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1.
Eur Cell Mater ; 38: 23-34, 2019 08 08.
Article in English | MEDLINE | ID: mdl-31393594

ABSTRACT

Articular cartilage is a specialised tissue that has a relatively homogenous endogenous cell population but a diverse extracellular matrix (ECM), with depth-dependent mechanical properties. Repair of this tissue remains an elusive clinical goal, with biological interventions preferred to arthroplasty in younger patients. Osteochondral transplantation (OCT) has emerged for the treatment of cartilage defects and osteoarthritis. Fresh allografts stored at 4 °C have been utilised, though matrix and cell viability loss remains an issue. To address this, several studies have developed media formulations to maintain cartilage explants in vitro. One promising factor for these applications is sprifermin, a human-recombinant fibroblast growth factor-18, which stimulates chondrocyte proliferation and matrix synthesis and is in clinical trials for the treatment of osteoarthritis. The study hypothesis was that addition of sprifermin during storage would maintain the unique depth-dependent mechanical profile of articular cartilage explants, a feature not often evaluated. Explants were maintained for up to 6 weeks with or without a weekly 24 h exposure to sprifermin (100 ng/mL) and the compressive modulus was assessed. Results showed that sprifermin-treated samples maintained their depth-dependent mechanical profile through 3 weeks, whereas untreated samples lost their mechanical integrity over 1 week of culture. Sprifermin also affected ECM balance by maintaining the levels of extracellular collagen and suppressing matrix metalloproteinase production. These findings support the use of sprifermin as a medium additive for OCT allografts during in vitro storage and present a potential mechanism where sprifermin may impact a functional characteristic of articular cartilage in repair strategies.


Subject(s)
Cartilage, Articular/drug effects , Compressive Strength , Fibroblast Growth Factors/pharmacology , Animals , Cartilage, Articular/chemistry , Cartilage, Articular/metabolism , Cattle , Cells, Cultured , Collagen/metabolism , Glycosaminoglycans/metabolism , Humans , Matrix Metalloproteinases/metabolism , Recombinant Proteins/pharmacology
2.
Behav Brain Res ; 259: 284-91, 2014 Feb 01.
Article in English | MEDLINE | ID: mdl-24231261

ABSTRACT

Clinical studies indicate that children who experience a traumatic brain injury (TBI) are often the victim of peer rejection, have very few mutual friends, and are at risk for long-term behavioural and social impairments. Owing to the fact that peer play is critical for healthy development, it is possible that the long-term impairments are associated not only with the TBI, but also altered play during this critical period of brain development. This study was designed to determine if social dynamics and juvenile play are altered in rats that experience a mild TBI (mTBI) early in life. Play-fighting behaviours were recorded and analyzed for young male and female Sprague Dawley rats that were given either an mTBI or a sham injury. The study found that the presence of an mTBI altered the play fighting relationship, and the nature of the alterations were dependent upon the sex of the pairing and the injury status of their peers. Sham rats were significantly less likely to initiate play with an mTBI rat, and were more likely to respond to a play initiation from an mTBI rat with an avoidant strategy. This effect was significantly more pronounced in female rats, whereby it appeared that female rats with an mTBI were particularly rejected and most often excluded from play experiences. Male rats with an mTBI learned normal play strategies from their sham peers (when housed in mixed cages), whereas female rats with an mTBI show heightened impairment in these conditions. Play therapy may need to be incorporated into treatment strategies for children with TBI.


Subject(s)
Brain Injuries/complications , Brain Injuries/psychology , Play and Playthings/psychology , Sex Characteristics , Social Behavior Disorders/etiology , Analysis of Variance , Animals , Body Weight , Disease Models, Animal , Female , Male , Rats , Rats, Sprague-Dawley , Reproducibility of Results
3.
Nutr Hosp ; 27(2): 504-9, 2012.
Article in English | MEDLINE | ID: mdl-22732975

ABSTRACT

OBJECTIVE: The effectiveness of influenza vaccination in preventing illness is lower in the elderly; this is why the ability of Lactobacillus plantarum CECT 7315/7316 to stimulate the response to influenza vaccination in elderly was evaluated. RESEARCH METHODS AND PROCEDURES: A randomized, double-blind, placebo-controlled human trial including 60 institutionalized volunteers aged 65-85 years was performed. All the volunteers were vaccinated with a trivalent influenza vaccine (A/Wisconsin/67/2005 NYMC X-161B (H3N2), A/Solomon Islands/3/2006 (H1N1) and B/Malaysia/2506/2004) for the Spanish vaccine campaign 2006/2007. The consumption of the probiotic began between three and four months after the vaccination. Volunteers were randomly assigned to one of three following groups: group A (receiving 5*10(9) cfu/day of L. plantarum CECT 7315/7316 in 20 g powdered skim milk), group B (receiving 5*10(8) cfu/day of L. plantarum CECT 7315/7316 in 20 g powdered skim milk) and group C or placebo (20 g powered skim milk). The participants consumed the probiotic during 3 months. RESULTS: The consumption of L. plantarum CECT 7315/7316 during 3 months after influenza vaccination increased the levels of influenza-specific IgA and IgG antibodies. Moreover, a trend towards an increase in influenza-specific IgM antibodies was also observed. CONCLUSION: L. plantarum CECT7315/7316 has an immunostimulating effect and could be used to improve the response to influenza vaccination in elderly.


Subject(s)
Immunoglobulins/biosynthesis , Influenza Vaccines/immunology , Lactobacillus plantarum , Probiotics/therapeutic use , Aged , Aged, 80 and over , Antibodies, Viral/analysis , Antibodies, Viral/biosynthesis , Dairy Products , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Immunization , Immunoglobulin A/biosynthesis , Immunoglobulin G/biosynthesis , Male , Spain
4.
Nutr. hosp ; 27(2): 504-509, mar.-abr. 2012. ilus
Article in English | IBECS | ID: ibc-103432

ABSTRACT

Objective: The effectiveness of influenza vaccination in preventing illness is lower in the elderly; this is why the ability of Lactobacillus plantarum CECT 7315/7316 to stimulate the response to influenza vaccination in elderly was evaluated. Research methods and procedures: A randomized, double-blind, placebo-controlled human trial including 60 institutionalized volunteers aged 65-85 years was performed. All the volunteers were vaccinated with a trivalent influenza vaccine (A/Wisconsin/67/2005 NYMC X-161B (H3N2), A/Solomon Islands/3/2006 (H1N1) and B/Malaysia/2506/2004) for the Spanish vaccine campaign 2006/2007. The consumption of the probiotic began between three and four months after the vaccination. Volunteers were randomly assigned to one of three following groups: group A (receiving 5*109 cfu/day of L. plantarum CECT 7315/7316 in 20 g powdered skim milk), group B (receiving 5*108 cfu/day of L. plantarum CECT 7315/7316 in 20 g powdered skim milk) and group C or placebo (20 g powered skim milk). The participants consumed the probiotic during 3 months. Results: The consumption of L. plantarum CECT 7315/7316 during 3 months after influenza vaccination increased the levels of influenza-specific IgA and IgG antibodies. Moreover, a trend towards an increase in influenza-specific IgM antibodies was also observed. Conclusion: L. plantarum CECT7315/7316 has an immunostimulating effect and could be used to improve the response to influenza vaccination in elderly (AU)


Introducción y objetivos: La efectividad de la vacunación contra la influenza es menor en ancianos por lo que en este trabajo se evalúa la habilidad de las cepas de Lactobacillus plantarum CECT 7315/7316 para estimular la respuesta a la vacuna contra la influenza en ancianos. Métodos: 60 ancianos institucionalizados (65-85 años) participaron en un diseño aleatorizado, doble ciego controlado por placebo. Los voluntarios fueron vacunados con una vacuna trivalente contra influenza (A/Wisconsin/67/2005 NYMC X-161B (H3N2), A/Solomon Islands/3/2006 (H1N1) and B/Malaysia/2506/2004) durante la campaña española de vacunación 2006/2007. El consumo del probiótico empezó entre tres y cuatro meses después de la vacunación. Los voluntarios fueron distribuidos aleatoriamente en tres grupos: grupo A (recibieron 5*109 ufc/día de L. plantarum CECT 7315/7316 en 20 g de leche desnatada en polvo), grupo B (recibieron 5*108 ufc/día de L. plantarum CECT 7315/7316 en 20 g de leche desnatada en polvo) y grupo C o placebo (recibieron 20 g de leche desnatada en polvo). Los participantes consumieron el probiótico durante 3 meses. Resultados: El consumo de L. plantarum CECT 7315/7316 durante tres meses después de la vacunación contra influenza incrementó los niveles de anticuerpos IgA y IgG específicos contra la influenza. Además, se observó una tendencia hacia un incremento en los niveles de anticuerpos IgM específicos contra la influenza. Conclusiones: Las cepas de L. plantarum CECT 7315/7316 tienen un efecto inmunoestimulador y podrían utilizarse para mejorar la respuesta a la vacuna contra la influenza en ancianos (AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Haemophilus Vaccines/administration & dosage , Lactobacillus plantarum , Probiotics/therapeutic use , Adjuvants, Immunologic/therapeutic use , Influenza, Human/prevention & control , Health of the Elderly
5.
J Nutr Health Aging ; 16(2): 115-22, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22323344

ABSTRACT

BACKGROUND: The elderly, and especially those attending nursing homes, are at great risk from certain nutritional deficiencies. OBJECTIVE: The aim of this study was to determine which food groups present the highest rates of consumption among the institutionalized elderly and study the energy density of each food group and the number of calories and amount of protein in the total diet of each resident. DESIGN: This was a multicentre observational study of a sample of the institutionalized population over the age of 65. The sample of patients was drawn from four Spanish nursing homes (Santa Coloma Gramanet, Barcelona, Madrid and Bilbao). Our final sample comprised a total of 62 individuals, of whom 22 were men and 40 women, aged between 68 and 96 years. METHODS: Dietary data were collected using the double weight method for each main meal (breakfast, lunch, afternoon snack and dinner), including food type, the quantity of food served and the amount of plate waste for each of the main meals served during 21 days. STATISTICAL ANALYSES: The characteristics of the study population were compared by Student's t-test and χ2 test. The results are expressed in terms of their median values and the interquartile range. To analyse the overall differences between sites, gender and food groups we used Kruskall-Wallis test combined with the Mann-Whitney U-test with Bonferroni correction for multiple comparisons. RESULTS: The food group that was served most was milk products (376.25 g/day). A large amount of potatoes were also served (109.64 g/day) as were sweets and pastries (62.14 g/day). The daily serving of fruit (138.34 g/day) and vegetables (239.47 g/day) was equivalent to no more than that of a daily ration in each case. Milk was the food group with the highest consumption (311 g/day). Most of the energy was provided by groups with a higher energy density like as fats and sauces, sweets and pastries and bread. The mean protein consumption was 82,6 g/day (Table 5) and no significant differences were recorded in this consumption between men and women. CONCLUSIONS: We conclude that there is a need to improve the residents' energy intake and to redistribute their energy and protein intake among the various food groups. An alternative to increasing food portions so as to improve energy intake might involve enriching certain food types.


Subject(s)
Diet/statistics & numerical data , Dietary Proteins/administration & dosage , Energy Intake , Homes for the Aged , Nursing Homes , Aged , Aged, 80 and over , Diet Surveys , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Feeding Behavior , Female , Food, Fortified , Humans , Male , Spain
6.
Exp Mech ; 49(2): 235-246, 2009.
Article in English | MEDLINE | ID: mdl-20300451

ABSTRACT

This report describes a torsional wave experiment used to measure the viscoelastic properties of vocal fold tissues and soft materials over the range of phonation frequencies. A thin cylindrical sample is mounted between two hexagonal plates. The assembly is enclosed in an environmental chamber to maintain the temperature and relative humidity at in vivo conditions. The bottom plate is subjected to small oscillations by means of a galvanometer driven by a frequency generator that steps through a sequence of frequencies. At each frequency, measured rotations of the top and bottom plates are used to determine the ratio of the amplitudes of the rotations of the two plates. Comparisons of the frequency dependence of this ratio with that predicted for torsional waves in a linear viscoelastic material allows the storage modulus and the loss angle, in shear, to be calculated by a best-fit procedure. Experimental results are presented for hydrogels that are being examined as potential materials for vocal fold regeneration.

7.
J Hazard Mater ; 157(2-3): 386-96, 2008 Sep 15.
Article in English | MEDLINE | ID: mdl-18308468

ABSTRACT

Granular activated carbon (GAC) was evaluated as a suitable sorbent for polycyclic aromatic hydrocarbons (PAHs) removal from aqueous solutions. For this purpose, kinetic measurements on the extraction of a family of six PAHs were taken. A morphology study was performed by means of a scanning electron microscopy (SEM) analysis of GAC samples. Analyses of the batch rate data for each PAH were carried out using two kinetic models: the homogenous particle diffusion model (HPDM) and the shell progressive model (SPM). The process was controlled by diffusion rate the solutes (PAHs) that penetrated the reacted layer at PAH concentrations in the range of 0.2-10 mg L(-1). The effective particle diffusion coefficients (D(eff)) derived from the two models were determined from the batch rate data. The Weber and Morris intraparticle diffusion model made a double contribution to the surface and pore diffusivities in the sorption process. The D(eff) values derived from both the HPMD and SPM equations varied from 1.1 x 10(-13) to 6.0 x 10(-14) m(2) s(-1). The simplest model, the pore diffusion model, was applied first for data analysis. The model of the next level of complexity, the surface diffusion model, was applied in order to gain a deeper understanding of the diffusion process. This model is able to explain the data, and the apparent surface diffusivities are in the same order of magnitude as the values for the sorption of functionalized aromatic hydrocarbons (phenols and sulphonates) that are described in the literature.


Subject(s)
Charcoal/chemistry , Polycyclic Aromatic Hydrocarbons/isolation & purification , Water Pollutants, Chemical/isolation & purification , Water Purification/methods , Adsorption , Diffusion , Kinetics , Molecular Structure , Particle Size , Polycyclic Aromatic Hydrocarbons/chemistry , Water Pollutants, Chemical/chemistry
9.
Eur J Clin Nutr ; 61(9): 1037-56, 2007 Sep.
Article in English | MEDLINE | ID: mdl-17375121

ABSTRACT

OBJECTIVE: This paper describes the ad hoc methodological concepts and procedures developed to improve the comparability of Nutrient databases (NDBs) across the 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). This was required because there is currently no European reference NDB available. DESIGN: A large network involving national compilers, nutritionists and experts on food chemistry and computer science was set up for the 'EPIC Nutrient DataBase' (ENDB) project. A total of 550-1500 foods derived from about 37,000 standardized EPIC 24-h dietary recalls (24-HDRS) were matched as closely as possible to foods available in the 10 national NDBs. The resulting national data sets (NDS) were then successively documented, standardized and evaluated according to common guidelines and using a DataBase Management System specifically designed for this project. The nutrient values of foods unavailable or not readily available in NDSs were approximated by recipe calculation, weighted averaging or adjustment for weight changes and vitamin/mineral losses, using common algorithms. RESULTS: The final ENDB contains about 550-1500 foods depending on the country and 26 common components. Each component value was documented and standardized for unit, mode of expression, definition and chemical method of analysis, as far as possible. Furthermore, the overall completeness of NDSs was improved (>or=99%), particularly for beta-carotene and vitamin E. CONCLUSION: The ENDB constitutes a first real attempt to improve the comparability of NDBs across European countries. This methodological work will provide a useful tool for nutritional research as well as end-user recommendations to improve NDBs in the future.


Subject(s)
Databases, Factual/standards , Diet Records , Food Analysis/standards , Europe , Humans , Neoplasms/prevention & control , Nutritional Physiological Phenomena/physiology , Reference Values
10.
J Colloid Interface Sci ; 310(1): 35-46, 2007 Jun 01.
Article in English | MEDLINE | ID: mdl-17367802

ABSTRACT

Polymeric supports are presented as an alternative to granular activated carbon (GAC) for organic contaminant removal from groundwater using permeable reactive barriers (PRB). The search for suitable polymeric sorbents for hydrocarbon extraction from aqueous streams has prompted the synthesis of new resins incorporating new functionalities or modifying the polymer network properties that solve many of the existing problems. Between them, the new type of polymeric sorbents Macronet Hypersol containing a styrene-divinylbenzene macroporous hyperreticulated network has been evaluated. Because of their potential sorptive properties, tests were conducted to determine the feasibility of using them as a low-cost reactive material for groundwater applications. The present work describes the sorption of six polycyclic hydrocarbons (PAHs) from aqueous solution onto both Macronet polymeric sorbent MN200 and granular activated carbon. Batch experiments were performed to determine loading rates of a family of PAHs (naphthalene, fluorene, anthracene, acenaphthene, pyrene, and fluoranthene), from a simple two-rings PAH (naphthalene) up to a four-ring PAH (pyrene). The behavior of a non-functionalized Macronet support (MN200) was compared with the behavior of a recognized material, granular activated carbon (GAC). Analyses of the respective rate data with three theoretical models (pseudo-first- and pseudo-second-order reaction models and the Elovich model) were used to describe the PAH sorption kinetics. Sorption rate constants were determined by graphical analysis of the proposed models. The study showed that sorption systems followed a pseudo-first-order reaction model, although the pseudo-second-order reaction model provides an acceptable description of the sorption process. Graphical analysis showed that the sorption process with activated carbon is a more complex process than the one observed for hyper-cross-linked polymers (MN200). A simulation of the barrier thickness needed to treat a PAH-polluted plume showed that 0.1-1 m of sorption media is enough even for high water fluxes such as 0.1-2 m(3)/m(2)/day for both sorbents.


Subject(s)
Charcoal/chemistry , Polycyclic Aromatic Hydrocarbons/isolation & purification , Water Purification/methods , Adsorption , Kinetics , Polystyrenes/chemistry , Water Pollutants, Chemical/isolation & purification
12.
J Chromatogr A ; 869(1-2): 481-5, 2000 Feb 11.
Article in English | MEDLINE | ID: mdl-10720261

ABSTRACT

Research efforts dealing with the processes affecting the transport of pesticides in soils are needed in order to prevent further damage of surface and groundwater reserves. Although organic matter has been recognised as the most important contributor to the adsorption of non-ionic organic pesticides in soils, in some cases clay minerals may have an important role in the retention of these compounds. The present study was designed to improve the knowledge of the behaviour of azinphos-methyl in soils. Coefficients from adsorption isotherms and HPLC analysis of soil column leachates were used in this work for predicting pesticide mobility in soils. The studied clay mineral was a Spanish bentonite with a predominant montmorillonite fraction. The results showed that azinphos-methyl was adsorbed on the clay mineral and demonstrated the catalytic effect of bentonite on the hydrolysis of the pesticide.


Subject(s)
Aluminum Silicates/chemistry , Azinphosmethyl/analysis , Insecticides/analysis , Chromatography, High Pressure Liquid , Clay , Minerals/chemistry
13.
Electrophoresis ; 20(17): 3381-7, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10608704

ABSTRACT

The development of capillary zone electrophoresis (CZE) methods for the determination of metal cyanide complexes in real samples showed some problems, such as the low detection signal of Au (CN)2- and the low resolution between Ni(II) and Fe(II) cyanides in gold processing solutions, and the lack of separation of Pt(CN)4(2-) and Pd(CN)4(2-) in the leachates from automobile catalytic converters. To optimize some analytical parameters, the present study thus focused on the application of experimental designs and multiregression models. The following factors were examined by a two-level factorial design: applied voltage, injection time, detection wavelength, buffer ion, ionic strength and buffer modifiers. For optimization of the CZE method, subsequent response-surface experiments with the important factors were made with the two kinds of leaching solutions. Optimal analytical conditions were obtained in each case, giving good detection signals and resolution for the components of the studied leachates.


Subject(s)
Cyanides/chemistry , Electrophoresis, Capillary/methods , Metals/chemistry , Models, Chemical , Spectrophotometry, Ultraviolet
14.
J Chromatogr A ; 823(1-2): 91-6, 1998 Oct 09.
Article in English | MEDLINE | ID: mdl-9818396

ABSTRACT

Chlorpyrifos was determined in air, leaves and soil in a greenhouse in order to establish performance differences between gas-chromatography with nitrogen-phosphorus detection (GC-NPD) and high-performance liquid chromatographic and capillary electrophoretic methods and to assess the farm workers' risk of overexposure due to air exposure and/or skin contact with this compound. Results obtained indicate that the three analytical techniques, with the specific procedures described, can be used, although only GC-NPD provides an operative limit of detection in air. Chlorpyrifos levels in air are dependent on time and greenhouse ventilation, whereas it remains for a long time on leaf surfaces and soil. As a consequence, specific instructions can be established for farm workers in order to avoid skin and respiratory exposure to chlorpyrifos.


Subject(s)
Air/analysis , Chlorpyrifos/analysis , Chromatography, Gas/methods , Chromatography, High Pressure Liquid/methods , Electrophoresis, Capillary/methods , Insecticides/analysis , Plant Leaves/chemistry , Soil/analysis , Agriculture , Occupational Exposure
17.
J Chromatogr ; 455: 163-72, 1988 Nov 25.
Article in English | MEDLINE | ID: mdl-3235610

ABSTRACT

Liquid chromatography with ultraviolet detection (LC-UV) and positive and negative ion mode (PI and NI, respectively) thermospray LC-mass spectrometry (LC-MS) were used for the analysis of the organophosphorus pesticides azinphos-methyl, diazinon and parathion-methyl and their corresponding breakdown products obtained after basic hydrolysis (pH 7-11). LC analysis was performed in the reversed-phase mode using methanol-water (80:20) or methanol-water (70:30) + 0.1 M ammonium acetate for LC-UV or LC-MS, respectively. By employing NI thermospray LC-MS the identification of p-nitrophenol, showing the [2M-H]- ion as the base peak, was feasible and confirmed the LC-UV chromatogram at 220 nm. When the PI mode was used, [M + NH4]+ and [M + H]+ ions were obtained as base peaks for azinphos-methyl and diazinon, respectively. The degradation rates varied from diazinon, which showed no degradation during a period of ten days, to azinphos-methyl and parathion-methyl, for which degradation occurred rapidly when the pH was increased from 7 to 11.


Subject(s)
Azinphosmethyl/analysis , Diazinon/analysis , Insecticides/analysis , Methyl Parathion/analysis , Parathion/analogs & derivatives , Chromatography, High Pressure Liquid , Hydrolysis , Mass Spectrometry , Spectrophotometry, Ultraviolet
19.
J Dev Behav Pediatr ; 7(5): 288-92, 1986 Oct.
Article in English | MEDLINE | ID: mdl-3771803

ABSTRACT

This study examined the hypothesis that low birth weight, preterm infants, owing to their severe illness and exposure to intensive care units (ICU), are predisposed to a more difficult temperament. Temperament was compared among three groups (n = 92): high-risk (HR) preterm infants (mean birth weight 1244 g), low-risk (LR) preterm infants (mean birth weight 2050 g), and full-term (FT) infants (mean birth weight 3159 g). Mothers completed the Infant Temperament Questionnaire (ITQ) when infants were 6 months (adjusted) old. The most striking differences were in mothers' subjective ratings of their infants: 21% of the HR mothers rated their infants as more difficult than average, compared to 4% of full-term and 0% of low-risk preterm mothers. By contrast, according to objective rating, HR infants met none of the ITQ criteria for the diagnostic category of "difficult." However, HR infants did have less favorable scores in mood, adaptability, persistence, and distractibility than LR and FT. When the HR group was further analyzed, differences in mothers' objective ratings were accounted for by length of hospitalization, while differences in mothers' subjective ratings were accounted for by severity of disease. Results suggest that, in our sample, exposure to ICU may have led to some temperament differences, but its effect was more pervasive on parents' perceptions of their infants.


Subject(s)
Infant, Low Birth Weight/psychology , Infant, Premature/psychology , Intensive Care Units, Neonatal , Personality , Temperament , Female , Humans , Infant, Newborn , Male
20.
J Dev Behav Pediatr ; 7(4): 217-23, 1986 Aug.
Article in English | MEDLINE | ID: mdl-3745447

ABSTRACT

Very low birth weight (VLBW) infants are known to experience more health problems after discharge from the hospital, but the effects of such problems in terms of the demand for medical care and of the effect of this on the family are only just beginning to be described. A survey of the families of 132 children who were born weighing less than 1750 g at mostly suburban hospitals and transported to a Children's Hospital, who were 1-4 years old at the time of the survey, has revealed that these children continue to experience health problems to the extent that 35% are limited in one or more activities of daily living. They also incur greater use of health care services (17% hospitalized in the prior year; 54% with a doctor's visit in the prior month). The most important predictors of high perceived impact of these problems on the family is related to the number of activities limited by health, the age of the child, and the financial resources the family could bring to coping with the child's care. These findings provide further characterization of the families which may be most vulnerable to the ongoing health problems of the VLBW infant.


Subject(s)
Family , Infant, Low Birth Weight/psychology , Activities of Daily Living , Child, Preschool , Female , Follow-Up Studies , Health Status , Humans , Infant , Infant, Newborn , Male , Social Class , Stress, Psychological/psychology
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