Sample records for aged 6-12 months

  1. Correlation of serum KL-6 and CC16 levels with neurodevelopmental outcome in premature infants at 12 months corrected age

    PubMed Central

    Zhang, Zhiqun; Lu, Hui; Zhu, Yunxia; Xiang, Junhua; Huang, Xianmei

    2015-01-01

    The aim of this study was to evaluate KL-6 and CC16 levels and their correlation with neurodevelopmental outcome among very low birth weight pre-term infants at 12 months corrected age. This prospective cohort study was performed from 2011 to 2013 by enrolling pre-term neonates of gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Serum KL-6 and CC16 levels were determined 7 days after birth and their correlation with neurodevelopment was evaluated using Gesell Mental Developmental Scales. Of the 86 eligible pre-term infants, 63 completed follow-up, of which 15 had bronchopulmonary dysplasia. At 12 months corrected age, 49 infants had favorable outcomes and 14 infants had poor neurodevelopmental outcome. KL-6 levels were higher and CC16 levels were lower in infants with poor neurodevelopmental outcome compared with those infants who had favourable neurodevelopmental outcome. Serum KL-6 levels less than 90.0 ng/ml and CC16 levels greater than 320.0 pg/ml at 7 days of life were found to be predictive of a favourable outcome at 12 months corrected age. These biological markers could predict neurodevelopmental outcome at 12 months corrected age in very low birth weight premature infants, and help the clinician plan early therapeutic interventions to minimize or avoid poor neurodevelopmental outcome. PMID:25631862

  2. Nationwide measles vaccination campaign for children aged 6 months-12 years--Afghanistan, 2002.

    PubMed

    2003-04-25

    The public health infrastructure in Afghanistan has been devastated by 23 years of civil war, and both the infant mortality rate (165 per 1,000 live-born infants) and the mortality rate for children aged <5 years (256 per 1,000 live-born infants) are among the highest in the world. The major causes of death among children aged <10 years are diarrhea (32%), measles (25%), respiratory tract infections (13%), and other causes (30%), including malnutrition, scurvy, chronic diseases, and fever of unknown origin. Measles accounts for an estimated 30,000-35,000 deaths each year in Afghanistan. To reduce measles-related mortality, during 2002, the Ministry of Health (MoH) of the Interim Government of Afghanistan, with the support of international organizations, organized a nationwide measles vaccination campaign for children aged 6 months-12 years. This report describes the planning, implementation, and impact of this campaign. The findings suggest that the campaign had a major impact on reducing measles-related mortality. Similar campaigns might be feasible in countries affected by complex emergencies.

  3. Assessment of the Dietary Intakes of 6- and 12-Month-Old Infants in Saudi Arabia.

    PubMed

    Alzaheb, Riyadh A; Alatawi, Norah; Daoud, Khawla A; Altawil, Naema

    2018-06-12

    Establishing understanding of infants' dietary intakes can support interventions to improve their diets and overall health. Because information on the dietary intakes of infants aged12 months in Saudi Arabia is scarce, this study examined the diets of infants aged 6 and 12 months in Saudi Arabia and determined their main dietary sources of total energy and macronutrients. A crosssectional dietary survey employing a single 24-hour recall was performed between May and December 2015 with a sample of mothers of 278 healthy 6-month-old and 259 12-month-old infants. An analysis of the dietary intake data determined the nutrient intake adequacy and the percentage contributions of foods to energy and macronutrient intakes. The respective mean daily energy intakes of the 6-month-old and 12-month-old infants in the study were 703 kcal and 929 kcal. Both age groups recorded adequate nutrient intakes, with the exception that the 6-month-olds' mean vitamin D intake fell below the recommended Adequate Intake (AI), and the 12-month-olds' intakes of omega-6 fatty acids and vitamin D were also below the AI, along with their iron intake which fell short of the Recommended Dietary Allowance (RDA). The data generated here will assist health professionals in planning interventions which aim to improve infants' diets and to offer guidance to parents on the appropriate selection of food for their infants.

  4. Iron Status at Age 6 Months in Colombian Infants Exclusively Breast-fed for 4 to 5 Versus 6 Months.

    PubMed

    Olaya, Gilma A; Lawson, Margaret; Fewtrell, Mary

    2017-03-01

    The optimal age for introducing complementary feeding to breast-fed infants may differ depending on the setting. Prolonged exclusive breast-feeding (EBF) protects against infection but may increase the risk of iron deficiency (ID)/anaemia (IDA) in vulnerable infants. The aim of the present study was to compare haemoglobin (Hb), serum ferritin (SF), anaemia (Hb < 11 g/L), ID (SF < 12 μg/L) and IDA (Hb < 10.5 g/dL + Hct < 33% + ID) using observational analyses in 6-month old infants from Bogota, Colombia who were EBF for 4 to 5 versus 6 months or older, and examine predictors. Infant feeding was recorded, anthropometry performed, and blood obtained for Hb and SF at 6 months in healthy term infants (birth weight > 2500 g), all EBF for ≥4 months. One hundred eight infants (54% boys) were recruited; 46% EBF for 4 to 5 months, 54% EBF at 6 months. Prevalence of anaemia, ID, and IDA was 20%, 10%, and 5%, with no significant difference between EBF4-5 and EBF6 groups. In multivariate models, anaemia/ID were predicted by greater weight gain from 0 to 6 months, and anaemia also by caesarean delivery; Hb was lower in infants with higher intake of cows' milk; SF was lower in boys and those with greater weight gain. EBF4-5 versus EBF6 was not a significant predictor of any outcome. Anaemia and ID were common at 6 months but were not affected by EBF for 4 to 5 versus 6 months, suggesting 6 months EBF is safe in this population. Further research is, however, required to examine effects on later iron status. The findings highlight the need to emphasise avoidance of cow's milk before 12 months.

  5. Retrofit Weight-Loss Outcomes at 6, 12, and 24 Months and Characteristics of 12-Month High Performers: A Retrospective Analysis.

    PubMed

    Painter, Stefanie; Ditsch, Gary; Ahmed, Rezwan; Hanson, Nicholas Buck; Kachin, Kevin; Berger, Jan

    2016-08-22

    Obesity is the leading cause of preventable death costing the health care system billions of dollars. Combining self-monitoring technology with personalized behavior change strategies results in clinically significant weight loss. However, there is a lack of real-world outcomes in commercial weight-loss program research. Retrofit is a personalized weight management and disease-prevention solution. This study aimed to report Retrofit's weight-loss outcomes at 6, 12, and 24 months and characterize behaviors, age, and sex of high-performing participants who achieved weight loss of 10% or greater at 12 months. A retrospective analysis was performed from 2011 to 2014 using 2720 participants enrolled in a Retrofit weight-loss program. Participants had a starting body mass index (BMI) of >25 kg/m² and were at least 18 years of age. Weight measurements were assessed at 6, 12, and 24 months in the program to evaluate change in body weight, BMI, and percentage of participants who achieved 5% or greater weight loss. A secondary analysis characterized high-performing participants who lost ≥10% of their starting weight (n=238). Characterized behaviors were evaluated, including self-monitoring through weigh-ins, number of days wearing an activity tracker, daily step count average, and engagement through coaching conversations via Web-based messages, and number of coaching sessions attended. Average weight loss at 6 months was -5.55% for male and -4.86% for female participants. Male and female participants had an average weight loss of -6.28% and -5.37% at 12 months, respectively. Average weight loss at 24 months was -5.03% and -3.15% for males and females, respectively. Behaviors of high-performing participants were assessed at 12 months. Number of weigh-ins were greater in high-performing male (197.3 times vs 165.4 times, P=.001) and female participants (222 times vs 167 times, P<.001) compared with remaining participants. Total activity tracker days and average steps per

  6. Retrofit Weight-Loss Outcomes at 6, 12, and 24 Months and Characteristics of 12-Month High Performers: A Retrospective Analysis

    PubMed Central

    Hanson, Nicholas Buck; Kachin, Kevin; Berger, Jan

    2016-01-01

    Background Obesity is the leading cause of preventable death costing the health care system billions of dollars. Combining self-monitoring technology with personalized behavior change strategies results in clinically significant weight loss. However, there is a lack of real-world outcomes in commercial weight-loss program research. Objective Retrofit is a personalized weight management and disease-prevention solution. This study aimed to report Retrofit’s weight-loss outcomes at 6, 12, and 24 months and characterize behaviors, age, and sex of high-performing participants who achieved weight loss of 10% or greater at 12 months. Methods A retrospective analysis was performed from 2011 to 2014 using 2720 participants enrolled in a Retrofit weight-loss program. Participants had a starting body mass index (BMI) of >25 kg/m² and were at least 18 years of age. Weight measurements were assessed at 6, 12, and 24 months in the program to evaluate change in body weight, BMI, and percentage of participants who achieved 5% or greater weight loss. A secondary analysis characterized high-performing participants who lost ≥10% of their starting weight (n=238). Characterized behaviors were evaluated, including self-monitoring through weigh-ins, number of days wearing an activity tracker, daily step count average, and engagement through coaching conversations via Web-based messages, and number of coaching sessions attended. Results Average weight loss at 6 months was −5.55% for male and −4.86% for female participants. Male and female participants had an average weight loss of −6.28% and −5.37% at 12 months, respectively. Average weight loss at 24 months was −5.03% and −3.15% for males and females, respectively. Behaviors of high-performing participants were assessed at 12 months. Number of weigh-ins were greater in high-performing male (197.3 times vs 165.4 times, P=.001) and female participants (222 times vs 167 times, P<.001) compared with remaining participants

  7. Improvement in GOS and GOSE scores 6 and 12 months after severe traumatic brain injury.

    PubMed

    Corral, Luisa; Ventura, José Luis; Herrero, José Ignacio; Monfort, Jose Luis; Juncadella, Montserrat; Gabarrós, Andreu; Bartolomé, Carlos; Javierre, Casimiro F; García-Huete, Lucía

    2007-11-01

    To assess improvements in Glasgow Outcome Scale (GOS) and GOS extended (GOSE) scores between 6 months and 1 year following severe traumatic brain injury (TBI). One studied 214 adult patients with severe TBI with Glasgow Coma Scale (GCS) <9 admitted to Intensive Care Unit (ICU). GOS scores were obtained 6 and 12 months after injury in 195 subjects. Patients were predominantly male (84%) and median age was 35 years. Outcome (GOS and GOSE at 6 months and 1 year) was better in the high GCS score at admission (6-8) group than in the low score group (3-5). The improvement in GOS scores between 6 months and 1 year was greater in the high GCS score at admission group than in the low score group. At 6 months, 75 patients had died and 120 survived. None died between the 6-12-month assessments; at 12 months, 36% had improved GOS score. GOS scores improved between 6-12 months after severe TBI in 36% of survivors and it is concluded that the expectancy of improvement is incomplete at 6 months. This improvement was greater in patients with better GCS scores (6-8) at admission than in those with worse GCS scores (3-5).

  8. [Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development].

    PubMed

    Xu, Kang; Zhang, Cui-Mei; Huang, Lian-Hong; Fu, Si-Mao; Liu, Yu-Ling; Chen, Ang; Ou, Jun-Bin

    2015-08-01

    To study the risk factors for moderate and severe iron deficiency anemia (IDA) in infants aged 6-12 months, and to preliminarily investigate the effects of IDA on the neuromotor development and temperament characteristics of infants. A total of 326 infants aged 6-12 months with IDA were classified into three groups: mild IDA (n=176), moderate IDA (n=111), and severe IDA (n=39) according to the severity of anemia. The risk factors for moderate or severe IDA were investigated by multivariate logistic regression analysis. Three hundred and forty-six infants without IDA who showed matched age, sex, and other backgrounds were selected as the control group. The Gesell Development Diagnosis Scale was used to evaluate children's mental development. The Temperament Scale for infants was used for evaluating children's temperament. The univariate analysis showed that the severity of IDA was associated with sex, birth weight, gestational age, multiple birth, maternal anemia during pregnancy, and mother's lack of knowledge about IDA (P<0.05). Setting the mild IDA group as control, the multivariate logistic regression analysis showed that multiple birth, premature birth, low birth weight (<2500 g), maternal anemia during pregnancy, breast feeding, and mother's lack of knowledge about IDA were the risk factors for severe IDA (OR>1; P<0.05); premature birth, breast feeding, and mixed feeding were the risk factors for moderate IDA (OR>1; P<0.05). The IDA group had significantly lower scores in Gesell general development quotient, gross motor, adaptive behavior, and fine motor than the control group (P<0.05). The IDA group had higher percentages of children with difficulty and intermediate difficulty temperaments than the control group (P<0.05). The IDA group had significantly higher scores in activity level, rhythmicity, adaptability, and perseverance than the control group (P<0.05). The severity of IDA is associated with premature birth, multiple birth, low birth weight, feeding

  9. Dietary Pattern Trajectories from 6 to 12 Months of Age in a Multi-Ethnic Asian Cohort

    PubMed Central

    Lim, Geraldine Huini; Toh, Jia Ying; Aris, Izzuddin M.; Chia, Ai-Ru; Han, Wee Meng; Saw, Seang Mei; Godfrey, Keith M.; Gluckman, Peter D.; Chong, Yap-Seng; Yap, Fabian; Lee, Yung Seng; Kramer, Michael S.; Chong, Mary Foong-Fong

    2016-01-01

    Little is known about the dietary patterns of Asian infants in the first year of life, nor of their associations with maternal socio-demographic factors. Based on the Growing Up in Singapore towards healthy Outcomes (GUSTO) mother-offspring cohort, cross-sectional dietary patterns were derived by factor analysis using 24-h recalls and food diaries of infants at 6-, 9- and 12-months of age. Dietary pattern trajectories were modeled by mapping similar dietary patterns across each age using multilevel mixed models. Associations with maternal socio-demographic variables, collected through questionnaires during pregnancy, were assessed using general linear models. In n = 486 infants, four dietary pattern trajectories were established from 6- to 12-months. Predominantly breastmilk: mainly breastmilk and less formula milk, Guidelines: rice porridge, vegetables, fruits and low-fat fish and meat, Easy-to-prepare foods: infant cereals, juices, cakes and biscuits and Noodles (in soup) and seafood: noodle and common accompaniments. In adjusted models, higher maternal education attainment was correlated with higher start scores on Predominantly breastmilk, but lowest education attainment increased its adherence over time. Older mothers had higher start scores on Easy-to-prepare foods, but younger mothers had increased adherence over time. Chinese mothers had higher start scores on Predominantly breastmilk but greater adherence to Guidelines over time, while Indian mothers had higher start scores on Easy-to-prepare foods but greater adherence to Predominantly breastmilk with time (p < 0.05 for all). Changes in trajectories over time were small. Hence, dietary patterns established during weaning are strongly influenced by maternal socio-demographic factors and remain stable over the first year of life. PMID:27314387

  10. Dietary Pattern Trajectories from 6 to 12 Months of Age in a Multi-Ethnic Asian Cohort.

    PubMed

    Lim, Geraldine Huini; Toh, Jia Ying; Aris, Izzuddin M; Chia, Ai-Ru; Han, Wee Meng; Saw, Seang Mei; Godfrey, Keith M; Gluckman, Peter D; Chong, Yap-Seng; Yap, Fabian; Lee, Yung Seng; Kramer, Michael S; Chong, Mary Foong-Fong

    2016-06-15

    Little is known about the dietary patterns of Asian infants in the first year of life, nor of their associations with maternal socio-demographic factors. Based on the Growing Up in Singapore towards healthy Outcomes (GUSTO) mother-offspring cohort, cross-sectional dietary patterns were derived by factor analysis using 24-h recalls and food diaries of infants at 6-, 9- and 12-months of age. Dietary pattern trajectories were modeled by mapping similar dietary patterns across each age using multilevel mixed models. Associations with maternal socio-demographic variables, collected through questionnaires during pregnancy, were assessed using general linear models. In n = 486 infants, four dietary pattern trajectories were established from 6- to 12-months. Predominantly breastmilk: mainly breastmilk and less formula milk, rice porridge, vegetables, fruits and low-fat fish and meat, Easy-to-prepare foods: infant cereals, juices, cakes and biscuits and Noodles (in soup) and seafood: noodle and common accompaniments. In adjusted models, higher maternal education attainment was correlated with higher start scores on Predominantly breastmilk, but lowest education attainment increased its adherence over time. Older mothers had higher start scores on Easy-to-prepare foods, but younger mothers had increased adherence over time. Chinese mothers had higher start scores on Predominantly breastmilk but greater adherence to GUIDELINES over time, while Indian mothers had higher start scores on Easy-to-prepare foods but greater adherence to Predominantly breastmilk with time (p < 0.05 for all). Changes in trajectories over time were small. Hence, dietary patterns established during weaning are strongly influenced by maternal socio-demographic factors and remain stable over the first year of life.

  11. Does Causal Action Facilitate Causal Perception in Infants Younger than 6 Months of Age?

    ERIC Educational Resources Information Center

    Rakison, David H.; Krogh, Lauren

    2012-01-01

    Previous research has established that infants are unable to perceive causality until 6 1/4 months of age. The current experiments examined whether infants' ability to engage in causal action could facilitate causal perception prior to this age. In Experiment 1, 4 1/2-month-olds were randomly assigned to engage in causal action experience via…

  12. Infant pain-related negative affect at 12 months of age: early infant and caregiver predictors.

    PubMed

    Din Osmun, Laila; Pillai Riddell, Rebecca; Flora, David B

    2014-01-01

    To examine the predictive relationships of early infant and caregiver variables on expressed pain-related negative affect duration at the 12-month immunization. Infants and their caregivers (N = 255) were followed during immunization appointments over the first year of life. Latent growth curve modeling in a structural equation modeling context was used. Higher levels of initial infant pain reactivity at 2 months and caregiver emotional availability averaged across 2, 4, and 6 months of age were related to larger decreases in the duration of infant negative affect over the first 6 months of life. Longer duration of infant negative affect at 2 months and poorer regulation of infant negative affect over the first 6 months of life predicted longer durations of infant negative affect by 12 months. Infant negative affect at 12 months was a function of both infant factors and the quality of caregiver interactive behaviors (emotional availability) in early infancy.

  13. Maternal stress and psychological distress preconception: association with offspring atopic eczema at age 12 months

    PubMed Central

    El-Heis, S; Crozier, SR; Healy, E; Robinson, SM; Harvey, NC; Cooper, C; Inskip, HM; Baird, J; Godfrey, KM

    2017-01-01

    Background Perinatal maternal stress and low mood have been linked to offspring atopic eczema. Objectives To examine the relation of maternal stress/mood with atopic eczema in the offspring, focusing particularly on stress/psychological distress preconception. Methods At recruitment in the UK Southampton Women’s Survey, preconception maternal reports of perceived stress in daily living and the effect of stress on health were recorded; in a sub-sample psychological distress was assessed (12-item General Health Questionnaire). Infants were followed up at ages 6 (n=2956) and 12 (n=2872) months and atopic eczema ascertained (based on UK Working Party Criteria for the Definition of Atopic Dermatitis). At 6 months postpartum, mothers were asked if they had experienced symptoms of low mood since childbirth and completed the Edinburgh Post-natal Depression Scale. Results Preconception perceived stress affecting health (OR 1.21 (95%CI 1.08-1.35), p=0.001) and stress in daily living (OR 1.16 (1.03-1.30), p=0.014) were associated with an increased risk of offspring atopic eczema at age 12 months but not at 6 months, robust to adjustment for potentially confounding variables. Findings were similar for maternal psychological distress preconception. Low maternal mood between delivery and 6 months postpartum was associated with an increased risk of infantile atopic eczema at age 12 months, but no significant association between postnatal mood and atopic eczema was seen after taking account of preconception stress. Conclusion & Clinical Relevance Our data provide novel evidence linking maternal stress at preconception to atopic eczema risk, supporting a developmental contribution to the aetiology of atopic eczema and pointing to potentially modifiable influences. PMID:28218994

  14. Recurrent endometrial carcinoma: prognosis for patients with recurrence within 6 to 12 months is worse relative to those relapsing at 12 months or later.

    PubMed

    Miyake, Takahito; Ueda, Yutaka; Egawa-Takata, Tomomi; Matsuzaki, Shinya; Yokoyama, Takuhei; Miyoshi, Yukari; Kimura, Toshihiro; Yoshino, Kiyoshi; Fujita, Masami; Yamasaki, Masato; Enomoto, Takayuki; Kimura, Tadashi

    2011-06-01

    We evaluated association of prognosis of endometrial carcinoma patients and treatment-free intervals (TFIs). We compared the effectiveness of second-line chemotherapy performed for patients with TFIs of 6-12 months and 12 or more months following a first-line chemotherapy based on taxane (paclitaxel) and carboplatin, with or without the anthracycline (TC). Progression-free and overall survivals were significantly shorter in patients with TFIs of 6-12 months than those with TFIs of 12 or more months. Among the patients who received similar second-line chemotherapy, response rates of 15 patients with TFIs of 12 or more months and 7 patients with TFIs of 6-12 months were 67% and 43%, respectively. Progression-free survival was significantly worse in those with TFIs of 6-12 months (median, 7 months) than those with TFIs of 12 or more months (median, 12 months). Our small retrospective analysis suggests that recurrent endometrial carcinomas with TFIs of 6-12 months can be regarded as being partially sensitive to TC-based chemotherapy. Copyright © 2011 Mosby, Inc. All rights reserved.

  15. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study.

    PubMed

    Lim, Shan-Xuan; Toh, Jia-Ying; van Lee, Linde; Han, Wee-Meng; Shek, Lynette Pei-Chi; Tan, Kok-Hian; Yap, Fabian; Godfrey, Keith M; Chong, Yap-Seng; Chong, Mary Foong-Fong

    2018-03-10

    Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother-offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies.

  16. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study

    PubMed Central

    Lim, Shan-Xuan; Toh, Jia-Ying; Han, Wee-Meng; Shek, Lynette Pei-Chi; Yap, Fabian; Chong, Yap-Seng; Chong, Mary Foong-Fong

    2018-01-01

    Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies. PMID:29534442

  17. Outcomes of ≤6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation

    PubMed Central

    Villablanca, Pedro A.; Massera, Daniele; Mathew, Verghese; Bangalore, Sripal; Christia, Panagiota; Perez, Irving; Wan, Ningxin; Schulz-Schüpke, Stefanie; Briceno, David F.; Bortnick, Anna E.; Garcia, Mario J.; Lucariello, Richard; Menegus, Mark; Pyo, Robert; Wiley, Jose; Ramakrishna, Harish

    2016-01-01

    Abstract Background: The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. Methods: We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement. For studies with longer follow-up, outcomes at 12 months were identified. Odds ratios and 95% confidence intervals were computed with the Mantel–Haenszel method. Fixed-effect models were used; if heterogeneity (I2) > 40 was identified, effects were obtained with random models. Results: Nine RCTs were included with total n = 19,224 patients. No significant differences were observed between ≤6-month compared with 12-month DAPT in all-cause mortality (OR 0.87; 95% confidence interval (CI): 0.69–1.11), cardiovascular (CV) mortality (OR 0.89; 95% CI: 0.66–1.21), non-CV mortality (OR 0.85; 95% 0.58–1.24), myocardial infarction (OR 1.10; 95% CI: 0.89–1.37), stroke (OR 0.97; 95% CI: 0.67–1.42), stent thrombosis (ST) (OR 1.37; 95% CI: 0.89–2.10), and target vessel revascularization (OR 0.95; 95% CI: 0.77–1.18). No significant difference in major bleeding (OR 0.72; 95% CI: 0.49–1.05) was observed, though the all-bleeding event rate was significantly lower in the ≤6-month DAPT group (OR 0.76; 95% CI: 0.59–0.96). In the meta-regression analysis, a significant association between bleeding events and non-CV mortality with 12-month DAPT was found, as well as between ST and mortality in addition to MI with ≤6-month DAPT. Conclusion: DAPT for ≤6 months is associated with similar mortality and ischemic outcomes but less bleeding events compared with 12-month DAPT after PCI with DES. PMID:28033306

  18. Measles Humoral and Cell-Mediated Immunity in Children Aged 5–10 Years After Primary Measles Immunization Administered at 6 or 9 Months of Age

    PubMed Central

    Gans, Hayley A.; Yasukawa, Linda L.; Sung, Phillip; Sullivan, Barbara; DeHovitz, Ross; Audet, Susette; Beeler, Judy; Arvin, Ann M.

    2013-01-01

    Background. Given the high infant measles mortality rate, there is interest in whether a measles immunization regimen beginning at <12 months of age provides lasting immunity. Methods. Measles-specific immune responses were evaluated in 70 children aged 5–10 years after primary measles vaccine administered at 6, 9, or 12 months. Results. At 5–10 years of age, the stimulation index for measles T-cell proliferation was 11.4 (SE, 1.3), 10.9 (SE, 1.5), and 14.4 (SE 2.1) when the first measles dose was given at 6, 9, or 12 months, respectively. Neutralizing antibody concentration (geometric mean titer [GMT]) in those immunized at 6 months of age was 125 mIU/mL (95% confidence interval [CI], 42–377) in the presence of passive antibodies (PAs) and 335 mIU/mL (95% CI, 211–531) in those without PAs; in those immunized at 9 months, GMTs were 186 mIU/mL (95% CI, 103–335) and 1080 mIU/mL (95% CI, 642–1827) in the presence and absence of PAs, respectively. The GMT was 707 mIU/mL (95% CI, 456–1095) when vaccine was administered at 12 months (P ≤ .04). Conclusions. Measles-specific T-cell responses were sustained at 5–10 years of age regardless of age at time of primary measles immunization. Neutralizing antibody concentrations were lower in cohorts given the first vaccine dose at 6 months of age and in the presence of PAs; however, responses could be boosted by subsequent doses. Starting measles vaccination at <12 months of age may be beneficial during measles outbreaks or in endemic areas. PMID:23300162

  19. Prognosis at 6 and 12months after self-attempted hanging.

    PubMed

    Gantois, Guillaume; Parmentier-Decrucq, Erika; Duburcq, Thibault; Favory, Raphaël; Mathieu, Daniel; Poissy, Julien

    2017-11-01

    Patients surviving a self-attempted hanging have a total neurological recovery in 57-77% of cases at hospital discharge, but no long-term data are available. In this observational study, all patients hospitalized post-self-attempted hanging in the intensive care unit (ICU) in a 5-year period were included. Neurological evaluations at 6 and 12months were performed according to Cerebral Performance Category (CPC) scores. Factors associated with neurological recovery were determined by comparing CPC2+3+4 (bad recovery) vs. CPC1 (good recovery). Of 231 patients included, 104 (47%) were found to have cardiac arrest (CA). Ninety-five (41%) patients died in the ICU: 93 (89%) in the CA group and 2 (1.6%) in the group without CA. Neurological evaluations at 6 and 12months were obtained in 97 of the 136 surviving patients. At 6months, in the CA group (n=9), the CPC score was 1 for 6 patients, 2 for 2, and 4 for 1 patient. In the group without CA (n=88), 79 patients had normal neurological status at 6months and 78 at 12months. Among these patients, 96% returned home, 77% returned to work, 16 (18%) patients re-attempted suicide within the year. Risk factors of neurological sequelae at 6months were a CA at the hanging site (P=0.045), an elevated diastolic blood pressure (87 vs. 70 mm Hg; P=0.04), a lower initial Glasgow score (4 vs. 5; P=0.04), and an elevated blood glucose level (139 vs. 113 mg/dL; P<0.001). Patients surviving a self-attempted hanging who did not have a CA had a good neurological outcome. The rate of suicidal recidivism is particularly important, which justifies joint work with psychiatrists. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Factors associated with haemoglobin concentration among Timor-Leste children aged 6-59 months.

    PubMed

    Agho, K E; Dibley, M J; D'Este, C; Gibberd, R

    2008-06-01

    The study was conducted to assess the prevalence of and factors associated with haemoglobin (Hb) concentrations among children aged 6-59 months in Timor-Leste. The 2003 Demographic and Health Survey was a multi-stage cluster survey of 4,320 households from four different geographic regions in Timor-Leste. In total, 4,514 children aged 6-59 months were included in the analysis. The prevalence of anaemia (Hb concentration <11.0g/dL) was 38.2% (638/1,668) for children aged 6-23 months and 22.6% (644/2,846) for older children (p<0.001). Girls had a higher mean Hb concentration than boys (11.9g/dL vs 11.7g/ dL, p<0.006) and children who had diarrhoea in the previous two weeks had a lower Hb concentration than children without diarrhoea (11.5g/dL vs 11.9g/dL, p<0.001). Children from the richest and middle-class households had a lower average Hb concentration than those from the poorest households (11.8g/ dL, 11.7g/dL vs 12.0g/dL, p<0.001). Children of mothers with some secondary or more education had a lower mean Hb concentration than children of mothers with completed primary, some primary and no education (11.7 g/dL vs 11.9 g/dL, 11.8 g/dL, and 11.9 g/dL, p=0.002). Children from severely-anaemic mothers had a lower mean Hb concentration than children from moderately-, mild and not anaemic mothers (10.5 g/dL vs 11.1 g/dL, 11.6 g/dL, 12.0 g/dL, p<0.001). After backward stepwise hierarchical multiple regression, wasting, male sex, recent diarrhoea, household wealth index (richest and middle-class), maternal educational status (some secondary or more and some primary), and maternal anaemic status were significantly associated with a lower Hb concentration in children and increased age of child and duration of breastfeeding (6 months) with a higher Hb concentration. Anaemia-prevention programmes among children in Timor-Leste should focus on those children aged less than two years, children with recent diarrhoea, wasted children, high socioeconomic status, and anaemic

  1. Age-related differences in memory expression during infancy: using eye-tracking to measure relational memory in 6- and 12-month-olds.

    PubMed

    Richmond, Jenny L; Power, Jessica

    2014-09-01

    Relational memory, or the ability to bind components of an event into a network of linked representations, is a primary function of the hippocampus. Here we extend eye-tracking research showing that infants are capable of forming memories for the relation between arbitrarily paired scenes and faces, by looking at age-related changes in relational memory over the first year of life. Six- and 12-month-old infants were familiarized with pairs of faces and scenes before being tested with arrays of three familiar faces that were presented on a familiar scene. Preferential looking at the face that matches the scene is typically taken as evidence of relational memory. The results showed that while 6-month-old showed very early preferential looking when face/scene pairs were tested immediately, 12-month-old did not exhibit evidence of relational memory either immediately or after a short delay. Theoretical implications for the functional development of the hippocampus and practical implications for the use of eye tracking to measure memory during early life are discussed. © 2014 Wiley Periodicals, Inc.

  2. Similar Antibody Levels in 3-Year-Old Children Vaccinated Against Measles, Mumps, and Rubella at the Age of 12 Months or 18 Months.

    PubMed

    Kontio, Mia; Palmu, Arto A; Syrjänen, Ritva K; Lahdenkari, Mika; Ruokokoski, Esa; Davidkin, Irja; Vaarala, Outi; Melin, Merit

    2016-06-15

    Measles-mumps-rubella (MMR) vaccinations have been offered to Finnish children at 14-18 months and 6 years of age. In May 2011, the recommended age for the first vaccine dose was lowered to 12 months because of the European measles epidemic. Fingertip capillary blood samples were collected from 3-year-old Finnish children vaccinated once with MMR vaccine at 11-19 months of age. The immunoglobulin G (IgG) antibodies to all 3 MMR antigens were measured with enzyme-linked immunosorbent assay. Neutralizing antibodies and the avidity of antibodies were measured for measles virus. From April through October 2013, 187 children were enrolled. Equally high proportions of the samples were seropositive for measles virus, mumps virus, or rubella virus antibodies, and there were no significant differences in the IgG antibody concentrations in children vaccinated at 11-13 months of age, compared with those vaccinated at 17-19 months of age. However, among children vaccinated at 11-13 months of age, boys had lower antibody concentrations than girls. Neutralizing measles virus antibody titers were above the threshold for protective immunity in all 78 samples analyzed. The measles virus antibody avidity indexes were high for all children. MMR induces similar antibody responses in 12-month-old children as compared to 18-month-old children, but in boys increasing age appears to improve the antibody responses. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  3. Infants Show a Facilitation Effect for Native Language Phonetic Perception between 6 and 12 Months

    ERIC Educational Resources Information Center

    Kuhl, Patricia K.; Stevens, Erica; Hayashi, Akiko; Deguchi, Toshisada; Kiritani, Shigeru; Iverson, Paul

    2006-01-01

    Patterns of developmental change in phonetic perception are critical to theory development. Many previous studies document a decline in nonnative phonetic perception between 6 and 12 months of age. However, much less experimental attention has been paid to developmental change in native-language phonetic perception over the same time period. We…

  4. Factors Associated with Haemoglobin Concentration among Timor-Leste Children Aged 6–59 Months

    PubMed Central

    Agho, K.E.; Dibley, M.J.; D'Este, C.; Gibberd, R.

    2008-01-01

    The study was conducted to assess the prevalence of and factors associated with haemoglobin (Hb) concentrations among children aged 6–59 months in Timor-Leste. The 2003 Demographic and Health Survey was a multi-stage cluster survey of 4,320 households from four different geographic regions in Timor-Leste. In total, 4,514 children aged 6–59 months were included in the analysis. The prevalence of anaemia (Hb concentration <11.0g/dL) was 38.2% (638/1,668) for children aged 6–23 months and 22.6% (644/2,846) for older children (p<0.001). Girls had a higher mean Hb concentration than boys (11.9g/dL vs 11.7g/dL, p<0.006) and children who had diarrhoea in the previous two weeks had a lower Hb concentration than children without diarrhoea (11.5g/dL vs 11.9g/dL, p<0.001). Children from the richest and middle-class households had a lower average Hb concentration than those from the poorest households (11.8g/dL, 11.7g/dL vs 12.0g/dL, p<0.001). Children of mothers with some secondary or more education had a lower mean Hb concentration than children of mothers with completed primary, some primary and no education (11.7 g/dL vs 11.9 g/dL, 11.8 g/dL, and 11.9 g/dL, p=0.002). Children from severely-anaemic mothers had a lower mean Hb concentration than children from moderately-, mild and not anaemic mothers (10.5 g/dL vs 11.1 g/dL, 11.6 g/dL, 12.0 g/dL, p<0.001). After backward stepwise hierarchical multiple regression, wasting, male sex, recent diarrhoea, household wealth index (richest and middle-class), maternal educational status (some secondary or more and some primary), and maternal anaemic status were significantly associated with a lower Hb concentration in children and increased age of child and duration of breastfeeding (6 months) with a higher Hb concentration. Anaemia-prevention programmes among children in Timor-Leste should focus on those children aged less than two years, children with recent diarrhoea, wasted children, high socioeconomic status, and anaemic

  5. Prospective associations of appetitive traits at 3 and 12 months of age with body mass index and weight gain in the first 2 years of life.

    PubMed

    Quah, Phaik Ling; Chan, Yiong Huak; Aris, Izzuddin M; Pang, Wei Wei; Toh, Jia Ying; Tint, Mya Thway; Broekman, Birit F P; Saw, Seang Mei; Kwek, Kenneth; Godfrey, Keith M; Gluckman, Peter D; Chong, Yap Seng; Meaney, Michael J; Yap, Fabian K P; van Dam, Rob M; Lee, Yung Seng; Chong, Mary F F

    2015-10-12

    Appetitive traits in childhood such as food responsiveness and enjoyment of food have been associated with body mass index (BMI) in later childhood. However, data on appetitive traits during infancy in relation to BMI in later childhood are sparse. We aimed to relate appetitive traits in infancy to subsequent BMI and weight gain up to 24 months of age. Data of 210 infants from the Singapore GUSTO mother-offspring cohort was obtained. The Baby Eating Behavior Questionnaire (BEBQ) and the Child Eating Behavior Questionnaire (CEBQ) were administered to mothers when their offspring were aged 3 and 12 months respectively. Height and weight of offspring were measured at ages 3, 6, 9,12,15,18 and 24 months. The association of appetitive traits with both BMI z-score and weight gain were evaluated using multivariate linear regression. Food responsiveness at 3 months was associated with higher BMI from 6 months up to 15 months of age (p < 0.01) and with greater weight gain between 3 and 6 months of age (p = 0.012). Slowness in eating and satiety responsiveness at 3 months was significantly associated with lower BMI at 6 months (p < 0.01) and with less weight gain between 3 to 6 months of age (p = 0.034). None of the appetitive traits at 12 months were significantly associated with BMI or weight gain over any time period. Early assessment of appetitive traits at 3 months of age but not at 12 months of age was associated with BMI and weight gain over the first two years of life. Clinical Trials identifier NCT01174875.

  6. Validity of the Test of Infant Motor Performance for prediction of 6-, 9- and 12-month scores on the Alberta Infant Motor Scale.

    PubMed

    Campbell, Suzann K; Kolobe, Thubi H A; Wright, Benjamin D; Linacre, John Michael

    2002-04-01

    The Test of Infant Motor Performance (TIMP) is a test of functional movement in infants from 32 weeks' post-conceptional age to 4 months postterm. The purpose of this study was to assess in 96 infants (44 females, 52 males) with varying risk, the relation between measures on the TIMP at 7, 30, 60, and 90 days after term age and percentile ranks (PR) on the Alberta Infant Motor Scale (AIMS). Correlation between scores on the TIMP and the AIMS was highest for TIMP tests at 90 days and AIMS testing at 6 months (r=0.67, p=0.0001), but all comparisons were statistically significant except those between the TIMP at 7 days and AIMS PR at 9 months. In a multiple regression analysis combining a perinatal risk score and 7-day TIMP measures to predict 12-month AIMS PR, risk, but not TIMP, predicted outcome (21% of variance explained). At older ages TIMP measures made increasing contributions to prediction of 12-month AIMS PR (30% of variance explained by 90-day TIMP). The best TIMP score to maximize specificity and correctly identify 84% of the infants above versus below the 10th PR at 6 months was a cut-off point of 1 SD below the mean. The same cut-off point correctly identified 88% of the infants at 12 months. A cut-off of -0.5 SD, however, maximized sensitivity at 92%. A negative test result, i.e. score above -0.5 SD at 3 months, carried only a 2% probability of a poor 12-month outcome. We conclude that TIMP scores significantly predict AIMS PR 6 to 12 months later, but the TIMP at 3 months of age has the greatest degree of validity for predicting motor performance on the AIMS at 12 months and can be used clinically to identify infants likely to benefit from intervention.

  7. Distinguishing Mother-Infant Interaction from Stranger-Infant Interaction at 2, 4, and 6 Months of Age

    ERIC Educational Resources Information Center

    Bigelow, Ann E.; Power, Michelle; Mcquaid, Nancy; Ward, Ashley; Rochat, Philippe

    2008-01-01

    Observers watched videotaped face-to-face mother-infant and stranger-infant interactions of 12 infants at 2, 4, or 6 months of age. Half of the observers saw each mother paired with her own infant and another infant of the same age (mother tapes) and half saw each infant paired with his or her mother and with a stranger (infant tapes). Observers…

  8. [Weaning before the age of 6 months in Marrakech: associated factors and prevalence].

    PubMed

    Adarmouch, L; Abourrahouat, A; Sebbani, M; Amine, M; Sbihi, M

    2013-10-01

    In Morocco breastfeeding has become a declining practice. The objectives of this study were to estimate the prevalence of weaning before the age of 6 months and to identify associated factors. A cross-sectional survey was conducted among 400 mothers of infants aged 0 to 24 months. Participants were recruited from patients attending 40 randomly selected general practices in Marrakech. A trained interviewer administered a questionnaire to collect data on breastfeeding practice and factors associated with it. Early weaning was defined as a cessation of breastfeeding before the age of 6 months and was studied in mother-child couples whose infants were aged 6 months and older. Three binary logistic regression models were used to model the probability that an infant aged 6 months or more is weaned early. Breastfeeding was initiated by the majority of respondents (97.5%). Early weaning was observed in 75 infants (28% of registered weaning). Factors associated with early weaning were: mother having an occupational activity (Odds Ratio [OR]=2.09; 95% confidence interval [CI]: [1.07-4.06]), caesarean delivery (OR=4.15; 95% CI: [1.74-9.88]) and the fact that the pregnancy was desired (OR=0.19; 95% CI: [0.05-0.68]). Weaning before 6 months of age is a common practice in our context. Identifying factors associated with early weaning is critical to promote breastfeeding. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children.

    PubMed

    Davies, G M; Worthington, H V; Ellwood, R P; Bentley, E M; Blinkhorn, A S; Taylor, G O; Davies, R M

    2002-09-01

    To assess the impact of regularly supplying free fluoride toothpaste regularly to children, initially aged 12 months, and living in deprived areas of the north west of England on the level of caries in the deciduous dentition at 5-6 years of age. A further aim was to compare the effectiveness of a programme using a toothpaste containing 440 ppmF (Colgate 0-6 Gel) with one containing 1,450 ppmF (Colgate Great Regular Flavour) in reducing caries. Randomised controlled parallel group clinical trial. Clinical data were collected from test and control groups when the children were 5-6 years old. A programme of posting toothpaste with dental health messages to the homes of children initially aged 12 months. Clinical examinations took place in primary schools. 7,422 children born in 3-month birth cohorts living in high caries areas in nine health districts in north west England. Within each district children were randomly assigned to test or control groups. Toothpaste, containing either 440 ppmF or 1450 ppmF, and dental health literature posted at three monthly intervals to children in test groups until they were aged 5-6 years. The dmft index, missing teeth and the prevalence of caries experience. An analysis of 3,731 children who were examined and remained in the programme showed the mean dmft to be 2.15 for the group who had received 1,450 ppmF toothpaste and 2.49 for the 440 ppmF group. The mean dmft for the control group was 2.57. This 16% reduction between the 1,450 ppmF and control group was statistically significant (P<0.05). The difference between the 440 ppmF group and control was not significant. Further analyses to estimate the population effect of the programme also confirmed this relationship. This study demonstrates that a programme distributing free toothpaste containing 1,450 ppmF provides a significant clinical benefit for high caries risk children living in deprived, non-fluoridated districts.

  10. Determinants of stunting at 6, 12, 24 and 60 months and postnatal linear growth in Pakistani children.

    PubMed

    Saleemi, M A; Ashraf, R N; Mellander, L; Zaman, S

    2001-11-01

    A "nested" case-control design was used to identify cases from a longitudinally followed cohort of 1236 newborns registered during 1984-1987, living in three socioeconomically different areas. The children had a length <-2SDS (standard deviation scores) at 6, 12, 24 and 60 mo of age using the NCHS reference. The controls were matched for gender, area and month of birth. A logistic regression analysis was used for determining the risk factors for stunting at each age. Postnatal linear growth was also examined in these two groups of children and body size was compared with the NCHS reference and that of upper-middle-class children (n = 240). At 6 mo of age, prematurity and duration of breastfeeding showed a significant association with stunting. At 12 mo, maternal height, birthweight and stunting at 6 mo, while at 24 mo, stunting at 6, 12 and 18 mo were identified as important factors. At 60 mo, no other factors besides previous stunting could be identified. The mean height reached at 60 mo showed a deficit of 6 and 13 cm for the controls and the cases, respectively, compared to the NCHS reference. Twenty-eight percent of the children from the two poor areas who were stunted at 6 mo had improved by 60 mo of age. The risk factors for stunting varied at different ages, relating more to feeding at early ages and to previous stunting, predominantly at higher ages. The linear growth showed that faltering increased with age when cases and controls were treated separately. Recovery from stunting could also be demonstrated.

  11. Dual Antiplatelet Therapy for 6 Months vs 12 Months After New-generation Drug-eluting Stent Implantation: Matched Analysis of ESTROFA-DAPT and ESTROFA-2.

    PubMed

    de la Torre Hernández, José M; Oteo Domínguez, Juan F; Hernández, Felipe; García Camarero, Tamara; Abdul-Jawad Altisent, Omar; Rivero Crespo, Fernando; Cascón, José D; Zavala, Germán; Gimeno, Federico; Arrebola Moreno, Antonio L; Andraka, Leire; Gómez Menchero, Antonio; Bosa, Francisco; Carrillo, Xavier; Sánchez Recalde, Ángel; Alfonso, Fernando; Pérez de Prado, Armando; López Palop, Ramón; Sanchis, Juan; Diarte de Miguel, José A; Jiménez Navarro, Manuel; Muñoz, Luz; Ramírez Moreno, Antonio; Tizón Marcos, Helena

    2015-10-01

    The recommendation for dual antiplatelet therapy following drug-eluting stent implantation ranges from 6 months to 12 months or beyond. Recent trials have suggested the safety of a 6-month dual antiplatelet therapy regimen, yet certain caveats to these studies limit the applicability of this shorter duration dual antiplatelet therapy strategy in real world settings. A registry was constructed with consecutive recruitment of patients undergoing new-generation drug-eluting stent implantation and prescribed 6 months of dual antiplatelet therapy. Propensity score matching was undertaken with a historical cohort of patients treated with second-generation drug-eluting stents who received 12 months of dual antiplatelet therapy from the ESTROFA-2 registry. The sample size was calculated using a noninferiority basis and the primary endpoint was the combination of cardiac death, myocardial infarction, revascularization, or major bleeding at 12 months. The analysis included 1286 patients in each group, with no significant differences in baseline characteristics. The primary endpoint occurred in 5.0% and 6.6% in the 6-month and 12-month groups, respectively (P = .001 for noninferiority). The incidence of definite or probable stent thrombosis was 0.5% and 0.7% in the 6-month and 12-month groups, respectively (P = .4). Major bleeding events were lower in the 6-month group than in the 12-month group (0.8% vs 1.4%; P = .2) CONCLUSIONS: In selected patients in this large multicenter study, the safety and efficacy of a 6-month dual antiplatelet therapy regimen after implantation of new-generation drug-eluting stents appeared to be noninferior to those of a 12-month dual antiplatelet therapy regimen. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Low maternal sensitivity at 6 months of age predicts higher BMI in 48 month old girls but not boys.

    PubMed

    Wendland, Barbara E; Atkinson, Leslie; Steiner, Meir; Fleming, Alison S; Pencharz, Paul; Moss, Ellen; Gaudreau, Hélène; Silveira, Patricia P; Arenovich, Tamara; Matthews, Stephen G; Meaney, Michael J; Levitan, Robert D

    2014-11-01

    Large population-based studies suggest that systematic measures of maternal sensitivity predict later risk for overweight and obesity. More work is needed to establish the developmental timing and potential moderators of this association. The current study examined the association between maternal sensitivity at 6 months of age and BMI z score measures at 48 months of age, and whether sex moderated this association. Longitudinal Canadian cohort of children from birth (the MAVAN project). This analysis was based on a dataset of 223 children (115 boys, 108 girls) who had structured assessments of maternal sensitivity at 6 months of age and 48-month BMI data available. Mother-child interactions were videotaped and systematically scored using the Maternal Behaviour Q-Sort (MBQS)-25 items, a standardized measure of maternal sensitivity. Linear mixed-effects models and logistic regression examined whether MBQS scores at 6 months predicted BMI at 48 months, controlling for other covariates. After controlling for weight-relevant covariates, there was a significant sex by MBQS interaction (P=0.015) in predicting 48 month BMI z. Further analysis revealed a strong negative association between MBQS scores and BMI in girls (P=0.01) but not boys (P=0.72). Logistic regression confirmed that in girls only, low maternal sensitivity was associated with the higher BMI categories as defined by the WHO (i.e. "at risk for overweight" or above). A significant association between low maternal sensitivity at 6 months of age and high body mass indices was found in girls but not boys at 48 months of age. These data suggest for the first time that the link between low maternal sensitivity and early BMI z may differ between boys and girls. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Complementary feeding at 4 versus 6 months of age for preterm infants born at less than 34 weeks of gestation: a randomised, open-label, multicentre trial.

    PubMed

    Gupta, Shuchita; Agarwal, Ramesh; Aggarwal, Kailash Chandra; Chellani, Harish; Duggal, Anil; Arya, Sugandha; Bhatia, Sunita; Sankar, Mari Jeeva; Sreenivas, Vishnubhatla; Jain, Vandana; Gupta, Arun Kumar; Deorari, Ashok K; Paul, Vinod K

    2017-05-01

    Evidence on the optimal time to initiation of complementary feeding in preterm infants is scarce. We examined the effect of initiation of complementary feeding at 4 months versus 6 months of corrected age on weight for age at 12 months corrected age in preterm infants less than 34 weeks of gestation. In this open-label, randomised trial, we enrolled infants born at less than 34 weeks of gestation with no major malformation from three public health facilities in India. Eligible infants were tracked from birth and randomly assigned (1:1) at 4 months corrected age to receive complementary feeding at 4 months corrected age (4 month group), or continuation of milk feeding and initiation of complementary feeding at 6 months corrected age (6 month group), using computer generated randomisation schedule of variable block size, stratified by gestation (30 weeks or less, and 31-33 weeks). Iron supplementation was provided as standard. Participants and the implementation team could not be masked to group assignment, but outcome assessors were masked. Primary outcome was weight for age Z-score at 12 months corrected age (WAZ 12 ) based on WHO Multicentre Growth Reference Study growth standards. Analyses were by intention to treat. The trial is registered with Clinical Trials Registry of India, number CTRI/2012/11/003149. Between March 20, 2013, and April 24, 2015, 403 infants were randomly assigned: 206 to receive complementary feeding from 4 months and 197 to receive complementary feeding from 6 months. 22 infants in the 4 month group (four deaths, two withdrawals, 16 lost to follow-up) and eight infants in the 6 month group (two deaths, six lost to follow-up) were excluded from analysis of primary outcome. There was no difference in WAZ 12 between two groups: -1·6 (SD 1·2) in the 4 month group versus -1·6 (SD 1·3) in the 6 month group (mean difference 0·005, 95% CI -0·24 to 0·25; p=0·965). There were more hospital admissions in the 4 month group compared with the 6

  14. Functional neuroimaging of high-risk 6-month-old infants predicts a diagnosis of autism at 24 months of age

    PubMed Central

    Emerson, Robert W.; Adams, Chloe; Nishino, Tomoyuki; Hazlett, Heather Cody; Wolff, Jason J.; Zwaigenbaum, Lonnie; Constantino, John N.; Shen, Mark D.; Swanson, Meghan R.; Elison, Jed T.; Kandala, Sridhar; Estes, Annette M.; Botteron, Kelly N.; Collins, Louis; Dager, Stephen R.; Evans, Alan C.; Gerig, Guido; Gu, Hongbin; McKinstry, Robert C.; Paterson, Sarah; Schultz, Robert T.; Styner, Martin; Network, IBIS; Schlaggar, Bradley L.; Pruett, John R.; Piven, Joseph

    2018-01-01

    Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social deficits and repetitive behaviors that typically emerge by 24 months of age. To develop effective early interventions that can potentially ameliorate the defining deficits of ASD and improve long-term outcomes, early detection is essential. Using prospective neuroimaging of 59 6-month-old infants with a high familial risk for ASD, we show that functional connectivity magnetic resonance imaging correctly identified which individual children would receive a research clinical best-estimate diagnosis of ASD at 24 months of age. Functional brain connections were defined in 6-month-old infants that correlated with 24-month scores on measures of social behavior, language, motor development, and repetitive behavior, which are all features common to the diagnosis of ASD. A fully cross-validated machine learning algorithm applied at age 6 months had a positive predictive value of 100% [95% confidence interval (CI), 62.9 to 100], correctly predicting 9 of 11 infants who received a diagnosis of ASD at 24 months (sensitivity, 81.8%; 95% CI, 47.8 to 96.8). All 48 6-month-old infants who were not diagnosed with ASD were correctly classified [specificity, 100% (95% CI, 90.8 to 100); negative predictive value, 96.0% (95% CI, 85.1 to 99.3)]. These findings have clinical implications for early risk assessment and the feasibility of developing early preventative interventions for ASD. PMID:28592562

  15. Plasticity after perceptual narrowing for voice perception: reinstating the ability to discriminate monkeys by their voices at 12 months of age

    PubMed Central

    Friendly, Rayna H.; Rendall, Drew; Trainor, Laurel J.

    2013-01-01

    Differentiating individuals by their voice is an important social skill for infants to acquire. In a previous study, we demonstrated that the ability to discriminate individuals by voice follows a pattern of perceptual narrowing (Friendly et al., 2013). Specifically, we found that the ability to discriminate between two foreign-species (rhesus monkey) voices decreased significantly between 6 and 12 months of age. Also during this period, there was a trend for the ability to discriminate human voices to increase. Here we investigate the extent to which plasticity remains at 12 months, after perceptual narrowing has occurred. We found that 12-month-olds who received 2 weeks of monkey-voice training were significantly better at discriminating between rhesus monkey voices than untrained 12-month-olds. Furthermore, discrimination was reinstated to a level slightly better than that of untrained 6-month-olds, suggesting that voice-processing abilities remain considerably plastic at the end of the first year. PMID:24130540

  16. Children aged 6-24 months like to watch YouTube videos but could not learn anything from them.

    PubMed

    Yadav, Savita; Chakraborty, Pinaki; Mittal, Prabhat; Arora, Udit

    2018-03-20

    Parents sometimes show young children YouTube videos on their smartphones. We studied the interaction of 55 Indian children born between December 2014 and May 2015 who watched YouTube videos when they were 6-24 months old. The children were recruited by the researchers using professional and personal contacts and visited by the same two observers at four ages, for at least 10 minutes. The observers recorded the children's abilities to interact with touch screens and identify people in videos and noted what videos attracted them the most. The children were attracted to music at six months of age and were interested in watching the videos at 12 months. They could identify their parents in videos at 12 months and themselves by 24 months. They started touching the screen at 18 months and could press the buttons that appeared on the screen, but did not understand their use. The children preferred watching dance performances by multiple artists with melodical music, advertisements for products they used and videos showing toys and balloons. Children up to two years of age could be entertained and kept busy by showing them YouTube clips on smartphones, but did not learn anything from the videos. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Hazardous Alcohol Drinking as Predictor of Smoking Relapse (3-, 6-, and 12-Months Follow-Up) by Gender.

    PubMed

    Rodríguez-Cano, Rubén; López-Durán, Ana; Martínez-Vispo, Carmela; Martínez, Úrsula; Fernández Del Río, Elena; Becoña, Elisardo

    2016-12-01

    Diverse studies have found a relation between alcohol consumption and smoking relapse. Few studies have analyzed the relation of smoking relapse with pretreatment alcohol consumption and gender differences. The main purpose of this study is to analyze the influence of alcohol consumption in smoking relapse over 12 months (3-, 6-, and 12-months follow-up) and to determine possible gender differences. The sample included 374 smokers who quit smoking by participating in a psychological smoking cessation treatment. We assessed hazardous pretreatment alcohol drinking (AUDIT), cigarette consumption (FTND; number of cigarettes) and sociodemographic variables. Higher scores on hazardous pretreatment alcohol drinking predict smoking relapse at 3-, 6-, and 12-months after smoking cessation. In males, higher scores on hazardous pretreatment alcohol drinking predict relapse at 6 and at 12 months. In females, higher scores on hazardous pretreatment alcohol drinking predict tobacco relapse at 3 months. Hazardous pretreatment alcohol drinking predicts relapse at all intervals after smoking cessation (3-, 6-, and 12-months follow-up). However, the influence of hazardous pretreatment alcohol drinking on smoking relapse differs as a function of gender, as it is a short-term predictor in women (3 months) and a long-term predictor in men (6 and 12 months). Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Physiological, pharmacokinetic and liver metabolism comparisons between 3-, 6-, 12- and 18-month-old male Sprague Dawley rats under ketamine-xylazine anesthesia

    PubMed Central

    Giroux, Marie-Chantal; Santamaria, Raphael; Hélie, Pierre; Burns, Patrick; Beaudry, Francis; Vachon, Pascal

    2015-01-01

    The main objective of this study was to compare the physiological changes (withdrawal and corneal reflexes, respiratory and cardiac frequency, blood oxygen saturation, and rectal temperature) following intraperitoneal administration of ketamine (80 mg/kg) and xylazine (10 mg/kg) to 3-, 6-, 12- and 18-month-old male Sprague Dawley rats (n=6/age group). Plasma pharmacokinetics, liver metabolism, and blood biochemistry were examined for a limited number of animals to better explain anesthetic drug effects. Selected organs were collected for histopathology. The results for the withdrawal and corneal reflexes suggest a shorter duration and decreased depth of anesthesia with aging. Significant cardiac and respiratory depression, as well as decreased blood oxygen saturation, occurred in all age groups however, cardiac frequency was the most affected parameter with aging, since the 6-, 12-, and 18-month-old animals did not recuperate to normal values during recovery from anesthesia. Pharmacokinetic parameters (T1/2 and AUC) increased and drug clearance decreased with aging, which strongly suggests that drug exposure is associated with the physiological results. The findings for liver S9 fractions of 18-month-old rats compared with the other age groups suggest that following a normal ketamine anesthetic dose (80 mg/kg), drug metabolism is impaired, leading to a significant increase of drug exposure. In conclusion, age and related factors have a substantial effect on ketamine and xylazine availability, which is reflected by significant changes in pharmacokinetics and liver metabolism of these drugs, and this translates into shorter and less effective anesthesia with increasing age. PMID:26489361

  19. Histological analysis and identification of spermatogenesis-related genes in 2-, 6-, and 12-month-old sheep testes

    NASA Astrophysics Data System (ADS)

    Bai, Man; Sun, Limin; Zhao, Jia; Xiang, Lujie; Cheng, Xiaoyin; Li, Jiarong; Jia, Chao; Jiang, Huaizhi

    2017-10-01

    Testis development and spermatogenesis are vital factors that influence male animal fertility. In order to identify spermatogenesis-related genes and further provide a theory basis for finding biomarkers related to male sheep fertility, 2-, 6-, and 12-month-old Small Tail Han Sheep testes were selected to investigate the dynamic changes of sheep testis development. Hematoxylin-eosin routine staining and RNA-Seq technique were used to perform histological and transcriptome analysis for these testes. The results showed that 630, 102, and 322 differentially expressed genes (DEGs) were identified in 2- vs 6-month-old, 6- vs 12-month-old, and 2- vs 12-month-old testes, respectively. GO and KEGG analysis showed the following: DEGs in 2- vs 6-month-old testes were mainly related to the GO terms of sexual maturation and the pathways of multiple metabolism and biosynthesis; in 6- vs 12-month-old testes, most of the GO terms that DEGs involved in were related to metabolism and translation processes; the most significantly enriched pathway is the ribosome pathway. The union of DEGs in 2- vs 6-month-old, 6- vs 12-month-old, and 2- vs 12-month-old testes was categorized into eight profiles by series cluster. Subsequently, the eight profiles were classified into four model profiles and four co-expression networks were constructed based on the DEGs in these model profiles. Finally, 29 key regulatory genes related to spermatogenesis were identified in the four co-expression networks. The expression of 13 DEGs (CA3, APOH, MYOC, CATSPER4, SYT6, SERPINA10, DAZL, ADIPOR2, RAB13, CEP41, SPAG4, ODF1, and FRG1) was validated by RT-PCR.

  20. A Randomized Trial Comparing Part-time Patching with Observation for Intermittent Exotropia in Children 12 to 35 Months of Age.

    PubMed

    Mohney, Brian G; Cotter, Susan A; Chandler, Danielle L; Holmes, Jonathan M; Chen, Angela M; Melia, Michele; Donahue, Sean P; Wallace, David K; Kraker, Raymond T; Christian, Melanie L; Suh, Donny W

    2015-08-01

    To determine the effectiveness of part-time patching for treating intermittent exotropia (IXT) in young children. Multicenter, randomized clinical trial. Two hundred one children 12 to 35 months of age with untreated IXT meeting the following criteria: (1) IXT at distance OR constant exotropia at distance and either IXT or exophoria at near, and (2) 15-prism diopter (Δ) or more exodeviation at distance or near by prism and alternate cover test (PACT) but at least 10 Δ exodeviation at distance by PACT. Participants were assigned randomly to either observation (no treatment for 6 months) or patching prescribed for 3 hours daily for 5 months, followed by 1 month of no patching. The primary outcome was deterioration, defined as constant exotropia measuring at least 10 Δ at distance and near or receipt of nonprotocol treatment for IXT. Of the 177 participants (88%) completing the 6-month primary outcome examination, deterioration occurred in 4.6% (4 of 87) of the participants in the observation group and in 2.2% (2 of 90) of the participants in the patching group (difference, 2.4%; P = 0.27; 95% confidence interval, -3.8% to +9.4%). Motor deterioration occurred in 2.3% (2 of 87) of the observation group and in 2.2% (2 of 90) of the patching group (difference, 0.08%; P = 0.55; 95% confidence interval, -5.8% to +6.1%). For the observation and patching groups, respectively, 6-month mean PACT measurements were 27.9 Δ versus 24.9 Δ at distance (P = 0.02) and 19.3 Δ versus 17.0 Δ at near (P = 0.10); 6-month mean exotropia control scores were 2.8 versus 2.3 points at distance (P = 0.02) and 1.4 versus 1.1 points at near (P = 0.26). Among children 12 to 35 months of age with previously untreated IXT, deterioration over 6 months was uncommon, with or without patching treatment. There was insufficient evidence to recommend part-time patching for the treatment of IXT in children in this age group. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier

  1. Prevalence and factors associated with anaemia among children aged 6 to 59 months in Namutumba district, Uganda: a cross- sectional study.

    PubMed

    Kuziga, Fiona; Adoke, Yeka; Wanyenze, Rhoda K

    2017-01-18

    Anaemia is one of the major causes of death among children under five years in Africa, with a prevalence of 64.6% among pre-school children. In 2014, we conducted a cross-sectional study in Namutumba district in East-central Uganda to determine the prevalence and factors associated with anaemia among children aged 6 to 59 months. We conducted a household survey in 376 randomly selected households. One child aged 6 to 59 months was randomly sampled from each selected household. A structured questionnaire administered to an adult caregiver was used to collect household data. Blood was collected by finger or heel prick to estimate the haemoglobin level using a portable haemocue analyser. Anthropometric data including age, weight and height was collected for each child. A modified poisson regression model was used to determine the correlates of anaemia, prevalence ratios and their 95% confidence intervals (CI). The prevalence of anaemia was high (58.8%) and was highest among children aged 12 to 23 months (68.5%) and males (61.3%). About 27.7% children were stunted. Children aged 6-11 and 12-23 months were more likely to be anaemic (APR = 1.12; 95% CI: 1.05-1.19 and APR = 1.12; 95% CI: 1.00-1.24 respectively), Resident of Magada and Namutumba (urban areas) were less likely to be anaemic (APR = 0.89; 95% CI: 0.87-0.91and APR = 0.86; 95% CI: 0. 85-0.88 respectively). Children of caretakers of a big family size (seven or more children) and with any formal education were less likely to be anaemic (APR = 0.94; 95% CI: 0.89-0.99 and APR = 0.93; 95% CI: 0.87-0.99). Stunting (HAZ scores) was a predictor of anaemia (APR = 1.07; 95% CI: 1.02-1.12). Anaemia is highly prevalent among children and there is need to invest in measures to prevent anaemia, especially among children in the rural areas.

  2. Breast milk composition and infant nutrient intakes during the first 12 months of life.

    PubMed

    Grote, V; Verduci, E; Scaglioni, S; Vecchi, F; Contarini, G; Giovannini, M; Koletzko, B; Agostoni, C

    2016-02-01

    The objective of this study was to quantify human milk supply and intake of breastfed infants up to age 12 months. In addition, human milk composition was quantified per energetic macronutrient and fatty-acid composition in a subsample of lactating mothers. One hundred and seventy-four Italian breastfed children were followed using test-weighing and 3-day food protocols from birth to age 12 months. From a subsample of 30 mothers breast milk samples were collected at child ages one (T1), two (T2), three (T3) and six (T6) months, and were analyzed for the amount of protein, digestible carbohydrates, total lipids and fatty-acid composition. One hundred and forty-two (82%) filled in at least one 3-day food protocol within the first 12 months of life and complied with test-weighing of all milk feeds. The number of valid food protocols declined from 126 infants at 1 month to 77 at 12 months of age. Only galactose, non-protein nitrogen and protein decreased significantly from age 1 to age 6 months of lactation. Maternal body mass index and age affected fatty-acid levels in human milk. Median human milk intake decreased from 625 ml at T1, over 724 ml at T3 to 477 ml/day at T6. Average energy and %energy from protein intake per day increased from 419 kcal (s.d. 99) and 8.4% (1.0) at T1, respectively, to 860 kcal (145) and 16.1% (2.6) at T12. These data provide a reference range of nutrient intakes in breastfed infants and may provide guidance for defining optimal nutrient intakes for infants that cannot be fully breastfed.

  3. Prevalence and demographic factors associated with vitamin A deficiency in Colombian children aged 12-59 months.

    PubMed

    Martínez-Torres, Javier; Meneses-Echavéz, José F; Ramírez-Vélez, Robinson

    2014-11-01

    To examine the sociodemographic factors associated with subclinical vitamin A deficiency in a representative sample of Colombian children. Subjects and methods A cross-sectional, descriptive study was conducted of data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010) on 4,279 children aged 12 to 59 months. Plasma vitamin A levels were measured using high resolution liquid chromatography (HRLC), and sociodemographic factors (sex, age, ethnicity, SISBEN score, and geographic region) were collected using a structured survey. Prevalence rates and associations were established using a multivariate regression model. Vitamin A levels ranged from 7.5-93.7 μg/dL (mean=26.2; 95% CI, 25.9 to 26.5μg/dL). Vitamin A levels less than 20 μg/dL (subclinical deficiency) were found in 24.3% of children. Children belonging to ethnic groups of African ascent, those living in the Orinoquia and Amazonia regions, and those aged 12-23 months had the greatest subclinical vitamin A deficiencies (29.5%, 31.1%, and 27.6% respectively. Regression models showed that age ranging from 12 and 23 months (OR 1.32; 95% CI, 1.01 to 1.73), a SISBEN score 1 (OR 1.66; 95% CI, 1.18 to 2.34), an African ascent (OR 1.35; 95% CI, 1.05 to 1.74), and living in the Orinoquia and Amazonia regions (OR 2.38; 95% CI, 1.62 to 3.51) were factors associated to subclinical vitamin A deficiency. The study population shows a high prevalence of subclinical vitamin A deficiency, and comprehensive interventions involving nutritional and educational components are therefore recommended. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  4. "Cancer Put My Life on Hold": Work-Related Challenges Among Middle-aged Adults 12 Months After a Diagnosis of Colorectal Cancer.

    PubMed

    McGrath, Catherine; Mihala, Gabor; Beesley, Vanessa L; Lynch, Brigid M; Graves, Nicholas; Gordon, Louisa G

    Colorectal cancer affects a wide range of working-age people. Little is known about the consequent work limitations. The aim of this study was to understand the extent and changing nature of work-related limitations of middle-aged (45-64 years) people over the first 12 months of colorectal cancer. Surveys were administered to participants recruited via the Queensland Cancer Registry, at 6 and 12 months after diagnosis. Among those who returned to work, the Work Limitations Questionnaire measured 4 job performance domains (time management, physical, mental-interpersonal, and output demands) and an overall productivity score. Open-ended questions supplemented the Work Limitations Questionnaire, and responses were thematically analyzed. Of 239 participants, 8% did not continue in the study, and 20% left employment by 12 months, leaving 171 participants eligible for this analysis. Open-ended responses for why participants stopped work included bowel problems and stoma, loss of strength, and medication adverse effects. At 12 months, 22% to 39% of participants reported work limitations, but there was no overall significant change in work limitations between 6 and 12 months. Qualitative data highlighted the key work-related issues were changes in work functioning, attitudes of employers and colleagues, financial pressures, and emotional responses. While a significant proportion left work because of treatment-related problems, and the majority of participants did not experience workplace limitations, some reported considerable work-related challenges. Discussions with health professionals about the possible impact of treatment adverse effects on employment, good communication with employers, and workplace flexibility may facilitate return to work for this population.

  5. Predictors of vaccination in India for children aged 12-36 months.

    PubMed

    Shrivastwa, Nijika; Gillespie, Brenda W; Kolenic, Giselle E; Lepkowski, James M; Boulton, Matthew L

    2015-11-27

    India has one of the lowest immunization rates worldwide despite a longstanding Universal Immunization Program (UIP) that provides free childhood vaccines. This study characterizes the predictors for under- and non-vaccination among Indian children aged 12-36 months. This study utilized District Level Household and Facility Survey Data, 2008 (DLHS3), from India. DLHS3 is a nationally representative sample collected from December 2007 through December 2008; this analysis was conducted during 2014. Children's vaccination status was categorized as fully, under-, and non-vaccinated based on whether children received all, some, or none of the UIP-recommended vaccines (one dose each of bacillus Calmette-Guérin and measles, and three doses of diphtheria-pertussis-tetanus). A multinomial logistic regression model estimated the odds of undervaccination compared with full vaccination, and odds of non-vaccination compared with full vaccination. Analytic predictors included socioeconomic, cultural, household, maternal, and childhood characteristics. The analysis included 108,057 children; the estimated proportions of fully, under-, and non-vaccinated children were 57%, 31%, and 12%, respectively. After adjusting for state of residence, age, gender, household wealth, and maternal education, additional significant predictors of children's vaccination status were religion, caste, place of delivery, number of antenatal care visits, and maternal tetanus vaccination, all of which demonstrated large effect sizes. India's immunization coverage remained low in 2008, with just slightly more than half of all children aged 12-36 months fully vaccinated with UIP-recommended vaccines. A better understanding of the predictors for vaccination can help shape interventions to reduce disparities in full vaccination among children of differing demographic/cultural groups. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. A comparison of the carcass and meat quality of Martina Franca donkey foals aged 8 or 12 months.

    PubMed

    Polidori, Paolo; Pucciarelli, Stefania; Ariani, Ambra; Polzonetti, Valeria; Vincenzetti, Silvia

    2015-08-01

    The effects of slaughter age (8 vs 12 months) were investigated on meat and carcass quality obtained from Martina Franca donkey foals. Sixteen male foals were used, eight were slaughtered at 8 months of age with a mean (±s.e.) final body weight of 101±18kg and the remaining 8 foals slaughtered at 12 months of age with a mean final body weight of 122±13kg. Carcass weight and dressing percentage were higher (P<0.05) in older foals. Shear force value was lower (P<0.05) in donkeys slaughtered at 8 months of age (54.03N) compared to the same muscle Longissimus Thoracis et Lumborum (LTL) collected in older animals (62.66N). Muscle glycogen content was higher (P<0.05) in foals slaughtered at 12months of age. Donkey foal meat showed an interesting content of essential amino acids and a notable percentage of unsaturated fatty acids in both groups of animals, giving a high nutritional value to this alternative red meat. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. First CT findings and improvement in GOS and GOSE scores 6 and 12 months after severe traumatic brain injury.

    PubMed

    Corral, Luisa; Herrero, José Ignacio; Monfort, José Luis; Ventura, José Luis; Javierre, Casimiro F; Juncadella, Montserrat; García-Huete, Lucía; Bartolomé, Carlos; Gabarrós, Andreu

    2009-05-01

    To analyse the association between individual initial computerized tomography (CT) scan characteristics and Glasgow Outcome Scale (GOS) and Extended Glasgow Outcome Scale (GOSE) improvement between 6 months and 1 year. Two hundred and twenty-four adult patients with severe traumatic brain injury and Glasgow Coma Scale (GCS) score of 8 or less who were admitted to an intensive care unit were studied. GOS and GOSE scores were obtained 6 and 12 months after injury in 203 subjects. Patients were predominantly male (84%) and median age was 35 years. Traumatic Coma Data Bank (TCDB) CT classification was associated with GOS/GOSE improvement between 6 months and 1 year, with diffuse injury type I, type II and evacuated mass improving more than diffuse injury type III, type IV and non-evacuated mass; for GOS 43/155 (28%) vs 3/48 (6%) (chi(2) = 9.66, p < 0.01) and for GOSE 71/155 (46%) vs 7/48 (15%) (chi(2) = 15.1, p < 0.01). CT individual abnormalities were not associated with GOS/GOSE improvement, with the exception of subarachnoid haemorrhage, which showed a negative association with GOSE improvement (chi(2) = 4.08, p < 0.05). TCDB CT scan classification and subarachnoid haemorrhage were associated with GOS/GOSE improvement from 6-12 months, but individual CT abnormalities were not associated.

  8. Do developmental milestones at 4, 8, 12 and 24 months predict IQ at 5-6 years old? Results of the EDEN mother-child cohort.

    PubMed

    Peyre, Hugo; Charkaluk, Marie-Laure; Forhan, Anne; Heude, Barbara; Ramus, Franck

    2017-03-01

    The present study aims: (i) to determine how well developmental milestones at 4, 8, 12 and 24 months may predict IQ at 5-6 years old, (ii) to identify cognitive domains during the first two years that best predict later IQ and (iii) to determine whether children with IQ in the normal range at 5-6 years old may differ from disabled (IQ < 70) and gifted children (IQ > 130) with regard to their early cognitive development. The main developmental milestones were collected through self-administered questionnaires rated by parents at 4, 8, 12 and 24 months and through parental questionnaires administered by a trained interviewer and questionnaires completed following a medical examination at 12 months. These questionnaires were derived from the Brunet-Lézine Psychomotor Development Scale and they addressed several cognitive domains (gross and fine motor skills, language and socialization). (i) Developmental milestones predict a substantial part of the later IQ variance from 24 months (R 2  ∼ 20%). (ii) Early language skills more strongly predict later IQ than the other cognitive domains. (iii) Several cognitive domains, but particularly language skills, predict disabled children at 5-6 years old (from the age of 8 months) and gifted children (from the age of 12 months). The present study provides valuable information for early developmental assessment and could contribute to a better understanding of intellectual development. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  9. 12-15 Months: Your Child's Development

    MedlinePlus

    ... Resources & Services Parenting Resource 12–15 Months: Your Child’s Development Download Files Feb 9, 2016 This is a ... who she is. Downloads 12–15 Months: Your Child’s Development PDF 418 KB Read more about: Ages and ...

  10. Determinants of inadequate complementary feeding practices among children aged 6-23 months in Ghana.

    PubMed

    Issaka, Abukari I; Agho, Kingsley E; Burns, Penelope; Page, Andrew; Dibley, Michael J

    2015-03-01

    To explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey. The source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling. Ghana. Children (n 822) aged 6-23 months. The prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6-8 months was 72.6 % (95 % CI 64.6 %, 79.3 %). The proportion of children aged 6-23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46.0 % (95 % CI 42.3 %, 49.9 %) and 51.4 % (95 % CI 47.4 %, 55.3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29.9 % (95 % CI 26.1 %, 34.1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3.55; 95 % CI 1.05, 12.02). The prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household

  11. Independent effect of type of breastfeeding on overweight and obesity in children aged 12-24 months.

    PubMed

    Contarato, Aila Anne Pinto Farias; Rocha, Erika Dantas de Medeiros; Czarnobay, Sandra Ana; Mastroeni, Silmara Salete de Barros Silva; Veugelers, Paul J; Mastroeni, Marco Fabio

    2016-12-22

    This study aimed to analyze the effect of type of breastfeeding on the nutritional status of children between 12-24 months of age. This cohort study included 435 children born in 2012 in a public hospital in Joinville, Santa Catarina State, Brazil. Two years after delivery the mothers and their children were contacted in their homes for a new investigation of demographic, economic, nutritional, and anthropometric data. In the unadjusted analysis, children who were not exclusively breastfed were more likely to be overweight (including obesity) at 2 years of age (OR = 1.6; p = 0.049) than exclusively breastfed children. After adjusting for several covariates, children who were not exclusively breastfed had a 12% higher risk of overweight including obesity compared to unadjusted analysis (OR = 2.6 vs. OR = 1.8; p = 0.043). In addition, birthweight was also an independent determinant of overweight including obesity (OR = 2.5; p = 0.002). The practice of exclusive breastfeeding can reduce the risk of overweight in children from developing countries such as Brazil.

  12. Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India.

    PubMed

    Murhekar, Manoj V; Kamaraj, P; Kanagasabai, K; Elavarasu, G; Rajasekar, T Daniel; Boopathi, K; Mehendale, Sanjay

    2017-03-01

    District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guérin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers' recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights. A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule. The coverage of FVC in Tamil Nadu was high, with about 80 per cent children completing

  13. Predictors of Vaccination in India for Children Aged 12-36 Months.

    PubMed

    Shrivastwa, Nijika; Gillespie, Brenda W; Kolenic, Giselle E; Lepkowski, James M; Boulton, Matthew L

    2015-12-01

    India has one of the lowest immunization rates worldwide despite a longstanding Universal Immunization Program (UIP) that provides free childhood vaccines. This study characterizes the predictors for under- and non-vaccination among Indian children aged 12-36 months. This study utilized District Level Household and Facility Survey Data, 2008 (DLHS3), from India. DLHS3 is a nationally representative sample collected from December 2007 through December 2008; this analysis was conducted during 2014. Children's vaccination status was categorized as fully, under-, and non-vaccinated based on whether children received all, some, or none of the UIP-recommended vaccines (one dose each of bacillus Calmette-Guérin and measles, and three doses of diphtheria-pertussis-tetanus). A multinomial logistic regression model estimated the odds of under-vaccination compared with full vaccination, and odds of non-vaccination compared with full vaccination. Analytic predictors included socioeconomic, cultural, household, maternal, and childhood characteristics. The analysis included 108,057 children; the estimated proportions of fully, under-, and non-vaccinated children were 57%, 31%, and 12%, respectively. After adjusting for state of residence, age, gender, household wealth, and maternal education, additional significant predictors of children's vaccination status were religion, caste, place of delivery, number of antenatal care visits, and maternal tetanus vaccination, all of which demonstrated large effect sizes. India's immunization coverage remained low in 2008, with just slightly more than half of all children aged 12-36 months fully vaccinated with UIP-recommended vaccines. A better understanding of the predictors for vaccination can help shape interventions to reduce disparities in full vaccination among children of differing demographic/cultural groups. Copyright © 2015 by American Journal of Preventive Medicine and Elsevier Ltd. Published by Elsevier Inc. All rights

  14. A path model analysis on predictors of dropout (at 6 and 12 months) during the weight loss interventions in endocrinology outpatient division.

    PubMed

    Perna, Simone; Spadaccini, Daniele; Riva, Antonella; Allegrini, Pietro; Edera, Chiara; Faliva, Milena Anna; Peroni, Gabriella; Naso, Maurizio; Nichetti, Mara; Gozzer, Carlotta; Vigo, Beatrice; Rondanelli, Mariangela

    2018-02-22

    This study aimed to identify the dropout rate at 6 and 12 months from the first outpatient visit, and to analyze dropout risk factors among the following areas: biochemical examinations, anthropometric measures, psychological tests, personal data, and life attitude such as smoking, physical activity, and pathologies. This is a retrospective longitudinal observational study. Patients undergo an outpatient endocrinology visit, which includes collecting biographical data, anthropometric measurements, physical and pathological history, psychological tests, and biochemical examinations. The sample consists of 913 subjects (682 women and 231 men), with an average age of 50.88 years (±15.80) for the total sample, with a BMI of 33.11 ± 5.65 kg/m 2 . 51.9% of the patients abandoned therapy at 6 months after their first visit, and analyzing the dropout rate at 12 months, it appears that 69.5% of subjects abandon therapy. The main predictor of dropout risk factors at 6 and 12 months is the weight loss during the first 3 months (p < 0.05). As regards the hematological predictors, white blood cell and iron level stated dropout at 12 months. Patients who introduced physical activity had a reduction of - 17% (at 6 months) and -13% (at 12 months) of dropout risk (p < 0.05). As regards the "worker" status, patients classified as"retired" had a decrease risk of dropout vs. other categories of worker (i = 0.58; p < 0.05). Dropout risk at 12 months decrease in patients with a previous history of cancer, Endocrine and psychic and behavioral disorders (p < 0.001). The main factor that predisposes patients to continue therapy or to abandon it is the success (or failure) of the diet in the initial period, based on weight lost (or not lost) in the early months of the initiation of therapy. Furthermore, considerable differences were found in different categories of "workers", and with previous "pathologies". The level of physical activity and previous diseases

  15. Daily use of Sprinkles micronutrient powder for 2 months reduces anemia among children 6 to 36 months of age in the Kyrgyz Republic: a cluster-randomized trial.

    PubMed

    Lundeen, Elizabeth; Schueth, Tobias; Toktobaev, Nurjan; Zlotkin, Stanley; Hyder, S M Ziauddin; Houser, Robert

    2010-09-01

    Iron-deficiency anemia is widespread among young children in the Kyrgyz Republic, and there is an urgent need to identify an effective intervention to address this significant public health problem. To test the effectiveness of a 2-month intervention with daily home fortification of complementary food using micronutrient powder (Sprinkles) in reducing anemia among children 6 to 36 months of age in the Kyrgyz Republic. In this cluster-randomized, community-based effectiveness trial conducted in three regions of the Kyrgyz Republic, 24 clusters of children aged 6 to 36 months were randomly assigned to two groups. The intervention group (12 clusters, n = 1,103) received 60 sachets of micronutrient powder (12.5 mg elemental iron), which were taken as one sachet daily for 2 months. The control group (12 clusters, n = 1,090) did not receive micronutrient powder until after the study period. Blood hemoglobin concentration was assessed at the start and end of the intervention. From baseline to follow-up, the mean hemoglobin concentration in the intervention group increased by 7 g/L, whereas it decreased by 2 g/L in the control group (p < .001). The prevalence of anemia (hemoglobin < 110 g/L) in the intervention group decreased from 72% at baseline to 52% at follow-up, whereas it increased from 72% to 75% in the control group (p < .001). Compliance with the intervention was high, with children consuming on average 45 of the 60 sachets given. A course of 60 Sprinkles micronutrient powder sachets taken daily for 2 months is effective in improving hemoglobin levels and reducing the prevalence of anemia among young children in the Kyrgyz Republic.

  16. Fatigue Following Traumatic Brain Injury in Children and Adolescents: A Longitudinal Follow-Up 6 to 12 Months After Injury.

    PubMed

    Crichton, Alison; Anderson, Vicki; Oakley, Ed; Greenham, Mardee; Hearps, Stephen; Delzoppo, Carmel; Beauchamp, Miriam H; Hutchison, James S; Guerguerian, Anne-Marie; Boutis, Kathy; Babl, Franz E

    Longitudinal fatigue data in children suffering from traumatic brain injury (TBI) are lacking. To examine the effects of time postinjury (6-12 months) and injury severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12 months postinjury against published control data. Three tertiary children's hospitals across Australia (n = 1) and Canada (n = 2). Parents (n = 109) of children (mean [M] = 9.9 years at injury; range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n = 69) or moderate/severe (n = 37) TBI. Longitudinal prospective study. Primary: Pediatric Quality of Life Multidimensional Fatigue Scale (total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic and children data were collected at recruitment. Mixed-models analysis demonstrated nonsignificant effects of time (6 vs 12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue worsened over time. Moderate/severe TBI was associated with worse fatigue 12 months postinjury (general, P = .03; cognitive, P = .02). Across all severities, fatigue 12 months postinjury was significantly worse compared with control data (total fatigue, P < .001; all domains, all Ps < .025). Fatigue remains significant at 12 months since injury, particularly for those with moderate/severe TBI.

  17. Lifetime and 12-month prevalence estimates for mental disorders in northeastern Germany: findings from the Study of Health in Pomerania.

    PubMed

    Asselmann, E; Beesdo-Baum, K; Hamm, A; Schmidt, C O; Hertel, J; Grabe, H J; Pané-Farré, C A

    2018-06-15

    Few epidemiological studies presented 12-month and lifetime prevalence estimates for DSM-IV mental disorders in the adult general population by sex and age up to very old age. From 2007 to 2010, DSM-IV mental disorders were assessed with the DIA-X/M-CIDI among N = 2400 participants (aged 29-89 years) from the Study of Health in Pomerania, an epidemiological study based on a two-stage stratified cluster sample randomly drawn from the adult general population in northeastern Germany. 36.3% of the sample was affected by any 12-month and 54.8% by any lifetime mental disorder. The most frequent diagnostic groups were anxiety (12-month: 14.8%, lifetime: 23.4%), substance use (12-month: 14.5%, lifetime: 25.0%), somatoform (12-month: 12.9%, lifetime: 20.4%) and depressive (12-month: 7.3%, lifetime: 18.6%) disorders. Except for substance use (higher prevalence in men) and bipolar disorders (comparable prevalence in men and women), higher 12-month and lifetime prevalence estimates were found in women vs. men. Moreover, lower 12-month and lifetime prevalence estimates were found in older (aged 60-74 or 75-89 years) vs. younger (aged 29-44 or 45-59 years) age groups. 22.6% (men: 21.1%, women: 23.9%) of those affected by any 12-month disorder met criteria for two and 13.6% (men: 9.6%, women: 16.9%) for three or more 12-month diagnoses. Similarly, 26.4% (men: 25.7%, women: 26.9%) of those affected by any lifetime disorder met criteria for two and 22.7% (men: 19.6%, women: 25.2%) for three or more lifetime diagnoses. Our findings demonstrate the frequency of mental disorders in northeastern Germany and emphasize the need for continued prevention and intervention efforts.

  18. Sequential Analysis of Mastery Behavior in 6- and 12-Month-Old Infants.

    ERIC Educational Resources Information Center

    MacTurk, Robert H.; And Others

    1987-01-01

    Sequences of mastery behavior were analyzed in a sample of 67 infants 6 to 12 months old. Authors computed (a) frequencies of six categories of mastery behavior, transitional probabilities, and z scores for each behavior change, and (b) transitions from a mastery behavior to positive affect. Changes in frequencies and similarity in organization…

  19. Child, Household, and Caregiver Characteristics Associated with Hospitalization for Influenza Among Children 6–59 Months of Age

    PubMed Central

    2014-01-01

    Background: Young children are at increased risk of severe outcomes from influenza illness, including hospitalization. We conducted a case-control study to identify risk factors for influenza-associated hospitalizations among children in US Emerging Infections Program sites. Methods: Cases were children 6–59 months of age hospitalized for laboratory-confirmed influenza infections during 2005–2008. Age- and zip-code-matched controls were enrolled. Data on child, caregiver and household characteristics were collected from parents and medical records. Conditional logistic regression was used to identify independent risk factors for hospitalization. Results: We enrolled 290 (64%) of 454 eligible cases and 1089 (49%) of 2204 eligible controls. Risk for influenza hospitalization increased with maternal age <26 years [odds ratio (OR): 1.8, 95% confidence interval (CI): 1.1–2.9]; household income below the poverty threshold (OR: 2.2, 95% CI: 1.4–3.6); smoking by >50% of household members (OR: 2.9, 95% CI: 1.4–6.6); lack of household influenza vaccination (OR: 1.8, 95% CI: 1.2–2.5) and presence of chronic illnesses, including hematologic/oncologic (OR: 11.8, 95% CI: 4.5–31.0), pulmonary (OR: 2.9, 95% CI: 1.9–4.4) and neurologic (OR: 3.8, 95% CI: 1.6–9.2) conditions. Full influenza immunization decreased the risk among children 6–23 months of age (OR: 0.5, 95% CI: 0.3–0.9) but not among those 24–59 months of age (OR: 1.5, 95% CI: 0.8–3.0; P value for difference = 0.01). Conclusions: Chronic illnesses, young maternal age, poverty, household smoking and lack of household influenza vaccination increased the risk of influenza hospitalization. These characteristics may help providers to identify young children who are at greatest risk for severe outcomes from influenza illness. PMID:24642518

  20. Clinical spectrum of Kawasaki disease in infants younger than 6 months of age.

    PubMed

    Burns, J C; Wiggins, J W; Toews, W H; Newburger, J W; Leung, D Y; Wilson, H; Glodé, M P

    1986-11-01

    We report an unselected series of eight patients younger than 6 months of age with Kawasaki disease evaluated between January 1982 and May 1984. The incidence of coronary artery aneurysms (six patients) and the mortality (two patients) were unusually high in this small series. Because of the confusing clinical presentation in three patients, diagnosis was delayed until pathologic or echocardiographic evidence of coronary vasculitis or aneurysm was discovered. The currently accepted clinical criteria for Kawasaki disease may not always identify patients with the pathologic findings of the syndrome who are younger than 6 months of age. The diagnosis of Kawasaki disease and echocardiographic evaluation of the coronary arteries should be considered in young infants with prolonged fever of unknown origin.

  1. Speech Production in 12-Month-Old Children with and without Hearing Loss

    ERIC Educational Resources Information Center

    McGowan, Richard S.; Nittrouer, Susan; Chenausky, Karen

    2008-01-01

    Purpose: The purpose of this study was to compare speech production at 12 months of age for children with hearing loss (HL) who were identified and received intervention before 6 months of age with those of children with normal hearing (NH). Method: The speech production of 10 children with NH was compared with that of 10 children with HL whose…

  2. Maternal feeding practices and feeding behaviors of Australian children aged 12-36 months.

    PubMed

    Chan, L; Magarey, A M; Daniels, L A

    2011-11-01

    To explore parents' perceptions of the eating behaviors and related feeding practices of their young children. Mothers (N=740) of children aged 12-36 months and born in South Australia were randomly selected by birth date in four 6-month age bands from a centralized statewide database and invited to complete a postal questionnaire. Valid completed questionnaires were returned for 374 children (51% response rate; 54% female). Although mothers generally reported being confident and happy in feeding their children, 23% often worried that they gave their child the right amount of food. Based on a checklist of 36 specified items, 15% of children consumed no vegetables in the previous 24 h, 11% no fruit and for a further 8% juice was the only fruit. Of 12 specified high fat/sugar foods and drinks, 11% of children consumed none, 20% one, 26% two, and 43% three or more. Six of eight child-feeding practices that promote healthy eating behaviors were undertaken by 75% parents 'often' or 'all of the time'. However, 8 of 11 practices that do not promote healthy eating were undertaken by a third of mothers at least 'sometimes'. In this representative sample, dietary quality issues emerge early and inappropriate feeding practices are prevalent thus identifying the need for very early interventions that promote healthy food preferences and positive feeding practices. Such programs should focus not just on the 'what', but also the 'how' of early feeding, including the feeding relationship and processes appropriate to developmental stage.

  3. Coverage of childhood vaccination among children aged 12-23 months, Tamil Nadu, 2015, India

    PubMed Central

    Murhekar, Manoj V.; Kamaraj, P.; Kanagasabai, K.; Elavarasu, G.; Rajasekar, T. Daniel; Boopathi, K.; Mehendale, Sanjay

    2017-01-01

    Background & objectives: District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. Methods: Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]. From each stratum, 30 clusters were selected using probability proportional to the population size linear systematic sampling; seven children aged 12-23 months were selected from each cluster and their mothers/care-takers were interviewed to collect information about vaccination status of the child. A child was considered fully vaccinated if he/she received bacillus Calmette-Guérin (BCG), three doses of pentavalent, three doses of oral polio vaccine and one dose of measles vaccine, and appropriately vaccinated if all vaccine doses were given at right age and with right interval. Further, coverage of fully vaccinated children (FVC) as per vaccination cards or mothers’ recall, validated coverage of FVC (V-FVC) among those having cards, and coverage of appropriately vaccinated children (AVC) were estimated using survey data analysis module with appropriate sampling weights. Results: A total of 3150 children were surveyed, of them 2528 (80.3%) had vaccination card. The weighted coverage of FVC, V-FVC and AVC in the State was 79.9 per cent [95% confidence interval (CI): 78.2-81.5], 78.8 per cent (95% CI: 76.9-80.5) and 69.7 per cent (95% CI: 67.7-71.7), respectively. The coverage of individual vaccine ranged between 84 per cent (measles) and 99.8 per cent (BCG). About 12 per cent V-FVC were not vaccinated as per the vaccination schedule. Interpretation & conclusions: The coverage of

  4. The 12-Month Prevalence of DSM-IV Anxiety Disorders among Nigerian Secondary School Adolescents Aged 13-18 Years

    ERIC Educational Resources Information Center

    Adewuya, Abiodun O.; Ola, Bola A.; Adewumi, Tomi A.

    2007-01-01

    Aims: To estimate the 12-month prevalence of DSM-IV-specific anxiety disorders among Nigerian secondary school adolescents aged 13-18 years. Method: A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. Results: The 12-month…

  5. Effect of kangaroo mother care on growth and development of low birthweight babies up to 12 months of age: a controlled clinical trial.

    PubMed

    Bera, Alpanamayi; Ghosh, Jagabandhu; Singh, Arun K; Hazra, Avijit; Mukherjee, Suchandra; Mukherjee, Ranajit

    2014-06-01

    Kangaroo mother care (KMC) is a nonconventional low-cost method of newborn care. Our aim was to assess the effect of sustained KMC on the growth and development of low birthweight Indian babies up to the age of 12 months. We enrolled 500 mother and baby pairs, in groups of five, in a parallel group controlled clinical trial. The three infants with the lowest birthweight in each group received KMC, while the other two received conventional care. All babies were exclusively breastfed for 6 months. Babies in the intervention group were provided KMC until the infant was 40 weeks of corrected gestation or weighed 2500 g. Weight, length and head, chest and arm circumferences were evaluated at birth and at the corrected ages of 0, 3, 6, 9 and 12 months. Development was assessed using the Developmental Assessment Scales for Indian Infants (DASII) at 12 months. The KMC babies rapidly achieved physical growth parameters similar to the control babies at 40 weeks of corrected age. But after that, they surpassed them, despite being smaller at birth. DASII motor and mental development quotients were also significantly better for KMC babies. The infants in the KMC group showed better physical growth and development than the conventional control group. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Early child care and obesity at 12 months of age in the Danish National Birth Cohort

    PubMed Central

    Neelon, Sara E Benjamin; Andersen, Camilla Schou; Morgen, Camilla Schmidt; Kamper-Jørgensen, Mads; Oken, Emily; Gillman, Matthew W; Sørensen, Thorkild IA

    2014-01-01

    Background/Objectives Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries. Subjects/Methods We studied 27821 children born to mothers participating in the Danish National Birth Cohort (DNBC), a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex-specific body mass index (BMI) z-score and overweight/obesity (BMI ≥85th percentile based on the World Health Organization classification) at 12 months. We conducted multivariable linear and logistic regression analyses examining child care use and weight outcomes. Results A total of 17721 (63.7%) children attended child care during their first year of life. After adjustment for potential confounders, a 30-day increment of child care was associated with a modestly higher BMI z-score at 12 months (0.03 units; 95% CI: 0.01, 0.05; p=0.003). Similarly, child care use was associated with increased odds of being overweight/obese at 12 months of age (OR 1.05; 95% CI: 1.01, 1.10; p=0.047). Conclusions Child care in the first year of life was associated with slightly higher weight at 12 months, suggesting that child care settings may be important targets for obesity prevention in infancy. PMID:25233894

  7. Factors Associated with Dental Pain in Mexican Schoolchildren Aged 6 to 12 Years

    PubMed Central

    Escoffié-Ramirez, Mauricio; Ávila-Burgos, Leticia; Baena-Santillan, Elena Saraí; Aguilar-Ayala, Fernando; Lara-Carrillo, Edith; Minaya-Sánchez, Mirna; Mendoza-Rodríguez, Martha; Márquez-Corona, María de Lourdes

    2017-01-01

    Objective To identify dental pain prevalence and associated factors in Mexican schoolchildren. Methods This cross-sectional study included 1,404 schoolchildren aged 6 to 12 years from public schools in the city of Pachuca de Soto, Hidalgo, Mexico. Data were collected through a questionnaire that addressed sociodemographic and socioeconomic factors, eating and dental hygiene habits, and behavior variables. The dependent variable was self-reported dental pain in the 12 months prior to the survey. Data were analyzed using nonparametric statistics and a binary logistical regression model. Results Dental pain prevalence among the studied children was 49.9%. The variables associated in the final model (p < 0.05) were younger mother's age, higher socioeconomic level, absence of an automobile in the home, fried food, fruit intake, lower tooth brushing frequency, never having used mouthwash or not knowing about it, and parents/guardians with regular to high levels of knowledge about oral health and a regular or good/very good perception of their child's oral health. Conclusions One in two children in the study had experienced dental pain in the twelve months prior to the survey. The association of socioeconomic variables with dental pain suggested inequalities among the children in terms of oral health. PMID:28685149

  8. Fructose in Breast Milk Is Positively Associated with Infant Body Composition at 6 Months of Age.

    PubMed

    Goran, Michael I; Martin, Ashley A; Alderete, Tanya L; Fujiwara, Hideji; Fields, David A

    2017-02-16

    Dietary sugars have been shown to promote excess adiposity among children and adults; however, no study has examined fructose in human milk and its effects on body composition during infancy. Twenty-five mother-infant dyads attended clinical visits to the Oklahoma Health Sciences Center at 1 and 6 months of infant age. Infants were exclusively breastfed for 6 months and sugars in breast milk (i.e., fructose, glucose, lactose) were measured by Liquid chromatography-mass spectrometry (LC-MS/MS) and glucose oxidase. Infant body composition was assessed using dual-energy X-ray absorptiometry at 1 and 6 months. Multiple linear regression was used to examine associations between breast milk sugars and infant body composition at 6 months of age. Fructose, glucose, and lactose were present in breast milk and stable across visits (means = 6.7 μg/mL, 255.2 μg/mL, and 7.6 g/dL, respectively). Despite its very low concentration, fructose was the only sugar significantly associated with infant body composition. A 1-μg/mL higher breast milk fructose was associated with a 257 g higher body weight ( p = 0.02), 170 g higher lean mass ( p = 0.01), 131 g higher fat mass ( p = 0.05), and 5 g higher bone mineral content ( p = 0.03). In conclusion, fructose is detectable in human breast milk and is positively associated with all components of body composition at 6 months of age.

  9. Serum anti-tetanus and measles antibody titres in Ugandan children aged 4 months to 6 years: implications for vaccine programme.

    PubMed

    Warrener, Lenesha; Bwogi, Josephine; Andrews, Nick; Samuel, Dhanraj; Kabaliisa, Theopista; Bukenya, Henry; Brown, Kevin; Roper, Martha H; Featherstone, David A; Brown, David

    2018-05-09

    To study the antibody response to tetanus toxoid and measles by age following vaccination in children aged 4 months to 6 years in Entebbe, Uganda. Serum samples were obtained from 113 children aged 4-15 months, at the Mother-Child Health Clinic (MCHC), Entebbe Hospital and from 203 of the 206 children aged between 12 and 75 months recruited through the Outpatients Department (OPD). Antibodies to measles were quantified by plaque reduction neutralisation test (PRNT) and with Siemens IgG EIA. VaccZyme IgG EIA was used to quantify anti-tetanus antibodies. Sera from 96 of 113 (85.0%) children attending the MCHC contained Measles PRNT titres below the protective level (120 mIU/ml). Sera from 24 of 203 (11.8%) children attending the OPD contained PRNT titres 0.15 IU/ml by EIA, a level considered protective. The overall concentration of anti-tetanus antibody was sixfold higher in children under 12 months compared with the older children, with geometric mean concentrations of 3.15 IU/ml and 0.49 IU/ml, respectively. For each doubling in age between 4 and 64 months, the anti-tetanus antibody concentration declined by 50%. As time since the administration of the third DTP vaccination doubled, anti-tetanus antibody concentration declined by 39%. The low measles antibody prevalence in the children presenting at the MCHC is consistent with the current measles epidemiology in Uganda, where a significant number of measles cases occur in children under 1 year of age and earlier vaccination may be indicated. The consistent fall in anti-tetanus antibody titre over time following vaccination supports the need for further vaccine boosters at age 4-5 years as recommended by the WHO.

  10. Prevalence and factors associated with parental concerns about development detected by the Parents’ Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort

    PubMed Central

    Woolfenden, Susan; Eapen, Valsamma; Jalaludin, Bin; Hayen, Andrew; Kemp, Lynn; Dissanyake, Cheryl; Hendry, Alexandra; Axelsson, Emma; Overs, Bronwyn; Eastwood, John; Črnčec, Rudi; McKenzie, Anne; Beasley, Deborah; Murphy, Elisabeth; Williams, Katrina

    2016-01-01

    Objectives Early identification of developmental vulnerability is vital. This study aimed to estimate the prevalence of moderate or high developmental risk on the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks; identify associated risk factors; and examine documentation of the PEDS at well-child checks. Design, participants A prospective birth cohort of 2025 children with 50% of those approached agreeing to participate. Demographic data were obtained via questionnaires and linked electronic medical records. Telephone interviews were conducted with parents to collect PEDS data. Primary and secondary outcomes Multiple logistic regression analyses identified risk factors for moderate or high developmental risk on the PEDS. A Cumulative Risk Index examined the impact of multiple risk factors on developmental risk and documentation of the PEDS at the well-child checks. Results Of the original cohort, 792 (39%) had 6-month, 649 (32%) had 12-month and 565 (28%) had 18-month PEDS data. Parental concerns indicating moderate or high developmental risk on the PEDS were 27% (95% CI 24 to 30) at 6months, 27% (95% CI 24 to 30) at 12months and 33% (95% CI 29 to 37) at 18 months. Factors associated with moderate or high developmental risk were perinatal risk (OR 12months: 1.7 (95% CI 1.1 to 2.7)); maternal Middle Eastern or Asian nationality (OR 6months: 1.6 (95% CI 1.1 to 2.4)), (OR 12months: 1.7 (95% CI 1.1 to 2.7)); and household disadvantage (OR 6months: 1.5 (95% CI 1.0 to 2.2). As the number of risk factors increased the odds increased for high or moderate developmental risk and no documentation of the PEDS at well-child checks. Conclusions Children with multiple risk factors are more likely to have parental concerns indicating developmental vulnerability using the PEDS and for these concerns to not be documented. PMID:27609853

  11. Factors affecting exclusive breast-feeding during the first 6 months in Korea.

    PubMed

    Kim, Myo Jing; Kim, Yu-Mi; Yoo, Jae-Ho

    2013-04-01

    The aim of this study was to identify the status of exclusive breast-feeding (EBF) in Korea and analyze the factors affecting exclusive breast-feeding at 6 months of age. This study was based on data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) IV, conducted from January 2007 to December 2008. A total of 404 mother-infant pairs were recruited. Exclusive breast-feeding was defined according to the criteria established by the World Health Organization. The rate of EBF was 60.9% for 1 month, 55.0% for 3 months, 35.4% for 6 months, 3.7% for 9 months and 1.2% for 12 months after birth. According to a stepwise logistic regression analysis, factors that were positively associated with EBF at 6 months were younger maternal age (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.79-0.92), higher maternal education level (OR = 2.29, 95%CI: 1.17-4.46) and living in a capital city (OR = 2.64, 95%CI: 1.46-4.75). The rate of EBF in Korea is still suboptimal. To promote EBF, persistent and systematic education and campaigns for breast-feeding should be provided, particularly in vulnerable regions. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

  12. Object Permanence in 3 1/2- and 4 1/2-Month-Old Infants.

    ERIC Educational Resources Information Center

    Baillargeon, Renee

    1987-01-01

    Three experiments test object permanenece in 3 1/2- and 4 1/2-month-old infants, and use an impossible-possible-habituation event format. The 4 1/2-month-olds, and the 3 1/2-month-olds who were fast habituators, look reliably longer at the impossible than at the possible event. Results seriously question Piaget's (1954) claims regarding the age at…

  13. Can parents' concerns predict autism spectrum disorder? A prospective study of high-risk siblings from 6 to 36 months of age.

    PubMed

    Sacrey, Lori-Ann R; Zwaigenbaum, Lonnie; Bryson, Susan; Brian, Jessica; Smith, Isabel M; Roberts, Wendy; Szatmari, Peter; Roncadin, Caroline; Garon, Nancy; Novak, Christopher; Vaillancourt, Tracy; McCormick, Theresa; MacKinnon, Bonnie; Jilderda, Sanne; Armstrong, Vickie

    2015-06-01

    This prospective study characterized parents' concerns about infants at high risk for developing autism spectrum disorder (ASD; each with an older sibling with ASD) at multiple time points in the first 2 years, and assessed their relation to diagnostic outcome at 3 years. Parents of low-risk controls (LR) and high-risk infant siblings (HR) reported any concerns that they had regarding their children's development between 6 and 24 months of age regarding sleep, diet, sensory behavior, gross/fine motor skills, repetitive movements, communication, communication regression, social skills, play, and behavioral problems, using a parent concern form designed for this study. At 3 years of age, an independent, gold-standard diagnostic assessment for ASD was conducted for all participants. As predicted, parents of HR children who received an ASD diagnosis reported more concerns than parents of LR and HR children who did not have ASD. The total number of concerns predicted a subsequent diagnosis of ASD as early as 12 months within the HR group. Concerns regarding sensory behavior and motor development predicted a subsequent diagnosis of ASD as early as 6 months, whereas concerns about social communication and repetitive behaviors did not predict diagnosis of ASD until after 12 months. Parent-reported concerns can improve earlier recognition of ASD in HR children. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Finding the 'who' in whooping cough: vaccinated siblings are important pertussis sources in infants 6 months of age and under.

    PubMed

    Bertilone, Christina; Wallace, Tania; Selvey, Linda A

    2014-09-30

    To describe the epidemiology of pertussis, and to identify changes in the source of pertussis in infants 6 months of age and under, during the 2008-2012 epidemic in south metropolitan Perth. Analysis of all pertussis cases notified to the South Metropolitan Population Health Unit and recorded on the Western Australian Notifiable Infectious Disease Database over the study period. Information on the source of pertussis was obtained from enhanced surveillance data. Notification rates were highest in the 5-9 years age group, followed by the 0-4 years and 10-14 years age groups. There was a significant increase in the proportion of known sources who were siblings from the early epidemic period of 2008-2010, compared with the peak epidemic period of 2011-2012 (14.3% versus 51.4%, p = 0.002). The majority of sibling sources were fully vaccinated children aged 2 and 3 years. The incidence of pertussis was highest in children aged 12 years and under in this epidemic. At its peak, siblings were the most important sources of pertussis in infants 6 months and younger, particularly fully vaccinated children aged 2 and 3 years. Waning immunity before the booster at 4 years may leave this age group susceptible to infection. Even if cocooning programs could achieve full vaccination coverage of parents and ensure all siblings were fully vaccinated according to national schedules, waning immunity in siblings could provide a means for ongoing transmission to infants. Recent evidence suggests that maternal antenatal vaccination would significantly reduce the risk of pertussis in infants 3 months of age and under.

  15. Prevalence and factors associated with parental concerns about development detected by the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort.

    PubMed

    Woolfenden, Susan; Eapen, Valsamma; Jalaludin, Bin; Hayen, Andrew; Kemp, Lynn; Dissanyake, Cheryl; Hendry, Alexandra; Axelsson, Emma; Overs, Bronwyn; Eastwood, John; Črnčec, Rudi; McKenzie, Anne; Beasley, Deborah; Murphy, Elisabeth; Williams, Katrina

    2016-09-08

    Early identification of developmental vulnerability is vital. This study aimed to estimate the prevalence of moderate or high developmental risk on the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks; identify associated risk factors; and examine documentation of the PEDS at well-child checks. A prospective birth cohort of 2025 children with 50% of those approached agreeing to participate. Demographic data were obtained via questionnaires and linked electronic medical records. Telephone interviews were conducted with parents to collect PEDS data. Multiple logistic regression analyses identified risk factors for moderate or high developmental risk on the PEDS. A Cumulative Risk Index examined the impact of multiple risk factors on developmental risk and documentation of the PEDS at the well-child checks. Of the original cohort, 792 (39%) had 6-month, 649 (32%) had 12-month and 565 (28%) had 18-month PEDS data. Parental concerns indicating moderate or high developmental risk on the PEDS were 27% (95% CI 24 to 30) at 6months, 27% (95% CI 24 to 30) at 12months and 33% (95% CI 29 to 37) at 18 months. Factors associated with moderate or high developmental risk were perinatal risk (OR 12months: 1.7 (95% CI 1.1 to 2.7)); maternal Middle Eastern or Asian nationality (OR 6months: 1.6 (95% CI 1.1 to 2.4)), (OR 12months: 1.7 (95% CI 1.1 to 2.7)); and household disadvantage (OR 6months: 1.5 (95% CI 1.0 to 2.2). As the number of risk factors increased the odds increased for high or moderate developmental risk and no documentation of the PEDS at well-child checks. Children with multiple risk factors are more likely to have parental concerns indicating developmental vulnerability using the PEDS and for these concerns to not be documented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Ethnic differences in dietary intake at age 12 and 18 months: the Born in Bradford 1000 Study.

    PubMed

    Sahota, Pinki; Gatenby, Lisa A; Greenwood, Darren C; Bryant, Maria; Robinson, Sian; Wright, John

    2016-01-01

    To compare the intake of key indicator foods at age 12 months and 18 months between infants of Pakistani and White British origin. Logistic regression was used to model associations between ethnicity and consumption of key indicator foods defined by high or low energy density using an FFQ at age 12 and 18 months. Born in Bradford 1000 study, Bradford, UK. Infants (n 1259; 38 % White British, 49 % Pakistani), mean age 12·7 (sd 1·0) months and toddlers (n 1257; 37 % White British, 49 % Pakistani), mean age 18·7 (sd1·0) months. At 12 months, Pakistani infants consumed more commercial sweet baby meals than White British infants, with greater odds for being above average consumers (adjusted OR (AOR)=1·90; 95 % CI 1·40, 2·56), more chips/roast potatoes (AOR=2·75; 95 % CI 2·09, 3·62), less processed meat products (AOR=0·11; 95 % CI 0·08, 0·15), more fruit (AOR=2·20; 95 % CI 1·70, 2·85) and more sugar-sweetened drinks (AOR=1·68; 95 % CI 1·29, 2·18). At 18 months these differences persisted, with Pakistani infants consuming more commercial sweet baby meals (AOR=4·57; 95 % CI 2·49, 8·39), more chips/roast potato shapes (AOR=2·26; 95 % CI 1·50, 3·43), more fruit (AOR=1·40; 95 % CI 1·08, 1·81), more sugar-sweetened drinks (AOR=2·03; 95 % CI 1·53, 2·70), more pure fruit juice (AOR=1·82; 95 % CI 1·40, 2·35), more water (AOR=3·24; 95 % CI 2·46, 4·25) and less processed meat (AOR=0·10; 95 % CI 0·06, 0·15) than White British infants. Dietary intake during infancy and the early toddlerhood period is associated with ethnicity, suggesting the importance of early and culturally adapted interventions aimed at establishing healthy eating behaviours.

  17. The moderating effect of age on the 12-month prevalence of anxiety and depressive disorders in adults with a lifetime history of cancer.

    PubMed

    Simning, Adam; Conwell, Yeates; Mohile, Supriya G; van Wijngaarden, Edwin

    2014-12-01

    To determine how age may modulate the association of a history of cancer with a 12-month history of anxiety and depressive disorders. The authors used population-based, cross-sectional surveys, the Collaborative Psychiatric Epidemiology Surveys. These surveys were conducted in the United States in 2001-2003 and included 16,423 adult participants, of whom 702 reported a cancer history. The Composite International Diagnostic Interview evaluated the presence of a 12-month history of anxiety and depressive disorders. Among those with a cancer history, older adults (≥60 years old) were less likely than younger adults (18-59 years old) to have a 12-month history of an anxiety or depressive disorder. Compared with their peers without cancer, younger adults with a cancer history had more anxiety (23.8% versus 13.9%) and depressive (16.0% versus 9.5%) disorders, whereas older adults with a cancer history had lower levels of anxiety (3.7% versus 6.3%) and depressive (1.9% versus 3.9%) disorders. In multivariable modeling, there was a statistically significant interaction between age group and cancer history, with the risk for anxiety and depressive disorders elevated in the younger age group with a cancer history (odds ratio: 5.84 and odds ratio: 6.13, respectively) but decreased in the older age group with a cancer history (odds ratio: 0.55 and odds ratio: 0.45, respectively). The authors' findings suggest a considerable age-dependent variation with regard to anxiety and depressive disorders in adults with a cancer history. Investigation of the mechanisms contributing to this apparent age differential in risk could have important mental illness treatment implications in this population. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Genetic and Environmental Contributions to Behavioral Stability and Change in Children 6-36 months of Age Using Louisville Twin Study Data.

    PubMed

    Davis, Deborah Winders; Finkel, Deborah; Turkheimer, Eric; Dickens, William

    2015-11-01

    The Infant Behavior Record (IBR) from the Bayley Scales of Infant Development has been used to study behavioral development since the 1960s. Matheny (1983) examined behavioral development at 6, 12, 18, and 24 months from the Louisville Twin Study (LTS). The extracted temperament scales included Task Orientation, Affect-Extraversion, and Activity. He concluded that monozygotic twins were more similar than same-sex dizygotic twins on these dimensions. Since this seminal work was published, a larger LTS sample and more advanced analytical methods are available. In the current analyses, Choleksy decomposition was applied to behavioral data (n = 1231) from twins 6-36 months. Different patterns of genetic continuity vs genetic innovations were identified for each IBR scale. Single common genetic and shared environmental factors explained cross-age twin similarity in the Activity scale. Multiple shared environmental factors and a single genetic factor coming on line at age 18 months contributed to Affect-Extraversion. A single shared environmental factor and multiple genetic factors explained cross-age twin similarity in Task Orientation.

  19. Development of Category Formation for Faces Differing by Age in 9- to 12-month-olds: An Effect of Experience with Infant Faces

    PubMed Central

    Damon, Fabrice; Quinn, Paul C.; Heron-Delaney, Michelle; Lee, Kang; Pascalis, Olivier

    2016-01-01

    We examined category formation for faces differing in age in 9- and 12-month-olds, and the influence of exposure to infant faces on such ability. Infants were familiarized with adult or infant faces, and then tested with a novel exemplar from the familiarized category paired with a novel exemplar from a novel category (Experiment 1). Both age groups formed discrete categories of adult and infant faces, but exposure to infant faces in everyday life did not modulate performance. The same task was conducted with child versus infant faces (Experiment 2). Whereas 9-month-olds preferred infant faces after familiarization with child faces, but not child faces after familiarization with infant faces, 12-month-olds formed discrete categories of child and infant faces. Moreover, more exposure to infant faces correlated with higher novel category preference scores when infants were familiarized with infant faces in 12-month-olds, but not 9-month-olds. The 9-month-old asymmetry did not reflect spontaneous preference for infant over child faces (Experiment 3). These findings indicate that 9- and 12-month-olds can form age-based categories of faces. The ability of 12-month-olds to form separate child and infant categories suggests that they have a more exclusive representation of face age, one that may be influenced by prior experience with infant faces. PMID:27393740

  20. Patterns of Developmental Change in Infants' Nighttime Sleep Awakenings from 6 through 36 Months of Age

    ERIC Educational Resources Information Center

    Weinraub, Marsha; Bender, Randall H.; Friedman, Sarah L.; Susman, Elizabeth J.; Knoke, Bonnie; Bradley, Robert; Houts, Renate; Williams, Jason

    2012-01-01

    Nighttime sleep awakenings and infant and family characteristics were measured longitudinally in more than 1,200 infants when the infants were 6, 15, 24, and 36 months old. By 6 months of age, the majority of children slept through the night, awakening their mothers only about once or twice per week. However, not all children followed this…

  1. Development assessment of HIV exposed children aged 6-18 months: a cohort study from North India.

    PubMed

    Rajan, Remya; Seth, Anju; Mukherjee, Sharmila B; Chandra, Jagdish

    2017-11-01

    HIV exposed children are vulnerable to developmental delay irrespective of their HIV status due to combined effect of risk factors like poverty, prenatal drug exposure, stress and chronic illness in family and malnutrition. This cohort study assessed the development of 50 HIV exposed children aged 6-18 months at a Pediatric Centre of Excellence in HIV care in India. The development was assessed using Development Assessment Scale for Indian Infants (DASII) at enrolment, 3 and 6 months later. The development quotient (DQ) scores and proportion of children with developmental delay (DQ ≤ 70) were compared among two sub-groups, HIV infected (HI) and HIV exposed uninfected (HEU) children. The various social and clinical factors affecting development were studied by univariate and multivariate analysis. Prevalence of developmental delay was 2.4% in the HEU (n = 41), and 33.3% in HI (n = 9). The DQ of HI was significantly lower than that of HEU at all three assessments. The DQ of HI were also significantly lower compared to the HEU at ages 12.1-18 months (83.37 ± 20.73 vs 94.68 ± 5.13, p = 0.005) and 18.1-24 months (84.55 ± 15.35 vs 94.63 ± 5.86, p = 0.006) respectively. The development of HEU was adversely affected by lower socioeconomic status and presence of wasting. In addition, development of HI was also adversely influenced by presence of stunting and opportunistic infections, advanced disease stage and shorter ART duration. We conclude that with optimum care, HEU can have a normal development, while a considerable proportion of HI may continue to have delayed development.

  2. Effect of Probiotic Containing Ice-cream on Salivary Mutans Streptococci (SMS) Levels in Children of 6-12 Years of Age: A Randomized Controlled Double Blind Study with Six-months Follow Up.

    PubMed

    Ashwin, Devasya; Ke, Vijayaprasad; Taranath, Mahanthesh; Ramagoni, Naveen Kumar; Nara, Asha; Sarpangala, Mythri

    2015-02-01

    To evaluate the caries risk based on the salivary levels of streptococcus mutans in children of 6-12 years of age group before and after consuming probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5. A double blind, placebo controlled trial was carried out in 60 children aged between 6 to 12 years with zero decayed, missing, and filled teeth (DMFT). They were randomly divided into two equal groups. Saliva sample were collected before the consumption of ice-cream and Streptococcus mutans count was calculated and recorded as baseline data. For the next seven days both the groups were given ice creams marked as A and B. Saliva samples were collected after ice-cream consumption at the end of study period and also after a washout period of 30 days and again after six months. Samples were inoculated and colonies were counted. On statistical evaluation by students paired t-test, probiotic ice-cream brought significant reduction in the Streptococcus mutans count after seven days of ice-cream ingestion (p<0.001) and also after 30 d of washout period (p<0.001). There was no significant reduction (p=0.076) by normal ice-cream consumption. After six months of the study period in both the groups the salivary levels of Streptococcus mutans was similar to the baseline. Probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5 can cause reduction in caries causative organism. The dosage of the probiotic organisms for the long term or synergetic effect on the oral health are still needed to be explored.

  3. Effect of Probiotic Containing Ice-cream on Salivary Mutans Streptococci (SMS) Levels in Children of 6-12 Years of Age: A Randomized Controlled Double Blind Study with Six-months Follow Up

    PubMed Central

    KE, Vijayaprasad; Taranath, Mahanthesh; Ramagoni, Naveen Kumar; Nara, Asha; Sarpangala, Mythri

    2015-01-01

    Introduction: To evaluate the caries risk based on the salivary levels of streptococcus mutans in children of 6-12 years of age group before and after consuming probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5. Materials and Methods: A double blind, placebo controlled trial was carried out in 60 children aged between 6 to 12 years with zero decayed, missing, and filled teeth (DMFT). They were randomly divided into two equal groups. Saliva sample were collected before the consumption of ice-cream and Streptococcus mutans count was calculated and recorded as baseline data. For the next seven days both the groups were given ice creams marked as A and B. Saliva samples were collected after ice-cream consumption at the end of study period and also after a washout period of 30 days and again after six months. Samples were inoculated and colonies were counted. Results: On statistical evaluation by students paired t-test, probiotic ice-cream brought significant reduction in the Streptococcus mutans count after seven days of ice-cream ingestion (p<0.001) and also after 30 d of washout period (p<0.001). There was no significant reduction (p=0.076) by normal ice-cream consumption. After six months of the study period in both the groups the salivary levels of Streptococcus mutans was similar to the baseline. Conclusion: Probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5 can cause reduction in caries causative organism. The dosage of the probiotic organisms for the long term or synergetic effect on the oral health are still needed to be explored. PMID:25859515

  4. Changes in sexual functioning from 6 to 12 months following traumatic brain injury: a prospective TBI model system multicenter study.

    PubMed

    Hanks, Robin A; Sander, Angelle M; Millis, Scott R; Hammond, Flora M; Maestas, Kacey L

    2013-01-01

    To investigate longitudinal changes in sexual functioning during the first year following moderate to severe traumatic brain injury (TBI). Prospective cohort study. Community. 182 persons (53 women and 129 men) with moderate to severe TBI who were admitted to 1 of 6 participating TBI Model System centers and followed in the community at 6 and 12 months after injury. Derogatis Interview for Sexual Functioning-Self-Report (DISF-SR); Global Sexual Satisfaction Index (GSSI). Mean T-scores on the DISF-SR Arousal subscale demonstrated marginal improvement over time, with a 2.59-point increase (P = .05) from 6 to 12 months after injury. There were no significant differences over this 6-month period on the remaining DISF-SR subscales, including sexual cognition/fantasy, sexual behavior/experience, and orgasm. There was no significant change in satisfaction with sexual functioning on the GSSI from 6 months (72% satisfied) to 12 months (71% satisfied). Sexual function and satisfaction appears to be stable in those with moderate to severe TBI from 6 to 12 months after injury, with the exception of minimal improvement in arousal. These findings, to our knowledge, reflect the first evidence regarding prospective changes in sexual functioning in this population. Future research can go far to assist clinicians in treatment planning and managing patient expectations of recovery of sexual functioning after TBI.

  5. Efficacy and safety of triptorelin 6-month formulation in patients with central precocious puberty.

    PubMed

    Klein, Karen; Yang, Joshua; Aisenberg, Javier; Wright, Nancy; Kaplowitz, Paul; Lahlou, Najiba; Linares, Jeannete; Lundström, Eija; Purcea, Daniela; Cassorla, Fernando

    2016-11-01

    Triptorelin is an established treatment for central precocious puberty (CPP) as 1- and 3-month formulations. The current triptorelin 22.5 mg 6-month formulation is approved for prostate cancer therapy. This is the first study in patients with CPP. The efficacy and safety of the triptorelin 6-month formulation in CPP were investigated. The primary objective was to evaluate the efficacy in achieving luteinizing hormone (LH) suppression to pre-pubertal levels at month 6. This was an international, non-comparative phase III study over 48 weeks. Eighteen medical centers in the US, Chile and Mexico participated. Forty-four treatment naïve patients (39 girls and five boys) aged at treatment start 2-8 years for girls and 2-9 years for boys with an advancement of bone age over chronological age ≥1 year were to be included. Triptorelin was administered im twice at an interval of 24 weeks. LH, follicle stimulating hormone (FSH) (basal and stimulated), estradiol (girls), testosterone (boys), auxological parameters, clinical signs of puberty and safety were assessed. Forty-one patients (93.2%) showed pre-pubertal LH levels (stimulated LH ≤5 IU/L) at month 6 and maintained LH suppression through month 12. The percentage of patients with LH suppression exceeded 93% at each time point and reached 97.7% at month 12. No unexpected drug-related adverse events were reported. The triptorelin 6-month formulation was safe and effective in suppressing the pituitary-gonadal axis in children with CPP. The extended injection interval may improve compliance and increase comfort in the management of CPP.

  6. Evaluation of the tooth brushing skills in children aged 6-12 years.

    PubMed

    Pujar, P; Subbareddy, V V

    2013-08-01

    To evaluate the tooth brushing skills in children aged between 6 and 12 years and its relation with age, type of grip used, duration of brushing and gender. A total of 105 children aged between 6 and 12 years were divided into seven groups and their plaque scores, type of grip used and duration of brushing were assessed. The most preferred grip was the distal oblique (58.1 %). Oblique, distal oblique and power grips were more efficient (plaque reduction up to 70 %). Plaque removal efficacy improved with age (57 % in 6-year-olds and 82 % in 12-year-old children). Plaque reduction was greater when the duration of brushing was longer (82 % plaque reduction when the brushing time was >2.5 min). Overall, the mean duration of tooth brushing in children aged 6-12 years was 1.71 min (103 s). Tooth brushing skills improved with age and the duration of tooth brushing made a significant difference to the oral hygiene status of the child. The type of grip used and gender did not influence tooth brushing ability in this group of children. Tooth brushing skills were low in children younger than 10 years of age. Hence, parental supervision is considered necessary and recommended until 10 years of age.

  7. Pre- and postnatal exposure to intimate partner violence among South African HIV-infected mothers and infant developmental functioning at 12 months of age.

    PubMed

    Rodriguez, Violeta J; Peltzer, Karl; Matseke, Gladys; Weiss, Stephen M; Shine, Agnes; Jones, Deborah L

    2018-05-23

    In rural South Africa, pregnant HIV-infected women report high rates of psychological (55%) and physical (20%) intimate partner violence (IPV). IPV increases the risk of infant developmental delays. Such delays may have negative socioemotional and cognitive outcomes throughout the lifespan. This paper assesses the relationship between IPV and infant development in rural South Africa. The present investigation was a cross-sectional add-on follow-up designed retrospectively. A randomly selected sub-sample of mothers from the main randomized controlled trial (n = 72) were asked to participate with their infants at 12 months of age; all women invited agreed to participate. Women were 18.35 ± 5.47 weeks pregnant; demographics, HIV disclosure status, and pre- and postnatal IPV measured via the Conflict Tactics Scale during pregnancy at baseline and 12 months post-partum were assessed. Infant HIV serostatus and developmental functioning at 12 months of age were assessed. Women were a mean age of 29 ± 2 years. One third had completed at least 12 years of education and had a monthly income of ~ US$76. At 12 months post-partum, 6% of infants tested HIV seropositive. Postnatal physical IPV was associated with delays in cognitive and receptive language development p < 0.05, but only in unadjusted analyses. This study identified an association between early IPV exposure and infant cognitive and receptive communication delays. Given the small sample size, findings support replication. Longitudinal studies are needed to confirm temporal order and identify appropriate timing for interventions in HIV-exposed infants.

  8. Maternal attitudes towards tooth decay in children aged 12-18 months in Pelotas, Brazil.

    PubMed

    da Silveira, E R; Dos Santos Costa, F; Azevedo, M S; Romano, A R; Cenci, M S

    2015-10-01

    This was to assess mothers' attitudes towards dental caries in children aged 12-18 months. This study targeted mothers of children aged 12-18 months. Data about demographic and socioeconomic status were collected by interviews with each mother. In addition, the mother was asked about her attitudes regarding caries in her child's primary teeth. A dental examination of each child was also conducted. Chi-square, bivariate, and multiple logistic regression analyses were performed. A total of 262 mother-child pairs were included, and 18.7 % of the children had dental caries. If a child presented with dental caries in their primary teeth, 93.5 % of the mothers reported that they would take the child to a dentist. Mothers who had only one child and those who had children with dental caries were more likely to report that they did not expect primary dental caries treatment by the dentist. Most mothers reported that they would take their children to a dentist when they presented with dental caries. Despite this positive result, educational measures should continue to be emphasised, especially among mothers of children at a higher risk of caries and among first-time mothers.

  9. Renal Tumors in Children Younger Than 12 Months of Age: A 65-Year Single Institution Review.

    PubMed

    Lamb, Margaret G; Aldrink, Jennifer H; O'Brien, Sarah H; Yin, Han; Arnold, Michael A; Ranalli, Mark A

    2017-03-01

    Wilms tumor (WT) is the most prevalent pediatric renal tumor and most commonly occurs between ages 1 and 5 years. Data are lacking on children younger than 12 months with renal tumors. The cancer registry at the authors' institution was queried to identify patients 12 months and younger with renal masses. Demographics, clinical presentation, histopathology, stage, and survival outcomes were reviewed. The most common presenting symptoms included an asymptomatic abdominal mass (73%) and hematuria (9%). Histopathology revealed WT in 73% of patients, mesoblastic nephroma in 20%. Of those infants younger than 1 month of age, mesoblastic nephroma was the most common histopathology (68%). The 5-year overall survival (OS) was 93%, and 5-year event-free survival (EFS) was 93% for the entire group. For patients with WT, 5-year OS was 88% and 5-year EFS was 83%. Outcomes for congenital mesoblastic nephroma were excellent with 5-year OS and EFS of 100%. Reasons for good prognosis may be multifactorial and may include frequent well child checks in the first year of life and favorable histology. Patients in this age group are more likely to be classified as very low risk and may be treated with surgical resection alone.

  10. Male reproductive tract lesions at 6, 12, and 18 months of age following in utero exposure to di(n-butyl) phthalate.

    PubMed

    Barlow, Norman J; McIntyre, Barry S; Foster, Paul M D

    2004-01-01

    In utero exposure of male rats to the antiandrogen di(n-butyl) phthalate (DBP) leads to decreased anogenital distance (AGD) on postnatal day (PND) 1, increased areolae retention on PND 13, malformations in the male reproductive tract, and histologic testicular lesions including marked seminiferous epithelial degeneration and a low incidence of Leydig cell (LC) adenomas on PND 90. One objective of this study was to determine the incidence and persistence of decreased AGD, increased areolae retention, and LC adenomas in adult rats following in utero DBP exposure. A second objective was to determine whether AGD and areolae retention during the early postnatal period are associated with lesions in the male reproductive tract. Pregnant Crl:CD(SD)BR rats were gavaged with corn oil or DBP at 100 or 500 mg/kg/day, 10 dams per group. Three replicates of rats (n = 30 rats per replicate) were exposed from gestation day 12 to 21 and the male offspring allowed to mature to 6, 12, or 18 months of age. Gross malformations in the male reproductive tract and histologic lesions in the testes were similar to those previously described. However, testicular dysgenesis, a lesion of proliferating LCs and aberrant tubules that has not been previously described in DBP-exposed testes, was diagnosed. The incidence of this lesion was approximately 20% unilateral and 7-18% bilateral in the high-dose group and was similar among all ages examined, implicating a developmental alteration rather than an age-related change. AGD and areolae retention were found to be permanent changes following in utero exposure to 500 mg/kg/day of DBP. Decreased AGD was a sensitive predictor of lesions in the male reproductive tract, relatively small changes in AGD were associated with a significant incidence of male reproductive malformations. In utero DBP exposure induced proliferative developmental lesions, some of which would have been diagnosed as LC adenomas by the morphological criteria set forth by the

  11. Determinants of anemia among 6-59 months aged children in Bangladesh: evidence from nationally representative data.

    PubMed

    Khan, Jahidur Rahman; Awan, Nabil; Misu, Farjana

    2016-01-11

    Anemia is a global public health problem but the burden of anemia is disproportionately borne among children in developing countries. Anemia in early stages of life has serious consequences on the growth and development of the children. We examine the prevalence of anemia, possible association between anemia and different socio-economic, demographic, health and other factors among children with ages from 6 to 59 months from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). Data on hemoglobin (Hb) concentration among the children aged 6-59 months from the most recent BDHS (2011) were used. This nationally representative survey allowed a multistage stratified cluster sampling design and provided data on a wide range of indicators such as fertility, mortality, women and child health, nutrition and other background characteristics. Anemia status was determined using hemoglobin level (<11.0 g/dl), and weighted prevalence of childhood anemia along with 95 % confidence intervals were provided. We also examined the distribution of weighted anemia prevalence across different groups and performed logistic regression to assess the association of anemia with different factors. A total of 2171 children aged 6-59 months were identified for this analysis, with weighted prevalence of anemia being 51.9 % overall- 47.4 % in urban and 53.1 % in rural regions. Results of a multivariable logistic regression analysis showed that, children below 24 months of age (odds ratio, [OR] 3.01; 95 % confidence interval [CI] 2.38-3.81), and those from an anemic mother (OR 1.80; 95 % CI 1.49-2.18) were at higher risk of anemia. Childhood anemia was significantly associated with chronic malnutrition of child, source of drinking water, household wealth and geographical location (defined by division). A high prevalence of anemia among 6-59 months aged children was observed in Bangladesh. Given the negative impact of anemia on the development of children in

  12. An Experimental Trial of Adaptive Programming in Drug Court: Outcomes at 6, 12 and 18 Months.

    PubMed

    Marlowe, Douglas B; Festinger, David S; Dugosh, Karen L; Benasutti, Kathleen M; Fox, Gloria; Harron, Ashley

    2014-06-01

    Test whether an adaptive program improves outcomes in drug court by adjusting the schedule of court hearings and clinical case-management sessions pursuant to a priori performance criteria. Consenting participants in a misdemeanor drug court were randomly assigned to the adaptive program (n = 62) or to a baseline-matching condition (n = 63) in which they attended court hearings based on the results of a criminal risk assessment. Outcome measures were re-arrest rates at 18 months post-entry to the drug court and urine drug test results and structured interview results at 6 and 12 months post-entry. Although previously published analyses revealed significantly fewer positive drug tests for participants in the adaptive condition during the first 18 weeks of drug court, current analyses indicate the effects converged during the ensuing year. Between-group differences in new arrest rates, urine drug test results and self-reported psychosocial problems were small and non-statistically significant at 6, 12 and 18 months post-entry. A non-significant trend (p = .10) suggests there may have been a small residual impact (Cramer's ν = .15) on new misdemeanor arrests after 18 months. Adaptive programming shows promise for enhancing short-term outcomes in drug courts; however, additional efforts are needed to extend the effects beyond the first 4 to 6 months of enrollment.

  13. In vivo measurements of tooth wear over 12 months.

    PubMed

    Rodriguez, J M; Austin, R S; Bartlett, D W

    2012-01-01

    The aim of this study was to measure the progression of tooth wear in a cohort of 63 patients, 43 males and 20 females with a mean age of 39.1 years. Recruitment followed referral from general practice to Guy's Hospital for advice/management of tooth wear. Addition silicone impressions were taken at 6-month intervals for a total of 12 months; impressions were subsequently poured in type IV gypsum. Casts were scanned using a non-contacting laser profilometer and then superimposed using Geomagic® Qualify 11. Wear was measured in μm by tooth per time interval. A questionnaire highlighting dietary, parafunctional and gastric risk factors was obtained from each participant. Clustered multiple regression analysis was used to determine the relationship between tooth wear progression and risk factors. Maximum follow-up times were 6 months for 63 participants and 12 months for 30 participants. The measurement error was 15 μm. At the tooth level, 72.2% of 1,078 teeth wore <15 μm over a 6-month period. At the subject level, 77.7% of 63 participants showed median wear <15 μm over a 6-month period. There was a statistical trend towards tooth wear progression being associated with gastric risk factors (p < 0.05). The lower molars and the upper anterior teeth were the most commonly affected teeth; the lower molars and the upper central incisors were the most severely affected teeth. Tooth wear progression was slow in this cohort, suggesting that tooth wear may be cyclical and inactive in the majority of participants. Copyright © 2011 S. Karger AG, Basel.

  14. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibucá, Honduras.

    PubMed

    Siega-Riz, Anna M; Estrada Del Campo, Yaniré; Kinlaw, Alan; Reinhart, Gregory A; Allen, Lindsay H; Shahab-Ferdows, Setareh; Heck, Jeff; Suchindran, Chirayath M; Bentley, Margaret E

    2014-05-01

    Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data. At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence. These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children. © 2014 John Wiley & Sons Ltd.

  15. Feeding patterns and diet - children 6 months to 2 years

    MedlinePlus

    Feeding children 6 months to 2 years; Diet - age appropriate - children 6 months to 2 years; Babies - feeding solid food ... 6 to 8 MONTHS At this age, your baby will probably eat about 4 to 6 times per day, but will eat more ...

  16. Quantitative analysis of seizure frequency 1 week and 6, 12, and 24 months after surgery of epilepsy.

    PubMed

    Lüders, H; Murphy, D; Awad, I; Wyllie, E; Dinner, D S; Morris, H H; Rothner, A D

    1994-01-01

    We made quantitative analysis of seizure frequency 1 week and 6, 12, and 24 months after seizure surgery. Seizure recurrence was significantly higher when seizures occurred in the first postoperative week. Seizure recurrence increased progressively with longer follow-ups, but the 6 month postoperative follow-up period was an excellent index of long-term outcome. In operative follow-up studies, seizure frequency should be reported at fixed follow-up periods, e.g., at 6 months and 1, 2, 5, and 10 years. Meaningful comparison of outcomes between different studies is possible only when reports include outcome at fixed postoperative follow-up periods (as opposed to ranges of follow-up periods).

  17. Safety and Immunogenicity of Full-Dose Trivalent Inactivated Influenza Vaccine (TIV) Compared With Half-Dose TIV Administered to Children 6 Through 35 Months of Age.

    PubMed

    Halasa, Natasha B; Gerber, Michael A; Berry, Andrea A; Anderson, Edwin L; Winokur, Patricia; Keyserling, Harry; Eckard, Allison Ross; Hill, Heather; Wolff, Mark C; McNeal, Monica M; Edwards, Kathryn M; Bernstein, David I

    2015-09-01

    Children 6 through 35 months of age are recommended to receive half the dose of influenza vaccine compared with older children and adults. This was a 6-site, randomized 2:1, double-blind study comparing full-dose (0.5 mL) trivalent inactivated influenza vaccine (TIV) with half-dose (0.25 mL) TIV in children 6 through 35 months of age. Children previously immunized with influenza vaccine (primed cohort) received 1 dose, and those with no previous influenza immunizations (naive cohort) received 2 doses of TIV. Local and systemic adverse events were recorded. Sera were collected before immunization and 1 month after last dose of TIV. Hemagglutination inhibition antibody testing was performed. Of the 243 subjects enrolled (32 primed, 211 naive), data for 232 were available for complete analysis. No significant differences in local or systemic reactions were observed. Few significant differences in immunogenicity to the 3 vaccine antigens were noted. The immune response to H1N1 was significantly higher in the full-dose group among primed subjects. In the naive cohort, the geometric mean titer for all 3 antigens after 2 doses of TIV were significantly higher in the 12 through 35 months compared with the 6 through 11 months age group. Our study confirms the safety of full-dose TIV given to children 6 through 35 months of age. An increase in antibody responses after full- versus half-dose TIV was not observed, except for H1N1 in the primed group. Larger studies are needed to clarify the potential for improved immunogenicity with higher vaccine doses. Recommending the same dose could simplify the production, storage, and administration of influenza vaccines.

  18. Association between depression in carers and malnutrition in children aged 6 months to 5 years

    PubMed Central

    Ganiyu, Adewale B.; Firth, Jacqueline A.

    2017-01-01

    Background Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. Aim The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. Setting The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. Methods This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. Results From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. Conclusion This study found a significant association between PCG depression and child malnutrition. PMID:28155288

  19. Food Consumption Patterns among U.S. Children from Birth to 23 Months of Age, 2009-2014.

    PubMed

    Hamner, Heather C; Perrine, Cria G; Gupta, Priya M; Herrick, Kirsten A; Cogswell, Mary E

    2017-08-26

    Early dietary patterns can have long-term health consequences. This study describes food consumption patterns among US children ≤23 months. We used one 24 h dietary recall from the National Health and Nutrition Examination Survey 2009-2014 to estimate the percentage of children ≤23 months who consumed selected food/beverage categories on any given day by age and race/Hispanic origin. Among 0 to 5 month olds, 42.9% (95% Confidence Interval (CI): 37.0%, 49.1%) consumed breast milk, with non-Hispanic blacks less likely (21.2%, 95% CI: 13.2%, 32.2%) compared with non-Hispanic whites (49.0%, 95% CI: 39.0%, 59.1%) ( p < 0.001). The percentage of children consuming vegetables was 57.4%, 48.2%, and 45.1% for ages 6 to 11, 12 to 18 and 19 to 23 months, respectively ( p < 0.01 for trend). The percentage of children consuming sugar-sweetened beverages was 6.6%, 31.8% and 38.3% for ages 6 to 11, 12 to 18 and 19 to 23 months, respectively ( p < 0.01 for trend). Among children aged6 months, lower percentages of non-Hispanic black and Hispanic children consumed vegetables, and higher percentages consumed sugar-sweetened beverages and 100% juice compared with non-Hispanic white children, although differences were not always statistically significant. Compared with children in the second year of life, a higher percentage of children 6 to 11 months of age consumed vegetables and a lower percentage consumed 100% juice, sugar-sweetened beverages, snacks, or sweets; with differences by race/Hispanic origin. These data may be relevant to the upcoming 2020-2025 federal dietary guidelines.

  20. Estimating influenza vaccine effectiveness using routine surveillance data among children aged 6-59 months for five consecutive influenza seasons.

    PubMed

    Su, Wei-Ju; Chan, Ta-Chien; Chuang, Pei-Hung; Liu, Yu-Lun; Lee, Ping-Ing; Liu, Ming-Tsan; Chuang, Jen-Hsiang

    2015-01-01

    We aimed to estimate the pooled vaccine effectiveness (VE) in children over five winters through data linkage of two existing surveillance systems. Five test-negative case-control studies were conducted from November to February during the 2004/2005 to 2008/2009 seasons. Sentinel physicians from the Viral Surveillance Network enrolled children aged 6-59 months with influenza-like illness to collect throat swabs. Through linking with a nationwide vaccination registry, we measured the VE with a logistic regression model adjusting for age, gender, and week of symptom onset. Both fixed-effects and random-effects models were used in the meta-analysis. Four thousand four hundred and ninety-four subjects were included. The proportion of influenza test-positive subjects across the five seasons was 11.5% (132/1151), 7.2% (41/572), 23.9% (189/791), 6.6% (75/1135), and 11.2% (95/845), respectively. The pooled VE was 62% (95% confidence interval (CI) 48-83%) in both meta-analysis models. By age category, VE was 51% (95% CI 23-68%) for those aged 6-23 months and 75% (95% CI 60-84%) for those aged 24-59 months. Influenza vaccination provided measurable protection against laboratory-confirmed influenza among children aged 6-59 months despite variations in the vaccine match during the 2004/2005 to 2008/2009 influenza seasons in Taiwan. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Risk of Bacterial Meningitis in Children 6 to 11 Months of Age With a First Simple Febrile Seizure: A Retrospective, Cross-sectional, Observational Study.

    PubMed

    Guedj, Romain; Chappuy, Hélène; Titomanlio, Luigi; Trieu, Thanh-Van; Biscardi, Sandra; Nissack-Obiketeki, Gisèle; Pellegrino, Béatrice; Charara, Oussama; Angoulvant, François; Villemeur, Thierry Billette De; Levy, Corinne; Cohen, Robert; Armengaud, Jean Baptiste; Carbajal, Ricardo

    2015-11-01

    National and international guidelines are very heterogeneous about the necessity to perform a lumbar puncture (LP) in children under 12 months of age with a first simple febrile seizure. We estimated the risk of bacterial meningitis in children aged 6 to 11 months with a first simple febrile seizure. This multicenter retrospective study was conducted in seven pediatric emergency departments (EDs) in the region of Paris, France. Visits of patients aged 6 to 11 months for a first simple febrile seizure from January 2007 to December 2011 were analyzed. Bacterial meningitis was sequentially sought for by 1) analyzing bacteriologic data at the time of the visit, 2) looking for data from a second visit to the hospital after the index visit, and 3) phone calling the child's parents to determine the symptom evolution after the index visit. Infants lost to this follow-up were searched for in a national bacterial meningitis database. From a total of 1,183,487 visits in the seven pediatric EDs, 116,503 were for children 6 to 11 months of age. From these, 205 visits were for a first simple febrile seizure. An LP was performed in 61 patients (29.8%). The outcome bacterial meningitis was ascertainable for 168 (82%) visits. No bacterial meningitis was found among these patients (95% confidence interval = 0% to 2.2%). None of the 37 infants lost to our follow-up were registered in the national database as having bacterial meningitis. Among children between 6 and 11 months of age with a first simple febrile seizure, the risk of bacterial meningitis is extremely low. These results should encourage national and international societies to either develop or endorse guidelines limiting routine LP in these infants and contribute to widely homogenized management practices. © 2015 by the Society for Academic Emergency Medicine.

  2. Associations between Infant Feeding Practice Prior to Six Months and Body Mass Index at Six Years of Age

    PubMed Central

    Imai, Cindy Mari; Gunnarsdottir, Ingibjorg; Thorisdottir, Birna; Halldorsson, Thorhallur Ingi; Thorsdottir, Inga

    2014-01-01

    Rapid growth during infancy is associated with increased risk of overweight and obesity and differences in weight gain are at least partly explained by means of infant feeding. The aim was to assess the associations between infant feeding practice in early infancy and body mass index (BMI) at 6 years of age. Icelandic infants (n = 154) were prospectively followed from birth to 12 months and again at age 6 years. Birth weight and length were gathered from maternity wards, and healthcare centers provided the measurements made during infancy up to 18 months of age. Information on breastfeeding practices was documented 0–12 months and a 24-h dietary record was collected at 5 months. Changes in infant weight gain were calculated from birth to 18 months. Linear regression analyses were performed to examine associations between infant feeding practice at 5 months and body mass index (BMI) at 6 years. Infants who were formula-fed at 5 months of age grew faster, particularly between 2 and 6 months, compared to exclusively breastfed infants. At age 6 years, BMI was on average 1.1 kg/m2 (95% CI 0.2, 2.0) higher among infants who were formula fed and also receiving solid foods at 5 months of age compared to those exclusively breastfed. In a high-income country such as Iceland, early introduction of solid foods seems to further increase the risk of high childhood BMI among formula fed infants compared with exclusively breastfed infants, although further studies with greater power are needed. PMID:24747694

  3. Analysis of nutritional adequacy of local foods for meeting dietary requirements of children aged 6-23 months in rural central Tanzania.

    PubMed

    Raymond, Jofrey; Agaba, Morris; Mollay, Clara; Rose, Jerman W; Kassim, Neema

    2017-01-01

    Under nutrition remains a serious problem among children in Sub-Saharan Africa. Analysing how diets composed of local foods could achieve nutritional goals for infants and young children in low-income settings is essential. The objective of this study was to analyse how local foods can be used rationally and to what extent these foods can be supplemented to achieve nutrient requirements for children aged 6 - 23 months in resource-poor settings. A cross-sectional study was carried out to estimate dietary intakes of 400 children aged 6-23 months using a 12-h weighed dietary record, 24-h dietary recalls, and 7-days food records. Anthropometric measurements on each subject were also taken. Analyses were done to establish the level of nutrient intake, and nutritional status of the study population using Microsoft Excel 2013 and ProPAN software version 2.0. The results showed that the prevalence of stunting, wasting and underweight for children aged 6-23 months was 30-41%, 1.5-3% and 4-9%, respectively. In addition, the results showed that diets that were consumed by the subjects comprised of local foods met vitamin A, vitamin C, protein and energy requirements for children aged 6-23 months. However, the extent of deficit in iron, zinc and calcium in baseline diets was large and difficult to meet under the existing feeding practices. The study shows that local foods in the study area have a potential to achieve recommended dietary intakes of some essential nutrients, and that interventions are needed to meet the required amount of iron, zinc and calcium for children aged 6-23 months. The interventions we propose here may encourage changes in traditional feeding habits and practices of the target population. Possible intervention options are (1) supplementation of local foods with nutrient-dense foods that are not normally consumed in the locality (2) providing new avenues for increasing the production and wide consumption of local nutrient-dense foods, or optimizing

  4. Triptorelin embonate (6-month formulation).

    PubMed

    Keating, Gillian M

    2010-02-12

    A 6-month formulation of the gonadotropin-releasing hormone agonist triptorelin embonate (designed to deliver 22.5 mg of triptorelin over a 6-month period) has been developed for use in the treatment of advanced prostate cancer. Following intramuscular administration of the 6-month formulation of triptorelin embonate 22.5 mg to men with advanced prostate cancer (subset of 15 patients from the pivotal clinical trial), serum testosterone levels initially increased, followed by a rapid, sustained decrease. Castrate serum testosterone levels (i.e. < or =1.735 nmol/L) were achieved in a geometric mean time of 18.8 days. The 6-month formulation of triptorelin embonate achieved and maintained castrate serum testosterone levels in patients with advanced prostate cancer (n = 120), according to the results of the pivotal, noncomparative, multicentre trial (patients received intramuscular triptorelin embonate 22.5 mg on day 1 and at month 6 [week 24]). By day 29, 97.5% of patients had castrate serum testosterone levels. Castrate serum testosterone levels were maintained from months 2 to 12 in 93.0% of patients. Prior to the second injection at month 6, 98.3% of patients had castrate serum testosterone levels, and 98.3% of patients had castrate serum testosterone levels at study completion. The 6-month formulation of triptorelin embonate 22.5 mg was generally well tolerated in patients with advanced prostate cancer; adverse events were of mild severity in the majority of patients. Drug-related adverse events (e.g. hot flushes) were consistent with the pharmacological action of triptorelin. Injection-site reactions occurred in 6.7% of triptorelin embonate recipients.

  5. Epidemiologic Analysis of Elective Operative Procedures in Infants Less Than 6 Months of Age in the United States.

    PubMed

    Einhorn, Lisa M; Young, Brian J; Routh, Jonathan C; Allori, Alexander C; Tracy, Elisabeth T; Greene, Nathaniel H

    2017-11-01

    This study uses publicly available data to analyze the total number of elective, potentially deferrable operative procedures involving infants <6 months of age in the United States. We investigated the factors associated with the performance of these procedures in this population. The State Ambulatory Surgery Database was used to identify patients in California, North Carolina, New York, and Utah during the years of 2007-2010 who were younger than 6 months of age at the time that they underwent outpatient (ambulatory) surgery. Operations that could reasonably be postponed until 6 months of age were classified as potentially deferrable procedures. Hernia repairs were analyzed separately from other deferrable procedures. Primary outcomes included the total number of elective procedures and the number and rates of potentially deferrable procedures per state per year in this population. Over the study period, a total of 27,540 procedures were identified as meeting inclusion criteria; of those, 7832 (28%) were classified as potentially deferrable, 4315 of which were hernia repairs. The average rates of potentially deferrable nonhernia procedures in California, North Carolina, New York, and Utah were 8.3, 43.8, 30.0, and 11.7 per 10,000 person-years, respectively. In multivariable analysis, private insurance (odds ratio [OR] = 1.36), self-pay status (OR = 1.50), and treatment in a different state (OR = 0.48-3.16) were independent predictors of a potentially deferrable procedure being performed on an infant younger than 6 months. Potentially deferrable procedures are still performed in infants <6 months of age. There appears to be significant variation in timing of these procedures among states. Insurance status and geography may be independent predictors of a procedure being potentially deferrable.

  6. Association between depression in carers and malnutrition in children aged 6 months to 5 years.

    PubMed

    Motlhatlhedi, Keneilwe; Setlhare, Vincent; Ganiyu, Adewale; Firth, Jacqueline

    2017-01-30

     Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. This study found a significant association between PCG depression and child malnutrition.

  7. TEMPERAMENTAL ADAPTABILITY, PERSISTENCE, AND REGULARITY: PARENTAL RATINGS OF NORWEGIAN INFANTS AGED 6 TO 12 MONTHS, WITH SOME IMPLICATIONS FOR PREVENTIVE PRACTICE.

    PubMed

    Olafsen, Kåre S; Ulvund, Stein Erik; Torgersen, Anne Mari; Wentzel-Larsen, Tore; Smith, Lars; Moe, Vibeke

    2018-03-01

    There is a need for standardized measures of infant temperament to strengthen current practices in prevention and early intervention. The present study provides Norwegian data on the Cameron-Rice Infant Temperament Questionnaire (CRITQ; J.R. Cameron & D.C. Rice, 1986a), which comprises 46 items and is used within a U.S. health maintenance organization. The CRITQ was filled out by mothers and fathers at 6 and again at 12 months as part of a longitudinal study of mental health during the first years of life (the "Little in Norway" study, N = 1,041 families enrolled; V. Moe & L. Smith, 2010). Results showed that internal consistencies were comparable with U.S. The temperament dimensions of persistence, adaptability, and regularity had acceptable or close-to-acceptable reliabilities in the U.S. study as well as in this study, and also were unifactorial in confirmatory factor analysis. These dimensions are the focus in this article. Findings concerning parents' differential ratings of their infants on the three dimensions are reported, as is the stability of parents' ratings of temperament from 6 to 12 months. In addition, results on the relation between temperament and parenting stress are presented. The study suggests that temperamental adaptability, persistence, and regularity may be relevant when assessing infant behavior, and may be applied in systematic prevention trials for families with infants. The inclusion of concepts related to individual differences in response tendencies and regulatory efforts may broaden the understanding of parent-infant transactions, and thus enrich prevention and sensitizing interventions with the aim of assisting infants' development. © 2018 Michigan Association for Infant Mental Health.

  8. Relationship between postural control and fine motor skills in preterm infants at 6 and 12 months adjusted age.

    PubMed

    Wang, Tien-Ni; Howe, Tsu-Hsin; Hinojosa, Jim; Weinberg, Sharon L

    2011-01-01

    We examined the relationship between postural control and fine motor skills of preterm infants at 6 and 12 mo adjusted age. The Alberta Infant Motor Scale was used to measure postural control, and the Peabody Developmental Motor Scales II was used to measure fine motor skills. The data analyzed were taken from 105 medical records from a preterm infant follow-up clinic at an urban academic medical center in south Taiwan. Using multiple regression analyses, we found that the development of postural control is related to the development of fine motor skills, especially in the group of preterm infants with delayed postural control. This finding supports the theoretical assumption of proximal-distal development used by many occupational therapists to guide intervention. Further research is suggested to corroborate findings.

  9. Incidence of laboratory-confirmed influenza disease among infants under 6 months of age: a systematic review

    PubMed Central

    Fell, Deshayne B; Johnson, Jeanene; Mor, Zohar; Katz, Mark A; Skidmore, Becky; Neuzil, Kathleen M; Ortiz, Justin R; Bhat, Niranjan

    2017-01-01

    Objectives The aim of this systematic review was to assess incidence rates of laboratory-confirmed influenza (LCI) outcomes among infants under 6months of age. Design Systematic literature search and review of indexed studies in PubMed, EMBASE, the Cochrane Library and CINAHL Plus from inception to 19 April 2017. Setting Population-based estimates from community or hospital settings. Participants Infants under 6months of age. Primary and secondary outcome measures LCI illness in ambulatory care settings, LCI hospitalisation, LCI intensive care unit admission and LCI death. Only studies with population-based incidence data were included. Results We identified 27 primary studies, 11 of which were from the USA, four were from other non-US high-income settings and the remaining were from lower-middle-income or upper-middle-income countries. Most studies (n=23) assessed incidence of LCI hospitalisation, but meta-analysis to pool study-specific rates was not possible due to high statistical and methodological heterogeneity. Among US studies, the reported incidence of LCI hospitalisation ranged from 9.3 to 91.2 per 10 000 infants under 6months for seasonal influenza, while the only US-based estimate for pandemic H1N1 influenza was 20.2 per 10 000 infants. Reported rates for LCI hospitalisation for seasonal influenza from other countries ranged from 6.2 to 73.0 per 10 000 infants under 6months, with the exception of one study with an estimated rate of 250 per 10 000 infants. No events were reported in five of the nine studies that evaluated LCI death among infants under 6months. Conclusion Our review of published studies found limited data on LCI outcomes for infants under 6months, particularly from non-US settings. Globally representative and reliable incidence data are necessary to fully evaluate influenza disease burden and the potential impact of maternal influenza immunisation programme on morbidity and mortality in young infants. PMID

  10. Duration of exclusive breast-feeding: introduction of complementary feeding may be necessary before 6 months of age.

    PubMed

    Reilly, John J; Wells, Jonathan C K

    2005-12-01

    The WHO recommends exclusive breast-feeding for the first 6 months of life. At present, <2 % of mothers who breast-feed in the UK do so exclusively for 6 months. We propose the testable hypothesis that this is because many mothers do not provide sufficient breast milk to feed a 6-month-old baby adequately. We review recent evidence on energy requirements during infancy, and energy transfer from mother to baby, and consider the adequacy of exclusive breast-feeding to age 6 months for mothers and babies in the developed world. Evidence from our recent systematic review suggests that mean metabolisable energy intake in exclusively breast-fed infants at 6 months is 2.2-2.4 MJ/d (525-574 kcal/d), and mean energy requirement approximately 2.6-2.7 MJ/d (632-649 kcal/d), leading to a gap between the energy provided by milk and energy needs by 6 months for many babies. Our hypothesis is consistent with other evidence, and with evolutionary considerations, and we briefly review this other evidence. The hypothesis would be testable in a longitudinal study of infant energy balance using stable-isotope techniques, which are both practical and valid.

  11. Effect of Exercise on Serum Sex Hormones in Men: A 12-Month Randomized Clinical Trial

    PubMed Central

    HAWKINS, VIVIAN N.; FOSTER-SCHUBERT, KAREN; CHUBAK, JESSICA; SORENSEN, BESS; ULRICH, CORNELIA M.; STANCYZK, FRANK Z.; PLYMATE, STEPHEN; STANFORD, JANET; WHITE, EMILY; POTTER, JOHN D.; MCTIERNAN, ANNE

    2011-01-01

    Purpose The effect of exercise on androgens in middle-aged to older men is poorly understood, and it could have implications for several aspects of health. This analysis was conducted to examine the effects of long-term aerobic exercise on serum sex hormones in middle-aged to older men. Methods One hundred two sedentary men, ages 40–75 yr, were randomly assigned to a 12-month exercise intervention or a control group (no change in activity). The combined facility- and home-based exercise program consisted of moderate/vigorous-intensity aerobic activity for 60 min·d−1, 6 d·wk−1. Serum concentrations of testosterone, free testosterone, dihydrotestosterone (DHT), 3α-androstanediol glucuronide (3α-Diol-G), estradiol, free estradiol, and sex hormone–binding globulin (SHBG) were measured at baseline, 3, and 12 months. Results Exercisers trained a mean of 370 min·wk−1 (102% of goal), with only two dropouts. Cardiopulmonary fitness (V̇O2max) increased 10.8% in exercisers and decreased by 1.8% in controls (P < 0.001). DHT increased 14.5% in exercisers versus 1.7% in controls at 3 months (P = 0.04); at 12 months, it remained 8.6% above baseline in exercisers versus a 3.1% decrease in controls (P = 0.03). SHBG increased 14.3% in exercisers versus 5.7% in controls at 3 months (P = 0.04); at 12 months, it remained 8.9% above baseline in exercisers versus 4.0% in controls (P = 0.13). There were significant trends toward increasing DHT and SHBG, with greater increases in V̇O2max at 3 and 12 months in exercisers. No statistically significant differences were observed for testosterone, free testosterone, 3α-Diol-G, estradiol, or free estradiol in exercisers versus controls. Conclusions A yearlong, moderate-intensity aerobic exercise program increased DHT and SHBG, but it had no effect on other androgens in middle-aged to older men. PMID:18202581

  12. Translating Comprehensive Conservative Care for Chronic Knee Pain Into a Digital Care Pathway: 12-Week and 6-Month Outcomes for the Hinge Health Program

    PubMed Central

    Erhart-Hledik, Jennifer C; Kinsella, Rose; Hunter, Simon; Mecklenburg, Gabriel; Perez, Daniel

    2017-01-01

    Background Chronic knee pain (CKP) affects a large number of adults, many of whom do not receive best-practice care and are at high risk for unnecessary surgery. Objective The aim of this study was to investigate the effect of the Hinge Health 12-week digital care program (DCP) for CKP on knee pain and function, with secondary outcomes of surgery interest and satisfaction, at 12 weeks and 6 months after starting the program. Methods Individuals with CKP were recruited onto the 12-week program, comprising sensor-guided physical exercises, weekly education, activity tracking, and psychosocial support such as personal coaching and cognitive behavioral therapy (CBT). We used a single-arm design with assessment of outcomes at baseline, 12 weeks, and 6 months after starting the program. We used a linear mixed effects model with Tukey contrasts to compare timepoints and report intention-to-treat statistics with last observation carried forward. Results The cohort consisted of 41 individuals (32 female, mean age 52 years, SD 9 years). Between baseline and week 12, participants reported clinically significant improvements in the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain and Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form (KOOS-PS) function scales of 16 points (95% CI 12-21, P<.001) and 10 points (95% CI 6-14, P<.001), respectively. Significant reductions of 57% (mean difference 30, 95% CI 21-38, P<.001) and 51% (mean difference 25, 95% CI 16-33, P<.001) in visual analog scale (VAS) knee pain and stiffness, respectively, were observed at 12 weeks, as well as a 67% reduction in surgery interest (mean reduction 2.3 out of 10, 95% CI 1.5-3.1, P<.001). Average satisfaction at week 12 was 9.2 out of 10. Critically, all improvements were maintained at 6 months at similar or greater magnitude. Conclusions Participants on the Hinge Health DCP for CKP showed substantial clinical improvements that were maintained 6 months after enrolling in the

  13. Vaccination coverage and immunization timeliness among children aged 12-23 months in Senegal: a Kaplan-Meier and Cox regression analysis approach

    PubMed Central

    Mbengue, Mouhamed Abdou Salam; Mboup, Aminata; Ly, Indou Deme; Faye, Adama; Camara, Fatou Bintou Niang; Thiam, Moussa; Ndiaye, Birahim Pierre; Dieye, Tandakha Ndiaye; Mboup, Souleymane

    2017-01-01

    Introduction Expanded programme on immunizations in resource-limited settings currently measure vaccination coverage defined as the proportion of children aged 12-23 months that have completed their vaccination. However, this indicator does not address the important question of when the scheduled vaccines were administered. We assessed the determinants of timely immunization to help the national EPI program manage vaccine-preventable diseases and impact positively on child survival in Senegal. Methods Vaccination data were obtained from the Demographic and Health Survey (DHS) carried out across the 14 regions in the country. Children were aged between 12-23 months. The assessment of vaccination coverage was done with the health card and/or by the mother’s recall of the vaccination act. For each vaccine, an assessment of delay in age-appropriate vaccination was done following WHO recommendations. Additionally, Kaplan-Meier survival function was used to estimate the proportion vaccinated by age and cox-proportional hazards models were used to examine risk factors for delays. Results A total of 2444 living children between 12–23 months of age were included in the analysis. The country vaccination was below the WHO recommended coverage level and, there was a gap in timeliness of children immunization. While BCG vaccine uptake was over 95%, coverage decreased with increasing number of Pentavalent vaccine doses (Penta 1: 95.6%, Penta 2: 93.5%: Penta 3: 89.2%). Median delay for BCG was 1.7 weeks. For polio at birth, the median delay was 5 days; all other vaccine doses had median delays of 2-4 weeks. For Penta 1 and Penta 3, 23.5% and 15.7% were given late respectively. A quarter of measles vaccines were not administered or were scheduled after the recommended age. Vaccinations that were not administered within the recommended age ranges were associated with mothers’ poor education level, multiple siblings, low socio-economic status and living in rural areas

  14. Vaccination coverage and immunization timeliness among children aged 12-23 months in Senegal: a Kaplan-Meier and Cox regression analysis approach.

    PubMed

    Mbengue, Mouhamed Abdou Salam; Mboup, Aminata; Ly, Indou Deme; Faye, Adama; Camara, Fatou Bintou Niang; Thiam, Moussa; Ndiaye, Birahim Pierre; Dieye, Tandakha Ndiaye; Mboup, Souleymane

    2017-01-01

    Expanded programme on immunizations in resource-limited settings currently measure vaccination coverage defined as the proportion of children aged 12-23 months that have completed their vaccination. However, this indicator does not address the important question of when the scheduled vaccines were administered. We assessed the determinants of timely immunization to help the national EPI program manage vaccine-preventable diseases and impact positively on child survival in Senegal. Vaccination data were obtained from the Demographic and Health Survey (DHS) carried out across the 14 regions in the country. Children were aged between 12-23 months. The assessment of vaccination coverage was done with the health card and/or by the mother's recall of the vaccination act. For each vaccine, an assessment of delay in age-appropriate vaccination was done following WHO recommendations. Additionally, Kaplan-Meier survival function was used to estimate the proportion vaccinated by age and cox-proportional hazards models were used to examine risk factors for delays. A total of 2444 living children between 12-23 months of age were included in the analysis. The country vaccination was below the WHO recommended coverage level and, there was a gap in timeliness of children immunization. While BCG vaccine uptake was over 95%, coverage decreased with increasing number of Pentavalent vaccine doses (Penta 1: 95.6%, Penta 2: 93.5%: Penta 3: 89.2%). Median delay for BCG was 1.7 weeks. For polio at birth, the median delay was 5 days; all other vaccine doses had median delays of 2-4 weeks. For Penta 1 and Penta 3, 23.5% and 15.7% were given late respectively. A quarter of measles vaccines were not administered or were scheduled after the recommended age. Vaccinations that were not administered within the recommended age ranges were associated with mothers' poor education level, multiple siblings, low socio-economic status and living in rural areas. A significant delay in receipt of infant

  15. Sustained 12 Month Benefit of Phrenic Nerve Stimulation for Central Sleep Apnea.

    PubMed

    Costanzo, Maria Rosa; Ponikowski, Piotr; Javaheri, Shahrokh; Augostini, Ralph; Goldberg, Lee R; Holcomb, Richard; Kao, Andrew; Khayat, Rami N; Oldenburg, Olaf; Stellbrink, Christoph; Abraham, William T

    2018-06-01

    Transvenous phrenic nerve stimulation improved sleep metrics and quality of life after 6 months versus control in the remedē System Pivotal Trial. This analysis explored the effectiveness of phrenic nerve stimulation in patients with central sleep apnea after 12 months of therapy. Reproducibility of treatment effect was assessed in the former control group in whom the implanted device was initially inactive for the sixth month and subsequently activated when the randomized control assessments were complete. Patients with moderate-to-severe central sleep apnea implanted with the remedē System were randomized to therapy activation at 1 month (treatment) or after 6 months (control). Sleep indices were assessed from baseline to 12 months in the treatment group and from 6 to 12 months in former controls. In the treatment group, a ≥50% reduction in apnea-hypopnea index occurred in 60% of patients at 6 months (95% confidence interval [CI] 47% to 64%) and 67% (95% CI 53% to 78%) at 12 months. After 6 months of therapy, 55% of former controls (95% CI 43% to 67%) achieved ≥50%reduction in apnea-hypopnea index. Patient Global Assessment was markedly ormoderately improved at 6 and 12 months in 60% of treatment patients.Improvements persisted at 12 months. A serious adverse event within 12 months occurred in 13 patients (9%). Phrenic nerve stimulation produced sustained improvements in sleep indices and quality of life to at least 12 months in patients with central sleep apnea. The similar improvement of former controls after 6 months of active therapy confirms benefits are reproducible and reliable. Copyright © 2018 Respicardia, Inc. Published by Elsevier Inc. All rights reserved.

  16. Assessing early communication skills at 12 months: a retrospective study of Autism Spectrum Disorder.

    PubMed

    Swain, Nathaniel Robert; Eadie, Patricia Ann; Prior, Margot Ruth; Reilly, Sheena

    2015-07-01

    Early identification of Autism Spectrum Disorder (ASD) is currently limited by the absence of reliable biological markers for the disorder, as well as the reliability of screening and assessment tools for children aged between 6 and 18 months. Ongoing research has demonstrated the importance of early social communication skills in differentiating children later diagnosed with ASD from their typically developing (TD) peers, but researchers have not yet investigated whether these differences can be detected using community-ascertained systematic observation data as early as 12 months. To investigate whether differences in early social communication skills can be detected at 12 months of age, comparing children later diagnosed with ASD, and TD peers; and to determine whether differences remain when groupings are based on age of subsequent ASD diagnosis. From a prospective community-ascertained sample, we collected data on children in early life, then conducted retrospective analyses for those children who were later diagnosed with ASD by the age of 7 years, compared with matched TD peers. We analysed standardized observational data of early communication skills, collected using the Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP) Behavior Sample, when participants were 12 months of age. Children in the ASD group exhibited significantly lower social communication skills than the TD group, including on the Total score and Social and Symbolic Composite scores of the CSBS-DP Behavior Sample. Differences on the Total score and Social Composite were also detected for both early and late ASD diagnosis groups when compared with the TD group. These findings give further support for the importance of social communication in assessing children at risk of ASD as early as 12 months of age. Future research could evaluate the sensitivity and specificity of direct observation of these early communication skills as diagnostic indicators for ASD at 12 months

  17. Predictors of anemia among haitian children aged 6 to 59 months and women of childbearing age and their implications for programming.

    PubMed

    Heidkamp, Rebecca A; Ngnie-Teta, Ismael; Ayoya, Mohamed Ag A; Stoltzfus, Rebecca J; Mamadoultaibou, Aissa; Durandisse, Emmanuela Blain; Pierre, Joseline Marhone

    2013-12-01

    The Haitian National Nutrition Policy prioritizes prevention and treatment of anemia among mothers and young children, but there are few available data to support planning for scale-up of anemia interventions. To describe the prevalence and predictors of anemia among Haitian women (15 to 49 years) and children (6 to 59 months) and to draw implications for national nutrition programming. Descriptive and univariate analyses and multivariate logistic regression models were performed using data from the nationally representative Haitian Demographic Health Survey 2005/06. The prevalence of mild (hemoglobin 11.0 to 11.9 g/dL), moderate (hemoglobin 8.0 to 10.9 g/dL), and severe (hemoglobin < 8.0 g/dL) anemia was 19.2%, 21.7%, and 4.4%, respectively, among women aged 15 to 49 years and 22.9%, 33.9%. and 2.2% among children aged 6 to 59 months. Unexpectedly anemia was more prevalent in urban women (54.4 %) and children (65.1%) than in rural women (43.1%, p < .001) and children (55.7%, p = .004). In multivariate regression models, factors associated with anemia among urban women (birth spacing, p = .027; overweight BMI, p < .001; education level, p = .022) were different from those in rural women (wealth quintile, p < .05; employment, p = .003). Anemia in urban and rural children aged 6 to 59 months increased with child age (p < .05) and maternal anemia status (p = .004; p < .001). Female sex (p = .007) and maternal overweight (p = .009) were associated with reduced risk of anemia in rural children only. Anemia among Haitian young children and women of childbearing age is a severe public health problem. The findings suggest the need for context-specific rural and urban strategies, reinforcement of anemia prevention in health services reaching women of childbearing age, and targeted interventions for young children.

  18. Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

    PubMed

    Solomon, Dagmawit; Aderaw, Zewdie; Tegegne, Teketo Kassaw

    2017-10-12

    Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6-23 months in Addis Ababa, Ethiopia. A health facility based cross sectional study was undertaken in the three sub-cities of Addis Ababa from 26th February to 28th April, 2016. A multi-stage sampling technique was used to sample the 352 study participants or mothers who had children aged 6-23 months. Data were collected by using a structured and pretested questionnaire, cleaned and entered into Epi info 7 and analyzed using SPSS 24 software. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to identify factors associated with minimum dietary diversity. In this study, the overall children with minimum dietary diversity score were found to be 59.9%. Mother's educational attainment and a higher household monthly income were positively associated with the minimum dietary diversity practice. Similarly, mothers' knowledge on dietary diversity and child feeding was positively associated with minimum dietary diversity child feeding practice, with an adjusted odds ratio of 1.98 (95% CI: 1.11-3.53). In this study, the consumption of minimum dietary diversity was found to be high. In spite of this, more efforts need to be done to achieve the recommended minimum dietary diversity intake for all children aged between 6 and 23 months.

  19. Corneal-Reflection Eye-Tracking Technique for the Assessment of Horizontal Sound Localization Accuracy from 6 Months of Age.

    PubMed

    Asp, Filip; Olofsson, Åke; Berninger, Erik

    2016-01-01

    The evaluation of sound localization accuracy (SLA) requires precise behavioral responses from the listener. Such responses are not always possible to elicit in infants and young children, and procedures for the assessment of SLA are time consuming. The aim of this study was to develop a fast, valid, and objective method for the assessment of SLA from 6 months of age. To this end, pupil positions toward spatially distributed continuous auditory and visual stimuli were recorded. Twelve children (29 to 157 weeks of age) who passed the universal newborn hearing screening and eight adults (18 to 40 years of age) who had pure-tone thresholds ≤20 dB HL in both ears participated in this study. Horizontal SLA was measured in a sound field with 12 loudspeaker/display (LD)-pairs placed in an audiological test room at 10 degrees intervals in the frontal horizontal plane (±55 degrees azimuth). An ongoing auditory-visual stimulus was presented at 63 dB SPL(A) and shifted to randomized loudspeakers simultaneously with pauses of the visual stimulus. The visual stimulus was automatically reintroduced at the azimuth of the sounding loudspeaker after a sound-only period of 1.6 sec. A corneal-reflection eye-tracking technique allowed the acquisition of the subjects' pupil positions relative to the LD-pairs. The perceived azimuth was defined as the median of the intersections between gaze and LD-pairs during the final 500 msec of the sound-only period. Overall SLA was quantified by an Error Index (EI), where EI = 0 corresponded to perfect match between perceived and presented azimuths, whereas EI = 1 corresponded to chance. SLA was rapidly measured in children (mean = 168 sec, n = 12) and adults (mean = 162 sec, n = 8). Visual inspection of gaze data indicated that gaze shifts occurred in sound-only periods. The medians of the perceived sound-source azimuths either coincided with the presenting sound-source azimuth or were offset by a maximum of 20 degrees in children. In contrast

  20. Life-Space Mobility Change Predicts 6-Month Mortality.

    PubMed

    Kennedy, Richard E; Sawyer, Patricia; Williams, Courtney P; Lo, Alexander X; Ritchie, Christine S; Roth, David L; Allman, Richard M; Brown, Cynthia J

    2017-04-01

    To examine 6-month change in life-space mobility as a predictor of subsequent 6-month mortality in community-dwelling older adults. Prospective cohort study. Community-dwelling older adults from five Alabama counties in the University of Alabama at Birmingham (UAB) Study of Aging. A random sample of 1,000 Medicare beneficiaries, stratified according to sex, race, and rural or urban residence, recruited between November 1999 and February 2001, followed by a telephone interview every 6 months for the subsequent 8.5 years. Mortality data were determined from informant contacts and confirmed using the National Death Index and Social Security Death Index. Life-space was measured at each interview using the UAB Life-Space Assessment, a validated instrument for assessing community mobility. Eleven thousand eight hundred seventeen 6-month life-space change scores were calculated over 8.5 years of follow-up. Generalized linear mixed models were used to test predictors of mortality at subsequent 6-month intervals. Three hundred fifty-four deaths occurred within 6 months of two sequential life-space assessments. Controlling for age, sex, race, rural or urban residence, and comorbidity, life-space score and life-space decline over the preceding 6-month interval predicted mortality. A 10-point decrease in life-space resulted in a 72% increase in odds of dying over the subsequent 6 months (odds ratio = 1.723, P < .001). Life-space score at the beginning of a 6-month interval and change in life-space over 6 months were each associated with significant differences in subsequent 6-month mortality. Life-space assessment may assist clinicians in identifying older adults at risk of short-term mortality. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. [Suicide attempts of 48 children aged 6-12 years].

    PubMed

    Berthod, C; Giraud, C; Gansel, Y; Fourneret, P; Desombre, H

    2013-12-01

    Research is limited on suicide attempts in children under 13 years of age. The objective of this study was to provide an in-depth description of this population. The present study is both retrospective and descriptive. Data were collected retrospectively from a file containing the causes for hospitalization of each child admitted into the Department of Child Psychiatry at the hôpital Femme-Mère-Enfant (hospices civils de Lyon). We included all patients under 13 years of age who were hospitalized for a suicide attempt between 2008 and 2011. The methods used to collect the medical records consisted in using a form made up of four major parts: suicide attempts, social environment, medical history, and therapy. The 26 girls and 22 boys included had a mean age of 11.52 years. The boys were younger than the girls (P=0.047) and their parents were usually separated (P=0.034). The boys used more violent means to commit suicide in comparison to the girls (P=0.048). On average, children using violent means were younger (P=0.013). Boys underwent more psychotherapy (P=0.027) and were prescribed more psychotropic medication in comparison to girls (P=0.051). Adjustment disorders (37.5%) and depression (27%) were the two main diagnoses for hospitalization. They were hospitalized on average (±standard deviation) 9.6 days (±10 days). Psychotherapy was organized when leaving the hospital (98%) with legal measures (8.3%), change of residence (12.5%), and prescription of psychotropic drugs (37.5%). None had physical complications. In children under 13 years of age, attempted suicide was more frequent in girls than boys. However, the sample included 18 girls and nine boys who were 12 years old (sex ratio of 12-year-olds, 0.5). There were more boys (16 boys/eight girls) in the children under 12 (sex ratio of 8- to 11-year-olds, 1.6). Children under 11 used more violent means (P=0.01). The literature also reports that more violent means lead to a greater risk of death by suicide

  2. Timely initiation of complementary feeding and associated factors among children aged 6 to 12 months in Northern Ethiopia: an institution-based cross-sectional study

    PubMed Central

    2013-01-01

    Background Exclusive breastfeeding (EBF) for the first six months of life is critical for the wellbeing of the child. In the mean while, timely initiation and starting nutritionally-adequate, safe, age-appropriate complementary feeding at six months is recommended for the better health and development of infants. According to the Ethiopian Demographic and Health Survey 2011, timely initiation of complementary feeding in Ethiopia at the 6th month was only 51%. The purpose of this study is to determine the magnitude of timely initiation of complementary feeding and associated factors in Mekelle town, Northern Ethiopia. Methods An institutional based cross-sectional study design was conducted among 422 mothers of infants aged from six months to one year selected from six public health facilities. Sample size proportional to the patient flow rate of each institution was allocated and systematic random sampling method was used to get the study participant. An exit interview using structured questionnaire was conducted about their experience on complementary feeding and related experience. The questionnaire was pretested among 21 mothers. Data were entered with EPI info version 3.5.1 and cleaning and analysis was done by using SPSS version 16. Frequencies distribution, binary and multiple logistic regressions were done. OR and 95% confidence interval was computed. Result The prevalence of timely initiation of complementary feeding at sixth month was 62.8% (265/422, 95% C.I: 58.1, 67.31%). Educational level, occupation of mother, parity, having ANC follow up, and birth preparedness were found to be independent predictor of timely initiation of complementary feeding. Conclusions Almost two-third of mothers initiated complementary feeding at six month of child’ age as recommended. This was relatively higher prevalence than most developing countries. However, significant proportion of mothers still did not initiate complementary feeding timely. Mothers who are illiterate

  3. Impact of malnutrition on 12-month mortality following acute hip fracture.

    PubMed

    Bell, Jack J; Pulle, Ranjeev C; Crouch, Alisa M; Kuys, Suzanne S; Ferrier, Rebecca L; Whitehouse, Sarah L

    2016-03-01

    Studies investigating the relationship between malnutrition and post-discharge mortality following acute hip fracture yield conflicting results. This study aimed to determine whether malnutrition independently predicted 12-month post-fracture mortality after adjusting for clinically relevant covariates. An ethics approved, prospective, consecutive audit was undertaken for all surgically treated hip fracture inpatients admitted to a dedicated orthogeriatric unit (November 2010-October 2011). The 12-month mortality data were obtained by a dual search of the mortality registry and Queensland Health database. Malnutrition was evaluated using the Subjective Global Assessment. Demographic (age, gender, admission residence) and clinical covariates included fracture type, time to surgery, anaesthesia type, type of surgery, post-surgery time to mobilize and post-operative complications (delirium, pulmonary and deep vein thrombosis, cardiac complications, infections). The Charlson Comorbidity Index was retrospectively applied. All diagnoses were confirmed by the treating orthogeriatrician. A total of 322 of 346 patients were available for audit. Increased age (P = 0.004), admission from residential care (P < 0.001), Charlson Comorbidity Index (P = 0.007), malnutrition (P < 0.001), time to mobilize >48 h (P < 0.001), delirium (P = 0.003), pulmonary embolism (P = 0.029) and cardiovascular complication (P = 0.04) were associated with 12-month mortality. Logistic regression analysis demonstrated that malnutrition (odds ratio (OR) 2.4 (95% confidence interval (CI) 1.3-4.7, P = 0.007)), in addition to admission from residential care (OR 2.6 (95% CI 1.3-5.3, P = 0.005)) and pulmonary embolism (OR 11.0 (95% CI 1.5-78.7, P = 0.017)), independently predicted 12-month mortality. Findings substantiate malnutrition as an independent predictor of 12-month mortality in a representative sample of hip fracture inpatients. Effective strategies to identify and treat malnutrition in hip

  4. Simultaneous vs. sequential treatment for smoking and weight management in tobacco quitlines: 6 and 12 month outcomes from a randomized trial.

    PubMed

    Bush, Terry; Lovejoy, Jennifer; Javitz, Harold; Torres, Alula Jimenez; Wassum, Ken; Tan, Marcia M; Spring, Bonnie

    2018-05-31

    Smoking cessation often results in weight gain which discourages many smokers from quitting and can increase health risks. Treatments to reduce cessation-related weight gain have been tested in highly controlled trials of in-person treatment, but have never been tested in a real-world setting, which has inhibited dissemination. The Best Quit Study (BQS) is a replication and "real world" translation using telephone delivery of a prior in-person efficacy trial. randomized control trial in a quitline setting. Eligible smokers (n = 2540) were randomized to the standard 5-call quitline intervention or quitline plus simultaneous or sequential weight management. Regression analyses tested effectiveness of treatments on self-reported smoking abstinence and weight change at 6 and 12 months. Study enrollees were from 10 commercial employer groups and three state quitlines. Participants were between ages 18-72, 65.8% female, 68.2% white; 23.0% Medicaid-insured, and 76.3% overweight/obese. The follow-up response rate was lower in the simultaneous group than the control group at 6 months (p = 0.01). While a completers analysis of 30-day point prevalence abstinence detected no differences among groups at 6 or 12 months, multiply imputed abstinence showed quit rate differences at 6 months for:simultaneous (40.3%) vs. sequential (48.3%), p = 0.034 and simultaneous vs. control (44.9%), p = 0.043. At 12 months, multiply imputed abstinence, was significantly lower for the simultaneous group (40.7%) vs. control (46.0%), p < 0.05 and vs. sequential (46.3%), p < 0.05. Weight gain at 6 and 12 months was minimal and not different among treatment groups. The sequential group completed fewer total calls (3.75) vs. control (4.16) and vs. simultaneous group (3.83), p = 0.01, and fewer weight calls (0.94) than simultaneous (2.33), p < 0.0001. The number of calls completed predicted 30-day abstinence, p < 0.001, but not weight outcomes. This study

  5. Vitamin A-first dose supplement coverage evaluation amongst children aged 12–23 months residing in slums of Delhi, India

    PubMed Central

    Sachdeva, Sandeep; Datta, Utsuk

    2009-01-01

    Objective: To determine vitamin A-first dose supplement coverage in children aged 12–23 months and to find out its correlates with selected variables. Materials and Methods: The 30-cluster sampling technique based on probability proportional to size advocated by the World Health Organization was used to assess vitamin A-first dose supplement amongst 210 children in the age group of 12–23 months residing in slums of a randomly selected municipal zone of Delhi during October to November 2005. Results: Only 79 (37.6%) children out of 210 had received vitamin A-first dose supplement. Further analysis of 79 children was carried out with regard to selected variables like religion, gender, birth order, place of birth, immunization status and literacy of mother. These analyses showed that 71 (89.9%) were Hindu and eight (10.1%) were non-Hindu (P = 0.04). Nearly 44 (55.7%) males and 35 (44.3%) females had received vitamin A (P = 0.74). The proportion of children born in a health institution who received first dose (57%) of vitamin A supplementation was significantly higher than of those who were born at home (43%) (P < 0.001). Similarly, higher proportion of children with birth order-one (48.1%) in comparison to birth order-three or above (26.6%) received vitamin A (P < 0.001). Thirty children though fully immunized for vaccine-preventable disease up to the age-of-one year had not received vitamin A-first dose supplement, suggesting that an opportunity had been missed. The association between receipt of vitamin A by the child and literacy status of mother was found to be significant (P < 0.001). Conclusion: The study reflects low coverage of Vitamin A supplement. PMID:19574699

  6. Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia).

    PubMed

    Poh, Bee Koon; Ng, Boon Koon; Siti Haslinda, Mohd Din; Nik Shanita, Safii; Wong, Jyh Eiin; Budin, Siti Balkis; Ruzita, Abd Talib; Ng, Lai Oon; Khouw, Ilse; Norimah, A Karim

    2013-09-01

    The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.

  7. [Analysis the statue of growth and development of infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China].

    PubMed

    Fang, Junqun; Luo, Jiayou; Liao, Kai; Wang, Hua; Zhou, Xu; Huang, Guangwen; Xie, Donghua; Peng, Zhonghua; Yang, Wenzhen

    2016-11-01

    To describe the statue of growth and development among infants and young children aged 6-23 months in poor rural areas of Hunan Province. A total of 15 248 rural infants and young children aged 6-23 months in 54 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by Probability-Proportional-to-Size Sampling( PPS) between 2009 and 2015. Participants' length and weight were tested, WHZ, WAZ, HAZ and BMI Z score were calculated according to The WHO Child Growth Standards, and describe the rate of wasting, underweight, stunting and low BMI, and the physical growth level of children were evaluated according to the WHO standards. The average weight of girls aged 6-23 months in poor rural areas of Hunan Province were 9. 17 kg, lower than boys which were 9. 79 kg. The average length of girls aged 6-23 months were 75. 53 cm, lower than boys which were 77. 19 cm. The average BMI of girls aged 6-23 months were15. 96, lower than boys which were 16. 40( P < 0. 05). The curve of weight-for-length Z scores and weight-for-age Z scores and length-for-age Z scores of infants and young children aged 6-23 months were lower than the WHO standards( P < 0. 05). The rate of wasting, underweight, stunting and low BMI of infants and young children aged 6-23 months were 3. 9%, 5. 1%, 7. 2% and 3. 9%, and boys were higher than girls in the rate of underweight and stunting, the rate of underweight and stunting were increased with the growth of age( P < 0. 05). The problem of growth and development of infants and young children aged 6-23 months in poor rural areas of Hunan Province are serious, and there are lower than the WHO standards. To improve the nutrition and health of infants and young children in poor rural areas, the ability of child health care and the feeding knowledge of caregivers are need to be improved.

  8. From early stress to 12-month development in very preterm infants: Preliminary findings on epigenetic mechanisms and brain growth.

    PubMed

    Fumagalli, Monica; Provenzi, Livio; De Carli, Pietro; Dessimone, Francesca; Sirgiovanni, Ida; Giorda, Roberto; Cinnante, Claudia; Squarcina, Letizia; Pozzoli, Uberto; Triulzi, Fabio; Brambilla, Paolo; Borgatti, Renato; Mosca, Fabio; Montirosso, Rosario

    2018-01-01

    Very preterm (VPT) infants admitted to Neonatal Intensive Care Unit (NICU) are at risk for altered brain growth and less-than-optimal socio-emotional development. Recent research suggests that early NICU-related stress contributes to socio-emotional impairments in VPT infants at 3 months through epigenetic regulation (i.e., DNA methylation) of the serotonin transporter gene (SLC6A4). In the present longitudinal study we assessed: (a) the effects of NICU-related stress and SLC6A4 methylation variations from birth to discharge on brain development at term equivalent age (TEA); (b) the association between brain volume at TEA and socio-emotional development (i.e., Personal-Social scale of Griffith Mental Development Scales, GMDS) at 12 months corrected age (CA). Twenty-four infants had complete data at 12-month-age. SLC6A4 methylation was measured at a specific CpG previously associated with NICU-related stress and socio-emotional stress. Findings confirmed that higher NICU-related stress associated with greater increase of SLC6A4 methylation at NICU discharge. Moreover, higher SLC6A4 discharge methylation was associated with reduced anterior temporal lobe (ATL) volume at TEA, which in turn was significantly associated with less-than-optimal GMDS Personal-Social scale score at 12 months CA. The reduced ATL volume at TEA mediated the pathway linking stress-related increase in SLC6A4 methylation at NICU discharge and socio-emotional development at 12 months CA. These findings suggest that early adversity-related epigenetic changes might contribute to the long-lasting programming of socio-emotional development in VPT infants through epigenetic regulation and structural modifications of the developing brain.

  9. Motor development curve from 0 to 12 months in infants born preterm.

    PubMed

    Kayenne Martins Roberto Formiga, Cibelle; Linhares, Maria Beatriz Martins

    2011-03-01

    To trace a reference curve for motor development from birth up to 12 months of corrected chronological age in infants born preterm and low birth weight. This is a cross-sectional study with a sample of 308 preterm infants (53% boys) weighing < 2500 g at birth. The Alberta Infant Motor Scale (AIMS) was used for motor development assessment. Comparing the motor performance of preterm infants with infants from a standardized sample on the AIMS, it was found that, except for the age group of the newborn, preterm infants showed lower motor development scores in comparison with the AIMS normative sample in all age groups between 1 and 12 months. The curve of motor development showed a continuous increase in the number of motor skills of preterm infants during their first 12 months of age. However, the average of motor acquisitions of preterm infants showed a nonlinear pattern with a standard indicator of stabilization between 8 and 10 months of age. Preterm infants, 1-12 months of age, showed motor development AIMS scores lower than the standards established in the normative sample. The findings may contribute as norm-reference for assessing the motor development of preterm infants in follow-up programmes in developing countries. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  10. Breast-feeding at 12 months of age and dietary habits among breast-fed and non-breast-fed infants.

    PubMed

    Lande, Britt; Andersen, Lene Frost; Veierød, Marit B; Baerug, Anne; Johansson, Lars; Trygg, Kerstin U; Bjørneboe, Gunn-Elin Aa

    2004-06-01

    To analyse factors associated with breast-feeding and use of sweetened drinks at 12 months, and to compare dietary habits among breast-fed and non-breast-fed infants. Data were collected by a semi-quantitative food-frequency questionnaire filled in by the parents. National dietary survey in Norway. In total, 1932 12-month-old infants were included. At 12 months, 36% of the infants were breast-fed. The odds of breast-feeding at this age were more than doubled both for mothers > or =35 years compared with mothers <25 years and for mothers in the highest educational group compared with mothers in the lowest. A negative association was found for maternal smoking, and the odds of breast-feeding were 40% lower for mothers who smoked than for non-smokers. Some dietary differences were observed between breast-fed and non-breast-fed infants apart from intake of milk. In particular, breast-fed infants had a significantly lower daily intake of sweetened drinks than non-breast-fed infants and a 16% lower mean daily intake of added sugars (P<0.001). Furthermore, breast-fed infants had 30% higher odds of not receiving sweetened drinks daily, compared with non-breast-fed infants. Maternal age, education and smoking status were important factors for breast-feeding at 12 months. Breast-fed infants had lower intakes of sweetened drinks and added sugars than non-breast-fed infants. From a public health perspective, continued promotion of breast-feeding is needed to reduce inequalities in breast-feeding. Moreover, prevention of high intakes of sweetened drinks and added sugars should start in infancy.

  11. Increased emergency room visits or hospital admissions in females after 12-month MMR vaccination, but no difference after vaccinations given at a younger age.

    PubMed

    Wilson, Kumanan; Ducharme, Robin; Ward, Brian; Hawken, Steven

    2014-02-26

    Previous studies have suggested that a child's sex may be a predictor of vaccine reactions. We used a self-controlled case series design, an extension of retrospective cohort methodology which controls for fixed confounders using a conditional Poisson modeling approach. We compared a risk period immediately following vaccination to a control period farther removed from vaccination in each child and estimated the relative incidence of emergency room visits and/or hospital admissions following the 2-, 4-, 6-, and 12-month vaccinations to investigate the effect of sex on relative incidence. All infants born in Ontario, Canada between April 1, 2002 and March 31, 2009 were eligible for study inclusion. In analyses combining immunizations at 2, 4 and 6 months and examining these vaccinations separately, there was no significant relationship between the relative incidence of an event and sex of the child. At 12 months, we observed a significant effect of sex, with female sex being associated with a significantly higher relative incidence of events (P=0.0027). The relative incidence ratio (95% CI) comparing females to males following the 12-month vaccination was 1.08 (1.03 to 1.14), which translates to 192 excess events per 100,000 females vaccinated compared to the number of events that would have occurred in 100,000 males vaccinated. As the MMR vaccine is given at 12 months of age in Ontario, our findings suggest that girls may have an increased reactogenicity to the MMR vaccine which may be indicative of general sex differences in the responses to the measles virus. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Prospective examination of visual attention during play in infants at high-risk for autism spectrum disorder: a longitudinal study from 6 to 36 months of age.

    PubMed

    Sacrey, Lori-Ann R; Bryson, Susan E; Zwaigenbaum, Lonnie

    2013-11-01

    Regulation of visual attention is essential to learning about one's environment. Children with autism spectrum disorder (ASD) exhibit impairments in regulating their visual attention, but little is known about how such impairments develop over time. This prospective longitudinal study is the first to describe the development of components of visual attention, including engaging, sustaining, and disengaging attention, in infants at high-risk of developing ASD (each with an older sibling with ASD). Non-sibling controls and high-risk infant siblings were filmed at 6, 9, 12, 15, 18, 24, and 36 months of age as they engaged in play with small, easily graspable toys. Duration of time spent looking at toy targets before moving the hand toward the target and the duration of time spent looking at the target after grasp were measured. At 36 months of age, an independent, gold standard diagnostic assessment for ASD was conducted for all participants. As predicted, infant siblings subsequently diagnosed with ASD were distinguished by prolonged latency to disengage ('sticky attention') by 12 months of age, and continued to show this characteristic at 15, 18, and 24 months of age. The results are discussed in relation to how the development of visual attention may impact later cognitive outcomes of children diagnosed with ASD. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Suicide attempts within 12 months of treatment for substance use disorders.

    PubMed

    Britton, Peter C; Conner, Kenneth R

    2010-02-01

    There are limited prospective data on suicide attempts (SA) during the months following treatment for substance use disorders (SUD), a period of high risk. In an analysis of the Drug Abuse Treatment Outcomes Study, a longitudinal naturalistic multisite study of treated SUDs, variables associated with SA in the 12 months following SUD treatment were examined. Participants included 2,966 patients with one or more SUDs. By 12 months, 77 (2.6%) subjects had attempted suicide. Multivariate logistic regression analyses were used to identify variables associated with SA. Variables collected at baseline that were associated with SA included lifetime histories of SA, suicidal ideation (SI), depression, cocaine as primary substance of use, outpatient methadone treatment, and short-term inpatient treatment. Male sex, older age, and minority race or ethnicity were associated with lower likelihood of SA. After controlling for baseline predictors, variables assessed at 12 months associated with SA included SI during follow-up and daily or more use of cocaine. The data contribute to a small but growing literature of prospective studies of SA among treated SUDs, and suggest that SUDs with cocaine use disorders in particular should be a focus of prevention efforts.

  14. Early Indicators of Autism Spectrum Disorders at 12 and 24 Months of Age: A Prospective, Longitudinal Comparative Study

    ERIC Educational Resources Information Center

    Veness, Carly; Prior, Margot; Bavin, Edith; Eadie, Patricia; Cini, Eileen; Reilly, Sheena

    2012-01-01

    Prospective questionnaire data from a longitudinal population sample on children with autism spectrum disorders (ASD), developmental delay, specific language impairment, or typical development (TD), were collected at ages eight, 12 and 24 months, via the Communication and Symbolic Behavior Scale Developmental Profile (CSBS)--Infant Toddler…

  15. Temperament and Behaviour of Infants Aged 4-12 Months on Admission to a Private Mother-Baby Unit and at 1- and 6-Month Follow-Up

    ERIC Educational Resources Information Center

    Fisher, Jane; Rowe, Heather; Feekery, Colin

    2004-01-01

    While infant behaviour is influenced by maternal care, infant crying and dysregulated sleep can reciprocally affect maternal mood. The temperament and behaviour of two 4-12-months-old infant cohorts admitted with their mothers to a residential parenting program were examined using behaviour charts and the Short Infant Temperament Questionnaire…

  16. Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort.

    PubMed

    Danuser, Brigitta; Simcox, Amira; Studer, Regina; Koller, Michael; Wild, Pascal

    2017-01-01

    Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model. All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation. Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation), pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6) and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1%) was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery. Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified.

  17. Coverage and Consumption of Micronutrient Powders, Fortified Staples, and Iodized Salt Among Children Aged 6 to 23 Months in Selected Neighborhoods of Nairobi County, Kenya.

    PubMed

    Leyvraz, Magali; David-Kigaru, Dorcus M; Macharia-Mutie, Catherine; Aaron, Grant J; Roefs, Marlene; Tumilowicz, Alison

    2018-03-01

    Intake of micronutrient-rich foods among children aged 6 to 23 months in Nairobi is low. This study aimed to assess existing coverage and utilization of micronutrient powders (MNPs), fortified staples, and iodized salt among children aged 6 to 23 months prior to implementation of an MNP program. A cross-sectional survey among caregivers of children aged 6 to 23 months (n = 618) was implemented in 7 neighborhoods within Nairobi County, representing the implementation area of the new MNP program. Results for MNP coverage and utilization showed 28.5% of all caregivers were aware of MNP, 18.5% had ever received MNP for their child, and 10.8% had fed MNP to their child in the previous 7 days. Effective coverage (ie, the child had been given the MNP at least 3 times in the previous 7 days) was 5.8%. Effective coverage of infants and young children with poor feeding practices was significantly lower as compared to those with non-poor feeding practices (coverage ratio, 0.34; confidence interval, 0.12-0.70). Most households purchased iodized salt (96.9%), fortified oil (61.0%), and fortified maize flour (93.9%). An estimated 23.9% of vitamin A requirements of children (6-23 months) were provided from fortified oil and 50.7% of iron from fortified maize flour. Most households consumed processed milk (81%). Coverage of MNPs in the surveyed neighborhoods was low. Coverage of fortified salt, oil, and maize flour was high and provided significant amount of micronutrients to children. Processed milk has potential as a vehicle for food fortification.

  18. Effects of 6 months of aging in water on hardness and surface roughness of two microhybrid dental composites.

    PubMed

    de Moraes, Rafael Ratto; Marimon, José Laurindo Machado; Schneider, Luis Felipe; Sinhoreti, Mário Alexandre Coelho; Correr-Sobrinho, Lourenço; Bueno, Márcia

    2008-06-01

    This study assessed the effect of 6 months of aging in water on surface roughness and surface/subsurface hardness of two microhybrid resin composites. Filtek Z250 and Charisma were tested. Cylindrical specimens were obtained and stored in distilled water for 24 hours or 6 months, at 37 degrees C. For Knoop hardness evaluation, the specimens were transversely wet-flattened, and indentations were made on surface and subsurface layers. Data were submitted to three-way ANOVA and Tukey's test (alpha < or = 0.05). Surface roughness baseline measurements were made at 24 hours and repeated after 6 months of storage. Data were submitted to repeated measures ANOVA and Tukey's test (alpha < or = 0.05). Surface hardness (KHN, kg/mm(2)) means (+/- standard deviation) ranged from 55 +/- 1 to 49 +/- 4 for Z250 and from 50 +/- 2 to 41 +/- 3 for Charisma, at 24 hours and 6 months, respectively. Subsurface means ranged from 58 +/- 2 to 61 +/- 3 for Z250 and from 50 +/- 1 to 54 +/- 2 for Charisma, at 24 hours and 6 months. For both composites, the aged specimens presented significantly softer surfaces (p < 0.01). For the subsurface hardness, alteration after storage was detected only for Charisma, which presented a significant rise in hardness (p < 0.01). Z250 presented significantly harder surface and subsurface layers in comparison with Charisma. Surface roughness (Ra, mum) means ranged from 0.07 +/- 0.00 to 0.07 +/- 0.01 for Z250 and from 0.06 +/- 0.01 to 0.07 +/- 0.01 for Charisma, at 24 hours and 6 months, respectively. For both composites, no significant roughness alteration was detected during the study (p= 0.386). The 6-month period of storage in water presented a significant softening effect on the surfaces of the composites, although no significant deleterious alteration was detected for the subsurface hardness. In addition, the storage period had no significant effect on the surface roughness of the materials.

  19. New Autism Diagnostic Interview-Revised Algorithms for Toddlers and Young Preschoolers from 12 to 47 Months of Age

    ERIC Educational Resources Information Center

    Kim, So Hyun; Lord, Catherine

    2012-01-01

    Autism Diagnostic Interview-Revised (Rutter et al. in "Autism diagnostic interview-revised." Western Psychological Services, Los Angeles, 2003) diagnostic algorithms specific to toddlers and young preschoolers were created using 829 assessments of children aged from 12 to 47 months with ASD, nonspectrum disorders, and typical development. The…

  20. Language development at 18 months is related to multimodal communicative strategies at 12 months.

    PubMed

    Igualada, Alfonso; Bosch, Laura; Prieto, Pilar

    2015-05-01

    The present study investigated the degree to which an infants' use of simultaneous gesture-speech combinations during controlled social interactions predicts later language development. Nineteen infants participated in a declarative pointing task involving three different social conditions: two experimental conditions (a) available, when the adult was visually attending to the infant but did not attend to the object of reference jointly with the child, and (b) unavailable, when the adult was not visually attending to neither the infant nor the object; and (c) a baseline condition, when the adult jointly engaged with the infant's object of reference. At 12 months of age measures related to infants' speech-only productions, pointing-only gestures, and simultaneous pointing-speech combinations were obtained in each of the three social conditions. Each child's lexical and grammatical output was assessed at 18 months of age through parental report. Results revealed a significant interaction between social condition and type of communicative production. Specifically, only simultaneous pointing-speech combinations increased in frequency during the available condition compared to baseline, while no differences were found for speech-only and pointing-only productions. Moreover, simultaneous pointing-speech combinations in the available condition at 12 months positively correlated with lexical and grammatical development at 18 months of age. The ability to selectively use this multimodal communicative strategy to engage the adult in joint attention by drawing his attention toward an unseen event or object reveals 12-month-olds' clear understanding of referential cues that are relevant for language development. This strategy to successfully initiate and maintain joint attention is related to language development as it increases learning opportunities from social interactions. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. [Mother’s strategies in the feeding process of children aged 6 to 24 months in two rural communities of Lima, Peru].

    PubMed

    Dolores-Maldonado, Gandy; Delgado-Pérez, Doris; Creed-Kanashiro, Hilary

    2015-01-01

    To know the strategies of mothers during the feeding process in children aged 6 to 24 months in two communities of Lima. Qualitative study in which 18 primiparous or multiparous mothers of children aged 6-24 months participated. We used intentional sampling by age and parity of the mother, and conducted 36 direct observations and 12 in-depth interviews. Inductive data analysis was conducted, categories were grouped by subject and technique, reaching a consensus of the themes among the authors. Verbal communication was markedly greater in multiparous mothers. Three major themes were found. Verbal mother-child communication, multiparous mothers were those who used affectionate words during the meal. Involvement and strategies in the feeding process was seen as characterized by encouraging the child to finish the meal with games and singing that multiparous mothers performed sometimes with help from other family members. However these results were not obtained by primiparous mothers, they usually became withdrawn upon the rejection of food. The context during eating favors whether a child will finish the meal. The strategies used during meal time were varied and biased, predominantly by multiparous mothers, acting in a more active and responsive way. However primiparous mothers may act in an authoritarian manner when the child gets dirty, plays and/or refuses food.

  2. Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia

    PubMed Central

    Syahrul; Sulistyorini, Lantin; Rondhianto; Yudisianto, Alfi

    2017-01-01

    Purpose This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia. Methods A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. Results LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ (0.96±0.97) and WAZ (0.45±0.72) increased; BAZ increased (1.12±0.93) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by 0.53±0.52, which indicated 57.8% had short stature. Conclusion The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers. PMID:29158766

  3. Retreatment of Exudative Age-Related Macular Degeneration after Loading 3-Monthly Intravitreal Ranibizumab.

    PubMed

    Sugiyama, Atsushi; Sakurada, Yoichi; Honda, Shigeru; Miki, Akiko; Matsumiya, Wataru; Yoneyama, Seigo; Kikushima, Wataru; Iijima, Hiroyuki

    2018-01-01

    The aim of this study was to investigate the clinical implications of required retreatment after 3-monthly intravitreal ranibizumab (IVR) injections followed by as-needed reinjections up to 5 years in eyes with exudative age-related macular degeneration (AMD). A retrospective cohort study was conducted for 165 treatment-naïve eyes from 165 patients with exudative AMD. Visual changes were investigated in terms of the required retreatments. Retreatment-free proportions were 37.0, 23.7, 16.6, 12.1, and 10.5% at 12, 24, 36, 48, and 60 months, respectively. Visual changes were significantly better in eyes which did not require retreatment at every yearly checkpoint within the 5 years. A multivariate logistic regression analysis revealed that requirement of additional IVR treatments in the first 12-24 months was associated with the T allele (risk allele) of ARMS2 A69S (p = 0.010 and 0.015, respectively). Cox regression analysis revealed that older age (p = 0.046) and the T allele of ARMS2 A69S (p = 0.036) were associated with required retreatment within the 5-year follow-up period. Age and the T allele of ARMS2 A69S are the risk factors requiring retreatments, leading to poor visual change in eyes with exudative AMD following the initial 3-monthly IVR. © 2017 S. Karger AG, Basel.

  4. A Case Study Assessing the Auditory and Speech Development of Four Children Implanted with Cochlear Implants by the Chronological Age of 12 Months

    PubMed Central

    2013-01-01

    Children with severe hearing loss most likely receive the greatest benefit from a cochlear implant (CI) when implanted at less than 2 years of age. Children with a hearing loss may also benefit greater from binaural sensory stimulation. Four children who received their first CI under 12 months of age were included in this study. Effects on auditory development were determined using the German LittlEARS Auditory Questionnaire, closed- and open-set monosyllabic word tests, aided free-field, the Mainzer and Göttinger speech discrimination tests, Monosyllabic-Trochee-Polysyllabic (MTP), and Listening Progress Profile (LiP). Speech production and grammar development were evaluated using a German language speech development test (SETK), reception of grammar test (TROG-D) and active vocabulary test (AWST-R). The data showed that children implanted under 12 months of age reached open-set monosyllabic word discrimination at an age of 24 months. LiP results improved over time, and children recognized 100% of words in the MTP test after 12 months. All children performed as well as or better than their hearing peers in speech production and grammar development. SETK showed that the speech development of these children was in general age appropriate. The data suggests that early hearing loss intervention benefits speech and language development and supports the trend towards early cochlear implantation. Furthermore, the data emphasizes the potential benefits associated with bilateral implantation. PMID:23509653

  5. A case study assessing the auditory and speech development of four children implanted with cochlear implants by the chronological age of 12 months.

    PubMed

    May-Mederake, Birgit; Shehata-Dieler, Wafaa

    2013-01-01

    Children with severe hearing loss most likely receive the greatest benefit from a cochlear implant (CI) when implanted at less than 2 years of age. Children with a hearing loss may also benefit greater from binaural sensory stimulation. Four children who received their first CI under 12 months of age were included in this study. Effects on auditory development were determined using the German LittlEARS Auditory Questionnaire, closed- and open-set monosyllabic word tests, aided free-field, the Mainzer and Göttinger speech discrimination tests, Monosyllabic-Trochee-Polysyllabic (MTP), and Listening Progress Profile (LiP). Speech production and grammar development were evaluated using a German language speech development test (SETK), reception of grammar test (TROG-D) and active vocabulary test (AWST-R). The data showed that children implanted under 12 months of age reached open-set monosyllabic word discrimination at an age of 24 months. LiP results improved over time, and children recognized 100% of words in the MTP test after 12 months. All children performed as well as or better than their hearing peers in speech production and grammar development. SETK showed that the speech development of these children was in general age appropriate. The data suggests that early hearing loss intervention benefits speech and language development and supports the trend towards early cochlear implantation. Furthermore, the data emphasizes the potential benefits associated with bilateral implantation.

  6. Household Food Insecurity and Its Association with Nutritional Status of Children 6-59 Months of Age in East Badawacho District, South Ethiopia.

    PubMed

    Betebo, Bealu; Ejajo, Tekle; Alemseged, Fissahaye; Massa, Desalegn

    2017-01-01

    Background . Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective . To assess household food insecurity and its association with the nutritional status of children 6-59 months of age in East Badawacho District, South Ethiopia. Methods . A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6-59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result . The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78-8.19) and stunting (AOR = 6.7; CI = 3.71-12.1) but not with wasting. Conclusion and Recommendation . Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children.

  7. A next-generation bioresorbable coronary scaffold system: from bench to first clinical evaluation: 6- and 12-month clinical and multimodality imaging results.

    PubMed

    Verheye, Stefan; Ormiston, John A; Stewart, James; Webster, Mark; Sanidas, Elias; Costa, Ricardo; Costa, J Ribamar; Chamie, Daniel; Abizaid, Andrea S; Pinto, Ibraim; Morrison, Lynn; Toyloy, Sara; Bhat, Vinayak; Yan, John; Abizaid, Alexandre

    2014-01-01

    This study sought to perform clinical and imaging assessments of the DESolve Bioresorbable Coronary Scaffold (BCS). BCS, which is drug eluting, may have potential advantages compared with conventional metallic drug-eluting stents. The DESolve system, designed to provide vessel support and neointimal suppression, combines a poly-l-lactic acid-based scaffold with the antiproliferative myolimus. The DESolve First-in-Man (a non-randomized, consecutive enrollment evaluation of the DESolve myolimus eluting bioresorbable coronary stent in the treatment of patients with de novo native coronary artery lesions) trial was a prospective multicenter study enrolling 16 patients eligible for treatment. The principal safety endpoint was a composite of cardiac death, myocardial infarction, and clinically indicated target lesion revascularization. The principal imaging endpoint was in-scaffold late lumen loss (LLL) assessed by quantitative coronary angiography (QCA) at 6 months. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) imaging was performed at baseline and 6 months; multislice computed tomography (MSCT) was performed at 12 months. Acute procedural success was achieved in 15 of 15 patients receiving a study scaffold. At 12 months, there was no scaffold thrombosis and no major adverse cardiac events directly attributable to the scaffold. At 6 months, in-scaffold LLL (by QCA) was 0.19 ± 0.19 mm; neointimal volume (by IVUS) was 7.19 ± 3.56%, with no evidence of scaffold recoil or late malapposition. Findings were confirmed with OCT and showed uniform, thin neointimal coverage (0.12 ± 0.04 mm). At 12 months, MSCT demonstrated excellent vessel patency. This study demonstrated the feasibility and efficacy of the DESolve BCS. Results showing low in-scaffold LLL, low % neointimal volume at 6 months, no chronic recoil, and maintenance of lumen patency at 12 months prompt further study. (DESolve First-in-Man; EudraCT number 2011-000027-32). Copyright © 2014

  8. Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort

    PubMed Central

    Danuser, Brigitta; Simcox, Amira; Koller, Michael; Wild, Pascal

    2017-01-01

    Background Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model. Methods All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation. Results Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation), pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6) and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1%) was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery. Conclusion Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified. PMID:28448501

  9. Anderson-hynes pyeloplasty in patients less than 12 months old. Is the laparoscopic approach safe and feasible?

    PubMed

    García-Aparicio, Luis; Blazquez-Gomez, Eva; Martin, Oriol; Manzanares, Alejandro; García-Smith, Natalie; Bejarano, Miguel; Rodo, Joan; Ribó, Josep M

    2014-08-01

    The aim of our study is to compare the outcomes of open and laparoscopic pyeloplasty in children less than 12 months of age. We reviewed all medical charts of patients less than 12 months old who underwent pyeloplasty from January 2007 to February 2013. We divided them in two groups: Open pyeloplasty (OP) and laparoscopic pyeloplasty (LP). The following data were analyzed: age, sex, weight, US measurements, operative time, hospital stay, complications, and success rate. Quantitative data were analyzed with the Student t test or Mann-Whitney U test, and chi-square test or Fisher test for qualitative data. Fifty-eight patients (46 boys and 12 girls) with a mean age of 4.66 months (±3.05) were included. Mean age was 4.25 months and 5.15 months in OP and LP group respectively. Mean weight was 6.78 kg and 7.02 kg in OP and LP groups. There were no statistical differences in age, weight, and sex between OP and LP groups. There were no statistical differences in preoperative ultrasonography measurements. Mean posterior-anterior (PA) pelvis diameter was 28.57 mm and 23.94 mm in OP and LP groups, respectively. Mean calices diameter were 10.86 mm and 10.96 mm in OP and LP groups, respectively. Mean operative time was 129.53 minutes in the OP group and 151.92 minutes in the LP group with statistical differences (P=0.018). Mean hospital stay was 6.34 days in the OP group and 3.46 in the LP group with statistical differences (P<0.05). No intraoperative and postoperative complications were found in either group. Hydronephrosis improved in all patients, and no patient needed a repeated pyeloplasty. The laparoscopic approach of Anderson-Hynes pyeloplasty in patients less than 12 months old is a safe procedure with the same outcomes as the open approach.

  10. Donor age does not influence 12-month outcome after orthotopic liver transplantation.

    PubMed

    Faber, W; Seehofer, D; Puhl, G; Guckelberger, O; Bertram, C; Neuhaus, P; Bahra, M

    2011-12-01

    Orthotopic liver transplantation (OLT) is the most effective treatment for patients with end-stage liver disease to date. The discrepancy between the numbers of donor livers and recipients has become a significant problem, resulting in a high patient mortality on the waiting list. Due to this, an expansion of the donor pool is necessary, for example, by accepting donor grafts from elderly donors. The aim of this study was to investigate the outcome after OLT depending on donor age. We retrospectively evaluated the outcome of 272 full-size cadaveric initial single OLTs within 12 months after OLT. The outcome was analyzed by dividing the collective into four donor age categories: donor age under 50, between 50 and 59, between 60 and 69, and 70 years or above. The outcome after OLT in these patients was retrospectively reviewed by using a prospective database. Patients positive for hepatitis C were excluded from the analysis. No increase of initial nonfunction was observed. Furthermore, no significant differences with regard to surgical complications and serum liver parameter were observed between the groups. Neither patient mortality rates nor rejection rates were different between the groups. However, ischemic-type biliary lesion rates increased significantly with donor age over 70 years (P<.05). The acceptance of liver grafts from older donors is a possible alternative to narrow the gap between donated and required organs. Safe use under optimal protocols is necessary to avoid a deterioration of post-OLT results. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Age-related changes in behavior in C57BL/6J mice from young adulthood to middle age.

    PubMed

    Shoji, Hirotaka; Takao, Keizo; Hattori, Satoko; Miyakawa, Tsuyoshi

    2016-01-28

    Aging is considered to be associated with progressive changes in the brain and its associated sensory, motor, and cognitive functions. A large number of studies comparing young and aged animals have reported differences in various behaviors between age-cohorts, indicating behavioral dysfunctions related to aging. However, relatively little is known about behavioral changes from young adulthood to middle age, and the effect of age on behavior during the early stages of life remains to be understood. In order to investigate age-related changes in the behaviors of mice from young adulthood to middle age, we performed a large-scale analysis of the behavioral data obtained from our behavioral test battery involving 1739 C57BL/6J wild-type mice at 2-12 months of age. Significant behavioral differences between age groups (2-3-, 4-5-, 6-7-, and 8-12-month-old groups) were found in all the behavioral tests, including the light/dark transition, open field, elevated plus maze, rotarod, social interaction, prepulse inhibition, Porsolt forced swim, tail suspension, Barnes maze, and fear conditioning tests, except for the hot plate test. Compared with the 2-3-month-old group, the 4-5- and 6-7-month-old groups exhibited decreased locomotor activity to novel environments, motor function, acoustic startle response, social behavior, and depression-related behavior, increased prepulse inhibition, and deficits in spatial and cued fear memory. For most behaviors, the 8-12-month-old group showed similar but more pronounced changes in most of these behaviors compared with the younger age groups. Older groups exhibited increased anxiety-like behavior in the light/dark transition test whereas those groups showed seemingly decreased anxiety-like behavior measured by the elevated plus maze test. The large-scale analysis of behavioral data from our battery of behavioral tests indicated age-related changes in a wide range of behaviors from young adulthood to middle age in C57BL/6J mice, though

  12. Measles Vaccination Coverage among Latino Children Aged 12 to 59 Months in Los Angeles County: A Household Survey.

    ERIC Educational Resources Information Center

    Ewert, Donnell P.; And Others

    1991-01-01

    Examines the results of a household survey of measles vaccination coverage among Hispanic American children aged 12 to 59 months. Between 81 percent and 91 percent of the children have been vaccinated, a percentage insufficient to stop the high rate of measles transmission within this population. Recommends that public health efforts be focused on…

  13. Predicting the Onset of Anxiety Syndromes at 12 Months in Primary Care Attendees. The PredictA-Spain Study

    PubMed Central

    Moreno-Peral, Patricia; Luna, Juan de Dios; Marston, Louise; King, Michael; Nazareth, Irwin; Motrico, Emma; GildeGómez-Barragán, María Josefa; Torres-González, Francisco; Montón-Franco, Carmen; Sánchez-Celaya, Marta; Díaz-Barreiros, Miguel Ángel; Vicens, Catalina; Muñoz-Bravo, Carlos; Bellón, Juan Ángel

    2014-01-01

    Background There are no risk algorithms for the onset of anxiety syndromes at 12 months in primary care. We aimed to develop and validate internally a risk algorithm to predict the onset of anxiety syndromes at 12 months. Methods A prospective cohort study with evaluations at baseline, 6 and 12 months. We measured 39 known risk factors and used multilevel logistic regression and inverse probability weighting to build the risk algorithm. Our main outcome was generalized anxiety, panic and other non-specific anxiety syndromes as measured by the Primary Care Evaluation of Mental Disorders, Patient Health Questionnaire (PRIME-MD-PHQ). We recruited 3,564 adult primary care attendees without anxiety syndromes from 174 family physicians and 32 health centers in 6 Spanish provinces. Results The cumulative 12-month incidence of anxiety syndromes was 12.2%. The predictA-Spain risk algorithm included the following predictors of anxiety syndromes: province; sex (female); younger age; taking medicines for anxiety, depression or stress; worse physical and mental quality of life (SF-12); dissatisfaction with paid and unpaid work; perception of financial strain; and the interactions sex*age, sex*perception of financial strain, and age*dissatisfaction with paid work. The C-index was 0.80 (95% confidence interval = 0.78–0.83) and the Hedges' g = 1.17 (95% confidence interval = 1.04–1.29). The Copas shrinkage factor was 0.98 and calibration plots showed an accurate goodness of fit. Conclusions The predictA-Spain risk algorithm is valid to predict anxiety syndromes at 12 months. Although external validation is required, the predictA-Spain is available for use as a predictive tool in the prevention of anxiety syndromes in primary care. PMID:25184313

  14. Association between breast milk intake at 9-10 months of age and growth and development among Malawian young children.

    PubMed

    Kumwenda, Chiza; Hemsworth, Jaimie; Phuka, John; Ashorn, Ulla; Arimond, Mary; Maleta, Kenneth; Prado, Elizabeth L; Haskell, Marjorie J; Dewey, Kathryn G; Ashorn, Per

    2018-07-01

    World Health Organization recommends exclusive breastfeeding for infants for the first 6 months of life, followed by introduction of nutritious complementary foods alongside breastfeeding. Breast milk remains a significant source of nourishment in the second half of infancy and beyond; however, it is not clear whether more breast milk is always better. The present study was designed to determine the association between amount of breast milk intake at 9-10 months of age and infant growth and development by 12-18 months of age. The study was nested in a randomized controlled trial conducted in Malawi. Regression analysis was used to determine associations between breast milk intake and growth and development. Mean (SD) breast milk intake at 9-10 months of age was 752 (244) g/day. Mean (SD) length-for-age z-score at 12 months and change in length-for-age z-score between 12 and 18 months were -1.69 (1.0) and -0.17 (0.6), respectively. At 18 months, mean (SD) expressive vocabulary score was 32 (24) words and median (interquartile range) skills successfully performed for fine, gross, and overall motor skills were 21 (19-22), 18 (16-19), and 38 (26-40), respectively. Breast milk intake (g/day) was not associated with either growth or development. Proportion of total energy intake from breast milk was negatively associated with fine motor (β = -0.18, p = .015) but not other developmental scores in models adjusted for potential confounders. Among Malawian infants, neither breast milk intake nor percent of total energy intake from breast milk at 9-10 months was positively associated with subsequent growth between 12 and 18 months, or development at 18 months. © 2018 John Wiley & Sons Ltd.

  15. Impact of an intervention for recently released homeless offenders on self-reported re-arrest at 6 and 12 months.

    PubMed

    Nyamathi, Adeline; Salem, Benissa E; Farabee, David; Hall, Elizabeth; Zhang, Sheldon; Faucette, Mark; Bond, Doug; Yadav, Kartik

    2017-01-01

    A randomized controlled trial was conducted with 600 paroled men, homeless prior to incarceration, to assess varying levels of peer-coach and nurse-partnered interventions on re-arrest at 6 and 12 months. Findings revealed that positive predictors of re-arrest at 12 months included having received social support from drug users and non-drug users, as well as having used marijuana at least once a week prior to their most recent incarceration. In terms of protective factors, those who participated in a substance abuse program contract within a residential drug treatment program or spent 90 days or greater in a residential drug treatment program were less likely to have been re-arrested within 12 months.

  16. Prevalence and risk factors for neurological disorders in children aged 6 months to 2 years in northern India.

    PubMed

    Kumar, Rashmi; Bhave, Anupama; Bhargava, Roli; Agarwal, Girdhar G

    2013-04-01

    To study prevalence and risk factors for neurological disorders--epilepsy, global developmental delay, and motor, vision, and hearing defects--in children aged 6 months to 2 years in northern India. A two-stage community survey for neurological disorders was conducted in rural and urban areas of Lucknow. After initial screening with a new instrument, the Lucknow Neurodevelopment Screen, screen positives and a random proportion of screen negatives were validated using predefined criteria. Prevalence was calculated by weighted estimates. Demographic, socio-economic, and medical risk factors were compared between validated children who were positive and negative for neurological disorders by univariate and logistic regression analysis. Of 4801 children screened (mean age [SD] 15.32mo [5.96]; 2542 males, 2259 females), 196 were positive; 190 screen positives and 269 screen negatives were validated. Prevalence of neurological disorders was 27.92 per 1000 (weighted 95% confidence interval 12.24-43.60). Significant risk factors (p≤0.01) for neurological disorders were higher age in months (p=0.010), lower mean number of appliances in the household (p=0.001), consanguineous marriage of parents (p=0.010), family history of neurological disorder (p=0.001), and infants born exceptionally small (parental description; p=0.009). On logistic regression, the final model included age (p=0.0193), number of appliances (p=0.0161), delayed cry at birth (p=0.0270), postneonatal meningoencephalitis (p=0.0549), and consanguinity (p=0.0801). Perinatal factors, lower socio-economic status, and consanguinity emerged as predictors of neurological disorders. These factors are largely modifiable. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

  17. Distress among women receiving uninformative BRCA1/2 results: 12-month outcomes.

    PubMed

    O'Neill, Suzanne C; Rini, Christine; Goldsmith, Rachel E; Valdimarsdottir, Heiddis; Cohen, Lawrence H; Schwartz, Marc D

    2009-10-01

    Few data are available regarding the long-term psychological impact of uninformative BRCA1/2 test results. This study examines change in distress from pretesting to 12-months post-disclosure, with medical, family history, and psychological variables, such as pretesting perceived risk of carrying a deleterious mutation prior to testing and primary and secondary appraisals, as predictors. Two hundred and nine women with uninformative BRCA1/2 test results completed questionnaires at pretesting and 1-, 6-, and 12-month post-disclosure, including measures of anxiety and depression, cancer-specific and genetic testing distress. We used a mixed models approach to predict change in post-disclosure distress. Distress declined from pretesting to 1-month post-disclosure, but remained stable thereafter. Primary appraisals predicted all types of distress at 1-month post-disclosure. Primary and secondary appraisals predicted genetic testing distress at 1-month as well as change over time. Receiving a variant of uncertain clinical significance and entering testing with a high expectation for carrying a deleterious mutation predicted genetic testing distress that persisted through the year after testing. As a whole, women receiving uninformative BRCA1/2 test results are a resilient group. For some women, distress experienced in the month after testing does not dissipate. Variables, such as heightened pretesting perceived risk and cognitive appraisals, predict greater likelihood for sustained distress in this group and could be amenable to intervention.

  18. Reasons for non-exclusive breast-feeding in the first 6 months.

    PubMed

    Zielinska, Monika A; Hamulka, Jadwiga

    2018-03-01

    Maternal sociodemographic, delivery- and infant-related factors as well as hospital practice are relevant for breast-feeding practice. The aim of this study was to identify the sociodemographic and delivery-related factors that may affect exclusive breast-feeding (EBF) of infants aged 0-6 months in Poland. A total of 446 mothers (18-42 years old) of infants aged 0-6 months were interviewed using the computer-assisted Web interview method. The questionnaire collected information about maternal sociodemographic situation and anthropometrics, delivery-related factors, and infant feeding-related factors. Data were analyzed using the chi-squared test and Mann-Whitney U-test. Predictors of non-exclusive breast-feeding (N-EBF) in the first 6 months of life were assessed on multivariate logistic regression. A total of 43% of mothers did not breast-feed exclusively (n = 191; N-EBF group) and 57% did breast-feed exclusively during the study period (n = 255; EBF group). After adjustment for other potential risk factors, the highest risk factors for N-EBF were maternal age <20 years (OR, 6.12; P ≤ 0.01), and inadequate breast-feeding knowledge (OR, 3.43; P ≤ 0.01), whereas the lowest risk was associated with pre-pregnancy intention to breast-feed (OR, 0.35; P ≤ 0.01), very good knowledge about breast-feeding (OR, 0.45; P ≤ 0.001) and maternal age 26-30 years (OR, 0.48; P ≤ 0.001). In a multivariate model, maternal education, employment status and preterm delivery were no longer statistically significant. Breast-feeding practice is influenced by a variety of factors, including sociodemographic and psychosocial conditions, maternal obesity and mode of delivery. Further work is needed to establish the role of education and prophylactic programs in modifying the aforementioned risk factors. © 2017 Japan Pediatric Society.

  19. Determinants of immunisation coverage of children aged 12-59 months in Indonesia: a cross-sectional study.

    PubMed

    Herliana, Putri; Douiri, Abdel

    2017-12-22

    Despite the adoption of WHO's Expanded Programme on Immunisation in Indonesia since 1977, a large proportion of children are still completely unimmunised or only partly immunised. This study aimed to assess factors associated with low immunisation coverage of children in Indonesia. Children aged 12-59 months in Indonesia. The socioeconomic characteristics and immunisation status of the children were obtained from the most recent Demographic and Health Survey, the 2012 Indonesia Demographic and Health Survey. Participants were randomly selected through a two-stage stratified sampling design. Data from 14 401 children aged 12-59 months nested within 1832 census blocks were included in the analysis. Multilevel logistic regression models were constructed to account for hierarchical structure of the data. The mean age of the children was 30 months and they were equally divided by sex. According to the analysis, 32% of the children were fully immunised in 2012. Coverage was significantly lower among children who lived in Maluku and Papua region (adjusted OR: 1.94; 95% CI 1.42 to 2.64), were 36-47 months old (1.39; 1.20 to 1.60), had higher birth order (1.68; 1.28 to 2.19), had greater family size (1.47; 1.11 to 1.93), whose mother had no education (2.13; 1.22 to 3.72) and from the poorest households (1.58; 1.26 to 1.99). The likelihood of being unimmunised was also higher among children without health insurance (1.16; 1.04 to 1.30) and those who received no antenatal (3.28; 2.09 to 5.15) and postnatal care (1.50; 1.34 to 1.69). Socioeconomic factors were strongly associated with the likelihood of being unimmunised in Indonesia. Unimmunised children were geographically clustered and lived among the most deprived population. To achieve WHO target of protective coverage, public health interventions must be designed to meet the needs of these high-risk groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  20. Moderate Traumatic Brain Injury: Clinical Characteristics and a Prognostic Model of 12-Month Outcome.

    PubMed

    Einarsen, Cathrine Elisabeth; van der Naalt, Joukje; Jacobs, Bram; Follestad, Turid; Moen, Kent Gøran; Vik, Anne; Håberg, Asta Kristine; Skandsen, Toril

    2018-06-01

    Patients with moderate traumatic brain injury (TBI) often are studied together with patients with severe TBI, even though the expected outcome of the former is better. Therefore, we aimed to describe patient characteristics and 12-month outcomes, and to develop a prognostic model based on admission data, specifically for patients with moderate TBI. Patients with Glasgow Coma Scale scores of 9-13 and age ≥16 years were prospectively enrolled in 2 level I trauma centers in Europe. Glasgow Outcome Scale Extended (GOSE) score was assessed at 12 months. A prognostic model predicting moderate disability or worse (GOSE score ≤6), as opposed to a good recovery, was fitted by penalized regression. Model performance was evaluated by area under the curve of the receiver operating characteristics curves. Of the 395 enrolled patients, 81% had intracranial lesions on head computed tomography, and 71% were admitted to an intensive care unit. At 12 months, 44% were moderately disabled or worse (GOSE score ≤6), whereas 8% were severely disabled and 6% died (GOSE score ≤4). Older age, lower Glasgow Coma Scale score, no day-of-injury alcohol intoxication, presence of a subdural hematoma, occurrence of hypoxia and/or hypotension, and preinjury disability were significant predictors of GOSE score ≤6 (area under the curve = 0.80). Patients with moderate TBI exhibit characteristics of significant brain injury. Although few patients died or experienced severe disability, 44% did not experience good recovery, indicating that follow-up is needed. The model is a first step in development of prognostic models for moderate TBI that are valid across centers. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  1. Age-related changes in tissue signal properties within cortical areas important for word understanding in 12- to 19-month-old infants.

    PubMed

    Travis, Katherine E; Curran, Megan M; Torres, Christina; Leonard, Matthew K; Brown, Timothy T; Dale, Anders M; Elman, Jeffrey L; Halgren, Eric

    2014-07-01

    Recently, our laboratory has shown that the neural mechanisms for encoding lexico-semantic information in adults operate functionally by 12-18 months of age within left frontotemporal cortices (Travis et al., 2011. Spatiotemporal neural dynamics of word understanding in 12- to 18-month-old-infants. Cereb Cortex. 8:1832-1839). However, there is minimal knowledge of the structural changes that occur within these and other cortical regions important for language development. To identify regional structural changes taking place during this important period in infant development, we examined age-related changes in tissue signal properties of gray matter (GM) and white matter (WM) intensity and contrast. T1-weighted surface-based measures were acquired from 12- to 19-month-old infants and analyzed using a general linear model. Significant age effects were observed for GM and WM intensity and contrast within bilateral inferior lateral and anterovental temporal regions, dorsomedial frontal, and superior parietal cortices. Region of interest (ROI) analyses revealed that GM and WM intensity and contrast significantly increased with age within the same left lateral temporal regions shown to generate lexico-semantic activity in infants and adults. These findings suggest that neurophysiological processes supporting linguistic and cognitive behaviors may develop before cellular and structural maturation is complete within associative cortices. These results have important implications for understanding the neurobiological mechanisms relating structural to functional brain development. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Mini Nutritional Assessment predicts gait status and mortality 6 months after hip fracture.

    PubMed

    Gumieiro, David N; Rafacho, Bruna P M; Gonçalves, Andrea F; Tanni, Suzana E; Azevedo, Paula S; Sakane, Daniel T; Carneiro, Carlos A S; Gaspardo, David; Zornoff, Leonardo A M; Pereira, Gilberto J C; Paiva, Sergio A R; Minicucci, Marcos F

    2013-05-01

    The aim of the present study was to evaluate the Mini Nutritional Assessment (MNA), the Nutritional Risk Screening (NRS) 2002 and the American Society of Anesthesiologists Physical Status Score (ASA) as predictors of gait status and mortality 6 months after hip fracture. A total of eighty-eight consecutive patients over the age of 65 years with hip fracture admitted to an orthopaedic unit were prospectively evaluated. Within the first 72 h of admission, each patient's characteristics were recorded, and the MNA, the NRS 2002 and the ASA were performed. Gait status and mortality were evaluated 6 months after hip fracture. Of the total patients, two were excluded because of pathological fractures. The remaining eighty-six patients (aged 80·2 (sd 7·3) years) were studied. Among these patients 76·7 % were female, 69·8 % walked with or without support and 12·8 % died 6 months after the fracture. In a multivariate analysis, only the MNA was associated with gait status 6 months after hip fracture (OR 0·773, 95 % CI 0·663, 0·901; P= 0·001). In the Cox regression model, only the MNA was associated with mortality 6 months after hip fracture (hazard ratio 0·869, 95 % CI 0·757, 0·998; P= 0·04). In conclusion, the MNA best predicts gait status and mortality 6 months after hip fracture. These results suggest that the MNA should be included in the clinical stratification of patients with hip fracture to identify and treat malnutrition in order to improve the outcomes.

  3. Digit Sucking Habit and Association with Dental Caries and Oral Hygiene Status of Children Aged 6 Months to 12 Years Resident in Semi-Urban Nigeria

    PubMed Central

    Kolawole, Kikelomo Adebanke; Folayan, Morenike Oluwatoyin; Agbaje, Hakeem Olatunde; Oyedele, Titus Ayodeji; Oziegbe, Elizabeth Obhioneh; Onyejaka, Nneka Kate; Chukwumah, Nneka Maureen; Oshomoji, Olusegun Victor

    2016-01-01

    Objectives Non-nutritive sucking (NNS) is a common behavior in childhood. The association between digit sucking, dental caries and oral health has been studied with inconclusive results. The objectives of this study were to determine the prevalence of, and the association between digit sucking, caries and oral hygiene status of children age six months to 12 years, resident in Ile-Ife, Osun State, Nigeria. Methods A cross-sectional study was conducted in Ife Central Local Government Area of Osun State. Data were collected through a household survey using a multi-stage sampling procedure from children between six months and 12 years. Details of each child’s socio-demographic characteristics, digit sucking habits, caries status and oral health status were collected. The association between digit sucking, caries status and oral hygiene status was determined using Chi square and Logistic regression. Results The mean age of the 992 study participants was 5.8 ± (3.2) years. The prevalence of digit sucking, caries and poor oral hygiene were 7.2%, 10.5% and 2.4% respectively. The mean dmft score was 0.22 ± (0.80), mean DMFT score was 0.04 ± (0.30) while mean Oral Hygiene Index score was 1.27 ± (0.73). Digit sucking increased the odds of having caries (OR: 1.28; CI: 0.58–2.81) but decreased the odds of having poor oral hygiene (OR: 0.58; CI: 0.34–1.01) insignificantly. Conclusions Digit sucking was not a significant predictor of caries and oral hygiene status, although the odds of having caries increased while the odds of having poor oral hygiene decreased with digit sucking. PMID:26890262

  4. Digit Sucking Habit and Association with Dental Caries and Oral Hygiene Status of Children Aged 6 Months to 12 Years Resident in Semi-Urban Nigeria.

    PubMed

    Kolawole, Kikelomo Adebanke; Folayan, Morenike Oluwatoyin; Agbaje, Hakeem Olatunde; Oyedele, Titus Ayodeji; Oziegbe, Elizabeth Obhioneh; Onyejaka, Nneka Kate; Chukwumah, Nneka Maureen; Oshomoji, Olusegun Victor

    2016-01-01

    Non-nutritive sucking (NNS) is a common behavior in childhood. The association between digit sucking, dental caries and oral health has been studied with inconclusive results. The objectives of this study were to determine the prevalence of, and the association between digit sucking, caries and oral hygiene status of children age six months to 12 years, resident in Ile-Ife, Osun State, Nigeria. A cross-sectional study was conducted in Ife Central Local Government Area of Osun State. Data were collected through a household survey using a multi-stage sampling procedure from children between six months and 12 years. Details of each child's socio-demographic characteristics, digit sucking habits, caries status and oral health status were collected. The association between digit sucking, caries status and oral hygiene status was determined using Chi square and Logistic regression. The mean age of the 992 study participants was 5.8 ± (3.2) years. The prevalence of digit sucking, caries and poor oral hygiene were 7.2%, 10.5% and 2.4% respectively. The mean dmft score was 0.22 ± (0.80), mean DMFT score was 0.04 ± (0.30) while mean Oral Hygiene Index score was 1.27 ± (0.73). Digit sucking increased the odds of having caries (OR: 1.28; CI: 0.58-2.81) but decreased the odds of having poor oral hygiene (OR: 0.58; CI: 0.34-1.01) insignificantly. Digit sucking was not a significant predictor of caries and oral hygiene status, although the odds of having caries increased while the odds of having poor oral hygiene decreased with digit sucking.

  5. Local food supplementation and psychosocial stimulation improve linear growth and cognitive development among Indonesian infants aged 6 to 9 months.

    PubMed

    Helmizar, Helmizar; Jalal, Fasli; Lipoeto, Nur Indrawati; Achadi, Endang L

    2017-01-01

    To evaluate the effect of culturally-relevant food supplementation and psychosocial stimulation on infant growth and development. A community-based randomized controlled trial was conducted in 40 clusters from 5 selected villages in Tanah Datar District of West Sumatera, Indonesia. We assessed 355 infants aged 6 to 9 months at the beginning of the study. The infants were divided into 4 groups: 1) Food Supplementation (FS); 2) Psychosocial Stimulation (PS); 3) Food Supplementation and Psychosocial Stimulation (FS+PS); and 4) Control Group (CG). The formula food supplement was comprised of a variety of local food sources (local MP-ASI) and adjusted for the local habits. The quality of psychosocial stimulation was assessed with the Infant HOME inventory method. Progress at 6 months was assessed by anthropometry and the Bayley scores of cognition, language and motor function. There were improvements in linear growth, cognitive and motor development of children in the FS (p<0.05) and the FS+PS (p<0.01) groups compared to the CG. After six months of intervention, mean length increased to 6.86±2.08 cm and 6.66±2.41 cm for FS and FS+PS respectively (p<0.05). With the combination of food supplementation and psychosocial stimulation (FS+PS), cognitive development increased to 21.4±12.2 points (effect size 0.56) (p<0.01) and motor development increased to 20.7±18.4 points (effect size 0.50) (p<0.001). Combined intervention with local food supplementation and psychosocial stimulation improved infant growth, cognitive and motor development.

  6. NICE guidelines for imaging studies in children with UTI adequate only in boys under the age of 6 months.

    PubMed

    Ristola, Marko Tapani; Hurme, Timo

    2013-03-01

    The purpose of this study was to evaluate the applicability of the National Institute for Health and Clinical Excellence (NICE) guidelines for imaging studies in children under the age of three with first urinary tract infection (UTI). In our cohort of 112 patients, we gathered data regarding the occurrence of indications for ultrasonography (US) and voiding cystourethrography (VCUG) according to the NICE guidelines, dimercaptosuccinic acid (DMSA) scintigraphy examinations, UTI recurrence, antimicrobial prophylaxis (AMP), anti-reflux procedures, and other urological procedures. If the NICE guidelines had been applied, 13 of the 25 patients (52 %) with vesicoureteral reflux (VUR), including 6 of the 12 patients (50 %) with dilating VUR and 3 of the 4 patients who underwent endoscopic anti-reflux treatment, would have been missed, and a negative VCUG would have been avoided in 25 of the 42 patients (60 %) with no VUR. None of the missed diagnoses occurred in the younger boys' group. Based on these preliminary analyses, we feel that the NICE guidelines for imaging studies in children under 3 years old with UTI may be applicable to clinical use only in boys under 6 months of age. For other patients the guidelines were unsuccessful.

  7. Behavioral characteristics of very-low-birth-weight infants of varying biologic risk at 6, 15, and 24 months of age.

    PubMed

    Oehler, J M; Thompson, R J; Goldstein, R F; Gustafson, K E; Brazy, J E

    1996-01-01

    To explore the relationship between developmental outcome and behavior of very-low-birth-weight (VLBW) infants (< or = 1500 g) at high and low biologic risk. Descriptive, ex post facto. Clinic for follow-up of infants at high risk. A convenience sample of 102 VLBW infants, free of major congenital anomalies, who completed 6-, 15-, and 24-month developmental testing and who were part of a larger study of 274 VLBW infants. Bayley Scales of Infant Development. Infants at high biologic risk, versus infants at low biologic risk, were less attentive and active through age 15 months and were less adept in gross and fine motor skills through age 24 months (p < or = 0.05-0.001). Infants with continuous delay were less attentive than infants with no delay or late delay through age 24 months, less active through age 15 months (p < or = 0.001-0.001), and less skilled in motor behaviors through age 24 months (p < or = 0.05-0.001). Infants at high biologic risk and infants with developmental delays are less attentive, less active, and less skilled in motor tasks during the first 15-24 months of life, suggesting an association between biologic risk and behavior and developmental delay and behavior.

  8. Household Food Insecurity and Its Association with Nutritional Status of Children 6–59 Months of Age in East Badawacho District, South Ethiopia

    PubMed Central

    Ejajo, Tekle; Alemseged, Fissahaye; Massa, Desalegn

    2017-01-01

    Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6–59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6–59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78–8.19) and stunting (AOR = 6.7; CI = 3.71–12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children. PMID:28408936

  9. Comparison of the effects of 12 months of monthly minodronate monotherapy and monthly minodronate combination therapy with vitamin K2 or eldecalcitol in patients with primary osteoporosis.

    PubMed

    Ebina, Kosuke; Noguchi, Takaaki; Hirao, Makoto; Kaneshiro, Shoichi; Tsukamoto, Yasunori; Yoshikawa, Hideki

    2016-05-01

    The aim of this observational, nonrandomized study was to compare the effects of 12 months of monthly minodronate (MIN; 50 mg/month) monotherapy and MIN combination therapy with vitamin K2 (VK; 45 mg/day) or eldecalcitol (ELD; 0.75 μg/day) in treatment-naïve patients with primary osteoporosis. Patients (n = 193; 178 postmenopausal women and 15 men; mean age 71.6 years) were treated with (1) MIN monotherapy (n = 63), (2) MIN plus VK combination therapy (n = 50), or (3) MIN plus ELD combination therapy (n = 80) for 12 months. Changes in bone mineral density (BMD) and the levels of serum bone turnover markers were monitored. No significant difference was observed in baseline BMD among the three groups. After 12 months, BMD increased by 2.93, 4.65, and 6.55 % in the lumbar spine, 0.66, 2.57, and 3.42 % in the total hip, and 0.05, 2.06, and 3.58 % in the femoral neck in groups 1, 2, and 3, respectively. The BMD increase induced by MIN plus ELD combination therapy was significantly greater than that induced by MIN monotherapy in the lumbar spine (P = 0.0002), total hip (P = 0.003), and femoral neck (P = 0.004), and also that induced by MIN plus VK combination therapy in the lumbar spine (P = 0.03). MIN plus ELD combination therapy compared with MIN monotherapy resulted in a greater decrease in serum procollagen type I N-terminal propeptide levels (-37.4 % vs -54.6 %; P = 0.001) and tartrate-resistant acid phosphatase isoform 5b levels (-41.1 % vs -52.9 %; P = 0.009) at 3 months, and a greater decrease in procollagen type I N-terminal propeptide levels (-64.3 % vs -50.3 %; P = 0.03) and a decrease in intact parathyroid hormone levels (-12.3 % vs 14.0 %; P = 0.01) at 12 months. Combination therapy with MIN and VK or ELD for 12 months showed additive effects in decreasing the levels of bone turnover markers compared with MIN monotherapy, whereas MIN plus ELD combination therapy resulted in the highest BMD increase compared

  10. [Adherence to pharmaceutical guidance in patients over 85 years of age with chronic heart failure-stage C. Effects on 12-month mortality].

    PubMed

    Esteve Arríen, Ainhoa; Domínguez de Pablos, Gema; Minaya Saiz, Jesús

    2009-01-01

    To describe factors related to prescription on discharge of treatment for Chronic Heart Failure(CHF)-Stage C and to analyse whether this is related to 12month-mortality. Observational follow-up study of patients over 85 hospitalized during 2006/7 with Stage C-Chronic Heart Failure in an outskirt support hospital. Drug-prescription adherence was assessed according to the American Heart Society 2005-Guidelines and recommendations of the American Geriatrics Society-2007. A multivariate analysis of logistic regression was performed to obtain odds for 12-month mortality for each recommended therapy, adjusting by mortality risk factors. 104 patients aged 90+/-3yr were followed on discharge, 85% of which were women. NYHA-classes were distributed NYHA I-28,2%, II-37,9%, III-30,1%, IV-3,9%. Most frequently prescribed drugs were loop diuretics (83,3%) and IACEs/ARB (62%), and the less frequent beta-blockers (19,1%). IACEs/ARB were prescribed to those with lower functional impairment (p=0.04), and beta-blockers to those with worse NYHA class (p=0.02). All recommended prescriptions had a tendency to 12 month mortality risk reduction, even adjusted by age, functional status, co-morbidity, NYHA class and co-morbid atrial fibrillation, except for spironolactone (OR-1,8; IC95% 0,48-17,19). Treatment with CHF disease-modifying therapies except for spironolactone can reduce 12 month risk mortality, also in the oldest old. There exists room for improvement in frequency of drug prescription in this group of age.

  11. Nasogastric Hydration in Infants with Bronchiolitis Less Than 2 Months of Age.

    PubMed

    Oakley, Ed; Bata, Sonny; Rengasamy, Sharmila; Krieser, David; Cheek, John; Jachno, Kim; Babl, Franz E

    2016-11-01

    To determine whether nasogastric hydration can be used in infants less than 2 months of age with bronchiolitis, and characterize the adverse events profile of these infants compared with infants given intravenous (IV) fluid hydration. A descriptive retrospective cohort study of children with bronchiolitis under 2 months of age admitted for hydration at 3 centers over 3 bronchiolitis seasons was done. We determined type of hydration (nasogastric vs IV fluid hydration) and adverse events, intensive care unit admission, and respiratory support. Of 491 infants under 2 months of age admitted with bronchiolitis, 211 (43%) received nonoral hydration: 146 (69%) via nasogastric hydration and 65 (31%) via IV fluid hydration. Adverse events occurred in 27.4% (nasogastric hydration) and 23.1% (IV fluid hydration), difference of 4.3%; 95%CI (-8.2 to 16.9), P = .51. The majority of adverse events were desaturations (21.9% nasogastric hydration vs 21.5% IV fluid hydration, difference 0.4%; [-11.7 to 12.4], P = .95). There were no pulmonary aspirations in either group. Apneas and bradycardias were similar in each group. IV fluid hydration use was positively associated with intensive care unit admission (38.5% IV fluid hydration vs 19.9% nasogastric hydration; difference 18.6%, [5.1-32.1], P = .004); and use of ventilation support (27.7% IV fluid hydration vs 15.1% nasogastric hydration; difference 12.6 [0.3-23], P = .03). Fewer infants changed from nasogastric hydration to IV fluid hydration than from IV fluid hydration to nasogastric hydration (12.3% vs 47.7%; difference -35.4% [-49 to -22], P < .001). Nasogastric hydration can be used in the majority of young infants admitted with bronchiolitis. Nasogastric hydration and IV fluid hydration had similar rates of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Prevalence of Corneal Astigmatism in Tohono O'odham Native American Children 6 Months to 8 Years of Age

    PubMed Central

    Dobson, Velma; Miller, Joseph M.; Schwiegerling, Jim; Clifford-Donaldson, Candice E.; Green, Tina K.; Messer, Dawn H.

    2011-01-01

    Purpose. To describe the prevalence of corneal astigmatism in infants and young children who are members of a Native American tribe with a high prevalence of refractive astigmatism. Methods. The prevalence of corneal astigmatism was assessed by obtaining infant keratometer (IK4) measurements from 1235 Tohono O'odham children, aged 6 months to 8 years. Results. The prevalence of corneal astigmatism >2.00 D was lower in the 1- to <2-year-old age group when compared with all other age groups, except the 6- to <7-year-old group. The magnitude of mean corneal astigmatism was significantly lower in the 1- to <2-year age group than in the 5- to <6-, 6- to <7-, and 7- to <8-year age groups. Corneal astigmatism was with-the-rule (WTR) in 91.4% of astigmatic children (≥1.00 D). Conclusions. The prevalence and mean amount of corneal astigmatism were higher than reported in non–Native American populations. Mean astigmatism increased from 1.43 D in 1-year-olds to nearly 2.00 D by school age. PMID:21460261

  13. Epidemiology and 12-month outcomes from traumatic brain injury in australia and new zealand.

    PubMed

    Myburgh, John A; Cooper, D James; Finfer, Simon R; Venkatesh, Balasubramanian; Jones, Daryl; Higgins, Alisa; Bishop, Nicole; Higlett, Tracey

    2008-04-01

    An epidemiologic profile of traumatic brain injury (TBI) in Australia and New Zealand was obtained following the publication of international evidence-based guidelines. Adult patients with TBI admitted to the intensive care units (ICU) of major trauma centers were studied in a 6-month prospective inception cohort study. Data including mechanisms of injury, prehospital interventions, secondary insults, operative and intensive care management, and outcome assessments 12-months postinjury were collected. There were 635 patients recruited from 16 centers. The mean (+/-SD) age was 41.6 years +/- 19.6 years; 74.2% were men; 61.4% were due to vehicular trauma, 24.9% were falls in elderly patients, and 57.2% had severe TBI (Glasgow Coma Scale score month mortality was 26.9% in all patients and 35.1% in patients with severe TBI. Favorable outcomes at 12 months were recorded in 58.8% of all patients and in 48.5% of patients with severe TBI. In Australia and New Zealand, mortality and favorable neurologic outcomes after TBI were similar to published data before the advent of evidence-based guidelines. A high incidence of prehospital secondary brain insults and an ageing population may have contributed to these outcomes. Strategies to improve outcomes from TBI should be directed at preventive public health strategies and interventions to minimize secondary brain injuries in the prehospital period.

  14. Caffeine Intake During Pregnancy in Different Intrauterine Environments and its Association with Infant Anthropometric Measurements at 3 and 6 Months of Age.

    PubMed

    de Medeiros, Thamíris Santos; Bernardi, Juliana Rombaldi; de Brito, Mariana Lopes; Bosa, Vera Lucia; Goldani, Marcelo Zubaran; da Silva, Clécio Homrich

    2017-06-01

    Objective To investigate the association between maternal caffeine intake during pregnancy and infant anthropometric measurements at age 3 and 6 months. Methods Longitudinal observational study of mother-child pairs stratified into five groups: diabetic women (DM), hypertensive women (HYP), smoking mothers (SMO), mothers of infants small for gestational age (SGA), and controls (CTL). Pairs were recruited from three public hospitals in Porto Alegre, Brazil, from 2011 to 2015, using a convenience sampling strategy. The Food Frequency Questionnaire (FFQ) was administered on postpartum day 7 to evaluate maternal caffeine intake during pregnancy. The anthropometric measurements of interest (weight, length, and skinfold thickness) were assessed at birth and at age 3 and 6 months. Linear regression was used to analyze the interaction between caffeine intake and skinfold thickness. Results Overall, 272 mother-child pairs were investigated (41 DM, 26 HYP, 68 SMO, 25 SGA, and 112 CTL). There were no differences in anthropometric measurements between infants born to mothers who had and had not consumed caffeine during pregnancy (P > 0.05). Children of mothers in the DM group had the highest adjusted average skinfold thicknesses at 3 months. An interaction between maternal caffeine intake during pregnancy and the sum of skinfolds at age 3 months was found in the DM and CTL groups (P < 0.05). However, significant differences were not observed at 6 months. Conclusions Maternal caffeine intake influenced infants skinfold thickness measurements at 3 months of age. This parameter was reduced in infants born to mothers with DM and increased in those born to healthy control mothers.

  15. A cohort study of developmental polychlorinated biphenyl (PCB) exposure in relation to post-vaccination antibody response at 6-months of age

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jusko, Todd A., E-mail: juskota@niehs.nih.gov; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA; De Roos, Anneclaire J.

    2010-05-15

    Background: Extensive experimental data in animals indicate that exposure to polychlorinated biphenyls (PCBs) during pregnancy leads to changes in offspring immune function during the postnatal period. Whether developmental PCB exposure influences immunologic development in humans has received little study. Methods: The study population was 384 mother-infant pairs recruited from two districts of eastern Slovakia for whom prospectively collected maternal, cord, and 6-month infant blood specimens were available. Several PCB congeners were measured in maternal, cord, and 6-month infant sera by high-resolution gas chromatography with electron capture detection. Concentrations of IgG-specific anti-haemophilus influenzae type b, tetanus toxoid, and diphtheria toxoid weremore » assayed in 6-month infant sera using ELISA methods. Multiple linear regression was used to estimate the relation between maternal, cord, and 6-month infant PCB concentrations and the antibody concentrations evaluated at 6-months of age. Results: Overall, there was little evidence of an association between infant antibody concentrations and PCB measures during the pre- and early postnatal period. In addition, our results did not show specificity in terms of associations limited to a particular developmental period (e.g. pre- vs. postnatal), a particular antibody, or a particular PCB congener. Conclusions: At the PCB concentrations measured in this cohort, which are high relative to most human populations today, we did not detect an association between maternal or early postnatal PCB exposure and specific antibody responses at 6-months of age.« less

  16. Comparison of the health status of children aged between 6 and 12 years reared by grandparents and parents.

    PubMed

    Nanthamongkolchai, Sutham; Munsawaengsub, Chokchai; Nanthamongkolchai, Chantira

    2011-09-01

    The purpose of the present study was to compare the health status of children aged between 6 and 12 years reared by grandparent and parent, including the factors affecting the development of both groups. A cross-sectional study was conducted in 2 different caregiver groups, 160 children living with their grandparents and 160 children living with their parents in Phrae province. The samples were selected by cluster sampling and data were collected from March 10 to April 8, 2006 by questionnaire. The Test of Nonverbal Intelligence-3 was used to test the child development. Data were analyzed by frequency distribution, percentage, χ(2) test, and multiple logistic regression. The illness in the past 6 months and nutritional status of the children aged 6 to 12 years were not different between 2 groups, but the child development and appropriateness of child rearing were different with statistical significance (P < .05). Children who were reared by grandparents had a higher percentage (66.7%) of below normal development than those reared by parents (33.3%), and had inappropriate child rearing by a rate of 57.7% compared with 42.3%. In addition, the factors affecting the development of children reared by grandparents were both the level of the family income and the child rearing factor, whereas the child development in those who were reared by parents was affected only by the child rearing factor.

  17. Does Caregiver Behavior Mediate the Relationship Between Cultural Individualism and Infant Pain at 12 Months of Age?

    PubMed

    O'Neill, Monica C; Pillai Riddell, Rebecca; Garfield, Hartley; Greenberg, Saul

    2016-12-01

    This study aimed to understand the relationship between caregiver culture and infant pain expression at the 12-month immunization and discern if a mechanism subsuming this relationship was the quality of caregiver behaviors (emotional availability). Infants (N = 393) with immunization data at 12 months of age were examined. On the basis of the Development of Infant Acute Pain Responding model, a mediation model was developed to examine how caregiver behaviors mediate the relationship between caregiver heritage culture and infant pain. Culture was operationalized by an objectively derived quantification of caregivers' self-reported heritage culture's individualism. Two mediation models were estimated, examining infant pain expression at 1 and 2 minutes post-needle. Caregivers who self-reported heritage cultures that were more highly individualistic tended to show greater emotional availability, which in turn predicted decreased infant pain expression at 1 and 2 minutes post-needle. The present findings further our understanding of one mechanism by which caregiver culture affects infant acute pain expression. Adding to the literature examining direct relationships between culture and infant immunization pain, this article proposes the quality of caregiver behaviors as a mechanism by which culture affects infant acute pain expression at 12 months of age. Results support the proposed mechanism and inform our understanding of the role of caregiver culture in the infant pain context. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  18. Iron supplementation until 6 months protects marginally low-birth-weight infants from iron deficiency during their first year of life.

    PubMed

    Berglund, Staffan K; Westrup, Björn; Domellöf, Magnus

    2015-03-01

    Low-birth-weight (LBW) infants (<2500 g) have an increased risk of iron deficiency (ID) during their first 6 months of life. The optimal dose and duration of iron supplementation to LBW infants are, however, unknown. The objective of the present study was to investigate the long-term effect on iron status and growth in marginally LBW (2000-2500 g) infants, of iron supplements given until 6 months of life. In a randomized controlled trial, 285 healthy marginally LBW infants received 0, 1, or 2 mg · kg(-1) · day(-1) of iron supplements from 6 weeks to 6 months of age. At 12 months and 3.5 years of life we measured length, weight, head circumference, and indicators of iron status (hemoglobin, ferritin, mean corpuscular volume, and transferrin saturation) and assessed the prevalence of iron depletion, functional ID, and ID anemia. At 12 months of age, there was a significant difference in ferritin between the groups (P = 0.006). Furthermore, there was a significant difference in the prevalence of iron depletion (23.7%, 10.6%, and 6.8%, respectively, in the placebo, 1-mg, and 2-mg groups, P = 0.009) and similar nonsignificant trends for functional ID and ID anemia. At 3.5 years of life there were no significant differences in iron status and the mean prevalence of iron depletion was 3.2%. Anthropometric data were not affected by the intervention. Iron supplements with 2 mg · kg(-1) · day(-1) until 6 months of life effectively reduces the risk of ID during the first 12 months of life and is an effective intervention for preventing early ID in marginally LBW infants.

  19. Inappropriate Feeding Behavior: One of the Important Causes of Malnutrition in 6- to 36-Month-Old Children in Myanmar

    PubMed Central

    Zhao, Ai; Gao, Hongchong; Li, Bo; Zhang, Jun; Win, Naing Naing; Wang, Peiyu; Li, Jiayin; Zhang, Yumei

    2016-01-01

    The complementary feeding period is an important time for children's growth and development. This study was conducted to 1) determine the feeding behaviors of 6- to 36-month-old children in Myanmar, 2) explore health effects of feeding behaviors, and 3) determine factors associated with feeding behaviors. A total of 807 children and their mothers (N = 642) were recruited from nine villages in Kachin, Shan, and Kokang, Myanmar. Feeding behaviors and sociodemographic characteristics were investigated using a validated questionnaire. Hemoglobin and anthropometric indicators were measured during the fieldwork. In our sample, 18.6%, 72.7%, and 9.8% of children were introduced to complementary foods (CFs) earlier than 4 months of age, between 4 and 8 months of age, and later than 8 months of age, respectively. For different types of CFs, up to the age of 24.1–36 months, there were still 6.5% and 4.1% of the children who had never been introduced to eggs and meat. Introduction of CFs earlier than 4 months of age was a risk factor for being underweight (age-adjusted odds ratio (ORadjust-age) = 1.7, 95% confidence interval (CI) = 1.2–2.5) and for stunting (ORadjust-age = 1.6, 95% CI = 1.1–2.3), whereas introduction of CFs later than 8 months of age was a risk factor for anemia (ORadjust-age = 3.5, 95% CI = 1.7–7.2). Mothers who had anemia (OR = 3.7, 95% CI = 2.0–6.9) tended toward early introduction of CFs. Women with a lower family income tended toward later introduction of CFs (OR = 2.0, 95% CI = 1.3–3.3). This study demonstrated that inappropriate feeding behavior was one of the important causes of malnutrition. PMID:27481057

  20. Acute malnutrition among children aged 6-59 months of the nomadic population in Hadaleala district, Afar region, northeast Ethiopia.

    PubMed

    Gizaw, Zemichael; Woldu, Wondwoson; Bitew, Bikes Destaw

    2018-02-07

    Acute malnutrition to be a major health burden in the world, particularly in the developing world. Acute malnutrition is associated with more than one third of the global disease burden for children. Malnourished children are physically, emotionally and intellectually less productive and suffer more from chronic illnesses and disabilities. The nature, magnitude and determinants of acute malnutrition are determined among the general populations; however, there is a lack of evidence in the nomadic communities. A cross-sectional study was conducted to assess the magnitude and factors associated with acute malnutrition among children aged 6-59 months in Hadaleala district, Afar Region. A total of 591 under-five children were included in this study, and subjects were recruited by the multistage cluster sampling technique. Data were collected by a pre-tested questionnaire and a simple anthropometric index so called mid-upper arm circumference (MUAC). The multivariable binary logistic regression analysis was used to identify factors associated with acute malnutrition on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05. The prevalence of acute malnutrition was 11.8% (95% CI = 9.3, 14.8%). The highest prevalence (50%) of acute malnutrition occurred among children aged between 12.0-23.0 months. Childhood acute malnutrition was associated with the presence of two (AOR = 2.49, p < 0.05) and three (AOR = 12.87, p < 0.001) children in each household, unprotected drinking water sources (AOR = 3.78, p < 0.05), absence of the latrine (AOR = 5.24, p < 0.05), hand washing with soap (AOR = 0.21, p < 0.05), childhood diarrheal disease (AOR = 2.72, p < 0.05), and child vaccination (AOR = 0.15, p < 0.001). The prevalence of acute malnutrition among children aged 6-59 months was was higher than the national prevalence. The number of children in each household, drinking water sources

  1. Micronutrient adequacy is poor, but not associated with stunting between 12-24 months of age: A cohort study findings from a slum area of Bangladesh

    PubMed Central

    Islam, M. Munirul; Mahfuz, Mustafa; Ahmed, A. M. Shamsir; Mondal, Dinesh; Haque, Rashidul; Ahmed, Tahmeed

    2018-01-01

    The prevalence of stunting among children below 5 years of age is higher in the slum-dwelling population of Bangladesh compared to that in both urban and rural areas. Studies have reported that several factors such as inadequate nutrition, low socio-economic status, poor hygiene and sanitation and lack of maternal education are the substantial predictors of childhood stunting. Almost all these factors are universally present in the slum-dwelling population of Bangladesh. However, few studies have prospectively examined such determinants of stunting among slum populations. In this paper, we reveal the findings of a cohort study with an aim to explore the status of micronutrient adequacy among such vulnerable children and establish its association with stunting along with other determinants. Two-hundred-sixty-five children were enrolled and followed since birth until 24 months of age. We collected anthropometric, morbidity and dietary intake data monthly. We used the 24-hour multiple-pass recall approach to collect dietary intake data from the age of 9 months onward. Micronutrient adequacy of the diet was determined by the mean adequacy ratio (MAR) which was constructed from the average intake of 9 vitamins and 4 minerals considered for the analysis. We used generalized estimating equation (GEE) regression models to establish the determinants of stunting between 12–24 months of age in our study population. The prevalence of low-birth-weight (LBW) was about 28.7% and approximately half of the children were stunted by the age of 24 months. The average micronutrient intake was considerably lower than the recommended dietary allowance and the MAR was only 0.48 at 24 months of age compared to the optimum value of 1. However, the MAR was not associated with stunting between 12–24 months of age. Rather, LBW was the significant determinant (AOR = 3.03, 95% CI: 1.69–5.44) after adjusting for other factors such as age (AOR = 2.12, 95% CI: 1.45–3.11 at 24 months and AOR

  2. Trajectories and predictors of developmental skills in healthy twins up to 24 months of age.

    PubMed

    Nan, Cassandra; Piek, Jan; Warner, Claire; Mellers, Diane; Krone, Ruth Elisabeth; Barrett, Timothy; Zeegers, Maurice P

    2013-12-01

    Low birth weight and low 5-min Apgar scores have been associated with developmental delay, while older maternal age is a protective factor. Little is known about trajectories and predictors of developmental skills in infant twins, who are generally born with lower birth weights, lower Apgar scores and to older mothers. Developmental skills were assessed at 3, 6, 9, 12, 18 and 24 months using the Ages and Stages Questionnaires in 152 twins from the Birmingham Registry for Twin and Heritability Studies. Multilevel spline and linear regression models (adjusted for gestational age, gender, maternal age) were used to estimate developmental trajectories and the associations between birth weight, maternal age and Apgar scores on developmental skills. Twins performed worse than singletons on communication, gross motor, fine motor, problem solving and personal-social skills (p < 0.001). Twins caught up around 6 months (score within -1 standard deviation of norm), except on gross motor skills, which did not catch up until after the age of 12 months. A one-year increase in maternal age was significantly associated with decreases in gross motor and personal-social z-scores of up to -0.09, whereas one unit increases in Apgar score increased z-scores up to 0.90 (p < 0.01). Healthy twins should be considered at a higher risk for developmental delay. Whether these results are comparable to preterm singletons, or whether there are twin-specific issues involved, should be further investigated in a study that uses a matched singleton control group. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Renal denervation with standard radiofrequency ablation catheter is effective in 24-hour ambulatory blood pressure reduction - follow-up at 1/3/6/12 months.

    PubMed

    Prochnau, D; Otto, S; Figulla, H-R; Surber, R

    2016-07-01

    To examine the effect of renal denervation (RDN) on 24‑h ambulatory blood pressure (ABP) with a standard radiofrequency ablation catheter (RF catheter). Seventy-five patients with resistant hypertension received bilateral RDN with an RF catheter (6 RF applications, 1 minute each, 8-12 watts). Seventy patients fulfilled inclusion criteria with mean systolic ABP ≥140 mmHg (mean 165/89) despite treatment with ≥3 antihypertensive drugs (mean 5.9) including a diuretic, and were further analysed for ABP changes. Follow-up at 1/3/6/12 months comprised biochemical evaluations and ABP measurement. At 6/12 months, duplex sonography of the renal arteries was additionally performed. At 1/3/6/12 months we observed a significant reduction in systolic ABP of -15/-17/-18/-15 mmHg (n = 55/53/57/50; non-parametric Friedman test, p < 0.001) and diastolic ABP of -6/-9/-10/-7 mmHg (p < 0.001). Of the patients, 70 %/64 % showed a systolic ABP reduction of ≥10 mmHg, and 77 %/70 % of ≥5 mmHg at 6/12-month follow-up. Two patients (2.7 %) developed renal artery stenosis (>70 %) with subsequent stenting without complications. Logistic regression analysis with systolic ABP reduction ≥10 mmHg at 12 months follow-up as criterion revealed that only the mean baseline systolic ABP was significant, OR = 2.174. RDN with a standard RF catheter can be used safely to reduce mean ABP in resistant hypertension as shown in long-term follow-up.

  4. Prevalence and risk factors of anaemia among children aged between 6 months and 14 years in Kenya.

    PubMed

    Ngesa, Oscar; Mwambi, Henry

    2014-01-01

    Anaemia is one of the significant public health problems among children in the world. Understanding risk factors of anaemia provides more insight to the nature and types of policies that can be put up to fight anaemia. We estimated the prevalence and risk factors of anaemia in a population-based, cross-sectional survey. Blood samples from 11,711 children aged between 6 months and 14 years were collected using a single-use, spring-loaded, sterile lancet to make a finger prick. Anaemia was measured based on haemoglobin concentration level. The generalized linear model framework was used to analyse the data, in which the response variable was either a child was anemic or not anemic. The overall prevalence of anaemia among the children in Kenya was estimated to be 28.8%. Across each band of age within which the definition of anaemia remained constant (0–4, 5–11, and 12–14 years old), the prevalence of anaemia declined with each year of age. [corrected]. The risk of anaemia was significantly higher in male than female children. Mothers with secondary and above education had a protective effect on the risk of anaemia on their children. Malaria diagnosis status of a child was positively associated with risk anaemia. Controlling co-morbidity of malaria and improving maternal knowledge are potential options for reducing the burden of anaemia.

  5. Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age.

    PubMed

    Agran, Phyllis F; Anderson, Craig; Winn, Diane; Trent, Roger; Walton-Haynes, Lynn; Thayer, Sharon

    2003-06-01

    children younger than 1 year, 1 year, and 2 years. The leading major causes of injury in descending order were falls, poisoning, transportation, foreign body, and fires/burns. The overall rate of the major category of falls exceeded poisoning, the second leading cause of injury, by a factor of 2. Age-related differences were detected within each major cause of injury. For children 0 to 12 months of age, there was a different leading cause of specific injury for each 3-month period: other falls from height (0-2 months), battering (3-5 months), falls from furniture (6-8 months), and nonairway foreign body (9-11 months). Hot liquid and vapor injuries were the leading specific causes for children 12 to 17 months. Poisoning by medication was the leading specific cause of injury for all age groups from 18 to 35 months and exceeded poisoning by other substances. Pedestrian injury was the leading specific cause of injury for all age groups from 36 to 47 months. Fall from furniture has the highest rates of specific causes of falls from age 3 to 47 months. Fall from stairs peaked at age 6 to 8 months and 9 to 11 months. Fall from buildings was highest at 24 to 26 months. Poisoning by medication peaked at age 21 to 23 months, but poisoning by other substances peaked at 15 to 17 months. The motor vehicle occupant injury rates were fairly stable over the age span of this study. The pedestrian injury rate increased beginning at age 12 to 14 months and by 15 to 17 months was double that of the motor vehicle occupant. Foreign body had a marked peak at age 9 to 11 months. Both battering and neglect rates were highest among infants 0 to 2 and 3 to 5 months. Bathtub submersions had a narrow peak at age 6 to 11 months. Other submersions peaked at 12 to 14 months and remained high until 33 to 35 months. We departed from usual groupings of E-codes and devised groupings that would be reflective of age-related developmental characteristics. Differences in rates by narrow age groups for young

  6. Trends and spatial distribution of deaths of children aged 12-60 months in São Paulo, Brazil, 1980-98.

    PubMed Central

    Antunes, José Leopoldo Ferreira; Waldman, Eliseu Alves

    2002-01-01

    OBJECTIVE: To describe trends in the mortality of children aged 12-60 months and to perform spatial data analysis of its distribution at the inner city district level in São Paulo from 1980 to 1998. METHODS: Official mortality data were analysed in relation to the underlying causes of death. The population of children aged 12-60 months, disaggregated by sex and age, was estimated for each year. Educational levels, income, employment status, and other socioeconomic indices were also assessed. Statistical Package for Social Sciences software was used for the statistical processing of time series. The Cochrane-Orcutt procedure of generalized least squares regression analysis was used to estimate the regression parameters with control of first-order autocorrelation. Spatial data analysis employed the discrimination of death rates and socioeconomic indices at the inner city district level. For classifying area-level death rates the method of K-means cluster analysis was used. Spatial correlation between variables was analysed by the simultaneous autoregressive regression method. FINDINGS: There was a steady decline in death rates during the 1980s at an average rate of 3.08% per year, followed by a levelling off. Infectious diseases remained the major cause of mortality, accounting for 43.1% of deaths during the last three years of the study. Injuries accounted for 16.5% of deaths. Mortality rates at the area level clearly demonstrated inequity in the city's health profile: there was an increasing difference between the rich and the underprivileged social strata in this respect. CONCLUSION: The overall mortality rate among children aged 12-60 months dropped by almost 30% during the study period. Most of the decline happened during the 1980s. Many people still live in a state of deprivation in underserved areas. Time-series and spatial data analysis provided indications of potential value in the planning of social policies promoting well-being, through the identification

  7. Frequency of cardiovascular risk factors before and 6 and 12 months after bariatric surgery.

    PubMed

    Silva, Maria Alayde Mendonça da; Rivera, Ivan Romero; Barbosa, Emília Maria Wanderley de Gusmão; Crispim, Maria Angélica Correia; Farias, Guilherme Costa; Fontan, Alberto Jorge Albuquerque; Bezerra, Rodrigo Azavedo; Sá, Larissa Gabriella de Souza

    2013-01-01

    To compare the frequency of cardiovascular risk factors (CVRFs) in obese patients of the Brazilian Unified Health System (Sistema Único de Saúde - SUS) with indication of bariatric surgery during the preoperative period and after the sixth month and the first year of the procedure. An observational, longitudinal, prospective, and analytical study was performed, with consecutive selection of obese patients with indication for surgery referred to preoperative cardiac evaluation. The protocol consisted of: medical history, physical examination, electrocardiogram, echocardiogram, and biochemical analysis. This study analyzed the following variables: weight, body mass index (BMI), waist circumference (WC), systemic arterial hypertension (SAH), diabetes mellitus type 2(DM), dyslipidemia (high LDL cholesterol; low HDL cholesterol; hypertriglyceridemia), and metabolic syndrome (MS). The chi-squared test and the Tukey-Kramer method were used for statistical analysis. The sample was composed of 96 obese people, among which 86 were women, aged between 18 and 58 years old (median 35 years old). At the end of six months, significant reductions of 88%, 95%, 71%, 89%, and 80% in the frequency of SAH, high LDL cholesterol, hypertriglyceridemia, DM, and MS could already be observed. A significant and small reduction in the frequency of low HDL cholesterol (24%) and abnormal WC (31%) was observed only at the end of 12 months. After six months and one year, weight and BMI experienced reductions of 33.4kg and 44.3kg, and 13.1kg/m(2) and 17.2kg/m(2), respectively. The positive impact on weight loss and the reduction in BMI, WC, and in the frequency of CVRFs are already extremely significant after six months and remain so one year after bariatric surgery. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  8. Validity of the Fine Motor Area of the 12-Month Ages and Stages Questionnaire in Infants Following Major Surgery

    ERIC Educational Resources Information Center

    Smith, Cally; Wallen, Margaret; Walker, Karen; Bundy, Anita; Rolinson, Rachel; Badawi, Nadia

    2012-01-01

    The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The…

  9. The Autism Parent Screen for Infants: Predicting risk of autism spectrum disorder based on parent-reported behavior observed at 6-24 months of age.

    PubMed

    Sacrey, Lori-Ann R; Bryson, Susan; Zwaigenbaum, Lonnie; Brian, Jessica; Smith, Isabel M; Roberts, Wendy; Szatmari, Peter; Vaillancourt, Tracy; Roncadin, Caroline; Garon, Nancy

    2018-04-01

    This study examined whether a novel parent-report questionnaire, the Autism Parent Screen for Infants, could differentiate infants subsequently diagnosed with autism spectrum disorder from a high-risk cohort (siblings of children diagnosed with autism spectrum disorder (n = 66)) from high-risk and low-risk comparison infants (no family history of autism spectrum disorder) who did not develop autism spectrum disorder (n = 138 and 79, respectively). Participants were assessed prospectively at 6, 9, 12, 15, 18, and 24 months of age. At 36 months, a blind independent diagnostic assessment for autism spectrum disorder was completed. Parent report on the Autism Parent Screen for Infants was examined in relation to diagnostic outcome and risk status (i.e. high-risk sibling with autism spectrum disorder, high-risk sibling without autism spectrum disorder, and low-risk control). The results indicated that from 6months of age, total score on the Autism Parent Screen for Infants differentiated between the siblings with autism spectrum disorder and the other two groups. The sensitivity, specificity, and positive and negative predictive validity of the Autism Parent Screen for Infants highlight its potential for the early screening of autism spectrum disorder in high-risk cohorts.

  10. A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up.

    PubMed

    Li, Xiaoming; Harrison, Sayward E; Fairchild, Amanda J; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2017-10-01

    Global literature suggests that resilience-based interventions may yield improvements in psychosocial well-being for vulnerable children, but limited data are available regarding the efficacy of such interventions among children affected by parental HIV/AIDS. To evaluate initial efficacy of a multi-level resilience-based intervention among children affected by parental HIV/AIDS in China in improving children's psychosocial well-being and resilience-related outcomes. Seven hundred-ninety children, 6-17 years of age, were recruited from rural China. Children were either AIDS orphans or were living with one or two parents infected with HIV/AIDS. Children and primary caregivers were randomly assigned to participate in a 4-arm trial to evaluate the Child-Caregiver-Advocacy Resilience (ChildCARE) intervention. This resilience-based psychosocial intervention provides programming at three levels (child, caregiver, community). Survey data were collected at baseline, 6-months, and 12-months in order to examine efficacy of the child-only and child + caregiver arms in improving children's psychological resilience. Intervention groups displayed improvements in several resilience-related outcomes at 6- and 12-month follow-ups, including self-reported coping, hopefulness, emotional regulation, and self-control. The child-only intervention arm showed some fading of intervention effects by 12-months. Preliminary findings suggest that the ChildCARE intervention is efficacious in promoting psychosocial well-being of children affected by parental HIV/AIDS in rural China. Targeting both children and caregivers for psychosocial intervention may be effective in improving children's resilience. Additional evaluation and modifications, including the inclusion of booster sessions, should be considered to further strengthen the program. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Safety and Immunogenicity of the HPV-16/18 AS04-adjuvanted Vaccine in 4-6-year-old Girls: Results to Month 12 From a Randomized Trial.

    PubMed

    Lin, Lan; Parra, Mercedes Macias; Sierra, Victor Y; Cespedes, Albino Salas; Granados, Maria Angelica; Luque, Adriana; Damaso, Silvia; Castrejon Alba, Maria Mercedes; Romano-Mazzotti, Luis; Struyf, Frank

    2018-04-01

    The burden of cervical cancer caused by human papillomavirus (HPV) is high in Latin America. The suboptimal HPV vaccination coverage in adolescents could be improved by pediatric immunization. HPV vaccination has not yet been reported in girls <9 years of age. This ongoing phase III, controlled, randomized, single-blind, multicenter study conducted in Colombia, Mexico and Panama (NCT01627561) evaluated the safety and immunogenicity of AS04-HPV-16/18 vaccine in 4-6-year-old girls. Healthy girls (randomized 1:1) received either 2 doses of AS04-HPV-16/18 vaccine (HPV group, N=74) or 1 dose of each measles-mumps-rubella and diphtheria-tetanus-acellular-pertussis vaccines (control group, N=74) 6 months apart. We report the safety and serum anti-HPV-16 and anti-HPV-18 antibodies (measured by enzyme-linked immunosorbent assay) up to 6 months postvaccination, that is, month (M) 12. Injection site pain was the most frequently reported solicited local symptom in HPV vaccinees. The incidence of other solicited and unsolicited symptoms after each vaccination was similar between the HPV and control group. Until M12, 1 girl in the HPV group and 2 in the control group reported serious adverse events; all serious adverse events were assessed as unrelated to study vaccines. No potential immune-mediated diseases were identified. All girls seroconverted for both antigens after 2 doses of AS04-HPV-16/18. In initially seronegative girls, anti-HPV-16 geometric mean concentrations were 20080.0 enzyme-linked immunosorbent assay units (EU)/mL at M7 and 3246.5 EU/mL at M12; anti-HPV-18 geometric mean concentrations were 10621.8 EU/mL at M7 and 1216.6 EU/mL at M12. Two-dose vaccination with AS04-HPV-16/18 was well tolerated and induced adequate antibody responses in 4-6-year-old girls.

  12. Electronic cigarettes, quit attempts and smoking cessation: a 6-month follow-up.

    PubMed

    Pasquereau, Anne; Guignard, Romain; Andler, Raphaël; Nguyen-Thanh, Viêt

    2017-09-01

    There is conflicting evidence that use of e-cigarettes promotes cessation in regular smokers, but contrasting findings may be due to differing definitions of vaping. The aim was to assess whether regular use of e-cigarettes while smoking is associated with subsequent smoking cessation. Baseline internet survey with outcomes measured at 6-month follow-up. All French metropolitan territory. A total of 2057 smokers aged 15-85 years were recruited through an access panel and responded to a 6-month follow-up: 1805 exclusive tobacco smokers and 252 dual users (tobacco plus regular e-cigarette users) at baseline. The three outcomes assessed at 6 months were: a minimum 50% reduction in the number of cigarettes smoked per day, quit attempts of at least 7 days and smoking cessation of at least 7 days at the time of follow-up. Logistic regressions were performed to model the three outcomes according to regular e-cigarette use at baseline, adjusted for socio-economic variables and smoking behaviours. Baseline dual users were more likely than baseline exclusive tobacco smokers to have halved cigarette consumption [25.9 versus 11.2%, P < 0.001, adjusted odds ratio (aOR) = 2.6, confidence interval (CI) = 1.8-3.8]. Dual users at baseline were also more likely to have made a quit attempt of at least 7 days (22.8 versus 10.9%, P < 0.001, aOR = 1.8, CI = 1.2-2.6). No significant difference was found for 7-day cessation rates at 6 months (12.5 versus 9.5%, P = 0.18, aOR = 1.2, CI = 0.8-1.9). Among people who smoke, those also using an e-cigarette regularly are more likely to try to quit smoking and reduce their cigarette consumption during the next 6 months. It remains unclear whether regular e-cigarette users are also more likely to stop smoking. © 2017 Society for the Study of Addiction.

  13. Differential vulnerability of gray matter and white matter to intrauterine growth restriction in preterm infants at 12 months corrected age.

    PubMed

    Padilla, Nelly; Junqué, Carme; Figueras, Francesc; Sanz-Cortes, Magdalena; Bargalló, Núria; Arranz, Angela; Donaire, Antonio; Figueras, Josep; Gratacos, Eduard

    2014-01-30

    Intrauterine growth restriction (IUGR) is associated with a high risk of abnormal neurodevelopment. Underlying neuroanatomical substrates are partially documented. We hypothesized that at 12 months preterm infants would evidence specific white-matter microstructure alterations and gray-matter differences induced by severe IUGR. Twenty preterm infants with IUGR (26-34 weeks of gestation) were compared with 20 term-born infants and 20 appropriate for gestational age preterm infants of similar gestational age. Preterm groups showed no evidence of brain abnormalities. At 12 months, infants were scanned sleeping naturally. Gray-matter volumes were studied with voxel-based morphometry. White-matter microstructure was examined using tract-based spatial statistics. The relationship between diffusivity indices in white matter, gray matter volumes, and perinatal data was also investigated. Gray-matter decrements attributable to IUGR comprised amygdala, basal ganglia, thalamus and insula bilaterally, left occipital and parietal lobes, and right perirolandic area. Gray-matter volumes positively correlated with birth weight exclusively. Preterm infants had reduced FA in the corpus callosum, and increased FA in the anterior corona radiata. Additionally, IUGR infants had increased FA in the forceps minor, internal and external capsules, uncinate and fronto-occipital white matter tracts. Increased axial diffusivity was observed in several white matter tracts. Fractional anisotropy positively correlated with birth weight and gestational age at birth. These data suggest that IUGR differentially affects gray and white matter development preferentially affecting gray matter. At 12 months IUGR is associated with a specific set of structural gray-matter decrements. White matter follows an unusual developmental pattern, and is apparently affected by IUGR and prematurity combined. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Epidemiological correlates of nutritional anemia among children (6-35 months) in rural Wardha, Central India.

    PubMed

    Sinha, N; Deshmukh, P R; Garg, B S

    2008-02-01

    Nutritional anemia is associated with impaired performance of a range of mental and physical functions in children, along with increased morbidity. Iron supplementation at a later age may not reverse the adverse effects. National Nutritional Anemia Control Program was launched in India in 1970, but it failed to make any impact. The present study was undertaken to find out prevalence of anemia and its correlates in rural Wardha in children 6-35 months of age. Seven hundred seventy-two children between 6 months and 35 months of age were studied for anemia by cluster-sampling method. The hemoglobin was estimated in the child by 'Filter paper cyanmethemoglobin method.' Pre-designed and pre-tested questionnaire was used to collect data on socio-demographic and other variables. Data was analyzed by SPSS 12.0.1. Mean hemoglobin level was 98.5+/-12.9 gm/L. Prevalence of anemia was 80.3%. Only 1.3% children had severe anemia (hemoglobin<70 gm/L). The univariate analysis showed that anemia is significantly associated with age of the child, education of mother and father, occupation of father, socioeconomic status, birth order and nutritional status as measured by weight for age. The final model suggested that only educational status of the mother, occupation of the father, birth order and nutritional status of the child were significantly associated with anemia. For short-term impact, appropriate nutritional interventions remain the only operational intervention as only the nutritional status (weight for age) is a modifiable factor. But for long-term sustained impact, policy makers need to focus on improving maternal education and reducing family size.

  15. Effects of imprint training procedure at birth on the reactions of foals at age six months.

    PubMed

    Williams, J L; Friend, T H; Collins, M N; Toscano, M J; Sisto-Burt, A; Nevill, C H

    2003-03-01

    While imprint training procedures have been promoted in popular magazines, they have received limited scientific investigation. To determine the effects of a neonatal imprint training procedure on 6-month-old foals and to determine if any one session had a greater effect than others. Foals (n = 131) were divided into the following treatments: no imprint training, imprint training at birth, 12, 24 and 48 h after birth or imprint training only at birth, 12, 24, 48, or 72 h after birth. Foals then received minimal human handling until they were tested at 6 months. During training, time to complete exposure to the stimulus was significant for only 2 of 6 stimuli. Percentage change in baseline heart rate was significant for only 2 of 10 stimuli. These 4 effects were randomly spread across treatments. Neither the number of imprint training sessions (0, 1, or 4) nor the timing of imprint training sessions (none, birth, 12, 24, 48, or 72 h after birth) influenced the foal's behaviour at 6 months of age. In this study, imprint training did not result in better behaved, less reactive foals.

  16. Developmental milestones record - 6 months

    MedlinePlus

    Normal childhood growth milestones - 6 months; Childhood growth milestones - 6 months; Growth milestones for children - 6 months ... the weight on hands (often occurs by 4 months) Able to pick up a dropped object Able ...

  17. Preterm infants fed nutrient-enriched formula until 6 months show improved growth and development.

    PubMed

    Jeon, Ga Won; Jung, Yu Jin; Koh, Sun Young; Lee, Yeon Kyung; Kim, Kyung Ah; Shin, Son Moon; Kim, Sung Shin; Shim, Jae Won; Chang, Yun Sil; Park, Won Soon

    2011-10-01

    The purpose of the present study was to determine the effect of feeding nutrient-enriched preterm formula to preterm infants until 6 months' corrected age (CA) on growth and development in the first 18 months of life. Very low-birthweight preterm infants were fed preterm formula until term (40 weeks CA). Infants were then assigned to one of three groups and were fed term formula until 6 months' CA (group 1, n= 29); preterm formula to 3 months' CA and then term formula to 6 months' CA (group 2, n= 30); or preterm formula until 6 months' CA (group 3, n= 31). Anthropometry was performed at term, 3, 6, 9, 12, 15, and at s18 months' CA. Mental and psychomotor development were assessed using the Bayley Scales of Infant Development II at 18 months' CA. Although body weight, length, head circumference and z score for CA at term in group 3 were significantly lower than those of groups 1 and 2, growth rates of these parameters were significantly higher in group 3 up to 18 months CA', as compared to groups 1 and 2. The mental developmental index and psychomotor developmental index of the Bayley test were not significantly different between the three groups. Very low-birthweight preterm infants fed nutrient-enriched preterm formula until 6 months' CA demonstrated significantly improved growth rates for bodyweight, length and head circumference, and comparable mental and psychomotor development throughout the first 18 months of life. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  18. Food and beverage intake in Australian children aged 12-16 months participating in the NOURISH and SAIDI studies.

    PubMed

    Byrne, Rebecca; Magarey, Anthea; Daniels, Lynne

    2014-08-01

    To describe the quantity and diversity of food and beverage intake in Australian children aged 12-16 months and to determine if the amount and type of milk intake is associated with dietary diversity. Mothers participating in the NOURISH and South Australian Infant Dietary Intake (SAIDI) studies completed a single 24-hour recall of their child's food intake, when children (n=551) were aged 12-16 months. The relationship between dietary diversity and intake of cow's milk, formula or breastmilk was examined using one-way ANOVA. Dairy and cereal were the most commonly consumed food groups and the greatest contributors to daily energy intake. Most children ate fruit (87%) and vegetables (77%) on the day of the 24-hour recall while 91% ate discretionary items. Half the sample ate less than 30 g of meat/alternatives. A quarter of the children were breastfeeding while formula was consumed by 32% of the sample, providing 29% of daily energy intake. Lower dietary diversity was associated with increased formula intake. The quality of dietary intake in this group of young children is highly variable. Most toddlers were consuming a diverse diet, though almost all ate discretionary items. The amount and type of meat/alternatives consumed was poor. Health professionals should advise parents to offer iron-rich foods, while limiting discretionary choices and use of formula at an age critical in the development of long-term food preferences. © 2014 Public Health Association of Australia.

  19. Extremely Preterm-Born Infants Demonstrate Different Facial Recognition Processes at 6-10 Months of Corrected Age.

    PubMed

    Frie, Jakob; Padilla, Nelly; Ådén, Ulrika; Lagercrantz, Hugo; Bartocci, Marco

    2016-05-01

    To compare cortical hemodynamic responses to known and unknown facial stimuli between infants born extremely preterm and term-born infants, and to correlate the responses of the extremely preterm-born infants to regional cortical volumes at term-equivalent age. We compared 27 infants born extremely preterm (<28 gestational weeks) with 26 term-born infants. Corrected age and chronological age at testing were between 6 and 10 months, respectively. Both groups were exposed to a gray background, their mother's face, and an unknown face. Cerebral regional concentrations of oxygenated and deoxygenated hemoglobin were measured with near-infrared spectroscopy. In the preterm group, we also performed structural brain magnetic resonance imaging and correlated regional cortical volumes to hemodynamic responses. The preterm-born infants demonstrated different cortical face recognition processes than the term-born infants. They had a significantly smaller hemodynamic response in the right frontotemporal areas while watching their mother's face (0.13 μmol/L vs 0.63 μmol/L; P < .001). We also found a negative correlation between the magnitude of the oxygenated hemoglobin increase in the right frontotemporal cortex and regional gray matter volume in the left fusiform gyrus and amygdala (voxels, 25; r = 0.86; P < .005). At 6-10 months corrected age, the preterm-born infants demonstrated a different pattern in the maturation of their cortical face recognition process compared with term-born infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Compliance with WHO IYCF Indicators and Dietary Intake Adequacy in a Sample of Malaysian Infants Aged 6-23 Months.

    PubMed

    Khor, Geok Lin; Tan, Sue Yee; Tan, Kok Leong; Chan, Pauline S; Amarra, Maria Sofia V

    2016-12-01

    The 2010 World Health Organisation (WHO) Infant and Young Child Feeding (IYCF) indicators are useful for monitoring feeding practices. A total sample of 300 subjects aged 6 to 23 months was recruited from urban suburbs of Kuala Lumpur and Putrajaya. Compliance with each IYCF indicator was computed according to WHO recommendations. Dietary intake based on two-day weighed food records was obtained from a sub-group ( N = 119) of the total sample. The mean adequacy ratio (MAR) value was computed as an overall measure of dietary intake adequacy. Contributions of core IYCF indicators to MAR were determined by multinomial logistic regression. Generally, the subjects showed high compliance for (i) timely introduction of complementary foods at 6 to 8 months (97.9%); (ii) minimum meal frequency among non-breastfed children aged 6 to 23 months (95.2%); (iii) consumption of iron-rich foods at 6 to 23 months (92.3%); and minimum dietary diversity (78.0%). While relatively high proportions achieved the recommended intake levels for protein (87.4%) and iron (71.4%), lower proportions attained the recommendations for calcium (56.3%) and energy (56.3%). The intake of micronutrients was generally poor. The minimum dietary diversity had the greatest contribution to MAR (95% CI: 3.09, 39.87) ( p = 0.000) among the core IYCF indicators. Malaysian urban infants and toddlers showed moderate to high compliance with WHO IYCF indicators. The robustness of the analytical approach in this study in quantifying contributions of IYCF indicators to MAR should be further investigated.

  1. The Development of Rational Imitation in 9- and 12-Month-Old Infants

    ERIC Educational Resources Information Center

    Zmyj, Norbert; Daum, Moritz M.; Aschersleben, Gisa

    2009-01-01

    Studies on rational imitation have provided evidence for the fact that infants as young as 12 months of age engage in rational imitation. However, the developmental onset of this ability is unclear. In this study, we investigated whether 9- and 12-month-olds detect voluntary and implicit as well as nonvoluntary and explicit constraints in the head…

  2. Injuries in Sedentary Individuals Enrolled in a 12-Month, Randomized, Controlled, Exercise Trial

    PubMed Central

    Campbell, Kristin L.; Foster-Schubert, Karen; Xiao, Liren; Cadmus Bertram, Lisa A.; Duggan, Catherine; Irwin, Melinda; McTiernan, Anne

    2014-01-01

    Background The risk of musculoskeletal injury with the introduction of moderate-to-vigorous exercise in sedentary adults is not well established. The purpose of this report is to examine the effect of a 12-month exercise intervention on musculoskeletal injury and bodily pain in predominately overweight, sedentary, men (n=102) and women (n=100), aged 40–75 years. Methods Participants were randomized to a moderate-to-vigorous aerobic exercise intervention (EX) (6 d/wk, 60 min/d, 60–85% max. heart rate) or usual lifestyle control (CON). Participants completed a self-report of musculoskeletal injury and body pain at baseline and 12-months. Results The number of individuals reporting an injury (CON; 27% vs. EX; 28%, p= .95) did not differ by group. The most commonly injured site was lower leg/ankle/foot. The most common causes of injury were sports/physical activity, home maintenance or “other”. In the control group, bodily pain increased over the 12 months compared to the exercise group (CON −7.9, EX −1.4, p=.05). Baseline demographics and volume of exercise were not associated with injury risk. Conclusions Previously sedentary men and women randomized to a 12-month aerobic exercise intervention with a goal of 360 min/wk reported the same number of injuries as those in the control group and less bodily pain. PMID:22368219

  3. Your Baby's Growth: 12 Months

    MedlinePlus

    ... little one). What's Next? For the remainder of this year and next year, expect that your baby's growth ... Gavin, MD Date reviewed: December 2014 More on this topic for: ... and Your 8- to 12-Month-Old Your Child's Checkup: 1 Year (12 Months) Movement, Coordination, and Your 8- to ...

  4. Community-led initiative for control of anemia among children 6 to 35 months of age and unmarried adolescent girls in rural Wardha, India.

    PubMed

    Dongre, Amol R; Deshmukh, Pradeep R; Garg, Bishan S

    2011-12-01

    Studies in India have reported a high prevalence of nutritional anemia among children and adolescent girls. Nutritional anemia is associated with impaired mental, physical, and cognitive performance in children and is a significant risk factor for maternal mortality. To evaluate the effect of a community-led initiative for control of nutritional anemia among children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age. This Participatory Action Research was done in 23 villages of the Primary Health Centre, Anji, in Wardha District of Maharashtra. In February and March 2008, needs assessment was undertaken by interviewing the mothers of 261 children and 260 adolescent girls. Hemoglobin levels of adolescent girls and children were measured with the use of the hemoglobin color scale. The girls were given weekly iron-folic acid tablets, and the children were given daily liquid iron prophylaxis for 100 days in a year through community participation. The adolescent girls and the mothers of the children and adolescent girls were also given nutritional education on the benefits and side effects of iron supplementation. In June and July 2008, follow-up assessment was performed by survey and force field analysis. There was a significant reduction in the prevalence of nutritional anemia from 73.8% to 54.6% among the adolescent girls and from 78.2% to 64.2% among the children. There was improvement in awareness of iron-rich food items among the adolescent girls and the mothers of the children. The benefits to girls, such as increase in appetite and reduction in scanty menses, tiredness, and weakness, acted as positive factors leading to better compliance with weekly iron supplementation. The benefits to children perceived by the mothers, such as increase in appetite, weight gain, reduction in irritability, and reduction in mud-eating behavior, acted as a dominant positive force and generated demand for iron syrup. The community-led initiative for

  5. Does Anaemia Have Major Public Health Importance in Children Aged 6-59 Months in the Duggina Fanigo District of Wolaita Zone, Southern Ethiopia?

    PubMed

    Tiku, Yohannes Samuel; Mekonnen, Tefera Chane; Workie, Shimelash Bitew; Amare, Endale

    2018-01-01

    Globally, a large number of children aged 6-59 months are affected by anaemia. In Ethiopia, like other developing countries, more than 40% of children under 5 years are affected by anaemia. Anaemia during infancy and childhood period is associated with poor health and impaired cognitive development, leading to reduced academic achievement and earning potential in their adult life. The aim of this research was to assess whether anaemia remained a major public health problem among children aged 6-59 months or not in Duggina Fanigo District of Wolaita Zone, South Ethiopia in 2016. A community-based cross-sectional study was conducted from February to March 2016, on 404 mothers with children aged 6-59 months who were selected through the systematic sampling method. Socio-demographic and other data on associated factors was collected using a pre-tested questionnaire. Capillary blood was taken from the fingertip of each child and hemoglobin was measured using Haemo-Cue digital photometer. All the necessary safety measures were taken during blood collection. Data analysis was made using SPSS version 21. Multivariable logistic regression analysis was used to assess the association of independent variables with outcome variables and to control the possible confounding factors. The overall prevalence of anaemia was 51.4%. Anaemia was common among young children as compared to older children. After controlling the effect of confounding and adjusting for age, gender and altitude, explanatory variables like low dietary diversity (AOR = 3.24; 95% CI [1.68-6.23]), food insecurity (AOR = 3.63; 95% CI [2.18-6.04]), stunting (AOR = 2.60; 95% CI [1.56-4.35]), underweight (AOR = 2.46; 95% CI [1.29-4.67]) and fever within 2 weeks (AOR = 2.49; 95% CI [1.29-4.81]) prior to the survey were significantly associated with anaemia. In conclusion, the overall prevalence of anaemia among children aged 6-59 months has remained a major public health importance in the study area. Integrated

  6. Validity of the fine motor area of the 12-month ages and stages questionnaire in infants following major surgery.

    PubMed

    Smith, Cally; Wallen, Margaret; Walker, Karen; Bundy, Anita; Rolinson, Rachel; Badawi, Nadia

    2012-08-01

    The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The ASQ2-FM was completed by caregivers of 74 infants who had cardiac surgery in the first 90 days of life, 104 infants who had noncardiac surgery in the first 90 days of life, and a control group of 154 infants. The Rasch item response analysis revealed that the ASQ2-FM had poor ability to discriminate among levels of fine motor ability. Sensitivity was poor (20%) and specificity was good (98%) when compared with the scores for the fine motor subscale of the Bayley Scales of Infant and Toddler Development. The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery.

  7. Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial.

    PubMed

    Emmelot-Vonk, M H; Verhaar, H J J; Nakhai-Pour, H R; Grobbee, D E; van der Schouw, Y T

    2009-01-01

    Serum testosterone levels decline significantly with aging and this has been associated with reduced sexual function. We have conducted a double-blind, randomized, placebo-controlled trial to investigate the effect of testosterone supplementation on sexual function in 237 elderly men with a testosterone level <13.7 nmol l(-1). Participants were randomly assigned to receive oral testosterone undecanoate or a placebo for 6 months. A total of 207 men completed the study. After treatment, there were no differences in scores on sexual function between the groups. Subanalysis showed that although a baseline testosterone level in the lowest tertile was associated with significantly lower scores for sexual fantasies, desire of sexual contact and frequency of sexual contact, supplementation of testosterone did not result in improvement on any of these items in this group. In conclusion, the findings do not support the view that testosterone undecanoate supplementation for 6 months to elderly men with low-normal testosterone concentrations favorably affects sexual function.

  8. Impact of a Brief Group Intervention to Enhance Parenting and the Home Learning Environment for Children Aged 6-36 Months: a Cluster Randomised Controlled Trial.

    PubMed

    Hackworth, N J; Berthelsen, D; Matthews, J; Westrupp, E M; Cann, W; Ukoumunne, O C; Bennetts, S K; Phan, T; Scicluna, A; Trajanovska, M; Yu, M; Nicholson, J M

    2017-04-01

    This study evaluated the effectiveness of a group parenting intervention designed to strengthen the home learning environment of children from disadvantaged families. Two cluster randomised controlled superiority trials were conducted in parallel and delivered within existing services: a 6-week parenting group (51 locations randomised; 986 parents) for parents of infants (aged 6-12 months), and a 10-week facilitated playgroup (58 locations randomised; 1200 parents) for parents of toddlers (aged 12-36 months). Each trial had three conditions: intervention (smalltalk group-only); enhanced intervention with home coaching (smalltalk plus); and 'standard'/usual practice controls. Parent-report and observational measures were collected at baseline, 12 and 32 weeks follow-up. Primary outcomes were parent verbal responsivity and home learning activities at 32 weeks. In the infant trial, there were no differences by trial arm for the primary outcomes at 32 weeks. In the toddler trial at 32-weeks, participants in the smalltalk group-only trial showed improvement compared to the standard program for parent verbal responsivity (effect size (ES) = 0.16; 95% CI 0.01, 0.36) and home learning activities (ES = 0.17; 95% CI 0.01, 0.38) but smalltalk plus did not. For the secondary outcomes in the infant trial, several initial differences favouring smalltalk plus were evident at 12 weeks, but not maintained to 32 weeks. For the toddler trial, differences in secondary outcomes favouring smalltalk plus were evident at 12 weeks and maintained to 32 weeks. These trials provide some evidence of the benefits of a parenting intervention focused on the home learning environment for parents of toddlers but not infants. 8 September 2011; ACTRN12611000965909 .

  9. Siblings, Theory of Mind, and Executive Functioning in Children Aged 3-6 Years: New Longitudinal Evidence

    ERIC Educational Resources Information Center

    McAlister, Anna R.; Peterson, Candida C.

    2013-01-01

    Longitudinal data were obtained from 157 children aged 3 years 3 months to 5 years 6 months at Time 1. At Time 2 these children had aged an average of 12 months. Theory of mind (ToM) and executive functioning (EF) were measured at both time points. Results suggest that Time 1 ToM scores predict Time 2 EF scores. Detailed examination of sibling…

  10. [Early prediction of the neurological result at 12 months in newborns at neurological risk].

    PubMed

    Herbón, F; Garibotti, G; Moguilevsky, J

    2015-08-01

    The aim of this study was to evaluate the Amiel-Tison neurological examination (AT) and cranial ultrasound at term for predicting the neurological result at 12 months in newborns with neurological risk. The study included 89 newborns with high risk of neurological damage, who were discharged from the Neonatal Intensive Care of the Hospital Zonal Bariloche, Argentina. The assessment consisted of a neurological examination and cranial ultrasound at term, and neurological examination and evaluation of development at 12 months. The sensitivity, specificity, positive and negative predictor value was calculated. The relationship between perinatal factors and neurodevelopment at 12 month of age was also calculated using logistic regression models. Seventy children completed the follow-up. At 12 months of age, 14% had an abnormal neurological examination, and 17% abnormal development. The neurological examination and the cranial ultrasound at term had low sensitivity to predict abnormal neurodevelopment. At 12 months, 93% of newborns with normal AT showed normal neurological results, and 86% normal development. Among newborns with normal cranial ultrasound the percentages were 90 and 81%, respectively. Among children with three or more perinatal risk factors, the frequency of abnormalities in the neurological response was 5.4 times higher than among those with fewer risk factors, and abnormal development was 3.5 times more frequent. The neurological examination and cranial ultrasound at term had low sensitivity but high negative predictive value for the neurodevelopment at 12 months. Three or more perinatal risk factors were associated with neurodevelopment abnormalities at 12 months of age. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  11. Burden of micronutrient deficiencies by socio-economic strata in children aged 6 months to 5 years in the Philippines.

    PubMed

    Wieser, Simon; Plessow, Rafael; Eichler, Klaus; Malek, Olivia; Capanzana, Mario V; Agdeppa, Imelda; Bruegger, Urs

    2013-12-11

    Micronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs have severe health consequences and are particularly harmful during early childhood due to their impact on the physical and cognitive development. We estimate the costs of illness due to iron deficiency (IDA), vitamin A deficiency (VAD) and zinc deficiency (ZnD) in 2 age groups (6-23 and 24-59 months) of Filipino children by socio-economic strata in 2008. We build a health economic model simulating the consequences of MNDs in childhood over the entire lifetime. The model is based on a health survey and a nutrition survey carried out in 2008. The sample populations are first structured into 10 socio-economic strata (SES) and 2 age groups. Health consequences of MNDs are modelled based on information extracted from literature. Direct medical costs, production losses and intangible costs are computed and long term costs are discounted to present value. Total lifetime costs of IDA, VAD and ZnD amounted to direct medical costs of 30 million dollars, production losses of 618 million dollars and intangible costs of 122,138 disability adjusted life years (DALYs). These costs can be interpreted as the lifetime costs of a 1-year cohort affected by MNDs between the age of 6-59 months. Direct medical costs are dominated by costs due to ZnD (89% of total), production losses by losses in future lifetime (90% of total) and intangible costs by premature death (47% of total DALY losses) and losses in future lifetime (43%). Costs of MNDs differ considerably between SES as costs in the poorest third of the households are 5 times higher than in the wealthiest third. MNDs lead to substantial costs in 6-59-month-old children in the Philippines. Costs are highly concentrated in the lower SES and in children 6-23 months old. These results may have important implications for the design, evaluation and choice of the most effective and cost-effective policies aimed

  12. Immunisation coverage and its determinants among children aged 12-23 months in Atakumosa-west district, Osun State Nigeria: a cross-sectional study.

    PubMed

    Adedire, Elizabeth B; Ajayi, Ikeoluwapo; Fawole, Olufunmilayo I; Ajumobi, Olufemi; Kasasa, Simon; Wasswa, Peter; Nguku, Patrick

    2016-08-30

    Routine immunisation (RI) contributes immensely to reduction in mortality from vaccine preventable diseases (VPD) among children. The Nigerian Demographic and Health Survey, 2008 revealed that only 58 % of children in Osun State had received all recommended vaccines, which is far below World Health Organization (WHO) target of 80 %. We therefore, assessed RI uptake and its determinants among children in Atakumosa-west district of Osun State. Atakumosa-west district has an estimated population of 90,525 inhabitants. We enrolled 750 mothers of children aged 12-23 months in this cross-sectional study. Semi-structured questionnaires were used to obtain data on socio-demographic characteristics, knowledge of mothers on RI, history of RI in children and factors associated with full RI uptake. A fully-immunised child was defined as a child who had received one dose of Bacillus-Calmette-Guerin, three doses of Oral-Polio-Vaccine, three doses of Diptheria-Pertusis-Tetanus vaccine and one dose of measles vaccine by 12 months of age. We tested for the association between immunisation uptake and its likely determinants using multivariable logistic regression at 0.05 level of significance and 95 % confidence Interval (CI). Mean ± (SD) age of the mothers and children were 27.9 ± 6.1 years and 17.2 ± 4.0 months, respectively. About 94 % (703/750) of mothers had received antenatal care (ANC) and 63.3 % (475) of the children possessed vaccination cards. Seventy-six percent (571/750) had good knowledge of RI and VPD. About 58 % (275/475) of children who possessed vaccination card were fully-immunised. Mothers antenatal care attendance (aOR = 3.3, 95 % CI = 1.1-8.3), maternal tetanus toxoid immunisation (aOR = 3.2, 95 % CI = 1.1-10.0) access to immunisation information (aOR = 1.8, 95 % CI = 1.1-2.5) and mothers having good knowledge of immunisation (aOR = 2.4, 95 % CI = 1.6-3.8) were significant determinants of full

  13. Infrapopliteal stenting with silicon carbide-coated stents in critical limb ischemia: a 12 month follow-up study.

    PubMed

    Atar, Eli; Avrahami, Ram; Koganovich, Yuri; Litvin, Sergey; Knizhnik, Michael; Belenky, Alexander

    2009-10-01

    Critical limb ischemia is an increasingly common condition that has high surgical morbidity and limited non-surgical options. To evaluate the use of silicon carbide-coated Motion stents, as compared to reported data for bare metal stents, in elderly patients with infrapopliteal artery stenoses causing critical limb ischemia after failed or complicated percutaneous transluminal angioplasty. Between January 2003 and March 2004, 41 stents were inserted into 17 consecutive patients (11 males, 6 females, mean age 82 years, range 75-93) following unsuccessful or complicated PTA. Seven patients had one-vessel run-off, six had two-vessel and four had three vessel run-off. All patients suffered from CLI, had up to three lesions and more than one co-morbid condition, and were considered at high surgical risk. Silicon carbide-coated Motion coronary stents, 2.5-4 mm diameterand 25 and 30 mm length, were used. Pre-intervention assessment included clinical condition, ankle brachial index, Doppler ultrasound and digital subtracted angiography. Postintervention evaluation included clinical condition, ABI and Doppler ultrasound at 3, 6 and 12 months. The technical success rate per lesion was 100% (41/41). Two patients died of unrelated causes after 2 and 8 months respectively. Primary patency rates with duplex ultrasound were 68.7% (11/16) at 3 months, 43.7% (7/16) at 6 months and 40% (6/15) after 12 months. Nine patients developed complete occlusion in 13 stents; three of these patients underwent a below-knee amputation and two patients a partial foot amputation. Re-intervention (PTA only) was performed in 7 patients (43.7%). Secondary patency rate was 81.2% (13/16) at 6 months and 60% (9/15) at one year. Mean ABI index had improved at 6 months from 0.32 to 0.67, and to 0.53 at one year. Clinical improvement was evident in 87.5% (14/16) at 6 months and in 66.6% (10/15) at one year. Silicon carbide-coated stents are comparable to bare metal stents after 6 and 12 months in

  14. Coverage and parental perceptions of influenza vaccination among parents of children aged 6 to 23 months in Hong Kong

    PubMed Central

    2013-01-01

    Background The impact of influenza on young children can be severe and even fatal. Influenza vaccination (IV) has been shown to be effective in reducing complications of influenza among children. This study investigated the prevalence and factors of IV among children aged 6-23 months in Hong Kong. Methods A sample of 401 Chinese parents of children aged 6-23 months were interviewed at local Maternal and Child Health Centers. Socio-demographic information, variables related to Health Belief Model, including perceptions about the child’s chance of contracting influenza, perceived harm of influenza on children, perceived benefits and side-effects of IV, having received recommendations from health professionals to uptake IV, and IV behaviors of the children were measured. Multivariate analysis was used to examine factors associated with IV behaviors of children. Results Only 9% of the children had ever been vaccinated. Among those parents who had heard of IV (92.0%), substantial proportions perceived that IV could reduce the risk of influenza-induced complications (70.5%), hospitalization (70.5%) and death (65.9%). Relatively few of the participants believed that IV had no side effects (17.1%) and even less had been recommended by health care professionals to uptake IV (10.6%). Results from multivariate analysis showed that physician recommendations were associated with a higher likelihood for IV among younger children, whilst parental perceptions of the side effects of IV was associated with a lower likelihood for IV. Conclusion The prevalence of IV among children aged 6-23 months in Hong Kong was very low. Promotion of IV with the component of physician recommendations and parents’ knowledge about IV safety for this group is warranted. PMID:24171947

  15. Circadian feeding patterns of 12-month-old infants.

    PubMed

    Wee, Poh Hui; Loy, See Ling; Toh, Jia Ying; Tham, Elaine Kwang Hsia; Cheung, Yin Bun; Godfrey, Keith M; Gluckman, Peter D; Saw, Seang Mei; Chong, Yap-Seng; Lek, Ngee; Chan, Jerry Kok Yen; Goh, Daniel Yam Thiam; Chong, Mary Foong-Fong; Yap, Fabian

    2017-06-01

    Early life nutrition and feeding practices are important modifiable determinants of subsequent obesity, yet little is known about the circadian feeding pattern of 12-month-old infants. We aimed to describe the 24-h feeding patterns of 12-month-old infants and examine their associations with maternal and infant characteristics. Mothers from a prospective birth cohort study (n 431) reported dietary intakes of their 12-month-old infants and respective feeding times using 24-h dietary recall. Based on their feeding times, infants were classified into post-midnight (00.00-05.59 hours) and pre-midnight (06.00-23.59 hours) feeders. Mean daily energy intake was 3234 (sd 950) kJ (773 (sd 227) kcal), comprising 51·8 (sd 7·8) % carbohydrate, 33·9 (sd 7·2) % fat and 14·4 (sd 3·2) % protein. Mean hourly energy intake and proportion of infants fed were lower during post-midnight than pre-midnight hours. There were 251 (58·2 %) pre-midnight and 180 (41·8 %) post-midnight feeders. Post-midnight feeders consumed higher daily energy, carbohydrate, fat and protein intakes than pre-midnight feeders (all P<0·001). The difference in energy intake originated from energy content consumed during the post-midnight period. Majority (n 173) of post-midnight feeders consumed formula milk during the post-midnight period. Using multivariate logistic regression with confounder adjustment, exclusively breast-feeding during the first 6 months of life was negatively associated with post-midnight feeding at 12 months (adjusted OR 0·31; 95 % CI 0·11, 0·82). This study provides new insights into the circadian pattern of energy intake during infancy. Our findings indicated that the timing of feeding at 12 months was associated with daily energy and macronutrient intakes, and feeding mode during early infancy.

  16. 12-MONTH PREVALENCE AND TREATMENT OF MENTAL DISORDERS IN LEBANON

    PubMed Central

    Karam, Elie G.; Mneimneh, Zeina N.; Karam, Aimee N.; Fayyad, John A.; Nasser, Soumana C.; Chatterji, Somnath; Kessler, Ronald C.

    2007-01-01

    SUMMARY Background: Mental disorders are thought to account for a significant portion of disease burden throughout the world. However, no national studies have been conducted to assess this assumption in the Arab world. Methods: As part of the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey of n = 2857 adults (ages 18+) was carried out in Lebanon (the Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation: LEBANON). Twelve-month prevalence and severity of DSM-IV disorders and treatment were assessed with the WHO Composite International Diagnostic Interview (CIDI, Version 3.0). Information was also obtained about socio-demographics and exposure to traumatic events in the Lebanon wars. Findings: One-sixth (17.0%) of respondents met criteria for at least one 12-month DSM-IV/CIDI disorder, 27.0% of whom were classified serious and an additional 36.0% moderate. Nearly half of respondents had a history of exposure to war-related traumatic events. Significantly elevated odd-ratios (OR) of mood, anxiety and impulse-control disorders were associated with two (OR = 2.0-3.6) or more (OR = 2.2-9.1) war-related traumatic events, resulting in substantially higher proportions of moderate or severe 12-month mental disorders among respondents exposed to multiple war-related traumata (16.8-20.4%) than other respondents (3.3-3.5%). Only 10.9% of respondents with 12-month disorders obtained treatment. Two-thirds of treatment was provided in the general medical sector. Interpretation: Mental disorders are common in Lebanon. Prevalence is similar to WMH surveys in Western Europe. Unmet need for treatment is considerably higher in Lebanon than in Western countries. PMID:16564362

  17. Effect of 12-month intervention with lipid-based nutrient supplements on physical activity of 18-month-old Malawian children: a randomised, controlled trial.

    PubMed

    Pulakka, A; Ashorn, U; Cheung, Y B; Dewey, K G; Maleta, K; Vosti, S A; Ashorn, P

    2015-02-01

    This study measured the effects of dietary supplementation with lipid-based nutrient supplements (LNSs) on 18-month-old children's physical activity. In a randomised, controlled, outcome-assessor blinded trial 1932 six-month-old children from Malawi received one of five interventions daily from 6-18 months of age: 10-g milk-LNS, 20-g milk-LNS, 20-g non-milk-LNS, 40-g milk-LNS or 40-g non-milk-LNS, or received no intervention in the same period (control). The control group received delayed intervention with corn-soy blend from 18-30 months. Physical activity was measured over 1 week by ActiGraph GT3X+ accelerometer at 18 months. Main outcome was mean vector magnitude accelerometer counts/15 s. Analyses were restricted to children with valid accelerometer data on at least 4 days with minimum 6 h of wearing time per day. Of the 1435 children recruited to this substudy, 1053 provided sufficient data for analysis. The mean (s.d.) vector magnitude accelerometer counts in the total sample were 307 (64). The difference (95% CI) in mean accelerometer counts, compared with the control group, was 8 (-6 to 21, P=0.258) in 10-g milk-LNS, 3 (-11 to 17, P=0.715) in 20-g milk-LNS, 5 (-8 to 19, P=0.445) in 20-g non-milk-LNS, 10 (-3 to 23, P=0.148) in 40-g milk-LNS and 2 (-12 to 16, P=0.760) in 40-g non-milk-LNS groups. Provision of 10-40 g doses of LNS daily for 12 months did not increase physical activity of Malawian toddlers.

  18. [RATE OF PHYSICAL DEVELOPMENT IN BOYS AGED 10-11 YEARS AND THE EFFECTS OF TRAINING LOADS DURING A 12-MONTH SOCCER PROGRAM].

    PubMed

    Boraczyński, Michał; Sozański, Henryk

    2015-01-01

    The aim of the study was to evaluate the rate of physical development in prepubertal boys in response to training at different loads. The study involved two groups of soccer players, experimental groups E1 (n = 26, age 10.4 ± 0.6 years) and E2 (n = 27, age 10.3 ± 0.8 years) who were involved in a 12-month soccer training program, and a control group (C) of age-matched untrained boys (n = 22). The training protocol of E1 involved a greater share of coordination-based exercises, in E2 more focus was placed on conditioning fitness and strength. Body height, mass, fat percentage, and body mass index were measured pre-, peri-, and post-training. Chronological and developmental age were used to calculate a Biological State Maturity Index (BSMI). Between-group differences were observed in body fat percentage, which was higher in the control group by 6.8% at post-training compared with E1 (p < 0.05). E1 showed the most congruence between chronological and developmental age. Developmental age was most retarded in E2 by an average of 4.3 months. Greatest between-group differences were observed in E1 and the control group for the BSMI of body height (49.9%) at pre-training. BSMI of height and mass in the control group were different (p < 0.01) from both experimental groups at pre-, peri-, and post-training. 1. The experimental soccer training programs were conducive to the physical development of boys aged 10-11 years as evidenced by the absence of disturbances in the range of observed variables characterizing the body built and biological development. 2. Body mass index did not accurately reflect changes in body composition. A more detailed analysis of body composition is required in the recruitment and selection of young soccer players in order to better control the effects of training and diet. 3. The adopted BSMI measure indicated a delay in growth according to developmental age norms in the entire sample. However, the accelerated physical development in E1 during the

  19. Compliance with WHO IYCF Indicators and Dietary Intake Adequacy in a Sample of Malaysian Infants Aged 6–23 Months

    PubMed Central

    Khor, Geok Lin; Tan, Sue Yee; Tan, Kok Leong; Chan, Pauline S.; Amarra, Maria Sofia V.

    2016-01-01

    Background: The 2010 World Health Organisation (WHO) Infant and Young Child Feeding (IYCF) indicators are useful for monitoring feeding practices. Methods: A total sample of 300 subjects aged 6 to 23 months was recruited from urban suburbs of Kuala Lumpur and Putrajaya. Compliance with each IYCF indicator was computed according to WHO recommendations. Dietary intake based on two-day weighed food records was obtained from a sub-group (N = 119) of the total sample. The mean adequacy ratio (MAR) value was computed as an overall measure of dietary intake adequacy. Contributions of core IYCF indicators to MAR were determined by multinomial logistic regression. Results: Generally, the subjects showed high compliance for (i) timely introduction of complementary foods at 6 to 8 months (97.9%); (ii) minimum meal frequency among non-breastfed children aged 6 to 23 months (95.2%); (iii) consumption of iron-rich foods at 6 to 23 months (92.3%); and minimum dietary diversity (78.0%). While relatively high proportions achieved the recommended intake levels for protein (87.4%) and iron (71.4%), lower proportions attained the recommendations for calcium (56.3%) and energy (56.3%). The intake of micronutrients was generally poor. The minimum dietary diversity had the greatest contribution to MAR (95% CI: 3.09, 39.87) (p = 0.000) among the core IYCF indicators. Conclusion: Malaysian urban infants and toddlers showed moderate to high compliance with WHO IYCF indicators. The robustness of the analytical approach in this study in quantifying contributions of IYCF indicators to MAR should be further investigated. PMID:27916932

  20. Characterization of age-associated changes in peripheral organ and brain region weights in C57BL/6 mice.

    PubMed

    Lessard-Beaudoin, Mélissa; Laroche, Mélissa; Demers, Marie-Josée; Grenier, Guillaume; Graham, Rona K

    2015-03-01

    In order to further understand age-related physiological changes and to have in depth reference values for C57BL/6 mice, we undertook a study to assess the effects of aging on peripheral organ weights, and brain region weights in wild type C57BL/6 male mice. Peripheral organs, body and brain region weights were collected from young (3-4 months), mid (12 months), old (23-28 months) and very old (>30 months) mice. Significant increases are observed with aging in body, liver, heart, kidney and spleen organ weights. A decrease in organ weight is observed with aging in liver and kidney only in the very old mice. In contrast, testes weight decreases with age. Within the brain, hippocampi, striata and olfactory bulbs weight decreases with age. These data further our knowledge of the anatomical and biological changes that occur with aging and provide reference values for physiological-based pharmacokinetic studies in C57BL/6 mice. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Knowledge and beliefs concerning early childhood caries from mothers of children ages zero to 12 months.

    PubMed

    Azevedo, Marina Sousa; Romano, Ana Regina; Dos Santos, Iná da Silva; Cenci, Maximiliano Sergio

    2014-01-01

    This study's purpose was to assess mothers' knowledge and beliefs about early childhood caries (ECC) etiology and prevention. This cross-sectional study targeted mothers (N=277) of zero- to 12-month-olds visiting 12 public health care centers in Pelotas, Rio Grande do Sul, Brazil. Information on causes of and recommendations to prevent ECC, as well as socioeconomic and demographic variables, was collected. Chi-square, univariate, and multiple logistic regression analyses were performed (P<.05). Sugar intake and lack of oral hygiene were the most frequently mentioned causes of caries. Ninety percent of the mothers were aware of the need to begin tooth-brushing during their children's first year. Mothers who had more children and were in lower socioeconomic positions were more likely to not know the correct age for the first dental visit. Our findings showed that mothers do not know all the factors that can influence caries in their children. None reported the role of micro-organisms and lack of fluoride in the caries etiology. These findings highlight the importance of providing preventive orientation to the mothers regarding early childhood caries. Information on age of first dental visit should be emphasized, especially among mothers with more than one child and low-income families.

  2. Will Any Doll Do? 12-Month-Olds' Reasoning about Goal Objects

    ERIC Educational Resources Information Center

    Spaepen, Elizabet; Spelke, Elizabeth

    2007-01-01

    Infants as young as 5 months of age view familiar actions such as reaching as goal-directed (Woodward, 1998), but how do they construe the goal of an actor's reach? Six experiments investigated whether 12-month-old infants represent reaching actions as directed to a particular individual object, to a narrowly defined object category (e.g., an…

  3. Effects of Duchenne muscular dystrophy on muscle stiffness and response to electrically-induced muscle contraction: A 12-month follow-up.

    PubMed

    Lacourpaille, Lilian; Gross, Raphaël; Hug, François; Guével, Arnaud; Péréon, Yann; Magot, Armelle; Hogrel, Jean-Yves; Nordez, Antoine

    2017-03-01

    The present study aimed to assess the ability of muscle stiffness (shear modulus) and response to electrically-induced muscle contraction to detect changes in muscle properties over a 12-month period in children with Duchenne muscular dystrophy (DMD). Ten children with DMD and nine age-matched healthy male controls participated in two experimental sessions (T 0 and T +12months ) separated by 12.4 ± 0.9 months. Two contractions of the biceps brachii were electrically-induced during which an ultrasound probe was placed over the muscle. The resting shear modulus was measured using elastography from six muscles. Evoked maximal torque was increased at T +12months in controls (+11.2 ± 7.6%, P <0.001) but was not modified in children with DMD (P = 0.222). Electromechanical delay (+12.9 ± 11.3%, P <0.001) and its force transmission component (+10.1 ± 21.6%, P = 0.003) were significantly longer at T +12months than T 0 for children with DMD. The results revealed an increase in muscle stiffness at T +12months in children with DMD for tibialis anterior (+75.1 ± 93.5%, P= 0.043), gastrocnemius medialis (+144.8 ± 180.6%, P= 0.050) and triceps brachii (+35.5 ± 32.2%, P= 0.005). This 12-month follow-up study demonstrates that electromechanical delay and elastography may help detect subtle muscle impairments in patients with DMD. These sensitive outcomes may improve the follow-up of innovative therapeutic interventions within the field of DMD. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Anemia and Micronutrient Status of Women of Childbearing Age and Children 6-59 Months in the Democratic Republic of the Congo.

    PubMed

    Harvey-Leeson, Sarah; Karakochuk, Crystal D; Hawes, Meaghan; Tugirimana, Pierrot L; Bahizire, Esto; Akilimali, Pierre Z; Michaux, Kristina D; Lynd, Larry D; Whitfield, Kyly C; Moursi, Mourad; Boy, Erick; Foley, Jennifer; McLean, Judy; Houghton, Lisa A; Gibson, Rosalind S; Green, Tim J

    2016-02-17

    Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK) and Kongo Central (KC). We determined hemoglobin (Hb), serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR), retinol binding protein (RBP), C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC), children 6-23 months (26% vs. 59% in SK; 25% vs. 42% in KC), and children 24-59 months (14% vs. 35% in SK; 23% vs. 44% in KC), respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC), children 6-23 months (51% vs. 14% in SK; 74% vs. 10% in KC), and children 24-59 months (23% vs. 4% in SK; 58% vs. 1% in KC). Regardless of indicator, iron deficiency anemia (IDA) never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP) deficiencies were all very low (<5%); RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC), children 6-23 months (23% in SK; 20% in KC), and children 24-59 months (25% in SK; 27% in KC). The rate of biochemical zinc deficiency among Congolese women and children requires attention.

  5. Risk of dietary exposure to aflatoxins and fumonisins in infants less than 6 months of age in Rombo, Northern Tanzania.

    PubMed

    Magoha, Happy; Kimanya, Martin; De Meulenaer, Bruno; Roberfroid, Dominique; Lachat, Carl; Kolsteren, Patrick

    2016-07-01

    Infants less than 6 months of age receiving foods other than breast milk are at a high risk of exposure to mycotoxins. We surveyed food intake and estimated the risk of exposures to aflatoxin and fumonisin mycotoxins for infants less than 6 months of age in Northern Tanzania. A total of 143 infants were progressively recruited and three follow-up visits were made at 1, 3 and 5 months of age. A 24-h dietary recall technique was used to estimate flour intake of infants who had been introduced to maize foods. Aflatoxins and fumonisins in the flours were analysed using high-performance liquid chromatography technique. Exposure to aflatoxins or fumonisins was estimated using the deterministic approach. By the age of 3 months, 98 infants had started taking food; 67 of them, maize flours at levels ranging from 0.57 to 37.50 g per infant per day (average 8 g per infant per day). Fifty-eight per cent of 67 maize flour samples contained detectable aflatoxins (range 0.33-69.47 μg kg(-1) ; median 6 μg kg(-1) ) and 31% contained detectable fumonisins (range 48-1224 μg kg(-1) ; median 124 μg kg(-1) ). For infants who consumed contaminated flours, aflatoxin exposure ranged from 0.14 to 120 ng kg(-1) body weight (BW) per day (all above the health concern level of 0.017 ng kg(-1) BW per day as recommended by the European Food Safety Agency) and fumonisin exposure ranged from 0.005 to 0.88 μg kg(-1) BW per day. Insignificant association was observed between exposure to fumonisins or aflatoxins and stunting or underweight. Reducing aflatoxin and fumonisin contamination of maize and dietary diversification can prevent infants and the public, in general, from exposure to the toxins. © 2014 John Wiley & Sons Ltd.

  6. [Risk factors associated to growth retardation in children 12 to 120 months of age in Arandas, Jalisco, México].

    PubMed

    Vásquez Garibay, Edgar M; Ortiz Ortega, Miguel Angel; Romero Velarde, Enrique; Nápoles Rodríguez, Francisco

    2008-12-01

    The purpose was to identify risk factors associated to deficit on linear growth in children from a semi-rural population in Arandas, Jalisco, Mexico. In a cross sectional study 432 children, 12 to 120 months old were included. Social, demographic, economical, dietetic and pathological characteristics and deficit in the height/age index (< - 1 and - 2 z score) were considered. A chi square test and Odds Ratio (CI 95%) to identify the risk and protection factors were also obtained. Risk factors for height/age deficit were: > 3 children in the family [OR 1.71 (1.01, 2.87)], soft drinks consumption > 4 times a week [OR 2.36 (1.19-4.73)], family's monthly income < 200 USA dollars [OR 3.5 (1.28, 9.76)] and per capita food expenses < 10% of a minimum salary (100 USA dollars a month) [OR 1.81 (1.06, 3.09)]; age < 24 months [OR 2.02 (1.09, 3.75)], adding sweeteners to the bottle [OR 8.56 (1.84, 54.9)], diet modification during diarrhea [OR 2.40 (1.02, 5.77)], milk intake < 4 times a week [OR 2.71 (1.55, 4.73)] and nearly significant, bean consumption [1.75 (0.98, 3.13). Protection factors: nuclear family [OR 0.28 (0.09, 0.85)] and an adequate infant formula dilution [OR 0.71 (0.60, 0.85)]. In multivariate models associated factors to deficit of height were higher consumption of soft drinks, beans and the addition of sweeteners to the bottle. In addition to socioeconomic variables, lower consumption of high quality food and proteins and higher intake of legumes were important risk factors for mild and moderate deficit height/age.

  7. Application of Ponseti method in patients older than 6 months with congenital talipes equinovarus.

    PubMed

    Wang, Yan-zhou; Wang, Xiao-wen; Zhang, Peng; Wang, Xing-shan

    2009-08-18

    To evaluate the effectiveness of Ponseti method in the treatment of congenital talipes equinovarus (CTE) in children older than 6 months. Ponseti method was used to treat 157 cases (227 feet) of CTE in children older than 6 months. All cases were classified by age and by the degree of deformity severity. The age group classification was: (1) I Group (6 months to 12 months), 113 feet in 81 cases; (2) II Group (1 to 3 years old), 78 feet in 52 cases; (3) III Group (> 3 years old), 36 feet in 24 cases. The degree of deformity of CTE was evaluated with Pirani scoring system. The cases were classified into three groups according to the deformity degree: (1) Mild Group (scoring 1-2.5), 85 feet in 56 cases; (2) Moderate Group (scoring 3-4.5), 104 feet in 71 cases; (3) Severe Group (scoring 5-6), 38 feet in 30 cases. A Pirani score of 0-0.5 is regarded as an excellent result. For each group, we evaluated the number of casts used, the percentage of excellent result according to the Pirani score, and the percentage of percutaneous achillotenotomy. The result was compared among different groups. The overall percentage of excellent result among all cases was 96.92%. Among the age groups, the percentage of excellence was not statistically different between I Group and II Group (P > 0.05). The percentage of excellence was lower in the III group than the other groups (P > 0.01). Among the groups classified by deformity degree, the percentage of excellence was the lowest in severe group (P < 0.05), and the difference between the mild group and moderate group was not statistically different (P > 0.05). The number of casts used among different groups were different (P < 0.01). Among different groups, the percentages of percutaneous achillotenotomy were significantly different (P < 0.01). 209 feet in 148 cases were followed up for average time duration of 3 years and 11 months. Relapse was observed in 40 feet in 29 cases. The percentages of relapse were not statistically different

  8. A 12-month multicenter, randomized study comparing the levonorgestrel intrauterine system with the etonogestrel subdermal implant.

    PubMed

    Apter, Dan; Briggs, Paula; Tuppurainen, Marjo; Grunert, Julia; Lukkari-Lax, Eeva; Rybowski, Sarah; Gemzell-Danielsson, Kristina

    2016-07-01

    To compare the levonorgestrel intrauterine system (LNG-IUS 8), which has an average levonorgestrel release rate of ∼8 μg/24 hours during the first year (total levonorgestrel content 13.5 mg; Jaydess/Skyla), with the etonogestrel (ENG) subdermal implant (total content, 68 mg) with regard to the 12-month discontinuation rate (primary outcome). Randomized, open-label, phase III study. Thirty-eight centers in six European countries. Study population of 766 healthy nulliparous and parous women aged 18-35 years. The LNG-IUS 8 or the ENG implant. Discontinuation rate, by treatment group, at Month 12. The 12-month discontinuation rates were 19.6% and 26.8% in the LNG-IUS 8 and ENG implant groups, respectively. The -7.2% difference was statistically significant (95% confidence interval -13.2%, -1.2%). Fewer women in the LNG-IUS 8 group than in the ENG implant group discontinued because of increased bleeding (3.2% vs. 11.3%) or adverse events (14.3% vs. 21.8%). At 12 months, more women in the LNG-IUS 8 group than in the ENG implant group were "very/somewhat satisfied" with their bleeding pattern (60.9% vs. 33.6%) and reported a preference to use their study treatment after study completion (70.1% vs. 58.5%). The LNG-IUS 8 was associated with a significantly lower 12-month discontinuation rate compared with the ENG implant; mainly because ENG implant users frequently discontinued due to increased bleeding. More LNG-IUS 8 users than ENG implant users reported being "very/somewhat satisfied" with their bleeding pattern, and reported a preference to continue using their study treatment after the study. NCT01397097. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

    PubMed

    Cheung, Gary; Foster, Gisele; de Beer, Wayne; Gee, Susan; Hawkes, Tracey; Rimkeit, Sally; Tan, Yu Mwee; Merry, Sally; Sundram, Frederick

    2017-08-01

    A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.

  10. Implications of newborn amygdala connectivity for fear and cognitive development at 6-months-of-age

    PubMed Central

    Graham, Alice M.; Buss, Claudia; Rasmussen, Jerod M.; Rudolph, Marc D.; Demeter, Damion V.; Gilmore, John H.; Styner, Martin; Entringer, Sonja; Wadhwa, Pathik D.; Fair, Damien A.

    2015-01-01

    The first year of life is an important period for emergence of fear in humans. While animal models have revealed developmental changes in amygdala circuitry accompanying emerging fear, human neural systems involved in early fear development remain poorly understood. To increase understanding of the neural foundations of human fear, it is important to consider parallel cognitive development, which may modulate associations between typical development of early fear and subsequent risk for fear-related psychopathology. We, therefore, examined amygdala functional connectivity with rs-fcMRI in 48 neonates (M=3.65 weeks, SD=1.72), and measured fear and cognitive development at 6-months-of-age. Stronger, positive neonatal amygdala connectivity to several regions, including bilateral anterior insula and ventral striatum, was prospectively associated with higher fear at 6-months. Stronger amygdala connectivity to ventral anterior cingulate/anterior medial prefrontal cortex predicted a specific phenotype of higher fear combined with more advanced cognitive development. Overall, findings demonstrate unique profiles of neonatal amygdala functional connectivity related to emerging fear and cognitive development, which may have implications for normative and pathological fear in later years. Consideration of infant fear in the context of cognitive development will likely contribute to a more nuanced understanding of fear, its neural bases, and its implications for future mental health. PMID:26499255

  11. Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month longitudinal prospective observational ARIZONA cohort study

    PubMed Central

    Pickering, Gisèle; Gavazzi, Gaëtan; Gaillat, Jacques; Paccalin, Marc; Bloch, Karine; Bouhassira, Didier

    2016-01-01

    Objectives To examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50–70 years of age: 70−) and old (≥70 years of age: 70+) patients. Design Post hoc analysis of the results of the 12-month longitudinal prospective multicentre observational ARIZONA cohort study. Settings and participants The study took place in primary care in France from 20 November 2006 to 12 September 2008. Overall, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ. Outcome measures Presence of HZ-related pain or PHN (pain persisting >3 months) was documented at day 0 and at months 3, 6, and 12. To investigate HZ and PHN burden, pain, quality of life (QoL) and mood were self-assessed using validated questionnaires (Zoster Brief Pain Inventory, 12-item Short-Form health survey and Hospital Anxiety and Depression Scale, respectively). Results As compared with younger patients, older patients more frequently presented with comorbidities, more frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion. Analgesics were more frequently prescribed to relieve acute pain or PHN in 70+ than 70− patients. Despite higher levels of medication prescription, poorer pain relief and poorer response to all questionnaires were reported in 70+ than 70− patients. Conclusions Occurrence of HZ and progression to PHN adds extra burden on top of pharmacological treatment and impaired quality of life, especially in older patients who already have health problems to cope with in everyday life. PMID:26892790

  12. Flexible memory retrieval in bilingual 6-month-old infants.

    PubMed

    Brito, Natalie; Barr, Rachel

    2014-07-01

    Memory flexibility is a hallmark of the human memory system. As indexed by generalization between perceptually dissimilar objects, memory flexibility develops gradually during infancy. A recent study has found a bilingual advantage in memory generalization at 18 months of age [Brito and Barr [2012] Developmental Science, 15, 812-816], and the present study examines when this advantage may first emerge. In the current study, bilingual 6-month-olds were more likely than monolinguals to generalize to a puppet that differed in two features (shape and color) than monolingual 6-month-olds. When challenged with a less complex change, two puppets that differed only in one feature--color, monolingual 6-month-olds were also able to generalize. These findings demonstrate early emerging differences in memory generalization in bilingual infants, and have important implications for our understanding of how early environmental variations shape the trajectory of memory development. © 2013 Wiley Periodicals, Inc.

  13. Visual acuity, refractive error, and endothelial cell density 6 and 12 months after deep lamellar endothelial keratoplasty.

    PubMed

    Fillmore, Parley D; Sutphin, John E; Goins, Kenneth M

    2010-06-01

    To report the visual acuity, refractive outcome, and endothelial cell density (ECD) up to 1 year after deep lamellar endothelial keratoplasty (DLEK) in a large prospective series. Eighty-six DLEK procedures were performed and evaluated in a prospective interventional case series. Subgroup analysis was performed to compare results from large-incision (9 mm) DLEK (n = 7), small-incision (5-8 mm) DLEK (n = 70), and penetrating keratoplasty (PKP) conversion (n = 9). Outcome measures included best-corrected visual acuity (BCVA), manifest refraction, corneal topographic astigmatism, and ECD. The percentage of eyes that achieved a BCVA of 20/40 or better after DLEK was 55% at 6 months, increasing to 61% at 1 year. Topographic astigmatism and spherical equivalent were not significantly different than preoperative measurements up to 1 year after DLEK (P > 0.05). An endothelial cell loss of 40% at 6 months and 48% by 1 year was observed. The mean ECD after DLEK was 1831 +/- 472 cells per square millimeter at 6 months and 1569 +/- 601 cells per square millimeter at 12 months. When evaluated by incision size, the ECD was better at 2066 +/- 558 cells per square millimeter with a 9-mm incision compared with only 1516 +/- 585 cells per square millimeter with a smaller incision at 1 year, although this did not reach significance (P = 0.075). The endothelial cell loss after penetrating keratoplasty conversion was similar to that in the large-incision group (P > 0.05). DLEK provides good visual acuity (> or =20/40) for the majority of patients at 1 year with stable refractive error compared with baseline. Refractive stability was observed with both large- and small-incision DLEKs; however, worrisome endothelial cell loss was observed, especially with a small-incision technique.

  14. Modifications of the acidic soluble salivary proteome in human children from birth to the age of 48months investigated by a top-down HPLC-ESI-MS platform.

    PubMed

    Manconi, B; Cabras, T; Pisano, E; Sanna, M T; Olianas, A; Fanos, V; Faa, G; Nemolato, S; Iavarone, F; Castagnola, M; Messana, I

    2013-10-08

    During the first year of life the infant oral environment undergoes dramatic changes. To investigate how the salivary proteome of human children evolves during infant development we have analyzed whole saliva of 88 children aged between 0 and 48months by a top-down platform based on RP-HPLC-ESI-MS. Children were divided according to their age into five groups (A, 0-6months, N=17; B, 7-12months, N=14; C, 13-24months, N=32; D, 25-36months, N=16; E, 37-48months, N=9). The proteins and peptides analyzed were histatins (histatin-1, histatin-3 1/24), acidic proline-rich proteins, statherin, P-B peptide, and salivary cystatins. Protein and peptide quantification based on the area of the RP-HPLC-ESI-MS extracted ion current peak evidenced that: (i) concentrations of the major salivary proteins/peptides showed a minimum in the 0-6-month-old group and increased with age; (ii) the level of histatin-1 reached a maximum in the 7-12-month-old group, a minimum in the 13-24-month-aged babies and it increased again in the 25-36-month-old group; (iii) S-type cystatins were almost undetectable in the 0-6-month-old group; (iv) P-B peptide concentration greatly increased with age; (v) histatin-3 1/24 and statherin concentrations did not show any age-related variation. The top-down proteomic approach undertaken in this work reveals that the salivary proteome of human children from birth to 48months of age shows important quantitative modifications. The concentrations of the major salivary proteins, with the exception of statherin and histatin-3 1/24, showed a minimum in the 0-6-month-old group when the expression in salivary glands is probably not fully activated. Concentrations of the salivary proteins slowly increased with age, with different trends. Only histatin-1 showed the highest concentration in the 7-12-month-old group, followed by a decrease in the 13-24-month-aged children. This particular trend could be related to the phenomenon of eruption of primary dentition. This study

  15. Variability in neurocognitive performance: Age, gender, and school-related differences in children and from ages 6 to 12.

    PubMed

    Kochhann, Renata; Gonçalves, Hosana Alves; Pureza, Janice da Rosa; Viapiana, Vanisa Fante; Fonseca, Flavia Dos Passos; Salles, Jerusa Fumagali; Fonseca, Rochele Paz

    2017-04-20

    Cognitive development in children presents peculiarities according to groups of age, gender, and type of school. Few studies have been investigating the effects of all these factors. The aim of this study was to investigate the main effects and the interactions of age, gender, and type of school in 419 children from ages 6 to 12 years old evaluated by the Child Brief Neuropsychological Assessment Battery (NEUPSILIN-Inf). Older children, children in private schools and girls presented better results. Interactions between all three independent variables were observed in different cognitive domains. The results highlight both the heterogeneity and the influence of multiple factors in children's neuropsychological development.

  16. Mutans Streptococci Colonization in Relation to Feeding Practices, Age and the Number of Teeth in 6 to 30-Month-Old Children: An in vivo Study

    PubMed Central

    Prabhakar, AR; Gaur, Anupama

    2012-01-01

    ABSTRACT Background: Early childhood caries has been characterized as first affecting the primary maxillary anterior teeth, followed by the involvement of the primary molars. Other terms for dental caries in preschool children, which inappropriately may imply cause for the disease, includes baby bottle tooth decay, nursing caries, milk bottle syndrome, baby bottle caries, nursing bottle mouth and nursing mouth. Aim: To explore the relationships of feeding practices, age and number of teeth present with mutans streptococci colonization in infants. Design and setting: A comparative clinical study conducted on 160 children aged from 6 to 30 months in the Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital in collaboration with Child Health Institute and Research Center and Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere. Materials and methods: Baseline data collection included: (i) Parents of the infants were asked open ended questions about the baby feeding practices, (ii) The age of the subjects were obtained from the immunization register maintained at Child Health Institute and Research Center and were grouped into group I (6-11 months), group II (12-17 months), group III (18-23 months) and group IV (24-30 months), (iii) Clinical examination of children was done by using mouth mirror and explorer in flash light.6 For each child number and location of erupted teeth was recorded, (iv) Microbial screening for mutans streptococci involved sampling of saliva from each child was performed by placing a sterile wooden tongue blade on the dorsum of the tongue and the number of colony forming units (CFU) were recorded. Results: According to feeding practices, 34 children were in breastfed category, 39 were in baby bottle category and 87 children reported no bottle usage. Out of 160 children examined, a total 142 children were colonized with mutans streptococci. 18 children were found to be

  17. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age--Analysis from the ROLO Randomised Controlled Trial.

    PubMed

    Horan, Mary K; McGowan, Ciara A; Gibney, Eileen R; Byrne, Jacinta; Donnelly, Jean M; McAuliffe, Fionnuala M

    2016-01-04

    Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

  18. Febrile Convulsion among Hospitalized Children Aged Six Months to Five Years and Its Association With Haemoglobin Electrophoretic Pattern.

    PubMed

    Adeboye, M; Ojuawo, A; Adeniyi, A; Ibraheem, R M; Amiwero, C

    2015-07-01

    Febrile convulsion and sickle cell disease are common in tropical countries and both are associated with significant morbidity and mortality. Worldwide, Nigeria has the highest prevalence of sickle cell disease. However, there is a dearth of knowledge on the haemoglobin electrophoresis in patients with febrile convulsions. This was a hospital based, descriptive, cross-sectional study of the relationship between haemoglobin genotype and febrile convulsion at the University of Ilorin Teaching Hospital over a period of 12 months. A self-designed pretested questionnaire was administered on the subjects, and necessary examinations and investigations were conducted. Of a total of 1675 children admitted into the emergency paediatric unit during the study period, children aged 6 months-5 years that presented with febrile convulsions were 167(10%). Of this, 1,212 were aged 6 months-5 years. Thus, the age specific, hospital-based prevalence was 13.8%. The M:F was 1.1:1. Their Haemoglobin genotype distribution was AA 131(78.4%), AS 23(13.8%), AC 6(3.6%), SS 6(3.6%), and 1(0.6%) SC. The mean age of the sickle cell disease patients was higher at 46.0±13.5 months compared to 29.2±15.4 months in the non-sickle cell disease patients (p=0.005). The mean packed cell volume in subjects with sickle cell anaemia was 8.8±1.5%; the only case of haemoglobin SC had packed cell volume of 20%, while the non-sickle cell disease patients had a normal PCV. Malaria was present in 80.4% of them. Febrile convulsion remains a common cause of hospitalisation. It is uncommon in haemoglobin SS where severe anaemia is always an accompanying derangement. The packed cell volume is nearly normal in children with normal haemoglobin genotype.

  19. A Longitudinal Analysis of Anger and Inhibitory Control in Twins from 12–36 Months of Age

    PubMed Central

    Goldsmith, H. Hill

    2010-01-01

    Inhibitory control (IC) is a dimension of child temperament that involves the self-regulation of behavioral responses under some form of instruction or expectation. Although IC is posited to appear in toddlerhood, the voluntary control of emotions such as anger begins earlier. Little research has analyzed relations between emotional development in infancy and later emerging IC. We examined phenotypic associations and genetic and environmental influences on parent-and laboratory-assessed anger and IC in a twin sample from 12 to 36 months of age. Typically, twins with low levels of IC had high levels of anger. Behavioral genetic findings confirmed significant genetic influences on anger and IC as assessed by parents, and on lab-based anger assessments. Shared environmental factors contributed to twin similarity on lab-assessed anger and IC at 36 months. Phenotypic covariance between anger and IC was largely due to overlapping genetic factors for parent ratings, and environmental factors in the laboratory. PMID:21159093

  20. Impact of mycophenolate mofetil dose posttransplantation on 12-month renal function: analysis of the MOST database.

    PubMed

    Salvadori, M; Bock, A; Chapman, J; Dussol, B; Fritsche, L; Kliem, V; Lebranchu, Y; Oppenheimer, F; Pohanka, E; Tufveson, G; Rosati, A; Puig, X; Corbetta, G

    2005-01-01

    Mycophenolate mofetil (MMF) has greatly reduced the risk of acute rejection episodes (ARE) after renal transplantation, but dose reductions/withdrawals could jeopardize long-term results. The MOST database of "de novo" patients treated with MMF at month 1 and functioning grafts at month 12 were divided into 2 groups: groups 1, 2 g MMF at month 1 and month 12; and group 2, 2 g MMF at month 1 but MMF <2 g at month 12 to evaluate renal function glonerular filtration rate (GFR). In this study, 1136 patients were receiving 2 g MMF at month 1. On month 12, 645 were on 2 g (56.8%, group 1) and 431 were on <2 g (43.2%, group 2). Group 1 included younger recipients of younger donors with fewer patients with delayed graft function (DGF). Group 1 showed more ARE during month 1 and more patients who received induction. Mean Neoral daily doses at month 1/month 12 were 5.3/3.0 and 5.3/3.1 mg/kg in group 1 and group 2, respectively (P = .05 at month 12). GFR in group 1 and group 2 were 59.06 (CI 57.10-60.60) and 53.81 (CI 52-55.7) at month 1 (P < .001); 63.7 (CI 62.1-65.30) and 55.9 (CI 54.1-57.7) mL/min*1.73 m(2) at month 12 (P < .001). The mean increases in GFR between month 1 and month 12 were 4.64 and 1.94 mL/min*1.73 m(2), respectively (P < .05). A multivariate analysis also included 795 patients from the "maintenance" patient database with retrospective detailed information. The following parameters were highly predictive for good renal function at month 12: donor age younger than 60 years, recipient age younger than 60 years, immediate graft function, 12-month MMF dose = 2 g, absence of CMV infection, and 12-month Neoral dose <3 mg/kg/d. Maintenance of MMF dose at 2 g/d during the first year appears to facilitate the attainment of optimal renal function at 12-months after kidney transplantation.

  1. The interactive association of dietary diversity scores and breast-feeding status with weight and length in Filipino infants aged 6-24 months.

    PubMed

    Wright, Melecia J; Bentley, Margaret E; Mendez, Michelle A; Adair, Linda S

    2015-07-01

    To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ). Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥ 4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included. Philippines. Infants (n 2822) measured bimonthly from 6 to 24 months. Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0.246 (95% CI 0.191, 0.302) sd longer and 0.523 (95% CI 0.451, 0.594) sd heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast-fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns. These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ.

  2. Determinants of stunting and severe stunting among Burundian children aged 6-23 months: evidence from a national cross-sectional household survey, 2014.

    PubMed

    Nkurunziza, Sandra; Meessen, Bruno; Van Geertruyden, Jean-Pierre; Korachais, Catherine

    2017-07-25

    Burundi is one of the poorest countries and is among the four countries with the highest prevalence of stunting (58%) among children aged less than 5 years. This situation undermines the economic growth of the country as undernutrition is strongly associated with less schooling and reduced economic productivity. Identifying the determinants of stunting and severe stunting may help policy-makers to direct the limited Burundian resources to the most vulnerable segments of the population, and thus make it more cost effective. This study aimed to identify predictors of stunting and severe stunting among children aged less than two years in Burundi. The sample is made up of 6199 children aged 6 to 23 months with complete anthropometric measurements from the baseline survey of an impact evaluation study of the Performance-Based financing (PBF) scheme applied to nutrition services in Burundi from 2015 to 2017. Binary and multivariable logistic regression analyses were used to examine stunting and severe stunting against a set of child, parental and household variables such as child's age or breastfeeding pattern, mother's age or knowledge of malnutrition, household size or socio-economic status. The prevalence of stunting and severe stunting were 53% [95%CI: 51.8-54.3] and 20.9% [95%CI: 19.9-22.0] respectively. Compared to children from 6-11 months, children of 12-17 months and 18-23 months had a higher risk of stunting (AdjOR:2.1; 95% CI: 1.8-2.4 and 3.2; 95% CI: 2.8-3.7). Other predictors for stunting were small babies (AdjOR=1.5; 95% CI: 1.3-1.7 for medium-size babies at birth and AdjOR=2.9; 95% CI: 2.4-3.6 for small-size babies at birth) and male children (AdjOR=1.5, 95% CI: 1.4-1.8). In addition, having no education for mothers (AdjOR=1.6; 95% CI: 1.2-2.1), incorrect mothers' child nutrition status assessment (AdjOR=3.3; 95% CI: 2.8-4), delivering at home (AdjOR=1.4; 95% CI: 1.2-1.6) were found to be predictors for stunting. More than to 2 under five children in the

  3. Frequency and determinants of malnutrition in children aged between 6 to 59 months in district Tharparkar, a rural area of Sindh.

    PubMed

    Ahsan, Shahid; Mansoori, Naveed; Mohiuddin, Syed Maqsood; Mubeen, Syed Muhammad; Saleem, Rubab; Irfanullah, Muhammad

    2017-09-01

    To assess the nutritional status of children living in Tharparkar. This cross-sectional study was conducted in four villages of Tharparkar district of Sindh, Pakistan, in 2014, and comprised children aged between 6 and 59 months. Data was collected from mothers and anthropometry of children was done using standard techniques. Nutritional status was assessed by using age- and sex-specific World Health Organisation standard charts for underweight, stunting and wasting. Data was analysed using SPSS 16. Of the 304 children assessed, 117(38.5%) were stunted, 58(19.1 %) were wasted and 101(33.2 %) were underweight with no gender discrimination. Under-nutrition was particularly observed in the second year of life. Statistically significant factors associated with stunting were illiteracy of mother, family size of >5 members, pregnancy>4 times, child mortality in last 6 months, absence of breastfeeding and no history of child vaccination(p<0.05 each). Logistic regression revealed family size of <5 members, pregnancy ?4 times, breastfeeding and vaccination were protective factors for stunting (p<0.05 each). Mortality of a child in the last 6 months in the family was 3 times more likely to have a stunted child. Stunting was the most common type of under-nutrition with no sex discrimination.

  4. Metabolic Benefits of Prior Weight Loss with and without Exercise on Subsequent 6-Month Weight Regain.

    PubMed

    Ryan, Alice S; Serra, Monica C; Goldberg, Andrew P

    2018-01-01

    To determine the 6-month follow-up effects after intentional 6-month weight loss alone (WL) and after weight loss with aerobic exercise (AEX + WL) on body composition, glucose metabolism, and cardiovascular disease risk factors in older postmenopausal women and to identify the mechanisms for weight regain. Women (n = 65, BMI > 25 kg/m 2 ) underwent maximal oxygen consumption testing, dual-energy x-ray absorptiometry, computed tomography scans, and oral glucose tolerance tests before and after 6 months of AEX + WL or WL and at 12 months ad libitum follow-up. Insulin sensitivity (M) (hyperinsulinemic-euglycemic clamp) was measured at baseline and 6 months. Thirty WL and thirty-five AEX + WL women completed a follow-up at 12 months. Similar weight loss was observed (-8%) in both groups from 0 to 6 months. Total fat mass, fat-free mass, visceral fat area, subcutaneous abdominal and midthigh fat areas, fasting glucose, insulin levels, homeostatic model assessment of insulin resistance (HOMA-IR), insulin areas under the curve, and triglyceride levels decreased similarly after WL and AEX + WL and remained lower at 12 months than at baseline, despite weight regain at 12 months. Initial M was associated with weight regain (r = -0.40, P < 0.01). Weight regain was related to independent changes in leptin and HOMA-IR from 6 to 12 months in a multiple regression model (r = 0.77, P < 0.0001). Reductions in body fat and improvements in insulin sensitivity after AEX + WL and WL were maintained at 12 months despite modest weight regain. Baseline insulin resistance partially predicted the magnitude of weight regain in postmenopausal women. © 2017 The Obesity Society.

  5. Maternal obesity increases insulin resistance, low-grade inflammation and osteochondrosis lesions in foals and yearlings until 18 months of age

    PubMed Central

    Nouveau, E.; Gautier, C.; Mendoza, L.; Dubois, C.; Dahirel, M.; Lagofun, B.; Aubrière, M-C; Lejeune, J-P; Caudron, I.; Guenon, I.; Viguié, C.; Wimel, L.; Bouraima-Lelong, H.; Serteyn, D.; Couturier-Tarrade, A.; Chavatte-Palmer, P.

    2018-01-01

    Introduction Obesity is a growing concern in horses. The effects of maternal obesity on maternal metabolism and low-grade inflammation during pregnancy, as well as offspring growth, metabolism, low-grade inflammation, testicular maturation and osteochondrotic lesions until 18 months of age were investigated. Material and methods Twenty-four mares were used and separated into two groups at insemination according to body condition score (BCS): Normal (N, n = 10, BCS ≤4) and Obese (O, n = 14, BCS ≥4.25). BCS and plasma glucose, insulin, triglyceride, urea, non-esterified fatty acid, serum amyloid A (SAA), leptin and adiponectin concentrations were monitored throughout gestation. At 300 days of gestation, a Frequently Sampled Intravenous Glucose Tolerance Test (FSIGT) was performed. After parturition, foals’ weight and size were monitored until 18 months of age with plasma SAA, leptin, adiponectin, triiodothyronine (T3), thyroxine (T4) and cortisol concentrations measured at regular intervals. At 6, 12 and 18 months of age, FSIGT and osteoarticular examinations were performed. Males were gelded at one year and expression of genes involved in testicular maturation analysed by RT-qPCR. Results Throughout the experiment, maternal BCS was higher in O versus N mares. During gestation, plasma urea and adiponectin were decreased and SAA and leptin increased in O versus N mares. O mares were also more insulin resistant than N mares with a higher glucose effectiveness. Postnatally, there was no difference in offspring growth between groups. Nevertheless, plasma SAA concentrations were increased in O versus N foals until 6 months, with O foals being consistently more insulin resistant with a higher glucose effectiveness. At 12 months of age, O foals were significantly more affected by osteochondrosis than N foals. All other parameters were not different between groups. Conclusion In conclusion, maternal obesity altered metabolism and increased low-grade inflammation in

  6. Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to <30 months in Panama: results of a cross-sectional survey.

    PubMed

    Villarreal, Iris; Turner, Rosario; Jo, Hyejin; Park, Julie; Gemmen, Eric; Pirçon, Jean-Yves; Castrejon, Maria M; Hausdorff, William P

    2017-01-05

    Acute otitis media (AOM) is the most common bacterial childhood infection. However, caregivers with children having mild episodes often do not seek healthcare services, which may lead to an under-appreciation of the disease experienced by the community. The objectives of this survey were to estimate the proportion of primary caregivers who went to a healthcare facility when they suspected that their child aged 6 to <30 months was having an AOM episode during the past 6 months and to assess what factors influenced their decision. This observational, cross-sectional survey of primary caregivers (≥18 years), with at least one child aged 6 to <30 months was performed in 19 healthcare facilities in Panama (March to May 2013). A 28-item paper questionnaire was administered to assess demographic data, AOM symptoms, as well as potential healthcare-seeking behaviour and factors influencing this behaviour. Potential confounding effects were individually assessed using Chi-squared or Cochran-Mantel-Haenszel tests, and all together in logistic regression models. The total number of eligible participants was 1330 (mean age 28.5 ± 8.0 years). Of these, 245 participants had at least one child whom they suspected had an AOM episode during the past 6 months. Of the 245 participants, 213 (86.9%) sought healthcare at a facility. Several factors were associated with healthcare usage: perceived severity of illness (p = 0.001), occupational status of the caregiver (p = 0.002), household income (p = 0.016) and length of time since the last suspected AOM episode (p = 0.032). When confronted with a child with obvious symptoms of AOM, the majority of caregivers reported seeking healthcare. This behaviour appeared to be associated with factors related to the severity of the illness, the length of time since the last episode, as well as with the income and occupational status of the caregivers themselves. As many episodes of AOM present with non

  7. Effectiveness of footwear and foot orthoses for calcaneal apophysitis: a 12-month factorial randomised trial.

    PubMed

    James, Alicia M; Williams, Cylie M; Haines, Terry P

    2016-10-01

    Calcaneal apophysitis, is a relatively common cause of heel pain in children. Very few randomised studies have evaluated treatment options. This trial compared the effectiveness of currently employed treatment options for the relief of pain and disability associated with calcaneal apophysitis. Factorial 2×2 randomised comparative effectiveness trial with 1, 2, 6 and 12-month follow-up. Participants were recruited from the caseload of podiatrists at Monash health and Peninsula Health. Children aged 8-14 years with clinically diagnosed calcaneal apophysitis. Treatment factor 1: two different types of in-shoe orthoses: a heel raise or prefabricated orthoses. Treatment factor 2: footwear replacement or no footwear replacement. Our primary outcome was functional disability, the secondary outcomes were pain and ankle dorsiflexion range. A total of 133 children and their parents responded to the recruitment advertisement, 124 participated in the trial.At the 1 and 2-month follow-up points, there was a main effect of the shoe insert (heel raise) in only the physical domain for the Oxford ankle foot questionnaire (p=0.04). At the 6 and 12-month follow-up points, there was no main effect or interaction effect for any outcome measure. This trial indicates at the 2-month time point there is a relative advantage in the use of heel raises over prefabricated orthoses for the treatment for calcaneal apophysitis. At 12months there was no relative advantage to any one of the investigated treatment choices over another. Therefore, if a physical impact is experienced for greater than 2 months, the selection of treatment choice may defer to clinical judgement, cost-minimisation and or patient preference. ACTRN12609000696291. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Prevalence and Incidence of Respiratory Syncytial Virus and Other Respiratory Viral Infections in Children Aged 6 Months to 10 Years With Influenza-like Illness Enrolled in a Randomized Trial

    PubMed Central

    Nolan, Terry; Borja-Tabora, Charissa; Lopez, Pio; Weckx, Lily; Ulloa-Gutierrez, Rolando; Lazcano-Ponce, Eduardo; Kerdpanich, Angkool; Weber, Miguel Angel Rodriguez; Mascareñas de Los Santos, Abiel; Tinoco, Juan-Carlos; Safadi, Marco Aurelio P.; Seng, Lim Fong; Hernandez-de Mezerville, Marcela; Faingezicht, Idis; Cruz-Valdez, Aurelio; Feng, Yang; Li, Ping; Durviaux, Serge; Haars, Gerco; Roy-Ghanta, Sumita; Vaughn, David W.; Taylor, Sylvia

    2015-01-01

    Background. The high burden of respiratory syncytial virus (RSV)-associated morbidity and mortality makes vaccine development a priority. Methods. As part of an efficacy trial of pandemic influenza vaccines (NCT01051661), RSV epidemiology in healthy children aged 6 months to <10 years at first vaccination with influenza-like illness (ILI) was evaluated in Australia, Brazil, Colombia, Costa Rica, Mexico, the Philippines, Singapore, and Thailand between February 2010 and August 2011. Active surveillance for ILI was conducted for approximately 1 year, with nasal and throat swabs analyzed by polymerase chain reaction. The prevalence and incidence of RSV among ILI episodes were calculated. Results. A total of 6266 children were included, of whom 2421 experienced 3717 ILI episodes with a respiratory sample available. RSV was detected for 359 ILI episodes, a prevalence of 9.7% (95% confidence interval: 8.7–10.7). The highest prevalence was in children aged 12–23 or 24–35 months in all countries except the Philippines, where it was in children aged 6–11 months. The incidence of RSV-associated ILI was 7.0 (6.3–7.7) per 100 person-years (PY). Eighty-eight ILI episodes resulted in hospitalization, of which 8 were associated with RSV (prevalence 9.1% [4.0–17.1]; incidence 0.2 [0.1–0.3] per 100 PY). The incidence of RSV-associated ILI resulting in medical attendance was 6.0 (5.4–6.7) per 100 PY. RSV B subtypes were observed more frequently than A subtypes. Conclusions. Active surveillance demonstrated the considerable burden of RSV-associated illness that would not be identified through hospital-based surveillance, with a substantial part of the burden occurring in older infants and children. PMID:25673560

  9. Measles virus antibody responses in children randomly assigned to receive standard-titer edmonston-zagreb measles vaccine at 4.5 and 9 months of age, 9 months of age, or 9 and 18 months of age.

    PubMed

    Martins, Cesario; Garly, May-Lill; Bale, Carlitos; Rodrigues, Amabelia; Njie-Jobe, Jainaba; Benn, Christine S; Whittle, Hilton; Aaby, Peter

    2014-09-01

    The World Health Organization recommends administration of measles vaccine (MV) at age 9 months in low-income countries. We tested the measles virus antibody response at 4.5, 9, 18, and 24 months of age for children randomly assigned to receive standard-titer Edmonston-Zagreb MV at 4.5 and 9 months, at 9 months, or at 9 and 18 months of age. At 4.5 months of age, 75% had nonprotective measles virus antibody levels. Following receipt of MV at 4.5 months of age, 77% (316/408) had protective antibody levels at 9 months of age; after a second dose at 9 months of age, 97% (326/337) had protective levels at 24 months of age. In addition, the response at both 9 and 24 months of age was inversely correlated with the antibody level at receipt of the first dose of MV, and the second dose of MV, received at 9 months of age, provided a significant boost in antibody level to children who had low antibody levels. In the group of 318 children who received MV at 9 months of age, with or without a second dose at 18 months of age, 99% (314) had protective levels at 24 months of age. The geometric mean titer at 24 months of age was significantly lower in the group that received MV at 4.5 and 9 months of age than in the group that received MV at 9 months of age (P = .0001). In conclusion, an early 2-dose MV schedule was associated with protective measles virus antibody levels at 24 months of age in nearly all children. Clinical Trials Registration. NCT00168558. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Weight changes in obese adults 6-months after discontinuation of double-blind zonisamide or placebo treatment

    PubMed Central

    Shin, J.H.; Gadde, K.M.; Øtbye, T.; Bray, Bray

    2014-01-01

    We evaluated weight changes in obese patients at 6-months after they ended participation in a 12-month randomized controlled trial in which they received daily placebo, zonisamide 200 mg, or zonisamide 400 mg, in addition to lifestyle counseling. Of the originally randomized 225 patients, 218 completed month-12 when study interventions were discontinued. For the 154 patients who returned for 6-month follow-up off-treatment, weight changes between month-12 and month-18 for placebo (n=53), zonisamide 200 mg (n=49), and zonisamide 400 mg groups (n=52) were 0.5 kg (95% CI, −0.8 to 1.8; 0.7%), 1.5 kg (0.2 to 2.8; 1.6%; p=0.26 vs placebo) and 2.4 kg (1.1 to 3.7; 2.6%; p=0.04 vs placebo), respectively. Our results suggest that although zonisamide 400 mg daily for 12-months resulted in greater weight loss than with placebo, weight regain after discontinuation of interventions was greater in the zonisamide 400 mg group than placebo group. PMID:25123600

  11. Correlation Between Mothers' Depression and Developmental Delay in Infants Aged 6-18 Months.

    PubMed

    Vameghi, Roshanak; Amir Ali Akbari, Sedigheh; Sajjadi, Homeira; Sajedi, Firoozeh; Alavimajd, Hamid

    2015-08-23

    Regarding the importance of children's developmental status and various factors that delay their development, this study was conducted to examine the correlation between mothers' depression levels and the developmental delay in infants. This descriptive study was performed on 1053 mothers and their infants' age 6 to18 month-old in medical centers affiliated with Shahid Beheshti University of Medical Sciences, Iran, in 2014-2015. The participants were selected through multi-stage random sampling. The following instruments were used in this study: A demographic and obstetric specification questionnaire, infant specification questionnaire, the Beck Depression Inventory, and the Ages and Stages Questionnaire to determine the status of the children's development. The data were analyzed using SPSS19 software, Mann-Whitney; independent T-test and logistic-Regression tests were used. The results showed that 491 mothers (46.7%) suffered mild to extremely severe depression. The delay in infant development was 11.8%. The Mann-Whitney test showed a correlation between mothers' depression levels and developmental delay in infants (P=0.001). Moreover, there was a significant correlation between mothers' depression and developmental delays in gross-motor and problem-solving skills (P<0/05). In logistic model age of infants showed significant correlation with developmental delay (P=0.004 OR=1.07), but unwanted pregnancy, gender of infants, type of delivery and socioeconomic status had no correlation with developmental delay. Given the correlation between mothers' depression and infant development, it is recommended to screen mothers for depression in order to perform early interventions in developmental delay.

  12. Body composition and weight gain in new users of the three-monthly injectable contraceptive, depot-medroxyprogesterone acetate, after 12 months of follow-up.

    PubMed

    dos Santos, Priscilla de Nazaré Silva; Modesto, Waleska Oliveira; Dal'Ava, Nathalia; Bahamondes, Maria Valéria; Pavin, Elizabeth João; Fernandes, Arlete

    2014-12-01

    To evaluate weight gain and body composition (BC) in new users of depot-medroxyprogesterone acetate (DMPA) as a contraceptive. This cohort study followed up 20 DMPA users and 20 copper intrauterine device (TCu380A IUD) users, paired for age (± 1 year) and body mass index (BMI ± 1 kg/m(2)), during 12-months. Healthy, non-obese women aged 18 to 40 years, unaffected by conditions that could influence their body weight, were enrolled. Socio-demographic variables, habits, weight, BMI, BC using dual-energy X-ray absorptiometry, circumferences, skinfold thickness, body fat percentage and waist-to-hip ratio were evaluated. All participants were encouraged to adopt healthy habits. At baseline, median age was 29 and 30.5 years, and mean BMI was 24.8 and 24.5 kg/m(2) in the DMPA and IUD groups, respectively. At 12 months, an increase was observed in waist and hip circumference in the DMPA users and 8/20 of them had a weight gain ≥ 5% (mean 4.6 kg) with accumulation of fat centrally. There were no differences in weight gain or in BC measurements between the groups; nevertheless 40% of women in the DMPA group had larger weight gain and accumulation of fat centrally. The duration of follow-up may have been insufficient to detect differences between the groups.

  13. Population deworming every 6 months with albendazole in 1 million pre-school children in north India: DEVTA, a cluster-randomised trial

    PubMed Central

    Awasthi, Shally; Peto, Richard; Read, Simon; Richards, Susan M; Pande, Vinod; Bundy, Donald; the DEVTA (Deworming and Enhanced Vitamin A) team

    2013-01-01

    Summary Background In north India many pre-school children are underweight, many have intestinal worms, and 2–3% die at ages 1·0–6·0 years. We used the state-wide Integrated Child Development Service (ICDS) infrastructure to help to assess any effects of regular deworming on mortality. Methods Participants in this cluster-randomised study were children in catchment areas of 8338 ICDS-staffed village child-care centres (under-5 population 1 million) in 72 administrative blocks. Groups of four neighbouring blocks were cluster-randomly allocated in Oxford between 6-monthly vitamin A (retinol capsule of 200 000 IU retinyl acetate in oil, to be cut and dripped into the child's mouth every 6 months), albendazole (400 mg tablet every 6 months), both, or neither (open control). Analyses of albendazole effects are by block (36 vs 36 clusters). The study spanned 5 calendar years, with 11 6-monthly mass-treatment days for all children then aged 6–72 months. Annually, one centre per block was randomly selected and visited by a study team 1–5 months after any trial deworming to sample faeces (for presence of worm eggs, reliably assessed only after mid-study), weigh children, and interview caregivers. Separately, all 8338 centres were visited every 6 months to monitor pre-school deaths (100 000 visits, 25 000 deaths at age 1·0–6·0 years [the primary outcome]). This trial is registered at ClinicalTrials.gov, NCT00222547. Findings Estimated compliance with 6-monthly albendazole was 86%. Among 2589 versus 2576 children surveyed during the second half of the study, nematode egg prevalence was 16% versus 36%, and most infection was light. After at least 2 years of treatment, weight at ages 3·0–6·0 years (standardised to age 4·0 years, 50% male) was 12·72 kg albendazole versus 12·68 kg control (difference 0·04 kg, 95% CI −0·14 to 0·21, p=0·66). Comparing the 36 albendazole-allocated versus 36 control blocks in analyses of the primary outcome, deaths

  14. Impact of multifamily psychoeducational psychotherapy in treating children aged 8 to 12 years with mood disorders.

    PubMed

    Fristad, Mary A; Verducci, Joseph S; Walters, Kimberly; Young, Matthew E

    2009-09-01

    Childhood mood disorders lack sufficient evidence-based treatments. While psychosocial treatments are recommended for both childhood depression and bipolar disorder, empirical support is scarce. To determine whether adjunctive multifamily psychoeducational psychotherapy would improve outcome for children aged 8 to 12 years with depression or bipolar disorder. One hundred sixty-five children were studied in a randomized controlled trial of multifamily psychoeducational psychotherapy plus treatment as usual (n = 78) compared with a wait-list control (WLC) condition plus treatment as usual (n = 87). Assessments occurred at baseline and at 6, 12, and 18 months. Intervention occurred between baseline and 6 months for the immediate treatment group and between 12 and 18 months for the WLC group. University medical center. Children were recruited from mental health and physical health care providers, media contacts, and word of mouth. All had a major mood disorder (major depressive disorder or dysthymic disorder, 30%; bipolar disorder type I, type II, or not otherwise specified, 70%). Intervention Children and 1 or more parents participated in eight 90-minute multifamily psychoeducational psychotherapy sessions. Parent and child groups met separately but began and ended sessions together. The Mood Severity Index (MSI) combines Mania Rating Scale and Children's Depression Rating Scale-Revised scores. Multifamily psychoeducational psychotherapy plus treatment as usual was associated with lower MSI scores at follow-up in intent-to-treat analyses compared with WLC plus treatment as usual (MSI: chi(2)(1) = 4.55; P = .03). The WLC group showed a similar decrease in MSI scores 1 year later, when also following their treatment (MSI decrease = 3.24 units per 6 months in the immediate treatment group and 3.50 units per 6 months in the WLC group). Brief, adjunctive psychoeducational group psychotherapy is associated with improved outcome for children aged 8 to 12 years with major

  15. Vesicoureteral Reflux Index: Predicting Primary Vesicoureteral Reflux Resolution in Children Diagnosed after Age 24 Months.

    PubMed

    Garcia-Roig, Michael; Ridley, Derrick E; McCracken, Courtney; Arlen, Angela M; Cooper, Christopher S; Kirsch, Andrew J

    2017-04-01

    The Vesicoureteral Reflux Index is a validated tool that reliably predicts spontaneous resolution of reflux or at least 2 grades of improvement for patients diagnosed before age 24 months. We evaluated the Vesicoureteral Reflux Index in children older than 2 years. Patients younger than 18 years who were diagnosed with primary vesicoureteral reflux after age 24 months and had undergone 2 or more voiding cystourethrograms were identified. Disease severity was scored using the Vesicoureteral Reflux Index, a 6-point scale based on gender, reflux grade, ureteral abnormalities and reflux timing. Proportional subdistribution hazard models for competing risks identified variables associated with resolution/improvement at different time points. A total of 21 males and 250 females met inclusion criteria. Mean ± SD age was 4.0 ± 2.1 years and patients had a median vesicoureteral reflux grade of 2. The Vesicoureteral Reflux Index score improved by 1 point in 1 patient (100%), 2 points in 25 (67.6%), 3 points in 48 (37%), 4 points in 18 (21.4%) and 5 to 6 points in 4 (18.2%). Female gender (p = 0.005) and vesicoureteral reflux timing (late filling, p = 0.002; early/mid filling, p <0.001) independently predicted nonresolution. Median resolution time based on Vesicoureteral Reflux Index score was 2 months or less in 15.6% of patients (95% CI 11.0-13.8), 3 months in 34.7% (95% CI 25.4-44.1), 4 months in 55.9% (95% CI 40.1 to infinity) and 5 months or more in 30.3% (95% CI 29.5 to infinity). High grade (IV or V) reflux was not associated with resolution at any point. Ureteral abnormalities were associated with lack of resolution in the first 12 to 18 months (HR 0.29, 95% CI 0.29-0.80) but not in later followup. Vesicoureteral Reflux Index scores of 3, 4 and 5 were significantly associated with lack of resolution/improvement compared to scores of 2 or less (p = 0.031). The Vesicoureteral Reflux Index reliably predicts primary vesicoureteral reflux improvement/resolution in

  16. Determinants of default to fully completion of immunization among children aged 12 to 23 months in south Ethiopia: unmatched case-control study.

    PubMed

    Asfaw, Abiyot Getachew; Koye, Digsu Negese; Demssie, Amsalu Feleke; Zeleke, Ejigu Gebeye; Gelaw, Yalemzewod Assefa

    2016-01-01

    Immunization is a cost effective interventions of vaccine preventable disease. There is still, 2.5 million children die by vaccine preventable disease every year in developing countries. In Ethiopia, default to fully completion of child immunization is high and determinants of default to completions are not explored well in the study setting. The aim of the study was to identify determinants of default to fully completion of immunization among children between ages 12 to 23 months in Sodo Zurea District, Southern Ethiopia. Community based unmatched case-control study was conducted. Census was done to identify cases and controls before the actual data collection. A total of 344 samples (172 cases and 172 controls) were selected by simple random sampling technique. Cases were children in the age group of 12 to 23 months old who missed at least one dose from the recommended schedule. Bivariable and multivariable binary logistic regression was used to identify the determinant factors. Odds ratio, 95%CI and p - value less than 0.05 was used to measure the presence and strength of the association. Mothers of infants who are unable to read and write (AOR=8.9; 95%CI: 2.4, 33.9) and attended primary school (AOR=4.1; 95% CI:1.4-15.8), mothers who had no postnatal care follow up (AOR=0.4; 95%CI: 0.3, 0.7), good maternal knowledge towards immunization (AOR= 0.5; 95% CI: 0.3, 0.8) and maternal favorable perception towards uses of health institution for maternal and child care (AOR= 0.2; 95% CI: 0.1, 0.6) were significant determinant factors to default to fully completion of immunization. Working on maternal education, postnatal care follow up, promoting maternal knowledge and perception about child immunization are recommended measures to mitigate defaults to complete immunization.

  17. Correlation between developmental quotients (DASII) and social quotient (Malin's VSMS) in Indian children aged 6 months to 2 years.

    PubMed

    Bhave, Anupama; Bhargava, Roli; Kumar, Rashmi

    2011-03-01

    To determine correlation between developmental quotients (DQ) (DASII) and social quotients (SQ) (Malin's Vineland Social Maturity Scale (VSMS)). Malin's VSMS and DASII were done in 135 children aged 6 months to 2 years. SQ and DQ motor and mental were correlated using Pearson's correlation coefficient (r). Mean SQ and DQ and age equivalent scores were compared. Correlation coefficients between SQ and DQ (mental and motor were 0.849 and 0.791, respectively. Social age correlated highly with mental age (r = 0.906). Mean SQ was higher than mean DQa. SQ tends to be higher than DQ and correlates best with DQ mental. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Cost of influenza hospitalization at a tertiary care children's hospital and its impact on the cost-benefit analysis of the recommendation for universal influenza immunization in children age 6 to 23 months.

    PubMed

    Hall, Jennifer L; Katz, Ben Z

    2005-12-01

    To calculate the costs of influenza hospitalization at a tertiary care children's hospital as the basis of a cost-benefit analysis of the new influenza vaccine recommendation for children age 6 to 23 months. We reviewed the medical records of all patients admitted to Children's Memorial Hospital (CMH) in 2002 diagnosed with influenza. Total hospital costs were obtained from the Business Development Office. Thirty-five charts were analyzed. Both of the 2 patients requiring mechanical ventilation and 4 of 6 patients admitted to the intensive care unit had high-risk underlying medical conditions. Nine children were age 6 to 23 months; 4 of these 9 had no preexisting medical conditions. Had all 18 high-risk children over age 6 months been protected from influenza, approximately $350,000 in hospital charges could have been saved. Preventing the additional 4 hospitalizations in the otherwise low-risk children age 6 to 23 months for whom vaccine is currently recommended would have cost approximately $281,000 ($46/child) more than the hospital charges saved. When all children age 6 to 23 months are considered, influenza vaccination is less costly than other prophylactic measures. Addition of indirect costs, deaths, outpatient costs, and the cost of secondary cases would favor the cost:benefit ratio for influenza vaccination of all children age 6 to 23 months.

  19. Associations with legal representation in a compensation setting 12 months after injury.

    PubMed

    Casey, Petrina P; Feyer, Anne Marie; Cameron, Ian D

    2015-05-01

    Many people with Whiplash Associated Disorder (WAD) seek treatment though a compensation system where factors such as legal involvement have been reported as having a negative impact on recovery outcomes. To compare those with and without legal involvement in their compensation claim, and identify associations with legal involvement at 12 months post injury; and longer term disability. Inception cohort study. 246 people with WAD compensation claim. Legal involvement and Functional Rating Index at 12 months post injury. Participants were recruited from an insurance database. Baseline health (Functional Rating Index, Pain Catastrophising Scale and SF-36), socio-economic, work capacity, and claims data were collected within three months of injury and 12 months. Logistic regression models were used to identify associations with legal involvement at 12 months; and disability (FRI) at 12 months. At baseline 246 participants were enrolled into the study in a median 72 days post injury. At 12 months post injury 52 (25%) had engaged a lawyer. The significant independent associations with legal involvement at 12 months were higher levels of initial disability, work disability, speaking a language other than English at home and lower levels of mental health. Specifically, the odds of lawyer involvement at 12 months post injury was 4.9 times greater for those with work disability; 2.3 times greater for those who spoke a language other than English at home. In terms of health, they had poorer mental health and for every 10 unit increase in the baseline FRI score the odds of having lawyer involvement increased by 38%. DISABILITY: at 12 months (FRI) was significantly independently associated with, PCS-helplessness (p<0.001), age (p<0.001) and prior claim (p=0.001). This study suggests the people with lawyer involvement in their claim 12 months after injury have socio-economic disadvantage, have had a prior claim and a worse baseline health profile compared to those without a

  20. Effects of tennis play on executive function in 6-11-year-old children: a 12-month longitudinal study.

    PubMed

    Ishihara, Toru; Mizuno, Masao

    2018-06-01

    The present study aimed to assess the effects of 12 months of frequent tennis play on executive functions and the relationships of daily moderate-to-vigorous physical activity (MVPA), physical competence, and enjoyment of playing tennis to executive functions in children. Thirty-two children (6-11 years old) who had regularly played tennis (once a week; mean = 3 years, range = 0-6 years) before the study were enrolled in a 12-month intervention. Participants were allocated into two groups: low-dose (maintain current frequency of tennis play, N = 19) or high-dose (increased frequency of tennis play to four times per week, N = 13). Participants' MVPA, physical competence, enjoyment of playing tennis, and executive functions (i.e. inhibitory control, working memory, and cognitive flexibility) were evaluated before and after this intervention. The high-dose group demonstrated a greater improvement in working memory than the low-dose group, while there was no group difference in MVPA, physical competence, and enjoyment of playing tennis. Changes in MVPA were associated with improvements in cognitive flexibility. Changes in physical competence were associated with improvements in working memory and cognitive flexibility. Changes in the enjoyment of playing tennis were associated with improvements in inhibitory control. The current findings suggest that replacement of MVPA with sports activity, such as tennis enhances executive functions development, and suggest that sports programmes that seek to build competence and enjoyment might help support the development of executive functions in children.

  1. FK506-Binding Protein 12.6/1b, a Negative Regulator of [Ca2+], Rescues Memory and Restores Genomic Regulation in the Hippocampus of Aging Rats

    PubMed Central

    Gant, John C.; Blalock, Eric M.; Chen, Kuey-Chu; Kadish, Inga; Thibault, Olivier; Porter, Nada M.

    2018-01-01

    Hippocampal overexpression of FK506-binding protein 12.6/1b (FKBP1b), a negative regulator of ryanodine receptor Ca2+ release, reverses aging-induced memory impairment and neuronal Ca2+ dysregulation. Here, we tested the hypothesis that FKBP1b also can protect downstream transcriptional networks from aging-induced dysregulation. We gave hippocampal microinjections of FKBP1b-expressing viral vector to male rats at either 13 months of age (long-term, LT) or 19 months of age (short-term, ST) and tested memory performance in the Morris water maze at 21 months of age. Aged rats treated ST or LT with FKBP1b substantially outperformed age-matched vector controls and performed similarly to each other and young controls (YCs). Transcriptional profiling in the same animals identified 2342 genes with hippocampal expression that was upregulated/downregulated in aged controls (ACs) compared with YCs (the aging effect). Of these aging-dependent genes, 876 (37%) also showed altered expression in aged FKBP1b-treated rats compared with ACs, with FKBP1b restoring expression of essentially all such genes (872/876, 99.5%) in the direction opposite the aging effect and closer to levels in YCs. This inverse relationship between the aging and FKBP1b effects suggests that the aging effects arise from FKBP1b deficiency. Functional category analysis revealed that genes downregulated with aging and restored by FKBP1b were associated predominantly with diverse brain structure categories, including cytoskeleton, membrane channels, and extracellular region. Conversely, genes upregulated with aging but not restored by FKBP1b associated primarily with glial–neuroinflammatory, ribosomal, and lysosomal categories. Immunohistochemistry confirmed aging-induced rarefaction and FKBP1b-mediated restoration of neuronal microtubular structure. Therefore, a previously unrecognized genomic network modulating diverse brain structural processes is dysregulated by aging and restored by FKBP1b overexpression

  2. The Relation of Infants' Home Environments to Mental Test Performance from 6 to 36 Months: A Longitudinal Analysis.

    ERIC Educational Resources Information Center

    Elardo, Richard; And Others

    This study attempted to determine whether the mental test performance of 77 children tested at 6, 12, and 36 months of age could be predicted from scores on an Inventory of Home Stimulation used to assess the children's home environment during their infancy. The Inventory of Home Stimulation had six subscales: (1) emotional and verbal responsivity…

  3. Prenatal Adversities and Latino Children’s Autonomic Nervous System Reactivity Trajectories from 6 Months to 5 Years of Age

    PubMed Central

    Alkon, Abbey; Boyce, W. Thomas; Tran, Linh; Harley, Kim G.; Neuhaus, John; Eskenazi, Brenda

    2014-01-01

    The purpose of the study was to determine whether mothers’ adversities experienced during early pregnancy are associated with offspring’s autonomic nervous system (ANS) reactivity trajectories from 6 months to 5 years of age. This cohort study of primarily Latino families included maternal interviews at 13–14 weeks gestation about their experience of a range of adversities: father’s absence, general social support, poverty level, and household density. ANS measures of heart rate, respiratory sinus arrhythmia (parasympathetic nervous system) and preejection period (sympathetic nervous system) were collected during resting and challenging conditions on children at 6 months and 1, 3.5 and 5 years of age. Reactivity measures were calculated as the mean of the responses to challenging conditions minus a resting condition. Fixed effects models were conducted for the 212 children with two or more timepoints of ANS measures. Interactions between maternal prenatal adversity levels and child age at time of ANS protocol were included in the models, allowing the calculation of separate trajectories or slopes for each level of adversity. Results showed no significant relations between mothers’ prenatal socioeconomic or social support adversity and offspring’s parasympathetic nervous system trajectories, but there was a statistically significant relationship between social support adversity and offspring’s heart rate trajectories (p<.05) and a borderline significant relationship between socioeconomic adversity and offspring’s sympathetic nervous system trajectories (p = .05). Children whose mothers experienced one, not two, social support adversity had the smallest increases in heart rate reactivity compared to children whose mothers experienced no adversity. The children whose mothers experienced no social support and no socioeconomic adversity had the largest increases in heart rate and preejection period respectively from 6 months to 5 years showing the

  4. [Prediction of Severe Course in Infants with RSV Bronchiolitis under 6 Months. Spain].

    PubMed

    Ramos-Fernández, José Miguel; Moreno-Pérez, David; Gutiérrez-Bedmar, Mario; Hernández-Yuste, Alexandra; Cordón-Martínez, Ana María; Milano-Manso, Guillermo; Urda-Cardona, Antonio

    2017-01-19

    The need for mechanical ventilation (MV) in acute bronchiolitis (AB) by respiratory syncytial virus (RSV) varies depending on the series (6-18%). Our goal is to determine the admissions to PICU for MV in patients under 6 months with AB and define the risk factors for building a prediction model. Retrospective study of patients younger than 6 months admitted by BA-VRS between the periods April 1, 2010 and March 31, 2015 was made. The primary variable was the admission to PICU for MV. Related addition, to find risk factors in a model of binary logistic regression clinical variables were collected. A ROC curve model was developed and optimal cutoff point was identified. In 695 cases, the need of MV in the PICU (Y) was 56 (8.1%). Risk factors (Xi) included in the equation were: 1. male sex (OR 4.27) 2. postmenstrual age (OR: 0.76) 3. Weight income less than p3 (OR: 5.53) 4. intake lees than 50% (OR: 12.4) 5. Severity by scale (OR: 1.58) 6. apneas before admission (OR: 25.5) 7. bacterial superinfection (OR 5.03) and 8. gestational age more than 37 weeks OR (0.32). The area under the curve, sensitivity and specificity were 0.943, 0.84 and 0.93 respectively. The PICU admission for MV was 8.1 in every 100 healthy infants hospitalized for AB and year. The prediction model equation can help to predict patients at increased risk of severe evolution.

  5. Twelve-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg and subdermal etonogestrel implant in women aged 18-44: A retrospective claims database analysis.

    PubMed

    Law, Amy; Liao, Laura; Lin, Jay; Yaldo, Avin; Lynen, Richard

    2018-04-21

    To investigate the 12-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg (LNG-IUS 13.5) and subdermal etonogestrel (ENG) implant in the US. We identified women aged 18-44 who had an insertion of LNG-IUS 13.5 or ENG implant from the MarketScan Commercial claims database (7/1/2013-9/30/2014). Women were required to have 12 months of continuous insurance coverage prior to the insertion (baseline) and at least 12-months after (follow-up). Discontinuation was defined as presence of an insurance claim for pregnancy-related services, hysterectomy, female sterilization, a claim for another contraceptive method, or removal of the index contraceptive without re-insertion within 30 days. Using Cox regression we examined the potential impact of ENG implant vs. LNG-IUS 13.5 on the likelihood for discontinuation after controlling for patient characteristics. A total of 3680 (mean age: 25.4 years) LNG-IUS 13.5 and 23,770 (mean age: 24.6 years) ENG implant users met the selection criteria. Prior to insertion, 56.6% of LNG-IUS 13.5 and 42.1% of ENG implant users had used contraceptives, with oral contraceptives being most common (LNG-IUS 13.5: 42.1%; ENG implant: 28.5%). Among users of LNG-IUS 13.5 and ENG implant, rates of discontinuation were similar during the 12-month follow-up (LNG-IUS 13.5: 24.9%; ENG implant: 24.0%). Regression results showed that women using LNG-IUS 13.5 vs. ENG implant had similar likelihood for discontinuation (hazard ratio: 0.97, 95% confidence interval: 0.90-1.05, p=.41). In the real-world US setting, women aged 18-44 using LNG-IUS 13.5 and ENG implant have similar discontinuation rates after 12 months. In the United States, women aged 18-44 using levonorgestrel intrauterine system (13.5 mg) and subdermal etonogestrel implant have similar discontinuation rates after 12 months. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Exercise and Education Program After Breast Cancer: Benefits on Quality of Life and Symptoms at 3, 6, 12, and 24 Months' Follow-up.

    PubMed

    Leclerc, Anne-France; Slomian, Justine; Jerusalem, Guy; Coucke, Philippe; Bury, Thierry; Deflandre, Dorian; Devos, Martine; Bruyère, Olivier; Foidart-Dessalle, Marguerite; Kaux, Jean-François; Crielaard, Jean-Michel; Maquet, Didier

    2018-05-19

    Various clinical trials have demonstrated the benefits of physical training offered during and/or after breast cancer treatments. However, given the variety of adverse events that may be encountered, physical training could be combined with psychologic, relational, and social guidance. This kind of multidisciplinary program, as well as its long-term effects, have been little studied so far. Therefore, the objective of our study was to determine the benefits at 3, 6, 12, and 24 months of a 3-month exercise and education program among women after breast cancer treatment. Two hundred nine outpatients treated for primary breast carcinoma were divided into a control group (n = 106) and an experimental group (n = 103) which underwent a 3-month rehabilitation program including physical training and psychoeducational sessions. The assessments, performed before the program and at 3, 6, 12, and 24 months after inclusion, included validated questionnaires on quality of life and symptoms. The analyses revealed an improvement in quality of life and symptoms after the exercise and education program within the experimental group and a maintenance of these improvements during the 2 years of follow-up. These improvements were significantly better than those in the control group, clearly demonstrating that the program has benefits. This trial identified the benefits of a well-detailed 3-month exercise and education program over 24 months' follow-up among women after breast cancer treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. [Anemia and nutritional status of infants from two to five months of age treated in facilities of the Ministry of Health of Peru, 2012].

    PubMed

    Gómez-Guizado, Guillermo; Munares-García, Oscar

    2014-01-01

    Determine the characteristics of the levels of anemia in infants from two to five months of age treated in facilities of the Ministry of Health of Peru during 2012. This cross-sectional study uses the nutritional status information system of the National Center for Food and Nutrition, National Institute of Health of Peru in 2012. Records of 7,513 infants from two to five months of age treated in small outpatient clinics, centers and hospitals of the Ministry of Health of Peru's 25 regions were analyzed. Descriptive statistics and logistic regression techniques were used for data analysis. 10.2% (95% CI 9.5-10.9) of the infants had anemia, with frequency differences by month of age (p<0.001), altitude, (p<0.001) regions (p<0.001) and type of facility (p<0.001). In the multivariate analysis, factors associated with anemia were: age of 4 months (OR 1.2; 95% CI 1.0-1.5), age of 5 months (OR 1.4; 95% CI 1.2-1.6), obesity (OR 0.7; 95% CI 0.5-1.0) and chronic malnutrition (OR 1.3; 95% CI 1.0-1.6). The presence of anemia and chronic malnutrition before 6 months of age was evidenced, as well as that the probability of anemia increases with age and is associated with some components of nutritional status.

  8. Effect of protein intake and weight gain velocity on body fat mass at 6 months of age: the EU Childhood Obesity Programme.

    PubMed

    Escribano, J; Luque, V; Ferre, N; Mendez-Riera, G; Koletzko, B; Grote, V; Demmelmair, H; Bluck, L; Wright, A; Closa-Monasterolo, R

    2012-04-01

    Higher protein intake during the first year of life is associated with increased weight gain velocity and body mass index (BMI). However, the relationship of protein intake and weight gain velocity with body composition is unclear. To assess if the increases in weight gain velocity and BMI induced by protein intake early in life are related to an increase in fat or fat-free mass. In all, 41 infants randomized at birth to a higher or lower protein content formula (HP=17 and LP=24, respectively) and 25 breastfed infants were included. Anthropometric measures were assessed at baseline, 6, 12 and 24 months, and fat-free mass (FFM) and fat mass (FM) were assessed by isotope dilution at 6 months. Weight gain velocity (g per month) during the first 6 months of life was significantly higher among HP infants (807.8 (±93.8) vs 724.2 (±110.0) (P=0.015)). Weight gain velocity strongly correlated with FM z-score (r=0.564, P<0.001) but showed no association with FFM z-scores. FFM showed no association with BMI. Nevertheless, FM strongly correlated with BMI at 6, 12 and 24 months (r=0.475, P<0.001; r=0.332, P=0.007 and r=0.247, P=0.051, respectively). FFM and FM z-scores did not differ significantly between HP and LP infants (0.32±1.75 vs -0.31±1.17 and 0.54±2.81 vs -0.02±1.65, respectively). Our findings support the hypothesis that higher protein intakes early in life are associated with faster weight gain and in turn to higher adiposity. This mechanism could be a determinant factor for later obesity risk.

  9. Mindfulness Meditation and CBT for Insomnia: A Naturalistic 12-Month Follow-up

    PubMed Central

    Ong, Jason C.; Shapiro, Shauna L.; Manber, Rachel

    2016-01-01

    A unique intervention combining mindfulness meditation with cognitive behavioral therapy for insomnia (CBT-I) has been shown to have acute benefits at post-treatment in an open label study. The aim of the present study was to examine the long-term effects of this integrated intervention on measures of sleep and sleep-related distress in an attempt to characterize the natural course of insomnia following this treatment and to identify predictors of poor long-term outcome. Analyses were conducted on 21 participants who provided follow-up data at 6 and 12 months post treatment. At each time point, participants completed one week of sleep and meditation diaries and questionnaires related to mindfulness, sleep, and sleep-related distress, including the Pre-Sleep Arousal Scale (PSAS), Glasgow Sleep Effort Scale (GSES), Kentucky Inventory of Mindfulness Skills (KIMS), and the Insomnia Episode Questionnaire. Analyses examining the pattern of change across time (baseline, end-of-treatment, 6 month, and 12 month) revealed that several sleep-related benefits were maintained during the 12-month follow-up period. Participants who reported at least one insomnia episode (≥ 1 month) during the follow-up period had higher scores on the PSAS (p < .05) and GSES (p < .05) at end-of-treatment compared to those with no insomnia episodes. Correlations between mindfulness skills and insomnia symptoms revealed significant negative correlations (p < .05) between mindfulness skills and daytime sleepiness at each of the three time points but not with nocturnal symptoms of insomnia. These results suggest that most sleep-related benefits of an intervention combining CBT-I and mindfulness meditation were maintained during the 12-month follow-up period with indications that higher pre-sleep arousal and sleep effort at end-of-treatment constitute a risk for occurrence of insomnia during the 12 months following treatment. PMID:19114261

  10. Evaluation of an intervention to promote protective infant feeding practices to prevent childhood obesity: outcomes of the NOURISH RCT at 14 months of age and 6 months post the first of two intervention modules.

    PubMed

    Daniels, L A; Mallan, K M; Battistutta, D; Nicholson, J M; Perry, R; Magarey, A

    2012-10-01

    To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. Randomised controlled trial of a community-based early feeding intervention. Six hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire. There were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n=598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P=0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1-2.1, P=0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P=0.001) or using games (67% vs 29%, P<0.001). These results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.

  11. Low risk of attrition among adults on antiretroviral therapy in the Rwandan national program: a retrospective cohort analysis of 6, 12, and 18 month outcomes.

    PubMed

    Nuwagaba-Biribonwoha, Harriet; Jakubowski, Aleksandra; Mugisha, Veronicah; Basinga, Paulin; Asiimwe, Anita; Nash, Denis; Elul, Batya

    2014-08-29

    We report levels and determinants of attrition in Rwanda, one of the few African countries with universal ART access. We analyzed data abstracted from health facility records of a nationally representative sample of adults [≥ 18 years] who initiated ART 6, 12, and 18 months prior to data collection; and collected facility characteristics with a health facility assessment questionnaire. Weighted proportions and rates of attrition [loss to follow-up or death] were calculated, and patient- and health facility-level factors associated with attrition examined using Cox proportional hazard models. 1678 adults initiated ART 6, 12 and 18 months prior to data collection, with 1508 person-years [PY] on ART. Attrition was 6.8% [95% confidence interval [CI] 6.0-7.8]: 2.9% [2.4-3.5] recorded deaths and 3.9% [3.4-4.5] lost to follow-up. Population attrition rate was 7.5/100 PY [6.1-9.3]. Adjusted hazard ratio [aHR] for attrition was 4.2 [3.0-5.7] among adults enrolled from in-patient wards [vs 2.2 [1.6-3.0] from PMTCT, ref: VCT]. Compared to adults who initiated ART 18 months earlier, aHR for adults who initiated ART 12 and 6 months earlier was 1.8 [1.3-2.5] and 1.3 [0.9-1.9] respectively. Male aHR was 1.4 [1.0-1.8]. AHR of adults enrolled at urban health facilities was 1.4 [1.1-1.8, ref: rural health facilities]. AHR for adults with CD4+ ≥ 200 cells/μL vs <200 cells/μL was 0.8 [0.6-1.0]; and adults attending facilities with performance-based financing since 2004-2006 [vs. 2007-2008] had aHR 0.8 [0.6-0.9]. Attrition was low in the Rwandan national program. The above patient and facility correlates of attrition can be the focus of interventions to sustain high retention.

  12. Repeated irradiation from micro-computed tomography scanning at 2, 4 and 6 months of age does not induce damage to tibial bone microstructure in male and female CD-1 mice.

    PubMed

    Sacco, Sandra M; Saint, Caitlin; Longo, Amanda B; Wakefield, Charles B; Salmon, Phil L; LeBlanc, Paul J; Ward, Wendy E

    2017-01-01

    Long-term effects of repeated i n vivo micro-computed tomography (μCT) scanning at key stages of growth and bone development (ages 2, 4 and 6 months) on trabecular and cortical bone structure, as well as developmental patterns, have not been studied. We determined the effect of repetitive μCT scanning at age 2, 4 and 6 months on tibia bone structure of male and female CD-1 mice and characterized developmental changes. At 2, 4 and 6 months of age, right tibias were scanned using in vivo μCT (Skyscan 1176) at one of three doses of radiation per scan: 222, 261 or 460 mGy. Left tibias of the same mice were scanned only at 6 months to serve as non-irradiated controls to determine whether recurrent radiation exposure alters trabecular and cortical bone structure at the proximal tibia. In males, eccentricity was lower ( P <0.05) in irradiated compared with non-irradiated tibias (222 mGy group). Within each sex, all other structural outcomes were similar between irradiated and non-irradiated tibias regardless of dose. Trabecular bone loss occurred in all mice due to age while cortical development continued to age 6 months. In conclusion, repetitive μCT scans at various radiation doses did not damage trabecular or cortical bone structure of proximal tibia in male and female CD-1 mice. Moreover, scanning at 2, 4 and 6 months of age highlight the different developmental time course between trabecular and cortical bone. These scanning protocols can be used to investigate longitudinal responses of bone structures to an intervention.

  13. Sustained glycaemic control and less nocturnal hypoglycaemia with insulin glargine 300U/mL compared with glargine 100U/mL in Japanese adults with type 1 diabetes (EDITION JP 1 randomised 12-month trial including 6-month extension).

    PubMed

    Matsuhisa, Munehide; Koyama, Masayoshi; Cheng, Xi; Sumi, Mariko; Riddle, Matthew C; Bolli, Geremia B; Hirose, Takahisa

    2016-12-01

    To evaluate the efficacy and safety of insulin glargine 300U/mL (Gla-300) versus glargine 100U/mL (Gla-100) in adults with type 1 diabetes in Japan over 12months. EDITION JP 1 was a multicentre, randomised, open-label phase 3 study. Following a 6-month on-treatment period, participants continued to receive Gla-300 or Gla-100 once daily, plus mealtime insulin, over a 6-month open-label extension phase. HbA1c, hypoglycaemia, body weight and adverse events were assessed. Overall, 114/122 (93%) and 114/121 (94%) of participants in the Gla-300 and Gla-100 group, respectively, completed the 6-month extension phase. Glycaemic control was sustained in both groups up to month 12 (mean HbA1c: Gla-300, 7.9% [62mmol/mol]; Gla-100, 7.8% [62mmol/mol]). Annualised rates of hypoglycaemia were lower with Gla-300 versus Gla-100; significantly for nocturnal confirmed (<3.0mmol/L [<54mg/dL]) or severe hypoglycaemia (2.39 and 3.85 events per participant-year; rate ratio: 0.62 [0.39-0.97]). No between-treatment differences in mean body weight change or adverse events were observed. Over 12months' treatment, participants with type 1 diabetes receiving Gla-300 achieved sustained glycaemic control and experienced less nocturnal hypoglycaemia that was confirmed (<3.0mmol/L [<54mg/dL]) or severe compared with Gla-100, supporting the 6-month results. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Beverage Consumption among U.S. Children Aged 0-24 Months: National Health and Nutrition Examination Survey (NHANES).

    PubMed

    Grimes, Carley A; Szymlek-Gay, Ewa A; Nicklas, Theresa A

    2017-03-13

    Data on beverage consumption patterns in early life are limited. The aim of this study was to describe beverage consumption by sociodemographic characteristics, along with water intake and sources of water among U.S. children aged 0-24 months. Data from 2740 children in the 2005-2012 NHANES were analysed. Food intake was determined via one 24-h dietary recall. Beverages were categorised according to What We Eat In America groups. Poverty-Income ratio was used to define household income. During infancy (0-5.9 months and 6-11.9 months) infant formulas were the most commonly consumed beverage, 74.1% and 78.6% of children consuming, respectively. Comparatively fewer children, 41.6% and 24.3%, consumed breast milk. In toddlers (12-24 months), the most commonly consumed beverages were plain milk (83.6% of children consuming), water (68.6%), 100% fruit juice (51.8%) and sweetened beverages (31.2%). Non-Hispanic black and Mexican-American children were more likely to consume sweetened beverages, 100% fruit juice and infant formula than Non-Hispanic white children. Children from lower income households were more likely to consume sweetened beverages and 100% fruit juice and less likely to consume breast milk than children from higher income households. Total water intake increased with age and the contribution of water from food and beverage sources was ~20% and ~80% for all children, respectively. Disparities in beverage consumption by race/ethnicity and income level are apparent in early life.

  15. Dietary optimisation with omega-3 and omega-6 fatty acids for 12-23-month-old overweight and obese children in urban Jakarta.

    PubMed

    Cahyaningrum, Fitrianna; Permadhi, Inge; Ansari, Muhammad Ridwan; Prafiantini, Erfi; Rachman, Purnawati Hustina; Agustina, Rina

    2016-12-01

    Diets with a specific omega-6/omega-3 fatty acid ratio have been reported to have favourable effects in controlling obesity in adults. However, development a local-based diet by considering the ratio of these fatty acids for improving the nutritional status of overweight and obese children is lacking. Therefore, using linear programming, we developed an affordable optimised diet focusing on the ratio of omega- 6/omega-3 fatty acid intake for obese children aged 12-23 months. A crosssectional study was conducted in two subdistricts of East Jakarta involving 42 normal-weight and 29 overweight and obese children, grouped on the basis of their body mass index for-age Z scores and selected through multistage random sampling. A 24-h recall was performed for 3-nonconsecutive days to assess the children's dietary intake levels and food patterns. We conducted group and structured interviews as well as market surveys to identify food availability, accessibility and affordability. Three types of affordable optimised 7-day diet meal plans were developed on the basis of breastfeeding status. The optimised diet plan fulfilled energy and macronutrient intake requirements within the acceptable macronutrient distribution range. The omega-6/omega-3 fatty acid ratio in the children was between 4 and 10. Moreover, the micronutrient intake level was within the range of the recommended daily allowance or estimated average recommendation and tolerable upper intake level. The optimisation model used in this study provides a mathematical solution for economical diet meal plans that approximate the nutrient requirements for overweight and obese children.

  16. Anemia and Micronutrient Status of Women of Childbearing Age and Children 6–59 Months in the Democratic Republic of the Congo

    PubMed Central

    Harvey-Leeson, Sarah; Karakochuk, Crystal D.; Hawes, Meaghan; Tugirimana, Pierrot L.; Bahizire, Esto; Akilimali, Pierre Z.; Michaux, Kristina D.; Lynd, Larry D.; Whitfield, Kyly C.; Moursi, Mourad; Boy, Erick; Foley, Jennifer; McLean, Judy; Houghton, Lisa A.; Gibson, Rosalind S.; Green, Tim J.

    2016-01-01

    Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK) and Kongo Central (KC). We determined hemoglobin (Hb), serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR), retinol binding protein (RBP), C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC), children 6–23 months (26% vs. 59% in SK; 25% vs. 42% in KC), and children 24–59 months (14% vs. 35% in SK; 23% vs. 44% in KC), respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC), children 6–23 months (51% vs. 14% in SK; 74% vs. 10% in KC), and children 24–59 months (23% vs. 4% in SK; 58% vs. 1% in KC). Regardless of indicator, iron deficiency anemia (IDA) never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP) deficiencies were all very low (<5%); RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC), children 6–23 months (23% in SK; 20% in KC), and children 24–59 months (25% in SK; 27% in KC). The rate of biochemical zinc deficiency among Congolese women and children requires attention. PMID:26901219

  17. Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up

    PubMed Central

    Dias E Dias de Macedo, Liliane; De Oliveira, Thaís Cristina Galdino; Soares, Fernanda Cabral; Bento-Torres, João; Bento-Torres, Natáli Valim Oliver; Anthony, Daniel Clive; Picanço-Diniz, Cristovam Wanderley

    2015-01-01

    We previously demonstrated the beneficial effects of a multisensory and cognitive stimulation program, consisting of 48 sessions, twice a week, to improve the cognition of elderly subjects living either in long-term care institutions (institutionalized – I) or in communities with their families (noninstitutionalized – NI). In the present study, we evaluated these subjects after the end of the intervention and compared the rate of age-related cognitive decline of those living in an enriched community environment (NI group, n=15, 74.1±3.9 years old) with those living in the impoverished environment of long-term care institutions (I group, n=20, 75.1±6.8 years old). Both groups participated fully in our stimulation program. Over 1 year, we conducted revaluations at five time points (2 months, 4 months, 6 months, 8 months, and 12 months) after the completion of the intervention. Both elderly groups were evaluated with the mini-mental state examination and selected language tests. Progressive cognitive decline was observed in both groups over the period. Indeed, it took only 4–6 months after the end of the stimulation program for significant reductions in language test scores to become apparent. However, earlier reductions in test scores were mainly associated with I group, and linguistic prosody test scores were significantly affected by institutionalization and time, two variables that interacted and reduced these scores. Moreover, I group reduced the Montréal cognitive assessment battery language tests scores 4 months before NI group. It remains to be investigated what mechanisms may explain the earlier and more intense language losses in institutionalized elderly. PMID:26316730

  18. 12-month prevalence and concomitants of DSM-IV depression and anxiety disorders in two violence-prone cities in Brazil.

    PubMed

    Blay, Sergio L; Fillenbaum, Gerda G; Mello, Marcelo F; Quintana, Maria I; Mari, Jair J; Bressan, Rodrigo A; Andreoli, Sergio B

    2018-05-01

    Estimating 12-month prevalence of depression, anxiety, and comorbid anxiety/depression in noninstitutionalized adults (age 15-75) in two violence-prone cities. The Composite International Diagnostic Interview v2.1 (Portuguese), administered in population-representative surveys (age 15-75) in São Paulo (N = 2536) and Rio de Janeiro (N = 1208), yielded 12-month prevalence of violent events experienced, and DSM-IV diagnoses of depression and anxiety, which were classified into mutually exclusive groups: 1) no anxiety/depression; 2) anxiety only; 3) depression only; 4) comorbid anxiety/depression. Weighted analyses estimated 12-month prevalence, multinomial logistic regression compared the demographic characteristics of the diagnosis groups, and association with experienced violence. Twelve-month prevalence of anxiety alone, depression alone, and comorbid anxiety/depression was 12.7% (of whom 24.9% were also depressed), 4.9% (of whom 46.2% had anxiety), and 4.2% respectively for São Paulo; and 12.1% (18.2% of whom were depressed), 4.6% (37.0% with anxiety), and 2.7% respectively for Rio de Janeiro. All conditions were approximately twice as prevalent in women than in men in both cities. In São Paulo, comorbidity was associated with age under 60, depression alone was more prevalent among 30-59 year olds, but in 23-29 year-olds in Rio de Janeiro. Exposure to violence increased the odds of anxiety, depression, and their comorbidity. With rare exception, marital status, education, and race/ethnicity were not associated with anxiety, depression, or their comorbidity. Cross-sectional design. Prevalence rates for all conditions were high, and particularly associated with exposure to violence. Means to ameliorate violence, and its mental health effects, particularly for women, are needed. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Description of the motor development of 3-12 month old infants with Down syndrome: the influence of the postural body position.

    PubMed

    Tudella, Eloisa; Pereira, Karina; Basso, Renata Pedrolongo; Savelsbergh, Geert J P

    2011-01-01

    The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down syndrome and 25 healthy full term typical infants were assessed using the Alberta Infant Motor Scale (AIMS) monthly from 3 to 12 months of age. The infants with Down syndrome achieved significant later the level of motor performance of the typical infants. In the supine posture, the performance was significantly lesser for the Down syndrome infants in comparison to the typical infants from the 3rd to 6th month and in the 8th month. In the prone, sitting and standing postures this difference is found for all the months. In conclusion, the sequence of motor development of the Down syndrome is the same as the typical infants. However infants with Down syndrome need more time to acquire skills, mainly antigravitational ones, among them the standing position. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Emerging Perception of Causality in Action-and-Reaction Sequences from 4 to 6 Months of Age: Is It Domain-Specific?

    ERIC Educational Resources Information Center

    Schlottmann, Anne; Ray, Elizabeth D.; Surian, Luca

    2012-01-01

    Two experiments (N=136) studied how 4- to 6-month-olds perceive a simple schematic event, seen as goal-directed action and reaction from 3 years of age. In our causal reaction event, a red square moved toward a blue square, stopping prior to contact. Blue began to move away before red stopped, so that both briefly moved simultaneously at a…

  1. Interval of gonadotropin administration for in vitro embryo production from oocytes collected from Holstein calves between 2 and 6 months of age by repeated laparoscopy.

    PubMed

    Baldassarre, Hernan; Currin, Luke; Michalovic, Laura; Bellefleur, Anne-Marie; Gutierrez, Karina; Mondadori, Rafael G; Glanzner, Werner G; Schuermann, Yasmin; Bohrer, Rodrigo C; Dicks, Naomi; Lopez, Rosalba; Grand, François-Xavier; Vigneault, Christian; Blondin, Patrick; Gourdon, Jim; Bordignon, Vilceu

    2018-08-01

    Laparoscopic Ovum Pick-Up (LOPU) in calves followed by in vitro embryo production (IVEP) and transfer (ET) into adult recipients has great potential for accelerated genetic gain through shortening of the generation interval. In this study, 11 Holstein calves were subjected to up to six LOPU procedures between the ages of 2-6 months at 2-3 weeks interval. In all cases, the animals received a CIDR 5 days prior to LOPU and were gonadotropin-stimulated starting at 72 h before LOPU using one of three protocols that were rotated twice among the animals during the study. Calves were injected with FSH every 12 h (FSH12h), or every 8 h (FSH8h) or every 8 h until -36 h from LOPU at which point the FSH was replaced with a single dose of 400 IU eCG (FSH8h-eCG). No statistical differences were observed among the 3 treatments in terms of mean follicles available for aspiration (35.7 ± 16 vs. 38.5 ± 25 vs. 31.1 ± 22), mean oocytes recovered (26.5 ± 14 vs. 21.6 ± 10 vs. 19.4 ± 14) and cleavage rate (66.0 ± 14 vs. 61.1 ± 11 vs. 72.2 ± 8), for FSH12h, FSH8h and FSH8h-eCG, respectively. However, FSH8h-eCG resulted in a significantly higher rate of transferable embryos (17.5 ± 8%) compared with FSH12h (8.9 ± 5%, P < 0.05). Oocytes from follicles of ≥5 mm in diameter yielded a higher rate (P < 0.05) of development to the blastocyst stage (13.8%) than those collected from <5 mm follicles (6.8%). Animal age, by comparing animals at <100, 101 to 130 and > 130 days of age, did not affect the mean number of follicles (34.2 ± 15 vs. 39.3 ± 26 vs. 31.6 ± 25), the mean number of oocytes recovered (21.2 ± 10 vs. 24.5 ± 15 vs. 22.6 ± 17), and the cleavage rate (68.6 ± 11 vs. 61.7 ± 12 vs. 70.7 ± 10%), respectively. However, animals in the older age range had significantly higher development to the blastocyst stage (19.9 ± 6 vs. 9.5 ± 8%, P < 0

  2. The influence of attention deficits on functional recovery post stroke during the first 12 months after discharge from hospital.

    PubMed

    Hyndman, D; Pickering, R M; Ashburn, A

    2008-06-01

    Attention deficits have been linked to poor recovery after stroke and may predict outcome. We explored the influence of attention on functional recovery post stroke in the first 12 months after discharge from hospital. People with stroke completed measures of attention, balance, mobility and activities of daily living (ADL) ability at the point of discharge from hospital, and 6 and 12 months later. We used correlational analysis and stepwise linear regression to explore potential predictors of outcome. We recruited 122 men and women, mean age 70 years. At discharge, 56 (51%) had deficits of divided attention, 45 (37%) of sustained attention, 43 (36%) of auditory selective attention and 41 (37%) had visual selective attention deficits. Attention at discharge correlated with mobility, balance and ADL outcomes 12 months later. After controlling for the level of the outcome at discharge, correlations remained significant in only five of the 12 relationships. Stepwise linear regression revealed that the outcome measured at discharge, days until discharge and number of medications were better predictors of outcome: in no case was an attention variable at discharge selected as a predictor of outcome at 12 months. Although attention and function correlated significantly, this correlation was reduced after controlling for functional ability at discharge. Furthermore, side of lesion and the attention variables were not demonstrated as important predictors of outcome 12 months later.

  3. Mild pituitary phenotype in 3- and 12-month-old Aip-deficient male mice.

    PubMed

    Lecoq, Anne-Lise; Zizzari, Philippe; Hage, Mirella; Decourtye, Lyvianne; Adam, Clovis; Viengchareun, Say; Veldhuis, Johannes D; Geoffroy, Valérie; Lombès, Marc; Tolle, Virginie; Guillou, Anne; Karhu, Auli; Kappeler, Laurent; Chanson, Philippe; Kamenický, Peter

    2016-10-01

    Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene predispose humans to pituitary adenomas, particularly of the somatotroph lineage. Mice with global heterozygous inactivation of Aip (Aip(+/-)) also develop pituitary adenomas but differ from AIP-mutated patients by the high penetrance of pituitary disease. The endocrine phenotype of these mice is unknown. The aim of this study was to determine the endocrine phenotype of Aip(+/-) mice by assessing the somatic growth, ultradian pattern of GH secretion and IGF1 concentrations of longitudinally followed male mice at 3 and 12months of age. As the early stages of pituitary tumorigenesis are controversial, we also studied the pituitary histology and somatotroph cell proliferation in these mice. Aip(+/-) mice did not develop gigantism but exhibited a leaner phenotype than wild-type mice. Analysis of GH pulsatility by deconvolution in 12-month-old Aip(+/-) mice showed a mild increase in total GH secretion, a conserved GH pulsatility pattern, but a normal IGF1 concentration. No pituitary adenomas were detected up to 12months of age. An increased ex vivo response to GHRH of pituitary explants from 3-month-old Aip(+/-) mice, together with areas of enlarged acini identified on reticulin staining in the pituitary of some Aip(+/-) mice, was suggestive of somatotroph hyperplasia. Global heterozygous Aip deficiency in mice is accompanied by subtle increase in GH secretion, which does not result in gigantism. The absence of pituitary adenomas in 12-month-old Aip(+/-) mice in our experimental conditions demonstrates the important phenotypic variability of this congenic mouse model. © 2016 Society for Endocrinology.

  4. Decreased tricuspid regurgitation following percutaneous closure of congenital perimembranous ventricular septal defect: immediate and 6-month echocardiographic assessment.

    PubMed

    Xu, Xu-Dong; Liu, Su-Xuan; Bai, Yuan; Zhang, Min; Zhao, Xian-Xian; Qin, Yong-Wen

    2015-09-01

    As a common concomitant performance and the most frequent complications of transcatheter perimembranous ventricular septal defect (VSD) closure, tricuspid regurgitation (TR) has rarely been concerned. From January 2008 to December 2012, a total of 70 patients (men: 33, women: 37; mean age: 30.0 ± 17.1 years) with at least mild TR before VSD closure were examined in 508 consecutive congenital perimembranous VSD patients to investigate the outcomes of TR. After VSD closure, the jet area decreased from 3.4 ± 2.5 to 1.2 ± 2.5 cm(2) (p < 0.001); however, no significant decrease was found in 3 patients (mean age 59.7 ± 2.5 years) with severe TR (12.0 ± 1.2 versus 11.2 ± 3.2 cm(2), p = 0.668). Compared to the early outcome after VSD closure, the jet area detected by TTE at 6-month follow-up had further decreased (1.2 ± 2.5 versus 0.9 ± 2.2 cm(2), p < 0.001). In 6 patients, a slight residual shunt was detected immediately after VSD closure and diminished in 3 patients at 6-month follow-up. The hemolysis occurred in one of these six patients and recovered after 3 days. In conclusion, functional TR was ameliorated after percutaneous VSD closure, although persistent abundant TR was common in patients with severe TR before procedure.

  5. Burden of micronutrient deficiencies by socio-economic strata in children aged 6 months to 5 years in the Philippines

    PubMed Central

    2013-01-01

    Background Micronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs have severe health consequences and are particularly harmful during early childhood due to their impact on the physical and cognitive development. We estimate the costs of illness due to iron deficiency (IDA), vitamin A deficiency (VAD) and zinc deficiency (ZnD) in 2 age groups (6–23 and 24–59 months) of Filipino children by socio-economic strata in 2008. Methods We build a health economic model simulating the consequences of MNDs in childhood over the entire lifetime. The model is based on a health survey and a nutrition survey carried out in 2008. The sample populations are first structured into 10 socio-economic strata (SES) and 2 age groups. Health consequences of MNDs are modelled based on information extracted from literature. Direct medical costs, production losses and intangible costs are computed and long term costs are discounted to present value. Results Total lifetime costs of IDA, VAD and ZnD amounted to direct medical costs of 30 million dollars, production losses of 618 million dollars and intangible costs of 122,138 disability adjusted life years (DALYs). These costs can be interpreted as the lifetime costs of a 1-year cohort affected by MNDs between the age of 6–59 months. Direct medical costs are dominated by costs due to ZnD (89% of total), production losses by losses in future lifetime (90% of total) and intangible costs by premature death (47% of total DALY losses) and losses in future lifetime (43%). Costs of MNDs differ considerably between SES as costs in the poorest third of the households are 5 times higher than in the wealthiest third. Conclusions MNDs lead to substantial costs in 6-59-month-old children in the Philippines. Costs are highly concentrated in the lower SES and in children 6–23 months old. These results may have important implications for the design, evaluation and choice of the

  6. Long-distance longitudinal prostate MRI quality assurance: from startup to 12 months.

    PubMed

    Curci, Nicole E; Gartland, Patrick; Shankar, Prasad R; Montgomery, Jeffrey S; Miller, David C; George, Arvin K; Davenport, Matthew S

    2018-02-22

    To evaluate a 12-month long-distance prostate MRI quality assurance (QA) program. The need for IRB approval was waived for this prospective longitudinal QA effort. One academic institution experienced with prostate MRI [~ 1000 examinations/year (Site 2)] partnered with a private institution 240 miles away that was starting a new prostate MRI program (Site 1). Site 1 performed all examinations (N = 249). Four radiologists at Site 1 created finalized reports, then sent images and reports to Site 2 for review on a rolling basis. One radiologist at Site 2 reviewed findings and exam quality and discussed results by phone (~ 2-10 minutes/MRI). In months 1-6 all examinations were reviewed. In months 7-12 only PI-RADS ≤ 2 and 'difficult' cases were reviewed. Repeatability was assessed with intra-class correlation (ICC). 'Clinically significant cancer' was Gleason ≥ 7. Image quality significantly (p < 0.001) improved after the first three months. Inter-rater agreement also improved in months 3-4 [ICC: 0.849 (95% CI 0.744-0.913)] and 5-6 [ICC: 0.768 (95% CI 0.619-0.864)] compared to months 1-2 [ICC: 0.621 (95% CI 0.436-0.756)]. PI-RADS ≤ 2 examinations were reclassified PI-RADS ≥ 3 in 19% (30/162); of these, 23 had post-MRI histology and 57% (13/23) had clinically significant cancer (5.2% of 249). False-negative examinations [N = 18 (PI-RADS ≤ 2 and Gleason ≥ 7)] were more common at Site 1 during months 1-6 [9% (14/160) vs. 4% (4/89)]. Positive predictive values for PI-RADS ≥ 3 were similar. Remote quality assurance of prostate MRI is feasible and useful, enabling new programs to gain durable skills with minimal risk to patients.

  7. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules.

    PubMed

    Bernardi, Stella; Stacul, Fulvio; Michelli, Andrea; Giudici, Fabiola; Zuolo, Giulia; de Manzini, Nicolò; Dobrinja, Chiara; Zanconati, Fabrizio; Fabris, Bruno

    2017-09-01

    Radiofrequency ablation has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodules. However, only a few studies have measured radiofrequency ablation efficacy on autonomously functioning benign thyroid nodules. The aim of this work was to evaluate the 12-month efficacy of a single session of radiofrequency ablation (performed with the moving shot technique) on solitary autonomously functioning benign thyroid nodules. Thirty patients with a single, benign autonomously functioning benign thyroid nodules, who were either unwilling or ineligible to undergo surgery and radioiodine, were treated with radiofrequency ablation between April 2012 and May 2015. All the patients underwent a single radiofrequency ablation, performed with the 18-gauge needle and the moving shot technique. Clinical, laboratory, and ultrasound evaluations were scheduled at baseline, and after 1, 3, 6, and 12 months from the procedure. A single radiofrequency ablation reduced thyroid nodule volume by 51, 63, 69, and 75 % after 1, 3, 6, and 12 months, respectively. This was associated with a significant improvement of local cervical discomfort and cosmetic score. As for thyroid function, 33 % of the patients went into remission after 3 months, 43 % after 6 months, and 50 % after 12 months from the procedure. This study demonstrates that a single radiofrequency ablation allowed us to withdraw anti-thyroid medication in 50 % of the patients, who remained euthyroid afterwards. This study shows that a single radiofrequency ablation was effective in 50 % of patients with autonomously functioning benign thyroid nodules. Patients responded gradually to the treatment. It is possible that longer follow-up studies might show greater response rates.

  8. Action Prediction Allows Hypothesis Testing via Internal Forward Models at 6 Months of Age

    PubMed Central

    Gredebäck, Gustaf; Lindskog, Marcus; Juvrud, Joshua C.; Green, Dorota; Marciszko, Carin

    2018-01-01

    We propose that action prediction provides a cornerstone in a learning process known as internal forward models. According to this suggestion infants’ predictions (looking to the mouth of someone moving a spoon upward) will moments later be validated or proven false (spoon was in fact directed toward a bowl), information that is directly perceived as the distance between the predicted and actual goal. Using an individual difference approach we demonstrate that action prediction correlates with the tendency to react with surprise when social interactions are not acted out as expected (action evaluation). This association is demonstrated across tasks and in a large sample (n = 118) at 6 months of age. These results provide the first indication that infants might rely on internal forward models to structure their social world. Additional analysis, consistent with prior work and assumptions from embodied cognition, demonstrates that the latency of infants’ action predictions correlate with the infant’s own manual proficiency. PMID:29593600

  9. Unexpectedly high early prevalence of anaemia in 6-month-old breast-fed infants in rural Bangladesh.

    PubMed

    Shakur, Yaseer A; Choudhury, Nuzhat; Hyder, S M Ziauddin; Zlotkin, Stanley H

    2010-01-01

    To determine the prevalence of anaemia and maternal and infant factors associated with Hb values in infants at 6 months of age in rural Bangladesh. Infants (born to mothers supplemented with Fe-folic acid from mid-pregnancy) were visited at birth and 6 months of age. Mothers' anthropometric status, and infants' birth weight, gestational age at birth, weight and Hb concentration at 6 months were measured. Household socio-economic and demographic data, infant feeding practices and health status were collected using a pre-tested structured questionnaire. Rural Bangladesh. Four hundred and two infants. For the total cohort (n 402), the range of anaemia prevalence values was from 30.6 % using a cut-off value of Hb < 95 g/l to 71.9 % using a value of Hb < 110 g/l. Birth weight and month of birth were the only factors positively associated with infant Hb in a linear regression model (P = 0.008 and 0.011, respectively). There was an unexpectedly high prevalence of anaemia in infants at 6 months of age, before the assumed period of vulnerability. Hb at this age tended to be higher in those with higher birth weight. We also found a season effect on Hb, as it tended to be higher as the study progressed. The high prevalence of anaemia at such an early age needs to be addressed to minimize the disease's long-term consequences.

  10. MILEPOST Multicenter Randomized Controlled Trial: 12-Month Weight Loss and Satiety Outcomes After pose SM vs. Medical Therapy.

    PubMed

    Miller, Karl; Turró, R; Greve, J W; Bakker, C M; Buchwald, J N; Espinós, J C

    2017-02-01

    Pose SM is an endolumenal weight-loss intervention in which suture anchors are placed endoscopically in the gastric fundus/distal gastric body. Observational studies of pose have shown safe, effective weight loss. Twelve-month results of a randomized controlled trial comparing weight loss and satiety after pose vs. conventional medical therapy are reported. Subjects with classes I-II obesity were randomized in a 3:1 ratio to pose or diet/exercise guidance only (control). Pose subjects received gastric fundus and distal body suture-anchor plications with diet/exercise counseling. Total body (%TBWL) and excess weight loss (%EWL) were assessed at 6 and 12 months. Analysis of covariance (ANCOVA) was used to analyze 12-month %TBWL. Satiety changes were assessed at 6 and 12 months. From November 2013 to July 2014, 44 subjects were randomized (34, 77.3 % female; mean age, 38.3 ± 10.7 years; body mass index, 36.5 ± 3.4 kg/m 2 ) to pose (n = 34) or control (n = 10) groups in three centers. Mean pose procedure time was 51.8 ± 14.5 min; pose subjects received a mean 8.8 ± 1.3 fundal and 4.2 ± 0.7 distal body plications. Twelve-month TBWL: pose, 13.0 % (EWL, 45.0 %), n = 30 vs. control group, 5.3 % (18.1 %), n = 9; significant mean difference, 7.7 % (95 % CI 2.2, 13.2; p < 0.01). Pose subjects showed significant reductions in satiety parameters (p < 0.001); controls experienced reduced caloric intake and satiety volume (p < 0.05). No serious device- or procedure-related adverse events occurred. In a randomized controlled trial at 12 months, pose-treated subjects had significantly greater weight loss than those treated with diet/exercise guidance alone. At 6 and 12 months, pose subjects showed significant reduction in satiety parameters. clinicaltrials.gov identifier # NCT01843231.

  11. The interactive association of dietary diversity scores and breast-feeding status with weight and length in Filipino infants aged 6–24 months

    PubMed Central

    Wright, Melecia J; Bentley, Margaret E; Mendez, Michelle A; Adair, Linda S

    2016-01-01

    Objective To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ). Design Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included. Setting Philippines. Subjects Infants (n 2822) measured bimonthly from 6 to 24 months. Results Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0·246 (95 % CI 0·191, 0·302) SD longer and 0·523 (95 % CI 0·451, 0·594) SD heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast- fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns. Conclusions These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ. PMID:25728248

  12. Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial.

    PubMed

    Brusco, Natasha Kareem; Watts, Jennifer J; Shields, Nora; Taylor, Nicholas F

    2015-04-18

    Our previous work showed that providing additional rehabilitation on a Saturday was cost effective in the short term from the perspective of the health service provider. This study aimed to evaluate if providing additional rehabilitation on a Saturday was cost effective at 12 months, from a health system perspective inclusive of private costs. Cost effectiveness analyses alongside a single-blinded randomized controlled trial with 12 months follow up inclusive of informal care. Participants were adults admitted to two publicly funded inpatient rehabilitation facilities. The control group received usual care rehabilitation services from Monday to Friday and the intervention group received usual care plus additional Saturday rehabilitation. Incremental cost effectiveness ratios were reported as cost per quality adjusted life year (QALY) gained and for a minimal clinical important difference (MCID) in functional independence. A total of 996 patients [mean age 74 years (SD 13)] were randomly assigned to the intervention (n = 496) or control group (n = 500). The intervention was associated with improvements in QALY and MCID in function, as well as a non-significant reduction in cost from admission to 12 months (mean difference (MD) AUD$6,325; 95% CI -4,081 to 16,730; t test p = 0.23 and MWU p = 0.06), and a significant reduction in cost from admission to 6 months (MD AUD$6,445; 95% CI 3,368 to 9,522; t test p = 0.04 and MWU p = 0.01). There is a high degree of certainty that providing additional rehabilitation services on Saturday is cost effective. Sensitivity analyses varying the cost of informal carers and self-reported health service utilization, favored the intervention. From a health system perspective inclusive of private costs the provision of additional Saturday rehabilitation for inpatients is likely to have sustained cost savings per QALY gained and for a MCID in functional independence, for the inpatient stay and 12 months following

  13. 'Toy' laser macular burns in children: 12-month update.

    PubMed

    Raoof, N; O'Hagan, J; Pawlowska, N; Quhill, F

    2016-03-01

    There is increasing evidence that high-powered hand-held laser devices cause retinal injury. We present 12-month follow-up data for three patients that we previously reported with such retinal injuries. A retrospective case series of three children with maculopathy secondary to exposure to high-power hand-held laser devices. All children underwent clinical examination and spectral domain optical coherence tomography (SD-OCT) at presentation and follow-up. Fundus-controlled microperimetry was also undertaken 12-19 months after exposure. Three children sustained macular injury after exposure to a high-powered hand-held laser. Acutely, they presented with a 'vitelliform-like' maculopathy with reduced vision. Over the course of follow-up, the best corrected Snellen acuity in all three patients improved to 'normal' levels (range 6/6-6/9). Long-term deficits in foveal retinal sensitivity were identified in two patients using fundus-controlled microperimetry. SD-OCT imaging showed persistent disruption of the foveal outer photoreceptor layers in all three children. Although visual acuity improved over time, deficits in microperimetry and SD-OCT persisted. All three children had retinal pigment epithelium changes, requiring follow-up for longer-term sequelae of laser injuries such as expansion of retinal atrophy and development of choroidal neovascular membranes.

  14. 12-month blood pressure results of catheter-based renal artery denervation for resistant hypertension: the SYMPLICITY HTN-3 trial.

    PubMed

    Bakris, George L; Townsend, Raymond R; Flack, John M; Brar, Sandeep; Cohen, Sidney A; D'Agostino, Ralph; Kandzari, David E; Katzen, Barry T; Leon, Martin B; Mauri, Laura; Negoita, Manuela; O'Neill, William W; Oparil, Suzanne; Rocha-Singh, Krishna; Bhatt, Deepak L

    2015-04-07

    Results of the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial confirmed the safety but not the efficacy of renal denervation for treatment-resistant hypertension at 6 months post procedure. This study sought to analyze the 12-month SYMPLICITY HTN-3 results for the original denervation group, the sham subjects who underwent denervation after the 6-month endpoint (crossover group), and the sham subjects who did not undergo denervation after 6 months (non-crossover group). Eligible subjects were randomized 2:1 to denervation or sham procedure. Subjects were unblinded to their treatment group after the 6-month primary endpoint was ascertained; subjects in the sham group meeting eligibility requirements could undergo denervation. Change in blood pressure (BP) at 12 months post randomization (6 months for crossover subjects) was analyzed. The 12-month follow-up was available for 319 of 361 denervation subjects and 48 of 101 non-crossover subjects; 6-month denervation follow-up was available for 93 of 101 crossover subjects. In denervation subjects, the 12-month office systolic BP (SBP) change was greater than that observed at 6 months (-15.5 ± 24.1 mm Hg vs. -18.9 ± 25.4 mm Hg, respectively; p = 0.025), but the 24-h SBP change was not significantly different at 12 months (p = 0.229). The non-crossover group office SBP decreased by -32.9 ± 28.1 mm Hg at 6 months, but this response regressed to -21.4 ± 19.9 mm Hg (p = 0.01) at 12 months, increasing to 11.5 ± 29.8 mm Hg. These data support no further reduction in office or ambulatory BP after 1-year follow-up. Loss of BP reduction in the non-crossover group may reflect decreased medication adherence or other related factors. (Renal Denervation in Patients With Uncontrolled Hypertension [SYMPLICITY HTN-3]; NCT01418261). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 vaccine and HPV-6/11/16/18 vaccine: follow-up from months 12-24 in a Phase III randomized study of healthy women aged 18-45 years.

    PubMed

    Einstein, Mark H; Baron, Mira; Levin, Myron J; Chatterjee, Archana; Fox, Bradley; Scholar, Sofia; Rosen, Jeffrey; Chakhtoura, Nahida; Meric, Dorothée; Dessy, Francis J; Datta, Sanjoy K; Descamps, Dominique; Dubin, Gary

    2011-12-01

    In this observer-blind study (NCT00423046), women (N=1,106), stratified by age (18-26, 27-35, 36-45 y), were randomized (1:1) to receive the HPV-16/18 vaccine (Cervarix®, GlaxoSmithKline Biologicals, Months 0, 1, 6) or the HPV-6/11/16/18 vaccine (Gardasil® Merck & Co., Inc., Months 0, 2, 6). Month 7 results were previously reported; we now report Month 24 results. In the according-to-protocol cohort for immunogenicity (seronegative and DNA-negative at baseline for HPV type analyzed), seropositivity rates of neutralizing antibodies (nAbs) [pseudovirion-based neutralization assay] were, across all age strata, 100% (HPV-16/18 vaccine) and 97.5-100% (HPV-6/11/16/18 vaccine) for HPV-16, and 99.0-100% (HPV-16/18 vaccine) and 72.3-84.4% (HPV-6/11/16/18 vaccine) for HPV-18. Corresponding geometric mean titers (GMTs) were 2.4-5.8-fold higher for HPV-16 and 7.7-9.4-fold higher for HPV-18 with the HPV-16/18 vaccine versus the HPV-6/11/16/18 vaccine; HPV-16 and HPV-18 GMTs were significantly higher with the HPV-16/18 vaccine than the HPV-6/11/16/18 vaccine (p< 0.0001) in the total vaccinated cohort (received ≥1 vaccine dose, irrespective of baseline sero/DNA-status). Similar results were obtained using enzyme-linked immunosorbent assay (ELISA). Positivity rates and GMTs of antigen-specific IgG antibodies in cervicovaginal secretions (ELISA) were not significantly different between vaccines. At Month 24, CD4⁺ T-cell responses for HPV-16 and HPV-18 were higher with the HPV-16/18 vaccine; memory B-cell response was higher for HPV-18 with the HPV-16/18 vaccine and similar between vaccines for HPV-16. Both vaccines were generally well tolerated. Although an immunological correlate of protection has not been defined, differences in the magnitude of immune response between vaccines may represent determinants of duration of protection.

  16. Immunogenicity, reactogenicity and safety of 2 doses of an adjuvanted herpes zoster subunit vaccine administered 2, 6 or 12 months apart in older adults: Results of a phase III, randomized, open-label, multicenter study.

    PubMed

    Lal, Himal; Poder, Airi; Campora, Laura; Geeraerts, Brecht; Oostvogels, Lidia; Vanden Abeele, Carline; Heineman, Thomas C

    2018-01-02

    In phase III trials, 2 doses of a herpes zoster (HZ) subunit vaccine (HZ/su; 50 µg varicella-zoster virus glycoprotein E [gE] and AS01 B Adjuvant System) administered 2-months apart in older adults (≥50 and ≥70 years) demonstrated >90% efficacy in preventing HZ and had a clinically acceptable safety profile. Here we report immunogenicity, reactogenicity and safety following administration of 2 HZ/su doses at intervals longer than 2 months. In this Phase III, open-label trial conducted in the US and Estonia, 354 adults ≥50 years were randomized 1:1:1 to receive 2 HZ/su doses 2, 6, or 12months apart. gE-specific humoral immune responses were evaluated at pre-vaccination, 1 and 12months post-dose 2. Co-primary objectives were to compare immune responses to HZ/su 1 month post-dose 2 when given 6-months or 12-months apart to those administered 2-months apart. For each participant, safety information was collected from dose 1 to 12months post-dose 2. 346 participants completed the study and 343 were included in the according-to-protocol cohort for immunogenicity. One month post-dose 2, vaccine response rates were 96.5% (97.5% confidence interval [CI]: 90.4; 99.2) and 94.5% (97.5% CI: 87.6; 98.3) for the 0, 6- and 0, 12-month schedules, respectively, both schedules meeting the pre-defined criterion. Non-inferiority of anti-gE geometric mean concentrations was demonstrated for HZ/su administered on 0, 6-month compared to a 0, 2-month schedule; however, HZ/su administered on a 0, 12-month schedule did not meet the non-inferiority criterion. Injection site pain was the most commonly reported solicited adverse event (AE). 26 participants each reported at least 1 serious AE; none were assessed as related to vaccination. Immune responses to HZ/su administered at 0, 6-month were non-inferior to those elicited by a 0, 2-month schedule. HZ/su exhibited a clinically acceptable safety profile for all dosing intervals. Clinicaltrials.gov (NCT01751165

  17. Nutritional Status and Effect of Maternal Employment among Children Aged 6-59 Months in Wolayta Sodo Town, Southern Ethiopia: A Cross-sectional Study.

    PubMed

    Eshete, Hiwot; Abebe, Yewelsew; Loha, Eskindir; Gebru, Teklemichael; Tesheme, Tesfalem

    2017-03-01

    Childhood malnutrition remains common in many parts of the world; the magnitude of worldwide stunting, underweight and wasting in children under five years of age were 24.7 %, 15.1 % and 7.8 %, respectively. More than 150 million children under the age of five years in the developing world are malnourished. Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of malnutrition. In Ethiopia, 44.4% and 9.7% of children under-five years old were stunted and wasted, respectively. This study was aimed to assess nutritional status and effect of maternal employment among children aged 6-59 months. A cross-sectional study was conducted in Wolayta Sodo Town, Southern Ethiopia. Socio-demographic characteristics, child feeding and healthcare seeking practice of mothers, and child's anthropometric status were assessed. Probability proportional to size sampling approach was used to select a sample of 316 mothers having children aged 6-59 months. The study was ethically approved by Institutional Review Board of Health Science College, Hawasa University. The overall result revealed that the prevalence of stunting was 22.2%, of which 21.8% and 22.6% were in children of employed and unemployed mothers, respectively. Low-weight-for age was 10.8% for children of employed mothers and 13.4% for children of unemployed mothers. Wasting was 8.8% and 10.8% for children of employed and unemployed mothers, respectively. There was no statistically significant association between maternal employment and nutritional status of their children. However, chronic malnutrition (stunting) was influenced by being educated mother (OR: 0.37) child age group of 24-59 months (OR: 0.36) and households' fifth wealth quintile (OR: 0.28). Low prevalence of stunting was observed. Stunting is a public health concern in the study area. Furthermore, stunting is significantly influenced by mothers' education, household wealth and child age. However, maternal employment was not statistically

  18. A follow-up study of neonatal interatrial shunt with echocardiography until twelve to fifteen months of age.

    PubMed

    Ho, Chi-Lin; Jan, Sheng-Ling; Lin, Ming-Chih; Fu, Yun-Ching

    2008-12-01

    To assess the incidence and natural history of full-term neonates with interatrial shunt (IAS). A follow-up study of 1389 neonates who received screening echocardiography between 2003 and 2006. Babies with IAS at 2 to 4 days of life underwent follow-up echocardiography at 2 to 4 months, 6 to 9 months and 12 to 15 months of age until closure of IAS. The ratio of IAS was 68.3% initially. No significant demographic differences were identified between infants with and without initial IAS. Among 949 neonates with initial IAS, 84.5% infants had a left-to-right interatrial shunt, 13.5% had bidirectional shunt and 2% had predominantly right-to-left shunt. The persistence rate of IAS at 12 to 15 months of age was 3.8% (44/1166). The initial size of IAS ranged from 1.2 to 7.7mm (4.3+/-1.1 mm) detected by color Doppler flow mapping and cases were divided into three groups: small (< or =5 mm), medium (5 to 8 mm) and large group (> or =8 mm). There were 74.6% infants in the small group and 25.4% in the medium group initially. The neonates in the initial small group would always see their IAS close or else they would remain in the small group. Those in the final medium and large size groups always came from the initial medium group. The late closure rate of IAS was 93.9% of infants with initial IAS. The closure curves of initial small and medium sized groups were significantly different, and their late closure rates were 95.1% and 90.4%, respectively. IAS was very common during early neonatal stage, but most cases would close after 1 year. The late closure rate of initial IAS was different if using a cutpoint of 5 mm.

  19. Predicting motor development in very preterm infants at 12 months' corrected age: the role of qualitative magnetic resonance imaging and general movements assessments.

    PubMed

    Spittle, Alicia J; Boyd, Roslyn N; Inder, Terrie E; Doyle, Lex W

    2009-02-01

    The objective of this study was to compare the predictive value of qualitative MRI of brain structure at term and general movements assessments at 1 and 3 months' corrected age for motor outcome at 1 year's corrected age in very preterm infants. Eighty-six very preterm infants (<30 weeks' gestation) underwent MRI at term-equivalent age, were evaluated for white matter abnormality, and had general movements assessed at 1 and 3 months' corrected age. Motor outcome at 1 year's corrected age was evaluated with the Alberta Infant Motor Scale, the Neuro-Sensory Motor Development Assessment, and the diagnosis of cerebral palsy by the child's pediatrician. At 1 year of age, the Alberta Infant Motor Scale categorized 30 (35%) infants as suspicious/abnormal; the Neuro-Sensory Motor Development Assessment categorized 16 (18%) infants with mild-to-severe motor dysfunction, and 5 (6%) infants were classified with cerebral palsy. White matter abnormality at term and general movements at 1 and 3 months significantly correlated with Alberta Infant Motor Scale and Neuro-Sensory Motor Development Assessment scores at 1 year. White matter abnormality and general movements at 3 months were the only assessments that correlated with cerebral palsy. All assessments had 100% sensitivity in predicting cerebral palsy. White matter abnormality demonstrated the greatest accuracy in predicting combined motor outcomes, with excellent levels of specificity (>90%); however, the sensitivity was low. On the other hand, general movements assessments at 1 month had the highest sensitivity (>80%); however, the overall accuracy was relatively low. Neuroimaging (MRI) and functional (general movements) examinations have important complementary roles in predicting motor development of very preterm infants.

  20. What barriers thwart postpartum women's physical activity goals during a 12-month intervention? A process evaluation of the Nā Mikimiki Project.

    PubMed

    Albright, Cheryl L; Saiki, Kara; Steffen, Alana D; Woekel, Erica

    2015-01-01

    Approximately 70% of new mothers do not meet national guidelines for moderate-to-vigorous physical activity (MVPA). The Nā Mikimiki ("the active ones") Project (2008-2011) was designed to increase MVPA among women with infants 2-12 months old. Participants' barriers to exercising and achievement of specific MVPA goals were discussed during telephone counseling calls over 12 months. Healthy, inactive women (n = 115, mean age = 31 ± 5 years, infants' mean age = 5.5 ± 3 months; 80% racial/ethnic minorities) received a total of 17 calls over 12 months in three phases. During Phase 1 weekly calls were made for a month, in Phase 2 biweekly calls were made for 2 months, and in Phase 3 monthly calls were made for 9 months. Across all phases, the most frequent barriers to achieving MVPA goals were: time/too busy (25%), sick child (11%), and illness (10%). Goals for MVPA minutes per week were achieved or surpassed 40.6% of the time during weekly calls, 39.9% during biweekly calls, and 42.0% during monthly calls. The least likely MVPA goals to be achieved (p < 0.04) were those which the woman encountered and for which she failed to overcome the barriers she had previously anticipated would impair her improvement of MVPA. This process evaluation demonstrated that telephone counseling somewhat facilitated the resolution of barriers and achievement of MVPA goals; thus, if clinical settings adopted such methods, chronic disease risks could be reduced in this vulnerable population of new mothers.

  1. The Effects of Irlen Colored Lenses on Students' Specific Reading Skills and Their Perception of Ability: A 12-Month Validity Study.

    ERIC Educational Resources Information Center

    Robinson, Gregory L. W.; Conway, Robert N. F.

    1990-01-01

    The study examined the effectiveness of the use of nonoptical tinted (Irlen) lenses with 44 children (ages 9-16) with reading disabilities. Evaluation after 6 and 12 months indicated a significant improvement in attitude to school and to basic academic skills. Reading comprehension and accuracy, but not rate, were also significantly improved.…

  2. Rituximab for Severe Membranous Nephropathy: A 6-Month Trial with Extended Follow-Up

    PubMed Central

    Debiec, Hanna; Plaisier, Emmanuelle; Cachanado, Marine; Rousseau, Alexandra; Wakselman, Laura; Michel, Pierre-Antoine; Mihout, Fabrice; Dussol, Bertrand; Matignon, Marie; Mousson, Christiane; Simon, Tabassome

    2017-01-01

    Randomized trials of rituximab in primary membranous nephropathy (PMN) have not been conducted. We undertook a multicenter, randomized, controlled trial at 31 French hospitals (NCT01508468). Patients with biopsy-proven PMN and nephrotic syndrome after 6 months of nonimmunosuppressive antiproteinuric treatment (NIAT) were randomly assigned to 6-month therapy with NIAT and 375 mg/m2 intravenous rituximab on days 1 and 8 (n=37) or NIAT alone (n=38). Median times to last follow-up were 17.0 (interquartile range, 12.5–24.0) months and 17.0 (interquartile range, 13.0–23.0) months in NIAT-rituximab and NIAT groups, respectively. Primary outcome was a combined end point of complete or partial remission of proteinuria at 6 months. At month 6, 13 (35.1%; 95% confidence interval [95% CI], 19.7 to 50.5) patients in the NIAT-rituximab group and eight (21.1%; 95% CI, 8.1 to 34.0) patients in the NIAT group achieved remission (P=0.21). Rates of antiphospholipase A2 receptor antibody (anti–PLA2R-Ab) depletion in NIAT-rituximab and NIAT groups were 14 of 25 (56%) and one of 23 (4.3%) patients at month 3 (P<0.001) and 13 of 26 (50%) and three of 25 (12%) patients at month 6 (P=0.004), respectively. Eight serious adverse events occurred in each group. During the observational phase, remission rates before change of assigned treatment were 24 of 37 (64.9%) and 13 of 38 (34.2%) patients in NIAT-rituximab and NIAT groups, respectively (P<0.01). Positive effect of rituximab on proteinuria remission occurred after 6 months. These data suggest that PLA2R-Ab levels are early markers of rituximab effect and that addition of rituximab to NIAT does not affect safety. PMID:27352623

  3. Age-related morphological changes in the basement membrane in the stria vascularis of C57BL/6 mice.

    PubMed

    Suzuki, Mitsuya; Sakamoto, Takashi; Kashio, Akinori; Yamasoba, Tatsuya

    2016-01-01

    Basement membrane anionic sites (BMAS) are involved in the selective transport of electrically charged macromolecules in cochlear capillaries. Using cationic polyethyleneimine (PEI), we examined age-related changes in BMAS in the cochleae of C57BL/6 mice. The mice were grouped according to age as follows: 3 days, 4 weeks, 8 weeks, 6 months, and 12 months. In the right bony labyrinths, widths of the stria vascularis were measured in paraffin-embedded sections using light microscopy. The left bony labyrinths were immersed in a 0.5 % cationic PEI solution and embedded in epoxy resin. Ultrathin sections of the left cochlea were examined using transmission electron microscopy. A significant difference in stria vascularis width was observed between the 4-week-old and 12-month-old mice. The PEI distribution in the capillary and epithelial basement membranes (BMs) of the cochlea was observed. In all animals, PEI particles were evenly distributed in the capillary BM of the spiral ligament and in the subepithelial BM of Reissner's membrane. In the stria vascularis, PEI particles were evenly distributed in the capillary BM in 3-day-old mice. In 4- and 8-week-old mice, PEI particle sizes were markedly lower than those observed in 3-day-old mice. In 6- and 12-month-old mice, PEI particles were hardly detected in the strial capillary BM. In the strial capillary BM in these mice, the laminae rarae externa and interna disappeared, but the lamina densa became larger. We speculated that age-related changes of strial capillary BMAS may affect electrically charged macromolecule transport systems in the stria vascularis of C57BL/6 mice.

  4. School Aged Children’s Experiences 7 and 13 Months Following a Sibling’s Death

    PubMed Central

    Youngblut, JoAnne M.

    2017-01-01

    This study described 6-year to 12-year-old children’s responses 7 and 13 months after siblings’ NICU/PICU/ED death. Using semi-structured interviews, at 7 months, children were asked about events around their sibling’s death. At both 7 and 13 months, children were asked about their thoughts and feelings about the deceased, concerns or fears, and life changes since the death. Thirty one children (58% female), recruited from four South Florida hospitals and Florida obituaries, participated. Children’s mean age was 8.4 years; 64.5% were Black, 22.5% Hispanic, 13% White. Interviews were analyzed using conventional content analysis. Resulting themes: circumstances of the death, burial events, thinking about and talking to the deceased sibling, fears, and life changes. Most children knew their sibling’s cause of death, attended funeral/memorials, thought about and talked to their deceased sibling, reported changes in family and themselves over the 13 months. Fears (something happening to themselves, parents, other siblings—death, cancer, being snatched away) decreased from 7 to 13 months especially in 7-year to 9-year-olds. Seven-year to 9-year-olds reported the greatest change in themselves from 7 to 13 months. More Black children and girls thought about the deceased and reported more changes in themselves over the 13 months. School aged children thought about and talked with their deceased sibling, reported changes in themselves and their family and their fears decreased over the first 13 months after their sibling’s death PMID:28845095

  5. Immunisation status and determinants of left-behind children aged 12-72 months in central China.

    PubMed

    Ni, Z L; Tan, X D; Shao, H Y; Wang, Y

    2017-07-01

    Many parents move from rural China to urban areas in search of job opportunities, and leave their children behind to be raised by relatives. We aimed to assess the immunisation coverage, including the 1:3:3:3:1 vaccine series (one dose of Bacilli Chalmette-Guérin vaccine; three doses of live attenuated oral poliomyelitis vaccine; three doses of diphtheria, tetanus and pertussis combined; three doses of hepatitis B vaccine; and one dose of measles-containing vaccine), in children aged 12-72 months and identify the determinants of immunisation uptake among left-behind children in Hubei Province, Central China, in 2014. In this cross-sectional study using the World Health Organization's cluster sampling technique, we surveyed 1368 children from 44 villages in 11 districts of Hubei Province. The socio-demographic and vaccination status data were collected by interviewing primary caregivers using a semi-structured questionnaire and reviewing the immunisation cards of the children. Univariate and multivariate analyses were used to identify the determinants of complete vaccination and age-appropriate vaccination. For each dose of the five vaccines, the vaccination coverage in the left-behind and non-left-behind children was >90%; however, the age-appropriate vaccination coverage for each vaccine was lower in left-behind than in non-left-behind children. For the five vaccines, the fully vaccinated rate of left-behind children were lower than those of non-left-behind children (89·1%, 92·7%; P = 0·013) and age-appropriate immunisation rate of left-behind children were lower than those of non-left-behind children (65·7%, 79·9%; P < 0·001). After controlling for potential confounders, we found that the parenting pattern, annual household income and attitude of the primary caregiver towards vaccination significantly influenced the vaccination status of children. Moreover, we noted a relatively high prevalence of delayed vaccination among left-behind children. Hence, we

  6. Effects of a large-scale micronutrient powder and young child feeding education program on the micronutrient status of children 6-24 months of age in the Kyrgyz Republic.

    PubMed

    Serdula, M K; Lundeen, E; Nichols, E K; Imanalieva, C; Minbaev, M; Mamyrbaeva, T; Timmer, A; Aburto, N J

    2013-07-01

    To combat iron and other micronutrient deficiencies, the Ministry of Health of the Kyrgyz Republic launched a regional Infant and Young Child Nutrition (IYCN) program in 2009, which included promotion of home fortification with micronutrient powder (MNP) containing iron (12.5 mg elemental iron), vitamin A (300 μg) and other micronutrients. Every 2 months children aged 6-24 months were provided 30 sachets to be taken on a flexible schedule. The objective was to assess biochemical indicators of iron and vitamin A status among children aged 6-24 months at the baseline and follow-up surveys. Cross-sectional representative cluster surveys were conducted in 2008 (n=571 children) and 2010 (n=541). Data collected included measurement of hemoglobin, serum ferritin, soluble transferrin receptor (sTfR), retinol-binding protein, C-reactive protein (CRP) and α1-glycoprotein acid (AGP). Among all children, declines were observed in the prevalence of: anemia, 50.6% versus 43.8% (P=0.05); total iron deficiency (either low ferritin or high sTfR), 77.3% versus 63.7% (P<0.01); and iron deficiency anemia, 45.5% versus 33.4% (P<0.01). Among children without inflammation as measured by CRP and AGP, similar declines were observed, but only declines in total iron deficiency and iron deficiency anemia reached statistical significance. Among all children and those without inflammation, the prevalence of vitamin A deficiency remained the same. One year after the introduction of home fortification with MNP, within a larger IYCN program, the prevalence of anemia, iron deficiency and iron deficiency anemia declined, but vitamin A deficiency remained unchanged.

  7. Optimal formulations of local foods to achieve nutritional adequacy for 6–23-month-old rural Tanzanian children

    PubMed Central

    Raymond, Jofrey; Kassim, Neema; Rose, Jerman W.; Agaba, Morris

    2017-01-01

    ABSTRACT Background: Achieving nutritional goals of infants and young children while maintaining the intake of local and culture-specific foods can be a daunting task. Diet optimisation using linear goal programming (LP) can effectively generate optimal formulations incorporating local and culturally acceptable foods. Objective: The primary objective of this study was to determine whether a realistic and affordable diet that achieves dietary recommended intakes (DRIs) for 22 selected nutrients can be formulated for rural 6–23-month-old children in Tanzania. Design: Dietary intakes of 400 children aged 6–23 months were assessed using a weighed dietary record (WDR), 24-hour dietary recalls and a 7-days food record. A market survey was also carried out to estimate the cost per 100 g of edible portion of foods that are commonly consumed in the study area. Dietary and market survey data were then used to define LP model parameters for diet optimisation. All LP analyses were done using linear program solver (LiPS) version 1.9.4 to generate optimal food formulations. Results: Optimal formulations that achieved DRIs for 20 nutrients for children aged 6–11 months and all selected nutrients for children aged 12–23 months were successfully developed at a twofold cost of the observed food purchase across age groups. Optimal formulations contained a mixture of ingredients such as wholegrain cereals, Irish potatoes, pulses and seeds, fish and poultry meat as well as fruits and vegetables that can be sourced locally. Conclusions: Our findings revealed that given the available food choices, it is possible to develop optimal formulations that can improve dietary adequacy for rural 6–23-month-old children if food budget for the child’s diets is doubled. These findings suggest the need for setting alternative interventions which can help households increase access to nutrient-dense foods that can fill the identified nutrient gaps. PMID:28814951

  8. Incidence of Medically Attended Respiratory Syncytial Virus and Influenza Illnesses in Children 6-59 Months Old During Four Seasons.

    PubMed

    Simpson, Melissa D; Kieke, Burney A; Sundaram, Maria E; McClure, David L; Meece, Jennifer K; Sifakis, Frangiscos; Gasser, Robert A; Belongia, Edward A

    2016-04-01

    Background.  Respiratory syncytial virus (RSV) and influenza are significant causes of seasonal respiratory illness in children. The incidence of influenza and RSV hospitalization is well documented, but the incidence of medically attended, laboratory-confirmed illness has not been assessed in a well defined community cohort. Methods.  Children aged 6-59 months with medically attended acute respiratory illness were prospectively enrolled during the 2006-2007 through 2009-2010 influenza seasons in a Wisconsin community cohort. Nasal swabs were tested for RSV and influenza by multiplex reverse-transcription polymerase chain reaction. The population incidence of medically attended RSV and influenza was estimated separately and standardized to weeks 40 through 18 of each season. Results.  The cohort included 2800-3073 children each season. There were 2384 children enrolled with acute respiratory illness; 627 (26%) were positive for RSV and 314 (13%) for influenza. The mean age was 28 months (standard deviation [SD] = 15) for RSV-positive and 38 months (SD = 16) for influenza-positive children. Seasonal incidence (cases per 10 000) was 1718 (95% confidence interval [CI], 1602-1843) for RSV and 768 (95% CI, 696-848) for influenza. Respiratory syncytial virus incidence was highest among children 6-11 (2927) and 12-23 months old (2377). Influenza incidence was highest (850) in children 24-59 months old. The incidence of RSV was higher than influenza across all seasons and age groups. Conclusions.  The incidence of medically attended RSV was highest in children 6-23 months old, and it was consistently higher than influenza. The burden of RSV remains high throughout the first 2 years of life.

  9. [Insulin-like growth factor 1 levels and their association with growth and development in infants aged 1-24 months].

    PubMed

    Wang, Xin-Li; Ge, Mei-Ru; Wu, Wen-Yan; Zhang, Juan

    2010-06-01

    To study serum insulin-like growth factor 1 (IGF-1) levels and their association with growth and development in infants aged 1-24 mouths. A total of 525 healthy infants (125 preterm, 400 term) were enrolled. Serum IGF-1 levels were measured using ELISA 1.5, 4, 6, 8, 12, 18 and 24 months after birth. The body weight and body length were simultaneously measured. Serum IGF-1 levels were the lowest in preterm infants 1.5 months after birth (86+/-60 ng/mL). Thereafter, serum IGF-1 levels increased, and were significantly higher than those in term infants between 4 and 12 months after birth. Serum IGF-1 levels in term infants were the highest (116+/-52 ng/mL) 1.5 months after birth during their life of 12 months old. Thereafter, serum IGF-1 levels decreased and reached to a nadir (69+/-58 ng/mL) 8 months after birth. IGF-I levels were positively correlated with the weight and the height (SDS) in both preterm and term infants. Serum IGF-1 levels are closely associated with growth and development in infants.

  10. Clinical outcomes of wavefront-guided laser in situ keratomileusis: 6-month follow-up.

    PubMed

    Aizawa, Daisuke; Shimizu, Kimiya; Komatsu, Mari; Ito, Misae; Suzuki, Masanobu; Ohno, Koji; Uozato, Hiroshi

    2003-08-01

    To evaluate the clinical outcomes 6 months after wavefront-guided laser in situ keratomileusis (LASIK) for myopia in Japan. Department of Ophthalmology, Sanno Hospital, Tokyo, Japan. This prospective study comprised 22 eyes of 12 patients treated with wavefront-guided LASIK who were available for evaluation at 6 months. The mean patient age was 31.2 years +/- 8.4 (SD) (range 23 to 50 years), and the mean preoperative spherical equivalent refraction was -7.30 +/- 2.72 diopters (D) (range -2.75 to -11.88 D). In all cases, preoperative wavefront analysis was performed with a Hartmann-Shack aberrometer and the Technolas 217z flying-spot excimer laser system (Bausch & Lomb) was used with 1.0 mm and 2.0 mm spot sizes and an active eye tracker with a 120 Hz tracking rate. The clinical outcomes of wavefront-guided LASIK were evaluated in terms of safety, efficacy, predictability, stability, complications, and preoperative and postoperative aberrations. At 6 months, 10 eyes had no change in best spectacle-correct visual acuity and 10 gained 1 or more lines. The safety index was 1.11 and the efficacy index, 0.82. Slight undercorrections were observed in highly myopic eyes. In all eyes, the postoperative refraction tended slightly toward myopia for 3 months and stabilized after that. No complication such as epithelial ingrowth, diffuse lamellar keratitis, or infection was observed. Comparison of the preoperative and postoperative aberrations showed that 2nd-order aberrations decreased and higher-order aberrations increased. In the 3rd order, aberrations increased in the high-myopia group (-6.0 D or worse) and decreased in the low to moderate-myopia group (better than -6.0 D). Wavefront-guided LASIK was a good option for refractive surgery, although a longer follow-up in a larger study is required.

  11. Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil

    PubMed Central

    Zanin, Francisca Helena Calheiros; da Silva, Camilo Adalton Mariano; Bonomo, Élido; Teixeira, Romero Alves; Pereira, Cíntia Aparecida de Jesus; dos Santos, Karina Benatti; Fausto, Maria Arlene; Negrão-Correa, Deborah Aparecida; Lamounier, Joel Alves; Carneiro, Mariângela

    2015-01-01

    Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6–71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2–40.8) and 9.8% (95%CI 7.2–12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7–22.6) and 21.8% (95%CI 17.8–26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2–2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4–3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1–2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions. PMID:26445270

  12. Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia

    PubMed Central

    Wang, Bingjie; Chu, Renyuan; Dai, Jinhui; Qu, Xiaomei; Zhou, Hao

    2015-01-01

    Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ) and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p < 0.001) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p < 0.001, p < 0.001, and p = 0.009, resp.). SEEQ scores increased (greater symptoms) following SMILE at 1 month (p < 0.001) and 3 months (p = 0.003) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). SMILE produced lower SEEQ scores (fewer symptoms) than FS-LASIK at 1, 3, and 6 months (p < 0.001). Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months. PMID:26649190

  13. The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants.

    PubMed

    Song, You Hong; Chang, Hyun Jung; Shin, Yong Beom; Park, Young Sook; Park, Yun Hee; Cho, Eun Sol

    2018-04-01

    To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.

  14. Follow-up after infants younger than 2 months of age with urinary tract infection in Southern Israel: epidemiologic, microbiologic and disease recurrence characteristics.

    PubMed

    Gurevich, Evgenia; Tchernin, Dov; Schreyber, Ruth; Muller, Robert; Leibovitz, Eugene

    2016-01-01

    The timing of most recurrences after neonatal urinary tract infection is during the first year of life, with peak incidence 2-6 months after the initial infection. Information on the microbiologic characteristics of recurrent urinary tract infection episodes in relation to the microbiology of the initial episodes is limited. To analyze the epidemiologic/microbiological characteristics of 1st and recurrent urinary tract infection in infants <2 months of age. A retrospective study including all infants <2 months of age with urinary tract infection admitted during 2005-2009 and followed till the age of 1 year. 151 neonates were enrolled (2.7% of all 5617 febrile infants <2 months of age admitted). The overall incidence of urinary tract infection occurring during the first 2 months of life was 151/73,480 (0.2%) live births during 2005-2009 in southern Israel (2.1 cases/1000 live births). One pathogen was isolated in 133 (88.1%); Escherichia coli, Klebsiella spp., Enterococcus spp., Morganella morganii, Proteus spp., and Enterobacter spp. represented the most common pathogens (57.9%, 12.2%, 7.9%, 6.7%, 6.1%, and 5%, respectively). Trimethoprim/sulfamethoxazole, ampicillin, and cefuroxime-axetil were the most commonly recommended prophylactic antibiotics (45%, 13.2%, and 8%, respectively). Twenty-three recurrent urinary tract infection episodes were recorded in 20 (13.2%) patients; 6/23 (26%) were diagnosed within one month following 1st episode. E. coli was the most frequent recurrent urinary tract infection pathogen (12/23, 52.2%). No differences were recorded in E. coli distribution between first urinary tract infection vs. recurrent urinary tract infection. Seventeen (74%) recurrent urinary tract infection episodes were caused by pathogens different (phenotypically) from those isolated in 1st episode. Recurrent urinary tract infection occurred in 25.0%, 8.3%, and 0 patients recommended trimethoprim/sulfamethoxazole, cefuroxime-axetil, or amoxicillin prophylaxis

  15. Selective and faithful imitation at 12 and 15 months.

    PubMed

    Hilbrink, Elma E; Sakkalou, Elena; Ellis-Davies, Kate; Fowler, Nia C; Gattis, Merideth

    2013-11-01

    Research on imitation in infancy has primarily focused on what and when infants imitate. More recently, however, the question why infants imitate has received renewed attention, partly motivated by the finding that infants sometimes selectively imitate the actions of others and sometimes faithfully imitate, or overimitate, the actions of others. The present study evaluates the hypothesis that this varying imitative behavior is related to infants' social traits. To do so, we assessed faithful and selective imitation longitudinally at 12 and 15 months, and extraversion at 15 months. At both ages, selective imitation was dependent on the causal structure of the act. From 12 to 15 months, selective imitation decreased while faithful imitation increased. Furthermore, infants high in extraversion were more faithful imitators than infants low in extraversion. These results demonstrate that the onset of faithful imitation is earlier than previously thought, but later than the onset of selective imitation. The observed relation between extraversion and faithful imitation supports the hypothesis that faithful imitation is driven by the social motivations of the infant. We call this relation the King Louie Effect: like the orangutan King Louie in The Jungle Book, infants imitate faithfully due to a growing interest in the interpersonal nature of interactions. © 2013 John Wiley & Sons Ltd.

  16. Neisseria meningitidis Group A IgG1 and IgG2 Subclass Immune Response in African Children Aged 12–23 Months Following Meningococcal Vaccination

    PubMed Central

    Holme, Daniel; Findlow, Helen; Sow, Samba O.; Idoko, Olubukola T.; Preziosi, Marie-Pierre; Carlone, George; Plikaytis, Brian D.; Borrow, Ray

    2015-01-01

    Background. A group A meningococcal conjugate vaccine, PsA-TT, was licensed in 2010 and was previously studied in a phase 2 clinical trial to evaluate its safety and immunogenicity in African children 12–23 months of age. Methods. Subjects received either PsA-TT; meningococcal group A, C, W, Y polysaccharide vaccine (PsACWY); or Haemophilus influenzae type b conjugate vaccine (Hib-TT). Forty weeks following primary vaccination, the 3 groups were further randomized to receive either PsA-TT, one-fifth dose of PsACWY, or Hib-TT. Group A–specific immunoglobulin G (IgG) subclass response was characterized using an enzyme-linked immunosorbent assay. Results. The predominant IgG subclass response, regardless of vaccine, was IgG1. One month following primary vaccination, the geometric mean concentrations (GMCs) of IgG1 and IgG2 in the PsA-TT group were 21.73 µg/mL and 6.27 µg/mL, whereas in the PsACWY group the mean GMCs were 2.01 µg/mL and 0.97 µg/mL, respectively (P < .0001). Group A–specific IgG1 and IgG2 GMCs remained greater in the PsA-TT group than in the PsACWY group 40 weeks following primary vaccination (P < .0001). One week following revaccination, those given 2 doses of PsA-TT had the greatest IgG1 and IgG2 GMCs of 125.23 µg/mL and 36.12 µg/mL, respectively (P = .0008), and demonstrated a significant increase in IgG1:IgG2 mean ratio, indicative of the T-cell–dependent response associated with conjugate vaccines. Conclusions. Vaccination of African children aged 12–24 months with either PsA-TT or PsACWY elicited a predominantly IgG1 response. The IgG1:IgG2 mean ratio decreased following successive vaccination with PsACWY, indicating a shift toward IgG2, suggestive of the T-cell–independent immune response commonly associated with polysaccharide antigens. Clinical Trials Registration. SRCTN78147026. PMID:26553689

  17. Association between serum lipids, glucose tolerance, and insulin sensitivity during 12 months of celiprolol treatment.

    PubMed

    Malminiemi, K

    1995-04-01

    The study was undertaken to evaluate the development and association of parameters related to the metabolic syndrome during celiprolol treatment. Hyperinsulinemic euglycemic clamp and independent oral glucose tolerance tests (OGTT) were performed on 25 nondiabetic patients with controlled hypertension and dyslipidemia. The tests were carried out during the patients' previous antihypertensive monotherapy (beta- or Ca-blocker, or an ACE inhibitor), and after 6 and 12 months of celiprolol treatment. About one third of patients were randomized to a control group in which treatment was kept unchanged. Insulin sensitivity index (ISI), measured by the euglycemic clamp test, increased 35% in the celiprolol group at 6 months and remained at that level at 12 months, independent of the previous treatment (p = 0.03, compared to the change in the control group). During a 2 hour OGTT, incremental glucose area under the curve (AUC) decreased from 4.5 to 1.9 hr x mmol/l during 6 months of celiprolol treatment, and decreased further to 1.5 hr x mmol/l at 12 months (p < 0.001). Insulin AUC decreased from 113 to 72 hr x mU/l, and decreased further to 68 hr x mU/l (p < 0.01). All insulin parameters in OGTT were highly significant (p < 0.0001) and inversely associated with ISI. Insulin AUC had the best linear correlation with ISI (r = -0.682, p < 0.0001). Glucose parameters in OGTT correlated only weakly and inversely with insulin sensitivity. From the fasting serum lipids, triglycerides showed an inverse (p < 0.001) and HDL a weak (p < 0.05) positive association with ISI. Four out of 20 metabolic, clinical, and demographic parameters proved to be independently significant predictors for ISI in multiple regression analysis. These were insulin AUC, fasting insulin levels, triglyceride values, and age. The coefficient of determination in this four-parameter linear model was 69%. In this preliminary, observer-masked trial with a limited control group, celiprolol improved the impaired

  18. Association Between Cognitive Function and Health Care Costs 3 Months and 6 Months After Initiating Antidepressant Medication for Depressive Disorders.

    PubMed

    Walker, Valery; Patel, Haridarshan; Kurlander, Jonathan L; Essoi, Breanna; Yang, Jiao; Mahableshwarkar, Atul R; Samp, Jennifer C; Akhras, Kasem S

    2015-09-01

    -related health care utilization and costs (all from a payer perspective) were assessed 6 months prior (baseline) to antidepressant initiation and 3 months and 6 months after (follow-up) initiation of antidepressant medication. Health care utilization and costs included ambulatory (office and hospital outpatient), emergency room, inpatient hospital, pharmacy, other medical (e.g., laboratory and diagnostics), and total (all categories combined). All-cause and depressive disorder-related total costs during the 3- and 6-month follow-up periods were modeled with generalized linear modeling with gamma distribution and log link, while adjusting for potential confounders (age, race, gender, education, employment, and comorbidities). Of the 13,537 patients who were mailed an invitation, 824 (6%) were eligible and agreed to participate. Of these, 563 patients provided informed consent, completed the interview, maintained eligibility, and were included in the 3-month calculations. Among these, 255 (45%) were classified as having cognitive dysfunction. Mean patient age was 41.3 (± 12.5) years; 80% were female. Most patients were white and employed. More patients in the cognitive normal cohort were white (P  less than  0.001) and employed full time (P = 0.029), had higher education attainment (P  less than    0.001), and had fewer comorbidities (P = 0.007) than those in the cognitive dysfunction cohort. Over the first 3 months, patients with cognitive dysfunction had higher adjusted all-cause costs ($3,309 vs. $2,157, P = 0.002) and higher adjusted depressive disorder-related costs ($718 vs. $406, P  less than  0.001) than patients without cognitive dysfunction. At 6 months, data from 4 patients were removed from the analysis because of exclusionary diagnoses. Over 6 months, patients with cognitive dysfunction had higher adjusted all-cause costs ($4,793) than patients without cognitive dysfunction ($3,683, P = 0.034). Over 6 months, depressive disorder

  19. Evidence of Increase in Mortality After the Introduction of Diphtheria-Tetanus-Pertussis Vaccine to Children Aged 6-35 Months in Guinea-Bissau: A Time for Reflection?

    PubMed

    Aaby, Peter; Mogensen, Søren Wengel; Rodrigues, Amabelia; Benn, Christine S

    2018-01-01

    Whole-cell diphtheria-tetanus-pertussis (DTP) and oral polio vaccine (OPV) were introduced to children in Guinea-Bissau in 1981. We previously reported that DTP in the target age group from 3 to 5 months of age was associated with higher overall mortality. DTP and OPV were also given to older children and in this study we tested the effect on mortality in children aged 6-35 months. In the 1980s, the suburb Bandim in the capital of Guinea-Bissau was followed with demographic surveillance and tri-monthly weighing sessions for children under 3 years of age. From June 1981, routine vaccinations were offered at the weighing sessions. We calculated mortality hazard ratio (HR) for DTP-vaccinated and DTP-unvaccinated children aged 6-35 months using Cox proportional hazard models. Including this study, the introduction of DTP vaccine and child mortality has been studied in three studies; we made a meta-estimate of these studies. At the first weighing session after the introduction of vaccines, 6-35-month-old children who received DTP vaccination had better weight-for-age z -scores (WAZ) than children who did not receive DTP; one unit increase in WAZ was associated with an odds ratio of 1.32 (95% CI = 1.13-1.55) for receiving DTP vaccination. Though lower mortality compared with not being DTP-vaccinated was, therefore, expected, DTP vaccination was associated with a non-significant trend in the opposite direction, the HR being 2.22 (0.82-6.04) adjusted for WAZ. In a sensitivity analysis, including all children weighed at least once before the vaccination program started, DTP (±OPV) as the most recent vaccination compared with live vaccines or no vaccine was associated with a HR of 1.89 (1.00-3.55). In the three studies of the introduction of DTP in rural and urban Guinea-Bissau, DTP-vaccinated children had an HR of 2.14 (1.42-3.23) compared to DTP-unvaccinated children; this effect was separately significant for girls [HR = 2.60 (1.57-4.32)], but not for

  20. Cognitive status is a determinant of health resource utilization among individuals with a history of falls: a 12-month prospective cohort study.

    PubMed

    Davis, J C; Dian, L; Khan, K M; Bryan, S; Marra, C A; Hsu, C L; Jacova, P; Chiu, B K; Liu-Ambrose, T

    2016-03-01

    Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function--specifically, executive functions--and cognitive status are significant determinants of health resource utilization among older fallers. Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls

  1. Antibody persistence for up to 5 years after a fourth dose of Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine (HibMenCY-TT) given at 12-15 months of age.

    PubMed

    Marshall, Gary S; Blatter, Mark; Marchant, Colin; Aris, Emmanuel; Mesaros, Narcisa; Miller, Jacqueline M

    2013-06-01

    A 4-dose series of recently licensed Haemophilus influenzae type b-meningococcal serogroups C and Y-tetanus toxoid conjugate vaccine (HibMenCY-TT) was immunogenic with a clinically acceptable safety profile in infants, with antibodies persisting in most participants for 1 year following dose 4. This study assessed antibody persistence up to 5 years after vaccination. Participants had received HibMenCY-TT or Hib-TT at 2, 4 and 6 months of age. At age 12-15 months, HibMenCY-TT vaccinees received a fourth HibMenCY-TT dose (HibMenCY x 4 group), whereas those who received Hib-TT received a fourth dose of either Hib-TT (Hib) or HibMenCY-TT (HibMenCY x 1). Blood samples were collected 1 month and 1, 3 and 5 years after the last dose for measurement of antipolyribosylribitol phosphate (the Hib capsular polysaccharide) antibodies and serum bactericidal activity (human complement source) against meningococcal serogroups C and Y. Five years after the fourth dose, the percentages of children with antipolyribosylribitol phosphate ≥0.15 μg/mL in HibMenCY x 4, HibMenCY x 1 and Hib groups were 98.8% (95% confidence interval: 93.5%-100%), 97.3% (85.8%-99.9%) and 92.3% (79.1%-98.4%), respectively. The percentages with human complement serum bactericidal activity ≥1:8 for meningococcal serogroup C were 82.9% (72.5%-90.6%), 73.5% (55.6%-87.1%) and 21.1% (9.6%-37.3%), respectively. The percentages with human complement serum bactericidal activity ≥1:8 for serogroup Y were 69.5% (58.4%-79.2%), 54.3% (36.6%-71.2%) and 18.4% (7.7%-34.3%), respectively. HibMenCY-TT given as a 4-dose series or as a single dose at 12-15 months of age induced immune responses for all 3 antigens that lasted for up to 5 years after vaccination in more than half of recipients.

  2. A Study to Determine the Incidence of Urinary Tract Infections in Infants and Children Ages 4 Months to 6 Years With Febrile Diarrhea.

    PubMed

    Nibhanipudi, Kumara V

    2016-01-01

    To determine the incidence of urinary tract infections (UTIs) in infants and children (4 months to 6 years of age) with febrile diarrhea, as outpatients. This was a prospective institutional review board-approved study. patients (between 4 months and 6 years of age) were enrolled in the study who presented to the pediatric emergency room with a complaint of fever (rectal temperature 101°F or more) and diarrhea (watery stools >3 in number). The patients were evaluated for state of hydration, and also urine samples were collected. For those children not toilet trained, urine specimens were collected by bladder catheterization, and for those children toilet trained, urine specimens were obtained by midstream collection method. The urine samples obtained were sent for analysis and culture. Eighty patients were enrolled in the study. The number of specimens obtained by clean catch midstream was 20, and by bladder catheterization was 60. None of the urine specimens obtained by both methods of collection grew any organism. There was no increased incidence of infections in male children whether circumcised (10/60) or uncircumcised (50/60). The mean temperature was 102.8°F (range = 101°F to 105°F). Using in silico online 2 × 2 χ(2) test by comparing both the positive and negative urine culture results, 2-tailed P value is <.0001. Our prospective randomized study concluded that there is no increased incidence of UTIs in infants and children (4 months to 6 years of age) with febrile diarrhea.

  3. Household Food Security Status Is Associated with Anemia Risk at Age 18 Months among Low-Income Infants in Massachusetts.

    PubMed

    Metallinos-Katsaras, Elizabeth; Colchamiro, Rachel; Edelstein, Sari; Siu, Elizabeth

    2016-11-01

    Food insecurity and anemia are prevalent among low-income families and infants. Anemia may reflect iron deficiency anemia (IDA) risk. IDA in infancy and early childhood may have long-lasting developmental effects. Few studies have examined food security status (FSS) as a risk factor for anemia. To examine the association between household FSS, sociodemographic and health-related variables, and anemia incidence at age 18 months among low-income infants in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (MA/WIC). This was a longitudinal study using data from MA/WIC (August 2001 to November 2009) to assess the relationship between household FSS during the 12 months preceding the 1-year visit (age 9 to 15 months) and anemia at age 18 months. Infants included were not anemic at age 12 months and had complete data on household FSS and the following covariates (N=17,831): race/Hispanic ethnicity, maternal education, breastfeeding duration, household size, and child age. Multiple logistic regression was used to examine the association between household FSS during the prior 12 months and anemia at 18 months, controlling for infant age, sex, and race/Hispanic ethnicity, breastfeeding, maternal education, and household size. A majority of infants (56%) were nonwhite, and 19.9% lived in food-insecure households (4.8% in very-low food security). Of the infants who were not anemic at age 12 months, 11.7% became anemic by age 18 months. Infants living in low-food-secure households were 42% more likely (adjusted odds ratio 1.42, 95% CI, 1.27-1.60) to develop anemia at age 18 months than were their food-secure counterparts. Nonwhite race, higher household size, and lower maternal education were also associated with an elevated risk of anemia at age 18 months. Low food security appears to be associated with a significant increased risk of anemia, as do nonwhite ethnicity, lower maternal education, and larger household size. Knowledge of

  4. BeGraft Peripheral PMCF Study: 12-month results.

    PubMed

    Deloose, Koen; Bosiers, Marc; Callaert, Joren; Peeters, Patrick; Verbist, Jurgen; van den Eynde, Wouter; Maene, Lieven; Beelen, Roel; Keirse, Koen

    2017-05-26

    The Begraft Peripheral PMCF study is a prospective, non-randomized study, conducted at the vascular departments of 4 hospitals in Belgium. This manuscript reports the findings up to 12-month follow-up time for the total cohort. The primary endpoint of the study is primary patency at 12 months. Primary patency is defined as a target lesion without a hemodynamically significant stenosis on duplex ultrasound (>50%, systolic velocity ratio no greater than 2.4) and without Target Lesion Revascularization (TLR) within 12 months. Between June 2014 and March 2015, 70 patients with TASC II Class A (77.1%), B (14.3%), C (5.7%) or D (2.9%) aortoiliac lesions were included. The mean lesion length was 34.3mm with a mean degree of stenosis of 83.16%. Primary patency rate for the total patient population was 94.4% at 12-month follow-up. Freedom from TLR at 12-month was 96.7%. These results confirm the already existing enthusiasm of the use of covered stents in the aorto-iliac field. Longer follow-up and more complex lesions have to be studies in the upcoming future.

  5. 12 CFR 12.6 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Fees. 12.6 Section 12.6 Banks and Banking... SECURITIES TRANSACTIONS § 12.6 Fees. A national bank may charge a reasonable fee for providing notification pursuant to § 12.5(b), (c), and (e). A national bank may not charge a fee for providing notification...

  6. Expressive timing in infant-directed singing between 3 and 6 months.

    PubMed

    Delavenne, Anne; Gratier, Maya; Devouche, Emmanuel

    2013-02-01

    This longitudinal study compared the temporal characteristics of maternal singing at 3 and then at 6 months. Infant-directed (ID) singing is claimed to have different functions in preverbal communication. However few studies have focused on the specific characteristics of ID singing that change across the first months of life. We aimed to explore these changes between 3 and 6 months because musical routines become prominent in the repertoire of games parents and infants spontaneously play during a period referred to as 'the period of games'. We focused specifically on expressive timing because it reflects how mothers dynamically adapt their singing to their infant's states of attention and involvement. We aimed to determine whether the expressive timing cues of maternal singing would be different at 3 and then at 6 months. To this end, the interactions of 18 mother-infant dyads were recorded while mothers were singing a popular French playsong for their infant at 3 and then at 6 months. Acoustic analyses revealed that mothers showed final-lengthening and tempo slowing for both age groups, but marked the ends of the hierarchical structural units of the song more saliently with their 6-month-olds. Unexpectedly, infant sex was also found to affect maternal singing: more exaggerated phrase-lengthening patterns were observed in singing to girls. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Developmental milestones record - 12 months

    MedlinePlus

    ... to 2 naps during the day SENSORY AND COGNITIVE DEVELOPMENT The typical 12-month-old: Begins pretend play ( ... Editorial team. Infant and Newborn Development Read more Toddler Development Read more NIH MedlinePlus Magazine Read more A. ...

  8. A randomized controlled study to evaluate the immunogenicity of a trivalent inactivated seasonal influenza vaccine at two dosages in children 6 to 35 months of age

    PubMed Central

    Pavia-Ruz, Noris; Angel Rodriguez Weber, Miguel; Lau, Yu-Lung; Nelson, E Anthony S; Kerdpanich, Angkool; Huang, Li-Min; Silas, Peter; Qaqundah, Paul; Blatter, Mark; Jeanfreau, Robert; Lei, Paul; Jain, Varsha; El Idrissi, Mohamed; Feng, Yang; Innis, Bruce; Peeters, Mathieu; Devaster, Jeanne-Marie

    2013-01-01

    The trivalent inactivated influenza vaccine Fluarix™ is licensed in the US for adults and children from 3 years old. This randomized observer-blind study (NCT00764790) evaluated Fluarix™ at two doses; 0.25 ml (Flu-25) and 0.5 ml (Flu-50) in children aged 6–35 months. The primary objective was to demonstrate immunogenic non-inferiority vs. a control vaccine (Fluzone®; 0.25 ml). Children received Flu-25 (n = 1107), Flu-50 (n = 1106) or control vaccine (n = 1104) at Day 0 and for un-primed children, also on Day 28. Serum hemagglutination-inhibition titers were determined pre-vaccination and at Day 28 (primed) or Day 56 (un-primed). Non-inferiority was assessed by post-vaccination geometric mean titer (GMT) ratio, (upper 95% confidence interval [CI] ≤ 1.5) and difference in seroconversion rate (upper 95% CI ≤ 10%). Reactogenicity/safety was monitored. The immune response to Flu-50 met all regulatory criteria. Indicated by adjusted GMT ratios [with 95% CI], the criteria for non-inferiority of Flu-50 vs. control vaccine were reached for the B/Florida strain (1.13 [1.01–1.25]) but not for the A/Brisbane/H1N1 (1.74 [1.54–1.98]) or A/Uruguay/H3N2 (1.72 [1.57–1.89]) strains. In children aged 18–35 months similar immune responses were observed for Flu-50 and the control vaccine. Flu-50 induced a higher response than Flu-25 for all strains. Temperature (≥ 37.5°C) was reported in 6.2%, 6.4%, and 6.6% of the Flu-25, Flu-50, and control group, respectively. Reactogenicity/safety endpoints were within the same range for all vaccines. In children aged 6–35 months, immune responses with Flu-50 fulfilled regulatory criteria but did not meet the pre-defined criteria for non-inferiority vs. control. This appeared to be due to differences in immunogenicity in children aged < 18 months. PMID:23782962

  9. Influence of bariatric surgery on quality of life, body image, and general self-efficacy within 6 and 24 months-a prospective cohort study.

    PubMed

    Nickel, Felix; Schmidt, Lukas; Bruckner, Thomas; Büchler, Markus W; Müller-Stich, Beat-Peter; Fischer, Lars

    2017-02-01

    It has been proven that bariatric surgery affects weight loss. Patients with morbid obesity have a significantly lower quality of life (QOL) and body image compared with the general population. To evaluate QOL, body image, and general self-efficacy (GSE) in patients with morbid obesity undergoing bariatric surgery within clinical parameters. Monocentric, prospective, longitudinal cohort study. Patients completed the short form 36 (SF-36) for QOL, body image questionnaire, and GSE scale 3 times: before surgery and within 6 months and 24 months after surgery. Influence of gender, age, and type of procedure, either laparoscopic sleeve gastrectomy (SG) or laparoscopic Roux-en-Y gastric bypass, were analyzed. Thirty patients completed the questionnaires before and within 6 and 24 months after surgery. SF-36 physical summary score improved significantly from 34.3±11.0 before surgery to 46.0±10.4 within 6 months (P<.001) and to 49.8±8.2 within 24 months (P<.001) after surgery. SF-36 mental summary score improved significantly from 42.1±14.7 before surgery to 52.3±8.4 within 6 months (P<.001) and to 48.4±12.2 within 24 months (P<.001) after surgery. There were no significant differences between gender, age, and type of operation. Body image and GSE improved significantly after bariatric surgery (P<.001), and both correlated to the SF-36 mental summary score. QOL, body image, and GSE improved significantly within 6 months and remained stable within 24 months after bariatric surgery. Improvements were independent of gender, age, and type of operation. Mental QOL was influenced by body image and GSE. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  10. Predictors of self-rated health: a 12-month prospective study of IT and media workers.

    PubMed

    Hasson, Dan; Arnetz, Bengt B; Theorell, Töres; Anderberg, Ulla Maria

    2006-07-31

    The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0-12 months). A prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23-64) from four information technology and two media companies. There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression). The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

  11. Beverage Consumption among U.S. Children Aged 0–24 Months: National Health and Nutrition Examination Survey (NHANES)

    PubMed Central

    Grimes, Carley A.; Szymlek-Gay, Ewa A.; Nicklas, Theresa A.

    2017-01-01

    Data on beverage consumption patterns in early life are limited. The aim of this study was to describe beverage consumption by sociodemographic characteristics, along with water intake and sources of water among U.S. children aged 0–24 months. Data from 2740 children in the 2005–2012 NHANES were analysed. Food intake was determined via one 24-h dietary recall. Beverages were categorised according to What We Eat In America groups. Poverty–Income ratio was used to define household income. During infancy (0–5.9 months and 6–11.9 months) infant formulas were the most commonly consumed beverage, 74.1% and 78.6% of children consuming, respectively. Comparatively fewer children, 41.6% and 24.3%, consumed breast milk. In toddlers (12–24 months), the most commonly consumed beverages were plain milk (83.6% of children consuming), water (68.6%), 100% fruit juice (51.8%) and sweetened beverages (31.2%). Non-Hispanic black and Mexican-American children were more likely to consume sweetened beverages, 100% fruit juice and infant formula than Non-Hispanic white children. Children from lower income households were more likely to consume sweetened beverages and 100% fruit juice and less likely to consume breast milk than children from higher income households. Total water intake increased with age and the contribution of water from food and beverage sources was ~20% and ~80% for all children, respectively. Disparities in beverage consumption by race/ethnicity and income level are apparent in early life. PMID:28335374

  12. Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration: twelve-month MONT BLANC study results.

    PubMed

    Larsen, Michael; Schmidt-Erfurth, Ursula; Lanzetta, Paolo; Wolf, Sebastian; Simader, Christian; Tokaji, Erika; Pilz, Stefan; Weisberger, Annemarie

    2012-05-01

    To compare the efficacy and safety of same-day verteporfin photodynamic therapy (PDT) and intravitreal ranibizumab combination treatment versus ranibizumab monotherapy in neovascular age-related macular degeneration. Prospective, multicenter, double-masked, randomized, active-controlled trial. We included 255 patients with all types of active subfoveal choroidal neovascularization. Patients were randomized 1:1 to as-needed (pro re nata; PRN) combination (standard-fluence verteporfin 6 mg/m(2) PDT and ranibizumab 0.5 mg) or PRN ranibizumab monotherapy (sham infusion [5% dextrose] PDT and ranibizumab 0.5 mg). Patients received 3 consecutive monthly injections followed by PRN retreatments based on protocol-specific retreatment criteria. Mean change in best-corrected visual acuity (BCVA) from baseline to month 12, and the proportion of patients with treatment-free interval ≥3 months at any timepoint after month 2. The mean change in BCVA at month 12 was +2.5 and +4.4 letters in the combination and monotherapy groups, respectively (P = 0.0048; difference: -1.9 letters [95% confidence interval, -5.76 to 1.86], for having achieved noninferiority with a margin of 7 letters). The proportion of patients with a treatment-free interval of ≥3 months at any timepoint after month 2 was high, but did not show a clinically relevant difference between the treatment groups. Secondary efficacy endpoints included the mean number of ranibizumab retreatments after month 2 (1.9 and 2.2 with combination and monotherapy, respectively [P = 0.1373]). The time to first ranibizumab retreatment after month 2 was delayed by 34 days (about 1 monthly visit) with combination (month 6) versus monotherapy (month 5). At month 12, mean ± standard error central retinal thickness decreased by 115.3±9.04 μm in the combination group and 107.7±11.02 μm in the monotherapy group. The mean number of verteporfin/sham PDT treatments was comparable in the 2 groups (combination, 1.7; monotherapy, 1.9). The

  13. Oral Supplementation of Parturient Mothers with Vitamin D and Its Effect on 25OHD Status of Exclusively Breastfed Infants at 6 Months of Age: A Double-Blind Randomized Placebo Controlled Trial.

    PubMed

    Naik, Prasanna; Faridi, M M A; Batra, Prerna; Madhu, S V

    2017-12-01

    Exclusively breastfed infants are at increased risk of vitamin D deficiency and many lactating mothers have been found deficient in 25OHD stores. To compare serum vitamin D levels in exclusively breastfed infants at 6 months of age with or without oral supplementation of 600,000 IU of vitamin D3 to mothers in early postpartum period. Exclusively breastfeeding term parturient mothers were randomized 24-48 hours following delivery to receive either 600,000 IU of vitamin D3 (Cholecalciferol) over 10 days in a dose of 60,000 IU/day or placebo. 25OHD levels were measured by Radio Immuno Assay method at recruitment and after 6 months in all mothers and their infants. Urinary calcium and creatinine ratio was measured to monitor adverse effects of vitamin D3 in both mothers and infants at 14 weeks and 6 months of age. X-ray of both wrists in anteroposterior view and serum alkaline phosphatase of infants were done in both groups at 6 months of age to look for evidence of rickets. Maternal profile was similar in intervention (A) and control (B) groups. Mothers' serum 25OHD levels at recruitment were also similar being 16.2 ± 9.3 ng/mL in group A and 14.1 ± 7.1 ng/mL in group B. After 6 months, 25OHD levels were 40.3 ± 21.6 and 22.9 ± 20.1 ng/mL in group A and group B mothers (p ≤ 0.00), respectively. The serum 25OHD levels in cord blood were 9.9 ± 5.7 and 8.9 ± 5.1 ng/mL, respectively, in infants born to mothers in intervention and control groups (p = 0.433). At 6 months of age, the serum 25OHD levels significantly (p < 0.00) raised to 29.1 ± 14.6 ng/mL in infants of group A compared to those of group B (15.7 ± 17.7 ng/mL). Four infants developed radiological rickets at 6 months of age, two infants each in intervention group and study group. As against 10 infants in the control group (16.94%), no infant in the study group had biochemical rickets. Urinary calcium and creatinine ratio in mothers and

  14. [Dietary intake of young Icelanders with psychotic disorders and weight development over an 8-12 months period].

    PubMed

    Fridthjofsdottir, Helga Gudrun; Geirsdottir, Olof Gudny; Jonsdottir, Halldora; Steingrimsdottir, Laufey; Thorsdottir, Inga; Thorgeirsdottir, Holmfridur; Briem, Nanna; Gunnarsdottir, Ingibjorg

    2017-01-01

    The prevalence of lifestyle related diseases is higher among people with psychotic disorders than the general population. The aim was to assess dietary intake of young people with psychotic disorders for the first time in Iceland. Subjects were young people (n=48, age 18-30y) with psychotic disorders. Dietary intake was assessed by a 24-hour recall in July-August 2016, and compared with official recommendations and intake of the general public (n=250, age 18-30y). Body weight in the past eight to 12 months, was retrieved from medical records. Consumption of fruits, fish, dairy products, vegetable and fish oil was significantly lower among subjects when compared with the general public, while their soft drink and sweets consumption was higher (p<0.001). Furthermore, the contribution of added sugar was higher (15E% vs. 12E%) and protein intake lower (16E% vs. 18E%). Consumption of omega-3 fatty acids and vitamin D was lower among subjects than the general public and lower than recommended (0.04±0.3% omega-3 of total energy vs. 1.2±0.6%, p<0.001 and 3.1±4.2 µg vitamin D/day vs. 5.6±6.5 µg/day, p<0.001). Almost 40% of the subjects had gained >5% of their initial body weight in the past 8-2 months. Diet of young people with psychotic disorders is not consistent with recommendations and is worse than the diet of their peers in the general population. It is important to find ways to improve the diet and thereby nutrient intake of the group. Key words: psychotic disorders, schizophrenia, recommended dietary allowances, fatty acids, omega-3, vitamin D. Correspondence: Ingibjorg Gunnarsdottir, ingigun@landspitali.is.

  15. Glycaemic control and hypoglycaemia with insulin glargine 300 U/mL compared with glargine 100 U/mL in Japanese adults with type 2 diabetes using basal insulin plus oral anti-hyperglycaemic drugs (EDITION JP 2 randomised 12-month trial including 6-month extension).

    PubMed

    Terauchi, Y; Koyama, M; Cheng, X; Sumi, M; Riddle, M C; Bolli, G B; Hirose, T

    2017-10-01

    To compare insulin glargine 300 U/mL (Gla-300) with glargine 100 U/mL (Gla-100) in Japanese adults with uncontrolled type 2 diabetes on basal insulin and oral anti-hyperglycaemic drugs over 12 months. EDITION JP 2 was a randomised, open-label, phase 3 study. Following a 6-month treatment period, participants continued receiving previously assigned once daily Gla-300 or Gla-100, plus oral anti-hyperglycaemic drugs, in a 6-month extension period. Glycaemic control, hypoglycaemia and adverse events were assessed. The 12-month completion rate was 88% for Gla-300 and 96% for Gla-100, with comparable reasons for discontinuation. Mean HbA 1c decrease from baseline to month 12 was 0.3% in both groups. Annualised rates of confirmed (≤3.9mmol/L [≤70mg/dL]) or severe hypoglycaemia were lower with Gla-300 than Gla-100 (nocturnal [00:00-05:59h]: rate ratio 0.41; 95% confidence interval: 0.18 to 0.92; anytime [24h]: rate ratio 0.64; 95% confidence interval: 0.44 to 0.94). Cumulative number of hypoglycaemic events was lower with Gla-300 than Gla-100. Adverse event profiles were comparable between treatments. Over 12 months, Gla-300-treated participants achieved sustained glycaemic control and experienced less hypoglycaemia, particularly at night, versus Gla-100, supporting 6-month results. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Animal Performance and Carcass Characteristics of Bulls (1/2 Purunã vs 1/2 Canchim) Slaughtered at 16 and 22 Months Old, and Three Different Weights

    PubMed Central

    do Prado, Ivanor Nunes; Eiras, Carlos Emanuel; Fugita, Carlos Alberto; Passetti, Rodrigo Augusto Cortêz; Ornaghi, Mariana Garcia; Rivaroli, Dayane Cristina; Pinto, Adriana Aparecida; Moletta, José Luiz

    2015-01-01

    Current study aimed to evaluate the performance of bulls (1/2 Purunã vs 1/2 Canchim) slaughtered at two ages and three different weights. One hundred and thirteen bulls were divided into two slaughter ages (16 and 22 months) and three different slaughter weights (light, 422 kg; medium, 470 kg; and heavy, 550 kg). The body weight was higher for bulls slaughtered at 16 months. Daily gain, carcass weight and dressing were higher for bulls slaughtered at 16 months. Feed intake was higher for bulls slaughtered at 22 months although feed efficiency was better for bulls slaughtered at 16 months. Carcass characteristics were better for bulls slaughtered at 16 months. The percentages of muscle, fat and bone and meat characteristics were similar between two slaughter ages. Feed intake and animal performance was lower for lighter animals. Feed conversion and carcass dressing were similar in the three slaughter weights. Muscle percentage was higher for heavier animals but fat and bone percentages were lower. Slaughter weight had no effect on meat characteristics. PMID:25715688

  17. Animal Performance and Carcass Characteristics of Bulls (1/2 Purunã vs 1/2 Canchim) Slaughtered at 16 and 22 Months Old, and Three Different Weights.

    PubMed

    do Prado, Ivanor Nunes; Eiras, Carlos Emanuel; Fugita, Carlos Alberto; Passetti, Rodrigo Augusto Cortêz; Ornaghi, Mariana Garcia; Rivaroli, Dayane Cristina; Pinto, Adriana Aparecida; Moletta, José Luiz

    2015-05-01

    Current study aimed to evaluate the performance of bulls (1/2 Purunã vs 1/2 Canchim) slaughtered at two ages and three different weights. One hundred and thirteen bulls were divided into two slaughter ages (16 and 22 months) and three different slaughter weights (light, 422 kg; medium, 470 kg; and heavy, 550 kg). The body weight was higher for bulls slaughtered at 16 months. Daily gain, carcass weight and dressing were higher for bulls slaughtered at 16 months. Feed intake was higher for bulls slaughtered at 22 months although feed efficiency was better for bulls slaughtered at 16 months. Carcass characteristics were better for bulls slaughtered at 16 months. The percentages of muscle, fat and bone and meat characteristics were similar between two slaughter ages. Feed intake and animal performance was lower for lighter animals. Feed conversion and carcass dressing were similar in the three slaughter weights. Muscle percentage was higher for heavier animals but fat and bone percentages were lower. Slaughter weight had no effect on meat characteristics.

  18. A breast health educational program for Chinese-American women: 3- to 12-month postintervention effect.

    PubMed

    Lee-Lin, Frances; Nguyen, Thuan; Pedhiwala, Nisreen; Dieckmann, Nathan; Menon, Usha

    2015-01-01

    To test the efficacy of a culturally targeted breast cancer screening educational program in increasing mammogram completion in Chinese-American immigrant women. Randomized controlled study. Chinese communities, Portland, Oregon. From April 2010 to September 2011, 300 women were randomized to receive a theory-based, culturally targeted breast cancer screening educational intervention (n = 147) or a mammography screening brochure published by the National Cancer Institute (n = 153). The two-part intervention consisted of group teaching with targeted, theory-based messages followed by individual counseling sessions. Mammography completion, perceived susceptibility, perceived benefits, perceived barriers, perceived cultural barriers, and demographic variables. A 2 × 3 mixed logistic model was applied to determine odds ratio of mammogram completion. Behavior changed in both groups, with a total of 170 participants (56.7%) reporting a mammogram at 12 months. The logistic model indicated increased odds of mammogram completion in the intervention compared to the control group at 3, 6, and 12 months. When controlling for marital status, age, and age moved to the United States, the intervention group was nine times more likely to complete mammograms than the control group. The culturally targeted educational program significantly increased mammogram use among Chinese immigrant women. Further testing of effectiveness in larger community settings is needed. The intervention may also serve as a foundation from which to develop education to increase cancer screening among other minority subgroups.

  19. Recurrent and chronic headaches in children below 6 years of age.

    PubMed

    Raieli, Vincenzo; Eliseo, Mario; Pandolfi, Eleonora; La Vecchia, Michela; La Franca, Girolama; Puma, Domenico; Ragusa, Donatella

    2005-06-01

    The objective was to determine the frequency of headache subtypes, according to International Headache Society (IHS) criteria, in a population of children below 6 years visiting a Center for Diagnosis and Treatment of Headache in Youth. Medical records of the children below 6 years at their first visit, admitted for headache between 1997 and 2003, were studied. Headache was classified according to the IHS criteria 2004. Children with less than three headache attacks or less than 15 days of daily headache were excluded. We found 1598 medical records of children who visited our Headache Center in the study period. One hundred and five (6.5%) were children younger than 6 years. The mean age at the first medical control was 4.8+/-1.3 years (range 17-71 months). There were 59 males (56.1%) and 46 females (43.9%). The mean age at onset of headaches was 4.3 years (range 14-69 months). According to the IHS criteria we found 37 cases (35.2%) with migraine, 19 cases (18%) with episodic tension headache, 5 cases (4.8%) with chronic daily headache, 13 cases (12.4%) with primary stabbing headache, 18 cases (17.1%) with post-traumatic headache, 7 cases (6.6%) with other non-dangerous secondary headaches (otorhinolaryngological diseases, post-infectious headaches), 3 cases (2.85%) with dangerous headaches (Arnold-Chiari type 1 malformation, brain tumour) and 9 cases (8.6%) with unclassifiable headaches. Six children (5.7%) reported more than one headache subtype. The prevalence of dangerous headaches was higher than those in school age (chi(2)=4.70, p<0.05). Our study shows some differences in headaches in this population vs. school children. In fact at this age migraine is the most common headache, but we also found an increase of secondary causes among the chronic/recurrent and daily headaches, especially posttraumatic disorders and potentially dangerous headaches. Finally our study shows the highest prevalence of the idiopathic stabbing headache in pre-school children in

  20. HIIT in the Real World: Outcomes from a 12-Month Intervention in Overweight Adults.

    PubMed

    Roy, Melyssa; Williams, Sheila M; Brown, Rachel C; Meredith-Jones, Kim A; Osborne, Hamish; Jospe, Michelle; Taylor, Rachael W

    2018-04-21

    Although high-intensity interval training (HIIT) and moderate-intensity continuous exercise have comparable health outcomes in the laboratory setting, effectiveness studies in real-world environments are lacking. The aim of this study was to determine the effectiveness of an unsupervised HIIT programme in overweight/obese adults over 12 months. 250 overweight/obese adults could choose HIIT or current exercise guidelines of 30 minutes/day moderate-intensity exercise. HIIT participants received a single training session and were advised to independently perform HIIT 3x/week utilizing a variety of protocols. Mixed models, with a random effect for participant, compared differences in weight, body composition, blood pressure, aerobic fitness, physical activity and blood indices at 12 months, adjusting for relevant baseline variables. Forty-two percent (n=104) of eligible participants chose HIIT in preference to current guidelines. At 12 months, there were no differences between exercise groups in weight (adjusted difference HIIT vs conventional; 95% CI: -0.44kg; -2.5, 1.6) or visceral fat (-103cm; -256, 49), although HIIT participants reported greater enjoyment of physical activity (p=0.01). Evidence of adherence to ≥2 sessions/week of unsupervised HIIT (from heart rate monitoring) declined from 60.8% at baseline to 19.6% by 12 months. Participants remaining adherent to HIIT over 12 months (23%) were more likely to be male (67% vs 36%, p=0.03), with greater reductions in weight (-2.7kg; -5.2 -0.2) and visceral fat (-292cm; -483, -101) than non-adherent participants. HIIT was well-accepted by overweight adults and opting for HIIT as an alternative to standard exercise recommendations led to no difference in health outcomes after 12 months. While regular participation in unsupervised HIIT declined rapidly, those apparently adherent to regular HIIT demonstrated beneficial weight loss and visceral fat reduction. Australian New Zealand Clinical Trials Registry (ACTRN

  1. Impact of Maternal Selenium Status on Infant Outcome during the First 6 Months of Life

    PubMed Central

    Varsi, Kristin; Bolann, Bjørn; Torsvik, Ingrid; Rosvold Eik, Tina Constanse; Høl, Paul Johan; Bjørke-Monsen, Anne-Lise

    2017-01-01

    Pregnant women and infants are at risk for selenium deficiency, which is known to have negative effects on immune and brain function. We have investigated selenium levels in 158 healthy never-pregnant women and in 114 pregnant and lactating women and their infants at age 6 months and related this to clinical outcomes during the first 6 months of life. Neurodevelopment was assessed with the parental questionnaire Ages and Stages (ASQ) at 6 months. A maternal selenium level ≤0.90 µmol/L in pregnancy week 18 was negatively related to infant neurodevelopment at 6 months (B = −20, p = 0.01), whereas a selenium level ≤0.78 µmol/L in pregnancy week 36 was associated with an increased risk (odds ratio 4.8) of having an infant infection during the first 6 weeks of life. A low maternal selenium status in pregnancy was found to be associated with an increased risk of infant infection during the first 6 weeks of life and a lower psychomotor score at 6 months. We suggest a cutoff for maternal serum selenium deficiency of 0.90 µmol/L in pregnancy week 18 and 0.78 µmol/L in pregnancy week 36. This should be reevaluated in an intervention study. PMID:28492511

  2. Impact of Maternal Selenium Status on Infant Outcome during the First 6 Months of Life.

    PubMed

    Varsi, Kristin; Bolann, Bjørn; Torsvik, Ingrid; Rosvold Eik, Tina Constanse; Høl, Paul Johan; Bjørke-Monsen, Anne-Lise

    2017-05-11

    Pregnant women and infants are at risk for selenium deficiency, which is known to have negative effects on immune and brain function. We have investigated selenium levels in 158 healthy never-pregnant women and in 114 pregnant and lactating women and their infants at age 6 months and related this to clinical outcomes during the first 6 months of life. Neurodevelopment was assessed with the parental questionnaire Ages and Stages (ASQ) at 6 months. A maternal selenium level ≤0.90 µmol/L in pregnancy week 18 was negatively related to infant neurodevelopment at 6 months (B = -20, p = 0.01), whereas a selenium level ≤0.78 µmol/L in pregnancy week 36 was associated with an increased risk (odds ratio 4.8) of having an infant infection during the first 6 weeks of life. A low maternal selenium status in pregnancy was found to be associated with an increased risk of infant infection during the first 6 weeks of life and a lower psychomotor score at 6 months. We suggest a cutoff for maternal serum selenium deficiency of 0.90 µmol/L in pregnancy week 18 and 0.78 µmol/L in pregnancy week 36. This should be reevaluated in an intervention study.

  3. Persistent Arthralgia and Related Risks Factors: A Cohort Study at 12 Months from Laboratory-Confirmed Chikungunya Infection.

    PubMed

    Murillo-Zamora, Efrén; Mendoza-Cano, Oliver; Trujillo-Hernández, Benjamín; Guzmán-Esquivel, José; Higareda-Almaraz, Enrique; Higareda-Almaraz, Martha Alicia; Sánchez-Piña, Ramón Alberto; Lugo-Radillo, Agustin

    2018-04-24

    To assess the cumulative incidence and clinical markers associated with persistent arthralgia (PA) at 12 months from acute chikungunya virus (CHIKV) infection. A multicenter retrospective cohort study was conducted in the state of Colima, Mexico, and 217 serologically confirmed cases of CHIKV infection were enrolled. Participants aged 15 years and older were interviewed on 6 months basis from acute illness onset and the main binary outcome was self-reported PA at 12 months. To assess clinical markers associated with PA we used a generalized linear model. The 2-item Patient Health Questionnaire (PHQ-2) was used to screen for depressive symptoms among PA-positive individuals. The cumulative incidence of PA was 31.8%. In the generalized linear model, individuals ≥40 years of age (risk ratio (RR) = 1.68; 95% confidence interval (CI), 1.10-2.55) and those with 8 or more arthralgia sites (RR = 2.91, 95% CI 1.87-4.53) at acute disease had a significantly increased risk of PA at 12 months from CHIKV infection. Self-reported arthralgia (any site) at 3 months post-infection, a sub-chronic clinical marker, was also associated with a significantly increased risk of long-term articular manifestations (RR = 7.06, 95% CI 2.97-16.81). Depressive symptoms (PHQ-2 score ≥3) were reported by 33.3% of PA-positive participants. Our findings suggest that chronic CHKV-related articular manifestations were a frequent event in the study sample and the impact on functional status was potential. These results may be useful in health care settings in the risk-stratification of PA after CHIKV infection. Copyright © 2018 IMSS. Published by Elsevier Inc. All rights reserved.

  4. HABIT-an early phase study to explore an oral health intervention delivered by health visitors to parents with young children aged 9-12 months: study protocol.

    PubMed

    Eskyte, Ieva; Gray-Burrows, Kara; Owen, Jenny; Sykes-Muskett, Bianca; Zoltie, Tim; Gill, Susanne; Smith, Victoria; McEachan, Rosemary; Marshman, Zoe; West, Robert; Pavitt, Sue; Day, Peter

    2018-01-01

    Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective home-based oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks.Working with health visitors and parents of children aged 9-24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9-12 months with oral health advice.The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB. Six health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9-12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20-25 qualitative interviews after the

  5. Family, friends, and 12-month PTSD among African Americans.

    PubMed

    Nguyen, Ann W; Chatters, Linda M; Taylor, Robert Joseph; Levine, Debra Siegel; Himle, Joseph A

    2016-08-01

    Despite a growing literature on the influence of social support on mental health, little is known about the relationship between social support and specific psychiatric disorders for African Americans, such as PTSD. This study investigated the relationship between social support, negative interaction with family and 12-month PTSD among African Americans. Analyses were based on a nationally representative sample of African Americans from the National Survey of American Life (n = 3315). Social support variables included emotional support from family, frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions with family. Results indicated that emotional support from family is negatively associated with 12-month PTSD while negative interaction with family is predictive of 12-month PTSD. Additionally, a significant interaction indicated that high levels of subjective closeness to friends could offset the impact of negative family interactions on 12-month PTSD. Overall, study results converged with previously established findings indicating that emotional support from family is associated with 12-month PTSD, while, negative interaction with family is associated with increased risk of 12-month PTSD. The findings are discussed in relation to prior research on the unique association between social support and mental health among African Americans.

  6. Family, Friends, and 12-month PTSD among African Americans

    PubMed Central

    Nguyen, Ann W.; Chatters, Linda M.; Taylor, Robert Joseph; Levine, Debra Siegel; Himle, Joseph A.

    2016-01-01

    Purpose Despite a growing literature on the influence of social support on mental health, little is known about the relationship between social support and specific psychiatric disorders for African Americans, such as PTSD. This study investigated the relationship between social support, negative interaction with family and 12-month PTSD among African Americans. Methods Analyses were based on a nationally representative sample of African Americans from the National Survey of American Life (n=3,315). Social support variables included emotional support from family, frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions with family. Results Results indicated that emotional support from family is negatively associated with 12-month PTSD while negative interaction with family is predictive of 12-month PTSD. Additionally, a significant interaction indicated that high levels of subjective closeness to friends could offset the impact of negative family interactions on 12-month PTSD. Conclusions Overall, study results converged with previously established findings indicating that emotional support from family is associated with 12-month PTSD, while, negative interaction with family is associated with increased risk of 12-month PTSD. The findings are discussed in relation to prior research on the unique association between social support and mental health among African Americans. PMID:27189209

  7. A memory span of one? Object identification in 6.5-month-old infants.

    PubMed

    Káldy, Zsuzsa; Leslie, Alan M

    2005-09-01

    Infants' abilities to identify objects based on their perceptual features develop gradually during the first year and possibly beyond. Earlier we reported [Káldy, Z., & Leslie, A. M. (2003). Identification of objects in 9-month-old infants: Integrating 'what' and 'where' information. Developmental Science, 6, 360-373] that infants at 9 months of age are able to use shape information to identify two objects and follow their spatiotemporal trajectories behind occlusion. On the other hand, another recent study suggests that infants at 4-5 months of age cannot identify objects by features and bind them to locations [Mareschal, D., & Johnson, M. H. (2003). The "what" and "where" of object representations in infancy. Cognition, 88, 259-276]. In the current study, we investigated the developmental steps between these two benchmark ages by testing 6.5-month-old infants. Experiment 1 and 2 adapted the paradigm used in our previous studies with 9-month-olds that involves two objects hidden sequentially behind separate occluders. This technique allows us to address object identification and to examine whether only one or both object identities are being tracked. Results of experiment 1 showed that 6.5-month-old infants could identify at least one of two objects based on shape and experiment 2 found that this ability holds for only one, the last object hidden. We propose that at this age, infants' working memory capacity is limited to one occluded object if there is a second intervening hiding. If their attention is distracted by an intervening object during the memory maintenance period, the memory of the first object identity appears to be lost. Results of experiment 3 supported this hypothesis with a simpler one-screen setup. Finally, results of experiment 4 show that temporal decay of the memory trace (without an intervening hiding) by itself cannot explain the observed pattern of results. Taken together, our findings suggest that at six months of age infants can store

  8. Breastfeeding as the sole source of milk for 6 months and adolescent bone mineral density.

    PubMed

    Blanco, E; Burrows, R; Reyes, M; Lozoff, B; Gahagan, S; Albala, C

    2017-10-01

    Little is known regarding the relationship between early life factors and bone mineral density (BMD). We found a positive association between breastfeeding for at least 6 months, without formula supplementation, and whole body adolescent BMD z-score. The aim of the study is to assess the role of breastfeeding BF on adolescent bone mineral density (BMD) in a cohort prospectively followed since infancy. We studied 679 participants from an infancy iron deficiency anemia preventive trial in Santiago, Chile, followed to adolescence. Breast and bottle feeding were ascertained weekly from 4 to 12 months. At 16 years, whole body BMD was assessed by DEXA. Using linear regression, we evaluated associations between BF duration and BF as the sole source of milk and adolescent BMD z-score, adjusting for possible infancy, adolescent, and background confounders. Mean birth weight and length were 3.5 (0.3) kg and 50.7 (1.6) cm. For at least 6 months, BF was the sole source of milk for 26.3% and with supplementation for 36.7%. For 37%, BF was provided for less than 6 months. Mean 16-year BMD z-score was 0.25 (1.0). Covariates included male sex, birth length, and gestational age. BF as the sole source of milk ≥6 months, compared to BF < 6 months, was associated with higher adolescent BMD z-score adjusting for covariates (β = 0.29, p < 0.05). Mixed BF was not significantly related to adolescent BMD z-score (β = 0.06, p = 0.47). For every 30 days of BF as the sole source of milk, adolescent BMD z-score increased by 0.03 (p = 0.01). BF without formula supplementation for at least 6 months was associated with higher adolescent BMD z-score and a suggestive trend in the same direction for BMD suggests that exclusivity and duration of BF may play a role in adolescent bone health.

  9. Stressful life events, perceived stress, and 12-month course of geriatric depression: direct effects and moderation by the 5-HTTLPR and COMT Val158Met polymorphisms.

    PubMed

    Zannas, Anthony S; McQuoid, Douglas R; Steffens, David C; Chrousos, George P; Taylor, Warren D

    2012-07-01

    Although the relation between stressful life events (SLEs) and risk of major depressive disorder is well established, important questions remain about the effects of stress on the course of geriatric depression. Our objectives were (1) to examine how baseline stress and change in stress is associated with course of geriatric depression and (2) to test whether polymorphisms of serotonin transporter (5-HTTLPR) and catechol-O-methyltransferase (COMT Val158Met) genes moderate this relation. Two-hundred and sixteen depressed subjects aged 60 years or older were categorized by remission status (Montgomery-Asberg depression rating scale≤6) at 6 and 12 months. At 6 months, greater baseline numbers of self-reported negative and total SLEs and greater baseline perceived stress severity were associated with lower odds of remission. At 12 months, only baseline perceived stress predicted remission. When we examined change in stress, 12-month decrease in negative SLEs and level of perceived stress were associated with improved odds of 12-month remission. When genotype data were included, COMT Val158Met genotype did not influence these relations. However, when compared with 5-HTTLPR L/L homozygotes, S allele carriers with greater baseline numbers of negative SLEs and with greater decrease in negative SLEs were more likely to remit at 12 months. This study demonstrates that baseline SLEs and perceived stress severity may influence the 12-month course of geriatric depression. Moreover, changes in these stress measures over time correlate with depression outcomes. 5-HTTLPR S carriers appear to be more susceptible to both the effects of enduring stress and the benefit of interval stress reduction.

  10. Understanding and measuring parent use of food to soothe infant and toddler distress: A longitudinal study from 6 to 18 months of age.

    PubMed

    Stifter, Cynthia A; Moding, Kameron J

    2015-12-01

    The present study examined the development of parent use of food to soothe infant distress by examining this feeding practice longitudinally when infants were 6, 12 and 18 months of age. Two measures of feeding to soothe were obtained: parent self-report and observations of food to soothe during each laboratory visit. Demographic and maternal predictors of food to soothe were examined as well as the outcome, infant weight gain. The findings showed that the two measures of food to soothe were unrelated but did reveal similar and unique relations with predictor variables such as parent feeding style and maternal self-efficacy. Only observations of the use of food to soothe were related to infant weight gain. The findings indicate that the two measures of food to soothe may be complementary and that observations of this feeding practice may capture certain relations that are not obtained through the use of self-report. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. A follow-up of a randomised study of metformin and insulin in gestational diabetes mellitus: growth and development of the children at the age of 18 months.

    PubMed

    Ijäs, H; Vääräsmäki, M; Saarela, T; Keravuo, R; Raudaskoski, T

    2015-06-01

    To compare the growth and development of children born to mothers with gestational diabetes mellitus (GDM) requiring pharmacological treatment, and randomised to treatment with metformin or insulin. Follow-up of a randomised controlled trial (RCT) comparing metformin and insulin treatment of GDM. Data were gathered during routine visits to child welfare clinics at the ages of 6, 12, and 18 months, including weight and height measurements, and assessment of motor, social, and linguistic development. The children of mothers with GDM randomised to metformin (n = 47) or insulin (n = 50) treatment during pregnancy. Data were collected from the structured questionnaire filled in at the child welfare clinics. The growth and development of the children until the age of 18 months. Children exposed to metformin were significantly heavier (10.47 versus 9.85 kg, 95% CI 0.04-1.20) at the age of 12 months and taller and heavier (83.9 vs 82.2 cm, 95% CI 0.23-3.03, 12.05 vs 11.32 kg, 95% CI 0.04-1.43) at the age of 18 months. The mean ponderal index (PI) did not differ significantly. The motor, social, or linguistic development evaluated at the age of 18 months did not differ between the groups. Children prenatally exposed to metformin were heavier at the 12 months measurements and taller and heavier at the 18 months measurements than those exposed to insulin, but their body composition defined by PI did not differ. Over the short term, metformin does not seem to be harmful with regards to early motor, linguistic, or social development. © 2014 Royal College of Obstetricians and Gynaecologists.

  12. Predicting 6- and 12-Month Risk of Mortality in Patients With Platinum-Resistant Advanced-Stage Ovarian Cancer: Prognostic Model to Guide Palliative Care Referrals.

    PubMed

    Foote, Jonathan; Lopez-Acevedo, Micael; Samsa, Gregory; Lee, Paula S; Kamal, Arif H; Alvarez Secord, Angeles; Havrilesky, Laura J

    2018-02-01

    Predictive models are increasingly being used in clinical practice. The aim of the study was to develop a predictive model to identify patients with platinum-resistant ovarian cancer with a prognosis of less than 6 to 12 months who may benefit from immediate referral to hospice care. A retrospective chart review identified patients with platinum-resistant epithelial ovarian cancer who were treated at our institution between 2000 and 2011. A predictive model for survival was constructed based on the time from development of platinum resistance to death. Multivariate logistic regression modeling was used to identify significant survival predictors and to develop a predictive model. The following variables were included: time from diagnosis to platinum resistance, initial stage, debulking status, number of relapses, comorbidity score, albumin, hemoglobin, CA-125 levels, liver/lung metastasis, and the presence of a significant clinical event (SCE). An SCE was defined as a malignant bowel obstruction, pleural effusion, or ascites occurring on or before the diagnosis of platinum resistance. One hundred sixty-four patients met inclusion criteria. In the regression analysis, only an SCE and the presence of liver or lung metastasis were associated with poorer short-term survival (P < 0.001). Nine percent of patients with an SCE or liver or lung metastasis survived 6 months or greater and 0% survived 12 months or greater, compared with 85% and 67% of patients without an SCE or liver or lung metastasis, respectively. Patients with platinum-resistant ovarian cancer who have experienced an SCE or liver or lung metastasis have a high risk of death within 6 months and should be considered for immediate referral to hospice care.

  13. [The effects of 6 months' multimodal training on functional performance, strength, endurance, and body mass index of older individuals. Are the benefits of training similar among women and men?].

    PubMed

    Gudlaugsson, Janus; Aspelund, Thor; Gudnason, Vilmundur; Olafsdottir, Anna Sigridur; Jonsson, Palmi V; Arngrimsson, Sigurbjorn Arni; Johannsson, Erlingur

    2013-07-01

    Good functional performance in elderly people greatly improves their changes of independence and well-being. Conversely, bad functional performance can impair their capability of managing the activities of daily life.. The main goal of this study was to investigate the effects of a 6-months' multimodal training intervention on the physical performance of males and females, possible gender differences and the outcome 6 and 12 months after its completion. This study examined 71-90 year old healthy seniors (n=117) participating in the AGES Reykjavik Study. It was a randomized and controlled cross-over trial, conducted in three 6-months' phases (time-points). After enrollment and baseline assessments, the study group was divided in two. Group 1 received 6-months' training while group 2 served as a control. In the second 6 months' phase, group 1 received no formal training while group 2 did. In the third phase, neither group received training. The groups' physical conditions were assessed after each phase. After 6-months' training, 32% improvement was seen in physical activity among males (p<0.001) and 39% among females (p<0.001). In physical performance, 5% improvement was seen for males (p<0.01) and 7% for females (p<0.001). Strength increased by 8% for males (p<0.001) and 13% for females (p<0.001). For both sexes, about 10% increase was seen in dynamic balance in the 8-foot up-and-go test (p<0.001) and 5-6% in walking distance for both sexes in the six minutes walking test (p<0.001). For both sexes, body mass index decreased by about 2% (p<0.001). No difference was seen between the sexes.in the training results. Both sexes retained long-term effects of the training on physical performance and dynamic balance for at least 12 months. Multimodal training intervention has positive effects on physical performance in older individuals, the sexes respond similarly to the training and retain achieved improvement for at least 12 months. The research indicates that moderate

  14. Catheter-based renal denervation for resistant hypertension: 12-month results of the EnligHTN I first-in-human study using a multielectrode ablation system.

    PubMed

    Papademetriou, Vasilios; Tsioufis, Costas P; Sinhal, Ajay; Chew, Derek P; Meredith, Ian T; Malaiapan, Yuvi; Worthley, Matthew I; Worthley, Stephen G

    2014-09-01

    Renal denervation has emerged as a novel approach for the treatment of patients with drug-resistant hypertension. To date, only limited data have been published using multielectrode radiofrequency ablation systems. In this article, we present the 12-month data of EnligHTN I, a first-in-human study using a multielectrode ablation catheter. EnligHTN I enrolled 46 patients (average age, 60±10 years; on average 4.7±1.0 medications) with drug-resistant hypertension. Eligible patients were on ≥3 antihypertensive medications and had a systolic blood pressure (BP) ≥160 mm Hg (≥150 mm Hg for diabetics). Bilateral renal artery ablation was performed using a percutaneous femoral approach and standardized techniques. The average baseline office BP was 176/96 mm Hg, average 24-hour ambulatory BP was 150/83 mm Hg, and average home BP was 158/90 mm Hg. The average reductions (mm Hg) at 1, 3, 6, and 12 months were as follows: office: -28/-10, -27/-10, -26/-10, and -27/-11 mm Hg (P<0.001 for all); 24-hour ambulatory: -10/-5, -10/-5, -10/-6 (P<0.001 for all), and -7/-4 for 12 months (P<0.0094). Reductions in home measurements (based on 2-week average) were -9/-4, -8/-5,-10/-7, and -11/-6 mm Hg (P<0.001 at 12 months). At 12 months, there were no signals of worsening renal function and no new serious or life-threatening adverse events. One patient with baseline nonocclusive renal artery stenosis progressed to 75% diameter stenosis, requiring renal artery stenting. The 12-month data continue to demonstrate safety and efficacy of the EnligHTN ablation system in patients with drug-resistant hypertension. Home BP measurements parallel measurements obtained with 24-hour ambulatory monitoring. © 2014 American Heart Association, Inc.

  15. Age-dependent Changes in the Articular Cartilage and Subchondral Bone of C57BL/6 Mice after Surgical Destabilization of Medial Meniscus.

    PubMed

    Huang, Henry; Skelly, Jordan D; Ayers, David C; Song, Jie

    2017-02-09

    Age is the primary risk factor for osteoarthritis (OA), yet surgical OA mouse models such as destabilization of the medial meniscus (DMM) used for evaluating disease-modifying OA targets are frequently performed on young adult mice only. This study investigates how age affects cartilage and subchondral bone changes in mouse joints following DMM. DMM was performed on male C57BL/6 mice at 4 months (4 M), 12 months (12 M) and 19+ months (19 M+) and on females at 12 M and 18 M+. Two months after surgery, operated and unoperated contralateral knees were harvested and evaluated using cartilage histology scores and μCT quantification of subchondral bone plate thickness and osteophyte formation. The 12 M and 19 M+ male mice developed more cartilage erosions and thicker subchondral bone plates after DMM than 4 M males. The size of osteophytes trended up with age, while the bone volume fraction was significantly higher in the 19 M+ group. Furthermore, 12 M females developed milder OA than males as indicated by less cartilage degradation, less subchondral bone plate sclerosis and smaller osteophytes. Our results reveal distinct age/gender-dependent structural changes in joint cartilage and subchondral bone post-DMM, facilitating more thoughtful selection of murine age/gender when using this surgical technique for translational OA research.

  16. Age-dependent Changes in the Articular Cartilage and Subchondral Bone of C57BL/6 Mice after Surgical Destabilization of Medial Meniscus

    PubMed Central

    Huang, Henry; Skelly, Jordan D.; Ayers, David C.; Song, Jie

    2017-01-01

    Age is the primary risk factor for osteoarthritis (OA), yet surgical OA mouse models such as destabilization of the medial meniscus (DMM) used for evaluating disease-modifying OA targets are frequently performed on young adult mice only. This study investigates how age affects cartilage and subchondral bone changes in mouse joints following DMM. DMM was performed on male C57BL/6 mice at 4 months (4 M), 12 months (12 M) and 19+ months (19 M+) and on females at 12 M and 18 M+. Two months after surgery, operated and unoperated contralateral knees were harvested and evaluated using cartilage histology scores and μCT quantification of subchondral bone plate thickness and osteophyte formation. The 12 M and 19 M+ male mice developed more cartilage erosions and thicker subchondral bone plates after DMM than 4 M males. The size of osteophytes trended up with age, while the bone volume fraction was significantly higher in the 19 M+ group. Furthermore, 12 M females developed milder OA than males as indicated by less cartilage degradation, less subchondral bone plate sclerosis and smaller osteophytes. Our results reveal distinct age/gender-dependent structural changes in joint cartilage and subchondral bone post-DMM, facilitating more thoughtful selection of murine age/gender when using this surgical technique for translational OA research. PMID:28181577

  17. Independent Predictors of 6-Month Mortality in Patients Successfully Resuscitated for Out-of-Hospital Cardiac Arrest: Observational Retrospective Single Center Study.

    PubMed

    Sinkovič, Andreja; Markota, Andrej; Marinšek, Martin; Svenšek, Franc

    2018-01-01

    Mortality of admitted out-of-hospital cardiac arrest (OHCA) patients is decreasing. Our aim was to evaluate independent predictors of six-month mortality of successfully resuscitated OHCA patients. We reviewed retrospectively the records of 119 OHCA patients, admitted in 2011 to 2013 (73.1% men, mean age 64 ± 13,5 years) and registered their clinical data, treatments, and predictors of 6-month mortality. Six-month mortality of admitted OHCA patients was 47.5% and was associated significantly with older age (67.7 ± 12.9 years versus 59.9 ± 13 years, p < 0.05), mechanical ventilation, longer time of resuscitation (24.6 ± 18.9 sec versus 8.9 ± 8.4 sec, p < 0.05), use of vasopressors (87.3% versus 62.5%, p < 0.05), and increased serum lactate (8.1 ± 3.9 mmol/l versus 4.5 ± 3.6 mmol/l, p < 0.05) but less likely with prior shockable rhythm (38% versus 73.2%, p < 0.05), percutaneous coronary intervention (27% versus 55.4%, p < 0.05), achieved target temperatures 32°-34°C of mild therapeutic hypothermia (47.6% versus 71.4%, p < 0.05), acute coronary syndromes (31.7% versus 51.8%, p < 0.05), and neurological recovery (4.8% versus 69.6%, p < 0.05) when compared to survivors. Neurological outcome was most significant early independent predictor of 6-month mortality (OR 50.47; 95% CI 6.74 to 377.68; p < 0.001). Postcardiac arrest brain injury most significantly and independently predicted 6-month mortality in hospitalized OHCA patients.

  18. Siblings, theory of mind, and executive functioning in children aged 3-6 years: new longitudinal evidence.

    PubMed

    McAlister, Anna R; Peterson, Candida C

    2013-01-01

    Longitudinal data were obtained from 157 children aged 3 years 3 months to 5 years 6 months at Time 1. At Time 2 these children had aged an average of 12 months. Theory of mind (ToM) and executive functioning (EF) were measured at both time points. Results suggest that Time 1 ToM scores predict Time 2 EF scores. Detailed examination of sibling influences suggests that benefits-in terms of advanced ToM development-accrue to children with siblings versus without, and to those with a larger number of child-aged siblings. Any advance in either area (ToM or EF) is likely to benefit the other, and early sibling interaction appears to act as a catalyst. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

  19. Age at Introduction to Solid Foods and Child Obesity at 6 Years.

    PubMed

    Barrera, Chloe M; Perrine, Cria G; Li, Ruowei; Scanlon, Kelley S

    2016-06-01

    Epidemiological evidence suggests that timing of introduction of solid foods may be associated with subsequent obesity, and the association may vary by whether an infant is breastfed or formula-fed. We included 1181 infants who participated in the Infant Feeding Practices Study II (IFPS II) and the Year 6 Follow Up (Y6FU) study. Data from IFPS II were used to calculate the primary exposure and timing of solid food introduction (<4, 4-<6, and ≥6 months), and data from Y6FU were used to calculate the primary outcome and obesity at 6 years of age (BMI ≥95th percentile). We used multivariable logistic regression to assess the association between timing of the introduction of solids and obesity at 6 years and test whether this association was modified by breastfeeding duration (breastfed for 4 months vs. not). Prevalence of obesity in our sample was 12.0%. The odds of obesity was higher among infants introduced to solids <4 months compared to those introduced at 4-<6 months (odds ratio [OR] = 1.66; 95% CI, 1.15, 2.40) in unadjusted analysis; however, this relationship was no longer significant after adjustment for covariates (OR = 1.18; 95% CI, 0.79, 1.77). Introduction of solids ≥6 months was not associated with obesity. We found no interaction between breastfeeding duration and early solid food introduction and subsequent obesity. Timing of introduction of solid foods was not associated with child obesity at 6 years in this sample. Given the inconsistency in findings with other studies, further studies in larger populations may be needed.

  20. Headache patients' satisfaction with telemedicine: a 12-month follow-up randomized non-inferiority trial.

    PubMed

    Müller, K I; Alstadhaug, K B; Bekkelund, S I

    2017-06-01

    We investigated non-acute headache patients' long-term satisfaction with a telemedicine consultation and consultation preferences in northern Norway. We hypothesized that patients were not less satisfied with telemedicine than traditional consultations. We also examined the influence of gender, age and education on satisfaction. For 2.5 years, patients were consecutively screened, recruited and randomly assigned to telemedicine or traditional visits with a consultation at a neurological outpatient department. The primary endpoint was frequency of satisfied patients at 3 and 12 months. Secondary endpoints were satisfaction with consultation, communication, information, diagnosis, advice and prescriptions, and preferred visit form at 12 months. Of 402 participants, 279 (69.4%) answered questionnaires at both 3 and 12 month, and 291 (72.4%) responded at 12 months. The long-term satisfaction of telemedicine patients was 124/145 (85.5%) compared with 118/134 (88.1%) in the traditional group (P = 0.653). The groups did not differ with respect to secondary endpoints, but females were more satisfied with telemedicine communication (P = 0.027). In the telemedicine group, 99/147 (67.3%) were indifferent to the type of consultation. Age and education did not alter the primary results. At 1 year after a specialist evaluation for headache, telemedicine patients did not express less satisfaction than those with traditional consultation. Telemedicine specialist consultations may be a good alternative for headache patients in secondary care. © 2017 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

  1. Serum n-6 and n-9 Fatty Acids Correlate With Serum IGF-1 and Growth Up to 4 Months of Age in Healthy Infants.

    PubMed

    Kjellberg, Emma; Roswall, Josefine; Bergman, Stefan; Strandvik, Birgitta; Dahlgren, Jovanna

    2018-01-01

    The aim of this study was to study the relationship between insulin-like growth factor-1 (IGF-1), serum phospholipid fatty acids, and growth in healthy full-term newborns during infancy. Prospective observational study of a population-based Swedish cohort comprising 126 healthy, term infants investigating cord blood and serum at 2 days and 4 months of age for IGF-1 and phospholipid fatty acid profile and breast milk for fatty acids at 2 days and 4 months, compared with anthropometric measurements (standard deviation scores). At all time-points arachidonic acid (AA) was negatively associated with IGF-1. IGF-1 had positive associations with linoleic acid (LA) at 2 days and 4 months and mead acid (MA) showed positive associations in cord blood. Multiple regression analyses adjusted for maternal factors (body mass index, weight gain, smoking, education), sex, birth weight and feeding modality confirmed a negative association for the ratio AA/LA to IGF-1. MA in cord blood correlated to birth size. Changes in the ratios of n-6/n-3 and AA/docosahexaenoic acid from day 2 to 4 months together with infants' weight and feeding modality determined 55% of the variability of delta-IGF-1. Breast-fed infants at 4 months had lower IGF-1 correlating with lower LA and higher AA concentrations, which in girls correlated with lower weight gain from birth to 4 months of age. Our data showed interaction of n-6 fatty acids with IGF-1 during the first 4 months of life, and an association between MA and birth size when adjusted for confounding factors. Further follow-up may indicate whether these correlations are associated with later body composition.

  2. IL-6 deficiency alters spatial memory in 4- and 24-month-old mice.

    PubMed

    Bialuk, Izabela; Taranta, Andrzej; Winnicka, Maria Małgorzata

    2018-06-19

    Significance of interleukin 6 (IL-6) deficiency in cognitive processes was evaluated in 4- and 24-month-old C57BL/6J IL-6-deficient (IL-6 KO) and control (WT) mice in Morris water maze (MWM), holeboard test (HB) and elevated plus maze (EPM). During 3-day learning escape latency time (ELT) was longer in IL-6 KO than in WT mice, however their swimming was slower, floating longer, and path length did not differ. The comparison of ELT and the distance traveled between the first and the third learning day within each group revealed significant decrease of ELT in all groups with the highest difference in 4-month-old WT mice, and significant decrease of distance traveled only in both groups of WT mice. In a single probe trial, performed 24 h after the last learning session, there were no major differences in the absolute values of ELT, but ELT turned out to be significantly shorter in both IL-6 KO groups, when it was compared to the ELT on the last learning day, indicating on better memory retrieval. In HB test only significant increase in number of rearings in aged WT mice, and in EPM significant prolongation of open arm time and higher number of open arm entries in 4-month-old IL-6 KO mice were observed. Results of HB and EPM tests showed that alterations of learning and reference memory observed in MWM were specific to cognition. Attenuation of learning ability in young adult IL-6-deficient mice assessed in MWM suggests that physiological level of IL-6 is involved in mechanisms engaged in proper memory formation, and it may also indicate on the importance of IL-6 signaling in brain development. Maintained on similar level in both 4- and 24-month-old IL-6 KO mice learning ability and its attenuation in 24-month-old vs 4-month-old WT mice indicates on slower age-related memory decline in mice not expressing IL-6. Better performance of IL-6 KO mice in the probe trial points to their reference memory improvement and may also indicate that IL-6 plays a role in mechanism

  3. [MRI monitoring of autologous hyaline cartilage grafts in the knee joint: a follow-up study over 12 months].

    PubMed

    Müller-Horvat, C; Schick, F; Claussen, C D; Grönewäller, E

    2004-12-01

    To evaluate the suitability of different MR sequences for monitoring the stage of maturation of hyaline cartilage grafts in the knee joint and the early detection of complications like hypertrophy. In addition, it was analyzed whether indirect MR arthrography can indicate debonding of the graft. MRI examinations were performed in 19 patients, aged 17 - 48 years, with autologous transplantation of a hyaline cartilage tissue graft after knee trauma. Examination dates were prior to transplantation to localize the defect, and 6 weeks, 3, 6 and 12 months after transplantation to control morphology and maturation of the autologous graft. Standard T2- and proton-density-weighted turbo spin echo (TSE) sequences and T1-weighted spin echo (SE) sequences were used, as well as gradient echo (GRE) sequences with and without magnetization transfer (MT) prepulses. In some cases, indirect MR arthrography was performed. Cartilage defect and the hyaline cartilage graft could be detected in all 19 patients. Hypertrophy of the graft could be found early in 3 patients and debonding in 1 patient. For depicting the graft a short time after surgery, T2-weighted TSE-sequences showed the best results. Six and 12 months after transplantation, spoiled 3D-GRE-sequences like FLASH3D (fast low angle shot) showed reduced artifacts due to magnetic residues from the surgery. Difference images from GRE-sequences with and without MT pulse provided high contrast between cartilage and surrounding tissue. The quantification of the MT effect showed an assimilation of the graft to the original cartilage within 12 months. Indirect MR arthrography showed subchondral contrast medium even 12 months after transplantation in 3 patients. MRI allows a reliable depiction of the hyaline graft and provides very early detection of complications like hypertrophy. The MT effect seems to be correlated with maturation of the graft and allows selective depiction of normal cartilage and engrafted cartilage.

  4. Impact of contaminated household environment on stunting in children aged 12-59 months in Burkina Faso.

    PubMed

    Fregonese, Federica; Siekmans, Kendra; Kouanda, Seni; Druetz, Thomas; Ly, Antarou; Diabaté, Souleymane; Haddad, Slim

    2017-04-01

    Stunting affects 165 million children worldwide, with repercussions on their survival and development. A contaminated environment is likely to contribute to stunting: frequent faecal-oral transmission possibly causes environmental enteropathy, a chronic inflammatory disorder that may contribute to faltering growth in children. This study's objective was to assess the effect of contaminated environment on stunting in Burkina Faso, where stunting prevalence is persistently high. Panel study of children aged 1-5 years in Kaya. Household socioeconomic characteristics, food needs and sanitary conditions were measured once, and child growth every year (2011-2014). Using multiple correspondence analysis and 12 questions and observations on water, sanitation, hygiene behaviours, yard cleanliness and animal proximity, we constructed a 'contaminated environment' index as a proxy of faecal-oral transmission exposure. Analysis was performed using a generalised structural equation model (SEM), adjusting for repeat observations and hierarchical data. Stunting (<2 SD height-for-age) prevalence was 29% among 3121 children (median (IQR) age 36 (25-48) months). Environment contamination was widespread, particularly in rural and peri-urban areas, and was associated with stunting (prevalence ratio 1.30; p=0.008), controlling for sex, age, survey year, setting, mother's education, father's occupation, household food security and wealth. This association was significant for children of all ages (1-5 years) and settings. Lower contamination and higher food security had effects of comparable magnitude. Environment contamination can be at least as influential as nutritional components in the pathway to stunting. There is a rationale for including interventions to reduce environment contamination in stunting prevention programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Effects of infant cereals with different carbohydrate profiles on colonic function--randomised and double-blind clinical trial in infants aged between 6 and 12 months--pilot study.

    PubMed

    Bernal, María José; Periago, María Jesús; Martínez, Rosario; Ortuño, Inmaculada; Sánchez-Solís, Manuel; Ros, Gaspar; Romero, Fernando; Abellán, Pedro

    2013-11-01

    Infant cereals are often the elected foodstuff for beginning complementary feeding and provide carbohydrates which are different to those found in maternal milk. The objective of this preliminary study was to ascertain the colonic effects of two infant cereals, with different carbohydrate profiles, in a randomised and double-blind trial in healthy infants. Nineteen term infants between 6.3 and 9.8 months of age were enrolled, after written informed consent was obtained from parents. Ten subjects were allocated to take infant cereal A and nine, infant cereal B. An intervention period was 2 months, with five visits every 15 days, to take anthropometric measurements and faeces samples for the analysis of microbiota, short-chain fatty acids concentration (SCFA), pH value and secretory immunoglobulin A (sIgA). An adequate growth and stool frequency was registered in both intervention groups. Faecal counts of Bifidobacterium, Lactobacillus, Enterobacteriaceae, Enterococcus, Clostridium and Bacteroides did not show any statistical differences. However, a significantly (P < 0.05) higher butyric acid and sIgA, and lower faecal pH were observed in infants who had ingested infant cereal A, with a higher ratio complex/simple carbohydrates. In conclusion, small changes in the carbohydrate profile of infant cereals could lead to significant differences in parameters related to fermentative activity of intestinal microbiota.

  6. Prenatal and postnatal serum PCB concentrations and cochlear function in children at 45 months of age.

    PubMed

    Jusko, Todd A; Sisto, Renata; Iosif, Ana-Maria; Moleti, Arturo; Wimmerová, Sonˇa; Lancz, Kinga; Tihányi, Juraj; Sovčiková, Eva; Drobná, Beata; Palkovičová, L'ubica; Jurečková, Dana; Thevenet-Morrison, Kelly; Verner, Marc-André; Sonneborn, Dean; Hertz-Picciotto, Irva; Trnovec, Tomáš

    2014-11-01

    Some experimental and human data suggest that exposure to polychlorinated biphenyls (PCBs) may induce ototoxicity, though results of previous epidemiologic studies are mixed and generally focus on either prenatal or postnatal PCB concentrations exclusively. Our aim was to evaluate the association between pre- and postnatal PCB concentrations in relation to cochlear status, assessed by distortion product otoacoustic emissions (DPOAEs), and to further clarify the critical periods in development where cochlear status may be most susceptible to PCBs. A total of 351 children from a birth cohort in eastern Slovakia underwent otoacoustic testing at 45 months of age. Maternal pregnancy, cord, and child 6-, 16-, and 45-month blood samples were collected and analyzed for PCB concentrations. At 45 months of age, DPOAEs were assessed at 11 frequencies in both ears. Multivariate, generalized linear models were used to estimate the associations between PCB concentrations at different ages and DPOAEs, adjusting for potential confounders. Maternal and cord PCB-153 concentrations were not associated with DPOAEs at 45 months. Higher postnatal PCB concentrations at 6-, 16-, and 45-months of age were associated with lower (poorer) DPOAE amplitudes. When all postnatal PCB exposures were considered as an area-under-the-curve metric, an increase in PCB-153 concentration from the 25th to the 75th percentile was associated with a 1.6-dB SPL (sound pressure level) decrease in DPOAE amplitude (95% CI: -2.6, -0.5; p = 0.003). In this study, postnatal rather than maternal or cord PCB concentrations were associated with poorer performance on otoacoustic tests at age 45 months.

  7. Risk factors for road traffic accidents in cats up to age 12months that were registered between 2010 and 2013 with the UK pet cat cohort ('Bristol Cats').

    PubMed

    Wilson, J L; Gruffydd-Jones, T J; Murray, J K

    2017-02-25

    Road traffic accidents (RTAs) are a common cause of death and injury in domestic cats, and a concern to many owners. This study assessed potential risk factors for RTAs in cats up to 12months of age within a UK cat cohort known as 'The Bristol Cats study'. Data were obtained from three questionnaires, completed by cat owners when their cats were approximately 8-16 weeks old, 6 months old and 12months old. Information was gathered regarding environmental conditions, cat characteristics and owner management factors. Univariable and multivariable logistic regression models were used to assess associations between these factors and RTAs. Of 1264 eligible study cats, 49 (3.9 per cent) had been involved in an RTA, of which 71.4 per cent (35/49) were known to result in fatal injuries. Rural locations were associated with a higher odds of RTAs than towns, cities or suburban locations. An increased odds of an RTA was also associated with cats that were reported by their owners to hunt at the roadside, as well as cats whose owners classified the road by their house as being a 'long straight section of road'. No significant associations were found between coat colour, breed, sex or neuter status and the odds of an RTA. British Veterinary Association.

  8. Exercise barriers and the relationship to self-efficacy for exercise over 12 months of a lifestyle-change program for people with heart disease and/or diabetes.

    PubMed

    Alharbi, Muaddi; Gallagher, Robyn; Neubeck, Lis; Bauman, Adrian; Prebill, Gabrielle; Kirkness, Ann; Randall, Sue

    2017-04-01

    Barriers to exercise are common in people with coronary heart disease (CHD) and/or diabetes mellitus (DM), and may influence self-efficacy for exercise. The purpose of this study was to describe the exercise barriers experienced by people who have CHD and/or DM participating in the Healthy Eating and Exercise Lifestyle Program and to determine whether these barriers influence self-efficacy. Participants ( n = 134) identified their barriers to exercise and completed the self-efficacy for exercise survey at baseline, at 4 months (following structured and supervised exercise) and at 12 months (following home-based exercise with three follow-up calls). The sample mean age was 63.6 years (SD 8.5) and 58% were male. Barriers to exercise were reported by 88% at baseline, 76% at 4 months, and 47% at 12 months. The most common barriers were lack of motivation (40.3%), lack of time overall (30.6%), and lack of time due to family commitments (17.2%). Only motivation changed significantly over time from baseline (40%) to 4 months (23%, p = 0.040). Lower self-efficacy for exercise was associated with lack of motivation at 12 months only, more depressive symptoms at baseline and 4 months, and a CHD diagnosis and higher body mass index at 12 months. In contrast, male gender and having higher self-efficacy at baseline were associated with higher self-efficacy for exercise at 4 and 12 months. Patients identified many exercise barriers despite participating in a lifestyle-change program. Lack of motivation negatively influenced self-efficacy for exercise at 12 months. Other factors needing attention include baseline self-efficacy, depressive symptoms, being female, being more overweight, and having CHD.

  9. Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6–59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey

    PubMed Central

    Tchoubi, Sébastien; Sobngwi-Tambekou, Joëlle; Noubiap, Jean Jacques N.; Asangbeh, Serra Lem; Nkoum, Benjamin Alexandre; Sobngwi, Eugene

    2015-01-01

    Background Childhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (<5 years) in Cameroon, based on weight-for-height index, has doubled between 1991 and 2006. This study aimed to determine the prevalence and risk factors of overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011. Methods Four thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity. Results The prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13–24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25–36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion. Conclusion This study underlines a high prevalence of

  10. Development of manipulation in capuchin monkeys during the first 6 months.

    PubMed

    Adams-Curtis, L E; Fragaszy, D M

    1994-03-01

    This study describes the orderly changes in manipulation over the first 6 months in capuchin monkeys (Cebus apella). By 6 months of age, all the basic forms of manipulation seen in adults have appeared. Actions that occur frequently in the first 8 weeks are gentle and involve sustained visual orientation and aimed reaching. Later actions are more vigorous, and involve grasping. Large increases in the rate of activity are evident over the period of development studied. The increase from the first 8 weeks to the second may be due to (a) an increase in the amount of time spent alert and active, (b) a decrease in the amount of time spent in a ventral position, (c) improvements in postural control and stamina and (d) the onset of independent locomotion. Changes in form can be attributed primarily to postural factors and to neuromuscular development (precisely aimed and controlled movements appearing in the 5th and 6th months).

  11. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial.

    PubMed

    Taylor, Angie L; Dunstan, Janet A; Prescott, Susan L

    2007-01-01

    Despite preliminary evidence, the role of probiotics in allergy prevention is unclear. To determine whether early probiotic supplementation prevents allergic disease in high-risk infants. Newborns of women with allergy (n = 231) received either Lactobacillus acidophilus (LAVRI-A1) or placebo daily for the first 6 months of life. Children were assessed for atopic dermatitis (AD) and other symptoms at 6 and 12 months and had allergen skin prick tests (SPT) at 12 months of age. A total of 178 infants completed the supplementation period. Those in the probiotic group showed significantly higher rates of Lactobacillus colonization (P = .039). At 6 months, AD rates were similar in the probiotic (n = 23/89; 25.8%) and placebo (n = 20/88; 22.7%) groups (P = .629). There was also no difference at 12 months, although the proportion of children with SPT+AD was significantly higher in the probiotic group (P = .045). At 12 months, the rate of sensitization was significantly higher in the probiotic group (P = .030). The presence of culturable Lactobacilli or Bifidobacterium in stools in the first month of life was not associated with the risk of subsequent sensitization or disease; however, the presence of Lactobacillus at 6 months of age was associated with increased risk of subsequent cow's milk sensitization (P = .012). Early probiotic supplementation with L acidophilus did not reduce the risk of AD in high-risk infants and was associated with increased allergen sensitization in infants receiving supplements. The long-term significance of the increased rate of sensitization needs to be investigated in further studies. These findings challenge the role of probiotics in allergy prevention.

  12. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity

    PubMed Central

    Lean, Michael; Brosnahan, Naomi; McLoone, Philip; McCombie, Louise; Higgs, Anna Bell; Ross, Hazel; Mackenzie, Mhairi; Grieve, Eleanor; Finer, Nick; Reckless, John; Haslam, David; Sloan, Billy; Morrison, David

    2013-01-01

    Background There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m2. Aim This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. Design and setting Feasibility study in primary care. Method Patients with a BMI ≥40 kg/m2 commenced a micronutrient-replete 810–833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months. Result Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m2, age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10–15 kg loss, and 11 (12%) had a 5–10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved. Conclusion A care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one

  13. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity.

    PubMed

    Lean, Michael; Brosnahan, Naomi; McLoone, Philip; McCombie, Louise; Higgs, Anna Bell; Ross, Hazel; Mackenzie, Mhairi; Grieve, Eleanor; Finer, Nick; Reckless, John; Haslam, David; Sloan, Billy; Morrison, David

    2013-02-01

    There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m(2). This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. Feasibility study in primary care. Patients with a BMI ≥40 kg/m(2) commenced a micronutrient-replete 810-833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months. Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m(2), age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10-15 kg loss, and 11 (12%) had a 5-10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved. A care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one-third of all patients entering the programme.

  14. Fish consumption in infancy and asthma-like symptoms at preschool age.

    PubMed

    Kiefte-de Jong, Jessica C; de Vries, Jeanne H; Franco, Oscar H; Jaddoe, Vincent W V; Hofman, Albert; Raat, Hein; de Jongste, Johan C; Moll, Henriette A

    2012-12-01

    To assess whether timing of introduction of fish and the amount of fish consumption in infancy were associated with asthmalike symptoms at preschool age. This study was embedded in the Generation R study (a population-based birth cohort in Rotterdam, Netherlands). At the age of 12 and 14 months, timing of introduction of fish into the infant's diet was assessed. The amount of fish consumption at 14 months was assessed by a semiquantitative food frequency questionnaire. Presence of asthmalike symptoms in the past year was assessed at the child's age of 36 and 48 months. Relative to no introduction in the first year of life, introduction between age 6 and 12 months was significantly associated with a lower risk of wheezing at 48 months (odds ratio [OR]: 0.64; 95% CI: 0.43-0.94). When compared with introduction between 6 and 12 months, no introduction in the first year and introduction between 0 and 6 months were associated with an increased risk of wheezing at 48 months (OR: 1.57; 95% CI: 1.07-2.31 and OR: 1.53; 95% CI: 1.07-2.19, respectively). The amount of fish at age 14 months was not associated with asthmalike symptoms (P > .15). Introduction of fish between 6 and 12 months but not fish consumption afterward is associated with a lower prevalence of wheezing. A window of exposure between the age of 6 and 12 months might exist in which fish might be associated with a reduced risk of asthma.

  15. Language evaluation protocol for children aged 2 months to 23 months: analysis of sensitivity and specificity.

    PubMed

    Labanca, Ludimila; Alves, Cláudia Regina Lindgren; Bragança, Lidia Lourenço Cunha; Dorim, Diego Dias Ramos; Alvim, Cristina Gonçalves; Lemos, Stela Maris Aguiar

    2015-01-01

    To establish cutoff points for the analysis of the Behavior Observation Form (BOF) of children in the ages of 2 to 23 months and evaluate the sensitivity and specificity by age group and domains (Emission, Reception, and Cognitive Aspects of Language). The sample consisted of 752 children who underwent BOF. Each child was classified as having appropriate language development for the age or having possible risk of language impairment. Performance Indicators (PI) were calculated in each domain as well as the overall PI in all domains. The values for sensitivity and specificity were also calculated. The cutoff points for possible risk of language impairment for each domain and each age group were obtained using the receiver operating characteristics curve. The results of the study revealed that one-third of the assessed children have a risk of language impairment in the first two years of life. The analysis of BOF showed high sensitivity (>90%) in all categories and in all age groups; however, the chance of false-positive results was higher than 20% in the majority of aspects evaluated. It was possible to establish the cutoff points for all categories and age groups with good correlation between sensitivity and specificity, except for the age group of 2 to 6 months. This study provides important contributions to the discussion on the evaluation of the language development of children younger than 2 years.

  16. Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study.

    PubMed

    Muhoozi, Grace K M; Atukunda, Prudence; Mwadime, Robert; Iversen, Per Ole; Westerberg, Ane C

    2016-01-01

    Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. Five hundred and twelve households with mother-infant (6-8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains. Undernutrition

  17. Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study

    PubMed Central

    Muhoozi, Grace K. M.; Atukunda, Prudence; Mwadime, Robert; Iversen, Per Ole; Westerberg, Ane C.

    2016-01-01

    Background Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. Objective In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. Design Five hundred and twelve households with mother–infant (6–8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. Results The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for

  18. 12 CFR 906.5 - Monthly interest rate survey.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Monthly interest rate survey. 906.5 Section 906... OPERATIONS OPERATIONS Monthly Interest Rate Survey (MIRS) § 906.5 Monthly interest rate survey. The Finance Board conducts its Monthly Survey of Rates and Terms on Conventional One-Family Non-farm Mortgage Loans...

  19. Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6-12 Years of Age in Mexico.

    PubMed

    Bashash, Morteza; Thomas, Deena; Hu, Howard; Martinez-Mier, E Angeles; Sanchez, Brisa N; Basu, Niladri; Peterson, Karen E; Ettinger, Adrienne S; Wright, Robert; Zhang, Zhenzhen; Liu, Yun; Schnaas, Lourdes; Mercado-García, Adriana; Téllez-Rojo, Martha María; Hernández-Avila, Mauricio

    2017-09-19

    Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6-12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children's Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6-12. We had complete data on 299 mother-child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n=299) and children with available urine samples (n=211) were 0.90 (0.35) mg/L and 0.82 (0.38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0.5mg/L (approximately the IQR) predicted 3.15 (95% CI: -5.42, -0.87) and 2.50 (95% CI -4.12, -0.59) lower offspring GCI and IQ scores, respectively. In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6-12 y. https://doi.org/10.1289/EHP655.

  20. Clinical evaluation of fiber-reinforced composite crowns in pulp-treated primary molars: 12-month results

    PubMed Central

    Mohammadzadeh, Zahra; Parisay, Iman; Mehrabkhani, Maryam; Madani, Azam Sadat; Mazhari, Fatemeh

    2016-01-01

    Objective: The aim of this study was to evaluate the clinical performance of tooth-colored fiber-reinforced composite (FRC) crowns in pulp-treated second primary mandibular teeth. Materials and Methods: This split-mouth randomized, clinical trial performed on 67 children between 3 and 6 years with two primary mandibular second molars requiring pulp treatment. After pulp therapy, the teeth were randomly assigned to stainless steel crown (SSC) or FRC crown groups. Modified United States Public Health Service criteria were used to evaluate marginal integrity, marginal discoloration, and secondary caries in FRC crowns at intervals of 3, 6, and 12 months. Retention rate and gingival health were also compared between the two groups. The data were analyzed using Friedman, Cochran, and McNemar's tests at a significance level of 0.05. Results: Intact marginal integrity in FRC crowns at 3, 6, and 12 months were 93.2%, 94.8%, and 94.2%, respectively. Marginal discoloration and secondary caries were not found at any of the FRC crowns. The retention rates of the FRC crowns were 100%, 98.3%, and 89.7% at 3, 6 and 12 months, respectively, whereas all the SSCs were found to be present and intact after 12 months (P = 0.016). There was no statistically significant difference between the two groups in gingival health. Conclusion: According to the results of this study, it seems that when esthetics is a concern, in cooperative patients with good oral hygiene, FRC crowns can be considered as a valuable procedure. PMID:28042269

  1. Ethnic comparisons of the 12 month prevalence of mental disorders and treatment contact in Te Rau Hinengaro: the New Zealand Mental Health Survey.

    PubMed

    Baxter, Joanne; Kokaua, Jesse; Wells, J Elisabeth; McGee, Magnus A; Oakley Browne, Mark A

    2006-10-01

    To compare ethnic groups for the 12 month prevalence of mental disorders and 12 month treatment contact in Te Rau Hinengaro: The New Zealand Mental Health Survey. Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken in 2003 and 2004, was a nationally representative face-to-face household survey of 12,992 New Zealand adults aged 16 years and over, including Māori (n = 2595), Pacific people (n = 2236) and a composite Other ethnic group (predominantly European) (n = 8161). Ethnicity was measured using the 2001 census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used to measure disorder. The overall response rate was 73.3%. The 12 month prevalence of any mental disorder was highest in Māori (29.5%; 26.6, 32.4), followed by Pacific people (24.4%; 21.2, 27.6) and Others (19.3%; 18.0, 20.6). Adjustment for age, sex, education and household income reduced differences: Māori (23.9%; 21.3, 26.4), Pacific (19.2%; 16.4, 22.1) and Other (20.3%; 18.9, 21.6). A similar pattern was seen for serious disorder and most individual disorders or disorder groups. After adjustment, Māori were most different from Pacific people and Others for substance use disorder. Both Māori and Pacific people had a higher prevalence of bipolar disorder than Others. Pacific people had the lowest prevalence of major depressive disorder. Among those with disorder, the proportion with a visit for mental health problems to any service was highest among Others (41.1%; 38.1, 44.1), with Māori (32.5%; 28.3, 36.7) intermediate and Pacific (25.4%, 19.4, 31.4) lowest. Adjustment did not alter ethnic differences in service contact. Māori, and to a lesser extent Pacific people, have a higher prevalence of 12 month mental disorders than Others. Differences are reduced after adjusting for sociodemographic correlates. Relative to need

  2. Object exploration in extremely preterm infants between 6 and 9 months and relation to cognitive and language development at 24 months.

    PubMed

    Zuccarini, Mariagrazia; Guarini, Annalisa; Savini, Silvia; Iverson, Jana M; Aureli, Tiziana; Alessandroni, Rosina; Faldella, Giacomo; Sansavini, Alessandra

    2017-09-01

    Although early object exploration is considered a key ability for subsequent achievements, very few studies have analyzed its development in extremely low gestational age infants (ELGA- GA <28 weeks), whose early motor skills are delayed. Moreover, no studies have examined its developmental relationship with cognitive and language skills. The present study examined developmental change in Motor Object Exploration (MOE) and different types of MOE (Holding, Oral, Manual and Manual Rhythmic Exploration) in 20 ELGA and 20 full term (FT) infants observed during mother-infant play interaction at 6 and 9 months. It also explored whether specific types of MOE were longitudinally related to 24-month language and cognitive abilities (GMDS-R scores). ELGA infants increased MOE duration from 6 to 9 months, eliminating the initial difference with FT infants. In addition, ELGA infants showed a different pattern of Oral Exploration, that did not increase at 6 months and decrease at 9 months. Oral and Manual Exploration durations at 6 months were longitudinally related to 24-month GMDS-R language and cognitive performance scores respectively. We discuss the relevance of assessing early exploratory abilities in ELGA infants in order to implement customized intervention programs for supporting the development of these skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Upper limb module in non-ambulant patients with spinal muscular atrophy: 12 month changes.

    PubMed

    Sivo, Serena; Mazzone, Elena; Antonaci, Laura; De Sanctis, Roberto; Fanelli, Lavinia; Palermo, Concetta; Montes, Jacqueline; Pane, Marika; Mercuri, Eugenio

    2015-03-01

    Recent studies have suggested that in non-ambulant patients affected by spinal muscular atrophy the Upper Limb Module can increase the range of activities assessed by the Hammersmith Functional Motor Scale Expanded. The aim of this study was to establish 12-month changes in the Upper Limb Module in a cohort of non-ambulant spinal muscular atrophy patients and their correlation with changes on the Hammersmith Functional Motor Scale Expanded. The Upper Limb Module scores ranged between 0 and 17 (mean 10.23, SD 4.81) at baseline and between 1 and 17 at 12 months (mean 10.27, SD 4.74). The Hammersmith Functional Motor Scale Expanded scores ranged between 0 and 34 (mean 12.43, SD 9.13) at baseline and between 0 and 34 at 12 months (mean 12.08, SD 9.21). The correlation betweeen the two scales was 0.65 at baseline and 0.72 on the 12 month changes. Our results confirm that the Upper Limb Module can capture functional changes in non-ambulant spinal muscular atrophy patients not otherwise captured by the other scale and that the combination of the two measures allows to capture changes in different subgroups of patients in whom baseline scores and functional changes may be influenced by several variables such as age. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Cytology and human papillomavirus testing 6 to 12 months after ASCUS or LSIL cytology in organized screening to predict high-grade cervical neoplasia between screening rounds.

    PubMed

    Tropé, Ameli; Sjøborg, Katrine D; Nygård, Mari; Røysland, Kjetil; Campbell, Suzanne; Alfsen, G Cecilie; Jonassen, Christine M

    2012-06-01

    We carried out a prospective study comparing the performance of human papillomavirus (HPV) E6/E7 mRNA (PreTect HPV-Proofer; NorChip, Klokkarstua, Norway) and DNA (Amplicor HPV test; Roche Diagnostics, Basel, Switzerland) triage testing of women 6 to 12 months after atypical-squamous-cells-of-undetermined-significance (ASCUS) or low-grade-squamous-intraepithelial-lesion (LSIL) cytology in organized screening to predict high-grade cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) between screening rounds. Between January 2005 and April 2008, 692 study women with screening-detected ASCUS/LSIL cytology 6 to 12 months earlier returned for HPV mRNA and DNA testing and repeat cytology. The median follow-up time was 3 years, using existing health care facilities. Follow-up test results were available for 625 women. Of the 145 CIN2+ cases detected during the study period, 95 (65.5%) were HPV mRNA positive 6 to 12 months after screening-detected ASCUS/LSIL, 44 (30.4%) were HPV mRNA negative, and 6 (4.1%) were invalid. The corresponding HPV DNA results were 139 (95.9%), 5 (3.4%), and 1 (0.7%), respectively. The cumulative incidences of CIN2+ 3 years after a negative HPV mRNA and DNA test were 10.3% (95% confidence interval [CI], 7.2 to 13.3%) and 1.8% (95% CI, 0.0 to 3.6%), respectively. The cumulative incidences of CIN2+ 3 years after positive HPV mRNA and DNA tests were 52.8% (95% CI, 40.1 to 60.1%) and 41.3% (95% CI, 35.5 to 46.6%), respectively. In conclusion, both positive HPV mRNA and DNA test results have a high enough long-term prediction of CIN2+ risk to consider referral to colposcopy as good practice when performed in delayed triage of women with ASCUS/LSIL cytology. In addition, the low CIN2+ risk among women with a negative Amplicor HPV test in our study confirms its safe use in a clinical setting.

  5. Cytology and Human Papillomavirus Testing 6 to 12 Months after ASCUS or LSIL Cytology in Organized Screening To Predict High-Grade Cervical Neoplasia between Screening Rounds

    PubMed Central

    Sjøborg, Katrine D.; Nygård, Mari; Røysland, Kjetil; Campbell, Suzanne; Alfsen, G. Cecilie; Jonassen, Christine M.

    2012-01-01

    We carried out a prospective study comparing the performance of human papillomavirus (HPV) E6/E7 mRNA (PreTect HPV-Proofer; NorChip, Klokkarstua, Norway) and DNA (Amplicor HPV test; Roche Diagnostics, Basel, Switzerland) triage testing of women 6 to 12 months after atypical-squamous-cells-of-undetermined-significance (ASCUS) or low-grade-squamous-intraepithelial-lesion (LSIL) cytology in organized screening to predict high-grade cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) between screening rounds. Between January 2005 and April 2008, 692 study women with screening-detected ASCUS/LSIL cytology 6 to 12 months earlier returned for HPV mRNA and DNA testing and repeat cytology. The median follow-up time was 3 years, using existing health care facilities. Follow-up test results were available for 625 women. Of the 145 CIN2+ cases detected during the study period, 95 (65.5%) were HPV mRNA positive 6 to 12 months after screening-detected ASCUS/LSIL, 44 (30.4%) were HPV mRNA negative, and 6 (4.1%) were invalid. The corresponding HPV DNA results were 139 (95.9%), 5 (3.4%), and 1 (0.7%), respectively. The cumulative incidences of CIN2+ 3 years after a negative HPV mRNA and DNA test were 10.3% (95% confidence interval [CI], 7.2 to 13.3%) and 1.8% (95% CI, 0.0 to 3.6%), respectively. The cumulative incidences of CIN2+ 3 years after positive HPV mRNA and DNA tests were 52.8% (95% CI, 40.1 to 60.1%) and 41.3% (95% CI, 35.5 to 46.6%), respectively. In conclusion, both positive HPV mRNA and DNA test results have a high enough long-term prediction of CIN2+ risk to consider referral to colposcopy as good practice when performed in delayed triage of women with ASCUS/LSIL cytology. In addition, the low CIN2+ risk among women with a negative Amplicor HPV test in our study confirms its safe use in a clinical setting. PMID:22518869

  6. Adverse Events following 12 and 18 Month Vaccinations: a Population-Based, Self-Controlled Case Series Analysis

    PubMed Central

    Wilson, Kumanan; Hawken, Steven; Kwong, Jeffrey C.; Deeks, Shelley; Crowcroft, Natasha S.; Van Walraven, Carl; Potter, Beth K.; Chakraborty, Pranesh; Keelan, Jennifer; Pluscauskas, Michael; Manuel, Doug

    2011-01-01

    Background Live vaccines have distinct safety profiles, potentially causing systemic reactions one to 2 weeks after administration. In the province of Ontario, Canada, live MMR vaccine is currently recommended at age 12 months and 18 months. Methods Using the self-controlled case series design we examined 271,495 12 month vaccinations and 184,312 18 month vaccinations to examine the relative incidence of the composite endpoint of emergency room visits or hospital admissions in consecutive one day intervals following vaccination. These were compared to a control period 20 to 28 days later. In a post-hoc analysis we examined the reasons for emergency room visits and the average acuity score at presentation for children during the at-risk period following the 12 month vaccine. Results Four to 12 days post 12 month vaccination, children had a 1.33 (1.29–1.38) increased relative incidence of the combined endpoint compared to the control period, or at least one event during the risk interval for every 168 children vaccinated. Ten to 12 days post 18 month vaccination, the relative incidence was 1.25 (95%, 1.17–1.33) which represented at least one excess event for every 730 children vaccinated. The primary reason for increased events was statistically significant elevations in emergency room visits following all vaccinations. There were non-significant increases in hospital admissions. There were an additional 20 febrile seizures for every 100,000 vaccinated at 12 months. Conclusions There are significantly elevated risks of primarily emergency room visits approximately one to two weeks following 12 and 18 month vaccination. Future studies should examine whether these events could be predicted or prevented. PMID:22174753

  7. Efficacy and safety of once-monthly pasireotide in Cushing's disease: a 12 month clinical trial.

    PubMed

    Lacroix, André; Gu, Feng; Gallardo, Wilson; Pivonello, Rosario; Yu, Yerong; Witek, Przemysław; Boscaro, Marco; Salvatori, Roberto; Yamada, Masanobu; Tauchmanova, Libuse; Roughton, Michael; Ravichandran, Shoba; Petersenn, Stephan; Biller, Beverly M K; Newell-Price, John

    2018-01-01

    Cushing's disease is a rare debilitating endocrine disorder for which few prospective interventional studies have been done. We report results of the first phase 3 trial assessing long-acting intramuscular pasireotide in patients with Cushing's disease. In this phase 3 clinical trial we recruited patients aged 18 years or older with persistent, recurrent, or de-novo (non-surgical candidates) Cushing's disease who had a mean urinary free cortisol (mUFC) concentration (from three 24 h samples) of 1·5-5·0 times the upper limit of normal (ULN), a normal or greater than normal morning plasma adrenocorticotropic hormone concentration, and a pituitary source of Cushing's syndrome, from 57 sites across 19 countries. Exclusion criteria included previous pasireotide treatment, mitotane therapy within 6 months, and pituitary irradiation within 10 years. We randomly allocated patients 1:1 (block size of four) using an interactive-response-technology system to intramuscular pasireotide 10 mg or 30 mg every 4 weeks for 12 months (in the core phase). We stratified randomisation by screening mUFC concentration (1·5 to <2·0 × ULN and 2·0-5·0 × ULN). The dose could be uptitrated (from 10 mg to 30 mg or from 30 mg to 40 mg) at month 4 if the mUFC concentration was greater than 1·5 × ULN, and at month 7, month 9, or month 12 if the mUFC concentration was greater than 1·0 × ULN. Investigators, patients, site personnel, and those assessing outcomes were masked to dose group allocation. The primary endpoint was the proportion of patients in each group with an mUFC concentration of less than or equal to the ULN at month 7. Efficacy analyses were based on intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01374906. Between Dec 28, 2011, and Dec 9, 2014, we randomly allocated 150 patients to receive pasireotide 10 mg (74 [49%] patients) or 30 mg (76 [51%] patients). The primary efficacy endpoint was met by 31 (41·9% [95% CI 30·5-53

  8. The effect of high-dose vitamin A supplementation at birth on measles incidence during the first 12 months of life in boys and girls: an unplanned study within a randomised trial.

    PubMed

    Diness, Birgitte R; Martins, Cesário L; Balé, Carlitos; Garly, May-Lill; Ravn, Henrik; Rodrigues, Amabelia; Whittle, Hilton; Aaby, Peter; Benn, Christine S

    2011-06-28

    Vitamin A treatment reduces mortality during acute measles infection, and vitamin A supplementation (VAS) to children above 6 months of age may reduce the incidence of measles infection. The effect of VAS at birth on measles incidence is unknown. In a randomised placebo-controlled trial in Guinea-Bissau, normal-birth-weight newborns were randomised to 50 000 IU (15 mg) VAS or placebo. During the trial, a measles epidemic occurred. We linked data from the trial with data from the measles infection surveillance and studied the effect of VAS on the measles incidence before 12 months of age in both sexes. A total of 165 measles cases were identified among the 4183 children followed from 28 d of age. Up to 6 months of age, the incidence rate ratio of measles for VAS compared with placebo was 0·54 (95 % CI 0·25, 1·15) among boys and 1·57 (95 % CI 0·80, 3·08) among girls (test of interaction, P = 0·04). The corresponding figures at 12 months were 0·67 (95 % CI 0·43, 1·05) and 1·17 (95 % CI 0·76, 1·79) (test of interaction, P = 0·08). VAS compared with placebo tended to be associated with less measles hospitalisation or death during the first 6 months of life in boys (P = 0·06), but not in girls. VAS at birth may affect the susceptibility to measles infection during the first 6 months of life in a sex-differential manner.

  9. Seroprevalence of transplacentally acquired measles antibodies in HIV-exposed versus HIV-unexposed infants at six months of age

    PubMed Central

    Jain, Sneha; Seth, Anju; Khare, Shashi; Chandra, Jagdish

    2017-01-01

    Background & objectives: Measles infection is reported to be more severe, prolonged and associated with a higher complication rate in children with HIV infection. Reports indicate that infants born to HIV-infected women [HIV exposed infants (HEI)] may be more vulnerable to measles. The World Health Organization recommends measles vaccination starting at six months of age in these infants who may be HIV-infected themselves. However, in India, they are given measles vaccination at nine months of age like all other infants. In this study, the seroprevalence of transplacentally acquired measles antibodies was compared in HEI and unexposed infants (HUnI) at six months of age and the proportion of HEI undergoing seroconversion after immunization with measles vaccine was assessed. Methods: In this prospective longitudinal study, measles IgG antibodies were estimated in serum of 49 HEI and 50 HUnI aged 6-7 months. Measles vaccine was then administered to HEI. Assessment for measles IgG antibodies was repeated 8-12 wk post-immunization. Results: Measles IgG antibodies were detected in two of 49 (4.1%) HEI and 16 of 50 (32%) HUnI. HEI were 11 times more likely to lack measles antibodies as compared to HUnI (odds ratio=11.05, 95% confidence interval=2.989-40.908). Post-vaccination, seroprevalence of measles antibodies increased to 38.5 per cent (P< 0.001) in HEI compared to 4 per cent at baseline. Interpretation & conclusions: Most HEI lacked measles antibodies at six months age and were, therefore, more vulnerable to measles than HUnI. Seroconversion in response to a single dose of measles vaccine administered at six months age was low in these infants, signifying the need of additional dose(s) of measles/measles-containing vaccine. PMID:28862187

  10. Predictors of Health-Care Utilization Among Children 6–59 Months of Age in Zambézia Province, Mozambique

    PubMed Central

    Bayham, Mary; Blevins, Meridith; Lopez, Melanie; Olupona, Omo; González-Calvo, Lazaro; Ndatimana, Elisée; Green, Ann F.; Moon, Troy D.

    2017-01-01

    Globally, approximately 5.9 million children under 5 years of age died in 2015, a reduction of over 50% since 1990. Millennium Development Goal 4 established the goal of reducing child mortality by two-thirds by 2015. Multiple countries have surpassed this goal; however, regional and within-country inequities exist. We sought to study determinants of health-care utilization among children 6–59 months of age with fever, diarrhea, and respiratory symptoms in Zambézia Province, Mozambique. We conducted a population-based cross-sectional survey of female heads of household between April and May 2014. Mobile teams conducted interviews in 262 enumeration areas, with three distinct districts being oversampled for improved precision. Descriptive statistics and logistic regression using Stata 13.1 and R 3.2.2 were used to examine factors associated with health-care utilization. A total of 2,317 children were evaluated in this study. Mothers' median age was 26 years, whereas child median age was 24 months. The proportion of children reporting fever, diarrhea, or respiratory illness in the prior 30 days was 44%, 22%, and 22%, respectively. Health-care utilization varied with 65% seeking health care for fever, compared with 57% for diarrhea and 25% for respiratory illness. In multivariable logistic regression, the characteristics most associated with health-care utilization across illnesses were delivery of last child at a facility, higher maternal education, and household ownership of a radio. The decision or ability to use health care is a multifaceted behavior swayed by societal norms, values, socioeconomics, and perceived need. Recognizing the predictors of a particular population may offer useful information to increase uptake in health-care services. PMID:27821686

  11. Bayley-III scales at 12 months of corrected age in preterm infants: Patterns of developmental performance and correlations to environmental and biological influences.

    PubMed

    Velikos, Konstantinos; Soubasi, Vasiliki; Michalettou, Irene; Sarafidis, Kosmas; Nakas, Christos; Papadopoulou, Vasiliki; Zafeiriou, Dimitrios; Drossou, Vasiliki

    2015-01-01

    Premature infants are at high risk for neurodevelopmental impairment (NDI) even in the absence of known brain complications of prematurity. Evaluation of the effectiveness of therapeutic interventions in association to neurodevelopmental outcome is required to improve or prevent the neurodevelopmental consequences of prematurity. The Bayley-III is currently the most commonly applied measurement tool for assessing early development both in clinical practice and research settings. To evaluate the relationship between known risk factors and early performance on the Bayley Scales of Infant Development-Third Edition at 12 months adjusted age in premature infants. Prospective study in a cohort of premature infants with gestational age ≤32 weeks, who underwent comprehensive developmental assessment using the five domains of Bayley Scales, cognitive, language, motor, social emotional and adaptive behavior at 12 months corrected age. Developmental scores were evaluated in relation to environmental influences, therapeutic interventions or practices and complications of prematurity. Composite and Subscale scores for the cognitive, language and motor scales were below the 50th percentile, with no significant differences among them. Scores for the social-emotional and adaptive behavior, which are derived from the parent-report questionnaires, were near the average and significantly higher than the scores derived by the examiners. Multiple regression analyses showed that blood transfusions, apart from severely abnormal head ultrasound, gender, being small for gestational age and duration of invasive mechanical ventilation and oxygen administration were consistently related to neurodevelopmental outcome. Bayley-III assessments are important for getting early information about development following premature birth. Parents may overestimate children's performance. Neurodevelopmental outcome is related to several environmental, biological or medical conditions associated with

  12. A 12-Month Prospective, Observational Study of Treatment Regimen and Quality of Life Associated with ADHD in Central and Eastern Europe and Eastern Asia

    ERIC Educational Resources Information Center

    Goetz, Michal; Yeh, Chin-Bin; Ondrejka, Igor; Akay, Aynur; Herczeg, Ilona; Dobrescu, Iuliana; Kim, Boong Nyun; Jin, Xingming; Riley, Anne W.; Martenyi, Ferenc; Harrison, Gavan; Treuer, Tamas

    2012-01-01

    Objectives: This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. Methods: 977 Male and female patients aged 6-17 years seeking treatment for…

  13. Factors influencing full immunization coverage among 12-23 months of age children in Ethiopia: evidence from the national demographic and health survey in 2011.

    PubMed

    Lakew, Yihunie; Bekele, Alemayhu; Biadgilign, Sibhatu

    2015-07-30

    Immunization remains one of the most important public health interventions to reduce child morbidity and mortality. The 2011 national demographic and health survey (DHS) indicated low full immunization coverage among children aged 12-23 months in Ethiopia. Factors contributing to the low coverage of immunization have been poorly understood. The aim of this study was to identify factors associated with full immunization coverage among children aged 12-23 months in Ethiopia. This study used the 2011 Ethiopian demographic and health survey data. The survey was cross sectional by design and used a multistage cluster sampling procedure. A total of 1,927 mothers with children of 12-23 months of age were extracted from the children's dataset. Mothers' self-reported data and observations of vaccination cards were used to determine vaccine coverage. An adjusted odds ratio (AOR) with 95% confidence intervals (CI) was used to outline the independent predictors. The prevalence of fully immunized children was 24.3%. Specific vaccination coverage for three doses of DPT, three doses of polio, measles and BCG were 36.5%, 44.3%, 55.7% and 66.3%, respectively. The multivariable analysis showed that sources of information from vaccination card [AOR 95% CI; 7.7 (5.95-10.06)], received postnatal check-up within two months after birth [AOR 95% CI; 1.8 (1.28-2.56)], women's awareness of community conversation program [AOR 95% CI; 1.9 (1.44-2.49)] and women in the rich wealth index [AOR 95% CI; 1.4 (1.06-1.94)] were the predictors of full immunization coverage. Women from Afar [AOR 95% CI; 0.07 (0.01-0.68)], Amhara [AOR 95% CI; 0.33 (0.13-0.81)], Oromiya [AOR 95% CI; 0.15 (0.06-0.37)], Somali [AOR 95% CI; 0.15 (0.04-0.55)] and Southern Nation and Nationalities People administrative regions [AOR 95% CI; 0.35 (0.14-0.87)] were less likely to fully vaccinate their children. The overall full immunization coverage in Ethiopia was considerably low as compared to the national target set (66

  14. Accuracy of MRI skeletal age estimation for subjects 12-19. Potential use for subjects of unknown age.

    PubMed

    Serinelli, Serenella; Panebianco, Valeria; Martino, Milvia; Battisti, Sofia; Rodacki, Karina; Marinelli, Enrico; Zaccagna, Fulvio; Semelka, Richard C; Tomei, Ernesto

    2015-05-01

    In forensic practice, there is a growing need for accurate methods of age estimation, especially in the cases of young individuals of unknown age. Age can be estimated through somatic features that are universally considered associated with chronological age. Unfortunately, these features do not always coincide with the real chronological age: for these reasons that age determination is often very difficult. Our aim is to evaluate accuracy of skeletal age estimation using Tomei's MRI method in subjects between 12 and 19 years old for forensic purposes. Two investigators analyzed MRI images of the left hand and wrist of 77 male and 74 female caucasian subjects, without chronic diseases or developmental disorders, whose age ranged from 12 to 19 years. Skeletal maturation was determined by two operators, who analyzed all MRI images separately, in blinded fashion to the chronological age. Inter-rater agreement was measured with Pearson (R (2)) coefficient. One of the examiners repeated the evaluation after 6 months, and intraobserver variation was analyzed. Bland-Altman plots were used to determine mean differences between skeletal and chronological age. Inter-rater agreement Pearson coefficient showed a good linear correlation, respectively, 0.98 and 0.97 in males and females. Bland-Altman analysis demonstrated that the differences between chronological and skeletal age are not significant. Spearman's correlation coefficient showed good correlation between skeletal and chronological age both in females (R (2) = 0.96) and in males (R (2) = 0.94). Our results show that MRI skeletal age is a reproducible method and has good correlation with chronological age.

  15. Totally endoscopic implant to effect a gastric bypass: 12-month safety and efficacy outcomes.

    PubMed

    Sandler, Bryan J; Biertho, Laurent; Anvari, Mehran; Rumbaut, Roberto; Morales-Garza, Luis Alonso; Torres-Barrera, Gustavo; Marceau, Simon; Hong, Dennis; Smith, C Daniel; Horgan, Santiago

    2018-04-20

    Only a small percentage of candidates for bariatric surgery ever undergo a procedure for weight loss. Devices duplicating key effects of bariatric surgeries with removable, fully trans-oral implants could extend their benefits to patients unwilling to undergo anatomy-altering abdominal surgeries. Thirty-two obese subjects (mean BMI: 42.3) were enrolled in a prospective, multicenter, single-arm, feasibility trial of the first fully trans-oral endoscopic gastrointestinal bypass device. The device is a cuff attached to the distal esophagus by transmural anchors and connected to a 120-cm sleeve diverting undigested nutrients to the jejunum. Bodyweight, vital signs, adverse events, medications, HbA1c, fasting glucose, and lipids were collected at baseline and follow-up visits. Device status was endoscopically assessed every 6 months. The fully trans-oral procedure was successful in all subjects without intraoperative adverse events or postoperative infections. Twenty-eight of 32 subjects (88%) remained implanted with continuing follow-up beyond their 12-month visit. At 12 months, the 32 subjects had lost an average of 44.8% of excess body weight, 17.6% of total body weight, 20.8 kg, and 7.5 BMI points. Weight loss depended on capture of ingesta by the esophageal cuff, with 18 of 32 subjects without visible gaps around their cuffs at the 6 month endoscopy having significantly greater EWL (53.6 vs. 33.4% in the remaining subjects, p < 0.002). Mean HbA1c and fasting glucose declined by 1.1% points and 29 mg/dL in type 2 diabetic subjects, 80% of whom had remission of their diabetes at 12 months. This study demonstrates the feasibility, safety, and efficacy of a fully trans-oral gastrointestinal bypass implant. This purely endoscopic device may provide a valuable addition to the armamentarium of treatment available for the management of morbid obesity.

  16. Lasting immune memory against hepatitis B following challenge 10-11 years after primary vaccination with either three doses of hexavalent DTPa-HBV-IPV/Hib or monovalent hepatitis B vaccine at 3, 5 and 11-12 months of age.

    PubMed

    Avdicova, Mária; Crasta, Priya D; Hardt, Karin; Kovac, Martina

    2015-05-28

    The combined hexavalent diphtheria-tetanus-pertussis-hepatitis B-inactivated poliomyelitis - Haemophilus influenzae type b conjugate vaccine (Infanrix hexa™; DTPa-HBV-IPV/Hib: GlaxoSmithKline Vaccines) induces robust responses to the HBV component when administered at 3, 5 and 11-12 months of age. We assessed long term HBV antibody persistence 10-11 years after primary vaccination in infancy. Antibody persistence and immune memory were assessed post-primary vaccination at 3, 5, 11-12 months with DTPa-HBV-IPV/Hib, or monovalent HBV vaccine (Engerix™ B, GlaxoSmithKline Vaccines) co-administered with DTPa-IPV/Hib (Infanrix™-IPV/Hib, GlaxoSmithKline Vaccines) in 185 children aged 11-12 years. Blood samples were collected before and 1 month after a challenge dose of Engerix™ B (10μg dose). 10-11 years after primary vaccination the percentage of subjects with persisting anti-HBs antibody concentrations ≥10mIU/ml was 48.4% in the DTPa-HBV-IPV/Hib group and 58.4% in the DTPa-IPV/Hib+HBV group. After the HBV challenge dose, the percentage with anti-HBs ≥100mIU/ml increased from 14.7% to 93.6% in the DTPa-HBV-IPV/Hib group and 19.1% to 94.4% in the DTPa-IPV/Hib+HBV group. Anti-HBs GMCs increased by at least 187-fold in each group. An anamnestic response (≥4-fold increase in initially seropositive or anti-HBs concentration ≥10mIU/ml in initially seronegative subjects) was observed in 96.8% and 96.6% of subjects in the DTPa-HBV-IPV/Hib and DTPa-IPV/Hib+HBV groups, respectively. No serious adverse events occurred that were considered related to challenge vaccination. Administration of HBV as part of a combination vaccine or as a monovalent vaccine induced long lasting immune memory against HBV in children primed at 3, 5 and 11 months of age. Antibody persistence and immune memory were similar, suggesting that protection afforded by DTPa-HBV-IPV/Hib and monovalent HBV vaccines, is likely to be of similar duration. The administration of HBV challenge dose 10

  17. Reasons for raising the maximum acceptable daily intake of EDTA and the benefits for iron fortification of foods for children 6-24 months of age.

    PubMed

    Wreesmann, Carel Theo Jozef

    2014-10-01

    The current maximum acceptable daily intake (ADI) of ethylenediaminetetraacetic acid (EDTA) of 1.9 mg day(-1) per kilogram bodyweight (mg day(-1)  kgbw(-1) ) limits the daily intake of iron as iron EDTA [ferric sodium EDTA; sodium iron(III) EDTA] to approximately 2-2.5 mg day(-1) for children 6-24 months of age. This limit was defined by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) in 1973 based on data from an animal-feed study published in 1963. Other animal studies indicate that this limit can be raised to 4.4 or possibly up to 21.7 mg day(-1)  kgbw(-1) , which is 2.3-11.4 times higher than the current value. For nearly 50 years, iron EDTA has been used in France in medicinal syrup for infants 1-6 months of age. The maximum recommended dosage of this drug is 37 times higher than the maximum ADI of EDTA. No adverse health effects have been reported as a result of this medicinal consumption of iron EDTA. Raising the maximum ADI of EDTA to only 4.4 mg day(-1)  kgbw(-1) would enable iron EDTA, an iron fortificant with proven bioavailability in phytate-rich meals, to be added in adequate amounts to cereal-based meals for children 6-24 months of age, who are at risk of iron deficiency. © 2014 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

  18. Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial.

    PubMed

    Nikolić, Marko; Kruljac, Ivan; Kirigin, Lora; Mirošević, Gorana; Ljubičić, Neven; Nikolić, Borka Pezo; Bekavac-Bešlin, Miroslav; Budimir, Ivan; Vrkljan, Milan

    2015-06-01

    Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL >20% for patients treated with BIB and >50% for patients treated with LAGB and SG. Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL >6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL >9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance.

  19. The role of verbal labels on flexible memory retrieval at 12-months of age.

    PubMed

    Taylor, Gemma; Liu, Hao; Herbert, Jane S

    2016-11-01

    The provision of verbal labels enhances 12-month-old infants' memory flexibility across a form change in a puppet imitation task (Herbert, 2011), although the mechanisms for this effect remain unclear. Here we investigate whether verbal labels can scaffold flexible memory retrieval when task difficulty increases and consider the mechanism responsible for the effect of language cues on early memory flexibility. Twelve-month-old infants were provided with English, Chinese, or empty language cues during a difficult imitation task, a combined change in the puppet's colour and form at the test (Hayne et al., 1997). Imitation performance by infants in the English language condition only exceeded baseline performance after the 10-min delay. Thus, verbal labels facilitated flexible memory retrieval on this task. There were no correlations between infants' language comprehension and imitation performance. Thus, it is likely that verbal labels facilitate both attention and categorisation during encoding and retrieval. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Reasons for raising the maximum acceptable daily intake of EDTA and the benefits for iron fortification of foods for children 6–24 months of age

    PubMed Central

    Wreesmann, Carel Theo Jozef

    2014-01-01

    The current maximum acceptable daily intake (ADI) of ethylenediaminetetraacetic acid (EDTA) of 1.9 mg day−1 per kilogram bodyweight (mg day−1 kgbw−1) limits the daily intake of iron as iron EDTA [ferric sodium EDTA; sodium iron(III) EDTA] to approximately 2–2.5 mg day−1 for children 6–24 months of age. This limit was defined by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) in 1973 based on data from an animal-feed study published in 1963. Other animal studies indicate that this limit can be raised to 4.4 or possibly up to 21.7 mg day−1 kgbw−1, which is 2.3–11.4 times higher than the current value. For nearly 50 years, iron EDTA has been used in France in medicinal syrup for infants 1–6 months of age. The maximum recommended dosage of this drug is 37 times higher than the maximum ADI of EDTA. No adverse health effects have been reported as a result of this medicinal consumption of iron EDTA. Raising the maximum ADI of EDTA to only 4.4 mg day−1 kgbw−1 would enable iron EDTA, an iron fortificant with proven bioavailability in phytate-rich meals, to be added in adequate amounts to cereal-based meals for children 6–24 months of age, who are at risk of iron deficiency. PMID:24521261

  1. Determinants of undernutrition among children aged 6 to 59 months in rural Zambézia Province, Mozambique: Results of two population-based serial cross-sectional surveys

    PubMed Central

    Rose, Elizabeth S.; Blevins, Meridith; González-Calvo, Lazaro; Ndatimana, Elisée; Green, Ann F.; Lopez, Melanie; Olupona, Omo; Vermund, Sten H.; Moon, Troy D.

    2016-01-01

    Background While many countries are transitioning from epidemics of undernutrition to overnutrition, Mozambique’s very high 44% prevalence of stunting in children under age 5 years is cause for serious concern. Methods We conducted two population-based cross-sectional surveys of ~4000 female heads of households each in Zambézia Province, Mozambique from August–September 2010 (Baseline) and April–May 2014 (Endline) as part of the USAID funded Strengthening Communities through Integrated Programs (SCIP) grant. Anthropometric measurements were collected on 560 children aged 6–59 months at Baseline and 912 children at Endline and classified as: “stunted,” a height-for-age z-score less than -2; “wasted,” weight-for-height z-score less than -2; and “underweight,” weight-for-age z-score less than -2. Descriptive statistics and logistic regression using Stata 13.1 were used to examine factors associated with undernutrition. Results Of children under age five years, 43% were undernourished in 2010 and 55% in 2014. The most common form of undernutrition was stunting (39% in 2010, 51% in 2014), followed by underweight (13% in both 2010 and 2014), and wasting (7% in 2010, 5% in 2014). Child’s age was found to have a non-linear association with stunting. Vitamin A supplementation was associated with a 31% (p=0.04) decreased odds of stunting. Children who were exclusively breastfed for at least six months had an 80% (p=0.02) lower odds of wasting in 2014 and 57% (p=0.05) decreased odds of being underweight in 2014. Introducing other foods after age six months was associated with a five-fold increased odds of wasting in 2014 (p=0.02); household food insecurity was associated with wasting (OR=2.08; p=0.03) and underweight in 2010 (OR=2.31; p=0.05). Children whose mother washed her hands with a cleaning agent had a 40% (p=0.05) decreased odds of being underweight. Surprisingly, per point increase in household dietary diversity score, children had 12% greater

  2. A 6-month, multicenter, open-label study of fixed dose naproxen/esomeprazole in adolescent patients with juvenile idiopathic arthritis.

    PubMed

    Lovell, Daniel J; Dare, Jason A; Francis-Sedlak, Megan; Ball, Julie; LaMoreaux, Brian D; Von Scheven, Emily; Reinhardt, Adam; Jerath, Rita; Alpan, Oral; Gupta, Ramesh; Goldsmith, Donald; Zeft, Andrew; Naddaf, Henry; Gottlieb, Beth; Jung, Lawrence; Holt, Robert J

    2018-06-26

    Juvenile idiopathic arthritis (JIA) is an inflammatory arthritis of unknown etiology, which lasts for greater than 6 weeks with onset before 16 years of age. JIA is the most common chronic rheumatic disease in children. NSAIDs have been the mainstay of initial management with naproxen (NAP) being commonly used, but they may cause serious side effects such as gastric ulcers which can be reduced by concomitant administration of proton pump inhibitors, such as esomeprazole (ESO). Primary objective was to evaluate the safety and tolerability of 3 fixed doses of NAP/ESO in JIA patients aged 12 to 16 years. Forty-six children and adolescents with JIA by International League of Associations for Rheumatology criteria, mean age of 13.6 years, from 18 US sites were prospectively enrolled over 2 years and followed for up to 6 months. Doses of the NAP/ESO fixed combination were based on baseline weight. The exploratory efficacy outcome was assessed with the ACR Pediatric-30, - 50, - 70, - 90 Response and the Childhood Health Assessment Questionnaire (CHAQ) discomfort and functional scores at months 1, 3, and 6 as change from baseline. Occurrence and causality were assessed for treatment emergent AEs (TEAEs) and discontinuations were monitored monthly. Forty-six patients received at least 1 dose of naproxen/esomeprazole and 36 completed the trial. Thirty-seven (80.4%) had at least 1 treatment emergent adverse event (TEAE) and, with the exception of 2 events in one patient, all of the TEAEs were mild or moderate. Frequent TEAEs (≥5% of patients) were upper respiratory tract and gastrointestinal related. Eleven (23.9%) had at least 1 TEAE considered to be related to study drug. Four patients (8.7%) discontinued due to a TEAE with one of these being the only serious AE reported, acute hepatitis. Mean number of active joints at baseline was 3.1. Improvement in JIA signs and symptoms occurred at most assessments and by month 6, the percentage of patients with an ACR

  3. International Urology Journal Club via Twitter: 12-month experience.

    PubMed

    Thangasamy, Isaac A; Leveridge, Michael; Davies, Benjamin J; Finelli, Antonio; Stork, Brian; Woo, Henry H

    2014-07-01

    Online journal clubs have increasingly been utilised to overcome the limitations of the traditional journal club. However, to date, no reported online journal club is available for international participation. To present a 12-mo experience from the International Urology Journal Club, the world's first international journal club using Twitter, an online micro-blogging platform, and to demonstrate the viability and sustainability of such a journal club. #urojc is an asynchronous 48-h monthly journal club moderated by the Twitter account @iurojc. The open invitation discussions focussed on papers typically published within the previous 2-4 wk. Data were obtained via third-party Twitter analysis services. Outcomes analysed included number of total and new users, number of tweets, and qualitative analysis of the relevance of tweets. Analysis was undertaken using GraphPad software, Microsoft Excel, and thematic qualitative analysis. The first 12 mo saw a total of 189 unique users representing 19 countries and 6 continents. There was a mean of 39 monthly participants that included 14 first-time participants per month. The mean number of tweets per month was 195 of which 62% represented original tweets directly related to the topic of discussion and 22% represented retweets of original posts. A mean of 130 832 impressions, or reach, were created per month. The @iurojc moderator account has accumulated >1000 followers. The study is limited by potentially incomplete data extracted by third-party Twitter analysers. Social media provides a potential for enormous international communication that has not been possible in the past. We believe the pioneering #urojc is both viable and sustainable. There is unlimited scope for journal clubs in other fields to follow the example of #urojc and utilise online portals to revitalise the traditional journal club while fostering international relationships. Copyright © 2014. Published by Elsevier B.V.

  4. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review.

    PubMed

    Santana, Géssica S; Giugliani, Elsa Regina J; Vieira, Tatiana de O; Vieira, Graciete O

    Synthesize the information about the factors associated with maintenance of breastfeeding for 12 months or more. A systematic review was conducted in the Pubmed/Medline, Scielo, and Lilacs databases, including articles published in Portuguese or English since 2004 on the factors associated with breastfeeding maintenance for at least 12 months; review articles and those with qualitative design were excluded. The factors were organized into four levels, according to the chronological proximity to the outcome: distal, distal intermediate, proximal intermediate, and proximal; nationality and place/area of residence were considered contextual factors. 1174 articles were identified, of which 19 were included in this review, comprising seven cohort studies and 12 cross-sectional studies. A total of 39 of the 75 assessed factors were associated with the outcome at least once. The factors with the highest percentages of associations with maintenance of breastfeeding for 12 months or more, considering the number of times they were tested were: children whose parents are the caregivers (100%), none type of maternal exposure to smoke (54%), children and/or parents are immigrants/foreigners (50%), live in urban areas (42.9%), older maternal age (40%), married women (37.5%), higher level of maternal education (31.3%), greater parity (30.8%), and lower income (30%). The maintenance of breastfeeding for 12 months or more is associated with multiple factors, emphasizing the contextual factors and those related to some maternal sociodemographic characteristics. Associations differ in effect and magnitude between the different populations studied. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Integrative analysis of gut microbiota composition, host colonic gene expression and intraluminal metabolites in aging C57BL/6J mice.

    PubMed

    van der Lugt, Benthe; Rusli, Fenni; Lute, Carolien; Lamprakis, Andreas; Salazar, Ethel; Boekschoten, Mark V; Hooiveld, Guido J; Müller, Michael; Vervoort, Jacques; Kersten, Sander; Belzer, Clara; Kok, Dieuwertje E G; Steegenga, Wilma T

    2018-05-16

    The aging process is associated with diminished colonic health. In this study, we applied an integrative approach to reveal potential interactions between determinants of colonic health in aging C57BL/6J mice. Analysis of gut microbiota composition revealed an enrichment of various potential pathobionts, including Desulfovibrio spp . , and a decline of the health-promoting Akkermansia spp . and Lactobacillus spp. during aging. Intraluminal concentrations of various metabolites varied between ages and we found evidence for an increased gut permeability at higher age. Colonic gene expression analysis suggested that during the early phase of aging (between 6 and 12 months), expression of genes involved in epithelial-to-mesenchymal transition and (re)organization of the extracellular matrix were increased. Differential expression of these genes was strongly correlated with Bifidobacterium spp. During the later phase of aging (between 12 and 28 months), gene expression profiles pointed towards a diminished antimicrobial defense and were correlated with an uncultured Gastranaerophilales spp. This study demonstrates that aging is associated with pronounced changes in gut microbiota composition and colonic gene expression. Furthermore, the strong correlations between specific bacterial genera and host gene expression may imply that orchestrated interactions take place in the vicinity of the colonic wall and potentially mediate colonic health during aging.

  6. Safety and immunogenicity of coadministering a combined meningococcal serogroup C and Haemophilus influenzae type b conjugate vaccine with 7-valent pneumococcal conjugate vaccine and measles, mumps, and rubella vaccine at 12 months of age.

    PubMed

    Miller, Elizabeth; Andrews, Nick; Waight, Pauline; Findlow, Helen; Ashton, Lindsey; England, Anna; Stanford, Elaine; Matheson, Mary; Southern, Joanna; Sheasby, Elizabeth; Goldblatt, David; Borrow, Ray

    2011-03-01

    The coadministration of the combined meningococcal serogroup C conjugate (MCC)/Haemophilus influenzae type b (Hib) vaccine with pneumococcal conjugate vaccine (PCV7) and measles, mumps, and rubella (MMR) vaccine at 12 months of age was investigated to assess the safety and immunogenicity of this regimen compared with separate administration of the conjugate vaccines. Children were randomized to receive MCC/Hib vaccine alone followed 1 month later by PCV7 with MMR vaccine or to receive all three vaccines concomitantly. Immunogenicity endpoints were MCC serum bactericidal antibody (SBA) titers of ≥8, Hib-polyribosylribitol phosphate (PRP) IgG antibody concentrations of ≥0.15 μg/ml, PCV serotype-specific IgG concentrations of ≥0.35 μg/ml, measles and mumps IgG concentrations of >120 arbitrary units (AU)/ml, and rubella IgG concentrations of ≥11 AU/ml. For safety assessment, the proportions of children with erythema, swelling, or tenderness at site of injection or fever or other systemic symptoms for 7 days after immunization were compared between regimens. No adverse consequences for either safety or immunogenicity were demonstrated when MCC/Hib vaccine was given concomitantly with PCV and MMR vaccine at 12 months of age or separately at 12 and 13 months of age. Any small differences in immunogenicity were largely in the direction of a higher response when all three vaccines were given concomitantly. For systemic symptoms, there was no evidence of an additive effect; rather, any differences between schedules showed benefit from the concomitant administration of all three vaccines, such as lower overall proportions with postvaccination fevers. The United Kingdom infant immunization schedule now recommends that these three vaccines may be offered at one visit at between 12 and 13 months of age.

  7. Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6-23 months in poor areas of Qinghai Province, China: a controlled interventional study.

    PubMed

    Zhang, Yanfeng; Wu, Qiong; Wang, Wei; van Velthoven, Michelle Helena; Chang, Suying; Han, Huijun; Xing, Min; Chen, Li; Scherpbier, Robert W

    2016-10-31

    To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6-23 months. A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). One intervention county and one control county in rural Qinghai Province, China. Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B 1 , B 2 , B 12 , D 3 , folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. Caregivers and their children aged 6-23 months. Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <-2.0) (controlled for differences between the counties), and on infant feeding practices. The surveys were conducted on 1804, 2187 and 2186 children aged 6-23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6-8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should

  8. Tympanogram findings in patients with cleft palates aged six months to seven years

    NASA Astrophysics Data System (ADS)

    Yanti, A.; Widiarni, D.; Alviandi, W.; Tamin, S.; Mansyur, M.

    2017-08-01

    Cleft palate is one of the most common congenital craniofacial deformities. Otitis media with effusion (OME) is a middle ear disease having a prevalence of almost 90% in patients with cleft palates. Tympanometry is a fast, safe, non-invasive, and easy tool for diagnosing middle ear disease qualitatively and quantitatively. Studies have been conducted using tympanometry to detect middle ear conditions in patients with cleft palates, but no research has studied tympanogram findings in patients with cleft palates in Indonesia. The aim of this study is to determine the tympanogram findings in Indonesian children aged six months to seven years with cleft palates. This is a cross-sectional study of 30 patients (17 males and 13 females) with Veau classification of palatal clefts aged six months to seven years (median 26.5 months) who underwent tympanometry examinations using a 226 Hztympanometer. Tympanograms were classified using the Jerger/Liden classification. Examinations of 58 ears found that type B tympanograms occurred most frequently (70.7%). The quantitative values of tympanometry analyzed included SAA (0.1-0.2 cm3), TPP value (-197.2-(-146.8 daPa)), Vec value (0.5-0.6 cm3), and gradient value (0.03-0.07 cm3). Using the Fisher test, a significant relationship was found between age and type of tympanogram (p = 0.0039) with the risk of type B and C tympanograms in infants (6-60 months) as high as 4.8 times that of children without cleft palates. The type B tympanogram was most frequently seen in patients with cleft palates aged six months to seven years old with the quantitative values of tympanometry lower than the normal values. Therefore, there was a significant difference in the type of tympanogram seen with age.

  9. Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study

    PubMed Central

    McAullay, Daniel; Strobel, Natalie A.; Marriott, Rhonda; Atkinson, David N.; Marley, Julia V.; Stanley, Fiona J.

    2016-01-01

    Background Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants. Methods Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation. Findings There were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356). Interpretation WA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live. PMID:27120331

  10. Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study.

    PubMed

    McAuley, Kimberley; McAullay, Daniel; Strobel, Natalie A; Marriott, Rhonda; Atkinson, David N; Marley, Julia V; Stanley, Fiona J; Edmond, Karen M

    2016-01-01

    Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants. Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation. There were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77-2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98-2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88-2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96-1.13, p = 0.356). WA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.

  11. Iron Deficiency and Iron-deficiency Anemia in Toddlers Ages 18 to 36 Months: A Prospective Study.

    PubMed

    Levin, Carina; Harpaz, Shira; Muklashi, Isam; Lumelsky, Nadia; Komisarchik, Ina; Katzap, Ilia; Abu Hanna, Manhal; Koren, Ariel

    2016-04-01

    In young children, iron deficiency (ID)-the most common cause of anemia-may adversely affect long-term neurodevelopment and behavior. We prospectively evaluated the prevalence of ID and iron deficiency anemia (IDA) in 256 healthy 18- to 36-month-old children in Northern Israel. Complete blood count and ferritin evaluation were performed, and risk factors were assessed. Hemoglobin (Hgb) was compared with first-year routine screening. Complete data were obtained from 208 children: 56.2% were boys; the mean age was 26.1±5.27 months. A prevalence of 5.8% IDA, 16.3% ID without anemia, 9.6% anemia with normal ferritin, and 68.3% normal Hgb and ferritin was found. In nonanemic infants at 1 year of age (n=156), ID/IDA was found in 19.9%, and 12.8% became anemic at study evaluation. Despite iron supplementation in the first year, and normal Hgb at first-year screening, ID and IDA were still prevalent, and might develop during the second year of life. Recognition of this child subset and consideration of iron supplementation are mandatory.

  12. Fish and Meat Are Often Withheld From the Diets of Infants 6 to 12 Months in Fish-Farming Households in Rural Bangladesh.

    PubMed

    Thorne-Lyman, Andrew L; Valpiani, Natalie; Akter, Rumana; Baten, Md Abdul; Genschick, Sven; Karim, Manjurul; Thilsted, Shakuntala H

    2017-09-01

    Fish is a widely available animal-source food in Bangladesh and a rich source of nutrients, yet little is known about practices related to incorporating fish into the diets of infants and young children. Use dietary diversity data to explore consumption patterns of fish and high-quality food items within the household and examine factors associated with delayed introduction of fish to infants and young children. Cross-sectional survey of 496 households with children <36 months participating in the Aquaculture for Income and Nutrition project in Bangladesh. Data collected included household characteristics, women's dietary diversity score, and minimum dietary diversity score along with data on Infant and Young Child Feeding practices. Most children (63.4%) met the threshold for minimum dietary diversity. Despite having received extensive nutrition education related to including fish in complementary foods, only half of the caretakers introduced fish at 6 months and the mean age of introduction of small fish was 8.7 months. Meat and fish were not common in infant diets but increased with child age. Concerns about bones were a major barrier to incorporating fish into infant diets. Given its nutrient profile and widespread availability in certain contexts, fish could be an underutilized opportunity to improve nutrition and health outcomes of infants and young children. Further research, including utilizing food processing technologies, is needed to develop appropriate responses to overcome these barriers.

  13. Association between unmet dental needs and school absenteeism because of illness or injury among U.S. school children and adolescents aged 6-17 years, 2011-2012.

    PubMed

    Agaku, Israel T; Olutola, Bukola G; Adisa, Akinyele O; Obadan, Enihomo M; Vardavas, Constantine I

    2015-03-01

    We assessed the prevalence of dental disease among U.S. children and adolescents aged 6-17 years, as well as the impact of unmet dental needs on school absenteeism because of illness/injury within the past 12 months. Data were from the 2011/2012 National Survey of Children's Health (n=65,680). Unmet dental need was defined as lack of access to appropriate and timely preventive or therapeutic dental healthcare when needed within the past 12 months. The impact of unmet dental needs on school absenteeism was measured using a multivariate generalized linear model with Poisson probability distribution (p<0.05). Within the past 12 months, 21.8% (10.8 million) of all U.S. children and adolescents aged 6-17 years had "a toothache, decayed teeth, or unfilled cavities." Of all U.S. children and adolescents aged 6-17 years, 15.8% (7.8 million) reported any unmet dental need (i.e., preventive and/or therapeutic dental need) within the past 12 months. The mean number of days of school absence because of illness/injury was higher among students with an unmet therapeutic dental need in the presence of a dental condition compared to those reporting no unmet dental need (β=0.25; p<0.001). Enhanced and sustained efforts are needed to increase access to dental services among underserved U.S. children and adolescents. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Predictive model for serious bacterial infections among infants younger than 3 months of age.

    PubMed

    Bachur, R G; Harper, M B

    2001-08-01

    To develop a data-derived model for predicting serious bacterial infection (SBI) among febrile infants <3 months old. All infants /=38.0 degrees C seen in an urban emergency department (ED) were retrospectively identified. SBI was defined as a positive culture of urine, blood, or cerebrospinal fluid. Tree-structured analysis via recursive partitioning was used to develop the model. SBI or No-SBI was the dichotomous outcome variable, and age, temperature, urinalysis (UA), white blood cell (WBC) count, absolute neutrophil count, and cerebrospinal fluid WBC were entered as potential predictors. The model was tested by V-fold cross-validation. Of 5279 febrile infants studied, SBI was diagnosed in 373 patients (7%): 316 urinary tract infections (UTIs), 17 meningitis, and 59 bacteremia (8 with meningitis, 11 with UTIs). The model sequentially used 4 clinical parameters to define high-risk patients: positive UA, WBC count >/=20 000/mm(3) or /=39.6 degrees C, and age <13 days. The sensitivity of the model for SBI is 82% (95% confidence interval [CI]: 78%-86%) and the negative predictive value is 98.3% (95% CI: 97.8%-98.7%). The negative predictive value for bacteremia or meningitis is 99.6% (95% CI: 99.4%-99.8%). The relative risk between high- and low-risk groups is 12.1 (95% CI: 9.3-15.6). Sixty-six SBI patients (18%) were misclassified into the lower risk group: 51 UTIs, 14 with bacteremia, and 1 with meningitis. Decision-tree analysis using common clinical variables can reasonably predict febrile infants at high-risk for SBI. Sequential use of UA, WBC count, temperature, and age can identify infants who are at high risk of SBI with a relative risk of 12.1 compared with lower-risk infants.

  15. Household food (in)security and nutritional status of urban poor children aged 6 to 23 months in Kenya.

    PubMed

    Mutisya, Maurice; Kandala, Ngianga-Bakwin; Ngware, Moses Waithanji; Kabiru, Caroline W

    2015-10-13

    Millions of people in low and low middle income countries suffer from extreme hunger and malnutrition. Research on the effect of food insecurity on child nutrition is concentrated in high income settings and has produced mixed results. Moreover, the existing evidence on food security and nutrition in children in low and middle income countries is either cross-sectional and/or is based primarily on rural populations. In this paper, we examine the effect of household food security status and its interaction with household wealth status on stunting among children aged between 6 and 23 months in resource-poor urban setting in Kenya. We use longitudinal data collected between 2006 and 2012 from two informal settlements in Nairobi, Kenya. Mothers and their new-borns were recruited into the study at birth and followed prospectively. The analytical sample comprised 6858 children from 6552 households. Household food security was measured as a latent variable derived from a set of questions capturing the main domains of access, availability and affordability. A composite measure of wealth was calculated using asset ownership and amenities. Nutritional status was measured using Height-for-Age (HFA) z-scores. Children whose HFA z-scores were below -2 standard deviation were categorized as stunted. We used Cox regression to analyse the data. The prevalence of stunting was 49 %. The risk of stunting increased by 12 % among children from food insecure households. When the joint effect of food security and wealth status was assessed, the risk of stunting increased significantly by 19 and 22 % among children from moderately food insecure and severely food insecure households and ranked in the middle poor wealth status. Among the poorest and least poor households, food security was not statistically associated with stunting. Our results shed light on the joint effect of food security and wealth status on stunting. Study findings underscore the need for social protection policies to

  16. Tooth-brushing behaviour in 6-12 year olds.

    PubMed

    Sandström, Anna; Cressey, Janet; Stecksén-Blicks, Christina

    2011-01-01

    A common clinical finding is that many schoolchildren display a nonacceptable oral hygiene. To evaluate the tooth-brushing behaviour in children aged 6-12 years. The study used a cross-sectional descriptive design. Children aged 6, 8, 10, and 12 years in an elementary school in a middle class area in Umeå, a city in northern Sweden, were invited and 82 (82%) consented. Visible plaque on buccal surfaces of incisors and canines was recorded from photographs of the participant's teeth before and after brushing using the scores of the Green and Vermillion Oral Hygiene Index. Brushing technique was recorded with a video camera. A questionnaire was used to collect data about oral hygiene habits at home. The ratio between the sum of plaque scores after and before brushing was statistically significantly higher in the 6-year-old group compared with the 10-year olds, (P < 0.05). There was a negative correlation between time spent for brushing and the ratio between the sum of plaque scores after and before brushing (r = -0.31, P < 0.01). The lowest correlation was displayed in the youngest age group (r = 0.07, P > 0.05). Six-year olds spent statistically significantly less time for brushing than older children (P < 0.05). Plaque removal from buccal surfaces from brushing was poor and averaged 19% for 6-year olds and 30% for older children. The results of brushing for children aged 8-12 years could benefit from increasing tooth-brushing time. Children could be given an increasing responsibility from 7 to 8 year of age but parental help is motivated up to 10 years of age. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

  17. Botulism in foals less than 6 months of age: 30 cases (1989-2002).

    PubMed

    Wilkins, Pamela A; Palmer, Jonathan E

    2003-01-01

    Botulism has been recognized as a clinical entity in foals since the 1960s. Also known as "Shaker foal" disease, the toxicoinfectious form of botulism affects foals, with the highest incidence in the United States seen in Kentucky and the mid-Atlantic region. The disease is characterized by progressive muscular weakness caused by the action of botulism neurotoxin at cholinergic neuromuscular junctions. Increased number of episodes and duration of recumbency, muscular trembling, and dysphagia are seen in affected foals. Left untreated, the disease can be rapidly fatal, with death occuring secondary to respiratory muscle paralysis within 24 to 72 hours of the onset of clinical signs. Very mildly affected foals can survive with minimal treatment Despite advances made in treatment of these foals, including administration of botulism antitoxin early in the course of the disease, there is still an impression that the disease carries a high mortality rate. The purpose of this study was to evaluate outcome in 30 foals <6 months of age diagnosed with botulism between 1989 and 2002 at the George D. Widener Large Animal Hospital, New Bolton Center. Two foals were euthanized for economic reasons early in the disease course, and I died while being treated. Survival of treated cases was greater than 96%. Approximately 50% of the cases required oxygen therapy, whereas 30% required mechanical ventilation. All foals, excepting 1 mildly affected foal, received botulism antitoxin. Mean duration of hospitalization was 14 days. With appropriate treatment, foals with botulism have a high survival rate.

  18. Treatment of femoro-popliteal lesions with scoring and drug-coated balloon angioplasty: 12-month results of the DCB-Trak registry.

    PubMed

    Baumhäkel, Magnus; Chkhetia, Shalva; Kindermann, Michael

    2018-01-01

    Debulking strategies prior to drug-coated balloon (DCB) angioplasty were suggested to improve clinical results in femoro-popliteal lesions. Currently, there are no data regarding plaque modification with a scoring balloon with subsequent DCB-angioplasty. Recently published 6-month results of the DCB-Trak registry in patients treated with scoring-balloon angioplasty and DCB-angioplasty were promising without any safety concerns. Herein, we report the 12-month follow-up data. In a single center registry, 29 consecutive patients with 32 femoro-popliteal lesions were treated with a scoring-balloon (VascuTrak®) and a DCB subsequently. The primary endpoint was the clinically driven target lesion revascularization (TLR). Secondary endpoints were clinically driven target vessel revascularization (TVR), binary restenosis (peak systolic velocity ratio > 2.4), change in Rutherford classification and ankle-brachial-index (ABI). Safety endpoints were major cardiovascular events (cardiovascular death, myocardial infarction, stroke, death) and need for amputation. The procedure was successful in 29 lesions. There were no clinically driven TLRs after 12 months. Two patients required clinically driven TVR and one patient had a binary restenosis. ABI significantly increased after the procedure (0.87±0.24 to 1.04±0.18, P < 0.01) without a relevant change after 6 months (1.01±0.15, P < 0.05) or 12 months (1.01±0.20, P < 0.05). Rutherford classification improved in more than 90% of patients after 6 and 12 months. There was one major cardiovascular event at 6-month follow-up, but no amputations at 6- or 12-month follow-up. Vessel preparation with a scoring-balloon and subsequent DCB-angioplasty was safe and effective in patients with femoro-popliteal lesions. Further multicenter trials have to validate these results.

  19. Age of Complementary Foods Introduction and Risk of Anemia in Children Aged 4-6 years: A Prospective Birth Cohort in China.

    PubMed

    Wang, Fenglei; Liu, Huijuan; Wan, Yi; Li, Jing; Chen, Yu; Zheng, Jusheng; Huang, Tao; Li, Duo

    2017-03-23

    Age of complementary foods introduction is associated with childhood anemia, but the ideal age for the introduction of complementary foods to infants is a continuing topic of debate. We examined the longitudinal association between complementary foods introduction age and risk of anemia in 18,446 children from the Jiaxing Birth Cohort, who had detailed complementary feeding records at 3 and 6 months of age and had hemoglobin concentrations measured at 4-6 years. Early introduction of complementary foods at 3-6 months of age was significantly associated with a higher risk of anemia (odds ratio = 1.14; 95% confidence interval: 1.01-1.28) and a lower hemoglobin concentration of -0.84 g/L (95% confidence interval: -1.33 to -0.35) in children aged 4-6 years, compared with those fed complementary foods starting at 6 months of age. When it comes to the specific type of complementary foods, early introduction of all plant-based foods was associated with increased anemia risks and lower hemoglobin concentrations, while early introduction of most animal-based foods was not. These findings may be informative regarding the appropriate time to introduce complementary foods in infants.

  20. The importance of age composition of 12-step meetings as a moderating factor in the relation between young adults' 12-step participation and abstinence.

    PubMed

    Labbe, Allison K; Greene, Claire; Bergman, Brandon G; Hoeppner, Bettina; Kelly, John F

    2013-12-01

    Participation in 12-step mutual help organizations (MHO) is a common continuing care recommendation for adults; however, little is known about the effects of MHO participation among young adults (i.e., ages 18-25 years) for whom the typically older age composition at meetings may serve as a barrier to engagement and benefits. This study examined whether the age composition of 12-step meetings moderated the recovery benefits derived from attending MHOs. Young adults (n=302; 18-24 years; 26% female; 94% White) enrolled in a naturalistic study of residential treatment effectiveness were assessed at intake, and 3, 6, and 12 months later on 12-step attendance, age composition of attended 12-step groups, and treatment outcome (Percent Days Abstinent [PDA]). Hierarchical linear models (HLM) tested the moderating effect of age composition on PDA concurrently and in lagged models controlling for confounds. A significant three-way interaction between attendance, age composition, and time was detected in the concurrent (p=0.002), but not lagged, model (b=0.38, p=0.46). Specifically, a similar age composition was helpful early post-treatment among low 12-step attendees, but became detrimental over time. Treatment and other referral agencies might enhance the likelihood of successful remission and recovery among young adults by locating and initially linking such individuals to age appropriate groups. Once engaged, however, it may be prudent to encourage gradual integration into the broader mixed-age range of 12-step meetings, wherein it is possible that older members may provide the depth and length of sober experience needed to carry young adults forward into long-term recovery. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. [Hematemesis in Togo: findings of a 12-month study in an intensive care unit].

    PubMed

    Djibril, A M; Tomta, K; Balaka, K; Bagny, A; M'ba, K B; Kaaga, L; Redah, D; Agbetra, A

    2010-06-01

    This prospective study was conducted over a 12-month period on patients who underwent upper digestive endoscopy for hematemesis in the medical intensive care unit (ICU) of the Tokoin University Hospital Center in Lomé, Togo. A total of 44 patients with a mean age of 44 years were included. The sex-ratio was 2.61. Risk factors included use of non-steroid anti-inflammatory (NSAI) in 16 patients (36.4%) and alcohol abuse in 13 (29.6%). At the time of admission to the ICU, 21 patients (47.7%) were in hemodynamic shock and 11 (25%) presented signs of portal hypertension. The underlying etiology was peptic ulcer in 18 cases (40.9%) including 13 cases of duodenal ulcer and 5 cases of stomach ulcer, rupture of esophageal varicosities in 8 (18.2%), gastric tumor in 6 (13.6%), Mallory Weiss syndrome in 5 (11.4%), gastritis in 4 (9,1%), and esophagitis in 3 (6.8%) due to peptic inflammation in 2 and mycotic infection in 1. The mortality rate was 45.5%. The main causes of hematemesis were peptic ulcer and rupture of esophageal varicosities. The death rate was high due to inadequate care facilities.

  2. Calcium intake of rural Gambian infants: a quantitative study of the relative contributions of breast milk and complementary foods at 3 and 12 months of age.

    PubMed

    Jarjou, L M A; Goldberg, G R; Coward, W A; Prentice, A

    2012-06-01

    There is a paucity of information from developing countries on total calcium intake during infancy, and potential consequences for growth and bone development. Observational longitudinal study of rural Gambian infants (13 males and 17 females) at 3 and 12 months of age. Breast-milk intake and calcium concentration, weighed dietary intake, anthropometry, midshaft radius bone mineral content (BMC) and bone width (BW). At 3 and 12 months (mean ± s.d.) calcium intake from breast milk was 179 ± 53 and 117 ± 38, and from other foods 12 ± 38 and 73 ± 105 mg/day. There was no difference in total calcium intake; 94% and 62% of calcium came from breast milk. At 3 and 12 months, weight s.d.-scores were -0.441 ± 1.07 and -1.967 ± 1.06; length s.d.-scores were -0.511 ± 1.04 and -1.469 ± 1.13. Breast-milk calcium intake positively predicted weight (P = 0.0002, P ≤ 0.0001) and length (P = 0.056, P = 0.001). These relationships were not independent of breast-milk intake, which positively predicted weight (P ≤ 0.002) and length (P = 0.06, P = 0.004). At 3, but not 12 months, weight and length correlated with total calcium intake. There were no relationships between total calcium intake and breast-milk intake with BW or BMC. The combination of low calcium intake from breast milk and complementary foods resulted in a low total calcium intake close to the estimated biological requirement for bone mineral accretion. Relationships between calcium intake and growth were largely accounted for by breast-milk intake, suggesting that low calcium intake per se was not the limiting factor in the poor growth. These findings have potential implications for deriving calcium requirements in developing countries.

  3. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    PubMed

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Sormani, Maria Pia; Messina, Sonia; D'Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P; Bertini, Enrico; Mercuri, Eugenio

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3) m at 12 months, of -58.9 (SD 125.7) m at 24 months and -104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available.

  4. Evaluation of blood zinc, calcium and blood lead levels among children aged 1-36 months.

    PubMed

    Ji, Xiaojun; He, Hong; Ren, Lisheng; Liu, Ji; Han, Chunhua

    2014-09-01

    Early childhood lead exposure is associated with numerous adverse health effects. Biomonitoring among susceptible populations, such as children, has not been previously conducted. The aim of the study is to evaluate the blood lead (Pb) and total blood calcium (Ca) levels; blood zinc (Zn) levels. A cross-sectional study was designed to collect healthy children age 1- 36 months (Mean ± SD: 1.5 ± 0.6 age, 60% boys) in the study from January 2010 to September 2011. The overall mean blood Pb levels were 42.18 ± 12.13 μg/L, the overall mean blood Zn and total blood Ca concentrations were 62.18 ± 12.33 μmol/L and 1.78 ± 0.13 mmol/L, respectively. The prevalence of elevated blood Pb levels in all children was 1.3%. A significant difference was found between female and male subjects for the blood Pb and Zn. After controlling for gender and age, there was a weak positive correlation between total blood Ca and Zn level. The blood Pb levels had a significant negative correlation with total blood Ca level after adjusting for age and gender, and these findings suggest that Pb had effect on positive blood Zn and total blood Ca levels; parents should pay more attention to the nutrition of girls. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  5. Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil.

    PubMed

    Zanin, Francisca Helena Calheiros; da Silva, Camilo Adalton Mariano; Bonomo, Élido; Teixeira, Romero Alves; Pereira, Cíntia Aparecida de Jesus; dos Santos, Karina Benatti; Fausto, Maria Arlene; Negrão-Correa, Deborah Aparecida; Lamounier, Joel Alves; Carneiro, Mariângela

    2015-01-01

    Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6-71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2-40.8) and 9.8% (95%CI 7.2-12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7-22.6) and 21.8% (95%CI 17.8-26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2-2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4-3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1-2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.

  6. Effects of 24 months of treatment with romosozumab followed by 12 months of denosumab or placebo in postmenopausal women with low bone mineral density: A randomized, double-blind, phase 2, parallel group study.

    PubMed

    McClung, Michael R; Brown, Jacques P; Diez-Perez, Adolfo; Resch, Heinrich; Caminis, John; Meisner, Paul; Bolognese, Michael A; Goemaere, Stefan; Bone, Henry G; Zanchetta, Jose R; Maddox, Judy; Bray, Sarah; Grauer, Andreas

    2018-04-25

    Over 12 months, romosozumab increased bone formation and decreased bone resorption, resulting in increased BMD in postmenopausal women with low BMD (NCT00896532). Herein we report the study extension evaluating 24 months treatment with romosozumab, discontinuation of romosozumab, alendronate followed by romosozumab, and romosozumab followed by denosumab. Postmenopausal women age 55-85 years with a lumbar spine (LS), total hip (TH), or femoral neck T-score ≤-2.0 and ≥-3.5 were enrolled and randomly assigned to placebo, one of five romosozumab regimens (70mg, 140mg, 210mg monthly [QM]; 140mg Q3M; 210mg Q3M) for 24 months, or open-label alendronate for 12 months followed by romosozumab 140mg QM for 12 months. Eligible participants were then re-randomized 1:1 within original treatment groups to placebo or denosumab 60mg Q6M for an additional 12 months. Percentage change from baseline in BMD and bone turnover markers (BTMs) at months 24 and 36 and safety were evaluated. Of 364 participants initially randomized to romosozumab, placebo, or alendronate, 315 completed 24 months of treatment and 248 completed the extension. Romosozumab markedly increased LS and TH BMD through month 24, with largest gains observed with romosozumab 210mg QM (LS = 15.1%; TH = 5.4%). Women receiving romosozumab who transitioned to denosumab continued to accrue BMD, whereas BMD returned toward pretreatment levels with placebo. With romosozumab 210mg QM, bone formation marker P1NP initially increased following treatment initiation and gradually decreased to below baseline by month 12, remaining below baseline through month 24; and bone resorption marker β-CTX rapidly decreased following treatment, remaining below baseline through month 24. Transition to denosumab further decreased both BTMs, while after transition to placebo, P1NP returned to baseline and β-CTX increased above baseline. Adverse events were balanced between treatment groups through month 36. These data suggest that

  7. PositiveLinks: A Mobile Health Intervention for Retention in HIV Care and Clinical Outcomes with 12-Month Follow-Up.

    PubMed

    Dillingham, Rebecca; Ingersoll, Karen; Flickinger, Tabor E; Waldman, Ava Lena; Grabowski, Marika; Laurence, Colleen; Wispelwey, Erin; Reynolds, George; Conaway, Mark; Cohn, Wendy F

    2018-06-01

    Mobile health interventions may help People Living with HIV (PLWH) improve engagement in care. We designed and piloted PositiveLinks, a clinic-affiliated mobile intervention for PLWH, and assessed longitudinal impact on retention in care and viral suppression. The program was based at an academic Ryan White Clinic serving a nonurban population in Central Virginia. The PL intervention included a smartphone app that connected participants to clinic staff and provided educational resources, daily queries of stress, mood and medication adherence, weekly quizzes, appointment reminders, and a virtual support group. Outcomes were analyzed using McNemar's tests for HRSA-1, visit constancy, and viral suppression and nonparametric Wilcoxon signed-rank tests for CD4 counts and viral loads. Of 77 participants, 63% were male, 49% black non-Hispanic, and 72% below the federal poverty level. Participants' achievement of a retention in care benchmark (HRSA-1) increased from 51% at baseline to 88% at 6 months (p < 0.0001) and 81% at 12 months (p = 0.0003). Visit constancy improved from baseline to 6 months (p = 0.016) and 12 months (p = 0.0004). Participants' mean CD4 counts increased from baseline to 6 months (p = 0.0007) and 12 months (p = 0.0005). The percentage of participants with suppressed viral loads increased from 47% at baseline to 87% at 6 months (p < 0.0001) and 79% at 12 months (p = 0.0007). This study is one of the first to demonstrate that a mobile health intervention can have a positive impact on retention in care and clinical outcomes for vulnerable PLWH. Next steps include integration with clinical practice and dissemination.

  8. Clinical and ocular motor analysis of the infantile nystagmus syndrome in the first 6 months of life.

    PubMed

    Hertle, R W; Maldanado, V K; Maybodi, M; Yang, D

    2002-06-01

    The infantile nystagmus syndrome (INS) usually begins in infancy and may or may not be associated with visual sensory system abnormalities. Little is known about its specific waveforms in the first 6 months of life or their relation to the developing visual system. This study identifies the clinical and ocular motility characteristics of the INS and establishes the range of waveforms present in the first 6 months of life. 27 infants with involuntary ocular oscillations typical of INS are included in this analysis. They were evaluated both clinically and with motility recordings. Eye movement analysis was performed off line from computer analysis of digitised data. Variables analysed included age, sex, vision, ocular abnormalities, head position, and null zone, neutral zone characteristics, symmetry, conjugacy, waveforms, frequencies, and foveation times. Ages ranged from 3 to 6.5 months (average 4.9 months). 15 patients (56%) had abnormal vision for age, nine (33%) had strabismus, five (19%) had an anomalous head posture, 13 (48%) had oculographic null and neutral positions, nine (33%) had binocular asymmetry, and only two showed consistent dysconjugacy. Average binocular frequency was 3.3 Hz, monocular frequency 6.6 Hz. Average foveation periods were longer and more "jerk" wave forms were observed in those patients with normal vision. Common clinical characteristics and eye movement waveforms of INS begin in the first few months of infancy and waveform analysis at this time may help with both diagnosis and visual status.

  9. Mothers' Expectations for Shared Reading Following Delivery: Implications For Reading Activities at 6 Months

    PubMed Central

    Berkule, Samantha B.; Dreyer, Benard P.; Klass, Perri E.; Huberman, Harris S.; Yin, Hsiang S.; Mendelsohn, Alan L.

    2008-01-01

    Objective To determine whether mothers with plans related to shared reading and baby books in the home at the time of delivery of their newborns would be more likely to engage in shared reading behaviors at age 6 months. Method This was a cohort study with enrollment post-partum and follow-up at 6 months in an urban public hospital. Predictors: mothers' attitudes and resources related to shared reading during the postpartum period. Outcomes: mothers' shared reading activities and resources at 6 months (StimQ-READ). Results 173 mother-infant dyads were assessed. In multiple regression analyses adjusting for sociodemographics and maternal depression and literacy, StimQ-READ at 6 months was increased in association with all 3 postpartum predictors: plans for reading as a strategy for school success (adjusted mean 1.7 point increase in 6 month score; 95% CI: 0.3 – 3.0), plans to read in infancy (3.1 point increase; 95% CI: 1.6-4.6), and having baby books in the home (2.3 point increase; 95% CI: 0.9 – 3.6). In multiple logistic regression analysis, mothers with two or more attitudes and resources had an AOR of 6.2 (95% CI: 2.0-18.9) for having initiated reading at 6 months. Conclusions Maternal attitudes and resources in early infancy related to shared reading are important predictors of reading behaviors by 6 months. Cumulative postnatal attitudes and resources are the strongest predictors of later behaviors. Additional research is needed regarding whether guidance about shared reading in early infancy or pregnancy would enhance programs such as Reach Out and Read. PMID:18501863

  10. Admission glucose does not improve GRACE score at 6 months and 5 years after myocardial infarction.

    PubMed

    de Mulder, Maarten; van der Ploeg, Tjeerd; de Waard, Guus A; Boersma, Eric; Umans, Victor A

    2011-01-01

    Admission plasma glucose (APG) is a biomarker that predicts mortality in myocardial infarction (MI) patients. Therefore, APG may improve risk stratification based on the GRACE risk score. We collected data on baseline characteristics and long-term (median 55 months) outcome of 550 MI patients who entered our hospital in 2003 and 2006. We determined the GRACE risk score at admission for each patient, which was entered in a logistic regression model, together with APG, to evaluate their prognostic value for 6-month and 5-year mortality. Patients with APG ≥7.8 mmol/l had a higher mortality than those with APG levels <7.8 mmol/l; 6 months: 13.7 versus 3.6%, p value <0.001; 5 years: 20.4 versus 11.1%, p value 0.003. After adjustment for the GRACE risk score variables, APG appeared a significant predictor of 6-month and 5-year mortality, adjusted OR 1.17 (1.06-1.29) and 1.12 (1.03-1.22). The combination of the GRACE risk score and APG increased the model's performance (discrimination C-index 0.87 vs. 0.85), although the difference was not significant (p = 0.095). Combining the GRACE risk score and APG reclassified 12.9% of the patients, but the net reclassification improvement was nonsignificant (p = 0.146). APG is a predictor of 6-month and 5-year mortality, each mmol/l increase in APG being associated with a mortality increase of 17 and 12%, respectively, independent of the GRACE risk score. However, adding APG to the GRACE model did not result in significantly improved clinical risk stratification. Copyright © 2012 S. Karger AG, Basel.

  11. Factors associated with dental caries in a group of American Indian children at age 36 months.

    PubMed

    Warren, John J; Blanchette, Derek; Dawson, Deborah V; Marshall, Teresa A; Phipps, Kathy R; Starr, Delores; Drake, David R

    2016-04-01

    Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Factors Associated with Dental Caries in a Group of American Indian Children at age 36 Months

    PubMed Central

    Warren, John J.; Blanchette, Derek; Dawson, Deborah V.; Marshall, Teresa A.; Phipps, Kathy R.; Starr, Delores; Drake, David R.

    2015-01-01

    Objectives Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This paper reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. Methods Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28 and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary and behavioral factors. Non-parametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). Results Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only non-cavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (p<0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. Conclusions By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size and maternal factors, but further analyses are needed to better understand caries in this population. PMID:26544674

  13. Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study

    PubMed Central

    Zhang, Yanfeng; Wu, Qiong; Wang, Wei; van Velthoven, Michelle Helena; Chang, Suying; Han, Huijun; Xing, Min; Chen, Li; Scherpbier, Robert W.

    2016-01-01

    Objective To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6–23 months. Design A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). Setting One intervention county and one control county in rural Qinghai Province, China. Intervention Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B1, B2, B12, D3, folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. Participants Caregivers and their children aged 6–23 months. Primary and secondary outcome measures Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <−2.0) (controlled for differences between the counties), and on infant feeding practices. Results The surveys were conducted on 1804, 2187 and 2186 children aged 6–23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6–8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. Conclusions We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements

  14. How well do WHO complementary feeding indicators relate to nutritional status of children aged 6-23 months in rural Northern Ghana?

    PubMed

    Saaka, Mahama; Wemakor, Anthony; Abizari, Abdul-Razak; Aryee, Paul

    2015-11-23

    Though the World Health Organization (WHO) recommended Infant and Young Child Feeding (IYCF) indicators have been in use, little is known about their association with child nutritional status. The objective of this study was to explore the relationship between IYCF indicators (timing of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet) and child growth indicators. A community-based cross-sectional survey was carried out in November 2013. The study population comprised mothers/primary caregivers and their children selected using a two-stage cluster sampling procedure. Of the 1984 children aged 6-23 months; 58.2 % met the minimum meal frequency, 34.8 % received minimum dietary diversity (≥4 food groups), 27.8 % had received minimum acceptable diet and only 15.7 % received appropriate complementary feeding. With respect to nutritional status, 20.5 %, 11.5 % and 21.1 % of the study population were stunted, wasted and underweight respectively. Multiple logistic regression analysis revealed that compared to children who were introduced to complementary feeding either late or early, children who started complementary feeding at six months of age were 25 % protected from chronic malnutrition (AOR = 0.75, CI = 0.50 - 0.95, P = 0.02). It was found that children whose mothers attended antenatal care (ANC) at least 4 times were 34 % protected [AOR 0.66; 95 % CI (0.50 - 0.88)] against stunted growth compared to children born to mothers who attended ANC less than 4 times. Children from households with high household wealth index were 51 % protected [AOR 0.49; 95 % CI (0.26 - 0.94)] against chronic malnutrition compared to children from households with low household wealth index. After adjusting for potential confounders, there was a significant positive association between appropriate complementary feeding index and mean WLZ (β = 0.10, p = 0.005) but was not associated with mean LAZ. The WHO IYCF

  15. A Phase III randomized, double-blind, clinical trial of an investigational hexavalent vaccine given at 2, 4, and 11-12 months.

    PubMed

    Silfverdal, Sven-Arne; Icardi, Giancarlo; Vesikari, Timo; Flores, Sheryl A; Pagnoni, Marco F; Xu, Jin; Liu, G Frank; Stek, Jon E; Boisnard, Florence; Thomas, Stéphane; Ziani, Eddy; Lee, Andrew W

    2016-07-19

    Combination vaccines simplify vaccination visits and improve coverage and timeliness. DTaP5-HB-IPV-Hib is a new investigational, fully-liquid, combination vaccine designed to protect against 6 infectious diseases, including 5 pertussis antigens and OMPC instead of PT as conjugated protein for Hib component. In this multicenter, double-blind, comparator-controlled, Phase III study (NCT01480258) conducted in Sweden, Italy, and Finland, healthy infants were randomized 1:1 to receive one two immunization regimens. The DTaP5-HB-IPV-Hib Group received the investigational hexavalent vaccine (DTaP5-HB-IPV-Hib) and the Control Group received Infanrix-hexa (DTPa3-HBV-IPV/Hib) at 2, 4 and 11-12months of age. Both groups received concomitantly Prevnar 13 (PCV13) and Rotateq (RV5) or Rotarix (RV1) at 2, 4months of age and PCV13 at 11-12months. Subjects administered RV5 received a 3rd dose at 5months of age. A total of 656 subjects were randomized to the DTaP5-HB-IPV-Hib Group and 659 subjects to Control Group. Immune responses to all vaccine antigens post-toddler dose were non-inferior in the DTaP5-HB-IPV-Hib Group as compared to the Control Group. Additionally, the post-dose 2 and pre-toddler DTaP5-HB-IPV-Hib anti-PRP responses were superior. The DTaP5-HB-IPV-Hib Group responses to concomitant RV1 were non-inferior compared to the Control Group. Solicited adverse event rates after any dose were similar in both groups, except for higher rates of pyrexia (6.4% difference; 95% CI: 1.5,11.3) and somnolence (5.8% difference; 95% CI: 1.7,9.8) in the DTaP5-HB-IPV-Hib Group. Vaccine-related serious adverse events occurred infrequently in the DTaP5-HB-IPV-Hib Group (0.3%) and the Control Group (0.5%). The safety and immunogenicity of DTaP5-HB-IPV-Hib is generally comparable to Control when administered in the 2, 4, 11-12month schedule. Early Hib responses were superior versus Control. DTaP5-HB-IPV-Hib could provide a new hexavalent option for pediatric combination vaccines, aligned

  16. Conditioning 1-6 Month Old Infants by Means of Myoelectrically Controlled Reinforcement.

    ERIC Educational Resources Information Center

    Stack, Dale M.; McDonnell, Paul M.

    1995-01-01

    In order to evaluate possibilities of fitting myoelectrically controlled prosthetic arms on infants, this study examined whether 32 infants (1-6 months) could learn to control environmental contingencies by means of contracting the forearm flexor muscle group. Results indicated that older subjects (age greater than 104 days) demonstrated learning,…

  17. Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in Dschang, West Region, Cameroon: a cross-sectional survey during a polio outbreak.

    PubMed

    Russo, Gianluca; Miglietta, Alessandro; Pezzotti, Patrizio; Biguioh, Rodrigue Mabvouna; Bouting Mayaka, Georges; Sobze, Martin Sanou; Stefanelli, Paola; Vullo, Vincenzo; Rezza, Giovanni

    2015-07-10

    Inadequate immunization coverage with increased risk of vaccine preventable diseases outbreaks remains a problem in Africa. Moreover, different factors contribute to incomplete vaccination status. This study was performed in Dschang (West Region, Cameroon), during the polio outbreak occurred in October 2013, in order to estimate the immunization coverage among children aged 12-23 months, to identify determinants for incomplete vaccination status and to assess the risk of poliovirus spread in the study population. A cross-sectional household survey was conducted in November-December 2013, using the WHO two-stage sampling design. An interviewer-administered questionnaire was used to obtain information from consenting parents of children aged 12-23 months. Vaccination coverage was assessed by vaccination card and parents' recall. Chi-square test and multilevel logistic regression model were used to identify the determinants of incomplete immunization status. Statistical significance was set at p < 0.05. Overall, 3248 households were visited and 502 children were enrolled. Complete immunization coverage was 85.9% and 84.5%, according to card plus parents' recall and card only, respectively. All children had received at least one routine vaccination, the OPV-3 (Oral Polio Vaccine) coverage was >90%, and 73.4% children completed the recommended vaccinations before 1-year of age. In the final multilevel logistic regression model, factors significantly associated with incomplete immunization status were: retention of immunization card (AOR: 7.89; 95% CI: 1.08-57.37), lower mothers' utilization of antenatal care (ANC) services (AOR:1.25; 95% CI: 1.07-63.75), being the ≥ 3(rd) born child in the family (AOR: 425.4; 95% CI: 9.6-18,808), younger mothers' age (AOR: 49.55; 95% CI: 1.59-1544), parents' negative attitude towards immunization (AOR: 20.2; 95% CI: 1.46-278.9), and poorer parents' exposure to information on vaccination (AOR: 28.07; 95 % CI: 2.26-348.1). Longer

  18. Comparison of mindfulness-based stress reduction versus yoga on urinary urge incontinence: a randomized pilot study. with 6-month and 1-year follow-up visits.

    PubMed

    Baker, Jan; Costa, Donna; Guarino, Julie M; Nygaard, Ingrid

    2014-01-01

    The objective of this study is to compare the effects of mindfulness-based stress reduction (MBSR) versus yoga on urinary urge incontinence (UI) at 8 weeks, 6 months, and 1 year after beginning an 8-week program. Participants in this prospective randomized single-masked pilot study were women aged 18 years or older with urge-predominant incontinence, 5 or more UI episodes (UIEs) on a 3-day voiding diary, and no recent anticholinergic use. Women were randomized to MBSR or yoga. The primary outcome was the percent change of UIE. Of 30 enrollees (15 in MBSR, 15 in yoga), 24 completed at least 5 of 8 sessions (13 in MBSR and 11 in yoga). Twenty and 21 women completed the 6-month and 12-month follow-up visits, respectively. At 8 weeks, 6 months, and 12 months, the median percent change from the baseline in UIE on the intention-to-treat analysis was greater for the MBSR group (-55.6, -71.4, and -66.7, respectively) compared with that for the yoga group (-33.3, -11.8, and -16.7, respectively), with P values ranging from 0.01 to 0.08. On intention-to-treat analysis, the median percent change in the Overactive Bladder Symptom and Quality of Life-Short Form and the Health-Related Quality of Life was greater at each time point for MBSR than for yoga but was statistically significant only at 8 weeks (P = 0.003 and 0.02, respectively). As per protocol analysis, at 8 weeks, 6/13 and 0/11 women in MBSR and yoga, respectively, reported they were very much or much better (P = 0.02), whereas at 1 year, 6/12 and 1/9 women in MBSR and yoga, respectively, did so (P = 0.16). These results support larger scale trials to evaluate MBSR, which seems to be a promising treatment of UI.

  19. Prevalence and associated factors for stunting among 6-12 years old school age children from rural community of Humbo district, Southern Ethiopia.

    PubMed

    Bogale, Tesfahun Yonas; Bala, Elazar Tadesse; Tadesse, Minyahil; Asamoah, Benedict Oppong

    2018-05-24

    Stunting is one of the most serious and challenging public health problems in Ethiopia, which constitute a significant obstacle to achieving better child health outcomes. This study aimed to assess the prevalence and factors associated with stunting among 6-12 years old children in Humbo district, Southern Ethiopia. This was a cross-sectional study conducted among 633 children 6-12 years old living in Humbo district, Southern Ethiopia, from March to April, 2015. A multistage cluster sampling technique was used to select participants from households in eight Villages in the study area. Height was measured using standard methods and height for age Z-score was computed to assess stunting. EPI info version 3.5.4 was used for data entry, whereas Anthroplus software and SPSS version 20.0 were used for computation of height for age Z-scores and statistical analyses respectively. Simple and multiple logistic regression analyses were used to examine factors associated with stunting in the study sample, using 95% confidence limits (statistical significance set at p < 0.050). Prevalence of stunting was 57%, about, 3.5% were severely stunted, 27.3% moderately stunted and 26.4% mildly stunted, and the mean (SD) was - 1.1 (±1.2). About 7 (1.1%) boys and 15 (2.4%) girls were severely stunted. Age groups 10-12 years had significantly higher rate of stunting than others. Age (AOR = 1.7, 95% CI = 1.1-2.6), big family size (AOR = 4.6, 95% CI = 2.2-9.5) and field disposal of wastes (AOR = 2.7, 95% CI = 1.2-5.8) were factors significantly associated with stunting. This study exposed high rate of stunting among school age children. Stunting remains a noticeable attribute of rural school age children. Findings suggest the need to implement evidence-based school-aged rural children nutrition policy and strategies as well as need for intervention to improve domestic waste management system in the rural community.

  20. Visual Acuity Change over 12 Months in the Prospective Progression of Atrophy Secondary to Stargardt Disease (ProgStar) Study: ProgStar Report Number 6.

    PubMed

    Kong, Xiangrong; Strauss, Rupert W; Cideciyan, Artur V; Michaelides, Michel; Sahel, José-Alain; Munoz, Beatriz; Ahmed, Mohamed; Ervin, Ann M; West, Sheila K; Cheetham, Janet K; Scholl, Hendrik P N

    2017-11-01

    To estimate the yearly rate of change of best-corrected visual acuity (BCVA) and the risk of loss 1 line or more over 1 year and to identify risk factors for BCVA loss in patients with Stargardt disease (STGD1). Multicenter, prospective cohort study. Two hundred fifty-nine patients (489 eyes) with molecularly confirmed STGD1 enrolled at 9 centers in the United States and Europe. Participants were followed up every 6 months, and data at the baseline and 6- and 12-month visits were analyzed. Best-corrected visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Standardized reporting forms were used to collect participants' characteristics and clinical observations. Linear mixed effects models were used to estimate the rate of BCVA loss. Linear models with generalized estimating equations were used to identify risk factors for BCVA loss of 1 line or more over 1 year. Change in BCVA over 1 year. Cross-sectional analysis at baseline showed that earlier symptom onset and longer duration since onset was associated with worse BCVA. Longitudinal analysis showed no overall significant change of BCVA within 12 months, but the rate of BCVA change was significantly different by baseline BCVA (P < 0.001). The BCVA of eyes with baseline BCVA of 20/25 or better declined at a rate of 2.8 ETDRS letters per year (P = 0.10), eyes with baseline BCVA between 20/25 and 20/70 declined at a rate of 2.3 ETDRS letters per year (P = 0.002), eyes with baseline BCVA between 20/70 and 20/200 declined at a rate of 0.8 ETDRS letters per year (P = 0.08), and eyes with baseline BCVA worse than 20/200 showed a significant improvement of 2.3 ETDRS letters per year (P < 0.001). Overall, 12.9% of eyes lost 1 line or more, and the risk of such BCVA loss was different by baseline BCVA level (P = 0.016). Smoking and vitamin A use was not associated significantly with baseline BCVA, nor with rate of BCVA loss over 1 year. Change in BCVA in STGD1 patients over a

  1. Glycaemic control and hypoglycaemia with new insulin glargine 300 U/ml versus insulin glargine 100 U/ml in people with type 2 diabetes using basal insulin and oral antihyperglycaemic drugs: the EDITION 2 randomized 12-month trial including 6-month extension.

    PubMed

    Yki-Järvinen, H; Bergenstal, R M; Bolli, G B; Ziemen, M; Wardecki, M; Muehlen-Bartmer, I; Maroccia, M; Riddle, M C

    2015-12-01

    To compare the efficacy and safety of new insulin glargine 300 U/ml (Gla-300) with insulin glargine 100 U/ml (Gla-100) over 12 months of treatment in people with type 2 diabetes using basal insulin and oral antihyperglycaemic drugs (OADs). EDITION 2 (NCT01499095) was a randomized, 6-month, multicentre, open-label, two-arm, phase IIIa study investigating once-daily Gla-300 versus Gla-100, plus OADs (excluding sulphonylureas), with a 6-month safety extension. Similar numbers of participants in each group completed 12 months of treatment [Gla-300, 315 participants (78%); Gla-100, 314 participants (77%)]. The reduction in glycated haemoglobin was maintained for 12 months with both treatments: least squares (LS) mean (standard error) change from baseline -0.55 (0.06)% for Gla-300 and -0.50 (0.06)% for Gla-100; LS mean difference -0.06 [95% confidence interval (CI) -0.22 to 0.10)%]. A significant relative reduction of 37% in the annualized rate of nocturnal confirmed [≤3.9 mmol/l (≤70 mg/dl)] or severe hypoglycaemia was observed with Gla-300 compared with Gla-100: rate ratio 0.63 [(95% CI 0.42-0.96); p = 0.031], and fewer participants experienced ≥1 event [relative risk 0.84 (95% CI 0.71-0.99)]. Severe hypoglycaemia was infrequent. Weight gain was significantly lower with Gla-300 than Gla-100 [LS mean difference -0.7 (95% CI -1.3 to -0.2) kg; p = 0.009]. Both treatments were well tolerated with a similar pattern of adverse events (incidence of 69 and 60% in the Gla-300 and Gla-100 groups). In people with type 2 diabetes treated with Gla-300 or Gla-100, and non-sulphonylurea OADs, glycaemic control was sustained over 12 months, with less nocturnal hypoglycaemia in the Gla-300 group. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  2. Risk of 12-month mortality among hospital inpatients using the surprise question and SPICT criteria: a prospective study.

    PubMed

    Mudge, Alison M; Douglas, Carol; Sansome, Xanthe; Tresillian, Michael; Murray, Stephen; Finnigan, Simon; Blaber, Cheryl Ruth

    2018-06-01

    People with serious life-limiting disease benefit from advance care planning, but require active identification. This study applied the Gold Standards Framework Proactive Identification Guidance (GSF-PIG) to a general hospital population to describe high-risk patients and explore prognostic performance for 12-month mortality. Prospective cohort study conducted in a metropolitan teaching hospital in Australia. Hospital inpatients on a single day aged 18 years and older were eligible, excluding maternity and neonatal, mental health and day treatment patients. Data sources included medical record and structured questions for medical and nursing staff. High-risk was predefined as positive response to the surprise question (SQ) plus two or more SPICT indicators of general deterioration. Descriptive variables included demographics, frailty and functional measures, treating team, advance care planning documentation and hospital utilisation. Primary outcome for prognostic performance was 12-month mortality. We identified 540 eligible inpatients on the study day and 513 had complete data (mean age 60, 54% male, 30% living alone, 19% elective admissions). Of these, 191 (37%) were high-risk; they were older, frailer, more dependent and had been in hospital longer than low-risk participants. Within 12 months, 92 participants (18%) died (72/191(38%) high-risk versus 20/322(6%) low-risk, P<0.001), providing sensitivity 78%, specificity 72%, positive predictive value 38% and negative predictive value 94%. SQ alone provided higher sensitivity, adding advanced disease indicators improved specificity. The GSF-PIG approach identified a large minority of hospital inpatients who might benefit from advance care planning. Future studies are needed to investigate the feasibility, cost and impact of screening in hospitals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  3. Velopharyngeal Status of Stop Consonants and Vowels Produced by Young Children with and without Repaired Cleft Palate at 12, 14, and 18 Months of Age: A Preliminary Analysis

    ERIC Educational Resources Information Center

    Eshghi, Marziye; Vallino, Linda D.; Baylis, Adriane L.; Preisser, John S.; Zajac, David J.

    2017-01-01

    Purpose: The objective was to determine velopharyngeal (VP) status of stop consonants and vowels produced by young children with repaired cleft palate (CP) and typically developing (TD) children from 12 to 18 months of age. Method: Nasal ram pressure (NRP) was monitored in 9 children (5 boys, 4 girls) with repaired CP with or without cleft lip and…

  4. Evaluation of the localization auditory screening test in children 6-18 months of age.

    PubMed

    Tillis, C H; Grimm, W A

    1978-01-01

    The present paper is a report of a project to develop an automated auditory screening test for infants six to 18 months of age. The first year of the project was devoted to developing equipment and test procedures; the second year was concerned with testing the effectiveness of the equipment and procedures on an actual population of six to 18 month old infants. Two-hundred and fifty infants were screened auditorily as part of a county health department child development clinic. The pass/fail results of the screening test were evaluated in terms of physical and developmental examination following the screening and by means of a case review of the child's previous history. The results indicate that the procedure under investigation can be used to differentiate the normal hearing infant from the infant with possible hearing problems. It is shown by the test environment in which this study was conducted that the procedure reported can be successfully incorporated into a public health program, i.e., child development clinics or EPSDT programs.

  5. Throwing enhances humeral shaft cortical bone properties in pre-pubertal baseball players: a 12-month longitudinal pilot study.

    PubMed

    Weatherholt, Alyssa M; Warden, Stuart J

    2018-06-01

    To explore throwing athletes as a prospective, within-subject controlled model for studying the response of the skeleton to exercise. Male pre-pubertal throwing athletes (n=12; age=10.3±0.6 yrs) had distal humerus cortical volumetric bone mineral density (Ct.vBMD), cortical bone mineral content (Ct.BMC), total area (Tt.Ar), cortical area (Ct.Ar), medullary area (Me.Ar), cortical thickness (Ct.Th) and polar moment of inertia (IP) assessed within their throwing (exercised) and nonthrowing (control) arms by peripheral quantitative computed tomography at baseline and 12 months. Throwing-to-nonthrowing arm percent differences (i.e. bilateral asymmetry) were compared over time. Over 12 months, the throwing arm gained 4.3% (95% Cl=1.1% to 7.5%), 2.9% (95% Cl=0.3% to 5.4%), 3.9% (95% Cl=0.7% to 7.0%), and 8.2% (95% Cl=2.0% to 6.8%) more Ct.BMC, Ct.Ar, Tt.Ar, and I P than the nonthrowing arm, respectively (all p<0.05). There was no significant effect of throwing on Ct.vBMD, Ct.Th and Me.Ar (all p=0.18-0.82). Throwing induced surface-specific cortical bone adaptation at the distal humeral diaphysis that contributed to a gain in estimated strength. These longitudinal pilot data support the utility of throwing athletes as a within-subject controlled model to explore factors influencing exercise-induced bone adaptation during the critical growing years.

  6. Biomass fuel use for household cooking in Swaziland: is there an association with anaemia and stunting in children aged 6-36 months?

    PubMed

    Machisa, Mercilene; Wichmann, Janine; Nyasulu, Peter S

    2013-09-01

    This study is the second to investigate the association between the use of biomass fuels (BMF) for household cooking and anaemia and stunting in children. Such fuels include coal, charcoal, wood, dung and crop residues. Data from the 2006-2007 Swaziland Demographic and Health Survey (a cross-sectional study design) were analysed. Childhood stunting was ascertained through age and height, and anaemia through haemoglobin measurement. The association between BMF use and health outcomes was determined in multinomial logistic regression analyses. Various confounders were considered in the analyses. A total of 1150 children aged 6-36 months were included in the statistical analyses, of these 596 (51.8%) and 317 (27.6%) were anaemic and stunted, respectively. BMF use was not significantly associated with childhood anaemia in univariate analysis. Independent risk factors for childhood anaemia were child's age, history of childhood diarrhoea and mother's anaemia status. No statistically significant association was observed between BMF use and childhood stunting, after adjusting for child's gender, age, birth weight and preceding birth interval. This study identified the need to prioritize childhood anaemia and stunting as health outcomes and the introduction of public health interventions in Swaziland. Further research is needed globally on the potential effects of BMF use on childhood anaemia and stunting.

  7. The First Year Inventory: a longitudinal follow-up of 12-month-old to 3-year-old children.

    PubMed

    Turner-Brown, Lauren M; Baranek, Grace T; Reznick, J Steven; Watson, Linda R; Crais, Elizabeth R

    2013-09-01

    The First Year Inventory is a parent-report measure designed to identify 12-month-old infants at risk for autism spectrum disorder. First Year Inventory taps behaviors that indicate risk in the developmental domains of sensory-regulatory and social-communication functioning. This longitudinal study is a follow-up of 699 children at 3 years of age from a community sample whose parents completed the First Year Inventory when their children were 12 months old. Parents of all 699 children completed the Social Responsiveness Scale-Preschool version and the Developmental Concerns Questionnaire to determine age 3 developmental outcomes. In addition, children deemed at risk for autism spectrum disorder based on liberal cut points on the First Year Inventory, Social Responsiveness Scale-Preschool, and/or Developmental Concerns Questionnaire were invited for in-person diagnostic evaluations. We found 9 children who had a confirmed diagnosis of autism spectrum disorder from the sample of 699. Receiver operating characteristic analyses determined that a two-domain cutoff score yielded optimal classification of children: 31% of those meeting algorithm cutoffs had autism spectrum disorder and 85% had a developmental disability or concern by age 3. These results suggest that the First Year Inventory is a promising tool for identifying 12-month-old infants who are at risk for an eventual diagnosis of autism spectrum disorder.

  8. 1 CFR 6.4 - Monthly list of sections affected.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

  9. 1 CFR 6.4 - Monthly list of sections affected.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

  10. 1 CFR 6.4 - Monthly list of sections affected.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

  11. 1 CFR 6.4 - Monthly list of sections affected.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

  12. 1 CFR 6.4 - Monthly list of sections affected.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

  13. Comparative humoral and cellular immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and HPV-6/11/16/18 vaccine in healthy women aged 18-45 years: follow-up through Month 48 in a Phase III randomized study.

    PubMed

    Einstein, Mark H; Levin, Myron J; Chatterjee, Archana; Chakhtoura, Nahida; Takacs, Peter; Catteau, Grégory; Dessy, Francis J; Moris, Philippe; Lin, Lan; Struyf, Frank; Dubin, Gary

    2014-01-01

    We previously reported higher anti-HPV-16 and -18 immune responses induced by HPV-16/18 vaccine compared with HPV-6/11/16/18 vaccine at Month 7 (one month after completion of full vaccination series) in women aged 18-45 y in an observer-blind study NCT00423046; the differences of immune response magnitudes were maintained up to Month 24. Here we report follow-up data through Month 48. At Month 48, in according-to-protocol cohort for immunogenicity (seronegative and DNA-negative for HPV type analyzed at baseline), geometric mean titers of serum neutralizing antibodies were 2.0- to 5.2-fold higher (HPV-16) and 8.6- to 12.8-fold higher (HPV-18) in HPV-16/18 vaccine group than in HPV-6/11/16/18 vaccine group. The majority of women in both vaccine groups remained seropositive for HPV-16. The same trend was observed for HPV-18 in HPV-16/18 vaccine group; however, seropositivity rates in HPV-6/11/16/18 vaccine group decreased considerably, particularly in the older age groups. In the total vaccinated cohort (regardless of baseline serological and HPV-DNA status), anti-HPV-16 and -18 neutralizing antibody levels induced by HPV-16/18 vaccine were higher than those induced by HPV-6/11/16/18 vaccine. CD4+ T-cell response for HPV-16 and HPV-18 was higher in HPV-16/18 vaccine group than in HPV-6/11/16/18 vaccine group. Memory B-cell responses appeared similar between vaccine groups. Both vaccines were generally well tolerated. Overall, the higher immune response observed with the HPV-16/18 vaccine was maintained up to Month 48. A head-to-head study incorporating clinical endpoints would be required to confirm whether the observed differences in immune response between the vaccines influence the duration of protection they provided.

  14. Foetal haemoglobin concentration at postmenstrual age is unaffected by gestational age at birth.

    PubMed

    Watanabe, Yuki; Osawa, Kayo; Sato, Itsuko; Iwatani, Sota; Kono, Ruri; Hayakawa, Ikuyo; Hayashi, Nobuhide; Iijima, Kazumoto; Saegusa, Jun; Morioka, Ichiro

    2018-05-01

    Background Our aim was to determine whether the postnatal age or postmenstrual age is a more appropriate criterion for evaluating foetal haemoglobin concentrations. Methods Blood samples ( n = 1095) were obtained from 394 infants and were divided into two groups based on gestational age at birth: <37 weeks ( n = 491) and ≥37 weeks ( n = 604). (1) Foetal haemoglobin concentrations divided by one month at age after birth were compared between the groups. (2) Foetal haemoglobin concentrations divided into ≤9 months from last menstruation and one month thereafter were compared between the groups. Results In samples from infants ≥37 weeks' gestational age at birth, the median foetal haemoglobin concentrations were 69.5%, 21.4% and 3.6% at 0-1 month, 2-3 months and ≥5 months after birth, respectively. The median foetal haemoglobin concentrations in infants <37 weeks' gestational age at birth were 75.5%, 62.7% and 5.1% at 0-1 month, 2-3 months and ≥5 months after birth, respectively. The median foetal haemoglobin concentrations in infants <37 weeks' gestational age at birth were significantly higher than that in infants ≥37 weeks' gestational age at birth at all postnatal age points. (2) There was no significant difference between the groups at all age points after nine months of postmenstrual age: 72.5 and 75.3% at 9-10 months, 25.1 and 26.6% at 11-12 months and 5.5 and 4.6% at >13 months after last menstruation in infants ≥37 and <37 weeks' gestational age at birth, respectively. Conclusions Evaluation of foetal haemoglobin concentrations at postmenstrual age is unaffected by gestational age at birth.

  15. PositiveLinks: A Mobile Health Intervention for Retention in HIV Care and Clinical Outcomes with 12-Month Follow-Up

    PubMed Central

    Ingersoll, Karen; Flickinger, Tabor E.; Waldman, Ava Lena; Grabowski, Marika; Laurence, Colleen; Wispelwey, Erin; Reynolds, George; Conaway, Mark; Cohn, Wendy F.

    2018-01-01

    Abstract Mobile health interventions may help People Living with HIV (PLWH) improve engagement in care. We designed and piloted PositiveLinks, a clinic-affiliated mobile intervention for PLWH, and assessed longitudinal impact on retention in care and viral suppression. The program was based at an academic Ryan White Clinic serving a nonurban population in Central Virginia. The PL intervention included a smartphone app that connected participants to clinic staff and provided educational resources, daily queries of stress, mood and medication adherence, weekly quizzes, appointment reminders, and a virtual support group. Outcomes were analyzed using McNemar's tests for HRSA-1, visit constancy, and viral suppression and nonparametric Wilcoxon signed-rank tests for CD4 counts and viral loads. Of 77 participants, 63% were male, 49% black non-Hispanic, and 72% below the federal poverty level. Participants' achievement of a retention in care benchmark (HRSA-1) increased from 51% at baseline to 88% at 6 months (p < 0.0001) and 81% at 12 months (p = 0.0003). Visit constancy improved from baseline to 6 months (p = 0.016) and 12 months (p = 0.0004). Participants' mean CD4 counts increased from baseline to 6 months (p = 0.0007) and 12 months (p = 0.0005). The percentage of participants with suppressed viral loads increased from 47% at baseline to 87% at 6 months (p < 0.0001) and 79% at 12 months (p = 0.0007). This study is one of the first to demonstrate that a mobile health intervention can have a positive impact on retention in care and clinical outcomes for vulnerable PLWH. Next steps include integration with clinical practice and dissemination. PMID:29851504

  16. Vitamin D insufficiency in the first 6 months of infancy and challenge-proven IgE-mediated food allergy at 1 year of age: a case-cohort study.

    PubMed

    Molloy, J; Koplin, J J; Allen, K J; Tang, M L K; Collier, F; Carlin, J B; Saffery, R; Burgner, D; Ranganathan, S; Dwyer, T; Ward, A C; Moreno-Betancur, M; Clarke, M; Ponsonby, A L; Vuillermin, P

    2017-08-01

    Ecological evidence suggests vitamin D insufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D 3 (25(OH)D 3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D 3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Children concurrently wasted and stunted: A meta‐analysis of prevalence data of children 6–59 months from 84 countries

    PubMed Central

    Khara, Tanya; Mwangome, Martha; Ngari, Moses

    2017-01-01

    Abstract Children can be stunted and wasted at the same time. Having both deficits greatly elevates risk of mortality. The analysis aimed to estimate the prevalence and burden of children aged 6–59 months concurrently wasted and stunted. Data from demographic and health survey and Multi‐indicator Cluster Surveys datasets from 84 countries were analysed. Overall prevalence for being wasted, stunted, and concurrently wasted and stunted among children 6 to 59 months was calculated. A pooled prevalence of concurrence was estimated and reported by gender, age, United Nations regions, and contextual categories. Burden was calculated using population figures from the global joint estimates database. The pooled prevalence of concurrence in the 84 countries was 3.0%, 95% CI [2.97, 3.06], ranging from 0% to 8.0%. Nine countries reported a concurrence prevalence greater than 5%. The estimated burden was 5,963,940 children. Prevalence of concurrence was highest in the 12‐ to 24‐month age group 4.2%, 95% CI [4.1, 4.3], and was significantly higher among boys 3.54%, 95% CI [3.47, 3.61], compared to girls; 2.46%, 95% CI [2.41, 2.52]. Fragile and conflict‐affected states reported significantly higher concurrence 3.6%, 95% CI [3.5, 3.6], than those defined as stable 2.24%, 95% CI [2.18, 2.30]. This analysis represents the first multiple country estimation of the prevalence and burden of children concurrently wasted and stunted. Given the high risk of mortality associated with concurrence, the findings indicate a need to report on this condition as well as investigate whether these children are being reached through existing programmes. PMID:28944990

  18. The relationship between antibiotic therapy in early childhood and the symptoms of allergy in children aged 6-8 years - the questionnaire study results.

    PubMed

    Raciborski, Filip; Tomaszewska, Aneta; Komorowski, Jarosław; Samel-Kowalik, Piotr; Białoszewski, Artur Z; Walkiewicz, Artur; Lusawa, Adam; Szymański, Jakub; Opoczyńska, Dagmara; Drużba, Michał; Borowicz, Jacek; Lipiec, Agnieszka; Kapalczynski, Wojciech J; Samoliński, Bolesław

    2012-09-01

    Studies based on the ISAAC questionnaire suggest a correlation between the use of antibiotics and the prevalence of asthma and allergy in children aged 6-7 years. The number of courses of antibiotic therapy is an important factor. To investigate the relationship between the use of antibiotics during the first years of life and the prevalence of allergy and asthma among children (aged 6-8 years) in the urban population of Poland. A survey-based study with a self-completed questionnaire. The respondents were parents of children aged 6-8 years living in Warszawa, Poland. 1461 completed questionnaires were collected. Asthma was declared in 4.3% of the children. Wheezing and/or sibilant rhonchi within 12 months before the study was observed in 13.5% of the cases. Asthma medication was taken by 21.8% of the children. Allergic rhinitis was declared in 18.7% of the children. Problems with sneezing, rhinorrhea, and nasal congestion not associated with cold or fever were observed in 40.7% of the children. The analysis of the odds ratios between the use of antibiotics and the symptoms of allergic diseases revealed a clear correlation. The highest odds ratio was observed between the completion of over three courses of antibiotic therapy prior to the age of 12 months and the declaration of one of the following: asthma (OR = 5.59, 95% CI: 2.6-12.01), wheezing and/or sibilant rhonchi (OR = 4.68, 95% CI: 3.01-7.27) and taking medicines for breathlessness (OR = 5.12, 95% CI: 3.42-7.68). There is a direct relationship between antibiotic use in the first 3 years of life and asthma and allergy symptoms in children aged 6-8 years old.

  19. Children with Down Syndrome: oral development and morphology after use of palatal plates between 6 and 18 months of age.

    PubMed

    Bäckman, B; Grevér-Sjölander, A-C; Holm, A-K; Johansson, I

    2003-09-01

    The aim of this study was to describe oral development and morphology in 18-month-old children with Down syndrome (DS) treated with palatal plates in combination with structured communication and speech training. The aim is further to describe the design of the palatal plates, compliance in their use and to give a brief report of their effect on oral motor function and speech. Forty-two children with DS were followed from < or = 6 months of age until 18+/-3 months old. In addition to language intervention, and oral motor and sensory stimulation provided by speech therapists for all children with DS in Sweden, palatal plates provided by dentists are included in the training programme. In the evaluation, the children in the project were compared with two control groups of children matched for age; one group of children with DS who had not been treated with palatal plates, and one group of children with normal development. Compared to the children with normal development, both groups of children with DS had fewer teeth erupted and a lower prevalence of sucking habits. Deviant morphology of the tongue in the form of diastase, lingua plicata or a sulcus in the anterior third of the tongue was only seen in children with DS. All children with normal development had positive values for overjet compared to 53% of the children with DS. The palatal plates were used 2-3 times daily for a total mean time of 15 min. Compliance in use of the plates decreased with age, mainly due to eruption of teeth and subsequent loss of retention. Evaluation of oral motor function and speech show that the children with DS in the project had better motor prerequisites for articulation than the control children with DS. Palatal plate therapy did not affect oral parameters, i.e., eruption of teeth, types and prevalence of sucking habits, tongue morphology and symptoms of hypotonia. In combination with oral motor and sensory stimulation, palatal plate therapy had a positive effect on oral motor

  20. Long Term Natural History Data in Ambulant Boys with Duchenne Muscular Dystrophy: 36-Month Changes

    PubMed Central

    Sormani, Maria Pia; Messina, Sonia; D′Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D′Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P.; Bertini, Enrico; Mercuri, Eugenio

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of −15.8 (SD 77.3) m at 12 months, of −58.9 (SD 125.7) m at 24 months and −104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available. PMID:25271887

  1. Correlates of self-report chronic insomnia disorders with 1-6 month and 6-month durations in home-dwelling urban older adults - the Shih-Pai Sleep Study in Taiwan: a cross-sectional community study.

    PubMed

    Chiou, Jing-Hui; Chen, Hsi-Chung; Chen, Kuang-Hung; Chou, Pesus

    2016-06-03

    To examine the correlates of insomnia disorder with different durations in home-dwelling older adults. A cross-sectional survey in the Shih-Pai area of Taipei City, Taiwan (The Shih-Pai Sleep Study). A total 4047 subjects over the age of 65 years completed the study (2259 men and 1788 women). The Pittsburgh Sleep Quality Index and the duration of insomnia symptoms were used to identify DSM-IV 1-6 month and 6-month insomnia disorders. The prevalence of DSM-IV defined insomnia disorder was 5.8 %; two-thirds of these case lasted for ≥6 months. The shared correlates for both 1-6 and 6-month insomnia disorders were gender (women), depression and moderate pain. Pulmonary diseases were exclusively associated with 1-6 month insomnia disorder (OR: 2.57, 95 % CI: 1.46-4.52). In contrast, heart disease (OR: 1.73, 95 % CI: 1.21-2.49) and severe pain (OR: 2.34, 95 % CI: 1.14-4.40) were associated with 6-month insomnia disorder. The prevalence of persistent insomnia disorder is higher than short-term insomnia disorder. Correlates for less persistent and more persistent insomnia disorder appears to be partially different. Duration quantifiers may be important in the identification of the etiology of insomnia and further studies with follow-ups are needed to examine the order of developing insomnia disorder and associated conditions.

  2. Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey

    PubMed Central

    Ishikawa, H.; Kawakami, N.; Kessler, R. C.

    2016-01-01

    Background The aim of this study is to estimate the lifetime and 12-month prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV) mental disorders in Japan based on the final data set of the World Mental Health Japan Survey conducted in 2002–2006. Methods Face-to-face household interviews of 4,130 respondents who were randomly selected from Japanese-speaking residents aged 20 years or older were conducted from 2002 to 2006 in 11 community populations in Japan (overall response rate, 56%). The World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay administered psychiatric diagnostic interview, was used for diagnostic assessment. Results Lifetime/12-month prevalence of any DSM-IV common mental disorders in Japan was estimated to be 20.3/7.6%. Rank-order of four classes of mental disorders was anxiety disorders (8.1/4.9%), substance disorders (7.4/1.0%), mood disorders (6.5/2.3%), and impulse control disorders (2.0/0.7%). The most common individual disorders were alcohol abuse/dependence (7.3/0.9%), major depressive disorder (6.1/2.2%), specific phobia (3.4/2.3%), and generalized anxiety disorder (2.6/1.3%). While the lifetime prevalence of any mental disorder was greater for males and the middle-aged, the persistence (proportion of 12-month cases among lifetime cases) of any mental disorder was greater for females and younger respondents. Among those with any 12-month disorder, 15.3% were classified as severe, 44.1% moderate, and 40.6% mild. Although a strong association between severity and service use was found, only 21.9% of respondents with any 12-month disorder sought treatment within the last 12 months; only 37.0% of severe cases received medical care. The mental health specialty sector was the most common resource used in Japan. Although the prevalence of mental disorders were quite low, mental disorders were the second

  3. Validation of the Infant-Toddler Checklist as a Broadband Screener for Autism Spectrum Disorders from 9 to 24 Months of Age

    PubMed Central

    Wetherby, Amy M.; Brosnan-Maddox, Susan; Peace, Vickie; Newton, Laura

    2009-01-01

    The purpose of this study was to examine the validity of the Infant-Toddler Checklist (ITC) as a broadband screener to detect infants and toddlers with communication delays including ASD from a general population sample. The ITC was used to screen 5,385 children from 6–24 months of age. Three surveillance methods were used to detect children with possible ASD and diagnosis was confirmed at a mean age of 3 years. Positive and negative predictive values support the validity of the ITC for children 9–24 months of age but not 6–8 months. Of 60 children diagnosed with ASD, 56 had a positive screen on the ITC; parent concern increased with child age from less than half reporting concern from 6–15 months and nearly three-fourths at 21–24 months. Implications for improving early detection of ASD are discussed. PMID:18805944

  4. Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 612 Years of Age in Mexico

    PubMed Central

    Thomas, Deena; Hu, Howard; Angeles Martinez-Mier, E.; Sanchez, Brisa N.; Basu, Niladri; Peterson, Karen E.; Ettinger, Adrienne S.; Wright, Robert; Zhang, Zhenzhen; Liu, Yun; Schnaas, Lourdes; Mercado-García, Adriana; María Téllez-Rojo, Martha; Hernández-Avila, Mauricio

    2017-01-01

    Background: Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. Objective: Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. Methods: We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 612 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children’s Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 612. Results: We had complete data on 299 mother–child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n=299) and children with available urine samples (n=211) were 0.90 (0.35) mg/L and 0.82 (0.38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0.5mg/L (approximately the IQR) predicted 3.15 (95% CI: −5.42, −0.87) and 2.50 (95% CI −4.12, −0.59) lower offspring GCI and IQ scores, respectively. Conclusions: In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 612 y. https://doi.org/10.1289/EHP655 PMID:28937959

  5. Perceptual Learning: 12-Month-Olds' Discrimination of Monkey Faces

    ERIC Educational Resources Information Center

    Fair, Joseph; Flom, Ross; Jones, Jacob; Martin, Justin

    2012-01-01

    Six-month-olds reliably discriminate different monkey and human faces whereas 9-month-olds only discriminate different human faces. It is often falsely assumed that perceptual narrowing reflects a permanent change in perceptual abilities. In 3 experiments, ninety-six 12-month-olds' discrimination of unfamiliar monkey faces was examined. Following…

  6. Advancing age increases sperm chromatin damage and impairs fertility in peroxiredoxin 6 null mice

    PubMed Central

    Ozkosem, Burak; Feinstein, Sheldon I.; Fisher, Aron B.; O’Flaherty, Cristian

    2015-01-01

    Due to socioeconomic factors, more couples are choosing to delay conception than ever. Increasing average maternal and paternal age in developed countries over the past 40 years has raised the question of how aging affects reproductive success of males and females. Since oxidative stress in the male reproductive tract increases with age, we investigated the impact of advanced paternal age on the integrity of sperm nucleus and reproductive success of males by using a Prdx6−/− mouse model. We compared sperm motility, cytoplasmic droplet retention sperm chromatin quality and reproductive outcomes of young (2-month-old), adult (8-month-old), and old (20-month-old) Prdx6−/− males with their age-matched wild type (WT) controls. Absence of PRDX6 caused age-dependent impairment of sperm motility and sperm maturation and increased sperm DNA fragmentation and oxidation as well as decreased sperm DNA compaction and protamination. Litter size, total number of litters and total number of pups per male were significantly lower in Prdx6−/− males compared to WT controls. These abnormal reproductive outcomes were severely affected by age in Prdx6−/− males. In conclusion, the advanced paternal age affects sperm chromatin integrity and fertility more severely in the absence of PRDX6, suggesting a protective role of PRDX6 in age-associated decline in the sperm quality and fertility in mice. PMID:25796034

  7. Advancing age increases sperm chromatin damage and impairs fertility in peroxiredoxin 6 null mice.

    PubMed

    Ozkosem, Burak; Feinstein, Sheldon I; Fisher, Aron B; O'Flaherty, Cristian

    2015-08-01

    Due to socioeconomic factors, more couples are choosing to delay conception than ever. Increasing average maternal and paternal age in developed countries over the past 40 years has raised the question of how aging affects reproductive success of males and females. Since oxidative stress in the male reproductive tract increases with age, we investigated the impact of advanced paternal age on the integrity of sperm nucleus and reproductive success of males by using a Prdx6(-/-) mouse model. We compared sperm motility, cytoplasmic droplet retention sperm chromatin quality and reproductive outcomes of young (2-month-old), adult (8-month-old), and old (20-month-old) Prdx6(-/-) males with their age-matched wild type (WT) controls. Absence of PRDX6 caused age-dependent impairment of sperm motility and sperm maturation and increased sperm DNA fragmentation and oxidation as well as decreased sperm DNA compaction and protamination. Litter size, total number of litters and total number of pups per male were significantly lower in Prdx6(-/-) males compared to WT controls. These abnormal reproductive outcomes were severely affected by age in Prdx6(-/-) males. In conclusion, the advanced paternal age affects sperm chromatin integrity and fertility more severely in the absence of PRDX6, suggesting a protective role of PRDX6 in age-associated decline in the sperm quality and fertility in mice. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  8. EEG and Heart Rate Measures of Working Memory at 5 and 10 Months of Age

    PubMed Central

    Cuevas, Kimberly; Bell, Martha Ann; Marcovitch, Stuart; Calkins, Susan D.

    2013-01-01

    We recorded electroencephalogram (EEG; 6–9 Hz) and heart rate (HR) from infants at 5 and 10 months of age during baseline and performance on the looking A-not-B task of infant working memory (WM). Longitudinal baseline-to-task comparisons revealed WM-related increases in EEG power (all electrodes) and EEG coherence (medial frontal-occipital electrode pairs) at both ages. WM-related decreases in HR were only present at 5 months, and WM-related increases in EEG coherence became more localized by 10 months. Regression analyses revealed that baseline-to-task changes in psychophysiology accounted for variability in WM performance at 10, but not 5, months. HR and EEG power (medial frontal and lateral frontal electrodes) were unique predictors of variability in 10-month WM performance. These findings are discussed in relation to frontal lobe development, and represent the first comprehensive longitudinal analysis of age-related changes in the behavioral and psychophysiological correlates of WM. PMID:22148943

  9. Vaccine immune response and interference of colostral antibodies in calves vaccinated against rabies at 2, 4 and 6 months of age born from antirabies revaccinated females.

    PubMed

    Filho, O A; Megid, J; Geronutti, L; Ratti, J; Almeida, M F A; Kataoka, A P A G; Martorelli, L F A

    2012-06-01

    Considering the high prevalence of rabies in cattle, we aimed to evaluate the interference of colostral antibodies transferred to calves after birth and the benefit of administering an antirabies vaccination in two-month-old calves compared to vaccinating at 4 and 6 months of age. Calves born from females revaccinated against rabies during the third trimester of pregnancy were studied. Forty-eight hours after parturition, blood samples from dams and offspring were collected, and antirabies neutralizing antibody titers were analyzed using the Rapid Focus Fluorescent Inhibition Test. We found that all calves had similar titers of antibodies transferred through the colostrum. Furthermore, none of the calves presented a satisfactory serological response after the first vaccination, but all had an appropriate response after revaccination. This study demonstrates that antirabies vaccination should be recommended for calves at two months of age in endemic and epizootic situations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Infant Humor Perception from 3- to 6-months and Attachment at One Year

    PubMed Central

    Mireault, Gina; Sparrow, John; Poutre, Merlin; Perdue, Brittany; Macke, Laura

    2012-01-01

    Infancy is a critical time for the development of secure attachment, which is facilitated by emotionally synchronous interactions with parents. Humor development, which includes shared laughter and joint attention to an event, emerges concurrently with attachment, but little is known regarding the relationship, if any, between humor development and attachment in the first year. Thirty 3-month-old infants were videoed at home each month until they were 6-months old while their parents attempted to amuse them. Frequency of infants’ smiles and laughs served as a measure of “state humor”, and the smiling/laughing subscale of the Infant Behavior Questionnaire-Revised served as a measure of “trait humor”. State and trait humor were not correlated. Lower trait humor as 6 months predicted higher attachment security on the Attachment Q-sort at 12-months (r=. 46), suggesting that less good-humored infants elicit greater parental engagement, which works to the benefit of attachment, or vice versa. Future studies should examine the importance of smiling and laughter as they relate to other developmental phenomena in the first year. PMID:22982281

  11. Infant humor perception from 3- to 6-months and attachment at one year.

    PubMed

    Mireault, Gina; Sparrow, John; Poutre, Merlin; Perdue, Brittany; Macke, Laura

    2012-12-01

    Infancy is a critical time for the development of secure attachment, which is facilitated by emotionally synchronous interactions with parents. Humor development, which includes shared laughter and joint attention to an event, emerges concurrently with attachment, but little is known regarding the relationship, if any, between humor development and attachment in the first year. Thirty 3-month-old infants were videoed at home each month until they were 6-months old while their parents attempted to amuse them. Frequency of infants' smiles and laughs served as a measure of "state humor", and the smiling/laughing subscale of the Infant Behavior Questionnaire-Revised served as a measure of "trait humor". State and trait humor were not correlated. Lower trait humor as 6 months predicted higher attachment security on the Attachment Q-sort at 12-months (r=.46), suggesting that less good-humored infants elicit greater parental engagement, which works to the benefit of attachment, or vice versa. Future studies should examine the importance of smiling and laughter as they relate to other developmental phenomena in the first year. Published by Elsevier Inc.

  12. Anthropometric evaluation of indigenous Brazilian children under 60 months of age using NCHS/1977 and WHO/2005 growth curves.

    PubMed

    Orellana, Jesem D Y; Santos, Ricardo V; Coimbra, Carlos E A; Leite, Maurício S

    2009-01-01

    To perform a comparative analysis of anthropometric data from Suruí, Xavánte and Wari' indigenous children under 60 months of age using the NCHS/1977 and the WHO/2005 growth curves. Anthropometric measurements followed standard procedures and the data obtained were converted into z scores using the Epi-Info (Version 3.4) and WHO-Anthro (Version Beta) softwares. The indices height/age (H/A), weight/age (W/A) and weight/height (W/H) were descriptors of nutritional status for all children under 60 months of age, as well as the body mass index (BMI) for children 24-59 months old. The frequencies of Suruí children < -2 z scores for H/A were 31.4 (NCHS/1977) and 38.6% (WHO/2005); Xavánte 30.9 and 42.3%; Wari' 61.7 and 68.3%. The frequencies of Suruí children < -2 z scores for W/A were 12.4 (NCHS/1977) and 8.5% (WHO/2005); Xavánte 16.5 and 11.6%; Wari' 51.7 and 45.0%. None of the Suruí children were < -2 z scores for W/H (NCHS/1977 and WHO/2005); the frequencies of Xavánte children were 1.7 and 3.3% and Wari' 1.7 and 0.0%. The frequencies of Suruí children > 2 z scores for W/H were 3.9 (NCHS/1977) and 3.9% (WHO/2005); Xavánte 0.0 and 0.8%; Wari' 0.0 and 0.0%. The frequency of Suruí children aged 24-59 months > 2 z scores for BMI was 5.4% (WHO/2005); Xavánte 9.5%; and Wari' 0.0%. Our findings revealed important differences in the results from nutritional assessment, according to the set of growth curves used; however, the use of both growth curves revealed a high prevalence of malnutrition. Therefore, future studies with indigenous populations should present their results using two sets of growth curves to allow consistent comparison.

  13. Feeding Your 8- to 12-Month-Old

    MedlinePlus

    ... cause botulism in babies. Do not give regular cow's milk until your baby is older than 12 months ... babies are ready to go from formula to cow's milk. If you're breastfeeding, you can continue beyond ...

  14. Changes in Oxygen Consumption and Heart Rate After Acute Myocardial Infarction During 6-Month Follow-up.

    PubMed

    Choe, Yuri; Han, Jae-Young; Choi, In-Sung; Park, Hyeng-Kyu

    2018-06-01

    Exercise intensity is a particularly important determinant of physiological responses to exercise training in patients with acute myocardial infarction. Heart rate (HR) is commonly used as a practical way of prescribing and monitoring exercise as specific intensities based on a linear relationship between the percentage of maximum HR (%HR max ) and the percentage of maximum oxygen consumption (%VO 2max ) regardless of age, gender, or exercise mode. To examine the change in variability in the correlation between %HR max and %VO 2max after acute myocardial infarction. Retrospective study. Regional cardio-cerebrovascular center at a tertiary hospital. A total of 66 patients were enrolled who were referred for cardiac rehabilitation (CR) after percutaneous intervention, and who had reached stage 3 of the modified Bruce Protocol (mBP) on an exercise tolerance test (ETT). There were 54 men and 12 women with an average age of 56.7 ± 9.48 years, ejection fraction (EF) of 56.4% ± 8.89%, and body mass index (BMI) of 24.73 ± 2.86 kg/m 2 . All patients participated in a 4-week outpatient CR program and underwent ETT with a gas analyzer to determine maximal heart rate and maximal oxygen consumption before CR and 1 month, 3 months, and 6 months after CR. VO 2max and HR max were defined as the highest values attained during the ETT. The HR and VO 2 values at each stage of the mBP were expressed as percentages of their maximum. %HR max and %VO 2max were calculated at each stage of the mBP. The maximum METs and VO 2max significantly improved at 1 month after CR, but not significantly at 3 and 6 months after CR. The correlation between VO 2max and HR max progressively changed in a favorable manner during CR. The relationship between %HR max and %VO 2max indicated a coefficient of variation before and 1, 3, and 6 months after of 0.800, 0.826, 0.832, and 0.880, respectively. This study showed that the %HR max correlates better with the %VO 2max in the late-stage post-AMI than in

  15. Effects of water-aging for 6 months on the durability of a novel antimicrobial and protein-repellent dental bonding agent.

    PubMed

    Zhang, Ning; Zhang, Ke; Weir, Michael D; Xu, David J; Reynolds, Mark A; Bai, Yuxing; Xu, Hockin H K

    2018-06-21

    Biofilms at the tooth-restoration bonded interface can produce acids and cause recurrent caries. Recurrent caries is a primary reason for restoration failures. The objectives of this study were to synthesize a novel bioactive dental bonding agent containing dimethylaminohexadecyl methacrylate (DMAHDM) and 2-methacryloyloxyethyl phosphorylcholine (MPC) to inhibit biofilm formation at the tooth-restoration margin and to investigate the effects of water-aging for 6 months on the dentin bond strength and protein-repellent and antibacterial durability. A protein-repellent agent (MPC) and antibacterial agent (DMAHDM) were added to a Scotchbond multi-purpose (SBMP) primer and adhesive. Specimens were stored in water at 37 °C for 1, 30, 90, or 180 days (d). At the end of each time period, the dentin bond strength and protein-repellent and antibacterial properties were evaluated. Protein attachment onto resin specimens was measured by the micro-bicinchoninic acid approach. A dental plaque microcosm biofilm model was used to test the biofilm response. The SBMP + MPC + DMAHDM group showed no decline in dentin bond strength after water-aging for 6 months, which was significantly higher than that of the control (P < 0.05). The SBMP + MPC + DMAHDM group had protein adhesion that was only 1/20 of that of the SBMP control (P < 0.05). Incorporation of MPC and DMAHDM into SBMP provided a synergistic effect on biofilm reduction. The antibacterial effect and resistance to protein adsorption exhibited no decrease from 1 to 180 d (P > 0.1). In conclusion, a bonding agent with MPC and DMAHDM achieved a durable dentin bond strength and long-term resistance to proteins and oral bacteria. The novel dental bonding agent is promising for applications in preventive and restorative dentistry to reduce biofilm formation at the tooth-restoration margin.

  16. Home-based Early Intervention on Auditory and Speech Development in Mandarin-speaking Deaf Infants and Toddlers with Chronological Aged 7-24 Months.

    PubMed

    Yang, Ying; Liu, Yue-Hui; Fu, Ming-Fu; Li, Chun-Lin; Wang, Li-Yan; Wang, Qi; Sun, Xi-Bin

    2015-08-20

    Early auditory and speech development in home-based early intervention of infants and toddlers with hearing loss younger than 2 years are still spare in China. This study aimed to observe the development of auditory and speech in deaf infants and toddlers who were fitted with hearing aids and/or received cochlear implantation between the chronological ages of 7-24 months, and analyze the effect of chronological age and recovery time on auditory and speech development in the course of home-based early intervention. This longitudinal study included 55 hearing impaired children with severe and profound binaural deafness, who were divided into Group A (7-12 months), Group B (13-18 months) and Group C (19-24 months) based on the chronological age. Categories auditory performance (CAP) and speech intelligibility rating scale (SIR) were used to evaluate auditory and speech development at baseline and 3, 6, 9, 12, 18, and 24 months of habilitation. Descriptive statistics were used to describe demographic features and were analyzed by repeated measures analysis of variance. With 24 months of hearing intervention, 78% of the patients were able to understand common phrases and conversation without lip-reading, 96% of the patients were intelligible to a listener. In three groups, children showed the rapid growth of trend features in each period of habilitation. CAP and SIR scores have developed rapidly within 24 months after fitted auxiliary device in Group A, which performed much better auditory and speech abilities than Group B (P < 0.05) and Group C (P < 0.05). Group B achieved better results than Group C, whereas no significant differences were observed between Group B and Group C (P > 0.05). The data suggested the early hearing intervention and home-based habilitation benefit auditory and speech development. Chronological age and recovery time may be major factors for aural verbal outcomes in hearing impaired children. The development of auditory and speech in hearing

  17. Chemical composition, vitamin E content, lipid oxidation, colour and cooking losses in meat from Tudanca bulls finished on semi-extensive or intensive systems and slaughtered at 12 or 14 months.

    PubMed

    Humada, M J; Sañudo, C; Serrano, E

    2014-02-01

    The effects of production system (SE: pasture based vs. IN: concentrate based) and slaughter age (12 vs. 14 months) on chemical composition, vitamin E and myoglobin contents, lipid oxidation at 0, 3 and 6 days of display, colour and cooking losses at 2 and 7 days postmortem from thirty-three Tudanca calves were studied. SE animals showed lower IMF and greater vitamin E contents (1.2 vs. 2.9% and 4.1 vs. 1.8 μg/g, respectively). Thiobarbituric acid reactive substances (TBARS) increased (p ≤ 0.001) with display time and was greater in the IN system. After 6 days display, IN animals presented twofold TBARS values (1.4 vs. 0.8 mg malonaldehyde/kg meat). At 7 days postmortem, SE groups presented greater (p ≤ 0.05) L* and lower (p ≤ 0.05) b* and H° than IN groups. Myoglobin increased with age (3.4 to 3.9 mg/g meat), but differences (p ≤ 0.05) on a* and C* values were observed only between 12 and 14 months at 2 days postmortem. © 2013.

  18. Long-term Seroprotection Rates Following Second Dose of Measles as MMR Vaccine at 15 months in Indian Children.

    PubMed

    Hansashree, P; Verma, Sanjay; Rawat, Amit; Sankhyan, Naveen; Bharti, Bhavneet

    2018-05-15

    To find out seropositivity rates at 4-6 and 9-12 years of age; among those who received one-dose measles at 9 months and one-dose MMR at 15 months of age. 80 healthy children (53 males) at 4-6 or 9-12 years of age, attending outpatient department for vaccination were enrolled. Antibody titers were estimated using commercially available quantitative-IgG ELISA kits. The seropositivity rates against measles, mumps, rubella were 80% (40/50), 86% (43/50), and 96% (48/50), respectively at 4-6 years, and 83.3% (25/30), 96.7% (29/30) and 96.7% (29/30), respectively at 9-12 years of age. Single dose of rubella vaccine seems to provide adequate long-term protection; however, measles vaccine requires more doses for similar protection.

  19. Do Maternal Living Arrangements Influence the Vaccination Status of Children Age 12–23 Months? A Data Analysis of Demographic Health Surveys 2010–11 from Zimbabwe

    PubMed Central

    Rossi, Rodolfo

    2015-01-01

    Introduction Although vaccination is an effective intervention to reduce childhood mortality and morbidity, reasons for incomplete vaccination, including maternal living arrangements, have been marginally explored. This study aims at assessing whether maternal living arrangements are associated with vaccination status of children aged 12–23 months in Zimbabwe. It also explores other variables that may be associated with having children not fully vaccinated. Materials and Methods A cross-sectional analysis was performed on the DHS-VI done in Zimbabwe in 2010–2011 (response rate 93%). Incomplete vaccination of children (outcome), was defined as not having received one dose of BCG and measles, 3 doses of polio and DPT/Pentavalent. Maternal living arrangements (main exposure), and other exposure variables were analysed. Survey logistic regression was used to calculate crude and adjusted OR for exposures against the outcome. Results The dataset included 1,031 children aged 12–23 months. 65.8% of children were fully vaccinated. 65.7% of the mothers were married and cohabitating with a partner, 20.3% were married/partnered but living separately and 14% were not married. Maternal living arrangements were not associated with the vaccination status of children both in crude and adjusted analysis. Factors associated with poorer vaccination status of the children included: no tetanus vaccination for mothers during pregnancy (adjusted OR = 2.1, 95%CI 1.5;3.0), child living away from mother (adjusted OR = 1.5, 95%CI 1.2;1.8), mother’s education (adjusted OR = 0.6, 95%CI 0.4;0.9), high number of children living in the household (adjusted OR = 1.5, 95%CI 1.1;2.2), child age (adjusted OR = 0.7, 95%CI 0.5;0.9). Discussion Maternal living arrangements were not associated with vaccination status of Zimbabwean children. Other factors, such as the mother’s health-seeking behaviour and education were major factors associated with the children’s vaccination status. Given the

  20. Age- and Gender-Based Populations

    MedlinePlus

    ... than women ages 12 and up reported using marijuana (10.9% vs. 6%), cocaine (0.8% vs. ... Campaign Recovery Month Recovery Month promotes the societal benefits of prevention, treatment, and recovery for mental and ...

  1. Maternal B vitamin intake during pregnancy and wheeze and eczema in Japanese infants aged 16-24 months: the Osaka Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Sasaki, Satoshi; Tanaka, Keiko; Hirota, Yoshio

    2011-02-01

    It is uncertain whether B group vitamins are risk or preventive factors for allergic disorders. We prospectively investigated the association between maternal intake of folate and vitamins B(12) , B(6) , and B(2) during pregnancy and the risk of wheeze and eczema in the infants aged 16-24 months. Subjects were 763 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed with a diet history questionnaire (DHQ). Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood. Among 763 infants, 169 (22.1%) and 142 (18.6%) had symptoms of wheeze and eczema, respectively. There were no evident relationships between maternal consumption of folate, vitamin B(12) , vitamin B(6) , and vitamin B(2) during pregnancy and the risk of wheeze or eczema in the offspring after adjustment for maternal age, gestation at baseline, residential municipality at baseline, family income, maternal and paternal education, maternal and paternal history of asthma, atopic eczema, and allergic rhinitis, changes in maternal diet in the previous 1 month, season when data at baseline were collected, maternal smoking during pregnancy, baby's older siblings, baby's sex, baby's birth weight, household smoking in the same room as the infant, breastfeeding duration, age at which solid foods were introduced, age of infant at the third survey, and maternal intake of docosahexaenoic acid, n-6 polyunsaturated fatty acids, vitamin D, calcium, vitamin E, and β-carotene during pregnancy. Further investigation is warranted to draw conclusions as to the question of whether maternal B vitamin intake during pregnancy is related to the risk of childhood allergic disorders. © 2010 John Wiley & Sons A/S.

  2. Learning, Play, and Your 8- to 12-Month-Old

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español Learning, Play, and Your 8- to 12-Month-Old ... these next few months. What Is My Child Learning? Your little one will make great strides in ...

  3. Determinants of stunting among children aged 6-59 months at Kindo Didaye woreda, Wolaita Zone, Southern Ethiopia: Unmatched case control study

    PubMed Central

    Batiro, Bancha; Demissie, Tsegaye; Halala, Yoseph

    2017-01-01

    Background Stunting is a well-established risk marker of poor child development. Globally in 2017, 155 million children under 5 were estimated to be stunted. While different activities are being done to reduce the burden of stunted growth, the problem is overwhelming in Africa; it was increased by 24%. Therefore, identifying determinants of stunting among children aged 6–59 would help to set priorities for action and to the design of stunting reduction plan at a grassroots level. Methods The unmatched case-control study was conducted in randomly selected 8 rural kebeles of Kindo Didaye woreda, Ethiopia from February to April, 2016 to identify the determinants of stunting among children aged 6–59 months. The sampling frame was identified by enumeration of 6–59 months of age children in the entire households of the study area. From which 155 as cases and 310 as controls were chosen using anthropometric measurement based on the median of WHO 2006 reference population. The anthropometric data were analyzed by WHO Anthro 2010 software to generate Z-score values. Odds Ratio along with 95% confidence interval was estimated to identify determinants of stunting using the multivariable logistic regression. Results Drinking water from unsafe source (AOR = 7.06, 95% CI; 4.40–20.42),occasionally eating animal source food (AOR = 0.51, 95% CI; 0.02–0.68), ARI in the past two weeks (AOR = 3.04, (95% CI; 1.04–13.35), late initiation of breastfeeding after one hours after birth (AOR = 5.16, 95% CI; 2.24–15.90) and lack of vaccination (AOR = 6.38, 95% CI; 2.54–17.10)were significantly associated with stunting. Conclusions Factors like exposure to diarrhea disease, exposure to acute respiratory infection, late initiation of breast milk after child breath, squeeze out of 1st breast milk, lack of vaccination, animal source of food, and unsafe source of water for drinking could be used to set priorities for action and to the design of Kindo Didaye woreda plan for stunting

  4. Immunization dropout rate and data quality among children 12-23 months of age in Ghana.

    PubMed

    Baguune, Benjamin; Ndago, Joyce Aputere; Adokiya, Martin Nyaaba

    2017-01-01

    Immunization against diseases is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, a proportion of children particularly in Africa are not fully immunized with the recommended vaccines. Thus, many children are still susceptible to the Expanded Program on Immunization (EPI) targeted diseases. The objective of this study was to determine the immunization dropout rate and data quality among children aged 12-23 months in Techiman Municipality, Ghana. A cross-sectional cluster survey was conducted among 600 children. Data was collected using semi-structured questionnaire through face-to-face interviews. Before the main data collection, the tools were pre-tested in three different communities in the Municipality. The mothers/caregivers were interviewed, extracted information from the child immunization cards and observation employed to confirm the presence of Bacillus Calmette-Guerin (BCG) scar on each child. Routine immunization data was also extracted from immunization registers and annual reports in the Municipality. I mmunization coverage for each of the fifteen vaccines doses is above 90.0% while full childhood immunized status is 89.5%. Immunization dropout rate was 5.6% (using BCG and Measles as proxy vaccines). This is lower than the 10.0% cutoff point by World Health Organization. However, routine administrative data was characterized by some discrepancies (e.g. > 100.0% immunization coverage for each of the vaccines) and high dropout rate (BCG - Measles = 31.5%). Binary regression was performed to determine predictors of dropout rate. The following were statistically significant: married (OR = 0.31; 95% = CI 0.15-0.62; and p  = 0.001), Christianity (OR = 0.27; 95% CI = 0.13-0.91; and p  < 0.001), female child (OR = 0.50; 95% CI = 0.26-0.91; and p  = 0.024) and possession of immunization card (OR = 50.3; 95% CI = 14.40-175.92; and p

  5. Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial

    PubMed Central

    Younge, John O.; Wery, Machteld F.; Utens, Elisabeth M. W. J.; Michels, Michelle; Rizopoulos, Dimitris; van Rossum, Liesbeth F. C.; Roos-Hesselink, Jolien W.; Hunink, Myriam M. G.

    2017-01-01

    There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen’s D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05–0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care. Trial registration: www.trialregister.nl NTR3453 PMID:28486559

  6. Beneficial effects of intravenous pamidronate treatment in children with osteogenesis imperfecta under 24 months of age.

    PubMed

    Kusumi, Kirsten; Ayoob, Rose; Bowden, Sasigarn A; Ingraham, Susan; Mahan, John D

    2015-09-01

    Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and low bone mass. Low bone density and fracture is a cause of morbidity. Limited data exists on bisphosphonate treatment in patients under 24 months of age. The objective of the study was to examine the safety and efficacy of pamidronate in children under 24 months with OI. To do so, we carried out a retrospective chart review and analysis of OI patients started on intravenous pamidronate under 24 months of age. Pamidronate was administered in three-day cycles. Growth, the number of fractures, and lumbar bone mineral densities were recorded both prior to and after treatment initiation. A total of 18 patients were reviewed. Five were classified as OI type I, seven were type III, and six were type IV. The mean age at treatment initiation was 12 months (range 11 days to 23 months). The mean lumbar z score at baseline was -3.63, which improved to -1.53 at one year (P < 0.01) and 0.79 (P < 0.01) at the end of the study. The fracture rate improved from 68 fractures in 209 months (0.32 fractures/patient-month) before treatment to 41 fractures in 1,248 months (0.03 fractures/patient-month) post-treatment (P < 0.05). Height standard deviation score (SDS) was conserved from baseline to end of study (-2.12 ± 2.45 vs. -2.45 ± 2.73) (P = 0.05) with an average follow-up of 73 months. The only adverse effect recorded in six infants was fever during the initial pamidronate infusion. Treatment with intravenous pamidronate is safe, significantly improves lumbar bone mineral density (L-BMD), and reduces fracture rates in young infants with OI while preserving linear growth.

  7. HIV-free survival at 12-24 months in breastfed infants of HIV-infected women on antiretroviral treatment.

    PubMed

    Chikhungu, Lana Clara; Bispo, Stephanie; Rollins, Nigel; Siegfried, Nandi; Newell, Marie-Louise

    2016-07-01

    To provide estimates of HIV-free survival at 12-24 months in breastfed children by maternal ART (6 months or lifelong) to inform WHO HIV and Infant Feeding guidelines. Eighteen studies published 2005-2015 were included in a systematic literature review (1295 papers identified, 156 abstracts screened, 55 full texts); papers were analysed by narrative synthesis and meta-analysis of HIV-free survival by maternal ART regimen in a random effects model. We also grouped studies by feeding modality. Study quality was assessed using a modified Newcastle-Ottawa Scale (NOS) and GRADE. The pooled estimates for 12-month HIV-free survival were 89.8% (95% confidence interval, CI: 86.5%, 93.2%) for infants of mothers on ART for 6 months post-natally (six studies) and 91.4% (95% CI 87.5%, 95.4%) for infants of mothers on lifelong ART (three studies). Eighteen-month HIV-free survival estimates were 89.0% (95% CI 83.9%, 94.2%) with 6 months ART (five studies) and 96.1% (95% CI 92.8%, 99.0%) with lifelong ART (three studies). Twenty-four-month HIV-free survival for infants whose mothers were on ART to 6 months post-natally (two studies) was 89.2% (95% CI 79.9%, 98.5%). Heterogeneity was considerable throughout. In four studies, HIV-free survival in breastfed infants ranged from 87% (95% CI 78%, 92%) to 96% (95% CI 91%, 98%) and in formula-fed infants from 67% (95% CI 35.5%, 87.9%) to 97.6% (95% CI 93.0%, 98.2%). Our results highlight the importance of breastfeeding for infant survival and of ART in reducing the risk of mother-to-child HIV transmission and support the WHO recommendation to initiate ART for life immediately after HIV diagnosis. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  8. [Changes in weight and diabetes compensation (HbA(1c)) in patients with diabetes mellitus type 2 after adding exenatide (Byetta) to the current treatment in 28 diabetology departments in the Czech Republic - BIBY-I study (observations lasting 3 to 12 months)].

    PubMed

    Perusicová, J; Haladová, I; Pit'hová, P; Acsová, D; Belobrádková, J; Belzová, A; Berková, K; Dolezalová, B; Dvoráková, H; Hejnicová, K; Hudcová, M; Kallmünzerová, D; Krejsová, Z; Markofová, G; Müllerová, H; Owen, K; Pelikánová, M; Raclavská, L; Racická, E; Skarpová, O; Váchová, A; Veselá, A; Vyoralos, J; Broz, J; Edelsberger, T; Honka, M; Hrdina, T; Chmura, P; Tosovský, J

    2013-03-01

    BIBY STUDY OBJECTIVE: To obtain experience with exenatide treatment (Byetta) in patients with diabetes mellitus type 2 in a common clinical practice ofdiabetology departments. TYPE OF OBSERVATION: Observational study conducted by a randomly selected group of outpatient medical practitioners from 28 diabetology departments in the Czech Republic. OBSERVED AND ASSESSED POPULATION: 465 patients underwent at least three months of Byetta treatment; 347 persons (74.6% ofthe research population) stayed forthe extended observation of 6-12 months. Apart from the basic identification data (year of birth, sex, age when diabetes mellitus manifested, height, maximum patient weight before diabetes and when diabetes mellitus manifested), the following information was recorded in three-month intervals: weight, waistline, glycated haemoglobin (HbA(1c)), and diabetes mellitus treatment The population included 50.3% women and 49.7% men, and the average age at the time of diabetes manifestation was 48 (20-73 years). The period between the diabetes manifestation and the start of exenatide treatment was 8.3 years on average. The average maximum BMI value before the detection of diabetes was 39.05 (+/- 6.73); at the time of the diabetes manifestation 37.88 (+/- 6.40); and at the start of Byetta treatment 39.01 (+/- 6.22). The BMI after three, six, and 12 months of treatment was as follows: 37.86 (+/- 6.12), 37.18 (+/- 6.0), and 36.60 (+/- 6.21); it decreased by > or = 0.5 in 83.3% patients who were under observation for 12 months. HbA(1c) value decreased in the first three months from 7.39% (+/- 1.57) to 6.41% (+/- 1.34), p < 0.0001. In the period of three-six months, the value decreased to 6.22% (+/- 1.34), and after 12 months, HbA(1c) was at 6.04 (+/- 1.20). An improvement in HbA(1c) value of 0.5-2.0% occurred after the first year in 49% of our research population. The waistline was measured on a regular basis in only 267 patients (58.9%). The average initial value of 120.7 cm was

  9. Risk factors for wheeze in the last 12 months in preschool children.

    PubMed

    Quah, B S; Mazidah, A R; Simpson, H

    2000-06-01

    Most children with asthma develop their symptoms before the age of 5 years and many preschool wheezers continue to wheeze in the early school years. It is thus important to investigate the factors that predispose young children to wheeze. The objective of this study was to investigate the relevant environmental and family influences on recent wheeze (wheeze within the last 12 months) in preschool children. A cross-sectional study was conducted in five primary health clinics in the district of Kota Bharu from April to October 1998. Nurses from these clinics distributed Bahasa Malaysia questionnaires containing questions on asthma symptoms, environmental risk factors, family's social status and family history of atopy and wheeze to preschool children aged 1-5 years during their home visits. The respondents were parent(s) or carer(s) of the children. A total of 2,524 (87.7%) complete questionnaires were available for analysis of risk factors. One hundred and fifty six (6.2%) children had current wheeze. Significant risk factors associated with current wheeze were a family history of asthma (O.R. = 6.36, 95% C.I. = 4.45-9.09), neonatal hospital admission (O.R. = 2.38, 95% C.I. = 1.51 - 3.75), and a maternal (O.R. = 2.12, 95% C.I. = 1.31-3.41) or paternal (O.R. = 1.52, 95% C.I. = 0.95-2.43) history of allergic rhinitis. Among environmental factors examined, namely, household pets, carpeting in bedroom, use of fumigation mats, mosquito coils and aerosol insect repellents, maternal and paternal smoking, and air conditioning, none were associated with an increased risk of wheeze. In conclusion, the strongest association with current wheeze was a family history of asthma. Also significant were neonatal hospital admission and a history of allergic rhinitis in either the mother or father. None of the environmental factors studied were related to current wheeze in preschool children.

  10. The Canadian Methotrexate and Etanercept Outcome Study: a randomised trial of discontinuing versus continuing methotrexate after 6months of etanercept and methotrexate therapy in rheumatoid arthritis

    PubMed Central

    Pope, Janet E; Haraoui, Boulos; Thorne, J Carter; Vieira, Andrew; Poulin-Costello, Melanie; Keystone, Edward C

    2014-01-01

    Objective To determine if withdrawing methotrexate (MTX) after 6months of combination etanercept (ETN)+MTX, in MTX-inadequate responders with active rheumatoid arthritis (RA), is non-inferior to continuing ETN+MTX. Methods Tumour necrosis factor-inhibitor naïve RA patients with disease activity score 28 (DAS28)≥3.2, swollen joint count≥3, despite stable MTX, were treated with ETN+MTX for 6months, followed by randomisation to either continue ETN+MTX or switch to ETN monotherapy for an additional 18 months. The primary endpoint was change in DAS28 from 6-month randomisation to 12months. The non-inferiority margin of change in DAS28 was 0.6, with prespecified analyses (DAS28<3.2 vs DAS28≥3.2). Results 205 patients were randomised. DAS28 was stable in patients on ETN+MTX and increased slightly in patients on ETN monotherapy from 6 to 12months. Non-inferiority was not achieved, with an adjusted difference of 0.4 (0.1 to 0.7) between the ETN and the ETN+MTX groups, for the month 612 change in DAS28. However, patients who achieved low disease activity (LDA; DAS28<3.2) at 6months had a similar disease activity at 12months, whether on monotherapy or combination therapy (DAS28 change 0.7 ETN vs 0.57 ETN+MTX, p=0.8148). Conversely, for patients who did not reach LDA at 6months, those on ETN monotherapy had increased disease activity at 12months, while disease activity continued to decrease for patients on combination therapy, at 12months (DAS28 change 0.4 ETN vs −0.4 ETN+MTX, p=0.0023). Conclusions Non-inferiority was not achieved. Withdrawing MTX after 6months of continuation ETN+MTX in MTX inadequate responders did not yield the same degree of improvement between 6 and 12months compared with continuing ETN+MTX. Trial Registration ClinicalTrials.gov−NCT00654368. PMID:23979914

  11. Single ocular injection of a sustained-release anti-VEGF delivers 6 months pharmacokinetics and efficacy in a primate laser CNV model

    PubMed Central

    Adamson, Peter; Wilde, Thomas; Dobrzynski, Eric; Sychterz, Caroline; Polsky, Rodd; Kurali, Edit; Haworth, Richard; Tang, Chi-Man; Korczynska, Justyna; Cook, Fiona; Papanicolaou, Irene; Tsikna, Lemy; Roberts, Chris; Hughes-Thomas, Zoe; Walford, James; Gibson, Daniel; Warrack, John; Smal, Jos; Verrijk, Ruud; Miller, Paul E.; Nork, T. Michael; Prusakiewicz, Jeffery; Streit, Timothy; Sorden, Steven; Struble, Craig; Christian, Brian; Catchpole, Ian R.

    2017-01-01

    A potent anti-vascular endothelial growth factor (VEGF) biologic and a compatible delivery system were co-evaluated for protection against wet age-related macular degeneration (AMD) over a 6month period following a single intravitreal (IVT) injection. The anti-VEGF molecule is dimeric, containing two different anti-VEGF domain antibodies (dAb) attached to a human IgG1 Fc region: a dual dAb. The delivery system is based on microparticles of PolyActive™ hydrogel co-polymer. The molecule was evaluated both in vitro for potency against VEGF and in ocular VEGF-driven efficacy modelsin vivo. The dual dAb is highly potent, showing a lower IC50 than aflibercept in VEGF receptor binding assays (RBAs) and retaining activity upon release from microparticles over 12 months in vitro. Microparticles released functional dual dAb in rabbit and primate eyes over 6 months at sufficient levels to protect Cynomolgus against laser-induced grade IV choroidal neovascularisation (CNV). This demonstrates proof of concept for delivery of an anti-VEGF molecule within a sustained-release system, showing protection in a pre-clinical primate model of wet AMD over 6 months. Polymer breakdown and movement of microparticles in the eye may limit development of particle-based approaches for sustained release after IVT injection. PMID:27810558

  12. Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis.

    PubMed

    Park, Lawrence P; Chu, Vivian H; Peterson, Gail; Skoutelis, Athanasios; Lejko-Zupa, Tatjana; Bouza, Emilio; Tattevin, Pierre; Habib, Gilbert; Tan, Ren; Gonzalez, Javier; Altclas, Javier; Edathodu, Jameela; Fortes, Claudio Querido; Siciliano, Rinaldo Focaccia; Pachirat, Orathai; Kanj, Souha; Wang, Andrew

    2016-04-18

    Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE. Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE-PLUS, 2008-2012, n=1197). The 6-month mortality was 971 of 4049 (24.0%) in the ICE-PCS cohort and 342 of 1197 (28.6%) in the ICE-PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left-sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6-month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62-0.89). A simplified risk model was developed by weight adjustment of these variables. Six-month mortality after IE is ≈25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE. © 2016 The Authors. Published on behalf of the American Heart

  13. Maternal folate status, but not that of vitamins B-12 or B-6, is associated with gestational age and preterm birth risk in a multiethnic Asian population.

    PubMed

    Chen, Ling-Wei; Lim, Ai Lin; Colega, Marjorelee; Tint, Mya-Thway; Aris, Izzuddin M; Tan, Chuen Seng; Chong, Yap-Seng; Gluckman, Peter D; Godfrey, Keith M; Kwek, Kenneth; Saw, Seang-Mei; Yap, Fabian; Lee, Yung Seng; Chong, Mary Foong-Fong; van Dam, Rob M

    2015-01-01

    Maternal folate, vitamin B-12, and vitamin B-6 concentrations during pregnancy have been shown to influence birth outcomes, but the evidence is inconclusive. We aimed to examine the associations of maternal B-vitamin status with gestational age, birth weight, and length in a birth cohort study in Singapore. Maternal blood samples (n = 999) collected during weeks 26-28 of gestation were assayed for plasma folate, vitamin B-12, and vitamin B-6 concentrations. Birth weight and gestational age data were obtained from hospital records, and other anthropometric variables were measured within 72 h after birth. Relations between B-vitamin status and birth outcomes were assessed by linear or logistic regression with adjustment for potential confounders. Median (IQR) plasma concentrations were 34.4 (24.5-44.6) nmol/L for folate, 209 (167-258) pmol/L for vitamin B-12, and 61.8 (25.9-113) nmol/L for vitamin B-6. We found that higher plasma folate concentrations were associated with a longer gestational age (0.12 wk per SD increase in folate; 95% CI: 0.02, 0.21) and tended to be associated with lower risk of all preterm birth (delivery at <37 wk of gestation; OR: 0.79; 95% CI: 0.63, 1.00) and spontaneous preterm birth (OR: 0.76; 95% CI: 0.56, 1.04). Overall, concentrations of maternal folate, vitamin B-12, and vitamin B-6 were not independently associated with birth weight or being born small for gestational age (SGA; birth weight <10th percentile for gestational age). Higher maternal folate concentrations during late pregnancy were associated with longer gestational age and tended to be associated with a lower risk of preterm birth in this multiethnic Asian population. In contrast, the results of our study suggested little or no benefit of higher folate concentrations for reducing the risk of SGA or of higher vitamin B-6 and vitamin B-12 concentrations for reducing the risk of preterm birth or SGA. © 2015 American Society for Nutrition.

  14. Prenatal Omega-3 Supplementation and Eczema Risk among Offspring at Age 36 Months

    PubMed Central

    Berman, D; Clinton, C; Limb, R; Somers, EC; Romero, V; Mozurkewich, E

    2017-01-01

    Background Long-term follow-up was completed in 84 mother-infant pairs of 118 women who completed a randomized controlled trial of prenatal supplementation with EPA- or DHA-rich fish oil or soy oil placebo. The goal of this study was to determine whether prenatal omega-3 fatty acid supplementation protects offspring against development of early childhood allergies. Methods and Findings Assessment of childhood allergic/atopic disease among offspring at age 36 months was performed by maternal interview using the National Health Interview Survey (NHIS) questions for childhood digestive allergies, wheezing, eczema or skin allergy, and respiratory allergy. Multiple logistic regressions examined the association between prenatal supplementation and childhood outcomes, adjusted for covariates. Eczema was reported in 26/84 (31%) of offspring at age 36 months, and was significantly more prevalent in the omega-3 supplementation groups vs. placebo: EPA 13/31 (41.9%); DHA 10/26 (38.5%); placebo 3/27 (11.1%), p=0.019. Compared to placebo, EPA and DHA were associated with ≥5 times risk of offspring eczema [odds ratios (ORs): EPA 5.8 (95% CI 1.4–23.3); DHA 5.0 (95% CI 1.2–21.0)]. After adjusting for other potential risk factors (race, birth weight, vaginal/Cesarean delivery, and maternal eczema) the magnitudes of association for omega-3 supplementation increased: EPA OR 8.1 (95% CI 1.4–45.6); DHA OR 9.6 (95% CI 1.6–58.5). Maternal eczema was also significantly associated with offspring eczema in the adjusted model: OR 10.8 (95% CI 2.1–54.3) Conclusion Contrary to our hypothesis, acids supplementation compared to soy oil was associated with a substantial increase in risk of childhood eczema. This association was not observed on childhood respiratory or digestive outcomes. It is unclear if these findings were driven by unfavorable effects of omega-3s, or whether there may have been unanticipated protective effects of the soy-based placebo with regards to eczema. PMID

  15. Validity and reliability of the expectations regarding aging (ERA-12) instrument among middle-aged Singaporeans.

    PubMed

    Joshi, Veena D; Malhotra, Rahul; Lim, Jeremy F Y; Østbye, Truls; Wong, Michael

    2010-05-01

    The 12-item Expectations Regarding Aging (ERA-12) instrument measures expectations that individuals have about how their health and cognitive function will be when they age. To date, primarily assessed among older adults in Western settings, expectations regarding ageing have been associated with physical activity and healthcare seeking behaviour. It has been suggested that it may be possible to develop interventions that promote positive expectations about ageing. Assessment of expectations regarding ageing among today's middle-aged population would allow for earlier interventions to help give them positive (but realistic) ageing expectations, and age successfully. We assess the reliability and validity of ERA-12 for middle-aged Singaporeans. A questionnaire that included ERA-12 was administered to 1020 patients aged 41 to 62 years attending 2 SingHealth polyclinics in Singapore. Data from 981 respondents who completed the ERA-12 instrument were analysed. ERA-12's construct validity was determined using Exploratory Factor Analysis (EFA), and through its correlation with depressive symptoms, and self-rated health and education. Internal consistency reliability was assessed using Cronbach's alpha. EFA confirmed that the ERA-12 consisted of 3 factors (each with 4 items)--expectations regarding physical health, mental health and cognitive function, together explaining 64% of the variance in ERA-12 total score with high factor loadings (range, 0.6 to 0.8). The ERA-12 total score was positively correlated with self-rated health (r = 0.13) and education (r = 0.19), and negatively correlated with depressive symptoms (r = -0.25). Cronbach's alpha exceeded 0.7 for ERA-12 overall, and for each subscale. ERA-12 can be used to evaluate expectations regarding ageing not only among elderly populations in the West, but also among middle-aged Singaporeans.

  16. Adherence to oral rehydration therapy among in-patient children aged 1-59 months with some or no dehydration.

    PubMed

    Migowa, A N; Gatinu, B; Nduati, R W

    2010-04-01

    To determine adherence to oral rehydration solution (ORS) among in-patients aged 1-59 months suffering from gastroenteritis and having some dehydration (SD) or no dehydration (ND) in two rural hospitals in Kenya. Children aged 1-59 months suffering from acute gastroenteritis with (SD) or (ND) were enrolled into the study, examined and medical records reviewed. On the second and third day of follow up, children were re-examined to ascertain hydration status and care-takers interviewed. Ninety-nine children were enrolled. Forty-five (75%) of the 60 children with SD received a correct prescription for ORS but only 12 (20%) received the correct amount. Among the 39 children with ND, 23 (59%) received a correct prescription for ORS, however only 16 (41%) received the correct amount. On the 3rd day, 9 (15%) of the 60 children with SD at baseline and 2 (5%) of the 39 with ND were classified as having SD. Four in five children with SD and 6 in 10 children with ND fail to receive the correct amounts of ORS.

  17. Prevalence of stunting and its associated factors among children 6-59 months of age in Libo-Kemekem district, Northwest Ethiopia; A community based cross sectional study.

    PubMed

    Geberselassie, Selamawit Bekele; Abebe, Solomon Mekonnen; Melsew, Yayehirad Alemu; Mutuku, Shadrack Mulinge; Wassie, Molla Mesele

    2018-01-01

    Children in developing countries are highly vulnerable to impaired physical growth because of poor dietary intake, lack of appropriate care, and repeated infections. This study aimed at assessing the prevalence of stunting and associated factors among children 6-59 months of age in Libo-kemekem district, northwest Ethiopia. A community based cross sectional study was conducted in Libo-Kemekem from October 15 to December 15, 2015. The multistage sampling technique was employed to select 1,320 children aged 6-59months. Data were collected by trained community health extension workers under regular supervision. Data were entered into EPI-Info version 3.5.1, and height for age was converted to Z-score with ENA-SMART software. Data were then exported to SPSS version 20 for descriptive and binary logistic regression analysees. The significance of associations was determined at p<0.05. Out of 1287 children included in the analysis, 49.4% (95% CI: 46.7%-52.3%) were found to be stunted. In the multivariate analysis, increased child age [AOR = 6.31, 95%CI: (3.65, 10.91)], family size of six and above [AOR = 1.77, 95%CI: (1.35, 2.32)] were positively associated with stunting, while, fathers with secondary school education [AOR = 0.50, 95%CI: (0.30, 0.81)], farmers as household heads [AOR = 0.56, 95%CI: (0.38, 0.84)] and self-employed parents as household head [AOR = 0.45, 95% CI: (0.28, 0.72)] were found to be preventive factors. The prevalence of stunting was high in the study area. We found that stunting was significantly correlated with child age, occupational status of household head, family size, and fathers' education. Therefore, intervention focusing on supporting housewives, family planning, and education on child feeding and nutrition should be implemented.

  18. Predictors and Course of Medically Intractable Epilepsy in Young Children Presenting Before 36 Months of Age: A Retrospective, Population-Based Study

    PubMed Central

    Wirrell, Elaine; Wong-Kisiel, Lily; Mandrekar, Jay; Nickels, Katherine

    2012-01-01

    Purpose To determine the prevalence and identify predictors of medical intractability in children presenting with epilepsy prior to 36 months of age, and to assess the impact of medical intractability on long-term mortality and intellectual function. Methods Children with newly-diagnosed epilepsy prior to 36 months between 1980–2009 while resident in Olmsted County, MN were identified. Medical records were reviewed to collect epilepsy specific variables and long-term outcome data. Medically intractable epilepsy was defined as either (1) seizures greater than every 6 months at final follow-up and failure of two or more antiepileptic drugs for lack of efficacy, or (2) having undergone epilepsy surgery after failure of two or more antiepileptic drugs. Key Findings One hundred and twenty seven children with new-onset epilepsy were identified and followed for a median of 78 months. Medically intractable seizures occurred in 35%, and significant predictors on multivariate analysis were age12 months at diagnosis (odds ratio [OR] 6.76, 95% confidence interval [CI] 2.00, 22.84, p=0.002), developmental delay at initial diagnosis of epilepsy (OR 20.03, 95% CI 3.49, 114.83, p=0.0008 ), neuroimaging abnormality (OR 6.48, 95% CI 1.96, 21.40, p=0.002) and focal slowing on initial EEG (OR 5.33, 95% CI 1.14, 24.88, p=0.03). Medical intractability occurred early in the course in most children, being seen in 61% by one year, and 93% by five years after initial diagnosis. Mortality was higher (20% vs 0%, p<0.001) and intellectual outcome poorer (p<0.001) if epilepsy was medically intractable. Significance One third of children presenting with epilepsy before 36 months will be medically intractable and significant predictors are identified. Medically intractable epilepsy is associated with increased mortality risk and significant intellectual disability. PMID:22738069

  19. Relation between hand function and gross motor function in full term infants aged 4 to 8 months.

    PubMed

    Nogueira, Solange F; Figueiredo, Elyonara M; Gonçalves, Rejane V; Mancini, Marisa C

    2015-01-01

    In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. RESULTS revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

  20. Relation between hand function and gross motor function in full term infants aged 4 to 8 months

    PubMed Central

    Nogueira, Solange F.; Figueiredo, Elyonara M.; Gonçalves, Rejane V.; Mancini, Marisa C.

    2015-01-01

    Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development. PMID:25714437