Childhood trauma and chronic illness in adulthood: mental health and socioeconomic status as explanatory factors and buffers

Directory of Open Access Journals (Sweden)

Steven E Mock

2011-01-01

Full Text Available Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typically adverse consequences of childhood trauma. The results suggest mental health and socioeconomic status partially explain the association of childhood trauma with chronic illness in adulthood, with mental health showing a stronger effect. In addition, an analysis of the interactions suggested higher socioeconomic status is a potential protective factor for those with a history of trauma. Results also suggest cumulative disadvantage following trauma may lead to chronic illness and suggest the need for public health expenditures on resources such as counseling and income supports to prevent or reduce psychological harm and chronic illness resulting from traumatic events.

Guidelines for the treatment of childhood-onset Graves' disease in Japan, 2016.

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Minamitani, Kanshi; Sato, Hirokazu; Ohye, Hidemi; Harada, Shohei; Arisaka, Osamu

2017-01-01

Purpose behind developing these guidelines: Over one decade ago, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (Japan Thyroid Association (JTA)) were published as the standard drug therapy protocol for Graves' disease. The "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" were published to provide guidance on the treatment of pediatric patients. Based on new evidence, a revised version of the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (JTA) was published in 2011, combined with the "Handbook of Radioiodine Therapy for Graves' Disease 2007" (JTA). Subsequently, newer findings on pediatric Graves' disease have been reported. Propylthiouracil (PTU)-induced serious hepatopathy is an important problem in pediatric patients. The American Thyroid Association's guidelines suggest that, in principle, physicians must not administer PTU to children. On the other hand, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2011" (JTA) state that radioiodine therapy is no longer considered a "fundamental contraindication" in children. Therefore, the "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" required revision.

Non-severe pneumonia in childhood: guidelines for management in ...

African Journals Online (AJOL)

Ann Burgess

Among the under 5-year-olds worldwide there are about 156,000,000 cases of pneumonia each year. This causes about 20% of all deaths in this age group. Effective implementation of the WHO. Integrated Management of Childhood Illness (IMCI) reduces this morbidity and mortality. The recommendations for treating ...

[Evidence-based therapy guideline of the German Working Group on Obesity in Childhood and Adolescence].

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Moss, A; Kunze, D; Wabitsch, M

2011-05-01

Obesity in childhood and adolescence has increased worldwide in recent years. A consensus guideline (S2) for treating obesity in childhood and adolescence in Germany was first published by the German Working Group on Obesity in Childhood and Adolescence (AGA) in 2000. The intention is to gradually replace this consensus-based (S2) guideline with an evidence-based (S3) guideline. Following a systematic literature search, 21 recommendations were predominantly approved with "strong consensus" (agreement >95%). Body weight and body fat mass can be significantly influenced by conventional behavior-based measures and also by the currently available drug therapies. However, the extent of the achieved weight reduction is small. Surgical measures (unproven, experimental therapy) to reduce body weight, in contrast, are very successful. In addition to the long version of this evidence-based guideline, an abbreviated version exists and a practice guideline is planned. This guideline should be further developed within the competence network on obesity of the German Federal Ministry of Education and Research. The guideline will be published in the scholarly journals of the professional associations concerned, will be available via the Internet, and will also be distributed through periodicals, congress events, and information at facilities.

Japanese Guideline for Childhood Asthma

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Toshiyuki Nishimuta

2011-01-01

JAGL differs from the Global Initiative for Asthma Guideline (GINA in that the former emphasizes long-term management of childhood asthma based on asthma severity and early diagnosis and intervention at <2 years and 2–5 years of age. However, a management method, including step-up or step-down of long-term management agents based on the status of asthma symptoms, is easy to understand and thus JAGL is suitable for routine medical treatment. JAGL also introduced treatment and management using a control test for children, recommending treatment and management aimed at complete control through avoiding exacerbation factors and appropriate use of antiinflammatory agents.

Drinking Water Systems, Hydrology, and Childhood Gastrointestinal Illness in Central and Northern Wisconsin

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Uejio, Christopher K.; Yale, Steven H.; Malecki, Kristen; Borchardt, Mark A.; Anderson, Henry A.; Patz, Jonathan A.

2014-01-01

Objectives. This study investigated if the type of drinking water source (treated municipal, untreated municipal, and private well water) modifies the effect of hydrology on childhood (aged water systems. Separate time series models were created for each system and half-year period (winter/spring, summer/fall). Results. More precipitation (summer/fall) systematically increased childhood gastrointestinal illness in municipalities accessing untreated water. The relative risk of contracting gastrointestinal illness was 1.4 in weeks with 3 centimeters of precipitation and 2.4 in very wet weeks with 12 centimeters of precipitation. By contrast, gastrointestinal illness in private well and treated municipal areas was not influenced by hydrologic conditions, although warmer winter temperatures slightly increased incidence. Conclusions. Our study suggests that improved drinking water protection, treatment, and delivery infrastructure may improve public health by specifically identifying municipal water systems lacking water treatment that may transmit waterborne disease. PMID:24524509

Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions

Science.gov (United States)

2014-01-01

Background More and more pediatric patients reach adulthood. Some of them are successfully integrating in adult life, but many others are not. Possibly Illness cognitions (IC) - the way people give meaning to their illness/disability – may play a role in individual differences on long-term adjustment. This study explored the association of IC with disease–characteristics and Health Related Quality of Life (HRQoL), anxiety and depression in young adults with a disability benefit due to childhood-onset chronic condition. Methods In a cross-sectional study, young adults (22–31 years, N = 377) who claimed a disability benefit because of a somatic condition since childhood, completed the Illness Cognition Questionnaire (acceptance-helplessness-benefits), RAND-36 (HRQoL) and HADS (anxiety and depression) online. Besides descriptive statistics, linear regression analyses were conducted to predict (1) illness cognitions by age, gender and disease-characteristics, and (2) HRQoL (Mental and Physical Component Scale), Anxiety and Depression by illness cognitions, controlling for disease-characteristics, age and gender. Results Respectively 90.2%, 83.8% and 53.3% of the young adults with a disability benefit experienced feelings of acceptance, benefits and helplessness. Several disease-characteristics were associated with IC. More acceptance and less helplessness were associated with better mental (β = 0.31; β = −0.32) and physical (β = 0.16; β = −0.15) HRQoL and with less anxiety (β = −0.27; β = 0.28) and depression (β = −0.29; β = 0.31). Conclusions IC of young adult beneficiaries were associated with their HRQoL and feelings of anxiety and depression. Early recognition of psychological distress and negative IC might be a key to the identification of pediatric patients at risk for long-term dysfunction. Identification of maladaptive illness cognitions enables the development of psychosocial interventions to optimise

Representation of Illness and Self-identity in Childhood Cancer Survivors

Czech Academy of Sciences Publication Activity Database

Blažková, T.; Koutná, Veronika; Blatný, Marek; Kepák, T.; Jelínek, Martin

2015-01-01

Roč. 24, JUL (2015), s. 348-348 ISSN 1057-9249. [World Congress of Psycho-Oncology. 28.07.2015-01.08.2015, Washington, DC] R&D Projects: GA ČR(CZ) GAP407/11/2421 Institutional support: RVO:68081740 Keywords : representation of illness * self-identity * childhood cancer survivors Subject RIV: AN - Psychology

Representation of Illness and Self-identity in Childhood Cancer Survivors

Czech Academy of Sciences Publication Activity Database

Blažková, T.; Koutná, Veronika; Blatný, Marek; Kepák, T.; Jelínek, Martin

2015-01-01

Roč. 24, JUL (2015), s. 348-348 ISSN 1057-9249. [World Congress of Psycho -Oncology. 28.07.2015-01.08.2015, Washington, DC] R&D Projects: GA ČR(CZ) GAP407/11/2421 Institutional support: RVO:68081740 Keywords : representation of illness * self-identity * childhood cancer survivors Subject RIV: AN - Psycho logy

Role of maternal childhood trauma on parenting among depressed mothers of psychiatrically ill children.

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Zalewski, Maureen; Cyranowski, Jill M; Cheng, Yu; Swartz, Holly A

2013-09-01

Independently, maternal depression and maternal history of childhood abuse confer risk for impaired parenting. These associations may be compounded when depressed mothers with histories of childhood abuse are faced with the challenge of parenting offspring who themselves struggle with mental health problems. This study examined the relationships among maternal history of childhood abuse, maternal depression, and parenting style in the context of parenting a psychiatrically ill child, with an emphasis on examining maternal emotional abuse and neglect. We hypothesized that maternal childhood emotional abuse would be associated with maladaptive parenting strategies (lower levels of maternal acceptance and higher levels of psychological control), independent of maternal depression severity and other psychosocial risk factors. Ninety-five mother-child dyads (children ages 7-18) were recruited from child mental health centers where children were receiving treatment for at least one internalizing disorder. Participating mothers met DSM-IV criteria for major depressive disorder. Mothers reported on their own childhood abuse histories and children reported on their mothers' parenting. Regression analyses demonstrated that maternal childhood emotional abuse was associated with child reports of lower maternal acceptance and greater psychological control, controlling for maternal depression severity, and other psychosocial risk factors. When treating psychiatrically ill children, it is important for a child's clinician to consider mothers' childhood abuse histories in addition to their history of depression. These mothers appear to have additional barriers to effective parenting. © 2013 Wiley Periodicals, Inc.

A Worldwide Collaboration to Harmonize Guidelines for the Long-Term Follow-Up of Childhood and Young Adult Cancer Survivors: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group

NARCIS (Netherlands)

Kremer, Leontien C. M.; Mulder, Renée L.; Oeffinger, Kevin C.; Bhatia, Smita; Landier, Wendy; Levitt, Gill; Constine, Louis S.; Wallace, W. Hamish; Caron, Huib N.; Armenian, Saro H.; Skinner, Roderick; Hudson, Melissa M.

2013-01-01

Childhood and young adult cancer survivors should receive optimum care to reduce the consequences of late effects and improve quality of life. We can facilitate achieving this goal by international collaboration in guideline development. In 2010, the International Late Effects of Childhood Cancer

Alcohol consumption and use of health care services in people with severe mental illness and stressful childhood experiences.

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Schneeberger, Andres R; Huber, Christian G; Seixas, Azizi; Muenzenmaier, Kristina H; Lang, Undine E; Castille, Dorothy; Larkin, Stefan; Link, Bruce G

2017-01-01

People who suffer from severe mental illness often present with histories of abuse during childhood. Alcohol use disorders is a common co-morbidity of survivors of childhood abuse and neglect. This study analyzes the effects of stressful childhood experiences, a proxy for trauma, on the frequency of alcohol consumption and the utilization of health care services in a population of people with severe mental illness. There were 111 men (mean age: 35 years) and 72 women (mean age: 40.0 years) with severe mental illness that were recruited from psychiatric outpatient clinics in New York City. The analysis focused on lifetime prevalence of stressful childhood experiences, alcohol consumption, and utilization of health care services over time. The longitudinal data were analyzed over 12 months with a level-2 model (multilevel modeling). Out of the participants, 41.5% reported a history of more than four types of abusive experiences. There were 33.3% that had a DSM-IV diagnosis of alcohol abuse and 27.3% qualified for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of alcohol dependence throughout their lives. Stressful childhood experiences predicted an increased frequency of alcohol consumption over time. People with histories of childhood abuse had more often been to outpatient clinics and 12-step programs, but at the same time showed lower frequency rates of psychiatrist visits and visits to outpatient clinics. Childhood abuse is prevalent in people with severe mental illness and is related to an increased alcohol consumption. Despite an increased need of health care services, affected persons might encounter more barriers to access them.

Childhood developmental vulnerabilities associated with early life exposure to infectious and noninfectious diseases and maternal mental illness.

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Green, Melissa J; Kariuki, Maina; Dean, Kimberlie; Laurens, Kristin R; Tzoumakis, Stacy; Harris, Felicity; Carr, Vaughan J

2017-12-26

Fetal exposure to infectious and noninfectious diseases may influence early childhood developmental functioning, on the path to later mental illness. Here, we investigated the effects of in utero exposure to maternal infection and noninfectious diseases during pregnancy on offspring developmental vulnerabilities at age 5 years, in the context of estimated effects for early childhood exposures to infectious and noninfectious diseases and maternal mental illness. We used population data for 66,045 children from an intergenerational record linkage study (the New South Wales Child Development Study), for whom a cross-sectional assessment of five developmental competencies (physical, social, emotional, cognitive, and communication) was obtained at school entry, using the Australian Early Development Census (AEDC). Child and maternal exposures to infectious or noninfectious diseases were determined from the NSW Ministry of Health Admitted Patients Data Collection (APDC) and maternal mental illness exposure was derived from both APDC and Mental Health Ambulatory Data collections. Multinomial logistic regression analyses were used to examine unadjusted and adjusted associations between these physical and mental health exposures and child developmental vulnerabilities at age 5 years. Among the physical disease exposures, maternal infectious diseases during pregnancy and early childhood infection conferred the largest associations with developmental vulnerabilities at age 5 years; maternal noninfectious illness during pregnancy also retained small but significant associations with developmental vulnerabilities even when adjusted for other physical and mental illness exposures and covariates known to be associated with early childhood development (e.g., child's sex, socioeconomic disadvantage, young maternal age, prenatal smoking). Among all exposures examined, maternal mental illness first diagnosed prior to childbirth conferred the greatest odds of developmental

Integrated management of childhood illness

Directory of Open Access Journals (Sweden)

1997-01-01

Full Text Available Millones de defunciones en niños menores de 5 años se podrían prevenir en países en desarrollo si se aplicaran las medidas de control y los tratamientos eficaces que se usan normalmente en países desarrollados. Conscientes de la necesidad de hacer frente a las principales causas de enfermedad y muerte en la infancia (infecciones respiratorias agudas, enfermedades diarreicas, desnutrición, malaria y enfermedades prevenibles por medio de la vacunación mediante una iniciativa global, la OMS y el UNICEF han desarrollado una estrategia conocida por Atención Integrada de las Enfermedades Prevalentes de la Infancia (Integrated Management of Childhood Illness, IMCI. Sus oficinas regionales para las Américas, que son la OPS y el UNICEF-TACRO, han aceptado los objetivos y actividades descritos en el presente informe a fin de reorientar su labor y dirigirla hacia el mejoramiento del estado de salud infantil en este hemisferio.

Cost-effectiveness analysis of revised WHO guidelines for management of childhood pneumonia in 74 Countdown countries.

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Zhang, Shanshan; Incardona, Beatrice; Qazi, Shamim A; Stenberg, Karin; Campbell, Harry; Nair, Harish

2017-06-01

Treatment of childhood pneumonia is a key priority in low-income countries, with substantial resource implications. WHO revised their guidelines for the management of childhood pneumonia in 2013. We estimated and compared the resource requirements, total direct medical cost and cost-effectiveness of childhood pneumonia management in 74 countries with high burden of child mortality (Countdown countries) using the 2005 and 2013 revised WHO guidelines. We constructed a cost model using a bottom up approach to estimate the cost of childhood pneumonia management using the 2005 and 2013 WHO guidelines from a public provider perspective in 74 Countdown countries. The cost of pneumonia treatment was estimated, by country, for year 2013, including costs of medicines and service delivery at three different management levels. We also assessed country-specific lives saved and disability adjusted life years (DALYs) averted due to pneumonia treated in children aged below five years. The cost-effectiveness of pneumonia treatment was estimated in terms of cost per DALY averted by fully implementing WHO treatment guidelines relative to no treatment intervention for pneumonia. Achieving full treatment coverage with the 2005 WHO guidelines was estimated to cost US$ 2.9 (1.9-4.2) billion compared to an estimated US$ 1.8 (0.8-3.0) billion for the revised 2013 WHO guidelines in these countries. Pneumonia management in young children following WHO treatment guidelines could save up to 39.8 million DALYs compared to a zero coverage scenario in the year 2013 in the 74 Countdown countries. The median cost-effectiveness ratio per DALY averted in 74 countries was substantially lower for the 2013 guidelines: US$ 26.6 (interquartile range IQR: 17.7-45.9) vs US$ 38.3 (IQR: US$ 26.2-86.9) per DALY averted for the 2005 guideline respectively. Child pneumonia management as detailed in standard WHO guidelines is a very cost-effective intervention. Implementation of the 2013 WHO guidelines is

Young adults' childhood experiences of support when living with a parent with a mental illness.

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Nilsson, Stefan; Gustafsson, Lisa; Nolbris, Margaretha Jenholt

2015-12-01

There are several concerns in relation to children living with a parent suffering from a mental illness. In such circumstances, the health-care professionals need to involve the whole family, offering help to the parents on parenting as well as support for their children. These children are often helped by participating in meetings that provide them with contact with others with similar experiences. The aim of this study was to investigate young adults' childhood experiences of support groups when living with a mentally ill parent. Seven young women were chosen to participate in this study. A qualitative descriptive method was chosen. The main category emerged as 'the influence of life outside the home because of a parent's mental illness' from the two generic categories: 'a different world' and 'an emotion-filled life'. The participants' friends did not know that their parent was ill and they 'always had to…take responsibility for what happened at home'. These young adults appreciated the support group activities they participated in during their childhood, stating that the meetings had influenced their everyday life as young adults. Despite this, they associated their everyday life with feelings of being different. This study highlights the need for support groups for children whose parents suffer from mental illness. © The Author(s) 2014.

The national curriculum guidelines of early childhood education: In search of a job to educational quality

Directory of Open Access Journals (Sweden)

Alessandra de Carvalho Faria

2014-08-01

childhood education. This paper intends to discuss the National Curriculum Guidelines for Early Childhood Education, which define how they should be organized teaching practice, and examine how the activities should be developed in early childhood education institutions, to objectify the holistic development of children in seeking quality care this stage of basic education.

Can Smartphones and Tablets Improve the Management of Childhood Illness in Tanzania? A Qualitative Study froma Primaryhealth Care worker’s Perspective

OpenAIRE

Shao, Amani Flexson; Rambaud-Althaus, Clotilde; Swai, Ndeniria; Kahama-Maro, Judith; Genton, Blaise; D’Acremont, Valerie; Pfeiffer, Constanze

2015-01-01

The impact of the Integrated Management of Childhood Illness (IMCI) strategy has been less than anticipated because of poor uptake. Electronic algorithms have the potential to improve quality of health care in children. However, feasibility studies about the use of electronic protocols on mobile devices over time are limited. This study investigated constraining as well as facilitating factors that influence the uptake of a new electronic Algorithm for Management of Childhood Illness (ALMANAC...

Nationwide implementation of integrated community case management of childhood illness in Rwanda

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Mugeni, Catherine; Levine, Adam C; Munyaneza, Richard M; Mulindahabi, Epiphanie; Cockrell, Hannah C; Glavis-Bloom, Justin; Nutt, Cameron T; Wagner, Claire M; Gaju, Erick; Rukundo, Alphonse; Habimana, Jean Pierre; Karema, Corine; Ngabo, Fidele; Binagwaho, Agnes

2014-01-01

ABSTRACT Background: Between 2008 and 2011, Rwanda introduced integrated community case management (iCCM) of childhood illness nationwide. Community health workers in each of Rwanda's nearly 15,000 villages were trained in iCCM and equipped for empirical diagnosis and treatment of pneumonia, diarrhea, and malaria; for malnutrition surveillance; and for comprehensive reporting and referral services. Methods: We used data from the Rwanda health management information system (HMIS) to calculate monthly all-cause under-5 mortality rates, health facility use rates, and community-based treatment rates for childhood illness in each district. We then compared a 3-month baseline period prior to iCCM implementation with a seasonally matched comparison period 1 year after iCCM implementation. Finally, we compared the actual changes in all-cause child mortality and health facility use over this time period with the changes that would have been expected based on baseline trends in Rwanda. Results: The number of children receiving community-based treatment for diarrhea and pneumonia increased significantly in the 1-year period after iCCM implementation, from 0.83 cases/1,000 child-months to 3.80 cases/1,000 child-months (P = .01) and 0.25 cases/1,000 child-months to 5.28 cases/1,000 child-months (P<.001), respectively. On average, total under-5 mortality rates declined significantly by 38% (P<.001), and health facility use declined significantly by 15% (P = .006). These decreases were significantly greater than would have been expected based on baseline trends. Conclusions: This is the first study to demonstrate decreases in both child mortality and health facility use after implementing iCCM of childhood illness at a national level. While our study design does not allow for direct attribution of these changes to implementation of iCCM, these results are in line with those of prior studies conducted at the sub-national level in other low-income countries. PMID:25276592

Perceived improvement in integrated management of childhood illness implementation through use of mobile technology: qualitative evidence from a pilot study in Tanzania.

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Mitchell, Marc; Getchell, Maya; Nkaka, Melania; Msellemu, Daniel; Van Esch, Jan; Hedt-Gauthier, Bethany

2012-01-01

This study examined health care provider and caretaker perceptions of electronic Integrated Management of Childhood Illness (eIMCI) in diagnosing and treating childhood illnesses. The authors conducted semi-structured interviews among caretakers (n = 20) and health care providers (n = 11) in the Pwani region of Tanzania. This qualitative study was nested within a larger quantitative study measuring impact of eIMCI on provider adherence to IMCI protocols. Caretakers and health care workers involved in the larger study provided their perceptions of eIMCI in comparison with the conventional paper forms. One health care provider from each participating health center participated in qualitative interviews; 20 caretakers were selected from 1 health center involved in the quantitative study. Interviews were conducted in Swahili and lasted 5-10 min each. Providers expressed positive opinions of eIMCI, noting that the personal digital assistants were faster and easier to use than were the paper forms and encouraged adherence to IMCI procedures. Caretakers also held a positive view of eIMCI, noting improved service from providers, more thorough examination of their child, and a perception that providers who used the personal digital assistants were more knowledgeable. Research indicates widespread nonadherence to IMCI guidelines, suggesting improved methods for implementing IMCI are necessary. The authors conclude that eIMCI represents a promising method for improving health care delivery because it improves health care provider and caretaker perception of the clinical encounter. Further investigation into this technology is warranted.

Systematic review of character development and childhood chronic illness.

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Maslow, Gary R; Hill, Sherika N

2016-05-08

To review empirical evidence on character development among youth with chronic illnesses. A systematic literature review was conducted using PubMed and PSYCHINFO from inception until November 2013 to find quantitative studies that measured character strengths among youth with chronic illnesses. Inclusion criteria were limited to English language studies examining constructs of character development among adolescents or young adults aged 13-24 years with a childhood-onset chronic medical condition. A librarian at Duke University Medical Center Library assisted with the development of the mesh search term. Two researchers independently reviewed relevant titles (n = 549), then abstracts (n = 45), and finally manuscripts (n = 3). There is a lack of empirical research on character development and childhood-onset chronic medical conditions. Three studies were identified that used different measures of character based on moral themes. One study examined moral reasoning among deaf adolescents using Kohlberg's Moral Judgement Instrument; another, investigated moral values of adolescent cancer survivors with the Values In Action Classification of Strengths. A third study evaluated moral behavior among young adult survivors of burn injury utilizing the Tennessee Self-Concept, 2(nd) edition. The studies observed that youth with chronic conditions reasoned at less advanced stages and had a lower moral self-concept compared to referent populations, but that they did differ on character virtues and strengths when matched with healthy peers for age, sex, and race/ethnicity. Yet, generalizations could not be drawn regarding character development of youth with chronic medical conditions because the studies were too divergent from each other and biased from study design limitations. Future empirical studies should learn from the strengths and weaknesses of the existing literature on character development among youth with chronic medical conditions.

Systematic review of character development and childhood chronic illness

Science.gov (United States)

Maslow, Gary R; Hill, Sherika N

2016-01-01

AIM: To review empirical evidence on character development among youth with chronic illnesses. METHODS: A systematic literature review was conducted using PubMed and PSYCHINFO from inception until November 2013 to find quantitative studies that measured character strengths among youth with chronic illnesses. Inclusion criteria were limited to English language studies examining constructs of character development among adolescents or young adults aged 13-24 years with a childhood-onset chronic medical condition. A librarian at Duke University Medical Center Library assisted with the development of the mesh search term. Two researchers independently reviewed relevant titles (n = 549), then abstracts (n = 45), and finally manuscripts (n = 3). RESULTS: There is a lack of empirical research on character development and childhood-onset chronic medical conditions. Three studies were identified that used different measures of character based on moral themes. One study examined moral reasoning among deaf adolescents using Kohlberg’s Moral Judgement Instrument; another, investigated moral values of adolescent cancer survivors with the Values In Action Classification of Strengths. A third study evaluated moral behavior among young adult survivors of burn injury utilizing the Tennessee Self-Concept, 2nd edition. The studies observed that youth with chronic conditions reasoned at less advanced stages and had a lower moral self-concept compared to referent populations, but that they did differ on character virtues and strengths when matched with healthy peers for age, sex, and race/ethnicity. Yet, generalizations could not be drawn regarding character development of youth with chronic medical conditions because the studies were too divergent from each other and biased from study design limitations. CONCLUSION: Future empirical studies should learn from the strengths and weaknesses of the existing literature on character development among youth with chronic medical conditions

Integrated management of childhood illness (IMCI) strategy for children under five

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Gera, Tarun; Shah, Dheeraj; Garner, Paul; Richardson, Marty; Sachdev, Harshpal S

2016-01-01

treat sick children are available but do not reach them. One reason for this is that health care services are often too far away or too expensive. Health facilities in these settings often lack supplies and well-trained health care workers. In addition, ill children may have several health problems at the same time, and this can make diagnosis and treatment difficult for health care workers. In the 1990s, the World Health Organization (WHO) developed a strategy called integrated management of childhood illness (IMCI) to address these problems. This strategy aims to prevent death and disease while improving the quality of care for ill children up to the age of five. It consists of three parts. • Improving the skills of health care workers by providing training and guidelines. • Improving how health care systems are organized and managed, including access to supplies. • Visiting homes and communities to promote good child rearing practices and good nutrition, while encouraging parents to bring their children to a clinic when the children are ill. The WHO encourages countries to adapt the IMCI strategy to their own national settings. Types of childhood illnesses prioritised and ways in which services are delivered may vary from country to country. What are the main results of the review? This Cochrane review included four studies assessing the effectiveness of the IMCI strategy. These studies were conducted in Tanzania, Bangladesh, and India. The IMCI strategy was used very differently across studies. For instance, the study from Tanzania implemented health care worker training and improved drug supply but did not include home visits or community activities; the study from Bangladesh added new health care workers while training existing health care workers; and the two Indian studies specifically targeted newborns as well as older children. This review showed that use of IMCI: • may lead to fewer deaths among children from birth to five years of age (low

Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia

OpenAIRE

Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

2014-01-01

Background It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and ...

ILO Policy Guidelines on the promotion of decent work for early childhood education personnel

OpenAIRE

ILO International Labour Office

2014-01-01

These Guidelines set out principles for the promotion of decent work for early childhood education (ECE) personnel as a means of ensuring universal access to high-quality ECE services. In this respect they cover conditions of work and employment of ECE personnel and related issues, including ECE financing, curricula and learning practices, social security, professional ethics and ECE governance systems. The Guidelines are meant to serve as a reference tool on principles that should be reflect...

[Mental illnesses in childhood and adolescence: A bioethical view of the stigma they entail].

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Bella, Mónica E; Vilarrodona, Hugo

2015-01-01

Literature suggests that general beliefs towards mental illnesses are strongly correlated to the social behavior towards people who suffer them. to explore beliefs and attitudes towards mental illnesses in children and adolescents and associate them to bioethics. exploratory, prospective and quantitative study. A questionnaire was administered to parents-tutors of children-adolescents with mental disorders, and to healthcare professionals of the Hospital de Niños de la Santísima Trinidad Córdoba (Argentina). Data processing was performed by means of frequency analysis. 68.5% of parents-tutors and 51.8% of healthcare professionals answered that mental illnesses are never considered like any other illness. Diagnose and treatment is perceived as a stigma by 25.9% of healthcare professionals. For 88.1% of parents-tutors and 9.8% of healthcare professionals, children and adolescents with mental illnesses are never dangerous. 77.1% of parents and 18.4% of professionals stated that people are never afraid of children-adolescents with MI. 42.8% of children-adolescents were excluded from school and 28.5% from family activities. mental illness during childhood entails a stigma that compromises development, equal opportunity and human rights.

Childhood Trauma and Chronic Illness in Adulthood: Mental Health and Socioeconomic Status as Explanatory Factors and Buffers

OpenAIRE

Mock, Steven E.; Arai, Susan M.

2011-01-01

Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typ...

Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

Science.gov (United States)

Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

2017-08-01

To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer

How are the Experiences and Needs of Families of Individuals with Mental Illness Reflected in Medical Education Guidelines?

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Riebschleger, Joanne; Scheid, Jeanette; Luz, Clare; Mickus, Maureen; Liszewski, Christine; Eaton, Monaca

2008-01-01

Objective: This descriptive study explored the extent that medical education curriculum guidelines contained content about the experiences and needs of family members of people with serious mental illness. Methods: Key family-focused-literature themes about the experiences and needs of families of individuals with mental illness were drawn from a…

Factors influencing the implementation of integrated management of childhood illness (IMCI) by healthcare workers at public health centers & dispensaries in Mwanza, Tanzania.

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Kiplagat, Augustine; Musto, Richard; Mwizamholya, Damas; Morona, Domenica

2014-03-25

Integrated Management of Childhood Illness (IMCI) was developed by the World Health Organization (WHO) and the United Nations International Children's Fund (UNICEF) and aims at reducing childhood morbidity and mortality in resource-limited settings including Tanzania. It was introduced in 1996 and has been scaled up in all districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza, Tanzania since reports indicates that the guidelines are not full adhered to by the healthcare workers. A cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza city were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the 2 facilitators. Data were analyzed using SPSS and presented using figures and tables. Only 51% of healthcare workers interviewed had been trained. 69% of trained Healthcare workers expressed understanding of the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illnesses especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, lack of onsite mentoring and lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through training, onsite mentoring, supportive supervision and strengthening the healthcare system through increasing access to essential medicines, vaccines, strengthening supply chain management, increasing healthcare financing, improving leadership & management were the major interventions that could assist in IMCI implementation. The healthcare workers can implement better IMCI through the

Guidelines for the Gamification of Self-Management of Chronic Illnesses: Multimethod Study.

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AlMarshedi, Alaa; Wills, Gary; Ranchhod, Ashok

2017-05-12

Gamification is the use of game elements and techniques in nongaming contexts. The use of gamification in health care is receiving a great deal of attention in both academic research and the industry. However, it can be noticed that many gamification apps in health care do not follow any standardized guidelines. This research aims to (1) present a set of guidelines based on the validated framework the Wheel of Sukr and (2) assess the guidelines through expert interviews and focus group sessions with developers. Expert interviews (N=6) were conducted to assess the content of the guidelines and that they reflect the Wheel of Sukr. In addition, the guidelines were assessed by developers (N=15) in 5 focus group sessions, where each group had an average of 3 developers. The guidelines received support from the experts. By the end of the sixth interview, it was determined that a saturation point was reached. Experts agreed that the guidelines accurately reflect the framework the Wheel of Sukr and that developers can potentially use them to create gamified self-management apps for chronic illnesses. Moreover, the guidelines were welcomed by developers who participated in the focus group sessions. They found the guidelines to be clear, useful, and implementable. Also, they were able to suggest many ways of gamifying a nongamified self-management app when they were presented with one. The findings suggest that the guidelines introduced in this research are clear, useful, and ready to be implemented for the creation of self-management apps that use the notion of gamification as described in the Wheel of Sukr framework. The guidelines are now ready to be practically tested. Further practical studies of the effectiveness of each element in the guidelines are to be carried out. ©Alaa AlMarshedi, Gary Wills, Ashok Ranchhod. Originally published in JMIR Serious Games (http://games.jmir.org), 12.05.2017.

Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

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Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

2014-04-12

It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

Childhood- versus adolescent-onset antisocial youth with conduct disorder: psychiatric illness, neuropsychological and psychosocial function.

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Johnson, Vicki A; Kemp, Andrew H; Heard, Robert; Lennings, Christopher J; Hickie, Ian B

2015-01-01

The present study investigates whether youths with childhood-onset antisocial behavior have higher rates of psychiatric illness, neuropsychological and psychosocial dysfunction than youths who engage in antisocial behavior for the first time in adolescence. Prior studies have generally focused on single domains of function in heterogeneous samples. The present study also examined the extent to which adolescent-onset antisocial behavior can be considered normative, an assumption of Moffitt's dual taxonomy model. Forty-three subjects (34 males, 9 females, mean age = 15.31, age range 12-21) with a diagnosis of conduct disorder (CD) were recruited through Headspace Services and the Juvenile Justice Community Centre. We compared childhood-onset antisocial youths (n = 23) with adolescent-onset antisocial youths (n = 20) with a conduct disorder, across a battery of psychiatric, neuropsychological and psychosocial measures. Neuropsychological function of both groups was also compared with normative scores from control samples. The childhood-onset group displayed deficits in verbal learning and memory, higher rates of psychosis, childhood maltreatment and more serious violent behavior, all effects associated with a large effect size. Both groups had impaired executive function, falling within the extremely low range (severely impaired). Childhood-onset CD displayed greater cognitive impairment, more psychiatric symptoms and committed more serious violent offences. The finding of severe executive impairment in both childhood- and adolescent-onset groupings challenges the assumption that adolescent-onset antisocial behavior is a normative process.

Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study.

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Karl Gauffin

Full Text Available The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872,912, which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.

‘Better medicines for children’ within the Integrated Management of Childhood Illness framework

DEFF Research Database (Denmark)

Nsabagasani, Xavier; Ogwal-Okeng, Jasper; Hansen, Ebba Holme

2016-01-01

. Conclusions: The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations – a missed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle to the integration of child-appropriate dosage formulations. Ministry of health should...... approach in Uganda has not been studied. Methods: Qualitative interviews were conducted with: two officials from the ministry of health; two district health officials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed for manifest and latent content. Results...

Psychiatric and physical sequelae of childhood physical and sexual abuse and forced sexual trauma among individuals with serious mental illness.

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Subica, Andrew M

2013-10-01

Trauma and posttraumatic stress disorder (PTSD) frequently co-occur with serious mental illness, yet the unique mental and physical health influences of childhood physical abuse (CPA), childhood sexual abuse (CSA), and forced sexual trauma on individuals with serious mental illness remain unevaluated. The present study of 172 individuals with serious mental illness investigated the adverse effects of CPA, CSA, and forced sexual trauma on severity of PTSD and depression, and overall mental and physical health functioning. Data analysis consisted of chi-square tests, independent t tests, bivariate odds ratios, and linear regressions. Prevalence of CPA (44.8%), CSA (29.1%), and forced sexual trauma (33.1%) were elevated, and nearly one third of participants (31.4%) reported clinical PTSD. Participants exposed to CSA or forced sexual trauma evidenced bivariate ORs ranging from 4.13 to 7.02 for PTSD, 2.44 to 2.50 for major depression, and 2.14 to 2.31 for serious physical illness/disability. Sexual trauma exposure associated with heightened PTSD and depression, and reduced mental and physical health functioning, with CSA uniquely predicting PTSD, depression, and physical health difficulties. CPA less significantly affected these clinical domains. Sexual traumas have profound negative effects on mental and physical health outcomes among individuals with serious mental illness; increased screening and treatment of sexual traumas is needed. Copyright © 2013 International Society for Traumatic Stress Studies.

Childhood- versus adolescent-onset antisocial youth with conduct disorder: psychiatric illness, neuropsychological and psychosocial function.

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Vicki A Johnson

Full Text Available The present study investigates whether youths with childhood-onset antisocial behavior have higher rates of psychiatric illness, neuropsychological and psychosocial dysfunction than youths who engage in antisocial behavior for the first time in adolescence. Prior studies have generally focused on single domains of function in heterogeneous samples. The present study also examined the extent to which adolescent-onset antisocial behavior can be considered normative, an assumption of Moffitt's dual taxonomy model.Forty-three subjects (34 males, 9 females, mean age = 15.31, age range 12-21 with a diagnosis of conduct disorder (CD were recruited through Headspace Services and the Juvenile Justice Community Centre. We compared childhood-onset antisocial youths (n = 23 with adolescent-onset antisocial youths (n = 20 with a conduct disorder, across a battery of psychiatric, neuropsychological and psychosocial measures. Neuropsychological function of both groups was also compared with normative scores from control samples.The childhood-onset group displayed deficits in verbal learning and memory, higher rates of psychosis, childhood maltreatment and more serious violent behavior, all effects associated with a large effect size. Both groups had impaired executive function, falling within the extremely low range (severely impaired.Childhood-onset CD displayed greater cognitive impairment, more psychiatric symptoms and committed more serious violent offences. The finding of severe executive impairment in both childhood- and adolescent-onset groupings challenges the assumption that adolescent-onset antisocial behavior is a normative process.

[Current Guidelines to Prevent Obesity in Childhood and Adolescence].

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Blüher, S; Kromeyer-Hauschild, K; Graf, C; Grünewald-Funk, D; Widhalm, K; Korsten-Reck, U; Markert, J; Güssfeld, C; Müller, M J; Moss, A; Wabitsch, M; Wiegand, S

2016-01-01

Current guidelines for the prevention of obesity in childhood and adolescence are presented. A literature search was performed in Medline via PubMed, and appropriate studies were analysed. Programs to prevent childhood obesity were to date mainly school-based. Effects were limited to date. Analyses tailored to different age groups show that prevention programs have the best effects in younger children (adolescence, school-based interventions were most effective when adolescents were directly addressed. To date, obesity prevention programs have mainly focused on behavior oriented prevention. Recommendations for condition oriented prevention have been suggested by the German Alliance of Non-communicable Diseases and include one hour of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory quality standards for meals at kindergarten and schools as well as a ban on unhealthy food advertisement addressing children. Behavior oriented prevention programs showed hardly any or only limited effects in the long term. Certain risk groups for the development of obesity are not reached effectively by available programs. Due to the heterogeneity of available studies, universally valid conclusions cannot be drawn. The combination with condition oriented prevention, which has to counteract on an obesogenic environment, is crucial for sustainable success of future obesity prevention programs. © Georg Thieme Verlag KG Stuttgart · New York.

Childhood risk factors for criminal justice involvement in a sample of homeless people with serious mental illness.

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Desai, R A; Lam, J; Rosenheck, R A

2000-06-01

It has been suggested that criminal justice involvement among the homeless, particularly those with mental illness, is largely situational. The objective of this study was to assess, in a sample of homeless seriously mentally ill people, the prevalence of childhood conduct disorder behaviors as a risk factor for adult criminal activity as well as the extent and types of adult criminal justice contact. Data were taken from the national ACCESS program, which conducted extensive baseline interviews with 7,222 homeless seriously mentally ill adults. The interview assessed demographics, childhood risk factors for criminal activity such as conduct disorder behaviors, foster care, and parental abuse, as well as current illness severity and recent criminal justice contact. The 2-month arrest rate in this sample was much higher than national rates (11% compared with 1% annually in the general population). Although most arrests were for minor crimes (10.8%), there were also substantial rates of arrest for major (2.7%) and substance-related charges (2.0%). The prevalence of a history of conduct disorder behavior was also substantial (55% in male subjects, 40% in female subjects), and conduct disorder was a strong predictor of recent criminal justice involvement, even after controlling for other predictors of arrest (odds ratio = 1.76 for major crimes, 1.49 for minor crimes, and 1.98 for substance-related crimes). Recent literature has criticized a trend to criminalize homeless mentally ill persons for attempting to get needed food, shelter, or medical attention. However, these data indicate that at least some proportion of arrests in this population are of people who have been exhibiting antisocial behavior since early adolescence, and that early antisocial behavior is a strong predictor of all types of recent arrests in this population.

Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province.

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Vhuromu, E N; Davhana-Maselesele, M

2009-09-01

Treatment of the under five years is a national priority as an attempt in curbing deaths and deformities affecting children. Primary health care was implemented in the clinics in order to help in the treatment of illnesses affecting the community, including children. As a result of childhood illnesses; the World Health Organization (WHO) and United Nation Children's Fund (UNICEF) came up with Integrated Management of Childhood illnesses (IMCI) strategy to enhance treatment of such illnesses in developing countries. Primary health care nurses (PHCNS) in Limpopo Province were also trained to implement the strategy. This study is intended to explore and describe the experiences of PHCNS in implementing the IMCI strategy at selected clinics in Vhembe District in the Limpopo Province. A qualitative, explorative, descriptive and contextual design was used. In-depth interviews were conducted with PHCNS who are IMCI trained and have implemented the strategy for a period of not less than two years. Data analysis was done through using Tesch 's method of open coding for qualitative analysis. Findings revealed that PHCNS had difficulty in rendering IMCI services due to lack of resources and poor working conditions. Recommendations address the difficulties experienced by PHCNS when implementing the IMCI strategy.

Translation of clinical practice guidelines for childhood obesity prevention in primary care mobilizes a rural Midwest community.

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Gibson, S Jo

2016-03-01

The purpose of this project was to implement clinic system changes that support evidence-based guidelines for childhood obesity prevention. Adherence rates for prevention and screening of children in a rural Midwest primary care setting were used to measure the success of the program. Retrospective chart reviews reflected gaps in current practice and documentation. An evidence-based toolkit for childhood obesity prevention was used to implement clinic system changes for the identified gaps. The quality improvement approach proved to be effective in translating knowledge of obesity prevention guidelines into rural clinic practices with significant improvements in documentation of prevention measures that may positively impact the childhood obesity epidemic. Primary care providers, including nurse practitioners (NPs), are at the forefront of diagnosing, educating, and counseling children and families on obesity prevention and need appropriate resources and tools to deliver premier care. The program successfully demonstrated how barriers to practice, even with the unique challenges in a rural setting, can be overcome. NPs fulfill a pivotal primary care role and can provide leadership that may positively impact obesity prevention in their communities. ©2015 American Association of Nurse Practitioners.

Connecting a sociology of childhood perspective with the study of child health, illness and wellbeing: introduction.

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Brady, Geraldine; Lowe, Pam; Olin Lauritzen, Sonja

2015-02-01

In the last decades we have seen a growing interest in research into children's own experiences and understandings of health and illness. This development, we would argue, is much stimulated by the sociology of childhood which has drawn our attention to how children as a social group are placed and perceived within the structure of society, and within inter-generational relations, as well as how children are social agents and co-constructors of their social world. Drawing on this tradition, we here address some cross-cutting themes that we think are important to further the study of child health: situating children within health policy, drawing attention to practices around children's health and well-being and a focus on children as health actors. The paper contributes to a critical analysis of child health policy and notions of child health and normality, pointing to theoretical and empirical research potential for the sociology of children's health and illness. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria.

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Sulaimon T Adedokun

Full Text Available To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria.The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS. Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1, nested within 896 communities (level 2 from 37 states (level 3.About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%. While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31-2.03, from rich households (aOR = 1.76; 95% CrI = 1.35-2.25, with access to media (radio, television or magazine (aOR = 1.18; 95% CrI = 1.08-1.29, and engaging in employment (aOR = 1.18; 95% CrI = 1.02-1.37 were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75-0.99 were less likely to have used health service for their children.Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of mobile clinics and establishment of more primary health care

Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders.

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Schalinski, Inga; Fischer, Yolanda; Rockstroh, Brigitte

2015-08-30

Accumulating evidence indicates an impact of childhood adversities on the severity and course of mental disorders, whereas this impact on psychotic disorders remains to be specified. Effects of childhood adversities on comorbidity, on symptom severity of the Positive and Negative Syndrome Scale and global functioning across four months (upon admission, 1 and 4 months after initial assessment), as well as the course of illness (measured by the remission rate, number of re-hospitalizations and dropout rate) were evaluated in 62 inpatients with psychotic spectrum disorders. Adverse experiences (of at least 1 type) were reported by 73% of patients. Patients with higher overall level of childhood adversities (n=33) exhibited more co-morbid disorders, especially alcohol/substance abuse and dependency, and higher dropout rates than patients with a lower levels of adverse experiences (n=29), together with higher levels of positive symptoms and symptoms of excitement and disorganization. Emotional and physical neglect were particularly related to symptom severity. Results suggest that psychological stress in childhood affects the symptom severity and, additionally, a more unfavorable course of disorder in patients diagnosed with psychoses. This impact calls for its consideration in diagnostic assessment and psychiatric care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Ethical Guidelines for Counselors when Working with Clients with Terminal Illness Requesting Physician Aid in Dying

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Kurt, Layla J.; Piazza, Nick J.

2012-01-01

In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors' purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the "ACA Code of Ethics" (ACA, 2005).

The importance of childhood and adulthood aspects of gendered life for adult mental ill-health symptoms – a 27-year follow-up of the Northern Swedish Cohort

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Månsdotter Anna

2012-07-01

Full Text Available Abstract Background The increasing gender equality during the 20th century, mainly in the Nordic countries, represents a major social change. A well-established theory is that this may affect the mental health patterns of women and men. This study aimed at examining associations between childhood and adulthood gendered life on mental ill-health symptoms. Methods A follow-up study of a cohort of all school leavers in a medium-sized industrial town in northern Sweden was performed from age 16 to age 42. Of those still alive of the original cohort, 94% (n = 1007 participated during the whole period. Gendered life was divided into three stages according to whether they were traditional or non-traditional (the latter includes equal: childhood (mother’s paid work position, adulthood at age 30 (ideology and childcare, and adulthood at age 42 (partnership and childcare. Mental ill-health was measured by self-reported anxious symptoms (“frequent nervousness” and depressive symptoms (“frequent sadness” at age 42. The statistical method was logistic regression analysis, finally adjusted for earlier mental ill-health symptoms and social confounding factors. Results Generally, parents’ gendered life was not decisive for a person’s own gendered life, and adulthood gender position ruled out the impact of childhood gender experience on self-reported mental ill-health. For women, non-traditional gender ideology at age 30 was associated with decreased risk of anxious symptoms (76% for traditional childhood, 78% for non-traditional childhood. For men, non-traditional childcare at age 42 was associated with decreased risk of depressive symptoms (84% for traditional childhood, 78% for non-traditional childhood. A contradictory indication was that non-traditional women in childcare at age 30 had a threefold increased risk of anxious symptoms at age 42, but only when having experienced a traditional childhood. Conclusion Adulthood gender equality is

Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities

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Brewster David

2010-03-01

Full Text Available Abstract Background There is limited epidemiological research that provides insight into the complex web of causative and moderating factors that links housing conditions to a variety of poor health outcomes. This study explores the relationship between housing conditions (with a primary focus on the functional state of infrastructure and common childhood illness in remote Australian Aboriginal communities for the purpose of informing development of housing interventions to improve child health. Methods Hierarchical multi-level analysis of association between carer report of common childhood illnesses and functional and hygienic state of housing infrastructure, socio-economic, psychosocial and health related behaviours using baseline survey data from a housing intervention study. Results Multivariate analysis showed a strong independent association between report of respiratory infection and overall functional condition of the house (Odds Ratio (OR 3.00; 95%CI 1.36-6.63, but no significant association between report of other illnesses and the overall functional condition or the functional condition of infrastructure required for specific healthy living practices. Associations between report of child illness and secondary explanatory variables which showed an OR of 2 or more included: for skin infection - evidence of poor temperature control in the house (OR 3.25; 95%CI 1.06-9.94, evidence of pests and vermin in the house (OR 2.88; 95%CI 1.25-6.60; for respiratory infection - breastfeeding in infancy (OR 0.27; 95%CI 0.14-0.49; for diarrhoea/vomiting - hygienic state of food preparation and storage areas (OR 2.10; 95%CI 1.10-4.00; for ear infection - child care attendance (OR 2.25; 95%CI 1.26-3.99. Conclusion These findings add to other evidence that building programs need to be supported by a range of other social and behavioural interventions for potential health gains to be more fully realised.

Childhood Illness and the Gender Gap in Adolescent Education in Low- and Middle-Income Countries.

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Alsan, Marcella; Xing, Anlu; Wise, Paul; Darmstadt, Gary L; Bendavid, Eran

2017-07-01

Achieving gender equality in education is an important development goal. We tested the hypothesis that the gender gap in adolescent education is accentuated by illnesses among young children in the household. Using Demographic and Health Surveys on 41 821 households in 38 low- and middle-income countries, we used linear regression to estimate the difference in the probability adolescent girls and boys were in school, and how this gap responded to illness episodes among children gender gap in education, we assessed the relationship between the gender gap and national immunization coverage. In our sample of 120 708 adolescent boys and girls residing in 38 countries, girls were 5.08% less likely to attend school than boys in the absence of a recent illness among young children within the same household (95% confidence interval [CI], 5.50%-4.65%). This gap increased to 7.77% (95% CI, 8.24%-7.30%) and 8.53% (95% CI, 9.32%-7.74%) if the household reported 1 and 2 or more illness episodes, respectively. The gender gap in schooling in response to illness was larger in households with a working mother. Increases in child vaccination rates were associated with a closing of the gender gap in schooling (correlation coefficient = 0.34, P = .02). Illnesses among children strongly predict a widening of the gender gap in education. Investments in early childhood health may have important effects on schooling attainment for adolescent girls. Copyright © 2017 by the American Academy of Pediatrics.

Adverse Childhood Experiences and the Risk of Criminal Justice Involvement and Victimization Among Homeless Adults With Mental Illness.

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Edalati, Hanie; Nicholls, Tonia L; Crocker, Anne G; Roy, Laurence; Somers, Julian M; Patterson, Michelle L

2017-12-01

Exposure to adverse childhood experiences (ACEs) is highly prevalent among homeless individuals and is associated with negative consequences during homelessness. This study examined the effect of ACEs on the risk of criminal justice involvement and victimization among homeless individuals with mental illness. The study used baseline data from a demonstration project (At Home/Chez Soi) that provided Housing First and recovery-oriented services to homeless adults with mental illness. The sample was recruited from five Canadian cities and included participants who provided valid responses on an ACEs questionnaire (N=1,888). Fifty percent reported more than four types of ACE, 19% reported three or four types, 19% reported one or two, and 12% reported none. Rates of criminal justice involvement and victimization were significantly higher among those with a history of ACEs. For victimization, the association was significant for all ten types of ACE, and for justice involvement, it was significant for seven types. Logistic regression models indicated that the effect of cumulative childhood adversity on the two outcomes was significant regardless of sociodemographic factors, duration of homelessness, and psychiatric diagnosis, with one exception: the relationship between cumulative childhood adversity and criminal justice involvement did not remain significant when the analysis controlled for a diagnosis of posttraumatic stress disorder and substance dependence. Findings support the need for early interventions for at-risk youths and trauma-informed practice and violence prevention policies that specifically target homeless populations.

Baby steps in the prevention of childhood obesity: IOM guidelines for pediatric practice.

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Gaffney, Kathleen F; Kitsantas, Panagiota; Brito, Albert; Kastello, Jennifer

2014-01-01

The aim of this paper is to present an overview of the infancy-related guidelines from the Institute of Medicine (IOM, 2011) report “Early Childhood Obesity Prevention Policies” and highlight research studies that support their implementation in pediatric practice. Findings from recent studies of infant growth monitoring, feeding, sleep, and physical activity are presented. Research strategies that may be applied to today's clinical assessments and interventions are specified. Participation by pediatric nurses in the development of future multi-component interventions to prevent rapid infant weight gain is recommended.

Barriers and Enablers to Implementation of Dietary Guidelines in Early Childhood Education Centers in Australia: Application of the Theoretical Domains Framework.

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Grady, Alice; Seward, Kirsty; Finch, Meghan; Fielding, Alison; Stacey, Fiona; Jones, Jannah; Wolfenden, Luke; Yoong, Sze Lin

2018-03-01

To identify perceived barriers and enablers to implementation of dietary guidelines reported by early childhood education center cooks, and barriers and enablers associated with greater implementation based on assessment of center menu compliance. Cross-sectional telephone interview. Early childhood education centers, New South Wales, Australia. A total of 202 cooks responsible for menu planning; 70 centers provided a menu for review of compliance with dietary guidelines. Barriers and enablers to dietary guideline implementation were determined using a tool assessing constructs of the Theoretical Domains Framework (TDF). Higher scores (≥6) for each construct indicated enablers to guideline implementation; lower scores (barriers. Multivariable linear regression identified TDF constructs associated with greater guideline implementation. Scores were lowest for reinforcement (mean, 5.85) and goals (mean, 5.89) domains, and highest for beliefs about consequences (mean, 6.51) and social/professional role and identity (mean, 6.50). The skills domain was positively associated with greater implementation of guidelines based on menu review (P = .01). Cooks perceived social/professional role and identity, and beliefs about consequences to be enablers to dietary guideline implementation; however, only the skills domain was associated with greater implementation. There are opportunities to target the incongruence in perceptions vs reality of the barriers and enablers to implementation. Future research could examine the utility of the TDF to identify barriers and enablers to implementation to inform intervention development and for evaluating interventions to examine intervention mechanisms. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Effect of shortened Integrated Management of Childhood Illness training on classification and treatment of under-five children seeking care in Rwanda

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Harerimana JM

2014-05-01

Full Text Available Jean-Modeste Harerimana,1 Laetitia Nyirazinyoye,1 Jean-Bosco Ahoranayezu,2 Ferdinand Bikorimana,3 Bethany L Hedt-Gauthier,1,4 Katherine A Muldoon,5 Edward J Mills,6,7 Joseph Ntaganira1 1University of Rwanda College of Medicine and Health Sciences School of Public Health, Kigali, Rwanda; 2Community Vision Initiative, Kigali, Rwanda; 3Maternal and Child Health, Child Unit, Rwandan Ministry of Health, Kigali, Rwanda; 4Harvard Medical School, Boston, MA, USA; 5University of British Columbia, Vancouver, BC, Canada; 6University of Ottawa, Ottawa, ON, Canada; 7Stanford University, Stanford, CA, USA Background: Integrated Management of Childhood Illness (IMCI is an effective 11-day standard training; however, due to budgetary expenses and human resource constraints, many health professionals cannot take 11 days off work. As a result, shortened training curriculums (6-day have been proposed. We used a cross-sectional study to evaluate the effect of this shortened training on appropriate IMCI classification and treatment of under-five childhood illness management in Rwanda. Methods: A cross-sectional study was conducted in 22 health centers in Rwanda, comparing data from 121 nurses, where 55 nurses completed the 11-day and 66 nurses completed the 6-day training. Among 768 children, we evaluated clinical outcomes from May 2011 to April 2012. Descriptive statistics were used to display the sociodemographic characteristics of health providers; including level of education, sex, age, and professional experiences. Bivariable and multivariable analyses were used to test for differences between nurses in the 6-day versus 11-day training on the appropriate classification and treatment of childhood illness. Results: Our findings show that at the bivariable level and after controlling for confounders in the multivariable analysis, the only significant differences detected between nurses in the long and short training was the classification of fever (adjusted odds

Examining Perpetration of Physical Violence by Women: The Influence of Childhood Adversity, Victimization, Mental Illness, Substance Abuse, and Anger.

Science.gov (United States)

Kubiak, Sheryl; Fedock, Gina; Kim, Woo Jong; Bybee, Deborah

2017-02-01

Research on women's perpetration of physical violence has focused primarily on partners, often neglecting perpetration against nonpartners. This study proposes a conceptual model with direct and indirect relationships between childhood adversity and different targets of violence (partners and nonpartners), mediated by victimization experiences (by partner and nonpartners), mental illness, substance abuse, and anger. Using survey data from a random sample of incarcerated women (N = 574), structural equation modeling resulted in significant, albeit different, indirect paths from childhood adversity, through victimization, to perpetration of violence against partners (β = .20) and nonpartners (β = .19). The results indicate that prevention of women's violence requires attention to specific forms of victimization, anger expression, and targets of her aggression.

Current management of gender identity disorder in childhood and adolescence: guidelines, barriers and areas of controversy.

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Shumer, Daniel E; Spack, Norman P

2013-02-01

The approach to gender identity disorder (GID) in childhood and adolescence has been rapidly evolving and is in a state of flux. In an effort to form management recommendations on the basis of the available literature, The Endocrine Society published clinical practice guidelines in 2009. The guidelines recommend against sex role change in prepubertal children, but they recommend the use of gonadotropin-releasing hormone (GnRH) agonists to suppress puberty in adolescence, and the use of cross-sex hormones starting around age 16 for eligible patients. In actual practice, the approach to GID is quite variable due to continued lack of consensus and specific barriers to treatment that are unique to GID. Recent literature has focused on the mental health approach to prepubertal children with GID and short-term outcomes using pubertal suppression and cross-sex steroids in adolescents with GID. This review will describe the literature published since the release of The Endocrine Society guidelines regarding the management of GID in both children and adolescents.

Can smartphones and tablets improve the management of childhood illness in Tanzania? A qualitative study from a primary health care worker's perspective.

Science.gov (United States)

Shao, Amani Flexson; Rambaud-Althaus, Clotilde; Swai, Ndeniria; Kahama-Maro, Judith; Genton, Blaise; D'Acremont, Valerie; Pfeiffer, Constanze

2015-04-02

The impact of the Integrated Management of Childhood Illness (IMCI) strategy has been less than anticipated because of poor uptake. Electronic algorithms have the potential to improve quality of health care in children. However, feasibility studies about the use of electronic protocols on mobile devices over time are limited. This study investigated constraining as well as facilitating factors that influence the uptake of a new electronic Algorithm for Management of Childhood Illness (ALMANACH) among primary health workers in Dar es Salaam, Tanzania. A qualitative approach was applied using in-depth interviews and focus group discussions with altogether 40 primary health care workers from 6 public primary health facilities in the three municipalities of Dar es Salaam, Tanzania. Health worker's perceptions related to factors facilitating or constraining the uptake of the electronic ALMANACH were identified. In general, the ALMANACH was assessed positively. The majority of the respondents felt comfortable to use the devices and stated that patient's trust was not affected. Most health workers said that the ALMANACH simplified their work, reduced antibiotic prescription and gave correct classification and treatment for common causes of childhood illnesses. Few HWs reported technical challenges using the devices and complained about having had difficulties in typing. Majority of the respondents stated that the devices increased the consultation duration compared to routine practice. In addition, health system barriers such as lack of staff, lack of medicine and lack of financial motivation were identified as key reasons for the low uptake of the devices. The ALMANACH built on electronic devices was perceived to be a powerful and useful tool. However, health system challenges influenced the uptake of the devices in the selected health facilities.

THE IMPACT OF HOSPITAL BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS TRAINING ON PEDIATRIC NURSE COMPETENCY

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Fitri Haryanti

2018-02-01

Full Text Available Background: Although the WHO strategy integrated management of childhood illness (IMCI for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies. Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004. Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities (nutritionist, pharmacist, laboratory in Cut Nyak Dien (CND Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis. Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up. The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster. Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a

Recommendations for breast cancer surveillance for female survivors of childhood, adolescent, and young adult cancer given chest radiation: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

NARCIS (Netherlands)

Mulder, Renée L.; Kremer, Leontien C. M.; Hudson, Melissa M.; Bhatia, Smita; Landier, Wendy; Levitt, Gill; Constine, Louis S.; Wallace, W. Hamish; van Leeuwen, Flora E.; Ronckers, Cécile M.; Henderson, Tara O.; Dwyer, Mary; Skinner, Roderick; Oeffinger, Kevin C.

2013-01-01

Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were given radiation to fields that include breast tissue (ie, chest radiation) have an increased risk of breast cancer. Clinical practice guidelines are essential to ensure that these individuals receive optimum care and

Childhood trauma, antisocial personality typologies and recent violent acts among inpatient males with severe mental illness: exploring an explanatory pathway.

Science.gov (United States)

Bruce, Matt; Laporte, Dionne

2015-03-01

Prevalence of childhood trauma is elevated among individuals with severe mental illness (SMI) compared to the general population and associated with poor prognosis, substance misuse, lower treatment compliance and violence. Antisocial personality disorder (ASPD) typologies (childhood vs adult onset) also represent possible mediating mechanisms to explain risk of violence among men with SMI. The current study aimed to explore an explanatory pathway linking childhood traumatic exposure, antisocial personality typologies and risk of violent behaviour among adult male inpatients with SMI. A total of 162 male inpatients with SMI were examined using a cross-sectional survey design. Information was extracted from medical files, interviews and official criminal records. Fifty-two participants (32.1%) reported experiencing a childhood trauma before 15. This group was 2.8 times more likely to engage in violent acts within the past 6months than those without such a history. Furthermore, those with childhood onset ASPD (early starters) were more likely to report childhood trauma and engage in violence compared to adult onset ASPD (late starters) and those without antisocial histories. Multivariate analyses revealed that early starter ASPD was the only variable that independently predicted violence and mediated the relationship between childhood trauma and recent violent acts. A significant subset of men reporting trauma and antisocial conduct from childhood (early starter ASPD) is at considerably elevated risk of engaging in violent behaviours. Assessment of antisocial typologies in men with SMI may assist effective and defensible case prioritisation, resource allocation and treatment planning. Copyright © 2014 Elsevier B.V. All rights reserved.

Growing up with a chronic illness: social success, educational/vocational distress.

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Maslow, Gary R; Haydon, Abigail; McRee, Annie-Laurie; Ford, Carol A; Halpern, Carolyn T

2011-08-01

We compared adult educational, vocational, and social outcomes among young adults with and without childhood-onset chronic illness in a nationally representative U.S. sample. We used data from Wave IV (2008) of the National Longitudinal Study of Adolescent Health. We compared respondents who reported childhood-onset cancer, heart disease, diabetes, or epilepsy with young adults without these chronic illnesses in terms of marriage, having children, living with parents, romantic relationship quality, educational attainment, income, and employment. Multivariate models controlled for sociodemographic factors and adult-onset chronic illness. As compared with those without childhood chronic illness, respondents with childhood chronic illness had similar odds of marriage (odds ratios [OR] = .89, 95% CI: .65-1.24), having children (OR = .99, 95% CI: .70-1.42), and living with parents (OR = 1.49, 95% CI .94-2.33), and similar reports of romantic relationship quality. However, the chronic illness group had lower odds of graduating college (OR = .49, 95% CI: .31-.78) and being employed (OR = .56, 95% CI: .39-.80), and higher odds of receiving public assistance (OR = 2.13, 95% CI: 1.39-3.25), and lower mean income. Young adults growing up with chronic illness succeed socially, but are at increased risk of poorer educational and vocational outcomes. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Effect of residence on mothers' health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross--sectional study.

Science.gov (United States)

Gelaw, Yalemzewod Assefa; Biks, Gashaw Andargie; Alene, Kefyalew Addis

2014-10-08

Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of

Parental Health Attributions of Childhood Health and Illness: Development of the Pediatric Cultural Health Attributions Questionnaire (Pedi-CHAQ).

Science.gov (United States)

Vaughn, Lisa M; McLinden, Daniel J; Shellmer, Diana; Baker, Raymond C

2011-01-01

The causes attributed to childhood health and illness across cultures (cultural health attributions) are key factors that are now more frequently identified as affecting the health outcomes of children. Research suggests that the causes attributed to an event such as illness are thought to affect subsequent motivation, emotional response, decision making, and behavior. To date, there is no measure of health attributions appropriate for use with parents of pediatric patients. Using the Many-Facets approach to Rasch analysis, this study assesses the psychometrics of a newly developed instrument, the Pediatric Health Attributions Questionnaire (Pedi-CHAQ), a measure designed to assess the cultural health attributions of parents in diverse communities. Results suggest acceptable Rasch model statistics of fit and reliability for the Pedi-CHAQ. A shortened version of the questionnaire was developed as a result of this study and next steps are discussed.

[Chronic urticaria in childhood : Rational diagnostics and treatment].

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Ott, H

2017-07-01

Chronic urticaria (CU) is defined by episodes of urticaria with or without angioedema, which recur daily or nearly daily over more than 6 weeks. Sudden manifestations of CU with or without known causes are termed chronic spontaneous urticaria, which is differentiated from chronic inducible urticaria. The differential diagnoses of CU in childhood range from self-limiting dermatoses to severe systemic diseases. Further targeted steps are taken to detect potential trigger factors or underlying illnesses only if suspicion arises on anamnestic grounds and CU is best treated in accordance with international guidelines. First-line therapy consists of non-sedating H 1 -antihistamines at approved or even higher doses. If symptoms persist, additional treatment with omalizumab, cyclosporine or montelukast can be initiated after careful individual consideration.

Nordic Comparative Analysis of Guidelines for Quality and Content in Early Childhood Education

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Ann-Christine Vallberg Roth

2014-09-01

Full Text Available The article is based on a project intended to further develop understanding of similarities and differences in Nordic binding guidelines and non-binding guidance for content and quality in early childhood education. The study is of a descriptive and comparative nature and the process is based on a research tradition connected to curriculum studies. Both variation and standardisation emerge in the comparative analysis with regard to content construction. Quality is expressed and may be interpreted as operationalised as both structure and process. In relation to the study results, quality may be interpreted as primarily oriented towards institutions, activities and secondarily towards individuals. Quality is consistently related to learning (lifelong learning and is more linear and oriented towards goal-rationality than non-linear.

Formative evaluation of a proposed mHealth program for childhood illness management in a resource-limited setting in Peru

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T. A. Calderón

2015-08-01

Full Text Available OBJECTIVE: To conduct a formative evaluation of a proposed mobile health (mHealth program designed to educate caregivers about management of common childhood illnesses. METHODS: A cluster-randomized sample (n = 220 of mothers in Cono Norte, Arequipa, Peru with at least one child under five completed an iPad-based survey. This descriptive study examined trends in mobile phone ownership and feasibility of and interest in mHealth across sociodemographic categories. Fisher's exact tests were used to evaluate associations. Univariate logistic regression models were fitted to calculate odds ratios and 95% confidence intervals. RESULTS: Of 220 participants, 82.3% and 95.0% reported mobile phone ownership and access, respectively. Ownership was significantly associated with educational level (P = 0.031; however, even among mothers with the lowest education, ownership approached 80%. Educational level and age, respectively, were associated with the ability to open (P < 0.001; P < 0.001, read (P < 0.001; P < 0.001, write (P < 0.001; P < 0.001, and send (P = 0.006; P = 0.047 text messages. Over 85% of mothers were interested in using their mobile phones to receive health advice for their child and to seek help during illness. Regression analyses revealed that ability to use a mobile phone was positively associated with the mother's intention to participate in the mHealth program. CONCLUSIONS: The study findings confirm widespread access to mobile phones and sufficient ability to utilize text messaging within this population of caregivers. In addition to access and feasibility, high levels of interest in using mobile phones for health-related purposes suggest the potential value associated with an mHealth program designed to improve childhood illness management in this community.

Illness Among Paralympic Athletes: Epidemiology, Risk Markers, and Preventative Strategies.

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Janse Van Rensburg, Dina Christina; Schwellnus, Martin; Derman, Wayne; Webborn, Nick

2018-05-01

Paralympic athletes have unique preexisting medical conditions that predispose them to increased risk of illness, but data are limited to studies conducted during the last 3 Paralympic Games. This article reviews the epidemiology of illness (risk, patterns, and predictors) in Paralympic athletes and provides practical guidelines for illness prevention. The incidence rate of illness (per 1000 athlete-days) in Paralympic athletes is high in Summer (10.0-13.2) and Winter (18.7) Paralympic Games. The authors propose general and specific guidelines on preventative strategies regarding illness in these athletes. Copyright © 2018 Elsevier Inc. All rights reserved.

Independent Evaluation of the integrated Community Case Management of Childhood Illness Strategy in Malawi Using a National Evaluation Platform Design.

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Amouzou, Agbessi; Kanyuka, Mercy; Hazel, Elizabeth; Heidkamp, Rebecca; Marsh, Andrew; Mleme, Tiope; Munthali, Spy; Park, Lois; Banda, Benjamin; Moulton, Lawrence H; Black, Robert E; Hill, Kenneth; Perin, Jamie; Victora, Cesar G; Bryce, Jennifer

2016-03-01

We evaluated the impact of integrated community case management of childhood illness (iCCM) on careseeking for childhood illness and child mortality in Malawi, using a National Evaluation Platform dose-response design with 27 districts as units of analysis. "Dose" variables included density of iCCM providers, drug availability, and supervision, measured through a cross-sectional cellular telephone survey of all iCCM-trained providers. "Response" variables were changes between 2010 and 2014 in careseeking and mortality in children aged 2-59 months, measured through household surveys. iCCM implementation strength was not associated with changes in careseeking or mortality. There were fewer than one iCCM-ready provider per 1,000 under-five children per district. About 70% of sick children were taken outside the home for care in both 2010 and 2014. Careseeking from iCCM providers increased over time from about 2% to 10%; careseeking from other providers fell by a similar amount. Likely contributors to the failure to find impact include low density of iCCM providers, geographic targeting of iCCM to "hard-to-reach" areas although women did not identify distance from a provider as a barrier to health care, and displacement of facility careseeking by iCCM careseeking. This suggests that targeting iCCM solely based on geographic barriers may need to be reconsidered. © The American Society of Tropical Medicine and Hygiene.

Heat-related illness in the African wilderness

African Journals Online (AJOL)

Wilderness heat-related illnesses span a continuum of medical problems caused by ... of modern science, clothing technology, and an understanding of physiology ..... guidelines for wilderness emergency care, heat-related illnesses, and EAH ...

Childhood-compared to adolescent-onset bipolar disorder has more statistically significant clinical correlates.

Science.gov (United States)

Holtzman, Jessica N; Miller, Shefali; Hooshmand, Farnaz; Wang, Po W; Chang, Kiki D; Hill, Shelley J; Rasgon, Natalie L; Ketter, Terence A

2015-07-01

The strengths and limitations of considering childhood-and adolescent-onset bipolar disorder (BD) separately versus together remain to be established. We assessed this issue. BD patients referred to the Stanford Bipolar Disorder Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD Affective Disorders Evaluation. Patients with childhood- and adolescent-onset were compared to those with adult-onset for 7 unfavorable bipolar illness characteristics with replicated associations with early-onset patients. Among 502 BD outpatients, those with childhood- (adolescent- (13-18 years, N=218) onset had significantly higher rates for 4/7 unfavorable illness characteristics, including lifetime comorbid anxiety disorder, at least ten lifetime mood episodes, lifetime alcohol use disorder, and prior suicide attempt, than those with adult-onset (>18 years, N=174). Childhood- but not adolescent-onset BD patients also had significantly higher rates of first-degree relative with mood disorder, lifetime substance use disorder, and rapid cycling in the prior year. Patients with pooled childhood/adolescent - compared to adult-onset had significantly higher rates for 5/7 of these unfavorable illness characteristics, while patients with childhood- compared to adolescent-onset had significantly higher rates for 4/7 of these unfavorable illness characteristics. Caucasian, insured, suburban, low substance abuse, American specialty clinic-referred sample limits generalizability. Onset age is based on retrospective recall. Childhood- compared to adolescent-onset BD was more robustly related to unfavorable bipolar illness characteristics, so pooling these groups attenuated such relationships. Further study is warranted to determine the extent to which adolescent-onset BD represents an intermediate phenotype between childhood- and adult-onset BD. Copyright © 2015 Elsevier B.V. All rights reserved.

Development of guidelines for tertiary education institutions to assist them in supporting students with a mental illness: a Delphi consensus study with Australian professionals and consumers

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Nicola J. Reavley

2013-02-01

Full Text Available Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students’ academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts.Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines.Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals. 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation.Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to

Long-term Consequences of Childhood ADHD on Criminal Activities*

OpenAIRE

Fletcher, Jason; Wolfe, Barbara

2009-01-01

The question of whether childhood mental illness has long term consequences in terms of criminal behavior has been little studied, yet it could have major consequences for both the individual and society more generally. In this paper, we focus on Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most prevalent mental conditions in school-age children, to examine the long-term effects of childhood mental illness on criminal activities, controlling for a rich set of individual, family...

Adverse Childhood Experiences and the Mental Health of Veterans.

Science.gov (United States)

McGuinness, Teena M; Waldrop, Jessica R

2015-06-01

Many U.S. Veterans have experienced the burdens of mental illness and suicide. The current article focuses on Veterans who served from 2001-2015. Although combat exposure and suicidal ideation are linked, approximately one half of all suicides among Active Duty service members (who have served since 2001) occurred among those who never deployed. Researchers who sought additional risks for suicide found that Veterans have greater odds of adversities in childhood than the general population. Adverse childhood experiences are stressful and traumatic experiences, including abuse and neglect, as well as witnessing household dysfunction, or growing up with individuals with mental illness or substance abuse. Further, childhood physical abuse has been shown to be a significant predictor for posttraumatic stress disorder and suicide. Adverse childhood experiences confer additional risk for the mental health of service members. Psychiatric nursing implications include the importance of assessing early childhood adversity during psychosocial assessments. Providing trauma-informed strategies for treatment is an essential element of psychiatric nursing care. Copyright 2015, SLACK Incorporated.

Protective connections and educational attainment among young adults with childhood-onset chronic illness.

Science.gov (United States)

Maslow, Gary; Haydon, Abigail A; McRee, Annie-Laurie; Halpern, Carolyn T

2012-08-01

Youth with childhood-onset chronic illness (COCI) are at risk of poor educational attainment. Specific protective factors that promote college graduation in this population have not been studied previously. In this study, we examine the role protective factors during adolescence play in promoting college graduation among young adults with COCI. Data were collected from 10,925 participants in the National Longitudinal Study of Adolescent Health (Add Health). Protective factors present before 18 years of age included mentoring, parent relationship quality, school connectedness, and religious attendance. College graduation was the outcome of interest assessed when participants had a mean age of 28 years. Analysis was stratified by presence of COCI. About 2% of participants (N = 230) had 1 of 4 COCIs (cancer, diabetes, epilepsy, or heart disease). All 4 protective factors were associated with college graduation for youth without COCI. In the final multivariate model, only school connectedness was associated with college graduation for youth with COCI. School connectedness is of particular importance in promoting educational attainment for youth with COCI. © 2012, American School Health Association.

Childhood maltreatment and the medical morbidity in bipolar disorder: a case-control study.

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Hosang, Georgina M; Fisher, Helen L; Uher, Rudolf; Cohen-Woods, Sarah; Maughan, Barbara; McGuffin, Peter; Farmer, Anne E

2017-09-07

Childhood maltreatment (abuse and neglect) can have long-term deleterious consequences, including increased risk for medical and psychiatric illnesses, such as bipolar disorder in adulthood. Emerging evidence suggests that a history of childhood maltreatment is linked to the comorbidity between medical illnesses and mood disorders. However, existing studies on bipolar disorder have not yet explored the specific influence of child neglect and have not included comparisons with individuals without mood disorders (controls). This study aimed to extend the existing literature by examining the differential influence of child abuse and child neglect on medical morbidity in a sample of bipolar cases and controls. The study included 72 participants with bipolar disorder and 354 psychiatrically healthy controls (average age of both groups was 48 years), who completed the Childhood Trauma Questionnaire, and were interviewed regarding various medical disorders. A history of any type of childhood maltreatment was significantly associated with a diagnosis of any medical illness (adjusted OR = 6.28, 95% confidence intervals 1.70-23.12, p = 0.006) and an increased number of medical illnesses (adjusted OR = 3.77, 95% confidence intervals 1.34-10.57, p = 0.012) among adults with bipolar disorder. Exposure to child abuse was more strongly associated with medical disorders than child neglect. No association between childhood maltreatment and medical morbidity was detected among controls. To summarise, individuals with bipolar disorder who reported experiencing maltreatment during childhood, especially abuse, were at increased risk of suffering from medical illnesses and warrant greater clinical attention.

Cadherin-related Family Member 3 Genetics and Rhinovirus C Respiratory Illnesses

DEFF Research Database (Denmark)

Bønnelykke, Klaus; Coleman, Amaziah T; Evans, Michael D

2018-01-01

Background Experimental evidence suggests that CDHR3 is a receptor for rhinovirus-C (RV-C), and a missense variant in this gene (rs6967330) is associated with childhood asthma with severe exacerbations. Objective To determine whether rs6967330 influences RV-C infections and illnesses in early...... childhood. Methods We studied associations between rs6967330 and respiratory infections and illnesses in the COPSAC2010 and COAST birth cohorts, where respiratory infections were monitored prospectively for the first 3 years of life. Nasal samples were collected during acute infections in both cohorts...

Integrated management of childhood illness (IMCI) strategy for children under five.

Science.gov (United States)

Gera, Tarun; Shah, Dheeraj; Garner, Paul; Richardson, Marty; Sachdev, Harshpal S

2016-06-22

More than 7.5 million children younger than age five living in low- and middle-income countries die every year. The World Health Organization (WHO) developed the integrated management of childhood illness (IMCI) strategy to reduce mortality and morbidity and to improve quality of care by improving the delivery of a variety of curative and preventive medical and behavioral interventions at health facilities, at home, and in the community. To evaluate the effects of programs that implement the IMCI strategy in terms of death, nutritional status, quality of care, coverage with IMCI deliverables, and satisfaction of beneficiaries. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE; EMBASE, Ovid; the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EbscoHost; the Latin American Caribbean Health Sciences Literature (LILACS), Virtual Health Library (VHL); the WHO Library & Information Networks for Knowledge Database (WHOLIS); the Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Science; Population Information Online (POPLINE); the WHO International Clinical Trials Registry Platform (WHO ICTRP); and the Global Health, Ovid and Health Management, ProQuest database. We performed searches until 30 June 2015 and supplemented these by searching revised bibliographies and by contacting experts to identify ongoing and unpublished studies. We sought to include randomised controlled trials (RCTs) and controlled before-after (CBA) studies with at least two intervention and two control sites evaluating the generic IMCI strategy or its adaptation in children younger than age five, and including at minimum efforts to improve health care worker skills for case management. We excluded studies in which IMCI was accompanied by other interventions including conditional

Consensus guidelines on management of childhood convulsive status epilepticus.

Science.gov (United States)

Mishra, Devendra; Sharma, Suvasini; Sankhyan, Naveen; Konanki, Ramesh; Kamate, Mahesh; Kanhere, Sujata; Aneja, Satinder

2014-12-01

Status epilepticus has a wide etiological spectrum, and significant morbidity and mortality. Management using a pre-determined uniform protocol leads to better outcomes. Multiple protocols for management of childhood status epilepticus are available, without much consensus. A 'Multi-disciplinary Consensus Development Workshop on Management of Status Epilepticus in Children in India' was organized. The invited experts included Pediatricians, Pediatric neurologists, Neurologists, Epileptologists, and Pediatric intensive care specialists from India, with experience in the relevant field. Experts had previously been divided into focus groups and had interacted on telephone and e-mail regarding their group recommendations, and developed consensus on the topic. During the meeting, each group presented their recommendations, which were deliberated upon by the house and a consensus was reached on various issues; the document was finalized after incorporating suggestions of experts on the draft document. To provide consensus guidelines on evaluation and management of convulsive status epilepticus in children in India (excluding neonatal and super-refractory status epilepticus). Each institution should use a pre-determined protocol for management of status epilepticus; pre-hospital management and early stabilization is the key to a satisfactory outcome of status epilepticus. Pharmacotherapy should not be delayed for any investigations; the initial management should consist of a parenteral benzodiazepine by any route feasible. Subsequent management has been detailed. The group also felt the need for more epidemiological research on status epilepticus from India, and identified certain research areas for the purpose.

What can we learn? Adult outcomes in children of seriously mentally ill mothers.

Science.gov (United States)

O'Connell, Kathleen LeClear

2008-05-01

Information is lacking about the experiences, needs of, and interventions for children of seriously mentally ill mothers. Quantitative and qualitative methods of inquiry were used to retrospectively explore the characteristics and needs of adult children of seriously mentally ill mothers. The sample (N = 40) was recruited by referral and media advertisements. Childhood variables related to attachment, family environment, and parenting were compared to adult well-being outcomes of depression, quality of life, sense of coherence, and self-esteem. Participants also responded to the question "What other question should have been included in this study about your experience as the child of a seriously mentally ill mother?" and, additionally, spontaneously added their own clarifications of their answers to the survey questions. It was apparent that the childhoods of participants were disruptive and often painful. Over half of the sample reported having their own diagnosis of depression in adulthood. Despite these factors, most members of the study sample were functioning well in adulthood, most often as a result of their own initiative. A high rate of depression in adulthood and participants' own descriptions of their painful memories and experiences of childhood identifies that more can and should be done to assist children of mentally ill mothers to cope with their environments. Interventions at various times in childhood are described.

Genetic associations with viral respiratory illnesses and asthma control in children

DEFF Research Database (Denmark)

Loisel, D A; Du, G; Ahluwalia, T S

2016-01-01

of asthma control phenotypes was performed in 2128 children in the Copenhagen Prospective Study on Asthma in Childhood (COPSAC). Significant associations in RhinoGen were further validated using virus-induced wheezing illness and asthma phenotypes in an independent sample of 122 children enrolled...... in the Childhood Origins of Asthma (COAST) birth cohort study. RESULTS: A significant excess of P values smaller than 0.05 was observed in the analysis of the 10 RhinoGen phenotypes. Polymorphisms in 12 genes were significantly associated with variation in the four phenotypes showing a significant enrichment...... differences in childhood viral respiratory illnesses and virus-induced exacerbations of asthma. Defining mechanisms of these associations may provide insight into the pathogenesis of viral respiratory infections and virus-induced exacerbations of asthma....

Asthma phenotypes in childhood.

Science.gov (United States)

Reddy, Monica B; Covar, Ronina A

2016-04-01

This review describes the literature over the past 18 months that evaluated childhood asthma phenotypes, highlighting the key aspects of these studies, and comparing these studies to previous ones in this area. Recent studies on asthma phenotypes have identified new phenotypes on the basis of statistical analyses (using cluster analysis and latent class analysis methodology) and have evaluated the outcomes and associated risk factors of previously established early childhood asthma phenotypes that are based on asthma onset and patterns of wheezing illness. There have also been investigations focusing on immunologic, physiologic, and genetic correlates of various phenotypes, as well as identification of subphenotypes of severe childhood asthma. Childhood asthma remains a heterogeneous condition, and investigations into these various presentations, risk factors, and outcomes are important since they can offer therapeutic and prognostic relevance. Further investigation into the immunopathology and genetic basis underlying childhood phenotypes is important so therapy can be tailored accordingly.

Childhood Obesity

Science.gov (United States)

Yuca, Sevil Ari, Ed.

2012-01-01

This book aims to provide readers with a general as well as an advanced overview of the key trends in childhood obesity. Obesity is an illness that occurs due to a combination of genetic, environmental, psychosocial, metabolic and hormonal factors. The prevalence of obesity has shown a great rise both in adults and children in the last 30 years.…

Severe childhood malnutrition

DEFF Research Database (Denmark)

Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J

2017-01-01

The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use...... the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal...... nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide...

A survey on Integrated Management of Neonatal and Childhood Illness implementation by nurses in four districts of West Arsi zone of Ethiopia.

Science.gov (United States)

Seid, Sheka Shemsi; Sendo, Endalew Gemechu

2018-01-01

In Ethiopia, one in 17 children dies before 1 year of age and one in 11 children dies before 5 years. Research that examines the factors influencing the implementation of the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) strategy in Ethiopia is limited. This study aimed to identify the factors compelling the execution of IMNCI by nurses in four districts of West Arsi zone of Ethiopia. A mixed-method cross-sectional study was conducted from February to March 2016 in West Arsi zone of Oromia regional state, Ethiopia. A total of 185 Integrated Management of Childhood Illness (IMCI)-trained registered nurses working at Under-Five Clinic were purposively chosen for the study among 291 registered nurses based at health centers and hospitals in the Arsi zone. The study was complemented by a qualitative method. More than half (57.8%) of the nurses interviewed had been trained (51.35% of them attended in-service training). The most common issues encountered in the implementation of IMCI were: lack of trained staff (56.2%), lack of essential drugs and supplies (37.3%), and irregular supportive supervision (89.2%). The qualitative data supplemented the factors that influence IMNCI implementation, including drug unavailability, lack of human resources, and lack of effective supportive supervision and follow-up visits. Therefore, interventions aiming at training nurses, with emphasis on performing supportive consistent supervision and supporting the system of health care by enhancing admittance to indispensable drugs and supplies, are recommended to help IMCI implementation.

Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions

NARCIS (Netherlands)

Verhoof, Eefje J. A.; Maurice-Stam, Heleen; Heymans, Hugo S. A.; Evers, Andrea W. M.; Grootenhuis, Martha A.

2014-01-01

Background: More and more pediatric patients reach adulthood. Some of them are successfully integrating in adult life, but many others are not. Possibly Illness cognitions (IC) - the way people give meaning to their illness/disability - may play a role in individual differences on long-term

Decreased lung function after preschool wheezing rhinovirus illnesses in children at risk to develop asthma.

Science.gov (United States)

Guilbert, Theresa W; Singh, Anne Marie; Danov, Zoran; Evans, Michael D; Jackson, Daniel J; Burton, Ryan; Roberg, Kathy A; Anderson, Elizabeth L; Pappas, Tressa E; Gangnon, Ronald; Gern, James E; Lemanske, Robert F

2011-09-01

Preschool rhinovirus (RV) wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. To determine the relationship of virus-specific wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Children with RV wheezing illness demonstrated significantly decreased spirometry values, FEV(1) (P = .001), FEV(0.5) (P Children who wheezed with respiratory syncytial virus or other viral illnesses did not have any significant differences in spirometric or impulse oscillometry indices when compared with children who did not. Children diagnosed with asthma at ages 6 or 8 years had significantly decreased FEF(25-75) (P = .05) compared with children without asthma. Among outpatient viral wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV wheezing illnesses is yet to be determined. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Molar-incisor hypomineralization and the association with childhood illnesses and antibiotics in a group of Finnish children.

Science.gov (United States)

Wuollet, Emma; Laisi, Sakari; Salmela, Eija; Ess, Anneli; Alaluusua, Satu

2016-07-01

Molar-incisor hypomineralization (MIH) is a developmental enamel defect affecting 1-4 first permanent molars (FPMs) and often also incisors. The aim of this study was to assess whether childhood illnesses or medication are associated with MIH. FPMs and incisors of 287 Finnish children were examined for MIH in line with the criteria of the EAPD. Health data from the first 3 years of life was collected from medical records and the associations with MIH and MIH2 (lesions in at least one FPM and incisor) were assessed using simple and multiple logistic regression analyses. The prevalence of MIH and MIH2 were 11.5% and 6.3%, respectively. During the first 3 years of life, the children with MIH had sought care for infectious illnesses more often than the children without MIH (mean number of visits (SD) 7.9(6.4) vs. 6.0(5.1), p = 0.045, independent samples t-test). After adjustment for confounding factors, children who had received penicillin or macrolides within the first year, or amoxicillin within the first 3 years had a higher risk for MIH (2.61, 4.07 and 2.58 times, adjusted OR, respectively) or MIH2 (3.16 times, aOR for penicillin and amoxicillin) compared to those who had not received that antibiotic. Of the illnesses, children with at least one episode of otitis within the first year had a higher risk for MIH (2.28 times, aOR) than those who had not suffered from otitis. Acute otitis media and the use of certain antibiotics were associated with the elevated risk of MIH/MIH2.

The Effects of Childhood ADHD on Adult Labor Market Outcomes. NBER Working Paper No. 18689

Science.gov (United States)

Fletcher, Jason

2013-01-01

While several types of mental illness, including substance abuse disorders, have been linked with poor labor market outcomes, no current research has been able to examine the effects of childhood ADHD. As ADHD has become one of the most prevalent childhood mental conditions, it is useful to understand the full set of consequences of the illness.…

The impact of adverse child and adult experiences on recovery from serious mental illness.

Science.gov (United States)

Stumbo, Scott P; Yarborough, Bobbi Jo H; Paulson, Robert I; Green, Carla A

2015-12-01

The purpose of this study was to compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a 2-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia, or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. Child and adult exposures to adverse experiences were high, at 91% and 82%, respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning and social functioning and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone. (c) 2015 APA, all rights reserved).

Is childhood cat ownership a risk factor for schizophrenia later in life?

Science.gov (United States)

Fuller Torrey, E; Simmons, Wendy; Yolken, Robert H

2015-06-01

Two previous studies suggested that childhood cat ownership is a possible risk factor for later developing schizophrenia or other serious mental illness. We therefore used an earlier, large NAMI questionnaire to try and replicate this finding. The results were the same, suggesting that cat ownership in childhood is significantly more common in families in which the child later becomes seriously mentally ill. If true, an explanatory mechanism may be Toxoplasma gondii. We urge our colleagues to try and replicate these findings to clarify whether childhood cat ownership is truly a risk factor for later schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

Infective basis in childhood leukaemia

International Nuclear Information System (INIS)

Kinlen, Leo

1995-01-01

Leukaemia in children has often been suspected of having an infective basis (as specifically identified in certain animal species) but, until recently, formal studies had gone no further than to show that it does not markedly cluster in time and space. Many infective illnesses, however, are uncommon responses to infections that are mainly spread by the majority of infected individuals who are not ill. These include, for example, glandular fever and certain types of meningitis. Such illnesses are not contagious and do not normally cluster. The possibilities that childhood leukamia might belong to this class of infective illnesses and be subject to increases in incidence as a result of epidemics of an underlying infection were suggested by the well-known excesses near Sellafield and Dounreay. (author)

Home management of childhood diarrhoea among mothers in ...

African Journals Online (AJOL)

Diarrhoea diseases are major causes of childhood morbidity and mortality in developing countries. Treatment guidelines by the World Health Organization indicate that most cases of childhood diarrhoea can be treated at home by increased fluid intake and continued feeding during diarrhoea episodes. The aim of this study ...

Childhood adversity and adult personality.

Science.gov (United States)

Rosenman, Stephen; Rodgers, Bryan

2006-05-01

To explore how recalled childhood adversity affects trait measures of personality in three age cohorts of an Australian adult population and to examine the effects of particular adversities on adult personality traits. A total of 7485 randomly selected subjects in the age bands of 20-24, 40-44 and 60-64 years were interviewed at the outset of a longitudinal community study of psychological health in the Canberra region of Australia. In the initial interview, subjects answered 17 questions about domestic adversity and three questions on positive aspects of upbringing to age 16 years. Personality traits were measured by Eysenck Personality Questionnaire, Behavioural Activation and Inhibition Scales, Positive and Negative Affect Scales and a measure of dissocial behaviours. Higher levels of childhood adversity substantially increase the risk of high neuroticism (OR = 2.6) and negative affect (OR = 2.6), less for behavioural inhibition (OR = 1.7) and for dissocial behaviour (OR = 1.7). No significant effect is seen for extraversion, psychoticism or behavioural activation. Age and gender had little effect on the pattern of risk. Maternal depression has significant and substantial independent effects on measures of neuroticism and negative affect as well as most other measures of personality. Childhood domestic adversity has substantial associations with clinically important aspects of personality: neuroticism and negative affect. Only small effects are seen on behavioural inhibition and dissocial behaviour, and no significant effect on extraversion and behavioural activation. These unexpected findings contradict clinical belief. Maternal psychological ill-health is pre-eminent among adversities predicting later disadvantageous traits, even for those traits that had only the slightest association with childhood adversity. Consequences of childhood adversity prevail throughout the lifespan in men and women equally. The study underlines the importance of childhood domestic

Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries.

Science.gov (United States)

Patel, L N; Detjen, A K

2017-06-21

Introduction: Childhood tuberculosis (TB) and undernutrition are major global public health challenges. In 2015, although an estimated 1 million children aged malnutrition from 17 high TB burden countries were reviewed to gather information on TB symptom screening, exposure history, and treatment. Results: Seven (41%) countries recommend routine TB screening among children with acute malnutrition, and six (35%) recommend obtaining a TB exposure history. Conclusion: TB screening is not consistently included in guidelines for acute malnutrition in high TB burden countries. Routine TB risk assessment, especially history of TB exposure, among acutely malnourished children, combined with improved linkages with TB services, would help increase TB case finding and could impact outcomes. Operational research on how best to integrate services at different levels of the health care system is needed.

Evidence-based guidelines for the use of tracheostomy in critically ill patients.

Science.gov (United States)

Raimondi, Néstor; Vial, Macarena R; Calleja, José; Quintero, Agamenón; Cortés, Albán; Celis, Edgar; Pacheco, Clara; Ugarte, Sebastián; Añón, José M; Hernández, Gonzalo; Vidal, Erick; Chiappero, Guillermo; Ríos, Fernando; Castilleja, Fernando; Matos, Alfredo; Rodriguez, Enith; Antoniazzi, Paulo; Teles, José Mario; Dueñas, Carmelo; Sinclair, Jorge; Martínez, Lorenzo; von der Osten, Ingrid; Vergara, José; Jiménez, Edgar; Arroyo, Max; Rodríguez, Camilo; Torres, Javier; Fernandez-Bussy, Sebastián; Nates, Joseph L

2017-04-01

To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system. The group identified 23 relevant questions among 87 issues that were initially identified. In the initial search, 333 relevant publications were identified, of which 226 publications were chosen. The taskforce generated a total of 19 recommendations, 10 positive (1B, 3; 2C, 3; 2D, 4) and 9 negative (1B, 8; 2C, 1). A recommendation was not possible in 6 questions. Percutaneous techniques are associated with a lower risk of infections compared with surgical tracheostomy. Early tracheostomy only seems to reduce the duration of ventilator use but not the incidence of pneumonia, the length of stay, or the long-term mortality rate. The evidence does not support the use of routine bronchoscopy guidance or laryngeal masks during the procedure. Finally, proper prior training is as important or even a more significant factor in reducing complications than the technique used. Copyright © 2016 Elsevier Inc. All rights reserved.

A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-experimental study from Uganda

Directory of Open Access Journals (Sweden)

Matthew J. Cummings

2017-11-01

Full Text Available Abstract Background To improve management of severely ill hospitalized patients in low-income settings, the World Health Organization (WHO established a triage tool called “Quick Check” to provide clinicians with a rapid, standardized approach to identify patients with severe illness based on recognition of abnormal vital signs. Despite the availability of these guidelines, recognition of severe illness remains challenged in low-income settings, largely as a result of infrequent vital sign monitoring. Methods We conducted a staggered, pre-post quasi-experimental study at four inpatient health facilities in western Uganda to assess the impact of a multi-modal intervention for improving quality of care following formal training on WHO “Quick Check” guidelines for diagnosis of severe illness in low-income settings. Intervention components were developed using the COM-B (“capability,” “opportunity,” and “motivation” determine “behavior” model and included clinical mentoring by an expert in severe illness care, collaborative improvement meetings with external support supervision, and continuous audits of clinical performance with structured feedback. Results There were 5759 patients hospitalized from August 2014 to May 2015: 1633 were admitted before and 4126 during the intervention period. Designed to occur twice monthly, collaborative improvement meetings occurred every 2–4 weeks at each site. Clinical mentoring sessions, designed to occur monthly, occurred every 4–6 months at each site. Audit and feedback reports were implemented weekly as designed. During the intervention period, there were significant increases in the site-adjusted likelihood of initial assessment of temperature, heart rate, blood pressure, respiratory rate, mental status, and pulse oximetry. Patients admitted during the intervention period were significantly more likely to be diagnosed with sepsis (4.3 vs. 0.4%, risk ratio 10.1, 95% CI 3.0–31

Integrated management of childhood illness (IMCI) - traditional ...

African Journals Online (AJOL)

2007-04-11

Apr 11, 2007 ... health professionals trained in IMCI and it being used at clinics in all 52 districts in the country. ... appropriate treatment or to refer, can be life-threatening. Because many ..... the value of IMCI guidelines to private practitioners ...

Early Childhood Infections and the Risk of Islet Autoimmunity

Science.gov (United States)

Snell-Bergeon, Janet K.; Smith, Jennifer; Dong, Fran; Barón, Anna E.; Barriga, Kathy; Norris, Jill M.; Rewers, Marian

2012-01-01

OBJECTIVE Type 1 diabetes is a common chronic childhood disease, and the incidence is increasing globally. Childhood infections are considered a potential environmental trigger of type 1 diabetes. Alternatively, improved hygiene and reduced childhood infections could explain the increase in type 1 diabetes in developed countries. The association of reported illnesses during infancy and later development of islet autoimmunity (IA) were examined in the Diabetes Autoimmunity Study in the Young. RESEARCH DESIGN AND METHODS Complete illness interviews through 9 months of age were collected for 1,729 children—1,174 without a family history of type 1 diabetes and 555 with a first-degree relative with type 1 diabetes. Persistent IA was defined as positive antibodies to insulin, glutamic acid decarboxylase, or tyrosine phosphatase on at least two consecutive study visits. RESULTS There were 109 children with persistent IA among the 1,729 children with illness records. A greater number of gastrointestinal illnesses were associated with an increased risk of IA, but only among children who were exposed to gluten-containing grains (wheat or barley) either <4 months of age (hazard ratio 1.37 [95% CI 1.22–1.55]; P < 0.0001) or ≥7 months of age (1.12 [1.05–1.19]; P = 0.0005) compared with 4–6 months of age (P for interaction = 0.02). There were no associations of upper respiratory symptoms, respiratory illnesses, or fevers with IA. CONCLUSIONS Specific pathogens such as enteroviruses or rotavirus may increase the risk of IA in the presence of existing inflammation induced by diet. PMID:23043167

Effects of child long-term illness on maternal employment: longitudinal findings from the UK Millennium Cohort Study

Science.gov (United States)

Pearce, Anna; Whitehead, Margaret; Law, Catherine

2017-01-01

Background: Maternal employment has increased in European countries, but levels of employment are lower among mothers whose children have a limiting long-term illness or disability. However, we do not know whether having a child with a limiting illness prevents take-up or maintenance of paid employment or whether ‘common causes’, such as lack of qualifications or maternal disability lead to both maternal unemployment and childhood illness. Longitudinal data have the potential to distinguish between these. Methods: We analyzed four waves (3, 5, 7 and 11 years) of the Millennium Cohort Study (MCS) to examine the relationship between childhood limiting illness and maternal employment, unadjusted and adjusted for covariates. Multinomial regression models were used to test the association between child illness and trajectories of maternal employment. Fixed effects models assessed whether a new report of a child illness increased the odds of a mother exiting employment. Results: At every wave, maternal employment was more likely if the child did not have a limiting illness. After adjustment for covariates, childhood illness was associated with risks of continuous non-employment (adjusted Relative Risk Ratio = 1.46 [Confidence Interval: 1.21, 1.76]) or disrupted employment (aRRR = 1.26 [CI: 1.06, 1.49]), compared with entering or maintaining employment. If a child developed a limiting long-term illness, the likelihood of their mother exiting employment increased (adjusted Odds Ratio = 1.27 [CI: 1.05, 1.54]). Conclusions: ‘Common causes’ did not fully account for the association between child illness and maternal employment. Having a child with a limiting illness potentially reduces maternal employment opportunities. PMID:28177497

Alagille Syndrome: A Case Report Highlighting Dysmorphic Facies, Chronic Illness, and Depression

Directory of Open Access Journals (Sweden)

James J. Bresnahan

2016-01-01

Full Text Available Alagille syndrome is a rare multisystem disorder affecting the liver, heart, vertebrae, eyes, and face. Alagille syndrome shares multiple phenotypic variants of other congenital or chronic childhood illnesses such as DiGeorge syndrome, Down syndrome, spina bifida, type 1 diabetes mellitus, and cystic fibrosis. All of these chronic illnesses have well-established links to psychiatric conditions. There are few community resources for Alagille patients, as it is an extremely rare condition. Despite the overlap with other chronic childhood illnesses, the psychiatric manifestations of Alagille syndrome have not been previously discussed in literature. The current study is a case report of a twelve-year-old female hospitalized in our pediatric psychiatric hospital for suicidal ideation with intent and plan. The patient had major depressive disorder, anxiety, other specified feeding and eating disorder, and attention-deficit/hyperactive disorder.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

Science.gov (United States)

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana

Directory of Open Access Journals (Sweden)

Lucia U. Mupara

2016-02-01

Full Text Available Background: Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. Design: A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. Results: The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. Conclusions: The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Can Telemedicine Improve Adherence to Resuscitation Guidelines for Critically Ill Children at Community Hospitals? A Randomized Controlled Trial Using High-Fidelity Simulation.

Science.gov (United States)

Yang, Chris P; Hunt, Elizabeth A; Shilkofski, Nicole; Dudas, Robert; Egbuta, Chinyere; Schwartz, Jamie M

2017-07-01

Children transferred from community hospitals lacking specialized pediatric care are more seriously ill than those presenting to pediatric centers. Pediatric consultation and adherence to management guidelines improve outcomes. The aims of the study were (1) to assess whether telemedicine consultation in critical situations is feasible and (2) to compare the impact of pediatric critical care medicine (PCCM) consultation via telemedicine versus telephone on community hospital adherence to resuscitation guidelines through a randomized controlled telemedicine trial. In situ, high-fidelity simulation scenarios of critically ill children presenting to a community hospital and progressing to cardiopulmonary arrest were performed. Scenarios were randomized to PCCM consultation via telephone (control) or telemedicine (intervention). Primary outcome measure was proportion of teams who successfully defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia. The following 30 scenarios were completed: 15 control and 15 intervention. Only 11 (37%) of 30 teams, defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia; control: 6 (40%) of 15 versus intervention: 5 (33%) of 15, P = 0.7. Request for or use of backboard during cardiopulmonary resuscitation occurred in 24 (80%) of 30 scenarios; control: 9 (60%) of 15 versus intervention: 15 (100%) of 15, P = 0.006. Request for or use of stepstool during cardiopulmonary resuscitation occurred in 6 (20%) of 30 scenarios; control: 1 (7%) of 15 versus intervention: 5 (33%) of 15, P = 0.07. This study demonstrates the feasibility of using telemedicine to support acute management of children who present to community hospitals. Neither study arm adhered to current resuscitation guidelines and telemedicine consultation with PCCM experts was not associated with improvement. However, further research on optimizing telemedicine impact on the quality of pediatric care at

Childhood Sexual Victimization, Educational Attainment, and the Returns to Schooling

Science.gov (United States)

Robst, John

2010-01-01

Numerous studies show that survivors of childhood sexual abuse suffer as adults from depression, post-traumatic stress disorder, alcohol and drug abuse, and other mental illnesses. As such, the effect of experiencing traumatic events during childhood including sexual abuse can have lasting implications. The purpose of this paper is to examine…

For better or worse? Long-term outcome of critical illness in childhood : Long-term outcome of critical illness in childhood

NARCIS (Netherlands)

L. van Zellem (Lennart)

2015-01-01

markdownabstract__Abstract__ The aim of this thesis was to investigate the long-term outcome of critically ill children admitted to the pediatric intensive care unit (PICU) of the Erasmus MC – Sophia Children’s’ Hospital in Rotterdam, the Netherlands. Our main focus was to investigate the

Impact of a community-based integrated management of childhood illnesses (IMCI) programme in Gegharkunik, Armenia.

Science.gov (United States)

Thompson, Michael E; Harutyunyan, Tsovinar L

2009-03-01

Maternal and child health status in the Martuni region of Gegharkunik marz, Armenia, precipitously declined following Armenia's independence in 1991. In response, the American Red Cross (ARC) and the Armenian Red Cross Society (ARCS) implemented the WHO community-level Integrated Management of Childhood Illnesses (IMCI) strategy, complementing recent clinical IMCI training in the region in which 387 community health volunteers from 16 villages were trained as peer educators, and approximately 5000 caretakers of children under age 5 were counselled on key nutrition and health practices. A pre-post independent sample design was used to assess the programme's impact. The evaluation instrument collected respondent demographic characteristics and knowledge, attitudes and practices consistent with 10 health indicators typical of child survival interventions. At baseline and at follow-up, 300 mothers were interviewed using a stratified simple random sampling of households with at least one child less than age 2. The assessment confirmed the population's poor health status and limited knowledge and application of recommended child care practices. The campaign reached its target: at follow-up, 67% had seen media messages within the past month, 82% had received the IMCI informational booklet, and 30% had seen other materials. Evidence of the success of the programme included the following: exclusive breastfeeding increased 31.4%, maternal knowledge of child illness signs increased 30%, knowledge of HIV increased 28.5%, and physician attended deliveries increased 15%. This evaluation documented the significant and substantial impact of the community IMCI programme on both knowledge and practice in rural areas of Armenia. Consideration should be given to continuing and expanding this project as a complement to health sector development activities in this region.

Teachers' Pedagogical Mathematical Awareness in Swedish Early Childhood Education

Science.gov (United States)

Björklund, Camilla; Barendregt, Wolmet

2016-01-01

Revised guidelines for Swedish early childhood education that emphasize mathematics content and competencies in more detail than before raise the question of the status of pedagogical mathematical awareness among Swedish early childhood teachers. The purpose of this study is to give an overview of teachers' current pedagogical mathematical…

2017 European guidelines for the management of genital herpes.

Science.gov (United States)

Patel, Rajul; Kennedy, Oliver J; Clarke, Emily; Geretti, Anna; Nilsen, Arvid; Lautenschlager, Stephan; Green, John; Donders, Gilbert; van der Meijden, Willem; Gomberg, Mikhail; Moi, Harald; Foley, Elizabeth

2017-12-01

Genital herpes is one of the commonest sexually transmitted infections worldwide. Using the best available evidence, this guideline recommends strategies for diagnosis, management, and follow-up of the condition as well as for minimising transmission. Early recognition and initiation of therapy is key and may reduce the duration of illness or avoid hospitalisation with complications, including urinary retention, meningism, or severe systemic illness. The guideline covers a range of common clinical scenarios, such as recurrent genital herpes, infection during pregnancy, and co-infection with human immunodeficiency virus.

Diagnostic challenges of childhood asthma.

Science.gov (United States)

Bakirtas, Arzu

2017-01-01

Diagnosis of asthma in childhood is challenging. Both underdiagnosis and overdiagnosis of asthma are important issues. The present review gives information about challenging factors for an accurate diagnosis of childhood asthma. Although underdiagnosis of asthma in childhood has always been the most important diagnostic problem, overdiagnosis of asthma has also been increasingly recognized. This is probably due to diagnosis of asthma based on symptoms and signs alone. Demonstration of variable airflow obstruction by lung function tests is the most common asthma diagnostic tests used in practice and is therefore strongly recommended in children who can cooperate. Recently, an asthma guideline combining the clinical and economic evidences with sensitivity and specificity of diagnostic procedures was developed to improve accuracy of diagnosis and to avoid overdiagnosis. This guideline provided an algorithmic clinical and cost-effective approach and included fractional exhaled nitric oxide measurement as one of the diagnostic tests in addition to lung function. Diagnosis of asthma in children should be made by combining relevant history with at least two confirmatory diagnostic tests whenever possible. Diagnosis based on short-period treatment trials should be limited to young children who are unable to cooperate with these tests.

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.

Science.gov (United States)

Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol

2017-07-01

This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The

Effect of a mental health training programme on Nigerian school pupils? perceptions of mental illness

OpenAIRE

Oduguwa, Adeola Oluwafunmilayo; Adedokun, Babatunde; Omigbodun, Olayinka Olusola

2017-01-01

Background Stigmatizing attitudes and discriminatory behaviour towards persons with mental illness are known to start in childhood. In Nigeria, it is not unusual to see children taunting persons with mental illness. This behaviour continues into adulthood as evidenced by the day-to-day occurrences in the community of negative attitudes and social distance from persons with mental illness. School-based interventions for pupils have been found to increase knowledge about mental illness. Childre...

Evaluation of the Integrated Management of Childhood Illness ...

African Journals Online (AJOL)

children, exit interviews with caregivers, and a structured inventory checklist for equipment, drugs and supplies at each health facility. ... Illness (IMCI) strategy was developed by the United Nations ... used to determine the first child, and thereafter we used our ... tasks performed for each child, frequencies of health system.

Oxygen supplementation for critically ill patients

DEFF Research Database (Denmark)

Barbateskovic, M; Schjørring, O L; Jakobsen, J C

2018-01-01

. The objective of this systematic review is to critically assess the evidence of randomised clinical trials on the effects of higher versus lower inspiratory oxygen fractions or targets of arterial oxygenation in critically ill adult patients. METHODS: We will search for randomised clinical trials in major......BACKGROUND: In critically ill patients, hypoxaemia is a common clinical manifestation of inadequate gas exchange in the lungs. Supplemental oxygen is therefore given to all critically ill patients. This can result in hyperoxaemia, and some observational studies have identified harms with hyperoxia...... in international guidelines despite lack of robust evidence of its effectiveness. To our knowledge, no systematic review of randomised clinical trials has investigated the effects of oxygen supplementation in critically ill patients. This systematic review will provide reliable evidence to better inform future...

Pre-hospital management and risk factors in children with acute ...

African Journals Online (AJOL)

Background. Diarrhoea remains a major cause of childhood morbidity and mortality in the developing world. Implementation of World Health Organization Integrated Management of Childhood Illness (IMCI) guidelines and pre-hospital use of oral rehydration therapy (ORT) in the Western Cape Province of South Africa are ...

Physical healthcare of people with severe mental illness: everybody's business!

OpenAIRE

Vasudev, Kamini; Martindale, Brian V

2010-01-01

Aim People with severe mental illness are at higher risk of physical health problems. Guidelines recommend annual monitoring. An audit cycle was completed on individuals with severe mental illness under the care of an early interventions in psychosis (EIP) service to evaluate and improve physical health monitoring practice.

Clinical guideline representation in a CDS: a human information processing method.

Science.gov (United States)

Kilsdonk, Ellen; Riezebos, Rinke; Kremer, Leontien; Peute, Linda; Jaspers, Monique

2012-01-01

The Dutch Childhood Oncology Group (DCOG) has developed evidence-based guidelines for screening childhood cancer survivors for possible late complications of treatment. These paper-based guidelines appeared to not suit clinicians' information retrieval strategies; it was thus decided to communicate the guidelines through a Computerized Decision Support (CDS) tool. To ensure high usability of this tool, an analysis of clinicians' cognitive strategies in retrieving information from the paper-based guidelines was used as requirements elicitation method. An information processing model was developed through an analysis of think aloud protocols and used as input for the design of the CDS user interface. Usability analysis of the user interface showed that the navigational structure of the CDS tool fitted well with the clinicians' mental strategies employed in deciding on survivors screening protocols. Clinicians were more efficient and more complete in deciding on patient-tailored screening procedures when supported by the CDS tool than by the paper-based guideline booklet. The think-aloud method provided detailed insight into users' clinical work patterns that supported the design of a highly usable CDS system.

Pre-service and in-service capacity building: Lessons learned from the Integrated Management of Childhood Illness (IMCI)

International Nuclear Information System (INIS)

Were, Wilson

2014-01-01

Background: Integrated management of childhood illness (IMCI) strategy was developed by the WHO and UNICEF in the mid-1990s as a strategy to reduce under-five mortality. Aimed at countries with mortalities >40/1000 live births, it has been adopted by more than 100 countries. The strategy aims not only to improve case management skills of health workers at the primary level health facilities, but also to strengthen health systems, and to improve home and community practices to prevent common childhood illnesses. The strategy has demonstrated success in enhancing health worker performance, improved quality of clinical care for sick children and low cost care per child correctly managed, improved nutrition status among children, and reduced child mortality where fully implemented. Lessons learnt from IMCI training: IMCI capacity building in both pre-service and in-service training has often been in increasing coverage of trained health workers. In-service training. Major obstacles with in-service training include the cost of a model reliant on centralised, tutor-based training, a shortage of experienced trainers, inadequate supply of training materials, poor follow-up and support supervision, frequent attrition of trained staff, and reaching few private practitioners. Other practical difficulties include releasing essential staff for off-site training, per diem, travel and accommodation costs, and reluctance to apply locally learned skills from centralised courses. To mitigate the challenges, countries responded with a number of strategies to increase coverage. Many countries shortened the IMCI course ranging from 5 to 7 days although the content was largely not reduced, and in some cases, was even increased. A meta-analysis that examined shortened IMCI courses demonstrated that the standard course was superior in terms of health work performance. Pre-service training. This was considered as a feasible solution to increase health system coverage by IMCI trained health

Japanese guidelines for allergic rhinitis 2017

Directory of Open Access Journals (Sweden)

Kimihiro Okubo

2017-04-01

To incorporate evidence based medicine (EBM introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA, this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

Childhood Determinants of Adult Psychiatric Disorder

Science.gov (United States)

Fryers, Tom; Brugha, Traolach

2013-01-01

The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then

Childhood determinants of adult psychiatric disorder.

Science.gov (United States)

Fryers, Tom; Brugha, Traolach

2013-01-01

The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then

Incidence and characteristics of early childhood wheezing, Dhaka, Bangladesh, 2004-2010.

Science.gov (United States)

Dawood, Fatimah S; Fry, Alicia M; Goswami, Doli; Sharmeen, Amina; Nahar, Kamrun; Anjali, Bilkis Ara; Rahman, Mustafizur; Brooks, W Abdullah

2016-06-01

Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing. In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions. Pediatr Pulmonol. 2016;51:588-595. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Evidence-based guidelines for the wise use of computers by children: physical development guidelines.

Science.gov (United States)

Straker, L; Maslen, B; Burgess-Limerick, R; Johnson, P; Dennerlein, J

2010-04-01

Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

Determining Childhood Blood Lead Level Screening Compliance Among Physicians.

Science.gov (United States)

Haboush-Deloye, Amanda; Marquez, Erika R; Gerstenberger, Shawn L

2017-08-01

Childhood Lead Poisoning Prevention Programs throughout the U.S. have addressed childhood lead poisoning by implementing primary and secondary prevention efforts. While many programs have helped increase screening rates, in some states children under the age of six still have not been tested for lead. This study aims to identify the barriers to childhood blood lead testing and develop a strategy to increase the number of children tested. Clark County physicians who work with children six and under were surveyed about blood lead level (BLL) testing practices, particularly, adherence to Centers for Disease Control and Prevention (CDC) guidelines, and parental compliance with orders to have their children tested to determine their blood lead levels. In addition, select in-person interviews were conducted with physicians who reported high parental compliance to identify best practices and barriers. Of the 77 physicians that provided data, 48% indicated they did not follow CDC guideline compared to 52% who follow guidelines. 18 of the 30 (or 60%) physicians reported more than 80% of parents complied with doctor recommended BLL testing. Twelve physicians identified cost, lack of insurance, and absence of symptomology as persistent barriers to lead screening. This study identified barriers to childhood lead screening including inadequate parental adherence to physician-ordered screenings and physician non-compliance with screening recommendations are two primary contributors. Addressing these issues could increase screening in children and reduce the risk of lead poisoning.

Implementing guidelines: Proposed definitions of neuropsychology services in pediatric oncology.

Science.gov (United States)

Baum, Katherine T; Powell, Stephanie K; Jacobson, Lisa A; Gragert, Marsha N; Janzen, Laura A; Paltin, Iris; Rey-Casserly, Celiane M; Wilkening, Greta N

2017-08-01

Several organizations have published guidelines for the neuropsychological care of survivors of childhood cancer. However, there is limited consensus in how these guidelines are applied. The model of neuropsychology service delivery is further complicated by the variable terminology used to describe recommended services. In an important first step to translate published guidelines into clinical practice, this paper proposes definitions for specific neuropsychological processes and services, with the goal of facilitating consistency across sites to foster future clinical program development and to clarify clinical practice guidelines. © 2017 Wiley Periodicals, Inc.

Morbidity and Mortality Pattern of Childhood Illnesses Seen at the ...

African Journals Online (AJOL)

The children emergency room (CHER) is the first point of contact for children who ... Ezeonwu, et al.: Childhood mortality at the Federal Medical Center, Asaba ..... if well-structured, would aid early detection and intervention thus stemming the ...

Family interaction and a supportive social network as salutogenic factors in childhood atopic illness.

Science.gov (United States)

Gustafsson, Per A; Kjellman, N-I Max; Björkstén, Bengt

2002-02-01

, alternating between total disinterest and over-involvement (p = 0.02), lack of support and rejection of offered support (p = 0.01), a greater number of individual decisions without regard to the other family members (p = 0.04), and indistinct 'generational boundaries' (p = 0.04). We conclude that psychosocial factors, such as family interaction and a supportive social network, play a significant role in the course of atopic illness in early childhood and that measures which enhance family interaction and the social network could influence the course of the disease favorably.

Effect of community integrated management of childhood illness on ...

African Journals Online (AJOL)

treated at home, severe illness should be treated by a health professional. Most child .... 3 Intensive Care Unit, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria ..... delay could be to try home care including.

Early Childhood Special Education for Children with Visual Impairments: Problems and Solutions

Science.gov (United States)

Kesiktas, A. Dolunay

2009-01-01

Studies showing developmental delays in infants and children with visual impairments have triggered early childhood special education studies for this population. Early childhood special education guidelines for visually impaired infants and children range from individualized services to personnel preparation issues while all display certain…

The paediatrician and middle childhood parenting.

Science.gov (United States)

Wong, Peter D; Wong, Jonathan P; van den Heuvel, Meta; Feller, Andrea E; Silver-Cohen, Justine; Talarico, Susanna; Humphreys, Joanna; Ford-Jones, Lee

2017-03-01

The 'forgotten years' of middle childhood, from age 6 to 12, represent a critical period in child development. Emotional, social and physical development during this time have a lifelong impact on health and adult contributions to society. Mental health conditions have displaced physical illness as the leading childhood disability. Positive parenting can improve child behaviour, prevent early-onset conduct problems and provide a buffer from adverse childhood events resulting in decreased toxic stress and improved health. Medical homes can play a key role in supporting parents with positive parenting skills that are practical, evidence-based and useful in everyday life. Paediatricians need to explore the domains that promote healthy development, including caring environments, fundamental needs and nurturing relationships. Our objective is to promote high-quality positive parenting through middle childhood by identifying opportunities for paediatricians to frame parenting discussions in the context of development, behaviour and safety and to provide access to valuable parenting resources.

Translating childhood tuberculosis case management research into operational policies.

Science.gov (United States)

Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

2011-08-01

The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

The Integrated Early Childhood Curriculum.

Science.gov (United States)

Krogh, Suzanne

This textbook provides an outline of an integrated curriculum for early childhood education. Part 1 discusses the human element in school: the child and the teacher and child development. Part 2 contains the curriculum itself and covers the subjects of language, mathematics, science, social studies, art, music, and movement. Guidelines provide…

Self-reported feeding advice by physicians for common childhood illnesses.

Science.gov (United States)

Nizami, S Q; Bhutta, Z A

1999-12-01

A nutritious diet is important for recovery during illnesses. Dietary advice by physicians and consumption of food by the patients are often based upon their hot and cold concepts and beliefs about various foods rather than on scientific basis. To look at the food-advising behaviour of physicians during illnesses and to know the maternal concepts about various foods being hot or cold. A questionnaire was served to the physicians participating in a continuous medical education session held at the Aga Khan University and Hospital, asking them to write the foods they advise or restrict during different illnesses such as fever, jaundice etc. Mothers of sick children suffering from diarrhea and other illnesses were also interviewed to know their concepts about various foods. Six (10%) out of sixty physicians believed in hot and cold concepts of the food. A variety of common foods were either restricted or strongly recommended by 10% to 50% of these physicians without any scientific basis, 23% physicians restricted fatty foods in jaundice, 17% physicians restricted in cough and cold. Although the interviewed mothers believed in hot-cold concepts of food but 55-63% of them were not sure what is meant by hot or cold food. In spite of that 70-80% of these mothers classified chicken, meat, egg, brinjal, masoor and mangoes are hot foods and rice, yogurt, moong, banana and orange as cold foods. Hot-Cold concept of food exists not only in mothers but also in physicians. Proper education regarding food intake is mandatory for both mothers and physicians to ascertain adequate intake of calories during sickness.

CHILDHOOD MALTREATMENT AND THE COURSE OF DEPRESSIVE AND ANXIETY DISORDERS : THE CONTRIBUTION OF PERSONALITY CHARACTERISTICS

NARCIS (Netherlands)

Hovens, Jacqueline G. F. M.; Giltay, Erik J.; van Hemert, Albert M.; Penninx, Brenda W. J. H.

BackgroundWe investigated the effect of childhood maltreatment on predicting the 4-year course of depressive and anxiety disorders and the possible mediating role of personality characteristics in the association between childhood maltreatment and illness course.MethodsLongitudinal data in a large

Childhood Environment and Mental Wellbeing at Age 60-64 Years: Prospective Evidence from the MRC National Survey of Health and Development.

Science.gov (United States)

Stafford, Mai; Gale, Catharine R; Mishra, Gita; Richards, Marcus; Black, Stephanie; Kuh, Diana L

2015-01-01

Mental wellbeing, conceptualised as positive affect, life satisfaction and realisation of needs that contribute to psychological growth, captures more than the absence of mental ill health. Several nations now aim to monitor and improve mental wellbeing. Whilst many studies document associations between adverse childhood experiences and mental disorders in adulthood, possible links between childhood experiences and adult mental wellbeing have so far received less attention. Using data from 1976 men and women in the MRC National Survey for Health and Development, we investigated prospective associations between childhood socioeconomic and psychosocial environments and the Warwick Edinburgh Mental Wellbeing Scale, designed to capture both hedonic and eudaimonic facets of wellbeing, at age 60-64. Whilst there was no evidence that childhood socioeconomic circumstances were related to later wellbeing independently of other childhood experiences, elements of childrearing and parenting, parental health and adjustment, and childhood illness were related. More advantaged socioeconomic position was associated with greater wellbeing but this did not explain the links between these childhood exposures and adult wellbeing, suggesting alternative explanatory pathways should be considered. Childhood illness and family psychosocial environment are associated with mental wellbeing in early older age, with effects sizes that are larger or comparable to socioeconomic circumstances in adulthood. Initiatives to improve the nation's mental wellbeing that include programmes targeted to supporting families and children may additionally have benefits that continue into older age.

Childhood Environment and Mental Wellbeing at Age 60-64 Years: Prospective Evidence from the MRC National Survey of Health and Development.

Directory of Open Access Journals (Sweden)

Mai Stafford

Full Text Available Mental wellbeing, conceptualised as positive affect, life satisfaction and realisation of needs that contribute to psychological growth, captures more than the absence of mental ill health. Several nations now aim to monitor and improve mental wellbeing. Whilst many studies document associations between adverse childhood experiences and mental disorders in adulthood, possible links between childhood experiences and adult mental wellbeing have so far received less attention.Using data from 1976 men and women in the MRC National Survey for Health and Development, we investigated prospective associations between childhood socioeconomic and psychosocial environments and the Warwick Edinburgh Mental Wellbeing Scale, designed to capture both hedonic and eudaimonic facets of wellbeing, at age 60-64.Whilst there was no evidence that childhood socioeconomic circumstances were related to later wellbeing independently of other childhood experiences, elements of childrearing and parenting, parental health and adjustment, and childhood illness were related. More advantaged socioeconomic position was associated with greater wellbeing but this did not explain the links between these childhood exposures and adult wellbeing, suggesting alternative explanatory pathways should be considered.Childhood illness and family psychosocial environment are associated with mental wellbeing in early older age, with effects sizes that are larger or comparable to socioeconomic circumstances in adulthood. Initiatives to improve the nation's mental wellbeing that include programmes targeted to supporting families and children may additionally have benefits that continue into older age.

[Trauma and psychosis--part 1. On the association of early childhood maltreatment in clinical populations with psychotic disorders].

Science.gov (United States)

Kapfhammer, Hans-Peter

2012-01-01

A comprehensive literature stresses a high percentage of severe childhood maltreatment in the history of many psychotically ill patients treated in mental health services. Early childhood abuse seems to be associated among other things with a more severe clinical state, a more chronic course of illness and a more unfavourable psychosocial adaptation. In order not to jump to unwarranted causal conclusions, several conceptual und methodological problems have to be clarified before. From a conceptual perspective psychotic disorders diagnosed according to conventional criteria define only a minor subgroup within a much broader psychosis continuum in general population. Early childhood abuse has to be differentiated according to type, severity, timing, and context. The rates of early childhood abuse are high in general population. The methods of measurement of psychotic symptoms on the one side, of early trauma on the other side have to be critically evaluated. There is an empirically well founded association of childhood maltreatment and psychological and psychosomatic morbidity during adult years in general. In order to establish a potential conditional link also to psychotic disorders, clinical populations have to be compared to adequate control groups at least. A systematic literature search shows a very small number of studies including control groups at all. These studies underline that early childhood abuse may be significantly associated to the risk of psychosis indeed. The conditional role of early childhood abuse, however, has to be investigated only within a multifactorial biopsychosocial model of psychotic illness.

Childhood socioeconomic status, telomere length, and susceptibility to upper respiratory infection.

Science.gov (United States)

Cohen, Sheldon; Janicki-Deverts, Denise; Turner, Ronald B; Marsland, Anna L; Casselbrant, Margaretha L; Li-Korotky, Ha-Sheng; Epel, Elissa S; Doyle, William J

2013-11-01

Low socioeconomic status (SES) during childhood and adolescence has been found to predict greater susceptibility to common cold viruses in adults. Here, we test whether low childhood SES is associated with shorter leukocyte telomere length in adulthood, and whether telomere length mediates the association between childhood SES and susceptibility to acute upper respiratory disease in adulthood. At baseline, 196 healthy volunteers reported whether they currently owned their home and, for each year of their childhood, whether their parents owned the family home. Volunteers also had blood drawn for assessment of specific antibody to the challenge virus, and for CD8+ CD28- T-lymphocyte telomere length (in a subset, n=135). They were subsequently quarantined in a hotel, exposed to a virus (rhinovirus [RV] 39) that causes a common cold and followed for infection and illness (clinical cold) over five post-exposure days. Lower childhood SES as measured by fewer years of parental home ownership was associated with shorter adult CD8+ CD28- telomere length and with an increased probability of developing infection and clinical illness when exposed to a common cold virus in adulthood. These associations were independent of adult SES, age, sex, race, body mass, neuroticism, and childhood family characteristics. Associations with infections and colds were also independent of pre-challenge viral-specific antibody and season. Further analyses do not support mediating roles for smoking, alcohol consumption or physical activity but suggest that CD8+ CD28- cell telomere length may act as a partial mediator of the associations between childhood SES and infection and childhood SES and colds. Copyright © 2013 Elsevier Inc. All rights reserved.

Management of high blood pressure in children: similarities and differences between US and European guidelines.

Science.gov (United States)

Brady, Tammy M; Stefani-Glücksberg, Amalia; Simonetti, Giacomo D

2018-03-28

Over the last several decades, many seminal longitudinal cohort studies have clearly shown that the antecedents to adult disease have their origins in childhood. Hypertension (HTN), which has become increasingly prevalent in childhood, represents one of the most important risk factors for cardiovascular diseases (CVD) such as heart disease and stroke. With the risk of adult HTN much greater when HTN is manifest in childhood, the future burden of CVD worldwide is therefore concerning. In an effort to slow the current trajectory, professional societies have called for more rigorous, evidence-based guideline development to aid primary care providers and subspecialists in improving recognition, diagnosis, evaluation, and treatment of pediatric HTN. In 2016 the European Society of Hypertension and in 2017 the American Academy of Pediatrics published updated guidelines for prevention and management of high blood pressure (BP) in children. While there are many similarities between the two guidelines, important differences exist. These differences, along with the identified knowledge gaps in each, will hopefully spur clinical researchers to action. This review highlights some of these similarities and differences, focusing on several of the more important facets regarding prevalence, prevention, diagnosis, management, and treatment of childhood HTN.

The prevalence of early childhood caries and its associated risk ...

African Journals Online (AJOL)

2014-12-01

Dec 1, 2014 ... of Lagos, 3Department of Pediatric Dentistry, Manubhai Patel Dental College and Hospital Baroda, ... owned tertiary hospitals in Nigeria, patients with diverse ...... antibiotics to manage childhood illness, thereby reducing.

Using community-based interventions to improve disease ...

African Journals Online (AJOL)

Department of Community Health and Primary Care, College of Medicine, University ..... Gove S. Integrated management of childhood illness by outpatient ... management guidelines for asthma and chronic heart failure, other common chronic.

Preventing mental illness: closing the evidence-practice gap through workforce and services planning.

Science.gov (United States)

Furber, Gareth; Segal, Leonie; Leach, Matthew; Turnbull, Catherine; Procter, Nicholas; Diamond, Mark; Miller, Stephanie; McGorry, Patrick

2015-07-24

Mental illness is prevalent across the globe and affects multiple aspects of life. Despite advances in treatment, there is little evidence that prevalence rates of mental illness are falling. While the prevention of cardiovascular disease and cancers are common in the policy dialogue and in service delivery, the prevention of mental illness remains a neglected area. There is accumulating evidence that mental illness is at least partially preventable, with increasing recognition that its antecedents are often found in infancy, childhood, adolescence and youth, creating multiple opportunities into young adulthood for prevention. Developing valid and reproducible methods for translating the evidence base in mental illness prevention into actionable policy recommendations is a crucial step in taking the prevention agenda forward. Building on an aetiological model of adult mental illness that emphasizes the importance of intervening during infancy, childhood, adolescence and youth, we adapted a workforce and service planning framework, originally applied to diabetes care, to the analysis of the workforce and service structures required for best-practice prevention of mental illness. The resulting framework consists of 6 steps that include identifying priority risk factors, profiling the population in terms of these risk factors to identify at-risk groups, matching these at-risk groups to best-practice interventions, translation of these interventions to competencies, translation of competencies to workforce and service estimates, and finally, exploring the policy implications of these workforce and services estimates. The framework outlines the specific tasks involved in translating the evidence-base in prevention, to clearly actionable workforce, service delivery and funding recommendations. The framework describes the means to deliver mental illness prevention that the literature indicates is achievable, and is the basis of an ongoing project to model the workforce

End-of-life content in treatment guidelines for life-limiting diseases.

Science.gov (United States)

Mast, Kimberly R; Salama, Marybeth; Silverman, Gabriel K; Arnold, Robert M

2004-12-01

Clinical guidelines are systematically developed statements that influence medical practice, education, and funding. Guidelines represent the consensus of leaders, often based on systematic reviews of the literature, regarding the "state of the art." To assess the degree to which end-of-life care is integrated into nationally developed guidelines for chronic, noncurable, life-limiting diseases. Four compendia were reviewed: The Healthcare Standards Directory ECRI, 2001; the Clinical Practice Guidelines Directory, 2000 edition; the National Guidelines Clearinghouse, (guideline.gov); and the National Library of Medicine's MEDLINE database on the OVID platform for guidelines on nine chronic diseases (chronic obstructive pulmonary disease, end-stage liver disease, amyotrophic lateral sclerosis, congestive heart failure, dementia, cerebrovascular accident, end-stage renal disease, cancer [breast, colon, prostate, lung], and human immunodeficiency virus). They were assessed by two reviewers for end-of-life content in 15 domains (e.g., epidemiology of death, symptom management, spiritual, family roles, and settings of care), the presence of eight specific terms dealing with palliative care, integration of palliative care information into the guideline, and descriptive variables. Not available. Each guideline was examined and rated on a 0-2 scale (0, absent content; 1, minimal content; 2, helpful content) using 15 end-of-life content domains. Scores from domains were summed and classified into 3 categories: 4 or less, minimal; 5-12, moderate; and more than 12, significant content. Ten percent of guidelines had significant palliative care content, 64% had minimal content, and 26% had moderate content. The least addressed domains dealt with spirituality, ethics, advocacy and family roles. When guidelines that dealt solely with prevention, acute exacerbations or complications of an illness, or specific treatment modalities were excluded 28% and 16% of these general guidelines

Children's conceptions of mental illness: a naïve theory approach.

Science.gov (United States)

Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

2010-09-01

This paper reports two studies that investigated children's conceptions of mental illness using a naïve theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing and card selection tasks to assess 6- to 11-year-old children's conceptions of the causes and consequences (Study 1) and the curability and timeline (Study 2) of different mental and physical illnesses/ailments. The studies revealed that, at all ages, the children held coherent causal-explanatory ideas about the causes, consequences, curability, and timeline of both mental and physical illnesses/ailments. However, while younger children tended to rely on their knowledge of common physical illnesses when thinking about mental illnesses, providing contagion and contamination explanations of cause, older children demonstrated differences in their thinking about mental and physical illnesses. No substantial gender differences were found in the children's thinking. It is argued that children hold coherent conceptions of mental illness at all ages, but that mental illness only emerges as an ontologically distinct conceptual domain by the end of middle childhood.

Early menarche and childhood adversities in a nationally representative sample.

Science.gov (United States)

Henrichs, Kimberly L; McCauley, Heather L; Miller, Elizabeth; Styne, Dennis M; Saito, Naomi; Breslau, Joshua

2014-01-01

Epidemiological evidence suggests that early menarche, defined as onset of menses at age 11 or earlier, has increased in prevalence in recent birth cohorts and is associated with multiple poor medical and mental health outcomes in adulthood. There is evidence that childhood adversities occurring prior to menarche contribute to early menarche. Data collected in face-to-face interviews with a nationally representative sample of women age 18 and over (N = 3288), as part of the National Comorbidity Survey-Replication, were analyzed. Associations between pre-menarchal childhood adversities and menarche at age 11 or earlier were estimated in discrete time survival models with statistical adjustment for age at interview, ethnicity, and body mass index. Adversities investigated included physical abuse, sexual abuse, neglect, biological father absence from the home, other parent loss, parent mental illness, parent substance abuse, parent criminality, inter-parental violence, serious physical illness in childhood, and family economic adversity. Mean age at menarche varied across decadal birth cohorts (χ(2)₍₄₎ = 21.41, p Childhood adversities were also more common in younger than older cohorts. Of the 11 childhood adversities, 5 were associated with menarche at age 11 or earlier, with OR of 1.3 or greater. Each of these five adversities is associated with a 26% increase in the odds of early menarche (OR = 1.26, 95% CI 1.14-1.39). The relationship between childhood sexual abuse and early menarche was sustained after adjustment for co-occurring adversities. (OR = 1.77, 95% CI 1.21-2.6). Evidence from this study is consistent with hypothesized physiological effects of early childhood family environment on endocrine development. Childhood sexual abuse is the adversity most strongly associated with early menarche. However, because of the complex way that childhood adversities cluster within families, the more generalized influence of highly dysfunctional

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys.

Science.gov (United States)

Kessler, Ronald C; McLaughlin, Katie A; Green, Jennifer Greif; Gruber, Michael J; Sampson, Nancy A; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; de Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Haro, Josep Maria; Hu, Chi-Yi; Karam, Elie G; Kawakami, Norito; Lee, Sing; Lépine, Jean-Pierre; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tsang, Adley; Ustün, T Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, David R

2010-11-01

Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

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

Science.gov (United States)

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

Health care-seeking behaviour for child illnesses among rural ...

African Journals Online (AJOL)

The aim of this study was to examine the health care-seeking behaviour of mothers when their children under five years suffer from common childhood illnesses such as diarrhoea, fever, cough and worms. The study was conducted in a rural community in the Limpopo Province of South Africa. The sample consisted of 100 ...

Severity of mental illness as a result of multiple childhood adversities: US National Epidemiologic Survey.

Science.gov (United States)

Curran, Emma; Adamson, Gary; Stringer, Maurice; Rosato, Michael; Leavey, Gerard

2016-05-01

To examine patterns of childhood adversity, their long-term consequences and the combined effect of different childhood adversity patterns as predictors of subsequent psychopathology. Secondary analysis of data from the US National Epidemiologic Survey on alcohol and related conditions. Using latent class analysis to identify childhood adversity profiles; and using multinomial logistic regression to validate and further explore these profiles with a range of associated demographic and household characteristics. Finally, confirmatory factor analysis substantiated initial latent class analysis findings by investigating a range of mental health diagnoses. Latent class analysis generated a three-class model of childhood adversity in which 60 % of participants were allocated to a low adversity class; 14 % to a global adversities class (reporting exposures for all the derived latent classes); and 26 % to a domestic emotional and physical abuse class (exposed to a range of childhood adversities). Confirmatory Factor analysis defined an internalising-externalising spectrum to represent lifetime reporting patterns of mental health disorders. Using logistic regression, both adversity groups showed specific gender and race/ethnicity differences, related family discord and increased psychopathology. We identified underlying patterns in the exposure to childhood adversity and associated mental health. These findings are informative in their description of the configuration of adversities, rather than focusing solely on the cumulative aspect of experience. Amelioration of longer-term negative consequences requires early identification of psychopathology risk factors that can inform protective and preventive interventions. This study highlights the utility of screening for childhood adversities when individuals present with symptoms of psychiatric disorders.

Follow-up in Childhood Functional Constipation

DEFF Research Database (Denmark)

Modin, Line; Walsted, Anne-Mette; Rittig, Charlotte Siggaard

2016-01-01

OBJECTIVES: Guidelines recommend close follow-up during treatment of childhood functional constipation. Only sparse evidence exists on how follow-up is best implemented. Our aim was to evaluate if follow-up by phone or self-management through web-based information improved treatment outcomes....... METHODS: In this randomized, controlled trial, conducted in secondary care, 235 children, aged 2-16 years, who fulfilled the Rome III criteria of childhood constipation, were assigned to one of three follow-up regimens: (I) control group (no scheduled contact), (II) phone group (2 scheduled phone contacts......: Improved self-management behavior caused by access to self-motivated web-based information induced faster short-term recovery during treatment of functional constipation. Patient empowerment rather than health care promoted follow-up might be a step towards more effective treatment for childhood...

Traumatic Childhood Events and Autism Spectrum Disorder

Science.gov (United States)

Kerns, Connor Morrow; Newschaffer, Craig J.; Berkowitz, Steven J.

2015-01-01

Traumatic childhood events are associated with a wide range of negative physical, psychological and adaptive outcomes over the life course and are one of the few identifiable causes of psychiatric illness. Children with autism spectrum disorder (ASD) may be at increased risk for both encountering traumatic events and developing traumatic sequelae;…

Clinical Profile and Predictors of Severe Illness in young South ...

African Journals Online (AJOL)

Background. Most childhood deaths occur within the first 2 months of life. Simple symptoms and signs that reliably indicate the presence of severe illness that would warrant urgent hospital management are of major public health importance. Objectives. To describe the disease profile of sick young infants aged 0 - 59 days ...

Liberation From Mechanical Ventilation in Critically Ill Adults

DEFF Research Database (Denmark)

Schmidt, Gregory A; Girard, Timothy D; Kress, John P

2017-01-01

BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST). METHODS: A ...

Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

Science.gov (United States)

Garrido, Melissa M; Prigerson, Holly G; Neupane, Suvam; Penrod, Joan D; Johnson, Christopher E; Boockvar, Kenneth S

2017-03-01

Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted. To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured. At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge. Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.

The association between adverse childhood experiences and adult traumatic brain injury/concussion: a scoping review.

Science.gov (United States)

Ma, Zechen; Bayley, Mark T; Perrier, Laure; Dhir, Priya; Dépatie, Lana; Comper, Paul; Ruttan, Lesley; Lay, Christine; Munce, Sarah E P

2018-01-12

Adverse childhood experiences are significant risk factors for physical and mental illnesses in adulthood. Traumatic brain injury/concussion is a challenging condition where pre-injury factors may affect recovery. The association between childhood adversity and traumatic brain injury/concussion has not been previously reviewed. The research question addressed is: What is known from the existing literature about the association between adverse childhood experiences and traumatic brain injury/concussion in adults? All original studies of any type published in English since 2007 on adverse childhood experiences and traumatic brain injury/concussion outcomes were included. The literature search was conducted in multiple electronic databases. Arksey and O'Malley and Levac et al.'s scoping review frameworks were used. Two reviewers independently completed screening and data abstraction. The review yielded six observational studies. Included studies were limited to incarcerated or homeless samples, and individuals at high-risk of or with mental illnesses. Across studies, methods for childhood adversity and traumatic brain injury/concussion assessment were heterogeneous. A positive association between adverse childhood experiences and traumatic brain injury occurrence was identified. The review highlights the importance of screening and treatment of adverse childhood experiences. Future research should extend to the general population and implications on injury recovery. Implications for rehabilitation Exposure to adverse childhood experiences is associated with increased risk of traumatic brain injury. Specific types of adverse childhood experiences associated with risk of traumatic brain injury include childhood physical abuse, psychological abuse, household member incarceration, and household member drug abuse. Clinicians and researchers should inquire about adverse childhood experiences in all people with traumatic brain injury as pre-injury health conditions can

'Rules' for boys, 'guidelines' for girls: Gender differences in symptom reporting during childhood and adolescence.

Science.gov (United States)

Maclean, Alice; Sweeting, Helen; Hunt, Kate

2010-02-01

The emergence of higher reported morbidity in females compared with males is a feature of adolescent health in a large proportion of the world's industrialised countries. In this paper, qualitative data from twenty-five single-sex focus groups (90 participants in total) conducted with 10-, 13-, and 15-year olds in two Scottish schools is used to explore whether symptom reporting is influenced by perceived societal gender- and age-related expectations and the social context of symptom experiences. The degree to which these factors can help explain quantitative evidence of increases in gender differences in symptom reporting during adolescence is also examined. Accounts suggested gender-related expectations act as strict 'rules' for boys and less prohibitive 'guidelines' for girls. An unexpected finding was the extent of similarity between these 'rules' and 'guidelines'. Both boys and girls presented themselves as pressured to react to symptoms in stoic, controlled and independent ways, particularly when in the company of their peers, and both perceived that boys and girls could incur negative consequences if seen to have physical (e.g. stomach ache) or, especially, psychological symptoms (e.g. feeling like crying). These qualitative findings do not suggest that girls are simply more willing than boys to report their symptoms as they get older, which is one potential explanation for the quantitative evidence of increasing gender differences in symptom reporting in adolescence. Rather, the findings suggest a need to highlight both the potentially damaging effects of gender stereotypes which make boys reluctant to seek help for physical and, particularly, psychological symptoms, and the misconception that girls are not similarly reluctant to report illness. Copyright 2009 Elsevier Ltd. All rights reserved.

Decline in physical activity level in the Childhood Cancer Survivor Study cohort.

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Wilson, Carmen L; Stratton, Kayla; Leisenring, Wendy L; Oeffinger, Kevin C; Nathan, Paul C; Wasilewski-Masker, Karen; Hudson, Melissa M; Castellino, Sharon M; Stovall, Marilyn; Armstrong, Gregory T; Brinkman, Tara M; Krull, Kevin R; Robison, Leslie L; Ness, Kirsten K

2014-08-01

We aimed to identify demographic and health-related predictors of declining physical activity levels over a four-year period among participants in the Childhood Cancer Survivor Study. Analyses included 7,287 ≥5-year childhood cancer survivors and 2,107 siblings who completed multiple follow-up questionnaires. Participants were classified as active if they met the Centers for Disease Control and Prevention guidelines for physical activity. Generalized linear models were used to compare participants whose physical activity levels declined from active to inactive over the study to those who remained active. In addition, selected chronic conditions (CTCAE v4.03 Grade 3 and 4) were evaluated as risk factors in an analysis limited to survivors only. The median age at last follow-up among survivors and siblings was 36 (range, 21-58) and 38 (range, 21-62) years, respectively. The rate of decline did not accelerate over time among survivors when compared with siblings. Factors that predicted declining activity included body mass index ≥30 kg/m(2) [RR = 1.32; 95% confidence interval (CI), 1.19-1.46, P physical activity levels were associated with the presence of chronic musculoskeletal conditions (P = 0.034), but not with the presence of cardiac (P = 0.10), respiratory (P = 0.92), or neurologic conditions (P = 0.21). Interventions designed to maximize physical activity should target female, obese, and less educated survivors. Survivors with chronic musculoskeletal conditions should be monitored, counseled, and/or referred for physical therapy. Clinicians should be aware of low activity levels among subpopulations of childhood cancer survivors, which may heighten their risk for chronic illness. ©2014 American Association for Cancer Research.

CHILDHOOD MALTREATMENT AND THE COURSE OF DEPRESSIVE AND ANXIETY DISORDERS: THE CONTRIBUTION OF PERSONALITY CHARACTERISTICS.

Science.gov (United States)

Hovens, Jacqueline G F M; Giltay, Erik J; van Hemert, Albert M; Penninx, Brenda W J H

2016-01-01

We investigated the effect of childhood maltreatment on predicting the 4-year course of depressive and anxiety disorders and the possible mediating role of personality characteristics in the association between childhood maltreatment and illness course. Longitudinal data in a large sample of participants with baseline depressive and/or anxiety disorders (n = 1,474, 18-65 years) were collected in the Netherlands Study of Depression and Anxiety. At baseline, childhood maltreatment was assessed with a semistructured interview. Personality trait questionnaires (Neuroticism-Extroversion-Openness Five Factor Inventory, Mastery scale, and Leiden Index of Depression Sensitivity), recent stressful life events (List of Threatening Experiences Questionnaire), and psychosocial variables were administered. The Life Chart Interview was used to determine the time to remission of depressive and/or anxiety disorders. At baseline, 846 participants (57.4%) reported any childhood maltreatment. Childhood maltreatment had a negative impact on psychosocial functioning and was predictive of more unfavorable personality characteristics and cognitive reactivity styles (P Childhood maltreatment was a significant predictor of lower likelihood of remission of depressive and/or anxiety disorders (HR = 0.94, P childhood maltreatment and 4-year remission of depressive and anxiety disorders. Certain personality characteristics are key players in the mechanism linking childhood maltreatment to an adverse illness course of depressive and anxiety disorders. Early interventions--reducing neuroticism and hopelessness, and enhancing extraversion and locus of control--might contribute to a better prognosis in a "high-risk" group of depressive and anxiety disorders. © 2015 Wiley Periodicals, Inc.

Perceptions of childhood immunisations in rural Transkei - a ...

African Journals Online (AJOL)

Objectives. To examine perceptions of childhood illnesses, and the role of immunisation in preventing them, among caretakers of young children in Mhlakulo, a rural community in Transkei, Eastern Cape, and to suggest reasons for the low uptake of immunisations in that area. Design. In-depth qualitative research using ...

Management of uncomplicated malaria in children under 13 years of age at a district hospital in Senegal: from official guidelines to usual practices.

Science.gov (United States)

Sarrassat, Sophie; Lalou, Richard; Cissé, Moustapha; Le Hesran, Jean-Yves

2011-09-29

To be effective, national malaria guidelines must be properly followed. This study evaluated nurses' practices in the management of uncomplicated malaria cases at a District Hospital. Its objective was to identify the reasons for discrepancies between official guidelines and usual practices. This study took place at Oussouye hospital, south-western Senegal. Blood smears were available for biological diagnosis in patients aged more than five years while the Integrated Management of Childhood Illness recommended treating fevers presumptively in children under five. First line anti-malarial was Amodiaquine plus sulphadoxine-pyrimethamine (AQ+SP) bi-therapy. Hospital records of children under 13 years of age seen between 2004 and 2005 were reviewed. Among children treated with anti-malarials, 74% (2, 063/2, 789) received AQ+SP. However, only 22% (406/1, 879) of febrile children and 19% (429/2, 198) of children diagnosed with malaria got a blood smear. Moreover, an anti-malarial was prescribed for 80% (377/474) of children with a negative blood smear. The transition from chloroquine to AQ+SP was well followed. Nonetheless, blood smear use was very low and many over-prescriptions were reported. Reasons for discrepancies between guidelines and practices can be classified in three main categories: ambiguous guidelines, health system's dysfunctions and nurses' own considerations. Aside from the strengthening of the public health system, in order to guarantee practices complying with guidelines, training content should be more adapted to nurses' own considerations.

Management of uncomplicated malaria in children under 13 years of age at a district hospital in senegal: from official guidelines to usual practices

Directory of Open Access Journals (Sweden)

Le Hesran Jean-Yves

2011-09-01

Full Text Available Abstract Background To be effective, national malaria guidelines must be properly followed. This study evaluated nurses' practices in the management of uncomplicated malaria cases at a District Hospital. Its objective was to identify the reasons for discrepancies between official guidelines and usual practices. Methods This study took place at Oussouye hospital, south-western Senegal. Blood smears were available for biological diagnosis in patients aged more than five years while the Integrated Management of Childhood Illness recommended treating fevers presumptively in children under five. First line anti-malarial was Amodiaquine plus sulphadoxine-pyrimethamine (AQ+SP bi-therapy. Hospital records of children under 13 years of age seen between 2004 and 2005 were reviewed. Results Among children treated with anti-malarials, 74% (2, 063/2, 789 received AQ+SP. However, only 22% (406/1, 879 of febrile children and 19% (429/2, 198 of children diagnosed with malaria got a blood smear. Moreover, an anti-malarial was prescribed for 80% (377/474 of children with a negative blood smear. Conclusions The transition from chloroquine to AQ+SP was well followed. Nonetheless, blood smear use was very low and many over-prescriptions were reported. Reasons for discrepancies between guidelines and practices can be classified in three main categories: ambiguous guidelines, health system's dysfunctions and nurses' own considerations. Aside from the strengthening of the public health system, in order to guarantee practices complying with guidelines, training content should be more adapted to nurses' own considerations.

Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium

Science.gov (United States)

van Dorp, Wendy; Mulder, Renée L.; Kremer, Leontien C.M.; Hudson, Melissa M.; van den Heuvel-Eibrink, Marry M.; van den Berg, Marleen H.; Levine, Jennifer M.; van Dulmen-den Broeder, Eline; di Iorgi, Natascia; Albanese, Assunta; Armenian, Saro H.; Bhatia, Smita; Constine, Louis S.; Corrias, Andreas; Deans, Rebecca; Dirksen, Uta; Gracia, Clarisa R.; Hjorth, Lars; Kroon, Leah; Lambalk, Cornelis B.; Landier, Wendy; Levitt, Gill; Leiper, Alison; Meacham, Lillian; Mussa, Alesandro; Neggers, Sebastian J.; Oeffinger, Kevin C.; Revelli, Alberto; van Santen, Hanneke M.; Skinner, Roderick; Toogood, Andrew; Haupt, Riccardo

2016-01-01

Purpose Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). Clinical practice guidelines can facilitate these survivors’ access to optimal treatment of late effects that may improve health and quality of survival; however, surveillance recommendations vary among the existing long-term follow-up guidelines, which impedes the implementation of screening. Patients and Methods The present guideline was developed by using an evidence-based approach and summarizes harmonized POI surveillance recommendations for female survivors of CAYA cancer who were diagnosed at age < 25 years. The recommendations were formulated by an international multidisciplinary panel and graded according to the strength of the evidence and the potential benefit gained from early detection and intervention. The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer. Results and Conclusion The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer. PMID:27458300

Abnormal illness behaviour: physiological, psychological and social dimensions of coping with distress.

Science.gov (United States)

Kirmayer, Laurence J; Looper, Karl J

2006-01-01

Pilowsky introduced the term 'abnormal illness behaviour' to characterize syndromes of excessive or inadequate response to symptoms, including hypochondriasis, somatization, and denial of illness. This review summarizes recent work from sociology, health psychology and psychiatry that contributes to an understanding of the processes that may underlie abnormal illness behaviour. Disturbances in the regulation of physiological systems may account for many 'unexplained' symptoms and sickness behaviour. Increased attention to bodily sensations, sensitivity to pain and catastrophizing play important roles in illness behaviour in medical illness. Developmental adversities and parental modelling of illness behaviour in childhood may increase bodily preoccupation and health care utilization. Apparent cross-national differences in illness behaviour may reflect differences in health care systems, but cultural models of illness and social stigma remain important determinants of illness denial and avoidance of mental health services. Research into illness behaviour is relevant to efforts to rethink the psychiatric nosology of somatoform disorders. The discrete somatoform disorders might well be replaced by a dimensional framework that identifies specific pathological processes in cognition, perception and social behaviour that contribute to bodily distress, impaired coping, inappropriate use of health services, chronicity and disability.

Development of quality indicators based on a multidisciplinary, evidence-based guideline on pediatric constipation

NARCIS (Netherlands)

Stienen, J.J.C.; Tabbers, M.M.; Benninga, M.A.; Harmsen, M.; Ouwens, M.M.T.J.

2011-01-01

Several clinical guidelines for childhood functional constipation have been developed, but none of them is accompanied by a set of quality indicators. It is important to gain insight into the quality of care in daily practice in order to improve the implementation of clinical guidelines. This can be

Asthma in childhood: a complex, heterogeneous disease

Directory of Open Access Journals (Sweden)

Hai Lee Chung

2011-01-01

Full Text Available Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheezing phenotypes in young children and about potential mechanisms and risk factors for the development of chronic asthma. The goal of these studies was to provide a better insight into the causes and natural course of childhood asthma. It is well-known that complicated interactions between genes and environmental factors contribute to the development of asthma. Because childhood is a period of rapid growth in both the lungs and the immune system, developmental factors should be considered in the pathogenesis of childhood asthma. The pulmonary system continues to grow and develop until linear growth is completed. Longitudinal studies have reported significant age-related immune development during postnatal early life. These observations suggest that the phenotypes of childhood asthma vary among children and also in an individual child over time. Improved classification of heterogeneous conditions of the disease will help determine novel strategies for primary and secondary prevention and for the development of individualized treatment for childhood asthma.

[Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

Science.gov (United States)

Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences. © Georg Thieme Verlag KG Stuttgart · New York.

National Guidelines for Prevention and Control of Iron Deficiency Anemia in India

Directory of Open Access Journals (Sweden)

Asha Bellad

2018-04-01

Full Text Available Anaemia is a serious public health challenge in India with more than 50% prevalence across vulnerable groups such as pregnant women, infants, young children and adolescents. It has adverse effects on health, physical and mental productivity affecting quality of life. Guideline is any document containing recommendations about health interventions, whether these are clinical, public health or policy recommendations. The National Anemia Prevention and control guidelines have been developed taking cognizance of the current scientific evidence. The National Iron+ Initiative guidelines have been developed by the Adolescent Division of the Ministry of Health and Family Welfare (MoHFW, Government of India.  Prevention and control of anaemia is one of the key strategies of the Health, Nutrition and Population Sector Programmes for reducing maternal, neonatal and childhood mortality and improving maternal, adolescent and childhood health status. It is estimated that anaemia causes 20 per cent of maternal deaths in India.

The experience of fatherhood following childhood cancer survival.

Science.gov (United States)

Agnew, Francis; Higgins, Aiveen; Casey, Maureen; McCarthy, Anthony

2017-07-01

This study explored the experience of becoming a father following childhood cancer survival. Semi-structured interviews were conducted with five fathers and analysed using interpretative phenomenological analysis. Three superordinate themes emerged: 'moving away from and revisiting the experience of cancer', 'making sense of fortune and loss following a life-threatening illness' and 'valuing the opportunity to be a father'. The transition to fatherhood brought unique and specific challenges to fathers. Nevertheless, all appeared to have positively adjusted to this transition. Findings recommended providing information and support to childhood survivors who wish to or who are about to become fathers.

Weight Loss Trajectories and Adverse Childhood Experience among Obese Adolescents with Polycystic Ovary Syndrome.

Science.gov (United States)

Rofey, Dana L; El Nokali, Nermeen E; Jackson Foster, Lovie J; Seiler, Emily; McCauley, Heather L; Miller, Elizabeth

2018-03-08

To examine the effect of childhood trauma and family history of psychiatric illness on weight loss trajectories of obese, female adolescents with polycystic ovary syndrome (PCOS). Prospective study. PCOS and adolescent medicine outpatient clinics. Participants were, on average, 15.8 years of age, 80% Caucasian (39/49 participants), and had a body mass index of 36.8 ± 8.8. Healthy Bodies, Healthy Minds is an evidence-based one-on-one intervention consisting of 4 weekly sessions, 4 biweekly sessions, and 3 monthly booster sessions. Each session was 45-60 minutes long with 15-30 minutes of physical activity with a lifestyle coach. Paired sample t tests were used to assess group differences in pre- and post-treatment weight between participants reporting childhood trauma and body mass index-matched controls not endorsing trauma. One-way analysis of variance was performed to assess the influence of childhood trauma on weight loss between the 2 groups. Adolescents without a family history of psychiatric illness lost more weight (mean, -1.28 kg; SD, 6.89) than those who had a family history of psychiatric illness (mean, -0.64 kg; SD, 4.7) from baseline to booster session completion (6 months). However, results of independent t tests did not reveal statistically significant group differences in weight loss from baseline to booster session completion (t 21  = 0.51; P = .6). Obese adolescents with PCOS who have experienced childhood trauma can lose weight and acquire its health benefits when enrolled in an intervention addressing weight, mood, and sleep. Family history of psychiatric illness emerged as a potential predictor of lesser weight loss. Copyright © 2018. Published by Elsevier Inc.

Born at the right time? Childhood health and the business cycle.

Science.gov (United States)

Angelini, Viola; Mierau, Jochen O

2014-05-01

We analyze the relationship between the state of the business cycle at birth and childhood health. We use a retrospective survey on self-reported childhood health for ten Western European countries and combine it with historically and internationally comparable data on the Gross Domestic Product. We validate the self-reported data by comparing them to realized illness spells. We find a positive relationship between being born in a recession and childhood health. This relationship is not driven by selection effects due to heightened infant mortality during recessions. Placebo regressions indicate that the observed effect is not spurious. Copyright © 2014 Elsevier Ltd. All rights reserved.

Early Childhood Special Educators and the Hospital Ethics Committee.

Science.gov (United States)

Lowenthal, Barbara

1989-01-01

The paper discusses issues of concern to early childhood special educators serving on hospital ethics committees to assist families with seriously ill and handicapped infants in neonatal intensive care units. Issues include infant euthanasia and the right to life, child abuse legislation, and possible effects on families. (Author/JDD)

Does integrated management of childhood illness (IMCI training improve the skills of health workers? A systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Duyen Thi Kim Nguyen

Full Text Available An estimated 6.9 million children die annually in low and middle-income countries because of treatable illneses including pneumonia, diarrhea, and malaria. To reduce morbidity and mortality, the Integrated Management of Childhood Illness strategy was developed, which included a component to strengthen the skills of health workers in identifying and managing these conditions. A systematic review and meta-analysis were conducted to determine whether IMCI training actually improves performance.Database searches of CIHAHL, CENTRAL, EMBASE, Global Health, Medline, Ovid Healthstar, and PubMed were performed from 1990 to February 2013, and supplemented with grey literature searches and reviews of bibliographies. Studies were included if they compared the performance of IMCI and non-IMCI health workers in illness classification, prescription of medications, vaccinations, and counseling on nutrition and admistration of oral therapies. Dersminion-Laird random effect models were used to summarize the effect estimates.The systematic review and meta-analysis included 46 and 26 studies, respectively. Four cluster-randomized controlled trials, seven pre-post studies, and 15 cross-sectional studies were included. Findings were heterogeneous across performance domains with evidence of effect modification by health worker performance at baseline. Overall, IMCI-trained workers were more likely to correctly classify illnesses (RR = 1.93, 95% CI: 1.66-2.24. Studies of workers with lower baseline performance showed greater improvements in prescribing medications (RR = 3.08, 95% CI: 2.04-4.66, vaccinating children (RR = 3.45, 95% CI: 1.49-8.01, and counseling families on adequate nutrition (RR = 10.12, 95% CI: 6.03-16.99 and administering oral therapies (RR = 3.76, 95% CI: 2.30-6.13. Trends toward greater training benefits were observed in studies that were conducted in lower resource settings and reported greater supervision.Findings suggest that

Accidental childhood poisoning in Benin City: Still a problem ...

African Journals Online (AJOL)

Accidental poisoning (AP) is a leading cause of ill – health and deaths among. Nigerian children. Reports on AP are infrequent in Nigeria. This retrospective descriptive study examined the prevailing pattern of accidental childhood poisoning in Benin City. Accidental poisonings were identified in 226 (3.3%) of the cases ...

Life-history theory, chronic childhood illness and the timing of first reproduction in a British birth cohort.

Science.gov (United States)

Waynforth, David

2012-08-07

Life-history theoretical models show that a typical evolutionarily optimal response of a juvenile organism to high mortality risk is to reach reproductive maturity earlier. Experimental studies in a range of species suggest the existence of adaptive flexibility in reproductive scheduling to maximize fitness just as life-history theory predicts. In humans, supportive evidence has come from studies comparing neighbourhoods with different mortality rates, historical and cross-cultural data. Here, the prediction is tested in a novel way in a large (n = 9099), longitudinal sample using data comparing age at first reproduction in individuals with and without life-expectancy-reducing chronic disease diagnosed during childhood. Diseases selected for inclusion as chronic illnesses were those unlikely to be significantly affected by shifting allocation of effort away from reproduction towards survival; those which have comparatively large effects on mortality and life expectancy; and those which are not profoundly disabling. The results confirmed the prediction that chronic disease would associate with early age at first reproduction: individuals growing up with a serious chronic disease were 1.6 times more likely to have had a first child by age 30. Analysis of control variables also confirmed past research findings on links between being raised father-absent and early pubertal development and reproduction.

Descriptive epidemiology and health consequences of childhood obesity.

Science.gov (United States)

Reilly, John J

2005-09-01

Obesity is now the most common disorder of childhood in the developed world, and its prevalence is still increasing. A large body of high-quality and consistent evidence shows that it is best defined using the body mass index (BMI) percentile relative to national BMI reference data. This definition diagnoses excessive fatness adequately, and denotes increased risk of adverse health outcomes. Future research may provide improved obesity definitions for epidemiological use, so that the obesity epidemic can be monitored more effectively. Paediatric obesity causes ill health in both childhood and adulthood, though further research is required on the economic consequences, on some of the co-morbidities in childhood (notably psychological morbidity), and in adulthood where the amount of empirical evidence on long-term effects is limited. The combination of high prevalence with adverse consequences has created a public health crisis.

Warning--Television Viewing May Harm Your Child's Health: Parent Perceptions of Early Childhood Viewing Habits

Science.gov (United States)

Garvis, Susanne; Pendergast, Donna

2011-01-01

In 2009, the Australian Government introduced the Get Up and Grow (Commonwealth Government, 2009) guidelines for healthy eating and exercise in early childhood as one element of a range of initiatives aiming to curb childhood obesity, a problem affecting an increasing proportion of Australia children. Included in the policy recommendations are…

Childhood trauma exposure and toxic stress: what the PNP needs to know.

Science.gov (United States)

Hornor, Gail

2015-01-01

Trauma exposure in childhood is a major public health problem that can result in lifelong mental and physical health consequences. Pediatric nurse practitioners must improve their skills in the identification of trauma exposure in children and their interventions with these children. This continuing education article will describe childhood trauma exposure (adverse childhood experiences) and toxic stress and their effects on the developing brain and body. Adverse childhood experiences include a unique set of trauma exposures. The adverse childhood experiences or trauma discussed in this continuing education offering will include childhood exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, domestic violence, household substance abuse, household mental illness, parental separation or divorce, and a criminal household member. Thorough and efficient methods of screening for trauma exposure will be discussed. Appropriate intervention after identification of trauma exposure will be explored. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Anxiety, stress and depression in family caregivers of the mentally ill

OpenAIRE

Lídia Cabral; João Duarte; Manuela Ferreira; Carlos dos Santos

2014-01-01

Background: The current policy guidelines on mental health aim to keep the mentally ill within the community, with the development of social support, including families, hence the emergence of the role of the family caregiver. Objectives: To identify socio-demographic variables influencing anxiety, depression and stress for the informal caregivers of the mentally ill; to determine the influence of family background variables on caregiver anxiety, depression and stress; to analyse the relat...

Childhood poverty and recruitment of adult emotion regulatory neurocircuitry

Science.gov (United States)

Ma, Sean T.; Okada, Go; Shaun Ho, S.; Swain, James E.; Evans, Gary W.

2015-01-01

One in five American children grows up in poverty. Childhood poverty has far-reaching adverse impacts on cognitive, social and emotional development. Altered development of neurocircuits, subserving emotion regulation, is one possible pathway for childhood poverty’s ill effects. Children exposed to poverty were followed into young adulthood and then studied using functional brain imaging with an implicit emotion regulation task focused. Implicit emotion regulation involved attention shifting and appraisal components. Early poverty reduced left dorsolateral prefrontal cortex recruitment in the context of emotional regulation. Furthermore, this emotion regulation associated brain activation mediated the effects of poverty on adult task performance. Moreover, childhood poverty also predicted enhanced insula and reduced hippocampal activation, following exposure to acute stress. These results demonstrate that childhood poverty can alter adult emotion regulation neurocircuitry, revealing specific brain mechanisms that may underlie long-term effects of social inequalities on health. The role of poverty-related emotion regulatory neurocircuitry appears to be particularly salient during stressful conditions. PMID:25939653

76 FR 36891 - Guidelines for Determining Probability of Causation Under the Energy Employees Occupational...

Science.gov (United States)

2011-06-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 81 [Docket Number NIOSH-0209] RIN 0920-AA39 Guidelines for Determining Probability of Causation Under the Energy Employees Occupational Illness...: HHS published a proposed rule entitled ``Guidelines for Determining Probability of Causation Under the...

Do biogenetic causal beliefs reduce mental illness stigma in people with mental illness and in mental health professionals? A systematic review.

Science.gov (United States)

Larkings, Josephine S; Brown, Patricia M

2018-06-01

Viewing mental illness as an 'illness like any other' and promoting biogenetic causes have been explored as a stigma-reduction strategy. The relationship between causal beliefs and mental illness stigma has been researched extensively in the general public, but has gained less attention in more clinically-relevant populations (i.e. people with mental illness and mental health professionals). A systematic review examining whether endorsing biogenetic causes decreases mental illness stigma in people with mental illness and mental health professionals was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Multiple databases were searched, and studies that explored the relationship between biogenetic causal beliefs and mental illness stigma in people with mental illness or mental health professionals were considered. Studies were included if they focussed on depression, schizophrenia, or mental illness in general, were in English, and had adult participants. The search identified 11 journal articles reporting on 15 studies, which were included in this review. Of these, only two provided evidence that endorsing biogenetic causes was associated with less mental illness stigma in people with mental illness or mental health professionals. The majority of studies in the present review (n = 10) found that biogenetic causal beliefs were associated with increased stigma or negative attitudes towards mental illness. The present review highlights the lack of research exploring the impacts of endorsing biogenetic causes in people with mental illness and mental health professionals. Clinical implications associated with these results are discussed, and suggestions are made for further research that examines the relationship between causal beliefs and treatment variables. © 2017 Australian College of Mental Health Nurses Inc.

Are health interventions implemented where they are most needed? District uptake of the integrated management of childhood illness strategy in Brazil, Peru and the United Republic of Tanzania.

Science.gov (United States)

Victora, C G; Huicho, L; Amaral, J J; Armstrong-Schellenberg, J; Manzi, F; Mason, E; Scherpbier, R

2006-10-01

To describe geographical patterns of implementation of the Integrated Management of Childhood Illness (IMCI) strategy in three countries and to assess whether the strategy was implemented in areas with the most pressing child health needs. We conducted interviews with key informants at the national and district levels in Brazil, Peru and the United Republic of Tanzania, and an ecological study of factors associated with health worker training in IMCI. Explanatory factors included district population, distance from the capital, human development index, other socioeconomic indicators and baseline mortality rates in children younger than five years. In line with recommendations by WHO, early implementation districts were characterized by proximity to the capital and suitable training sites, presence of motivated health managers and a functioning health system. In the expansion phase, IMCI tended to be adopted by other districts with similar characteristics. In Brazil, uptake by poor and small municipalities and those further away from the state capital was significantly lower. In Peru, there was no association with distance from Lima, and a non-significant trend for IMCI adoption by small and poor departments. In the United Republic of Tanzania, the only statistically significant finding was a lower uptake by remote districts. Implementation was not associated with baseline mortality levels in any country studied. Whereas clear and reasonable guidelines are provided for selection of early use districts, no criteria for promoting IMCI expansion had been issued, and areas of greatest need were not prioritized. Equity analyses based on the geographical deployment of new programmes and strategies can contribute to assessing whether they are reaching those who need them most.

Memories of Parent Behaviors and Adult Attachment in Childhood Cancer Survivors

NARCIS (Netherlands)

Lehmann, Vicky; Hagedoorn, Mariët; Gerhardt, Cynthia A; Keim, Madelaine C; Guthrie, Lory; Sanderman, Robbert; Tuinman, Marrit A

PURPOSE: Childhood cancer is stressful for the entire family. Preoccupation and anxiety surrounding the child's illness may result in parents of children with cancer being overprotective or less emotionally responsive toward their children. Such parenting in response to a negative life event like

Sensitive Situations. The DLM Early Childhood Program Professional Library.

Science.gov (United States)

Schiller, Pam

Teachers know how to educate young children, but many feel ill-prepared when faced with students' emotional issues in the classroom. This book is intended as a resource for early childhood teachers who find themselves in the middle of such "sensitive situations." The information is presented by using a fictional, but typical, scenario…

Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders

NARCIS (Netherlands)

Nuttin, Bart; Wu, Hemmings; Mayberg, Helen; Hariz, Marwan; Gabriëls, Loes; Galert, Thorsten; Merkel, Reinhard; Kubu, Cynthia; Vilela-Filho, Osvaldo; Matthews, Keith; Taira, Takaomi; Lozano, Andres M.; Schechtmann, Gastón; Doshi, Paresh; Broggi, Giovanni; Régis, Jean; Alkhani, Ahmed; Sun, Bomin; Eljamel, Sam; Schulder, Michael; Kaplitt, Michael; Eskandar, Emad; Rezai, Ali; Krauss, Joachim K.; Hilven, Paulien; Schuurman, Rick; Ruiz, Pedro; Chang, Jin Woo; Cosyns, Paul; Lipsman, Nir; Voges, Juergen; Cosgrove, Rees; Li, Yongjie; Schlaepfer, Thomas

2014-01-01

Background For patients with psychiatric illnesses remaining refractory to 'tandard' therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods

77 FR 5711 - Guidelines for Determining Probability of Causation Under the Energy Employees Occupational...

Science.gov (United States)

2012-02-06

... Guidelines for Determining Probability of Causation Under the Energy Employees Occupational Illness... provide a technical review of a proposed amendment to the probability of causation guidelines.\\2\\ All of..., and hence had required DOL to assign a probability of causation value of ``zero.'' There were two...

Use of virtual reality gaming systems for children who are critically ill.

Science.gov (United States)

Salem, Yasser; Elokda, Ahmed

2014-01-01

Children who are critically ill are frequently viewed as "too sick" to tolerate physical activity. As a result, these children often fail to develop strength or cardiovascular endurance as compared to typically developing children. Previous reports have shown that early participation in physical activity in is safe and feasible for patients who are critically ill and may result in a shorter length of stay and improved functional outcomes. The use of the virtual reality gaming systems has become a popular form of therapy for children with disabilities and has been supported by a growing body of evidence substantiating its effectiveness with this population. The use of the virtual reality gaming systems in pediatric rehabilitation provides the children with opportunity to participate in an exercise program that is fun, enjoyable, playful, and at the same time beneficial. The integration of those systems in rehabilitation of children who are critically ill is appealing and has the potential to offer the possibility of enhancing physical activities. The lack of training studies involving children who are critically ill makes it difficult to set guidelines on the recommended physical activities and virtual reality gaming systems that is needed to confer health benefits. Several considerations should be taken into account before recommended virtual reality gaming systems as a training program for children who are critically ill. This article highlighted guidelines, limitations and challenges that need to be considered when designing exercise program using virtual reality gaming systems for critically ill children. This information is helpful given the popular use of virtual reality gaming systems in rehabilitation, particularly in children who are critically ill.

Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study

Science.gov (United States)

Trotta, Antonella; Murray, Robin M.; David, Anthony S.; Kolliakou, Anna; O’Connor, Jennifer; Di Forti, Marta; Dazzan, Paola; Mondelli, Valeria; Morgan, Craig; Fisher, Helen L.

2016-01-01

While the role of childhood adversity in increasing the risk of psychosis has been extensively investigated, it is not clear what the impact of early adverse experiences is on the outcomes of psychotic disorders. Therefore, we investigated associations between childhood adversity and 1-year outcomes in 285 first-presentation psychosis patients. Exposure to childhood adversity prior to 17 years of age was assessed using the Childhood Experience of Care and Abuse Questionnaire. Data on illness course, symptom remission, length of psychiatric hospitalization, compliance with medication, employment, and relationship status were extracted from clinical records for the year following first contact with mental health services for psychosis. Seventy-one percent of patients reported exposure to at least 1 type of childhood adversity (physical abuse, sexual abuse, parental separation, parental death, disrupted family arrangements, or being taken into care). No robust associations were found between childhood adversity and illness course or remission. However, childhood physical abuse was associated with almost 3-fold increased odds of not being in a relationship at 1-year follow-up compared to patients who did not report such adverse experiences. There was also evidence of a significant association between parental separation in childhood and longer admissions to psychiatric wards during 1-year follow-up and 2-fold increased odds of noncompliance with medication compared to those not separated from their parents. Therefore, our findings suggest that there may be some specificity in the impact of childhood adversity on service use and social functioning among psychosis patients over the first year following presentation to mental health services. PMID:26373540

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program.

Science.gov (United States)

Losina, Elena; Yang, Heidi Y; Deshpande, Bhushan R; Katz, Jeffrey N; Collins, Jamie E

2017-01-01

Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work. We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0-74 min/week), medium (75-149 min/week) and meeting CDC guidelines (≥150 min/week). We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism. The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11), 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74) of physical activity and missed a mean of 14 hours of work (SD 38) due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3-4.5) fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7-7.2) fold higher rate of illness-related absenteeism. Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism.

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program.

Directory of Open Access Journals (Sweden)

Elena Losina

Full Text Available Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work.We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0-74 min/week, medium (75-149 min/week and meeting CDC guidelines (≥150 min/week. We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism.The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11, 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74 of physical activity and missed a mean of 14 hours of work (SD 38 due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3-4.5 fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7-7.2 fold higher rate of illness-related absenteeism.Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism.

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program

Science.gov (United States)

Yang, Heidi Y.; Katz, Jeffrey N.; Collins, Jamie E.

2017-01-01

Background Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work. Methods We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0–74 min/week), medium (75–149 min/week) and meeting CDC guidelines (≥150 min/week). We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism. Results The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11), 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74) of physical activity and missed a mean of 14 hours of work (SD 38) due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3–4.5) fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7–7.2) fold higher rate of illness-related absenteeism. Discussion Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism. PMID:28472084

The relationship between childhood trauma and adult psychosis in a UK Early Intervention Service: results of a retrospective case note study

Directory of Open Access Journals (Sweden)

Reeder FD

2017-02-01

Full Text Available Francesca D Reeder,1 Nusrat Husain,2 Abdul Rhouma,3 Peter M Haddad,2 Tariq Munshi,4 Farooq Naeem,4 Davit Khachatryan,4 Imran B Chaudhry2 1School of Medicine, 2Neurosciences and Psychiatry Unit, University of Manchester, Manchester, 3Early Intervention Service, Lancashire Care NHS Foundation Trust, Preston, UK; 4Queen’s University, Kingston, Ontario, Canada Aim: There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.Methods: This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.Results: The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample. Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%, parental mental illness (19%, bullying (18%, absence of a parent (13%, and ‘other’ trauma (24% – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.Conclusion: A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with

Health problems in childhood cancer survivors: Linkage studies and guideline development

NARCIS (Netherlands)

Font-Gonzalez, A.

2016-01-01

This thesis comprises two parts. The first part of this thesis aims to increase the evidence on the burden of disease in childhood cancer survivors and to define high-risk groups of survivors by using medical record linkage studies. A two-step record linkage methodology between Dutch national

Pregnancy and Cardiomyopathy After Anthracyclines in Childhood

Directory of Open Access Journals (Sweden)

Kara Annette Thompson

2018-03-01

Full Text Available With advances in cancer therapy, there has been a remarkable increase in survival in children diagnosed with malignancies. Many of these children are treated with anthracyclines which are well known to cause cardiotoxicity. As more childhood cancer survivors reach childbearing age, many will choose to become pregnant. At this time, the factors associated with development of cardiomyopathy after anthracycline treatment are not clearly identified. It is possible that cardiac stress could predispose to cardiac deterioration in a patient with reduced functional reserve from prior anthracycline exposure. Pregnancy is one form of cardiovascular stress. The cardiac outcomes of pregnancy in childhood cancer survivors must be considered. In view of limited data, guidelines for pregnancy planning, management, and monitoring after cardiotoxic cancer therapy have not been established. This review summarizes the limited data available on the topic of pregnancy after anthracyclines in childhood.

Challenges of childhood obesity in a developing economy: A review

African Journals Online (AJOL)

2015-02-24

Feb 24, 2015 ... critical period of opportunity when exposure of the fetus could predict ..... under – or over-estimate the risk of childhood obesity in ... are all diseases arising in obese adults, efforts should be ... School absenteeism: Owing to prolonged period of ill – .... obesity by increasing energy expenditure and resting.

Epidemiology of childhood heart failure in Port Harcourt, Nigeria ...

African Journals Online (AJOL)

Background: Heart failure (HF) is a clinical syndrome that complicates a variety of childhood illnesses. Recent studies in various parts of Nigeria show a prevalence rate of 5.8-15.5%. There is relatively scant data on heart failure in children in the south-south geo-political region of the country, necessitating this study. Aim: To ...

Guidelines for prevention in psychology.

Science.gov (United States)

2014-04-01

The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Population attributable fractions of psychopathology and suicidal behaviour associated with childhood adversities in Northern Ireland.

Science.gov (United States)

McLafferty, Margaret; O'Neill, Siobhan; Murphy, Sam; Armour, Cherie; Bunting, Brendan

2018-03-01

Childhood adversities are strong predictors of psychopathology and suicidality. However, specific adversities are associated with different outcomes, with cross-national variations reported. The current study examined rates of adversities reported in Northern Ireland (NI), and associations between adverse childhood experiences and psychopathology and suicidal behaviour were explored. Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health (WMH) survey initiative (2004-2008); response rate 68.4% (n = 1,986). The on-line survey used, the WHO Composite International Diagnostic Interview (CIDI) to examine psychopathology and associated risk factors in the NI population. Prevalence rates of retrospectively reported childhood adversities were calculated, with gender and age variations explored. Females were more likely to experience sexual abuse. Individuals who grew up during the worst years of the civil conflict in NI experienced elevated levels of childhood adversities. Participants who endured childhood adversities were more likely to have mental health problems but variations in risk factors were found for different disorders. Parental mental illness was associated with all disorders however, with ORs ranging from 2.20 for mood disorders to 4.07 for anxiety disorders. Population attributable fractions (PAF) estimated the reduction in psychopathology and suicidal behaviour in the population if exposure to adverse childhood events had not occurred. The highest PAF values were revealed for parental mental illness and sexual abuse. The findings indicate that a substantial proportion of psychopathology and suicide risk in NI are attributable to childhood adversities, providing support for early intervention and prevention initiatives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding childhood asthma in focus groups: perspectives from mothers of different ethnic backgrounds

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McKenzie Sheila

2001-09-01

Full Text Available Abstract Background Diagnosing childhood asthma is dependent upon parental symptom reporting but there are problems in the use of words and terms. The purpose of this study was to describe and compare understandings of childhood 'asthma' by mothers from three different ethnic backgrounds who have no personal experience of diagnosing asthma. A better understanding of parents' perceptions of an illness by clinicians should improve communication and management of the illness. Method Sixty-six mothers living in east London describing their ethnic backgrounds as Bangladeshi, white English and black Caribbean were recruited to 9 focus groups. Discussion was semi-structured. Three sessions were conducted with each ethnic group. Mothers were shown a video clip of a boy with audible wheeze and cough and then addressed 6 questions. Sessions were recorded and transcribed verbatim. Responses were compared within and between ethnic groups. Results Each session, and ethnic group overall, developed a particular orientation to the discussion. Some mothers described the problem using single signs, while others imitated the sound or made comparisons to other illnesses. Hereditary factors were recognised by some, although all groups were concerned with environmental triggers. Responses about what to do included 'normal illness' strategies, use of health services and calls for complementary treatment. All groups were concerned about using medication every day. Expectations about the quality of life were varied, with recognition that restrictions may be based on parental beliefs about asthma, rather than asthma itself. Conclusion Information from these focus groups suggests mothers know a great deal about childhood asthma even though they have no personal experience of it. Knowledge of how mothers from these ethnic backgrounds perceive asthma may facilitate doctor – patient communication with parents of children experiencing breathing difficulties.

Childhood Urinary Tract Infection in Abakaliki: Etiological Organisms ...

African Journals Online (AJOL)

hanumantp

its presentation is non-specific and similar to other common illnesses. This makes it easy to miss children with UTI.[1,2]. UTI occurs in 3 to 5% of girls and 1% of boys during childhood, with the first attack occurring in girls by 5 years, peaking during infancy and toilet training while it is commoner in boys during the first year of ...

Procalcitonin-guided antibiotic treatment in critically ill patients.

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Hohn, Andreas; Heising, Bernhard; Schütte, Jan-Karl; Schroeder, Olaf; Schröder, Stefan

2017-02-01

In critically ill patients, length of antibiotic treatment can be effectively guided by procalcitonin (PCT) protocols. International sepsis guidelines and guidelines on antibiotic stewardship strategies recommend PCT as helpful laboratory marker for a rational use of antibiotics. A number of studies and meta-analyses have confirmed the effectiveness of PCT-protocols for shortening antibiotic treatment without compromising clinical outcome in critically ill patients. But in clinical practice, there is still uncertainty how to interpret PCT levels and how to adjust antibiotic treatment in various infectious situations, especially in the perioperative period. This narrative review gives an overview on the application of PCT-protocols in critically ill patients with severe bacterial infections on the basis of 5 case reports and the available literature. Beside strengths and limitations of this biomarker, also varying kinetics and different maximum values with regard to the infectious focus and pathogens are discussed. PCT-guided antibiotic treatment appears to be safe and effective. Most of the studies revealed a shorter antibiotic treatment without negative clinical outcomes. Cost effectiveness is still a matter of debate and effects on bacterial resistance due to shorter treatments, possible lower rates of drug-related adverse events, or decreased rates of Clostridium difficile infections are not yet evaluated. Guidance of antibiotic treatment can effectively be supported by PCT-protocols. However, it is important to consider the limitations of this biomarker and to use PCT protocols along with antibiotic stewardship programmes and regular clinical rounds together with infectious diseases specialists.

Burden of childhood diseases and malnutrition in a semi-urban slum in southern India

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Sarkar Rajiv

2013-01-01

Full Text Available Abstract Background India has seen rapid unorganized urbanization in the past few decades. However, the burden of childhood diseases and malnutrition in such populations is difficult to quantify. The morbidity experience of children living in semi-urban slums of a southern Indian city is described. Methods A total of 176 children were recruited pre-weaning from four geographically adjacent, semi-urban slums located in the western outskirts of Vellore, Tamil Nadu for a study on water safety and enteric infections and received either bottled or municipal drinking water based on their area of residence. Children were visited weekly at home and had anthropometry measured monthly until their second birthday. Results A total of 3932 episodes of illness were recorded during the follow-up period, resulting in an incidence of 12.5 illnesses/child-year, with more illness during infancy than in the second year of life. Respiratory, mostly upper respiratory infections, and gastrointestinal illnesses were most common. Approximately one-third of children were stunted at two years of age, and two-thirds had at least one episode of growth failure during the two years of follow up. No differences in morbidity were seen between children who received bottled and municipal water. Conclusions Our study found a high burden of childhood diseases and malnutrition among urban slum dwellers in southern India. Frequent illnesses may adversely impact children’s health and development, besides placing an additional burden on families who need to seek healthcare and find resources to manage illness.

Childhood poverty and recruitment of adult emotion regulatory neurocircuitry.

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Liberzon, Israel; Ma, Sean T; Okada, Go; Ho, S Shaun; Swain, James E; Evans, Gary W

2015-11-01

One in five American children grows up in poverty. Childhood poverty has far-reaching adverse impacts on cognitive, social and emotional development. Altered development of neurocircuits, subserving emotion regulation, is one possible pathway for childhood poverty's ill effects. Children exposed to poverty were followed into young adulthood and then studied using functional brain imaging with an implicit emotion regulation task focused. Implicit emotion regulation involved attention shifting and appraisal components. Early poverty reduced left dorsolateral prefrontal cortex recruitment in the context of emotional regulation. Furthermore, this emotion regulation associated brain activation mediated the effects of poverty on adult task performance. Moreover, childhood poverty also predicted enhanced insula and reduced hippocampal activation, following exposure to acute stress. These results demonstrate that childhood poverty can alter adult emotion regulation neurocircuitry, revealing specific brain mechanisms that may underlie long-term effects of social inequalities on health. The role of poverty-related emotion regulatory neurocircuitry appears to be particularly salient during stressful conditions. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

What Can We Do to Prevent Childhood Obesity?

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Lumeng, Julie

2005-01-01

This article explores the growing problem of childhood obesity and suggests guidelines for professionals to recommend to parents. Research has shown that an overweight child at 3 years is nearly eight times as likely to become an overweight young adult as is a typically developing 3-year-old. More of America's children are becoming overweight, and…

Prenatal programming of childhood overweight and obesity.

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Huang, Jennifer S; Lee, Tiffany A; Lu, Michael C

2007-09-01

To review the scientific evidence for prenatal programming of childhood overweight and obesity, and discuss its implications for MCH research, practice, and policy. A systematic review of observational studies examining the relationship between prenatal exposures and childhood overweight and obesity was conducted using MOOSE guidelines. The review included literature posted on PubMed and MDConsult and published between January 1975 and December 2005. Prenatal exposures to maternal diabetes, malnutrition, and cigarette smoking were examined, and primary study outcome was childhood overweight or obesity as measured by body mass index (BMI) for children ages 5 to 21. Four of six included studies of prenatal exposure to maternal diabetes found higher prevalence of childhood overweight or obesity among offspring of diabetic mothers, with the highest quality study reporting an odds ratio of adolescent overweight of 1.4 (95% CI 1.0-1.9). The Dutch famine study found that exposure to maternal malnutrition in early, but not late, gestation was associated with increased odds of childhood obesity (OR 1.9, 95% CI 1.5-2.4). All eight included studies of prenatal exposure to maternal smoking showed significantly increased odds of childhood overweight and obesity, with most odds ratios clustering around 1.5 to 2.0. The biological mechanisms mediating these relationships are unknown but may be partially related to programming of insulin, leptin, and glucocorticoid resistance in utero. Our review supports prenatal programming of childhood overweight and obesity. MCH research, practice, and policy need to consider the prenatal period a window of opportunity for obesity prevention.

Best Practice Guidelines for Computer Technology in the Montessori Early Childhood Classroom.

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Montminy, Peter

1999-01-01

Presents a draft for a principle-centered position statement of a Montessori early childhood program in central Pennsylvania, on the pros and cons of computer use in a Montessori 3-6 classroom. Includes computer software rating form. (Author/KB)

Correlates of adverse childhood events among adults with schizophrenia spectrum disorders.

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Rosenberg, Stanley D; Lu, Weili; Mueser, Kim T; Jankowski, Mary Kay; Cournos, Francine

2007-02-01

Multiple studies have found that childhood adversity is related to a range of poor mental health, substance abuse, poor physical health, and poor social functioning outcomes in the general population of adults. However, despite the high rates of childhood adversity in schizophrenia, the clinical correlates of these events have not been systematically evaluated. This study evaluated the relationship between adverse experiences in childhood and functional, clinical, and health outcomes among adults with schizophrenia. The authors surveyed 569 adults with schizophrenia regarding adverse childhood events (including physical abuse, sexual abuse, parental mental illnesses, loss of a parent, parental separation or divorce, witnessing domestic violence, and foster or kinship care). The relationships between cumulative exposure to these events and psychiatric, physical, and functional outcomes were evaluated. Increased exposure to adverse childhood events was strongly related to psychiatric problems (suicidal thinking, hospitalizations, distress, and posttraumatic stress disorder), substance abuse, physical health problems (HIV infection), medical service utilization (physician visits), and poor social functioning (homelessness or criminal justice involvement). The findings extend the results of research in the general population by suggesting that childhood adversity contributes to worse mental health, substance abuse, worse physical health, and poor functional outcomes in schizophrenia.

The illness/non-illness model: hypnotherapy for physically ill patients.

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Navon, Shaul

2014-07-01

This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

Research Into Childhood Obstructive Sleep-Disordered Breathing : A Systematic Review

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Venekamp, Roderick P.; Chandrasekharan, Deepak; Abel, Francois; Blackshaw, Helen; Kreis, Irene A.; E R Evans, Hannah; Schilder, Anne G.M.

2017-01-01

Background Despite recent clinical guideline development, the best pathway of care for children with symptoms of obstructive sleep-disordered breathing (oSDB) is still debated. This systematic review aims to map the research in childhood oSDB that has been conducted so far to support further

Integrated community case management for childhood illnesses: explaining policy resistance in Kenya.

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Juma, Pamela A; Owuor, Karen; Bennett, Sara

2015-12-01

There has been a re-emphasis recently on community health workers to provide child health care services including integrated community case management for childhood illness (iCCM). This research analysed iCCM policy development in Kenya and in particular the types of decision-making criteria used by Kenyan policy-makers in considering whether to advance iCCM policy. Data were collected through document reviews (n = 41) and semi-structured interviews (n = 19) with key stakeholders in iCCM policy including government officials, development partners, bilateral donors, and civil society organizations. Initial analysis was guided by the policy triangle with further analysis of factors affecting policy decision-making drawing upon a simple framework developed by Grindle and Thomas (Policy makers, policy choices and policy outcomes: the political economy of reform in developing countries. 1989; Policy Sci 22: :213-48.). Policy development for iCCM has been slow in Kenya, compared with other Sub-Saharan African countries. At the time of the study, the Government had just completed the Community Health Training Manual which incorporated iCCM as a module, but this was the only formal expression of iCCM in Kenya. We found technical considerations, notably concerns about community health workers dispensing antibiotics to be a key factor slowing iCCM policy development, but this also overlapped with bureaucratic considerations, such as how the development of community health worker cadres may affect clinicians, as well as initial concerns about how an integrated approach might affect vertically oriented programs. International actors through agreements such as the Millennium Development Goals helped to get child survival onto the national policy agenda and such actors were active promoters of iCCM policy change. However international funders had not committed funding to scale-up iCCM policy, and this probably constrained their influence over iCCM policy debate. Kenyan actors

Exercise recommendations for childhood cancer survivors exposed to cardiotoxic therapies: an institutional clinical practice initiative.

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Okada, Maki; Meeske, Kathleen A; Menteer, Jondavid; Freyer, David R

2012-01-01

Childhood cancer survivors who have received treatment with anthracyclines are at risk for developing cardiomyopathy in dose-dependent fashion. Historically, restrictions on certain types of physical activity that were intended to preserve cardiac function have been recommended, based on a mixture of evidence-based and consensus-based recommendations. In the LIFE Cancer Survivorship & Transition Program at Children's Hospital Los Angeles, the authors reevaluated their recommendations for exercise in survivors who were exposed to anthracyclines, with or without irradiation in proximity to the myocardium. The primary goal was to develop consistent, specific, practical, safe, and (where possible) evidence-based recommendations for at-risk survivors in the program. To accomplish this, the authors referred to current exercise guidelines for childhood cancer survivors, consulted recent literature for relevant populations, and obtained input from the program's pediatric cardiology consultant. The resulting risk-based exercise recommendations are designed to complement current published guidelines, maximize safe exercise, and help childhood cancer survivors return to a normal life that emphasizes overall wellness and physical activity. This article describes a single institution's experience in modifying exercise recommendations for at-risk childhood survivors and includes the methods, findings, and current institutional practice recommendations along with sample education materials.

Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines.

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Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P

2010-09-01

Poor adherence to medication can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey (39 questions, 521 options) on adherence problems in schizophrenia and bipolar disorder was completed by 41 experts in 2008. This article first reviews the literature on interventions aimed at improving adherence. It then presents the experts' recommendations for targeting factors that can contribute to nonadherence and relates them to the literature. The following psychosocial/programmatic and pharmacologic interventions were rated first line for specific problems that can lead to nonadherence: ongoing symptom/ side-effect monitoring for persistent symptoms or side effects; services targeting logistic problems; medication monitoring/environmental supports (e.g., Cognitive Adaptation Training, assertive community treatment) for lack of routines or cognitive deficits; and adjusting the dose or switching to a different oral antipsychotic for persistent side effects (also high second-line for persistent symptoms). Among pharmacologic interventions, the experts gave high second-line ratings to switching to a long-acting antipsychotic when lack of insight, substance use, persistent symptoms, logistic problems, lack of routines, or lack of family/ social support interfere with adherence and to simplifying the treatment regimen when logistic problems, lack of routines, cognitive deficits, or lack of family/social support interfere with adherence. Psychosocial/programmatic interventions that received high second-line ratings in a number of situations included medication monitoring/environmental supports, patient psychoeducation, more frequent and/or longer visits if possible, cognitive behavioral therapy (CBT), family-focused therapy

Early psychological reactions in parents of children with a life threatening illness within a pediatric hospital setting.

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Muscara, F; McCarthy, M C; Woolf, C; Hearps, S J C; Burke, K; Anderson, V A

2015-07-01

Parents of children with life threatening illness or injuries are at elevated risk of distress reactions, involving symptoms of acute stress disorder, depression and anxiety. Currently, the impact of child illness factors is unclear, and to date research systematically examining the prevalence of these psychological reactions across different illness groups with an acute life threat is sparse. This is important to explore given that studies show that parent functioning impacts on the psychological adjustment and recovery of the ill child. WHAT DOES THIS STUDY ADD?: At four weeks following a child's diagnosis of a serious illness, 49-54% of parents met DSM-IV criteria for acute stress disorder, across a number of illness groups, whereas 15-27% of parents were in the moderate/severe range for depression and anxiety, and 25-31% for stress. Results from this study demonstrate that rates and severity of these psychological reactions in parents of seriously ill children do not vary according to illness type. A life threatening childhood illness/injury can lead to significant distress reactions in parents, with independent studies finding such reactions in several different illness groups. To date, there is limited research systematically comparing the prevalence of adverse parental psychological reactions across different childhood illness groups with an acute life threat. This study aimed to investigate the frequency and severity of symptoms of acute traumatic stress, depression, anxiety and general stress in parents, following admission of their child to hospital for a life threatening illness. The study also aimed to explore the relationship between these symptoms, and to determine whether they differ according to illness/injury. Cross-sectional data from a prospective, longitudinal study are reported. Participants were 194 parents of 145 children (49 couples), admitted to cardiology (n=53), oncology (n=40) and pediatric intensive care units (n=52), for serious

Dietary beliefs among informal caregivers regarding common childhood diseases in rural north-west India

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Rajiv Kumar Gupta

2017-09-01

Full Text Available Background: Dietary practices among infants and children are predictor of their growth and development. India being a huge of diverse cultures, diversity in beliefs and practices regarding diet during childhood illnesses is expected. Harmful beliefs and practices can contribute to malnutrition among children. These beliefs can have adverse consequences in already sick children. Aims and Objectives: To assess the dietary knowledge, beliefs and practices of rural care givers during childhood illnesses. Material & Methods: This cross-sectional descriptive study was conducted among 271 rural informal (parent / family member caregivers in one of the sub-health centres which was selected using simple random sampling technique. In the context of this study, the word informal care-giver was used for parent/family member of the child, preferably a mother with a child / children aged less than five years. The survey tool was an open ended and pretested questionnaire which was developed by public health expert’s familiar with the culture of the study setting and was pilot tested before administration. For the purpose of recruiting the study participants a house to house survey was conducted and the data thus collected was analyzed in percentages. Results: Informal Caregivers had low knowledge of common childhood illnesses as well as the reasons of their causation. Majority of them consulted a doctor in the event of child’s illness. 53.81% reduced feeding and 31.93% diluted diet during child’ illness but significantly 77.85% didn’t change breastfeeding practice during illness. As far as the beliefs regarding dietary practices were concerned, it found that egg, meat, chicken and jaggery were labelled hot foods while curd, butter milk and vegetables were labelled as cold foods. Rice water and khichadi were preferred in diarrhoea but spicy food and milk were restricted. Ginger and Tulsi tea were preferred in respiratory infections while ice-cream and

Dietary beliefs among informal caregivers regarding common childhood diseases in rural north-west India

Directory of Open Access Journals (Sweden)

Rajiv Kumar Gupta

2017-09-01

Full Text Available Background: Dietary practices among infants and children are predictor of their growth and development. India being a huge of diverse cultures, diversity in beliefs and practices regarding diet during childhood illnesses is expected. Harmful beliefs and practices can contribute to malnutrition among children. These beliefs can have adverse consequences in already sick children. Aims and Objectives: To assess the dietary knowledge, beliefs and practices of rural care givers during childhood illnesses. Material & Methods: This cross-sectional descriptive study was conducted among 271 rural informal (parent / family member caregivers in one of the sub-health centres which was selected using simple random sampling technique. In the context of this study, the word informal care-giver was used for parent/family member of the child, preferably a mother with a child / children aged less than five years. The survey tool was an open ended and pretested questionnaire which was developed by public health expert’s familiar with the culture of the study setting and was pilot tested before administration. For the purpose of recruiting the study participants a house to house survey was conducted and the data thus collected was analyzed in percentages. Results: Informal Caregivers had low knowledge of common childhood illnesses as well as the reasons of their causation. Majority of them consulted a doctor in the event of child’s illness. 53.81% reduced feeding and 31.93% diluted diet during child’ illness but significantly 77.85% didn’t change breastfeeding practice during illness. As far as the beliefs regarding dietary practices were concerned, it found that egg, meat, chicken and jaggery were labelled hot foods while curd, butter milk and vegetables were labelled as cold foods. Rice water and khichadi were preferred in diarrhoea but spicy food and milk were restricted. Ginger and Tulsi tea were preferred in respiratory infections while ice

Severe childhood malnutrition.

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Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

2017-09-21

The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

I'll show them: the social construction of (in)competence in survivors of childhood brain tumors.

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Boydell, Katherine M; Stasiulis, Elaine; Greenberg, Mark; Greenberg, Corin; Spiegler, Brenda

2008-01-01

Multimodal therapy for the treatment of childhood cancer has resulted in increased survival rates, yet as growing cohorts of children mature, late effects are becoming apparent. Specifically, brain tumor survivors tend to have poor social skills, peer relationship problems, academic difficulties, and delayed college entry. This article addresses findings specific to the unique experience of childhood cancer survivors as they transition from adolescence to adulthood. Qualitative methods involving focus groups and in-depth interviews with 14 childhood cancer survivors and 22 family members were used. The dialectic of incompetence/competence pervaded all narratives. Contradictory concepts of integration/ isolation, realistic/unrealistic goals, and the need for special help/no help were underscored by respondents. The struggle to deal with these contradictory factors led to the simultaneous resistance and acceptance of feelings of competence.

Childhood adversities and clinical symptomatology in first-episode psychosis.

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Lindgren, Maija; Mäntylä, Teemu; Rikandi, Eva; Torniainen-Holm, Minna; Morales-Muñoz, Isabel; Kieseppä, Tuula; Mantere, Outi; Suvisaari, Jaana

2017-12-01

In addition to severe traumatic experiences, milder, more common childhood adversities reflecting psychosocial burden may also be common in people with psychotic disorders and have an effect on symptomatology and functioning. We explored eleven negative childhood experiences and their influence on clinical symptoms among young adults with first-episode psychosis (FEP, n = 75) and matched population controls (n = 51). Individuals with FEP reported more adversities than controls. Specifically serious conflicts within the family, bullying at school, maternal mental health problems, and one's own and parents' serious illness during childhood were experienced by the patients more often than by controls. In the FEP group, the severity of adversity was associated with increased anxiety, manic, and obsessive-compulsive symptoms, but not with the severity of positive psychotic symptoms. Adversity produced a more pronounced effect on symptoms in male patients than in female patients. To conclude, in line with earlier studies of more chronic psychosis, a majority of the participants with FEP reported exposure to childhood adversities, with the FEP group reporting more adversities than controls. High levels of mood and anxiety symptoms in patients with FEP may be related to cumulative exposure to childhood adversities. This should be taken into account in the treatment for FEP. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of in-hospital management for febrile illness in Northern Tanzania before and after 2010 World Health Organization Guidelines for the treatment of malaria.

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Andrew M Moon

Full Text Available In 2010, the World Health Organization (WHO published updated guidelines emphasizing and expanding recommendations for a parasitological confirmation of malaria before treating with antimalarials. This study aimed to assess differences in historic (2007-2008 (cohort 1 and recent (2011-2012 (cohort 2 hospital cohorts in the diagnosis and treatment of febrile illness in a low malaria prevalence area of northern Tanzania.We analyzed data from two prospective cohort studies that enrolled febrile adolescents and adults aged ≥13 years. All patients received quality-controlled aerobic blood cultures and malaria smears. We compared patients' discharge diagnoses, treatments, and outcomes to assess changes in the treatment of malaria and bacterial infections.In total, 595 febrile inpatients were enrolled from two referral hospitals in Moshi, Tanzania. Laboratory-confirmed malaria was detected in 13 (3.2% of 402 patients in cohort 1 and 1 (0.5% of 193 patients in cohort 2 (p = 0.041. Antimalarials were prescribed to 201 (51.7% of 389 smear-negative patients in cohort 1 and 97 (50.5% of 192 smear-negative patients in cohort 2 (p = 0.794. Bacteremia was diagnosed from standard blood culture in 58 (14.5% of 401 patients in cohort 1 compared to 18 (9.5% of 190 patients in cohort 2 (p = 0.091. In cohort 1, 40 (69.0% of 58 patients with a positive blood culture received antibacterials compared to 16 (88.9% of 18 patients in cohort 2 (p = 0.094. In cohort 1, 43 (10.8% of the 399 patients with known outcomes died during hospitalization compared with 12 (6.2% deaths among 193 patients in cohort 2 (p = 0.073.In a setting of low malaria transmission, a high proportion of smear-negative patients were diagnosed with malaria and treated with antimalarials despite updated WHO guidelines on malaria treatment. Improved laboratory diagnostics for non-malaria febrile illness might help to curb this practice.

Treating the Sleep Disorders of Childhood: Current Practice in the United Kingdom

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Bartlet, L. B.

2006-01-01

Sleep disorders are common in childhood. Their prevalence is especially high in the presence of disability or chronic illness. They cause considerable stress to the children themselves and to their parents. Sleep deprivation leads to daytime behavioral problems and educational difficulties. In assessing sleep problems thorough history taking is…

Physical Activity Design Guidelines for School Architecture.

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Brittin, Jeri; Sorensen, Dina; Trowbridge, Matthew; Lee, Karen K; Breithecker, Dieter; Frerichs, Leah; Huang, Terry

2015-01-01

Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

Childhood adversity and midlife suicidal ideation.

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Stansfeld, S A; Clark, C; Smuk, M; Power, C; Davidson, T; Rodgers, B

2017-01-01

Childhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties. At 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood. Illness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67-6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29-5.75), sexual abuse (OR 4.99, 95% CI 2.90-11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI -7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97-27.88) and sexual abuse (OR 6.59, 95% CI 2.40-38.36) with suicidal ideation at 45 years. Adversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive

How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness

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Schwellnus, Martin; Alonso, Juan-Manuel; Bahr, Roald; Clarsen, Ben; Dijkstra, H Paul; Gabbett, Tim J; Gleeson, Michael; Hutchinson, Mark R; Janse Van Rensburg, Christa; Meeusen, Romain; Orchard, John W; Pluim, Babette M; Raftery, Martin; Budgett, Richard; Engebretsen, Lars

2016-01-01

The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of load—including rapid changes in training and competition load, competition calendar congestion, psychological load and travel—and health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified. PMID:27535991

Position Statement: Palliative Care for Children.

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Death Studies, 1993

1993-01-01

Notes that International Work Group on Death, Dying, and Bereavement recognizes wide variation of attitudes, beliefs, and behaviors pertaining to childhood death, dying, and bereavement. Statement identifies set of assumptions which can serve as guidelines, across cultures, in care of children with terminal illness and their families. (Author/NB)

Is refeeding syndrome relevant for critically ill patients?

Science.gov (United States)

Koekkoek, Wilhelmina A C; Van Zanten, Arthur R H

2018-03-01

To summarize recent relevant studies regarding refeeding syndrome (RFS) in critically ill patients and provide recommendations for clinical practice. Recent knowledge regarding epidemiology of refeeding syndrome among critically ill patients, how to identify ICU patients at risk, and strategies to reduce the potential negative impact on outcome are discussed. RFS is a potentially fatal acute metabolic derangement that ultimately can result in marked morbidity and even mortality. These metabolic derangements in ICU patients differ from otherwise healthy patients with RFS, as there is lack of anabolism. This is because of external stressors inducing a hypercatabolic response among other reasons also reflected by persistent high glucagon despite initiation of feeding. Lack of a proper uniform definition complicates diagnosis and research of RFS. However, refeeding hypophosphatemia is commonly encountered during critical illness. The correlations between risk factors proposed by international guidelines and the occurrence of RFS in ICU patients remains unclear. Therefore, regular phosphate monitoring is recommended. Based on recent trials among critically ill patients, only treatment with supplementation of electrolytes and vitamins seems not sufficient. In addition, caloric restriction for several days and gradual increase of caloric intake over days is recommendable.

Needs, expectations and consequences for the child growing up in a family with a parent with mental illness

OpenAIRE

Tabak, Izabella; Zabłocka-Żytka, Lidia; Ryan, Peter; Zanone Poma, Stefano; Joronen, Katja; Viganò, Giovanni; Simpson, Wendy; Paavilainen, Eija; Scherbaum, Norbert; Smith, Martin; Dawson, Ian

2016-01-01

Parental mental illness is considered one of the strongest risk-factors for development of offspring psychopathology. The lack of pan-European guidelines for empowering children of parents with mental illness led to EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The first task in this project, was to analyse needs, expectations and consequences for children, with respect to living wi...

Use of Intravenous Fat Emulsions in Adult Critically Ill Patients: Does ...

African Journals Online (AJOL)

2017-08-09

Aug 9, 2017 ... estimated to range from 20% to 60%, with approximately ... This literature review focuses on the administration of different lipid emulsions, ... including the ideal method of assessing energy and protein ... published guidelines for lipid intake in critically ill patients ..... In adults, fat accumulation more often ...

The management of anaphylaxis in childhood

DEFF Research Database (Denmark)

Muraro, A; Roberts, G; Clark, A

2007-01-01

to provide practical guidelines for managing anaphylaxis in childhood based on the limited evidence available. Intramuscular adrenaline is the acknowledged first-line therapy for anaphylaxis, in hospital and in the community, and should be given as soon as the condition is recognized. Additional therapies......, involving school staff, healthcare professionals and patients' organizations. Absolute indications for prescribing self-injectable adrenaline are prior cardiorespiratory reactions, exercise-induced anaphylaxis, idiopathic anaphylaxis and persistent asthma with food allergy. Relative indications include...

Assessment of adherence problems in patients with serious and persistent mental illness: recommendations from the Expert Consensus Guidelines.

Science.gov (United States)

Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P

2010-01-01

Poor adherence to medication treatment can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article concerning assessment of adherence are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey contained 39 questions (521 options) that asked about defining nonadherence, extent of adherence problems in schizophrenia and bipolar disorder, risk factors for nonadherence, assessment methods, and interventions for specific types of adherence problems. The survey was completed by 41 (85%) of the 48 experts to whom it was sent. When evaluating adherence, the experts considered it important to assess both behavior and attitude, although they considered actual behavior most important. They also noted the importance of distinguishing patients who are not willing to take medication from those who are willing but not able to take their medication as prescribed due to forgetfulness, misunderstanding of instructions, or financial or environmental problems, since this will affect the type of intervention needed. Although self- and physician report are most commonly used to clinically assess adherence, they are often inaccurate and may underestimate nonadherence. The experts believe that more accurate information will be obtained by asking about any problems patients are having or anticipate having taking medication rather than if they have been taking their medication; They also recommended speaking with family or caregivers, if the patient gives permission, as well as using more objective measures (e.g., pill counts, pharmacy records, smart pill containers if available, and, when appropriate, medication plasma levels). Use of a validated self-report scale may also help improve accuracy. For patients who appear adherent to medication, the experts recommended monthly assessments for

Lower respiratory tract illness in young children: predictors of disease and health care utilization

NARCIS (Netherlands)

Jong, B.M. de

2008-01-01

Lower respiratory tract illness (LRTI) is an important health problem in early childhood. More than half of all infants develop LRTI in the first years of life. LRTI is an important risk factor for asthma. At the age of six, 10-15% still has symptoms of LRTI. Most of the children grow over the

Revisiting current “barefoot doctors” in border areas of China: system of services, financial issue and clinical practice prior to introducing integrated management of childhood illness (IMCI

Directory of Open Access Journals (Sweden)

Li Xiuyun

2012-08-01

Full Text Available Abstract Background Under-5-years child mortality remains high in rural China. Integrated management of childhood illness (IMCI was introduced to China in 1998, but only a few rural areas have been included. This study aimed at assessing the current situation of the health system of rural health care and evaluating the clinical competency of village doctors in management of childhood illnesses prior to implementing IMCI programme in remote border rural areas. Methods The study was carried out in the border areas of Puer prefecture of Yunnan province. There were 182 village doctors in the list of the health bureau in these border areas. Of these, 154 (84.6% were recruited into the study. The local health system components were investigated using a qualitative approach and analyzed with triangulation of information from different sources. The clinical component was assessed objectively and quantitatively presented using descriptive statistics. Results The study found that the New Rural Cooperative Medical Scheme (NRCMS coordinated the health insurance system and the provider service through 3 tiers: village doctor, township and county hospitals. The 30 RMB per person per year premium did not cover the referral cost, and thereby decreased the number of referrals. In contrast to available treatment facilities and drug supply, the level of basic medical education of village doctors and township doctors was low. Discontent among village doctors was common, especially concerning low rates of return from the service, exceptions being procedures such as injections, which in fact may create moral hazards to the patients. Direct observation on the assessment and management of paediatric patients by village doctors revealed inadequate history taking and physical examination, inability to detect potentially serious complications, overprescription of injection and antibiotics, and underprescription of oral rehydration salts and poor quality of counseling

Age of onset of bipolar disorder: Combined effect of childhood adversity and familial loading of psychiatric disorders.

Science.gov (United States)

Post, Robert M; Altshuler, Lori L; Kupka, Ralph; McElroy, Susan L; Frye, Mark A; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Keck, Paul E; Leverich, Gabriele S; Nolen, Willem A

2016-10-01

Family history and adversity in childhood are two replicated risk factors for early onset bipolar disorder. However, their combined impact has not been adequately studied. Based on questionnaire data from 968 outpatients with bipolar disorder who gave informed consent, the relationship and interaction of: 1) parental and grandparental total burden of psychiatric illness; and 2) the degree of adversity the patient experienced in childhood on their age of onset of bipolar disorder was examined with multiple regression and illustrated with a heat map. The familial loading and child adversity vulnerability factors were significantly related to age of onset of bipolar and their combined effect was even larger. A heat map showed that at the extremes (none of each factor vs high amounts of both) the average age of onset differed by almost 20 years (mean = 25.8 vs 5.9 years of age). The data were not based on interviews of family members and came from unverified answers on a patient questionnaire. Family loading for psychiatric illness and adversity in childhood combine to have a very large influence on age of onset of bipolar disorder. These variables should be considered in assessment of risk for illness onset in different populations, the need for early intervention, and in the design of studies of primary and secondary prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adult children of parents with mental illness: Dehumanization of a parent - 'She wasn't the wreck in those years that she was to become later'.

Science.gov (United States)

Murphy, Gillian; Peters, Kath; Wilkes, Lesley; Jackson, Debra

2018-06-01

Children who have lived with parental mental illness experience long-standing reduced health and social outcomes, alongside ongoing personal distress. While there has been some dialogue regarding interventions to support children who are living with parental mental illness, there remains a paucity of knowledge regarding adult children's experiences and potential needs. Given this, the aim of the present study was to establish parenting narratives of adult children who had experienced childhood parental mental illness. This included their experiences of being parented alongside their own subsequent parenting roles. Three men and 10 women, ranging from 30 to 78 years old, met individually with a researcher to tell their stories. Narratives were thematically analysed to establish themes. The findings of the study demonstrated that individuals who have lived with childhood parental mental illness dehumanized their parent with mental illness. The authors argue that all mental health services should be underpinned with a whole of family assessment and care philosophy. There is also a need for all mental health services to consider how policies and procedures might inadvertently dehumanize clients who are parents, which could contribute to familial dehumanization. This could prevent the dehumanization of parents who experience mental illness to preserve parental and child relationships. © 2017 Australian College of Mental Health Nurses Inc.

Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers.

Science.gov (United States)

Rothman, Emily F; Edwards, Erika M; Heeren, Timothy; Hingson, Ralph W

2008-08-01

Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States. In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank. Sixty-six percent of respondents reported >or=1 adverse childhood experiences, and 19% reported experiencing >or=4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at or=21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol. Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be social).

Current guidelines for management of children with functional constipation

Directory of Open Access Journals (Sweden)

V. P. Bulatov

2015-01-01

Full Text Available Despite the fact that functional constipations are a common and hence relevant problem of pediatrics, there are difficulties in managing this category of patients. The paper presents the current guidelines for the diagnosis and treatment of functional constipation in children, which rely on the principles of evidence-based medicine. Particular attention is given to the age-related aspects of constipation in childhood.

Living with uncertainty and hope: A qualitative study exploring parents' experiences of living with childhood multiple sclerosis.

Science.gov (United States)

Hinton, Denise; Kirk, Susan

2017-06-01

Background There is growing recognition that multiple sclerosis is a possible, albeit uncommon, diagnosis in childhood. However, very little is known about the experiences of families living with childhood multiple sclerosis and this is the first study to explore this in depth. Objective Our objective was to explore the experiences of parents of children with multiple sclerosis. Methods Qualitative in-depth interviews with 31 parents using a grounded theory approach were conducted. Parents were sampled and recruited via health service and voluntary sector organisations in the United Kingdom. Results Parents' accounts of life with childhood multiple sclerosis were dominated by feelings of uncertainty associated with four sources; diagnostic uncertainty, daily uncertainty, interaction uncertainty and future uncertainty. Parents attempted to manage these uncertainties using specific strategies, which could in turn create further uncertainties about their child's illness. However, over time, ongoing uncertainty appeared to give parents hope for their child's future with multiple sclerosis. Conclusion Illness-related uncertainties appear to play a role in generating hope among parents of a child with multiple sclerosis. However, this may lead parents to avoid sources of information and support that threatens their fragile optimism. Professionals need to be sensitive to the role hope plays in supporting parental coping with childhood multiple sclerosis.

Improving the physical health of people with severe mental illness: boundaries of care provision.

Science.gov (United States)

Ehrlich, Carolyn; Kendall, Elizabeth; Frey, Nicolette; Kisely, Steve; Crowe, Elizabeth; Crompton, David

2014-06-01

There is compelling evidence that the physical health of people with severe mental illness is poor. Health-promotion guidelines have been recommended as a mechanism for improving the physical health of this population. However, there are significant barriers to the adoption of evidence-based guidelines in practice. The purpose of this research was to apply existing implementation theories to examine the capability of the health system to integrate physical health promotion into mental health service delivery. Data were collected within a regional city in Queensland, Australia. Fifty participants were interviewed. The core theme that emerged from the data was that of 'care boundaries' that influenced the likelihood of guidelines being implemented. Boundaries existed around the illness, care provision processes, sectors, the health-care system, and society. These multilevel boundaries, combined with participants' ways of responding to them, impacted on capability (i.e. the ability to integrate physical health promotion into existing practices). Participants who were able to identify strategies to mediate these boundaries were better positioned to engage with physical health-promotion practice. Thus, the implementation of evidence-based guidelines depended heavily on the capability of the workforce to develop and adopt boundary-mediating strategies. © 2013 Australian College of Mental Health Nurses Inc.

Guideline for stress ulcer prophylaxis in the intensive care unit

DEFF Research Database (Denmark)

Madsen, Kristian Rørbaek; Lorentzen, Kristian; Clausen, Niels

2014-01-01

Stress ulcer prophylaxis (SUP) is commonly used in the intensive care unit (ICU), and is recommended in the Surviving Sepsis Campaign guidelines 2012. The present guideline from the Danish Society of Intensive Care Medicine and the Danish Society of Anesthesiology and Intensive Care Medicine sums...... critically ill patients in the ICU outside the context of randomized controlled trials (GRADE 1C). No robust evidence supports recommendations for subpopulations in the ICU such as septic, burn, trauma, cardiothoracic or enterally fed patients. However, if SUP is considered clinically indicated in individual...

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

Science.gov (United States)

Lewinsohn, Peter M.; Holm-Denoma, Jill M.; Small, Jason W.; Seeley, John R.; Joiner, Thomas E.

2008-01-01

A study to examine the association between childhood separation anxiety disorder (SAD) and the risk of the development of psychopathology during young adulthood was conducted. Results showed that SAD contributed to the risk for the development of internalizing disorders, which are panic and depression, but decreased the risk for externalizing…

A qualitative systematic review of the reasons for parental attendance at the emergency department with children presenting with minor illness.

Science.gov (United States)

Butun, Ahmet; Hemingway, Pippa

2018-01-01

Over 5 million children attend the Emergency Department (ED) annually in England with an ever-increasing paediatric emergency caseload echoed globally. Approximately 60% of children present with illness and the majority have non-urgent illness creating burgeoning pressures on children's ED and this crisis resonates globally. To date no qualitative systematic review exists that focuses on the parental reasons for childhood attendance at the ED in this sub-group. To identify parental reasons for attending ED for their children presenting with minor illness. A qualitative systematic review was conducted against inclusion/exclusion criteria. Five electronic databases and key journals were searched in June 2015. 471 studies were identified and following study selection, 4 qualitative studies were included. Nine themes were identified e.g. dissatisfaction with family medical services, perceived advantages of ED and 'child suffering' with novel and insightful sub-themes of 'hereditary anxiety', 'taking it off our hands', ED as a 'magical place'. This novel qualitative systematic review examined parental attendance presenting with childhood minor illness of interest to emergency care reformers and clinicians. ED attendance is complex and multifactorial but parents provide vital insight to ED reformers on parental reasons for ED attendance in this sub-group. Copyright © 2017 Elsevier Ltd. All rights reserved.

Secular trends in new childhood epidemics: insights from evolutionary medicine.

Science.gov (United States)

Brüne, Martin; Hochberg, Ze'ev

2013-10-21

In the last few decades, pediatric medicine has observed a dramatic increase in the prevalence of hitherto rare illnesses, among which obesity, diabetes, allergies and other autoimmune diseases stand out. In addition, secular trends towards earlier onset of puberty and sexual activity contribute to the psychological problems of youth and adolescents. All this has occurred in spite of the improved health care provision for children, yet traditional concepts of medicine have failed to explain these new "epidemics". A recent conference and science school of the European Society of Paediatric Endocrinology (ESPE) in Acre, Israel, has taken up this challenge. Experts across disciplines including medicine, anthropology and developmental psychology discussed potential causes of childhood ill-health from an evolutionary point-of-view. Seen from an evolutionary vantage point, the "epidemics" of childhood obesity, diabetes and psychological dysfunction appear, in part, to be related to a mismatch between ancestral adaptations and novel environmental contingencies. These include changing exposures to pathogens, which impact on the function of the immune system, as well as changing patterns of parenting, which influence the timing of puberty and the risk for developing psychopathology.

Do healthy school meals affect illness, allergies and school attendance in 8- to 11-year-old children?

DEFF Research Database (Denmark)

Laursen, Rikke Pilmann; Lauritzen, Lotte; Ritz, Christian

2015-01-01

Background/Objectives:A nutritionally adequate diet in childhood is important for health and resistance of allergies and infections. This study explored the effects of school meals rich in fish, vegetables and fibre on school attendance, asthma, allergies and illness in 797 Danish 8- to 11-year-o...

Adverse childhood experiences of low-income urban youth.

Science.gov (United States)

Wade, Roy; Shea, Judy A; Rubin, David; Wood, Joanne

2014-07-01

Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination. Gathering youth perspectives on childhood adversity broadens our understanding of the experience of stress and trauma in childhood. Future work is needed to determine the significance of this broader set of adverse experiences in predisposing children to poor health outcomes as adults. Copyright © 2014 by the American Academy of Pediatrics.

Admission, discharge and triage guidelines for paediatric intensive care units in Spain.

Science.gov (United States)

de la Oliva, Pedro; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Rey-Galán, Corsino; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; de Carlos-Vicente, Juan Carlos; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodríguez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis

2018-05-01

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Physical Activity Design Guidelines for School Architecture.

Directory of Open Access Journals (Sweden)

Jeri Brittin

Full Text Available Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

Exposure to Childhood Poverty and Mental Health Symptomatology in Adolescence: A Role of Coping Strategies.

Science.gov (United States)

Kim, Pilyoung; Neuendorf, Cynthia; Bianco, Hannah; Evans, Gary W

2016-12-01

Childhood poverty is associated with stress dysregulation which contributes to psychological illness in later ages. The adverse effects of childhood poverty on stress regulation may be mediated in part by the use of disengaging strategies to cope with stress. However, the relations among childhood poverty, coping strategies and psychopathology throughout childhood to adolescence have not been explored. This prospective, longitudinal study included 185 low- and middle-income adolescents at age 17. Chronic exposure to poverty from birth to early adolescence (age 13) was prospectively associated with increases in the use of disengagement versus engagement coping four years later. Increased use of disengagement coping between the ages of 13 and 17 explained the indirect link between poverty exposure since birth and both externalizing and internalizing symptoms at age 17. The findings provide evidence for a coping pathway underlying the link between prolonged exposure to childhood poverty and mental health sequelae. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Parents' perceptions, attitudes and acceptability of treatment of childhood malaria with artemisinin combination therapies in ghana

DEFF Research Database (Denmark)

Adjei, G O; Darkwah, A K; Goka, B Q

2009-01-01

as having potential negative impact on care-seeking practices and adherence. CONCLUSIONS: Health education messages aimed at improving the response to childhood febrile illness should include other strategic stakeholders, such as decision-makers at the household level. The effectiveness and implementation...

Parenteral nutrition in the critically ill.

Science.gov (United States)

Gunst, Jan; Van den Berghe, Greet

2017-04-01

Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.

The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention.

Science.gov (United States)

Jortberg, Bonnie T; Rosen, Raquel; Roth, Sarah; Casias, Luke; Dickinson, L Miriam; Coombs, Letoynia; Awadallah, Nida S; Bernardy, Meaghann K; Dickinson, W Perry

2016-01-01

Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic interventions. The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care-based childhood obesity intervention. A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a childhood obesity program in primary care; secondary outcomes were changes in BMI percentile, BMI z-scores, blood pressure, and changes in lifestyle factors related to childhood obesity. Implementation of FFC is feasible, statically significant changes were seen for decreases in BMI percentile and BMI z-scores for participants who completed 9 to 15 months of follow-up; lifestyle factors related to childhood obesity in proved Spanish-speaking families and food insecurity were associated with less follow-up time (P childhood obesity intervention may result in significant clinical and lifestyle changes. © Copyright 2016 by the American Board of Family Medicine.

Gender, mental illness and the Hindu Marriage Act, 1955.

Science.gov (United States)

Pathare, Soumitra; Nardodkar, Renuka; Shields, Laura; Bunders, Joske F G; Sagade, Jaya

2015-01-01

Section 5(ii) of The Hindu Marriage Act, 1955 (HMA) states that under certain circumstances, mental illness is accepted as a ground for the annulment of marriage, while Section 13(1) (iii) states that mental illness is a ground for divorce. There is little data on how this provision is used and applied in matrimonial petitions. This paper assesses judicial practices in divorce cases, exploring the extent to which gender and the diagnosis of mental illness affect the decision to grant annulment or divorce. The paper analyses judgments related to annulment and divorce at the Family Court in Pune and at the High Courts in India. In the Family Court at Pune, 85% of the cases were filed by husbands, who alleged that their spouse was mentally ill. Medical evidence of mental illness was presented in only 36% of the cases and in many cases, divorce/nullity was granted even in the absence of medical evidence. In 14% of the cases, nullity/divorce was granted even when both spouses were not present. Of the Family Court cases reaching the High Court, 95% were filed by male petitioners. The High Courts reversed the lower courts' judgments in 50% of the cases. Our analysis highlights the need for standardised guidelines for lower courts on what constitutes adequate medical proof of mental illness when hearing a petition related to nullity or divorce under HMA. It also provides a critical review of Section 5(ii) of HMA.

Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan - 2013 update.

Science.gov (United States)

Kitamura, Ken; Iino, Yukiko; Kamide, Yosuke; Kudo, Fumiyo; Nakayama, Takeo; Suzuki, Kenji; Taiji, Hidenobu; Takahashi, Haruo; Yamanaka, Noboru; Uno, Yoshifumi

2015-04-01

To (1) indicate methods of diagnosis and testing for childhood (otitis media (AOM) and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of AOM in Children (Subcommittee of Clinical Practice Guideline), in light of the causative bacteria and their drug sensitivity of AOM in Japan. We investigated the most recently detected bacteria causing childhood AOM in Japan as well as antibacterial sensitivity and the worldwide distinct progress of vaccination, produced Clinical Questions concerning the diagnosis, testing methods, and treatment of AOM, searched literature published during 2000-2004, and issued the 2006 Guidelines. In the 2009 and 2013 Guidelines, we performed the same investigation with the addition of literature, which were not included in the 2006 Guidelines and published during 2005-2008 and during 2009-2012, respectively. We categorized AOM as mild, moderate, or severe on the basis of tympanic membrane findings and clinical symptoms, and presented recommended treatment for each degree of severity. Accurate assessment of tympanic membrane findings is important for judging the degree of severity and selecting a method of treatment. Some of new antimicrobial agents and pneumococcal vaccination are recommended as new treatment options. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

FEEDING GUIDELINES FOR INFANTS AND TODDLERS (START HEALTHY PROGRAM

Directory of Open Access Journals (Sweden)

Nancy Butte

2007-01-01

Full Text Available The dietary guidelines for americans contains recommendations on diets and healthy lifestyles but it does not deal with specificities of the diet and feeding breast and small infants (to 2 years. However, parents and carecgivers need practical recommendations on feeding infants and toddlers that are necessary to ensure a normal growth and to create the basis for forming healthy food habits, which apart from other benefits might help prevent the development of obesity and other diseases in both childhood and adulthood. The feeding guidelines for infants and toddlers is aimed at providing parents and carecgivers with practical information on feeding breast and small infants. It is intendced for adding and broadening recommendations worked out by other expert groups and organizations. The article provides a substantiation of the guidelines. The methodology, results and a complete reference list used to work out the recommendations are presented in another document.Key words: infants, nutrition.

Systematic review of pediatric health outcomes associated with childhood adversity.

Science.gov (United States)

Oh, Debora Lee; Jerman, Petra; Silvério Marques, Sara; Koita, Kadiatou; Purewal Boparai, Sukhdip Kaur; Burke Harris, Nadine; Bucci, Monica

2018-02-23

Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected. Mental and behavioral health outcomes were excluded, as were physical health outcomes that were a direct result of adversity (i.e. abusive head trauma). Data were extracted and risk of bias was assessed by 2 independent reviewers. After identifying 15940 records, 35 studies were included in this review. Selected studies indicated that exposure to childhood adversity was associated with delays in cognitive development, asthma, infection, somatic complaints, and sleep disruption. Studies on household dysfunction reported an effect on weight during early childhood, and studies on maltreatment reported an effect on weight during adolescence. Maternal mental health issues were associated with elevated cortisol levels, and maltreatment was associated with blunted cortisol levels in childhood. Furthermore, exposure to childhood adversity was associated with alterations of immune and inflammatory response and stress-related accelerated telomere erosion. Childhood adversity affects brain development and multiple body systems, and the physiologic manifestations can be detectable in childhood. A history of childhood adversity should be considered in the differential diagnosis of developmental delay, asthma, recurrent infections requiring hospitalization, somatic complaints, and sleep disruption. The variability in children's response to adversity suggests complex underlying mechanisms and poses a challenge in the development of uniform diagnostic guidelines. More large longitudinal studies are needed to better

Indian Childhood Cirrhosis: Case Report and Pediatric Diagnostic Challenges

Directory of Open Access Journals (Sweden)

Jaivinder Yadav

2015-08-01

Full Text Available Introduction: Indian childhood cirrhosis is a chronic liver disease usually seen in paediatric age group and is unique to the Indian subcontinent. The definitive causative factor for the disease is not found till now but excess copper ingestion has been associated with it.Case presentation: An Indian origin one and half year old premorbidly normal male child presented with history of gradual distension of abdomen for 6 months and jaundice, generalized body swelling, high colour urine for 20 days. There was no history of any bleeding or feature suggestive of hepatic encephalopathy. On physical examination child was icteric, pale and had anasarca, massive hepatosplenomegaly and ascites. The child was evaluated for various causes of hepatic failure in pediatric age group including infective, metabolic and autoimmune etiologies. Unfortunately the child succumbed to the illness. The post-mortem liver biopsy and copper estimation cleared the air, revealing Indian childhood cirrhosis as the underlying etiology.Conclusion: Though Indian childhood cirrhosis is a rare entity and reported less frequently in literature, the treating pediatrician should keep this as a differential in case of pediatric hepatic failure. The liver biopsy and hepatic copper estimation are the gold standard diagnostic tests for diagnosing Indian Childhood cirrhosis.

A mixed-methods systematic review protocol to examine the use of physical restraint with critically ill adults and strategies for minimizing their use.

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Rose, Louise; Dale, Craig; Smith, Orla M; Burry, Lisa; Enright, Glenn; Fergusson, Dean; Sinha, Samir; Wiesenfeld, Lesley; Sinuff, Tasnim; Mehta, Sangeeta

2016-11-21

Critically ill patients frequently experience severe agitation placing them at risk of harm. Physical restraint is common in intensive care units (ICUs) for clinician concerns about safety. However, physical restraint may not prevent medical device removal and has been associated with negative physical and psychological consequences. While professional society guidelines, legislation, and accreditation standards recommend physical restraint minimization, guidelines for critically ill patients are over a decade old, with recommendations that are non-specific. Our systematic review will synthesize evidence on physical restraint in critically ill adults with the primary objective of identifying effective minimization strategies. Two authors will independently search from inception to July 2016 the following: Ovid MEDLINE, CINAHL, Embase, Web of Science, Cochrane Library, PROSPERO, Joanna Briggs Institute, grey literature, professional society websites, and the International Clinical Trials Registry Platform. We will include quantitative and qualitative study designs, clinical practice guidelines, policy documents, and professional society recommendations relevant to physical restraint of critically ill adults. Authors will independently perform data extraction in duplicate and complete risk of bias and quality assessment using recommended tools. We will assess evidence quality for quantitative studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and for qualitative studies using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) guidelines. Outcomes of interest include (1) efficacy/effectiveness of physical restraint minimization strategies; (2) adverse events (unintentional device removal, psychological impact, physical injury) and associated benefits including harm prevention; (3) ICU outcomes (ventilation duration, length of stay, and mortality); (4) prevalence, incidence, patterns of use

A mixed-methods systematic review protocol to examine the use of physical restraint with critically ill adults and strategies for minimizing their use

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Louise Rose

2016-11-01

Full Text Available Abstract Background Critically ill patients frequently experience severe agitation placing them at risk of harm. Physical restraint is common in intensive care units (ICUs for clinician concerns about safety. However, physical restraint may not prevent medical device removal and has been associated with negative physical and psychological consequences. While professional society guidelines, legislation, and accreditation standards recommend physical restraint minimization, guidelines for critically ill patients are over a decade old, with recommendations that are non-specific. Our systematic review will synthesize evidence on physical restraint in critically ill adults with the primary objective of identifying effective minimization strategies. Methods Two authors will independently search from inception to July 2016 the following: Ovid MEDLINE, CINAHL, Embase, Web of Science, Cochrane Library, PROSPERO, Joanna Briggs Institute, grey literature, professional society websites, and the International Clinical Trials Registry Platform. We will include quantitative and qualitative study designs, clinical practice guidelines, policy documents, and professional society recommendations relevant to physical restraint of critically ill adults. Authors will independently perform data extraction in duplicate and complete risk of bias and quality assessment using recommended tools. We will assess evidence quality for quantitative studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE approach and for qualitative studies using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual guidelines. Outcomes of interest include (1 efficacy/effectiveness of physical restraint minimization strategies; (2 adverse events (unintentional device removal, psychological impact, physical injury and associated benefits including harm prevention; (3 ICU outcomes (ventilation duration, length of stay, and mortality; (4

Exertional Heat Illnesses and Environmental Conditions During High School Football Practices.

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Tripp, Brady L; Eberman, Lindsey E; Smith, Michael Seth

2015-10-01

Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes. To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period. Descriptive epidemiology study. For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes. Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours. The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population. Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and

Effects of socio-economic and behavioural factors on childhood malnutrition in Yemen.

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Sunil, T S

2009-07-01

This study examined the effects of socio-economic and behavioural factors on childhood malnutrition in Yemen. The three anthropometric indicators such as height-for-age, weight-for-height and weight-for-age are used to examine the nutritional status of children aged less 5 years in Yemen. The independent variables include background characteristics, behavioural risk factors and illness characteristics. Data for the study come the most recent Yemen Demographic and Health Survey, a nationally representative sample, conducted in Yemen in 1997. Logistic regression analysis is used to estimate the odds of being malnourished. The three anthropometric indicators show high to very high levels of child malnutrition in Yemen. The prevalence of stunting and underweight is so widespread that almost every other child under the age of 5 is either stunted or underweight. Social, economic and behavioural factors show very significant association with childhood malnutrition. The study results indicate the importance of social and behavioural factors in describing childhood malnutrition in Yemen. The study results will help develop nutritional and health promotion policies in order to improve childhood malnutrition in this country.

Longitudinal associations of experiences of adversity and socioeconomic disadvantage during childhood with labour force participation and exit in later adulthood.

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Fahy, A E; Stansfeld, S A; Smuk, M; Lain, D; van der Horst, M; Vickerstaff, S; Clark, C

2017-06-01

The Extending Working Lives (EWL) agenda seeks to sustain employment up to and beyond traditional retirement ages. This study examined the potential role of childhood factors in shaping labour force participation and exit among older adults, with a view to informing proactive interventions early in the life-course to enhance individuals' future capacity for extending their working lives. Childhood adversity and socioeconomic disadvantage have previously been linked to ill-health across the life-span and sickness benefit in early adulthood. This study builds upon previous research by examining associations between childhood adversity and self-reported labour force participation among older adults (aged 55). Data was from the National Child Development Study - a prospective cohort of all English, Scottish, & Welsh births in one week in 1958. There was evidence for associations between childhood adversity and increased risk of permanent sickness at 55 years - which were largely sustained after adjustment for educational disengagement and adulthood factors (mental/physical health, qualifications, socioeconomic disadvantage). Specifically, children who were abused or neglected were more likely to be permanently sick at 55 years. In addition, among males, those in care, those experiencing illness in the home, and those experiencing two or more childhood adversities were more likely to be permanently sick at 55 years. Childhood factors were also associated with part-time employment and retirement at 55 years. Severe childhood adversities may represent important distal predictors of labour force exit at 55 years, particularly via permanent sickness. Notably, some adversities show associations among males only, which may inform interventions designed to extend working lives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Home mechanical ventilation: a Canadian Thoracic Society clinical practice guideline.

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McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Cote, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, Fracois; Morrison, Debra L; O'Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert

2011-01-01

Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of userfriendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness.

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Schwellnus, Martin; Soligard, Torbjørn; Alonso, Juan-Manuel; Bahr, Roald; Clarsen, Ben; Dijkstra, H Paul; Gabbett, Tim J; Gleeson, Michael; Hägglund, Martin; Hutchinson, Mark R; Janse Van Rensburg, Christa; Meeusen, Romain; Orchard, John W; Pluim, Babette M; Raftery, Martin; Budgett, Richard; Engebretsen, Lars

2016-09-01

The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of load-including rapid changes in training and competition load, competition calendar congestion, psychological load and travel-and health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Canadian 24-hour movement guidelines for the early years (0-4 years): exploring the perceptions of stakeholders and end users regarding their acceptability, barriers to uptake, and dissemination.

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Riazi, Negin; Ramanathan, Subha; O'Neill, Meghan; Tremblay, Mark S; Faulkner, Guy

2017-11-20

It is important to engage stakeholders and end users in the development of guidelines for knowledge translation purposes. The aim of this study was to examine stakeholders' (experts in pediatric and family medicine, physical activity knowledge translation, and research) and end users' (parents and early childhood educators) perceptions of the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years). Stakeholders (n = 10) engaged in telephone interviews and end users (n = 92) participated in focus groups (n = 14) to discuss perceived clarity and need for the guidelines, potential barriers to implementation, identification of credible messengers, and methods for dissemination of the guidelines. A thematic analysis was conducted. The proposed guidelines were very well received by both stakeholders and end users. A clear need for such guidelines was identified, and most believed the guidelines were achievable. Stakeholders and end users identified several potential barriers to uptake, including low awareness of current guidelines; 'daily challenges' such as allure of screen time, lack of time, and competing priorities; and challenges in the context of shifting social norms. A range of methods and messengers of dissemination were identified. Medical and child care settings were the most frequently cited places for dissemination, and physicians and early childhood educators were the most common suggestions for messengers. There was consistent support for the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) from both stakeholders and end users. Moving forward, it is important to dedicate appropriate support and funding toward dissemination efforts in order to reach end users, particularly parents and early childhood educators.

Cumulative childhood stress and autoimmune diseases in adults.

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Dube, Shanta R; Fairweather, DeLisa; Pearson, William S; Felitti, Vincent J; Anda, Robert F; Croft, Janet B

2009-02-01

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p or=2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Gene-Environment Interactions in Severe Mental Illness

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Rudolf eUher

2014-05-01

Full Text Available Severe mental illness is a broad category that includes schizophrenia, bipolar disorder and severe depression. Both genetic disposition and environmental exposures play important roles in the development of severe mental illness. Multiple lines of evidence suggest that the roles of genetic and environmental depend on each other. Gene-environment interactions may underlie the paradox of strong environmental factors for highly heritable disorders, the low estimates of shared environmental influences in twin studies of severe mental illness and the heritability gap between twin and molecular heritability estimates. Sons and daughters of parents with severe mental illness are more vulnerable to the effects of prenatal and postnatal environmental exposures, suggesting that the expression of genetic liability depends on environment. In the last decade, gene-environment interactions involving specific molecular variants in candidate genes have been identified. Replicated findings include an interaction between a polymorphism in the AKT1 gene and cannabis use in the development of psychosis and an interaction between the length polymorphism of the serotonin transporter gene and childhood maltreatment in the development of persistent depressive disorder. Bipolar disorder has been underinvestigated, with only a single study showing an interaction between a functional polymorphism in BDNF and stressful life events triggering bipolar depressive episodes. The first systematic search for gene-environment interactions has found that a polymorphism in CTNNA3 may sensitise the developing brain to the pathogenic effect of cytomegalovirus in utero, leading to schizophrenia in adulthood. Strategies for genome-wide investigations will likely include coordination between epidemiological and genetic research efforts, systematic assessment of multiple environmental factors in large samples, and prioritization of genetic variants.

Association of Adverse Childhood Experiences with Co-occurring Health Conditions in Early Childhood.

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Bright, Melissa A; Thompson, Lindsay A

2018-01-01

To understand how adverse childhood experiences (ACEs) are associated with co-occurring physical, mental and developmental problems during early childhood. A subsample of 19,957 children aged 2-5 years were selected from the 2011-2012 National Survey for Child Health. Outcomes included 18 health conditions organized in singular condition domains (physical, mental, and developmental), and combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). Predictors included 8 ACEs (divorce of a parent, death of a parent, exposure to domestic violence, living with someone with a drug or alcohol abuse problem, household member with a mental illness, parent incarceration, neighborhood violence, discrimination). Multivariable logistic regression was performed controlling for demographic characteristics, having a personal doctor, health insurance coverage, and seeing a health care professional in the previous year. Experiencing 3 or more ACEs before the age of 5 years was associated with increased likelihood of nearly every co-occurring condition combination across 3 domains of health. Most notably, experiencing 3 or more ACEs was also associated with a 2-fold increase in likelihood of having ≥1 physical condition and ≥1 developmental condition, a 9-fold increase in likelihood of having ≥1 mental and ≥1 developmental condition, and a 7-fold increase in likelihood of having ≥1 physical, ≥1 mental, and ≥1 developmental condition. This study demonstrates that we can identify the health effects of adversity quite early in development and that management should include communication between both health care and early childhood education providers.

Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report

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Migliorati, Cesar A.; Hudson, Melissa M.; McMullen, Kevin P.; Kaste, Sue C.; Ruble, Kathy; Guilcher, Gregory M. T.; Shah, Ami J.; Castellino, Sharon M.

2014-01-01

Purpose Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children’s Oncology Group. Methods An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network “Categories of Consensus” system. Results The Children’s Oncology Group oral-dental pan el selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Addition ally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent ma lignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. Conclusions Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life. PMID:24781353

Guidelines for rating Global Assessment of Functioning (GAF

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Aas IH Monrad

2011-01-01

Full Text Available Abstract Background Global Assessment of Functioning (GAF is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines. Methods A thorough literature search was conducted. Results Few studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1 general points about guidelines for rating GAF; (2 introduction to guidelines, with ground rules; (3 starting scoring at the top, middle or bottom level of the scale; (4 scoring for different time periods and of different values (highest, lowest or average; (5 the finer grading of the scale; (6 different guidelines for different conditions; and (7 different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding. Conclusions Few studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and

Careseeking for childhood diarrhoea at the primary level of care in communities in Cross River State,

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Oluranti Ekpo

2016-12-01

Full Text Available Risk factors for care-seeking choices for childhood diarrhea in Nigeria are poorly understood. They are essential to the control of childhood illnesses because diarrhea is an important cause of childhood mortality. This study explored the contributors to care-seeking choices in Cross River State, Nigeria. Caregivers of children aged 0–59 months in 1240 randomly selected households in Cross River State were involved in this cross-sectional study. Questionnaires were used to collect information on demographics, knowledge of illness, and care-seeking patterns, and observed associations were explored using logistic regression. Care was given at home (50.4%, n = 142; as recommended, at the health center (27%, n = 76, and at the local drug store (19.1%, n = 54. Main reasons for care sought were health education (31.9%, n = 94, treatment cost (18%, n = 53, and experiences (16.6%, n = 49. Caregivers living in the mainly urban area of Calabar Municipality [Adjusted Odds Ratio (AOR = 2.81 (1.26–6.26] and the mainly rural area of Obanliku [AOR = 3.59 (1.94–6.64], were more likely to give home treatment. Choice of treatment was only associated with area of residence. Influencers of care-seeking behavior, especially for childhood diarrhea, are complex and need to be better understood to encourage enhanced care for young children with diarrhea.

AsMA Medical Guidelines for Air Travel: Reported In-Flight Medical Events and Death.

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Thibeault, Claude; Evans, Anthony D

2015-06-01

Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Although there are no publicly available databases providing information on the number of in-flight medical emergencies, the few studies published in the literature indicate that they are uncommon. Minor illnesses such as near-fainting, dizziness, and hyperventilation occur more frequently. However, serious illnesses, such as seizures and myocardial infarction, also occur. In-flight deaths are also rare.

Ethical considerations in the study of online illness narratives: a qualitative review.

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Heilferty, Catherine McGeehin

2011-05-01

This aim of the review was to describe differences in ethical approaches to research on Internet communication during illness and to report conclusions drawn relevant to a proposed narrative analysis of parent blogs of childhood illness. As the study of the online expression of illness experiences becomes more expansive, discussion of related ethical issues is central to promoting research trustworthiness and rigour. Ethical considerations are central to the patient-provider relationship. The EBSCO Host, CINAHL, Medline, Communication & Mass Media Complete, and Google Scholar databases were searched from January 1990 to September 2009 using the terms 'Internet research and ethics', 'Internet research, illness and ethics' and 'blog, Internet research and ethics'. Of the 4114 references found, 21 met the inclusion criteria for the review. The review was designed to be a comprehensive assessment of the concepts analysed and the qualitative research measures taken concerning ethics in Internet research across formats. Three main approaches to ethical conduct in Internet research on illness experiences were found: human subjects, representation and open source approaches. The personal and sensitive nature of online illness narratives demand their consideration in health care as 'human subjects' research. The best hope for ethical treatment of author-participants is the creation of a comprehensive plan for addressing any and all potential ethical conflicts that may arise in the collection, analysis and reporting of data, taking into consideration rapid changes in technology. © 2011 Blackwell Publishing Ltd.

Science Technology Engineering and Math (STEM) Education MUST Begin in Early Childhood Education: A Systematic Analysis of Washington State Guidelines Used to Gauge the Development and Learning of Young Learners

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Briseno, Luis Miguel

This paper reflects future direction for early Science Technology Engineering and Mathematics (STEM) education, science in particular. Washington State stakeholders use guidelines including: standards, curriculums and assessments to gauge young children's development and learning, in early childhood education (ECE). Next Generation Science Standards (NGSS), and the Framework for K-12 programs (National Research Council, 2011) emphasizes the need for reconfiguration of standards: "Too often standards are a long list of detailed and disconnected facts... this approach alienates young people, it also leaves them with fragments of knowledge and little sense of the inherent logic and consistency of science and of its universality." NGSS' position elevates the concern and need for learners to experience teaching and learning from intentionally designed cohesive curriculum units, rather than as a series of unrelated and isolated lessons. To introduce the argument the present study seeks to examine Washington State early learning standards. To evaluate this need, I examined balance and coverage/depth. Analysis measures the level of continuum in high-quality guidelines from which Washington State operates to serve its youngest citizens and their families.

Invited Commentary: Childhood and Adolescent Obesity--Psychological and Behavioral Issues in Weight Loss Treatment

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Sarwer, David B.; Dilks, Rebecca J.

2012-01-01

The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss.…

[Admission, discharge and triage guidelines for paediatric intensive care units in Spain].

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de la Oliva, Pedro; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Rey-Galán, Corsino; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; de Carlos-Vicente, Juan Carlos; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodríguez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis

2018-05-01

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Memories of Parent Behaviors and Adult Attachment in Childhood Cancer Survivors.

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Lehmann, Vicky; Hagedoorn, Mariët; Gerhardt, Cynthia A; Keim, Madelaine C; Guthrie, Lory; Sanderman, Robbert; Tuinman, Marrit A

2017-03-01

Childhood cancer is stressful for the entire family. Preoccupation and anxiety surrounding the child's illness may result in parents of children with cancer being overprotective or less emotionally responsive toward their children. Such parenting in response to a negative life event like childhood cancer may cause survivors to be more insecurely attached than healthy peers, which could have downstream effects on survivors' romantic relationships later in life. Therefore, we examined survivors' perspectives on parent behaviors, adult attachment, and marital status among adult survivors of childhood cancer relative to controls. One hundred forty-nine young adult survivors and 149 matched controls (M age  = 28, range 20-40) indicated their relationship status (single vs. partnered) and completed standardized questionnaires assessing memories of upbringing (warmth, overprotection, rejection) and adult attachment (avoidance, anxiety). Adult survivors of childhood cancer remembered mothers and fathers as emotionally warmer (d = 0.53/0.30), and mothers as less rejecting than controls (d = 0.30). Adult attachment was overall similar between survivors and controls, but partnered survivors reported particularly low attachment-related anxiety. Childhood cancer was related to higher mother and father warmth, which were associated with lower attachment-related avoidance and in turn with a greater likelihood of being in a relationship. Adult childhood cancer survivors did not remember their parents as overprotective, but reported more positive parenting relative to controls; and similar adult attachment and relationship status. The results were unexpected, but offer novel insights for future prospective studies, which are necessary to better understand psychosocial late effects of childhood cancer.

Intra- and extra-familial adverse childhood experiences and a history of childhood psychosomatic disorders among Japanese university students

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Munemoto Takao

2007-04-01

Full Text Available Abstract Background Japan has been witnessing a considerable increase in the number of children with psychosomatic disorders. The purpose of this study is to examine the relationship between the risk of psychosomatic disorder in adolescents and intra- and extra-familial adverse childhood experiences (ACEs. Methods A retrospective cohort study of 1592 Japanese university students (52% male, mean age 19.9 years who completed a survey about intra- and extra-familial ACEs and the incidence of childhood psychosomatic disorders. Intra-familial ACEs included domestic violence, physical violence, emotional abuse, illness in household, parental divorce, no parental affection, and dysfunctional family. Extra-familial ACEs included physical violence or negative recognition by teachers, being bullied in elementary or junior high school, or sexual violence. Results The frequency of psychosomatic disorders among the respondents was 14.8%. Among the 7 intra-familial ACEs, emotional abuse (relative risk, RR = 1.9 and illness in household (RR = 1.7 increased the risk of psychosomatic disorders. Estimates of the relative risk for the 5 extra-familial ACEs were statistically significant and ranged from 1.5 for being bullied in elementary school or physical violence from teachers to 2.4. Students who had 3 or more intra-familial ACEs and 2 or more extra-familial ACEs had a 3.0 relative risk for psychosomatic disorder. Conclusion These results suggest that intra- and extra-familial ACEs are associated with the development of psychosomatic disorders. Therefore, sufficient evaluation of ACEs should be performed in adolescent patients with psychosomatic disorder.

Childhood onset diagnoses in a case series of teens at clinical high risk for psychosis.

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Mazzoni, Paola; Kimhy, David; Khan, Shamir; Posner, Kelly; Maayan, Lawrence; Eilenberg, Mara; Messinger, Julie; Kestenbaum, Clarice; Corcoran, Cheryl

2009-12-01

REASONS: Schizophrenia is typically an adult neurodevelopmental disorder that has its antecedents in childhood and adolescence. Little is known about disorders "usually first diagnosed in infancy, childhood and adolescence" (e.g., childhood-onset disorders) in "prodromal" teens at heightened clinical risk for psychotic disorder. Childhood-onset disorders were prevalent in putatively prodromal teens, including anxiety and disruptive disorders, attention-deficit/hyperactivity disorder (ADHD), and, surprisingly, elimination disorders. These may reflect developmental antecedents in psychotic disorders such as schizophrenia. A case series of 9 teens (ages 13-17) identified as prodromal to psychosis were evaluated with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Childhood-onset diagnoses commonly endorsed (threshold or subthreshold) included ADHD (5/9), oppositional defiant disorder (5/9), enuresis or encopresis (4/9), conduct disorder (2/9), separation anxiety (3/9), and transient tic disorder (2/9). Enuresis was identified in 3 of the 4 older teens (ages 15-17). An understanding of the childhood-onset disorders that occur in teens at risk for psychotic illnesses, such as schizophrenia, can shed light on the pathophysiology of schizophrenia and potentially inform early identification and intervention.

Adverse childhood experiences and risk of paternity in teen pregnancy.

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Anda, Robert F; Chapman, Daniel P; Felitti, Vincent J; Edwards, Valerie; Williamson, David F; Croft, Janet B; Giles, Wayne H

2002-07-01

Few studies have investigated risk factors that predispose males to be involved in teen pregnancies. To provide new information on such factors, we examined the relationships of eight common adverse childhood experiences to a male's risk of impregnating a teenager. We conducted a retrospective cohort study using questionnaire responses from 7399 men who visited a primary care clinic of a large health maintenance organization in California. Data included age of the youngest female ever impregnated; the man's own age at the time; his history of childhood emotional, physical, or sexual abuse; having a battered mother; parental separation or divorce; and having household members who were substance abusers, mentally ill, or criminals. Odds ratios (ORs) for the risk of involvement in a teen pregnancy were adjusted for age, race, and education. At least one adverse childhood experience was reported by 63% of participants, and 34% had at least two adverse childhood experiences; 19% of men had been involved in a teen pregnancy. Each adverse childhood experience was positively associated with impregnating a teenager, with ORs ranging from 1.2 (sexual abuse) to 1.8 (criminal in home). We found strong graded relationships (P teen pregnancy for each of four birth cohorts during the last century. Compared with males with no adverse childhood experiences, a male with at least five adverse childhood experiences had an OR of 2.6 (95% confidence interval [CI] 2.0, 3.4) for impregnating a teenager. The magnitude of the ORs for the adverse childhood experiences was reduced 64-100% by adjustment for potential intermediate variables (age at first intercourse, number of sexual partners, having a sexually transmitted disease, and alcohol or drug abuse) that also exhibited a strong graded relationship to adverse childhood experiences. Adverse childhood experiences have an important relationship to male involvement in teen pregnancy. This relationship has persisted throughout four

Experience in Training of Primary Health Care Specialists in the Context of the Integrated Management of Childhood Illness in the Teaching of Pediatrics to Junior Students

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O.D. Fofanov

2013-09-01

Full Text Available The article describes an overview of the basic principles of the integrated management of childhood illness (IMCI strategy, which is designed to improve the quality of care for children up to 5 years at the level of primary health care. The first experience of the implementation of this strategy in the educational process while studying of pediatrics at the junior courses within the curriculum is described. A considerable attention is paid to the method of mastering communication skills by the junior students’ and applying them in the collection of medical history, communicating with parents and relatives of children. According to IMCI recommendations all health care professionals, who work in primary health care, must master the methodology of counseling family about care for healthy and sick children, feeding, providing optimal conditions for the physical and neuropsychological development. Our first experience demonstrates the feasibility of implementing IMCI individual issues in the educational process while studying pediatrics for the junior classes.

Parental overprotection, perceived child vulnerability, and parenting stress: a cross-illness comparison.

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Hullmann, Stephanie E; Wolfe-Christensen, Cortney; Ryan, Jamie L; Fedele, David A; Rambo, Philip L; Chaney, John M; Mullins, Larry L

2010-12-01

The current study sought to investigate differences in parenting capacity variables across four disease groups. Parents (N = 425), the majority of whom were mothers, of children with either cancer, asthma, Type 1 diabetes, or cystic fibrosis, completed measures of parental overprotection, perceived child vulnerability, and parenting stress. After controlling for significant demographic variables, parents of children with cystic fibrosis and asthma reported higher perceived child vulnerability than parents of children with either diabetes or cancer, while parents of children with asthma and diabetes reported higher parenting stress than parents of children with cancer or cystic fibrosis. No differences between disease groups were found for parental overprotection. The current study provides support for an illness-specific approach to understanding parenting capacity variables in the context of childhood chronic illnesses.

Longtintudinal asscociations of experience of adversity and socioeconomic disadvantage during childhood with labour force participation and exit in later adulthood

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Fahy, A.E; Stansfield, S.A; Smuk, M.; Lain, D.; Van der Horst, Mariska; Vickerstaff, Sarah; Clark, C.

2017-01-01

The Extending Working Lives (EWL) agenda seeks to sustain employment up to and beyond traditional retirement ages. This study examined the potential role of childhood factors in shaping labour force participation and exit among older adults, with a view to informing proactive interventions early in the life-course to enhance individuals’ future capacity for extending their working lives. Childhood adversity and socioeconomic disadvantage have previously been linked to ill-health across the li...

Longitudinal associations of experiences of adversity and socioeconomic disadvantage during childhood with labour force participation and exit in later adulthood

OpenAIRE

Fahy, A. E.; Stansfeld, S. A.; Smuk, M.; Lain, D.; van der Horst, M.; Vickerstaff, S.; Clark, C.

2017-01-01

The Extending Working Lives (EWL) agenda seeks to sustain employment up to and beyond traditional retirement ages. This study examined the potential role of childhood factors in shaping labour force participation and exit among older adults, with a view to informing proactive interventions early in the life-course to enhance individuals’ future capacity for extending their working lives. Childhood adversity and socioeconomic disadvantage have previously been linked to ill-health across the li...

Economic Hardship in Childhood: A Neglected Issue in ACE Studies?

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Braveman, Paula; Heck, Katherine; Egerter, Susan; Rinki, Christine; Marchi, Kristen; Curtis, Mike

2018-03-01

Objectives Adverse childhood experiences (ACEs) have been linked with ill-health in adulthood, but ACE literature has focused on family disruption or dysfunction (e.g., child abuse, parental separation), with less attention to economic adversity. We examined whether a mother's economic hardship in childhood (EHC) was associated with women's hardships and health-risk behaviors during/just before pregnancy. Methods We analyzed population-based survey data on 27,102 postpartum California women. EHC included respondents' reports that during childhood they/their families experienced hunger because of inability to afford food or moved because of problems paying rent/mortgage and the frequency of difficulty paying for basic needs. We examined six maternal hardships/behaviors during/just before pregnancy, including four hardships (poverty, food insecurity, homelessness/no regular place to sleep, intimate partner violence) and two behaviors (smoking, binge drinking). Prevalence ratios (PRs) were calculated from sequential logistic regression models estimating associations between EHC (categorized by level of hardship) and each maternal hardship/behavior, first without adjustment, then adjusting for other childhood and current maternal factors, and finally adding family disruption/dysfunction. Results Before adjustment for family disruption/dysfunction, the highest and intermediate EHC levels were associated with each maternal hardship/behavior; after full adjustment, those associations persisted except with smoking. Higher EHC levels generally appeared associated with larger PRs, although confidence intervals overlapped. Conclusions for Policy/Practice These findings link childhood economic hardship with women's hardships, binge drinking, and possibly smoking around the time of pregnancy. Without establishing causality, they support previous research indicating that childhood economic adversity should be considered an ACE.

Childhood bullying involvement predicts low-grade systemic inflammation into adulthood

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Copeland, William E.; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E. Jane

2014-01-01

Bullying is a common childhood experience that involves repeated mistreatment to improve or maintain one’s status. Victims display long-term social, psychological, and health consequences, whereas bullies display minimal ill effects. The aim of this study is to test how this adverse social experience is biologically embedded to affect short- or long-term levels of C-reactive protein (CRP), a marker of low-grade systemic inflammation. The prospective population-based Great Smoky Mountains Study (n = 1,420), with up to nine waves of data per subject, was used, covering childhood/adolescence (ages 9–16) and young adulthood (ages 19 and 21). Structured interviews were used to assess bullying involvement and relevant covariates at all childhood/adolescent observations. Blood spots were collected at each observation and assayed for CRP levels. During childhood and adolescence, the number of waves at which the child was bullied predicted increasing levels of CRP. Although CRP levels rose for all participants from childhood into adulthood, being bullied predicted greater increases in CRP levels, whereas bullying others predicted lower increases in CRP compared with those uninvolved in bullying. This pattern was robust, controlling for body mass index, substance use, physical and mental health status, and exposures to other childhood psychosocial adversities. A child’s role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health. PMID:24821813

Childhood trauma increases the risk of post-traumatic stress disorder in response to first-episode psychosis.

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Bendall, Sarah; Alvarez-Jimenez, Mario; Hulbert, Carol A; McGorry, Patrick D; Jackson, Henry J

2012-01-01

To investigate the relationship between childhood trauma, post-traumatic stress symptoms due to the experience of childhood trauma, and post-traumatic stress symptoms due to the experience of psychosis. The current study assessed childhood trauma and post-traumatic stress disorder (PTSD) symptoms as a result of both childhood trauma and psychosis using the Impact of Events Scale - Revised, in a group of 36 people with first-episode psychosis. Reported rates of clinical level post-psychotic PTSD symptoms, childhood trauma and childhood trauma-related clinical level PTSD symptoms were 47% (95% CI 31-64%), 64% (95% CI 48-80%) and 39% (95% CI 23-55%), respectively. Reporting childhood trauma increased the risk of developing post-psychosis PTSD 27-fold (95% CI 2.96-253.80, p = 0.01). Having childhood trauma-related PTSD increased the risk of developing post-psychosis PTSD 20-fold (95% CI 3.38-123.25, p = 0.01). These risks were not explained by illness factors such as duration of untreated psychosis, age of onset or severity of psychotic symptoms. Those without post-psychotic PTSD symptoms at clinical levels were unlikely to report childhood trauma (6%; 95% CI 3-8%). These results suggest the cognitive, social and biological consequences of childhood trauma can prevent effective recovery from the trauma of acute first-episode psychosis resulting in post-psychotic PTSD. Treatment strategies for post-psychotic PTSD must address childhood trauma and related PTSD.

Drinking-water treatment, climate change, and childhood gastrointestinal illness projections for northern Wisconsin (USA) communities drinking untreated groundwater

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Uejio, Christopher K.; Christenson, Megan; Moran, Colleen; Gorelick, Mark

2017-06-01

This study examined the relative importance of climate change and drinking-water treatment for gastrointestinal illness incidence in children (age first quantified the observed (1991-2010) precipitation and gastrointestinal illness associations after controlling for seasonality and temporal trends. Precipitation likely transported pathogens into drinking-water sources or into leaking water-distribution networks. Building on observed relationships, the second analysis projected how climate change and drinking-water treatment installation may alter gastrointestinal illness incidence. Future precipitation values were modeled by 13 global climate models and three greenhouse-gas emissions levels. The second analysis was rerun using three pathways: (1) only climate change, (2) climate change and the same slow pace of treatment installation observed over 1991-2010, and (3) climate change and the rapid rate of installation observed over 2011-2016. The results illustrate the risks that climate change presents to small rural groundwater municipalities without drinking water treatment. Climate-change-related seasonal precipitation changes will marginally increase the gastrointestinal illness incidence rate (mean: ˜1.5%, range: -3.6-4.3%). A slow pace of treatment installation somewhat decreased precipitation-associated gastrointestinal illness incidence (mean: ˜3.0%, range: 0.2-7.8%) in spite of climate change. The rapid treatment installation rate largely decreases the gastrointestinal illness incidence (mean: ˜82.0%, range: 82.0-83.0%).

Evidence That the Impact of Childhood Trauma on IQ Is Substantial in Controls, Moderate in Siblings, and Absent in Patients With Psychotic Disorder

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Marsman, Anne; van Dam, Daniela; Simons, Claudia J. P.

2017-01-01

Abstract Research suggests that childhood trauma is associated with cognitive alterations, but it is not known whether the cognitive alterations observed in patients with psychotic disorder, and their relatives, is trauma-related. Patients with a schizophrenia-spectrum diagnosis (n = 1119), siblings of patients (n = 1059) and healthy comparison subjects (HCS; n = 586) were interviewed 3 times over a period of 6 years. Repeated measures of IQ were analyzed as a function of childhood trauma and group, controlling for confounders. There were significant differences in the impact of childhood trauma on IQ across the 3 groups. Exposure in HCS was associated with a nearly 5-point reduction in IQ (−4.85; 95% confidence interval [CI]: −7.98 to −1.73, P = .002), a lesser reduction in siblings (−2.58; 95% CI: −4.69 to −0.46, P = .017) and no significant reduction in patients (−0.84; 95% CI: −2.78 to 1.10, P = .398). One-fourth of the sibling-control difference in IQ was reducible to childhood trauma, whereas for patients this was only 5%. Over the 6-year follow-up, those with trauma exposure showed significantly less learning effects with repeated cognitive assessments (b = 1.36, 95% CI: 0.80‒1.92, P < .001) than the nonexposed (b = 2.31, 95% CI: 1.92‒2.71, P < .001; P interaction = .001). Although childhood trauma impacts cognitive ability and learning in non-ill people at low and high genetic risk, its effect on the observed cognitive alterations in psychotic disorder may be minor. Twin and family studies on cognitive alterations in psychotic disorder need to take into account the differential impact of trauma on cognition across ill and non-ill, at risk groups. PMID:28177077

Individuals with currently untreated mental illness: causal beliefs and readiness to seek help.

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Stolzenburg, S; Freitag, S; Evans-Lacko, S; Speerforck, S; Schmidt, S; Schomerus, G

2018-01-16

Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future. In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceived need for professional help, help-seeking intentions, severity of depressive symptoms (Patient Health Questionnaire - Depression), and whether respondents had previously sought mental healthcare. Most participants fulfilled diagnostic criteria for a mood disorder (n = 181, 87.4%) and/or neurotic, stress-related and somatoform disorders (n = 120, 58.0%) according to the ICD-10. N = 94 (45.4%) participants had never received mental health treatment previously. Exploratory factor analysis of a list of 25 different causal explanations resulted in five factors: biomedical causes, person-related causes, childhood trauma, current stress and unhealthy behaviour. Attributing the present problem to biomedical causes, person-related causes, childhood trauma and stress were all associated with stronger self-identification as having a mental illness. In persons who had never received mental health treatment previously, attribution to biomedical causes was related to greater perceived need and stronger help-seeking intentions. In those with treatment experience, lower attribution to person-related causes and

Reliability and Validity of a Measure of Sexual and Physical Abuse Histories among Women with Serious Mental Illness.

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Meyer, Ilan H.; And Others

1996-01-01

Structured clinical interviews concerning childhood histories of physical and sexual abuse with 70 mentally ill women at 2 times found test-retest reliability of .63 for physical abuse and .82 for sexual abuse. Validity, assessed as consistency with an independent clinical assessment, showed 75% agreement for physical abuse and 93% agreement for…

Prevalence of mental illness within families in a regional child-focussed mental health service.

Science.gov (United States)

Naughton, Michael F A; Maybery, Darryl J; Goodyear, Melinda

2018-04-01

Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co-occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross-sectional study design was employed involving a case record review and clinician-completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co-occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family-focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent. © 2017 Australian College of Mental Health Nurses Inc.

Physical activity interventions for people with mental illness: a systematic review and meta-analysis.

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Rosenbaum, Simon; Tiedemann, Anne; Sherrington, Catherine; Curtis, Jackie; Ward, Philip B

2014-09-01

To determine effects of physical activity on depressive symptoms (primary objective), symptoms of schizophrenia, anthropometric measures, aerobic capacity, and quality of life (secondary objectives) in people with mental illness and explore between-study heterogeneity. MEDLINE, Cochrane Controlled Trials Register, PsycINFO, CINAHL, Embase, and the Physiotherapy Evidence Database (PEDro) were searched from earliest record to 2013. Randomized controlled trials of adults with a DSM-IV-TR, ICD-10, or clinician-confirmed diagnosis of a mental illness other than dysthymia or eating disorders were selected. Interventions included exercise programs, exercise counseling, lifestyle interventions, tai chi, or physical yoga. Study methodological quality and intervention compliance with American College of Sports Medicine (ACSM) guidelines were also assessed. Two investigators extracted data. Data were pooled using random-effects meta-analysis. Meta-regression was used to examine sources of between-study heterogeneity. Thirty-nine eligible trials were identified. The primary meta-analysis found a large effect of physical activity on depressive symptoms (n = 20; standardized mean difference (SMD) = 0.80). The effect size in trial interventions that met ACSM guidelines for aerobic exercise did not differ significantly from those that did not meet these guidelines. The effect for trials with higher methodological quality was smaller than that observed for trials with lower methodological quality (SMD = 0.39 vs 1.35); however, the difference was not statistically significant. A large effect was found for schizophrenia symptoms (SMD = 1.0), a small effect was found for anthropometry (SMD = 0.24), and moderate effects were found for aerobic capacity (SMD = 0.63) and quality of life (SMD = 0.64). Physical activity reduced depressive symptoms in people with mental illness. Larger effects were seen in studies of poorer methodological quality. Physical activity reduced symptoms of

[The German National Disease Management Guideline "Chronic Heart Failure"].

Science.gov (United States)

Weinbrenner, S; Langer, T; Scherer, M; Störk, S; Ertl, G; Muth, Ch; Hoppe, U C; Kopp, I; Ollenschläger, G

2012-02-01

Chronic heart failure (CHF) is an illness mostly affecting elderly people. In Germany CHF is one of the most common causes of death and at the same time one of the most common diagnosis in inpatient care. Due to the expected increase in life expectancy in the next few years experts predict a further step-up of the incidence. Against this background development of a national guideline on chronic heart failure was prioritised and accordingly the National Disease Management Guideline (NDMG) Chronic Heart Failure was developed by a multi- and interdisciplinary group. The guideline group comprised experts from all relevant scientific medical societies as well as a patient expert. The National Disease Management Guideline (NDMG) on Chronic Heart Failure aims at supporting patients and health care providers with respect to decisions on a specific health care problem by giving recommendations for actions. Recommendations are informed by the best available scientific evidence on this topic.Patients with CHF often suffer from multiple conditions. Due to this fact and the old age patients do have very complex and demanding health care needs. Thus accounting for co-morbidities is paramount in planning and providing health care for theses patients and communication between doctor and patient but also between all health care providers is crucial.Basic treatment strategies in chronic heart failure comprise management of risk factors and prognostic factors as well as appropriate consideration of co-morbidities accompanied by measures empowering patients in establishing a healthy life style and a self-dependant management of their illness.Psycho-social aspects have a very strong influence on patients' acceptance of the disease and their self-management. In addition they have a strong influence on therapy management of the treating physician thus they have to be addressed adequately during the consultation.The National Disease Management Guideline (NDMG) Chronic Heart Failure (CHF

Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

Directory of Open Access Journals (Sweden)

Douglas A McKim

2011-01-01

Full Text Available Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

Illness Experience, Self-Determination, and Recreational Activities in Pediatric Asthma.

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Bingham, Peter M; Crane, Ian; Manning, Sarah Waterman

2017-06-01

Although asthma self-management depends on ongoing and accurate self-assessment by the patient, pediatric asthma patients have weak skills in the area of symptom perception. Before developing an asthma game targeted to improving asthma self-management and improved symptom awareness, we sought to identify gaps in existing games. To clarify the role of relatedness and autonomy in asthma health game design, we investigated symptom awareness, vocabulary, and self-determination through a series of semi-structured interviews with children suffering from asthma. Using self-determination theory as a framework, interviews were oriented to patients' illness experience and vocabulary related to symptomatology, as well as to recreational activities. Formative analysis of the interviews reveals attitudes, perceptions, and motivational factors arising in the context of childhood asthma, and it elucidates the images and vocabulary associated with both illness experience and recreational activities. Qualitative assessment of patient perspectives leads to specific recommendations for game design ideas that will support market entry of a spirometer-controlled game for children with asthma.

Relationships between adverse childhood experiences and adult mental well-being: results from an English national household survey

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Karen Hughes

2016-03-01

Full Text Available Abstract Background Individuals’ childhood experiences can strongly influence their future health and well-being. Adverse childhood experiences (ACEs such as abuse and dysfunctional home environments show strong cumulative relationships with physical and mental illness yet less is known about their effects on mental well-being in the general population. Methods A nationally representative household survey of English adults (n = 3,885 measuring current mental well-being (Short Edinburgh-Warwick Mental Well-being Scale SWEMWBS and life satisfaction and retrospective exposure to nine ACEs. Results Almost half of participants (46.4 % had suffered at least one ACE and 8.3 % had suffered four or more. Adjusted odds ratios (AORs for low life satisfaction and low mental well-being increased with the number of ACEs. AORs for low ratings of all individual SWEMWBS components also increased with ACE count, particularly never or rarely feeling close to others. Of individual ACEs, growing up in a household affected by mental illness and suffering sexual abuse had the most relationships with markers of mental well-being. Conclusions Childhood adversity has a strong cumulative relationship with adult mental well-being. Comprehensive mental health strategies should incorporate interventions to prevent ACEs and moderate their impacts from the very earliest stages of life.

Metabolic Control and Illness Perceptions in Adolescents with Type 1 Diabetes

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Line Wisting

2016-01-01

Full Text Available Background. Disturbed eating behavior and psychosocial variables have been found to influence metabolic control, but little is known about how these variables interact or how they influence metabolic control, separately and combined. Objective. To explore associations between metabolic control (measured by HbA1c and eating disorder psychopathology, coping strategies, illness perceptions, and insulin beliefs in adolescents with type 1 diabetes. Methods. A total of 105 patients (41.9% males with type 1 diabetes (12–20 years were interviewed with the Child Eating Disorder Examination. In addition, self-report psychosocial questionnaires were completed. Clinical data, including HbA1c, was obtained from the Norwegian Childhood Diabetes Registry. Results. Significant gender differences were demonstrated. Among females, HbA1c correlated significantly with eating restriction (.29, p < .05, the illness perception dimensions consequences, personal control, coherence, and concern (ranging from .33 to .48, and the coping strategy ventilating negative feelings (−.26, p < .05. Illness perception personal control contributed significantly to HbA1c in a regression model, explaining 23% of the variance among females (β .48, p < .001. None of the variables were significantly associated with HbA1c among males. Conclusions. Illness perceptions appear to be important contributors to metabolic control in females, but not males, with type 1 diabetes.

Palliative Sedation: An Analysis of International Guidelines and Position Statements.

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Gurschick, Lauren; Mayer, Deborah K; Hanson, Laura C

2015-09-01

To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. CINAHL, PubMed, and Web of Science were searched for publications since 1997 for recommended guidelines and position statements on palliative sedation as well as data on its provision. Keywords included palliative sedation, terminal sedation, guidelines, United States, and end of life. Inclusion criteria were palliative sedation policies, frameworks, guidelines, or discussion of its practice, general or oncology patient population, performance of the intervention in an inpatient unit, for humans, and in English. Exclusion criteria were palliative sedation in children, acute illness, procedural, or burns, and predominantly ethical discussions. Guidelines were published by American College of Physicians-American Society of Internal Medicine (2000), Hospice and Palliative Nurses Association (2003), American Academy of Hospice and Palliative Medicine (2006), American Medical Association (2008), Royal Dutch Medical Association (2009), European Association for Palliative Care (2009), National Hospice and Palliative Care Organization (2010), and National Comprehensive Cancer Network (2012). Variances throughout guidelines include definitions of the practice, indications for its use, continuation of life-prolonging therapies, medications used, and timing/prognosis. The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the United States. © The Author(s) 2014.

The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

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Sandel Megan T

2009-05-01

Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

25-hydroxyvitamin D and health service utilization for asthma in early childhood.

Science.gov (United States)

Omand, Jessica A; To, Teresa; L O'Connor, Deborah; Parkin, Patricia C; Birken, Catherine S; Thorpe, Kevin E; Maguire, Jonathon L

2018-06-15

Asthma is the most common chronic illness of childhood and a common reason for hospital admission. Studies suggest that low vitamin D levels may be associated with health service utilization (HSU) for childhood asthma. The primary objective was to determine if vitamin D serum levels in early childhood were associated with HSU for asthma including: a) hospital admissions; b) emergency department visits; and c) outpatient sick visits. Secondary objectives were to determine whether vitamin D supplementation in pregnancy or childhood were associated with HSU for asthma. Prospective cohort study of children participating in the TARGet Kids! practice-based research network between 2008 and 2013 in Toronto, Canada. HSU was determined by linking each child's provincial health insurance number to health administrative databases. Multivariable quasi-Poisson and logistic regression were used to evaluate the association between 25-hydroxyvitamin D concentrations, vitamin D supplementation in pregnancy, and childhood and HSU for asthma. A total of 2926 healthy children aged 0-6 years had 25-hydroxyvitamin D data available and were included in the primary analysis. Mean (IQR) 25-hydroxyvitmain D level was 84 nmol/L (65-98 nmol/L), 218 and 1267 children had 25-hydroxyvitamin D concentrations D concentrations (continuously or dichotomized at 50 and 75 nmol/L), vitamin D supplementation in pregnancy or childhood and HSU for asthma. Vitamin D blood values do not appear to be associated with HSU for asthma in this population of healthy urban children. © 2018 Wiley Periodicals, Inc.

Pregnancy x-rays and childhood cancers: effects of exposure age and radiation dose

International Nuclear Information System (INIS)

Gilman, E.A.; Kneale, G.W.; Knox, E.G.; Stewart, A.M.

1988-01-01

Using data from the Oxford Survey of Childhood Cancers this paper examines the effect of foetal age and number of films used on the subsequent risk of childhood cancer associated with prenatal x-rays. X-rays early in pregnancy were taken for different reasons and required more films when compared with those taken in late pregnancy. Therefore, Mantel-Haenszel techniques were used to estimate the independent effects of (a) exposure age and (b) number of films. Age at exposure had a clearly significant effect; x-rays taken in the first trimester of pregnancy were 2.69 times as effective as x-rays taken in the third trimester. First trimester exposures were often the result of maternal illnesses, so these maternal illnesses were then included among the controlling factors. When this was done the first trimester x-rays were 2.73 times as effective as later exposures. First trimester x-rays were most strongly associated with the cancers which were diagnosed between 4 and 5 years of age. Although the number of films had no detectable effect upon relative risk calculated over all ages, multiple exposures were demonstrably associated with early age at diagnosis. (author)

Parental illness perceptions and medication perceptions in childhood asthma, a focus group study

NARCIS (Netherlands)

Klok, Ted; Brand, Paul L.; Bomhof-Roordink, Hanna; Duiverman, Eric J.; Kaptein, Adrian A.

Aim: Asthma treatment according to guidelines fails frequently, through patients' nonadherence to doctors' advice. This study aimed to explore how differences in asthma care influence parents' perceptions to inhaled corticosteroids (ICS). Methods: We conducted six semistructured focus groups,

Integration of Educational Methods and Physical Settings: Design Guidelines for High/Scope Methodology in Pre-Schools

Science.gov (United States)

Izadpanah, Shirin; Günçe, Kaðan

2014-01-01

Quality design and appropriate space organization in preschool settings can support preschool children's educational activities. Although the relationship between the well-being and development of children and physical settings has been emphasized by many early childhood researchers, there is still a need for theoretical design guidelines that are…

Overcoming the Odds: Long-term psychosocial outcomes in survivors of meningococcal septic shock in childhood, and in their parents

NARCIS (Netherlands)

L.C.A.C. Vermunt (Lindy)

2008-01-01

textabstractSeptic shock, caused by Neisseria meningitidis with petechiae and/or purpura, also called Meningococcal Septic Shock (MSS), is the most serious form of meningococcal infection in early childhood. MSS is a life-threatening illness in mostly previously healthy children, with an unexpected

Neonatal Bacterial Colonization Predispose to Lower Respiratory Infections in Early Childhood

DEFF Research Database (Denmark)

Vissing, Nadja Hawwa

2014-01-01

, and high sensitivity to respiratory, infectious and skin related illness. In particular, sensitivity on LRI was 96%. There was no evidence of bias from concurrent asthmatic disease or socioeconomic status. In conclusion, the study confirmed that COPSAC data is a valid source for investigating childhood......Lower respiratory infections (LRI) in childhood are common and account for considerable morbidity and health care utilization. The frequency of LRI varies significantly between otherwise healthy children, but extrinsic and intrinsic triggers of such variation are poorly understood. Traditionally...... neonatal airway colonization and risk of the LRI in a validated study cohort, and whether a possible association could be reflected in the early immune response to airway pathogens. In study I we aimed to ascertain the quality of information on child’s health, including asthma, allergy, eczema, respiratory...

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

Science.gov (United States)

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.

More stressors prior to and during the course of bipolar illness in patients from the United States compared with the Netherlands and Germany

NARCIS (Netherlands)

Post, Robert M.; Altshuler, Lori; Leverich, Gabriele; Nolen, Willem; Kupka, Ralph; Grunze, Heinz; Frye, Mark; Suppes, Trisha; McElroy, Sue; Keck, Paul; Rowe, Mike

2013-01-01

Considerable data suggest that compared to some European countries, in the U.S. there are more childhood onset bipolar disorders, more adverse courses of illness, and greater treatment resistance. Psychosocial variables related to these findings have not been adequately explored. Therefore we

Illness Identity in Adults with a Chronic Illness.

Science.gov (United States)

Oris, Leen; Luyckx, Koen; Rassart, Jessica; Goubert, Liesbet; Goossens, Eva; Apers, Silke; Arat, Seher; Vandenberghe, Joris; Westhovens, René; Moons, Philip

2018-02-21

The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one's identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22-78 year old; n = 276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17-81 year old; n = 241). The IIQ could differentiate four illness identity states (i.e., engulfment, rejection, acceptance, and enrichment) in both samples, based on exploratory and confirmatory factor analysis. All four subscales proved to be reliable. Rejection and engulfment were related to maladaptive psychological and physical functioning, whereas acceptance and enrichment were related to adaptive psychological and physical functioning. The present findings underscore the importance of the concept of illness identity. The IIQ, a self-report questionnaire, is introduced to measure four different illness identity states in adults with a chronic illness.

A process to establish nutritional guidelines to address obesity: Lessons from Mexico.

Science.gov (United States)

Charvel, Sofia; Cobo, Fernanda; Hernández-Ávila, Mauricio

2015-11-01

In 2010, the Mexican government implemented a multi-sector agreement to prevent obesity. In response, the Ministries of Health and Education launched a national school-based policy to increase physical activity, improve nutrition literacy, and regulate school food offerings through nutritional guidelines. We studied the Guidelines' negotiation and regulatory review process, including government collaboration and industry response. Within the government, conflicting positions were evident: the Ministries of Health and Education supported the Guidelines as an effective obesity-prevention strategy, while the Ministries of Economics and Agriculture viewed them as potentially damaging to the economy and job generation. The food and beverage industries opposed and delayed the process, arguing that regulation was costly, with negative impacts on jobs and revenues. The proposed Guidelines suffered revisions that lowered standards initially put forward. We documented the need to improve cross-agency cooperation to achieve effective policymaking. The 'siloed' government working style presented a barrier to efforts to resist industry's influence and strong lobbying. Our results are relevant to public health policymakers working in childhood obesity prevention.

Design of the Lifestyle Interventions for severe mentally ill Outpatients in the Netherlands (LION) trial; a cluster randomised controlled study of a multidimensional web tool intervention to improve cardiometabolic health in patients with severe mental illness

NARCIS (Netherlands)

Looijmans, Anne; Jorg, Frederike; Bruggeman, Richard; Schoevers, Robert; Corpeleijn, Eva

2017-01-01

Background: The cardiometabolic health of persons with a severe mental illness (SMI) is alarming with obesity rates of 45-55% and diabetes type 2 rates of 10-15%. Unhealthy lifestyle behaviours play a large role in this. Despite the multidisciplinary guideline for SMI patients recommending to

[Mental health of children, adolescents and young adults--part 2: burden of illness, deficits of the German health care system and efficacy and effectiveness of early intervention services].

Science.gov (United States)

Karow, A; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Lambert, M

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use of children, adolescents and young adults is low, even lower than in adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the border of child and adolescent and adult psychiatry. Emerging studies show that these health care structures are effective and efficient. Part 2 of the present review focuses on illness burden including disability and costs, deficits of the present health care system in Germany, and efficacy and efficiency of early intervention services. © Georg Thieme Verlag KG Stuttgart · New York.

Early childhood adversities and risk of eating disorders in women: A Danish register-based cohort study.

Science.gov (United States)

Larsen, Janne Tidselbak; Munk-Olsen, Trine; Bulik, Cynthia M; Thornton, Laura M; Koch, Susanne Vinkel; Mortensen, Preben Bo; Petersen, Liselotte

2017-12-01

Previous studies evaluating the association between early childhood adversities and eating disorders have yielded conflicting results. The aim of this study is to examine the association between a range of adversities and risk of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS) in 495,244 women. In this nationwide, register-based cohort study, nine types of early childhood adversity (family disruption, residential instability, placement in out-of-home care, familial death, parental somatic illness, parental psychiatric illness, parental disability, severe parental criminality, and parental substance use disorder) were defined and exposure during the first 6 years of life was determined. Hazard ratios for eating disorders were calculated using Cox regression. Few adversities were significantly associated with AN, and for each, the presence of the adversity was associated with lower risk for AN. BN, and EDNOS were positively associated with several types of adversities. AN rates were unchanged or reduced by up to 54% by adversities, whereas rates of BN and EDNOS were unchanged or increased by adversities by up to 49 and 89%, respectively. Our findings indicate that childhood adversities appear to be associated with an increased risk of BN and in particular EDNOS, whereas they seem to be either unassociated or associated with a decreased risk of AN. © 2017 Wiley Periodicals, Inc.

The evidence-practice gap in specialist mental healthcare: systematic review and meta-analysis of guideline implementation studies.

Science.gov (United States)

Girlanda, Francesca; Fiedler, Ines; Becker, Thomas; Barbui, Corrado; Koesters, Markus

2017-01-01

Clinical practice guidelines are not easily implemented, leading to a gap between research synthesis and their use in routine care. To summarise the evidence relating to the impact of guideline implementation on provider performance and patient outcomes in mental healthcare settings, and to explore the performance of different strategies for guideline implementation. A systematic review of randomised controlled trials, controlled clinical trials and before-and-after studies comparing guideline implementation strategies v. usual care, and different guideline implementation strategies, in patients with severe mental illness. In total, 19 studies met our inclusion criteria. The studies did not show a consistent positive effect of guideline implementation on provider performance, but a more consistent small to modest positive effect on patient outcomes. Guideline implementation does not seem to have an impact on provider performance, nonetheless it may influence patient outcomes positively. © The Royal College of Psychiatrists 2017.

Implementing exertional heat illness prevention strategies in US high school football.

Science.gov (United States)

Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

2014-01-01

Approximately 6500 high school football athletes are treated annually for exertional heat illness (EHI). In 2009, the National Athletic Trainers Association (NATA)-led Inter-Association Task Force (NATA-IATF) released preseason heat acclimatization guidelines to help athletes become accustomed to environmental factors contributing to EHI. This study examines compliance with NATA-IATF guidelines and related EHI prevention strategies. The study used a cross-sectional survey completed by 1142 certified athletic trainers (AT), which captured compliance with 17 NATA-IATF guidelines and EHI prevention strategies in high school football during the 2011 preseason. On average, AT reported football programs complying with 10.4 NATA-IATF guidelines (SD = 3.2); 29 AT (2.5%) reported compliance with all 17. Guidelines with the lowest compliance were as follows: "Single-practice days consisted of practice no more than three hours in length" (39.7%); and "During days 3-5 of acclimatization, only helmets and shoulder pads should be worn" (39.0%). An average of 7.6 EHI prevention strategies (SD = 2.5) were used. Common EHI prevention strategies were as follows: having ice bags/cooler available (98.5%) and having a policy with written instructions for initiating emergency medical service response (87.8%). Programs in states with mandated guidelines had higher levels of compliance with guidelines and greater prevalence of EHI prevention strategies. A low proportion of surveyed high school football programs fully complied with all 17 NATA-IATF guidelines. However, many EHI prevention strategies were voluntarily implemented. State-level mandated EHI prevention guidelines may increase compliance with recognized best practices recommendations. Ongoing longitudinal monitoring of compliance is also recommended.

Complete mental health in adult siblings of those with a chronic illness or disability.

Science.gov (United States)

Hallion, Madeleine; Taylor, Amanda; Roberts, Rachel

2018-02-01

Sibling relationships have lifelong significance and childhood chronic illness and disability can have considerable impacts on healthy siblings, influencing development into adulthood. Research has not yet assessed well-being in this population using measures of both mental health and mental illness. Thus, this study assessed well-being in a comprehensive manner using the complete mental health (CMH) model. Participants (N = 144) included both adult siblings of those with chronic illness or disability and adults with healthy siblings. Measures of positive social, psychological and emotional well-being were used to assess mental health and a measure of depression, anxiety, and stress was used to assess mental illness. A high proportion of participants, both with and without siblings with a chronic illness or disability, were experiencing symptoms of mental illness, accompanied by high wellbeing. This indicates that many participants fit into the struggling category of the CMH model. The present research highlights the need for early intervention services to ensure that siblings of those with a chronic illness or disability are well supported in developing strengths, as well as managing difficulties. Results also indicate that targeting students in mental health promotion is important to encourage participation in services. Implications for rehabilitation Siblings of those with a chronic illness or disability need to be included in assessments in order to understand the experience of the family unit. It is important for families and clinicians to be aware of the needs of healthy siblings and encourage them to interact with support services in order to maximise and maintain well-being. Skills-based support could be beneficial, particularly for providing caregivers with strategies to meet the needs of both their child with a chronic illness or disability and their healthy children.

Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness.

Science.gov (United States)

Stanton, Robert; Rosenbaum, Simon; Lederman, Oscar; Happell, Brenda

2018-04-01

Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.

Childhood Bereavement and Lower Stress Resilience in Late Adolescence.

Science.gov (United States)

Kennedy, Beatrice; Chen, Ruoqing; Valdimarsdóttir, Unnur; Montgomery, Scott; Fang, Fang; Fall, Katja

2018-04-30

Although childhood traumatic experiences are recognized as important determinants for adolescent psychiatric health in general, our objective was to explore the specific influence of childhood bereavement on the stress resilience development trajectory. In this national register-based cohort study, we identified 407,639 men born in Sweden between 1973 and 1983, who underwent compulsory military enlistment examinations in late adolescence, including measures of psychological stress resilience. We defined exposure as loss of a first-degree family member in childhood, and estimated relative risk ratios (RRRs) for reduced (moderate or low), compared with high, stress resilience with 95% confidence intervals (CIs) using multinomial logistic regression. Loss of a parent or sibling in childhood conferred a 49% increased risk of subsequent low stress resilience (RRR, 1.49, 95% CI, 1.41-1.57) and an 8% increased risk of moderate stress resilience (RRR, 1.08, 95% CI, 1.03-1.13) in late adolescence. There was also a graded increase in risk with increasing age at loss; teenagers were at higher risk for low resilience (RRR, 1.64, 95% CI, 1.52-1.77) than children aged 7-12 (RRR, 1.47, 95% CI, 1.34-1.61) and ≤6 years (RRR, 1.16 95% CI, 1.02-1.32). The excess risk was observed for all causes of death, including suicide and unexpected deaths as well as deaths due to other illnesses. The associations remained after exclusion of parents with a history of hospitalization for psychiatric diagnoses. The long-term consequences of childhood bereavement may include lower stress resilience in late adolescence. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease.

Science.gov (United States)

Kuhlman, Kate Ryan; Chiang, Jessica J; Horn, Sarah; Bower, Julienne E

2017-09-01

Childhood adversity has been repeatedly and robustly linked to physical and mental illness across the lifespan. Yet, the biological pathways through which this occurs remain unclear. Functioning of the inflammatory arm of the immune system and the hypothalamic-pituitary-adrenal (HPA)-axis are both hypothesized pathways through which childhood adversity leads to disease. This review provides a novel developmental framework for examining the role of adversity type and timing in inflammatory and HPA-axis functioning. In particular, we identify elements of childhood adversity that are salient to the developing organism: physical threat, disrupted caregiving, and unpredictable environmental conditions. We propose that existing, well-characterized animal models may be useful in differentiating the effects of these adversity elements and review both the animal and human literature that supports these ideas. To support these hypotheses, we also provide a detailed description of the development and structure of both the HPA-axis and the inflammatory arm of the immune system, as well as recent methodological advances in their measurement. Recommendations for future basic, developmental, translational, and clinical research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Premorbid childhood ocular alignment abnormalities and adult schizophrenia-spectrum disorder

DEFF Research Database (Denmark)

Schiffman, Jason; Maeda, Justin A; Hayashi, Kentaro

2005-01-01

non-psychotic psychopathology and children who did not develop a mental illness. The mean rank for children in the high-risk group (offspring of parents with schizophrenia) on the eye scale and the strabismus scale was greater than the mean rank for children in the matched control groups (both...... offspring of parents with other non-psychotic disorder and no mental illness), although the results failed to reach statistical significance. Results from this study suggest a premorbid relation between ocular deficits and schizophrenia-spectrum disorders in childhood prior to onset of psychopathology....... All children whose mothers or fathers had a psychiatric diagnosis of schizophrenia comprised the first group (N=90). Children who had at least one parent with a diagnosis other than schizophrenia comprised the first matched control group (N=93). The second control group consisted of children...

Development of clinical practice guidelines for supportive care in childhood cancer-prioritization of topics using a Delphi approach

NARCIS (Netherlands)

Loeffen, E. A. H.; Mulder, R. L.; Kremer, L. C. M.; Michiels, E. M. C.; Abbink, F. C. H.; Ball, L. M.; Segers, H.; Mavinkurve-Groothuis, A. M. C.; Smit, F. J.; Vonk, I. J. M.; vd Wetering, M. D.; Tissing, W. J. E.

Currently, very few guidelines for supportive care for children with cancer exist. In the Netherlands, nationwide guidelines are over 10 years old and mostly based on expert opinion. Consequently, there is growing support and need for clinical practice guidelines (CPGs), which ought to be developed

Development of clinical practice guidelines for supportive care in childhood cancer--prioritization of topics using a Delphi approach

NARCIS (Netherlands)

Loeffen, E. A. H.; Mulder, R. L.; Kremer, L. C. M.; Michiels, E. M. C.; Abbink, F. C. H.; Ball, L. M.; Segers, H.; Mavinkurve-Groothuis, A. M. C.; Smit, F. J.; Vonk, I. J. M.; Vd Wetering, M. D.; Tissing, W. J. E.

2015-01-01

Currently, very few guidelines for supportive care for children with cancer exist. In the Netherlands, nationwide guidelines are over 10 years old and mostly based on expert opinion. Consequently, there is growing support and need for clinical practice guidelines (CPGs), which ought to be developed

Clinical practice guidelines in complementary and alternative medicine. An analysis of opportunities and obstacles. Practice and Policy Guidelines Panel, National Institutes of Health Office of Alternative Medicine.

Science.gov (United States)

1997-01-01

An estimated 1 of 3 Americans uses some form of complementary and alternative medicine (CAM), such as acupuncture, homeopathy, or herbal medicine. In 1995, the National Institutes of Health Office of Alternative Medicine convened an expert panel to examine the role of clinical practice guidelines in CAM. The panel concluded that CAM practices currently are unsuitable for the development of evidence-based practice guidelines, in part because of the lack of relevant outcomes data from well-designed clinical trials. Moreover, the notions of standardization and appropriateness, inherent in guideline development, face challenging methodologic problems when applied to CAM, which considers many different treatment practices appropriate and encourages highly individualized care. Due to different belief systems and divergent theories about the nature of health and illness, CAM disciplines have fundamental differences in how they define target conditions, causes of disease, interventions, and outcome measures of effectiveness. These differences are even more striking when compared with those used by Western medicine. The panel made a series of recommendations on strategies to strengthen the evidence base for future guideline development in CAM and to meet better the current information needs of clinicians, patients, and guideline developers who seek information about CAM treatments.

Psychopathology and self-esteem in chronic illness.

Science.gov (United States)

Pradhan, Prakash V; Shah, Henal; Rao, Pradeep; Ashturkar, Dhananjay; Ghaisas, Pradnya

2003-02-01

To evaluate psychopathology and self-esteem in chronic illness. 60 children and their parents were selected to participate in an open study. 30 children had epilepsy and the other 30 had thalassemia. Both the groups consisted of children randomly selected from the Epilepsy Clinic and Thalassemia Centre respectively, of a teaching general hospital. The children and their parents were interviewed and also rated on Childhood Psychopathology Measurement Schedule (CPMS) and Rosenberg's self esteem scale. The data was analysed using Pearson's chi square test and Pearson's correlation coefficient. The children were seen to have high psychopathology on CPMS (average score: thalassemia group = 28.56, epilepsy group = 26.06). Depression was the subscale with the maximum elevation in both groups. Behavior problems were high in epilepsy. In addition, sadness and disinterest in life were common symptoms in thalassemia while irritability and panic were high in epilepsy. Children with epilepsy perceived a change in lifestyle after diagnosis. Self-esteem was moderately affected in both groups and this affected compliance with treatment in thalassemia. Chronic illness affects psychological health and self esteem in children. Hence, in addition to the physical aspects it is necessary also, to focus on the psychological health of the child in order to ensure compliance and thus treat the child comprehensively.

Why should survivors of childhood renal tumor and others with only one kidney be denied the chance to play contact sports?

Science.gov (United States)

Spreafico, Filippo; Terenziani, Monica; van den Heuvel-Eibrink, Marry M; Pritchard-Jones, Kathy; Levitt, Gill; Graf, Norbert; Bergeron, Christophe; Massimino, Maura

2014-04-01

Over the last few decades advances in the treatment of childhood and young adult cancer have greatly improved survival. As a result most children diagnosed with Wilms' tumor (the most common renal tumor in childhood) or other renal tumors become long-term survivors, living with surgically solitary kidneys. As physical activity is gaining credibility as a therapy enhancing well-being, encouraging cancer survivors do exercise during adolescence and adulthood is advisable. Discussing current evidence-based information would help to provide a framework for the harmonization of guidelines for sport participation of childhood and young adult renal tumor survivors.

Effects of Omalizumab on Rhinovirus Infections, Illnesses, and Exacerbations of Asthma.

Science.gov (United States)

Esquivel, Ann; Busse, William W; Calatroni, Agustin; Togias, Alkis G; Grindle, Kristine G; Bochkov, Yury A; Gruchalla, Rebecca S; Kattan, Meyer; Kercsmar, Carolyn M; Khurana Hershey, G; Kim, Haejin; Lebeau, Petra; Liu, Andrew H; Szefler, Stanley J; Teach, Stephen J; West, Joseph B; Wildfire, Jeremy; Pongracic, Jaqueline A; Gern, James E

2017-10-15

Allergic inflammation has been linked to increased susceptibility to viral illnesses, but it is unclear whether this association is causal. To test whether omalizumab treatment to reduce IgE would shorten the frequency and duration of rhinovirus (RV) illnesses in children with allergic asthma. In the PROSE (Preventative Omalizumab or Step-up Therapy for Severe Fall Exacerbations) study, we examined children with allergic asthma (aged 6-17 yr; n = 478) from low-income census tracts in eight U.S. cities, and we analyzed virology for the groups randomized to treatment with guidelines-based asthma care (n = 89) or add-on omalizumab (n = 259). Weekly nasal mucus samples were analyzed for RVs, and respiratory symptoms and asthma exacerbations were recorded over a 90-day period during the fall seasons of 2012 or 2013. Adjusted illness rates (illnesses per sample) by treatment arm were calculated using Poisson regression. RVs were detected in 97 (57%) of 171 exacerbation samples and 2,150 (36%) of 5,959 nonexacerbation samples (OR, 2.32; P Omalizumab decreased the duration of RV infection (11.2 d vs. 12.4 d; P = 0.03) and reduced peak RV shedding by 0.4 log units (95% confidence interval, -0.77 to -0.02; P = 0.04). Finally, omalizumab decreased the frequency of RV illnesses (risk ratio, 0.64; 95% confidence interval, 0.49-0.84). In children with allergic asthma, treatment with omalizumab decreased the duration of RV infections, viral shedding, and the risk of RV illnesses. These findings provide direct evidence that blocking IgE decreases susceptibility to RV infections and illness. Clinical trial registered with www.clinicaltrials.gov (NCT01430403).

Promoting healthy lifestyles and decreasing childhood obesity: increasing physician effectiveness through advocacy.

Science.gov (United States)

Saxe, Jessica Schorr

2011-01-01

Childhood obesity is a well-documented public health crisis. Even many children who are not overweight have inadequate physical activity, poor nutrition, excessive television and other screen time, or some combination thereof. The solution lies in the community. Environmental interventions are among the most effective for improving public health. In addition to addressing lifestyle issues in the office, physicians should advocate for environmental approaches. We can advocate at institutional, local, state, and federal levels through speaking, writing, and collaborating with others. In the United States, the timing is right to synergize with efforts such as the White House Task Force on Childhood Obesity and the Surgeon General's emphasis on changing the national conversation "from a negative one about obesity and illness" to a positive one about health and fitness.

Psychiatrisch-psychotherapeutische Behandlung: Zwangs- und Ticstörungen bei Kindern und Jugendlichen

OpenAIRE

Brezinka, Veronika; Tagwerker, Frederika; Walitza, Susanne

2016-01-01

Compulsive and tic disorders are chronic, neuropsychiatric illnesses. Whilst compulsive disorders frequently, though not necessarily, appear during childhood or youth, tic disorders always do. More rapid detection and treatment of compulsive disorders coincide with more favorable clinical outcome. Guidelines by the American Academy of Child and Adolescent Psychiatry (AACAP) recommend behavioral therapy as a first- line treatment for mild to moderate symptoms, and a com...

Study about Illness: Through the Narrative of "Illness Image"

OpenAIRE

岩城, 晶子

2013-01-01

In this research, the meaning of the illness was studied from the perpective of Image. From listening to the narrative about two types of Illness Image, i.e., "my illness" and "A's illness, " we found that there was a characteristic that the Illness Image was similar to the real image. In addition, there were several differences between 2 images, which indicated that distance between the narrator and these images had an influence. From the syudy of two cases, it was indicated that Illness Ima...

Early Childhood Screen Time and Parental Attitudes Toward Child Television Viewing in a Low-Income Latino Population Attending the Special Supplemental Nutrition Program for Women, Infants, and Children.

Science.gov (United States)

Asplund, Karin M; Kair, Laura R; Arain, Yassar H; Cervantes, Marlene; Oreskovic, Nicolas M; Zuckerman, Katharine E

2015-10-01

Early childhood media exposure is associated with obesity and multiple adverse health conditions. The aims of this study were to assess parental attitudes toward childhood television (TV) viewing in a low-income population and examine the extent to which child BMI, child/parent demographics, and household media environment are associated with adherence to American Academy of Pediatrics (AAP) guidelines for screen time. This was a cross-sectional survey study of 314 parents of children ages 0-5 years surveyed in English or Spanish by self-administered questionnaire at a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinic in Oregon. In this majority Latino sample (73%), half (53%) of the children met AAP guidelines on screen time limits, 56% met AAP guidelines for no TV in the child's bedroom, and 29% met both. Children were more likely to meet AAP guidelines when there were child screen time. Programs aimed at reducing child screen time may benefit from interventions that address parental viewing habits.

Identifying faecal impaction is important for ensuring the timely diagnosis of childhood functional constipation

DEFF Research Database (Denmark)

Modin, Line; Walsted, Anne-Mette; Jakobsen, Marianne Skytte

2015-01-01

AIM: Most research on functional constipation has been carried out at a tertiary level. We focused this study on a secondary-level hospital outpatients' department, assessing the distribution of diagnostic criteria for childhood functional constipation and evaluating the consequences of current...... diagnostic practice based on current guidelines. METHODS: We enrolled 235 children, aged two to 16 years of age, with functional constipation according to the Rome III criteria and assessed them using medical histories and physical examinations, including rectal examinations and ultrasound measurements...... the timely diagnosis of childhood functional constipation at the secondary care level. Ultrasound examination proved a reliable alternative to rectal examination or abdominal radiography when identifying faecal impaction....

Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults.

Science.gov (United States)

Björkenstam, Emma; Hjern, Anders; Mittendorfer-Rutz, Ellenor; Vinnerljung, Bo; Hallqvist, Johan; Ljung, Rickard

2013-01-01

Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR) with 95% confidence intervals (CIs) using logistic regression analysis. Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3-2.5) and for men 3.1 (95% CI 2.9-3.2). The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences.

Adverse Childhood Environment: Relationship With Sexual Risk Behaviors and Marital Status in a Large American Sample.

Science.gov (United States)

Anderson, Kermyt G

2017-01-01

A substantial theoretical and empirical literature suggests that stressful events in childhood influence the timing and patterning of subsequent sexual and reproductive behaviors. Stressful childhood environments have been predicted to produce a life history strategy in which adults are oriented more toward short-term mating behaviors and less toward behaviors consistent with longevity. This article tests the hypothesis that adverse childhood environment will predict adult outcomes in two areas: risky sexual behavior (engagement in sexual risk behavior or having taken an HIV test) and marital status (currently married vs. never married, divorced, or a member of an unmarried couple). Data come from the Behavioral Risk Factor Surveillance System. The sample contains 17,530 men and 23,978 women aged 18-54 years living in 13 U.S. states plus the District of Columbia. Adverse childhood environment is assessed through 11 retrospective measures of childhood environment, including having grown up with someone who was depressed or mentally ill, who was an alcoholic, who used or abused drugs, or who served time in prison; whether one's parents divorced in childhood; and two scales measuring childhood exposure to violence and to sexual trauma. The results indicate that adverse childhood environment is associated with increased likelihood of engaging in sexual risk behaviors or taking an HIV test, and increased likelihood of being in an unmarried couple or divorced/separated, for both men and women. The predictions are supported by the data, lending further support to the hypothesis that childhood environments influence adult reproductive strategy.

Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults.

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Emma Björkenstam

Full Text Available PURPOSE: Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. METHODS: This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR with 95% confidence intervals (CIs using logistic regression analysis. RESULTS: Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3-2.5 and for men 3.1 (95% CI 2.9-3.2. The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. CONCLUSIONS: Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences.

Official Executive Summary of an American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline

DEFF Research Database (Denmark)

Schmidt, Gregory A; Girard, Timothy D; Kress, John P

2017-01-01

BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A mult...

Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

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Kirschenbaum, Daniel S.; Gierut, Kristen

2013-01-01

Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

Modulation of HPA axis response to social stress in schizophrenia by childhood trauma.

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Lange, Claudia; Huber, Christian G; Fröhlich, Daniela; Borgwardt, Stefan; Lang, Undine E; Walter, Marc

2017-08-01

HPA axis functioning plays an important role in the etiology of schizophrenia spectrum disorders (SSD). However, only few studies have examined HPA axis responsivity to psychosocial stress in SSD, and results are heterogeneous. Furthermore, childhood trauma is known to influence psychopathology and treatment outcome in SSD, but studies on the influence of childhood trauma on stress related HPA axis activity are missing. The purpose of this study was to investigate cortisol response to a psychosocial stress challenge in SSD patients, and to examine its association with severity of childhood trauma. The present study included 25 subacutely ill patients with a current episode of a chronic SSD and 25 healthy controls. Participants underwent the modified Trier Social Stress Test, and salivary cortisol levels were assessed. The childhood trauma questionnaire was used to assess severity of adverse life events. Overall, cortisol response was blunted in the patient group compared to the control group (pchildhood trauma experience: responders had experienced more emotional abuse in their past (pchildhood trauma might influence stress-related HPA axis activity in SSD. Our data contribute to the hypothesis that severity of childhood trauma may be of pathophysiological relevance in schizophrenia. In addition, it may be an overlooked factor contributing to inconsistent findings regarding HPA axis response to psychosocial stress in SSD. Copyright © 2017. Published by Elsevier Ltd.

Culturally Informed Social Work Practice with American Indian Clients: Guidelines for Non-Indian Social Workers.

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Williams, Edith Ellison; Ellison, Florence

1996-01-01

Culturally informed social work health and mental health interventions directed toward American Indian clients must be harmonious with their environment and acculturation. Discusses American Indian beliefs about health and illness and degrees of acculturation. Guidelines are offered to help non-Indian social workers design culturally appropriate…

[Children of mentally ill parents. Research perspectives exemplified by children of depressed parents].

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Mattejat, F; Wüthrich, C; Remschmidt, H

2000-03-01

Children of psychiatrically ill parents represent a risk group that has received growing attention during the last years. The risk for this group to develop a psychiatric illness is markedly increased due to genetic and psychosocial factors. The development of effective preventive concepts requires a thorough knowledge of the psychosocial factors. In this paper, deficits and problems of research in psychosocial transmission mechanism are discussed taking the example of children of depressive parents. Conclusions from this exemplary considerations may serve as guidelines for future research. The authors suggest that the focus be rather placed on coping strategies and developmental psychopathology. Further, research criteria are formulated that refer to theoretical models as well as to study design.

Arte: Un Programa Creativo Para Ninos Pre-Escolares (Art: A Creative Curriculum for Early Childhood).

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Creative Associates, Inc., Washington, DC.

Written in Spanish and focusing on art activities for early childhood education, this manual provides guidelines for Spanish-speaking teachers of preschool and primary school children. The content of the manual is oriented to the learning styles and special interests of Spanish-speaking children. Part One defines artistic activity in the preschool…

How do general practitioners use 'safety netting' in acutely ill children?

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Bertheloot, Karen; Deraeve, Pieterjan; Vermandere, Mieke; Aertgeerts, Bert; Lemiengre, Marieke; De Sutter, An; Buntinx, Frank; Verbakel, Jan Y

2016-01-01

'Safety netting' advice allows general practitioners (GPs) to cope with diagnostic uncertainty in primary care. It informs patients on 'red flag' features and when and how to seek further help. There is, however, insufficient evidence to support useful choices regarding 'safety netting' procedures. To explore how GPs apply 'safety netting' in acutely ill children in Flanders. We designed a qualitative study consisting of semi-structured interviews with 37 GPs across Flanders. Two researchers performed qualitative analysis based on grounded theory components. Although unfamiliar with the term, GPs perform 'safety netting' in every acutely ill child, guided by their intuition without the use of specific guidelines. They communicate 'red flag' features, expected time course of illness and how and when to re-consult and try to tailor their advice to the context, patient and specific illness. Overall, GPs perceive 'safety netting' as an important element of the consultation, acknowledging personal and parental limitations, such as parents' interpretation of their advice. GPs do not feel a need for any form of support in the near future. GPs apply 'safety netting' intuitively and tailor the content. Further research should focus on the impact of 'safety netting' on morbidity and how the advice is conveyed to parents.

Attorney General forces Infectious Diseases Society of America to redo Lyme guidelines due to flawed development process.

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Johnson, L; Stricker, R B

2009-05-01

Lyme disease is one of the most controversial illnesses in the history of medicine. In 2006 the Connecticut Attorney General launched an antitrust investigation into the Lyme guidelines development process of the Infectious Diseases Society of America (IDSA). In a recent settlement with IDSA, the Attorney General noted important commercial conflicts of interest and suppression of scientific evidence that had tainted the guidelines process. This paper explores two broad ethical themes that influenced the IDSA investigation. The first is the growing problem of conflicts of interest among guidelines developers, and the second is the increasing centralisation of medical decisions by insurance companies, which use treatment guidelines as a means of controlling the practices of individual doctors and denying treatment for patients. The implications of the first-ever antitrust investigation of medical guidelines and the proposed model to remediate the tainted IDSA guidelines process are also discussed.

Enhancing the passing moments: An educational criticism of family visits to an early childhood science exhibition

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Munroe, Elizabeth Ann

This educational criticism describes and interprets the nature of family visits to an early childhood science exhibition, Working Wonders, at The Science Centre in Calgary, Alberta. The specific exhibits are described and features that contributed to exhibit popularity are examined. Examples of visitors' interactions with each exhibit are given. The visit experiences of four families are described in detail and analyzed. Typical family visitors' reactions, expectations, and experiences are summarized. Because one of the mutual expectations of the granting agency, The Science Centre, and the adult visitors was that a visit to the exhibition would be educational, the family visits are examined for instances of learning and analyzed to determine the factors that influenced the learning. Constructivism forms the basis for understanding the process of learning during family visits. The analysis is supported by reference to research from the fields of museum studies, education, and environmental design. The analysis of the educational significance and potential of family visits to an early childhood exhibition leads to the conclusion that specific features may facilitate learning in such an environment. Those features are represented in a set of guidelines for the development and evaluation of early childhood exhibitions. The guidelines suggest attention must be given to the ambience of the space, the general layout of the space, the exhibits, the copy and graphics, additional programs and information, the subtle influences of the building and the staff, and the learning processes of young children, adults, and intergenerational groups. The guidelines suggest specific issues to consider to develop a space that is stimulating and memorable, responsive to the needs of the two distinct visitor groups (young children and adults), and conducive to learning.

Epilepsy and vaccinations: Italian guidelines.

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Pruna, Dario; Balestri, Paolo; Zamponi, Nelia; Grosso, Salvatore; Gobbi, Giuseppe; Romeo, Antonino; Franzoni, Emilio; Osti, Maria; Capovilla, Giuseppe; Longhi, Riccardo; Verrotti, Alberto

2013-10-01

Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Compliance with nutrition support guidelines in acutely burned patients.

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Holt, Brennen; Graves, Caran; Faraklas, Iris; Cochran, Amalia

2012-08-01

Adequate and timely provision of nutritional support is a crucial component of care of the critically ill burn patient. The goal of this study was to assess a single center's consistency with Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for nutritional support in critically ill patients. Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review. Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay. Descriptive statistics were used for all analyses. IRB approval was obtained. Thirty-seven patients were included in this retrospective review. Median age of patients was 44.9 years (IQR: 24.2-55.1), and median burn injury size was 30% (IQR: 19-47). Median time to feeding tube placement was 31.1h post admission (IQR: 23.6-50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4-59.9h). The median time required for patients to reach 60% of caloric goal was 3 days post-admission (IQR: 3-4.5). The median time for initiation of enteral nutrition was within the SCCM/ASPEN guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Global challenges with scale-up of the integrated management of childhood illness strategy: results of a multi-country survey

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Muhe Lulu M

2011-06-01

Full Text Available Abstract Background The Integrated Management of Childhood Illness Strategy (IMCI, developed by WHO/UNICEF, aims to contribute to reducing childhood morbidity and mortality (MDG4 in resource-limited settings. Since 1996 more than 100 countries have adopted IMCI. IMCI case management training (ICMT is one of three IMCI components and training is usually residential over 11 consecutive days. Follow-up after ICMT is an essential part of training. We describe the barriers to rapid acceleration of ICMT and review country perspectives on how to address these barriers. Methods A multi-country exploratory cross-sectional questionnaire survey of in-service ICMT approaches, using quantitative and qualitative methods, was conducted in 2006-7: 27 countries were purposively selected from all six WHO regions. Data for this paper are from three questionnaires (QA, QB and QC, distributed to selected national focal IMCI persons/programme officers, course directors/facilitators and IMCI trainees respectively. QC only gathered data on experiences with IMCI follow-up. Results 33 QA, 163 QB and 272 QC were received. The commonest challenges to ICMT scale-up relate to funding (high cost and long duration of the residential ICMT, poor literacy of health workers, differing opinions about the role of IMCI in improving child health, lack of political support, frequent changes in staff or rules at Ministries of Health and lack of skilled facilitators. Countries addressed these challenges in several ways including increased advocacy, developing strategic linkages with other priorities, intensifying pre-service training, re-distribution of funds and shortening course duration. The commonest challenges to follow-up after ICMT were lack of funding (93.1% of respondents, inadequate funds for travelling or planning (75.9% and 44.8% respectively, lack of gas for travelling (41.4%, inadequately trained or few supervisors (41.4% and inadequate job aids for follow-up (27

The Medical Transition from Pediatric to Adult-Oriented Care: Considerations for Child and Adolescent Psychiatrists.

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Hart, Laura C; Maslow, Gary

2018-01-01

More adolescents and young adults are surviving previously fatal childhood illness and need support to transition from pediatric care to adult-oriented care. There are many barriers, but guidelines and tools assist providers with emphasis on gradually addressing transition with patients and families. Child and adolescent psychiatrists should be particularly attuned to the needs of adolescents with previously identified mental illness who are at high risk of falling out of regular care during transition. Providers are also uniquely suited to address the needs of adolescents and young adults with intellectual and developmental disabilities. Copyright © 2017 Elsevier Inc. All rights reserved.

Feasibility of a transition intervention aimed at adolescents with chronic illness

DEFF Research Database (Denmark)

Hanghøj, Signe; Boisen, Kirsten A; Schmiegelow, Kjeld

2018-01-01

BACKGROUND: International guidelines recommend planned and structured transition programmes for adolescents with chronic illness because inadequate transition may lead to poor disease control and risk of lacking outpatient follow-up. OBJECTIVE: To investigate the feasibility of a transition...... intervention. Reasons for decline and drop-outs were calculated. Adolescents' experiences of advantages and disadvantages of participating and reasons for no-shows were investigated through focus groups and telephone interviews, which were analysed using thematic analysis. RESULTS: One hundred and twenty...

Childhood maltreatment, psychopathology, and the development of hippocampal subregions during adolescence.

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Whittle, Sarah; Simmons, Julian G; Hendriksma, Sylke; Vijayakumar, Nandita; Byrne, Michelle L; Dennison, Meg; Allen, Nicholas B

2017-02-01

It is well established that childhood maltreatment has a detrimental impact on the brain, particularly the hippocampus. However, the hippocampus is a functionally and structurally heterogeneous region, and little is known about how maltreatment might affect hippocampal subregion development throughout important periods of plasticity. This study investigated whether childhood maltreatment was associated with the development of hippocampal subregion volumes from early to late adolescence. It also investigated associations between onset of psychiatric disorder and hippocampal subregion volume development. One hundred and sixty-six (85 male) adolescents took part in three magnetic resonance imaging assessments during adolescence (mean age at each assessment: 12.79 [ SD 0.43] years, 16.70 [ SD 0.52] years, and 19.08 [ SD 0.46] years), provided a self-report of childhood maltreatment, and were assessed for Axis I psychopathology. Childhood maltreatment was associated with the development of right total and left cornu ammonis 4 (CA4-DG) volumes from early to late adolescence. Early and late onset psychopathology was associated with the development of right presubiculum and right cornu ammonis 1 (CA1) volumes, respectively. Maltreatment findings appeared to be specific to males, whereas psychopathology findings appeared to be specific to females. These findings provide evidence for possible deleterious effects of childhood maltreatment and early onset psychiatric disorder on the development of different subregions of the hippocampus. Altered development of the right CA1, on the other hand, might precede the development of late-adolescent onset psychopathology. Our results highlight the importance of considering development in research examining associations between stress, mental illness, and hippocampal morphology.

Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature.

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McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia

2012-06-01

Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Childhood adversity and cognitive function in schizophrenia spectrum disorders and healthy controls: evidence for an association between neglect and social cognition.

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Kilian, S; Asmal, L; Chiliza, B; Olivier, M R; Phahladira, L; Scheffler, F; Seedat, S; Marder, S R; Green, M F; Emsley, R

2017-12-22

Childhood adversity is associated with cognitive impairments in schizophrenia. However, findings to date are inconsistent and little is known about the relationship between social cognition and childhood trauma. We investigated the relationship between childhood abuse and neglect and cognitive function in patients with a first-episode of schizophrenia or schizophreniform disorder (n = 56) and matched healthy controls (n = 52). To the best of our knowledge, this is the first study assessing this relationship in patients and controls exposed to similarly high levels of trauma. Pearson correlational coefficients were used to assess correlations between Childhood Trauma Questionnaire abuse and neglect scores and cognition. For the MCCB domains displaying significant (p childhood neglect remained a significant predictor of impairment in social cognition in both patients and controls. Neglect was also a significant predictor of poorer verbal learning in patients and of attention/vigilance in controls. However, childhood abuse did not significantly predict cognitive impairments in either patients or controls. These findings are cross sectional and do not infer causality. Nonetheless, they indicate that associations between one type of childhood adversity (i.e. neglect) and social cognition are present and are not illness-specific.

Disparities in adverse childhood experiences among sexual minority and heterosexual adults: results from a multi-state probability-based sample.

Directory of Open Access Journals (Sweden)

Judith P Andersen

Full Text Available Adverse childhood experiences (e.g., physical, sexual and emotional abuse, neglect, exposure to domestic violence, parental discord, familial mental illness, incarceration and substance abuse constitute a major public health problem in the United States. The Adverse Childhood Experiences (ACE scale is a standardized measure that captures multiple developmental risk factors beyond sexual, physical and emotional abuse. Lesbian, gay, and bisexual (i.e., sexual minority individuals may experience disproportionately higher prevalence of adverse childhood experiences.To examine, using the ACE scale, prevalence of childhood physical, emotional, and sexual abuse and childhood household dysfunction among sexual minority and heterosexual adults.Analyses were conducted using a probability-based sample of data pooled from three U.S. states' Behavioral Risk Factor Surveillance System (BRFSS surveys (Maine, Washington, Wisconsin that administered the ACE scale and collected information on sexual identity (n = 22,071.Compared with heterosexual respondents, gay/lesbian and bisexual individuals experienced increased odds of six of eight and seven of eight adverse childhood experiences, respectively. Sexual minority persons had higher rates of adverse childhood experiences (IRR = 1.66 gay/lesbian; 1.58 bisexual compared to their heterosexual peers.Sexual minority individuals have increased exposure to multiple developmental risk factors beyond physical, sexual and emotional abuse. We recommend the use of the Adverse Childhood Experiences scale in future research examining health disparities among this minority population.

The International Childhood Cardiovascular Cohort (i3C) consortium outcomes study of childhood cardiovascular risk factors and adult cardiovascular morbidity and mortality: Design and recruitment.

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Sinaiko, Alan R; Jacobs, David R; Woo, Jessica G; Bazzano, Lydia; Burns, Trudy; Hu, Tian; Juonala, Markus; Prineas, Ronald; Raitakari, Olli; Steinberger, Julia; Urbina, Elaine; Venn, Alison; Jaquish, Cashell; Dwyer, Terry

2018-04-22

Although it is widely thought that childhood levels of cardiovascular (CV) risk factors are related to adult CV disease, longitudinal data directly linking the two are lacking. This paper describes the design and organization of the International Childhood Cardiovascular Cohort Consortium Outcomes Study (i3C Outcomes), the first longitudinal cohort study designed to locate adults with detailed, repeated, childhood biological, physical, and socioeconomic measurements and a harmonized database. I3C Outcomes uses a Heart Health Survey (HHS) to obtain information on adult CV endpoints, using mail, email, telephone, and clinic visits in the United States (U.S.) and Australia and a national health database in Finland. Microsoft Access, REsearch Data Capture (REDCap) (U.S.), LimeSurvey (Australia), and Medidata™ Rave data systems are used to collect, transfer and organize data. Self-reported CV events are adjudicated via hospital and doctor-released medical records. After the first two study years, participants (N = 10,968) were more likely to be female (56% vs. 48%), non-Hispanic white (90% vs. 80%), and older (10.4 ± 3.8 years vs. 9.4 ± 3.3 years) at their initial childhood study visit than the currently non-recruited cohort members. Over 48% of cohort members seen during both adulthood and childhood have been found and recruited, to date, vs. 5% of those not seen since childhood. Self-reported prevalences were 0.7% Type 1 Diabetes, 7.5% Type 2 Diabetes, 33% hypertension, and 12.8% CV event. 32% of CV events were judged to be true. I3C Outcomes is uniquely able to establish evidence-based guidelines for child health care and to clarify relations to adult CV disease. Copyright © 2018 Elsevier Inc. All rights reserved.

Paediatric chronic illness and educational failure: the role of emotional and behavioural problems.

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Layte, Richard; McCrory, Cathal

2013-08-01

Chronic illness in childhood is associated with worse educational outcomes. The association is usually explained via lowered cognitive development, decreased readiness to learn and school absence. However, this paper examines whether worse psychological adjustment may also play a role. We use data from the Growing Up in Ireland study, a cohort study, which collected data on 8,568 nine-year-old children through the Irish national school system using a two-stage sampling method. Maximum likelihood path analytic models are used to assess the direct effect of child chronic illness on reading and maths test scores and the mediating role of emotional and behavioural problems. In unadjusted analyses, children with a mental and behavioural condition scored 14.5 % points less on reading tests and 16.9 % points less on maths tests than their healthy peers. Children with non-mental and behavioural conditions scored 3 % points less on both tests, a significant difference. Mental and behavioural (OR, 9.58) and other chronic conditions (OR, 1.61) were significantly more likely to have 'high' levels of difficulties on the SDQ. Path analysis models showed that the association between chronic illness and educational test scores was completely mediated by emotional and behavioural problems controlling for school absence and bullying by peers. Child and adolescent chronic illness can have significant effects on educational development and a long-lasting impact on future life-chances. The psychological adjustment of the child is important in mediating the effect of chronic illness on educational outcomes. Interventions should target this developmental pathway.

Do Childhood Adversities Predict Suicidality? Findings from the General Population of the Metropolitan Area of Sao Paulo, Brazil.

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Bruno Mendonça Coêlho

Full Text Available Childhood adversities have been associated with a number of medical and psychiatric outcomes. However, the reported effects that specific childhood adversities have on suicidality vary across studies.This was a cross-sectional, stratified, multistage area probability investigation of a general population in Brazil, designated the São Paulo Megacity Mental Health Survey. The World Mental Health Composite International Diagnostic Interview was applied in 5037 individuals ≥ 18 years of age, in order to assess 12 different adversities occurring during childhood and/or adolescence, as well as to look for associations between those adversities and subsequent suicidality in different age strata.Over half of the respondents reported at least one childhood adversity. Only physical abuse was consistently associated with suicide attempts in all subsequent life stages (OR = 2.1. Among adults 20-29 years of age, the likelihood of a suicide attempt was correlated with parental divorce, whereas suicidal ideation was associated with prior sexual abuse. Among adults over 30 years of age, physical illness and economic adversity emerged as relevant childhood adversities associated with suicide attempts, whereas sexual abuse, family violence, and economic adversity were associated with suicidal ideation.Childhood adversities, especially physical abuse, are likely associated with unfavorable consequences in subsequent years. For suicidality across a lifespan, the role of different childhood adversities must be examined independently.

Reports of chronic pain in childhood and adolescence among patients at a tertiary care pain clinic.

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Hassett, Afton L; Hilliard, Paul E; Goesling, Jenna; Clauw, Daniel J; Harte, Steven E; Brummett, Chad M

2013-11-01

Although chronic pain in childhood can last into adulthood, few studies have evaluated the characteristics of adults with chronic pain who report childhood chronic pain. Thus, 1,045 new patients (mean age, 49.5 ± 15.4) at an academic tertiary care pain clinic were prospectively evaluated using validated self-report questionnaires. Patients also responded to questions about childhood pain. We found that almost 17% (n = 176) of adult chronic pain patients reported a history of chronic pain in childhood or adolescence, with close to 80% indicating that the pain in childhood continues today. Adults reporting childhood chronic pain were predominantly female (68%), commonly reported widespread pain (85%), and had almost 3 times the odds of meeting survey criteria for fibromyalgia (odds ratio [OR] = 2.94, 95% confidence interval [CI] = 2.04-4.23) than those denying childhood chronic pain. Similarly, those with childhood pain had twice the odds of having biological relatives with chronic pain (OR = 2.03, 95% CI = 1.39-2.96) and almost 3 times the odds of having relatives with psychiatric illness (OR = 2.85, 95% CI = 1.97-4.11). Lastly, compared to patients who did not report childhood chronic pain, those who did were more likely to use neuropathic descriptors for their pain (OR = 1.82, 95% CI = 1.26-2.64), have slightly worse functional status (B = -2.12, t = -3.10, P = .002), and have increased anxiety (OR = 1.77, 95% CI = 1.24-2.52). Our study revealed that 1 in 6 adult pain patients reported pain that dated back to childhood or adolescence. In such patients, evidence suggested that their pain was more likely to be widespread, neuropathic in nature, and accompanied by psychological comorbidities and decreased functional status. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

Obesity in childhood and adolescence: evidence based clinical and public health perspectives

OpenAIRE

Reilly, J J

2006-01-01

A global epidemic of paediatric obesity occurred in recent years, and prevalence of obesity is continuing to rise. In the developed world obesity is now the most common disease of childhood and adolescence. Paediatric obesity is not a cosmetic issue, being associated with a significant burden of ill health both for obese children and for adults who were obese as children. Health professionals tend to underestimate the impact of paediatric obesity, and lack the skills, knowledge, and time to t...

The effects of breastfeeding on childhood BMI: a propensity score matching approach.

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Gibson, Laura A; Hernández Alava, Mónica; Kelly, Michael P; Campbell, Michael J

2017-12-01

Many studies have found a statistical association between breastfeeding and childhood adiposity. This paper investigates whether breastfeeding has an effect on subsequent childhood body mass index (BMI) using propensity scores to account for confounding. We use data from the Millennium Cohort Study, a nationally representative UK cohort survey, which contains detailed information on infant feeding and childhood BMI. Propensity score matching is used to investigate the mean BMI in children breastfed exclusively and partially for different durations of time. We find statistically significant influences of breastfeeding on childhood BMI, particularly in older children, when breastfeeding is prolonged and exclusive. At 7 years, children who were exclusively breastfed for 16 weeks had a BMI 0.28 kg/m2 (95% confidence interval 0.07 to 0.49) lower than those who were never breastfed, a 2% reduction from the mean BMI of 16.6 kg/m2. For this young cohort, even small effects of breastfeeding on BMI could be important. In order to reduce BMI, breastfeeding should be encouraged as part of wider lifestyle intervention. This evidence could help to inform public health bodies when creating public health guidelines and recommendations. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health.

Intra-household relations and treatment decision-making for childhood illness: a Kenyan case study.

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Molyneux, C S; Murira, G; Masha, J; Snow, R W

2002-01-01

This study, conducted on the Kenyan coast, assesses the effect of intra-household relations on maternal treatment-seeking. Rural and urban Mijikenda mothers' responses to childhood fevers in the last 2 weeks (n=317), and to childhood convulsions in the previous year (n=43), were documented through survey work. The intra-household relations and decision-making dynamics surrounding maternal responses were explored through in-depth individual and group interviews, primarily with women (n=223). Responses to convulsions were more likely than responses to fevers to include a healer consultation (p<0.0001), and less likely to include the purchase of over-the-counter medications (p<0.0001). Mothers received financial or advisory assistance from others in 71% (n=236) of actions taken outside the household in response to fevers. In-depth interviews suggested that general agreement on appropriate therapy results in relatively few intra-household conflicts over the treatment of fevers. Disputes over perceived cause and appropriate therapy of convulsions, however, highlighted the importance of age, gender and relationship to household head in intra-household relations and treatment decision-making. Although mothers' treatment-seeking preferences are often circumscribed by these relations, a number of strategies can be drawn upon to circumvent 'inappropriate' decisions, sometimes with implications for future household responses to similar syndromes. The findings highlight the complexity of intra-household relations and treatment decision-making dynamics. Tentative implications for interventions aimed at improving the home management of malaria, and for further research, are presented.

Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines

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Mary-Ann Fitzcharles

2013-01-01

Full Text Available Objectives. Fibromyalgia syndrome (FMS, characterized by subjective complaints without physical or biomarker abnormality, courts controversy. Recommendations in recent guidelines addressing classification and diagnosis were examined for consistencies or differences. Methods. Systematic searches from January 2008 to February 2013 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, Guidelines International Network, and Medline for evidence-based guidelines for the management of FMS were conducted. Results. Three evidence-based interdisciplinary guidelines, independently developed in Canada, Germany, and Israel, recommended that FMS can be clinically diagnosed by a typical cluster of symptoms following a defined evaluation including history, physical examination, and selected laboratory tests, to exclude another somatic disease. Specialist referral is only recommended when some other physical or mental illness is reasonably suspected. The diagnosis can be based on the (modified preliminary American College of Rheumatology (ACR 2010 diagnostic criteria. Discussion. Guidelines from three continents showed remarkable consistency regarding the clinical concept of FMS, acknowledging that FMS is neither a distinct rheumatic nor mental disorder, but rather a cluster of symptoms, not explained by another somatic disease. While FMS remains an integral part of rheumatology, it is not an exclusive rheumatic condition and spans a broad range of medical disciplines.

Efficacy of cognitive-behavioral therapy for childhood anxiety and depression.

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Crowe, Katherine; McKay, Dean

2017-06-01

A review of meta-analyses of cognitive-behavioral therapy (CBT) for childhood anxiety and depression was conducted. A total of 36 meta-analyses were identified that met inclusion criteria for this review. In most cases, medium-to-large effect sizes for treatment reduction were observed when CBT was compared to non-active control conditions. Small-to-medium effects were observed when CBT was compared to active control treatments. The available meta-analyses generally did not examine, or data were not sufficient to evaluate, potential moderators of outcome, differential effects for parental involvement, or changes in quality of life or functional outcomes associated with treatment. Accordingly, while CBT should be broadly considered an effective treatment approach for childhood anxiety and depression, additional research is warranted in order to establish guidelines for service delivery for complicating factors in client presentation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review.

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Bennett, Sophie; Shafran, Roz; Coughtrey, Anna; Walker, Susan; Heyman, Isobel

2015-04-01

Children with chronic physical illness are significantly more likely to develop common psychiatric symptoms than otherwise healthy children. These children therefore warrant effective integrated healthcare yet it is not established whether the known, effective, psychological treatments for symptoms of common childhood mental health disorders work in children with chronic physical illness. EMBASE, MEDLINE, PsycINFO and CINAHL databases were searched with predefined terms relating to evidence-based psychological interventions for psychiatric symptoms in children with chronic physical illness. We included all studies (randomised and non-randomised designs) investigating interventions aimed primarily at treating common psychiatric symptoms in children with a chronic physical illness in the review. Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality analysis. Ten studies (209 children, including 70 in control groups) met the criteria for inclusion in the review. All studies demonstrated some positive outcomes of cognitive behavioural therapy for the treatment of psychiatric symptoms in children with chronic physical illness. Only two randomised controlled trials, both investigating interventions for symptoms of depression, were found. There is preliminary evidence that cognitive behavioural therapy has positive effects in the treatment of symptoms of depression and anxiety in children with chronic physical illness. However, the current evidence base is weak and fully powered randomised controlled trials are needed to establish the efficacy of psychological treatments in this vulnerable population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Evidence to modify guidelines for routine retinopathy of prematurity screening to avoid childhood blindness in middle-income countries

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Miroslava Paolah Meraz-Gutiérrez

2016-07-01

Conclusions: These findings show that the valid guidelines at the time of the screening were based on a different population and were not sufficient to detect all ROP cases in a middle-income country. With the update of the Mexican guidelines established in July 2015, the patients from this study would have been screened. Therefore, review and modification of the current screening guidelines in other middle-income countries should be considered to include all babies at risk for ROP.

Design as if people matter: aesthetic guidelines for the wind industry

International Nuclear Information System (INIS)

Gipe, P.

1995-01-01

Opinion surveys show that wind has high public support, but a worrisome NIMBY factor. This support erodes once specific projects are proposed. Because support is fragile and can be squandered by ill-conceived projects, the industry must do everything it can to ensure that wind turbines and wind power plants become good neighbours. One means of maximizing acceptance is to incorporate aesthetic guidelines into the design of wind turbines and wind power plants. (Author)

Reproductive health in young male adults with chronic diseases in childhood.

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De Sanctis, Vincenzo; Soliman, Ashraf; Mohamed, Yassin

2013-01-01

The Centres for Disease Control and Prevention have defined a chronic diseases as an "illnesses that are prolonged, do not resolve spontaneously, and are rarely cured completely". Approximately 20% of all children have a chronic illness and 65% of them the illness is severe enough to interfere with daily activities. Failure of pubertal growth, delay or absence of sexual development, infertility and sexual dysfunction due to hypogonadism and defective spermatogenesis are well recognized disturbances among adolescents and young male adult patients with chronic diseases. The causes are multifactorial and can be due to disease itself, associated complications or drugs. Haemoglobinopathies, endocrine disorders, gastrointestinal and renal diseases are some examples that frequently cause some degree of disability. Infertility affects the future quality of life of these patients and is a predictor of stress in current and future relationships. Health care providers often neglect the reproductive health of chronically ill adolescents and young adults, although many studies indicate that they are sexually active and interested in knowing about their future fertility. This review article provides an overview of the literature concerning the impact of some chronic diseases in adolescents and young adults on reproductive health but will not address patients with cancer because it has been tackled adequately in the literature.MEDLINE database search of English-language medical journal articles published between 1975 and 2012 for papers related to reproductive health in adolescents and young adults with chronic diseases since childhood was done. Several Authors, recommend that all young adult patients with severe/prolonged chronic disease in childhood should be offered reproductive health care in a specialized center with appropriate expertise, involving a multidisciplinary team, including endocrinologists, andrologists, geneticists, psychologists, urologists and specialist

Developing Professional Ethics for Social Educators and Early Childhood Educators in Denmark

DEFF Research Database (Denmark)

Ribers, Bjørn

2016-01-01

Over the last two decades, Danish labour unions have been working continuously on developing professional ethical codes and guidelines for social educators and early childhood and youth educators in Denmark. The majority of empirical research projects studying ethical dimensions of social work...... empirical research results on ethical issues in the professional practice and in the education of welfare professionals. The paper discusses the current state of professional ethics in childhood and youth work and debates the constellation between educational policies, the political process of developing...... and education in Denmark has not previously been published for an international audience. Consequently, many of the important findings and insights remain accessible only in Danish research reports, books and articles written in Danish or other Scandinavian languages. The scope of this paper is to discuss...

Treatment actions and treatment failure: case studies in the response to severe childhood febrile illness in Mali

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Ellis Amy A

2012-11-01

Full Text Available Abstract Background Appropriate home management of illness is vital to efforts to control malaria. The strategy of home management relies on caregivers to recognize malaria symptoms, assess severity and promptly seek appropriate care at a health facility if necessary. This paper examines the management of severe febrile illness (presumed malaria among children under the age of five in rural Koulikoro Region, Mali. Methods This research examines in-depth case studies of twenty-five households in which a child recently experienced a severe febrile illness, as well as key informant interviews and focus group discussions with community members. These techniques were used to explore the sequence of treatment steps taken during a severe illness episode and the context in which decisions were made pertaining to pursing treatments and sources of care, while incorporating the perspective and input of the mother as well as the larger household. Results Eighty-one participants were recruited in 25 households meeting inclusion criteria. Children's illness episodes involved multiple treatment steps, with an average of 4.4 treatment steps per episode (range: 2–10. For 76% of children, treatment began in the home, but 80% were treated outside the home as a second recourse. Most families used both traditional and modern treatments, administered either inside the home by family members, or by traditional or modern healers. Participants’ stated preference was for modern care, despite high rates of reported treatment failure (52%, n=12, however, traditional treatments were also often deemed appropriate and effective. The most commonly cited barrier to seeking care at health facilities was cost, especially during the rainy season. Financial constraints often led families to use traditional treatments. Conclusions Households have few options available to them in moments of overlapping health and economic crises. Public health research and policy should focus on

Child behaviour problems and childhood illness: development of the Eczema Behaviour Checklist.

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Mitchell, A E; Morawska, A; Fraser, J A; Sillar, K

2017-01-01

Children with atopic dermatitis are at increased risk of both general behaviour problems, and those specific to the condition and its treatment. This can hamper the ability of parents to carry out treatment and manage the condition effectively. To date, there is no published instrument available to assess child behaviour difficulties in the context of atopic dermatitis management. Our aim was to develop a reliable and valid instrument to assess atopic dermatitis-specific child behaviour problems, and parents' self-efficacy (confidence) for managing these behaviours. The Eczema Behaviour Checklist (EBC) was developed as a 25-item questionnaire to measure (i) extent of behaviour problems (EBC Extent scale), and (ii) parents' self-efficacy for managing behaviour problems (EBC Confidence scale), in the context of child atopic dermatitis management. A community-based sample of 292 parents completed the EBC, measures of general behaviour difficulties, self-efficacy with atopic dermatitis management and use of dysfunctional parenting strategies. There was satisfactory internal consistency and construct validity for EBC Extent and Confidence scales. There was a negative correlation between atopic dermatitis-specific behaviour problems and parents' self-efficacy for dealing with behaviours (r = -.53, p behaviours; (ii) symptom-related behaviours; and (iii) behaviours related to impact of the illness. Variation in parents' self-efficacy for managing their child's atopic dermatitis was explained by intensity of illness-specific child behaviour problems and parents' self-efficacy for dealing with the behaviours. The new measure of atopic dermatitis-specific child behaviour problems was a stronger predictor of parents' self-efficacy for managing their child's condition than was the measure of general child behaviour difficulties. Results provide preliminary evidence of reliability and validity of the EBC, which has potential for use in clinical and research settings, and

Early Childhood Screen Time and Parental Attitudes Toward Child Television Viewing in a Low-Income Latino Population Attending the Special Supplemental Nutrition Program for Women, Infants, and Children

OpenAIRE

Asplund, Karin M.; Kair, Laura R.; Arain, Yassar H.; Cervantes, Marlene; Oreskovic, Nicolas M.; Zuckerman, Katharine E.

2015-01-01

Background: Early childhood media exposure is associated with obesity and multiple adverse health conditions. The aims of this study were to assess parental attitudes toward childhood television (TV) viewing in a low-income population and examine the extent to which child BMI, child/parent demographics, and household media environment are associated with adherence to American Academy of Pediatrics (AAP) guidelines for screen time.

Divorce and Childhood Chronic Illness: A Grounded Theory of Trust, Gender, and Third-Party Care Providers.

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Russell, Luke T; Coleman, Marilyn; Ganong, Lawrence H; Gayer, Debra

2016-05-01

Divorced parents face distinct challenges in providing care for chronically ill children. Children's residence in two households necessitates the development of family-specific strategies to ensure coparents' supervision of regimen adherence and the management of children's health care. Utilizing a risk and resilience perspective, a grounded theory study was conducted with 14 divorced parents of children with chronic illnesses. The importance of trust, gender, and relationships with third-party care providers emerged as key themes related to the development of effective coparenting relationships for maintaining children's health. Divorced parents were best able to support the management of their children's chronic conditions when care providers operated as neutral third parties and intermediaries. Collaborative family care may require health care practitioners to avoid being drawn into contentious inter-parental conflicts. © The Author(s) 2016.

Ventilator-associated pneumonia management in critical illness.

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Albertos, Raquel; Caralt, Berta; Rello, Jordi

2011-03-01

Ventilator-associated pneumonia (VAP) is a frequent adverse event in the intensive care unit.We review recent publications about the management and prevention of VAP. The latest care bundles introduced standard interventions to facilitate implementation of evidence-based clinical guidelines and to improve the outcome of patients. Recent studies find that prevention management of ventilated patients decreases the risk of VAP. Enteral feeding, considered a risk factor for VAP, currently has been recommended, with appropriate administration, for all critical ill patients if no contraindications exist. In view of the recently available data, it can be concluded that the implementation of care bundles on the general management of ventilated patients in daily practice has reduced the VAP rates. The main pharmacological measures to prevent VAP are proper hands hygiene, high nurse-to-patient ratio, avoid unnecessary transfer of ventilated patients, use of noninvasive mechanical ventilation, shortening weaning period, avoid the use of nasal intubation, prevent bio-film deposition in endotracheal tube, aspiration of subglottic secretions, maintenance of adequate pressure of endotracheal cuffs, avoid manipulation of ventilator circuits, semi-recumbent position and adequate enteral feeding.In addition, updated guidelines incorporate more comprehensive diagnostic protocols to the evidence-based management of VAP.

Mental Illness

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... the same time. For example, you may have depression and a substance use disorder. Complications Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include: ...

Evaluation and treatment of childhood physical abuse and neglect: a review.

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Cummings, Marissa; Berkowitz, Steven J

2014-01-01

According to 2010 CDC estimates, 1 in 5 US children have experienced maltreatment. Risk factors for child maltreatment include child characteristics such as non-compliance and diagnostic conditions that increase caregiver burden. Parent characteristic risk factors include parental mental illness and low social support. New developments in radiologic evaluation of child maltreatment will be reviewed. New findings in evidence based psychotherapies for childhood maltreatment will be discussed. A review of the role of pharmacotherapy in child maltreatment cases will also be presented. New evidence from prevention models targeting young mothers and families are also reviewed.

Microbiological Guideline Values for Recreational Bathing in Canada: Time for Change?

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Benoit Lévesque

2007-01-01

Full Text Available Recreational bathing is an activity practiced by thousands of Canadians every year. While its health benefits are numerous, bathing in polluted water can also be a source of health problems. These problems are generally nonspecific and are difficult to detect through usual health monitoring systems. Most involve ear and eye ailments, febrile respiratory illness and, particularly, gastroenteritis. In 1992, Health Canada recommended microbiological guideline values for recreational water quality. The values are based on the presence of fecal indicator bacteria, namely, enterococci for marine water, and Escherichia coli or fecal coliforms for fresh water. In marine water, the guideline value is set at 35 enterococci/100 mL, while in fresh water, the standard is 200 E coli/100 mL or 200 fecal coliforms/100 mL when experience demonstrates that over 90% of the fecal coliforms are E coli. Notwithstanding certain variances, many Canadian provinces apply these guidelines. However, in Ontario, the guideline is 100 E coli/100 mL. Over the past several years, many epidemiological studies, including randomized clinical trials, have examined the relationship between bathing in polluted water and ensuing health problems. On review of this literature, the Canadian guideline values for marine water seems appropriate, but scientific evidence argues toward lowering the Canadian guideline values for fresh water to 100 E coli/100 mL, in line with the standard currently in effect in Ontario.

The experience of childhood trauma and its influence on the course of illness in first-episode psychosis

DEFF Research Database (Denmark)

Jansen, Jens Einar; Pedersen, Marlene Buch; Trauelsen, Anne Marie

2016-01-01

Persons with schizophrenia spectrum disorders often report high levels of childhood trauma, which often exacerbates symptoms and impede the process of recovery. However, little is known about how these traumas are experienced by service users and how they are integrated in their life stories...

Illness perception and related behaviour in lower respiratory tract infections—a European study

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Hordijk, Patricia M; Broekhuizen, Berna D L; Butler, Chris C; Coenen, Samuel; Godycki-Cwirko, Maciek; Goossens, Herman; Hood, Kerry; Smith, Richard; van Vugt, Saskia F; Little, Paul; Verheij, Theo J M

2015-01-01

Background. Lower respiratory tract infection (LRTI) is a common presentation in primary care, but little is known about associated patients’ illness perception and related behaviour. Objective. To describe illness perceptions and related behaviour in patients with LRTI visiting their general practitioner (GP) and identify differences between European regions and types of health care system. Methods. Adult patients presenting with acute cough were included. GPs recorded co morbidities and clinical findings. Patients filled out a diary for up to 4 weeks on their symptoms, illness perception and related behaviour. The chi-square test was used to compare proportions between groups and the Mann-Whitney U or Kruskal Wallis tests were used to compare means. Results. Three thousand one hundred six patients from 12 European countries were included. Eighty-one per cent (n = 2530) of the patients completed the diary. Patients were feeling unwell for a mean of 9 (SD 8) days prior to consulting. More than half experienced impairment of normal or social activities for at least 1 week and were absent from work/school for a mean of 4 (SD 5) days. On average patients felt recovered 2 weeks after visiting their GP, but 21% (n = 539) of the patients did not feel recovered after 4 weeks. Twenty-seven per cent (n = 691) reported feeling anxious or depressed, and 28% (n = 702) re-consulted their GP at some point during the illness episode. Reported illness duration and days absent from work/school differed between countries and regions (North-West versus South-East), but there was little difference in reported illness course and related behaviour between health care systems (direct access versus gate-keeping). Conclusion. Illness course, perception and related behaviour in LRTI differ considerably between countries. These finding should be taken into account when developing International guidelines for LRTI and interventions for setting realistic expectations about illness course

Associations between Stereotype Awareness, Childhood Trauma and Psychopathology: A Study in People with Psychosis, Their Siblings and Controls

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van Zelst, Catherine; van Nierop, Martine; van Dam, Daniëlla S.; Bartels-Velthuis, Agna A.; Delespaul, Philippe

2015-01-01

Introduction Stereotype awareness—or an individual’s perception of the degree to which negative beliefs or stereotypes are held by the public—is an important factor mediating public stigma, self-stigma and their negative consequences. Research is required to assess how individuals become more sensitive to perceive stereotypes, pointing the way to therapeutic options to reduce its negative effects and increase stigma resilience. Because perception and interpretation can be guided by belief systems, and childhood trauma (CT) is reported to impact such beliefs, CT is explored in relation to stereotype awareness (SA) in persons with psychosis, their siblings and controls. Method Data from the GROUP project (Genetic Risk and Outcome of Psychosis) were analyzed. SA was measured by devaluation scales which assess a respondent’s perception of the degree to which stereotypes about people with mental illness and about their families are held by the public. CT was measured using the Childhood Trauma Questionnaire (short form). Results In patients, symptoms of disorganization and emotional distress were associated with SA about people with mental illness. In siblings, schizotypal features were associated with both types of SA (more schizotypy = more SA). In both patients and siblings, CT was associated with both types of SA (more CT = more SA), independent of symptoms (patients) or schizotypy (siblings). Conclusion CT in people with psychosis and their siblings may sensitize to SA. Thus, CT may not only impact on risk for illness onset, it may also increase SA associated with mental illness, potentially interfering with the recovery process. CT-induced SA may indicate a heightened sensitivity to threat, which may also impact psychopathology. PMID:25705878

Associations between stereotype awareness, childhood trauma and psychopathology: a study in people with psychosis, their siblings and controls.

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Catherine van Zelst

Full Text Available Stereotype awareness--or an individual's perception of the degree to which negative beliefs or stereotypes are held by the public--is an important factor mediating public stigma, self-stigma and their negative consequences. Research is required to assess how individuals become more sensitive to perceive stereotypes, pointing the way to therapeutic options to reduce its negative effects and increase stigma resilience. Because perception and interpretation can be guided by belief systems, and childhood trauma (CT is reported to impact such beliefs, CT is explored in relation to stereotype awareness (SA in persons with psychosis, their siblings and controls.Data from the GROUP project (Genetic Risk and Outcome of Psychosis were analyzed. SA was measured by devaluation scales which assess a respondent's perception of the degree to which stereotypes about people with mental illness and about their families are held by the public. CT was measured using the Childhood Trauma Questionnaire (short form.In patients, symptoms of disorganization and emotional distress were associated with SA about people with mental illness. In siblings, schizotypal features were associated with both types of SA (more schizotypy = more SA. In both patients and siblings, CT was associated with both types of SA (more CT = more SA, independent of symptoms (patients or schizotypy (siblings.CT in people with psychosis and their siblings may sensitize to SA. Thus, CT may not only impact on risk for illness onset, it may also increase SA associated with mental illness, potentially interfering with the recovery process. CT-induced SA may indicate a heightened sensitivity to threat, which may also impact psychopathology.

Implementing local projects to reduce the stigma of mental illness.

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Warner, Richard

2008-01-01

This editorial describes strategies used and the lessons learned in implementing two local anti-stigma projects. The WPA Programme to Reduce Stigma and Discrimination Because of Schizophrenia established projects to fight stigma in 20 countries, using social-marketing techniques to enhance their effectiveness. First steps at each site were to establish an action committee and conduct a survey of perceived stigma. Based on survey results, the action committees selected a few homogeneous and accessible target groups, such as employers, and criminal justice personnel. Messages and media were selected, tested, and refined. Guidelines are provided for setting up a consumer (service-user) speakers' bureau and for establishing a media-watch organization, which can lobby news and entertainment media to exclude negative portrayals of people with mental illness. Improvements in knowledge about mental illness were effected in high school students and criminal justice personnel. Positive changes in attitude towards people with mental illness were achieved with high school students, but were more difficult to achieve with police officers. Local antistigma projects can be effective in reducing stigma and relatively inexpensive. The involvement of consumers is important in working with police officers. Project organizers should be on the lookout for useful changes that can become permanent.

Needs, expectations and consequences for children growing up in a family where the parent has a mental illness.

Science.gov (United States)

Tabak, Izabela; Zabłocka-Żytka, Lidia; Ryan, Peter; Poma, Stefano Zanone; Joronen, Katja; Viganò, Giovanni; Simpson, Wendy; Paavilainen, Eija; Scherbaum, Norbert; Smith, Martin; Dawson, Ian

2016-08-01

The lack of pan-European guidelines for empowering children of parents with mental illness led to the EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The aim of this initial task in the project was to analyse needs, expectations and consequences for children with respect to living with a parent with mental illness from the perspective of professionals and family members. This qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland with 96 professionals, parents with mental illness, adult children and partners of parents with mental illness. A framework analysis method was used. Results of the study highlighted that the main consequences described for children of parental mental illness were role reversal; emotional and behavioural problems; lack of parent's attention and stigma. The main needs of these children were described as emotional support, security and multidisciplinary help. Implications for practice are that professionals working with parents with mental illness should be aware of the specific consequences for the children and encourage parents in their parental role; multi-agency collaboration is necessary; schools should provide counselling and prevent stigma. © 2016 Australian College of Mental Health Nurses Inc.

Gender-related dimensions of childhood adversities in the general population.

Science.gov (United States)

Coêlho, Bruno M; Santana, Geilson L; Viana, Maria C; Andrade, Laura H; Wang, Yuan-Pang

2018-06-11

Childhood adversities (CAs) comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women. Parental mental illness, substance misuse, criminality, death, divorce, other parental loss, family violence, physical abuse, sexual abuse, neglect, physical illness, and economic adversity were assessed in a general-population sample (n=5,037). Exploratory and confirmatory factor analysis determined gender-related dimensions of CA. The contribution of each individual adversity was explored through Rasch analysis. Adversities were reported by 53.6% of the sample. A three-factor model of CA dimensions fit the data better for men, and a two-factor model for women. For both genders, the dimension of family maladjustment - encompassing physical abuse, neglect, parental mental disorders, and family violence - was the core cluster of CAs. Women endorsed more CAs than men. Rasch analysis found that sexual abuse, physical illness, parental criminal behavior, parental divorce, and economic adversity were difficult to report in face-to-face interviews. CAs embrace sensitive personal information, clustering of which differed by gender. Acknowledging CAs may have an impact on medical and psychiatric outcomes in adulthood.

Gender-related dimensions of childhood adversities in the general population

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Bruno M. Coêlho

2018-06-01

Full Text Available Objective: Childhood adversities (CAs comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women. Methods: Parental mental illness, substance misuse, criminality, death, divorce, other parental loss, family violence, physical abuse, sexual abuse, neglect, physical illness, and economic adversity were assessed in a general-population sample (n=5,037. Exploratory and confirmatory factor analysis determined gender-related dimensions of CA. The contribution of each individual adversity was explored through Rasch analysis. Results: Adversities were reported by 53.6% of the sample. A three-factor model of CA dimensions fit the data better for men, and a two-factor model for women. For both genders, the dimension of family maladjustment – encompassing physical abuse, neglect, parental mental disorders, and family violence – was the core cluster of CAs. Women endorsed more CAs than men. Rasch analysis found that sexual abuse, physical illness, parental criminal behavior, parental divorce, and economic adversity were difficult to report in face-to-face interviews. Conclusion: CAs embrace sensitive personal information, clustering of which differed by gender. Acknowledging CAs may have an impact on medical and psychiatric outcomes in adulthood.

Childhood Risk Factors in Substance Abuse Among a Group of Abuser 20-30 Year-Old Group in Tehran

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A.R. Zahiredin

2004-01-01

Full Text Available Substance use disorder is the second most common psychiatric disorders and is far more prevalent among young adults (ages;18-34y/0. Because of its importance and main effect in society, this study performed for evaluation of association fourteen childhood and adoleseence pathologic factors with substance use disorder among a group of abuser (20-30/0that referred to five addiction center in Tehran . The sample consist 100 patient: including 50 case and 50 control who were selected by DSM- IV based semi-structured diagnostic interviews for decrease memory biases in this retrospective cohart study. The patient’s parents also evaluated by DSM- IV based Semi-structured diagnostic interviews. The analysis showed significant relation between: parents control on the siblings, addiction in relatives of pt (except parents, addicted peers and friends, to be affected with the peers and friends and substance use disorder at the ages (20-30y/o. There wasn’t any association between: Disruptive childhood behaviors (under 11y/o, diagnosed medical illness (under 11y/o diagnosed Psychiatric illness (under 6 mo , family size, socio economic state and substance use disorder at the age(20-30y/0 . Finally some childhood and adolescence pathologic factors has association with Substance use disorder at the ages ( 20-30y/5 that these can be used for education all planning , prevention , design high risk group and remedical plans.

Urinary tract infection in children: Diagnosis, treatment, imaging - Comparison of current guidelines.

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Okarska-Napierała, M; Wasilewska, A; Kuchar, E

2017-12-01

Urinary tract infection (UTI) is a frequent disorder of childhood, yet the proper approach for a child with UTI is still a matter of controversy. The objective of this study was to critically compare current guidelines for the diagnosis and management of UTI in children, in light of new scientific data. An analysis was performed of the guidelines from: American Academy of Pediatrics (AAP), National Institute for Health and Care Excellence (NICE), Italian Society of Pediatric Nephrology, Canadian Paediatric Society (CPS), Polish Society of Pediatric Nephrology, and European Association of Urology (EAU)/European Society for Pediatric Urology (ESPU). Separate aspects of the approach for a child with UTI, including diagnosis, treatment and further imaging studies, were compared, with allowance for recent research in each field. The analyzed guidelines tried to reconcile recent reports about diagnosis, treatment, and further diagnostics in pediatric UTI with prior practices and opinions, and economic capabilities. There was still a lack of sufficient data to formulate coherent, unequivocal guidelines on UTI management in children, with imaging tests remaining the main area of controversy. As a result, the authors formulated their own proposal for UTI management in children. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Folic acid, one-carbon metabolism & childhood cancer

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Nirmalya Roy Moulik

2017-01-01

Full Text Available Folate has been studied in relation to many diseases, especially cancer. Although it has been postulated to exert a dual effect on development of cancer, its role remains to be clearly defined. Its effect on cancer is the result of gene-nutrient interaction between the genes in folate metabolic pathway and dietary folate availability; mutations in genes of folate metabolism have been shown to alter individual susceptibility to certain childhood cancers as well as response to cancer chemotherapy. Although mandatory fortification of food items with folate has been initiated in some countries, many countries are yet to adopt this due to concerns about undesired adverse effects of high folate levels on health, especially cancer. However, initial reports suggest that folate fortification has led to reduction in incidence of certain childhood cancers such as neuroblastoma, wilms tumour and leukaemias. Despite studies showing folate depletion during antifolate chemotherapy and higher toxicity of chemotherapy in folate-depleted individuals, folate supplementation during cancer chemotherapy is not routinely recommended. Studies investigating the precise effect of folate supplementation during chemotherapy on both short- and long-term outcomes of cancer are needed to arrive at a consensus guideline.

Parenting and Childhood Chronicity: making visible the invisible work.

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Ray, Lynne D

2002-12-01

The work required to raise a child with a chronic illness or disability is above and beyond that of raising a typical child. This article presents a model, Parenting and Childhood Chronicity (PACC), that was developed during an interpretive study with 43 parents of 34 children (aged 15 months to 16 years) with various chronic conditions, is presented. "Special needs parenting" describes the additional care that a child needs and includes medical care, parenting plus, and working the systems. "Minimizing consequences" reflects the struggle to balance the rest of family life and includes parenting siblings, maintaining relationships, and keeping yourself going. Copyright 2002, Elsevier Science (USA). All rights reserved.

Childhood dyspraxia predicts adult-onset nonaffective-psychosis-spectrum disorder

DEFF Research Database (Denmark)

Schiffman, Jason; Mittal, Vijay; Kline, Emily

2015-01-01

abnormalities spanning functionally distinct brain networks) specifically predict adult nonaffective-psychosis-spectrum disorders are consistent with a theory of abnormal connectivity, and they highlight a marked early-stage vulnerability in the pathophysiology of nonaffective-psychosis-spectrum disorders.......Several neurological variables have been investigated as premorbid biomarkers of vulnerability for schizophrenia and other related disorders. The current study examined whether childhood dyspraxia predicted later adult nonaffective-psychosis-spectrum disorders. From a standardized neurological...... showed higher scores on the dyspraxia scale predict nonaffective-psychosis-spectrum disorders relative to other psychiatric disorders and no mental illness outcomes, even after controlling for genetic risk, χ2 (4, 244) = 18.61, p

Predictive value of IL-35 and IL-17 in diagnosis of childhood asthma.

Science.gov (United States)

Mansour, Amira Ibrahim; Abd Almonaem, Eman Rateb; Behairy, Ola Galal; Gouda, Tahany Mahmoud

2017-09-01

This study aimed to evaluate the correlation between serum levels of IL-17 and IL-35 and the presence and severity of childhood asthma. The study was performed on 60 diagnosed asthmatic children, who were further classified into four groups according to the Global Initiative for Asthma Guidelines for Asthma Severity and Control (GINA) 2016, plus 30 age- and sex-matched apparently healthy children. All participants were subjected to full medical history, clinical examination, pulmonary function tests and laboratory evaluation in the form of complete blood count (CBC), serum total IgE, IL-17 and IL-35 by ELISA. Our results revealed that eosinophils count, IgE and IL-17 were significantly higher in the asthmatic group than the control group (p 13.1 pg/mL; this value could predict childhood asthma with sensitivity of 81.7% and 83.3%, and specificity of 76.7% and 70%, respectively. A combination of both cytokines yielded an increase in sensitivity to 95%. In conclusion, in the current study, IL-17 is upregulated while IL-35 is downregulated in childhood asthma with a significant negative correlation between both. These results suggest that both may play an important role in the pathogenesis of childhood asthma.

Childhood Mental Ability and Lifetime Psychiatric Contact: A 66-Year Follow-Up Study of the 1932 Scottish Mental Ability Survey.

Science.gov (United States)

Walker, Nicholas P.; McConville, Pauline M; Hunter, David; Deary, Ian J.; Whalley, Lawrence J.

2002-01-01

Tested the hypothesis that intelligence is related to the risk of mental illness by linking childhood mental ability data to registers of psychiatric contact in a stable population of 4,199 adults in Scotland. Findings show intelligence to be an independent predictor of psychiatric contact, with each standard deviation decrease in IQ resulting in…

Hodgkin Illness in the childhood. Results with combined treatment of OPPA with radiotherapy

International Nuclear Information System (INIS)

Terselich z, Gretti

1999-01-01

A retrospective revision was made (not randomized) among the years 1988 and 1997, of patients histories that had entered the INC for treatment for the Hodgkin illness. All the cases, patient smaller than 16 years were studied, that had not been treated in other centers neither it had received another oncospecific treatment. The sheets or the anatomy-pathology study were revised, being remarkable that for but of 10 years the histology study is in charge of oneself pathologists' group. In total 144 patients were recruited; 29 were excluded: 2 for treatments in other centers, 17 to only have received radiotherapy, 9 to receive other outlines of treatment chemo therapeutic and a patient to reject the treatment; finally 115 patients were studied. To all they were made complete analysis of hematology with erythro sedimentation and serology for hepatitis study B and C. Biopsy of bony marrow was not made in the I and II states; echography and thorax X rays, was made to all patients but the TAC it could not be carried out to all for logistical difficulties; in some patients the corporal journey was made with gammagraphy, using gallium. The final results showed a complete answer in 100 patients (87%). There were 7 deaths: 2 for causes different to the illness, one for sepsis for klebsiella, one for cardio toxicity for anthracycline, 2 for abandonment of the treatment and 3 patients got lost. 13 patients were presented with neutropenia, 3 patients with pneumonia, 1 with chicken pox and 2 with sepsis. The global survival is of 90%

Adalimumab for treating childhood plaque psoriasis: a clinical trial evaluation.

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Di Lernia, Vito

2017-12-01

Most systemic therapies have not been systematically investigated in moderate to severe childhood plaque psoriasis. Evidence on the efficacy and safety of systemic treatments is limited and therapeutic guidelines are lacking. Recently adalimumab, a fully human monoclonal antibody that binds tumor necrosis factor (TNF)- alpha, was investigated in childhood psoriasis. Adalimumab is licensed for many inflammatory conditions including chronic plaque psoriasis in adults. Areas covered: A randomized phase III study published provided favourable efficacy and safety data of adalimumab in childhood psoriasis. The active comparator was methotrexate. After 16 weeks of treatment, a PASI 75 score was achieved in 58% of patients within the adalimumab 0.8 mg/kg group compared with 32% of patients within the methotrexate group. Safety data gave no evidence of drug-related serious adverse events and no organ toxicity. This is the first randomised controlled study of either adalimumab or methotrexate in children and adolescents with psoriasis. Expert opinion: The aforementioned trial was the first to provide clinical data on adalimumab's efficacy and safety in the short term when treating children and adolescents with psoriasis. Through the use of an active comparator, this study has opened the way for the future assessment of systemic therapies in children and adolescent with this condition.

Childhood Obesity

OpenAIRE

Trandafir, Laura Mihaela; Ioniuc, Ileana; Miron, Ingrith

2017-01-01

Childhood obesity has important consequences for health and wellbeing both during childhood and also in later adult life. The rising prevalence of childhood obesity poses a major public health challenge in both developed and developing countries by increasing the burden of chronic non-communicable diseases. Despite the urgent need for effective preventative strategies, there remains disagreement over its definition due to a lack of evidence on the optimal cut-offs linking childhood BMI to dis...

Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol

OpenAIRE

von Kobyletzki, Laura Beate; Beckman, Linda; Smeeth, Liam; McKee, Martin; Quint, Jennifer K; Abuabara, Katrina; Langan, Sinead

2017-01-01

Introduction Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the a...

Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

NARCIS (Netherlands)

Koolen, B.B.; Pijnenburg, M.W.; Brackel, H.J.; Landstra, A.M.; Berg, N.J. van den; Merkus, P.J.F.M.; Hop, W.C.J.; Vaessen-Verberne, A.A.

2011-01-01

Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children. 145 children with

Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence.

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Schomerus, G; Matschinger, H; Angermeyer, M C

2014-01-01

There is an ongoing debate whether biological illness explanations improve tolerance towards persons with mental illness or not. Several theoretical models have been proposed to predict the relationship between causal beliefs and social acceptance. This study uses path models to compare different theoretical predictions regarding attitudes towards persons with schizophrenia, depression and alcohol dependence. In a representative population survey in Germany (n = 3642), we elicited agreement with belief in biogenetic causes, current stress and childhood adversities as causes of either disorder as described in an unlabelled case vignette. We further elicited potentially mediating attitudes related to different theories about the consequences of biogenetic causal beliefs (attribution theory: onset responsibility, offset responsibility; genetic essentialism: differentness, dangerousness; genetic optimism: treatability) and social acceptance. For each vignette condition, we calculated a multiple mediator path model containing all variables. Biogenetic beliefs were associated with lower social acceptance in schizophrenia and depression, and with higher acceptance in alcohol dependence. In schizophrenia and depression, perceived differentness and dangerousness mediated the largest indirect effects, the consequences of biogenetic causal explanations thus being in accordance with the predictions of genetic essentialism. Psychosocial causal beliefs had differential effects: belief in current stress as a cause was associated with higher acceptance in schizophrenia, while belief in childhood adversities resulted in lower acceptance of a person with depression. Biological causal explanations seem beneficial in alcohol dependence, but harmful in schizophrenia and depression. The negative correlates of believing in childhood adversities as a cause of depression merit further exploration.

The hidden penalties of gender inequality: fetal origins of ill-health.

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Osmani, Siddiq; Sen, Amartya

2003-01-01

This paper is concerned with the interconnections between gender inequality and maternal deprivation, on the one hand, and the health of children (of either sex) and of adults that the children grow into (again, of either sex). The basic message of the paper is that women's deprivation in terms of nutrition and healthcare rebounds on the society as a whole in the form of ill-health of their offspring-males and females alike-both as children and as adults. There are a variety of pathways through which women's deprivation can affect the health of the society as a whole. This paper focuses on the pathways that operate through undernourishment of the mother. Maternal deprivation adversely affects the health of the fetus, which in turn leads to long-term health risks that extend not just into childhood but into adulthood as well. There are, however, important differences in the way children and adults experience the consequences of maternal deprivation via fetal deprivation. In particular, the pathways that lead to their respective risk factors and the circumstances under which those risk factors actually translate into ill-health are very different. These differences are best understood through the concept of 'overlapping health transition' in which two different regimes of diseases coexist side by side. Gender inequality exacerbates the old regime of diseases among the less affluent through the pathway of childhood undernutrition. At the same time it also exacerbates the new regime of diseases among the relatively more affluent through a pathway that has come to be known as the 'Barker hypothesis'. Gender inequality thus leads to a double jeopardy-simultaneously aggravating both regimes of diseases and thus raising the economic cost of overlapping health transition.

Diet Quality throughout Early Life in Relation to Allergic Sensitization and Atopic Diseases in Childhood

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Anh N. Nguyen

2017-08-01

Full Text Available Early-life nutrition is an important modifiable determinant in the development of a child’s immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations of diet quality in early life with allergic sensitization, self-reported physician-diagnosed inhalant and food allergies, eczema, and asthma among 5225 children participating in a population-based cohort in the Netherlands. Diet was assessed during pregnancy, infancy, and childhood using validated food-frequency questionnaires. We calculated food-based diet quality scores (0–10 or 0–15, reflecting adherence to dietary guidelines. At age 10 years, allergic sensitization was assessed with skin prick tests. Information on physician-diagnosed inhalant and food allergies, eczema, and asthma was obtained with questionnaires. We observed no associations between diet quality during pregnancy and allergic sensitization (odds ratio (OR = 1.05 per point in the diet score, 95% confidence interval (CI: 0.99, 1.13, allergies (0.96, 95% CI: 0.88, 1.04, eczema (0.99, 95% CI: 0.93, 1.06, or asthma (0.93, 95% CI: 0.85, 1.03 in childhood. Also, diet quality in infancy or childhood were not associated with atopic outcomes in childhood. Our findings do not support our hypothesis that a healthy dietary pattern in early life is associated with a lower risk of allergic sensitization or atopic diseases in childhood.

Variations in the sleep–wake cycle from childhood to adulthood: chronobiological perspectives

Directory of Open Access Journals (Sweden)

Carpenter JS

2015-07-01

Full Text Available Joanne S Carpenter, Rébecca Robillard, Ian B HickieClinical Research Unit, Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, AustraliaAbstract: Changes in the sleep–wake cycle across development from childhood to adulthood, typically involve a steady shortening of the sleep period and a delay of sleep phase, with a period of more rapid change across adolescence. Accompanying these changes is the maturation of neuroendocrine rhythms such as melatonin, cortisol, and pubertal hormones. These endogenous rhythms are closely associated with behavioral changes in rest and activity rhythms, although environmental factors such as light exposure and academic and social demands likely play an interactive role. Other behavioral aspects, such as physical activity and eating behaviors, are also associated with changes in sleep–wake rhythms, and may be mediational factors in the development of physical illnesses. The sleep–wake cycle and related factors are implicated in the development of mental illnesses. There are several potential avenues of future research that may be valuable in terms of improving interventions and treatments for both mental and physical illnesses.Keywords: circadian rhythm, developmental, adolescence, youth

Perspectives on the causes of childhood leukemia.

Science.gov (United States)

Wiemels, Joseph

2012-04-05

Acute leukemia is the most common cancer in children but the causes of the disease in the majority of cases are not known. About 80% are precursor-B cell in origin (CD19+, CD10+), and this immunophenotype has increased in incidence over the past several decades in the Western world. Part of this increase may be due to the introduction of new chemical exposures into the child's environment including parental smoking, pesticides, traffic fumes, paint and household chemicals. However, much of the increase in leukemia rates is likely linked to altered patterns of infection during early childhood development, mirroring causal pathways responsible for a similarly increased incidence of other childhood-diagnosed immune-related illnesses including allergy, asthma, and type 1 diabetes. Factors linked to childhood leukemia that are likely surrogates for immune stimulation include exposure to childcare settings, parity status and birth order, vaccination history, and population mixing. In case-control studies, acute lymphoblastic leukemia (ALL) is consistently inversely associated with greater exposure to infections, via daycare and later birth order. New evidence suggests also that children who contract leukemia may harbor a congenital defect in immune responder status, as indicated by lower levels of the immunosuppressive cytokine IL-10 at birth in children who grow up to contract leukemia, as well as higher need for clinical care for infections within the first year of life despite having lower levels of exposure to infections. One manifestation of this phenomenon may be leukemia clusters which tend to appear as a leukemia "outbreak" among populations with low herd immunity to a new infection. Critical answers to the etiology of childhood leukemia will require incorporating new tools into traditional epidemiologic approaches - including the classification of leukemia at a molecular scale, better exposure assessments at all points in a child's life, a comprehensive

The experience of Chinese American parents of children with life-limiting illness: a comprehensive review.

Science.gov (United States)

Wang, Jinjiao; Kearney, Joan A

2013-07-01

Life-limiting childhood illness is a traumatic experience presenting parents with psychological, physical, and social challenges. While cultural influences affect all parents coping with the life-limiting illness and end-of-life period of their child, little is known about the experiences of Chinese American parents. The purpose of this comprehensive literature review was to describe Chinese American parents' experiences during their children's end-of-life period from a culturally informed perspective. Important themes in the literature are revealed including culture-based phenomena regarding philosophy of life and illness that can affect treatment choices, cultural mores that influence parental behaviour in Western health-care systems, specific communication patterns within families and between families and providers, certain coping risks, and gender-based roles and caregiving activities that have implications for provider communication patterns. The findings are consonant with the larger literature regarding the impact of traditional culture and values on Chinese family and health behaviours. Health professionals must be sensitive to Chinese American parents' communication styles, unspoken concerns, and unresolved cultural conflicts in American health-care settings. Educational interventions may be very helpful in this regard.

Cost-benefit analysis of childhood asthma management through school-based clinic programs.

Science.gov (United States)

Tai, Teresa; Bame, Sherry I

2011-04-01

Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

INDIAN CHILDHOOD AND OTHER CHILDHOODS

Directory of Open Access Journals (Sweden)

Alceu Zoia

2010-12-01

Full Text Available This article aims to show how children of the Indian community Terena, from North Mato Grosso, live, how they are educated, and what are the conceptions of childhood among the members of this community. Taking childhood in various contexts, we seek to analyze how this education process has been carried out.

Diabetes care and mental illness: the social organization of food in a residential care facility.

Science.gov (United States)

Lowndes, Ruth H; Angus, Jan E; Peter, Elizabeth

2013-06-21

To explore the social organization of food provision and dietary intake in seriously mentally ill people with diabetes who reside in a for-profit group home. Institutional ethnography was used to explore diabetes-related care practices among 26 women in a rural residential care facility in southern Ontario. Semi-structured, in-depth interviews were conducted with residents with diabetes, care providers, field workers, and health professionals. Observations and document analysis were also used to understand the lack of congruence between diabetes guidelines and the possibilities for diabetes management within the confines of group home care. Although it was mandated in group home guidelines that "Health Canada's Eating Well with Canada's Food Guide" (2007) be followed, menus were planned within the context of a limited food budget of approximately $1.91 per day per resident. Group home policies regulated systems of safety, reporting, and financial accountability, but not health promotion. Inspections carried out by the Public Health Department focused primarily on food safety during handling, preparation, and storage, and compliance to regulations regarding environmental cleanliness and infection control. Resource rationing found in group home care exacerbates illness in an already marginalized group. Financial support is required to enable provision of healthy food choices, including dairy products, fresh fruits, and vegetables. Additional support is required for care of co-morbid conditions such as diabetes for associated food costs and education to improve outcomes. Group home policies must take into consideration health threats to this population and give primacy to health promotion and illness prevention.

Childhood traumatic events and types of auditory verbal hallucinations in first-episode schizophrenia patients.

Science.gov (United States)

Misiak, Błażej; Moustafa, Ahmed A; Kiejna, Andrzej; Frydecka, Dorota

2016-04-01

Evidence is accumulating that childhood trauma might be associated with higher severity of positive symptoms in patients with psychosis and higher incidence of psychotic experiences in non-clinical populations. However, it remains unknown whether the history of childhood trauma might be associated with particular types of auditory verbal hallucinations (AVH). We assessed childhood trauma using the Early Trauma Inventory Self-Report - Short Form (ETISR-SF) in 94 first-episode schizophrenia (FES) patients. Lifetime psychopathology was evaluated using the Operational Criteria for Psychotic Illness (OPCRIT) checklist, while symptoms on the day of assessment were examined using the Positive and Negative Syndrome Scale (PANSS). Based on ETISR-SF, patients were divided into those with and without the history of childhood trauma: FES(+) and FES(-) patients. FES(+) patients had significantly higher total number of AVH types and Schneiderian first-rank AVH as well as significantly higher PANSS P3 item score (hallucinatory behavior) in comparison with FES(-) patients. They experienced significantly more frequently third person AVH and abusive/accusatory/persecutory voices. These differences remained significant after controlling for education, PANSS depression factor score and chlorpromazine equivalent. Linear regression analysis revealed that the total number of AVH types was predicted by sexual abuse score after controlling for above mentioned confounders. This effect was significant only in females. Our results indicate that the history of childhood trauma, especially sexual abuse, is associated with higher number AVH in females but not in males. Third person AVH and abusive/accusatory/persecutory voices, representing Schneiderian first-rank symptoms, might be particularly related to childhood traumatic events. Copyright © 2015 Elsevier Inc. All rights reserved.

Medical curricula and preventing childhood obesity: pooling the resources of medical students and primary care to inform curricula.

Science.gov (United States)

Wylie, Ann; Furmedge, Daniel S; Appleton, Amber; Toop, Helen; Coats, Tom

2009-03-01

The study aimed to firstly provide a small self-selecting group of medical students with the opportunity to explore current approaches and opportunities addressing the prevention of childhood obesity and, secondly, to consider what aspects could be part of the taught curriculum. Medical students in their third and fourth year were invited to self-design special study modules (SSMs) exploring interventions and processes addressing the growing concern about childhood obesity. One student looked at the role of the primary care teams, two looked at community-based opportunities to improve physical activity in urban areas where there is significant deprivation and one student explored the complex role of the media as a social determinant of dietary patterns and sedentary behaviour. Primary care health professionals questioned their role in regard to raising the topic of obesity in the consultation and had limited awareness of current NICE guidelines and local interventions for referral. Local authority physical activity programmes have an important role in preventing and tackling obesity and although the media are regulated, there is limited impact on reducing obesity. Conversely, the influence of the media is complex and enables medical students and teachers to be aware of some of the social determinants influencing health-related behaviour. About a third of UK GP practices have some role in medical undergraduate education. It will therefore be inevitable that students will encounter GPs working with prevention and management of childhood obesity, however limited, and this will increasingly be part of the teaching agenda, whether formal and planned or opportunistic. Curricula could include being familiar with the evidence that informs NICE guidelines, observing these guidelines being implemented and their limitations, awareness of local schemes for referral to prevent or treat obesity and the influence of wider determinants on diet and physical activity behaviour

Computerization of guidelines: towards a "guideline markup language".

Science.gov (United States)

Dart, T; Xu, Y; Chatellier, G; Degoulet, P

2001-01-01

Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

Japanese guidelines for food allergy 2017.

Science.gov (United States)

Ebisawa, Motohiro; Ito, Komei; Fujisawa, Takao

2017-04-01

Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence. Infantile atopic dermatitis associated with food allergy type is especially important as the onset of most food allergies occurs during infancy. We have discussed the neonatal and infantile gastrointestinal allergy and special forms of immediate type food allergy types separately. Diagnostic procedures are highlighted, such as probability curves and component-resolved diagnosis, including the recent advancement utilizing antigen-specific IgE. The oral food challenge using a stepwise approach is recommended to avoid complete elimination of causative foods. Although oral immunotherapy (OIT) has not been approved as a routine treatment by nationwide insurance, we included a chapter for OIT, focusing on efficacy and problems. Prevention of food allergy is currently the focus of interest, and many changes were made based on recent evidence. Finally, the contraindication between adrenaline and antipsychotic drugs in Japan was discussed among related medical societies, and we reached an agreement that the use of adrenaline can be allowed based on the physician's discretion. In conclusion, this guideline encourages physicians to follow the principle to let patients

The Impact of Illness Identity on Recovery from Severe Mental Illness.

Science.gov (United States)

Yanos, Philip T; Roe, David; Lysaker, Paul H

2010-04-01

The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.

Childhood Trauma, Social Networks, and the Mental Health of Adult Survivors.

Science.gov (United States)

Schneider, F David; Loveland Cook, Cynthia A; Salas, Joanne; Scherrer, Jeffrey; Cleveland, Ivy N; Burge, Sandra K

2017-03-01

The purpose of this study was to investigate the relationship of childhood trauma to the quality of social networks and health outcomes later in adulthood. Data were obtained from a convenience sample of 254 adults seen in one of 10 primary care clinics in the state of Texas. Standardized measures of adverse childhood experiences (ACEs), stressful and supportive social relationships, medical conditions, anxiety, depression, and health-related quality of life were administered. Using latent class analysis, subjects were assigned to one of four ACE classes: (a) minimal childhood abuse (56%), (b) physical/verbal abuse of both child and mother with household alcohol abuse (13%), (c) verbal and physical abuse of child with household mental illness (12%), and (d) verbal abuse only (19%). Statistically significant differences across the four ACE classes were found for mental health outcomes in adulthood. Although respondents who were physically and verbally abused as children reported compromised mental health, this was particularly true for those who witnessed physical abuse of their mother. A similar relationship between ACE class and physical health was not found. The quality of adult social networks partly accounted for the relationship between ACE classes and mental health outcomes. Respondents exposed to ACEs with more supportive social networks as adults had diminished odds of reporting poor mental health. Conversely, increasing numbers of stressful social relationships contributed to adverse mental health outcomes. Although efforts to prevent childhood trauma remain a critical priority, the treatment of adult survivors needs to expand its focus on both strengthening social networks and decreasing the negative effects of stressful ones.

Using videogames to treat childhood obesity.

Directory of Open Access Journals (Sweden)

Druzhinenko D.A.

2014-12-01

Full Text Available Childhood obesity is one of the most dangerous pathologies; it can lead to serious illness in the absence of medical support. In this article we give an overview of the use of videogames for reducing and normalizing the weight of overweight and obese children. We discuss the categorization of the existing games and their limits, and we outline the perspectives of psychopedagogical research in the domain of game design for treating obese and overweight children. The role of long-term motivation in the treatment of obesity is one of the crucial questions we discuss. We try to understand how videogames can help children and parents maintain motivation during weight-loss treatment. The role of parents is undeniable in ensuring the success of weight-loss programs for overweight or obese children. Perhaps videogames can be the instrument for families’ lifestyle changes.

An Alternative Approach for Supportive Supervision and Skill Measurements of Health Workers for Integrated Management of Neonatal and Childhood Illnesses Program in 10 Districts of Haryana.

Science.gov (United States)

Aggarwal, Arun K; Gupta, Rakesh; Das, Dhritiman; Dhakar, Anar S; Sharma, Gourav; Anand, Himani; Kaur, Kamalpreet; Sheoran, Kiran; Dalpath, Suresh; Khatri, Jaidev; Gupta, Madhu

2018-01-01

"Integrated Management of Neonatal and Childhood Illnesses" (IMNCI) needs regular supportive supervision (SS). The aim of this study was to find suitable SS model for implementing IMNCI. This was a prospective interventional study in 10 high-focus districts of Haryana. Two methods of SS were used: (a) visit to subcenters and home visits (model 1) and (b) organization of IMNCI clinics/camps at primary health center (PHC) and community health center (CHC) (model 2). Skill scores were measured at different time points. Routine IMNCI data from study block and randomly selected control block of each district were retrieved for 4 months before and after the training and supervision. Change in percentage mean skill score difference and percentage difference in median number of children were assessed in two areas. Mean skill scores increased significantly from 2.1 (pretest) to 7.0 (posttest 1). Supportive supervisory visits sustained and improved skill scores. While model 2 of SS could positively involve health system officials, model 1 was not well received. Outcome indicator in terms of number of children assessed showed a significant improvement in intervention areas. SS in IMNCI clinics/camps at PHC/CHC level and innovative skill scoring method is a promising approach.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: neurocritical patient.

Science.gov (United States)

Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

2011-11-01

Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calorie intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.

Implementation of the Integrated Management of Childhood Illness strategy in Peru and its association with health indicators: an ecological analysis.

Science.gov (United States)

Huicho, Luis; Dávila, Miguel; Gonzales, Fernando; Drasbek, Christopher; Bryce, Jennifer; Victora, Cesar G

2005-12-01

The Multi-Country Evaluation of Integrated Management of Childhood Illness (IMCI) Effectiveness, Cost and Impact (MCE) was launched to assess the global effectiveness of this strategy. Impact evaluations were started in five countries. The objectives of the Peru MCE were: (1) to document trends in IMCI implementation in the 24 departments of Peru from 1996 to 2000; (2) to document trends in indicators of health services coverage and impact (mortality and nutritional status) for the same period; (3) to correlate changes in these two sets of indicators, and (4) to attempt to rule out contextual factors that may affect the observed trends and correlations. An ecological analysis was performed in which the units of study were the 24 departments. By 2000, 10.2% of clinical health workers were trained in IMCI, but some districts showed considerably higher rates. There were no significant associations between clinical IMCI training coverage and indicators of outpatient utilization, vaccine coverage, mortality or malnutrition. The lack of association persisted after adjustment for several contextual factors including socioeconomic and environmental indicators and the presence of other child health projects. Community health workers were also trained in IMCI, and training coverage was not associated with any of the process or impact indicators, except for a significant positive correlation with mean height for age. According to the MCE impact model, IMCI implementation must be sufficiently strong to lead to an impact on health and nutrition. Health systems support for IMCI implementation in Peru was far from adequate. This finding, along with low training coverage level and a relatively low child mortality rate, may explain why the expected impact was not documented. Nevertheless, even districts with high levels of training coverage failed to show an impact. Further national effectiveness studies of IMCI and other child interventions are warranted as these interventions are

Childhood Socioeconomic Disadvantage, Occupational, Leisure-Time, and Household Physical Activity, and Diabetes in Adulthood.

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Tsenkova, Vera K; Lee, Chioun; Boylan, Jennifer Morozink

2017-10-01

Regular physical activity is a key way to prevent disease. However, we have a limited understanding of the socioeconomic precursors and glucoregulatory sequelae of engaging in physical activity in different domains. We examined the associations among life course socioeconomic disadvantage; meeting the physical activity guidelines with leisure-time physical activity, occupational physical activity, or household physical activity; and prediabetes and diabetes in the Midlife in the United States national study (N = 986). Childhood disadvantage was associated with lower odds of meeting the guidelines with leisure-time physical activity (odds ratio = 0.75; 95% confidence interval, 0.65-0.86). Adulthood disadvantage was associated with higher odds of meeting the guidelines with occupational physical activity (odds ratio = 1.94; 95% confidence interval, 1.49-2.53). Importantly, while meeting the guidelines with leisure-time physical activity was associated with lower odds of prediabetes and diabetes, we found no evidence for associations among occupational physical activity, household physical activity, and glucoregulation. Current US physical activity guidelines do not differentiate between physical activity for leisure or work, assuming that physical activity in any domain confers comparable health benefits. We documented important differences in the associations among lifetime socioeconomic disadvantage, physical activity domain, and diabetes, suggesting that physical activity domain potentially belongs in the guidelines, similar to other characteristics of activity (eg, type, intensity).

Acute otitis media guidelines in selected developed and developing countries: uniformity and diversity.

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Ovnat Tamir, Sharon; Shemesh, Shay; Oron, Yahav; Marom, Tal

2017-05-01

Acute otitis media (AOM) is a common childhood disease, with an enormous economic and healthcare-related burden. Guidelines and consensus papers for AOM diagnosis and management were published in many countries. Our objective was to study the differences and similarities between these protocols in developing and developed countries. The keywords: 'acute otitis media' AND 'children' AND ['treatment' or 'management'] AND ['guideline' or 'consensus'] were used in various electronic databases between 1 January 1989 through 31 December 2015. Overall, 99 sources from 62 countries were retrieved: 53 from 22 developed countries, and 46 from 40 developing countries. Representative guidelines from America (the USA, Argentina), Europe (Italy, Moldova), Africa (South Africa, Tanzania, Ethiopia), Asia (Japan, Afghanistan, Sri Lanka),and Oceania (South Australia, Fiji) were compared. Paediatric societies publish guidelines in most developed countries; in developing countries, the Ministry of Health usually initiates guideline formulation. Most guidelines use the same diagnostic criteria and offer watchful waiting in mild-moderate scenarios. Amoxicillin is the suggested first-line antibiotic, whereas options for second-line and third-line therapies vary. Duration of therapy varies and is usually age dependent: 5-7 days for children 2 years in developed countries, while duration and age groups vary greatly in developing countries. Reduction of AOM risk factors is encouraged in developed countries, but rarely in developing countries. Guidelines for AOM from developing and developed countries are similar in many aspects, with variation in specific recommendations, due to local epidemiology and healthcare accessibility. Formulation of regional guidelines may help reduce AOM burden. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Imagery rescripting and eye movement desensitisation and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder : IREM study design

NARCIS (Netherlands)

Boterhoven de Haan, K.L.; Lee, C.W.; Fassbinder, E.; Voncken, M.J.; Meewisse, M.; Van Es, S.M.; Menninga, S.; Kousemaker, M.; Arntz, A.

2017-01-01

BACKGROUND: Post-traumatic stress disorder (PTSD) that originates from childhood trauma experiences can develop into a chronic condition that has lasting effects on an individual's functioning and quality of life. While there are evidence-based guidelines for treating adult onset PTSD, treatments

Thai pediatricians' current practice toward childhood asthma.

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Kamalaporn, Harutai; Chawalitdamrong, Pongpan; Preutthipan, Aroonwan

2018-04-01

Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians. Asthma diagnosis and management were evaluated for compliance with standard guidelines. The practices of PCP and RS were compared. From 800 surveys distributed, there were 405 respondents (51%). Most respondents (81%) were PCP, who preferred to use clinical diagnosis rather than laboratory investigations to diagnose asthma. For acute asthmatic attacks, 58% of the pediatricians prescribed a systemic corticosteroid. For uncontrolled asthma, 89% of the pediatricians prescribed at least one controller. For exercise-induced bronchospasm, 55% of the pediatricians chose an inhaled bronchodilator, while 38% chose a leukotriene receptor antagonist (LTRA). For virus-induced wheeze, 40% of the respondents chose an LTRA, while 15% chose inhaled corticosteroids (ICS). PCP prescribed more oral bronchodilators (31% vs. 18%, p = 0.02), antibiotics (20% vs. 6%, p attack. Most of the Thai pediatricians' practices toward diagnosis and treatment of acute asthmatic attack and uncontrolled asthma conform to the guidelines. PCP prescribed more oral bronchodilators, antibiotics, and antihistamines than RS.

Mental Illness Statistics

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... News & Events About Us Home > Health Information Share Statistics Research shows that mental illnesses are common in ... of mental illnesses, such as suicide and disability. Statistics Top ı cs Mental Illness Any Anxiety Disorder ...

Psychosocial Risk Factors for Child Welfare among Postpartum Mothers with a History of Childhood Maltreatment and Neglect.

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Koenig, A M; Schury, K; Reister, F; Köhler-Dauner, F; Schauer, M; Ruf-Leuschner, M; Gündel, H; Ziegenhain, U; Fegert, J M; Kolassa, I-T

2016-03-01

Background: Childhood maltreatment (CM) can increase the risk of psychosocial risk factors in adulthood (e. g. intimate partner violence, financial problems, substance abuse or medical problems). The transition to parenthood presents those affected by CM with particular challenges, in addition to usual birth-related stressors. Methods: In this cross-sectional study a total of 240 women were interviewed in the puerperium with respect to CM experiences, using the German version of the Childhood Trauma Questionnaire (CTQ). Current psychosocial risk factors (e. g. financial concerns, maternal mental illness, single parent) were assessed using the Constance Index (KINDEX) for early childhood risk factors. Associations between CM experience and psychosocial risk factors were calculated using simple correlation. Results: The average age of participants was 33 years. On the CTQ 13.8 % of participants reported emotional abuse, 6.7 % physical abuse and 12.5 % sexual abuse, while 32.1 % reported emotional neglect and 7.5 % physical neglect during childhood. With rising severity of CM, more psychosocial risk factors (KINDEX) were present. Conclusions: This study shows a clear association between experiences of maltreatment during childhood and the presence of psychosocial stressors among women in the puerperium. Regular screening for a history of CM and parental psychosocial stressors should be conducted early, i.e. during pregnancy, to avoid negative consequences for the child.

EUROPAEM EMF Guideline 2016 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

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Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Kern, Markus; Kundi, Michael; Moshammer, Hanns; Lercher, Piero; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

2016-09-01

major impact on the oxidative and nitrosative regulation capacity in affected individuals. This concept also may explain why the level of susceptibility to EMF can change and why the range of symptoms reported in the context of EMF exposures is so large. Based on our current understanding, a treatment approach that minimizes the adverse effects of peroxynitrite - as has been increasingly used in the treatment of multisystem illnesses - works best. This EMF Guideline gives an overview of the current knowledge regarding EMF-related health risks and provides recommendations for the diagnosis, treatment and accessibility measures of EHS to improve and restore individual health outcomes as well as for the development of strategies for prevention.

Factors That Influence Campus Dwelling University Students' Facility to Practice Healthy Living Guidelines.

Science.gov (United States)

Walsh, Audrey; Taylor, Claudette; Brennick, Debbie

2017-01-01

Background Young adult university students living on campus are at an increased risk of developing lifestyle habits that encourage unintentional weight gain. Purpose The purpose of this study was to identify the individual and contextual factors that influence campus dwelling university students' facility to practice healthy living guidelines that reduce their risk of unintentional weight gain. Lifestyle practices included nutrition, physical activity, and sleep. Methods For seven days, 48 campus dwelling students recorded their activities and reflected on how closely they were able to follow recommended healthy living guidelines. Recorded data were supplemented by follow-up focus groups. All data were analyzed using thematic analysis. Results Students described multiple factors and conditions that influenced their facility to practice healthy living guidelines for nutrition, activity, and sleep. Many students' lifestyle practices put them at an increased risk of unintentional weight gain. Conclusions The campus environment challenges student's facility to practice healthy living guidelines. Nurses can intervene to build individual student capacity and to advocate for environmental polices that increase students' facility to choose lifestyle practices that promote health, lessen their risk of unintentional weight gain, and reduce their risk of developing chronic illness.

CHILDHOODS AND INTERPRETATIONS: RESEARCH ON ATTITUDES TOWARDS CONTEMPORARY DISCOURSES ON CHILDHOOD

Directory of Open Access Journals (Sweden)

Czető, Krisztina

2018-01-01

Full Text Available This study deals with the theoretical interpretations of childhoods in the twenty-first century, and presents the results of an exploratory research on students’ attitudes towards contemporary childhood discourses conducted in Hungarian secondary schools. In a narrative literature review, the developmental and the new social paradigms of childhood are discussed. In the quantitative part of the research, the participants’ (N=806 attitudes were measures by a four-dimension questionnaire. The results of the exploratory research show that there are three dominant themes in childhood discourses highly accepted by the research participants: childhood as a development, the motif of initiation and the social and cultural relativity of childhoods.

Associations of adversity in childhood and risk factors for cardiovascular disease in mid-adulthood.

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Anderson, Emma L; Fraser, Abigail; Caleyachetty, Rishi; Hardy, Rebecca; Lawlor, Debbie A; Howe, Laura D

2018-02-01

Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. The aim of this study is to assess associations of various types of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. At study enrolment, women from the Avon Longitudinal Study of Parents and Children (N=3612) retrospectively reported: lack of maternal care, maternal overprotection, parental mental illness, household dysfunction, sexual abuse, physical and emotional abuse, and neglect in childhood. Approximately 23 years later, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma glucose, insulin, triglycerides, low and high density lipoprotein cholesterol, C-reactive protein, carotid intima-media thickness (cIMT) and arterial distensibility were assessed (mean age 51 years). We examined associations of each specific type of psychosocial adversity and cumulative adversity with CVD risk factors. No specific type of psychosocial adversity was consistently associated with the CVD risk factors. There was evidence that a one standard deviation greater cumulative psychosocial adversity was associated with 0.51cm greater waist circumference (95% confidence interval [CI]: 0.02cm, 1.00cm, p=0.04) and a lower arterial distensibility, even after adjustment for age, ethnicity and childhood and adult socioeconomic position. We found no consistent evidence that any specific type of psychosocial adversity, or cumulative psychosocial adversity in childhood, is associated with CVD risk factors in adult women. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Disabling pansclerotic morphea of childhood with extracutaneous manifestations

Directory of Open Access Journals (Sweden)

Mahendra M Kura

2013-01-01

Full Text Available Disabling pansclerotic morphea (DPM of childhood is a rare generalized type of localized scleroderma (LS that is known to follow an aggressive course with pansclerotic lesions leading to severe joint contractures and consequent immobility. Mortality is due to complications of the disease such as bronchopneumonia, sepsis, or gangrene. There is no specific laboratory finding. Treatment protocols are still evolving for this severe recalcitrant disorder. Extracutaneous manifestations are rarely reported in DPM. We present the case of a 7-year-old girl with DPM with severe extracutaneous manifestations in the form of gastrointestinal and vascular disease, whose disease progressed rapidly. In spite of treatment with methotrexate, corticosteroids, and PUVA therapy, she ultimately succumbed to her illness due to sepsis.

Childhood Cancer Statistics

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... Watchdog Ratings Feedback Contact Select Page Childhood Cancer Statistics Home > Cancer Resources > Childhood Cancer Statistics Childhood Cancer Statistics – Graphs and Infographics Number of Diagnoses Incidence Rates ...

Adverse childhood experiences and gender influence treatment seeking behaviors in obsessive-compulsive disorder.

Science.gov (United States)

Benedetti, Francesco; Poletti, Sara; Radaelli, Daniele; Pozzi, Elena; Giacosa, Chiara; Smeraldi, Enrico

2014-02-01

Exposure to adverse childhood experiences (ACE) increases the risk of adult physical and mental health disorders, including obsessive-compulsive disorder (OCD), and influences adult brain structure and function. ACE could influence the use of psychotropic drugs in adulthood, and treatment seeking behaviors. We assessed the severity of ACE in a sample of 31 healthy controls and 66 patients with OCD who were consecutively referred for hospitalization and were either drug-naïve or drug-treated. In addition, we explored the possible clinical relevance of ACE with two additional analyses: (a) a discriminant function analysis with sex and ACE as factors, and (b) a logistic regression with use of medication as dependent variable and ACE as factor. Despite comparable age, years at school, age at onset of illness, duration of illness, and severity of illness (Y-BOCS), adult drug-naïve patients reported lower exposure to ACE and later contacts with mental health professionals than drug-treated. This effect was particularly evident in female patients compared to males. The interaction of gender with factors linked with the early familial environment biased access to psychiatric care and use of medication, independent of OCD-associated factors such as severity of symptoms or duration of illness. The need for medications of patients could be higher in families where OCD symptomatology is associated with ACE. © 2014.

[Antibiotics in the critically ill].

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Kolak, Radmila R

2010-01-01

Antibiotics are one the most common therapies administered in the intensive care unit setting. This review outlines the strategy for optimal use of antimicrobial agents in the critically ill. In severely ill patients, empirical antimicrobial therapy should be used when a suspected infection may impair the outcome. It is necessary to collect microbiological documentation before initiating empirical antimicrobial therapy. In addition to antimicrobial therapy, it is recommended to control a focus of infection and to modify factors that promote microbial growth or impair the host's antimicrobial defence. A judicious choice of antimicrobial therapy should be based on the host characteristics, the site of injection, the local ecology, and the pharmacokinetics/pharmacodynamics of antibiotics. This means treating empirically with broad-spectrum antimicrobials as soon as possible and narrowing the spectrum once the organism is identified (de-escalation), and limiting duration of therapy to the minimum effective period. Despite theoretical advantages, a combined antibiotic therapy is nor more effective than a mono-therapy in curing infections in most clinical trials involving intensive care patients. Nevertheless, textbooks and guidelines recommend a combination for specific pathogens and for infections commonly caused by these pathogens. Avoiding unnecessary antibiotic use and optimizing the administration of antimicrobial agents will improve patient outcomes while minimizing risks for the development of bacterial resistance. It is important to note that each intensive care unit should have a program in place which monitors antibiotic utilisation and its effectiveness. Only in this way can the impact of interventions aimed at improving antibiotic use be evaluated at the local level.

Analysis of the 2015 American and European guidelines for the management of infective endocarditis.

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Tattevin, P; Mainardi, J-L

2016-12-01

The optimal management of infective endocarditis requires a broad range of expertise (infectious disease specialists, cardiologists, microbiologists, cardiac surgeons, and intensivists). Given the low level of evidence currently available to support the management of infective endocarditis, international guidelines have always been particularly awaited and rather well implemented. Their cautious analysis of the medical literature and the range of expertise combined within the groups in charge of these guidelines are usually broadly acknowledged and respected. The publications, a few weeks apart, of the 2015 updates of the American and European guidelines, was quite disturbing. Indeed, several discrepancies on major therapeutic propositions were observed, including empirical treatment (penicillin M+penicillin A+gentamicin for Europeans in acutely ill patients; penicillin A+beta-lactamase inhibitor+gentamicin for Americans), or first-line treatment for the most common pathogen responsible for endocarditis in 2016, Staphylococcus aureus (trimethoprim-sulfamethoxazole+clindamycin as an alternative in the European guidelines, while this regimen is not even mentioned in the American guidelines). Other discrepancies were observed, although less significant: the role of positron emission tomography labelled with 18 F-fluorodeoxyglucose and administration modalities for aminoglycosides. We aimed to detail the main changes brought upon by these guidelines, their discrepancies, and the 'pros' and 'cons' that may help you select the best treatment regimen for your patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Alliance for a Healthier Generation's Competitive Beverage and Food Guidelines: Do Elementary School Administrators Know about Them and Do They Report Implementing Them?

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Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J.

2012-01-01

Background: The availability of competitive foods in schools is a modifiable factor in efforts to prevent childhood obesity. The Alliance for a Healthier Generation launched the Healthy Schools Program in 2006 to encourage schools to create healthier food environments, including the adoption of nutritional guidelines for competitive beverages and…

Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients.

Science.gov (United States)

Gosselink, R; Bott, J; Johnson, M; Dean, E; Nava, S; Norrenberg, M; Schönhofer, B; Stiller, K; van de Leur, H; Vincent, J L

2008-07-01

The Task Force reviewed and discussed the available literature on the effectiveness of physiotherapy for acute and chronic critically ill adult patients. Evidence from randomized controlled trials or meta-analyses was limited and most of the recommendations were level C (evidence from uncontrolled or nonrandomized trials, or from observational studies) and D (expert opinion). However, the following evidence-based targets for physiotherapy were identified: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure. Discrepancies and lack of data on the efficacy of physiotherapy in clinical trials support the need to identify guidelines for physiotherapy assessments, in particular to identify patient characteristics that enable treatments to be prescribed and modified on an individual basis. There is a need to standardize pathways for clinical decision-making and education, to define the professional profile of physiotherapists, and increase the awareness of the benefits of prevention and treatment of immobility and deconditioning for critically ill adult patients.

Childhood quality influences genetic sensitivity to environmental influences across adulthood: A life-course Gene × Environment interaction study.

Science.gov (United States)

Keers, Robert; Pluess, Michael

2017-12-01

While environmental adversity has been shown to increase risk for psychopathology, individuals differ in their sensitivity to these effects. Both genes and childhood experiences are thought to influence sensitivity to the environment, and these factors may operate synergistically such that the effects of childhood experiences on later sensitivity are greater in individuals who are more genetically sensitive. In line with this hypothesis, several recent studies have reported a significant three-way interaction (Gene × Environment × Environment) between two candidate genes and childhood and adult environment on adult psychopathology. We aimed to replicate and extend these findings in a large, prospective multiwave longitudinal study using a polygenic score of environmental sensitivity and objectively measured childhood and adult material environmental quality. We found evidence for both Environment × Environment and Gene × Environment × Environment effects on psychological distress. Children with a poor-quality material environment were more sensitive to the negative effects of a poor environment as adults, reporting significantly higher psychological distress scores. These effects were further moderated by a polygenic score of environmental sensitivity. Genetically sensitive children were more vulnerable to adversity as adults, if they had experienced a poor childhood environment but were significantly less vulnerable if their childhood environment was positive. These findings are in line with the differential susceptibility hypothesis and suggest that a life course approach is necessary to elucidate the role of Gene × Environment in the development of mental illnesses.

Childhood trauma and childhood urbanicity in relation to psychotic disorder

NARCIS (Netherlands)

Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René; Meije, Carin; Myin-Germeys, Inez; van Os, Jim; Wiersma, Durk

2015-01-01

Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of

Childhood trauma and childhood urbanicity in relation to psychotic disorder

NARCIS (Netherlands)

Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Cahn, W

2015-01-01

BACKGROUND: Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect

[DGPPN compass of participation for vocational integration of persons with mental illnesses].

Science.gov (United States)

Stengler, K; Rauschenbach, J; Riedel-Heller, S G; Becker, T; Steinhart, I; Gerlinger, G; Hauth, I

2016-11-01

Working and living for persons with mental illnesses are a major concern of rehabilitative psychiatry. In Germany the definition of rehabilitation for persons with mental illnesses is closely linked to different sectors of social welfare and to the strongly organized supply chain of prevention, acute treatment, rehabilitation and care. In successfully supporting people with mental health problems in terms of vocational integration, professionals face various obstacles. Besides finding the correct content, structural and organizational difficulties can also arise. The welfare system with its specific institutions and settings is complicated which often leads to delays in the onset of rehabilitation. Some essential reasons are insufficient knowledge about established options of rehabilitative treatment and about responsibilities related to participation in specialized training and further education for professional caregivers. Also information and (positive) experiences from pilot projects working in an inclusive, cross-sectional way and across different settings are practically unavailable in Germany. The presented compass of participation from the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) for vocational integration of persons with mental illnesses starts at this point: it provides guidelines for psychiatric and psychotherapeutic practitioners, general practitioners as well as for physicians working in residential or day care institutions with a psychiatric and psychotherapeutic background. Both the paper and planned online versions should help professionals to help people, particularly those with severe mental illnesses to navigate the system of services for vocational integration in Germany.

Challenging the public stigma of mental illness: a meta-analysis of outcome studies.

Science.gov (United States)

Corrigan, Patrick W; Morris, Scott B; Michaels, Patrick J; Rafacz, Jennifer D; Rüsch, Nicolas

2012-10-01

Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. The investigators heeded published guidelines for systematic literature reviews in health care. This comprehensive and systematic review included articles in languages other than English, dissertations, and population studies. The search included all articles from the inception of the databases until October 2010. Search terms fell into three categories: stigma, mental illness (such as schizophrenia and depression), and change program (including contact and education). The search yielded 72 articles and reports meeting the inclusion criteria of relevance to changing public stigma and sufficient data and statistics to complete analyses. Studies represented 38,364 research participants from 14 countries. Effect sizes were computed for all studies and for each treatment condition within studies. Comparisons between effect sizes were conducted with a weighted one-way analysis of variance. Overall, both education and contact had positive effects on reducing stigma for adults and adolescents with a mental illness. However, contact was better than education at reducing stigma for adults. For adolescents, the opposite pattern was found: education was more effective. Overall, face-to-face contact was more effective than contact by video. Future research is needed to identify moderators of the effects of both education and contact.

Childhood psychosocial adversity and female reproductive timing: a cohort study of the ALSPAC mothers.

Science.gov (United States)

Magnus, Maria C; Anderson, Emma L; Howe, Laura D; Joinson, Carol J; Penton-Voak, Ian S; Fraser, Abigail

2018-01-01

Previous studies of childhood psychosocial adversity and age at menarche mostly evaluated single or a few measures of adversity, and therefore could not quantify total psychosocial adversity. Limited knowledge is currently available regarding childhood psychosocial adversity in relation to age at menopause and reproductive lifespan. We examined the associations of total and specific components of childhood psychosocial adversity with age at menarche (n=8984), age at menopause (n=945), and length of reproductive lifespan (n=841), in mothers participating in the Avon Longitudinal Study of Parents and Children. We used confirmatory factor analysis to characterise lack of care, maladaptive family functioning, non-sexual abuse, overprotective parenting, parental mental illness and sexual abuse. These specific components of childhood psychosocial adversity were combined into a total psychosocial adversity score using a second-order factor analysis. We used structural equation models to simultaneously conduct the factor analysis and estimate the association with the continuous outcomes of interest. Total childhood psychosocial adversity was not associated with age at menarche, age at menopause or length of reproductive lifespan. When we examined the separate psychosocial adversity constructs, sexual abuse was inversely associated with age at menarche, with a mean difference of -0.17 (95% CI -0.23 to -0.12) years per SD higher factor score, and with age at menopause, with a mean difference of -0.17 (95% CI -0.52 to 0.18) per SD higher factor score. Childhood sexual abuse was associated with lower age at menarche and menopause, but the latter needs to be confirmed in larger samples. © 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.

Changes to the school food and physical activity environment after guideline implementation in British Columbia, Canada

OpenAIRE

Watts, Allison W; Mâsse, Louise C; Naylor, Patti-Jean

2014-01-01

Background High rates of childhood obesity have generated interest among policy makers to improve the school food environment and increase students’ levels of physical activity. The purpose of this study was to examine school-level changes associated with implementation of the Food and Beverage Sales in Schools (FBSS) and Daily Physical Activity (DPA) guidelines in British Columbia, Canada. Methods Elementary and middle/high school principals completed a survey on the school food and physical...

Impact of childhood cancer on parents' relationships: an integrative review.

Science.gov (United States)

da Silva, Fernanda Machado; Jacob, Eufemia; Nascimento, Lucila Castanheira

2010-09-01

The diagnosis of cancer and the treatment decisions associated with it may cause uncertainty, stress, and anxiety among parents. Emotional tensions can affect parents' relationships during the trajectory of the child's cancer illness. We conducted an integrative review to examine the evidence related to the effects of childhood cancer on parents' relationships. An integrative literature search of studies published between 1997 and 2009 was conducted in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychology Information (PsycINFO), PubMed, Scopus, CUIDEN, and Latin American and Caribbean Health Science Literature (LILACS). The key words used were neoplasms, child, marriage, spouses, family relations, and nursing. Articles were reviewed if the (a) topic addressed parents' relationships during childhood cancer; (b) participants were mothers, fathers, or both; (c) design was either qualitative or quantitative; (d) language was English, Portuguese, or Spanish; (e) date of publication was between January 1997 and October 2009; and (f) abstract was available. Fourteen articles met the search criteria and were reviewed using Cooper's framework for integrative reviews. Four themes emerged: (a) changes in the parents' relationship during the trajectory of the child's illness; (b) difficulty in communication between couples; (c) gender differences in parental stress and coping; and (d) role changes. Findings revealed positive and negative changes in parents' relationships, communication, stress, and roles. Nurses need to assess the impact of cancer diagnosis and treatments on parent relationships, offer support and encouragement, and allow expression of feelings. Future research is needed to develop and test interventions that increase parents' potentials and strengthen relationships during the challenging trajectory of their children's cancer and treatment. The multiple sources of stress and uncertainty associated with a child's cancer diagnosis and

Malaria diagnosis and treatment under the strategy of the integrated management of childhood illness (IMCI): relevance of laboratory support from the rapid immunochromatographic tests of ICT Malaria P.f/P.v and OptiMal.

Science.gov (United States)

Tarimo, D S; Minjas, J N; Bygbjerg, I C

2001-07-01

The algorithm developed for the integrated management of childhood illness (IMCI) provides guidelines for the treatment of paediatric malaria. In areas where malaria is endemic, for example, the IMCI strategy may indicate that children who present with fever, a recent history of fever and/or pallor should receive antimalarial chemotherapy. In many holo-endemic areas, it is unclear whether laboratory tests to confirm that such signs are the result of malaria would be very relevant or useful. Children from a holo-endemic region of Tanzania were therefore checked for malarial parasites by microscopy and by using two rapid immunochromatographic tests (RIT) for the diagnosis of malaria (ICT Malaria P.f/P.v and OptiMal. At the time they were tested, each of these children had been targeted for antimalarial treatment (following the IMCI strategy) because of fever and/or pallor. Only 70% of the 395 children classified to receive antimalarial drugs by the IMCI algorithm had malarial parasitaemias (68.4% had Plasmodium falciparum trophozoites, 1.3% only P. falciparum gametocytes, 0.3% P. ovale and 0.3% P. malariae). As indicators of P. falciparum trophozoites in the peripheral blood, fever had a sensitivity of 93.0% and a specificity of 15.5% whereas pallor had a sensitivity of 72.2% and a specificity of 50.8%. The RIT both had very high corresponding sensitivities (of 100.0% for the ICT and 94.0% for OptiMal) but the specificity of the ICT (74.0%) was significantly lower than that for OptiMal (100.0%). Fever and pallor were significantly associated with the P. falciparum asexual parasitaemias that equalled or exceeded the threshold intensity (2000/microl) that has the optimum sensitivity and specificity for the definition of a malarial episode. Diagnostic likelihood ratios (DLR) showed that a positive result in the OptiMal test (DLR = infinity) was a better indication of malaria than a positive result in the ICT (DLR = 3.85). In fact, OptiMal had diagnostic reliability (0