Browsing Publications by Subjects
Now showing items 1-20 of 49
-
Are the special educational needs of children in their first year in primary school in Ireland being identified: a cross-sectional studyAbstract Background If the window of opportunity presented by the early years is missed, it becomes increasingly difficult to create a successful life-course. A biopsychosocial model of special educational need with an emphasis on participation and functioning moves the frame of reference from the clinic to the school and the focus from specific conditions to creating supportive environments cognisant of the needs of all children. However, evidence suggests that an emphasis on diagnosed conditions persists and that the needs of children who do not meet these criteria are not identified.The Early Development Instrument (EDI) is a well-validated, teacher-completed population-level measure of five domains of child development. It is uniquely placed, at the interface between health and education, to explore the developmental status of children with additional challenges within a typically developing population. The aim of this study was to examine the extent to which the special educational needs of children in their first year of formal education have been identified. Methods This cross-sectional study was conducted in Ireland in 2011. EDI (teacher completed) scores were calculated for 1344 children. Data were also collected on special needs and on children identified by the teacher as needing assessment. Mean developmental scores were compared using one-way ANOVA. Results Eighty-three children in the sample population (6.2%) had identified special educational needs. A further 132 children were judged by the teacher as needing assessment. Children with special needs had lower mean scores than typically developing children, in all five developmental domains. Children considered by the teacher as needing assessment also had lower scores, which were not significantly different from those of children with special needs. Speech, emotional or behavioural difficulties were the most commonly reported problems among children needing further assessment. There was also a social gradient among this group. Conclusions A small but significant number of children have not had their needs adequately assessed. Teacher observation is an effective means of identifying children with a level of impairment which prevents them from fully participating in their educational environment and could be integrated into a multi-disciplinary approach to meeting the needs of all children.
-
Autoantibodies to a 140-kd protein in juvenile dermatomyositis are associated with calcinosis.OBJECTIVE: The identification of novel autoantibodies in juvenile dermatomyositis (DM) may have etiologic and clinical implications. The aim of this study was to describe autoantibodies to a 140-kd protein in children recruited to the Juvenile DM National Registry and Repository for UK and Ireland. METHODS: Clinical data and sera were collected from children with juvenile myositis. Sera that recognized a 140-kd protein by immunoprecipitation were identified. The identity of the p140 autoantigen was investigated by immunoprecipitation/immunodepletion, using commercial monoclonal antibodies to NXP-2, reference anti-p140, and anti-p155/140, the other autoantibody recently described in juvenile DM. DNA samples from 100 Caucasian children with myositis were genotyped for HLA class II haplotype associations and compared with those from 864 randomly selected UK Caucasian control subjects. RESULTS: Sera from 37 (23%) of 162 patients with juvenile myositis were positive for anti-p140 autoantibodies, which were detected exclusively in patients with juvenile DM and not in patients with juvenile DM-overlap syndrome or control subjects. No anti-p140 antibody-positive patients were positive for other recognized autoantibodies. Immunodepletion suggested that the identity of p140 was consistent with NXP-2 (the previously identified MJ autoantigen). In children with anti-p140 antibodies, the association with calcinosis was significant compared with the rest of the cohort (corrected P < 0.005, odds ratio 7.0, 95% confidence interval 3.0-16.1). The clinical features of patients with anti-p140 autoantibodies were different from those of children with anti-p155/140 autoantibodies. The presence of HLA-DRB1*08 was a possible risk factor for anti-p140 autoantibody positivity. CONCLUSION: This study has established that anti-p140 autoantibodies represent a major autoantibody subset in juvenile DM. This specificity may identify a further immunogenetic and clinical phenotype within the juvenile myositis spectrum that includes an association with calcinosis.
-
Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland.To examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries.
-
Children's participation in school: a cross-sectional study of the relationship between school environments, participation and health and well-being outcomesAbstract Background Schools are a key setting for health promotion and improvement activities and the psycho-social environment of the school is an important dimension for promoting the health and well-being of children. The development of Health Promoting Schools (HPS) draws on the settings-based approach to health promotion and includes child participation as one of its basic values. This paper investigates the relationships between child participation, the school environment and child outcomes. Methods Study participants were recruited from nine primary schools, three of which were designated as Health Promoting Schools (HPS). Each HPS was matched with two non-HPS (NHPS) with similar characteristics. Two hundred and thirty-one pupils in the 4th-6th class groups completed self-report questionnaires to document their perspectives on the school socio-ecological environment, how they take part in school life, school processes and their health and well-being. Results School participation was measured with four scales: participation in school decisions and rules, school activities, school events and positive perception of school participation. The differences in the reported mean score for three of the four scales were marginal and not statistically significant. However, the mean score for reported positive perception of school participation was significantly lower (χ2 = 5.13, df =1, p < 0.05) among pupils in HPS (mean = 26.03; SD 3.37) compared to NHPS (mean = 26.30; SD 3.36). Participation in school decisions and rules (OR 1.22, 95% CI 1.12-1.33), participating in school activities (OR 1.20, 95% CI 1.10-1.31), participating in school events (OR 1.19, 95% CI 1.10-1.29) and reported positive perception of school participation (OR 1.26, 95% CI 1.15-1.39) were all positively associated with health and well-being outcomes for all pupils. Logistic regression analyses indicated positive associations between school participation and school socio-ecological environment. Conclusions These findings suggest that school participation is important for children in schools and is relevant for improved school environment, relationships and positive health and well-being outcomes. The positive associations between school participation and school socio-ecological environment and health and well-being outcomes suggests that pupil health and well-being and school relationships could be improved or sustained by providing or supporting an environment that encourages pupil participation in school life.
-
Evaluation of a pilot national online asthma e-learning program for secondary school students.Ireland has the fourth highest incidence of asthma in the world, with Irish children losing on average 10 days of school per annum due to their asthma. It is highly probable that a large percentage of students in each class in Irish schools have asthma and are required to manage symptoms during the out-of-home period. Young people with chronic illnesses such as asthma find themselves labelled and marginalized due to a lack of awareness of others about their condition.
