Bjork, Robert M.; Fraser, Stewart E.
This monograph discusses world population problems, examines the underlying concepts and issues in population education, and looks at the future. The monograph begins by describing an attempt at population education in a village of India. Eight guiding concepts that are considered to be essential for population educators are then discussed. These…
Holcomb, Matthew J.; Pufpaff, Lisa A.; McIntosh, David E.
Childhood obesity has become a problem of epidemic proportions in the United States, but much of the research has focused on prevention and intervention programs, which target the general population of school children. Overlooked in the literature are children with special needs (including autism, genetic disorders, Down syndrome, and Prader-Willi…
As part of the 2002 Current Population Survey, this report presents information on several characteristics of children, covering different aspects of their lives. It focuses on demographic characteristics of the child population of the United States and family living arrangements, including single parent families, cohabiting parent families, and…
Jorjoliani, L; Karseladze, R; Vekua, M; Chkhartishvili, E; Bigvava, T
The anthropometric data were studied in early school aged (6-7 years old) children and the degree of harmonization during physical development was evaluated. Representative population of 400 otherwise healthy early school aged children was included in study group. Study period covered the end of school year. In the selected under observation focused population the level of individual anthropometric data was determined in percentile intervals according its position. Anthropometric data assessments by using percentile method it was revealed in early school aged (6-7 years of old children) excess in body height and weight in comparison with normal values. This phenomenon indicates the prevalence of acceleration and weight gain. Anthropometric data in boys were increased while comparing with physical development data in girls. This result difference has the tendency to statistically insignificant. Physical development harmonization values were studied in 200 children. Harmonized physical development revealed in 50 children (25%); disharmonized physical development I 50 children (15%), among them with I degree weight gain were 48 (24%), and with I degree weight deficit were 2 (1%). Markedly disharmonized development had 100 children (50%), among them with II degree weight gain were 98 (49%), and with II degree weight deficit were 2 (1%). According to the children's anthropometric data and assessment by physical development harmonization percentiles tables three groups of children were organized: main, risk group and the group with deviation in physical development. On the basis of resulted data the study of early school age children's physical development gives possibility for risk groups stratification, which in turn itself makes a strong basis for reasonable preventive measurements and stepwise monitoring implementation.
fertile women are also important. The State's population policy of rewards and penalties also affects the costs and benefits. Administrative intervention to implement the FP program have been effectively and adequately used in the past to control population growth, even though it is recognized that social and economic development is another way of affecting population growth. Parents still need to be guaranteed that 1 child will indeed be a benefit. Children's economic value has been accepted, and policy is moving in the direction of correcting the imbalances between children's costs and benefits, such as increasing fines along with improving education and income distribution.
Eijkemans, Marinus J.C.; van Poppel, Frans; Habbema, Dik F.; Smith, Ken R.; Leridon, Henri; te Velde, Egbert R.
STUDY QUESTION Is it possible to construct an age curve denoting the ages above which women are biologically too old to reproduce? SUMMARY ANSWER We constructed a curve based on the distribution of female age at last birth in natural fertility populations reflecting the ages above which women have become biologically too old to have children. WHAT IS KNOWN ALREADY The median age at last birth (ALB) for females is ∼40–41 years of age across a range of natural fertility populations. This suggests that there is a fairly universal pattern of age-related fertility decline. However, little is known about the distribution of female ALB and in the present era of modern birth control, it is impossible to assess the age-specific distribution of ALB. Reliable information is lacking that could benefit couples who envisage delaying childbearing. STUDY DESIGN, SIZE, DURATION This study is a review of high-quality historical data sets of natural fertility populations in which the distributions of female age at last birth were analysed. The studies selected used a retrospective cohort design where women were followed as they age through their reproductive years. PARTICIPANTS/MATERIALS, SETTING, METHODS Using a common set of eligibility criteria, large data files of natural fertility populations were prepared such that the analysis could be performed in parallel across all populations. Data on the ALB and confounding variables are presented as box and whisker plots denoting the 5th, 25th, 50th, 75th and 95th percentile distribution of the age at last birth for each population. The analysis includes the estimation of Kaplan–Meier curves for age at last birth of each population. The hazard curve for ALB was obtained by plotting the smoothed hazard curve of each population and taking the lowest hazard within a time period of at least 5 years. This lowest hazard curve was then transformed into a cumulative distribution function representing the composite curve of the end of
Shooshtari, Shahin; Brownell, Marni; Dik, Natalia; Chateau, Dan; Yu, C. T.; Mills, Rosemary S. L.; Burchill, Charles A.; Wetzel, Monika
In this population-based study, prevalence of depression was estimated and compared between children with and without developmental disability (DD). Twelve years of administrative data were linked to identify a cohort of children with DD living in the Canadian province of Manitoba. Children in the study cohort were matched with children without DD…
Freedman, Brian H.; Kalb, Luther G.; Zablotsky, Benjamin; Stuart, Elizabeth A.
Despite speculation about an 80% divorce rate among parents of children with an Autism Spectrum Disorder (ASD), very little empirical and no epidemiological research has addressed the issue of separation and divorce among this population. Data for this study was taken from the 2007 National Survey of Children's Health, a population-based,…
Khalifa, Najah; Von Knorring, Anne-Liis
Objective: To examine patterns of psychiatric comorbid disorders and associated problems in a school population of children with tic disorders. Method: From a total population of 4,479 children, 25 with Tourette's disorder (TD), 34 with chronic motor tics (CMT), 24 with chronic vocal tics (CVT), and 214 with transient tics (TT) during the past…
Tavormina, J. B.; And Others
To investigate vulnerability to psychological and emotional stress among chronically ill children, a battery of personality tests was selectively administered to 144 children (5- to 19-years-old) afflicted with one of the following conditions: diabetes, asthma, cystic fibrosis, or hearing impairment. Analyses centered on comparisons of norms…
Sigurdardottir, Solveig; Indredavik, Marit S.; Eiriksdottir, Audur; Einarsdottir, Katrin; Gudmundsson, Halldor S.; Vik, Torstein
Aim: To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP). Method: Children with congenital CP, assessed with the Child Behavior Checklist/1 1/2-5 (CBCL/1 1/2-5) and Caregiver-Teacher Report Form (C-TRF), were enrolled in the study. A comparison group was recruited from the general population.…
Sivertsen, Borge; Posserud, Maj-Britt; Gillberg, Christopher; Lundervold, Astri J.; Hysing, Mari
This study examined the prevalence and chronicity of sleep problems in children who manifest problems believed to be typical of Autism Spectrum Disorders (ASD). Using data from a longitudinal total population study, symptoms of ASD, insomnia and potential explanatory factors were assessed at ages 7-9 and 11-13. Children were included in a group…
Kielinen, Marko; Rantala, Heikki; Timonen, Eija; Linna, Sirkka-Liisa; Moilanen, Irma
A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated…
Missiuna, Cheryl; Cairney, John; Pollock, Nancy; Russell, Dianne; Macdonald, Kathryn; Cousins, Martha; Veldhuizen, Scott; Schmidt, Louis
The purpose of this study was to describe the motor, attention and intellectual characteristics of a population-based sample of children first screened for motor impairment and to discuss the recruitment and identification methods employed. A two stage cross-sectional, school-based survey was conducted to screen for children with motor…
Khalafli, Kh N
The results of carried out studies demonstrated that children with intestinal parasitoses are more affected by different diseases than children without this pathology. In particular during last two years in the first group 78.2 ± 1.5% of cases of diseases were registered while total children morbidity comes to 36.4 ± 2.0% of cases in average (t = 16.72, p < 0.001). Summarily, on each child with intestinal parasitoses accounts for 0.78 ± 0.11% of cases of disease in average which resulted in 2.82 ± 0.07 cases of missing school lessons. The rate of intestinal parasitoses is largely impacted by level of material well-fare and living conditions of families. The elimination of established social epidemiological prerequisites opens wide perspectives for organization and implementation of rational measures of prevention of intestinal parasitoses in urban children.
Goerge, Robert; Dilts, John; Yang, Duck-Hye; Wasserman, Miriam; Clary, Anne
This report draws on demographic data to examine and project trends in the size and composition of the child population in all seventy-seven Chicago communities up to the year 2010. The report highlights the changing age mix of Chicago children and provides some context in which to consider these demographic trends. It describes population changes…
Hoekstra, P J; Lundervold, A J; Lie, S A; Gillberg, C; Plessen, Kerstin J
Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the developmental trajectory of children with and without tics when they were 7-9 years old. Parents and teachers completed the strengths and difficulties questionnaire (SDQ) when the children were 7-9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94% of the total cohort) with a preponderance of boys (78.9%). 22 children (57.9%) in the group with tics had only motor tics, and 16 (42.1%) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.
Non-insulin dependent (type 2) diabetes mellitus (DM) is a rapidly emerging health threat in minority populations in the United States, with the African-American, Hispanic, and Native American populations at greatest risk. Clearly, environmental factors play a role in this disorder, but the ethnic predilection suggests a significant genetic component. Type 2 DM is a condition not well understood on a genetic basis. Familial clustering and ethnic variation have been documented. The populations of Africans living in diverse environments provide a unique opportunity to study type 2 DM as the mechanism is becoming more clear.
Research has shown a prevalence of psychosocial difficulties ranging from about 20% to 50% among children with hearing loss. This study evaluates the prevalence of psychosocial difficulties in a Danish population in relation to different explanatory variables. Five scales and questionnaires measuring sign language, spoken language, hearing…
Vaillancourt, Tracy; Trinh, Vi; McDougall, Patricia; Duku, Eric; Cunningham, Lesley; Cunningham, Charles; Hymel, Shelley; Short, Kathy
A two-part screening procedure was used to assess school-age children's experience with bullying. In the first part 16,799 students (8,195 girls, 8,604 boys) in grades 4 to 12 were provided with a definition of bullying and then asked about their experiences using two general questions from the Olweus Bully/Victim Questionnaire (1996). In the…
Zhou, W; Johnson, TN; Xu, H; Cheung, SYA; Bui, KH; Li, J; Al‐Huniti, N
Predictive performance of physiologically based pharmacokinetic (PBPK) and population pharmacokinetic (PopPK) models of drugs predominantly eliminated through kidney in the pediatric population was evaluated. After optimization using adult clinical data, the verified PBPK models can predict 33 of 34 drug clearance within twofold of the observed values in children 1 month and older. More specifically, 10 of 11 of predicted clearance values were within 1.5‐fold of those observed in children between 1 month and 2 years old. The PopPK approach also predicted 19 of 21 drug clearance within twofold of the observed values in children. In summary, our analysis demonstrated both PBPK and PopPK adult models, after verification with additional adult pharmacokinetic (PK) studies and incorporation of known ontogeny of renal filtration, could be applied for dosing regimen recommendation in children 1 month and older for renally eliminated drugs in a first‐in‐pediatric study. PMID:27566992
National Academy of Sciences - National Research Council, Washington, DC.
Adverse health effects from exposure to lead are now recognized to be among industrialized society's most important health problems. This report, prepared by the National Research Council's Committee on Measuring Lead Exposure in Critical Populations, concurs with new findings issued by the Centers for Disease Control which state that lead…
Blanken, Laura M E; White, Tonya; Mous, Sabine E; Basten, Maartje; Muetzel, Ryan L; Jaddoe, Vincent W V; Wals, Marjolein; van der Ende, Jan; Verhulst, Frank C; Tiemeier, Henning
Psychiatric symptoms in childhood are closely related to neurocognitive deficits. However, it is unclear whether internalising and externalising symptoms are associated with general or distinct cognitive problems. We examined the relation between different types of psychiatric symptoms and neurocognitive functioning in a population-based sample of 1177 school-aged children. Internalising and externalising behaviour was studied both continuously and categorically. For continuous, variable-centred analyses, broadband scores of internalising and externalising symptoms were used. However, these measures are strongly correlated, which may prevent identification of distinct cognitive patterns. To distinguish groups of children with relatively homogeneous symptom patterns, a latent profile analysis of symptoms at age 6 yielded four exclusive groups of children: a class of children with predominantly internalising symptoms, a class with externalising symptoms, a class with co-occurring internalising and externalising symptoms, that resembles the CBCL dysregulation profile and a class with no problems. Five domains of neurocognitive ability were tested: attention/executive functioning, language, memory and learning, sensorimotor functioning, and visuospatial processing. Consistently, these two different modelling approaches demonstrated that children with internalising and externalising symptoms show distinct cognitive profiles. Children with more externalising symptoms performed lower in the attention/executive functioning domain, while children with more internalising symptoms showed impairment in verbal fluency and memory. In the most severely affected class of children with internalising and externalising symptoms, we found specific impairment in the sensorimotor domain. This study illustrates the specific interrelation of internalising and externalising symptoms and cognition in young children.
Raju, P Krishnam; Vasanti, D; Kumar, J Raghavendra; Niranjani, K; Kumar, M S Saravana
Background: Oral hygiene has been given due importance since ages. Different cultures have been using different methods for the maintenance of good oral hygiene. The study was done to find out the oral hygiene levels in children of tribal population and to correlate the brushing methods used and the oral hygiene levels. Methodology: A total of 5129 children of 5-12 years age (boys 2778, girls 2351) were checked for the simplified oral hygiene index in the study. Results: The overall oral hygiene status of 1267 girls and 1348 boys was fair, whereas 821 girls and 937 boys was good and 263 girls and 493 boys was poor. It has been shown that fair oral hygiene practices were being followed by the children. Conclusion: Children using twigs and other materials for oral hygiene had nearly equally good oral hygiene when compared to the tooth brush and tooth paste, though children using toothbrush and tooth paste had slightly better oral hygiene. PMID:26229382
Stark, Lindsay; Landis, Debbie
Children in humanitarian settings are thought to experience increased exposure to violence, which can impair their physical, emotional, and social development. Violence against children has important economic and social consequences for nations as a whole. The purpose of this review is to examine population-based approaches measuring violence against children in humanitarian settings. The authors reviewed prevalence studies of violence against children in humanitarian contexts appearing in peer-reviewed journals within the past twenty years. A Boolean search procedure was conducted in October 2014 of the electronic databases PubMed/Medline and PsychInfo. If abstracts contained evidence of the study's four primary themes--violence, children, humanitarian contexts and population-based measurement--a full document review was undertaken to confirm relevance. Out of 2634 identified articles, 22 met the final inclusion criteria. Across studies, there was varying quality and no standardization in measurement approach. Nine out of 22 studies demonstrated a relationship between conflict exposure and adverse health or mental health outcomes. Among studies that compared rates of violence between boys and girls, boys reported higher rates of physical violence, while girls reported higher rates of sexual violence. Children in infancy and early childhood were found to be among the most under-researched. Ultimately, the body of evidence in this review offers an incomplete picture regarding the prevalence, nature and impact of violence against children in emergencies, demonstrating a weak evidence base for some of the basic assumptions underpinning humanitarian practice. The development of standardized approaches to more rigorously measure violence against children is urgently needed in order to understand trends of violence against children in humanitarian contexts, and to promote children's healthy development and well-being.
Ezpeleta, Lourdes; de la Osa, Núria; Granero, Roser; Domènech, Josep Maria; Reich, Wendy
There is a need for reliable and well-validated diagnostic measures for studying psychopathology in preschool and young children. The goal is to study the psychometric properties of the Diagnostic Interview for Children and Adolescents for Parents of Preschool and Young Children (DICA-PPYC) in the general population. A sample of 852 Spanish school children, aged 3 to 7 years, were randomly selected and screened for a double phase design. A total of 251 families were interviewed with the DICA-PPYC and 244 participated in a test-retest design. Different measures of psychopathology and functional impairment were also administered. Test-retest agreement with a mean interval of 8.8 days ranged from excellent to slight (kappa from 1 to 0.39) for DSM-IV-TR and from good to fair (kappa from 0.77 to 0.49) for Research Diagnostic Criteria-Preschool Age diagnoses. Attenuation between test and retest was not significant for the prevalence of diagnoses, although it was significant for the number of externalising and total symptoms in the interview. The diagnoses converged moderately with the CBCL and Dominic scores. The presence of diagnoses in the DICA-PPYC significantly differentiated preschoolers and young children who had used mental health services, were more impaired, and presented more severe psychopathology measured by dimensional scales. The DICA-PPYC is a reliable and valid semi-structured interview schedule for preschool and young children, and can serve to advance the knowledge and mental health care of this population.
Richter, J; Stiborová, I; Pohorská, J; Dobiásová, L; Král, V
A group of 156 children aged between 10 and 12 years were screened for IgG and IgE antibodies to Ascaris lumbricoides. The study subjects were 64 children of Romany origin and 92 children from the majority population. IgG antibodies to Ascaris lumbricoides were detected in 112 (71.8%) children. No difference in the prevalence of IgG antibodies was found between Romany children and those from the majority population. As many as 34.1% of the study subjects had IgE antibodies to Ascaris lumbricoides, again with no difference between the two ethnic groups. Children with IgG antibodies to Ascaris lumbricoides had significantly higher total IgE levels compared to those who had tested IgG negative. To demonstrate induction of a non-specific IgE response was one of the study objectives. The high prevalence rates of IgG and IgE antibodies to Ascaris lumbricoides are suggestive of a high frequency of cross- and non-specific reactions. Possible effect of cross-reactivity to other antigens on the specific IgG and IgE antibody response to Ascaris lumbricoides is discussed.
Jokiranta, Elina; Sourander, Andre; Suominen, Auli; Timonen-Soivio, Laura; Brown, Alan S.; Sillanpää, Matti
The present population-based study examines associations between epilepsy and autism spectrum disorders (ASD). The cohort includes register data of 4,705 children born between 1987 and 2005 and diagnosed as cases of childhood autism, Asperger's syndrome or pervasive developmental disorders--not otherwise specified. Each case was matched to four…
Lauruschkus, Katarina; Westbom, Lena; Hallstrom, Inger; Wagner, Philippe; Nordmark, Eva
The aims of this study were to describe the participation in physical activity of children with cerebral palsy (CP) at school and during leisure time and to identify characteristics associated with physical activity. The frequency of receiving physiotherapeutic interventions were described as a variable of interest. A total population of 364…
Ullebo, Anne Karin; Breivik, Kyrre; Gillberg, Christopher; Lundervold, Astri J.; Posserud, Maj-Britt
Objective: To examine whether a bifactor model with a general ADHD factor and domain specific factors of inattention, hyperactivity and impulsivity was supported in a large general population sample of children. We also explored the utility of forming subscales based on the domain-specific factors. Methods: Child mental health questionnaires were…
McGaw, Sue; Shaw, Tom; Beckley, Kerry
This study identified and investigated the incidence of childhood trauma and psychopathology across a population of parents with intellectual disabilities (IDs) known to a parenting service in the United Kingdom over a 5-year period and examined the emotional and physical welfare of their children. Data were gathered from 49 parents with ID and 58…
Tham, Diana Su Yun; Bremner, J Gavin; Hay, Dennis
The role of experience with other-race faces in the development of the other-race effect was investigated through a cross-cultural comparison between 5- and 6-year-olds and 13- and 14-year-olds raised in a monoracial (British White, n=83) population and a multiracial (Malaysian Chinese, n=68) population. British White children showed an other-race effect to three other-race faces (Chinese, Malay, and African Black) that was stable across age. Malaysian Chinese children showed a recognition deficit for less experienced faces (African Black) but showed a recognition advantage for faces of which they have direct or indirect experience. Interestingly, younger (Malaysian Chinese) children showed no other-race effect for female faces such that they can recognize all female faces regardless of race. These findings point to the importance of early race and gender experiences in reorganizing the face representation to accommodate changes in experience across development.
McDowell, Brona C.; Salazar-Torres, Jose J.; Kerr, Claire; Cosgrove, Aidan P.
-While passive range of motion (PROM) is commonly used to inform decisions on therapeutic management, knowledge of PROM of children with spastic cerebral palsy (CP) is limited. A population-based sample of 178 children with spastic CP (110 male; unilateral, n = 94; bilateral, n = 84; age range 4-17 years) and 68 typically developing children (24…
Soke, Gnakub N.; Rosenberg, Steven A.; Hamman, Richard F.; Fingerlin, Tasha; Robinson, Cordelia; Carpenter, Laura; Giarelli, Ellen; Lee, Li-Ching; Wiggins, Lisa D.; Durkin, Maureen S.; DiGuiseppi, Carolyn
Self-injurious behaviors (SIB) have been reported in more than 30% of children with an autism spectrum disorder (ASD) in clinic-based studies. This study estimated the prevalence of SIB in a large population-based sample of children with ASD in the United States. A total of 8,065 children who met the surveillance case definition for ASD in the…
Lin, Hsiao-Chuan; Chao, Yu-Hua; Wu, Kang-Hsi; Yen, Ting-Yu; Hsu, Yu-Lung; Hsieh, Tsung-Hsueh; Wei, Hsiu-Mei; Wu, Jhong-Lin; Muo, Chih-Hsin; Hwang, Kao-Pin; Peng, Ching-Tien; Lin, Cheng-Chieh; Li, Tsai-Chung
Herpes zoster is rare in healthy children, but immunocompromised persons have an increased risk of herpes zoster and severe diseases. Considering the very limited information on herpes zoster in children with cancer, we performed a nationwide population-based cohort study to estimate the incidence of herpes zoster in children with cancer and to explore the association between the 2 diseases.Data were obtained from the National Health Research Institutes Database in Taiwan. A total of 4432 children with newly diagnosed cancer between 2000 and 2007 were identified as the cancer cohort, and 17,653 children without cancer frequency-matched by sex and age at entry were considered the noncancer cohort. The association between herpes zoster and childhood cancer was determined.Children with cancer had a higher risk of herpes zoster. The incidence rate of herpes zoster was higher in the cancer cohort than in the noncancer cohort (20.7 vs 2.4 per 10,000 person-years; IRR = 8.6; 95% CI = 4.8-15.6). The cumulative incidence was significantly higher in the cancer cohort (P < 0.0001). Leukemia, lymphoma, and solid tumor were all associated with the increased risk, and leukemia had the highest magnitude of strength of association.This nationwide population-based cohort study demonstrated that children with cancer were associated with an increased risk of herpes zoster. In addition to early antiviral treatment, vaccination with heat-treated zoster vaccine or adjuvanted subunit vaccine could be an appropriate policy to decrease the incidence in children with cancer.
Infants and toddlers are prone to rapidly contracting illnesses, which are usually attributed to infectious diseases. Most nurseries and schools in Japan, however, refuse to accept children even with mild illnesses. For working parents, a sick child may therefore create new problems as the situation requires new day-care arrangements. To support such families, the Japanese government subsidizes construction and management of nurseries that operate especially for sick children. However, it has not been known whether most families are able to access such nurseries. To clarify the accessibility of these services, I calculated the distance to the nurseries from each of the 211,012 "blocks" (small residential areas with a median of 0.18 km(2)) in Japan and determined the proportion of children aged 0-4 years who lived within 3, 5, 10, 20 or 30 km of the nearest such nursery. Overall, 82.1% of these children lived within 10 km. However, the proportion was lower in northern parts of Japan such as Hokkaido and Tohoku, which have expansive land areas and low population and pediatric department densities. The proportion of children who lived within that same distance of the nearest nursery was also much lower in small towns and villages with 10,000 or fewer residents. Nurseries for sick children were not evenly distributed, and children and their caregivers in under-populated areas had to travel further to access these facilities. As the national government subsidizes such services, children and caregivers throughout Japan should have equal access to them.
Wind, Carina; Henninger, Erin M.; Chinitz, Susan
This study examined the relationship between sensory processing difficulties, parental stress, and behavioral problems in a clinical sample of young children with developmental and behavioral difficulties. We hypothesized that a high rate of sensory processing difficulties would be found, that there would be a high rate of comorbidity between sensory processing difficulties and behavioral problems, and that children’s sensory processing difficulties and parental stress would be highly correlated. Parents of 59 children ages two to five who attended an out-patient clinic in a low income, urban community completed the Child Behavior Checklist, Parental Stress Inventory-Short Form and the Short Sensory Profile. Children in this clinical population showed a high prevalence (55.9%) of sensory processing difficulties, a significantly higher rate than previously reported. Sensory processing deficits were correlated with behavioral difficulties and parental stress levels-suggesting that as sensory processing difficulties increase, so do behavioral difficulties and parental stress. Parents of children with sensory processing deficits had significantly higher levels of parental stress than parents of children without sensory deficits. Parenting stress levels were also clinically elevated for the cohort of children in which sensory processing difficulties and behavioral concerns co-existed. These findings suggest that treatment outcomes might improve and parental stress could be reduced if mental health clinicians were trained to identify and address sensory problems. This could result in more children being screened and treated for sensory processing difficulties and an eventual reduction in the rates of parental stress. PMID:24443636
Di Gioia, Giuseppe; Creta, Antonio; Fittipaldi, Mario; Giorgino, Riccardo; Quintarelli, Fabio; Satriano, Umberto; Cruciani, Alessandro; Antinolfi, Vincenzo; Di Berardino, Stefano; Costanzo, Davide; Bettini, Ranieri; Mangiameli, Giuseppe; Caricato, Marco; Mottini, Giovanni
Background Malnutrition among children population of less developed countries is a major health problem. Inadequate food intake and infectious diseases are combined to increase further the prevalence. Malnourishment brings to muscle cells loss with development of cardiac complications, like arrhythmias, cardiomyopathy and sudden death. In developed countries, malnutrition has generally a different etiology, like chronic diseases. The aim of our study was to investigate the correlation between malnutrition and left ventricular mass in an African children population. Methods 313 children were studied, in the region of Antsiranana, Madagascar, with age ranging from 4 to 16 years old (mean 7,8 ± 3 years). A clinical and echocardiographic evaluation was performed with annotation of anthropometric and left ventricle parameters. Malnutrition was defined as a body mass index (BMI) value age- and sex-specific of 16, 17 and 18,5 at the age of 18, or under the 15th percentile. Left ventricle mass was indexed by height2.7 (LVMI). Results We identified a very high prevalence of children malnutrition: 124 children, according to BMI values, and 100 children under the 15th percentile. LVMI values have shown to be increased in proportion to BMI percentiles ranging from 29,8 ± 10,8 g/m2.7 in the malnutrition group to 45 ± 15,1 g/m2.7 in >95th percentile group. LVMI values in children < 15th BMI percentile were significantly lower compared to normal nutritional status (29,8 ± 10,8 g/m2,7 vs. 32,9 ± 12,1 g/m2,7, p = 0.02). Also with BMI values evaluation, malnourished children showed statistically lower values of LVMI (29,3 ± 10,1 g/m2,7 vs. 33,6 ± 12,5 g/m2,7, p = 0.001). Conclusion In African children population, the malnourishment status is correlated with cardiac muscle mass decrease, which appears to be reduced in proportion to the decrease in body size. PMID:27140179
Background Diffusely adherent Escherichia coli (DAEC) have been considered a diarrheagenic category of E. coli for which several potential virulence factors have been described in the last few years. Despite this, epidemiological studies involving DAEC have shown inconsistent results. In this work, two different collections of DAEC possessing Afa/Dr genes, from children and adults, were studied regarding characteristics potentially associated to virulence. Results DAEC strains were recovered in similar frequencies from diarrheic and asymptomatic children, and more frequently from adults with diarrhea (P < 0.01) than from asymptomatic adults. Association with diarrhea (P < 0.05) was found for SAT-positive strains recovered from children and for curli-positive strains recovered from adults. Mixed biofilms involving DAEC and a Citrobacter freundii strain have shown an improved ability to form biofilms in relation to the monocultures. Control strains have shown a greater diversity of Afa/Dr adhesins and higher frequencies of cellulose, TTSS, biofilm formation and induction of IL-8 secretion than strains from cases of diarrhea in children. Conclusions DAEC strains possessing Afa/Dr genes isolated from children and adults represent two different bacterial populations. DAEC strains carrying genes associated to virulence can be found as part of the normal microbiota present in asymptomatic children. PMID:23374248
Fuhrmann, Pia; Equit, Monika; Schmidt, Karin; von Gontard, Alexander
Depression is an incapacitating disorder, which is often overlooked in preschool children. The aim of this study was to analyse the prevalence of depressive symptoms and co-occurring risk factors in a large, population-based sample of preschool children. All 653 children (of a total of 731) in a defined geographical area were assessed during the school-entry exam by community care paediatricians. In addition to clinical appraisal, parents filled out the Preschool Feelings Checklist, a 16-item screening instrument with good psychometric properties. The mean age was 6.2 years (range 5.0-7.6 years) and the sample included 344 boys and 305 girls. The prevalence of depressive symptoms of clinical relevance (total score ≥3) was 5.7% (37). There were no differences between boys and girls, and between younger (<6 years) and older (>6 years) children. Depressive symptoms were associated with parental separation and comorbid behavioural problems, but especially with developmental motor and speech problems and disorders. Migration to Germany had no influence. Depressive symptoms are common in preschool children and associated with developmental problems. Depression should be considered in children with speech and motor problems who are at special risk. Early detection and treatment are recommended.
Gowin, Ewelina; Wysocki, Jacek; Kałużna, Ewelina; Świątek-Kościelna, Bogna; Wysocka-Leszczyńska, Joanna; Michalak, Michał; Januszkiewicz-Lewandowska, Danuta
Abstract Vaccination effectiveness is proven when the disease does not develop after a patient is exposed to the pathogen. In the case of rare diseases, vaccination effectiveness is assessed by monitoring specific antibody levels in the population. Such recurrent analyses allow the evaluation of vaccination programs. The primary schedule of diphtheria and tetanus vaccinations is similar in various countries, with differences mainly in the number and timing of booster doses. The aim of the study was to assess diphtheria and tetanus antibody concentrations in a population of healthy children. Diphtheria and tetanus antibody levels were analyzed in a group of 324 children aged 18 to 180 months. All children were vaccinated in accordance with the Polish vaccination schedule. Specific antibody concentrations greater than 0.1 IU/mL were considered protective against tetanus or diphtheria. Levels above 1.0 were considered to ensure long-term protection. Protective levels of diphtheria antibodies were found in 229 patients (70.46%), and of tetanus in 306 patients (94.15%). Statistically significant differences were found in tetanus antibody levels in different age groups. Mean concentrations and the percentage of children with high tetanus antibody titers increased with age. No similar correlation was found for diphtheria antibodies. High diphtheria antibody levels co-occurred in 72% of the children with high tetanus antibody levels; 95% of the children with low tetanus antibody levels had low levels of diphtheria antibodies. The percentage of children with protective diphtheria antibody levels is lower than that in the case of tetanus antibodies, both in Poland and abroad, but the high proportion of children without diphtheria protection in Poland is an exception. This is all the more puzzling when taking into account that Polish children are administered a total of 5 doses containing a high concentration of diphtheria toxoid, at intervals shorter than 5 years. The
Roca, Marta; Miralles-Marco, Ana; Ferré, Joan; Pérez, Rosa; Yusà, Vicent
The exposure to pesticides amongst school-aged children (6-11 years old) was assessed in this study. One hundred twenty-five volunteer children were selected from two public schools located in an agricultural and in an urban area of Valencia Region, Spain. Twenty pesticide metabolites were analyzed in children's urine as biomarkers of exposure to organophosphate (OP) insecticides, synthetic pyrethroid insecticides, and herbicides. These data were combined with a survey to evaluate the main predictors of pesticide exposure in the children's population. A total of 15 metabolites were present in the urine samples with detection frequencies (DF) ranging from 5% to 86%. The most frequently detected metabolites with DF>53%, were 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos), diethyl phosphate (DEP, generic metabolite of OP insecticides), 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY, metabolite of diazinon) and para-nitrophenol (PNP, metabolite of parathion and methyl parathion). The calculated geometric means ranged from 0.47 to 3.36 µg/g creatinine, with TCPy and IMPY showing the higher mean concentrations. Statistical significant differences were found between exposure subgroups (Mann-Whitney test, p<0.05) for TCPy, DEP, and IMPY. Children living in the agricultural area had significantly higher concentrations of DEP than those living in the urban area. In contrast, children aged 6-8 years from the urban area, showed statistically higher IMPY levels than those from agricultural area. Higher levels of TCPy were also found in children with high consumption of vegetables and higher levels of DEP in children whose parents did not have university degree studies. The multivariable regression analysis showed that age, vegetable consumption, and residential use of pesticides were predictors of exposure for TCPy, and IMPY; whereas location and vegetable consumption were factors associated with DEP concentrations. Creatinine concentrations were the most
Fernández-Castillo, Antonio; Vílchez-Lara, Maria J; López-Naranjo, Isabel
This study explored the relation between parents' stress and satisfaction during children's hospitalization, seeking possible differences between immigrant and autochthonous population and also as a function of gender in a sample of parents of hospitalized children in Andalusia, Spain. A total of 1347 parents participated in this study. Of the sample, 50% were immigrants and the other 50% were autochthonous. The assessment instruments were the Hospitalization Stress Scale and the Satisfaction with Hospitalization Scale. The results show that stress was associated with the manifestations of the child's illness, the alteration of family life or of parental roles during the process and some aspects of the clinical staff's work. General satisfaction in immigrant parents was higher than in the autochthonous population and the levels of satisfaction were higher in men than in women. Small changes and initiatives in relation to care could substantially improve the satisfaction of patients and their relatives during the process of hospitalization.
Vélez van Meerbeke, Alberto; Sandoval-Garcia, Carolina; Ibáñez, Milciades; Talero-Gutiérrez, Claudia; Fiallo, Dolly; Halliday, Karen
The aim of this article was to assess the validity of the emotional and developmental components of the Koppitz human figure drawing test. 2420 children's drawings available in a database resulting from a previous cross sectional study designed to determine the prevalence of neurological diseases in children between 0 and 12 years old in Bogota schools were evaluated. They were scored using the criteria proposed by Koppitz, and classified into 16 groups according to age, gender, and presence/absence of learning or attention problems. The overall results were then compared with the normative study to assess whether descriptive parameters of the two populations were significantly different. There were no significant differences associated with presence/absence of learning and attention disorders or school attended within the overall sample. An Interrater reliability test has been made to assure the homogeneity of scoring by the evaluator team. There were significant differences between this population and that of the original study. New scoring tables contextualized for our population based on the frequency of appearance in this sample are presented. We can conclude that various ethnic, social, and cultural factors can influence the way children draw the human figure. It is thus important to establish local reference values to adequately distinguish between normality and abnormality. The new scoring tables proposed here should be followed up with a clinical study to corroborate their validity.
Grelat, Natacha; Houot, Hélène; Pujol, Sophie; Levain, Jean-Pierre; Defrance, Jérôme; Mariet, Anne-Sophie; Mauny, Frédéric
Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children′s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child′s bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child′s bedroom (p ≤ 0.01), family residential satisfaction (p ≤ 0.03) and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05) remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health. PMID:27801858
Olson, Karen L.; Mandl, Kenneth D.
This study aimed to comprehensively describe prevalence and temporal dispensing patterns for medications prescribed to children and adolescents in the United States. Participants were 1.6 million children (49% female) under 18 years old enrolled in a nation-wide, employer-provided insurance plan. All medication claims from 1999–2006 were reviewed retrospectively. Drugs were assigned to 16 broad therapeutic categories. Effects of trend over time, seasonality, age and gender on overall and within category prevalence were examined. Results: Mean monthly prevalence for dispensed medications was 23.5% (range 19.4–27.5), with highest rates in winter and lowest in July. The age group with the highest prevalence was one-year-old children. On average each month, 17.1% of all children were dispensed a single drug and 6.4% were dispensed two or more. Over time, prevalence for two or more drugs did not change, but the proportion of children dispensed a single drug decreased (slope -.02%, p = .001). Overall, boys had higher monthly rates than girls (average difference 0.9%, p = .002). However, differences by gender were greatest during middle childhood, especially for respiratory and central nervous system agents. Contraceptives accounted for a large proportion of dispensed medication to older teenage girls. Rates for the drugs with the highest prevalence in this study were moderately correlated (average Pearson r.66) with those from a previously published national survey. Conclusion: On average, nearly one quarter of a population of insured children in the United States was dispensed medication each month. This rate decreased somewhat over time, primarily because proportionally fewer children were dispensed a single medication. The rate for two or more drugs dispensed simultaneously remained steady. PMID:22829905
Creta, Antonio; Campanale, Cosimo Marco; Fittipaldi, Mario; Giorgino, Riccardo; Quintarelli, Fabio; Satriano, Umberto; Cruciani, Alessandro; Antinolfi, Vincenzo; Di Berardino, Stefano; Costanzo, Davide; Bettini, Ranieri; Mangiameli, Giuseppe; Caricato, Marco; Mottini, Giovanni
Background Left ventricular hypertrophy (LVH) is a marker of pediatric hypertension and predicts development of cardiovascular events. Electrocardiography (ECG) screening is used in pediatrics to detect LVH thanks to major accessibility, reproducibility and easy to use compared to transthoracic echocardiography (TTE), that remains the standard technique. Several diseases were previously investigated, but no data exists regarding our study population. The aim of our study was to evaluate the relationship between electrocardiographic and echocardiographic criteria of LVH in normotensive African children. Methods We studied 313 children (mean age 7,8 ± 3 yo), in north-Madagascar. They underwent ECG and TTE. Sokolow-Lyon index was calculated to identify ECG-LVH (>35 mm). Left ventricle mass (LVM) with TTE was calculated and indexed by height2.7 (LVMI2.7) and weight (LVMIw). We report the prevalence of TTE-LVH using three methods: (1) calculating percentiles age- and sex- specific with values >95th percentile identifying LVH; (2) LVMI2.7 >51 g/m2.7; (3) LVMIw >3.4 g/weight. Results 40 (13%) children showed LVMI values >95th percentile, 24 children (8%) an LVMI2.7 >51 g/m2.7 while 19 children (6%) an LVMIw >3.4 g/kg. LVH-ECG by Sokolow-Lyon index was present in five, three and three children respectively, with poor values of sensitivity (ranging from 13 to 16%), positive predictive value (from 11 to 18%) and high values of specificity (up to 92%). The effects of anthropometrics parameters on Sokolow-Lyon were analyzed and showed poor correlation. Conclusion ECG is a poor screening test for detecting LVH in children. In clinical practice, TTE remains the only tool to be used to exclude LVH. PMID:27651998
Thompson, Lisa; Diaz, Janet; Jenny, Alisa; Diaz, Anaite; Bruce, Nigel; Balmes, John
Estimating the prevalence of asthma is an epidemiologic challenge, particularly in rural areas of lesser-developed countries characterized by low literacy and poor access to health care. To avoid under or over reporting of symptoms, questionnaires must use terminology familiar to participants and that accurately describes the triad of cough, wheeze and breathlessness characteristic of asthma. In preparation for a large longitudinal cohort study entitled Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter (CRECER) that will examine the effects of variable early lifetime woodsmoke exposure on the respiratory health of Mam-speaking children residing in communities in the western highlands of Guatemala, we conducted individual interviews (n=18) and five focus groups (n=46) with indigenous women from 17 of these communities to elicit and define local Mam and Spanish terms for common respiratory symptoms used to describe their own and their children's respiratory symptoms. Focus group participants were also shown an International Study of Asthma and Allergies in Childhood (ISAAC) video of wheezing children and adults. We developed a conceptual framework that can be used as an efficient model for future studies investigating health and/or disease terminology in isolated communities, an integral step in the development of standardized questionnaires. Among this Mam-speaking population, wheeze was best described as nxwisen or ntzarrin, "breathing sounds that are heard in the neck but come from the chest." The variation in understanding of terms between women with and without children with a history of wheeze (such that for those without wheezing children some terms were virtually unrecognized), has important implications for large-scale population surveys within countries and comparative surveys such as ISAAC. It is important to use linguistically and culturally appropriate terminology to describe wheeze in prevalence studies of
Goh, K Y; Poon, W S
All Vietnamese patients with head injuries from two of the largest refugee camps in Hong Kong are routinely referred to the Neurosurgical Unit of the Prince of Wales Hospital for management. In order to determine the epidemiology of head injuries in this population group, we have retrospectively reviewed all hospitalized cases over a 4 year period from January 1990 to December 1993. We have found a unique social situation in this population group, with an unusually high proportion of paediatric cases (2253 per 100,000 children aged 5 years or less), compared with other epidemiological studies. The most common mechanism of injury in between 57 and 75 per cent of cases was a fall from bed. Based on this information, appropriate preventive measures have been recommended and have successfully decreased the incidence of head injuries. This study demonstrates the value and effectiveness of epidemiological studies in identifying a previously unrecognized health risk in a specified population group.
Reid, Susan M.; McCutcheon, Jennifer; Reddihough, Dinah S.; Johnson, Hilary
Aim: To establish a prevalence estimate for drooling and explore factors associated with drooling in a population sample of children with cerebral palsy (CP) aged 7 to 14 years living in Victoria, Australia. Method: A self-report questionnaire was used to collect data on drooling from parents of children born between 1996 and 2001, and registered…
Lewis, Charlotte W
This paper grew out of a project reviewing progress in children's oral health after Oral Health in America: A Report of the Surgeon General was published in 2000. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006 National Survey of Children with Special Health Care Needs to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to children without special health care needs, and to results from the previous iteration of this survey. Dental care remains the most frequently cited unmet health need for CSHCN. More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. In summary, CSHCN are more likely to be insured and to receive preventive dental care at equal or higher rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely affected, are more likely to report unmet dental care need compared with unaffected children. Despite advances in knowledge about dental care among CSHCN, unanswered questions remain. Recommendations are provided toward obtaining additional data and facilitating dental care access for this vulnerable population.
Iannelli, Andrea M; Assis, Simone Gonçalves; Pinto, Liana Wernersbach; Pinto, Liana Wenersbach
The scope of this article is to present and analyze data from Brazilian foster care services for children / adolescents from the perspective of family reintegration. It also seeks to support the implementation of public policies in order to provide effective reintegration in accordance with the differing local contexts. It uses data from 1,157 municipalities that have foster care services. The methodology takes into account the data collection of 2,624 Brazilian centers and 36,929 children and adolescents in care. The growing number of children/adolescents in care is in line with the increase in population size: 8.4 per small city; 60 per large city and 602.4 per metropolis. With respect to care residence in a different municipality there are varying indices: 12.4% in metropolises and 33.6% in small cities, revealing the absence of centers close to family units in the smaller communities. Regarding the activities promoted together with families, it was seen that there are still units that do not perform any activities, which runs contrary to Brazilian law. It is clear that policies for the child/adolescent in foster care centers need to consider the capacity of the municipality in accordance with population size to implement support actions for families to assist in family reintegration.
Adel, El Taguri; Marie-Françoise, Rolland-Cachera; Mahmud Salaheddin, M; Najeeb, Elmrzougi; Ahmed, Abdel Monem; Ibrahim, Betilmal; Gerard, Lenoir
Aim To describe the nutritional status of children under-five years of age in Libya. Population and methods A secondary analysis of data of 5348 children taken from a national representative, two-stage, cluster-sample survey that was performed in 1995. Results: Prevalence rates of underweight, wasting, stunting, and overweight were determined using standard definitions in reference to newly established WHO growth charts. The study revealed that 4.3% of children were underweight, 3.7% wasted, 20.7% stunted, and 16.2% overweight. Seventy percent of children had normal weight. Undernutrition was more likely to be found in males, in rural areas, and in underprivileged groups. Overweight was more likely found in urban, privileged groups. Wasting was more common in arid regions; stunting was more common in mountainous regions of Al-Akhdar, Al-Gharbi, and in Sirt. Al-Akhdar had the highest prevalence of overweight. Conclusion The country had a low prevalence of underweight and wasting, moderate prevalence of stunting, and high prevalence of overweight. The country is in the early stages of transition with evidence of dual-burden in some regions. Similar surveys are needed to verify secular trends of these nutritional problems, particularly overweight. PMID:21499476
Goldsmith, H H; Van Hulle, C A; Arneson, C L; Schreiber, J E; Gernsbacher, M A
Some adults and children exhibit defensive behaviors to tactile or auditory stimulation. These symptoms occur not only in subsets of children with ADHD, autism, and Fragile X syndrome, but also in the apparent absence of accompanying disorders. Relatively little research explores the correlates and antecedents of sensory defensiveness. Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems. The incidence of defensive symptoms was widely distributed, with some accumulation of cases in the extreme range. Girls were overrepresented in the extreme tactile defensiveness group. Both auditory and tactile defensiveness were modestly associated with fearful temperament and anxiety, but they were relatively distinct from other common dimensions of childhood behavioral dysfunction. Twin correlations for the full range of scores and concordance rates for the extremes suggested moderate genetic influences, with some indication that the tactile domain might be more heritable than the auditory domain.
Goldsmith, H. H.; Van Hulle, C. A.; Arneson, C. L.; Schreiber, J. E.; Gernsbacher, M. A.
Some adults and children exhibit defensive behaviors to tactile or auditory stimulation. These symptoms occur not only in subsets of children with ADHD, autism, and Fragile X syndrome, but also in the apparent absence of accompanying disorders. Relatively little research explores the correlates and antecedents of sensory defensiveness. Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems. The incidence of defensive symptoms was widely distributed, with some accumulation of cases in the extreme range. Girls were overrepresented in the extreme tactile defensiveness group. Both auditory and tactile defensiveness were modestly associated with fearful temperament and anxiety, but they were relatively distinct from other common dimensions of childhood behavioral dysfunction. Twin correlations for the full range of scores and concordance rates for the extremes suggested moderate genetic influences, with some indication that the tactile domain might be more heritable than the auditory domain. PMID:16649001
Mallarino, Christina; Gómez, Luis F; González-Zapata, Laura; Cadena, Yazmín; Parra, Diana C
The rapid nutrition transition occurring in Latin America has resulted in a sharp increase of childhood overweight and obesity. Recent evidence has shown that food and beverage advertising has a great influence on children's eating behavior. This population has become a key target market for the ultra-processed foods and beverages industry, which is marketing products in an aggressive way. Evidence shows that Latin American countries have poor regulation of ultra-processed foods and beverages advertising, where the discourse of self-regulation still prevails over statutory regulations. The following commentary explores how advertising might play an important role in developing unhealthy dietary patterns and obesity in Latin American children, as well as the urgent need for government action and the involvement of civil society to tackle this public health issue.
Albitskiy, V S; Ustinova, N V; Antonova, Ye V
The article considers trends and priority directions of research studies of the field of public health and health care of children population. The interpretative content analysis was applied to study dissertations in the field of public health and health care in 1991-2012. The sampling included 4194 units of information. The first stage of study established that problems of children population are considered in 14.8% dissertations defended on the mentioned specialty. The next stage the categories of content-analysis were examined. They were divided on the following axes: axis I "Main problem of study", axis II "Localization of study", axis III "Examined age groups", axis IV "Distribution of studies on gender of examined contingent", axis V "Examined contingent", axis VI "Additional medical specialty". It is established that in dissertations on public health and health care of children population on axis I prevails organizational subject matter (27.2%). The health condition of various contingents of children population (16.8%), preventive aspects of pediatrics (12.2%), examination of particular conditions/diseases/classes of diseases (10.8%) are fixed as priority directions. In the most dissertations the regional character of studies is presented (98.2%). The prevailing age group in studies is the adolescent group (19.9%). The inter-disciplinary relationships of dissertations on problems of public health and health care of children population are revealed with such specialties as "Pediatrics" (16.2%), "Obstetrics and gynecology" (3.8%) and "Hygiene" (3.4%). With consideration for recognition of health promotion and optimization of health care of children population as priority directions of public health policy amount of research studies in this field is to be admitted as inadequate. With purpose of optimization of scientific knowledge and development of system of medical social care to children population it is needed to promote research studies of problems of
Huang, Bin; Kercsmar, Carolyn M.; Guilbert, Theresa W.; McLinden, Daniel J.; Lierl, Michelle B.; Kahn, Robert S.
Rationale: Allergen sensitization is associated with asthma morbidity. A better understanding of allergen sensitization patterns among children hospitalized for asthma could help clinicians tailor care more effectively. To our knowledge, however, sensitization profiles among children hospitalized for asthma are unknown. Objectives: We sought to describe allergen sensitization profiles and the distribution of self-reported in-home exposures among children hospitalized for asthma. We also sought to assess how sensitization profiles varied by sociodemographic and clinical factors. Methods: This population-based cohort study includes data for 478 children, aged 4–16 years, hospitalized for an asthma exacerbation. Predictors included child age, race, sex, insurance status, reported income, salivary cotinine, exposure to traffic-related air pollution, asthma and atopic history, and season of admission. Outcomes included serum IgE specific to Alternaria alternata/A. tenuis, Aspergillus fumigatus, American cockroach, mouse epithelium, dust mite (Dermatophagoides pteronyssinus and farinae), cat dander, and dog dander (deemed sensitive if IgE ≥ 0.35). Self-reported adverse exposures included mold/mildew, water leaks, cockroaches, rodents, and cracks or holes in the walls or ceiling. Presence of carpeting and furry pets was also assessed. Measurements and Main Results: More than 50% of included patients were sensitized to each of Alternaria, Aspergillus, dust mite, cat dander, and dog dander; 28% were sensitized to cockroach and 18% to mouse. Roughly 68% were sensitized to three or more allergens with evidence of clustering. African American children, compared with white children, were more likely to be sensitized to Alternaria, Aspergillus, cockroach, and dust mite (all P < 0.01). White children were more likely to be sensitized to mouse, cat, and dog (all P < 0.01). Lower income was associated with cockroach sensitization whereas higher income was associated
Wu, Xiangmei (May); Bennett, Deborah H.; Calafat, Antonia M.; Kato, Kayoko; Strynar, Mark; Andersen, Erik; Moran, Rebecca E.; Tancredi, Daniel J.; Tulve, Nicolle S.; Hertz-Picciotto, Irva
Perfluorinated compounds (PFCs) have been widely used in industrial applications and consumer products. Their persistent nature and potential health impacts are of concern. Given the high cost of collecting serum samples, this study is to understand whether we can quantify PFC serum concentrations using factors extracted from questionnaire responses and indirect measurements, and whether a single serum measurement can be used to classify an individual’s exposure over a one-year period. The study population included three demographic groups: young children (2–8 years old) (N=67), parents of young children (<55 years old) (N=90), and older adults (>55 years old) (N=59). PFC serum concentrations, house dust concentrations, and questionnaires were collected. The geometric mean of perfluorooctane sulfonic acid (PFOS) was highest for the older adults. In contrast, the geometric mean of perfluorooctanoic acid (PFOA) was highest for children. Serum concentrations of the parent and the child from the same family were moderately correlated (Spearman correlation (r)=0.26–0.79, p<0.05), indicating common sources within a family. For adults, age, having occupational exposure or having used fire extinguisher, frequencies of consuming butter/margarine, pork, canned meat entrées, tuna and white fish, freshwater fish, and whether they ate microwave popcorn were significantly positively associated with serum concentrations of individual PFCs. For children, residential dust concentrations, frequency of wearing waterproof clothes, frequency of having canned fish, hotdogs, chicken nuggets, French fries, and chips, and whether they ate microwave popcorn were significant positive predictors of individual PFC serum concentrations. In addition, the serum concentrations collected in a subset of young children (N=20) and the parents (N=42) one year later were strongly correlated (r=0.68–0.98, p<0.001) with the levels measured at the first visits, but showed a decreasing trend
Pufall, Erica L.; Nyamukapa, Constance; Eaton, Jeffrey W.; Mutsindiri, Reggie; Chawira, Godwin; Munyati, Shungu; Robertson, Laura; Gregson, Simon
Background There are an estimated half-million children living with HIV in sub-Saharan Africa. The predominant source of infection is presumed to be perinatal mother-to-child transmission, but general population data about paediatric HIV are sparse. We characterise the epidemiology of HIV in children in sub-Saharan Africa by describing the prevalence, possible source of infection, and effects of paediatric HIV in a southern African population. Methods From 2009 to 2011, we conducted a household-based survey of 3389 children (aged 2–14 years) in Manicaland, eastern Zimbabwe (response rate: 73.5%). Data about socio-demographic correlates of HIV, risk factors for infection, and effects on child health were analysed using multi-variable logistic regression. To assess the plausibility of mother-to-child transmission, child HIV infection was linked to maternal survival and HIV status using data from a 12-year adult HIV cohort. Results HIV prevalence was (2.2%, 95% CI: 1.6–2.8%) and did not differ significantly by sex, socio-economic status, location, religion, or child age. Infected children were more likely to be underweight (19.6% versus 10.0%, p = 0.03) or stunted (39.1% versus 30.6%, p = 0.04) but did not report poorer physical or psychological ill-health. Where maternal data were available, reported mothers of 61/62 HIV-positive children were deceased or HIV-positive. Risk factors for other sources of infection were not associated with child HIV infection, including blood transfusion, vaccinations, caring for a sick relative, and sexual abuse. The observed flat age-pattern of HIV prevalence was consistent with UNAIDS estimates which assumes perinatal mother-to-child transmission, although modelled prevalence was higher than observed prevalence. Only 19/73 HIV-positive children (26.0%) were diagnosed, but, of these, 17 were on antiretroviral therapy. Conclusions Childhood HIV infection likely arises predominantly from mother-to-child transmission and is
Kennedy, Christine; Floriani, Victoria
Synopsis This paper provides two examples of approaches nursing can take to reach diverse populations of children and their families to enhance health lifestyles. First a descriptive summary of a brief after-school intervention program aimed at influencing 8 and 9 year-old children’s media habits and the prevention of negative health behaviors will be presented. Design consideration for translating health lifestyles research findings into a Nurse managed inner city primary care practice will be reviewed in the 2nd example. PMID:18674672
Cardoso, Marly A.; Scopel, Kézia K.G.; Muniz, Pascoal T.; Villamor, Eduardo; Ferreira, Marcelo U.
Background Although iron deficiency is considered to be the main cause of anemia in children worldwide, other contributors to childhood anemia remain little studied in developing countries. We estimated the relative contributions of different factors to anemia in a population-based, cross-sectional survey. Methodology We obtained venous blood samples from 1111 children aged 6 months to 10 years living in the frontier town of Acrelândia, northwest Brazil, to estimate the prevalence of anemia and iron deficiency by measuring hemoglobin, erythrocyte indices, ferritin, soluble transferrin receptor, and C-reactive protein concentrations. Children were simultaneously screened for vitamin A, vitamin B12, and folate deficiencies; intestinal parasite infections; glucose-6-phosphate dehydrogenase deficiency; and sickle cell trait carriage. Multiple Poisson regression and adjusted prevalence ratios (aPR) were used to describe associations between anemia and the independent variables. Principal Findings The prevalence of anemia, iron deficiency, and iron-deficiency anemia were 13.6%, 45.4%, and 10.3%, respectively. Children whose families were in the highest income quartile, compared with the lowest, had a lower risk of anemia (aPR, 0.60; 95%CI, 0.37–0.98). Child age (<24 months, 2.90; 2.01–4.20) and maternal parity (>2 pregnancies, 2.01; 1.40–2.87) were positively associated with anemia. Other associated correlates were iron deficiency (2.1; 1.4–3.0), vitamin B12 (1.4; 1.0–2.2), and folate (2.0; 1.3–3.1) deficiencies, and C-reactive protein concentrations (>5 mg/L, 1.5; 1.1–2.2). Conclusions Addressing morbidities and multiple nutritional deficiencies in children and mothers and improving the purchasing power of poorer families are potentially important interventions to reduce the burden of anemia. PMID:22574149
Dijkstra, L.; Houthuijs, D.; Brunekreef, B.; Akkerman, I.; Boleij, J.S. )
The effect of indoor exposure to nitrogen dioxide on respiratory health was studied over a period of 2 yr in a population of nonsmoking Dutch children 6 to 12 yr of age. Lung function was measured at the schools, and information on respiratory symptoms was collected from a self-administered questionnaire completed by the parents of the children. Nitrogen dioxide was measured in the homes of all children with Palmes' diffusion tubes. In addition, information on smoking and dampness in the home was collected by questionnaire. There was no relationship between exposure to nitrogen dioxide in the home and respiratory symptoms. Respiratory symptoms were found to be associated with exposure to tobacco smoke and home dampness. There was a weak, negative association between maximal midexpiratory flow (MMEF) and exposure to nitrogen dioxide. FEV1, peak expiratory flow, and MMEF were all negatively associated with exposure to tobacco smoke. Home dampness was not associated with pulmonary function. Lung function growth, measured over a period of 2 yr, was not consistently associated with any of the indoor exposure variables. The development of respiratory symptoms over time was not associated with indoor exposure to nitrogen dioxide. There was a significant association between exposure to environmental tobacco smoke in the home and the development of wheeze. There was also a significant association between home dampness and the development of cough.
Kimmel, Gary L. . E-mail: email@example.com
There has been an increasing focus on children as a special population in the fields of toxicology and epidemiology. At the same time, there has been considerable improvement in the technology for defining normal development and pathways of pathogenesis. Increased support of these areas has culminated in stronger research programs and greater professional involvement in addressing the specific challenges of applying new techniques and data to the improvement of children's health. Part of these challenges relates to the ever changing environment of the child. Not only does a child's anatomy, physiology, and metabolism change with time, but their lifestyle and awareness change as well. All of these can have a significant impact on a child's exposure and the potential of that exposure to have an effect on health and development. This paper will provide a brief overview of the susceptibility of the child relative to sensitive developmental life stages, the changing nature of exposure parameters during development, and how these factors can impact the relevance of predictive biomarkers of chemical toxicity in children.
Silla, Lucia Mariano da Rocha; Zelmanowicz, Alice; Mito, Ingrid; Michalowski, Mariana; Hellwing, Tania; Shilling, Marco Antonio; Friedrisch, João Ricardo; Bittar, Christina M; Albrecht, Cristina Arthmar Mentz; Scapinello, Elaine; Conti, Claudia; Albrecht, Marcia Arthmar Mentz; Baggio, Letícia; Pezzi, Annelise; Amorin, Bruna; Valim, Vanessa; Fogliatto, Laura; Paz, Alessandra; Astigarraga, Claudia; Bittencourt, Rosane Isabel; Fischer, Gustavo; Daudt, Liane
This population-based study was designed to detect the prevalence of anemia in a healthy population of children (18 months to 7 years) and women (14 to 30 years) tested in 2006-2007 in the state of Rio Grande do Sul, Brazil as part of an effort to tackle this massive problem that still affects so many people in the XXI century. Anemia was defined according to the WHO. Capillary blood was measured and socioeconomic status was determined according to the Brazilian Association of Market Research Agencies. The median prevalence of anemia in 2198 children was 45.4% and in 1999 women 36.4%. Anemia decreased with age during childhood; although significantly more prevalent in lower classes individuals, it was also high in the upper classes. There are indirect evidences that the lack of iron supplementation and/or iron fortified food may play a role in it. Professionals and society wise measures of education have to be implemented in order to address possible biologic factors involved in childhood psychosocial development in southern Brazil.
Silla, Lucia Mariano da Rocha; Zelmanowicz, Alice; Mito, Ingrid; Michalowski, Mariana; Hellwing, Tania; Shilling, Marco Antonio; Friedrisch, João Ricardo; Bittar, Christina M.; Albrecht, Cristina Arthmar Mentz; Scapinello, Elaine; Conti, Claudia; Albrecht, Marcia Arthmar Mentz; Baggio, Letícia; Pezzi, Annelise; Amorin, Bruna; Valim, Vanessa; Fogliatto, Laura; Paz, Alessandra; Astigarraga, Claudia; Bittencourt, Rosane Isabel; Fischer, Gustavo; Daudt, Liane
This population-based study was designed to detect the prevalence of anemia in a healthy population of children (18 months to 7 years) and women (14 to 30 years) tested in 2006–2007 in the state of Rio Grande do Sul, Brazil as part of an effort to tackle this massive problem that still affects so many people in the XXI century. Anemia was defined according to the WHO. Capillary blood was measured and socioeconomic status was determined according to the Brazilian Association of Market Research Agencies. The median prevalence of anemia in 2198 children was 45.4% and in 1999 women 36.4%. Anemia decreased with age during childhood; although significantly more prevalent in lower classes individuals, it was also high in the upper classes. There are indirect evidences that the lack of iron supplementation and/or iron fortified food may play a role in it. Professionals and society wise measures of education have to be implemented in order to address possible biologic factors involved in childhood psychosocial development in southern Brazil. PMID:23922664
Chen, Yanxian; Zhang, Jian; Morgan, Ian G.; He, Mingguang
Purpose To construct reference centile curves of refraction based on population-based data as an age-specific severity scale to evaluate their efficacy as a tool for identifying children at risk of developing high myopia in a longitudinal study. Methods Data of 4218 children aged 5–15 years from the Guangzhou Refractive Error Study in Children (RESC) study, and 354 first-born twins from the Guangzhou Twin Eye Study (GTES) with annual visit were included in the analysis. Reference centile curves for refraction were constructed using a quantile regression model based on the cycloplegic refraction data from the RESC. The risk of developing high myopia (spherical equivalent ≤ -6 diopters [D]) was evaluated as a diagnostic test using the twin follow-up data. Results The centile curves suggested that the 3rd, 5th, and 10th percentile decreased from -0.25 D, 0.00 D and 0.25 D in 5 year-olds to -6.00 D, -5.65D and -4.63 D in 15 year-olds in the population-based data from RESC. In the GTES cohort, the 5th centile showed the most effective diagnostic value with a sensitivity of 92.9%, a specificity of 97.9% and a positive predictive value (PPV) of 65.0% in predicting high myopia onset (≤-6.00D) before the age of 15 years. The PPV was highest (87.5%) in 3rd centile but with only 50.0% sensitivity. The Mathew’s correlation coefficient of 5th centile in predicting myopia of -6.0D/-5.0D/-4.0D by age of 15 was 0.77/0.51/0.30 respectively. Conclusions Reference centile curves provide an age-specific estimation on a severity scale of refractive error in school-aged children. Children located under lower percentiles at young age were more likely to have high myopia at 15 years or probably in adulthood. PMID:28030593
Miura, Makoto; Sando, Isamu; Hirsch, Barry E; Orita, Yorihisa
This study analyzed features of total and segmental spiral ganglion cell populations in children with normal ears and those with various pathological conditions. Sixty-three human temporal bone specimens, obtained from 43 children 4 days to 9 years of age, were studied histopathologically. These specimens were divided into 5 diagnostic groups: group 1, normal ears (13 ears); group 2, congenital infectious diseases (13 ears); group 3, chromosomal aberrations (11 ears); group 4, multiple craniofacial anomalies with hereditary or genetic causes (21 ears); and group 5, perinatal and postnatal asphyxia (5 ears). Eighteen of the 63 ears had documented profound deafness. In either normal ears (group 1) or those with various pathological conditions (groups 2 through 5), the total number of ganglion cells did not change as a function of age during the first 10 years. The total number of ganglion cells was significantly larger in group 1 (33,702) than in each of groups 2, 3, 4, and 5 (p < .01), and the number was significantly larger in group 2 than in each of groups 4 and 5 (p < .01 and p < .05, respectively). The ratio of basal to apical ganglion cell populations remained constant in both normal and pathological ears. Each ratio of the number of basal and apical ganglion cells in groups 2, 3, 4, and 5 to the mean number in group 1 (basal and apical survival ratios) was at least approximately 40%. There was no statistical difference between these two ratios in groups 2, 3, 4, and 5. The mean (+/-SD) total number of ganglion cells in ears with documented profound deafness was 15,417 +/- 5,944, which is approximately 40% of those present in normal ears. Our results suggest that normally, cochlear neurons are completely present at birth and minimally regress during the first decade of life. In addition, although intergroup differences among various pathological groups were present, the majority of pathological ears had more than 10,000 spiral ganglion cells present. Cochlear
Christensen, Jakob; Pedersen, Henrik Søndergaard; Kjaersgaard, Maiken Ina Siegismund; Parner, Erik Thorlund; Vestergaard, Mogens; Sørensen, Merete Juul; Olsen, Jørn; Bech, Bodil Hammer; Pedersen, Lars Henning
Objectives It is unknown if prenatal exposure to antiepileptic drugs (AEDs) increases the risk of low Apgar score in offspring. Setting Population-based study using health registers in Denmark. Participants We identified all 677 021 singletons born in Denmark from 1997 to 2008 and linked the Apgar score from the Medical Birth Register with information on the women's prescriptions for AEDs during pregnancy from the Danish Register of Medicinal Product Statistics. We used the Danish National Hospital Registry to identify mothers diagnosed with epilepsy before birth of the child. Results were adjusted for smoking and maternal age. Results Among 2906 children exposed to AEDs, 55 (1.9%) were born with an Apgar score ≤7 as compared with 8797 (1.3%) children among 674 115 pregnancies unexposed to AEDs (adjusted relative risk (aRR)=1.41 (95% CI 1.07 to 1.85). When analyses were restricted to the 2215 children born of mothers with epilepsy, the aRR of having a low Apgar score associated with AED exposure was 1.34 (95% CI 0.90 to 2.01) When assessing individual AEDs, we found increased, unadjusted RR for exposure to carbamazepine (RR=1.86 (95% CI 1.01 to 3.42)), valproic acid (RR=1.85 (95% CI 1.04 to 3.30)) and topiramate (RR=2.97 (95% CI 1.26 to 7.01)) when compared to unexposed children. Conclusions Prenatal exposure to AEDs was associated with increased risk of being born with a low Apgar score, but the absolute risk of a low Apgar score was <2%. Risk associated with individual AEDs indicate that the increased risk is not a class effect, but that there may be particularly high risks of a low Apgar score associated with certain AEDs. PMID:26359281
Wallis, Belinda A; Watt, Kerrianne; Franklin, Richard C; Nixon, James W; Kimble, Roy M
Objective This retrospective population-based study examined drowning location by the site of immersion for both fatal and non-fatal drowning events in Queensland. Drowning location is not routinely collected, and this study used data linkage to identify drowning sites. The resulting enhanced quality data quantify drowning incidence for specific locations by geographic region, age group and by severity for the first time. Design Linked data were accessed from the continuum of care (prehospital, emergency, hospital admission and death data) on fatal and non-fatal drowning episodes in children aged 0–19 years in Queensland for the years 2002–2008 inclusive. Results Drowning locations ranked in order of overall incidence were pools, inland water, coastal water, baths and other man-made water hazards. Swimming pools produced the highest incidence rates (7.31/100 000) for overall drowning events and were more often privately owned pools and in affluent neighbourhoods. Toddlers 0–4 years were most at risk around pools (23.94/100 000), and static water bodies such as dams and buckets—the fatality ratios were highest at these 2 locations for this age group. Children 5–14 years incurred the lowest incidence rates regardless of drowning location. Adolescents 15–19 years were more frequently involved in a drowning incident on the coast shoreline, followed by inland dynamic water bodies. Conclusions Linked data have resulted in the most comprehensive data collection on drowning location and severity to date for children in the state of Queensland. Most mortality and morbidity could have been prevented by improving water safety through engaged supervision around pools and bath time, and a heightened awareness of buckets and man-made water hazards around the farm home for young children. These data provide a different approach to inform prevention strategies. PMID:26610762
Hawwa, Ahmed F; Westwood, Paul M; Collier, Paul S; Millership, Jeffrey S; Yakkundi, Shirish; Thurley, Gillian; Shields, Mike D; Nunn, Anthony J; Halliday, Henry L; McElnay, James C
Aims To characterize the population pharmacokinetics of ranitidine in critically ill children and to determine the influence of various clinical and demographic factors on its disposition. Methods Data were collected prospectively from 78 paediatric patients (n = 248 plasma samples) who received oral or intravenous ranitidine for prophylaxis against stress ulcers, gastrointestinal bleeding or the treatment of gastro-oesophageal reflux. Plasma samples were analysed using high-performance liquid chromatography, and the data were subjected to population pharmacokinetic analysis using nonlinear mixed-effects modelling. Results A one-compartment model best described the plasma concentration profile, with an exponential structure for interindividual errors and a proportional structure for intra-individual error. After backward stepwise elimination, the final model showed a significant decrease in objective function value (−12.618; P < 0.001) compared with the weight-corrected base model. Final parameter estimates for the population were 32.1 l h−1 for total clearance and 285 l for volume of distribution, both allometrically modelled for a 70 kg adult. Final estimates for absorption rate constant and bioavailability were 1.31 h−1 and 27.5%, respectively. No significant relationship was found between age and weight-corrected ranitidine pharmacokinetic parameters in the final model, with the covariate for cardiac failure or surgery being shown to reduce clearance significantly by a factor of 0.46. Conclusions Currently, ranitidine dose recommendations are based on children's weights. However, our findings suggest that a dosing scheme that takes into consideration both weight and cardiac failure/surgery would be more appropriate in order to avoid administration of higher or more frequent doses than necessary. PMID:23016949
King, Pat; Landahl, John
This pamphlet has been prepared in response to a new problem, a rapidly increasing population, and a new need, population education. It is designed to help teachers provide their students with some basic population concepts with stress placed on the elements of decision making. In the first section of the pamphlet, some of the basic concepts of…
Data on the population of Venezuela between 1975 and 1977 are presented in descriptive tables and graphs. Information is included on the employed population according to category, sex, and type of economic activity, and by sex, age, and area on the employment rate and the total, the economically active, and the unemployed population.
Møen, Kathy Ainul; Diaz, Esperanza
Objectives Health status, disease spectrum and use of healthcare have been reported to vary across groups of migrants and according to the different phases of migration. However, most studies are conducted among adults. This study assesses usage of primary healthcare (PHC) by children with immigrant background compared with non-immigrant children in Norway and describes their relative morbidity burden. Design Population-based retrospective cohort study. Setting This study used 3 linked population-based registers in Norway for children under 18 years of age in 2008. Main exposure and outcome measures Immigrants were defined as children with both parents born abroad, and further classified into first and second generation, and according to the World Bank income categories of their parents' country of origin. Usage and morbidity were assessed with negative binomial regression and logistic regression analyses, respectively. Further, population-attributable fraction analyses on PHC visits were conducted to estimate the impact on the primary health system. Participants 1 168 365 children including 119 251 with immigrant background. Results The mean number of visits to PHC for non-immigrant children was 1.40 compared with 1.19 for immigrants from high-income countries (HIC) and 1.76 for immigrants from low-income countries (LIC). Compared with non-immigrants, first generation immigrants used PHC significantly less after adjusting for age and sex (incidence risk ratio (IRR) 0.70 (HIC) to 0.93 (LIC)) while second generation immigrant children generally used PHC more (IRR 1.03 (HIC) to 1.43 (LIC)); however, the median number of visits were similar between all groups. The morbidity spectrum also varied between the groups. Conclusions Compared with non-immigrants, the excess number of consultations attributable to immigrant groups corresponds to around 1.3% of PHC visits among children. PMID:27737883
Bundy, D A; Thompson, D E; Golden, M H; Cooper, E S; Anderson, R M; Harland, P S
The Trichuris trichiura worm burdens of 23 children living in a Place-of-Safety in Kingston, Jamaica, were assessed by stool collection for more than five days after treatment with mebendazole. This procedure was repeated after a seven-month period of natural re-infection. For both collections the maximum rate of worm expulsion was achieved on the fourth day after starting treatment. The worm population distributions were overdispersed and well described by the negative binomial probability model (k = 0.29) in each case. For any one individual, the number of worms passed on the first expulsion was unrelated, absolutely or relatively, to the number passed on the second. These data suggest that: knowledge of the time dependency of helminth expulsion is essential for the accurate estimation of worm burdens by this method; populations of Trichuris are more highly aggregated than those of Ascaris and may thus be more susceptible to control by selective rather than random chemotherapy; and the inherent predisposition of hosts to infection may be of minor importance in determining the distribution of worms in the population-heavily infected hosts appear no more or less likely to acquire large worm burdens on subsequent exposures.
Examined whether children of alcoholic mothers were more psychologically damaged than children of nonalcoholic mothers. The subject families' potential for creating a good upbringing environment and subjects' childhoods were studied. Found that children of alcoholic mothers develop social maladjustment problems and addictions, and have a high rate…
Benton, Laura; Johnson, Hilary
In the past technology products created to overcome accessibility and usability issues experienced by individuals with special needs have also resulted in greater usability for the wider population. Technology is increasingly being seen as a key component within the education of children with special needs and recently researchers have developed…
Tsiboukis, D; Sazakli, E; Jelastopulu, E; Leotsinidis, M
Anthelmintics, such as benzimidazoles and probenzimidazoles, are veterinary drugs used against endoparasites in food producing animals. A number of these drugs are considered responsible for embryotoxicity and teratogenicity. The residue levels of Albendazole, Febantel, Fenbendazole, Mebendazole and some of their metabolites (Albendazole sulphoxide, Albendazole sulphone, Fenbendazole sulfone) were assessed in 123 (42 goat, 69 sheep, 12 bovine) raw milk samples collected from all farms throughout Southern Greece. Sample analysis was performed by HPLC with Diode Array Detector. A high percentage (27.6%) of the samples examined was found to be positive for the investigated compounds. In 14 samples (11.4%), the residues' concentration exceeded the established Maximum Residue Limits. Estimated Daily Intakes were calculated for a population of 723 children aged 10-12 years. Data on milk consumption were obtained by personal interview through a 7-day food frequency questionnaire. The maximum Estimated Daily Intakes for the anthelmintic residues, concerning raw milk, did not exceed the current Acceptable Daily Intake.
Jokiranta, Elina; Sourander, Andre; Suominen, Auli; Timonen-Soivio, Laura; Brown, Alan S; Sillanpää, Matti
The present population-based study examines associations between epilepsy and autism spectrum disorders (ASD). The cohort includes register data of 4,705 children born between 1987 and 2005 and diagnosed as cases of childhood autism, Asperger's syndrome or pervasive developmental disorders--not otherwise specified. Each case was matched to four controls by gender, date of birth, place of birth, and residence in Finland. Epilepsy was associated with ASD regardless of the subgroup after adjusting for covariates. The associations were stronger among cases with intellectual disability, especially among females. Epilepsy's age at onset was similar between the cases and controls regardless of the ASD subgroup. These findings emphasize the importance to examine the neurodevelopmental pathways in ASD, epilepsy and intellectual disability.
Baidaulet, I O; Namazbaeva, Z I; Dasybayeva, G N; Bazeluk, L T; Sabirov, Zh V; Kusainova, D S
Adverse environmental conditions in Shymkent significantly increase the risk of accumulation of lead in the bodies of the children of the third generation of the population residing in the contaminated areas, cause deteriorations of antioxidant defense in the respiratory system, greatly decline barrier-protective properties of cellular systems of the local immunity, disturb the process of hematopoiesis. Performed statistical analysis of the data permitted to identify a correlation relationship between the accumulation of lead in the soil and the change in the functional activity of the cells of buccal cheek epithelium, catalase activity in expired breath condensate. Haematological signs of lead poisoning include not only the number of reticulocytes, but also the correction (RPI) for the alteration with allowances made for the maturation of reticulocytes in peripheral blood circulation as early criterion for toxic anemia.
Salomonsson, S; Dzikaite, V; Zeffer, E; Eliasson, H; Ambrosi, A; Bergman, G; Fernlund, E; Theander, E; Ohman, A; Rydberg, A; Skogh, T; Wållberg-Jonsson, S; Elfving, A; Fored, M; Ekbom, A; Lundström, U; Mellander, M; Winqvist, O; Sonesson, S-E; Gadler, F; Jonzon, A; Wahren-Herlenius, M
The objective of the study was to investigate the antigen specificity and occurrence of individual autoantibodies in mothers of children diagnosed with atrioventricular (AV) block in a nation-wide setting. Patients with AV block detected before 15 years of age were identified using national quality registries as well as a network of pediatric and adult cardiologists and rheumatologists at the six university hospitals in Sweden. Patients with gross heart malformations, surgically or infectiously induced blocks were excluded. Blood samples were obtained from the mothers and maternal autoantibody profile, including the occurrence of antibodies against Ro52, Ro60, La, SmB, SmD, RNP-70k, RNP-A, RNP-C, CENP-C, Scl-70, Jo-1, ribosomal RNP and histones was investigated in 193 mothers of children with AV block by immunoblotting and ELISA. Autoantibody reactivity was detected in 48% (93/193) of the mothers of children with AV block. In autoantibody-positive mothers, the vast majority, 95% (88/93), had antibodies against Ro52, while 63% (59/93) had autoantibodies to Ro60 and 58% (54/93) had autoantibodies to La. In addition, 13% (12/93) of the autoantibody-positive mothers had antibodies to other investigated antigens besides Ro52, Ro60 and La, and of these anti-histone antibodies were most commonly represented, detected in 8% (7/93) of the mothers. In conclusion, this Swedish population-based study confirms that maternal autoantibodies may associate with heart block in the child. Further, our data demonstrate a dominant role of Ro52 antibodies in association with AV block.
To determine the attitudes of Indian children and adolescents toward family planning, a sample of 863 high school students (aged 10-18 years) from the state of Andhra Pradesh was asked 2 operational questions ("have you heard about family planning" and "why does India need family planning?") to measure levels of family planning awareness, and 2 additional questions to measure approval of family planning ("do you think family planning is a good thing" and "which is better, a big family or a small family?"). Other variables considered were religion, socioeconomic status, education, political knowledge, and media exposure. 70% of the respondents had heard of family planning. 49% were able to state a reason for family planning (FP), while 32% were able to grasp the causal connection between population growth and economic development. Of the students who had heard of FP, 85% believed that FP was good, while 14% favored large families. The findings reflected the higher level of approval of the Andhra Pradesh youth towards FP compared with their adults; this was attributed to generational differences, and possibly to the lower level of education of Indian adults. Religion exhibited a strong effect on youth's attitudes toward FP, with Hindu children exhibiting a more favorable attitude compared with their Muslim counterparts who felt that family planning was bad and large families were good. Although education appears to be the critical determinant of family planning awareness, the results suggest that overall, the integral element of the socialization process is exposure to a modernizing environment. Nevertheless, reduction of population growth rate still largely depends on the Indian government's provision of educational opportunities to its youth.
Thijssen, Sandra; Wildeboer, Andrea; Muetzel, Ryan L; Bakermans-Kranenburg, Marian J; El Marroun, Hanan; Hofman, Albert; Jaddoe, Vincent W V; van der Lugt, Aad; Verhulst, Frank C; Tiemeier, Henning; van IJzendoorn, Marinus H; White, Tonya
Prosocial behavior plays an important role in establishing and maintaining relationships with others and thus may have important developmental implications. This study examines the association between cortical thickness and prosocial behavior in a population-based sample of 6- to 9-year-old children. The present study was embedded within the Generation R Study. Magnetic resonance scans were acquired from 464 children whose parents had completed the prosocial scale of the Strengths and Difficulties Questionnaire. To study the association between cortical thickness and prosocial behavior, we performed whole-brain surface-based analyses. Prosocial behavior was related to a thicker cortex in a cluster that covers part of the left superior frontal and rostral middle frontal cortex (p < .001). Gender moderated the association between prosocial behavior and cortical thickness in a cluster including the right rostral middle frontal and superior frontal cortex (p < .001) as well as in a cluster covering the right superior parietal cortex, cuneus, and precuneus (p < .001). Our results suggest that prosocial behavior is associated with cortical thickness in regions related to theory of mind (superior frontal cortex, rostral middle frontal cortex cuneus, and precuneus) and inhibitory control (superior frontal and rostral middle frontal cortex).
Yao, T-C; Tsai, H-J; Tu, Y-L; Chang, S-W; Hua, M-C; Liao, S-L; Tsai, M-H; Chiu, C-Y; Lai, S-H; Yeh, K-W; Huang, J-L
This study investigated the relationship between the specific immunoglobulin E (IgE) profile for 40 allergens using a novel microarray technique (BioIC) and fraction of exhaled nitric oxide (FeNO) in a population sample of 1321 children. Significant positive associations were found between FeNO and sensitization to mites (P < 0.001), animals (P = 0.001), cockroaches (P < 0.001), and foods (P = 0.042), and furthermore, between FeNO and the number of sensitizations (all P < 0.05) or the sum of specific IgE (all P ≤ 0.01) against the aforementioned allergen categories. Specifically, sensitization to the following allergens was significantly related to higher FeNO: Dermatophagoides pteronyssinus, Dermatophagoides farina, Blomia tropicalis, cat, German cockroach, Oriental cockroach, codfish, crab, shrimp, and cheese (all P ≤ 0.01). In conclusion, IgE sensitization to mites, pets, cockroaches, seafood, and cheese, respectively, is significantly associated with elevated FeNO levels in a dose-dependent fashion in children. Our results provide new evidence that sensitization to certain food allergens may contribute to prompt inflammation in the airways.
Pearn, J; Nixon, J; Wilkey, I
A large total population study of childhood fresh water immersion accidents is reported. The study was undertaken in the City of Brisbane over the five-year period 1971 to 1975 inclusive, and 111 fresh water immersion accidents involving children were studied and analysed. The childhood fresh water immersion accident rate, including drowning and near-drownings, of 10-43 per year per 100,000 at risk (fatality rate of 5-17) is the highest reported. If an unsupervised child gets into difficulties in fresh water and loses consciousness he has a 50% chance of dying. The immersion accident rate has doubled over the last six years. Age-specific immersion accident rates have been calculated, and have revealed that, in the toddler group (12 months to 23 months), the fresh water immersion accident rate is 50-01 per 100,000 (fatality rate of 22-55). Rates for drowning and near-drowning accidents after a fresh water immersion, by site, age and outcome (survival versus fatality), are also presented for the first time. Swimming pools produce 6-20 immersion accidents per year per 100,000 children at risk, and the domestic family bath tub produces 1-78. Possible factors explaining the high incidence are discussed, and comparisons of drowning rates from other centres are made.
International Planned Parenthood Federation, London (England).
In an effort to help meet the growing interest and concern about the problems created by the rapid growth of population, The International Planned Parenthood Federation has prepared this booklet with the aim of assisting the study of the history and future trends of population growth and its impact on individual and family welfare, national,…
Paciorek, Christopher J; Stevens, Gretchen A; Finucane, Mariel M; Ezzati, Majid
Summary Background Urban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban–rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban–rural differentials in height and weight over time. Methods We used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban–rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes. Findings Urban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban–rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most
Snowden, Jonathan M.; Mortimer, Kathleen M.; Dufour, Mi-Suk Kang; Tager, Ira B.
Health effects of ambient air pollution are most frequently expressed in individual studies as responses to a standardized unit of air pollution changes (e.g., an interquartile interval), which is thought to enable comparison of findings across studies. However, this approach does not necessarily convey health effects in terms of a real-world air pollution scenario. In the present study, we employ population intervention modeling to estimate the effect of an air pollution intervention that makes explicit reference to the observed exposure data and is identifiable in those data. We calculate the association between ambient summertime NO2 and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25–75) in a cohort of children with asthma in Fresno, California. We scale the effect size to reflect NO2 abatement on a majority of summer days. The effect estimates were small, imprecise, and consistently indicated improved pulmonary function with decreased NO2. The effects ranged from −0.8% of mean FEF25–75 (95% Confidence Interval: −3.4 , 1.7) to −3.3% (95% CI: −7.5, 0.9). We conclude by discussing the nature and feasibility of the exposure change analyzed here given the observed air pollution profile, and we propose additional applications of the population intervention model in environmental epidemiology. PMID:25182844
Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy
Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment.
A 15-year longitudinal study in Sweden compared 211 male alcoholic inpatients and their children with a random sample of 200 men and their children. Men in both groups who used hepatotoxic drugs had more psychosocial problems than men in both groups who did not. Children of inpatients required more social assistance than children of controls. (MDM)
Kim, Moon Jung; Park, Inho; Lim, Myung Ho; Paik, Ki Chung; Cho, Sungja; Kwon, Ho Jang; Lee, Sang Gyu; Yoo, Seung Jin; Ha, Mina
The aim of this study was to determine the prevalence of attention deficit hyperactivity disorders (ADHD) in children according to socio-demographic factors and the distribution of ADHD subtypes in a community in Korea. A screening survey using the Korean version of ADHD Rating Scale (K-ARS) was conducted between 2007 and 2008, and clinical interviews by a pediatric psychiatrist were performed for selected children between 2009 and 2010. A total of 49,573 elementary school students, between ages of 7 and 12, constituted the target population, among which 38,365 students (77.2%) and respective parents gave consent to participate. Of the participants, 200 screened children were clinically examined to confirm the diagnosis of ADHD. We estimated the prevalence of ADHD and its comorbidity in the population, after adjusting for nonresponse and nonparticipation. The prevalence of ADHD was 11.7% in boys and 5.2% in girls, with an overall prevalence of 8.5%. The combined type of inattentive and hyperactive was the most frequent at 4.7% of the whole population. Children were more likely to have ADHD if their parents were separated and had less education. Most commonly combined comorbidity was autism spectrum disorder (ASD) (10.1%). The prevalence of ADHD in the school-aged population is an essential information for improving the quality of public health mental services for evaluation and treatment of ADHD.
Lekhal, Ratib; Zachrisson, Henrik Daae; Wang, Mari Vaage; Schjolberg, Synnve; von Soest, Tilmann
This study examines the association between type of child care arrangement at age 1, 1.5 and 3 years and late talking (LT). The data were from 19,919 children in the population-based prospective Norwegian Mother and Child Cohort Study (MoBa) and included information about child care arrangement, LT and a variety of covariates. Attendance at…
The aim of this study was to determine the prevalence of attention deficit hyperactivity disorders (ADHD) in children according to socio-demographic factors and the distribution of ADHD subtypes in a community in Korea. A screening survey using the Korean version of ADHD Rating Scale (K-ARS) was conducted between 2007 and 2008, and clinical interviews by a pediatric psychiatrist were performed for selected children between 2009 and 2010. A total of 49,573 elementary school students, between ages of 7 and 12, constituted the target population, among which 38,365 students (77.2%) and respective parents gave consent to participate. Of the participants, 200 screened children were clinically examined to confirm the diagnosis of ADHD. We estimated the prevalence of ADHD and its comorbidity in the population, after adjusting for nonresponse and nonparticipation. The prevalence of ADHD was 11.7% in boys and 5.2% in girls, with an overall prevalence of 8.5%. The combined type of inattentive and hyperactive was the most frequent at 4.7% of the whole population. Children were more likely to have ADHD if their parents were separated and had less education. Most commonly combined comorbidity was autism spectrum disorder (ASD) (10.1%). The prevalence of ADHD in the school-aged population is an essential information for improving the quality of public health mental services for evaluation and treatment of ADHD. PMID:28145641
Our objective was to determine what foods, nutrients, and dietary patterns are associated with development of kwashiorkor in populations of vulnerable 1- to 3-year-old Malawian children. This was a prospective observational study conducted in 8 rural villages. Upon enrollment, demographic, anthropom...
Guhn, Martin; Zumbo, Bruno D.; Janus, Magdalena; Hertzman, Clyde
This paper delineates general validity and research questions that are underlying an ongoing program of research pertaining to the Early Development Instrument (EDI, Janus and Offord 2007), a population-level measure, on which teachers rate kindergarten children's developmental outcomes in the social, emotional, physical, cognitive, and…
McDowell, Brona C.; Kerr, Claire; Parkes, Jackie
Gross Motor Function Classification System (GMFCS) level was reported by three independent assessors in a population of children with cerebral palsy (CP) aged between 4 and 18 years (n=184; 112 males, 72 females; mean age 10y 10mo [SD 3y 7mo]). A software algorithm also provided a computed GMFCS level from a regional CP registry. Participants had…
Hoie, B.; Sommerfelt, K.; Waaler, P. E.; Alsaker, F. D.; Skeidsvoll, H.; Mykletun, A.
The combined burden of psychosocial (Achenbach scales), cognitive (Raven matrices), and executive function (EF) problems was studied in a population-based sample of 6- to 12-year-old children with epilepsy (n = 162; 99 males, 63 females) and in an age- and sex-matched control group (n = 107; 62 males, 45 females). Approximately 35% of the children…
Meyer, Robert E; Liu, Gang; Gilboa, Suzanne M; Ethen, Mary K; Aylsworth, Arthur S; Powell, Cynthia M; Flood, Timothy J; Mai, Cara T; Wang, Ying; Canfield, Mark A
Trisomy 13 (T13) and trisomy 18 (T18) are among the most prevalent autosomal trisomies. Both are associated with a very high risk of mortality. Numerous instances, however, of long-term survival of children with T13 or T18 have prompted some clinicians to pursue aggressive treatment instead of the traditional approach of palliative care. The purpose of this study is to assess current mortality data for these conditions. This multi-state, population-based study examined data obtained from birth defect surveillance programs in nine states on live-born infants delivered during 1999-2007 with T13 or T18. Information on children's vital status and selected maternal and infant risk factors were obtained using matched birth and death certificates and other data sources. The Kaplan-Meier method and Cox proportional hazards models were used to estimate age-specific survival probabilities and predictors of survival up to age five. There were 693 children with T13 and 1,113 children with T18 identified from the participating states. Among children with T13, 5-year survival was 9.7%; among children with T18, it was 12.3%. For both trisomies, gestational age was the strongest predictor of mortality. Females and children of non-Hispanic black mothers had the lowest mortality. Omphalocele and congenital heart defects were associated with an increased risk of death for children with T18 but not T13. This study found survival among children with T13 and T18 to be somewhat higher than those previously reported in the literature, consistent with recent studies reporting improved survival following more aggressive medical intervention for these children. © 2015 Wiley Periodicals, Inc.
Tomayko, Emily J.; Weinert, Bethany A.; Godfrey, Liz; Adams, Alexandra K.
Introduction Tribe-based or reservation-based data consistently show disproportionately high obesity rates among American Indian children, but little is known about the approximately 75% of American Indian children living off-reservation. We examined obesity among American Indian children seeking care off-reservation by using a database of de-identified electronic health records linked to community-level census variables. Methods Data from electronic health records from American Indian children and a reference sample of non-Hispanic white children collected from 2007 through 2012 were abstracted to determine obesity prevalence. Related community-level and individual-level risk factors (eg, economic hardship, demographics) were examined using logistic regression. Results The obesity rate for American Indian children (n = 1,482) was double the rate among non-Hispanic white children (n = 81,042) (20.0% vs 10.6%, P < .001). American Indian children were less likely to have had a well-child visit (55.9% vs 67.1%, P < .001) during which body mass index (BMI) was measured, which may partially explain why BMI was more likely to be missing from American Indian records (18.3% vs 14.6%, P < .001). Logistic regression demonstrated significantly increased obesity risk among American Indian children (odds ratio, 1.8; 95% confidence interval, 1.6–2.1) independent of age, sex, economic hardship, insurance status, and geographic designation. Conclusion An electronic health record data set demonstrated high obesity rates for nonreservation-based American Indian children, rates that had not been previously assessed. This low-cost method may be used for assessing health risk for other understudied populations and to plan and evaluate targeted interventions. PMID:26916900
daCosta, Oluranti Olatokunbo; Aikins, Elfleda Angelina; Isiekwe, Gerald Ikenna; Adediran, Virginia Efunyemi
Introduction: The aims of this study were to establish the prevalence of dental features that indicate a need for early intervention and to ascertain the prevalence of different methods of early treatment among a population of Nigerian children in mixed dentition. Methods: Occlusal relationships were evaluated in 101 children in mixed dentition between the ages of 6 and 12 years who presented at the Orthodontic Unit, Department of Child Dental Health, Lagos University Teaching Hospital over a 2 years period. The need for different modes of early orthodontic treatment was also recorded. Results: Anterior tooth rotations (61.4%) and increased overjet (44.6%) were the most prevalent occlusal anomalies. Others included deep bite (31.7%), reverse overjet (13.9%), and anterior open bite (14.8%). Severe maxillary spacing and crowding were exhibited in 12.0% and 5.0%, respectively. About a third (35.7%) of the subjects presented with crossbite while lip incompetence was observed in 43.6% of the subjects. About 44% of the subjects also presented with various oral habits with digit (15.8%) and lip sucking (9.9%) being the most prevalent. Subjects were recommended for treatment with 2 by 4 fixed orthodontic appliances (22.3%), habit breakers (20.7%), removable orthodontic appliances (16.5%), and extractions (15.7%). Conclusions: Increased overjet and anterior tooth rotation were the majority of occlusal anomalies seen, which are not only esthetically displeasing but may also cause an increased susceptibility to trauma to these teeth. Treatment options varied from extractions only to the use of appliance therapy. PMID:27556019
Mirmirani, Paradi; Carpenter, Diane M
Obesity in children is a major public health concern in the United States. The objectives of the current study were to determine the prevalence of various groups of cutaneous disorders in obese children and adolescents and to compare the use of dermatology services in obese subjects with that those with a normal body mass index (BMI). This was a retrospective, population-based study at the Kaiser Permanente Northern California Managed Healthcare System. The main outcome measures were the relative risk of cutaneous disorders associated with insulin resistance, androgen excess, bacterial infection, fungal infection, viral infection, inflammation, mechanical changes, and other skin conditions (hidradenitis, hyperhidrosis) in three weight groups (normal, overweight, obese) and the number of dermatology visits. A total of 248,775 subjects were included. Bivariate analyses showed a higher proportion of insulin resistance disorders, bacterial infection, fungal infection, inflammatory disorders, mechanical changes, and other skin conditions in obese subjects than in subjects with a normal BMI (p < 0.001). Disorders of androgen excess and viral infection were significantly less common in obese subjects (p < 0.001). Obese subjects had significantly lower odds of having at least one dermatology encounter than subjects with a normal BMI (odds ratio = 0.92, 95% confidence interval 0.88, 0.96, p = 0.003). Early onset obesity is associated with cutaneous disorders characterized by hyperproliferation, inflammation, bacterial and fungal infection, and mechanical changes but lower rates of disorders of androgen excess and viral infection. The use of dermatology services was not greater in obese patients. Heightened recognition and further analysis of adipose tissue as an endocrine organ that is capable of affecting the skin is warranted.
Chung, Eun Kyoung; Knoderer, Chad A.; Buenger, Lauren E.; Healy, Daniel P.; Dees, Jennifer; Crumby, Ashley S.; Kays, Michael B.
The study objective was to evaluate the population pharmacokinetics and pharmacodynamics of extended-infusion piperacillin-tazobactam in children hospitalized in an intensive care unit. Seventy-two serum samples were collected at steady state from 12 patients who received piperacillin-tazobactam at 100/12.5 mg/kg of body weight every 8 h infused over 4 h. Population pharmacokinetic analyses were performed using NONMEM, and Monte Carlo simulations were performed to estimate the piperacillin pharmacokinetic profiles for dosing regimens of 80 to 100 mg/kg of the piperacillin component given every 6 to 8 h and infused over 0.5, 3, or 4 h. The probability of target attainment (PTA) for a cumulative percentage of the dosing interval that the drug concentration exceeds the MIC under steady-state pharmacokinetic conditions (TMIC) of ≥50% was calculated at MICs ranging from 0.25 to 64 mg/liter. The mean ± standard deviation (SD) age, weight, and estimated glomerular filtration rate were 5 ± 3 years, 17 ± 6.2 kg, and 118 ± 41 ml/min/1.73 m2, respectively. A one-compartment model with zero-order input and first-order elimination best fit the pharmacokinetic data for both drugs. Weight was significantly associated with piperacillin clearance, and weight and sex were significantly associated with tazobactam clearance. Pharmacokinetic parameters (mean ± SD) for piperacillin and tazobactam were as follows: clearance, 0.22 ± 0.07 and 0.19 ± 0.07 liter/h/kg, respectively; volume of distribution, 0.43 ± 0.16 and 0.37 ± 0.14 liter/kg, respectively. All extended-infusion regimens achieved PTAs of >90% at MICs of ≤16 mg/liter. Only the 3-h infusion regimens given every 6 h achieved PTAs of >90% at an MIC of 32 mg/liter. For susceptible bacterial pathogens, piperacillin-tazobactam doses of ≥80/10 mg/kg given every 8 h and infused over 4 h achieve adequate pharmacodynamic exposures in critically ill children. PMID:26552978
Nichols, Kristen; Chung, Eun Kyoung; Knoderer, Chad A; Buenger, Lauren E; Healy, Daniel P; Dees, Jennifer; Crumby, Ashley S; Kays, Michael B
The study objective was to evaluate the population pharmacokinetics and pharmacodynamics of extended-infusion piperacillin-tazobactam in children hospitalized in an intensive care unit. Seventy-two serum samples were collected at steady state from 12 patients who received piperacillin-tazobactam at 100/12.5 mg/kg of body weight every 8 h infused over 4 h. Population pharmacokinetic analyses were performed using NONMEM, and Monte Carlo simulations were performed to estimate the piperacillin pharmacokinetic profiles for dosing regimens of 80 to 100 mg/kg of the piperacillin component given every 6 to 8 h and infused over 0.5, 3, or 4 h. The probability of target attainment (PTA) for a cumulative percentage of the dosing interval that the drug concentration exceeds the MIC under steady-state pharmacokinetic conditions (TMIC) of ≥50% was calculated at MICs ranging from 0.25 to 64 mg/liter. The mean ± standard deviation (SD) age, weight, and estimated glomerular filtration rate were 5 ± 3 years, 17 ± 6.2 kg, and 118 ± 41 ml/min/1.73 m(2), respectively. A one-compartment model with zero-order input and first-order elimination best fit the pharmacokinetic data for both drugs. Weight was significantly associated with piperacillin clearance, and weight and sex were significantly associated with tazobactam clearance. Pharmacokinetic parameters (mean ± SD) for piperacillin and tazobactam were as follows: clearance, 0.22 ± 0.07 and 0.19 ± 0.07 liter/h/kg, respectively; volume of distribution, 0.43 ± 0.16 and 0.37 ± 0.14 liter/kg, respectively. All extended-infusion regimens achieved PTAs of >90% at MICs of ≤16 mg/liter. Only the 3-h infusion regimens given every 6 h achieved PTAs of >90% at an MIC of 32 mg/liter. For susceptible bacterial pathogens, piperacillin-tazobactam doses of ≥80/10 mg/kg given every 8 h and infused over 4 h achieve adequate pharmacodynamic exposures in critically ill children.
Saunders, Natasha Ruth; Macpherson, Alison; Guan, Jun; Sheng, Lisa; Guttmann, Astrid
Background: Unintentional injury is the leading cause of childhood death. Injury is associated with a number of sociodemographic characteristics, but little is known about risk in immigrants. Our objective was to examine the association between family immigrant status and unintentional injury in children and youth. Methods: We performed a population-based, cross-sectional study involving children and youth (age 0-24 yr) residing in Ontario from 2008 to 2012. Multiple linked health and administrative databases were used to describe unintentional injuries by family immigrant status. Unintentional injury events (e.g., emergency department visits, admissions to hospital, deaths) were analyzed using Poisson regression models to estimate rate ratios (RRs) for injury by immigrant status. Results: Annualized injury rates were 11 749 emergency department visits per 100 000 population, 267 hospital admissions per 100 000 population and 12 deaths per 100 000 population. Injury rates were lower among immigrants across all causes of unintentional injury (adjusted RR 0.56, 95% confidence interval [CI] 0.54-0.59). Among nonimmigrants, lowest neighbourhood income quintile was associated with the highest rates (RR 1.13, 95% CI 1.08-1.18, quintile 5 v. 1); among immigrants, lowest income quintile was associated with the lowest rates of injury (RR 0.88, 95% CI 0.82-0.94, quintile 5 v. 1). Highest rates of injury for nonimmigrants were among adolescents (age 10-14 yr, RR 1.23, 95% CI 1.18-1.28; v. 20-24 yr), but for immigrants, was highest among young children (0-4 yr RR 1.23, 95% CI 1.16-1.31; v. 20-24 yr). Interpretation: Rates of unintentional injury are lower among immigrant than among Canadian-born children, supporting a healthy immigrant effect. Socioeconomic status and age have different associations with injury risk, suggesting alternative causal pathways for injuries in immigrant children and youth.
The prevalence of infestation with the head louse, Pediculus capitis, was assessed among the child population, from birth to 10 years old inclusive, of the rapidly expanding Saudi Arabian city of Jeddah. Over a period of two months, 300 consecutive children attending the general practitioner for any reason were examined specifically to identify those infested with head lice: 37 cases of active infestation were found, which is an overall prevalence of 12%. An interesting distribution, however, was noted in respect of age, ranging from less than 2% in the first year of life, rising rapidly to around 30% in ages six to eight years, thereafter declining steadily to about 16% by age 10 years. The distribution of infestation among males and females was broadly similar. These results show a high head lice infestation, particularly in the early school years, where presumably interpersonal contacts are most frequent, facilitating contagious spread. As the head lice is known to spread several viral and rickettsial diseases, such as relapsing fever and typhus, greater efforts should be made towards patient education in hygiene, and towards identifying and treating the disease when found.
Peleg-Oren, Neta; Rahav, Giora; Teichman, Meir
This study examined the association between parental substance use and the increased risk among school-age children to developing psychosocial problems. Data were collected from 148 children aged 8-11 from urban areas in Israel. The following variables were assessed by four self-report questionnaires administered to the children: …
Josse, Jonathan M.; MacKay, Morag; Osmond, Martin H.; MacPherson, Alison K.
Background: Injuries are the leading cause of death among Canadian children and are responsible for a substantial proportion of hospitalizations and emergency department visits. This investigation sought to identify the factors associated with the likelihood of sustaining an injury at school among Ottawa-area children. Methods: Children presenting…
Ghaderpanah, Mahboubeh; Farrahi, Feraidoon; Khataminia, Gholamreza; Jahanbakhshi, Ahmad; Rezaei, Leila; Tashakori, Ashraf; Mahboubi, Mohammad
This study was designed to compare the Intelligence Quotient (IQ) among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population. In this cross-sectional study, 108 preschool children with equal numbers of strabismic/non-strabismic disorder (age 3–7 years) were randomly selected from exceptional strabismus clinics of Ahvaz and were evaluated with the preschool and primary scale of intelligence versions of Wechsler (WPPSI). In the current study, 108 children were evaluated. In strabismic patients the mean performance, verbal and total IQ were 89.46±19.79, 89.57±21.57 and 91.54±22.08 respectively. These mean scores in normal children were 91.89±47.53, 87.56±15.6 and 89.96±17.62consecuently. The results showed that these three different IQ subscales were not significantly different among 3 to 7 years old strabismic and nonstrabismic children ((P>0.05 for all comparisons). There was no significant difference in IQ between two sexes (P>0.05) while Persian tribe children had greater IQ score compared to other tribes (P<0.05). Also, higher paternal educational status of children related to higher IQ score. IQ score was better in combined deviations and was higher in exotropes than esotropes; however, these differences were not statistically significant (P>0.05). In this evaluation, we did not found a significant negative interference of strabismus on IQ score of preschool children. It can be concluded that paternal educational level and tribe have a significant effect on intelligent quotient, while this is not the case on sex and ocular deviation. PMID:26493422
Ghaderpanah, Mahboubeh; Farrahi, Feraidoon; Khataminia, Gholamreza; Jahanbakhshi, Ahmad; Rezaei, Leila; Tashakori, Ashraf; Mahboubi, Mohammad
This study was designed to compare the Intelligence Quotient (IQ) among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population. In this cross-sectional study, 108 preschool children with equal numbers of strabismic/non-strabismic disorder (age 3-7 years) were randomly selected from exceptional strabismus clinics of Ahvaz and were evaluated with the preschool and primary scale of intelligence versions of Wechsler (WPPSI). In the current study, 108 children were evaluated. In strabismic patients the mean performance, verbal and total IQ were 89.46±19.79, 89.57±21.57 and 91.54±22.08 respectively.These mean scores in normal children were 91.89±47.53 , 87.56±15.6 and 89.96±17.62 consecuently. The results showed that these three different IQ subscales were not significantly different among 3 to 7 years old strabismic and nonstrabismic children ((P>0.05 for all comparisons). There was no significant difference in IQ between two sexes (P>0.05) while Persian tribe children had greater IQ score compared to other tribes (P<0.05). Also, higher paternal educational status of children related to higher IQ score. IQ score was better in combined deviations and was higher in exotropes than esotropes; however, these differences were not statistically significant.(p>0.05) In this evaluation, we did not found a significant negative interference of strabismus on IQ score of preschool children. It can be concluded that paternal educational level and tribe have a significant effect on intelligent quotient, while this is not the case on sex and ocular deviation.
Götze, Heide; Weissflog, Gregor; Brähler, Elmar; Romer, Georg; Bergelt, Corinna; von Klitzing, Kai; Herzog, Wolfgang; Flechtner, Hans-Henning; Lehmkuhl, Ulrike; Ernst, Jochen
The psychological distress of men with underage children, whose female partners have cancer, was examined using the Hospital Anxiety and Depression Scale (HADS). The sample (N=141) was compared with the partners who have cancer and a comparison group of men from the general population (N=154). The male partners of cancer patients were psychological strongly distressed. About half of the partners showed increased scores in anxiety and one third of the partners had a high level of depression. There was a high correlation within the couple. The male partners of cancer patients were significantly more distressed than the comparison group of men with underage children from the general population. It is very important to assess psychosocial support needs of partners of cancer patients and to provide adequate options of possible psychosocial treatment.
Moalic é; Zérilli, A; Capo-Chichi, S; Apovi, G
Dental caries is becoming increasingly common in developing countries but very few attempts have been made to assess its prevalence accurately. We therefore carried out an epidemiological survey in 1998 in the south of Benin, to estimate the prevalence of dental caries in 300 school children, both boys and girls, aged 12 to 14 years. Each child underwent a dental examination and interview and the data obtained were recorded in a personal clinical record. We determined DMF index for various subgroups of children. We then analyzed DMF index and its correlation with sex, age, socioeconomic level, the urban or rural origin of the child, diet and daily dental hygiene practices. We found that mean DMF index at age 12 years was 0.83 (38.7% had dental caries and 4.4% had fillings), and thus, 61. 3% of the children were free of dental caries. We also found that 80% of the children had an accumulation of tartar. More boys than girls had dental caries. Rural children were less likely to have dental caries than urban children. The prevalence of caries appears to be low despite poor dental hygiene and a lack of dental treatment. These results conflict with those of most other studies. However, they should be interpreted with caution because the population studied was very homogeneous (selection bias), the age of the children could be no more than approximate (some were probably younger than 12 and others older than 14, because the registry system is inaccurate), there had been health education classes in some schools before the survey and it was difficult to define socioeconomic level and a sugary diet. For example, the lower socioeconomic level (no TV, radio, electricity or tap water) was probably an accurate representation of children from the rural area, whereas urban children were proud of being well-equipped and may have had a tendency to exaggerate. The prevalence of dental caries in this population is currently as low as that for most pre-industrial African countries. To
Kilanowski, Jill F; Ryan-Wenger, Nancy A
One goal of Healthy People 2010 (2003) is to close the gap of disparities in access to care and health. The purpose of this descriptive exploratory study was to evaluate health status indicators in the children of itinerant carnival and migrant farmworkers aged birth to 12 years. Health status outcomes (immunization records, well-child examinations, dental health status, and growth parameters) were compared between the two groups and to national averages to identify health disparities. All forms were available in Spanish and English. A total of 97 children were recruited for this study: 45 carnival children and 52 migrant farmworker children.
Samara, Muthanna; Johnson, Samantha; Lamberts, Koen; Marlow, Neil; Wolke, Dieter
Aim: The aim of this study was to investigate the prevalence of eating problems and their association with neurological and behavioural disabilities and growth among children born extremely preterm (EPC) at age 6 years. Method: A standard questionnaire about eating was completed by parents of 223 children (125 males [56.1%], 98 females [43.9%])…
O'Neil, Sharon Lund; And Others
A study of the 4,382 children in the New Milford (Connecticut) Public School System was conducted to determine if upper respiratory conditions and other health problems were related to school performance. On the basis of this study, special education programing was not recommended for asthmatic children. (Author/MT)
Dansby, Virginia S.; Marinelli, Robert P.
A comparison of adolescent children of Vietnam combat veterans with non-combat veterans found the majority of outcomes were not significantly different. However, children of combat veterans showed poorer attitudes towards school; more negative attitudes towards their father; experienced more depression, tension, apprehension, and anxiety; and…
Nilsen, Elizabeth S.; Fecica, Agnieszka M.
Successful communication requires that individuals attend to the perspective of their conversational partners and use this information to modify their behavior accordingly. This paper presents a framework by which to understand children's communicative perspective-taking skills and, within this framework, outlines three routes by which children's…
Urbano, Richard C.; Hodapp, Robert M.
In this study, we examined the nature, timing, and correlates of divorce in families of children with Down syndrome (647), other birth defects (10,283) and no identified disability (361,154). Divorce rates among families of children with Down syndrome were lower than in the other two groups. When divorce did occur in the Down syndrome group,…
McDaniel, Grace Ann
The number of homeless children in the United States is increasing. The National Center on Family Homelessness (2010) reports that on average one in 50 children in the United States have experienced homelessness, defined as unstable housing. The needs of this student demographic are varied and complex. For the purpose of this study, the homeless…
To, Carol K. S.; Cheung, Pamela S. P.; McLeod, Sharynne
Purpose: This study investigated children's acquisition of Hong Kong Cantonese. Method: Participants were 1,726 children ages 2;4 to 12;4 (years;months). Single-word speech samples were collected to examine 4 measures: initial consonants, final consonants, vowels/diphthongs, and lexical tones. A 2-way analysis of variance was performed to examine…
Bågenholm, A; Gillberg, C
The probands of this study were 60 children and young adults between 5 and 20 years of age, 20 of whom had siblings with autism, 20 of whom had siblings with mental retardation, and 20 of whom had siblings who were free of handicap. The three proband groups were matched for gender, birth order and socioeconomic status. The children were questioned about their sibling relationships and about particular problems they faced concerning their handicapped brothers or sisters and about problems concerning themselves. Parents were interviewed about the healthy child's behaviour and social adjustment. Mothers completed the Eysenck Personality Inventory concerning themselves. Siblings of handicapped children and especially siblings of children with autism were more concerned about the future. They also felt lonely more often and many of them had peer problems. They often regarded their handicapped siblings as a burden. They tended to have only one sibling. Siblings often did not know why their handicapped brother or sister was different from other children. There were more behaviour disturbances in the siblings of handicapped children and mothers with a child with autism reported more 'stressful events'. There were no differences as regards the personality of the mothers and the self-concept of the children between the three groups.
US Department of Agriculture, 2009
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides food, nutrition education, breastfeeding support, and health care and social service referrals to nutritionally at-risk low-income pregnant women, new mothers, infants, and children through age 4. This report offers updated estimates of the population that…
Kirby, A.; Woodward, A.; Jackson, S.; Wang, Y.; Crawford, M. A.
Despite the increased interest in the effects of omega-3 supplementation on childrens' learning and behaviour, there are a lack of controlled studies of this kind that have utilised a typically developing population. This study investigated the effects of omega-3 supplementation in 450 children aged 8-10 years old from a mainstream school…
Mejía-Aranguré, Juan Manuel; Bonilla, Miguel; Lorenzana, Rodolpho; Juárez-Ocaña, Servando; de Reyes, Gladys; Pérez-Saldivar, María Luisa; González-Miranda, Guadalupe; Bernáldez-Ríos, Roberto; Ortiz-Fernández, Antonio; Ortega-Alvarez, Manuel; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo
Background There are very few studies that report the incidence of acute leukemias in children in Latin America. This work assesses the incidence of acute leukemias, between 1996 and 2000, in children from 0–14 years old who were attended at the Mexican Social Security Institute in Mexico City and in children from 0–11 years old in El Salvador. Methods Design: Population-based data. Hospitals: In San Salvador, El Salvador, Hospital Nacional de Niños "Benjamín Bloom", the only center in El Salvador which attends all children, younger than 12 years, with oncologic disease. The Pediatric Hospital and the General Hospital of the Mexican Social Security Institute in Mexico City, the only centers in Mexico City which attend all those children with acute leukemia who have a right to this service. Diagnosis: All patients were diagnosed by bone marrow smear and were divided into acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and unspecified leukemias (UL). The annual incidence rate (AIR) and average annual incidence rate (AAIR) were calculated per million children. Cases were stratified by age and assigned to one of four age strata: 1) <1 year; 2) 1–4 years; 3) 5–9 years, or 4) 10–14 or 10–11 years, for Mexico City and El Salvador, respectively. Results The number of cases was 375 and 238 in El Salvador and Mexico City, respectively. AAIRs in Mexico City were 44.9, 10.6, 2.5, 0.5, and 58.4 per million children for ALL, AML, CML, UL, and total leukemias, respectively. The AAIRs in El Salvador could not be calculated because the fourth age stratum in El Salvador included children only from 0–11 years old. The incidence rates for the Salvadoran group of 0–11 year olds were 34.2, 7.1, 0.6, 0.2, and 43.2 per million children for ALL, AML, CML, UL, and total leukemias, respectively. Conclusion Reported AIRs for each age group in El Salvador were similar to those from other American countries. The AAIR of ALL in
Dworkin, Paul H; Sood, Aradhana Bela
What if the goal of child health services was not "merely" treating, or even preventing, childhood diseases and disorders, but was expanded to that of promoting children's optimal healthy development? Pediatrics has evolved from an exclusive focus on the treatment of illness to the opportunity to promote children's healthy development. This evolution has profound implications for the content of child health services and programs, for system transformation, and for public policy. Enhanced understanding of the impact of social determinants on children's health and developmental outcomes underscores the importance of an evolving framework for system transformation with key policy implications.
Waterhouse, David; de Sousa-Figueiredo, Jose C.; Roberts, Stephen A.; Atuhaire, Aaron; Van Dam, Govert J.; Corstjens, Paul L. A. M.; Scott, Janet T.; Stanton, Michelle C.; Kabatereine, Narcis B.; Ward, Stephen; Hope, William W.; Stothard, J. Russell
ABSTRACT Each year, millions of African children receive praziquantel (PZQ) by mass drug administration (MDA) to treat schistosomiasis at a standard single dose of 40 mg/kg of body weight, a direct extrapolation from studies of adults. A higher dose of 60 mg/kg is also acceptable for refractory cases. We conducted the first PZQ pharmacokinetic (PK) and pharmacodynamic (PD) study in young children comparing dosing. Sixty Ugandan children aged 3 to 8 years old with egg patent Schistosoma mansoni received PZQ at either 40 mg/kg or 60 mg/kg. PK parameters of PZQ racemate and enantiomers (R and S) were quantified. PD outcomes were assessed by standard fecal egg counts and novel schistosome-specific serum (circulating anodic antigen [CAA]) and urine (circulating cathodic antigen [CCA]) antigen assays. Population PK and PD analyses were performed to estimate drug exposure in individual children, and the relationship between drug exposure and parasitological cure was estimated using logistic regression. Monte Carlo simulations were performed to identify better, future dosing regimens. There was marked PK variability between children, but the area under the concentration-time curve (AUC) of PZQ was strongly predictive of the parasitological cure rate (CR). Although no child achieved antigenic cure, which is suggestive of an important residual adult worm burden, higher AUC was associated with greater CAA antigenic decline at 24 days. To optimize the performance of PZQ, analysis of our simulations suggest that higher doses (>60 mg/kg) are needed, particularly in smaller children. PMID:27507822
Scott, Nicola; Blair, Peter S; Emond, Alan M; Fleming, Peter J; Humphreys, Joanna S; Henderson, John; Gringras, Paul
Associations between sleep duration and disturbance in infancy and early childhood and attention deficit hyperactivity disorder diagnoses were investigated. Data from the Avon Longitudinal Study of Parents and Children, a population-based prospective longitudinal birth-cohort study of children born in 1991-1992 in South-West England, were employed. Eight thousand, one hundred and ninety-five children were assessed using the Development and Well-Being Assessment. One hundred and seventy-three cases (2.1%) met criteria for attention deficit hyperactivity disorder. Parental report at eight time points showed children with attention deficit hyperactivity disorder slept less than peers. Absolute differences were small and mainly restricted to night-time sleep, with no strong evidence of differences from controls, except at 69 months [5 years 9 months; 12 min (95% CI: 5-19), P = 0.001], at 81 months [6 years 9 months; 15 min (95% CI: 8-22), P < 0.001] and at 115 months [9 years 7 months; 11 min (95% CI: 4-18), P = 0.001]. The attention deficit hyperactivity disorder group had more night-waking at every age, significant from about 5 years. When tracking children's sleep along a normative centiles chart, a shift in sleep duration from one centile to a lower centile was a useful predictor of attention deficit hyperactivity disorder. Age-specific decreases of >1SD in sleep duration across adjacent time points was a significant predictor of attention deficit hyperactivity disorder at 3-5 years (P = 0.047). In children with attention deficit hyperactivity disorder, shorter sleep duration and sleep disturbances appear early and predate the usual age of clinical diagnosis. The rate of change of sleep duration relative to an individual, rather than absolute sleep duration at any stage, may prove beneficial in identifying increased risk of attention deficit hyperactivity disorder.
Tsai, Jeng-Dau; Wang, I-Chung; Chen, Hsuan-Ju; Sheu, Ji-Nan; Li, Tsai-Chung; Tsai, Henry J; Wei, Chang-Ching
Attention-deficit/hyperactivity disorder (ADHD) and nocturnal enuresis are common disorders with extensive psychosocial suffering in affected children, and healthcare burden on parents. Whether the childhood psychological disorders and nocturnal enuresis are factors contributing to ADHD have not been clearly established. This study conducted a population-based case-control study using data sets from the National Health Research Insurance database, and identified 14 900 children diagnosed with ADHD. Risk factors that have been associated with or possibly related to ADHD development were included in this study. Performance of in groups of ADHD with enuresis was compared with controls. With adjustment for potential covariates, participants with enuresis exhibited a 2.24-fold greater risk of subsequent ADHD development compared with controls (95% CI 1.84 to 2.73). Participants with enuresis and comorbidity had a significantly greater risk of ADHD than those with no enuresis and no comorbidity (adjusted OR=8.43, 95% CI 4.38 to 16.2). Children who are assessed for ADHD should be evaluated for the presence of enuresis or other neurobehavioral comorbidities. Multidisciplinary treatment may benefit children with ADHD and minimize psychological burden on parents.
Douglas, Emily M; Hines, Denise A
Children whose parents seek help for partner violence (PV) victimization are at an increased risk for internalizing and externalizing behavioral health problems. The literature has examined this phenomenon primarily among children of battered women. This study examines the sociodemographic characteristics and behavioral health of children whose fathers have sought help for PV victimization and compares them to children of men from the general population. Children whose fathers sought help for PV victimization were less likely to live with their fathers. Bivariate analyses showed that children of male victims had elevated scores in Diagnostic and Statistical Manual of Mental Disorders (DSM)-related areas of behavioral health; many of these findings remain in multivariate analyses, especially among older children. The implications of the results are discussed for researchers and social service practitioners.
Gheshlaghi, Farzad; Piri-Ardakani, Mohammad-Reza; Yaraghi, Mansooreh; Shafiei, Faranak; Behjati, Mohaddaseh
Objective Acute accidental poisoning in children is still an important public health problem. The epidemiological investigation specific for each country is necessary to determine the extent and characteristics of the problem. The aim of our study was to elucidate the current pattern of acute poisoning among children. Methods The present retrospective study describes the epidemiology of acute accidental poisoning in children (less than 10 years old) admitted to the Emergency Department of two teaching hospitals during a period of two years. Findings Three hundred and forty four children under 10 years old were admitted to emergency department of two teaching hospitals due to acute accidental poisoning. Drugs were the most common agents causing the poisoning (58.1%), followed by Hydrocarbons (13.1%), and opioids (9.3%). Common signs were neurological (42.6%) with lethargy being the most common (39.1%). 50.6% of cases were discharged from hospital within 6-12 hours, 91.6% of them without any complication. Conclusion Accidental poisonings are still a significant cause of morbidity among children in developing countries. Regarding the high prevalence of pharmaceutical drug poisoning and because lethargic was the most frequent neurological sign, comprehensive toxicology screen tests should be included as part of the routine evaluation of children presenting to an ED with an apparent life-threatening event. PMID:23724181
Tseng, Jen-Ho; Tseng, Ming-Yuan
Primary malignant brain tumor is the second most common cancer in children. To investigate factors affecting children's survival at a population level, data of 3,169 patients (age<15 years) from the Cancer Registry in England and Wales were used. They were diagnosed during 1971-1990 and followed up until 1995. Variables including age, gender, morphology, WHO grade, tumor site, socioeconomic status, geographical region, and period of diagnosis were available for analysis using the Kaplan-Meier method and the Cox hazards ratio (HR) regression. Results showed that the median survival and the 1-, 5-, and 10-year crude survival rate for this population were 8.7 years, 72.4, 54.0, and 49.2% respectively. Survival was influenced by age (HR 0.88/5 years), morphology (ependymoma HR 2.43), WHO grades (HR 1.42/grade), tumor sites (brain stem HR 2.11), and periods of diagnosis (HR 0.88/5 years). Gender, socioeconomic status, and geographical region did not affect their survival. Results from this population-based data are very helpful for comparison with other hospital-based studies and for public health purposes.
McGill, Kenneth; McGill, Scott A
The continued need for improvement within a 'system of care' is essential as the need for mental health services by those 'youth' within the child welfare system continually grows. This article outlines the statewide reform of New Jersey's Children's Behavioral Healthcare System, which began in 2000, as well as including the recommendations of the University of South Florida as part of their 'Final Report: Independent Assessment of New Jersey's Child Behavioral Health Services' on continued changes within the system of care. Successful outcomes have resulted from this welfare reform initiative, which include most notably the significant caseload decrease of the Division of Youth and Family Services (DYFS) and the creation of a new cabinet entity, the Department of Children and Families (DCF). This article specifically outlines systemic recommendations to best serve the target population of 'transitional' youth between the ages of 16 to 18+ years utilizing interagency cooperation based upon 'theory of change' and Total Clinical Outcomes Management (TCOM) strategies.
Pedraza-Bernal, Angela M; Rodriguez-Martinez, Carlos E; Acuña-Cordero, Ranniery
Although predictors of severe viral acute lower respiratory infections (ALRIs) in children have been reported, there have been few research studies performed in low- and middle-income countries (LMIC). The aim of the present study was to determine predictors of disease severity in a population of Colombian children <5 years of age with ALRI. In a prospective cohort study, we determined independent predictors of severe ALRI in a hospitalized population of children under 5 years old with ALRI during a 1-year period. We included both underlying disease conditions and the infecting respiratory viruses as predictor variables of severe disease. We defined severe disease as the necessity of pediatric intensive care unit admission. Of a total of 1,180 patients admitted with a diagnosis of ALRI, 416 (35.3%) were included because they were positive for any kind of respiratory virus. After controlling for potential confounders, it was found that a history of pulmonary hypertension (RR 3.62; CI 95% 2.38-5.52; P < 0.001) and a history of recurrent wheezing (RR 1.77; CI 95% 1.12-2.79; P = 0.015) were independent predictors of severe disease. The present study shows that respiratory viruses are significant causes of ALRI in infants and young children in Colombia, a typical tropical LMIC, especially during the rainy season. Additionally, the results of the present study show that clinical variables such as a history of pulmonary hypertension and a history of recurrent wheezing are more relevant for predicting ALRI severity than the infecting respiratory viruses.
Translating adult electrophysiology findings to younger patient populations: difficulty measuring 40 Hz auditory steady-state responses in typically developing children and children with autism spectrum disorder
Edgar, J. Christopher; Fisk, Charles L.; Liu, Song; Pandey, Juhi; Herrington, John D.; Schultz, Robert T.; Roberts, Timothy P.L.
Background Gamma (~30 to 80 Hz) brain rhythms are thought to be abnormal in neurodevelopmental disorders such as schizophrenia (SZ) and autism spectrum disorder (ASD). In adult populations, auditory 40 Hz click trains or 40 Hz amplitude-modulated tones are used to assess the integrity of superior temporal gyrus (STG) 40 Hz gamma-band circuits. As STG 40 Hz auditory steady-state responses (ASSRs) are not fully developed in children, tasks using these stimuli may not be optimal in younger patient populations. The present study examined this issue in typically developing (TD) children as well as in children with ASD, using source localization to directly assess activity in the principal generators of the 40 Hz ASSR - left and right primary/secondary auditory cortex. Methods 40 Hz amplitude-modulated tones of 1sec duration were binaurally presented while magnetoencephalography (MEG) data were obtained from forty-eight TD children (45 males; 7- to 14-years-old) and forty-two children with ASD (38 males; 8- to 14-years-old). T1-weighted structural MRI was obtained. Using single dipoles anatomically constrained to each participant's left and right Heschl's Gyrus, left and right 40 Hz ASSR total power (TP) and inter-trial coherence (ITC) measures were obtained. Associations between 40 Hz ASSR TP, ITC and age as well as superior temporal gyrus (STG) gray matter cortical thickness were measured. Group STG function and structure differences were also examined. Results TD and ASD groups did not differ on 40 Hz ASSR TP or ITC. In TD and ASD, age was associated with left and right 40 Hz ASSR ITC (p < 0.01). The interaction term was not significant, indicating in both groups a ~0.01/year increase in ITC. 40 Hz ASSR TP and ITC were greater in the right than left STG. Groups did not differ in STG cortical thickness, and no associations were observed between 40 Hz ASSR activity and STG cortical thickness. Finally, right STG transient gamma (50 to 100 ms and 30 to 50 Hz) was greater
Dinçel, Nida; Ünalp, Aycan; Kutlu, Ayşe; Öztürk, Aysel; Uran, Nedret; Ulusoy, Sadık
Background & objectives: It has been hypothesized that abnormal levels of serum nerve growth factor (NGF) may represent a serological marker for autistic children who may develop cognitive impairment, regression and finally epilepsy. The objective of this preliminary study was to measure serum NGF concentrations of autistic children and compare these levels with those of healthy children. Methods: Consecutive children who were referred to the Paediatric Neurology and Child Psychiatry Policlinics of Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Turkey between February and September 2008 were included in the study. Serum samples were analyzed for NGF levels using ChemiKine NGF Sandwich ELISA Kit. Comparisons between the study and the control groups were made using student's t test and Chi-square test. Results: Forty-nine autistic children and an equal number of healthy children (control group) were included in the study. No significant difference was found between the study and the control groups in terms of children's age, while number of boys was significantly higher (P<0.05) in the study group. Average serum NGF concentrations were 46.94 ± 51.40 and 32.94 ± 12.48 pg/ml in the study and control group, respectively. Serum NGF concentrations were significantly higher (P<0.05) in the study group compared with the control group. Interpretation & conclusions: Our preliminary findings show that enhanced serum NGF concentration may be used as a potential diagnostic tool in autism, however, further studies including a large number of patients are required to confirm the findings. PMID:24521633
Benedict, Ruth E; Patz, Jean; Maenner, Matthew J; Arneson, Carrie L; Yeargin-Allsopp, Marshalyn; Doernberg, Nancy S; Van Naarden Braun, Kim; Kirby, Russell S; Durkin, Maureen S
For conditions with wide-ranging consequences, such as cerebral palsy (CP), population-based surveillance provides an estimate of the prevalence of case status but only the broadest understanding of the impact of the condition on children, families or society. Beyond case status, information regarding health, functional skills and participation is necessary to fully appreciate the consequences of the condition. The purpose of this study was to assess the feasibility and reliability of enhancing population-based surveillance by classifying gross motor function (GMF) from information available in medical records of children with CP. We assessed inter-rater reliability of two GMF classification methods, one the Gross Motor Function Classification System (GMFCS) and the other a 3-category classification of walking ability: (1) independently, (2) with handheld mobility device, or (3) limited or none. Two qualified clinicians independently reviewed abstracted evaluations from medical records of 8-year-old children residing in southeast Wisconsin, USA who were identified as having CP (n = 154) through the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network. Ninety per cent (n = 138) of the children with CP had information in the record after age 4 years and 108 (70%) had adequate descriptions of gross motor skills to classify using the GMFCS. Agreement was achieved on 75.0% of the GMFCS ratings (simple kappa = 0.67, 95% confidence interval [95% CI 0.57, 0.78], weighted kappa = 0.83, [95% CI 0.77, 0.89]). Among case children for whom walking ability could be classified (n = 117), approximately half walked independently without devices and one-third had limited or no walking ability. Across walking ability categories, agreement was reached for 94% (simple kappa = 0.90, [95% CI 0.82, 0.96], weighted kappa = 0.94, [95% CI 0.89, 0.98]). Classifying GMF in the context of active records-based surveillance is feasible and reliable
Posserud, Maj-Britt; Lundervold, Astri J.; Gillberg, Christopher
Background: The prevalence of autism is reported to be on the rise worldwide. Change of diagnostic criteria and a broadening of the concept of autism have been mentioned as contributing factors. Further studies of general populations are needed. The present study assessed the distribution of autistic features in a total population of children 7-9…
Carvalho, Anita Cruz; Paiva, Saul Martins; Viegas, Claudia Marina; Scarpelli, Ana Carolina; Ferreira, Fernanda Morais; Pordeus, Isabela Almeida
The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families.
Urbano, Richard C; Hodapp, Robert M
In this study, we examined the nature, timing, and correlates of divorce in families of children with Down syndrome (647), other birth defects (10,283) and no identified disability (361,154). Divorce rates among families of children with Down syndrome were lower than in the other two groups. When divorce did occur in the Down syndrome group, however, a higher proportion occurred within the first 2 years after the child's birth. Mothers and fathers of children with Down syndrome were much more likely to divorce if they were younger, had not graduated from high school, and if fathers were less educated and lived in a rural area. Few effects on divorce were noted for a variety of family structure variables.
Beals, J.A.J.; Funk, L.M.; Fountain, R.; Sedman, R.
Assessments of inhalation exposure to environmental agents necessitate quantitative estimates of pulmonary ventilation rates. Estimating a range of exposures in a given population requires an understanding of the variability of ventilation rates in the population. Distribution of ventilation rates (Ve) were described based on the results of a large study where Ve were measured while subjects performed a variety of physical tasks. Three distinct ventilation levels were identified using cluster analyses of the mean Ve and then various activities were assigned to the three levels using a k-means procedure. Separate distributions were identified for the three Ve levels for adult males, adult females, and children. The variability of Ve was consistent with a lognormal distribution for all groups. An aggregate daily inhalation rate can be estimated based on the distributions of Ve. 41 refs., 1 fig., 5 tabs.
Wolfe-Christensen, Cortney; Fedele, David A; Grant, DeMond; Veenstra, Amy L; Kovacevic, Larisa G; Elder, Jack S; Lakshmanan, Yegappan
The research objective was to identify the factor structure of the pediatric symptom checklist (PSC) in children with voiding dysfunction and/or nocturnal enuresis who were seen in a pediatric urology clinic. Retrospective chart reviews were conducted for 498 consecutive patients, ages 6-16, who were seen over a 13-month period. The PSC, a 35-item measure used to screen for psychosocial difficulties, was completed by the patient's caregiver. Confirmatory factor analyses using three previous models were conducted. A four factor model comprised of internalizing, externalizing, attention problems, and chronic illness factors represented the best fit to the data. Within this population, the PSC appears to capture internalizing and externalizing problems, difficulties with attention, and possible side effects of a medical condition. This information could aid clinicians in assessing adjustment difficulties within this population and concurrently allow researchers to examine whether these specific factors are related to other relevant outcomes.
Gordon, Linda W.
Presents the age-sex structures of refugee populations arriving in the United States from Cambodia, Laos, and Vietnam from 1975 through 1986. Differences in the composition of these young populations reflect varying flight and resettlement experiences and changing factors influencing migration. High fertility rates predict a generation of rapid…
Lansford, L. M.; Asmussen, J. M.
Differences in the normative data presented in the Koppitz Scoring System for the Bender Gestalt Test (a measure for diagnosing learning and neurological disorders) were compared for 838 elementary age children of the Sioux, Chippewa, Navajo, and Apache tribes and a Koppitz normative group. Considered were mean error differences and mean time…
Ettaro, L.; Berger, R. P.; Songer, T.
Objective: To describe the presenting characteristics, hospital course, and hospital charges associated with hospital admissions for head trauma in young children at a regional pediatric trauma center, and to examine whether these factors differ among abused and non-abused subjects. Method: Comparative case series study involving a retrospective…
Rosemberg, Celia Renata; Alam, Florencia; Stein, Alejandra
The study analyzed the conversational exchanges through which child tutors mediated literacy abilities and knowledge with young children in the framework of the project "From Child to Child: A Tutor-Child Literacy Program," that is being conducted in Buenos Aires, Argentina. The analysis considered the conversational moves deployed by…
Yeaw, John David Andrew
This paper reviews the effectiveness of music therapy in treating children with psychiatric and developmental problems. The clinical utility of music therapy is first evaluated by examining the foundational effects of music on affect and behavior. Next, the two broad approaches to music therapy, active and passive music therapy, are discussed.…
Alqahtani, Mohammed M.
Objective: To investigate comorbidity of oppositional-defiant disorder (ODD), conduct disorder (CD), anxiety, and depression and to investigate the impaired social and academic developments among children with ADHD in primary school settings in Saudi Arabia. Method: Data for the purpose of this study are obtained from parent and teachers of 652…
Lahaye, Magali; Mikolajczak, Moira; Rieffe, Carolien; Villanueva, Lidon; Van Broeck, Nady; Bodart, Eddy; Luminet, Olivier
The main aim of the present study was to examine the cross-cultural equivalence of a newly developed questionnaire, the Emotion Awareness Questionnaire (EAQ30) that assesses emotional awareness of children through self-report. Participants were recruited in three countries: the Netherlands (N = 665), Spain (N = 464), and Belgium (N = 707),…
Vreeke, Leonie J; Muris, Peter; Mayer, Birgit; Huijding, Jorg; Bos, Arjan E R; van der Veen, Monique; Raat, Hein; Verheij, Fop
The Behavioral Inhibition Questionnaire-Short Form (BIQ-SF) is a 14-item parent-rating scale for assessing an inhibited, anxiety-prone temperament in preschool children. This study examined the psychometric properties of the BIQ-SF scores in a multi-ethnic community population of Dutch boys and girls aged 2.5-6 years (total N = 2,343, from which various subsamples were derived). Results revealed that the factor structure of the BIQ-SF was as hypothesized: a model with six correlated factors representing children's inhibited behaviors in various social and non-social contexts provided a good fit for the data. The internal consistency of the BIQ-SF was generally satisfactory and scores on the scale were found to be fairly stable over a time period of up to 2 years. Parent-teacher agreement was acceptable, and relations between the BIQ-SF and observations of an inhibited temperament were moderate. Finally, BIQ-SF scores were positively associated with measures of anxiety and internalizing symptoms, whereas no significant links were found with externalizing symptoms. Altogether, these results provide support for the reliability and validity of the BIQ-SF as an economical method for assessing behavioral inhibition and anxiety proneness in young children.
Background Population-based self-reported data on off-label medicine use independent from health care provisions are lacking. The purpose of this study is to investigate off-label medicine use in children and adolescents in Germany in a non-clinical setting and to identify prevalence, determinants and spectrum of off-label medicine use. Methods Data were obtained from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) conducted by the Robert Koch Institute (2003–2006). 17,450 randomly selected children aged 0–17 years took part in the drug interviews. Of those, 8,899 took at least one medicine during the 7 days preceding the interview. Off-label medicine use was defined as the discrepancy between actual use and the intended use described in the summary of product characteristics. Off-label medicine use was stratified into off-label indication, off-label age, off-label over-dosing, and off-label under-dosing. Results The prevalence rate of off-label medicine use among those who used medicines amount of is 40.2%. The prevalence rate is significantly higher in boys (41.4%), in children aged 3 to 6 years (48.7%), without migration background (40.9%), with high social status (42.5%), living in small (42.0%) and medium sized cities (41.6%), and with a poor parents rated health status (41.7%). 12,667 preparations (attributable in respect to off-label use) were taken by 8,899 children. 30% of the medicines have been used off-label. Off-label medicine use was highest in preparations of the ATC-class “C00 Cardiovascular System”. In all origins of medicine, all age groups and all ATC-classes under-dosing was the most frequent reason for off-label medicine use. Conclusions There is a considerable level of self-reported off-label medicines use in the general paediatric population. Further investigations are needed to examine in how far off-label medicine use is based on lack of knowledge or on empiricism in paediatric
Background Externalising and internalising problems affect one in seven school-aged children and are the single strongest predictor of mental health problems into early adolescence. As the burden of mental health problems persists globally, childhood prevention of mental health problems is paramount. Prevention can be offered to all children (universal) or to children at risk of developing mental health problems (targeted). The relative effectiveness and costs of a targeted only versus combined universal and targeted approach are unknown. This study aims to determine the effectiveness, costs and uptake of two approaches to early childhood prevention of mental health problems ie: a Combined universal-targeted approach, versus a Targeted only approach, in comparison to current primary care services (Usual care). Methods/design Three armed, population-level cluster randomised trial (2010–2014) within the universal, well child Maternal Child Health system, attended by more than 80% of families in Victoria, Australia at infant age eight months. Participants were families of eight month old children from nine participating local government areas. Randomised to one of three groups: Combined, Targeted or Usual care. The interventions comprises (a) the Combined universal and targeted program where all families are offered the universal Toddlers Without Tears group parenting program followed by the targeted Family Check-Up one-on-one program or (b) the Targeted Family Check-Up program. The Family Check-Up program is only offered to children at risk of behavioural problems. Participants will be analysed according to the trial arm to which they were randomised, using logistic and linear regression models to compare primary and secondary outcomes. An economic evaluation (cost consequences analysis) will compare incremental costs to all incremental outcomes from a societal perspective. Discussion This trial will inform public health policy by making recommendations about the
Dales, Robert E.; Cakmak, Sabit
Background Both air pollution exposure and the presence of mental illness are associated with an increased risk of physical illness. Objective To determine whether or not children with less favourable mental health are more susceptible to pulmonary and cardiovascular effects of ambient air pollution, compared to those who are mentally healthy. Methods We carried out a cross-sectional study of 1,883 children between the ages of 6 and 17 years of age who participated in the Canadian Health Measures population survey between 2007 and 2009. Subjects were assigned the air pollution values obtained from the National Air Pollution monitor closest to their neighborhood. Lung function, heart rate and blood pressure were stratified by indicators of mental health. The latter were ascertained by questions about feelings of happiness, a diagnosed mood disorder, and the emotional symptom subscale of the Strengths and Difficulties Questionnaire. Results Among those who reported a mood disorder, an interquartile increase in ozone was associated with increases in systolic and diastolic pressures of 3.8 mmHg (95% CI 1.6, 5.9) and 3.0mmHg (95%CI 0.9, 5.2) respectively, and a decreases in FVC of 7.6% (95% CI 2.9, 12.3). No significant changes in these variables were observed in those who did not report a mood disorder. Among those with unfavourable emotional symptoms, ozone was associated with a 6.4% (95% CI 1.7, 11.3) increase in heart rate, a 4.1% (95%CI 1.2, 7.1) increase in systolic blood pressure, and a 6.0% (95% CI 1.4, 10.6) decrease in FEVl. No significant effect was seen in these variables among those with no emotional symptoms. Conclusions In the Canadian population, children who report mood disorders or unfavourable emotional symptoms appear to be more vulnerable to the adverse physiologic effects of air pollution. PMID:28030615
Lupo, Philip J; Danysh, Heather E; Plon, Sharon E; Curtin, Karen; Malkin, David; Hettmer, Simone; Hawkins, Douglas S; Skapek, Stephen X; Spector, Logan G; Papworth, Karin; Melin, Beatrice; Erhardt, Erik B; Grufferman, Seymour; Schiffman, Joshua D
Relatively little is known about the epidemiology and factors underlying susceptibility to childhood rhabdomyosarcoma (RMS). To better characterize genetic susceptibility to childhood RMS, we evaluated the role of family history of cancer using data from the largest case–control study of RMS and the Utah Population Database (UPDB). RMS cases (n = 322) were obtained from the Children's Oncology Group (COG). Population-based controls (n = 322) were pair-matched to cases on race, sex, and age. Conditional logistic regression was used to evaluate the association between family history of cancer and childhood RMS. The results were validated using the UPDB, from which 130 RMS cases were identified and matched to controls (n = 1300) on sex and year of birth. The results were combined to generate summary odds ratios (ORs) and 95% confidence intervals (CI). Having a first-degree relative with a cancer history was more common in RMS cases than controls (ORs = 1.39, 95% CI: 0.97–1.98). Notably, this association was stronger among those with embryonal RMS (ORs = 2.44, 95% CI: 1.54–3.86). Moreover, having a first-degree relative who was younger at diagnosis of cancer (<30 years) was associated with a greater risk of RMS (ORs = 2.37, 95% CI: 1.34–4.18). In the largest analysis of its kind, we found that most children diagnosed with RMS did not have a family history of cancer. However, our results indicate an increased risk of RMS (particularly embryonal RMS) in children who have a first-degree relative with cancer, and among those whose relatives were diagnosed with cancer at <30 years of age. PMID:25809884
Shapiro, Cheri J; Kilburn, Janice; Hardin, James W
Because young children with disabilities are at elevated risk for development of challenging behaviors, and caregivers of these children typically lack access to evidence-based parenting interventions, two randomized trials were conducted to examine the impact of an evidence-based parenting intervention, Stepping Stones Triple P (SSTP), as a selective preventive intervention. Both studies targeted parents of children under two with a variety of disabilities who were enrolled in the IDEA Part C Early Intervention (EI) system in one state. SSTP was delivered in family homes. In Study One, 49 families were randomly assigned to EI services as usual, with or without SSTP; a 52% attrition rate from treatment was seen. No significant between-group differences were seen aside from a trend toward reduced symptoms of parental depression at follow-up. Intervention group children demonstrated significant decline in behavior problems from post treatment to follow-up, and there was a trend toward improved parenting style in the intervention group during this same time frame. Study Two incorporated a separate workforce intervention for EI service coordinators; 40 families on their caseloads were then randomly assigned to receive EI services as usual with or without SSTP. Attrition from treatment was limited to 20%. No differential impact was seen on child behavior; a trend was noted post-treatment on parent symptoms of depression and on the observed parent-child relationship. At 12-month follow-up, there was a trend favoring improvement in the intervention group in parenting style; statistically significant impact was also seen on the observed quality of the parent-child relationship. SSTP shows promise as a selective preventive intervention for an early intervention population. Reasons for the differential findings between the two studies are explored and suggestions for future research are provided.
Thiering, E.; Brüske, I.; Kratzsch, J.; Hofbauer, L. C.; Berdel, D.; von Berg, A.; Lehmann, I.; Hoffmann, B.; Bauer, C. P.; Koletzko, S.; Heinrich, J.
Severe vitamin D deficiency is known to cause rickets, however epidemiological studies and RCTs did not reveal conclusive associations for other parameters of bone health. In our study, we aimed to investigate the association between serum levels of 25(OH) vitamin D and bone turnover markers in a population-based sample of children. 25(OH)D, calcium (Ca), osteocalcin (OC), and β-Crosslaps (β-CTx) were measured in 2798 ten-year-old children from the German birth cohorts GINIplus and LISAplus. Linear regression was used to determine the association between bone turnover markers and 25(OH)D levels. 25(OH)D, OC, and β-CTx showed a clear seasonal variation. A 10 nmol/l increase in 25(OH)D was significantly associated with a 10.5 ng/l decrease (p < 0.001) in β-CTx after adjustment for design, sex, fasting status, time of blood drawn, BMI, growth rate, and detectable testosterone/estradiol. For OC alone no significant association with 25(OH)D was observed, whereas the β-CTx-to-OC ratio was inversely associated with 25(OH)D (−1.7% change, p < 0.001). When stratifying the analyses by serum calcium levels, associations were stronger in children with Ca levels below the median. This study in school-aged children showed a seasonal variation of 25(OH)D and the bone turnover markers OC and β-CTx. Furthermore a negative association between 25(OH)D and the bone resorption marker β-CTx was observed. PMID:26667774
Oualha, Mehdi; Tréluyer, Jean-Marc; Lesage, Fabrice; de Saint Blanquat, Laure; Dupic, Laurent; Hubert, Philippe; Spreux-Varoquaux, Odile; Urien, Saïk
Aim The aim of the study was to investigate the pharmacokinetics and pharmacodynamics of norepinephrine in hypotensive critically ill children, including associated variability factors. Methods This was a prospective study in an 18-bed neonatal and paediatric intensive care unit. All children were aged less than 18 years, weighed more than 1500 g and required norepinephrine for systemic arterial hypotension. The pharmacokinetics and haemodynamic effects were described using the non-linear mixed effect modelling software MONOLIX. Results Norepinephrine dosing infusions ranging from 0.05 to 2 μg kg−1 min−1 were administered to 38 children whose weight ranged from 2 to 85 kg. A one compartment open model with linear elimination adequately described the norepinephrine concentration–time courses. Bodyweight (BW) was the main covariate influencing norepinephrine clearance (CL) and endogenous norepinephrine production rate (q0) via an allometric relationship: CL(BWi) = θCL × (BWi)3/4 and q0(BWi) = θq0 × (BWi)3/4. The increase in mean arterial pressure (MAP) as a function of norepinephrine concentration was well described using an Emax model. The effects of post-conceptional age (PCA) and number of organ dysfunctions were significant on basal MAP level (MAP0i = MAP0 × PCA/9i0.166) and on the maximal increase in MAP (32 mmHg and 12 mmHg for a number of organ dysfunctions ≤3 and ≥4, respectively). Conclusion The pharmacokinetics and haemodynamic effects of norepinephrine in hypotensive critically ill children highlight the between-subject variability which is related to the substantial role of age, BW and severity of illness. Taking into account these individual characteristics may help clinicians in determining an appropriate initial a priori dosing regimen. PMID:24802558
Armstrong, J; Dorosty, A; Reilly, J; Child, H; Emmett, P
Aims: To test for the coexistence of social inequalities in undernutrition and obesity in preschool children. Methods: Retrospective, cross sectional, study of routinely collected data from 74 500 children aged 39–42 months in 1998/99. Main outcome measures were weight, height, sex, and age routinely recorded by health visitors. Body mass index (BMI) standardised for age and sex, relative to UK 1990 reference data, was used to define undernutrition (BMI <2nd centile) and obesity (BMI >95th centile; BMI >98th centile). Social deprivation was assessed as Carstairs deprivation category (1 = most affluent to 7 = most deprived). Results: Both undernutrition (3.3%) and obesity (8.5% above 95th centile; 4.3% above 98th centile) significantly exceeded expected frequencies from UK 1990 reference data. Undernutrition and obesity were significantly more common in the more deprived families. Odds ratios in deprivation category 7 relative to category 1 were 1.51 (95% CI 1.22 to 1.87) for undernutrition (BMI <2nd centile) and 1.30 (95% CI 1.05 to 1.60) for obesity (BMI >98th centile). The cumulative prevalence of under and overnutrition (malnutrition) in the most deprived group was 9.5% compared to 6.9% in the least deprived group. Conclusions: Undernutrition and obesity are significantly more common than expected in young children and strongly associated with social deprivation. Both undernutrition and obesity have adverse short and long term health effects. Public health strategies need to tackle malnutrition (both undernutrition and obesity) in children and take into consideration the association with social deprivation. PMID:12876159
Mueller, W H; Titcomb, M
Parent-offspring correlations and heritabilities of body measurements from midparent-offspring regressions are presented for school-aged children from the village of Tenza, Colombia (N = 403 families). Parent-child correlations and midparent regressions in this subsistence farming sample, are similar in magnitude to those for well nourished, urban industrial samples, suggesting that the environmental component of variability in body size is the same regardless of the environment. Tenza children are significantly shorter and lighter than upper class Bogota children, and Tenza parents have mean heights and weights similar to those of other lower class Colombian samples. Thus, chronic undernutrition has affected the growth of parents and continues to affect the growth of the present generation. Although it has been hypothesized that heritability of growth might be reduced in samples experiencing malnutrition and its sequelae, such a reduction may only be observable where environment of parents during their development is different from that of their offspring, which is not the case here. The pattern of heritabilities with respect to different body measurements in Tenza, is similar to that seen in well nourished samples, except that measurements of breadth (biacromial, bicristal, bicondylar) have heritabilities similar in magnitude to those of linear measurements (height, sitting-height, subischial length) especially in males; and heritabilities of some measurements related to adiposity are significantly higher in daughters than in sons.
This research seeks to measure children's awareness of and support for family planning in India, on the premise that they are indications of future fertility behavior. The survey was conducted in June-August 1975 in 6 districts of Andhra Pradesh State, including schools in cities, small towns and villages. The 863 respondents included Hindus and Muslims, various caste groups, 3 language groups, and students in the 6th to 12th classes. Children's awareness of family planning was operationalized through 2 questions: "Have you heard about family planning?" and "Which is better, a big family or a small family?". Results show that 70% had heard of family planning and that approval of family planning is extensive, with only 14% of the sample expressing a preference for large families. Awareness of family planning is clearly correlated in the expected direction with exposure to a modernizing environment, particularly education. Exposure to media and political involvement are also correlated with awareness. Support for family planning is most highly correlated with religion, with Muslim children less approving than Hindu. Party identification and political knowledge are both associated with higher approval. Education and the index of modernity are the only indicators of modernization that correlate with approval.
Background Morbidity, use of healthcare and medication use have been reported to vary across groups of migrants and according to the different phases of migration, but little is known about children with immigrant background. In this study, we investigate whether the immigrant children's age of arrival predicts differences in usage of primary healthcare (PHC) and in use of prescribed medication. Methods This nationwide, population-based study used information for children under 18 years of age in 2008 from three linked registers in Norway. Use of medication was assessed with logistic regression analyses presented with ORs with 95% CIs. Results Of 1 168 365 children, 119 251 had immigrant background. The mean number of PHC visits among children aged 10–18 years, was 1.19 for non-immigrants, 1.17 among second generation immigrants, 1.12, 1.05 and 0.83 among first immigrant children who were <5, 5–9 and ≥10 years at arrival in Norway, respectively. Patterns were similar for younger immigrants, and were confirmed with regression models adjusting for age and sex. First generation immigrant children used less of nearly all groups of prescribed medication compared to non-immigrants when adjusting for age and sex (overall OR 0.48 (0.47 to 0.49)), and medication was also generally less used among second generation immigrant children (overall OR 0.92 (0.91 to 0.94)). Conclusions Age of arrival predicted PHC usage among children among first-generation children. First-generation immigrant children, particularly those arriving later in adolescence, used PHC less than age corresponding non-immigrant children. Immigrant children used less prescribed medication compared to non-immigrants after adjustment for age and sex. PMID:28148537
Soroko, S I; Bekshaev, S S; Rozhkov, V P
Traditional and original methods of EEG analysis were used to study the brain electrical activity maturation in 156 children and adolescents from 7 to 17 years old who represented the native (Koryaks and Evenks) and newcomers' populations living in severe climatic and geographic conditions of the Russian North-East. New data revealing age-, sex- and ethnic-related features in quantitative EEG parameters are presented. Markers are obtained that characterize alterations in the structure of interaction between different EEG rhythms. The results demonstrate age-dependent transformation of this structure separated in time for both different cortical areas and different EEG frequency bands. These alterations show time lag from 2 to 3 years in children of native population compared to the newcomers. The revealed differences are assumed to reflect geno-phenotypical features of morpho-functional CNS development in children of the native and newcomers' population that depend on strong adaptation tension for extreme environmental conditions.
Dietz, Claudine; Swinkels, Sophie; van Daalen, Emma; van Engeland, Herman; Buitelaar, Jan K.
A two-stage protocol for screening for autistic spectrum disorders (ASD) was evaluated in a random population of 31,724 children aged 14-15 months. Children were first pre-screened by physicians at well-baby clinics using a 4-item screening instrument. Infants that screened positive were then evaluated during a 1.5-h home visit by a trained…
Salman, Sam; Page-Sharp, Madhu; Griffin, Susan; Kose, Kaye; Siba, Peter M; Ilett, Kenneth F; Mueller, Ivo; Davis, Timothy M E
There are sparse published data relating to the pharmacokinetic properties of artemether, lumefantrine, and their active metabolites in children, especially desbutyl-lumefantrine. We studied 13 Papua New Guinean children aged 5 to 10 years with uncomplicated malaria who received the six recommended doses of artemether (1.7 mg/kg of body weight) plus lumefantrine (10 mg/kg), given with fat over 3 days. Intensive blood sampling was carried out over 42 days. Plasma artemether, dihydroartemisinin, lumefantrine, and desbutyl-lumefantrine were assayed using liquid chromatography-mass spectrometry or high-performance liquid chromatography. Multicompartmental pharmacokinetic models for a drug plus its metabolite were developed using a population approach that included plasma artemether and dihydroartemisinin concentrations below the limit of quantitation. Although artemether bioavailability was variable and its clearance increased by 67.8% with each dose, the median areas under the plasma concentration-time curve from 0 h to infinity (AUC(0-∞)s) for artemether and dihydroartemisinin (3,063 and 2,839 μg · h/liter, respectively) were similar to those reported previously in adults with malaria. For lumefantrine, the median AUC(0-∞) (459,980 μg · h/liter) was also similar to that in adults with malaria. These data support the higher dose recommended for children weighing 15 to 35 kg (35% higher than that for a 50-kg adult) but question the recommendation for a lower dose in children weighing 12.5 to 15 kg. The median desbutyl-lumefantrine/lumefantrine ratio in the children in our study was 1.13%, within the range reported for adults and higher at later time points because of the longer desbutyl-lumefantrine terminal elimination half-life. A combined desbutyl-lumefantrine and lumefantrine AUC(0-∞) weighted on in vitro antimalarial activity was inversely associated with recurrent parasitemia, suggesting that both the parent drug and the metabolite contribute to the
Bafti, Leila Shafie; Hashemipour, Maryam Alsadat; Poureslami, Hamidreza; Hoseinian, Zeinab
The aim of the present study was to evaluate the relationship between BMI and tooth decay in a population of Iranian children. In this cross-sectional descriptive/analytical study, 1482 children were selected from kindergartens and preschool centers in Kerman, Iran. The children underwent examination of deciduous teeth (using the dmft index) after determination of height and weight for calculation of BMI. The relationship between BMI (after adjustment for age) and dmft was determined using Poisson's regression model. The mean of dmft in children with normal BMI was 1.5-fold that in subjects with extra body weight. Age had a significant effect on dmft. In addition, dmft was higher in boys compared to girls. The results of the present study showed that caries rate in the deciduous teeth of 3-6-year-old children decreases with an increase in body weight.
Ferguson, Christopher J; Olson, Cheryl K
The issue of children's exposure to violent video games has been a source of considerable debate for several decades. Questions persist whether children with pre-existing mental health problems may be influenced adversely by exposure to violent games, even if other children are not. We explored this issue with 377 children (62 % female, mixed ethnicity, mean age = 12.93) displaying clinically elevated attention deficit or depressive symptoms on the Pediatric Symptom Checklist. Results from our study found no evidence for increased bullying or delinquent behaviors among youth with clinically elevated mental health symptoms who also played violent video games. Our results did not support the hypothesis that children with elevated mental health symptoms constitute a "vulnerable" population for video game violence effects. Implications and suggestions for further research are provided.
Noll, Matias; Candotti, Cláudia Tarragô; da Rosa, Bruna Nichele; Loss, Jefferson Fagundes
ABSTRACT OBJECTIVE To identify the prevalence of back pain among Brazilian school children and the factors associated with this pain. METHODS All 1,720 schoolchildren from the fifth to the eight grade attending schools from the city of Teutonia, RS, Southern Brazil, were invited to participate in the study. From these, 1,597 children participated. We applied the Back Pain and Body Posture Evaluation Instrument. The dependent variable was back pain, while the independent one were demographic, socioeconomic, behavior and heredity data. The prevalence ratio was estimated by multivariate analysis using the Poisson regression model (α = 0.05). RESULTS The prevalence of back pain in the last three months was 55.7% (n = 802). The multivariate analysis showed that back pain is associated with the variables: sex, parents with back pain, weekly frequency of physical activity, daily time spent watching television, studying in bed, sitting posture to write and use the computer, and way of carrying the backpack. CONCLUSIONS The prevalence of back pain in schoolchildren is high and it is associated with demographic, behavior and heredity aspects. PMID:27305406
White, R F; Campbell, R; Echeverria, D; Knox, S S; Janulewicz, P
This paper provides a strategy for the assessment of brain function in longitudinal cohort studies of children. The proposed strategy invokes both domain-specific and omnibus intelligence test approaches. In order to minimise testing burden and practice effects, the cohort is divided into four groups with one-quarter tested at 6-monthly intervals in the 0–2-year age range (at ages 6 months, 1.0, 1.5 and 2.0 years) and at annual intervals from ages 3–20 (one-quarter of the children at age 3, another at age 4, etc). This strategy allows investigation of cognitive development and of the relationship between environmental influences and development at each age. It also allows introduction of new domains of function when age-appropriate. As far as possible, tests are used that will provide a rich source of both longitudinal and cross-sectional data. The testing strategy allows the introduction of novel tests and new domains as well as piloting of tests when the test burden is relatively light. In addition to the recommended tests for each age and domain, alternative tests are described. Assessment methodology and knowledge about child cognitive development will change over the next 20 years, and strategies are suggested for altering the proposed test schedule as appropriate. PMID:19098136
Wang, Zhenjie; Zheng, Xiaoying; Zhang, Lei; Chen, Gong
The prevalence and risk factors associated with psychiatric disability among Chinese children under 14 years of age has long been of interest. Data used in the study included two nationally representative population-based surveys from the first and second China National Sample Surveys on Disability, conducted in 1987 and 2006. Both surveys used multistage, stratified random cluster sampling, with probability proportion to size, to derive nationally representative samples. Age-standardized point prevalence of mental disability was estimated through direct standardization using the 2000 census-derived Chinese population as the standard. Associations between psychiatric disability in children and possible risk factors were examined by logistic regression. Age-standardized point prevalence of psychiatric disability in children increased sharply from 0.18% to 1.11% in the 20 years between surveys. In the logistic regression analysis, the children's age and household size presented inverse associations with psychiatric disability in both surveys, although these associations were not all significant in 1987. Residential area, minority group status and gender of children were consistently associated with psychiatric disability in both surveys. To face the challenge of rising prevalence rates of psychiatric disability among children in China, the government should adopt more vigorous strategies to prevent it, especially for minority ethnicity children and those living in rural areas.
Fuller-Thomson, Esme; B Katz, Robyn; T Phan, Vi; P M Liddycoat, Jessica; Brennenstuhl, Sarah
Parental addictions have been associated with adult children's depression in several clinical and population-based studies. However, these studies have not examined if gender differences exist nor have they controlled for a range of potential explanatory factors. Using a regionally representative sample of 6268 adults from the 2005 Canadian Community Health Survey (response rate=83%), we investigated the association between parental addictions and adulthood depression controlling for four clusters of variables: adverse childhood experiences, adult health behaviors, adult socioeconomic status and other stressors. After controlling for all factors, adults exposed to parental addiction had 69% higher odds of depression compared to their peers with non-addicted parents (OR=1.69; 95% CI, 1.25-2.28). The relationship between parental addictions and depression did not vary by gender. These findings underscore the intergenerational consequences of drug and alcohol addiction and reinforce the need to develop interventions that support healthy childhood development.
Kaiser, Sunitha V.; Sundaram, Vandana; Cohen, Eyal; Shulman, Rayzel; Guan, Jun; Sanders, Lee; Guttmann, Astrid
Background: Children with diabetes mellitus in low-income families have poor outcomes, but little is known as to how this relates to healthcare system structure. Our objective was to gain insight into how best to structure health systems to serve these children by describing their health care use in 2 health system models: a Canadian model, with an organized diabetes care network that includes generalists, and an American model, with targeted support services for children from low-income families. Methods: We performed a population-based retrospective cohort study involving children aged 1-17 years with type 1 diabetes mellitus. We used administrative data from between 2009 and 2012 from the California Children's Services program and Ontario. We used Ontario Drug Benefit Program enrolment to identify children from low-income families. Proportions of children receiving 2 or more routine diabetes visits per year were compared using χ2 tests, and diabetes-complication hospital admission rates were compared using direct standardization. Results: More California children from low-income families (n = 4922) received routine care for diabetes from pediatric endocrinologists (63.9% v. 26.9%, p < 0.001) and used insulin pumps (22.8% v. 16.4%, p < 0.001) than Ontario children (n = 2050).California children from low-income families were less likely than Ontario children to receive 2 visits for routine diabetes care per year (64.7% v. 75.7%, p < 0.001), and had slightly higher per-patient year hospital admission rates for diabetes complications (absolute differences 0.02, 95% confidence interval [CI] 0.02-0.02, for boys; 0.03, 95% CI 0.03-0.03, for girls). Interpretation: Ontario children from low-income families received more routine diabetes care than did California children from low-income families. Both groups of children had clinically comparable rates of hospital admission for diabetes complications. Diabetes care networks that integrate generalists may play a role in
Gać, Paweł; Pawlas, Natalia; Wylężek, Paweł; Poręba, Rafał; Poręba, Małgorzata; Pawlas, Krystyna
This study aimed at evaluation of a relationship between blood selenium concentration (Se-B) and blood cystatin C concentration (CST) in a randomly selected population of healthy children, environmentally exposed to lead and cadmium. The studies were conducted on 172 randomly selected children (7.98 ± 0.97 years). Among participants, the subgroups were distinguished, manifesting marginally low blood selenium concentration (Se-B 40-59 μg/l), suboptimal blood selenium concentration (Se-B: 60-79 μg/l) or optimal blood selenium concentration (Se-B ≥ 80 μg/l). At the subsequent stage, analogous subgroups of participants were selected separately in groups of children with BMI below median value (BMI <16.48 kg/m(2)) and in children with BMI ≥ median value (BMI ≥16.48 kg/m(2)). In all participants, values of Se-B and CST were estimated. In the entire group of examined children no significant differences in mean CST values were detected between groups distinguished on the base of normative Se-B values. Among children with BMI below 16.48 kg/m(2), children with marginally low Se-B manifested significantly higher mean CST values, as compared to children with optimum Se-B (0.95 ± 0.07 vs. 0.82 ± 0.15 mg/l, p < 0.05). In summary, in a randomly selected population of healthy children no relationships could be detected between blood selenium concentration and blood cystatin C concentration. On the other hand, in children with low body mass index, a negative non-linear relationship was present between blood selenium concentration and blood cystatin C concentration.
Jeddi, Marjan; Dabbaghmanesh, Mohammad Hossein; Kharmandar, Alireza; Ranjbar Omrani, Gholamhossein; Bakhshayeshkaram, Marzieh
Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents. Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured. Results: We found a prevalence of 12.9% for fracture. (34.5% for girls and 65.5% for boys); about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine (0.19±0.04 vs. 0.20±0.03, p=0.04), lower serum albumin (4.6±0.5 vs 4.8±0.4, p=0.02), and higher serum alkaline phosphatase level (446±174 vs. 361±188, p=0.02) compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture (p=0.003, p=0.039). Conclusion: Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures. PMID:28246621
Flynn-O'Brien, Katherine T; Rivara, Frederick P; Weiss, Noel S; Lea, Veronica A; Marcelin, Louis H; Vertefeuille, John; Mercy, James A
Although physical violence against children is common worldwide, there are no national estimates in Haiti. To establish baseline national estimates, a three-stage clustered sampling design was utilized to administer a population-based household survey about victimization due to physical violence to 13-24 year old Haitians (n=2,916), including those residing in camps or settlements. Descriptive statistics and weighted analysis techniques were used to estimate national lifetime prevalence and characteristics of physical violence against children. About two-thirds of respondents reported having experienced physical violence during childhood (67.0%; 95% CI 63.4-70.4), the percentage being similar in males and females. More than one-third of 13-17 year old respondents were victimized in the 12 months prior to survey administration (37.8%; 95% CI 33.6-42.1). The majority of violence was committed by parents and teachers; and the perceived intent was often punishment or discipline. While virtually all (98.8%; 95% CI 98.0-99.3) victims of childhood physical violence were punched, kicked, whipped or beaten; 11.0% (95% CI 9.2-13.2) were subject to abuse by a knife or other weapon. Injuries sustained from violence varied by victim gender and perpetrator, with twice as many females (9.6%; 95% CI 7.1-12.7) than males (4.0%; 95% CI 2.6-6.1) sustaining permanent injury or disfigurement by a family member or caregiver (p-value<.001). Our findings suggest that physical violence against children in Haiti is common, and may lead to severe injury. Characterization of the frequency and nature of this violence provides baseline estimates to inform interventions.
Carpiano, Richard M; Lloyd, Jennifer E V; Hertzman, Clyde
A number of studies demonstrates a relationship between neighbourhood concentration of affluence and disadvantage and the health and development of its residents. We contribute to this literature by testing hypotheses about the relationship between neighbourhood-level concentrated affluence/disadvantage and child-level developmental outcomes in a study population of 37,798 Kindergarten children residing in 433 neighbourhoods throughout the province of British Columbia, Canada. We utilise a previously-validated measure of neighbourhood socioeconomic composition--the Index of Concentration at the Extremes (ICE)--which not only allows for more precise estimation of the competing influences of concentrated affluence and disadvantage, but also facilitates examination of the potential impact of neighbourhood-level income inequality. Our findings show that increases in neighbourhood affluence are associated with increases in children's scores on the Early Development Instrument (EDI), a holistic measure of Kindergarteners' readiness for school. Particularly noteworthy is that, for four of the five EDI scales (physical, social, emotional, and communication) and the total score, results indicate a significant curvilinear relationship--whereby the highest average child-level outcomes are not found in locations with the highest concentrations of affluence, but rather in locations with relatively equal proportions of affluent and disadvantaged families. This finding suggests, first, that concentrated affluence may have diminishing rates of return on contributing to enhanced child development, and, second, that children residing in mixed-income neighbourhoods may benefit both from the presence of affluent residents and from the presence of services and institutions aimed at assisting lower-income residents. Implications and future directions are discussed.
Hietala, Sofia Friberg; Mårtensson, Andreas; Ngasala, Billy; Dahlström, Sabina; Lindegårdh, Niklas; Annerberg, Anna; Premji, Zul; Färnert, Anna; Gil, Pedro; Björkman, Anders; Ashton, Michael
The combination of artemether (ARM) and lumefantrine is currently the first-line treatment of uncomplicated falciparum malaria in mainland Tanzania. While the exposure to lumefantrine has been associated with the probability of adequate clinical and parasitological cure, increasing exposure to artemether and the active metabolite dihydroartemisinin (DHA) has been shown to decrease the parasite clearance time. The aim of this analysis was to describe the pharmacokinetics and pharmacodynamics of artemether, dihydroartemisinin, and lumefantrine in African children with uncomplicated malaria. In addition to drug concentrations and parasitemias from 50 Tanzanian children with falciparum malaria, peripheral parasite densities from 11 asymptomatic children were included in the model of the parasite dynamics. The population pharmacokinetics and pharmacodynamics of artemether, dihydroartemisinin, and lumefantrine were modeled in NONMEM. The distribution of artemether was described by a two-compartment model with a rapid absorption and elimination through metabolism to dihydroartemisinin. Dihydroartemisinin concentrations were adequately illustrated by a one-compartment model. The pharmacokinetics of artemether was time dependent, with typical oral clearance increasing from 2.6 liters/h/kg on day 1 to 10 liters/h/kg on day 3. The pharmacokinetics of lumefantrine was sufficiently described by a one-compartment model with an absorption lag time. The typical value of oral clearance was estimated to 77 ml/h/kg. The proposed semimechanistic model of parasite dynamics, while a rough approximation of the complex interplay between malaria parasite and the human host, adequately described the early effect of ARM and DHA concentrations on the parasite density in malaria patients. However, the poor precision in some parameters illustrates the need for further data to support and refine this model.
Tsherlinga, Sherab; Thomas, Maya Mary; Dutton, Gordon N; Bowman, Richard
Introduction Cerebral Visual Impairment (CVI) is a leading cause of vision impairment in developed and developing countries due to and increased survival of preterm and low birth weight infants. There are few data concerning the validity of protocols available to diagnose CVI. Aim This study aimed to document the face, content and construct validity of an assessment protocol namely, a 15-domain, Structured Clinical Question Inventory (SCQI), which is based on structured history taking and clinical examination, for the diagnosis of CVI in a clinical population of India. Materials and Methods This study was a retro-spective chart analysis of all children below the age of 18years, referred to the CVI clinic of a tertiary care teaching hospital in Southern India from March 2011-Feb 2012. Clinical case-notes including the SCQI findings of all children referred to the clinic were reviewed. The data were extracted after Institutional Review Board approval. Statistical Analysis Pearson correlation coefficient, Cronbach’s alpha and exploratory factor analysis were used to document the content and construct validity of the examination protocol. Results A total of 342 children (35.7% male, 64.3% female), with a mean age of 3.8 years (range 0-17 years, the median was 3 years) were included in the study and their data were examined. The internal consistency of the SCQI was 0.93 suggesting it as an excellent tool to characterise and profile CVI and a 2-factor model (Dorsal Stream Dysfunction and Ventral Stream Dysfunction) based on a biologically plausible model explained 63% of the variance. Conclusion The results of using the SCQI affirm published data and endorse a theoretical construct similar across cultures. The potential diagnostic accuracy, reliability and utility of this measure for CVI needs to be studied further. The clinical use of a short version of the SCQI may be helpful to contribute to the identification of CVI, especially for middle and low-income countries
Sekerci, Ahmet Ercan; Cantekin, Kenan; Aydinbelge, Mustafa
Objectives. This is the first study to identify and classify the different morphological shapes of the mandibular lingula (ML) in children using cone-beam computed tomography (CBCT). Material and Methods. A retrospective study was performed to evaluate the shape, height, and location of the ML in relation to the surrounding structures using CBCT images of mandibles obtained from 269 children. The shape of the ML was classified into triangular, truncated, nodular, or assimilated types. The location was determined by five distances. The height of the lingula was also measured from the lingular tip to the mandibular foramen. Results. A nodular shape of the ML was most commonly found (48.3%, n = 260) followed by truncated (23.4%, n = 126), assimilated (14.4%, n = 78), and triangular (13.7%, n = 74). The mean distance of ML from the anterior and posterior borders of mandibular ramus was 13.3 ± 2.3 mm and 10.2 ± 1.6 mm, respectively. In the majority of the mandibles studied, the ML was located above the occlusal plane. Conclusion. The present study provides new information to the literature concerning the shape, height, and location of the lingula in a Turkish pediatric population. This finding may assist clinicians to localize the lingula and avoid intraoperative complications. PMID:24490173
Ausili, E; Focarelli, B; Tabacco, F; Fortunelli, G; Caradonna, P; Massimi, L; Sigismondi, M; Salvaggio, E; Rendeli, C
Myelomeningocele causes serious locomotor disability, osteoporosis and pathologic fractures. The aim of this study was to investigate the relationship between body composition, bone mineral density, walking ability and sport activity in myelomeningocele children. 60 patients aged between 5 and 14 yrs with myelomeningocele (22 ambulatory and 38 non-ambulatory), were studied. Fat mass and fat-free-mass were calculated by anthropometry. The bone mineral density at lumbar and femoral neck were evaluated. Bone mineral density at the lumbar and femoral neck was lower than in the normal population. In the non-ambulaty group, bone mineral density was approximately 1 SD lower than in the ambulatory one (p < 0.01). Fat mass was greater than expected but without significantly differences between walking group (mean 26%) and wheel-chair users (25%). Patients practised sport activity had a better bone mineral density and body fat compared with other patients with the same disability. Patients with myelomeningocele have decreased bone mineral density and are at higher risk of pathologic bone fractures. All subjects showed an excess of fat as percentage of body weight and are shorter than normal children. The measurement of bone mineral density may help to identify those patients at greatest risk of suffering of multiple fractures. Walk ability and sport activity, associated with the development of muscle mass, are important factors in promoting bone and body growth, to reduce the risk of obesity and of pathological fractures.
Nouhjah, Sedigheh; R. Niakan Kalhori, Sharareh; Saki, Azadeh
Introduction: In addition to the annual mortality rate, unintentional home injury may result in temporary or permanent disability and requires medical attention and continuous care in millions of children. This study aimed to explore features and risk factors of these injuries. Methods: In this cross-sectional study, demographic variables and epidemiologic pattern of home injuries among children under 5 years of age were collected via a population-based survey in seven main cities of Khuzestan province, southwest Iran, during September 2011 to December 2012. Developing a risk stratification model, independent risk factors of unintentional home injury were determined and put to multivariate logistic regression analysis. Result: 2693 children with the mean age of 27.36 ± 15.55 months (1 to 60) were evaluated (50.9% boy). 827 (30.7%) cases had a history of at least one home injury occurrence since birth to study time. The most common injury mechanisms were burning with 291 (38.4%) cases, falling with 214 (28.3%) and poisoning with 66 (8.7%) cases, respectively. The independent risk factors of unintentional home injury were age ≥ 24 month (p<0.001), residency in Ahvaz city (p<0.001), mother’s illiteracy (p<0.014), ethnicity (p<0.001), private housing (p=0.01), birth weight (p<0.001), and being the first child (p=0. 01). Sensitivity, specificity, and area under the ROC curve of the model designed by multivariate analysis were 53.5%, 84.8%, and 0.75 (95% CI: 0.73- 0.77; P < 0.001, figure 1), respectively. Conclusion: According to the findings of this study, 30.7% of the studied children were injured at least once since birth. Burning, falling, poisoning, swallowing objects, choking, and biting were the main home injury mechanisms. Age ≥ 24 months, being the first child, living in a private house, being a resident of Ahvaz city, and having an illiterate mother were found to be risk factors of home injury. PMID:28286813
Grimaldi, Roberta; Cela, Drinalda; Swann, Jonathan R; Vulevic, Jelena; Gibson, Glenn R; Tzortzis, George; Costabile, Adele
Children with autism spectrum disorders (ASD) often suffer gastrointestinal problems consistent with imbalances in the gut microbial population. Treatment with antibiotics or pro/prebiotics has been postulated to regulate microbiota and improve gut symptoms, but there is a lack of evidence for such approaches, especially for prebiotics. This study assessed the influence of a prebiotic galactooligosaccharide (B-GOS) on gut microbial ecology and metabolic function using faecal samples from autistic and non-autistic children in an in vitro gut model system. Bacteriology was analysed using flow cytometry combined with fluorescence in situ hybridization and metabolic activity by HPLC and (1)H-NMR. Consistent with previous studies, the microbiota of children with ASD contained a higher number of Clostridium spp. and a lower number of bifidobacteria compared with non-autistic children. B-GOS administration significantly increased bifidobacterial populations in each compartment of the models, both with autistic and non-autistic-derived samples, and lactobacilli in the final vessel of non-autistic models. In addition, changes in other bacterial population have been seen in particular for Clostridium, Rosburia, Bacteroides, Atopobium, Faecalibacterium prausnitzii, Sutterella spp. and Veillonellaceae. Furthermore, the addition of B-GOS to the models significantly altered short-chain fatty acid production in both groups, and increased ethanol and lactate in autistic children.
Grimaldi, Roberta; Cela, Drinalda; Swann, Jonathan R.; Vulevic, Jelena; Gibson, Glenn R.; Tzortzis, George; Costabile, Adele
Children with autism spectrum disorders (ASD) often suffer gastrointestinal problems consistent with imbalances in the gut microbial population. Treatment with antibiotics or pro/prebiotics has been postulated to regulate microbiota and improve gut symptoms, but there is a lack of evidence for such approaches, especially for prebiotics. This study assessed the influence of a prebiotic galactooligosaccharide (B-GOS) on gut microbial ecology and metabolic function using faecal samples from autistic and non-autistic children in an in vitro gut model system. Bacteriology was analysed using flow cytometry combined with fluorescence in situ hybridization and metabolic activity by HPLC and 1H-NMR. Consistent with previous studies, the microbiota of children with ASD contained a higher number of Clostridium spp. and a lower number of bifidobacteria compared with non-autistic children. B-GOS administration significantly increased bifidobacterial populations in each compartment of the models, both with autistic and non-autistic-derived samples, and lactobacilli in the final vessel of non-autistic models. In addition, changes in other bacterial population have been seen in particular for Clostridium, Rosburia, Bacteroides, Atopobium, Faecalibacterium prausnitzii, Sutterella spp. and Veillonellaceae. Furthermore, the addition of B-GOS to the models significantly altered short-chain fatty acid production in both groups, and increased ethanol and lactate in autistic children. PMID:27856622
Kerkhofs, T M A; Ettaieb, M H T; Verhoeven, R H A; Kaspers, G J L; Tissing, W J E; Loeffen, J; Van den Heuvel-Eibrink, M M; De Krijger, R R; Haak, H R
Adrenocortical carcinoma (ACC) is rare in both adult and pediatric populations. Literature suggests significant differences between children and adults in presentation, histological properties and outcome. The aim of this first nationwide study on pediatric ACC was to describe the incidence, presentation, pathological characteristics, treatment and survival in The Netherlands. All ACC patients aged <20 years at diagnosis and registered in the population-based Netherlands Cancer Registry between 1993 and 2010 were included. Clinical data were extracted from medical records. Archival histological slides were collected via the Dutch Pathology Registry (PALGA). We compared our findings to all clinical studies on pediatric ACC that were found on PubMed. Based on the results, 12 patients were identified: 8 females and 4 males. The median age was 4.1 years (range 1.1-18.6). The population-based age-standardized incidence rate for patients <20 years was 0.18 per million person-years. Autonomous hormonal secretion was present in 10 patients. Seven patients were aged ≤4 years at diagnosis, 5 presented with localized disease and 2 with locally advanced disease. Five patients were aged ≥5 years, 3 presented with distant metastases and 1 with locally advanced disease. For all patients, histological examination displayed malignant characteristics. All patients aged ≤4 years at diagnosis survived; the median follow-up was 97 months (57-179 months). All patients aged ≥5 years died; the median survival was 6 months (0-38 months). Pediatric ACC is extremely rare in the Western world. The clinical outcome was remarkably better in patients aged ≤4 years. This is in accordance with less advanced stage of disease at presentation, yet contrasts with the presence of adverse histological characteristics. Clinical management in advanced disease is adapted from adult practice in the absence of evidence regarding pediatric ACC.
Lahaye, Magali; Luminet, Olivier; Van Broeck, Nady; Bodart, Eddy; Mikolajczak, Moira
In this study, we investigated the psychometric properties of the French version of the Emotion Awareness Questionnaire (EAQ30; Rieffe et al., 2008). The EAQ30 was administered to 707 French-speaking children aged 8 to 16 years old. The original 6-factor structure was replicated in our data. The internal consistency coefficients of the EAQ30 subscales were satisfactory. We found small significant differences for gender and age. Regarding convergent validity, we found positive correlations between EAQ30 scores and emotional intelligence and negative correlations between EAQ30 scores and alexithymia. There was preliminary evidence of discriminant validity, with EAQ30 scores being weakly related to school performance, and concurrent validity, with EAQ30 scores being negatively related to somatic complaints, depression, and anxiety. Finally, except for 1 dimension, EAQ30 scores were not susceptible to social desirability. Although some weaknesses of the scale remain to be addressed, these findings support the use of the EAQ30 for research and clinical purposes.
Wang, Zhenjie; Zheng, Xiaoying; Zhang, Lei; Chen, Gong
The prevalence and risk factors associated with psychiatric disability among Chinese children under 14 years of age has long been of interest. Data used in the study included two nationally representative population-based surveys from the first and second China National Sample Surveys on Disability, conducted in 1987 and 2006. Both surveys used multistage, stratified random cluster sampling, with probability proportion to size, to derive nationally representative samples. Age-standardized point prevalence of mental disability was estimated through direct standardization using the 2000 census-derived Chinese population as the standard. Associations between psychiatric disability in children and possible risk factors were examined by logistic regression. Age-standardized point prevalence of psychiatric disability in children increased sharply from 0.18% to 1.11% in the 20 years between surveys. In the logistic regression analysis, the children’s age and household size presented inverse associations with psychiatric disability in both surveys, although these associations were not all significant in 1987. Residential area, minority group status and gender of children were consistently associated with psychiatric disability in both surveys. To face the challenge of rising prevalence rates of psychiatric disability among children in China, the government should adopt more vigorous strategies to prevent it, especially for minority ethnicity children and those living in rural areas. PMID:28282923
Huss, John D.; And Others
Arizona's migrant farmworker population was examined to determine the recent changes in its demographic characteristics, and changes in worker characteristics that could be anticipated by 1980 and their implications for educative and supportive services to migrant children between 1977 and 1980. Information was also obtained on migrant student…
Devoe, Jennifer E.; Krois, Lisa; Stenger, Rob
Purpose: To determine if rural residence is independently associated with different access to health care services for children eligible for public health insurance. Methods: We conducted a mail-return survey of 10,175 families randomly selected from Oregon's food stamp population (46% rural and 54% urban). With a response rate of 31%, we used a…
Ramo, Ana; Quílez, Joaquín; Vergara-Castiblanco, Claudia; Monteagudo, Luis; Del Cacho, Emilio; Clavel, Antonio
A multilocus typing approach with eight variable-number tandem-repeat (VNTR) loci and the GP60 gene was used to analyze the inter- and intra-species variation of 44 Cryptosporidium isolates from pediatric patients in Zaragoza city (NE, Spain). Restriction and sequence analyses of the SSU rRNA gene revealed that Cryptosporidium transmission is mostly anthroponotic in this area, with the predominance of Cryptosporidium hominis (n: 41) over Cryptosporidium parvum (n: 3). GP60 subtyping showed limited genetic diversity and four subtypes were identified, including IbA10G2 (n: 35), IaA24R3 (n: 6), IIaA15G1R1 (n: 1) and IIaA15G2R1 (n: 2). Five out of eight VNTR loci showed a discriminatory power higher than the GP60 gene, although each locus had a predominant allele exhibited by more than 50% of isolates. All but four alleles were associated to either C. hominis or C. parvum and linked alleles at different loci were found. Multilocus typing substantially increased the discriminatory power (Hunter-Gaston index: 0.807, 95% CI, 0.683-0.926) and revealed that genetic diversity is much higher than that reported by GP60 sequencing, since 17 multilocus subtypes (MLTs) were identified. Nearly half of the specimens were allocated to a single major MLT. However, no more than three specimens were allocated to each of the remaining MLTs. Both phylogenetic and population analyses revealed a population clustering of C. hominis according to the GP60 subtype, which indicates the robustness of this marker to differentiate genetic subpopulations. Subpopulations had an overall clonal genetic structure, although traces of genetic flow between them were also observed.
González-Del-Castillo-McGrath, Mauricio; Madrigal-Orozco, Catalina; Anguiano-Flores, Laura; Amador-Licona, Norma
Objectives: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. Study Design: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. Results: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p<0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p<0.0001). Bacterial plaque determined by the O’Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p= 0.002) respectively. Conclusions: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque. Key words:Health educational, motivational interviewing, caries risk. PMID:25674320
Rotheram-Borus, Mary Jane; Tomlinson, Mark; Scheffler, Aaron; Harris, Danielle M; Nelson, Sandahl
Mothers living with HIV (MLH) and their children are typically studied to ensure that perinatal HIV transmission is blocked. Yet, HIV impacts MLH and their children lifelong. We examine child outcomes from pregnancy to 3 years post-birth among a peri-urban population of pregnant MLH and mothers without HIV (MWOH). Almost all pregnant women in 12 neighborhoods (98 %; N = 584) in Cape Town, South Africa were recruited and repeatedly assessed within 2 weeks of birth (92 %), at 6 months (88 %), 18 months (84 %), and 3 years post-birth (86 %). There were 186 MLH and 398 MWOH. Controlling for neighborhood and repeated measures, child and maternal outcomes were contrasted over time using longitudinal random effects regression analyses. For measures collected only at 3 years, outcomes were analyzed using multiple regressions. Compared to MWOH, MLH had less income, more informal housing and food insecurity, used alcohol more often during pregnancy, and were more depressed during pregnancy and over time. Only 4.8 % of MLH's children were seropositive; seropositive children were excluded from additional analyses. Children of MLH tended to have significantly lower weights (p < .10) over time (i.e., lower weight-for-age Z-scores) and were also hospitalized significantly more often than children of MWOH (p < .01). Children of MLH and MWOH died at similar rates (8.5 %) and were similar in social and behavioral adjustment, vocabulary, and executive functioning at 3 years post-birth. Despite living in households with fewer resources and having more depressed mothers, only the physical health of children of MLH is compromised, compared to children of MWOH. In township neighborhoods with extreme poverty, social, behavioral, language, and cognitive functioning appear similar over the first three years of life between children of MLH and MWOH.
Pontiles de Sánchez, Milagros; Morón de Salim, Alba; Rodríguez de Perdomo, Henny; Perdomo Oramas, Germán
No Alcoholic Fatty Liver Disease (NAFLD) is characterized by an abnormal accumulation of fat in hepatocytes, without alcohol, where overweight and obesity are determinants. Ecosonografia evaluated the prevalence of fatty liver in obese pediatric patients and its relation to nutritional assessment. The sample consisted of 85 children (51 females, 34 males), age 3-17. The abdominal ecosonography, BMI, waist circumference were performed; Godard Test for physical activity, history of diabetes, dyslipidemia, obesity and cardiovascular disease were questioned. Lipid profile, glucose and insulin resistance were determined. Data analyzed from descriptive and comparative tables. We obtained: mean age 9.8 ± 2.7 females and males 9.6 ± 2.7 years. The ecosonography indicated 50% and 50% fatty liver-pancreas fatty liver in children aged 3-6 years; 7-11 years 39.7% fatty liver-pancreas; 12-17yrs 31.6% fatty liver-pancreas (p > 0.05); BMI > 26 kg/m2 42.9% fatty liver-pancreas; 21 to 25 kg/m2 44.7% fatty liver; 15 to 20 kg/m2 60%fatty liver-pancreas (p> 0.05). 97.6% with high CC; 68.2% with inadequate physical activity; high frequency of history of chronic non-communicable diseases. We concluded that this population had predominantly fatty liver fatty replacement of the pancreas (HG-RGP) in the groups with higher BMI, CC and high male unrelated insulin resistance, altered lipid profile and diagnosis HG. We inferred that the anthropometric assessment of waist circumference and abdominal ecosonography indicate the presence of visceral obesity, a condition that predisposes to hepatic steatosis, pancreas and/or liver-pancreas.
Beringer, Paul; Aminimanizani, Amir; Synold, Timothy; Scott, Christy
High-dose ibuprofen therapy has demonstrated to slow deterioration in pulmonary function in children with cystic fibrosis with mild lung disease. Therapeutic drug monitoring has been recommended to maintain peak concentrations within the range of 50 to 100 mg/L to ensure efficacy. Current methods for dosage individualization are based on dose proportionality using visual inspection of the peak concentration; however, because of interpatient variability in the absorption of the various formulations this method may result in incorrect assessments of the peak concentration achieved. Maximum a posteriori Bayesian analysis (MAP-B) has proven to be a useful and precise method of individualizing the dose of aminoglycosides but requires a description of the structural model. In this study we performed parametric population modeling analysis on plasma concentrations of ibuprofen after single doses of 20 to 30-mg/kg tablet or suspension in children with cystic fibrosis. Patients evaluated in this study were part of a single dose pharmacokinetic study that has been published previously. A one-compartment model with first order absorption and a lag time best described the data. The pharmacokinetic parameters differed significantly depending on the formulation administered. D-optimal sampling times for the suspension and tablet formulations are 0, 0.25 to 0.5, 1, and 3 to 4 hours and 0, 0.25 to 0.5, 1 to 1.5, and 5 hours respectively. Use of MAP-B analysis performed with the 4 d-optimal sampling strategy resulted in accurate and precise estimates of the pharmacokinetic parameters when compared with maximum likelihood analysis using the complete plasma concentrations data set. Further studies are needed to evaluate the performance of these models and the impact on patient outcomes.
Klein, B; Damiani-Taraba, G; Koster, A; Campbell, J; Scholz, C
Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.
Headley, Clea; Campbell, Marilyn A.
This study examined primary school teachers' knowledge of anxiety and excessive anxiety symptoms in children. Three hundred and fifteen primary school teachers completed a questionnaire exploring their definitions of anxiety and the indications they associated with excessive anxiety in primary school children. Results showed that teachers had an…
Yu, Hwa-Lung; Chien, Lung-Chang
Advert health impacts associated with the PM2.5 exposure have been confirmed in mortality and cardiovascular diseases; however, findings of the influence of PM2.5 on respiratory diseases investigated among previous studies are still inconsistent. We investigated the short-term population-based associations between the respiratory clinic visits of children population and the PM2.5 exposure levels with considering both the spatiotemporal distributions of the ambient pollution and clinic visit data. We applied a spatiotemporal structured additive regression model to examine the concentration-response (C-R) association between daily children's respiratory clinic visits and PM2.5 concentrations. The analysis was performed separately on the four selected respiratory disease categories of the population-based dataset, obtained from Taiwan National Health Insurance database, covering the 41 districts in Taipei area during the period of 2005 to 2007. This study reveals a strong nonlinear C-R pattern that the PM2.5 increment can significantly affect respiratory health at PM2.5 concentration ≤ 18.17µg/m3 for both preschool children and schoolchildren. The elevated risks are especially present in the category of acute respiratory infections. PM2.5 increase is mostly non-significant to the more severe respiratory diseases, e.g., COPD and pneumonia, over the ranges of 8.85-92.45µg/m3. The significantly higher relative rate of respiratory clinic visit most likely concentrated at populated areas. We highlight the nonlinearity of the respiratory health impacts of PM2.5 on children's populations from the first study, to our knowledge, to investigate this population-based association. The strong nonlinearity can possibly cause the inconsistency of PM2.5 health impact assessments with linear assumptions.
Genik, Lara M; McMurtry, C Meghan; Breau, Lynn M
Some children with intellectual disabilities (ID): experience pain more frequently than children without ID, express their pain differently, and are incapable of providing self-reports. No research has examined disability and pain-related beliefs of respite workers (RW) and their relations to pain assessment and management decisions for children with ID.
Deutch, Susanna; Labouriau, Rodrigo; Schønheyeder, Henrik C; Ostergaard, Lars; Nørgård, Bente; Sørensen, Henrik Toft
Meningococcal disease (MD) remains an important health problem. Crowding has been suggested to be a risk factor for MD in children, but the evidence is relatively sparse. We performed a nationwide nested case-control study comprising 1222 children with MD and 24,549 population controls. We identified MD cases younger than 6 y in the Danish National Hospital Discharge Registry from 1980 to 1999, and obtained information on household density as a measure of crowding, per capita income and other potential confounders through The Danish Civil Registration System and social registries. The risk of MD associated with household density was estimated by conditional logistic regression for children less than 1 y of age (infants) and children aged 1 to 5 y, respectively. The risk of MD increased with increasing household density. In both age groups, the crude OR was 1.8 (95% confidence interval [CI]: 1.4-2.3) at a density of less than 20 m2 per person compared with the reference of more than 50 m2 per person. The adjusted OR for MD was 1.5 (95% CI: 1.1-1.9) for infants, and 1.5 (95% CI: 1.1-2.0) for children older than 1 y. Household density appears to be a risk factor of MD in preschool children.
Gowin, Ewelina; Wysocki, Jacek; Kałużna, Ewelina; Świątek-Kościelna, Bogna; Wysocka-Leszczyńska, Joanna; Michalak, Michał; Januszkiewicz-Lewandowska, Danuta
Vaccination effectiveness is proven when the disease does not develop after a patient is exposed to the pathogen. In the case of rare diseases, vaccination effectiveness is assessed by monitoring specific antibody levels in the population. Such recurrent analyses allow the evaluation of vaccination programs. The primary schedule of diphtheria and tetanus vaccinations is similar in various countries, with differences mainly in the number and timing of booster doses. The aim of the study was to assess diphtheria and tetanus antibody concentrations in a population of healthy children.Diphtheria and tetanus antibody levels were analyzed in a group of 324 children aged 18 to 180 months. All children were vaccinated in accordance with the Polish vaccination schedule.Specific antibody concentrations greater than 0.1 IU/mL were considered protective against tetanus or diphtheria. Levels above 1.0 were considered to ensure long-term protection.Protective levels of diphtheria antibodies were found in 229 patients (70.46%), and of tetanus in 306 patients (94.15%). Statistically significant differences were found in tetanus antibody levels in different age groups. Mean concentrations and the percentage of children with high tetanus antibody titers increased with age. No similar correlation was found for diphtheria antibodies. High diphtheria antibody levels co-occurred in 72% of the children with high tetanus antibody levels; 95% of the children with low tetanus antibody levels had low levels of diphtheria antibodies.The percentage of children with protective diphtheria antibody levels is lower than that in the case of tetanus antibodies, both in Poland and abroad, but the high proportion of children without diphtheria protection in Poland is an exception. This is all the more puzzling when taking into account that Polish children are administered a total of 5 doses containing a high concentration of diphtheria toxoid, at intervals shorter than 5 years. The decrease in
Hayter, Arabella K M; Draper, Alizon K; Ohly, Heather R; Rees, Gail A; Pettinger, Clare; McGlone, Pauline; Watt, Richard G
Good nutrition in the early years of life is essential, yet the diets of many pre-school children in the UK are known to be poor. Understanding the decisions parents make when feeding young children is very important in determining what type and nature of interventional support may be developed to promote good nutrition. The aim of this study was to explore using qualitative methods, parental perceptions of feeding their children in order to inform the development of a nutrition intervention. Focus groups (n = 33) and individual interviews (n = 6) were undertaken with parents, most of whom were attending children's centres in two deprived populations from one urban (Islington, north London) and one rural (Cornwall) location in England. Accounts of feeding pre-school children were primarily concerned with dealing with the practicalities of modern life, in particular the cost of food and the need to manage on a restricted household budget. Time pressures, a lack of perceived knowledge and confidence in preparing food and managing conflict over food choices between family members were also strong themes. Parents commonly reported differences between how they would like to feed their children and the reality of what they were able to do in their circumstances. These findings suggest that the poor eating habits of many pre-school children may be less a case of parental ignorance but rather the product of a range of coping strategies. Designing an intervention, which helps parents to build their confidence and self-efficacy, may enable them to make positive changes to their children's diets.
Lundbo, Lene F.; Sørensen, Henrik T.; Clausen, Louise N.; Hollegaard, Mads V.; Hougaard, David M.; Konradsen, Helle B.; Harboe, Zitta Barrella; Nørgaard, Mette; Benfield, Thomas
Background. Neisseria meningitidis is the cause of meningococcal bacteremia and meningitis, and nasopharyngeal colonization with this pathogen is common. The incidence of invasive disease is highest in infants, whereas adolescents more often are carriers. Altered regulation or dysfunction of the innate immune system may predispose to invasive meningococcal disease (IMD). In this study, we investigated the effect of genetic variation in the mannose-binding lectin gene, MBL2, and its promoter on susceptibility to IMD and IMD-associated mortality among children. Methods. Children (<5 years) diagnosed during 1982–2007 with IMD and controls were identified through Danish national registries. DNA was obtained from the Danish Neonatal Screening Biobank. The associations between MBL2 diplotypes and IMD susceptibility and 30- and 90-day mortality were investigated using logistic regression analysis. Results. We included 1351 children: 406 with meningitis, 272 with bacteremia, and 673 age- and sex-matched controls. Of the children studied, 1292 (96%) were successfully genotyped and assigned MBL2 diplotypes. The median age in IMD cases was 19.1 months (interquartile range [IQR], 8.8–32.2 months). Children with defective MBL2 diplotypes were not at higher risk for meningococcal meningitis than children with intermediate and normal diplotypes (odds ratio [OR] = 0.69; 95% confidence interval [CI], .47–1.02). Similar results were found for children with bacteremia and defective diplotypes (OR = 0.84; 95% CI, .53–1.32) as well as for all cases (OR = 0.75; 95% CI, .56–1.01). There was no association between MBL2 diplotypes and mortality. Conclusions. Defective MBL2 diplotypes did not predict either an increased IMD susceptibility or mortality in a Danish population of children. PMID:26464842
Dutton, Daniel J; Campbell, Norman R C; Elliott, Charlene; McLaren, Lindsay
There is increasing recognition in Canada and elsewhere of the need for population-level interventions related to diet. One example of such an intervention is a ban on the marketing of foods/beverages to children, for which several health organizations have or are in the process of developing position statements. Considering the federal government's inaction to impose restrictions that would yield meaningful impact, there is opportunity for the health community to unite in support of a stronger set of policies. However, several issues and challenges exist, some of which we outline in this commentary. We emphasize that, despite challenges, the present and predicted future of diet-related illness in Canadian children is such that population-level intervention is necessary and becoming increasingly urgent, and there is an important role for the health community in facilitating action.
Rizk, Matthew L.; Du, Lihong; Bennetto-Hood, Chantelle; Wenning, Larissa; Teppler, Hedy; Homony, Brenda; Graham, Bobbie; Fry, Carrie; Nachman, Sharon; Wiznia, Andrew; Worrell, Carol; Smith, Betsy; Acosta, Edward P.
P1066 is an open-label study of raltegravir in HIV+ youth, ages 4 weeks-18 years. Here we summarize P1066 pharmacokinetic (PK) data and a population PK model for the pediatric chewable tablet and oral granules. Raltegravir PK parameters were calculated using non-compartmental analysis. A two-compartment model was developed using data from P1066 and an adult study of the pediatric formulations. Inter-individual variability was described by an exponential error model, and residual variability was captured by an additive/proportional error model. Twelve-hour concentrations (C12hr) were calculated from the model-derived elimination rate constant and 8-hour observed concentration. Simulated steady-state concentrations were analyzed by non-compartmental analysis. Target area-under-the-curve (AUC0-12hr) and C12hr were achieved in each cohort. For the pediatric formulations, geometric mean AUC0-12hr values were 18.0–22.6 μM*hr across cohorts, and C12hr values were 71–130 nM, with lower coefficients of variation vs the film-coated tablet. A two-compartment model with first-order absorption adequately described raltegravir plasma PK in pediatric and adult patients. Weight was a covariate on clearance and central volume, and incorporated using allometric scaling. Raltegravir chewable tablets and oral granules exhibited PK parameters consistent with those from prior adult studies and older children in P1066, as well as lower variability than the film-coated tablet. PMID:25753401
Lee, Sun Eun; West, Keith P; Cole, Robert N; Schulze, Kerry J; Wu, Lee Shu-Fune; Yager, James D; Groopman, John; Christian, Parul
Improving child cognition in impoverished countries is a public health priority. Yet, biological pathways and associated biomarkers of impaired cognition remain poorly understood and largely unknown, respectively. This study aimed to explore and quantify associations between functional plasma protein biomarkers and childhood intellectual test performance. We applied proteomics to quantify proteins in plasma samples of 249 rural Nepalese children, 6-8years of age who, 1year later at 7-9years of age, were administered the Universal Nonverbal Intelligence Test (UNIT). Among 751 plasma proteins quantified, 22 were associated with UNIT scores, passing a false discovery rate threshold of 5.0% (q<0.05). UNIT scores were higher by 2.3-9.2 points for every 50% increase in relative abundance of two insulin-like growth factor binding proteins (IGFBPs), six subclasses of apolipoprotein (Apo) and transthyretin, and lower by 4.0-15.3 points for each 50% increase in relative abundance of 13 proteins predominantly involved in inflammation. Among them, IGFBP-acid labile subunit, orosomucoid 1 (ORM1), Apo C-I, and pyruvate kinase isoenzymes M1/M2 jointly explained 37% of the variance in UNIT scores. After additional adjustment for height-for-age Z-score and household socio-economic status as indicators of long-term nutritional and social stress, associations with 6 proteins involved in inflammation, including ORM1, α-1-antichymotrypsin, reticulocalbin 1, and 3 components of the complement cascade, remained significant (q<0.05). Using untargeted proteomics, stable, constitutive facets of subclinical inflammation were associated with lower developmental test performance in this rural South Asian child population. Plasma proteomics may offer opportunities to identify functional, antecedent biomarkers of child cognitive development.
Daoud, Katrina; Gollenberg, Audra; Fendley, Kim
Background As posited in multiple health communication theories, it is vital to understand modern health communication preferences among communities in order to develop tailored interventions to reduce Infant Mortality (IM). Literature suggests that health communication inequalities play an important role in infant health knowledge gaps, thus contributing to the disparate IM rates. We sought to understand preferred methods of communication among expectant or mothers of young children of varying sociodemographics. We hypothesized that methods of communication would vary by sociodemographics. Methods A bilingual questionnaire, developed using community based participatory research principles was offered at pre-selected women's health agencies in the Shenandoah Valley of Virginia. Participants chose from a researched list of 22 methods of communication and also designated their “top three choices.” Communication methods were compared across sociodemographics using chi-squared statistical tests. Results A total of 292 participants completed the questionnaire at the various sites. Participants were predominantly White (60%) or Hispanic/Latina (30%), and lived in Frederick county/Winchester city (77%). Of the 22 communication methods, the five most prevalent were: talking with a healthcare provider (91%), family or friends (85-87%), using internet (84%), and handouts/booklets (80%). Communication methods most frequently chosen as a “top three choice” were: internet (46%), talking with healthcare providers (33%), and talking with family (32%). A higher preference for talking with a healthcare provider was noted among higher income individuals (100%) compared to lower income (82%; p-value=0.0062), a higher preference for call-in hotlines among Hispanic (49%) vs. non-Hispanic women (15%; p-value<0.0001), and a higher preference for placemats at fast-food restaurants among older women (42%) compared to younger (16%, p-value=0.0361). Conclusion Results suggest the
Sollai, Sara; Ghetti, Francesca; Bianchi, Leila; de Martino, Maurizio; Galli, Luisa; Chiappini, Elena
Abstract Infectious diseases are common in internationally adopted children (IAC). With the objective to evaluate infectious diseases prevalence in a large cohort of IAC and to explore possible risk factors for tuberculosis (TB) and parasitic infections, clinical and laboratory data at first screening visit of all IAC (<18 years) consecutively referred to our Center in 2009 to 2015 were collected and analyzed. In total, 1612 children (median age: 5.40 years; interquartile range: 3.00–7.90) were enrolled, 123/1612 (7.60%) having medical conditions included in the special needs definition. The most frequent cutaneous infections were Molluscum contagiosum (42/1612; 2.60%) and Tinea capitis (37/1612; 2.30%). Viral hepatitis prevalence was <1% (hepatitis B virus [HBV]: 13 children, 0.80%; hepatitis C virus: 1 child, 0.10%; hepatitis A virus: 6 children, 0.40%). A parasitic infection was diagnosed in 372/1612 (23.10%) children. No risk factors for parasitosis were evidenced. Active TB was diagnosed in 4/1355 (0.3%) children, latent TB in 222/1355 (16.40%). Only 3.7% (51/1355) children had concordant positive tuberculin skin test (TST) and QuantiFERON-TB-Gold In-Tube (QFT-G-IT) results. Risk factors for TST+/QFT-G-IT− results were previous Bacille de Calmette-Guérin vaccination (adjusted odds ratio [aOR]: 2.18; 96% confidence interval [CI]: 1.26–3.79; P = 0.006), and age ≥5 years (aOR: 1.49; 95% CI: 1.06–2.11; P = 0.02). The proportion of children with nonprotective titers for vaccine-preventable diseases (VPD) ranged from 15.70% (208/1323) for tetanus to 35.10% (469/1337) for HBV. Infectious diseases were commonly observed in our cohort. The high rate of discordant TST/QFT-G results brings up questions regarding the optimal management of these children, and suggests that, at least in children older than 5 years, only QFT-G-IT results may be reliable. The low proportion of children protected for VPD, confirms importance of a timely screening. PMID
Briggs, Andrew M; Smith, Anne J; Straker, Leon M; Bragge, Peter
Background Thoracic spine pain (TSP) is experienced across the lifespan by healthy individuals and is a common presentation in primary healthcare clinical practice. However, the epidemiological characteristics of TSP are not well documented compared to neck and low back pain. A rigorous evaluation of the prevalence, incidence, correlates and risk factors needs to be undertaken in order for epidemiologic data to be meaningfully used to develop evidence-based prevention and treatment recommendations for TSP. Methods A systematic review method was followed to report the evidence describing prevalence, incidence, associated factors and risk factors for TSP among the general population. Nine electronic databases were systematically searched to identify studies that reported either prevalence, incidence, associated factors (cross-sectional study) or risk factors (prospective study) for TSP in healthy children, adolescents or adults. Studies were evaluated for level of evidence and method quality. Results Of the 1389 studies identified in the literature, 33 met the inclusion criteria for this systematic review. The mean (SD) quality score (out of 15) for the included studies was 10.5 (2.0). TSP prevalence data ranged from 4.0–72.0% (point), 0.5–51.4% (7-day), 1.4–34.8% (1-month), 4.8–7.0% (3-month), 3.5–34.8% (1-year) and 15.6–19.5% (lifetime). TSP prevalence varied according to the operational definition of TSP. Prevalence for any TSP ranged from 0.5–23.0%, 15.8–34.8%, 15.0–27.5% and 12.0–31.2% for 7-day, 1-month, 1-year and lifetime periods, respectively. TSP associated with backpack use varied from 6.0–72.0% and 22.9–51.4% for point and 7-day periods, respectively. TSP interfering with school or leisure ranged from 3.5–9.7% for 1-year prevalence. Generally, studies reported a higher prevalence for TSP in child and adolescent populations, and particularly for females. The 1 month, 6 month, 1 year and 25 year incidences were 0–0.9%, 10.3%, 3
Farris, R P; Cresanta, J L; Frank, G C; Webber, L S; Berenson, G S
Dietary intakes of carbohydrate (CHO) and fiber were examined in children randomly selected from a biracial community-Bogalusa, LA. Intakes of CHO per 1,000 kcal were similar for both sexes and both races at ages 10 and 13 years. No group or race differences were found for nine components assessed in two cohorts of 10-year-old children examined three years apart. There were sex differences in sucrose (boys less than girls) and lactose (boys greater than girls) intakes. Comparison of 10- and 13-year-olds examined in 1976 showed a racial difference in fiber and starch intakes (black greater than white). Longitudinal comparisons of a cohort of 148 children examined at both 10 and 13 years showed lower lactose intakes over time. At both ages starch, fiber, and glucose intakes per 1,000 kcal were higher in black children, with higher sucrose/starch ratios in white children. The percent of calories from CHO and sugars was higher in Bogalusa children than values for US adults, but starch intakes were lower. None of the children's intakes was compatible with prudent dietary recommendations. Dietary CHO patterns of Bogalusa children reflect food market trends of increased use of simple CHO and decreased use of complex CHO.
Singh, Veeran-Anne S.; Thornton, Tiffany; Tonmyr, Lil
Substance abuse is an important health issue facing children involved with child welfare, but little is known about the associated factors. The purpose of this study was to build on findings from the "Canadian Incidence Study of Reported Child Abuse and Neglect-2003" and use a national sample of 10-15 year old children to examine the…
Jennings, Jerry T.
This report presents a statistical portrait of the demographic, social, and economic characteristics of American children and youth. The source of the data in U.S. government sources includes surveys, censuses, and vital statistics. In general, children are defined as persons under 14 years old, and youth as persons 14 to 24 years old. Exceptions…
Lee, Nancy Raitano; Fidler, Deborah J.; Blakeley-Smith, Audrey; Daunhauer, Lisa; Robinson, Cordelia; Hepburn, Susan L.
The current study describes everyday executive function (EF) profiles in young children with Down syndrome. Caregivers of children with Down syndrome (n = 26; chronological ages = 4-10 years; mental ages = 2-4 years) completed the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P; G. A. Gioia, K. A. Espy, & P. K. Isquith, 2003), a…
Parkinson, Kathryn N.; Wright, Charlotte M.; Drewett, Robert F.
Background: The essential link between energy needs and energy intake is feeding behaviour, yet few studies have directly observed feeding behaviour in children who have failed to thrive. A cohort of 961 term infants was screened to identify children with first year weight gain below the 5th centile in order to examine their feeding behaviour and…
Barnevik-Olsson, Martina; Gillberg, Christopher; Fernell, Elisabeth
This work was a follow-up study (birth years 1999-2003) of the prevalence of autism in children of Somali background living in the county of Stockholm, Sweden. In a previous study (birth years 1988-98), the prevalence of autism associated with learning disability was found to be three to four times higher among Somali children compared with other…
Wei, Chang-Ching; Lin, Cheng-Li; Shen, Te-Chun; Tsai, Jeng-Dau
Primary immune thrombocytopenia (ITP) is currently defined as an acquired autoimmune disorder with persistent thrombocytopenia. However, the temporal interaction between T helper type 2 cell (Th2)-mediated allergic diseases and T helper type 1 cell (Th1)-mediated ITP remains unknown. Atopic dermatitis (AD) is considered one of the first steps in the atopic march. Herein, we conducted a population-based cohort analysis to investigate the risk of ITP in children with AD in comparison with non-AD controls. We subsequently compared the occurrence of other autoimmune diseases in ITP children in both AD and non-AD cohorts. From 2000 to 2007, 120,704 children with newly diagnosed AD and 241,408 randomly selected non-AD controls were included in the study. By the end of 2008, incidences of ITP in both cohorts and the AD cohort to non-AD cohort hazard ratios (HRs) and confidence intervals (CIs) were measured. Comparison of the occurrence of other autoimmune diseases in ITP between children with and without AD was analyzed. The incidence of ITP during the study period was 1.72-fold greater (95% CI: 1.13-2.62) in the AD cohort than in the non-AD cohort (6.96 vs 4.00 per 100,000 person-years). The risk was greatest among male children, children >2 years, those in densely populated areas, and those with white-collar parents. The HR of ITP in AD children increased significantly with the number of AD-related clinical visits (P < 0.001). The risk of developing ITP in the AD cohort was highest within the first 3 years after the diagnosis of AD (HR: 1.78; CI: 1.14-2.78). The AD cohort with ITP had a higher occurrence rate of other autoimmune diseases than the non-AD cohort with ITP. AD children had a greater risk of developing ITP and other autoimmune diseases. Further research is needed to clarify the role of allergy in the pathogenesis of ITP and autoimmune diseases.
Madren, Eric; Santianni, Kirsten A.
Abstract Objective: Parents of children with autism spectrum disorders (ASDs) often try a variety of treatments for their children, including complementary and alternative medicine (CAM). The objective of this study was to improve understanding of the frequency of CAM use by parents for their children with autism and to quantify the parents' perceived effectiveness of various CAM therapies in mitigating the health and functioning problems associated with autism. Methods: Parents in southeastern Virginia were recruited for study participation from local autism organizations and a clinical practice where a large proportion of the patients are children with autism. Parents completed an online survey and answered questions about CAM use for their children with autism, and they rated the perceived effectiveness of each therapy. Results: Of 194 parents surveyed, 80.9% reported that they had tried some form of CAM for their child with autism. Among CAM users, the most frequently used therapies were multivitamins (58.6%), the gluten-free casein-free diet (54.8%), and methyl B-12 injections (54.1%). The CAM therapies that received the highest average rating of effectiveness were sensory integration therapy, melatonin, and off-label use of prescription antifungal medications. Conclusion: CAM therapies were frequently used in this population, and many were perceived to be effective in helping to ease some of the health challenges associated with autism. CAM therapies for the autism population should be further studied in well-controlled clinical research settings to provide safety and efficacy data on treatments, as well as validated treatment options for those with ASD. PMID:26654976
Akins, CDR Roger Scott; Krakowiak, Paula; Angkustsiri, Kathleen; Hertz-Picciotto, Irva; Hansen, Robin L.
Objective This study compared the utilization of conventional treatments to utilization of complementary and alternative medicine (CAM) in preschoolers with autism spectrum disorders (ASD) and other developmental disabilities (DD). Methods Participants were 578 children who were part of an ongoing population-based, case-control study of 2 to 5 year-olds with ASD, DD, and the general population. Parents completed an interview on past and current services. Results Four hundred fifty-three children with ASD and 125 DD children were included. ASD families received more hours of conventional services compared to DD (17.8 vs. 11; p<0.001). The use of psychotropic medications was low in both groups (~3%). CAM use overall was not significantly different in ASD (39%) versus DD (30%). Hispanic families in both groups used CAM less often than non-Hispanics. Variables such as level of function, immunization status, and presence of an identified neurogenetic disorder were not predictive of CAM use. A higher level of parental education was associated with increased CAM use in ASD and DD. Families who utilized >20 hours per week of conventional services were more likely to use CAM, including potentially unsafe or disproven CAM. Under-immunized children were marginally more likely to use CAM, but not more likely to have received potentially unsafe or disproven CAM. Conclusion CAM use is common in families of young children with neurodevelopmental disorders and is predicted by higher parental education and non-Hispanic ethnicity but not developmental characteristics. Further research should address how healthcare providers can support families in making decisions about CAM use. PMID:24399100
De Pelsmaeker, Sara; Schouteten, Joachim; Gellynck, Xavier
Although milk and dairy products are seen as an important part of a child's diet, their consumption is declining. The aim of this study is to investigate the consumption of milk and flavored milk among a sample of 513 Belgian children aged between 8 and 13 years. In addition, the association between flavored milk brands and emotions is examined. Children prefer and consume more flavored than plain milk. They indicate that consumption is a self-made choice and that parents mainly ensure the availability of these products. Children prefer flavored milk to plain milk, although it is perceived to be less healthy. No correlation could be found between brand awareness and the consumption of flavored milk. Brands of flavored milk evoke divergent emotions and can be classified into different groups based upon their association with a type of emotion (i.e. positive/negative). This study demonstrates that taste is an important factor in flavored milk consumption by children and shows a strong relationship between brands and emotions. Consequently, the taste needs to be appealing for children, but it is equally important that children associate the brand with positive emotions, as this will lead to a higher preference. Milk producers who target children can use the insights gained from this study in the development of new products.
Borzabadi-Farahani, Ali; Borzabadi-Farahani, Anahid; Eslamipour, Faezeh
The aim of this cross-sectional study was to determine the prevalence of malocclusions, occlusal traits, and their gender distribution in urban Iranian school children. Five hundred and two subjects (253 females and 249 males, aged 11-14 years) were examined. Molar relationship, overjet (OJ), overbite, midline deviation, crossbite, and crowding/spacing were recorded. Gender dimorphism was evaluated by the chi-square test. According to the classification of Angle, the prevalence of Class I, Class II division 1, Class II division 2, and Class III malocclusions was 41.8, 24.1, 3.4, and 7.8 per cent, respectively. Symmetric molar relationship was present in 69.5 per cent. An OJ of at least 3.5 mm or more was present in 28.1 per cent; an OJ of more than 6 mm in 3.6 per cent, and 4.2 per cent had a reverse OJ. A normal overbite was observed in 60.4 per cent, while 34.5 per cent had an increased and 2.2 per cent a very deep overbite. An anterior open bite (AOB) was present in 1.6 per cent and a scissor bite or anterior crossbite in 2 and 8.4 per cent, respectively. A posterior crossbite was observed in 12.4 per cent (8.4 per cent unilateral, 2 per cent bilateral, and 2 per cent in association with an anterior crossbite). Midline deviation was present in 23.7 per cent. Severe crowding (>or=5.1 mm) was observed in 16.7 and 10.8 per cent and spacing in 18.9 and 20.7 per cent of the maxillary and mandibular arches, respectively. Significant gender differences were found for overbite (P < 0.001), midline deviation (P < 0.05), and maxillary and mandibular arch crowding/spacing (P < 0.05). The prevalence of Class II malocclusions was comparable with Caucasians; however, the most severe forms of Class II malocclusions were rare in this Iranian population. The relative prevalence of Class III malocclusions in the present study was greater than in Caucasians. Crowding was the most common dental anomaly in both arches.
Kojouharova, Mira; Gatcheva, Nina; Setchanova, Lena; Robertson, Susan E.; Wenger, Jay D.
OBJECTIVE: To assess the incidence of meningitis caused by Haemophilus influenzae type b (Hib) among children in Bulgaria and to provide evidence for an informed decision on the use of Hib vaccines in Bulgaria. METHODS: From 1 July 1997 to 31 December 1999, active surveillance for meningitis was conducted in six regions. For children with suspected meningitis, a cerebrospinal fluid (CSF) specimen was sent for cytology, chemistry, latex agglutination testing, culture and sensitivity. FINDINGS: During the 2.5-year study period, surveillance was conducted among 138 249 children aged <5 years - a sample representing 40% of all Bulgarian children in this age group. Overall, 285 children with suspected meningitis were identified. In eight children, clinical symptoms of meningitis resolved rapidly before a CSF specimen could be obtained. Of the remaining 277 children, 121 (44%) were classified as having probable bacterial meningitis on the basis of a CSF examination. An organism was identified for 88 (73%) of the 121 cases with probable bacterial meningitis. There were 21 cases of Hib, giving a mean annual incidence of 6.1 Hib meningitis cases per 100 000 children <5 years; the case-fatality rate was 10%. Nearly 60% of Hib isolates were resistant to one or more antibiotics, but they were not resistant to third-generation cephalosporins. CONCLUSION: On the basis of these findings, Hib conjugate vaccines have been included in the list of vaccines recommended for children by the Bulgarian Ministry of Health. The recommended initial treatment for paediatric bacterial meningitis has been changed to third-generation cephalosporins. PMID:12378285
Changing Trends within the Population of Children Who Are Deaf or Hard of Hearing in Flanders (Belgium): Effects of 12 Years of Universal Newborn Hearing Screening, Early Intervention, and Early Cochlear Implantation
De Raeve, Leo; Lichtert, Guido
The purpose of this study is to show the changing trends within the population of children who are deaf and hard of hearing in Belgium over the last 12 years. The combination of Universal Newborn Hearing Screening programs, early intervention, and cochlear implants have tremendously influenced the education and support of children who are deaf or…
Lee, Yu-Sheng; Jeng, Mei-Jy; Tsao, Pei-Chen
Background The mortality risk associated with congenital airway anomalies (CAA) in children with congenital heart disease (CHD) is unclear. This study aimed to investigate the factors associated with CAA, and the associated mortality risk, among children with CHD. Methods This nationwide, population-based study evaluated 39,652 children with CHD aged 0–5 years between 2000 and 2011, using the Taiwan National Health Insurance Research Database (NHIRD). We performed descriptive, logistic regression, Kaplan–Meier, and Cox regression analyses of the data. Results Among the children with CHD, 1,591 (4.0%) had concomitant CAA. Children with CHD had an increased likelihood of CAA if they were boys (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.33–1.64), infants (OR, 5.42; 95%CI, 4.06–7.24), or had a congenital musculoskeletal anomaly (OR, 3.19; 95%CI, 2.67–3.81), and were typically identified 0–3 years after CHD diagnosis (OR, 1.33; 95%CI 1.17–1.51). The mortality risk was increased in children with CHD and CAA (crude hazard ratio [HR], 2.05; 95%CI, 1.77–2.37), even after adjusting for confounders (adjusted HR, 1.76; 95%CI, 1.51–2.04). Mortality risk also changed by age and sex (adjusted HR and 95%CI are quoted): neonates, infants, and toddlers and preschool children, 1.67 (1.40–2.00), 1.93 (1.47–2.55), and 4.77 (1.39–16.44), respectively; and boys and girls, 1.62 (1.32–1.98) and 2.01 (1.61–2.50), respectively. Conclusion The mortality risk is significantly increased among children with CHD and comorbid CAA. Clinicians should actively seek CAA during the follow-up of children with CHD. PMID:26334302
Serra-Negra, Junia Maria; Paiva, Saul Martins; Abreu, Mauro Henrique; Flores-Mendoza, Carmen Elvira; Pordeus, Isabela Almeida
Background Tasks can be instruments of stress and may affect the health of children. Sleep bruxism is a multifactorial sleep-related movement disorder that affects children and adults. The aim of the present study was to analyze the association between children’s tasks, personality traits and sleep bruxism. Methods And Findings A cross-sectional, population-based study of 652 randomly selected Brazilian schoolchildren (52% of whom were female), aged from 7 to 10 years was conducted in the city of Belo Horizonte, Brazil. A questionnaire based on criteria proposed by the American Academy of Sleep Medicine (AASM) was completed by parents. In addition, the Neuroticism and Responsibility sub-scales of the Big Five Questionnaire for Children (BFQ-C) were administered to the children. Psychological tests were administered and evaluated by psychologists. The Social Vulnerability Index from the city council database was used to determine the social classification of the families. Chi-square and Poisson regression statistical tests were used with a 95% confidence interval. The majority of families were classified as having low social vulnerability (61.3%), whereas, 38.7% were classified as having high social vulnerability. Regarding extracurricular activities, the majority of girls performed household work (56.4%) and some artistic activity (51.3%) while sporting activities were most common among boys (61%). The results of the Poisson regression model indicated that sleep bruxism was most prevalent in children who scored highly in the Neuroticism sub-scale, and who frequently performed household tasks. Conclusion Children whose personality domain has a high level of Neuroticism and who perform household chores imposed by the family are more vulnerable to sleep bruxism. PMID:24244614
Yu, Yunjiang; Wang, Qiong; Li, Liangzhong; Liu, Zien; Sun, Peng; Zhang, Yanping; Lin, Haipeng; Xiang, Mingdeng; Li, Hui; Lin, Bigui
Concentrations of benzo[a]pyrene (B[a]P) in ambient air from different areas in Lanzhou city in northwest of China, and its metabolite 1-hydroxypyrene (1-OHP) in the urine of resident children and adults were determined by using gas chromatography/mass spectrometry and high performance liquid chromatography. Results showed that the atmospheric environmental concentration of B[a]P varied significantly from one part of the city to another with levels of 150 ng/m(3) in the industrial area of Xigu and 73.8 ng/m(3) in the agricultural area of Yuzhong. The geometric mean urinary 1-OHP concentration was 0.42 µmol/mol-creatinine, with a range of means between 0.067 and 2.05 for the various population sub-groups. The non-occupationally exposed populations' age, gender and area of residence were the major factors that influenced urinary 1-OHP levels. The health risks of B[a]P for adults and children in Xigu and for children in Yuzhong exceeded the acceptable level (1 × 10(-4)) of the US Environmental Protection Agency.
Kaiser, Marie; Kuwert, Philipp; Braehler, Elmar; Glaesmer, Heide
At the end of World War II and during the first decade after the war, roughly 200,000 children were fathered in intimate contacts between German women and foreign soldiers. The experiences of these German occupation children (GOC) have been so far described in case reports and from historical perspective only. Research on psychosocial consequences of growing up as a GOC has been missing so far. This study examined traumatic experiences, posttraumatic stress disorder, somatization, and depression in GOC (N = 146) using self-report instruments: Posttraumatic Diagnostic Scale and Patient Health Questionnaire. Findings have then been compared with a representative birth cohort-matched sample from the German general population (N = 977). German occupation children showed significantly higher prevalence rates of most traumatic experiences, higher point prevalence rates of full and partial posttraumatic stress disorder, depression, and somatization than the control group. In summary, GOC often grew up under difficult conditions (e.g., poverty, single mothers, and stigmatization). Even decades later, they showed higher rates of different mental disorders and higher comorbidity. These findings underline the complex and long-term impact of their burdened social, financial, and familial conditions. The results underpin the importance of conceptualizing occupation children as a vulnerable group in postconflict settings.
Urbonas, Vaidotas; Sadauskaite, Jolita; Cerkauskiene, Rimante; Kaminskas, Arvydas; Mäki, Markku; Kurppa, Kalle
Background Selective immunoglobulin A (IgA) deficiency is the most common inherited immunodeficiency disorder world-wide. An early diagnosis is advocated because of the increased risk of infections, autoimmune diseases, and allergic reactions. We investigated the usefulness of a rapid point-of-care test in detecting for IgA deficiency in a population with a previously unknown prevalence. Material/Methods Altogether, 1000 children aged 11–13 years from randomly selected Lithuanian schools were enrolled. A point-of-care test with a fingertip sample was used to screen for the presence of IgA deficiency in children whose parents gave consent. Those with suspected IgA deficiency were referred to hospital for further clinical examination and confirmation of the diagnosis. In addition, their medical histories were compared with those of 30 age- and sex-matched healthy controls. Results IgA deficiency was suspected in one girl and in three boys on the basis of the rapid test, and the diagnosis was confirmed for all four cases (prevalence 0.4%, 95% confidence interval 0.16–1.02%). There was no difference in disease history or complications between IgA-deficient children and healthy controls. Conclusions The rapid antibody test is a practical and accurate method to diagnose selective IgA deficiency in children. The prevalence of IgA deficiency among Lithuanian schoolchildren is 1:250. PMID:27920422
Mantovani, Saulo Augusto Silva; Ramalho, Alanderson Alves; Pereira, Thasciany Moraes; Branco, Fernando Luiz Cunha Castelo; Oliart-Guzmán, Humberto; Delfino, Breno Matos; Braña, Athos Muniz; Martins, Antonio Camargo; Filgueira-Júnior, José Alcântara; Santos, Ana Paula; Campos, Rhanderson Gardinali; Guimarães, Andréia Silva; Araújo, Thiago Santos de; Oliveira, Cristieli Sérgio de Menezes; Codeço, Cláudia Torres; da Silva-Nunes, Mônica
Despite the process of nutritional transition in Brazil, in some places, such as the Amazon region, stunting is still an important public health problem. We identified the prevalence and factors associated with stunting in children under five years old residing in the urban area of Assis Brasil. A survey was conducted in which a questionnaire on socioeconomic, maternal and children's conditions was applied, and height or length was measured. The children with height for age index below -2 Z-scores were considered stunted, according to the criteria by the World Health Organization. Four hundred and twenty-eight children were evaluated. Of these, 62 were stunted. Factors associated with stunting, according to adjusted models, were: the presence of open sewer, the wealth index for households, the receipt of governmental financial aid and the mother's height, age and education. Therefore, it was observed that family and the mother's characteristics as well as environmental and socioeconomic factors were closely related to the occurrence of stunting in the population studied, and such nutritional disturbance is still a health problem in the Brazilian Amazon.
Watt, Kevin M; Gonzalez, Daniel; Benjamin, Daniel K; Brouwer, Kim L R; Wade, Kelly C; Capparelli, Edmund; Barrett, Jeffrey; Cohen-Wolkowiez, Michael
Candida infections are a leading cause of infectious disease-related death in children supported by extracorporeal membrane oxygenation (ECMO). The ECMO circuit can alter drug pharmacokinetics (PK); thus, standard fluconazole dosing may result in suboptimal drug exposures. The objective of our study was to determine the PK of fluconazole in children on ECMO. Forty children with 367 PK samples were included in the analysis. The PK data were analyzed using nonlinear mixed-effect modeling (NONMEM). A one-compartment model best described the data. Weight was included in the base model for clearance (CL) and volume of distribution (V). The final model included the effect of serum creatinine (SCR) level on CL and the effect of ECMO on V as follows: CL (in liters per hour) = 0.019 × weight × (SCR/0.4)(-0.29) × exp(ηCL) and V (in liters) = 0.93 × weight × 1.4(ECMO) × exp(ηV). The fluconazole V was increased in children supported by ECMO. Consequently, children on ECMO require a higher fluconazole loading dose for prophylaxis (12 mg/kg of body weight) and treatment (35 mg/kg) paired with standard maintenance doses to achieve exposures similar to those of children not on ECMO.
Tan, Yafei; Ma, Di; Chen, Ying; Cheng, Fuyuan; Liu, Xiangxiang; Li, Liping
The purpose of this study is to explore the relationships between sleep behaviors and injury occurrence among Chinese school-aged children. Data were collected with self-administered questionnaires of a cross-sectional survey which covered the school-aged children from southeastern Chinese urban and rural areas in April 2010. Information was collected on unintentional injury in the past year, sleep duration, napping and daytime fatigue, sleeping pill use, and social-demographic variables. Multivariable logistic regression analyses, controlling for confounding factors, were conducted to assess sleep-related variables that were associated with injuries. Students who slept for less than 8 h had a 30% increased risk of injury (OR: 1.30; 95%CI: 1.01-1.69) compared with those who slept for 8-9 h. Lack of napping, snoring and use of sleeping pills were significantly associated with injury. Among different genders, the slight difference in sleep behaviors predicted the occurrence of injury. Rural children displayed more sleep behaviors associated with injury than urban children. The sleep behaviors of primary school students were more negatively correlated with injury occurrence than junior/senior high school children. Consideration should be given to the prevention of problematic sleep behaviors as a potential risk factor in order to decrease injury rates and promote the health of school-aged children.
Tan, Yafei; Ma, Di; Chen, Ying; Cheng, Fuyuan; Liu, Xiangxiang; Li, Liping
The purpose of this study is to explore the relationships between sleep behaviors and injury occurrence among Chinese school-aged children. Data were collected with self-administered questionnaires of a cross-sectional survey which covered the school-aged children from southeastern Chinese urban and rural areas in April 2010. Information was collected on unintentional injury in the past year, sleep duration, napping and daytime fatigue, sleeping pill use, and social-demographic variables. Multivariable logistic regression analyses, controlling for confounding factors, were conducted to assess sleep-related variables that were associated with injuries. Students who slept for less than 8 h had a 30% increased risk of injury (OR: 1.30; 95%CI: 1.01–1.69) compared with those who slept for 8–9 h. Lack of napping, snoring and use of sleeping pills were significantly associated with injury. Among different genders, the slight difference in sleep behaviors predicted the occurrence of injury. Rural children displayed more sleep behaviors associated with injury than urban children. The sleep behaviors of primary school students were more negatively correlated with injury occurrence than junior/senior high school children. Consideration should be given to the prevention of problematic sleep behaviors as a potential risk factor in order to decrease injury rates and promote the health of school-aged children. PMID:26501305
Shields, Alexandra E; McGinn-Shapiro, Mary; Fronstin, Paul
This chapter examines trends in private and public health coverage, as well as implications for vulnerable populations and health disparities. We find that there has been erosion in employment-based health benefits. Both the percentage of employers offering coverage and the percentage of workers with coverage declined in recent years. Those with coverage face eroding benefits and increased cost sharing. Within the public sector, Medicaid enrollment has decreased, with benefits increasingly restricted. Although State Children's Health Insurance Program (SCHIP) enrollment has increased among low-income children, the future of SCHIP remains uncertain. Meeting the healthcare needs of Americans and reducing health disparities requires both the provision of health coverage to all and sufficient comprehensiveness of benefits within private and public programs to meet enrollees' healthcare needs. Our findings suggest that we have a long way to go in reaching these goals.
Gobbi, Erica; Elliot, Catherine; Varnier, Maurizio; Carraro, Attilio
The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It). Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170) examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA) and construct validity with enjoyment perception during physical activity. Study 2 (n = 59) reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry) over the span of seven consecutive days. Study 3 (n = 58) examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD). In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83). Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36), with BMI (r = -.30 and -.79 for CHD simple form), and with the VO2max (r = .55 for CHD simple form). Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p < .05). Findings of the EFA suggested a two-factor structure for the PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe. PMID:27228050
Duicu, Carmen; Mărginean, Cristina Oana; Voidăzan, Septimiu; Tripon, Florin; Bănescu, Claudia
Abstract Obesity is a disorder with increasing frequency in children and adolescents, directly linked with various diseases. Variants in the FTO (fat mass and obesity-related) gene have been associated with body mass index and waist and hip circumferences in widespread populations. The aim of this case-control study was to assess if there is any association between FTO gene variants rs9939609, respectively, rs17817449 with anthropometric and metabolic biomarkers (fasting glucose, TC, HDL-cholesterol, LDL-cholesterol, triglycerides) and adipokines (adiponectin and leptin), in Romanian obese children. A total of 387 children, 201 obese and 186 nonobese individuals, were included in this prospective study. Genotyping of the FTO gene polymorphisms for all subjects was performed using the restriction fragment length polymorphism (PCR–RFLP) method. Significant associations were found between FTO rs9939609 single nucleotide polymorphism (SNP) and obesity. AA genotype carriers have a 2.02 times higher risk for obesity compared with AT+TT genotype carriers. Risk allele carriers of rs17817449 SNP had somewhat higher values of weight, body mass index, waist and hip circumference, total cholesterol, triglycerides, adiponectin, and fasting glucose. This study revealed the genetic association between rs9939609 SNP of FTO and obesity in a Romanian population, and to the authors’ knowledge, this is the first study to investigate this association in a Romanian population. This study also established that combined variant genotypes (AA/GG) of FTO rs9939609 /rs17817449 are strongly associated with several measures of adiposity (weight, BMI-SD, mid-upper arm circumference, tricipital skinfold thicknesses) and are also associated with total cholesterol, triglyceride, and LDL-cholesterol levels. PMID:27196486
Duicu, Carmen; Mărginean, Cristina Oana; Voidăzan, Septimiu; Tripon, Florin; Bănescu, Claudia
Obesity is a disorder with increasing frequency in children and adolescents, directly linked with various diseases. Variants in the FTO (fat mass and obesity-related) gene have been associated with body mass index and waist and hip circumferences in widespread populations.The aim of this case-control study was to assess if there is any association between FTO gene variants rs9939609, respectively, rs17817449 with anthropometric and metabolic biomarkers (fasting glucose, TC, HDL-cholesterol, LDL-cholesterol, triglycerides) and adipokines (adiponectin and leptin), in Romanian obese children.A total of 387 children, 201 obese and 186 nonobese individuals, were included in this prospective study. Genotyping of the FTO gene polymorphisms for all subjects was performed using the restriction fragment length polymorphism (PCR-RFLP) method.Significant associations were found between FTO rs9939609 single nucleotide polymorphism (SNP) and obesity. AA genotype carriers have a 2.02 times higher risk for obesity compared with AT+TT genotype carriers. Risk allele carriers of rs17817449 SNP had somewhat higher values of weight, body mass index, waist and hip circumference, total cholesterol, triglycerides, adiponectin, and fasting glucose.This study revealed the genetic association between rs9939609 SNP of FTO and obesity in a Romanian population, and to the authors' knowledge, this is the first study to investigate this association in a Romanian population. This study also established that combined variant genotypes (AA/GG) of FTO rs9939609 /rs17817449 are strongly associated with several measures of adiposity (weight, BMI-SD, mid-upper arm circumference, tricipital skinfold thicknesses) and are also associated with total cholesterol, triglyceride, and LDL-cholesterol levels.
Schroeder, H; Wacher, J; Larsson, H; Rosthoej, S; Rechnitzer, C; Pedersen, B L; Carlsen, N L T
Treatment results for neuroblastoma in Denmark have been poorer than in other Nordic countries, so we investigated whether a change in incidence, stage distribution and survival had occurred between 1981 and 2000. Clinical data were retrieved from the medical charts of 160 children <15 years of age with extra-cranial neuroblastoma (n=139) or ganglioneuroblastoma (n=21) diagnosed in Denmark between 1981 and 2000. The minimal follow-up time was 52 months. Statistical analyses were performed in STATA. The incidence was 8.55 per million children below 15 years of age (world standard 9.6) and 42.6 per million children below 12 months of age, and it has remained unchanged since 1970. The median age at diagnosis was 27 months. In all, 32% of the children were aged below 12 months at diagnosis, 53% had metastatic disease and in 12% the diagnosis was made incidentally. Prognostic factors such as age, stage and site of primary tumour were the same as in other studies and did not change. During the study period, the mortality rate decreased steadily, and the 5-year survival rate increased from 38% in 1981–1985 to 59% in 1996–2000, corresponding to the level found in other Western countries. Increased survival was also seen in children with metastatic disease. Participation in international studies, better supportive care and possibly postoperative autologous stem cell transplantation may have contributed to the increased survival. PMID:19223904
Currier, Joseph M.; Hermes, Susan
Objective To examine a revised measure of benefit finding for children, in relation to perceptions of illness-related burden, and other measures of child psychological functioning. Methods A sample of 78 children with cancer completed the newly revised Benefit/Burden Scale for Children (BBSC) and measures of optimism/pessimism, positive/negative affect, anxiety and defensiveness. Results Factor analysis of the BBSC revealed a clear two-factor solution, with benefit finding and illness-related burden representing orthogonal factors. Both scales were internally consistent and demonstrated different patterns of correlation with the other measures assessed in the study. Conclusion The BBSC is internally reliable and preliminary data supports the validity of separate benefit and burden constructs. Children report positive and negative aspects of their illness simultaneously, and perceptions of benefit and burden function as independent constructs. The BBSC is a useful measure for pediatric cancer patients that could be applied to children experiencing other significant life events. PMID:19342537
Guhn, Martin; Janus, Magdalena; Enns, Jennifer; Brownell, Marni; Forer, Barry; Duku, Eric; Muhajarine, Nazeem; Raos, Rob
Introduction Early childhood is a key period to establish policies and practices that optimise children's health and development, but Canada lacks nationally representative data on social indicators of children's well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in children's developmental health and to advance research examining the social determinants of health. Methods and analysis Canada-wide EDI records from 2004 to 2014 (representing over 700 000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics and dissemination Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood
Bateman, B; Warner, J; Hutchinson, E; Dean, T; Rowlandson, P; Gant, C; Grundy, J; Fitzgerald, C; Stevenson, J
Aims: To determine whether artificial food colourings and a preservative in the diet of 3 year old children in the general population influence hyperactive behaviour. Methods: A sample of 1873 children were screened in their fourth year for the presence of hyperactivity at baseline (HA), of whom 1246 had skin prick tests to identify atopy (AT). Children were selected to form the following groups: HA/AT, not-HA/AT, HA/not-AT, and not-HA/not-AT (n = 277). After baseline assessment, children were subjected to a diet eliminating artificial colourings and benzoate preservatives for one week; in the subsequent three week within subject double blind crossover study they received, in random order, periods of dietary challenge with a drink containing artificial colourings (20 mg daily) and sodium benzoate (45 mg daily) (active period), or a placebo mixture, supplementary to their diet. Behaviour was assessed by a tester blind to dietary status and by parents' ratings. Results: There were significant reductions in hyperactive behaviour during the withdrawal phase. Furthermore, there were significantly greater increases in hyperactive behaviour during the active than the placebo period based on parental reports. These effects were not influenced by the presence or absence of hyperactivity, nor by the presence or absence of atopy. There were no significant differences detected based on objective testing in the clinic. Conclusions: There is a general adverse effect of artificial food colouring and benzoate preservatives on the behaviour of 3 year old children which is detectable by parents but not by a simple clinic assessment. Subgroups are not made more vulnerable to this effect by their prior levels of hyperactivity or by atopy. PMID:15155391
Chikhungu, Lana Clara; Madise, Nyovani Janet; Padmadas, Sabu S
Using the 2004 data from the Malawi Integrated Household Survey and the Malawi Community Survey, this study investigates the influence of community characteristics on stunting among children under five years of age in a rural context. Multilevel logistic regression modelling on 4284 children with stunting as the dependent variable shows that availability of daily markets and lineage defined in terms of patrilineal or matrilineal communities were significant community determinants of childhood stunting in Malawi. There were significant differences in socio-economic status between household heads from matrilineal and patrilineal communities. Implementation of strategies that empower communities and households economically such as supporting the establishment of community daily markets and promoting household income generating opportunities can effectively reduce the burden of childhood stunting in Malawi.
Götze, Heide; Brähler, Elmar; Romer, Georg; Bergelt, Corinna; von Klitzing, Kai; Herzog, Wolfgang; Flechtner, Hans-Henning; Lehmkuhl, Ulrike; Ernst, Jochen
A cancer disease in the family is an emotional crisis with psychological distress for the partner. The study observed the psychological distress of female partners of cancer patients with underage children (HADS-D). The results were compared with the psychological distress of the cancer patient as well as a representative comparison group of women from the general population. Every second female partner showed clinically anxiety scores. On average, the female partners were significantly more anxious than male cancer patients and even more afraid than women from the general population. Regarding the degree of depression, between the partners there were no differences. With regard to mental distress, a medium correlation was found on the pair level. Based on the use of psycho-oncological support the high emotional distress on the female partners is discussed.
Clark, Samuel J.; Kahn, Kathleen; Houle, Brian; Arteche, Adriane; Collinson, Mark A.; Tollman, Stephen M.; Stein, Alan
Background There is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after her death. Therefore we investigated the relationship between young children's likelihood of dying and the timing of their mother's death and, in particular, the existence of a critical period of increased risk. Methods and Findings Data from a health and socio-demographic surveillance system in rural South Africa were collected on children 0–5 y of age from 1 January 1994 to 31 December 2008. Discrete time survival analysis was used to estimate children's probability of dying before and after their mother's death, accounting for moderators. 1,244 children (3% of sample) died from 1994 to 2008. The probability of child death began to rise 6–11 mo prior to the mother's death and increased markedly during the 2 mo immediately before the month of her death (odds ratio [OR] 7.1 [95% CI 3.9–12.7]), in the month of her death (OR 12.6 [6.2–25.3]), and during the 2 mo following her death (OR 7.0 [3.2–15.6]). This increase in the probability of dying was more pronounced for children whose mothers died of AIDS or tuberculosis compared to other causes of death, but the pattern remained for causes unrelated to AIDS/tuberculosis. Infants aged 0–6 mo at the time of their mother's death were nine times more likely to die than children aged 2–5 y. The limitations of the study included the lack of knowledge about precisely when a very ill mother will die, a lack of information about child nutrition and care, and the diagnosis of AIDS deaths by verbal autopsy rather than serostatus. Conclusions Young children in lower income settings are more likely to die not only after their mother's death but also in the months before, when
Quah, Phaik Ling; Cheung, Yin Bun; Pang, Wei Wei; Toh, Jia Ying; Saw, Seang-Mei; Godfrey, Keith M; Yap, Fabian; Chong, Yap Seng; Mary, Chong Foong-Fong
The Children's Eating Behaviour Questionnaire (CEBQ) was developed to measure eating behaviors related to obesity risk in children. However, this questionnaire has not been validated for use in South East Asia, where parenting practices are different from those in western countries and child obesity rates are increasing. The aim of this study was to examine the validity of the CEBQ administered to mothers of children aged 3 years in Singapore. Confirmatory factor analysis (CFA) was used to examine if the original 35-item, 8-factor model was supported in our cohort. Participants were 636 mother-child dyads (mean (SD) child age = 36.7 (1.6) months), from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort in which the mothers were characterized in pregnancy and children were followed up to age 3 years. The CFA showed a poor model fit; RMSEA = 0.072 (PCLOSE<0.001), SRMR = 0.094, CFI = 0.826, and TLI = 0.805. Exploratory factor analysis revealed a 35 item, 7-factor structure (factor loadings ≥ 0.35): enjoyment of food, food fussiness, emotional overeating, desire to drink, emotional under eating, satiety responsiveness and slowness in eating. Cronbach's alpha estimates ranged from 0.70 to 0.88 for the 7 subscales. Convergent validity tests via correlation analysis revealed that emotional under eating (r = -0.14), slowness in eating (r = -0.16) and satiety responsiveness (r = -0.11) were negatively correlated with BMI z-score at 3 years, while enjoyment of food (r = 0.12) was positively correlated, p < 0.05. In conclusion, we found a revised 7-factor structure of the CEBQ more appropriate for examining eating behavior in 3 year old children in the Singapore setting. Further replication studies in a separate cohort study are warranted before further use of these factor structures generated.
Palmu, Arto A.; Rinta-Kokko, Hanna; Nohynek, Hanna; Nuorti, J. Pekka; Kilpi, Terhi M.; Jokinen, Jukka
Background The ten-valent pneumococcal conjugate vaccine (PCV10) was introduced into the Finnish National Vaccination Program (NVP) in September 2010 using a 2+1 schedule (3, 5, 12 months). We estimated the direct and indirect effects of PCV10 on pneumonia among children to evaluate the public health impact of the vaccine. Methods We conducted a nation-wide population-based, observational study comparing rates of pneumonia in children before and after the NVP introduction. For the total (direct and indirect) effect, the cohort of vaccine-eligible children (born June 1, 2010 or later) was followed until the end of 2013 (age range 3–42 months). For the indirect effect, a cohort of older children (age range 7–71 months) not eligible for the PCV vaccination was followed from 2011 to 2013. Both cohorts were compared with two season- and age-matched reference cohorts before NVP introduction. Hospitals’ in- and outpatient discharge notifications with ICD-10 diagnoses compatible with pneumonia (J10.0, J11.0, J12-J18, J85.1 or J86) as set by the hospital pediatricians were collected from the national Care Register. The main outcome was hospital-treated primary pneumonia (HTPP), defined as primary diagnosis of pneumonia after in-patient hospitalization. We compared rates of pneumonia in the NVP target and reference cohorts by using Poisson regression models. Results The rate of HTPP episodes was 5.3/1000 person-years in the combined reference cohorts and 4.1/1000 person-years in the target cohort vaccine-eligible children. Compared with the reference cohort, the relative rate reduction in target cohort was 23% (95%CI 18–28) and the absolute reduction 1.3/1000 person-years. In the indirect effect evaluation, we observed continued increase in HTPP incidence until 2011 with a subsequent reduction of 18% (95%CI 10–25) during years 2012 to 2013. Number of empyema diagnoses remained low. Conclusions A substantial decrease in pneumonia rates was observed both among
Halland, Frode; Morken, Nils-Halvdan; DeRoo, Lisa A; Klungsøyr, Kari; Wilcox, Allen J; Skjærven, Rolv
Objective To assess the association between perinatal losses and mother's long-term mortality and modification by surviving children and attained education. Design A population-based cohort study. Setting Norwegian national registries. Participants We followed 652 320 mothers with a first delivery from 1967 and completed reproduction before 2003, until 2010 or death. We excluded mothers with plural pregnancies, without information on education (0.3%) and women born outside Norway. Main outcome measures Main outcome measures were age-specific (40–69 years) cardiovascular and non-cardiovascular mortality. We calculated mortality in mothers with perinatal losses, compared with mothers without, and in mothers with one loss by number of surviving children in strata of mothers’ attained education (<11 years (low), ≥11 years (high)). Results Mothers with perinatal losses had increased crude mortality compared with mothers without; total: HR 1.3 (95% CI 1.3 to 1.4), cardiovascular: HR 1.8 (1.5 to 2.1), non-cardiovascular: HR 1.3 (1.2 to 1.4). Childless mothers with one perinatal loss had increased mortality compared with mothers with one child and no loss; cardiovascular: low education HR 2.7 (1.7 to 4.3), high education HR 0.91 (0.13 to 6.5); non-cardiovascular: low education HR 1.6 (1.3 to 2.2), high education HR 1.8 (1.1 to 2.9). Mothers with one perinatal loss, surviving children and high education had no increased mortality, whereas corresponding mothers with low education had increased mortality; cardiovascular: two surviving children HR 1.7 (1.2 to 2.4), three or more surviving children HR 1.6 (1.1 to 2.4); non-cardiovascular: one surviving child HR 1.2 (1.0 to 1.5), two surviving children HR 1.2 (1.1 to 1.4). Conclusions Irrespective of education, we find excess mortality in childless mothers with a perinatal loss. Increased mortality in mothers with one perinatal loss and surviving children was limited to mothers with low education. PMID:27884847
Lakhan, Ram; Mawson, Anthony R.
Background: Low-and middle-income countries (LAMI) lack an integrated and systematic approach to identify people with intellectual disabilities. Screening surveys are considered resource-intensive; therefore, alternative approaches are needed. This study attempted to identify children up to age 18 years with intellectual disabilities through a…
Xue, Wenwen; Lu, Lina; Zhu, Jianfeng; He, Xiangui; He, Jiangnan; Zhao, Rong; Zou, Haidong
We investigated the prevalence of clinical trachoma in 154,265 children aged 6 to 16 years in 206 Shanghai migrant schools. Clean water availability in school, each child's facial cleanliness, eyelids, corneas, and the presenting distance visual acuities were examined. Trachoma was clinically diagnosed in accordance with the World Health Organization simplified classification. Eyes diagnosed with trachoma were swabbed to test for ocular Chlamydia trachomatis infections (OCTI) with a rapid latex immunochromatographic test. Among 153,977 students, no blindness was found related to trachoma. Trachoma was diagnosed in 8029 children (5.2%). In 87 schools clinical trachoma prevalence was higher than 5%. OCTI was confirmed in 2073 of 6823 trachoma diagnosed children (30.4%). Clinical trachoma prevalence was higher among females than males (p < 0.001), but gender comparison showed no statistical difference in the prevalence of OCTI (p = 0.077). Age and clinical trachoma (r = -0.014; p < 0.001) or OCTI (r = -0.026; p = 0.031) prevalence were negatively correlated. Clinical trachoma was different in different districts and counties (p < 0.001). Trachoma warrants close attention in Shanghai migrant children because the condition remains endemic in some schools.
Chang, Yu-Chia; Lin, Jin-Ding; Tung, Ho-Jui; Chiang, Po-Huang; Hsu, Shang-Wei
This study analyzed the utilization and utilization determinants of outpatient physical therapy (PT) among children and adolescents with intellectual disabilities (ID) in Taiwan. A cross-sectional study was conducted to analyze 2007 national health insurance (NHI) claim data from 35,802 eighteen-year-old and younger persons with intellectual disabilities. A total of 3944 (11.02%) claimants received outpatient physical therapy. Variables that affected PT utilization included age, residence urbanization level, ID level, copayment status and major co-morbidity. The average annual PT visit frequency was 25.4 ± 33.0; pre-school children, claimants suffering from catastrophic disease and ID co-occurring with cerebral palsy had a higher mean cost per visit. Age, ID level, copayment status and co-morbidity were factors that influenced expenditure. Pre-school children, males, individuals who resided in the lowest urbanization areas and individuals with a catastrophic disease tended to use hospital services. The point prevalence of epilepsy and cerebral palsy were 12.10% and 19.80%, respectively. Despite the NHI program and government regulations to provide special services, the use of physical therapy for children and adolescents with intellectual disabilities was low, and the utilization decreased as the subjects aged.
Shattuck, Paul T.; Durkin, Maureen; Maenner, Matthew; Newschaffer, Craig; Mandell, David S.; Wiggins, Lisa; Lee, Li-Ching; Rice, Catherine; Giarelli, Ellen; Kirby, Russell; Baio, Jon; Pinto-Martin, Jennifer; Cuniff, Christopher
Analysis of the data from Center for Disease Control's autism surveillance program found that the median age of identification of children with autism is 5.7 years. Being male, having an IQ of 70 or lower, and having developmental regression are the factors linked to a younger age of identification. There is a need for research, innovation, and…
Machado, Daniella Borges; Brizon, Valéria Silva Cândido; Ambrosano, Gláucia Maria Bovi; Madureira, Davidson Fróis; Gomes, Viviane Elisângela; de Oliveira, Ana Cristina Borges
INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010). The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0) with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02). Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03). CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite. PMID:25715723
Xue, Wenwen; Lu, Lina; Zhu, Jianfeng; He, Xiangui; He, Jiangnan; Zhao, Rong
We investigated the prevalence of clinical trachoma in 154,265 children aged 6 to 16 years in 206 Shanghai migrant schools. Clean water availability in school, each child's facial cleanliness, eyelids, corneas, and the presenting distance visual acuities were examined. Trachoma was clinically diagnosed in accordance with the World Health Organization simplified classification. Eyes diagnosed with trachoma were swabbed to test for ocular Chlamydia trachomatis infections (OCTI) with a rapid latex immunochromatographic test. Among 153,977 students, no blindness was found related to trachoma. Trachoma was diagnosed in 8029 children (5.2%). In 87 schools clinical trachoma prevalence was higher than 5%. OCTI was confirmed in 2073 of 6823 trachoma diagnosed children (30.4%). Clinical trachoma prevalence was higher among females than males (p < 0.001), but gender comparison showed no statistical difference in the prevalence of OCTI (p = 0.077). Age and clinical trachoma (r = −0.014; p < 0.001) or OCTI (r = −0.026; p = 0.031) prevalence were negatively correlated. Clinical trachoma was different in different districts and counties (p < 0.001). Trachoma warrants close attention in Shanghai migrant children because the condition remains endemic in some schools. PMID:27610383
Heckbert, S R; Stryker, W S; Coltin, K L; Manson, J E; Platt, R
The computerized outpatient records of the Harvard Community Health Plan, a 230,000-member health maintenance organization, were used to determine the frequency with which serum sickness is recognized in the practice setting after exposure to antibiotics. The medical records of 3,487 children who had been prescribed cefaclor or amoxicillin were searched in December 1986 for coded diagnoses of serum sickness and related conditions. Diagnoses were validated by blinded review of dictated and written office notes. There were 12 cases of serum sickness in 11,523 child-years. During this time, these children were prescribed 13,487 courses of amoxicillin, 5,597 courses of trimethoprim-sulfamethoxazole (TMP-SMZ), 3,553 courses of cefaclor, and 2,325 courses of penicillin V. Serum sickness was considered to be antibiotic-related if it occurred within 20 days of initiation of antibiotic therapy. Five cases were temporally associated with cefaclor, one with both amoxicillin and TMP-SMZ, four with TMP-SMZ alone, and one with penicillin V alone. One case was not associated with any antibiotic exposure. All antibiotic-related cases occurred in children under age 6 years who were treated for otitis media or streptococcal pharyngitis, and most cases began 7-11 days after initiation of antibiotic. All but one of the antibiotic-related cases occurred in children who had relatively heavy lifetime antibiotic exposure. The risk of serum sickness was significantly elevated after cefaclor compared with amoxicillin, even among the most heavily exposed children (relative risk = 14.8, p = 0.01, 95% confidence interval 2.0-352.0). Most cases prompted several physician visits, but none required hospitalization.
Décard, Bernhard F; Schädelin, Sabine; Grimm, Alexander; Fischer, Dirk; Hafner, Patricia
Background High-resolution ultrasonography is a new and promising technique to evaluate peripheral and spinal nerves. Its validity as a diagnostic tool in neurological diseases has been demonstrated in adults. Up to now no reference values have been published in children and adolescents although this technique would be ideal in this population as it is fast and non-invasive. Methods/design Our aim is to generate ultrasonographic reference values for several peripheral nerves (median, ulnar, radial, tibial, sural, peroneal and tibial nerve) as well as for the spinal nerves C5 and C6 and the vagus nerve in children and adolescents. In an observational prospective study, we will recruit 205 children and adolescents aged between ≥2 and ≤18 years without neuromuscular symptoms/signs and without a history of neuromuscular disease. After the collection of demographic and anthropometric data (height, weight, body mass index, age, gender and handedness) and a neurologic examination, a high-resolution ultrasonography of peripheral and spinal nerves at several anatomic landmarks will be performed. These data will be used to estimate age-dependent percentile curves and to evaluate inter-rater, intrarater and interequipment reliability of the measurements. Ethics and dissemination This study was approved by the local ethics committee (EKNZ 2015-210). The findings from this study will be disseminated through peer-reviewed publications and conference presentations. Trial registration number NCT02570802, pre-results publication. PMID:27940636
Sharp, Carla; Venta, Amanda; Marais, Lochner; Skinner, Donald; Lenka, Molefi; Serekoane, Joe
Due to the HIV/AIDS pandemic which has left 12 million children orphaned in Sub-Saharan Africa, children are at increased risk for mental health problems. Currently, no validity data exist for any screening measure of emotional-behavior disorders in pre-adolescent children in Sub-Saharan Africa. The aims of the current study were to evaluate the construct validity of the caregiver-, teacher-, and self-report versions of the one-page Strengths and Difficulties Questionnaire (SDQ) in 466 orphans in South Africa between the ages of 7 and 11 (Mage = 9.23 years, SD = 1.33, 51.93% female) and to provide, for the first time, clinical cut-offs for this population. Findings demonstrated support for the caregiver SDQ, but not the teacher and selfreport versions. We provide clinical cut-offs, but caution their use before further research is conducted. There remains a critical need for further psychometric studies of the SDQ in the developing world. PMID:24623068
Scope, Alon; Dusza, Stephen W.; Marghoob, Ashfaq A.; Satagopan, Jaya M.; Braga, Casagrande Tavoloni Juliana; Psaty, Estee L.; Weinstock, Martin A.; Oliveria, Susan A.; Bishop, Marilyn; Geller, Alan C.; Halpern, Allan C.
Nevi are important risk markers of melanoma. The study aim was to describe changes in nevi of children using longitudinal data from a population-based cohort. Overview back photography and dermoscopic imaging of up to 4 index back nevi was performed at age 11 (baseline) and repeated at age 14 (follow-up). Of 443 children (39% females) imaged at baseline, 366 children (39% females) had repeated imaging three year later. At age 14, median back nevus counts increased by 2; 75% of students (n=274) had at least one new back nevus and 28% (n=103) had at least one nevus that disappeared. Of 936 index nevi imaged dermoscopically at baseline and follow-up, 69% (645 nevi) had retained the same dermoscopic classification from baseline evaluation. Only 4% (n=13) of nevi assessed as globular at baseline were classified as reticular at follow-up, and just 3% (n=3) of baseline reticular nevi were classified as globular at follow-up. Of 9 (1%) index nevi that disappeared at follow-up, none showed halo or regression at baseline. In conclusion, the relative stability of dermoscopic pattern of individual nevi in the face of the overall volatility of nevi during adolescence suggests that specific dermoscopic patterns may represent distinct biologic nevus subsets. PMID:21562569
González Jiménez, E; Aguilar Cordero, M J; Álvarez Ferre, J; Padilla López, C; Valenza, M C
Recent studies show an alarming increase in levels of overweight and obesity among children and adolescents. The main objectives of this research were the following: (i) to carry out an anthropometric evaluation of the nutritional status and body composition of school children in the city and province of Granada; (ii) to compare the nutritional status of this population sample with national and international reference standards. The results obtained in this study showed that the general prevalence of overweight in both sexes was 22.03% and that 9.12% of the children were obese. Statistically significant differences were found between the variable, weight for age and sex (p < 0.05) and the variable, height for age and sex (p < 0.05). Regarding the body mass index, no statistically significant differences were found for the variable, sex (p = 0.182). This contrasted with the variable, age, which did show statistically significant differences (p < 0.05). As a conclusion, the results of our study highlighted the fact that these anthropometric values were much higher than national and international reference standards.
Crume, T. L.; Ogden, L.; West, N. A.; Vehik, K. S.; Scherzinger, A.; Daniels, S.; McDuffie, R.; Bischoff, K.; Hamman, R. F.; Norris, J. M.
Aims/hypothesis To evaluate whether exposure to maternal gestational diabetes (GDM) is associated with adiposity and fat distribution in a multiethnic population of children. Methods Retrospective cohort study of 82 children exposed to maternal GDM and 379 unexposed youths 6–13 years of age with measured BMI, waist circumference, skinfold thickness, and visceral and subcutaneous abdominal fat. Results Exposure to maternal GDM was associated with higher BMI (p=0.02), larger waist circumference (p=0.004), more subcutaneous abdominal fat (p=0.01) and increased subscapular to triceps skinfold thickness ratio (p=0.01) in models adjusted for age, sex, race/ethnicity and Tanner stage. Adjustment for socioeconomic factors, birthweight and gestational age, maternal smoking during pregnancy and current diet and physical activity did not influence associations; however, adjustment for maternal pre-pregnancy BMI attenuated all associations. Conclusions/interpretation Exposure to maternal GDM is associated with increased overall and abdominal adiposity, and a more central fat distribution pattern in 6- to 13-year-old youths from a multi-ethnic population, providing further support for the fetal overnutrition hypothesis. PMID:20953862
Voss, Linda D; Hosking, Joanne; Metcalf, Brad S; Jeffery, Alison N; Frémeaux, Alissa E; Wilkin, Terence J
Lifestyle interventions to improve health in young children tend to target areas of relative deprivation, but the evidence for so doing is largely historical. Accordingly, we have re-examined the link between deprivation, obesity and metabolic risk in contemporary UK children. Using a postcode-based index of multiple deprivation (IMD), we assessed 269 children from the community-based EarlyBird Study, attending 53 schools representing a wide socio-economic range. Annual measures of fatness from 5 to 8 yr included body mass index (BMI), waist circumference (WC), and sum of five skinfolds (SSF). A metabolic risk score, based on blood pressure, lipids and insulin resistance, was derived from annual fasting blood samples. There were no significant associations between deprivation and any measure of adiposity in girls (all p > 0.37). In boys, there was a weak but consistently inverse relationship between deprivation and WC (r = -0.19, p = 0.03) and BMI (r = -0.14, p = 0.09) at 8 yr. Changes in adiposity over 3 yr were unrelated to deprivation in boys. In girls there was a slight but significant increase in SSF only (1 mm/yr per 20 IMD units, p = 0.001). Importantly, in both genders, metabolic risk score was unrelated to deprivation throughout (r values -0.05 to -0.13, all p > 0.12), as was change in metabolic risk (all p > 0.30). Our data do not support the assumption that obesity, metabolic disturbance and thus risk of type 2 diabetes are more prevalent among poorer children. In today's increasingly obesogenic environment, youngsters from all backgrounds appear to be vulnerable, with population-wide implications for public health spending, and the prevention of diabetes in contemporary youth.
Weng, Wen-Chin; Huang, Hui-Ling; Wong, Lee Chin; Jong, Yuh-Jyh; Yin, Yun-Ju; Chen, Hong-An; Lee, Wang-Tso; Ho, Shinn-Ying
Both epilepsy and tic disorders may share common mechanisms with the involvement of abnormal cortical-basal ganglion circuit connection and dopaminergic dysfunction. However, the association between epilepsy and tic disorders has never been studied. This study investigated the risks of developing tic disorders among children with epilepsy using databases of a universal health insurance system in Taiwan. The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The study cohort included children with epilepsy between 2001 and 2007 (n=2629) and a three-fold age- and gender-matched controls (n=7887). All subjects were followed up for 3 years from the date of cohort entry to identify their admissions due to tic disorders (ICD-9-CM codes 307.2, 307.20-307.23). Cox hazard regression analysis was performed to estimate the effect of epilepsy on the occurrence of tics. The epilepsy cohort had a higher prevalence of tics (1.7% vs. 0.2%), and a 8.70-fold increased risk of developing a tic disorder compared with the controls (adjusted hazard ratio (AHR) 8.70, 95% confidence interval (CI) 4.26-16.37, p<0.001). Male patients were observed to have a higher risk of developing a tic disorder (AHR 1.90, 95% CI=1.04-3.46, p<0.001) compared to female individuals. Patients with multiple antiepileptic drugs treatment also exhibited higher crude OR for developing tic disorders. This nationwide population-based cohort study, for the first time, demonstrated that there is a significantly increased risk for tic disorders among children with epilepsy. We also found males, attention deficit disorder and the use of multiple AEDs to be independent risk factors of tic disorders. Closely evaluating possible tic disorders would be crucial for improving the outcome and life quality in children with epilepsy.
Huynh, S C; Wang, X Y; Ip, J; Robaei, D; Kifley, A; Rose, K A; Mitchell, P
Aim To study the distribution of anisometropia and aniso‐astigmatism in young Australian children, together with clinical and ocular biometry relations. Method The Sydney Myopia Study examined 1765 predominantly 6 year old children from 34 randomly selected Sydney schools during 2003–4. Keratometry, cycloplegic autorefraction, and questionnaire data were collected. Results Spherical equivalent (SE) anisometropia (⩾1 dioptre) prevalence was 1.6% (95% confidence interval (CI) 1.1% to 2.4%). Aniso‐astigmatism (⩾1D) prevalence was 1.0% (CI: 0.6% to 1.6%). Both conditions were significantly more prevalent among moderately hyperopic (SE ⩾2.0D) than mildly hyperopic (SE 0.5–1.9D) children. Myopic children (SE ⩽−0.5D) had higher anisometropia prevalence. Neither condition varied by age, sex, or ethnicity. In multivariate analyses, anisometropia was significantly associated with amblyopia, odds ratio (OR) 29, (CI: 8.7 to 99), exotropia (OR 7.7, CI: 1.2 to 50), and neonatal intensive care unit (NICU) admission (OR 3.6, CI: 1.1 to 12.6). Aniso‐astigmatism was significantly associated with amblyopia (OR 8.2, CI: 1.4 to 47), maternal age >35 years (OR 4.0, CI: 1.3 to 11.9), and NICU admission (OR 4.6, CI: 1.2 to 17.2). Anisometropia resulted from relatively large interocular differences in axial length (p<0.0001) and anterior chamber depth (p = 0.0009). Aniso‐astigmatism resulted from differences in corneal astigmatism (p<0.0001). Conclusion In this predominantly 6 year old population, anisometropia and aniso‐astigmatism were uncommon, had important birth and biometry associations, and were strongly related to amblyopia and strabismus. PMID:16622090
Pisesky, Andrea; Benchimol, Eric I.; Wong, Coralie A.; Hui, Charles; Crowe, Megan; Belair, Marc-Andre; Pojsupap, Supichaya; Karnauchow, Tim; O'Hearn, Katie; Yasseen, Abdool S.; McNally, James D.
increasing or decreasing linear trend in the incidence of hospitalized RSV, hospital length of stay and PICU admission rates. Among the Ontario RSV cohort, 16.3% had one or more major risk factors, with a decreasing trend observed over time. Conclusion Children hospitalized for RSV-related disease can be accurately identified within population-based health administrative data. RSV is a major public health concern and incidence has not changed over time, suggesting a lack of progress in prevention. PMID:26958849
Masseria, Cristina; Buikema, Ami R; Liu, Fang; Krishnarajah, Girishanthy
The Advisory Committee on Immunization Practices recommends administering diphtheria, tetanus and acellular pertussis (DTaP) vaccines to children at 2, 4, 6, 15–18 months, and 4–6 y of age; preferably with the same-brand vaccine for the whole series. We estimated age-appropriate DTaP dose completion and the proportion of children receiving a “mixed” DTaP vaccination series (ie, including DTaP vaccines from ≥2 brands) across the 3 milestones. Commercially-insured children born between 01/01/2003 and 04/30/2011 were identified from United States health insurance claims data and assigned to ≥1 of 3 study cohorts based on the duration of continuous health plan enrollment: 1) birth to <8 months; 2) birth to <20 months; 3) birth to <7 years. Dose completion and brand mixing of the first 3, first 4 or all 5 doses were measured in the respective cohorts. Administered DTaP vaccinations were identified in claims data and classified by brand (based on vaccine components and manufacturer). The analysis included children who received ≥2 DTaP vaccinations and had known brand information for all doses. Age-appropriate dose completion was 77% with 3 doses (<8 months cohort), 71% with 4 doses (<20 months cohort), and 85% with 5 doses (<7 years cohort). Mixed DTaP series were received by 4.7% (95% confidence interval [CI]: 4.6%-4.7%) in the <8 months cohort, 29.0% (95% CI: 28.6%–29.4%) in the <20 months cohort, and 39.0% (95% CI: 34.5, 43.6) in the <7 years cohort. DTaP mixing was just 4.7% for the first 3 doses but subsequently increased with the number of administered doses. PMID:25714800
Nadal, Martí; Bocio, Ana; Schuhmacher, Marta; Domingo, Jose L
Hair samples of 134 school children (12-14 yr old) living in three residential zones in the vicinity of a new hazardous waste incinerator (HWI) (Constanti, Tarragona County, Catalonia, Spain) were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) for arsenic (As), beryllium (Be), cadmium (Cd), chromium (Cr), mercury (Hg), manganese (Mn), nickel (Ni), lead (Pb), tin (Sn), thallium (Tl), and vanadium (V) concentrations. These concentrations were compared with those obtained in a baseline survey performed in the same area during the period of construction of the HWI. Current mean concentrations ranged from values under the respective limit of detection (As, Be, Cd, Tl, and V) to 0.70 and 0.86 microg/g for Hg and Pb, respectively. In comparison to the baseline survey, the levels of Cr, Mn, Ni, Pb, and Sn showed a significant reduction, whereas Hg concentrations were similar. No significant differences were observed according to the sex of the children. However, some differences were noted, especially for Pb and Cr, with respect to the specific zone of residence. In general terms, the current metal levels in hair of school children are similar or even lower than those recently reported for a number of industrial and residential areas of various regions and countries.
Moore, Matthew R.; Link-Gelles, Ruth; Schaffner, William; Lynfield, Ruth; Lexau, Catherine; Bennett, Nancy M.; Petit, Susan; Zansky, Shelley M.; Harrison, Lee H.; Reingold, Arthur; Miller, Lisa; Scherzinger, Karen; Thomas, Ann; Farley, Monica M.; Zell, Elizabeth R.; Taylor, Thomas H.; Pondo, Tracy; Rodgers, Loren; McGee, Lesley; Beall, Bernard; Jorgensen, James H.; Whitney, Cynthia G.
SUMMARY Background In 2000, 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in the U.S. and resulted in dramatic reductions in invasive pneumococcal disease (IPD) and modest increases in non-PCV7-type IPD. In 2010, a 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 in the U.S. immunization schedule. We evaluated the effect of PCV13 use in children on IPD in children and adults in the U.S. Methods We used laboratory- and population-based data on incidence of IPD from CDC’s Emerging Infections Program / Active Bacterial Core surveillance in a time-series model to estimate the impact of vaccination. Cases of IPD during July 2004–June 2013 were classified as being caused by the PCV13 serotypes against which PCV7 has no effect (PCV13/nonPCV7). Findings Compared with incidence expected among children <5 years old if PCV7 alone had been continued, incidence of IPD overall and IPD caused by PCV13/nonPCV7 serotypes declined by 64% (95% interval estimate [IE] 59–68 %) and 93% (95%IE 91–94), respectively, by July 2012–June 2013. Among adults, incidence of IPD overall and PCV13/nonPCV7-type IPD also declined by 12–32% and 58–72%, respectively, depending on age. In all age groups, reductions were driven principally by changes in incidence of serotypes 19A and 7F. We estimate that over 30,000 cases of IPD and 3,000 deaths were averted in the first 3 years following PCV13 introduction. Interpretation PCV13 has reduced IPD among all ages when used routinely in children in the U.S. Serotypes 19A and 7F, which emerged after PCV7 introduction, have been effectively controlled. PMID:25656600
Atzmon, Gil; Hao, Li; Pe'er, Itsik; Velez, Christopher; Pearlman, Alexander; Palamara, Pier Francesco; Morrow, Bernice; Friedman, Eitan; Oddoux, Carole; Burns, Edward; Ostrer, Harry
For more than a century, Jews and non-Jews alike have tried to define the relatedness of contemporary Jewish people. Previous genetic studies of blood group and serum markers suggested that Jewish groups had Middle Eastern origin with greater genetic similarity between paired Jewish populations. However, these and successor studies of monoallelic Y chromosomal and mitochondrial genetic markers did not resolve the issues of within and between-group Jewish genetic identity. Here, genome-wide analysis of seven Jewish groups (Iranian, Iraqi, Syrian, Italian, Turkish, Greek, and Ashkenazi) and comparison with non-Jewish groups demonstrated distinctive Jewish population clusters, each with shared Middle Eastern ancestry, proximity to contemporary Middle Eastern populations, and variable degrees of European and North African admixture. Two major groups were identified by principal component, phylogenetic, and identity by descent (IBD) analysis: Middle Eastern Jews and European/Syrian Jews. The IBD segment sharing and the proximity of European Jews to each other and to southern European populations suggested similar origins for European Jewry and refuted large-scale genetic contributions of Central and Eastern European and Slavic populations to the formation of Ashkenazi Jewry. Rapid decay of IBD in Ashkenazi Jewish genomes was consistent with a severe bottleneck followed by large expansion, such as occurred with the so-called demographic miracle of population expansion from 50,000 people at the beginning of the 15th century to 5,000,000 people at the beginning of the 19th century. Thus, this study demonstrates that European/Syrian and Middle Eastern Jews represent a series of geographical isolates or clusters woven together by shared IBD genetic threads.
Atzmon, Gil; Hao, Li; Pe'er, Itsik; Velez, Christopher; Pearlman, Alexander; Palamara, Pier Francesco; Morrow, Bernice; Friedman, Eitan; Oddoux, Carole; Burns, Edward; Ostrer, Harry
For more than a century, Jews and non-Jews alike have tried to define the relatedness of contemporary Jewish people. Previous genetic studies of blood group and serum markers suggested that Jewish groups had Middle Eastern origin with greater genetic similarity between paired Jewish populations. However, these and successor studies of monoallelic Y chromosomal and mitochondrial genetic markers did not resolve the issues of within and between-group Jewish genetic identity. Here, genome-wide analysis of seven Jewish groups (Iranian, Iraqi, Syrian, Italian, Turkish, Greek, and Ashkenazi) and comparison with non-Jewish groups demonstrated distinctive Jewish population clusters, each with shared Middle Eastern ancestry, proximity to contemporary Middle Eastern populations, and variable degrees of European and North African admixture. Two major groups were identified by principal component, phylogenetic, and identity by descent (IBD) analysis: Middle Eastern Jews and European/Syrian Jews. The IBD segment sharing and the proximity of European Jews to each other and to southern European populations suggested similar origins for European Jewry and refuted large-scale genetic contributions of Central and Eastern European and Slavic populations to the formation of Ashkenazi Jewry. Rapid decay of IBD in Ashkenazi Jewish genomes was consistent with a severe bottleneck followed by large expansion, such as occurred with the so-called demographic miracle of population expansion from 50,000 people at the beginning of the 15th century to 5,000,000 people at the beginning of the 19th century. Thus, this study demonstrates that European/Syrian and Middle Eastern Jews represent a series of geographical isolates or clusters woven together by shared IBD genetic threads. PMID:20560205
Dietrich, Andrea; Ormel, Johan; Buitelaar, Jan K; Verhulst, Frank C; Hoekstra, Pieter J; Hartman, Catharina A
Anxiety and depressive problems have often been related to higher hypothalamic-pituitary-adrenal (HPA)-axis activity (basal morning cortisol levels and cortisol awakening response [CAR]) and externalizing problems to lower HPA-axis activity. However, associations appear weaker and more inconsistent than initially assumed. Previous studies from the Tracking Adolescents Individual Lives Study (TRAILS) suggested sex-differences in these relationships and differential associations with specific dimensions of depressive problems in a general population sample of children (10-12 years). Using the TRAILS population sample (n=1604), we tested hypotheses on the association between single day cortisol (basal morning levels and CAR) and specifically constructed dimensions of anxiety (cognitive versus somatic), depressive (cognitive-affective versus somatic), and externalizing problems (reactive versus proactive aggression), and explored the modifying role of sex. Moreover, we repeated analyses in an independent same-aged clinic-referred sample (n=357). Structural Equation Modeling was used to investigate the association between cortisol and higher- and lower-order (thus, broad and specific) problem dimensions based on self-reports in an integrated model. Overall, findings were consistent across the population and clinic-referred samples, as well as with the existing literature. Most support was found for higher cortisol (mainly CAR) in relation to depressive problems. However, in general, associations were weak in both samples. Therefore, the present results shed doubt on the relevance of single day cortisol measurements for problem behaviors in the milder range. Associations may be stronger in more severe or persistent psychopathology.
Siu, Andrew M. H.; Lai, Cynthia Y. Y.; Chiu, Amy S. M.; Yip, Calvin C. K.
Objectives: Most of the fine-motor assessment tools used in Hong Kong have been designed in Western countries, so there is a need to develop a standardized assessment which is relevant to the culture and daily living tasks of the local (that is, Chinese) population. This study aimed to (1) develop a fine-motor assessment tool (the Hong Kong…
Scharf, Jeremiah M.; Miller, Laura L.; Mathews, Carol A.; Ben-Shlomo, Yoav
Objective: Recent epidemiologic studies have demonstrated that Tourette syndrome (TS) and chronic tic disorder (CT) are more common than previously recognized. However, few population-based studies have examined the prevalence of co-occurring neuropsychiatric conditions such as obsessive-compulsive disorder (OCD) and…
Yawn, Barbara P; Schroeder, Clayton; Wollan, Peter; Rocca, Liliana; Zimmerman, Rick; Bardenheier, Barbara
Background Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. Methods Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all) who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. Results Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30) received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%). Conclusion The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but rebounded quickly to above pre
Larrañaga, Nerea; Sanchez, Mª José; Ardanaz, Eva; Felipe, Saray; Marcos-Gragera, Rafael; Ramos, María; Carulla, Marià; Chirlaque, Mª Dolores; Argüelles, Marcial V.; Martos, Carmen; Mateo, Antonio; Peris-Bonet, Rafael
Objective: To describe incidence patterns and trends in children (0-14 years) and adolescents (15-19 age-range) with solid tumours, except those of central nervous system (CNS), in Spain. Methods: Cases were drawn from eleven Spanish population-based cancer registries. Incidence was estimated for the period 1983-2007 and trends were evaluated using Joinpoint regression analysis. Results: The studied tumour groups accounted for 36% of total childhood cancers and 47.6% of those diagnosed in adolescence with annual rates per million of 53.5 and 89.3 respectively. In children 0 to 14 years of age, Neuroblastoma (NB) was the commonest (7.8%) followed by Soft-tissue sarcomas (STS) (6.3%), bone tumours (BT) (6.2%) and renal tumours (RT) (4.5%). NB was the most frequently diagnosed tumour before the 5th birthday, while STS and BT were the commonest at 5-9 years of age, and BT and Carcinoma and other epithelial tumours (COET) at 10-14. COET presented the highest incidence in adolescents, followed by germ-cell tumours (GCT), BT and STS. These four diagnostic groups accounted for 94% of total non-CNS solid tumours, in adolescents. Overall incidence rates increased significantly in children up to 1996 with an annual percentage change (APC) of 2.6% (95%CI: 1.7; 3.6). NB and COET showed significant time trend (APCs: 1.4% and 3.8% respectively) while other tumour groups such as RT, STS, BT or GCT had no significant changes over time. A significant increase was present in NB under the age of 5 and in BT and STS in children aged 10-14 years. In adolescents there were significant increases for all tumours combined (APC=2.7; 95%CI: 1.8-3.6) and for STS, GCT and COET (APCs: 3.2%, 4.4% and 3.5% respectively), while other tumour groups such as hepatic tumours, BT or thyroid carcinomas showed a decreasing trend or no increase. Conclusions: Overall, the incidence of the studied cancers in children increased along the period 1983-1996 with no posterior significant rise, while the incidence
Sharav, T; Bowman, T
Thirty sibling pairs, each with one Down syndrome child between the ages of 2 and 14, were selected from families who had participated in an infant-stimulation program. The maternal and paternal educational levels were 14.9 and 16.9 years, respectively. The Down syndrome patients and their siblings were compared in terms of body-mass index, that is, weight/stature2 (w/s2); activity as measured on a questionnaire; and weekly caloric intake. There were no significant differences between the Down syndrome children and their siblings in terms of w/s2. The Down syndrome patients were less active than their siblings and spent significantly more time indoors, showing a preference for indoor activities. Caloric intake calculated as percentage of recommended allowance for height was somewhat less in the Down syndrome children--88.7%, compared with 95% in the siblings--but not significantly so. It is postulated that even though Down syndrome patients have been shown to be at risk for obesity, familial and other environmental factors, such as dietary control and involvement in physical activity, have an influence.
Homaira, Nusrat; Mallitt, Kylie-Ann; Oei, Ju-Lee; Hilder, Lisa; Bajuk, Barbara; Lui, Kei; Rawlinson, William; Snelling, Tom; Jaffe, Adam
Background Data on risk factors for respiratory syncytial virus (RSV)-associated hospitalisation in Australian children may be informative for preventive measures. Methods A whole-of-population-based study was conducted to identify comparable risk factors for RSV hospitalisation in different subgroups of children aged <2 years in New South Wales. The cohort was divided into Indigenous children and high-risk and standard risk non-Indigenous children. Data on risk factors were obtained from the Perinatal Data Collection. RSV hospitalisations were ascertained from the Admitted Patient Data Collection. Adjusted HRs were calculated for each subgroup. Population-attributable risk associated with risk factors was estimated. Results Four factors were associated with increased risk of RSV hospitalisation: maternal smoking during pregnancy, male sex, multiparity and birth during the first half of the RSV season. Increase in relative socioeconomic advantage was associated with decreased risk of hospitalisation. Among high and standard risk non-Indigenous children, the hazard was approximately double for children born to multiparous women compared to those born to primiparous women and among Indigenous children the hazard was approximately double among those born during the first half of the RSV season. Maternal smoking during pregnancy was associated with a 26–45% increased risk across subgroups and accounted for 17% (95% CI 9.3% to 24%) of RSV hospitalisations in Indigenous children, 5% (95% CI 2.5% to 8%) in high-risk and 6% (95% 5% to 7%) in standard risk non-Indigenous children. Discussion Promoting avoidance of smoking during pregnancy may help in lowering the disease burden, with Indigenous children likely to benefit most. PMID:27357197
Yamaguchi, Harutaka; Tada, Saaya; Nakanishi, Yoshinori; Kawaminami, Shingo; Shin, Teruki; Tabata, Ryo; Yuasa, Shino; Shimizu, Nobuhiko; Kohno, Mitsuhiro; Tsuchiya, Atsushi; Tani, Kenji
As mouth breathing is associated with asthma and otitis media, it may be associated with other diseases. Therefore, this population-based cross-sectional study evaluated the association of mouth breathing with the prevalences of various diseases in children. Preschool children older than 2 years were included. A questionnaire was given to parents/guardians at 13 nurseries in Tokushima City. There were 468 valid responses (45.2%). We defined a subject as a mouth breather in daytime (MBD) if they had 2 or more positive items among the 3 following items: “breathes with mouth ordinarily,” “mouth is open ordinarily,” and “mouth is open when chewing.” We defined subjects as mouth breathers during sleep (MBS) if they had 2 or more positive items among the following 3 items: “snoring,” “mouth is open during sleeping,” and “mouth is dry when your child gets up.” The prevalences of MBD and MBS were 35.5% and 45.9%, respectively. There were significant associations between MBD and atopic dermatitis (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.4–4.2), MBS and atopic dermatitis (OR: 2.4, 95% CI: 1.3–4.2), and MBD and asthma (OR: 2.2, 95% CI: 1.2–4.0). After adjusting for history of asthma and allergic rhinitis; family history of atopic dermatitis, asthma, and allergic rhinitis; and nasal congestion; both MBD (OR: 2.6, 95% CI: 1.3–5.4) and MBS (OR: 4.1, 95% CI: 1.8–9.2) were significantly associated with atopic dermatitis. In preschool children older than 2 years, both MBD and MBS may be associated with the onset or development of atopic dermatitis. PMID:25915864
Simon, Laure; Nusinovici, Simon; Flamant, Cyril; Cariou, Bertrand; Rouger, Valérie; Gascoin, Géraldine; Darmaun, Dominique; Rozé, Jean-Christophe; Hanf, Matthieu
While the effects of growth from birth to expected term on the subsequent development of preterm children has attracted plentiful attention, less is known about the effects of post-term growth. We aimed to delineate distinct patterns of post-term growth and to determine their association with the cognitive development of preterm children. Data from a prospective population-based cohort of 3,850 surviving infants born at less than 35 weeks of gestational age were used. Growth was assessed as the Body Mass Index (BMI) Z-scores at 3, 9, 18, 24, 36, 48, and 60 months. Cognitive development at five years of age was evaluated by the Global School Adaptation score (GSA). Latent class analysis was implemented to identify distinct growth patterns and logistic regressions based on propensity matching were used to evaluate the relationship between identified growth trajectories and cognitive development. Four patterns of post-term growth were identified: a normal group with a Z-score consistently around zero during childhood (n = 2,469; 64%); a group with an early rapid rise in the BMI Z-score, but only up to 2 years of age (n = 195; 5%); a group with a slow yet steady rise in the BMI Z-score during childhood (n = 510; 13%); and a group with a negative Z-score growth until 3 years of age (n = 676; 18%). The group with a slow yet steady rise in the BMI Z-score was significantly associated with low GSA scores. Our findings indicate heterogeneous post-term growth of preterm children, with potential for association with their cognitive development.
Simon, Laure; Nusinovici, Simon; Flamant, Cyril; Cariou, Bertrand; Rouger, Valérie; Gascoin, Géraldine; Darmaun, Dominique; Rozé, Jean-Christophe; Hanf, Matthieu
While the effects of growth from birth to expected term on the subsequent development of preterm children has attracted plentiful attention, less is known about the effects of post-term growth. We aimed to delineate distinct patterns of post-term growth and to determine their association with the cognitive development of preterm children. Data from a prospective population-based cohort of 3,850 surviving infants born at less than 35 weeks of gestational age were used. Growth was assessed as the Body Mass Index (BMI) Z-scores at 3, 9, 18, 24, 36, 48, and 60 months. Cognitive development at five years of age was evaluated by the Global School Adaptation score (GSA). Latent class analysis was implemented to identify distinct growth patterns and logistic regressions based on propensity matching were used to evaluate the relationship between identified growth trajectories and cognitive development. Four patterns of post-term growth were identified: a normal group with a Z-score consistently around zero during childhood (n = 2,469; 64%); a group with an early rapid rise in the BMI Z-score, but only up to 2 years of age (n = 195; 5%); a group with a slow yet steady rise in the BMI Z-score during childhood (n = 510; 13%); and a group with a negative Z-score growth until 3 years of age (n = 676; 18%). The group with a slow yet steady rise in the BMI Z-score was significantly associated with low GSA scores. Our findings indicate heterogeneous post-term growth of preterm children, with potential for association with their cognitive development. PMID:28350831
Perla, M E; Rue, Tessa; Cheadle, Allen; Krieger, James; Karr, Catherine J; Karr, C K
Differences in cultural and economic status may place ethnic subgroups of children at higher risk for exposure, leading to heightened health risks, and health inequities. Although Latino-Americans represent 22% of all children in the United States, few studies have explored within-group differences in their exposure to toxicants. Using socio-demographic and biomarker data from the National Health and Nutrition Examination Survey from 1999 to 2008, we characterized determinants of health and estimated geometric means of environmental contaminant biomarkers (blood concentrations of lead and mercury, serum concentrations of dichlorodiphenyldichloroethylene [p,p'-DDE] and cotinine, and urinary metabolites of organophosphate [OP] pesticides and polycyclic aromatic hydrocarbons [PAHs]) among 4,257 Mexican American (MA), 677 Other Latino-American (OL), and 3,370 Non-Hispanic White (NHW) children. MAs had the lowest levels of health insurance coverage and regular access to health care, and largest household size compared to NHWs and OLs. MAs had higher levels of p,p'-DDE, lead, and cadmium while OLs had higher estimates of mercury relative to other groups. MAs had higher urinary metabolite concentrations of 2-hydroxynaphthalene; otherwise MAs and OLs had lower concentrations of PAHs. NHWs had higher levels of cotinine and dimethylthiophosphate. For other OP metabolites, differences among groups were less clear. Lead and p,p'-DDE exposure differences likely reflect later and less regulatory control of these chemicals in Latin America. Additionally, poor quality housing with lead paint is more common in economically disadvantaged subpopulations. Dietary habits are possible sources of differential cadmium, mercury, and organophosphate exposure. Cotinine exposure differences by income and U.S.- vs. foreign-born may represent increased acculturation. These results, coupled with additional research on exposure sources may contribute to refinement of environmental health
Cardona, Guillermo A; Carabin, Hélène; Goñi, Pilar; Arriola, Larraitz; Robinson, Guy; Fernández-Crespo, Juan C; Clavel, Antonio; Chalmers, Rachel M; Carmena, David
The prevalence of and factors associated with the protozoan enteropathogens Cryptosporidium and Giardia have been investigated in selected children and cattle populations from the province of Álava (Northern Spain). The presence of these organisms was detected in fecal samples using commercially available coproantigen-ELISA (CpAg-ELISA) and immunochromatographic (ICT) assays. A total of 327 caregivers of children participants were asked to answer questions on risk factors potentially associated to the prevalence of Cryptosporidium and Giardia, including water-use practices, water sports and contact with domestic or pet animals. Molecular analyses were conducted using a nested-PCR technique to amplify the small-subunit (SSU) rRNA gene of Cryptosporidium and the triosephosphate isomerase (tpi) gene of Giardia. Cryptosporidium oocysts and Giardia cysts were found in 3 and 16 samples using the CpAg-ELISA, and in 5 and 9 samples using the ICT test, respectively. Cryptosporidium and Giardia were also found in 7 and 17 samples by CpAg-ELISA, and 4 and 14 samples by ICT, respectively, of 227 cattle fecal samples. The overall Cryptosporidium and Giardia infection prevalences, based on a Bayesian approach accounting for the imperfect sensitivities and specificities of both diagnostic tests, were estimated to 1.0% (95% BCI: 0.2%-2.8%) and 3.1% (1.5%-5.3%) in children and 3.0% (0.5%-9.2%) and 1.4% (0.0%-6.4%) in cattle, respectively. In humans, a single Cryptosporidium isolate was characterized as C. hominis. Of seven Giardia isolates, four were identified as assemblage B, two as assemblage A-II and one was a mixed assemblage B+A-II infection. No Cryptosporidium or Giardia isolates could be obtained from cattle samples. Although limited, these results seem to suggest that cattle are unlikely to be an important reservoir of zoonotic Cryptosporidium and/or Giardia in the province of Álava.
Furu, Kari; Karlstad, Øystein; Zoega, Helga; Martikainen, Jaana E; Bahmanyar, Shahram; Kieler, Helle; Pottegård, Anton
Use of stimulants to treat attention-deficit/hyperactivity disorder (ADHD) has increased over the past two decades and varies substantially between countries. The objective of this multinational population-based study was to examine utilization of ADHD drugs (stimulants and atomoxetine) including comedication with other psychotropic drugs in the entire child population in the five Nordic countries. We included longitudinal data on dispensed ADHD drugs from five Nordic prescription registers during 2008-2012, which in 2012 comprised 48,296 individuals among 5.42 million inhabitants aged 0-17 years. Prevalence of filling ≥1 prescriptions of ADHD drugs among children aged 6-17 years increased during 2008-2012 from 5.9 to 11.2 and 19.4 to 31.0 per 1000 girls and boys, respectively. Prevalence by country showed that Iceland, Finland and Sweden had a steady increase during the study period, while in Norway the prevalence was quite stable and in Denmark it levelled off from 2010. Use in preschoolers (aged 0-5 years) was rare. Iceland had much higher prevalence and incidence than the other Nordic countries. The incidence of ADHD drug use increased during the study period, from 4.0 to 4.9 and from 1.5 to 2.3 per 1000 boys and girls, respectively. The increasing number of new users levelled off somewhat after 2010. Comedication with other psychotropic drugs was more common among girls (33.9%) than boys (27.0%) and was mainly melatonin, followed by antidepressants and antipsychotics. Overall prevalence of ADHD drug use increased among Nordic girls and boys aged 6-17 years, whereas the incidence increased slightly during 2008-2010 but levelled off through 2012. The substantial differences in ADHD drug use across the Nordic countries and high degree of comedication with other psychotropic drugs underscore the importance of close monitoring of treatment for ADHD among children.
Glock, Fabian; Vogel, Mandy; Naumann, Stephanie; Kuehnapfel, Andreas; Scholz, Markus; Hiemisch, Andreas; Kirsten, Toralf; Rieger, Kristin; Koerner, Antje; Loeffler, Markus; Kiess, Wieland
BackgroundConventional anthropometric measurements are time consuming and require well trained medical staff. To use three-dimensional whole body laser scanning in daily clinical work, validity and reliability have to be confirmed.MethodsWe compared a whole body laser scanner to conventional anthropometry in a group of 473 children and adolescents from the Leipzig Research Centre for Civilization Diseases (LIFE-Child). Concordance correlation coefficients (CCC) were calculated separately for sex, weight and age to assess validity. Overall CCC (OCCC) were used to analyze intra-observer reliability.ResultsBody height and the circumferences of waist, hip, upper arm and calf had an "excellent" (CCC ≥ 0.9), neck and thigh circumference a "good" (CCC ≥ 0.7) and head circumference a "low" (CCC < 0.5) degree of concordance over the complete study population. We observed dependencies of validity on sex, weight and age. Intra-observer reliability of both techniques is "excellent" (OCCC ≥ 0.9).ConclusionScanning is faster, requires a less intensive staff training and provides more information. It can be used in an epidemiologic setting with children and adolescents but some measurements should be considered with caution due to reduced agreement with conventional anthropometry.Pediatric Research (2017); doi:10.1038/pr.2016.274.
Malm, Olaf; Dórea, José G; Barbosa, Antonio C; Pinto, Fernando N; Weihe, Pal
Riverine populations of the Brazilian Amazon depend on fish for their principal source of protein, which changes in availability with seasonal fluctuations in the aquatic ecosystem. We report seasonal (high and low waters) and interannual changes in total mercury and methylmercury concentrations in hair of subsistence fish-eaters from a traditional riverine village on the banks of the Rio Tapajós in the Brazilian Amazonia. Retrospective exposure assessment was conducted from hair concentrations in segments representative of 2 years. A total of 32 mothers and their 51 children were studied. They reported high fish consumption (4-14 times a week). Ranges of total mercury and methylmercury concentrations in hair were 1.0-51.0 and 0.5-41.4microgg(-1), with means of 12.4 and 10.2microgg(-1), respectively. The relative mean value for methylmercury was 80%. There was a significant correlation between mothers and children for both total-Hg (r=0.4826; P=0.003) and methyl-Hg (r=0.5214; P=0.004). Mercury concentrations along hair strands of individuals showed significant variation coinciding with seasonal high and low waters. The changes in the aquatic environment impacted fish species availability, which is reflected in the total and MeHg concentrations in hair.
Rodríguez-Martínez, Carlos E.; Melo, Andrea; Restrepo, Sonia; Sossa-Briceño, Monica P.; Nino, Gustavo
Background There is a critical need for additional validation studies of questionnaires designed to assess the level of control of asthma in pediatric patients. Objective To validate the Spanish version of the Childhood Asthma Control Test (cACT) in children aged between 4 and 11 years with physician-diagnosed asthma Methods In a prospective cohort validation study, asthmatic children aged between 4 and 11 years and their parents, attended both a baseline and a follow-up visit 2 to 6 weeks later. In these two visits, they completed the information required to assess the criterion validity, construct validity, test-retest reliability, sensitivity to change, internal consistency, and usability of the cACT. Results At baseline, cACT scores were significantly different between patients with controlled, partly controlled, and uncontrolled asthma [24.0 (23.0-26.0), 18.0 (18.0-22.0), and 17.5 (13.0-20.0) respectively, p<0.001], and also between patients for whom this visit resulted in a step-up, no change, or step-down in therapy [18.0 (15.0-21.0), 24.0 (23.0-24.0), and 26.0 (23.5-26.0) respectively, p<0.001]. The score of the cACT correlated positively and significantly with the score of the Pediatric Asthma Caregivers Quality of life Questionnaire - PACQLQ (Spearman’s rho = 0.50, p<0.001).The intraclass correlation coefficient of the measurements in patients with no change in clinical status was 0.849 (95% CI: 0.752-0.908). There were statistical significant differences between baseline and follow-up cACT scores in patients with an improvement in clinical status [19.0 (18.0-22.0) vs. 24.5 (24.0-25.0), p<0.001]. Cronbach’s α was 0.8276 for the questionnaire as a whole. Conclusion The Spanish version of the cACT has adequate criterion validity, adequate construct validity, adequate sensitivity to change, good internal consistency, good test-retest reliability, and excellent usability when administered to asthmatic children aged between 4 and 11 years. PMID:24830881
Chankina, O. V.; Kovalskaya, G. A.; Koutzenogii, K. P.; Osipova, L. P.; Savchenko, T. I.
SRXRF has been used to determine the multielement composition of the hair and blood of Tundra Nenetz children. The method allows one to simultaneously determine 21 elements in the blood and 22 elements in the hair. Individual differences have been revealed in the element composition of the hair and blood. Sexual and age changes have been revealed in the content of some elements in the hair. A technique has been developed to prepare blood and hair samples for measuring the element composition by the SRXRF method. The blood samples were prepared by spreading 20 μl over the 1 cm 2 Whatman filter. The hair samples were obtained by pressing in the form of tablets of 1 cm in diameter and a mass of 10-40 mg.
Blumer, Jeffrey; Rodriguez, Adib; Sánchez, Pablo J.; Sallas, William; Kaiser, Guenther; Hamed, Kamal
A multicenter, open-label study evaluated the single-dose pharmacokinetics and safety of a pediatric oral famciclovir (prodrug of penciclovir) formulation in infants aged 1 to 12 months with suspicion or evidence of herpes simplex virus infection. Individualized single doses of famciclovir based on the infant's body weight ranged from 25 to 175 mg. Eighteen infants were enrolled (1 to <3 months old [n = 8], 3 to <6 months old [n = 5], and 6 to 12 months old [n = 5]). Seventeen infants were included in the pharmacokinetic analysis; one infant experienced immediate emesis and was excluded. Mean Cmax and AUC0-6 values of penciclovir in infants <6 months of age were ∼3- to 4-fold lower than those in the 6- to 12-month age group. Specifically, mean AUC0-6 was 2.2 μg·h/ml in infants aged 1 to <3 months, 3.2 μg·h/ml in infants aged 3 to <6 months, and 8.8 μg·h/ml in infants aged 6 to 12 months. These data suggested that the dose administered to infants <6 months was less than optimal. Eight (44.4%) infants experienced at least one adverse event with gastrointestinal events reported most commonly. An updated pharmacokinetic analysis was conducted, which incorporated the data in infants from the present study and previously published data on children 1 to 12 years of age. An eight-step dosing regimen was derived that targeted exposure in infants and children 6 months to 12 years of age to match the penciclovir AUC seen in adults after a 500-mg dose of famciclovir. PMID:20160046
Vilor-Tejedor, Natàlia; Bustamante, Mariona; Pujol, Jesús; Macià, Dídac; Martínez-Vilavella, Gerard; Fenoll, Raquel; Alvárez-Pedrerol, Mar; Forns, Joan; Júlvez, Jordi; Suades-González, Elisabet; Llop, Sabrina; Rebagliato, Marisa; Sunyer, Jordi
Background Attention function filters and selects behaviorally relevant information. This capacity is impaired in some psychiatric disorders and has been proposed as an endophenotype for Attention-Deficit/Hyperactivity Disorder; however, its genetic basis remains largely unknown. This study aimed to identify single nucleotide polymorphism (SNPs) associated with attention function. Materials and Methods The discovery sample included 1655 children (7–12 years) and the replication sample included 546 children (5–8 years). Five attention outcomes were assessed using the computerized Attentional Network Test (ANT): alerting, orienting, executive attention, Hit Reaction time (HRT) and the standard error of HRT (HRTSE). A Genome-wide Association Study was conducted for each outcome. Gene set enrichment analyses were performed to detect biological pathways associated with attention outcomes. Additional neuroimaging analyses were conducted to test neural effects of detected SNPs of interest. Results Thirteen loci showed suggestive evidence of association with attention function (P<10−5) in the discovery sample. One of them, the rs4321351 located in the PID1 gene, was nominally significant in the replication sample although it did not survive multiple testing correction. Neuroimaging analysis revealed a significant association between this SNP and brain structure and function involving the frontal-basal ganglia circuits. The mTOR signaling and Alzheimer disease-amyloid secretase pathways were significantly enriched for alerting, orienting and HRT respectively (FDR<5%). Conclusion These results suggest for the first time the involvement of the PID1 gene, mTOR signaling and Alzheimer disease-amyloid secretase pathways, in attention function during childhood. These genes and pathways have been proposed to play a role in neuronal plasticity, memory and neurodegenerative disease. PMID:27656889
Conard, David; Lawson, Chester A.
This Teacher's Guide is designed for use with the Science Curriculum Improvement Study's (SCIS) unit Population. Populations is the third of a six-unit sequence of SCIS's Life Science Program for grades K-6. The Populations guide consists of activity outlines along with suggestions for guiding children's observation and manipulations of living…
Ronsley, Rebecca; Scott, David; Warburton, William P; Hamdi, Ramsay D; Louie, Dianna Clare; Davidson, Jana; Panagiotopoulos, Constadina
Objectifs : Établir les taux de prévalence des prescriptions d’antipsychotiques (AP) à des enfants et des adolescents de 18 ans et moins en Colombie-Britannique (C.-B.) de 1996 à 2011 selon l’âge, le sexe, le type d’AP, et le diagnostic primaire; et identifier les prescripteurs d’AP prédominants pour les enfants par formation de spécialité. Méthodes : Les données administratives du ministère de la Santé de la C.-B. ont servi à décrire les prescriptions d’AP à des adolescents de 18 ans ou moins. Des comparaisons ont été effectuées au moyen de la prévalence de la population selon le sexe, le groupe d’âge, les AP, la 9e édition de la Classification internationale des maladies, le diagnostic, et la spécialité du prescripteur. Résultats : De 1996 à 2011, le taux global de prévalence des prescriptions d’AP (de la première et de la deuxième génération) a augmenté 3,8 fois (1,66 à 6,37 par 1000 de population); les prescriptions d’AP de deuxième génération (ADG) ont augmenté 18,1 fois (0,33 à 5,98 par 1000 de population). L’augmentation la plus élevée de toutes les prescriptions d’AP a touché les jeunes hommes de 13 à 18 ans (3,3 à 14,4 par 1000 de population; soit 4,4 fois plus), suivie par des augmentations semblables chez les garçons de 6 à 12 ans (2,3 à 8,6 par 1000 de population; soit 3,7 fois plus) et chez les filles de 13 à 18 ans (2,8 à 10,7 par 1000 de population; soit 3,8 fois plus). En général, les 3 diagnostics les plus communs associés à toutes les prescriptions d’AP étaient les troubles dépressifs (12,8 %), l’instabilité de l’enfance (11,7 %), et les troubles névrotiques (11,1 %); toutefois, une variation a été observée dans la formation de spécialité du prescripteur. Parmi toutes les nouvelles prescriptions d’AP en 2010-2011, 38,6 %, 34,3 %, et 15,6 % ont été fournies par des psychiatres, des médecins de famille, et des pédiatres, respectivement. Conclusions : Il y a
Dahlström, Lisen A; Tran, Trung N; Lundholm, Cecilia; Young, Cecilia; Sundström, Karin; Sparén, Pär
In this population-based survey undertaken in Sweden in 2007, we investigated correlates of attitudes to human papillomavirus (HPV) vaccination among parents of children aged 12-15 years. We invited 16,000 parents of girls and 4,000 parents of boys, randomly selected from the Swedish population. Response rates were 70 and 69%, respectively. Multinomial logistic regression models were applied to investigate correlates of acceptability to HPV vaccination. Among studied parents, 76% were willing to vaccinate their child if the vaccine is for free and 63% were willing to vaccinate even if the vaccine comes with a cost. Having heard of HPV was associated with both willingness to vaccinate if the vaccine is free (odds ratio [OR]: 1.42; 95% confidence interval [CI]: 1.21-1.66) and willingness to vaccinate even if the vaccine is not free (OR: 1.96; 95% CI: 1.75-2.20) compared with those who never heard of HPV. Beliefs about vaccine safety and efficacy were also strong correlates of willingness to vaccinate. Parents born outside Europe and those with higher education were less willing to vaccinate if the vaccine is not free. In conclusion, the willingness to vaccinate was reasonably high and cost did not appear to be a major barrier. Information about vaccine safety and efficacy is important and parents need information about HPV and the HPV vaccine.
Vinceti, Marco; Rothman, Kenneth J; Crespi, Catherine M; Sterni, Antonella; Cherubini, Andrea; Guerra, Luisa; Maffeis, Giuseppe; Ferretti, Enrica; Fabbi, Sara; Teggi, Sergio; Consonni, Dario; De Girolamo, Gianfranco; Meggiato, Alessandro; Palazzi, Giovanni; Paolucci, Paolo; Malagoli, Carlotta
Benzene, a recognized occupational leukemogen in adults, has been hypothesized to also increase the risk of childhood leukemia. We carried out a population-based case-control study in a northern Italy community involving 83 cases with acute childhood leukemia diagnosed in the years 1998-2009 and 332 matched controls. We assessed residential exposure to benzene and to particulate matter ≤10 μm (PM10) from motorized traffic using geocoded residences and detailed emission and dispersion modeling. Exposure to benzene, and to a lesser extent to PM10, appeared to be independently associated with an excess leukemia risk. When we stratified the study population by age and by leukemia subtype, the relative risk associated with benzene exposure was higher among children aged less than 5 years, and despite small numbers this relation appeared to be considerably stronger for acute myeloid leukemia than for acute lymphoblastic leukemia. Overall, these findings suggest that exposure to low levels of benzene released from motorized traffic may increase the risk of childhood leukemia, and suggest a possible independent effect of PM10, although unmeasured confounding due to other pollutants cannot be ruled out.
Stolk, Lisette; Bouwland-Both, Marieke I; van Mil, Nina H; van Mill, Nina H; Verbiest, Michael M P J; Eilers, Paul H C; Zhu, Huiping; Suarez, Lucina; Uitterlinden, André G; Steegers-Theunissen, Régine P M
Folate deficiency is implicated in the causation of neural tube defects (NTDs). The preventive effect of periconceptional folic acid supplement use is partially explained by the treatment of a deranged folate-dependent one carbon metabolism, which provides methyl groups for DNA-methylation as an epigenetic mechanism. Here, we hypothesize that variations in DNA-methylation of genes implicated in the development of NTDs and embryonic growth are part of the underlying mechanism. In 48 children with a neural tube defect and 62 controls from a Dutch case-control study and 34 children with a neural tube defect and 78 controls from a Texan case-control study, we measured the DNA-methylation levels of imprinted candidate genes (IGF2-DMR, H19, KCNQ1OT1) and non-imprinted genes (the LEKR/CCNL gene region associated with birth weight, and MTHFR and VANGL1 associated with NTD). We used the MassARRAY EpiTYPER assay from Sequenom for the assessment of DNA-methylation. Linear mixed model analysis was used to estimate associations between DNA-methylation levels of the genes and a neural tube defect. In the Dutch study group, but not in the Texan study group we found a significant association between the risk of having an NTD and DNA methylation levels of MTHFR (absolute decrease in methylation of -0.33% in cases, P-value = 0.001), and LEKR/CCNL (absolute increase in methylation: 1.36% in cases, P-value = 0.048), and a borderline significant association for VANGL (absolute increase in methylation: 0.17% in cases, P-value = 0.063). Only the association between MTHFR and NTD-risk remained significant after multiple testing correction. The associations in the Dutch study were not replicated in the Texan study. We conclude that the associations between NTDs and the methylation of the MTHFR gene, and maybe VANGL and LEKKR/CNNL, are in line with previous studies showing polymorphisms in the same genes in association with NTDs and embryonic development, respectively.
Indicators of Children's Well-Being: Conference Papers. Cross-Cutting Issues; Population, Family, and Neighborhood; Social Development and Problem Behaviors. Volume III. Special Report Series. Special Report Number 60c.
Wisconsin Univ., Madison. Inst. for Research on Poverty.
Papers in this volume explore indicators of children's well-being in the following areas: cross-cutting issues; population, family, and neighborhood; and social development and problem behaviors. The first section includes: (1) "Potential and Problems in Developing Indicators on Child Well-Being from Administrative Data" (Robert M.…
Grootendorst-van Mil, Nina H; Steegers-Theunissen, Régine P M; Hofman, Albert; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning
Objective Season of birth has repeatedly been found to be a risk indicator for adverse neurodevelopmental outcomes. Several explanations for this finding have been put forward but no conclusion has been reached. In the current study, we explored the role of sociodemographic and biological factors in the association between season of birth and child IQ. Design In a prenatally recruited birth cohort (born in 2002–2006), we examined the association between season of birth and non-verbal IQ at age 6 years among 6034 children. We explored how adjusting for socioeconomic status and maternal IQ, childbirth outcomes, pregnancy vitamin D status, nutritional intake, exposure to infections, and child age relative to peers in class changed the relation between season of birth and child IQ. Results We found that spring birth was associated with lower non-verbal IQ (estimate: more than 1 point; β−1.24 (95% CI −2.31 to −0.17), p=0.02; seasonal trend β−0.40 (95% CI −0.74 to −0.07), p=0.02) than birth in summer. Adjustment for different covariates led to a substantial reduction (−65.0% change, in a seasonal trend analysis) of this association. In particular, sociodemographic factors and maternal IQ (−10.0% and −22.5% change, respectively) contributed. Conclusions Season of birth is an indicator of many underlying factors related to child IQ. The observed effects on IQ were small and therefore not of clinical significance. PMID:28213594
Czeizel, Andrew E; Vereczkey, Attila; Bánhidy, Ferenc
Previously an unexpected association of maternal angina pectoris (MAP) during pregnancy with a higher risk of orofacial clefts in their children was found. There were three objectives of this study: (i) to evaluate the validity of MAP-diagnoses in the previous study and the recent history of mothers with MAP in a follow-up study; (ii) to estimate the prevalence of other congenital abnormalities in the offspring of mothers with MAP; and (iii) to analyze the possible effect of confounders for the risk of orofacial clefts. The large dataset of population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996 was evaluated including 22 843 cases with congenital abnormalities and 38 151 controls without any defect. Twenty-two cases (0.10%) and 12 controls (0.03%) were born to mothers with medically recorded MAP (odds ratio [OR] with 95% confidence interval [CI]: 3.7, 1.8-7.3). Of 22 cases, six had isolated cleft lip ± palate (OR with 95% CI: 13.3, 4.9-35.9) and two were affected with isolated cleft palate (OR with 95% CI: 10.5, 2.3-47.6). The diagnosis of MAP was confirmed in seven women visited at home in 2009-2010, two had recent myocardial infarction and five were smokers. There was no higher risk for other congenital abnormalities. In conclusion the higher risk of orofacial clefts was confirmed in the children of mothers with MAP and smoking may trigger the genetic predisposition of both MAP and orofacial clefts. However, the number of cases was limited and therefore further studies are needed to confirm or reject this theoretically and practically important observation.
This article summarizes basic statistics on population growth, concepts about population momentum, and evidence of fertility declines in the world. World population was about 5.84 billion in mid-1997. 86 million people are added yearly. Almost 1 billion people are added every 11 years. The first billion was reached in the early 1800s, and each billion took fewer and fewer years to attain. World population is expected to expand until about 2050 and level off after 2150. Dramatic declines in death rates and health improvements contributed to smaller numbers of children per woman. Absolute increases are due to population momentum, which is the continued large concentration of women in the childbearing years. World population will continue to grow, even after replacement-level fertility of 2 children/woman is reached, due to population momentum. Developing countries continue to have a young age structure and high birth rates, which result in higher population growth. 35% of population in developing countries is aged under 15 years, and almost 50% of population in sub-Saharan African countries is aged under 15 years. Fertility has declined in most regions, with the exception of sub-Saharan Africa. All developing regions have above replacement-level fertility. Declines to below replacement-level fertility in developed countries is attributed to improvements in health for women and children, greater use of family planning, and more education for women and girls. Fertility is high where infant mortality is high. Family planning allows mothers to have healthier children.
Lewit, Eugene M.
Reviews statistics on children in foster care. Examines the definition of foster care, the reasons children are placed in foster care, the various living arrangements that constitute foster care, and the rapid growth of the foster care population. (MDM)
Holmberg, Hanna; Wahlberg, Jeanette; Vaarala, Outi; Ludvigsson, Johnny
Breast-feeding has been suggested to have a protective effect against the development of type 1 diabetes. In the present study, we investigated the relation between duration of breast-feeding and beta-cell autoantibodies in 5-year-old non-diabetic children who participated in a prospective population-based follow-up study (the All Babies in Southeast Sweden study). Autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA) and the protein tryosine phosphatase-like IA-2 (IA-2A) were measured by radiobinding assays. A short duration of total breast-feeding was associated with an increased risk of GADA and/or IAA above the ninety-fifth percentile at 5 years of age (OR 2.09, 95% CI 1.45, 3.02; P<0.000) as well as with an increased risk of IAA above the ninety-fifth percentile at this age (OR 2.89, 95% CI 1.81, 4.62, P<0.000). A short duration of exclusive breast-feeding was associated with an increased risk of GADA, IAA and/or IA-2A above the ninety-ninth percentile (OR 2.01, 95% CI 1.08, 3.73; P=0.028) as well as with an increased risk of IA-2A above the ninety-ninth percentile (OR 3.50, 95% CI 1.38, 8.92, P=0.009) at 5 years of age. An early introduction of formula was associated with an increased risk of GADA, IAA and/or IA-2A above the ninety-ninth percentile (OR 1.84, 95% CI 1.01, 3.37; P=0.047) at 5 years of age. The positive association between a short duration of both total and exclusive breast-feeding, as well as an early introduction of formula, and positivity for beta-cell autoantibodies in children from the general population suggest that breast-feeding modifies the risk of beta-cell autoimmunity, even years after finishing breast-feeding.
Matsuzaki, Mika; Kulkarni, Bharati; Kuper, Hannah; Wells, Jonathan C.; Ploubidis, George B.; Prabhakaran, Poornima; Gupta, Vipin; Walia, Gagandeep Kaur; Aggarwal, Aastha; Prabhakaran, Dorairaj; Davey Smith, George; Radhakrishna, Kankipati Vijaya; Ben-Shlomo, Yoav; Kinra, Sanjay
Background Fat mass is variably associated with bone mass, possibly due to differential mechanical and biological effects of fat mass. We examined the association of fat mass with bone mass in a lean population. Objective To investigate association between hip bone mineral density and fat and lean mass in a cross-sectional study from southern India. Design The Andhra Pradesh Children and Parents Study is a prospective cohort study in Hyderabad, India. In 2009–2012, the study collected data on anthropometric measures, bone mineral density (BMD), fat mass, and lean mass measured by dual-energy x-ray absorptiometry, and socioeconomic data of the adult participants (n = 1760; mean age = 34.9 years old for women; 2130 and 32.3 for men). Results The median BMI (kg/m2) was 20.1 kg/m2. Women had relatively higher fat mass as compared to men. In models adjusted for lean mass, there was an association between hip bone mineral density and fat mass in women (β (95% confidence interval): premenopausal 0.025 (0.006 to 0.045); postmenopausal 0.045 (0.014 to 0.076)) but not in men (0.001 (-0.012 to 0.0014)). The association between hip BMD and fat mass was stronger in postmenopausal than premenopausal women. Hip BMD was consistently associated with lean mass, in both men and women. Conclusions In this relatively lean population, lean mass was more consistently associated with hip BMD than fat mass. Weight gain through lean mass improvement may be a more reliable public health strategy for strengthening bone health in transitional settings. PMID:28060826
Valve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective endocarditis - children; ...
Background Number of internal rural to urban migrant children in China increased rapidly. The disparity of anemia prevalence among them and children of local permanent residents has been reported, both in big and middle-size cities. There has been no population-based study to explore the associated factors on feeding behaviors in small size cities of China. This study aimed to identify whether there was a difference in the prevalence of anemia between children of rural to urban migrant families and local children under 2 years old in a small coastal city in China, and to identify the associated factors of any observed difference. Methods A community-based, cross-sectional survey was conducted in Pinghu, a newly-developing city in Zhejiang Province, China, among the caregivers of 988 children (667 who were identified as children of migrants and 321 locals) aged 6–23 months. Disparity of anemia prevalence were reported. Association between anemia prevalence and socio-economic status and feeding behaviors were explored among two groups respectively. Results Anemia prevalence among the migrant and local children was 36.6% and 18.7% respectively (aPR 1.86, 95% CI 1. 40 to 2.47). Results from adjusted Poisson models revealed: having elder sibling/s were found as an associated factor of anemia with the aPR 1.47 (95% CI 1.16 to 1.87) among migrant children and 2.58 (95% CI 1.37 to 4.58) among local ones; anemia status was associated with continued breastfeeding at 6 months (aPR = 1.57, 95% CI 1.15 to 2.14) and lack of iron-rich and/or iron-fortified foods (aPR = 0.68, 95% CI 0.50 to 0.89) among the migrant children but not among local ones. Conclusion Anemia was more prevalent among migrant children, especially those aged 6–11 months. Dislike their local counterparts, migrant children were more vulnerable at early life and seemed sensitive to feeding behaviors, such as, over reliance on breastfeeding for nutrition after aged 6 months, lack of iron-rich and
Bobillo, Cecilia; Navoni, Julio A; Olmos, Valentina; Merini, Luciano J; Villaamil Lepori, Edda; Corach, Daniel
Because the ratio between the two major arsenic metabolites is related to the adverse health effects of arsenic, numerous studies have been performed to establish a relationship between the ability to metabolically detoxify arsenic and other variables, including exposure level, gender, age and ethnicity. Because ethnicity may play a key role and provide relevant information for heterogeneous populations, we characterized a group of 70 children from rural schools in the Argentinean provinces of Chaco and Santiago del Estero who were exposed to high levels of arsenic. We used genetic markers for maternal, paternal and bi-parental ancestry to achieve this goal. Our results demonstrate that the Amerindian maternal linages are present in 100% of the samples, whereas the Amerindian component transmitted through the paternal line is less than 10%. Informative markers for autosomal ancestry show a predominantly European ancestry, in which 37% of the samples contained between 90 and 99% European ancestry. The native American component ranged from 50 to 80% in 15.7% of the samples, and in all but four samples, the African component was less than 10%. Correlation analysis demonstrated that the ethnicity and the ratio of the excreted arsenic metabolites monomethyl arsenic and dimethyl arsenic are not associated, dismissing a relationship between ethnic origin and differential metabolism.
Bobillo, Cecilia; Navoni, Julio A; Olmos, Valentina; Merini, Luciano J; Villaamil Lepori, Edda; Corach, Daniel
Because the ratio between the two major arsenic metabolites is related to the adverse health effects of arsenic, numerous studies have been performed to establish a relationship between the ability to metabolically detoxify arsenic and other variables, including exposure level, gender, age and ethnicity. Because ethnicity may play a key role and provide relevant information for heterogeneous populations, we characterized a group of 70 children from rural schools in the Argentinean provinces of Chaco and Santiago del Estero who were exposed to high levels of arsenic. We used genetic markers for maternal, paternal and bi-parental ancestry to achieve this goal. Our results demonstrate that the Amerindian maternal linages are present in 100% of the samples, whereas the Amerindian component transmitted through the paternal line is less than 10%. Informative markers for autosomal ancestry show a predominantly European ancestry, in which 37% of the samples contained between 90 and 99% European ancestry. The native American component ranged from 50 to 80% in 15.7% of the samples, and in all but four samples, the African component was less than 10%. Correlation analysis demonstrated that the ethnicity and the ratio of the excreted arsenic metabolites monomethyl arsenic and dimethyl arsenic are not associated, dismissing a relationship between ethnic origin and differential metabolism. PMID:24596592
Totsika, Vasiliki; Hastings, Richard Patrick; Vagenas, Dimitrios; Emerson, Eric
We examined parenting behaviors, and their association with concurrent and later child behavior problems. Children with an intellectual disability (ID) were identified from a UK birth cohort (N = 516 at age 5). Compared to parents of children without an ID, parents of children with an ID used discipline less frequently, but reported a more…
Population Action International, Washington, DC.
Population growth around the world affects Americans through its impact on economy, environment, safety, and health, and the condition of the world children will inherit. The cumulative evidence is strong that current rates of population growth pose significant and interacting risks to human well-being and are a legitimate concern for Americans.…
Early Childhood Screen Time and Parental Attitudes Toward Child Television Viewing in a Low-Income Latino Population Attending the Special Supplemental Nutrition Program for Women, Infants, and Children
Kair, Laura R.; Arain, Yassar H.; Cervantes, Marlene; Oreskovic, Nicolas M.; Zuckerman, Katharine E.
Abstract Background: Early childhood media exposure is associated with obesity and multiple adverse health conditions. The aims of this study were to assess parental attitudes toward childhood television (TV) viewing in a low-income population and examine the extent to which child BMI, child/parent demographics, and household media environment are associated with adherence to American Academy of Pediatrics (AAP) guidelines for screen time. Methods: This was a cross-sectional survey study of 314 parents of children ages 0–5 years surveyed in English or Spanish by self-administered questionnaire at a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinic in Oregon. Results: In this majority Latino sample (73%), half (53%) of the children met AAP guidelines on screen time limits, 56% met AAP guidelines for no TV in the child's bedroom, and 29% met both. Children were more likely to meet AAP guidelines when there were <2 TVs in the home, there was no TV during dinner, or their parents spent less time viewing electronic media. Parents who spent less time viewing electronic media were more likely to report believing that TV provides little value or usefulness. Conclusions: In this low-income, predominantly Latino population attending WIC, parent media-viewing and household media environment are strongly associated with child screen time. Programs aimed at reducing child screen time may benefit from interventions that address parental viewing habits. PMID:26390321
Uggla, Caroline; Mace, Ruth
How to allocate resources between somatic maintenance and reproduction in a manner that maximizes inclusive fitness is a fundamental challenge for all organisms. Life history theory predicts that effort put into somatic maintenance (health) should vary with sex, mating and parenting status because men and women have different costs of reproduction, and because life transitions such as family formation alter the fitness payoffs from investing in current versus future reproduction. However, few tests of how such life history parameters influence behaviours closely linked to survival exist. Here we examine whether specific forms of preventable death (accidents/suicides, alcohol-related causes, and other preventable diseases) are predicted by marital status and dependent offspring in a modern developed context; that of Northern Ireland. We predict that men, non-partnered individuals and individuals who do not have dependent offspring will be at higher risk of preventable death. Running survival analyses on the entire adult population (aged 16-59, n = 927,134) controlling for socioeconomic position (SEP) and other potential confounds, we find that being single (compared to cohabiting/married) increases risk of accidental/suicide death for men (but not for women), whereas having dependent children is associated with lower risk of preventable mortality for women but less so for men. We also find that the protective effect of partners is larger for men with low SEP than for high SEP men. Findings support life history predictions and suggest that individuals respond to variation in fitness costs linked to their mating and parenting status.
Pitter, Gisella; Ludvigsson, Jonas Filip; Romor, Pierantonio; Zanier, Loris; Zanotti, Renzo; Simonato, Lorenzo; Canova, Cristina
Several epidemiological studies reported an association between antibiotic consumption in the first year of life and later asthma, but results are conflicting and affected by potential biases. We examined this controversial issue in a population-based birth cohort. Using administrative data, we identified 143,163 children born in 1995-2011 in Friuli-Venezia Giulia (Italy) (median follow-up 5.25 years, 927,350 person-years). Antibiotic prescriptions in the first year of life and subsequent treated asthma (defined as ≥2 anti-asthmatic drug prescriptions within a 12-month period) were retrieved from drug prescription records. We estimated incidence rate ratios (IRR) using Poisson regression models, adjusted for perinatal variables and for hospitalizations for infections in the first year of life. We identified 34,957 new-onset asthma cases. Antibiotic consumption in the first year of life increased the risk of new-onset asthma [IRR 1.51, 95% confidence interval (CI) 1.48-1.54] with a dose-response relationship (p-trend <0.001). The risk was highest for asthma identified at 13-35 months of life (IRR 2.07, 95% CI 2.00-2.14), but remained statistically significant for asthma identified at 36-71 months (IRR 1.17, 95% CI 1.14-1.21) and at ≥72 months (IRR 1.15, 95% CI 1.08-1.22). Antibiotics increased the risk of current asthma at ≥6 years (IRR 1.35, 95% CI 1.30-1.41) and at ≥13 years of age (IRR 1.19, 95% CI 1.08-1.33). Antibiotic exposure in infancy is associated with an increased risk of asthma up to adolescence. The association detected at older ages is not explained by reverse causation; however, confounding by respiratory infections not leading to hospital admission cannot be excluded.
Hamilton, Leslie J; Lerner, Carlos F; Presson, Angela P; Klitzner, Thomas S
The Pediatric Medical Home Program at UCLA enrolled 41 patients in a primary care model focused on providing intensive care coordination for medically complex, ethnically diverse children with special health care needs (CSHCN) in our Pediatric Resident Continuity clinic. We sought to determine the effect of our program on parental satisfaction, and to compare differences in parental satisfaction between English and Spanish speaking patients. The Medical Home Family Index, developed by the Center for Medical Home Improvement, was administered to a total of 22 participating parents, in the family's primary language by a native speaker, at various times after enrollment in the program. Survey data and language effects were analyzed. The 36 standardized mean scores for the 15 Spanish speaking families were significantly higher (8.5 points higher) than the mean scores from the seven English speaking families (p = 0.003). Although no statistically significant differences were noted in individual questions between Spanish and English speakers, a trend towards more positive responses by Spanish speakers was noted in questions regarding physician-patient communication (p = 0.054) and family-centeredness (p = 0.053). Our results suggest that a primary care model focused on providing intensive care coordination produces positive parental perceptions of the organization and delivery of primary care services in a medically complex population of CSHCN. The main finding of the study is that utilizing the AAP's approach to the medical home model, emphasizing family-centered and culturally competent care, can produce higher satisfaction scores in Spanish speaking parents when compared to English speaking parents.
Background The aim of this study was to analyse the prevalence of undernutrition, overweight and associated factors, before and after the implementation of the Interoceanic Highway. Methods A population-based cross-sectional study on children under 5 years of age was conducted in the municipality of Assis Brasil, AC, Brazil, in 2003 and 2010. Prevalence of undernutrition was observed by using height-for-age Z-scores (HAZ) and adopting a cut-off point equal to or lower than a -2 Z-score. Overweight prevalence was defined by a cut-off point equal to or greater than a +2 Z-score of the WHZ index. Z-scores were calculated relative to WHO 2006 reference data. Semi-structured questionnaires were applied to the children’s guardians, investigating family socio-economic and demographic characteristics, morbidities, access to services and child care. Associated factors were identified by hierarchical multiple logistic regression analysis. Results The prevalence of low HAZ (undernutrition) was 7.0% in 2003 and 12.2% in 2010. The prevalence of high WHZ (overweight) was 1.0% and 6.6% for 2003 and 2010, respectively. It was not possible to adjust the multiple model for the year 2003. The factors associated with low HAZ in 2010 were: wealth index, the situation of living with biological parents, maternal height and presence of open sewage, whereas the factors associated with a high WHZ in the same year were: child’s age, mother’s time of residence in the location, mother’s body mass index. Conclusions Overweight increase within this undernutrition scenario reveals that the process of nutritional transition began in this Amazonian city only in the last decade, and therefore, it is delayed when compared to overweight in other parts of Brazil. Such nutritional transition in Assis Brasil may have been facilitated by the construction of the Interoceanic Highway. PMID:24283293
Commission on Emotional and Learning Disorders in Children, Toronto (Ontario).
Presented are the results of a national study of Canadian children with emotional and learning disorders, who number 12% of the Canadian population up to 19 years of age, or no less than 1,000,000 children, who need attention, treatment, and care. The category includes children with neurotic or psychotic or behavior disorders, learning…
Sherman, Dianne, Ed.
This double issue of the "ZPG Reporter" focuses on the theme of ZPG's Children's Stress Index", the first national survey of children's well-being based on population- related pressures. Using an extensive list of social, economic, and environmental factors that affect the lives of children, the index ranks 828 cities, counties, and…
Waldman, H B
Limited attention has been directed in the dental literature to the emotional, economic and associated consequences of divorces on children. A general introduction is provided on 1) the numbers of children involved in divorces in different single-parent population groups, with 2) emphasis on the emotional impact of divorce on children and 3) the potential significance for pediatric dental practices.
Fox, Mary Kay; Cole, Nancy
Data from the Third National Health and Nutrition Examination Survey (NHANES-III), conducted in 1988-94, were used to compare the nutrition and health characteristics of the Nation's school-age children--boys and girls ages 5-18. Three groups of children were compared based on household income: income at or below 130 percent of poverty (lowest…
van Oudenhoven, Nico
Begun in 1978 by a small group of Colombians who were affiliated with a private organization and who were interested in children's upbringing, education, and development, the Promesa Project began by organizing discussion groups among about 20 mothers and their children between 3 and 7 years of age in four remote villages on the shores of the…
Law, J.; Rush, R.; McBean, K.
Considerable evidence supports the association between language learning difficulties and behaviour in young children and this is likely to be particularly true of children raised in social disadvantage. Less is known about the way that different aspects of language, specifically pragmatics, interact with behaviour. This study examines the extent…
Chemtob, Claude M.; Conroy, David L.; Hochauser, Carl J.; Laraque, Danielle; Banks, Josette; Schmeidler, James; Dela Cruz, Maan; Nelsen, William C.; Landrigan, Philip J.
Children who experience traumatic bereavement in the context of catastrophic disasters are at increased risk for developing post-disaster problems. Despite massive loss of life on September 11th, 2001, no public data were collected on those children who lost a parent in the multiple terrorist attacks. Such a registry would be an important public…
Cavezian, Celine; Vilayphonh, Marc; de Agostini, Maria; Vasseur, Vivien; Watier, Laurence; Kazandjian, Seta; Laloum, Laurent; Chokron, Sylvie
In young children, visual attention, analysis or memory is only rarely evaluated. Moreover, tools to test for such higher-order visual capacities in children are limited. In an attempt to develop and refine such tools, we selected nine tests to assess visuo-attentional abilities before formal reading education (grade 1). The battery consisted of…
Totsika, Vasiliki; Hastings, Richard Patrick; Vagenas, Dimitrios; Emerson, Eric
We examined parenting behaviors, and their association with concurrent and later child behavior problems. Children with an intellectual disability (ID) were identified from a UK birth cohort (N = 516 at age 5). Compared to parents of children without an ID, parents of children with an ID used discipline less frequently, but reported a more negative relationship with their child. Among children with an ID, discipline, and home atmosphere had no long-term association with behavior problems, whereas relationship quality did: closer relationships were associated with fewer concurrent and later child behavior problems. Increased parent-child conflict was associated with greater concurrent and later behavior problems. Parenting programs in ID could target parent-child relationship quality as a potential mediator of behavioral improvements in children.
What about These Children? Assessing Poverty among the "Hidden Population" of Multiracial Children in Single-Mother Families. University of Kentucky Center for Poverty Research Discussion Paper Series, DP2010-09
Bratter, Jenifer; Damaske, Sarah
Capturing the conditions of children of color living in single-parent families has become more complex due to the growing presence of interracial households. This analysis assesses the size and poverty status of single-female headed families housing multiracial children. Using data from the 2000 Census, we find that 9 percent of female-headed…
Burnham, Joy J.; Lomax, Richard G.
The American Fear Survey Schedule for Children (FSSC-AM; J. J. Burnham, 1995, 2005) has been used to measure fears of children and adolescents. The FSSC-AM is based on the 2nd revision of a psychometrically sound and well-known fear scale (i.e., FSSC-II; E. Gullone & N. J. King, 1992). In this study, age and gender differences, fear intensity…
Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data
Stevens, Gretchen A; Finucane, Mariel M; De-Regil, Luz Maria; Paciorek, Christopher J; Flaxman, Seth R; Branca, Francesco; Peña-Rosas, Juan Pablo; Bhutta, Zulfiqar A; Ezzati, Majid
Summary Background Low haemoglobin concentrations and anaemia are important risk factors for the health and development of women and children. We estimated trends in the distributions of haemoglobin concentration and in the prevalence of anaemia and severe anaemia in young children and pregnant and non-pregnant women between 1995 and 2011. Methods We obtained data about haemoglobin and anaemia for children aged 6–59 months and women of childbearing age (15–49 years) from 257 population-representative data sources from 107 countries worldwide. We used health, nutrition, and household surveys; summary statistics from WHO's Vitamin and Mineral Nutrition Information System; and summary statistics reported by other national and international agencies. We used a Bayesian hierarchical mixture model to estimate haemoglobin distributions and systematically addressed missing data, non-linear time trends, and representativeness of data sources. We quantified the uncertainty of our estimates. Findings Global mean haemoglobin improved slightly between 1995 and 2011, from 125 g/L (95% credibility interval 123–126) to 126 g/L (124–128) in non-pregnant women, from 112 g/L (111–113) to 114 g/L (112–116) in pregnant women, and from 109 g/L (107–111) to 111 g/L (110–113) in children. Anaemia prevalence decreased from 33% (29–37) to 29% (24–35) in non-pregnant women, from 43% (39–47) to 38% (34–43) in pregnant women, and from 47% (43–51) to 43% (38–47) in children. These prevalences translated to 496 million (409–595 million) non-pregnant women, 32 million (28–36 million) pregnant women, and 273 million (242–304 million) children with anaemia in 2011. In 2011, concentrations of mean haemoglobin were lowest and anaemia prevalence was highest in south Asia and central and west Africa. Interpretation Children's and women's haemoglobin statuses improved in some regions where concentrations had been low in the 1990s, leading to a modest global increase in
Rose, Elizabeth S.; Blevins, Meridith; González-Calvo, Lazaro; Ndatimana, Elisée; Green, Ann F.; Lopez, Melanie; Olupona, Omo; Vermund, Sten H.; Moon, Troy D.
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
Verbeek, Nienke E.; van der Maas, Nicoline A. T.; Jansen, Floor E.; van Kempen, Marjan J. A.; Lindhout, Dick; Brilstra, Eva H.
Objectives To determine the prevalence of Dravet syndrome, an epileptic encephalopathy caused by SCN1A-mutations, often with seizure onset after vaccination, among infants reported with seizures following vaccination. To determine differences in characteristics of reported seizures after vaccination in children with and without SCN1A-related Dravet syndrome. Methods Data were reviewed of 1,269 children with seizures following immunization in the first two years of life, reported to the safety surveillance system of the Dutch national immunization program between 1 January 1997 and 31 December 2006. Selective, prospective follow-up was performed of children with clinical characteristics compatible with a diagnosis of Dravet syndrome. Results In 21.9% (n = 279) of children, a diagnosis of Dravet syndrome could not be excluded based on available clinical data (median age at follow-up 16 months). Additional follow-up data were obtained in 83.9% (n = 234) of these children (median age 8.5 years). 15 (1.2% of 1,269; 95%CI:0.6 to 1.8%) children were diagnosed with SCN1A-related Dravet syndrome. Of all reported seizures following vaccinations in the first year of life, 2.5% (95%CI:1.3 to 3.6%) were due to SCN1A-related Dravet syndrome, as were 5.9% of reported seizures (95%CI:3.1 to 8.7%) after 2nd or 3rd DTP-IPV-Hib vaccination. Seizures in children with SCN1A-related Dravet syndrome occurred more often with a body temperature below 38.5°C (57.9% vs. 32.6%, p = 0.020) and reoccurred more often after following vaccinations (26.7% vs. 4.0%, p = 0.003), than in children without a diagnosis of SCN1A-related Dravet Syndrome. Conclusions Although Dravet syndrome is a rare genetic epilepsy syndrome, 2.5% of reported seizures following vaccinations in the first year of life in our cohort occurred in children with this disorder. Knowledge on the specific characteristics of vaccination-related seizures in this syndrome might promote early diagnosis and indirectly
Jalali-Farahani, Sara; Amiri, Parisa; Abbasi, Behnood; Karimi, Mehrdad; Cheraghi, Leila; Daneshpour, Maryam Sadat; Azizi, Fereidoun
Objectives To investigate clustering of parental sociobehavioral factors and their relationship with the incidence of overweight and obesity in Iranian children. Methods Demographics, body weight, and certain medical characteristics of the parents of 2999 children were used to categorize parents by cluster; children's weights were assessed for each cluster. Specifically, survival analysis and Cox regression models were used to test the effect of parental clustering on the incidence of childhood overweight and obesity. Results Maternal metabolic syndrome, education level, age, body weight status, and paternal age had important roles in distinguishing clusters with low, moderate, and high risk. Crude incidence rates (per 10,000 person-years) of overweight and obesity were 416.8 (95% confidence interval (CI) 388.2-447.5) and 114.7 (95% CI 101.2-129.9), respectively. Children of parents with certain constellations of demographic and medical characteristics were 37.0 and 41.0% more likely to become overweight and obese, respectively. Conclusions for Practice The current study demonstrated the vital role of maternal characteristics in distinguishing familial clusters, which could be used to predict the incidence of overweight and obesity in children.
Lin, Jin-Ding; Chen, Yi-Hsin; Lin, Lan-Ping
Medical costs of attention-deficit/hyperactivity disorder (ADHD) are substantial and have a large impact on the public health system. The present study presents information regarding outpatient rehabilitation care usage and medical expenditure for children with ADHD. A cross-sectional study was conducted by analyzing data from the Taiwan National Health Insurance claims database for the year 2009. A total of 6643 children aged 0-7 years with ADHD (ICD-9-CM codes 314.0x: attention deficit disorder, 314.00: attention deficit disorder without hyperactivity, or 314.01: attention-deficit disorder with hyperactivity) who had used outpatient rehabilitation care were included in the analyses. Results showed that the mean annual rehabilitation care was 22.24 visits. Among the care users, 76% of patients were male, and 24% were female. More than half of the children with ADHD had comorbid mental illnesses as well. A logistic regression analysis of outpatient rehabilitation expenditure (low vs. high) showed that of those children with ADHD, those aged 0-2 years tended to incur more medical costs than those aged 6-7 years. Other factors such as frequency of rehabilitation visits, hospital medical setting and ownership, location of medical care setting, and types of rehabilitation were also significantly correlated with medical expenditure. The results from this study suggest that health care systems should ensure accurate diagnosis and measurement of impairment to maintain appropriate and successful management of rehabilitation needs for children with ADHD.
Rutherford, Marion; McKenzie, Karen; Johnson, Tess; Catchpole, Ciara; O'Hare, Anne; McClure, Iain; Forsyth, Kirsty; McCartney, Deborah; Murray, Aja
This article reports on gender ratio, age of diagnosis and the duration of assessment procedures in autism spectrum disorder diagnosis in a national study which included all types of clinical services for children and adults. Findings are reported from a retrospective case note analysis undertaken with a representative sample of 150 Scottish children and adults recently diagnosed with autism spectrum disorder. The study reports key findings that the gender ratio in this consecutively referred cohort is lower than anticipated in some age groups and reduces with increasing age. The gender ratio in children, together with the significant difference in the mean age of referral and diagnosis for girls compared to boys, adds evidence of delayed recognition of autism spectrum disorder in younger girls. There was no significant difference in duration of assessment for males and females suggesting that delays in diagnosis of females occur prior to referral for assessment. Implications for practice and research are considered.
Alvarenga, Pedro G; do Rosario, Maria C; Cesar, Raony C; Manfro, Gisele G; Moriyama, Tais S; Bloch, Michael H; Shavitt, Roseli G; Hoexter, Marcelo Q; Coughlin, Catherine G; Leckman, James F; Miguel, Euripedes C
Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an "at-risk" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 ± 1.84 years; 55.0% male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.
Millei, Zsuzsa; Lee, Libby
This article critiques the Smart Population Foundation Initiative (SPFI), which was established to "bring parenting information and the science of child development to Australian parents and carers" (Smart Population Foundation, 2006) and to satisfy the need for a credible and easily accessible source of information for parents. The…
Newgard, Craig D.; Rudser, Kyle; Atkins, Dianne L.; Berg, Robert; Osmond, Martin H.; Bulger, Eileen M.; Davis, Daniel P.; Schreiber, Martin A.; Warden, Craig; Rea, Thomas D.; Emerson, Scott
Objective The validity of using adult physiologic criteria to triage injured children in the out-of-hospital setting remains unproven. Among children meeting adult field physiologic criteria, we assessed the availability of physiologic information, the incidence of death or prolonged hospitalization, and whether age-specific criteria would improve the specificity of the physiologic triage step. Methods We analyzed a prospective, out-of-hospital cohort of injured children aged ≤14 years collected from December 2005 through February 2007 by 237 emergency medical services (EMS) agencies transporting to 207 acute care hospitals (trauma and nontrauma centers) in 11 sites across the United States and Canada. Inclusion criteria were standard adult physiologic values: systolic blood pressure (SBP) ≤90 mmHg, respiratory rate <10 or >29 breaths/min, Glasgow Coma Scale (GCS) score ≤12, and field intubation attempt. Seven physiologic variables (including age-specific values) and three demographic and mechanism variables were included in the analysis. “High-risk” children included those who died (field or in-hospital) or were hospitalized >2 days. The decision tree was derived and validated using binary recursive partitioning. Results Nine hundred fifty-five children were included in the analysis, of whom 62 (6.5%) died and 117 (12.3%) were hospitalized >2 days. Missing values were common, ranging from 6% (respiratory rate) to 53% (pulse oximetry), and were associated with younger age and high-risk outcome. The final decision rule included four variables (assisted ventilation, GCS score <11, pulse oximetry <95%, and SBP >96 mmHg), which demonstrated improved specificity (71.7% [95% confidence interval (CI) 66.7–76.6%]) at the expense of missing high-risk children (sensitivity 76.5% [95% CI 66.4–86.6%]). Conclusions The incidence of high-risk injured children meeting adult physiologic criteria is relatively low and the findings from this sample do not support using
Stene-Larsen, Kim; Borge, Anne I. H.; Vollrath, Margarete E.
The analysis of the data on 22,545 smoking mothers and their 18-month-old children finds that maternal smoking during pregnancy increases the risk for externalizing behavior problem at the age of 18-months. The child's gender is found to have no moderating effects on the findings.
Rutherford, Marion; McKenzie, Karen; Johnson, Tess; Catchpole, Ciara; O'Hare, Anne; McClure, Iain; Forsyth, Kirsty; McCartney, Deborah; Murray, Aja
This article reports on gender ratio, age of diagnosis and the duration of assessment procedures in autism spectrum disorder diagnosis in a national study which included all types of clinical services for children and adults. Findings are reported from a retrospective case note analysis undertaken with a representative sample of 150 Scottish…
Griffith, Annette K.; Hurley, Kristin Duppong; Trout, Alexandra L.; Synhorst, Lori; Epstein, Michael H.; Allen, Elizabeth
Over the past decade, there has been an increased need for the development and use of psychometrically acceptable measures to assess the behavioral and emotional strengths of young children served in statewide preschool and Head Start programs. One measure developed to address this need is the Preschool Behavioral and Emotional Rating Scale…
Background To screen for visual impairment in Malaysian preschool children. Methods Visual screening was conducted in 400 preschool children aged 4 to 6 years. The screening involved two basic procedures; the distant visual acuity test using the Sheridan Gardiner chart and the depth perception test using the Langs stereoacuity test. Criteria for referral were a visual acuity of 6/12 or less in the better eye or a fail in the depth perception test. Results The prevalence of visual impairment was 5% (95% confidence interval [CI] = 3.3, 7.6). Of the 400 preschool children screened, 20 of them failed the distant visual acuity test or the stereopsis test. Refractive errors were the most common cause of visual impairment (95%, 95% CI = 76.2, 98.8); myopic astigmatism was the commonest type of refractive error (63.2%, 95% CI = 40.8, 80.9). Conclusion The study is a small but important step in the effort to understand the problem of visual impairment among our preschool children. Our study showed that it is feasible to measure distant visual acuity and stereopsis in this age group. PMID:23601160
Bergamo, Silvia; Parata, Francesca; Nosadini, Margherita; Boniver, Clementina; Toldo, Irene; Suppiej, Agnese; Vecchi, Marilena; Amigoni, Angela; Da Dalt, Liviana; Zanconato, Stefania; Perilongo, Giorgio; Sartori, Stefano
Convulsive epileptic seizures in children represent a common cause of admission to pediatric emergency department. Data about incidence, etiology, and outcome are still lacking in literature. We retrospectively reviewed medical records of children presenting to our pediatric emergency department with convulsive seizures during a 12-month period and collected their diagnoses over the following year. In all, 182 children met the inclusion criteria, for a total of 214 visits (1.2% of all attendances, n = 24 864). Seizures lasted less than 5 minutes in 76%, 5 to 30 minutes in 20%, 30 to 60 minutes in 2%, and over 60 minutes in 2% visits ("early," "established," "refractory," convulsive status epilepticus, respectively). Incidence of "early" (seizure lasting 5-30 minutes) and "established" (seizure lasting 30-60 minutes) status epilepticus was 52/100 000/year and 7/100 000/year respectively. Most common causes were febrile seizures (56%) and remote symptomatic seizures (19%). Knowing the epidemiology of convulsive seizures in children is important to guide appropriate management and individualized follow-up.
Norbury, Courtenay Frazier; Gooch, Debbie; Baird, Gillian; Charman, Tony; Simonoff, Emily; Pickles, Andrew
Background: The youngest children in an academic year are reported to be educationally disadvantaged and overrepresented in referrals to clinical services. In this study we investigate for the first time whether these disadvantages are indicative of a mismatch between language competence at school entry and the academic demands of the classroom.…
Tan, Jee Peng; Haines, Michael
The schooling of children, thought to be an important factor in explaining changes in fertility over time, is examined. Theory predicts that it exerts a negative effect on parental fertility. The mechanisms by which this relationship occurs at the micro-level are elaborated by Becker in this quantity-quality trade-off model, and by Cadwell in his…
Gustafsson, Peik; Kallen, Karin
Aim: The aim of this study was to evaluate the impact of pre- and perinatal factors on the risk of developing attention-deficit-hyperactivity disorder (ADHD). Method: We investigated the medical history of 237 children (206 male; 31 female) from Malmo, Sweden born between 1986 and 1996 and in whom a diagnosis of ADHD (Diagnostic and Statistical…
Lindblad, Ida; Gillberg, Christopher; Fernell, Elisabeth
The aim was to examine the rates and types of parent reported neuropsychiatric problems in children and adolescents with mild mental retardation (MMR) (mild intellectual disability/UK) using the Five-To-Fifteen questionnaire (FTF). The target group comprised all pupils with clinically diagnosed MMR, aged between 7 and 15 years, attending the…
Verity, Christopher M.; Winstone, Anne Marie; Stellitano, Lesley; Krishnakumar, Deepa; Will, Robert; McFarland, Robert
Aim: Our aim was to study the clinical presentation, mode of diagnosis, and epidemiology of mitochondrial disorders in children from the UK who have progressive intellectual and neurological deterioration (PIND). Method: Since April 1997, we have identified patients aged 16 years or younger with suspected PIND through the monthly notification card…
Patel, Rita; Donohue, Kevin D.; Unnikrishnan, Harikrishnan; Kryscio, Richard J.
Purpose: This article presents a quantitative method for assessing instantaneous and average lateral vocal-fold motion from high-speed digital imaging, with a focus on developmental changes in vocal-fold kinematics during childhood. Method: Vocal-fold vibrations were analyzed for 28 children (aged 5-11 years) and 28 adults (aged 21-45 years)…
McLean, Mary; And Others
The study evaluated the Batelle Developmental Inventory (BDI) with 40 disabled children under 30 months of age. Subjects were also given the Bayley Scales and Vine Scales of Adaptive Behavior. Results indicated high concurrent validity, interrater reliability, and internal consistency for the BDI. (Author/DB)
Introduction At hospital arrival, early prognostication for children after out-of-hospital cardiac arrest (OHCA) might help clinicians formulate strategies, particularly in the emergency department. In this study, we aimed to develop a simple and generally applicable bedside tool for predicting outcomes in children after cardiac arrest. Methods We analyzed data of 5,379 children who had undergone OHCA. The data were extracted from a prospectively recorded, nationwide, Utstein-style Japanese database. The primary endpoint was survival with favorable neurological outcome (Cerebral Performance Category (CPC) scale categories 1 and 2) at 1 month after OHCA. We developed a decision tree prediction model by using data from a 2-year period (2008 to 2009, n = 3,693), and the data were validated using external data from 2010 (n = 1,686). Results Recursive partitioning analysis for 11 predictors in the development cohort indicated that the best single predictor for CPC 1 and 2 at 1 month was the prehospital return of spontaneous circulation (ROSC). The next predictor for children with prehospital ROSC was an initial shockable rhythm. For children without prehospital ROSC, the next best predictor was a witnessed arrest. Use of a simple decision tree prediction model permitted stratification into four outcome prediction groups: good (prehospital ROSC and initial shockable rhythm), moderately good (prehospital ROSC and initial nonshockable rhythm), poor (prehospital non-ROSC and witnessed arrest) and very poor (prehospital non-ROSC and unwitnessed arrest). By using this model, we identified patient groups ranging from 0.2% to 66.2% for 1-month CPC 1 and 2 probabilities. The validated decision tree prediction model demonstrated a sensitivity of 69.7% (95% confidence interval (CI) = 58.7% to 78.9%), a specificity of 95.2% (95% CI = 94.1% to 96.2%) and an area under the receiver operating characteristic curve of 0.88 (95% CI = 0.87 to 0.90) for predicting 1-month
Forman, Michele R; Zhu, Yeyi; Hernandez, Ladia M; Himes, John H; Dong, Yongquan; Danish, Robert K; James, Kyla E; Caulfield, Laura E; Kerver, Jean M; Arab, Lenore; Voss, Paula; Hale, Daniel E; Kanafani, Nadim; Hirschfeld, Steven
Surrogate measures are needed when recumbent length or height is unobtainable or unreliable. Arm span has been used as a surrogate but is not feasible in children with shoulder or arm contractures. Ulnar length is not usually impaired by joint deformities, yet its utility as a surrogate has not been adequately studied. In this cross-sectional study, we aimed to examine the accuracy and reliability of ulnar length measured by different tools as a surrogate measure of recumbent length and height. Anthropometrics [recumbent length, height, arm span, and ulnar length by caliper (ULC), ruler (ULR), and grid (ULG)] were measured in 1479 healthy infants and children aged <6 y across 8 study centers in the United States. Multivariate mixed-effects linear regression models for recumbent length and height were developed by using ulnar length and arm span as surrogate measures. The agreement between the measured length or height and the predicted values by ULC, ULR, ULG, and arm span were examined by Bland-Altman plots. All 3 measures of ulnar length and arm span were highly correlated with length and height. The degree of precision of prediction equations for length by ULC, ULR, and ULG (R(2) = 0.95, 0.95, and 0.92, respectively) was comparable with that by arm span (R(2) = 0.97) using age, sex, and ethnicity as covariates; however, height prediction by ULC (R(2) = 0.87), ULR (R(2) = 0.85), and ULG (R(2) = 0.88) was less comparable with arm span (R(2) = 0.94). Our study demonstrates that arm span and ULC, ULR, or ULG can serve as accurate and reliable surrogate measures of recumbent length and height in healthy children; however, ULC, ULR, and ULG tend to slightly overestimate length and height in young infants and children. Further testing of ulnar length as a surrogate is warranted in physically impaired or nonambulatory children.
Aliarzadeh, Babak; Meaney, Christopher; Moineddin, Rahim; White, David; Birken, Catherine; Parkin, Patricia; Greiver, Michelle
Background: Uncertainty exists about the need to screen for hypertension in children and adolescents. Information on current screening and follow-up rates in Canadian community practices is not available. There are no Canadian guidelines on the subject. We sought to identify current rates of pediatric hypertension screening and follow-up in Canada. In addition, we examined patient and provider characteristics associated with rates of blood pressure screening. Methods: We used electronic medical record data extracted on Apr. 1, 2013, from 79 family practices in Toronto. We identified children seen at least twice between the ages of 3 and 18 years, with at least 6 months between first and last encounter. We used Multivariate Poisson regression analysis to analyze variation in blood pressure measurement rates and associations with patient and physician factors. Results: We identified 5996 children (62% of 9667 in total) who had at least 1 blood pressure measurement recorded. Of these children, 14% had at least 1 abnormal blood pressure measurement, and of those children, only 5% had a follow-up measurement recorded within 6 months. After adjustment, increases in rates of blood pressure measurements were associated with greater number of encounters (rate ratio [RR] = 1.03, 95% confidence interval [CI] 1.02-1.04, p < 0.001), older age at first encounter (RR = 1.06, 95% CI 1.03-1.10, p = 0.002), and female sex (RR = 1.12, 95% CI 1.03-1.20, p = 0.006). Obesity or a recorded family history of hypertension were not associated with more blood pressure measurements. Female physicians recorded more blood pressure measurements than did male physicians (RR = 1.41, 95% CI 1.04-1.89, p = 0.02). Interpretation: This screening measure was frequently done and appeared to be incompletely followed up. Clear guidance is needed; guideline developers should consider reviewing this topic. PMID:27398368
Neonatal and childhood neurodevelopmental, health and educational outcomes of children exposed to antidepressants and maternal depression during pregnancy: protocol for a retrospective population-based cohort study using linked administrative data
Singal, Deepa; Brownell, Marni; Chateau, Dan; Ruth, Chelsea; Katz, Laurence Y
Introduction Antidepressants are commonly prescribed during pregnancy; however, there are inconsistent data on the safety of these medications during the prenatal period. To address this gap, this study will investigate short-term and long-term neurodevelopmental, physical and mental health, and educational outcomes of children who have been exposed to selective serotonin reuptake inhibitors (SSRIs) or selective serotonin norepinephrine reuptake inhibitors (SNRIs) and/or maternal depression during pregnancy. Methods and analysis Administrative data will be linked to generate 4 population-based exposed groups from all children born in Manitoba between 1996 and 2014 whose mother had at least 2 prescriptions for either an SSRI or SNRI: (1) throughout the prenatal period (beginning of pregnancy until birth); (2) in the first trimester (≤14 weeks gestation); (3) in the second trimester (15–26 weeks gestation); (4) in the third trimester (≥27 weeks gestation) and 1 population-based unexposed group consisting of children whose mothers had a diagnosis of mood or anxiety disorder during pregnancy but did not use antidepressants. Propensity scores and inverse probability treatment weights will be used to adjust for confounding. Multivariate regression modelling will determine whether, compared with untreated mood/anxiety disorder, prenatal exposure to antidepressant medications is associated with: (1) adverse birth and neonatal outcomes, including: preterm birth, low birth weight, low Apgar scores, respiratory distress, congenital malformations and persistent pulmonary hypertension; (2) adverse early childhood outcomes, including: early childhood education challenges, diagnosis of neurodevelopmental disorders and diagnosis of mental disorders. We will determine if exposure effects differ between SSRIs and SRNIs, and determine if exposure effects differ between gestation timing of exposure to antidepressants. Ethics and dissemination Ethical approval was obtained
Incidence of pediatric invasive pneumococcal disease in the Island of Majorca (2008-2010), an area with non-universal vaccination, and estimations of serotype & children population coverage by available conjugate vaccines
Background The World Health Organization reported in 2007 that inclusion of PCV7 in national immunization programs should be seen as a priority, also encouraging countries to conduct appropriate surveillances for monitoring the impact of vaccination. These analyses should be conducted in specific geographical areas and should be aimed to evolution of invasive pneumococcal disease (IPD), by age groups, clinical presentation, and vaccine serotypes (and non-vaccine serotypes to detect possible replacement). This study aimed to monitor the evolution of IPD incidence in children <15 years requiring hospitalization in the Island of Majorca. Methods A prospective clinical surveillance of all culture and/or PCR-confirmed IPD in children <15 years was performed in all hospitals in the Island of Majorca (approximately 900,000 inhabitants) from January 2008 to December 2010. Incidence rate (IR) was calculated as cases/100000 inhabitants using children population data. Results 66 IPDs were identified: 39 (59.1%) parapneumonic pneumococcal empyema (PPE), 16 (24.2%) bacteremic pneumonia (BP), 7 (10.6%) primary bacteremia, 3 (4.5%) meningitis, and 1 (1.5%) osteomyelitis. IRs in the three-year study period were: 64.22 for children 12- < 24 months, 37.21 for those 24-59 months, 22.62 for those <12 months, and 3.98 for children >59 months. By study year, IRs were 21.25 in 2008, 19.89 in 2009 and 9.80 in 2010. The reduction found in 2010 was significant and due to significant reductions in IRs of IPDs caused by serotypes included in PCV10 and PCV13. Overall, estimated serotype coverage by conjugate vaccines was 12.1% for PCV7, 37.9% for PCV10 and 65.2% for PCV13. Of the 66 hospitalized children with IPD, 20 had received at least one dose of PCV7 (13 cases with identified serotype). None of these 13 cases was caused by PCV7 serotypes, all were caused by PCV13 serotypes and only 53.8% by PCV10 serotypes. Conclusions The results of the present study evidence the importance of
Cook, John T; Black, Maureen; Chilton, Mariana; Cutts, Diana; Ettinger de Cuba, Stephanie; Heeren, Timothy C; Rose-Jacobs, Ruth; Sandel, Megan; Casey, Patrick H; Coleman, Sharon; Weiss, Ingrid; Frank, Deborah A
This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with "marginal food security," as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children's fair/poor health and developmental risk and caregivers' depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers.
Advanced vertebral fracture among newly diagnosed children with acute lymphoblastic leukemia: results of the Canadian Steroid-Associated Osteoporosis in the Pediatric Population (STOPP) research program.
Halton, Jacqueline; Gaboury, Isabelle; Grant, Ronald; Alos, Nathalie; Cummings, Elizabeth A; Matzinger, Maryann; Shenouda, Nazih; Lentle, Brian; Abish, Sharon; Atkinson, Stephanie; Cairney, Elizabeth; Dix, David; Israels, Sara; Stephure, David; Wilson, Beverly; Hay, John; Moher, David; Rauch, Frank; Siminoski, Kerry; Ward, Leanne M
Vertebral compression is a serious complication of childhood acute lymphoblastic leukemia (ALL). The prevalence and pattern of vertebral fractures, as well as their relationship to BMD and other clinical indices, have not been systematically studied. We evaluated spine health in 186 newly diagnosed children (median age, 5.3 yr; 108 boys) with ALL (precursor B cell: N = 167; T cell: N = 19) who were enrolled in a national bone health research program. Patients were assessed within 30 days of diagnosis by lateral thoraco-lumbar spine radiograph, bone age (also used for metacarpal morphometry), and BMD. Vertebral morphometry was carried out by the Genant semiquantitative method. Twenty-nine patients (16%) had a total of 75 grade 1 or higher prevalent vertebral compression fractures (53 thoracic, 71%; 22 lumbar). Grade 1 fractures as the worst grade were present in 14 children (48%), 9 patients (31%) had grade 2 fractures, and 6 children (21%) had grade 3 fractures. The distribution of spine fracture was bimodal, with most occurring in the midthoracic and thoraco-lumbar regions. Children with grade 1 or higher vertebral compression had reduced lumbar spine (LS) areal BMD Z-scores compared with those without (mean +/- SD, -2.1 +/- 1.5 versus -1.1 +/- 1.2; p < 0.001). LS BMD Z-score, second metacarpal percent cortical area Z-score, and back pain were associated with increased odds for fracture. For every 1 SD reduction in LS BMD Z-score, the odds for fracture increased by 80% (95% CI: 10-193%); the presence of back pain had an OR of 4.7 (95% CI: 1.5-14.5). These results show that vertebral compression is an under-recognized complication of newly diagnosed ALL. Whether the fractures will resolve through bone growth during or after leukemia chemotherapy remains to be determined.
the ages of 0 - 4. Mothers were 73% of the respondents. The special needs of the children were primarily physical (70%) and learning disabilities (40...Physical disabilities included everything from cerebral palsy to orthopedic problems to cancer. Learning disabilities covered retardation to...emotional 50% - learning disabilities : 9. Ethnicity of 82% White child? 8% Black 5% Hispanic 5% other 10. Approx. annual 2% $15K or less Income categories
Pujol, Sophie; Levain, Jean-Pierre; Houot, Hélène; Petit, Rémy; Berthillier, Marc; Defrance, Jérôme; Lardies, Joseph; Masselot, Cyril; Mauny, Frédéric
Most of the studies investigating the effects of the external noise on children's school performance have concerned pupils in schools exposed to high levels due to aircraft or freeway traffic noise. However, little is known about the consequences of the chronic ambient noise exposure at a level commonly encountered in residential urban areas. This study aimed to assess the relationship between the school performance of 8- to 9-year-old-children living in an urban environment and their chronic ambient noise exposure at home and at school. The children's school performances on the national standardized assessment test in French and mathematics were compared with the environmental noise levels. Children's exposure to ambient noise was calculated in front of their bedrooms (Lden) and schools (LAeq,day) using noise prediction modeling. Questionnaires were distributed to the families to collect potential confounding factors. Among the 746 respondent children, 586 were included in multilevel analyses. On average, the LAeq,day at school was 51.5 dB (SD= 4.5 dB; range = 38-58 dB) and the outdoor Lden at home was 56.4 dB (SD= 4.4 dB; range = 44-69 dB). LAeq,day at school was associated with impaired mathematics score (p = 0.02) or impaired French score (p = 0.01). For a + 10 dB gap, the French and mathematics scores were on average lower by about 5.5 points. Lden at home was significantly associated with impaired French performance when considered alone (p < 10(-3)) and was borderline significant when the combined home-school exposure was considered (p = 0.06). The magnitude of the observed effect on school performance may appear modest, but should be considered in light of the number of people who are potentially chronically exposed to similar environmental noise levels.
Fajardo-Gutiérrez, Arturo; Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Palma-Padilla, Virginia; Carreón-Cruz, Rogelio; Ortega-Alvárez, Manuel Carlos; Mejía-Arangure, Juan Manuel
Background In 1996, Mexico started to register cases of childhood cancer. Here, we describe the incidence of cancer in children, residing in ten Mexican jurisdictions, who were treated by the Instituto Mexicano del Seguro Social (IMSS). Methods New cases of childhood cancer, which were registered prospectively in nine principal Medical Centers of IMSS during the periods 1998–2000 (five jurisdictions) and 1996–2002 (five jurisdictions), were analyzed. Personnel were specifically trained to register, capture, and encode information. For each of these jurisdictions, the frequency, average annual age-standardized incidence (AAS) and average annual incidence per period by sex and, age, were calculated (rates per 1,000,000 children/years). Results In total 2,615 new cases of cancer were registered, with the male/female ratio generally >1, but in some tumors there were more cases in females (retinoblastoma, germ cells tumors). The principal groups of neoplasms in seven jurisdictions were leukemias, central nervous system tumors (CNS tumors), and lymphomas, and the combined frequency for these three groups was 62.6 to 77.2%. Most frequently found (five jurisdictions) was the North American-European pattern (leukemias-CNS tumors-lymphomas). Eight jurisdictions had AAS within the range reported in the world literature. The highest incidence was found for children underless than five year of age. In eight jurisdictions, leukemia had high incidence (>50). The AAS of lymphomas was between 1.9 to 28.6. Chiapas and Guerrero had the highest AAS of CNS tumors (31.9 and 30.3, respectively). The frequency and incidence of neuroblastoma was low. Chiapas had the highest incidence of retinoblastoma (21.8). Germ-cell tumors had high incidence. Conclusion The North American-European pattern of cancers was the principal one found; the overall incidence was within the range reported worldwide. In general but particularly in two jurisdictions (Yucatán and Chiapas), it will be necessary
Background The primary aim of this study was to assess the effect of immigrant status on Emergency Room (ER) utilisation by children under age one, considering all, non-urgent, very urgent, and followed by hospitalisation visits. The second aim was to investigate the role played by mother’s educational level in the relationship between citizenship and ER utilisation. Methods The cohort study included all healthy singleton live births in the years 2008–2009 and residing in the province of Reggio Emilia, followed for the first year of life in order to study their ER visits. The outcomes were the ER utilisation rate for all, non-urgent, very urgent, and followed by hospitalisation visits. The main explanatory variable was mother’s citizenship. Other covariates were mother’s educational level, maternal age, parity, and child gender. Multivariate analyses (negative binomial regression and zero inflated when appropriate) were performed. Adjusted utilisation Rate Ratios (RR) and their 95% Confidence Intervals (95% CI) were calculated. Trend for age in months by citizenship is depicted. Results There were 3,191 children (36.4%) with at least one ER visit in the first year of life. Adjusted RR show a significantly greater risk of ER visit for immigrants than for Italians: (RR 1.51; 95% CI 1.39-1.63). Immigrants also had a higher risk of non-urgent visits (RR 1.72; 95% CI 1.48-2.00) and for visits followed by hospitalizations (RR 1.58; 95% CI 1.33-1.89). For very urgent visits, the immigrants had a slightly higher risk compared to Italians (RR 1.25; 95% CI 0.98-1.59). The risk of ER visits is higher in the first two months of life (RR1stvs 3rd-12th 2.08; 95% CI 1.93-2.24 and RR 2ndvs 3rd-12th 1.45; 95% CI 1.33-1.58, respectively). Considering all visits, the ER utilisation rate was inversely related with maternal education only for Italians (low educational level 44.0 and high educational level 73.9 for 100 children; p value for trend test < 0.001). Conclusions
Watkins, George A.
This study related population problem attitudes and socioeconomic variables. Six items concerned with number of children, birth control, family, science, economic depression, and overpopulation were selected for a Guttman scalogram. Education, occupation, and number of children were correlated with population problems scale scores; marital status,…
Students who understand the relationship between population growth and change and the quality of their life and the life of their children will be better able to make responsible decisions about their world. Discusses the addition of population education to the curriculum, the objectives of teachers and the government in teaching it, and how it…
CHILDREN AND HOME FIRES Fast Facts Children under the age of five are twice as likely to die in a home fire than the rest of the population, and child-playing fires are the leading cause of fire deaths among ...
Waldman, H. Barry; Perlman, Steven P.; Lederman, Cindy S.
Children and youth in foster care are a vulnerable population. They are at risk for abuse, neglect, and permanent separation from birth parents and have a greater incidence of emotional and behavioral difficulties. This is not surprising because these children are abused, neglected, or abandoned by the very people who are supposed to love and care…
Sheldon, George H.
This paper discusses some of the major concerns associated with the instructional process of our homeless children. The reader is provided with a brief overview of the prevalence of this population. According to the National Center on Family Homelessness the number of school children who are homeless is growing rapidly with 1.4 to 1.5 million…
Department of Health, Education, and Welfare, Washington, DC.
This book of charts of comparative statistics was compiled to help the 1970 White House Conference on Children evaluate past efforts to improve the well-being of America's children. First, it presents data about aspects of the world into which American children are born, such as population, urbanization, income levels, incidence of disease,…
Anton, S D; Han, H; Newton, R L; Martin, C K; York-Crowe, E; Stewart, T M; Williamson, D A
The primary aims of this study were to empirically test the factor structure of the Children's Eating Attitudes Test (ChEAT) through both exploratory and confirmatory factor analyses and to interpret the factor structure of the ChEAT within the context of a new scoring method. The ChEAT was administered to 728 children in the 2nd through 6th grades (from five schools) at two different time points. Exactly half the students were male and half were female. To the best of our knowledge, this is the first study to empirically test the merits of an alternative 6-point scoring system as compared to the traditionally used 4-point scoring system. With the new scoring procedure, the skewness for all factor scores decreased, which resulted in increased variance in the item scores, as well as the total ChEAT score. Since the internal consistency of two factors in a recently proposed model was not acceptable (<0.60), this model did not adequately fit our data. Thus, exploratory and confirmatory factor analyses were conducted. A 6-factor solution based on a 20-item version was found to best fit the data and have the best internal reliability. The six factors were labeled: 1) overconcern with body size, 2) dieting, 3) food preoccupation, 4) social pressure to gain weight, 5) vomiting, and 6) caloric awareness and control. The obtained factor solution had considerable overlap with the original factor analysis performed on the 26-item Eating Attitudes Test and with the factor structure of the ChEAT reported by previous investigations. Intercorrelations among the factors suggested three higher order constructs. These findings indicate that the ChEAT subscales may be sufficiently stable to allow use in non-clinical samples of children.
Danese, Elisa; Montagnana, Martina; Fava, Cristiano
Primary hypertension is a very common disorder particularly in the aging population but hypertensive disorders can appear earlier in life, especially when obesity and unhealthy lifestyle are present. Also pregnant women can be at risk of developing gestational hypertension and/or pre-eclampsia, which causes complications in nearly 7% of pregnancies. These "special" populations could be regarded as natural models suited to reveal mechanisms of hypertension development which are either common to other forms of hypertension, including primary hypertension or specific to these populations. Recent studies in the field of genetics of primary hypertension have used new powerful tools, such as genome-wide association studies (GWAS) and sequencing, but studies about hypertension during childhood and in pregnancy have seldom used high-throughput technologies and the knowledge in this field comes mostly from the candidate gene approach. In this review we summarize some interesting results from genetic studies conducted in childhood and adolescence and during pregnancy and underline the need to apply modern technologies in these potentially very fruitful populations.
Rouse, Heather L.; Fantuzzo, John W.; LeBoeuf, Whitney
This population-based study investigated the unique and cumulative relations between risks that are monitored by public surveillance systems and academic and behavioral outcomes for an entire cohort of third graders in a large, urban public school system. Using integrated, administrative records from child welfare, public health, housing, and…
Skuse, David H.; Mandy, William D.; Steer, Colin; Miller, Laura L.; Lawrence, Kate; Amond, Alan; Golding, Jean
Results from a Social and Communication Disorders Checklist finds that the scores were continuously distributed in the general population and that boys had mean scores 30 percent higher than girls. Above-average verbal IQ appears to protect female subjects from social communication impairments but not in male subjects. Participants to the study…
Lloyd, Jennifer E. V.; Irwin, Lori G.; Hertzman, Clyde
In British Columbia, Canada, two population-based databases have been linked at the level of the individual child: the "Early Development Instrument", a Kindergarten school readiness measure; and the "Foundation Skills Assessment", a Grade Four academic assessment. Utilising these linked data, we explored the early school…
Advanced Vertebral Fracture among Newly Diagnosed Children with Acute Lymphoblastic Leukemia: Results of the Canadian STeroid-associated Osteoporosis in the Pediatric Population (STOPP) Research Program
Halton, J.; Gaboury, I.; Grant, R.; Alos, N.; Cummings, E. A.; Matzinger, M.; Shenouda, N.; Lentle, B.; Abish, S.; Atkinson, S.; Cairney, E.; Dix, D.; Israels, S.; Stephure, D.; Wilson, B.; Hay, J.; Moher, D.; Rauch, F.; Siminoski, K.; Ward, L.M.
Vertebral compression is a serious complication of childhood acute lymphoblastic leukemia (ALL). The prevalence and pattern of vertebral fractures, as well as their relationship to bone mineral density (BMD) and other clinical indices, have not been systematically studied. We evaluated spine health in 186 newly diagnosed children (median age 5.3 years, 108 boys) with ALL (precursor B cell: N=167; T-cell: N=19), who were enrolled in a national bone health research program. Patients were assessed within 30 days of diagnosis by lateral thoraco-lumbar spine radiograph, bone age (also used for metacarpal morphometry) and BMD. Vertebral morphometry was carried out by the Genant semi-quantitative method. Twenty-nine patients (16%) had a total of 75 grade 1 or higher prevalent vertebral compression fractures (53 thoracic, 71%; 22 lumbar). Grade 1 fractures as the worst grade were present in 14 children (48%), 9 patients (31%) had grade 2 fractures, and 6 children (21%) had grade 3 fractures. The distribution of spine fracture was bi-modal, with most occurring in the mid-thoracic and thoraco-lumbar regions. Children with grade 1 or higher vertebral compression had reduced lumbar spine (LS) areal BMD Z-scores compared to those without (mean±SD, −2.1±1.5 vs. −1.1±1.2; P < 0.001). LS BMD Z-score, second metacarpal percent cortical area Z-score, and back pain were associated with increased odds for fracture. For every 1 SD reduction in LS BMD Z-score, the odds for fracture increased by 80% (95% CI 10% to 193%); the presence of back pain had an odds ratio of 4.7 (95% CI, 1.5 to 14.5). These results show that vertebral compression is an under-recognized complication of newly diagnosed ALL. Whether the fractures will resolve through bone growth during or after leukemia chemotherapy remains to be determined. PMID:19210218
Children's Defense Fund, Washington, DC.
This data book provides statistics on a range of indicators that measure critical aspects of children's lives in each of the 50 states and the District of Columbia. Statistics are provided in the following categories: (1) population and family characteristics (including number of children under age 18 and age 5, percentage of population under age…
Huang, R-C; Prescott, Susan L; Godfrey, Keith M; Davis, Elizabeth A
Pregnancy and birth cohorts have been utilised extensively to investigate the developmental origins of health and disease, particularly in relation to understanding the aetiology of obesity and related cardiometabolic disorders. Birth and pregnancy cohorts have been utilised extensively to investigate this area of research. The aim of the present review was twofold: first to outline the necessity of measuring cardiometabolic risk in children; and second to outline how it can be assessed. The major outcomes thought to have an important developmental component are CVD, insulin resistance and related metabolic outcomes. Conditions such as the metabolic syndrome, type 2 diabetes and CHD all tend to have peak prevalence in middle-aged and older individuals but assessments of cardiometabolic risk in childhood and adolescence are important to define early causal factors and characterise preventive measures. Typically, researchers investigating prospective cohort studies have relied on the thesis that cardiovascular risk factors, such as dyslipidaemia, hypertension and obesity, track from childhood into adult life. The present review summarises some of the evidence that these factors, when measured in childhood, may be of value in assessing the risk of adult cardiometabolic disease, and as such proceeds to describe some of the methods for assessing cardiometabolic risk in children.
Thors, Valtyr; Morales-Aza, Begonia; Pidwill, Grace; Vipond, Ian; Muir, Peter; Finn, Adam
Bacterial vaccines can reduce carriage rates. Colonization is usually a binary endpoint. Real time quantitative PCR (qPCR) can quantify bacterial DNA in mucosal samples over a wide range. Using culture and single-gene species-specific qPCRs for Streptococcus pneumoniae (lytA), Streptococcus pyogenes (ntpC), Moraxella catarrhalis (ompJ), Haemophilus influenzae (hdp) and Staphylococcus aureus (nuc) and standard curves against log-phase reference strain broth cultures we described frequency and peak density distributions of carriage in nasopharyngeal swabs from 161 healthy 2–4 y old children collected into STGG broth. In general, detection by qPCR and culture was consistent. Discordance mostly occurred at lower detection thresholds of both methods, although PCR assays for S. pyogenes and S. aureus were less sensitive. Density varied across 5-7 orders of magnitude for the 5 species with the abundant species skewed toward high values (modes: S. pneumoniae log3-4, M. catarrhalis & H. influenzae log4-5 CFU/ml broth). Wide ranges of bacterial DNA concentrations in healthy children carrying these bacteria could mean that different individuals at different times vary greatly in infectiousness. Understanding the host, microbial and environmental determinants of colonization density will permit more accurate prediction of vaccine effectiveness. PMID:26367344
Battal, F; Silan, F; Topaloğlu, N; Aylanç, H; Köksal Binnetoğlu, F; Tekin, M; Kaymaz, N; Ozdemir, O
Abstract The aim of the current study was to determine the frequency of the Mediterranean fever (MEFV) gene pathogenic variants in 60 children diagnosed with familial Mediterranean fever (FMF) and to compare the phenotype-genotype correlation. Genomic DNA was isolated by the spin-column method from peripheral blood samples (collected in vacutainers containing EDTA) and buccal smears. The MEFV gene profiles for the current FMF cohort were genotyped by pyrosequencing and direct Sanger sequencing techniques for the target pathogenic variants. The most prominent clinical symptoms were abdominal pain (53.4%), fever (23.4%) and arthritis (23.3%). Eighteen different pathogenic variants were identified and the most frequent were p.Met694Val (20.0%), p.Glu148Gln (13.3%), p.Met680 Ile (11.7%) and p.Arg202Gln (11.7%). Abdominal pain, fever and arthritis were the most common presenting clinical characteristics. Results showed that not only clinical characteristics, but also genotyping of the MEFV gene is needed to establish the correct diagnosis of FMF in children and other family members. PMID:28289585
Yokoya, Masana; Higuchi, Yukito
The School Health Examination Survey is a nationwide examination carried out annually in Japan, and the results are entered into a prefectural-level physical measurement database. We used this database to determine the geographical differences in a population-based cross-sectional growth curve and investigated the association between age at peak height velocity (PHV) and the prevalence rate of overweight in children among Japanese prefectures. Mean prefectural-level age at PHV was estimated by the cubic spline-fitting procedure using cross-sectional whole-year prefectural mean height data (5-17 years, 2006-2013), and 8-year (2006-2013) means of the standardized prevalence rates of overweight children and other anatomical data (8-year standardized weight and height) were recalculated. Mean prefectural age at PHV was more strongly correlated with the mean prefectural prevalence rate of overweight (age 5-8 years) than with other weights or heights in both sexes. On the basis of these findings and their confirmation by multiple regression analysis, the prevalence rate of overweight was selected as a primary factor to explain the geographical difference in age at PHV. These findings suggest that childhood overweight is a dominant factor responsible for the observed geographical differences in onset of puberty in Japan.
Allareddy, Veerajalandhar; Martinez-Schlurmann, Natalia; Rampa, Sankeerth; Nalliah, Romesh P; Lidsky, Karen B; Allareddy, Veerasathpurush; Rotta, Alexandre T
Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA, 67.3%). Frequently present CMC in patients included obstructive sleep apnea (OSA, 26.4%), chronic pulmonary disease (CPD, 14.6%), neurological disorders (ND, 6.7%), and obesity (4.8%). Majority of patients were discharged routinely (98%). Overall complication rate was 6.4% with common complications being postoperative pneumonia (2.3%), bacterial infections (1.4%), respiratory complications (1.3%), and hemorrhage (1.2%). All-cause mortality included a total of 60 patients. Patients in TH (odds ratio [OR] = 0.72, 95%CI = 0.62-0.85), LH (OR = 0.80, 95% CI = 0.69-0.93), and those who had the procedures during EA (OR = 0.64, 95% CI = 0.56-0.74) had significantly lower odds of complications compared with their counterparts. CMC such as anemia, CPD, coagulopathy, HT, ND, and fluid/electrolyte disorders were independent predictors of significantly higher complication risk (P < .05). In conclusion, hospitalized children who underwent tonsillectomy (w/woA) in large or teaching hospitals, or
Population pharmacokinetic (PK) approach is now often used to evaluate PK characteristics of a new compound during its clinical development. Recently, new legislation governing the development and authorization of medicines for use in children aged 0-17 years was introduced in the European Union. Among the strategies proposed in relation to clinical aspects, use of population PKs is stated. In this manuscript, comparison between standard PK and population PK methods will be briefly addressed to understand why the second is particularly adapted to perform PK studies in paediatrics. Then, specific patients' characteristics (covariates) in paediatrics will be presented. Examples of PK and PK-pharmacodynamic (PK-PD) studies will be finally given. The number of population PK studies published still exceeds largely those of PK-PD.
Baker, Jillian M; To, Teresa; Beyene, Joseph; Zagorski, Brandon; Greenberg, Mark L; Sung, Lillian
The objectives were to describe times to diagnosis and initiation of treatment in pediatric ALL in Ontario from 1997 to 2007, and to measure their impact on OS and EFS. In 1000 children, the median times to diagnosis and treatment were both 1 day (IQR = 1-2). Those who began treatment >3 days after diagnosis had inferior OS (AHR = 2.49; 95% CI = 1.40-4.43; p = 0.002), and inferior EFS (AHR = 1.73; 95% CI = 1.01-2.96; p = 0.047) compared to those who began treatment ≤ 3 days after diagnosis. There was no statistically significant relationship between time to diagnosis and survival. Longer time to treatment was associated with worse survival in pediatric ALL; reasons for this relationship may be multi-factorial.
Background There is a paucity of data on the national prevalence of diabetes and prediabetes among youth. The Saudi Abnormal Glucose Metabolism and Diabetes Impact Study (SAUDI-DM) was used to assess the prevalence of type 1 and type 2 diabetes as well as impaired fasting glucose (IFG) among children and adolescents. Methods Sociodemographic, anthropometric and clinical data were collected through a nationwide household randomly selected 23 523 children and adolescents aged ≤18 years. Known participants with diabetes were classified according to their diabetes type, while participants without diabetes were subjected to fasting plasma glucose assessment and patients with diabetes were identified using the American Diabetes Association (ADA) criteria. All the studied participants were tested for lipid parameters. Multivariate logistic regression analysis was used to assess different risk factors. Results The overall prevalence of diabetes was 10.84%, of which 0.45% were known type 1 and type 2 patients with diabetes and 10.39% were either newly identified cases of diabetes (4.27%) or IFG (6.12%) with more than 90% of the participants with diabetes being unaware of their disease. The prevalence of known type 1 and type 2 diabetes as well as the newly identified cases was higher than what has been reported internationally. Age, male gender, obesity, urban residency, high family income and presence of dyslipidaemia were found to be significant risk factors for diabetes and IFG. Conclusions Diabetes and IFG are highly prevalent in this society with the majority of the patients being unaware of their disease, which warrants urgent adoption of early detection, treatment and prevention programmes. PMID:26085648
Leaderer, Brian P; Belanger, Kathleen; Triche, Elizabeth; Holford, Theodore; Gold, Diane R; Kim, Young; Jankun, Thomas; Ren, Ping; McSharry Je, Jean-ellen; Platts-Mills, Thomas A E; Chapman, Martin D; Bracken, Michael B
Home exposures to aeroallergens are an important environmental factor in allergic sensitization and in the development and exacerbation of asthma. We assessed variations in home concentrations of dust mite, cockroach, cat, and dog allergens in dust collected in the main living areas of asthmatics' homes by family income, mother's education, dwelling type, population density, household population density, and ethnicity in Connecticut and south-central Massachusetts. Dust samples were collected at the time of home interview in 999 homes as part of an ongoing longitudinal birth cohort study of 1,002 infants and their asthmatic siblings. The analysis employed lower and upper cut points for group 1 dust mite (> or = 2.0 microg/g and > or = 10 microg/g), cockroach (> or = 1.0 U/g and > or = 4.0 U/g), cat (> or = 1.0 microg/g and > or = 8.0 ug/g), and dog (> or = 2.0 microg/g and > or = 10.0 microg/g) allergens. Subject residences were geocoded to assess population density from the U.S. Census, and multiple logistic regression was used to control for confounding. The portion of homes at the lower cut point for dust mite, cockroach, cat, and dog allergens were 46.9%, 24.9%, 42.2%, and 35.6%, respectively; the upper cut point for each of the allergens was reached in 22.4%, 13.4%, 21.0%, and 22.9% of the homes, respectively. In all, 86.0% of the homes had at least one allergen at the lower cut point, and 58.0% had at least one allergen at the upper cut point. Forty-nine percent of the homes had two or more allergens at the lower cut point, and 19.7% had two or more allergens at the upper cut point. Higher education of the mother, higher household income, living in a single-family home in a less densely populated area with fewer people per room, and being a white household were associated with elevated dust mite, cat, and dog allergens and low cockroach allergen. In contrast, low income, living in a multifamily home in a high population density area with a higher occupancy
Data on Maine's population of minority language children consists of three sections. The first contains summative data in tabular or graphic form on: the distribution of monolingual-English and bilingual children, including: children of limited English proficiency (LEP); distribution of languages spoken by school-aged children; current trends in…
Patel, Y T; Daryani, V M; Patel, P; Zhou, D; Fangusaro, J; Carlile, D J; Martin, P D; Aarons, L; Stewart, C F
Selumetinib (AZD6244, ARRY-142886), a mitogen activated protein kinases (MEK1 and 2) inhibitor, has been granted orphan drug designation for differentiated thyroid cancer. The primary aim of this analysis was to characterize the population pharmacokinetics of selumetinib and its active metabolite N-desmethyl-selumetinib in patients with cancer. Concentration-time data from adult and pediatric clinical trials were pooled to develop a population pharmacokinetic model using a sequential approach where selumetinib and N-desmethyl-selumetinib data were modeled separately. A sequential zero- and first-order absorption with lag time with a two-compartment model for selumetinib and a two-compartment model for N-desmethyl-selumetinib best described the concentration-time data. Intrapatient variability in absorption was higher than interpatient variability. The apparent drug clearance (CL/F) from the central compartment was 13.5 L/hr (RSE 4.9%). Significant covariates for CL/F were age, alanine aminotransferase, and body surface area. This study confirms that flat dosing is appropriate in adults, whereas body-surface area based dosing should be used in pediatric patients.
Bianchi, Fiorella; Cucunubá, Zulma; Guhl, Felipe; González, Nadia Lorena; Freilij, Hector; Nicholls, Rubén Santiago; Ramírez, Juan David; Montilla, Marleny; Flórez, Astrid Carolina; Rosas, Fernando; Saavedra, Victor; Silva, Nubia
Background Chagas disease is an anthropozoonosis caused by Trypanosoma cruzi. Two drugs are currently used for the etiological treatment of the disease: Nifurtimox (Lampit) and Benznidazole. This study presents a quasi-experimental trial (non-control group) of sixty-two patients who were treated for Chagas disease with Nifurtimox (Lampit), and were then followed for 30 months post-treatment. The safety of Nifurtimox (Lampit) for Chagas disease in this group of children primarily between 4 and 19 years old was also evaluated. Materials and methods The 62 patients included in the study were selected when resulted seropositive for two out of three fundamentally different serological tests. All children were treated during two months according to protocols established by WHO. Monitoring was performed every twenty days to evaluate treatment safety. In 43 patients, two different serological tests: ELISA and IFAT; and two parasitological tests: blood culture, and real time PCR, (qPCR) were performed to assess therapeutic response, defined as post-treatment serological negativization. Principal findings All patients completed the treatment successfully, and six patients abandoned the post-treatment follow-up. Adverse effects occurred in 74% of patients, but only 4.8% of cases required temporary suspension to achieve 100% adherence to the 60-day treatment, and all symptoms reverted after treatment completion. Both parasite load (measured through qPCR) and antibodies (ELISA absorbance) evidenced a significant median reduction 6 months after treatment from 6.2 to 0.2 parasite equivalents/mL, and from 0.6 to 0.2 absorbance units respectively (p<0.001). Serological negativization by ELISA was evident since 6 months post-treatment, whereas by IFAT only after 18 months. Serological negativization by the two tests (ELISA and IFAT) was 41.9% (95%CI: 26.5–57.3) after 30 months post-treatment. qPCR was positive in 88.3% of patients pre-treatment and only in 12.1% of patients after
A community engagement process identifies environmental priorities to prevent early childhood obesity: the Children's Healthy Living (CHL) program for remote underserved populations in the US Affiliated Pacific Islands, Hawaii and Alaska.
Fialkowski, Marie Kainoa; DeBaryshe, Barbara; Bersamin, Andrea; Nigg, Claudio; Leon Guerrero, Rachael; Rojas, Gena; Areta, Aufa'i Apulu Ropeti; Vargo, Agnes; Belyeu-Camacho, Tayna; Castro, Rose; Luick, Bret; Novotny, Rachel
Underserved minority populations in the US Affiliated Pacific Islands (USAPI), Hawaii, and Alaska display disproportionate rates of childhood obesity. The region's unique circumstance should be taken into account when designing obesity prevention interventions. The purpose of this paper is to (a), describe the community engagement process (CEP) used by the Children's Healthy Living (CHL) Program for remote underserved minority populations in the USAPI, Hawaii, and Alaska (b) report community-identified priorities for an environmental intervention addressing early childhood (ages 2-8 years) obesity, and (c) share lessons learned in the CEP. Four communities in each of five CHL jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Hawai'i) were selected to participate in the community-randomized matched-pair trial. Over 900 community members including parents, teachers, and community leaders participated in the CEP over a 14 month period. The CEP was used to identify environmental intervention priorities to address six behavioral outcomes: increasing fruit/vegetable consumption, water intake, physical activity and sleep; and decreasing screen time and intake of sugar sweetened beverages. Community members were engaged through Local Advisory Committees, key informant interviews and participatory community meetings. Community-identified priorities centered on policy development; role modeling; enhancing access to healthy food, clean water, and physical activity venues; and healthy living education. Through the CEP, CHL identified culturally appropriate priorities for intervention that were also consistent with the literature on effective obesity prevention practices. Results of the CEP will guide the CHL intervention design and implementation. The CHL CEP may serve as a model for other underserved minority island populations.
Sherris, Jacqueline D.; Quillin, Wayne F.
An overview of and rationale for population education for elementary and secondary schools are given beginning with a definition of population education as an effort to teach children about basic population issues and to encourage them to have smaller families. Various aspects and concerns related to the selection and implementation of population…
In a summer program for school-agers 6 to 12 years old, the children devise a meaningful, real-life experience to alleviate the midsummer doldrums and hope to "make the world a better place." They collect, repair, and paint old children's bicycles to present, along with new helmets, to children at a nearby homeless shelter. In this article, the…
Scientists use sampling to get an estimate of things they cannot easily count. A population is made up of all the organisms of one species living together in one place at the same time. All of the people living together in one town are considered a population. All of the grasshoppers living in a field are a population. Scientists keep track of the…
Activities and concerns of Ford Foundation supported population research and training centers are described in this report. The centers are concerned with population growth, consequences of growth for human welfare, forces that determine family planning, interrelations among population variables, economics of contraceptive distribution, and…
National Inst. of Child Health and Human Development (NIH), Bethesda, MD.
The scope of population research as carried on by the National Institute of Child Health and Human Development (NICHD) is set forth in this booklet. Population problems of the world, United States, and the individual are considered along with international population policies based on voluntary family planning programs. NICHD goals for biological…
Hoppu, Kalle; Sri Ranganathan, Shalini
Millions of children die every year before they reach the age of 5 years, of conditions largely treatable with existing medicines. The WHO Model List of Essential Medicines was launched in 1977 to make the most necessary drugs available to populations whose basic health needs could not be met by the existing supply system. During the first 30 years of the Model List of Essential Medicines, children's needs were not systematically considered. After adoption of the 'Better medicines for children' resolution by the World Health Assembly, things changed. The first WHO Model List of Essential Medicines for Children was drawn up by a Paediatric Expert Subcommittee and adopted in October 2007. The most recent, 4th Model List of Essential Medicines for Children was adopted in 2013. Data from country surveys show that access to essential medicines for children is still generally poor; much more work is needed.
Morales-Espinosa, Rosario; Delgado, Gabriela; Espinosa, Luis F.; Isselo, Dassaev; Méndez, José L.; Rodriguez, Cristina; Miranda, Guadalupe; Cravioto, Alejandro
Pseudomonas aeruginosa is an opportunistic pathogen and is associated with nosocomial infections. Its ability to thrive in a broad range of environments is due to a large and diverse genome of which its accessory genome is part. The objective of this study was to characterize P. aeruginosa strains isolated from children who developed bacteremia, using pulse-field gel electrophoresis, and in terms of its genomic islands, virulence genes, multilocus sequence type, and antimicrobial susceptibility. Our results showed that P. aeruginosa strains presented the seven virulence genes: toxA, lasB, lecA, algR, plcH, phzA1, and toxR, a type IV pilin alleles (TFP) group I or II. Additionally, we detected a novel pilin and accessory gene, expanding the number of TFP alleles to group VI. All strains presented the PAPI-2 Island and the majority were exoU+ and exoS+ genotype. Ten percent of the strains were multi-drug resistant phenotype, 18% extensively drug-resistant, 68% moderately resistant and only 3% were susceptible to all the antimicrobial tested. The most prevalent acquired β-Lactamase was KPC. We identified a group of ST309 strains, as a potential high risk clone. Our finding also showed that the strains isolated from patients with bacteremia have important virulence factors involved in colonization and dissemination as: a TFP group I or II; the presence of the exoU gene within the PAPI-2 island and the presence of the exoS gene. PMID:28298909
Morales-Espinosa, Rosario; Delgado, Gabriela; Espinosa, Luis F; Isselo, Dassaev; Méndez, José L; Rodriguez, Cristina; Miranda, Guadalupe; Cravioto, Alejandro
Pseudomonas aeruginosa is an opportunistic pathogen and is associated with nosocomial infections. Its ability to thrive in a broad range of environments is due to a large and diverse genome of which its accessory genome is part. The objective of this study was to characterize P. aeruginosa strains isolated from children who developed bacteremia, using pulse-field gel electrophoresis, and in terms of its genomic islands, virulence genes, multilocus sequence type, and antimicrobial susceptibility. Our results showed that P. aeruginosa strains presented the seven virulence genes: toxA, lasB, lecA, algR, plcH, phzA1, and toxR, a type IV pilin alleles (TFP) group I or II. Additionally, we detected a novel pilin and accessory gene, expanding the number of TFP alleles to group VI. All strains presented the PAPI-2 Island and the majority were exoU+ and exoS+ genotype. Ten percent of the strains were multi-drug resistant phenotype, 18% extensively drug-resistant, 68% moderately resistant and only 3% were susceptible to all the antimicrobial tested. The most prevalent acquired β-Lactamase was KPC. We identified a group of ST309 strains, as a potential high risk clone. Our finding also showed that the strains isolated from patients with bacteremia have important virulence factors involved in colonization and dissemination as: a TFP group I or II; the presence of the exoU gene within the PAPI-2 island and the presence of the exoS gene.
Brown, L; Mitchell, J
This article is a reprint of the Worldwatch Institute's "State of the World Report," Chapter 10: "Building a New Economy." 16 countries reached zero population growth by 1997. 33 countries have stabilized population, which amounts to 14% of world population. It is estimated that by 2050 population will include an additional 3.6 billion people beyond the present 6 billion. About 60% of the added population will be in Asia, an increase from 3.4 billion in 1995 to 5.4 billion in 2050. China's current population of 1.2 billion will reach 1.5 billion. India's population is expected to rapidly rise from 930 million to 1.53 billion. Populations in the Middle East and North Africa are expected to double in size. Sub-Saharan population is expected to triple in size. By 2050, Nigeria will have 339 million people, which was the entire population of Africa in 1960. There is a great need to stabilize population in a number of currently unstabilized countries. In 1971, Bangladesh and Pakistan had the same population; however, by 2050, Pakistan, without a strong commitment to reducing population growth, will have 70 million more people than Bangladesh. Population stabilization will depend on removal of physical and social barriers that prevent women from using family planning services and thereby help them control their own unwanted fertility. Stabilization will require poverty alleviation and removal of the need for large families. Family size is reduced with lower infant and child mortality risk, increased education, a higher legal age of marriage, and investment in stabilization programs. Solutions to global population growth cannot wait for health reform and budget deficit reductions.
Inflammatory bowel disease in children - Crohn disease; IBD in children - Crohn disease; Regional enteritis - children; Ileitis - children; Granulomatous ileocolitis - children; Colitis in children; CD - children
The global population passed 5 billion in 1987. In the year 2000 the world's population will be more than 6 billion, increasing by 90-100 million each year. About 95% of future demographic growth will take place in developing countries. The number of school age children is projected to increase from 940 million in 1980 to 1280 million by the year 2000. Under current labor force growth projections in developing countries, around 1.6 billion new jobs will have to be created between 1980 and 2025, with nearly 1 billion of them in Asia. Population often increases at a more rapid rate than agricultural growth. Food production per capita has declined in 70 developing countries. Much of the projected population increase will take place in environmentally fragile regions of the developing world. Population pressures contribute to deforestation, desertification, and scarcity of clean water. The United Nations Population Fund has estimated that in Asia over 43% of women not using family planning would like to postpone, space, or limit their childbearing. Over half of the world's couples of reproductive age are now using contraception. Family planning to postpone the first birth and to eliminate late child bearing would reduce both child loss and maternal illness and death. Both infant and maternal mortality are greater with higher order births. Reducing average family size is an effective way of reducing infant and maternal mortality. The World Bank has given high priority to population assistance, with large programs in Bangladesh, Egypt, India, Indonesia, the Philippines, and Thailand. Population assistance provided by the Australian International Development Assistance Bureau totaled about $4.5 million during 1989-90 and is expected to be about $8 million during 1991-92. Australia should increase the proportion of its development assistance budget devoted to population, and family planning programs should increase to around $26 million in line with other major donors.
Shulman, Rayzel; Stukel, Therese A; Miller, Fiona A; Newman, Alice; Daneman, Denis; Wasserman, Jonathan D; Guttmann, Astrid
Objective To describe adverse events in pediatric insulin pump users since universal funding in Ontario and to explore the role of socioeconomic status and 24-hour support. Research design and methods Population-based cohort study of youth (<19 years) with type 1 diabetes (n=3193) under a universal access program in Ontario, Canada, from 2006 to 2013. We linked 2012 survey data from 33 pediatric diabetes centers to health administrative databases. The relationship between patient and center-level characteristics and time to first diabetic ketoacidosis (DKA) admission or death was tested using a Cox proportional hazards model and the rate of diabetes-related emergency department visits and hospitalizations with a Poisson model, both using generalized estimating equations. Results The rate of DKA was 5.28/100 person-years and mortality 0.033/100 person-years. Compared with the least deprived quintile, the risk of DKA or death for those in the most deprived quintile was significantly higher (HR 1.58, 95% CI 1.05 to 2.38) as was the rate of diabetes-related acute care use (RR 1.60, 95% CI 1.27 to 2.00). 24-hour support was not associated with these outcomes. Higher glycated hemoglobin, prior DKA, older age, and higher nursing patient load were associated with a higher risk of DKA or death. Conclusions The safety profile of pump therapy in the context of universal funding is similar to other jurisdictions and unrelated to 24-hour support. Several factors including higher deprivation were associated with an increased risk of adverse events and could be used to inform the design of interventions aimed at preventing poor outcomes in high-risk individuals. PMID:27547416
WHO defines Essential medicines as those that satisfy the priority health-care needs of the population (1). The right to Essential medicines has been considered an important component of the right to health. In the name of equity children should also have access to appropriate, available, affordable, and quality essential medicines they need, but children's essential medicines are too often missing. This article is protected by copyright. All rights reserved.
Smith, Martin H.
Describes an educational game called "Population Blocks" that is designed to illustrate the concept of exponential growth of the human population and some potential effects of overpopulation. The game material consists of wooden blocks; 18 blocks are painted green (representing land), 7 are painted blue (representing water); and the remaining…
The relationship between world hunger and world population is explored in this document for high school global education classes. Reasons for the high birth rates in developing nations are suggested, e.g., a poor family has many children because children are an inexpensive work force, provide extra income, and care for parents in old age. The…
... prevent an unwanted pregnancy. When Children Have Children, “Facts for Families,” No. 31 (5/12) If pregnancy occurs, teenagers and their families deserve honest and sensitive counseling about options available to them, from abortion to adoption. Special support systems, including consultation with ...
A population geographer cannot depend on the standard population profile because it does not reflect spatial distribution of the desired characteristics. A more revealing approach is the modified box-and- whisker plot with the vertical lines of the box placed at the 1st and 3rd quartiles and the whiskers defining the variance. The geography of the age-sex structure variability in Thailand was examined using this method and by mapping and classifying all the age-sex structures. Classification of these structures includes comparing adjacent age-sex group differences, determining population profiles at each significance level, and spatially portraying each population structure. If the profile includes a 10th or more of the districts, it is called a uniform population profile. One should not generalize over a wide grouping of data because data is not normally regular. Geographical mapping given a usable description of the findings only when appropriate subdivisions of the data are utilized.
The policy of apartheid, until recently one of the dominant aspects of South African society, has caused grievous harm to that nation's non-white population, especially black women and children. Most black children have not grown up in stable, two-parent families due to migrant labor policies and low wages. Housing, health care, nutrition, and…
Andrejack, Kate, Comp.; Judge, Amy, Comp.; Simons, Janet, Comp.
This data book provides statistics on a range of indicators that measure critical aspects of children's lives in each of the 50 states and the District of Columbia. Statistics are provided in the following categories: (1) national rankings in population and family characteristics; (2) health and disabilities (including children lacking health…
Children constitute nearly 40% of India's population, a significant portion of whom suffer mental ailments. Ways to sensitize those who work with children to various aspects associated with child mental health are explored in this book. The focus is not on mental handicap but on the internal or external distress which warps the psychosocial…
In late October, 1993, 43 national scientific academies convened for 4 days in Delhi, India. This was the first time that so many academies had come together to discuss a topic of common interest: the controversial issue of population in conjunction with environment and development. The New Delhi gathering, known as the Population Summit, came up with a Conference Statement that earned the signatures of almost all participants. The statement proclaimed that ultimate success in dealing with global social, economic, and environmental problems cannot be achieved without stable world population. The goal should be zero population growth within the lifetime of our children. This goal will require prodigious planning efforts. If all couples were to decide right now that they would produce no more than 2 children, the world's population would still keep on growing through demographic momentum for another several decades. The source in shortest supply is probably not money but time. Said the Royal Society and the US National Academy of Sciences in 1993, "If current predictions of population growth prove accurate and patterns of human activity on the planet remain unchanged, science and technology may not be able to prevent irreversible degradation of the natural environment and continued poverty for much of the world ... Some of the environmental changes may produce irreversible damage to the Earth's capacity to sustain life. The future of our planet is in the balance." The Delhi statement was backed by 25 professional papers on subjects such as population history, energy, and water.
Africa has the highest population growth rate in the world (3%). It has 650 million people (about 900 million in 2000). Rapid population growth has serious consequences which, if not addressed, will be disastrous. This worrisome situation has led some governments to adopt demographic policies to slow down population growth. The UN Economic, Scientific and Cultural Organization (UNESCO) recommends that schools provide population education. Various population conferences have popularized population education in schools among African countries. UNESCO began its regional program on population education in Africa in 1969. National family life and population education (FL/PE) projects have increased from 4 in 1970 to 32 in 1990 (17 in French- and Portuguese-speaking Africa and 5 in English-speaking Africa). These projects teach students about the links between demographic problems and socioeconomic factors and contemporary culture. They aim for total development of the individual and improvement of the quality of life for the individual, family, and community. Topics covered in FL/PE are birth rate; fertility; health; and maternal, infant, and child mortality; unwanted pregnancy; illegal abortion; sexually transmitted diseases; rural-urban migration; and urbanization. Benin introduced FL/PE at all levels of its education system while Senegal, Guinea, Mauritania, and Zaire introduced it to only the primary and secondary school levels. Some countries teach FL/PE as one discipline while most countries (e.g., Senegal) have integrated it into other disciplines (e.g., geography). FL/PE should begin in primary schools because they have the most students and prepare students for middle schools, which provide FL/PE. Elementary education in Senegal is being overhauled to introduce current major problems bit by bit. Senegal also wants to incorporate FL/PE into literacy and adult education programs. Integration of FL/PE into other disciplines should be encouraged.
Accelerated urban growth is one of the main impediments to rapid development in Latin America. Birth rates are closely tied to development, and improved living standards in urban areas induce migration to cities. The Brazilian urban population exceeded 70% of the total population in 1980, while rural population declined. During the period of 1950-70 high demographic growth occurred as a result of high fertility and the drop of mortality. From the 1970s fertility declined from the under 20 years of age, a fact that will sustain high fertility for sometime. Education exerted an impact on fertility: in 1980 illiterate women averaged 6 children vs. 2.6 children for women with 8 years of education and 2.2 children for those with 12 years. Migration was another major factor: in 1950 the urban population of Latin America amounted to 40 million, and it reached 142 million in 1974. Every year about 8.7 million people are added to the urban population. In 1950 those who resided in an urban area made up 9.2%, in 1975 they increased to 22%, but all urban residents amount to about 40% of the total population. This urbanization has also produced major income differentials. In Argentina 20% of the poorest people get 4.5% of total income, while 10% of the richest get 35%. In Brazil 20% of the poorest receive 2% of income, while 10% of the richest get 50.5% of total income. Unfortunately, the Brazilian model is more typical of Latin America. It is a fundamental premise that balanced population growth and economic development go hand in hand, and the improvement of living standards is essential for the reduction of exponential population growth.
Across Europe children's nurses today face many challenges, including rising childhood obesity, the soaring incidence of issues with the mental health of children and young people, the effects of social media, child maltreatment and the impact of poverty, war and conflict on children and families. There are opportunities for children's nurses to undertake new roles and to influence both policy and practice to improve the health outcomes of children and young people, and thereby the future health of the population.
Rogers, John G.; And Others
IQ studies on 68 children (5 months-15 years) with skeletal dysplasia (dwarfism) were reviewed to provide counseling to parents of newborn affected children. Results of the study show that this population performs intellectually in the same range as other children. Journal availability: see EC 115 198. (PHR)
Wilson, Allison B.; Squires, Jane
The increasing prevalence of homelessness among young children and families in the United States is described, as is the developmental impact on young children and cost to society. Although services are mandated for this population under the McKinney-Vento Act, Education of Homeless Children and Youth Program, and the Individuals With…
Duffey, Jane G.
A survey of 121 families who were home schooling children with special needs found family profiles were similar to the general home schooling population and, unlike the general home schooling population, children often spent as much time in a school setting as in a home school environment. Four case studies identified themes as needs-based…
Despite efforts to reduce population growth, the World Bank projects a world population of 10 billion by 2050, with 7 billion living in developing countries. From October 1979 to September 1984, the US Agency for International Development (AID) funded the Research Triangle Institute's (RTI) Integrated Population and Development Planning (IPDP) project to assess rapid population growth effects in 25 developing countries. In October 1984, US AID extended funding for the program, nicknamed INPLAN, for 3 years, at a cost of $6.3 million. Up to 50% of people in developing countries are under age 15, a fact that guarantees large population increases for the next 50-75 years. Also, many regions have been slow to correlate high fertility with socioeconomic development, and in some areas, fertility is actually increasing. INPLAN aims to make governments more aware of population dynamics and to provide training and tools for effective development planning. 40% of INPLAN's work will be done in Africa, 25% in Latin America, and 20% in Asia, with some activity in the Near East. One project in Egypt, involving the use of model generation by microcomputer, was developed by RTI to show rural to urban migration and rapid population growth affects on the educational system. INPLAN expects to develop several other planning sector models on labor force and employment, health and family planning, food supply, housing, and urban development, and apply them to 20-25 countries. Another project provided 9 microcomputer systems and training to Nigerian government agencies. IMPLAN will purchase and distribute 60 such systems in the future.
Tolbert, Jaszianne; Carpenter, Shannon L
Compared to adults, venous thromboembolism in the pediatric population is a rare event. Cancer, cardiac disease, antiphospholipid antibodies, and indwelling catheters are established risk factors for thromboembolism in children. We examined the literature related to thrombophilia in children, childhood cancer and thrombosis, cardiac disease and thrombosis, and antiphospholipid antibody syndrome in children. Citations in identified articles yielded additional articles for review. We found that studies of acquired thrombophilia in children are limited. Current treatment for thromboembolism in children is based on adult data therefore optimal treatment in this population remains unclear.
Lamerz, Andreas; Kuepper-Nybelen, Jutta; Bruning, Nicole; Wehle, Christine; Trost-Brinkhues, Gabriele; Brenner, Hermann; Hebebrand, Johannes; Herpertz-Dahlmann, Beate
Background: To assess the prevalence of obesity, obesity-related binge eating, non-obesity-related binge eating, and night eating in five- to six-year-old children and to examine the impact of parental eating disturbances. Methods: When 2020 children attended their obligatory health exam prior to school entry in the city of Aachen, Germany, 1979…
Prevalence of Methylphenidate Prescription among School-Aged Children in a Swiss Population: Increase in the Number of Prescriptions in the Swiss Canton of Vaud, from 2002 to 2005, and Changes in Patient Demographics
Gumy, Cedric; Huissoud, Therese; Dubois-Arber, Francoise
Objective: Methylphenidate is prescribed for children and adolescents to treat ADHD. As in many Western countries, the increase in methylphenidate consumption is a public concern in Switzerland. The article discusses the authors' assessment of prescription prevalence in 2002 and 2005 for school-aged children in the canton of Vaud. Method: Pharmacy…
Australia's position on international population issues is consistent with the major international statements on population: the World Population Plan of Action (1974), the Mexico City Declaration (1984), and the Amsterdam Declaration (1989). Australia's policy emphasizes the importance of population policies as an integral part of social, economic, and cultural development aimed at improving the quality of life of the people. Factors that would promote smaller families include improving economic opportunities, old-age security, education and health (particularly for women), as well as improving the accessibility and quality of family planning services. The quality of care approach is directly complementary to the Australian International Development Assistance Bureau (AIDAB)'s Women-In-Development Policy and its Health Policy, which stresses the theme of Women And Their Children's Health (WATCH). Australia's support for population programs and activities has increased considerably over the last few years. Total assistance for the year 1990/91 was around $7 million out of a total aid program of $1216 million. In recent years AIDAB has funded family planning activities or health projects with family planning components in a number of countries in the Asia-Pacific region. In the South Pacific region AIDAB has funded a reproductive health video project taking into consideration the cultural sensitivities and customs of the peoples of the region. AIDAB has supported a UN Population Fund project in Thailand that aims to strengthen the capacity of the National Statistical Office to collect population data. The US currently accounts for around 40% of all population-related development assistance to improve the health of women and children through family planning. The other major donors are Japan, the Scandinavian countries, and the Netherlands. Funding for population has been a relatively low percentage of overall development assistance budgets in OECD countries. In the
Kandyil, Roshni M; Davis, Carla M
Food allergies affect approximately 3.5-4.0% of the world's population and can range from a mere inconvenience to a life-threatening condition. Over 90% of food allergies in childhood are caused by eight foods: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish, and shellfish. Shellfish allergy is known to be common and persistent in adults, and is an important cause of food induced anaphylaxis around the world for both children and adults. Most shellfish-allergic children have sensitivity to dust mite and cockroach allergens. Diagnostic cut-off levels for skin prick testing in children with shrimp allergy exist but there are no diagnostic serum-specific immunoglobulin E (IgE) values. All patients with symptoms of IgE-mediated reactions to shellfish should receive epinephrine autoinjectors, even if the initial symptoms are mild. In this study, we review three cases of clinical presentations of shellfish allergy in children.
Imms, Christine; Reilly, Sheena; Carlin, John; Dodd, Karen
The aim of this study was to investigate the participation of children with cerebral palsy (CP) in activities outside school and to compare their participation with a large representative sample of children. A population-based survey was conducted of children with CP born in Victoria, Australia in 1994 and 1995. Of 219 living children identified,…
Guarnaccia, Vincent J.; Vane, Julia R.
The three wishes of group-tested children, individually tested problem children, and individually tested nonproblem children were collected and categorized. Overall, there was considerable similarity in the types of wishes made by children across groups. It was concluded that wishes alone are not a good indicator of psychopathology. (Author)
Chavis, Kanawha Z.
For educational delivery systems to meet the needs of special rural populations of minority children, teaching and learning strategies must take into account the three factors of human identity, culture, and ruralness itself. Children who are members of special populations often have an even greater need than most children for recognition,…
This paper focuses on the impact of population aging in China, the most densely populated country in the world. Statistics indicate that by the end of 1998, 83.75 million out of the 1.248 billion Chinese people will be over 65 years old. According to the UN standards, China will soon become an aging society. The aging population poses several challenges to the country with the greatest challenge being the increasing social responsibility to care for the aged. With the undeveloped legislative framework to protect the interests of the aged and the serious drawbacks in the pension system to cater only to the income part and not the service part of the aged, China is not yet ready for the advent of aging. Violation of the rights of senior citizens is still very rampant despite enactment of the law on Protection of the Rights of the Elderly in 1996. Moreover, China is not economically ready to become an aging society. China faces this challenge by adopting a three-pronged approach to solve the problem namely: family support, establishment of nursing homes, and creating a social security framework that addresses the needs of the society suited to the Chinese condition. It is believed that with the growing economy of the country and the rising income of its people, a comprehensive social security net will be created to take care of the aged.
The United Nations High Commission for Refugees (UNHCR) recently reported that Kampuchea has an estimated population of 6 million. The count was made to determine future United Nations aid to Kampuchea. The count, made by administrators in Kampuchea's 19 provinces, reached a total of 6.4 million versus the 5.75 million estimated by the central government in Phnom Penh. The population estimate made by the Kampuchea provincial administrators surprised observers of the country, including UN representatives, in view of the country's decade of experience with war and destruction, which took a heavy toll on the population; the fatalities in the Vietnamese invasion of 1979, and the ensuing famine of that year. The 1979 vital statistics of Kampuchea are presented in Table 1. Kampuchean refugees at the Thai border camps were reported to be reluctant to go back to their country in spite of reports of good foodgrain harvests and improved prospects for living. The refugees' main concern was their fear and hate of both the Vietnamese troops and the Khmer Rouge.
Jiang, Yang; Ekono, Mercedes; Skinner, Curtis
Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Young children under age 6 years appear to be particularly vulnerable, with 48 percent living in…
Jiang, Yang; Ekono, Mercedes; Skinner, Curtis
Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Our very youngest children--infants and toddlers under age 3 years--appear to be particularly…
Jiang, Yang; Ekono, Mercedes; Skinner, Curtis
Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Among our oldest children--adolescents age 12 through 17 years--41 percent live in low-income…
Jiang, Yang; Ekono, Mercedes; Skinner, Curtis
Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Similarly, among children in middle childhood (age 6 through 11 years), 45 percent live in…
Volkert, Valerie M.; Vaz, Petula C. M.
This paper reviews recent studies on behavioral interventions for children with autism and feeding problems. The applicability of interventions that have been tested with other populations of children with feeding problems is discussed, as well as directions for future research.
Knitzer, Jane; And Others
This book is the seventh Children's Defense Fund report on major problems facing American children at risk of placement or already placed out of their homes. The findings are based on a survey of child welfare and probation offices in a stratified random sample of 140 counties (27 with populations over 300,000, and 113 with populations under…
Núñez-Enríquez, J C; Fajardo-Gutiérrez, A; Buchán-Durán, E P; Bernáldez-Ríos, R; Medina-Sansón, A; Jiménez-Hernández, E; Amador-Sanchez, R; Peñaloza-Gonzalez, J G; Paredes-Aguilera, R; Alvarez-Rodriguez, F J; Bolea-Murga, V; de Diego Flores-Chapa, J; Flores-Lujano, J; Bekker-Mendez, V C; Rivera-Luna, R; del Carmen Rodriguez-Zepeda, M; Rangel-López, A; Dorantes-Acosta, E M; Núñez-Villegas, N; Velazquez-Aviña, M M; Torres-Nava, J R; Reyes-Zepeda, N C; Cárdenas-Cardos, R; Flores-Villegas, L V; Martinez-Avalos, A; Salamanca-Gómez, F; Gorodezky, C; Arellano-Galindo, J; Mejía-Aranguré, J M
Background: Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). Methods: A case–control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. Results: Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47–11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20–0.91). Conclusion: Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS. PMID:23695017
Doucette-Dudman, Deborah; LaCure, Jeffrey R.
There are 3.2 million children in the United States living with their grandparents or other kin, a 40 percent increase since 1980. This exploding sociological trend with far-reaching implications for our future spans every segment of our society--rich and poor, black and white, Asian and Hispanic, urban and suburban. Based on interviews with…
A population study of 5 to 15 year olds: full time maternal employment not associated with high BMI. The importance of screen-based activity, reading for pleasure and sleep duration in children's BMI.
Taylor, Anne W; Winefield, Helen; Kettler, Lisa; Roberts, Rachel; Gill, Tiffany K
To describe the relationship between maternal full time employment and health-related and demographic variables associated with children aged 5-15 years, and the factors associated with child overweight/obesity. Data from a chronic disease and risk factor surveillance system were limited to children aged 5-15 years whose mothers responded on their behalf (n = 641). Univariate/multivariate analyses described the differences between mothers who did and did not work full time. The same data were analysed comparing children who are overweight/obese against those with a normal BMI. The children of mothers who worked full time are more likely to be older, live in a household with a higher household income, be an only child or have one sibling or other child in the household, have a sole mother family structure and not spend any time reading for pleasure. No relationship was found between maternal employment and BMI. Compared with children of normal weight, those who were overweight/obese were more likely to spend no time studying, spend more than 2 h per day in screen-based activity and sleep less than 10 h per night. Child BMI status was not related to maternal employment. Although this analysis included eight diet related variables none proved to be significant in the final models.This study has shown that mothers' working status is not related to children's BMI. The relationship between overweight/obesity of children and high levels of screen-based activity, low levels of studying, and short sleep duration suggests a need for better knowledge and understanding of sedentary behaviours of children.
Girardet, J-P; Rieu, D; Bocquet, A; Bresson, J-L; Briend, A; Chouraqui, J-P; Darmaun, D; Dupont, C; Frelut, M-L; Hankard, R; Goulet, O; Simeoni, U; Turck, D; Vidailhet, M
Very early in life, sodium intake correlates with blood pressure level. This warrants limiting the consumption of sodium by children. However, evidence regarding exact sodium requirements in that age range is lacking. This article focuses on the desirable sodium intake according to age as suggested by various groups of experts, on the levels of sodium intake recorded in consumption surveys, and on the public health strategies implemented to reduce salt consumption in the pediatric population. Practical recommendations are given by the Committee on nutrition of the French Society of Pediatrics in order to limit salt intake in children.
Black, Dan A; Kolesnikova, Natalia; Sanders, Seth G; Taylor, Lowell J
We examine Becker's (1960) contention that children are "normal." For the cross section of non-Hispanic white married couples in the U.S., we show that when we restrict comparisons to similarly-educated women living in similarly-expensive locations, completed fertility is positively correlated with the husband's income. The empirical evidence is consistent with children being "normal." In an effort to show causal effects, we analyze the localized impact on fertility of the mid-1970s increase in world energy prices - an exogenous shock that substantially increased men's incomes in the Appalachian coal-mining region. Empirical evidence for that population indicates that fertility increases in men's income.
Shah, Sharita; Kamat, Sanjeev; Sawant, Urmila; Dhavale, H.S.
The higher prevalence of schizophrenia in children of schizophrenics than in the general population has generated an interest in pinpointing those behaviors that may precede the disorder and serve as an index of vulnerability to the disorder. Signs of neurobehavioral dysfunction in areas of neurocognitive functioning and social behavior have been found in school-age children of schizophrenic parents. This study assessed the neurobehavioral functioning, social behavior, cognitive functioning, attention and intelligence in children with a schizophrenic parent and compared the same parameters with children of mentally healthy parents. The children aged 12-15 years, were assessed with a battery of neurobehavioral tests. The children with a schizophrenic parent performed more poorly on the tests as compared to the children of mentally healthy parents. The children with a schizophrenic parent were seen to have more behavioral problems, especially withdrawn behavior and more social problems when compared to the other children in the study. Poor attention, disordered thoughts and lower intelligence were also observed to be more in the children of the schizophrenic parent PMID:21206831
In this article, Chojiro Kunii, chairman and executive director of the Japanese Organization for International Cooperation in Family Planning (JOICFP), briefly describes the evolution of the INtegrated Family Planning, Nutrition, and Parasite Control Project (IP). The IP project began in Japan during the post-war period, when midwives and public health nurses introduced family planning alongside maternal and child health care services to make it more acceptable to people. Based on Japan's experience, JOICFP formed an international cooperation project based on parasite control, family planning, and nutrition. Introduced in several Asian countries in the mid-1970s, the project was quickly transported to Central and South America. And in 1983, Africa witnesses its first IP project. This took place in the Masama district of Tanzania, where the results of deworming quickly captures the attention of the population, making it easier for family planning workers to spread their message. In the 2 regions where the IP project was introduced, contraceptive prevalence among women has increased from 9.3% to 33%, and from 27% to 60%. Tanzania is now considering incorporating the IP project in its next 5-year development plan. Other African countries have followed suit. Kunii explains that JOICFP's Ip project enjoys support from both IPPF and UNFPA. He adds that, for its 2nd stage of development, the IP project hopes to become a union of family planning and preventive health. This new phase can already be observed in Asian countries. In developing its population strategy, JOICFP learned from the experience' of Japan, which demonstrated the importance of balancing quantity and quality.
Physical activity and dietary behaviour in a population-based sample of British 10-year old children: the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people)
van Sluijs, Esther MF; Skidmore, Paula ML; Mwanza, Kim; Jones, Andrew P; Callaghan, Alison M; Ekelund, Ulf; Harrison, Flo; Harvey, Ian; Panter, Jenna; Wareham, Nicolas J; Cassidy, Aedin; Griffin, Simon J
Background The SPEEDY study was set up to quantify levels of physical activity (PA) and dietary habits and the association with potential correlates in 9–10 year old British school children. We present here the analyses of the PA, dietary and anthropometry data. Methods In a cross-sectional study of 2064 children (926 boys, 1138 girls) in Norfolk, England, we collected anthropometry data at school using standardised procedures. Body mass index (BMI) was used to define obesity status. PA was assessed with the Actigraph accelerometer over 7 days. A cut-off of ≥ 2000 activity counts was used to define minutes of moderate-to-vigorous PA (MVPA). Dietary habits were assessed using the Health Behaviour in School Children food questionnaire. Weight status was defined using published international cut-offs (Cole, 2000). Differences between groups were assessed using independent t-tests for continuous data and chi-squared tests for categorical data. Results Valid PA data (>500 minutes per day on ≥ 3 days) was available for 1888 children. Mean (± SD) activity counts per minute among boys and girls were 716.5 ± 220.2 and 635.6 ± 210.6, respectively (p < 0.001). Boys spent an average of 84.1 ± 25.9 minutes in MVPA per day compared to 66.1 ± 20.8 among girls (p < 0.001), with an average of 69.1% of children accumulating 60 minutes each day. The proportion of children classified as overweight and obese was 15.0% and 4.1% for boys and 19.3% and 6.6% for girls, respectively (p = 0.001). Daily consumption of at least one portion of fruit and of vegetables was 56.8% and 49.9% respectively, with higher daily consumption in girls than boys and in children from higher socioeconomic backgrounds. Conclusion Results indicate that almost 70% of children meet national PA guidelines, indicating that a prevention of decline, rather than increasing physical activity levels, might be an appropriate intervention target. Promotion of daily fruit and vegetable intake in this age group is
Children bear disproportionate consequences of armed conflict. The 21st century continues to see patterns of children enmeshed in international violence between opposing combatant forces, as victims of terrorist warfare, and, perhaps most tragically of all, as victims of civil wars. Innocent children so often are the victims of high-energy wounding from military ordinance. They sustain high-energy tissue damage and massive burns - injuries that are not commonly seen in civilian populations. Children have also been deliberately targeted victims in genocidal civil wars in Africa in the past decade, and hundreds of thousands have been killed and maimed in the context of close-quarter, hand-to-hand assaults of great ferocity. Paediatricians serve as uniformed military surgeons and as civilian doctors in both international and civil wars, and have a significant strategic role to play as advocates for the rights and welfare of children in the context of the evolving 'Laws of War'. One chronic legacy of contemporary warfare is blast injury to children from landmines. Such blasts leave children without feet or lower limbs, with genital injuries, blindness and deafness. This pattern of injury has become one of the post-civil war syndromes encountered by all intensivists and surgeons serving in four of the world's continents. The continued advocacy for the international ban on the manufacture, commerce and military use of antipersonnel landmines is a part of all paediatricians' obligation to promote the ethos of the Laws of War. Post-traumatic stress disorder remains an undertreated legacy of children who have been trapped in the shot and shell of battle as well as those displaced as refugees. An urgent, unfocused and unmet challenge has been the increase in, and plight of, child soldiers themselves. A new class of combatant comprises these children, who also become enmeshed in the triad of anarchic civil war, light-weight weaponry and drug or alcohol addiction. The
Chotibut, Thiparat; Nelson, David R.
Standard neutral population genetics theory with a strictly fixed population size has important limitations. An alternative model that allows independently fluctuating population sizes and reproduces the standard neutral evolution is reviewed. We then study a situation such that the competing species are neutral at the equilibrium population size but population size fluctuations nevertheless favor fixation of one species over the other. In this case, a separation of timescales emerges naturally and allows adiabatic elimination of a fast population size variable to deduce the fluctuation-induced selection dynamics near the equilibrium population size. The results highlight the incompleteness of the standard population genetics with a strictly fixed population size.
Your child's health includes physical, mental and social well-being. Most parents know the basics of keeping children healthy, like offering ... for children to get regular checkups with their health care provider. These visits are a chance to ...
LaCross, Nathan C.; Marrs, Carl F.; Gilsdorf, Janet R.
Nontypeable Haemophilus influenzae (NTHi) frequently colonize the human pharynx asymptomatically, and are an important cause of otitis media in children. Past studies have identified typeable H. influenzae as being clonal, but the population structure of NTHi has not been extensively characterized. The research presented here investigated the diversity and population structure in a well-characterized collection of NTHi isolated from the middle ears of children with otitis media or the pharynges of healthy children in three disparate geographic regions. Multilocus sequence typing identified 109 unique sequence types among 170 commensal and otitis media-associated NTHi isolates from Finland, Israel, and the US. The largest clonal complex contained only five sequence types, indicating a high level of genetic diversity. The eBURST v3, ClonalFrame 1.1, and structure 2.3.3 programs were used to further characterize diversity and population structure from the sequence typing data. Little clustering was apparent by either disease state (otitis media or commensalism) or geography in the ClonalFrame phylogeny. Population structure was clearly evident, with support for eight populations when all 170 isolates were analyzed. Interestingly, one population contained only commensal isolates, while two others consisted solely of otitis media isolates, suggesting associations between population structure and disease. PMID:23266487
A subset of the 27 safety and pharmacokinetic studies of levetiracetam has been conducted in selected special populations: children, the elderly, and people with renal or hepatic impairment. The results of these studies indicate that higher doses need to be used for children (on a per-weight basis), and individuals with renal dysfunction require dosage modifications related to creatinine clearance. Individuals with hepatic impairment do not require modifications from standard doses. Little information is available on the effect of levetiracetam on the developing fetus, so cautious use during pregnancy is recommended until more information is available. Additional studies will refine the recommendations for use of levetiracetam in these special populations.
Seizure disorder - children; Convulsion - childhood epilepsy; Medically refractory childhood epilepsy; Anticonvulsant - childhood epilepsy; Antiepileptic drug - childhood epilepsy; AED - childhood epilepsy
Viet Nam's 1993 population of 72 million makes it the second largest country of Southeast Asia after Indonesia. Viet Nam's demographic transition is underway, but growth is still a rapid 2% annually, a sufficiently high rate to hinder socioeconomic development. The 1979 and 1989 censuses and the 1988 Demographic and Health Survey are the major recent sources of data on Viet Nam's population. Marriage is universal in Viet Nam. Men marry at 24.5 and women at 23.2 years on average. Fertility estimates based on nonadjusted census data indicate a total fertility rate for 1988-89 of 3.8 overall, 2.2 in urban areas, and 4.3 in rural areas. Regional differences resulting from contraceptive usage, educational differentials, and tabus regarding spacing are strong. The average household size is 5. Viet Nam's first fertility reduction policy was announced in 1963 and sought to improve the welfare of women to increase their productivity for the war effort. More recent family planning policies are based on the view that rapid demographic growth is one of the great obstacles to development. The objectives of the current policy are to reduce the growth rate to 1% by the end of the century, increase contraceptive prevalence, delay arrival of the first child, limit family size to 2 children or 3 for ethnic minorities, and increase birth intervals from 3 to 5 years. The program is voluntarist in nature but includes incentives and disincentives. Life expectancy at birth in 1989 was 67.5 years for women and 63 for men. Infant mortality was 37/1000, with regional differentials. The principal causes of hospital deaths are tuberculosis, malaria, and diarrhea. Objectives of the current health policy are to prevent infectious diseases, reinforce primary health care services, promote traditional medicine, achieve self-sufficiency in basic medicines, and improve environmental health and access to clean water. Viet Nam is one of the most densely populated Southeast Asian countries and is still
Thank you Mr. Chairman, for the opportunity to speak out not only as a Japanese parliamentarian, but also as a member of GLOBE International, Global Legislators Organization for a Balanced Environment, consisting of legislators from the US Congress, EC Parliament, USSR Assembly and Japanese Diet who have joined together to compare, improve and coordinate our respective legislative activities in an effort to effectively address the complex issues surrounding environment and development. Mr. Chairman, world population--which reached 5.4 billion in mid-1991--is growing exponentially. According to 1 UNFPA report 3 people are born every second, a total of 250,000 people every day or 95-100 million people every year. At this rate, world population will reach 6.4 billion by year 2001, and if this rate continues to go unchecked, world population will reach 14-15 billion by the end of the 21st century. GLOBE is highly aware of the relationship between rapidly growing human populations, environmental degradation and sustainable development. We urge UNCED negotiators to address population growth rates and the integrally linked concerns of resource consumption levels, particularly in the industrialized world, in their search for solutions to the conflict between environment and development. Negotiators should also seriously consider ways in which to broaden educational and economic opportunities for women to ease population growth rates, and to alleviate poverty and stresses on the environment that result from population pressures. Social and economic factors must be integrated into population planning. It is saddening to note that almost 40,000 children die every day due to malnutrition, lack of fresh water and access to resources. Over 100 million children do not receive a primary education. Mr. Chairman, worldwide demand for a range of family planning services is increasing faster than supply. Recent studies indicate that if quality family planning information, training and
Stamper, B M
This article critically examines 4 conceptual frameworks for Third World population policies: the family planning approach, beyond family planning measures, the development hypothesis and transition theory, and the distributive hypothesis and fertility. Although family planning is a basic human right and can lead to lower levels of population and improved maternal-child health, this approach alone does not always have a meaningful demographic impact. If high fertility is economically rational from the family viewpoint, the demand for family planning services will remain marginal. Other policies seek to go beyond the family planning approach and to directly influence the demand for reproductive control through provision of old age support, monetary incentives for reduced fertility or stringent and coercive measures. However, such policies can have adverse distributional effects and directly penalize the children of large families. The demographic transition theory lacks a measurable and specifiable causation mechanism, giving it little predictive value. It may be that economic growth increases fertility in the short run and reduces fertility only over the long run through indirect effects. The key issue is how the rate of growth is distributed across the population. The development and demographic transition hypothesis focuses mainly on aggregate economic and social measures rather than on their underlying distributions. The distributive hypothesis implies policies that promote a greater level of investment in human capital, with a wide distributional emphasis. Diffused investment in human capital is believed to indirectly influence the desire to control fertility. It is concluded that all 4 conceptual frameworks for analyzing fertility-related policies for the Third World are inadequate or seriously flawed. They are not pragmatic, do not identify or assign weights to the crucial causal variables, fail to specify thresholds or critical minimum levels, discount
A consequence of the increasing pressure on Rwanda's ecosystem resulting from population growth has been that demographic factors have played a significant role in modifying attitudes and beliefs of the population. The history of Rwanda demonstrates a constant struggle for survival in the face of increasing population pressure. Migration, colonization of new agricultural lands, adoption of new crops and new forms of animal husbandry have been responses to population pressures. Recent unprecedented population growth has exceeded the capacity of older systems of cultivation and combinations of agricultural and animal husbandry to support the population. Smaller animals have largely replaced the cattle that once roamed freely in extensive pastures, and new techniques of stabling animals, use of organic or chemical fertilizers, and new tools adapted to the shrinking size of farm plots have represented responses to the new demographic realities. The concept of the family is likewise undergoing modification in the face of population growth and modernization. Children, who once were valued as a source of labor and constrained to conform to the wishes of the parents in return for the eventual inheritance of the goods and livelihood, now increasingly look beyond the household for education and employment. Family land holdings have become too small to support all the members with a claim on them. The greater distances between family members inevitably mean that relations between them lose closeness. The choice of a marriage partner is increasingly assumed by the young people themselves and not by their families. Old traditions of food sharing and hospitality have been curtailed because of the increasing scarcity of food. Despite the changes engendered by increasing population pressure, pronatalist sentiments are still widespread. But the desire to assure the future of each child rather than to await his services, a new conception of women less dependent on their reproductive
Benedict, Susan; Shields, Linda; O'Donnell, Alison J
Children with disabilities were killed during the Nazi era, often by nurses. Some nurses killed children, saying that they were under orders. Propaganda about the need for "racial purity" was all pervasive and influenced much of the population, including nurses. The German people accepted the "mercy" killing of children with disabilities. We describe the children's "euthanasia" program, explore the influence of propaganda, ask why it was acceptable to kill children, and provide historical context demonstrating "slippery slopes" which can lead to abrogation of ethical principles. Discussion of such history is essential as the ethical principles which were breached are still the cornerstone of nursing practice today. Only by openly discussing past wrongs can we attempt to ensure that they do not happen again. Archival documents from Germany and Israel, including trial depositions and transcripts, provided material, supplemented by secondary classic sources.
This article describes trends in population growth in Tibet during the Yuan Dynasty (1260-1287), the Qing Dynasty (1734-36), and during decennial periods after 1952, until 1994. Tibet was conquered by the Mongols who founded the Yuan Dynasty in the 13th century. During 1260-87, 3 enumerations revealed a total population of about 559,962 Tibetans, of whom 70,000 were lamas. Enumeration during 1734-36, revealed a total population of 941,151 Tibetans and 138,617 households. Tibet's population increased to about 1 million in 1951, an addition of 60,000 persons over 210 years. During 1952-59, the rate of population growth was fairly low at 0.94%. The total increase was 78,000 persons, or 11,000/year. Population increased from 1.15 million to about 1.23 million during 1952-59. The Dalai Lama went into exile with about 74,000 Tibetans in March 1959. Population during 1960-69 increased from 1.23 million to 1.48 million. The annual growth rate was 1.89%. Population increased by 252,500 persons, or 25.300/year. Reforms were carried out during this period. The region shifted from feudalism to socialism. Tibetans obtained free medical care and access to land. The birth rate was 25/1000, and the death rate was 10/1000. During 1970-79, both economic and population growth increased. Population increased from 1.48 million to 1.83 million, or a rate of annual growth of 2.14%. Population during this period increased by 348,500 persons, or 34,900/year. This was the fastest period of population growth. During 1980-89, the total fertility rate was maintained at around 4 children/woman, and family planning was implemented in urban areas. The annual rate of growth was 1.85%. Population increased by 367,000 persons, or 36,700/year. During 1990-94, the annual growth rate was 1.76 with a total increase of 159,000 persons, or 39,800/year.
Forman, Michele R.; Zhu, Yeyi; Hernandez, Ladia M.; Himes, John H.; Dong, Yongquan; Danish, Robert K.; James, Kyla E.; Caulfield, Laura E.; Kerver, Jean M.; Arab, Lenore; Voss, Paula; Hale, Daniel E.; Kanafani, Nadim; Hirschfeld, Steven
Surrogate measures are needed when recumbent length or height is unobtainable or unreliable. Arm span has been used as a surrogate but is not feasible in children with shoulder or arm contractures. Ulnar length is not usually impaired by joint deformities, yet its utility as a surrogate has not been adequately studied. In this cross-sectional study, we aimed to examine the accuracy and reliability of ulnar length measured by different tools as a surrogate measure of recumbent length and height. Anthropometrics [recumbent length, height, arm span, and ulnar length by caliper (ULC), ruler (ULR), and grid (ULG)] were measured in 1479 healthy infants and children aged <6 y across 8 study centers in the United States. Multivariate mixed-effects linear regression models for recumbent length and height were developed by using ulnar length and arm span as surrogate measures. The agreement between the measured length or height and the predicted values by ULC, ULR, ULG, and arm span were examined by Bland-Altman plots. All 3 measures of ulnar length and arm span were highly correlated with length and height. The degree of precision of prediction equations for length by ULC, ULR, and ULG (R2 = 0.95, 0.95, and 0.92, respectively) was comparable with that by arm span (R2 = 0.97) using age, sex, and ethnicity as covariates; however, height prediction by ULC (R2 = 0.87), ULR (R2 = 0.85), and ULG (R2 = 0.88) was less comparable with arm span (R2 = 0.94). Our study demonstrates that arm span and ULC, ULR, or ULG can serve as accurate and reliable surrogate measures of recumbent length and height in healthy children; however, ULC, ULR, and ULG tend to slightly overestimate length and height in young infants and children. Further testing of ulnar length as a surrogate is warranted in physically impaired or nonambulatory children. PMID:25031329
Weitzman, M; Adair, R
The divorce rate in the United States is currently half the rate of marriages. Whether this rate will continue is not known. Millions of American children have already experienced their parents' divorce and millions more are likely to share the experience in the future. This makes divorce a problem that frequently appears in a pediatrician's patient population. Most children of divorce will experience it at the least as a potent transient stress that disrupts virtually all aspects of their lives. Many will accommodate to their new life circumstances successfully, but a substantial percentage will suffer long-term negative effects. Many of the problems of these children and their families can be anticipated, prevented, or alleviated by thoughtful and timely intervention. The pediatrician can be helpful by serving as the child's advocate, offering anticipatory guidance, helping the family weather the turmoil of the acute stage, screening for maladjustment or maladaptive behavior of children and parents, providing counseling, and referring the children and family for more specialized mental health input when indicated.
The Sahel region is comprised of Burkina Faso, Cape Verde, Chad, the Gambia, Guinea-Bissau, Mali, Mauritania, Niger, and Senegal. It is one of the poorest regions on earth. 44 million people live in the Sahel countries with a life expectancy of 49 years and more than one out of every eight babies die during infancy. The rate of contraceptive prevalence is no higher than 11% for any of the countries and women have an average of 6.5 births during their lifetimes; the rate of natural population growth is 3.1% per year. Delegates from the Sahel region countries met in Chad in 1989 to discuss population and development issues. Formulating the N'Djamena Plan of Action on Population and Development in the Sahel, the countries have been moving fast on the issues ever since. By the convening of the population policy conference held in Dakar, Senegal, July 1992, Senegal, Burkina Faso, Mali, and Niger had adopted population policies, the Gambia planned to adopt one later in the year, and policies or programs were in progress in each of the other countries. This progress indicates a new commitment to population issues. There was a great deal of solidarity at the 1992 population talks, with participants recognizing the challenge posed by rapid population growth in the context of their economic situations. Concern was expressed for the need to address the health and status of women and children, with a call for specific actions to translate policy rhetoric into action and results. Moreover, compared to the 1989 talks, the 1992 Sahel meeting involved more open discussion of family planning and was attended by a greater number of women delegates.
Drawing conclusions about the validity of available dietary assessment instruments in school age children is hampered by the differences in instruments, research design, reference methods, and populations in the validation literature.
As with school age children, it is difficult to make conclusions about the validity of available dietary assessment instruments for adolescents because of the differences in instruments, research designs, reference methods, and populations in the validation literature.
Christenson, Matthew; McDevitt, Thomas; Stanecki, Karen
Global Population Profile: 2002 summarizes the most important trends in global population at the dawn of the 21st century. The presentation is organized around four themes: (1) Global Population; (2) Growth, Global Population; (3) Composition, Contraceptive Prevalence in the Developing World; and (4) the AIDS Pandemic in the 21st Century. This…
Ebert, Kerry Danahy; Kohnert, Kathryn
We review and synthesize empirical evidence at the intersection of two populations: children with language learning impairment (LLI) and children from immigrant families who learn a single language from birth and a second language beginning in early childhood. LLI is a high incidence disorder that, in recent years, has been referred to by…
Used teacher questionnaires to examine incidence of left-handedness in nearly 2,800 Singaporean children, racial differences in this left-handed population, and educational provisions in preschool and primary school. Findings indicated that 7.5% of preschoolers and 6.3% of primary children were left-handed, with a higher proportion being Chinese…
The population of migrants moving within China's borders has reached some 80 million, including 2-3 million school-aged children. As migrant workers flock to cities, their children strain urban school systems or receive no education. But independent schools for migrants are illegal and substandard. In some rural provinces, vocational training may…
Gifford, Diane Baty
Research has shown that educators may be missing an under-identified population of approximately 10 percent of typically developing children, who have fluent, age-appropriate decoding and word recognition skills, yet have specific difficulties with other higher-level text processing factors. These children are said to have specific comprehension…
Izadpanah, Ali; Viezel-Mathieu, Alex; Izadpanah, Arash; Luc, Mario
Dupuytren contracture of the palm is a relatively common benign fibroproliferative disease of the palmar fascia typically affecting the adult population. There have however been several reported cases of Dupuytren contracture in children. We sought to review the literature for Dupuytren contracture and highlight the main clinical features and management of the disease in children.
The Fourth Asian and Pacific Population Conference was held at Denpasar, Indonesia, August 19-27, 1992. The theme of the Conference was Population and Sustainable Development: Goals and Strategies into the Twenty-first Century. Prior to the Conference three preparatory seminars were held: on population, environment and sustainable development (Thailand, 1991); on migration and urbanization (Seoul, 1992); and on planning and implementation of family planning/family health and welfare programs (Beijing, 1992). The Conference, jointly sponsored by the Economic and Social Commission for Asia and the Pacific (ESCAP) and the United Nations Population Fund (UNFPA), adopted the Bali Declaration on Population and Sustainable Development, which spells out regional goals and recommendations for population and sustainable development into the 21st century. The preamble recognizes that population plays a decisive role in all human endeavors, especially in safeguarding the environment and the pursuit of sustainable development. Population problems must be addressed on local, national, regional, and global levels. It is urged that all members make a commitment to incorporate population and environmental concerns into efforts to achieve sustainable development. The population goals should include attainment of replacement level fertility of about 2.2 children per woman by the year 2010. In the Asian countries the present average is 3.1 children per woman. The rate of infant mortality should also be reduced to 40 per 1000 live births during this period. A number of recommendations are also made concerning population, environment, and development; urbanization, internal and international migration; family planning and maternal and child health; population and human resources development; women and population; population and poverty alleviation; mortality and morbidity; aging; population data, research and information dissemination; and resource mobilization.
Maskey, Morag; Warnell, Frances; Parr, Jeremy R.; Le Couteur, Ann; McConachie, Helen
The type, frequency and inter-relationships of emotional and behavioural problems in 863 children with autism spectrum disorder (ASD) were investigated using the population-based Database of children with ASD living in the North East of England (Daslne). A high rate of problems was reported, with 53% of children having 4 or more types of problems…
Green, Dido; Charman, Tony; Pickles, Andrew; Chandler, Susie; Loucas, Tom; Simonoff, Emily; Baird, Gillian
Aim: We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. Method: Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children (n=101: 89 males,12 females; mean…
Silver, Archie A.
The report describes the clinical findings of a collaborative program to provide appropriate neuropsychiatric skills for 60 children ages 8 to 14 (grade 3 to 8) and their teachers. The children represented the entire population of two self-contained units (eight classes) for the treatment of children designated as severely emotionally handicapped…
Lambek, Rikke; Tannock, Rosemary; Dalsgaard, Soeren; Trillingsgaard, Anegen; Damm, Dorte; Thomsen, Per Hove
Objective: The study examined executive function deficits (EFD) in school-age children (7 to 14 years) with ADHD. Method: A clinical sample of children diagnosed with ADHD (n = 49) was compared to a population sample (n = 196) on eight executive function (EF) measures. Then, the prevalence of EFD in clinical and non-clinical children was examined…
Turner, Laura B.; Romanczyk, Raymond G.
Although intense fears have been reported in up to 64% of children with an autism spectrum disorder (ASD), little is known about the phenomenology of fear in this population. This study assessed the relationship between fear and core symptoms of autism in children with an ASD. In Phase I of this study, parents of 41 children with an ASD completed…
Cunningham, Michelle Doucette
This KIDS COUNT data book examines statewide trends in the well-being of Connecticut's children. After listing the regional population, racial/ethnic background, poverty status, and family setting of Connecticut's children, the statistical report examines 13 indicators of well-being: (1) percentage of children receiving welfare benefits; (2) low…
Joint attention has long been considered absent or deviant in children with autism. Although this deficit is seen, there is variability in joint attention within the population and some children with autism employ it. Little is known about the profile of joint attention skills of these children or how joint attention use affects concurrent…
Voices for Children in Nebraska, Omaha.
Over a period of 4 months in early 1994, Voices for Children investigated low-income children's access to 15 benefits for which they might be eligible. Of those benefits, six were further analyzed to determine how many eligible low-income children were actually receiving them. Counties were grouped by population size to determine if differences…
Bedoin, D.; Scelles, R.
This study focuses on the qualitative research interview, an essential tool frequently used in the human and social sciences, conducted with children having communication disorders. Two distinct populations are addressed--children with intellectual disability and deaf children without related disabilities--with the aim of identifying the main…
Fortuny, Karina; Chaudry, Ajay
This fact sheet is the first in a series of publications on children of immigrants. The series updates the Urban Institute's May 2006 fact sheet that described the characteristics of children of immigrants in the early 2000s. The current series profiles the population of children of immigrants in the United States using data from the 2007 American…
Clegg, Jennifer M.; Legare, Cristine H.
Recent research with Western populations has demonstrated that children use imitation flexibly to engage in both instrumental and conventional learning. Evidence for children's imitative flexibility in non-Western populations is limited, however, and has only assessed imitation of instrumental tasks. This study (N = 142, 6- to 8-year-olds)…
Ireland, Penelope Jane; McGill, James; Zankl, Andreas; Ware, Robert S.; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth M.; Townshend, Sharron; Johnston, Leanne Marie
Aim: The aim of this study was to determine population-specific developmental milestones for independence in self-care, mobility, and social cognitive skills in children with achondroplasia, the most common skeletal dysplasia. Methods: Population-based recruitment from October 2008 to October 2010 identified 44 Australian children with…
The Third African Population Conference was held in Dakar over the period December 7-12, 1992, on the theme of population, family, and sustainable development. The conference examined the implementation of the Kilimanjaro Program of Action for African Population and Self-Reliant Development, the African family in the context of socioeconomic development, strategies for sustainable development, emerging population problems and new orientations and strategies, and population policies and programs in Africa. The Dakar/Ngor Declaration on Population, Family, and Sustainable Development was adopted and is presented in the following sections: preamble; principles and objectives; recommendations for population, sustained economic growth, sustainable development, family, fertility and family planning, mortality, morbidity, AIDS, urbanization, migration, physical planning, refugees and displaced persons, women in development, children, youth, data collection and analysis, information dissemination, training and research, and information, education and communication; resource mobilization; and follow-up and implementation.
Toublanc, Nathalie; Lacroix, Brigitte D; Yamamoto, Junichi
Levetiracetam [E Keppra(®)] is a second generation antiepileptic drug for different types of epilepsy in adults and children ≥1 month. The objective is to develop a population pharmacokinetic model to describe the pharmacokinetics of levetiracetam in Japanese children and adults as well as North American children, the purpose being to explore potential dosing recommendations in Japanese children. Levetiracetam plasma concentration-time data were obtained from Japanese adult and pediatric clinical studies. The data were analyzed through non-linear mixed effects modelling. The model was used to perform simulations and compare the exposure in Japanese children and adults. It was subsequently extended to North American children through an external validation. A one-compartment model with first-order absorption and first-order elimination adequately described the data. The exposure parameters determined based on the simulations in children were well within the adult range. The external validation against historical data from North American children was successful. The integrated population pharmacokinetic model provided a good description of the data, confirming the similarity of levetiracetam pharmacokinetics in these various populations. In Japanese children, a target dose of 10 to 30 mg/kg twice daily ensures the same exposure as the recommended dose in Japanese adults of 500 to 1,500 mg twice daily.
Wong, Helen H. L.; Smith, Ronald G.
Previous studies suggest that complementary and alternative medical (CAM) therapy use in children with chronic illnesses is higher than in children in the general population. In this study, we investigated patterns of CAM therapy use in children diagnosed with autism spectrum disorders (ASD, n = 50) as compared to a control population of children…
Garcia, Eugene E.
The linguistic and cultural diversity of America's school population has increased dramatically during the past decade, and is expected to increase even more in the future. But, for many children of immigrant and minority families, U.S. education is not a successful experience. One fourth of African Americans, one third of Hispanics, one half of…
Robinson, Sally; Howatson-Jones, Lioba
Worldwide demographic change means that the responsibility for an aging population will fall to younger generations. This narrative literature review comprises an international examination of what has been published about children's views of older people between 1980 and 2011. Sixty-nine academic articles were inductively analyzed, and the…
Myers, Jane E.
This book was developed to assist counselors and other caregivers in working with adult children and their aging parents. The first chapter addresses normative developmental issues in later life. This includes the demography of aging, theories of aging, and attitudes toward older persons, along with suggestions for identifying at-risk populations,…
Maynes, Bill; Foster, Rosemary
Presents six critical thoughts and questions about educating poor urban children in Canada. These thoughts were derived from the development of a directory of Canadian educational poverty programs. Findings from that study emphasize the increasing diversity of the student population, the importance of temporary and large-scale funding, and the…
Cook, John T.; Black, Maureen; Chilton, Mariana; Cutts, Diana; Ettinger de Cuba, Stephanie; Heeren, Timothy C.; Rose-Jacobs, Ruth; Sandel, Megan; Casey, Patrick H.; Coleman, Sharon; Weiss, Ingrid; Frank, Deborah A.
This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with “marginal food security,” as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children’s fair/poor health and developmental risk and caregivers’ depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers. PMID:23319123
Daily supplementation with iron plus folic acid, zinc, and their combination is not associated with younger age at first walking unassisted in malnourished preschool children from a deficient population in rural Nepal.
Katz, Joanne; Khatry, Subarna K; Leclerq, Steven C; Mullany, Luke C; Yanik, Elizabeth L; Stoltzfus, Rebecca J; Siegel, Emily H; Tielsch, James M
A community-based, cluster-randomized, placebo-controlled trial of daily zinc and/or iron+folic acid supplementation was conducted in rural southern Nepal to examine motor milestone attainment among 3264 children 1-36 mo of age between 2001 and 2006. Treatment groups included placebo, zinc (10 mg), iron+folic acid (12.5 mg iron + 50 microg folic acid), and zinc+iron+folic acid (10 mg zinc + 12.5 mg iron + 50 microg folic acid). Infants received half of these doses. The iron arms were stopped November 2003 by recommendation of the Data Safety and Monitoring Board; zinc and placebo continued until January 2006. A total of 2457 children had not walked at the time of entry into the trial and 1775 were followed through 36 mo. Mean age at first walking unassisted did not differ among groups and was 444 +/- 81 d (mean +/- SD) in the placebo group, 444 +/- 81 d in the zinc group, 464 +/- 85 d in the iron+folic acid group, and 446 +/- 87 d in the iron+folic acid+zinc group. Results were similar after adjustment for age at enrollment, asset ownership, maternal literacy, and prior child deaths in the household and in children who consumed at least 60 tablets. Compared with placebo, iron+folic acid was associated with an adjusted mean delay of 28.0 d (95% CI: 11.3, 44.7) in time to walking among infants and the delay was more pronounced with mid-upper arm circumference (MUAC) < 9.5 cm [60.6 d, (95% CI: 28.5, 92.6)]. Risks and benefits of universal iron+folic acid supplementation of infants beyond improved hematologic status deserve further consideration.
Food hypersensitivity affects children and adults with an increasing prevalence, and is therefore an important public health problem in the majority of developed countries. Moreover, self-reported reactions to food are of several times higher prevalence, compared to hypersensitivity diagnosed following well established evidence-based diagnostic guidelines. In children, allergic food reactions are more common compared to non-allergic food hypersensitivity reactions, and 90% of them are caused with only 8 food allergens: cow's milk, soya, egg, fish, shellfish, peanut, tree-nuts and gluten. Diagnosis should be based on challenge tests with the potentially offending food allergens. Concerning other, more conservative diagnostic procedures, negative serology and negative skin-prick tests can exclude IgE-mediated food allergy, but positive tests, due to high rate of false positive reactions are not sufficient for diagnosis. Strict dietary avoidance of incriminated allergens is the only well established management strategy. However, this should be applied only if food allergy is well documented - following the exposition tests. Introducing elimination diet in a paediatric population, particularly with the elimination of multiple foods, could cause inappropriate growth and disturb organ maturation. Concerning allergy prevention, avoidance of allergens is not efficacious either during pregnancy and lactation or weaning period, and is therefore, not recommended neither as a population preventive measure, nor in children at risk.
... children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children) ... The cause of primary brain tumors is unknown. Primary brain tumors may ... (spread to nearby areas) Cancerous (malignant) Brain tumors ...
Building on the work of Piaget, this article examines how children explain scientific phenomena using simile and metaphor. Demonstrates the difficulty children have in constructing explanations which contain sufficient "semantic distance" to be effective. Contends that comparison-as-explanation may bid for a place among the basic…
Gualtieri, C. Thomas C.; And Others
The use of the diagnosis "borderline" was evaluated with 16 children (6 to 13 years old) who were referred for comprehensive evaluation. None met DSM III criteria for borderline personality disorder. The borderline label had a negative impact on some children and was not helpful for treatment planning or disposition. (Author/SEW)
Gallo, Patrizia; Cioffi, Luigi; Limauro, Raffaele; Farris, Evelina; Bianco, Vincenzo; Sassi, Roberto; De Giovanni, Maria; Gallo, Valeria; D’Onofrio, Antonietta; Di Maio, Salvatore
Background: Epidemiologic evidences suggest a strong association between low birth weight and some diseases in adult life ( hypertension, diabetes, cardiovascular diseases).Aim of this study was to evaluate the obesity/overweight prevalence in a population of children born small for gestation age, SGA children 400, 208 males and 192 females compared to a population of children born appropriate for gestational age 6818 AGA children, 3502 males and 3316 females, during childhood. Our intention was also to build the natural history of weight gain during prepubertal age in children born SGA and AGA. Design and Methods: Observational prospective longitudinal study. We followed our patients from January2001 up to December 2010; weight, height and body mass index (BMI) were evaluated in all the SGA and AGA children. BMI z-score range for defining overweight and obesity was, respectively, 1.13 to 1.7 and >1.7 according to CDC growth charts. Results: In transversal evaluation, we prove that 10-year-old SGA females are twice obese and more overweight compared to equal age AGA females. In longitudinal evaluation, we highlight different observations: SGA children obese at 2 years are still obese at 10 years; the number of obese SGA children increases gradually until the age of 10; AGA children, appear to be less obese than SGA children at 10 years. Conclusion: SGA males and females are more obese at 5 and 10 years compared to the AGA population. Primary care pediatricians, through early detection of the children at risk, can carry out an effective obesity prevention project in SGA children. PMID:27583297
Myeloproliferative neoplasms (MPN) are a group of clonal hematopoietic stem cell disorders characterized by aberrant proliferation of one or more myeloid lineages often with increased immature cells in the peripheral blood. The three classical BCR-ABL-negative MPNs are: 1) polycythemia vera (PV), 2) essential thrombocythemia (ET), and 3) primary myelofibrosis (PMF), which are typically disorders of older adults and are exceedingly rare in children. The diagnostic criteria for MPNs remain largely defined by clinical, laboratory and histopathology assessments in adults, but they have been applied to the pediatric population. The discovery of the JAK2 V617F mutation, and more recently, MPL and CALR mutations, are major landmarks in the understanding of MPNs. Nevertheless, they rarely occur in children, posing a significant diagnostic challenge given the lack of an objective, clonal marker. Therefore, in pediatric patients, the diagnosis must rely heavily on clinical and laboratory factors, and exclusion of secondary disorders to make an accurate diagnosis of MPN. This review focuses on the clinical presentation, diagnostic work up, differential diagnosis, treatment and prognosis of the classical BCR-ABL-negative MPNs (PV, ET and PMF) in children and highlights key differences to the adult diseases. Particular attention will be given to pediatric PMF, as it is the only disorder of this group that is observed in infants and young children, and in many ways appears to be a unique entity compared to adult PMF. PMID:26609329
The purpose of this review was to identify current terms and definitions used to identify and describe children and adolescents who require technology. A total of 400 articles published from January 2000 through May 2012 were reviewed; 26 articles met the inclusion criteria. The review included only primary research studies that focused on a child and adolescent sample (birth to 18 years old) who required technology. Current terms and definitions used to describe children and adolescents who require technology include technology and complex care. Technology is a constant in both terminology and definitions, and it differentiates this population from the general population of children with chronic illness and special health care needs. This review highlights the need for better, more detailed descriptions of the population of children and adolescents who require technology in their daily lives.
Solís-Arias, Martha Patricia; García-Romero, Maria Teresa
Onychomycosis is considered an age-related infection with increasing prevalence in the older age groups. It is rare in the pediatric population, except in children with Down syndrome and with immunodeficiencies, who are more likely to have fungal nail infections. The number of reports about onychomycosis in children is relatively small, and the epidemiologic data vary, but a rise in prevalence has been demonstrated. In this article, we review the most up-to-date literature and summarize the epidemiology, etiology, clinical presentation, diagnosis, and treatment of onychomycosis in children, as well as the differences with the disease presenting in adults. Dermatologists must consider onychomycosis in the differential diagnosis of nail alterations in children and always perform a mycological study to confirm the diagnosis.
Olson, Kristina R; Key, Aidan C; Eaton, Nicholas R
A visible and growing cohort of transgender children in North America live according to their expressed gender rather than their natal sex, yet scientific research has largely ignored this population. In the current study, we adopted methodological advances from social-cognition research to investigate whether 5- to 12-year-old prepubescent transgender children (N = 32), who were presenting themselves according to their gender identity in everyday life, showed patterns of gender cognition more consistent with their expressed gender or their natal sex, or instead appeared to be confused about their gender identity. Using implicit and explicit measures, we found that transgender children showed a clear pattern: They viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender (nontransgender) control groups. These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity.
Sanjad, Sami A
While most hypertension in children has been previously considered secondary to renal, cardiovascular or endocrine etiology, a substantial number of children aged 6 to 20 years are now diagnosed with primary or essential hypertension. Hypertension in children and adolescents seems to be increasing over the past two decades. This is attributed at least in part to an increased prevalence of overweight in this population. Essential hypertension in childhood is a diagnosis arrived at by excluding the known causes of secondary hypertension. This paper will discuss the etiology of hypertension in children and adolescents.
Prevalence of gene rearrangements in Mexican children with acute lymphoblastic leukemia: a population study-report from the Mexican Interinstitutional Group for the identification of the causes of childhood leukemia.
Bekker-Méndez, Vilma Carolina; Miranda-Peralta, Enrique; Núñez-Enríquez, Juan Carlos; Olarte-Carrillo, Irma; Guerra-Castillo, Francisco Xavier; Pompa-Mera, Ericka Nelly; Ocaña-Mondragón, Alicia; Rangel-López, Angélica; Bernáldez-Ríos, Roberto; Medina-Sanson, Aurora; Jiménez-Hernández, Elva; Amador-Sánchez, Raquel; Peñaloza-González, José Gabriel; de Diego Flores-Chapa, José; Fajardo-Gutiérrez, Arturo; Flores-Lujano, Janet; Rodríguez-Zepeda, María Del Carmen; Dorantes-Acosta, Elisa María; Bolea-Murga, Victoria; Núñez-Villegas, Nancy; Velázquez-Aviña, Martha Margarita; Torres-Nava, José Refugio; Reyes-Zepeda, Nancy Carolina; González-Bonilla, Cesar; Mejía-Aranguré, Juan Manuel
Mexico has one of the highest incidences of childhood leukemia worldwide and significantly higher mortality rates for this disease compared with other countries. One possible cause is the high prevalence of gene rearrangements associated with the etiology or with a poor prognosis of childhood acute lymphoblastic leukemia (ALL). The aims of this multicenter study were to determine the prevalence of the four most common gene rearrangements [ETV6-RUNX1, TCF3-PBX1, BCR-ABL1, and MLL rearrangements] and to explore their relationship with mortality rates during the first year of treatment in ALL children from Mexico City. Patients were recruited from eight public hospitals during 2010-2012. A total of 282 bone marrow samples were obtained at each child's diagnosis for screening by conventional and multiplex reverse transcription polymerase chain reaction to determine the gene rearrangements. Gene rearrangements were detected in 50 (17.7%) patients. ETV6-RUNX1 was detected in 21 (7.4%) patients, TCF3-PBX1 in 20 (7.1%) patients, BCR-ABL1 in 5 (1.8%) patients, and MLL rearrangements in 4 (1.4%) patients. The earliest deaths occurred at months 1, 2, and 3 after diagnosis in patients with MLL, ETV6-RUNX1, and BCR-ABL1 gene rearrangements, respectively. Gene rearrangements could be related to the aggressiveness of leukemia observed in Mexican children.
Prevalence of Gene Rearrangements in Mexican Children with Acute Lymphoblastic Leukemia: A Population Study—Report from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia
Bekker-Méndez, Vilma Carolina; Miranda-Peralta, Enrique; Núñez-Enríquez, Juan Carlos; Olarte-Carrillo, Irma; Guerra-Castillo, Francisco Xavier; Pompa-Mera, Ericka Nelly; Ocaña-Mondragón, Alicia; Bernáldez-Ríos, Roberto; Medina-Sanson, Aurora; Jiménez-Hernández, Elva; Amador-Sánchez, Raquel; Peñaloza-González, José Gabriel; de Diego Flores-Chapa, José; Fajardo-Gutiérrez, Arturo; Flores-Lujano, Janet; Rodríguez-Zepeda, María del Carmen; Dorantes-Acosta, Elisa María; Bolea-Murga, Victoria; Núñez-Villegas, Nancy; Velázquez-Aviña, Martha Margarita; Torres-Nava, José Refugio; Reyes-Zepeda, Nancy Carolina; González-Bonilla, Cesar; Mejía-Aranguré, Juan Manuel
Mexico has one of the highest incidences of childhood leukemia worldwide and significantly higher mortality rates for this disease compared with other countries. One possible cause is the high prevalence of gene rearrangements associated with the etiology or with a poor prognosis of childhood acute lymphoblastic leukemia (ALL). The aims of this multicenter study were to determine the prevalence of the four most common gene rearrangements [ETV6-RUNX1, TCF3-PBX1, BCR-ABL1, and MLL rearrangements] and to explore their relationship with mortality rates during the first year of treatment in ALL children from Mexico City. Patients were recruited from eight public hospitals during 2010–2012. A total of 282 bone marrow samples were obtained at each child's diagnosis for screening by conventional and multiplex reverse transcription polymerase chain reaction to determine the gene rearrangements. Gene rearrangements were detected in 50 (17.7%) patients. ETV6-RUNX1 was detected in 21 (7.4%) patients, TCF3-PBX1 in 20 (7.1%) patients, BCR-ABL1 in 5 (1.8%) patients, and MLL rearrangements in 4 (1.4%) patients. The earliest deaths occurred at months 1, 2, and 3 after diagnosis in patients with MLL, ETV6-RUNX1, and BCR-ABL1 gene rearrangements, respectively. Gene rearrangements could be related to the aggressiveness of leukemia observed in Mexican children. PMID:25692130
Curtin, Carol; Jojic, Mirjana; Bandini, Linda G
Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is at least as high as that seen in typically developing children. Many of the risk factors for children with ASD are likely the same as for typically developing children, especially within the context of today's obesogenic environment. The particular needs and challenges that this population faces, however, may render them more susceptible to the adverse effects of typical risk factors, and they may also be vulnerable to additional risk factors not shared by children in the general population, including psychopharmacological treatment, genetics, disordered sleep, atypical eating patterns, and challenges for engaging in sufficient physical activity. For individuals with ASD, obesity and its sequelae potentially represent a significant threat to independent living, self-care, quality of life, and overall health.
Stewart, Shannon L.; Leschied, Alan; den Dunnen, Wendy; Zalmanowitz, Sharla; Baiden, Philip
Background: Children involved in the child welfare system (CWS) have a greater need for mental health treatment relative to children in the general population. However, the research on mental health treatment for children in the CWS is sparse with only one known previous review of mental health services with children in the CWS. Objective: This…
Arif, Ahmed A.; Venati, Girikumar; Borders, Tyrone F.; Rohrer, James E.
Health care services use by children varies tremendously. Because of the increasing prevalence of diabetes in children and adolescents, one of the major concerns is access to physician care among children with diabetes and diabetes symptoms. This population-based cross-sectional study examines correlates of physician visit among children and…
There are basic differences between Marxian and Malthusian population thought: 1) For Marx, population is a social phenomenon--human reproduction belongs to social production and population laws are social laws influenced by the means of production. Marx recognized that human reproduction had both a natural and a social relationship, but Malthus population theory only acknowledges the natural relationship of human reproduction. Malthus believed that if population grows without interference, it will double every 25 years, or geometrically. It is evident Malthus substituted biological possibilities for the objective inevitability of population evolution, and natural population laws for social population laws. 2) Marx believed that social production is the unification of material production and human reproduction. Material production is controlled and necessitates control of human reproduction. For Malthus, the growth of the means of subsistence never catches up with the growth of the population, but Marx said that even though land is limited, the development of production forces is limitless. Marxist theory postulates that man is basically a producer, but that population must be planned because not everyone is a producer (e.g., children and the unskilled). 3) Malthus believed that in capitalistic countries unemployment, famine, and poverty stem from too many births by the laboring class, i.e., population determines the economy. The only solution to population problems is to have fewer children. For Marx, economics determines population problems.
Bennett, Claudette E.
This report presents a statistical portrait of the demographic, social, and economic characteristics of blacks, based primarily on the March 1991 Supplement to the Current Population Survey (CPS). Topics covered include population growth, marital status, family type and distribution, living arrangements of children, fertility, education,…
This document establishes the policy for protecting the privacy of children on the EPA public access website and the EPA Intranet and also establishes policy on copyright issues related to works created by and submitted to EPA by children both online and offline.
Stagg, Steven D.; Slavny, Rachel; Hand, Charlotte; Cardoso, Alice; Smith, Pamela
Research investigating expressivity in children with autism spectrum disorder has reported flat affect or bizarre facial expressivity within this population; however, the impact expressivity may have on first impression formation has received little research input. We examined how videos of children with autism spectrum disorder were rated for…
Jiang, Yang; Ekono, Mercedes; Skinner, Curtis
Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Being a child in a low-income or poor family does not happen by chance. Parental education and…
Rolland-Cachera, M F; Sempé, M; Guilloud-Bataille, M; Patois, E; Péquignot-Guggenbuhl, F; Fautrad, V
On the basis of a longitudinal study of growth in French children, we attempted to find a valid index for estimating adiposity, and to specify the optimal conditions for its use. The Quetelet index was found suitable for application to children, but as with all methods, a certain lack of precision proved unavoidable because of the different stages of growth observed at a given age. For use by clinicians, we provide charts, based on the Quetelet index and on age, permitting estimation of adiposity in any child on the basis of longitudinal study measurements. For use by epidemiologists, we give standard values for studying groups of subjects, even when a reference population is not available. Body adiposity may be expressed independently of age and sex.
Although population assistance represents a relatively small share of official development assistance, it influences many other aspects of development planning. The organizations that comprise the population establishment have a common purpose--the reduction of population growth in the Third World--but they are not homogeneous and sometimes have conflicting goals and strategies. National governments, multilateral agencies, nongovernmental organizations, foundations, academic centers, and pressure groups all contribute to creating and sustaining what has become a virtual population control industry. Through scholarships, travel grants, awards, and favorable publicity, Third World elites have been encouraged to join the population establishment. The World Bank, the U.S. Agency for International Development, and the U.N. Fund for Population Activities have pursued explicit strategies for pressuring Third World governments to design and implement population policies, most recently in Africa.
Presents a strategy to help students grasp the important implications of population growth. Involves an interactive demonstration that allows students to experience exponential and logistic population growth followed by a discussion of the implications of population-growth principles. (JRH)
Uses graphs to involve students in inquiry-based population investigations on the Wisconsin gray wolf. Requires students to predict future changes in the wolf population, carrying capacity, and deer population. (YDS)
Roncević, Nevenka; Stojadinović, Aleksandra; Batrnek-Antonić, Daliborka
According to UNICEF, street child is any child under the age of 18 for whom the street has become home and/or source of income and which is not adequately protected or supervised by adult, responsible person. It has been estimated that there are between 100 and 150 million street children worldwide. Life and work on the street have long term and far-reaching consequences for development and health of these children. By living and working in the street, these children face the highest level of risk. Street children more often suffer from the acute illness, injuries, infection, especially gastrointestinal, acute respiratory infections and sexually transmitted diseases, inadequate nutrition, mental disorders, and drug abuse. They are more often victims of abuse, sexual exploitation, trafficking; they have higher rate of adolescent pregnancy than their peers from poor families. Street children and youth have higher rates of hospitalization and longer hospital stay due to seriousness of illness and delayed health care. Street children/youth are reluctant to seek health care, and when they try, they face many barriers. Street children are invisible to the state and their number in Serbia is unknown. Recently, some non-governmental organizations from Belgrade, Novi Sad and Nis have recognized this problem and tried to offer some help to street children, by opening drop-in centers, but this is not enough. To solve this problem, an engagement of the state and the whole community is necessary, and primary responsibility lies in health, social and educational sector. The best interests of the child must serve as a basic guideline in all activities aimed at improving health, quality of life and rights of children involved in the life and work in the street.
Chaturvedi, U. C.; Mathur, A.; Singh, U. K.; Kushwaha, M. R.; Mehrotra, R. M.; Kapoor, A. K.; Rai, S.; Gurha, R. G.
A house to house survey was done from October 1972 to March 1974, covering 528952 individuals of urban population at Lucknow and 50,156 individuals of rural population of Unnao district, to find out the incidence of polio-like paralysis in our population. Among 12874 urban children up to 8 years old 8.2/1000 had polio-like paralysis while 4.6/1000 children of the rural population of 13554 children were affected. The incidence was significantly higher in the urban population. In the preschool age group almost 1 out of every 100 children was affected. A higher number of children were affected during 1968-9 and 1971-2, though it did not reach epidemic proportion. The findings show that paralytic polio is a serious problem in our country where poliomyelitis is endemic: this is contrary to the views generally held so far. PMID:701784
MacMillan, Donald L.; And Others
The position is taken that the system identification of educable mentally retarded (EMR) children is designed to find children for service delivery and is not intended to identify a population with known parameters. (Author)
Effect of the different 13-valent pneumococcal conjugate vaccination uptakes on the invasive pneumococcal disease in children: Analysis of a hospital-based and population-based surveillance study in Madrid, Spain, 2007-2015
Picazo, Juan; Ruiz-Contreras, Jesús; Casado-Flores, Juan; Negreira, Sagrario; Baquero, Fernando; Hernández-Sampelayo, Teresa; Otheo, Enrique; Méndez, Cristina
In the Community of Madrid, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced the 7-valent (PCV7) in the fully government-funded Regional Immunization Program (RIP) in May, 2010, but was later excluded in May, 2012, and included again in January, 2015. These unique changes allowed us to assess the impact of the different pneumococcal vaccination policies on PCV13 uptake in infants and on the incidence rate (IR) of invasive pneumococcal disease (IPD) in children <15 years old. In this prospective, active, surveillance study, we estimated PCV13 uptakes, IR and incidence rate ratios (IRR) for total IPD and for IPD caused by PCV13- and non-PCV13 serotypes in children <15 years, stratified by age, in four periods with different vaccination policies: fully government-funded PCV7 vaccination, fully government-funded PCV13, mixed public/private funding and only private funding. Vaccine uptakes reached 95% in periods with public-funded pneumococcal vaccination, but fell to 67% in the private funding period. Overall, IR of IPD decreased by 68% (p<0.001) in 2014–15, due to 93% reduction in the IR of PCV13-type IPD (p<0.001) without significant changes in non-PCV13-type IPD. A fully government-funded PCV13 vaccination program lead to high vaccine uptake and dramatic reductions in both overall and PCV13-type IPD IR. When this program was switched to private PCV13 vaccination, there was a fall in vaccine coverage and stagnation in the decline of PCV13-type IPD with data suggesting a weakening of herd immunity. PMID:28207888
Golombok, Susan; Perry, Beth; Burston, Amanda; Murray, Clare; Mooney-Somers, Julie; Stevens, Madeleine; Golding, Jean
Existing research on children with lesbian parents is limited by reliance on volunteer or convenience samples. The present study examined the quality of parent-child relationships and the socioemotional and gender development of a community sample of 7-year-old children with lesbian parents. Families were recruited through the Avon Longitudinal Study of Parents and Children, a geographic population study of 14,000 mothers and their children. Thirty-nine lesbian-mother families, 74 two-parent heterosexual families, and 60 families headed by single heterosexual mothers were compared on standardized interview and questionnaire measures administered to mothers, co-mothers/fathers, children, and teachers. Findings are in line with those of earlier investigations showing positive mother-child relationships and well-adjusted children.
Best, Nicole T; Mertin, Peter
The phenomenon of auditory hallucinations in clinical populations of nonpsychotic children is an intriguing and little understood area. To date, investigations in this area have reported on a range of correlates, including family histories of psychiatric illness, family dysfunction, and significant levels of stress in the children themselves. The current study reported on 10 nonpsychotic children drawn from a number of community-based child and family agencies that provide therapeutic outpatient services. Consistent with previous studies, the present study found strong associations with family dysfunction, specifically family break-up, as well as significant levels of anxiety and depression in the presenting children. In addition, half the children reported the presence of imaginary companions. Despite confirmation of some previous findings, many other features of this phenomenon remain unanswered, including the different psychological functions that hallucinations and imaginary companions may serve for emotionally troubled children.
Salt, Alison; Sargent, Jenefer
Children with disability are at a substantially higher risk of visual impairment (VI) (10.5% compared with 0.16%) but also of ocular disorders of all types, including refractive errors and strabismus. The aetiology of VI in children with disability reflects that of the general population and includes cerebral VI, optic atrophy, as well as primary visual disorders such as retinal dystrophies and structural eye anomalies. VI and other potentially correctable ocular disorders may not be recognised without careful assessment and are frequently unidentified in children with complex needs. Although assessment may be more challenging than in other children, identifying these potential additional barriers to learning and development may be critical. There is a need to develop clearer guidelines, referral pathways and closer working between all professionals involved in the care of children with disability and visual disorders to improve our focus on the assessment of vision and outcomes for children with disability. PMID:25165073