Older infants are good referential learners. That is, at around 14-months of age, they begin to learn the verbal labels of objects and events around them. However, referential learning can be made more challenging by increasing the lexical similarity between labels. The primary goal of this study was to examine whether an adult speaker's ostensive cues and eye gaze-object contingency could augment referential learning in 14-month-old infants under difficult conditions (i.e., minimal pair labels). In Experiment 1, infants were familiarized and tested on two word-object associations with minimal pairs (e.g., "bin" and "din"), presented on an eye-tracker. Importantly, each session began when infants made eye contact with a female speaker on the screen, and she continually looked at and verbally referenced each object in an infant-directed style. On test trials when the familiar object+label was switched, infants significantly increased their visual scanning of the speaker's mouth compared to control trials. In Experiment 2, the same procedure was followed with a new group of 14-month-olds, except that the speaker now looked in the opposite direction from the objects on the screen, but continued to label them with minimal pairs in an infant-directed style. In contrast to the results of Experiment 1, infants in this latter experiment did not differentially attend to any area of her face during the switch trials. This pattern of results shows that the ostensive nature of a social partner augments infants' referential learning under cognitive challenge, but it is the contingent nature of the speaker's regard to what is being labeled that is a necessary factor in promoting learning. / Ph. D.

Sensitive and responsive parenting during early infancy is highly understudied, particularly in families with a low socioeconomic status. Longitudinal data from 41 mothers and their 4 to 16 week old infants found that accurate maternal knowledge of infant development positively affected parenting contemporaneously and over time while depression did not affect parenting in this sample. Implications for intervention and research are discussed.

Language is integrally involved in all stages of the learning process. Children who have a language disability are therefore likely to have difficulty with their schooling. The Centre for Language and Hearing Impaired Children was established to provide these children with an optimal start to their education and to maximize the impact of early intervention. The aim of this retrospective study was to obtain follow-up information about the pupils who attended this language-rich nursery school environment, and to discover if their progress reflected significant long-term improvements in their education. The study design involved both quantitative aspects, for which it became necessary to create an educational outcome scoring system in order to objectively assess children’s outcomes, and descriptive components to understand the children’s progress. The data collection involved two phases, where the initial data provided the basic demographics of 94 children who attended the Centre, and the second stage considered information obtained in the follow-up interviews with 32 families that could be traced. The latter data showed that, in spite of previously reported improvements while at the Centre, significant disabilities persisted in 56.25 % of the children, where they were unable to reach mainstream education. In addition, there were significant numbers (81.25%) that attended or passed through remedial/special education during their formal school career, reinforcing the need for supportive, therapeutic forms of education for children with language impairments.

Acute respiratory tract infections are the most common cause o f illness and death in the pediatric population worldwide. It is estimated that 70 - 80% o f severe pneumonias in Africa are caused by S.pnewnoniae (the pneumococcus) followed by H. influenzae type b. Surveillance reveals that drug resistance is increasing worldwide, South Africa not being an exception. This has considerably complicated the management o f infections caused by both the pneumococcus and H. influenzae type b ( H ib ). It is widely accepted that colonization of the nasopharynx even briefly precedes middle ear infection and invasive pneumococcal disease. Early onset of colonization after birth has been associated with early onset o f middle ear infections. Furthermore, colonized children are able to transmit these organisms to other children. Carriage o f pneumococci commonly occurs in young children. The carriage of resistant pneumococci is usually limited to those serotypes carried in children. N ew conjugate vaccines may be able to reduce colonization o f these serotypes. This study was undertaken to determine the serotypes and susceptibility o f pneumococci and H. influenzae type b, and the proportion o f healthy children colonized at Zola Community Health Centre (ZCHC) in Soweto.

A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Diagnostic Radiology Johannesburg, 2013 / INTRODUCTION: There is limited information on the radiographic presentation of children eligible to start HAART in resource-limited settings. OBJECTIVES: Determine radiographic patterns on pre-HAART chest X-rays (CXRs) in children, compare findings in immune-suppressed vs. non immune-suppressed children, compare the percentage of children with radiographic features of pulmonary TB to the percentage of children on TB treatment and assess inter-observer agreement between 3 radiologists. METHODS: Children (0-8 years) participating in a cohort study of TB and BCG-IRIS who had an acceptable routine pre-HAART CXR were included. CXRs were independently assessed by 3 radiologists, blinded from clinical data, using a standardised assessment form. All 3 readings were used to create a majority consensus finding during the data analysis phase. RESULTS: Amongst 161 children, the median age at enrolment was 2.3 years (25% (41/161) were <1year), 54% (87/161) were on TB treatment and 65% (100/154) were immune-suppressed. The majority (71%) had an abnormal CXR finding, predominantly air space disease (42%) and parenchymal interstitial disease (21%). Of the sub-group of 112 (70%) CXRs that could be assessed for lymphadenopathy, 75(67%) had one or more features suggestive of TB (74 lymphadenopathy, 2 cavities, 18 miliary infiltration) and 65% (70/107) were immune-suppressed. Statistically significant differences between immune-suppressed and non-immune-suppressed children were noted for features of lymphadenopathy and radiographic pulmonary TB. Amongst the sub-group of 112 CXRs a high percentage 49/75 (65%) were on TB treatment, with 26/75 (35%) not on TB treatment. Inter-observer agreement between all 3 readers was fair for overall abnormal CXR findings (K=0.23), airspace disease (K=0.22), moderate for parenchymal interstitial disease (K=0.54) and slight for lymphadenopathy (K=0.05). CONCLUSION: Among children eligible to start HAART, most (71%) presented with abnormal CXR findings and the majority (67%) had one or more CXR signs suggestive of TB. Of concern was the high proportion of CXRs (30%) that were of insufficient quality to be assessed for lymphadenopathy and the poor inter-observer agreement for lymphadenopathy.

There are few reports on the impact of HIV-1 infection on tuberculosis in children. Microbiologic diagnosis of tuberculosis is difficult and much reliance is placed on the tuberculin skin test, as part of a scoring system, in diagnosing tuberculosis in children. A prospective study, enrolling 168 patients with clinical tuberculosis, was performed between July 1996 and January 1997 at the teaching hospitals attached to the Department of Paediatrics and Child Health, University of the Witwatersrand. Forty-two percent of children with tuberculosis were HIV-1 infected. Extrapulmonary tuberculosis was diagnosed more frequently in HIV uninfected children. Progressive pulmonary tuberculosis, based on radiographic findings, and mortality was higher in HIV-1 infected children with tuberculosis. HIV-1 infected children with pulmonary tuberculosis showed marked hyporeactivity to tuberculin skin testing. Both CD4+ lymphocyte counts and concurrent delayed type hypersensitivity testing, using the "CMI Multitest®”, offered little value in interpreting the tuberculin skin test in HIV-1 infected children with tuberculosis. The findings of the study suggest that aggressive microbiologic investigations coupled with a low threshold of clinical suspicion is essential in diagnosing tuberculosis in children, especially in HIV infected children.

Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Medicine. Johannesburg, 2014 / Background: The causes of renal dysfunction in children treated for childhood cancers are multifactorial and clinical manifestations of dysfunction include hypertension, proteinuria and varying degrees of renal insufficiency. This study aimed to determine the different residual effects of cancer therapy on the renal system and factors associated with the residual effects in children treated for childhood cancers. Patients and Methods: The study was a descriptive cross sectional study that assessed 130 children, between the age of 1 and 18 years, who had completed treatment at Charlotte Maxeke Johannesburg Academic Hospital and were being followed up at the paediatric oncology clinic of the hospital. Results: After a median follow-up post treatment of 2 years, the various manifestations of renal dysfunction identified in the survivors included; decreased GFR, hypomagnesaemia, hypophosphataemia, proteinuria, haematuria and hypertension. In total, 34 survivors (26.15%) had at least one manifestation of renal dysfunction after completing treatment. The most prevalent manifestation of renal dysfunction detected was decreased GFR (17.69%). Hypomagnesaemia and hypophosphataemia were present in 8 (6.15%) and 6 (4.62%) of the survivors respectively. Patients who had renal dysfunction pre-treatment were three times more likely to have renal dysfunction post-treatment. Ifosfamide, Carboplatinum, and nephrectomy were significantly associated with a reduction in GFR Conclusion: A significant number of the survivors had a decreased GFR while some of them had hypomagnesaemia and hypophosphataemia. There was a strong association between pre-treatment and post-treatment renal dysfunction. These findings are very important in terms of decision making for individual patients with respect to selecting treatment modalities and dosages and also with respect to instituting nephro-protective measures to avoid further damage to the kidneys during and after treatment.

Orientador: Carmen Lucia Soares / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-10T04:19:19Z (GMT). No. of bitstreams: 1 Danailof_Katia_D.pdf: 5744742 bytes, checksum: 49dc5176c6b7faeb88c70f8a2ad33582 (MD5) Previous issue date: 2006 / Resumo: A atuação de Mário de Andrade como primeiro diretor do Departamento de Cultura de Cultura de São Paulo (1935-1938) e a projeção dos Parques Infantis na cidade são os elementos centrais para a análise da forma como se configurava a educação do corpo nos Parques Infantis. O diálogo entre ciência e arte permite observar, nos Parques, a possibilidade deste ser responsável por discursos e práticas que encerram modelos de corpos distintos. A educação do corpo, no caso, diz respeito às formas de educação mediadas pelo lugar que ocupam os sujeitos, estejam eles na escola, nas ruas e, no que tange à presente pesquisa, nos Parques Infantis de São Paulo. Considerando que cada época marca os corpos e os representam de maneira diversa, tempo e espaço são as categorias fundamentais para pensar a infância e a maneira como a sociedade forma e conforma os indivíduos. Os arquivos consultados encontram-se, em São Paulo, na Biblioteca Mário de Andrade, no Instituto de Estudos Brasileiros (IEB/USP) e no Departamento de Patrimônio Histórico (DPH). As principais fontes utilizadas são: a) Regimento Interno do Departamento de Cultura: divisão de Educação e Recreio; b) Revista do Arquivo Municipal (RAM); c) "I Curso de Etnografia" realizado por Dina Lévi-Strauss no ano de 1937 / Abstract: Mário de Andrade was the first director of the Culture Department em São Paulo (1935-1938) and projected the Infancy Parks in the city. Both themes are key elements for the analysis in which the child body's education occurred. The dialog between science and art, at the Parks, opens the possibility for different speeches and practices. The body's education, in this case, is the education that happens in the place occupied by the men, being it at school, on the streets and also at the Infancy Parks. Each period marks the bodies in many ways. Time and space are the main categories to talk about the childhood and the way that society forms individuals. The archives consulted can be found, in São Paulo, in Mário de Andrade Library, in the Institute of Brazilian Studies (IEB/USP) and in the Historic Patrimony Division (DPH). The main sources are: a) Culture Department Interior Regiment: division of Education and Recreation; b) Magazine from the Municipal Archive (RAM); c) "I Ethnography course" by Dina Lévi-Strauss, in 1937 / Doutorado / Educação, Conhecimento, Linguagem e Arte / Doutor em Educação

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