aortic (p<0.001) calcification scores. CONCLUSIONS: Dp-ucMGP was severely increased in COVID-19 patients, indicating extrahepatic vitamin K insufficiency, which was related to poor outcome while hepatic procoagulant factor II remained unaffected. These data suggest a mechanism of pneumonia-induced extrahepatic vitamin K depletion leading to accelerated elastic fiber damage and thrombosis in severe COVID-19 due to impaired activation of MGP and endothelial protein S, respectively. A clinical trial could assess whether vitamin K administration improves COVID-19 outcomes

First test of Verlinde's theory of Emergent Gravity using weak gravitational lensing measurements

Verlinde (2016) proposed that the observed excess gravity in galaxies and clusters is the consequence of Emergent Gravity (EG). In this theory the standard gravitational laws are modified on galactic and larger scales due to the displacement of dark energy by baryonic matter. EG gives an estimate of the excess gravity (described as an apparent dark matter density) in terms of the baryonic mass distribution and the Hubble parameter. In this work we present the first test of EG using weak gravitational lensing, within the regime of validity of the current model. Although there is no direct description of lensing and cosmology in EG yet, we can make a reasonable estimate of the expected lensing signal of low redshift galaxies by assuming a background LambdaCDM cosmology. We measure the (apparent) average surface mass density profiles of 33,613 isolated central galaxies, and compare them to those predicted by EG based on the galaxies' baryonic masses. To this end we employ the ~180 square degrees overlap of the Kilo-Degree Survey (KiDS) with the spectroscopic Galaxy And Mass Assembly (GAMA) survey. We find that the prediction from EG, despite requiring no free parameters, is in good agreement with the observed galaxy-galaxy lensing profiles in four different stellar mass bins. Although this performance is remarkable, this study is only a first step. Further advancements on both the theoretical framework and observational tests of EG are needed before it can be considered a fully developed and solidly tested theory