34 CFR 299.9 - What are the requirements concerning property, equipment, and supplies for the benefit of private...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., equipment, and supplies for the benefit of private school children and teachers? 299.9 Section 299.9....9 What are the requirements concerning property, equipment, and supplies for the benefit of private school children and teachers? (a) A public agency must keep title to, and exercise continuing...

[Long-term outcomes of children treated with continuous renal replacement therapy].

PubMed

Almarza, S; Bialobrzeska, K; Casellas, M M; Santiago, M J; López-Herce, J; Toledo, B; Carrillo, Á

2015-12-01

The objective of this study is to analyze long-term outcomes and kidney function in children requiring continuous renal replacement therapy (CRRT) after an acute kidney injury episode. A retrospective observational study was performed using a prospective database of 128 patients who required CRRT admitted to the pediatric intensive care unit between years 2006 and 2012. The subsequent outcomes were assessed in those surviving at hospital discharge. Of the 128 children who required RRT in the pediatric intensive care unit, 71 survived at hospital discharge (54.4%), of whom 66 (92.9%) were followed up. Three patients had chronic renal failure prior to admission to the NICU. Of the 63 remaining patients, 6 had prolonged or relapses of renal function disturbances, but only one patient with atypical Hemolytic Uremic Syndrome developed end-stage renal failure. The rest had normal kidney function at the last check-up. Most of surviving children that required CRRT have a positive outcome later on, presenting low mortality rates and recovery of kidney function in the medium term. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Pediatric anesthesia after APRICOT (Anaesthesia PRactice In Children Observational Trial): who should do it?

PubMed

Habre, Walid

2018-06-01

This review highlights the requirements for harmonization of training, certification and continuous professional development and discusses the implications for anesthesia management of children in Europe. A large prospective cohort study, Anaesthesia PRactice In Children Observational Trial (APRICOT), revealed a high incidence of perioperative severe critical events and a large variability of anesthesia practice across 33 European countries. Relevantly, quality improvement programs have been implemented in North America, which precisely define the requirements to manage anesthesia care for children. These programs, with the introduction of an incident-reporting system at local and national levels, could contribute to the improvement of anesthesia care for children in Europe. The main factors that likely contributed to the APRICOT study results are discussed with the goal of defining clear requirement guidelines for anesthetizing children. Emphasis is placed on the importance of an incident-reporting system that can be used for both competency-based curriculum for postgraduate training as well as for continuous professional development. Variability in training as well as in available resources, equipment and facilities limit the generalization of some of the APRICOT results. Finally, the impact on case outcome of the total number of pediatric cases attended by the anesthesiologist should be taken into consideration along with the level of expertise of the anesthesiologist for complex pediatric anesthesia cases.

Parental preference and perspectives on continuous pulse oximetry in infants and children with bronchiolitis

PubMed Central

Hendaus, Mohamed A; Nassar, Suzan; Leghrouz, Bassil A; Alhammadi, Ahmed H; Alamri, Mohammed

2018-01-01

Objective The purpose of the study was to investigate parental preference of continuous pulse oximetry in infants and children with bronchiolitis. Materials and methods A cross-sectional prospective study was conducted at Hamad Medical Corporation in Qatar. Parents of infants and children <24 months old and hospitalized with bronchiolitis were offered an interview survey. Results A total of 132 questionnaires were completed (response rate 100%). Approximately 90% of participants were 20–40 years of age, and 85% were females. The mean age of children was 7.2±5.8 months. Approximately eight in ten parents supported the idea of continuous pulse oximetry in children with bronchiolitis. Almost 43% of parents believed that continuous pulse-oximetry monitoring would delay their children’s hospital discharge. Interestingly, approximately 85% of caregivers agreed that continuous pulse oximetry had a good impact on their children’s health. In addition, around one in two of the participants stated that good bedside examinations can obviate the need for continuous pulse oximetry. Furthermore, 80% of parents believed that continuous pulse-oximetry monitoring would give the health-care provider a good sense of security regarding the child’s health. Finally, being a male parent was associated with significantly increased risk of reporting unnecessary fatigue, attributed to the sound of continuous pulse oximetry (P=0.031). Conclusion Continuous pulse-oximetry monitoring in children with bronchiolitis was perceived as reassuring for parents. Involving parents in decision-making is considered essential in the better management of children with bronchiolitis or any other disease. The first step to decrease continuous pulse oximetry will require provider education and change as well. Furthermore, we recommend proper counseling for parents, emphasizing that medical technology is not always essential, but is a complementary mode of managing a disease. PMID:29662305

Preschool and School Readiness: Experiences of Children with Non-English Speaking Parents

ERIC Educational Resources Information Center

Cannon, Jill S.; Jacknowitz, Alison; Karoly, Lynn A.

2012-01-01

Many children begin school unprepared to meet its academic requirements. If this school readiness gap is not addressed, it can be a precursor to continuing low achievement. One promising approach to this problem is to provide high-quality early learning opportunities to low-income children. Many publicly funded early care and education programs in…

Continuous subcutaneous infusion of morphine in children with cancer.

PubMed

Miser, A W; Davis, D M; Hughes, C S; Mulne, A F; Miser, J S

1983-04-01

Seventeen children with severe pain due to malignant neoplasm were successfully treated with a subcutaneous infusion of morphine sulfate using a syringe pump. Pain relief was adequate in every case without major side effects. The median dosage required was 0.06 mg/kg/hr (range, 0.025 to 1.79 mg/kg/hr). Three patients received the subcutaneous infusion at home. No patient required an intravenous line for pain control.

Making Sense of Sensory Systems

ERIC Educational Resources Information Center

Hendrix, Marie

2010-01-01

The role of caregivers requires that they continuously assess the needs and performance of children and provide the support necessary for them to achieve their potential. A thorough understanding of child development, including the role and impact of sensory development, is critical for caregivers to properly evaluate and assist these children.…

42 CFR 457.110 - Enrollment assistance and information requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies... 42 Public Health 4 2010-10-01 2010-10-01 false Enrollment assistance and information requirements...

Early Identification of Developmental Delays through Surveillance, Screening, and Diagnostic Evaluation

ERIC Educational Resources Information Center

Pizur-Barnekow, Kris; Erickson, Stephanie; Johnston, Mark; Bass, Tamicah; Lucinski, Loraine; Bleuel, Dan

2010-01-01

Developmental and behavioral problems in young children are prevalent in the United States. While young children experience an increased prevalence of such problems, a lack of early identification services continues to exist. Not only are early identification services required under American law, such as the Individual with Disabilities Education…

5 CFR 890.1107 - Length of temporary continuation of coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dependent children, were covered family members of a former employee receiving continued coverage under this... after the former spouse ceased meeting the requirements for coverage as a family member, unless it is...) Whose marriage to the former employee terminates after the former employee's separation but before the...

5 CFR 890.1107 - Length of temporary continuation of coverage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dependent children, were covered family members of a former employee receiving continued coverage under this... after the former spouse ceased meeting the requirements for coverage as a family member, unless it is...) Whose marriage to the former employee terminates after the former employee's separation but before the...

5 CFR 890.1107 - Length of temporary continuation of coverage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dependent children, were covered family members of a former employee receiving continued coverage under this... after the former spouse ceased meeting the requirements for coverage as a family member, unless it is...) Whose marriage to the former employee terminates after the former employee's separation but before the...

5 CFR 890.1107 - Length of temporary continuation of coverage.

Code of Federal Regulations, 2011 CFR

2011-01-01

... dependent children, were covered family members of a former employee receiving continued coverage under this... after the former spouse ceased meeting the requirements for coverage as a family member, unless it is...) Whose marriage to the former employee terminates after the former employee's separation but before the...

45 CFR 1301.30 - General requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false General requirements. 1301.30 Section 1301.30 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.30 - General requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false General requirements. 1301.30 Section 1301.30 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.30 - General requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false General requirements. 1301.30 Section 1301.30 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.20 - Matching requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Matching requirements. 1301.20 Section 1301.20 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.20 - Matching requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Matching requirements. 1301.20 Section 1301.20 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.20 - Matching requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Matching requirements. 1301.20 Section 1301.20 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

7 CFR 215.7 - Requirements for participation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... authority under this part to support a nonprofit nutrition program for the elderly, including a program... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL MILK PROGRAM FOR CHILDREN § 215.7 Requirements for participation...

34 CFR 300.114 - LRE requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false LRE requirements. 300.114 Section 300.114 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

45 CFR 1301.20 - Matching requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Matching requirements. 1301.20 Section 1301.20 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.20 - Matching requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Matching requirements. 1301.20 Section 1301.20 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.30 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false General requirements. 1301.30 Section 1301.30 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1301.30 - General requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false General requirements. 1301.30 Section 1301.30 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

Development and validation of a child health workforce competence framework.

PubMed

Smith, Lynda; Hawkins, Jean; McCrum, Anita

2011-05-01

Providing high quality, effective services is fundamental to the delivery of key health outcomes for children and young people. This requires a competent workforce. This paper reports on the development of a validated competence framework tool for the children and young people's health workforce. The framework brings together policy, strategic agendas and existing workforce competences. The framework will contribute to the improvement of children's physical and mental wellbeing by identifying competences required to provide proactive services that respond to children and young people with acute, continuing and complex needs. It details five core competences for the workforce, the functions that underpin them and levels of competence required to deliver a particular service. The framework will be of value to commissioners to inform contracting, to providers to ensure services are delivered by a workforce with relevant competences to meet identified needs, and to the workforce to assess existing capabilities and identify gaps in competence.

29 CFR 2590.606-2 - Notice requirement for employers.

Code of Federal Regulations, 2010 CFR

2010-07-01

....606-2 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION..., Qualified Medical Child Support Orders, Coverage for Adopted Children § 2590.606-2 Notice requirement for employers. (a) General. Pursuant to section 606(a)(2) of the Employee Retirement Income Security Act of 1974...

45 CFR 1307.4 - Grantee reporting requirements concerning certain conditions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Grantee reporting requirements concerning certain conditions. 1307.4 Section 1307.4 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

45 CFR 1307.4 - Grantee reporting requirements concerning certain conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Grantee reporting requirements concerning certain conditions. 1307.4 Section 1307.4 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

45 CFR 1307.4 - Grantee reporting requirements concerning certain conditions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Grantee reporting requirements concerning certain conditions. 1307.4 Section 1307.4 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

International Law as Remedy: When the State Breaches Child Protection Statutes

ERIC Educational Resources Information Center

Bessant, Judith

2011-01-01

While legislative frameworks prescribe the legal obligations of the parents to protect and nurture their children, there is no equivalent legal framework requiring and sanctioning the conduct of agents of the state who act in loco parentis. In consequence some children continue to be "at risk" and may even be in greater danger once the…

Intervention for Childhood Apraxia of Speech: A Single-Case Study

ERIC Educational Resources Information Center

Martikainen, Anna-Leena; Korpilahti, Pirjo

2011-01-01

The underlying nature and diagnosis of childhood apraxia of speech (CAS) still requires clarification. However, the label "CAS" or "suspected CAS" continues to be assigned to a group of children with speech problems, and speech and language therapists need to be aware of effective treatment for these children. The aim of this study was to assess…

Relationships between Continuous Performance Task Scores and Other Cognitive Measures: Causality or Commonality?

ERIC Educational Resources Information Center

Aylward, Glen P.; Gordon, Michael; Verhulst, Steven J.

1997-01-01

Relationships among continuous performance test (CPT), IQ, achievement, and memory/learning scores were explored for 1,280 children about 9 years old. Associations among the CPT measures and various cognitive/academic tasks suggest that all require attention and inhibition. The importance of assessing attention and disinhibition in psychological…

21 CFR 201.23 - Required pediatric studies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Required pediatric studies. 201.23 Section 201.23 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... neonates, infants, children, and adolescents, depending upon the known or appropriate use of the drug...

21 CFR 201.23 - Required pediatric studies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Required pediatric studies. 201.23 Section 201.23 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... neonates, infants, children, and adolescents, depending upon the known or appropriate use of the drug...

21 CFR 201.23 - Required pediatric studies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Required pediatric studies. 201.23 Section 201.23 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... neonates, infants, children, and adolescents, depending upon the known or appropriate use of the drug...

Children's need for favorable acoustics in schools

NASA Astrophysics Data System (ADS)

Nelson, Peggy B.

2003-10-01

Children continue to improve their understanding of speech in noise and reverberation throughout childhood and adolescence. They do not typically achieve adult performance levels until their late teenage years. As a result, schools that are designed to be acoustically adequate for adult understanding may be insufficient for full understanding by young children. In addition, children with hearing loss, those with attention problems, and those learning in a non-native language require even more favorable signal-to-noise ratios. This tutorial will review the literature gathered by the ANSl/ASA working group on classroom acoustics that shaped the recommendations of the working group. Special topics will include speech perception data from typically developing infants and children, from children with hearing loss, and from adults and children listening in a non-native language. In addition, the tutorial will overview recommendations contained within ANSI standard 12.60-2002: Acoustical Performance Criteria, Design Requirements, and Guidelines for Schools. The discussion will also include issues related to designing quiet classrooms and working with local schools and professionals.

Humanitarian and primary healthcare needs of refugee women and children in Afghanistan.

PubMed

Higgins-Steele, Ariel; Lai, David; Chikvaidze, Paata; Yousufi, Khaksar; Anwari, Zelaikha; Peeperkorn, Richard; Edmond, Karen

2017-12-11

This Commentary describes the situation and healthcare needs of Afghans returning to their country of origin. With more than 600,000 Afghans returned from Pakistan and approximately 450,000 Afghans returned from Iran in 2016, the movement of people, which has been continuing in 2017, presents additional burden on the weak health system and confounds new health vulnerabilities especially for women and children. Stewardship and response is required at all levels: the central Ministry of Public Health, Provincial Health Departments and community leaders all have important roles, while continued support from development partners and technical experts is needed to assist the health sector to address the emergency and primary healthcare needs of returnee and internally displaced women, children and families.

38 CFR 39.10 - Cemetery requirements and prohibitions and recapture provisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION..., unmarried adult children who were physically or mentally disabled and incapable of self-support, and...

26 CFR 54.4980B-6 - Electing COBRA continuation coverage.

Code of Federal Regulations, 2011 CFR

2011-04-01

... without children who is receiving employer-paid coverage under a group health plan voluntarily terminates... dependent child's ceasing to be a dependent child under the generally applicable requirements of the plan or a divorce or legal separation of a covered employee. The group health plan is not required to offer...

26 CFR 54.4980B-6 - Electing COBRA continuation coverage.

Code of Federal Regulations, 2012 CFR

2012-04-01

... without children who is receiving employer-paid coverage under a group health plan voluntarily terminates... dependent child's ceasing to be a dependent child under the generally applicable requirements of the plan or a divorce or legal separation of a covered employee. The group health plan is not required to offer...

26 CFR 54.4980B-6 - Electing COBRA continuation coverage.

Code of Federal Regulations, 2013 CFR

2013-04-01

... without children who is receiving employer-paid coverage under a group health plan voluntarily terminates... dependent child's ceasing to be a dependent child under the generally applicable requirements of the plan or a divorce or legal separation of a covered employee. The group health plan is not required to offer...

Preterm children at early adolescence and continuity and discontinuity in maternal responsiveness from infancy.

PubMed

Beckwith, L; Rodning, C; Cohen, S

1992-10-01

Patterns in mother-child interaction from infancy to age 12 were investigated in a prospective, longitudinal study of 44 English-speaking mothers and their preterm children. Maternal responsiveness was assessed by home observations during infancy and the Family Interaction Q-Sort at age 12, derived from 2 structured laboratory situations requiring cooperation of mother and child. A cluster of maternal behaviors of critical control toward the toddler was assessed at age 2 years. Children of mothers who were consistently more responsive during both infancy and early adolescence, as well as children whose mothers became more responsive by age 12, achieved higher IQ and arithmetic scores, had more positive self-esteem, and their teachers reported fewer behavioral and emotional problems than children of mothers who were consistently less responsive both during infancy and at age 12. Continuity in parenting behaviors was related to control and criticism beginning in the toddler period and not to degree of responsiveness to the infant.

Violence against Women in the Family Home: Acknowledging the Role of Education and the Opportunities to Utilise Technology in Prevention Efforts

ERIC Educational Resources Information Center

Guggisberg, Marika

2017-01-01

Professionals in the health and education sector require knowledge and understanding of issues of family violence. Violence in the family home against women and children continues to present alarming problems. Significant evidence suggests that not only current and former female partners, but also children, are exposed to violence in the home.…

Findings from a Clinical Learning Needs Survey at Ireland's first children's hospice.

PubMed

Quinn, Claire; Hillis, Rowan

2015-12-01

Caring for children with life-limiting conditions places exceptional demands on health professionals. Staff require the optimal skills and expertise necessary to provide the highest quality of care and to achieve this it is essential to understand their learning requirements. The aim is to share the main findings from a Clinical Learning Needs Survey conducted at LauraLynn, currently Ireland's only children's hospice. To date no other Irish service has conducted a formal identification of professional learning and development needs specific to the Irish context. The findings from the study assist workforce planning by providing a glimpse into the immediate study needs of staff working in a children's palliative care setting. The study had two main aims: a) Assist clinical staff within one organisation to identify their own professional learning priorities in children's palliative care and b) Inform the design and delivery of a responsive suite of workshops, programmes and study sessions for children's palliative care. The study identified the key learning needs as end-of-life care, palliative emergencies, communication skill development and bereavement support. These findings are similar to those found internationally and demonstrate the commitment of a new organisation to ensure that specific employee learning requirements are met if the organisation and wider specialty of Irish children's palliative care is to continue its evolution.

45 CFR 1310.12 - Required use of School Buses or Allowable Alternate Vehicles.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Required use of School Buses or Allowable Alternate Vehicles. 1310.12 Section 1310.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

45 CFR 1310.12 - Required use of School Buses or Allowable Alternate Vehicles.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Required use of School Buses or Allowable Alternate Vehicles. 1310.12 Section 1310.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...

47 CFR 97.509 - Administering VE requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 97.509 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO... comply with their instructions. (d) No VE may administer an examination to his or her spouse, children, grandchildren, stepchildren, parents, grandparents, stepparents, brothers, sisters, stepbrothers, stepsisters...

[Medico-prophylactic foundations of the safety of information and communication technologies used in educational institutions].

PubMed

Baranov, A A; Kuchma, V R; Sukhareva, L M; Stepanova, M I; Teksheva, L M

2011-01-01

The problems pertaining to the safety of information and communication technologies used in the spheres of education and leisure activities of children and adolescents are discussed. The relevant risk factors are identified. Results of physiological and hygienic studies for substantiating regulations of continuous work with a personal computer are presented taking into account the children's age and hygienic requirements to electronic teaching aids.

Differentiating children with and without a history of repeated problematic sexual behavior.

PubMed

Curwen, Tracey; Jenkins, Jennifer M; Worling, James R

2014-01-01

Many adolescents who sexually offend commenced problematic sexual behaviors as children. There is little evidence to indicate which children may be at risk to continue problematic sexual behaviors and which children will desist once identified. The goal of this study was to determine variables that differentiate children who repeated problematic sexual behaviors following adult reprimand from those who did not. Predictive accuracy of 33 risk variables was investigated using 62 children assessed for problematic sexual behaviors. Eight individual variables were related to group membership, and a total score based on the combination of these variables was predictive of group membership. The results indicate variables that may assist in identifying children requiring intervention versus those likely to discontinue problematic sexual behaviors once they are identified and reprimanded.

Focusing and shifting attention in human children (Homo sapiens) and chimpanzees (Pan troglodytes).

PubMed

Herrmann, Esther; Tomasello, Michael

2015-08-01

Humans often must coordinate co-occurring activities, and their flexible skills for doing so would seem to be uniquely powerful. In 2 studies, we compared 4- and 5-year-old children and one of humans' nearest relatives, chimpanzees, in their ability to focus and shift their attention when necessary. The results of Study 1 showed that 4-year-old children and chimpanzees were very similar in their ability to monitor two identical devices and to sequentially switch between the two to collect a reward, and that they were less successful at doing so than 5-year-old children. In Study 2, which required subjects to alternate between two different tasks, one of which had rewards continuously available whereas the other one only occasionally released rewards, no species differences were found. These results suggest that chimpanzees and human children share some fundamental attentional control skills, but that such abilities continue to develop during human ontogeny, resulting in the uniquely human capacity to succeed at complex multitasking. (c) 2015 APA, all rights reserved).

Interhospital paediatric intensive care transport: a novel transport unit based on a standard ambulance trolley.

PubMed

Vos, Gijs D; Buurman, Wim A; van Waardenburg, Dick A; Visser, Timo P L; Ramsay, Graham; Donckerwolcke, Raymond A M G

2003-09-01

A recent development in providing intensive care for children is that it is more and more centralized in tertiary centres. The centralization of intensive care facilities for children in tertiary centres demands a safe and well-organized transport system. The transfer of critically ill children from a referring general hospital to a tertiary paediatric intensive care centre should be performed by a specially trained and fully equipped transport team. During the transfer of these children continuous intensive care facilities should be provided. The minimal requirements of equipment and materials for transport that allow such care have been determined. The equipment consists of a monitor allowing continuous measurement of vital signs, a defibrillator, tools for airway and ventilatory management, an oxygen source, suction unit, fluid and electrolyte management, medication, resuscitation chart and a communication system. A mobile paediatric intensive care unit was constructed in order to store this equipment, including easily accessible ventilator and materials optimized for close patient observation and ventilator control.

Dietary intervention strategies to enhance zinc nutrition: Promotion and support of breastfeeding for infants and young children

PubMed Central

Brown, Kenneth H.; Engle-Stone, Reina; Krebs, Nancy F.; Peerson, Janet M.

2017-01-01

Breastmilk is the only dietary source of zinc for exclusively breastfed young infants, and it remains a potentially important source of zinc for older infants and young children who continue breastfeeding beyond early infancy. Therefore, we examined available information on breastmilk zinc concentration and total milk consumption to develop estimates of the amount of zinc transferred in breastmilk to children of different ages. Breastmilk zinc concentration declines rapidly during the first few months postpartum and more slowly thereafter. Breastmilk supplies all of the theoretical zinc needs for at least the first several months of life, although the period during which breastmilk alone remains sufficient is uncertain. Breastmilk continues to provide more than half of children’s estimated zinc requirements after the introduction of complementary foods, even into the second year of life. Public health programs to promote and support breastfeeding should be included among the strategies to ensure adequate zinc status of young children. PMID:19472605

34 CFR 300.122 - Evaluation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Evaluation. 300.122 Section 300.122 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND... DISABILITIES State Eligibility Additional Eligibility Requirements § 300.122 Evaluation. Children with...

45 CFR 1080.8 - Reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF COMMUNITY SERVICES, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES EMERGENCY COMMUNITY SERVICES... Community Services Homeless Grant Program shall submit an annual report to the Secretary, within 6 months of...

45 CFR 1080.8 - Reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF COMMUNITY SERVICES, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES EMERGENCY COMMUNITY SERVICES... Community Services Homeless Grant Program shall submit an annual report to the Secretary, within 6 months of...

Metabolic syndrome in young children: definitions and results of the IDEFICS study.

PubMed

Ahrens, W; Moreno, L A; Mårild, S; Molnár, D; Siani, A; De Henauw, S; Böhmann, J; Günther, K; Hadjigeorgiou, C; Iacoviello, L; Lissner, L; Veidebaum, T; Pohlabeln, H; Pigeot, I

2014-09-01

To estimate the prevalence of the metabolic syndrome (MetS) using reference standards obtained in European children and to develop a quantitative MetS score and describe its distribution in children. Population-based survey in eight European countries, including 18745 children 2.0 to 10.9 years, recruited during a second survey. Anthropometry (weight, height and waist circumference), blood pressure and serum-fasting triglycerides, HDL cholesterol, glucose and insulin were measured. We applied three widely accepted definitions of the pediatric MetS and we suggest a new definition, to guide pediatricians in decisions about close monitoring or even intervention (values of at least three of the MetS components exceeding the 90th or 95th percentile, respectively). We used a z-score standardisation to calculate a continuous score combining the MetS components. Among the various definitions of MetS, the highest prevalence (5.5%) was obtained with our new definition requiring close observation (monitoring level). Our more conservative definition, requiring pediatric intervention gives a prevalence of 1.8%. In general, prevalences were higher in girls than in boys. The prevalence of metabolic syndrome is highest among obese children. All definitions classify a small percentage of thin or normal weight children as being affected. The metabolic syndrome score shows a positive trend with age, particularly regarding the upper percentiles of the score. According to different definitions of pediatric MetS, a non-negligible proportion of mostly prepubertal children are classified as affected. We propose a new definition of MetS that should improve clinical guidance. The continuous score developed may also serve as a useful tool in pediatric obesity research. It has to be noted, however, that the proposed cutoffs are based on a statistical definition that does not yet allow to quantify the risk of subsequent disease.

The efficacy and safety of burr-hole craniotomy without continuous drainage for chronic subdural hematoma and subdural hygroma in children under 2 years of age.

PubMed

Matsuo, Kazuya; Akutsu, Nobuyuki; Otsuka, Kunitoshi; Yamamoto, Kazuki; Kawamura, Atsufumi; Nagashima, Tatsuya

2016-12-01

Various treatment modalities have been used in the management of chronic subdural hematoma and subdural hygroma (CSDH/SDHy) in children. However, few studies have examined burr-hole craniotomy without continuous drainage in such cases. Here, we retrospectively evaluated the efficacy and safety of burr-hole craniotomy without continuous drainage for CSDH/SDHy in children under 2 years old. We also aimed to determine the predictors of CSDH/SDHy recurrence. We conducted a retrospective chart review of 25 children under 2 years old who underwent burr-hole craniotomy without continuous drainage for CSDH/SDHy at a pediatric teaching hospital over a 10-year period. We analyzed the relationship between CSDH/SDHy recurrence and factors such as abusive head trauma, laterality of CSDH/SDHy, and subdural fluid collection type (hematoma or hygroma). CSDH/SDHy recurred in 5 of the 25 patients (20 %), requiring a second operation at an average of 0.92 ± 1.12 months after the initial procedure. The mean follow-up period was 25.1 ± 28.6 months. There were no complications related to either operation. None of the assessed factors were statistically associated with recurrence. Burr-hole craniotomy without continuous drainage for CSDH/SDHy appears safe in children aged under 2 years and results in a relatively low recurrence rate. No predictors of CSDH/SDHy recurrence were identified. Advantages of this method include avoiding external subdural drainage-related complications. However, burr-hole drainage may be more effective for CSDH, which our data suggests is more likely to recur than SDHy, providing the procedure is performed with specific efforts to reduce complications.

Intravenous magnesium sulfate for vaso-occlusive episodes in sickle cell disease.

PubMed

Goldman, Ran D; Mounstephen, William; Kirby-Allen, Melanie; Friedman, Jeremy N

2013-12-01

Vaso-occlusive episodes (VOEs) are the most common complication of sickle cell disease in children. Treatment with magnesium seems to improve cellular hydration and may result in reduced vaso-occlusion. This study aimed to determine if intravenous (IV) magnesium sulfate (MgSO4) reduces length of stay (LOS) in hospital, pain scores, and cumulative analgesia when compared with placebo. Randomized, double-blind, placebo-controlled trial in children aged 4 to 18 years requiring admission to hospital with a sickle cell disease VOE requiring IV analgesia. Participating children received IV MgSO4 (100 mg/kg) every 8 hours or placebo in addition to standard therapy. We used a t test or Mann-Whitney test (continuous variables), Fisher's exact test, or χ2 test (frequencies). P values were considered significant if <.05, and 95% confidence intervals were calculated for the difference between groups. One hundred six children were randomly assigned to the study, and 104 were included. Fifty-one (49%) received MgSO4. Children's mean age was 12.4 years (range: 4-18 years; SD: 3.8 years), and 56 (54%) were females. There was no significant difference in the primary outcome measure, LOS in hospital, with a mean of 132.6 and 117.7 hours in the MgSO4 and placebo groups, respectively (P = .41). There was no significant difference between groups for the secondary outcomes of mean pain scores (4.9 ± 2.6 vs 4.8 ± 2.6, respectively; P = .92) or analgesic requirements (continuous morphine infusion [P = .928], boluses of IV morphine [P = .82], acetaminophen [P = .34], ibuprofen [P = .15], naproxen [P = .10]). Only minor adverse events were recorded in both groups. Pain at the infusion site was more common in the MgSO4 group. IV MgSO4 was well tolerated but had no effect on the LOS in hospital, pain scores, or cumulative analgesia use in admitted children with a VOE.

34 CFR 300.123 - Confidentiality of personally identifiable information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements... 34 Education 2 2010-07-01 2010-07-01 false Confidentiality of personally identifiable information. 300.123 Section 300.123 Education Regulations of the Offices of the Department of Education (Continued...

34 CFR 300.123 - Confidentiality of personally identifiable information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements... 34 Education 2 2011-07-01 2010-07-01 true Confidentiality of personally identifiable information. 300.123 Section 300.123 Education Regulations of the Offices of the Department of Education (Continued...

7 CFR 246.28 - OMB control numbers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN... information collection requirements in 7 CFR part 246 by the Office of Management and Budget pursuant to the...

7 CFR 246.28 - OMB control numbers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN... information collection requirements in 7 CFR part 246 by the Office of Management and Budget pursuant to the...

7 CFR 246.28 - OMB control numbers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN... information collection requirements in 7 CFR part 246 by the Office of Management and Budget pursuant to the...

7 CFR 246.28 - OMB control numbers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN... information collection requirements in 7 CFR part 246 by the Office of Management and Budget pursuant to the...

7 CFR 246.28 - OMB control numbers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN... information collection requirements in 7 CFR part 246 by the Office of Management and Budget pursuant to the...

Classification and Management of Pediatric Subaxial Cervical Spine Injuries.

PubMed

Madura, Casey J; Johnston, James M

2017-01-01

Appropriate management of subaxial spine injury in children requires an appreciation for the differences in anatomy, biomechanics, injury patterns, and treatment options compared with adult patients. Increased flexibility, weak neck muscles, and cranial disproportion predispose younger children to upper cervical injuries and spinal cord injury without radiographic abnormality. A majority of subaxial cervical spine injuries can be treated nonoperatively. Surgical instrumentation options for children have significantly increased in recent years. Future studies of outcomes for children with subaxial cervical spine injury should focus on injury classification and standardized outcome measures to ensure continued improvement in quality of care for this patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

Parenting practices and problem behavior across three generations: monitoring, harsh discipline, and drug use in the intergenerational transmission of externalizing behavior.

PubMed

Bailey, Jennifer A; Hill, Karl G; Oesterle, Sabrina; Hawkins, J David

2009-09-01

Using data from grandparents (G1), parents (G2), and children (G3), this study examined continuity in parental monitoring, harsh discipline, and child externalizing behavior across generations, and the contribution of parenting practices and parental drug use to intergenerational continuity in child externalizing behavior. Structural equation and path modeling of prospective, longitudinal data from 808 G2 participants, their G1 parents, and their school-age G3 children (n = 136) showed that parental monitoring and harsh discipline demonstrated continuity from G1 to G2. Externalizing behavior demonstrated continuity from G2 to G3. Continuity in parenting practices did not explain the intergenerational continuity in externalizing behavior. Rather, G2 adolescent externalizing behavior predicted their adult substance use, which was associated with G3 externalizing behavior. A small indirect effect of G1 harsh parenting on G3 was observed. Interparental abuse and socidemographic risk were included as controls but did not explain the intergenerational transmission of externalizing behavior. Results highlight the need for preventive interventions aimed at breaking intergenerational cycles in poor parenting practices. More research is required to identify parental mechanisms influencing the continuity of externalizing behavior across generations.

42 CFR 457.1180 - Program specific review process: Notice.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections § 457.1180 Program specific review process... explanation of applicable rights to review of that determination, the standard and expedited time frames for...

42 CFR 457.1180 - Program specific review process: Notice.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections § 457.1180 Program specific review process... explanation of applicable rights to review of that determination, the standard and expedited time frames for...

42 CFR 457.1180 - Program specific review process: Notice.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections § 457.1180 Program specific review process... explanation of applicable rights to review of that determination, the standard and expedited time frames for...

42 CFR 457.1180 - Program specific review process: Notice.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections § 457.1180 Program specific review process... explanation of applicable rights to review of that determination, the standard and expedited time frames for...

42 CFR 457.1180 - Program specific review process: Notice.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections § 457.1180 Program specific review process... explanation of applicable rights to review of that determination, the standard and expedited time frames for...

Avoiding Failure

ERIC Educational Resources Information Center

McGraw, Michael

2010-01-01

Evidence continues to emerge about the effect indoor air quality has on a student's ability to learn. One study cited by the U.S. Environmental Protection Agency (EPA) shows moderate changes in room temperature affect children's abilities to perform mental tasks requiring concentration, such as addition, multiplication and sentence comprehension.…

Evaluation of adverse events noted in children receiving continuous infusions of dexmedetomidine in the intensive care unit.

PubMed

Honey, Brooke L; Harrison, Donald L; Gormley, Andrew K; Johnson, Peter N

2010-01-01

Dexmedetomidine is an α(2)-adrenergic receptor agonist with sedative and analgesic effects in mechanically ventilated adults and children. Safety and efficacy data are limited in children. The purpose of this study is to retrospectively identify the incidence and types of adverse events noted in children receiving continuous infusions of dexmedetomidine and evaluate potential risk factors for adverse events. Between July 1, 2006, and July 31, 2007, data were collected on all children (< 18 years) who received continuous infusions of dexmedetomidine. Data collection included demographics, dexmedetomidine regimen, and type/number of adverse events. The primary endpoint was the total number of adverse events noted, including: transient hypertension, hypotension, neurological manifestations, apnea, and bradycardia. Secondary endpoints included categorization of each type of adverse event and an assessment of risk factors. A logistic regression model was used to assess the relationship of adverse events with independent variables including length of ICU stay, cumulative dose, peak infusion rate, duration of therapy, PRISM III score, and bolus dose. Thirty-six patients received dexmedetomidine representing 41 infusions. The median age was 16 months (range, 0.1-204 months) and median PRISM III score was 2 (range, 0-18). Eighteen (43.9%) patients received a bolus dose of dexmedetomidine. The median cumulative dose (mcg/kg) and peak dose (mcg/kg/hr) were 8.5 (range, 2.2-193.7) and 0.5 (range, 0.2-0.7), respectively. Dexmedetomidine was continued for a median of 20 (range, 3-263) hours. Six (14.6%) patients were slowly tapered off the continuous infusions. Twenty-one adverse events were noted in 17 patients, including 4 neurologic manifestations. Fourteen patients required interventions for adverse events. ICU length of stay was the only independent risk factor (p=0.036) for development of adverse events. Several potential adverse events were noted with dexmedetomidine continuous infusions including possible neurological manifestations. Further studies are needed looking at adverse events associated with dexmedetomidine use in the pediatric population.

Glucose metabolism disorder in obese children assessed by continuous glucose monitoring system.

PubMed

Zou, Chao-Chun; Liang, Li; Hong, Fang; Zhao, Zheng-Yan

2008-02-01

Continuous glucose monitoring system (CGMS) can measure glucose levels at 5-minute intervals over a few days, and may be used to detect hypoglycemia, guide insulin therapy, and control glucose levels. This study was undertaken to assess the glucose metabolism disorder by CGMS in obese children. Eighty-four obese children were studied. Interstitial fluid (ISF) glucose levels were measured by CGMS for 24 hours covering the time for oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), type 2 diabetic mellitus (T2DM) and hypoglycemia were assessed by CGMS. Five children failed to complete CGMS test. The glucose levels in ISF measured by CGMS were highly correlated with those in capillary samples (r=0.775, P<0.001). However, the correlation between ISF and capillary glucose levels was lower during the first hour than that in the later time period (r=0.722 vs r=0.830), and the ISF glucose levels in 69.62% of children were higher than baseline levels in the initial 1-3 hours. In 79 obese children who finished the CGMS, 2 children had IFG, 2 had IGT, 3 had IFG + IGT, and 2 had T2DM. Nocturnal hypoglycemia was noted during the overnight fasting in 11 children (13.92%). Our data suggest that glucose metabolism disorder including hyperglycemia and hypoglycemia is very common in obese children. Further studies are required to improve the precision of the CGMS in children.

We are not alone: international learning for professionals caring for children requiring palliative care.

PubMed

Price, Jayne; Quinn, Karen; McNeilly, Patricia; Heywood, Melissa

2015-06-01

Educational opportunities for professionals working with children requiring palliative care are central to future development within the specialty across countries. International educational initiatives involving a range of professionals are important for learning with and from others working within the field. To explore the experiences and value to students from participating in an international online discussion forum. This article examines one such initiative; the use of an international asynchronous discussion forum with students in Melbourne, Australia and Belfast, UK who work with children and families. The innovation is examined and student perspectives of the forum's value are presented. Students endorsed the value of the forum, identifying three main areas of learning: differences across locations within countries, respecting different views and being open, and need for continued learning within children's palliative care. The overarching theme 'we are not alone' supported the idea that participation in the international discussion forum enabled students to see a broader perspective. Ideas for future developments of similar forums are also explored.

Access to augmentative and alternative communication: new technologies and clinical decision-making.

PubMed

Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

2012-01-01

Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

Connecting, Creating and Composing: A Shared Multimodal Journey

ERIC Educational Resources Information Center

Krause, Margaret B.

2015-01-01

Given the dynamic nature of our society, literacy conceptualizations are constantly being redefined. While print literacy continues to be the primary literacy within elementary classroom, the growing nature of technological capabilities, social networking, and multimodal affordances require educators to delve into explorations of how children can…

34 CFR 300.155 - Hearings relating to LEA eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements § 300.155... 34 Education 2 2010-07-01 2010-07-01 false Hearings relating to LEA eligibility. 300.155 Section 300.155 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF...

34 CFR 300.155 - Hearings relating to LEA eligibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements § 300.155... 34 Education 2 2011-07-01 2010-07-01 true Hearings relating to LEA eligibility. 300.155 Section 300.155 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF...

Family Functions and Life Quality of Parents of Children With Cleft Lip and Palate.

PubMed

Aslan, Belma I; Gülşen, Ayşe; Tirank, Şadiye B; Findikçioğlu, Kemal; Uzuner, F Deniz; Tutar, Hakan; Üçüncü, Neslihan

2018-05-15

This study was designed to identify variables affecting family functions and life quality of parents with cleft lip and/or palate children. Family Assesment Scale (FAS) and short form of World Health Organization quality of life (WHOQOL-BREF-TR) were used to measure family functions and life quality of parents. Questionnaire Forms were given to 146 parents: 74 having cleft lip and/or palate children (cleft-group), and the other 72 with healthy children (control-group). Parents were divided into 3 subgroups according to children's age as 0 to 6, 7 to 12, and 13 to 18 years. Kruskal-Wallis and Mann-Whitney U tests were used to evaluate differences between the groups. Behavior of cleft patients' parents was found to be problematic in behavioral control, required attention and role areas at 0 to 6 years, required attention area at ages 7 to 12 and 13 to 18 years. When compared to control group, significant differences were detected in required attention at ages 0 to 6 years, problem-solving, and communication areas at 7 to 12 years. Findings of life quality were found to be over medium level in physical, social, psychological and environmental areas in cleft group at all age groups; however, life quality was found better in control group in physical, psychological, and social subtests at age 13 to 18 years. Cleft children influence family functions in behavioral control, required attention and role areas at early childhood, and continue to affect required attention through adolescence. Also social, physical, and psychological fields of life quality were found lower in cleft parents compared to control group at adolescence.

A longitudinal study of resolution of allergy to well-cooked and uncooked egg.

PubMed

Clark, A; Islam, S; King, Y; Deighton, J; Szun, S; Anagnostou, K; Ewan, P

2011-05-01

Egg allergy is common and although resolution to uncooked egg has been demonstrated, there is lack of evidence to guide reintroduction of well-cooked egg. To examine the rate of resolution to well-cooked, compared with uncooked egg in children, and safety of egg challenges. A longitudinal study of egg-allergic children from 2004 to 2010, who underwent challenge with well-cooked and if negative, uncooked egg. Participants underwent repeat annual challenges and egg-specific IgE measurement. One hundred and eighty-one open egg challenges were performed in 95 children whose median age of allergy onset was 12 months. Fifty-three of 95 (56%) had at least one annual repeat challenge. Pre-study historical reactions occurred to baked egg in five (5%), lightly cooked in 58 (61%) and uncooked in nine (9%); respiratory reactions occurred in 11 (12%) and seven (7%) had anaphylaxis; adrenaline was used during five reactions. There were 77 well-cooked and 104 uncooked egg challenges. Tolerance was gained twice as rapidly to well-cooked than uncooked egg (median 5.6 vs. 10.3 years; P<0.0001) and continued to 13 years; hazard ratio 2.23 (95% confidence interval 1.6-3.9). Nearly 1/3 had resolved allergy to well-cooked egg at 3 years and 2/3 at 6 years. Of 28/77 (37%) positive well-cooked egg challenges, 65% had cutaneous symptoms, 68% gastrointestinal and 39% rhinitis, with no other respiratory reactions. Adrenaline was not required. CONCLUSIONS AND CLINICAL RELEVANCE RESOLUTION: of egg allergy takes place over many years, with children outgrowing allergy to well-cooked egg approximately twice as quickly as they outgrow allergy to uncooked egg. There were no severe reactions to well-cooked egg challenge, and adrenaline was not required. Our data support initiation of home reintroduction of well-cooked egg from 2 to 3 years of age in children with previous mild reactions and no asthma. Resolution continues to occur in older children, so that despite an earlier positive challenge, attempts at reintroduction should be continued. © 2011 Blackwell Publishing Ltd.

Feasibility of integrated home/hospital physiotherapeutic support for children with cancer.

PubMed

Savio, Christian; Garaventa, Alberto; Gremmo, Marina; Camoriano, Riccardo; Manfredini, Luca; Fieramosca, Sara; Dini, Giorgio; Miano, Maurizio

2007-01-01

Children suffering from cancer often have to undergo physiotherapy that either extends the duration of in-patient hospitalisation or requires more frequent visits to the outpatient clinic. To improve care and to decrease the length of hospitalisation of children being treated at the Dept. of Haematoloy/Oncology of the Gaslini Children's Hospital, a programme of Home Care was set up in April 2000. In June 2003, rehabilitation was added to the procedures that were feasible at home and included i.v. therapy administration, blood examinations, transfusion and/or psychological support, as well as palliative care for terminally ill children. The physiotherapy sessions were done in the ward, in the Rehabilitation Unit Gym, or at home, depending on the clinical conditions and the needs of the child and the family. Between June 2003 and May 2005, 46 children, whose median age was 7 years (range 6 months-21 years) suffering from CNS tumours (13), leukaemia (13), neuroblastoma (7), bone tumours (6), sarcoma (4) and lymphoma (3), underwent 1,398 physiotherapy sessions for neuro-motor re-education (534), motor rehabilitation (485), strain re-education and training (250), respiratory care (79), or to improve comfort during the terminal phase of the disease (50). To maintain continuity of care, the treatments were performed at home (931), in the hospital ward (282), or in the gymnasium of our Physiotherapy Service (185). The physiotherapist was able to start or to continue assistance at home or in the hospital, and to keep up the programme based on the child's needs. Integrated home/hospital physiotherapy for children suffering from cancer is feasible and is useful for maintaining continuity of treatment without lengthening hospitalisation.

[Cannabis use among children and adolescents: impacts and consequences].

PubMed

Peyret, Emmanuelle; Delorme, Richard

2014-03-01

A health policy for the prevention and treatment of cannabis-related disorders is urgently needed in France, given the high prevalence of cannabis use among children and adolescents. Such a policy will require a better understanding of the endo-cannabinoid system and the impact of exogenous cannabinoids in this fragile population. The brain continues to undergo significant development until the age of about 25 years, and cannabis consumption by young people therefore carries specific risks of dependence (frequency and intensity), and of neuroanatomical, cognitive and emotional damage. This article summarizes the available data and offers a medical view of the risks and consequences of cannabis use by children and adolescents.

Outcomes of an inner-city vision outreach program: give kids sight day.

PubMed

Dotan, Gad; Truong, Billy; Snitzer, Melanie; McCauley, Colleen; Martinez-Helfman, Sarah; Santa Maria, Kathy; Levin, Alex V

2015-05-01

Low-socioeconomic urban children often do not have access to ophthalmic care. To characterize the demographic characteristics and ophthalmic conditions in children attending Give Kids Sight Day (GKSD), an outreach ophthalmic care program held annually in Philadelphia, Pennsylvania, providing vision screening and immediate treatment when needed. Retrospective case-series study of children attending GKSD in 2012 (GKSD 2012) at an ophthalmology center in Philadelphia. Registration forms and records of all children attending GKSD 2012 were reviewed. Demographic characteristics, insurance status, spoken languages, reasons for attending, prior failure of vision screening, and attendance pattern of previous events were analyzed. The ophthalmological findings of these children were examined, including refractive errors, need for optical correction, and diagnoses for which continuous ophthalmic care was necessary. For children who needed ophthalmic follow-up, the rate of return to clinic and barriers for continuous care were analyzed. We studied 924 children (mean age, 9 years; age range, 0-18 years; 51% female; 25% speaking a non-English language) coming from 584 families who attended GKSD 2012, of whom 27% were uninsured and 10% were not aware of their insurance status. Forty-two percent of participants had public insurance, which covered vision care and glasses, but 35% did not know their benefits and did not realize vision care was covered. Forty-nine percent of children attended because they failed community vision screening. Provision of free glasses and failure of previous vision screening were the most common reasons families elected to attend GKSD (64% and 49%, respectively). Eighty-five percent of children attended GKSD 2012 for the first time, whereas 15% attended prior events. Glasses were provided to 61% of attendees. Ten percent of the attendees needed continuous ophthalmic care, most commonly for amblyopia. Ten children needed ocular surgery for cataract, strabismus, nystagmus, ptosis, or nasolacrimal duct obstruction. With the assistance of a social worker, 59% of children requiring continuous treatment returned to the clinic, compared with 2% in prior years before social worker intervention. Programs such as GKSD can bridge the gap between successful vision screening and ophthalmic treatment, a gap that often occurs in low-socioeconomic urban populations. Those with public insurance coverage for vision services may not realize these services are covered. Social worker intervention is useful in overcoming common barriers to follow-up care.

Electrographic status epilepticus in children with critical illness: Epidemiology and outcome.

PubMed

Abend, Nicholas S

2015-08-01

Electrographic seizures and electrographic status epilepticus are common in children with critical illness with acute encephalopathy, leading to increasing use of continuous EEG monitoring. Many children with electrographic status epilepticus have no associated clinical signs, so EEG monitoring is required for seizure identification. Further, there is increasing evidence that high seizure burdens, often classified as electrographic status epilepticus, are associated with worse outcomes. This review discusses the incidence of electrographic status epilepticus, risk factors for electrographic status epilepticus, and associations between electrographic status epilepticus and outcomes, and it summarizes recent guidelines and consensus statements addressing EEG monitoring in children with critical illness. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.

Physical punishment of children: can we continue to accept the status quo?

PubMed

Oates, Kim

2011-08-01

All children require discipline, although physical punishment is just one form of discipline. Parental use of physical punishment is inter-generational. There is now evidence that physical punishment of children is not only less effective than other forms of discipline but can also lead to aggressive behaviour in childhood and adult life. Twenty-nine countries, including New Zealand, have laws against physical punishment in the home. Australian attitudes are slowly changing in favour of less use of physical punishment, but there is a long way to go. As advocates for children, paediatricians should not be content to accept the status quo. © 2011 The Author. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

42 CFR 457.1110 - Privacy protections.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Privacy protections. 457.1110 Section 457.1110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections §...

42 CFR 457.1110 - Privacy protections.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Privacy protections. 457.1110 Section 457.1110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections §...

42 CFR 457.1110 - Privacy protections.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Privacy protections. 457.1110 Section 457.1110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections §...

42 CFR 457.1110 - Privacy protections.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Privacy protections. 457.1110 Section 457.1110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections §...

42 CFR 457.1110 - Privacy protections.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Privacy protections. 457.1110 Section 457.1110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Applicant and Enrollee Protections §...

34 CFR 300.103 - FAPE-methods and payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false FAPE-methods and payments. 300.103 Section 300.103 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.103 FAPE—methods and payments...

45 CFR 1356.22 - Implementation requirements for children voluntarily placed in foster care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... voluntary foster care maintenance expenditures made within the first 180 days of the child's placement in... voluntarily placed in foster care. 1356.22 Section 1356.22 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1356.22 - Implementation requirements for children voluntarily placed in foster care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... only for voluntary foster care maintenance expenditures made within the first 180 days of the child's... voluntarily placed in foster care. 1356.22 Section 1356.22 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1356.22 - Implementation requirements for children voluntarily placed in foster care.

Code of Federal Regulations, 2014 CFR

2014-10-01

... only for voluntary foster care maintenance expenditures made within the first 180 days of the child's... voluntarily placed in foster care. 1356.22 Section 1356.22 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1356.22 - Implementation requirements for children voluntarily placed in foster care.

Code of Federal Regulations, 2013 CFR

2013-10-01

... only for voluntary foster care maintenance expenditures made within the first 180 days of the child's... voluntarily placed in foster care. 1356.22 Section 1356.22 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1356.22 - Implementation requirements for children voluntarily placed in foster care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... voluntary foster care maintenance expenditures made within the first 180 days of the child's placement in... voluntarily placed in foster care. 1356.22 Section 1356.22 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1356.21 - Foster care maintenance payments program implementation requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND... maintain the family unit and prevent the unnecessary removal of a child from his/her home, as long as the...

45 CFR 1356.21 - Foster care maintenance payments program implementation requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be filed within 60 days of the judicial determination that the child is an abandoned infant; or, (iii... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

45 CFR 1356.21 - Foster care maintenance payments program implementation requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND... maintain the family unit and prevent the unnecessary removal of a child from his/her home, as long as the...

45 CFR 1356.21 - Foster care maintenance payments program implementation requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... be filed within 60 days of the judicial determination that the child is an abandoned infant; or, (iii... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

45 CFR 1356.21 - Foster care maintenance payments program implementation requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND... maintain the family unit and prevent the unnecessary removal of a child from his/her home, as long as the...

34 CFR 300.109 - Full educational opportunity goal (FEOG).

Code of Federal Regulations, 2011 CFR

2011-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.109 Full educational... 34 Education 2 2011-07-01 2010-07-01 true Full educational opportunity goal (FEOG). 300.109 Section 300.109 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF...

34 CFR 300.158-300.159 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false [Reserved] 300.158-300.159 Section 300.158-300.159 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements §§ 300.158-300.159...

34 CFR 300.125-300.128 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false [Reserved] 300.125-300.128 Section 300.125-300.128 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements §§ 300.125-300.128...

34 CFR 300.125-300.128 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true [Reserved] 300.125-300.128 Section 300.125-300.128 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements §§ 300.125-300.128...

34 CFR 300.125-300.128 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false [Reserved] 300.125-300.128 Section 300.125-300.128 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements §§ 300.125-300.128...

34 CFR 300.158-300.159 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false [Reserved] 300.158-300.159 Section 300.158-300.159 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements §§ 300.158-300.159...

34 CFR 300.158-300.159 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true [Reserved] 300.158-300.159 Section 300.158-300.159 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION... CHILDREN WITH DISABILITIES State Eligibility Additional Eligibility Requirements §§ 300.158-300.159...

34 CFR 300.109 - Full educational opportunity goal (FEOG).

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.109 Full educational... 34 Education 2 2010-07-01 2010-07-01 false Full educational opportunity goal (FEOG). 300.109 Section 300.109 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF...

42 CFR 457.310 - Targeted low-income child.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

42 CFR 457.402 - Definition of child health assistance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Definition of child health assistance. 457.402... SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Coverage and Benefits § 457.402 Definition of child health assistance. For the...

42 CFR 457.310 - Targeted low-income child.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

42 CFR 457.310 - Targeted low-income child.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

42 CFR 457.310 - Targeted low-income child.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

42 CFR 457.310 - Targeted low-income child.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

BIOCHEMICAL HOMEOSTASIS AND BODY GROWTH ARE RELIABLE END POINTS IN CLINICAL NUTRITION TRIALS

USDA-ARS?s Scientific Manuscript database

Studies of biochemical homeostasis and/or body growth have been included as outcome variables in most nutrition trials in paediatric patients. Moreover, these outcome variables have provided important insights into the nutrient requirements of infants and children, and continue to do so. Examples ...

Autism and Pediatric Practice: Toward a Medical Home

ERIC Educational Resources Information Center

Hyman, Susan L.; Johnson, Jara K.

2012-01-01

The pediatrician sees a child for 11 well child visits by their third birthday. The provision of continuous primary care supports development of trust with parents, provides opportunity for screening and surveillance of autism spectrum disorders (ASD), allows monitoring the progress of children requiring therapy, and a framework to support and…

29 CFR 2590.606-4 - Notice requirements for plan administrators.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Coverage, Qualified Medical Child Support Orders, Coverage for Adopted Children § 2590.606-4 Notice... child; (v) An explanation of the plan's procedures for electing continuation coverage, including an... the Social Security Administration, under title II or XVI of the Social Security Act (42 U.S.C. 401 et...

FOCUSING ON CHILDREN'S INHALATION DOSIMETRY AND HEALTH EFFECTS FOR RISK ASSESSMENT: AN INTRODUCTION (Journal Article)

EPA Science Inventory

Substantial effort has been invested in improving children’s health risk assessment in recent years. However, the body of scientific evidence in support of children’s health assessment is constantly advancing requiring continual updating of risk assessment methods. Children’s i...

Impact of childhood cancer on maternal employment in Japan.

PubMed

Okada, Hiromi; Maru, Mitsue; Maeda, Rumi; Iwasaki, Fuminori; Nagasawa, Masayuki; Takahashi, Miyako

2015-01-01

Family members of children with cancer experience various long-term effects as a result of cancer diagnosis and treatment. Therefore, comprehensive and long-term support is needed. As the employment rate of women has increased in recent years, support for working mothers with children diagnosed with cancer is also required. We investigated the following issues and relevant changes that working mothers of children diagnosed with cancer must deal with: (1) work change, (2) stress, (3) social support, (4) work motivation, and (5) employment status after diagnosis. A cross-sectional exploratory study design was used. Data were collected from 62 mothers of children who were diagnosed with cancer using self-report questionnaires. Of the 32 mothers who worked at the time of diagnosis, 10 continued to work, 12 took an extended leave, and 10 quit working, and 70% lost motivation for work following diagnosis. Half of mothers who continued to work during treatment reported financial reasons. These findings indicate that mothers who quit work following diagnosis did not initially consider a long leave of absence. Even mothers who continued to work during treatment desired a long leave of absence to care for their children. Nurses should provide mothers with explanations of the prospects after the completion of cancer treatment and determine their expectations for their lifestyle and work during treatment. We recommend that nurses confirm mothers' willingness to take a long leave of absence from work and give relevant advice about seeking financial assistance.

Diagnosis and management of classical congenital adrenal hyperplasia.

PubMed

Marumudi, Eunice; Khadgawat, Rajesh; Surana, Vineet; Shabir, Iram; Joseph, Angela; Ammini, Ariachery C

2013-08-01

Congenital adrenal hyperplasia (CAH) is among the most common genetic disorders. Deficiency of adrenal steroid 21-hydroxylase deficiency due to mutations in the CYP21A2 gene accounts for about 95% cases of CAH. This disorder manifests with androgen excess with or without salt wasting. It also is a potentially life threatening disorder; neonatal screening with 17-hydroxyprogesterone measurement can diagnose the condition in asymptomatic children. Carefully monitored therapy with glucocorticoid and mineralocorticoid supplementation will ensure optimal growth and development for children with CAH. Genital surgery may be required for girls with CAH. Continued care is required for individuals with CAH as adults to prevent long-term adverse consequences of the disease, including infertility, metabolic syndrome and osteoporosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Managing problematic severe asthma: beyond the guidelines.

PubMed

Pike, Katharine C; Levy, Mark L; Moreiras, John; Fleming, Louise

2018-04-01

This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients' asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Continuous subcutaneous insulin infusion: Special needs for children.

PubMed

Adolfsson, Peter; Ziegler, Ralph; Hanas, Ragnar

2017-06-01

Continuous subcutaneous insulin infusion (CSII) is a very common therapy for children with type 1 diabetes. Due to physiological differences they have other requirements for their insulin pump than adults. The main difference is the need for very low basal rates. Even though most available insulin pumps reach a high accuracy at usual basal rates, accuracy decreases for lower rates. In addition, the lowest delivered amount at 1 time is limiting the fine tuning of the basal rate as well as the option for temporary basal rates. Alarms in case of occlusions depend on accumulation of a certain amount of insulin in the catheter, and therefore the time until such an alarm is triggered is much longer with lower basal rates. Accordingly, the risk for hyperglycemia developing into diabetic ketoacidosis increases. The availability of bolus advisors facilitates the calculation of meal and correction boluses for children and their parents. However, there are some differences between the calculators, and the settings that the calculation is based on are very important. Better connectivity, for example with a system for continuous glucose monitoring, might help to further increase safety in the use of CSII in children. When selecting an insulin pump for a child, the features and characteristics of available pumps should be properly compared to ensure an effective and safe therapy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Safety and efficacy of intravenous labetalol for hypertensive crisis in infants and small children.

PubMed

Thomas, Christopher A; Moffett, Brady S; Wagner, Jeffrey L; Mott, Antonio R; Feig, Daniel I

2011-01-01

To determine the efficacy and safety of labetalol for hypertensive crisis in children ≤ 24 months of age. Retrospective chart review. Statistical analysis utilized analysis of variance for continuous data, chi-square tests for nominal data, and linear regression. A 737-bed pediatric teaching institution. Twenty-seven patients ≤ 24 months of age were treated with 37 intravenous infusions of labetalol, nicardipine, or nitroprusside for hypertensive crisis or hypertensive urgency. None. The primary end point consisted of time to 20% reduction in systolic blood pressure. Primary safety end points measured the prevalence of deleterious effects of labetalol. Continuous infusion of labetalol reduced mean systolic blood pressure by at least 20% in < 8 hrs. This effect was similar to nicardipine and nitroprusside infusions. The reported side effects were similar in each group. Patients receiving labetalol and presenting with ischemic or traumatic brain injury were likely to develop hypotension requiring infusion discontinuation. Continuous intravenous labetalol infusion is efficacious for treatment of hypertensive crisis in children ≤ 24 months of age. Aside from patients presenting with ischemic or traumatic brain injury, labetalol was safe to use in this population for hypertensive emergencies and had a satisfactory adverse effect profile. Labetalol may reach dose saturation at a much lower dose in young children in comparison to adults. Clinicians should use caution when initiating labetalol infusions in young patients with brain injury.

A child with a difficult airway: what do I do next?

PubMed

Engelhardt, Thomas; Weiss, Markus

2012-06-01

Difficulties in pediatric airway management are common and continue to result in significant morbidity and mortality. This review reports on current concepts in approaching a child with a difficult airway. Routine airway management in healthy children with normal airways is simple in experienced hands. Mask ventilation (oxygenation) is always possible and tracheal intubation normally simple. However, transient hypoxia is common in these children usually due to unexpected anatomical and functional airway problems or failure to ventilate during rapid sequence induction. Anatomical airway problems (upper airway collapse and adenoid hypertrophy) and functional airway problems (laryngospasm, bronchospasm, insufficient depth of anesthesia and muscle rigidity, gastric hyperinflation, and alveolar collapse) require urgent recognition and treatment algorithms due to insufficient oxygen reserves. Early muscle paralysis and epinephrine administration aids resolution of these functional airway obstructions. Children with an 'impaired' normal (foreign body, allergy, and inflammation) or an expected difficult (scars, tumors, and congenital) airway require careful planning and expertise. Training in the recognition and management of these different situations as well as a suitably equipped anesthesia workstation and trained personnel are essential. The healthy child with an unexpected airway problem requires clear strategies. The 'impaired' normal pediatric airway may be handled by anesthetists experienced with children, whereas the expected difficult pediatric airway requires dedicated pediatric anesthesia specialist care and should only be managed in specialized centers.

45 CFR 1357.30 - State fiscal requirements (title IV-B, subpart 1, child welfare services).

Code of Federal Regulations, 2013 CFR

2013-10-01

... match the title IV-B, subpart 1 allotment may include foster care maintenance expenditures in any amount... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

45 CFR 1357.30 - State fiscal requirements (title IV-B, subpart 1, child welfare services).

Code of Federal Regulations, 2012 CFR

2012-10-01

... match the title IV-B, subpart 1 allotment may include foster care maintenance expenditures in any amount... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

45 CFR 1357.30 - State fiscal requirements (title IV-B, subpart 1, child welfare services).

Code of Federal Regulations, 2010 CFR

2010-10-01

... match the title IV-B, subpart 1 allotment may include foster care maintenance expenditures in any amount... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

45 CFR 1356.68 - Tribal title IV-E agency requirements for in-kind administrative and training contributions from...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE... third-party sources. (a) Option to claim in-kind expenditures from third-party sources for non-Federal...

45 CFR 1356.68 - Tribal title IV-E agency requirements for in-kind administrative and training contributions from...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE... third-party sources. (a) Option to claim in-kind expenditures from third-party sources for non-Federal...

45 CFR 1357.30 - State fiscal requirements (title IV-B, subpart 1, child welfare services).

Code of Federal Regulations, 2011 CFR

2011-10-01

... match the title IV-B, subpart 1 allotment may include foster care maintenance expenditures in any amount... (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

45 CFR 1356.68 - Tribal title IV-E agency requirements for in-kind administrative and training contributions from...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE... third-party sources. (a) Option to claim in-kind expenditures from third-party sources for non-Federal...

Education Abroad and Domestic Cultural Immersion: A Comparative Study of Cultural Competence among Teacher Candidates

ERIC Educational Resources Information Center

Hare Landa, Melissa; Odòna-Holm, Jocelyn; Shi, Lijuan

2017-01-01

As the demographics of the United States continue to shift, American classrooms reflect the richness of cultural diversity and the vibrancy of immigrant populations. Education abroad programs provide opportunities for preservice teachers to develop their cultural competence, required for effectively teaching children from a range of cultural…

Serving Students with Dysphagia in the Schools? Educational Preparation Is Essential!

ERIC Educational Resources Information Center

Power-deFur, Lissa

2000-01-01

This article discusses the rise of students with dysphagia in schools and addresses issues associated with serving students with dysphagia in the public education setting. The role and preparation of the speech-language pathologist is serving children with dysphagia, and the accompanying continuing education and ethical requirements, are outlined.…

Yakama Nation Head Start Early Childhood Education Program

ERIC Educational Resources Information Center

Butterfly, Rose

2012-01-01

As a Program Director, every day requires decisions regarding children, parents, extended families, what curriculum to use, and of course, managing the finances. Making the day-to-day decisions and ensuring the overall health, safety, and well-being of each child served by the Yakama Nation Head Start is made easier by continually reflecting on…

THE IMPACT OF MODE OF ACQUISITION ON BIOLOGICAL MARKERS OF PAEDIATRIC HEPATITIS C VIRUS INFECTION

PubMed Central

England, Kirsty; Thorne, Claire; Harris, Helen; Ramsay, Mary; Newell, Marie-Louise

2012-01-01

Background Despite the introduction of blood donor screening, worldwide, children continue to become infected with HCV via un-sterile medical injections, receipt of unscreened blood and isolated hospital contamination outbreaks. It is plausible that the natural history and disease progression in these children might differ from that of their vertically infected counterparts. Materials and Methods Vertically and parenterally HCV infected children were prospectively followed within the European Paediatric HCV Network and the UK National HCV Register respectively. Biological profiles were compared. Results Vertically and parenterally HCV infected children differed in terms of some key characteristics including the male:female ratio and the proportion of children receiving therapy. Parenterally infected children were more likely to have at least one hepatomegaly event during follow-up, 20% vs. 10%. Parenteral infection did not significantly affect the odds of being consistently viraemic, AOR 1.14 p=0.703 and there was no significant difference in the odds of having consistently elevated ALT levels and mode of acquisition, AOR 0.83 p=0.748. The proportion of children with 2 or more markers of HCV infection did not differ significantly by mode of acquisition, χ21.13 p=0.288. Conclusions This analysis does not support substantial differences between vertically and parenterally infected groups but there are specific mechanisms identified requiring further investigation. Given the continued parenteral infection of children worldwide it is vital that knowledge of disease progression in this group is accurate and that the differences in comparison to vertically infected children are clarified to inform more accurate and individualised clinical management. PMID:21762285

Cushing's syndrome in childhood: update on genetics, treatment, and outcomes.

PubMed

Lodish, Maya

2015-02-01

To provide an update on the genes associated with Cushing's syndrome in children, as well as to familiarize the clinician with recent treatment guidelines and outcome data for children with Cushing's syndrome. The list of genes associated with Cushing's syndrome continues to grow. In addition, treatment for childhood Cushing's syndrome is evolving. As long-term follow-up data on children becomes available, clinicians need to be aware of the issues that require attention. Knowledge of the specific genetic causes of Cushing's syndrome has potential implications for treatment, surveillance, and counseling. Advances in surgical technique, radiation modalities, and medical therapies offer the potential for additional treatment options in Cushing's syndrome. Early identification and management of post-treatment morbidities in children treated for Cushing's syndrome is crucial in order to optimize care.

Developmental continuity in reward-related enhancement of cognitive control.

PubMed

Strang, Nicole M; Pollak, Seth D

2014-10-01

Adolescents engage in more risky behavior than children or adults. The most prominent hypothesis for this phenomenon is that brain systems governing reward sensitivity and brain systems governing self-regulation mature at different rates. Those systems governing reward sensitivity mature in advance of those governing self-control. This hypothesis has substantial empirical support, however, the evidence supporting this theory has been exclusively derived from contexts where self-control systems are required to regulate reward sensitivity in order to promote adaptive behavior. In adults, reward promotes a shift to a proactive control strategy and better cognitive control performance. It is unclear whether children and adolescents will respond to reward in the same way. Using fMRI methodology, we explored whether children and adolescents would demonstrate a shift to proactive control in the context of reward. We tested 22 children, 20 adolescents, and 23 adults. In contrast to our hypothesis, children, adolescents, and adults all demonstrated a shift to proactive cognitive control in the context of reward. In light of the results, current neurobiological theories of adolescent behavior need to be refined to reflect that in certain contexts there is continuity in the manner reward and cognitive control systems interact across development. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

The background and rationale for a new fixed-dose combination for first-line treatment of tuberculosis in children.

PubMed

Graham, S M; Grzemska, M; Gie, R P

2015-12-01

In 2010, the World Health Organization revised the recommendations for the treatment of tuberculosis (TB) in children. The major revision was to increase isoniazid, rifampicin and pyrazinamide dosages according to body weight in children. The recommendations for higher dosages are based on consistent evidence from 1) pharmacokinetic studies suggesting that young children require higher dosages than adolescents and adults to achieve desired serum concentrations; and 2) observational studies reporting that the higher dosages would not be associated with increased risk of toxicity in children. However, national tuberculosis programmes faced unforeseen challenges in implementing the revised recommendations. The main difficulty was to adapt the revised dosages for the treatment of children with drug-susceptible TB using available fixed-dose combinations (FDCs). A more suitable FDC for the intensive and continuation phases of treatment has now been developed for planned implementation in 2015. This paper explains the background and rationale for the development of a new FDC tablet for children with drug-susceptible TB.

Jordan-3: measuring visual reversals in children as symptoms of learning disability and attention-deficit/hyperactivity disorder.

PubMed

Jordan, Brian T; Martin, Nancy; Austin, J Sue

2012-12-01

The purpose of this research was to establish new norms for the Jordan-3 for children ages 5 to 18 years. The research also investigated the frequency of visual reversals in children previously identified as having reading disability, attention-deficit/hyperactivity disorder, and broader learning disabilities. Participants were regular education students, ages 5 through 18 years, and special education students previously diagnosed with attention-deficit/hyperactivity disorder, reading disability, or broader learning disability. Jordan-3 Accuracy and Error raw scores were compared to assess if there was a significant difference between the two groups. Mean Accuracy and Error scores were compared for males and females. Children with learning disability and attention-deficit/hyperactivity disorder had higher reversals when compared to regular education children, which lends continued support to the Jordan-3 as a valid and reliable measure of visual reversals in children and adolescents. This study illustrates the utility of the Jordan-3 when assessing children who may require remediation to reach their academic potential.

Duhamel operation for children with distal colonic dysmotility.

PubMed

Tan, Yew-Wei; Borrelli, Osvaldo; Lindley, Keith; Thapar, Nikhil; Curry, Joe

2017-08-01

To report outcomes of children with constipation refractory to medical management and manometrically proven distal colonic dysmotility, managed with rectosigmoidectomy followed by Duhamel operation (Duhamel). Children who underwent a Duhamel from 2009 onwards for intractable constipation and left colonic dysmotility were retrospectively reviewed. The primary end point was resolution of constipation, and secondary end point was postoperative complications. Continuous data were median (range). 11 patients (4 males) had Duhamel at 11 years (5-16) with constipation started from 2 years (1-8). Hirschsprung's disease was excluded. All Duhamels were performed with a covering ileostomy: 9 following a Hartmann procedure, one following a previously failed reversal of Hartmann, and one Duhamel performed with a pre-existing ileostomy. All ileostomies were subsequently closed. Median resection length was 22 cm (11-31). Length of stay was 8 days (5-23). Follow-up was 5 years (0.5-7). Age at final review was 15 years (10-18). Resolution of constipation occurred in nine patients (4 required antegrade continence enemas (ACE), 5 with laxative); two had persistent constipation and faecal incontinence despite ACE, ultimately requiring an ileostomy. Two postoperative small bowel obstructions required laparotomy. Duhamel performed in children with manometrically proven distal colonic dysmotility yielded 82% resolution of refractory constipation; half of them subsequently needed ACE.

[The Nutrition Commission of the Austrian Society of Pediatrics and Adolescent Medicine. Prevention of caries].

PubMed

Haschke, F

1992-01-01

Effective preventive programs must be instituted early in the life of a child. The pediatrician plays an important role in preventive oral health care, because most children do not visit a dentist before 3 years of age. Fluoride therapy decreases the caries vulnerability of the tooth, oral hygiene measures are important to remove bacterial plaque, and dietary modifications reduce the number of carbohydrate exposures per day. Community water fluoridation is proposed in Austrian cities, because it continues to be the most cost-effective caries prevention measure available. As long as the population does not have access to optimally fluoridated water, dietary fluoride supplementation offers an effective alternative. The recommended dosage of fluoride supplements for children depends on the amount of fluoride present in their drinking water and on the child's age. Liquid fluoride supplements and chewable tablets are proposed for children between 0.5 and 3 years and children between 3 and 13 years, respectively. Home use topical fluorides and professionally applied topical fluorides are useful beyond 3 years of age. Teaching of oral hygiene measures should be continued in kindergarten and school. The 3-6 year-old children require parental assistance to achieve effective plaque removal. Semiannual dental visits should begin at the age of three and continue throughout childhood and adolescence. As far as the diet is concerned, the frequency of exposure to sugar appears to be the most important factor in the development of dental caries. It now appears that most sugars are nearly equally cariogenic in a pure form.

Vaccine risk assessment in children with a referred reaction to a previous vaccine dose: 2009-2011 retrospective report at the Bambino Gesu' children hospital, Rome, Italy.

PubMed

Nicolosi, Luciana; Vittucci, Annachiara; Mancini, Rossella; Bozzola, Elena; Cagigi, Alberto; Grandin, Annalisa; Villani, Alberto

2014-03-31

During the last century, mass vaccination programs have achieved considerable success across the world in immunizing against several serious infectious diseases. However, vaccinations are threatened by their own success after results have been obtained: the more the incidence of potentially devastating diseases decreases, thanks to the success of vaccination programs, the more public attention shifts towards real or alleged "side effects" of vaccines. We analyze the experience of 153 children with "reaction to a previous vaccine dose" continuing the vaccination protocol in the safe environment of the Center for risk vaccination at the Bambino Gesù Children's Hospital IRCCS in Rome, from 2009 to 2011. To assess the suitability for vaccination, a specialized pre-vaccination advice and a skin prick test (SPT) was undergone, according to Wood's guideline; 151 children were SPT negative and full vaccine was administered. Of the 153 children examined just 13 had symptoms suggestive of IgE-mediated reaction-type reactions with angioedema manifestations. Among them, 2 had positive STP, which required alternative measures of administration of the vaccine. No cases of post vaccination reaction was reported and no vaccination program was stopped due to a severe reaction. Inadequate levels of immunization against infectious diseases remain a significant problem for public health. However, the reasons for incomplete vaccination and non-adoption of vaccination services are manifold. To maintain public confidence in vaccines, advanced immunization programs must include activities for monitoring the safety of the vaccine at the individual level and pursuing specialized counseling pre-and post-vaccination for those at risk. Our results underlined a gap between true and referred adverse reactions and are consistent with vaccine safety. Anyway, a continuous assessment of the risks and benefits of vaccination is required and the results must be disclosed in order to strengthen confidence in the existing and in the new immunization programs.

Variation in Generational Perceptions of Child Health and Well-being.

PubMed

Freed, Gary L; Davis, Matthew M; Singer, Dianne C; Gebremariam, Acham; Schultz, Sara L; Matos-Moreno, Amilcar; Wietecha, Mark

To assess adults' perceptions regarding the health and well-being of children today relative to their own health and well-being as youth and the potential for intergenerational differences in those perceptions. A cross-sectional, Internet-based survey of a nationally representative household sample was conducted using GfK Custom Research's Web-enabled KnowledgePanel, a probability-based panel representative of the US population. We assessed perceptions of children's health and well-being today compared to when respondents were growing up, including physical and mental health; and children's education, exercise, diet, health care, safety of communities, and emotional support from families, groups, and organizations. Overall, 1330 (65%) of 2047 adult respondents completed the survey. Only 26% of respondents believed that the current physical health of children, and 14% that the current mental health of children, is better today than when they were growing up. There was a significant trend among generations, with a greater proportion of older generations perceiving the physical health of children to be better today. Only 15% of respondents reported the chances for a child to grow up with good mental health in the future are "better" now than when they were growing up. Adults across all generations in the United States today view children's health as unlikely to meet the goals of the American Dream of continuous improvement. Although demographic changes require continued focus on our aging population, we must equally recognize the importance of advancing a healthy future for our nation's children, who will assume the mantle of our future. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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

A Social Norms Approach to Changing School Children's Perceptions of Tobacco Usage

ERIC Educational Resources Information Center

Sheikh, Afzal; Vadera, Sunil; Ravey, Michael; Lovatt, Gary; Kelly, Grace

2017-01-01

Purpose: Over 200,000 young people in the UK embark on a smoking career annually, thus continued effort is required to understand the types of interventions that are most effective in changing perceptions about smoking amongst teenagers. Several authors have proposed the use of social norms programmes, where correcting misconceptions of what is…

42 CFR 457.805 - State plan requirement: Procedures to address substitution under group health plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) The child lost coverage due to the death or divorce of a parent. [78 FR 42313, July 15, 2013] ... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... from the date a child otherwise eligible for CHIP is disenrolled from coverage under a group health...

42 CFR 457.805 - State plan requirement: Procedures to address substitution under group health plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... child otherwise eligible for CHIP is disenrolled from coverage under a group health plan. (2) A waiting period may not be applied to a child following the loss of eligibility for and enrollment in Medicaid or...

75 FR 62838 - Award of a Single-Source Expansion Supplement to the Research Foundation of CUNY on Behalf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... Social Work AGENCY: Children's Bureau, ACYF, ACF, HHS. ACTION: Notice. CFDA Number: 93.556. Legislative... School of Social Work, New York, NY, to provide expanded technical assistance to address continuing challenges in the field as child welfare programs work to implement the requirements of new legislation. The...

The Forest, the Trees, and the Leaves: Differences of Processing across Development

ERIC Educational Resources Information Center

Krakowski, Claire-Sara; Poirel, Nicolas; Vidal, Julie; Roëll, Margot; Pineau, Arlette; Borst, Grégoire; Houdé, Olivier

2016-01-01

To act and think, children and adults are continually required to ignore irrelevant visual information to focus on task-relevant items. As real-world visual information is organized into structures, we designed a feature visual search task containing 3-level hierarchical stimuli (i.e., local shapes that constituted intermediate shapes that formed…

D'Nealian Handwriting versus Circle-Stick Print.

ERIC Educational Resources Information Center

Thurber, Donald N.

This paper argues against teaching children to make letters using circle-stick writing. It contends that the circle-stick method requires continued pen/pencil lifts hindering rhythm or flow in the writing process and that there is little carry-over value into cursive writing as the two scripts are totally different. D'Nealian print, one type of…

A Quantitative Study of the Summer Slide in Science of Elementary School Students

ERIC Educational Resources Information Center

Donovan, Giovanna Guadagno

2009-01-01

Concerned parents and educators agree children learn best when the rhythm of instruction is continuous with practice and application of skills. Long summer breaks may interrupt the flow of formal school learning leading some students to forget previous instruction. A review of the previous school work is generally required in the fall upon return…

Perceptual Learning of Intonation Contour Categories in Adults and 9- to 11-Year-Old Children: Adults Are More Narrow-Minded.

PubMed

Kapatsinski, Vsevolod; Olejarczuk, Paul; Redford, Melissa A

2017-03-01

We report on rapid perceptual learning of intonation contour categories in adults and 9- to 11-year-old children. Intonation contours are temporally extended patterns, whose perception requires temporal integration and therefore poses significant working memory challenges. Both children and adults form relatively abstract representations of intonation contours: Previously encountered and novel exemplars are categorized together equally often, as long as distance from the prototype is controlled. However, age-related differences in categorization performance also exist. Given the same experience, adults form narrower categories than children. In addition, adults pay more attention to the end of the contour, while children appear to pay equal attention to the beginning and the end. The age range we examine appears to capture the tail-end of the developmental trajectory for learning intonation contour categories: There is a continuous effect of age on category breadth within the child group, but the oldest children (older than 10;3) are adult-like. Copyright © 2016 Cognitive Science Society, Inc.

How children's rights are constructed in family-centred care: a review of the literature.

PubMed

Kelly, Margaret; Jones, Susan; Wilson, Val; Lewis, Peter

2012-06-01

It appears that the acceptance of children's rights within the acute care setting is treated as a given but such a given requires a more systematic analysis. This has been undertaken here in the form of a review of the literature. The purpose of the review is to explore how children's rights, defined by the United Nations Convention on the Rights of the Child (UNCRC) are recognized in family-centred care in the acute care paediatric setting as reported in the literature. Reports that were available from 1989 to 2010 were reviewed. Children's rights are not mentioned frequently in the literature of interest to children's nurses. What is revealed are the ethical tensions in the challenge to act at all times in children's best interests (in the spirit of Article 3) while giving due weight to their views (in the spirit of Article 12) (OHCHR, 1989). The continuing failure to address these tensions undermines the spirit and practice of family-centred care.

Perceptual learning of intonation contour categories in adults and 9 to 11-year-old children: Adults are more narrow-minded

PubMed Central

Kapatsinski, Vsevolod; Olejarczuk, Paul; Redford, Melissa A.

2015-01-01

We report on rapid perceptual learning of intonation contour categories in adults and 9- to 11-year-old children. Intonation contours are temporally extended patterns whose perception requires temporal integration and therefore poses significant working memory challenges. Both children and adults form relatively abstract representations of intonation contours: previously encountered and novel exemplars are categorized together equally often, as long as distance from the prototype is controlled. However, age-related differences in categorization performance also exist. Given the same experience, adults form narrower categories than children. In addition, adults pay more attention to the end of the contour while children appear to pay equal attention to the beginning and the end. The age range we examine appears to capture the tail-end of the developmental trajectory for learning intonation contour categories: there is a continuous effect of age on category breadth within the child group, but the oldest children (older than 10;3) are adult-like. PMID:26901251

Medical and Psychosocial Aspects of the Habilitation of Thalidomide Children

PubMed Central

Mongeau, M.; Gingras, G.; Sherman, E. D.; Hebert, B.; Hutchison, J.; Corriveau, C.

1966-01-01

The habilitation of 34 thalidomide children, begun in 1963 at the Rehabilitation Institute of Montreal, involved the contribution of many medical and paramedical disciplines. These individual contributions are described. Habilitation of congenitally deformed children must be initiated at an early age. The early prescription of a prosthesis is desirable. Their care involves a broad range of services that must be continued over many years. Parents require support before they can accept the misfortune that has befallen them and their deformed child. Despite the necessity of frequent hospitalizations, children should be reared in a home setting. From their experience, the authors conclude that children born with malformations, and their parents, should be thoroughly evaluated and followed up for many years; and recommend that governments should finance programs for the complete habilitation of all children born with congenital malformations. National registries for the compulsory recording of birth deformities should also be established. ImagesFig. 1Fig. 2Fig. 3 PMID:5923651

Laryngotracheal reconstruction with resorbable microplate buttressing.

PubMed

Javia, Luv R; Zur, Karen B

2012-04-01

In patients undergoing laryngotracheal reconstruction (LTR), malacic segments of trachea can pose challenges to successful reconstruction. Malacic segments may inadequately support cartilage grafts used in augmentation surgery, sometimes requiring cricotracheal or tracheal resections. We describe a novel technique of LTR with resorbable microplate buttressing of malacic lateral tracheal segments. Retrospective case series. Review of technique, treatment outcomes, and complications of seven children with subglottic stenosis and tracheomalacia requiring a microplate-augmented LTR technique. Seven infants ranging from 26 months to 9 years of age successfully underwent LTR for subglottic stenosis. Six children had a grade III subglottic stenosis. The seventh child had grade II subglottic stenosis, bilateral vocal fold paralysis, an elliptical cricoid, and an obstructing giant suprastomal fibroma. Five children underwent a double-stage LTR with resorbable microplates sutured bilaterally to support severely malacic lateral tracheal segments. A cricotracheal resection would not have been feasible in one child due to the resection length and inadequate tracheal mobilization. Two children underwent a single-stage LTR with unilateral application of a microplate. Six children were decannulated within 3 months and continue without airway symptoms or complications. One child, who is just over 2 months from reconstructive surgery, is being setup for decannulation. No complications were encountered. LTR with resorbable microplate buttressing of malacic lateral tracheal segments is technically feasible, safe, and can avoid more extensive surgery requiring tracheal resection. Further experience may support the use of this technique in challenging airway reconstructions. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Age-related differences in brain electrical activity during extended continuous face recognition in younger children, older children and adults.

PubMed

Van Strien, Jan W; Glimmerveen, Johanna C; Franken, Ingmar H A; Martens, Vanessa E G; de Bruin, Eveline A

2011-09-01

To examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9 years old) and 36 healthy older children (11-12 years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 faces was shown randomly six times interspersed with distracter faces. The children were required to make old vs. new decisions. Older children responded faster than younger children, but younger children exhibited a steeper decrease in latencies across the five repetitions. Older children exhibited better accuracy for new faces, but there were no age differences in recognition accuracy for repeated faces. For the N2, N400 and late positive complex (LPC), we analyzed the old/new effects (repetition 1 vs. new presentation) and the extended repetition effects (repetitions 1 through 5). Compared to older children, younger children exhibited larger frontocentral N2 and N400 old/new effects. For extended face repetitions, negativity of the N2 and N400 decreased in a linear fashion in both age groups. For the LPC, an ERP component thought to reflect recollection, no significant old/new or extended repetition effects were found. Employing the same face recognition paradigm in 20 adults (Study 2), we found a significant N400 old/new effect at lateral frontal sites and a significant LPC repetition effect at parietal sites, with LPC amplitudes increasing linearly with the number of repetitions. This study clearly demonstrates differential developmental courses for the N400 and LPC pertaining to recognition memory for faces. It is concluded that face recognition in children is mediated by early and probably more automatic than conscious recognition processes. In adults, the LPC extended repetition effect indicates that adult face recognition memory is related to a conscious and graded recollection process rather than to an automatic recognition process. © 2011 Blackwell Publishing Ltd.

Technology-dependent children and the demand for pharmaceutical care.

PubMed

Okido, Aline Cristiane Cavicchioli; Cunha, Suelen Teles da; Neves, Eliane Tatsch; Dupas, Giselle; Lima, Regina Aparecida Garcia de

2016-01-01

to understand the experience of mothers of technology-dependent children as regards pharmaceutical care. this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis. this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks. pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.

Management of background pain and anxiety in critically burned children requiring protracted mechanical ventilation.

PubMed

Sheridan, R; Stoddard, F; Querzoli, E

2001-01-01

Optimal control of pain and anxiety is an elusive but important goal in children with protracted critical illness. This review represents an effort to document the doses of background medication required to achieve this goal in a group of children managed under a pain and anxiety protocol that adjusts background infusions to comfort. The course of children with wounds involving at least 10% of the body surface and coincident respiratory failure requiring mechanical ventilation for more than 7 days managed 1 Jan 97 to 31 Dec 98 was reviewed. A pain and anxiety protocol was used, including background infusions of morphine and midazolam adjusted to comfort. These 28 children had a mean (+/- standard deviation) age of 5.3 +/- 4.6 years, wound size of 48.3 +/- 28.4%, and were intubated for 25.0 +/- 23.9 days. Neuromuscular blocking drugs were administered for 65 of 447 (14.5%) ventilator days. To maintain comfort, drugs were required at doses substantially above standard dosing schemes. The highest daily background infusion of morphine sulfate averaged 0.40 mg/kg/hr +/- 0.24 mg/kg/hr (usual starting dose was 0.05 to 0.1 mg/kg/hr) and was reached 14.1 +/- 12.8 days after admission. The highest daily background infusion of midazolam averaged 0.15 +/- 0.07 mg/kg/hr (usual starting dose was 0.04 mg/kg/hr) and was reached 14.0 +/- 3.8 days after admission. Morphine infusions at extubation averaged 0.22 +/- 0.17 mg/kg/hr and midazolam infusions 0.10 +/- 0.12 mg/kg/hr. All children survived to discharge and there was no perceived morbidity related to these high doses of medication. Children with serious burns and respiratory failure will require high doses of background opiates and benzodiazepines to remain comfortable, because they develop drug tolerance during protracted critical illness. Infusions can be continued at a reduced dose through extubation, do not result in addiction or other apparent morbidity if adjusted to desired level of comfort, and may contribute to a reduced incidence of treatment-related stress disorders.

Association of sleep disordered breathing symptoms with early postoperative analgesic requirement in pediatric ambulatory surgical patients

PubMed Central

Yang, Kamie; Baetzel, Anne; Chimbira, Wilson T; Yermolina, Yuliya; Reynolds, Paul I; Nafiu, Olubukola O

2017-01-01

Introduction Sleep disordered breathing (SDB) symptoms are associated with increased rates of opioid-induced respiratory depression as well as enhanced nociception. Consequently, practitioners often withhold or administer lower intraoperative doses of opioids out of concern for postoperative respiratory depression. Therefore, SDB may be a critical determinant of analgesic requirement in the post-anesthesia care unit (PACU). We investigated whether preoperative SDB classification was independently associated with need for PACU analgesic intervention in a cross-sectional sample of 985 children who underwent elective, painful ambulatory surgical procedures. Methods Using prospectively collected data, children aged 4–17yr were grouped into two categories based on whether or not they had symptoms of SDB. Perioperative variables were compared between the exposed and control groups using Chi-squared test for categorical or t-test for continuous variables. Logistic regression analysis was used to assess the association between SDB and the odds of requiring PACU IV opioids. Results Children with preoperative SDB symptoms (N=325) compared with the reference group of children who did not have these symptoms had higher rates of PACU analgesic intervention (47.1% vs. 37.4%; p=0.004) and higher mean arousal pain scores (3.7±3.5 vs.1.9±2.9; p<0.001). In our primary multivariable logistic regression model adjusted for a number of variables, preoperative SDB symptoms was associated with a two-fold increased odds of receiving PACU intravenous opioid (OR = 2.01, 95%CI, 1.29–3.12; p=0.002). Conclusion These results suggest that preoperative SDB symptoms in children undergoing ambulatory surgery, exerts a significant influence on PACU pain behavior and analgesic requirement. Mechanisms underlying this enhanced pain experience deserve further elucidation. PMID:28390605

Morphine Pharmacokinetics in Children With Down Syndrome Following Cardiac Surgery.

PubMed

Goot, Benjamin H; Kaufman, Jon; Pan, Zhaoxing; Bourne, David W A; Hickey, Francis; Twite, Mark; Galinkin, Jeffrey; Christians, Uwe; Zuk, Jeannie; da Cruz, Eduardo M

2018-05-01

To assess if morphine pharmacokinetics are different in children with Down syndrome when compared with children without Down syndrome. Prospective single-center study including subjects with Down syndrome undergoing cardiac surgery (neonate to 18 yr old) matched by age and cardiac lesion with non-Down syndrome controls. Subjects were placed on a postoperative morphine infusion that was adjusted as clinically necessary, and blood was sampled to measure morphine and its metabolites concentrations. Morphine bolus dosing was used as needed, and total dose was tracked. Infusions were continued for 24 hours or until patients were extubated, whichever came first. Postinfusion, blood samples were continued for 24 hours for further evaluation of kinetics. If patients continued to require opioid, a nonmorphine alternative was used. Morphine concentrations were determined using a unique validated liquid chromatography tandem-mass spectrometry assay using dried blood spotting as opposed to large whole blood samples. Morphine concentration versus time data was modeled using population pharmacokinetics. A 16-bed cardiac ICU at an university-affiliated hospital. Forty-two patients (20 Down syndrome, 22 controls) were enrolled. None. The pharmacokinetics of morphine in pediatric patients with and without Down syndrome following cardiac surgery were analyzed. No significant difference was found in the patient characteristics or variables assessed including morphine total dose or time on infusion. Time mechanically ventilated was longer in children with Down syndrome, and regarding morphine pharmacokinetics, the covariates analyzed were age, weight, presence of Down syndrome, and gender. Only age was found to be significant. This study did not detect a significant difference in morphine pharmacokinetics between Down syndrome and non-Down syndrome children with congenital heart disease.

Historical Overview of Transitional Feeding Recommendations and Vegetable Feeding Practices for Infants and Young Children

PubMed Central

Kleinman, Ronald E.; Coletta, Frances A.

2016-01-01

Although recommendations for introducing solid foods to infants and young children have changed significantly since the beginning of the 20th century, vegetable consumption recommendations have always been an important part of the child-feeding repertoire. In 1958, the first report of the American Academy of Pediatrics (AAP) Committee on Nutrition stated that developmental maturity of the gut and neuromuscular system, growth rate, and activity level were good indicators for determining when to introduce solid foods to infants than age. All 7 editions of the AAP Pediatric Nutrition Handbook use an evidence-based model for recommendations concerning the complementary feeding of infants and young children. The model includes developmental readiness principles, feeding practices, and age-appropriate nutrient requirements. Dietary patterns and nutrient consumption among infants and young children have been analyzed using data from the 2002 and 2008 Feeding Infants and Toddlers Study (FITS). The 2008 FITS also collected information concerning participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Since 1972, WIC has been a cost-effective means of improving the diets and health of infants and young children from low-income families. Data from the 2008 FITS showed that many young children did not consume recommended amounts of fiber or potassium, and vegetable and fruit intakes continued to be lower than recommended. Low vegetable consumption and limited variety were also seen among WIC participants and nonparticipants aged 6 months to 4 years prior to changes in the WIC food package. Increasing children’s consumption of all vegetables should continue to be a focus going forward. PMID:27003950

The contribution of the French Muskoka Fund to improving access to essential medicines and priority health products for mothers and children.

PubMed

Macé, C; Nikiema, J-B

2016-11-01

One objective of the French Muskoka Fund since 2011 has been to improve the availability of quality healthcare services for mothers and children and thus to contribute to the continued presence of essential drugs and affordable quality health products and to their rational use by healthcare personnel. This project thus contributed to reinforcing the work of the national regulatory authorities, guarantor of the quality of the products supplied to the populations, but also to strengthening the coordination of supplies at the country level. It also enabled the provision of support for the implementation of drug price controls and helped to strengthen the ability of healthcare staff to optimize their use of the products available to them. This work should be continued in these countries as they meet the agenda of the Sustainable Development Goals, which require the establishment of universal healthcare coverage.

Use of Nasal Bubble CPAP in Children with Hypoxemic Clinical Pneumonia—Report from a Resource Limited Set-Up

PubMed Central

KiranBabu, HB; Singhi, Sunit; Nallasamy, Karthi

2016-01-01

Objective: Nasal bubble continuous positive airway pressure (bCPAP) is preferred in developing economies for easy applicability and low cost. Because its use in older children is unexplored, we sought to evaluate its utility in hypoxemic clinical pneumonia. Methods: Of 330 children (1 month–12 years) with clinical pneumonia enrolled prospectively over 1 year, those with increased work of breathing and/or SpO2 <92% received bCPAP delivered via an underwater ‘T' tube through nasal prongs. Proportion requiring intubation despite bCPAP constituted primary outcome. Incidence of complications, duration of bCPAP and emergency stay were secondary outcomes. Results: Oxygen was initiated by nasal prongs (NPO2) in 204 (61.8%), and by bCPAP in 110 (33.3%). Sixteen (4.8%) were intubated at the outset. Fifty-three (25.9%) on NPO2 were shifted to bCPAP for worsening distress and hypoxemia. Only three (1.8%) from bCPAP group required intubation, of which one died. Failure rate and complications were negligent. The median emergency stay was 4 days. Conclusions: Nasal bCPAP was safe and effective in children with hypoxemic clinical pneumonia. PMID:26428195

Treating the sibling subsystem: an adjunct of divorce therapy.

PubMed

Schibuk, M

1989-04-01

Sibling therapy, frequently overlooked as a method of treatment, is particularly appropriate in situations that require a deliberate focus on the "unit of continuity," or the subsystem that remains intact during a process of family reorganization. For this and other reasons it can be an effective tool in treating children of divorce. A case illustrating this use of sibling therapy is presented.

Challenges to the Concept "Partnership with Parents" in Special Needs Education

ERIC Educational Resources Information Center

Abed, Mohaned

2014-01-01

It is observed that professionals would meet the needs of individual children if they work closely with the child's parents [58]. The growing of a child is a continuous process which requires a coherent, close partnership between home and school, since the house is the first educational environment, and the first community in which a child lives…

Classroom-Community Consultation (C [superscript 3]) 10 Years after Hurricane Katrina: A Retrospective Look at a Collaborative, School-Based Referral Model

ERIC Educational Resources Information Center

Lee, Madeline Y.; Danna, Laura; Walker, Douglas W.

2017-01-01

The long-term nature of mental health needs after disasters, such as Hurricane Katrina, continues to require attention. Research that emerged during the anniversaries of the storm has shown Katrina and its aftermath to be associated with posttraumatic stress, depression, anxiety, disruptive behavior, and somatic complaints in children and…

Science, Technology and Social Change Course's Effects on Technological Literacy Levels of Social Studies Pre-Service Teachers

ERIC Educational Resources Information Center

Yigit, E. Ozlem

2013-01-01

Social studies curricula are required in order to prepare to educate children who continue to learn after their formal training, and it is vital that teachers receive an education properly. In Social Studies Education Departments of Education Faculties Science, Technology and Social Change course is convenient to this aim and it contributes to…

Enamel defects and dental caries in 9-year-old children living in fluoridated and nonfluoridated areas of Auckland, New Zealand.

PubMed

Kanagaratnam, Sathananthan; Schluter, Philip; Durward, Callum; Mahood, Robyn; Mackay, Tim

2009-06-01

This epidemiological study aims to investigate the developmental enamel defects and dental caries among 9-year-old children resident in fluoridated and nonfluoridated regions in Auckland, New Zealand. A stratified, two-stage random selection design where strata were defined by fluoridation status, school size, and school decile. After informed consent was obtained, parents completed oral health questionnaires and children underwent dental examinations at school clinics. 612 children from 38 schools participated in the study. Overall, 175 (29%) children had lived continuously in fluoridated areas, 149 (24%) had lived continuously in nonfluoridated areas, and 288 (47%) had resided intermittently in fluoridated areas. Diffuse opacities were present in 117 (19%) children and deciduous teeth dental caries was seen in 370 (60%) children. After adjustment for covariates, a strong dose-response relationship between diffuse opacity and fluoridation status was found, with children who lived continuously in fluoridated areas being 4.17 times as likely to have diffuse opacities as children who lived continuously in nonfluoridated areas (P < 0.001). Conversely, a strong protective dose-response relationship between caries experience and fluoridation status was seen, with children who lived continuously in fluoridated areas being 0.42 times as likely to have dental caries as children who lived continuously in nonfluoridated areas (P < 0.001). Reticulated water fluoridation in Auckland reduces the risk of dental caries but increases the risk of diffuse opacities in 9-year-old children. Guidelines and health-promotion strategies that enable children to minimize their risk to diffuse opacities yet reduce their risk of dental caries should be reviewed.

20 CFR 10.537 - What reports are needed when compensation payments continue for children over age 18?

Code of Federal Regulations, 2010 CFR

2010-04-01

... payments continue for children over age 18? 10.537 Section 10.537 Employees' Benefits OFFICE OF WORKERS... What reports are needed when compensation payments continue for children over age 18? (a) Compensation payable on behalf of a child that would otherwise end when the child reaches 18 years of age will continue...

Vaccination coverage in the US Commonwealth of the Northern Mariana Islands, 2005.

PubMed

Luman, Elizabeth T; Sablan, Mariana; Anaya, Gabriel; Stokley, Shannon; McCauley, Mary Mason; Shaw, Kate M; Salazar, Angela; Balajadia, Ron; Chaine, Jean Paul; Duncan, Richard

2007-01-01

In July 2005, a house-to-house survey was conducted to determine vaccination coverage achieved through routine health services on the three inhabited islands (Saipan, Rota, and Tinian) of the US Commonwealth of the Northern Mariana Islands (CNMI). A population-based cluster survey was conducted on Saipan; clusters and households were selected by systematic random sampling. On the smaller islands of Rota and Tinian, all households were visited. Vaccination histories and demographic information were obtained during household interview for all children aged 19-35 months, children aged 6 years, and adults aged 65 years and older. Vaccination histories for children were supplemented by hospital/clinic records and an electronic vaccination registry. Among 295 children aged 19-35 months, estimated coverage with the primary vaccination series was 80 percent; coverage with individual vaccines was generally higher. Among 193 children aged 6 years, coverage for vaccines required at school-aged was 83 percent. Among 226 adults aged 65 years and older, 52 percent received influenza vaccine during the previous season while 21 percent had ever received pneumococcal vaccine. The CNMI has achieved the US Healthy People 2010 objective of 80 percent coverage for the standard vaccination series among children aged 19-35 months. High coverage levels among 6-year-old children may reflect the benefit of school entry requirements. Influenza and pneumococcal vaccination among older adults remains low. Efforts to ensure that children and older adults throughout the CNMI are equally well-protected should continue. Strategies to address parental awareness of vaccinations that are due should be explored and may be facilitated by upgrading the electronic vaccination registry.

Caring for children with intellectual and developmental disabilities: virtual patient instruction improves students' knowledge and comfort level.

PubMed

Sanders, Carla L; Kleinert, Harold L; Free, Teresa; Slusher, Ida; Clevenger, Kim; Johnson, Stephanie; Boyd, Sara E

2007-12-01

Nurses play a vital role in providing health care to children with developmental disability (DD) throughout the United States. Unfortunately, most nurses continue to report that they receive little or no clinical education in the area of DDs. In response to this need, a core development team consisting of nurse practitioners and nursing faculty from three universities, one physician assistant faculty, parents of children with DD, and educational specialists developed two multimedia (virtual patient) pediatric instructional modules in CD-ROM format--one involving a child with Down syndrome, and the other involving an infant born at 26 weeks' gestation. Participants were required to make clinical decisions throughout the cases. The modules on CD were piloted with nursing students from three universities. Results of the effectiveness study demonstrated significant gains in knowledge and comfort level regarding the care of children with DD.

Cushing’s syndrome in childhood: update on genetics, treatment, and outcomes

PubMed Central

Lodish, Maya

2015-01-01

Purpose of review To provide an update on the genes associated with Cushing’s syndrome in children, as well as to familiarize the clinician with recent treatment guidelines and outcome data for children with Cushing’s syndrome. Recent findings The list of genes associated with Cushing’s syndrome continues to grow. In addition, treatment for childhood Cushing’s syndrome is evolving. As long-term follow-up data on children becomes available, clinicians need to be aware of the issues that require attention. Summary Knowledge of the specific genetic causes of Cushing’s syndrome has potential implications for treatment, surveillance, and counseling. Advances in surgical technique, radiation modalities, and medical therapies offer the potential for additional treatment options in Cushing’s syndrome. Early identification and management of post-treatment morbidities in children treated for Cushing’s syndrome is crucial in order to optimize care. PMID:25517021

Gastric Transposition for Esophageal Replacement in Children

PubMed Central

Hirschl, Ronald B.; Yardeni, Dani; Oldham, Keith; Sherman, Neil; Siplovich, Leo; Gross, Eitan; Udassin, Raphael; Cohen, Zehavi; Nagar, Hagith; Geiger, James D.; Coran, Arnold G.

2002-01-01

Objective To evaluate the authors’ experience with gastric transposition as a method of esophageal replacement in children with congenital or acquired abnormalities of the esophagus. Summary Background Data Esophageal replacement in children is almost always done for benign disease and thus requires a conduit that will last more than 70 years. The organ most commonly used in the past has been colon; however, most series have been fraught with major complications and conduit loss. For these reasons, in 1985 the authors switched from using colon interpositions to gastric transpositions for esophageal replacement in infants and children. Methods The authors retrospectively reviewed the records of 41 patients with the diagnoses of esophageal atresia (n = 26), corrosive injury (n = 8), leiomyomatosis (n = 5), and refractory gastroesophageal reflux (n = 2) who underwent gastric transposition for esophageal replacement. Results Mean ± SE age at the time of gastric transposition was 3.3 ± 0.6 years. All but two transpositions were performed through the posterior mediastinum without mortality or loss of the gastric conduit despite previous surgery on the gastric fundus in 8 (20%), previous esophageal operations in 15 (37%), and previous esophageal perforations in 6 (15%) patients. Complications included esophagogastric anastomotic leak (n = 15, 36%), which uniformly resolved without intervention; stricture formation (n = 20, 49%), all of which no longer require dilation; and feeding intolerance necessitating jejunal feeding (n = 8, 20%) due to delayed gastric emptying (n = 3), feeding aversion related to the underlying anomaly (n = 1), or severe neurological impairment (n = 4). No redo anastomoses were required. Conclusions Gastric transposition reestablishes effective gastrointestinal continuity with few complications. Oral feeding and appropriate weight gain are achieved in most children. Therefore, gastric transposition is an appropriate alternative for esophageal replacement in infants and children. PMID:12368682

Severe acute malnutrition.

PubMed

Nel, E D

2016-05-01

The mortality and morbidity associated with severe acute malnutrition (SAM) remain high. A summary of recent studies that are of interest to clinicians treating children with SAM is provided. Three important themes emerged in 2015: the use of anthropometry in the diagnosis of SAM and its correlation with body composition; the composition of ready-to-use therapeutic feeds (RUTF); and an improved understanding of the pathophysiology of SAM. Standard anthropometry does not accurately predict body composition and mid-upper arm circumference more accurately reflects fat mass in children. As single measure, mid-upper arm circumference identifies those children who are most likely to die from SAM and is not influenced by dehydration. However, a significant proportion of SAM children requiring treatment will not be detected. Present RUTF formulations are deficient in long chain polyunsaturated fatty acids. Current evidence suggests that preformed docosahexaenoic acid should be added and/or the content of linoleic acid reduced in RUTF. In contrast to an animal model, stabile children with SAM have the same cardiac index as children without SAM. The situation in haemodynamically unstable children is unknown, continued conservative use of intravenous fluids seems advisable. A reduction in variability of the faecal DNA virome may account for increased susceptibility to malnutrition in vulnerable children.

Low CD4+ T-cell levels and B-cell apoptosis in vertically HIV-exposed noninfected children and adolescents.

PubMed

Miyamoto, Maristela; Pessoa, Silvana D; Ono, Erika; Machado, Daisy M; Salomão, Reinaldo; Succi, Regina C de M; Pahwa, Savita; de Moraes-Pinto, Maria Isabel

2010-12-01

Lymphocyte subsets, activation markers and apoptosis were assessed in 20 HIV-exposed noninfected (ENI) children born to HIV-infected women who were or not exposed to antiretroviral (ARV) drugs during pregnancy and early infancy. ENI children and adolescents were aged 6-18 years and they were compared to 25 age-matched healthy non-HIV-exposed children and adolescents (Control). ENI individuals presented lower CD4(+) T cells/mm(3) than Control group (control: 1120.3 vs. ENI: 876.3; t-test, p = 0.030). ENI individuals had higher B-cell apoptosis than Control group (Control: 36.6%, ARV exposed: 82.3%, ARV nonexposed: 68.5%; Kruskal-Wallis, p < 0.05), but no statistical difference was noticed between those exposed and not exposed to ARV. Immune activation in CD4(+) T, CD8(+) T and in B cells was comparable in ENI and in Control children and adolescents. Subtle long-term immune alterations might persist among ENI individuals, but the clinical consequences if any are unknown, and these children require continued monitoring.

Underlying mechanisms of writing difficulties among children with neurofibromatosis type 1.

PubMed

Gilboa, Yafit; Josman, Naomi; Fattal-Valevski, Aviva; Toledano-Alhadef, Hagit; Rosenblum, Sara

2014-06-01

Writing is a complex activity in which lower-level perceptual-motor processes and higher-level cognitive processes continuously interact. Preliminary evidence suggests that writing difficulties are common to children with Neurofibromatosis type 1 (NF1). The aim of this study was to compare the performance of children with and without NF1 in lower (visual perception, motor coordination and visual-motor integration) and higher processes (verbal and performance intelligence, visual spatial organization and visual memory) required for intact writing; and to identify the components that predict the written product's spatial arrangement and content among children with NF1. Thirty children with NF1 (ages 8-16) and 30 typically developing children matched by gender and age were tested, using standardized assessments. Children with NF1 had a significantly inferior performance in comparison to control children, on all tests that measured lower and higher level processes. The cognitive planning skill was found as a predictor of the written product's spatial arrangement. The verbal intelligence predicted the written content level. Results suggest that high level processes underlie the poor quality of writing product in children with NF1. Treatment approaches for children with NF1 must include detailed assessments of cognitive planning and language skills. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Audit of Clinical Practice in a Single Centre in Kuwait: Management of Children on Continuous Subcutaneous Insulin Infusion and Cardiovascular Risk Factors Screening.

PubMed

Omar, Dina; Alsanae, Hala; Al Khawari, Mona; Abdulrasoul, Majedah; Rahme, Zahraa; Al Refaei, Faisal; Behbehani, Kazem; Shaltout, Azza

2017-01-01

To audit the current clinical practice of continuous subcutaneous insulin infusion (CSII) for the treatment of type 1 diabetes mellitus (T1D) in children and adolescents attending a single centre in Kuwait. A one year retrospective audit was performed in children and adolescents with T1D on CSII, who attended the paediatric diabetes clinic, Dasman Diabetes Institute during 2012. The primary outcome measure was glycaemic control as evidenced by glycated haemoglobin (HbA1c) level and the secondary outcome measures were the frequency of monitoring of the risk for microvascular complications and occurrence of acute complications and adverse events. 58 children and adolescents (mean age ± SD: 12.6 ± 4.1 years) were included. Mean HbA1c at baseline was 8.8% (72.7 mmol/mol) and 8.9% (73.8 mmol/mol) at the end of a 12 months observation period. Children with poor control (HbA1c >9.5% (80 mmol/mol) had a significant 1.4% reduction in HbA1c compared with the overall reduction of 0.1% (p=0.7). Rate of screening for cardiovascular risk factors and for long term complications were well documented. However, there was underreporting of acute complications such as severe hypoglycaemia and diabetic ketoacidosis. Only 1.7% of patients discontinued the pump. There was no significant change in HbA1c values at the end of 12 months follow up. However, HbA1c values in poorly controlled children improved. CSII requires care by skilled health professionals as well as education and selection of motivated parents and children.

Integrating Telemedicine in Urban Pediatric Primary Care: Provider Perspectives and Performance

PubMed Central

Wood, Nancy; Herendeen, Neil; ten Hoopen, Cynthia; Denk, Larry; Neuderfer, Judith

2010-01-01

Abstract Background: Health-e-Access, an urban telemedicine service, enabled 6,511 acute-illness telemedicine visits over a 7-year period for children at 22 childcare and school sites in Rochester, NY. Objectives: The aims of this article were to (1) describe provider attitudes and perceptions about efficiency and effectiveness of Health-e-Access and (2) assess hypotheses that (a) providers will complete a large proportion of the telemedicine visits attempted and (b) high levels of continuity with the primary care practice will be achieved. Design/Methods: This descriptive study focused on the 24-month Primary Care Phase in the development of Health-e-Access, initiated by the participation of 10 primary care practices. Provider surveys addressed efficiency, effectiveness, and overall acceptability. Performance measures included completion of telemedicine visits and continuity of care with the medical home. Results: Among survey respondents, the 30 providers who had completed telemedicine visits perceived that decision-making required slightly less time and total time required was slightly greater than for in-person visits. Confidence in diagnosis was somewhat less for telemedicine visits. Providers were comfortable collaborating with telemedicine assistants and confident that communications met parent needs. Among the 2,554 consecutive telemedicine visits attempted during the Primary Care Phase, 2,475 (96.9%) were completed by 47 providers. For visits by children with a participating primary care practice, continuity averaged 83.2% among practices (range, 28.1–92.9%). Conclusions: Providers perceived little or no advantage in efficiency or effectiveness to their practice in using telemedicine to deliver care; yet they used it effectively in serving families, completing almost all telemedicine visits requested, providing high levels of continuity with the medical home, and believing they communicated adequately with parents. PMID:20406114

Continuity in Primary School Children's Eating Problems and the Influence of Parental Feeding Strategies

ERIC Educational Resources Information Center

Matton, Annelies; Goossens, Lien; Braet, Caroline; Van Durme, Kim

2013-01-01

Eating problems are highly prevalent and seem to show continuity in children. Nevertheless, the effect of different maternal and paternal feeding practices on changes in these problems is not fully understood yet. This study examines short-term continuity in primary school children's overeating, loss of control (over eating), restraint and…

Use of Nasal Bubble CPAP in Children with Hypoxemic Clinical Pneumonia-Report from a Resource Limited Set-Up.

PubMed

Jayashree, Muralidharan; KiranBabu, H B; Singhi, Sunit; Nallasamy, Karthi

2016-02-01

Nasal bubble continuous positive airway pressure (bCPAP) is preferred in developing economies for easy applicability and low cost. Because its use in older children is unexplored, we sought to evaluate its utility in hypoxemic clinical pneumonia. Of 330 children (1 month-12 years) with clinical pneumonia enrolled prospectively over 1 year, those with increased work of breathing and/or SpO2 <92% received bCPAP delivered via an underwater 'T' tube through nasal prongs. Proportion requiring intubation despite bCPAP constituted primary outcome. Incidence of complications, duration of bCPAP and emergency stay were secondary outcomes. Oxygen was initiated by nasal prongs (NPO2) in 204 (61.8%), and by bCPAP in 110 (33.3%). Sixteen (4.8%) were intubated at the outset. Fifty-three (25.9%) on NPO2 were shifted to bCPAP for worsening distress and hypoxemia. Only three (1.8%) from bCPAP group required intubation, of which one died. Failure rate and complications were negligent. The median emergency stay was 4 days. Nasal bCPAP was safe and effective in children with hypoxemic clinical pneumonia. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effectiveness of water fluoridation in caries reduction in a remote Indigenous community in Far North Queensland.

PubMed

Johnson, N W; Lalloo, R; Kroon, J; Fernando, S; Tut, O

2014-09-01

Children in remote Indigenous communities in Australia have levels of dental caries much greater than the national average. One such, the Northern Peninsula Area of Far North Queensland (NPA), had an oral health survey conducted in 2004, shortly before the introduction of fluoridated, reticular water. Children were again surveyed in 2012, following five years exposure. An oral examination was conducted on all consenting children enrolled in schools across the community, using WHO Basic Oral Health Survey methodology. Few teeth had restorations in both surveys. Age-weighted overall caries prevalence and severity declined from 2005 to 2012 by 37.3%. The effect was most marked in younger children, dmft decreasing by approximately 50% for ages 4-9 years; at age 6, mean decayed score decreased from 5.20 to 3.43. DMFT levels also decreased by almost half in 6-9 year olds. However, significant unmet treatment needs exist at all ages. There has been considerable improvement in child dental health in the NPA over the past 6-7 years. In light of continued poor diet and oral hygiene, water fluoridation is the most likely explanation. The cost-effectiveness for this small community remains an issue which, in the current climate of political antagonism to water fluoridation in many quarters, requires continued study. © 2014 Australian Dental Association.

Diagnoses, Labels and Stereotypes: Supporting Children with Intellectual Disabilities in the Hospital

ERIC Educational Resources Information Center

Aston, Megan; Breau, Lynn; MacLeod, Emily

2014-01-01

Children with intellectual disabilities (IDs) and their parents continue to experience stigma within health-care systems. Whilst some research studies have examined the stigma associated with children who have IDs, there continues to be a gap in understanding how the experiences of these children, their parents and nurses have been constructed…

Effects of magnesium sulphate on intraoperative neuromuscular blocking agent requirements and postoperative analgesia in children with cerebral palsy.

PubMed

Na, H-S; Lee, J-H; Hwang, J-Y; Ryu, J-H; Han, S-H; Jeon, Y-T; Do, S-H

2010-03-01

In this double-blind, randomized, placebo-controlled study, we evaluated the effects of magnesium sulphate on neuromuscular blocking agent requirements and analgesia in children with cerebral palsy (CP). We randomly divided 61 children with CP undergoing orthopaedic surgery into two groups. The magnesium group (Group M) received magnesium sulphate 50 mg kg(-1) i.v. as a bolus and 15 mg kg(-1) h(-1) by continuous infusion during the operation. The control group (Group S) received the same amount of isotonic saline. Rocuronium was administered 0.6 mg kg(-1) before intubation and 0.1 mg kg(-1) additionally when train-of-four counts were 2 or more. I.V. fentanyl and ketorolac were used to control postoperative pain. Total infused analgesic volumes and pain scores were evaluated at postoperative 30 min, and at 6, 24, and 48 h. The rocuronium requirement of Group M was significantly less than that of Group S [0.29 (0.12) vs 0.42 (0.16) mg kg(-1) h(-1), P<0.05]. Cumulative analgesic consumption in Group M was significantly less after operation at 24 and 48 h (P<0.05), and pain scores in Group M were lower than in Group S during the entire postoperative period (P<0.05). Serum magnesium concentrations in Group M were higher until 24 h after operation (P<0.05). The incidence of postoperative nausea and vomiting and rescue drug injections was similar in the two groups. No shivering or adverse effects related to hypermagnesaemia were encountered. I.V. magnesium sulphate reduces rocuronium requirements and postoperative analgesic consumption in children with CP.

[Structural quality of rheumatology clinics for children and adolescents. Paper by a task force of the "Society of Pediatric and Adolescent Rheumatology" and of the "Association of Rheumatology Clinics in Germany"].

PubMed

Michels, H; Ganser, G; Dannecker, G; Forster, J; Häfner, R; Horneff, G; Küster, R M; Lakomek, H-J; Lehmann, H; Minden, K; Rogalski, B; Schöntube, M

2006-07-01

Rheumatic diseases in childhood and adolescence differ from those of adulthood according to type, manifestation, treatment and course. A specialized therapy, starting as early as possible, improves the prognosis, can prevent long-term damage and saves the costs of long-term care. Only a specialized pediatric care system can guarantee optimum quality of the processes involved and the results for rheumatology in childhood and adolescence within a global financial system. This requires adequate structural quality of the specialized clinics and departments for pediatric rheumatology. The management of rheumatic diseases in childhood and adolescence is comprehensive and requires a multidisciplinary, specialized and engaged team which can cover the whole spectrum of rheumatic diseases with their various age-dependent aspects. In order to guarantee an adequate, cost-efficient routine, a specialized center which concentrates on inpatient care should treat at least 300 patients with pediatric rheumatic diseases per year. The diagnoses should be divided among the various disease categories with at least 70% of them involving inflammatory rheumatic diseases. For the inpatient care of small children, an accompanying person (parent) is necessary, requiring adequate structures and services. Patient rooms as well as diagnostic (radiography, sonography, etc.) and therapeutic services (physiotherapy, occupational therapy, pool, etc.) must be adequate for small children and school children as well as adolescents. Suitable mother-child units must also be provided and a school for patients is required within the clinic. A pediatric rheumatologist must be available 24 h a day, and it must be possible to reach other specialists within a short time. For painful therapeutic procedures, age-appropriate pain management is obligatory. A continuous adjustment of these recommendations to changing conditions in health politics is intended.

Developmental outcomes of cord blood transplantation for Krabbe disease: A 15-year study.

PubMed

Wright, Matthew D; Poe, Michele D; DeRenzo, Anthony; Haldal, Shilpa; Escolar, Maria L

2017-09-26

To describe long-term outcomes of children with early-infantile Krabbe disease who underwent hematopoietic stem cell transplantation (HSCT) in the first 7 weeks of life. In this prospective longitudinal study, evaluations performed at baseline and follow-up included brain imaging, neurodiagnostic tests, and neurobehavioral evaluations. Of the 18 patients in this study (11 girls, 7 boys; mean follow-up 9.5 years, range 4-15), 5 died (3 of peritransplant complications, 1 of a surgical complication unrelated to Krabbe disease, 1 of disease progression). One of the surviving patients has normal cognitive function and 10 continue to develop cognitive skills at a slightly slower rate than normal. All surviving patients continue to gain receptive language skills, with 7 falling within the normal range. Ten patients receive speech therapy, and 2 of these patients require augmentative communication devices. Gross motor development varies widely, but 3 patients can walk independently, and 7 walk with assistive devices. Spasticity ranges from mild to severe, and 12 patients wear orthotics. Fine motor skills are generally preserved. Brain myelination and atrophy stabilized in 8 patients, improved in 4 patients, and worsened in 1 patient. Nerve conduction velocities initially improved but continue to be abnormal in most patients. The surviving patients function at a much higher level than untreated children or symptomatic children who underwent HSCT. These results show that early HSCT changes the natural history of this disease by improving both lifespan and functional abilities. This study provides Class IV evidence that for children with early-infantile Krabbe disease, early HSCT improves lifespan and functional abilities. © 2017 American Academy of Neurology.

Tobacco use among adolescents. Strategies for prevention.

PubMed

Epps, R P; Manley, M W; Glynn, T J

1995-04-01

Tobacco use is a major public health problem that has its onset during childhood and adolescence. To prevent the onset, physicians can reach children and their parents in their offices beginning in the prenatal period and continuing through adulthood. For pediatricians and other physicians who care for children, NCI recommends five office-based activities that begin with the letter A. The 5 As include anticipatory guidance, ask, advise, assist, and arrange follow-up visits. Elimination of tobacco use requires a comprehensive strategy that includes health professional interventions, policy changes, advertising restrictions, comprehensive school-based programs, community activities, and advocacy approaches. Physicians and health professionals have major roles to play in each of these interventions.

Drawing and interpreting data: Children's impressions of onchocerciasis and community-directed treatment with ivermectin (CDTI) in four onchocerciasis endemic countries in Africa

PubMed Central

Amuyunzu-Nyamongo, Mary; Tchounkeu, Yolande Flore Longang; Oyugi, Rahel Akumu; Kabali, Asaph Turinde; Okeibunor, Joseph C.; Manianga, Cele; Amazigo, Uche V.

2011-01-01

Although the depiction of a child leading a blind man is the most enduring image of onchocerciasis in Africa, research activities have hardly involved children. This paper aims at giving voice to children through drawings and their interpretation. The study was conducted in 2009 in Cameroon, Democratic Republic of Congo (DRC), Nigeria and Uganda. Children aged 6–16 years were asked to draw their perceptions of onchocerciasis and community-directed treatment with ivermectin (CDTI) in their communities. A total of 50 drawings were generated. The drawings depicted four main aspects of onchocerciasis: (1) the disease symptoms, (2) the negative consequences of onchocerciasis among children and in the community generally, (3) the ivermectin distribution process, and (4) the benefits or effects of taking ivermectin. Out of the 50 drawings, 30 were on symptoms, 7 on effects of the disease on children, 8 on distribution process, and 5 represented multiple perceptions on symptoms, drug distribution processes, benefits, and effects of treatment. The lack of clarity when treatment with ivermectin can be stopped in endemic areas requires working with children to ensure continued compliance with treatment into the future. Children's drawings should be incorporated into health education interventions. PMID:21637349

Age differences between children and young adults in the dynamics of dual-task prioritization: body (balance) versus mind (memory).

PubMed

Schaefer, Sabine; Krampe, Ralf Th; Lindenberger, Ulman; Baltes, Paul B

2008-05-01

Task prioritization can lead to trade-off patterns in dual-task situations. The authors compared dual-task performances in 9- and 11-year-old children and young adults performing a cognitive task and a motor task concurrently. The motor task required balancing on an ankle-disc board. Two cognitive tasks measured working memory and episodic memory at difficulty levels individually adjusted during the course of extensive training. Adults showed performance decrements in both task domains under dual-task conditions. In contrast, children showed decrements only in the cognitive tasks but actually swayed less under dual-task than under single-task conditions and continued to reduce their body sway even when instructed to focus on the cognitive task. The authors argue that children perform closer to their stability boundaries in the balance task and therefore prioritize protection of their balance under dual-task conditions. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Laparoscopic esophagomyotomy for achalasia in children: A review

PubMed Central

Pandian, T Kumar; Naik, Nimesh D; Fahy, Aodhnait S; Arghami, Arman; Farley, David R; Ishitani, Michael B; Moir, Christopher R

2016-01-01

Esophageal achalasia in children is rare but ultimately requires endoscopic or surgical treatment. Historically, Heller esophagomyotomy has been recommended as the treatment of choice. The refinement of minimally invasive techniques has shifted the trend of treatment toward laparoscopic Heller myotomy (LHM) in adults and children with achalasia. A review of the available literature on LHM performed in patients < 18 years of age was conducted. The pediatric LHM experience is limited to one multi-institutional and several single-institutional retrospective studies. Available data suggest that LHM is safe and effective. There is a paucity of evidence on the need for and superiority of concurrent antireflux procedures. In addition, a more complete portrayal of complications and long-term (> 5 years) outcomes is needed. Due to the infrequency of achalasia in children, these characteristics are unlikely to be defined without collaboration between multiple pediatric surgery centers. The introduction of peroral endoscopic myotomy and single-incision techniques, continue the trend of innovative approaches that may eventually become the standard of care. PMID:26839646

Education of young children concerning poison prevention.

PubMed Central

Butts, J D; Beck, C L

1986-01-01

Every year about 5,000 fatal accidental poisonings occur in the United States. About 50 percent of those who die are children under the age of 5 years. Medications, house plants, and household cleaning agents are the three leading causes of accidental poisonings in this age range. Since there is an always changing population of children under the age of 5 years, there is a continuing need for education. A committee of the Student American Kentucky Pharmaceutical Association decided to become actively involved in filling the need for education by writing and performing a poison prevention puppet play. The 10-minute play is suitable for small volunteer organizations. It requires only a small financial outlay, and two persons with minimal training can present the play. The play has been shown to more than 6,000 youngsters in the past 2 years. Responses to followup surveys of both the teachers and the students have shown a positive effect on the children's attitudes toward poison prevention. Images p92-a PMID:3080798

Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control.

PubMed

Liwanag, Harvy Joy; Uy, Jhanna; Bataller, Ramil; Gatchalian, Janis Ruth; De La Calzada, Betty; Uy, Justine Alessandra; Dayrit, Manuel

2017-10-01

Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Education of young children concerning poison prevention.

PubMed

Butts, J D; Beck, C L

1986-01-01

Every year about 5,000 fatal accidental poisonings occur in the United States. About 50 percent of those who die are children under the age of 5 years. Medications, house plants, and household cleaning agents are the three leading causes of accidental poisonings in this age range. Since there is an always changing population of children under the age of 5 years, there is a continuing need for education. A committee of the Student American Kentucky Pharmaceutical Association decided to become actively involved in filling the need for education by writing and performing a poison prevention puppet play. The 10-minute play is suitable for small volunteer organizations. It requires only a small financial outlay, and two persons with minimal training can present the play. The play has been shown to more than 6,000 youngsters in the past 2 years. Responses to followup surveys of both the teachers and the students have shown a positive effect on the children's attitudes toward poison prevention.

[Vegetarian Diets in Children? - An Assessment from Pediatrics and Nutrition Science].

PubMed

Kersting, Mathilde; Kalhoff, Hermann; Melter, Michael; Lücke, Thomas

2018-02-01

In Germany, the "Dietary Schedule for the 1st year of life" and the "Optimised Mixed Diet" for children and adolescents serve as scientifically based and generally applicable dietary concepts throughout the period of growth and development. Vegetarian diets as the lacto-ovo-vegetarian diet (exclusion of meat, fish) and the vegan diet (exclusion of all food groups of animal origin) need to be evaluated for their potential to safely meet the high and specific requirements for growth and development. In this regard, high-quality studies are needed. In individuals on lacto-ovo-vegetarian diets, the safe supply with critical nutrients should be checked by thorough dietary history, possibly additional laboratory tests in risk situations like pregnancy, infancy and toddlerhood. Children on pure vegan diet need ongoing elaborate dietary strategies and continuous supplementation at any age, similar to nutritional management in children with metabolic disorders. A vegan diet is disadvised during all periods with intense growth and development. © Georg Thieme Verlag KG Stuttgart · New York.

Continuous Venovenous Hemodiafiltration in the Treatment of Maple Syrup Urine Disease.

PubMed

Demirkol, Demet; Şık, Güntülü; Topal, Nilüfer; Çıtak, Agop; Zeybek, Çigdem; Tüten, Abdülhamit; Bilge, Ilmay

2016-01-01

The study aims to define the efficacy of continuous renal replacement therapy in acute metabolic decompensation treatment of maple syrup urine disease (MSUD). All the neonates, infants and children who have had life threatening conditions due to MSUD and were treated with continuous venovenous hemodiafiltration (CVVHDF) were analyzed retrospectively. Fourteen patients underwent 15 sessions of CVVHDF (age range 15 days to 87 months, mean 40.8 ± 31.4 months). One patient required additional CVVHDF 1 week after cessation of CVVHDF. Twenty seven percent (n = 4) of the patients were intubated and mechanically ventilated. Twelve patients responded to treatment and dramatic neurological improvement was observed within 24 h. Two of the 14 patients required 36 h of CVVHDF for neurological improvement. The mean duration of CVVHDF was 20.2 ± 8.6 (9-36) h. The mean leucine level was 1,648 ± 623.8 (714-2,768) μmol/l before and was 256.5 ± 150.6 (117-646) μmol/l at the end of treatment. No mortality was observed. Continuous hemodiafiltration is an effective and safe method in correcting metabolic disturbances in MSUD. © 2016 S. Karger AG, Basel.

Age-Related Differences in Brain Electrical Activity during Extended Continuous Face Recognition in Younger Children, Older Children and Adults

ERIC Educational Resources Information Center

Van Strien, Jan W.; Glimmerveen, Johanna C.; Franken, Ingmar H. A.; Martens, Vanessa E. G.; de Bruin, Eveline A.

2011-01-01

To examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9 years old) and 36 healthy older children (11-12 years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 faces was shown randomly six times interspersed with…

A retrospective cohort study of suspected child maltreatment cases resulting in hospitalization.

PubMed

Friedman, Lee S; Sheppard, Shirley; Friedman, Daniel

2012-11-01

Although the incidence and risk factors of child abuse have been well researched, there continues to be a need for large studies that provide information regarding the process of recognizing children whose health and lives are most seriously threatened by abuse and neglect, in particular children requiring hospitalization as a result of child abuse. The purpose of this study was to (1) describe differences in the type of injuries and illnesses of children hospitalized for abuse and neglect and (2) assess the relationship between in-hospital mortality and child maltreatment. For this retrospective cohort study, child maltreatment cases were identified using medical record databases of patients treated in all hospitals and trauma units in Illinois. A comparison group of children not suffering from suspected maltreatment were randomly selected and matched by age and data source to the suspected maltreatment cases. 2656 children under the age of 13 years suspected of suffering maltreatment who were admitted to any hospital in Illinois between 2000 and 2009. The analysis showed distinct patterns in injury, physical illness and psychological disorders for each subgroup of maltreatment cases. Among the cases of maltreatment 75.6% were discharged home, 2.9% into child protective services and 15.8% to an intermediate care facility. In the final multivariable conditional logistic regression model, children suffering maltreatment continued to have a higher odds of dying during hospitalization (adjusted OR=2.99; CI95%: 1.63, 5.45; p<0.001). There were distinct diagnostic patterns and outcomes among suspected cases of child maltreatment admitted to Illinois hospitals over a 10-year period. This large retrospective cohort study confirms findings reported in many smaller studies and larger national cross-sectional surveys. Copyright © 2012 Elsevier Ltd. All rights reserved.

Children's Voices: Providing Continuity in Transition Experiences in Singapore

ERIC Educational Resources Information Center

Ebbeck, Marjory; Saidon, Suraya Binte; Rajalachime, Gunathilakan nee; Teo, Lay Yan

2013-01-01

The issue about when children should begin primary schooling continues to be an area for discussion amongst educators, parents, and children who indeed have some views about this. The compulsory entry age of children into formal schooling is different in many countries. It is not only the starting age that has invoked discussion, but also the…

Pharmacological therapy in children with nodal reentry tachycardia: when, how and how long to treat the affected patients.

PubMed

Bouhouch, R; El Houari, T; Fellat, I; Arharbi, M

2008-01-01

Atrio-ventricular nodal reentrant tachycardia (AVNRT) is a rare supra-ventricular tachycardia (SVT) in children and becomes more frequent in adolescents. Most of children with an AVNRT have a healthy heart thus rarely experiencing severe symptoms. Because of haemodynamic instability or risk of complications, recurrences of SVT may require a chronic therapy. Interruption of dual atrio-ventricular nodal physiology is the basic mechanism to terminate AVNRT. This may be achieved by using anti-arrhythmic drugs or through Radiofrequency catheter ablation (RF). We aim to review the literature on the use of anti-arrhythmic drugs for the management of AVNRT in children aged more than 1 year and discuss the recommended dosages and the duration of a long term therapy. In the absence of comparative trials of risks and benefits between pharmacological therapy and RF and because of a greater clinical experience with anti-arrhythmic drugs, these last but not the least continue to be first-line therapy in the management of most SVT in children. Trials on pharmacotherapy in children with SVT in general and AVNRT in particular are lacking, use of anti-arrhythmic drugs being extrapolated from adult literature. Although Adenosine is becoming more used since it is the safest and effective drug in the acute setting, Digoxin continue to be the drug of first choice. Beta-blockers and Class I anti-arrhythmic are the second choice drugs with Flecainide being the preferred anti-arrhythmic drug for treatment failures. Amiodarone is rarely used as a chronic therapy in resistant cases. With the new advances in the RF technology, this therapy is becoming more safe and effective for AVNRT in children. Therefore, additional well-designed controlled trials are needed to further evaluate the comparative efficacy of anti-arrhythmic drugs in the management of AVNRT in children, as well as to evaluate dosing and toxicity in various age groups and determine the duration of a chronic therapy as compared to a potential RF.

Impact of 3-tier formularies on drug treatment of attention-deficit/hyperactivity disorder in children.

PubMed

Huskamp, Haiden A; Deverka, Patricia A; Epstein, Arnold M; Epstein, Robert S; McGuigan, Kimberly A; Muriel, Anna C; Frank, Richard G

2005-04-01

Expenditures for medications used to treat attention-deficit/hyperactivity disorder (ADHD) in children have increased rapidly. Many employers and health plans have adopted 3-tier formularies in an attempt to control costs for these and other drugs. To assess the effect of copayment increases associated with 3-tier formulary adoption on use and spending patterns for ADHD medications for children. Observational study using quasi-experimental design to compare effects on ADHD medication use and spending for children enrolled as dependents in an employer-sponsored plan that made major changes to its pharmacy benefit design and a comparison group of children covered by the same insurer. The plan simultaneously moved from a 1-tier (same copayment required for all drugs) to a 3-tier formulary and implemented an across-the-board copayment increase. The plan later moved 3 drugs from tier 3 to tier 2. An intervention group of 20 326 and a comparison group of 15 776 children aged 18 years and younger. Monthly probability of using an ADHD medication; plan, enrollee, and total ADHD medication spending; and medication continuation. A 3-tier formulary implementation resulted in a 17% decrease in the monthly probability of using medication (P<.001), a 20% decrease in expected total medication expenditures, and a substantial shifting of costs from the plan to families (P<.001). Intervention group children using medications in the pre-period were more likely to change to a medication in a different tier after 3-tier adoption, relative to the comparison group (P = .08). The subsequent tier changes resulted in increased plan spending (P<.001) and decreased patient spending (P = .003) for users but no differences in continuation. The copayment increases associated with 3-tier formulary implementation by 1 employer resulted in lower total ADHD medication spending, sizeable increases in out-of-pocket expenditures for families of children with ADHD, and a significant decrease in the probability of using these medications.

5 CFR 831.113 - Payments to children.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Payments to children. 831.113 Section 831.113 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Administration and General Provisions § 831.113 Payments to children. For purposes of...

5 CFR 831.113 - Payments to children.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Payments to children. 831.113 Section 831.113 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Administration and General Provisions § 831.113 Payments to children. For purposes of...

5 CFR 831.113 - Payments to children.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Payments to children. 831.113 Section 831.113 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Administration and General Provisions § 831.113 Payments to children. For purposes of...

5 CFR 831.113 - Payments to children.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Payments to children. 831.113 Section 831.113 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Administration and General Provisions § 831.113 Payments to children. For purposes of...

5 CFR 831.113 - Payments to children.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Payments to children. 831.113 Section 831.113 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Administration and General Provisions § 831.113 Payments to children. For purposes of...

Three Justifications for Effectively Teaching Exceptional Babies to Third Grade with Respect to Their Characteristics, an Effective Curricula, and an Exceptional-Research Data Base

ERIC Educational Resources Information Center

Jaramillo, James Anthony Montrose

2013-01-01

Both Pre-K and K-3rd grade exceptional or talented children/students not only want but need more of an "accommodative" ambiance where their senses are given novel multiple-intelligences data so that they can continue to intellectually grow with respect to Piaget, Erickson, and Vygotsky's developmental schemes. Thus, to do this requires us to…

Auditory training of speech recognition with interrupted and continuous noise maskers by children with hearing impairment

PubMed Central

Sullivan, Jessica R.; Thibodeau, Linda M.; Assmann, Peter F.

2013-01-01

Previous studies have indicated that individuals with normal hearing (NH) experience a perceptual advantage for speech recognition in interrupted noise compared to continuous noise. In contrast, adults with hearing impairment (HI) and younger children with NH receive a minimal benefit. The objective of this investigation was to assess whether auditory training in interrupted noise would improve speech recognition in noise for children with HI and perhaps enhance their utilization of glimpsing skills. A partially-repeated measures design was used to evaluate the effectiveness of seven 1-h sessions of auditory training in interrupted and continuous noise. Speech recognition scores in interrupted and continuous noise were obtained from pre-, post-, and 3 months post-training from 24 children with moderate-to-severe hearing loss. Children who participated in auditory training in interrupted noise demonstrated a significantly greater improvement in speech recognition compared to those who trained in continuous noise. Those who trained in interrupted noise demonstrated similar improvements in both noise conditions while those who trained in continuous noise only showed modest improvements in the interrupted noise condition. This study presents direct evidence that auditory training in interrupted noise can be beneficial in improving speech recognition in noise for children with HI. PMID:23297921

Children in an ageing society.

PubMed

Hall, D M

1999-11-20

This paper explores the implications of demographic aging for children and pediatric practice in the Western society. It focuses on the social class differences in childbearing patterns, specific issues related to disability, and distribution of resources between age groups. Women in the Western world are now having children at an older age than at any time in the past 50 years. Voluntary childlessness or deliberate delay in childbearing is common among highly educated women. This changing pattern in childbearing may increase and polarize health and wealth inequalities. With advancements in neonatal and pediatric care which prolong life expectancy and survival of disabled children, it is projected that there will be an increasing number of very old parents caring for severely disabled offspring. Meanwhile, there are also many children who are carrying considerable burdens of caring for their disabled parents. The community burden of disability will continue to rise. The needs of the elderly population may drain resources from child health services. Despite this demographic pattern, care for the children is still important. Health care authorities must not become contented with the existing pediatric care services just because demographic changes require that the nation should invest more in care of the older population.

Turtle-Associated Salmonellosis, United States, 2006–2014

PubMed Central

Tauxe, Robert V.; Behravesh, Casey Barton

2016-01-01

During 2006–2014, a total of 15 multistate outbreaks of turtle-associated salmonellosis in humans were reported in the United States. Exposure to small pet turtles has long been recognized as a source of human salmonellosis. The risk to public health has persisted and may be increasing. Turtles are a popular reptilian pet among children, and numerous risky behaviors for the zoonotic transmission of Salmonella bacteria to children have been reported in recent outbreaks. Despite a long-standing federal ban against the sale and distribution of turtles <4 in (<10.16 cm) long, these small reptiles can be readily acquired through multiple venues and continue to be the main source of turtle-associated salmonellosis in children. Enhanced efforts are needed to minimize the disease risk associated with small turtle exposure. Prevention will require novel partnerships and a comprehensive One Health approach involving human, animal, and environmental health. PMID:27315584

Early Childhood Caries

PubMed Central

Kawashita, Yumiko; Kitamura, Masayasu; Saito, Toshiyuki

2011-01-01

Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC) is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries. PMID:22007218

Turtle-Associated Salmonellosis, United States, 2006-2014.

PubMed

Bosch, Stacey; Tauxe, Robert V; Behravesh, Casey Barton

2016-07-01

During 2006-2014, a total of 15 multistate outbreaks of turtle-associated salmonellosis in humans were reported in the United States. Exposure to small pet turtles has long been recognized as a source of human salmonellosis. The risk to public health has persisted and may be increasing. Turtles are a popular reptilian pet among children, and numerous risky behaviors for the zoonotic transmission of Salmonella bacteria to children have been reported in recent outbreaks. Despite a long-standing federal ban against the sale and distribution of turtles <4 in (<10.16 cm) long, these small reptiles can be readily acquired through multiple venues and continue to be the main source of turtle-associated salmonellosis in children. Enhanced efforts are needed to minimize the disease risk associated with small turtle exposure. Prevention will require novel partnerships and a comprehensive One Health approach involving human, animal, and environmental health.

Research to practice: developing an integrated anaphylaxis education curriculum for school nurses.

PubMed

Cavanaugh, Rebecca; Strickland, C June

2011-06-01

The numbers of school-aged children with life-threatening allergies that cause anaphylaxis continues to increase. Many states, including Washington, have responded to this by developing specific guidelines for school districts to follow in order to provide a safe learning environment for children with medical conditions that put them at risk for anaphylaxis. School nurses require resources to assist them in providing health training for school staff on how to manage potentially life-threatening health conditions for children in their school, however, resources to address this training are limited. A search for and content analysis of currently available literature and resources about anaphylaxis and anaphylaxis training curricula revealed a lack of an integrated curriculum to train school staff. This article presents a discussion of the development of a train-the-trainer anaphylaxis education program providing school nurses with curriculum, lesson plans, teaching-learning activities, and resources for anaphylaxis education of all school staff.

Bourdieu at the bedside: briefing parents in a pediatric hospital.

PubMed

LeGrow, Karen; Hodnett, Ellen; Stremler, Robyn; McKeever, Patricia; Cohen, Eyal

2014-12-01

The philosophy of family-centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision-making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. © 2014 John Wiley & Sons Ltd.

Commentary: Prevention of violence against children: a framework for progress in low- and middle-income countries.

PubMed

Chandran, Aruna; Puvanachandra, Prasanthi; Hyder, Adnan A

2011-02-01

Violence against children has been the least reported, studied, and understood area of child injuries. Initial awareness emerged from international conferences and resolutions, followed by national policies and statements. More effective responses around the world will require action. Although previous calls for action have pointed to important activities (gathering of baseline data, passing of legal reforms, and providing services to those who experience violence), the agenda is limited. Data collection needs to be continuous, systematic, and sustainable, and should enable ongoing evaluation of intervention programs. An inter-sectoral approach to violence against children incorporating public health, criminal justice, social services, education, non-governmental organizations, media, and businesses is imperative if the growing burden is to be mitigated. Thus we offer a framework, building on earlier recommendations, to focus on four domains: national surveillance, intervention research, legislation and policy, and partnerships and collaboration.

Effects of MPH-OROS on the organizational, time management, and planning behaviors of children with ADHD.

PubMed

Abikoff, Howard; Nissley-Tsiopinis, Jenelle; Gallagher, Richard; Zambenedetti, Maurizio; Seyffert, Michael; Boorady, Roy; McCarthy, John

2009-02-01

To evaluate the effects of stimulant medication on organizational, time management, and planning (OTMP) in children with attention-deficit/hyperactivity disorder (ADHD) and ascertain whether OTMP is normalized with medication. Participants included 19 stimulant-naïve children with ADHD (aged 8-13 years) and impaired OTMP functioning, defined as greater than 1 SD below norms on the Children's Organizational Skills Scale. A double-blind, placebo-controlled, crossover design, with 4 weeks of each condition, evaluated medication (methylphenidate-osmotic-release oral system [MPH-OROS]) effects on OTMP, based on the parent and teacher versions of the Children's Organizational Skills Scale. The parent and teacher Swanson, Nolan, and Pelham, Version IV, rating scales assessed ADHD symptoms. "Not impaired" in OTMP was defined as no longer meeting study entry criteria, and "not impaired" in ADHD symptoms was defined as having mean Swanson, Nolan, and Pelham, Version IV, scores of < or = 1.0. MPH-OROS significantly improved children's OTMP behaviors. These improvements were correlated with significant reductions in ADHD symptoms. However, most of the children (61%) continued to show significant OTMP impairments on MPH-OROS. The MPH-OROS reduced children's OTMP deficits, and these improvements were associated with improvements in ADHD symptoms. Some children remained impaired in OTMP even after effective stimulant treatment of ADHD symptoms. These youngsters may require other treatments that target OTMP deficits.

Unresolved antiretroviral treatment management issues in HIV-infected children.

PubMed

Heidari, Shirin; Mofenson, Lynne M; Hobbs, Charlotte V; Cotton, Mark F; Marlink, Richard; Katabira, Elly

2012-02-01

Antiretroviral therapy in children has expanded dramatically in low-income and middle-income countries. The World Health Organization revised its pediatric HIV guidelines to recommend initiation of antiretroviral therapy in all HIV-infected children younger than 2 years, regardless of CD4 count or clinical stage. The number of children starting life-long antiretroviral therapy should therefore expand dramatically over time. The early initiation of antiretroviral therapy has indisputable benefits for children, but there is a paucity of definitive information on the potential adverse effects. In this review, a comprehensive literature search was conducted to provide an overview of our knowledge about the complications of treating pediatric HIV. Antiretroviral therapy in children, as in adults, is associated with enhanced survival, reduction in opportunistic infections, improved growth and neurocognitive function, and better quality of life. Despite antiretroviral therapy, HIV-infected children may continue to lag behind their uninfected peers in growth and development. In addition, epidemic concurrent conditions, such as tuberculosis, malaria, and malnutrition, can combine with HIV to yield more rapid disease progression and poor treatment outcomes. Additional studies are required to evaluate the long-term effects of antiretroviral therapy in HIV-infected infants, children, and adolescents, particularly in resource-limited countries where concomitant infections and conditions may enhance the risk of adverse effects. There is an urgent need to evaluate drug-drug interactions in children to determine optimal treatment regimens for both HIV and coinfections.

Literacy Outcomes for Primary School Children Who Are Deaf and Hard of Hearing: A Cohort Comparison Study.

PubMed

Harris, Margaret; Terlektsi, Emmanouela; Kyle, Fiona E

2017-03-01

In this study, we compared the language and literacy of two cohorts of children with severe-profound hearing loss, recruited 10 years apart, to determine if outcomes had improved in line with the introduction of newborn hearing screening and access to improved hearing aid technology. Forty-two children with deafness, aged 5-7 years with a mean unaided loss of 102 DB, were assessed on language, reading, and phonological skills. Their performance was compared with that of a similar group of 32 children with deafness assessed 10 years earlier and also a group of 40 children with normal hearing of similar single word reading ability. English vocabulary was significantly higher in the new cohort although it was still below chronological age. Phonological awareness and reading ability had not significantly changed over time. In both cohorts, English vocabulary predicted reading, but phonological awareness was only a significant predictor for the new cohort. The current results show that vocabulary knowledge of children with severe-profound hearing loss has improved over time, but there has not been a commensurate improvement in phonological skills or reading. They suggest that children with severe-profound hearing loss will require continued support to develop robust phonological coding skills to underpin reading.

Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children

PubMed Central

Salmon, Daniel A.; Pan, William K.Y.; Omer, Saad B.; Navar, Ann Marie; Orenstein, Walter; Marcuse, Edgar K.; Taylor, James; deHart, M. Patricia; Stokley, Shannon; Carter, Terrell; Halsey, Neal A.

2014-01-01

Objectives: Compare vaccine knowledge, attitudes and practices of primary care providers for fully vaccinated children and children who are exempt from school immunization requirements. Methods: We conducted a mailed survey of parent-identified primary care providers from four states to measure perceived risks and benefits of vaccination and other key immunization beliefs. Frequencies of responses were stratified by type of provider, identified by exempt versus vaccinated children. Logistic regression was used to calculate odds ratios for responses by provider type. Results: 551 surveys were completed (84.3% response rate). Providers for exempt children had similar attitudes to providers for non-exempt children. However, there were statistically significant increased concerns among providers for exempt children regarding vaccine safety and lack of perceived individual and community benefits for vaccines compared to other providers. Conclusions: The great majority of providers for exempt children had similar attitudes about vaccine safety, effectiveness and benefits as providers of non-exempt children. Although providers for exempt children were more likely to believe that multiple vaccines weaken a child’s immune system and were concerned about vaccine safety and less likely to consider vaccines were beneficial, a substantial proportion of providers of both exempt and vaccinated children have concerns about vaccine safety and believe that CDC underestimates the frequency of vaccine side effects. Effective continuing education of providers about the risks and benefits of immunization and including in vaccine recommendations more information on pre and post licensing vaccine safety evaluations may help address these concerns. PMID:18424918

Munchausen Syndrome by Proxy: two case reports and an update of the literature.

PubMed

Moldavsky, Maria; Stein, Daniel

2003-01-01

Munchausen Syndrome by Proxy (MSP) may significantly hamper the normal development of children. Our aim was to describe the first two Israeli children who fit this diagnosis. Case #1 was diagnosed at the age of seven months with failure to thrive, severe recurrent vomiting, and recurrent unexplained fever. Medical tests performed were normal. No improvement was noted following prolonged treatment, which included several surgical interventions. Case #2 was hospitalized at the age of four years because of recurrent convulsive episodes. Medical examinations performed were normal, and there was no improvement in the reported seizure disorder despite continuous treatment. In both cases, MSP was suspected because of a persistent illness that could not be explained by adequate medical basis, and because the symptoms and signs occurred only in the mother's presence. A confrontation was made, leading to rapid deterioration of the hitherto devoted relationship of the mother of case #1 with her child, and of the previous cooperative relationship of both mothers with the medical staff. Removal of both children from their families ensued, with considerable improvement within a brief period, which continued in a one- to two-year follow-up period. The study reviews the required diagnostic criteria for MSP and possible treatment options.

Support for immunization registries among parents of vaccinated and unvaccinated school-aged children: a case control study.

PubMed

Linkins, Robert W; Salmon, Daniel A; Omer, Saad B; Pan, William Ky; Stokley, Shannon; Halsey, Neal A

2006-09-22

Immunizations have reduced childhood vaccine preventable disease incidence by 98-100%. Continued vaccine preventable disease control depends on high immunization coverage. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies. Despite substantial resources directed towards registry development in the U.S., only 48% of children were enrolled in a registry in 2004. Parental attitudes likely impact child participation. Consequently, the purpose of this study was to assess the attitudes of parents of vaccinated and unvaccinated school-aged children regarding: support for immunization registries; laws authorizing registries and mandating provider reporting; opt-in versus opt-out registry participation; and financial worth and responsibility of registry development and implementation. A case control study of parents of 815 children exempt from school vaccination requirements and 1630 fully vaccinated children was conducted. Children were recruited from 112 elementary schools in Colorado, Massachusetts, Missouri, and Washington. Surveys administered to the parents, asked about views on registries and perceived utility and safety of vaccines. Parental views were summarized and logistic regression models compared differences between parents of exempt and vaccinated children. Surveys were completed by 56.1% of respondents. Fewer than 10% of parents were aware of immunization registries in their communities. Among parents aware of registries, exempt children were more likely to be enrolled (65.0%) than vaccinated children (26.5%) (p value = 0.01). A substantial proportion of parents of exempt children support immunization registries, particularly if registries offer choice for participation. Few parents of vaccinated (6.8%) and exempt children (6.7%) were aware of laws authorizing immunization registries. Support for laws authorizing registries and requiring health care providers to report to registries was more common among parents of vaccinated than exempt children. Most parents believed that the government, vaccine companies or insurance companies should pay for registries. Parental support for registries was relatively high. Parental support for immunization registries may increase with greater parental awareness of the risks of vaccine preventable diseases and utility of vaccination.

Factors Associated with Young Children's Opportunities for Maintaining Family Relationships during Maternal Incarceration

ERIC Educational Resources Information Center

Poehlmann, Julie; Shlafer, Rebecca J.; Maes, Elizabeth; Hanneman, Ashley

2008-01-01

Children affected by maternal incarceration experience challenges maintaining continuous family relationships because of changes in caregivers, separation from siblings, and limited contact with mothers. In this mixed-method study, we investigated maternal and contextual factors associated with continuity in family relationships of children living…

A prospective randomised trial comparing nasogastric with intravenous hydration in children with bronchiolitis (protocol) The comparative rehydration in bronchiolitis study (CRIB)

PubMed Central

2010-01-01

Background Bronchiolitis is the most common reason for admission of infants to hospital in developed countries. Fluid replacement therapy is required in about 30% of children admitted with bronchiolitis. There are currently two techniques of fluid replacement therapy that are used with the same frequency-intravenous (IV) or nasogastric (NG). The evidence to determine the optimum route of hydration therapy for infants with bronchiolitis is inadequate. This randomised trial will be the first to provide good quality evidence of whether nasogastric rehydration (NGR) offers benefits over intravenous rehydration (IVR) using the clinically relevant continuous outcome measure of duration of hospital admission. Methods/Design A prospective randomised multi-centre trial in Australia and New Zealand where children between 2 and 12 months of age with bronchiolitis, needing non oral fluid replacement, are randomised to receive either intravenous (IV) or nasogastric (NG) rehydration. 750 patients admitted to participating hospitals will be recruited, and will be followed daily during the admission and by telephone 1 week after discharge. Patients with chronic respiratory, cardiac, or neurological disease; choanal atresia; needing IV fluid resuscitation; needing an IV for other reasons, and those requiring CPAP or ventilation are excluded. The primary endpoint is duration of hospital admission. Secondary outcomes are complications, need for ICU admission, parental satisfaction, and an economic evaluation. Results will be analysed using t-test for continuous data, and chi squared for categorical data. Non parametric data will be log transformed. Discussion This trial will define the role of NGR and IVR in bronchiolitis Trail registration The trial is registered with the Australian and New Zealand Clinical Trials Registry - ACTRN12605000033640 PMID:20515467

Management of complex glottic stenosis in children with recurrent respiratory papillomatosis.

PubMed

Siegel, Bianca; Smith, Lee P

2013-10-01

To describe our management of complex glottic stenosis in tracheotomy dependent children with severe recurrent respiratory papillomatosis. Retrospective chart review at a tertiary care children's hospital. Three children with complex glottic stenosis secondary to severe recurrent respiratory papillomatosis were treated at our institution since 2011. Two patients had complete stenosis, and the third had near-complete stenosis. Two patients were managed using balloon dilation alone, and the third also underwent laryngotracheal reconstruction with posterior costal cartilage grafting. Two patients have been successfully decannulated and the third has been tolerating continuous tracheotomy capping for greater than twelve months. All three patients underwent aggressive debridement of papillomatosis and balloon dilation every 4-6 weeks until their burden of disease was controlled. In two patients, the glottic airway was patent, and the third continued to have complete restenosis between procedures and required laryngotracheoplasty with multiple post-operative dilation procedures to establish an adequate glottic airway. Severe laryngeal stenosis is a well-described complication of recurrent respiratory papillomatosis, but its management is not well-defined. Aggressive management of papillomatosis with frequent debridement is critical in successfully managing laryngeal stenosis. Balloon dilation alone may be surprisingly effective in these patients, and laryngotracheoplasty can be used as an adjunct procedure in those patients who fail balloon dilation. Given the quality of life issues and concerns regarding distal spread of disease with tracheotomies in these patients, we feel that aggressive management and early decannulation is in the patient's best interest. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Health seeking and access to care for children with suspected dengue in Cambodia: an ethnographic study.

PubMed

Khun, Sokrin; Manderson, Lenore

2007-09-24

The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue.

Health seeking and access to care for children with suspected dengue in Cambodia: An ethnographic study

PubMed Central

Khun, Sokrin; Manderson, Lenore

2007-01-01

Background The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Methods Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Results Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. Conclusion The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue. PMID:17892564

Mother-caregiver expectations for function among survivors of childhood brain tumors

PubMed Central

Barakat, Lamia P.; Ulrich, Connie M.; Jones, Nora L.; Deatrick, Janet A.

2015-01-01

Purpose Children diagnosed with brain tumors increasingly survive to adulthood, although they do so with needs often requiring continued parental caregiving. We sought to describe the nature of caregivers’ expectations about survivors’ function and how expectations connect to ongoing management and decision-making. Methods Forty-five qualitative interviews with mother-caregivers were conducted and coded for themes related to expectations for their adolescent/young adult children living post-childhood brain tumors. Results Five main themes emerged as integral to mother-caregiver expectations: realizing a difference in the survivor, noticing limitations to independence in the survivor, memories of learning about clinical prognoses as understood from consent meetings and education, managing these realizations, and acknowledging unresolved challenges. Conclusions Caregiver expectations are influenced by both initial clinical interactions and contemporary family dynamics and require individual- and family-specific survivorship planning. As caregiver expectations can influence management behaviors that impact outcomes and possibly independence, implications for clinician-caregiver shared decision-making are substantial. PMID:26556212

[Maternal alcoholism and its impact on child health].

PubMed

Sivolap, Y P

2015-01-01

Maternal alcoholism hinders the normal development of child and threatens his mental and physical health due to three factors: the hereditary transmission of predisposition to alcohol abuse; alcohol consumption during pregnancy; adverse family environment. The children of mothers suffering from alcoholism revealed are characterized by increased risk of depression, anxiety and other mental disorders, including alcohol and substance dependence. The adverse impact of maternal alcoholism (or, to speak more widely, parents' alcoholism) on the child health requires special preventive and treatment programs for both parents and children. Separation from the mother (even if the mother is addicted to alcohol) seriously injures the child, and therefore treatment programs for alcohol abusing women should be focused on the possible continuation of the parental rights of patients.

The epidemiology of rheumatic fever in the Tairawhiti/Gisborne region of New Zealand: 1997-2009.

PubMed

Siriett, Victoria; Crengle, Sue; Lennon, Diana; Stonehouse, Mary; Cramp, Geoffrey

2012-11-09

To establish Acute Rheumatic Fever (ARF) rates within the Tairawhiti District Health Board (1997-2009) to identify communities for primary prevention programmes. ARF cases (1997-2009) sought by audit of Gisborne Hospital admissions, penicillin prophylaxis lists and the EpiSurv notifiable disease database. ARF rates (n=44 cases) during 1997 to 2009 (7.6/100,000) with a continuing significant disparity between Maori (n=40, 15.2/100,000) and non-Maori, (n=3, 1.1/100,000). One case was Pacific. This disparity was marked in school-aged children (5-14 years: Maori 59/100,000 vs non-Maori 8/100,000). Over 80% of ARF cases demonstrated heart damage (18% moderate, 20% severe and 8% requiring heart surgery). ARF cases were strongly associated with living and schooling within high deprivation areas Forty ARF cases were enrolled in 13/21 Gisborne schools, 4/18 East Coast schools and 2/17 western rural schools. (No school for 8 cases). When assessed as a percentage of school rolls there were no discernable differences between primary, intermediate and secondary schools. Of the 44 cases, 35 (80%) resided in areas of NZDep06 score 8-10 (most deprived). Very high ARF rates were recorded in the 1960's; the continuing burden of ARF in Maori children indicate a strong requirement for primary prevention strategies. Progress has plateaued in the last 20 years.

[Fertility in adolescence].

PubMed

Mardones Restat, F; Jones Orellana, G

1985-03-01

Mortality rates among infants of mothers under 18 years old and their association with relevant variables were analyzed for the light they could shed on control of infant mortality and morbidity in Chile. Increased attention has been paid in recent years to maternal age, birth weight, and other risk factors in birth and death registration. Adolescent mothers who do not satisfy their own increased nutritional requirements are at greater risk of fetal malnutrition, often associated with low birth weight, high rates of infant mortality, and cerebral damages. 6% of all births in Chile in 1982 were to mothers aged 14-17. But the proportion of births to mothers under 20 has increased in Chile from 9% in 1965 to 17% in 1982. The age specific fertility rate declined for women 15-19 in the same years from 79 to 63/1000, while it declined by 1/2 for women aged 20-34. Infant mortality rates for children of adolescent mothers declined from 68.1/1000 in 1978 to 30/1000 in 1982, but marked rural-urban and regional differentials were noted. The infant mortality rate in 1978 we 43.8/1000 for children of married adolescent mothers and 96.5/1000 for children of unmarried adolescent mothers. Even higher rates were found in rural areas. By 1981, the rates and the magnitude of the differences had decreased, but rates continued to be higher for children of adolescent mothers. Malnutrition continues to be more prevalent among children of adolescent mothers, especially outside of the Santiago metropolitan region. Infant mortality increased with birth order among children of mothers under 18. Children weighing under 2 k can now be sent to centers for treatment of malnutrition when the household is judged to be incompetent for any reason. Such infants gain weight rapidly when they are well fed in a healthy environment. The mothers are instructed in child care at the center.

Utility of a routine urinalysis in children who require clean intermittent catheterization.

PubMed

Forster, C S; Haslam, D B; Jackson, E; Goldstein, S L

2017-10-01

Children who require clean intermittent catheterization (CIC) frequently have positive urine cultures. However, diagnosing a urinary tract infection (UTI) can be difficult, as there are no standardized criteria. Routine urinalysis (UA) has good predictive accuracy for UTI in the general pediatric population, but data are limited on the utility of routine UA in the population of children who require CIC. To determine the utility of UA parameters (e.g. leukocyte esterase, nitrites, and pyuria) to predict UTI in children who require CIC, and identify a composite UA that has maximal predictive accuracy for UTI. A cross-sectional study of 133 children who required CIC, and had a UA and urine culture sent as part of standard of care. Patients in the no-UTI group all had UA and urine cultures sent as part of routine urodynamics, and were asymptomatic. Patients included in the UTI group had growth of ≥50,000 colony-forming units/ml of a known uropathogen on urine culture, in addition to two or more of the following symptoms: fever, abdominal pain, back pain, foul-smelling urine, new or worse incontinence, and pain with catheterization. Categorical data were compared using Chi-squared test, and continuous data were compared with Student's t-test. Sensitivity, specificity, and positive and negative predictive values were calculated for individual UA parameters, as well as the composite UA. Logistic regression was performed on potential composite UA models to identify the model that best fit the data. There was a higher proportion of patients in the no-UTI group with negative leukocyte esterase compared with the UTI group. There was a higher proportion of patients with UTI who had large leukocyte esterase and positive nitrites compared with the no-UTI group (Summary Figure). There was no between-group difference in urinary white blood cells. Positive nitrites were the most specific (84.4%) for UTI. None of the parameters had a high positive predictive value, while all had high negative predictive values. The composite model with the best Akaike information criterion was >10 urinary white blood cells and either moderate or large leukocyte esterase, which had a positive predictive value of 33.3 and a negative predictive value of 90.4. Routine UA had limited sensitivity, but moderate specificity, in predicting UTI in children who required CIC. The composite UA and moderate or large leukocyte esterase both had good negative predictive values for the outcome of UTI. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Bilingual Mothers' Language Choice in Child-directed Speech: Continuity and Change.

PubMed

De Houwer, Annick; Bornstein, Marc H

2016-01-01

An important aspect of Family Language Policy in bilingual families is parental language choice. Little is known about the continuity in parental language choice and the factors affecting it. This longitudinal study explores maternal language choice over time. Thirty-one bilingual mothers provided reports of what language(s) they spoke with their children. Mother-child interactions were videotaped when children were pre-verbal (5M), producing words in two languages (20M), and fluent speakers (53M). All children had heard two languages from birth in the home. Most mothers reported addressing children in the same single language. Observational data confirmed mothers' use of mainly a single language in interactions with their children, but also showed the occasional use of the other language in over half the sample when children were 20 months. Once children were 53 months mothers again used only the same language they reported speaking to children. These findings reveal a possible effect of children's overall level of language development and demonstrate the difficulty of adhering to a strict "one person, one language" policy. The fact that there was longitudinal continuity in the language most mothers mainly spoke with children provided children with cumulative language input learning opportunities.

Bilingual Mothers' Language Choice in Child-directed Speech: Continuity and Change

PubMed Central

De Houwer, Annick; Bornstein, Marc H.

2016-01-01

An important aspect of Family Language Policy in bilingual families is parental language choice. Little is known about the continuity in parental language choice and the factors affecting it. This longitudinal study explores maternal language choice over time. Thirty-one bilingual mothers provided reports of what language(s) they spoke with their children. Mother-child interactions were videotaped when children were pre-verbal (5M), producing words in two languages (20M), and fluent speakers (53M). All children had heard two languages from birth in the home. Most mothers reported addressing children in the same single language. Observational data confirmed mothers' use of mainly a single language in interactions with their children, but also showed the occasional use of the other language in over half the sample when children were 20 months. Once children were 53 months mothers again used only the same language they reported speaking to children. These findings reveal a possible effect of children's overall level of language development and demonstrate the difficulty of adhering to a strict “one person, one language” policy. The fact that there was longitudinal continuity in the language most mothers mainly spoke with children provided children with cumulative language input learning opportunities. PMID:28210008

Life Course and Intergenerational Continuity of Intimate Partner Aggression and Physical Injury: A 20-Year Study.

PubMed

Knight, Kelly E; Menard, Scott; Simmons, Sara B; Bouffard, Leana A; Orsi, Rebecca

2016-01-01

The objective of this study is to examine continuity of intimate partner aggression (IPA), which is defined as repeated annual involvement in IPA, across respondents' life course and into the next generation, where it may emerge among adult children. A national, longitudinal, and multigenerational sample of 1,401 individuals and their adult children is analyzed. Annual data on IPA severity and physical injury were collected by the National Youth Survey Family Study across a 20-year period from 1984 to 2004. Three hypotheses and biological sex differences are tested and effect sizes are estimated. First, findings reveal evidence for life course continuity (IPA is a strong predictor of subsequent IPA), but the overall trend decreases over time. Second, intergenerational continuity is documented (parents' IPA predicts adult children's IPA), but the effect is stronger for female than for male adult children. Third, results from combined and separate, more restrictive, measures of victimization and perpetration are nearly identical except in the intergenerational analyses. Fourth, evidence for continuity is not found when assessing physical injury alone. Together, these findings imply that some but not all forms of IPA are common, continuous, and intergenerational. Life course continuity appears stronger than intergenerational continuity.

Project Developmental Continuity: Field Procedures Manual.

ERIC Educational Resources Information Center

Morris, Mary

This operations manual for field staff (site monitors, site coordinators, and testers) involved in the observation and testing of children is part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's…

Personality and Psychopathology in Flemish Referred Children: Five Perspectives of Continuity

ERIC Educational Resources Information Center

De Bolle, Marleen; De Clercq, Barbara; Van Leeuwen, Karla; Decuyper, Mieke; Rosseel, Yves; De Fruyt, Filip

2009-01-01

The present study investigates five types of continuity of personality and internalizing and externalizing problems (i.e., structural, differential, mean-level, individual-level and ipsative continuity) in a sample of referred children and adolescents (N = 114) with a broad variety of psychological problems. Mothers were administered a child…

Sleep Disorders and Their Management in Children With Ehlers-Danlos Syndrome Referred to Sleep Clinics.

PubMed

Domany, Keren Armoni; Hantragool, Sumalee; Smith, David F; Xu, Yuanfang; Hossain, Monir; Simakajornboon, Narong

2018-04-15

The nature of sleep disorders in children with Ehlers-Danlos syndrome (EDS) is unknown. We aimed to describe the type, the management, and the short-term outcome of sleep disorders in children with EDS referred to sleep clinics. This is a retrospective review of medical records and polysomnography tests of children with EDS younger than 18 years who were referred to the sleep clinic. Demographic information and medical history were collected, and polysomnography tests were reviewed. Questionnaires completed during previous clinic visits, including the Pediatrics Sleep Questionnaire (PSQ), Epworth Sleepiness Scale (ESS), and Pediatric Quality of Life Inventory (PedsQL), were also evaluated. Sixty-five patients with EDS-hypermobility type were included. The mean age was 13.15 ± 3.9 years. There were 68% of patients who were female, and 91% of patients were Caucasian. The mean follow-up period was 1.14 ± 1.55 years. Common sleep diagnoses included insomnia (n = 14, 22%), obstructive sleep apnea (OSA) (n = 17, 26%), periodic limb movement disorder (PLMD) (n = 11, 17%), and hypersomnia (n = 10, 15%). In addition, 65% required pharmacologic treatment and 29% were referred to behavioral sleep medicine. For OSA, two patients required continuous positive airway pressure. A significant improvement was observed in the PSQ, ESS, and PedsQL scores during follow-up visits after treatment (n = 34; P = .0004, 0.03, and 0.01, respectively). There is a high prevalence of sleep disorders, including OSA, insomnia, PLMD, and hypersomnia in children with EDS referred to sleep clinics. Specific management can improve quality of life and questionnaire scores of this patient population. Our study emphasizes the importance of screening for sleep disorders in children with EDS. © 2018 American Academy of Sleep Medicine.

[Reference values of folic acid for the Venezuelan population].

PubMed

García-Casal, María Nieves; Carias, Diamela; Soto de Sanabria, Ingrid; Victoria López, Ana

2013-12-01

The review on folic acid requirements for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). In contrast with the situation in some countries, that required adjustments in fortification policies in order to avoid excessive folic acid consumption, in Venezuela several studies show an elevated prevalence of deficiency. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances for Venezuela are 65-80 microg/day for infants less than 1 year old, 150-300 microg/day for children and 400 microg/day for adolescents and adults, increasing to 600 microg/day during pregnancy and to 500 microg/day during lactation. The estimated average requirement is 120-250 microg/day for children, 330 microg/day for adolescents, 320 microg/day for adults, 520 microg/day for pregnancy and 450 microg/day during lactation. The tolerable upper intake levels for folic acid are 300-600 microg/day for children, 800 microg/day for adolescents and 1000 microg/day for adults. During pregnancy and lactation the UL is 800 microg/day for pregnant and lactating women between 14 and 18 years of age, and 1000 microg/day for older pregnant and lactating women. The continuous evaluation of folic acid status is important to design adequate and efficient policies to control both, the deficiency and the excess of folic acid consumption.

Challenges in infant and young child nutrition in the context of HIV.

PubMed

Sint, Tin Tin; Lovich, Ronnie; Hammond, Wendy; Kim, Maria; Melillo, Sara; Lu, Lydia; Ching, Pamela; Marcy, Jennifer; Rollins, Nigel; Koumans, Emilia H; Heap, Amie N; Brewinski-Isaacs, Margaret

2013-11-01

There is consensus on the benefits for all infants of exclusive breastfeeding for 6 months and introduction of appropriate complementary foods at 6 months, followed by continued breastfeeding. However, guidelines on infant and young child feeding (IYCF) for HIV-positive mothers have changed continually since 2000. This article explores issues and evidence related to IYCF for the prevention and care of paediatric HIV in resource-limited settings in light of new HIV treatment guidelines, implementation challenges and knowledge gaps.In 2010 the impact of antiretroviral drugs (ARVs) on reducing the risk of mother-to-child transmission of HIV moved WHO to urge countries to endorse either avoidance of all breastfeeding or exclusive breastfeeding for the first 6 months while taking ARVs, depending on which strategy could give their infants the greatest chance of HIV-free survival. Implementation of the 2010 recommendations is challenged by lack of healthcare provider training, weak clinic-community linkages to support mother/infant pairs and lack of national monitoring and reporting on infant feeding indicators.More evidence is needed to inform prevention and treatment of malnutrition among HIV-exposed and HIV-infected children. Knowledge gaps include the effects of prolonged ARV exposure, the cause of HIV-associated growth faltering, the effects of early infant testing on continuation of breastfeeding and specific nutrition interventions needed for HIV-infected children.Significant progress has been made toward keeping mothers alive and reducing paediatric HIV infection, but sustained political, financial and scientific commitment are required to ensure meaningful interventions to eliminate postnatal transmission and meet the nutritional needs of HIV-exposed and HIV-infected children.

Melatonin for insomnia in children with autism spectrum disorders.

PubMed

Andersen, Ivy M; Kaczmarska, JoAnna; McGrew, Susan G; Malow, Beth A

2008-05-01

We describe our experience in using melatonin to treat insomnia, a common sleep concern, in children with autism spectrum disorders. One hundred seven children (2-18 years of age) with a confirmed diagnosis of autism spectrum disorders who received melatonin were identified by reviewing the electronic medical records of a single pediatrician. All parents were counseled on sleep hygiene techniques. Clinical response to melatonin, based on parental report, was categorized as (1) sleep no longer a concern, (2) improved sleep but continued parental concerns, (3) sleep continues to be a major concern, and (4) worsened sleep. The melatonin dose varied from 0.75 to 6 mg. After initiation of melatonin, parents of 27 children (25%) no longer reported sleep concerns at follow-up visits. Parents of 64 children (60%) reported improved sleep, although continued to have concerns regarding sleep. Parents of 14 children (13%) continued to report sleep problems as a major concern, with only 1 child having worse sleep after starting melatonin (1%), and 1 child having undetermined response (1%). Only 3 children had mild side-effects after starting melatonin, which included morning sleepiness and increased enuresis. There was no reported increase in seizures after starting melatonin in children with pre-existing epilepsy and no new-onset seizures. The majority of children were taking psychotropic medications. Melatonin appears to be a safe and well-tolerated treatment for insomnia in children with autism spectrum disorders. Controlled trials to determine efficacy appear warranted.

Insulin therapy in children and adolescents with type 1 diabetes.

PubMed

Malik, Faisal S; Taplin, Craig E

2014-04-01

Treatment of type 1 diabetes mellitus (T1DM) requires lifelong administration of exogenous insulin. The primary goal of treatment of T1DM in children and adolescents is to maintain near-normoglycemia through intensive insulin therapy, avoid acute complications, and prevent long-term microvascular and macrovascular complications, while facilitating as close to a normal life as possible. Effective insulin therapy must, therefore, be provided on the basis of the needs, preferences, and resources of the individual and the family for optimal management of T1DM. To achieve target glycemic control, the best therapeutic option for patients with T1DM is basal-bolus therapy either with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Many formulations of insulin are available to help simulate endogenous insulin secretion as closely as possible in an effort to eliminate the symptoms and complications of hyperglycemia, while minimizing the risk of hypoglycemia secondary to therapy. When using MDI, basal insulin requirements are given as an injection of long- or intermediate-acting insulin analogs, while meal-related glucose excursions are controlled with bolus injections of rapid-acting insulin analogs. Alternatively, CSII can be used, which provides a 24-h preselected but adjustable basal rate of rapid-acting insulin, along with patient-activated mealtime bolus doses, eliminating the need for periodic injections. Both MDI treatment and CSII therapy must be supported by comprehensive education that is appropriate for the individual needs of the patient and family before and after initiation. Current therapies still do not match the endogenous insulin profile of pancreatic β-cells, and all still pose risks of suboptimal control, hypoglycemia, and ketosis in children and adolescents. The safety and success of a prescribed insulin regimen is, therefore, dependent on self-monitoring of blood glucose and/or a continuous glucose monitoring system to avoid critical hypoglycemia and glucose variability. Regardless of the mode of insulin therapy, doses should be adapted on the basis of the daily pattern of blood glucose, through regular review and reassessment, and patient factors such as exercise and pubertal status. New therapy options such as sensor-augmented insulin pump therapy, which integrates CSII with a continuous glucose sensor, along with emerging therapies such as the artificial pancreas, will likely continue to improve safe insulin therapy in the near future.

Expanding the recommendations for annual influenza vaccination to school-age children in the United States.

PubMed

Fiore, Anthony E; Epperson, Scott; Perrotta, Dennis; Bernstein, Henry; Neuzil, Kathleen

2012-03-01

Despite long-standing recommendations to vaccinate children who have underlying chronic medical conditions or who are contacts of high-risk persons, vaccination coverage among school-age children remains low. Community studies have indicated that school-age children have the highest incidence of influenza and are an important source of amplifying and sustaining community transmission that affects all age groups. A consultation to discuss the advantages and disadvantages of a universal recommendation for annual influenza vaccination of all children age ≥6 months was held in Atlanta, Georgia, in September 2007. Consultants provided summaries of current data on vaccine effectiveness, safety, supply, successful program implementation, and economics studies and discussed challenges associated with continuing a risk- and contact-based vaccination strategy compared with a universal vaccination recommendation. Consultants noted that school-age children had a substantial illness burden caused by influenza, that vaccine was safe and effective for children aged 6 months through 18 years, and that evidence suggested that vaccinating school-age children would provide benefits to both the vaccinated children and their unvaccinated household and community contacts. However, implementation of an annual recommendation for all school-age children would pose major challenges to parents, medical providers and health care systems. Alternative vaccination venues were needed, and of these school-located vaccination programs might offer the most promise as an alternative vaccination site for school-age children. Expansion of recommendations to include all school-age children will require additional development of an infrastructure to support implementation and methods to adequately evaluate impact.

Cerebral Perfusion Changes in Post-Concussion Syndrome: A Prospective Controlled Cohort Study

PubMed Central

Marcil, Lorenzo D.; Dewey, Deborah; Carlson, Helen L.; MacMaster, Frank P.; Brooks, Brian L.; Lebel, R. Marc

2017-01-01

Abstract The biology of post-concussive symptoms is unclear. Symptoms are often increased during activities, and have been linked to decreased cerebrovascular reactivity and perfusion. The aim of this study was to examine cerebral blood flow (CBF) in children with different clinical recovery patterns following mild traumatic brain injury (mTBI). This was a prospective controlled cohort study of children with mTBI (ages 8 to 18 years) who were symptomatic with post-concussive symptoms at one month post-injury (symptomatic, n = 27) and children who had recovered quickly (asymptomatic, n = 24). Pseudo continuous arterial spin labeling magnetic resonance imaging (MRI) was used to quantify CBF. The mTBI groups were imaged at 40 days post-injury. Global and regional CBF were compared with healthy controls of similar age and sex but without a history of mTBI (n = 21). Seventy-two participants (mean age: 14.1 years) underwent neuroimaging. Significant differences in CBF were found: global CBF was higher in the symptomatic group and lower in the asymptomatic group compared with controls, (F(2,69) 9.734; p < 0.001). Post-injury symptom score could be predicted by pre-injury symptoms and CBF in presence of mTBI (adjusted R2 = 0.424; p < 0.001). Altered patterns of cerebral perfusion are seen following mTBI and are associated with the recovery trajectory. Symptomatic children have higher CBF. Children who “recovered” quickly, have decreased CBF suggesting that clinical recovery precedes the cerebral recovery. Further longitudinal studies are required to determine if these perfusion patterns continue to change over time. PMID:27554429

Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique.

PubMed

Madrid, Lola; Sitoe, Antonio; Varo, Rosauro; Nhampossa, Tacilta; Lanaspa, Miguel; Nhama, Abel; Acácio, Sozinho; Riaño, Isolina; Casellas, Aina; Bassat, Quique

2017-05-02

Hypoglycaemia is a frequent complication among admitted children, particularly in malaria-endemic areas. This study aimed to estimate the occurrence of hypoglycaemia not only upon admission but throughout the first 72 h of hospitalization in children admitted with malaria. A simple pilot study to continuously monitor glycaemia in children aged 0-10 years, admitted with malaria in a rural hospital was conducted in Southern Mozambique by inserting continuous glucose monitors (CGMs) in subcutaneous tissue of the abdominal area, producing glycaemia readings every 5 min. Glucose was continuously monitored during a mean of 48 h, in 74 children. Continuous measurements of blood glucose were available for 72/74 children (97.3%). Sixty-five of them were admitted with density-specific malaria diagnosis criteria (17 severe, 48 uncomplicated). Five children (7.7%) had hypoglycaemia (<54 mg/dL) on admission as detected by routine capillary determination. Analysing the data collected by the CGMs, hypoglycaemia episodes (<54 mg/dL) were detected in 10/65 (15.4%) of the children, of which 7 (10.8%) could be classified as severe (≤45 mg/dL). No risk factors were independently associated with the presence of at least one episode of hypoglycaemia (<54 mg/dL) during hospitalization. Only one death occurred among a normoglycaemic child. All episodes of hypoglycaemia detected by CGMs were subclinical episodes or not perceived by caregivers or clinical staff. Hypoglycaemia beyond admission in children with malaria appears to be much more frequent than what had been previously described. The clinical relevance of these episodes of hypoglycaemia in the medium or long term remains to be determined.

An exploration of factors that influence the regular consumption of water by Irish primary school children.

PubMed

Molloy, C Johnston; Gandy, J; Cunningham, C; Slattery, Glennon

2008-10-01

Inadequate hydration has been linked to many factors that may impact on children's education and health. Teachers play an important role in the education and behaviour of children. Previous research has demonstrated low water intake amongst children and negative teachers' attitudes to water in the classroom. The present study aimed to explore teachers' knowledge about water and the perceived barriers to allowing children access to water during lesson time. In-depth interviews were conducted with 12 teachers from primary schools in the Midlands of Ireland. Interviews were continued until there was saturation of the data. Thematic analysis of the data was conducted. Participants had a poor knowledge of hydration requirements and the associated health benefits and effect on concentration. Low water intake amongst teachers and pupils, and barriers such as disruption to class and increased need to urinate, were reported. Teachers identified the hydration effect on learning as the education message most likely to influence the decision to allow water in the classroom. The issues, opinions and perceived barriers raised by teachers as part of this qualitative research provide a basis for future health promotion around water.

Transient central diabetes insipidus induced by ketamine infusion.

PubMed

Hatab, Sarah Z; Singh, Arun; Felner, Eric I; Kamat, Pradip

2014-12-01

Report a case of central diabetes insipidus (DI) associated with ketamine infusion. A 2-year-old girl with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency and stable hypertrophic cardiomyopathy was admitted to the pediatric intensive care with pneumonia. She subsequently developed respiratory failure and required intubation. Continuous ketamine infusion was used for the sedation and facilitation of mechanical ventilation. Shortly after infusion of ketamine, the patient developed DI and responded appropriately to vasopressin. The Naranjo adverse drug reaction probability scale indicated a probable relationship between the development of central DI and ketamine. The most likely mechanism involves ketamine's antagonist action on N-methyl-d-aspartate receptors, resulting in inhibition of glutamate-stimulated arginine vasopressin release from the neurohypophysis. This is the second case report of ketamine-induced central DI and the only report in children. Clinicians who sedate children with continuous ketamine infusions should monitor patients for developing signs and symptoms of DI by measuring serum sodium and urine output prior to, during, and after ketamine infusion in order to make a timely diagnosis of this potentially serious complication. © The Author(s) 2014.

Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? A retrospective case-control study.

PubMed

Brorsson, Anna Lena; Viklund, Gunnel; Örtqvist, Eva; Lindholm Olinder, Anna

2015-11-01

To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI). This retrospective case-control study compares 216 patients starting CSII with a control group on MDI (n = 215), matched for glycated hemoglobin (HbA1c), sex, and age during a 2-yr period. Variables collected were gender, age, HbA1c, insulin requirement, BMI, BMI-SDS, ketoacidosis, and serious hypoglycaemic events. In the CSII group there was an improvement in HbA1c after 6 and 12 months compared with the MDI group. For boys and girls separately the same effect was detected after 6 months, but only for boys after 12 months. The incidence of ketoacidosis was higher in the CSII group compared with the MDI group (2.8 vs. 0.5/100 person-yr). The incidences of severe hypoglycaemic episodes per 100 person-yr were three in the CSII group and six in the MDI group (p < 0.05). After 6, 12, and 24 months, the insulin requirement was higher in the MDI group. This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pediatric scalds: do cooking-related burns have a higher injury burden?

PubMed

Bachier, Marielena; Hammond, Sarah E; Williams, Regan; Jancelewicz, Timothy; Feliz, Alexander

2015-11-01

Pediatric scald burns result in frequent emergency room visits and hospitalizations. We investigated whether cooking-related burns produce greater morbidity requiring more extensive care than noncooking burns. We performed a 6-y review at our free-standing children's hospital. Children aged <18 y admitted for accidental scald burns were included. Demographics, injury pattern, treatment, and outcome (contractures and/or limited mobility and nonhealing and/or infected wounds) data were analyzed comparing cooking versus noncooking burns. The Mann-Whitney U test, a chi-square test, and the negative binomial were used to compare continuous, categorical, and count data between groups. Bivariate analysis was performed to identify risk factors among patients with adverse outcomes. We identified 308 patients; 262 (85%) cooking and 46 (15%) noncooking burns. Most patients were African-American males, with public insurance, and a median age of 2 y. Cooking burns preferentially occurred over the head, neck, and upper body; noncooking burns were distributed over the lower body (P < 0.02). Median total body surface area was equal for both groups (P > 0.11). In subgroup analysis, semisolid and grease burns resulted in increased rates of wound contractures and/or limited mobility when compared with noncooking burns (P = 0.05 and P = 0.008, respectively). Patients with complications were more likely to have third degree burns and required more consults, longer hospitalization, and more surgical debridements and clinic visits. Most accidental scald burns occurred in young children during food preparation. Greater long-term morbidity was found in patients with semisolid and grease burns. This subset of children has a higher injury burden and requires extensive care in the acute and long-term setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Prader-Willi syndrome: clinical picture, psychosocial support and current management.

PubMed

Wigren, M; Hansen, S

2003-11-01

Prader-Willi syndrome (PWS) is a rare, genetically based disorder that occurs in about 1 of 15 000 live-born children. To raise a child with PWS is challenging for parents and requires support from multiprofessional habilitation services. This paper maps the need for psychosocial support and current management of children and adolescents with PWS. Parents to 58 children with PWS (aged 5-18 years) completed questionnaires covering clinical, diagnostic and psychosocial issues. The children received their diagnosis at a mean age of 2.5 year. Growth hormone treatment was given to 72%. Sixty-three per cent of the sample was not overweight. Neuropsychiatric symptoms were common from early age and some were related to obesity. Most parents wanted information as to availability of external resources and future child needs. Few parents needed family-directed support. The overall impression is that the eating disorder is managed relatively well. Even so PWS symptoms typically exacerbate over time and consequently parents need continuous support throughout childhood and adolescence. Greater attention should be paid to idiosyncrasies in cognitive functioning and to clinical markers of neuropsychiatric problems.

Varieties of quantity estimation in children.

PubMed

Sella, Francesco; Berteletti, Ilaria; Lucangeli, Daniela; Zorzi, Marco

2015-06-01

In the number-to-position task, with increasing age and numerical expertise, children's pattern of estimates shifts from a biased (nonlinear) to a formal (linear) mapping. This widely replicated finding concerns symbolic numbers, whereas less is known about other types of quantity estimation. In Experiment 1, Preschool, Grade 1, and Grade 3 children were asked to map continuous quantities, discrete nonsymbolic quantities (numerosities), and symbolic (Arabic) numbers onto a visual line. Numerical quantity was matched for the symbolic and discrete nonsymbolic conditions, whereas cumulative surface area was matched for the continuous and discrete quantity conditions. Crucially, in the discrete condition children's estimation could rely either on the cumulative area or numerosity. All children showed a linear mapping for continuous quantities, whereas a developmental shift from a logarithmic to a linear mapping was observed for both nonsymbolic and symbolic numerical quantities. Analyses on individual estimates suggested the presence of two distinct strategies in estimating discrete nonsymbolic quantities: one based on numerosity and the other based on spatial extent. In Experiment 2, a non-spatial continuous quantity (shades of gray) and new discrete nonsymbolic conditions were added to the set used in Experiment 1. Results confirmed the linear patterns for the continuous tasks, as well as the presence of a subset of children relying on numerosity for the discrete nonsymbolic numerosity conditions despite the availability of continuous visual cues. Overall, our findings demonstrate that estimation of numerical and non-numerical quantities is based on different processing strategies and follow different developmental trajectories. (c) 2015 APA, all rights reserved).

Children with Word Finding Difficulties: Continuities and Profiles of Abilities

ERIC Educational Resources Information Center

Messer, David; Dockrell, Julie E.

2013-01-01

Word finding difficulties (WFDs) occur in more than a quarter of children who are receiving speech and language therapy. This study provides the first investigation of the continuity in WFDs and investigates whether WFDs are associated with phonological or semantically related abilities. Thirty-eight children with WFDs were seen at age 7;0 and at…

Continuity in Literacy Achievements from Kindergarten to First Grade: A Longitudinal Study of Arabic-Speaking Children

ERIC Educational Resources Information Center

Hassunah Arafat, Safieh; Korat, Ofra; Aram, Dorit; Saiegh-Haddad, Elinor

2017-01-01

The study addressed the question of continuity in literacy achievements from kindergarten to first grade among Arabic-speaking children in Israel. We examined (1) how age and family socio-economic status (SES) predict children's literacy skills in kindergarten and (2) how age, SES, and early literacy skills in kindergarten predict literacy…

Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences.

PubMed

Hammer, Carol Scheffner; Morgan, Paul; Farkas, George; Hillemeier, Marianne; Bitetti, Dana; Maczuga, Steve

2017-03-01

This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months. We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old. The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness. Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

[Active search for leprosy and other skin diseases in school children from Agua de Dios, Colombia].

PubMed

Rodríguez, Gerzaín; González, Rosalba; Gonzalez, Deysy; Granados, Carolina; Pinto, Rafael; Herrera, Hilda; Gutiérrez, Luisa F; Hernández, Elkin; López, Fernando; Gómez, Yenny

2007-01-01

Actively searching for leprosy, other skin diseases and BCG vaccination scars amongst school children from Agua de Dios, the municipality having the highest prevalence of leprosy in Colombia. A clinical examination of the children was carried out by nurses, interns, general practitioners and experts on leprosy. Skin smear tests and skin biopsies were performed when the clinical findings suggested leprosy. Anti-phenolic glycolipid antibodies in blood were determined in special cases. 86 % of the 2 844 school children were examined; 833 had skin diseases and 16 % of these required evaluation by specialists. Four new cases of paucibacillary leprosy, two indeterminate and two primary polyneuritic cases were found. Pediculosis capitis, pityriasis alba, tinea versicolor, hypopigmented nevus, insect bites and miliaria were frequently detected. BCG vaccination scars were absent in 387 children; following several logistical problems, they were vaccinated. Four children had signs of childhood abuse. An 11-year-old girl presented hypopigmented mycosis fungoides. All diseases and conditions found were treated. The community received information regarding the results, emphasising the importance of an early diagnosis of leprosy. The incidence of leprosy found (16/10,000) was 123 times higher than the rest of the country's incidence. It is advisable to continue clinical examinations in Agua de Dios and research into risk factors for acquiring leprosy.

Understanding linear measurement: A comparison of filipino and new zealand children

NASA Astrophysics Data System (ADS)

Irwin, Kathryn C.; Ell, Fiona R.; Vistro-Yu, Catherine P.

2004-06-01

An understanding of linear measurement depends on principles that include standard unit size, iteration of units, numbering of a unit at its end, and partial units for measuring continuous length. Children may learn these principles at school, for example through experience with informal measurement, or they may learn them through use of measurement in society. This study compared the application of these principles by children aged 8 and 9 from the Philippines and New Zealand. These countries were selected because they have quite different curricula, societal influences and economies. Ninety-one children were interviewed individually on a common set of unusual tasks that were designed to tap underlying principles. Results showed many similarities and some differences between countries. Most tasks requiring visualisation and informal units were done more accurately by New Zealand children. Some tasks involving the use of a conventional ruler were done more accurately by Filipino children. These differences appear to be related to differences in curricula and possibly to differences in societal use of measurement. We suggest that these results, like those of other writers cited, demonstrate the need for extensive work on the underlying concepts in measurement through work on informal measurement and a careful transition between informal and formal measurement.

The relation between categorical perception of speech stimuli and reading skills in children

NASA Astrophysics Data System (ADS)

Breier, Joshua; Fletcher, Jack; Klaas, Patricia; Gray, Lincoln

2005-09-01

Children ages 7 to 14 years listened to seven tokens, /ga/ to /ka/ synthesized in equal steps from 0 to 60 ms along the voice onset time (VOT) continuum, played in continuous rhythm. All possible changes (21) between the seven tokens were presented seven times at random intervals, maintaining the rhythm. Children were asked to press a button as soon as they detected a change. Maps of the seven tokens, constructed from multidimensional scaling of reaction times, indicated two salient dimensions: one phonological and the other acoustic/phonetic. Better reading, spelling, and phonological processing skills were associated with greater relative weighting of the phonological as compared to the acoustic dimension, suggesting that children with reading difficulty and associated deficits may underweight the phonological and/or overweight the acoustic information in speech signals. This task required no training and only momentary memory of the tokens. That an analysis of a simple task coincides with more complex reading tests suggests a low-level deficit (or shift in listening strategy). Compared to control children, children with reading disabilities may pay more attention to subtle details in these signals and less attention to the global pattern or attribute. [Supported by NIH Grant 1 RO1 HD35938 to JIB.

Pediatric sports injuries: an age comparison of children versus adolescents.

PubMed

Stracciolini, Andrea; Casciano, Rebecca; Levey Friedman, Hilary; Meehan, William P; Micheli, Lyle J

2013-08-01

Significant knowledge deficits exist regarding sports injuries in the young child. Children continue to engage in physically demanding, organized sports to a greater extent despite the lack of physical readiness, predisposing themselves to injury. To evaluate sports injuries sustained in very young children (5-12 years) versus their older counterparts (13-17 years) with regard to the type and location of injuries, severity, and diagnosis. Cross-sectional study; Level of evidence, 3. A retrospective chart review was performed on a 5% random probability sample (final N = 2133) of 5- to 17-year-old patients treated for sports injuries in the Division of Sports Medicine at a large, academic pediatric medical center between 2000 and 2009. Using descriptive statistics, correlates of injuries by age group, injury type, and body area are shown. Five- to 12-year-old patients differed in key ways from older patients. Children in this category sustained injuries that were more often traumatic in nature and more commonly of the upper extremity. Older patients (13-17 years) were more likely to be treated for injuries to the chest, hip/pelvis, and spine. A greater proportion of the older children were treated for overuse injuries, as compared with their younger counterparts (54.4% vs. 49.2%, respectively), and a much larger proportion of these injuries were classified as soft tissue injuries as opposed to bony injuries (37.9% vs. 26.1%, respectively). Injury diagnosis differed between the 2 age groups. The 13- to 17-year age group sustained more anterior cruciate ligament injuries, meniscal tears, and spondylolysis, while younger children were diagnosed with fractures, including physeal fractures, apophysitis, and osteochondritis dissecans. The 5- to 12-year-old patients treated for spine injuries were disproportionately female (75.8%); most of these injuries were overuse (78.8%) and bony (60.6%); over one third of the youngest children were diagnosed with spondylolysis. Surgery was required in 40% of the injuries in the full sample. Sports injuries to children differ by age in injury diagnosis, type, and body area. Older children sustain a greater proportion of overuse injuries classified as soft tissue in nature. Children of all ages are sustaining significant sports injuries that require surgical intervention.

[Health-related requirements for the print design of illustrated texts in publications intended for children].

PubMed

Teksheva, L M

2001-01-01

The fact that there are essential differences in the volumes of texts for continuous reading in the belles-lettres and those for episodic reading (encyclopaedias, comic books, etc.) and marked differences in the area of the type pages intended for illustrations made it necessary to substantiate differential requirements for these groups of publications. Hygienic requirements were corrected by using the data obtained from 150 experiments covering 36 secondary-form pupils. Based on the well-known data on temporary visual fatigue thresholds (TVFT) and on the experimental findings, the authors defined the ratio of higher TVFT to the actual time of reading the texts of different volumes. A complex of print design indices to be hygienically regulated varies with the multiplicity that is in fact a safety factor.

Palliative care in children with spinal muscular atrophy type I: What do they need?

PubMed

García-Salido, Alberto; de Paso-Mora, María García; Monleón-Luque, Manuel; Martino-Alba, Ricardo

2015-04-01

Our aim was to describe the clinical evolution and needs of children with spinal muscular atrophy type I treated in a domiciliary palliative care program. We undertook a retrospective chart review of nine consecutive patients. Descriptions of the clinical and demographic profile of children with spinal muscular atrophy (SMA) type I were referred to a pediatric palliative care team (PPCT). Six males and three females were admitted to the PPCT, all before six months of age, except for one afflicted with SMA type I with respiratory distress. The median time of attention was 57 days (range 1-150). The domiciliary attention mainly consisted of respiratory care. The patient with SMA type I with respiratory distress required domiciliary mechanical ventilation by tracheotomy. In all cases, a nasogastric tube (NT) was indicated. As end-of-life care, eight required morphine to manage the dyspnea, four received it only by enteral (oral or NT) administration, and four received it first by enteral administration with continuous subcutaneous infusion (CSI) later. Three of the four patients with CSI also received benzodiazepines. While they were attended by the PPCT, none required hospital admission. All the patients died at home except for the one attended to for just one day. Domiciliary care for these patients is possible. The respiratory morbidity and its management are the main issues. Application of an NT is useful to maintain nutritional balance. Morphine administration is necessary to manage the dyspnea. Palliative sedation is not always necessary.

Reception thresholds for sentences in quiet, continuous noise, and interrupted noise in school-age children.

PubMed

Stuart, Andrew

2008-02-01

Sentence recognition in noise was employed to investigate the development of temporal resolution in school-age children. Eighty children aged 6 to 15 years and 16 young adults participated. Reception thresholds for sentences (RTSs) were determined in quiet and in backgrounds of competing continuous and interrupted noise. In the noise conditions, RTSs were determined with a fixed noise level. RTSs were higher in quiet for six- to seven-year-old children (p = .006). Performance was better in the interrupted noise evidenced by lower RTS signal-to-noise ratios (S/Ns) relative to continuous noise (p < .0001). An effect of age was found in noise (p < .0001) where RTS S/Ns decreased with increasing age. Specifically, children under 14 years performed worse than adults. "Release from masking" was computed by subtracting RTS S/Ns in interrupted noise from continuous noise for each participant. There was no significant difference in RTS S/N difference scores as a function of age (p = .057). Children were more adversely affected by noise and needed greater S/Ns in order to perform as well as adults. Since there was no effect of age on the amount of release from masking, one can suggest that school-age children have inherently poorer processing efficiency rather than temporal resolution.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

PubMed

John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

2014-04-01

Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

Progress toward poliomyelitis eradication - Afghanistan and Pakistan, 2009.

PubMed

2010-03-12

Afghanistan, Pakistan, India, and Nigeria are the four remaining countries where indigenous wild poliovirus (WPV) transmission has never been interrupted. This report updates previous reports and describes polio eradication activities in Afghanistan and Pakistan during January-December 2009 and proposed activities in 2010 to address challenges. During 2009, both countries continued to conduct coordinated supplemental immunization activities (SIAs) and used multiple strategies to reach previously unreached children. These strategies included 1) use of short interval additional dose (SIAD) SIAs to administer a dose of oral poliovirus vaccine (OPV) within 1-2 weeks after a prior dose during negotiated periods of security; 2) systematic engagement of local leaders; 3) negotiations with conflict parties; and 4) increased engagement of nongovernmental organizations delivering basic health services. However, security problems continued to limit access by vaccination teams to large numbers of children. In Afghanistan, poliovirus transmission during 2009 predominantly occurred in 12 high-risk districts in the conflict-affected South Region; 38 WPV cases were confirmed in 2009, compared with 31 in 2008. In Pakistan, 89 WPV cases were confirmed in 2009, compared with 118 in 2008, but transmission persisted both in security-compromised areas and in accessible areas, where managerial and operational problems continued to affect immunization coverage. Continued efforts to enhance safe access of vaccination teams in insecure areas will be required for further progress toward interruption of WPV transmission in Afghanistan and Pakistan. In addition, substantial improvements in subnational accountability and oversight are needed to improve immunization activities in Pakistan.

Magnetic resonance imaging findings in pediatric bilateral vocal fold dysfunction.

PubMed

Steiner, Joel I; Fink, A Michelle; Berkowitz, Robert G

2013-07-01

We studied the findings of brain magnetic resonance imaging (MRI) in infants with idiopathic congenital bilateral vocal fold dysfunction (CBVFD). We performed a retrospective investigation of a case series. We identified 26 children (14 male, 12 female) over 11 years. Three children were excluded. Thirteen patients required airway interventions, including continuous positive airway pressure (4 patients), endotracheal intubation (1), and tracheostomy (8). The findings on brain MRI were abnormal in 8 patients (35%). Tracheostomy was required in 3 patients (38%) with abnormal MRI findings, as compared with 5 of 15 patients (33%) with normal MRI findings. The MRI abnormalities involved evidence of white matter injury (2), abnormal white matter signal (1), subdural blood (3), cerebral swelling (1), and perisylvian polymicrogyria (1). The cranial ultrasound findings were abnormal in 4 of 11 patients. The MRI findings were abnormal in 2 of 7 children in whom the cranial ultrasound findings were normal, and in 2 of the 4 patients in whom the cranial ultrasound findings were abnormal. The MRI abnormalities were nonspecific; however, they may indicate unrecognized perinatal intracranial injury as being related to CBVFD. In addition, MRI may reveal an underlying structural brain anomaly. Cranial ultrasound has poor sensitivity and specificity. Hence, MRI should be considered as part of the routine assessment of neonates with CBVFD.

A preliminary examination of child well-being of physically abused and neglected children compared to a normative pediatric population.

PubMed

Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy

2015-02-01

Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment. © The Author(s) 2014.

Annotation: Development of facial expression recognition from childhood to adolescence: behavioural and neurological perspectives.

PubMed

Herba, Catherine; Phillips, Mary

2004-10-01

Intact emotion processing is critical for normal emotional development. Recent advances in neuroimaging have facilitated the examination of brain development, and have allowed for the exploration of the relationships between the development of emotion processing abilities, and that of associated neural systems. A literature review was performed of published studies examining the development of emotion expression recognition in normal children and psychiatric populations, and of the development of neural systems important for emotion processing. Few studies have explored the development of emotion expression recognition throughout childhood and adolescence. Behavioural studies suggest continued development throughout childhood and adolescence (reflected by accuracy scores and speed of processing), which varies according to the category of emotion displayed. Factors such as sex, socio-economic status, and verbal ability may also affect this development. Functional neuroimaging studies in adults highlight the role of the amygdala in emotion processing. Results of the few neuroimaging studies in children have focused on the role of the amygdala in the recognition of fearful expressions. Although results are inconsistent, they provide evidence throughout childhood and adolescence for the continued development of and sex differences in amygdalar function in response to fearful expressions. Studies exploring emotion expression recognition in psychiatric populations of children and adolescents suggest deficits that are specific to the type of disorder and to the emotion displayed. Results from behavioural and neuroimaging studies indicate continued development of emotion expression recognition and neural regions important for this process throughout childhood and adolescence. Methodological inconsistencies and disparate findings make any conclusion difficult, however. Further studies are required examining the relationship between the development of emotion expression recognition and that of underlying neural systems, in particular subcortical and prefrontal cortical structures. These will inform understanding of the neural bases of normal and abnormal emotional development, and aid the development of earlier interventions for children and adolescents with psychiatric disorders.

Spatial Frequency Discrimination: Effects of Age, Reward, and Practice

PubMed Central

Peters, Judith Carolien

2017-01-01

Social interaction starts with perception of the world around you. This study investigated two fundamental issues regarding the development of discrimination of higher spatial frequencies, which are important building blocks of perception. Firstly, it mapped the typical developmental trajectory of higher spatial frequency discrimination. Secondly, it developed and validated a novel design that could be applied to improve atypically developed vision. Specifically, this study examined the effect of age and reward on task performance, practice effects, and motivation (i.e., number of trials completed) in a higher spatial frequency (reference frequency: 6 cycles per degree) discrimination task. We measured discrimination thresholds in children aged between 7 to 12 years and adults (N = 135). Reward was manipulated by presenting either positive reinforcement or punishment. Results showed a decrease in discrimination thresholds with age, thus revealing that higher spatial frequency discrimination continues to develop after 12 years of age. This development continues longer than previously shown for discrimination of lower spatial frequencies. Moreover, thresholds decreased during the run, indicating that discrimination abilities improved. Reward did not affect performance or improvement. However, in an additional group of 5–6 year-olds (N = 28) punishments resulted in the completion of fewer trials compared to reinforcements. In both reward conditions children aged 5–6 years completed only a fourth or half of the run (64 to 128 out of 254 trials) and were not motivated to continue. The design thus needs further adaptation before it can be applied to this age group. Children aged 7–12 years and adults completed the run, suggesting that the design is successful and motivating for children aged 7–12 years. This study thus presents developmental differences in higher spatial frequency discrimination thresholds. Furthermore, it presents a design that can be used in future developmental studies that require multiple stimulus presentations such as visual perceptual learning. PMID:28135272

Spatial Frequency Discrimination: Effects of Age, Reward, and Practice.

PubMed

van den Boomen, Carlijn; Peters, Judith Carolien

2017-01-01

Social interaction starts with perception of the world around you. This study investigated two fundamental issues regarding the development of discrimination of higher spatial frequencies, which are important building blocks of perception. Firstly, it mapped the typical developmental trajectory of higher spatial frequency discrimination. Secondly, it developed and validated a novel design that could be applied to improve atypically developed vision. Specifically, this study examined the effect of age and reward on task performance, practice effects, and motivation (i.e., number of trials completed) in a higher spatial frequency (reference frequency: 6 cycles per degree) discrimination task. We measured discrimination thresholds in children aged between 7 to 12 years and adults (N = 135). Reward was manipulated by presenting either positive reinforcement or punishment. Results showed a decrease in discrimination thresholds with age, thus revealing that higher spatial frequency discrimination continues to develop after 12 years of age. This development continues longer than previously shown for discrimination of lower spatial frequencies. Moreover, thresholds decreased during the run, indicating that discrimination abilities improved. Reward did not affect performance or improvement. However, in an additional group of 5-6 year-olds (N = 28) punishments resulted in the completion of fewer trials compared to reinforcements. In both reward conditions children aged 5-6 years completed only a fourth or half of the run (64 to 128 out of 254 trials) and were not motivated to continue. The design thus needs further adaptation before it can be applied to this age group. Children aged 7-12 years and adults completed the run, suggesting that the design is successful and motivating for children aged 7-12 years. This study thus presents developmental differences in higher spatial frequency discrimination thresholds. Furthermore, it presents a design that can be used in future developmental studies that require multiple stimulus presentations such as visual perceptual learning.

Nutritional Content of Food and Beverage Products in Television Advertisements Seen on Children's Programming

PubMed Central

Schermbeck, Rebecca M.; Chaloupka, Frank J.

2013-01-01

Abstract Background: Given the high rates of childhood obesity, assessing the nutritional content of food and beverage products in television (TV) advertisements to which children are exposed is important. Methods: TV ratings data for children 2–5 and 6–11 years of age were used to examine the nutritional content of food and beverage products in advertisements seen by children on all programming and children's programming (≥35% child-audience share). Nutritional content was assessed based on the federal Interagency Working Group (IWG) recommended nutrients to limit (NTL), including saturated fat, trans fat, sugar, and sodium. Results: A total of 46.2% of 2- to 5-year-olds' and 43.5% of 6- to 11-year-olds' total exposure to food and beverage TV advertising was for ads seen on children's programming. Among children 2–5 and 6–11 years, respectively, 84.1 and 84.4% of ads seen on all programming and 95.8 and 97.3% seen on children's programming were for products high in NTL, and 97.8 and 98.1% of Children's Food and Beverage Advertising Initiative (CFBAI) company-member ads seen on children's programming were for products high in NTL, compared to 80.5 and 89.9% of non-CFBAI product ads. Conclusions: Most food and beverage products in TV ads seen by children do not meet the IWG nutrition recommendations and less than one half of such ads are covered by self-regulation. Products advertised on children's versus general-audience programming and by CFBAI- versus non-CFBAI-member companies are particularly of low nutritional quality, suggesting that self-regulation has not successfully protected children from exposure to advertising for unhealthy foods and that continued monitoring is required. PMID:24206260

Feeding problems reported by parents of young children with type 1 diabetes on insulin pump therapy and their associations with children's glycemic control.

PubMed

Patton, Susana R; Williams, Laura B; Dolan, Lawrence M; Chen, Ming; Powers, Scott W

2009-11-01

Previous research demonstrated high rates of perceived mealtime behavior problems in families of young children with type 1 diabetes who were managed with conventional therapy. Because of new insulin regimens that offer greater flexibility, reexamination of mealtime behaviors is required. We assessed parent-reported mealtime behaviors in a sample of young children using an insulin pump. An additional aim was to evaluate the associations of two measures of parental feeding behavior with children's glycemic control. Primary caregivers of 31 young children (mean age = 5.0 +/- 1.3 yr) completed the Child Feeding Questionnaire (CFQ) and the Behavioral Pediatric Feeding Assessment Scale (BPFAS). Hemoglobin A1c (HbA1c) was used as a surrogate marker for children's glycemic control. Children had a mean HbA1c of 7.8 +/- 0.64%. Mean CFQ - Restriction and Pressure to Eat scores were 3.1 +/- 0.94 and 2.0 +/- 0.88, respectively (range = 1-5). Mean BPFAS - Parent and Child scores were 16.0 +/- 4.3 (range = 10-50) and 44.9 +/- 9.3 (range = 25-125), respectively. Positive correlations were found between children's HbA1c levels and caregivers' reporting of frequency of child mealtime behavior problems. Caregivers of young children on pump therapy report relatively low rates of mealtime behavior problems. However, correlations with children's HbA1c suggest that parent-child mealtime behaviors continue to relate to children's health outcomes. Research is needed to determine if changing mealtime interactions can improve children's glycemic control; items from the BPFAS and CFQ can offer targets to guide interventions.

Nutritional content of food and beverage products in television advertisements seen on children's programming.

PubMed

Powell, Lisa M; Schermbeck, Rebecca M; Chaloupka, Frank J

2013-12-01

Given the high rates of childhood obesity, assessing the nutritional content of food and beverage products in television (TV) advertisements to which children are exposed is important. TV ratings data for children 2-5 and 6-11 years of age were used to examine the nutritional content of food and beverage products in advertisements seen by children on all programming and children's programming (≥35% child-audience share). Nutritional content was assessed based on the federal Interagency Working Group (IWG) recommended nutrients to limit (NTL), including saturated fat, trans fat, sugar, and sodium. A total of 46.2% of 2- to 5-year-olds' and 43.5% of 6- to 11-year-olds' total exposure to food and beverage TV advertising was for ads seen on children's programming. Among children 2-5 and 6-11 years, respectively, 84.1 and 84.4% of ads seen on all programming and 95.8 and 97.3% seen on children's programming were for products high in NTL, and 97.8 and 98.1% of Children's Food and Beverage Advertising Initiative (CFBAI) company-member ads seen on children's programming were for products high in NTL, compared to 80.5 and 89.9% of non-CFBAI product ads. Most food and beverage products in TV ads seen by children do not meet the IWG nutrition recommendations and less than one half of such ads are covered by self-regulation. Products advertised on children's versus general-audience programming and by CFBAI- versus non-CFBAI-member companies are particularly of low nutritional quality, suggesting that self-regulation has not successfully protected children from exposure to advertising for unhealthy foods and that continued monitoring is required.

Needs of Internally Displaced Women and Children in Baghdad, Karbala, and Kirkuk, Iraq

PubMed Central

Lafta, Riyadh; Aflouk, Nesreen A; Dhiaa, Saba; Lyles, Emily; Burnham, Gilbert

2016-01-01

Background: The continuing conflict in Iraq has now created an estimated four million internally displaced persons (IDPs). The bulk of recently displaced persons are in Central Iraq, often in insecure and difficult situations. Objective: To determine the health status and health needs of women and children, age 15 and under, among a sample of this IDP population in Kirkuk, Baghdad, and Karbala governorates. Methods: Data were collected from the senior female in 1216 families which contained 3665 children living in 45 makeshift settlements. Findings: The majority of IDPs were living in tents or religious centers. Repeated displacements were common. Kidnappings were reported by 5.2% of families, and 7.9% of families reported a death of a family member during or after displacement. Intentional violence accounted for 72.3% of deaths. Only a third of children in school at the time of displacement continued in school. On average, households had received assistance on 3.2 occasions since displacement, food being the most common form. Access to health services was difficult. Some form of transport was often required. Few women knew where to secure antenatal services and many did not know where childhood immunization services were available. During or after displacement 307 women had delivered or were currently pregnant. Complications of pregnancies were common, with a quarter reporting anemia, and 22.1% experiencing hemorrhage. Both communicable and non-communicable diseases (NCDs) were common in the women and children in the survey. Scabies, diarrhea and lice were common among children. Among women, hypertension accounted for 36.6% of NCDs and type 2 diabetes for 15.9%. Domestic violence directed against women was reported in 17.4% of families and against children in 26.6% Interpretation: Women and children in IDP settlements of Central Iraq experience many vulnerabilities involving their health, education and their environment, in addition to living in physical danger. While some external assistance was received, much more is needed to meet the needs of a displaced population which is unlikely to return home soon. PMID:28966867

Controlled Study of the Effects of Continuous Intrathecal Baclofen Infusion in Non-Ambulant Children with Cerebral Palsy

ERIC Educational Resources Information Center

Morton, Richard E.; Gray, Natalie; Vloeberghs, Michael

2011-01-01

Aim: To measure changes in children with severe spastic cerebral palsy (CP) after continuous intrathecal baclofen (ITB) infusion over 18 months and to compare the results with those of a comparison group awaiting treatment. Method: Thirty-eight children with severe spastic CP considered suitable for ITB were assessed when first seen, just before…

CONGENITAL HYPOGLYCEMIA DISORDERS: NEW ASPECTS OF ETIOLOGY, DIAGNOSIS, TREATMENT AND OUTCOMES

PubMed Central

De Leon, Diva D.; Stanley, Charles A.

2017-01-01

Hypoglycemia continues to be an important cause of morbidity in neonates and children. Prompt diagnosis and management of the underlying hypoglycemia disorder is critical for preventing brain damage and improving outcomes. Congenital hyperinsulinism is the most common and severe cause of persistent hypoglycemia in neonates and children. Recent discoveries of the genetic causes of hyperinsulinism have improved our understanding of the pathophysiology, but its management is complex and requires the integration of clinical, biochemical, molecular and imaging findings to establish the appropriate treatment according to the subtype. Here we present a summary of a recent international symposium on congenital hypoglycemia disorders with emphasis on novel molecular mechanisms resulting in hyperinsulinism, genetic diagnosis, overall approach to management, novel therapies under development, and current outcomes. PMID:27753189

An incurable itch

PubMed Central

Smith, Christine H.; Goldman, Ran D.

2012-01-01

Abstract Question Head lice infestations continue to be seen frequently in many communities. Some of these children require multiple treatments before eradication. What are the current treatment recommendations for head lice? Answer Head lice (Pediculus humanus capitis) infestations are common, particularly among school-aged children. In order to minimize louse resistance, insecticide usage, and social stigmatization, diagnosis and treatment should be limited to those with live lice on the scalp. Options for management are predominantly topical therapies or physical removal. Large studies comparing the efficacy of these treatments are lacking. Treatment should be repeated in approximately 7 days if topical insecticides are used or every 2 to 3 days for 2 weeks if wet combing is used. Lice resistance patterns vary widely geographically, and resistance is now the most common cause of treatment failure. PMID:22893334

Weinberg's syndrome: a disorder of attention and behavior problems needing further research.

PubMed

Brumback, R A

2000-07-01

A subset of inattentive children have an underlying problem in sustaining wakefulness ("vigilance"). This disorder of vigilance, termed Weinberg's syndrome, is characterized by difficulty in maintaining wakefulness and alertness as evidenced by (among other symptoms) motor restlessness (fidgeting and moving about, yawning and stretching, talkativeness) and complaints of tiredness. During tasks requiring concentration (continuous mental activity) such as reading, children with Weinberg's syndrome will daydream, lose interest, complain of boredom, and become increasingly restless. Napping, while infrequent, usually is not refreshing. A distinct personality described by family members and friends as kind, affectionate, compassionate, or "angelic" also seems to characterize this condition. Weinberg's syndrome has a familial pattern suggesting autosomal-dominant inheritance. Additional neurophysiologic, pharmacotherapeutic, epidemiologic, and genetic studies will be necessary for a full understanding of Weinberg's syndrome.

Family impact of assistive technology scale: development of a measurement scale for parents of children with complex communication needs.

PubMed

Delarosa, Elizabeth; Horner, Stephanie; Eisenberg, Casey; Ball, Laura; Renzoni, Anne Marie; Ryan, Stephen E

2012-09-01

Young people use augmentative and alternative communication (AAC) systems to meet their everyday communication needs. However, the successful integration of an AAC system into a child's life requires strong commitment and continuous support from parents and other family members. This article describes the development and evaluation of the Family Impact of Assistive Technology Scale for AAC Systems - a parent-report questionnaire intended to detect the impact of AAC systems on the lives of children with complex communication needs and their families. The study involved 179 parents and clinical experts to test the content and face validities of the questionnaire, demonstrate its internal reliability and stability over time, and estimate its convergent construct validity when compared to a standardized measure of family impact.

An incurable itch: head lice.

PubMed

Smith, Christine H; Goldman, Ran D

2012-08-01

Head lice infestations continue to be seen frequently in many communities. Some of these children require multiple treatments before eradication. What are the current treatment recommendations for head lice? Head lice (Pediculus humanus capitis) infestations are common, particularly among school-aged children. In order to minimize louse resistance, insecticide usage, and social stigmatization, diagnosis and treatment should be limited to those with live lice on the scalp. Options for management are predominantly topical therapies or physical removal. Large studies comparing the efficacy of these treatments are lacking. Treatment should be repeated in approximately 7 days if topical insecticides are used or every 2 to 3 days for 2 weeks if wet combing is used. Lice resistance patterns vary widely geographically, and resistance is now the most common cause of treatment failure.

Peristeen anal irrigation as a substitute for the MACE procedure in children who are in need of reconstructive bladder surgery

PubMed Central

Alenezi, Husain; Alhazmi, Hamdan; Trbay, Mahmoud; Khattab, Amna; Neel, Khalid Fouda

2014-01-01

Introduction: We evaluate the efficacy of the Peristeen (Coloplast A/S, Kokkedal, Denmark) transanal irrigation (TAI) system, as a stool cleansing mechanism, to gain stool continence in children who need reconstructive bladder surgery and have fecal incontinence. Methods: We prospectively evaluated children with neuropathic bladder and bowel dysfunction who were intended for reconstructive bladder surgery and the Malone antegrade continence enema (MACE) procedure. All patients were started on the Peristeen TAI system at least 3 months before surgery to assess their response. Each patient’s bowel function, frequency of using the system, satisfaction (and that of their parents) and diaper independency were evaluated before and after reconstructive surgery. Results: We included 18 patients (11 female, 7 male) who were evaluated from April 2006 to the present. The mean age of the group was 7.6 years (range: 4–15). Fifteen patients (83.3%) showed complete dryness from stools. Of the 15 patients, 8 (53.3%) were able to be diaper-free, while 6 continued wearing diapers due to fear of soiling and 1 due to urinary incontinence. The patients underwent reconstructive bladder surgery and continued to use the Peristeen TAI system with the same results postoperatively. The main limitation of this study is the small number of patients included, although this is a very specific patient group. Conclusion: Our initial results suggest that the Peristeen TAI system is a successful conservative substitute for the MACE procedure in children who require reconstructive bladder surgery. PMID:24454594

Exposure to road traffic noise and children's behavioural problems and sleep disturbance: results from the GINIplus and LISAplus studies.

PubMed

Tiesler, Carla M T; Birk, Matthias; Thiering, Elisabeth; Kohlböck, Gabriele; Koletzko, Sibylle; Bauer, Carl-Peter; Berdel, Dietrich; von Berg, Andrea; Babisch, Wolfgang; Heinrich, Joachim

2013-05-01

Exposure to transportation noise showed negative health effects in children and adults. Studies in children mainly focussed on aircraft noise at school. We aimed to investigate road traffic noise exposure at home and children's behavioural problems and sleeping problems. 872 10-year-old children from Munich from two German population-based, birth-cohort studies with data on modelled façade noise levels at home and behavioural problems were included. Noise was assessed by the day-evening-night noise indicator Lden and the night noise indicator Lnight. Behavioural problems were assessed by the Strengths and Difficulties Questionnaire (SDQ). A subgroup (N=287) had information on sleeping problems. Continuation ratio models (logistic regression models) adjusted for various covariates were applied to investigate the association between interquartile range increases in noise and SDQ scales (sleeping problems). Noise measured by Lden at the most exposed façade of the building was related to more hyperactivity/inattention (continuation odds ratio (cOR)=1.28(95%-confidence interval(CI):1.03-1.58). Noise at the least exposed façade increased the relative odds for having borderline or abnormal values on the emotional symptoms scale, especially the relative odds to have abnormal values for a subject with at least borderline values (Lden:cOR=2.19(95% CI:1.32-3.64). Results for Lnight were similar. Nocturnal noise at the least exposed façade was associated with any sleeping problems (odds ratio (OR)=1.79(95% CI=1.10-2.92)). Road traffic noise exposure at home may be related to increased hyperactivity and more emotional symptoms in children. Future longitudinal studies are required to explore noise exposure and behavioural problems in more detail, especially the role of sleep disturbances. Copyright © 2013 Elsevier Inc. All rights reserved.

Generational status, health insurance, and public benefit participation among low-income Latino children.

PubMed

DeCamp, Lisa Ross; Bundy, David G

2012-04-01

The objectives of this study were to (1) measure health insurance coverage and continuity across generational subgroups of Latino children, and (2) determine if participation in public benefit programs is associated with increased health insurance coverage and continuity. We analyzed data on 25,388 children income-eligible for public insurance from the 2003 to 2004 National Survey of Children's Health and stratified Latinos by generational status. First- and second-generation Latino children were more likely to be uninsured (58 and 19%, respectively) than third-generation children (9.5%). Second-generation Latino children were similarly likely to be currently insured by public insurance as third-generation children (61 and 62%, respectively), but less likely to have private insurance (19 and 29%, respectively). Second-generation Latino children were slightly more likely than third-generation children to have discontinuous insurance during the year (19 and 15%, respectively). Compared with children in families where English was the primary home language, children in families where English was not the primary home language had higher odds of being uninsured versus having continuous insurance coverage (OR: 2.19; 95% CI [1.33-3.62]). Among second-generation Latino children, participation in the Food Stamp (OR 0.26; 95% CI [0.14-0.48]) or Women, Infants, and Children (OR 0.40; 95% CI [0.25-0.66]) programs was associated with reduced odds of being uninsured. Insurance disparities are concentrated among first- and second-generation Latino children. For second-generation Latino children, connection to other public benefit programs may promote enrollment in public insurance.

[Prosody, speech input and language acquisition].

PubMed

Jungheim, M; Miller, S; Kühn, D; Ptok, M

2014-04-01

In order to acquire language, children require speech input. The prosody of the speech input plays an important role. In most cultures adults modify their code when communicating with children. Compared to normal speech this code differs especially with regard to prosody. For this review a selective literature search in PubMed and Scopus was performed. Prosodic characteristics are a key feature of spoken language. By analysing prosodic features, children gain knowledge about underlying grammatical structures. Child-directed speech (CDS) is modified in a way that meaningful sequences are highlighted acoustically so that important information can be extracted from the continuous speech flow more easily. CDS is said to enhance the representation of linguistic signs. Taking into consideration what has previously been described in the literature regarding the perception of suprasegmentals, CDS seems to be able to support language acquisition due to the correspondence of prosodic and syntactic units. However, no findings have been reported, stating that the linguistically reduced CDS could hinder first language acquisition.

Processing of positive-causal and negative-causal coherence relations in primary school children and adults: a test of the cumulative cognitive complexity approach in German.

PubMed

Knoepke, Julia; Richter, Tobias; Isberner, Maj-Britt; Naumann, Johannes; Neeb, Yvonne; Weinert, Sabine

2017-03-01

Establishing local coherence relations is central to text comprehension. Positive-causal coherence relations link a cause and its consequence, whereas negative-causal coherence relations add a contrastive meaning (negation) to the causal link. According to the cumulative cognitive complexity approach, negative-causal coherence relations are cognitively more complex than positive-causal ones. Therefore, they require greater cognitive effort during text comprehension and are acquired later in language development. The present cross-sectional study tested these predictions for German primary school children from Grades 1 to 4 and adults in reading and listening comprehension. Accuracy data in a semantic verification task support the predictions of the cumulative cognitive complexity approach. Negative-causal coherence relations are cognitively more demanding than positive-causal ones. Moreover, our findings indicate that children's comprehension of negative-causal coherence relations continues to develop throughout the course of primary school. Findings are discussed with respect to the generalizability of the cumulative cognitive complexity approach to German.

An ethical approach to resolving value conflicts in child protection.

PubMed

Webb, E; Moynihan, S

2010-01-01

Child protection professionals working in diverse societies are regularly faced with value conflicts. Recognising these, and resolving them in the best interests of children, is a task that requires child protection specialists to make complex judgements and decisions. In this paper the philosophical concepts of absolutism and relativism to child abuse are applied, and it explores how this approach has practical relevance to solving ethical dilemmas in child protection. Children's interests are best served by erring towards an absolutist approach to the diagnosis and recognition of maltreatment and towards a relativistic approach in determining how services respond to a harmful incident or situation. Absolutism and relativism are not alternatives, but part of a continuous process of recognising and negotiating ever-changing community, national and global norms. At the service level the dichotomy transpires into the need to be culturally competent in handling the conflicting needs, rights and values of children, families, communities and professionals, whilst retaining the skill of child advocacy.

Untrivial Pursuit: Measuring Motor Procedures Learning in Children with Autism.

PubMed

Sparaci, Laura; Formica, Domenico; Lasorsa, Francesca Romana; Mazzone, Luigi; Valeri, Giovanni; Vicari, Stefano

2015-08-01

Numerous studies have underscored prevalence of motor impairments in children with autism spectrum disorders (ASD), but only few of them have analyzed motor strategies exploited by ASD children when learning a new motor procedure. To evaluate motor procedure learning and performance strategies in both ASD and typically developing (TD) children, we built a virtual pursuit rotor (VPR) task, requiring tracking a moving target on a computer screen using a digitalized pen and tablet. Procedural learning was measured as increased time on target (TT) across blocks of trials on the same day and consolidation was assessed after a 24-hour rest. The program and the experimental setting (evaluated in a first experiment considering two groups of TD children) allowed also measures of continuous time on target (CTT), distance from target (DT) and distance from path (DP), as well as 2D reconstructions of children's trajectories. Results showed that the VPR was harder for children with ASD than for TD controls matched for chronological age and intelligence quotient, but both groups displayed comparable motor procedure learning (i.e., similarly incremented their TT). However, closer analysis of CTT, DT, and DP as well as 2D trajectories, showed different motor performance strategies in ASD, highlighting difficulties in overall actions planning. Data underscore the need for deeper investigations of motor strategies exploited by children with ASD when learning a new motor procedure. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Support for immunization registries among parents of vaccinated and unvaccinated school-aged children: a case control study

PubMed Central

Linkins, Robert W; Salmon, Daniel A; Omer, Saad B; Pan, William KY; Stokley, Shannon; Halsey, Neal A

2006-01-01

Background Immunizations have reduced childhood vaccine preventable disease incidence by 98–100%. Continued vaccine preventable disease control depends on high immunization coverage. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies. Despite substantial resources directed towards registry development in the U.S., only 48% of children were enrolled in a registry in 2004. Parental attitudes likely impact child participation. Consequently, the purpose of this study was to assess the attitudes of parents of vaccinated and unvaccinated school-aged children regarding: support for immunization registries; laws authorizing registries and mandating provider reporting; opt-in versus opt-out registry participation; and financial worth and responsibility of registry development and implementation. Methods A case control study of parents of 815 children exempt from school vaccination requirements and 1630 fully vaccinated children was conducted. Children were recruited from 112 elementary schools in Colorado, Massachusetts, Missouri, and Washington. Surveys administered to the parents, asked about views on registries and perceived utility and safety of vaccines. Parental views were summarized and logistic regression models compared differences between parents of exempt and vaccinated children. Results Surveys were completed by 56.1% of respondents. Fewer than 10% of parents were aware of immunization registries in their communities. Among parents aware of registries, exempt children were more likely to be enrolled (65.0%) than vaccinated children (26.5%) (p value = 0.01). A substantial proportion of parents of exempt children support immunization registries, particularly if registries offer choice for participation. Few parents of vaccinated (6.8%) and exempt children (6.7%) were aware of laws authorizing immunization registries. Support for laws authorizing registries and requiring health care providers to report to registries was more common among parents of vaccinated than exempt children. Most parents believed that the government, vaccine companies or insurance companies should pay for registries. Conclusion Parental support for registries was relatively high. Parental support for immunization registries may increase with greater parental awareness of the risks of vaccine preventable diseases and utility of vaccination. PMID:16995946

Generational Status, Health Insurance, and Public Benefit Participation Among Low-Income Latino Children

PubMed Central

Bundy, David G.

2015-01-01

The objectives of this study were to (1) measure health insurance coverage and continuity across generational subgroups of Latino children, and (2) determine if participation in public benefit programs is associated with increased health insurance coverage and continuity. We analyzed data on 25,388 children income-eligible for public insurance from the 2003 to 2004 National Survey of Children’s Health and stratified Latinos by generational status. First- and second-generation Latino children were more likely to be uninsured (58 and 19%, respectively) than third-generation children (9.5%). Second-generation Latino children were similarly likely to be currently insured by public insurance as third-generation children (61 and 62%, respectively), but less likely to have private insurance (19 and 29%, respectively). Second-generation Latino children were slightly more likely than third-generation children to have discontinuous insurance during the year (19 and 15%, respectively). Compared with children in families where English was the primary home language, children in families where English was not the primary home language had higher odds of being uninsured versus having continuous insurance coverage (OR: 2.19; 95% CI [1.33–3.62]). Among second-generation Latino children, participation in the Food Stamp (OR 0.26; 95% CI [0.14–0.48]) or Women, Infants, and Children (OR 0.40; 95% CI [0.25–0.66]) programs was associated with reduced odds of being uninsured. Insurance disparities are concentrated among first- and second-generation Latino children. For second-generation Latino children, connection to other public benefit programs may promote enrollment in public insurance. PMID:21505783

Intermittent versus Continuous Physiotherapy in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Christiansen, Annette Sandahl; Lange, Christa

2008-01-01

The aim of this study was to compare the effect of the delivery of the same amount of intermittent versus continuous physiotherapy given to children with cerebral palsy (CP). This was organized either in an intermittent regime four times a week for 4 weeks alternating with a 6-week treatment pause, or a continuous once or twice a week regime, both…

Food and beverage TV advertising to young children: Measuring exposure and potential impact.

PubMed

Harris, Jennifer L; Kalnova, Svetlana S

2018-04-01

Children of all ages are vulnerable to influence from exposure to unhealthy food advertisements, but experts raise additional concerns about children under 6 due to their more limited cognitive abilities. Most companies in the U.S. Children's Food and Beverage Advertising Initiative (CFBAI) industry self-regulatory program pledge to not direct any advertising to children under 6. However, young children also watch programming primarily directed to older children and thus may view food-related advertising despite companies' pledges. Research is required to understand the amount and potential impact of this exposure on preschool-age children. Study 1 uses Nielsen advertising exposure data to compare preschoolers' (2-5 years) and older children's (6-11 years) exposure to food advertising in 2015. Preschoolers viewed on average 3.2 food ads daily on children's programming, just 6% fewer compared to 6- to 11-year-olds; over 60% were placed by CFBAI-participating companies. Study 2 exposed young children (N = 49) in a child-care setting to child-directed food ads, measured their attitudes about the ads and advertised brands, and compared responses by 4- to 5-year-olds and 6- to 7-year olds. Most children indicated that they liked the child-directed ads, with media experience associated with greater liking for both age groups. Ad liking and previous consumption independently predicted brand liking for both age groups, although previous consumption was a stronger predictor for older children. Despite pledges by food companies to not direct advertising to children under age 6, preschoolers continue to view advertisements placed by these companies daily, including on children's programming. This advertising likely increases children's preferences for nutritionally poor advertised brands. Food companies and media companies airing children's programming should do more to protect young children from advertising that takes advantage of their vulnerabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

The dragnet of children's feeding programs in Atlantic Canada.

PubMed

Dayle, J B; McIntyre, L; Raine-Travers, K D

2000-12-01

Ivan Illich's 1976 prediction that medical dragnets will continue was correct. Now quasi-health dragnets are being established ostensibly to feed children perceived to be hungry. Our qualitative, multi-site case study found that programs justify their expansion to non-target group children as a means of reducing stigmatization, while reaching only an estimated one-third of targeted children. The dragnet continues as new services are added and franchising is proposed while the purpose of the program feeding healthy foods to children ultimately succumbs to drives for efficiency and the desire to maintain the program itself. In this field of social power relations, children become commodified through dialectical interplays among fundamental needs, manipulated needs, benevolence, and domination.

Sports and recreational injuries in children and adolescents: prevention and education.

PubMed

Davis, Elaine K

2004-01-01

Youth and children's sports are becoming increasingly popular in America. Previous studies have shown that children and adolescents are not small adults in their responses to exercise and stress. As children around the world become involved in more competitive and organized sports activities, the frequency and severity of acute and overuse injuries continue to rise. Safety guidelines, protective equipment and prevention education are crucial to reducing pediatric recreational and sports injuries. Preventing injuries and ensuring safe athletic practices are necessary for children and adolescents to continue to receive benefits from organized sports and recreational activities. Efforts to minimize these injuries are warranted both to ensure the long-term health of children and to reduce medical costs.

[Primary care in maternal-child health].

PubMed

Pedreira Massa, J L

1986-07-01

The theoretical and methodological elements of primary health care (PHC) include a philosophy of work and an epistemological focus toward the processes of health and illness, as well as a practical medical anthropological knowledge of the culture-specific aspects of disease. The work methodology of PHC requires care of the individual as a bio-psycho-socio-affective being integrated into a particular environment; none of the aspects of being should be neglected or given priority. Care should also be integrated in the sense of providing preventive health care as well as curative and rehabilitative services, in all phases from training of health personnel to record keeping. The primary health care team is multidisciplinary in constitution and interdisciplinary in function. PHC assumes that health care will be accessible to users and that continuity of care will be provided. The need for community participation in all phases of health care has been reiterated in several international health declarations. A well-functioning PHC system will require new types of pre- and postgraduate health education in a changing social and professional system and continuing education under adequate supervision for health workers. Research capability for identifying community health problems, a rigorous evaluation system, and epidemiologic surveillance are also needed. All of these elements are applicable to the field of maternal and child health as well as to PHC. The most appropriate place to intervene in order to correct existing imbalances in access to health care for mothers and children is in the PHC system. Examples of areas that should be stressed include vaccinations, nutrition, psychomotor development, early diagnosis and treatment for handicapped children, prevention of childhood accidents, school health and absenteeism, all aspects of health education, adoption and alternatives to abandonment of children, alcoholism and addiction, adolescent pregnancy and family planning, dental health, and mental problems. Trained primary care pediatricians working within the community as part of the PHC system will be required to confront and solve complex health problems. The training needed does not signify a new speciality or subspeciality, but rather a training methodology and a new type of professional practice.

Relative Affordability of Health Insurance Premiums under CHIP Expansion Programs and the ACA.

PubMed

Gresenz, Carole Roan; Laugesen, Miriam J; Yesus, Ambeshie; Escarce, José J

2011-10-01

Affordability is integral to the success of health care reforms aimed at ensuring universal access to health insurance coverage, and affordability determinations have major policy and practical consequences. This article describes factors that influenced the determination of affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program (CHIP) expansions in three states that sought to universalize access to coverage for youth. It also compares subsidy levels developed in these states to the premium subsidy schedule under the Affordable Care Act (ACA) for health insurance plans purchased through an exchange. We find sizeable variability in premium-contribution requirements for children's coverage as a percentage of family income across the three states and in the progressivity and regressivity of the premium-contribution schedules developed. These findings underscore the ambiguity and subjectivity of affordability standards. Further, our analyses suggest that while the ACA increases the affordability of family coverage for families with incomes below 400 percent of the federal poverty level, the evolution of CHIP over the next five to ten years will continue to have significant implications for low-income families.

Resources available to the family of the child with cancer.

PubMed

Monaco, G P

1986-07-15

Progressive and continuing advances in the care of the child with cancer have resulted in potential cure of over 50% of our children. However, no matter how encouraging these statistics, nearly one half of our children now die from their disease. To bring the family through the cancer experience, we must meet the challenge of attending to their practical, spiritual, emotional and experiential requirement from diagnosis, treatment through possible relapse, death, hoped for cure, and survival as an adult with the stigmata of a history of cancer as an obstacle to jobs, insurance, and productive lives, and the further shadow of a possible late second cancer caused by their curative treatment. Families require access to a firm, unfragmented foundation of support, incorporating a multidisciplinary network of resources, involving the combined efforts of the primary health care team and the family's community. Medical and emotional counseling, peer support, spiritual guidance, and special community services contribute to the optimal care of both patient and family. In addition, legal advisory assistance and help with financial planning are important ingredients in assisting families.

Sugar sweetened beverage consumption by Australian children: Implications for public health strategy

PubMed Central

2011-01-01

Background High consumption of sugar sweetened beverages (SSBs) has been linked to unhealthy weight gain and nutrition related chronic disease. Intake of SSB among children remains high in spite of public health efforts to reduce consumption, including restrictions on marketing to children and limitations on the sale of these products in many schools. Much extant literature on Australian SSB consumption is out-dated and lacks information on several key issues. We sought to address this using a contemporary Australian dataset to examine purchase source, consumption pattern, dietary factors, and demographic profile of SSB consumption in children. Methods Data were from the 2007 Australian National Children's Nutrition and Physical Activity Survey, a representative random sample of 4,834 Australian children aged 2-16 years. Mean SSB intake by type, location and source was calculated and logistic regression models were fitted to determine factors associated with different levels of consumption. Results SSB consumption was high and age-associated differences in patterns of consumption were evident. Over 77% of SSB consumed was purchased via supermarkets and 60% of all SSB was consumed in the home environment. Less than 17% of SSB was sourced from school canteens and fast food establishments. Children whose parents had lower levels of education consumed more SSB on average, while children whose parents had higher education levels were more likely to favour sweetened juices and flavoured milks. Conclusions SSB intake by Australian children remains high and warrants continued public health attention. Evidence based and age-targeted interventions, which also recognise supermarkets as the primary source of SSB, are recommended to reduce SSB consumption among children. Additionally, education of parents and children regarding the health consequences of high consumption of both carbonated and non-carbonated SSBs is required. PMID:22192774

Sweet promises: Candy advertising to children and implications for industry self-regulation.

PubMed

Harris, Jennifer L; LoDolce, Megan; Dembek, Cathryn; Schwartz, Marlene B

2015-12-01

Candy advertising illustrates limitations of the Children's Food and Beverage Advertising Initiative (CFBAI) self-regulatory program to improve food marketing to children. Participating companies pledge to not advertise candy in child-directed media. Yet independent analyses show that children viewed 65% more candy ads on U.S. television in 2011 than in 2007, before CFBAI implementation. The present research corroborates these findings, characterizes the increase, and examines how CFBAI-participating and non-participating companies use child-targeted techniques and media placement to advertise candy on U.S. television. Content analysis identified child-targeted messages and techniques in 2011 television candy ads, and Nielsen data (2008-2011) quantified candy advertising viewed on children's and other types of television programming. Differences between brands according to CFBAI status and use of child-targeted techniques in ads are evaluated. Data were obtained and analyzed in 2013. CFBAI-company non-approved brands represented 65% of candy ads viewed by children in 2011, up from 45% in 2008, and 77% of these ads contained child-targeted techniques. Although CFBAI companies only placed ads for approved brands on children's networks, 31% of ads viewed by children for CFBAI non-approved brands appeared on networks with higher-than-average youth audiences. CFBAI non-participating companies placed child-targeted candy ads primarily on children's networks. Despite CFBAI pledges, companies continue to advertise candy during programming with large youth audiences utilizing techniques that appeal to children. Both increased CFBAI participation and a more effective definition of "child-directed advertising" are required to reduce children's exposure to targeted advertising for foods that can harm their health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sugar sweetened beverage consumption by Australian children: implications for public health strategy.

PubMed

Hafekost, Katherine; Mitrou, Francis; Lawrence, David; Zubrick, Stephen R

2011-12-22

High consumption of sugar sweetened beverages (SSBs) has been linked to unhealthy weight gain and nutrition related chronic disease. Intake of SSB among children remains high in spite of public health efforts to reduce consumption, including restrictions on marketing to children and limitations on the sale of these products in many schools. Much extant literature on Australian SSB consumption is out-dated and lacks information on several key issues. We sought to address this using a contemporary Australian dataset to examine purchase source, consumption pattern, dietary factors, and demographic profile of SSB consumption in children. Data were from the 2007 Australian National Children's Nutrition and Physical Activity Survey, a representative random sample of 4,834 Australian children aged 2-16 years. Mean SSB intake by type, location and source was calculated and logistic regression models were fitted to determine factors associated with different levels of consumption. SSB consumption was high and age-associated differences in patterns of consumption were evident. Over 77% of SSB consumed was purchased via supermarkets and 60% of all SSB was consumed in the home environment. Less than 17% of SSB was sourced from school canteens and fast food establishments. Children whose parents had lower levels of education consumed more SSB on average, while children whose parents had higher education levels were more likely to favour sweetened juices and flavoured milks. SSB intake by Australian children remains high and warrants continued public health attention. Evidence based and age-targeted interventions, which also recognise supermarkets as the primary source of SSB, are recommended to reduce SSB consumption among children. Additionally, education of parents and children regarding the health consequences of high consumption of both carbonated and non-carbonated SSBs is required.

Preschool Neuropsychological Measures as Predictors of Later Attention Deficit Hyperactivity Disorder

PubMed Central

Breaux, Rosanna P.; Griffith, Shayl F.; Harvey, Elizabeth A.

2016-01-01

The present study examined preschool neuropsychological measures as predictors of school-age attention deficit hyperactivity disorder (ADHD). Participants included 168 children (91 males) who completed neuropsychological measures at ages 3 and 4, and who were evaluated for ADHD and oppositional defiant disorder at age 6. The Conners’ Kiddie Continuous Performance Test (K-CPT), NEPSY Statue subtest, and a delay aversion task significantly distinguished at-risk children who later did and did not meet criteria for ADHD, with poor to fair overall predictive power, specificity, and sensitivity. However, only the K-CPT ADHD Confidence Index and battery added incremental predictive validity beyond early ADHD symptoms. This battery approach, which required impairment on at least 2 of the 3 significant measures, yielded fair overall predictive power, specificity, and sensitivity, and correctly classified 67% of children. In addition, there was some support for the specificity hypothesis, with evidence that cool executive function measures (K-CPT and Statue subtest) tended to predict inattentive symptoms. These findings suggest that neuropsychological deficits are evident by preschool-age in children with ADHD, but neuropsychological tests may still misclassify approximately one-third of children if used alone. Thus, neuropsychological measures may be a useful component of early ADHD assessments, but should be used with caution and in combination with other assessment methods. PMID:26936037

[Outcome of rapidly progressive glomerulonephritis post-streptococcal disease in children].

PubMed

Jellouli, Manel; Maghraoui, Sondos; Abidi, Kamel; Hammi, Yosra; Goucha, Rim; Naija, Ouns; Zarrouk, Chokri; Gargah, Tahar

2015-11-01

Rapidly progressive glomerulonephritis is a rare form of postinfectious glomerulonephritis. The aim of this study was to describe the outcome of our patients with severe post-streptococcal glomerulonephritis. This retrospective study was conducted in the department of pediatrics in Charles-Nicolle Hospital during a period of 13 years (1997-2009). Twenty-seven children were identified. The mean age was 8.7 years. All patients presented renal failure at presentation. The mean serum creatinine at presentation was 376.9 μmol/L. Six patients presented nephrotic syndrome. Twenty-six children had renal biopsies. Renal biopsies showed crescents in 24 cases. Eighteen children received pulse dose of corticosteroids (66.6%) and 6 children (22%) received pulse dose of corticosteroids and cyclophosphamide. Eleven patients required dialysis. At last follow-up, 22 patients (81.5%) had normal kidney function, 2 had renal dysfunction and 3 reached end stage renal disease. The only significant determinant for renal survival was the supportive dialysis (P=0.015). Rapidly progressive glomerulonephritis is uncommon. There have been significant advancements in supportive, as well as specific therapy, but the outcome continues to be poor. Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Rule-based and information-integration perceptual category learning in children with attention-deficit/hyperactivity disorder.

PubMed

Huang-Pollock, Cynthia L; Maddox, W Todd; Tam, Helen

2014-07-01

Suboptimal functioning of the basal ganglia is implicated in attention-deficit/hyperactivity disorder (ADHD). These structures are important to the acquisition of associative knowledge, leading some to theorize that associative learning deficits might be expected, despite the fact that most extant research in ADHD has focused on effortful control. We present 2 studies that examined the acquisition of explicit rule-based (RB) and associative information integration (II) category learning among school-age children with ADHD. In Study 1, we found deficits in both RB and II category learning tasks among children with ADHD (n = 81) versus controls (n = 42). Children with ADHD tended to sort by the more salient but irrelevant dimension (in the RB paradigm) and were unable to acquire a consistent sorting strategy (in the II paradigm). To disentangle whether the deficit was localized to II category learning versus a generalized inability to consider more than 1 stimulus dimension, in Study 2 children completed a conjunctive RB paradigm that required consideration of 2 stimulus dimensions. Children with ADHD (n = 50) continued to underperform controls (n = 33). Results provide partial support for neurocognitive developmental theories of ADHD that suggest that associative learning deficits should be found, and highlight the importance of using analytic approaches that go beyond asking whether an ADHD-related deficit exists to why such deficits exist.

Medicaid and Children's Health Insurance Programs: Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Other Provisions Related to Eligibility and Enrollment for Medicaid and CHIP. Final rule.

PubMed

2016-11-30

This final rule implements provisions of the Affordable Care Act that expand access to health coverage through improvements in Medicaid and coordination between Medicaid, CHIP, and Exchanges. This rule finalizes most of the remaining provisions from the "Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing; Proposed Rule" that we published in the January 22, 2013, Federal Register. This final rule continues our efforts to assist states in implementing Medicaid and CHIP eligibility, appeals, and enrollment changes required by the Affordable Care Act.

Socialization Processes and Clergy Offenders.

PubMed

Anderson, Jane

2016-01-01

This article uses feminist theory to investigate how the socialization processes used to maintain the clergy community in the Roman Catholic Church contributes to a vulnerability in some clergy for sexually abusing children. This vulnerability is identified first in an examination of the literature on the impact of socialization processes on clergy offenders between the 1960s and 1980s. A comparison is then made with the implications of the apostolic exhortation, Pastores Dabo Vobis, which provides a theological basis to clergy formation. The article argues that the document works to ensure a continuity of socialization processes that not only have been shown to create a vulnerability for committing child sexual abuse but compound existing vulnerabilities. The article concludes that constraints produced by the preservation of a hegemonic masculinity and patriarchy retain a threat of violence against children and require recommended reforms.

Towards developing an ethical framework for decision making in long-term ventilation in children.

PubMed

Ray, Samiran; Brierley, Joe; Bush, Andy; Fraser, James; Halley, Gillian; Harrop, Emily Jane; Casanueva, Lidia

2018-06-05

The use of long-term ventilation (LTV) in children is growing in the UK and worldwide. This reflects the improvement in technology to provide LTV, the growing number of indications in which it can be successfully delivered and the acceptability of LTV to families and children. In this article, we discuss the various considerations to be made when deciding to initiate or continue LTV, describe the process that should be followed, as decided by a consensus of experienced physicians, and outline the options available for resolution of conflict around LTV decision making. We recognise the uncertainty and hope provided by novel and evolving therapies for potential disease modification. This raises the question of whether LTV should be offered to allow time for a therapy to be trialled, or whether the therapy is so unlikely to be effective, LTV would simply prolong suffering. We put this consensus view forward as an ethical framework for decision making in children requiring LTV. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Associations of Postural Knowledge and Basic Motor Skill with Dyspraxia in Autism: Implication for Abnormalities in Distributed Connectivity and Motor Learning

PubMed Central

Dowell, Lauren R.; Mahone, E. Mark; Mostofsky, Stewart H.

2009-01-01

Children with autism often have difficulty performing skilled movements. Praxis performance requires basic motor skill, knowledge of representations of the movement (mediated by parietal regions), and transcoding of these representations into movement plans (mediated by premotor circuits). The goals of this study were: (a) to determine whether dyspraxia in autism is associated with impaired representational (“postural”) knowledge, and (b) to examine the contributions of postural knowledge and basic motor skill to dyspraxia in autism. Thirty-seven children with autism spectrum disorder (ASD) and 50 typically developing (TD) children, ages 8–13, completed: (a) an examination of basic motor skills, (b) a postural knowledge test assessing praxis discrimination, and (c) a praxis examination. Children with ASD showed worse basic motor skill and postural knowledge than controls. The ASD group continued to show significantly poorer praxis than controls after accounting for age, IQ, basic motor skill, and postural knowledge. Dyspraxia in autism appears to be associated with impaired formation of spatial representations, as well as transcoding and execution. Distributed abnormality across parietal, premotor, and motor circuitry, as well as anomalous connectivity may be implicated. PMID:19702410

Initiation of a medical toxicology consult service at a tertiary care children's hospital.

PubMed

Wang, George Sam; Monte, Andrew; Hatten, Benjamin; Brent, Jeffrey; Buchanan, Jennie; Heard, Kennon J

2015-05-01

Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children < 6 years, poisoning continues to be a common pediatric diagnosis and bedside toxicology consultation is not common at children's hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children's hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8-16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship.

Bathroom scald burns in Queensland Children.

PubMed

Gole, Hobia; Kimble, Roy; Stockton, Kellie

2017-05-01

To evaluate the current characteristics of bathroom scald injuries in Queensland Children. Data was collected from patients who presented with a bathroom scald injury to the Stuart Pegg Paediatric Burns Centre at the Royal Children's Hospital and Lady Cilento Children's Hospital, Brisbane from January 2013 to December 2014. Bathroom scald burns represented 2.6% of total burns cases with an inpatient rate of 39%. The family home is the location of injury in 84% of cases and in 79% the patient was aged 2 years of age or younger. Total body surface area ranged from 0.5% to 20% with a median of 1.75% (IQR 0.63, 3.38%). In our study 8% of patients underwent grafting and 24% received follow up for scar management. Injuries occurred in rental properties in 47% of tempering valve survey respondents. The rate of installation of tempering valves was 23%. Bathroom scald burns continue to be over-represented in inpatient data. Tempering valves were not consistently installed after injury, this intervention would require further legislation to be an effective prevention strategy. This study provides important insights into paediatric bathroom scald injuries and will assist with the development of prevention strategies. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Respiratory manifestations of gastro-oesophageal reflux in children.

PubMed

de Benedictis, Fernando Maria; Bush, Andrew

2018-03-01

Gastro-oesophageal reflux disease (GORD) is a complex problem in children. Suspected respiratory manifestations of GORD, such as asthma, chronic cough and laryngitis, are commonly encountered in the paediatric practice, but continue to be entities with more questions than answers. The accuracy of diagnostic tests (ie, pH or pH-impedance monitoring, laryngoscopy, endoscopy) for patients with suspected extraoesophageal manifestations of GORD is suboptimal and therefore whether there is a causal relationship between these conditions remains largely undetermined. An empiric trial of proton pump inhibitors can help individual children with undiagnosed respiratory symptoms and suspicion of GORD, but the response to therapy is unpredictable, and in any case what may be being observed is spontaneous improvement. Furthermore, the safety of these agents has been called into question. Poor response to antireflux therapy is an important trigger to search for non-gastro-oesophageal reflux causes for patients' symptoms. Evidence for the assessment of children with suspected extraoesophageal manifestations of GORD is scanty and longitudinal studies with long-term follow-up are urgently required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessment of Program Impact Through First Grade, Volume VI: Summary of Impact on Institutions, Teachers and Classrooms, Parents and Children. An Evaluation of Project Developmental Continuity. Interim Report X.

ERIC Educational Resources Information Center

Powell, Marjorie; And Others

The final volume in a series of six evaluation reports, this document provides a summary of the results of the evaluation of Project Developmental Continuity (PDC), conducted when the evaluation study's cohort of children had completed grade 1. Begun at 15 sites in 1974 with the purpose of ensuring that disadvantaged children receive continuous…

Assessment of Program Impact Through First Grade, Volume I: The Context, Conceptual Approach and Methods of the Evaluation. An Evaluation of Project Developmental Continuity. Interim Report X.

ERIC Educational Resources Information Center

Rosario, Jose; And Others

This volume is the first of a series reporting evaluation findings on the impact of Project Developmental Continuity (PDC) on institutions, classroom staff, parents and children from the time the children entered Head Start through the first grade. PDC was begun in 1974 with the purpose of ensuring that disadvantaged children receive continuous…

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.

Development of Proportional Reasoning: Where Young Children Go Wrong

PubMed Central

Boyer, Ty W.; Levine, Susan C.; Huttenlocher, Janellen

2008-01-01

Previous studies have found that children have difficulty solving proportional reasoning problems involving discrete units until 10- to 12-years of age, but can solve parallel problems involving continuous quantities by 6-years of age. The present studies examine where children go wrong in processing proportions that involve discrete quantities. A computerized proportional equivalence choice task was administered to kindergartners through fourth-graders in Study 1, and to first- and third-graders in Study 2. Both studies involved four between-subjects conditions that were formed by pairing continuous and discrete target proportions with continuous and discrete choice alternatives. In Study 1, target and choice alternatives were presented simultaneously and in Study 2 target and choice alternatives were presented sequentially. In both studies, children performed significantly worse when both the target and choice alternatives were represented with discrete quantities than when either or both of the proportions involved continuous quantities. Taken together, these findings indicate that children go astray on proportional reasoning problems involving discrete units only when a numerical match is possible, suggesting that their difficulty is due to an overextension of numerical equivalence concepts to proportional equivalence problems. PMID:18793078

Intellectual and Emotional Development and School Adjustment in Preterm Children at 6 and 7 Years of Age. Continuation of a Follow-Up Study.

ERIC Educational Resources Information Center

Grigoroiu-Serbanescu, Maria

1984-01-01

Continues a previous five-year follow-up of preterm and full-term children by studying the continuity in their intellectual and emotional development. Prematurity was predictive for school adjustment at ages six and seven only when regression was performed on the preterm group, but failed to be predictive when mixed groups of preterm and full-term…

Upgrading a Piped Water Supply from Intermittent to Continuous Delivery and Association with Waterborne Illness: A Matched Cohort Study in Urban India

PubMed Central

Ercumen, Ayse; Arnold, Benjamin F.; Kumpel, Emily; Burt, Zachary; Ray, Isha; Nelson, Kara; Colford, John M.

2015-01-01

Background Intermittent delivery of piped water can lead to waterborne illness through contamination in the pipelines or during household storage, use of unsafe water sources during intermittencies, and limited water availability for hygiene. We assessed the association between continuous versus intermittent water supply and waterborne diseases, child mortality, and weight for age in Hubli-Dharwad, India. Methods and Findings We conducted a matched cohort study with multivariate matching to identify intermittent and continuous supply areas with comparable characteristics in Hubli-Dharwad. We followed 3,922 households in 16 neighborhoods with children <5 y old, with four longitudinal visits over 15 mo (Nov 2010–Feb 2012) to record caregiver-reported health outcomes (diarrhea, highly credible gastrointestinal illness, bloody diarrhea, typhoid fever, cholera, hepatitis, and deaths of children <2 y old) and, at the final visit, to measure weight for age for children <5 y old. We also collected caregiver-reported data on negative control outcomes (cough/cold and scrapes/bruises) to assess potential bias from residual confounding or differential measurement error. Continuous supply had no significant overall association with diarrhea (prevalence ratio [PR] = 0.93, 95% confidence interval [CI]: 0.83–1.04, p = 0.19), bloody diarrhea (PR = 0.78, 95% CI: 0.60–1.01, p = 0.06), or weight-for-age z-scores (Δz = 0.01, 95% CI: −0.07–0.09, p = 0.79) in children <5 y old. In prespecified subgroup analyses by socioeconomic status, children <5 y old in lower-income continuous supply households had 37% lower prevalence of bloody diarrhea (PR = 0.63, 95% CI: 0.46–0.87, p-value for interaction = 0.03) than lower-income intermittent supply households; in higher-income households, there was no significant association between continuous versus intermittent supply and child diarrheal illnesses. Continuous supply areas also had 42% fewer households with ≥1 reported case of typhoid fever (cumulative incidence ratio [CIR] = 0.58, 95% CI: 0.41–0.78, p = 0.001) than intermittent supply areas. There was no significant association with hepatitis, cholera, or mortality of children <2 y old; however, our results were indicative of lower mortality of children <2 y old (CIR = 0.51, 95% CI: 0.22–1.07, p = 0.10) in continuous supply areas. The major limitations of our study were the potential for unmeasured confounding given the observational design and measurement bias from differential reporting of health symptoms given the nonblinded treatment. However, there was no significant difference in the prevalence of the negative control outcomes between study groups that would suggest undetected confounding or measurement bias. Conclusions Continuous water supply had no significant overall association with diarrheal disease or ponderal growth in children <5 y old in Hubli-Dharwad; this might be due to point-of-use water contamination from continuing household storage and exposure to diarrheagenic pathogens through nonwaterborne routes. Continuous supply was associated with lower prevalence of dysentery in children in low-income households and lower typhoid fever incidence, suggesting that intermittently operated piped water systems are a significant transmission mechanism for Salmonella typhi and dysentery-causing pathogens in this urban population, despite centralized water treatment. Continuous supply was associated with reduced transmission, especially in the poorer higher-risk segments of the population. PMID:26505897

Upgrading a piped water supply from intermittent to continuous delivery and association with waterborne illness: a matched cohort study in urban India.

PubMed

Ercumen, Ayse; Arnold, Benjamin F; Kumpel, Emily; Burt, Zachary; Ray, Isha; Nelson, Kara; Colford, John M

2015-10-01

Intermittent delivery of piped water can lead to waterborne illness through contamination in the pipelines or during household storage, use of unsafe water sources during intermittencies, and limited water availability for hygiene. We assessed the association between continuous versus intermittent water supply and waterborne diseases, child mortality, and weight for age in Hubli-Dharwad, India. We conducted a matched cohort study with multivariate matching to identify intermittent and continuous supply areas with comparable characteristics in Hubli-Dharwad. We followed 3,922 households in 16 neighborhoods with children <5 y old, with four longitudinal visits over 15 mo (Nov 2010-Feb 2012) to record caregiver-reported health outcomes (diarrhea, highly credible gastrointestinal illness, bloody diarrhea, typhoid fever, cholera, hepatitis, and deaths of children <2 y old) and, at the final visit, to measure weight for age for children <5 y old. We also collected caregiver-reported data on negative control outcomes (cough/cold and scrapes/bruises) to assess potential bias from residual confounding or differential measurement error. Continuous supply had no significant overall association with diarrhea (prevalence ratio [PR] = 0.93, 95% confidence interval [CI]: 0.83-1.04, p = 0.19), bloody diarrhea (PR = 0.78, 95% CI: 0.60-1.01, p = 0.06), or weight-for-age z-scores (Δz = 0.01, 95% CI: -0.07-0.09, p = 0.79) in children <5 y old. In prespecified subgroup analyses by socioeconomic status, children <5 y old in lower-income continuous supply households had 37% lower prevalence of bloody diarrhea (PR = 0.63, 95% CI: 0.46-0.87, p-value for interaction = 0.03) than lower-income intermittent supply households; in higher-income households, there was no significant association between continuous versus intermittent supply and child diarrheal illnesses. Continuous supply areas also had 42% fewer households with ≥1 reported case of typhoid fever (cumulative incidence ratio [CIR] = 0.58, 95% CI: 0.41-0.78, p = 0.001) than intermittent supply areas. There was no significant association with hepatitis, cholera, or mortality of children <2 y old; however, our results were indicative of lower mortality of children <2 y old (CIR = 0.51, 95% CI: 0.22-1.07, p = 0.10) in continuous supply areas. The major limitations of our study were the potential for unmeasured confounding given the observational design and measurement bias from differential reporting of health symptoms given the nonblinded treatment. However, there was no significant difference in the prevalence of the negative control outcomes between study groups that would suggest undetected confounding or measurement bias. Continuous water supply had no significant overall association with diarrheal disease or ponderal growth in children <5 y old in Hubli-Dharwad; this might be due to point-of-use water contamination from continuing household storage and exposure to diarrheagenic pathogens through nonwaterborne routes. Continuous supply was associated with lower prevalence of dysentery in children in low-income households and lower typhoid fever incidence, suggesting that intermittently operated piped water systems are a significant transmission mechanism for Salmonella typhi and dysentery-causing pathogens in this urban population, despite centralized water treatment. Continuous supply was associated with reduced transmission, especially in the poorer higher-risk segments of the population.

5 CFR 894.306 - Are foster children eligible as family members?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Are foster children eligible as family members? 894.306 Section 894.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Eligibility § 894...

5 CFR 894.306 - Are foster children eligible as family members?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Are foster children eligible as family members? 894.306 Section 894.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Eligibility § 894...

Is pediatric IBD treatment different than in adults?

PubMed

Lev-Tzion, R; Turner, D

2012-06-01

The incidence of pediatric inflammatory bowel disease (IBD) continues to rise in most countries. Approximately 20-25% of IBD patients present before the age of 20, and their management is associated with many unique challenges. These challenges stem both from the inherent differences between children and adults, and from the differences in the nature and course of the disease. Children with IBD are more likely than adults to present with extensive disease ‑ both in Crohn's disease (CD) and ulcerative colitis (UC). Diagnosis requires a high index of suspicion, as children may present with less typical signs such as poor growth and delayed puberty. In the very young patients with inflammatory bowel disease, the pediatric clinician must consider a broader range of immunological and allergic disorders. Optimal management requires recognition of pediatric patterns of presentation, efficacy and adverse-effect profiles, and understanding monitoring aspects unique to pediatrics. These aspects include pediatric disease-related psychological issues, adherence to therapy and transition to adult care. Inadequate attention to growth, puberty or bone health in childhood can result in long-term consequences, such as impaired adult height and increased risk of fractures. Management of pediatric IBD and prevention of adverse long-term consequences relies on a variety of therapies well-known to the adult practitioner, along with therapies that are not widespread in adults, most notably exclusive enteral nutrition (EEN). The latter is as effective as corticosteroids in achieving clinical remission in children, while achieving better results than corticosteroids with regard to mucosal healing and growth. This review discusses the broad variety of issues that form the basis for management of pediatric IBD.

Act No. 89-487 of 10 July 1989 relating to the prevention of the mistreatment of minors and protection of childhood.

PubMed

1989-01-01

This Act amends the French Family and Social Aid Code to insert provisions designed to prevent the mistreatment of minors. It provides that childhood social aid services are to have the additional objectives of preventing mistreatment and collecting information on the mistreatment of minors and are to inform and sensitize the public at large, as well as concerned persons, about the conditions of mistreated minors. The Act requires the president of each local general council to establish a system for collection of information, require the collaboration of professionals and associations dealing with the protection of the family and children, and notify legal authorities when a minor has or appears to have been mistreated and it is impossible to evaluate the situation or the family refuses to cooperate. The Act also creates a free telephone service to respond at any time of the day to requests for information or advice on minors who are or appear to be mistreated and to convey to the presidents of local general councils information and recommendations about these minors. In addition, all physicians, medical and paramedical personnel, magistrates, teachers, and police are to receive initial and continuing training to allow them to respond to cases of mistreated children and take actions necessary to prevent mistreatment and protect children.

Outcomes and healthcare utilization in children and young adults with aplastic anemia: A multiinstitutional analysis.

PubMed

Gupta, Ashish; Fu, Pingfu; Hashem, Hasan; Vatsayan, Anant; Shein, Steven; Dalal, Jignesh

2017-12-01

Aplastic anemia is a bone marrow failure syndrome with high mortality affecting children and young adults. Although current treatment guidelines recommend hematopoietic stem cell transplant (HCT) for patients with matched sibling donors, outcomes with alternate donor options have been improving. We analyzed a validated multiinstitutional pediatric cohort using one of the largest pediatric and young adult database, the Pediatric Health Information System, for patients diagnosed with aplastic anemia (AA) from 2006 to 2015. Outcomes with upfront and salvage transplants were analyzed along with healthcare utilization. Among 2,169 patients in the study period, almost 20% underwent HCT, while others received immunosuppressive therapy. In a multivariate model, there was no significant difference in mortality with upfront or salvage transplants (odds ratio [OR] 1.24, 95% confidence interval [CI] 0.6-2.58, P = 0.567), while every platelet transfusion was associated with higher mortality (OR 1.37, 95% CI 1.12-1.67, P = 0.002). Healthcare utilization was significantly higher in salvage transplants requiring frequent hospitalization and transfusion requirements. Treatment mortality and graft failure rates were significantly reduced in the salvage transplant group in recent years (2011-2015 as compared to 2006-2010). As outcomes with HCT continue to improve in severe AA, transplant with good alternate donors should be considered upfront in children and young adults. © 2017 Wiley Periodicals, Inc.

Society of Behavioral Medicine (SBM) position statement: SBM urges Congress to preserve and extend funding for Medicaid services.

PubMed

Behrman, Pamela; Demirci, Jill; Yanez, Betina; Beharie, Nisha; Laroche, Helena

2018-05-08

In May 2017, the Trump administration proposed steep cuts to Medicaid funding. This proposal was met with bipartisan criticism, as this program provides vital healthcare coverage for vulnerable children, adults, and families, including those living below the federal poverty line. In addition to the proposed funding cuts, federally authorized state restrictions to Medicaid access (e.g., work requirements) have been proposed, putting the Medicaid coverage of scores of enrollees at risk. Overwhelming health costs from inadequate or absent insurance are found to contribute to financial problems, including bankruptcy. Financial strain, in turn, is related to serious and life-threatening health problems in both children and adults. Given these impacts, the Society of Behavioral Medicine (SBM) urges Congress to protect and extend Medicaid funding. To maintain subscriber access, SBM recommends that Congress continue to use percentage rather than block funding determinants and eliminate states' authority to enforce program qualification requirements, including work provisions and stipulations for locking out subscribers who do not pay their premiums on time. It is also recommended that Congress increase and improve the scope and quality of reporting Medicaid's evidence base. This could be achieved through regular evaluations, focusing on Medicaid's impact on the health and economic well-being of its participants. SBM further recommends efforts to increase the public's awareness of and participation in Medicaid for eligible individuals, children, and families.

Management of diarrhea in a DTU.

PubMed

Kamala, C S; Vishwanathakumar, H M; Shetti, P M; Anand, N

1996-10-01

A retrospective review of cases seen in the Diarrhea Treatment and Training Unit (DTU) of Bangalore (India) Medical College's Vani Vilas Children's Hospital during 1992-1994 confirmed the efficacy of the standard case management approach. This strategy entails oral rehydration therapy (ORT), continued feeding, and selective use of intravenous fluids and antibiotics. Of the 7966 children (4374 males and 3592 females) reporting to the DTU during the 2-year study period, only 2412 (30.5%) had received oral rehydration solution (ORS) or home-available fluids before admission. Acute watery diarrhea was present in 7316 cases (91.84%). Death occurred in 59 acute watery diarrhea cases, 6 dysentery cases, and 7 persistent diarrhea cases. The average time for cases managed in the ORT area was 2 hours and 45 minutes, while the hospital stay for admitted cases averaged 3 days. In 6957 cases (87.33%), ORS was sufficient treatment. Of the 1009 children (12.67%) who required intravenous fluids, 254 had dehydration attributable to conditions such as persistent vomiting and inability to drink due to oral thrush. Only the 512 children (6.2%) with cholera and dysentery received antibiotics. Of the 72 children who died (case fatality rate, 0.9%), 43 had associated severe malnutrition with pneumonia and anemia, 14 had a central nervous system infection, and 13 had septicemia; in only 2 cases could death be directly ascribed to diarrheal disease. One of these cases was due to shigella encephalopathy and the other to severe dehydration with acidosis. The average cost of treatment per patient was Rs 2.91 when only ORS was used compared with Rs 24.28 when intravenous rehydration was required. The finding that less than one-third of children had received ORS before admission suggests a need for the establishment of more DTUs in large hospitals that can train community-based health personnel in diarrhea case management.

Lessons Learned From a Pilot RCT of Simultaneous Versus Delayed Initiation of Continuous Glucose Monitoring in Children and Adolescents With Type 1 Diabetes Starting Insulin Pump Therapy

PubMed Central

Olivier, Patricia; Huot, Celine; Richardson, Christine; Nakhla, Meranda; Romain, Judette

2014-01-01

Uncertainty remains about effectiveness of continuous glucose monitoring (CGM) in pediatric type 1 diabetes (T1D). Success with CGM is related to CGM adherence, which may relate to readiness to make the behavior changes required for effective use. We hypothesize that readiness for change will be greater at initiation of insulin pump therapy than in established pump users, and that this will predict CGM adherence. Our objective was to evaluate the feasibility of a randomized controlled trial (RCT) in children with established T1D comparing simultaneous pump and CGM initiation to standard pump therapy with delayed CGM initiation. We randomized participants to simultaneous pump and CGM initiation or to standard pump therapy with the option of adding CGM 4 months later. CGM adherence was tracked via web-based download and readiness for change assessed with the SOCRATES questionnaire. Of 41 eligible children, 20 agreed to participate; 15 subjects completed the study (7 males; baseline age 11.8 ± 4.0 years; T1D duration 2.7 ± 2.7 years; mean A1C 8.2 ± 0.8%). Six of 8 simultaneous group subjects used CGM > 60% of the time for 4 months compared to 1 of 7 delayed group subjects (P = .02). Using SOCRATES, we could assign 87-100% of subjects to a single motivation stage at baseline and 4 months. This pilot study demonstrates the feasibility of randomizing pump naïve children and adolescents with established T1D to simultaneous pump and CGM initiation versus standard pump therapy with delayed CGM initiation. Lessons from this pilot study were used to inform development of a full-scale multicenter RCT. PMID:24876616

Improved access and quality of care after enrollment in the New York State Children's Health Insurance Program (SCHIP).

PubMed

Szilagyi, Peter G; Dick, Andrew W; Klein, Jonathan D; Shone, Laura P; Zwanziger, Jack; McInerny, Thomas

2004-05-01

Although many studies have noted that uninsured children have poorer access and quality of health care than do insured children, few studies have been able to demonstrate the direct benefits of providing health insurance to previously uninsured children. The State Children's Health Insurance Program (SCHIP), enacted as Title XXI of the Social Security Act, was intended to improve insurance coverage and access to health care for low-income, uninsured children. With limited state and federal resources for health care, continued funding of SCHIP requires demonstration of success of the program. As yet, little is known about the effectiveness of SCHIP on improving access and quality of care to enrollees. To measure the impact of the New York State (NYS) SCHIP on access, utilization, and quality of health services for enrolled children. NYS, stratified into 4 regions. The NYS SCHIP is modeled on commercial insurance (32 managed care plans) and at the time of the study had 18% of SCHIP enrollees nationwide. For the study group, the design used pre/poststudy telephone interviews of parents of children enrolling in the NYS SCHIP, with baseline interviews soon after enrollment and follow-up interviews 1 year after enrollment. Baseline interviews reflected the child's experience during the 1-year period before enrollment in SCHIP. The follow-up interviews reflected the 1-year period after enrollment in SCHIP. For the comparison group, the design used baseline interviews of a comparison group enrolled 1 year after the study group to test for secular trends; these interviews reflected the 1-year period before enrollment in SCHIP. Children (n = 2644) 0 to 18 years of age who enrolled in the NYS SCHIP for the first time (November 2000 to March 2001), stratified by age (0-5, 6-11, and 12-18 years), race/ethnicity (white non-Hispanic, black non-Hispanic, and Hispanic; others excluded), and region of NYS. The comparison group consisted of 400 children. Telephone interviews were conducted in English or Spanish throughout the day and evening, 7 days per week, to obtain measures. Demographic and health measures (child and family characteristics, health status, presence of a special health care need, and prior health insurance), access (usual source of care [USC] and unmet needs for health care), utilization (visits for specific health services), and quality (continuity with USC and measures of primary care interactions). Analyses included bivariate tests, comparing the pre-SCHIP period to the 1-year period after enrollment in SCHIP. Multivariate models were computed to generate standardized populations comprised of key characteristics of the sample to test for differences in measures (after SCHIP versus before SCHIP), controlling for demographic characteristics. Of the 2644 study-group children who completed the initial interview, 2290 (87%) completed the follow-up interview. Key measures for the pre-SCHIP period and short-term "postenrollment" measures for the study group were not statistically different from measures for the comparison group, suggesting no major secular trends. Participants were non-Hispanic white (25%), non-Hispanic black (31%), and Hispanic (45%). Fifty-one percent of the parents were single, and 61% had a high school education or less; 81% of families had income <160% of the federal poverty level. Sixty-two percent of the children were uninsured > or = 12 months before the NYS SCHIP; of those insured, 43% previously had Medicaid. The proportion of children who had a USC increased after enrollment in the NYS SCHIP (86% to 97%). Two measures of accessibility (difficulty getting a medical person by telephone and difficulty getting an appointment) improved after enrollment in SCHIP. The proportion of children with any unmet health care needs decreased (31% to 19%). Specific types of unmet need also were reduced after enrollment; for example, among SCHIP enrollees who had a need for specific type of care, unmet needs wds were significantly lower postenrollment versus pre-SCHIP for specialty care (-15.5% in unmet need), acute care (-10.1%), preventive care (-9.6%), dental care (-13.0%%), and vision care (-13.2%). Emergency and total ambulatory visits did not change, but the proportion of children with a preventive care visit increased (74% to 82%). The proportion of children who used their USC for most or all visits increased (47% to 89%), demonstrating increased continuity of care. Several indicators of health care quality improved, including an overall rating of quality, the 4 indicators of physician-patient interaction used by the Consumer Assessment of Health Plans Survey, and a measure of parental worry about their child's health. Improvements were noted among major subgroups of children, with the greatest improvements for those with the lowest baseline levels. For example, at baseline, a lower percentage of children living at <160% of the federal poverty level had a presence of a USC or continuity with their USC than children living in families at >160% of the federal poverty level, and these poorer children experienced the greatest gains in having a USC or having continuity with their USC after enrollment in SCHIP. Enrollment in the NYS SCHIP was associated with 1) improved access, continuity, and quality of care and 2) a change in the pattern of health care, with a greater proportion of care taking place within the usual source of primary care.

Management of preschool recurrent wheezing and asthma: a phenotype-based approach.

PubMed

Beigelman, Avraham; Bacharier, Leonard B

2017-04-01

The purpose of this review is to summarize the recent evidence on the management of preschool children with wheezing and asthma, and to propose a phenotype-based approach to the management of these children. Recent studies have begun to identify populations of preschool children that are likely to benefit from inhaled corticosteroids (ICS) therapy and defined ICS regimens: daily ICS in preschool children with persistent asthma, and pre-emptive high-dose intermittent ICS among preschool children with intermittent disease reduce the risk of exacerbation. In addition, among preschool children with mild persistent asthma, the presence of aeroallergen sensitivity and/or blood eosinophil counts of 300/μL or greater are predictors of good response to daily ICS therapy. Other studies identified intermittent azithromycin as a therapy to prevent, and potentially to treat, acute exacerbations.The uncertainty of the role of oral corticosteroids (OCS) as a therapy for acute exacerbations continues, as a recent meta-analysis showed that OCS did not prevent hospitalizations or urgent visits, and did not reduce the need for additional courses of OCS. Whereas previous epidemiologic studies suggested acetaminophen may increase risk of exacerbations, a clinical trial clearly demonstrated acetaminophen use, compared to ibuprofen use,does not increase exacerbation risk among preschool children with mild-persistent asthma. Recent studies have shown potential for phenotypic-driven therapies for the management of preschool children with asthma. Targeting airway bacteria has emerged as a promising therapeutic approach, but its effect on antibiotic resistance still needs to be investigated. Finally, more studies are required to evaluate if oral corticosteroids provide any benefits for acute episodic wheeze.

Predictive Validity of a Continuous Alternative to Nominal Subtypes of Attention-Deficit Hyperactivity Disorder for DSM-V

PubMed Central

Lahey, Benjamin B.; Willcutt, Erik G.

2010-01-01

Three subtypes of attention-deficit/hyperactivity disorder (ADHD) based on numbers of symptoms of inattention (I) and hyperactivity-impulsivity (HI) were defined in DSM-IV to reduce heterogeneity of the disorder, but the subtypes proved to be highly unstable over time. A continuous alternative to nominal subtyping is evaluated in a longitudinal study of 129 4–6 year old children with ADHD and 130 comparison children. Children who met criteria for all subtypes in year 1 continued to exhibit greater functional impairment than comparison children during years 2–9. Among children with ADHD in year 1, I and HI symptoms differentially predicted teacher-rated need for treatment and reading and mathematics achievement scores over the next 8 years in controlled analyses. Consistent with other studies, these findings suggest that the use of diagnostic modifiers specifying the numbers of I and HI symptoms could reduce heterogeneity and facilitate clinical intervention, prognosis, and research. PMID:21058124

Predictive validity of a continuous alternative to nominal subtypes of attention-deficit/hyperactivity disorder for DSM-V.

PubMed

Lahey, Benjamin B; Willcutt, Erik G

2010-01-01

Three subtypes of attention-deficit/hyperactivity disorder (ADHD) based on numbers of symptoms of inattention (I) and hyperactivity-impulsivity (HI) were defined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) to reduce heterogeneity of the disorder, but the subtypes proved to be highly unstable over time. A continuous alternative to nominal subtyping is evaluated in a longitudinal study of 129 four- to six-year-old children with ADHD and 130 comparison children. Children who met criteria for all subtypes in Year 1 continued to exhibit greater functional impairment than comparison children during Years 2 to 9. Among children with ADHD in Year 1, I and HI symptoms differentially predicted teacher-rated need for treatment and reading and mathematics achievement scores over the next 8 years in controlled analyses. Consistent with other studies, these findings suggest that the use of diagnostic modifiers specifying the numbers of I and HI symptoms could reduce heterogeneity and facilitate clinical intervention, prognosis, and research.

PROTECTING CHILDREN FROM ENVIRONMENTAL THREATS - A CONTINUING EDUCATION PROGRAM FOR NURSES OF THE AMERICAN NURSES FOUNDATION/ASSOCIATION

EPA Science Inventory

The American Nurses Association/Foundation will develop online, in print and pre conference continuing education (CE) children's environmental health protection programs to meet the objective of the program. The first CE program is on school environments, the second on home and ...

Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services.

PubMed

Bernard, Kristin; Butzin-Dozier, Zachary; Rittenhouse, Joseph; Dozier, Mary

2010-05-01

To examine differences in waking to bedtime cortisol production between children who remained with birth parents vs children placed in foster care following involvement of Child Protective Services (CPS). Between-subject comparison of cortisol patterns among 2 groups of children. Children referred from the child welfare system. Three hundred thirty-nine children aged 2.9 to 31.4 months who were living with birth parents (n = 155) or placed in foster care (n = 184) following CPS involvement as well as 96 unmatched children from low-risk environments. Main Exposures Involvement by CPS and foster care. Main Outcome Measure Salivary cortisol samples obtained at waking and bedtime for children on 2 days. Child Protective Services-involved children who continued to live with birth parents and CPS-involved children placed in foster care differed in cortisol production, with children living with their birth parents showing flatter slopes in waking to bedtime values. Continuing to live with birth parents following involvement of CPS is associated with greater perturbation to the diurnal pattern of cortisol production than living with foster parents. Foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment.

Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics

PubMed Central

Battelino, Tadej; Danne, Thomas; Hovorka, Roman; Jarosz‐Chobot, Przemyslawa; Renard, Eric

2015-01-01

Summary The level of glycaemic control necessary to achieve optimal short‐term and long‐term outcomes in subjects with type 1 diabetes mellitus (T1DM) typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion. For continuous subcutaneous insulin infusion, the insulins of choice are the rapid‐acting insulin analogues, insulin aspart, insulin lispro and insulin glulisine. The advantages of continuous subcutaneous insulin infusion over multiple daily injections in adult and paediatric populations with T1DM include superior glycaemic control, lower insulin requirements and better health‐related quality of life/patient satisfaction. An association between continuous subcutaneous insulin infusion and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of continuous subcutaneous insulin infusion is widely recommended in both adult and paediatric T1DM populations but is limited in pregnant patients and those with type 2 diabetes mellitus. All available rapid‐acting insulin analogues are approved for use in adult, paediatric and pregnant populations. However, minimum patient age varies (insulin lispro: no minimum; insulin aspart: ≥2 years; insulin glulisine: ≥6 years) and experience in pregnancy ranges from extensive (insulin aspart, insulin lispro) to limited (insulin glulisine). Although more expensive than multiple daily injections, continuous subcutaneous insulin infusion is cost‐effective in selected patient groups. This comprehensive review focuses on the European situation and summarises evidence for the efficacy and safety of continuous subcutaneous insulin infusion, particularly when used with rapid‐acting insulin analogues, in adult, paediatric and pregnant populations. The review also discusses relevant European guidelines; reviews issues that surround use of this technology; summarises the effects of continuous subcutaneous insulin infusion on patients' health‐related quality of life; reviews relevant pharmacoeconomic data; and discusses recent advances in pump technology, including the development of closed‐loop ‘artificial pancreas’ systems. © 2015 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd. PMID:25865292

Robot-aided developmental assessment of wrist proprioception in children.

PubMed

Marini, Francesca; Squeri, Valentina; Morasso, Pietro; Campus, Claudio; Konczak, Jürgen; Masia, Lorenzo

2017-01-09

Several neurodevelopmental disorders and brain injuries in children have been associated with proprioceptive dysfunction that will negatively affect their movement. Unfortunately, there is lack of reliable and objective clinical examination protocols and our current knowledge of how proprioception evolves in typically developing children is still sparse. Using a robotic exoskeleton, we investigated proprioceptive acuity of the wrist in a group of 49 typically developing healthy children (8-15 years), and a group of 40 young adults. Without vision participants performed an ipsilateral wrist joint position matching task that required them to reproduce (match) a previously experienced target position. All three joint degrees-of-freedom of the wrist/hand complex were assessed. Accuracy and precision were evaluated as a measure of proprioceptive acuity. The cross-sectional data indicating the time course of development of acuity were then fitted by four models in order to determine which function best describes developmental changes in proprioception across age. First, the robot-aided assessment proved to be an easy to administer method for objectively measuring proprioceptive acuity in both children and adult populations. Second, proprioceptive acuity continued to develop throughout middle childhood and early adolescence, improving by more than 50% with respect to the youngest group. Adult levels of performance were reached approximately by the age of 12 years. An inverse-root function best described the development of proprioceptive acuity across the age groups. Third, wrist/forearm proprioception is anisotropic across the three DoFs with the Abduction/Adduction exhibiting a higher level of acuity than those of Flexion/extension and Pronation/Supination. This anisotropy did not change across development. Proprioceptive development for the wrist continues well into early adolescence. Our normative data obtained trough this novel robot-aided assessment method provide a basis against which proprioceptive function of pediatric population can be compared. This may aid the design of more effective sensorimotor intervention programs.

47 CFR 76.1703 - Commercial records on children's programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Commercial records on children's programs. 76.1703 Section 76.1703 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO....1703 Commercial records on children's programs. Cable operators airing children's programming must...

Risk Factors in Divorce: Perceptions by the Children Involved.

ERIC Educational Resources Information Center

Moxnes, Kari

2003-01-01

Draws on children's divorce stories to examine how children cope with their parents' divorce. Focuses on how children experienced risk for divorce and the changes and continuities enduring during the divorce process. Argues that even if divorce is stressful and causes loss of capital for most children, what is crucial for children's well-being is…

Effects of Latino children on their mothers' dietary intake and dietary behaviors: The role of children's acculturation and the mother-child acculturation gap.

PubMed

Soto, Sandra H; Arredondo, Elva M; Marcus, Bess; Shakya, Holly B; Roesch, Scott; Ayala, Guadalupe X

2017-10-01

Research shows that acculturation is important to Latinas' dietary intake and related behaviors. Although evidence suggests children may also play a role, it remains unclear whether children's acculturation is related to mothers' dietary intake/behaviors. We examined the relationship between Latino children's acculturation and mothers' dietary intake/behaviors. We also examined the mother-child acculturation gap to identify dyad characteristics associated with mothers' diet. Baseline surveys were collected in 2010 from 314 Latino mother-child (7-13 years old) dyads of Mexican-origin enrolled in a family-based dietary intervention in Southern California, USA. Mother's daily intake of fruits, vegetables, and sugary beverages, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were assessed via self-report. Mothers' and children's bidimensional acculturation were examined using acculturation groups (e.g., assimilated, bicultural) derived from Hispanic and non-Hispanic dimensions of language. We also assessed the acculturation gap between mothers and children with the a) difference in acculturation between mothers' and children's continuous acculturation scores and b) mother-child acculturation gap typologies (e.g., traditional mothers of assimilated children). Findings show that having an assimilated versus a bicultural child was negatively associated with mothers' vegetable intake and positively associated with mothers' sugary beverage intake, percent of calories from fat, and frequency of away-from-home eating, regardless of mothers' acculturation. Traditional mothers of assimilated children reported more sugary beverage intake, calories from fat, and more frequent away-from-home eating than traditional mothers of bicultural children. Results suggest that children's acculturation is associated with their mothers' dietary intake/behaviors and traditional mothers of assimilated children require more attention in future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Feeding practices for infants and young children during and after common illness. Evidence from South Asia

PubMed Central

Aguayo, Víctor M.

2016-01-01

Abstract Global evidence shows that children's growth deteriorates rapidly during/after illness if foods and feeding practices do not meet the additional nutrient requirements associated with illness/convalescence. To inform policies and programmes, we conducted a review of the literature published from 1990 to 2014 to document how children 0–23 months old are fed during/after common childhood illnesses. The review indicates that infant and young child feeding (IYCF) during common childhood illnesses is far from optimal. When sick, most children continue to be breastfed, but few are breastfed more frequently, as recommended. Restriction/withdrawal of complementary foods during illness is frequent because of children's anorexia (perceived/real), poor awareness of caregivers' about the feeding needs of sick children, traditional beliefs/behaviours and/or suboptimal counselling and support by health workers. As a result, many children are fed lower quantities of complementary foods and/or are fed less frequently when they are sick. Mothers/caregivers often turn to family/community elders and traditional/non‐qualified practitioners to seek advice on how to feed their sick children. Thus, traditional beliefs and behaviours guide the use of ‘special’ feeding practices, foods and diets for sick children. A significant proportion of mothers/caregivers turn to the primary health care system for support but receive little or no advice. Building the knowledge, skills and capacity of community health workers and primary health care practitioners to provide mothers/caregivers with accurate and timely information, counselling and support on IYCF during and after common childhood illnesses, combined with large‐scale communication programmes to address traditional beliefs and norms that may be harmful, is an urgent priority to reduce the high burden of child stunting in South Asia. PMID:26840205

A child's house: social memory, identity, and the construction of childhood in early postclassic Mexican households.

PubMed

De Lucia, Kristin

2010-01-01

Despite the recent attention given to the archaeology of childhood, households continue to be treated by archaeologists as the product of adult behavior and activities. Yet children shaped the decisions and motivations of adults and influenced the structure and organization of daily activities and household space. Further, children's material culture serves to both create and disrupt social norms and daily life, making children essential to understanding broader mechanisms of change and continuity. Thus, archaeologists should reconceptualize houses as places of children. This research brings together multiple lines of evidence from the Early Postclassic site of Xaltocan, Mexico, including ethnohistory, burials, and figurines to reconstruct the social roles and identities of children and to problematize our understanding of households. I argue that thinking of houses as places of children enables us to see that children were essential to daily practice, the construction and transmission of social identity, and household economic success.

Understanding the health care utilization of children who require medical technology: A descriptive study of children who require tracheostomies.

PubMed

Spratling, Regena

2017-04-01

Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology. A retrospective electronic health record (EHR) review was completed on the EHR records on 171 children who require medical technology, specifically tracheostomies, at an outpatient technology dependent pulmonary clinic over a three year period (January 2010-December 2012). Descriptive statistics were used to analyze sociodemographic and clinical characteristics, including medical diagnoses, and emergency department (ED) visits and hospitalizations. Of the 171 children requiring medical technology studied, there were numerous medical diagnoses (n=791), 99% had chronic illnesses affecting two or more body systems, and 88% required two or more technologies, including a tracheostomy and a feeding tube. In addition, 91% of the children had at least one ED visit or hospitalization and were treated in the ED approximately three times over the three year period. The findings from this study noted an increased utilization of health care by these children, and identified common symptoms and medical technologies for which caregivers may need interventions, focusing on education in managing symptoms and medical technology prior to presentation to the ED or hospital. Copyright © 2017 Elsevier Inc. All rights reserved.

Health disparities in chickenpox or shingles in Alberta?

PubMed

Russell, M L; Schopflocher, D P; Svenson, L W

2008-01-01

Exploring for evidence of socio-economic health disparities in chickenpox and shingles in Alberta, Canada. Chickenpox and shingles cases were identified from administrative data from Alberta's universal health care insurance system for 1994-2002. Incident cases were those with the earliest dated utilization of a health service (chickenpox: ICD9-CM 052/ICD10-CA B01; shingles: ICD9-CM 053/ ICD10-CA B02). Crude and age-specific rates were estimated for each year by an indicator of socio-demographic status based upon the nature of the payer and eligibility for health care premium subsidy (SES-proxy) for the provincial health care insurance system. Among young children there is a gradient of disparity in chickenpox rates prior to the year in which publicly funded vaccination programs were implemented. After this point, disparities decline but less so for First Nations children than for others. There was no evidence of disparity by SES-proxy for shingles. Publicly funded vaccination programs may effectively contribute to reduction in disease disparities for vaccine-preventable diseases. Further study is required to ascertain why disparities continue for First Nations children.

How getting noticed helps getting on: successful attention capture doubles children's cooperative play

PubMed Central

Yuill, Nicola; Hinske, Steve; Williams, Sophie E.; Leith, Georgia

2014-01-01

Cooperative social interaction is a complex skill that involves maintaining shared attention and continually negotiating a common frame of reference. Privileged in human evolution, cooperation provides support for the development of social-cognitive skills. We hypothesize that providing audio support for capturing playmates' attention will increase cooperative play in groups of young children. Attention capture was manipulated via an audio-augmented toy to boost children's attention bids. Study 1 (48 6- to 11-year-olds) showed that the augmented toy yielded significantly more cooperative play in triads compared to the same toy without augmentation. In Study 2 (33 7- to 9-year-olds) the augmented toy supported greater success of attention bids, which were associated with longer cooperative play, associated in turn with better group narratives. The results show how cooperation requires moment-by-moment coordination of attention and how we can manipulate environments to reveal and support mechanisms of social interaction. Our findings have implications for understanding the role of joint attention in the development of cooperative action and shared understanding. PMID:24904453

Risk factors associated with typhoid fever in children aged 2-16 years in Karachi, Pakistan.

PubMed

Khan, M I; Ochiai, R L; Soofi, S B; Von-Seidlein, L; Khan, M J; Sahito, S M; Habib, M A; Puri, M K; Park, J K; You, Y A; Ali, M; Nizami, S Q; Acosta, C J; Bradley-Sack, R; Clemens, J D; Bhutta, Z A

2012-04-01

We analysed the data from the control group in a typhoid vaccine trial in Karachi to assess the differences in individual-, household- and cluster-level characteristics for developing typhoid fever. The annual incidence of typhoid in children aged 2-16 years in the control arm of the vaccine trial was 151/100 000 population. After adjustment, the risk of typhoid was lower with increasing age [risk ratio (RR) 0·89, 95% confidence interval (CI) 0·83-0·95], was higher with an increase in population density (RR 1·13, 95% CI 1·05-1·21) and was lower in the households using a safe drinking-water source (RR 0·63, 95% CI 0·41-0·99). Typhoid fever affects younger children living in areas of high population density and lack of access to safe water in Pakistan. A combination of environmental and biological interventions is required to prevent the continued epidemiological and economic impact of typhoid fever in high-risk areas of Pakistan.

The sound of barking dogs: violence and terror among Salvadoran families in the postwar.

PubMed

Dickson-Gómez, Julia

2002-12-01

This article examines the transgenerational transmission of trauma among campensino living in a rural, repopulated community in El Salvador. Research with Holocaust survivors and their children has shown that traumatic symptoms can be transmitted to children who did not directly experience the Holocaust. The mechanisms by which this transgenerational transmission occurs have not been fully explored and require an expansion of medical and anthropological conceptualizations of posttraumatic illness. Through their reactions to and interpretations of everyday events, campesino parents who lived in the guerrilla camps explicitly transmit trauma to children who did not experience the recent civil war. Illness narratives by sufferers of nervios transmit trauma and point to the basic immorality of the war, an immorality that continues today. In addition, the symptoms of nervios constitute a mechanism by which trauma is implicitly transmitted. Symptoms of nervios point to what generally is not and, indeed, cannot be voiced: the destruction of primary relationships in the family and unresolved grief and helplessness, which, through the responses of family members to the sufferer, are reproduced and reenacted in the present family context.

Speed-accuracy trade-off in a trajectory-constrained self-feeding task: a quantitative index of unsuppressed motor noise in children with dystonia

PubMed Central

Lunardini, Francesca; Bertucco, Matteo; Casellato, Claudia; Bhanpuri, Nasir; Pedrocchi, Alessandra; Sanger, Terence D.

2015-01-01

Motor speed and accuracy are both affected in childhood dystonia. Thus, deriving a speed-accuracy function is an important metric for assessing motor impairments in dystonia. Previous work in dystonia studied the speed-accuracy trade-off during point-to-point tasks. To achieve a more relevant measurement of functional abilities in dystonia, the present study investigates upper-limb kinematics and electromyographic activity of 8 children with dystonia and 8 healthy children during a trajectory-constrained child-relevant task that emulates self-feeding with a spoon and requires continuous monitoring of accuracy. The speed-accuracy trade-off is examined by changing the spoon size to create different accuracy demands. Results demonstrate that the trajectory-constrained speed-accuracy relation is present in both groups, but it is altered in dystonia in terms of increased slope and offset towards longer movement times. Findings are consistent with the hypothesis of increased signal-dependent noise in dystonia, which may partially explain the slow and variable movements observed in dystonia. PMID:25895910

Speed-Accuracy Trade-Off in a Trajectory-Constrained Self-Feeding Task: A Quantitative Index of Unsuppressed Motor Noise in Children With Dystonia.

PubMed

Lunardini, Francesca; Bertucco, Matteo; Casellato, Claudia; Bhanpuri, Nasir; Pedrocchi, Alessandra; Sanger, Terence D

2015-10-01

Motor speed and accuracy are both affected in childhood dystonia. Thus, deriving a speed-accuracy function is an important metric for assessing motor impairments in dystonia. Previous work in dystonia studied the speed-accuracy trade-off during point-to-point tasks. To achieve a more relevant measurement of functional abilities in dystonia, the present study investigates upper-limb kinematics and electromyographic activity of 8 children with dystonia and 8 healthy children during a trajectory-constrained child-relevant task that emulates self-feeding with a spoon and requires continuous monitoring of accuracy. The speed-accuracy trade-off is examined by changing the spoon size to create different accuracy demands. Results demonstrate that the trajectory-constrained speed-accuracy relation is present in both groups, but it is altered in dystonia in terms of increased slope and offset toward longer movement times. Findings are consistent with the hypothesis of increased signal-dependent noise in dystonia, which may partially explain the slow and variable movements observed in dystonia. © The Author(s) 2015.

Obesity prevention in children.

PubMed

Moreno, Luis A; Bel-Serrat, Silvia; Santaliestra-Pasías, Alba M; Rodríguez, Gerardo

2013-01-01

The prevalence of childhood overweight and obesity continues to be unacceptably high and of public health concern in Europe. During childhood and adolescence, environmental factors are the main drivers of obesity development. Obesity is caused by a chronic energy imbalance involving both dietary intake and physical activity patterns. Several risk factors are influencing obesity development, even starting in the prenatal period. From birth, along life, mainly diet and physical activity/inactivity are the most important drivers on top of genetic susceptibility. The first years of life can therefore be crucial to start preventive interventions that can have an impact on lifestyle and on later overweight and obesity. Schools are an attractive and popular setting for implementing interventions for children. Interventions including a community component are considered to be the most effective. Obesity control will require policy interventions to improve the environments that promote poor dietary intake and physical inactivity rather than individually focused interventions. More solid institutional and health policies are needed together with more effective interventions to obtain evident changes for the prevention of excess adiposity among children. Copyright © 2013 S. Karger AG, Basel.

Sports-related Concussion in Children and Adolescents.

PubMed

Refakis, Christian A; Turner, Christian D; Cahill, Patrick J

2017-06-01

Concussions are becoming increasingly important to manage properly as sports participation continues to rise. Repeated injuries occurring before the brain has had a chance to recover from an initial insult are particularly dangerous and must be prevented. Although much national media attention has been devoted to concussions in professional sports, it is important to appreciate that athletes in any age group, children and adolescents in particular, are at risk of sports-related concussion. It is crucial to remove an athlete from play any time concussion is suspected. Once removed from play, recovery then begins with a period of cognitive and physical rest, followed by a gradual return to cognitive and athletic activities as symptoms resolve. Children and adolescents pose a unique challenge to the clinician managing their recovery, as the physical and cognitive rest periods required often involve time away from school and sports, which can be academically detrimental and socially isolating. Recently developed sideline assessment tools have greatly aided the urgent sideline assessment of an athlete suspected of having a concussion. In this article, a brief review of current guidelines is presented in tandem with the authors' preferred treatment of concussion.

Danger in the Classroom: The Continuing Problem of Asbestos in the Public Schools.

ERIC Educational Resources Information Center

Lang, Robert D.

Asbestos in school buildings continues to threaten the future health of children. Because of prolonged exposure while their metabolism and activity levels are relatively high and their cellular development is relatively rapid, children and adolescents have a lifetime risk of developing asbestos-related diseases--such as asbestosis, mesothelioma,…

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…

A Continuing Education Program on Attention Deficit/Hyperactivity Disorder.

ERIC Educational Resources Information Center

Reeve, Ron; And Others

This manual and accompanying videotape are intended to be used as a continuing education program to enhance the skills of special and general educators in serving children with attention deficit hyperactivity disorder (ADHD). The video can also be used alone to provide a general overview of issues related to children with attention deficit…

ACCOUNTING FOR THE ENDOGENEITY OF HEALTH AND ENVIRONMENTAL TOBACCO SMOKE EXPOSURE IN CHILDREN: AN APPLICATION TO CONTINUOUS LUNG FUNCTION

EPA Science Inventory

The goal of this study is to estimate an unbiased exposure effect of environmental tobacco smoke (ETS) exposure on children's continuous lung function. A majority of the evidence from health studies suggests that ETS exposure in early life contributes significantly to childhood ...

5 CFR 894.307 - Are disabled children age 22 or over eligible as family members?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Are disabled children age 22 or over eligible as family members? 894.307 Section 894.307 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

5 CFR 894.307 - Are disabled children age 22 or over eligible as family members?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Are disabled children age 22 or over eligible as family members? 894.307 Section 894.307 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

Between-Word Simplification Patterns in the Continuous Speech of Children with Speech Sound Disorders

ERIC Educational Resources Information Center

Klein, Harriet B.; Liu-Shea, May

2009-01-01

Purpose: This study was designed to identify and describe between-word simplification patterns in the continuous speech of children with speech sound disorders. It was hypothesized that word combinations would reveal phonological changes that were unobserved with single words, possibly accounting for discrepancies between the intelligibility of…

Transition from Long Day Care to Kindergarten: Continuity or Not?

ERIC Educational Resources Information Center

Barblett, Lennie; Barratt-Pugh, Caroline; Kilgallon, Pam; Maloney, Carmel

2011-01-01

Transition practices that ensure continuity between early childhood settings have been shown to be important in assisting children's short-term and long-term growth and development (Vogler, Cravello & Woodhead, 2008). In Western Australia many young children move from and between long day care (LDC) settings to kindergarten. In that state,…

Auditory Assessment of Children from a Psychologist's Point of View.

ERIC Educational Resources Information Center

Mira, Mary P.

Behavioral studies of listening in children with both normal and exceptional hearing are presented. The conjugate of assessing listening is discussed. This method provides a continuous record of ongoing behavior allowing for observation of moment-to-moment changes in listening. It determines how sustained, how strong, and how continuous a child's…

Children's Program Outcome Review Team: 2001 Evaluation Results.

ERIC Educational Resources Information Center

Wade, Patricia C.

In its eighth year of evaluating children's services in the state, the Children's Program Outcome Review Team (CPORT), under the direction of the Tennessee Commission on Children and Youth, continued to collect and analyze data to improve service delivery to children and families involved in state custody. Using the Quality Service Review…

Trafficking of children in Albania: patterns of recruitment and reintegration.

PubMed

Gjermeni, Eglantina; Van Hook, Mary P; Gjipali, Saemira; Xhillari, Lindita; Lungu, Fatjon; Hazizi, Anila

2008-10-01

Many children in Albania and other countries of Eastern Europe are being trafficked as part of the global business of human trafficking. The study sought to identify the patterns of child trafficking involving Albanian children, and especially children's views of the role of family issues and the nature of the trafficking experience. The study included verbally administered questionnaires, semi-structured interviews, focus groups, and use of already existing reports. Study participants included 61 children who had escaped from trafficking, 22 children from similar at-risk groups who had not been trafficked, 15 parents of currently or previously trafficked children, 10 parents from similar groups whose children had not been trafficked, and 8 key informants. Children at greatest risk of trafficking had very limited education and frequently were working on the streets. Their families were poor with many interpersonal problems, including violence. They typically belonged to the Gypsy community. Trusted community members usually recruited the children by promising that the children would work to help the family financially. Once abroad, the children were harshly treated, forced to work long hours, physically abused, and isolated from family members. Families did not receive the promised payment. Once returned, children had a difficult time reentering due to family, educational, and economic issues. Contextual issues supporting child trafficking in Albania include poverty, major internal and external migrations, discrimination, and problems in the legal system. Poverty combined with family problems and membership in the marginalized Gypsy group places children at increased risk of trafficking into harsh labor conditions. The study of Albanian children who were trafficked suggests that dealing with trafficking of children requires addressing family problems and complex social issues that perpetuate poverty as well as the legal and social structures that place children at risk and continue to marginalize certain communities. As a result, changes in social policies that protect victims and punish traffickers and the development of programs that facilitate integration and promote the economic and interpersonal welfare of families whose children are at-risk have been established in Albania.

Cognitive Improvement of Attention and Inhibition in the Late Afternoon in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Treated With Osmotic-Release Oral System Methylphenidate.

PubMed

Slama, Hichem; Fery, Patrick; Verheulpen, Denis; Vanzeveren, Nathalie; Van Bogaert, Patrick

2015-07-01

Long-acting medications have been developed and approved for use in the treatment of attention-deficit hyperactivity disorder (ADHD). These compounds are intended to optimize and maintain symptoms control throughout the day. We tested prolonged effects of osmotic-release oral system methylphenidate on both attention and inhibition, in the late afternoon. A double-blind, randomized, placebo-controlled study was conducted in 36 boys (7-12 years) with ADHD and 40 typically developing children. The ADHD children received an individualized dose of placebo or osmotic-release oral system methylphenidate. They were tested about 8 hours after taking with 2 continuous performance tests (continuous performance test-X [CPT-X] and continuous performance test-AX [CPT-AX]) and a counting Stroop. A positive effect of osmotic-release oral system methylphenidate was present in CPT-AX with faster and less variable reaction times under osmotic-release oral system methylphenidate than under placebo, and no difference with typically developing children. In the counting Stroop, we found a decreased interference with osmotic-release oral system methylphenidate but no difference between children with ADHD under placebo and typically developing children. © The Author(s) 2014.

Identifying High Ability Children with DSM-5 Autism Spectrum or Social Communication Disorder: Performance on Autism Diagnostic Instruments.

PubMed

Foley-Nicpon, Megan; L Fosenburg, Staci; G Wurster, Kristin; Assouline, Susan G

2017-02-01

This study was a replication of Mazefsky et al.'s (Journal of Autism and Developmental Disabilities 43:1236-1242, 2013) investigation among a sample of 45 high ability children and adolescents diagnosed with ASD under DSM-IV-TR. Items from the ADOS and ADI-R were mapped onto DSM-5 diagnostic criteria for ASD and SCD to determine whether participants would meet either diagnosis under DSM-5. If the ADOS were administered alone, 62% of individuals diagnosed with ASD would no longer meet criteria under DSM-5; however, when the ADI-R and ADOS scores were combined, 100% of individuals would continue to meet ASD diagnosis. The ADOS was determined to be an insufficient measure for SCD due to the small number of algorithm items measuring SCD diagnostic criteria, suggesting the development of SCD measures is required.

Tracheostomy and mechanical ventilation weaning in children affected by respiratory virus according to a weaning protocol in a pediatric intensive care unit in Argentina: an observational restrospective trial

PubMed Central

2011-01-01

We describe difficult weaning after prolonged mechanical ventilation in three tracheostomized children affected by respiratory virus infection. Although the spontaneous breathing trials were successful, the patients failed all extubations. Therefore a tracheostomy was performed and the weaning plan was begun. The strategy for weaning was the decrease of ventilation support combining pressure control ventilation (PCV) with increasing periods of continuous positive airway pressure + pressure support ventilation (CPAP + PSV) and then CPAP + PSV with increasing intervals of T-piece. They presented acute respiratory distress syndrome on admission with high requirements of mechanical ventilation (MV). Intervening factors in the capabilities and loads of the respiratory system were considered and optimized. The average MV time was 69 days and weaning time 31 days. We report satisfactory results within the context of a directed weaning protocol. PMID:21244710

Congenital Hypoglycemia Disorders: New Aspects of Etiology, Diagnosis, Treatment and Outcomes: Highlights of the Proceedings of the Congenital Hypoglycemia Disorders Symposium, Philadelphia April 2016.

PubMed

De Leon, Diva D; Stanley, Charles A

2017-02-01

Hypoglycemia continues to be an important cause of morbidity in neonates and children. Prompt diagnosis and management of the underlying hypoglycemia disorder is critical for preventing brain damage and improving outcomes. Congenital hyperinsulinism (HI) is the most common and severe cause of persistent hypoglycemia in neonates and children. Recent discoveries of the genetic causes of HI have improved our understanding of the pathophysiology, but its management is complex and requires the integration of clinical, biochemical, molecular, and imaging findings to establish the appropriate treatment according to the subtype. Here we present a summary of a recent international symposium on congenital hypoglycemia disorders with emphasis on novel molecular mechanisms resulting in HI, genetic diagnosis, overall approach to management, novel therapies under development, and current outcomes. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Current and emerging strategies for treatment of childhood dystonia

PubMed Central

Bertucco, Matteo; Sanger, Terence D.

2014-01-01

Childhood dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contractions causing twisting and repetitive movements, abnormal postures, or both (Sanger et al. 2003). Dystonia is a devastating neurological condition that prevents the acquisition of normal motor skills during critical periods of development in children. Moreover, it is particularly debilitating in children when dystonia affects the upper extremities such that learning and consolidation of common daily motor actions are impeded. Thus, the treatment and rehabilitation of dystonia is a challenge that continuously requires exploration of novel interventions. This review will initially describe the underlying neurophysiological mechanisms of the motor impairments found in childhood dystonia followed by the clinical measurement tools that are available to document the presence and severity of symptoms. Finally, we will discuss the state-of-the-art of therapeutic options for childhood dystonia, with particular emphasis on emergent and innovative strategies. PMID:25835254

Climbing the Ladder: Experience with Developing a Large Group Genetic Counselor Career Ladder at Children's National Health System.

PubMed

Kofman, Laura; Seprish, Mary Beth; Summar, Marshall

2016-08-01

Children's National Health System (CNHS) is a not-for-profit pediatric hospital that employs around twenty genetic counselors in a range of specialties, including clinical pediatric, neurology, fetal medicine, research, and laboratory. CNHS lacked a structured system of advancement for their genetic counselors; therefore, a formal career ladder was proposed by the genetic counselors based on years of experience, responsibility, and job performance. This career ladder utilized monetary, academic, and seniority incentives to encourage advancement and continue employment at CNHS. The creation and ultimate approval of the career ladder required direct input from genetic counselors, Department Chairs, and Human Resource personnel. The establishment of a genetic counselor career ladder at CNHS will hopefully benefit the profession of genetic counselors as a whole and allow other facilities to create and maintain their own career ladder to meet the needs of the growing, competitive, field of genetic counseling.

Hot topics in paediatric immunology: IgE-mediated food allergy and allergic rhinitis.

PubMed

Rueter, Kristina; Prescott, Susan

2014-10-01

The epidemic of allergic disease is a major public health crisis. The greatest burden of allergies is in childhood, when rapidly rising rates of disease are also most evident. General practitioners (GP) have a key role in recognising and addressing aller-gy-related problems and identifying whether a child requires referral to a paediatric allergist. This article focuses on IgE-mediated food allergies and allergic rhinitis, the most commonly seen conditions in paediatric im-munology. We will discuss prevention, diagnosis, management and treatment strategies. Currently there is no cure for food allergy. Oral tolerance induction continues to be a significant focus of research. All children with a possible food allergy should be referred to an allergist for further testing and advice. Children who develop allergic rhinitis need a regular review by their GP. Immunotherapy should be discussed early in the disease process and needs to be com-menced by an allergist.

Impact of diabetes education on type 1 diabetes mellitus control in children.

PubMed

Alonso Martín, Daniel E; Roldán Martín, M Belén; Álvarez Gómez, M Ángeles; Yelmo Valverde, Rosa; Martín-Frías, María; Alonso Blanco, Milagros; Barrio Castellanos, Raquel

2016-12-01

Diabetes education is an essential tool to achieve treatment objectives in type1 diabetes mellitus (T1DM). The aim of this study was to determine if understanding of diabetes by caregivers/patients or sociodemographic factors affect blood glucose control in children and adolescents with T1DM. The level of knowledge of 105 caregivers of children and adolescents with T1DM was assessed using a survey adapted to the type of treatment used (multiple dose insulin [MDI] or continuous subcutaneous insulin infusion [CSII]). Mean HbA1c levels in the previous year was considered as metabolic control marker. Mean HbA1c levels were similar in both treatment groups, with slightly higher values in children over 12years of age. Patients on CSII had a longer time since disease onset and had poorer results, maybe because the items were more difficult due to the higher level of knowledge required for this treatment modality (P=.005). Caregivers with lower educational levels achieved poorer scores in the survey, but mean HbA1c levels of their children were lower, probably because of their greater involvement in disease care. The level of knowledge of caregivers and/or patients with T1DM was high, and this was associated to good metabolic control. Studies to assess the impact of caregiver knowledge on metabolic control of children are needed. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals' challenges.

PubMed

Williams, Margaret; Van Rooyen, Dalena R M; Ricks, Esmeralda J

2018-03-12

 The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children.  To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics.  The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa.  The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell's data analysis spiral. We used Lincoln and Guba's model to ensure trustworthiness. Ethical standards were applied.  Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level.  Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level.

Sufficient protein quality of food aid varies with the physiologic status of recipients

USDA-ARS?s Scientific Manuscript database

Protein quality scores use the amino acid (AA) requirements of a healthy North American child. AA requirements vary with physiologic status. We estimated AA requirements for healthy North American children, children with environmental enteric dysfunction, children recovering from wasting, and childr...

[Attention deficit disorder with or without hyperactivity. Relationship among nurses, parents and school].

PubMed

Vallejo, Raúl García; Sanabria, Sheila García; Ramos, Paula García

2009-09-01

Attention deficit hyperactivity disorder (ADHD) is characterized by a series of behaviors which interfere with the optimal evolutionary development of a child, at the cognitive level as well as in his/her relations with his/her family and integration with other children in his/her age group. An estimated 7% of children have this disorder. 80% of these children will continue to have problems during adolescence while 30 to 65% show symptoms as adults. Correct diagnosis requires, besides an exploration, an interview/s with teachers, family and the child and an evaluation of diverse tests designed for each of the implicated parties. For difficult cases, it is recommended there be a combined evaluation by pediatric, neurologist, child psychiatrist, clinical psychologist or neuropsychologist, and psycho-pedagogue. A multi-modal treatment has proven more effective; this combines pharmacological, psychological and psycho-pedagogical aspects and in this approach, the role of family and educators is fundamental. Primary Health Care Services Protocol contemplates periodical revisions, included in the Program to Attend to Healthy Children, which covers all children and teenagers. The role of nurses in these revisions is quite relevant to develop an exhaustive evaluation which enables collaboration in precocious detection and follow-up for this pathology This article hopes to facilitate this activity to all nurses involved in Primary Health Care, especially in pediatrics.

Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children's Health Study.

PubMed

Chen, Zhanghua; Salam, Muhammad T; Eckel, Sandrah P; Breton, Carrie V; Gilliland, Frank D

2015-01-01

Outdoor air pollution is one of the leading contributors to adverse respiratory health outcomes in urban areas around the world. Children are highly sensitive to the adverse effects of air pollution due to their rapidly growing lungs, incomplete immune and metabolic functions, patterns of ventilation and high levels of outdoor activity. The Children's Health Study (CHS) is a continuing series of longitudinal studies that first began in 1993 and has focused on demonstrating the chronic impacts of air pollution on respiratory illnesses from early childhood through adolescence. A large body of evidence from the CHS has documented that exposures to both regional ambient air and traffic-related pollutants are associated with increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits of lung function growth, and airway inflammation. These associations may be modulated by key genes involved in oxidative-nitrosative stress pathways via gene-environment interactions. Despite successful efforts to reduce pollution over the past 40 years, air pollution at the current levels still brings many challenges to public health. To further ameliorate adverse health effects attributable to air pollution, many more toxic pollutants may require regulation and control of motor vehicle emissions and other combustion sources may need to be strengthened. Individual interventions based on personal susceptibility may be needed to protect children's health while control measures are being implemented.

An eye witness perspective of the changing patterns of food allergy.

PubMed

Walker-Smith, John

2005-12-01

Food allergy may affect the gastrointestinal tract of children and adults too, albeit less commonly. The changing clinico-pathological expression of such food allergy in children over a 30 year period is related, from the eye witness perspective of a paediatric gastroenterologist in London. Tissue diagnosis by biopsy, related to dietary elimination and challenge has been the basis for the first clinico-pathological descriptions and accurate clinical diagnosis of these syndromes as they affect the gastrointestinal tract. In the 1970s cow's milk sensitive enteropathy presenting as chronic diarrhoea and failure to thrive in infancy often after infective gastroenteritis, especially with enteropathogenic Escherichia coli, was an important problem. By the late 1990s such presentations had become most uncommon in developed communities but they continue to occur in developing communities. By contrast in more recent times, multiple food allergy associated with minor small intestinal enteropathy and gastro-oesophageal reflux in older children has become an important clinical problem in children seen in developed communities. Accompanying these changes has been a dramatic fall in the number of children with clinically severe gastroenteritis with severe dehydration requiring hospital admission. Furthermore, the widespread diagnostic use of endoscopy of the upper and lower gastrointestinal tract in children with multiple biopsies has expanded gastroenterological diagnosis in children. This approach gives information about the oesophagus and ileo-colon not available in the earlier studies, which largely concentrated upon small intestinal biopsies, obtained by Crosby capsule biopsy. So, over this 30 year period clinico-pathological expression has altered but also the diagnostic approach has technically changed.

Iron profile and dietary pattern of primary school obese Egyptian children.

PubMed

Abd-El Wahed, Mohamed A; Mohamed, Maha H; Ibrahim, Samia S; El-Naggar, Wafaa A

2014-08-01

Poor iron status affects billions of people worldwide. The prevalence of obesity continues to rise in both the developed and developing nations. An association between iron status and obesity has been described in children and adults. The aim of the study was to assess the iron profile and dietary pattern in primary school-aged obese Egyptian children. A case-control study was conducted on 120 children, both obese (n=60) and control group (n=60), recruited from three primary governmental schools located in Dokki Sector, El-Giza Governorate, Egypt. Their ages ranged from 6 to 12 years. All children were subjected to full medical and dietetic history, anthropometric measurements, thorough clinical examination, and determination of complete blood count, serum iron, total iron-binding capacity, transferrin saturation (TS), and ferritin. Despite similar dietary iron intake in the two groups, obese children showed highly significantly decreased hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, serum iron, and TS, and increased mean corpuscular hemoglobin concentration and total iron-binding capacity when compared with the nonobese group. The obese group showed a highly significant increased rate of iron deficiency (ID) (TS<15% or mean corpuscular volume<76 fl) when compared with the nonobese group. Obesity was a significant risk factor for the development of ID (odds ratio: 7.09, 95% confidence interval: 3.16-15.92). The association between ID and obesity may have important public health and clinical implications. For primary school children with elevated BMIs, screening for ID should be considered. Increasing awareness of the importance of physical activity and carrying out nutritional education programs are required.

The impact of age on bispectral index values and EEG bispectrum during anaesthesia with desflurane and halothane in children.

PubMed

Tirel, O; Wodey, E; Harris, R; Bansard, J Y; Ecoffey, C; Senhadji, L

2006-04-01

The relationship between end-tidal sevoflurane concentration, bispectral index (BIS) and the EEG bispectrum in children appears to be age dependent. The aim of this study was to quantify the BIS values at 1 MAC (minimum alveolar concentration) for desflurane and halothane, and explore the relationship with age for these anaesthetic agents in children. ECG, EEG and BIS were recorded continuously in 90 children aged 6-170 months requiring anaesthesia for elective surgery. Fifty children were anaesthetized with desflurane, and 40 children with halothane. Recordings were performed through to a steady state of 2 MAC, and thereafter at 1 and 0.5 MAC, respectively. The bispectrum of the EEG was estimated using MATLAB(c) software. A multiple correspondence analysis (MCA) was used. At a steady state of 1 MAC, BIS values were significantly higher with halothane 62 (43-80) than desflurane 34 (18-64). BIS values were significantly correlated with age in both groups: DES (r(2)=0.57; P<0.01) and HALO (r(2)=0.48; P<0.01). Changes in position in the structured model of the MCA (dependent on the pattern of the EEG bispectrum) were different for the two volatile anaesthetic agents. In children, BIS values are linked to age irrespective of the volatile anaesthetic agent used. The difference in BIS values for different agents at the same MAC can be explained by the specific effect on the EEG bispectrum induced by each anaesthetic agent, bringing into question the ability of the EEG bispectrum to accurately determine the depth of anaesthesia.

Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions.

PubMed

Lartey, Anna

2008-02-01

Women of child-bearing age (especially pregnant and lactating women), infants and young children are in the most nutritionally-vulnerable stages of the life cycle. Maternal malnutrition is a major predisposing factor for morbidity and mortality among African women. The causes include inadequate food intake, poor nutritional quality of diets, frequent infections and short inter-pregnancy intervals. Evidence for maternal malnutrition is provided by the fact that between 5 and 20% of African women have a low BMI as a result of chronic hunger. Across the continent the prevalence of anaemia ranges from 21 to 80%, with similarly high values for both vitamin A and Zn deficiency levels. Another challenge is the high rates of HIV infection, which compromise maternal nutritional status. The consequences of poor maternal nutritional status are reflected in low pregnancy weight gain and high infant and maternal morbidity and mortality. Suboptimal infant feeding practices, poor quality of complementary foods, frequent infections and micronutrient deficiencies have largely contributed to the high mortality among infants and young children in the region. Feeding children whose mothers are infected with HIV continues to remain an issue requiring urgent attention. There are successful interventions to improve the nutrition of mothers, infants and young children, which will be addressed. Interventions to improve the nutrition of infants and young children, particularly in relation to the improvement of micronutrient intakes of young children, will be discussed. The recent release by WHO of new international growth standards for assessing the growth and nutritional status of children provides the tool for early detection of growth faltering and for appropriate intervention.

Preterm Versus Term Children: Analysis of Sedation/Anesthesia Adverse Events and Longitudinal Risk.

PubMed

Havidich, Jeana E; Beach, Michael; Dierdorf, Stephen F; Onega, Tracy; Suresh, Gautham; Cravero, Joseph P

2016-03-01

Preterm and former preterm children frequently require sedation/anesthesia for diagnostic and therapeutic procedures. Our objective was to determine the age at which children who are born <37 weeks gestational age are no longer at increased risk for sedation/anesthesia adverse events. Our secondary objective was to describe the nature and incidence of adverse events. This is a prospective observational study of children receiving sedation/anesthesia for diagnostic and/or therapeutic procedures outside of the operating room by the Pediatric Sedation Research Consortium. A total of 57,227 patients 0 to 22 years of age were eligible for this study. All adverse events and descriptive terms were predefined. Logistic regression and locally weighted scatterplot regression were used for analysis. Preterm and former preterm children had higher adverse event rates (14.7% vs 8.5%) compared with children born at term. Our analysis revealed a biphasic pattern for the development of adverse sedation/anesthesia events. Airway and respiratory adverse events were most commonly reported. MRI scans were the most commonly performed procedures in both categories of patients. Patients born preterm are nearly twice as likely to develop sedation/anesthesia adverse events, and this risk continues up to 23 years of age. We recommend obtaining birth history during the formulation of an anesthetic/sedation plan, with heightened awareness that preterm and former preterm children may be at increased risk. Further prospective studies focusing on the etiology and prevention of adverse events in former preterm patients are warranted. Copyright © 2016 by the American Academy of Pediatrics.

An affordable compact humanoid robot for Autism Spectrum Disorder interventions in children.

PubMed

Dickstein-Fischer, Laurie; Alexander, Elizabeth; Yan, Xiaoan; Su, Hao; Harrington, Kevin; Fischer, Gregory S

2011-01-01

Autism Spectrum Disorder impacts an ever-increasing number of children. The disorder is marked by social functioning that is characterized by impairment in the use of nonverbal behaviors, failure to develop appropriate peer relationships and lack of social and emotional exchanges. Providing early intervention through the modality of play therapy has been effective in improving behavioral and social outcomes for children with autism. Interacting with humanoid robots that provide simple emotional response and interaction has been shown to improve the communication skills of autistic children. In particular, early intervention and continuous care provide significantly better outcomes. Currently, there are no robots capable of meeting these requirements that are both low-cost and available to families of autistic children for in-home use. This paper proposes the piloting the use of robotics as an improved diagnostic and early intervention tool for autistic children that is affordable, non-threatening, durable, and capable of interacting with an autistic child. This robot has the ability to track the child with its 3 degree of freedom (DOF) eyes and 3-DOF head, open and close its 1-DOF beak and 1-DOF each eyelids, raise its 1-DOF each wings, play sound, and record sound. These attributes will give it the ability to be used for the diagnosis and treatment of autism. As part of this project, the robot and the electronic and control software have been developed, and integrating semi-autonomous interaction, teleoperation from a remote healthcare provider and initiating trials with children in a local clinic are in progress.

Factors influencing overweight children's commencement of and continuation in a resistance training program

PubMed Central

2010-01-01

Background In light of the child overweight and obesity problem in Australia, resistance training programs have been trialled as an innovative way of assisting children increase lean body mass and reduce body fat. The purpose of this study was to investigate the factors influencing overweight children's participation in a resistance training trial program. Method Parent-child pairs who participated in the trial program were invited to take part in a follow-up individual interview to discuss their program experiences. In total, 22 semi-structured interviews were conducted with 11 parent-child pairs. Results The factors found to be most relevant to program commencement among parents were a desire for their child to lose weight and gain confidence, the proximity of the venue, and no cost for participation. For children, the most relevant factors were the opportunity to build strength and improve fitness and having supportive parents who facilitated program initiation. The factors most relevant to continuation for parents were the quality of the program management, being able to stay for the sessions, the child's improved weight status, coordination, and confidence, and no cost for participation. Weight loss and improved confidence were also motivators for continuation among the children, along with pleasant social interaction with peers and trainers and ongoing parental support. Conclusion Different factors variably influence program commencement and program continuation in both parents and children. This has important implications for future interventions that aim to successfully recruit and retain intervention participants. PMID:21083936

[Evolution of non-invasive ventilation in acute bronchiolitis].

PubMed

Toledo del Castillo, B; Fernández Lafever, S N; López Sanguos, C; Díaz-Chirón Sánchez, L; Sánchez da Silva, M; López-Herce Cid, J

2015-08-01

The aim of the study was to analyse the evolution, over a12-year period, of the use of non-invasive (NIV) and invasive ventilation (IV) in children admitted to a Paediatric Intensive Care Unit (PICU) due to acute bronchiolitis. A retrospective observational study was performed including all children who were admitted to the PICU requiring NIV or IV between 2001 and 2012. Demographic characteristics, ventilation assistance and clinical outcome were analysed. A comparison was made between the first six years and the last 6 years of the study. A total of 196 children were included; 30.1% of the subjects required IV and 93.3% required NIV. The median duration of IV was 9.5 days and NIV duration was 3 days. The median PICU length of stay was 7 days, and 2% of the patients died. The use of NIV increased from 79.4% in first period to 100% in the second period (P<.0001) and IV use decreased from 46% in first period to 22.6% in the last 6 years (P<.0001). Continuous positive airway pressure and nasopharyngeal tube were the most frequently used modality and interface, although the use of bi-level non-invasive ventilation (P<.001) and of nasal cannulas significantly increased (P<.0001) in the second period, and the PICU length of stay was shorter (P=.011). The increasing use of NIV in bronchiolitis in our PICU during the last 12 years was associated with a decrease in the use of IV and length of stay in the PICU. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

[Physical therapy in pediatric primary care: a review of experiences].

PubMed

de Sá, Miriam Ribeiro Calheiros; Thomazinho, Paula de Almeida; Santos, Fabiano Luiz; Cavalcanti, Nicolette Celani; Ribeiro, Carla Trevisan Martins; Negreiros, Maria Fernanda Vieira; Vinhaes, Marcia Regina

2014-11-01

To review pediatric physical therapy experiences described in the literature and to analyze the production of knowledge on physical therapy in the context of pediatric primary health care (PPHC). A systematic review was conducted according to the PRISMA criteria. The following databases were searched: MEDLINE, LILACS, SciELO, PubMed, Scopus and Cochrane; Brazilian Ministry of Health's CAPES doctoral dissertations database; and System for Information on Grey Literature in Europe (SIGLE). The following search terms were used: ["primary health care" and ("physical therapy" or "physiotherapy") and ("child" or "infant")] and equivalent terms in Portuguese and Spanish, with no restriction on publication year. Thirteen articles from six countries were analyzed and grouped into three main themes: professional dilemmas (three articles), specific competencies and skills required in a PPHC setting (seven articles), and practice reports (four articles). Professional dilemmas involved expanding the role of physical therapists to encompass community environments and sharing the decision-making process with the family, as well as collaborative work with other health services to identify the needs of children. The competencies and skills mentioned in the literature related to the identification of clinical and sociocultural symptoms that go beyond musculoskeletal conditions, the establishment of early physical therapy diagnoses, prevention of overmedication, and the ability to work as team players. Practice reports addressed stimulation in children with neurological diseases, respiratory treatment, and establishing groups with mothers of children with these conditions. The small number of studies identified in this review suggests that there is little knowledge regarding the roles of physical therapists in PPHC and possibly regarding the professional abilities required in this setting. Therefore, further studies are required to provide data on the field, along with a continuing education effort on the part of physical therapists.

Short bowel mucosal morphology, proliferation and inflammation at first and repeat STEP procedures.

PubMed

Mutanen, Annika; Barrett, Meredith; Feng, Yongjia; Lohi, Jouko; Rabah, Raja; Teitelbaum, Daniel H; Pakarinen, Mikko P

2018-04-17

Although serial transverse enteroplasty (STEP) improves function of dilated short bowel, a significant proportion of patients require repeat surgery. To address underlying reasons for unsuccessful STEP, we compared small intestinal mucosal characteristics between initial and repeat STEP procedures in children with short bowel syndrome (SBS). Fifteen SBS children, who underwent 13 first and 7 repeat STEP procedures with full thickness small bowel samples at median age 1.5 years (IQR 0.7-3.7) were included. The specimens were analyzed histologically for mucosal morphology, inflammation and muscular thickness. Mucosal proliferation and apoptosis was analyzed with MIB1 and Tunel immunohistochemistry. Median small bowel length increased 42% by initial STEP and 13% by repeat STEP (p=0.05), while enteral caloric intake increased from 6% to 36% (p=0.07) during 14 (12-42) months between the procedures. Abnormal mucosal inflammation was frequently observed both at initial (69%) and additional STEP (86%, p=0.52) surgery. Villus height, crypt depth, enterocyte proliferation and apoptosis as well as muscular thickness were comparable at first and repeat STEP (p>0.05 for all). Patients, who required repeat STEP tended to be younger (p=0.057) with less apoptotic crypt cells (p=0.031) at first STEP. Absence of ileocecal valve associated with increased intraepithelial leukocyte count and reduced crypt cell proliferation index (p<0.05 for both). No adaptive mucosal hyperplasia or muscular alterations occurred between first and repeat STEP. Persistent inflammation and lacking mucosal growth may contribute to continuing bowel dysfunction in SBS children, who require repeat STEP procedure, especially after removal of the ileocecal valve. Level IV, retrospective study. Copyright © 2018 Elsevier Inc. All rights reserved.

An Algorithmic Approach to Operative Management of Complex Pediatric Dog Bites: 3-Year Review of a Level I Regional Referral Pediatric Trauma Hospital

PubMed Central

Shayesteh, Ali; Xu, Min Li

2017-01-01

Background: Incidence of dog bites continues to rise among the pediatric population and serves as a public health threat for the well-being of children. Plastic surgeons are at the forefront of initial management and eventual outcome of these devastating injuries. This study set out to determine the nature of dog bite injuries treated over a 3-year period at a large level 1 pediatric trauma center. Methods: A retrospective review of emergency room records of all pediatric patients (age, 0–18 years old) who sustained dog bites between January 2012 and December 2014 were gathered. All details about age of patient, location and severity of dog bites, type of dog breed, antibiotics given, and emergency versus operative treatment were recorded and analyzed. Results: One hundred eight patients aged 5 months to 18 years old were treated in the emergency department after suffering dog bite injuries during the study period. The highest incidence of dog bites occurred in preschool children. The mean age for patients who required operative repair was lower than the mean age for patients who underwent primary closure in the emergency department. The location of injury was most commonly isolated to the head/neck region. Of the 56 cases that had an identified dog breed, pit bulls accounted for 48.2% of the dog bites, and 47.8% of pit bull bites required intervention in the operating room. Conclusion: Children with large dog bite injuries require more immediate care in a level 1 pediatric trauma hospitals in order to optimize their hospitalization course and eventual outcome. PMID:29184724

An economic evaluation of pediatric small bowel transplantation in the United Kingdom.

PubMed

Longworth, Louise; Young, Tracey; Beath, Sue V; Kelly, Deirdre A; Mistry, Hema; Protheroe, Sue M; Ratcliffe, Julie; Buxton, Martin J

2006-08-27

Small bowel transplantation (SBTx) offers an alternative to parenteral nutrition (PN) for the treatment of chronic intestinal failure in children: this study estimated its cost-effectiveness in the early phase of a U.K. program. Children assessed for SBTx were categorized as: 1) requiring SBTx following PN-related complications (n=23), 2) stable at home not requiring SBTx (n=24), and 3) terminally ill and unsuitable for SBTx (n=6). Costs were estimated from detailed resource-use data. Two comparisons were used for effectiveness: actual survival following transplantation (n=14) compared to: 1) estimated survival without transplantation using a prognostic model, and 2) the waiting list experiences of all patients listed for SBTx (n=23). Mean costs up to 30 months were pounds sterling 207,000 for those transplanted or on the waiting list, pounds sterling 159,000 for those stable on home PN, and pounds sterling 56,000 for those terminally ill. The prognostic model estimated a mean survival gain from transplantation of 0.12 years over 30 months, and suggested that transplantation was cost-saving. The second approach suggested that transplantation reduced survival by 0.24 years at an additional cost of pounds sterling 131,000. Firm conclusions on cost-effectiveness of SBTx are not possible given the two different estimates. The prognostic model approach (suggesting that pediatric SBTx may provide a small survival benefit at a small reduction in costs) should be less subject to bias, but the model requires external validation. Meanwhile, children at risk of fatal PN-complications should be given the opportunity to receive a SBTx only within a continuing formal assessment of the technology.

Depression in Children and Adolescents

ERIC Educational Resources Information Center

Davis, Noel M.

2005-01-01

During the past 20 years, depression has been recognized widely in children and adolescents. However, even with what is known today about depression, many children and adolescents remain undiagnosed. Early recognition is imperative to prevent further episodes that may continue into adulthood. Depression in children and adolescents affects social…

[The Study of Psychological Characteristics of Children and Adolescents with Digestive Diseases].

PubMed

Sviridova, T V; Lazurenko, S B; Venger, A L; Komarova, E V; Potapov, A S; Buslaeva, A S

2015-01-01

The present study was aimed at the psychological characteristics of children with different chronic diseases of the digestive system and the identification of key factors influencing the formation of their personality. The continuous prospective study of psychological peculiarities of 125 patients (7-17 y.o.) with diseases of the digestive system who have been monitored at Scientific Centre of Children's Health (Moscow) was performed. As research methods were used: analysis of medical and pedagogical documentation, participant observation, educational experiment, interview, questionnaires and projective methods. The study involved 125 patients aged 7-17 years (12.4 averagely) with diseases of the digestive system including teens--68 (54%), primary school pupil--57 (46%). The number of boys significantly prevailed over the number of girls (2:1). The study confirmed the existence of a close relationship and mutual influence of three factors: the physical condition, social situation of development, and individual psychological characteristics of children. According to the psychological characteristics the children can be combined in three groups: Group I (47 of 125 people; 37.6%) - children with bad psychological status. This is most typicalfor children with active form of chronic diseases requiring intensive medical assistance (37 of 47people; 78.7%). Group II (59 of 125 people; 47.2%)--children with instable psychological condition, with risk of neurotization. This group mainly comprises patients with chronic diseases at the stage of unstable clinical remission with preserved or compensated functions of organism bodies and systems or with incomplete compensation of functions requiring long term supportive treatment (45 of 59 people; 76.3%). Group III--patients with rather stable psychological condition (19 of 125 people; 15.2%). It comprises patients with rather stable psychological condition, anyway, with expressed psychological vulnerability in stress situation. Most children suffer from chronic diseases of different etiology at the stage of clinical remission with rare aggravations, with preserved or compensated functions, provided there are no aggravations of the basic disease (17of 19 people; 89.5%). Most children with diseases of the digestive system have the psychological difficulties, while their identity is often formed in the distorted social conditions. Therefore, these children need psychological and pedagogical support, as well the special psychological and pedagogical conditions for the realization of their mental and cognitive capacities. To put together a program of psychological and educational assistance we should take into account the child's age at the moment of occurrence of the disease, etiology, duration and severity of the illness, the nature and degree of non-compliance of social environmental.

75 FR 42311 - Third Party Testing for Certain Children's Products; Vinyl Plastic Film: Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Testing for Certain Children's Products; Vinyl Plastic Film: Requirements for Accreditation of Third Party... relating to vinyl plastic film. The Commission is issuing this notice of requirements pursuant to the.... Comments should be captioned ``Third Party Testing for Certain Children's Products; Vinyl Plastic Film...

Usefulness and Validity of Continuous Performance Tests in the Diagnosis of Attention-Deficit Hyperactivity Disorder Children.

PubMed

Berger, Itai; Slobodin, Ortal; Cassuto, Hanoch

2017-02-01

Despite the popularity of continuous performance tests (CPT) in supporting the diagnostic procedure of attention-deficit hyperactivity disorder (ADHD), these measures are still controversial mainly due to limited sensitivity, specificity, and ecological validity. Thus, there continues to be a need for further validation of these objective attention measures. The purpose of this study was to evaluate the usefulness of a CPT that includes environmental distracting stimuli, in supporting the diagnosis of ADHD in children. Participants were 798 children aged 7-12 years (493 boys and 305 girls). The ADHD group included 339 children, whereas the control group included 459 children without ADHD. The study employed the MOXO-CPT, which incorporates visual and auditory stimuli serving as environmental distractors. Compared to their unaffected peers, children with ADHD received significantly lower scores in all 4 CPT indices: attention, timing, hyperactivity, and impulsivity. Specifically, ADHD children were less attended to the stimuli and performed fewer reactions on accurate timing. Furthermore, children with ADHD performed significantly more impulsive and hyperactive responses than controls. Receiver operating characteristic analysis revealed fair to excellent diagnostic ability of all CPT indices except impulsivity, which showed poor ability to distinguish ADHD children from controls. The test's total score yielded excellent diagnostic performance. MOXO-CPT consistently distinguished between children with ADHD and their unaffected peers, so that children with ADHD performed worse than controls in all study indices. Integration of CPT indices improves the diagnostic capacity of ADHD and may better reflect the complexity and heterogeneity of ADHD. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Long-term use of nerve block catheters in paediatric patients with cancer related pathologic fractures

PubMed Central

BURGOYNE, L. L.; PEREIRAS, L. A.; BERTANI, L. A.; KADDOUM, R. N.; NEEL, M.; FAUGHNAN, L. G.; ANGHELESCU, D. L.

2013-01-01

SUMMARY We report three cases of children with osteosarcoma and pathologic fractures treated with long-term continuous nerve blocks for preoperative pain control. One patient with a left distal femoral diaphysis fracture had a femoral continuous nerve block catheter for 41 days without complications. Another with a fractured left proximal femoral shaft had three femoral continuous nerve block catheters for 33, 26 and 22 days respectively. The third patient, whose right proximal humerus was fractured, had a brachial plexus continuous nerve block catheter for 36 days without complication. In our experience, prolonged use of continuous nerve block is safe and effective in children with pathologic fractures for preoperative pain control. PMID:22813501

Functional Communication Training to Increase Communication Skills for Young Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Collins, Terri Lane Sutherland

2010-01-01

The prevalence rates of children being diagnosed with autism spectrum disorder (ASD) continue to rise at alarming rates. Recent figures suggest that approximately 1 in 90 children have an ASD. Children with ASD have significant deficits that affect communication skills and social interaction. Children with ASD may also engage in high levels of…

Prompting Children to Reason Proportionally: Processing Discrete Units as Continuous Amounts

ERIC Educational Resources Information Center

Boyer, Ty W.; Levine, Susan C.

2015-01-01

Recent studies reveal that children can solve proportional reasoning problems presented with continuous amounts that enable intuitive strategies by around 6 years of age but have difficulties with problems presented with discrete units that tend to elicit explicit count-and-match strategies until at least 10 years of age. The current study tests…

Factors Influencing Children's Performances of a Steady-State Bimanual Coordination Task

ERIC Educational Resources Information Center

Lantero, Dawn A.; Ringenbach, Shannon D.

2009-01-01

Children ages 4, 6, and 8 years and adults performed self-selected, continuous, unimanual and bimanual coordination tasks for 30 s. The length of time performing the task was investigated as a potential control parameter. As hypothesized, all groups spent less time in antiphase than in in-phase coordination as the trial continued. These results…

The Recession's Ongoing Impact on America's Children: Indicators of Children's Economic Well-Being through 2011

ERIC Educational Resources Information Center

Isaacs, Julia B.

2011-01-01

Children throughout the United States continue to be negatively impacted by the lingering effects of the Great Recession, with children in some states more hard hit than others. The impact of the recession on children can be hard to see. Some economic statistics ignore children, while others come out with a long time delay. This updated issue…

Providing for consideration of the joint resolution (H.J. Res. 75) making continuing appropriations for the Special Supplemental Nutrition Program for Women, Infants, and Children for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; waiving a requirement of clause 6(a) of rule XIII with respect to consideration of certain resolutions reported from the Committee on Rules; and for other purposes.

THOMAS, 113th Congress

Rep. Cole, Tom [R-OK-4

2013-10-03

House - 10/04/2013 On agreeing to the Cole amendment (A001) Agreed to without objection. (All Actions) Tracker: This bill has the status Agreed to in HouseHere are the steps for Status of Legislation:

Management of a hyperactive teen and cardiac safety.

PubMed

Sowinski, Heather; Karpawich, Peter P

2014-02-01

Since the earliest descriptions of the condition, controversy has prevailed as to the existence of as well as appropriate management of attention deficit hyperactivity disorder. Often diagnosed in childhood, symptoms of attention deficit hyperactivity disorder can continue into adolescence and adulthood, requiring lifelong therapy. Effective therapeutic interventions include stimulant medications with all their respective potential side effects, including the cardiovascular system. However, although initial studies raised concerns for an increase in serious adverse cardiovascular effects among children receiving these drugs, more recent and extensive reports have failed to substantiate those findings among young patients. Copyright © 2014 Elsevier Inc. All rights reserved.

A theory of marks and mind: the effect of notational systems on hominid brain evolution and child development with an emphasis on exchanges between mothers and children.

PubMed

Sheridan, Susan Rich

2005-01-01

A model of human language requires a theory of meaningful marks. Humans are the only species who use marks to think. A theory of marks identifies children's scribbles as significant behavior, while hypothesizing the importance of rotational systems to hominid brain evolution. By recognizing the importance of children's scribbles and drawings in developmental terms as well as in evolutionary terms, a marks-based rather than a predominantly speech-based theory of the human brain, language, and consciousness emerges. Combined research in anthropology, primatology, art history, neurology, child development (including research with deaf and blind children), gender studies and literacy suggests the importance of notational systems to human language, revealing the importance of mother/child interactions around marks and sounds to the development of an expressive, communicative, symbolic human brain. An understanding of human language is enriched by identifying marks carved on bone 1.9 million years ago as observational lunar calendar-keeping, pushing proto-literacy back dramatically. Neurologically, children recapitulate the meaningful marks of early hominins when they scribble and draw, reminding us that literacy belongs to humankind's earliest history. Even more than speech, such meaningful marks played - and continue to play - decisive roles in human brain evolution. The hominid brain required a model for integrative, transformative neural transfer. The research strongly suggests that humankind's multiple literacies (art, literature, scientific writing, mathematics and music) depended upon dyadic exchanges between hominid mothers and children, and that this exchange and sharing of visuo-spatial information drove the elaboration of human speech in terms of syntax, grammar and vocabulary. The human brain was spatial before it was linguistic. The child scribbles and draws before it speaks or writes. Children babble and scribble within the first two years of life. Hands and mouths are proximal on the sensory-motor cortex. Gestures accompany speech. Illiterate brains mis-pronounce nonsense sounds. Literate brains do not. Written language (work of the hands) enhances spoken language (work of the mouth). Until brain scans map the neurological links between human gesture, speech and marks in the context of mother/caregiver/child interactions, and research with literate and illiterate brains document even more precisely the long-term differences between these brains, the evolutionary pressure of marks on especially flexible maternal and infant brain tissue that occurred 1.9 million years, radically changing primate brain capabilities, requires an integrated theory of marks and mind.

The Children's Health Insurance Program Reauthorization Act Evaluation Findings on Children's Health Insurance Coverage in an Evolving Health Care Landscape.

PubMed

Harrington, Mary E

2015-01-01

The Children's Health Insurance Program (CHIP) Reauthorization Act (CHIPRA) reauthorized CHIP through federal fiscal year 2019 and, together with provisions in the Affordable Care Act, federal funding for the program was extended through federal fiscal year 2015. Congressional action is required or federal funding for the program will end in September 2015. This supplement to Academic Pediatrics is intended to inform discussions about CHIP's future. Most of the new research presented comes from a large evaluation of CHIP mandated by Congress in the CHIPRA. Since CHIP started in 1997, millions of lower-income children have secured health insurance coverage and needed care, reducing the financial burdens and stress on their families. States made substantial progress in simplifying enrollment and retention. When implemented optimally, Express Lane Eligibility has the potential to help cover more of the millions of eligible children who remain uninsured. Children move frequently between Medicaid and CHIP, and many experienced a gap in coverage with this transition. CHIP enrollees had good access to care. For nearly every health care access, use, care, and cost measure examined, CHIP enrollees fared better than uninsured children. Access in CHIP was similar to private coverage for most measures, but financial burdens were substantially lower and access to weekend and nighttime care was not as good. The Affordable Care Act coverage options have the potential to reduce uninsured rates among children, but complex transition issues must first be resolved to ensure families have access to affordable coverage, leading many stakeholders to recommend funding for CHIP be continued. Copyright © 2015 Academic Pediatric Association. All rights reserved.

Pathways to Care for Critically Ill or Injured Children: A Cohort Study from First Presentation to Healthcare Services through to Admission to Intensive Care or Death.

PubMed

Hodkinson, Peter; Argent, Andrew; Wallis, Lee; Reid, Steve; Perera, Rafael; Harrison, Sian; Thompson, Matthew; English, Mike; Maconochie, Ian; Ward, Alison

2016-01-01

Critically ill or injured children require prompt identification, rapid referral and quality emergency management. We undertook a study to evaluate the care pathway of critically ill or injured children to identify preventable failures in the care provided. A year-long cohort study of critically ill and injured children was performed in Cape Town, South Africa, from first presentation to healthcare services until paediatric intensive care unit (PICU) admission or emergency department death, using expert panel review of medical records and caregiver interview. Main outcomes were expert assessment of overall quality of care; avoidability of severity of illness and PICU admission or death and the identification of modifiable factors. The study enrolled 282 children, 252 emergency PICU admissions, and 30 deaths. Global quality of care was graded good in 10% of cases, with half having at least one major impact modifiable factor. Key modifiable factors related to access to care and identification of the critically ill, assessment of severity, inadequate resuscitation, and delays in decision making and referral. Children were transferred with median time from first presentation to PICU admission of 12.3 hours. There was potentially avoidable severity of illness in 185 (74%) of children, and death prior to PICU admission was avoidable in 17/30 (56.7%) of children. The study presents a novel methodology, examining quality of care across an entire system, and highlighting the complexity of the pathway and the modifiable events amenable to interventions, that could reduce mortality and morbidity, and optimize utilization of scarce critical care resources; as well as demonstrating the importance of continuity and quality of care.

Pilot undergraduate course teaches students about chronic illness in children: an educational intervention study.

PubMed

Montenegro, Roberto E; Birnie, Krista D; Fisher, Paul Graham; Dahl, Gary V; Binkley, John; Schiffman, Joshua D

2014-01-01

Recent data question whether medical education adequately prepares physicians to care for the growing number of children with chronic medical conditions. We describe a 10-week course designed to provide undergraduate students with the knowledge and skills required to understand and care for children with chronic or catastrophic illnesses. The course presented the illness experience from the child's perspective and thus presented information in a manner that was efficient, conducive, and memorable. The curriculum was designed like a graduate-level seminar that included workshops, lectures, readings, writing, and lively discussions. This is an educational intervention study that used survey data to assess changes in attitudes among and between participants completing this course versus students not exposed to this course. We used Somers' D test and Fisher's z-transformation to perform both pre- and post-nonparametric comparisons. Course participants were more likely to change their attitudes and agree that chronically ill children "feel comfortable talking with their peers about their condition" (P=0.003) and less likely to agree that these children "want to be treated differently," "want more sympathy," or "care less about romantic relationships" (P = 0.003, 0.002 and 0.02, respectively). Controls were more likely to continue to agree that chronically ill children "want to be treated differently" (P = 0.009) and "care less about romantic relationships" (P = 0.02), and less likely to agree that these children "talk openly" or "feel comfortable talking with their peers about their condition" (P = 0.04). This classroom-based course serves as a feasible and cost-effective model for universities and medical schools to aid in improving student attitudes toward treating chronically ill children. The course provides the unique opportunity to learn directly from those who care for and those who have lived with chronic illness.

[Development, implementation, and analysis of a "collaborative decision-making for reasonable care" document in pediatric palliative care].

PubMed

Paoletti, M; Litnhouvongs, M-N; Tandonnet, J

2015-05-01

In France, a legal framework and guidelines state that decisions to limit treatments (DLT) require a collaborative decision meeting and a transcription of decisions in the patient's file. The do-not-attempt-resuscitation order involves the same decision-making process for children in palliative care. To fulfill the law's requirements and encourage communication within the teams, the Resource Team in Pediatric Palliative Care in Aquitaine created a document shared by all children's hospital units, tracing the decision-making process. This study analyzed the decision-making process, quality of information transmission, and most particularly the relevance of this new "collaborative decision-making for reasonable care" card. Retrospective study evaluating the implementation of a traceable document relating the DLT process. All the data sheets collected between January and December 2013 were analyzed. A total of 58 data sheets were completed between January and December 2013. We chose to collect the most relevant data to evaluate the relevance of the items to be completed and the transmission of the document, to draw up the patients' profile, and the contents of discussions with families. Of the 58 children for whom DLT was discussed, 41 data sheets were drawn up in the pediatric intensive care unit, seven in the oncology and hematology unit, five in the neonatology unit, four in the neurology unit, and one in the pneumology unit. For 30 children, one sheet was created, for 11 children, two sheets and for two children, three sheets were filled out. Thirty-nine decisions were made for withholding lifesaving treatment, 11 withdrawing treatment, and for five children, no limitation was set. Nine children survived after DLT. Of the 58 data sheets, only 31 discussions with families were related to the content of the data sheet. Of the 14 children transferred out of the unit with a completed data sheet, it was transmitted to the new unit for 11 children (79%). The number of data sheets collected in 1 year shows the value of this document. The participation of several pediatric specialities' referents in its creation, then its progressive presentation in the children's hospital units, were essential steps in introducing and establishing its use. Items describing the situation, management proposals, and adaptation of the children's supportive care were completed in the majority of cases. They correspond to a clinical description, the object of the discussion, and the daily caregiver's practices, respectively. On the other hand, discussions with families were related to the card's contents in only 53% of the cases. This can be explained by the time required to complete the DLT process. It is difficult for referring doctors to systematically, faithfully, and objectively transcribe discussions with parents. Although this process has been used for a long time in intensive care units, this document made possible an indispensable formalisation in the decision-making process. In other pediatric specialities, the sheet allowed introducing the palliative approach and was a starter and a tool for reflection on the do-not-attempt-resuscitation order, thus suggesting the need for anticipation in these situations. With the implementation of this new document, the DLT, data transmission, and continuity of care conditions were improved in the children's hospital units. Sharing this sheet with all professionals in charge of these children would support homogeneity and quality of management and care for children and their parents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Policy improves what beverages are served to young children in child care.

PubMed

Ritchie, Lorrene D; Sharma, Sushma; Gildengorin, Ginny; Yoshida, Sallie; Braff-Guajardo, Ellen; Crawford, Patricia

2015-05-01

During 2008, we conducted a statewide survey on beverages served to preschool-aged children in California child care that identified a need for beverage policy. During 2011, the US Department of Agriculture began requiring that sites participating in the Child and Adult Care Food Program (CACFP) make drinking water available throughout the day and serve only low-fat or nonfat milk to children aged 2 years and older. During 2012, the California Healthy Beverages in Childcare law additionally required that all child-care sites eliminate all beverages with added sweetener and limit 100% juice to once daily. To assess potential policy effects, we repeated the statewide survey in 2012. During 2008 and 2012, a cross-sectional sample of ∼1,400 licensed child-care sites was randomly selected after stratifying by category (ie, Head Start, state preschool, other CACFP center, non-CACFP center, CACFP home, and non-CACFP home). Responses were obtained from 429 sites in 2008 and 435 in 2012. After adjustment for child-care category, significant improvements in 2012 compared with 2008 were found; more sites served water with meals/snacks (47% vs 28%; P=0.008) and made water available indoors for children to self-serve (77% vs 69%; P=0.001), and fewer sites served whole milk usually (9% vs 22%; P=0.006) and 100% juice more than once daily (20% vs 27%; P=0.038). During 2012, 60% of sites were aware of beverage policies and 23% were judged fully compliant with the California law. A positive effect occurred on beverages served after enactment of state and federal policies. Efforts should continue to promote beverage policies and support their implementation. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Impact of expanded newborn screening--United States, 2006.

PubMed

2008-09-19

Universal newborn screening for selected metabolic, endocrine, hematologic, and functional disorders is a well-established practice of state public health programs. Recent developments in tandem mass spectrometry (MS/MS), which is now capable of multi-analyte analysis in a high throughput capacity, has enabled newborn screening to include many more disorders detectable from a newborn blood spot. In 2006, to address the substantial variation that existed from state to state in the number of disorders included in newborn screening panels, the American College of Medical Genetics (ACMG), under guidance from the Health Resources and Services Administration, recommended a uniform panel of 29 disorders, which was subsequently endorsed by the federal Advisory Committee on Heritable Disorders in Newborns and Children. After 2006, most states began to expand their panels to include all 29 disorders; currently, 21 states and the District of Columbia have fully implemented the ACMG panel. To estimate the burden to state newborn screening programs resulting from this expansion, CDC used 2001-2006 data from those states with well-established MS/MS screening programs to estimate the number of children in the United States who would have been identified with disorders in 2006 if all 50 states and the District of Columbia had been using the ACMG panel. This report describes the results of that analysis, which indicated that, although such an expansion would have increased the number of children identified by only 32% (from 4,370 to 6,439), these children would have had many rare disorders that require local or regional capacity to deliver expertise in screening, diagnosis, and management. The findings underscore the need for public health and health-care delivery systems to build or expand the programs required to manage the rare disorders detected through expanded newborn screening, while also continuing programs to address more common disorders.

Parenting Behaviours and Children's Development from Infancy to Early Childhood: Changes, Continuities and Contributions

ERIC Educational Resources Information Center

Gutman, Leslie Morrison; Feinstein, Leon

2010-01-01

This study investigated trajectories of parenting behaviours and children's development from infancy to early childhood, associations between parenting behaviours and children's development and how these associations vary according to socioeconomic indicators. Mothers and children were examined from an ongoing longitudinal study of families…

Facilitating Attachment between School-Aged Children and a Dying Parent

ERIC Educational Resources Information Center

Saldinger, Amy; Cain, Albert C.; Porterfield, Katherine; Lohnes, Kelly

2004-01-01

A qualitative, community study of 58 parentally bereaved children and their 35 surviving parents illustrates how families take advantage of forewarning of death to foster connections between children and dying parents and prepare for youngsters' continued attachment to dying parents after the death. Children and parents displayed strong yearnings…

Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis.

PubMed

Jeitler, K; Horvath, K; Berghold, A; Gratzer, T W; Neeser, K; Pieber, T R; Siebenhofer, A

2008-06-01

We compared the effects of continuous subcutaneous insulin infusion (CSII) with those of multiple daily insulin (MDI) injections on glycaemic control, risk of hypoglycaemic episodes, insulin requirements and adverse events in type 1 and type 2 diabetes mellitus. The electronic databases MEDLINE, EMBASE and CENTRAL were systematically searched for randomised controlled trials up to March 2007. A systematic review and meta-analysis were performed. Overall, 22 studies were included (17 on type 1 diabetes mellitus, two on type 2 diabetes mellitus, three on children). With regard to adults with type 1 diabetes mellitus, our meta-analysis found a between-treatment difference of -0.4% HbA(1c) (six studies) in favour of CSII therapy. Available median rates of mild or overall hypoglycaemic events were comparable between the different interventions (1.9 [0.9-3.1] [CSII] vs 1.7 [1.1-3.3] [MDI] events per patient per week). Total daily insulin requirements were lower with CSII than with MDI therapy. In patients with type 2 diabetes mellitus, CSII and MDI treatment showed no statistically significant difference for HbA(1c). The incidence of mild hypoglycaemic events was comparable between the treatment groups. In adolescents with type 1 diabetes mellitus, glycated haemoglobin and insulin requirements were significantly lower in the CSII groups; no data were available on hypoglycaemic events. The only study performed in younger children did not provide enough data for conclusive inferences. No overall conclusions were possible for severe hypoglycaemia and adverse events for any of the different patient groups due to rareness of such events, different definitions and insufficient reporting. CSII therapy in adults and adolescents with type 1 diabetes mellitus resulted in a greater reduction of glycated haemoglobin, in adult patients without a higher rate of hypoglycaemia. No beneficial effect of CSII therapy could be detected for patients with type 2 diabetes mellitus.

Therapeutic robotics for children with disabilities: a case study.

PubMed

Drane, James; Safos, Charlotte; Lathan, Corinna E

2009-01-01

The advancement of technology is having a profound effect on enhancing the lives of children with disabilities. As advances in biomedical technology allow research breakthroughs to continue at a steady pace, more and more is being discovered about the nature of different disorders in children. At the same time, partly due to the continuing rapid rate of advancement (and societal acceptance) of robotics technology, researchers, educators, and therapists are exploring the idea that robots might be used as an effective therapeutic and educational tool. Over the past nine years, AnthroTronix has collaborated extensively with therapists, educators, researchers, parents, and children to uncover the therapeutic and educational benefits of including robotics as part of rehabilitation curriculum for children. As a central part of this effort, the company has worked with its colleagues to develop and refine the CosmoBot system, an interactive robotic toolkit designed to enhance therapy, education, and play for children with disabilities.

Gradient perception of children's productions of /s/ and /θ/: A comparative study of rating methods.

PubMed

Schellinger, Sarah K; Munson, Benjamin; Edwards, Jan

2017-01-01

Past studies have shown incontrovertible evidence for the existence of covert contrasts in children's speech, i.e. differences between target productions that are nonetheless transcribed with the same phonetic symbol. Moreover, there is evidence that these are relevant to forming prognoses and tracking progress in children with speech sound disorder. A challenge remains to determine the most efficient and reliable methods for assessing covert contrasts. This study investigates how readily listeners can identify covert contrasts in children's speech when using a continuous rating scale in the form of a visual analogue scale (VAS) to denote children's productions. Individual listeners' VAS responses were found to correlate statistically significantly with a variety of continuous measures of children's production accuracy, including judgements of binary accuracy pooled over a large set of listeners. These findings reinforce the growing body of evidence that VAS judgements are potentially useful clinical measures of covert contrast.

Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects

PubMed Central

Mathias, Elton

2017-01-01

Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population. The pain management of the children with major burns challenges the skills of the personnel of every unit. Managing these wounds requires intensive therapeutic treatment for multi-organ dysfunction, and surgical treatment to prevent sepsis and other complications that further delay wound closure. Alternatives to the practice of donor site harvest and autografting for the treatment of severe burns and other complex skin defects are urgently needed for both adult and pediatric populations. This review article focuses on thermal burn pathophysiology and pain management and provides an overview of currently approved products used for the treatment of pediatric burn wounds. A new promising approach has been presented as a first-line therapy in the treatment of burns to reduce surgical autografting in pediatric patients. PMID:29232903

Persistent exposure to arsenic via drinking water in rural Bangladesh despite major mitigation efforts.

PubMed

Gardner, Renee; Hamadani, Jena; Grandér, Margaretha; Tofail, Fahmida; Nermell, Barbro; Palm, Brita; Kippler, Maria; Vahter, Marie

2011-12-01

Elevated arsenic levels in tube-well water in Bangladesh have prompted extensive mitigation projects. We evaluated the effectiveness of long-term mitigation efforts by longitudinally measuring arsenic exposure in pregnant women and their children, the most susceptible population groups. The study was nested in a population-based nutrition intervention in Matlab, Bangladesh. Mother-child pairs (n = 1951) were followed from 2001 to 2003, beginning in early gestation and continuing to 5 years postpartum. We measured arsenic concentrations in urine (U-As) of the 5-year-old children by using high-performance liquid chromatography online with hydride generation and inductively coupled plasma mass spectrometry and compared them with earlier childhood U-As and maternal U-As during pregnancy. Children had elevated U-As at 5 years old (median = 51 μg/L, 5th-95th percentiles = 16-355 μg/L), and U-As distribution was similar to that observed in the mothers during gestation. Children's U-As at 5 years old significantly correlated with their U-As at 1.5 years old and to maternal U-As during early and late gestation. Despite major mitigation efforts, arsenic exposure remains highly elevated in rural Bangladesh. Further mitigation strategies are required and must be rigorously evaluated for long-term efficacy.

Washing machine related injuries in children: a continuing threat

PubMed Central

Warner, B; Kenney, B; Rice, M

2003-01-01

Objective: To describe washing machine related injuries in children in the United States. Methods: Injury data for 496 washing machine related injuries documented by the Consumer Product Safety Commission's National Electronic Injury Surveillance System and death certificate data files were analyzed. Gender, age, diagnosis, body part injured, disposition, location and mechanism of injury were considered in the analysis of data. Results: The upper extremities were most frequently injured in washing machine related injuries, especially with wringer machines. Fewer than 10% of patients required admission, but automatic washers accounted for most of these and for both of the deaths. Automatic washer injuries involved a wider range of injury mechanism, including 23 children who fell from the machines while in baby seats. Conclusions: Though most injuries associated with washing machines are minor, some are severe and devastating. Many of the injuries could be avoided with improvements in machine design while others suggest a need for increased education of potential dangers and better supervision of children if they are allowed access to areas where washing machines are operating. Furthermore, washing machines should only be used for their intended purpose. Given the limitations of educational efforts to prevent injuries, health professionals should have a major role in public education regarding these seemingly benign household appliances. PMID:14693900

Persistent Exposure to Arsenic via Drinking Water in Rural Bangladesh Despite Major Mitigation Efforts

PubMed Central

Gardner, Renee; Hamadani, Jena; Grandér, Margaretha; Tofail, Fahmida; Nermell, Barbro; Palm, Brita; Kippler, Maria

2011-01-01

Objectives. Elevated arsenic levels in tube-well water in Bangladesh have prompted extensive mitigation projects. We evaluated the effectiveness of long-term mitigation efforts by longitudinally measuring arsenic exposure in pregnant women and their children, the most susceptible population groups. Methods. The study was nested in a population-based nutrition intervention in Matlab, Bangladesh. Mother–child pairs (n = 1951) were followed from 2001 to 2003, beginning in early gestation and continuing to 5 years postpartum. We measured arsenic concentrations in urine (U-As) of the 5-year-old children by using high-performance liquid chromatography online with hydride generation and inductively coupled plasma mass spectrometry and compared them with earlier childhood U-As and maternal U-As during pregnancy. Results. Children had elevated U-As at 5 years old (median = 51 μg/L, 5th–95th percentiles = 16–355 μg/L), and U-As distribution was similar to that observed in the mothers during gestation. Children's U-As at 5 years old significantly correlated with their U-As at 1.5 years old and to maternal U-As during early and late gestation. Conclusions. Despite major mitigation efforts, arsenic exposure remains highly elevated in rural Bangladesh. Further mitigation strategies are required and must be rigorously evaluated for long-term efficacy. PMID:21778503

Results from the United States of America's 2016 Report Card on Physical Activity for Children and Youth

PubMed Central

Katzmarzyk, Peter T.; Denstel, Kara N.; Beals, Kim; Bolling, Christopher; Wright, Carly; Crouter, Scott E.; McKenzie, Thomas L.; Pate, Russell R.; Saelens, Brian E.; Staiano, Amanda E.; Stanish, Heidi I.; Sisson, Susan B.

2017-01-01

Background The 2016 U.S. Report Card on Physical Activity for Children and Youth provides a comprehensive evaluation of physical activity levels and factors influencing physical activity among children and youth. Methods The Report Card includes 10 indicators: overall physical activity, sedentary behavior, active transportation, organized sport participation, active play, health-related fitness, family and peers, school, community and the built environment, and government strategies and investments. Nationally representative data were used to evaluate the indicators using a standard grading rubric. Results Sufficient data were available to assign grades to 7 of the indicators, and these ranged from B- for community and the built environment to F for active transportation. Overall physical activity received a grade of D- due to the low prevalence of meeting physical activity guidelines. A grade of D was assigned to health-related fitness, reflecting the low prevalence of meeting cardiorespiratory fitness standards. Disparities across age, gender, racial/ethnic and socio-economic groups were observed for several indicators. Conclusions Continued poor grades suggest that additional work is required to provide opportunities for U.S. children to be physically active. The observed disparities indicate that special attention should be given to girls, minorities, and those from lower socio-economic groups when implementing intervention strategies. PMID:27848726

Results From the United States of America's 2016 Report Card on Physical Activity for Children and Youth.

PubMed

Katzmarzyk, Peter T; Denstel, Kara D; Beals, Kim; Bolling, Christopher; Wright, Carly; Crouter, Scott E; McKenzie, Thomas L; Pate, Russell R; Saelens, Brian E; Staiano, Amanda E; Stanish, Heidi I; Sisson, Susan B

2016-11-01

The 2016 United States (U.S.) Report Card on Physical Activity for Children and Youth provides a comprehensive evaluation of physical activity levels and factors influencing physical activity among children and youth. The report card includes 10 indicators: Overall Physical Activity, Sedentary Behavior, Active Transportation, Organized Sport Participation, Active Play, Health-related Fitness, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments. Nationally representative data were used to evaluate the indicators using a standard grading rubric. Sufficient data were available to assign grades to 7 of the indicators, and these ranged from B- for Community and the Built Environment to F for Active Transportation. Overall Physical Activity received a grade of D- due to the low prevalence of meeting physical activity guidelines. A grade of D was assigned to Health-related Fitness, reflecting the low prevalence of meeting cardiorespiratory fitness standards. Disparities across age, gender, racial/ethnic and socioeconomic groups were observed for several indicators. Continued poor grades suggest that additional work is required to provide opportunities for U.S. children to be physically active. The observed disparities indicate that special attention should be given to girls, minorities, and those from lower socioeconomic groups when implementing intervention strategies.

Microsoft Kinect-based Continuous Performance Test: An Objective Attention Deficit Hyperactivity Disorder Assessment.

PubMed

Delgado-Gomez, David; Peñuelas-Calvo, Inmaculada; Masó-Besga, Antonio Eduardo; Vallejo-Oñate, Silvia; Baltasar Tello, Itziar; Arrua Duarte, Elsa; Vera Varela, María Constanza; Carballo, Juan; Baca-García, Enrique

2017-03-20

One of the major challenges in mental medical care is finding out new instruments for an accurate and objective evaluation of the attention deficit hyperactivity disorder (ADHD). Early ADHD identification, severity assessment, and prompt treatment are essential to avoid the negative effects associated with this mental condition. The aim of our study was to develop a novel ADHD assessment instrument based on Microsoft Kinect, which identifies ADHD cardinal symptoms in order to provide a more accurate evaluation. A group of 30 children, aged 8-12 years (10.3 [SD 1.4]; male 70% [21/30]), who were referred to the Child and Adolescent Psychiatry Unit of the Department of Psychiatry at Fundación Jiménez Díaz Hospital (Madrid, Spain), were included in this study. Children were required to meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria of ADHD diagnosis. One of the parents or guardians of the children filled the Spanish version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) rating scale used in clinical practice. Each child conducted a Kinect-based continuous performance test (CPT) in which the reaction time (RT), the commission errors, and the time required to complete the reaction (CT) were calculated. The correlations of the 3 predictors, obtained using Kinect methodology, with respect to the scores of the SWAN scale were calculated. The RT achieved a correlation of -.11, -.29, and -.37 with respect to the inattention, hyperactivity, and impulsivity factors of the SWAN scale. The correlations of the commission error with respect to these 3 factors were -.03, .01, and .24, respectively. Our findings show a relation between the Microsoft Kinect-based version of the CPT and ADHD symptomatology assessed through parental report. Results point out the importance of future research on the development of objective measures for the diagnosis of ADHD among children and adolescents. ©David Delgado-Gomez, Inmaculada Peñuelas-Calvo, Antonio Eduardo Masó-Besga, Silvia Vallejo-Oñate, Itziar Baltasar Tello, Elsa Arrua Duarte, María Constanza Vera Varela, Juan Carballo, Enrique Baca-García. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.03.2017.

Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range.

PubMed

Bell, Lana M; Byrne, Sue; Thompson, Alisha; Ratnam, Nirubasini; Blair, Eve; Bulsara, Max; Jones, Timothy W; Davis, Elizabeth A

2007-02-01

Overweight/obesity in children is increasing. Incidence data for medical complications use arbitrary cutoff values for categories of overweight and obesity. Continuous relationships are seldom reported. The objective of this study is to report relationships of child body mass index (BMI) z-score as a continuous variable with the medical complications of overweight. This study is a part of the larger, prospective cohort Growth and Development Study. Children were recruited from the community through randomly selected primary schools. Overweight children seeking treatment were recruited through tertiary centers. Children aged 6-13 yr were community-recruited normal weight (n = 73), community-recruited overweight (n = 53), and overweight treatment-seeking (n = 51). Medical history, family history, and symptoms of complications of overweight were collected by interview, and physical examination was performed. Investigations included oral glucose tolerance tests, fasting lipids, and liver function tests. Adjusted regression was used to model each complication of obesity with age- and sex-specific child BMI z-scores entered as a continuous dependent variable. Adjusted logistic regression showed the proportion of children with musculoskeletal pain, obstructive sleep apnea symptoms, headaches, depression, anxiety, bullying, and acanthosis nigricans increased with child BMI z-score. Adjusted linear regression showed BMI z-score was significantly related to systolic and diastolic blood pressure, insulin during oral glucose tolerance test, total cholesterol, high-density lipoprotein, triglycerides, and alanine aminotransferase. Child's BMI z-score is independently related to complications of overweight and obesity in a linear or curvilinear fashion. Children's risks of most complications increase across the entire range of BMI values and are not defined by thresholds.

Comparison of single-dose nalbuphine versus tramadol for postoperative pain management in children: a randomized, controlled trial.

PubMed

Liaqat, Naeem; Dar, Sajid Hameed

2017-04-01

Acute postoperative pain control in children is an essential component of postoperative care, particularly in daycare procedures. Giving patients continuous narcotic analgesics can be risky; however, a single dose may be sufficient. This study used a prospective, randomized controlled design and was conducted at the Pediatric Surgery Unit, Services Hospital, Lahore. In total, 150 patients who underwent inguinal herniotomy (age range: 1-12 years) were randomly assigned to two groups: group A (nalbuphine) and group B (tramadol). Patients were given a single dose of either nalbuphine (0.2 mg/kg) or tramadol (2 mg/kg) immediately after surgery and pain was measured at 0, 1, 2, 4, and 8 h. The demographic characteristics were similar between the two groups. The mean pain score was lower in group A than in group B at 0 and 1 h (P < 0.05). However, at 4 h and 8 h, the pain scores in group A were still lower, but not significantly. In all, 9 patients (12.0%) required rescue analgesics in group A compared to 16 patients (21.3%) in group B (P = 0.051). The mean time for requirement of rescue analgesics was 6.5 ± 0.5 h in group A and 5.3 ± 1.7 h in group B (P = 0.06). A single dose of nalbuphine is sufficient, and superior to tramadol, for postoperative pain management in children who have undergone daycare procedures.

The Area and Community Components of Children's Well-Being

ERIC Educational Resources Information Center

Jack, Gordon

2006-01-01

Until recently, mainstream services for children in the UK have largely relied upon individual and reactive approaches to safeguarding children's welfare. However, recent legislative and policy reforms require the development of a more preventive orientation, capable of promoting the well-being of all children. This will require that agencies…

Outcomes of Spinal Fusion for Cervical Kyphosis in Children with Neurofibromatosis.

PubMed

Helenius, Ilkka J; Sponseller, Paul D; Mackenzie, William; Odent, Thierry; Dormans, John P; Asghar, Jahangir; Rathjen, Karl; Pahys, Joshua M; Miyanji, Firoz; Hedequist, Daniel; Phillips, Jonathan H

2016-11-02

Cervical kyphosis may occur with neurofibromatosis type I (NF1) and is often associated with vertebral dysplasia. Outcomes of cervical spinal fusion in patients with NF1 are not well described because of the rarity of the condition. We aimed to (1) characterize the clinical presentation of cervical kyphosis and (2) report the outcomes of posterior and anteroposterior cervical fusion for the condition in these children. The medical records and imaging studies of 22 children with NF1 who had undergone spinal fusion for cervical kyphosis (mean, 67°) at a mean age of 11 years and who had been followed for a minimum of 2 years were reviewed. Thirteen children presented with neck pain; 10, with head tilt; 9, with a previous cervical laminectomy or fusion; and 5, with a neurologic deficit. Two patients had spontaneous dislocation of the mid-cervical spine without a neurologic deficit. Eleven had scoliosis, with the major curve measuring a mean of 61°. Nine patients underwent posterior and 13 underwent anteroposterior surgery. Twenty-one received spinal instrumentation, and 1 was not treated with instrumentation. Preoperative halo traction was used for 9 patients, and it reduced the mean preoperative kyphosis by 34% (p = 0.0059). At the time of final follow-up, all spinal fusion sites had healed and the cervical kyphosis averaged 21° (mean correction, 69%; p < 0.001). The cervical kyphosis correction was significantly better after the anteroposterior procedures (83%) than after the posterior-only procedures (58%) (p = 0.031). Vertebral dysplasia and erosion continued in all 17 patients who had presented with dysplasia preoperatively. Thirteen patients had complications, including 5 new neurologic deficits and 8 cases of junctional kyphosis. Nine patients required revision surgery. Junctional kyphosis was more common in children in whom ≤5 levels had been fused (p = 0.054). Anteroposterior surgery provided better correction of cervical kyphosis than posterior spinal fusion in children with NF1. Erosion of vertebral bodies continued during the postoperative follow-up period in all patients who had presented with dysplastic changes preoperatively. The cervical spine should be screened in all children with NF1. Fusion should include at least 6 levels to prevent junctional kyphosis. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Booster seat or seat belt? Motor vehicle injuries and child restraint laws in preschool and early school-age children.

PubMed

Angulo-Vazquez, Vicki; De Santis, Joseph P

2005-01-01

Despite numerous interventions to reduce motor vehicle injuries and deaths in children living in the United States, unintentional motor vehicle injuries continue to be the leading cause of death of U.S. children. Even though child restraint laws have been enacted, many children 5 to 9 years of age continue to be injured in motor vehicle crashes. These injuries are related to the improper use of child restraints. Reasons for injuries in this age group were explored by a review of the current literature. Nurses have a unique role in educating families about proper restraint and in contributing to the evidence base for practice.

[The use of continuous subcutaneous insulin infusion (CSII) with personal insulin pumps in the treatment of children and adolescents with diabetes type 1].

PubMed

Jarosz-Chobot, Przemysława

2004-01-01

This paper sums up recently published researches on the continuous subcutaneous insulin infusion (CSII) with the use of insulin pump in children and adolescents with diabetes type 1. Obtaining a balance in the organism metabolism in childhood and adolescence diabetology is nowadays one of the most important rules of the diabetes management in children. One of the modern ways to achieve that goal is the intensive insulin therapy model with use of the insulin pump. In this paper the advantages and disadvantages as well as the indications and contraindications for the CSII in children and adolescents with diabetes are widely discussed.

Country, Sex, and Parent Occupational Status: Moderators of the Continuity of Aggression from Childhood to Adulthood

PubMed Central

Kokko, Katja; Simonton, Sharon; Dubow, Eric; Lansford, Jennifer E.; Olson, Sheryl L.; Huesmann, L. Rowell; Boxer, Paul; Pulkkinen, Lea; Bates, John E.; Dodge, Kenneth A.; Pettit, Gregory S.

2015-01-01

Using data from two American and one Finnish long-term longitudinal studies, we examined continuity of general aggression from age 8 to physical aggression in early adulthood (age 21–30) and whether continuity of aggression differed by country, sex, and parent occupational status. In all samples, childhood aggression was assessed via peer nominations and early adulthood aggression via self-reports. Multi-group structural equation models revealed significant continuity in aggression in the American samples but not in the Finnish sample. These relations did not differ by sex but did differ by parent occupational status: whereas there was no significant continuity among American children from professional family-of-origin backgrounds, there was significant continuity among American children from non-professional backgrounds. PMID:24990543

Gesturing Gives Children New Ideas About Math

PubMed Central

Goldin-Meadow, Susan; Cook, Susan Wagner; Mitchell, Zachary A.

2009-01-01

How does gesturing help children learn? Gesturing might encourage children to extract meaning implicit in their hand movements. If so, children should be sensitive to the particular movements they produce and learn accordingly. Alternatively, all that may matter is that children move their hands. If so, they should learn regardless of which movements they produce. To investigate these alternatives, we manipulated gesturing during a math lesson. We found that children required to produce correct gestures learned more than children required to produce partially correct gestures, who learned more than children required to produce no gestures. This effect was mediated by whether children took information conveyed solely in their gestures and added it to their speech. The findings suggest that body movements are involved not only in processing old ideas, but also in creating new ones. We may be able to lay foundations for new knowledge simply by telling learners how to move their hands. PMID:19222810

Diagnoses, labels and stereotypes: Supporting children with intellectual disabilities in the hospital.

PubMed

Aston, Megan; Breau, Lynn; MacLeod, Emily

2014-12-01

Children with intellectual disabilities (IDs) and their parents continue to experience stigma within health-care systems. Whilst some research studies have examined the stigma associated with children who have IDs, there continues to be a gap in understanding how the experiences of these children, their parents and nurses have been constructed personally, socially and institutionally. Face-to-face semi-structured interviews were conducted with 17 mothers, 12 nurses and 8 children. Feminist post-structuralism and discourse analysis were used to examine the experiences of children, parents and nurses with the intent of understanding the dominant taken-for-granted everyday practices as well as hidden or marginalized practices. Four main themes emerged, which included the theme of Diagnoses, Labels and Stereotypes, which will be discussed in this article. Participants provided rich detail about their experiences in the hospital and how they addressed and often attempted to challenge the stigma associated with children with IDs. © The Author(s) 2014.

Autonomic nervous system function, child behavior, and maternal sensitivity in three-year-old children with surgically corrected transposition.

PubMed

Harrison, Tondi M

2013-01-01

Explore relationships among autonomic nervous system (ANS) function, child behavior, and maternal sensitivity in three-year-old children with surgically corrected transposition of the great arteries (TGA) and in children healthy at birth. Children surviving complex congenital heart defects are at risk for behavior problems. ANS function is associated with behavior and with maternal sensitivity. Child ANS function (heart rate variability) and maternal sensitivity (Parent-Child Early Relational Assessment) were measured during a challenging task. Mother completed the Child Behavior Checklist. Data were analyzed descriptively and graphically. Children with TGA had less responsive autonomic function and more behavior problems than healthy children. Autonomic function improved with more maternal sensitivity. Alterations in ANS function may continue years after surgical correction in children with TGA, potentially impacting behavioral regulation. Maternal sensitivity may be associated with ANS function in this population. Continued research on relationships among ANS function, child behavior, and maternal sensitivity is warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

The influence of participation in target-shooting sport for children with inattentive, hyperactive and impulsive symptoms - A controlled study of best practice.

PubMed

Månsson, Annegrete Gohr; Elmose, Mette; Dalsgaard, Søren; Roessler, Kirsten K

2017-03-28

Practising target-shooting sport requires focused attention and motoric steadiness. A previous non-controlled pilot study suggests that children with impairing symptoms of attention-deficit/hyperactivity disorder (ADHD) benefit from participating in target-shooting sport in local shooting associations, as rated by parents and teachers. This study aims at examining if, and to which extent, target-shooting sport reduces parent- and teacher-reported severity of inattentiveness, hyperactivity, and impulsivity in children with attention difficulties, and if, and to which extend, target-shooting sport improves the children's wellbeing and quality of life. A mixed method approach is applied. A non-blinded, waiting list controlled study is combined with a case study, consisting of interviews and observations. The intervention consists of children practising target-shooting sport, by attending a local shooting association, once a week for six months, during regular school hours. Data from questionnaires (ADHD-RS, SDQ, Kidscreen-27), as well as a computerized continued performance test (Qb test), measure the children's activity and attention. The study includes 50 children in an intervention group and 50 children in a waiting list control group. The Qb test collects data from at least 20 children from the intervention group and at least 20 children from the waiting list control group. Data from the questionnaires and Qb-test is collected at baseline, and six months post intervention. In addition, a case study is carried out, consisting of interviews of at least five children from the intervention group, their parents, teachers and shooting instructors. Observations are carried out, when children are in school and while they are attending the local shooting association. The case study adds to an in-depth understanding of children's participation in target-shooting sports. At present, little is known about the effects and influence of practising target-shooting sport for children experiencing difficulties with inattentiveness, hyperactivity and impulsivity. This study is expected to contribute to an understanding of the influence of participating in target-shooting sports on inattentive, hyperactive and impulsive symptoms, and the effects on the children's psychological wellbeing and quality of life. Current Controlled Trials NCT02898532 . Retrospectively registered 14 September 2016.

Health care access and utilization among children of single working and nonworking mothers in the United States.

PubMed

Clarke, Tainya C; Arheart, Kristopher L; Muennig, Peter; Fleming, Lora E; Caban-Martinez, Alberto J; Dietz, Noella; Lee, David J

2011-01-01

To examine indicators of health care access and utilization among children of working and nonworking single mothers in the United States, the authors used data on unmarried women participating in the 1997-2008 National Health Interview Survey who financially supported children under 18 years of age (n = 21,842). Stratified by maternal employment, the analyses assessed health care access and utilization for all children. Outcome variables included delayed care, unmet care, lack of prescription medication, no usual place of care, no well-child visit, and no doctor's visit. The analyses reveal that maternal employment status was not associated with health care access and utilization. The strongest predictors of low access/utilization included no health insurance and intermittent health insurance in the previous 12 months, relative to those with continuous private health insurance coverage (odds ratio ranges 3.2-13.5 and 1.3-10.3, respectively). Children with continuous public health insurance compared favorably with those having continuous private health insurance on three of six access/utilization indicators (odds ratio range 0.63-0.85). As these results show, health care access and utilization for the children of single mothers are not optimal. Passage of the U.S. Healthcare Reform Bill (HR 3590) will probably increase the number of children with health insurance and improve these indicators.

Comparison of extracorporeal shock wave lithotripsy for inferior caliceal calculus between children and adults: a retrospective analysis--why do results vary?

PubMed

Mandal, Swarnendu; Sankhwar, Satya N; Singh, Manish Kumar; Kathpalia, Rohit; Singh, Vishwajeet; Goel, Apul; Singh, Bhupendra P; Dalela, Divakar

2012-12-01

To retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) for inferior caliceal calculi ≤ 20 mm in size and compare the results between children and adults. From January 2004 to January 2012, ESWL was performed for inferior caliceal calculi in 230 children and 1006 adults. The Dornier compact alpha-K1025163 (Dornier Med Tech) was used. The success rates, number of ESWL sessions required, and auxiliary procedures used were evaluated in a comparative manner. The overall stone-free rate (for both stone sizes) was 82.2% for children and 40% for the adults. Of the children, 17% had a residual stone compared with 47.8% of the adults. ESWL was unsuccessful in 0.8% of children and 12.2% of adults. The mean number of ESWL sessions required in children and adults was 1.43 (range 1-4) and 2.13 (range 1-4), respectively. Repeat treatment was required in 31% of the children and 65% of the adults. Auxiliary procedures were required in 5.2% of the children and 16.2% of the adults. Complications were seen in 5.6% of the children and 15% of the adults. The results of ESWL for inferior caliceal calculi ≤ 20 mm in adults remains poor but not so in children. Children can achieve high stone-free rates, require a fewer number of ESWL sessions than adults to be stone free, and have a lower need for repeat treatment and auxiliary procedures, and have fewer complications. Copyright © 2012 Elsevier Inc. All rights reserved.

Dietary Protein Intake in Young Children in Selected Low-Income Countries Is Generally Adequate in Relation to Estimated Requirements for Healthy Children, Except When Complementary Food Intake Is Low.

PubMed

Arsenault, Joanne E; Brown, Kenneth H

2017-05-01

Background: Previous research indicates that young children in low-income countries (LICs) generally consume greater amounts of protein than published estimates of protein requirements, but this research did not account for protein quality based on the mix of amino acids and the digestibility of ingested protein. Objective: Our objective was to estimate the prevalence of inadequate protein and amino acid intake by young children in LICs, accounting for protein quality. Methods: Seven data sets with information on dietary intake for children (6-35 mo of age) from 6 LICs (Peru, Guatemala, Ecuador, Bangladesh, Uganda, and Zambia) were reanalyzed to estimate protein and amino acid intake and assess adequacy. The protein digestibility-corrected amino acid score of each child's diet was calculated and multiplied by the original (crude) protein intake to obtain an estimate of available protein intake. Distributions of usual intake were obtained to estimate the prevalence of inadequate protein and amino acid intake for each cohort according to Estimated Average Requirements. Results: The prevalence of inadequate protein intake was highest in breastfeeding children aged 6-8 mo: 24% of Bangladeshi and 16% of Peruvian children. With the exception of Bangladesh, the prevalence of inadequate available protein intake decreased by age 9-12 mo and was very low in all sites (0-2%) after 12 mo of age. Inadequate protein intake in children <12 mo of age was due primarily to low energy intake from complementary foods, not inadequate protein density. Conclusions: Overall, most children consumed protein amounts greater than requirements, except for the younger breastfeeding children, who were consuming low amounts of complementary foods. These findings reinforce previous evidence that dietary protein is not generally limiting for children in LICs compared with estimated requirements for healthy children, even after accounting for protein quality. However, unmeasured effects of infection and intestinal dysfunction on the children's protein requirements could modify this conclusion.

Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan.

PubMed

Maeda, Eri; Higashi, Takahiro; Hasegawa, Tomonobu; Yokoya, Susumu; Mochizuki, Takahiro; Ishii, Tomohiro; Ito, Junko; Kanzaki, Susumu; Shimatsu, Akira; Takano, Koji; Tajima, Toshihiro; Tanaka, Hiroyuki; Tanahashi, Yusuke; Teramoto, Akira; Nagai, Toshiro; Hanew, Kunihiko; Horikawa, Reiko; Yorifuji, Toru; Wada, Naohiro; Tanaka, Toshiaki

2016-10-21

Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys: 156.4 cm; girls: 145.4 cm). However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation. A retrospective analysis of 696 adolescent patients (451 boys and 245 girls) who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects. Of the 696 children in the analysis, 108 (15.5 %) were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not (75.9 % vs. 52.0 %, P < 0.001). The odds ratios of financial support to continuing treatment were 4.04 (95 % confidence interval [CI]: 1.86-8.78) in boys and 1.72 (95 % CI: 0.80-3.70) in girls, after adjusting for demographic characteristics and clinical factors. Financial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.

"Are There Other Kids like Me?" Children with a Parent in Prison

ERIC Educational Resources Information Center

Clopton, Kerri L.; East, Katheryn K.

2008-01-01

The number of children who experience parental incarceration continues to rise with the United States. In 1999, an estimated 1.5 million minor children had a parent in a United States prison. One-fifth of these children are under 5 years of age (Mumola, Incarcerated parents and their children, Bureau of Justice Statistics Special Report, 2000). A…

Effects of Strategy Use on Children's Motor Performance in a Continuous Timing Task

ERIC Educational Resources Information Center

Liu, Ting; Jensen, Jody L.

2011-01-01

The purposes of this study were to associate age-related performance deficits in children with the use of recall strategies and to determine whether children who performed poorly in cycling would benefit from learning a recall strategy. In Experiment 1, 18 younger children (ages 5-7 years) and 18 older children (ages 8-10 years) were asked to…

Pediatric clinical drug trials in low-income countries: key ethical issues.

PubMed

MacLeod, S M; Knoppert, D C; Stanton-Jean, M; Avard, D

2015-02-01

Potential child participants in clinical research trials in low-income countries are often vulnerable because of poverty, high morbidity and mortality, inadequate education, and varied local cultural norms. However, vulnerability by itself must not be accepted as an obstacle blocking children from the health benefits that may accrue as an outcome of sound clinical research. As greater emphasis is placed on evidence-based treatment of children, it should be anticipated that there will be a growing call for agreement on principles to guide clinical investigations in low-income countries. There is now general acceptance of the view that children must be protected from non-evidence-based interventions and from substandard treatments. The questions remaining relate to how best to stimulate clinical research activity that will serve the needs of infants, children, and youth in developing countries and how best to assign priority to ethically sound research that will meet their clinical requirements. In low-income countries, 39 % of citizens are 13 years of age or younger, and consequently it is certain that clinical investigations of some new therapeutic products will be conducted there more frequently. This review offers some suggestions for approaches that will help to achieve more effective ethical consideration, including (1) improving the quality of research ethics boards; (2) fostering collaborative partnerships among important stakeholders; (3) making concerted efforts to build capacity; (4) improving the quality of the consent and waiver process; and (5) developing improved governance for harmonized ethics platforms. Continuing support by international organizations is required to sustain the establishment and maintenance of stronger research ethics boards to protect children enrolled in clinical trials. This review underscores the importance of developing a culture of solidarity and true partnership between developed and low-income country organizations, which will allow all those involved, and especially child patients, to benefit from the advancement of therapeutics.

Reading and reading instruction for children from low-income and non-English-speaking households.

PubMed

Lesaux, Nonie K

2012-01-01

Although most young children seem to master reading skills in the early grades of elementary school, many struggle with texts as they move through middle school and high school. Why do children who seem to be proficient readers in third grade have trouble comprehending texts in later grades? To answer this question, Nonie Lesaux describes what is known about reading development and instruction, homing in on research conducted with children from low-income and non-English-speaking homes. Using key insights from this research base, she offers two explanations. The first is that reading is a dynamic and multifaceted process that requires continued development if students are to keep pace with the increasing demands of school texts and tasks. The second lies in the role of reading assessment and instruction in U.S. schools. Lesaux draws a distinction between the "skills-based competencies" that readers need to sound out and recognize words and the "knowledge-based competencies" that include the conceptual and vocabulary knowledge necessary to comprehend a text's meaning. Although U.S. schools have made considerable progress in teaching skills-based reading competencies that are the focus of the early grades, most have made much less progress in teaching the knowledge-based competencies students need to support reading comprehension in middle and high school. These knowledge-based competencies are key sources of lasting individual differences in reading outcomes, particularly among children growing up in low-income and non-English-speaking households. Augmenting literacy rates, Lesaux explains, will require considerable shifts in the way reading is assessed and taught in elementary and secondary schools. First, schools must conduct comprehensive reading assessments that discern learners' (potential) sources of reading difficulties--in both skills-based and knowledge-based competencies. Second, educators must implement instructional approaches that offer promise for teaching the conceptual and knowledge-based reading competencies that are critical for academic success, particularly for academically vulnerable populations.

Old and new ways: family planning in Kenya.

PubMed

Antarsh, L

1989-04-01

Kenya has the highest fertility rate in the world. The average woman has 8 children. Further, urban areas attract people from rural areas leaving fewer people to farm the finite land or raise cattle. Therefore a reduced need for children to partake in agricultural activities exists. Nevertheless many barriers to family planning continue in Kenya. Family planning services are scarce especially in rural areas. Husbands must agree to their wives undergoing voluntary sterilization by going to the clinic to sign a consent form. Children are highly valued. Succession of the generations is important. The higher a woman's fertility the more valuable she is to husband. The continuance of legal polygamy fosters competition among a man's wives to have many sons with the 1 having the most being his most prized wife. In spite of these obstacles, the president of Kenya promotes family planning through his speeches and requires the Ministry of Health (MOH) to provide family planning services at all government hospitals. Moreover, church hospitals also provide family planning services. Additionally, articles that cover teenage pregnancy and family planning programs appear in daily newspapers. The MOH and the National Council on Population and Development are organizing a network of government and nongovernment organizations that provide family planning services to the public. A sample of these organizations include the Family Planning Association of Kenya, an influential women's organization (Mandeleo ya Wanawake), and several church organizations. The Association for Voluntary Surgical Contraception's regional office has promoted minilaparotomies under local anesthesia since 1986. They are now used in maternal and child health programs in government hospitals, mission hospitals, and in several family planning clinics.

An observational study comparing continuous subcutaneous insulin infusion (CSII) and insulin glargine in children with type 1 diabetes.

PubMed

Schiaffini, Riccardo; Ciampalini, Paolo; Spera, Sabrina; Cappa, Marco; Crinó, Antonino

2005-01-01

The advantages of continuous subcutaneous insulin infusion (CSII) or insulin glargine have been demonstrated both in adult and paediatric diabetic patients; however, as no data comparing these two approaches during childhood are available, we have examined the efficacy of these two intensive approaches. We retrospectively evaluated data from 36 diabetic children, who had changed their previous insulin regimen [with isophane insulin (NPH) at bedtime] because of HbA1c levels >8.0%. Twenty patients underwent CSII, while the other 16 (significantly younger for age) started insulin glargine at bedtime. At 6 and 12 months, CSII-treated patients showed a significant reduction in HbA1c values from 8.5 +/- 1.8 to 7.4 +/- 1.1% and to 7.6 +/- 1.2%, respectively. The insulin requirement significantly decreased from 0.93 +/- 0.2 IU/kg to 0.73 +/- 0.2 IU/kg of body weight and to 0.74 +/- 0.15 IU/kg of body weight, respectively, while no significant differences were observed for BMI SDS, fructosamine and severe hypoglycaemic events. The patients treated with glargine showed a small decline in HbA1c values from 8.9 +/- 1.7 to 8.3 +/- 0.9% (not significant) in the first 6 months of treatment and to 8.2 +/- 0.9% after 12 months. The basal insulin supplementation can be supplied effectively in children with type 1 diabetes by either CSII or insulin glargine. As previously reported for adults, it is confirmed that CSII is the best current intensive approach aimed to the improvement of glycaemic control.

Prevalence of smoking restrictions and child exposure to secondhand smoke in cars and homes: a repeated cross-sectional survey of children aged 10–11 years in Wales

PubMed Central

Moore, Graham F; Moore, Laurence; Littlecott, Hannah J; Ahmed, Nilufar; Lewis, Sophia; Sulley, Gillian; Jones, Elen; Holliday, Jo

2015-01-01

Objective Small increases in smoking restrictions in cars and homes were reported after legislation prohibiting smoking in public places. Few studies examine whether these changes continued in the longer term. This study examines changes in restrictions on smoking in cars and homes, and child exposure to secondhand smoke (SHS) in these locations, since 2008 postlegislation surveys in Wales. Setting State-maintained primary schools in Wales (n=75). Participants Children aged 10–11 years (year 6) completed CHETS (CHild exposure to Environmental Tobacco Smoke) Wales surveys in 2007 (n=1612) and 2008 (n=1605). A replication survey (CHETS Wales 2) was conducted in 2014, including 1601 children. Primary outcome variable Children's reports of whether smoking was allowed in their car or home and exposure to SHS in a car or home the previous day. Results The percentage of children who reported that smoking was allowed in their family vehicle fell from 18% to 9% in 2014 (OR=0.42; 95% CI 0.33 to 0.54). The percentage living in homes where smoking was allowed decreased from 37% to 26% (OR=0.30; 95% CI 0.20 to 0.43). Among children with a parent who smoked, one in five and one in two continued to report that smoking was allowed in their car and home. The percentage reporting SHS exposure in a car (OR=0.52; 95% CI 0.38 to 0.72) or home (OR=0.44; 95% CI 0.36 to 0.53) the previous day also fell. Children from poorer families remained less likely to report smoking restrictions. Conclusions Smoking in cars and homes has continued to decline. Substantial numbers of children continue to report that smoking is allowed in cars and homes, particularly children from poorer families. A growing number of countries have legislated, or plan to legislate, banning smoking in cars carrying children. Attention is needed to the impact of legislation on child health and health inequalities, and reducing smoking in homes. PMID:25636793

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.

Children and Divorce

MedlinePlus

... own problems, but continue to be the most important people in their children's lives. While parents may be devastated or relieved by the divorce, children are invariably frightened and confused by the threat to their security. Some parents feel so hurt or overwhelmed by ...

Total Sulfur Amino Acid Requirements Are Not Altered in Children with Chronic Renal Insufficiency, but Minimum Methionine Needs Are Increased.

PubMed

Elango, Rajavel; Humayun, Mohammad A; Turner, Justine M; Rafii, Mahroukh; Langos, Veronika; Ball, Ronald O; Pencharz, Paul B

2017-10-01

Background: The total sulfur amino acid (TSAA) and minimum Met requirements have been previously determined in healthy children. TSAA metabolism is altered in kidney disease. Whether TSAA requirements are altered in children with chronic renal insufficiency (CRI) is unknown. Objective: We sought to determine the TSAA (Met in the absence of Cys) requirements and minimum Met (in the presence of excess Cys) requirements in children with CRI. Methods: Five children (4 boys, 1 girl) aged 10 ± 2.6 y with CRI were randomly assigned to receive graded intakes of Met (0, 5, 10, 15, 25, and 35 mg · kg -1 · d -1 ) with no Cys in the diet. Four of the children (3 boys, 1 girl) were then randomly assigned to receive graded dietary intakes of Met (0, 2.5, 5, 7.5, 10, and 15 mg · kg -1 · d -1 ) with 21 mg · kg -1 · d -1 Cys. The mean TSAA and minimum Met requirements were determined by measuring the oxidation of l-[1- 13 C]Phe to 13 CO 2 (F 13 CO 2 ). A 2-phase linear-regression crossover analysis of the F 13 CO 2 data identified a breakpoint at minimal F 13 CO 2 Urine samples collected from all study days and from previous studies of healthy children were measured for sulfur metabolites. Results: The mean and population-safe (upper 95% CI) intakes of TSAA and minimum Met in children with CRI were determined to be 12.6 and 15.9 mg · kg -1 · d -1 and 7.3 and 10.9 mg · kg -1 · d -1 , respectively. In healthy school-aged children the mean and upper 95% CI intakes of TSAA and minimum Met were determined to be 12.9 and 17.2 mg · kg -1 · d -1 and 5.8 and 7.3 mg · kg -1 · d -1 , respectively. A comparison of the minimum Met requirements between healthy children and children with CRI indicated significant ( P < 0.05) differences. Conclusion: These results suggest that children with CRI have a similar mean and population-safe TSAA to that of healthy children, suggesting adequate Cys synthesis via transsulfuration, but higher minimum Met requirement, suggesting reduced remethylation rates. © 2017 American Society for Nutrition.

Assessment of Program Impact Through First Grade, Volume V: Impact on Children. An Evaluation of Project Developmental Continuity. Interim Report X.

ERIC Educational Resources Information Center

Berrueta-Clement, John; And Others

Fifth in a series of six volumes reporting outcomes of the preliminary evaluation of an educational intervention, this report presents the findings of the effects of Project Developmental Continuity (PDC) up to the time the evaluation study's cohort of children completed grade 1. Preliminary findings concerning the relationship between variables…

Transition into and out of Special Education Services by Young Australian School Children between 2006 and 2010

ERIC Educational Resources Information Center

Dempsey, Ian

2014-01-01

The extent to which school students continue to receive special education services over time is largely unknown because longitudinal studies are rare in this area. The present study examined a large Australian longitudinal database to track the status of children who received special education support in 2006 and whether they continued to access…

Long-Term Safety and Adverse Events of Risperidone in Children, Adolescents, and Adults with Pervasive Developmental Disorders

ERIC Educational Resources Information Center

Hellings, Jessica A.; Cardona, Alicia M.; Schroeder, Stephen R.

2010-01-01

The objective of this study was to examine long-term adverse events of risperidone in 19 children, adolescents, and adults with Pervasive Developmental Disorders and intellectual disability, continuing risperidone for a mean of 186.5 weeks, following a 46-week risperidone study. Nineteen individuals continued long-term follow-up after our…

Continuous Learning: Balancing Educational Excellence and Cultural Diversity for At-Risk. A Developing, Generalizing, Working Model.

ERIC Educational Resources Information Center

Demery, Marie

This proactive research and development model presents data of misfortune, reality, and hope for approximately 40 percent of American children labeled as "at-risk." The model was based on the premise that in spite of their past and an environment of failure, these children can learn successfully and continuously through the balancing of…

Developmental Differences in Cognitive Control: Goal Representation and Maintenance during a Continuous Performance Task

ERIC Educational Resources Information Center

Lorsbach, Thomas C.; Reimer, Jason F.

2010-01-01

The present study examined whether younger and older children differ in the use of the goal-related information in a continuous performance task (AX-CPT), and if so, whether those age differences are due to the ability to represent and/or maintain goal information. Experiment 1 compared third- and sixth-grade children in their ability to transform…

Working Memory and Reinforcement Schedule Jointly Determine Reinforcement Learning in Children: Potential Implications for Behavioral Parent Training

PubMed Central

Segers, Elien; Beckers, Tom; Geurts, Hilde; Claes, Laurence; Danckaerts, Marina; van der Oord, Saskia

2018-01-01

Introduction: Behavioral Parent Training (BPT) is often provided for childhood psychiatric disorders. These disorders have been shown to be associated with working memory impairments. BPT is based on operant learning principles, yet how operant principles shape behavior (through the partial reinforcement (PRF) extinction effect, i.e., greater resistance to extinction that is created when behavior is reinforced partially rather than continuously) and the potential role of working memory therein is scarcely studied in children. This study explored the PRF extinction effect and the role of working memory therein using experimental tasks in typically developing children. Methods: Ninety-seven children (age 6–10) completed a working memory task and an operant learning task, in which children acquired a response-sequence rule under either continuous or PRF (120 trials), followed by an extinction phase (80 trials). Data of 88 children were used for analysis. Results: The PRF extinction effect was confirmed: We observed slower acquisition and extinction in the PRF condition as compared to the continuous reinforcement (CRF) condition. Working memory was negatively related to acquisition but not extinction performance. Conclusion: Both reinforcement contingencies and working memory relate to acquisition performance. Potential implications for BPT are that decreasing working memory load may enhance the chance of optimally learning through reinforcement. PMID:29643822

Alternative Organization of Speech Perception Deficits in Children

ERIC Educational Resources Information Center

Gosy, Maria

2007-01-01

Children's first-language perception base takes shape gradually from birth onwards. Empirical research has confirmed that children may continue to fall short of age-based expectations in their speech perception. The purpose of this study was to assess the contribution of various perception processes in both reading and learning disabled children.…

The Effectiveness of CASAs in Achieving Positive Outcomes for Children.

ERIC Educational Resources Information Center

Litzelfelner, Pat

2000-01-01

Evaluated effectiveness of court-appointed special advocates (CASAs) in achieving positive outcomes for children in the child welfare system, using data from court and CASA program files on 200 children. Found that CASAs may have reduced the number of placements and court continuances children experienced. More services were provided to children…

"I Want to Learn My Phone Number": Encourage Young Children to Set Their Own Learning Goals

ERIC Educational Resources Information Center

Warash, Bobbie Gibson; Smith, Keri; Root, Amy

2011-01-01

Young children's capabilities continue to be revealed through brain and other scientific research. These advances in knowledge have led to the implementation of more progressive learning experiences in preschool programs. More in-depth explorations accommodate young children's intellect and they help children develop life skills as competent…

Continuity and Change From Full-Inclusion Early Childhood Programs Through the Early Elementary Period

PubMed Central

Guralnick, Michael J.; Neville, Brian; Hammond, Mary A.; Connor, Robert T.

2010-01-01

A large and well-characterized group of children with mild developmental delays initially enrolled in full-inclusion preschool or kindergarten programs was followed for 3 years. Changes in the type of inclusive placements as children transitioned to first and second grades were monitored, and associations between placement type and child and family characteristics were examined. Results revealed a high level of continuity in that most children remained in partial or full inclusion settings over time. However, a substantial reduction in full-inclusion placements occurred between the 2nd and 3rd year when children were completing the transition to first and second grades. Placements in less inclusive settings were associated with children’s levels of cognitive and language development but not their adaptive, social, or behavioral characteristics. A hypothesis was put forward that placement in full-inclusion programs during the early childhood years creates a momentum to continue maximum participation in inclusive settings over time. PMID:20890373

47 CFR 54.520 - Children's Internet Protection Act certifications required from recipients of discounts under the...

Code of Federal Regulations, 2011 CFR

2011-10-01

... “technology protection measure” as used in this section, are defined in the Children's Internet Protection Act... 47 Telecommunication 3 2011-10-01 2011-10-01 false Children's Internet Protection Act... Libraries § 54.520 Children's Internet Protection Act certifications required from recipients of discounts...

47 CFR 54.520 - Children's Internet Protection Act certifications required from recipients of discounts under the...

Code of Federal Regulations, 2010 CFR

2010-10-01

... “technology protection measure” as used in this section, are defined in the Children's Internet Protection Act... 47 Telecommunication 3 2010-10-01 2010-10-01 false Children's Internet Protection Act... Libraries § 54.520 Children's Internet Protection Act certifications required from recipients of discounts...

Children with Down syndrome are high-risk for severe respiratory syncytial virus disease.

PubMed

Stagliano, David R; Nylund, Cade M; Eide, Matilda B; Eberly, Matthew D

2015-03-01

To assess Down syndrome as an independent risk factor for respiratory syncytial virus (RSV) hospitalization in children younger than 3 years of age and to evaluate illness severity. A retrospective cohort study of children enrolled in the military health system database was conducted. The effect of Down syndrome on RSV hospitalization was assessed by Cox proportional hazards model, while we controlled for risk factors. Disease severity was assessed by length of hospital stay, need for respiratory support, and age at hospitalization. The study included 633 200 children and 3 209 378 person-years. Children with Down syndrome had a hospitalization rate of 9.6% vs 2.8% in children without Down syndrome. Down syndrome had a greater adjusted hazard ratio (HR) for RSV hospitalization than most risk factors, 3.46 (95% CI 2.75-4.37). A sensitivity analysis demonstrated HR 3.21 (95% CI 2.51-4.10) for patients with Down syndrome ages 0-23 months and HR 5.07 (95% CI 2.21-11.59) ages 24-36 months. The median (IQR) length of stay of children with and without Down syndrome was 4 days (2-7) and 2 days (1-4) (P < .001). Patients with Down syndrome had a greater risk of requiring respiratory support (relative risk 5.5; 95% CI, 2.5-12.3). The median (IQR) ages at admission for children with and without Down syndrome were 9.8 months (5.5-17.7) and 3.5 months (1.7-8.7) (P < .001). Down syndrome is independently associated with an increased risk for RSV hospitalization. Children with Down syndrome are older at time of RSV hospitalization and have more severe RSV illness than children without Down syndrome. This increased risk for hospitalization continues beyond 24 months. Published by Elsevier Inc.

How do children learn to cross the street? The process of pedestrian safety training

PubMed Central

Schwebel, David C.; Shen, Jiabin; McClure, Leslie A.

2016-01-01

Objective Pedestrian injuries are a leading cause of child death, and may be reduced by training children to cross streets more safely. Such training is most effective when children receive repeated practice at the complex cognitive-perceptual task of judging moving traffic and selecting safe crossing gaps, but there is limited data on how much practice is required for children to reach adult levels of functioning. Using existing data, we examined how children’s pedestrian skill changed over the course of six pedestrian safety training sessions, each comprised of 45 crossings within a virtual pedestrian environment. Methods As part of a randomized controlled trial on pedestrian safety training, 59 children ages 7-8 crossed the street within a semi-immersive virtual pedestrian environment 270 times over a 3-week period (6 sessions of 45 crossings each). Feedback was provided after each crossing, and traffic speed and density was advanced as children’s skill improved. Post-intervention pedestrian behavior was assessed a week later in the virtual environment and compared to adult behavior with identical traffic patterns. Results Over the course of training, children entered traffic gaps more quickly and chose tighter gaps to cross within; their crossing efficiency appeared to increase. By the end of training, some aspects of children’s pedestrian behavior was comparable to adult behavior but other aspects were not, indicating the training was worthwhile but insufficient for most children to achieve adult levels of functioning. Conclusions Repeated practice in a simulated pedestrian environment helps children learn aspects of safe and efficient pedestrian behavior. Six twice-weekly training sessions of 45 crossings each were insufficient for children to reach adult pedestrian functioning, however, and future research should continue to study the trajectory and quantity of child pedestrian safety training needed for children to become competent pedestrians. PMID:26760077

High prevalence of Schistosoma mansoni and other intestinal parasites among elementary school children in Southwest Ethiopia: a cross-sectional study.

PubMed

Jejaw, Ayalew; Zemene, Endalew; Alemu, Yayehirad; Mengistie, Zemenu

2015-07-02

Intestinal parasitic infections (IPIs) pose significant public health challenges in school children in developing countries. The aim of this study is to determine prevalence of intestinal parasites among elementary school children in Mizan-Aman town, southwest Ethiopia. Institution-based cross-sectional study involving 460 elementary school children in Mizan-Aman Town was conducted from May to June 2013. The school children were selected using multistage sampling technique. Data on demography and predisposing factors of IPIs were collected using pretested questionnaire. Moreover, single stool specimen was examined microscopically after wet mount and formol-ether sedimentation concentration procedures. Infection intensity of Schistosoma mansoni and soil-transmitted helminths (STHs) was estimated using Kato-Katz egg counting method. Age of the children ranged from 5 to 17 years. Overall, 76.7% (95%CI: 72.8-80.6) of the children harbored at least one species of intestinal parasite. Eight species of intestinal parasites were detected with S. mansoni (44.8%) and Ascaris lumbricoides (28.7%) being predominant. Helminths and pathogenic intestinal protozoa were detected in 73.9 and 7.8% of the children, respectively. After adjusting for other variables, age between 5 and 9 years (AOR, 2.6, 95%CI, 1.552-4.298), male gender (AOR, 2.1, 95%CI, 1.222-3.526), attending public school (AOR, 0.1, 95%CI, 0.060-0.256), using river/well water (AOR, 2.4, 95%CI, 0.912-6.191), irregular washing of hands before meal (AOR, 0.5, 95%CI, 0.254-0.865), consuming street food (AOR, 2.3, 95%CI, 1.341-3.813) and raw vegetables (AOR, 2.7, 95%CI, 1.594-4.540) were significantly associated with IPIs in the study participants. Prevalence of intestinal parasites among the school children was high. Deworming of the school children and continuous follow up is required.

Developing future clinical leaders for quality improvement: experience from a London children's hospital.

PubMed

Runnacles, Jane; Moult, Beki; Lachman, Peter

2013-11-01

Medical training does not necessarily prepare graduates for the real world of healthcare in which continual improvement is required. Doctors in postgraduate training (DrPGT) rarely have the opportunity to develop skills to implement changes where they work. Paradoxically they are often best placed to identify safety and quality concerns and can innovate across organisational boundaries. In order to address this, educational programmes require a supportive educational environment and should include experiential learning on a safety and quality project, alongside teaching of quality improvement (QI) knowledge and systems theory. Enabling Doctors in Quality Improvement and Patient Safety (EQuIP) has been designed for DrPGT at a London children's hospital. The aim is to prepare trainees for the future of continual improvement to ensure safe and effective services are developed through effective clinical microsystems. This paper describes the rationale and design of EQuIP with evaluation built in the evolving programme. EQuIP supports DrPGTs through a QI project within their department, aligned to the Great Ormond Street NHS Foundation Trust's objectives. This changes the way DrPGTs view healthcare as they become quality champions for their department. A three-level approach to the programme is described. The innovation involves a peer-designed programme while being work-based, delivering organisational strategies. Results of the preprogramme and postprogramme evaluations demonstrate an improvement in knowledge, skills and attitudes. Benefits to both the DrPGTs and the organisation are emphasised and key factors to achieve success and barriers identified by the participants. The design and evaluation of EQuIP may inform similar educational programmes in other organisations. This capacity building is crucial to ensure that future clinical leaders have the skills and motivation to improve the effectiveness of clinical microsystems.

Sibling bereavement and continuing bonds.

PubMed

Packman, Wendy; Horsley, Heidi; Davies, Betty; Kramer, Robin

2006-11-01

Historically, from a Freudian and medical model perspective, emotional disengagement from the deceased was seen as essential to the successful adaptation of bereavement. A major shift in the bereavement literature has occurred and it is now generally accepted that despite the permanence of physical separation, the bereaved remains involved and connected to the deceased and can be emotionally sustained through continuing bonds. The majority of literature has focused on adults and on the nature of continuing bonds following the death of a spouse. In this article, the authors demonstrate how the continuing bonds concept applies to the sibling relationship. We describe the unique continued relationship formed by bereaved children and adolescents following a sibling loss, highlight the factors that influence the siblings continuing bonds expressions, and offer clinical interventions. In our view, mental health professionals can play an important role in helping parents encourage activities that may facilitate the creation and maintenance of continuing bonds in their children.

High-dose anti-histamine use and risk factors in children with urticaria.

PubMed

Uysal, Pınar; Avcil, Sibelnur; Erge, Duygu

2016-12-01

The drugs of choice in the treatment of urticaria in children are H1-antihistamines. The aim of the study was to evaluate children with urticaria and define risk factors for requirement of high-dose H1-antihistamines in children with urticaria. The medical data of children who were diagnosed as having urticaria admitted to our outpatient clinic between January 2014 and January 2016 were searched. The medical histories, concomitant atopic diseases, parental atopy histories, medications, treatment responses, blood eosinophil and basophil counts, and serum total IgE levels were recorded. In addition, the urticaria activity score for seven days, autoimmune antibody tests, and skin prick test results were evaluated in children with chronic urticaria. The numbers of the children with acute and chronic urticaria were 138 and 92, respectively. The age of the children with chronic urticaria was higher than that of those with acute urticaria (p<0.0001). There was no difference between the two groups in terms of blood eosinophil and basophil counts, and serum total IgE levels (p>0.05). There was a negative correlation between blood eosinophil count and the UAS7 score in children with chronic urticaria (r=-0.276, p=0.011). Chronic urticaria and requirement of high dose H1-antihistamines were significant in children aged ≥10 years (p<0.001, p=0.015). High UAS7 score (OR: 1.09; CI 95%: [1.03-1.15]) and basopenia (OR: 6.77; CI 95%: [2.01-22.75]) were associated with the requirement of high-dose H1-AH in children with chronic urticaria. The requirement of high-dose H1-antihistamines was higher with children's increasing age. Disease severity and basopenia were risk factors for the requirement of high-dose H1-antihistamines.

Mothers' functioning and children's symptoms 5 years after a SCUD missile attack.

PubMed

Laor, N; Wolmer, L; Cohen, D J

2001-07-01

The authors assessed the long-term consequences of the SCUD missile attack in Israel on children as a function of their mothers' psychological functioning, family cohesion, and the event itself. Five years after the Gulf War, the authors assessed the internalizing, externalizing, stress, and posttraumatic symptoms of 81 children aged 8-10 years whose homes were damaged in the SCUD missile attack, as well as general and posttraumatic symptoms, defensive style, and object relations in their mothers. There was a significant decrease in severity in most symptom domains and an increase in avoidant symptoms in the children. Greater severity of symptoms was associated with being displaced, living in a family with inadequate cohesion, and having a mother with poor psychological functioning. The association between the symptoms of children and mothers was stronger among the younger children. Posttraumatic symptoms increased in one-third of the children and decreased in one-third over the last 30 months of the study. Severe posttraumatic symptoms were reported in 8% of the children. Despite a continuous decrease in symptom severity, risk factors identified shortly after the Gulf War continued to exert their influence on children 5 years after the traumatic exposure.

Clinical trials in neonates and children: Report of the pulmonary hypertension academic research consortium pediatric advisory committee

PubMed Central

Adatia, Ian; Haworth, Sheila G.; Wegner, Max; Barst, Robyn J.; Ivy, Dunbar; Stenmark, Kurt R.; Karkowsky, Abraham; Rosenzweig, Erika; Aguilar, Christopher

2013-01-01

Drug trials in neonates and children with pulmonary hypertensive vascular disease pose unique but not insurmountable challenges. Childhood is defined by growth and development. Both may influence disease and outcomes of drug trials. The developing pulmonary vascular bed and airways may be subjected to maldevelopment, maladaptation, growth arrest, or dysregulation that influence the disease phenotype. Drug therapy is influenced by developmental changes in renal and hepatic blood flow, as well as in metabolic systems such as cytochrome P450. Drugs may affect children differently from adults, with different clearance, therapeutic levels and toxicities. Toxicity may not be manifested until the child reaches physical, endocrine and neurodevelopmental maturity. Adverse effects may be revealed in the next generation, should the development of ova or spermatozoa be affected. Consideration of safe, age-appropriate tablets and liquid formulations is an obvious but often neglected prerequisite to any pediatric drug trial. In designing a clinical trial, precise phenotyping and genotyping of disease is required to ensure appropriate and accurate inclusion and exclusion criteria. We need to explore physiologically based pharmacokinetic modeling and simulations together with statistical techniques to reduce sample size requirements. Clinical endpoints such as exercise capacity, using traditional classifications and testing cannot be applied routinely to children. Many lack the necessary neurodevelopmental skills and equipment may not be appropriate for use in children. Selection of endpoints appropriate to encompass the developmental spectrum from neonate to adolescent is particularly challenging. One possible solution is the development of composite outcome scores that include age and a developmentally specific functional classification, growth and development scores, exercise data, biomarkers and hemodynamics with repeated evaluation throughout the period of growth and development. In addition, although potentially costly, we recommend long-term continuation of blinded dose ranging after completion of the short-term, double-blind, placebo-controlled trial for side-effect surveillance, which should include neurodevelopmental and peripubertal monitoring. The search for robust evidence to guide safe therapy of children and neonates with pulmonary hypertensive vascular disease is a crucial and necessary goal. PMID:23662203

Profiles of selected nutrients affecting skin condition in children with atopic dermatitis.

PubMed

Strucińska, Małgorzata; Rowicka, Grażyna; Riahi, Agnieszka

2015-01-01

Atopic dermatitis (AD) is a chronic inflammation of the skin recognised to be one of the first clinical signs of allergy. In the first years of life, epidemiological evidence has demonstrated that common causative foods of a child's diet are: cow's milk, hen's eggs, wheat and soya. Children with AD being treated with elimination diets are at risk of nutritional deficiencies that include those nutrients required for ensuring proper skin structure and function. The aim of the study was to assess dietary intake of nutrients which affect skin condition in children with AD being treated with a milk-free diet. Subjects were 25 children aged 4-6 years with AD undergoing the milk exclusion diet and 25 age-matched healthy controls. The energy and nutritional value of diets were evaluated that included those components affecting skin condition; ie. vitamins A, D, E, B2 and C; minerals iron (Fe) and zinc (Zn); polyunsaturated fatty acids (PUFAs). The Dieta 5.0 programme was used for dietary assessment and outcomes were then related to dietary recommendations. There were no significant differences between groups in mean energy values and mean intakes of protein, fats and carbohydrates (p>0.05). The percentage of subjects with low energy value were 44% and 36% in respectively Groups I and II. Deficiencies of fat intake were observed in 60% in Group I and 44% in Group II. There were however no risks in the dietary intakes of protein, carbohydrate, vitamins A, B2 and C nor of Fe and Zn. Deficiencies of dietary intakes were observed in respectively Groups I and II in the following; vitamin E (24% vs 64%), vitamin D (36% vs 92%), linoleic acid (36% vs 72%), α-linolenic acid (36% vs 40%) and long chain PUFAs (96% in both groups). Ensuring recommended dietary supply of those nutrients affecting skin condition is required for both groups of children. Children with AD had better balanced diets in respect of the studied nutrients that may reflect the influence of continuous healthcare received from physicians and dieticians.

Explaining errors in children's questions.

PubMed

Rowland, Caroline F

2007-07-01

The ability to explain the occurrence of errors in children's speech is an essential component of successful theories of language acquisition. The present study tested some generativist and constructivist predictions about error on the questions produced by ten English-learning children between 2 and 5 years of age. The analyses demonstrated that, as predicted by some generativist theories [e.g. Santelmann, L., Berk, S., Austin, J., Somashekar, S. & Lust. B. (2002). Continuity and development in the acquisition of inversion in yes/no questions: dissociating movement and inflection, Journal of Child Language, 29, 813-842], questions with auxiliary DO attracted higher error rates than those with modal auxiliaries. However, in wh-questions, questions with modals and DO attracted equally high error rates, and these findings could not be explained in terms of problems forming questions with why or negated auxiliaries. It was concluded that the data might be better explained in terms of a constructivist account that suggests that entrenched item-based constructions may be protected from error in children's speech, and that errors occur when children resort to other operations to produce questions [e.g. Dabrowska, E. (2000). From formula to schema: the acquisition of English questions. Cognitive Liguistics, 11, 83-102; Rowland, C. F. & Pine, J. M. (2000). Subject-auxiliary inversion errors and wh-question acquisition: What children do know? Journal of Child Language, 27, 157-181; Tomasello, M. (2003). Constructing a language: A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press]. However, further work on constructivist theory development is required to allow researchers to make predictions about the nature of these operations.

Ethnic variations in overweight and obesity among children over time: findings from analyses of the Health Surveys for England 1998-2009.

PubMed

Karlsen, S; Morris, S; Kinra, S; Vallejo-Torres, L; Viner, R M

2014-06-01

The increase in the prevalence of obesity among children and adolescents in England since the mid-1990s has been dramatic. Cross-sectional evidence suggests ethnic variations in childhood obesity prevalence. The objective of the study was to examine whether and how ethnic variations in childhood overweight/obesity have changed over time, and are affected by socioeconomic factors. This study uses logistic regression to analyse ethnic differences in the relative likelihood of being at or above the age- and gender-specific thresholds for overweight and obesity developed by the International Obesity Task Force among children aged between 2 and 15 from 11 ethnic groups included in the Health Surveys for England between 1998 and 2009, adjusting for age, gender, year of data collection and equivalized household income. We separately analyse the likelihood of being at or above the thresholds for overweight (but below those for obesity) and obesity. Trends in overweight/obesity over time among ethnic minority groups do not follow those of white English children. Black African children had higher rates of overweight and obesity, which appear to have peaked, and black Caribbean children had higher rates of obesity than other groups examined, which appear to continue rising. These differences were not explained by socioeconomic variations between groups. Policies are required that encourage healthy lifestyles among ethnic minority young people, while engaging with the complexities associated with these choices during childhood and adolescence. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Should short children born small for gestational age with a distance to target height <1 standard deviation score be excluded from growth hormone treatment?

PubMed

Lem, Annemieke J; de Kort, Sandra W K; de Ridder, Maria A J; Hokken-Koelega, Anita C S

2010-09-01

The criteria for starting growth hormone (GH), an approved treatment for short children born small for gestational age (SGA), differ between Europe and the USA. One European requirement for starting GH, a distance to target height (DTH) of > or =1 standard deviation score (SDS), is controversial. To investigate the influence of DTH on growth during GH treatment in short SGA children and to ascertain whether it is correct to exclude children with a DTH <1 SDS from GH. A large group of short prepubertal SGA children (baseline n = 446; 4 years GH n = 215). We analysed the prepubertal growth response during 4 years of GH. We investigated the influence of the continuous variable DTH SDS on growth response and a possible DTH SDS cut-off level below which point the growth response is insufficient. Height gain SDS during 4 years of GH showed a wide variation at every DTH SDS level. Multiple regression analyses demonstrated that, after correction for other significant variables, an additional DTH of 1 SDS resulted in 0.13 SDS more height gain during 4 years of GH. We found no significant differences in height gain below and above certain DTH SDS cut-off levels. DTH SDS had a weak positive effect on height gain during 4 years of GH, while several other determinants had much larger effects. We found no support for using any DTH cut-off level. Based on our data, excluding children with a DTH <1 SDS from GH treatment is not justified.

Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals’ challenges

PubMed Central

2018-01-01

Background The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children. Aim To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics. Setting The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa. Methodology The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell’s data analysis spiral. We used Lincoln and Guba’s model to ensure trustworthiness. Ethical standards were applied. Results Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level. Conclusion Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level. PMID:29781680

Potential Impact of Conjugate Vaccine on the Incidence of Invasive Pneumococcal Disease among Children in Scotland

PubMed Central

Clarke, Stuart C.; Jefferies, Johanna M.; Smith, Andrew J.; McMenamin, Jim; Mitchell, Timothy J.; Edwards, Giles F. S.

2006-01-01

We sought to determine the potential impact of seven-valent pneumococcal conjugate vaccine on the incidence of invasive pneumococcal disease (IPD) among children in Scotland. Invasive pneumococci from blood and cerebrospinal fluid, isolated between 2000 and 2004 from all children aged less than 5 years in Scotland, were characterized by serotyping. Using reported efficacy data of the seven-valent pneumococcal conjugate vaccine (PCV7) along with likely coverage rates, we made an estimation of the potential impact on the incidence of IPD among children in Scotland. A total of 217 pneumococci were characterized into 22 different serogroups/types, the most common, in rank order, being 14, 19F, 6B, 18C, 23F, 9V, 4, 1, 19A, and 6A. Estimated serotype coverage for PCV7 was 76.5% in those aged less than 5 years of age but increased to 88.9% for those aged 1 year. By using serotype coverage and estimates of vaccine efficacy and uptake, the potential impact of the vaccine for those greater than 2 months of age, but less than 5 years, was estimated as 67.3%, leading to an average of 29 preventable cases per year. The introduction of PCV7 into the childhood immunization schedule would reduce the burden of pneumococcal disease in children, and the incidence would be particularly reduced in those children aged 1 year. Additional benefits may be gained in adults through herd protection. Continued surveillance of IPD is required before, during, and after the introduction of PCV7. PMID:16597842

Fundoplication and gastrostomy versus image-guided gastrojejunal tube for enteral feeding in neurologically impaired children with gastroesophageal reflux.

PubMed

Wales, Paul W; Diamond, Ivan R; Dutta, Sanjeev; Muraca, Sergio; Chait, Peter; Connolly, Bairbre; Langer, Jacob C

2002-03-01

Neurologically impaired children with gastroesophageal reflux (GER) usually are treated with a fundoplication and gastrostomy (FG); however, this approach is associated with a high rate of complications and morbidity. The authors evaluated the image-guided gastrojejunal tube (GJ) as an alternative approach for this group of patients. A retrospective review of 111 neurologically impaired patients with gastroesophageal reflux was performed. Patients underwent either FG (n = 63) or GJ (n = 48). All FGs were performed using an open technique by a pediatric surgeon, and all GJ tubes were placed by an interventional radiologist. The 2 groups were similar with respect to diagnosis, age, sex and indication for feeding tube. Patients in the GJ group were followed up for an average of 3.11 years, and those in the FG group for 5.71 years. The groups did not differ statistically with respect to most complications (bleeding, peritonitis, aspiration pneumonia, recurrent gastroesophageal reflux [GER], wound infection, failure to thrive, and death), subsequent GER related admissions, or cost. Children in the GJ group were more likely to continue taking antireflux medication after the procedure (P <.05). Also, there was a trend for GJ patients to have an increased incidence of bowel obstruction or intussusception (20.8% v 7.9%). Of the FG patients 36.5% experienced retching, and 12.7% experienced dysphagia. Eighty-five percent of patients in the GJ group experienced GJ tube-specific complications (breakage, blockage, dislodgment), and GJ tube manipulations were required an average of 1.68 times per year follow-up. Nine patients (14.3%) in the FG group had wrap failure, with 7 (11.1%) of these children requiring repeat fundoplication. In the GJ group, 8.3% of patients went on to require a fundoplication for persistent problems. A total of 14.5% of GJ patients had their tube removed by the end of the follow-up period because they no longer needed the tube for feeding. Image-guided gastrojejunal tubes are a reasonable alternative to fundoplication and gastrostomy for neurologically impaired children with GER. The majority can be inserted without general anesthesia. This technique failed in only 8.3% patients, and they subsequently required fundoplication. A total of 14.5% of GJ patients showed some spontaneous improvement and had their feeding tube removed. Each approach, however, still is associated with a significant complication rate. A randomized prospective study comparing these 2 approaches is needed. Copyright 2002 by W.B. Saunders Company.

Prognostic value of continuous electroencephalography monitoring in children with severe brain damage.

PubMed

Lan, Yan-huai; Zhu, Xiao-mei; Zhou, Yuan-feng; Qiu, Peng-ling; Lu, Guo-ping; Sun, Dao-kai; Wang, Yi

2015-06-01

The purpose of this study is to determine whether there is a relationship between continuous electroencephalography (EEG) monitoring patterns and prognosis for children with severe brain damage. Patients and The different patterns of EEG were analyzed for 103 children (Glasgow Coma Scale [GCS] score < 8) who were monitored with continuous video-EEG (CVEEG) within 72 hours after the onset of coma. The clinical outcomes were scored and evaluated at hospital discharge by the modified Pediatric Cerebral and Overall Performance Category Scale (PCOPCS). EEG parameters of the different prognosis groups were compared and risk factors for prognosis were identified. Of the 103 children, 36 were in the good prognosis group (PCOPCS scores 1 and 2) and 67 were in the poor prognosis group (PCOPCS scores 3-6). The poor prognosis group had the lower proportion of events in reactive EEG patterns and sleep architecture, and a higher proportion of low-voltage events. Multivariate analyses showed that the lower GCS score and no sleep architecture were significantly associated with poor prognosis. Comatose children with higher GCS score and sleep architecture have better clinical outcomes in terms of morbidity and mortality. Georg Thieme Verlag KG Stuttgart · New York.

Conflict Resolution and Children's Behaviour: Observing and Understanding Social and Cooperative Play in Early Years Educational Settings

ERIC Educational Resources Information Center

Broadhead, Pat

2009-01-01

This paper draws from continuing research into the growth of sociability and cooperation in young children. It began in the mid-1980s and has continued periodically in a range of early years educational settings across the 3-6 age range. The research has underpinned the development of an observational tool. This tool--the Social Play Continuum or…

Assessment of Program Impact Through First Grade, Volume III: Impact on Parents. An Evaluation of Project Developmental Continuity. Interim Report X.

ERIC Educational Resources Information Center

Morris, Mary; And Others

Third in a series of six, this volume reports findings concerning the impact of Project Developmental Continuity (PDC) on the parents of the evaluation study's cohort of children as well as preliminary findings on the relationship between family characteristics and program outcome variables up to the time the children had completed grade 1. Begun…

Current Training and Continuing Education Needs of Preschool and School-Based Speech-Language Pathologists regarding Children with Cleft Lip/Palate

ERIC Educational Resources Information Center

Bedwinek, Anne P.; Kummer, Ann W.; Rice, Gale B.; Grames, Lynn Marty

2010-01-01

Purpose: The purpose of this study was to obtain information regarding the education and experience of preschool and school-based speech-language pathologists (SLPs) regarding the assessment and treatment of children born with cleft lip and/or palate and to determine their continuing education needs in this area. Method: A 16-item mixed-methods…

A Comparative Study of Performance in the Conners' Continuous Performance Test between Brazilian and North American Children

ERIC Educational Resources Information Center

Miranda, Monica Carolina; Sinnes, Elaine Girao; Pompeia, Sabine; Bueno, Orlando Francisco Amodeo

2008-01-01

Objective: The present study investigated the performance of Brazilian children in the Continuous Performance Test, CPT-II, and compared results to those of the norms obtained in the United States. Method: The U.S. norms were compared to those of a Brazilian sample composed of 6- to 11-year-olds separated into 4 age-groups (half boys) that…

Title 1 Schools Parent Liaisons' Reports Regarding Their Roles and Associated Responsibilities to Facilitate Parent Engagement to Support Children's Academic Achievement

ERIC Educational Resources Information Center

Tacchi, Barbara M.

2013-01-01

Parent Liaisons can play an integral role in working to realize a vision for a strategic, comprehensive, and continuous system of family, school, and community partnerships that demonstrably contribute to children's development and school success. Parent involvement continues to receive an increasing amount of attention in federal and state…

A Three-Year Study of Continuity of Creative Growth under a Cognitive-Structured Approach to Educational Stimulation.

ERIC Educational Resources Information Center

Torrance, E. Paul; Phillips, Victor K.

Tasks from the Torrance Tests of Creative Thinking were administered to children in a cognitive-structured preprimary program. Results indicated that children entering as 5-year-olds showed a continuity of creative growth and excelled their controls on elaboration at the beginning of grade 1 and end of grade 2. Also, at the end of grade 2, they…

School Dropouts in Hong Kong: Parents' Experiences

ERIC Educational Resources Information Center

Lau, Yuk King

2011-01-01

Chinese parenting emphasises parents' responsibility in training and governing children's appropriate and expected behaviors, including good academic performance. As reflected by the Attendance Ordinance and the strong involvement of parents in children's study, there is continuous emphasis on parental responsibility in children's education in…

Dignifying Black Children's Lives.

ERIC Educational Resources Information Center

Hale, Janice E.

1992-01-01

Maintains that educators need to dignify the language and cognitive experiences of African-American children. Asserts that African-American culture emphasizes charismatic and stylistic uses of language. Teachers must understand African-American cultural styles if they are to create cultural continuity for African-American children who attend…

Growth Failure in Children with Systemic Juvenile Idiopathic Arthritis and Prolonged Inflammation despite Treatment with Biologicals: Late Normalization of Height by Combined Hormonal Therapies.

PubMed

de Zegher, Francis; Reynaert, Nele; De Somer, Lien; Wouters, Carine; Roelants, Mathieu

2018-06-25

Biologicals targeting the interleukin (IL)-1β or IL-6 pathway are becoming prime choices for the treatment of children with systemic juvenile idiopathic arthritis (sJIA). Up to 1 in 3 sJIA children receiving such treatment continues to have inflammatory activity and to require supra-physiological glucocorticoid doses which may reduce growth velocity for years and may lead to an extremely short stature for age, if not for life. Currently, there is no long-term proposal to normalize the adult height of these children with sJIA. We present long-term (up to 10 years), proof-of-concept evidence that the adult stature and adipose body composition of short sJIA children can be normalized with a hormonal combination strategy: (i) pubertal onset is postponed with a gonadotropin-releasing hormone analog (triptorelin) until a minimum height is reached, or until prepubertal growth is exhausted, and (ii) height gain is promoted with growth hormone (≈50 μg/kg/day), once inflammation is under control and high glucocorticoid doses are no longer needed. The latter treatment takes advantage of the window of relative glucocorticoid deficiency, which is known to open after prolonged glucocorticoid administration, and to be uniquely favorable to height gain. A long-term combination of biological and hormonal treatments for short sJIA children can be guided by a simple concept that involves (i) postponement of pubertal development and (ii) growth-promoting therapy after the episodes of major inflammation and high-dose glucocorticoid treatment. Limited long-term experience in short sJIA children suggests that this strategy leads consistently - albeit late - to a normal adult stature. © 2018 S. Karger AG, Basel.

Use of magnetic resonance imaging in short stature: data from National Cooperative Growth Study (NCGS) Substudy 8.

PubMed

Kemp, Stephen F; Alter, Craig A; Dana, Ken; Baptista, Joyce; Blethen, Sandra L

2002-05-01

The primary use of magnetic resonance imaging (MRI) in the evaluation of children with short stature (SS) is to discover lesions in the central nervous system (CNS), particularly tumors that may require intervention. MRI has a secondary role in identifying structural abnormalities responsible for growth hormone deficiency (GHD). We examined data from the National Cooperative Growth Study (NCGS) Substudy 8 to determine how American physicians are using MRI in evaluating children with SS. Of the 21,738 short children enrolled in NCGS, 5% underwent MRI during their follow-up. Children who had GH stimulation testing were more likely to have had an MRI than those in whom no GH stimulation test was performed (19% vs 2%, p <0.0001). Moreover, children diagnosed with severe GHD (maximum GH <5 ng/ml) were more likely to have an abnormal finding on MRI. Of these patients, 27% demonstrated an abnormality as compared to 12% and 12.5% in patients with partial GHD and normal GH stimulation test results (>10 ng/ml), respectively. Abnormalities unrelated to the hypothalamus or pituitary represented 30% of these findings, while disorders in pituitary anatomy, including pituitary hypoplasia, pituitary stalk interruption, and ectopic posterior pituitary, represented an additional 30% of abnormal MRI examinations. CNS tumors comprised 23% of abnormal findings in these patients. We conclude that MRI provides significant value in the evaluation of children with SS, by identifying CNS tumors associated with growth failure as well as anatomical abnormalities of the pituitary. These findings are useful in confirming the diagnosis of GHD in children and identifying potential candidates for continued GH replacement in adulthood.

Trajectories of child externalizing problems between ages 3 and 10 years: Contributions of children's early effortful control, theory of mind, and parenting experiences.

PubMed

Olson, Sheryl L; Choe, Daniel Ewon; Sameroff, Arnold J

2017-10-01

Preventing problem behavior requires an understanding of earlier factors that are amenable to intervention. The main goals of our prospective longitudinal study were to trace trajectories of child externalizing behavior between ages 3 and 10 years, and to identify patterns of developmentally significant child and parenting risk factors that differentiated pathways of problem behavior. Participants were 218 3-year-old boys and girls who were reassessed following the transition to kindergarten (age 5-6 years) and during the late school-age years (age 10). Mothers contributed ratings of children's externalizing behavior at all three time points. Children's self-regulation abilities and theory of mind were assessed during a laboratory visit, and parenting risk (frequent corporal punishment and low maternal warmth) was assessed using interview-based and questionnaire measures. Four developmental trajectories of externalizing behavior yielded the best balance of parsimony and fit with our longitudinal data and latent class growth analysis. Most young children followed a pathway marked by relatively low levels of symptoms that continued to decrease across the school-age years. Atypical trajectories marked chronically high, increasing, and decreasing levels of externalizing problems across early and middle childhood. Three-year-old children with low levels of effortful control were far more likely to show the chronic pattern of elevated externalizing problems than changing or low patterns. Early parental corporal punishment and maternal warmth, respectively, differentiated preschoolers who showed increasing and decreasing patterns of problem behavior compared to the majority of children. The fact that children's poor effortful regulation skills predicted chronic early onset problems reinforces the need for early childhood screening and intervention services.

The Continuing Problem of Asthma in Very Young Children: A Community-Based Participatory Research Project

ERIC Educational Resources Information Center

Nelson, Belinda Wilburn; Awad, Daniel; Alexander, Jeffrey; Clark, Noreen

2009-01-01

Background: Asthma is a chronic health condition that has a disproportionate effect on low-income minority children who reside in large urban areas. African American children report significantly higher rates than the general population of children and have more-severe asthma and poorer outcomes. This article describes the prevalence of asthma in…

Dream Recall and Dream Content in Children with Attention Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Schredl, Michael; Sartorius, Heiko

2010-01-01

Although sleep is widely investigated in children with ADHD, dream studies in this group are completely lacking. The continuity hypothesis of dreaming stating that waking life is reflected in dreams would predict that waking-life symptoms are reflected in the dreams of such children. 103 children with ADHD and 100 controls completed a dream…

76 FR 35095 - Special Supplemental Nutrition Program for Women, Infants and Children (WIC): Exclusion of Combat...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... Nutrition Program for Women, Infants and Children (WIC): Exclusion of Combat Pay From WIC Income Eligibility... Children (WIC) a statutory provision set forth in Section 734(b) of the Agriculture, Rural Development... NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) 0 1. The authority citation for part 246 continues...

"In Kindy You Don't Get Taught": Continuity and Change as Children Start School

ERIC Educational Resources Information Center

Dockett, Sue; Perry, Bob

2012-01-01

Over the last decade, there has been increasing awareness of the importance of engaging young children in research about their experiences and considering ways in which children's experiences, expectations and perceptions influence both their interactions and those of others. This has resulted from recognition of young children as active citizens,…

The Effects of Acoustic Bandwidth on Simulated Bimodal Benefit in Children and Adults with Normal Hearing.

PubMed

Sheffield, Sterling W; Simha, Michelle; Jahn, Kelly N; Gifford, René H

2016-01-01

The primary purpose of this study was to examine the effect of acoustic bandwidth on bimodal benefit for speech recognition in normal-hearing children with a cochlear implant (CI) simulation in one ear and low-pass filtered stimuli in the contralateral ear. The effect of acoustic bandwidth on bimodal benefit in children was compared with the pattern of adults with normal hearing. Our hypothesis was that children would require a wider acoustic bandwidth than adults to (1) derive bimodal benefit, and (2) obtain asymptotic bimodal benefit. Nineteen children (6 to 12 years) and 10 adults with normal hearing participated in the study. Speech recognition was assessed via recorded sentences presented in a 20-talker babble. The AzBio female-talker sentences were used for the adults and the pediatric AzBio sentences (BabyBio) were used for the children. A CI simulation was presented to the right ear and low-pass filtered stimuli were presented to the left ear with the following cutoff frequencies: 250, 500, 750, 1000, and 1500 Hz. The primary findings were (1) adults achieved higher performance than children when presented with only low-pass filtered acoustic stimuli, (2) adults and children performed similarly in all the simulated CI and bimodal conditions, (3) children gained significant bimodal benefit with the addition of low-pass filtered speech at 250 Hz, and (4) unlike previous studies completed with adult bimodal patients, adults and children with normal hearing gained additional significant bimodal benefit with cutoff frequencies up to 1500 Hz with most of the additional benefit gained with energy below 750 Hz. Acoustic bandwidth effects on simulated bimodal benefit were similar in children and adults with normal hearing. Should the current results generalize to children with CIs, these results suggest pediatric CI recipients may derive significant benefit from minimal acoustic hearing (<250 Hz) in the nonimplanted ear and increasing benefit with broader bandwidth. Knowledge of the effect of acoustic bandwidth on bimodal benefit in children may help direct clinical decisions regarding a second CI, continued bimodal hearing, and even optimizing acoustic amplification for the nonimplanted ear.