Subject(s)
Child Behavior , Coagulants/administration & dosage , Hemarthrosis/prevention & control , Hemophilia A/drug therapy , Absenteeism , Child , Cognition , Cost of Illness , Drug Administration Schedule , Educational Status , Hemarthrosis/etiology , Hemarthrosis/psychology , Hemophilia A/complications , Hemophilia A/psychology , Humans , Quality of Life , UnderachievementABSTRACT
Data from the Hemophilia Growth and Development Study (HGDS) were used to evaluate the association between hemophilia morbidity, measured by abnormalities in coordination and gait (CG), and intellectual ability and academic achievement. The CG abnormalities observed in the HGDS participants (n = 333) were primarily due to hemophilia-related morbidity. Although HGDS participants performed within the average range for age on measures of intellectual ability, there were meaningful differences between CG outcomes at baseline and throughout the 4 years of study. Participants without CG abnormalities consistently achieved higher scores than those with CG abnormalities on Reading, Spelling, and Arithmetic subtests of the Wide Range Achievement Test-Revised. Our findings suggest that lowered achievement is related to the functional severity of hemophilia.
Subject(s)
Cognition , Developmental Disabilities/etiology , Hemophilia A/complications , Adolescent , Adult , Child , Humans , Intelligence Tests , Male , Neuropsychological TestsABSTRACT
OBJECTIVE: To determine the effects of human immunodeficiency virus (HIV) infection on children's development by identifying neurological and environmental variables associated with neuropsychological measures of cognitive development in HIV-seronegative (HIV-) and HIV-seropositive (HIV+)children and adolescents with hemophilia. METHODS: Participants (N = 298; 60% HIV+) were males ages 7-19 years enrolled in the Hemophilia Growth and Development Study (HGDS). Least squares modeling was used to determine whether there was a difference at baseline in mean neuropsychological test scores by HIV status, age, and neurological baseline findings, adjusting for selected environmental and medical history variables. RESULTS: The participants were within age expectations for general intelligence. Variables associated with lowered neuropsychological performance included academic problems, coordination and/or gait abnormalities, parents' education, and previous head trauma. CONCLUSIONS: Hemophilia-related morbidity has a subtle adverse influence on cognitive performance. HIV infection was not associated with neuropsychological dysfunction in this group even when MRI abnormalities were present.
Subject(s)
Developmental Disabilities/epidemiology , HIV Infections/complications , Hemophilia A/complications , Adolescent , Child , Humans , Least-Squares Analysis , Magnetic Resonance Imaging , Male , Neurologic Examination , United States/epidemiologyABSTRACT
BACKGROUND: Quantitative measures of alcohol intake are not always available in population studies. METHOD: The authors evaluated whether a question on alcohol intake embedded within a general health survey could be used as a surrogate marker for alcohol intake. We compared alcohol intake assessed with a food frequency questionnaire (FFQ) with alcohol intake assessed with a simple dichotomous survey question in a population-based sample. RESULTS: The study population consisted of 755 men and 1164 women from two communities in southeastern New England in the USA. There was strong agreement between the two alcohol questions for the classification of nondrinkers (98.1%). When participants were classified according to the quantity of alcohol consumed on the FFQ, the ability of the simple question to identify drinkers improved in a dose-response fashion. The Kappa statistic was 0.08 (P < 0.001), 0.38 (P < 0.001), and 0.81 (P < 0.001) for low, medium, and high consumers of alcohol, respectively. CONCLUSIONS: These results suggest that the survey alcohol question provides a useful qualitative measure of categorizing nondrinkers and identifying drinkers who consume more than one drink per day. In population studies where quantitative measures of alcohol intake may not be available a survey alcohol question may prove useful when alcohol intake is likely to confound results, and adjustment of the data is needed.