Anthony D. Elliman

The growth of low-birth-weight children

The growth of 171 seven‐year‐old children, free from major disability, with a birth weight of 2000 g or less was examined and compared with that of their own parents and of normal‐birth‐weight peers. Measurements included height, weight, occipitofrontal circumference, biparietal, occipitofrontal and bi‐iliac diameters, triceps and subscapular skinfold thickness. Low‐birth‐weight children were shorter than their parents whereas those of normal birth weight were taller. For all parameters, particularly weight, the low‐birth‐weight children were significantly less well grown. There was no significant relationship between occipitofrontal circumference and intellectual ability.

e-Government online forms: design guidelines for older adults in Europe

This paper reports on the findings of Delivering Inclusive Access to Disabled and Elderly Members of the community (DIADEM), a 3-year project, funded by the European Commission’s Sixth Framework Programme, to assist older adults when accessing, completing, and submitting online forms, by developing web-based assistive technologies that adapt the online form according to users’ needs. A user-centred approach is adopted to gain insights into the challenges faced by 80 older adults in three European countries as they interact with a representative sample of public service-based online forms. A thematic analysis is then carried out on the data, which revealed five over-arching themes that relate to the challenges faced by users: assistance, trust, layout, the technology paradigm, and language. From these themes, 23 online form design guidelines are derived, which provide valuable guidance for the development of the DIADEM application and for e-Government online form design for an ageing population in general.

A Comment on Kidd’s Characterisation of Knowledge Workers

Abstract: Irrespective of the frequency to which it is referred, the concept of ‘knowledge work’ remains surprisingly ill defined and generally not well understood. In this paper we address one of the more insightful contributions by Kidd in 1994 and contrast her characterisation with our experience in a case study of a legal team. In general this shows strong correlation with her definitions of knowledge work but also raises interesting questions about some of her secondary characteristics. These lend support to the hypothesis that knowledge work is not a uniform area. Thus, it is inappropriate to generalise too much on attributes that are governed by the domain of expertise in search of a universal definition. However, there is sufficient common ground to believe that only a few major groups exist distinguished mainly by working practice, team and career structures.

People, Information Systems and Change

Abstract: Information systems are the glue between people and computers. Both the social and business environments are in a continual, some might say chaotic, state of change while computer hardware continues to double its performance about every 18 months. This presents a major challenge for information system developers.  The term user-friendly is an old one, but one which has come to take on a multitude of meanings. However, in today’s context we might well take a user-friendly system to be one where the technology fits the user’s cognitive models of the activity in hand. This article looks at the relationship between information systems and the changing demands of their users as the underlying theme for the current issue of Cognition, Technology and Work.  People, both as individuals and organisations, change. The functionalist viewpoint, which attempts to freeze and inhibit such change, has failed systems developers on numerous occasions. Responding to, and building on, change in the social environment is still a significant research issue for information systems specialists who need to be able to create living information systems.

Developing Organisational Stories Through Grounded Theory Data Analysis: A Case Example for Studying IS Phenomena

This article provides a concrete example of a technique or tool that may improve intensive case research and understanding, especially when considering explanatory case study research. It is argued that researchers must work hard and be creative to provide robust methodological tools so that their work is accepted in the Information Systems field (in particular), as it is traditionally skeptical about qualitative studies. This paper argues that story-telling grounded in the data through the use of the Grounded Theory methodology and its associated methods provide a way of identifying the causal conditions in any case where the underlying dynamics for any type of organisational change are unknown. Although this research and method of presentation is relevant to the IS field, it has applications in any social science research where it is necessary to present the causal conditions for the phenomena under study.

38 HAND EYE COORDINATION IN 7-YEAR OLD LOW BIRTHWEIGHT CHILDREN

As part of a larger study, hand-eye coordination was measured in a group of low birthweight (LBW) (BW2000g) 7 year olds attending normal school, and a control group of normal birth-weight children selected from local schools. Children with cerebral palsy were excluded. The distribution of sex, social class and race was similar in the two groups but there were significantly more first surviving and only children in the LBW group (p<.005). LBW children were less good at finger-nose pointing (p<.01), diadochokinesis (p≪.001) and finger opposition using both hands simultaneously (p<.05). There was no significant difference in the ability to throw a ball up and catch it, but LBW children were less able to clap while the ball was in the air (p<.001). Within the LBW group there was no significant difference between children of different birth weight, sex or gestation, but children who were appropriate for gestational age (AGA) were better at diadochokinesis than those who were small for gestational age (p<.05). These findings show that LBW children are less good at hand-eye coordination than children of normal birthweight*

171 LOW BIRTHWEIGHT CHILDREN - HOW TALL ARE THEY AT THREE|[quest]|

As part of an ongoing study of all babies with a birthweight of 501-2000 grams inclusive born at or transferred into Hammersmith and Queen Charlottes Maternity Hospitals, London, in a one-year period from June 1979 to May 1980, 176 children were weighed and measured at birth and three years. They were classified as small for gestational age (SGA)(birthweight below tenth centile for gestational age) or appropriate for gestational age (AGA). Three-year-old heights and weights are expressed as standard deviations (SD) from the norm using both real age (RA) and age corrected for prematurity (CA). Thus two values were obtained for each child. Using RA the mean weight at three years was -0.9 SD and mean height -0.4 SD, but after correction the mean weight was -0.7 SD and mean height 0.0 SD. AGA children and children with birthweights over 1500 g were significantly taller (p<0.001). Sex and length of gestation did not appear to affect height at three years. In general the childrens height was higher than weight on the growth chart; the higher the height or lower the weight the greater the discrepancy. These findings suggest that in as far as three-year-old height can be used to predict adult height, these low birthweight children will not differ from the general population as adults.

HEAD NARROWING IN PRETERM INFANTS

The marked narrowing of the head which develops in many preterm infants often causes concern to their parents, who may worry that the unusual shape will persist or that it may be associated with intracranial pathology and developmental delay. The biparietal (BP) and anteroposterior (AP) diameters were measured weekly in 203 preterm infants during their stay in NICU, and at regular intervals up to three years of age. The AP/BP ratio was calculated (Baum J D and Searls D, Dev Med and Child Neurol. 1971 13: 576-581). This ratio rose from a mean of 1.36 in the first week to a mean of 1.48 at six weeks and fell to a mean of 1.42 by 13 weeks. Less mature babies and those with lower birth weights showed more flattening but this was not statistically significant. The presence of intracranial pathology detected by ultrasound did not affect head shape. 11% of babies showed marked early flattening (AP/BP ratio 1.55). These were compared with the rest of the group. At three years there was no significant difference in AP/BP ratio or in Griffiths Development Quotient. We conclude that by the age of 3 years the babies showing very marked early head flattening did not differ from the rest of the cohort in the areas examined.(NICU = Neonatal Intensive Care Unit)

ENAMEL DEFECTS IN DECIDIOUS DENTITION OF LOW BIRTH WEIGHT INFANTS

Enamel defects have been observed in the deciduous dentition of preterm infants, but few systematic studies have been carried out. A dental examination is part of the study of a cohort of infants weighing 2000g or less at birth for which comprehensive neonatal and maternal medical histories are available. The Fédération Dentaire Internationale index for developmental defects of enamel was used to record opacities (defective calcification), hypoplasis (deficient amount of enamel) or discolouration. Data from 86 children aged 3-5 years showed a much higher prevalence of defects than that found in a normal population (Murray J Shaw L Arch Oral Biol 1979; 24: 7-13 71 (81%) were affected with 49 (56%) having hypoplasia of one or more incisor. In our study, enamel was frequently missing from the incisal edge of incisors. This enamel begins to calcify at 4 months of intrauterine life and is maturing at birth. 16 children who had major neonatal illness all had hypoplasia of the incisal edge of one or more incisor. This may indicate developmental disturbances in the second half of pregnancy or reflect post-natal influences on maturation. Trauma from endotracheal intubation has been postulated as an aetiological factor but due to the symmetry of the lesion the authors favour sytemic disturbances.

THE GROWTH OF LOW BIRTH WEIGHT 3 YEAR OLDS

177 children (81% of a cohort of 218 weighing 2000g or less at birth) were measured regularly until the age of 3 years. At 3 years the weights of 36% (53% SGA and 26% AGA) were <10th centile, and of 11% (5% with handicap) <3rd centile. The heights of 23% (31% SGA, 18% AGA) were <10th centile. When height was corrected for prematurity only 11% were <10th centile, suggesting that many childrens heights were close to this centile. If they continued on their 3 year old centile their adult height would be close to the tenth centile. Categorising them as “below the 10th centile” gives a misleading pessimistic impression. Comparison with the weight centile at 6 month showed that 33% crossed the 10th centile by 3 years. The predictive value of the weight at 6 months was better for boys than girls. The study confirmed the findings of previous workers and showed that predictions about growth cannot reliably be made at 6 months. Furthermore, many of those whose height was below the 10th centile at 3 years may well attain an acceptable adult height. SGA = Small for Gestational Age, AGA = Appropriate for Gestational Age.