Bridging the gap between health and education: words are not enough.

OBJECTIVES: When using specific terminology for childhood developmental disorders, paediatricians make assumptions about what teachers know and believe. If these assumptions are incorrect, collaborative management may be compromised. We surveyed primary school teachers in North Brisbane regarding their beliefs about developmental disorders and their views on collaboration between medical and educational professionals. METHODS: A survey questionnaire was written specifically, and then piloted with professional colleagues and 40 teachers. Questions examined teachers' opinions about, and personal experience with various developmental disorders. Free comments addressed barriers to collaboration with doctors, and how this might be improved. Responses were analysed using descriptive statistics. RESULTS: Responses were received from all of the 41 schools surveyed. Overall, completed questionnaires were obtained from 297 of 397 (75%) primary classroom teachers surveyed. Several apparent misconceptions were held, either by the majority (e.g. 70% felt dietary modification is commonly successful treatment for ADHD), or by a significant minority of teachers (e.g. 23% believed autistic spectrum disorder is not a permanent neurological condition). Responses to many questions concurred with the authors' assumptions. Teachers reported high levels of concern about lack of training and resource support for managing special-needs children. Over three-quarters of teachers did not access doctors for information, relying instead on special education professionals (96%) or parents (94%). Few group differences were noted by age, sex, years teaching experience, or system (Catholic, State). Free comments identified significant barriers to the collaboration process, and suggested strategies to address these. CONCLUSIONS: Doctors cannot assume teachers' beliefs about developmental disorders are similar to their own. Furthermore, doctors should recognize constraints that teachers work under, and can take the initiative to improve collaboration with topic-based as well as child-specific information.

Non-anaemic iron deficiency identified by ZPP test in extremely premature infants: prevalence, dietary risk factors, and association with neurodevelopmental problems.

INTRODUCTION: The aims of this study were to determine, in a cohort of extremely premature infants, the prevalence of iron deficiency identified by zinc protoporphyrin/heme ratio (ZPP) testing, and its association with neurodevelopmental problems and dietary risk factors for iron deficiency. METHODS: Infants of less than 29 weeks' gestation or less than 1000 g birth weight were studied prospectively at a multidisciplinary follow-up clinic. Assessments were made at a corrected age of either 12 months (n=72) or 2 years (n=69). Physical examination, Griffiths Developmental Scale, and neurosensory-motor assessment were administered, information on diet and behaviour was obtained by questionnaire, and a fingerprick ZPP ratio was performed to identify iron deficiency. RESULTS: 18.4% of infants had positive ZPP tests. There was no significant association between a positive ZPP test result and dietary risk factors, or symptoms of lethargy, irritability or poor attention. In children without cerebral palsy, there was no difference on Griffiths scores or neurosensory-motor assessment between ZPP-positive and ZPP-negative groups. The diagnosis of cerebral palsy (n=12) was significantly associated with both a positive ZPP test and a lower Griffiths general quotient (GQ) score. CONCLUSIONS: Iron deficiency occurs commonly in extremely low birth weight (ELBW) children in early childhood, and is not predicted by dietary risk factors. The prevalence of iron deficiency is increased in ELBW children with cerebral palsy. Non-anaemic iron deficiency (NAID) does not impair development or significantly affect behaviour of ELBW subjects who do not have cerebral palsy.

Supercritical fluid extraction (SFE) as a multi-residue extraction procedure for beta-agonists in bovine liver tissue.

A supercritical fluid extraction procedure has been developed for the extraction of beta-agonists in bovine liver samples. The method is suitable for compounds of different beta-agonist classes: the substituted aniline-type compounds (e.g. clenbuterol) and the phenolic-type compounds (e.g. salbutamol), including conjugated forms of the latter. The developed procedure involves a combination of supercritical fluid extraction with enzyme immunoassay for the determination of clenbuterol and salbutamol residues at the low ppb level. Addition of methanol modifier and removal of sample moisture are necessary for the extraction of more polar analytes such as salbutamol. Method validation incorporating intra- and inter-assays was carried out on fortified liver tissue and showed good recovery and low variation (RSD < 15%). An enzyme hydrolysis procedure was incorporated into the method for the deconjugation of conjugated residues. The developed procedure was shown to be successful for the determination of both clenbuterol and salbutamol in incurred liver tissue.

Supercritical fluid extraction of clenbuterol from bovine liver tissue.

The development of a supercritical fluid extraction procedure for the extraction of clenbuterol from bovine liver tissue is described. The procedure involves a combination of supercritical fluid extraction with enzyme immunoassay for the determination of clenbuterol residues at the low ppb level. Method validation incorporating inter- and intra-assays was carried out on fortified liver tissue and showed good recoveries and low variations (RSD < 15%) for levels of clenbuterol of 0.5, 2 and 5 ppb. The developed procedure was shown to be successful for the determination of clenbuterol in incurred liver tissue. The effects of organic modifiers and of inherent sample moisture on analyte extractability are also presented.