In comparison with their peers, adolescents with ADHD are at increased risk for developing depression, with prevalence estimates for comorbid depression ranging from 14% to 20%. Youth with comorbid ADHD and depression are at greater risk for multiple negative outcomes compared to youth with ADHD alone, including suspension from school, failing a grade, or difficulties in peer relationships. Identifying risk factors for depression among adolescents with ADHD is important for facilitating early identification and treatment efforts. Research completed to date indicates that interpersonal impairment and emotion regulation may mediate the relationship between ADHD and depression. However, a comprehensive longitudinal model including both interpersonal impairment and emotion regulation has not been tested. The aim of the current study was to evaluate whether the indirect pathway from ADHD to depression through interpersonal impairment is moderated by emotion regulation in a longitudinal study of young adolescents with ADHD (N = 239; M age at follow-up = 12.30, SD = .92). Data were collected at three time points over 18 months. Parents completed ratings of externalizing symptoms (ADHD and Oppositional Defiant Disorder, [ODD]), parent-child relationship problems, and peer relationship problems. Adolescents rated their depressive symptoms and emotion regulation problems. Moderated mediation models as outlined by Preacher, Rucker, and Hayes (2007) were used to test whether the indirect effects of externalizing symptoms on depression through parent-child relationship stress and peer relationship problems are moderated by emotion regulation. Controlling for baseline levels of depression, results suggest that these pathways vary as a function of emotion regulation, such that the paths from externalizing symptoms to depression are significantly stronger among adolescents with high levels of emotion regulation problems. In addition, an exploratory analysis of the associations between multiple aspects of emotion regulation problems and depression revealed that access to emotion regulation strategies was the only unique predictor of later depression among adolescents with ADHD.

Thesis (MPH.) -- University of Limpopo, 2015 / Purpose: The purpose of this study was to determine the prevalence and causes of visual impairment (low vision and blindness) among eye clinic patients at Nkhensani hospital in Limpopo province, South Africa. Methods: This was a cross sectional design in which 400 stratified participants aged ≥ 6 years were selected {100 participants in each stratum (6 – 18; 19 – 35; 36 – 59 and ≥ 60 years)}. Presenting, pinhole and best corrected visual acuities were measured using a logMAR E chart. Where reduced visual acuity (VA) was due to uncorrected refractive errors (UREs), ophthalmic lenses were used to compensate for the refractive errors using subjective refraction method and best corrected VA was measured. All participants underwent external and internal ocular examinations using ophthalmoscope to detect eye diseases. Participants with ocular pathology were referred to the ophthalmic nurse and/or ophthalmologist for further management. Refractive error findings were elaborated on in this study in order to highlight the importance and impact of this eye condition. Results: The ages of participants ranged from 6 to 92 years with mean of 39.5 ± 23.5 years. They included 161 (40.3%) males and 239 (59.8%) females. The prevalence of significant visual impairment (SVI) (VA < 6/18 to no light perception, i.e. low vision and blindness), low vision and blindness based on presenting visual acuity (PVA) in the right eye were 34.8%, 16.3% and 18.5% respectively while the prevalence based on the best corrected VA were 24.0%, 7.5% and 16.5% respectively. Based on the PVA, there was a significant association between age (Chi = 71.6; df =3; p = 0.00) and gender (Chi = 8.9; df =1; p = 0.003) with visual impairment (VI) of the right eye. In the left eye, the prevalence of SVI, low vision and blindness based on PVA were 35.8%, 17.5% and 18.3% respectively, while the prevalence based on best corrected VA were 24.8%, 8.5% and 16.3% respectively. Based on PVA, there was a significant association between age and visual impairment in the left eye (Chi = 52.9; df =3; p = 0.00) but there was no association between gender and VI (Chi = 1.9; df =1; p = 0.163). In both eyes, the prevalence of SVI, low vision and blindness based on PVA were 27.0%, 17.5% and 10.3% respectively, while the prevalence based on best corrected VA were 16.8%, 3.8% and 9.5% respectively. Based on the PVA, there was a significant association between age and VI (Chi = 54.1; df =3; p = 0.00) and gender and VI (Chi = 4.7; df =1; p = 0.03) in both eyes. iv The causes of significant visual impairment were uncorrected refractive errors (38.0%), cataract (25.9%) and glaucoma (17.6%) in both eyes. Among all participants, the leading causes of low vision based on presenting VA were uncorrected refractive errors (56.7%), cataract (20.9%) and glaucoma (9.0%). The main causes of blindness in both eyes were cataract (34.1%), glaucoma (31.7%) and corneal anomalies (17.1%) based on presenting visual acuity. After optical corrections, the main causes of VI were cataract (39.4%), glaucoma (28.8%) and corneal anomalies (18.2%). The main causes of low vision were cataract (42.9%), glaucoma (21.4%) and corneal anomalies (17.9%), while the main causes of blindness were cataract (39.5%), glaucoma (34.2%) and corneal anomalies (15.8%). Conclusion: The findings in this study indicate that the overall prevalence of visual impairment, low vision and blindness among patients attending the Nkhensani hospital eye clinic were 27.0%, 16.8% and 10.3% respectively. The main causes of visual impairment, low vision and blindness were uncorrected refractive errors, cataract and glaucoma. A focus on the optical correction of refractive errors and surgical intervention in the case of cataract would lead to a significant reduction in the burden of visual impairment among patients who utilise Nkhensani hospital for eye care services. Also, early detection and appropriate management of glaucoma will reduce the burden of this ocular morbidity. A significant proportion of these prevailing ocular morbidities are avoidable and with appropriate management, visual impairment is preventable.

Contexte : il est possible qu’une victime subisse de multiples conséquences d’accident de la route,conséquences pouvant retentir durablement sur sa vie. Cependant, peu d’études permettent de connaitre leprofil du blessé grave ainsi que les facteurs prédictifs de son devenir. De plus, il existe peu d'outilsprédictifs servant à prédire les conséquences post-accidentelles. L’objectif de la thèse est de caractériserces conséquences, de chercher les éléments pronostiques de gravité des conséquences un an aprèsl’accident et de donner une évaluation, à partir de données réelles, de la qualité de prédiction del’indicateur de déficience à un an appelé IIS (Injury Impairment Score - un indice de déficience - défini apriori à partir des lésions- et utilisé fréquemment).Méthodes : la thèse est réalisée dans le cadre de la cohorte ESPARR (Étude et Suivi d’une Populationd’Accidentés de la Route dans le Rhône), qui s’appuie sur les données du Registre des accidents de lacirculation du Rhône, et qui inclut 1372 sujets blessés dans des accidents de la route dont 1168 sujets âgésde 16 ans et plus. Parmi ces sujets, 886 adultes ont répondu à un questionnaire de suivi à un an, 616 sujetsont des données complètes et sont classés dans des groupes homogènes en fonction de leur devenir à unan par l'analyse des correspondances multiples et la méthode de classification hiérarchique. L’analyse desfacteurs prédictifs de leur appartenance à un de ces groupes de victimes, mesurés à la date de l'accident, aété effectuée à l’aide de modèles de régressions logistiques multinomiales pondérés. L'évaluation de l'IISsur les données réelles est réalisée en regardant la cohérence entre l'IIS et les différents facteurs mesurés àun an.Résultats : cinq groupes homogènes au niveau des conséquences de l’accident à un an ont été identifiés :le groupe-1 contient 206 sujets, dont une majorité est considérée en bonne récupération ; le groupe-2concerne les sujets ayant uniquement des conséquences physiques ; les groupes 3, 4 et 5 concernent lessujets ayant des conséquences multiples. À part les conséquences physiques en lien avec les sujets dansces groupes, certains plus en lien avec des répercussions sur la vie social (groupe-3), d’autres en lien avecdes difficultés sociales ou environnementales (groupe-4). Le groupe-5 comprend tous les sujets quisouffrent de syndrome post-commotionnel de la population d’étude. Après avoir ajusté sur plusieursvariables recueillies lors de l'accident, notre étude montre que, en plus des facteurs déjà évoqués dans lalittérature (âge, gravité…), le niveau de fragilité socioéconomique et le fait d'avoir un proche blessé dansl'accident sont également des facteurs prédisant le devenir des victimes d’un accident. En ce qui concernel'évaluation de l'IIS sur les données réelles, nous trouvons que le niveau des conséquences prédites par l’IIS ne correspond pas parfaitement à celui observé en réalité à un an quels que soient les facteurs mesurés.Conclusion : un an après l’accident, de nombreuses victimes d'accident de la route, même parmi cellessouffrant de lésions légères, continuent de présenter de multiples problèmes tant sur leur santé physiqueque mentale, sur le plan social ainsi que sur leur environnement. Dans une perspective de réadaptation à lavie quotidienne, ces résultats peuvent être utiles à l’amélioration de la prise en charge des accidentés de laroute. / Background: it is possible that victims can suffer from multiple problems after an accident, and this canbe seen in the people with the most serious consequences. However, few studies allow us to know theprofile and prognostic factors of severity of consequences after the accident in this population of victims.Moreover, there are few tools to predict 1-year post-traumatic sequelae in road crash victims.The thesis aims to determine subgroups of victims with similar outcomes 1 year after the crash andpredictive factors for attribution to these subgroups and validate sequelae prediction by the InjuryImpairment Score (IIS), in comparison with the one year outcomes.Methods: the thesis is a part of the broader ESPARR study based on the Rhône Registry of Road TrafficCasualties. The ESPARR cohort comprised 1,372 subjects, including 1,168 aged 16 years. Among 886adult subjects who responded to a follow-up questionnaire one year later, the main analysis was carriedout on 616 participants, who completed a self-report questionnaire on health, social, emotional andfinancial status 1 year after a crash. The multiple correspondence analysis and hierarchical clusteringmethod was implemented to produce homogeneous road-crash victim subgroups according to differencesin outcome. Baseline (time of accident) predictive factors for subgroup attribution were analysed onweighted multinomial logistic regression models. We used outcomes data at 1-year follow-up of roadinjury to validate the ability of IIS to predict sequelae.Results: five different victim groups were identified in terms of consequences one year after the crash:one group (206 subjects, 33.4%) presented few problems, one group with essentially physical sequelae,one group with essentially physical and social problems, and two groups presented many problems (oneincluded more victims with psychological problem and less environment problem). As well as the knownprognostic factors of age, initial injury severity and lesion type, socioeconomic fragility and the fact of arelative being involved in the accident emerged as being predictive of poor outcome one year later. IIS, inthis injured population, failed to predict sequelae one year later as measured by real data.Conclusion: one year after a road accident, victims may still experience multiple problems in terms notonly of physical health but also of mental health, social life and environment. Poor outcome may bepredicted both from accident-related factors and from victims' socioeconomic fragility. These findings areuseful in guiding prevention in terms not only of recovery of health status but also of recovery of sociallife in the best possible environment.

De flesta elever med språkstörning går i vanliga grundskoleklasser. Denna grupp elever riskerar dock oftare än andra elever att misslyckas i skolan på grund av bristande stöd och anpassningar, skolors organisation och lärares kompetens (SOU 2016:46). I vår studie undersöks hur föräldrar till barn med språkstörning uppfattar sina barns möjligheter till likvärdig utbildning i skolan. Frågor som studien ger svar på är: Vad anser föräldrar att barnen är i behov av för stöd i skolan? Vilka hinder anser föräldrar att barnen möter i skolan? Vad fungerar bra för barnen – Vilka är framgångsfaktorerna? Hur upplever föräldrar att de kan stötta sina barn i skolan? Som teoretisk utgångspunkt används ett sociokulturellt perspektiv. Undersökningen genomfördes som en kvalitativ studie där vi använde öppna diskussionsforum på internet för insamling av data. De öppna forum som vi valde var specifika diskussionsgrupper för föräldrar till barn med språkstörning. För analys av vårt datamaterial utgick vi från en tematisk sex-stegsanalysmodell. Resultatet visar att föräldrar anser att utbildningen inte är likvärdig och att barnen är i behov av mycket stöd i skolan. Stöd som önskas är att skolor organiseras utifrån barnens behov och förutsättningar, större tillgång till talpedagog och logoped, anpassade hjälpmedel, att utredningar görs tidigt för att få större möjlighet till stöd samt att det finns kompetenta lärare som stöttar barnen både socialt och kunskapsmässigt. Föräldrar ser lärares positiva bemötande som en framgångsfaktor för att barnets självkänsla ska stärkas och därmed ha större förutsättningar för att lyckas i skolan. Resultatet visar att det finns ett stort engagemang hos föräldrar kring barnets skolgång, men upplevelsen finns att de inte alltid blir lyssnade på, vilket försvårar samarbetet mellan hem och skola. Tillgången till specialskolor, språkklasser och språkspår är väldigt ojämnt fördelat geografiskt, vilket också försämrar förutsättningarna för barnen.

Children with high-functioning autism, children with specific language impairment, children with autism and language impairment, and controls produced sentences after a prompt to form a sentence using a specific word. The sentences were analyzed for syntactic complexity. Children with language impairment, regardless of autism diagnosis, made less complex sentences than their age peers. However, children with autism and language impairment exhibited a broader range of ability than children with language impairment alone. Children with high-functioning autism without concomitant structural language impairment created sentences of similar complexity to age peers. Word variables also influenced sentence complexity, with word meaning (abstract vs. concrete) having the most robust effect and word frequency having a negligible effect. Implications for this study in relation to double-deficit and syntactic bootstrapping models are discussed.

IFRS allows firms to choose between fair-value accounting and historical cost accounting with impairment testing for property, plant and equipment (PPE). This study examines the effect of firms' accounting choices for this group of non-financial assets on over-investment after IFRS mandatory adoption in the European Union (EU). My results indicate that over-investment in PPE (or capital expenditures) is lower following IFRS adoption among EU firms that used historical cost accounting with impairment testing in the post-IFRS period, consistent with EU firms having more timely loss recognition for PPE under IFRS strict impairment rules. In my analysis of United Kingdom (UK) firms, I find that most UK firms elected to use historical cost accounting with impairment testing for PPE after IFRS mandatory adoption. I also find that UK firms that previously used fair-value accounting under UK GAAP and then switched to historical cost accounting with impairment testing under IFRS exhibit greater reductions in over-investment relative to other EU firms that used historical cost accounting with impairment testing prior to IFRS adoption. Additional analysis suggests that the reductions in over-investment after IFRS mandatory adoption are greater as the severity of agency conflicts increases, consistent with outside shareholders demanding timely loss recognition as a means of addressing agency conflicts with managers.

The overall aim of the current research was to investigate the corticostriatal system in developmental language impairment (DLI) at the behavioral and neuroanatomical levels. Two groups of young adults, one with DLI (N = 25) and the other without (N = 23), participated in the behavioral study. A sample of procedural learning and reinforcement learning (RL) tasks was selected. Each task represents a unique aspect of procedural memory, and learning processes during these tasks have been linked, at least partially, to the functionality of the corticostriatal system. Findings showed that individuals with DLI demonstrated relatively poor performance on different aspects of procedural learning and on RL. Correlation results provide further evidence for a close relationship between individual differences in implicit learning and individual differences in language. These results implicate an abnormal corticostriatal system in DLI. In the structural imaging study, two subgroups of participants from the first study, one with DLI (n = 10) and the other without (n = 10), were matched on age, gender, and handedness. Conventional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were used to investigate the subcortical components of the corticostriatal system in individuals with DLI. Results showed pathological enlargement in the bilateral putamen, the right globus pallidus, and the bilateral nucleus accumbens of individuals with DLI. In addition, the DLI group revealed decreased FA in the globus pallidus and in the thalamus, indicating abnormal white matter integrity in the two subcortical regions. These imaging results underpin the behavioral results, showing corticostriatal abnormalities in DLI at both macrostructural and microstructural levels. In addition to subcortical regions, the four cerebral lobes were also included for an exploratory analysis. Findings showed that individuals with DLI had global diffusion abnormalities in cerebral white matters in the absence of volumetric alterations, and these abnormalities were closely associated with impaired language performance. The results support a role of white matter integrity in language function. In conclusion, individuals with DLI have an abnormal corticostriatal system, which may lead to compromise of a wide variety of cognitive learning, including procedural learning, RL, and certain aspects of language learning.

Language serves as an essential resource to learn about cause and effect throughout childhood. Causal adverbial sentences use causal conjunctions (e.g., because, so) to join two clauses to express cause-effect relationships (Diessel & Hetterle, 2011). Causal adverbial sentences are frequently used to explain causal relationships in academic contexts, such as elementary school science and social studies classes (Kinzie et al., 2014; Williams et al., 2014). Children with specific language impairment (SLI) are at risk for failure in these academically relevant language skills. Here, a multiple probe design was used to examine the effect of language intervention focused on causal adverbials on both causal adverbials and acquisition of academic content for preschool/kindergarten children with SLI. Child performance on sentence elicitation probes of causal adverbials and an untreated control structure were analyzed. Six of seven participants exhibited gains at some level in production of causal adverbials containing because. Performance on daily probes of science content learning, and science unit tests indicate that participants are able to learn science content, but the magnitude of gains may not relate to skill in causal adverbial production. Language intervention for young children with SLI can effectively treat complex syntactic targets such as causal adverbials in the context of science instruction, but it is unclear whether this can affect science content learning.

Individuals with physical impairments have been marginalized and discriminated against since the social identification of these individuals occurred as a sub-group within society. While much has been done to resolve prejudice against individuals with physical impairments, more needs to be done to decrease, or at least deter, discrimination and prejudice against individuals who have been marginalized. The purpose of this study is to give four individuals with physical impairments the opportunity to tell their stories. Through the telling of these stories, I believe others can identify with these individuals, and thereby, help decrease discrimination against individuals with physical impairments. Life history has been shown to be an effective method to study individuals with impairments. In order to facilitate understanding of what it is like to be an individual with a physical impairment, four individuals with physical impairments shared their life histories. Research questions include: How do these individuals with physical impairments understand and give meaning to their lived experiences? and How do participants in this study who have congenital disabilities differ from those who have acquired disabilities in the ways they understand and give meaning to their lives? The research questions and parameters of interest are intended to develop and share what it is like to be an individual with a physical impairment. The researcher has known each of the participants for at least ten years. The participants include a 33 year old male with a congenital disability who is white, a 32 year old female who acquired a disability 12 years ago and who is African American, and a married couple who are 62 and 63 years old, one with a congenital disability, the other acquired a disability when she was 14 years old. The researcher shares his responses and reflections, thereby becoming the fifth participant in the study. Because this type of research depends upon verisimilitude, the responses to the research questions are presented for each individual. Each participant defines areas of his or her life that best defines how that person constructs his or her identity and what part the physical impairment plays in that definition. The participants feel that there are some differences between individuals with congenital physical impairments and those with acquired physical impairments. The participants relate that individuals with acquired physical impairments have greater access to funds and equipment based on their perception of how funding agencies provide services and equipment to individuals with physical impairments. The participants also feel that there is a greater stigma associated with having a congenital physical impairment compared to having an acquired physical impairment. Recommendations for future research are offered.

Adolescents spend a large proportion of their everyday life in school, and schooling is vital for future success and well-being. One group that are in risk for reduced school success are children with disabilities or long-term illnesses. The aim of this study is to investigate whether the factors age, gender, self-perceived relationship with teachers, self-perceived relationship with peers and parental bonding can predict school engagement of students with self-reported long term health conditions and impairment. School engagement is defined as having three aspects, behavioral, emotional and cognitive. HBSC (Health behaviors in School Children) data from Sweden is used. The result shows that self-perceived relationship with teachers and age are related to all three components of school engagement, behavioral, emotional and cognitive in this study.  Self-perceived relationship with peers is related to emotional school engagement only. Gender is related to cognitive engagement. Parent bonding cannot predict any of the three aspects of school engagement. This study demonstrated that school environment, especially teachers, is important for the school engagement of students with long-term health condition and impairment. Dispite the inconsistent results with previous reseach which focus on typical functioning students, School and educators should focus on how to maintain and improve and promote school engagement of students with long-term health condition and impairment in mainstream school setting.