Effect modification by parental education on the associations of birth order and gender with learning achievement in adolescents.

BACKGROUND: A child's gender and ordinal position within a family have varied implications on his or her personality and cognitive development. However, little is known about whether or not parental educational level may moderate the effects of birth order and gender. METHODS: Basic Competence Test (BCT) scores of 290,588 young adolescents aged 15-16 years in Taiwan were analysed. Parental educational level was calculated as the highest educational attainment of the subjects' parents. The multiple linear regression model was used to assess the modification effects of parental educational levels on the associations of interest. RESULTS: After controlling for covariates, we noted a clear inverse relationship between birth order and BCT scores in Mandarin, Mathematics and Science. Additionally, boys had significantly lower mean scores in Mandarin, but had significantly higher mean scores in both Mathematics and Science. We also found the significant interactive effects of birth order, gender and parental educational attainment on BCT scores, in which the birth order and gender effects were more evident in higher-educated families than in lower-educated ones. CONCLUSIONS: This large cohort study confirmed that both birth order and gender may pose independent influences on BCT scores; moreover, such influences are significantly modified by parental educational attainment.

Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study.

BACKGROUND: There has been considerable interest in traditional Chinese herbal medicine (TCHM) as a treatment for atopic dermatitis (AD). A twice-daily concoction of an ancestral formula containing five herbs has been found to be beneficial in an open study. OBJECTIVES: To assess the efficacy and tolerability of the concoction in children with AD. METHODS: Following a 2-week run-in period, children with long-standing moderate-to-severe AD were randomized to receive a 12-week treatment with twice-daily dosing of three capsules of either TCHM or placebo. The SCORing of Atopic Dermatitis (SCORAD) score, Children's Dermatology Life Quality Index (CDLQI), allergic rhinitis score, and requirement for topical corticosteroid and oral antihistamine were assessed before and at weeks 4, 8, 12 and 16 after treatment. Adverse events, tolerability, haematological and biochemical parameters were monitored during the study. RESULTS: Eighty-five children with AD were recruited. Over 12 weeks, the mean SCORAD score fell from 58.3 to 49.7 in the TCHM group (n = 42; P = 0.003) and from 56.9 to 46.9 in the placebo group (n = 43; P = 0.001). However, there was no significant difference in the scores at the corresponding time points between the two groups. The CDLQI in TCHM-treated patients was significantly improved compared with patients receiving placebo at the end of the 3-month treatment and 4 weeks after stopping therapy (P = 0.008 and 0.059, respectively). The total amount of topical corticosteroid used was also significantly reduced by one-third in the TCHM group (P = 0.024). No serious adverse effects were observed between the groups. CONCLUSIONS: The TCHM concoction is efficacious in improving quality of life and reducing topical corticosteroid use in children with moderate-to-severe AD. The formulation was palatable and well tolerated.

Grip strength in different positions of elbow and shoulder.

This study investigated the effect of shoulder position on grip strength in 80 men and 80 women. A Jamar dynamometer was used to measure the grip strength in the four testing positions. The four hand strength tests consisted of three positions in which the elbow was maintained in full extension combined with varying degrees of shoulder flexion (ie, 0 degrees, 90 degrees, and 180 degrees) and of one position in which the elbow was flexed at 90 degrees with the shoulder in 0 degrees of flexion. Only the dominant hand was tested. The highest mean grip strength measurement was recorded when the shoulder was positioned at 180 degrees of flexion with elbow in full extension; whereas the position of 90 degrees elbow flexion with shoulder in 0 degrees of flexion had the lowest grip strength score. In addition, the grip strength measured with the elbow in extension, regardless of shoulder position (ie, 0 degrees, 90 degrees, and 180 degrees of flexion), was significantly higher than when the elbow was flexed at 90 degrees with the shoulder positioned at 0 degrees of flexion. Finally, grip strength differed significantly for both sexes and for each age group. The grip values of the standardized 90 degrees elbow flexed position were further analyzed to determine the average performances in the study population. For men, grip strength peaked within the 20 to 39 years age group and gradually declined thereafter. For women, the highest mean grip strength measurement was recorded in the 40- to 49-year-old age group and then deteriorated with age.(ABSTRACT TRUNCATED AT 250 WORDS)

Grip strength: relationship to shoulder position in normal subjects.

The objective of this study was to evaluate the effect of shoulder position on grip strength. A Jamar dynamometer was used to measure the grip strength of 160 subjects (80 males and 80 females), stratified on both sex and age, in the four testing positions. For each of the tests of grip strength, the subject stood with the shoulder adducted and neutrally rotated while the forearm and wrist were held in the neutral position. The four hand strength tests consisted of three positions in which the elbow was maintained in full extension combined with varying degrees of shoulder flexion (i.e., 0 degree, 90 degrees, and 180 degrees) and of one position in which the elbow was flexed at 90 degrees with the shoulder in 0 degree of flexion. Only the dominant hand was tested. The results showed that the highest mean grip strength measurement was recorded when the shoulder was positioned at 180 degrees of flexion with elbow in full extension; whereas the position of 90 degrees elbow flexion with shoulder in 0 degree of flexion had the lowest grip strength score. In addition, the grip strength measured with the elbow in extension, regardless of shoulder position (i.e., 0 degree, 90 degrees, and 180 degrees of flexion), was significantly higher than when the elbow was flexed at 90 degrees with the shoulder positioned at 0 degree of flexion. Finally, grip strength differed significantly for both sexes and for each age group. The findings are valuable in the evaluation and rehabilitation training of hand injured patients.

[The relationship between functional recovery one year after a stroke, and related factors].

This study examines the factors affecting functional performance of 40 hemiplegic subjects in their homes following discharge from the hospital. All subjects suffered a cerebral vascular accident at least one year prior to this research period. Barthel Index was used to assess subjects' self-reported functional level in activities of daily living (ADL). A backward elimination of stepwise regression analysis was performed to ascertain the predictive value of the variables in determining functional performance one year after the onset of a stroke. These variables are factors related to the initial onset and those affecting the patient's functional status at home. The results revealed that subjects who had a shorter length of stay in the hospital, scored a higher on the Barthel Index (p less than 0.05). It also demonstrated that subjects who were more satisfied with their current subjective health status, had a higher Barthel Index score.

[The relationship between early motor stage and hand function recovery six months after stroke].

The prognosis of hemiplegic hand function may reflect intrinsic recovery. Applying the variables of initial neurological loss in the hemiplegic upper extremity to predict the prognosis of hand function will enable therapists to establish the ultimate goals of rehabilitation and to select the appropriate treatment programs. Pinch and grip strength tests, Frenchay arm function test and the nine-hole peg test were used to determine the relationship between the initial Brunnstrom motor stage of the hemiplegic upper extremity and the prognosis of hand function after six months. Forty stroke patients were divided into three groups. Group I was subjects with a motor stage below the Brunnstrom motor stage III in both proximal and distal parts of the hemiplegic upper extremity. Group II was subjects with motor stage below Brunnstrom motor stage III in the proximal part and above stage III in the distal part or vice versa. Group III was subjects with a motor stage above Brunnstrom motor stage III both in the proximal and the distal parts. The results of this study indicated that the prognosis of the Brunnstrom motor stage of the hemiplegic upper extremity generally improved about one or two stages. According to the results of the grip and pinch strength tests, the Frenchay arm function test or the nine-hole peg test, group I patients could hardly use their affected hand functionally. The grip strength and the pinch strength deficits of group I were 93.8% and 91.4% respectively. The grip strength and the pinch strength deficits of group II were 72.1% and 68.5% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Application and evaluation of the VICON system in gait analysis].

By employing the VICON system, segment angular displacement, velocity and acceleration of the lower limbs were achieved from an Above-Knee (A/K) Amputee using a constant friction prosthesis during the swing phase of the gait cycle. By applying computer for data analysis and inputing anthropometric data of the (A/K) Amputee, kinematic trajectory and a stick diagram of lower limbs were obtained. The data were then compared with those obtained from normal subjects. The results showed that the VICON system can provide quantitative analysis of several important parameters in the gait cycle and that it is very helpful in the evaluation and rehabilitation training of abnormal gait.

Scanning electron microscopy of human lungs in various forms of heart disease.

The surface morphologic features of the lung obtained from 21 patients with various forms of heart disease were investigated by scanning electron microscopy, with particular emphasis on the correlation between the surface pathology and cardiopulmonary hemodynamics. There were almost no pathologic findings on the bronchiolar and alveolar surfaces in patients with normal pulmonary arterial wedge pressure (PAWP). The characteristic changes of the surface morphology of the lung parenchyma in patients with abnormal elevation of PAWP included various degrees of desquamating loss of the bronchiolar epithelium associated with inflammatory cell infiltration and fibrotic changes and focal epithelial disruption of the individual alveoli which often extended to involve the surface of the entire alveoli with perforated rupture of the alveolar septa. The severity of abnormal surface morphologic findings of the lung seemed to correlate to the degree of PAWP. From our results it is concluded that chronic lung congestion plays a major role in the pathogenesis of the surface pathologic changes of the lung in patients with heart disease of various etiologies. Our findings may provide a clearer understanding of the structural and functional relationship of congestive lung and a clinical explanation for pulmonary manifestations in patients with chronic congestive heart failure.

The surface morphology and ultrastructure of renal arterial smooth muscle cells in patients with renovascular hypertension.

The surface and internal ultrastructure of renal arterial smooth muscle cells were investigated in 3 patients with renovascular hypertension. The most characteristic features of the surface pathology in hypertrophied smooth muscle cells consisted of various degrees of surface defects, including both extensive loss of surface details and an irregular thickening and disruption of the basement membrane, which was widely separated from the plasma membrane by a clear space. Ultrastructural changes include the appearance of highly lobulated nuclei, multinucleation, disorganization of myofilaments and increased numbers of rough-surfaced sarcoplasmic reticulum and mitochondria, which are usual manifestations of cellular hypertrophy. These results suggest that ionic movement across the cell membranes, particularly of Ca2+, is probably abnormal in hypertrophied smooth muscle cells. This may result in functional disorders of hypertensive arteries.

The surface morphology of the infundibular muscle in patients with tetralogy of fallot.

The surface morphology of the infundibular muscles obtained from open heart surgery was investigated in 10 patients with tetralogy of Fallot. Various degrees of abnormal surface morphological changes were observed from the endocardium to the myocardium. In the endocardium striking proliferation of the endothelial cells was usually accompanied by focal loss of the endothelium with fibrotic change. Based on the characteristic alterations of the surface morphology 4 different groups of myocardial cells could be identified: normal myocytes, defective myocytes, sclerotic myocytes, and necrotic myocytes. Because intact surface morphology is responsible for integrated cellular function these pathological findings observed on the surface morphology of the endocardium and myocardium can provide a valuable reference to further understanding of functional disorders of the infundibular muscle in patients with tetralogy of Fallot.