Long-term outcomes of pneumococcal meningitis in childhood and adolescence

The validity of the Five Factor Model (FFM) to describe personality differences in childhood and adolescence is well established. Personality differences can be reliably assessed in children and adolescents, and available research converges on the validity of the FFM as the predominant model to provide a comprehensive and manageable account of these notable differences. In addition, there is strong agreement that personality traits in childhood/adolescence are related to a broad range of short- and long-term consequential outcomes, underscoring their utility in research and assessment. The aims of the present chapter are threefold: first, to review FFM measures developed for children and adolescents; second, to discuss parallels and dissimilarities obtained with adults; and finally to summarize the significance and validity of the model in gaining an understanding of a broad series of outcomes, including interpersonal relationships, psychopathology, health and well-being, learning and learning outcomes, and long-term outcomes manifested in adulthood.

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Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol

BMJ Open ◽

10.1136/bmjopen-2018-027486 ◽

2019 ◽

Vol 9 (6) ◽

pp. e027486 ◽

Cited By ~ 3

Author(s):

Meghan E Munger ◽

Brian Po-Jung Chen ◽

Bruce A MacWilliams ◽

Mark L McMulkin ◽

Michael H Schwartz

Keyword(s):

Cerebral Palsy ◽

Study Protocol ◽

Management Strategies ◽

Intrathecal Baclofen ◽

The Other ◽

Institutional Review Boards ◽

Spastic Cerebral Palsy ◽

Childhood And Adolescence ◽

Long Term Outcomes

IntroductionSpasticity is one of the primary pathologies associated with cerebral palsy (CP), yet no definitive evidence exists to guide the appropriate level of spasticity management for an individual. Spasticity management strategies often differ by center. On one end of this strategy spectrum is a highly-interventional approach, characterized by treatments such as a selective dorsal rhizotomy (SDR), intrathecal baclofen pump (ITB), and anti-spasticity injections and medications. On the other end of the spectrum is a less interventional approach, involving minimal use of these treatments, and no SDR.Methods and analysisA retrospectively-matched, multi-center study protocol is described that comprehensively compares the long-term outcomes of a highly-interventional versus a minimally-interventional spasticity management strategy. We will analyze two groups of adults with spastic bilateral CP (≥21 years). In one group are individuals who underwent an SDR between the ages of 4 and 10 years, along with ongoing spasticity management during childhood and adolescence. In the other group are individuals who received minimal spasticity management and did not undergo an SDR. Individuals with prolonged use of an intrathecal baclofen (ITB) pump will be excluded. The two groups will be matched for spasticity and other important clinical characteristics at baseline. This study design improves on many of the limitations found in the existing outcome literature.Ethics and disseminationThis study received necessary approval from the University of Minnesota and Western Institutional Review Boards. Results will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberNCT03789786.

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Infant Cognitive Development Trajectory and Middle Childhood and Adolescent Development Outcomes: A Chinese Birth Cohort Study (P11-144-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-144-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Zhonghai Zhu ◽

Yue Cheng ◽

Qii Qi ◽

Shaoru Li ◽

Mohamed Elhoumeda ◽

...

Keyword(s):

Cognitive Development ◽

Birth Cohort ◽

Middle Childhood ◽

Maternal Education ◽

Multinomial Logistic Regression ◽

Developmental Trajectories ◽

Childhood And Adolescence ◽

Long Term Outcomes ◽

Reduced Risk

Abstract Objectives To identify developmental trajectories of infant cognitive, examine its predictors, and associations with long-term outcomes at middle childhood and adolescence. Methods The data were obtained from a prospective birth cohort in 1388 infants born to women who participated in a randomized trial of antenatal micronutrient supplementation in China. Cognitive development was assessed six times from 3 to 30 months of age using Bayley Scales of Infant Development, and at middle childhood and adolescence using Wechsler Intelligence Scale for Children. Group-based trajectory modeling was applied to identify cognitive z-score developmental trajectories during the first two years of life. Multinomial logistic regression and generalized estimating equations models were performed to examine its predictors and associations with long-term outcomes, respectively. Results Four distinct cognitive developmental trajectories were identified: 1) “Subgroup 1: Start below average-then decrease” (3.2%), 2) “Subgroup 2: Start below average-then increase” (10.2%), 3) “Subgroup 3: Consistently average” (40.3%), and 4) “Subgroup 4: Consistently above average” (46.3%). Compared with Subgroup 4, per grade increase of maternal education reduced risk of being in Subgroup 1 by 73% (95% CI 0.54, 0.84); and small-for-gestational age birth and low birth weight were associated with 4.94 times (95% CI 2.16, 11.33) and 10.60 times (95% CI 3.57, 31.49) risk of being in Subgroup 1. Consuming antenatal multiple micronutrients ≥ 180 days (versus < 180 days of iron and/or folic acid) had an 84% (95% CI -.07, 0.98) reduced risk of being in Subgroup 1 and a 63% (95% CI 0.10, 0.84) reduced risk of being in Subgroup 2. Statistical differences in trajectories early in childhood persisted through middle childhood and early adolescence. Conclusions Our findings highlight the importance of promoting interventions as early as possible. Integration of nutritional and educational interventions to address multiple health and development domains is necessary to reduce the risk of suboptimal developmental outcomes across the life course. Funding Sources The study was supported by the National Natural Science Foundation of China and China Scholarship Council.

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Maternal immune-related conditions during pregnancy may be a risk factor for neuropsychiatric problems in offspring throughout childhood and adolescence

Psychological Medicine ◽

10.1017/s0033291720001580 ◽

2020 ◽

pp. 1-11

Author(s):

Shrujna Patel ◽

Matthew N. Cooper ◽

Hannah Jones ◽

Andrew J.O. Whitehouse ◽

Russell C. Dale ◽

...

Keyword(s):

Child Behavior Checklist ◽

Emotional Problems ◽

Childhood And Adolescence ◽

Long Term Outcomes ◽

Behavioral And Emotional Problems ◽

Increased Risk ◽

Males And Females ◽

Using Data ◽

The Relationship

Abstract Background Emerging research suggests that maternal immune activation (MIA) may be associated with an increased risk of adverse neurodevelopmental and mental health outcomes in offspring. Using data from the Raine Study, we investigated whether MIA during pregnancy was associated with increased behavioral and emotional problems in offspring longitudinally across development. Methods Mothers (Generation 1; N = 1905) were classified into the following categories: AAAE (Asthma/Allergy/Atopy/Eczema; N = 1267); infection (during pregnancy; N = 1082); no AAAE or infection (N = 301). The Child Behavior Checklist (CBCL) was administered for offspring at ages 5, 8, 10, 14, and 17. Generalized estimating equations were used to investigate the effect of maternal immune status on CBCL scores. Results AAAE conditions were associated with significant increases in CBCL Total (β 2.49; CI 1.98–3.00), Externalizing (β 1.54; CI 1.05–2.03), and Internalizing (β 2.28; CI 1.80–2.76) scores. Infection conditions were also associated with increased Total (β 1.27; CI 0.77–1.78), Externalizing (β 1.18; CI 0.70–1.66), and Internalizing (β 0.76; CI 0.28–1.24) scores. Exposure to more than one AAAE and/or infection condition was associated with a greater elevation in CBCL scores than single exposures in males and females. Females showed greater increases on the Internalizing scale from MIA, while males showed similar increases on both Internalizing and Externalizing scales. Conclusions MIA was associated with increased behavioral and emotional problems in offspring throughout childhood and adolescence. This highlights the need to understand the relationship between MIA, fetal development, and long-term outcomes, with the potential to advance early identification and intervention strategies.

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Traumatic Brain Injury: A Trauma Surgeon's Perspective

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.82 ◽

2012 ◽

Vol 22 (3) ◽

pp. 82-89

Author(s):

Oscar D. Guillamondegui

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multidisciplinary Approach ◽

Trauma Team ◽

The United States ◽

Long Term Outcomes ◽

Term Care ◽

Injured Brain ◽

The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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