John M. Belmont

The Relations of Short-Term Memory to Development and Intelligence

Publisher Summary This chapter summarizes the current status of knowledge about relationships of forgetting rate to chronological and mental age (CA and MA) and to intelligence (IQ), and to consider the methodological limitations and interpretative difficulties encountered in the research upon which this current knowledge is based. The chapter reviews those studies in which both forgetting rate and IQ or age (early childhood to adulthood) are observable variables, whether or not the investigators were explicitly concerned with the correlation of memory with age and IQ. The approach used to separate acquisition and retrieval to assess their contributions to total short-term memory (STM) functioning is also discussed.

Cognitive Strategies and Strategic Learning: The Socio-Instructional Approach.

Recent developmental studies have focused on childrens learning strategies and on the socio-instructional dynamics that foster strategic learning. The introduction of Vygotskys concept of the zone of proximal development has been central to this research effort. Zone theory is discussed in the context of traditional cognitive strategies research and in terms of its practical applications.

Predictors of Prosthesis Survival, Growth, and Functional Status Following Mechanical Mitral Valve Replacement in Children Aged <5 Years, a Multi-Institutional Study

Background—Prosthesis survival, growth, and functional status after initial mechanical mitral valve replacement (MVR) in children <5 years of age are poorly defined. Methods and Results—The experience of the Pediatric Cardiac Care Consortium (45 centers, 1982 to 1999), which included 102 survivors after initial MVR, was analyzed. Median follow-up: 6.0 years (interquartile range: 3.0 to 10.6 years; 96% complete). Twenty-nine survivors had undergone a second MVR at an interval of 4.8±3.8 years after initial MVR. Reasons for second MVR were prosthetic valve stenosis 24 (83%), thrombosis 4 (14%), and endocarditis 1 (3%). For those who had second MVR, prosthesis sizes were: first MVR 19±2 mm and second MVR 22±3 mm, and their body weight increased from 7.4±2.8 kg to 16.8±10.5 kg. To identify risk factors for having a second MVR, the 29 second MVR survivors were compared with the 73 who did not have a second MVR on first-MVR demographic and perioperative variables. By univariate analysis, patients with shorter prosthesis survival were younger, weighed less, had smaller prostheses, greater ratio of prosthesis size:body weight, were less likely to have a St. Jude prosthesis and more likely to have Shone’s syndrome. By multivariate analysis prosthesis survival was predicted only by first MVR age: odds ratio (OR) 7.7 (95% confidence interval [CI] 2.6–22.7) and prosthesis size: OR 6.8 (95% CI 2.6–18.2). High risk patients (age <2 years and prosthesis <20 mm at first MVR) had an OR=46.3 compared with low-risk patients (age ≥2 years and prosthesis ≥20 mm at first MVR) over similar follow-up intervals. Using first-MVR weight-matched controls, body weight increased similarly for patients <2 years old who had a second MVR versus those who did not. Prosthesis size, however, differed significantly, with second MVR patients having smaller prostheses at first MVR (18.7±0.8 mm versus 22.4±3.6 mm, P =0.017). An estimate of current New York Heart Association (NYHA) functional status was class 1 in 76%, class 2 in 22%, and classes 3 or 4 in 2%. Conclusion—Prosthesis survival can be predicted based on first MVR age and prosthesis size. Somatic growth is comparable regardless of the need for second MVR. There is an increment in prosthesis size at second MVR, suggesting continued annular growth. Significant limitation of function after MVR is uncommon. MVR may be an appropriate strategy for children <5 years old despite the risk of second MVR in the youngest patients in whom the smallest prostheses are used.

The relationship of children's hope to pediatric asthma treatment adherence

This study investigated the relationship between hope and adherence to a daily inhaled steroid regimen among 48 asthma patients ages 8–12 years old who participated in a 14 day adherence assessment. Participants completed the Childrens Hope Scale, and parents completed a questionnaire aimed at demographic and disease-related information. Adherence was measured by electronic monitoring of the use of the participants metered-dose inhaler. A multivariate model predicting nonadherence was built, including FEV1 in the first step and childrens hope level in the second step. This model was a significant predictor of adherence (Nagelkerke R 2 = 0.24, p = 0.01). No other demographic or psychosocial variables were significant predictors of adherence. These findings highlight the need to attend to psychosocial predictors of adherence, specifically hope, and may help practitioners target these factors in their efforts to increase adherence among pediatric asthma patients.

Prevention of nonadherence to nonsteroidal anti-inflammatory medications for newly diagnosed patients with juvenile rheumatoid arthritis.

Adherence to medications for chronic pediatric diseases decreases overtime. This randomized controlled trial evaluated a clinic-based, nurse-administered educational and behavioral intervention to prevent the anticipated drop in adherence to nonsteroidal medications among newly diagnosed patients with juvenile rheumatoid arthritis. Thirty-four participants completed the study (mean age = 8.44 years, SD = 3.96), including 19 in the experimental group and 15 in the standard-treatment (education) control group. There were significant group and Group x Time effects for adherence (assessed with an electronic monitor over a 13-month period) favoring the experimental group. In contrast, the groups did not differ significantly in disease activity or functional limitations. Factors that may have prevented detection of differences in these health parameters are dicussed.

Validating theories of intelligence.

Publisher Summary This chapter describes a research strategy for validating theories of intelligence. The strategy is required by the wide acceptance of two simple ideas. The first is that intelligence develops: Behavior becomes increasingly complex and abstractly organized with age. The second idea is that individual differences in intelligence are general: People who perform relatively intelligently in one situation are likely to perform relatively intelligently in other situations. Even though some people use specialized forms of knowledge and specialized ways of thinking, a person must behave effectively in general to be termed intelligent. In the Piagetian argument, an instructional experiment has not influenced intelligence unless it has changed a wide range of uninstructed behaviors as well as the instructed ones. The idea can be seen in any standardized test of intelligence, because even the most factorially pure tests yield composite IQ or mental age scores.

A group-administered test of children’s metamemory

A group-administered test of children’s metamemory was assessed for retest reliability, internal consistency, sensitivity to age, and sensitivity to IQ. In all important psychometric respects, this group test was similar to previously published individually administered tests. The new test provides an easily administered, broad-based index of memory-related knowledge for young children.

The use of TeleMedicine in the treatment of paediatric obesity: feasibility and acceptability

To assess the feasibility of conducting empirically supported family-based paediatric obesity group treatment via TeleMedicine. Seventeen families were randomly assigned to one of two conditions (physician visit, TeleMedicine). Measures included feasibility, satisfaction and intervention outcome measures such as BMI percentile, and nutrition and activity behaviours. Measures were completed at baseline, post-treatment and at 1-year follow-up. Analyses indicate that both feasibility and satisfaction data regarding the TeleMedicine intervention were positive. Intervention outcome indicates no change in BMI percentile or nutrition and activity behaviours for either treatment group. A behavioural family-based weight loss intervention delivered via TeleMedicine was well received by both parents and providers. Due to the small sample size, null findings regarding intervention outcome should be interpreted with caution. Future research should focus on methods to increase the impact of this intervention on key outcome variables.

Beyond matching on the mean in developmental disabilities research

The matching of groups is a traditional way to control for confounding variables in developmental disabilities research. The equivalency of means across groups is routinely checked for these variables, but not the homogeneity of their variances or the shapes of their distributions. In the present paper, it is argued that group matching can go seriously wrong unless it directly confronts the distributional concerns by the use of well-known statistical indices and very simple graphical displays of the distributions. The question of the equivalency of item response profiles is also addressed since two participants or two groups of participants can obtain the same overall score on the matching variable by passing different items. In this case, the matching cannot be considered satisfactory because of poor concordance between the molar (overall score) and molecular (item scores) levels of matching. Angoffs Delta plot method, a statistical approach for detecting differential item functioning across small groups is described. It is promising as a simple way to prove whole test/individual item correspondence and, in addition, a useful tool for making post hoc statistical analyses at the item level on the dependent variables.

Discrepancies between creatinine- and cystatin C-based equations: Implications for identification of chronic kidney disease in the general population

Abstract Objective. Early detection and treatment of chronic kidney disease (CKD) is important for slowing the progression of the disease and decreasing the associated risk of cardiovascular disease. This study examined how two creatinine-based and two cystatin C-based equations for calculating estimated glomerular filtration rate (eGFR) perform relative to each other in identifying CKD in a large cohort of community-dwelling individuals. Material and methods. A total of 1630 adults were recruited from the Reykjavik area. Each subjects eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) Study and Cockroft–Gault equations, and two cystatin C-based equations. The prevalence of decreased eGFR obtained by the four equations was compared and the relative performance of the equations examined. Results. The MDRD equation labelled significantly fewer individuals as having CKD (5.3%) relative to the other equations (12.8–19.7%). Agreement between equations was limited, with up to one-third of subjects diagnosed as having CKD by the MDRD equation being classified as normal by other equations. Correlations between creatinine- and cystatin C-based equations varied with age, gender and diuretic use. Conclusions. The MDRD equation results in lower population-wide estimates of CKD relative to the other equations tested. An understanding of the performance of these equations is critical when they are used for estimating the prevalence of CKD in a population-wide setting or for diagnosing the disorder in clinical practice.