ADHD and school

Author(s):  
Christine Merrell ◽  
Kapil Sayal

Within the school environment, teachers are well placed to identify children who exhibit ADHD symptoms. Universal school-based screening for ADHD is, however, not recommended. Teachers’ ratings of children’s behaviour at age 5 have been found to predict later academic outcomes. Longitudinal research suggests that inattention is substantively and significantly associated with poor academic outcomes whereas hyperactivity is not significantly related to later academic attainment, and impulsivity might be advantageous. Symptoms of inattention remain largely stable over time but symptoms of hyperactivity and impulsivity change. Whilst the school environment can present significant challenges for children with ADHD, advice and guidance to teachers about how to help children with inattentive, hyperactive, and impulsive behaviour to succeed in the classroom can facilitate more positive behavioural and academic outcomes. There is a need for research that assesses long-term outcomes and cost-effectiveness of school-based interventions as well as the impact of transition into secondary schooling.

2019 ◽  
Author(s):  
Ashley Cox ◽  
Stuart J. Fairclough ◽  
Maria-Christina Kosteli ◽  
Robert J. Noonan

Background: It has been reported that boys’ and girls’ physical activity (PA) levels decline throughout adolescence. Boys are at risk of physical inactivity during adolescence however, in intervention research they are an under-represented group relative to girls. It is suggested that the school environment may be central to developing interventions that support adolescents in meeting the current PA guidelines. The purpose of this systematic review and meta-analysis was to investigate the efficacy of school-based interventions to increase moderate to vigorous physical activity (MVPA) and muscle and bone strengthening exercise (MBSE) outcomes in adolescent males. Methods: This systematic review and meta-analysis followed the preferred reporting systems for meta-analyses guidelines and was registered on PROSPERO (Registration number: CRD42018091023). Eligible studies were published in English within peer-reviewed articles. Searches were conducted in three databases, with an additional grey literature search in Google Scholar. Studies with MVPA and MBSE as outcomes were included.Results: There were 51 data sets identified across 15 studies, from eight countries. Overall methodological quality of the studies was moderate to strong. Significant, small effect sizes were identified following a pooled analysis of all studies which aimed to increase MVPA and MBSE outcomes (g = 0.26, 95% CI = 0.15, 0.37, P = <.001). Interventions targeting MVPA were ineffective (g = -0.09, 95% CI -0.72, -0.53, P = 0.77). Interventions targeting MBSE evidenced a small to medium effect (g = 0.27, CI 0.16, 0.39, P = <.001). Sub-group analyses of MBSE delivery method resulted in small to medium effects: Upper limb MBSE (g = 0.23, 95% CI 0.03, 0.43, p = 0.02), lower limb MBSE (g = 0.21, 95% CI 0.09, 0.33, p <0.00), combined resistance activities (g = 0.22, 95% CI 0.05 – 0.39, p = <0.00), plyometric activities (g = 0.39, 95% CI 0.09, 0.68, p = 0.01), body weight (g = 0.21, 95% CI -0.00, 0.44, p = 0.05), and traditional MBSE methods (g = 0.43, 95% CI -0.09, 0.78, p = 0.01).Conclusions: School-based interventions which aim to increase MVPA in adolescent males were not effective. Interventions focused on MBSE demonstrated small to moderate effects. Traditional and plyometric methods of MBSE appear to be the most effective form of PA delivery in adolescent males. More quality research is required to assess the impact of MBSE delivered in the school environment in order to inform future intervention design.


2003 ◽  
Author(s):  
Teresa Garate-Serafini ◽  
Jose Mendez ◽  
Patty Arriaga ◽  
Larry Labiak ◽  
Carol Reynolds

Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract


Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 227
Author(s):  
Rudaina Banihani ◽  
Judy Seesahai ◽  
Elizabeth Asztalos ◽  
Paige Terrien Church

Advances in neuroimaging of the preterm infant have enhanced the ability to detect brain injury. This added information has been a blessing and a curse. Neuroimaging, particularly with magnetic resonance imaging, has provided greater insight into the patterns of injury and specific vulnerabilities. It has also provided a better understanding of the microscopic and functional impacts of subtle and significant injuries. While the ability to detect injury is important and irresistible, the evidence for how these injuries link to specific long-term outcomes is less clear. In addition, the impact on parents can be profound. This narrative summary will review the history and current state of brain imaging, focusing on magnetic resonance imaging in the preterm population and the current state of the evidence for how these patterns relate to long-term outcomes.


Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 396
Author(s):  
Purificación Cerrato-Carretero ◽  
Raúl Roncero-Martín ◽  
Juan D. Pedrera-Zamorano ◽  
Fidel López-Espuela ◽  
Luis M. Puerto-Parejo ◽  
...  

Preventive actions and potential obesity interventions for children are mainly researched throughout the school period, either as part of the school curricula or after regular school hours, via interventions mostly lasting less than 12 months. We aimed to perform a meta-analysis on randomized controlled clinical trials to evaluate the evidence of the efficacy of long-term school-based interventions in the management of childhood obesity in terms of BMI from a dietary and physical activity-based approach. Eleven randomized controlled clinical trials were examined using the random effects model, and the results showed that there were no significant effects associated with physical activity + nutrition intervention in school children aged 6–12 years, with a pooled standardized mean difference (SMD) (95% CI) of −0.00 (−0.05, 0.04). No effects were observed after subgroup analysis based on the intervention length. The findings from our study indicate that long-term school-based interventions on physical activity and dietary habits received by children aged 6–12 years seem to have no effect on BMI. However, the promotion of such interventions should not be discouraged, as they promote additional positive health outcomes for other domains of children’s health.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15540-e15540
Author(s):  
Andrew MacCormick ◽  
Mark Puckett ◽  
Adam Streeter ◽  
Somaiah Aroori

e15540 Background: Recent research has demonstrated the impact that body composition parameters can have on the outcomes following cancer surgery. Adipose tissue deposition in muscle, known as myosteatosis, can be detected on pre-operative imaging. This systematic review aims to analyse the impact of pre-operative myosteatosis on long-term outcomes following surgery for gastro-intestinal malignancy. Methods: Using MeSH terms, a systematic search of the databases PubMed MEDLINE, EMBASE, Cochrane, CINAHL and AMED was performed. Studies were included if they reported hazard ratios (HR) analysing the impact of pre-operatively defined myosteatosis, or similar term, on the long-term outcomes following surgery for gastro-intestinal malignancy. A total of 39 full texts articles were reviewed for inclusion, with 19 being included after the inclusion criteria were applied. A sub-group analysis was performed for those studies reporting outcomes for colorectal cancer patients only. Results: The total number of included patients across all studies was 14,481. Patients with myosteatosis had a significantly poorer overall survival, according to univariate (HR 1.82, 95% CI 1.67 – 1.99) and multivariable (HR 1.66, 95% CI 1.49 – 1.86) analysis. This was also demonstrated with regards to cancer-specific survival (univariate HR 1.62, 95% CI 1.18 – 2.22, multivariable HR 1.73, 95% CI 1.48 – 2.03) and recurrence-free survival (univariate HR 1.28, 95% CI 1.10 – 1.48, multivariable HR 1.38, 95% CI 1.07 – 1.77). Conclusions: This review demonstrates that patients with pre-operative myosteatosis have poorer long-term outcomes following surgery for gastro-intestinal malignancy. Therefore, myosteatosis should be used for pre-operative optimisation and as a prognostic tool before surgery. More standardised definitions of myosteatosis and further cohort studies of patients with non-colorectal malignancies are required.


Author(s):  
Jiyoung Lee ◽  
Kan Kajimoto ◽  
Taira Yamamoto ◽  
Kenji Kuwaki ◽  
Yuki Kamikawa ◽  
...  

Background and Aim of the Study: Ischemic mitral valve regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) is associated with worse long-term outcomes. The aim of this study was to assess the impact of mitral valve repair with CABG in patients with moderate IMR. Method: This observational study enrolled 3,215 consecutive patients from the Juntendo CABG registry with moderate IMR and multivessel coronary artery disease who underwent CABG between 2002 and 2017. The CABG alone and CABG with mitral valve surgery (MVs) groups were compared. The propensity score was calculated for each patient. Long-term all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results: A total of 101 patients who underwent CABG had moderate IMR in our database. Propensity score matching selected 40 pairs for final analysis. MVs was associated with increased risks of postoperative atrial fibrillation, blood transfusion, and longer hospitalization. There were no differences between the two groups in long-term outcomes, including all-cause mortality, cardiac mortality, and the incidence of MACCEs. Conclusions: Surgical treatment of moderate IMR combined with CABG was as safe as CABG alone, with no differences in long-term outcomes. Further studies are needed to determine the effects of MVs in patients with moderate IMR and severe coronary artery disease.


Author(s):  
Marianna Rita Stancampiano ◽  
Kentaro Suzuki ◽  
Stuart O’Toole ◽  
Gianni Russo ◽  
Gen Yamada ◽  
...  

Abstract In the newborn, penile length is determined by a number of androgen dependent and independent factors. The current literature suggests that there are inter-racial differences in stretched penile length in the newborn and although congenital micropenis should be defined as a stretched penile length of less than 2.5SDS of the mean for the corresponding population and gestation, a pragmatic approach would be to evaluate all boys with a stretched penile length below 2 cm, as congenital micropenis can be a marker for a wide range of endocrine conditions. However, it remains unclear as to whether the state of micropenis, itself, is associated with any long-term consequences. There is a lack of systematic studies comparing the impact of different therapeutic options on long-term outcomes, in terms of genital appearance, quality of life and sexual satisfaction. To date, research has been hampered by a small sample size and inclusion of a wide range of heterogeneous diagnoses; for these reasons, condition specific outcomes have been difficult to compare between studies. Lastly, there is a need for a greater collaborative effort in collecting standardized data so that all real-world or experimental interventions performed at an early age can be studied systematically into adulthood.


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