ObjectivesIt is known that during the middle childhood years those with permanent childhood hearing loss (PCHL) are at increased risk of showing emotional and behaviour difficulties (EBD). It has yet to be established whether this risk continues into the late teenage years. There is a paucity of longitudinal studies on the association between PCHL and EBD.MethodsThe Strengths and Difficulties Questionnaire (SDQ) was used to measure EBD based on parent, teacher and self-ratings in 76 teenagers with PCHL and 38 in a hearing comparison group (HCG) from a population sample of children that was followed up from birth to adolescence.ResultsOn parent-rated SDQ, the PCHL group had significantly higher Total Difficulties score than the HCG (Standardised mean difference (SMD) = +0.39, 95%CI 0.00 to 0.79). Amongst the PCHL group the presence of disabilities other than hearing loss had a substantial impact on the level of parent-rated EBD (SMD = +1.68, 1.04 to 2.33). There was a relationship between receptive language ability and EBD in both the HCG (r = −0.33, 95%CI −0.59 to −0.01) and the PCHI group (r = −0.33, 95%CI −0.53 to −0.02). The effect of PCHL on EBD became non-significant when receptive language was included as a covariate (F = 0.12, df = 1,95, p = 0.729). Early confirmation of hearing loss (i.e. before 9 months of age) did not have a significant effect on EBD scores (SMD = +0.31, 95%CI −0.15 to 0.77).ConclusionsPCHL continues to be associated with elevated EBD scores as measured by parent rated SDQ into the late teenage years but the degree of this elevation is less than in childhood and is not apparent on teacher or self-ratings. Poor receptive language ability appeared to account for these elevated EBD scores in the group with PCHL. Particular attention needs to be paid to the mental health of children and adolescents with PCHL that is accompanied by other disabilities and to those with poor receptive language ability. However, the majority of teenagers with PCHL do not show clinically significant elevated levels of EBD.
The impact of the prolonged use of cetirizine at high dose (0.25 mg/kg twice a day over 18 mo) on behavior and cognitive ability was examined in a double-blind, randomized, placebocontrolled trial (ETAC-Early Treatment of the Atopic Child) designed to establish whether it was possible to prevent young children (1-2 y old at study entry) with atopic dermatitis from developing asthma. Well-validated and standardized measures of behavior (Behavior Screening Questionnaire) and cognition (McCarthy Scales of Children's Abilities) were used. In addition, the ages of attainment of psychomotor milestones were established. These measures were taken between an average of 32 and 53 mo of age, both during the study treatment with cetirizine or placebo and after the study treatment had been discontinued. The Behavior Screening Questionnaire was completed at least once on approximately 300 children in each group and on approximately 200 children on five occasions. The McCarthy Scales of Children's Abilities were administered to approximately 100 in each group at three different times. There were no significant differences between the cetirizine and placebo groups on either of the behavior and cognition measures or in psychomotor milestones during or after the study treatment. These findings suggest that there are no adverse effects on behavior or learning processes associated with the prolonged use of cetirizine in young children with atopic dermatitis. There is evidence that the use of some antihistamines has an effect on behavior and that this is shown most markedly as sedation (1-3). These side effects may have implications for the long-term development of the child. Little is known about the development of histamine receptors with age, and, given that all antihistamines can gain access to the brain (4), it is important to establish whether antihistamines have a deleterious effect on histamine receptor sites and on the cognitive and behavioral systems regulated by histamine (5). There has been no study on the impact of the long-term administration of antihistamines on children's behavioral development. The present study aimed to fill this gap.A number of findings that have suggested that firstgeneration antihistamines can interfere with learning. Sedating (diphenhydramine) and nonsedating (loratadine) antihistamines and a placebo have been used with children suffering from seasonal allergic rhinitis (6). It was found that those on placebo and diphenhydramine learned significantly less well than healthy controls. The nonsedating antihistamine only partially counteracted this effect. A subsequent study of young adults with seasonal allergic rhinitis showed that this learning deficit could be avoided by the use of a combination compound of acrivastine and pseudoephedrine (7). The indications from these previous studies made it essential to determine whether
The study reports on factors predicting the longevity of 328 people over the age of 65 drawn from an English city and followed over 20 years. Both the reported activities score and the individual's comparative evaluation of their own level of activity independently reduced the risk of death, even when health and cognitive status were taken into account. The analysis has provided a strong test of the relevance of measures of reported activity and measures of self-perception to longevity. The study confirms the important predictive role of reported activity levels even when detailed health measures are taken into account. But in addition personal perception of one's own relative level of activity, and to a lesser extent subjective assessment of health, also predicted longevity.
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