The Isle of Wight Studies began in 1964–65 with a series of epidemiological studies of educational, psychiatric and physical disorders in 9- to 11-year-old children. These early studies were financed by the Department of Education and Science and the Foundation for Child Development (then the Association for the Aid of Crippled Children). The findings were fully reported in two books (Rutter, Tizard & Whitmore, 1970; Rutter, Graham & Yule, 1970) and only brief details are included here.
SUMMARY Among 85 school‐children with epilepsy attending ordinary schools, 31.2 per cent were achieving an above‐average level of work, 53.1 per cent were holding their own at a below‐average level and 15.6 per cent were falling seriously behind. 21.1 per cent were showing deviant behaviour which presented their teachers with problems of management. These findings are discussed in relation to a number of factors, including the patterns of seizures. The frequency of seizures appears to be an important factor in behaviour disorder. Special consideration is given to the fact that inattentiveness was noticed in the majority of children who were educationally retarded or presented behaviour problems. The vulnerability of children with epilepsy is emphasised, as is their need for comprehensive assessment. RÉSUMÉ Parmi 85 écoliers épileptiques fréquentant des écoles ordinaires, vingt se sont situés au‐dessus de la moyenne, 34 légèrement en dessous et dix présentaient un échec indiscutable. Il n'a pas été possible de classer 21 enfants dont la majorité avait moins de 6 ans. 18 enfants présentaient des troubles du comportement posant des problèmes à leurs enseignants. Ces faits sont discutés en function d'un certain nombre de caractéristiques incluant l'allure des crises. La frequence des crises parait fortement liée aux troubles du comportement. Un intérêt particulier est accordé aux facteurs d'inattention que les enseignants ont particulièrement remarqué chez la majorité des enfants effectivement retardés ou présentant des troubles du comportement. La ‘vulnérabilité’ des enfants épileptiques est soulignée et leur besoin de fixation affective est discuté. ZUSAMMENFASSUNG Von 85 Schulkindern mit Epilepsie, die eine normale Schule besuchten, erreichten 20 überdurchschnittliche Leistungen, 34 Kinder hielten sich auf einem unter dem Durchschnitt liegenden Niveau und 10 Kinder waren sehr zurückgeblieben. 21 Kinder konnten nicht eingestuft werden, die Mehrzahl von ihnen war unter 6 Jahre alt. 18 Kinder zeigten ein abnormes Verhalten und stellten damit ihre Lehrer vor Probleme in der Behandlung. Diese Befunde werden im Zusammenhang mit einer Reihe von Besonderheiten dieser Kinder einschließlich ihrer Anfallsmuster diskutiert. Die Häufigkeit der Anfälle könnte ein wichtiger Faktor in Verbindung mit Verhaltensstörungen sein. Besondere Berücksichtigung findet die Unaufmerksamkeit, die von den Lehrern hauptsächlich bei einer Mehrzahl von Kindern bemerkt wurde, die entweder emotional retardiert waren oder Verhaltensstörungen hatten. Es wird auf die Probleme der Kinder mit Epilepsie eindringlich hingewiesen und diskutiert, daß sie einer umfassenden Beurteilung bedürfen. RESUMEN De entre 85 niños escolares con epilepsia que asistían a colegios ordinarios, 20 conseguían un nivel superior al medio en su trabajo, 34 se mantenían en un nivel inferior y 10 quedaban muy retrasados. No fue posible clasificar 21 niños, la mayoria de menos de 6 años de edad. 18 niños presentaban desviación en su comportamiento que representaba problemas para s...
Aims Effective and efficient education and patient engagement are fundamental to improve health outcomes in heart failure (HF). The use of artificial intelligence (AI) to enable more effective delivery of education is becoming more widespread for a range of chronic conditions. We sought to determine whether an avatar-based HF-app could improve outcomes by enhancing HF knowledge and improving patient quality of life and self-care behaviour. Methods and results In a randomized controlled trial of patients admitted for acute decompensated HF (ADHF), patients at high risk (≥33%) for 30-day hospital readmission and/or death were randomized to usual care or training with the HF-app. From August 2019 up until December 2020, 200 patients admitted to the hospital for ADHF were enrolled in the Risk-HF study. Of the 72 at high-risk, 36 (25 men; median age 81.5 years; 9.5 years of education; 15 in NYHA Class III at discharge) were randomized into the intervention arm and were offered education involving an HF-app. Whilst 26 (72%) could not use the HF-app, younger patients [odds ratio (OR) 0.89, 95% confidence interval (CI) 0.82–0.97; P < 0.01] and those with a higher education level (OR 1.58, 95% CI 1.09–2.28; P = 0.03) were more likely to enrol. Of those enrolled, only 2 of 10 patients engaged and completed ≥70% of the program, and 6 of the remaining 8 who did not engage were readmitted. Conclusions Although AI-based education is promising in chronic conditions, our study provides a note of caution about the barriers to enrolment in critically ill, post-acute, and elderly patients.
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