Inadequate feeding practices and impaired growth among children from subsistence farming households in Sidama, Southern Ethiopia.

PubMed

Gibson, Rosalind S; Abebe, Yewelsew; Hambidge, K Michael; Arbide, Isabel; Teshome, Aklilu; Stoecker, Barbara J

2009-07-01

Whether current child feeding practices and behaviours among rural households in Sidama, Southern Ethiopia conform to the World Health Organization (WHO) guiding principles for complementary feeding is uncertain. We assessed socio-demographic status, anthropometry, breastfeeding, complementary feeding practices and behaviours, and motor development milestones in a convenience sample of 97 breastfed children aged 6-23 months from three rural Sidama communities. Energy and nutrient intakes from complementary foods were also calculated from 1-day in-home weighed records. Prevalence of stunting ranged from 25% for infants aged 6-8 months to 52% for children aged 12-23 months, whereas for wasting, the corresponding prevalence was 10% and 14%, respectively. Very few children were exclusively breastfed up to 6 months of age (n = 2), or received solids/semi-solids for the recommended minimum number of times containing the recommended number of food groups. Responsive feeding was not practised and no cellular animal products were consumed. Median intakes of energy, and intakes and densities of micronutrients from complementary foods (but not protein) were below WHO recommendations, assuming average breast milk intakes; greatest shortfalls were for retinol, vitamin C and calcium densities. Mothers of stunted children were shorter and lighter, and from households of lower socio-economic status than non-stunted children (P < 0.05). Acquisition of some motor development milestones was delayed in stunted infants compared with their non-stunted counter-parts. In conclusion, interventions that address the WHO guiding principles for complementary feeding practices and behaviours, as well as prenatal influences on growth, are urgently required in this setting.

Solid fuel in kitchen and acute respiratory tract infection among under five children: evidence from Nepal demographic and health survey 2011.

PubMed

Acharya, Pawan; Mishra, Shiva Raj; Berg-Beckhoff, Gabriele

2015-06-01

This study assessed the association between use of solid fuel in kitchen and ARI among under five children in Nepal. The latest data from the Nepal Demographic and Health Survey 2011 were used. A total of 4,802 under 5 de-jure children were included in this analysis. Cough accompanied by short/rapid breath and chest problem within 2 weeks before survey was considered as the symptoms of ARI. Logistic regression analysis was performed to calculate the odds of being suffered from ARI among the children from households using solid fuel in comparison to the children from households using cleaner fuel. About 84.6% of the families used solid fuel as a primary fuel. Approximately 4.5% children had symptoms of ARI within 2 weeks before the survey. About 3.4 and 4.9% of children from the families using cleaner fuel and solid fuel respectively had symptoms of ARI within 2 weeks preceding survey. After adjusting for age, sex, birth order, urban/rural residence, ecological zone, development region, economic status, number of family members, mother's smoking status and mother's education, odds of suffering from ARI was 1.79 times higher among the children from the households using solid fuel in comparison to the children from households using cleaner fuel (95% CI 1.02, 3.14). This study found the use of solid fuel in the kitchen has as a risk factor for ARI among under five children in Nepal. Longitudinal studies with direct measurement of indoor air pollution and clinical ARI cases can be future research priority.

Association of Frontline Worker-Provided Services with Change in Block-Level Complementary Feeding Indicators: An Ecological Analysis from Bihar, India

PubMed Central

Das, Aritra; Mahapatra, Sanchita; Sai Mala, Guntur; Chaudhuri, Indrajit; Mahapatra, Tanmay

2016-01-01

Background Insufficiencies in complementary feeding put infants and young children at increased risk of undernutrition. Till now, most Indian studies have looked at the individual level determinants of complementary feeding practices. We aimed to evaluate the association of frontline worker (FLW) provided nutritional counselling services, with change in community level indicators of complementary feeding practices among 9–11 month old children over time. Methods The study data was obtained from five rounds of ‘Lot Quality Assurance Sampling’ survey in eight districts of Bihar, an impoverished Indian state. The surveys were conducted as evaluation exercises for the ‘Integrated Family Health Initiative (IFHI)’–a multi-faceted program aimed at improving the maternal and child health outcomes in Bihar. The main outcome indicators were—current breastfeeding, age-appropriate minimum frequency of semi-solid food, age-appropriate minimum quantity of semi-solid food, initiation of complementary feeding at the right age, and dietary diversity. Repeated measures analysis was performed to determine the association of changes in the outcome indicators with coverage of FLW-provided counselling services. Results Visits by FLW, advices on age-appropriate frequency and handwashing were significant predictors of receiving age-appropriate frequency of feeding. The determinants of receiving age-appropriate quantity were—advices on age appropriate frequency and advices on handwashing. Receiving food support from AWC and FLW visits were significantly associated with initiating complementary feeding at the right age. Conclusions The present study identified the critical elements among the different types of FLW-provided services. The study findings, from an economically and socially underdeveloped region of India, would inform the relevant programs about the nutritional counselling services that need to be emphasized upon for reducing the burden of childhood malnutrition. PMID:27832211

Nutritional status of children with Wilms' tumour on admission to a South African hospital and its influence on outcome.

PubMed

Lifson, Lauren F; Hadley, G P; Wiles, Nicola L; Pillay, Kirthee

2017-07-01

In developing countries up to 77% of children with cancer have been shown to be malnourished on admission. High rates of malnutrition occur due to factors such as poverty and advanced disease. Weight can be an inaccurate parameter for nutritional assessment of children with solid tumours as it is influenced by tumour mass. This study aimed to assess the prevalence of malnutrition amongst children with Wilms tumour (WT), the level of nutritional support received on admission and the influence of nutritional status on outcome. Seventy-six children diagnosed with WT and admitted to Inkosi Albert Luthuli Central Hospital between 2004 and 2012 were studied prospectively. Nutritional assessment was conducted using weight, height, mid-upper arm circumference (MUAC) and triceps skinfold thickness (TSFT) prior to initiating treatment. Outcome was determined 2 years after admission. Time until commencement of nutritional resuscitation and nature, thereof, were recorded. Stunting and wasting was evident in 12% and 15% of patients, respectively. The prevalence of malnutrition was 66% when MUAC, TSFT and albumin were used. Malnutrition was not a predictor of poor outcome and did not predict advanced disease. The majority of patients (84%) received nutritional resuscitation within 2 weeks of admission. When classifying nutritional status in children with WT, the utilisation of weight and height in isolation can lead to an underestimation of the prevalence of malnutrition. Nutritional assessment of children with WT should also include MUAC and TSFT. Early aggressive nutritional resuscitation is recommended. © 2016 Wiley Periodicals, Inc.

Thyroid Adenomas After Solid Cancer in Childhood

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

Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine

Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose receivedmore » at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.« less

Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial.

PubMed

Williams Erickson, Liz; Taylor, Rachael W; Haszard, Jillian J; Fleming, Elizabeth A; Daniels, Lisa; Morison, Brittany J; Leong, Claudia; Fangupo, Louise J; Wheeler, Benjamin J; Taylor, Barry J; Te Morenga, Lisa; McLean, Rachael M; Heath, Anne-Louise M

2018-06-07

Despite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS; BLISS) on food and nutrient intake at 7⁻24 months of age. Two hundred and six women recruited in late pregnancy were randomized to Control ( n = 101) or BLISS ( n = 105) groups. All participants received standard well-child care. BLISS participants also received lactation consultant support to six months, and educational sessions about BLISS (5.5, 7, and 9 months). Three-day weighed diet records were collected for the infants (7, 12, and 24 months). Compared to the Control group, BLISS infants consumed more sodium (percent difference, 95% CI: 35%, 19% to 54%) and fat (6%, 1% to 11%) at 7 months, and less saturated fat (-7%, -14% to -0.4%) at 12 months. No differences were apparent at 24 months of age but the majority of infants from both groups had excessive intakes of sodium (68% of children) and added sugars (75% of children). Overall, BLISS appears to result in a diet that is as nutritionally adequate as traditional spoon-feeding, and may address some concerns about the nutritional adequacy of unmodified BLW. However, BLISS and Control infants both had high intakes of sodium and added sugars by 24 months that are concerning.

Gastric emptying of solids in children: reference values for the (13) C-octanoic acid breath test.

PubMed

Hauser, B; Roelants, M; De Schepper, J; Veereman, G; Caveliers, V; Devreker, T; De Greef, E; Vandenplas, Y

2016-10-01

(99m) Technetium scintigraphy ((99m) TS) is the 'gold standard' for measuring gastric emptying (GE), but it is associated with a radiation exposure. For this reason, the (13) C-octanoic acid breath test ((13) C-OBT) was developed for measuring GE of solids. The objective of this study was to determine normal values for gastric half-emptying time (t1/2 GE) of solids in healthy children. Gastric emptying of a standardized solid test meal consisting of a pancake evaluated with (99m) TS and (13) C-OBT was compared in 22 children aged between 1 and 15 years with upper gastrointestinal symptoms. Subsequently, the (13) C-OBT was used to determine normal values for GE of the same solid test meal in 120 healthy children aged between 1 and 17 years. The results showed a significant correlation (r = 0.748, p = 0.0001) between t1/2 GE measured with both techniques in the group of children with upper gastrointestinal symptoms. In the group of healthy children, mean t1/2 GE was 157.7 ± 54.0 min (range 71-415 min), but t1/2 GE decreased with age between 1 and 10 years and remained stable afterward. There was no influence of gender, weight, height, body mass index, and body surface area on t1/2 GE. Normal values for GE of solids measured with the (13) C-OBT using a standardized methodology were determined in healthy children. We propose to use this method and corresponding reference ranges to study GE of solids in children with gastrointestinal problems. © 2016 John Wiley & Sons Ltd.

Relation between gastric emptying rate and energy intake in children compared with adults.

PubMed Central

Maes, B D; Ghoos, Y F; Geypens, B J; Hiele, M I; Rutgeerts, P J

1995-01-01

Measurement of gastric emptying rate of solids in children is difficult because the available methods are either invasive or induce a substantial radiation burden. In this study the newly developed 13C octanoic acid breath test was used to examine the gastric emptying rate of solids and milk in healthy children and to compare gastric emptying in children and adults. Fifteen healthy children and three groups of nine healthy adults were studied, using three different test meals labelled with 50 mg of 13C octanoic acid: a low caloric pancake (150 kcal), a high caloric pancake (250 kcal), and 210 ml of milk (134 kcal). Breath samples were taken before and at regular intervals after ingestion of the test meal, and analysed by isotope ratio mass spectrometry. The gastric emptying parameters were derived from the 13CO2 excretion curves by non-linear regression analysis. No significant difference was found between children and adults in the emptying rate of the low caloric solid test meal. In children as well as in adults, increasing the energy content of the solid meal resulted in a significantly slower emptying rate. The milk test meal, however, was emptied at a faster rate in adults and at slower rate in children compared with the low caloric solid test meal. Moreover, the emptying rate of milk in children was significantly slower than in adults. In conclusion, a similar gastric emptying rate of solids but a slower emptying of full cream milk was shown in children of school age compared with adults, using the non-radioactive 13C octanoic acid breath test. PMID:7883214

Randomized trial comparing overnight preoperative fasting period Vs oral administration of apple juice at 06:00-06:30 am in pediatric orthopedic surgical patients.

PubMed

Castillo-Zamora, Carlos; Castillo-Peralta, Luz A; Nava-Ocampo, Alejandro A

2005-08-01

We aimed to evaluate the efficacy of clear liquids orally administered at 06:00-06:30 am on the morning of surgery to reduce prolonged preoperative fasting periods. After obtaining informed parental consent, 100 children undergoing scheduled orthopedic surgical procedures, ASA I-II, were randomly allocated to two groups. In group 1, children underwent the typical overnight preoperative period and patients in group 2 received a commercial brand of apple juice (glucose 28 g in 250 ml) at 06:00-06:30 am on the day of surgery. Patients <3 years old received 15 ml.kg(-1) and older children 10 ml.kg(-1) to a maximum volume of 250 ml. All patients underwent overnight fasting for milk and solids. Fasting time was 4.8 +/- 2.1 h (ranging from 3 to 11 h) in the group receiving apple juice at 06:00-06:30 am and 13.2 +/- 3.3 h (ranging from 5 to 19 h) in the overnight-fasting group (P < 0.05; 95% CI: -9.6 to -7.4 h). More patients were irritable (odds ratio, OR 4.5; 95% CI: 1.9-10.8) and dehydrated (OR 21.6; 95% CI: 5.9-79.0) in the overnight-fasting group. Glucose levels <2.7 mmol.l(-1) (50 mg.dl(-1)) were not reported in any case. A 15 ml.kg(-1) of apple juice for patients of <3 years of age or 10 ml.kg(-1) for older children, at 06:00-06:30 am of the surgical morning is a simple procedure to prevent dehydration and to produce positive behavior in low-risk, pediatric surgical patients.

Management of children with solid organ injuries after blunt torso trauma.

PubMed

Wisner, David H; Kuppermann, Nathan; Cooper, Arthur; Menaker, Jay; Ehrlich, Peter; Kooistra, Josh; Mahajan, Prashant; Lee, Lois; Cook, Lawrence J; Yen, Kenneth; Lillis, Kathy; Holmes, James F

2015-08-01

Management of children with intra-abdominal solid organ injuries has evolved markedly. We describe the current management of children with intra-abdominal solid organ injuries after blunt trauma in a large multicenter network. We performed a planned secondary analysis of a prospective, multicenter observational study of children (<18 years) with blunt torso trauma. We included children with spleen, liver, or kidney injuries identified by computed tomography, laparotomy/laparoscopy, or autopsy. Outcomes included disposition and interventions (blood transfusion for intra-abdominal hemorrhage, angiography, laparotomy/laparoscopy). We performed subanalyses of children with isolated injuries. A total of 12,044 children were enrolled; 605 (5.0%) had intra-abdominal solid organ injuries. The mean (SD) age was 10.7 (5.1) years, and injured organs included spleen 299 (49.4%), liver 282 (46.6%), and kidney 147 (24.3%). Intraperitoneal fluid was identified on computed tomography in 461 (76%; 95% confidence interval [CI], 73-80%), and isolated solid organ injuries were present in 418 (69%; 95% CI, 65-73%). Treatment included therapeutic laparotomy in 17 (4.1%), angiographic embolization in 6 (1.4%), and blood transfusion in 46 (11%) patients. Laparotomy rates for isolated injury were 11 (5.4%) of 205 (95% CI, 2.7-9.4%) at non-freestanding children's hospitals and 6 (2.8%) of 213 (95% CI, 1.0-6.0%) at freestanding children's hospitals (difference, 2.6%; 95% CI, -7.1% to 12.2%). Dispositions of the 212 children with isolated Grade I or II organ injuries were home in 6 (3%), emergency department observation in 9 (4%), ward in 114 (54%), intensive care unit in 73 (34%), operating suite in 7 (3%), and transferred in 3 (1%) patients. Intensive care unit admission for isolated Grade I or II injuries varied by center from 9% to 73%. Most children with solid organ injuries are managed with observation. Blood transfusion, while uncommon, is the most frequent therapeutic intervention; angiographic embolization and laparotomy are uncommon. Emergency department disposition of children with isolated Grade I to II solid organ injuries is highly variable and often differs from published guidelines. Prognostic/epidemiologic study, level III; therapeutic study, level IV.

[Endoscopic operation in the treatment of congenital duodenal membranous stenosis].

PubMed

Kong, Chihuan; Li, Long; Dong, Ning; Li, Xu; Zhang, Yanling

2015-08-01

To investigate the safety and efficacy of endoscopic duodenal valvectomy in the treatment of congenital duodenal membranous stenosis. Clinical data of two children with congenital duodenal membranous stenosis undergoing endoscopic duodenal valvectomy in our institute within October 2014 were analyzed retrospectively. This procedure was performed with Microknife XL and CRE balloon catheter through porous channel in the 9 mm flexible endoscope. The first case was a 2-year-old boy who received two endoscopic operations including duodenal diaphragm resection and duodenal dilatation because of incision retraction. The second case was a 19-month-old gril who received once endoscopic duodenal valvectomy. Duodenal obstruction of these two children was relieved after operation. Postoperative x-rays showed no perforation. They could play in the floor 6 hours after operation without any complains, drink water 12 hours, take liquid diets 2 days and half solid food 3 days after operation. During follow-up a month after operation, the body weight gained was 1.5 and 1.0 kg respectively, and the dietary components was significantly improved. Endoscopic duodenal valvectomy is feasible and effective in the treatment of congenital duodenal membranous stenosis.

World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries.

PubMed

Marriott, Bernadette P; White, Alan; Hadden, Louise; Davies, Jayne C; Wallingford, John C

2012-07-01

Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and ≥ 50% of 12-23-month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12-15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age-appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12-15 months (P < 0.001). For infants 6-8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron-rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries. © 2011 Blackwell Publishing Ltd.

Rotary bulk solids divider

DOEpatents

Maronde, Carl P.; Killmeyer, Jr., Richard P.

1992-01-01

An apparatus for the disbursement of a bulk solid sample comprising, a gravity hopper having a top open end and a bottom discharge end, a feeder positioned beneath the gravity hopper so as to receive a bulk solid sample flowing from the bottom discharge end, and a conveyor receiving the bulk solid sample from the feeder and rotating on an axis that allows the bulk solid sample to disperse the sample to a collection station.

ROTARY BULK SOLIDS DIVIDER

DOEpatents

Maronde, Carl P.; Killmeyer JR., Richard P.

1992-03-03

An apparatus for the disbursement of a bulk solid sample comprising, a gravity hopper having a top open end and a bottom discharge end, a feeder positioned beneath the gravity hopper so as to receive a bulk solid sample flowing from the bottom discharge end, and a conveyor receiving the bulk solid sample from the feeder and rotating on an axis that allows the bulk solid sample to disperse the sample to a collection station.

MHealth to Improve Measles Immunization in Guinea-Bissau: Study Protocol for a Randomized Controlled Trial

PubMed Central

Ravn, Henrik; Batista, Celso Soares Pereira; Rodrigues, Amabelia

2016-01-01

Background Recent studies have revealed a low measles vaccination (MV) rate in the Republic of Guinea-Bissau (West Africa) that has not increased in accordance with the increasing coverage of other vaccinations. Measles is the deadliest of all childhood rash/fever illnesses and spreads easily, implying that if the vaccination coverage is declining there is a significant risk of new measles outbreaks [27]. Meanwhile, mobile health (mHealth; the use of mobile phones for health interventions) has generated much enthusiasm, and shown potential in improving health service delivery in other contexts. Objective The aim of this study is to evaluate the efficiency of mHealth as a tool for improving MV coverage while contributing to the mHealth evidence base. Methods This study will take place at three health centers in different regions of Guinea-Bissau. Participants, defined as mothers of the children receiving the MV, will be enrolled when they arrive with their children at the health center to receive the Bacillus Calmette-Guérin vaccination, usually within one month of the child’s birth. Enrolment will continue until a study population of 990 children has been reached. The participants will be randomly assigned to a control arm or one of two intervention arms. Each of the three groups will have 330 participants, distributed equally between health centers. Participants in the first intervention arm will receive a scheduled short message service (SMS) text message reminding them of the MV. Participants in the second intervention arm will receive a voice call in addition to the SMS message, while the control arm will receive no interventions. The MV is scheduled to be administered at 9 months of age. Although the vaccine would still be effective after 12 months, local policy in Guinea-Bissau prevents children aged >12 months from receiving the vaccination, and thus the study will follow-up with participants after the children reach 12 months of age. Children who have not yet received the MV will be offered vaccination by the project group. Results The study will analyze the efficiency of the intervention by determining its overall effect on MV coverage and timeliness when children reach 12 months of age. The main analysis will be stratified by intervention group, health center, level of education, ethnic group, and role of the person receiving the text messages (eg, mother, father, other family member). Secondary outcomes include the average number of health center visits (with intention to obtain the MV) required before successful administration. Conclusions Despite the rapid proliferation of mHealth projects, only a small number have been evaluated in terms of direct links to health outcomes. This gap in knowledge requires solid evidence on which policy-makers can base decisions. This study aims to produce significant knowledge about mHealth implementation within a Sub-Saharan context while creating data-supported evidence. Trial Registration Clinicaltrials.gov: NCT02662595; https://clinicaltrials.gov/ct2/show/NCT02662595 (Archived by WebCite at http://www.webcitation.org/6jH8YiSjY) PMID:27466046

Bullying in an Aboriginal Context

ERIC Educational Resources Information Center

Coffin, Juli; Larson, Ann; Cross, Donna

2010-01-01

Aboriginal children appear to be more likely to be involved in bullying than non-Aboriginal children. This paper describes part of the "Solid Kids Solid Schools" research process and discusses some of the results from this three year study involving over 260 Aboriginal children, youth, elders, teachers and Aboriginal Indigenous Education…

The effect of red ginseng extract on inflammatory cytokines after chemotherapy in children.

PubMed

Lee, Jae Min; Hah, Jeong Ok; Kim, Hee Sun

2012-10-01

Ginseng has been used as an herbal medicine, widely used in Asian countries, for long time. Recently, beneficial effects for immune functions of Korean red ginseng (KRG) have been reported in adults. This study was performed to investigate the effects of ginseng on immune functions in children after cessation of chemotherapy or stem cell transplantation for advanced cancer. Thirty patients, who were diagnosed and treated for leukemia and solid cancer at the department of pediatrics and adolescence of the Yeungnam University Hospital from June 2004 to June 2009, were enrolled for the study. The study group consisted of 19 patients who received KRG extract (60 mg/kg/d) for 1 yr and 11 patients who did not receive KRG extract were the control group. Blood samples were collected every 6 mo. Immune assays included circulating lymphocyte subpopulation, serum cytokines (IL- 2, IL-10, IL-12, TNF-alpha, and IFN-gamma), and total concentrations of serum IgG, IgA, and IgM subclasses. Age at diagnosis ranged from 2 mo to 15 yr (median 5 yr). Nine patients received stem cell transplantation. The cytokines of the KRG treated group were decreasing more rapidly than that of the control group. Lymphocyte subpopulations (T cell, B cell, NK cell, T4, T8, and T4/ T8 ratio) and serum immunoglobulin subclasses (IgG, IgA, and IgM) did not show significant differences between the study and the control groups. This study suggests that KRG extract might have a stabilizing effect on the inflammatory cytokines in children with cancer after chemotherapy.

Sublimation systems and associated methods

DOEpatents

Turner, Terry D.; McKellar, Michael G.; Wilding, Bruce M.

2016-02-09

A system for vaporizing and sublimating a slurry comprising a fluid including solid particles therein. The system includes a first heat exchanger configured to receive the fluid including solid particles and vaporize the fluid and a second heat exchanger configured to receive the vaporized fluid and solid particles and sublimate the solid particles. A method for vaporizing and sublimating a fluid including solid particles therein is also disclosed. The method includes feeding the fluid including solid particles to a first heat exchanger, vaporizing the fluid, feeding the vaporized fluid and solid particles to a second heat exchanger and sublimating the solid particles. In some embodiments the fluid including solid particles is liquid natural gas or methane including solid carbon dioxide particles.

Alimentary fluoride intake in preschool children

PubMed Central

2011-01-01

Background The knowledge of background alimentary fluoride intake in preschool children is of utmost importance for introducing optimal and safe caries preventive measures for both individuals and communities. The aim of this study was to assess the daily fluoride intake analyzing duplicate samples of food and beverages. An attempt was made to calculate the daily intake of fluoride from food and swallowed toothpaste. Methods Daily alimentary fluoride intake was measured in a group of 36 children with an average age of 4.75 years and an average weight of 20.69 kg at baseline, by means of a double plate method. This was repeated after six months. Parents recorded their child's diet over 24 hours and collected duplicated portions of food and beverages received by children during this period. Pooled samples of food and beverages were weighed and solid food samples were homogenized. Fluoride was quantitatively extracted from solid food samples by a microdiffusion method using hexadecyldisiloxane and perchloric acid. The content of fluoride extracted from solid food samples, as well as fluoride in beverages, was measured potentiometrically by means of a fluoride ion selective electrode. Results Average daily fluoride intake at baseline was 0.389 (SD 0.054) mg per day. Six months later it was 0.378 (SD 0.084) mg per day which represents 0.020 (SD 0.010) and 0.018 (SD 0.008) mg of fluoride respectively calculated per kg bw/day. When adding the values of unwanted fluoride intake from the toothpaste shown in the literature (0.17-1.21 mg per day) the estimate of the total daily intake of fluoride amounted to 0.554-1.594 mg/day and recalculated to the child's body weight to 0.027-0.077 mg/kg bw/day. Conclusions In the children studied, observed daily fluoride intake reached the threshold for safe fluoride intake. When adding the potential fluoride intake from swallowed toothpaste, alimentary intake reached the optimum range for daily fluoride intake. These results showed that in preschool children, when trying to maximize the benefit of fluoride in caries prevention and to minimize its risk, caution should be exercised when giving advice on the fluoride containing components of child's diet or prescribing fluoride supplements. PMID:21974798

Using a Chaser to Decrease Packing in Children with Feeding Disorders

ERIC Educational Resources Information Center

Vaz, Petula C. M.; Piazza, Cathleen C.; Stewart, Victoria; Volkert, Valerie M.; Groff, Rebecca A.; Patel, Meeta R.

2012-01-01

Packing is a problematic mealtime behavior that is characterized by pocketing or holding solids or liquids in the mouth without swallowing. In the current study, we examined the effects of a chaser, a liquid or solid consistently accepted and swallowed by the child, to decrease packing of solid foods in 3 children with feeding disorders. During…

Power generation plant integrating concentrated solar power receiver and pressurized heat exchanger

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

Sakadjian, Bartev B; Flynn, Thomas J; Hu, Shengteng

A power plant includes a solar receiver heating solid particles, a standpipe receiving solid particles from the solar receiver, a pressurized heat exchanger heating working fluid by heat transfer through direct contact with heated solid particles flowing out of the bottom of the standpipe, and a flow path for solid particles from the bottom of the standpipe into the pressurized heat exchanger that is sealed by a pressure P produced at the bottom of the standpipe by a column of heated solid particles of height H. The flow path may include a silo or surge tank comprising a pressure vesselmore » connected to the bottom of the standpipe, and a non-mechanical valve. The power plant may further include a turbine driven by heated working fluid discharged from the pressurized heat exchanger, and a compressor driven by the turbine.« less

First-Graders' Spatial-Mathematical Reasoning about Plane and Solid Shapes and Their Representations

ERIC Educational Resources Information Center

Hallowell, David A.; Okamoto, Yukari; Romo, Laura F.; La Joy, Jonna R.

2015-01-01

The primary goal of the study was to explore first-grade children's reasoning about plane and solid shapes across various kinds of geometric representations. Children were individually interviewed while completing a shape-matching task developed for this study. This task required children to compose and decompose geometric figures to identify…

Neural Mechanisms of Qigong Sensory Training Massage for Children With Autism Spectrum Disorder: A Feasibility Study.

PubMed

Jerger, Kristin K; Lundegard, Laura; Piepmeier, Aaron; Faurot, Keturah; Ruffino, Amanda; Jerger, Margaret A; Belger, Aysenil

2018-01-01

Despite the enormous prevalence of autism spectrum disorder (ASD), its global impact has yet to be realized. Millions of families worldwide need effective treatments to help them get through everyday challenges like eating, sleeping, digestion, and social interaction. Qigong Sensory Training (QST) is a nonverbal, parent-delivered intervention recently shown to be effective at reducing these everyday challenges in children with ASD. This study tested the feasibility of a protocol for investigating QST's neural mechanism. During a single visit, 20 children, 4- to 7-year-old, with ASD viewed images of emotional faces before and after receiving QST or watching a video (controls). Heart rate variability was recorded throughout the visit, and power in the high frequency band (0.15-0.4 Hz) was calculated to estimate parasympathetic tone in 5-s nonoverlapping windows. Cerebral oximetry of prefrontal cortex was recorded during rest and while viewing emotional faces. 95% completion rate and 7.6% missing data met a priori standards confirming protocol feasibility for future studies. Preliminary data suggest: (1) during the intervention, parasympathetic tone increased more in children receiving massage (M = 2.9, SD = 0.3) versus controls (M = 2.5, SD = 0.5); (2) while viewing emotional faces post-intervention, parasympathetic tone was more affected (reduced) in the massage group ( p  = 0.036); and (3) prefrontal cortex response to emotional faces was greater after massage compared to controls. These results did not reach statistical significance in this small study powered to test feasibility. This study demonstrates solid protocol feasibility. If replicated in a larger sample, these findings would provide important clues to the neural mechanism of action underlying QST's efficacy for improving sensory, social, and communication difficulties in children with autism.

Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children's Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children's Oncology Group.

PubMed

O'Neill, Allison F; Towbin, Alexander J; Krailo, Mark D; Xia, Caihong; Gao, Yun; McCarville, M Beth; Meyers, Rebecka L; McGahren, Eugene D; Tiao, Greg M; Dunn, Stephen P; Langham, Max R; Weldon, Christopher B; Finegold, Milton J; Ranganathan, Sarangarajan; Furman, Wayne L; Malogolowkin, Marcio; Rodriguez-Galindo, Carlos; Katzenstein, Howard M

2017-10-20

Purpose To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates with outcome. Methods Thirty-two patients with metastatic HB were enrolled on Children's Oncology Group Protocol AHEP0731 and treated with vincristine and irinotecan (VI). Responders to VI received two additional cycles of VI intermixed with six cycles of cisplatin/fluorouracil/vincristine/doxorubicin (C5VD), and nonresponders received six cycles of C5VD alone. Patients were imaged after every two cycles and at the conclusion of therapy. All computed tomography scans and pathology reports were centrally reviewed, and information was collected regarding lung nodule number, size, laterality, timing of resolution, and pulmonary surgery. Results Among the 29 evaluable patients, only 31% met Response Evaluation Criteria in Solid Tumors (RECIST) for measurable metastatic disease. The presence of measurable disease by RECIST, the sum of nodule diameters greater than or equal to the cumulative cohort median size, bilateral disease, and ≥ 10 nodules were each associated with an increased risk for an event-free survival event ( P = .48, P = .08, P = .065, P = .03, respectively), with nodule number meeting statistical significance. Ten patients underwent pulmonary resection/metastasectomy at various time points, the benefit of which could not be determined because of small patient numbers. Conclusion Children with metastatic HB have a poor prognosis. Overall tumor burden may be an important prognostic factor for these patients. Lesions that fail to meet RECIST size criteria (ie, those < 10 mm) at diagnosis may contain viable tumor, whereas residual lesions at the end of therapy may constitute eradicated tumor/scar tissue. Patients may benefit from risk stratification on the basis of the burden of lung metastatic disease at diagnosis.

The impacts of hinged and solid ankle-foot orthoses on standing and walking in children with spastic diplegia.

PubMed

Dalvand, Hamid; Dehghan, Leila; Feizi, Awat; Hosseini, Seyed Ali; Amirsalari, Susan

2013-01-01

The purpose of this study was to examine the impacts of hinged and solid anklefoot orthoses (AFOs) on standing and walking abilities in children with spastic diplegia. In a quasi-experimental design, 30 children with spastic diplegia, aged 4-6 years were recruited. They were matched in terms of age, IQ, and level of GMFCS E&R. Children were randomly assigned into 3 groups: a hinged AFO group (n=10) plus occupational therapy (OT), a solid AFO group (n=10) plus OT, a control group who used only OT for three months. Gross motor abilities were measured using Gross Motor Measure Function (GMFM). We obtained statistically significant differences in the values between baseline and after treatment in all groups. The groups were also significantly different in total GMFM after intervention. Furthermore, there were differences between hinged AFOs and solid AFOs groups, and between hinged AFOs and control groups. We concluded that gross motor function was improved in all groups; however, hinged AFOs group appears to improve the gross motor function better than solid AFOs and control groups.

Solid oral forms availability in children: a cost saving investigation

PubMed Central

Lajoinie, Audrey; Henin, Emilie; Kassai, Behrouz; Terry, David

2014-01-01

Aim To assess the suitability and potential cost savings, from both the hospital and community perspective, of prescribed oral liquid medicine substitution with acceptable solid forms for children over 2 years. Method Oral liquid medicines dispensed from a paediatric hospital (UK) in 1 week were assessed by screening for existence of the solid form alternative and evaluating the acceptability of the available solid form, firstly related to the prescribed dose and secondly to acceptable size depending on the child's age. Costs were calculated based on providing treatment for 28 days or prescribed duration for short term treatments. Results Over 90% (440/476) of liquid formulations were available as a marketed solid form. Considering dosage acceptability (maximum of 10% deviation from prescribed dosage or 0% for narrow therapeutic range drugs, maximum tablet divisions into quarters) 80% of liquids could be substituted with a solid form. The main limitation for liquid substitution would be solid form size. However, two-thirds of prescribed liquids could have been substituted with a suitable solid form for dosage and size, with estimated savings being of £5K and £8K in 1 week, respectively based on hospital and community costs, corresponding to a projected annual saving of £238K and £410K (single institution). Conclusion Whilst not all children over 2 years will be able to swallow tablets, drug cost savings if oral liquid formulations were substituted with suitable solid dosage forms would be considerable. Given the numerous advantages of solid forms compared with liquids, this study may provide a theoretical basis for investing in supporting children to swallow tablets/capsules. PMID:24965935

Recurrent craniopharyngioma after conformal radiation in children and the burden of treatment.

PubMed

Klimo, Paul; Venable, Garrett T; Boop, Frederick A; Merchant, Thomas E

2015-05-01

In this paper the authors present their experience treating children with recurrent craniopharyngioma who were initially managed with surgery followed by conformal radiation therapy (CRT). A departmental oncology information system was queried to identify all children (< 18 years old) who received CRT for a craniopharyngioma between 1998 and 2010 (inclusive) and specifically those who experienced tumor progression. For each patient, the authors recorded the type of recurrence (solid, cystic, or both), the time interval to first progression and each subsequent progression, the associated treatment complications, and disease status at last follow-up evaluation. Among the 97 patients that met criteria for entry into this study, 18 (18.6%) experienced tumor progression (9 cystic, 3 solid, 6 cystic and solid). The median time to first recurrence was 4.62 years (range 1.81-9.11 years). The subgroup included 6 female and 12 male patients with a median age of 7.54 years (range 3.61-13.83 years). Ten patients experienced first progression within 5 years of CRT. The 5- and 10-year treatment-free survival rates for the entire cohort were 89.0% (95% confidence interval [CI] 80.5%-93.9%) and 76.2% (95% CI 64%-85%), respectively. Seven patients had a single episode of progression and 11 had more than 1. The time interval between each subsequent progression was progressively shorter. The 18 patients underwent 38 procedures. The median follow-up duration for this group was 9.32 years (range 4.04-19.0 years). Three patients died, including 1 from perioperative complications. Craniopharyngioma progression after prior irradiation is exceedingly difficult to treat and local control is challenging despite repeated surgical procedures. Given our results, gross-total resection may need to be the surgical goal at the time of first recurrence, if possible. Decompressing new cyst formation alone has a low rate of long-term success.

Solid organ transplants following hematopoietic stem cell transplant in children.

PubMed

Bunin, Nancy; Guzikowski, Virginia; Rand, Elizabeth R; Goldfarb, Samuel; Baluarte, Jorge; Meyers, Kevin; Olthoff, Kim M

2010-12-01

SOT may be indicated for a select group of pediatric patients who experience permanent organ failure following HSCT. However, there is limited information available about outcomes. We identified eight children at our center who received an SOT following an HSCT. Patients were six months to 18 yr at HSCT. Diseases for which children underwent HSCT included thalassemia, Wiskott-Aldrich syndrome, Shwachman-Diamond/bone marrow failure, sickle cell disease (SCD), erythropoietic porphyria (EP), ALL, chronic granulomatous disease, and neuroblastoma. Time from HSCT to SOT was 13 days to seven yr (median, 27 months. Lung SOT was performed for two patients with BO, kidney transplants for three patients, and liver transplants for three patients (VOD, chronic GVHD). Seven patients are alive with functioning allografts 6-180 months from SOT. Advances in organ procurement, operative technique, immunosuppressant therapy, and infection control may allow SOT for a select group of patients post-HSCT. However, scarcity of donor organs available in a timely fashion continues to be a limiting factor. Children who have undergone HSCT and develop single organ failure should be considered for an SOT if there is a high likelihood of cure of the primary disease. © 2010 John Wiley & Sons A/S.

Solid fuel use is associated with anemia in children.

PubMed

Accinelli, Roberto A; Leon-Abarca, Juan A

2017-10-01

Over 3 billion people use solid fuels as a means of energy and heating source, and ~ 50% of households burn them in inefficient, poorly ventilated stoves. In 2010, ~ 43% of the 640 million preschool children in 220 countries suffered from a certain degree of anemia, with iron deficiency as the main cause in developed countries whereas its causes remained multifactorial in the undeveloped group. In this study, we explore the relations of country-wide variables that might affect the people's health status (from socioeconomic status to more specific variables such as water access). We found independent relationship between solid fuel use and anemia in children under five years old (p < 0.0001), taking into account the prevalence of anemia in pregnant woman and the access to improved water sources. Countries in which the population uses solid fuel the most have over three times higher anemia rates in children than countries with the lowest prevalence of solid fuels use. There is still a complex relationship between solid fuels use and anemia, as reflected in its worldwide significance (p < 0.05) controlled for measles immunization, tobacco consumption, anemia in pregnant mothers, girl's primary education, life expectancy and improved water access but not (p > 0.05) when weighing for sanitation access or income per capita. Copyright © 2017 Elsevier Inc. All rights reserved.

Contrasting two models of academic self-efficacy--domain-specific versus cross-domain--in children receiving and not receiving special instruction in mathematics.

PubMed

Jungert, Tomas; Hesser, Hugo; Träff, Ulf

2014-10-01

In social cognitive theory, self-efficacy is domain-specific. An alternative model, the cross-domain influence model, would predict that self-efficacy beliefs in one domain might influence performance in other domains. Research has also found that children who receive special instruction are not good at estimating their performance. The aim was to test two models of how self-efficacy beliefs influence achievement, and to contrast children receiving special instruction in mathematics with normally-achieving children. The participants were 73 fifth-grade children who receive special instruction and 70 children who do not receive any special instruction. In year four and five, the children's skills in mathematics and reading were assessed by national curriculum tests, and in their fifth year, self-efficacy in mathematics and reading were measured. Structural equation modeling showed that in domains where children do not receive special instruction in mathematics, self-efficacy is a mediating variable between earlier and later achievement in the same domain. Achievement in mathematics was not mediated by self-efficacy in mathematics for children who receive special instruction. For normal achieving children, earlier achievement in the language domain had an influence on later self-efficacy in the mathematics domain, and self-efficacy beliefs in different domains were correlated. Self-efficacy is mostly domain specific, but may play a different role in academic performance depending on whether children receive special instruction. The results of the present study provided some support of the Cross-Domain Influence Model for normal achieving children. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Geographic, Racial/Ethnic, and Sociodemographic Disparities in Parent-Reported Receipt of Family-Centered Care among US Children

PubMed Central

Azuine, Romuladus E.; Singh, Gopal K.; Ghandour, Reem M.; Kogan, Michael D.

2015-01-01

This study examined geographic, racial/ethnic, and sociodemographic disparities in parental reporting of receipt of family-centered care (FCC) and its components among US children aged 0–17 years. We used the 2011-2012 National Survey of Children's Health to estimate the prevalence and odds of not receiving FCC by covariates. Based on parent report, 33.4% of US children did not receive FCC. Children in Arizona, Mississippi, Nevada, California, New Jersey, Virginia, Florida, and New York had at least 1.51 times higher adjusted odds of not receiving FCC than children in Vermont. Non-Hispanic Black and Hispanic children had 2.11 and 1.58 times higher odds, respectively, of not receiving FCC than non-Hispanic White children. Children from non-English-speaking households had 2.23 and 2.35 times higher adjusted odds of not receiving FCC overall and their doctors not spending enough time in their care than children from English-speaking households, respectively. Children from low-education and low-income households had a higher likelihood of not receiving FCC. The clustering of children who did not receive FCC and its components in several Southern and Western US states, as well as children from poor, uninsured, and publicly insured and of minority background, is a cause for concern in the face of federal policies to reduce health care disparities. PMID:26793395

Geographic, Racial/Ethnic, and Sociodemographic Disparities in Parent-Reported Receipt of Family-Centered Care among US Children.

PubMed

Azuine, Romuladus E; Singh, Gopal K; Ghandour, Reem M; Kogan, Michael D

2015-01-01

This study examined geographic, racial/ethnic, and sociodemographic disparities in parental reporting of receipt of family-centered care (FCC) and its components among US children aged 0-17 years. We used the 2011-2012 National Survey of Children's Health to estimate the prevalence and odds of not receiving FCC by covariates. Based on parent report, 33.4% of US children did not receive FCC. Children in Arizona, Mississippi, Nevada, California, New Jersey, Virginia, Florida, and New York had at least 1.51 times higher adjusted odds of not receiving FCC than children in Vermont. Non-Hispanic Black and Hispanic children had 2.11 and 1.58 times higher odds, respectively, of not receiving FCC than non-Hispanic White children. Children from non-English-speaking households had 2.23 and 2.35 times higher adjusted odds of not receiving FCC overall and their doctors not spending enough time in their care than children from English-speaking households, respectively. Children from low-education and low-income households had a higher likelihood of not receiving FCC. The clustering of children who did not receive FCC and its components in several Southern and Western US states, as well as children from poor, uninsured, and publicly insured and of minority background, is a cause for concern in the face of federal policies to reduce health care disparities.

Memory strategy training in children with cerebral infarcts related to sickle cell disease.

PubMed

Yerys, Benjamin E; White, Desirée A; Salorio, Cynthia F; McKinstry, Robert; Moinuddin, Asif; DeBaun, Michael

2003-06-01

Cerebral infarcts occur in approximately 30% of children with sickle cell disease (SCD), but little information exists regarding remediation of associated cognitive deficits. The authors examined the benefits of training children with infarcts to use memory strategies. Six children with SCD-related infarcts received academic tutoring; three of these children received additional training in memory strategies (silent rehearsal to facilitate short-term memory and semantic organization to facilitate long-term memory). The performance of children receiving strategy training appeared to improve more than that of children receiving only tutoring. Memory in children with SCD-related infarcts may be enhanced through strategy training.

Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru.

PubMed

Vasquez, Liliana; Diaz, Rosdali; Chavez, Sharon; Tarrillo, Fanny; Maza, Ivan; Hernandez, Eddy; Oscanoa, Monica; García, Juan; Geronimo, Jenny; Rossell, Nuria

2018-06-01

Abandonment of treatment is a major cause of treatment failure and poor survival in children with cancer in low- and middle-income countries. The incidence of treatment abandonment in Peru has not been reported. The aim of this study was to examine the prevalence of and factors associated with treatment abandonment by pediatric patients with solid tumors in Peru. We retrospectively reviewed the sociodemographic and clinical data of children referred between January 2012 and December 2014 to the two main tertiary centers for childhood cancer in Peru. The definition of treatment abandonment followed the International Society of Paediatric Oncology, Paediatric Oncology in Developing Countries, Abandonment of Treatment recommendation. Data from 1135 children diagnosed with malignant solid tumors were analyzed, of which 209 (18.4%) abandoned treatment. Bivariate logistic regression analysis showed significantly higher abandonment rates in children living outside the capital city, Lima (forest; odds ratio [OR] 3.25; P < 0.001), those living in a rural setting (OR 3.44; P < 0.001), and those whose parent(s) lacked formal employment (OR 4.39; P = 0.001). According to cancer diagnosis, children with retinoblastoma were more likely to abandon treatment compared to children with other solid tumors (OR 1.79; P = 0.02). In multivariate regression analyses, rural origin (OR 2.02; P = 0.001) and lack of formal parental employment (OR 2.88; P = 0.001) were independently predictive of abandonment. Treatment abandonment prevalence of solid tumors in Peru is high and closely related to sociodemographical factors. Treatment outcomes could be substantially improved by strategies that help prevent abandonment of therapy based on these results. © 2018 Wiley Periodicals, Inc.

Investigation of Tank 241-AN-101 Floating Solids

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

Kraft, Douglas P.; Meznarich, H. K.

Tank 241-AN-101 is the receiver tank for retrieval of several C-Farms waste tanks, including Tanks 241-C-102 and 241-C-111. Tank 241 C 111 received first-cycle decontamination waste from the bismuth phosphate process and Plutonium and Uranium Extraction cladding waste, as well as hydraulic fluid. Three grab samples, 1AN-16-01, 1AN-16-01A, and 1AN-16-01B, were collected at the surface of Tank 241-AN-101 on April 25, 2016, after Tank 241-C-111 retrieval was completed. Floating solids were observed in the three grab samples in the 11A hot cell after the samples were received at the 222-S Laboratory. Routine chemical analyses, solid phase characterization on the floatingmore » and settled solids, semivolatile organic analysis mainly on the aqueous phase for identification of degradation products of hydraulic fluids were performed. Investigation of the floating solids is reported.« less

25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and Families...

25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and Families...

Introduction of solid food to young infants.

PubMed

Kuo, Alice A; Inkelas, Moira; Slusser, Wendelin M; Maidenberg, Molly; Halfon, Neal

2011-11-01

Timing of the first introduction of solid food during infancy may have potential effects on life-long health. To understand the characteristics that are associated with the timing of infants' initial exposure to solid foods. The 2000 National Survey of Early Childhood Health (NSECH) was a nationally representative telephone survey of 2,068 parents of children aged 4-35 months, which profiled content and quality of health care for young children. African-American and Latino families were over-sampled. Analyses in this report include bivariate tests and logistic regressions. 62% of parents reported introducing solids to their child between 4-6 months of age. African-American mothers (OR=0.5 [0.3, 0.9]), English-speaking Latino mothers (OR=0.4 [0.2, 0.7]), White mothers with more than high school education (OR=0.5 [0.2, 1.0]), and mothers who breastfed for 4 months or longer (OR=0.4 [0.3, 0.7]) were less likely to introduce solids early. Most parents (92%) of children 4-9 months of age reported that their pediatric provider had discussed introduction of solids with them since the child's birth, and provider discussion of feeding was not associated with the timing of introduction of solids. Although most parents recall discussing the introduction of solid foods with their child's physician, several subgroups of mothers introduce solid foods earlier than the AAP recommendation of 4-6 months. More effective discussion of solid food introduction linked to counseling and support of breastfeeding by the primary health care provider may reduce early introduction of solids.

Kids Count New Jersey 1998: State and County Profiles of Child Well-Being.

ERIC Educational Resources Information Center

Hernandez, Eloisa

This Kids Count report provides information on state and countywide trends in the well-being of New Jersey's children between 1990 and 1998. The statistical portrait is based on 19 social indicators: (1) children receiving AFDC/TANF; (2) children receiving food stamps; (3) children receiving Medicaid; (4) Women, Infants and Children (WIC) program…

Dietary and Physical Activity Counseling Trends in U.S. Children, 2002-2011.

PubMed

Odulana, Adebowale; Basco, William T; Bishu, Kinfe G; Egede, Leonard E

2017-07-01

In 2007 and 2010, Expert Committee and U.S. Preventive Services Task Force guidelines were released, respectively, urging U.S. practitioners to deliver preventive obesity counseling for children. This study determined the frequency and evaluated predictors of receiving counseling for diet and physical activity among a national sample of children from 2002 to 2011. Children aged 6-17 years were used from the 2002-2011 Medical Expenditure Panel Surveys and analyzed in 2016. Parental report of two questions assessed whether children received both dietary and exercise counseling from the provider. Children were grouped by weight category. Bivariate analyses compared the frequency of receiving counseling; logistic regression evaluated predictors of receiving counseling. The sample included 36,114 children; <50% of children received counseling. Across all time periods, children were more likely to receive counseling with increasing weight. Logistic regression models showed that obese children had greater odds of receiving counseling versus normal-weight children, even after adjusting for covariates. Additional significant positive correlates of receiving counseling were Hispanic ethnicity, living in an urban setting, and being in the highest income stratum. Being uninsured was associated with lower odds of counseling. Years 2007-2009 and 2010-2011 were associated with increased counseling versus the benchmark year category in the multivariable model. Counseling appears more likely with greater weight and increased after both guidelines in 2007 and 2010. Overall counseling rates for children remain low. Future work should focus on marginalized groups, such as racial and ethnic minorities and rural populations. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Antibiotic use in children and the use of medicines by parents.

PubMed

de Jong, Josta; Bos, Jens H J; de Vries, Tjalling W; de Jong-van den Berg, Lolkje T W

2012-06-01

Antibiotic drugs are frequently used for viral infections in children. It is probable that health beliefs and parental concern have great influence on the use of drugs in children. This study, performed in The Netherlands, investigates whether the use of antibiotics in children is associated with the use of medicines by parents. In this observational cohort study, the authors selected 6731 children from the prescription database IADB.nl who did not receive antibiotics until their fifth birthday and 1479 children who received at least one antibiotic prescription every year. The authors then selected parents for each group of children (5790 mothers and 4250 fathers for the children who did not receive antibiotics and 1234 mothers and 1032 fathers for the children who regularly received antibiotics). The authors compared the use of antibiotics and other medicines between the two groups of parents. Parents of children who received antibiotics recurrently were found to use more antibiotics themselves compared with parents of children who did not receive antibiotics. Moreover, this group also showed a higher percentage of chronic medication use: (11.3 vs 6.2% (mothers) and 13.1% vs 9.5% (fathers)). Mothers more often use antacids, non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, anxiolytics, hypnotics, antidepressants, drugs for treatment of asthma and antihistamines. Fathers use more antacids, cardiovascular drugs, NSAIDs and asthma drugs. The parents of children who receive antibiotic drugs regularly use more medicines compared with the parents of children who use no antibiotic drugs. Parents' medicine use may influence that of children and is a factor physicians and pharmacists should take into account.

Discipline and Responsibility: Building Solid Foundations To Prevent and Resolve Family Conflict.

ERIC Educational Resources Information Center

Franklin, Diane, Ed.; Bankston, Karen, Ed.

This guide contains suggestions for building a solid foundation of discipline and responsibility to contribute to positive relationships between parents and children. Three important steps are to: (1) model appropriate behavior; (2) provide age-appropriate choices to help children build decision-making skills and self-esteem; and (3) set…

Which Preschool Children with Specific Language Impairment Receive Language Intervention?

ERIC Educational Resources Information Center

Wittke, Kacie; Spaulding, Tammie J.

2018-01-01

Purpose: Potential biases in service provision for preschool children with specific language impairment (SLI) were explored. Method: In Study 1, children with SLI receiving treatment (SLI-T) and those with SLI not receiving treatment (SLI-NT) were compared on demographic characteristics and developmental abilities. Study 2 recruited children with…

Solar power satellite system definition study. Volume 4: Solid State SPS Analysis, Phase 3

NASA Technical Reports Server (NTRS)

1980-01-01

A 2500 megawatt solid ground output Solar Power Satellite (SPS) of conventional configuration was designed and analyzed. Because the power per receiving antenna is halved, as compared with the klystron reference, twice the number of receiving antennas are needed to deliver the same total power. The solid state approach appears feasible with a slightly greater specific mass and slightly higher cost than the klystron SPS design.

System design of a 1 MW north-facing, solid particle receiver

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

Christian, J.; Ho, C.

Falling solid particle receivers (SPR) utilize small particles as a heat collecting medium within a cavity receiver structure. The components required to operate an SPR include the receiver (to heat the particles), bottom hopper (to catch the falling particles), particle lift elevator (to lift particles back to the top of the receiver), top hopper (to store particles before being dropped through the receiver), and ducting. In addition to the required components, there are additional features needed for an experimental system. These features include: a support structure to house all components, calibration panel to measure incident radiation, cooling loops, and sensorsmore » (flux gages, thermocouples, pressure gages). Each of these components had to be designed to withstand temperatures ranging from ambient to 700 °C. Thermal stresses from thermal expansion become a key factor in these types of high temperature systems. The SPR will be housing ~3000 kg of solid particles. The final system will be tested at the National Solar Thermal Test Facility in Albuquerque, NM.« less

System design of a 1 MW north-facing, solid particle receiver

DOE PAGES

Christian, J.; Ho, C.

2015-05-01

Falling solid particle receivers (SPR) utilize small particles as a heat collecting medium within a cavity receiver structure. The components required to operate an SPR include the receiver (to heat the particles), bottom hopper (to catch the falling particles), particle lift elevator (to lift particles back to the top of the receiver), top hopper (to store particles before being dropped through the receiver), and ducting. In addition to the required components, there are additional features needed for an experimental system. These features include: a support structure to house all components, calibration panel to measure incident radiation, cooling loops, and sensorsmore » (flux gages, thermocouples, pressure gages). Each of these components had to be designed to withstand temperatures ranging from ambient to 700 °C. Thermal stresses from thermal expansion become a key factor in these types of high temperature systems. The SPR will be housing ~3000 kg of solid particles. The final system will be tested at the National Solar Thermal Test Facility in Albuquerque, NM.« less

Potential Use of {sup 18}F-fluorodeoxyglucose Positron Emission Tomography–Based Quantitative Imaging Features for Guiding Dose Escalation in Stage III Non-Small Cell Lung Cancer

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

Fried, David V., E-mail: dvfried@mdanderson.org; Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas; Mawlawi, Osama

2016-02-01

Purpose: To determine whether previously identified quantitative image features (QIFs) based on {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) (co-occurrence matrix energy and solidity) are able to isolate subgroups of patients who would receive a benefit or detriment from dose escalation in terms of overall survival (OS) or progression-free survival (PFS). Methods and Materials: Subgroups of a previously analyzed 225 patient cohort were generated with the use of 5-percentile increment cutoff values of disease solidity and primary tumor co-occurrence matrix energy. The subgroups were analyzed with a log-rank test to determine whether there was a difference in OS and PFS betweenmore » patients treated with 60 to 70 Gy and those receiving 74 Gy. Results: In the entire patient cohort, there was no statistical difference in terms of OS or PFS between patients receiving 74 Gy and those receiving 60 to 70 Gy. It was qualitatively observed that as disease solidity and primary co-occurrence matrix energy increased, patients receiving 74 Gy had an improved OS and PFS compared with those receiving 60 to 70 Gy. The opposite trend (detriment of receiving 74 Gy) was also observed regarding low values of disease solidity and primary co-occurrence matrix energy. Conclusions: FDG-PET–based QIFs were found to be capable of isolating subgroups of patients who received a benefit or detriment from dose escalation.« less

Independent and combined effects of maternal smoking and solid fuel on infant and child mortality in sub-Saharan Africa.

PubMed

Akinyemi, Joshua O; Adedini, Sunday A; Wandera, Stephen O; Odimegwu, Clifford O

2016-12-01

To estimate the independent and combined risks of infant and child mortality associated with maternal smoking and use of solid fuel in sub-Saharan Africa. Pooled weighted data on 143 602 under-five children in the most recent demographic and health surveys for 15 sub-Saharan African countries were analysed. The synthetic cohort life table technique and Cox proportional hazard models were employed to investigate the effect of maternal smoking and solid cooking fuel on infant (age 0-11 months) and child (age 12-59 months) mortality. Socio-economic and other confounding variables were included as controls. The distribution of the main explanatory variable in households was as follows: smoking + solid fuel - 4.6%; smoking + non-solid fuel - 0.22%; no smoking + solid fuel - 86.9%; and no smoking + non-solid fuel - 8.2%. The highest infant mortality rate was recorded among children exposed to maternal smoking + solid fuel (72 per 1000 live births); the child mortality rate was estimated to be 54 per 1000 for this group. In full multivariate models, the risk of infant death was 71% higher among those exposed to maternal smoking + solid fuel (HR = 1.71, CI: 1.29-2.28). For ages 12 to 59 months, the risk of death was 99% higher (HR = 1.99, CI: 1.28-3.08). Combined exposures to cigarette smoke and solid fuel increase the risks of infant and child mortality. Mothers of under-five children need to be educated about the danger of smoking while innovative approaches are needed to reduce the mortality risks associated with solid cooking fuel. © 2016 John Wiley & Sons Ltd.

Monitoring Haloperidol Plasma Concentration and Associated Adverse Events in Critically Ill Children With Delirium: First Results of a Clinical Protocol Aimed to Monitor Efficacy and Safety.

PubMed

Slooff, Valerie D; van den Dungen, Desley K; van Beusekom, Babette S; Jessurun, Naomi; Ista, Erwin; Tibboel, Dick; de Wildt, Saskia N

2018-02-01

As delirium in critically ill children is increasingly recognized, more children are treated with the antipsychotic drug haloperidol, while current dosing guidelines are lacking solid evidence and appear to be associated with a high risk of adverse events. We aim to report on the safety and efficacy of a recently implemented clinical dose-titration protocol with active monitoring of adverse events. From July 2014 until June 2015, when a potential delirium was identified by regular delirium scores and confirmed by a child psychiatrist, haloperidol was prescribed according to the Dutch Pediatric Formulary. Daily, adverse events were systematically assessed, haloperidol plasma concentrations were measured, and delirium symptoms followed. Dependent on the clinical response, plasma concentration, and adverse event, the dose was adjusted. A 28-bed tertiary PICU in the Netherlands. All patients admitted to the PICU diagnosed with delirium. Treatment with haloperidol according to a dose-titration protocol MEASUREMENTS AND MAIN RESULTS:: Thirteen children (median age [range] 8.3 yr [0.4-13.8 yr]) received haloperidol, predominantly IV (median dose [range] 0.027 mg/kg/d [0.005-0.085 mg/kg/d]). In all patients, pediatric delirium resolved, but five of 13 patients developed possible adverse event. These were reversed after biperiden (n = 2), discontinuing (n = 3), and/or lowering the dose (n = 3). Plasma concentrations were all below the presumed therapeutic threshold of 3-12 µg/L. Prospective systematic monitoring of adverse event in critically ill children receiving haloperidol revealed a significant proportion of possible adverse events. Adverse event developed despite low plasma concentrations and recommended dose administration in the majority of the patients. Our data suggest that haloperidol can potentially improve pediatric delirium, but it might also put patients at risk for developing adverse events.

Pocket Money: Influence on Body Mass Index and Dental Caries among Urban Adolescents.

PubMed

Punitha, V C; Amudhan, A; Sivaprakasam, P; Rathnaprabhu, V

2014-12-01

To explore the influence of pocket money on Dental Caries and Body Mass Index. A cross-sectional study was conducted wherein urban adolescent schoolchildren of age 13-18(n=916) were selected by two stage random sampling technique. Dental caries was measured using the DMFT Index. The children's nutritional status was assessed by means of anthropometric measurements. Body Mass Index using weight and height of children was evaluated using the reference standard of the WHO 2007. RESULTS showed that 50% of children receive pocket money from parents. The average amount received was Rs. 360/month. There was a significant correlation between age and amount of money received (r=0.160, p=.001). The average amount received by male children was significantly higher (Rs. 400) when compared to female children (Rs. 303). It was observed that income of the family (>30,000 Rs./month) and socioeconomic status (Upper class) was significantly dependent on the amount of money received by children (p<0.05). There was no significant difference in the occurrence of caries among children receiving pocket money or not. When BMI categories and pocket money were considered, statistically significant difference was seen among overweight and obese and normal weight children (p<.05). Higher proportion (40.1%) of overweight and obese adolescent children frequented the fast food restaurants every week when compared to the underweight (31.7%) and normal weight children (29.9%). Adolescent children receiving pocket money from parents could influence their eating habits in turn affect general health. Parents and teachers should motivate children on healthy spending of their pocket money.

Solid Phase Characterization of Tank 241-C-105 Grab Samples

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

Ely, T. M.; LaMothe, M. E.; Lachut, J. S.

The solid phase characterization (SPC) of three grab samples from single-shell Tank 241-C-105 (C-105) that were received at the laboratory the week of October 26, 2015, has been completed. The three samples were received and broken down in the 11A hot cells.

A National Description of Treatment among United States Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

PubMed

Danielson, Melissa L; Visser, Susanna N; Chronis-Tuscano, Andrea; DuPaul, George J

2018-01-01

To characterize lifetime and current rates of attention-deficit/hyperactivity disorder (ADHD) treatments among US children and adolescents with current ADHD and describe the association of these treatments with demographic and clinical factors. Data are from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a follow-back survey of parents from the 2011-2012 National Survey of Children's Health. Weighted analyses focused on receipt of ADHD treatment among children aged 4-17 years with current ADHD (n = 2495) by 4 treatment types: medication, school supports, psychosocial interventions, and alternative treatments. Medication and school supports were the most common treatments received, with two-thirds of children and adolescents with ADHD currently receiving each treatment. Social skills training was the most common psychosocial treatment ever received (39%), followed by parent training (31%), peer intervention (30%), and cognitive behavioral therapy (20%). Among alternative treatments, 9% were currently taking dietary supplements, and 11% had ever received neurofeedback. Most children (67%) had received at least 2 of the following: current medication treatment, current school supports, or lifetime psychosocial treatment; 7% had received none of these 3 treatment types. A majority of school-aged children and adolescents with ADHD received medication treatment and school supports, whereas fewer received recommended psychosocial interventions. Efforts to increase access to psychosocial treatments may help close gaps in service use by groups currently less likely to receive treatment, which is important to ensure that the millions of school-aged US children diagnosed with ADHD receive quality treatment. Published by Elsevier Inc.

Predicting successful introduction of novel fruit to preschool children.

PubMed

Blissett, Jacqueline; Bennett, Carmel; Donohoe, Jessica; Rogers, Samantha; Higgs, Suzanne

2012-12-01

Few children eat sufficient fruits and vegetables despite their established health benefits. The feeding practices used by parents when introducing novel foods to their children, and their efficacy, require further investigation. We aimed to establish which feeding strategies parents commonly use when introducing a novel fruit to their preschool-aged children and assess the effectiveness of these feeding strategies on children's willingness to try a novel fruit. Correlational design. Twenty-five parents and their children aged 2 to 4 years attended our laboratory and consumed a standardized lunch, including a novel fruit. Interactions between parent and child were recorded and coded. Pearson's correlations and multiple linear regression analyses. The frequency with which children swallowed and enjoyed the novel fruit, and the frequency of taste exposures to the novel fruit during the meal, were positively correlated with parental use of physical prompting and rewarding/bargaining. Earlier introduction of solids was related to higher frequency of child acceptance behaviors. The child's age at introduction of solids and the number of physical prompts displayed by parents significantly predicted the frequency of swallowing and enjoying the novel fruit. Age of introduction to solids and parental use of rewards/bargaining significantly predicted the frequency of taste exposures. Prompting a child to eat and using rewards or bargains during a positive mealtime interaction can help to overcome barriers to novel fruit consumption. Early introduction of solids is also associated with greater willingness to consume a novel fruit. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Prescriptions of opioids to children and adolescents; a study from a national prescription database in Norway.

PubMed

Fredheim, Olav Magnus S; Log, Tomas; Olsen, Wenche; Skurtveit, Svetlana; Sagen, Øystein; Borchgrevink, Petter C

2010-06-01

Analgesics are among the groups of drugs most frequently prescribed to children and adolescents. The prevalence of opioid use in children and adolescents is, however, not known. The primary aim was to determine the 1-year periodic prevalence of opioid dispension in Norwegian children and adolescents below 18 years of age. The secondary aim was to determine to which extent children and adolescents receive opioids for acute or chronic pain. All pharmacies in Norway submit data electronically to the Norwegian Prescription Database on all dispensed prescriptions. All prescriptions to any individual are identified with a pseudonym. All Norwegians who were dispensed opioids from 2004 to 2007 are included in the study. In 2004, 6386 children and adolescents received opioid dispensions, a number which had increased by 35% to 8607 in 2007. These numbers correspond to an increase in 1-year periodic prevalence from 0.59 to 0.79%. Each year during the study period, approximately 95% of the patients received only one or two opioid dispensions. Only 262 Norwegian children and adolescents below 18 years of age received opioid dispensions in three successive years from 2005 to 2007. About 93-95% of children and adolescents receiving opioids each year received the weak opioid codeine. The 1-year periodic prevalence of opioid use in Norwegian children and adolescents is only one-sixteenth of the previously reported prevalence in the Norwegian adult population. Children and adolescents primarily receive opioids for acute pain.

The symptom experiences of Puerto Rican children undergoing cancer treatments and alleviation practices as reported by their mothers.

PubMed

Gonzalez-Mercado, Velda J; Williams, Phoebe D; Williams, Arthur R; Pedro, Elsa; Colon, Gloria

2017-02-01

Although symptoms during cancer treatments are prevalent and are important clinical outcomes of childhood cancer, the symptom experiences of Puerto Rican children along with the symptom alleviation/care practices that parents provide during cancer treatments have received limited attention. To examine the occurrence/severity of symptoms on the Therapy-Related Symptom Checklist-Children (TRSC-C), reported by mothers of Puerto Rican children undergoing cancer treatments and identifying mothers' symptom alleviation/management strategies. Descriptive study conducted between January and May 2012. Mothers of 65 Puerto Rican children/adolescents undergoing cancer treatments responded to the Spanish versions of the TRSC-C, Symptom Alleviation: Self-Care Methods, and a Demographic and Health form. The children/adolescents' mean age was 9.2 (1-17) years; 62% were boys; 56 had chemotherapy; 9 had chemoradiotherapy. Children diagnoses were 35.4% leukemia, 24.6% solid tumors, 24.6% nervous system tumors, and 15.4% other. On the TRSC-C, the symptoms experienced by 70% or more of the children were: irritability (77%), nausea (75%), and hair loss (72%). On the Symptom Alleviation: Self-Care Methods, the most commonly reported symptom alleviation category was "taking prescribed medicines." Puerto Rican mothers reported the use of alleviation practices to treat their children experiencing symptoms during pediatric cancer treatments. Patients and caregivers need to be educated about treatment-induced side effects, and the life-threatening consequences of underreporting and undermanagement. Symptoms should always be addressed at the time of initiation of primary or adjuvant cancer therapy because pretreatment symptoms may persist or get worse across the trajectory of treatment. A continuous assessment and management of symptoms during the childhood cancer trajectory can optimize clinical care and improve quality of life of patients and families. © 2016 John Wiley & Sons Australia, Ltd.

Adherence to oral rehydration therapy among in-patient children aged 1-59 months with some or no dehydration.

PubMed

Migowa, A N; Gatinu, B; Nduati, R W

2010-04-01

To determine adherence to oral rehydration solution (ORS) among in-patients aged 1-59 months suffering from gastroenteritis and having some dehydration (SD) or no dehydration (ND) in two rural hospitals in Kenya. Children aged 1-59 months suffering from acute gastroenteritis with (SD) or (ND) were enrolled into the study, examined and medical records reviewed. On the second and third day of follow up, children were re-examined to ascertain hydration status and care-takers interviewed. Ninety-nine children were enrolled. Forty-five (75%) of the 60 children with SD received a correct prescription for ORS but only 12 (20%) received the correct amount. Among the 39 children with ND, 23 (59%) received a correct prescription for ORS, however only 16 (41%) received the correct amount. On the 3rd day, 9 (15%) of the 60 children with SD at baseline and 2 (5%) of the 39 with ND were classified as having SD. Four in five children with SD and 6 in 10 children with ND fail to receive the correct amounts of ORS.

Nominal group technique-elicited barriers and facilitators to following the Dietary Guidelines for solid fats and added sugars in children: The HEALTH Study

USDA-ARS?s Scientific Manuscript database

The US population has a high intake of discretionary solid fats and added sugars (SoFAS) which currently exceeds federal dietary recommendations. The goal of this study was to identify barriers and facilitators to following the DGA. Thirty-eight 5th grade children across six Human Nutrition Resear...

Guidelines for the Prophylaxis of Pneumocystis jirovecii Pneumonia (PJP) in Children With Solid Tumors.

PubMed

Proudfoot, Rebecca; Phillips, Bob; Wilne, Sophie

2017-04-01

Although it is well-established that children undergoing allogeneic stem cell transplants and treatment for leukemia should be offered prophylaxis against Pneumocystis jirovecii pneumonia, the risk for children with solid malignancies is less certain. This guideline has been developed with the aim of standardizing practice and optimizing the benefit versus risk of prophylactic medication in this group of patients. P. jirovecii pneumonia has a high mortality rate even with prompt antimicrobial treatment. Since prophylaxis with co-trimoxazole is safe, effective, and inexpensive, we suggest that all children with malignancies undergoing immunosuppressive therapy are offered prophylaxis unless there are clear contraindications.

7 CFR 1126.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2013 CFR

2013-01-01

...; (3) The total pounds of butterfat, protein, and other solids contained in the producer's milk; (4... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... protein received times the protein price for the month; (iv) Multiply the pounds of other solids received...

7 CFR 1126.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2011 CFR

2011-01-01

...; (3) The total pounds of butterfat, protein, and other solids contained in the producer's milk; (4... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... protein received times the protein price for the month; (iv) Multiply the pounds of other solids received...

7 CFR 1126.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2012 CFR

2012-01-01

...; (3) The total pounds of butterfat, protein, and other solids contained in the producer's milk; (4... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... protein received times the protein price for the month; (iv) Multiply the pounds of other solids received...

7 CFR 1126.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; (3) The total pounds of butterfat, protein, and other solids contained in the producer's milk; (4... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... protein received times the protein price for the month; (iv) Multiply the pounds of other solids received...

7 CFR 1126.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2014 CFR

2014-01-01

...; (3) The total pounds of butterfat, protein, and other solids contained in the producer's milk; (4... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... protein received times the protein price for the month; (iv) Multiply the pounds of other solids received...

Health disparities and impact on outcomes in children with primary central nervous system solid tumors.

PubMed

Austin, Mary T; Hamilton, Emma; Zebda, Denna; Nguyen, Hoang; Eberth, Jan M; Chang, Yuchia; Elting, Linda S; Sandberg, David I

2016-11-01

OBJECTIVE Health disparities in access to care, early detection, and survival exist among adult patients with cancer. However, there have been few reports assessing how health disparities impact pediatric patients with malignancies. The objective in this study was to examine the impact of racial/ethnic and social factors on disease presentation and outcome for children with primary CNS solid tumors. METHODS The authors examined all children (age ≤ 18 years) in whom CNS solid tumors were diagnosed and who were enrolled in the Texas Cancer Registry between 1995 and 2009 (n = 2421). Geocoded information was used to calculate the driving distance between a patient's home and the nearest pediatric cancer treatment center. Socioeconomic status (SES) was determined using the Agency for Healthcare Research and Quality formula and 2007-2011 US Census block group data. Logistic regression was used to determine factors associated with advanced-stage disease. Survival probability and hazard ratios were calculated using life table methods and Cox regression. RESULTS Children with advanced-stage CNS solid tumors were more likely to be < 1 year old, Hispanic, and in the lowest SES quartile (all p < 0.05). The adjusted odds ratios of presenting with advanced-stage disease were higher in children < 1 year old compared with children > 10 years old (OR 1.71, 95% CI 1.06-2.75), and in Hispanic patients compared with non-Hispanic white patients (OR 1.56, 95% CI 1.19-2.04). Distance to treatment and SES did not impact disease stage at presentation in the adjusted analysis. Furthermore, 1- and 5-year survival probability were worst in children 1-10 years old, Hispanic patients, non-Hispanic black patients, and those in the lowest SES quartile (p < 0.05). In the adjusted survival model, only advanced disease and malignant behavior were predictive of mortality. CONCLUSIONS Racial/ethnic disparities are associated with advanced-stage disease presentation for children with CNS solid tumors. Disease stage at presentation and tumor behavior are the most important predictors of survival.

Health disparities are important determinants of outcome for children with solid tumor malignancies

PubMed Central

Austin, Mary T.; Nguyen, Hoang; Eberth, Jan M.; Chang, Yuchia; Heczey, Andras; Hughes, Dennis P.; Lally, Kevin P.; Elting, Linda S.

2015-01-01

Purpose The purpose of this study was to identify health disparities in children with non-CNS solid tumor malignancies and examine their impact on disease presentation and outcome. Methods We examined the records of all children (age ≤ 18 years) diagnosed with a non-CNS solid tumor malignancy and enrolled in the Texas Cancer Registry between 1995 and 2009 (n = 4603). The primary outcome measures were disease stage and overall survival (OS). Covariates included gender, age, race/ethnicity, year of diagnosis, socioeconomic status (SES), and driving distance to the nearest pediatric cancer treatment facility. Statistical analyses included life table methods, logistic, and Cox regression. Statistical significance was defined as p < 0.05. Results Children with advanced-stage disease were more likely to be male, <10 years old, and Hispanic or non-Hispanic Blacks (all p < 0.05). Distance to treatment and SES did not impact stage of disease at presentation. However, Hispanic and non-Hispanic Blacks and patients in the lowest SES quartile had the worst 1- and 5-year survival (all p < 0.05). The adjusted OS differed by age, race, and stage, but not SES or distance to the nearest treatment facility. Conclusions Race/ethnicity plays an important role in survival for children with non-CNS solid tumor malignancies. Future work should better define these differences to establish mechanisms to decrease their impact. PMID:25598116

KidsCount in Colorado! 2000.

ERIC Educational Resources Information Center

Vasquez, Jenifer

This Kids Count report examines statewide and county trends in the well-being of Colorado's children. The statistical portrait is based on 24 indicators of well-being: (1) children receiving AFDC (Aid to Families with Dependent children); (2) children receiving TANF; (3) children qualifying for free lunch; (4) children in out-of-home placements;…

Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia.

PubMed

Cantekin, Kenan; Yildirim, Mustafa Denizhan; Cantekin, Isin

2014-01-01

This study's purpose was to investigate how young children's and parent/caregivers' oral health-related quality of life and children's dental fears were affected by dental rehabilitation under general anesthesia (DRGA). A consecutive clinical sample of dyads of parents/caregivers and their four- to six-year-old children who received DRGA were surveyed before and after DRGA. Parents/caregivers responded through a self-administered questionnaire [Early Childhood Oral Health Impact Scale (ECOHIS)], and children received a dentist-administered questionnaire [children's fear survey schedule-dental subscale (CFSS-DS)]. The final sample consisted of 311 children/caregiver dyads. One to six teeth were extracted in 91 percent of children. There was a 44 percent decrease in total ECOHIS scores following treatment (P<.001). Overall child impact section scores decreased 34 percent following treatment (P<.001), and family impact section scores decreased 65 percent (P<.001). CFSS-DS anxiety scores after dental treatment were significantly higher for 14 of 15 situations/conditions assessed (P<.001). There was a trend of higher CFSS-DS scores in children who received increasing numbers of extractions. Children's and parent/caregivers' quality of life improved after the children received dental rehabilitation under general anesthesia, and children's fears increased for all situations tested. The number of extractions the children received was associated with increased levels of fear.

76 FR 16538 - Solid Waste Rail Transfer Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

... circumstances. Upon receiving a land-use-exemption permit issued by the Board, a solid waste rail transfer... new application for a land-use-exemption permit if the rail line associated with the solid waste rail... transportation of solid waste by rail. (2) The Board will not grant a land-use-exemption permit for a solid waste...

First-time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream.

PubMed

Cozzi, Giorgio; Borrometi, Fabio; Benini, Franca; Neri, Elena; Rusalen, Francesca; Celentano, Loredana; Zanon, Davide; Schreiber, Silvana; Ronfani, Luca; Barbi, Egidio

2017-05-01

More than 50% of children report apian during venepuncture or intravenous cannulation and using local anaesthetics before needle procedures can lead to different success rates. This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream. We conducted this multicentre randomised controlled trial at three tertiary-level children's hospitals in Italy in 2015. Children aged three to 10 years were enrolled in an emergency department, paediatric day hospital and paediatric ward and randomly allocated to receive a warm lidocaine and tetracaine patch or EMLA cream. The primary outcome was the success rate at the first attempt. The analysis included 172 children who received a warm lidocaine and tetracaine patch and 167 who received an EMLA cream. The needle procedure was successful at the first attempt in 158 children (92.4%) who received the warm patch and in 142 children (85.0%) who received the cream (p = 0.03). The pain scores were similar in both groups. This study showed that the first-time needle procedure success was 7.4% higher in children receiving a warm lidocaine and tetracaine patch than EMLA cream. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Macrophage activation syndrome in children with systemic lupus erythematosus and children with juvenile idiopathic arthritis.

PubMed

Bennett, Tellen D; Fluchel, Mark; Hersh, Aimee O; Hayward, Kristen N; Hersh, Adam L; Brogan, Thomas V; Srivastava, Rajendu; Stone, Bryan L; Korgenski, E Kent; Mundorff, Michael B; Casper, T Charles; Bratton, Susan L

2012-12-01

To describe patient demographics, interventions, and outcomes in hospitalized children with macrophage activation syndrome (MAS) complicating systemic lupus erythematosus (SLE) or juvenile idiopathic arthritis (JIA). We performed a retrospective cohort study using data recorded in the Pediatric Health Information System (PHIS) database from October 1, 2006 to September 30, 2010. Participants had International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for MAS and either SLE or JIA. The primary outcome was hospital mortality (for the index admission). Secondary outcomes included intensive care unit (ICU) admission, critical care interventions, and medication use. A total of 121 children at 28 children's hospitals met the inclusion criteria, including 19 children with SLE and 102 children with JIA. The index admission mortality rate was 7% (8 of 121 patients). ICU admission (33%), mechanical ventilation (26%), and inotrope/vasopressor therapy (26%) were common. Compared to children with JIA, those with SLE had a similar mortality rate (6% versus 11%, respectively; exact P = 0.6). More patients with SLE than those with JIA received ICU care (63% versus 27%; P = 0.002), received mechanical ventilation (53% versus 21%; P = 0.003), and had cardiovascular dysfunction (47% versus 23% received inotrope/vasopressor therapy; P = 0.02). Children with SLE and those with JIA received cyclosporine at similar rates, but more children with SLE received cyclophosphamide and mycophenolate mofetil, and more children with JIA received interleukin-1 antagonists. Organ system dysfunction is common in children with rheumatic diseases complicated by MAS, and more organ system support is required in children with underlying SLE than in children with JIA. Current treatment of pediatric MAS varies based on the underlying rheumatic disease. Copyright © 2012 by the American College of Rheumatology.

Effect of micronutrient supplementation on treatment outcomes in children with intrathoracic tuberculosis: a randomized controlled trial.

PubMed

Lodha, Rakesh; Mukherjee, Aparna; Singh, Varinder; Singh, Sarman; Friis, Henrik; Faurholt-Jepsen, Daniel; Bhatnagar, Shinjini; Saini, Savita; Kabra, Sushil K; Grewal, Harleen M S

2014-11-01

Micronutrients play an important role in immune function. To our knowledge, there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis. We assessed the effect of micronutrient supplementation in children treated with antituberculosis therapy (ATT). A randomized, double-blind, placebo-controlled trial that used a 2 × 2 factorial design was undertaken at 2 teaching hospitals in Delhi. Children with newly diagnosed intrathoracic tuberculosis were enrolled, and they received ATT together with daily supplementation for 6 mo with either zinc alone, micronutrients without zinc, micronutrients in combination with zinc, or a placebo. Main outcomes were weight gain and an improvement in a chest X-ray (CXR) lesion assessed at 6 mo of treatment. A total of 403 children were enrolled and randomly assigned. A microbiological diagnosis of tuberculosis was confirmed in 179 children (44.4%). The median (95% CI) increase in weight-for-age z score at 6 mo was not significantly different between subjects who received micronutrients [0.75 (0.66, 0.84)] and those who did not receive micronutrients [0.76 (0.67, 0.85)] and between subjects who received zinc [0.76 (0.68, 0.85)] and those who did not receive zinc [0.75 (0.66, 0.83)]. An improvement in CXR was observed in 285 children, but there was no difference between those receiving zinc and no zinc or between those receiving micronutrients and no micronutrients after 6 mo of ATT. However, children who received micronutrients had a faster gain in height over 6 mo than did those who did not receive micronutrients (height-for-age z score Δ = 0.08; P = 0.014). Micronutrient supplementation did not modify the weight gain or clearance of lesions on CXR in children with intrathoracic tuberculosis. However, micronutrient supplementation during treatment may improve height gain in children with intrathoracic tuberculosis. This trial was registered at clinicaltrials.gov as NCT00801606. © 2014 American Society for Nutrition.

What do Indian children drink when they do not receive water? Statistical analysis of water and alternative beverage consumption from the 2005-2006 Indian National Family Health Survey.

PubMed

Fledderjohann, Jasmine; Doyle, Pat; Campbell, Oona; Ebrahim, Shah; Basu, Sanjay; Stuckler, David

2015-07-05

Over 1.2 billion people lack access to clean water. However, little is known about what children drink when there is no clean water. We investigated the prevalence of receiving no water and what Indian children drink instead. We analysed children's beverage consumption using representative data from India's National Family and Health Survey (NFHS-3, 2005-2006). Consumption was based on mothers' reports (n = 22,668) for children aged 6-59 months (n = 30,656). About 10 % of Indian children had no water in the last 24 h, corresponding to 12,700,000 children nationally, (95 % CI: 12,260,000 to 13,200,000). Among children who received no water, 23 % received breast or fresh milk and 24 % consumed formula, "other liquid", juice, or two or more beverages. Children over 2 were more likely to consume non-milk beverages, including tea, coffee, and juice than those under 2 years. Those in the lowest two wealth quintiles were 16 % less likely to have received water (OR = 0.84; 95 % CI: 0.74 to 0.96). Compared to those living in households with bottled, piped, or tanker water, children were significantly less likely to receive water in households using well water (OR = 0.75; 95 % CI: 0.64 to 0.89) or river, spring, or rain water (OR =0.70; 95 % CI: 0.53 to 0.92) in the last 24 h. About 13 million Indian children aged 6-59 months received no water in the last 24 h. Further research is needed to assess the risks potentially arising from insufficient water, caffeinated beverages, and high sugar drinks at early stages of life.

Pocket Money: Influence on Body Mass Index and Dental Caries among Urban Adolescents

PubMed Central

Amudhan, A.; Sivaprakasam, P.; Rathnaprabhu, V.

2014-01-01

Objective: To explore the influence of pocket money on Dental Caries and Body Mass Index. Materials and Methods: A cross-sectional study was conducted wherein urban adolescent schoolchildren of age 13-18(n=916) were selected by two stage random sampling technique. Dental caries was measured using the DMFT Index. The children’s nutritional status was assessed by means of anthropometric measurements. Body Mass Index using weight and height of children was evaluated using the reference standard of the WHO 2007. Results: Results showed that 50% of children receive pocket money from parents. The average amount received was Rs. 360/month. There was a significant correlation between age and amount of money received (r=0.160, p=.001). The average amount received by male children was significantly higher (Rs. 400) when compared to female children (Rs. 303). It was observed that income of the family (>30,000 Rs./month) and socioeconomic status (Upper class) was significantly dependent on the amount of money received by children (p<0.05). There was no significant difference in the occurrence of caries among children receiving pocket money or not. When BMI categories and pocket money were considered, statistically significant difference was seen among overweight and obese and normal weight children (p<.05). Higher proportion (40.1%) of overweight and obese adolescent children frequented the fast food restaurants every week when compared to the underweight (31.7%) and normal weight children (29.9%). Conclusion: Adolescent children receiving pocket money from parents could influence their eating habits in turn affect general health. Parents and teachers should motivate children on healthy spending of their pocket money. PMID:25653973

Memory immune response and safety of a booster dose of Japanese encephalitis chimeric virus vaccine (JE-CV) in JE-CV-primed children

PubMed Central

Feroldi, Emmanuel; Capeding, Maria Rosario; Boaz, Mark; Gailhardou, Sophia; Meric, Claude; Bouckenooghe, Alain

2013-01-01

Japanese encephalitis chimeric virus vaccine (JE-CV) is a licensed vaccine indicated in a single dose administration for primary immunization. This controlled phase III comparative trial enrolled children aged 36–42 mo in the Philippines. 345 children who had received one dose of JE-CV in a study two years earlier, received a JE-CV booster dose. 105 JE-vaccine-naïve children in general good health were randomized to receive JE-CV (JE-vaccine naïve group; 46 children) or varicella vaccine (safety control group; 59 children). JE neutralizing antibody titers were assessed using PRNT50. Immunological memory was observed in children who had received the primary dose of JE-CV before. Seven days after the JE-CV booster dose administration, 96.2% and 66.8% of children were seroprotected and had seroconverted, respectively, and the geometric mean titer (GMT) was 231 1/dil. Twenty-eight days after the JE-CV booster dose seroprotection and seroconversion were achieved in 100% and 95.3% of children, respectively, and the GMT was 2,242 1/dil. In contrast, only 15.4% of JE-CV-vaccine naïve children who had not received any prior JE vaccine were seroprotected seven days after they received JE-CV. One year after receiving the JE-CV booster dose, 99.4% of children remained seroprotected. We conclude that JE-CV is effective and safe, both as a single dose and when administrated as a booster dose. A booster dose increases the peak GMT above the peak level reached after primary immunization and the antibody persistence is maintained at least one year after the JE-CV booster dose administration. Five year follow up is ongoing. PMID:23442823

Memory immune response and safety of a booster dose of Japanese encephalitis chimeric virus vaccine (JE-CV) in JE-CV-primed children.

PubMed

Feroldi, Emmanuel; Capeding, Maria Rosario; Boaz, Mark; Gailhardou, Sophia; Meric, Claude; Bouckenooghe, Alain

2013-04-01

Japanese encephalitis chimeric virus vaccine (JE-CV) is a licensed vaccine indicated in a single dose administration for primary immunization. This controlled phase III comparative trial enrolled children aged 36-42 mo in the Philippines. 345 children who had received one dose of JE-CV in a study two years earlier, received a JE-CV booster dose. 105 JE-vaccine-naïve children in general good health were randomized to receive JE-CV (JE-vaccine naïve group; 46 children) or varicella vaccine (safety control group; 59 children). JE neutralizing antibody titers were assessed using PRNT50. Immunological memory was observed in children who had received the primary dose of JE-CV before. Seven days after the JE-CV booster dose administration, 96.2% and 66.8% of children were seroprotected and had seroconverted, respectively, and the geometric mean titer (GMT) was 231 1/dil. Twenty-eight days after the JE-CV booster dose seroprotection and seroconversion were achieved in 100% and 95.3% of children, respectively, and the GMT was 2,242 1/dil. In contrast, only 15.4% of JE-CV-vaccine naïve children who had not received any prior JE vaccine were seroprotected seven days after they received JE-CV. One year after receiving the JE-CV booster dose, 99.4% of children remained seroprotected. We conclude that JE-CV is effective and safe, both as a single dose and when administrated as a booster dose. A booster dose increases the peak GMT above the peak level reached after primary immunization and the antibody persistence is maintained at least one year after the JE-CV booster dose administration. Five year follow up is ongoing.

Indoor air pollution in developing countries: research and implementation needs for improvements in global public health.

PubMed

Gall, Elliott T; Carter, Ellison M; Earnest, C Matt; Stephens, Brent

2013-04-01

Exposure to indoor air pollution (IAP) from the burning of solid fuels for cooking, heating, and lighting accounts for a significant portion of the global burden of death and disease, and disproportionately affects women and children in developing regions. Clean cookstove campaigns recently received more attention and investment, but their successes might hinge on greater integration of the public health community with a variety of other disciplines. To help guide public health research in alleviating this important global environmental health burden, we synthesized previous research on IAP in developing countries, summarized successes and challenges of previous cookstove implementation programs, and provided key research and implementation needs from structured discussions at a recent symposium.

Indoor Air Pollution in Developing Countries: Research and Implementation Needs for Improvements in Global Public Health

PubMed Central

Gall, Elliott T.; Carter, Ellison M.; Matt Earnest, C.

2013-01-01

Exposure to indoor air pollution (IAP) from the burning of solid fuels for cooking, heating, and lighting accounts for a significant portion of the global burden of death and disease, and disproportionately affects women and children in developing regions. Clean cookstove campaigns recently received more attention and investment, but their successes might hinge on greater integration of the public health community with a variety of other disciplines. To help guide public health research in alleviating this important global environmental health burden, we synthesized previous research on IAP in developing countries, summarized successes and challenges of previous cookstove implementation programs, and provided key research and implementation needs from structured discussions at a recent symposium. PMID:23409891

Increased Use of Dental Services by Children Covered by Medicaid: 2000–2010

PubMed Central

Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie

2013-01-01

This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done. PMID:24753975

Increased use of dental services by children covered by Medicaid: 2000-2010.

PubMed

Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie

2013-01-01

This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done.

A new method to monitor the contribution of fast food restaurants to the diets of US children.

PubMed

Rehm, Colin D; Drewnowski, Adam

2014-01-01

American adults consume 11.3% of total daily calories from foods and beverages from fast food restaurants. The contribution of different types of fast food restaurants to the diets of US children is unknown. To estimate the consumption of energy, sodium, added sugars, and solid fats among US children ages 4-19 y by fast food restaurant type. Analyses used the first 24-h recall for 12,378 children in the 2003-2010 cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES 2003-2010). NHANES data identify foods by location of origin, including stores and fast food restaurants (FFR). A novel custom algorithm divided FFRs into 8 segments and assigned meals and snacks to each. These included burger, pizza, sandwich, Mexican, Asian, fish, and coffee/snack restaurants. The contribution of each restaurant type to intakes of energy and other dietary constituents was then assessed by age group (4-11 y and 12-19 y) and by race/ethnicity. Store-bought foods and beverages provided 64.8% of energy, 61.9% of sodium, 68.9% of added sugars, and 60.1% of solid fats. FFRs provided 14.1% of energy, 15.9% of sodium, 10.4% of added sugars and 17.9% of solid fats. Among FFR segments, burger restaurants provided 6.2% of total energy, 5.8% of sodium, 6.2% of added sugars, and 7.6% of solid fats. Less energy was provided by pizza (3.3%), sandwich (1.4%), Mexican (1.3%), and chicken restaurants (1.2%). Non-Hispanic black children obtained a greater proportion of their total energy (7.4%), sodium (7.1%), and solid fats (9.5%) from burger restaurants as compared to non-Hispanic white children (6.0% of energy, 5.5% of sodium, and 7.3% of solid fat). These novel analyses, based on consumption data by fast food market segment, allow public health stakeholders to better monitor the effectiveness of industry efforts to promote healthier menu options.

A New Method to Monitor the Contribution of Fast Food Restaurants to the Diets of US Children

PubMed Central

Rehm, Colin D.; Drewnowski, Adam

2014-01-01

Background American adults consume 11.3% of total daily calories from foods and beverages from fast food restaurants. The contribution of different types of fast food restaurants to the diets of US children is unknown. Objective To estimate the consumption of energy, sodium, added sugars, and solid fats among US children ages 4–19 y by fast food restaurant type. Methods Analyses used the first 24-h recall for 12,378 children in the 2003–2010 cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES 2003–2010). NHANES data identify foods by location of origin, including stores and fast food restaurants (FFR). A novel custom algorithm divided FFRs into 8 segments and assigned meals and snacks to each. These included burger, pizza, sandwich, Mexican, Asian, fish, and coffee/snack restaurants. The contribution of each restaurant type to intakes of energy and other dietary constituents was then assessed by age group (4–11 y and 12–19 y) and by race/ethnicity. Results Store-bought foods and beverages provided 64.8% of energy, 61.9% of sodium, 68.9% of added sugars, and 60.1% of solid fats. FFRs provided 14.1% of energy, 15.9% of sodium, 10.4% of added sugars and 17.9% of solid fats. Among FFR segments, burger restaurants provided 6.2% of total energy, 5.8% of sodium, 6.2% of added sugars, and 7.6% of solid fats. Less energy was provided by pizza (3.3%), sandwich (1.4%), Mexican (1.3%), and chicken restaurants (1.2%). Non-Hispanic black children obtained a greater proportion of their total energy (7.4%), sodium (7.1%), and solid fats (9.5%) from burger restaurants as compared to non-Hispanic white children (6.0% of energy, 5.5% of sodium, and 7.3% of solid fat). Conclusions These novel analyses, based on consumption data by fast food market segment, allow public health stakeholders to better monitor the effectiveness of industry efforts to promote healthier menu options. PMID:25062277

Impact of an active video game on healthy children's physical activity.

PubMed

Baranowski, Tom; Abdelsamad, Dina; Baranowski, Janice; O'Connor, Teresia Margareta; Thompson, Debbe; Barnett, Anthony; Cerin, Ester; Chen, Tzu-An

2012-03-01

This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether the effect would be greater among children in unsafe neighborhoods, who might not be allowed to play outside. Participants were children 9 to 12 years of age, with a BMI >50th percentile, but <99th percentile; none of these children a medical condition that would preclude physical activity or playing video games. A randomized clinical trial assigned children to receiving 2 active or 2 inactive video games, the peripherals necessary to run the games, and a Wii console. Physical activity was monitored by using accelerometers for 5 weeks over the course of a 13-week experiment. Neighborhood safety was assessed with a 12 item validated questionnaire. There was no evidence that children receiving the active video games were more active in general, or at anytime, than children receiving the inactive video games. The outcomes were not moderated by parent perceived neighborhood safety, child BMI z score, or other demographic characteristics. These results provide no reason to believe that simply acquiring an active video game under naturalistic circumstances provides a public health benefit to children.

Minnesota Kids: A Closer Look. 2001 Data Book.

ERIC Educational Resources Information Center

Coffin, Linda

This KIDS COUNT data book examines trends in the well-being of Minnesota's children. The statistical portrait is based on 12 indicators of child well-being: (1) children in poverty; (2) children in families receiving food stamps; (3) children receiving free or reduced-price school lunch; (4) children born to teenage mothers; (5) children born at…

Receipt of Medication and Behavioral Therapy Among a National Sample of School-Age Children Diagnosed With Attention-Deficit/Hyperactivity Disorder.

PubMed

Walls, Morgan; Allen, Caitlin G; Cabral, Howard; Kazis, Lewis E; Bair-Merritt, Megan

2018-04-01

In 2011, the American Academy of Pediatrics published practice guidelines for attention-deficit/hyperactivity disorder (ADHD), recommending both medication and behavioral therapy for school-age children. The current study examines associations between child/family characteristics and ADHD medication, behavioral, and combined therapy. This study used data from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette syndrome, a nationally representative follow-up survey to the 2011-2012 National Survey of Children's Health. Descriptive statistics were used to estimate frequencies of ADHD treatments and multivariable logistic regression to examine child/family characteristics associated with parent-reported medication use, classroom management, and parent training for children aged 8 to 17 diagnosed with ADHD (n = 2401). Black and Hispanic children were less likely than white children to have ever received ADHD medication. Hispanic children were less likely than white children to be currently receiving medications (adjusted odds ratio, 0.49; 95% confidence interval, 0.30-0.80). No differences were found in current medication use for black children compared to white children. Thirty-percent of parents reported that their child was currently receiving classroom management, and 31% reported having ever received parent training for ADHD. Children whose ADHD medication was managed by a primary care physician were less likely to receive combined medication and behavioral therapy compared to children managed by specialty physicians (adjusted odds ratio, 2.58; 95% confidence interval, 1.75-3.79). Most school-age children reported receiving medication for ADHD; however, medication disparities persist. Parent-reported use of behavioral therapies are low. Future research should examine reasons for observed variation in treatment and interventions to optimize ADHD care. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

CaEDTA vs CaEDTA plus BAL to treat children with elevated blood lead levels.

PubMed

O'Connor, M E

1992-07-01

The effectiveness of CaEDTA alone vs CaEDTA plus BAL was compared retrospectively in a group of 72 children with lead levels between 2.41 mumol/L (50 micrograms/dL) and 2.90 mumol/L (60 micrograms/dL). The children who received both drugs had higher median zinc protoporphyrin (ZnP) concentrations at the initiation of therapy than children who received CaEDTA alone (160 micrograms/dL vs 96 micrograms/dL, p less than .01). There was a significantly increased incidence of vomiting and abnormal liver-function test results in the children who received both drugs. The children who received CaEDTA alone had a greater percent mean fall in lead level at one to three weeks postchelation (30.5% vs 18.1%, p less than .05). Children who received both CaEDTA and BAL had a greater percent decrease in ZnP at four to eight months postchelation, but there was no difference in percent decrease in lead levels. Children who received both drugs also had a greater number of repeat courses of chelation by six months. The addition of BAL to CaEDTA for treatment of children with lead levels of 2.41 mumol/L (50 micrograms/dL) to 2.90 mumol/L (60 micrograms/dL) produced greater toxicity and does not seem to prevent repeat chelations within six months.

The Early Childhood Obesity Prevention Program (ECHO): an ecologically-based intervention delivered by home visitors for newborns and their mothers.

PubMed

Cloutier, Michelle M; Wiley, James; Wang, Zhu; Grant, Autherene; Gorin, Amy A

2015-06-24

Obesity is a major problem in the United States, particularly among socio-economically disadvantaged Latino and Black children. Effective interventions that can be disseminated to large numbers of at-risk children and their families are needed. The goals of the Early Childhood Obesity Prevention Program (ECHO) are to examine the 12-month efficacy of a primary obesity prevention program targeting the first year of life that is delivered by home visitors and that engages mothers as agents of change to modify their own behavior and their infant's behavior through education and skill-building around nutrition, physical activity, and wellness, and then "echoes" her training with linkages to neighborhood programs and resources. Six family centers located in low-income neighborhoods in Hartford, CT were randomized into control and intervention neighborhoods. Fifty-seven mothers were recruited either prenatally or shortly after delivery into the Nurturing Families Network home visitation program; 27 lived in a control neighborhood and received the standard home visitation program and 30 lived in an intervention neighborhood and received both the standard home visitation program and the ECHO intervention. The intervention increases maternal skills in goal-setting, stimulus control and problem-solving, engages family members to support changes, links mothers to neighborhood resources and is embedded in the standard home visitation program. ECHO targets include breastfeeding, solids, juice and sugar-sweetened beverages, routines for sleep and responding to infant cues, television/screen time, and maternal diet and physical activity. We hypothesize that infants in ECHO will have been breastfed longer and exclusively, will have delayed introduction of solids and juice, have longer sleep duration, decreased television/screen time and a lower weight for length z-score at 12 months, and their mothers will have greater fruit and vegetable consumption and higher levels of physical activity. ECHO will provide important information about whether an enhanced behavior change curriculum integrated into an existing home visitation program, focused on the mother as the agent of change and linked to neighborhood resources is effective in changing energy balance behaviors in the infant and in the mother. If effective, the intervention could be widely disseminated to prevent obesity in young children. ClinicalTrials.gov NCT02052518 January 30, 2014.

Effectiveness of Parent-Child Interaction Therapy (PCIT) in the Treatment of Young Children's Behavior Problems. A Randomized Controlled Study.

PubMed

Bjørseth, Åse; Wichstrøm, Lars

2016-01-01

The aim of the present investigation was to compare the effectiveness of Parent-Child Interaction Therapy (PCIT) with treatment as usual (TAU) in young children who were referred to regular child and adolescent mental health clinics for behavior problems. Eighty-one Norwegian families with two- to seven-year-old children (52 boys) who had scored ≥ 120 on the Eyberg Child Behavior Inventory (ECBI) were randomly assigned to receive either PCIT or TAU. The families were assessed 6 and 18 months after beginning treatment. Parenting skills were measured using the Dyadic Parent-Child Interaction Coding System (DPICS), and child behavior problems were measured using the ECBI and the Child Behavior Checklist (CBCL). Linear growth curve analyses revealed that the behavior problems of children receiving PCIT improved more compared with children receiving TAU according to mother reports (ECBI d = .64, CBCL d = .61, both p < .05) but not according to father report. Parents also improved with regard to Do and Don't skills (d = 2.58, d = 1.46, respectively, both p ≤ .001). At the 6-month assessment, which often occurred before treatment was finished, children who had received PCIT had lower father-rated ECBI and mother-rated CBCL-scores (p = .06) compared with those who had received TAU. At the 18-month follow-up, the children who had received PCIT showed fewer behavior problems compared with TAU according to mother (d = .37) and father (d = .56) reports on the ECBI and mother reports on the CBCL regarding externalizing problems (d = .39). Parents receiving PCIT developed more favorable Do Skills (6-month d = 1.81; 18-month d = 1.91) and Don't Skills (6-month d = 1.46; 18-month d = 1.42) according to observer ratings on the DPICS compared with those receiving TAU. Children receiving PCIT in regular clinical practice exhibited a greater reduction in behavior problems compared with children receiving TAU, and their parents' parenting skills improved to a greater degree compared with those receiving TAU. ClinicalTrials.gov NTC01085305.

Beliefs and practices regarding solid food introduction among Latino parents in Northern California.

PubMed

Beck, Amy L; Hoeft, Kristin S; Takayama, John I; Barker, Judith C

2018-01-01

Latino children are more likely to be obese than non-Hispanic white children, and feeding patterns that begin in infancy may contribute to this disparity. The objective of this study was to elucidate beliefs and practices related to the introduction of solids and solid food feeding in the first year of life among low-income Latino parents residing in Northern California. We conducted 26 semi-structured interviews that explored the timing of introduction of solids, selection of foods to serve to infants, feeding strategies, sources of information on solid food feeding and concerns about infant weight. We found that most parents relied on traditional practices in selecting first foods for infants and had a strong preference for homemade food, which was often chicken soup with vegetables. Parents generally described responsive feeding practices; however a minority used pressuring practices to encourage infants to eat more. Very few parents practiced repeated gentle introduction of unfamiliar food to increase acceptance. High calorie low nutrient foods were typically introduced at around 12 months of age and parents struggled to limit such foods once children were old enough to ask for them. Parents were concerned about the possibility of infants becoming overweight and considered health care providers to be an important source of information on infant weight status. The results of this study can be used to inform the development of interventions to prevent obesity in Latino children with similar demographics to our study population. Copyright © 2017 Elsevier Ltd. All rights reserved.

32 CFR 80.2 - Applicability and scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FAMILIES, AND SPECIAL EDUCATION CHILDREN WITH DISABILITIES WITHIN THE SECTION 6 SCHOOL ARRANGEMENTS § 80.2... children, and children receiving or entitled to receive early intervention services or special educational...

Comparing interventions for selective mutism: a pilot study.

PubMed

Manassis, Katharina; Tannock, Rosemary

2008-10-01

To examine the outcome within 6 to 8 months of medical and nonmedical intervention for children with severe selective mutism (SM). Children with SM (n = 17) and their mothers, seen in a previous study, attended follow-up appointments with a clinician. Obtained by maternal report were: treatment received, current diagnosis (based on semi-structured interview), speech in various environments, and global improvement. An independent clinician also rated global functioning. The diagnosis of SM persisted in 16 children, but significant symptomatic improvement was evident in the sample. All children had received school consultations. Children who had been treated with selective serotonin reuptake inhibitors (SSRI) (n = 10) showed greater global improvement, improvement in functioning, and improvement in speech outside the family than children who were unmedicated (n = 7). No differences were evident for children receiving and not receiving additional nonmedical intervention. The findings suggest the potential benefit of SSRI treatment in severe SM, but randomized comparative treatment studies are indicated.

Early Intervention for Children with Hearing Loss: Information Parents Receive about Supporting Children's Language

ERIC Educational Resources Information Center

Decker, Kalli B.; Vallotton, Claire D.

2016-01-01

Family-centered early intervention for children with hearing loss is intended to strengthen families' interactions with their children to support children's language development, and should include providing parents with information they can use as part of their everyday routines. However, little is known about the information received by families…

Minnesota Kids: A Closer Look. 2003 Data Book.

ERIC Educational Resources Information Center

Coffin, Linda

This KIDS COUNT data book examines trends in the well-being of Minnesotas children. The statistical portrait is based on 11 indicators of child well-being: (1) children living in poverty; (2) children in families receiving food stamps; (3) children receiving free or reduced-price school lunch; (4) children born to teenage mothers; (5) children…

Minnesota Kids: A Closer Look. 2002 Data Book.

ERIC Educational Resources Information Center

Coffin, Linda

This KIDS COUNT data book examines trends in the well-being of Minnesota's children. The statistical portrait is based on 11 indicators of child well-being: (1) children living in poverty; (2) children in families receiving food stamps; (3) children receiving free or reduced-price school lunch; (4) children born to teenage mothers; (5) children…

Quality of life and chemotherapy-related symptoms of Turkish cancer children undergoing chemotherapy.

PubMed

Arslan, Fatma Tas; Basbakkal, Zumrut; Kantar, Mehmet

2013-01-01

This cross-sectional and descriptive study was designed to determine symptoms emerging due to chemotherapy treatment and their effects on children's quality of life. The research was carried out between February 2008 and February 2009 at the pediatric oncology clinics in four hospitals, focusing on 93 patients receiving chemotherapy. A survey form, the Pediatric Quality of Life Inventory (PedsQL 4.0) and the Memorial Symptom Assessment Scale (MSAS) were used as data collection tools. Chi-square and Student t tests were performed for data analysis. Some 51.6% of the children were aged 13-15 years old, and 51.8% were boys and 50.5% were diagnosed as having solid tumors. There were significant relations between: antimetabolite chemotherapeutics and feeling irritable and worrying (p=0.001, p=0.030); vinkoalkaloid and numbness/tingling in hands/feet (p=0.043); antracyclines and lack of energy and skin changes (p=0.021, p=0.004); and corticosteroids and lack of appetite, nausea and sadness (p=0.008, p=0.009, p=0.009). Several symptoms such as feeling sad, worrying and feeling irritable caused a significant decrease in the total domain of quality of life scores (p=0.034, p=0.012, p=0.010, respectively). Chemotherapeutic drugs can cause symptoms that can seriously affect quality of life in children.

Association of Preprocedural Fasting With Outcomes of Emergency Department Sedation in Children.

PubMed

Bhatt, Maala; Johnson, David W; Taljaard, Monica; Chan, Jason; Barrowman, Nick; Farion, Ken J; Ali, Samina; Beno, Suzanne; Dixon, Andrew; McTimoney, C Michelle; Dubrovsky, Alexander Sasha; Roback, Mark G

2018-05-07

It is not clear whether adherence to preprocedural fasting guidelines prevent pulmonary aspiration and associated adverse outcomes during emergency department (ED) sedation of children. To examine the association between preprocedural fasting duration and the incidence of sedation-related adverse outcomes in a large sample of children. We conducted a planned secondary analysis of a multicenter prospective cohort study of children aged 0 to 18 years who received procedural sedation for a painful procedure in 6 Canadian pediatric EDs from July 2010 to February 2015. The primary risk factor was preprocedural fasting duration. Secondary risk factors were age, sex, American Society of Anesthesiologists classification, preprocedural and sedation medications, and procedure type. Four outcomes were examined: (1) pulmonary aspiration, (2) the occurrence of any adverse event, (3) serious adverse events, and (4) vomiting. A total of 6183 children with a median age of 8.0 years (interquartile range, 4.0-12.0 years), of whom 6166 (99.7%) had healthy or mild systemic disease (American Society of Anesthesiologists levels I or II), were included in the analysis. Of these, 2974 (48.1%) and 310 (5.0%) children did not meet American Society of Anesthesiologists fasting guidelines for solids and liquids, respectively. There were no cases of pulmonary aspiration. There were 717 adverse events (11.6%; 95% CI, 10.8%-12.4%), of which 68 (1.1%; 95% CI, 0.9%-1.3%) were serious adverse events and 315 (5.1%; 95% CI, 4.6%-5.7%) were vomiting. The odds ratio (OR) of occurrence of any adverse event, serious adverse events, and vomiting did not change significantly with each additional hour of fasting duration for both solids (any adverse event: OR, 1.00; 95% CI, 0.98 to 1.02; serious adverse events, OR, 1.01; 95% CI, 0.95-1.07; vomiting: OR, 1.00; 95% CI, 0.97-1.03) and liquids (any adverse event: OR, 1.00; 95% CI, 0.98-1.02; serious adverse events: 1.01, 95% CI, 0.95-1.07; vomiting: OR, 1.00; 95% CI, 0.96-1.03). In this study, there was no association between fasting duration and any type of adverse event. These findings do not support delaying sedation to meet established fasting guidelines.

Otitis media in Brazilian human immunodeficiency virus infected children undergoing antiretroviral therapy.

PubMed

Miziara, I D; Weber, R; Araújo Filho, B Cunha; Pinheiro Neto, C Diógenes

2007-11-01

To assess changes in the prevalence of otitis media, associated with the use of highly active antiretroviral therapy, in Brazilian human immunodeficiency virus (HIV) infected children. Division of otorhinolaryngology, Hospital das Clínicas, Sao Paulo University Medical School, Brazil. A cohort of 459 HIV-infected children aged below 13 years. The prevalence of otitis media and the serum cluster of differentiation four glycoprotein T lymphocyte count were compared for children receiving highly active antiretroviral therapy (with protease inhibitors) and those receiving standard antiretroviral therapy (without protease inhibitors). Otitis media was present in 33.1 per cent of the children. Children aged from zero years to five years 11 months receiving highly active antiretroviral therapy had a higher prevalence of acute otitis media (p=0.02) and a lower prevalence of chronic otitis media (p=0.02). Children who were receiving highly active antiretroviral therapy had a mean serum cluster of differentiation four glycoprotein T lymphocyte count greater than that of those who were receiving standard antiretroviral therapy (p<0.001). The use of highly active antiretroviral therapy in Brazilian HIV-infected children was associated with a lower prevalence of chronic otitis media.

78 FR 31946 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

.... Information Collection Request Title: Children's Hospital Graduate Medical Education Payment Program (CHGME PP... freestanding children's hospitals, similar to Medicare GME support received by other, non-children's hospitals. The legislation indicates that eligible children's hospitals will receive payments for both direct and...

75 FR 23771 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

...: Children's Hospital Graduate Medical Education Payment Program (CHGME PP) Annual Report (OMB No. 0915-0313... education (GME) to freestanding children's hospitals, similar to Medicare GME support received by other, non- children's hospitals. The legislation indicates that eligible children's hospitals will receive payments...

Palliative sedation at home for terminally ill children with cancer.

PubMed

Korzeniewska-Eksterowicz, Aleksandra; Przysło, Łukasz; Fendler, Wojciech; Stolarska, Małgorzata; Młynarski, Wojciech

2014-11-01

The presence of symptoms that are difficult to control always requires adjustment of treatment, and palliative sedation (PS) should be considered. We analyzed our experience in conducting PS at home for terminally ill children with cancer during a seven-year period. We performed a retrospective analysis of medical records of children with cancer treated at home between the years 2005 and 2011. We analyzed the data of 42 cancer patients (18% of all patients); in 21 cases, PS was initiated (solid tumors n = 11, brain tumors [5], bone tumors [4], leukemia [1]). Sedation was introduced because of pain (n = 13), dyspnea (9), anxiety (5), or two of those symptoms (6). The main drug used for sedation was midazolam; all patients received morphine. There were no significant differences in the dose of morphine or midazolam depending on the patient's sex; age was correlated with an increase of midazolam dose (R = 0.68; P = 0.005). Duration of sedation (R = 0.61; P = 0.003) and its later initiation (R = 0.43; P = 0.05) were correlated with an increase of the morphine dose. All patients received adjuvant treatment; in patients who required a morphine dose increase, metoclopramide was used more often (P = 0.0002). Patients did not experience any adverse reactions. Later introduction of sedation was associated with a marginally higher number of intervention visits and a significantly higher number of planned visits (R = 0.53; P = 0.013). Sedation may be safely used at home. It requires close monitoring and full cooperation between the family and hospice team. Because of the limited data on home PS in pediatric populations, further studies are needed. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

KANSAS KIDS COUNT Data Book, 2000: Kansas Children at Risk.

ERIC Educational Resources Information Center

Kansas Action for Children, Inc., Topeka.

This KIDS COUNT Data Book provides state and county data on the well-being of Kansas' children. The statistical portrait is based on 22 indicators of well-being: (1) births to single teens; (2) children living in poverty; (3) children receiving free school meals; (4) children in families receiving economic assistance; (5) childhood deaths; (6)…

California County Data Book, 1999: How Our Youngest Children Are Faring.

ERIC Educational Resources Information Center

Children Now, Oakland, CA.

This Kids Count Data Book examines trends in the well-being of California's children, focusing on factors influencing young children. This statistical portrait is based on trends in 19 indicators of child well-being in four areas: (1) family economics, including child poverty rate, children receiving TANF, children receiving WIC, fair market rent,…

Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-Based Mental Health Settings

ERIC Educational Resources Information Center

Mandell, David S.; Walrath, Christine M.; Manteuffel, Brigitte; Sgro, Gina; Pinto-Martin, Jennifer

2005-01-01

This study describes the characteristics of children with autistic spectrum disorders (ASD) receiving treatment in community mental health settings. Data from a national community mental health initiative was used to identify children who had received a primary diagnosis of ASD. These children were compared with children with other diagnoses on…

Everyday beliefs about sources of advice for the parents of difficult children.

PubMed

Sonuga-Barke, E J; Thompson, M; Balding, J

1993-01-01

Parents were asked which sources of advice families with difficult children should seek. The results suggested a similar hierarchy of agencies for both boys and girls with emotional and behavioural problems. Teachers, doctors, child psychiatrists and health visitors all received strong positive ratings, books about children with problems received moderate positive ratings, religious leaders received the strongest negative ratings and grandparents and friends received neutral ratings. Implications for service provision are discussed.

Abemaciclib in Children With DIPG or Recurrent/Refractory Solid Tumors

ClinicalTrials.gov

2017-07-14

Diffuse Intrinsic Pontine Glioma; Brain Tumor, Recurrent; Solid Tumor, Recurrent; Neuroblastoma, Recurrent, Refractory; Ewing Sarcoma, Recurrent, Refractory; Rhabdomyosarcoma, Recurrent, Refractory; Osteosarcoma, Recurrent, Refractory; Rhabdoid Tumor, Recurrent, Refractory

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

PubMed Central

Mandell, David S.; Novak, Maytali M.; Zubritsky, Cynthia D.

2010-01-01

Objective Early diagnosis of children with autism spectrum disorders (ASD) is critical but often delayed until school age. Few studies have identified factors that may delay diagnosis. This study attempted to identify these factors among a community sample of children with ASD. Methods Survey data were collected in Pennsylvania from 969 caregivers of children who had ASD and were younger than 21 years regarding their service experiences. Linear regression was used to identify clinical and demographic characteristics associated with age of diagnosis. Results The average age of diagnosis was 3.1 years for children with autistic disorder, 3.9 years for pervasive developmental disorder not otherwise specified, and 7.2 years for Asperger’s disorder. The average age of diagnosis increased 0.2 years for each year of age. Rural children received a diagnosis 0.4 years later than urban children. Near-poor children received a diagnosis 0.9 years later than those with incomes >100% above the poverty level. Children with severe language deficits received a diagnosis an average of 1.2 years earlier than other children. Hand flapping, toe walking, and sustained odd play were associated with a decrease in the age of diagnosis, whereas oversensitivity to pain and hearing impairment were associated with an increase. Children who had 4 or more primary care physicians before diagnosis received a diagnosis 0.5 years later than other children, whereas those whose pediatricians referred them to a specialist received a diagnosis 0.3 years sooner. Conclusion These findings suggest improvements over time in decreasing the age at which children with ASD, especially higher functioning children, receive a diagnosis. They also suggest a lack of resources in rural areas and for near-poor families and the importance of continuous pediatric care and specialty referrals. That only certain ASD-related behaviors, some of which are not required to satisfy diagnostic criteria, decreased the age of diagnosis suggests the importance of continued physician education. PMID:16322174

Children's Developing Understanding of Technology

ERIC Educational Resources Information Center

Mawson, Brent

2010-01-01

The issue of children's conceptions of technology and technology education is seen as important by technology educators. While there is a solid body of literature that documents groups of children's understandings of technology and technology education, this is primarily focused on snapshot studies of children aged 11 and above. There is little…

Infections during induction therapy for children with acute lymphoblastic leukemia. the role of sulfamethoxazole-trimethoprim (SMX-TMP) prophylaxis.

PubMed

Rungoe, Christine; Malchau, Emma Louise; Larsen, Line Nordahl; Schroeder, Henrik

2010-08-01

Bacteremias are frequent during induction therapy for acute lymphoblastic leukemia (ALL) in children. Antibacterial prophylaxis therapy may thus be warranted. The purpose of this study was to analyze the rate of infections during induction therapy in two cohorts of children with ALL where one cohort received prophylactic sulfamethoxazole-trimethoprim (SMX-TMP). All infections were registered through a retrospective non-randomized review of medical records of 171 consecutive children newly diagnosed with ALL below 15 years of age at diagnosis. A total of 85 children treated from 1992 to 2000 did not receive SMX-TMP, whereas 86 children treated from 2000 to 2008 received SMX-TMP 20 mg/kg in one daily oral dose during induction therapy. A total of 26% of all children had no febrile episodes during induction. Infections were more frequent in children below 5 years of age. Significantly fewer children receiving SMX-TMP developed fever (17% vs. 34%, P = 0.02) and bacteremia (20% vs. 45%, P = 0.0003). Especially children with non-high risk criteria had fewer infections when receiving prophylaxis. When adjusting for age, type of catheter, and SMX-TMP prophylaxis on the risk of bacteremia by a multiple Cox regression analysis, we found that age and prophylaxis, but not the type of catheter, were associated with a significantly reduced risk of bacteremia. Children with ALL receiving SMX-TMP prophylaxis during induction therapy experienced fewer febrile episodes, fewer days with fever demanding intravenous antibiotic treatment, and fewer episodes of bacteremia. Both SMX-TMP prophylaxis and age played significant independent roles for the occurrence of bacteremia. (c) 2010 Wiley-Liss, Inc.

Strategies for reducing exposure to indoor air pollution from household burning of solid fuels: effects on acute lower respiratory infections in children under the age of 15 years

PubMed Central

Havens, Deborah; Jary, Hannah R; Patel, Latifa B; Chiume, Msandeni E; Mortimer, Kevin J

2015-01-01

This is the protocol for a review and there is no abstract. The objectives are as follows: This study aims to assess the effects of intervention strategies that reduce exposure to household air pollution from burning solid fuels on episodes of acute lower respiratory infection (ALRI) in children under the age of 15 years.

Effects of welfare and maternal work on recommended preventive care utilization among low-income children.

PubMed

Holl, Jane L; Oh, Elissa H; Yoo, Joan; Amsden, Laura B; Sohn, Min-Woong

2012-12-01

We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. We identified American Academy of Pediatrics-recommended preventive care visits from medical records of children in the 1999-2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.

Temozolomide and O6-benzylguanine in Treating Children With Solid Tumors

ClinicalTrials.gov

2015-04-28

Brain and Central Nervous System Tumors; Childhood Germ Cell Tumor; Extragonadal Germ Cell Tumor; Kidney Cancer; Liver Cancer; Neuroblastoma; Ovarian Cancer; Sarcoma; Unspecified Childhood Solid Tumor, Protocol Specific

Analgesia and sedation practices for incarcerated inguinal hernias in children.

PubMed

Al-Ansari, Khalid; Sulowski, Christopher; Ratnapalan, Savithiri

2008-10-01

In this study, the use of medications for analgesia and/or sedation for incarcerated inguinal hernia reductions in the emergency department was analyzed. A retrospective chart review was conducted for all patients presenting to a pediatric emergency department with incarcerated inguinal hernia from 2002 to 2005. A total of 99 children presented with incarcerated hernias during the study period. The median age was 11 months. Forty-four percent of children received medication for the procedure, of them 75% received parenteral and 25% oral or intranasal medications. Forty-five percent of children who received medication went through at least 1 hernia reduction attempt initially without medications. More than half the children with incarcerated inguinal hernias did not receive any medication for pain and/or sedation prior to hernia reduction. Guidelines for medication use for children with incarcerated inguinal hernias need to be developed.

A latent class analysis of bullies, victims and aggressive victims in Chinese adolescence: relations with social and school adjustments.

PubMed

Shao, Aihui; Liang, Lichan; Yuan, Chunyong; Bian, Yufang

2014-01-01

This study used the latent class analysis (LCA) to identify and classify Chinese adolescent children's aggressive behaviors. It was found that (1) Adolescent children could be divided into four categories: general children, aggressive children, victimized children and aggressive victimized children. (2) There were significant gender differences among the aggressive victimized children, the aggressive children and the general children. Specifically, aggressive victimized children and aggressive children had greater probabilities of being boys; victimized children had equal probabilities of being boys or girls. (3) Significant differences in loneliness, depression, anxiety and academic achievement existed among the aggressive victims, the aggressor, the victims and the general children, in which the aggressive victims scored the worst in all questionnaires. (4) As protective factors, peer and teacher supports had important influences on children's aggressive and victimized behaviors. Relative to general children, aggressive victims, aggressive children and victimized children had lower probabilities of receiving peer supports. On the other hand, compared to general children, aggressive victims had lower probabilities of receiving teacher supports; while significant differences in the probability of receiving teacher supports did not exist between aggressive children and victimized children.

A Latent Class Analysis of Bullies, Victims and Aggressive Victims in Chinese Adolescence: Relations with Social and School Adjustments

PubMed Central

Shao, Aihui; Liang, Lichan; Yuan, Chunyong; Bian, Yufang

2014-01-01

This study used the latent class analysis (LCA) to identify and classify Chinese adolescent children's aggressive behaviors. It was found that (1) Adolescent children could be divided into four categories: general children, aggressive children, victimized children and aggressive victimized children. (2) There were significant gender differences among the aggressive victimized children, the aggressive children and the general children. Specifically, aggressive victimized children and aggressive children had greater probabilities of being boys; victimized children had equal probabilities of being boys or girls. (3) Significant differences in loneliness, depression, anxiety and academic achievement existed among the aggressive victims, the aggressor, the victims and the general children, in which the aggressive victims scored the worst in all questionaires. (4) As protective factors, peer and teacher supports had important influences on children's aggressive and victimized behaviors. Relative to general children, aggressive victims, aggressive children and victimized children had lower probabilities of receiving peer supports. On the other hand, compared to general children, aggressive victims had lower probabilities of receiving teacher supports; while significant differences in the probability of receiving teacher supports did not exist between aggressive children and victimized children. PMID:24740096

Relationship of preschool special education outcomes to instructional practices and parent-child interaction.

PubMed

Mahoney, Gerald; Wheeden, C Abigail; Perales, Frida

2004-01-01

Developmental outcomes attained by children receiving preschool special education services in relationship to both the general instructional approach used by their teachers and their parents' style of interaction were examined. The sample included 70 children from 41 Early Childhood Special Education (ECSE) classrooms. The type of instructional model children received was determined by dividing the sample into three clusters based upon six global ratings of children's classroom environment: Choice; Cognitive Problem-Solving; Child-Initiated Learning; Developmental Match; Child-Centered Routines; and Rewards and Discipline Strategies. Based on this analysis, 27 children were classified as receiving developmental instruction; 15 didactic instruction; and 28 naturalistic instruction. Observations of parent-child interaction collected at the beginning and end of the year were classified along four dimensions using the Maternal Behavior Rating Scale: Responsiveness, Affect, Achievement Orientation and Directiveness. Results indicated that the kinds of experiences that children received varied significantly across the three instructional models. However, there were no significant differences in the impact of these instructional models on children's rate of development. Regression analyses indicated that children's rate of development at the end of intervention was significantly related to their parents' style of interaction but was unrelated to the type of instructional model they received.

Impact of an Active Video Game on Healthy Children’s Physical Activity

PubMed Central

Abdelsamad, Dina; Baranowski, Janice; O’Connor, Teresia Margareta; Thompson, Debbe; Barnett, Anthony; Cerin, Ester; Chen, Tzu-An

2012-01-01

OBJECTIVE: This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether the effect would be greater among children in unsafe neighborhoods, who might not be allowed to play outside. METHODS: Participants were children 9 to 12 years of age, with a BMI >50th percentile, but <99th percentile; none of these children a medical condition that would preclude physical activity or playing video games. A randomized clinical trial assigned children to receiving 2 active or 2 inactive video games, the peripherals necessary to run the games, and a Wii console. Physical activity was monitored by using accelerometers for 5 weeks over the course of a 13-week experiment. Neighborhood safety was assessed with a 12 item validated questionnaire. RESULTS: There was no evidence that children receiving the active video games were more active in general, or at anytime, than children receiving the inactive video games. The outcomes were not moderated by parent perceived neighborhood safety, child BMI z score, or other demographic characteristics. CONCLUSIONS: These results provide no reason to believe that simply acquiring an active video game under naturalistic circumstances provides a public health benefit to children. PMID:22371457

CCCT - NCTN Steering Committees - Pediatric and Adolescent Tumor

Cancer.gov

The Pediatric and Adolescent Solid Tumor Steering Committee addresses the design, prioritization and evaluation of concepts for large phase 2 and phase 3 clinical trials in extracranial solid tumors of children and youth.

How Important Is Teaching Phonemic Awareness to Children Learning to Read in Spanish?

ERIC Educational Resources Information Center

Goldenberg, Claude; Tolar, Tammy D.; Reese, Leslie; Francis, David J.; Bazán, Antonio Ray; Mejía-Arauz, Rebeca

2014-01-01

This comparative study examines relationships between phonemic awareness and Spanish reading skill acquisition among three groups of Spanish-speaking first and second graders: children in Mexico receiving reading instruction in Spanish and children in the United States receiving reading instruction in either Spanish or English. Children were…

Functional Decline in Children Undergoing Selective Dorsal Rhizotomy after Age 10

ERIC Educational Resources Information Center

MacWilliams, Bruce A.; Johnson, Barbara A.; Shuckra, Amy L.; D'Astous, Jacques L.

2011-01-01

Aim: To compare function and gait in a group of children older than most children who received selective dorsal rhizotomy (SDR) with age- and function-matched peers who received either orthopedic surgery or no surgical intervention. Method: A retrospective study examined ambulatory children with diplegic cerebral palsy, aged between 10 years and…

Comparison of Environmental Attitudes and Experiences of Five-Year-Old Children Receiving Preschool Education in the Village and City Centre

ERIC Educational Resources Information Center

Durkan, Nazmi; Güngör, Hande; Fetihi, Leyla; Erol, Ahmet; Gülay Ogelman, Hülya

2016-01-01

The purpose of the study is to compare environmental attitudes and experiences of five-year-old children receiving preschool education in the village and city centre. The first group comprised 54 five-year-old children who received preschool education and attended kindergartens of two primary schools in the Karateke and Kocabas villages of Honaz…

The impact of ethnicity on cochlear implantation in Norwegian children.

PubMed

Amundsen, Viktoria Vedeler; Wie, Ona Bø; Myhrum, Marte; Bunne, Marie

2017-02-01

To explore the impact of parental ethnicity on cochlear implantation in children in Norway with regard to incidence rates of cochlear implants (CIs), comorbidies, age at onset of profound deafness (AOD), age at first implantation, uni- or bilateral CI, and speech recognition. This retrospective cohort study included all children (N = 278) aged <18 years in Norway who received their first CI during the years 2004-2010. 86 children (30.9%) in our study sample had parents of non-Nordic ethnicity, of whom 46 were born in Nordic countries with two non-Nordic parents. Compared with the background population, children with non-Nordic parents were 1.9 times more likely to have received CI than Nordic children (i.e., born in Nordic countries with Nordic parents). When looking at AOD, uni-vs. bilateral CIs, and comorbidities, no significant differences were found between Nordic children and children with a non-Nordic ethnicity. Among children with AOD <1 year (n = 153), those born in non-Nordic countries with two non-Nordic parents (n = 6) and adopted non-Nordic children (n = 6) received their first CI on average 14.9 and 21.1 months later than Nordic children (n = 104), respectively (p = 0.006 and 0.005). Among children with AOD <1 year, those born in Nordic countries with two non-Nordic parents (n = 31) received their CI at an older age than Nordic children, but this difference was not significant after adjusting for calendar year of implantation and excluding comorbidity as a potential cause of delayed implantation. The mean age at implantation for children with AOD <1 year dropped 2.3 months/year over the study period. The mean monosyllable speech recognition score was 84.7% for Nordic children and 76.3% for children born in Norway with two non-Nordic parents (p = 0.002). The incidence of CI was significantly higher in children with a non-Nordic vs. a Nordic ethnicity, reflecting a higher incidence of profound deafness. Children born in Norway have equal access to CIs regardless of their ethnicity, but despite being born and receiving care in Norway, prelingually deaf children with non-Nordic parents are at risk of receiving CI later than Nordic children. Moreover, prelingually deaf children who arrive in Norway at an older age may be at risk for a worse prognosis after receiving a CI due to lack of auditory stimulation in early childhood, which is critical for language development and late implantation; this is a serious issue with regard to deafness among refugees. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Transmission of Cognitive Bias and Fear From Parents to Children: An Experimental Study.

PubMed

Remmerswaal, Danielle; Muris, Peter; Huijding, Jorg

2016-01-01

This study explored the role of parents in the development of a cognitive bias and subsequent fear levels in children. In Experiment 1, nonclinical children ages 8-13 (N = 122) underwent a training during which they worked together with their mothers on an information search task. Mothers received instructions to induce either a positive or negative information search bias in their children. Experiment 2 investigated to what extent mothers own cognitive bias predicted children's information search bias. Mothers of 49 nonclinical children ages 9-12 received no explicit training instructions before working together with their child on an information search task. Experiment 1 demonstrated that mothers had a significant impact on children's cognitive bias and fear. More precisely, children who had received a negative parental training displayed an increase in negative information search bias and fear, whereas children who had received a positive parental training showed an increase in positive information search bias and a decrease in fear. In Experiment 2, it was found that children's information search biases after working together with their mothers were predicted by their mothers' initial cognitive bias scores. These findings can be taken as support for the intergenerational transmission of cognitive biases from mothers to children.

Translational Research in Pediatrics IV: Solid Tissue Collection and Processing.

PubMed

Gillio-Meina, Carolina; Zielke, H Ronald; Fraser, Douglas D

2016-01-01

Solid tissues are critical for child-health research. Specimens are commonly obtained at the time of biopsy/surgery or postmortem. Research tissues can also be obtained at the time of organ retrieval for donation or from tissue that would otherwise have been discarded. Navigating the ethics of solid tissue collection from children is challenging, and optimal handling practices are imperative to maximize tissue quality. Fresh biopsy/surgical specimens can be affected by a variety of factors, including age, gender, BMI, relative humidity, freeze/thaw steps, and tissue fixation solutions. Postmortem tissues are also vulnerable to agonal factors, body storage temperature, and postmortem intervals. Nonoptimal tissue handling practices result in nucleotide degradation, decreased protein stability, artificial posttranslational protein modifications, and altered lipid concentrations. Tissue pH and tryptophan levels are 2 methods to judge the quality of solid tissue collected for research purposes; however, the RNA integrity number, together with analyses of housekeeping genes, is the new standard. A comprehensive clinical data set accompanying all tissue samples is imperative. In this review, we examined: the ethical standards relating to solid tissue procurement from children; potential sources of solid tissues; optimal practices for solid tissue processing, handling, and storage; and reliable markers of solid tissue quality. Copyright © 2016 by the American Academy of Pediatrics.

Child, caregiver, and family characteristics associated with emergency department use by children who remain at home after a child protective services investigation

PubMed Central

Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue

2012-01-01

Objectives To examine emergency department (ED) use among children involved with child protective services (CPS) in the U.S. but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method We analyzed data on 4,001 children in the National Survey of Child and Adolescent Well-being. Multivariate models compared rates of ED use for whether the family received CPS services or did not receive CPS services as well as child characteristics, caregiver characteristics and caregiver/family psychological variables. Results ED use among children who remained at home receiving CPS services was similar to that of children who did not receive CPS services (35.6% and 37.4%, respectively). In multivariate modeling, children with families who received CPS services, children six years or older, and children without a chronic health problem were less likely to use the ED. Children who remained at home in families identified with numerous stressors and, therefore, likely at high risk for future abuse and neglect were 1.73 times (95% CI, 1.14–2.63) more likely to have repeat ED use than children in low risk families. Conclusion Children who remain at home after a CPS evaluation are at high risk for ED use. Future research should focus on the health problems that precipitate an ED visit as well as the relationship between primary care and ED use. PMID:22265905

Brain metastases in patients diagnosed with a solid primary cancer during childhood: experience from a single referral cancer center.

PubMed

Suki, Dima; Khoury Abdulla, Rami; Ding, Minming; Khatua, Soumen; Sawaya, Raymond

2014-10-01

Metastasis to the brain is frequent in adult cancer patients but rare among children. Advances in primary tumor treatment and the associated prolonged survival are said to have increased the frequency of brain metastasis in children. The authors present a series of cases of brain metastases in children diagnosed with a solid primary cancer, evaluate brain metastasis trends, and describe tumor type, patterns of occurrence, and prognosis. Patients with brain metastases whose primary cancer was diagnosed during childhood were identified in the 1990-2012 Tumor Registry at The University of Texas M.D. Anderson Cancer Center. A review of their hospital records provided demographic data, history, and clinical data, including primary cancer sites, number and location of brain metastases, sites of extracranial metastases, treatments, and outcomes. Fifty-four pediatric patients (1.4%) had a brain metastasis from a solid primary tumor. Sarcomas were the most common (54%), followed by melanoma (15%). The patients' median ages at diagnosis of the primary cancer and the brain metastasis were 11.37 years and 15.03 years, respectively. The primary cancer was localized at diagnosis in 48% of patients and disseminated regionally in only 14%. The primary tumor and brain metastasis presented synchronously in 15% of patients, and other extracranial metastases were present when the primary cancer was diagnosed. The remaining patients were diagnosed with brain metastasis after initiation of primary cancer treatment, with a median presentation interval of 17 months after primary cancer diagnosis (range 2-77 months). At the time of diagnosis, the brain metastasis was the first site of systemic metastasis in only 4 (8%) of the 51 patients for whom data were available. Up to 70% of patients had lung metastases when brain metastases were found. Symptoms led to the brain metastasis diagnosis in 65% of cases. Brain metastases were single in 60% of cases and multiple in 35%; 6% had only leptomeningeal disease. The median Kaplan-Meier estimates of survival after diagnoses of primary cancer and brain metastasis were 29 months (95% CI 24-34 months) and 9 months (95% CI 6-11 months), respectively. Untreated patients survived for a median of 0.9 months after brain metastasis diagnosis (95% CI 0.3-1.5 months). Those receiving treatment survived for a median of 8 months after initiation of therapy (95% CI 6-11 months). The results of this study challenge the current notion of an increased incidence of brain metastases among children with a solid primary cancer. The earlier diagnosis of the primary cancer, prior to its dissemination to distant sites (especially the brain), and initiation of presumably more effective treatments may support such an observation. However, although the actual number of cases may not be increasing, the prognosis after the diagnosis of a brain metastasis remains poor regardless of the management strategy.

Using quality improvement methods to reduce clear fluid fasting times in children on a preoperative ward.

PubMed

Newton, Richard J G; Stuart, Grant M; Willdridge, Daniel J; Thomas, Mark

2017-08-01

We applied quality improvement (QI) methodology to identify the different aspects of why children fasted for prolonged periods in our institution. Our aim was for 75% of all children to be fasted for clear fluid for less than 4 hours. Prolonged fasting in children can increase thirst and irritability and have adverse effects on haemodynamic stability on induction. By reducing this, children may be less irritable, more comfortable and more physiologically stable, improving the preoperative experience for both children and carers. We conducted a QI project from January 2014 until August 2016 at a large tertiary pediatric teaching hospital. Baseline data and the magnitude of the problem were obtained from pilot studies. This allowed us to build a key driver diagram, a process map and conduct a failure mode and effects analysis. Using a framework of Plan-Do-Study-Act cycles our key interventions primarily focused on reducing confusion over procedure start times, giving parents accurate information, empowering staff and reducing variation by allowing children to drink on arrival (up to one hour) before surgery. Prior to this project, using the 6,4,2 fasting rule for solids, breast milk, and clear fluids, respectively, 19% of children were fasted for fluid for less than 4 hours, mean fluid fasting time was 6.3 hours (SD 4.48). At the conclusion 72% of patients received a drink within 4 hours, mean fluid fasting reduced to 3.1 hours (SD 2.33). The secondary measures of aspiration (4.14:10 000) and cancellations have not increased since starting this project. By using established QI methodology we reduced the mean fluid fasting time for day admissions at our hospital to 3.1 hours and increased the proportion of children fasting for less than 4 hours from 19% to 72%. © 2017 John Wiley & Sons Ltd.

[CLINICAL AND IMMUNOLOGICAL CRITERIA FOR THE ADVERSE COURSE OF INFECTIOUS MONONUCLEOSIS IN CHILDREN].

PubMed

Kolesnik, Ya; Zharkova, T; Rzhevskaya, O; Kvaratskheliya, T; Sorokina, O

2018-05-01

The article presents the results of our own studies to determine the criteria for the adverse variants of the course of infectious mononucleosis (IM) in children. The study was conducted in the regional children's infectious clinical hospital in Kharkov. 161 children aged three to fifteen years were under observation with diagnosis of infectious moninucleosis. Out of 161 ill children, 140 (86.9%) had moderate severity of disease, and 21 (13.1%) had severe forms. All children were prescribed standard clinical and laboratory-instrumental examinations. The diagnosis of IM was verified by PCR (detection of VEB DNA in the blood) and ELISA (anti-VEB Ig M and Ig G). In 140 children (86.9%) IM proceeded sharply, smoothly (the first group), in 21 (13.1%) - unfavorably (wave and / or prolonged course) - the second group. The groups were comparable according to age, the severity of the disease and other parameters. All children received therapy according to approved protocols (Order of the Ministry of Health of Ukraine No. 354 of 09.07.2004). Immune status of children was assessed by determining the relative contents of CD3 +, CD4 +, CD8 +, CD16 +, CD19 + blood cells with appropriate monoclonal antibodies, serum IgA, IgM, IgG concentration by Mancini and interleukin (IL) -1β cytokine response and - 4, tumor necrosis factor (TNF α) is a solid-phase enzyme-linked immunosorbent assay. Based on the results of observations, it was established that the prognostically unfavorable criteria of IМ at the stages of manifestation of disease include: generalized lymphadenopathy involving 5-6 groups of lymph nodes and a significant increasing of them, purulent tonsillitis, marked increasing of size of liver and spleen on the background of anemia, thrombocytopenia, neutropenia and the absence of atypical mononuclears in the complete blood count. There is a depression of the cellular link and an increase in the humoral mechanisms of immune responses in case of development of adverse course of IM.

Effects of Welfare and Maternal Work on Recommended Preventive Care Utilization Among Low-Income Children

PubMed Central

Holl, Jane L.; Oh, Elissa H.; Yoo, Joan; Amsden, Laura B.

2012-01-01

Objectives. We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. Methods. We identified American Academy of Pediatrics–recommended preventive care visits from medical records of children in the 1999–2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. Results. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. Conclusion. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care. PMID:23078495

An Odyssey of Connecticut's Children: KIDS COUNT Data Book 2001.

ERIC Educational Resources Information Center

Sampson, Amy E.

This Kids Count Data Book provides state and regional trends in the well-being of Connecticut's children. The statistical portrait is based on 19 indicators of well-being: (1) children in families receiving welfare; (2) children receiving free or reduced-price meals; (3) high school employment; (4) births to teen mothers; (5) low birth weight; (6)…

Child-Child Interactions and Positive Social Focus among Preschool Children

ERIC Educational Resources Information Center

Naerland, Terje; Martinsen, Harald

2011-01-01

This study is based on video-recorded observations of 64 children during free play at their nursery. A measure of "social focus" in the preschool, regarded as an indicator of social status, was constructed from the amount of positive and neutral contacts children received from their peers. Only six children often received positive or…

The Role of Expectations in Children's Experience of Novel Events

ERIC Educational Resources Information Center

Gurland, Suzanne T.; Grolnick, Wendy S.; Friendly, Rachel W.

2012-01-01

The expectations children bring to interactions, as well as the information they receive prior to them, may be important for children's experiences of new adults. In this study, 148 children (8-13 years old) reported on their expectations of adults, received one of three types of information about a new adult (positive, realistic, or control), and…

Using Participant Data to Extend the Evidence Base for Intensive Behavioral Intervention for Children with Autism

ERIC Educational Resources Information Center

Eldevik, Sigmund; Hastings, Richard P.; Hughes, J. Carl; Jahr, Erik; Eikeseth, Svein; Cross, Scott

2010-01-01

We gathered individual participant data from 16 group design studies on behavioral intervention for children with autism. In these studies, 309 children received behavioral intervention, 39 received comparison interventions, and 105 were in a control group. More children who underwent behavioral intervention achieved reliable change in IQ (29.8%)…

Conditions Fostering the Use of Informative Feedback by Young Children.

ERIC Educational Resources Information Center

Teager, Joyce; Stern, Carolyn

In order to investigate the effect of reinforcement on learning, 21 disadvantaged black children, 4 to 5 years of age, were divided among three treatment groups. Group I children received only feedback (information) as to the correctness or incorrectness of their responses. Group II children received a raisin for each correct response, and group…

Feeding patterns and diet - children 6 months to 2 years

MedlinePlus

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

Influence of ethnic group on asthma treatment in children in 1990-1: national cross sectional study.

PubMed Central

Duran-Tauleria, E.; Rona, R. J.; Chinn, S.; Burney, P.

1996-01-01

OBJECTIVE--To examine the extent to which the prescription of drugs for asthma adhered to recommended guidelines in 1990-1 and to assess the influence of ethnic group on prescription. DESIGN--Cross sectional. SETTING--Primary schools in England and Scotland in 1990-1. SUBJECTS--Children aged mainly 5-11 years. The representative samples included 10628 children. The inner city sample included 7049 children, 4866 (69%) from ethnic minority groups. For the prevalence estimation 14490 children were included in the analysis (82% of the eligible children). For the treatment analysis a subgroup of 5494 children with respiratory symptoms was selected. MAIN OUTCOME MEASURES--Prevalence of respiratory symptoms and drugs commonly prescribed for asthma, method of administration, inappropriate treatment, and odds ratios to assess the effect of ethnic group on rate of prescription and method of administration. RESULTS--Children with respiratory symptoms in the inner city sample were less likely to be diagnosed as having asthma. Of children with reported asthma attacks, those in inner city areas had a higher risk of not having been prescribed any drug for asthma (odds ratio 1.87 (95% confidence interval 1.26 to 2.77). Overall, 773 (75%) of these children had received a beta 2 agonist, 259 (25%) had received steroids, 148 (14%) had received sodium cromoglycate, and 194 (19%) had received no drug treatment in the previous year. When prescribed, beta 2 agonists were inhaled in 534 (69%) of cases, and this percentage was even lower in ethnic minority groups. Children of Afro-Caribbean and Indian subcontinent origin who had asthma were less likely to receive beta 2 agonists, and those from the Indian subcontinent were less likely to receive anti-inflammatory drugs. Antibiotics were less prescribed and antitussives more prescribed in children from ethnic minority groups than in white children. CONCLUSION--In 1990-1 the risk of underdiagnosis and undertreatment of asthma was higher in children from ethnic minority groups. The implementation of indicators and targets to monitor inequalities in the treatment of asthma in ethnic groups could improve equity and effectiveness in the NHS. PMID:8688777

The Importance of Efficacy: Using the Extended Parallel Process Model to Examine Factors Related to Preschool-Age Children Enrolled in Medicaid Receiving Preventive Dental Visits

ERIC Educational Resources Information Center

Askelson, Natoshia M.; Chi, Donald L.; Momany, Elizabeth T.; Kuthy, Raymond A.; Carter, Knute D.; Field, Kathryn; Damiano, Peter C.

2015-01-01

Early preventive dental visits are vital to the oral health of children. Yet many children, especially preschool-age children enrolled in Medicaid, do not receive early visits. This study attempts to uncover factors that can be used to encourage parents to seek preventive dental care for preschool-age children enrolled in Medicaid. The extended…

Timing of solid food introduction and obesity: Hong Kong's "children of 1997" birth cohort.

PubMed

Lin, Shi Lin; Leung, Gabriel M; Lam, Tai Hing; Schooling, C Mary

2013-05-01

Some observational studies in Western settings show that early introduction of solid food is associated with subsequent obesity. However, introduction of solid food and obesity share social patterning. We examined the association of the timing of the introduction of solid food with BMI and overweight (including obesity) into adolescence in a developed non-Western setting, in which childhood obesity is less clearly socially patterned. We used generalized estimating equation models to estimate the adjusted associations of the timing of the introduction of solid food (<3, 3-4, 5-6, 7-8, and >8 months) with BMI z score and overweight (including obesity) at different growth phases (infancy, childhood, and puberty) in 7809 children (88% follow-up) from a Chinese birth cohort, "Children of 1997." We assessed if the associations varied with gender or breastfeeding. We used multiple imputation for missing exposure and confounders. The introduction of solid food at <3 months of age was associated with lower family socioeconomic position (SEP) but was not clearly associated with BMI or overweight (including obesity) in infancy [mean difference in BMI z score: 0.01; 95% confidence interval (CI): -0.14 to 0.17], childhood (0.14; 95% CI: -0.11 to 0.40), or at puberty (0.22; 95% CI: -0.07 to 0.52), adjusted for SEP and infant and maternal characteristics. In a non-Western developed setting, there was no clear association of the early introduction of solid food with childhood obesity. Together with the inconsistent evidence from studies in Western settings, this finding suggests that any observed associations might simply be residual confounding by SEP.

Timeliness and risk factors associated with delay for pneumococcal conjugate 10-valent routine immunization in Brazilian children.

PubMed

Sartori, Ana Lucia; Minamisava, Ruth; Afonso, Eliane Terezinha; Policena, Gabriela Moreira; Pessoni, Grécia Carolina; Bierrenbach, Ana Luiza; Andrade, Ana Lucia

2017-02-15

Vaccination coverage is the usual metrics to evaluate the immunization programs performance. For the 10-valent pneumococcal conjugate (PCV10) vaccine, measuring the delay of vaccination is also important, particularly as younger children are at increased risk of disease. Routinely collected administrative data was used to assess the timeliness of PCV10 vaccination, and the factors associated with delay to receive the first and second doses, and the completion of the PCV10 3+1 schedule. A population-based retrospective cohort study was conducted with children born in 2012 in Central Brazil. Children who received the PCV10 first dose in public health services were followed-up until 23months of age. Timeliness of receiving each PCV10 dose at any given age was defined as receiving the dose within 28days grace period from the recommended age by the National Immunization Program. Log-binomial regression models were used to examine risk factors for delays of the first dose and the completion PCV10 3+1 schedule. In total, 14,282 children were included in the cohort of study. Delayed vaccination occurred in 9.4%, 23.8%, 36.8% and 39.9% children for the first, second, third and the booster doses, respectively. A total of 1912 children (12.8% of the cohort) were not adequately vaccinated at the 6months of life; 1,071 (7%) received the second dose after 6months of age, 784 (5.4%) did not receive the second dose, and 57 (0.4%) received the first dose after six months of life. A considerable delay was found in PCV10 third and booster doses. Almost 2 thousand children had not received the recommended PCV10 doses at 6months of age. Timeliness of vaccination is an issue in Brazil although high vaccination coverages. Copyright © 2017 Elsevier Ltd. All rights reserved.

Identifying Twice-Exceptional Children and Three Gifted Styles in the Japanese Primary Science Classroom

NASA Astrophysics Data System (ADS)

Sumida, Manabu

2010-10-01

Children with mild developmental disorders sometimes show giftedness. In this study, an original checklist was developed to identify gifted characteristics specific to science learning among twice-exceptional primary school children in Japan. The checklist consisted of 60 items on Attitudes, Thinking, Skills, and Knowledge/Understanding. A total of 86 children from eight primary schools in an urban area in Japan, 50% of whom had Learning Disabilities (LD), Attention Deficit/Hyperactivity Disorder (ADHD), and/or High-functioning Autism (HA), were observed using the checklist. Factor analysis revealed three factors. A cluster analysis with the subscale points of each factor identified three "gifted styles" in science. These were: (1) Spontaneous Style; (2) Expert Style; and (3) Solid Style. LD/ADHD/HA children characteristically displayed a Spontaneous Style while the non- LD/ADHD/HA children were characterized by the Solid Style. In both subject groups, the number of Expert Style children was the lowest with no significant difference in their numbers. Based on the results of this research, this paper discusses the implications of the findings for teaching science to twice-exceptional children and argues the benefits of inclusive science education for children with and without mild developmental disorders.

Prolonged fasting of children before anaesthesia is common in private practice.

PubMed

Buller, Y; Sims, C

2016-01-01

Fasting guidelines for children are well established. Despite these guidelines, previous studies have shown children are often fasted for prolonged periods before anaesthesia, potentially causing discomfort and distress. Moreover, recent publications indicate shorter fasting times for oral clear fluids in children may be safe. We audited fasting times of children having elective surgery at a local large private hospital that provides care for both adults and children. We gave feedback and education to our caregivers, then repeated the audit. Data were collected from 307 children (age 6.0 ± 4.1 years) in an initial eight-week audit, and from 153 children (age 6.7 ± 4.5 years) in a follow-up four-week audit. We found fasting durations were excessive in many children. Sixty-two percent of children in each audit fasted longer than four hours for clear fluids. Children on morning lists fasted longer than children on afternoon lists. Fasting from solids was also excessively long. In the initial audit, 30% fasted more than 12 hours for solids, including 18 who last ate more than 16 hours before surgery. Data from the follow-up audit were similar. We conclude that fasting of children at our hospital is excessive, despite our efforts to shorten the duration. We suspect that our hospital is not the only one with a high incidence of prolonged fasting for children and suggest possible solutions.

ADVERSE EVENTS POST-DTAP AND DTwP VACCINATION IN THAI CHILDREN.

PubMed

Fortuna, Librada; Sirivichayakul, Chukiat; Watanaveeradej, Veerachai; Soonthornworasiri, Ngamphol; Sitcharungsi, Raweerat

2015-07-01

We conducted a prospective study to compare the development of fever (axillary T ≥ 37.9 °C) within 4 hours of vaccination, determine the proportion of children who develop high fever (T ≥ 39°C) and evaluate parental days missed from work due to their children's vaccination with either the diphtheria-tetanus-whole cell pertussis (DTwP) or diphtheria-tetanus-acellular pertussis (DTaP) vaccine. The results of this study can help physicians and parents decide whether to have their child vaccinated with the DTwP or more expensive DTaP vaccine. We studied 140 healthy Thai children aged 2 months to 6 years from December 2011 to March 2012 who presented for vaccination. Parents recorded their child's temperature, local and systemic adverse reactions and missed days from work due to these adverse events on a diary card. Of the 140 participants, 72 received the DTwP vaccine and 68 received the DTaP vaccine. The median (IQR) age was 4 (2-6) months and the median weight was 7.1 (5.6-8.7) kg. Twenty children developed fever (axillary T ≥ 37.9°C) within 4 hours following vaccination, 17 (23.6%) had received the DTwP vaccine and 3 (4.4%) had received the DTaP vaccine (p = 0.040). One child (1.4%) who had received the DTwP vaccine and none who received the DTaP vaccine developed high fever (T ≥ 39°C) within 4 hours of vaccination (p = 0.329). Parents of two children who received the DTwP vaccine and one child who received the DTaP vaccine missed work following vaccination (p = 0.059). In conclusion, children who received the DTwP vaccines were more likely to have early post-vaccination fever and higher fever but there was no significant difference between the two groups in parental days lost from work.

Communication Satellites 1958 to 1986

DTIC Science & Technology

1984-10-01

information by tracking a ground-based beacon. The payload has redundant wideband receivers and redundant transmitters, with 230 W helix type TWTs , for...70.3, International Conference on Comrounications; ICC 󈨕 (June 1981). , and R. H. Tamashiro, "A 20 GHz 75 Watt Helix TWT for Space...WB) All solid state except TWT 10-W output Receiver 1723.3. 1726.7 MHz (NB), 1725 HHz (WB) All solid state 14-dB noise figure Antenna 2

Upfront window vincristine/irinotecan treatment of high-risk hepatoblastoma: A report from the Children's Oncology Group AHEP0731 study committee.

PubMed

Katzenstein, Howard M; Furman, Wayne L; Malogolowkin, Marcio H; Krailo, Mark D; McCarville, M Beth; Towbin, Alexander J; Tiao, Greg M; Finegold, Milton J; Ranganathan, Sarangarajan; Dunn, Stephen P; Langham, Max R; McGahren, Eugene D; Rodriguez-Galindo, Carlos; Meyers, Rebecka L

2017-06-15

The identification of new therapies for high-risk (HR) hepatoblastoma is challenging. Children's Oncology Group study AHEP0731 included a HR stratum to explore the efficacy of novel agents. Herein, the authors report the response rate to the combination of vincristine (V) and irinotecan (I) and the outcome of patients with high-risk hepatoblastoma. Patients with newly diagnosed metastatic hepatoblastoma or those with a serum α-fetoprotein (AFP) level <100 ng/mL were eligible. Patients received 2 cycles of V at a dose of 1.5 mg/m 2 /day intravenously on days 1 and 8 and I at a dose of 50 mg/m 2 /day intravenously on days 1 to 5. Patients were defined as responders if they had either a 30% decrease in tumor burden according to Response Evaluation Criteria In Solid Tumors (RECIST) or a 90% (>1 log 10 ) decline in their AFP level. Responders were to receive 2 additional cycles of VI intermixed with 6 cycles of the combination of cisplatin, doxorubicin, 5-fluorouracil, and vincristine (C5VD). Nonresponders were to receive 6 cycles of C5VD alone. A total of 32 patients with a median age at diagnosis of 26 months (range, 11-159 months) were enrolled between September 2009 and February 2012. Fourteen of 30 evaluable patients were responders (RECIST and AFP in 6 patients, RECIST only in 3 patients, and AFP only in 5 patients). The median AFP decline after 2 cycles of VI for the entire group was 345,565 ng/mL (85% of the initial AFP). The 3-year event-free and overall survival rates were 49% (95% confidence interval, 30%-65%) and 62% (95% confidence interval, 42%-77%), respectively. The VI combination appears to have substantial activity against HR hepatoblastoma. The ultimate impact of this regimen in improving the outcomes of children with HR hepatoblastoma remains to be determined. Cancer 2017;123:2360-2367. © 2017 American Cancer Society. © 2017 American Cancer Society.

The Influence of Juggling on Mental Rotation Performance in Children with Spina Bifida

ERIC Educational Resources Information Center

Lehmann, Jennifer; Jansen, Petra

2012-01-01

This study examined the influence of juggling training on mental rotation ability in children with spina bifida. Children between the ages of 8 and 12 solved a chronometric mental rotation test. Half of the children received juggling training (EG) over an 8 week time period; the other half did not receive training (CG). Afterwards, all…

No visible dental staining in children treated with doxycycline for suspected Rocky Mountain Spotted Fever.

PubMed

Todd, Suzanne R; Dahlgren, F Scott; Traeger, Marc S; Beltrán-Aguilar, Eugenio D; Marianos, Donald W; Hamilton, Charlene; McQuiston, Jennifer H; Regan, Joanna J

2015-05-01

To evaluate whether cosmetically relevant dental effects occurred among children who had received doxycycline for treatment of suspected Rocky Mountain spotted fever (RMSF). Children who lived on an American Indian reservation with high incidence of RMSF were classified as exposed or unexposed to doxycycline, based on medical and pharmacy record abstraction. Licensed, trained dentists examined each child's teeth and evaluated visible staining patterns and enamel hypoplasia. Objective tooth color was evaluated with a spectrophotometer. Fifty-eight children who received an average of 1.8 courses of doxycycline before 8 years of age and who now had exposed permanent teeth erupted were compared with 213 children who had never received doxycycline. No tetracycline-like staining was observed in any of the exposed children's teeth (0/58, 95% CI 0%-5%), and no significant difference in tooth shade (P=.20) or hypoplasia (P=1.0) was found between the 2 groups. This study failed to demonstrate dental staining, enamel hypoplasia, or tooth color differences among children who received short-term courses of doxycycline at <8 years of age. Healthcare provider confidence in use of doxycycline for suspected RMSF in children may be improved by modifying the drug's label. Published by Elsevier Inc.

A Comparison of Concept Development and Human Figure Drawings of Children Who Receive Preschool Education vs Those Who Do Not

ERIC Educational Resources Information Center

Balat, Gulden Uyanik

2010-01-01

This study evaluated from a developmental point of view the basic concept knowledge and human figure drawings of children who did and did not attend preschool. A total of 118 children who received preschool education and 147 children who did not do so participated in the study. The mean age of children was 75.4 months. Their concept knowledge was…

Growth and development after hematopoietic cell transplant in children.

PubMed

Sanders, J E

2008-01-01

Hematopoietic cell transplantation (HCT) following high-dose chemotherapy or chemoradiotherapy for children with malignant or nonmalignant hematologic disorders has resulted in an increasing number of long-term disease-free survivors. The preparative regimens include high doses of alkylating agents, such as CY with or without BU, and may include TBI. These agents impact the neuroendocrine system in growing children and their subsequent growth and development. Children receiving high-dose CY or BUCY have normal thyroid function, but those who receive TBI-containing regimens may develop thyroid function abnormalities. Growth is not impacted by chemotherapy-only preparative regimens, but TBI is likely to result in growth hormone deficiency and decreased growth rates that need to be treated with synthetic growth hormone therapy. Children who receive high-dose CY-only have normal development through puberty, whereas those who receive BUCY have a high incidence of delayed pubertal development. Following fractionated TBI preparative regimens, approximately half of the patients have normal pubertal development. These data demonstrate that the growth and development problems after HCT are dependent upon the preparative regimen received. All children should be followed for years after HCT for detection of growth and development abnormalities that are treatable with appropriate hormone therapy.

Crossing the border for health care: access and primary care characteristics for young children of Latino farm workers along the US-Mexico border.

PubMed

Seid, Michael; Castañeda, Donna; Mize, Ronald; Zivkovic, Mirjana; Varni, James W

2003-01-01

To examine prevalence and correlates of cross-border health care for children of Latino farm workers in counties near the US-Mexico border and to compare access and primary care in the United States and Mexico. Two hundred ninety-seven parents at Head Start centers in San Diego and Imperial counties were surveyed regarding percentage of health care received in Mexico and the United States, access, and primary care characteristics. More than half of all health care was reported as received in Mexico. Reasons for Mexican use revolved around cost, accessibility, and perceptions of effectiveness. Parents of insured children reported slightly more US care, yet even this group reported approximately half of health care in Mexico. Insurance status was related to having a regular source of care, while uninsured children reporting most care in Mexico were less likely than uninsured children in the United States to have had a routine health care visit. Primary care characteristics were related to insurance status and source of care. Uninsured children reporting most care in Mexico fared better in some aspects of primary care than uninsured children reporting most care in the United States and as well as children with insurance receiving care in the United States or Mexico. Children of farm workers living along the US-Mexico border, almost irrespective of insurance status, receive a large proportion of care in Mexico. Especially for uninsured children, parent reports of Mexican care characteristics compare favorably with that received in the United States. Mexican health care might be a buffer against vulnerability to poor health outcomes for these children.

Missed Opportunities for Hepatitis A Vaccination, National Immunization Survey-Child, 2013.

PubMed

Casillas, Shannon M; Bednarczyk, Robert A

2017-08-01

To quantify the number of missed opportunities for vaccination with hepatitis A vaccine in children and assess the association of missed opportunities for hepatitis A vaccination with covariates of interest. Weighted data from the 2013 National Immunization Survey of US children aged 19-35 months were used. Analysis was restricted to children with provider-verified vaccination history (n = 13 460). Missed opportunities for vaccination were quantified by determining the number of medical visits a child made when another vaccine was administered during eligibility for hepatitis A vaccine, but hepatitis A vaccine was not administered. Cross-sectional bivariate and multivariate polytomous logistic regression were used to assess the association of missed opportunities for vaccination with child and maternal demographic, socioeconomic, and geographic covariates. In 2013, 85% of children in our study population had initiated the hepatitis A vaccine series, and 60% received 2 or more doses. Children who received zero doses of hepatitis A vaccine had an average of 1.77 missed opportunities for vaccination compared with 0.43 missed opportunities for vaccination in those receiving 2 doses. Children with 2 or more missed opportunities for vaccination initiated the vaccine series 6 months later than children without missed opportunities. In the fully adjusted multivariate model, children who were younger, had ever received WIC benefits, or lived in a state with childcare entry mandates were at a reduced odds for 2 or more missed opportunities for vaccination; children living in the Northeast census region were at an increased odds. Missed opportunities for vaccination likely contribute to the poor coverage for hepatitis A vaccination in children; it is important to understand why children are not receiving the vaccine when eligible. Copyright © 2017 Elsevier Inc. All rights reserved.

School Breakfast Receipt and Obesity among American Fifth- and Eighth-Graders.

PubMed

Sudharsanan, Nikkil; Romano, Sebastian; Cunningham, Solveig A

2016-04-01

School breakfast consumption can improve children's nutrition, but the implications of breakfast at school for children's weight remains unclear. The aim of this study was to determine whether receiving breakfast at school is related to changes in children's weight between the fifth and eighth grades, and whether the relationship between school breakfasts and obesity varies for children of different socioeconomic backgrounds. This was a longitudinal study of children observed in the fifth and eighth grades. Data are from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99, a nationally representative prospective cohort of children in the United States. The analytic sample consisted of 6,495 children interviewed in the fifth and eighth grades. Standard thresholds from the Centers for Disease Control and Prevention were used to classify children as not obese or obese based on direct-measured height and weight. Difference-in-difference propensity score matching and fixed-effect logistic regression models were used to estimate the relationship between receipt of school breakfast and change in obesity between the fifth and eighth grades, adjusting for child, household, and school characteristics. School breakfast receipt was not associated with a change in obesity status between the fifth and eighth grades for children overall (odds ratio=1.31; P=0.129). In the propensity score model, receiving school breakfasts more than doubled the odds of becoming obese (odds ratio=2.31; P=0.0108) for children from families below the federal poverty line compared with children of similar socioeconomic backgrounds who did not regularly receive school breakfasts. School breakfast receipt was not independently related to obesity for most children. Receiving school breakfasts in the fifth grade may be associated with weight gain between the fifth and eighth grades for children from families below the federal poverty line compared with children of similar socioeconomic status who did not receive breakfasts. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Intracranial Pressure Monitoring in Infants and Young Children With Traumatic Brain Injury.

PubMed

Dixon, Rebecca R; Nocera, Maryalice; Zolotor, Adam J; Keenan, Heather T

2016-11-01

To examine the use of intracranial pressure monitors and treatment for elevated intracranial pressure in children 24 months old or younger with traumatic brain injury in North Carolina between April 2009 and March 2012 and compare this with a similar cohort recruited 2000-2001. Prospective, observational cohort study. Twelve PICUs in North Carolina. All children 24 months old or younger with traumatic brain injury, admitted to an included PICU. None. The use of intracranial pressure monitors and treatments for elevated intracranial pressure were evaluated in 238 children with traumatic brain injury. Intracranial pressure monitoring (risk ratio, 3.7; 95% CI, 1.5-9.3) and intracranial pressure therapies were more common in children with Glasgow Coma Scale less than or equal to 8 compared with Glasgow Coma Scale greater than 8. However, only 17% of children with Glasgow Coma Scale less than or equal to 8 received a monitoring device. Treatments for elevated intracranial pressure were more common in children with monitors; yet, some children without monitors received therapies traditionally used to lower intracranial pressure. Unadjusted predictors of monitoring were Glasgow Coma Scale less than or equal to 8, receipt of cardiopulmonary resuscitation, nonwhite race. Logistic regression showed no strong predictors of intracranial pressure monitor use. Compared with the 2000 cohort, children in the 2010 cohort with Glasgow Coma Scale less than or equal to 8 were less likely to receive monitoring (risk ratio, 0.5; 95% CI, 0.3-1.0), although the estimate was not precise, or intracranial pressure management therapies. Children in the 2010 cohort with a Glasgow Coma Scale less than or equal to 8 were less likely to receive an intracranial pressure monitor or hyperosmolar therapy than children in the 2000 cohort; however, about 10% of children without monitors received therapies to decrease intracranial pressure. This suggests treatment heterogeneity in children 24 months old or younger with traumatic brain injury and a need for better evidence to support treatment recommendations for this group of children.

Trends in intakes and sources of solid fats and added sugars among US children and adolescents: 1994-2010

PubMed Central

Slining, Meghan M.; Popkin, Barry M.

2013-01-01

Objective There are increasing global concerns about improving the dietary intakes of children and adolescents. In the United States (U.S.) the focus is on reducing energy from foods and beverages that provide empty calories from solid fats and added sugars (SoFAS). We examine trends in intakes and sources of solid fat and added sugars among U.S. 2- to 18- year olds from 1994-2010. Methods Data from five nationally representative surveys, the Continuing Survey of Food Intakes by Individuals Surveys (1994-1996) and the What We Eat In America, National Health and Nutrition Examination Surveys (2003-2004, 2005-2006, 2007-2008 and 2009-2010) were used to examine key food sources and energy from solid fats and added sugars. Sample sizes ranged from 2,594 to 8,259 per survey period, for a total of 17,268 observations across the five surveys. Food files were linked over time to create comparable food groups and nutrient values. Differences were examined by age, race/ethnicity and family income. Results Daily intake of energy from SoFAS among U.S. 2-18 year olds decreased from 1994-2010, with declines primarily detected in the recent time periods. Solid fats accounted for a greater proportion of total energy intake than did added sugars. Conclusions Although the consumption of solid fats and added sugars among children and adolescents in the United States decreased between 1994–1998 and 2009–2010, mean intakes continue to exceed recommended limits. PMID:23554397

Trends in intakes and sources of solid fats and added sugars among U.S. children and adolescents: 1994-2010.

PubMed

Slining, M M; Popkin, B M

2013-08-01

There are increasing global concerns about improving the dietary intakes of children and adolescents. In the United States (U.S.), the focus is on reducing energy from foods and beverages that provide empty calories from solid fats and added sugars (SoFAS). We examine trends in intakes and sources of solid fat and added sugars among U.S. 2-18 year olds from 1994 to 2010. Data from five nationally representative surveys, the Continuing Survey of Food Intakes by Individuals Surveys (1994-1996) and the What We Eat In America, National Health and Nutrition Examination Surveys (2003-2004, 2005-2006, 2007-2008 and 2009-2010) were used to examine key food sources and energy from solid fats and added sugars. Sample sizes ranged from 2594 to 8259 per survey period, for a total of 17 268 observations across the five surveys. Food files were linked over time to create comparable food groups and nutrient values. Differences were examined by age, race/ethnicity and family income. Daily intake of energy from SoFAS among U.S. 2-18 year olds decreased from 1994 to 2010, with declines primarily detected in the recent time periods. Solid fats accounted for a greater proportion of total energy intake than did added sugars. Although the consumption of solid fats and added sugars among children and adolescents in the U.S. decreased between 1994-1998 and 2009-2010, mean intakes continue to exceed recommended limits. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Surgical treatment of lung metastases in patients with embryonal pediatric solid tumors: an update.

PubMed

Fuchs, Joerg; Seitz, Guido; Handgretinger, Rupert; Schäfer, Juergen; Warmann, Steven W

2012-02-01

Distant metastases regularly occur in children with solid tumors. The most affected organ is the lung. Nearly in all extracranial pediatric solid tumors, the presence of lung metastases is associated with an adverse prognosis for the children. Therefore, the correct treatment of lung metastases is essential and influences the outcome. Despite different national and international trials for pediatric tumor entities, specific surgical aspects or guidelines for lung metastases are usually not addressed thoroughly in these protocols. The aim of this article is to present the diagnostic challenges and principles of surgical treatment by focusing on the influence of surgery on the outcome of children. Special points of interest are discussed that emphasize sarcomas, nephroblastomas, hepatoblastomas, and other tumors. Surgery of lung metastases is safe, has a positive impact on the patients' prognosis, and should be aggressive depending on the tumor entity. An interdisciplinary approach, including pediatric oncology and radiology, is mandatory in any case. Copyright © 2012 Elsevier Inc. All rights reserved.

34 CFR 300.226 - Early intervening services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CHILDREN WITH DISABILITIES Local Educational Agency Eligibility § 300.226 Early intervening services. (a... annually report to the SEA on— (1) The number of children served under this section who received early intervening services; and (2) The number of children served under this section who received early intervening...

Access to antiepileptic drug therapy in children in Camagüey Province, Cuba

PubMed Central

Arencibia, Zeina Bárzaga; Leyva, Alberto López; Peña, Yordanka Mejías; Reyes, Alba Rosa González; Nápolez, Maurilys Acosta; Carbonell Perdomo, Demetrio; Manzano, Edita Fernández; Choonara, Imti

2012-01-01

Objective To describe access to antiepileptic drug therapy and estimate the prevalence of epilepsy in children in Camagüey Province, Cuba. Methods All the community pharmacies in the province were visited and information collected about the number of children receiving antiepileptic drugs in 2009. Availability and cost of each antiepileptic drug were determined. The prevalence of epilepsy was estimated by determining the number of children receiving antiepileptic drugs. Results There were 923 children who received a total of 977 antiepileptic drugs in Camagüey Province. The estimated prevalence of epilepsy was 5.18 per thousand children which is lower than previously reported rates in other low and lower-middle income countries. Most of the children (871, 94%) received a single antiepileptic drug. Carbamazepine and valproate were the two most frequently prescribed antiepileptic drugs. Antiepileptic drugs were available from the local pharmacy on 76% of occasions. If the antiepileptic drug was not available from the local pharmacy, the parent had to travel to another pharmacy to obtain the medicine. Conclusions The estimated prevalence of epilepsy in children in Cuba is lower than that estimated in other lower-middle income countries. Access to drug therapy in children with epilepsy can be achieved in lower-middle income countries. PMID:23134098

Introduction to Exploring Nature

ERIC Educational Resources Information Center

Early Childhood Today, 2006

2006-01-01

Children are fascinated with the world of nature. From the tiniest of seeds to the highest of birds, they wonder "Why?" "How?" and "What can I do with it?" This paper provides intriguing nature activities that provide a solid starting point for expanding children's thinking and learning. Through these activities, children will be building skills…

Better Schools: A Values Perspective.

ERIC Educational Resources Information Center

Beck, Clive

The purpose of this book is to identify schooling goals and suggest what form of schooling is needed to achieve them. Although schools manage to care for children and give them a solid social, cultural, and intellectual grounding they also massively deprive children of intellectual and cultural stimulation and enormously distort children's…

Trends in Consumption of Solid Fats, Added Sugars, Sodium, Sugar-Sweetened Beverages, and Fruit from Fast Food Restaurants and by Fast Food Restaurant Type among US Children, 2003-2010.

PubMed

Rehm, Colin D; Drewnowski, Adam

2016-12-13

Energy intakes from fast food restaurants (FFRs) have declined among US children. Less is known about the corresponding trends for FFR-sourced solid fats, added sugars, and sodium, and food groups of interest, such as fruit and sugar-sweetened beverages (SSBs). Using data from a single 24-h dietary recall among 12,378 children aged 4-19 years from four consecutive cycles of the nationally-representative National Health and Nutrition Examination Survey (NHANES), 2003-2010 a custom algorithm segmented FFRs into burger, pizza, sandwich, Mexican cuisine, chicken, Asian cuisine, fish restaurants, and coffee shops. There was a significant population-wide decline in FFR-sourced solid fats (-32 kcal/day, p -trend < 0.001), added sugars (-16 kcal/day; p -trend < 0.001), SSBs (-0.12 servings (12 fluid ounces or 355 mL)/day; p -trend < 0.001), and sodium (-166 mg/day; p -trend < 0.001). Declines were observed when restricted to fast food consumers alone. Sharp declines were observed for pizza restaurants; added sugars, solid fats, and SSBs declined significantly from burger restaurants. Fruit did not change for fast food restaurants overall. Temporal analyses of fast food consumption trends by restaurant type allow for more precise monitoring of the quality of children's diets than can be obtained from analyses of menu offerings. Such analyses can inform public health interventions and policy measures.

Long-term outcomes of children after solid organ transplantation

PubMed Central

Kim, Jon Jin; Marks, Stephen D.

2014-01-01

Solid organ transplantation has transformed the lives of many children and adults by providing treatment for patients with organ failure who would have otherwise succumbed to their disease. The first successful transplant in 1954 was a kidney transplant between identical twins, which circumvented the problem of rejection from MHC incompatibility. Further progress in solid organ transplantation was enabled by the discovery of immunosuppressive agents such as corticosteroids and azathioprine in the 1950s and ciclosporin in 1970. Today, solid organ transplantation is a conventional treatment with improved patient and allograft survival rates. However, the challenge that lies ahead is to extend allograft survival time while simultaneously reducing the side effects of immunosuppression. This is particularly important for children who have irreversible organ failure and may require multiple transplants. Pediatric transplant teams also need to improve patient quality of life at a time of physical, emotional and psychosocial development. This review will elaborate on the long-term outcomes of children after kidney, liver, heart, lung and intestinal transplantation. As mortality rates after transplantation have declined, there has emerged an increased focus on reducing longer-term morbidity with improved outcomes in optimizing cardiovascular risk, renal impairment, growth and quality of life. Data were obtained from a review of the literature and particularly from national registries and databases such as the North American Pediatric Renal Trials and Collaborative Studies for the kidney, SPLIT for liver, International Society for Heart and Lung Transplantation and UNOS for intestinal transplantation. PMID:24860856

The prevalence and use of antidepressant medication in pediatric cancer patients.

PubMed

Portteus, Andrew; Ahmad, Naveed; Tobey, Daniel; Leavey, Patrick

2006-08-01

During the period of cancer diagnosis and active treatment, several small case series have revealed high rates of psychiatric difficulty in pediatric patients. However, due to the methodological limitations in these studies, it remains impossible to determine accurately the true prevalence of mood disorders in pediatric cancer patients receiving cancer treatment. To date, no study has reported rates of antidepressant treatment in this population. The aims of this study were: (1) To determine the prevalence of the use of antidepressant medication (ADM) in children with cancer; (2) to identify a group of children being treated for cancer, that are likely to receive ADM, and who therefore may be eligible for a prospective observational or interventional clinical trial of depression during cancer therapy. We reviewed the medical records of 224 pediatric patients suspected for cancer in 2003 at the Children's Medical Center of Dallas. Of these, 6 proved non-oncologic and 2 were lost to follow up, leaving 216 charts for review. Within 1 year of diagnosis, 29 patients (13%) had received a psychiatric consultation. Twenty-two patients (10.2%) received ADM within 1 year of cancer diagnosis. Children >/= 12 years, children with acute lymphoblastic leukemia, and children receiving radiotherapy or opiate analgesics were more likely to receive ADM by multivariate analysis. Race, sex, bone marrow transplant, and surgery were not significantly associated with ADM use. The prevalence of ADM use in pediatric cancer patients (10.2%) was higher than the reported rates of depression (4-8%) and ADM treatment (1%) in the general pediatric population. Teenagers and those who received opiate analgesic medications during their cancer therapy represent a subgroup of children in whom further study of depression and cancer therapy may be valuable.

The effect of educational interventions with siblings of hospitalized children.

PubMed

Gursky, Barbara

2007-10-01

Research has demonstrated that siblings of chronically ill children can experience significant emotional and behavior changes; however, few studies have looked at the specific impact of pediatric hospitalization on the nonhospitalized child. Studies also indicate that children who receive age-appropriate information are better equipped to handle the stress and anxiety often associated with hospitalization.This study explored whether siblings of hospitalized children who received educational interventions had lower anxiety levels compared to siblings who did not receive interventions. A pretest-posttest experimental design was used with 50 subjects, ages 6-17 years, recruited from a children's hospital within a university medical center. Subjects were matched according to age, sex, and race, with 25 siblings each in the experimental and control groups. Siblings assigned to the experimental group received interventions from a standardized educational intervention protocol developed by the researcher. Interventions focused on teaching the sibling about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development. All interventions were conducted by child life specialists on staff at the hospital with extensive training and experience in preparation and procedural teaching. Results shows that siblings who received educational interventions had significantly lower anxiety levels after interventions, compared to siblings who did not receive interventions. These findings have significant impact on children's health care and supporting family needs when a child is hospitalized.

Use of medical expulsive therapy in children: An assessment of nationwide practice patterns and outcomes

PubMed Central

Ellison, Jonathan S.; Merguerian, Paul A.; Fu, Benjamin C.; Holt, Sarah K.; Lendvay, Thomas S.; Gore, John L.; Shnorhavorian, Margarett

2018-01-01

Summary Introduction Early data support the use of medical expulsive therapy (MET) in children. However, little is known regarding use or outcomes associated with MET outside of pediatric-specific practices. Using a national administrative dataset, we sought to characterize utilization patterns of MET as well as assess outcomes associated with MET exposure. Study design We interrogated the MarketScan Commercial Claims and Encounters database to identify children under the age of 18 presenting to the emergency department (ED) with any diagnosis of upper urinary tract calculi (UUTC, including renal and ureteral calculi). MET exposure was defined as having a prescription filled for a MET agent within 1 week of the ED encounter. Characteristics of children receiving MET were defined and outcomes compared between children with and without MET exposure. Results Of 1325 children included in the study, 13.2% received MET, including 15.4% of children with a diagnosis of “calculus of the ureter.” MET use increased significantly throughout the study period (p = 0.004), although only 30.4% of children considered potential MET candidates received MET in the final year of the study (2013). Among all patients, receipt of MET was associated with male gender, presence of comorbidity, provider-type (urologist), and year of diagnosis, although among those with a specific diagnosis of “calculus of the ureter,” only year of diagnosis remained a significant factor. Rates of unplanned physician visits and surgical interventions were similar between groups. Children receiving MET were more likely to receive follow-up imaging, although only 46% of children with ureteral calculi had appropriate follow-up imaging within 90 days, regardless of MET exposure. Odds ratios of factors and outcomes associated with MET exposure are shown in the Table. Discussion Although early data support safety and efficacy MET in children, nationwide use in children is low among potential candidates for MET. For children with ureteral calculi, only year of diagnosis was a significant factor associated with MET use. No difference in unplanned physician visits or surgical interventions was noted. Most notable, however, was the low rate of follow-up imaging within 90 days for children presenting acutely with UUTC. Conclusions Use of MET for children with ureteral calculi is increasing, although still fewer than a third of children considered potential candidates receive this treatment. Follow-up imaging is not obtained for many children with ureteral calculi. Future work is needed to standardize management and follow-up protocols for children with acute renal colic. PMID:28483465

Intrathecal Baclofen Therapy: Benefits and Complications

ERIC Educational Resources Information Center

Zdolsek, Helena Aniansson; Olesch, Christine; Antolovich, Giuliana; Reddihough, Dinah

2011-01-01

Background: Spasticity and dystonia in children with cerebral palsy has been treated with intrathecal baclofen therapy (ITB) at the Royal Children's Hospital, Melbourne, Australia (RCH) since 1999. Methods: The records of children having received or still receiving ITB during the period September 1999 until August 2005 were studied to evaluate…

Impact of an active video game on healthy children's physical activity

USDA-ARS?s Scientific Manuscript database

This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether the effect would be greater among children in unsafe neighborhoods,who might not be allowed to play outsi...

Living Happily with Television.

ERIC Educational Resources Information Center

McGilvary, Linda; Penrose, Pat

The amount of violence and inappropriate information that children receive through television and other media is a matter of concern. This paper reviews the values of fantasy play and compares those values with the effects of television viewing on New Zealand children. Both obvious and subtle messages that children receive from television are…

Dyslipidemia in a Cohort of HIV-infected Latin American Children Receiving Highly Active Antiretroviral Therapy*

PubMed Central

Brewinski, Margaret; Megazzini, Karen; Freimanis Hance, Laura; Cruz, Miguel Cashat; Pavia-Ruz, Noris; Della Negra, Marinella; Ferreira, Flavia Gomes Faleiro; Marques, Heloisa

2011-01-01

In order to describe the prevalence of hypercholesterolemia and hypertriglyceridemia in a cohort of HIV-infected children and adolescents in Latin America and to determine associations with highly active antiretroviral therapy (HAART), we performed this cross-sectional analysis within the NICHD International Site Development Initiative pediatric cohort study. Eligible children had to be at least 2 years of age and be on HAART. Among the 477 eligible HIV-infected youth, 98 (20.5%) had hypercholesterolemia and 140 (29.4%) had hypertriglyceridemia. In multivariable analyses, children receiving protease inhibitor (PI)-containing HAART were at increased risk for hypercholesterolemia [adjusted odds ratio (AOR) = 2.7, 95% confidence interval (CI) 1.3–5.6] and hypertriglyceridemia (AOR = 3.5, 95% CI 1.9–6.4) compared with children receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing HAART. In conclusion, HIV-infected youth receiving PI-containing HAART in this Latin American cohort were at increased risk for hypercholesterolemia and hypertriglyceridemia compared with those receiving NNRTI-containing HAART. PMID:20889625

Solid-state Terahertz Sources for Space Applications

NASA Technical Reports Server (NTRS)

Maiwald, Frank; Pearson, John C.; Ward, John S.; Schlecht, Erich; Chattopadhyay, Goutam; Gill, John J.; Ferber, R.; Tsang, Raymond; Lin, Robert H.; Peralta, Alejandro;

Antibiotic resistance patterns of community-acquired urinary tract infections in children with vesicoureteral reflux receiving prophylactic antibiotic therapy.

PubMed

Cheng, Chi-Hui; Tsai, Ming-Horng; Huang, Yhu-Chering; Su, Lin-Hui; Tsau, Yong-Kwei; Lin, Chi-Jen; Chiu, Cheng-Hsun; Lin, Tzou-Yien

2008-12-01

The goal was to examine bacterial antimicrobial resistance of recurrent urinary tract infections in children receiving antibiotic prophylaxis because of primary vesicoureteral reflux. We reviewed data retrospectively for children with documented vesicoureteral reflux in 2 hospitals during a 5-year follow-up period. The patients were receiving co-trimoxazole, cephalexin, or cefaclor prophylaxis or prophylaxis with a sequence of different antibiotics (alternative monotherapy). Demographic data, degree of vesicoureteral reflux, prophylactic antibiotics prescribed, and antibiotic sensitivity results of first urinary tract infections and breakthrough urinary tract infections were recorded. Three hundred twenty-four patients underwent antibiotic prophylaxis (109 with co-trimoxazole, 100 with cephalexin, 44 with cefaclor, and 71 with alternative monotherapy) in one hospital and 96 children underwent co-trimoxazole prophylaxis in the other hospital. Breakthrough urinary tract infections occurred in patients from both hospitals (20.4% and 25%, respectively). Escherichia coli infection was significantly less common in children receiving antibiotic prophylaxis, compared with their initial episodes of urinary tract infection, at both hospitals. Children receiving cephalosporin prophylaxis were more likely to have an extended-spectrum beta-lactamase-producing organism for breakthrough urinary tract infections, compared with children with co-trimoxazole prophylaxis. Antimicrobial susceptibilities to almost all antibiotics decreased with cephalosporin prophylaxis when recurrent urinary tract infections developed. The extent of decreased susceptibilities was also severe for prophylaxis with a sequence of different antibiotics. However, antimicrobial susceptibilities decreased minimally in co-trimoxazole prophylaxis groups. Children receiving cephalosporin prophylaxis are more likely to have extended-spectrum beta-lactamase-producing bacteria or multidrug-resistant uropathogens other than E coli for breakthrough urinary tract infections; therefore, these antibiotics are not appropriate for prophylactic use in patients with vesicoureteral reflux. Co-trimoxazole remains the preferred prophylactic agent for vesicoureteral reflux.

Receipt of preventive oral health care by U.S. children: a population-based study of the 2005-2008 medical expenditure panel surveys.

PubMed

Huebner, Colleen E; Bell, Janice F; Reed, Sarah C

2013-11-01

This study provides estimates of the annual use of preventive oral health care by U.S. children ages 6 months-17 years. We estimated the annual use of preventive oral health care with data from the Medical Expenditure Panel Survey for the years 2005 through 2008 (n = 18,218). Additionally, we tested associations between use of preventive oral health care and predisposing factors, enabling factors and health need within three age groups: young children, school-age children and youth. Overall, 21 % of the sample was reported to have received preventive oral health care in the prior year. More school-age children received preventive care than did young children or youth regardless of gender, race/ethnicity, health status, residence, or family size. Among the youngest children, low parental education and lack of health insurance were associated with lower odds of receiving preventive care. School-age children of racial and ethnic minority groups had a higher odds of receiving preventive care than did non-Hispanic Whites. Youth with special health care needs were less likely to receive care than their peers. Within each age group, use of preventive care increased significantly from 2005 to 2008. In the U.S. there has been an increase in use of pediatric preventive dental care. Continued effort is needed to achieve primary prevention. Outreach and education should include all parents and especially parents with low levels of education, parents of children with special health care needs and those without health insurance.

Family Characteristics and Children's Receipt of Autism Services in Low-Resourced Families.

PubMed

Karp, Elizabeth A; Dudovitz, Rebecca; Nelson, Bergen B; Shih, Wendy; Gulsrud, Amanda; Orlich, Felice; Colombi, Costanza; Kuo, Alice A

2018-04-01

Parents of children with autism spectrum disorder (ASD) face competing demands when caring for their child and fulfilling family commitments. It remains unknown whether family obligations and parental stress might decrease the use of intervention services for young children with ASD. The current study is a secondary analysis of baseline date from a published randomized control trial with 147 low-resourced caregiver-child dyads. Demographic information, data on service use, maternal employment, parent's perception of their child's development, and parental stress were collected for primary caregivers of 2- to 5-year-old children with ASD from 5 sites. Multiple logistic regressions of accessing any intervention services or more than 1 services on familial characteristics were performed, controlling for demographic and contextual variables. Twenty-five percent of children were receiving no intervention service; 26% were receiving 1 service; and 49% were receiving 2 or more services. Perceived developmental delay and not having a sibling in the home were associated with higher odds of receiving intervention services. Children were more likely to receive more than 1 service if their parents had at least a college education and low levels of stress. Factors including perceived developmental level, parental stress, and caring for siblings may play a role in accessing services for children with ASD. Results reveal that competing family needs may be barriers to service use. Mothers of children with ASD with multiple children in the home, low levels of education, and high levels of stress may need additional supports or alternative service delivery models. Copyright © 2018 by the American Academy of Pediatrics.

Competing infant feeding information in mothers' networks: advice that supports v. undermines clinical recommendations.

PubMed

Ashida, Sato; Lynn, Freda B; Williams, Natalie A; Schafer, Ellen J

2016-05-01

To identify the social contextual factors, specifically the presence of information that supports v. undermines clinical recommendations, associated with infant feeding behaviours among mothers in low-income areas. Cross-sectional survey evaluating social support networks and social relationships involved in providing care to the infant along with feeding beliefs and practices. Out-patient paediatric and government-funded (Women, Infants, and Children) clinics in an urban, low-income area of the south-eastern USA. Eighty-one low-income mothers of infants between 0 and 12 months old. Most mothers reported receiving both supportive and undermining advice. The presence of breast-feeding advice that supports clinical recommendations was associated with two infant feeding practices that are considered beneficial to infant health: ever breast-feeding (OR=6·7; 95% CI 1·2, 38·1) and not adding cereal in the infant's bottle (OR=15·9; 95% CI 1·1, 227·4). Advice that undermines clinical recommendations to breast-feed and advice about solid foods were not associated with these behaviours. Efforts to facilitate optimal infant feeding practices may focus on increasing information supportive of clinical recommendations while concentrating less on reducing the presence of undermining information within mothers' networks. Cultural norms around breast-feeding may be stronger than the cultural norms around the introduction of solid foods in mothers' social environments; thus, additional efforts to increase information regarding introduction of solid foods earlier in mothers' infant care career may be beneficial.

A 2-year step-down withdrawal from inhaled corticosteroids in asthmatic children receiving immunotherapy.

PubMed

He, Chun-Hui; Li, Xing; Lin, Jun-Hong; Xiao, Qiang; Yu, Jia-Lu; Liu, Ying-Fen; Jiang, Wen-Hui; Chen, Chen; Deng, Li; Zhou, Jie

2017-12-01

Inhaled corticosteroids (ICSs) for treating asthma are controversial because of their negative effects on the growth of asthmatic children and without clearly defined withdrawal strategy. A 2-year ICS step-down and withdrawal strategy has been developed for asthmatic children receiving 3-year subcutaneous immunotherapy (SCIT). Eleven children were included into the SCIT group and 13 children into the ICS group. ICSs were discontinued when children met the following criteria: requiring only 1 puffper day, with good control, for at least 6 months; having a forced expiratory volume in 1 second (FEV 1 )/forced vital capacity ≥80%; and SCIT discontinued for ≥24 months. The main endpoints were the results of both the childhood asthma control test (C-CAT) and the methacholine bronchial provocation test. In the SCIT group, all the 11 children had ICS discontinued, with one child developed asthma attack after pneumonia and received ICS again after completion of SCIT. In the ICS group, five children discontinued ICS and developed asthma attacks later and received ICS again; the other eight children developed severe symptoms during ICS step-down. Thus, the discontinuation of ICS was only achieved in the SCIT group. The dose of methacholine that caused a decrease of 20% in FEV 1 continued to improve after discontinuation of ICS for the SCIT group and presented better results than the ICS group (P=0.050). After completion of SCIT, the C-CAT had improved significantly after 30 months of treatment compared with the ICS group (P<0.05). In the present study, we developed a 2-year step-down and withdrawal strategy from ICSs strategy for allergic asthma children receiving SCIT; the strategy was efficacious and safe.

Who Receives Speech/Language Services by 5 Years of Age in the United States?

PubMed Central

Hammer, Carol Scheffner; Farkas, George; Hillemeier, Marianne M.; Maczuga, Steve; Cook, Michael; Morano, Stephanie

2016-01-01

Purpose We sought to identify factors predictive of or associated with receipt of speech/language services during early childhood. We did so by analyzing data from the Early Childhood Longitudinal Study–Birth Cohort (ECLS-B; Andreassen & Fletcher, 2005), a nationally representative data set maintained by the U.S. Department of Education. We addressed two research questions of particular importance to speech-language pathology practice and policy. First, do early vocabulary delays increase children's likelihood of receiving speech/language services? Second, are minority children systematically less likely to receive these services than otherwise similar White children? Method Multivariate logistic regression analyses were performed for a population-based sample of 9,600 children and families participating in the ECLS-B. Results Expressive vocabulary delays by 24 months of age were strongly associated with and predictive of children's receipt of speech/language services at 24, 48, and 60 months of age (adjusted odds ratio range = 4.32–16.60). Black children were less likely to receive speech/language services than otherwise similar White children at 24, 48, and 60 months of age (adjusted odds ratio range = 0.42–0.55). Lower socioeconomic status children and those whose parental primary language was other than English were also less likely to receive services. Being born with very low birth weight also significantly increased children's receipt of services at 24, 48, and 60 months of age. Conclusion Expressive vocabulary delays at 24 months of age increase children’s risk for later speech/language services. Increased use of culturally and linguistically sensitive practices may help racial/ethnic minority children access needed services. PMID:26579989

The patient-centered medical home, practice patterns, and functional outcomes for children with attention deficit/hyperactivity disorder.

PubMed

Toomey, Sara L; Chan, Eugenia; Ratner, Jessica A; Schuster, Mark A

2011-01-01

To determine whether children with attention deficit/hyperactivity disorder (ADHD) receive care in a patient-centered medical home (PCMH) and how that relates to their ADHD treatment and functional outcomes. Cross-sectional analysis of the 2007 National Survey for Children's Health, a nationally representative survey of 91,642 parents. This analysis covers 5169 children with parent-reported ADHD ages 6-17. The independent variable is receiving care in a PCMH. Main outcome measures are receiving ADHD medication, mental health specialist involvement, and functional outcomes (difficulties with participation in activities, attending school, making friends; having problem behaviors; missed school days; and number of times parents contacted by school). Only 44% of children with ADHD received care in a PCMH. Children with ADHD receiving care in a PCMH compared with those who did not were more likely to receive medication for ADHD (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.9); less likely to have mental health specialist involvement (OR, 0.6; 95% CI, 0.4-0.7); less likely to have difficulties participating in activities (OR, 0.6; 95% CI 0.4-0.8), making friends (OR, 0.6; 95% CI, 0.5-0.9), and attending school (OR, 0.4; 95% CI, 0.3-06); less likely to have problem behaviors (OR 0.6; 95% CI 0.5-0.9); had fewer missed school days (β = -1.5, 95% CI -2.4 to -0.5); and parents were contacted by school less frequently (β = -0.2, 95% CI -0.3 to -0.1). For children with ADHD, receiving care in a PCMH is associated with practice pattern change and better outcomes. The PCMH may represent a promising opportunity to improve quality of care and outcomes for children with ADHD. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Differences in risk factors for children with special health care needs (CSHCN) receiving needed specialty care by socioeconomic status

PubMed Central

Lykens, Kristine A; Fulda, Kimberly G; Bae, Sejong; Singh, Karan P

2009-01-01

Background The purpose of this study is to identify factors affecting CSHCN's receiving needed specialty care among different socioeconomic levels. Previous literature has shown that Socioeconomic Status (SES) is a significant factor in CHSHCN receiving access to healthcare. Other literature has shown that factors of insurance, family size, race/ethnicity and sex also have effects on these children's receipt of care. However, this literature does not address whether other factors such as maternal education, geographic location, age, insurance type, severity of condition, or race/ethnicity have different effects on receiving needed specialty care for children in each SES level. Methods Data were obtained from the National Survey of Children with Special Health Care Needs, 2000–2002. The study analyzed the survey which studies whether CHSCN who needed specialty care received it. The analysis included demographic characteristics, geographical location of household, severity of condition, and social factors. Multiple logistic regression models were constructed for SES levels defined by federal poverty level: < 199%; 200–299%; ≥ 300%. Results For the poorest children (,199% FPL) being uninsured had a strong negative effect on receiving all needed specialty care. Being Hispanic was a protective factor. Having more than one adult in the household had a positive impact on receipt of needed specialty care but a larger number of children in the family had a negative impact. For the middle income group of children (200–299% of FPL severity of condition had a strong negative association with receipt of needed specialty care. Children in highest income group (> 300% FPL) were positively impacted by living in the Midwest and were negatively impacted by the mother having only some college compared to a four-year degree. Conclusion Factors affecting CSHCN receiving all needed specialty care differed among socioeconomic groups. These differences should be addressed in policy and practice. Future research should explore the CSHCN population by income groups to better serve this population PMID:19646227

Mental health treatment patterns in perinatally HIV-infected youth and controls.

PubMed

Chernoff, Miriam; Nachman, Sharon; Williams, Paige; Brouwers, Pim; Heston, Jerry; Hodge, Janice; Di Poalo, Vinnie; Deygoo, Nagamah Sandra; Gadow, Kenneth D

2009-08-01

Youths perinatally infected with HIV often receive psychotropic medication and behavioral treatment for emotional and behavioral symptoms. We describe patterns of intervention for HIV-positive youth and youth in a control group in the United States. Three hundred nineteen HIV-positive youth and 256 controls, aged 6 to 17 years, enrolled in the International Maternal Adolescent AIDS Clinical Trials 1055, a prospective, 2-year observational study of psychiatric symptoms. One hundred seventy-four youth in the control group were perinatally exposed to HIV, and 82 youth were uninfected children living in households with HIV-positive members. Youth and their primary caregivers completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-referenced symptom-rating scales. Children's medication and behavioral psychiatric intervention histories were collected at entry. We evaluated the association of past or current psychiatric treatment with HIV status, baseline symptoms, and impairment by using multiple logistic regression, controlling for potential confounders. HIV-positive youth and youth in the control group had a similar prevalence of psychiatric symptoms (61%) and impairment (14% to 15%). One hundred four (18%) participants received psychotropic medications (stimulants [14%], antidepressants [6%], and neuroleptic agents [4%]), and 127 (22%) received behavioral treatment. More HIV-positive youth than youth in the control group received psychotropic medication (23% vs 12%) and behavioral treatment (27% vs 17%). After adjusting for symptom class and confounders, HIV-positive children had twice the odds of children in the control group of having received stimulants and >4 times the odds of having received antidepressants. Caregiver-reported symptoms or impairment were associated with higher odds of intervention than reports by children alone. HIV-positive children are more likely to receive mental health interventions than control-group children. Pediatricians and caregivers should consider available mental health treatment options for all children living in families affected by HIV.

Effects of Person- and Process-Focused Feedback on Prosocial Behavior in Middle Childhood

PubMed Central

Dunsmore, Julie C.

2014-01-01

Effects of person- and process-focused feedback, parental lay theories, and prosocial self-concept on children’s prosocial behavior were investigated with 143 9- and 10-year-old children who participated in a single session. Parents reported entity (person-focused) and incremental (process-focused) beliefs related to prosocial behavior. Children completed measures of prosocial self-concept, then participated in a virtual online chat with child actors who asked for help with service projects. After completing the chat, children could assist with the service projects. In the first cohort, children were randomly assigned to receive person-focused, process-focused, or control feedback about sympathy. In the second cohort, with newly-recruited families, children received no feedback. When given process-focused feedback, children spent less time spent helping and worked on fewer service projects. When given no feedback, children spent less time helping when parents held incremental (process-focused) beliefs. Children with higher prosocial self-concept who received no feedback worked on more service projects. PMID:25684859

The Receipt of Special Education Services Following Elementary School Grade Retention

PubMed Central

Silverstein, Michael; Guppy, Nicole; Young, Robin; Augustyn, Marilyn

2009-01-01

Objective To estimate the proportion of children who receive an Individualized Education Program (IEP) following grade retention in elementary school. Design/setting Descriptive analysis of a nationally representative, longitudinal cohort. Participants Children retained in K/1 and 3rd grade for presumed academic reasons, followed through fifth grade. Outcome measure Presence or absence of an IEP. Results 300 children retained for presumed academic reasons in K/1, and 80 in 3rd grade were included in the study. Of the K/1 retainees, 68% never received an IEP over the subsequent four to five years; of the 3rd grade retainees, 73% never received an IEP. K/1 retainees in the highest SES quintile and suburban K/1 retainees were less likely to receive an IEP than retained children in all other SES quintiles (aOR 0.17; 95% CI 0.05-0.62) and in rural communities (aOR 0.16; 95% CI 0.06-0.44), respectively. Among K/1 retainees with persistent low academic achievement in reading and math (as assessed by standardized testing), 37% and 28%, respectively, never received an IEP. Conclusions The majority of children retained in K/1 or 3rd grade for academic reasons, including a many of those who demonstrate sustained academic difficulties, never receive an IEP during elementary school. Further studies are important to elucidate whether retained elementary school children are being denied their rights to special education services. In the meantime, early grade retention may provide an opportunity for pediatricians to help families advocate for appropriate special education evaluations for children experiencing school difficulties. PMID:19487611

Who Gets Severe Gynecomastia Among HIV-infected Children in the United Kingdom and Ireland?

PubMed

Kenny, Julia; Doerholt, Katja; Gibb, Di M; Judd, Ali

2017-03-01

There are few data on gynecomastia in HIV-infected children. Within the UK/Ireland's national cohort, 56 of 1873 (3%) HIV-infected children had gynecomastia, of which 10 (0.5%) were severe. All 10 had received antiretroviral therapy for a median of 27.5 (21, 42) months; 4 of 10 had received efavirenz, 7 of 10 and 6 of 10 had received stavudine and/or didanosine respectively. Five were nonreversible, despite changing antiretroviral therapy, and required breast reduction surgery.

The effects of psychotherapy on behavior problems of sexually abused deaf children.

PubMed

Sullivan, P M; Scanlan, J M; Brookhouser, P E; Schulte, L E; Knutson, J F

1992-01-01

This study assessed the effectiveness of a broad based psychotherapeutic intervention with a sample of 72 children sexually abused at a residential school for the deaf. An untreated comparison group emerged when about half of their parents refused the offer for psychotherapy provided by the school. Treated and untreated children were randomly assigned to two assessment groups: those who participated in a pretreatment assessment and those who did not. Houseparents at the residential school used the Child Behavior Checklist (CBC) to rate the pretreatment assessment children before treatment and all 72 children one year after the implementation of psychotherapy. Children receiving therapy had significantly fewer behavior problems than children not receiving therapy. There was a differential response to therapy on the basis of sex. Boys receiving therapy had significantly lower scores on the following CBC scales than the no treatment group: Total, Internal, External, Somatic, Uncommunicative, Immature, Hostile, Delinquent, Aggressive, and Hyperactive. There were no differences on the Schizoid and Obsessive scales. Girls receiving therapy had significantly lower scores than the no treatment group on the following CBC scales: Total, External, Depressed, Aggressive, and Cruel. There were no differences on the Internal, Anxious, Schizoid, Immature, Somatic, and Delinquent scales.

System and method for conditioning a hardwood pulp liquid hydrolysate

DOEpatents

Waite, Darrell M; Arnold, Richard; St. Pierre, James; Pendse, Hemant P; Ceckler, William H

2013-12-17

A system and method for hardwood pulp liquid hydrolysate conditioning includes a first evaporator receives a hardwood mix extract and outputting a quantity of vapor and extract. A hydrolysis unit receives the extract, hyrolyzes and outputs to a lignin separation device, which separates and recovers a quantity of lignin. A neutralization device receives extract from the lignin separation device and a neutralizing agent, producing a mixture of solid precipitate and a fifth extract. The solid precipitate is removed from the fifth extract. A second evaporator removes a quantity of acid from the fifth extract in a vapor form. This vapor may be recycled to improve total acid recovery or discarded. A desalination device receives the diluted extract, separates out some of the acid and salt and outputs a desalinated solution.

Mass screening of multiple abdominal solid organs using mobile helical computed tomography scanner--a preliminary report.

PubMed

Ishikawa, Susumu; Aoki, Jun; Ohwada, Susumu; Takahashi, Toru; Morishita, Yasuo; Ueda, Keisuke

2007-04-01

The possibility of a new screening procedure for multiple abdominal solid organs using a mobile helical computed tomography (CT) scanner was evaluated. A total of 4,543 residents, who were 40 years of age or older, received CT scanning without contrast medium. The mean age of participants was 64 years including 2,022 males and 2,521 females. A total of 2,105 abnormal findings were uniquely detected in 1,594 participants. Liver and kidney diseases including ureter occupied around 30% of total abnormal findings, respectively. Besides frequent cystic or calcified lesions, solid tumours were suspected in 56 lesions, which received further examination by specialized physicians. Five (9%) of them were confirmed as being malignant tumours including pancreatic cancer in two patients, and liver, lung and ovary cancers in one patient each, respectively. All five patients with each malignant lesion received curative operations. Small-sized abdominal aortic aneurysms and heart valve diseases were uniquely found in 22 and two patients, respectively. Qualitative diagnoses of solid tumours were difficult using CT findings without contrast medium. CT screening procedures require further investigation in aspect of the selection of examinees, CT scanning procedure, sensitivity and specificity, and cost-effectiveness.

Low incidence of abacavir hypersensitivity reaction among African children initiating antiretroviral therapy.

PubMed

Nahirya-Ntege, Patricia; Musiime, Victor; Naidoo, Bethany; Bakeera-Kitaka, Sabrina; Nathoo, Kusum; Munderi, Paula; Mugyenyi, Peter; Kekitiinwa, Adeodata; Bwakura-Dangarembizi, Mutsa F; Crawley, Jane

2011-06-01

Hypersensitivity reactions are reported in approximately 5% of adults receiving abacavir, but there are few published data in children. Among 1150 African children receiving antiretroviral therapy in a randomized trial, suspected hypersensitivity reactions to abacavir were rare (0.3%; 95% CI, 0.01-0.9). Patients were managed successfully through the provision of clear guidelines and education of clinical staff, children, and their caregivers.

Oral health need and access to dental services: evidence from the National Survey of Children's Health, 2007.

PubMed

Bell, Janice F; Huebner, Colleen E; Reed, Sarah C

2012-04-01

This study examines associations between parents' report of their children's oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1-17 years, using data from the 2007 National Survey of Children's Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.

A Soybean Education Curriculum for Preschoolers: Introducing New Foods to Children.

ERIC Educational Resources Information Center

Oscarson, Renee A.; Branum, Judy

1999-01-01

Parents of 27 preschoolers completed pretests and 14 completed posttests assessing nutrition knowledge, food purchases, and children's food intake. Children who received snacks and soybean-related instruction found both soy and nonsoy snacks acceptable, compared to those who did not receive instruction. Home eating habits did not change. (SK)

Linking Employment Status, Maternal Psychological Well-Being, Parenting, and Children's Attributions about Poverty in Families Receiving Government Assistance.

ERIC Educational Resources Information Center

Murry, Velma McBride; Brody, Gene H.; Brown, Anita; Wisenbaker, Joseph; Cutrona, Carolyn E.; Simons, Ronald L.

2002-01-01

Using an ecological risk-protection perspective, explores functional changes in single African American mothers (N=96) receiving government assistance. Examines links among maternal employment, mothers' physical and psychological health, and children's attributions about causes of poverty. Maternal psychological distress was linked with children's…

Cerebral Palsy Symptoms in Children Decreased Following Massage Therapy

ERIC Educational Resources Information Center

Hernandez-Reif, Maria; Field, Tiffany; Largie, Shay; Diego, Miguel; Manigat, Natasha; Seoanes, Jacqueline; Bornstein, Joan

2005-01-01

Twenty young children (mean age = 32 months) with cerebral palsy (CP) recruited from early intervention programs received 30 minutes of massage or reading twice weekly for 12 weeks. The children receiving massage therapy showed fewer physical symptoms including reduced spasticity, less rigid muscle tone overall and in the arms, and improved fine…

Family Stability as a Protective Factor against Psychopathology for Urban Children Receiving Psychological Services

ERIC Educational Resources Information Center

Ivanova, Masha Y.; Israel, Allen C.

2006-01-01

Family stability, defined as the consistency of family activities and routines, was examined in a sample of urban families (n = 70) with children (ages 7 to 16) receiving psychological services. Parent-reported family stability was associated with lower parent-reported children's internalizing behavior problems. Child-reported family stability…

The Incredible Year Teacher Classroom Management Program: Initial Findings from a Group Randomized Control Trial

ERIC Educational Resources Information Center

Reinke, Wendy M.; Herman, Keith C.; Dong, Nianbo

2014-01-01

A significant number of children in schools have mental health problems (World Health Organization, 2004). If children receive any type of mental health services, the vast majority receive these supports at school (Rones & Hoagwood, 2000). Mental health needs in children often manifest as emotional dysregulation, social incompetence, and…

New York City Department of Education

Science.gov Websites

and Chancellor Carranza Announce Four Times More Children Receiving 3-K for All Offers Mayor de Blasio and Chancellor Carranza Announce Four Times More Children Receiving 3-K for All Offers Mayor ; Talented NYC Schools Account News Mayor de Blasio and Chancellor Carranza Announce Four Times More Children

The Expression of Distress by Children Receiving Medical Treatment.

ERIC Educational Resources Information Center

Ballard, Brenda D.; Gipson, Martin

The nature of children's distress reactions to medical treatment is examined in terms of age and sex differences and initial normative data are provided. Predominately white, middle class children, ages 1 to 11, were observed while receiving allergy treatment injections. Males were observed on 453 injection occasions while females were observed on…

Effectiveness of amoxicillin/clavulanate potassium in the treatment of acute bacterial sinusitis in children.

PubMed

Wald, Ellen R; Nash, David; Eickhoff, Jens

2009-07-01

The role of antibiotic therapy in managing acute bacterial sinusitis (ABS) in children is controversial. The purpose of this study was to determine the effectiveness of high-dose amoxicillin/potassium clavulanate in the treatment of children diagnosed with ABS. This was a randomized, double-blind, placebo-controlled study. Children 1 to 10 years of age with a clinical presentation compatible with ABS were eligible for participation. Patients were stratified according to age (<6 or >or=6 years) and clinical severity and randomly assigned to receive either amoxicillin (90 mg/kg) with potassium clavulanate (6.4 mg/kg) or placebo. A symptom survey was performed on days 0, 1, 2, 3, 5, 7, 10, 20, and 30. Patients were examined on day 14. Children's conditions were rated as cured, improved, or failed according to scoring rules. Two thousand one hundred thirty-five children with respiratory complaints were screened for enrollment; 139 (6.5%) had ABS. Fifty-eight patients were enrolled, and 56 were randomly assigned. The mean age was 66 +/- 30 months. Fifty (89%) patients presented with persistent symptoms, and 6 (11%) presented with nonpersistent symptoms. In 24 (43%) children, the illness was classified as mild, whereas in the remaining 32 (57%) children it was severe. Of the 28 children who received the antibiotic, 14 (50%) were cured, 4 (14%) were improved, 4 (14%) experienced treatment failure, and 6 (21%) withdrew. Of the 28 children who received placebo, 4 (14%) were cured, 5 (18%) improved, and 19 (68%) experienced treatment failure. Children receiving the antibiotic were more likely to be cured (50% vs 14%) and less likely to have treatment failure (14% vs 68%) than children receiving the placebo. ABS is a common complication of viral upper respiratory infections. Amoxicillin/potassium clavulanate results in significantly more cures and fewer failures than placebo, according to parental report of time to resolution of clinical symptoms.

All about Solids, Liquids & Gases. Physical Science for Children[TM]. Schlessinger Science Library. [Videotape].

ERIC Educational Resources Information Center

2000

In All About Solids, Liquids and Gases, young students will be introduced to the three common forms of matter. They'll learn that all things are made up of tiny particles called atoms and that the movement of these particles determines the form that matter takes. In solids, the particles are packed tightly together and move very little. The…

Assessing patterns of restorative and preventive care among children enrolled in Medicaid, by type of dental care provider.

PubMed

Taichman, L Susan; Sohn, Woosung; Lim, Sungwoo; Eklund, Stephen; Ismail, Amid

2009-07-01

The authors investigate the relationship of preventive dental treatment to subsequent receipt of comprehensive treatment among Medicaid-enrolled children. The authors analyzed Medicaid dental claims data for 50,485 children residing in Wayne County, Mich. The study sample included children aged 5 through 12 years in 2002 who had been enrolled in Medicaid for at least one month and had had at least one dental visit each year from 2002 through 2005. The authors assessed dental care utilization and treatment patterns cross-sectionally for each year and longitudinally. Among the Medicaid-enrolled children in 2002, 42 percent had had one or more dental visits during the year. At least 20 percent of the children with a dental visit in 2002 were treated by providers who billed Medicaid exclusively for diagnostic and preventive (DP) services. Children treated by DP care providers were less likely to receive restorative and/or surgical services than were children who were treated by dentists who provided a comprehensive mix of dental services. The logistic model showed that children who visited a DP-care provider were about 2.5 times less likely to receive restorative or surgical treatments than were children who visited comprehensive-care providers. Older children and African-American children were less likely to receive restorative and surgical treatments from both types of providers. The study results show that the type of provider is a significant determinant of whether children received comprehensive restorative and surgical services. The results suggest that current policies that support preventive care-only programs may achieve increased access to preventive care for Medicaid-enrolled children in Wayne County, but they do not provide access to adequate comprehensive dental care.

Ovarian Damage in Young Premenopausal Women Undergoing Chemotherapy for Cancer

ClinicalTrials.gov

2012-03-16

Leukemia; Long-term Effects Secondary to Cancer Therapy in Adults; Long-term Effects Secondary to Cancer Therapy in Children; Lymphoma; Sexual Dysfunction and Infertility; Sexuality and Reproductive Issues; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific

An Action Research in Young Children (3-5) with Activities on Solid Waste Management in Greece: An Attempt for Assessment.

ERIC Educational Resources Information Center

Apanomeritaki, Olga

This action research project sought to increase the waste management and recycling knowledge among 20 children age 4 and 5 years enrolled in a preschool program in Thessaloniki, Greece. A structured interview was developed to assess the children's pre-intervention knowledge of waste management and recycling. It indicated that most children knew…

Pregnant women and children's exposure to tobacco and solid fuel smoke in southwestern India.

PubMed

Kelly, Patricia J; Goudar, Shivaprasad S; Chakraborty, Hrishikesh; Moore, Janet; Derman, Richard; Kodkany, Bhala; Bellad, Mrutyunjaya; Naik, Vijjaya A; Angolkar, Mubashir; Bloch, Michele

2011-07-01

To examine factors associated with smoke exposure among pregnant women in rural India. We conducted a survey of exposure to second-hand smoke (SHS) and solid fuel smoke (SFS) among 736 pregnant women. Odds ratios (OR) and 95% confidence intervals (CI) were computed using logistic regression models to assess the relationship between demographic variables and exposure to SHS and to SFS. While few respondents smoked cigarettes, 19.9% of women and 27.8% of children were frequently or always exposed to SHS, and 43.5% were at high and 46.7% at medium risk for SFE. Low educational levels and illiteracy were associated with exposure. Smoke exposure is a serious health risk for many poor women and children in India.

Comparison of iron status 28 d after provision of antimalarial treatment with iron therapy compared with antimalarial treatment alone in Ugandan children with severe malaria.

PubMed

Cusick, Sarah E; Opoka, Robert O; Ssemata, Andrew S; Georgieff, Michael K; John, Chandy C

2016-03-01

The provision of iron with antimalarial treatment is the standard of care for concurrent iron deficiency and malaria. However, iron that is given during a malaria episode may not be well absorbed or used, particularly in children with severe malaria and profound inflammation. We aimed to 1) determine baseline values of iron and inflammatory markers in children with severe malarial anemia (SMA), children with cerebral malaria (CM), and community children (CC) and 2) compare markers in iron-deficient children in each group who received 28 d of iron supplementation during antimalarial treatment with those in children who did not receive iron during treatment.. Seventy-nine children with CM, 77 children with SMA, and 83 CC who presented to Mulago Hospital, Kampala, Uganda, were enrolled in a 28-d iron-therapy study. Children with malaria received antimalarial treatment. All children with CM or SMA, as well as 35 CC, had zinc protoporphyrin (ZPP) concentrations ≥80 μmol/mol heme and were randomly assigned to receive a 28-d course of iron or no iron. We compared iron markers at day 0 among study groups (CM, SMA, and CC groups) and at day 28 between children in each group who were randomly assigned to receive iron or to not receive iron. At day 0, children with CM and SMA had greater values of C-reactive protein, ferritin, and hepcidin than those of CC. At day 28, interactions between study and treatment group were NS. Children in the no-iron compared with iron groups had similar mean values for hemoglobin (115 compared with 113 g/L, respectively; P = 0.73) and ZPP (124 compared with 124 μmol/mol heme, respectively; P = 0.96) but had lower median ferritin [101.0 μg/L (95% CI: 84.2, 121.0 μg/L) compared with 152.9 μg/L (128.8, 181.6 μg/L), respectively; P ≤ 0.001] and hepcidin [45.8 ng/mL (36.8, 56.9 ng/mL) compared with 83.1 ng/mL (67.6, 102.2 ng/mL), respectively; P < 0.011]. Severe inflammation is a characterization of children with CM and SMA. The withholding of iron from children with severe malaria is associated with lower ferritin and hepcidin at day 28 but not a lower hemoglobin concentration. This trial was registered at clinicaltrials.gov as NCT01093989. © 2016 American Society for Nutrition.

Medicaid’s Role in Financing Health Care for Children With Behavioral Health Care Needs in the Special Education System: Implications of the Deficit Reduction Act

PubMed Central

Mandell, David S.; Machefsky, Aliza; Rubin, David; Feudtner, Chris; Pita, Susmita; Rosenbaum, Sara

2010-01-01

BACKGROUND Recent changes to Medicaid policy may have unintended consequences in the education system. This study estimated the potential financial impact of the Deficit Reduction Act (DRA) on school districts by calculating Medicaid-reimbursed behavioral health care expenditures for school-aged children in general and children in special education in particular. METHODS Medicaid claims and special education records of youth ages 6 to 18 years in Philadelphia, PA, were merged for calendar year 2002. Behavioral health care volume, type, and expenditures were compared between Medicaid-enrolled children receiving and not receiving special education. RESULTS Significant overlap existed among the 126,533 children who were either Medicaid enrolled (114,257) or received special education (27,620). Medicaid-reimbursed behavioral health care was used by 21% of children receiving special education (37% of those Medicaid enrolled) and 15% of other Medicaid-enrolled children. Total expenditures were $197.8 million, 40% of which was spent on the 5728 children in special education and 60% of which was spent on 15,092 other children. CONCLUSIONS Medicaid-reimbursed behavioral health services disproportionately support special education students, with expenditures equivalent to 4% of Philadelphia’s $2 billion education budget. The results suggest that special education programs depend on Medicaid-reimbursed services, the financing of which the DRA may jeopardize. PMID:18808472

Stimulant use and its impact on growth in children receiving growth hormone therapy: an analysis of the KIGS International Growth Database.

PubMed

Miller, Bradley S; Aydin, Ferah; Lundgren, Frida; Lindberg, Anders; Geffner, Mitchell E

2014-01-01

Children receiving stimulants for attention deficit hyperactivity disorder (ADHD) frequently present to pediatric endocrinology clinics for evaluation and treatment of growth disorders. The worldwide prevalence of stimulant use in children with ADHD also receiving recombinant human growth hormone (rhGH) and the impact on response to rhGH are unknown. Data on children enrolled in the KIGS® (Pfizer International Growth Study) registry were evaluated for the associated diagnosis of ADHD prior to initiation of Genotropin® rhGH. Concomitant stimulant medications and auxological information were captured. Response to rhGH was evaluated using established growth prediction models. The prevalence of ADHD in KIGS was 2.3% (1,748/75,251), with stimulants used in 1.8% (1,326/75,251). Children with idiopathic growth hormone deficiency (IGHD) who received stimulants grew significantly less (1.1 cm) in the first year of rhGH therapy than expected for rhGH-treated non-ADHD IGHD children. After one year of rhGH, idiopathic short stature (ISS) children with ADHD were significantly shorter [0.74 cm (with stimulants) and 0.69 cm (without stimulants)] than non-ADHD ISS children. We demonstrated an impaired response to rhGH in IGHD and ISS children with ADHD. Our findings suggest that the ADHD phenotype, alone or in conjunction with stimulant therapy, may impair the short-term growth response to rhGH.

Medicaid's role in financing health care for children with behavioral health care needs in the special education system: implications of the Deficit Reduction Act.

PubMed

Mandell, David S; Machefsky, Aliza; Rubin, David; Feudtner, Chris; Pati, Susmita; Pita, Susmita; Rosenbaum, Sara

2008-10-01

Recent changes to Medicaid policy may have unintended consequences in the education system. This study estimated the potential financial impact of the Deficit Reduction Act (DRA) on school districts by calculating Medicaid-reimbursed behavioral health care expenditures for school-aged children in general and children in special education in particular. Medicaid claims and special education records of youth ages 6 to 18 years in Philadelphia, PA, were merged for calendar year 2002. Behavioral health care volume, type, and expenditures were compared between Medicaid-enrolled children receiving and not receiving special education. Significant overlap existed among the 126,533 children who were either Medicaid enrolled (114,257) or received special education (27,620). Medicaid-reimbursed behavioral health care was used by 21% of children receiving special education (37% of those Medicaid enrolled) and 15% of other Medicaid-enrolled children. Total expenditures were $197.8 million, 40% of which was spent on the 5728 children in special education and 60% of which was spent on 15,092 other children. Medicaid-reimbursed behavioral health services disproportionately support special education students, with expenditures equivalent to 4% of Philadelphia's $2 billion education budget. The results suggest that special education programs depend on Medicaid-reimbursed services, the financing of which the DRA may jeopardize.

Hyperhomocysteinaemia in children receiving phenytoin and carbamazepine monotherapy: a cross-sectional observational study.

PubMed

Chandrasekaran, Saravanan; Patil, Sooraj; Suthar, Renu; Attri, Savita Verma; Sahu, Jitendra Kumar; Sankhyan, Naveen; Tageja, Mini; Singhi, Pratibha

2017-04-01

Long-term therapy with phenytoin and carbamazepine is known to cause hyperhomocysteinaemia. We evaluated the prevalence of hyperhomocysteinaemia in North Indian children receiving phenytoin or carbamazepine monotherapy for >6 months duration and the effect of folic acid supplementation on plasma homocysteine. In this cross-sectional observational study we enrolled consecutive children aged 2-12 years with epilepsy who had received phenytoin or carbamazepine monotherapy for >6 months. Plasma total homocysteine, folic acid, vitamin B12 and antiepileptic drug concentrations were measured. Healthy age- and sex-matched controls were recruited. Children with homocysteine >10.4 µmol/L received folic acid supplementation for 1 month and homocysteine and folic acid concentrations were measured after 1 month follow-up. A total of 112 children receiving antiepileptic monotherapy for >6 months were enrolled. Hyperhomocysteinaemia was present in 54 children (90%) receiving phenytoin, 45 children (90%) receiving carbamazepine therapy and 17 (34%) controls (p<0.05). Mean plasma homocysteine concentrations were significantly higher (18.9±10.2 vs 9.1±3 µmol/L) and serum folic acid concentrations (10.04±8.5 ng/ml vs 12.6±4.8 p<0.001) and vitamin B12 concentrations (365±155 pg/mL vs 474±332 pg/mL, p=0.02) were significantly lower in the study group compared with the control group. Duration of antiepileptic drug therapy correlated significantly with elevated homocysteine and reduced folic acid concentrations (p<0.05). Supplementation with folic acid for 1 month led to a reduction in plasma homocysteine concentrations in the study group (from 20.9±10.3 µmol/L to 14.2±8.2 µmol/L, p<0.05). Phenytoin or carbamazepine monotherapy for >6 months duration is associated with hyperhomocysteinaemia in 90% of North Indian children. Elevated homocysteine concentrations were normalised in these children with folic acid supplementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Treatment of Acute Otitis Media in Children under 2 Years of Age

PubMed Central

Hoberman, Alejandro; Paradise, Jack L.; Rockette, Howard E.; Shaikh, Nader; Wald, Ellen R.; Kearney, Diana H.; Colborn, D. Kathleen; Kurs-Lasky, Marcia; Bhatnagar, Sonika; Haralam, Mary Ann; Zoffel, Lisa M.; Jenkins, Carly; Pope, Marcia A.; Balentine, Tracy L.; Barbadora, Karen A.

2011-01-01

Background Recommendations vary regarding immediate antimicrobial treatment versus watchful waiting for children younger than 2 years of age with acute otitis media. Methods We randomly assigned 291 children 6 to 23 months of age, with acute otitis media diagnosed with the use of stringent criteria, to receive amoxicillin–clavulanate or placebo for 10 days. We measured symptomatic response and rates of clinical failure. Results Among the children who received amoxicillin–clavulanate, 35% had initial resolution of symptoms by day 2, 61% by day 4, and 80% by day 7; among children who received placebo, 28% had initial resolution of symptoms by day 2, 54% by day 4, and 74% by day 7 (P = 0.14 for the overall comparison). For sustained resolution of symptoms, the corresponding values were 20%, 41%, and 67% with amoxicillin–clavulanate, as compared with 14%, 36%, and 53% with placebo (P = 0.04 for the overall comparison). Mean symptom scores over the first 7 days were lower for the children treated with amoxicillin–clavulanate than for those who received placebo (P = 0.02). The rate of clinical failure — defined as the persistence of signs of acute infection on otoscopic examination — was also lower among the children treated with amoxicillin–clavulanate than among those who received placebo: 4% versus 23% at or before the visit on day 4 or 5 (P<0.001) and 16% versus 51% at or before the visit on day 10 to 12 (P<0.001). Mastoiditis developed in one child who received placebo. Diarrhea and diaper-area dermatitis were more common among children who received amoxicillin–clavulanate. There were no significant changes in either group in the rates of nasopharyngeal colonization with nonsusceptible Streptococcus pneumoniae. Conclusions Among children 6 to 23 months of age with acute otitis media, treatment with amoxicillin–clavulanate for 10 days tended to reduce the time to resolution of symptoms and reduced the overall symptom burden and the rate of persistent signs of acute infection on otoscopic examination. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT00377260.) PMID:21226576

Hooking the Geographer in Children with Field-Based Studies

ERIC Educational Resources Information Center

Krall, Florence; And Others

1978-01-01

Suggests projects to help elementary students learn about man-land relationships through field experience, inquiry techniques, and a thematic, interdisciplinary approach. Children study a natural community, a human community, solid wastes, and energy conservation. (Author/AV)

MRI-based assessment of the pineal gland in a large population of children aged 0-5 years and comparison with pineoblastoma: part I, the solid gland.

PubMed

Galluzzi, Paolo; de Jong, Marcus C; Sirin, Selma; Maeder, Philippe; Piu, Pietro; Cerase, Alfonso; Monti, Lucia; Brisse, Hervé J; Castelijns, Jonas A; de Graaf, Pim; Goericke, Sophia L

2016-07-01

Differentiation between normal solid (non-cystic) pineal glands and pineal pathologies on brain MRI is difficult. The aim of this study was to assess the size of the solid pineal gland in children (0-5 years) and compare the findings with published pineoblastoma cases. We retrospectively analyzed the size (width, height, planimetric area) of solid pineal glands in 184 non-retinoblastoma patients (73 female, 111 male) aged 0-5 years on MRI. The effect of age and gender on gland size was evaluated. Linear regression analysis was performed to analyze the relation between size and age. Ninety-nine percent prediction intervals around the mean were added to construct a normal size range per age, with the upper bound of the predictive interval as the parameter of interest as a cutoff for normalcy. There was no significant interaction of gender and age for all the three pineal gland parameters (width, height, and area). Linear regression analysis gave 99 % upper prediction bounds of 7.9, 4.8, and 25.4 mm(2), respectively, for width, height, and area. The slopes (size increase per month) of each parameter were 0.046, 0.023, and 0.202, respectively. Ninety-three percent (95 % CI 66-100 %) of asymptomatic solid pineoblastomas were larger in size than the 99 % upper bound. This study establishes norms for solid pineal gland size in non-retinoblastoma children aged 0-5 years. Knowledge of the size of the normal pineal gland is helpful for detection of pineal gland abnormalities, particularly pineoblastoma.

Ondansetron versus granisetron in the prevention of chemotherapy induced nausea and vomiting in children with acute lymphoblastic leukemia.

PubMed

Siddique, R; Hafiz, M G; Rokeya, B; Jamal, C Y; Islam, A

2011-10-01

Effect of ondansetron and granisetron were evaluated in sixty (60) children (age 4-11 years) irrespective of sex, diagnosed case of acute lymphoblastic leukemia (ALL) who received high dose methotrexate and did not receive any antiemetic 24 hours prior to HDMTX. This was a prospective, randomized, double-blind, single center study. Of 60 children, 30 received oral ondansetron (4mg) and rest 30 granisetron (1mg) half an hour before therapy. Drugs were randomly allocated with appropriate code. The patients were followed up from day 1 to day 5 of therapy. Episodes of nausea and vomiting were recorded and scorings was done every 24 hours following chemotherapy. No significant difference was found between two groups according to acute emesis (Day-1) (p=0.053). In day two and day three it was significant (p<0.05). In day four it was significant (p=0.002). Early chemotherapy induced nausea and vomiting (CINV) were controlled 90% in children who received granisetron and 70% in children who received ondansetron. Delayed (Day 2-4) CINV were controlled in 80% of children who received granisetron and 43.4% who received ondansetron (p<0.05). Granisetron group required additional doses only 3.3% cases and ondanseton group 30% cases on the second day (p<0.05). Result was significant between two groups. About 36.7% patients had episodes of nausea on day four of chemotherapy in ondansetron group and it was only 3.3% in granisetron group due to adverse effects of antiemetic drug itself (p=0.001). Maximum episodes of vomiting were found on the second day in ondansetron group 33.3% and in granisetron group 3.3% (p=0.003). Though adverse effects like headache, constipation, abdominal pain and loose motion were common in both group of children but their number was much less in children who received granisetron. On second day of therapy score of nausea and vomiting was maximum in ondansetron and minimum in granisetron treated on day 4 and the result was significant. So, to prevent acute and delayed CINV in children with ALL, oral graniseteron can be considered as more effective and well tolerated with minimum adverse effects compared with ondansetrons.

Dyslipidemia in HIV Infected Children Receiving Highly Active Antiretroviral Therapy.

PubMed

Mandal, Anirban; Mukherjee, Aparna; Lakshmy, R; Kabra, Sushil K; Lodha, Rakesh

2016-03-01

To assess the prevalence of dyslipidemia and lipodystrophy in Indian children receiving non-nucleoside reverse transcriptase inhibitor (NNRTI) based highly active antiretroviral therapy (HAART) and to determine the associated risk factors for the same. The present cross-sectional study was conducted at a Pediatric Clinic of a tertiary care teaching center in India, from May 2011 through December 2012. HIV infected children aged 5-15 y were enrolled if they did not have any severe disease or hospital admission within last 3 mo or receive any medications known to affect the lipid profile. Eighty-one children were on highly active antiretroviral therapy (HAART) for at least 6 mo and 16 were receiving no antiretroviral therapy (ART). Participants' sociodemographic, nutritional, clinical, and laboratory data were recorded in addition to anthropometry and evidence of lipodystrophy. Fasting lipid profile, apolipoprotein A1 and B levels were done for all the children. Among the children on highly active antiretroviral therapy (HAART), 38.3 % had dyslipidemia and 80.2 % had lipodystrophy, while 25 % antiretroviral therapy (ART) naïve HIV infected children had dyslipidemia. No clinically significant risk factors could be identified that increased the risk of dyslipidemia or lipodystrophy in children on highly active antiretroviral therapy (HAART). There is a high prevalence of dyslipidemia and lipodystrophy in Indian children with HIV infection with an imminent need to establish facilities for testing and treatment of these children for metabolic abnormalities.

Outpatient Rehabilitation for Medicaid-Insured Children Hospitalized With Traumatic Brain Injury

PubMed Central

Symons, Rebecca G.; Wang, Jin; Ebel, Beth H.; Vavilala, Monica S.; Buchwald, Dedra; Temkin, Nancy; Jaffe, Kenneth M.; Rivara, Frederick P.

2016-01-01

OBJECTIVES: To describe the prevalence of postdischarge outpatient rehabilitation among Medicaid-insured children hospitalized with a traumatic brain injury (TBI) and to identify factors associated with receipt of services. METHODS: Retrospective cohort of children <21 years, hospitalized for a TBI between 2007 and 2012, from a national Medicaid claims database. Outcome measures were receipt of outpatient rehabilitation (physical, occupational, or speech therapies or physician visits to a rehabilitation provider) 1 and 3 years after discharge. Multivariable regression analyses determined the association of demographic variables, injury severity, and receipt of inpatient services with receipt of outpatient rehabilitation at 1 and 3 years. The mean number of services was compared between racial/ethnic groups. RESULTS: Among 9361 children, only 29% received any type of outpatient rehabilitation therapy during the first year after injury, although 62% sustained a moderate to severe TBI. The proportion of children receiving outpatient therapies declined to 12% in the second and third years. The most important predictor of receipt of outpatient rehabilitation was receipt of inpatient therapies or consultation with a rehabilitation physician during acute care. Compared with children of other racial/ethnic groups, Hispanic children had lower rates of receipt of outpatient speech therapy. CONCLUSIONS: Hospitalized children who received inpatient assessment of rehabilitation needs were more likely to continue outpatient rehabilitation care. Hispanic children with TBI were less likely than non-Hispanics to receive speech therapy. Interventions to increase inpatient rehabilitation during acute care might increase outpatient rehabilitation and improve outcomes for all children. PMID:27244850

Oral Cryotherapy for Preventing Oral Mucositis in Patients Receiving Cancer Treatment.

PubMed

Riley, Philip; McCabe, Martin G; Glenny, Anne-Marie

2016-10-01

In patients receiving treatment for cancer, does oral cryotherapy prevent oral mucositis? Oral cryotherapy is effective for the prevention of oral mucositis in adults receiving fluorouracil-based chemotherapy for solid cancers, and for the prevention of severe oral mucositis in adults receiving high-dose melphalan-based chemotherapy before hematopoietic stem cell transplantation (HSCT).

Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations

PubMed Central

Canani, Roberto Berni; Cirillo, Pia; Terrin, Gianluca; Cesarano, Luisa; Spagnuolo, Maria Immacolata; Vincenzo, Anna De; Albano, Fabio; Passariello, Annalisa; Marco, Giulio De; Manguso, Francesco

2007-01-01

Objective To compare the efficacy of five probiotic preparations recommended to parents in the treatment of acute diarrhoea in children. Design Randomised controlled clinical trial in collaboration with family paediatricians over 12 months. Setting Primary care. Participants Children aged 3-36 months visiting a family paediatrician for acute diarrhoea. Intervention Children's parents were randomly assigned to receive written instructions to purchase a specific probiotic product: oral rehydration solution (control group); Lactobacillus rhamnosus strain GG; Saccharomyces boulardii; Bacillus clausii; mix of L delbrueckii var bulgaricus, Streptococcus thermophilus, L acidophilus, and Bifidobacterium bifidum; or Enterococcus faecium SF68. Main outcome measures Primary outcomes were duration of diarrhoea and daily number and consistency of stools. Secondary outcomes were duration of vomiting and fever and rate of admission to hospital. Safety and tolerance were also recorded. Results 571 children were allocated to intervention. Median duration of diarrhoea was significantly shorter (P<0.001) in children who received L rhamnosus strain GG (78.5 hours) and the mix of four bacterial strains (70.0 hours) than in children who received oral rehydration solution alone (115.0 hours). One day after the first probiotic administration, the daily number of stools was significantly lower (P<0.001) in children who received L rhamnosus strain GG and in those who received the probiotic mix than in the other groups. The remaining preparations did not affect primary outcomes. Secondary outcomes were similar in all groups. Conclusions Not all commercially available probiotic preparations are effective in children with acute diarrhoea. Paediatricians should choose bacterial preparations based on effectiveness data. Trial registration number Current Controlled Trials ISRCTN56067537. PMID:17690340

Therapeutic Plasma Exchange in Critically Ill Children Requiring Intensive Care.

PubMed

Cortina, Gerard; McRae, Rosemary; Chiletti, Roberto; Butt, Warwick

2018-02-01

To characterize the clinical indications, procedural safety, and outcome of critically ill children requiring therapeutic plasma exchange. Retrospective observational study based on a prospective registry. Tertiary and quaternary referral 30-bed PICU. Forty-eight critically ill children who received therapeutic plasma exchange during an 8-year period (2007-2014) were included in the study. Therapeutic plasma exchange. A total of 48 patients underwent 244 therapeutic plasma exchange sessions. Of those, therapeutic plasma exchange was performed as sole procedure in 193 (79%), in combination with continuous renal replacement therapy in 40 (16.4%) and additional extracorporeal membrane oxygenation in 11 (4.6%) sessions. The most common admission diagnoses were hematologic disorders (30%), solid organ transplantation (20%), neurologic disorders (20%), and rheumatologic disorders (15%). Complications associated with the procedure occurred in 50 (21.2%) therapeutic plasma exchange sessions. Overall, patient survival from ICU was 82%. Although patients requiring therapeutic plasma exchange alone (n = 31; 64%) had a survival rate of 97%, those with additional continuous renal replacement therapy (n = 13; 27%) and extracorporeal membrane oxygenation (n = 4; 8%) had survival rates of 69% and 50%, respectively. Factors associated with increased mortality were lower Pediatric Index of Mortality 2 score, need for mechanical ventilation, higher number of failed organs, and longer ICU stay. Our results indicate that, in specialized centers, therapeutic plasma exchange can be performed relatively safely in critically ill children, alone or in combination with continuous renal replacement therapy and extracorporeal membrane oxygenation. Outcome in children requiring therapeutic plasma exchange alone is excellent. However, survival decreases with the number of failed organs and the need for continuous renal replacement therapy and extracorporeal membrane oxygenation.

Impact of pediatric cancer on family relationships.

PubMed

Erker, Craig; Yan, Ke; Zhang, Liyun; Bingen, Kristin; Flynn, Kathryn E; Panepinto, Julie

2018-05-01

Little is known about the impact of cancer on family relationships from the perspective of the pediatric cancer patient and their sibling(s). This study assessed and compared children's experiences of family relationships in patients receiving active cancer therapy, those who have completed therapy, and siblings. A cross-sectional study of children with cancer and their siblings aged 8-17 years old was conducted. Children completed the PROMIS Pediatric Family Relationships short form and the Depressive Symptoms, Anxiety, and Peer Relationships short forms. The Mann-Whitney test assessed differences in Family Relationships scores between therapy groups, while the Wilcoxon signed-rank test assessed differences between patients and siblings. An actor-partner interdependence model (APIM) was used to assess how patient and sibling variables were associated with their own and each others' family relationships. Two hundred and sixty-five children completed the assessments. Siblings of patients on-therapy had worse family relationships than patients on-therapy (P = 0.015). Family relationships of patients off-therapy did not differ from their siblings or the patients on-therapy. Family relationships scores did not differ between the sibling cohorts. The APIM found patient family relationships were impaired when their own peer relationships decreased and when either their own or their siblings had increased depressive symptoms. Sibling family relationships were impaired when their own depression increased, and when the patient counterpart was female, younger age, had less depressive symptoms, more anxiety or a diagnosis of leukemia/lymphoma (compared to solid tumor). Based on these findings, increased psychosocial resources for patients and siblings of children undergoing cancer therapy may be warranted. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Trends in parent-reported emotional and behavioral problems among children using special education services.

PubMed

Pastor, Patricia N; Reuben, Cynthia A

2015-06-01

This report describes trends in health conditions reported by parents as the limitations leading to special education services for their children. Data are reported for children ages 6-17 (N=182,998) surveyed in households in the 2001-2012 National Health Interview Survey. Between 2001 and 2012, the overall percentage of U.S. children ages 6-17 who were receiving special education services increased from 7.2% to 8.7%. Between 2001 and 2012, the leading causes of activity limitations among children receiving special education services included emotional or behavioral problems, which increased from 36% to 43%; speech problems, which increased from 16% to 22%; and learning disability, which decreased from 41% to 27%. There were no significant trends in any of the other conditions considered as possible sources of activity limitations. Emotional and behavioral problems have become the most frequently reported source of activity limitations among children receiving special education services.

The Medical Home Model and Pediatric Asthma Symptom Severity: Evidence from a National Health Survey.

PubMed

Rojanasarot, Sirikan; Carlson, Angeline M

2018-04-01

The objective was to investigate the association between receiving care under the medical home model and parental assessment of the severity of asthma symptoms. It was hypothesized that parents of children who received care under the medical home model reported less severe asthma symptoms compared with their counterparts, whose care did not meet the medical home criteria. Secondary analyses were conducted using cross-sectional data from the 2011-2012 National Survey of Children's Health. Children with asthma aged 0-17 years were included and classified as receiving care from the medical home if their care contained 5 components: a personal doctor, a usual source of sick care, family-centered care, no problems getting referrals, and effective care coordination. Ordinal logistic regression was used to examine the relationship between parent-rated severity of asthma symptoms (mild, moderate, and severe symptoms) and the medical home. Approximately 52% of 8229 children who reported having asthma received care from the medical home. Only 30.8% of children with severe asthma symptoms received care that met the medical home criteria, compared to 55.7% of children with mild symptoms. After accounting for confounding factors, obtaining care under the medical home model decreased the odds of parent-reported severe asthma symptoms by 31% (adjusted odds ratio 0.69; 95% CI, 0.56-0.85). Study results suggest that the medical home model can reduce parent-rated severity of asthma symptoms. The findings highlight the importance of providing medical home care to children with asthma to improve the outcomes that matter most to children and their families.

Bioavailability of an extemporaneous suspension of propafenone made from tablets.

PubMed

Olguín, Hugo Juárez; Pérez, Carmen Flores; Pérez, Janett Flores; Mendiola, Blanca Ramírez; Portugal, Miriam Carrasco; Chávez, Jesús Bobadilla

2006-07-01

Propafenone is an effective antiarrhythmic agent used in children, while in Mexico no specific formulation for children is available, which causes errors in adequate dosage. The aim of this study was to determine the bioavailability of a suspension prepared extemporaneously using commercial tablets of propafenone. The bioavailability was determined in two groups of rabbits (n = 8): the first group received a single intravenous dose of 2 mg/kg of propafenone; the second was orally administered an extemporaneous suspension of propafenone prepared from commercial tablets. Blood samples were drawn at several times during the next 24 h and analysed by HPLC to determine drug levels. The extemporaneous suspension was tested previously with satisfactory results regarding physicochemical and microbiologic stability. The area under the curve (AUC) for the i.v. route was 5600.6 ng/ml.h and for oral administration the AUC was 3327.6 ng/ml.h. The bioavailability was calculated at 59.41%. These results are consistent with previous reports for solid dosage forms. The propafenone suspension prepared extemporaneously using commercial tablets is bioavailable using an animal model; nevertheless, it is necessary to carry out human studies either in volunteers or in patients to confirm these results.

Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition.

PubMed

Agostoni, Carlo; Decsi, Tamas; Fewtrell, Mary; Goulet, Olivier; Kolacek, Sanja; Koletzko, Berthold; Michaelsen, Kim Fleischer; Moreno, Luis; Puntis, John; Rigo, Jacques; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; van Goudoever, Johannes

2008-01-01

This position paper on complementary feeding summarizes evidence for health effects of complementary foods. It focuses on healthy infants in Europe. After reviewing current knowledge and practices, we have formulated these conclusions: Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding (ie, solid foods and liquids other than breast milk or infant formula and follow-on formula) should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing scientific evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish and eggs, reduces allergies, either in infants considered at increased risk for the development of allergy or in those not considered to be at increased risk. During the complementary feeding period, >90% of the iron requirements of a breast-fed infant must be met by complementary foods, which should provide sufficient bioavailable iron. Cow's milk is a poor source of iron and should not be used as the main drink before 12 months, although small volumes may be added to complementary foods. It is prudent to avoid both early (<4 months) and late (>or=7 months) introduction of gluten, and to introduce gluten gradually while the infant is still breast-fed, inasmuch as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Infants and young children receiving a vegetarian diet should receive a sufficient amount ( approximately 500 mL) of breast milk or formula and dairy products. Infants and young children should not be fed a vegan diet.

Protecting Our Children: State and Federal Policies for Exempt Child Care Settings.

ERIC Educational Resources Information Center

Blank, Helen

This study examined the extent to which states are adequately ensuring the health and safety of children who are cared for in informal care settings receiving public funds. Protections were analyzed for children receiving in-home care or family child care in settings that are legally exempt from state licensing or registration requirements. The…

Effects of Recall of Experience and Emotional Display Upon Empathy in Children.

ERIC Educational Resources Information Center

Johnston, Charlotte; Fouts, Gregory

The contribution of cognitive and affective experiences on empathy in children was assessed. It was expected that children receiving experience with both components would show more empathy than those receiving experience with only one or neither of these components. Six- to eight-year-olds participated in two phases, Training and Assessment. In…

Minnesota Kids: A Closer Look. 2000 Data Book.

ERIC Educational Resources Information Center

Coffin, Linda

This Kids Count data book examines trends in the well-being of Minnesota's children. The statistical portrait is based on 11 indicators of child well-being: (1) child poverty rate; (2) children receiving free or reduced-price school lunch; (3) children in families receiving food stamps; (4) births to teenage mothers; (5) low birth weight rates;…

Minnesota Kids: A Closer Look. 1998 Data Book.

ERIC Educational Resources Information Center

Kids Count Minnesota, Minneapolis.

This Kids Count data book examines statewide trends in the well-being of Minnesota children during the 1990s. The statistical portrait is based on 11 indicators of well-being: (1) child poverty rate; (2) percent of children receiving Aid to Families with Dependent Children; (3) percent receiving free or reduced-price school lunches; (4) teen birth…

Primary intracranial tumours in Black and Indian children, 1960-1975.

PubMed

Quinn, R J; Scragg, J N; Rubidge, C J

1978-02-11

This report of cerebral tumours in 60 children admitted to the medical wards of King Edward VIII Hospital, Durban, shows that cerebral tumour is the commonest solid neoplasm in both Black and Indian children. There is a significantly lower incidence of cerebral tumour in Black children. No difference was apparent in age, sex ratio, site or histological types in our racial groups compared with studies in White children from other parts of the world.

A 2 Thz Schottky Solid-State Heterodyne Receiver for Atmospheric Studies

NASA Technical Reports Server (NTRS)

Treuttel, Jeanne; Schlecht, Erich; Siles, Jose; Lee, Choonsup; Lin, Robert; Thomas, Bertrand; Gonzalez-Olvero, David; Yee, Jeng-Hwa; Wu, Dong; Mehdi, Imran

2016-01-01

Obtaining temperature, pressure, and composition profiles along with wind velocities in the Earth's thermosphere/ionosphere system is a key NASA goal for understanding our planet. We report on the status of a technology development effort to build an all-solid-state heterodyne receiver at 2.06 terahertz that will allow the measurement of the 2.06 terahertz [OI] line for altitudes greater than 100 kilometers. The receiver front end features low-parasitic Schottky diode mixer chips that are driven by a local oscillator (LO) source using Schottky diode based multipliers. The multiplier chain consists of a 38 gigahertz oscillator followed by a set of three cascaded triplers at 114 gigahertz, 343 gigahertz and 1.03 terahertz.

[Post-transplantation lymphoproliferative disorder in childhood].

PubMed

Stréhn, Anita; Szőnyi, László; Kriván, Gergely; Kovács, Lajos; Reusz, György; Szabó, Attila; Rényi, Imre; Kovács, Gábor; Dezsőfi, Antal

2014-02-23

Among possible complications of transplantation the post-transplant lymphoproliferative disease due to immunosuppressive therapy is of paramount importance. In most cases the direct modulating effect of Epstein-Barr virus on immune cells can be documented. The aim of the authors was to evaluate the incidence os post-transplant lymphoproliferative diseases in pediatric transplant patients in Hungary. The study group included kidney, liver and lung transplant children followed up at the 1st Department of Pediatrics, Semmelweis University, Budapest and stem cell transplant children at Szent László Hospital, Budapest. Data were collected from 78 kidney, 109 liver and 17 lung transplant children as well as from 243 children who underwent allogenic stem cell transplantation. Between 1998 and 2012, 13 children developed post-transplant lymphoproliferative disorder (8 solid organ transplanted and 5 stem cell transplanted children). The diagnosis was based on histological findings in all cases. Mortality was 3 out of the 8 solid organ transplant children and 4 out of the 5 stem cell transplant children. The highest incidence was observed among lung transplant children (17.6%). These data indicate that post-transplant lymphoproliferative disease is a rare but devastating complication of transplantation in children. The most important therapeutic approaches are reduction of immunosuppressive therapy, chemotherapy and rituximab. Early diagnosis may improve clinical outcome and, therefore, routine polymerase chain reaction screening for Epstein-Barr virus of high risk patients is recommended.

Unsweetened ice popsicles impart a positive feeling and reduce self-mutilation after paediatric dental treatment with local anaesthesia.

PubMed

Ram, Diana; Berson, Tamar; Moskovitz, Moti; Efrat, Jacob

2010-09-01

The purpose of the current study was to assess whether an unsweetened ice-popsicle imparts a positive feeling to children after dental treatment in which local anaesthesia is administered, and whether it reduces the tendency of children to self-mutilate (bite the lip, cheek or tongue) after the administration of local anaesthesia. Crossover study of 31 children aged 4-11 years old who needed similar dental treatments on both sides of the mandible or maxilla under local anaesthesia. At the end of each appointment the child received a toy or an ice-popsicle especially made for this study. Patients and parents answered a questionnaire regarding the children's behaviour and feeling immediately after the treatment, and 10 and 30 min after receiving the ice-popsicle or toy. Children who received ice-popsicles after dental treatment under local anaesthesia felt less discomfort and suffered less soft tissue trauma than they did when they received a toy. Reduction in soft tissue trauma was evident 10 min after receiving the ice-popsicles. Licking of an ice-popsicle after dental treatment with local anaesthesia reduces the feeling of discomfort and the biting of soft tissue and self- mutilation.

Management of Pediatric Perforated Appendicitis: Comparing Outcomes Using Early Appendectomy Versus Solely Medical Management.

PubMed

Bonadio, William; Rebillot, Katie; Ukwuoma, Onyinyechi; Saracino, Christine; Iskhakov, Arthur

2017-10-01

There is controversy regarding whether children with perforated appendicitis should receive early appendectomy (EA) versus medical management (MM) with antibiotics and delayed interval appendectomy. The objective of this study was to compare outcomes of children with perforated appendicitis who receive EA versus MM. Case review of consecutive children <18 years of age with perforated appendicitis who received either EA or MM during an 8-year period. Criteria for hospital discharge included patient being afebrile for at least 24 hours, pain-free and able to tolerate oral intake. Of 203 patients diagnosed with perforated appendicitis, 122 received EA and 81 received MM. All received parenteral antibiotic therapy initiated in the emergency department and continued during hospitalization. There were no significant differences between groups in mean patient age, mean complete blood count total white blood cells count, gender distribution, rates of emergency department fever or rates of intra-abdominal infection (abscess or phlegmon) identified on admission. Compared with patients receiving MM, those receiving EA experienced significantly fewer (1) days of hospitalization, parenteral antibiotic therapy and in-hospital fever; (2) radiographic studies, percutaneous drainage procedures and placement of central venous catheters performed; (3) post admission intra-abdominal complications and (4) unscheduled repeat hospitalizations after hospital discharge. Only 1 EA-managed patient developed a postoperative wound infection. Children with perforated appendicitis who receive EA experience significantly less morbidity and complications versus those receiving MM. The theoretical concern for enhanced morbidity associated with EA management of perforated appendicitis is not supported by our analysis.

Prevention of febrile neutropenia: use of prophylactic antibiotics.

PubMed

Cullen, M; Baijal, S

2009-09-01

Febrile neutropenia (FN) causes significant morbidity and mortality in patients receiving cytotoxic chemotherapy and can lead to reduced chemotherapy dose intensity and increased overall treatment costs. Antibiotic prophylaxis reduces the incidence of FN. Recent research and meta-analyses confirm that prophylactic fluoroquinolones decrease FN and infection-related mortality in patients with acute leukaemia and those receiving high-dose chemotherapy. Fluoroquinolone prophylaxis also lowers the incidence of FN and all-cause mortality following the first cycle of myelosuppressive chemotherapy for solid tumours. Levofloxacin has been the agent studied most thoroughly in this context. Although there is no convincing evidence that colonisation of individuals with resistant organisms due to antibiotic prophylaxis increases FN or mortality, such concerns must be taken seriously and the use of prophylaxis should be limited responsibly for patients with the greatest chance of benefit. Fluoroquinolone prophylaxis is well tolerated and cost-effective and should be offered to patients receiving chemotherapy for haematological malignancies and high-dose chemotherapy for solid tumours in which prolonged (>7 days) neutropenia is expected. It should also be considered for those receiving chemotherapy for solid tumours and lymphomas during the first cycle of chemotherapy when grade 4 neutropenia is anticipated.

Prevention of febrile neutropenia: use of prophylactic antibiotics

PubMed Central

Cullen, M; Baijal, S

2009-01-01

Febrile neutropenia (FN) causes significant morbidity and mortality in patients receiving cytotoxic chemotherapy and can lead to reduced chemotherapy dose intensity and increased overall treatment costs. Antibiotic prophylaxis reduces the incidence of FN. Recent research and meta-analyses confirm that prophylactic fluoroquinolones decrease FN and infection-related mortality in patients with acute leukaemia and those receiving high-dose chemotherapy. Fluoroquinolone prophylaxis also lowers the incidence of FN and all-cause mortality following the first cycle of myelosuppressive chemotherapy for solid tumours. Levofloxacin has been the agent studied most thoroughly in this context. Although there is no convincing evidence that colonisation of individuals with resistant organisms due to antibiotic prophylaxis increases FN or mortality, such concerns must be taken seriously and the use of prophylaxis should be limited responsibly for patients with the greatest chance of benefit. Fluoroquinolone prophylaxis is well tolerated and cost-effective and should be offered to patients receiving chemotherapy for haematological malignancies and high-dose chemotherapy for solid tumours in which prolonged (>7 days) neutropenia is expected. It should also be considered for those receiving chemotherapy for solid tumours and lymphomas during the first cycle of chemotherapy when grade 4 neutropenia is anticipated. PMID:19756000

Outcome differences between children and adolescents and young adults with non-Hodgkin lymphoma following stem cell transplantation.

PubMed

Kobayashi, Ryoji; Mitsui, Tetsuo; Fujita, Naoto; Osumi, Tomoo; Aoki, Tomohiro; Aoki, Kazunari; Suzuki, Ritsuro; Fukuda, Takahiro; Miyamoto, Toshihiro; Kato, Koji; Nakamae, Hirohisa; Goto, Hiroaki; Eto, Tetsuya; Inoue, Masami; Mori, Takehiko; Terui, Kiminori; Onizuka, Masahito; Koh, Katsuyoshi; Koga, Yuhki; Ichinohe, Tatsuo; Sawada, Akihisa; Atsuta, Yoshiko; Suzumiya, Junji

2017-03-01

Several studies of patients with acute lymphoblastic leukemia and acute myeloid leukemia who received stem cell transplantation (SCT) have reported that adolescents and young adults (AYAs) experience higher transplant-related mortality than that in younger children. However, to the best of our knowledge, there have been no reports of a similar comparison of non-Hodgkin lymphoma (NHL) patients who received SCT. We analyzed 918 patients aged 30 years and younger who received their first stem cell transplantation for NHL. Of the allogeneic transplant patients, children and AYAs did not significantly differ in survival rate, event-free survival rate, relapse rate, or transplant-related mortality. However, 5-year transplant-related mortality after autologous transplantation was significantly higher in children than in AYAs (5.1% in children vs. 0.8% in AYAs, P = 0.0043). The cause of transplant-related death in three of four children was interstitial pneumonitis. In NHL patients, transplantation results in AYAs were not inferior than those in children.

Classroom phonological awareness instruction and literacy outcomes in the first year of school.

PubMed

Carson, Karyn L; Gillon, Gail T; Boustead, Therese M

2013-04-01

Despite strong investment in raising literacy achievement for all children, significant inequalities in literacy outcomes continue to exist among some of the world's most advanced economies. This study investigated the influence of a short, intensive period of phonological awareness (PA) instruction implemented by classroom teachers on raising the literacy achievement of children with and without spoken language impairment (SLI). A quasi-experimental design was employed to measure the PA, reading, and spelling development of one hundred twenty-nine 5-year-olds. Thirty-four children received 10 weeks of PA instruction from their teachers. Ninety-five children continued with their usual reading program, which included phonics instruction but did not target PA. Children who received PA instruction demonstrated superior literacy outcomes compared to children who followed the usual literacy curriculum. Children with SLI showed significant improvements in PA, reading, and spelling but had a different pattern of response to instruction compared to children with typical language. Importantly, the number of children experiencing word decoding difficulties at the end of the program was 26% among children who followed the usual literacy curriculum compared to 6% among children who received the PA instruction. A short, intensive period of classroom PA instruction can raise the literacy profiles of children with and without spoken language difficulties.

Correlates of emotional congruence with children in sexual offenders against children: a test of theoretical models in an incarcerated sample.

PubMed

McPhail, Ian V; Hermann, Chantal A; Fernandez, Yolanda M

2014-02-01

Emotional congruence with children is a psychological construct theoretically involved in the etiology and maintenance of sexual offending against children. Research conducted to date has not examined the relationship between emotional congruence with children and other psychological meaningful risk factors for sexual offending against children. The current study derived potential correlates of emotional congruence with children from the published literature and proposed three models of emotional congruence with children that contain relatively unique sets of correlates: the blockage, sexual deviance, and psychological immaturity models. Using Area under the Curve analysis, we assessed the relationship between emotional congruence with children and offense characteristics, victim demographics, and psychologically meaningful risk factors in a sample of incarcerated sexual offenders against children (n=221). The sexual deviance model received the most support: emotional congruence with children was significantly associated with deviant sexual interests, sexual self-regulation problems, and cognition that condones and supports child molestation. The blockage model received partial support, and the immaturity model received the least support. Based on the results, we propose a set of further predictions regarding the relationships between emotional congruence with children and other psychologically meaningful risk factors to be examined in future research. Copyright © 2013 Elsevier Ltd. All rights reserved.

What Is Philosophy for Children? From an Educational Experiment to Experimental Education

ERIC Educational Resources Information Center

Vansieleghem, Nancy

2014-01-01

Philosophy seems to have gained solid ground in the hearts and minds of educational researchers and practitioners. We critique Philosophy for Children as an experimental programme aimed at improving children's thinking capacity, by questioning the concept of critique itself. What does it mean when an institutional framework like the school…

Chin Prompt Plus Re-Presentation as Treatment for Expulsion in Children with Feeding Disorders

ERIC Educational Resources Information Center

Wilkins, Jonathan W.; Piazza, Cathleen C.; Groff, Rebecca A.; Vaz, Petula C. M.

2011-01-01

Expulsion (spitting out food) is a problem behavior observed in many children with feeding disorders. In the current investigation, we identified 4 children diagnosed with a feeding disorder who exhibited high rates of expulsion. Treatment with re-presentation (placing expelled liquids or solids back into the child's mouth) was not effective in…

Read and Rise: Preparing Our Children for a Lifetime of Success.

ERIC Educational Resources Information Center

Brown, Kia

This guide presents information and ideas to help parents support their children as they grow into readers. It provides literacy-building activities that parents can use to help their children acquire a solid foundation for learning to read and mastering other academic subjects. The guide is divided by age and grade: infants and toddlers,…

A user-centered, iterative engineering approach for advanced biomass cookstove design and development

NASA Astrophysics Data System (ADS)

Shan, Ming; Carter, Ellison; Baumgartner, Jill; Deng, Mengsi; Clark, Sierra; Schauer, James J.; Ezzati, Majid; Li, Jiarong; Fu, Yu; Yang, Xudong

2017-09-01

Unclean combustion of solid fuel for cooking and other household energy needs leads to severe household air pollution and adverse health impacts in adults and children. Replacing traditional solid fuel stoves with high efficiency, low-polluting semi-gasifier stoves can potentially contribute to addressing this global problem. The success of semi-gasifier cookstove implementation initiatives depends not only on the technical performance and safety of the stove, but also the compatibility of the stove design with local cooking practices, the needs and preferences of stove users, and community economic structures. Many past stove design initiatives have failed to address one or more of these dimensions during the design process, resulting in failure of stoves to achieve long-term, exclusive use and market penetration. This study presents a user-centered, iterative engineering design approach to developing a semi-gasifier biomass cookstove for rural Chinese homes. Our approach places equal emphasis on stove performance and meeting the preferences of individuals most likely to adopt the clean stove technology. Five stove prototypes were iteratively developed following energy market and policy evaluation, laboratory and field evaluations of stove performance and user experience, and direct interactions with stove users. The most current stove prototype achieved high performance in the field on thermal efficiency (ISO Tier 3) and pollutant emissions (ISO Tier 4), and was received favorably by rural households in the Sichuan province of Southwest China. Among household cooks receiving the final prototype of the intervention stove, 88% reported lighting and using it at least once. At five months post-intervention, the semi-gasifier stoves were used at least once on an average of 68% [95% CI: 43, 93] of days. Our proposed design strategy can be applied to other stove development initiatives in China and other countries.

System and method for conditioning a hardwood pulp liquid hydrolysate

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

Waite, Darrell; Arnold, Richard; St. Pierre, James

2015-06-30

A system and method for hardwood pulp liquid hydrolysate conditioning includes a first evaporator receives a hardwood mix extract and outputting a quantity of vapor and extract. A hydrolysis unit receives the extract, hydrolyzes and outputs to a lignin separation device, which separates and recovers a quantity of lignin. A neutralization device receives extract from the lignin separation device and a neutralizing agent, producing a mixture of solid precipitate and a fifth extract. The solid precipitate is removed from the fifth extract. A second evaporator removes a quantity of acid from the fifth extract in a vapor form. This vapormore » may be recycled to improve total acid recovery or discarded. A desalination device receives the diluted extract, separates out some of the acid and salt and outputs a desalinated solution.« less

Clinical outcomes in Mexican children with febrile acute upper respiratory tract infections: no impact of antibiotic therapy.

PubMed

Carranza-Martinez, Martha I; Newton-Sanchez, Oscar; Franco-Paredes, Carlos; Villaseñor-Sierra, Alberto

2010-09-01

To compare the clinical outcomes (duration of signs and symptoms) and the microbiology in Mexican children with non-complicated febrile upper respiratory tract infections (URI), with and without the use of antibiotics. We conducted a prospective cohort study from September 2006 to July 2007. The study population consisted of 880 children aged 6 months to 5 years 11 months, attending four community daycare centers run by the Instituto Mexicano del Seguro Social (IMSS) and three non-IMSS daycare centers. Children with a febrile URI were enrolled before receiving any antimicrobials and were followed up for two weeks. Duration of the fever, cough, runny nose, stuffy nose, irritability, loss of appetite, tiredness, and diarrhea, and isolation of Haemophilus influenzae,Streptococcus pneumoniae, and Streptococcus pyogenes were compared in those children who received antibiotic treatment and those who did not receive antibiotics. During the study period, a total of 145 out of 880 children were enrolled, and among those enrolled, 85/145 (59%) children received antibiotics. There was no significant difference in the duration of the signs and symptoms evaluated in the two groups. Although the proportions of S. pneumoniae, H. influenzae, and S. pyogenes isolated in children with and without antibiotics were comparable, those in whom we isolated S. pneumoniae had both a significantly longer episode of URI, as well as longer lasting diarrhea. Similarly, children receiving trimethoprim-sulfamethoxazole treatment experienced significantly longer durations of fever and diarrhea. The mean duration of signs and symptoms and the microbiological isolates of children with febrile URI were comparable among children treated with or without antibiotics, with the exception of a longer duration of URI and diarrhea in those children with an S. pneumoniae isolate. Our findings suggest that in our population, most cases of febrile URI are caused by viral infections, and demonstrate that antibiotics should not be used routinely in children with non-complicated febrile URI. Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Research Opportunities for Cancer Associated with Indoor Air Pollution from Solid-Fuel Combustion

EPA Science Inventory

Background: Indoor air pollution (IAP) derived largely from the use of solid fuels for cooking and heating affects about 3 billion people worldwide, resulting in substantial adverse health outcomes, including cancer. Women and children from developing countries are the most expos...

Improved noise-adding radiometer for microwave receivers

NASA Technical Reports Server (NTRS)

Batelaan, P. D.; Stelzried, C. T.; Goldstein, R. M.

1973-01-01

Use of input switch and noise reference standard is avoided by using noise-adding technique. Excess noise from solid state noise-diode is coupled into receiver through directional coupler and square-wave modulated at low rate. High sensitivity receivers for radioastronomy applications are utilized with greater confidence in stability of radiometer.

40 CFR 258.29 - Recordkeeping requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 258.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Operating Criteria § 258.29 Recordkeeping requirements. (a) The... of an approved state program may receive electronic documents only if the state program includes the...

40 CFR 258.29 - Recordkeeping requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 258.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Operating Criteria § 258.29 Recordkeeping requirements. (a) The... of an approved state program may receive electronic documents only if the state program includes the...

40 CFR 258.29 - Recordkeeping requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 258.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Operating Criteria § 258.29 Recordkeeping requirements. (a) The... of an approved state program may receive electronic documents only if the state program includes the...

A theory-based approach to teaching young children about health: A recipe for understanding

PubMed Central

Nguyen, Simone P.; McCullough, Mary Beth; Noble, Ashley

2011-01-01

The theory-theory account of conceptual development posits that children’s concepts are integrated into theories. Concept learning studies have documented the central role that theories play in children’s learning of experimenter-defined categories, but have yet to extensively examine complex, real-world concepts such as health. The present study examined whether providing young children with coherent and causally-related information in a theory-based lesson would facilitate their learning about the concept of health. This study used a pre-test/lesson/post-test design, plus a five month follow-up. Children were randomly assigned to one of three conditions: theory (i.e., 20 children received a theory-based lesson); nontheory (i.e., 20 children received a nontheory-based lesson); and control (i.e., 20 children received no lesson). Overall, the results showed that children in the theory condition had a more accurate conception of health than children in the nontheory and control conditions, suggesting the importance of theories in children’s learning of complex, real-world concepts. PMID:21894237

Poverty, Family Process, and the Mental Health of Immigrant Children in Canada

PubMed Central

Beiser, Morton; Hou, Feng; Hyman, Ilene; Tousignant, Michel

2002-01-01

Objectives. This study examined the differential effects of poverty on the mental health of foreign-born children, Canadian-born children of immigrant parents, and children of nonimmigrant parents. Methods. Secondary analysis of data from a national Canadian study of children between 4 and 11 years of age was conducted. Results. Compared with their receiving-society counterparts, foreign-born children were more than twice as likely to live in poor families, but they had lower levels of emotional and behavioral problems. The effect of poverty on children's mental health among long-term immigrant and receiving-society families was indirect and primarily mediated by single-parent status, ineffective parenting, parental depression, and family dysfunction. In comparison, the mental health effect of poverty among foreign-born children could not be explained by the disadvantages that poor families often suffer. Conclusions. Poverty may represent a transient and inevitable part of the resettlement process for new immigrant families. For long-stay immigrant and receiving-society families, however, poverty probably is not part of an unfolding process; instead, it is the nadir of a cycle of disadvantage. PMID:11818295

Population pharmacokinetics of temsirolimus and sirolimus in children with recurrent solid tumours: a report from the Children's Oncology Group.

PubMed

Mizuno, Tomoyuki; Fukuda, Tsuyoshi; Christians, Uwe; Perentesis, John P; Fouladi, Maryam; Vinks, Alexander A

2017-05-01

Temsirolimus is an inhibitor of the mammalian target of rapamycin (mTOR). Pharmacokinetic (PK) characterization of temsirolimus in children is limited and there is no paediatric temsirolimus population PK model available. The objective of this study was to simultaneously characterize the PK of temsirolimus and its metabolite sirolimus in paediatric patients with recurrent solid or central nervous system tumours and to develop a population PK model. The PK data for temsirolimus and sirolimus were collected as a part of a Children's Oncology Group phase I clinical trial in paediatric patients with recurrent solid tumours. Serial blood concentrations obtained from 19 patients participating in the PK portion of the study were used for the analysis. Population PK analysis was performed by nonlinear mixed effect modelling using NONMEM. A three-compartment model with zero-order infusion was found to best describe temsirolimus PK. Allometrically scaled body weight was included in the model to account for body size differences. Temsirolimus dose was identified as a significant covariate on clearance. A sirolimus metabolite formation model was developed and integrated with the temsirolimus model. A two-compartment structure model adequately described the sirolimus data. This study is the first to describe a population PK model of temsirolimus combined with sirolimus formation and disposition in paediatric patients. The developed model will facilitate PK model-based dose individualization of temsirolimus and the design of future clinical studies in children. © 2016 The British Pharmacological Society.

Population pharmacokinetics of temsirolimus and sirolimus in children with recurrent solid tumours: a report from the Children's Oncology Group

PubMed Central

Mizuno, Tomoyuki; Fukuda, Tsuyoshi; Christians, Uwe; Perentesis, John P.; Fouladi, Maryam

2016-01-01

Aims Temsirolimus is an inhibitor of the mammalian target of rapamycin (mTOR). Pharmacokinetic (PK) characterization of temsirolimus in children is limited and there is no paediatric temsirolimus population PK model available. The objective of this study was to simultaneously characterize the PK of temsirolimus and its metabolite sirolimus in paediatric patients with recurrent solid or central nervous system tumours and to develop a population PK model. Methods The PK data for temsirolimus and sirolimus were collected as a part of a Children's Oncology Group phase I clinical trial in paediatric patients with recurrent solid tumours. Serial blood concentrations obtained from 19 patients participating in the PK portion of the study were used for the analysis. Population PK analysis was performed by nonlinear mixed effect modelling using NONMEM. Results A three‐compartment model with zero‐order infusion was found to best describe temsirolimus PK. Allometrically scaled body weight was included in the model to account for body size differences. Temsirolimus dose was identified as a significant covariate on clearance. A sirolimus metabolite formation model was developed and integrated with the temsirolimus model. A two‐compartment structure model adequately described the sirolimus data. Conclusion This study is the first to describe a population PK model of temsirolimus combined with sirolimus formation and disposition in paediatric patients. The developed model will facilitate PK model‐based dose individualization of temsirolimus and the design of future clinical studies in children. PMID:28000286

Safety and usage of darbepoetin alfa in children with chronic kidney disease: prospective registry study.

PubMed

Schaefer, Franz; Hoppe, Bernd; Jungraithmayr, Therese; Klaus, Günter; Pape, Lars; Farouk, Mourad; Addison, Janet; Manamley, Nick; Vondrak, Karel

2016-03-01

Limited prospective data are available on the long-term safety of darbepoetin alfa (DA) for treating anemia in children with chronic kidney disease (CKD). In this prospective, phase IV, observational registry study, children ≤16 years of age with CKD anemia and receiving DA were observed for ≤2 years. Adverse events (AEs), DA dosing, hemoglobin (Hb) concentrations, and transfusions were recorded. A total of 319 patients were included in the analysis (mean age, 9.1 years), 158 (49.5%) of whom were on dialysis at study entry. Of 434 serious AEs reported in 162 children, the most common were peritonitis (10.0%), gastroenteritis (6.0%), and hypertension (4.1%). Six patients (1.9%) died (unrelated to DA). Four patients (1.3%) experienced six serious adverse drug reactions. The geometric mean DA dose range was 1.4-2.0 μg/kg/month. Mean baseline Hb concentration was 11.1 g/dl; mean values for children receiving and not receiving dialysis at baseline ranged between 10.9 and 11.5 g/dl and 11.2-11.7 g/dl, respectively. Overall, 48 patients (15.0%) received ≥1 transfusion. No new safety signals for DA were identified in children receiving DA for CKD anemia for ≤2 years. Based on Hb concentrations and transfusion requirements, DA was effective at managing anemia in these patients.

Hybrid fluidized bed combuster

DOEpatents

Kantesaria, Prabhudas P.; Matthews, Francis T.

1982-01-01

A first atmospheric bubbling fluidized bed furnace is combined with a second turbulent, circulating fluidized bed furnace to produce heat efficiently from crushed solid fuel. The bed of the second furnace receives the smaller sizes of crushed solid fuel, unreacted limestone from the first bed, and elutriated solids extracted from the flu gases of the first bed. The two-stage combustion of crushed solid fuel provides a system with an efficiency greater than available with use of a single furnace of a fluidized bed.

Administration of Bifidobacterium breve Decreases the Production of TNF-α in Children with Celiac Disease.

PubMed

Klemenak, Martina; Dolinšek, Jernej; Langerholc, Tomaž; Di Gioia, Diana; Mičetić-Turk, Dušanka

2015-11-01

Increasing evidence suggests that not only genetics, but also environmental factors like gut microbiota dysbiosis play an important role in the pathogenesis of celiac disease (CD). The aim of our study was to investigate the effect of two probiotic strains Bifidobacterium breve BR03 and B. breve B632 on serum production of anti-inflammatory cytokine interleukin 10 (IL-10) and pro-inflammatory cytokine tumor necrosis factor alpha (TNF-α) in children with CD. The study was a double-blinded, placebo-controlled trial that included 49 children with CD on gluten-free diet (GFD) randomized into two groups and 18 healthy children in the control group. The first group (24 children with CD) daily received B. breve BR03 and B632 (2 × 10(9) colony-forming units) and the second group (25 children with CD) received placebo for 3 months. TNF-α levels were significantly decreased in the first group after receiving B. breve for 3 months. On follow-up, 3 months after receiving probiotics, TNF-α levels increased again. Children with CD who were on GFD for less than 1 year showed similar baseline TNF-α levels as children who were on GFD for more than 1 year. IL-10 levels were in all groups of patients below detection level. Probiotic intervention with B. breve strains has shown a positive effect on decreasing the production of pro-inflammatory cytokine TNF-α in children with CD on GFD.

Federal Autism Activities: Agencies Are Encouraging Early Identification and Providing Services, and Recent Actions Could Improve Coordination. Report to Congressional Requesters. GAO-16-446

ERIC Educational Resources Information Center

US Government Accountability Office, 2016

2016-01-01

Research has shown that early intervention can greatly improve the development of a child with autism. Children with disabilities--including children with autism--can receive intervention services through the Individuals with Disabilities Education Act. Low income children may also receive intervention services through Medicaid or the State…

Dividing Attention Lowers Children's but Increases Adults' False Memories

ERIC Educational Resources Information Center

Otgaar, Henry; Peters, Maarten; Howe, Mark L.

2012-01-01

The present study examined the impact of divided attention on children's and adults' neutral and negative true and false memories in a standard Deese/Roediger-McDermott paradigm. Children (7- and 11-year-olds; n = 126) and adults (n = 52) received 5 neutral and 5 negative Deese/Roediger-McDermott word lists; half of each group also received a…

Linguistic and Pragmatic Skills in Toddlers with Cochlear Implant

ERIC Educational Resources Information Center

Rinaldi, Pasquale; Baruffaldi, Francesca; Burdo, Sandro; Caselli, Maria Cristina

2013-01-01

Background: An increasing number of deaf children received cochlear implants (CI) in the first years of life, but no study has focused on linguistic and pragmatic skills in children with CI younger than 3 years of age. Aims: To estimate the percentage of children who had received a CI before 2 years of age whose linguistic skills were within the…

Effect of information on dental anxiety and behaviour ratings in children.

PubMed

Folayan, M O; Idehen, E E

2004-09-01

To establish the effect of information received about dental care on the anxiety level of the child prior to receiving any form of dental treatment and on their behaviour during dental treatment. Eighty-four healthy child patients at their first dental visit, between the ages of 8 and 13 years attending a paediatric dental clinic in Nigeria participated in the study. Information on their dental anxiety level was collected using the Dental Subscale of the Child Fear Survey Schedule. The children were asked to identify their source and type of dental information received. The information given was later categorised into positive or negative for analysis purposes. The children's behaviour during dental treatment was assessed using Venham's clinical ratings of anxiety and cooperative behaviour. The mean dental anxiety scores, as well as the mean Venham behavioural ratings, of those that had received information on dental treatment were compared with those that had never received any information. Previously received information did not appear to have any significant impact on the measures of the dental anxiety level of these children neither was there a statistically significant association between information received and behaviour of the child in the dental chair. Past information may play only a minor role in affecting dental anxiety levels and behaviour of the child during dental treatment.

Comparative Effectiveness Study to Assess Two Examination Modalities Used to Detect Dental Caries in Preschool Urban Children

PubMed Central

Billings, Ronald J.

2013-01-01

Abstract Background: Dental caries affecting the primary dentition of U.S. children continues to be the most prevalent chronic childhood disease. Preventive screening for dental caries in toddlers by dental professionals is labor-intensive and costly. Studies are warranted to examine innovative screening modalities that reduce cost, are less labor-intensive, and have the potential to identify caries in high-risk children. Subjects and Methods: Two hundred ninety-one children were randomized into two groups: Group 1 received a traditional, visual tactile examination initially and follow up-examinations at 6 and 12 months, and Group 2 received a teledentistry examination initially and follow-up examinations at 6 and 12 months. The mean primary tooth decayed and filled surfaces (dfs) scores were calculated for all children at baseline and 6 and 12 months. Results: At baseline, the mean dfs score for children examined by means of teledentistry was 2.19, and for the children examined by means of the traditional method, the mean was 1.27; the means were not significantly different. At the 12-month examination, the mean dfs score for the children examined by means of teledentistry was 3.02, and for the children examined by means of the clinical method, the mean dfs was 1.70; the means were not significantly different. At 12 months the mean fillings score for the children examined by means of teledentistry was 1.43 and for the children examined by means of the clinical method was 0.51; the means were statistically significantly different (p<0.001). Conclusions: These results suggest that the teledentistry examinations were comparable to clinical examinations when screening for early childhood caries in preschool children. The data further showed that color printouts of teeth with cavities provided to parents of children who received teledentistry screenings promoted oral healthcare utilization, as children from the teledentistry study group received more dental care than children from the clinical study group. PMID:24053114

Receipt of special education services following elementary school grade retention.

PubMed

Silverstein, Michael; Guppy, Nicole; Young, Robin; Augustyn, Marilyn

2009-06-01

To estimate the proportion of children who receive an Individualized Education Program (IEP) following grade retention in elementary school. Longitudinal cohort study. Children retained in kindergarten or first (K/1) grade and third grade, presumably for academic reasons, were followed up through fifth grade. Presence or absence of an IEP. A total of 300 children retained in K/1 and 80 retained in third grade were included in the study. Of the K/1 retainees, 68.9% never received an IEP during the subsequent 4 to 5 years; of the third-grade retainees, 72.3% never received an IEP. Kindergarten/first-grade retainees in the highest quintile for socioeconomic status and those with suburban residence were less likely to receive an IEP than retained children in all other socioeconomic status quintiles (adjusted odds ratio, 0.17; 95% confidence interval, 0.05-0.62) and in rural communities (0.16; 0.06-0.44). Among K/1 retainees with persistently low academic achievement in math and reading, as assessed by standardized testing, 38.2% and 29.7%, respectively, never received an IEP. Most children retained in K/1 or third grade for academic reasons, including many of those who demonstrated sustained academic difficulties, never received an IEP during elementary school. Further studies are important to elucidate whether retained elementary schoolchildren are being denied their rights to special education services. In the meantime, early-grade retention may provide an opportunity for pediatricians to help families advocate for appropriate special education evaluations for children experiencing school difficulties.

[Recent incidences and trends of childhood malignant solid tumors in Shanghai, 2002-2010].

PubMed

Bao, Ping-Ping; Li, Kai; Wu, Chun-Xiao; Huang, Zhe-Zhou; Wang, Chun-Fang; Xiang, Yong-Mei; Peng, Peng; Gong, Yang-Ming; Xiao, Xian-Min; Zheng, Ying

2013-04-01

To examine the recent incidences and trends of childhood malignant solid tumors in Shanghai. Data from the population-based Shanghai Cancer Registry and related retrospective survey were used to analyze the patterns of incidence and trends of malignant solid tumors diagnosed between 2002 and 2010 in children aged 0-14 years. The distributions of incidences were described according to gender, age and cancer types which were classified according to International Classification of Childhood Cancer (ICCC). Annual age-standardized rates (ASRs) were adjusted by the world standard population. Approximate confidence intervals for standardized rate ratios (SRR) based Poisson distribution test-based methods were used to assess changes in incidence over the period 2002 - 2006 and 2007 - 2010. (1)A total of 868 cases of childhood malignant solid tumors were diagnosed in Shanghai during 2002 - 2010, accounting for 65.8% of all childhood cancers. The ASR of 2002 - 2010 was 80.2 per million for all solid tumors. (2) The ASR was higher in boys (86.3 per million) than in girls (73.8 per million) with SRR 1.2 (95%CI 1.0 - 1.3). Incidence rate was the highest in the first five years of life with 93.4 per million. The age-specific incidence rates in 5 - 9 and 10 - 14 age groups were 65.2 and 79.3 per million, respectively. (3) CNS tumors, lymphomas, germ cell tumors, neuroblastoma, and soft tissue sarcomas were the top 5 most common solid tumors in children, with the incidence rate of 23.8, 11.0, 7.8, 7.7 and 6.8 per million, respectively. The patterns of subgroups varied in different age groups. Blastomas, such as neuroblastoma, retinoblastoma, were more common in the children aged 0 - 4 years, whereas epithelial carcinomas and bone tumors developed more frequently in elder children aged 10 - 14 years. (4) Compared with the ASR in 2002 - 2006, the ASR for both genders in 2007 - 2010 had no substantial changes (78.7 per million in 2002 - 2006 and 82.9 per million in 2007 - 2010). However, among boys, the incidence rate in 2007 - 2010 was significantly higher than that in 2002 - 2006 with SRR 1.2 (95%CI: 1.0 - 1.4). For specific subgroups of cancer, there were no substantial changes. Some cautions should be taken when interpreting results involving a small number of cases per year and those with wide 95% confidence intervals. The incidence rate of pediatric malignant solid tumors among males was higher than females during 2002 - 2010, and it differed among different age groups with the highest in the first five years of life. CNS tumor was the most common type of solid tumors in children. This was a unique characteristics comparing with adult reflected in disease spectrum and age of onset. The patterns of incidence and its trends for childhood malignant solid tumors in Shanghai could provide a basis for etiologic research and preventive interventions. The findings also suggest an urgent need for longer population-based surveillance to verify the pattern and changing trends.

What's Possible for First-Grade At-Risk Literacy Learners Receiving Early Intervention Services

ERIC Educational Resources Information Center

Bufalino, Janet; Wang, Chuang; Gomez-Bellenge, Francisco X.; Zalud, Garreth

2010-01-01

This paper summarizes a study that was conducted on data from children who received a one-on-one intervention called Reading Recovery[R] during the first half of their first-grade year in school. The purpose was to investigate the relationship between accelerated progress children made during and after receiving a Reading Recovery intervention,…

Evaluating the effectiveness of infant mental health enhanced case management for dependency populations.

PubMed

Congdon, David

2010-10-01

Children who are receiving services for abuse and neglect are likely to have reduced developmental levels and are less prepared for success in school as a result. The progress of 144 children receiving services from The Children's Home Society of Florida was tracked with half being randomly assigned to a control group and half to an experimental group receiving enhanced infant mental health oriented case management services from two social work professionals in each of two locations in Tallahassee and West Palm Beach Florida. Those receiving enhanced case management showed significantly higher results in the following areas: more visits with their parents (for those removed from the family home), more service referrals, more completed assessments for services, more services based on the assessments they received, and more success in completing goals of treatment for which they were referred. Their parents had more contact with professionals to whom they were referred and had more success in completing goals of the treatment for which they were referred. Children who received intensive case management also showed improvement in their developmental skills related to problem solving from inception to completion of services. Implications for further research are considered.

Pain outcomes in children who received intrathecal vs intravenous opioids for pain control following major urologic surgery: a retrospective review.

PubMed

Putnam, Elizabeth M; Koppera, Prabhat; Malviya, Shobha; Voepel-Lewis, Terri

2015-12-01

Intrathecal (IT) opioid administration has been associated with postoperative benefits including reduced pain and opioid use in children. However, the postoperative benefits and risks of IT opioid administration during major urologic surgery in children remain unclear. The aim of this study was to compare postoperative pain and adverse event outcomes among children who received IT vs intravenous (IV) opioids during major urologic surgery. We reviewed the medical records of children 3-17 years of age who underwent ureteroneocystostomy or pyeloplasty between 2006 and 2012. Electronically captured anesthetic and surgical data, postanesthesia care recovery unit (PACU) and nursing flowsheets, and daily progress notes through hospital discharge were reviewed. Analgesic techniques (i.e., IT or IV patient/nurse controlled opioids), all analgesic drugs and doses were recorded. Outcome measures included pain scores, need for rescue analgesics, opioid-related adverse events, and their treatments. Seventy-seven children received IT opioids and 51 received IV opioids. More children in the IV group required rescue analgesics and had higher pain scores at PACU discharge. Children in the IV group required rescue opioids more frequently than the IT group from 0 to 8 h and 8 to 16 h after PACU discharge, but rates were similar by 16-24 h 70% of children in IT group transitioned directly to oral opioids. Seven IT placements were considered as failed due to early need for rescue opioids. Four (8%) of the IV group and seven (9%) of the IT group experienced oxygen desaturation. Two of these, both in IT group required naloxone and one was admitted to ICU for observation. The IT group experienced a higher incidence of pruritus, constipation and hypotension. We observed better postoperative pain control in children who received IT vs IV opioids for the first 16 h with no discernible difference thereafter. The intrathecal group experienced higher incidences of pruritus, constipation, and hypotension. © 2015 John Wiley & Sons Ltd.

Vaccination status and sequence of vaccinations as risk factors for hospitalisation among outpatients in a high mortality country.

PubMed

Biai, Sidu; Rodrigues, Amabelia; Nielsen, Jens; Sodemann, Morten; Aaby, Peter

2011-05-09

Most developing countries are implementing the WHO immunisation programme. Although vaccines reach most children, many modifications of the recommended schedule are observed in practice. We investigated the association between vaccination status and risk of hospitalisation in Guinea-Bissau. From May 2003 to May 2004, all consultations of children less than five years of age at the outpatient clinic of the paediatric ward at the national hospital in Bissau were registered. For each consultation, information was collected about the child's name, sex, age and socio-cultural conditions, as well as diagnosis and whether the child was hospitalised. Information about vaccinations was also registered from the child's vaccination card. We analysed the association between vaccination status and risk of hospitalisation in age intervals according to the pre-dominant vaccines. We particularly emphasised the comparison of those who had received the recommended vaccination for the age groups and those who were delayed and only had the previous vaccinations. We also examined those who had received the vaccines out of sequence. Information about vaccinations was available for 11,949 outpatient children of whom 2219 (19%) were hospitalised. Among children less than 3 months of age, unvaccinated children compared to BCG children had as expected a higher risk of hospitalisation; controlled for important determinants of hospitalisation, the hospitalisation risk ratio (HRR) was 1.99 (95% CI 1.37-2.89). In contrast, there was no difference in the HRR for children aged 1½-8 months who were delayed and had only received BCG compared to those who as recommended had received diphtheria-tetanus-pertussis (DTP) vaccine after BCG (HRR=1.10 (0.77-1.59)). In the age interval 9-17 months of age, children who were delayed and had only received DTP had significantly higher risk of hospitalisation compared with children who as recommended had measles vaccine (MV) as the most recent vaccination (HRR=1.39 (1.16-1.66)). Having received DTP after MV (HRR=1.60 (1.15-2.24)) or MV and DTP simultaneously (HRR=1.51 (1.16-1.97)) was also associated with higher risk than MV only as most recent vaccination. In contrast, the children aged 18-59 months who as recommended had received a DTP booster after MV did not have lower risk of hospitalisations compared with children who were delayed and had received only MV (RR=0.90 (0.75-1.07)). After 9 months of age, there was a significant difference in the female-male HRR for children who had MV (HRR=0.85 (0.72-1.00)) or DTP (HRR=1.08 (0.96-1.22)) as most recent vaccination (p=0.02, test of interaction). Following the recommended vaccination schedule for BCG and MV is associated with a reduced risk of hospitalisation but this is not the case for DTP and booster DTP. Receiving DTP simultaneously with MV or after MV is associated with increased risk of hospitalisation. Vaccines have sex-differential effects on the risk of hospitalisation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effect of Play-based Occupational Therapy on Symptoms of Hospitalized Children with Cancer: A Single-subject Study.

PubMed

Mohammadi, Ahmad; Mehraban, Afsoon Hassani; Damavandi, Shahla A

2017-01-01

Cancer is one of the four leading causes of death in children. Its courses of diagnosis and treatment can cause physiologic symptoms and psychological distress that secondarily affect children's quality of life and participation in daily activities. The aim of this study was to investigate the effect of play-based occupational therapy on pain, anxiety, and fatigue in hospitalized children with cancer who were receiving chemotherapy. Two hospitalized children with acute lymphoblastic leukemia at least 4 months after diagnoses who received two courses of chemotherapy participated in this pilot study. Takata Play History and Iranian Children Participation Assessment Scale were used to develop intervention protocol. Nine, 30-45 min play-based occupational therapy sessions took place for each child. Children filled out the Faces Pain Scale, Visual Fatigue Scale, and Faces Anxiety Scale before and after each intervention session. Pain, anxiety, and fatigue levels decreased in both participants. Furthermore, the results showed a relationship between pain, anxiety, and fatigue variables in these children. Play-based occupational therapy can be effective in improving pain, anxiety, and fatigue levels in hospitalized children with cancer receiving chemotherapy.

Effect of Play-based Occupational Therapy on Symptoms of Hospitalized Children with Cancer: A Single-subject Study

PubMed Central

Mohammadi, Ahmad; Mehraban, Afsoon Hassani; Damavandi, Shahla A.

2017-01-01

Objective: Cancer is one of the four leading causes of death in children. Its courses of diagnosis and treatment can cause physiologic symptoms and psychological distress that secondarily affect children's quality of life and participation in daily activities. The aim of this study was to investigate the effect of play-based occupational therapy on pain, anxiety, and fatigue in hospitalized children with cancer who were receiving chemotherapy. Methods: Two hospitalized children with acute lymphoblastic leukemia at least 4 months after diagnoses who received two courses of chemotherapy participated in this pilot study. Takata Play History and Iranian Children Participation Assessment Scale were used to develop intervention protocol. Nine, 30–45 min play-based occupational therapy sessions took place for each child. Children filled out the Faces Pain Scale, Visual Fatigue Scale, and Faces Anxiety Scale before and after each intervention session. Results: Pain, anxiety, and fatigue levels decreased in both participants. Furthermore, the results showed a relationship between pain, anxiety, and fatigue variables in these children. Conclusions: Play-based occupational therapy can be effective in improving pain, anxiety, and fatigue levels in hospitalized children with cancer receiving chemotherapy. PMID:28503651

30 CFR 75.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2014 CFR

2014-07-01

... casing having low resistance to earth; (c) A solid connection to metal waterlines having low resistance to earth; (d) A solid connection to a grounding conductor extending to a low resistance ground field... earth. ...

30 CFR 75.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2012 CFR

2012-07-01

... casing having low resistance to earth; (c) A solid connection to metal waterlines having low resistance to earth; (d) A solid connection to a grounding conductor extending to a low resistance ground field... earth. ...

30 CFR 75.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2013 CFR

2013-07-01

... casing having low resistance to earth; (c) A solid connection to metal waterlines having low resistance to earth; (d) A solid connection to a grounding conductor extending to a low resistance ground field... earth. ...

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

PubMed Central

Sachdeva, Sandeep; Datta, Utsuk

2009-01-01

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

Comparing recurrent antibiotic prescriptions in children treated with a brand name or a generic formulation.

PubMed

Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bortolotti, Angela; Fortino, Ida; Merlino, Luca; Bonati, Maurizio

2015-02-01

The aim of this study was to investigate the rate of recurrent prescriptions and hospital admissions in children receiving a brand name or generic antibiotic prescription. The data source was a database of reimbursed prescriptions. Outpatient children/adolescents <18 years old (Lombardy Region, Italy) were included. The observational period was February-April 2010. A recurrence was defined as an antibiotic prescription occurring within 28 days after an index prescription. The rate of recurrent prescriptions and hospital admissions was calculated for generic/brand name formulations and for each age strata (0-5, 6-11, and 12-17 years old) for four antibiotics: amoxicillin, amoxicillin clavulanate, clarithromycin, and cefaclor. The percentage of therapy switches was calculated. Cochran-Mantel-Haenszel test was used to compare the age-adjusted outcomes. In all, 17.5% (57 346) of children received at least one recurrent prescription. The rate of recurrent prescriptions was slightly lower in children receiving any generic (OR 0.96; 95%CI 0.93-0.98), compared with any brand name, antibiotic. The percentage of hospital admissions occurring in children initially treated with a brand name (1.01%; 95%CI 0.98-1.08) or generic (1.03%; 0.96-1.06) antibiotic was not different (p = 0.43). For children receiving amoxicillin clavulanate, the hospital admission rate was slightly higher in the brand name group (p = 0.002), while no differences were found for the other active substances. Children treated with generic antibiotics had no worse safety and effectiveness outcomes when compared with those receiving brand name ones. These results provide additional evidence on the safety of generic antibiotics. Copyright © 2014 John Wiley & Sons, Ltd.

[Initial evaluation of a programme to prevent mother-to-child transmission of human immunodeficiency virus infection in Equatorial Guinea].

PubMed

Badillo-Navarro, Katie; Prieto-Tato, Luis; Obiang-Esomoyo, Jacinta; Avedillo-Jiménez, Pedro; Vargas-Brizuela, Antonio; Rojo-Conejo, Pablo

2014-01-01

The prevalence of human immunodeficiency virus (HIV)-infected pregnant women in Equatorial Guinea (EG) has been reported as 7.3%. In 2008 an updated version of the PMTCT protocol was accepted according to the current WHO guidelines. The aim of this study was to describe the characteristics and outcome of children exposed to HIV after the introduction of the protocol. A retrospective review was conducted on the clinical characteristics of the infants born to HIV-infected mothers in the Hospital Regional de Bata and Primary Health Care Centre Maria Rafols in Bata (EG) between June 2008 and November 2011. The diagnosis of HIV infection in children was based on rapid serology tests. A total of 103 children were included, of which 47 were males. Fifty three patients (51%) completed the follow-up (51%). Fourteen children (26%) were diagnosed with HIV infection (11 presumptive diagnosis, 3 due to persistence of antibodies at 18 months). Six children (12%) died before a definitive diagnosis. Just over than half (52%) of mothers received antiretroviral therapy (ART) during pregnancy. The transmission rate in children whose mothers received ART was 16% (3/19), compared with 43% (10/23) in children whose mothers did not receive it. Only one child was infected (8%) when the mother received ART, and child received postnatal prophylaxis. The PMTCT protocol compliance was still very low. Antiretroviral therapy in pregnant women decreased the rate of vertical transmission, but the rate still remains very high. Many children were lost to follow-up. Strategies to prevent loss to follow-up and methods for earlier virological diagnostic are needed. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Efficacy and Safety of Drotaverine Hydrochloride in Children with Recurrent Abdominal Pain: A Randomized Placebo Controlled Trial.

PubMed

Narang, Manish; Shah, Dheeraj; Akhtar, Hina

2015-10-01

To evaluate the efficacy and safety of Drotaverine hydrochroride in children with recurrent abdominal pain. Double blind, randomized placebo-controlled trial. Pediatric Gastroenterology clinic of a teaching hospital. 132 children (age 4-12 y) with recurrent abdominal pain (Apley Criteria) randomized to receivedrotaverine (n=66) or placebo (n=66) orally. Children between 4-6 years of age received 10 mL syrup orally (20 mg drotaverine hydrochloride or placebo) thrice daily for 4 weeks while children >6 years of age received one tablet orally (40 mg drotaverine hydrochloride or placebo) thrice daily for 4 weeks. Primary: Number of episodes of pain during 4 weeks of use of drug/placebo and number of pain-free days. Secondary: Number of school days missed during the study period, parental satisfaction (on a Likert scale), and occurrence of solicited adverse effects. Reduction in number of episodes of abdominal pain [mean (SD) number of episodes 10.3 (14) vs 21.6 (32.4); P=0.01] and lesser school absence [mean (SD) number of school days missed 0.25 (0.85) vs 0.71 (1.59); P=0.05] was noticed in children receiving drotaverine in comparison to those who received placebo. The number of pain-free days, were comparable in two groups [17.4 (8.2) vs 15.6 (8.7); P=0.23]. Significant improvement in parental satisfaction score was noticed on Likert scale by estimation of mood, activity, alertness, comfort and fluid intake. Frequency of adverse events during follow-up period was comparable between children receiving drotaverine or placebo (46.9% vs 46.7%; P=0.98). Drotaverine hydrochloride is an effective and safe pharmaceutical agent in the management of recurrent abdominal pain in children.

Child mortality from solid-fuel use in India: a nationally-representative case-control study

PubMed Central

2010-01-01

Background Most households in low and middle income countries, including in India, use solid fuels (coal/coke/lignite, firewood, dung, and crop residue) for cooking and heating. Such fuels increase child mortality, chiefly from acute respiratory infection. There are, however, few direct estimates of the impact of solid fuel on child mortality in India. Methods We compared household solid fuel use in 1998 between 6790 child deaths, from all causes, in the previous year and 609 601 living children living in 1.1 million nationally-representative homes in India. Analyses were stratified by child's gender, age (neonatal, post-neonatal, 1-4 years) and colder versus warmer states. We also examined the association of solid fuel to non-fatal pneumonias. Results Solid fuel use was very common (87% in households with child deaths and 77% in households with living children). After adjustment for demographic factors and living conditions, solid-fuel use significantly increase child deaths at ages 1-4 (prevalence ratio (PR) boys: 1.30, 95%CI 1.08-1.56; girls: 1.33, 95%CI 1.12-1.58). More girls than boys died from exposure to solid fuels. Solid fuel use was also associated with non-fatal pneumonia (boys: PR 1.54 95%CI 1.01-2.35; girls: PR 1.94 95%CI 1.13-3.33). Conclusions Child mortality risks, from all causes, due to solid fuel exposure were lower than previously, but as exposure was common solid, fuel caused 6% of all deaths at ages 0-4, 20% of deaths at ages 1-4 or 128 000 child deaths in India in 2004. Solid fuel use has declined only modestly in the last decade. Aside from reducing exposure, complementary strategies such as immunization and treatment could also reduce child mortality from acute respiratory infections. PMID:20716354

Near-Blackbody Enclosed Particle-Receiver Development

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

Ma, Zhiwen; Sakadjian, Bartev

2015-12-01

This 3-year project develops a technology using gas/solid, two-phase flow as a heat-transfer fluid and separated, stable, solid particles as a thermal energy storage (TES) medium for a concentrating solar power (CSP) plant, to address the temperature, efficiency, and cost barriers associated with current molten-salt CSP systems. This project focused on developing a near-blackbody particle receiver and an integrated fluidized-bed heat exchanger with auxiliary components to achieve greater than 20% cost reduction over current CSP plants, and to provide the ability to drive high-efficiency power cycles.

Running Head: Texas State Children’s Health Insurance Program. Proposed Solutions for the Continuance of the Texas State Children’s Health Insurance Program

DTIC Science & Technology

2009-04-01

many feel a social obligation to provide healthcare to the elderly , disabled, and children. The elderly and disabled receive health coverage...Studies have shown that children who receive healthcare are more likely to be healthier adults . The purpose of the report, Overcoming Obstacles to Health ...income families. Underprivileged adults are five times more likely to be in poor health than adults with higher incomes. Analyses of this data reflect

Development of a predictive model for 6 month survival in patients with venous thromboembolism and solid malignancy requiring IVC filter placement.

PubMed

Huang, Steven Y; Odisio, Bruno C; Sabir, Sharjeel H; Ensor, Joe E; Niekamp, Andrew S; Huynh, Tam T; Kroll, Michael; Gupta, Sanjay

2017-07-01

Our purpose was to develop a predictive model for short-term survival (i.e. <6 months) following inferior vena cava filter placement in patients with venous thromboembolism (VTE) and solid malignancy. Clinical and laboratory parameters were retrospectively reviewed for patients with solid malignancy who received a filter between January 2009 and December 2011 at a tertiary care cancer center. Multivariate Cox proportional hazards modeling was used to assess variables associated with 6 month survival following filter placement in patients with VTE and solid malignancy. Significant variables were used to generate a predictive model. 397 patients with solid malignancy received a filter during the study period. Three variables were associated with 6 month survival: (1) serum albumin [hazard ratio (HR) 0.496, P < 0.0001], (2) recent or planned surgery (<30 days) (HR 0.409, P < 0.0001), (3) TNM staging (stage 1 or 2 vs. stage 4, HR 0.177, P = 0.0001; stage 3 vs. stage 4, HR 0.367, P = 0.0002). These variables were used to develop a predictive model to estimate 6 month survival with an area under the receiver operating characteristic curve of 0.815, sensitivity of 0.782, and specificity of 0.715. Six month survival in patients with VTE and solid malignancy requiring filter placement can be predicted from three patient variables. Our predictive model could be used to help physicians decide whether a permanent or retrievable filter may be more appropriate as well as to assess the risks and benefits for filter retrieval within the context of survival longevity in patients with cancer.

The Effect of Body Build and BMI on Aerobic Test Performance in School Children (10-15 Years)

PubMed Central

Slinger, Jantine; Verstappen, Frans; Breda, Eric Van; Kuipers, Harm

2006-01-01

Body Mass Index (BMI) has often questionably been used to define body build. In the present study body build was defined more specifically using fat free mass index (FFMI = fat free mass normalised to the stature) and fat mass index (FMI = fat mass normalised to stature). The body build of an individual is ‘solid’ in individuals with a high FFMI for their FMI and is ‘slender’ in individuals with a low FFMI relative to their FMI. The aim of the present study was to investigate the association between aerobic test performance and body build defined as solid, average or slender in 10 to 15 year old children. Five-hundred-and-two children (53% boys) aged 10 to 15 years of age were included in the study. Aerobic test performance was estimated with an incremental cycle ergometer protocol and a shuttle run test. BMI and percentage fat (by skin folds) were determined to calculate FMI and FFMI. After adjustment for differences in age, gender and body mass the solid group achieved a significantly higher maximal power output (W) and power output relative to body mass (W/kg) during the cycle test (p < 0.05) and a higher shuttle-run score (p < 0.05) compared to the slender group. The power output relative to FFM (W/kg FFM) was comparable (p > 0.05) between different body build groups. This study showed that body build is an important determinant of the aerobic test performance. In contrast, there were no differences in aerobic test performance per kilogramme FFM over the body build groups. This suggests that the body build may be determined by genetic predisposition. Key Points Children with a solid body build perform better in aerobic exercise tests than slender children. The power output relative to fat free mass was comparable in the solid, slender and average group. Besides body composition, body build should be considered related to other performance measurements. PMID:24357967

Solid-state vs water-perfused catheters to measure colonic high-amplitude propagating contractions.

PubMed

Liem, O; Burgers, R E; Connor, F L; Benninga, M A; Reddy, S N; Mousa, H M; Di Lorenzo, C

2012-04-01

  Solid-state (SS) manometry catheters with portable data loggers offer many potential advantages over traditional water-perfused (WP) systems, such as prolonged recordings in a more physiologic ambulatory setting and the lack of risk for water overload. The use of SS catheters has not been evaluated in comparison with perfused catheters in children. This study aims to compare data provided by SS and WP catheters in children undergoing colonic manometry studies.   A SS catheter and a WP catheter were taped together such that their corresponding sensors were at the same location. Simultaneous recordings were obtained using the SS and WP catheters (both 8 channels, 10 cm apart) in 15 children with severe defecation disorders referred for colonic manometry. Signals were recorded for a minimum of 1 h during fasting, 1 h after ingestion of a meal, and 1 h after the administration of bisacodyl. Solid-state signals from the data logger were analyzed against the perfused signals. All high-amplitude propagated contractions (HAPCs), the most recognizable and interpreted colonic motor event, were evaluated for spatial and temporal features including their durations, amplitudes, and propagation velocities.   A total of 107 HAPCs were detected with SS and 91 with WP catheters. All WP-HAPC were also observed with SS. Linear regression analysis showed that SS catheters tended to give higher readings in the presence of amplitudes <102 mmHg and lower reading with amplitudes >102 mmHg. An opposite trend was found for the duration of contractions. No significant difference was found for HAPC velocity.   SS catheters are more sensitive in recording HAPCs in children with defecation disorders compared with the more traditional WP assembly. There is a difference in measurements of amplitude between the two systems. Solid-state catheters offer potential advantages over WP catheters in children, being portable, safer to use, and may provide data over a more prolonged period. © 2012 Blackwell Publishing Ltd.

Pediatric Phase I Trial and Pharmacokinetic Study of Vorinostat: A Children's Oncology Group Phase I Consortium Report

PubMed Central

Fouladi, Maryam; Park, Julie R.; Stewart, Clinton F.; Gilbertson, Richard J.; Schaiquevich, Paula; Sun, Junfeng; Reid, Joel M.; Ames, Matthew M.; Speights, Roseanne; Ingle, Ashish M.; Zwiebel, James; Blaney, Susan M.; Adamson, Peter C.

2010-01-01

Purpose The purpose of this study was to determine the maximum-tolerated dose (MTD), dose-limiting toxicities (DLT), and pharmacokinetics of vorinostat administered as a single agent and in combination 13-cis retinoic acid (13cRA) in children with refractory solid tumors; to evaluate the tolerability of the solid tumor MTD in children with refractory leukemias; and to characterize the pharmacokinetics of a vorinostat suspension in children. Patients and Methods Vorinostat was administered orally daily starting at 180 mg/m2/d with escalations planned in 30% increments. Pharmacokinetic studies were performed with the initial dose. Acetyl-histone (H3) accumulation was assessed by Western blotting of peripheral blood mononuclear cells (PBMC). Results Sixty-four patients were enrolled on this multipart trial. In patients with solid tumors, the MTD was 230 mg/m2/d with dose-limiting neutropenia, thrombocytopenia, and hypokalemia at 300 mg/m2/d. DLTs observed with the combination of 13cRA and vorinostat included thrombocytopenia, neutropenia, anorexia, and hypertriglyceridemia, resulting in a MTD of vorinostat 180 mg/m2/d 4 times per week and 13cRA 80 mg/m2/dose twice per day, days 1 through 14 every 28 days. Wide interpatient variability was noted in vorinostat disposition, with area under the concentration-time curves at 230 mg/m2/d for the capsule (range, 1,415 to 9,291 ng/mL × hr) and oral suspension (range, 1,186 to 4,780 ng/mL × hr). Significant accumulation of acetylated H3 histone in PBMC was observed after administration of vorinostat, particularly at higher doses. One patient with neuroblastoma experienced a complete response to the combination. Conclusion In children with recurrent solid tumors, vorinostat is well-tolerated at 230 mg/m2/d, with a modest dose reduction being required when combining vorinostat with 13cRA. Drug disposition is similar to that observed in adults. PMID:20606092

Feasibility of Community Food Item Collection for the National Children's Study.

EPA Science Inventory

Background: The National Children’s Study proposes to investigate the role of environmental influences on health outcomes in pregnant women and children. A specific area of concern is contaminant exposure through the ingestion of solid foods. National food contaminant database...

Household food security and adequacy of child diet in the food insecure region north in Ghana.

PubMed

Agbadi, Pascal; Urke, Helga Bjørnøy; Mittelmark, Maurice B

2017-01-01

Adequate diet is of crucial importance for healthy child development. In food insecure areas of the world, the provision of adequate child diet is threatened in the many households that sometimes experience having no food at all to eat (household food insecurity). In the context of food insecure northern Ghana, this study investigated the relationship between level of household food security and achievement of recommended child diet as measured by WHO Infant and Young Child Feeding Indicators. Using data from households and 6-23 month old children in the 2012 Feed the Future baseline survey (n = 871), descriptive analyses assessed the prevalence of minimum meal frequency; minimum dietary diversity, and minimum acceptable diet. Logistic regression analysis was used to examine the association of minimum acceptable diet with household food security, while accounting for the effects of child sex and age, maternal -age, -dietary diversity, -literacy and -education, household size, region, and urban-rural setting. Household food security was assessed with the Household Hunger Scale developed by USAID's Food and Nutrition Technical Assistance Project. Forty-nine percent of children received minimum recommended meal frequency, 31% received minimum dietary diversity, and 17% of the children received minimum acceptable diet. Sixty-four percent of the children lived in food secure households, and they were significantly more likely than children in food insecure households to receive recommended minimum acceptable diet [O.R = 0.53; 95% CI: 0.35, 0.82]. However, in 80% of food secure households, children did not receive a minimal acceptable diet by WHO standards. Children living in food secure households were more likely than others to receive a minimum acceptable diet. Yet living in a food secure household was no guarantee of child dietary adequacy, since eight of 10 children in food secure households received less than a minimum acceptable diet. The results call for research into factors besides household food security in the search for determinants of child diet adequacy. In this study at least, household food security was a very weak marker of child diet adequacy. This finding is of significance to public health practice, since it calls into question any assumption that having enough food in a household necessarily results in adequately fed children.

Household food security and adequacy of child diet in the food insecure region north in Ghana

PubMed Central

Agbadi, Pascal; Urke, Helga Bjørnøy; Mittelmark, Maurice B.

2017-01-01

Background and objectives Adequate diet is of crucial importance for healthy child development. In food insecure areas of the world, the provision of adequate child diet is threatened in the many households that sometimes experience having no food at all to eat (household food insecurity). In the context of food insecure northern Ghana, this study investigated the relationship between level of household food security and achievement of recommended child diet as measured by WHO Infant and Young Child Feeding Indicators. Methods Using data from households and 6–23 month old children in the 2012 Feed the Future baseline survey (n = 871), descriptive analyses assessed the prevalence of minimum meal frequency; minimum dietary diversity, and minimum acceptable diet. Logistic regression analysis was used to examine the association of minimum acceptable diet with household food security, while accounting for the effects of child sex and age, maternal -age, -dietary diversity, -literacy and -education, household size, region, and urban-rural setting. Household food security was assessed with the Household Hunger Scale developed by USAID’s Food and Nutrition Technical Assistance Project. Results Forty-nine percent of children received minimum recommended meal frequency, 31% received minimum dietary diversity, and 17% of the children received minimum acceptable diet. Sixty-four percent of the children lived in food secure households, and they were significantly more likely than children in food insecure households to receive recommended minimum acceptable diet [O.R = 0.53; 95% CI: 0.35, 0.82]. However, in 80% of food secure households, children did not receive a minimal acceptable diet by WHO standards. Conclusions Children living in food secure households were more likely than others to receive a minimum acceptable diet. Yet living in a food secure household was no guarantee of child dietary adequacy, since eight of 10 children in food secure households received less than a minimum acceptable diet. The results call for research into factors besides household food security in the search for determinants of child diet adequacy. In this study at least, household food security was a very weak marker of child diet adequacy. This finding is of significance to public health practice, since it calls into question any assumption that having enough food in a household necessarily results in adequately fed children. PMID:28494024

The Real Facts of Life for Children of Color in Washington State.

ERIC Educational Resources Information Center

Washington Univ., Seattle. Human Services Policy Center.

This report presents the conditions of children of color in the state of Washington, with statistics about economic support, health, and safety. Comments from leaders of color and other true stories help explain the situations reflected by the numerical data. It is important to note that most children of color in Washington live in solid families…

Hepatic and splenic blush on computed tomography in children following blunt abdominal trauma: Is intervention necessary?

PubMed

Ingram, Martha-Conley E; Siddharthan, Ragavan V; Morris, Andrew D; Hill, Sarah J; Travers, Curtis D; McKracken, Courtney E; Heiss, Kurt F; Raval, Mehul V; Santore, Matthew T

2016-08-01

There are no widely accepted guidelines for management of pediatric patients who have evidence of solid organ contrast extravasation ("blush") on computed tomography (CT) scans following blunt abdominal trauma. We report our experience as a Level 1 pediatric trauma center in managing cases with hepatic and splenic blush. All pediatric blunt abdominal trauma cases resulting in liver or splenic injury were queried from 2008 to 2014. Patients were excluded if a CT was unavailable in the medical record. The presence of contrast blush was based on final reports from attending pediatric radiologists. Correlations between incidence of contrast blush and major outcomes of interest were determined using χ and Wilcoxon rank-sum tests for categorical and continuous variables, respectively, evaluating statistical significance at p < 0.05. Of 318 patients with splenic or liver injury after blunt abdominal trauma, we report on 30 patients (9%) with solid organ blush, resulting in 18 cases of hepatic blush and 16 cases of splenic blush (four patients had extravasation from both organs). Blush was not found to correlate significantly with age, gender, or type of injury (liver vs. splenic) but was found to associate with higher grades of solid organ injury (p = 0.002) and higher ISS overall (p < 0.001). Patients with contrast blush on imaging were more likely to be admitted to the intensive care unit (90% vs. 41%, p < 0.001), receive blood products, (50% vs. 12%, p < 0.001), and be considered for an intervention (p < 0.001). Eighty percent of patients with an isolated contrast blush of the spleen or liver did not require an operation. Only 17% of patients with blush required definitive treatment, such as embolization (n = 1), packing (n = 1), or splenectomy (n = 3). Blush had no significant correlation with overall survival (p = 0.13). The finding of a blush on CT from a splenic or liver injury is associated with higher grade of injury. These patients receive intensive medical management but do not uniformly require invasive intervention. From our data, we suggest that a blush can safely be managed nonoperatively and that treatment should be dictated by change in physiology. Therapeutic study, level IV.

Update on the diagnosis and treatment of Pneumocystis pneumonia.

PubMed

Carmona, Eva M; Limper, Andrew H

2011-02-01

Pneumocystis is an opportunistic fungal pathogen that causes an often-lethal pneumonia in immunocompromised hosts. Although the organism was discovered in the early 1900s, the first cases of Pneumocystis pneumonia in humans were initially recognized in Central Europe after the Second World War in premature and malnourished infants. This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs. At that time, only anecdotal cases were reported in adults and usually these patients had a baseline malignancy that led to a malnourished state. In the 1960-1970s additional cases were described in adults and children with hematological malignancies, but Pneumocystis pneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic, Pneumocystis prevalence increased dramatically and became widely recognized as an opportunistic infection that caused potentially life-treating pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystis pneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness. Despite the decreased number of cases among HIV-infected patients over the past decade, Pneumocystis pneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions. This is mostly due to increased use of immunosuppressive medications to treat patients with autoimmune diseases, following bone marrow and solid organ transplantation, and in patients with hematological and solid malignancies. Patients with hematologic disorders and solid organ and hematopoietic stem cell transplantation are currently the most vulnerable groups at risk for developing this infection. However, any patient with an impaired immunity, such as those receiving moderate doses of oral steroids for greater than 4 weeks or those receiving other immunosuppressive medications are at also at significant risk.

Family stability as a protective factor against psychopathology for urban children receiving psychological services.

PubMed

Ivanova, Masha Y; Israel, Allen C

2006-12-01

Family stability, defined as the consistency of family activities and routines, was examined in a sample of urban families (n = 70) with children (ages 7 to 16) receiving psychological services. Parent-reported family stability was associated with lower parent-reported children's internalizing behavior problems. Child-reported family stability significantly attenuated the influence of parental depressive symptoms on parent-reported children's internalizing, externalizing, and total behavior problems, while controlling for the effect of children's age. Parental depressive symptoms were associated with problems in child adjustment only at the low level of family stability.

7 CFR 1030.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dates such milk was received from that producer; (3) The total pounds of butterfat, protein, and other... payment is not made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1001.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and total pounds of milk received; (3) The total pounds of butterfat, protein, and other solids... shall pay each producer as follows: (1) Partial payment. For each producer who has not discontinued... butterfat received by the butterfat price for the month; (iii) Multiply the pounds of protein received by...

7 CFR 1001.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and total pounds of milk received; (3) The total pounds of butterfat, protein, and other solids... shall pay each producer as follows: (1) Partial payment. For each producer who has not discontinued... butterfat received by the butterfat price for the month; (iii) Multiply the pounds of protein received by...

7 CFR 1030.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dates such milk was received from that producer; (3) The total pounds of butterfat, protein, and other... payment is not made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1001.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and total pounds of milk received; (3) The total pounds of butterfat, protein, and other solids... shall pay each producer as follows: (1) Partial payment. For each producer who has not discontinued... butterfat received by the butterfat price for the month; (iii) Multiply the pounds of protein received by...

7 CFR 1030.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dates such milk was received from that producer; (3) The total pounds of butterfat, protein, and other... payment is not made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1032.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... pursuant to paragraph (c)(1) of this section; and (3) For the total quantity of milk received during the... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1032.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... pursuant to paragraph (c)(1) of this section; and (3) For the total quantity of milk received during the... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1001.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... and total pounds of milk received; (3) The total pounds of butterfat, protein, and other solids... shall pay each producer as follows: (1) Partial payment. For each producer who has not discontinued... butterfat received by the butterfat price for the month; (iii) Multiply the pounds of protein received by...

7 CFR 1030.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... dates such milk was received from that producer; (3) The total pounds of butterfat, protein, and other... payment is not made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1032.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... pursuant to paragraph (c)(1) of this section; and (3) For the total quantity of milk received during the... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1032.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... pursuant to paragraph (c)(1) of this section; and (3) For the total quantity of milk received during the... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1030.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dates such milk was received from that producer; (3) The total pounds of butterfat, protein, and other... payment is not made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1... of protein received times the protein price for the month; (iv) The pounds of other solids received...

7 CFR 1001.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and total pounds of milk received; (3) The total pounds of butterfat, protein, and other solids... shall pay each producer as follows: (1) Partial payment. For each producer who has not discontinued... butterfat received by the butterfat price for the month; (iii) Multiply the pounds of protein received by...

7 CFR 1032.73 - Payments to producers and to cooperative associations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... pursuant to paragraph (c)(1) of this section; and (3) For the total quantity of milk received during the... made to a cooperative association pursuant to paragraph (b) of this section, as follows: (1) Partial... of protein received times the protein price for the month; (iv) The pounds of other solids received...

Hydroxyurea is associated with lower costs of care of young children with sickle cell anemia.

PubMed

Wang, Winfred C; Oyeku, Suzette O; Luo, Zhaoyu; Boulet, Sheree L; Miller, Scott T; Casella, James F; Fish, Billie; Thompson, Bruce W; Grosse, Scott D

2013-10-01

In the BABY HUG trial, young children with sickle cell anemia randomized to receive hydroxyurea had fewer episodes of pain, hospitalization, and transfusions. With anticipated broader use of hydroxyurea in this population, we sought to estimate medical costs of care in treated versus untreated children. The BABY HUG database was used to compare inpatient events in subjects receiving hydroxyurea with those receiving placebo. Unit costs were estimated from the 2009 MarketScan Multi-state Medicaid Database for children with sickle cell disease, aged 1 to 3 years. Inpatient costs were based on length of hospital stay, modified by the occurrence of acute chest syndrome, splenic sequestration, or transfusion. Outpatient expenses were based on the schedule required for BABY HUG and a "standard" schedule for 1- to 3-year-olds with sickle cell anemia. There were 232 hospitalizations in the subjects receiving hydroxyurea and 324 in those on placebo; length of hospital stay was similar in the 2 groups. Estimated outpatient expenses were greater in those receiving hydroxyurea, but these were overshadowed by inpatient costs. The total estimated annual cost for those on hydroxyurea ($11 072) was 21% less than the cost of those on placebo ($13 962; P = .038). Savings on inpatient care resulted in a significantly lower overall estimated medical care cost for young children with sickle cell anemia who were receiving hydroxyurea compared with those receiving placebo. Because cost savings are likely to increase with age, these data provide additional support for broad use of hydroxyurea treatment in this population.

Hydroxyurea Is Associated With Lower Costs of Care of Young Children With Sickle Cell Anemia

PubMed Central

Oyeku, Suzette O.; Luo, Zhaoyu; Boulet, Sheree L.; Miller, Scott T.; Casella, James F.; Fish, Billie; Thompson, Bruce W.; Grosse, Scott D.

2013-01-01

BACKGROUND AND OBJECTIVE: In the BABY HUG trial, young children with sickle cell anemia randomized to receive hydroxyurea had fewer episodes of pain, hospitalization, and transfusions. With anticipated broader use of hydroxyurea in this population, we sought to estimate medical costs of care in treated versus untreated children. METHODS: The BABY HUG database was used to compare inpatient events in subjects receiving hydroxyurea with those receiving placebo. Unit costs were estimated from the 2009 MarketScan Multi-state Medicaid Database for children with sickle cell disease, aged 1 to 3 years. Inpatient costs were based on length of hospital stay, modified by the occurrence of acute chest syndrome, splenic sequestration, or transfusion. Outpatient expenses were based on the schedule required for BABY HUG and a “standard” schedule for 1- to 3-year-olds with sickle cell anemia. RESULTS: There were 232 hospitalizations in the subjects receiving hydroxyurea and 324 in those on placebo; length of hospital stay was similar in the 2 groups. Estimated outpatient expenses were greater in those receiving hydroxyurea, but these were overshadowed by inpatient costs. The total estimated annual cost for those on hydroxyurea ($11 072) was 21% less than the cost of those on placebo ($13 962; P = .038). CONCLUSIONS: Savings on inpatient care resulted in a significantly lower overall estimated medical care cost for young children with sickle cell anemia who were receiving hydroxyurea compared with those receiving placebo. Because cost savings are likely to increase with age, these data provide additional support for broad use of hydroxyurea treatment in this population. PMID:23999955

Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations.

PubMed

Kenny, D J; Casas, M J; McPherson, K A

1989-01-01

Preliminary results of an investigation that synchronizes the videotaped output of ultrasound camera and the analog data from physiological measurements of swallowing and ventilation in normal and cerebral palsied (CP) children are presented. Four cerebral palsied children and three control children undertook a single sip-swallow of 5 ml of liquid and a solid mastication-swallow sequence on three occasions according to a defined protocol. The CP children exhibited much more variability and less control of the liquid bolus than did the controls. The ultrasound image clearly demonstrates the lack of control of the posterior of the tongue in many CP children. Some parts of the sequence of oral swallow and the time to achieve maximum anterior displacement of the hyoid bone appear to be slowed. The sequential events of swallowing show less variability as the sip-swallow proceeds from the oral voluntary to pharyngeal and lower involuntary phases. This study also identified a short-latency apnea that appears to accompany a saliva (protective) swallow and a long-latency apnea that accompanies semi-solid or liquid bolus (alimentary) swallows. Further investigations of normal and CP children utilizing a combined diagnostic imaging-physiological measurement approach will follow this initial study.

The specificity of reciprocity: Young children reciprocate more generously to those who intentionally benefit them.

PubMed

Vaish, Amrisha; Hepach, Robert; Tomasello, Michael

2018-03-01

Young children engage in direct reciprocity, but the mechanisms underlying such reciprocity remain unclear. In particular, prior work leaves unclear whether children's reciprocity is simply a response to receiving benefits (regardless of whether the benefits were intended) or driven by a mechanism of rewarding or preferring all benefactors (regardless of whom they benefited). Alternatively, perhaps children engage in genuine reciprocity such that they are particularly prosocial toward benefactors who intentionally provided them with benefits. Our findings support this third, richer possibility; the 3-year-olds who received benefits through the good intentions of a benefactor were subsequently more generous toward the benefactor than children who either (a) received the same benefits from the benefactor unintentionally or (b) observed the benefactor bestow the same benefits on another individual. Thus, young children are especially motivated to benefit those who have demonstrated goodwill toward them, suggesting, as one possible mechanism, an early sense of gratitude. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of a School-Based Instrumental Music Program on Verbal and Visual Memory in Primary School Children: A Longitudinal Study

PubMed Central

Roden, Ingo; Kreutz, Gunter; Bongard, Stephan

2012-01-01

This study examined the effects of a school-based instrumental training program on the development of verbal and visual memory skills in primary school children. Participants either took part in a music program with weekly 45 min sessions of instrumental lessons in small groups at school, or they received extended natural science training. A third group of children did not receive additional training. Each child completed verbal and visual memory tests three times over a period of 18 months. Significant Group by Time interactions were found in the measures of verbal memory. Children in the music group showed greater improvements than children in the control groups after controlling for children’s socio-economic background, age, and IQ. No differences between groups were found in the visual memory tests. These findings are consistent with and extend previous research by suggesting that children receiving music training may benefit from improvements in their verbal memory skills. PMID:23267341

The Effect of Directed Medical Play on Young Children's Pain and Distress during Burn Wound Care

PubMed Central

Moore, Elizabeth R.; Bennett, Katherine; Dietrich, Mary S.; Wells, Nancy

2015-01-01

Directed medical play is used to reduce children's pain and distress during medical treatment. In this pilot study, young children who attended the burn clinic received either directed medical play provided by a child life specialist or standard preparation from the burn clinic nurse, to prepare for their first dressing change. Data were collected using validated instruments. Children who participated in medical play experienced less distress during their dressing change (M= 0.5, n=12) than those receiving standard preparation (M=2.0, n=9). Children who received standard care reported a 2 point increase in pain during the procedure whereas children who participated in medical play reported a 1 point increase. Change in parental anxiety was similar for both groups. Parent satisfaction was higher for caregivers who observed medical play than standard preparation. Although all findings were in the hypothesized direction, none were statically significant, most likely because of the small sample size. PMID:25631102

PERMEABILITY PROPERTIES OF FLY ASH FORM FURNACE SORBENT INJECTION PROCESS

EPA Science Inventory

The paper discusses tests of the applicability of furnace sorbent injection (FSI) waste solids for use as synthetic waste landfill liners by measuring the mechanical strength and permeability of moisture-cured samples. SI waste solids were received from the EPA-sponsored demonstr...

Phase I/II Trial and Pharmacokinetic Study of Cixutumumab in Pediatric Patients With Refractory Solid Tumors and Ewing Sarcoma: A Report From the Children's Oncology Group

PubMed Central

Malempati, Suman; Weigel, Brenda; Ingle, Ashish M.; Ahern, Charlotte H.; Carroll, Julie M.; Roberts, Charles T.; Reid, Joel M.; Schmechel, Stephen; Voss, Stephan D.; Cho, Steven Y.; Chen, Helen X.; Krailo, Mark D.; Adamson, Peter C.; Blaney, Susan M.

2012-01-01

Purpose A phase I/II study of cixutumumab (IMC-A12) in children with refractory solid tumors was conducted. This study was designed to assess the toxicities, pharmacokinetics, and pharmacodynamics of cixutumumab in children to determine a recommended phase II dose and to assess antitumor activity in Ewing sarcoma (ES). Patients and Methods Pediatric patients with relapsed or refractory solid tumors were treated with cixutumumab as a 1-hour intravenous infusion once per week. Two dose levels—6 and 9 mg/kg—were evaluated using a standard three-plus-three cohort design. Patients with refractory ES were treated in an expanded phase II cohort at each dose level. Results Forty-seven eligible patients with a median age of 15 years (range, 4 to 28 years) were enrolled. Twelve patients were treated in the dose-finding phase. Hematologic and nonhematologic toxicities were generally mild and infrequent. Dose-limiting toxicities included grade 4 thrombocytopenia at 6 mg/kg and grade 3 dehydration at 9 mg/kg. Mean trough concentration (± standard deviation) at 9 mg/kg was 106 ± 57 μg/mL, which exceeded the effective trough concentration of 60 μg/mL observed in xenograft models. Three patients with ES had confirmed partial responses: one of 10 at 6 mg/kg and two of 20 at 9 mg/kg. Serum insulin-like growth factor I (IGF-I) levels consistently increased after one dose of cixutumumab. Tumor IGF-I receptor expression by immunohistochemistry did not correlate with response in patients with ES. Conclusion Cixutumumab is well tolerated in children with refractory solid tumors. The recommended phase II dose is 9 mg/kg. Limited single-agent activity of cixutumumab was seen in ES. PMID:22184397

Solar solids reactor

DOEpatents

Yudow, B.D.

1986-02-24

A solar powered kiln is provided, that is of relatively simple design and which efficiently uses solar energy. The kiln or solids reactor includes a stationary chamber with a rearward end which receives solid material to be reacted and a forward end through which reacted material is disposed of, and a screw conveyor extending along the bottom of the chamber for slowly advancing the material between the chamber ends. Concentrated solar energy is directed to an aperture at the forward end of the chamber to heat the solid material moving along the bottom of the chamber. The solar energy can be reflected from a mirror facing at an upward incline, through the aperture and against a heat-absorbing material near the top of the chamber, which moves towards the rear of the chamber to distribute heat throughout the chamber. Pumps at the forward and rearward ends of the chamber pump heated sweep gas through the length of the chamber, while minimizing the flow of gas through an open aperture through which concentrated sunlight is received.

Solar solids reactor

DOEpatents

Yudow, Bernard D.

1987-01-01

A solar powered kiln is provided, that is of relatively simple design and which efficiently uses solar energy. The kiln or solids reactor includes a stationary chamber with a rearward end which receives solid material to be reacted and a forward end through which reacted material is disposed of, and a screw conveyor extending along the bottom of the chamber for slowly advancing the material between the chamber ends. Concentrated solar energy is directed to an aperture at the forward end of the chamber to heat the solid material moving along the bottom of the chamber. The solar energy can be reflected from a mirror facing at an upward incline, through the aperture and against a heat-absorbing material near the top of the chamber, which moves towards the rear of the chamber to distribute heat throughout the chamber. Pumps at the forward and rearward ends of the chamber pump heated sweep gas through the length of the chamber, while minimizing the flow of gas through an open aperture through which concentrated sunlight is received.

Effect of Audiovisual Distraction on Distress and Oxygenation Status in Children Receiving Aerosol Therapy.

PubMed

Shinta Devi, Ni Luh Putu; Nurhaeni, Nani; Hayati, Happy

Aerosol therapy, a treatment for children with disorders of the respiratory system, often causes distress, especially in young children. Distress during aerosol therapy can decrease the effectiveness of the treatment. This study aimed to determine the effect of audiovisual distraction on distress levels and oxygenation status (measured by oxygen saturation and respiratory frequency) in children who receive aerosol therapy for disorders of the respiratory system. A quasi-experimental design was employed, specifically a non-equivalent control group, pre-test-post-test design. The study sample consisted of 38 children who were divided into 2 groups (control and intervention), each group consisting of 19 children. The results of this study showed that there were significant differences in distress scores between the control group and the intervention group (p = .0001). There were also significant differences in the mean value changes in oxygenation status before and after intervention between the control and intervention groups. These findings could be used to prevent distress and increase oxygenation status in children who receive aerosol therapy.

Wacky Wednesday: use of distraction through humor to reduce preoperative anxiety in children and their parents.

PubMed

Berger, Jill; Wilson, Darlena; Potts, Linda; Polivka, Barbara

2014-08-01

The purpose of this study was to determine the effect of distraction through humor on anxiety among children having outpatient surgery, and their parents. Quasi-experimental design using a nonrandomized control group. The study assessed preoperative anxiety in child-parent dyads. The control group received usual care. The intervention group received the "Wacky Wednesday" (WW) intervention in which they entered an environment where employees were dressed in "wacky" attire and children and parents were provided with gifts and costume items. Anxiety scores, heart rate, and blood pressure were collected from patients and parents in both groups on admission and just before transfer to surgery. Children who arrived for surgery on WW had significantly lower anxiety scores on admission than children in the control group. In addition, children and parents who received the WW intervention had significantly lower anxiety scores just before surgery than those in the control group. Humor and distraction are effective with children and parents in relieving preoperative anxiety. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Mom told me scary things about this animal: parents installing fear beliefs in their children via the verbal information pathway.

PubMed

Muris, Peter; van Zwol, Lisanne; Huijding, Jorg; Mayer, Birgit

2010-04-01

This study investigated whether fear beliefs can be installed in children after parents had received negatively tinted information about a novel stimulus. Parents of children aged 8-13 years (N = 88) were presented with negative, positive, or ambiguous information about an unknown animal and then given a number of open-ended vignettes describing confrontations with the animal with the instruction to tell their children what would happen in these situations. Results indicated that children's fear beliefs were influenced by the information that was provided to the parent. That is, parents who had received negative information provided more threatening narratives about the animal and hence installed higher levels of fear beliefs in their children than parents who had received positive information. In the case of ambiguous information, the transmission of fear was dependent on parents' trait anxiety levels. More precisely, high trait anxious parents told more negative stories about the unknown animal, which produced higher fear levels in children. 2009 Elsevier Ltd. All rights reserved.

Chemical Characterization of an Envelope B/D Sample from Hanford Tank 241-AZ-102

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

Hay, M.S.

2000-08-23

A sample from Hanford waste tank 241-AZ-102 was received at the Savannah River Technology Center (SRTC) and chemically characterized. The sample containing supernate and a small amount of sludge solids was analyzed as-received. The filtered supernatant liquid, the total dried solids of the sample, and the washed insoluble solids obtained from filtration of the sample were analyzed. A mass balance calculation of the three fractions of the sample analyzed indicate the analytical results appear relatively self-consistent for major components of the sample. However, some inconsistency was observed between results were more than one method of determination was employed and formore » species present in low concentrations. The actinides isotopes, plutonium, americium, and curium, present analytical challenges due to the low concentration of these species and the potential for introduction of small amounts of contamination during sampling handling resulting in large uncertainties. A direct comparison to previous analyses of material from tank 241-AZ-102 showed good agreement with the filtered supernatant liquid. However, the comparison of solids data showed poor agreement. The poor agreement shown between the current results for the solids samples and previous analyses most likely results from the uncertainties associated with obtaining small solids samples from a large non-homogenized waste tank.« less

Prevalence of Chagas Disease among Solid Organ-Transplanted Patients in a Nonendemic Country.

PubMed

Salvador, Fernando; Sánchez-Montalvá, Adrián; Sulleiro, Elena; Moreso, Francesc; Berastegui, Cristina; Caralt, Mireia; Pinazo, María-Jesús; Moure, Zaira; Los-Arcos, Ibai; Len, Oscar; Gavaldà, Joan; Molina, Israel

2018-03-01

Reactivation of Chagas disease in the chronic phase may occur after solid organ transplantation, which may result in high parasitemia and severe clinical manifestations such as myocarditis and meningoencephalitis. The aim of the present study is to describe the prevalence of Chagas disease among solid organ-transplanted patients in a tertiary hospital from a nonendemic country. A cross-sectional study was performed at Vall d'Hebron University Hospital (Barcelona, Spain) from April to September 2016. Chagas disease screening was performed through serological tests in adult patients coming from endemic areas that had received solid organ transplantation and were being controlled in our hospital during the study period. Overall, 42 patients were included, 20 (47.6%) were male and median age was 50.5 (23-73) years. Transplanted organs were as follows: 18 kidneys, 17 lungs, and 7 livers. Three patients had Chagas disease, corresponding to a prevalence among this group of solid organ-transplanted patients of 7.1%. All three patients were born in Bolivia, had been diagnosed with Chagas disease and received specific treatment before the organ transplantation. We highly recommend providing screening tests for Chagas disease in patients with or candidates for solid organ transplantation coming from endemic areas, early treatment with benznidazole, and close follow-up to prevent clinical reactivations.

Language Development in the First Year of Life: What Deaf Children Might Be Missing Before Cochlear Implantation.

PubMed

Levine, Dani; Strother-Garcia, Kristina; Golinkoff, Roberta Michnick; Hirsh-Pasek, Kathy

2016-02-01

Language development is a multifaceted, dynamic process involving the discovery of complex patterns, and the refinement of native language competencies in the context of communicative interactions. This process is already advanced by the end of the first year of life for hearing children, but prelingually deaf children who initially lack a language model may miss critical experiences during this early window. The purpose of this review is twofold. First, we examine the published literature on language development during the first 12 months in typically developing children. Second, we use this literature to inform our understanding of the language outcomes of prelingually deaf children who receive cochlear implants (CIs), and therefore language input, either before or after the first year. During the first 12 months, typically developing infants exhibit advances in speech segmentation, word learning, syntax acquisition, and communication, both verbal and nonverbal. Infants and their caregivers coconstruct a communication foundation during this time, supporting continued language growth. The language outcomes of hearing children are robustly predicted by their experiences and acquired competencies during the first year; yet these predictive links are absent among prelingually deaf infants lacking a language model (i.e., those without exposure to sign). For deaf infants who receive a CI, implantation timing is crucial. Children receiving CIs before 12 months frequently catch up with their typically developing peers, whereas those receiving CIs later do not. Explanations for the language difficulties of late-implanted children are discussed.

Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia.

PubMed

Estepp, Jeremie H; Winter, Bryan; Johnson, Margery; Smeltzer, Matthew P; Howard, Scott C; Hankins, Jane S

2014-11-01

In children with sickle cell anemia (SCA), hydroxyurea reduces morbidity, but adherence is frequently suboptimal. Because most families of children with SCA have access to cellular telephone services, we assessed the impact of text messaged reminders as a tool to improve adherence to hydroxyurea. All patients <19 years of age with HbSS or HbSβ(0) thalassemia who were treated with hydroxyurea at a maximal tolerated dosage (MTD) at St. Jude Children's Research Hospital Comprehensive Pediatric Sickle Cell Program and who received automated text message reminders (SIMON®) were retrospectively identified. Laboratory parameters, hospitalizations, and medication possession ratios (MPR) prior to and after initiation of SIMON® were compared to assess the impact of SIMON®. Of the 97.3% of families with access to a cell phone, 91% elected to receive text message reminders. Among 55 children receiving hydroxyurea at MTD, laboratory parameters reflected waning medication compliance during the 12 months prior to SIMON®. Following initiation of SIMON®, children had higher mean corpuscular volumes, hemoglobin levels and fetal hemoglobin percentages and lower absolute reticulocyte counts and bilirubin levels, suggesting improved medication adherence. Hospitalizations were uncommon before and after SIMON®, and medication possession ratios (MPRs) were high before and after SIMON®, neither was significantly changed. SIMON® was feasible and improved hematologic parameters in children with SCA receiving hydroxyurea at a MTD. Future work will include extension of this technology to children with other chronic medical conditions who require daily use of medication. © 2014 Wiley Periodicals, Inc.

Rifapentine Pharmacokinetics and Tolerability in Children and Adults Treated Once Weekly With Rifapentine and Isoniazid for Latent Tuberculosis Infection.

PubMed

Weiner, Marc; Savic, Radojka M; Kenzie, William R Mac; Wing, Diane; Peloquin, Charles A; Engle, Melissa; Bliven, Erin; Prihoda, Thomas J; Gelfond, Jonathan A L; Scott, Nigel A; Abdel-Rahman, Susan M; Kearns, Gregory L; Burman, William J; Sterling, Timothy R; Villarino, M Elsa

2014-06-01

In a phase 3, randomized clinical trial (PREVENT TB) of 8053 people with latent tuberculosis infection, 12 once-weekly doses of rifapentine and isoniazid had good efficacy and tolerability. Children received higher rifapentine milligram per kilogram doses than adults. In the present pharmacokinetic study (a component of the PREVENT TB trial), rifapentine exposure was compared between children and adults. Rifapentine doses in children ranged from 300 to 900 mg, and adults received 900 mg. Children who could not swallow tablets received crushed tablets. Sparse pharmacokinetic sampling was performed with 1 rifapentine concentration at 24 hours after drug administration (C24). Rifapentine area under concentration-time curve (AUC) was estimated from a nonlinear, mixed effects regression model (NLME). There were 80 children (age: median, 4.5 years; range, 2-11 years) and 77 adults (age: median, 40 years; all ≥18 years) in the study. The geometric mean rifapentine milligram per kilogram dose was greater in children than in adults (children, 23 mg/kg; adults, 11 mg/kg). Rifapentine geometric mean AUC and C24 were 1.3-fold greater in children (all children combined) than in adults. Children who swallowed whole tablets had 1.3-fold higher geometric mean AUC than children who received crushed tablets, and children who swallowed whole tablets had a 1.6-fold higher geometric mean AUC than adults. The higher rifapentine doses in children were well tolerated. To obtain rifapentine exposures comparable in children to adults, dosing algorithms modeled by NLME were developed. A 2-fold greater rifapentine dose for all children resulted in a 1.3-fold higher AUC compared to adults administered a standard dose. Use of higher weight-adjusted rifapentine doses for young children are warranted to achieve systemic exposures that are associated with successful treatment of latent tuberculosis infection in adults. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society 2014. This work is written by US Government employees and is in the public domain in the US.

Feasibility of Community Food Item Collection for the National Children's Study

EPA Science Inventory

The National Children’s Study proposes to investigate the role of contaminants on health outcomes in pregnant women and children. A specific area of concern is contaminant exposure through the ingestion of solid foods. National food contaminant databases may miss environmental ex...

United Kingdom national paediatric bilateral project: Results of professional rating scales and parent questionnaires.

PubMed

Cullington, H E; Bele, D; Brinton, J C; Cooper, S; Daft, M; Harding, J; Hatton, N; Humphries, J; Lutman, M E; Maddocks, J; Maggs, J; Millward, K; O'Donoghue, G; Patel, S; Rajput, K; Salmon, V; Sear, T; Speers, A; Wheeler, A; Wilson, K

2017-01-01

This fourteen-centre project used professional rating scales and parent questionnaires to assess longitudinal outcomes in a large non-selected population of children receiving simultaneous and sequential bilateral cochlear implants. This was an observational non-randomized service evaluation. Data were collected at four time points: before bilateral cochlear implants or before the sequential implant, one year, two years, and three years after. The measures reported are Categories of Auditory Performance II (CAPII), Speech Intelligibility Rating (SIR), Bilateral Listening Skills Profile (BLSP) and Parent Outcome Profile (POP). Thousand and one children aged from 8 months to almost 18 years were involved, although there were many missing data. In children receiving simultaneous implants after one, two, and three years respectively, median CAP scores were 4, 5, and 6; median SIR were 1, 2, and 3. Three years after receiving simultaneous bilateral cochlear implants, 61% of children were reported to understand conversation without lip-reading and 66% had intelligible speech if the listener concentrated hard. Auditory performance and speech intelligibility were significantly better in female children than males. Parents of children using sequential implants were generally positive about their child's well-being and behaviour since receiving the second device; those who were less positive about well-being changes also generally reported their children less willing to wear the second device. Data from 78% of paediatric cochlear implant centres in the United Kingdom provide a real-world picture of outcomes of children with bilateral implants in the UK. This large reference data set can be used to identify children in the lower quartile for targeted intervention.

Intervention study shows suboptimal growth among children receiving a food supplement for five months in a slum in Bangladesh

PubMed Central

Choudhury, Nuzhat; Bromage, Sabri; Alam, M. Ashraful; Ahmed, A.M. Shamsir; Islam, M. Munirul; Hossain, M. Iqbal; Mahfuz, Mustafa; Mondal, Dinesh; Haque, M. Rashidul; Ahmed, Tahmeed

2017-01-01

Aim This study assessed weight and height changes among underweight children who received a locally produced, cereal-based, ready-to-use supplementary food. Methods We recruited 500 underweight Bangladeshi children aged 6–23 months from a Dhaka slum and individually matched them by sex and neighbourhood with 480 well-nourished controls. The intervention group received the daily food supplement for five months and both groups received daily micronutrient supplements. Their weight, height, mid-upper-arm circumference and head circumference were measured monthly. Results The children’s mean daily weight gain decreased from 1.27 to 0.66 grams per kilogram per day (g/kg/day) in the intervention group and 0.77 to 0.49 g/kg/day in the controls after adjusting for age differences between the two groups from baseline to five months of follow up. The mean monthly height gain decreased from 1.13 to 1.03 millimeters per metre per month in the intervention children and 1.26 to 1.01 in the controls. The weight gain was highest in the intervention children who were most wasted at baseline and the controls who were least stunted. Conclusion The children showed suboptimal growth despite food supplements, highlighting the need for ongoing research to develop inexpensive, locally-sourced food supplements to improve the nutrition of underweight children in Bangladesh. PMID:27415153

Enabling parents who smoke to prevent their children from initiating smoking: results from a 3-year intervention evaluation.

PubMed

Jackson, Christine; Dickinson, Denise

2006-01-01

To evaluate effects of a home-based antismoking socialization program on the initiation of smoking among children whose parents smoke. Three-year randomized controlled trial. Parents who were current smokers and had a child in the third grade who had not tried smoking were eligible; 873 parents-offspring pairs met these criteria, completed baseline interviews, and were randomly assigned to the intervention or control condition; 776 children (89%) completed an interview 3 years after baseline and were included in the study. During 3 months, the intervention group (n = 371) received 5 printed activity guides, parenting tip sheets, child newsletters, and incentives; this group also received a booster activity guide 1 year later. The control group (n = 405) received fact sheets about smoking. Initiation of smoking (first instance of puffing on a cigarette) was reported by 12% vs 19% of children in the intervention vs control groups. Logistic regression analysis indicated that children in the control condition had twice the odds of reporting initiation of smoking as children in the intervention condition (adjusted odds ratio, 2.16; P<.001), after adjusting for child sex, parent sex, parent race, parent educational achievement, child's best friends' smoking, parent smoking rate at baseline, and parent cessation status. Children in the pre-initiation phase of smoking who receive antismoking socialization from their parents are less likely to initiate smoking, even if their parents smoke.

Brief report: application of the TEACCH program on Chinese pre-school children with autism--Does culture make a difference?

PubMed

Tsang, Sandra K M; Shek, Daniel T L; Lam, Lorinda L; Tang, Florence L Y; Cheung, Penita M P

2007-02-01

A longitudinal study was conducted on 34 children with autism to evaluate the usefulness of the Treatment and Education of Autistic and related Communication Handicapped Children (TEACCH) program for Chinese pre-school children in Hong Kong. Eighteen children received full-time center-based TEACCH program training. The control group included 16 children who received different types of individualized or group training but not TEACCH program training. Instruments validated in Hong Kong were used to assess the children's cognitive, social adaptive functioning and developmental abilities before and during the training at 6-month intervals for 12 months. Children in the experimental group showed better outcomes at posttest. They also showed progress in different developmental domains over time. The study provided initial support for the effectiveness of using the TEACCH program with Chinese children.

Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow-up care.

PubMed

Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

2006-08-01

The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. A total of 115 pharmacies detected current stimulant users <16 years old in their pharmacy information system and sent parents a questionnaire regarding their child's stimulant treatment. Parents returned 924 of 1,307 questionnaires (71%). The median age of the stimulant users was 10 years and 85% were boys. In all, 91% were diagnosed with attention-deficit/hyperactivity disorder (ADHD). In 77% of the cases, the child or parents received other therapies besides stimulants-21% received psychotropic co-medication, with melatonin (11%) and antipsychotics (7%) being mentioned most frequently. Stimulant use was primarily initiated by child psychiatrists (51%) and pediatricians (32%), but most children received repeat prescriptions from general practitioners (61%). Of these 924 children, 19% did not receive any follow-up care, and transfer of prescribing responsibility increased the risk of not receiving follow-up care. The 732 children (79%) who were monitored visited a physician approximately twice a year. During follow-up visits, pediatricians performed physical check ups significantly more often. Stimulant treatment in The Netherlands is initiated mainly by specialists such as child psychiatrists and pediatricians. In the current study, follow-up care for stimulant-treated children in The Netherlands appeared to be poor, suggesting an urgent need for improvement.

Outcome after intensive reinduction therapy and allogeneic stem cell transplant in paediatric relapsed acute myeloid leukaemia.

PubMed

Karlsson, Lene; Forestier, Erik; Hasle, Henrik; Jahnukainen, Kirsi; Jónsson, Ólafur G; Lausen, Birgitte; Norén Nyström, Ulrika; Palle, Josefine; Tierens, Anne; Zeller, Bernward; Abrahamsson, Jonas

2017-08-01

Given that 30-40% of children with acute myeloid leukaemia (AML) relapse after primary therapy it is important to define prognostic factors and identify optimal therapy. From 1993 to 2012, 543 children from the Nordic countries were treated according to two consecutive protocols: 208 children relapsed. The influence of disease characteristics, first line treatment, relapse therapy and duration of first remission on outcome was analysed. Second complete remission (CR2) was achieved in 146 (70%) patients. Estimated 5-year overall survival (OS 5y ) was 39 ± 4% for the whole group and 43 ± 4% for the 190 patients given re-induction therapy, of whom 76% received regimens that included fludarabine, cytarabine (FLA) ± anthracyclines, 18% received Nordic Society for Paediatric Haematology and Oncology (NOPHO) upfront blocks and 5% received other regimens. Late relapse ≥1 year from diagnosis, no allogeneic stem cell transplantation (SCT) in first remission and core binding factor AML were independent favourable prognostic factors for survival. For the 128 children (124 in CR2) that received SCT as consolidation therapy after relapse, OS 5y was 61 ± 5%. Four of 19 children (21%) survived without receiving SCT as part of relapse therapy. Our data show that intensive re-induction followed by SCT can give cure rates of 40% in children with relapsed AML. © 2017 John Wiley & Sons Ltd.

The safety of H1N1 vaccine in children in Saudi Arabia: a cohort study using modern technology in a developing country.

PubMed

Aljadhey, Hisham; Alyabsi, Mesnad; Alrwisan, Adel; Alqahtani, Nasser; Almutairi, Reem; Al Tawil, Esraa; Adam, Mansour; Shakir, Saad; Aljeraisy, Majed; Al-Blowi, Ali; Alkhashan, Hesham; Albogami, Yasser; Murray, Michael D

2012-07-01

With its rapid introduction in 2009, concerns about the safety of the H1N1 vaccines have been raised. Data were especially limited on the pediatric safety of H1N1 vaccine in Saudi Arabia. The objectives of this study were to investigate the safety of the H1N1 vaccine (Pandemrix(®)) in children and examine the feasibility of obtaining information on possibly associated adverse reactions using mobile telephone contact with child caregivers. A cohort study was conducted in Riyadh, Saudi Arabia. Patients were included if they were aged between 6 and 18 years and had received one dose of the H1N1 vaccine. A control group involved children from the same school system who had not received the vaccine. Six months following vaccination, a clinical pharmacist called the caregiver of the child to ask about hospitalization, emergency room visits and events related to H1N1 vaccine administration using a standardized questionnaire. Caregivers of 372 school-age children were contacted. The response rate was 97% (n = 359). A total of 169 children who received at least one dose of the H1N1 vaccine were compared with 190 children in the control group who had not received the vaccine. Controlling for age, sex, education and use of medications, the odds ratio (OR) of hospitalization or emergency room visits for children within the 6 months after vaccination relative to the unvaccinated children was 1.25 (95% CI 0.47, 3.35). The risk of influenza-like symptoms was significantly reduced in vaccinated children compared with unvaccinated children (OR 0.63; 95% CI 0.41, 0.99). School-age children in Saudi Arabia who received the H1N1 vaccine did not have an increased risk of hospitalization or emergency room visits. Larger studies are needed to confirm these results. Proactive pharmacovigilance is important in assessing the safety of vaccines and other medications. It is feasible to collect information on adverse drug reactions using mobile telephones, a method that can be of benefit in both developed and developing countries.

A survey of caregivers of Nigerian children less than 6 years of age to determine the experience and perception of acceptability of oral solid dosage forms.

PubMed

Orubu, Samuel; Okwelogu, Chinyere; Opanuga, Olabisi; Tuleu, Catherine

2018-02-05

The World Health Organization (WHO) recommends flexible solid oral dosage forms such as dispersible tablet as the preferred formulation for (young) children, especially in developing/low- and middle-income countries, LMIC. The aim of this study was to assess experience, perceptions of acceptability, and formulation preferences, among 10 oral dosage forms for young children in a sample of end-users in Nigeria as an exemplar LMIC. Using a semi-structured and validated questionnaire, 148 caregivers were surveyed. Acceptability was assessed by level of liking using a 3-point Likert scale and ease of administration. Preference was assessed from participants' dosage form of choice. Oral dosage forms assessed were those mentioned in the British National Formulary for children, 2013. The formulation perceived as the most acceptable was the chewable/suckable tablet. However, preference was for liquids. Specifically with the dispersible tablet, whilst 89% (n=111) of caregivers of young children found it easy-to-administer, only 50% of children liked it. There is a gap between the proposal of dispersible tablet as the preferred dosage form for young children and caregivers' perceptions of acceptability and preference. Educational strategies to increase acceptability of dispersible tablets as the preferred formulation for young children would be required. Copyright © 2017 Elsevier B.V. All rights reserved.

"Watch out for the gerbils, my child!" the role of maternal information on children's fear in an experimental setting using real animals.

PubMed

Remmerswaal, Danielle; Muris, Peter; Huijding, Jorg

2013-06-01

Using an experimental approach, we examined the effects of verbal information as provided by the mothers on children's fear of real novel animals. Mothers of children aged 8 to 12 years (N=47) were shown a cage containing a pair of exotic rodents (i.e., Mongolian gerbils) and then received either positive or negative information about these animals. Mothers were told that their child would have to approach the animals and had the opportunity to prepare their children for this confrontation. Results showed that mothers spontaneously passed over the information they had received to their children. Most importantly, this information to some extent determined children's fear reactions towards the animals. That is, whereas no clear effects of information were found on subjective fear ratings, the data did indicate that children of mothers in the negative information condition were more reluctant to approach the animals as compared to children of mothers who had received positive information. The findings provide further support for the idea that verbal information as provided by parents may induce fear in their offspring. Copyright © 2013. Published by Elsevier Ltd.

Fear of repeated injections in children younger than 4 years receiving subcutaneous allergy immunotherapy.

PubMed

de Vos, Gabriele; Shankar, Viswanathan; Nazari, Ramin; Kooragayalu, Shravan; Smith, Mitchell; Wiznia, Andrew; Rosenstreich, David

2012-12-01

Allergy immunotherapy during early childhood may have potential benefits for the prevention of asthma and allergy morbidity. However, subcutaneous immunotherapy has not yet been prospectively researched in children younger than 4 years, primarily because of safety concerns, including the fear and psychological distress young children may experience with repeated needle injections. To quantify fear in atopic children younger than 4 years with a history of wheezing who are receiving subcutaneous immunotherapy. Fear of injection was graded during a total of 788 immunotherapy injection visits in 18 children (age, 37 months; SD, 9 months) receiving subcutaneous allergy immunotherapy. The parent and the injection nurse assigned fear scores on a scale of 0 to 10 after each injection visit. At the time of analysis, children had a median of 49 injection visits (range, 12-88) during a median study period of 81.5 weeks (range, 15-165 weeks). Fifteen children (83%) lost their fear of injections during the study. A fear score of 0 was achieved after a mean of 8.4 visits (SD, 7.4). The more injection visits were missed, the more likely children were to retain fear of injections (hazard ratio, 0.13; 95% confidence interval, 0.02-1.02; P=.05). Age, adverse events, number of injections at each visit, and change of injection personnel were not associated with increased fear. Our analysis suggests that most children receiving weekly subcutaneous immunotherapy lose their fear of injections during the treatment course. Children with increased intervals between visits may be at higher risk of experiencing fear of injections. clinicaltrial.gov identifier NCT01028560. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Indoor air pollution and the lung in low- and medium-income countries.

PubMed

Kurmi, Om P; Lam, Kin Bong Hubert; Ayres, Jon G

2012-07-01

Over half the world's population, mostly from developing countries, use solid fuel for domestic purposes and are exposed to very high concentrations of harmful air pollutants with potential health effects such as respiratory problems, cardiovascular problems, infant mortality and ocular problems. The evidence also suggests that, although the total percentage of people using solid fuel is decreasing, the absolute number is currently increasing. Exposure to smoke from solid fuel burning increases the risk of chronic obstructive pulmonary disease (COPD) and lung cancer in adults, and acute lower respiratory tract infection/pneumonia in children. Despite the heterogeneity among studies, the association between COPD and exposure to smoke produced by burning different types of solid fuel is consistent. However, there is strong evidence that while coal burning is a risk factor for lung cancer, exposure to other biomass fuel smoke is less so. There is some evidence that reduction of smoke exposure using improved cooking stoves reduces the risk of COPD and, possibly, acute lower respiratory infection in children, so approaches to reduce biomass smoke exposure are likely to result in reductions in the global burden of respiratory disease.

77 FR 7147 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-10

...: Municipal Solid Waste Landfills (MSWLFs) and Non- Municipal, Non-Hazardous Waste Disposal Units That Receive Conditionally Exempt Small Quantity Generator (CESQG) Hazardous Waste (Renewal) AGENCY: Environmental Protection... Adequacy Determination: Municipal Solid Waste Landfills (MSWLFs) and Non-Municipal, Non-Hazardous Waste...

Impact of solids retention time on dissolved organic nitrogen and its biodegradability in treated wastewater

USDA-ARS?s Scientific Manuscript database

Dissolved organic nitrogen (DON) and its biodegradability in treated wastewater have recently gained attention because DON potentially causes oxygen depletion and/or eutrophication in receiving waters. Laboratory scale chemostat experiments were conducted at 9 different solids retention times (SRTs)...

Bullying and the Need to Belong: Early Adolescents' Bullying-Related Behavior and the Acceptance They Desire and Receive from Particular Classmates

ERIC Educational Resources Information Center

Olthof, Tjeert; Goossens, Frits A.

2008-01-01

Based on the notion that one of the motives underlying children's antisocial behavior is their need to belong to particular peers, it was examined how each of four types of bullying-related behavior would be related to the acceptance that 10 to 13-year-old children desired and received from same- and other-sex children with different…

The psychosocial challenges of solid organ transplant recipients during childhood.

PubMed

Annunziato, Rachel A; Jerson, Bradley; Seidel, Jordan; Glenwick, David S

2012-11-01

A large proportion of pediatric solid organ transplant recipients are young children, yet dedicated studies on the challenges faced by these patients are sparse. The present article aims to provide a summary of key considerations for pediatric solid organ transplant teams, describing what challenges are more likely for younger patients and how they might identify and address these circumstances. Our findings suggest that the mental health of patients and caregivers, issues at school, neurocognitive difficulties, and self-management are areas of particular relevance for children. We offer several recommendations that stem from these identified areas of concern. Dedicated focus on the well-being of younger patients could in the long-term stave off adverse events that are often associated with adolescence. In the short-term, certainly intervening in any of these domains could lead to improved quality of life during childhood. © 2012 John Wiley & Sons A/S.

Steroid therapy in children with fulminant hepatitis A.

PubMed

Zakaria, H M; Salem, T A; El-Araby, H A; Salama, R M; Elbadry, D Y; Sira, A M; Ali, M A; Salem, M E; Abd-Alaaty, B M; Goda, S S; Eltaras, S M; Khalil, F O; Abou-Zeinah, S S; Sira, M M

2018-02-03

Fulminant hepatic failure is a life-threatening disease. Hepatitis A virus (HAV) can cause fulminant hepatic failure and death in about 0.2% of cases. Extensive destruction of infected hepatocytes by immune-mediated lysis is thought to be the cause. We aimed to evaluate the use of steroid therapy in children with fulminant HAV. This study included 33 children with fulminant HAV in two groups. Steroid group: comprised of 18 children who received prednisolone (1 mg/kg/d) or its equivalent dose of methylprednisolone, and the nonsteroid group: comprised another 15 children who did not receive steroid therapy. Age and sex were matched for both groups (P > .05), and they were comparable regarding baseline clinical and laboratory characteristics. Of the steroid group, 15 patients survived and 3 died, while in the nonsteroid group, 4 patients survived and 11 died (P = .001). Of the living patients, 15 of 19 (78.9%) received steroids while only 3 of 14 (21.4%) of the dead patients received steroids (P = .001). Stepwise regression analysis showed that steroid therapy was the only independent variable associated with recovery (P = .001). Steroid therapy in children with fulminant HAV associated significantly with improved outcome and survival. Future studies on a larger population size are strongly recommended. © 2018 John Wiley & Sons Ltd.

IgE sensitization to gelatin: the probable role of gelatin-containing diphtheria-tetanus-acellular pertussis (DTaP) vaccines.

PubMed

Sakaguchi, M; Inouye, S

2000-04-03

We recently found that most events of anaphylaxis to live attenuated viral vaccines containing gelatin as a stabilizer might be caused by the gelatin. However, the mechanism that the children were sensitized to gelatin was unclear. In Japan, both diphtheria-tetanus-acellular pertussis (DTaP) vaccines with and without gelatin are available. We explored the possibility that gelatin-containing DTaP vaccines before live viral vaccines sensitize children to gelatin. We received the serum samples of 87 children who had systemic immediate-type reactions including anaphylaxis to the vaccines from both physicians and vaccine manufacturers throughout Japan. We then surveyed the DTaP vaccination histories of the children who demonstrated anti-gelatin IgE. Of the above 87 children, 79 (91%) had anti-gelatin IgE. We successfully collected DTaP vaccination histories including the manufacturers' names and numbers of doses on 55 children. Only one child had not received any DTaP vaccine, the other 54 had received gelatin-containing DTaP vaccines and none received gelatin-free DTaP vaccines. We concluded that there was a strong causal relationship between gelatin-containing DTaP vaccination, anti-gelatin IgE production, and risk of anaphylaxis following subsequent immunization with live viral vaccines which contain a larger amount of gelatin.

Aprepitant as an add-on therapy in children receiving highly emetogenic chemotherapy: a randomized, double-blind, placebo-controlled trial.

PubMed

Bakhshi, Sameer; Batra, Atul; Biswas, Bivas; Dhawan, Deepa; Paul, Reeja; Sreenivas, Vishnubhatla

2015-11-01

Aprepitant, a neurokinin-1 receptor antagonist, in combination with 5 HT-3 antagonist and dexamethasone is recommended in adults receiving moderately and highly emetogenic chemotherapy to reduce chemotherapy-induced vomiting (CIV). Data for use of aprepitant in children is limited and hence aprepitant is not recommended by Pediatric Oncology Group of Ontario guidelines for prevention of CIV in children <12 years. A randomized, double-blind, placebo-controlled trial was conducted at a single center in chemotherapy naïve children (5-18 years) receiving highly emetogenic chemotherapy. All patients received intravenous ondansetron (0.15 mg/kg) and dexamethasone (0.15 mg/kg) prior to chemotherapy followed by oral ondansetron and dexamethasone. Patients randomly assigned to aprepitant arm received oral aprepitant (15-40 kg = days 1-3, 80 mg; 41-65 kg = day 1, 125 mg and days 2-3, 80 mg) 1 h before chemotherapy. Control group received placebo as add-on therapy. Primary outcome measure was the incidence of acute moderate to severe vomiting, which was defined as more than two vomiting episodes within 24 h after the administration of the first chemotherapy dose until 24 h after the last chemotherapy dose in the block. Complete response (CR) was defined as absence of vomiting and retching during the specified phase. Of the 96 randomized patients, three were excluded from analysis; 93 patients were analyzed (50 in aprepitant arm and 43 in placebo arm). Acute moderate and severe vomiting was reported in 72 % patients receiving placebo and 38 % patients receiving aprepitant (p = 0.001). Complete response rates during acute phase were significantly higher in aprepitant arm (48 vs. 12 %, p < 0.001). No major adverse effects were reported by patients/guardians. This double-blind, randomized, placebo-controlled trial shows that aprepitant significantly decreases the incidence of CIV during acute phase when used as an add-on drug with ondansetron and dexamethasone in children receiving highly emetogenic chemotherapy.

Kids & Media @ the New Millennium: A Kaiser Family Foundation Report. A Comprehensive National Analysis of Children's Media Use. Executive Summary.

ERIC Educational Resources Information Center

Roberts, Donald F.

A study examined media use patterns among a large, nationally representative sample of children ages 2-18, and which explored how children choose and interact with the whole array of media available to them, including television, movies, computers, music, video games, radio, magazines, books, and newspapers. The goal was to provide a solid base…

Space or Physics? Children Use Physical Reasoning to Solve the Trap Problem from 2.5 Years of Age

ERIC Educational Resources Information Center

Seed, Amanda M.; Call, Josep

2014-01-01

By 3 years of age, children can solve tasks involving physical principles such as locating a ball that rolled down a ramp behind an occluder by the position of a partially visible solid wall (Berthier, DeBlois, Poirer, Novak, & Clifton, 2000; Hood, Carey, & Prasada, 2000). However, the extent to which children use physical information (the…

Children's medicines in Tanzania: a national survey of administration practices and preferences.

PubMed

Adams, Lisa V; Craig, Sienna R; Mmbaga, Elia John; Naburi, Helga; Lahey, Timothy; Nutt, Cameron T; Kisenge, Rodrick; Noel, Gary J; Spielberg, Stephen P

2013-01-01

The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics. We surveyed children aged 6-12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre. Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take. There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings.

United Kingdom national paediatric bilateral cochlear implant audit: preliminary results.

PubMed

Cullington, Helen; Bele, Devyanee; Brinton, Julie; Lutman, Mark

2013-11-01

Prior to 2009, United Kingdom (UK) public funding was mainly only available for children to receive unilateral cochlear implants. In 2009, the National Institute for Health and Care Excellence published guidance for cochlear implantation following their review. According to these guidelines, all suitable children are eligible to have simultaneous bilateral cochlear implants or a sequential bilateral cochlear implant if they had received the first before the guidelines were published. Fifteen UK cochlear implant centres formed a consortium to carry out a multi-centre audit. The audit involves collecting data from simultaneously and sequentially implanted children at four intervals: before bilateral cochlear implants or before the sequential implant, 1, 2, and 3 years after bilateral implants. The measures include localization, speech recognition in quiet and background noise, speech production, listening, vocabulary, parental perception, quality of life, and surgical data including complications. The audit has now passed the 2-year point, and data have been received on 850 children. This article provides a first view of some data received up until March 2012.

Significant factors in family difficulties for fathers and mothers who use support services for children with hikikomori.

PubMed

Funakoshi, Akiko; Miyamoto, Yuki

2015-04-01

Hikikomori is a new psychosociological phenomenon among youth, of almost complete withdrawal from social interaction, and it has received considerable attention in community mental health in Japan. The aims of the present study were to identify the influential factors of family difficulties of parents who use support services for children with hikikomori, and compare them between fathers and mothers. Data were collected from 110 parents (55 couples) of children with hikikomori with regard to family difficulties, quality of life, and depression variables via self-report questionnaires. To assess the influential factors of Family Difficulties for parents with children with hikikomori, hierarchical multiple linear regression analysis was carried out for gender. While 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. For both genders, the number of services that the fathers received was significantly correlated with marital cooperation, and the number of services that the mothers received was significantly correlated with support resource utilization. It is necessary for fathers to receive more support, and it is important for professionals to encourage parents to address their difficulties together. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Malnutrition, poverty and intellectual development.

PubMed

Brown, J L; Pollitt, E

1996-02-01

New findings with important policy implications have revealed that malnutrition in childhood impairs intellectual function in more ways than was previously recognized, but also that some of the damage to the brain caused by malnutrition may be reversed. Early research indicated that malnourished animals lacked the energy to interact with their environment and, thus, performed poorly on tests of mental ability. To determine the effect of poor diet and an impoverished environment on mental development in humans, an extensive follow-up study was made of Guatemalan children who received two different nutritional supplements in a 1969-77 study. Mothers and children in two villages received a high-protein supplement (Atole), and those in two additional villages received a supplement with no protein (Fresco). Both supplements reduced mortality, but Atole villages saw a 69% reduction in infant mortality (vs. 24% in the Fresco villages). The 1988-89 follow-up of 70% of the original participants involved extensive cognitive testing and socioeconomic assessment. Atole subjects performed significantly better on the cognitive tests, and the lowest-income children did as well as their more economically advantaged (but still poor) peers. Those who received Atole exhibited an increased benefit from their years of education and grew up faster and stronger than those who received Fresco. Smaller children who appear younger than their age may receive less stimulation from adult expectations than larger children. These findings indicate that the deleterious effects of early malnutrition on intellectual development can continue into adulthood. Other research has revealed that iron supplements can improve the intellectual and motor abilities of infants. While enriched educational programs can ameliorate some of the problems associated with malnutrition, poor children rarely live where such programs are available. The best and least expensive policy would be to prevent malnutrition among young children who would then be able to take advantage of the money invested in schools for their education.

PAH EXPOSURES OF NINE PRESCHOOL CHILDREN

EPA Science Inventory

The exposures to 20 polycyclic aromatic hydrocarbons (PAH) of 9 children, ages 2-5 yr, were measured over 48 hr at day care and at home. Sampled media included indoor and outdoor air, floor dust, outdoor play area soil, hand surface, and solid and liquid food. Urine samples ...

Attention-Deficit/Hyperactivity Disorder Medication Treatment Impact on Response to Growth Hormone Therapy: Results from the ANSWER Program, a Non-Interventional Study.

PubMed

Rose, Susan R; Reeves, Grafton; Gut, Robert; Germak, John

2015-12-01

To examine whether attention-deficit/hyperactivity disorder (ADHD) stimulant medication modified the linear growth response to growth hormone (GH) treatment in children enrolled in the American Norditropin Studies: Web-Enabled Research Program. Short, GH treatment-naive children with or without GH deficiency (GHD) received GH therapy. A subset also received ADHD stimulant medication (n = 1190), and others did not (n = 7230). Linear mixed models (adjusted means) examined height SDS (HSDS) and body mass index (BMI) SDS from baseline through year 4. Analyses were repeated with ADHD groups matched for baseline age, height, weight, BMI, and sex. Groups with and without GHD were compared between ADHD groups. Adjusted change in HSDS for the group receiving ADHD stimulant medication was slightly lower than that for patients not receiving stimulant medication at years 1 to 4 (P < .05). However, adjusted change in HSDS was similar between children receiving and not receiving ADHD stimulant medication when matched for baseline measurements. At year 4, 86.7% of patients receiving ADHD stimulant medication, 86.8% of total patients not receiving ADHD stimulant medication, and 84.6% of matched group patients not receiving ADHD stimulant medication achieved HSDS >-2. Year 4 adjusted change in BMI SDS was greater in the patients receiving ADHD stimulant medication compared with both groups not receiving ADHD stimulant medication (P < .05). Patients with GHD showed comparable differences in adjusted change in BMI SDS among the ADHD groups at year 4, whereas patients without GHD showed no significant differences. ADHD medication did not affect the linear growth response of children treated with GH when those receiving or not receiving ADHD stimulant medication were matched for baseline measurements. Underlying reasons for the observed greater increase in BMI in patients with GHD concomitantly treated with ADHD medication remain to be elucidated. ClinicalTrials.gov: NCT01009905. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The effect of rehearsal training on working memory span of children with fetal alcohol spectrum disorder.

PubMed

Loomes, Carly; Rasmussen, Carmen; Pei, Jacqueline; Manji, Shazeen; Andrew, Gail

2008-01-01

A key area of weakness in individuals with fetal alcohol spectrum disorder (FASD) is working memory, thus the goal of this study was to determine whether teaching children (aged 4-11) with FASD verbal rehearsal would increase their memory. Rehearsal training has been effective in other populations with working memory difficulties, so we hypothesized that children with FASD would also benefit from rehearsal training. Children were divided into an Experimental group, who received rehearsal training and a Control group, who did not receive training. All children were tested on digit span tasks over three sessions: a pretest (baseline) and then post-test 1 and post-test 2 (where only the Experimental group received rehearsal training). The Experimental group showed a significant increase in performance across session but the Control group did not. Children in the Experimental group performed significantly higher than the Control group on post-test 2 but not on the pretest or post-test 1. More children in the Experimental group showed behavioral evidence and self-report of rehearsal after training. Rehearsal training was successful at increasing the memory for numbers among children with FASD and may help to ameliorate working memory difficulties in FASD, ultimately supporting academic and developmental growth of children with FASD.

General and abdominal fat outcomes in school-age children associated with infant breastfeeding patterns.

PubMed

Durmuş, Büşra; Heppe, Denise H M; Gishti, Olta; Manniesing, Rashindra; Abrahamse-Berkeveld, Marieke; van der Beek, Eline M; Hofman, Albert; Duijts, Liesbeth; Gaillard, Romy; Jaddoe, Vincent W V

2014-06-01

Breastfeeding may have a protective effect on the development of obesity in later life. Not much is known about the effects of infant feeding on more-specific fat measures. We examined associations of breastfeeding duration and exclusiveness and age at the introduction of solid foods with general and abdominal fat outcomes in children. We performed a population-based, prospective cohort study in 5063 children. Information about infant feeding was obtained by using questionnaires. At the median age of 6.0 y (95% range: 5.7 y, 6.8 y), we measured childhood anthropometric measures, total fat mass and the android:gynoid fat ratio by using dual-energy X-ray absorptiometry, and preperitoneal abdominal fat by using ultrasound. We observed that, in the models adjusted for child age, sex, and height only, a shorter breastfeeding duration, nonexclusive breastfeeding, and younger age at the introduction of solid foods were associated with higher childhood general and abdominal fat measures (P-trend < 0.05) but not with higher childhood body mass index. The introduction of solid foods at a younger age but not breastfeeding duration or exclusivity was associated with higher risk of overweight or obesity (OR: 2.05; 95% CI: 1.41, 2.90). After adjustment for family-based sociodemographic, maternal lifestyle, and childhood factors, the introduction of solid food between 4 and 4.9 mo of age was associated with higher risks of overweight or obesity, but the overall trend was not significant. Associations of infant breastfeeding and age at the introduction of solid foods with general and abdominal fat outcomes are explained by sociodemographic and lifestyle-related factors. Whether infant dietary composition affects specific fat outcomes at older ages should be further studied. © 2014 American Society for Nutrition.

Consumption of added sugars from liquid but not solid sources predicts impaired glucose homeostasis and insulin resistance among youth at risk of obesity.

PubMed

Wang, Jiawei; Light, Kelly; Henderson, Mélanie; O'Loughlin, Jennifer; Mathieu, Marie-Eve; Paradis, Gilles; Gray-Donald, Katherine

2014-01-01

Little is known about longitudinal associations between added sugar consumption (solid and liquid sources) and glucose-insulin homeostasis among youth. Caucasian children (8-10 y) with at least one obese biological parent were recruited in the QUébec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort (n = 630) and followed-up 2 y later (n = 564). Added sugars were assessed by 3 24-h dietary recalls at baseline. Two-year changes were examined in multivariate linear regression models, adjusting for baseline level, age, sex, Tanner stage, energy intake, fat mass (dual-energy X-ray absorptiometry), and physical activity (7 d accelerometer). Added sugar intake in either liquid or solid sources was not related to changes in adiposity measures (fat mass, body mass index, or waist circumference). However, a higher consumption (10 g/d) of added sugars from liquid sources was associated with 0.04 mmol/L higher fasting glucose, 2.3 pmol/L higher fasting insulin, 0.1 unit higher homeostasis model assessment of insulin resistance (HOMA-IR), and 0.4 unit lower Matsuda-insulin sensitivity index (Matsuda-ISI) in all participants (P < 0.01). No associations were observed with consumption of added sugars from solid sources. Overweight/obese children at baseline had greater increases in adiposity indicators, fasting insulin, and HOMA-IR and decreases in Matsuda-ISI during those 2 y than normal-weight children. Consumption of added sugars from liquid or solid sources was not associated with changes in adiposity, but liquid added sugars were a risk factor for the development of impaired glucose homeostasis and insulin resistance over 2 y among youth at risk of obesity.

[Feeding practices in 6-to-24-month-old children in Yaoundé, Cameroon: relationship with their nutritional status].

PubMed

Ngo Um-Sap, S; Mbassi Awa, H; Hott, O; Tchendjou, P; Womga, A; Tanya, A; Koki Ndombo, P

2014-01-01

Shifting from breastfeeding to solid food is known as the complementary feeding period. When complementary feeding is inadequate, malnutrition results in most cases. These practices differ depending on cultural and religious backgrounds as well as geographical location. Ruel and Menon studied the relationship between feeding practices during diversification and nutritional status of children at 6 and 36 months, using a score called the Infant and Child Feeding Index (ICFI). This ICFI scored feeding practices such as breastfeeding, bottle-feeding, food diversity, and meal frequency, which has never been studied in Cameroon. The aim of this study was to describe actual feeding practices in children in our context as well as to investigate their relationship with children's nutritional status. We carried out a cross-sectional study throughout the month of January 2011 at the Chantal-Biya Foundation. Mothers completed a questionnaire on how their infants were fed at birth, the initiation of complementary food, and feeding practices for the 3 days before the survey. The children's anthropometric parameters were noted. All mothers coming for vaccination or vitamin A supplementation for their children aged between 6 and 24 months were enrolled in the study. We enrolled 197 mothers and their infants. Breastfeeding was the main feeding method at birth, but was exclusive until 6 months for only 15 % of the infants. Three-quarter of nursing mothers started adding complementary food at age 4-6 months, using pap. Half of the children did not receive animal products, fruits, or vegetables. When applying the ICFI to these practices, it appeared that the various diversification practices scored less than 8 for 50% of the population. A positive association was noted between the ICFI and nutritional status, as expressed by height-of-age Z-score (HAZ) and the weight-for-age Z-score (WAZ). We concluded that the codified feeding practices with respect to Ruel and Menon's ICFI are associated with the nutritional status of children between 6 and 24 months in Yaounde, Cameroon. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Control valve and control valve system for controlling solids flow, methods of manufacture thereof and articles comprising the same

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

Jukkola, Glen D.; Teigen, Bard C.

Disclosed herein is a solids flow control valve comprising a standpipe; a shoe; and a transport pipe; wherein the standpipe is in operative communication with the shoe and lies upstream of the shoe; the standpipe comprising a first end and a second end, where the first end is in contact with a source that contains disposable solids and the second end is in fluid contact with the shoe; the shoe being operative to restrict the flow of the disposable solids; the transport pipe being disposed downstream of the shoe to receive and transport the solids from the shoe.

Propofol sedation in children: sleep trumps amnesia.

PubMed

Veselis, Robert; Kelhoffer, Eric; Mehta, Meghana; Root, James C; Robinson, Fay; Mason, Keira P

Detailed assessments of the effects of propofol on memory in children are lacking. We assessed the feasibility of measuring memory during propofol infusion, as commonly performed in sedation for MRI scanning. In addition, we determined the onset of memory loss in relation to the onset of sedation measured by verbal responsiveness. Children scheduled for sedation for MRI received a 10-min infusion of propofol (3 mg/kg) as they viewed and named 100 simple line drawings, one shown every five seconds, until they were no longer responsive (encoding). A control group receiving no sedation for MRI underwent similar tasks. Sedation was measured as any verbal response, regardless of correctness. After recovery from sedation, recognition memory was tested, with correct yes/no recognitions matched to sedation responses during encoding (subsequent memory paradigm). Of the 48 children who received propofol, 30 could complete all study tasks (6.2 ± 1.6 years, 16 males). Individual responses could be modeled in all 30 children. On average, there was a 50% probability of no verbal response 3.1 min after the start of infusion, with 50% memory loss at 2.7 min. Children receiving propofol recognized 65 ± 16% of the pictures seen, whereas the control group recognized 93 ± 5%. Measurement of memory and sedation is possible in verbal children receiving propofol by infusion in a clinical setting. Despite propofol being an amnestic agent, there was little or no amnestic effect of propofol while the child was verbally responsive. It is important for sedation providers to realize that propofol sedation does not always produce amnesia while the child is responsive. CLINICALTRIALS. NCT02278003. Copyright © 2016. Published by Elsevier B.V.

Scaling-Up Access to Antiretroviral Therapy for Children: A Cohort Study Evaluating Care and Treatment at Mobile and Hospital-Affiliated HIV Clinics in Rural Zambia

PubMed Central

van Dijk, Janneke H.; Moss, William J.; Hamangaba, Francis; Munsanje, Bornface; Sutcliffe, Catherine G.

2014-01-01

Background Travel time and distance are barriers to care for HIV-infected children in rural sub-Saharan Africa. Decentralization of care is one strategy to scale-up access to antiretroviral therapy (ART), but few programs have been evaluated. We compared outcomes for children receiving care in mobile and hospital-affiliated HIV clinics in rural Zambia. Methods Outcomes were measured within an ongoing cohort study of HIV-infected children seeking care at Macha Hospital, Zambia from 2007 to 2012. Children in the outreach clinic group received care from the Macha HIV clinic and transferred to one of three outreach clinics. Children in the hospital-affiliated clinic group received care at Macha HIV clinic and reported Macha Hospital as the nearest healthcare facility. Results Seventy-seven children transferred to the outreach clinics and were included in the analysis. Travel time to the outreach clinics was significantly shorter and fewer caretakers used public transportation, resulting in lower transportation costs and fewer obstacles accessing the clinic. Some caretakers and health care providers reported inferior quality of service provision at the outreach clinics. Sixty-eight children received ART at the outreach clinics and were compared to 41 children in the hospital-affiliated clinic group. At ART initiation, median age, weight-for-age z-scores (WAZ) and CD4+ T-cell percentages were similar for children in the hospital-affiliated and outreach clinic groups. Children in both groups experienced similar increases in WAZ and CD4+ T-cell percentages. Conclusions HIV care and treatment can be effectively delivered to HIV-infected children at rural health centers through mobile ART teams, removing potential barriers to uptake and retention. Outreach teams should be supported to increase access to HIV care and treatment in rural areas. PMID:25122213

Typhilitis in the pediatric patient.

PubMed

Haut, Cathy

2008-01-01

Cancer statistics in children are promising as mortality rates consistently decrease, reflecting newer chemotherapeutic agents and the evolution of hematopoietic stem cell transplant. Typhilitis or neutropenic enterocolitis is a potentially life-threatening complication of cancer treatment often found in immunocompromised children receiving vigorous chemotherapeutic regimens and noted in children post-stem-cell transplant. Recent literature suggests a relationship between typhilitis and other types of cancers and immunocompromised illness occurring in both children and adults. The pathogenesis of typhilitis is poorly understood, with limited evidence regarding incidence. Nursing care and assessment of children receiving oncologic treatment requires vigilance and immediate response to prevent and manage complications, especially gastrointestinally related typhilitis.

Heat Recovery Incinerator-Equipment Selection and Plant Layout for Safety, Human Engineering and Maintainability.

DTIC Science & Technology

1984-10-01

16 4.2 Solid Waste Receiving and Storage Area ........................ 17 4.3 Equipment Location and Spacing...10OROS (Ccr4n-ifl. **,0d. d - -eet -.d tdonfffy by bltk -P-+) HRI, RAM, Human factors, HRI design, IRI safety, solid waste , energy recovery 10 AOSTNACT...health and safety hazards to individuals hand-sorting the conglomerate of solid waste , the potential of dangerous substances and inflammable or ex

RCRA SUBTITLE D (258): SEISMIC DESIGN GUIDANCE FOR MUNICIPAL SOLID WASTE LANDFILL FACILITIES

EPA Science Inventory

On October 9, 1993, the new RCRA Subtitle D regulations (40 CFR Part 258) went into effect. These regulations are applicable to landfills receiving municipal solid waste (MSW) and establish minimum Federal criteria for the siting, design, operation, and closure of MSW landfills....

The Influence of Seasonality and Community-Based Health Worker Provided Counselling on Exclusive Breastfeeding - Findings from a Cross-Sectional Survey in India

PubMed Central

Das, Aritra; Chatterjee, Rahul; Karthick, Morchan; Mahapatra, Tanmay; Chaudhuri, Indrajit

2016-01-01

Background Exclusive breastfeeding (EBF) during the first six months of life is considered a high impact but low-cost measure for reducing the morbidity and mortality among children. The current study investigated the association of seasonality and frontline worker(FLW) provided counselling with practice of EBF in Bihar, India. Methods We used the ‘Lot Quality Assurance Sampling’ technique to conduct a multi-stage sampling survey in 8 districts of Bihar. Regarding EBF, mothers of 0–5 (completed) months old children were asked if they had given only breastmilk to their children during the previous day, while mothers of 6–8 (completed) months old children were inquired about the total duration of EBF. We tested for association between EBF during the previous day with season of interview and EBF for full 6 months with nursing season. We also assessed if receiving counselling on EBF and complementary feeding had any association with relevant EBF indicators. Results Among the under-6 month old children, 76% received EBF during the previous day, whereas 92% of 6–8 (completed) months old children reportedly received EBF for the recommended duration. Proportion of 0–5 (completed) month old children receiving only breastmilk (during last 24 hours) decreased significantly with increasing age and with change of season from colder to warmer months. Odds of receiving only breastmilk during the previous day was significantly higher during the winter months (Adjusted odds ratio(AOR) = 1.50; 95% CI = 1.37, 1.63) compared to summer. Also, the children nursed primarily during the winter season had higher odds of receiving EBF for 6 months (AOR = 1.90, 95% CI = 1.43, 2.52) than those with non-winter nursing. Receiving FLW-counselling was positively associated with breastfeeding exclusively, even after adjusting for seasonality and other covariates (AOR = 1.82; 95% CI = 1.67, 1.98). Conclusions Seasonality is a significant but non-modifiable risk factor for EBF. However, FLW-counselling was found to increase practice of EBF irrespective of season. Scale-up of FLW-counselling services, with emphasis on summer months and mothers of older infants, can potentially reduce the impact of seasonality on EBF. PMID:27513642

Early Respiratory Bacterial Detection and Antistaphylococcal Antibiotic Prophylaxis in Young Children with Cystic Fibrosis.

PubMed

Hurley, Matthew N; Fogarty, Andrew; McKeever, Tricia M; Goss, Christopher H; Rosenfeld, Margaret; Smyth, Alan R

2018-01-01

Consensus is lacking regarding antistaphylococcal antibiotic prophylaxis use for young children with cystic fibrosis. Prophylaxis is recommended in the United Kingdom, but it is recommended against in the United States. To test the hypothesis that antistaphylococcal antibiotic prophylaxis is associated with a decreased risk of Staphylococcus aureus acquisition but no increased risk of Pseudomonas aeruginosa acquisition. We undertook a longitudinal observational study of children with cystic fibrosis who were recruited from birth (or from their first registry entry in the period) and followed until the age of 4 years (1,500 d) using 2000-2009 data from the UK Cystic Fibrosis Trust and Cystic Fibrosis Foundation registries. Children were excluded if they had a positive culture result for S. aureus or P. aeruginosa, or if they were receiving inhaled antibiotics, at the first encounter. Time to first S. aureus and P. aeruginosa detection in the UK/U.S. cohorts was compared using a Cox proportional hazards model. A UK-based analysis compared the same for those receiving flucloxacillin with those who received no prophylaxis. We included the following covariates: sex, age at registry entry, dornase alfa use, genotype, and center size. The primary analysis comprised 1,074 UK and 3,677 U.S. children. The risk of first detection was greater in U.S. children than in UK children for S. aureus (hazard ratio [HR], 5.79; 95% confidence interval [CI], 4.85, 6.90; P < 0.001) and P. aeruginosa (HR, 1.92; 95% CI, 1.65, 2.24; P < 0.001). In the UK analysis, we compared 278 children receiving flucloxacillin and 306 receiving no prophylaxis. Flucloxacillin was not associated with a reduced risk of S. aureus detection (HR, 1.22; 95% CI, 0.74, 2.0; P = 0.43), but it was associated with an increased risk of P. aeruginosa detection (HR, 2.53; 95% CI, 1.71, 3.74; P < 0.001). None of the covariates significantly affected the risk estimate in either analysis. The risk of first detection of S. aureus and P. aeruginosa was greater in the United States than in the United Kingdom. In the United Kingdom, the risk of first P. aeruginosa detection was increased among those receiving flucloxacillin compared with those who received no prophylaxis. These observational findings should be examined in randomized controlled trials.

[Subcutaneously inserted central intravascular devices in the pediatric oncology patient: can we minimize their infection].

PubMed

Tardáguila, A R; Del Cañizo, A; Santos, M M; Fanjul, M; Corona, C; Zornoza, M; Parente, A; Carrera, N; Beléndez, C; Cerdá, J; Saavedra, J; Molina, E; García-Casillas, M A; Peláez, D

2011-10-01

Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. We have made a retrospective review of 120 oncologic pediatric patients who received a central venous device between 2003 and 2009. We searched for epidemiologic, clinic, microbiologic and surgical risk factors. We made a comparative data analysis among: GROUP A, children who suffered device infection, GROUP B the others. Group A was divided into early infection (first month after implantation)/late infection, removed/not removed. Data were analized with statistical program SPSS. 29 suffered from leukemia, 19 from lymphoma and the main part, 72, from solid tumour. 31% experienced infection (GROUP A), being early in the 36% of them. 16% had to be withdrawn. Data analysis revealed statistical association with the age (p=0.015) and with the reception of chemiotherapic treatment the week before the surgical insertion. The rest of the studied factors did not revealed a real association, but could be guess a relationship among infection and leukemia, subclavian catheters, those patients whose deviced was introduced using a guide over a previous catheter and also transplanted. Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.

Is enhanced physical activity possible using active videogames?

USDA-ARS?s Scientific Manuscript database

Our research indicated that 10– to 12-year-old children receiving two active Wii (TM)(Nintendo (R); Nintendo of America, Inc., Redmond, WA) console videogames were no more physically active than children receiving two inactive videogames. Research is needed on how active videogames may increase phys...

Predictors of Change in Eligibility Status among Preschoolers in Special Education

ERIC Educational Resources Information Center

Daley, Tamara C.; Carlson, Elaine

2009-01-01

Relatively little is known about the incidence of declassification among young children who receive preschool special education services or about factors associated with declassification. The Pre-Elementary Education Longitudinal Study (PEELS) follows a nationally representative sample of children who were receiving preschool special education…

Reasons Parents Exempt Children from Receiving Immunizations

ERIC Educational Resources Information Center

Luthy, Karlen E.; Beckstrand, Renea L.; Callister, Lynn C.; Cahoon, Spencer

2012-01-01

School nurses are on the front lines of educational efforts to promote childhood vaccinations. However, some parents still choose to exempt their children from receiving vaccinations for personal reasons. Studying the beliefs of parents who exempt vaccinations allows health care workers, including school nurses, to better understand parental…

Is Enhanced Physical Activity Possible Using Active Videogames?

PubMed

Baranowski, Tom; Baranowski, Janice; O'Connor, Teresia; Lu, Amy Shirong; Thompson, Debbe

2012-06-01

Our research indicated that 10-12-year-old children receiving two active Wii ™ (Nintendo ® ; Nintendo of America, Inc., Redmond, WA) console videogames were no more physically active than children receiving two inactive videogames. Research is needed on how active videogames may increase physical activity.

Risperidone in children with autism: randomized, placebo-controlled, double-blind study.

PubMed

Nagaraj, Ravishankar; Singhi, Pratibha; Malhi, Prahbhjot

2006-06-01

Some open-label studies suggest that risperidone can be useful in the treatment of certain target symptoms in children with autism. We aimed to study whether the use of risperidone in comparison with placebo improved functioning in children with autism with regard to behavior (aggressiveness, hyperactivity, irritability), social and emotional responsiveness, and communication skills. We conducted a randomized, double-blind, placebo-controlled trial with 40 consecutive children with autism, whose ages ranged from 2 to 9 years, who were receiving either risperidone or placebo given orally at a dose of 1 mg/day for 6 months. Autism symptoms were monitored periodically. The outcome variables were total scores on the Childhood Autism Rating Scale (CARS) and the Children's Global Assessment Scale (CGAS) after 6 months. Of the 40 children enrolled, 39 completed the trial over a period of 18 months; 19 received risperidone, and 20 received placebo. In the risperidone group, 12 of 19 children showed improvement in the total Childhood Autism Rating Scale score and 17 of 19 children in the Children's Global Assessment Scale score compared with 0 of 20 children for the Childhood Autism Rating Scale score and 2 of 20 children for the Children's Global Assessment Scale score in the placebo group (P < .001 and P = .035, respectively). Risperidone also improved social responsiveness and nonverbal communication and reduced the symptoms of hyperactivity and aggression. Risperidone was associated with increased appetite and a mild weight gain, mild sedation in 20%, and transient dyskinesias in three children. Risperidone improved global functioning and social responsiveness while reducing hyperactivity and aggression in children with autism and was well tolerated.

Caregiver perceptions of mental health problems and treatment utilisation in siblings of children with mental health problems.

PubMed

Ma, Nylanda; Furber, Gareth; Roberts, Rachel; Winefield, Helen

2016-01-01

Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.

Spontaneous regulation of emotions in preschool children who stutter: preliminary findings.

PubMed

Johnson, Kia N; Walden, Tedra A; Conture, Edward G; Karrass, Jan

2010-12-01

Emotional regulation of preschool children who stutter (CWS) and children who do not stutter (CWNS) was assessed through use of a disappointing gift (DG) procedure (P. M. Cole, 1986; C. Saarni, 1984, 1992). Participants consisted of 16 CWS and CWNS (11 boys and 5 girls in each talker group) who were 3 to 5 years of age. After assessing each child's knowledge of display rules about socially appropriate expression of emotions, the authors asked the children to participate in a DG procedure. The children received a desirable gift preceding the first free-play task and a disappointing gift preceding a second free-play task. Dependent variables consisted of participants' positive and negative expressive nonverbal behaviors exhibited during receipt of a desirable gift and disappointing gift as well as conversational speech disfluencies exhibited following receipt of each gift. Findings indicated that CWS and CWNS exhibited no significant differences in amount of positive emotional expressions after receiving the desired gift; however, CWS--when compared with CWNS--exhibited more negative emotional expressions after receiving the undesirable gift. Furthermore, CWS were more disfluent after receiving the desired gift than after receiving the disappointing gift. Ancillary findings also indicated that CWS and CWNS had equivalent knowledge of display rules. Findings suggest that efforts to concurrently regulate emotional behaviors and that speech disfluencies may be problematic for preschool-age CWS.

Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children.

PubMed

Hieu, Nguyen Trung; Sandalinas, Fanny; de Sesmaisons, Agnès; Laillou, Arnaud; Tam, Nguyen Phuong; Khan, Nguyen Cong; Bruyeron, Olivier; Wieringa, Frank Tammo; Berger, Jacques

2012-10-28

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95% CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95% CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95% CI 15·2, 51·2) μg/l; P < 0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95% CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95% CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95% CI 5·1, 7·1) mg/l; P = 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2) mg/kg body weight) and SUP (mean 6·1 (sd 2·5) mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3) mg/kg body weight, P < 0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0%) compared with the C group (10·4%, P = 0·006), with the SUP group being intermediate (7·4%). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P = 0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children.

Randomized Trial of 2 Versus 1 Dose of Measles Vaccine: Effect on Hospital Admission of Children After 9 Months of Age.

PubMed

Brønd, Marie; Martins, Cesario L; Byberg, Stine; Benn, Christine S; Whittle, Hilton; Garly, May-Lill; Aaby, Peter; Fisker, Ane B

2017-06-15

Two doses of measles vaccine (MV) might reduce the nonmeasles mortality rate more than 1 dose of MV does. The effect of 2 versus 1 dose on morbidity has not been examined. Within a randomized trial of the effect of 2 doses versus 1 dose of MV on mortality in Guinea-Bissau, we investigated the effect on hospital admissions. Children were randomly assigned 1:2 to receive MV at 4.5 and 9 months of age or the currently recommended dose at 9 months. We compared hospital admission rates among children between 9 and 18 months of age in a Cox regression model with age as the underlying time scale. Half of the children had received neonatal vitamin A supplementation (NVAS) in another trial. The beneficial effect of MV at 4.5 and 9 months on mortality was limited to children who had not received NVAS; therefore, we investigated the interaction of MV with NVAS on admission rates. Among 5626 children (2 doses of MV, 1960 children; 1 dose of MV, 3666), we identified 311 hospital admissions of children between 9 and 18 months of age. Overall, compared to 1 dose of MV, 2 doses reduced the risk of hospital admission for children who had not received NVAS (hazard ratio [HR], 0.66 [95% confidence interval (CI), 0.47-0.93]), but we found no effect among NVAS recipients (HR, 1.16 [95% CI, 0.82-1.63]) (P = .02 for interaction). The benefit of 2 doses of MV was limited to children who had not received NVAS. NVAS is not generally recommended; hence, an early 2-dose measles vaccination policy might reduce hospital admissions more than the current policy of providing the first MV at 9 months of age. ClinicalTrials.gov identifier NCT00168558. © The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care.

PubMed

Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew

2018-06-01

The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P < .02) correlated with the gap in home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

Trends in Consumption of Solid Fats, Added Sugars, Sodium, Sugar-Sweetened Beverages, and Fruit from Fast Food Restaurants and by Fast Food Restaurant Type among US Children, 2003–2010

PubMed Central

Rehm, Colin D.; Drewnowski, Adam

2016-01-01

Energy intakes from fast food restaurants (FFRs) have declined among US children. Less is known about the corresponding trends for FFR-sourced solid fats, added sugars, and sodium, and food groups of interest, such as fruit and sugar-sweetened beverages (SSBs). Using data from a single 24-h dietary recall among 12,378 children aged 4–19 years from four consecutive cycles of the nationally-representative National Health and Nutrition Examination Survey (NHANES), 2003–2010 a custom algorithm segmented FFRs into burger, pizza, sandwich, Mexican cuisine, chicken, Asian cuisine, fish restaurants, and coffee shops. There was a significant population-wide decline in FFR-sourced solid fats (−32 kcal/day, p-trend < 0.001), added sugars (−16 kcal/day; p-trend < 0.001), SSBs (−0.12 servings (12 fluid ounces or 355 mL)/day; p-trend < 0.001), and sodium (−166 mg/day; p-trend < 0.001). Declines were observed when restricted to fast food consumers alone. Sharp declines were observed for pizza restaurants; added sugars, solid fats, and SSBs declined significantly from burger restaurants. Fruit did not change for fast food restaurants overall. Temporal analyses of fast food consumption trends by restaurant type allow for more precise monitoring of the quality of children’s diets than can be obtained from analyses of menu offerings. Such analyses can inform public health interventions and policy measures. PMID:27983573

Potentially preventable dental care in operating rooms for children enrolled in Medicaid.

PubMed

Bruen, Brian K; Steinmetz, Erika; Bysshe, Tyler; Glassman, Paul; Ku, Leighton

2016-09-01

In this study, the authors examined the prevalence and cost of care for children enrolled in Medicaid for potentially preventable dental conditions who receive surgical care in hospital operating rooms (ORs) or ambulatory surgery centers (ASCs). The authors analyzed Medicaid data from 8 states to find cases in which children aged 1 to 20 years received surgical care in ORs or ASCs in 2010 and 2011 for potentially preventable diagnoses, as defined with diagnostic codes. For 6 states with complete data, there were 26,373 cases in 2011 in which children received OR or ASC surgical care for potentially preventable conditions. These cases represent approximately 0.5% of all children enrolled in Medicaid in these states and approximately 1% of children enrolled in Medicaid who received any dental care. There were $68 million in total Medicaid payments for these cases, with an average of $2,581 per case. Diagnostic codes indicated that 98% of cases were related to treatment of dental caries. More than two-thirds of the cases (71%) were children aged 1 to 5 years. Extrapolation to the United States suggests that approximately $450 million in additional expenditures occurred in 2011 because of OR or ASC surgical care for potentially preventable pediatric dental conditions, primarily related to early childhood caries. Strategies to improve prevention of early childhood caries, including community- and family-based education, and to increase access to timely and early dental care for low-income children could reduce the burdens and costs of these dental problems. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

The dental care of U.S. children: access, use and referrals by nondentist providers, 2003.

PubMed

Chu, May; Sweis, Luciana E; Guay, Albert H; Manski, Richard J

2007-10-01

Improvements in oral health care services have not reached evenly across every segment of American society. The authors examine the role of nondentist practitioners in referring child patients for dental care by analyzing data from the 2003 Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. The authors provide national estimates of the percentage of the civilian noninstitutionalized population of the United States aged 2 through 17 years who had a dental visit, who had a dental checkup and who received advice from a nondentist health care provider to have a dental checkup. Overall, 38 percent of all poor, near-poor or low-income children and 60 percent of all middle- or high-income children aged 2 through 17 years reported having had a dental checkup during 2003. The authors observed no significant differences between poor, near-poor and low-income children and higher-income children in terms of having been advised by a nondentist health care provider to have a dental checkup. Although income may not predict the likelihood of patients' receiving advice from a nondentist health care provider to have a dental checkup, children from families with higher levels of income were more likely to seek dental care than were children from families with lower levels of income. Practice Implications. Efforts to increase access to dental care should aim to maximize the benefit of advice provided by nondentist health care practitioners to receive a dental checkup, so that children from families with limited income are as likely to receive a dental checkup as are children from families with higher levels of income.

A Multinational Study of Thromboprophylaxis Practice in Critically Ill Children*

PubMed Central

Faustino, Edward Vincent S.; Hanson, Sheila; Spinella, Philip C.; Tucci, Marisa; O'Brien, Sarah H.; Nunez, Antonio Rodriguez; Yung, Michael; Truemper, Edward; Qin, Li; Li, Simon; Marohn, Kimberly; Randolph, Adrienne G.

2015-01-01

Objectives Although critically ill children are at increased risk for developing deep venous thrombosis, there are few pediatric studies establishing the prevalence of thrombosis or the efficacy of thromboprophylaxis. We tested the hypothesis that thromboprophylaxis is infrequently used in critically ill children even for those in whom it is indicated. Design Prospective multinational cross-sectional study over four study dates in 2012. Setting Fifty-nine PICUs in Australia, Canada, New Zealand, Portugal, Singapore, Spain, and the United States. Patients All patients less than 18 years old in the PICU during the study dates and times were included in the study, unless the patients were 1) boarding in the unit waiting for a bed outside the PICU or 2) receiving therapeutic anticoagulation. Interventions None. Measurements and Main Results Of 2,484 children in the study, 2,159 (86.9%) had greater than or equal to 1 risk factor for thrombosis. Only 308 children (12.4%) were receiving pharmacologic thromboprophylaxis (e.g., aspirin, low-molecular-weight heparin, or unfractionated heparin). Of 430 children indicated to receive pharmacologic thromboprophylaxis based on consensus recommendations, only 149 (34.7%) were receiving it. Mechanical thromboprophylaxis was used in 156 of 655 children (23.8%) 8 years old or older, the youngest age for that device. Using nonlinear mixed effects model, presence of cyanotic congenital heart disease (odds ratio, 7.35; p < 0.001) and spinal cord injury (odds ratio, 8.85; p = 0.008) strongly predicted the use of pharmacologic and mechanical thromboprophylaxis, respectively. Conclusions Thromboprophylaxis is infrequently used in critically ill children. This is true even for children at high risk of thrombosis where consensus guidelines recommend pharmacologic thromboprophylaxis. PMID:24351371

Clinical and Immune Responses to Inactivated Influenza A(H1N1)pdm09 Vaccine in Children

PubMed Central

Kotloff, Karen L.; Halasa, Natasha B.; Harrison, Christopher J.; Englund, Janet A.; Walter, Emmanuel B.; King, James C.; Creech, C. Buddy; Healy, Sara A.; Dolor, Rowena J.; Stephens, Ina; Edwards, Kathryn M.; Noah, Diana L.; Hill, Heather; Wolff, Mark

2014-01-01

Background As the influenza AH1N1 pandemic emerged in 2009, children were found to experience high morbidity and mortality and were prioritized for vaccination. This multicenter, randomized, double-blind, age-stratified trial assessed the safety and immunogenicity of inactivated influenza A(H1N1)pdm09 vaccine in healthy children aged 6 months to 17 years. Methods Children received two doses of approximately 15 μg or 30 μg hemagglutin antigen 21 days apart. Reactogenicity was assessed for 8 days after each dose, adverse events through day 42, and serious adverse events or new-onset chronic illnesses through day 201. Serum hemagglutination inhibition (HAI) titers were measured on days 0 (pre-vaccination), 8, 21, 29, and 42. Results A total of 583 children received the first dose and 571 received the second dose of vaccine. Vaccinations were generally well-tolerated and no related serious adverse events were observed. The 15 μg dosage elicited a seroprotective HAI (≥1:40) in 20%, 47%, and 93% of children in the 6-35 month, 3-9 year, and 10-17 year age strata 21 days after dose 1 and in 78%, 82%, and 98% of children 21 days after dose 2, respectively. The 30 μg vaccine dosage induced similar responses. Conclusions The inactivated influenza A(H1N1)pdm09 vaccine exhibited a favorable safety profile at both dosage levels. While a single 15 or 30 μg dose induced seroprotective antibody responses in most 10-17 year olds, younger children required 2 doses, even when receiving dosages 4-6 fold higher than recommended. Well-tolerated vaccines are needed that induce immunity after a single dose for use in young children during influenza pandemics. PMID:25222307

Proactive enteral tube feeding in pediatric patients undergoing chemotherapy.

PubMed

Sacks, Nancy; Hwang, Wei-Ting; Lange, Beverly J; Tan, Kay-See; Sandler, Eric S; Rogers, Paul C; Womer, Richard B; Pietsch, John B; Rheingold, Susan R

2014-02-01

To determine feasibility and safety of proactive enteral tube feeding (ETF) in pediatric oncology patients. Pediatric patients with newly diagnosed brain tumors, myeloid leukemia or high-risk solid tumors were eligible. Subjects agreeing to start ETF before cycle 2 chemotherapy were considered proactive participants (PPs). Those who declined could enroll as chart collection receiving nutritional standard of care. Nutritional status was assessed using standard anthropometric measurements. Episodes of infection and toxicity related to ETF were documented from diagnosis to end of therapy. A descriptive comparison between PPs and controls was conducted. One hundred four eligible patients were identified; 69 enrolled (20 PPs and 49 controls). At diagnosis, 17% of all subjects were underweight and 26% overweight. Barriers to enrollment included physician, subject and/or family refusal, and inability to initiate ETF prior to cycle 2 of chemotherapy. Toxicity of ETF was minimal, but higher percentage of subjects in the proactive group had episodes of infection than controls. Thirty-nine percent of controls eventually started ETF and were twice as likely to receive parenteral nutrition. PPs experienced less weight loss at ETF initiation than controls receiving ETF and were the only group to demonstrate improved nutritional status at end of study. Proactive ETF is feasible in children with cancer and results in improved nutritional status at end of therapy. Episodes of infection in this study are concerning; therefore, a larger randomized trial is required to further delineate infectious risks and toxicities that may be mitigated by improved nutritional status. © 2013 Wiley Periodicals, Inc.

The effect of different physiotherapy interventions in post-BTX-A treatment of children with cerebral palsy.

PubMed

Desloovere, K; De Cat, J; Molenaers, G; Franki, I; Himpens, E; Van Waelvelde, H; Fagard, K; Van den Broeck, C

2012-01-01

To distinguish the effects of different physiotherapeutic programs in a post BTX-A regime for children with Cerebral Palsy (CP). Retrospective, controlled intervention study. A group of 38 children (X¯ = 7y7m, GMFCS I-III, 27 bilateral, 11 unilateral CP) receiving an individually defined Neurodevelopment Treatment (NDT) program, was matched and compared to a group of children with the same age, GMFCS and diagnosis, receiving more conventional physiotherapy treatment. All patients received selective tone-reduction by means of multilevel BTX-A injections and adequate follow-up treatment, including physiotherapy. Three-dimensional gait analyses and clinical examination was performed pre and two months post-injection. Treatment success was defined using the Goal Attainment Scale (GAS). Both groups' mean converted GAS scores were above 50. The average converted GAS score was higher in the group of children receiving NDT than in the group receiving conventional physiotherapy (p < 0.05). In the NDT group, overall treatment success was achieved in 76% of the goals, compared to 67% of the goals defined for the conventional physiotherapy group. Especially for the goals based on gait analyses (p < 0.05) and in the group of children with bilateral CP (p < 0.05), treatment success was higher in the NDT group. In a post-BTX-A regime, the short-term effects of an NDT approach are more pronouncedthan these from a conventional physiotherapy approach. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Development of the SoFAS(solid fats and added sugars) concept: The 2010 Dietary Guidelines for Americans

USDA-ARS?s Scientific Manuscript database

The diets of most U.S. children and adults are poor, as reflected by low diet quality scores, when compared with the recommendations of the Dietary Guidelines for Americans (DGAs). Contributing to these low scores is that most Americans overconsume solid fats, which may contain saturated fatty acids...

Improvement of Rural Children's Asthma Self-Management by Lay Health Educators

ERIC Educational Resources Information Center

Horner, Sharon D.; Fouladi, Rachel T.

2008-01-01

Background: The purpose of the present analysis is to examine changes in rural children's asthma self-management after they received lay health educator (LHE)-delivered classes. Methods: Elementary schools were randomly assigned to the treatment or attention-control condition and their participating students received either asthma education or…

Reciprocity of Prosocial Behavior in Japanese Preschool Children

ERIC Educational Resources Information Center

Fujisawa, Keiko K.; Kutsukake, Nobuyuki; Hasegawa, Toshikazu

2008-01-01

This study investigated the reciprocity of prosocial behavior among 3- and 4-year-old Japanese preschool children during free-play time. Matrix correlation tests revealed positive correlations between the frequencies of object offering given and received within dyads and between the frequencies of helping given and received within dyads. These…

Children's Electrophysiological Responses to Music.

ERIC Educational Resources Information Center

Flohr, John W.; And Others

This study examined the electrophysiological differences between baseline EEG frequencies and EEG frequencies obtained while listening to music stimuli. The experimental group comprised 22 children, ages 4 to 6 years old, who received special music instruction twice a week for 25 minutes for 7 weeks. The control group received no music…

Is Enhanced Physical Activity Possible Using Active Videogames?

PubMed Central

Baranowski, Janice; O'Connor, Teresia; Lu, Amy Shirong; Thompson, Debbe

2012-01-01

Abstract Our research indicated that 10–12-year-old children receiving two active Wii™ (Nintendo®; Nintendo of America, Inc., Redmond, WA) console videogames were no more physically active than children receiving two inactive videogames. Research is needed on how active videogames may increase physical activity. PMID:24416640

Effects of an Integrated Physical Education/Music Program in Changing Early Childhood Perceptual-Motor Performance.

ERIC Educational Resources Information Center

Brown, Judy; And Others

1981-01-01

Two approaches to facilitating perceptual-motor development in children ages 4-6 were investigated. Fifteen children (the experimental group) received integrated physical education/music instruction based on Kodaly and Dalcroze (Eurhythmics) concepts. The control group received movement exploration and self-testing instruction. Significant…

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands.

PubMed

Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

2010-02-01

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified in 115 pharmacies and a questionnaire was sent to their stimulant prescribing physician. Of 773 questionnaires sent out, 556 were returned and were suitable for analysis (72%). The results are based on 510 questionnaires concerning stimulant-treated children for whom a diagnosis of ADHD was reported. Of the 510 children diagnosed with ADHD, 31% had also received one or more other psychiatric diagnoses, mainly pervasive developmental disorder or oppositional defiant disorder/conduct disorder. We found an association between the presence of co-morbidity and the use of psychosocial interventions for the child (P < 0.001) and the parents (P < 0.001). In the ADHD-only group, 26% did not receive any form of additional interventions, while psychosocial interventions varied from 8 to 18% in children with ADHD and psychiatric co-morbidity. The presence of diagnostic co-morbidity was also associated with the use of psychotropic co-medication (overall, P = 0.012) and antipsychotics (P < 0.001). Stimulant-treated youths with ADHD and psychiatric co-morbidity received more psychosocial interventions and psychotropic co-medication than children with ADHD-only. The type of psychosocial interventions and psychotropic co-medication received by the children and their parents, depended on the specific co-morbid psychiatric disorder being present.

The effect of orofacial myofunctional treatment in children with anterior open bite and tongue dysfunction: a pilot study

PubMed Central

Van Dyck, Claire; Dekeyser, Aline; Vantricht, Elien; Manders, Eric; Goeleven, Ann; Fieuws, Steffen

2016-01-01

Summary Objectives: Insufficient attention is given in the literature to the early treatment of anterior open bite (AOB) subjects receiving orofacial myofunctional therapy (OMT), which aims to harmonize the orofacial functions. This prospective pilot study investigates the effects of OMT on tongue behaviour in children with AOB and a visceral swallowing pattern. Materials and methods: The study comprised of 22 children (11 boys, 11 girls; age range: 7.1–10.6 years). They were randomly assigned into OMT and non-OMT subjects. The randomization was stratified on the presence of a transversal crossbite. At baseline (T0), at the end of treatment (T1) and at 6 months after T1 (T2) maximum tongue elevation strength was measured with the IOPI system (IOPI MEDICAL LLC, Redmond, Washington, USA). Functional characteristics such as tongue posture at rest, swallowing pattern and articulation and the presence of an AOB were observed. Results: OMT did significantly change tongue elevation strength, tongue posture at rest, and tongue position during swallowing of solid food. At T2 more OMT subjects had contact between the lower central incisors and their antagonists or palate (P = 0.036). More OMT subjects performed a physiological pattern of water swallowing than non-OMT children at T1 and T2, although the differences were not significant. Articulation of /s,l,n,d,t/ was not improved by OMT. No interaction between OMT and expansion was found for any of the parameters. Conclusion: OMT can positively influence tongue behaviour. However, further research is recommended to clarify the success of OMT as an adjunct to orthodontic treatment and to identify possible factors influencing the outcome. PMID:26136435

Child support and alimony: 1985 (supplemental report).

PubMed

Hanlon, R A

1989-03-01

This report on child support and alimony is based on data from the 1987 and 1986 US Current Population Surveys. As of spring 1986, 8.8 million mothers were living with children under 21 years of age whose fathers were not living in the household; 61%, or about 5.4 million, of these women were awarded or had an agreement to receive child support payments for their children as of the survey date. Of the 5.4 million women awarded child support, 4.4 million were supposed to receive child support for their children in 1985. Of those due payment, about half received the full amount they were due. Of the remaining women, there was no evidence of a difference between the proportion receiving partial payment and those receiving no payment at all--about 26% each. Of the 5.4 million women with awards for their children, 45% had health insurance included as part of the award. Of the 3.4 million women without child support awards, about half (48%) wanted but could not obtain awards for their children. The child support award rate reported in 1986 showed a slight increase from that of 1984 (up 2.2% to 58%). The proportion of women awarded child support payments in 1986 was higher for Whites (71%) than for Blacks (36%) or Hispanics (42%). Women with 4 or more years of college were more likely to have been awarded support payments (77%) than women with 4 years of high school (63%). The average (mean) amount of child support received in 1985 was $2200.

Asthma Action Plan Receipt among Children with Asthma 2-17 Years of Age, United States, 2002-2013.

PubMed

Simon, Alan E; Akinbami, Lara J

2016-04-01

To examine national trends in the receipt of asthma action plans, an intervention recommended by the National Asthma Education and Prevention Program guidelines. We used data from the sample child component of the National Health Interview Survey from 2002, 2003, 2008, and 2013 to examine the percentage of children 2-17 years of age with asthma (n = 3714) that have ever received an asthma action plan. Bivariate and multivariate (with adjustment for sociodemographic characteristics and asthma outcomes consistent with greater disease severity) logistic regressions were conducted to examine trends from 2002 to 2013 and to examine, with 2013 data only, the relationship between having received an asthma action plan and both sociodemographic characteristics and indicators of asthma severity. The percentage of children with asthma that had ever received an asthma action plan increased from 41.7% in 2002 to 50.7% in 2013 (P < .001 for trend). In 2013, a greater percentage of non-Hispanic black (58.4%) than non-Hispanic white (47.4%) children (P = .028), privately insured (56.2%) vs those with public insurance only (46.3%) (P = .016), and users of inhaled preventive asthma medication vs those that did not (P < .001) had ever received an asthma action plan. Adjusted results were similar. The percentage of US children with asthma that had ever received an asthma action plan increased between 2002 and 2013, although one-half had never received an asthma action plan in 2013. Some sociodemographic and asthma severity measures are related to receipt of an asthma action plan. Published by Elsevier Inc.

Association between Parental Access to Paid Sick Leave and Children's Access to and Use of Healthcare Services

PubMed Central

Asfaw, Abay; Colopy, Maria

2017-01-01

Background We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. Methods We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Results Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06–1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04–1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76–0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27–0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82–0.97] fewer ER visits per year. Conclusion PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. PMID:28169438

Outcome evaluation of clarithromycin, metronidazole and lansoprazole regimens in Helicobacter pylori positive or negative children with resistant otitis media with effusion.

PubMed

Mel-Hennawi, D; Ahmed, M R

2015-11-01

To compare the efficacy of two treatment regimens among Helicobacter pylori stool antigen positive children suffering from resistant otitis media with effusion. The study comprised 258 children with bilateral otitis media with effusion; 134 were positive for H pylori stool antigen, and were equally and randomly allocated to the control group or study group. The control group received standard otitis media with effusion therapy (amoxicillin and clavulanate), while the study group received standard H pylori triple therapy (clarithromycin, metronidazole and lansoprazole). In the control group, there was a marked clinical response to treatment in 33 of the 67 children (49.3 per cent). In the study group, there was a marked response in a significantly higher number of children (46 out of 67, 68.7 per cent). The 124 H pylori stool antigen negative children not included in the 2 aforementioned groups received amoxicillin and clavulanate, and a marked response in symptoms was evident in 98 of these children (79 per cent). H pylori infection may lead to resistance to traditional otitis media with effusion treatment in some cases. H pylori eradication is associated with a high cure rate.

H1N1 antibody persistence 1 year after immunization with an adjuvanted or whole-virion pandemic vaccine and immunogenicity and reactogenicity of subsequent seasonal influenza vaccine: a multicenter follow-on study.

PubMed

Walker, Woolf T; de Whalley, Philip; Andrews, Nick; Oeser, Clarissa; Casey, Michelle; Michaelis, Louise; Hoschler, Katja; Harrill, Caroline; Moulsdale, Phoebe; Thompson, Ben; Jones, Claire; Chalk, Jem; Kerridge, Simon; John, Tessa M; Okike, Ifeanyichukwu; Ladhani, Shamez; Tomlinson, Richard; Heath, Paul T; Miller, Elizabeth; Faust, Saul N; Snape, Matthew D; Finn, Adam; Pollard, Andrew J

2012-03-01

We investigated antibody persistence in children 1 year after 2 doses of either an AS03(B)-adjuvanted split-virion or nonadjuvanted whole-virion monovalent pandemic influenza vaccine and assessed the immunogenicity and reactogenicity of a subsequent dose of trivalent influenza vaccine (TIV). Children previously immunized at age 6 months to 12 years in the original study were invited to participate. After a blood sample was obtained to assess persistence of antibody against swine influenza A/H1N1(2009) pandemic influenza, children received 1 dose of 2010/2011 TIV, reactogenicity data were collected for 7 days, and another blood sample was obtained 21 days after vaccination. Of 323 children recruited, 302 received TIV. Antibody persistence (defined as microneutralization [MN] titer ≥1:40) 1 year after initial vaccination was significantly higher in the AS03(B)-adjuvanted compared with the whole-virion vaccine group, 100% (95% confidence interval [CI], 94.1%-100%) vs 32.4% (95% CI, 21.5%-44.8%) in children immunized <3 years old and 96.9% (95% CI, 91.3%-99.4%) vs 65.9% (95% CI, 55.3%-75.5%) in those 3-12 years old at immunization, respectively (P < .001 for both groups). All children receiving TIV had post-vaccination MN titers ≥1:40. Although TIV was well tolerated in all groups, reactogenicity in children <5 years old was slightly greater in those who originally received AS03(B)-adjuvanted vaccine. This study provides serological evidence that 2 doses of AS03(B)-adjuvanted pandemic influenza vaccine may be sufficient to maintain protection across 2 influenza seasons. Administration of TIV to children who previously received 2 doses of either pandemic influenza vaccine is safe and is immunogenic for the H1N1 strain.

H1N1 Antibody Persistence 1 Year After Immunization With an Adjuvanted or Whole-Virion Pandemic Vaccine and Immunogenicity and Reactogenicity of Subsequent Seasonal Influenza Vaccine: A Multicenter Follow-on Study

PubMed Central

Walker, Woolf T.; de Whalley, Philip; Andrews, Nick; Oeser, Clarissa; Casey, Michelle; Michaelis, Louise; Hoschler, Katja; Harrill, Caroline; Moulsdale, Phoebe; Thompson, Ben; Jones, Claire; Chalk, Jem; Kerridge, Simon; John, Tessa M.; Okike, Ifeanyichukwu; Ladhani, Shamez; Tomlinson, Richard; Heath, Paul T.; Miller, Elizabeth; Snape, Matthew D.; Finn, Adam; Pollard, Andrew J.

2012-01-01

Background. We investigated antibody persistence in children 1 year after 2 doses of either an AS03B-adjuvanted split-virion or nonadjuvanted whole-virion monovalent pandemic influenza vaccine and assessed the immunogenicity and reactogenicity of a subsequent dose of trivalent influenza vaccine (TIV). Methods. Children previously immunized at age 6 months to 12 years in the original study were invited to participate. After a blood sample was obtained to assess persistence of antibody against swine influenza A/H1N1(2009) pandemic influenza, children received 1 dose of 2010/2011 TIV, reactogenicity data were collected for 7 days, and another blood sample was obtained 21 days after vaccination. Results. Of 323 children recruited, 302 received TIV. Antibody persistence (defined as microneutralization [MN] titer ≥1:40) 1 year after initial vaccination was significantly higher in the AS03B-adjuvanted compared with the whole-virion vaccine group, 100% (95% confidence interval [CI], 94.1%–100%) vs 32.4% (95% CI, 21.5%–44.8%) in children immunized <3 years old and 96.9% (95% CI, 91.3%–99.4%) vs 65.9% (95% CI, 55.3%–75.5%) in those 3–12 years old at immunization, respectively (P < .001 for both groups). All children receiving TIV had post-vaccination MN titers ≥1:40. Although TIV was well tolerated in all groups, reactogenicity in children <5 years old was slightly greater in those who originally received AS03B-adjuvanted vaccine. Conclusions. This study provides serological evidence that 2 doses of AS03B-adjuvanted pandemic influenza vaccine may be sufficient to maintain protection across 2 influenza seasons. Administration of TIV to children who previously received 2 doses of either pandemic influenza vaccine is safe and is immunogenic for the H1N1 strain. PMID:22267719

[Causes of stopping subcutaneous specific immunotherapy in asthmatic children].

PubMed

Huang, Ya-Na; Huang, Ying; Dai, Ji-Hong; Yang, Fang-Fang

2012-09-01

To improve the compliance with subcutaneous specific immunotherapy (SCIT) by analyzing the causes of stopping SCIT in asthmatic children. A telephone follow-up was conducted in the asthmatic children who received SCIT but did not finished the 3-year course of treatment from June 2005 to October 2010, so as to analyze the causes of stopping SCIT. A total of 616 asthmatic children received SCIT, and 322 (52.2%) of them stopped SCIT.A total of 127 cases (39.4%) of the 322 children received telephone follow-up. In the 127 children, 53 (41.8%) stopped the SCIT for the reason of bad effecacy, 29 (22.8%) for remission of asthma,12 (9.4%) for expensive fees, 10 (7.9%) for complex process of treatment, 10 (7.9%) for adverse reaction, 9 (7.1%) for long distance from the hospital, and 4 (3.1%) for having no time for treatment. And 69 (54.3%) of them stopped SCIT in the first year, 28 (22.1%) in the second year, and 30 (23.6%) in the third year. Currently, 85 cases (66.9%) of the 127 asthmatic children were up to the control level, and the other 42 cases were not. There was significant difference in the control level of asthma berween the group receiving treatment with regular inhaled corticosteroids (ICS) and the group receiving treatment with irregular ICS (P<0.01). Bad efficacy, remission of asthma, expensive fees, complex process of treatment, and adverse reaction are the main reasons contributing to the stop of SCIT in asthmatic children. To improve the compliance with SCIT, It is important to make the patients and their parents understand the long treatment course and slow effect of SCIT, encourage them to use objective indices for evaluating the state of asthma, and effectively prevent and treat the adverse reactions.

Risk for Health Care-Associated Bloodstream Infections in Pediatric Oncology Patients With Various Malignancies.

PubMed

Thurman, Cara B; Abbott, Maura; Liu, Jinfang; Larson, Elaine

This was a retrospective cohort study to identify the rates, predictors, and outcomes of health care-associated bloodstream infections (HA-BSI) among children with solid tumors, lymphoma, lymphoid leukemia, and myeloid leukemia. The study population included 4500 children ≤18 years old at a pediatric hospital in New York City from 2006 to 2014. A total of 147 HA-BSI cases were identified; using multivariable logistic regression modeling, children with a hematologic diagnosis (lymphoma, lymphoid leukemia, myeloid leukemia) were at greater risk for HA-BSI than those with a solid tumor diagnosis (all P values <.0001). The odds of mortality for patients with HA-BSI were 6.98 (95% confidence interval 3.02-16.10) times that of those without HA-BSI. Although malignancy type was identified as risk factor for HA-BSI, there was no significant difference in overall mortality from HA-BSI by tumor type ( P = .51).

The Effectiveness of Self-regulatory Speech Training for Planning and Problem Solving in Children with Specific Language Impairment.

PubMed

Abdul Aziz, Safiyyah; Fletcher, Janet; Bayliss, Donna M

2016-08-01

Self-regulatory speech has been shown to be important for the planning and problem solving of children. Our intervention study, including comparisons to both wait-list and typically developing controls, examined the effectiveness of a training programme designed to improve self-regulatory speech, and consequently, the planning and problem solving performance of 87 (60 males, 27 females) children aged 4-7 years with Specific Language Impairment (SLI) who were delayed in their self-regulatory speech development. The self-regulatory speech and Tower of London (TOL) performance of children with SLI who received the intervention initially or after a waiting period was compared with that of 80 (48 male, 32 female) typically developing children who did not receive any intervention. Children were tested at three time points: Time 1- prior to intervention; Time 2 - after the first SLI group had received training and the second SLI group provided a wait-list control; and Time 3 - when the second SLI group had received training. At Time 1 children with SLI produced less self-regulatory speech and were impaired on the TOL relative to the typically developing children. At Time 2, the TOL performance of children with SLI in the first training group improved significantly, whereas there was no improvement for the second training group (the wait-list group). At Time 3, the second training group improved their TOL performance and the first group maintained their performance. No significant differences in TOL performance were evident between typically developing children and those with SLI at Time 3. Moreover, decreases in social speech and increases in inaudible muttering following self-regulatory speech training were associated with improvements in TOL performance. Together, the results show that self-regulatory speech training was effective in increasing self-regulatory speech and in improving planning and problem solving performance in children with SLI.

Prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results

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

Packer, R.J.; Sutton, L.N.; Atkins, T.E.

1989-05-01

As survival rates have risen for children with malignant primary brain tumors, so has the concern that many survivors have significant permanent cognitive deficits. Cranial irradiation (CRT) has been implicated as the major cause for cognitive dysfunction. To clarify the etiology, incidence, and severity of intellectual compromise in children with brain tumors after CRT, a prospective study was undertaken comparing the neuropsychological outcome in 18 consecutive children with malignant brain tumors treated with CRT to outcome in 14 children harboring brain tumors in similar sites in the nervous system who had not received CRT. Children with cortical or subcortical brainmore » tumors were not eligible for study. Neuropsychological testing was performed after surgery prior to radiotherapy, after radiotherapy, and at 1- and 2-year intervals thereafter. Children who had received CRT had a mean full-scale intelligence quotient (FSIQ) of 105 at diagnosis which fell to 91 by Year 2. Similar declines were noted in their performance intelligence quotient (IQ) and verbal IQ. After CRT, patients demonstrated a statistically significant decline from baseline in FSIQ (p less than 0.02) and verbal IQ (p less than 0.04). Children who had not received CRT did not demonstrate a fall in any cognitive parameter over time. The decline between baseline testing and testing performed at Year 2 in patients who had CRT was inversely correlated with age (p less than 0.02), as younger children demonstrated the greatest loss of intelligence. Children less than 7 years of age at diagnosis had a mean decline in FSIQ of 25 points 2 years posttreatment. No other clinical parameter correlated with the overall IQ or decline in IQ. After CRT, children demonstrated a wide range of dysfunction including deficits in fine motor, visual-motor, and visual-spatial skills and memory difficulties.« less

Prevalence of Café-au-Lait Spots in children with solid tumors

PubMed Central

dos Santos, Anna Claudia Evangelista; Heck, Benjamin; Camargo, Beatriz De; Vargas, Fernando Regla

2016-01-01

Abstract Cafe-au-lait maculae (CALM) are frequently observed in humans, and usually are present as a solitary spot. Multiple CALMs are present in a smaller fraction of the population and are usually associated with other congenital anomalies as part of many syndromes. Most of these syndromes carry an increased risk of cancer development. Previous studies have indicated that minor congenital anomalies may be more prevalent in children with cancer. We investigated the prevalence of CALMs in two samples of Brazilian patients with childhood solid tumors, totaling 307 individuals. Additionally, 176 school children without diagnosis of cancer, or of a cancer predisposing syndrome, were investigated for the presence of CALMs. The prevalence of solitary CALM was similar in both study groups (18% and 19%) and also in the group of children without cancer. Multiple CALMs were more frequently observed in one of the study groups (Z = 2.1). However, when both groups were analyzed together, the significance disappeared (Z = 1.5). The additional morphological abnormalities in children with multiple CALMs were analyzed and compared to the findings observed in the literature. The nosologic entities associated with CALMs are reviewed. PMID:27223488

Prevalence of Café-au-Lait Spots in children with solid tumors.

PubMed

Santos, Anna Claudia Evangelista Dos; Heck, Benjamin; Camargo, Beatriz De; Vargas, Fernando Regla

2016-05-24

Cafe-au-lait maculae (CALM) are frequently observed in humans, and usually are present as a solitary spot. Multiple CALMs are present in a smaller fraction of the population and are usually associated with other congenital anomalies as part of many syndromes. Most of these syndromes carry an increased risk of cancer development. Previous studies have indicated that minor congenital anomalies may be more prevalent in children with cancer. We investigated the prevalence of CALMs in two samples of Brazilian patients with childhood solid tumors, totaling 307 individuals. Additionally, 176 school children without diagnosis of cancer, or of a cancer predisposing syndrome, were investigated for the presence of CALMs. The prevalence of solitary CALM was similar in both study groups (18% and 19%) and also in the group of children without cancer. Multiple CALMs were more frequently observed in one of the study groups (Z = 2.1). However, when both groups were analyzed together, the significance disappeared (Z = 1.5). The additional morphological abnormalities in children with multiple CALMs were analyzed and compared to the findings observed in the literature. The nosologic entities associated with CALMs are reviewed.

Effects of a supplemental Spanish oral language program on sentence length, complexity, and grammaticality in Spanish-speaking children attending English-only preschools.

PubMed

Restrepo, M Adelaida; Castilla, Anny P; Schwanenflugel, Paula J; Neuharth-Pritchett, Stacey; Hamilton, Claire E; Arboleda, Alejandra

2010-01-01

The purpose of this study was to examine the effects of a supplemental Spanish language instruction program for children who spoke Spanish as their native language and were attending English-only preschool programs. Specifically, the study evaluated the program's effects on the children's Spanish sentence length in words, subordination index, and grammaticality of sentences. Forty-five Spanish-speaking children attending English-only prekindergarten classrooms were selected for study. Of those, 15 children received 30 min of Spanish instruction 5 days a week for 16 weeks. The program targeted 5-10 vocabulary words a week, dialogic book reading, phonemic awareness, and letter knowledge. The remaining 30 children participated in regular preschool English instruction. Students were evaluated before intervention, immediately after intervention, and 4 months following intervention. Repeated measures analyses of variance indicated that the children who received the small-group supplemental Spanish language instruction made significant gains in their Spanish sentence length in words and subordination index when compared to those receiving regular English-only classroom instruction. There were no differences in the children's grammaticality of sentences. The findings demonstrate that a daily short native language program has significant effects on sentence length in words and subordination index in English language learners who are attending English-only preschool programs.

The role of diverse instruction in conceptual change.

PubMed

Hayes, Brett K; Goodhew, Alison; Heit, Evan; Gillan, Joanna

2003-12-01

This study examined how a fundamental principle of induction and scientific reasoning, information diversity, could be used to promote change in children's mental models of the earth's shape. Six-year-old children (N=132) were randomly allocated to a control or to one of two training conditions. Some training groups received instruction that simultaneously challenged children's beliefs concerning (a) why the earth appears flat to a surface observer and (b) the role of gravity. Others received instruction that repeatedly challenged only one of these beliefs. An adaptation of the Vosniadou and Brewer (1992, Cognitive Psychology 24, 535-585) protocol for identifying mental models of the earth was administered before and after instruction. Both instruction methods produced increases in factual knowledge. Only children receiving instruction about two core beliefs, however, showed an increased rate of acceptance of a spherical earth model at posttest. The findings show that instruction that challenges diverse aspects of children's naïve scientific beliefs is more likely to produce conceptual change.

Language Profile in Congenital Hypothyroid Children Receiving Replacement Therapy.

PubMed

Soliman, Hend; Abdel Hady, Aisha Fawzy; Abdel Hamid, Asmaa; Mahmoud, Heba

2016-01-01

The aim of this work was to evaluate receptive and expressive language skills in children with congenital hypothyroidism receiving early hormonal replacement treatment before the age of 3 months and to identify any subtle areas of weaknesses in their language development to check the necessity for future language intervention. The study was conducted on 30 hypothyroid children receiving hormonal replacement. They were subdivided into group I (5-8 years 11 months; 12 cases) and group II (9-12 years 11 months; 18 cases). All patients were subjected to a protocol of assessment applied in the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU) and evaluation of language skills by the REAL scale. The younger group reached average Arabic language scores, while the older group showed moderate language delay. Early replacement therapy supports language development in young children. However, longitudinal and follow-up studies are required to identify difficulties presenting at older ages that may affect children in the academic settings. © 2016 S. Karger AG, Basel.

Phase I results of a phase I/II study of weekly nab-paclitaxel in paediatric patients with recurrent/refractory solid tumours: A collaboration with innovative therapies for children with cancer.

PubMed

Moreno, Lucas; Casanova, Michela; Chisholm, Julia C; Berlanga, Pablo; Chastagner, Pascal B; Baruchel, Sylvain; Amoroso, Loredana; Melcón, Soledad Gallego; Gerber, Nicolas U; Bisogno, Gianni; Fagioli, Franca; Geoerger, Birgit; Glade Bender, Julia L; Aerts, Isabelle; Bergeron, Christophe; Hingorani, Pooja; Elias, Ileana; Simcock, Mathew; Ferrara, Stefano; Le Bruchec, Yvan; Slepetis, Ruta; Chen, Nianhang; Vassal, Gilles

2018-06-21

nab-Paclitaxel has demonstrated efficacy in adults with solid tumours and preclinical activity in paediatric solid tumour models. Results from phase I of a phase I/II study in paediatric patients with recurrent/refractory solid tumours treated with nab-paclitaxel are reported. Patients with recurrent/refractory extracranial solid tumours received nab-paclitaxel on days 1, 8 and 15 every 4 weeks at 120, 150, 180, 210, 240, or 270 mg/m 2 (rolling-6 dose-escalation) to establish the maximum tolerated dose (MTD) and recommended phase II dose (RP2D). Sixty-four patients were treated. Dose-limiting toxicities were grade 3 dizziness at 120 mg/m 2 and grade 4 neutropenia >7 days at 270 mg/m 2 . The most frequent grade 3/4 adverse events were haematologic, including neutropenia (36%), leukopenia (36%) and lymphopenia (25%). Although the MTD was not reached, 270 mg/m 2 was declared non-tolerable due to grade 3/4 toxicities during cycles 1-2 (neutropenia, n = 5/7; skin toxicity, n = 2/7; peripheral neuropathy, n = 1/7). Of 58 efficacy-evaluable patients, complete response occurred in one patient (2%; Ewing sarcoma) and partial responses in four patients (7%; rhabdomyosarcoma, Ewing sarcoma, renal tumour with pulmonary metastases [high-grade, malignant] and sarcoma not otherwise specified); all responses occurred at ≥210 mg/m 2 . Thirteen patients (22%) had stable disease (5 lasting ≥16 weeks) per RECIST. nab-Paclitaxel 240 mg/m 2 qw3/4 (nearly double the adult recommended monotherapy dose for this schedule in metastatic breast cancer) was selected as the RP2D based on the tolerability profile, pharmacokinetics and antitumour activity. Phase II is currently enrolling patients with recurrent/refractory neuroblastoma, rhabdomyosarcoma and Ewing sarcoma. CLINICALTRIALS.GOV: NCT01962103. 2013-000144-26. Copyright © 2018 Elsevier Ltd. All rights reserved.

Worrying about one's children after breast cancer diagnosis: desired timing of psychosocial intervention.

PubMed

Stinesen Kollberg, Karin; Wilderäng, Ulrica; Möller, Anders; Steineck, Gunnar

2014-11-01

The purposes of this observational study were to analyze at what time point mothers desired psychosocial support regarding the worry about their children during the year after breast cancer diagnosis and to identify any psychosocial factors associated with this worry. In a population-based study, we analyzed data from 280 mothers diagnosed with breast cancer at Sahlgrenska University Hospital in Gothenburg, Sweden. Of those who did not receive chemotherapy treatment, 70 out of 112 women (63 %) reported a desire to receive support about the worry about their children, and of those who received chemotherapy treatment, 20 out of 49 (41 %) reported a need for support immediately following diagnosis and before surgery. We identified having children at home (P < 0.0001), worry about sex life (P = 0.0009), fear of dying from breast cancer (P = 0.0055), and worried about one's personal financial situation (P = 0.0413) as the variables most closely related to worry about the children. Our population-based study shows that mothers with breast cancer had an immediate desire to receive psychosocial support regarding the worry about their own children. If we wish to shorten the pain associated with this worry among women diagnosed with breast cancer, it may be helpful to offer support as early in the disease trajectory as possible as it may reduce the risk of a later, more complicated, unnecessarily prolonged psychosocial rehabilitation process.

Evaluation of a targeted cognitive-behavioral program for children with conduct problems--the SNAP Under 12 Outreach Project: service intensity, age and gender effects on short- and long-term outcomes.

PubMed

Koegl, Christopher J; Farrington, David P; Augimeri, Leena K; Day, David M

2008-07-01

This study tested the effectiveness of a multifaceted, cognitive-behavioral therapy (CBT) program for antisocial children--the SNAP Under 12 Outreach Project (ORP)--in relation to age, sex and indices of treatment intensity. Study participants were 80 clinic-referred children (59 boys and 21 girls) aged 6-11 years assigned to one of the following groups: control (CG; n = 14) who did not receive the ORP, matched (MG; n = 50) who received the ORP, and experimental (EG; n = 16) who received an enhanced version of the ORP. Results indicated significant pre-post changes for the EG and MG for Child Behavior Checklist (CBCL)-measured delinquency and aggression, but no improvement for the CG. Positive relationships between the number of individual ORP components (e.g. number of children's CBT sessions) received and CBCL change scores were also found. Statistical associations tended to be larger for girls and older children (i.e. 10-11 years old) who may have been more cognitively advanced. Also, the number of children's CBT sessions predicted later convictions, even after controlling for prior CBCL delinquency scores. Findings from this study support the effectiveness of the ORP, but also highlight the need to take into account client characteristics when offering clinical treatment.

Antipyretic effect of ibuprofen in Gabonese children with uncomplicated falciparum malaria: a randomized, double-blind, placebo-controlled trial

PubMed Central

Matsiégui, Pierre-Blaise; Missinou, Michel A; Necek, Magdalena; Mavoungou, Elie; Issifou, Saadou; Lell, Bertrand; Kremsner, Peter G

2008-01-01

Background Antipyretic drugs are widely used in children with fever, though there is a controversy about the benefit of reducing fever in children with malaria. In order to assess the effect of ibuprofen on fever compared to placebo in children with uncomplicated Plasmodium falciparum malaria in Gabon, a randomized double blind placebo controlled trial, was designed. Methods Fifty children between two and seven years of age with uncomplicated malaria were included in the study. For the treatment of fever, all patients "received" mechanical treatment when the temperature rose above 37.5°C. In addition to the mechanical treatment, continuous fanning and cooling blanket, patients were assigned randomly to receive ibuprofen (7 mg/kg body weight, every eight hours) or placebo. Results The fever clearance time using a fever threshold of 37.5°C was similar in children receiving ibuprofen compared to those receiving placebo. The difference was also not statistically significant using a fever threshold of 37.8°C or 38.0°C. However, the fever time and the area under the fever curve were significantly smaller in the ibuprofen group compared to the placebo group. Conclusion Ibuprofen is effective in reducing the time with fever. The effect on fever clearance is less obvious and depends on definition of the fever threshold. Trial registration The trial registration number is: NCT00167713 PMID:18503714

Language Comprehension in Language-Learning Impaired Children Improved with Acoustically Modified Speech

NASA Astrophysics Data System (ADS)

Tallal, Paula; Miller, Steve L.; Bedi, Gail; Byma, Gary; Wang, Xiaoqin; Nagarajan, Srikantan S.; Schreiner, Christoph; Jenkins, William M.; Merzenich, Michael M.

1996-01-01

A speech processing algorithm was developed to create more salient versions of the rapidly changing elements in the acoustic waveform of speech that have been shown to be deficiently processed by language-learning impaired (LLI) children. LLI children received extensive daily training, over a 4-week period, with listening exercises in which all speech was translated into this synthetic form. They also received daily training with computer "games" designed to adaptively drive improvements in temporal processing thresholds. Significant improvements in speech discrimination and language comprehension abilities were demonstrated in two independent groups of LLI children.

The potential of wood-based composite poles

Treesearch

Todd F. Shupe; Cheng Piao; Chung Y. Hse

2009-01-01

Wood-based composite utility poles are receiving increasing attention in the North American pole market. This interest is being driven by many increasing factors such as increasing: (1) disposal costs of solid wood poles, (2) liability and environmental concerns with traditional means of disposal of solid wood poles, (3) cost and concerns of long-term...

40 CFR Appendix I to Part 265 - Recordkeeping Instructions

Code of Federal Regulations, 2010 CFR

2010-07-01

... physical form, i.e., liquid, sludge, solid, or contained gas. If the waste is not listed in part 261..., solid filter cake from production of ___, EPA Hazardous Waste Number W051). Each hazardous waste listed... technique(s) used at the facility to treat, store or dispose of each quantity of hazardous waste received. 1...

Mothers' lived experiences of support when living with young children with congenital heart defects

PubMed Central

Bruce, Elisabeth; Lilja, Catrine; Sundin, Karin

2014-01-01

Purpose The purpose of this study was to illuminate the meanings of support as disclosed by mothers of children with congenital heart defects (CHD). Design and Method Narrative interviews were conducted with 10 mothers of children with CHD. A phenomenological-hermeneutic method was used for interpretation of the transcribed interviews. Results The comprehensive understanding of mothers' lived experiences of support emerged as the experiences of receiving good support, receiving “poor support,” and absence of support. Practice Implications Mothers receiving person-centered and family-centered care feel more supported and are more likely to adapt to the stresses of parenting a child with CHD. PMID:24124764

Usage of emergency medical services by children with special health care needs.

PubMed

Suruda, A; Vernon, D D; Diller, E; Dean, J M

2000-01-01

To describe the usage of emergency medical services (EMS) by children with special health care needs (CSHCN). All EMS runs and related hospital records for children aged 0-17 years in Utah in 1991-92 were linked. The CSHCN status was determined from ICD-9 diagnoses using three available definitions. The amounts of EMS usage were compared between CSHCN and other children. A pediatric intensive care practitioner determined CSHCN status by chart review for 915 children transported by EMS to a pediatric tertiary care hospital, and his classification was compared with the CSHCN status assigned by the three ICD-9-based definitions. The three definitions assigned CSHCN status for 2% to 24% of children using EMS. When compared with other children, CSHCN were more likely to be admitted to the hospital, more likely to use EMS for transfer between health care facilities, and more likely to receive prehospital procedures such as intravenous therapy. In the group of children whose charts were reviewed individually, one ICD-9-based definition most closely agreed to determination of CSHCN status by a pediatric intensive care practitioner. Children with special health care needs who use EMS are more likely to receive advanced life support service, to receive prehospital procedures, and to be transferred from one health care facility to another. There is need for a specific and measurable definition of CSHCN that can be applied to existing health data.

Randomised trial of biofeedback training for encopresis.

PubMed Central

van der Plas, R N; Benninga, M A; Redekop, W K; Taminiau, J A; Büller, H A

1996-01-01

AIMS: To evaluate biofeedback training in children with encopresis and the effect on psychosocial function. DESIGN: Prospective controlled randomised study. PATIENT INTERVENTIONS: A multimodal treatment of six weeks. Children were randomised into two groups. Each group received dietary and toilet advice, enemas, oral laxatives, and anorectal manometry. One group also received five biofeedback training sessions. MAIN OUTCOME MEASURES: Successful treatment was defined as less than two episodes of encopresis, regular bowel movements, and no laxatives. Psychosocial function after treatment was assessed using the Child Behaviour Checklist. RESULTS: Children given laxatives and biofeedback training had higher success rates than those who received laxatives alone (39% v 19%) at the end of the intervention period. At 12 and 18 months, however, approximately 50% of children in each group were successfully treated. Abnormal behaviour scores were initially observed in 35% of children. Most children had improved behaviour scores six months after treatment. Children with an initial abnormal behaviour score who were successfully treated had a significant improvement in their behavioural profiles. CONCLUSIONS: Biofeedback training had no additional effect on the success rate or behaviour scores. Psychosocial problems are present in a subgroup of children with encopresis. The relation between successful treatment and improvement in behavioural function supports the idea that encopresis has an aetiological role in the occurrence and maintenance of behavioural problems in children with encopresis. PMID:8957948

Pulverized fuel-oxygen burner

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

Taylor, Curtis; Patterson, Brad; Perdue, Jayson

A burner assembly combines oxygen and fuel to produce a flame. The burner assembly includes an oxygen supply tube adapted to receive a stream of oxygen and a solid fuel conduit arranged to extend through the oxygen tube to convey a stream of fluidized, pulverized, solid fuel into a flame chamber. Oxygen flowing through the oxygen supply tube passes generally tangentially through a first set of oxygen-injection holes formed in the solid fuel conduit and off-tangentially from a second set of oxygen-injection holes formed in the solid fuel conduit and then mixes with fluidized, pulverized, solid fuel passing through themore » solid fuel conduit to create an oxygen-fuel mixture in a downstream portion of the solid fuel conduit. This mixture is discharged into a flame chamber and ignited in the flame chamber to produce a flame.« less

Diarrhoea and child feeding practices in Saudi Arabia.

PubMed

Bani, Ibrahim Ahmed; Saeed, Abdallah Abdul Wahid; Othman, Abdul Aziz Mohammed Al

2002-12-01

The aim of the study was to estimate the prevalence of diarrhoea in children less than two years old and study the relationship between diarrhoeal episodes and action taken for these episodes by their mothers. The prevalence of diarrhoeal episodes among children and its associations with sociodemographic information and anthropometric measurements of the subjects was examined. Predictive factors for morbidity-associated diarrhoeal disease and actions taken for this were explored. Primary health care centres (PHCCs) in Riyadh, Kingdom of Saudi Arabia. Children less than two years of age. Nearly a quarter of the children contracted diarrhoea during the two weeks preceding the data collection point, giving about six episodes of diarrhoea per child per year. Diarrhoea was more common in children over 6 months of age, in children who had no vaccination or follow-up cards, and in those who were taken care of by friends and neighbours if their mothers were working outside the home. The mothers of the affected children were young, married before 25 years of age with 2-6 years of formal schooling. During diarrhoeal episodes, about 25% of mothers stopped or decreased breast-feeding, 11.3% reduced the volume of fluids given to their children, and 22.7% of children were fed less solid/semi-solid foods. Mothers used oral rehydration salt in more than 40% of diarrhoeal episodes and unprescribed antibiotics were used in 17% of cases. The mothers who were not taking appropriate action included young mothers with low education level and those working outside the home. Diarrhoea is common in children less than two years old in Riyadh City, and intervention based in PHCCs needs to be undertaken to correct the faulty practices of mothers during diarrhoeal episodes in their children. Health education messages should emphasise feeding during diarrhoeal episodes.

Process and system for removing impurities from a gas

DOEpatents

Henningsen, Gunnar; Knowlton, Teddy Merrill; Findlay, John George; Schlather, Jerry Neal; Turk, Brian S

2014-04-15

A fluidized reactor system for removing impurities from a gas and an associated process are provided. The system includes a fluidized absorber for contacting a feed gas with a sorbent stream to reduce the impurity content of the feed gas; a fluidized solids regenerator for contacting an impurity loaded sorbent stream with a regeneration gas to reduce the impurity content of the sorbent stream; a first non-mechanical gas seal forming solids transfer device adapted to receive an impurity loaded sorbent stream from the absorber and transport the impurity loaded sorbent stream to the regenerator at a controllable flow rate in response to an aeration gas; and a second non-mechanical gas seal forming solids transfer device adapted to receive a sorbent stream of reduced impurity content from the regenerator and transfer the sorbent stream of reduced impurity content to the absorber without changing the flow rate of the sorbent stream.

Solid fat and added sugar intake among U.S. children: The role of stores, schools, and fast food, 1994-2010.

PubMed

Poti, Jennifer M; Slining, Meghan M; Popkin, Barry M

2013-11-01

Little is known about the role of location in U.S. children's excess intake of energy from solid fat and added sugar, collectively referred to as SoFAS. The goal of this study was to compare the SoFAS content of foods consumed by children from stores, schools, and fast-food restaurants and to determine whether trends from 1994 to 2010 differ across these locations. Children aged 2-18 years (N=22,103) from five nationally representative surveys of dietary intake from 1994 to 2010 were studied. SoFAS content was compared across locations for total intake and key foods. Regression models were used to test and compare linear trends across locations. Data were analyzed in 2012. The mean percentage of total energy intake consumed from each location that was provided by SoFAS remained above recommendations, despite significant improvements between 1994 and 2010 at stores (1994, 38.3%; 2004, 33.2%); schools (1994, 38.7%; 2004, 31.2%); and fast-food restaurants (1994, 34.6%; 2004, 34.6%). For each key food, SoFAS content decreased significantly at stores and schools, yet progress at schools was comparatively slower. Milk was higher in SoFAS at schools compared to stores because of shifts toward flavored milk at schools. Schools provided french fries that were higher in solid fat than store-bought versions and pizza that was not significantly different in SoFAS content than fast-food pizza. However, schools made significantly greater progress for sugar-sweetened beverages, as lower-sugar beverages replaced regular sodas. Key fast foods showed little improvement. These findings can inform future strategies targeted to the specific locations and foods where continued progress is needed to reduce children's SoFAS consumption. © 2013 American Journal of Preventive Medicine.

Mothers' restrictive eating and food neophobia and fathers' dietary quality are associated with breast-feeding duration and introduction of solid foods: the STEPS study.

PubMed

Vaarno, Jenni; Niinikoski, Harri; Kaljonen, Anne; Aromaa, Minna; Lagström, Hanna

2015-08-01

The purpose of the present study was to examine the association between parental eating behaviours and dietary patterns and feeding practices of infants and young children. Data on infant-feeding practices were collected from each infant's birth via parentally self-administered follow-up diaries. Three questionnaires, the Three-Factor Eating Questionnaire, the Food Neophobia Scale and the Index of Diet Quality, were administered when the children were aged 4 and 13 months. South-western Finland. Families participating in the STEPS longitudinal cohort study (n 1797). Mean duration of exclusive breast-feeding was 2.4 months and total duration of breast-feeding averaged 8.1 months. The first solid food was introduced into children's diets at the age of 3.9 months, on average. Mothers with highly restrictive eating were more likely to introduce solid foods sooner than mothers who ranked lower in these behaviours (3.8 months v. 4.0 months, P = 0.012). Neophobic mothers breast-fed exclusively (2.0 v. 2.6 months, P = 0.038) and in total (7.2 v. 8.5 months, P = 0.039) for shorter times than average mothers, even after adjusting for various demographic characteristics. Fathers' diet quality was associated with total breast-feeding duration and with introduction of complementary foods in unadjusted analyses and with total breast-feeding duration also after adjusting for confounding factors. Mothers' and fathers' eating patterns and practices are associated with the feeding practices of infants and young children. Health promotion interventions seeking to improve parents' eating patterns might lead to more favourable feeding practices for infants and young children.

Morphometric analysis of abdominal organs and rib cage: Implication for risk of solid organ injuries in children.

PubMed

Harbaugh, Calista M; Shlykov, Maksim A; Tsuchida, Ryan E; Holcombe, Sven A; Hirschl, Jake; Wang, Stewart C; Ehrlich, Peter F

2015-06-01

Motor vehicle crashes are the leading cause of injury-related mortality in children, with a higher rate of multiorgan injuries than in adults. This may be related to increased solid organ volume relative to abdominal cavity and decreased protection of an underdeveloped cartilaginous rib cage in young children. To date, these anatomic relationships have not been fully described. Our study used analytic morphomics to obtain precise measures of the pediatric liver, spleen, kidneys, and ribs. This pilot study included 215 trauma patients (aged 0-18 years) with anonymized computed tomography (CT) scans. Liver, spleen, and kidney volumes were modeled using semiautomatic algorithms (MATLAB 2013a, MathWorks Inc., Natick, MA). Thirty-one scans were adequate to model the rib cage. Pearson's r was used to correlate absolute organ volume, fractional organ volume, and organ exposure with age and weight. Spleen, right and left kidney, and liver volumes increased with age and weight (p < 0.01). Right/left kidney and liver fractional volumes decreased with age (p < 0.01), whereas spleen fractional volume remained relatively constant. Exposed surface area of the liver only significantly decreased with age in the anterior (p < 0.01), right (p < 0.01), and posterior views (p = 0.02). With this study, we have demonstrated the ability to model solid organ and rib cage anatomy of children using cross-sectional imaging. In younger children, there may be a decrease in fractional organ volume and increase in liver surface exposure, although analysis of a larger sample size is warranted. In the future, this information may be used to improve the design of safety restraints in motor vehicles.

Infant feeding in relation to islet autoimmunity and type 1 diabetes in genetically susceptible children: the MIDIA Study.

PubMed

Lund-Blix, Nicolai A; Stene, Lars C; Rasmussen, Trond; Torjesen, Peter A; Andersen, Lene F; Rønningen, Kjersti S

2015-02-01

We aimed to study the association of breast-feeding duration and age at the introduction of solid foods with the risk of islet autoimmunity and type 1 diabetes in genetically susceptible children. Newborns were recruited from the Norwegian general population during 2001-2007. After genetic screening of nearly 50,000 newborns, 908 children with the high-risk HLA genotype were followed up with blood samples and questionnaires at age 3, 6, 9, and 12 months and then annually. Complete infant diet data were available for 726 children. Any breast-feeding for 12 months or longer predicted a decreased risk of developing type 1 diabetes compared with any breast-feeding for less than 12 months before and after adjusting for having a first-degree relative with type 1 diabetes, vitamin D supplementation, maternal education, sex, and delivery type (hazard ratio 0.37 [95% CI 0.15-0.93]). Any breast-feeding for 12 months or longer was not associated with islet autoimmunity but predicted a lower risk of progression from islet autoimmunity to type 1 diabetes (hazard ratio 0.35 [95% CI 0.13-0.94]). Duration of full breast-feeding was not significantly associated with the risk of islet autoimmunity or type 1 diabetes nor was age at introduction of solid foods or breast-feeding at the time of introduction of any solid foods. These results suggest that breast-feeding for 12 months or longer predict a lower risk of progression from islet autoimmunity to type 1 diabetes among genetically predisposed children. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Electronically shielded solid state charged particle detector

DOEpatents

Balmer, D.K.; Haverty, T.W.; Nordin, C.W.; Tyree, W.H.

1996-08-20

An electronically shielded solid state charged particle detector system having enhanced radio frequency interference immunity includes a detector housing with a detector entrance opening for receiving the charged particles. A charged particle detector having an active surface is disposed within the housing. The active surface faces toward the detector entrance opening for providing electrical signals representative of the received charged particles when the received charged particles are applied to the active surface. A conductive layer is disposed upon the active surface. In a preferred embodiment, a nonconductive layer is disposed between the conductive layer and the active surface. The conductive layer is electrically coupled to the detector housing to provide a substantially continuous conductive electrical shield surrounding the active surface. The inner surface of the detector housing is supplemented with a radio frequency absorbing material such as ferrite. 1 fig.

Electronically shielded solid state charged particle detector

DOEpatents

Balmer, David K.; Haverty, Thomas W.; Nordin, Carl W.; Tyree, William H.

1996-08-20

An electronically shielded solid state charged particle detector system having enhanced radio frequency interference immunity includes a detector housing with a detector entrance opening for receiving the charged particles. A charged particle detector having an active surface is disposed within the housing. The active surface faces toward the detector entrance opening for providing electrical signals representative of the received charged particles when the received charged particles are applied to the active surface. A conductive layer is disposed upon the active surface. In a preferred embodiment, a nonconductive layer is disposed between the conductive layer and the active surface. The conductive layer is electrically coupled to the detector housing to provide a substantially continuous conductive electrical shield surrounding the active surface. The inner surface of the detector housing is supplemented with a radio frequency absorbing material such as ferrite.

The Quality Rating System of Chinese Preschool Education: Prospects and Challenges

ERIC Educational Resources Information Center

Hu, Bi Ying; Li, Kejian

2012-01-01

In China, the Central People's Government (2010) recently promulgated the "Compendium for China's Mid- and Long-Term Education Development," which declared that 95% of Chinese children should receive at least one year of preschool education, while 75% of children should receive a three-year preschool education by 2020. Subsequently, The…

The Experiences of School Nurses Caring for Students Receiving Continuous Subcutaneous Insulin Infusion Therapy

ERIC Educational Resources Information Center

Darby, Wendy

2006-01-01

Diabetes mellitus is the most common metabolic disorder in childhood. Today, children with diabetes are receiving new technologically advanced treatment options, such as continuous subcutaneous insulin infusion (CSII) therapy. School nurses are the primary health caregivers of children with diabetes during school hours. Therefore, it is important…

Distributional Effects of Educational Improvements: Are We Using the Wrong Model?

ERIC Educational Resources Information Center

Bourguignon, Francois; Rogers, F. Halsey

2007-01-01

Measuring the incidence of public spending in education requires an intergenerational framework distinguishing between what current and future generations--that is, parents and children--give and receive. In standard distributional incidence analysis, households are assumed to receive a benefit equal to what is spent on their children enrolled in…

An Evaluation of Resurgence during Functional Communication Training

ERIC Educational Resources Information Center

Wacker, David P.; Harding, Jay W.; Morgan, Theresa A.; Berg, Wendy K.; Schieltz, Kelly M.; Lee, John F.; Padilla, Yaniz C.

2013-01-01

Three children who displayed destructive behavior maintained by negative reinforcement received functional communication training (FCT). During FCT, the children were required to complete a demand and then to mand (touch a card attached to a microswitch, sign, or vocalize) to receive brief play breaks. Prior to and 1 to 3 times following the…

Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

ERIC Educational Resources Information Center

Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

2014-01-01

Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

First Permanent Molar Restoration Differences between Those with or without Dental Sealants.

ERIC Educational Resources Information Center

Kuthy, Raymond A.; And Others

1990-01-01

The study examined differences in the number of restorations in permanent, posterior teeth for those children receiving dental sealants with cost sharing when compared to children who do not receive sealants. Results indicated a 51 percent reduction in restoration rates for each quadrant sealed. Findings have implications for cost savings and…

Psychological wellbeing, physical impairments and rural aging in a developing country setting.

PubMed

Abas, Melanie A; Punpuing, Sureeporn; Jirapramupitak, Tawanchai; Tangchonlatip, Kanchana; Leese, Morven

2009-07-16

There has been very little research on wellbeing, physical impairments and disability in older people in developing countries. A community survey of 1147 older parents, one per household, aged sixty and over in rural Thailand. We used the Burvill scale of physical impairment, the Thai Psychological Wellbeing Scale and the brief WHO Disability Assessment Schedule. We rated received and perceived social support separately from children and from others and rated support to children. We used weighted analyses to take account of the sampling design. Impairments due to arthritis, pain, paralysis, vision, stomach problems or breathing were all associated with lower wellbeing. After adjusting for disability, only impairment due to paralysis was independently associated with lowered wellbeing. The effect of having two or more impairments compared to none was associated with lowered wellbeing after adjusting for demographic factors and social support (adjusted difference -2.37 on the well-being scale with SD = 7.9, p < 0.001) but after adjusting for disability the coefficient fell and was non-significant. The parsimonious model for wellbeing included age, wealth, social support, disability and impairment due to paralysis (the effect of paralysis was -2.97, p = 0.001). In this Thai setting, received support from children and from others and perceived good support from and to children were all independently associated with greater wellbeing whereas actual support to children was associated with lower wellbeing. Low received support from children interacted with paralysis in being especially associated with low wellbeing. In this Thai setting, as found in western settings, most of the association between physical impairments and lower wellbeing is explained by disability. Disability is potentially mediating the association between impairment and low wellbeing. Received support may buffer the impact of some impairments on wellbeing in this setting. Giving actual support to children is associated with less wellbeing unless the support being given to children is perceived as good, perhaps reflecting parental obligation to support adult children in need. Improving community disability services for older people and optimizing received social support will be vital in rural areas in developing countries.

Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study.

PubMed

van den Hooven, Edith H; Gharsalli, Mounira; Heppe, Denise H M; Raat, Hein; Hofman, Albert; Franco, Oscar H; Rivadeneira, Fernando; Jaddoe, Vincent W V

2016-03-28

Breast-feeding has been associated with later bone health, but results from previous studies are inconsistent. We examined the associations of breast-feeding patterns and timing of introduction of solids with bone mass at the age of 6 years in a prospective cohort study among 4919 children. We collected information about duration and exclusiveness of breast-feeding and timing of introduction of any solids with postnatal questionnaires. A total body dual-energy X-ray absorptiometry scan was performed at 6 years of age, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC) and bone area (BA) were analysed. Compared with children who were ever breast-fed, those never breast-fed had lower BMD (-4·62 mg/cm2; 95 % CI -8·28, -0·97), BMC (-8·08 g; 95 % CI -12·45, -3·71) and BA (-7·03 cm2; 95 % CI -12·55, -1·52) at 6 years of age. Among all breast-fed children, those who were breast-fed non-exclusively in the first 4 months had higher BMD (2·91 mg/cm2; 95 % CI 0·41, 5·41) and aBMC (3·97 g; 95 % CI 1·30, 6·64) and lower BA (-4·45 cm2; 95 % CI -8·28, -0·61) compared with children breast-fed exclusively for at least 4 months. Compared with introduction of solids between 4 and 5 months, introduction <4 months was associated with higher BMD and aBMC, whereas introduction between 5 and 6 months was associated with lower aBMC and higher BA. Additional adjustment for infant vitamin D supplementation did not change the results. In conclusion, results from the present study suggest that ever breast-feeding compared with never breast-feeding is associated with higher bone mass in 6-year-old children, but exclusive breast-feeding for 4 months or longer was not positively associated with bone outcomes.

Going to School with Madame Curie and Mr. Einstein: Gender Roles in Children's Science Biographies

ERIC Educational Resources Information Center

Owens, Trevor

2009-01-01

One of the first places children encounter science and scientists is children's literature. Children's books about science and scientists have, however, received limited scholarly attention. By exploring the history of children's biographies of Marie Curie and Albert Einstein, the two most written about scientist in children's literature, this…

Social Status and Self-Esteem: Children with ADHD and Their Peers.

ERIC Educational Resources Information Center

Stewart, Jennifer; Buggey, Tom

This study compared the social status and self-esteem of 8 third grade children with attention deficit hyperactivity disorder, 2 children with attention deficit disorder (ADD) alone, and 26 children without the disorders, in light of hypothesized effects of perceived negative feedback received by these children from peers. The children nominated…

Embracing Jewish Day School Education in England, 1965-1979

ERIC Educational Resources Information Center

Mendelsson, David

2009-01-01

Between 1965 and 1979 the demand for places at Jewish day schools in England rose dramatically. In the preceding decades, most parents sent their children to state non-denominational schools, showing little interest in providing their children with a solid Jewish education. Sunday or after-school Hebrew classes, rarely extending beyond Bar/Bat…

Teaching Young Children with ADHD: Successful Strategies and Practical Interventions for PreK-3

ERIC Educational Resources Information Center

Lougy, Richard A.; DeRuvo, Sylvia L.; Rosenthal, David

2007-01-01

This resource provides general education teachers with a solid understanding of Attention Deficit Hyperactivity Disorder (ADHD), detailed descriptions of how it manifests in preschool and the primary grades, and research-based approaches for designing and adapting instruction to meet the needs of all young children. Together, the authors offer…

Developing food supplements for moderately malnourished children: Lessons learned from ready-to-use therapeutic foods

USDA-ARS?s Scientific Manuscript database

Ready-to-use therapeutic foods (RUTFs) are solid foods that were developed by changing the formulation of the existing liquid diet, F-100, recommended by the World Health Organization (WHO) for the rapid catch-up phase of the treatment of children suffering from severe acute malnutrition (SAM). The ...

Play Therapy Practices among Elementary School Counselors

ERIC Educational Resources Information Center

Ray, Dee C.; Armstrong, Stephen A.; Warren, E. Scott; Balkin, Richard S.

2005-01-01

When elementary school counselors have a solid developmental understanding of children, play therapy might be one counseling intervention that they use with their students. Landreth (2002) has promoted the use of play therapy in schools by explaining that its objective is to help children get ready to profit from what teachers have to offer. Play…

Application of low-level laser radiation in children's oncology with complications caused by chemoradiation

NASA Astrophysics Data System (ADS)

Balakirev, S. A.; Gusev, L. I.; Grabovschiner, A. A.; Khristoforov, V. N.; Ivanova, J. V.; Shyshkova, E. I.

1999-12-01

The present work is based on a 12 month clinical observation period of 155 patients aged from 6 months to 15 years with multiple complications after chemoradiant treatment of hemoblastos and solid tumors. The application of Magnetic Infrared Laser therapy for different complications caused by chemoradiation treatment of children's malignant tumors is an entirely new method and for the first time has been tried in children's oncology.

Phase I study of single-agent ribociclib in Japanese patients with advanced solid tumors.

PubMed

Doi, Toshihiko; Hewes, Becker; Kakizume, Tomoyuki; Tajima, Takeshi; Ishikawa, Norifumi; Yamada, Yasuhide

2018-01-01

The cyclin D-CDK4/6-INK4-Rb pathway is frequently dysregulated in cancers. Ribociclib, an orally available, selective CDK4/6 inhibitor, showed preliminary clinical activity in a phase I study in the USA and Europe for patients with solid tumors and lymphomas. The present study aimed to determine the single-agent maximum tolerated dose (MTD) and recommended dose for expansion (RDE) in Japanese patients with advanced solid tumors. Ribociclib safety, tolerability, pharmacokinetic profile, and preliminary antitumor activity were also assessed. Japanese patients with solid tumors that had progressed on prior therapies received escalating doses of single-agent ribociclib on a 3-weeks-on/1-week-off schedule. Treatment continued until the development of toxicity or disease progression. A dose escalation was planned for patients with esophageal cancer. In the dose-escalation phase, 4 patients received 400 mg ribociclib and 13 patients received 600 mg ribociclib. Four patients experienced dose-limiting toxicities, 3 of whom were in the 600 mg group. The RDE was declared to be 600 mg, and the MTD was not determined. The most frequent adverse events were hematologic and gastrointestinal. Four patients achieved stable disease at the 600 mg dose; no patients achieved complete or partial response. All patients discontinued the study, the majority due to disease progression. No patients discontinued due to adverse events. Dose escalation was not pursued due to lack of observed efficacy in esophageal cancer. At the RDE of 600 mg/d on a 3-weeks-on/1-week-off schedule, ribociclib showed acceptable safety and tolerability profiles in Japanese patients with advanced solid tumors. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Supplemental Security Income Benefits for Mental Disorders.

PubMed

Perrin, James M; Houtrow, Amy; Kelleher, Kelly; Hoagwood, Kimberly; Stein, Ruth E K; Zima, Bonnie

2016-07-01

The Supplemental Security Income Program (SSI) provides financial support to low-income households with children and youth with severe disabilities. The program included children when it began in the early 1970s. The numbers of children receiving SSI benefits increased substantially in the early 1990s, in part through an expansion of the listings of mental health conditions with which children could become eligible. Over the past 20 years, larger numbers of children have received SSI benefits for mental disorders, and these increases have led to questions from the press and Congress regarding these numbers. Do they indicate more of an increase in mental disorders among SSI children than in the general population? The National Academy of Medicine (NAM; formerly the Institute of Medicine) convened a study panel to examine what is known about mental disorders among the child SSI population and how that compares with evidence about mental disorders in children in general. The NAM report provides detailed information about how SSI works, about the changing numbers of children receiving SSI for mental disorders, and some comparisons with other evidence about rising rates of mental disorders in the general population and especially among children living in poverty. The report indicates that increasing numbers of children with mental disorders in SSI mirror similar increases in the population in general. This article summarizes key evidence from the NAM report and suggests the implications for pediatricians. Copyright © 2016 by the American Academy of Pediatrics.

Vitamin D supplementation: we must not fail our children!

PubMed

Drury, Rosalyn; Rehm, Andreas; Johal, Simran; Nadler, Robert

2015-05-01

There is increasing concern that vitamin D deficiency poses a major health problem for children. Deficiency can cause hypocalcemic seizures, growth disturbances, and rickets and may influence diabetes, cardiovascular dysfunction, autoimmune diseases, and attention deficit hyperactivity disorders. Reduced vitamin D levels in children presenting to pediatric orthopedic services are common.In the United Kingdom, recommendations on vitamin D supplementation are set by the Department of Health (DoH) and the National Institute of Health and Clinical Excellence. These state that all children aged 6 months to 5 years ought to receive 7 to 8.5 μg of vitamin D daily.We carried out a survey of 203 parents attending our pediatric and pediatric orthopedic and fracture clinics to evaluate parental awareness of the DoH recommendations on vitamin D supplementation for children and to assess the extent to which children were receiving vitamin D supplements.About 85.71% of parents were not aware of the recommendations. Only 14.29% stated that they were aware of the benefits of vitamin D for their children and just 17.73% of children were receiving vitamin D supplementation; 17 via formula milk and 18 via multivitamin formulations.Parents are generally not aware about vitamin D supplementation because of a lack of information with the high rates of reported suboptimal vitamin D levels amongst children not being addressed resulting in increased health risks to our children. Major improvements are needed in the implementation of supplementation at all points of contact between parents and health-care professionals.

Representational Momentum and Children's Sensori-Motor Representations of Objects

ERIC Educational Resources Information Center

Perry, Lynn K.; Smith, Linda B.; Hockema, Stephen A.

2008-01-01

Recent research has shown that 2-year-olds fail at a task that ostensibly only requires the ability to understand that solid objects cannot pass through other solid objects. Two experiments were conducted in which 2- and 3-year-olds judged the stopping point of an object as it moved at varying speeds along a path and behind an occluder, stopping…

Changing Waste in Changing Times: Solid Waste and Natural Resource Issues in Rural Alaska--A Teacher's Guide.

ERIC Educational Resources Information Center

Moses, Shirley

This guide was developed to present activities which inform the teacher and students of solid waste management problems that are becoming commonplace in villages. The lessons included present alternatives for taking care of the environment and contains methods to make not only school children more sensitive to environmental problems, but hopefully…

Receiver calibration and the nonlinearity parameter measurement of thick solid samples with diffraction and attenuation corrections.

PubMed

Jeong, Hyunjo; Barnard, Daniel; Cho, Sungjong; Zhang, Shuzeng; Li, Xiongbing

2017-11-01

This paper presents analytical and experimental techniques for accurate determination of the nonlinearity parameter (β) in thick solid samples. When piezoelectric transducers are used for β measurements, the receiver calibration is required to determine the transfer function from which the absolute displacement can be calculated. The measured fundamental and second harmonic displacement amplitudes should be modified to account for beam diffraction and material absorption. All these issues are addressed in this study and the proposed technique is validated through the β measurements of thick solid samples. A simplified self-reciprocity calibration procedure for a broadband receiver is described. The diffraction and attenuation corrections for the fundamental and second harmonics are explicitly derived. Aluminum alloy samples in five different thicknesses (4, 6, 8, 10, 12cm) are prepared and β measurements are made using the finite amplitude, through-transmission method. The effects of diffraction and attenuation corrections on β measurements are systematically investigated. When diffraction and attenuation corrections are all properly made, the variation of β between different thickness samples is found to be less than 3.2%. Copyright © 2017 Elsevier B.V. All rights reserved.

Improved quality of life at end of life related to home-based palliative care in children with cancer.

PubMed

Friedrichsdorf, Stefan J; Postier, Andrea; Dreyfus, Jill; Osenga, Kaci; Sencer, Susan; Wolfe, Joanne

2015-02-01

Nearly 2000 children die due to a malignancy in the United States annually. Emerging data suggest that home is the desired location of care for children with cancer at end of life. However, one obstacle to enrollment in a pediatric palliative care (PPC) home care program may be fear that distressing symptoms at end of life cannot be adequately managed outside the hospital. To compare the symptom distress and quality-of-life experience for children who received concurrent end-of-life care from a PPC home care program (PPC/Oncology) with that of those who died without exposure to the PPC program (Oncology). We conducted a retrospective survey study of a cohort of bereaved parents of children who died of cancer between 2002 and 2008 at a U.S. tertiary pediatric institution. Sixty bereaved parents were surveyed (50% PPC/Oncology). Prevalence of constipation and high distress from fatigue were more common in the PPC/Oncology group; other distressing symptoms were similar between groups, showing room for improvement. Children who received PPC/Oncology were significantly more likely to have fun (70% versus 45%), to experience events that added meaning to life (89% versus 63%), and to die at home (93% versus 20%). This is the first North American study to assess outcomes among children with cancer who received concurrent oncology and palliative home care compared with those who received oncology care alone. Symptom distress experiences were similar in groups. However, children enrolled in a PPC home care program appear to have improved quality of life and are more likely to die at home.

Mobility Status as a Predictor of Obesity, Physical Activity, and Screen Time Use among Children Aged 5-11 Years in the United States.

PubMed

Wilson, Patrick B; Haegele, Justin A; Zhu, Xihe

2016-09-01

To examine physical activity participation, screen time habits, and the prevalence of overweight/obesity among children in the general population with mobility limitations and those enrolled in special education services. An observational, cross-sectional analysis of the 2011-2014 National Health and Nutrition Examination Survey, a representative sample of the US population. Mobility limitations, special education services utilization, proxy-reported physical activity and screen time, and overweight/obesity status were assessed in children aged 5-11 years. Boys with mobility limitations were less likely to meet physical activity guidelines (≥60 minutes daily) compared with those with no limitations (58.1% vs 74.4%, adjusted F = 4.61, P = .04). In a logistic regression model, boys with mobility limitations had significantly lower odds (0.42, 95% CI 0.20-0.86) of meeting physical activity guidelines. The prevalence of children meeting screen time recommendations (≤2 hours daily) among those receiving special education services (42.4%) was lower than children not receiving services (53.2%; adjusted F = 8.87, P < .01). In a logistic regression model, children receiving special education services showed a trend toward significantly lower odds (0.74, 95% CI 0.54-1.03, P = .07) of meeting screen time recommendations. No statistically significant differences for overweight/obesity were found. Clear differences were present in physical activity between boys with and without mobility limitations. Furthermore, children receiving special education services demonstrated a lower likelihood of meeting screen time recommendations. Children with disabilities may benefit from targeted interventions aimed at increasing physical activity while decreasing screen time. Copyright © 2016 Elsevier Inc. All rights reserved.

Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation

PubMed Central

Sung, Lillian; Robinson, Paula; Treister, Nathaniel; Baggott, Tina; Gibson, Paul; Tissing, Wim; Wiernikowski, John; Brinklow, Jennifer; Dupuis, L Lee

2017-01-01

Purpose To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0–18 years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). Methods The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria: cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. Results We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest KGF may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. Conclusions All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted. PMID:25818385

Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation.

PubMed

Sung, Lillian; Robinson, Paula; Treister, Nathaniel; Baggott, Tina; Gibson, Paul; Tissing, Wim; Wiernikowski, John; Brinklow, Jennifer; Dupuis, L Lee

2017-03-01

To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0-18 years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria: cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest KGF may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Ondansetron Oral Dissolve Tab vs. Oral Solution in Children Presenting to the Emergency Department with Gastroenteritis.

PubMed

Thompson, Graham C; Morrison, Ellen L; Chaulk, David; Wobma, Holly; Kwong, Simon; Johnson, David W

2016-11-01

Ondansetron is often used in the emergency department (ED) to promote oral rehydration in children with acute gastroenteritis (AGE), yet medication solutions administered orally may be poorly tolerated in this population. We compared the tolerability of ondansetron oral dissolve tab (ODT) to oral solution (OS) in children presenting to the ED with AGE. Using alternate-day controlled clinical trial design, children aged 3 months to 10 years received either ondansetron ODT or OS. Our primary outcome was early vomiting (within 15 min of drug administration). The secondary outcome was intravenous (i.v.) fluid administration. There were 462/534 eligible children who met study criteria. Demographics, severity, and duration of illness were similar between groups. Using intention-to-treat analysis, early vomiting occurred in 8/209 ODT vs. 19/253 OS children (3.8% vs. 7.5%; odds ratio [OR] 0.49; 95% confidence interval [CI] 0.18-1.21). Using as-treated analysis, 6/222 (2.7%) children receiving ODT experienced early vomiting, compared with 21/221 (9.5%) of the OS group (OR 0.26; 95% CI 0.09-0.70). The proportion of children discharged without i.v. fluids was not different (intention-to-treat: ODT = 91.4% (191/209), OS = 94.1% (238/253), OR 1.49, 95% CI 0.69-3.28; as-treated: ODT = 92.3% (205/222), OS = 93.2% (206/221), OR 0.88, 95% CI 0.40-1.93). Using a conservative intention-to-treat analysis, we found that children presenting to an ED with AGE did not have statistically less early vomiting with ondansetron ODT as compared with OS. However, our as-treated analysis demonstrates that children receiving ondansetron ODT experienced early vomiting approximately one-third as often as those receiving OS. The rate of i.v. fluid administration was no different between groups regardless of the type of analysis used. Copyright © 2016 Elsevier Inc. All rights reserved.

Who gets severe gynaecomastia among HIV-infected children in the UK and Ireland?

PubMed Central

Kenny, Julia; Doerholt, Katja; Gibb, Di M.; Judd, Ali

2018-01-01

Unstructured Abstract There are few data on gynaecomastia in HIV-infected children. Within the UK/Ireland’s national cohort, 56/1,873 (3%) HIV-infected children had gynaecomastia, of which 10 (0.5%) were severe. All 10 had received antiretroviral therapy for median 27.5 [21,42] months. 4/10 had received efavirenz, 7/10 and 6/10 stavudine and/or didanosine respectively. Five were non-reversible, despite changing ART, and required breast reduction surgery. PMID:27879556

School children's use of computers and teachers' education in computer ergonomics.

PubMed

Dockrell, S; Fallon, E; Kelly, M; Masterson, B; Shields, N

2007-10-01

A national survey to investigate the education of teachers in computer-related ergonomics was carried out by postal questionnaire. The use of computers by primary school children (age 4-12 years) was also investigated. Data were collected from a random sample of 25% (n = 830) of primary schools in the Republic of Ireland. Questionnaires (n = 1863) were returned from 416 schools giving a response rate of 50.1%. Almost all schools (99.7%) had computers for children's use. The computers were most often (69.8%) used in the classroom. The majority (56.3%) of children worked in pairs. Most teachers (89.6%) had received computer training, but few (17.6%) had received ergonomics information during the training. Respondents were not satisfied with their current knowledge of ergonomics. Over 90% stated that they would like to receive further information by printed format or during a training course, rather than by computer (web or CD-ROM).

Quality of Inpatient Pediatric Case Management for Four Leading Causes of Child Mortality at Six Government-Run Ugandan Hospitals

PubMed Central

Sears, David; Mpimbaza, Arthur; Kigozi, Ruth; Sserwanga, Asadu; Chang, Michelle A.; Kapella, Bryan K.; Yoon, Steven; Kamya, Moses R.; Dorsey, Grant; Ruel, Theodore

2015-01-01

Background A better understanding of case management practices is required to improve inpatient pediatric care in resource-limited settings. Here we utilize data from a unique health facility-based surveillance system at six Ugandan hospitals to evaluate the quality of pediatric case management and the factors associated with appropriate care. Methods All children up to the age of 14 years admitted to six district or regional hospitals over 15 months were included in the study. Four case management categories were defined for analysis: suspected malaria, selected illnesses requiring antibiotics, suspected anemia, and diarrhea. The quality of case management for each category was determined by comparing recorded treatments with evidence-based best practices as defined in national guidelines. Associations between variables of interest and the receipt of appropriate case management were estimated using multivariable logistic regression. Results A total of 30,351 admissions were screened for inclusion in the analysis. Ninety-two percent of children met criteria for suspected malaria and 81% received appropriate case management. Thirty-two percent of children had selected illnesses requiring antibiotics and 89% received appropriate antibiotics. Thirty percent of children met criteria for suspected anemia and 38% received appropriate case management. Twelve percent of children had diarrhea and 18% received appropriate case management. Multivariable logistic regression revealed large differences in the quality of care between health facilities. There was also a strong association between a positive malaria diagnostic test result and the odds of receiving appropriate case management for comorbid non-malarial illnesses - children with a positive malaria test were more likely to receive appropriate care for anemia and less likely for illnesses requiring antibiotics and diarrhea. Conclusions Appropriate management of suspected anemia and diarrhea occurred infrequently. Pediatric quality improvement initiatives should target deficiencies in care unique to each health facility, and interventions should focus on the simultaneous management of multiple diagnoses. PMID:25992620

No recurrence of Pneumocystis jirovecii Pneumonia after solid organ transplantation regardless of secondary prophylaxis.

PubMed

Kim, Tark; Sung, Heungsup; Lee, Yu-Mi; Hong, Hyo-Lim; Kim, Sung-Han; Choi, Sang-Ho; Woo, Jun Hee; Kim, Yang Soo; Lee, Sang-Oh

2012-11-01

There are no data on the efficacy of secondary prophylaxis against Pneumocystis pneumonia after solid organ transplantation. Therefore, we investigated the rate of recurrence of Pneumocystis pneumonia after solid organ transplantation in a retrospective cohort study. Between 2005 and 2011, a total of 41 recipients recovered from Pneumocystis pneumonia. Of these, 22 (53.7%) received secondary prophylaxis. None of the 41 recipients experienced recurrence of Pneumocystis pneumonia during the follow-up, regardless of secondary prophylaxis.

Importance of Content and Format of Oral Health Instruction to Low-income Mexican Immigrant Parents: A Qualitative Study.

PubMed

Chang, Corissa P; Barker, Judith C; Hoeft, Kristin S; Guerra, Claudia; Chung, Lisa H; Burke, Nancy J

2018-01-01

This study's purpose was to explore how content and format of children's oral health instruction in the dental clinic is perceived by parents and might affect parents' knowledge and behaviors. Thirty low-income Mexican immigrant parents of children age five years and under were recruited from dental clinics in 2015 to 2016. In-person qualitative interviews in Spanish about their children's and their own experiences of dental care and home oral hygiene practices were conducted, digitally recorded, translated, and transcribed. Data analysis involved iteratively reading text data and developing and refining codes to find common themes. Twenty-five of 30 parents recalled receiving oral hygiene instruction, and 18 recalled receiving nutrition instruction and were included in analyses. The format and effectiveness of instruction varied. More engaging educational approaches were recalled and described in more detail than less engaging educational approaches. As a result of oral hygiene and nutritional instruction, most parents reported changing their oral hygiene home behaviors for their children; half aimed to reduce purchasing sugary foods and drinks. Most parents recalled receiving oral hygiene and nutrition instruction as part of their child's dental visit and reported incorporating the instruction and recommendations they received into their children's home routine.

Biological nitrate removal from water and wastewater by solid-phase denitrification process.

PubMed

Wang, Jianlong; Chu, Libing

2016-11-01

Nitrate pollution in receiving waters has become a serious issue worldwide. Solid-phase denitrification process is an emerging technology, which has received increasing attention in recent years. It uses biodegradable polymers as both the carbon source and biofilm carrier for denitrifying microorganisms. A vast array of natural and synthetic biopolymers, including woodchips, sawdust, straw, cotton, maize cobs, seaweed, bark, polyhydroxyalkanoate (PHA), polycaprolactone (PCL), polybutylene succinate (PBS) and polylactic acid (PLA), have been widely used for denitrification due to their good performance, low cost and large available quantities. This paper presents an overview on the application of solid-phase denitrification in nitrate removal from drinking water, groundwater, aquaculture wastewater, the secondary effluent and wastewater with low C/N ratio. The types of solid carbon source, the influencing factors, the microbial community of biofilm attached on the biodegradable carriers, the potential adverse effect, and the cost of denitrification process are introduced and evaluated. Woodchips and polycaprolactone are the popular and competitive natural plant-like and synthetic biodegradable polymers used for denitrification, respectively. Most of the denitrifiers reported in solid-phase denitrification affiliated to the family Comamonadaceae in the class Betaproteobacteria. The members of genera Diaphorobacter, Acidovorax and Simplicispira were mostly reported. In future study, more attention should be paid to the simultaneous removal of nitrate and toxic organic contaminants such as pesticide and PPCPs by solid-phase denitrification, to the elucidation of the metabolic and regulatory relationship between decomposition of solid carbon source and denitrification, and to the post-treatment of the municipal secondary effluent. Solid-phase denitrification process is a promising technology for the removal of nitrate from water and wastewater. Copyright © 2016 Elsevier Inc. All rights reserved.

Kidney growth and renal functions under the growth hormone replacement therapy in children.

PubMed

Ece, Aydın; Çetinkaya, Semra; Ekşioğlu, Seçil; Şenel, Saliha; Özkasap, Serdar; Giniş, Tayfur; Sen, Velat; Şahin, Cahit

2014-05-01

The aim of this study was to investigate the kidney growth and renal functions in children receiving recombinant human growth hormone (rhGH) treatment. A total of 37 children who received rhGH for 1.5 years before the study was started and 48 healthy controls were included at first evaluation. Hormone levels were determined and kidney sizes were measured by ultrasound. Kidney functions were assessed by serum creatinine and estimated glomerular filtration rate (eGFR). After 3 years of first evaluation, 23 patients were re-assessed. Kidney sizes were found to be lower in rhGH received children compared with controls at first evaluation (p<0.05). Significant positive correlations were found between anthropometric measurements and kidney length and kidney volume (p<0.05). Height was the most significant predictor of kidney volume in rhGH received children (p<0.001). After 3-years of follow-up significantly increases were found in kidney length and volume compared with the first measurements (p<0.05). Increase percentage of body height was similar to increasing percent of kidney length and liver long axis (14.2%, 11.7.1% and 7.7%, respectively, p>0.05). Although no abnormal renal function test results were found at first and second evaluations; rhGH received children had significantly lower eGFR, at first evaluation, compared with controls; however, renal functions significantly increased after 3 years of follow-up (p<0.05). In conclusion, effect rhGH treatment on kidney growth is parallel to growth in body height and other visceral organs. A 3-years rhGH treatment resulted in significant increases in renal functions.

Adjunct Systemic Corticosteroid Therapy in Children With Community-Acquired Pneumonia in the Outpatient Setting.

PubMed

Ambroggio, Lilliam; Test, Matthew; Metlay, Joshua P; Graf, Thomas R; Blosky, Mary Ann; Macaluso, Maurizio; Shah, Samir S

2015-03-01

The role of adjunct systemic corticosteroid therapy in children with community-acquired pneumonia (CAP) is not known. The objective was to determine the association between adjunct systemic corticosteroid therapy and treatment failure in children who received antibiotics for treatment of CAP in the outpatient setting. The study included a retrospective cohort study of children, aged 1-18 years, with a diagnosis of CAP who were managed at an outpatient practice affiliated with Geisinger Health System from January 1, 2008 to January 31, 2010. The primary exposure was the receipt of adjunct corticosteroid therapy. The primary outcome was treatment failure defined as a respiratory-associated follow-up within 14 days of diagnosis in which the participant received a change in antibiotic therapy. The probability of receiving adjunct systemic corticosteroid therapy was calculated using a matched propensity score. A multivariable conditional logistic regression model was used to estimate the association between adjunct corticosteroids and treatment failure. Of 2244 children with CAP, 293 (13%) received adjunct corticosteroids, 517 (23%) had underlying asthma, and 624 (28%) presented with wheezing. Most patients received macrolide monotherapy for their CAP diagnosis (n = 1329; 59%). Overall, treatment failure was not associated with adjunct corticosteroid treatment (odds ratio [OR], 1.72; 95% confidence interval [CI], 0.93 and 3.19), but the association was statistically significant among patients with no history of asthma (OR, 2.38; 95% CI, 1.03 and 5.52), with no statistical association among patients with a history of asthma. Adjunct corticosteroid therapy was associated with treatment failure among children diagnosed with CAP who did not have underlying asthma. © The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The impact of a novel franchise clinic network on access to medicines and vaccinations in Kenya: a cross-sectional study

PubMed Central

Adhvaryu, Achyuta

2012-01-01

Objectives To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya. Design The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects. Setting Demographic and Health Survey data from Kenya, 2008–2009. Participants 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness. Main outcome measures Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops. Results Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; p<0.001), treatment for fever (0.117; p=0.007) and treatments specifically stocked by CFWShops (0.064; p=0.015). Use of CFWShop services was not significantly different for lower-income vis-a-vis higher-income households. Conclusions The franchise health clinic model could substantially increase access to essential vaccinations and treatments in low-income countries. Moreover, the model's benefits may accrue to lesser- and higher-income households alike. PMID:22786948

The impact of a novel franchise clinic network on access to medicines and vaccinations in Kenya: a cross-sectional study.

PubMed

Berk, Justin; Adhvaryu, Achyuta

2012-01-01

To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya. The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects. Demographic and Health Survey data from Kenya, 2008-2009. 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness. Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops. Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; p<0.001), treatment for fever (0.117; p=0.007) and treatments specifically stocked by CFWShops (0.064; p=0.015). Use of CFWShop services was not significantly different for lower-income vis-a-vis higher-income households. The franchise health clinic model could substantially increase access to essential vaccinations and treatments in low-income countries. Moreover, the model's benefits may accrue to lesser- and higher-income households alike.

Effects of early maternal docosahexaenoic acid intake on neuropsychological status and visual acuity at five years of age of breast-fed term infants.

PubMed

Jensen, Craig L; Voigt, Robert G; Llorente, Antolin M; Peters, Sarika U; Prager, Thomas C; Zou, Yali L; Rozelle, Judith C; Turcich, Marie R; Fraley, J Kennard; Anderson, Robert E; Heird, William C

2010-12-01

We previously reported better psychomotor development at 30 months of age in infants whose mothers received a docosahexaenoic acid (DHA) (22:6n-3) supplement for the first 4 months of lactation. We now assess neuropsychological and visual function of the same children at 5 years of age. Breastfeeding women were assigned to receive identical capsules containing either a high-DHA algal oil (∼200 mg/d of DHA) or a vegetable oil (containing no DHA) from delivery until 4 months postpartum. Primary outcome variables at 5 years of age were measures of gross and fine motor function, perceptual/visual-motor function, attention, executive function, verbal skills, and visual function of the recipient children at 5 years of age. There were no differences in visual function as assessed by the Bailey-Lovie acuity chart, transient visual evoked potential or sweep visual evoked potential testing between children whose mothers received DHA versus placebo. Children whose mothers received DHA versus placebo performed significantly better on the Sustained Attention Subscale of the Leiter International Performance Scale (46.5 ± 8.9 vs 41.9 ± 9.3, P < .008) but there were no statistically significant differences between groups on other neuropsychological domains. Five-year-old children whose mothers received modest DHA supplementation versus placebo for the first 4 months of breastfeeding performed better on a test of sustained attention. This, along with the previously reported better performance of the children of DHA-supplemented mothers on a test of psychomotor development at 30 months of age, suggests that DHA intake during early infancy confers long-term benefits on specific aspects of neurodevelopment. Copyright © 2010 Mosby, Inc. All rights reserved.

How parents of children receiving pediatric palliative care use religion, spirituality, or life philosophy in tough times.

PubMed

Hexem, Kari R; Mollen, Cynthia J; Carroll, Karen; Lanctot, Dexter A; Feudtner, Chris

2011-01-01

How parents of children with life threatening conditions draw upon religion, spirituality, or life philosophy is not empirically well described. Participants were parents of children who had enrolled in a prospective cohort study on parental decision-making for children receiving pediatric palliative care. Sixty-four (88%) of the 73 parents interviewed were asked an open-ended question on how religion, spirituality, or life philosophy (RSLP) was helpful in difficult times. Responses were coded and thematically organized utilizing qualitative data analysis methods. Any discrepancies amongst coders regarding codes or themes were resolved through discussion that reached consensus. Most parents of children receiving palliative care felt that RSLP was important in helping them deal with tough times, and most parents reported either participation in formal religious communities, or a sense of personal spirituality. A minority of parents, however, did not wish to discuss the topic at all. For those who described their RSLP, their beliefs and practices were associated with qualities of their overall outlook on life, questions of goodness and human capacity, or that "everything happens for a reason." RSLP was also important in defining the child's value and beliefs about the child's afterlife. Prayer and reading the bible were important spiritual practices in this population, and parents felt that these practices influenced their perspectives on the medical circumstances and decision-making, and their locus of control. From religious participation and practices, parents felt they received support from both their spiritual communities and from God, peace and comfort, and moral guidance. Some parents, however, also reported questioning their faith, feelings of anger and blame towards God, and rejecting religious beliefs or communities. RSLP play a diverse and important role in the lives of most, but not all, parents whose children are receiving pediatric palliative care.

Pregnancy outcomes among solid organ transplant recipients in British Columbia.

PubMed

Humphreys, Robert A; Wong, Helen H L; Milner, Ruth; Matsuda-Abedini, Mina

2012-05-01

Since 1954, over 14 000 women have given birth after having had an organ transplantation. Unfortunately, some women and physicians remain misinformed about the feasibility and outcomes of pregnancy post transplantation. Our primary objective was to assess their perceptions and difficulties with regard to becoming pregnant. Our secondary objectives were to determine the incidence of pregnancies among transplant recipients in British Columbia and any maternal, graft, or fetal complications. From 1997 to 2007 in British Columbia, there were over 500 female recipients of solid organ transplants. We surveyed recipients in this group who were of child-bearing age. One hundred forty of 295 (47%) eligible recipients responded: 44 of these women had attempted pregnancy after transplant, and 31 women gave birth to 47 children. One half of the respondents planned to have children post transplant; 108 of 140 (77%) had no children before transplant. One quarter of the respondents were advised against pregnancy by their physician, and 33% of these women found a new physician to support their pregnancy. Rates of miscarriage (27%), rejection (21%), and prematurity (65%) were higher than expected. Infections were rare, and no birth defects or noteworthy health problems in the offspring were reported. Overall, pregnancy appears to be safe following solid organ transplantation, but careful monitoring and counselling are recommended.

Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans.

PubMed

Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Okunseri, Christopher

2017-12-01

Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008. Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received. Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group. DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees. © 2016 American Association of Public Health Dentistry.

Use of the Binaural Sensory Aid by Young Children.

ERIC Educational Resources Information Center

Strelow, E. R.

1983-01-01

Four blind children aged 10-30 months received training in the use of the Binaural Sensory Aid, adapted for use by children. Although the two youngest children learned to use the aid, the two older children showed substantially less ability to respond to information provided by the aid. (Author/CL)

Symbolic Play in School-Aged Minimally Verbal Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Chang, Ya-Chih; Shih, Wendy; Landa, Rebecca; Kaiser, Ann; Kasari, Connie

2018-01-01

Few interventions exist for school-aged minimally verbal children with autism spectrum disorder (ASD). Even though play skills are associated with children's production of language, few studies have focused on play for minimally verbal children. Fifty-eight minimally verbal children with ASD received a naturalistic developmental behavioral…

Development and pilot testing of an educational intervention for parents, caregivers and teachers of children with verbal communication disabilities in Mexico.

PubMed

Parada-Toro, Irene; Gómez-Quiroz, Rosa M; Treviño-Siller, Sandra

2017-03-01

The purpose of this study was to implement and test an educational intervention aimed at training parents/caregivers and teachers in strategies to support children with verbal communication disabilities (VCDs). We carried out a descriptive observational research conducted in two phases during 2013-2014: a mixed-method diagnosis and intervention development. We used convenience sampling to select the parents/caregivers and teachers of first-to-third graders with VCDs across four public elementary schools in a suburban community in central Mexico. Diagnosis was based on questionnaires conducted with parents/caregivers (n = 38) and teachers (n = 16). The instruments focused not only on the respondents' socioeconomic characteristics and general knowledge about VCDs but also included open questions (24/42) about their common practices and support for children with VCDs. The intervention was built on data collected through the questionnaires, and was designed according to the Integral Intervention Model framework based on the ecosystemic approach. Participants were parents/caregivers and teachers of children with VCDs. Main results showed that the participants were trained in various support techniques, they gained knowledge about VCDs and changed their perception of their own ability to help children with language impairments. As an important upshot of the intervention, communication and networking among parents/caregivers and teachers increased. The main strengths of this research reside in its solid theoretical foundation and the fact that intervention design was based on the specific needs of the target group. In as much as the public health problem of VCDs in Mexico has barely been studied and has received minimal official support, it is essential to engage additional social actors, stakeholders and decision-makers in the implementation of permanent actions. Our study emphasises the importance of recognising this form of health impairment as a social responsibility and not as an individual family problem. © 2016 John Wiley & Sons Ltd.

Pidotimod for the prevention of acute respiratory infections in healthy children entering into daycare: A double blind randomized placebo-controlled study.

PubMed

Mameli, Chiara; Pasinato, Angela; Picca, Marina; Bedogni, Giorgio; Pisanelli, Stefania; Zuccotti, Gian Vincenzo

2015-07-01

Acute respiratory tract infections (ARTIs) are very common in pediatric age and reach a peak in the first 4 years of life, especially in children attending daycare. Pidotimod, a synthetic immunostimulant, may reduce the incidence of ARTIs in children with predisposing risk factors. Nevertheless studies on healthy children are presently lacking. We performed a double-blinded randomized placebo-controlled trial study to assess the efficacy of Pidotimod in a population of 3-year-old healthy children who just entered kindergarten. The main outcome was the incidence of respiratory infections in this population and the secondary outcome was the prescription of antibiotics. The study group consisted of healthy 3-year-old children who had not yet attended day-care centers. Patients were enrolled by a convenience sample of 17 family pediatricians (FP). Children were randomized to receive either Pidotimod 400 mg per os or placebo twice daily for the last 10 days of each month from October 2013 to April 2014. Any time a child presented to his/her FP with fever and ARTI was diagnosed, clinical and therapeutic data were collected. A total of 800 children were pre-screened, 733 did not meet the inclusion criteria and 10 refused to participate. Of the 67 eligible subjects, 57 were successfully enrolled within the study recruitment period and randomized to receive Pidotimod (n = 29) or placebo (n = 28). Eight children were lost to follow-up. In the final analysis were thus included 24 children who received Pidotimod and 25 who received placebo. The incidence rate ratio for respiratory infections was 0.78 (95%CI 0.53 to 1.15, p = 0.211) for Pidotimod vs. placebo. The corresponding risk ratio for antibiotic usage was 0.56 (95%CI 0.27 to 1.16, p = 0.120). In our trial, Pidotimod did not prove to be statistically superior to placebo for the prevention of ARTI in a population of healthy children who entered kindergarten. However, Pidotimod showed some potential as a means for reducing antibiotic usage in these children. Copyright © 2015 Elsevier Ltd. All rights reserved.

A randomized, controlled trial of an aerosolized vaccine against measles.

PubMed

Low, Nicola; Bavdekar, Ashish; Jeyaseelan, Lakshmanan; Hirve, Siddhivinayak; Ramanathan, Kavitha; Andrews, Nicholas J; Shaikh, Naseem; Jadi, Ramesh S; Rajagopal, Arunachalam; Brown, Kevin E; Brown, David; Fink, James B; John, Oommen; Scott, Pippa; Riveros-Balta, A Ximena; Greco, Michel; Dhere, Rajeev; Kulkarni, Prasad S; Henao Restrepo, Ana Maria

2015-04-16

Aerosolized vaccine can be used as a needle-free method of immunization against measles, a disease that remains a major cause of illness and death. Data on the immunogenicity of aerosolized vaccine against measles in children are inconsistent. We conducted an open-label noninferiority trial involving children 9.0 to 11.9 months of age in India who were eligible to receive a first dose of measles vaccine. Children were randomly assigned to receive a single dose of vaccine by means of either aerosol inhalation or a subcutaneous injection. The primary end points were seropositivity for antibodies against measles and adverse events 91 days after vaccination. The noninferiority margin was 5 percentage points. A total of 1001 children were assigned to receive aerosolized vaccine, and 1003 children were assigned to receive subcutaneous vaccine; 1956 of all the children (97.6%) were followed to day 91, but outcome data were missing for 331 children because of thawed specimens. In the per-protocol population, data on 1560 of 2004 children (77.8%) could be evaluated. At day 91, a total of 662 of 775 children (85.4%; 95% confidence interval [CI], 82.5 to 88.0) in the aerosol group, as compared with 743 of 785 children (94.6%; 95% CI, 92.7 to 96.1) in the subcutaneous group, were seropositive, a difference of -9.2 percentage points (95% CI, -12.2 to -6.3). Findings were similar in the full-analysis set (673 of 788 children in the aerosol group [85.4%] and 754 of 796 children in the subcutaneous group [94.7%] were seropositive at day 91, a difference of -9.3 percentage points [95% CI, -12.3 to -6.4]) and after multiple imputation of missing results. No serious adverse events were attributable to measles vaccination. Adverse-event profiles were similar in the two groups. Aerosolized vaccine against measles was immunogenic, but, at the prespecified margin, the aerosolized vaccine was inferior to the subcutaneous vaccine with respect to the rate of seropositivity. (Funded by the Bill and Melinda Gates Foundation; Measles Aerosol Vaccine Project Clinical Trials Registry-India number, CTRI/2009/091/000673.).

Social Information Processing in Elementary-School Aged Children with ADHD: Medication Effects and Comparisons with Typical Children

ERIC Educational Resources Information Center

King, Sara; Waschbusch, Daniel A.; Pelham, William E., Jr.; Frankland, Bradley W.; Andrade, Brendan F.; Jacques, Sophie; Corkum, Penny V.

2009-01-01

Examined social information processing (SIP) in medicated and unmedicated children with ADHD and in controls. Participants were 75 children (56 boys, 19 girls) aged 6-12 years, including 41 children with ADHD and 34 controls. Children were randomized into medication conditions such that 20 children with ADHD participated after receiving placebo…

Sustainable construction in rural Guatemala.

PubMed

Temple, Ericka K; Rose, Elizabeth

2011-11-01

Waste management is a significant problem in Guatemala, as elsewhere in the developing world. The inappropriate disposal of solid waste produces pollution and places the environment and human health at risk. Environmental risk factors, including inadequate disposal of solid waste, are implicated in 25-30% of disease worldwide with children bearing a disproportionate burden of those diseases. Therefore, economic development which reduces inappropriate disposal of waste and affords economic opportunities may help reduce the global burden of disease on children. In the indigenous highlands of central Guatemala, a community supported non-profit organisation called Long Way Home (http://www.longwayhomeinc.org) is employing alternative construction techniques to build a vocational school complex. The construction of the school from waste materials demonstrates the use and principles of re-purposing materials, helps clean the environment and affords further educational and vocational opportunities. This article will outline the health problems inherent in an indigenous area of a developing country and will offer an alternative solution to reverse environmental risk factors associated with solid waste pollution and also actively improve child health.

Brief report: Adherence to fluid recommendations in children receiving treatment for retentive encopresis.

PubMed

Kuhl, Elizabeth S; Felt, Barbara T; Patton, Susana R

2009-01-01

Limited data are available regarding whether children being treated for retentive encopresis are adherent to recommendations to increase their daily fluid intake. The purpose of this study was to examine fluid adherence in children who received treatment for retentive encopresis. A retrospective chart review was performed using diet diary data for 26 children (ages 3-12) who completed a group behavioral intervention for retentive encopresis. Mean daily intake of clear fluid increased significantly during treatment and children relied primarily on water and juice to make this dietary change. However, adherence rates to clear fluid goals were <50%. Children's increased clear fluid intake did not equate to high fluid adherence. Children's high juice consumption is concerning as it could place them at risk for other negative health consequences. Future research should examine whether enhanced fluid education and use of behavior change strategies yield higher fluid adherence.

Developmental dyspraxia by any other name: are they all just clumsy children?

PubMed

Missiuna, C; Polatajko, H

1995-01-01

The recent introduction of the diagnostic category developmental coordination disorder (DCD) (American Psychiatric Association [APA], 1987, 1994), has generated confusion among researchers and clinicians in many fields, including occupational therapy. Although the diagnostic criteria appear to be similar to those used to define clumsy children, children with developmental dyspraxia, or children with sensory integrative dysfunction, we are left with the question: Are children who receive the diagnosis of DCD the same as those who receive the other diagnoses, a subgroup, or an entirely distinct group of children? This article will examine the theoretical and empirical literature and use the results to support the thesis that these terms are not interchangeable and yet are not being used in the literature in a way that clearly defines each subgroup of children. Clear definitions and characteristic features need to be identified and associated with each term to guide occupational therapy assessment and intervention and clinical research.

The Children's Orientation and Amnesia Test: educational status is a moderator variable in tracking recovery from TBI.

PubMed

Iverson, G L; Iverson, A M; Barton, E A

1994-01-01

The Children's Orientation and Amnesia Test (COAT) is an objective, standardized means of assessing cognitive functioning in children and adolescents who are in the early stages of recovery from traumatic brain injury. The COAT is composed of 16 items that assess general orientation, temporal orientation, and memory. This study was designed to determine if children who are receiving special education services perform more poorly on the COAT than children who are in the regular classroom. It was found that children receiving special services performed significantly more poorly, and 13% of them were classified in the impaired range, as compared to 3% of the students in the regular classroom. The results provide important reference data for interpreting COAT scores of children with traumatic brain injuries who have either premorbid learning disabilities or other special service needs.

A survey of inner city youth and their parents about participation in sports.

PubMed

Busey, Sharon L; Batten, Casey G; Young, Craig C; Bragg, Dawn S

2007-09-01

Several studies have explored motivating factors for sports participation for youth, but limited data is available regarding factors motivating inner-city children to participate in sports. A consecutive sample of parents (n=100 parents) and children (n=138 children) attending a health fair in an inner-city community were surveyed regarding motivating factors for enrolling in a team sport (or enrolling their child in a team sport). Parents and children indicated the importance of 10 factors (1=not very important to 4=very important) on separate but similar written surveys. "Developing healthy habits" and "Becoming physically fit and healthy" received the highest mean rankings from both parents and children. "Helping my child gain or lose weight" received one of the lowest rankings from parents. To encourage sports participation by inner-city children, health care professionals and others should emphasize identified motivational factors for children and their parents.

Dosimetric impact in the dose-volume histograms of rectal and vesical wall contouring in prostate cancer IMRT treatments.

PubMed

Gómez, Laura; Andrés, Carlos; Ruiz, Antonio

2017-01-01

The main purpose of this study was to evaluate the differences in dose-volume histograms of IMRT treatments for prostate cancer based on the delineation of the main organs at risk (rectum and bladder) as solid organs or by contouring their wall. Rectum and bladder have typically been delineated as solid organs, including the waste material, which, in practice, can lead to an erroneous assessment of the risk of adverse effects. A retrospective study was made on 25 patients treated with IMRT radiotherapy for prostate adenocarcinoma. 76.32 Gy in 36 fractions was prescribed to the prostate and seminal vesicles. In addition to the delineation of the rectum and bladder as solid organs (including their content), the rectal and bladder wall were also delineated and the resulting dose-volume histograms were analyzed for the two groups of structures. Data analysis shows statistically significant differences in the main parameters used to assess the risk of toxicity of a prostate radiotherapy treatment. Higher doses were received on the rectal and bladder walls compared to doses received on the corresponding solid organs. The observed differences in terms of received doses to the rectum and bladder based on the method of contouring could gain greater importance in inverse planning treatments, where the treatment planning system optimizes the dose in these volumes. So, one should take into account the method of delineating of these structures to make a clinical decision regarding dose limitation and risk assessment of chronic toxicity.

Associations between added sugar (solid vs. liquid) intakes, diet quality, and adiposity indicators in Canadian children.

PubMed

Wang, JiaWei; Shang, Lei; Light, Kelly; O'Loughlin, Jennifer; Paradis, Gilles; Gray-Donald, Katherine

2015-08-01

Little is known about the influence of different forms of added sugar intake on diet quality or their association with obesity among youth. Dietary intake was assessed by three 24-h recalls in 613 Canadian children (aged 8-10 years). Added sugars (mean of 3-day intakes) were categorized according to source (solid or liquid). Dietary intake and the Canadian Healthy Eating Index (« HEI-C ») were compared across tertiles of solid and liquid added sugars separately as were adiposity indicators (body mass index (BMI), fat mass (dual-energy X-ray absorptiometry), and waist circumference). Cross-sectional associations were examined in linear regression models adjusting for age, sex, energy intake, and physical activity (7-day accelerometer). Added sugar contributed 12% of total energy intake (204 kcal) on average, of which 78% was from solid sources. Higher consumption of added sugars from either solid or liquid source was associated with higher total energy, lower intake of micronutrients, vegetables and fruit, and lower HEI-C score. Additionally liquid sources were associated with lower intake of dairy products. A 10-g higher consumption of added sugars from liquid sources was associated with 0.4 serving/day lower of vegetables and fruit, 0.4-kg/m(2) higher BMI, a 0.5-kg higher fat mass, and a 0.9-cm higher waist circumference whereas the associations of added sugars from solid sources and adiposity indicators tended to be negative. In conclusion, higher consumption of added sugar from either solid or liquid sources was associated with lower overall diet quality. Adiposity indicators were only positively associated with added sugars from liquid sources.

Volatile anesthetic rescue therapy in children with acute asthma: innovative but costly or just costly?.

PubMed

Char, Danton S; Ibsen, Laura M; Ramamoorthy, Chandra; Bratton, Susan L

2013-05-01

To describe volatile anesthesia (VA) use for pediatric asthma, including complications and outcomes. Retrospective cohort study. Children's hospitals contributing to the Pediatric Health Information System between 2004-2008. Children 2-18 years old with a primary diagnosis code for asthma supported with mechanical ventilation. Those treated with VA were compared to those not treated with VA or extracorporeal membrane oxygenation. Hospital VA use was grouped as none, <5%, 5-10% and >10% among intubated children. One thousand five hundred and fifty-eight patients received mechanical ventilation at 40 hospitals for asthma: 47 (3%) received VA treatment at 11 (28%) hospitals. Those receiving a VA were significantly less likely to receive inhaled b-agonists, ipratropium bromide, and heliox, but more likely to receive neuromuscular blocking agents than patients treated without VA. Length of mechanical ventilation, hospital stay (length of stay [LOS]) and charges were significantly greater for those treated with VA. Aspiration was more common but death and air leak did not differ. Patients at hospitals with VA use >10% were significantly less likely to receive inhaled b agonist, ipratropium bromide, methylxanthines, and heliox, but more likely to receive systemic b agonist, neuromuscular blocking agents compared to those treated at hospitals not using VA. LOS, duration of ventilation, and hospital charges were significantly greater for patients treated at centers with high VA use. Mortality does not differ between centers that use VA or not. Patients treated at centers with high VA use had significantly increased hospital charges and increased LOS.

Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy.

PubMed

El-Shamy, Shamekh Mohamed; Abd El Kafy, Ehab Mohamed

2014-01-01

The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy. Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured. Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p < 0.05). The results also showed significantly better improvement in the measured parameters for the study group, as compared to the control group (p < 0.05). Balance training on Biodex system is a useful tool that can be used in improving postural balance control in children with diplegic cerebral palsy.

Association between parental access to paid sick leave and children's access to and use of healthcare services.

PubMed

Asfaw, Abay; Colopy, Maria

2017-03-01

We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06-1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04-1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76-0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27-0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82-0.97] fewer ER visits per year. PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. Am. J. Ind. Med. 60:276-284, 2017. © 2017 Wiley Periodicals, Inc. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

The beliefs, motivations, and expectations of parents who have enrolled their children in a genetic biorepository.

PubMed

Harris, Erin D; Ziniel, Sonja I; Amatruda, Jonathan G; Clinton, Catherine M; Savage, Sarah K; Taylor, Patrick L; Huntington, Noelle L; Green, Robert C; Holm, Ingrid A

2012-03-01

Little is known about parental attitudes toward return of individual research results (IRRs) in pediatric genomic research. The aim of this study was to understand the views of the parents who enrolled their children in a genomic repository in which IRRs will be returned. We conducted focus groups with parents of children with developmental disorders enrolled in the Gene Partnership (GP), a genomic research repository that offers to return IRRs, to learn about their understanding of the GP, motivations for enrolling their children, and expectations regarding the return of IRRs. Parents hoped to receive IRRs that would help them better understand their children's condition(s). They understood that this outcome was unlikely, but hoped that their children's participation in the GP would contribute to scientific knowledge. Most parents wanted to receive all IRRs about their child, even for diseases that were severe and untreatable, citing reasons of personal utility. Parents preferred electronic delivery of the results and wanted to designate their preferences regarding what information they would receive. It is important for researchers to understand participant expectations in enrolling in a research repository that offers to disclose children's IRRs in order to effectively communicate the implications to parents during the consenting process.

Determinants of immunization status among 12- to 23-month-old children in Indonesia (2008-2013): a multilevel analysis.

PubMed

Holipah; Maharani, Asri; Kuroda, Yoshiki

2018-02-27

Immunization is one of the most cost-effective public health interventions to prevent children from contracting vaccine-preventable diseases. Indonesia launched the Expanded Program for Immunization (EPI) in 1977. However, immunization coverage remains far below the United Nations International Children's Emergency Fund (UNICEF) and World Health Organization (WHO) target of 80%. This study aims to investigate the determinants of complete immunization status among children aged 12-23 months in Indonesia. We used three waves of the Indonesian National Socioeconomic Survey (2008, 2011, and 2013) and national village censuses from the same years. Multilevel logistic regression was used to conduct the analysis. The number of immunized children increased from 47.48% in 2008 to 61.83% in 2013. The presence of health professionals, having an older mother, and having more educated mothers were associated with a higher probability of a child's receiving full immunization. Increasing the numbers of hospitals, village health posts, and health workers was positively associated with children receiving full immunization. The MOR (median odds ratio) showed that children's likelihood of receiving complete immunization varied significantly among districts. Both household- and district-level determinants were found to be associated with childhood immunization status. Policy makers may take these determinants into account to increase immunization coverage in Indonesia.

Credit PSR. View looks west southwest (238°) at the north ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Credit PSR. View looks west southwest (238°) at the north and east elevations of the liner lab. Solid rocket motor casings receive specially formulated rubber insulating liners that protect the casings from the heat generated by burning solid motors - Jet Propulsion Laboratory Edwards Facility, Liner Laboratory, Edwards Air Force Base, Boron, Kern County, CA

78 FR 41960 - Notice of Permit Applications Received Under the Antarctic Conservation Act of 1978

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... with the various excursions are typically air emissions, waste water (urine, grey-water) and solid waste (food waste, human solid waste, and packaging materials). Human waste and grey water would be..., Santa Cruz, CA. Activity for Which Permit Is Requested Waste Permit; A small expedition would use an ice...

Application of Berry's Phase to the Effective Mass of Bloch Electrons

ERIC Educational Resources Information Center

Rave, M. J.; Kerr, W. C.

2010-01-01

Berry's phase, although well known since 1984, has received little attention among textbook authors of solid state physics. We attempt to address this lack by showing how the presence of the Berry's phase significantly changes a standard concept (effective mass) found in most solid state texts. Specifically, we show that the presence of a non-zero…

Comparison of Physical Activity between Children with Autism Spectrum Disorders and Typically Developing Children

ERIC Educational Resources Information Center

Bandini, Linda G.; Gleason, James; Curtin, Carol; Lividini, Keith; Anderson, Sarah E.; Cermak, Sharon A.; Maslin, Melissa; Must, Aviva

2013-01-01

Regular physical activity is important for promoting health and well-being; however, physical activity behaviors in children with autism spectrum disorders (ASD) have received little attention. We compared physical activity levels among 53 children with ASD and 58 typically developing children aged 3-11 years who participated in the Children's…

Factors affecting decisions to seek treatment for sick children in Kerala, India.

PubMed

Pillai, Rajamohanan K; Williams, Sankey V; Glick, Henry A; Polsky, Daniel; Berlin, Jesse A; Lowe, Robert A

2003-09-01

The purpose of this study was to measure the effects of social and economic variables, disease-related variables, and child gender on the decisions of parents in Kerala, India, to seek care for their children and on their choice of providers in the allopathic vs. the alternative system. A case-control analysis was done using data from the Kerala section of the 1996 Indian National Family Health Survey, a cross-sectional survey of a probability sample of households conducted by trained interviewers with a close-ended questionnaire. Of the 469 children who were eligible for this study because they had at least one common symptom suggestive of acute respiratory illness or diarrhea during the 2 weeks before the interview, 78 (17%) did not receive medical care, while the remaining 391 (83%) received medical care. Of the 391 children who received medical care, 342 (88%) received allopathic medical care, and 48 (12%) received alternative medical care. In multivariable analyses, parents chose not to seek medical care for their children significantly more often when the illness was mild, the child had a specific diagnosis, the mother had previously made fewer antenatal visits, and the family had a higher economic status. When parents sought medical care for their children, care was sought significantly more often in the alternative provider system when the child was a boy, the family lived in a rural area, and the family had a lower social class. We conclude that, in Kerala, disease severity and economic status predict whether children with acute respiratory infection or diarrhea are taken to medical providers. In contrast, most studies of this issue carried out in other populations have identified economic status as the primary predictor of medical system utilization. Also in Kerala, the gender of the child did not influence whether or not the child was taken for treatment but did influence whether care was sought in the alternative or the allopathic system.

Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial.

PubMed

Frye, R E; Slattery, J; Delhey, L; Furgerson, B; Strickland, T; Tippett, M; Sailey, A; Wynne, R; Rose, S; Melnyk, S; Jill James, S; Sequeira, J M; Quadros, E V

2018-02-01

We sought to determine whether high-dose folinic acid improves verbal communication in children with non-syndromic autism spectrum disorder (ASD) and language impairment in a double-blind placebo control setting. Forty-eight children (mean age 7 years 4  months; 82% male) with ASD and language impairment were randomized to receive 12 weeks of high-dose folinic acid (2 mg kg -1 per day, maximum 50 mg per day; n=23) or placebo (n=25). Children were subtyped by glutathione and folate receptor-α autoantibody (FRAA) status. Improvement in verbal communication, as measured by a ability-appropriate standardized instrument, was significantly greater in participants receiving folinic acid as compared with those receiving placebo, resulting in an effect of 5.7 (1.0,10.4) standardized points with a medium-to-large effect size (Cohen's d=0.70). FRAA status was predictive of response to treatment. For FRAA-positive participants, improvement in verbal communication was significantly greater in those receiving folinic acid as compared with those receiving placebo, resulting in an effect of 7.3 (1.4,13.2) standardized points with a large effect size (Cohen's d=0.91), indicating that folinic acid treatment may be more efficacious in children with ASD who are FRAA positive. Improvements in subscales of the Vineland Adaptive Behavior Scale, the Aberrant Behavior Checklist, the Autism Symptom Questionnaire and the Behavioral Assessment System for Children were significantly greater in the folinic acid group as compared with the placebo group. There was no significant difference in adverse effects between treatment groups. Thus, in this small trial of children with non-syndromic ASD and language impairment, treatment with high-dose folinic acid for 12 weeks resulted in improvement in verbal communication as compared with placebo, particularly in those participants who were positive for FRAAs.

Oral health assessment and mouth care for children and young people receiving palliative care. Part one.

PubMed

Sargeant, Stephanie; Chamley, Carol

2013-03-01

This is the first part of two articles exploring oral health problems and treatments for children receiving palliative care, successful management of which can improve considerably the quality of life for this group of children and young people. Part one includes an adapted oral health assessment tool for use in children and young people with complex and palliative healthcare needs that has the potential to help nurses identify and monitor oral health problems and prevent or minimise oral problems from developing. Part two--to be published next month--focuses on basic oral hygiene and the management of specific oral health problems.

[Health-related problems in adopted children].

PubMed

Laubjerg, Merete; Petersson, Birgit H

2006-10-09

International research shows that the standard of health among children adopted from abroad, especially those adopted by single parents, is not as good as that of other children. Danish studies indicate similar problems. The causes could be several, such as poor development in the embryonic and fetal stages, low birth weight, starvation, neglect, infections, and the lack of the natural bonds between mother and child. Surveys indicate that many adoptive parents, single parents in particular, receive children with health problems. There is no Danish research available, but it is important to be aware of these issues in order for both adoptees and adoptants to receive the most support.