Comparison of the prevalence and impact of health problems of pre-school children with and without cerebral palsy.

Background: The range of health problems associated with children with cerebral palsy (CP) is well documented in the literature; however, the existing data are often either reported for samples of children with all types of CP, or stratified by typology of motor disorder, rather than using the Gross Motor Function Classification System (GMFCS), which has been shown to be the most reliable way of classifying children with CP. Furthermore, availability of research on pre-school-aged children (under 5 years) is sparse. The aim of this study is to compare the prevalence and impact of health problems in pre-school children with and without CP, stratified by the GMFCS.

Sharing of lessons learned from multisite research.

Purpose: To highlight key considerations for planning and implementing multisite research based on experiences and reflections in conducting a large, international, multisite study.

Description: Successes and challenges encountered throughout a multisite study process, and collective recommendations for future researchers are presented. Considerations addressed include creation of the research team and a "community of practice," study preparation and management time, approval by institutional review boards, training of future researchers, recruitment and retention of participants, and dissemination and translation of study materials to consumers.

Economic outcomes in young adulthood for extremely low birth weight survivors.

Objective: The goal was to compare educational attainment and labor market outcomes in young adulthood (21-26 years of age) for a Canadian, population-based cohort of 149 extremely low birth weight (ELBW) (<1000 g) survivors and a normal birth weight (NBW) cohort of 133 young adults from the same geographic area who were matched to the ELBW cohort in childhood.

Methods: We estimated the effects of ELBW status, according to gender, on continuous outcomes through least-squares regression and those on binary outcomes through logistic regression. We controlled for family background and considered neurosensory impairment and IQ as mediating variables.

The Move & PLAY study: an example of comprehensive rehabilitation outcomes research.

This perspective article provides an example of a study planned using guidelines for comprehensive rehabilitation outcomes research, an approach that is believed to give service providers meaningful evidence to support practice. This line of investigation has been guided by the World Health Organization's International Classification of Functioning, Disability and Health. The short title of a study under way is Move & PLAY (Movement and Participation in Life Activities of Young Children).

Impact of extreme prematurity on family functioning and maternal health 20 years later.

Objective: The goal was to examine the impact of illness on families and the long-term effects on the health of parents of young adults (YAs) who were born with extremely low birth weight (ELBW), compared with normal birth weight (NBW) control subjects.

Methods: A longitudinal cohort study was performed. Participants were mothers of eligible ELBW and NBW YAs.

Comparison of current health, functional limitations, and health care use of young adults who were born with extremely low birth weight and normal birth weight.

Objective: The objective of this study was to compare the current health status, physical ability, functional limitations, and health care use of extremely low birth weight and normal birth weight young adults.

Methods: A longitudinal study was conducted of a population-based cohort of 166 extremely low birth weight survivors (501-1000 g birth weight; 1977-1982 births) and a group of 145 sociodemographically comparable normal birth weight individuals. Current health status, history of illnesses, hospitalizations, use of health resources, and physical self-efficacy were assessed through questionnaires that were administered to the young adults by masked interviewers.

Growth trajectories of extremely low birth weight infants from birth to young adulthood: a longitudinal, population-based study.

We compared sex-specific growth attainment of a population-based cohort of 147/166 (89%) extremely low birthweight (ELBW < 1000 g) and 131/145 (90%) sociodemographically comparable normal birthweight (NBW) cohort at young adulthood, and examined the pattern of growth trajectories and correlates of growth at ages 1, 2, 3, and 8 y, and teen and young adulthood (mean age, 23.3 versus 23.6 y).

Self-perceived health-related quality of life of former extremely low birth weight infants at young adulthood.

Objectives: The goals were to compare the self-reported, health-related quality of life of former extremely low birth weight and normal birth weight infants at young adulthood and to determine whether there were any changes over time.

Methods: A prospective, longitudinal, population-based study with concurrent control subjects was performed. We interviewed 143 of 166 extremely low birth weight survivors (birth weight: 501-1000 g; 1977-1982 births) and 130 of 145 sociodemographically comparable, normal birth weight, reference subjects.

Transition of extremely low-birth-weight infants from adolescence to young adulthood: comparison with normal birth-weight controls.

Context: Traditionally, educational attainment, getting a job, living independently, getting married, and parenthood have been considered as markers of successful transition to adulthood.

Objective: To describe and compare the achievement and the age at attainment of the above markers between extremely low-birth-weight (ELBW) and normal birth-weight (NBW) young adults.

Design, Setting, And Participants: A prospective, longitudinal, population-based study in central-west Ontario, Canada, of 166 ELBW participants who weighed 501 to 1000 g at birth (1977-1982) and 145 sociodemographically comparable NBW participants assessed at young adulthood (22-25 years).

Development, reliability and validity of a new measure of overall health for pre-school children.

Background: Few comprehensive systems are available for assessing and reporting the overall health of preschool children.

Objectives: (i) To develop a multi-dimension health status classification system (HSCS) to describe pre-school (PS) children 2.5-5 years of age; (ii) to report reliability and validity of the newly developed measure.

Stability of maternal preferences for pediatric health states in the perinatal period and 1 year later.

Background: We have previously shown that parents of premature children provided relatively high valuation of their children's health state in adolescence. However, stability of parental preferences for future pediatric health states is unknown during the antenatal and neonatal periods and infancy.

Objective: To determine whether preference-based, health-related quality-of-life scores obtained serially from 2 cohorts (women with high-risk pregnancies [antenatal cohort] and mothers of very low-birth-weight newborns [VLBW cohort]) are stable during the first year after birth.

Physical growth and current health status of infants who were of extremely low birth weight and controls at adolescence.

Objectives: To compare the physical growth, current health status, and utilization of health care resources by extremely low birth weight (ELBW) and control (C) adolescents and to look at changes over time.

Methods: A longitudinal regional cohort study was conducted. Growth measures were converted to z scores on the National Center for Health Statistics growth curves.

Attitudes of parents and health care professionals toward active treatment of extremely premature infants.

Objectives: To compare the attitudes of neonatologists, neonatal nurses, the parents of extremely low birth weight (ELBW) children, and the parents of normal birth weight children toward saving infants of borderline viability and who should be involved in the decision-making process and to compare physicians' and nurses' estimates of the proportion of infants who are born at various gestational ages with regard to survival, morbidity, and treatment.

Methods: A questionnaire was given to 169 parents of ELBW children and 123 parents of term children, who were part of a longitudinal study of the outcome of ELBW infants. A similar questionnaire was completed by 98 Canadian neonatologists and 99 neonatal nurses.

Impact of extreme prematurity on families of adolescent children.

Objectives: To compare the impact of burden of illness on families of teenaged children who were extremely low birth weight (ELBW) with that of members of a term control group (C) and to determine whether the attitudes toward active treatment of very immature infants differ between the 2 cohorts.

Design: In a cross-sectional survey, parents of 145 (86%) of 169 members of an ELBW cohort and 123 (85%) of 145 members of a control cohort completed a 23-item self-completed questionnaire encompassing occupational, marital, and family-related issues and attitudes toward treatment of infants of borderline viability.

Results: Both positive (P =.

Parental perspectives of the health status and health-related quality of life of teen-aged children who were extremely low birth weight and term controls.

Objectives: To compare the health status and health-related quality of life of teen-aged children who were extremely low birth weight (ELBW) with matched controls from the perspective of their parents.

Study Design: Geographically defined cohort; longitudinal follow-up; cross-sectional interviews.

Participants: parents of 149/169 (88%) ELBW children between 12 and 16 years of age (including 41 children with neurosensory impairments) and 126/145 (87%) parents of term controls.

School difficulties at adolescence in a regional cohort of children who were extremely low birth weight.

Objectives: To compare measures of psychometric assessment and school difficulties in a cohort of extremely low birth weight (ELBW) teenagers and term controls, and to determine whether there is stability in psychometric measures between age 8 and the teen years.

Study Design: Longitudinal follow-up; geographically defined region.

Participants: 150 of 169 (89%) ELBW survivors born between 1977 and 1982 and 124 of 145 (86%) sociodemographically matched term controls between 12 and 16 years of age.

Differences in preferences for neonatal outcomes among health care professionals, parents, and adolescents.

Context: In neonatal intensive care, parents make important clinical management decisions in conjunction with health care professionals. Yet little information is available on whether preferences of health care professionals and parents for the resulting health outcomes differ.

Objective: To measure and compare preferences for selected health states from the perspectives of health care professionals (ie, neonatologists and neonatal nurses), parents of extremely low-birth-weight (ELBW) or normal birth-weight infants, and adolescents who were either ELBW or normal birth-weight infants.

Self-perceived health status and health-related quality of life of extremely low-birth-weight infants at adolescence.

Objectives: To estimate and to compare the self-assessed health status and health-related quality of life of extremely low-birth-weight (ELBW) and control infants during adolescence.

Design: Prospective, observational study of an inception cohort with a concurrent control group.

Setting: Geographically defined region in central-west Ontario.

Comprehensive assessment of the health status of extremely low birth weight children at eight years of age: comparison with a reference group.

Objective: To apply a multiattribute health status (MAHS) classification system to data available on two cohorts of school-aged children to describe several dimensions of health simultaneously. The MAHS system describes both the type and severity of functional limitations according to seven attributes: sensation, mobility, emotion, cognition, self-care, pain, and fertility (fertility not applicable in this study), with four or five levels of function within each attribute.

Design: The MAHS system was applied retrospectively to clinical and psychometric data collected prospectively at age 8 years.

Recruitment for an efficacy study in chemoprevention--the Concerned Smoker Study.

Efficacy studies are important for the development of long-term cancer prevention strategies. Recruitment aims for a highly motivated group of participants. The Concerned Smoker Study is aimed at smokers with at least a 15 pack-year history and bronchial atypia on sputum sampling Recruitment has been primarily through use of the media.

Outcome in infants 501 to 1000 gm birth weight delivered to residents of the McMaster Health Region.

The mortality and morbidity for all 255 live births of infants with birth weight 501 to 1000 gm and delivered to residents of a geographically defined region between 1977 and 1980 are reported. In all, 117 (46%) infants were discharged alive; there were four postdischarge deaths, and three infants were lost to follow-up. The mean birth weight and gestational age of the survivors was 850 +/- 118 gm and 27.

Effect of delivery method on outcomes in the very low-birth weight breech infant: is the improved survival related to cesarean section or other perinatal care maneuvers?

The perinatal mortality rate among very low-birth weight infants has been decreased by 20% during the last 4 years of the 1973 to 1980 period here reported. The concurrent increase in the cesarean section rate from 11.9% to 49.