Aspirin and Statin Nonuse Associated With Early Biochemical Failure After Prostate Radiation Therapy

International Nuclear Information System (INIS)

Zaorsky, Nicholas G.; Buyyounouski, Mark K.; Li, Tianyu; Horwitz, Eric M.

2012-01-01

Purpose: To present the largest retrospective series investigating the effect of aspirin and statins, which are hypothesized to have antineoplastic properties, on biochemical failure (nadir plus 2 ng/mL) after prostate radiation therapy (RT). Methods and Materials: Between 1989 and 2006, 2051 men with clinically localized prostate cancer received definitive RT alone (median dose, 76 Gy). The rates of aspirin use and statin use (defined as any use at the time of RT or during follow-up) were 36% and 34%, respectively. The primary endpoint of the study was an interval to biochemical failure (IBF) of less than 18 months, which has been shown to be the single strongest predictor of distant metastasis, prostate cancer survival, and overall survival after RT. Patient demographic characteristics and tumor staging factors were assessed with regard to associations with the endpoint. Univariate analysis was performed with the χ 2 test for categorical variables and the Wilcoxon test for continuous variables. Multivariable analysis was performed with a multiple logistic regression. Results: The median follow-up was 75 months. Univariate analysis showed that an IBF of less than 18 months was associated with aspirin nonuse (P<.0001), statin nonuse (P<.0001), anticoagulant nonuse (P=.0006), cardiovascular disease (P=.0008), and prostate-specific antigen (continuous) (P=.008) but not with Gleason score, age, RT dose, or T stage. On multivariate analysis, only aspirin nonuse (P=.0012; odds ratio, 2.052 [95% confidence interval, 1.328-3.172]) and statin nonuse (P=.0002; odds ratio, 2.465 [95% confidence interval, 1.529-3.974]) were associated with an IBF of less than 18 months. Conclusions: In patients who received RT for prostate cancer, aspirin or statin nonuse was associated with early biochemical failure, a harbinger of distant metastasis and death. Further study is needed to confirm these findings and to determine the optimal dosing and schedule, as well as the relative

Arthur Andersen study confirms non-U.S. focus by U.S. operators

International Nuclear Information System (INIS)

Anon.

1992-01-01

This paper reports that investment in non-US projects in 1991 accounted for 60% of combined exploration and development spending by 30 of the largest US oil and gas companies, a survey by Arthur Andersen and Co. shows. Combined non-US E and D spending in 1991 by surveyed companies increased by 15% to $21.2 billion, while spending on US E and D projects declined by 5% to $14.3 billion, Arthur Andersen found. Combined global E and D spending by the 30 companies surveyed in 1991 totaled $35.5 million, a 6% increase from 1990. An earlier Oil and Gas Journal survey of 22 major integrated companies found combined world capital and exploration spending in 1991 increased by nearly 8% to more than $45.9 billion. Only one third of OGJ's 22 major companies cut spending. Arthur Andersen taillied US and non-US E and D spending based on a survey of 1991 annual reports filed with the Securities and Exchange Commission

Determinants of emergency contraception non-use among women in unplanned or ambivalent pregnancies

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Osmara Alves dos Santos

2014-08-01

Full Text Available Objective To analyze the determinants of emergency contraception non-use among women in unplanned and ambivalent pregnancies. Method Cross-sectional study with a probabilistic sample of 366 pregnant women from 12 primary health care units in the city of São Paulo, Brazil. A multinomial logistic regression was performed, comparing three groups: women who used emergency contraception to prevent ongoing pregnancies (reference; women who made no use of emergency contraception, but used other contraceptive methods; and women who made no use of any contraceptive methods at all. Results Cohabitation with a partner was the common determinant of emergency contraception non-use. No pregnancy risk awareness, ambivalent pregnancies and no previous use of emergency contraception also contributed to emergency contraception non-use. Conclusion Apart from what is pointed out in the literature, knowledge of emergency contraception and the fertile period were not associated to its use.

Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge.

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Roffman, Caroline E; Buchanan, John; Allison, Garry T

2016-07-01

It is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be used to identify future issues with locomotion or prosthetic use. The purpose of this study was to determine whether different tests of locomotor performance during rehabilitation were associated with significantly greater risk of prosthetic abandonment at 12 months postdischarge. This was a retrospective cohort study. Data for descriptive variables and locomotor tests (ie, 10-Meter Walk Test [10MWT], Timed "Up & Go" Test [TUGT], Six-Minute Walk Test [6MWT], and Four Square Step Test [FSST]) were abstracted from the medical records of 201 consecutive participants with lower limb amputation. Participants were interviewed and classified as prosthetic users or nonusers at 12 months postdischarge. The Mann-Whitney U test was used to analyze whether there were differences in locomotor performance. Receiver operating characteristic curves were generated to determine performance thresholds, and relative risk (RR) was calculated for nonuse. At 12 months postdischarge, 18% (n=36) of the participants had become prosthetic nonusers. Performance thresholds, area under the curve (AUC), and RR of nonuse (95% confidence intervals [CI]) were: for the 10MWT, if walking speed was ≤0.44 ms(-1) (AUC=0.743), RR of nonuse=2.76 (95% CI=1.83, 3.79; PLocomotor performance during rehabilitation may predict future risk of prosthetic nonuse. It may be implied that the 10MWT has the greatest clinical utility as a single screening tool for prosthetic nonuse, given the highest proportion of participants were able to perform this test early in rehabilitation. However, as locomotor skills improve, other tests (in particular, the 6MWT) have specific clinical utility. To fully enable implementation of these locomotor criteria for prosthetic nonuse into clinical practice, validation is warranted

Children's Alcohol Initiation: An Analytic Overview

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Ward, Bernadette; Snow, Pamela; Aroni, Rosalie

2010-01-01

Many parents support the "supervised introduction" of alcohol to children. While initiation to regular alcohol consumption in early adolescence has been linked with alcohol-related problems in adult life, the findings from these studies cannot be extrapolated to early childhood. The definition of initiation to alcohol in early childhood is often…

Children-Engaging Social and Environmental Initiatives as Determinants of Corporate Reputation

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Ingrida Smaiziene

2016-02-01

Full Text Available Objective:  The paper aims to explore children-engaging social and green initiatives as determinants of corporate reputation.  Research Design & Methods: The research data were collected by means of a consumer survey (n=354 in Lithuania. During the research, consumers’ perception and attitudes towards companies which take children-engaging social and environmental initiatives were surveyed. Findings: The research findings indicate that consumers tend to agree that companies implementing children-engaging CSR initiatives contribute to the development of children as responsible citizens. However, consumers have a different attitude towards companies which implement children-engaging environmental initiatives and companies which take children-engaging social initiatives.  Implications & Recommendations: The research results suggest that consumers form opinions about the company not only by assessing the company’s behaviour towards them, but also by assessing the corporate performance targeted at children. Therefore, companies should consider children-engaging CSR as determinants of corporate reputation. Contribution & Value Added: The paper provides some empirical evidence on how CSR practices targeted at children may affect corporate reputation.

Rates of bone loss among women initiating antidepressant medication use in midlife.

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Diem, Susan J; Ruppert, Kristine; Cauley, Jane A; Lian, YinJuan; Bromberger, Joyce T; Finkelstein, Joel S; Greendale, Gail A; Solomon, Daniel H

2013-11-01

Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. We conducted a prospective cohort study at five clinical centers in the United States. The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck.

Children Develop Initial Orthographic Knowledge during Storybook Reading

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Apel, Kenn; Brimo, Danielle; Wilson-Fowler, Elizabeth B.; Vorstius, Christian; Radach, Ralph

2013-01-01

We examined whether young children acquire orthographic knowledge during structured adult-led storybook reading even though minimal viewing time is devoted to print. Sixty-two kindergarten children were read 12 storybook "chapters" while their eye movements were tracked. Results indicated that the children quickly acquired initial mental…

The developmental association of relationship quality, hormonal contraceptive choice and condom non-use among adolescent women.

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Sayegh, M Aaron; Fortenberry, J Dennis; Shew, Marcia; Orr, Donald P

2006-09-01

Consistent condom use is critical to efforts to prevent sexually transmitted infections among adolescents, but condom use may decline as relationships and contraceptive needs change. The purpose of this research is to assess changes in condom non-use longitudinally in the context of changes in relationship quality, coital frequency and hormonal contraceptive choice. Participants were women (aged 14-17 years at enrollment) recruited from three urban adolescent medicine clinics. Data were collected at three-month intervals using a face-to-face structured interview. Participants were able to contribute up to 10 interviews, but on average contributed 4.2 interviews over the 27-month period. Independent variables assessed partner-specific relationship quality (five items; scale range 5-25; alpha = .92, e.g., this partner is a very important person to me); and, number of coital events with a specific partner. Additional items assessed experience with oral contraceptive pills (OCP) use and injected depo medroxy-progesterone acetate (DMPA). The outcome variable was number of coital events without condom use during the past three months. Analyses were conducted as a three-level hierarchical linear growth curve model using HLM 6. The Level 1 predictor was time, to test the hypothesis that condom non-use increases over time. Level 2 predictors assessed relationship quality and coital frequency across all partners to assess hypotheses that participants' condom non-use increases over time as a function of relationship quality and coital frequency. Level 3 predictors assessed the participant-level influence of OCP or DMPA experience on time-related changes in condom non-use. A total of 176 women reported 279 sex partners and contributed 478 visits. Both average coital frequency and average condom non-use linearly increased during the 27-month follow-up. At any given follow-up, about 35% reported recent OCP use, and 65% reported DMPA use. HLM analyses showed that condom non-use

Nonuse of Prenatal Care: Implications for Social Work Involvement.

Science.gov (United States)

Bedics, Bonnie C.

1994-01-01

Interviewed 44 women who did not obtain prenatal care. Identified four categories of reasons for nonuse: women's lifestyles differed from mainstream; stressful events took priority over prenatal care; women attempted to receive care but were discouraged, turned away, or given poor information by service delivery system personnel; and women did not…

Users and Nonusers of Marijuana: Some Attitudinal and Behavioral Correlates

Science.gov (United States)

King, Francis W.

1970-01-01

Users tend to: oppose external control; view marihuana as relaxing agent; favor legalization of the drug; and feel they are better informed on effects of the drug than nonusers. Presented at American College Health Association, Oklahoma City, April 1969. (Author)

Technologies for physical activity self-monitoring: a study of differences between users and non-users

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Åkerberg A

2017-02-01

Full Text Available Anna Åkerberg,1,2 Anne Söderlund,2 Maria Lindén1 1School of Innovation, Design and Engineering, 2School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden Background: Different kinds of physical activity (PA self-monitoring technologies are used today to monitor and motivate PA behavior change. The user focus is essential in the development process of this technology, including potential future users such as representatives from the group of non-users. There is also a need to study whether there are differences between the groups of users and non-users. The aims of this study were to investigate possible differences between users and non-users regarding their opinions about PA self-monitoring technologies and to investigate differences in demographic variables between the groups. Materials and methods: Participants were randomly selected from seven municipalities in central Sweden. In total, 107 adults responded to the Physical Activity Products Questionnaire, which consisted of 22 questions. Results: Significant differences between the users and non-users were shown for six of the 20 measurement-related items: measures accurately (p=0.007, measures with high precision (p=0.024, measures distance (p=0.020, measures speed (p=0.003, shows minutes of activity (p=0.004, and shows geographical position (p=0.000. Significant differences between the users and non-users were also found for two of the 29 encouragement items: measures accurately (p=0.001 and has long-term memory (p=0.019. Significant differences between the groups were also shown for level of education (p=0.030 and level of physical exercise (p=0.037. Conclusion: With a few exceptions, the users and the non-users in this study had similar opinions about PA self-monitoring technologies. Because this study showed significant differences regarding level of education and level of physical exercise, these demographic variables seemed more relevant to investigate

Introduction and critique of using contingent valuation to measure nonuse damages

International Nuclear Information System (INIS)

Desvousges, W.H.

1993-01-01

Contingent valuation (CV) is a method for measuring natural resource damages that involves the use of surveys to elicit people's stated willingness to pay for natural resources. The CV method involves a series of steps ranging from the development and testing of the survey questionnaire to the analysis of the resulting data. In this presentation, the author will describe the main steps involved in using the CV method and will use examples to illustrate the various ways the CV has been used in natural resource damage assessments. The presentation will highlight a few applications of CV to measuring use values, but the majority of the emphasis will be on the so-called nonuse or passive values that do not require people to use the potentially affected resources. In discussing the issues related to nonuse values, the author will use examples to highlight several of the important problem that arise in using CV to measure nonuse damages. These problems include the inability of CV to differentiate the scope of potential injuries, the influence of information and survey design on the estimated values, the lack of consideration of substitute resources, and the lack of calibration of stated willingness to pay with commitments of real dollars. The author will draw on examples from several oil spills including the Exxon Valdez and several of the Superfund cases that have featured CV applications

Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers: Application in a Non-US Sample of 1,104 Children

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de Bildt, Annelies; Sytema, Sjoerd; Zander, Eric; Bölte, Sven; Sturm, Harald; Yirmiya, Nurit; Yaari, Maya; Charman, Tony; Salomone, Erica; LeCouteur, Ann; Green, Jonathan; Bedia, Ricardo Canal; Primo, Patricia García; van Daalen, Emma; de Jonge, Maretha V.; Guðmundsdóttir, Emilía; Jóhannsdóttir, Sigurrós; Raleva, Marija; Boskovska, Meri; Rogé, Bernadette; Baduel, Sophie; Moilanen, Irma; Yliherva, Anneli; Buitelaar, Jan; Oosterling, Iris J.

2015-01-01

The current study aimed to investigate the Autism Diagnostic Interview-Revised (ADI-R) algorithms for toddlers and young preschoolers (Kim and Lord, "J Autism Dev Disord" 42(1):82-93, 2012) in a non-US sample from ten sites in nine countries (n = 1,104). The construct validity indicated a good fit of the algorithms. The diagnostic…

Early sexual debut and condom nonuse among adolescents in South Korea.

Science.gov (United States)

Kim, Jiyun; Lee, Jong-Eun

2012-11-01

The purpose of this study was to investigate the factors related to sexual debut among adolescents, and to examine the association between subject characteristics and condom nonuse among those who experienced sexual intercourse in South Korea. Data were obtained from the 2009 Korean Youth Risk Behaviour Survey, a nationally representative sample. Logistic regression analysis was conducted to investigate the factors related to sexual debut, associations of condom nonuse and subject characteristics. Among male adolescents, age, early age at first emission, low academic achievement, living with a step-parent, perceived low level of household income, frequent drinking and smoking, and depressive feelings were associated with early sexual debut. Attending a coeducational school, living with a single biological parent and step-parent, risky health behaviour such as drinking and smoking, and depressive feelings were related risks factors for early sexual debut among female students. Factors associated with condom nonuse included early sexual debut (less than 16 years of age) (odds ratio (OR)=1.79, 95% confidence interval (CI)=1.32-2.43) and frequent smoking behaviour (OR=1.49, 95% CI=1.08-2.05) for males and early sexual debut (OR=4.37, 95% CI=1.02-18.68) and frequent drinking (OR=2.05, 95% CI=1.12-3.75) for females. Appropriate interventions should be implemented for adolescents in Korea to delay sexual debut and educate them on the proper use of condoms.

Timing of the initiation of parenteral nutrition in critically ill children.

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Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P

2017-05-01

To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.

Non-use of Formal Health Services in Malawi: Perceptions from Non ...

African Journals Online (AJOL)

for those who were non-users of health services due to poor attitudes of health workers, they ..... services (especially mother and child services) free of charge to the .... Ngozo C: Malawi: vaccination foiled by divine intervention. Africaonline: the ...

Socio- cultural effects on children's initiation of joint attention

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Yana eGavrilov

2012-10-01

Full Text Available Exchanging gazes with a social partner in response to an event in the environment is considered an effective means to direct attention, share affective experiences and highlight a target in the environment. This behavior appears during infancy and plays an important role in children's learning and in shaping their socio-emotional development. It has been suggested that cultural values of the community affect socio-emotional development through attentional dynamics of social reference (Rogoff et al., 1993. Maturational processes of brain-circuits have been found to mediate socio-cultural learning and the behavioral manifestation of cultural norms starting at preschool age (Nelson and Guyer, 2011. The aim of the current study was to investigate the relations between cultural ecology levels and children's joint attention (JA. Initiation of JA bids was studied empirically as a function of the level of social load of the target toy (3 levels, the community level of adherence to traditional values (3 levels parental education (2 levels and gender. Sixty-two kindergarten aged children were enrolled in a structured toy-exploration task, during which they were presented with toys of various social loads, with social agents (i.e., mother and experimenter present nearby, and non-social distracters presented intermittently. Analysis of variance indicated that the child's initiation of JA towards the social partner was affected by all levels of cultural ecology (i.e., toy's social load, adherence to tradition values, parental education, gender, thus supporting the study's hypotheses. The effects were such that overall, children, particularly girls' JA initiation was augmented in social toys and moderated by the socio-cultural variables. Cultural ecology seems to be related to children's JA, thereby scaffolding initiation of social sharing cues between children and adults. JA plays a role in adjusting children's internal representations of their ecological

Effects of periods of nonuse and fluctuating ammonia concentration on biofilter performance.

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Chen, Ying-Xu; Yin, Jun; Wang, Kai-Xiong; Fang, Shi

2004-01-01

A systematic study on the transient behavior of odor treatment using biofilters is described. The biofilters were exposed to variations in contaminant loading and periods of nonuse. Two bench-scale biofilters with different filter media were used. Mixtures of compost/perlite (5:1) and dry sludge/granular active carbon (5:1) were used as filter media. Ammonia (NH3), one of the main malodorous gases, was used as the target compound. The response of each biofilter to variations in contaminant mass loading, periodic nonuse, water content, and inlet concentration pulse was studied. The nonuse period comprised of two stages: the "idle phase" when no air was passing through the biofilters, and the "no-contaminant-loading phase" when only humidified air was passing through the biofilters. Concentration spike was applied to study the effects of shock loading on the biofilter performance. Biofilters responded effectively to NH3 concentration variations and shock loading by rapidly recovering to the original removal rates within 6-12h. The results indicated re-acclimation times ranged from several hours to longer than a day. Longer idle phase produced longer re-acclimation periods than periods of no contaminant loading. When the media was dried during the biofiltration process, elimination capacity dropped accordingly for both biofilters. After 24 h of drying, the biofilter experiment could be restarted and run for a few days for recovering.

A survey of users and non-users of a UK teaching hospital library and information service.

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Turtle, Kathleen M

2005-12-01

The Lancashire Teaching Hospitals NHS Trust was formed in 2002 with the merger of two existing trusts. The library services unified to create a new expanded service with 11 staff. The librarians wanted to test out users' opinions of the service, as a basis for a developmental strategy. They also wanted to find out to what extent they were offering a multi-disciplinary service, available to all staff. Therefore it was decided to include both users and non-users in the survey. A twenty-question questionnaire was sent out to a 10% sample of registered users in all staff categories. The same questionnaire was sent out to a 10% sample of non-users, with the help of the Human Resources Department. The library staff and facilities were generally well regarded. The stock needed expansion in various areas, especially allied health and biomedical science. Non-users were in fact often occasional or remote users. Other non-users needed informing that they were entitled to use the service. Further research is required, especially concerning the information needs of allied health and scientific staff. There is a need for stock expansion. A marketing strategy is required to capture the interest of potential users.

Use and Non-Use of Humor in Academic ESL Classrooms

Science.gov (United States)

Ziyaeemehr, Ali; Kumar, Vijay; Abdullah, Mohd S. Faiz

2011-01-01

A substantial body of research emphasizes the importance of humor in teaching/learning processes; however, research on the reasons for non-use of humor in academic contexts has enjoyed scant attention. Addressing this gap, this study examines the reasons for instructors' humor avoidance taking into account student perceived benefits of using humor…

Attitudinal Study of User and Non-User Teachers' towards ICT in Relation to Their School Teaching Subjects

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Lal, Chhavi

2014-01-01

The present study aimed to know the attitude towards ICT of user and non-user teachers of ICT. The data were collected from 40 (20 male and 20 Female) user and non-user of ICT secondary school teachers from Agra city. Attitude towards ICT was measured by Computer Attitude Scale (CAS), originally developed by Loyd and Gressard (1984). Data were…

Comparing Facebook Users and Facebook Non-Users: Relationship between Personality Traits and Mental Health Variables - An Exploratory Study.

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Brailovskaia, Julia; Margraf, Jürgen

2016-01-01

Over one billion people use Facebook as a platform for social interaction and self-presentation making it one of the most popular online sites. The aim of the present study was to investigate differences in various personality traits and mental health variables between Facebook users and people who do not use this platform. The data of 945 participants (790 Facebook users, 155 Facebook non-users) were collected. Results indicate that Facebook users score significantly higher on narcissism, self-esteem and extraversion than Facebook non-users. Furthermore, they have significantly higher values of social support, life satisfaction and subjective happiness. Facebook non-users have (marginally) significantly higher values of depression symptoms than Facebook users. In both groups, extraversion, self-esteem, happiness, life satisfaction, resilience and social support, on the one hand, and depression, anxiety and stress symptoms, on the other hand, are negatively correlated. Neuroticism is positively associated with depression, anxiety and stress symptoms. However, significant differences exist between Facebook users and Facebook non-users regarding some associations of personality traits and mental health variables. Compared to Facebook non-users, the present results indicate that Facebook users have higher values of certain personality traits and positive variables protecting mental health. These findings are of particular interest considering the high importance of social online-platforms in the daily life of many people.

Comparing Facebook Users and Facebook Non-Users: Relationship between Personality Traits and Mental Health Variables - An Exploratory Study.

Directory of Open Access Journals (Sweden)

Julia Brailovskaia

Full Text Available Over one billion people use Facebook as a platform for social interaction and self-presentation making it one of the most popular online sites. The aim of the present study was to investigate differences in various personality traits and mental health variables between Facebook users and people who do not use this platform. The data of 945 participants (790 Facebook users, 155 Facebook non-users were collected. Results indicate that Facebook users score significantly higher on narcissism, self-esteem and extraversion than Facebook non-users. Furthermore, they have significantly higher values of social support, life satisfaction and subjective happiness. Facebook non-users have (marginally significantly higher values of depression symptoms than Facebook users. In both groups, extraversion, self-esteem, happiness, life satisfaction, resilience and social support, on the one hand, and depression, anxiety and stress symptoms, on the other hand, are negatively correlated. Neuroticism is positively associated with depression, anxiety and stress symptoms. However, significant differences exist between Facebook users and Facebook non-users regarding some associations of personality traits and mental health variables. Compared to Facebook non-users, the present results indicate that Facebook users have higher values of certain personality traits and positive variables protecting mental health. These findings are of particular interest considering the high importance of social online-platforms in the daily life of many people.

Lifestyle factors among proton pump inhibitor users and nonusers: a cross-sectional study in a population-based setting.

Science.gov (United States)

Hvid-Jensen, Frederik; Nielsen, Rikke B; Pedersen, Lars; Funch-Jensen, Peter; Drewes, Asbjørn Mohr; Larsen, Finn B; Thomsen, Reimar W

2013-01-01

Lifestyle factors may influence observed associations between proton pump inhibitor (PPI) usage and health outcomes. The aim of the study reported here was to examine characteristics and differences in lifestyle among PPI users and nonusers. This cross-sectional study utilized data from a 2006 population-based health survey of 21,637 persons in the Central Danish Region. All persons using prescribed PPIs were identified through linkage to a population-based prescription database. Biometric measures and prevalence of smoking, excessive alcohol consumption, diet, and physical exercise were analyzed, comparing PPI users with nonusers. Among 10,129 (46.8%) male and 11,508 (53.2%) female survey respondents, 1,356 (13.4%) males and 1,691 (14.7%) females reported ever use of PPIs. PPI users were more obese (16.7%) than nonusers (13.1%), with an age- and sex-standardized prevalence ratio (PR) of 1.3 (95% confidence interval [CI]: 1.2-1.4). The prevalence of smokers was also higher in the PPI group (26.2% vs 22.3% [PR =1.2, 95% CI: 1.1-1.3]), as was the prevalence of ex-smokers (41.0% vs 32.0% [PR =1.2, 95% CI: 1.1-1.2]). Unhealthy diet was slightly more common among PPI users than among nonusers (15.4% vs 13.0%), with a PR of 1.2 (95% CI: 1.1-1.3). Physical exercise level and alcohol consumption were similar in the two groups. Hospital-diagnosed comorbidity was observed in 35% of PPI users (a Charlson Comorbidity Index score of 1 or more) compared with only 15% among nonusers. PPI users are more obese, smoke more, and have significantly more comorbidities than PPI nonusers. These data are important when evaluating unmeasured confounding in observational studies of PPI effects.

Food and Beverage Selection Patterns among Menu Label Users and Nonusers: Results from a Cross-Sectional Study.

Science.gov (United States)

Gruner, Jessie; Ohri-Vachaspati, Punam

2017-06-01

By May 5, 2017, restaurants with 20 or more locations nationwide will be required to post calorie information on menus and menu boards. Previous research shows that those who use menu labels purchase fewer calories, but how users are saving calories is unknown. To assess food and beverage selection patterns among menu label users and nonusers. Secondary, cross-sectional analysis using data from a study examining sociodemographic disparities in menu label usage at a national fast-food restaurant chain. Participants were recruited outside restaurant locations, using street-intercept survey methodology. Consenting customers submitted receipts and completed a brief oral survey. Receipt data were used to categorize food and beverage purchases. Side, beverage, and entrée purchases. Sides and beverages were classified as healthier and less-healthy options consistent with the 2015 Dietary Guidelines for Americans. Healthier options contained items promoted in the guidelines, such as whole fruits, vegetables, low-fat dairy, and 100% fruit juice; less-healthy options contained solid fat or added sugar. Entrées were categorized as lower-, medium-, and higher-calorie options, based on quartile cutoffs. Multinomial logistic regression models were used to estimate prevalence ratios (PRs) for purchases among menu label users and nonusers, controlling for sociodemographic characteristics and total price paid. Healthier sides were selected by 7.5% of users vs 2.5% of nonusers; healthier beverages were selected by 34.0% of users vs 11.6% of nonusers; and lowest-calorie entrées were selected by 28.3% of users vs 30.1% of nonusers. Compared with nonusers (n=276), users (n=53) had a higher probability of purchasing healthier sides (PR=5.44; P=0.034), and healthier beverages (PR=3.37; P=0.005). No significant differences were seen in the purchasing patterns of entrées. Targeting educational campaigns to side and beverage purchasing behaviors may increase the effectiveness of menu

Using donation mechanisms to value nonuse benefits from public goods

Science.gov (United States)

Patricia A. Champ; Richard C. Bishop; Thomas C. Brown; Daniel W. McCollum

1997-01-01

This paper discusses an experiment in which the value for an unfamiliar environmental good, whose total value has a large nonuse component, is verified using a revealed-preference method. As we were unable to observe preferences via an incentive compatible mechanism, we collected voluntary contributions toward the provision of the good. We make a case for interpreting...

Outcomes among HIV-infected children initiating HIV care and antiretroviral treatment in Ethiopia.

Science.gov (United States)

Melaku, Zenebe; Lulseged, Sileshi; Wang, Chunhui; Lamb, Matthew R; Gutema, Yoseph; Teasdale, Chloe A; Ahmed, Solomon; Gadisa, Tsigereda; Habtamu, Zelalem; Bedri, Abubaker; Fayorsey, Ruby; Abrams, Elaine J

2017-04-01

To describe pediatric ART scale-up in Ethiopia, one of the 21 global priority countries for elimination of pediatric HIV infection. A descriptive analysis of routinely collected HIV care and treatment data on HIV-infected children (<15 years) enrolled at 70 health facilities in four regions in Ethiopia, January 2006-September 2013. Characteristics at enrollment and ART initiation are described along with outcomes at 1 year after enrollment. Among children who initiated ART, cumulative incidence of death and loss to follow-up (LTF) were estimated using survival analysis. 11 695 children 0-14 years were enrolled in HIV care and 6815 (58.3%) initiated ART. At enrollment, 31.2% were WHO stage III and 6.3% stage IV. The majority (87.9%) were enrolled in secondary or tertiary facilities. At 1 year after enrollment, 17.9% of children were LTF prior to ART initiation. Among children initiating ART, cumulative incidence of death was 3.4%, 4.1% and 4.8%, and cumulative incidence of LTF was 7.7%, 11.8% and 16.6% at 6, 12 and 24 months, respectively. Children <2 years had higher risk of LTF and death than older children (P < 0.0001). Children with more advanced disease and those enrolled in rural settings were more likely to die. Children enrolled in more recent years were less likely to die but more likely to be LTF. Over the last decade large numbers of HIV-infected children have been successfully enrolled in HIV care and initiated on ART in Ethiopia. Retention prior to and after ART initiation remains a major challenge. © 2017 John Wiley & Sons Ltd.

Comparing Facebook Users and Facebook Non-Users: Relationship between Personality Traits and Mental Health Variables – An Exploratory Study

Science.gov (United States)

2016-01-01

Over one billion people use Facebook as a platform for social interaction and self-presentation making it one of the most popular online sites. The aim of the present study was to investigate differences in various personality traits and mental health variables between Facebook users and people who do not use this platform. The data of 945 participants (790 Facebook users, 155 Facebook non-users) were collected. Results indicate that Facebook users score significantly higher on narcissism, self-esteem and extraversion than Facebook non-users. Furthermore, they have significantly higher values of social support, life satisfaction and subjective happiness. Facebook non-users have (marginally) significantly higher values of depression symptoms than Facebook users. In both groups, extraversion, self-esteem, happiness, life satisfaction, resilience and social support, on the one hand, and depression, anxiety and stress symptoms, on the other hand, are negatively correlated. Neuroticism is positively associated with depression, anxiety and stress symptoms. However, significant differences exist between Facebook users and Facebook non-users regarding some associations of personality traits and mental health variables. Compared to Facebook non-users, the present results indicate that Facebook users have higher values of certain personality traits and positive variables protecting mental health. These findings are of particular interest considering the high importance of social online-platforms in the daily life of many people. PMID:27907020

Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders.

Science.gov (United States)

Ostovar, Afshin; Haerinejad, Mohammad Javad; Akbarzadeh, Samad; Keshavarz, Mojtaba

2017-10-01

Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported. Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants' information, including demographic characteristics, sports' status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests. Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders. Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders.

Racial-ethnic variation in U.S. mental health service use among Latino and Asian non-U.S. citizens.

Science.gov (United States)

Lee, Sungkyu; Laiewski, Laurel; Choi, Sunha

2014-01-01

This study examined the factors associated with service utilization for mental health conditions among Latino and Asian non-U.S. citizens in the United States by service type and race. Data were obtained from the National Latino and Asian American Study (NLAAS). The sample for this study was 849 Latino and 595 Asian non-U.S. citizens between ages 18 and 64 (N=1,444). Mental health services obtained through three types of service providers were examined: specialty mental health services, general medical services, and other services. Guided by the modified Andersen health behavioral model, analyses involved logistic regression models conducted with penalized maximum likelihood estimation. Although having a psychiatric disorder increased mental health service use in both groups, only 32% of Latino and 52% of Asian non-U.S. citizens with psychiatric needs reported using mental health services during the past 12 months. Overall, noncitizen Latinos and Asians were more likely to use mental health services from general health care providers and other providers than from specialty mental health providers. Several significant predisposing, enabling, and need factors, such as age, health insurance, and having psychiatric conditions, also interacted with race. Findings of the study suggest that there are ethnoracial variations in mental health service use between Latino and Asian non-U.S. citizens. Mental health professionals should consider developing tailored mental health interventions that account for cultural variations to enhance access to services for these vulnerable subgroups of Latinos and Asians. Further research should examine ethnic disparities in mental health service use among various non-U.S. citizen racial-ethnic subgroups.

Norm of nuclear weapons non-use and deterrence: interaction of the conceptions in case of usa

OpenAIRE

Bladaitė, Neringa

2016-01-01

Norm of Nuclear Weapons Non-use and Deterrence: Interaction of the Conceptions in Case of USA The problem that is analyzed in this master thesis is formed according the paradox. Although, US is thought to be the county that maintains norm of non-use, in the practice US forms the strategy according nuclear deterrence. The object of this master thesis is nuclear weapons posture of US during the period of 2009-2015. The main aim of this thesis is to explore posture of US nuclear weapons use base...

Forest Conservation in Costa Rica: when nonuse benefits are uncertain but rising

NARCIS (Netherlands)

Bulte, E.H.; Soest, van D.P.; Kooten, van G.C.; Schipper, R.A.

2002-01-01

Stochastic dynamic programming is used to investigate optimal holding of primary tropical forest in humid Costa Rica when future nonuse benefits of forest conservation are uncertain and increasing. The quasi-option value of maintaining primary forests is included as a component of investment in

Why don't urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults.

Directory of Open Access Journals (Sweden)

Jessie Pinchoff

Full Text Available Zambia experiences high unmet need for family planning and high rates of HIV, particularly among youth. While male condoms are widely available and 95% of adults have heard of them, self-reported use in the past 12 months is low among young adults (45%. This study describes factors associated with non-use of male condoms among urban young adults in Zambia.A household cross-sectional survey in four urban districts was conducted from November 2015 to January 2016 among sexually active young adults ages 18-24 years. A random walk strategy was implemented in urban areas; eligible, enrolled participants were administered a survey on household characteristics, health access, and knowledge, attitudes and practices related to contraception. Relative risk regression models were built to determine factors associated with the decision to not use a male condom (non-use at most recent sexual intercourse.A total of 2,388 individuals were interviewed; 69% were female, 35% were married, and average lifetime sex partners was 3.45 (SD±6.15. Non-use of male condoms was 59% at most recent sexual intercourse. In a multivariate model, women were more likely to report non-use of a male condom compared with men (aRR = 1.24 [95% CI: 1.11, 1.38], married individuals were more likely to report non-use compared with unmarried individuals (aRR = 1.59 [1.46, 1.73], and those residing in the highest poverty wards were more likely to report non-use compared with those in the lowest poverty wards (aRR = 1.31 [1.16, 1.48]. Those with more negative perceptions of male condom use were 6% more likely to report non-use (aRR = 1.06 [1.03, 1.09]. Discussion regarding contraception with a partner decreased non-use 13% (aRR = 0.87 [0.80, 0.95] and agreement regarding male condom use with a partner decreased non-use 16% (aRR = 0.84 [0.77, 0.91].Non-use of male condoms is high among young, married adults, particularly women, who may be interested in contraception for family planning but

State-owned companies dominate list of largest non-U.S. producers

International Nuclear Information System (INIS)

Beck, R.J.; Williamson, M.

1994-01-01

Because state-owned oil and gas companies dominate Oil and Gas Journal's list of largest non-US producers, data aren't fully comparable with those of the OGJ300. Many state companies report only production and reserves, with little or no financial data. Companies on the OGJ100, therefore, cannot be ranked by assets or revenues. Instead, they are listed by regions, based on location of corporate headquarters. There was no change in makeup of the top 20 holders of crude oil reserves. These companies' reserves totaled 872.3 billion bbl in 1993. The top 20 non-US companies now control 87.3 % of total world crude oil reserves, according to OGJ estimates. This is up marginally from 87.2 % of total world oil reserves in 1992. The top 20 had 87.7 % of total world reserves in 1991 and 85.5 % in 1990. The table lists company name, total assets, revenues, net income, capital and exploratory expenditures, worldwide oil production, gas production, oil and gas reserves worldwide

Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders

Directory of Open Access Journals (Sweden)

Afshin Ostovar

2017-10-01

Full Text Available Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported.Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants’ information, including demographic characteristics, sports’ status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests.Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders.Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders.

Troublesome telephony: how users and non-users shaped the development of early British exchange telephony

Directory of Open Access Journals (Sweden)

Dr Michael Kay

2015-05-01

Full Text Available When exchange telephony was first marketed to the British public by the early telephone companies in the late nineteenth century it was as an intuitive technology requiring no specialist knowledge or training. This has gone unquestioned in subsequent telephone historiography but, as this article demonstrates, telephone instruments and systems were not always unproblematic or easy to use. Whilst other scholars have discussed important factors in the development and uptake of telephony, such as business economics and intellectual property, this article focuses on usage, and argues that difficulties in using telephone instruments and systems also influenced key changes in the operations of early British exchange systems. To understand these responses and developments it is necessary to look at the opinions and complaints of both users and non-users of telephone exchange systems. In investigating non-users as well as users, this article is influenced by the work of Sally Wyatt in Oudshoorn and Pinch's (2003 edited volume regarding users and non-users of technologies. Recovering the reactions of such people is possible through extensive use of letters received by the telephone companies or published in the periodical press, and opinions voiced at select committee meetings investigating the state of the country's telephone system. In recovering the difficulties early users and non-users faced when confronted with exchange telephone systems this article emphasises the importance of problematising the historical uptake of new technologies, and highlights how, in the case of early British telephony in particular, these problems can reveal specific facts both about historical telephone use-experience and about how exchange telephony spread around the country.

Systems Analysis, Machineable Circulation Data and Library Users and Non-Users.

Science.gov (United States)

Lubans, John, Jr.

A study to be made with computer-based circulation data of the non-use and use of a large academic library is discussed. A search of the literature reveals that computer-based circulation systems can be, but have not been, utilized to provide data bases for systematic analyses of library users and resources. The data gathered in the circulation…

Socioeconomic Inequalities in Nonuse of Seatbelts in Cars and Helmets on Motorcycles among People Living in Kurdistan Province, Iran.

Science.gov (United States)

Moradi, Ghobad; Malekafzali Ardakani, Hossein; Majdzadeh, Reza; Bidarpour, Farzam; Mohammad, Kazem; Holakouie-Naieni, Kourosh

2014-09-01

The aim of this study was to determine the socioeconomic inequalities in nonuse of seatbelts in cars and helmets on motorcycles in Kurdistan Province, west of Iran, 2009. The data used in this study was collected from the data gathered in non-communicable disease surveillance system (NCDSS) in 2009 in Kurdistan. A total of 1000 people were included in this study. The outcome variable of this study was the nonuse of seatbelts and helmets. The socio-economic status (SES) was calculated based on participants' residential area and assets using Principal Component Analysis (PCA) method. The concentration index, concentration curve, and comparison of Odds Ratio (OR) in different SES groups were used to measure the socioeconomic inequalities using logistic regression. In order to determine the contribution of determinants of inequality, decomposition analysis was used. The prevalence of nonuse of seatbelts in cars and helmets on motorcycles were 47.5%, 95%CI [44%, 55%], respectively. The Concentration index was -0.097, CI [-0.148, -0.046]. The OR of nonuse of seatbelts in cars and helmets on motorcycles in the richest group compared with the poorest group was 0.39, 95%CI [0.23, 0.68]. The results of the decomposition analysis showed that 34% of inequalities were due to SES, 47% were due to residential area, and 12% were due to unknown factors. There is a reverse association between SES and nonuse of seatbelts in cars and helmets on motorcycles. This issue must be considered while planning to reduce traffic accidents injuries.

Use and non-use values as motivational construct dimensions for farm animal welfare: impacts on the economic outcome for the farm.

Science.gov (United States)

Hansson, H; Lagerkvist, C J; Azar, G

2018-01-24

This study explored how farmers' motivation in terms of use values and/or non-use values to work with farm animal welfare are associated with the economic outcome for the farm. Use values in farm animal welfare refer to economic value derived from productivity and profitability considerations. Non-use values in farm animal welfare refer to economic value derived from good animal welfare, irrespective of the use the farmer derives from the animal, currently or in the future. The analysis was based on detailed information about the income statements of a sample of Swedish dairy farmers, obtained from the Swedish Farm Economic Survey, complemented with survey information about their perceived use and non-use values in farm animal welfare. The findings suggest that farm economic outcome is significantly associated with motivation in terms of use values, but not so much with motivation in terms of non-use values. This is interesting from a policy point of view, because it indicates that farmers with different approaches to farm animal welfare may experience different economic outcomes for their farms. Findings can, for instance, be used to strengthen farmers' engagement in various private quality assurance standards, which generally focus on values of non-use type, by pointing to that realisation of such values will not impair the economic outcome of the farms. Moreover, findings also suggest that farmers' economic incentives for engagement in such standards may need to be further strengthened in order to become more attractive, as findings point to that a focus on non-use values generally is not associated with more favourable economic outcomes.

Sustained Benefits of Exercise-based Motivational Interviewing, but Only among Nonusers of Opioids in Patients with Fibromyalgia.

Science.gov (United States)

Kim, Sunghye; Slaven, James E; Ang, Dennis C

2017-04-01

Given the known side effects of opioids and their potential effects on cognition, we sought to evaluate the benefits of motivational interviewing (MI) to promote physical activity on 2 subsets of participants with fibromyalgia (FM): nonusers and users of opioids. This was a secondary data analysis of a 36-week randomized controlled trial to assess the efficacy of MI to promote physical activity among participants with FM. Participants were randomized to 1 of 2 treatment arms: 6 phone-based MI sessions (n = 107) or 6 sessions of FM self-management instructions [attention control (AC), n = 109]. The primary outcomes were changes in physical function (Medical Outcomes Study Short Form-36), pain severity (Brief Pain Inventory), global FM symptom severity (Fibromyalgia Impact Questionnaire), and the amount of light to moderate physical activity (LMPA) from baseline to each followup visit. At study entry, subjects were categorized as opioid nonusers versus users. Repeated measures ANOVA was used to assess treatment effects adjusting for potential confounders. Of the 216 participants, 145 (67%) were nonusers and 71 (33%) were opioid users. Among nonusers, MI was associated with improved physical function, reduced pain severity, and global FM severity, and increased LMPA at 6-month followup. Among opioid users, there were no significant differences in any outcome measures between the MI and AC groups. Exercise-based MI was associated with sustained clinical benefits 6 months after completion of therapy, but only for those who were not taking opioids.

Reasons for not using ecstasy: a qualitative study of non-users, ex-light users and ex-moderate users

Science.gov (United States)

2012-01-01

Background Although ecstasy is often consumed in the electronic music scene, not everyone with the opportunity to use it chooses to do so. The objective of this study was to understand the reasons for non-use or the cessation of use, which could provide information for public health interventions. Methods A qualitative reference method was used. Our “snowball” sample group consisted of 53 people who were split into three subgroups: non-users (NU, n = 23), ex-light users (EX-L, n = 12) and ex-moderate users (EX-M, n = 18). Individual, semi-structured interviews were conducted, transcribed and subjected to content analysis with the aid of NVivo8. Results Adverse health effects and personal values were given as reasons for non-use in the three groups. Non-users (NU) and ex-light users (EX-L) provided reasons that included fear of possible effects as well as moral, family and religious objections. Ex-moderate users (EX-M) cited reasons related to health complications and concomitant withdrawal from the electronic music scene. However, most of the ex-moderate users did not rule out the possibility of future use. Conclusions Potential effects and undesirable consequences appear to guide the decisions within the different groups. Prevention might target these motivations. Individuals who have used ecstasy indicate that social and environmental factors are the most important factors. PMID:22583984

Association of initial CT findings with quality-of-life outcomes for traumatic brain injury in children

Energy Technology Data Exchange (ETDEWEB)

Swanson, Jonathan O. [Seattle Children' s Hospital and University of Washington, Department of Radiology, Seattle, WA (United States); Vavilala, Monica S.; Wang, Jin; Rivara, Frederick P. [Harborview Medical Center, University of Washington, Department of Pediatrics, Seattle, WA (United States); Pruthi, Sumit [Monroe Carell Jr. Children' s Hospital at Vanderbilt University, Department of Radiology, Nashville, TN (United States); Fink, James [University of Washington, Department of Radiology, Seattle, WA (United States); Jaffe, Kenneth M. [University of Washington, Department of Rehabilitation Medicine, Seattle, WA (United States); Durbin, Dennis [University of Pennsylvania, Department of Pediatrics, Center for Injury Research and Prevention, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Koepsell, Thomas [University of Washington, Department of Epidemiology, Seattle, WA (United States); Temkin, Nancy [University of Washington, Biostatistics, Seattle, WA (United States)

2012-08-15

Traumatic brain injury (TBI) is a leading cause of acquired disability in children and adolescents. To demonstrate the association between specific findings on initial noncontrast head CT and long-term outcomes in children who have suffered TBI. This was an IRB-approved prospective study of children ages 2-17 years treated in emergency departments for TBI and who underwent a head CT as part of the initial work-up (n = 347). The change in quality of life at 12 months after injury was measured by the PedsQL scale. Children with TBI who had intracranial injuries identified on the initial head CT had a significantly lower quality-of-life scores compared to children with TBI whose initial head CTs were normal. In multivariate analysis, children whose initial head CT scans demonstrated intraventricular hemorrhage, parenchymal injury, midline shift {>=}5 mm, hemorrhagic shear injury, abnormal cisterns or subdural hematomas {>=}3 mm had lower quality of life scores 1 year after injury than children whose initial CTs did not have these same injuries. Associations exist between findings from the initial noncontrast head CT and quality of life score 12 months after injury in children with TBI. (orig.)

Intake of micronutrients among Danish adult users and non-users of dietary supplements

DEFF Research Database (Denmark)

Tetens, Inge; Biltoft-Jensen, Anja Pia; Spagner, Camilla

2011-01-01

Objectives: To evaluate the intake of micronutrients from the diet and from supplements in users and non-users of dietary supplements, respectively, in a representative sample of the Danish adult population. A specific objective was to identify the determinants of supplement use. Design: A cross-...

Effects of video modeling on social initiations by children with autism.

Science.gov (United States)

Nikopoulos, Christos K; Keenan, Michael

2004-01-01

We examined the effects of a video modeling intervention on social initiation and play behaviors with 3 children with autism using a multiple baseline across subjects design. Each child watched a videotape showing a typically developing peer, and the experimenter engaged in a simple social interactive play using one toy. For all children, social initiation and reciprocal play skills were enhanced, and these effects were maintained at 1- and 3-month follow-up periods.

Reasons for School Counselors' Use or Nonuse of Play Therapy: An Exploratory Study

Science.gov (United States)

Shen, Yih-Jiun

2008-01-01

The reasons for elementary and secondary school counselors' use or nonuse of play therapy were surveyed with 239 Texas public school counselors. Play therapy users applied the approach because of intervention advantages, counselor's philosophy, counselor's rewarding counseling outcomes, convincing empirical data, and the support of clients'…

Dairy farmers' use and non-use values in animal welfare: Determining the empirical content and structure with anchored best-worst scaling.

Science.gov (United States)

Hansson, H; Lagerkvist, C J

2016-01-01

In this study, we sought to identify empirically the types of use and non-use values that motivate dairy farmers in their work relating to animal welfare of dairy cows. We also sought to identify how they prioritize between these use and non-use values. Use values are derived from productivity considerations; non-use values are derived from the wellbeing of the animals, independent of the present or future use the farmer may make of the animal. In particular, we examined the empirical content and structure of the economic value dairy farmers associate with animal welfare of dairy cows. Based on a best-worst scaling approach and data from 123 Swedish dairy farmers, we suggest that the economic value those farmers associate with animal welfare of dairy cows covers aspects of both use and non-use type, with non-use values appearing more important. Using principal component factor analysis, we were able to check unidimensionality of the economic value construct. These findings are useful for understanding why dairy farmers may be interested in considering dairy cow welfare. Such understanding is essential for improving agricultural policy and advice aimed at encouraging dairy farmers to improve animal welfare; communicating to consumers the values under which dairy products are produced; and providing a basis for more realistic assumptions when developing economic models about dairy farmers' behavior. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

US versus non-US utility procurement practices

International Nuclear Information System (INIS)

Clark, H.

1991-01-01

Utilities, particularly in the USA, have often been accused by the uranium industry of behaving like a herd with respect to their activities in the nuclear fuel market. While I disagree with this characterization, I do recognize that utilities in general have certain common motivations influencing their nuclear fuel procurement activities which may make them appear to follow each other. This paper reviews these motivations, how they differ between US and non-US utilities, how such differences lead to different procurement practices in the USA and elsewhere, the resulting impacts on the nuclear fuel market, and the changes, if, any, which one may expect in the future. The discussion in this paper is geared mainly towards the uranium market, though the concepts discussed are also somewhat applicable to the other components of nuclear fuel. (author)

Mayan Children's Creation of Learning Ecologies by Initiative and Cooperative Action.

Science.gov (United States)

de León, Lourdes

2015-01-01

This chapter examines Mayan children's initiatives in creating their own learning environments in collaboration with others as they engage in culturally relevant endeavors of family and community life. To this end, I carry out a fine-grained ethnographic and linguistic analysis of the interactional emergence of learning ecologies. Erickson defines learning ecology as a socioecological system where participants mutually influence one another through verbal and nonverbal actions, as well as through other forms of semiotic communication (2010, 254). In analyzing learning ecologies, I adopt a "theory of action" approach, taking into account multimodal communication (e.g., talk, gesture, gaze, body positioning), participants' sociospatial organization, embodied action, objects, tools, and other culturally relevant materials brought together to build action (Goodwin, 2000, 2013; Hutchins, 1995). I use microethnographic analysis (Erickson, 1992) to bring to the surface central aspects of children's agentive roles in learning through "cooperative actions" (Goodwin, 2013) and "hands-on" experience (Ingold, 2007) the skills of competent members of their community. I examine three distinct Learning Ecologies created by children's initiatives among the Mayan children that I observed: (i) children requesting guidance to collaborate in a task, (ii) older children working on their own initiative with subsequent monitoring and correction from competent members, and (iii) children with near competence in a task with occasional monitoring and no guidance. I argue that these findings enrich and add power to models of family- and community-based learning such as Learning by Observing and Pitching In (Rogoff, 2014). © 2015 Elsevier Inc. All rights reserved.

Methods for Measuring Non-use Values: A Contingent Valuation Study of Groundwater Cleanup (1992-1994)

Science.gov (United States)

The motivating question the groundwater study was designed to address is simply: Do any non-use benefits derive from corrective actions regarding groundwater contamination and if so, how large might they be?

The Nonuse, Misuse, and Proper Use of Pilot Studies in Experimental Evaluation Research

Science.gov (United States)

Westlund, Erik; Stuart, Elizabeth A.

2017-01-01

This article discusses the nonuse, misuse, and proper use of pilot studies in experimental evaluation research. The authors first show that there is little theoretical, practical, or empirical guidance available to researchers who seek to incorporate pilot studies into experimental evaluation research designs. The authors then discuss how pilot…

A Comparison of Marijuana Users and Nonusers On A Number of Personality Variables

Science.gov (United States)

Simon, William E.; And Others

1974-01-01

The present study compares marijuana users and nonusers in terms of (a) psychological needs, (b) self-descriptions, (c) self-esteem, (d) academic achievement, (e) ordinal position of birth, and (f) attitudes toward the legalization of various items. Some significant differences were reported between groups of users. (Author/PC)

Barriers and facilitators to using NHS Direct: a qualitative study of 'users' and 'non-users'.

Science.gov (United States)

Cook, Erica J; Randhawa, Gurch; Large, Shirley; Guppy, Andy; Chater, Angel M; Ali, Nasreen

2014-10-25

NHS Direct, introduced in 1998, has provided 24/7 telephone-based healthcare advice and information to the public in England and Wales. National studies have suggested variation in the uptake of this service amongst the UK's diverse population. This study provides the first exploration of the barriers and facilitators that impact upon the uptake of this service from the perspectives of both 'users' and 'non- users'. Focus groups were held with NHS Direct 'users' (N = 2) from Bedfordshire alongside 'non-users' from Manchester (N = 3) and Mendip, Somerset (N = 4). Each focus group had between five to eight participants. A total of eighty one people aged between 21 and 94 years old (M: 58.90, SD: 22.70) took part in this research. Each focus group discussion lasted approximately 90 minutes and was audiotape-recorded with participants' permission. The recordings were transcribed verbatim. A framework approach was used to analyse the transcripts. The findings from this research uncovered a range of barriers and facilitators that impact upon the uptake of NHS Direct. 'Non-users' were unaware of the range of services that NHS Direct provided. Furthermore, 'non-users' highlighted a preference for face-to face communication, identifying a lack of confidence in discussing healthcare over the telephone. This was particularly evident among older people with cognitive difficulties. The cost to telephone a '0845' number from a mobile was also viewed to be a barrier to access NHS Direct, expressed more often by 'non-users' from deprived communities. NHS Direct 'users' identified that awareness, ease of use and convenience were facilitators which influenced their decision to use the service. An understanding of the barriers and facilitators which impact on the access and uptake of telephone-based healthcare is essential to move patients towards the self-care model. This research has highlighted the need for telephone-based healthcare services to increase public awareness; through

Mexican-American mothers’ initiation and understanding of home oral hygiene for young children

Science.gov (United States)

HOEFT, Kristin S.; BARKER, Judith C.; MASTERSON, Erin E.

2012-01-01

Purpose To investigate caregiver beliefs and behaviors as key issues in the initiation of home oral hygiene routines. Oral hygiene helps reduce the prevalence of early childhood caries, which is disproportionately high among Mexican-American children. Methods Interviews were conducted with a convenience sample of 48 Mexican-American mothers of young children in a low income, urban neighborhood. Interviews were digitally recorded, translated, transcribed, coded and analyzed using standard qualitative procedures. Results The average age of tooth brushing initiation was 1.8±0.8 years; only a small proportion of parents (13%) initiated oral hygiene in accord with American Dental Association (ADA) recommendations. Mothers initiated 2 forms of oral hygiene: infant oral hygiene and regular tooth brushing. For the 48% of children who participated in infant oral hygiene, mothers were prompted by pediatrician and social service (WIC) professionals. For regular tooth brushing initiation, a set of maternal beliefs exist about when this oral hygiene practice becomes necessary for children. Beliefs are mainly based on a child’s dental maturity, interest, capacity and age/size. Conclusions Most (87%) of the urban Mexican-American mothers in the study do not initiate oral hygiene practices in compliance with ADA recommendations. These findings have implications for educational messages. PMID:19947134

Paediatric early warning scores on a children's ward: a quality improvement initiative.

LENUS (Irish Health Repository)

Ennis, Linda

2014-09-09

The aim of this quality improvement initiative was to incorporate a paediatric early warning score (PEWS) and track and trigger system in the routine care of children in an acute general children\\'s ward at a regional hospital in the Republic of Ireland. In the absence of a nationally recommended specific PEWS strategy, a local plan was developed. The experience of structuring and implementing the PEWS and track and trigger system is presented in this article. Data from the first year of use were collected to evaluate the clinical utility and effectiveness of this system. In the busy acute children\\'s service, the PEWS initiative was found to benefit processes of early detection, prompt referral and timely, appropriate management of children at potential risk of clinical deterioration. Nursing staff were empowered and supported to communicate concerns immediately and to seek rapid medical review, according to an agreed PEWS escalation plan. Outcomes were significantly improved.

Innovation technology in the initial training of children by the example of sport games

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Ruslana Sushko

2015-04-01

Full Text Available Purpose: to determine the characteristics of innovative technologies and the current state of organizational work with children at the initial stage of training in sports. Material and Methods: to understand the application of innovative technologies used coaches poll and summarized expert assessment specialists in the field of sports. Results: the current state of the question concerning the possibility of the initial training of children in early specialization in sports for example basketball, volleyball and tennis. Clarified the importance and necessity of innovative activities for children at the initial stage of training in sports. Conclusions: the identified innovative approaches for constructing the process of initial training in tennis, which are not observed in other kinds of sports.

Trends in characteristics of children served by the Children's Mental Health Initiative: 1994-2007.

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Walrath, Christine; Garraza, Lucas Godoy; Stephens, Robert; Azur, Melissa; Miech, Richard; Leaf, Philip

2009-11-01

Data from 14 years of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program were used to understand the trends of the emotional and behavioral problems and demographic characteristics of children entering services. The data for this study were derived from information collected at intake into service in 90 sites who received their initial federal funding between 1993 and 2004. The findings from this study suggest children entering services later in a site's funding cycle had lower levels of behavioral problems and children served in sites funded later in the 14 year period had higher levels of behavioral problems. Females have consistently entered services with more severe problems and children referred from non-mental health sources, younger children, and those from non-white racial/ethnic backgrounds have entered system of care services with less severe problems. The policy and programming implications, as well as implications for local system of care program development and implementation are discussed.

Examining Marijuana User and Non-User Prototypes in Formative Research for Prevention Campaigns

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Comello, Maria Leonora G.; Slater, Michael D.

2010-01-01

We report on research--both quantitative and qualitative--conducted to explore perceptions of prototypes of marijuana users, as well as the extent to which self-prototype congruence predicted marijuana use intention. Results of a survey of undergraduates (N = 139) showed that prototypes of users and non-users differed in terms of key attributes,…

Temporal features of word-initial /s/+stop clusters in bilingual Mandarin-English children and monolingual English children and adults.

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Yang, Jing

2018-03-01

This study investigated the durational features of English word-initial /s/+stop clusters produced by bilingual Mandarin (L1)-English (L2) children and monolingual English children and adults. The participants included two groups of five- to six-year-old bilingual children: low proficiency in the L2 (Bi-low) and high proficiency in the L2 (Bi-high), one group of age-matched English children, and one group of English adults. Each participant produced a list of English words containing /sp, st, sk/ at the word-initial position followed by /a, i, u/, respectively. The absolute durations of the clusters and cluster elements and the durational proportions of elements to the overall cluster were measured. The results revealed that Bi-high children behaved similarly to the English monolinguals whereas Bi-low children used a different strategy of temporal organization to coordinate the cluster components in comparison to the English monolinguals and Bi-high children. The influence of language experience and continuing development of temporal features in children were discussed.

Sleep Hygiene and Melatonin Treatment for Children and Adolescents with ADHD and Initial Insomnia

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Weiss, Margaret D.; Wasdell, Michael B.; Bomben, Melissa M.; Rea, Kathleen J.; Freeman, Roger D.

2006-01-01

Objective: To evaluate the efficacy of sleep hygiene and melatonin treatment for initial insomnia in children with attention-deficit/hyperactivity disorder (ADHD). Method: Twenty-seven stimulant-treated children (6-14 years of age) with ADHD and initial insomnia (greater than 60 minutes) received sleep hygiene intervention. Nonresponders were…

Who uses physician-rating websites? Differences in sociodemographic variables, psychographic variables, and health status of users and nonusers of physician-rating websites.

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Terlutter, Ralf; Bidmon, Sonja; Röttl, Johanna

2014-03-31

The number of physician-rating websites (PRWs) is rising rapidly, but usage is still poor. So far, there has been little discussion about what kind of variables influence usage of PRWs. We focused on sociodemographic variables, psychographic variables, and health status of PRW users and nonusers. An online survey of 1006 randomly selected German patients was conducted in September 2012. We analyzed the patients' knowledge and use of online PRWs. We also analyzed the impact of sociodemographic variables (gender, age, and education), psychographic variables (eg, feelings toward the Internet, digital literacy), and health status on use or nonuse as well as the judgment of and behavior intentions toward PRWs. The survey instrument was based on existing literature and was guided by several research questions. A total of 29.3% (289/986) of the sample knew of a PRW and 26.1% (257/986) had already used a PRW. Younger people were more prone than older ones to use PRWs (t967=2.27, P=.02). Women used them more than men (χ(2) 1=9.4, P=.002), the more highly educated more than less educated people (χ(2) 4=19.7, P=.001), and people with chronic diseases more than people without (χ(2) 1=5.6, P=.02). No differences were found between users and nonusers in their daily private Internet use and in their use of the Internet for health-related information. Users had more positive feelings about the Internet and other Web-based applications in general (t489=3.07, P=.002) than nonusers, and they had higher digital literacy (t520=4.20, PUsers ascribed higher usefulness to PRWs than nonusers (t612=11.61, Pusers trusted information on PRWs to a greater degree than nonusers (t559=11.48, PUsers were also more likely to rate a physician on a PRW in the future (t367=7.63, Pincrease use of PRWs in the future.

Initial Orientation of Attention towards Emotional Faces in Children with Attention Deficit Hyperactivity Disorder

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Mehrnoosh Ahmadi

2011-09-01

Full Text Available Objective: Early recognition of negative emotions is considered to be of vital importance. It seems that children with attention deficit hyperactivity disorder have some difficulties recognizing facial emotional expressions, especially negative ones. This study investigated the preference of children with attention deficit hyperactivity disorder for negative (angry, sad facial expressions compared to normal children.Method: Participants were 35 drug naive boys with ADHD, aged between 6-11 years ,and 31 matched healthy children. Visual orientation data were recorded while participants viewed face pairs (negative-neutral pairs shown for 3000ms. The number of first fixations made to each expression was considered as an index of initial orientation. Results: Group comparisons revealed no difference between attention deficit hyperactivity disorder group and their matched healthy counterparts in initial orientation of attention. A tendency towards negative emotions was found within the normal group, while no difference was observed between initial allocation of attention toward negative and neutral expressions in children with ADHD .Conclusion: Children with attention deficit hyperactivity disorder do not have significant preference for negative facial expressions. In contrast, normal children have a significant preference for negative facial emotions rather than neutral faces.

Missing Photos, Suffering Withdrawal, or Finding Freedom? How Experiences of Social Media Non-Use Influence the Likelihood of Reversion

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Eric P. S. Baumer

2015-11-01

Full Text Available This article examines social media reversion, when a user intentionally ceases using a social media site but then later resumes use of the site. We analyze a convenience sample of survey data from people who volunteered to stay off Facebook for 99 days but, in some cases, returned before that time. We conduct three separate analyses to triangulate on the phenomenon of reversion: simple quantitative predictors of reversion, factor analysis of adjectives used by respondents to describe their experiences of not using Facebook, and statistical topic analysis of free-text responses. Significant factors predicting either increased or decreased likelihood of reversion include, among others, prior use of Facebook, experiences associated with perceived addiction, issues of social boundary negotiation such as privacy and surveillance, use of other social media, and friends’ reactions to non-use. These findings contribute to the growing literature on technology non-use by demonstrating how social media users negotiate, both with each other and with themselves, among types and degrees of use and non-use.

Assessment of pain experience in adults and children after bracket bonding and initial archwire insertion

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Marcio José da Silva Campos

2013-10-01

Full Text Available INTRODUCTION: Ninety five percent of orthodontic patients routinely report pain, due to alterations in the periodontal ligament and surrounding soft tissues, with intensity and prevalence varying according to age. OBJECTIVE: This study aimed to assess toothache and buccal mucosal pain in adults and children during two initial phases of the orthodontic treatment. METHODS: The intensity of toothache and buccal mucosal pain reported by 20 patients, 10 children (11-13 years and 10 adults (18-37 years was recorded with the aid of a Visual Analog Scale (VAS, during 14 days - 7 days with bonded brackets only and 7 days with the initial archwire inserted. RESULTS: There was no significant difference in pain intensity among adults and children. After bracket bonding, 50% of the children and 70% of the adults reported pain. 70% of both groups reported pain after initial archwire insertion. While adults reported constant, low intensity, buccal mucosal pain, the children showed great variation of pain intensity, but with a trend towards decreasing pain during the assessment period. After initial archwire insertion the peaks of toothache intensity and prevalence occurred 24 hours in children and 48 hours in adults. CONCLUSIONS: In general, children reported pain less frequently than adults did, though with greater intensity.

Print Knowledge in Yucatec Maya-Spanish Bilingual Children: An Initial Inquiry

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Bengochea, Alain; Justice, Laura M.; Hijlkema, Maria J.

2017-01-01

This study serves as an initial inquiry regarding the early print knowledge of emergent bilingual preschool-age children living in an Indigenous community in Mexico. In this research, we examine various dimensions of print knowledge with Yucatec Maya-Spanish bilingual children for whom one of their languages (Yucatec Maya) is seldom seen in print…

Obesogenic habits among children and their families in response to initiation of gluten-free diet.

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Levran, Neriya; Wilschanski, Michael; Livovsky, Jessica; Shachar, Edna; Moskovitz, Moti; Assaf-Jabrin, Lama; Shteyer, Eyal

2018-06-01

Initiation of a lifelong, gluten-free diet (GFD) in children with celiac disease (CD) influences the child's life in many ways. The aim of this study was to assess the influence of GFD on the child and his/her family's eating habits and lifestyle behaviors. To study this, we asked children and their parents completed the Family Eating and Activity Habits Questionnaire (FEAHQ) at the time of diagnosis of CD and at least 6 months after initiation of GFD and a questionnaires assessing symptoms related to CD and adherence to the GFD diet. We analyzed questionnaires from 40 children with CD and their families. There were 21 females, ranging in age from 4 to 15.7 years (median age 7.4 years±2.8 years). The control group comprised 15 healthy children. After initiation of GFD the family ate more junk food including snacks and candies (p = 0.05), with the significant change reported by children and fathers (p = 0.001 and 0.03 respectively). All family members in the control group had significantly less snacks. Parents and children reported a significant increase in obesogenic eating styles, such as eating from the cooking pot and eating while doing other activities (mothers, p = 0.001; fathers, 0.02; and children, 0.02 respectively). Our study shows that initiation of GFD in children with CD leads to changes in eating habits and staple food eating that may lead to a more obesogenic environment. Care givers, pediatricians, gastroenterologists, and dieticians alike should be aware of these implications and educate families towards a healthier lifestyle and diet beyond the GFD itself. What's Known: • Gluten-free diet has been shown to affect various psychosocial aspects of children with celiac disease. • Obesity and celiac are associated. What is New: • Initiation of gluten-free diet led to increased eating of junk food both in the patient and his/her family. • After initiation of GFD pro-obesogenic eating habits is increased.

Verbal learning and memory in adolescent cannabis users, alcohol users and non-users.

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Solowij, Nadia; Jones, Katy A; Rozman, Megan E; Davis, Sasha M; Ciarrochi, Joseph; Heaven, Patrick C L; Lubman, Dan I; Yücel, Murat

2011-07-01

Long-term heavy cannabis use can result in memory impairment. Adolescent users may be especially vulnerable to the adverse neurocognitive effects of cannabis. In a cross-sectional and prospective neuropsychological study of 181 adolescents aged 16-20 (mean 18.3 years), we compared performance indices from one of the most widely used measures of learning and memory--the Rey Auditory Verbal Learning Test--between cannabis users (n=52; mean 2.4 years of use, 14 days/month, median abstinence 20.3 h), alcohol users (n=67) and non-user controls (n=62) matched for age, education and premorbid intellectual ability (assessed prospectively), and alcohol consumption for cannabis and alcohol users. Cannabis users performed significantly worse than alcohol users and non-users on all performance indices. They recalled significantly fewer words overall (pmemory performance after controlling for extent of exposure to cannabis. Despite relatively brief exposure, adolescent cannabis users relative to their age-matched counterparts demonstrated similar memory deficits to those reported in adult long-term heavy users. The results indicate that cannabis adversely affects the developing brain and reinforce concerns regarding the impact of early exposure.

Scandinavian guidelines for initial management of minor and moderate head trauma in children

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Astrand, Ramona; Rosenlund, Christina; Undén, Johan

2016-01-01

. CONCLUSIONS: We present new evidence and consensus based Scandinavian Neurotrauma Committee guidelines for initial management of minor and moderate head trauma in children. These guidelines should be validated before extensive clinical use and updated within four years due to rapid development of new......BACKGROUND: The management of minor and moderate head trauma in children differs widely between countries. Presently, there are no existing guidelines for management of these children in Scandinavia. The purpose of this study was to produce new evidence-based guidelines for the initial management...... of head trauma in the paediatric population in Scandinavia. The primary aim was to detect all children in need of neurosurgical intervention. Detection of any traumatic intracranial injury on CT scan was an important secondary aim. METHODS: General methodology according to the Appraisal of Guidelines...

The Comparison of Attitudes Toward Infidelity and Religious Orientation in Facebook Social Network users and non-users

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سیدهادی سیدعلی تبار

2015-12-01

Full Text Available This study aimed to compare attitudes towards infidelity and religious orientation in users and non-users of Facebook social network. This research was basic in terms of purpose and casual-comparative in terms of data collection. The study population included all married men and women referring to consulting centers of Tehran. A sample of 280 people (109 users an-d 171 non-users were selected through convenience sampling. Attitude toward Infidelity Scale and Religious Orientation Scale were used to collect the data and analyzed with Multivariate Analysis of Variance (MANOVA. Results showed that internal religious orientation (P0.05. This study suggests that using Facebook does not have any impact on attitude toward infidelity singly, but it can cause differences in internal and external religious orientation among Facebook users.

Substance Use and Depression Symptomatology: Measurement Invariance of the Beck Depression Inventory (BDI-II among Non-Users and Frequent-Users of Alcohol, Nicotine and Cannabis.

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Ashlee A Moore

Full Text Available Depression is a highly heterogeneous condition, and identifying how symptoms present in various groups may greatly increase our understanding of its etiology. Importantly, Major Depressive Disorder is strongly linked with Substance Use Disorders, which may ameliorate or exacerbate specific depression symptoms. It is therefore quite plausible that depression may present with different symptom profiles depending on an individual's substance use status. Given these observations, it is important to examine the underlying construct of depression in groups of substance users compared to non-users. In this study we use a non-clinical sample to examine the measurement structure of the Beck Depression Inventory (BDI-II in non-users and frequent-users of various substances. Specifically, measurement invariance was examined across those who do vs. do not use alcohol, nicotine, and cannabis. Results indicate strict factorial invariance across non-users and frequent-users of alcohol and cannabis, and metric invariance across non-users and frequent-users of nicotine. This implies that the factor structure of the BDI-II is similar across all substance use groups.

Substance Use and Depression Symptomatology: Measurement Invariance of the Beck Depression Inventory (BDI-II) among Non-Users and Frequent-Users of Alcohol, Nicotine and Cannabis.

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Moore, Ashlee A; Neale, Michael C; Silberg, Judy L; Verhulst, Brad

2016-01-01

Depression is a highly heterogeneous condition, and identifying how symptoms present in various groups may greatly increase our understanding of its etiology. Importantly, Major Depressive Disorder is strongly linked with Substance Use Disorders, which may ameliorate or exacerbate specific depression symptoms. It is therefore quite plausible that depression may present with different symptom profiles depending on an individual's substance use status. Given these observations, it is important to examine the underlying construct of depression in groups of substance users compared to non-users. In this study we use a non-clinical sample to examine the measurement structure of the Beck Depression Inventory (BDI-II) in non-users and frequent-users of various substances. Specifically, measurement invariance was examined across those who do vs. do not use alcohol, nicotine, and cannabis. Results indicate strict factorial invariance across non-users and frequent-users of alcohol and cannabis, and metric invariance across non-users and frequent-users of nicotine. This implies that the factor structure of the BDI-II is similar across all substance use groups.

Online communication predicts Belgian adolescents' initiation of romantic and sexual activity.

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Vandenbosch, Laura; Beyens, Ine; Vangeel, Laurens; Eggermont, Steven

2016-04-01

Online communication is associated with offline romantic and sexual activity among college students. Yet, it is unknown whether online communication is associated with the initiation of romantic and sexual activity among adolescents. This two-wave panel study investigated whether chatting, visiting dating websites, and visiting erotic contact websites predicted adolescents' initiation of romantic and sexual activity. We analyzed two-wave panel data from 1163 Belgian adolescents who participated in the MORES Study. We investigated the longitudinal impact of online communication on the initiation of romantic relationships and sexual intercourse using logistic regression analyses. The odds ratios of initiating a romantic relationship among romantically inexperienced adolescents who frequently used chat rooms, dating websites, or erotic contact websites were two to three times larger than those of non-users. Among sexually inexperienced adolescents who frequently used chat rooms, dating websites, or erotic contact websites, the odds ratios of initiating sexual intercourse were two to five times larger than that among non-users, even after a number of other relevant factors were introduced. This is the first study to demonstrate that online communication predicts the initiation of offline sexual and romantic activity as early as adolescence. Practitioners and parents need to consider the role of online communication in adolescents' developing sexuality. • Adolescents increasingly communicate online with peers. • Online communication predicts romantic and sexual activity among college students. What is New: • Online communication predicts adolescents' offline romantic activity over time. • Online communication predicts adolescents' offline sexual activity over time.

Is Pornography Really about "Making Hate to Women"? Pornography Users Hold More Gender Egalitarian Attitudes Than Nonusers in a Representative American Sample.

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Kohut, Taylor; Baer, Jodie L; Watts, Brendan

2016-01-01

According to radical feminist theory, pornography serves to further the subordination of women by training its users, males and females alike, to view women as little more than sex objects over whom men should have complete control. Composite variables from the General Social Survey were used to test the hypothesis that pornography users would hold attitudes that were more supportive of gender nonegalitarianism than nonusers of pornography. Results did not support hypotheses derived from radical feminist theory. Pornography users held more egalitarian attitudes--toward women in positions of power, toward women working outside the home, and toward abortion--than nonusers of pornography. Further, pornography users and pornography nonusers did not differ significantly in their attitudes toward the traditional family and in their self-identification as feminist. The results of this study suggest that pornography use may not be associated with gender nonegalitarian attitudes in a manner that is consistent with radical feminist theory.

Initiating insulin therapy in children and adolescents with type 1 diabetes mellitus

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Subhash Kumar Wangnoo

2015-01-01

Full Text Available The primary clinical goals to be achieved with insulin initiation are elimination of ketosis and hyperglycemia with prevention of chronic complications. Insulin therapy is the mainstay in management of type 1 diabetes, which should be aimed at achieving good glycemic control, with achievement of hemoglobin A1c (HbA1c <7.5%, pre-meal self-monitored blood glucose (SMBG of 90-130 mg/dL, bed time SMBG of 100-140 mg/dL, mean blood glucose level of 120-160 mg/dL and no ketonuria. Two classes of insulin are available for use in T1DM viz. bolus/prandial insulins (rapid-acting insulins and short-acting insulins and basal insulins (intermediate-acting insulin and long-acting insulin. Insulin glargine and glulisine can be used in children above 6 years, lispro in children above 3 years and detemir and aspart in children above 2 years. The caution for hypoglycemia should be exercised while prescribing them. Degludec is currently not approved for pediatric use. The initial insulin regimen should comprise of ≥2 daily bolus and ≥1 basal insulin injections. Insulin intensification would be required if the initial regimen fails, which can be achieved by increasing frequency of long and rapid acting insulin analogues. The American Diabetes Association guidelines recommend HbA1c targets of <8.0% for children <6 years of age, ≤7.5% for children 6 to 12 years of age, and ≤7.0% for adolescents, 12-18 years of age. However, the evidence is now in favor of a single target HbA1c of ≤7.5% for all children and adolescents <19 years of age.

Employees’ Involuntary Non-Use of ICT Influenced by Power Differences: A Case Study with the Grounded Theory Approach

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Thale Kvernberg Andersen

2015-07-01

Full Text Available Power differences affect implementation of information and communication technology (ICT in a way that creates differences in ICT use. Involuntary non-use of new ICT at work occurs when employees want to use the new technology, but are unable to due to factors beyond their control. Findings from an in-depth qualitative study show how involuntary non-use of new ICT can be attributed to power differences between occupational groups in the same organization. The findings suggest that experience is a moderating variable and that closeness to formal power holders as well as closeness to the new technology increases the probability for expert control of the ICT-organization processes. These power differences favor ICT experts over ICT novices and result in a high-quality learning environment for the ICT experts characterized by autonomy, inclusion, and adequate work processes and technological solutions. The ICT novices try to navigate in a learning-hostile work environment characterized by marginalization through expert control, isolation, and inadequate work processes and technological solutions. This led to involuntary non-use by the ICT novices, while the experts became more proficient in ICT use. These findings give managers facing a technological organizational change tools to understand important mechanisms for implementing the change in their own organization, and help them take the right actions to integrate new technology and new organization of work.

[E-learning in orthopedics and traumatology. A comparative pilot study on acceptance and knowledge acquisition among users and non-users].

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Hoff, E; Haberstroh, N; Sostmann, K; Perka, C; Putzier, M; Schmidmaier, G; Back, D A

2014-07-01

Additional internet-based learning tools (e-learning) are successfully used in the curricula of many disciplines and are highly accepted among students. However, in orthopedics and traumatology e-learning is underrepresented and scientific papers are rare. The aim of the present pilot study was to evaluate the acceptance of the e-learning module network for students in traumatology and orthopedics (NESTOR) among users and non-users and to analyze the effect of this additional learning tool on knowledge acquisition. A total of 544 students were asked to complete evaluation questionnaires at the end of two semesters using different ones for NESTOR users and non-users. The gain of knowledge was analyzed by two written knowledge tests (pre-post test, 20 multiple choice questions) at the beginning and end of the semester comparing these two groups. A total of 191 students took part in the evaluation and 152 completed both written tests. The NESTOR users showed a high acceptance of the e-learning system and non-users considered e-learning beneficial as well. Reasons given for not using NESTOR were lack of time, lack of information about the existence of NESTOR and a lack of interest in this discipline and e-learning in general. Both groups significantly increased their level of knowledge during the course of the semester (p e-learning project NESTOR in teaching students in orthopedics and traumatology. Based on experience and these results the permanent implementation of an additional e-learning module in the curriculum can be recommended for other faculties. In this process the critical comments of the non-users determined in the present study should be addressed.

The Influence of Hearing Aid Use on Outcomes of Children With Mild Hearing Loss.

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Walker, Elizabeth A; Holte, Lenore; McCreery, Ryan W; Spratford, Meredith; Page, Thomas; Moeller, Mary Pat

2015-10-01

This study examined the effects of consistent hearing aid (HA) use on outcomes in children with mild hearing loss (HL). Five- or 7-year-old children with mild HL were separated into 3 groups on the basis of patterns of daily HA use. Using analyses of variance, we compared outcomes between groups on speech and language tests and a speech perception in noise task. Regression models were used to investigate the influence of cumulative auditory experience (audibility, early intervention, HA use) on outcomes. Full-time HA users demonstrated significantly higher scores on vocabulary and grammar measures compared with nonusers. There were no significant differences between the 3 groups on articulation or speech perception measures. After controlling for the variance in age at confirmation of HL, level of audibility, and enrollment in early intervention, only amount of daily HA use was a significant predictor of grammar and vocabulary. The current results provide evidence that children's language development benefits from consistent HA use. Nonusers are at risk in areas such as vocabulary and grammar compared with other children with mild HL who wear HAs regularly. Service providers should work collaboratively to encourage consistent HA use.

Perceptions of Pediatric Nephrologists regarding Timing of Dialysis Initiation in Children in Canada

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Jeremy A. Saban

2016-07-01

Full Text Available Background: Significant practice variation exists in Canada with respect to timing of dialysis initiation in children. In the absence of evidence to guide practice, physicians' perceptions may significantly influence decision-making. Objective: The objectives of this study are to (1 evaluate Canadian pediatric nephrologists' perceptions regarding dialysis initiation in children with chronic kidney disease (CKD and (2 determine the factors guiding practice that may contribute to practice variation across Canada. Design: This study was a cross-sectional online survey. Setting: This study was done in academic pediatric nephrology centers in Canada. Participants: The participants of this study are pediatric nephrologists. Measurements and methods: An anonymous web-based survey was administered to pediatric nephrologists in Canada to evaluate perspectives and practice patterns regarding timing of dialysis initiation. We also explored the importance of estimated glomerular filtration rate (eGFR vs. symptoms and the role of patient and provider factors influencing decisions. Results: Thirty-five nephrologists (59 % completed the survey. Most respondents care for advanced CKD patients in a multidisciplinary clinic (86 % and no centers have a formal policy on timing of dialysis initiation. Seventy-five percent of centers follow 30 patients. Discussions about dialysis initiation are generally informal (75 % and the decision to start is made by the nephrologist (37 % or a team (57 %. Fifty percent agreed GFR was important when deciding when to initiate dialysis, 41 % were neutral, and 9 % disagreed. Variability exists in the threshold that nephrologists considered early (vs. late dialysis initiation: >20 (21 %, >15 (38 %, >12 (26 %, and >10 ml/min/1.73 m 2 (12 %. Practitioners however typically start dialysis in asymptomatic patients at eGFRs of 7–9 (9 %, 10–11 (41 %, 12–14 (38 %, and 15–19 (6 % ml/min/1.73 m 2 . Patient factors important in the

Legal aspects of cruise medicine - can a non-US ship's doctor be sued for malpractice in Florida?

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Dahl, Eilif

2014-01-01

An English ship's doctor treated a non-US female patient for abdominal discomfort on a foreign-flagged cruise ship off the coast of Haiti. In Mexico the patient underwent abdominal surgery, followed by complications, for which her lawyers wanted to take the ship's doctor to court in Florida, USA. A trial court granted their wish, but this decision was reversed on appeal as the factors discussed were insufficient to establish Florida jurisdiction over the ship's doctor. The decision is not about whether malpractice occurred; it is about limiting the possibility of taking the ship's doctor to a court in a location preferred by the plaintiffs' lawyers. The appeal court ruling is important for non-US doctors working as independent contractors on cruise vessels that visit US ports, and it will hopefully prevent some of the more frivolous law suits from being filed in the future.

Characteristics of HIV-Infected Children at Enrollment into Care and at Antiretroviral Therapy Initiation in Central Africa.

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Adebola Adedimeji

Full Text Available Despite the World Health Organization (WHO regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described.Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA pediatric cohort of 3,426 children (0-15 years entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and weight-for-age Z score (WAZ, each at enrollment into HIV care and at ART initiation. Changes in the medians or proportions of each measure by year of enrollment and year of ART initiation were assessed to capture potential impacts of changing ART guidelines.Median age at care enrollment decreased from 77.2 months in 2004-05 to 30.3 months in 2012-13. The median age at ART initiation (n = 2058 decreased from 83.0 months in 2004-05 to 66.9 months in 2012-13. The proportion of children ≤24 months of age at enrollment increased from 12.7% in 2004-05 to 46.7% in 2012-13, and from 9.6% in 2004-05 to 24.2% in 2012-13 for ART initiation. The median CD4 count at enrollment into care increased from 563 (IQR: 275, 901 in 2004-05 to 660 (IQR: 339, 1071 cells/μl in 2012-13, and the median CD4 count at ART initiation increased from 310 (IQR:167, 600 in 2004-05 to 589 (IQR: 315, 1113 cells/μl in 2012-13. From 2004-05 to 2012-13, median WAZ improved from -2 (IQR: -3.4, -1.1 to -1 (IQR: -2.5, -0.2 at enrollment in care and from -2 (IQR: -3.8, -1.6 to -1 (IQR: -2.6, -0.4 at ART initiation.Although HIV-infected children ≤24 months of age accounted for half of all children enrolling in care in our cohort during 2012-13, they represented less than a quarter of all those who were initiated on ART during the same period

Which Spouse Initiates Marital Separation when There Are Children Involved?

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Hewitt, Belinda

2009-01-01

This report examines whether the presence of children in marriage differentially influences the risk of wives or husbands initiating separation. The analytic sample consists of 9,118 first marriages from the Households, Income and Labour Dynamics in Australia survey (2001). Using event history and competing risks analysis, I find weak evidence…

Association between age at antiretroviral therapy initiation and 24-month immune response in West-African HIV-infected children

DEFF Research Database (Denmark)

Desmonde, Sophie; Dicko, Fatoumata; Koueta, Fla

2014-01-01

measurements, including one at ART initiation (baseline) were included. CD4 cell gain on ART was estimated using a multivariable linear mixed model adjusted for baseline variables: age, CD4 cell count, sex, first-line ART regimen. Kaplan-Meier survival curves and a Cox proportional hazards regression model...... compared immune recovery for age within 24 months post-ART. RESULTS: Of the 4808 children initiated on ART, 3014 were enrolled at a median age of 5.6 years; 61.2% were immunodeficient. After 12 months, children at least 4 years at baseline had significantly lower CD4 cell gains compared with children less...... these children, 75% reached immune recovery: 12-month rates were significantly highest in all those aged 2-5 years at ART initiation compared with those less than 2 years. Beyond 12 months on ART, immune recovery was significantly lower in children initiated more than 5 years (adjusted hazard ratio: 0.69, 95...

Estimating the value of non-use benefits from small changes in the provision of ecosystem services.

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Dutton, Adam; Edwards-Jones, Gareth; Macdonald, David W

2010-12-01

The unit of trade in ecosystem services is usually the use of a proportion of the parcels of land associated with a given service. Valuing small changes in the provision of an ecosystem service presents obstacles, particularly when the service provides non-use benefits, as is the case with conservation of most plants and animals. Quantifying non-use values requires stated-preference valuations. Stated-preference valuations can provide estimates of the public's willingness to pay for a broad conservation goal. Nevertheless, stated-preference valuations can be expensive and do not produce consistent measures for varying levels of provision of a service. Additionally, the unit of trade, land use, is not always linearly related to the level of ecosystem services the land might provide. To overcome these obstacles, we developed a method to estimate the value of a marginal change in the provision of a non-use ecosystem service--in this case conservation of plants or animals associated with a given land-cover type. Our method serves as a tool for calculating transferable valuations of small changes in the provision of ecosystem services relative to the existing provision. Valuation is achieved through stated-preference investigations, calculation of a unit value for a parcel of land, and the weighting of this parcel by its ability to provide the desired ecosystem service and its effect on the ability of the surrounding land parcels to provide the desired service. We used the water vole (Arvicola terrestris) as a case study to illustrate the method. The average present value of a meter of water vole habitat was estimated at UK £ 12, but the marginal value of a meter (based on our methods) could range between £ 0 and £ 40 or more. © 2010 Society for Conservation Biology.

Parental smoking, exposure to secondhand smoke at home, and smoking initiation among young children.

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Wang, Man Ping; Ho, Sai Yin; Lam, Tai Hing

2011-09-01

To investigate the associations of parental smoking and secondhand smoke (SHS) exposure at home with smoking initiation among young children in Hong Kong. A prospective school-based survey of Hong Kong primary 2-4 students was conducted at baseline in 2006 and followed up in 2008. Self-administered anonymous questionnaires were used to collect information about smoking, SHS exposure at home, parental smoking, and sociodemographic characteristics. Cross-sectional and prospective associations of SHS exposure at home and parental smoking with student smoking were analyzed using logistic regression adjusting for potential confounders. Cross-sectional association between parental smoking and ever smoking was significant with adjustment of sociodemographic characteristics but became insignificant after adjusting for home SHS exposure. Home SHS exposure mediated the association between parental smoking and students smoking (p = .03). Prospectively, parental smoking was not associated with smoking initiation after adjusting for home SHS exposure. Each day increase in home SHS exposure significantly predicted 16% excess risk of smoking initiation after adjusting for parental smoking. The prospective effect of parental smoking on smoking initiation was significantly mediated by baseline home SHS exposure (p smoking initiation of young Chinese children in Hong Kong independent of parental smoking status. On the other hand, the effect of parental smoking on smoking initiation was mediated through SHS exposure at home. To prevent children from smoking as well as the harm of SHS exposure, parents and other family members should quit smoking or at least reduce smoking at home.

Reducing hospital admissions of healthy children with functional constipation: a quality initiative.

Science.gov (United States)

Deneau, Mark; Mutyala, Ramakrishna; Sandweiss, David; Harnsberger, Janet; Varier, Raghu; Pohl, John F; Allen, Lauren; Thackeray, Callie; Zobell, Sarah; Maloney, Christopher

2017-01-01

Functional constipation (FC) is a common medical problem in children, with minimal risk of long-term complications. We determined that a large number of children were being admitted to our children's hospital for FC in which there was no neurological or anatomical cause. Our hospital experienced a patient complication in which a patient died after inpatient treatment of FC. Subsequently, we developed a standardised approach to determine when paediatric patients needed hospitalisation for FC, as well as to develop a regimented outpatient therapeutic approach for such children to prevent hospitalisation. Our quality improvement initiative resulted in a large decrease in the number of children with FC admitted into the hospital as well as a decrease in the number of children needing faecal disimpaction in the operating room. Our quality improvement process can be used to decrease hospitalisations, decrease healthcare costs and improve patient care for paediatric FC.

A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

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Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

2016-06-01

Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

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

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Jackson, Christine; Dickinson, Denise

2006-01-01

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

A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland.

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Ahmed, Charisse V; Jolly, Pauline; Padilla, Luz; Malinga, Musa; Harris, Chantal; Mthethwa, Nobuhle; Ba, Inessa; Styles, Amy; Perry, Sarah; Brooks, Raina; Naluyinda-Kitabire, Florence; Mamba, Makhosini; Preko, Peter

2017-12-01

HIV/AIDS remains one of the leading causes of death among children under 5 years old in Swaziland. Although studies have shown that early initiation of infants and children diagnosed with HIV on antiretroviral therapy (ART) significantly reduces mortality, many children do not initiate ART until the later stages of disease. This study was designed to collect qualitative data from mothers and caregivers of HIV-positive children to identify the barriers to ART initiation. Focus group discussion (FGD) sessions were conducted in siSwati between July and September 2014 among caregivers of aged children 2-18 months in Swaziland who did or did not initiate ART between January 2011 and December 2012 after HIV DNA PCR-positive diagnosis of the infants. Denial, guilt, lack of knowledge, tuberculosis (TB)/HIV co-infection, HIV-related stigma, lack of money, and distance to clinics were reported by the participants as barriers to ART initiation. The findings further revealed that non-initiation on ART was not linked to a negative perception of the treatment. Findings suggest a need to improve sensitivity among healthcare workers as well as education and counselling services that will facilitate the ART initiation process.

Caries preventive efficiency of therapeutic complex accomponying orthodontic treatment of children with initial dental caries

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Denga A.E.

2013-12-01

Full Text Available The use of orthodontic non-removable appliance in orthodontic treatment inter¬feres with the process of teeth mineralization, worsens level of oral cavity hygiene, stimulates development of caries process. The situation is complicated when a patient has an initial tooth decay. The aim of this study was to determine genetic characteristics of children with initial caries and clinical evaluation of effectiveness of the developed caries preventive therapeutic complex accompanying treatment of jaw facial anomalies (JFA. 47 children aged 12-14 with initial tooth decay participated in the examination. Complex diagnostics, including molecular genetic studies was carried out. Therapeutic complex for children, of the main group included remineralizing, adaptogenic, biogenic agents, which increase non-specific resistance, as well as infiltration ICON therapy before fixing braces. Caries preventive complex accompanying JFA treatment in children with primary tooth decay developed with regard to revealed genetic disorders of amelogenesis, 2-nd of phase detoxification, collagen formation, functional responses in the oral cavity, state of hard tissues of teeth and periodontal tissues enabled to preserve existing carious process, normalize periodontal and hygienic indices at all stages of treatment.

Advertising to children initiatives have not reduced unhealthy food advertising on Australian television.

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Watson, Wendy L; Lau, Vivien; Wellard, Lyndal; Hughes, Clare; Chapman, Kathryn

2017-12-01

In response to rising childhood obesity rates, the Australian food industry implemented two initiatives in 2009 to reduce the marketing of unhealthy food to children. This study evaluated the efficacy of these initiatives on the rate of unhealthy food advertising to children on Australian television. The rates of food advertisements on three free-to-air commercial television channels and a youth-oriented digital channel in Sydney, Australia were analysed over 2 weekdays (16 h) and two weekend days (22 h). Advertisements were categorized according to the healthiness of foods advertised (non-core, core, miscellaneous) and signatory status to the food industry advertising initiatives. Total food advertising rates for the three channels increased from 5.5/h in 2011 to 7.3/h in 2015, due to an increase of 0.8/h for both core and miscellaneous foods. The rate of non-core food advertisements in 2015 (3.1/h) was similar to 2011 (3.0/h). The youth-oriented channel had fewer total food advertisements (3.7/h versus 7.3/h) but similar fast-food advertisement rates (1.3/h versus 1.3/h). There was no change in the rate of unhealthy food advertising since 2011, suggesting minimal impact of the current food industry initiatives on reducing children's exposure to unhealthy food advertising. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Self-Regulation, Language Skills, and Emotion Knowledge in Young Children from Northern Germany

Science.gov (United States)

von Salisch, Maria; Haenel, Martha; Denham, Susanne Ayers

2015-01-01

Research Findings: In order to examine the explanatory power of behavioral self-regulation in the domain of emotion knowledge, especially in a non-U.S. culture, 365 German 4- and 5-year-olds were individually tested on these constructs. Path analyses revealed that children's behavioral self-regulation explained their emotion knowledge in the…

Factors associated with use and non-use of the Fecal Immunochemical Test (FIT) kit for Colorectal Cancer Screening in Response to a 2012 outreach screening program: a survey study.

Science.gov (United States)

Gordon, Nancy P; Green, Beverly B

2015-06-11

The one-sample fecal immunochemical test (FIT) is gaining popularity for colorectal cancer (CRC) screening of average-risk people. However, uptake and annual use remain suboptimal. In 2013, we mailed questionnaires to three groups of nonHispanic White, Black, and Latino Kaiser Permanente Northern California (KPNC) members ages 52-76 who received FIT kits in 2010-2012: Continuers did the FIT all 3 years; Converts in 2012, but not 2010 or 2011; and Nonusers in none of the 3 years. The questionnaires covered social influences, perceived CRC risk, reasons for using (Continuers, Converts) or avoiding using (Nonusers) the FIT, and recommendations for improving the kit. Continuers (n = 607, response rate 67.5%), Converts (n = 317, response rate 35.6%), and Nonusers (n = 215, response rate 21.1%) did not differ in perceived risk or family history of CRC, but Nonusers were less likely than Continuers and Converts to know someone who had polyps or CRC. Continuers, Converts, and Nonusers did not differ in social network encouragement of CRC screening, but did differ in believing that it was very important that they be screened (88.3%, 68.4%, 47.7%) and that their medical team thought it very important that they be screened (88.6%, 79.9%, 53.9%). Approximately half of Continuers and Converts completed the FIT to please their doctor. Converts were less likely than Continuers to use the FIT to "make sure they were OK" (53.7% vs. 72.6%) or "protect their health" (46.1% vs. 76.4%). Nearly half of Converts completed the FIT out of guilt. Approximately half of FIT kit users suggested adding a disposable glove, extra paper, and wider-mouth tube to the kit. Nonusers' reasons for not using the FIT included discomfort, disgust, or embarrassment (59.6%); thinking it unnecessary (32.9%); fatalism/fear (15.5%); and thinking it too difficult to use (14.5%), but screening at all. Nonusers and irregular users of the FIT are less intrinsically motivated to get CRC screening than

Cerebral palsy in adult patients: constraint-induced movement therapy is effective to reverse the nonuse of the affected upper limb

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Ana Cecília P. Oliveira

2016-01-01

Full Text Available ABSTRACT Objective To determine if the original protocol of Constraint-Induced Movement Therapy (CIMT, is adequate to reverse the nonuse of the affected upper limb (AUL in patients with Cerebral Palsy (CP in adulthood. Method The study included 10 patients diagnosed with CP hemiparesis had attended the adult protocol CIMT, from January/August 2009/2014. Results Average age 24.6 (SD 9.44; MAL average pretreatment How Often (HO = 0.72 and How Well (HW = 0.68 and post-treatment HO = 3.77 and HW = 3.60 (p ≤ 0.001 and pretreatment WMFT average = 21.03 and post-treatment average = 18.91 (p = 0.350. Conclusion The constraint-induced movement therapy is effective to reverse the nonuse learn of the AUL in adult patients with CP.

Parental encouragement of initiative-taking and adjustment in Chinese children from rural, urban, and urbanized families.

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Chen, Xinyin; Li, Dan

2012-12-01

Due to the requirements of the competitive, market-oriented urban society, parents in urban and urbanized families are more likely than parents in rural families to encourage initiative-taking in child rearing in China. The socialization experiences of children from different types of families may be related to their adjustment. This study examined parental socialization attitudes, social and school adjustment, and their relations in Chinese children from rural, urban, and urbanized families. Participants were elementary school students (N = 1,033; M age = 11 years) and their parents in China. Data were obtained from parental reports, peer evaluations, teacher ratings, and school records. A multivariate analysis of variance revealed that parents in urban and urbanized families had higher scores than parents in rural families on encouragement of initiative-taking. Urban children, particularly girls, were more sociable, obtained higher social status, and had fewer school problems than their rural counterparts. Children from urbanized families were different from rural children and similar to urban children in social and school adjustment. Moreover, multigroup invariance tests showed that parental encouragement of initiative-taking was associated more strongly with children's sociable-assertive behavior and social standing in the urban and urbanized groups than in the rural group. The results indicate that particular socialization attitudes may vary in their adaptive value in child development as a function of specific social and cultural requirements in changing societies. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Drugs and personality: comparison of drug users, nonusers, and other clinical groups on the 16PF.

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Spotts, J V; Shontz, F C

1991-10-01

This article reviews published 16PF research on drug users. It also compares the 16PF scores of a new sample of nonusers with scores of matched groups of heavy, chronic users of cocaine, amphetamine, opiates, and barbiturates/sedative hypnotics, as well as combined groups of stimulant users, depressant users, and a combined group of users of all substances. No significant differences were found among drug user groups, but the profile of the nonuser group was distinctive. K-Means Cluster Analyses, as well as Cattell's Similarity and Pearson Product Moment Correlation Coefficients, were used to compare profiles of these new samples with the 19 groups described in an earlier meta-analysis of published 16PF studies. Data from the new samples did not cluster with data from other published research, although certain specific similarities appeared in more detailed correlational analyses. Methodological problems are discussed, and it is recommended that in future studies drug user groups be more carefully selected and defined, sample descriptions be more thorough and complete, complete profile information be routinely provided, and efforts be made to explore the utility of the Cattell CAQ in studies of drug users/misusers.

Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention

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Eysenbach Gunther

2010-11-01

Full Text Available Abstract Background Attrition, or nonuse of the intervention, is a significant problem in e-health. However, the reasons for this phenomenon are poorly understood. Building on Eysenbach's "Law of Attrition", this study aimed to explore the usage behavior of users of e-health services. We used two theoretical models, Andersen's Behavioral Model of Health Service Utilization and Venkatesh's Unified Theory of Acceptance and Use of Technology, to explore the factors associated with uptake and use of an internet-mediated intervention for caregivers taking care of a family member with dementia. Methods A multiphase, longitudinal design was used to follow a convenience sample of 46 family caregivers who received an e-health intervention. Applying the two theories, usage behavior was conceptualized to form four stages: consideration, initiation, utilization (attrition or continuation, and outcome. The variables and measurement scales were selected based on these theories to measure the sociodemographic context, technology aptitudes, and clinical needs of the caregivers. Results In the Consideration Stage, caregivers who felt that the information communication technology (ICT-mediated service was easy to use were more likely to consider participating in the study (p = 0.04. In the Initiation Stage, caregivers who showed greater technology acceptance were more likely to initiate service earlier (p = 0.02. In the Utilization Stage, the frequent users were those who had a more positive attitude toward technology (p = 0.04 and a lower perceived caregiver competence (p = 0.04 compared with nonusers. In the Outcome Stage, frequent users experienced a decline in perceived burden compared with an escalation of perceived burden by nonusers (p = 0.02. Conclusions We illustrate a methodological framework describing how to develop and expand a theory on attrition. The proposed framework highlighted the importance of conceptualizing e-health "use" and "adoption" as

Angular cheilitis as the initial sign of Crohn’s disease in children

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Nuzul Rezki Ramadhani

2016-06-01

Full Text Available Crohn’s disease (CD is a chronic inflammatory process of gastrointestinal tract and originally described as a disorder of the smallest intestine caused by an inappropiate mucosal inflammatory response to intestinal bacteria in genetically predisposed host. Oral manifestation are important clinical finding in Crohn’s disease especially in a pediatric patient. This review highlight oral manifestation of gastrointestinal disorder with angular cheilitis as the initial sign of CD in children. Angular cheilitis are considered to be an important extraintestinal manifestation an presenting as the initial sign of Crohn’s disease in children, although uncommon but can be an important clue in the diagnosis of CD before the development of gastrointestinal symptoms. Angular cheilitis may occasionally occur before the onset of gastrointestinal  disease be present during the disease process or persist even even after the disease has resolved.

A longitudinal study of the relationship between receptivity to e-cigarette advertisements and e-cigarette use among baseline non-users of cigarettes and e-cigarettes, United States

OpenAIRE

Israel T. Agaku; Kevin Davis; Deesha Patel; Paul Shafer; Shanna Cox; William Ridgeway; Brian A. King

2017-01-01

Background We investigated the relationship between receptivity to electronic cigarette (e-cigarette) advertisements at baseline and e-cigarette use at follow-up among adult baseline non-users of cigarettes and e-cigarettes. Material and Methods A nationally representative online panel was used to survey non-users of cigarettes and e-cigarettes (n = 2191) at baseline and 5-month follow-up. At baseline, respondents were shown an e-cigarette advertisement and asked if they were aware ...

Young women's accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study

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Free, Caroline; Lee, Raymond M; Ogden, Jane

2002-01-01

Objectives To explore young women's accounts of their use and non-use of emergency contraception. Design Qualitative study using in-depth interviews. Participants 30 women aged 16-25; participants from socially deprived inner city areas were specifically included. Setting Community, service, and educational settings in England. Results Young women's accounts of their non-use of emergency contraception principally concerned evaluations of the risk conferred by different contraceptive behaviours, their evaluations of themselves in needing emergency contraception, and personal difficulties in asking for emergency contraception. Conclusions The attitudes and concerns of young women, especially those from disadvantaged backgrounds, may make them less able or willing than others to take advantage of recent increases in access to emergency contraception. Interventions that aim to increase the use of emergency contraception need to address the factors that influence young women's non-use of emergency contraception. What is already known on this topicLimited knowledge of, or poor access to, emergency contraception, and concerns about side effects and moral issues may reduce the use of emergency contraception in women at riskYoung people can be embarrassed about using contraception servicesInterventions to increase knowledge of and access to emergency contraception have had limited success among teenagersWhat this study addsPerceptions of low vulnerability to pregnancy, negative self evaluations about the need for such contraception, and concerns about what others think deter young women from using emergency contraceptionThese women find it difficult to ask for emergency contraceptionThe attitudes and concerns of young women, especially those from deprived inner city areas, may render them least willing and able to obtain emergency contraception PMID:12480855

Progression paths in children's problem solving: The influence of dynamic testing, initial variability, and working memory.

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Resing, Wilma C M; Bakker, Merel; Pronk, Christine M E; Elliott, Julian G

2017-01-01

The current study investigated developmental trajectories of analogical reasoning performance of 104 7- and 8-year-old children. We employed a microgenetic research method and multilevel analysis to examine the influence of several background variables and experimental treatment on the children's developmental trajectories. Our participants were divided into two treatment groups: repeated practice alone and repeated practice with training. Each child received an initial working memory assessment and was subsequently asked to solve figural analogies on each of several sessions. We examined children's analogical problem-solving behavior and their subsequent verbal accounts of their employed solving processes. We also investigated the influence of verbal and visual-spatial working memory capacity and initial variability in strategy use on analogical reasoning development. Results indicated that children in both treatment groups improved but that gains were greater for those who had received training. Training also reduced the influence of children's initial variability in the use of analogical strategies with the degree of improvement in reasoning largely unrelated to working memory capacity. Findings from this study demonstrate the value of a microgenetic research method and the use of multilevel analysis to examine inter- and intra-individual change in problem-solving processes. Copyright © 2016 Elsevier Inc. All rights reserved.

A pilot study on nicotine residues in houses of electronic cigarette users, tobacco smokers, and non-users of nicotine-containing products.

Science.gov (United States)

Bush, Derek; Goniewicz, Maciej L

2015-06-01

Nicotine deposited on the surfaces has been shown to react with airborne chemicals leading to formation of carcinogens and contributing to thirdhand exposure. While prior studies revealed nicotine residues in tobacco smokers' homes, none have examined the nicotine residue in electronic cigarette (e-cigarette) users' homes. We measured nicotine on the surfaces in households of 8 e-cigarette users, 6 cigarette smokers, and 8 non-users of nicotine-containing products in Western New York, USA. Three surface wipe samples were taken from the floor, wall and window. Nicotine was extracted from the wipes and analyzed using gas chromatography. Half of the e-cigarette users' homes had detectable levels of nicotine on surfaces whereas nicotine was found in all of the tobacco cigarette smokers' homes. Trace amounts of nicotine were also detected in half of the homes of non-users of nicotine-containing products. Nicotine levels in e-cigarette users homes was significantly lower than that found in cigarette smokers homes (average concentration 7.7±17.2 vs. 1303±2676 μg/m2; pe-cigarette users and non-users (p>0.05). Nicotine is a common contaminant found on indoor surfaces. Using e-cigarettes indoors leads to significantly less thirdhand exposure to nicotine compared to smoking tobacco cigarettes. Copyright © 2015 Elsevier B.V. All rights reserved.

Weight and height z-scores improve after initiating ART among HIV-infected children in rural Zambia: a cohort study

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Sinywimaanzi Pamela

2011-03-01

Full Text Available Abstract Background Deficits in growth observed in HIV-infected children in resource-poor settings can be reversed with antiretroviral treatment (ART. However, many of the studies have been conducted in urban areas with older pediatric populations. This study was undertaken to evaluate growth patterns after ART initiation in a young pediatric population in rural Zambia with a high prevalence of undernutrition. Methods Between 2007 and 2009, 193 HIV-infected children were enrolled in a cohort study in Macha, Zambia. Children were evaluated every 3 months, at which time a questionnaire was administered, height and weight were measured, and blood specimens were collected. Weight- and height-for-age z-scores were constructed from WHO growth standards. All children receiving ART at enrollment or initiating ART during the study were included in this analysis. Linear mixed effects models were used to model trajectories of weight and height-for-age z-scores. Results A high proportion of study children were underweight (59% and stunted (72% at treatment initiation. Improvements in both weight- and height-for-age z-scores were observed, with weight-for-age z-scores increasing during the first 6 months of treatment and then stabilizing, and height-for-age z-scores increasing consistently over time. Trajectories of weight-for-age z-scores differed by underweight status at treatment initiation, with children who were underweight experiencing greater increases in z-scores in the first 6 months of treatment. Trajectories of height-for-age z-scores differed by age, with children older than 5 years of age experiencing smaller increases over time. Conclusions Some of the effects of HIV on growth were reversed with ART initiation, although a high proportion of children remained underweight and stunted after two years of treatment. Partnerships between treatment and nutrition programs should be explored so that HIV-infected children can receive optimal nutritional

Why Do They Refuse to Use My Robot? : Reasons for Non-Use Derived from a Long-Term Home Study

NARCIS (Netherlands)

De Graaf, Maartje; Ben Allouch, Somaya; Van Dijk, Jan

2017-01-01

Research on why people refuse or abandon the use of technology in general, and robots specifically, is still scarce. Consequently, the academic understanding of people's underlying reasons for non-use remains weak. Thus, vital information about the design of these robots including their acceptance

Predictors of poor CD4 and weight recovery in HIV-infected children initiating ART in South Africa.

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Brian C Zanoni

Full Text Available To identify baseline demographic and clinical risk factors associated with poor CD4 and weight response after initiation of antiretroviral therapy (ART in a cohort of human immunodeficiency virus (HIV-infected children in KwaZulu-Natal, South Africa.We performed a retrospective cohort study of 674 children initiating antiretroviral therapy at McCord and St. Mary's hospitals in KwaZulu-Natal, South Africa, from August 2003 to December 2008. We extracted data from paper charts and electronic medical records to assess risk factors associated with CD4 and weight response using logistic regression.From the initial cohort of 901 children <10 years old initiating ART between August 2003 and December 2008, we analyzed 674 children with complete baseline data. Viral suppression rates (<400 copies/ml were 84% after six months of therapy and 88% after 12 months of therapy. Seventy-three percent of children achieved CD4 recovery after six months and 89% after 12 months. Weight-for-age Z-score (WAZ improvements were seen in 58% of children after six months of ART and 64% after 12 months. After six months of ART, lower baseline hemoglobin (p = 0.037, presence of chronic diarrhea (p = 0.007, and virologic failure (p = 0.046 were all associated with poor CD4 recovery by multivariate logistic regression. After 12 months of ART, poor CD4 recovery was associated with higher baseline CD4% (p = 0.005, chronic diarrhea (p = 0.02, and virologic failure (p<0.001. Age less than 3 years at ART initiation (p = 0.0003, higher baseline CD4% (p<0.001, and higher baseline WAZ (p<0.001 were all associated with poor WAZ improvements after 6 months by multivariate logistic regression.The presence of chronic diarrhea at baseline, independent of nutritional status and viral response, predicts poor CD4 recovery. Age at initiation of ART is an important factor in early WAZ response to ART, while viral suppression strongly predicts CD4 recovery but not WAZ improvement.

A longitudinal study of the relationship between receptivity to e-cigarette advertisements and e-cigarette use among baseline non-users of cigarettes and e-cigarettes, United States

OpenAIRE

Agaku, Israel T.; Davis, Kevin; Patel, Deesha; Shafer, Paul; Cox, Shanna; Ridgeway, William; King, Brian A.

2017-01-01

Background We investigated the relationship between receptivity to electronic cigarette (e-cigarette) advertisements at baseline and e-cigarette use at follow-up among adult baseline non-users of cigarettes and e-cigarettes. Methods A nationally representative online panel was used to survey non-users of cigarettes and e-cigarettes (n = 2191) at baseline and 5-month follow-up. At baseline, respondents were shown an e-cigarette advertisement and asked if they were aware of it (exposure). Among...

The market share of non-US uranium producers under different US embargo scenarios

International Nuclear Information System (INIS)

Franks, W.A.

1988-01-01

The imposition of US restrictions on the use of foreign uranium has a potentially far reaching impact. This analysis examines various US import restriction scenarios and their impact on the market both inside and outside the USA. Specifically, the market share that the non-US producers would lose is estimated for a 50% embargo, a 62.5% embargo, and a 100% embargo, with and without the grandfathering of US utilities' foreign contracts. These results are then compared to what the market share would have been in a free market. The increase in the US market share is also briefly discussed. (author)

E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013-2015.

Science.gov (United States)

Berry, Kaitlyn M; Reynolds, Lindsay M; Collins, Jason M; Siegel, Michael B; Fetterman, Jessica L; Hamburg, Naomi M; Bhatnagar, Aruni; Benjamin, Emelia J; Stokes, Andrew

2018-03-24

The role of electronic cigarettes (e-cigarettes) in product transitions has been debated. We used nationally representative data from the Population Assessment of Tobacco and Health Study waves 1 (2013-2014) and 2 (2014-2015) to investigate the associations between e-cigarette initiation and cigarette cessation/reduction in the USA. We limited the sample to current cigarette smokers aged 25+ years who were not current e-cigarette users at wave 1. We modelled 30-day cigarette cessation and substantial reduction in cigarette consumption as a function of e-cigarette initiation between surveys using multivariable logistic regression. Between waves 1 and 2, 6.9% of cigarette smokers who were not current e-cigarette users transitioned to former smokers. After adjusting for covariates, cigarette smokers who initiated e-cigarette use between waves and reported they used e-cigarettes daily at wave 2 had 7.88 (95% CI 4.45 to 13.95) times the odds of 30-day cigarette cessation compared with non-users of e-cigarettes at wave 2. Cigarette smokers who began using e-cigarettes every day and did not achieve cessation had 5.70 (95% CI 3.47 to 9.35) times the odds of reducing their average daily cigarette use by at least 50% between waves 1 and 2 compared with e-cigarette non-users. Daily e-cigarette initiators were more likely to have quit smoking cigarettes or reduced use compared with non-users. However, less frequent e-cigarette use was not associated with cigarette cessation/reduction. These results suggest incorporating frequency of e-cigarette use is important for developing a more thorough understanding of the association between e-cigarette use and cigarette cessation. © 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.

MOOC as a Laboratory of Culture Shock: Helping Non-U.S. Students Integrate into All-American Virtual Environment

Science.gov (United States)

Chukhlomin, Valeri; Deshpande, Anant

2017-01-01

"iMOOC101: Mastering American e-Learning" is a Coursera-based, free, massive online course aimed at preparing non-U.S. students to succeed in regular, for-credit, online classes in American universities. The course is also intended to help foreign-born professionals integrate into virtual work environments in U.S.-based companies. The…

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

Science.gov (United States)

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

2006-08-01

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

The perioperative surgical home (PSH): a comprehensive review of US and non-US studies shows predominantly positive quality and cost outcomes.

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Kash, Bita A; Zhang, Yichen; Cline, Kayla M; Menser, Terri; Miller, Thomas R

2014-12-01

Policy Points: The perioperative surgical home (PSH) is complementary to the patient-centered medical home (PCMH) and defines methods for improving the patient experience and clinical outcomes, and controlling costs for the care of surgical patients. The PSH is a physician-led care delivery model that includes multi-specialty care teams and cost-efficient use of resources at all levels through a patient-centered, continuity of care delivery model with shared decision making. The PSH emphasizes "prehabilitation" of the patient before surgery, intraoperative optimization, improved return to function through follow-up, and effective transitions to home or post-acute care to reduce complications and readmissions. The evolving concept of more rigorously coordinated and integrated perioperative management, often referred to as the perioperative surgical home (PSH), parallels the well-known concept of a patient-centered medical home (PCMH), as they share a vision of improved clinical outcomes and reductions in cost of care through patient engagement and care coordination. Elements of the PSH and similar surgical care coordination models have been studied in the United States and other countries. This comprehensive review of peer-reviewed literature investigates the history and evolution of PSH and PSH-like models and summarizes the results of studies of PSH elements in the United States and in other countries. We reviewed more than 250 potentially relevant studies. At the conclusion of the selection process, our search had yielded a total of 152 peer-reviewed articles published between 1980 and 2013. The literature reports consistent and significant positive findings related to PSH initiatives. Both US and non-US studies stress the role of anesthesiologists in perioperative patient management. The PSH may have the greatest impact on preparing patients for surgery and ensuring their safe and effective transition to home or other postoperative rehabilitation. There appear

Governance Challenges in the Initiatives for Out-of-School Children in Tajikistan

Science.gov (United States)

Lo, William Yat Wai; Maclean, Rupert

2015-01-01

This article discusses the initiatives for out-of-school children in Tajikistan. The Tajik government has published two blueprint documents, namely, the "National Strategy for Education Development 2006-2015" and the "National Strategy for Education Development until 2020," which outlines a national vision for universal access…

Perceptions and Reasons Regarding E-Cigarette Use among Users and Non-Users: A Narrative Literature Review

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Kim A. G. J. Romijnders

2018-06-01

Full Text Available This paper aims to provide an in-depth understanding of the attractiveness of e-cigarettes for several different groups. For this purpose, perceptions of and reasons for e-cigarette use were systematically reviewed as reported by e-cigarette users, cigarette smokers, dual users, and non-users, among both adults and youth. MEDLINE® and Scopus were used to search for relevant articles, and references of included studies were also investigated. Two reviewers screened all titles and abstracts independently, blinded to authors and journal titles (Cohen’s Kappa = 0.83, resulting in 72 eligible articles. Risk perceptions, perceived benefits, and reasons for e-cigarette use were categorized in themes and sub-themes. Risk perceptions included harmfulness in general, and specific health risks. Perceived benefits included improved taste and smell, and safety for bystanders. Reasons for use included (health benefits, curiosity, smoking cessation, and friends using e-cigarettes. The findings highlight that there is a variety of perceptions and reasons mentioned by adult and youth e-cigarette users, cigarette smokers, dual users, and non-users. As such, this overview provides valuable information for scientists, public health professionals, behavior change experts, and regulators to improve future research, risk communication, and possibilities to effectively regulate e-cigarettes.

Effects of hydropower operations on recreational use and nonuse values at Glen Canyon and Flaming Gorge Dams

Energy Technology Data Exchange (ETDEWEB)

Carlson, J.L.

1995-03-01

Increases in streamflows are generally positively related to the use values of angling and white-water boating, and constant flows tend to increase the use values more than fluctuating flows. In most instances, however, increases in streamflows beyond some threshold level cause the use values to decrease. Expenditures related to angling and white-water boating account for about $24 million of activity in the local economy around Glen Canyon Dam and $24.8 million in the local economy around flaming Gorge Dam. The range of operational scenarios being considered in the Western Area Power Administration`s Electric Power Marketing Environmental Impact Statement, when use rates are held constant, could change the combined use value of angling and white-water boating below Glen Canyon Dam, increasing it by as much as 50%, depending on prevailing hydrological conditions. Changes in the combined use value below Flaming Gorge Dam could range from a decrease of 9% to an increase of 26%. Nonuse values, such as existence and bequest values, could also make a significant contribution to the total value of each site included in this study; however, methodological and data limitations prevented estimating how each operational scenario could change nonuse values.

Comparing the Trend of Physical Activity and Caloric Intake between Lipid-Lowering Drug Users and Nonusers among Adults with Dyslipidemia: Korean National Health and Nutrition Examination Surveys (2010-2013).

Science.gov (United States)

Oh, Jin-Young; Chekal, Lan; Kim, Se-Won; Lee, Jee-Yon; Lee, Duk-Chul

2016-03-01

The purpose of this study was to compare the physical activity and caloric intake trends of lipid-lowering drug users with those of non-users among Korean adults with dyslipidemia. This study was a repeated cross-sectional study with a nationally representative sample of 2,635 Korean adults with dyslipidemia based on the 2010-2013 Korea National Health and Nutrition Examination Survey. Physical activity was assessed using the International Physical Activity Questionnaire, and caloric intake was estimated through 24-hour dietary recall. All statistical analyses were conducted using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The changes in physical activity and caloric intake were investigated for lipid-lowering drug users and non-users using generalized linear models. The proportion of lipid-lowering drug users in the 2010-2013 survey population increased from 3.5% to 5.0% (PPhysical activity trends were tested separately for the lipid-lowering drug users and non-users, and a significant decrease was found among the drug users during the study period. Physical activity among the drug users in 2013 was 38% lower (1,357.3±382.7 metabolic equivalent [MET]; P for trend=0.002) than in 2010 (2,201.4±442.6 MET). In contrast, there was no statistically significant difference between drug users and non-users in the trend of caloric intake during the same period. Physical activity significantly decreased among lipid-lowering drug users between 2010 and 2013, which was not observed among non-users. The importance of physical activity may need to be re-emphasized for lipid-lowering drug users.

Pharmaceutical Cognitive Enhancement in Greek University Students: Differences Between Users and Non-Users in Social Cognitive Variables, Burnout, and Engagement.

Science.gov (United States)

Lazuras, Lambros; Ypsilanti, Antonia; Lamprou, Efthymios; Kontogiorgis, Christos

2017-06-07

Pharmaceutical cognitive enhancement (PCE) represents the non-medical use of prescribed medication for the improvement of cognitive functioning and academic performance. Although there are some studies about PCE prevalence, it is less clear how users and non-users of PCE substances differ with respect to their positive and negative student experiences (e.g. academic burnout and engagement with studies) and in social cognitive variables that relate to decision-making and self-regulation of PCE use. The present study assessed whether students with different experiences of PCE substance use displayed differences in academic burnout, study engagement, and social cognitive variables relevant to PCE use. Three hundred and forty-seven university students (mean age (M) = 22.15 years, SD = 1.69; 54% females) completed a battery of anonymous questionnaires on academic burnout, engagement with studies, social cognitive variables relevant to PCE use, and self-reported use of PCE substances and non-prescribed nutritional supplements. Three user groups emerged, namely non-users (51.9%, n = 180), single users of non-prescribed dietary supplements (25.4%, n = 88), and dual users of both non-prescribed dietary supplements and PCE (22.8%, n = 79). Multivariate analysis of variance indicated significant differences among the three user groups in intentions, attitudes, social norms, and anticipated regret toward PCE use. No significant differences were observed with respect to academic burnout and work engagement. The findings show that university students may engage in PCE use independent of their student experiences. Rather, a chemically assisted performance enhancement mindset seems to differentiate users from non-users of PCE substances.

Significance of screening electrocardiogram before the initiation of amitriptyline therapy in children with functional abdominal pain.

Science.gov (United States)

Patra, Kamakshya P; Sankararaman, Senthilkumar; Jackson, Robert; Hussain, Sunny Z

2012-09-01

Amitriptyline (AMT) is commonly used in the management of children with irritable bowel syndrome. AMT is pro-arrhythmogenic and increases the risk of sudden cardiac death. However, there is not enough data regarding the cardiac toxicity in therapeutic doses of AMT in children and the need for screening electrocardiogram (EKG). Errors in computer EKG interpretation are not uncommon. In a risk-prevention study, the authors sought to identify the true incidence of prolonged corrected QT (QTc) interval and other arrhythmias in children with irritable bowel syndrome before the initiation of AMT. Out of the 760 EKGs screened, 3 EKGs demonstrated a true prolonged QTc after the careful manual reading by a pediatric cardiologist and they were not picked by computer-generated reading. The authors conclude that screening EKG should always be performed on children before initiating AMT therapy. Also, the computer-generated EKG needs to be verified by a pediatric cardiologist to avoid serious misinterpretations.

Not in Love, or Not in the Know? Graduate Student and Faculty Use (and Non-Use) of E-Books

Science.gov (United States)

Cassidy, Erin Dorris; Martinez, Michelle; Shen, Lisa

2012-01-01

This study focuses on usage of electronic books (e-books) among advanced researchers, including graduate students and faculty, at a four-year academic institution. The researchers aimed to highlight differences in behavior, perception, and attitude between users and non-users of e-books. The survey findings suggest that, while a majority of these…

Measurement of use value and non-use value of environmental quality consistent with general equilibrium approach

OpenAIRE

Naoki Sakamoto; Kazunori Nakajima

2014-01-01

This paper proposes the consistent method with general equilibrium models to measure use value and non-use value of large-scale change in environmental quality. First, we develop a general equilibrium model that parameters of the utility function with environmental quality as a dependent variable can be estimated on the basis of the travel cost method and the contingent variation method. Second, we examine to identify the general equilibrium impact of environmental quality by a comparative st...

Initial teacher training. His musical impact on children in terms of refuge

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Ana Rita Castañeda-de Liendo

2017-04-01

Full Text Available The initial teacher training was the cultivation of teacher preparation in order to be the executors of government projects drive enacted by social groups of power in the historical development of Venezuela This article analyzes the initial teacher training in Venezuela, with the help of the logical place to unveil what characterizes the initial training of teachers historical method, specifically the working conditions of temporary shelter, and develops the axiological dynamics through musical training, which determine the current and future behavior regarding the formation of these. There is insufficient number of documents that allow raising the methodological work in the preparation of teachers of children of preschool age who are in temporary shelter provided, this work contributes to the improvement of such problems.

Quality of life of users of psychoactive substances, relatives, and non-users assessed using the WHOQOL-BREF

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Taís de Campos Moreira

2013-07-01

Full Text Available Quality of life is related to one of the basic human desires, which is to live well and feel good. The scope of this study was to evaluate the quality of life of psychoactive substance users and relatives, compared to non-users, analyzed by socioeconomic strata. A cross-sectional study with users of psychoactive substances, relatives, and other individuals who called the Information and Orientation Service regarding drug abuse. Data collection took place between November 2009 and December 2010. Data was collected from users, relatives, and non-users, including socioeconomic characteristics and data regarding substance consumption when appropriate. In addition to this the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF questionnaire was given to 347 individuals. Among the 138 users (70% used alcohol, 76 (39%, marijuana, 111 (57% tobacco, 78 (40% cocaine and 70 (36% crack. Control subjects had higher, scores than the relatives of users and users in all areas of the questionnaire (p < 0.05. Psychoactive substance users scored lower in almost all domains and overall score in the WHOQOL-BREF questionnaire in comparison with the sample of non-drug users. These findings reflect poor quality of life of patients and their relatives.

An Initial Look at the Quality of Life of Malaysian Families That Include Children with Disabilities

Science.gov (United States)

Clark, M.; Brown, R.; Karrapaya, R.

2012-01-01

Background: While there is a growing body of literature in the quality of life of families that include children with disabilities, the majority of research has been conducted in western countries. The present study provides an initial exploration of the quality of life of Malaysian families that include children with developmental/intellectual…

The Association between Self-Reported Mother-Child Attachment and Social Initiative and Withdrawal in Chinese School-Aged Children

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Chen, Bin-Bin

2012-01-01

The purpose of this study was to examine relations between mother-child attachment and social initiative and withdrawal in Chinese urban children. Participants were 487 school-aged children (247 boys, 240 girls) in Shanghai, the People's Republic of China. Data on mother-child attachment styles were collected from children's self-reports.…

Determinants of use and non-use of a web-based communication system in cerebral palsy care: evaluating the association between professionals' system use and their a priori expectancies and background

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van Harten Wim H

2011-06-01

Full Text Available Abstract Background Previously we described parents' and professionals' experiences with a web-based communication system in a 6-month pilot in three Dutch cerebral palsy care settings. We found that half of the participating professionals had not used the system, and of those who had used the system one third had used it only once. The present study aimed to evaluate whether professionals' system use was associated with their a priori expectancies and background. Methods Professionals who had not used the system (n = 54 were compared with professionals who had used the system more than once (n = 46 on the basis of their questionnaire responses before the pilot, their affiliation and the number of patients which they represented in the study. The questionnaire items comprised professionals' expectancies regarding the system's performance and ease of use, as well as the expected time availability and integration into daily care practice. Results Overall, users had higher a priori expectancies than non-users. System use was associated with expected ease of use (p = .046 and time availability (p = .005: 50% of the users (vs. 31% of the non-users expected that the system would be easy to use and 93% of the users (vs. 72% of the non-users expected that they would be able to reserve a time slot each week for responding to submitted questions. With respect to professionals' affiliation, system use was associated with professionals' institution (p = .003 and discipline (p = .001, with more (para- medical professionals among users (93% vs. 63% among non-users, and more education professionals among non-users (37% vs. 7% among users. In addition, users represented more patients (mean 2, range 1-8 than non-users (mean 1.1, range 1-2 (p = .000. Conclusions Professionals' system use was associated with expected ease of use and time availability, professionals' affiliation and the number of represented patients, while no association was found with expected

Analysis of risk factors associated with unilateral hearing loss in children who initially passed newborn hearing screening.

Science.gov (United States)

Appelbaum, Eric N; Howell, Jessica B; Chapman, Derek; Pandya, Arti; Dodson, Kelley M

2018-03-01

To analyze 2007 Joint Committee on Infant Hearing (JCIH) risk factors in children with confirmed unilateral hearing loss (UHL) who initially passed newborn hearing screening. Retrospective record review of 16,108 infants who passed newborn hearing screening but had one or more JCIH risk factors prompting subsequent follow-up through the universal newborn hearing screening (UNHS) program in Virginia from 2010 to 2012. The study was reviewed and qualified as exempt by the Virginia Commonwealth University Institutional Review Board (IRB) and the Virginia Department of Health. Over the 2-year study period, 14896 (4.9% of total births) children passed UNHS but had the presence of one or more JCIH risk factor. Ultimately, we identified 121 babies from this group with confirmed hearing loss (0.7%), with 48 babies (0.2%) showing UHL. The most common risk factors associated with the development of confirmed UHL after passing the initial screen were neonatal indicators, craniofacial anomalies, family history, and stigmata of syndrome associated with hearing loss. Neonatal indicators and craniofacial anomalies were the categories most often found in children with confirmed unilateral hearing loss who initially passed their newborn hearing screen. While neonatal indicators were also the most common associated risk factor in all hearing loss, craniofacial abnormalities are relatively more common in children with UHL who initially passed newborn hearing screening. Further studies assessing the etiology underlying the hearing loss and risk factor associations are warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

Science.gov (United States)

Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

2012-01-01

Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

INITIAL ALLERGY PREVENTION IN CHILDREN

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A.N. Pampura

2009-01-01

Full Text Available Allergy prevention is an urgent pediatric issue. Food allergy spread among infants amounts to 6–8%. This review highlights the modern viewpoints on diet prevention of this pathology among children, including by means of the hypoallergic nutritional formulas.Key words: food allergy, prevention, allergies, prebiotics, children.

Determinants of non-use of family planning methods by young married women (15-24 years living in urban slums of Uttar Pradesh

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Kriti Yadav

2017-03-01

Full Text Available Background: Total fertility rate of Uttar Pradesh is 2.7 with annual growth rate of 16.5. Age specific marital fertility rate (ASMFR in Uttar Pradesh is highest in the age group of 20-24 years (383.9 followed by 15-19 years (271.0 age group. Use of contraceptives is also very low in this most productive age group. Among the Young married women in the age group of 15-24 years the contraceptive prevalence rate (CPR is only 27.75% which is quite low than the target CPR of 60%. State level data presents a grim picture of contraceptive use in the slum areas in comparison to non-slum areas. This slum population is the most vulnerable section of our society. Aims & Objectives: i To assess the prevalence of non-use of contraceptives among young married women living in urban slums. ii To understand the reasons for non-use of contraceptives among young married women. iii To explore the factors influencing non-use of contraceptive among young married women. Materials and Methods: A cross sectional study was carried out in the urban slums of Lucknow. Out of the eight Nagar-Nigam zones in Lucknow, one Urban-Primary Health Centre was selected randomly from each zone. From each Urban- Primary Health Centre, 2 slums were selected randomly. In selected slum, all the households were visited until at least 33 young married women (15-24 years were interviewed using a pre-tested questionnaire to obtain the desired sample size of 535. The data was analyzed using SPSS 16.0. Results: Current use of contraceptives was found to be 33.8 % and almost two-thirds (66.2% of the participants were not using any form of contraceptive method. The important reasons for non-use of contraception were embarrassment / hesitancy / shyness regarding family planning, lack of knowledge about the contraceptive method or place of availability of services, opposition to contraceptive use by husband or family members and women’s desire to get pregnant. About one third of the women had no

Value of repeat brain MRI in children with focal epilepsy and negative findings on initial MRI

Energy Technology Data Exchange (ETDEWEB)

Jeon, Tae Yeon; Kim, Ji Hye; Lee, Jee Hun; Yoo, So Young; Hwang, Sook Min; Lee, Mun Hyang [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2017-08-01

To evaluate the value of repeat brain magnetic resonance imaging (MRI) in identifying potential epileptogenic lesions in children with initial MRI-negative focal epilepsy. Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. During a 15-year period, 257 children (148 boys and 109 girls) with initial MRI-negative focal epilepsy were included. After re-evaluating both initial and repeat MRIs, positive results at repeat MRI were classified into potential epileptogenic lesions (malformation of cortical development and hippocampal sclerosis) and other abnormalities. Contributing factors for improved lesion conspicuity of the initially overlooked potential epileptogenic lesions were analyzed and classified into lesion factors and imaging factors. Repeat MRI was positive in 21% (55/257) and negative in 79% cases (202/257). Of the positive results, potential epileptogenic lesions comprised 49% (27/55) and other abnormalities comprised 11% of the cases (28/257). Potential epileptogenic lesions included focal cortical dysplasia (n = 11), hippocampal sclerosis (n = 10), polymicrogyria (n = 2), heterotopic gray matter (n = 2), microlissencephaly (n = 1), and cortical tumor (n = 1). Of these, seven patients underwent surgical resection. Contributing factors for new diagnoses were classified as imaging factors alone (n = 6), lesion factors alone (n = 2), both (n = 18), and neither (n = 1). Repeat MRI revealed positive results in 21% of the children with initial MRI-negative focal epilepsy, with 50% of the positive results considered as potential epileptogenic lesions. Enhanced MRI techniques or considering the chronological changes of lesions on MRI may improve the diagnostic yield for identification of potential epileptogenic lesions on repeat MRI.

Value of repeat brain MRI in children with focal epilepsy and negative findings on initial MRI

International Nuclear Information System (INIS)

Jeon, Tae Yeon; Kim, Ji Hye; Lee, Jee Hun; Yoo, So Young; Hwang, Sook Min; Lee, Mun Hyang

2017-01-01

To evaluate the value of repeat brain magnetic resonance imaging (MRI) in identifying potential epileptogenic lesions in children with initial MRI-negative focal epilepsy. Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. During a 15-year period, 257 children (148 boys and 109 girls) with initial MRI-negative focal epilepsy were included. After re-evaluating both initial and repeat MRIs, positive results at repeat MRI were classified into potential epileptogenic lesions (malformation of cortical development and hippocampal sclerosis) and other abnormalities. Contributing factors for improved lesion conspicuity of the initially overlooked potential epileptogenic lesions were analyzed and classified into lesion factors and imaging factors. Repeat MRI was positive in 21% (55/257) and negative in 79% cases (202/257). Of the positive results, potential epileptogenic lesions comprised 49% (27/55) and other abnormalities comprised 11% of the cases (28/257). Potential epileptogenic lesions included focal cortical dysplasia (n = 11), hippocampal sclerosis (n = 10), polymicrogyria (n = 2), heterotopic gray matter (n = 2), microlissencephaly (n = 1), and cortical tumor (n = 1). Of these, seven patients underwent surgical resection. Contributing factors for new diagnoses were classified as imaging factors alone (n = 6), lesion factors alone (n = 2), both (n = 18), and neither (n = 1). Repeat MRI revealed positive results in 21% of the children with initial MRI-negative focal epilepsy, with 50% of the positive results considered as potential epileptogenic lesions. Enhanced MRI techniques or considering the chronological changes of lesions on MRI may improve the diagnostic yield for identification of potential epileptogenic lesions on repeat MRI

In abstinent MDMA users the cortisol awakening response is off-set but associated with prefrontal serotonin transporter binding as in non-users

DEFF Research Database (Denmark)

Frokjaer, Vibe Gedsoe; Erritzoe, David; Holst, Klaus Kähler

2014-01-01

awakening response (CAR). Here, we tested (1) if such a correlation persists in a human model of chronic serotonin depletion, namely in 3,4-Methylenedioxymethamphetamine (MDMA or 'Ecstasy') users, and (2) if CAR differed between MDMA users (N = 18) and non-using healthy volunteers (N = 32). Participants...... underwent SERT brain imaging with [11C]DASB-PET, and performed home-sampling of CAR, defined as the area under curve with respect to cortisol increase from awakening level. When adjusting for age and group, CAR was positively coupled to prefrontal SERT binding (p = 0.006) and MDMA users showed significantly...... higher CAR than the control group (p = 0.0003). In conclusion, our data confirm the recently described positive association between prefrontal SERT binding and CAR, this time in a human model of serotonin deficiency. Also, we find that CAR was higher in MDMA users relative to non-users. We suggest...

Non-U.S. Citizen, Community College Students: Their Federal Student Aid Status, Gender, Achievement, and Persistence at an Emerging HSI

Science.gov (United States)

Sanchez, Jafeth E.; Smith, Jeannette

2017-01-01

This study presents a quantitative, exploratory analysis of 535 students attending Truckee Meadows Community College in Northern Nevada who were eligible or ineligible for federal student aid and were non-U.S. citizens. Within a snapshot of the Fall 2015 through Fall 2016 semesters, we examined the variables of gender, grade point average (GPA),…

Myocardial delayed-enhancement CT: initial experience in children and young adults

Energy Technology Data Exchange (ETDEWEB)

Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

2017-10-15

Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

Myocardial delayed-enhancement CT: initial experience in children and young adults

International Nuclear Information System (INIS)

Goo, Hyun Woo

2017-01-01

Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

Origins of the Children's Vaccine Initiative: the political foundations.

Science.gov (United States)

Muraskin, W

1996-06-01

The Children's Vaccine Initiative (CVI) was founded in 1990-91 as a means to revolutionize the way that vaccines were developed for the South. The system for the creation of vaccines was a dis-articulated one in which basic research, product development and delivery were handled by different, often insufficiently linked groups. The public sector was deeply involved in research and delivery but not the vital product development area. That area was left to the private sector which was increasingly driven by the needs to maximize profits. Potential vaccines for diseases found in the South, where a hard currency market was limited, were often left undeveloped. The CVI was designed to change that situation. The CVI hoped to exploit the discoveries of biotechnology and produce not only new and improved vaccines, but ultimately to work towards a single multi-antigen vaccine given near birth that would immunize children for life. This article deals with the events that directly led to the creation of the CVI, and to the political problems caused by organizational and national rivalries that the new venture faced from its inception.

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children Ages 1-5 Years: A Causal Modeling Analysis.

Science.gov (United States)

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N'Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2016-03-01

There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modeling analysis in children ages 1-5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups, and regions. ART-naïve children of ages 12-59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. About one quarter of the 5,826 included children was from West Africa (24.6%).The median (first; third quartile) CD4% at the first visit was 16% (11%; 23%), the median weight-for-age z-scores and height-for-age z-scores were -1.5 (-2.7; -0.6) and -2.5 (-3.5; -1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count <750 cells/mm³ or CD4% <25% was 0.2% (95% CI = -0.2%; 0.3%), and the difference in the mean height-for-age z-scores of those who survived was -0.02 (95% CI = -0.04; 0.01). Younger children ages 1-2 and children in West Africa had worse outcomes. Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, although we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below 750/25%.

Genotypic characterization of initial acquisition of Streptococcus mutans in American Indian children

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David J. Lynch

2015-04-01

Full Text Available Background: Severe-early childhood caries (S-ECC is one of the most common infectious diseases in children and is prevalent in lower socio-economic populations. American Indian children suffer from the highest levels of S-ECC in the United States. Members of the mutans streptococci, Streptococcus mutans, in particular, are key etiologic agents in the development of caries. Children typically acquire S. mutans from their mothers and early acquisition is often associated with higher levels of tooth decay. Methods: We have conducted a 5-year birth cohort study with a Northern Plains Tribe to determine the temporality and fidelity of S. mutans transmission from mother to child in addition to the genotypic diversity of S. mutans in this community. Plaque samples were collected from 239 mother/child dyads at regular intervals from birth to 36 months and S. mutans were isolated and genotyped by arbitrarily primed-polymerase chain reaction (AP-PCR. Results: Here we present preliminary findings from a subset of the cohort. The focus for this paper is on initial acquisition events in the children. We identified 17 unique genotypes in 711 S. mutans isolates in our subset of 40 children, 40 mothers and 14 primary caregivers. Twelve of these genotypes were identified in more than one individual. S. mutans colonization occurred by 16 months in 57.5% of the children and early colonization was associated with higher decayed, missing and filled surface (DMFS scores (p=0.0007. Children colonized by S. mutans shared a common genotype with their mothers 47.8% of the time. While multiple genotypes were common in adults, only 10% of children harbored multiple genotypes. Conclusion: These children acquire S. mutans at an earlier age than the originally described ‘window of infectivity’ and often, but not exclusively, from their mothers. Early acquisition is associated with both the caries status of the children and the mothers.

Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

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Jane N Mutanga

Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

Cardiovascular Safety of Stimulants in Children with Attention-Deficit/Hyperactivity Disorder

DEFF Research Database (Denmark)

Dalsgaard, S.; Kvist, A. P.; Leckman, J. F.

2014-01-01

Objective: The purpose of this study was to determine whether stimulant users are at higher risk of a later cardiovascular event than are non-users, examining this association in both a national cohort and a population-based sample of children and adolescents diagnosed with attention-deficit/hyperactivity...... disorder (ADHD). We also aim to examine a possible dose-response relationship in such an association. Methods: We conducted a longitudinal, prospective cohort study of all children born in Denmark between 1990 and 1999. Within this cohort, children with ADHD were identified. Data from national health...... using Cox regression, adjusted for other known risk factors. Results: In the total population (n = 714,258 contributing a total of 6,767,982 person-years) use of stimulants increased the risk of a cardiovascular event; adjusted HR = 1.83 (1.10-3.04). In children with ADHD (n = 8300) stimulant treatment...

Comparing Facebook Users and Facebook Non-Users: Relationship between Personality Traits and Mental Health Variables ? An Exploratory Study

OpenAIRE

Brailovskaia, Julia; Margraf, J?rgen

2016-01-01

Over one billion people use Facebook as a platform for social interaction and self-presentation making it one of the most popular online sites. The aim of the present study was to investigate differences in various personality traits and mental health variables between Facebook users and people who do not use this platform. The data of 945 participants (790 Facebook users, 155 Facebook non-users) were collected. Results indicate that Facebook users score significantly higher on narcissism, se...

Early initiation of breastfeeding among mothers of children under the age of 24 months in Southern Ethiopia

NARCIS (Netherlands)

Beyene, Misrak Getnet; Geda, Nigatu Regassa; Habtewold, Tesfa Dejenie; Assen, Zuriash Mengistu

2017-01-01

BACKGROUND: The early initiation of breastfeeding (EIBF), or timely initiation of breastfeeding, is the proportion of children put to the breast within one hour of birth. It is an important strategy for reducing perinatal and infant morbidity and mortality, but it remains under practiced in

Need for appropriate formulations for children: the national institute of child health and human development-pediatric formulations initiative, part 2.

Science.gov (United States)

Giacoia, George P; Taylor-Zapata, Perdita; Mattison, Donald

2007-01-01

The development and compounding of pharmacotherapeutic formulations that are suitable for infants and young children can be a challenging problem. This problem results from the lack of knowledge on the acceptability of different dosage forms and formulations to children in relation to age and developmental status, as well as the lack of reliable documentation of formulations used in pediatric clinical trials. As part of its mandate under the Best Pharmaceuticals for Children Act to improve pediatric therapeutics, the National Institute of Child Health and Human Development has sponsored the Pediatric Formulations Initiative. The goal of this ongoing initiative is to address the issues and concerns associated with pediatric therapeutics by convening groups of researchers and experts in pediatric formulations from academia, pharmaceutical companies, the National Institutes of Health, and the U.S. Food and Drug Administration. In this second part of a two-part article, the activities of the various groups that constitute the Pediatric Formulations Initiative are discussed, in addition the Initiative's future activities and plans are outlined.

Planet Press: an EGU initiative to bring geoscientific research to children

Science.gov (United States)

Ferreira, Bárbara

2016-04-01

Planet Press (http://www.egu.eu/education/planet-press/) is an EGU educational project that aims to get children (mainly 7-13 year olds), as well as their parents and educators, interested in and engaged with up-to-date scientific research and news. Planet Press articles are short versions of EGU press releases written in child-friendly language. Because EGU press releases cover research published in the various EGU scientific journals, Planet Press focuses on topics as varied as air pollution, glaciers, climate change, earthquakes, ocean sciences, droughts and floods, or space sciences. The texts are reviewed by both scientists and educators to make sure they are accurate and clear to their target audience. By sharing new and exciting geoscientific research with young kids, we hope to inspire them to develop an interest in the Earth, planetary and space sciences. In this presentation, we describe how the Planet Press idea came about, how the project is run, and the challenges and lessons learnt since the launch of this educational initiative in 2014. Planet Press, which has the support of the EGU Committee on Education, is made possible by the work of volunteer scientists and educators who review and translate the texts. We are grateful for the help of Jane Robb, former EGU Educational Fellow, with launching the project. Planet Press is inspired by Space Scoop (http://www.spacescoop.org/), an initiative by UNAWE, the EU-Universe Awareness organisation, that brings astronomy news to children every week.

Nutrition recommendations and the Children's Food and Beverage Advertising Initiative's 2014 approved food and beverage product list.

Science.gov (United States)

Schermbeck, Rebecca M; Powell, Lisa M

2015-04-23

We compare the Children's Food and Beverage Advertising Initiative's (CFBAI's) April 2014 list of food and beverage products approved to be advertised on children's television programs with the federal Interagency Working Group's nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group's recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children.

Barriers to initiating tuberculosis treatment in sub-Saharan Africa: a systematic review focused on children and youth.

Science.gov (United States)

Sullivan, Brittney J; Esmaili, B Emily; Cunningham, Coleen K

2017-01-01

Tuberculosis (TB) is the deadliest infectious disease globally, with 10.4 million people infected and more than 1.8 million deaths in 2015. TB is a preventable, treatable, and curable disease, yet there are numerous barriers to initiating treatment. These barriers to treatment are exacerbated in low-resource settings and may be compounded by factors related to childhood. Timely initiation of tuberculosis (TB) treatment is critical to reducing disease transmission and improving patient outcomes. The aim of this paper is to describe patient- and system-level barriers to TB treatment initiation specifically for children and youth in sub-Saharan Africa through systematic review of the literature. This review was conducted in October 2015 in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Six databases were searched to identify studies where primary or secondary objectives were related to barriers to TB treatment initiation and which included children or youth 0-24 years of age. A total of 1490 manuscripts met screening criteria; 152 met criteria for full-text review and 47 for analysis. Patient-level barriers included limited knowledge, attitudes and beliefs regarding TB, and economic burdens. System-level barriers included centralization of services, health system delays, and geographical access to healthcare. Of the 47 studies included, 7 evaluated cost, 19 health-seeking behaviors, and 29 health system infrastructure. Only 4 studies primarily assessed pediatric cohorts yet all 47 studies were inclusive of children. Recognizing and removing barriers to treatment initiation for pediatric TB in sub-Saharan Africa are critical. Both patient- and system-level barriers must be better researched in order to improve patient outcomes.

Users and non-users of web-based health advice service among Finnish university students – chronic conditions and self-reported health status (a cross-sectional study

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Castrén Johanna

2008-01-01

Full Text Available Abstract Background The Internet is increasingly used by citizens as source of health information. Young, highly educated adults use the Internet frequently to search for health-related information. Our study explores whether reported chronic conditions or self-reported health status differed among Finnish university students using the Finnish Student Health Services web-based health advice service compared with those not using the service. Methods Cross-sectional study performed by a national postal survey in 2004. Material: A random sample (n = 5 030 of a population of 101 805 undergraduate Finnish university students aged 19–35. The response rate: 63% (n = 3 153. Main outcome measures: Proportion of university students reporting use a of web-based health advice service, diagnosed chronic conditions, and self-reported health status of users and non-users of a web-based health advice service. Statistical methods: Data were presented with frequency distributions and cross-tabulations and the χ2 test was used. Results 12% (n = 370 of Finnish undergraduate students had used the web-based health advice service and were identified as 'users'. The proportion of male students reporting allergic rhinitis or conjunctivitis was greater among users than non-users (24%, n = 22 vs. 15%, n = 154, χ2, P = .03. The proportion of female students reporting chronic mental health problems was greater among users than non-users (12%, n = 34 vs. 8%, n = 140, χ2, P = .03. There was no statistical significance between the group differences of male or female users and non-users in self-reported health status (good or fairly good, average, rather poor or poor. Conclusion Among young, highly educated adults the use of a web-based health advice service is not associated with self-reported health status. However, a web-based health advice service could offer support for managing several specific chronic conditions. More research data is needed to evaluate the role of

Non-US electrodynamic launchers research and development

Energy Technology Data Exchange (ETDEWEB)

Parker, J.V.; Batteh, J.H.; Greig, J.R.; Keefer, D.; McNab, I.R.; Zabar, Z.

1994-11-01

Electrodynamic launcher research and development work of scientists outside the United States is analyzed and assessed by six internationally recognized US experts in the field of electromagnetic and electrothermal launchers. The assessment covers five broad technology areas: (1) Experimental railguns; (2) Railgun theory and design; (3) Induction launchers; (4) Electrothermal guns; (5) Energy storage and power supplies. The overall conclusion is that non-US work on electrodynamic launchers is maturing rapidly after a relatively late start in many countries. No foreign program challenges the US efforts in scope, but it is evident that the United States may be surpassed in some technologies within the next few years. Until recently, published Russian work focused on hypervelocity for research purposes. Within the last two years, large facilities have been described where military-oriented development has been underway since the mid-1980s. Financial support for these large facilities appears to have collapsed, leaving no effective effort to develop practical launchers for military or civilian applications. Electrodynamic launcher research in Europe is making rapid progress by focusing on a single application, tactical launchers for the military. Four major laboratories, in Britain, France, Germany, and the Netherlands, are working on this problem. Though narrower in scope than the US effort, the European work enjoys a continuity of support that has accelerated its progress. The next decade will see the deployment of electrodynamic launcher technology, probably in the form of an electrothermal-chemical upgrade for an existing gun system. The time scale for deployment of electromagnetic launchers is entirely dependent on the level of research-and-development effort. If resources remain limited, the advantage will lie with cooperative efforts that have reasonably stable funding such as the present French-German program.

DESTRUCTIVE LESIONS OF BONES AS A RESULT OF MYCOBACTERIAL PROCESS IN CHILDREN WITH INITIAL IMMUNODEFICIENCIES (CLINICAL, DIAGNOSTICAL AND TACTIC PECULIARITIES

Directory of Open Access Journals (Sweden)

A.Yu. Mushkin

2011-01-01

Full Text Available Initial immunodeficiencies are genetically conditioned defects of immune system; they are the basis for generalized infections including those induced by mycobacteria of tuberculosis complex. The lesions of skeleton in those patients are of different types depending on the kind of immunodeficiency. The article presents the results of clinical observation, conservative and surgical treatment of 12 children with mycobacterial lesions of skeleton on the ground different initial immunodeficiencies — severe combined immune deficiency, chronic granulematosis and insufficiency of interferon and interleukin 12.Key words: children, initial immunodeficiency, mycobacterial infection, bone lesions, surgical treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 60–64

Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

International Nuclear Information System (INIS)

Jaksic, E.; Bogdanovic, R.; Artiko, V.

2011-01-01

Assessment of the first febrile urinary tract infection (UTI) in children has been the subject of debate for many years. Diagnosis of acute pyelonephritis (APN) is usually based on clinical and biological data. The clinical usefulness of early Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy remains controversial, although it may influence the type and duration of treatment. The aim of this study was to assess the role of initial cortical scintigraphy in the detection of early renal parenchymal damage in children highly suspected of having APN and to compare the scintigraphic findings with selected clinical/laboratory parameters and ultrasonography. A prospective study was conducted in 34 infants and young children (18 boys, 16 girls), aged 1.5-36 months (mean 9.8±8.7 months), hospitalized with a first episode of clinically suspected APN. Within the first 5 days after admission, Tc-99m DMSA renal scintigraphy, ultrasonography (US), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC) and urine analyses were performed. DMSA scintigraphy showed changes consistent with APN in 27/34 (79%) patients, with a mean age of 10.9 months, including 12 males (44%) and 15 (56%) females. Out of 9 febrile children with negative urine culture and supportive evidence of UTI, scintigraphy showed parenchymal involvement in 8 children (24% in the whole group, 30% in scintigraphically documented APN). There were no statistically significant correlations between the frequency or size of the initial scintigraphic abnormalities and age, sex, body temperature, CRP levels or ESR. A CRP level of >54 mg/L and a WBC of >13,300/mm 3 had sensitivities of 56 and 59% and specificities of 86 and 71%, respectively. US showed changes consistent with APN in 7/34 (21%) in the whole group and in 7/27 (26%) patients with positive cortical scan (p<0.05). Initial DMSA renal scintigraphy is a sensitive method for the early diagnosis of APN in young children and is

The Impact of Integrated Infant and Young Child Feeding and Micronutrient Powder Intervention on Feeding Practices and Anemia in Children Aged 6-23 Months in Madagascar.

Science.gov (United States)

Locks, Lindsey M; Reerink, Ietje; Tucker Brown, Amal; Gnegne, Smaila; Ramalanjaona, Noelimanjaka; Nanama, Simeon; Duggan, Christopher P; Garg, Aashima

2017-06-07

This study assesses the impact of an integrated infant and young child feeding (IYCF) and micronutrient powder (MNP) intervention on children's risk of anemia and IYCF practices in Madagascar. Quantitative baseline and endline surveys were conducted in representative households with children 6-23 months from two districts, where an 18-month IYCF-MNP intervention was implemented. Relative risks comparing children's risk of anemia and maternal IYCF knowledge and practices at baseline versus endline, and also at endline among MNP-users versus non-users were estimated using log-binomial regression models. 372 and 475 children aged 6-23 months were assessed at baseline and endline respectively. Prevalence of anemia fell from 75.3% to 64.9% from baseline to endline ( p = 0.002); the reduction in the risk of anemia remained significant in models adjusting for sociodemographic characteristics (ARR (95% CI): 0.86 (0.78, 0.95), p = 0.003). In endline assessments, 229 out of 474 (48.3%) of children had consumed MNPs. MNP-users had a lower risk of anemia (ARR (95% CI): 0.86 (0.74, 0.99), p = 0.04) than non-users, after controlling for child's dietary diversity and morbidity, maternal counseling by community-health-workers, and sociodemographic characteristics. Mothers interviewed at endline also had greater nutrition knowledge and were more likely to feed their children ≥4 food groups (ARR (95% CI): 2.92 (2.24, 3.80), p children's consumption of micronutrients and reducing risk of anemia. The addition of MNP does not negatively impact, and may improve, IYCF practices.

A National Study of the Reasons for Use and Non-Use of Alcohol among College Student-Athletes by Sex, Race, and NCAA Division

Science.gov (United States)

Milroy, Jeffrey J.; Orsini, Muhsin Michael; Wyrick, David L.; Fearnow-Kenney, Melodie; Kelly, Samantha E.; Burley, Jane

2014-01-01

Alcohol use among college student-athletes should be of great concern due to their risk for excessive consumption and related negative consequences compared to their non-athlete peers. Previous research has focused on reasons and/or motives for alcohol and other drug use among student-athletes, rather than non-use. Additionally, previous studies…

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis

Science.gov (United States)

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N’Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2017-01-01

Background There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions. Methods ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. Results About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes. Conclusions Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%. PMID:26479876

Factors associated with nonuse of condoms in heterosexual men and women attending an HIV testing clinic in Israel.

Science.gov (United States)

Soskolne, V; Maayan, S

1998-01-01

To examine gender differences in HIV-related knowledge, perceived vulnerability, beliefs in self-control, type of sexual partnership, and their associations with nonuse of condoms. Heterosexual men and women who voluntarily attended an HIV testing clinic in Israel were asked to complete a self-report questionnaire. Scales of HIV knowledge and control and a single item for vulnerability were used. Type of sexual relationship (monogamous vs. nonmonogramous) and condom use in vaginal sex (never vs. ever) referred to the previous 6 months. Response rate was 84%; 154 men and 109 women participated. Beliefs in self-control did not form a reliable scale and single items were used. No statistically significant gender differences were found in knowledge, vulnerability, or beliefs in self-control. Levels of correct HIV-related knowledge were high, but so were some misconceptions. The vast majority (87%) perceived themselves as vulnerable to HIV infection. The beliefs in self-control were moderate in some items, and low in others. In logistic regression models, different factors were significantly associated with nonuse of condoms in the two genders: the belief that their lifestyle protected them against HIV infection (OR = 2.72, CI = 1.06-7.03) among men, and being monogamous (OR = 3.72, CI = 1.28-10.8) among women. Heterosexual men and women attending an HIV testing clinic need counseling to further lower misconceptions about HIV transmission and additional gender-specific counseling to address HIV-related beliefs.

The use of alternative medicine by children.

Science.gov (United States)

Spigelblatt, L; Laîné-Ammara, G; Pless, I B; Guyver, A

1994-12-01

Alternative medicine (AM) is of growing interest to the general public. Although several studies have been published concerning its use in adults, the use by children is less well known. The purpose of this study is to determine the frequency with which alternative medicine is employed in a pediatric population that also uses conventional medicine. A second goal is to investigate the sociodemographic factors that influence the choice of these forms of therapy. Parents of children consulting the general outpatient clinic of a university hospital completed a self-administered questionnaire asking about previous use of AM for themselves or their children. Based on 1911 completed questionnaires, 208 children (11%) previously consulted one or more AM practitioners. Chiropractic, homeopathy, naturopathy, and acupuncture together accounted for 84% of use. Children who used AM differed significantly from those who only used conventional medicine in that they were older than the nonusers, their mothers were better educated, and their parents also tended to use AM. The findings indicate that AM is an aspect of child health care that no longer can be ignored. Being aware of these practices will enable physicians to discuss alternative therapies with parents in order to ensure the continuity of essential conventional treatments.

Wild Beginnings: How a San Antonio Initiative Instills the Love of Nature in Young Children

Science.gov (United States)

Kharod, Deepti; Arreguín-Anderson, Maria G.

2015-01-01

This paper describes an environmental education initiative called Starting out Wild (SoW) designed for toddlers and their caretakers. The program, developed by staff and volunteers of a city parks department, engages children ages 1-3 and their parents and caretakers through outdoor learning experiences. We suggest that environmental education…

Effect of Age at Antiretroviral Therapy Initiation on Catch-Up Growth within the First 24 Months among HIV-Infected Children in the IeDEA West African Pediatric Cohort

Science.gov (United States)

Jesson, Julie; Koumakpaï, Sikiratou; Diagne, Ndeye R.; Amorissani-Folquet, Madeleine; Kouéta, Fla; Aka, Addi; Lawson-Evi, Koko; Dicko, Fatoumata; Kouakou, Kouadio; Pety, Touré; Renner, Lorna; Eboua, Tanoh; Coffie, Patrick A.; Desmonde, Sophie; Leroy, Valériane

2015-01-01

Background We described malnutrition and the effect of age at antiretroviral therapy (ART) initiation on catch-up growth over 24 months among HIV-infected children enrolled in the IeDEA West African paediatric cohort (pWADA). Methods Malnutrition was defined at ART initiation (baseline) by a Z-score malnutrition at ART initiation, ART regimen, time period and country, were compared by age at ART initiation. Cox proportional hazards regression models determined predictors of catch-up growth on ART over 24 months. Results Between 2001 and 2012, 2004 HIV-infected children Malnutrition among these children is an additional burden that has to be urgently managed. Despite a significant growth improvement after 24 months on ART, especially in children <5 years, a substantial proportion of children still never achieved catch-up growth. Nutritional care should be part of the global healthcare of HIV-infected children in sub-Saharan Africa. PMID:25955835

Initial Psychometric Properties of a Brief Parent-Report Instrument for Assessing Tic Severity in Children with Chronic Tic Disorders

Science.gov (United States)

Chang, Susanna; Himle, Michael B.; Tucker, Benjamin T. P.; Woods, Douglas W.; Piacentini, John

2009-01-01

This article describes the development and initial psychometric properties of the Parent Tic Questionnaire (PTQ)--a new measure assessing the number, frequency, and intensity of motor and vocal tics in children and adolescents with Chronic Tic Disorder (CTD). Parents of 40 children with a CTD completed the PTQ as part of a larger assessment…

Word-initial /r/-clusters in Swedish speaking children with typical versus protracted phonological development.

Science.gov (United States)

Lundeborg Hammarström, Inger

2018-01-01

The present study investigated word-initial (WI) /r/-clusters in Central Swedish-speaking children with and without protracted phonological development (PPD). Data for WI singleton /r/ and singleton and cluster /l/ served as comparisons. Participants were twelve 4-year-olds with PPD and twelve age- and gender-matched typically developing (TD) controls. Native speakers audio-recorded and transcribed 109 target single words using a Swedish phonology test with 12 WI C+/r/-clusters and three WI CC+/r/-clusters. The results showed significantly higher match scores for the TD children, a lower match proportion for the /r/ targets and for singletons compared with clusters, and differences in mismatch patterns between the groups. There were no matches for /r/-cluster targets in the PPD group, with all children except two in that group showing deletions for both /r/-cluster types. The differences in mismatch proportions and types between the PPD group and controls suggests new directions for future clinical practice.

BUILDING HUMAN CAPITAL: THE IMPACT OF PARENTS´ INITIAL EDUCATIONAL LEVEL AND LIFELONG LEARNING ON THEIR CHILDREN

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FISCHER, Jakub

2013-12-01

Full Text Available The aim of this paper is to examine the impact of parents´ educational level on lifelong learning of children and relationship between parents´ and student´ lifelong learning including language skills and computer literacy. This intergenerational transmission, if proven, could influence the investments into the human capital in the long run. We used data from Adult Education Survey 2011 (AES to test the hypothesis that the parental attained level of education has a significant impact on the initial educational level of their children as well as on their lifelong learning participation. Furthermore, using data from AES, we tested the association between parental educational level and children´s language skills and reading activity and between parental non-formal as well as informal education and students´ lifelong learning. We have found that the parental effect on lifelong learning participation is slightly weaker than the effect of initial adult´s education. Nevertheless, the intergenerational transmission mechanism obviously works. The relationship between parental and students computer literacy is statistically significant, nevertheless weak. As for the nominal and ordinal character of the data, we used mainly the standard statistical methods including nonparametric tests, logit model and correspondence analysis.

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

NARCIS (Netherlands)

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

Objectives: The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. Methods: A total of 115 pharmacies detected current stimulant users <16 years old in their pharmacy

Role of young women's depression and stress symptoms in their weekly use and nonuse of contraceptive methods.

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Hall, Kelli Stidham; Moreau, Caroline; Trussell, James; Barber, Jennifer

2013-08-01

We prospectively examined the influence of young women's depression and psychological stress symptoms on their weekly contraceptive method use. We examined data from 689 women ages 18-20 years participating in a longitudinal cohort study. Women completed 8,877 weekly journals over the first year, which assessed reproductive, relationship, and health information. We focused on baseline depression (Center for Epidemiologic Studies-Depression Scale) and stress (Perceived Stress Scale) symptoms and weekly contraceptive method use. Analyses used multivariate random effects and multinomial logistic regression. Approximately one quarter of women exhibited moderate/severe depression (27%) and stress (25%) symptoms at baseline. Contraception was not used in 10% of weekly journals, whereas coital and noncoital methods were used in 42% and 48% of weeks, respectively. In adjusted models, women with moderate/severe stress symptoms had more than twice the odds of contraception nonuse than women without stress (odds ratio [OR] 2.23, confidence interval [CI] 1.02-4.89, p = .04). Additionally, women with moderate/severe depression (RR .52, CI .40-.68, p contraceptives (OCs; reference category). Women with stress symptoms also had higher relative risks of using condoms (RR 1.17, CI 1.00-1.34, p = .02) and withdrawal (RR 1.29, CI 1.10-1.51, p = .001) than OCs. The relative risk of dual versus single method use was also lower for women with stress symptoms. Women's psychological symptoms predicted their weekly contraceptive nonuse and use of less effective methods. Further research can determine the influence of dynamic psychological symptoms on contraceptive choices and failures over time. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Prognostic factors of a good response to initial therapy in children and adolescents with differentiated thyroid cancer

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Fernanda Vaisman

2011-01-01

Full Text Available BACKGROUND: Therapeutic approaches in pediatric populations are based on adult data because there is a lack of appropriate data for children. Consequently, there are many controversies regarding the proper treatment of pediatric patients. OBJECTIVE: The present study was designed to evaluate patients with differentiated thyroid carcinoma diagnosed before 20 years of age and to determine the factors associated with the response to the initial therapy. METHODS: Sixty-five patients, treated in two tertiary-care referral centers in Rio de Janeiro between 1980 and 2005 were evaluated. Information about clinical presentation and the response to initial treatment was analyzed and patients had their risk stratified in Tumor-Node- Metastasis; Age-Metastasis-Extracapsular-Size; distant Metastasis-Age-Completeness of primary tumor resection-local Invasion-Size and American-Thyroid-Association classification RESULTS: Patients ages ranged from 4 to 20 years (median 14. The mean follow-up was 12,6 years. Lymph node metastasis was found in 61.5% and indicated a poor response to initial therapy, with a significant impact on time for achieving disease free status (p = 0.014 for response to initial therapy and p<0,0001 for disease-free status in follow-up. Distant metastasis was a predictor of a poor response to initial therapy in these patients (p = 0.014. The risk stratification systems we analyzed were useful for high-risk patients because they had a high sensitivity and negative predictive value in determining the response to initial therapy. CONCLUSIONS: Metastases, both lymph nodal and distant, are important predictors of the persistence of disease after initial therapy in children and adolescents with differentiated thyroid cancer.

Anthropometric Improvement among HIV Infected Pre-School Children Following Initiation of First Line Anti-Retroviral Therapy: Implications for Follow Up.

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Atnafu Mekonnen Tekleab

Full Text Available Antiretroviral therapy (ART is a lifesaving intervention for HIV infected children. There is a scarcity of data on immunological recovery and its relation with growth indicators among HIV infected young children. The current study aims to assess the pattern of anthropometric Z-score improvement following initiation of first-line ART among under-five children and the relationship between anthropometric Z-score improvement and immunologic recovery.We included under-five children who were on first-line ART at five major hospitals in Addis Ababa, Ethiopia. We measured anthropometry and collected clinical and laboratory data at follow up, and we retrieved clinical and anthropometric data at ART initiation from records. Z-scores for each of the anthropometric indices were calculated based on WHO growth standards using ENA for SMART 2011 software. Linear regression was used to assess the relationship between time on ART and anthropometric Z-score improvement; and the relationship between anthropometric Z-score improvement and immunologic recovery. Multiple linear regression was used to assess the independent predictors of anthropometric Z-score change.The median age of the participants was 4.1 (Interquartile range (IQR: 3.3-4.9 years. More than half (52.48% were female. The median duration of follow up was 1.69 (IQR: 1.08-2.63 years. There was a significant improvement in all anthropometric indices at any follow up after initiation of first-line ART (underweight; 39.5% vs16.5%, stunting; 71.3% vs 62.9% and wasting; 16.3% vs 1.0%; p-value< 0.0001. There was an inverse relationship between improvement in weight for age Z-score (WAZ and duration of ART (R2 = 0.04; F (1, 158; p = 0.013. Height for age Z-score (HAZ both at the time of ART initiation and follow up has a positive linear relationship with CD4 percentage at follow up (Coef. = 1.92; R2 = 0.05; p-value = 0.002. Duration on ART (Std. Err. = 0.206, t = -1.99, p-value = 0.049 and level of maternal

Need for appropriate formulations for children: the national institute of child health and human development-pediatric formulations initiative, part 1.

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Giacoia, George P; Taylor-Zapata, Perdita; Mattison, Donald

2007-01-01

The development and compounding of pharmacotherapeutic formulations that are suitable for infants and young children can be a challenging problem. This problem results from the lack of knowledge on the acceptability of different dosage forms and formulations in children in relation to age and developmental status, as well as the lack of reliable documentation of formulations used in pediatric clinical trials. As part of its mandate under the Best Pharmaceuticals for Children Act to improve pediatric therapeutics, the National Institute of Child Health and Human Development has sponsored the Pediatric Formulation Initiative. The goal of this ongoing initiative is to address the issues and concnerns associated with pediatric therapeutics by convening groups of researchers and experts in pediatric formulations from academia, pharmaceutical companies, the National Institutes of Health, and the U.S. Food and Drug Administration.

Association of High-Dose Ibuprofen Use, Lung Function Decline, and Long-Term Survival in Children with Cystic Fibrosis.

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Konstan, Michael W; VanDevanter, Donald R; Sawicki, Gregory S; Pasta, David J; Foreman, Aimee J; Neiman, Evgueni A; Morgan, Wayne J

2018-04-01

Cystic fibrosis deaths result primarily from lung function loss, so chronic respiratory therapies, intended to preserve lung function, are cornerstones of cystic fibrosis care. Although treatment-associated reduction in rate of lung function loss should ultimately improve cystic fibrosis survival, no such relationship has been described for any chronic cystic fibrosis therapy. In part, this is because the ages of most rapid lung function decline-early adolescence-precede the median age of cystic fibrosis deaths by more than a decade. To study associations of high-dose ibuprofen treatment with the rate of forced expiratory volume in 1 second decline and mortality among children followed in the Epidemiologic Study of Cystic Fibrosis and subsequently in the U.S. Cystic Fibrosis Foundation Patient Registry. We performed a matched cohort study using data from Epidemiologic Study of Cystic Fibrosis. Exposure was defined as high-dose ibuprofen use reported at ≥80% of encounters over 2 years. Unexposed children were matched to exposed children 5:1 using propensity scores on the basis of demographic, clinical, and treatment covariates. The rate of decline of percent predicted forced expiratory volume in 1 second during the 2-year follow-up period was estimated by mixed-effects modeling with random slopes and intercepts. Survival over 16 follow-up years in the U.S. Cystic Fibrosis Foundation Patient Registry was compared between treatment groups by using proportional hazards modeling controlling for matching and covariates. We included 775 high-dose ibuprofen users and 3,665 nonusers who were well matched on demographic, clinical, and treatment variables. High-dose ibuprofen users declined on average 1.10 percent predicted forced expiratory volume in 1 second/yr (95% confidence interval; 0.51, 1.69) during the 2-year treatment period, whereas nonusers declined at a rate of 1.76% percent predicted forced expiratory volume in 1 second/yr (95% confidence interval; 1.48, 2

Non-use Economic Values for Little-Known Aquatic Species at Risk: Comparing Choice Experiment Results from Surveys Focused on Species, Guilds, and Ecosystems

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Rudd, Murray A.; Andres, Sheri; Kilfoil, Mary

2016-09-01

Accounting for non-market economic values of biological diversity is important to fully assess the benefits of environmental policies and regulations. This study used three choice experiments (species-, guild-, and ecosystem-based surveys) in parallel to quantify non-use values for little-known aquatic species at risk in southern Ontario. Mean willingness-to-pay (WTP) ranged from 9.45 to 21.41 per listing status increment under Canada's Species at Risk Act for both named and unnamed little-known species. Given the broad range of valuable ecosystem services likely to accrue to residents from substantial increases in water quality and the rehabilitation of coastal wetlands, the difference in WTP between species- and ecosystem-based surveys seemed implausibly small. It appeared that naming species—the `iconization' of species in two of the three surveys—had an important effect on WTP. The results suggest that reasonable annual household-level WTP values for little-known aquatic species may be 10 to 25 per species or 10 to 20 per listing status increment. The results highlighted the utility of using parallel surveys to triangulate on non-use economic values for little-known species at risk.

Initial clinical presentation of young children with N-methyl-d-aspartate receptor encephalitis.

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Favier, Marion; Joubert, Bastien; Picard, Géraldine; Rogemond, Véronique; Thomas, Laure; Rheims, Sylvain; Bailhache, Marion; Villega, Frédéric; Pédespan, Jean-Michel; Berzero, Giulia; Psimaras, Dimitri; Antoine, Jean-Christophe; Desestret, Virginie; Honnorat, Jérôme

2018-05-01

Autoimmune encephalitis with anti-N-methyl-d-aspartate receptor autoantibodies (NMDA-R-Abs) is a recently described disease affecting adult and pediatric patients. Symptoms of the disease are now perfectly described in the adult population but the clinical presentation is less known in young children. The aim of the present study was to describe the clinical presentation and the specificities of symptoms presented by young children with NMDA-R-Abs encephalitis to improve diagnosis of this disease, and to compare these to a series of previously published female adult patients. Fifty cases of children younger than twelve years of age diagnosed with NMDA-R-Abs encephalitis between January 1, 2007 and December 31, 2016 (27 females and 23 males) were retrospectively studied. The first neurological symptoms observed in young children with NMDA-R-Abs encephalitis were characterized by seizure (72%), especially focal seizure (42%), within a median of 15 days before other encephalitis symptoms; other patients mostly had behavioral disorders (26%). The seizures were frequently difficult to diagnose because of the transient unilateral dystonic or tonic posturing presentation or sudden unilateral pain in the absence of clonic movements. A post-ictal motor deficit was also frequently observed. This clinical presentation is different from that observed in adult females with NMDA-R-Abs encephalitis who initially present mainly psychiatric disorders (67%) or cognitive impairment (19%), and less frequently seizures (14%). The diagnosis of NMDA-R-Abs encephalitis should be systematically considered in young children of both sexes who present neurological symptoms suggesting recent seizures (focal or generalized) without obvious other etiology. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Comparison of pregnancy outcomes between maternity waiting home users and non-users at hospitals with and without a maternity waiting home: retrospective cohort study.

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Braat, Floris; Vermeiden, Tienke; Getnet, Gashaw; Schiffer, Rita; van den Akker, Thomas; Stekelenburg, Jelle

2018-01-01

To examine the impact of a maternity waiting home (MWH) by comparing pregnancy outcomes between users and non-users at hospitals with and without an MWH. We conducted a retrospective cohort study in Ethiopia comparing one hospital with an MWH (Attat) to a second hospital without one (Butajira). A structured questionnaire among sampled women in 2014 and hospital records from 2011 to 2014 were used to compare sociodemographic characteristics and pregnancy outcomes between Attat MWH users and non-MWH users, Attat MWH users and Butajira, and Attat non-MWH users and Butajira. χ2 or ORs with 95% CIs were calculated. Compared with Attat non-MWH users (n=306) and Butajira women (n=153), Attat MWH users (n=244) were more often multiparous (multipara vs primigravida: OR 4.43 [95% CI 2.94 to 6.68] and OR 3.58 [95% CI 2.24 to 5.73]), less educated (no schooling vs secondary school: OR 2.62 [95% CI 1.53 to 4.46] and OR 5.21 [95% CI 2.83 to 9.61], primary vs secondary school: OR 4.84 [95% CI 2.84 to 8.25] and OR 5.19 [95% CI 2.91 to 9.27]), poor (poor vs wealthy: OR 8.94 [95% CI 5.13 to 15.61] and OR 12.34 [95% CI 6.78 to 22.44] and further from the hospital (2 h 27 min vs 1 h 00 min and 1 h 12 min: OR 3.08 [95% CI 2.50 to 3.80] and OR 2.18 [95% CI 1.78 to 2.67]). Comparing hospital records of Attat MWH users (n=2784) with Attat non-users (n=5423) and Butajira women (n=9472), maternal deaths were 0 vs 20 (0.4%; p=0.001) and 31 (0.3%; p=0.003), stillbirths 38 (1.4%) vs 393 (7.2%) (OR 0.18 [95% CI 0.13 to 0.25]) and 717 (7.6%) (OR 0.17 [95% CI 0.12 to 0.24]) and uterine ruptures 2 (0.1%) vs 40 (1.1%) (OR 0.05 [95% CI 0.01 to 0.19]) and 122 (1.8%) (OR 0.04 (95% CI 0.01 to 0.16]). No significant differences were found regarding maternal deaths and stillbirths between Attat non-users and Butajira women. Attat MWH users had less favourable sociodemographic characteristics but better birth outcomes than Attat non-users and Butajira women. © The Author(s) 2018. Published by Oxford

The influence of the Children's Food and Beverage Advertising Initiative: change in children's exposure to food advertising on television in Canada between 2006-2009.

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Potvin Kent, M; Wanless, A

2014-04-01

To assess whether children's exposure to television food/beverage advertising has changed since the implementation of the self-regulatory Canadian Children's Food and Beverage Advertising Initiative (CAI). Data on 11 advertised food/beverage categories (candy, chocolate bars, cookies, portable snacks, cheese, yogurt, cereal, juices, soft drinks, diet soft drinks and fast food) were purchased from Nielsen Media Research for May 2006, 2009 and 2011 for the broadcasting markets of Toronto and Vancouver. The number of advertisements aired on 27 television stations between 0600 hours-1200 hours was determined in Toronto and Vancouver for May 2006, 2009 and 2011 and the percentage change in the number of spots between May 2006 and May 2011 on all stations, on children's specialty stations and on generalist stations was then calculated. The average number food/beverage spots seen by children aged 2-11 was determined for May 2006 and 2009 and the percentage change was calculated. On children's specialty channels, a 4.5% decrease in total spots aired was observed while spots aired on generalist stations increased by 44% (Toronto) and 45% (Vancouver). On all stations, children's total average exposure to food/beverage advertising increased by 16.8% in Toronto and 6.4% in Vancouver between 2006 and 2009. Significant increases were seen in snacks and yogurt in both cities, and in fast food in Toronto. On children's specialty channels, children's exposure to the food/beverage categories considered increased by 5.4% in Toronto and by 2.5% in Vancouver. Despite improvements in the volume of spots on children's specialty channels, children's exposure to food and beverage advertising has increased since the implementation of the CAI. The current self-regulatory system is failing to protect children from food marketing high in fat, sugar and sodium on television. Government regulation needs to be considered.

Evaluation of the Global Lung Initiative 2012 Reference Values for Spirometry in African Children.

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Arigliani, Michele; Canciani, Mario C; Mottini, Giovanni; Altomare, Michele; Magnolato, Andrea; Loa Clemente, Sofia Vanda; Tshilolo, Leon; Cogo, Paola; Quanjer, Philip H

2017-01-15

Despite the high burden of respiratory disease, no spirometry reference values for African children are available. Investigate whether the Global Lung Initiative (GLI-2012) reference values for spirometry are appropriate for children in sub-Saharan Africa and assess the impact of malnutrition on lung function. Anthropometry and spirometry were obtained in children aged 6 to 12 years from urban and semiurban schools in three African countries. Spirometry z-scores were derived using the GLI-2012 prediction equations for African Americans. Thinness (body mass index z-score Spirometry outcomes were compared with those of African American children from the third National Health and Nutrition Survey. Spirometry data were analyzed from 1,082 schoolchildren (51% boys) aged 6.0 to 12.8 years in Angola (n = 306), Democratic Republic of the Congo (n = 377), and Madagascar (n = 399). GLI-2012 provided a good fit with mean (SD) z-scores of -0.11 (0.83) for FEV 1 , -0.08 (0.86) for FVC, and -0.07 (0.83) for FEV 1 /FVC. Because of low scatter, the fifth centile corresponded to -1.3 z-scores in boys and -1.5 z-scores in girls. Malnourished African children had a normal FEV 1 /FVC ratio but significant reductions of ∼0.5 z-scores (∼5%) in FEV 1 and FVC compared with African American peers from the third National Health and Nutrition Survey. Children in Angola had the lowest, and those in Madagascar had the highest, zFEV 1 and zFVC. The results of this study support the use of GLI-2012 reference values for schoolchildren in sub-Saharan Africa. Malnutrition affects body growth, leading to a proportionately smaller FEV 1 and FVC without respiratory impairment, as shown by the normal FEV 1 /FVC ratio.

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior.

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Kremers, S P J; Mudde, A N; De Vries, H

2004-05-01

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.

Fasting serum C-peptide is useful for initial classification of diabetes mellitus in children and adolescents

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Min Jung Cho

2014-06-01

Full Text Available PurposeWith rising obesity rates in children, it is increasingly difficult to differentiate between type 1 and type 2 diabetes mellitus (T1DM, T2DM on clinical grounds alone. Using C-peptide as a method of classifying diabetes mellitus (DM has been suggested. This study aimed to find a correlation between fasting C-peptide level and DM types in children and adolescents.MethodsA total of 223 diabetic children, newly diagnosed at 5 hospitals between January 2001 and December 2012, were enrolled in this study. Initial DM classification was based on clinical and laboratory data including fasting C-peptide at diagnosis; final classification was based on additional data (pancreatic autoantibodies, human leukocyte antigen type, and clinical course.ResultsOf 223 diabetic children, 140 were diagnosed with T1DM (62.8% and the remaining 83 with T2DM (37.2%. The mean serum C-peptide level was significantly lower in children with T1DM (0.80 ng/mL than in children with T2DM (3.91 ng/mL. Among 223 children, 54 had a serum C-peptide level 3.0 ng/mL; 48 of them (97.9% were diagnosed with T2DM.ConclusionIn this study, we found that if the C-peptide level was 3.0 ng/mL, a T1DM diagnosis is unlikely. This finding suggests that serum fasting C-peptide level is useful for classifying DM type at the time of diagnosis in youth.

Immune reconstitution inflammatory syndrome after initiating highly active antiretroviral therapy in HIV-infected children

International Nuclear Information System (INIS)

Kilborn, Tracy; Zampoli, Marco

2009-01-01

The outcome of HIV infection has improved since the widespread availability of highly active antiretroviral therapy (HAART). Some patients, however, develop a clinical and radiological deterioration following initiation of HAART due to either the unmasking of occult subclinical infection or an enhanced inflammatory response to a treated infection. This phenomenon is believed to result from the restored ability to mount an immune response and is termed immune reconstitution inflammatory syndrome (IRIS) or immune reconstitution disease. IRIS is widely reported in the literature in adult patients, most commonly associated with mycobacterial infections. There is, however, a paucity of data documenting the radiological findings of IRIS in children. Radiologists need to be aware of this entity. As a diagnosis of exclusion it is essential that the radiological findings be assessed in the context of the clinical presentation. This article reviews the common clinical and radiological manifestations of IRIS in HIV-infected children. (orig.)

Provision for Mathematically Able Children in Primary Schools: A Review of Practice Five Years after England Dropped the Gifted and Talented Initiative

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Dimitriadis, Christos; Georgeson, Jan

2018-01-01

After the abandonment of the Gifted and Talented initiative and the recent developments in mathematics educational policy (i.e. the new national curriculum and the "mastery" initiative), this research project aimed to explore the current primary school situation regarding educating the "most able" children in mathematics, along…

Optimal timing of antiretroviral treatment initiation in HIV-positive children and adolescents: a multiregional analysis from Southern Africa, West Africa and Europe.

Science.gov (United States)

Schomaker, Michael; Leroy, Valeriane; Wolfs, Tom; Technau, Karl-Günter; Renner, Lorna; Judd, Ali; Sawry, Shobna; Amorissani-Folquet, Madeleine; Noguera-Julian, Antoni; Tanser, Frank; Eboua, François; Navarro, Maria Luisa; Chimbetete, Cleophas; Amani-Bosse, Clarisse; Warszawski, Josiane; Phiri, Sam; N'Gbeche, Sylvie; Cox, Vivian; Koueta, Fla; Giddy, Janet; Sygnaté-Sy, Haby; Raben, Dorthe; Chêne, Geneviève; Davies, Mary-Ann

2017-04-01

There is limited knowledge about the optimal timing of antiretroviral treatment initiation in older children and adolescents. A total of 20 576 antiretroviral treatment (ART)-naïve patients, aged 1-16 years at enrolment, from 19 cohorts in Europe, Southern Africa and West Africa, were included. We compared mortality and growth outcomes for different ART initiation criteria, aligned with previous and recent World Health Organization criteria, for 5 years of follow-up, adjusting for all measured baseline and time-dependent confounders using the g-formula. Median (1st;3rd percentile) CD4 count at baseline was 676 cells/mm 3 (394; 1037) (children aged ≥ 1 and 10 years at enrolment we did not find any difference in mortality or growth with immediate ART initiation, with estimated differences of -0.1% (-0.2%; 0.6%) and -0.03 (-0.05; 0.00), respectively. Growth differences in children aged < 10 years persisted for treatment thresholds using higher CD4 values. Regular follow-up led to better height and mortality outcomes. Immediate ART is associated with lower mortality and better growth for up to 5 years in children < 10 years old. Our results on adolescents were inconclusive. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Age and CD4 count at initiation of antiretroviral therapy in HIV-infected children: effects on long-term T-cell reconstitution.

Science.gov (United States)

Lewis, Joanna; Walker, A Sarah; Castro, Hannah; De Rossi, Anita; Gibb, Diana M; Giaquinto, Carlo; Klein, Nigel; Callard, Robin

2012-02-15

Effective therapies and reduced AIDS-related morbidity and mortality have shifted the focus in pediatric human immunodeficiency virus (HIV) from minimizing short-term disease progression to maintaining optimal long-term health. We describe the effects of children's age and pre-antiretroviral therapy (ART) CD4 count on long-term CD4 T-cell reconstitution. CD4 counts in perinatally HIV-infected, therapy-naive children in the Paediatric European Network for the Treatment of AIDS 5 trial were monitored following initiation of ART for a median 5.7 years. In a substudy, naive and memory CD4 counts were recorded. Age-standardized measurements were analyzed using monophasic, asymptotic nonlinear mixed-effects models. One hundred twenty-seven children were studied. Older children had lower age-adjusted CD4 counts in the long term and at treatment initiation (P memory CD4 counts increased less, albeit on a faster timescale. It appears the immature immune system can recover well from HIV infection via the naive pool. However, this potential is progressively damaged with age and/or duration of infection. Current guidelines may therefore not optimize long-term immunological health.

State companies dominate OGJ100 list of non-U.S. oil producers

International Nuclear Information System (INIS)

Anon.

1993-01-01

State owned oil and gas companies dominate the OGJ100 list of non-U.S. producers. Because many of them report only operating information, companies on the worldwide list cannot be ranked by assets or revenues. The list, therefore, is organized regionally, based on location of companies' corporate headquarters. The leading nongovernment company in both reserves and production is Royal Dutch/Shell. It ranks sixth in the world in liquids production and 11th in liquids reserves, as it has for the past 2 years. British Petroleum is the next largest nongovernment company. BP ranks 11th in liquids production and 16th in liquids reserves. Elf Aquitaine, 55.8% government-controlled, ranked 17th in liquids production. AGIP was 20th in liquids production. Kuwait Petroleum returned to the list of top 20 producers, ranking 12th, as it restored production shut in by facilities damage sustained during the Persian Gulf crisis. New to the top 20 reserves list is Petroleo Brasileiro, which moved to 20th position. The top 20 companies in the OGJ100 held reserves estimated at 869.3 billion bbl in 1992 vs. 869.5 billion bbl in 1991 and 854.2 billion bbl in 1990

Insiders' Perspectives: A Children's Rights Approach to Involving Children in Advising on Adult-Initiated Research

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Dunn, Jill

2015-01-01

Consulting with children is widely recognised as an essential element in building understanding about children's lives. From a children's rights perspective, it is also a legal requirement on professionals working with children. However, translating the rhetoric into research and practice is still evolving. Previous studies report on working with…

Children's Literacy Growth, and Candidates' and Teachers' Professional Development Resulting from a PDS-Based Initial Certification Literacy Course

Science.gov (United States)

Rosenthal, Julie L.; Donnantuono, Marie; Lebron, Mary; Flynn, Christina

2017-01-01

This paper reports the effects on children, teacher candidates, and classroom teachers of a PDS-based initial certification course in the teaching of literacy. In this course, teacher candidates work with individual struggling readers on a range of literacy tasks, and the classroom teacher and university faculty member serve as course…

Personality traits and mental health states of methamphetamine-dependent and methamphetamine non-using MSM.

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Solomon, Todd M; Kiang, Mathew V; Halkitis, Perry N; Moeller, Robert W; Pappas, Molly K

2010-02-01

This analysis considers the relation between personality traits, mental health states and methamphetamine (MA) use in 60 men who have sex with men (MSM). Thirty MA-dependent and 30 MA non-using MSM were assessed on the Neo Five Factor Inventory, the Brief Symptom Inventory, the Perceived Stress Scale, and the Posttraumatic Stress Disorder Checklist-Civilian Version tests. Our results indicate differences between groups on a variety of measures of personality traits and mental states. Specifically, MA-dependent participants were found to be more Neurotic, less Open, less Agreeable, and less Conscientious. Further, MA-dependent participants were found to have higher levels of Paranoid Ideation and higher levels of Interpersonal Sensitivity. Given the high prevalence of MA use in the MSM community and the association between MA use and sexual risk taking, our findings provided a clearer understanding of how individual personality traits may be a factor in the continued use of this drug among MSM. Further research should seek to incorporate individual personality traits into the development of efficacious MA-specific treatment interventions.

Low-dose CT colonography in children: initial experience, technical feasibility and utility

International Nuclear Information System (INIS)

Anupindi, Sudha; Perumpillichira, James; Zalis, Michael E.; Jaramillo, Diego; Israel, Esther J.

2005-01-01

CT colonography (CTC) is utilized as a diagnostic tool in the detection of colon polyps and early colorectal cancer in adults. Large studies in the literature, although focused on adult populations, have shown CTC to be a safe, accurate, non-invasive technique. We evaluated the technical feasibility of CTC in children using a low-dose technique. From November 2001 to April 2004 we evaluated eight patients (3-17 years) with non-contrast CTC. Seven of the patients had CTC, followed by standard colonoscopy (SC) the same day; in one patient, CTC followed a failed SC. CTC results were compared to results of SC. The estimated effective dose from each CTC was calculated and compared to that of standard barium enema. CTC results were consistent with those of SC. Sensitivity for polyps 5-10 mm was 100%, and sensitivity for polyps 10 mm and larger was 66.7%. The estimated mean effective dose was 2.17 mSv for CTC, compared to the 5-6 mSv for a standard air-contrast barium enema in a small child. Our initial experience shows CTC in children is well-tolerated, safe, and useful. The procedure can be performed successfully with a low radiation dose, and preliminary results compare well with SC. (orig.)

Knowledge, non-use, use and source of information on contraceptive methods among women in various stages of reproductive age in rural Lagos, Southwest Nigeria

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Afolabi BM

2015-05-01

Full Text Available Bamgboye M Afolabi,1 Emmanuel NU Ezedinachi,2 Iwara Arikpo,2 Abiodun Ogunwale,3 Damilola Fatimah Ganiyu,1 Rashidat A Abu,1 Adewunmi A Ajibade1 1Health, Environment and Development Foundation, Yaba, Lagos, Nigeria; 2Institute of Tropical Disease and Research, University of Calabar, Calabar, Nigeria; 3Project Hope, Washington, DC, USA Background: Contraceptives are advocated to be used against unwanted pregnancy and sexually transmitted diseases as unsafe abortion contributes to high maternal mortality in Nigeria while unwanted pregnancies have terminated the educational development of many females. Objective: This questionnaire-based survey aimed to describe the knowledge, nonuse, and use of various contraceptive methods among women in different child-bearing age groups in rural Lagos, Nigeria. Materials and methods: Between 2012 and 2013, 816 females in rural communities within Lagos State were surveyed for their knowledge, source of information, and use of contraceptives. They were grouped into early, mid, and late reproductive age. Statistical analysis of data harvested from respondents was carried out using STATA 13 software. Results: In all, 816 females in different stages of reproductive age were involved in the study, among whom 19% were single, 78% married, 3% divorced, and 0.5% widowed. About 6% had no formal education, while the majority (81% were of the Yoruba ethnic group. Married respondents were approximately thrice more likely to know of contraceptives than single respondents (χ2=29.9, P=0.000, odds ratio =2.9, 95% confidence interval =1.9, 4.2. Condom use was the most widely known and used method of contraceptive regardless of marital status and reproductive age status. Information about contraceptives was mainly from health facilities among married and divorced women and from school or educational institution among singles. Overall prevalence of contraceptive use was 51.9%. Nonuse of contraceptives was 43% among married women

Initial experience with intravenous pentobarbital sedation for children undergoing MRI at a tertiary care pediatric hospital: the learning curve

International Nuclear Information System (INIS)

Greenberg, S.B.; Adams, R.C.; Aspinall, C.L.

2000-01-01

Objective. Our purpose is to describe the initial experience with intravenous pentobarbital sedation in children undergoing MRI at a tertiary pediatric hospital to identify errors associated with inexperience. Subjects and methods. The study included the first 100 children sedated with intravenous pentobarbital prior to magnetic resonance examination at a tertiary pediatric hospital. The protocol included a maximum dose of 6 mg/kg administered in three divided doses with the total dose not to exceed 200 mg. Flow sheets documenting vital signs, administered drug doses, and adverse reactions were maintained contemporaneous to sedation. Results. Sedation was successful in 92 children. Of the eight children who failed sedation, three were at least 12 years old and three weighed more than 50 kg. χ 2 tests identified significantly greater failure rates in children older than 11 years or weight greater than 50 kg. Two children had prolonged sedation after the maximum suggested dose was exceeded. Conclusions. The success rate was good, but could have been improved by restricting the use of pentobarbital to children less than 12 years of age and weighing less than 50 kg. Radiologists inexperienced with intravenous sedation should strictly observe the maximum suggested dose of pentobarbital to prevent prolonged sedation. (orig.)

Time to and Predictors of CD4+ T-Lymphocytes Recovery in HIV-Infected Children Initiating Highly Active Antiretroviral Therapy in Ghana

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Lorna Renner

2011-01-01

Full Text Available Background. CD4+ T-lymphocyte monitoring is not routinely available in most resource-limited settings. We investigated predictors of time to CD4+ T-lymphocyte recovery in HIV-infected children on highly active antiretroviral (HAART at Korle-Bu Teaching Hospital, Ghana. Methods. Time to CD4+ T-lymphocyte recovery was defined as achieving percent CD4+ T-lymphocytes of 25%. We used Cox proportional hazard models for identifying significant predictor variables. Results. Of the 233 children with complete CD4+ T-lymphocyte data, the mean age at HAART initiation was 5.5 (SD=3.1 years. The median recovery time was 60 weeks (95% CL: 55–65. Evidence at baseline of severe suppression in CD4+ T-lymphocyte count adjusted for age, age at HAART initiation, gender, and having parents alive were statistically significant in predicting time to CD4+ T-lymphocyte recovery. Conclusions. A targeted approach based on predictors of CD4+ T-lymphocyte recovery can be a viable and cost-effective way of monitoring HAART in HIV-infected children in resource-limited settings.

Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection.

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Masahiko Mori

Full Text Available The incidence and severity of infections in childhood is typically greater in males. The basis for these observed sex differences is not well understood, and potentially may facilitate novel approaches to reducing disease from a range of conditions. We here investigated sex differences in HIV-infected children in relation to antiretroviral therapy (ART initiation and post-treatment outcome. In a South African cohort of 2,101 HIV-infected children, we observed that absolute CD4+ count and CD4% were significantly higher in ART-naïve female, compared to age-matched male, HIV-infected children. Absolute CD4 count and CD4% were also significantly higher in HIV-uninfected female versus male neonates. We next showed that significantly more male than female children were initiated on ART (47% female; and children not meeting criteria to start ART by >5 yrs were more frequently female (59%; p<0.001. Among ART-treated children, immune reconstitution of CD4 T-cells was more rapid and more complete in female children, even after adjustment for pre-ART absolute CD4 count or CD4% (p=0.011, p=0.030, respectively. However, while ART was initiated as a result of meeting CD4 criteria less often in females (45%, ART initiation as a result of clinical disease in children whose CD4 counts were above treatment thresholds occurred more often in females (57%, p<0.001. The main sex difference in morbidity observed in children initiating ART above CD4 thresholds, above that of TB disease, was as a result of wasting and stunting observed in females with above-threshold CD4 counts (p=0.002. These findings suggest the possibility that optimal treatment of HIV-infected children might incorporate differential CD4 treatment thresholds for ART initiation according to sex.

Analysis of the Activities of Children in Initial Education in Indigenous Communities of Oaxaca, Mexico

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Julián Jiménez Ramírez

2016-01-01

Full Text Available This study provides partial results of a 200-hour intensive training experience (called a diplomado lasting one school year (2011-2012 for 35 indigenous teachers of Initial education who attend children 0 to 3 years old in marginalized communities of Oaxaca, mexico. Children’s spontaneous activities and those planned by teachers, presented through photographs and accompanying teacher’ narratives, are part of the written and photographic evidence submitted by the participants in their final diplomado portfolio of tasks. the purposes of the diplomado were to enrich teachers’communal knowledge and equip them with research skills to investigate and honor the communal practices, forms of governance, and the perspectives of the rural indigenous communities where they teach, in order to generate an authentic, alternative, community-based approach to initial education for babies and toddlers.

Effects of a Multimedia Social Skills Program in Increasing Social Responses and Initiations of Children with Autism Spectrum Disorder

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Block, Heidi M.; Radley, Keith C.; Jenson, William R.; Clark, Elaine; O'Neill, Robert E.

2015-01-01

The current study evaluated the effectiveness of Superheroes Social Skills, a multimedia social skills package, in improving social responsiveness and social initiation behaviors of four elementary school children with an autism spectrum disorder (ASD). The program was implemented in a public school setting in the southwestern United States for…

Student initiative: A conceptual analysis

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Polovina Nada

2014-01-01

Full Text Available In the description and scientific consideration of the attitude of children and youth towards their education and development, the concept of student initiative has been gaining ground lately, and it is hence the subject of analysis in this paper. The analysis is important because of the discrepancy between the increased efforts of the key educational policy holders to promote the idea about the importance of the development of student initiative and rare acceptance of this idea among theoreticians, researchers and practitioners dealing with the education and development of children and youth. By concretising the features of initiative student behaviour, our aim was, on the one hand, to observe the structural determinants and scientific status of the very concept of an initiative student, and, on the other, to contribute to the understanding of the initiative behaviour in practice. In the first part of the paper we deal with different notions and concretisations of the features of initiative behaviour of children and youth, which includes the consideration of: basic student initiative, academic student initiative, individual student initiative, the capacity for initiative and personal development initiative. In the second part of the paper, we discuss the relations of the concept of student initiative with the similar general concepts (activity/passivity, proactivity, agency and the concepts immediately related to school environment (student involvement, student participation. The results of our analysis indicate that the concept of student initiative has: particular features that differentiate it from similar concepts; the potential to reach the status of a scientific concept, bearing in mind the initial empirical specifications and general empirical verifiability of the yet unverified determinants of the concept. In the concluding part of the paper, we discuss the implications of the conceptual analysis for further research, as well as for

WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children.

LENUS (Irish Health Repository)

Wijnhoven, T M A

2012-09-21

What is already known about this subject Overweight and obesity prevalence estimates among children based on International Obesity Task Force definitions are substantially lower than estimates based on World Health Organization definitions. Presence of a north-south gradient with the highest level of overweight found in southern European countries. Intercountry comparisons of overweight and obesity in primary-school children in Europe based on measured data lack a similar data collection protocol. What this study adds Unique dataset on overweight and obesity based on measured weights and heights in 6-9-year-old children from 12 European countries using a harmonized surveillance methodology. Because of the use of a consistent data collection protocol, it is possible to perform valid multiple comparisons between countries. It demonstrates wide variations in overweight and obesity prevalence estimates among primary-school children between European countries and regions. BACKGROUND: Nutritional surveillance in school-age children, using measured weight and height, is not common in the European Region of the World Health Organization (WHO). The WHO Regional Office for Europe has therefore initiated the WHO European Childhood Obesity Surveillance Initiative. OBJECTIVE: To present the anthropometric results of data collected in 2007\\/2008 and to investigate whether there exist differences across countries and between the sexes. METHODS: Weight and height were measured in 6-9-year-old children in 12 countries. Prevalence of overweight, obesity, stunting, thinness and underweight as well as mean Z-scores of anthropometric indices of height, weight and body mass index were calculated. RESULTS: A total of 168 832 children were included in the analyses and a school participation rate of more than 95% was obtained in 8 out of 12 countries. Stunting, underweight and thinness were rarely prevalent. However, 19.3-49.0% of boys and 18.4-42.5% of girls were overweight (including

Systematic review of frequent users of emergency departments in non-US hospitals: state of the art.

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van Tiel, Sofie; Rood, Pleunie P M; Bertoli-Avella, Aida M; Erasmus, Vicky; Haagsma, Juanita; van Beeck, Ed; Patka, Peter; Polinder, Suzanne

2015-10-01

This review focuses on frequent users (FUs) of the emergency department (ED). Elucidation of the characteristics of frequent ED users will help to improve healthcare services. A systematic review of the literature (from 1999 onwards) on frequent ED users in non-US hospitals was performed. Twenty-two studies were included. FUs are responsible for a wide variety of 1-31% of ED visits depending on the FU definition used. They have a mean age between 40 and 50 years and are older than nonfrequent users. Chronic physical and mental diseases seem to be the main reasons for frequent ED visits. In terms of social characteristics, lacking a partner is more frequently reported among FUs in some studies. The absence of a universal definition for FUs complicates the determination of the burden on emergency healthcare services. FUs are a heterogeneous group of patients with genuine medical needs and high consumption of other healthcare services.

Predictors of early breastfeeding initiation among mothers of children under 24 months of age in rural part of West Ethiopia.

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Hailemariam, Tsedeke Wolde; Adeba, Emiru; Sufa, Alem

2015-10-21

The World Health Organization recommends initiation of breastfeeding within the first hour after childbirth. In developing countries alone, early initiation of breastfeeding could save as many as 1.45 million lives each year by reducing deaths mainly due to diarrheal disorders and lower respiratory tract infections in children. The current study aimed to determine the rate and the predictors of breastfeeding initiation in East Wollega Zones of West Ethiopia. A community-based, cross-sectional study was conducted from April to May 2014 among 594 mothers who had children less than 24 months. Multi stage cluster sampling method was used to select the study population. Eligible mothers were invited to interview using pretested questionnaires to gather data regarding sociodemographics, health-related variables, breastfeeding initiation, and current breastfeeding practices. A multivariable logistic regression analysis was used to identify independent predictors of early initiation of breastfeeding after controlling for confounding variables. A sample of 593 mothers was included in the study. Breastfeeding was initiated by 83.1 % of mothers within the first hour of childbirth. Being a housewife (AOR (95 % CI) = 2.48 (1.54- 3.99)) and infant received colostrum (AOR (95 % CI) =2.22 (1.08-4.55)) were significant positive predictors for early breastfeeding initiation as revealed by logistic regression. The multivariable logistic regression analysis showed that the mothers who had no radio and/or TV in the household (AOR (95 % CI = 0.55 (0.35-0.88)), were not exposure to health information (AOR (95 % CI) = 0.44 (0.25-0.75)), and infants were provided with prelacteal feeds (AOR (95 % CI)=0.30 (0.14-0.65)) were less likely to initiate breastfeeding. The rate of timely initiation of breastfeeding was high. Breastfeeding promotion program is essential to encourage the practice of timely initiation of breastfeeding, and reduce the practice of providing prelacteal

Do dietary supplements improve micronutrient sufficiency in children and adolescents?

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Bailey, Regan L.; Fulgoni, Victor L.; Keast, Debra R.; Lentino, Cindy V.; Dwyer, Johanna T.

2012-01-01

Objective To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Study design Data were analyzed for children (2–18 y) from the NHANES 2003–2006, a nationally representative, cross-sectional survey (n=7,250). Diet was assessed using two 24-hour recalls, and dietary supplement use was assessed with a 30-day questionnaire. Results Prevalence of supplements use was 21% (Supplement users had higher micronutrient intakes than nonusers. Calcium and vitamin D intakes were low for all children. Inadequate intakes of phosphorus, copper, selenium, folate, and vitamins B-6 and B-12 were minimal from foods alone among 2–8 y olds. However, among 9–18 y olds, a higher prevalence of inadequate intakes of magnesium, phosphorus, and vitamins A, C, and E were observed. Supplement use increased the likelihood of intakes above the Upper Tolerable Intake Level for iron, zinc, copper, selenium, folic acid, and vitamins A and C. Conclusions Even with the use of supplements, more than a one-third of children failed to meet calcium and vitamin D recommendations. Children 2–8 y had nutritionally adequate diets regardless of supplement use. However, in children older than 8 y dietary supplements added micronutrients to diets that would have otherwise been inadequate for magnesium, phosphorus, vitamins A,C, and E. Supplement use contributed to the potential for excess intakes of some nutrients. These findings may have implications for reformulating dietary supplements for children. PMID:22717218

A search algorithm for identifying likely users and non-users of marijuana from the free text of the electronic medical record.

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Salomeh Keyhani

Full Text Available The harmful effects of marijuana on health and in particular cardiovascular health are understudied. To develop such knowledge, an efficient method of developing an informative cohort of marijuana users and non-users is needed.We identified patients with a diagnosis of coronary artery disease using ICD-9 codes who were seen in the San Francisco VA in 2015. We imported these patients' medical record notes into an informatics platform that facilitated text searches. We categorized patients into those with evidence of marijuana use in the past 12 months and patients with no such evidence, using the following text strings: "marijuana", "mjx", and "cannabis". We randomly selected 51 users and 51 non-users based on this preliminary classification, and sent a recruitment letter to 97 of these patients who had contact information available. Patients were interviewed on marijuana use and domains related to cardiovascular health. Data on marijuana use collected from the medical record was compared to data collected as part of the interview.The interview completion rate was 71%. Among the 35 patients identified by text strings as having used marijuana in the previous year, 15 had used marijuana in the past 30 days (positive predictive value = 42.9%. The probability of use in the past month increased from 8.8% to 42.9% in people who have these keywords in their medical record compared to those who did not have these terms in their medical record.Methods that combine text search strategies for participant recruitment with health interviews provide an efficient approach to developing prospective cohorts that can be used to study the health effects of marijuana.

Behavioral Initiatives in Broad Perspective.

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California Univ., Los Angeles. Center for Mental Health in Schools.

This booklet is a technical assistance sampler addressing the issues of student misbehavior, discipline problems, and behavioral initiatives. The term behavioral initiative is defined, disciplining children with disabilities is discussed, and a cautionary note concerning ignoring students' reasons for misbehavior is presented. A brief entitled…

Motivos de uso y no uso de puentes peatonales en la Ciudad de México: la perspectiva de los peatones Use and non-use of pedestrian bridges in Mexico City: the pedestrian perspective

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Elisa Hidalgo-Solórzano

2010-12-01

Full Text Available OBJETIVO. Analizar los motivos de uso y no uso de puentes peatonales (PP. MATERIAL Y MÉTODOS. Se empleó un diseño transversal, a partir de una muestra de peatones usuarios y no usuarios de PP; se utilizó regresión logística para identificar los factores que influyen en el uso y no uso de PP. RESULTADOS. La prevalencia de no uso fue 50.5% en 813 peatones entrevistados; la principal razón para usar PP fue "seguridad", del no uso fue "flojera". Hubo diferencias significativas al analizar motivos de no uso de PP en las edades de 19 a 36 años, ajustando por escolaridad y características físicas del PP, con RMa. 1.7 (IC95% 1.06-2.86 y RMa. 1.9 (IC95% 1.14-3.33, respectivamente. CONCLUSIONES. Los resultados de este estudio permiten identificar aspectos importantes a considerar desde la perspectiva de los peatones, antes de construir nuevos PP, así como aquéllos que deben mejorarse para incrementar su uso en zonas de alto riesgo de lesiones por atropellamiento.OBJECTIVE. To analyze the motives for using and not using pedestrian bridges (PB. MATERIAL AND METHODS. A cross-sectional survey was conducted of a sample of pedestrian users and non-users of PB; a logistic regression model was used to analyze the motives for use and non-use. RESULTS. The prevalence of non-use was 50.5 % of 813 surveyed pedestrians; the principal reason to use a PB was safety, and not to use it was "laziness". There were significant differences when analyzing the reason of non-use in the age groups 19 to 36 years, adjusted for education and physical characteristics of the PB ([aOR=1.7; 95 % CI=1.06-2.86] and [ORa.1.9; 95 % CI=1.14-3.33], respectively. CONCLUSIONS. The results of this study allow us to identify important aspects to consider "from the perspective of the pedestrians" when constructing new PB and improving existing PB to increase use in areas with a high risk of pedestrian injuries.

Initial default among sputum-positive pulmonary TB patients at a referral hospital in Uttarakhand, India.

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Mehra, Darshan; Kaushik, Rajeev M; Kaushik, Reshma; Rawat, Jagdish; Kakkar, Rajesh

2013-09-01

Initial default is a serious issue which can enhance the transmission of TB. We determined the magnitude of and the causative factors for initial default among sputum-positive pulmonary TB (PTB) patients. In this prospective study, 2310 patients attending a referral hospital in Uttarakhand state, north India, with presumptive TB were investigated and 555 patients with sputum-positive PTB were followed-up for initiation of anti-TB treatment (ATT) during 2010-2012. The patients not confirmed as having started ATT were considered initial defaulters. Initial default was seen in 120 (21.6%) patients comprising 22 (18.3%) defaulters during diagnosis and 98 (81.6%) defaulters after referral for directly observed treatment, short-course (DOTS). The initial default rate was significantly higher among patients from rural areas than urban areas, illiterate patients than literate patients and smokeless tobacco-users than non-users (pdefault among patients referred for DOTS were limited trust in DOTS (n = 44, 44.8%), adverse effects of previous ATT (n = 41, 41.8%), dissatisfaction with health services (n = 38, 38.7%), local deaths while taking DOTS (n = 28, 28.5%), advice by others against DOTS (n = 25, 25.5%), disbelief in the diagnosis (n = 18, 18.3%) and patient death before starting treatment (n = 4, 4.0%). A high initial default rate was seen among patients with PTB. There is an urgent need to promote public awareness to lower the initial default rate.

If at First You Don't Remember, Try, Try Again: The Role of Initial Encoding in Children's False Reports

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Principe, Gabrielle F.

2004-01-01

To examine the extent to which differences in the initial encoding of information affect preschoolers' vulnerability to suggestion, 4 groups of 4-year-olds (N = 54) individually participated in a simulated shopping event in which they were asked to purchase 6 items from a specially constructed grocery store. Half the children had only 1…

A model of roles and responsibilities in oral health promotion based on perspectives of a community-based initiative for pre-school children in the U.K.

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Henderson, E; Rubin, G

2014-03-01

(i) To explore dental, school and family perspectives of an oral health promotion (OHP) initiative to improve access for pre-school children in deprived communities; (ii) to develop a model of roles and responsibilities for OHP in community settings. Semi-structured focus groups (n = 6) with dental practice staff (n = 24), and semi-structured interviews with school staff (n = 9) and parents and children (n = 4) who were involved in an OHP initiative for pre-school children. Framework analysis was applied to identify themes. Themes were used to develop a model of roles and responsibilities for OHP, based on the WHO Planning and evaluating health promotion model. Respondents subscribed to a community-based approach to improving access to dental services for pre-school children in deprived areas, with an emphasis on shared responsibility and communication. In addition to macro-level actions in directing health policy and services, commissioners were held responsible for investing in micro-level actions, such as funding OHP training and involving parents, and meso-level actions such as reducing barriers to access. The model we have developed builds on WHO recommendations on health promotion to identify the key roles and responsibilities that should be incorporated into further initiatives in OHP.

Social Support Questionnaire for Children: Development and Initial Validation

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Gordon-Hollingsworth, Arlene T.; Thompson, Julia E.; Geary, Meghan A.; Schexnaildre, Mark A.; Lai, Betty S.; Kelley, Mary Lou

2016-01-01

The Social Support Questionnaire for Children (SSQC) is a 50-item scale that assesses children's social support from parents, relatives, nonrelative adults, siblings, and peers. The SSQC demonstrates good psychometric properties (e.g., internal consistency, factorial validity). Furthermore, the SSQC appears to be an ethnically sensitive measure of…

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

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

2011-12-01

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

Knowledge, non-use, use and source of information on contraceptive methods among women in various stages of reproductive age in rural Lagos, Southwest Nigeria.

Science.gov (United States)

Afolabi, Bamgboye M; Ezedinachi, Emmanuel Nu; Arikpo, Iwara; Ogunwale, Abiodun; Ganiyu, Damilola Fatimah; Abu, Rashidat A; Ajibade, Adewunmi A

2015-01-01

Contraceptives are advocated to be used against unwanted pregnancy and sexually transmitted diseases as unsafe abortion contributes to high maternal mortality in Nigeria while unwanted pregnancies have terminated the educational development of many females. This questionnaire-based survey aimed to describe the knowledge, nonuse, and use of various contraceptive methods among women in different child-bearing age groups in rural Lagos, Nigeria. Between 2012 and 2013, 816 females in rural communities within Lagos State were surveyed for their knowledge, source of information, and use of contraceptives. They were grouped into early, mid, and late reproductive age. Statistical analysis of data harvested from respondents was carried out using STATA 13 software. In all, 816 females in different stages of reproductive age were involved in the study, among whom 19% were single, 78% married, 3% divorced, and 0.5% widowed. About 6% had no formal education, while the majority (81%) were of the Yoruba ethnic group. Married respondents were approximately thrice more likely to know of contraceptives than single respondents ( χ 2 =29.9, P =0.000, odds ratio =2.9, 95% confidence interval =1.9, 4.2). Condom use was the most widely known and used method of contraceptive regardless of marital status and reproductive age status. Information about contraceptives was mainly from health facilities among married and divorced women and from school or educational institution among singles. Overall prevalence of contraceptive use was 51.9%. Nonuse of contraceptives was 43% among married women and 67% among singles. Knowledge of contraceptive method was negatively associated with marital status ( t =-2.24, P =0.025) but positively associated with source of information on contraceptives ( t =20.00, P =0.000). Use of contraceptives was positively associated with stage of reproductive age ( t =1.94, P =0.05) and source of information on contraceptives ( t =11.22, P =0.000), but negatively

Does Facial Expressivity Count? How Typically Developing Children Respond Initially to Children with Autism

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Stagg, Steven D.; Slavny, Rachel; Hand, Charlotte; Cardoso, Alice; Smith, Pamela

2014-01-01

Research investigating expressivity in children with autism spectrum disorder has reported flat affect or bizarre facial expressivity within this population; however, the impact expressivity may have on first impression formation has received little research input. We examined how videos of children with autism spectrum disorder were rated for…

Parent Scaffolding of Young Children When Engaged with Mobile Technology.

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Wood, Eileen; Petkovski, Marjan; De Pasquale, Domenica; Gottardo, Alexandra; Evans, Mary Ann; Savage, Robert S

2016-01-01

Shared parent-child experiences while engaged with an iPad(TM) were examined to determine if and then how parents interact with their children when using mobile digital devices. In total, 104 parent-child dyads participated in an observation session where parent-child interactions using the touchscreen tablet device were video recorded in order to observe first-hand the supports and exchanges between parent and child (age range 46.21-75.9 months). Results indicate that parents provide a great deal of support to their children while interacting with the touchscreen tablet device including verbal, emotional-verbal, physical and emotional-physical supports. The types of support offered did not differ as a function of parent gender or experience with mobile devices (users versus non-users). Overall, parents rated their own experience engaging with the touchscreen tablet and that of their child's positively. Additional survey measures assessed parents' perceptions of their child's technology use and attitudes regarding optimal ages and conditions for introducing and using technology. Most parents indicated a preference for very early introduction to mobile technologies. Implications of these findings are discussed.

DRAMA IN SCHOOL. AN EDUCATIONAL INITIATIVE FOR THE FUTURE

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Sylvia ROTTER

2017-12-01

Full Text Available The aim of this paper is to highlight experiences and benefits of drama in education that have been developed through the project „The National Educational Initiative – Drama in education”. The project was carried out in 2014 in Romanian secondary schools by the Vienna Theatre for Children Association. The initiative addressed to children, teens and teachers alike. The starting point of the project lies in the research and methodology that were developed within the “School for Life” initiative of the Vienna Theatre for Children in 2008. The focal point consists in exploring the impact of play in education and learning. The two projects that are mentioned in the paper identified and evaluated the skills of the children and youth who got involved in the drama activities. The results showed cognitive, emotional and interpersonal progress in acquisition.

MR cholangiopancreatography in children: feasibility, safety, and initial experience

International Nuclear Information System (INIS)

Delaney, Lisa; Karmazyn, Boaz; Akisik, M.F.; Jennings, S.G.; Applegate, Kimberly E.

2008-01-01

The indications for MR cholangiopancreatography (MRCP) in children, and its safety and findings, might differ from those in adults and are not well described. To investigate the safety, feasibility, and accuracy of MRCP in children. We reviewed all prospective MRCP reports, noting the indication, the use of secretin, endoscopic retrograde cholangiopancreatography (ERCP) findings, and patient outcomes. Two readers reviewed each MRCP study by consensus to rate duct visualization and compare pancreatic duct sizes before and after secretin administration (paired t-test). The likelihood of a normal versus an abnormal MRCP study was compared by gender, pancreatitis as the primary indication, secretin use, and whether ERCP was performed (Fisher's exact test), as well as age (t-test). A total of 85 MRCP studies were performed in children (mean age 10.3 years), most commonly for evaluation of pancreatitis (n=47, 55%); 41 (48%) used secretin and 39 (46%) used a negative oral contrast agent. Of the 85 studies, 72 (85%) had excellent image quality and 43 were normal. ERCP was performed after 16 of the 85 MRCP studies (19%); the diagnoses were concordant with those of MRCP in 13 (81%). There were 42 abnormal MRCP studies, and these were more likely to be in girls (P=0.03) and in children who had undergone ERCP (P<0.01). Secretin and the negative oral contrast agent were well-tolerated. Secretin improved duct visualization (P<0.001). MRCP safely and accurately depicted pancreaticobiliary anatomy in children. The use of secretin improved visualization of the pancreatic duct. (orig.)

FACTORS RELATED TO ORAL CANDIDIASIS IN ELDERLY USERS AND NON-USERS OF REMOVABLE DENTAL PROSTHESES.

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Bianchi, Cyra Maria Pires de Carvalho; Bianchi, Hélcio Aparecido; Tadano, Tomoko; Paula, Claudete Rodrigues de; Hoffmann-Santos, Hugo Dias; Leite, Diniz Pereira; Hahn, Rosane Christine

2016-01-01

This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group) who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3%) who used prosthesis and in 23 (53.5%) in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p oral candidiasis (n = 24), 83.3% (n = 20) belonged to the group that wore dentures, while only 16.7% (n = 4) belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.

Technical report—Diagnosis and management of an initial UTI in febrile infants and young children.

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Finnell, S Maria E; Carroll, Aaron E; Downs, Stephen M

2011-09-01

The diagnosis and management of urinary tract infections (UTIs) in young children are clinically challenging. This report was developed to inform the revised, evidence-based, clinical guideline regarding the diagnosis and management of initial UTIs in febrile infants and young children, 2 to 24 months of age, from the American Academy of Pediatrics Subcommittee on Urinary Tract Infection. The conceptual model presented in the 1999 technical report was updated after a comprehensive review of published literature. Studies with potentially new information or with evidence that reinforced the 1999 technical report were retained. Meta-analyses on the effectiveness of antimicrobial prophylaxis to prevent recurrent UTI were performed. Review of recent literature revealed new evidence in the following areas. Certain clinical findings and new urinalysis methods can help clinicians identify febrile children at very low risk of UTI. Oral antimicrobial therapy is as effective as parenteral therapy in treating UTI. Data from published, randomized controlled trials do not support antimicrobial prophylaxis to prevent febrile UTI when vesicoureteral reflux is found through voiding cystourethrography. Ultrasonography of the urinary tract after the first UTI has poor sensitivity. Early antimicrobial treatment may decrease the risk of renal damage from UTI. Recent literature agrees with most of the evidence presented in the 1999 technical report, but meta-analyses of data from recent, randomized controlled trials do not support antimicrobial prophylaxis to prevent febrile UTI. This finding argues against voiding cystourethrography after the first UTI.

Children and ICT European Initiatives and Policies on Protecting Children Online

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Wojniak, Justyna; Majorek, Marta

2016-01-01

The paper concerns the opportunities of use information and communication technologies for the education purposes. It presents key assumptions of the European Union policy concerning innovative methods of training and the prospects for their further development. As nowadays one can observe increasing activity of the children and young people in…

Neurocognitive Function in Children with Primary Hypertension after Initiation of Antihypertensive Therapy.

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Lande, Marc B; Batisky, Donald L; Kupferman, Juan C; Samuels, Joshua; Hooper, Stephen R; Falkner, Bonita; Waldstein, Shari R; Szilagyi, Peter G; Wang, Hongyue; Staskiewicz, Jennifer; Adams, Heather R

2018-04-01

To determine the change in neurocognitive test performance in children with primary hypertension after initiation of antihypertensive therapy. Subjects with hypertension and normotensive control subjects had neurocognitive testing at baseline and again after 1 year, during which time the subjects with hypertension received antihypertensive therapy. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed, and parents completed rating scales of executive function. Fifty-five subjects with hypertension and 66 normotensive control subjects underwent both baseline and 1-year assessments. Overall, the blood pressure (BP) of subjects with hypertension improved (24-hour systolic BP load: mean baseline vs 1 year, 58% vs 38%, P < .001). Primary multivariable analyses showed that the hypertension group improved in scores of subtests of the Rey Auditory Verbal Learning Test, Grooved Pegboard, and Delis-Kaplan Executive Function System Tower Test (P < .05). However, the control group also improved in the same measures with similar effects sizes. Secondary analyses by effectiveness of antihypertensive therapy showed that subjects with persistent ambulatory hypertension at 1 year (n = 17) did not improve in subtests of Rey Auditory Verbal Learning Test and had limited improvement in Grooved Pegboard. Overall, children with hypertension did not improve in neurocognitive test performance after 1 year of antihypertensive therapy, beyond that also seen in normotensive controls, suggesting improvements with age or practice effects because of repeated neurocognitive testing. However, the degree to which antihypertensive therapy improves BP may affect its impact upon neurocognitive function. Copyright © 2017 Elsevier Inc. All rights reserved.

Chronic Use of Aspirin and Total White Matter Lesion Volume: Results from the Women's Health Initiative Memory Study of Magnetic Resonance Imaging Study.

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Holcombe, Andrea; Ammann, Eric; Espeland, Mark A; Kelley, Brendan J; Manson, JoAnn E; Wallace, Robert; Robinson, Jennifer

2017-10-01

To investigate the relationship between aspirin and subclinical cerebrovascular heath, we evaluated the effect of chronic aspirin use on white matter lesions (WML) volume among women. Chronic aspirin use was assessed in 1365 women who participated in the Women's Health Initiative Memory Study of Magnetic Resonance Imaging. Differences in WML volumes between aspirin users and nonusers were assessed with linear mixed models. A number of secondary analyses were performed, including lobe-specific analyses, subgroup analyses based on participants' overall risk of cerebrovascular disease, and a dose-response relationship analysis. The mean age of the women at magnetic resonance imaging examination was 77.6 years. Sixty-one percent of participants were chronic aspirin users. After adjusting for demographic variables and comorbidities, chronic aspirin use was nonsignificantly associated with 4.8% (95% CI: -6.8%, 17.9%) larger WML volumes. These null findings were confirmed in secondary and sensitivity analyses, including an active comparator evaluation where aspirin users were compared to users of nonaspirin nonsteroidal anti-inflammatory drugs or acetaminophen. There was a nonsignificant difference in WML volumes between aspirin users and nonusers. Further, our results suggest that chronic aspirin use may not have a clinically significant effect on WML volumes in women. Published by Elsevier Inc.

Transcatheter closure of patent ductus arteriosus in children weighing 10 kg or less: Initial experience at Sohag University Hospital.

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Ali, Safaa; El Sisi, Amel

2016-04-01

To assess the challenges, feasibility, and efficacy of device closure of patent ductus arteriosus (PDA) in small children weighing ⩽10 kg for different types of devices used in an initial experience at Sohag University hospital. Between March 2011 and September 2014, 91 patients with PDA underwent transcatheter closure in our institute, among whom 54 weighed ⩽10 kg. All of these patients underwent transcatheter closure of PDA using either a Cook Detachable Coil, PFM Nit-Occlud, or Amplatzer duct occluder. A retrospective review of the treatment results and adverse events was performed. Successful device placement was achieved in 53/54 small children (98.1%). The median minimum PDA diameter was 2.4 mm [interquartile range (IQR, 1.8-3.5 mm), median weight 8 kg (IQR, 7-10 kg), and median age 10 months (IQR, 8-17 months)]. Mild aortic obstruction occurred in one case (1.9%), as the device became displaced towards the aorta after release. The device embolized in one case (1.9%) and no retrieval attempt was made. Five cases (9.3%) had minor vascular complications. With the current availability of devices for PDA closure, transcatheter closure of PDA is considered safe and efficacious in small children weighing ⩽10 kg with good mid-term outcome. The procedure had a low rate of high-severity adverse events even with the initial experience of the catheterization laboratory.

Prognostic significance of the initial cerebro-spinal fluid (CSF) involvement of children with acute lymphoblastic leukaemia (ALL) treated without cranial irradiation: results of European Organization for Research and Treatment of Cancer (EORTC) Children Leukemia Group study 58881.

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Sirvent, Nicolas; Suciu, Stefan; Rialland, Xavier; Millot, Frédéric; Benoit, Yves; Plantaz, Dominique; Ferster, Alice; Robert, Alain; Lutz, Patrick; Nelken, Brigitte; Plouvier, Emmanuel; Norton, Lucilia; Bertrand, Yves; Otten, Jacques

2011-01-01

To evaluate the prognostic significance of the initial cerebro-spinal fluid (CSF) involvement of children with ALL enrolled from 1989 to 1996 in the EORTC 58881 trial. Patients (2025) were categorised according to initial central nervous system (CNS) status: CNS-1 (CNS negative, n=1866), CNS-2 (treatment were each related to a lower CNS relapse risk. The presence of initial CNS involvement has no prognostic significance in EORTC 58881. Intensification of CNS-directed chemotherapy, without CNS radiation, is an effective treatment of initial meningeal leukaemic involvement. Copyright © 2010 Elsevier Ltd. All rights reserved.

Emergent Literacy Skills in Preschool Children With Hearing Loss Who Use Spoken Language: Initial Findings From the Early Language and Literacy Acquisition (ELLA) Study.

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Werfel, Krystal L

2017-10-05

The purpose of this study was to compare change in emergent literacy skills of preschool children with and without hearing loss over a 6-month period. Participants included 19 children with hearing loss and 14 children with normal hearing. Children with hearing loss used amplification and spoken language. Participants completed measures of oral language, phonological processing, and print knowledge twice at a 6-month interval. A series of repeated-measures analyses of variance were used to compare change across groups. Main effects of time were observed for all variables except phonological recoding. Main effects of group were observed for vocabulary, morphosyntax, phonological memory, and concepts of print. Interaction effects were observed for phonological awareness and concepts of print. Children with hearing loss performed more poorly than children with normal hearing on measures of oral language, phonological memory, and conceptual print knowledge. Two interaction effects were present. For phonological awareness and concepts of print, children with hearing loss demonstrated less positive change than children with normal hearing. Although children with hearing loss generally demonstrated a positive growth in emergent literacy skills, their initial performance was lower than that of children with normal hearing, and rates of change were not sufficient to catch up to the peers over time.

Initiating Young Children into Basic Astronomical Concepts and Phenomena

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Kallery, M.

2010-07-01

In the present study we developed and implemented three units of activities aiming at acquainting very young children with basic astronomical concepts and phenomena such as the sphericity of the earth, the earth’s movements and the day/night cycle. The activities were developed by a group composed of a researcher/facilitator and six early-years teachers. In the activities children were presented with appropriate for their age scientific information along with conceptual tools such as a globe and an instructional video. Action research processes were used to optimize classroom practices and to gather useful information for the final shaping of the activities and the instruction materials. In these activities the adopted approach to learning can be characterized as socially constructed. The results indicated awareness of concepts and phenomena that the activities dealt with in high percentages of children, storage of the new knowledge in the long term memory and easy retrieval of it, and children’s enthusiasm for the subject.

Facilitators and barriers to implementation of the AIDES initiative, a social innovation for participative assessment of children in need and for coordination of services.

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Dufour, Sarah; Lessard, Danielle; Chamberland, Claire

2014-12-01

As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Young Children's Initiation into Family Literacy Practices in the Digital Age

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Marsh, Jackie; Hannon, Peter; Lewis, Margaret; Ritchie, Louise

2017-01-01

This article reports a study that explored young children's digital literacy in the home. The aim of the study was to identify the range of digital literacy practices in which children are engaged in the home and to explore how these are embedded into family life and involve family members. Four children, two girls and two boys aged between 2 and…

[WTP guidance technology: a comparison of payment card, single-bounded and double-bounded dichotomous formats for evaluating non-use values of Sanjiang Plain ecotourism water resources].

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Chen, Hong-Guang; Wang, Qiu-Dan; Li, Chen-Yang

2014-09-01

Contingent valuation method (CVM) is the most widespread method to assess resources and value of environmental goods and services. The guidance technology of willingness to pay (WTP) is an important means of CVM. Therefore, the study on the WTP guidance technology is an important approach to improve the reliability and validity of CVM. This article conducted comprehensive evaluation on non-use value of eco-tourism water resources in Sanjiang Plain by using payment card, single-bound dichotomous choice and double-bound dichotomous choice. Results showed that the socio-economic attributes were consistent with the willingness to pay in the three formats, and the tender value, age, educational level, annual income and the concern level had significant effect on the willingness to pay, while gender and job did not have significant influence. The WTP value was 112.46 yuan per capita with the payment card, 136.15 with the single-bound dichotomous choice, and 168.74 with the double-bound dichotomous choice. Comprehensive consideration of the nature of the investigation, investigation costs and statistical techniques, the result of double-bound dichotomous choice (47.86 x 10(8) yuan · a(-1)) was best in accordance with the reality, and could be used as non-use value of eco-tourism water resources in Sanjiang Plain. The format of questionnaire was very important to improve its validity, and made a great influence on the WTP.

Distracted: Academic Performance Differences between Teen Users and Non-Users of MySpace and other Communication Technology

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Tamyra A. Pierce

2008-06-01

Full Text Available This study examined the differences in academic performance between teen users and non-users of various communication technologies. Participants included 517 high school students who completed a self-report survey. The results revealed that approximately 3/4 of the teens had a MySpace account and a cell phone and more than 1/2 had an IM account. Results also showed that those who had a MySpace account, cell phone and IM had signifi cantly lower grades than those who did not. Results also revealed that teens who used their MySpace, cell phone and IM while doing their homework reported having lower grades than those who did not use the technology while doing their homework. In addition, those who put off doing their homework to spend time on MySpace also reported lower grades than those who did not put off doing their homework to spend time with MySpace. Finally, results showed that 28% text messaged during class from always to frequently, and 5% reported text messaging during an exam from always to frequently.

Parent Scaffolding of Young Children When Engaged With Mobile Technology

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Eileen eWood

2016-05-01

Full Text Available Shared parent-child experiences while engaged with an iPad™ were examined to determine if and then how parents interact with their children when using mobile digital devices. In total, 104 parent-child dyads participated in an observation session where parent-child interactions using the touchscreen tablet device were video recorded in order to observe first-hand the supports and exchanges between parent and child (age range 46.21- 75.9 months. Results indicate that parents provide a great deal of support to their children while interacting with the touchscreen tablet device including verbal, emotional-verbal, physical and emotional-physical supports. The types of support offered did not differ as a function of parent gender or experience with mobile devices (users versus non-users. Overall, parents rated their own experience engaging with the touchscreen tablet and that of their child’s positively. Additional survey measures assessed parents’ perceptions of their child’s technology use and attitudes regarding optimal ages and conditions for introducing and using technology. Most parents indicated a preference for very early introduction to mobile technologies. Implications of these findings are discussed.

Long-term trends in mortality and AIDS-defining events after combination ART initiation among children and adolescents with perinatal HIV infection in 17 middle- and high-income countries in Europe and Thailand: A cohort study.

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Ali Judd

2018-01-01

Full Text Available Published estimates of mortality and progression to AIDS as children with HIV approach adulthood are limited. We describe rates and risk factors for death and AIDS-defining events in children and adolescents after initiation of combination antiretroviral therapy (cART in 17 middle- and high-income countries, including some in Western and Central Europe (W&CE, Eastern Europe (Russia and Ukraine, and Thailand.Children with perinatal HIV aged 6 months of cART death and progression to AIDS were assessed. Of 3,526 children included, 32% were from the United Kingdom or Ireland, 30% from elsewhere in W&CE, 18% from Russia or Ukraine, and 20% from Thailand. At cART initiation, median age was 5.2 (IQR 1.4-9.3 years; 35% of children aged 400 c/mL predicted late death. Predictors of early and late progression to AIDS were similar. Study limitations include incomplete recording of US Centers for Disease Control (CDC disease stage B events and serious adverse events in some countries; events that were distributed over a long time period, and that we lacked power to analyse trends in patterns and causes of death over time.In our study, 3,526 children and adolescents with perinatal HIV infection initiated antiretroviral therapy (ART in countries in Europe and Thailand. We observed that over 40% of deaths occurred ≤6 months after cART initiation. Greater early mortality risk in infants, as compared to older children, and in Russia, Ukraine, or Thailand as compared to W&CE, raises concern. Current severe immune suppression, being underweight, and unsuppressed viral load were associated with a higher risk of death at >6 months after initiation of cART.

Failure to initiate early insulin therapy - A risk factor for diabetic retinopathy in insulin users with Type 2 diabetes mellitus: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS, Report number 35).

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Gupta, Aditi; Delhiwala, Kushal S; Raman, Rajiv P G; Sharma, Tarun; Srinivasan, Sangeetha; Kulothungan, Vaitheeswaran

2016-06-01

Insulin users have been reported to have a higher incidence of diabetic retinopathy (DR). The aim was to elucidate the factors associated with DR among insulin users, especially association between duration, prior to initiating insulin for Type 2 diabetes mellitus (DM) and developing DR. Retrospective cross-sectional observational study included 1414 subjects having Type 2 DM. Insulin users were defined as subjects using insulin for glycemic control, and insulin nonusers as those either not using any antidiabetic treatment or using diet control or oral medications. The duration before initiating insulin after diagnosis was calculated by subtracting the duration of insulin usage from the duration of DM. DR was clinically graded using Klein's classification. SPSS (version 9.0) was used for statistical analysis. Insulin users had more incidence of DR (52.9% vs. 16.3%, P 1) and sight threatening DR (19.1% vs. 2.4%, P 1) in comparison to insulin nonusers. Among insulin users, longer duration of DM (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.00-1.25, P = 0.044) and abdominal obesity (OR 1.15, 95% CI 1.02-1.29, P = 0.021) was associated with DR. The presence of DR was significantly associated with longer duration (≥5 years) prior to initiating insulin therapy, overall (38.0% vs. 62.0%, P = 0.013), and in subjects with suboptimal glycemic control (32.5% vs. 67.5%, P = 0.022). The presence of DR is significantly associated with longer duration of diabetes (>5 years) and sub-optimal glycemic control (glycosylated hemoglobin insulin users, abdominal obesity was found to be a significant predictor of DR; DR is associated with longer duration prior to initiating insulin therapy in Type 2 DM subjects with suboptimal glycemic control.

Pretend Play of Children with Cerebral Palsy

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Pfeifer, Luzia Iara; Pacciulio, Amanda Mota; dos Santos, Camila Abrao; dos Santos, Jair Licio; Stagnitti, Karen Ellen

2011-01-01

Background and Purpose: Evaluate self-initiated pretend play of children with cerebral palsy. Method: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. Results: There were significant negative correlations between the children's…

Adaptive characteristics of main muscular groups’ static endurance in 6 years children in initial school period

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S.V. Bondarenko

2017-08-01

Full Text Available Purpose: to study adaptation of 6 years children’s muscular skeletal apparatus to learning work by indicators of static endurance dynamic. Material: in the research 6 years children participated (n=64, boys - n=36, girls- n=28. Indicators of main muscular groups’ static endurance were studied. Results: we determined comparative topography of 13 muscular groups’ static endurance and substantial sex dimorphism was found. In 9 muscular groups the boys advantage was 11.7 - 50.2% (р < 0.05 ÷ 0.01. The level and correlation of muscles-antagonists’ static endurance from the point of evolutionary and ontogeny development of muscular-skeletal apparatus were substantiated. At the end of semester we found significant (р < 0.001 reduction of static endurance indicators as well as the fact that torso muscles were the most sensitive to influence of learning work’s static component. The level of static endurance weakening, under which syndrome of static over-tension appears, was determined. Conclusions: the research results permit to balance the volumes of learning load at initial stage of school work. Organizational-methodic principles of learning and physical education system for children shall be oriented on overcoming muscular-skeletal apparatus’s dysfunctions.

Student initiative: A conceptual analysis

OpenAIRE

Polovina Nada

2014-01-01

In the description and scientific consideration of the attitude of children and youth towards their education and development, the concept of student initiative has been gaining ground lately, and it is hence the subject of analysis in this paper. The analysis is important because of the discrepancy between the increased efforts of the key educational policy holders to promote the idea about the importance of the development of student initiative and rare a...

Improving Care for Children With Cancer in Low- and Middle-Income Countries--a SIOP PODC Initiative.

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Arora, Ramandeep Singh; Challinor, Julia M; Howard, Scott C; Israels, Trijn

2016-03-01

The Paediatric Oncology in Developing Countries (PODC) committee of International Society of Paediatric Oncology (SIOP) has 10 working groups that provide a forum for individuals to engage, network, and implement improvements in the care of children with cancer in low- and middle-income countries. The development of adapted guidelines (medulloblastoma, retinoblastoma, Wilms tumor, neuroblastoma, retinoblastoma, Burkitt lymphoma, supportive care), advocacy and awareness (on hospital detention and essential drugs), education and training, and global mapping (nutritional practice, abandonment rates, and twinning collaborations) have been the initial areas of focus, and the impact of some of these activities is evident, for example, in the SIOP Africa PODC Collaborative Wilms tumor project. © 2015 Wiley Periodicals, Inc.

Initial development and psychometric testing of an instrument to measure the quality of children's end-of-life care.

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Widger, Kimberley; Tourangeau, Ann E; Steele, Rose; Streiner, David L

2015-01-01

The field of pediatric palliative care is hindered by the lack of a well-defined, reliable, and valid method for measuring the quality of end-of-life care. The study purpose was to develop and test an instrument to measure mothers' perspectives on the quality of care received before, at the time of, and following a child's death. In Phase 1, key components of quality end-of-life care for children were synthesized through a comprehensive review of research literature. These key components were validated in Phase 2 and then extended through focus groups with bereaved parents. In Phase 3, items were developed to assess structures, processes, and outcomes of quality end-of-life care then tested for content and face validity with health professionals. Cognitive testing was conducted through interviews with bereaved parents. In Phase 4, bereaved mothers were recruited through 10 children's hospitals/hospices in Canada to complete the instrument, and psychometric testing was conducted. Following review of 67 manuscripts and 3 focus groups with 10 parents, 141 items were initially developed. The overall content validity index for these items was 0.84 as rated by 7 health professionals. Based on feedback from health professionals and cognitive testing with 6 parents, a 144-item instrument was finalized for further testing. In Phase 4, 128 mothers completed the instrument, 31 of whom completed it twice. Test-retest reliability, internal consistency, and construct validity were demonstrated for six subscales: Connect With Families, Involve Parents, Share Information With Parents, Share Information Among Health Professionals, Support Parents, and Provide Care at Death. Additional items with content validity were grouped in four domains: Support the Child, Support Siblings, Provide Bereavement Follow-up, and Structures of Care. Forty-eight items were deleted through psychometric testing, leaving a 95-item instrument. There is good initial evidence for the reliability and

Reflections on the Ready to Learn Initiative 2010 to 2015: How a Federal Program in Partnership with Public Media Supported Young Children's Equitable Learning during a Time of Great Change

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Pasnik, Shelley; Llorente, Carlin; Hupert, Naomi; Moorthy, Savitha

2016-01-01

"Reflections on the Ready to Learn Initiative, 2010 to 2015," draws upon interviews with 26 prominent children's media researchers, producers, and thought leaders and a review of scholarly articles and reports to provide a big picture view of the status and future directions of children's media. In this illuminating report, EDC and SRI…

Reducing occurrence of Giardia duodenalis in children living in semiarid regions: impact of a large scale rainwater harvesting initiative.

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Fonseca, Jacqueline Evangelista; Carneiro, Mariângela; Pena, João Luiz; Colosimo, Enrico A; da Silva, Nívea Bispo; da Costa, André Gabriel F C; Moreira, Luciano E; Cairncross, Sandy; Heller, Léo

2014-06-01

In Brazil, about two million people living in rural semiarid regions were benefited with the construction of rainwater cement cisterns, as an initiative from the program "One Million Cisterns" (P1MC). Nevertheless, few epidemiological studies have been conducted to assess health risks or protection effects associated with consumption of this water source. The aim of this study was to evaluate whether access to rainwater harvesting cisterns is associated with the decrease in the occurrence of Giardia duodenalis infections in children, compared to other children living in households supplied by other water sources. A quasi-experimental study with two concurrent cohorts was developed in two rural municipalities of the semiarid region of Brazil. A sample of 664 children, aged between 4 months and 5 years old, was followed up, of which 332 had access to rainwater cisterns (cistern group) and 332 did not, having water supplied from alternative sources (comparison group). In a period of approximately one year (2010) intestinal parasites were investigated in feces three times. The prevalence of G. duodenalis in children from the cistern group ranged from 4.8 to 10.5%, while the prevalence in the comparison group ranged from 7.6 to 16.7%. Multivariate analysis (GEE) showed a higher risk of G. duodenalis infection in children who did not have access to rainwater cisterns, when compared to children who did (OR 1.72; 95% CI 1.14-2.59). The other variables associated with G. duodenalis infection were: number of rooms per house (OR 0.89; 95% CI 0.80-0.99); family income (OR0.48; 95% CI 0.26-0.88); birth order (OR 1.72; 95% CI 1.17-2.51); preterm children (OR 1.70; 95% CI 1.19-2.43); and improper hand hygiene prior to food preparation (OR 4.78; 95% CI 1.95-11.76). Ownership of a rainwater cistern is associated with a lower prevalence of G. duodenalis infection in children after adjustment for environmental and family-related factors. Nevertheless, the study suggests the necessity

Reducing occurrence of Giardia duodenalis in children living in semiarid regions: impact of a large scale rainwater harvesting initiative.

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Jacqueline Evangelista Fonseca

2014-06-01

Full Text Available BACKGROUND: In Brazil, about two million people living in rural semiarid regions were benefited with the construction of rainwater cement cisterns, as an initiative from the program "One Million Cisterns" (P1MC. Nevertheless, few epidemiological studies have been conducted to assess health risks or protection effects associated with consumption of this water source. The aim of this study was to evaluate whether access to rainwater harvesting cisterns is associated with the decrease in the occurrence of Giardia duodenalis infections in children, compared to other children living in households supplied by other water sources. METHODOLOGY/PRINCIPAL FINDINGS: A quasi-experimental study with two concurrent cohorts was developed in two rural municipalities of the semiarid region of Brazil. A sample of 664 children, aged between 4 months and 5 years old, was followed up, of which 332 had access to rainwater cisterns (cistern group and 332 did not, having water supplied from alternative sources (comparison group. In a period of approximately one year (2010 intestinal parasites were investigated in feces three times. The prevalence of G. duodenalis in children from the cistern group ranged from 4.8 to 10.5%, while the prevalence in the comparison group ranged from 7.6 to 16.7%. Multivariate analysis (GEE showed a higher risk of G. duodenalis infection in children who did not have access to rainwater cisterns, when compared to children who did (OR 1.72; 95% CI 1.14-2.59. The other variables associated with G. duodenalis infection were: number of rooms per house (OR 0.89; 95% CI 0.80-0.99; family income (OR0.48; 95% CI 0.26-0.88; birth order (OR 1.72; 95% CI 1.17-2.51; preterm children (OR 1.70; 95% CI 1.19-2.43; and improper hand hygiene prior to food preparation (OR 4.78; 95% CI 1.95-11.76. CONCLUSIONS/SIGNIFICANCE: Ownership of a rainwater cistern is associated with a lower prevalence of G. duodenalis infection in children after adjustment for

Classification trees for identifying non-use of community-based long-term care services among older adults.

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Penkunas, Michael James; Eom, Kirsten Yuna; Chan, Angelique Wei-Ming

2017-10-01

Home- and center-based long-term care (LTC) services allow older adults to remain in the community while simultaneously helping caregivers cope with the stresses associated with providing care. Despite these benefits, the uptake of community-based LTC services among older adults remains low. We analyzed data from a longitudinal study in Singapore to identify the characteristics of individuals with referrals to home-based LTC services or day rehabilitation services at the time of hospital discharge. Classification and regression tree analysis was employed to identify combinations of clinical and sociodemographic characteristics of patients and their caregivers for individuals who did not take up their referred services. Patients' level of limitation in activities of daily living (ADL) and caregivers' ethnicity and educational level were the most distinguishing characteristics for identifying older adults who failed to take up their referred home-based services. For day rehabilitation services, patients' level of ADL limitation, home size, age, and possession of a national medical savings account, as well as caregivers' education level, and gender were significant factors influencing service uptake. Identifying subgroups of patients with high rates of non-use can help clinicians target individuals who are need of community-based LTC services but unlikely to engage in formal treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

A Critical Review of Constraint-Induced Movement Therapy and Forced Use in Children With Hemiplegia

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Jeanne Charles

2005-01-01

Full Text Available Hemiplegia is a physical impairment that can occur in childhood following head trauma, cerebral vascular accident or transient ischemic attack (stroke, brain tumor, or congenital or perinatal injury. One of the most disabling symptoms of hemiplegia is unilaterally impaired hand and arm function. Sensory and motor impairments in children with hemiplegia compromise movement efficiency. Such children often tend not to use the affected extremity, which may further exacerbate the impairments, resulting in a developmentally learned non-use of the involved upper extremity, termed ‘developmental disuse’. Recent studies suggest that children with hemiplegia benefit from intensive practice. Forced use and Constraint-lnduced Movement Therapy (CI therapy are recent therapeutic interventions involving the restraint of the non-involved upper extremity and intensive practice with the involved upper extremity. These approaches were designed for adults with hemiplegia, and increasing evidence suggests that they are efficacious in this population. Recently, forced use and constraint-induced therapy have been applied to children with hemiplegia. In this review, we provide a brief description of forced use and CI therapy and their historical basis, provide a summary of studies of these interventions in children, and discuss a number of important theoretical considerations, as well as implications for postural control. We will show that whereas the studies to date suggest that both forced use and CI therapy appear to be promising for improving hand function in children with hemiplegia, the data are limited. Substantially more work must be performed before this approach can be advocated for general clinical use.

The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families.

Science.gov (United States)

Wong, Sabrina T; Lynam, M Judith; Khan, Koushambhi B; Scott, Lorine; Loock, Christine

2012-10-04

The Responsive Interdisciplinary Child-Community Health Education and Research (RICHER) initiative is an intersectoral and interdisciplinary community outreach primary health care (PHC) model. It is being undertaken in partnership with community based organizations in order to address identified gaps in the continuum of health services delivery for 'at risk' children and their families. As part of a larger study, this paper reports on whether the RICHER initiative is associated with increased: 1) access to health care for children and families with multiple forms of disadvantage and 2) patient-reported empowerment. This study provides the first examination of a model of delivering PHC, using a Social Paediatrics approach. This was a mixed-methods study, using quantitative and qualitative approaches; it was undertaken in partnership with the community, both organizations and individual providers. Descriptive statistics, including logistic regression of patient survey data (n=86) and thematic analyses of patient interview data (n=7) were analyzed to examine the association between patient experiences with the RICHER initiative and parent-reported empowerment. Respondents found communication with the provider clear, that the provider explained any test results in a way they could understand, and that the provider was compassionate and respectful. Analysis of the survey and in-depth interview data provide evidence that interpersonal communication, particularly the provider's interpersonal style (e.g., being treated as an equal), was very important. Even after controlling for parents' education and ethnicity, the provider's interpersonal style remained positively associated with parent-reported empowerment (p<0.01). This model of PHC delivery is unique in its purposeful and required partnerships between health care providers and community members. This study provides beginning evidence that RICHER can better meet the health and health care needs of people, especially

The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families

Directory of Open Access Journals (Sweden)

Wong Sabrina T

2012-10-01

Full Text Available Abstract Background The Responsive Interdisciplinary Child-Community Health Education and Research (RICHER initiative is an intersectoral and interdisciplinary community outreach primary health care (PHC model. It is being undertaken in partnership with community based organizations in order to address identified gaps in the continuum of health services delivery for ‘at risk’ children and their families. As part of a larger study, this paper reports on whether the RICHER initiative is associated with increased: 1 access to health care for children and families with multiple forms of disadvantage and 2 patient-reported empowerment. This study provides the first examination of a model of delivering PHC, using a Social Paediatrics approach. Methods This was a mixed-methods study, using quantitative and qualitative approaches; it was undertaken in partnership with the community, both organizations and individual providers. Descriptive statistics, including logistic regression of patient survey data (n=86 and thematic analyses of patient interview data (n=7 were analyzed to examine the association between patient experiences with the RICHER initiative and parent-reported empowerment. Results Respondents found communication with the provider clear, that the provider explained any test results in a way they could understand, and that the provider was compassionate and respectful. Analysis of the survey and in-depth interview data provide evidence that interpersonal communication, particularly the provider’s interpersonal style (e.g., being treated as an equal, was very important. Even after controlling for parents’ education and ethnicity, the provider’s interpersonal style remained positively associated with parent-reported empowerment (p Conclusions This model of PHC delivery is unique in its purposeful and required partnerships between health care providers and community members. This study provides beginning evidence that RICHER can

Early smoking initiation and associated factors among in-school ...

African Journals Online (AJOL)

Objective: This report examines the prevalence and common correlates of early smoking initiation among male and female school children across seven African countries. Method: The total sample included 17,725 school children aged 13 to 15 years from nationally representative samples in seven African countries.

Absence of verbal recall or memory for symptom acquisition in fear and trauma exposure: a conceptual case for fear conditioning and learned nonuse in assessment and treatment.

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Seifert, A Ronald

2012-01-01

Absence of memory or verbal recall for symptom acquisition in fear and trauma exposure, as well as absence of successful coping behavior for life events, is associated with a number of diagnoses, including traumatic brain injury, posttraumatic stress disorder, pain, and anxiety. The difficulty with diagnosis and treatment planning based on the absence of recall, memory, and successful coping behavior is threefold: (1) these assessments do not distinguish between disruption of behavior and lack of capacity, (2) the absence of verbal recall and memory complicates cognitive-based treatment, and (3) a confounding issue is the same absent behavior can be observed at different times and contexts. While memory of the specific details of the initial traumatic event(s) may not be available to verbal report, the existence of time- and context-dependent relationships for the initial as well as subsequent experiences is arguable. The absence of memory or lack of verbal recall does not rule out measurable physiological bodily responses for the initial trauma(s), nor does it help to establish the effects of subsequent experiences for symptom expression. Also, the absence of memory must include the prospect of fear-based learning that does not require or involve the cortex. It is posited that the literatures of fear conditioning and learned nonuse provide complementary illustrations of how the time and context of the initial trauma(s) and subsequent experiences affect behavior, which is not dependent on the effected individual being able to provide a memory-based verbal report. The replicated clinical application demonstrates that, without scientific demonstration, neither neuroanatomy nor verbal report can be assumed sufficient to predict overt behavior or physiologic responses. For example, while commonly assumed to be predictively so, autonomic nervous system innervation is insufficient to define the unique stimulus- and context-dependent physiological responses of an

Mixed feelings of children and adolescents with unilateral congenital below elbow deficiency: an online focus group study.

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Ingrid G M de Jong

Full Text Available The existing literature is inconsistent about the psychosocial functioning of children and adolescents with Unilateral Congenital Below Elbow Deficiency (UCBED. The objective of this qualitative study was to explore the psychosocial functioning of children and adolescents with UCBED in terms of their feelings about the deficiency and what helps them to cope with those feelings. Additionally, the perspectives of prosthesis wearers and non-wearers were compared, as were the perspectives of children, adolescents, parents and health professionals. Online focus group interviews were carried out with 42 children and adolescents (aged 8-12, 13-16 and 17-20, 16 parents and 19 health professionals. Questions were asked about psychosocial functioning, activities, participation, prosthetic use or non-use, and rehabilitation care. This study concerned remarks about psychosocial functioning. Children and adolescents with UCBED had mixed feelings about their deficiency. Both negative and positive feelings were often felt simultaneously and mainly depended on the way people in the children's environment reacted to the deficiency. People staring affected the children negatively, while support from others helped them to cope with the deficiency. Wearing a prosthesis and peer-to-peer contact were also helpful. Non-wearers tended to be more resilient than prosthesis wearers. Wearers wore their prosthesis for cosmetic reasons and to prevent them from negative reactions from the environment. We recommend that rehabilitation teams make parents aware of their great influence on the psychosocial functioning of their child with UCBED, to adjust or extend the currently available psychosocial help, and to encourage peer-to-peer contact.

Mixed feelings of children and adolescents with unilateral congenital below elbow deficiency: an online focus group study.

Science.gov (United States)

de Jong, Ingrid G M; Reinders-Messelink, Heleen A; Janssen, Wim G M; Poelma, Margriet J; van Wijk, Iris; van der Sluis, Corry K

2012-01-01

The existing literature is inconsistent about the psychosocial functioning of children and adolescents with Unilateral Congenital Below Elbow Deficiency (UCBED). The objective of this qualitative study was to explore the psychosocial functioning of children and adolescents with UCBED in terms of their feelings about the deficiency and what helps them to cope with those feelings. Additionally, the perspectives of prosthesis wearers and non-wearers were compared, as were the perspectives of children, adolescents, parents and health professionals. Online focus group interviews were carried out with 42 children and adolescents (aged 8-12, 13-16 and 17-20), 16 parents and 19 health professionals. Questions were asked about psychosocial functioning, activities, participation, prosthetic use or non-use, and rehabilitation care. This study concerned remarks about psychosocial functioning. Children and adolescents with UCBED had mixed feelings about their deficiency. Both negative and positive feelings were often felt simultaneously and mainly depended on the way people in the children's environment reacted to the deficiency. People staring affected the children negatively, while support from others helped them to cope with the deficiency. Wearing a prosthesis and peer-to-peer contact were also helpful. Non-wearers tended to be more resilient than prosthesis wearers. Wearers wore their prosthesis for cosmetic reasons and to prevent them from negative reactions from the environment. We recommend that rehabilitation teams make parents aware of their great influence on the psychosocial functioning of their child with UCBED, to adjust or extend the currently available psychosocial help, and to encourage peer-to-peer contact.

HEARING FUNCTION IN PREMATURE CHILDREN WITH INTRAUTERINE GROWTH RESTRICTION

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I. V. Rakhmanova

2012-01-01

Full Text Available Initial audiological test was performed in 136 premature children with various gestational age born from single fetation. The children were divided into 2 groups: prematures with intrauterine growth restriction (IUGR and prematures with normal weight for their gestational age (normotrophy. The study showed that the rate of passing the initial audiological test using the method of DPOAE was lower in both ears in children with IUGR, than in children with normotrophy. The correlation between the results of initial audiological test and birth weight was found: the lower was weight, the higher was risk of absence of acoustic response registration on initial examination.

Conference report: formulating better medicines for children: 4th European Paediatric Formulation Initiative conference.

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Walsh, Jennifer; Mills, Simon

2013-01-01

The fourth annual European Paediatric Formulation Initiative (EuPFI) conference on Formulating Better Medicines for Children was held on 19-20 September 2012 at the Institute of Molecular Genetics Congress Centre, Prague, Czech Republic. The 2-day conference concentrated on the latest advances, challenges and opportunities for developing medicinal products and administration devices for pediatric use, both from European and US perspectives. It was aimed specifically at providing exposure to emerging practical applications, and for illustrating remedies utilized by pediatric drug-development teams to overcome hurdles faced in developing medicines for pediatric patients. The conference format included plenary talks, focus sessions on each of the EuPFI work streams (extemporaneous preparations, excipients, pediatric administration devices, taste masking and taste assessment, age-appropriate formulations), case studies, soapbox sessions and a parallel poster display. This conference report summarizes the keynote lectures and also gives a flavor of other presentations and posters from the conference.

Exploring engagement in a virtual community of practice in pediatric rehabilitation: who are non-users, lurkers, and posters?

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Hurtubise, Karen; Pratte, Gabrielle; Rivard, Lisa; Berbari, Jade; Héguy, Léa; Camden, Chantal

2017-12-20

Communities of practice are increasingly recognized in rehabilitation as useful knowledge transfer tools; however, little is known about their users. This exploratory study describes the characteristics of participants and non-participants invited to engage in a pediatric rehabilitation virtual community of practice. In addition, we explored virtual community of practice utilization behaviors, engagement predictors, and the impact of strategies designed to foster engagement. Participants' demographics including information-seeking style and organization e-readiness, as well as online platform frequency of use data were collected and analyzed using descriptive, comparative, and predictive statistics. Seventy-four percent of those invited used the virtual community of practice. Users had less years of experience in pediatric rehabilitation than non-users. Among the users, 71% were classified as "lurkers," who engaged through reading content only; while 29% were classified as "posters," editing online content. Predictive factors were not uncovered, however an increased number of forum visits correlated with being a poster, a non-information seeker, an employee of an organization demonstrating e-readiness, and regularly working with children with the virtual community of practice specific condition. User-engagement strategies increased visits to the forum. These findings will assist rehabilitation leaders in leveraging rehabilitation-specific virtual community of practice to improve knowledge transfer and practice in pediatric rehabilitation and disability management. Implications for Rehabilitation Communities of practice are increasingly recognized as useful knowledge transfer tools for rehabilitation professionals and are made more accessible thanks to virtual technologies. Our virtual community of practice was found to be optimized in health care organizations with an electronic culture, when the topic area had daily relevance to its target audience, and was

The Saudi Initiative for asthma

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Al-Moamary Mohamed

2009-01-01

Full Text Available The Saudi Initiative for Asthma (SINA provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system.

The Cultural Adaptation of a Community-Based Child Maltreatment Prevention Initiative.

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McLeigh, Jill D; Katz, Carmit; Davidson-Arad, Bilha; Ben-Arieh, Asher

2017-06-01

A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6-year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community-level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community-based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance. © 2015 Family Process Institute.

Computed tomography of arteriovenous malformation in children

International Nuclear Information System (INIS)

Takahashi, Shinichiro; Sonobe, Makoto; Kuwayama, Naoya; Suzuki, Michiyasu

1985-01-01

Cases of AVM in children under the age of 15 were analyzed and compared with adult cases. Thirty-nine cases of AVM have been experienced since CT was introduced, consisting of eight cases in children. The initial symptom in children was hemorrhage in seven cases and convulsive seizure in one case. In adults, hemorrhage was found in 26 cases and convulsive seizure in five cases. Initial CT was performed within 24 hours after onset in seven cases in children and in 12 cases in adults. In children, findings of those initial CT were intracerebral hematoma (ICH) in one case, ICH+intraventricular hemorrhage (IVH) in three cases and IVH in two cases. In adults, ICH was found in five cases, ICH+IVH in five cases and ICH+IVH+SAH in two cases. As in the adult cases, it may be proper to consider that the primary lesion in the acute stage of ruptured AVM in children is not SAH but ICH or IVH. (author)

Access to Anti-smoking Information among School Children and its Potential Impact on Preventing Smoking Initiation: Results from the Global Youth Tobacco Use Survey (GYTS) 2014 in Viet Nam.

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Minh, Hoang Van; Minh, Hoang Van; Giang, Kim Bao; Hai, Phan Thi; Hoang, Trinh Dinh; Huyen, Doan Thu; Khue, Luong Ngoc; Linh, Nguyen Thuy; Lam, Nguyen Tuan; Nga, Pham Thi Quynh

2016-01-01

Scientific evidence on all aspects of smoking amongst youth is very important for designing appropriate interventions to reduce smoking among this vulnerable population. This paper describes current access to antismoking information among school children aged 13 to 15 years in Vietnam in 2014 and examines its potential impact on preventing smoking initiation. The data used in this paper were obtained from the 2014 Global Youth Tobacco Survey (GYTS) in Vietnam. Students were asked questions about their level of awareness of anti-smoking information from various sources in the past 30 days and about lessons in school regarding the dangers of tobacco use during the last 12 months. Those who have never smoked were asked "whether or not they thought about avoiding cigarettes because of health warnings on cigarette packages" and answers were analyzed in combination with data on access to anti-smoking information from other sources. The prevalence of exposure to antismoking campaigns was high among school children in Viet Nam: 55.3% of current smokers reported thoughts of smoking cessation because of health warnings on cigarette packages; 60.5% of never smokers avoided initiating smoking because of the same health warnings. The potential impact of graphic health warnings to prevent school-aged children from smoking initiation would be stronger if there was concurrent access to anti-smoking programs on the dangers of tobacco use in schools. However, school education for tobacco prevention and control has not been as strong as expected. A more comprehensive school curriculum on tobacco prevention and control is recommended to reinforce antismoking messages among school children.

Adults' Orientation of Children--And Children's Initiative to Pitch In--To Everyday Adult Activities in a Tsotsil Maya Community.

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Martínez-Pérez, Margarita

2015-01-01

This chapter examines how 2-year-old children attempt to actively participate in adult work in a Mayan community in Chiapas, Mexico, and how adults contribute and accommodate to the contributions. As children enter into activities and adults orient and reorient the activity to direct the children, teaching from expert to novice is generated by children's agency in co-participatory interactions. The chapter enriches the LOPI model by focusing on the structure of participation and communication, social and community organization, and the evaluation that occurs in the activity itself. © 2015 Elsevier Inc. All rights reserved.

Condoms: mis-use = non-use. The condom equation in Gujarat, India.

Science.gov (United States)

Sharma, V; Dave, S; Sharma, A; Chauhan, P

1997-12-01

Condoms are a common denominator for three prestigious national prevention programmes in India, none of which has been a real success. The present study was undertaken to investigate prevalence of condom use and to assess knowledge about correct use of condoms among married, sexually active men, who had not adopted any permanent method of contraception. The study was conducted by a house-to-house survey in eight randomly selected villages of Anand, Gujarat (a 10% sample). All married men (ages: 18-55 years) were interviewed with the help of a pre-tested, structured questionnaire, comprising questions on: (a) their sexual practices; (b) knowledge about the correct use of condoms; and (c) reasons for their use/non-use. Respondents were evaluated for knowledge about correct use of condoms by scoring on a scale of 10. The sample consisted of 1,478 men whose mean age was 29.8 (± 6.75) years and mean duration of married life was 8.4 (± 6.25) years. Almost 52% (n = 771) were either illiterate or had been educated up to primary level; while 131 (8.8%) had university qualifications. More than 74% (n = 1,092) had never used condoms; 24.4% had used them irregularly and only 1.8% (n = 26) were using them regularly. The mean knowledge score for the correct use of condoms was 1.44 ± 2.29 on a scale of 10 and it was positively related to regularity of use and educational status of respondents (p condoms offer protection against STDs and/or AIDS. The most common mistakes related to incorrect use of condoms were use of oil-based lubricants with condoms, ignorance about the technique of putting on a condom, re-use of condoms, etc. The commonly cited reasons for non-use of condoms were interference with sexual activity; lack of privacy; fear of losing it inside the woman's body, and lack of confidence in its effectiveness as a contraceptive. To be effective as a contraceptive and to offer protection against sexually transmitted diseases and AIDS, condoms need to be used regularly

Maternal cell phone and cordless phone use during pregnancy and behaviour problems in 5-year-old children.

Science.gov (United States)

Guxens, Mònica; van Eijsden, Manon; Vermeulen, Roel; Loomans, Eva; Vrijkotte, Tanja G M; Komhout, Hans; van Strien, Rob T; Huss, Anke

2013-05-01

A previous study found an association between maternal cell phone use during pregnancy and maternal-reported child behaviour problems at age 7. Together with cell phones, cordless phones represent the main exposure source of radiofrequency-electromagnetic fields to the head. Therefore, we assessed the association between maternal cell phone and cordless phone use during pregnancy and teacher-reported and maternal-reported child behaviour problems at age 5. The study was embedded in the Amsterdam Born Children and their Development study, a population-based birth cohort study in Amsterdam, the Netherlands (2003-2004). Teachers and mothers reported child behaviour problems using the Strength and Difficulties Questionnaire at age 5. Maternal cell phone and cordless phone use during pregnancy was asked when children were 7 years old. A total of 2618 children were included. As compared to non-users, those exposed to prenatal cell phone use showed an increased but non-significant association of having teacher-reported overall behaviour problems, although without dose-response relationship with the number of calls (OR=2.12 (95% CI 0.95 to 4.74) for cell phone and cordless phone use with maternal-reported overall behaviour problems remained non-significant. Non-significant associations were found for the specific behaviour problem subscales. Our results do not suggest that maternal cell phone or cordless phone use during pregnancy increases the odds of behaviour problems in their children.

Children's Social Identities

Science.gov (United States)

Bennett, Mark

2011-01-01

This paper provides a brief overview of recent developmental research on themes related to children's social identities. Initially, consideration is given to the capacity for social categorization, following which attention is given to children's developing conceptions of social identities, their identification with social groups, and the…

WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010.

LENUS (Irish Health Repository)

Wijnhoven, Trudy Ma

2014-01-01

The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009\\/2010) and to explore changes in body mass index (BMI) and overweight among children within and across nine countries from school years 2007\\/2008 to 2009\\/2010.

Comparing cardiovascular factors in opium abusers and non-users candidate for coronary artery bypass graft surgery.

Science.gov (United States)

Aghadavoudi, Omid; Eizadi-Mood, Nastaran; Najarzadegan, Mohammad Reza

2015-01-01

In some opinions, opium consumption has traditionally been considered to be a means to lower blood lipids and to put off heart diseases. In this study, the relationship between opium consumption and risk factors of coronary artery diseases, hemodynamic factors and cardiac related functions before and after surgery was evaluated. In a cross-sectional study 325 patient's candidate for elective coronary artery bypass grafting were enrolled in a period of 6 months. Opium addicted patients were recognized based on taking history from the patients by an anaesthesiologist. Serum lipid profile was determined at the beginning of the study. Frequency and distribution of coronary artery diseases were assessed according to the pre-operative coronary angiography. From 325 patients, 117 patients were opium abusers and 208 patients were not. Mean duration of opium abuse was 12.6 ± 7.7 years. Mean total serum cholesterol levels were not significantly different in abusers and non-users patients (185 ± 47 vs. 190 ± 49, P > 0.05). Mean level of low-density lipoprotein cholesterol was significantly higher in addicted group (121 ± 27 vs. 81 ± 22, P opium addicted cases. Mean body mass index was also lower in addicted patients significantly (25.3 ± 3.7 vs. 27.5 ± 4.1, P opium abuse and aggravating lipid profile and hypercholesterolemia and coronary artery disease.

Micronutrient Intake and the Contribution of Dietary Supplements in Hispanic Infants.

Science.gov (United States)

Amaro-Rivera, Kiara; López-Cepero, Andrea; Diaz, Beatriz; Lee, Jae Eun; Palacios, Cristina

2018-03-04

To calculate micronutrient adequacy among infants and toddlers and to determine the contribution of dietary supplements to this adequacy, micronutrient intake was assessed using two nonconsecutive 24-hour recalls in a sample of 296 infants aged 0-24 months. Micronutrient intake was calculated from foods and beverages and from supplements and compared between nonusers and users of supplements. Percentages of children below the Dietary Reference Intake (DRI) and above the tolerable upper limit intake (UL) were also compared between groups. A total of 241 participants had complete data. The prevalence of dietary supplement use among the sample was 15%. Mean intake of all micronutrients from foods and beverages was similar between nonusers and users of supplements (p > .05) but significantly higher for the following vitamins when supplements were included: D, E, B1, B2, B3, and B6 (p supplements were included, this percentage significantly decreased among users compared to nonusers (p supplements were added. Supplements significantly increased the intake of some vitamins. Vitamins D and E had the highest percentage of children below the DRI, which was partly corrected with the use of supplements. The UL was exceeded for magnesium, zinc, and vitamin B3 in many children. It is important to understand these patterns as they may be indicative of future nutritional deficiencies and excesses.

Risk factors of vitamin D deficiency in children with epilepsy taking anticonvulsants at initial and during follow-up

Directory of Open Access Journals (Sweden)

Seung Ho Lee

2015-12-01

Full Text Available PurposeVitamin D status was evaluated in children with epilepsy taking anticonvulsants to determine the prevalence and risk factors of vitamin D deficiency.MethodsThis study was designed as both a cross-sectional and a retrospective cohort study. A sum of 198 children who were diagnosed with epilepsy at the Department of Pediatrics in Dankook University Hospital was included. Their serum vitamin D levels were reviewed based on clinical information, and analyzed using IBM SPSS ver. 20.0.ResultsOne hundred twenty-four children (62.6% had vitamin D deficiency. Two risk factors were associated: winter to spring season (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.835-7.492 and age more than 12 years (OR, 3.22; 95% CI, 1.377-7.542. Out of the 57 patients who were not vitamin D deficient at the time of initial assay, 47 patients (82.5% became vitamin D deficient during followup. The change of serum 25-hydroxy vitamin D3 (25(OHD levels during follow up showed a weak negative correlation with the duration of medication (r=-0.283, P=0.033. Medication duration was longer and brain magnetic resonance imaging (MRI abnormality, abnormal underlying conditions, and nonambulatory status were more frequently present in twenty-five patients (44% who showed a decline of more than 15 ng/mL during follow-up (P<0.05.ConclusionVitamin D deficiency is common in children with epilepsy taking anticonvulsants, especially in adolescents more than 12 years of age. This study emphasizes the regular monitoring of vitamin D level, especially in the presence of longer duration of medication, brain MRI abnormality, abnormal underlying conditions, and nonambulatory status.

76 FR 7222 - Medical Device Innovation Initiative; Public Meeting; Request for Comments

Science.gov (United States)

2011-02-09

... public meeting will be provided on a space-available basis beginning at 7 a.m. Non-U.S. citizens are... The United States is the global leader in medical device innovation and CDRH is committed to assuring... public health. CDRH is responsible for advancing public health and facilitating innovation to help bring...

Children's Budget 2015

Science.gov (United States)

Kyle, Sarah, Ed.

2015-01-01

The federal government makes more than 200 distinct investments in children. These include traditional children's initiatives like education and child abuse and neglect prevention. They also include other investments that improve the lives of kids, like Medicaid and the Supplemental Nutrition Assistance Program (formerly Food Stamps). Following a…

Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

Science.gov (United States)

Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

2015-01-01

Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi

Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria – Niger Delta and Sahel Savannah

Directory of Open Access Journals (Sweden)

Otsemobor Peju

2009-02-01

Full Text Available Abstract Background Current use of treated mosquito nets for the prevention of malaria falls short of what is expected in sub-Saharan Africa (SSA, though research within the continent has indicated that the use of these commodities can reduce malaria morbidity by 50% and malaria mortality by 20%. Governments in sub-Sahara Africa are investing substantially in scaling-up treated mosquito net coverage for impact. However, certain significant factors still prevent the use of the treated mosquito nets, even among those who possess them. This survey examines household ownership as well as use and non-use of treated mosquito nets in Sahel Savannah and Niger Delta regions of Nigeria. Methodology This survey employed cross-sectional survey to collect data from households on coverage and use of mosquito nets, whether treated or not. Fever episodes in previous two weeks among children under the age of five were also recorded. The study took place in August 1 – 14 2007, just five months after the March distribution of treated mosquito nets, coinciding with the second raining period of the year and a time of high malaria transmission during the wet season. EPI INFO version 2003 was used in data analysis. Results The survey covered 439 households with 2,521 persons including 739 under-fives, 585 women in reproductive age and 78 pregnant women in Niger Delta Region and Sahel Savannah Region. Of the 439 HHs, 232 had any mosquito nets. Significantly higher proportion of households in the Niger Delta Region had any treated or untreated mosquito nets than those in the Sahel Savannah Region. In the Niger Delta Region, the proportion of under-fives that had slept under treated nets the night before the survey exceeded those that slept under treated nets in the Sahel Savannah Region. Children under the age of five years in the Niger Delta Region were four times more likely to sleep under treated nets than those in the Sahel Savannah Region. Conclusion This study

Warfarin Initiation, Atrial Fibrillation, and Kidney Function: Comparative Effectiveness and Safety of Warfarin in Older Adults With Newly Diagnosed Atrial Fibrillation.

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Jun, Min; James, Matthew T; Ma, Zhihai; Zhang, Jianguo; Tonelli, Marcello; McAlister, Finlay A; Manns, Braden J; Ravani, Pietro; Quinn, Robert R; Wiebe, Natasha; Perkovic, Vlado; Wilton, Stephen B; Winkelmayer, Wolfgang C; Hemmelgarn, Brenda R

2017-06-01

The effectiveness and safety of warfarin use among patients with atrial fibrillation (AF) and reduced kidney function are uncertain. Community-based retrospective cohort study (May 1, 2003, to March 31, 2012) using province-wide laboratory and administrative data in Alberta, Canada. 14,892 adults 66 years or older with new AF and a measurement of kidney function. Long-term dialysis patients or kidney transplant recipients were excluded. Propensity scores were used to construct a matched-pairs cohort of patients with AF who did and did not have a warfarin prescription within a 60-day period surrounding their AF diagnosis. Within 1 year of initiating warfarin therapy (or the matched date for nonusers): (1) the composite of all-cause death, ischemic stroke, or transient ischemic attack (also assessed as separate end points) and (2) first hospitalization or emergency department visit for a major bleeding episode defined as an intracranial, upper or lower gastrointestinal, or other bleeding. Baseline glomerular filtration rate (GFR) was estimated using the CKD-EPI creatinine equation. Patients were matched within estimated GFR (eGFR) categories: ≥90, 60 to 89, 45 to 59, 30 to 44, and warfarin therapy initiation was associated with lower risk for the composite outcome compared to nonuse (adjusted HRs [95% CI] for eGFR categories ≥ 90, 60-89, 45-59, 30-44, and warfarin therapy was not associated with higher risk for major bleeding except for those with eGFRs of 60 to 89mL/min/1.73m 2 (HR, 1.36; 95% CI, 1.13-1.64). Selection bias. Among older adults with AF, warfarin therapy initiation was associated with a significantly lower 1-year risk for the composite outcome across all strata of kidney function. The risk for major bleeding associated with warfarin use was increased only among those with eGFRs of 60 to 89mL/min/1.73m 2 . Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Low pain intensity after opioid withdrawal as a first step of a comprehensive pain rehabilitation program predicts long-term nonuse of opioids in chronic noncancer pain.

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Krumova, Elena K; Bennemann, Philipp; Kindler, Doris; Schwarzer, Andreas; Zenz, Michael; Maier, Christoph

2013-09-01

In specialized pain clinics there is an increasing number of patients with severe chronic noncancer pain (CNCP) despite long-term opioid medication. Few clinical studies show short-term pain relief after opioid withdrawal (OW). We have evaluated the relation between pain intensity after OW and long-term opioid nonuse. One hundred two consecutive patients with severe CNCP despite opioid medication (mean treatment duration, 43 mo) reported pain intensity (numerical rating scale, 0 to 10), Pain Disability Index, mood (CES-D), and quality of life (Short Form 36) before, shortly, and 12 to 24 months after inpatient OW. Total opioid withdrawal (n = 78) or significant dose reduction (DR; n = 24, mean reduction, 82%) was performed after individual decision. Opioid intake 12 to 24 months later, respectively dose increase ≥ 100% (DR group), was considered relapse. T tests, multivariable analysis of variance, logistic regression. After OW current pain intensity significantly decreased on an average by 41% (6.4 ± 2.4 vs. 3.8 ± 2.5), maximal and average pain by 18% and 24%, respectively. Twelve to 24 months later 42 patients (41%) relapsed (31 of the total opioid withdrawal group, 6 of the DR group, 5 lost). Patients without later relapse showed significantly lower pain scores than the later relapsed patients already shortly after OW (5.0 ± 2.2 vs. 5.9 ± 2.1) and 12 to 24 months later (5.5 ± 2.4 vs. 6.5 ± 2.0). There was a significant relation between relapse probability and pain intensity immediately after OW. In many patients with severe CNCP, despite opioid medication, sustainable pain relief can be achieved if OW is included in the rehabilitation program. Consequently, we recommend OW for opioid-resistant CNCP before any opioid escalation. Lower pain intensity shortly after OW may predict the long-term opioid nonuse probability.

Statins use and risk of new-onset diabetes in hypertensive patients: a population-based retrospective cohort study in Yinzhou district, Ningbo city, People’s Republic of China

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Li H

2018-05-01

Full Text Available Hailong Li,1 Hongbo Lin,2 Houyu Zhao,1 Yang Xu,1 Yinchu Cheng,1 Peng Shen,2 Siyan Zhan1 1Department of Epidemiology and Bio-statistics, School of Public Health, Peking University Health Science Centre, Beijing, People’s Republic of China; 2Department of Chronic Diseases and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, People’s Republic of China Background: Reports have suggested that statin use is associated with an increased incidence of type 2 diabetes mellitus (T2DM. Guidelines suggested that statins should be prescribed in hypertensive patients for primary prevention. However, there were very few studies on the risk of T2DM associated with statin use among patients with hypertension in mainland People’s Republic of China. Purpose: To determine the association between statin use and new-onset diabetes mellitus among patients with hypertension in mainland People’s Republic of China. Patients and methods: We performed a retrospective cohort study of hypertensive patients using the Yinzhou regional health care database from January 1, 2010, to August 31, 2016. Patients aged 30–90 years old without T2DM were eligible for inclusion. We identified new statin initiators and nonusers by using prescription records of inpatients and outpatients. Multivariate Cox model and propensity score methods were used to adjust potential confounders, including age, sex, body mass index, comorbidities, lifestyle characteristics, and baseline antihypertensive drug use. The risk of incident T2DM among statin initiators compared to nonusers was estimated by the Cox proportional hazards model. Propensity scores for statin use were then developed using logistic regression, statin initiators were matched 1:1 with nonusers according to propensity scores with the nearest neighbor matching method within 0.2 caliper width, and Cox regression was again conducted. Results: Among 67,993 patients (21,551 statin initiators; 46

Neurodevelopmental and body composition outcomes in children with congenital hypothyroidism treated with high-dose initial replacement and close monitoring.

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Albert, Benjamin B; Heather, Natasha; Derraik, José G B; Cutfield, Wayne S; Wouldes, Trecia; Tregurtha, Sheryl; Mathai, Sarah; Webster, Dianne; Jefferies, Craig; Gunn, Alistair J; Hofman, Paul L

2013-09-01

Despite newborn screening and early levothyroxine replacement, there are continued reports of mild neurocognitive impairment in children with congenital hypothyroidism (CHT). In Auckland, New Zealand, cases are identified by a neonatal screening program with rapid institution of high-dose levothyroxine replacement (10-15 μg/kg·d), producing prompt normalization of thyroid function. Subsequently, frequent monitoring and dose alterations are performed for 2 years. We aimed to assess whether the Auckland treatment strategy prevents impairment of intellectual and motor development. This study encompassed all children with CHT born in 1993-2006 in Auckland and their siblings. Neurocognitive assessments included the following: 1) intelligence quotient via Weschler Preschool and Primary Scale of Intelligence III or Weschler Intelligence Scale for Children IV; 2) Movement Assessment Battery for Children; and 3) Beery Developmental Test of Visual-Motor Integration. Body composition was assessed by dual-energy x-ray absorptiometry. Forty-four CHT cases and 53 sibling controls aged 9.6 ± 3.9 years were studied. Overall intelligence quotient was similar among CHT cases and controls (95.2 vs 98.6; P = .20), and there were also no differences in motor function. Severity of CHT did not influence outcome, but greater time to normalize free T4 was associated with worse motor balance. There were no differences in anthropometry or body composition between groups. These findings suggest that a strategy of rapidly identifying and treating infants with CHT using high-dose levothyroxine replacement is associated with normal intellectual and motor development. The subtle negative impact on motor function associated with time to normalize free T4 levels is consistent with benefit from rapid initial correction.

Improving Early Childhood Development among Vulnerable Populations: A Pilot Initiative at a Women, Infants, and Children Clinic

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Brian A. Ferguson

2018-01-01

Full Text Available Objective. Early childhood development (ECD programs have demonstrated drastic improvements in survival, growth, health, and social productivity. An ECD pilot intervention was delivered to vulnerable populations of a Women, Infants, and Children (WIC clinic in Des Moines, Iowa, to assess ECD outcomes and parental receivability in this setting. Study Design. In a randomized, single blinded control initiative, WIC group sessions of mothers (children aged 2 years and younger were selected for pilot ECD intervention (37 participants or control (36. Care for Child Development ECD course material was supplemented to intervention groups. Survey results were assessed with paired samples T-testing and by an ANOVA. Results. Pilot session receivability demonstrated significance in all areas relative to control: enjoyment, p=0.008; learning capacity, p=0.011; and participant sharing, p=0.023. Furthermore, the previously validated ECD intervention demonstrated significantly improved cumulative 1 month behavior outcomes following the intervention: p=0.006. Conclusions. The WIC setting provides an ideal environment for delivering ECD education beyond traditional counseling in nutrition. High receivability indices among parents demonstrate remarkable capacity for improvement and growth. The significance in receivability, as well as 1 month behavior outcomes, represents parents’ overall readiness to enhance the home environment for their child if merely educated how.

Minimal access surgery in children: An initial experience of 28 months

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Gupta Abhaya

2009-01-01

Full Text Available Background : This study reports our 28 months experience with minimal access surgery (MAS in children. Materials and Methods : This was a review of all children who underwent MAS between December 2004 and March 2007 at the Departments of Paediatric Surgery, Seth Gordhandas Sunderdas Medical College (GSMC and King Edward the VII Memorial (KEM Hospital, India. Results and observations were tabulated and analysed, comparing with observations by various other authors regarding variety of indications such as, operative time, hospital stay, conversion rate, complications, safety, and feasibilty of MAS in neonates, in the appropriate operative groups. Results : A total of 199 procedures were performed in 193 children aged between 10 days and 12 years (average age: 5.7 years. One case of each, adrenal mass, retroperitoneoscopic nephrectomy, laparoscopic congenital diaphragmatic hernia (CDH repair, and abdominoperineal pull-through for anorectal malformation, were converted to open surgeries due to technical difficulty. The overall conversion rate was 3%. Morbidity and mortality were very minimal and the procedures were well tolerated in majority of cases. Conclusion : We concluded that MAS procedures appear to be safe for a wide range of indications in neonates and children. Further development and expansion of its indications in neonatal and paediatric surgery requires further multi-institutional studies and larger cohort of patients, to compare with standards of open surgery.

The Saudi Initiative for Asthma - 2016 update: Guidelines for the diagnosis and management of asthma in adults and children

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Al-Moamary, Mohamed S.; Alhaider, Sami A.; Idrees, Majdy M.; Al Ghobain, Mohammed O.; Zeitouni, Mohammed O.; Al-Harbi, Adel S.; Yousef, Abdullah A.; Al-Matar, Hussain; Alorainy, Hassan S.; Al-Hajjaj, Mohamed S.

2016-01-01

This is an updated guideline for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have guidelines that are up to date, simple to understand and easy to use by nonasthma specialists, including primary care and general practice physicians. SINA approach is mainly based on symptom control and assessment of risk as it is the ultimate goal of treatment. The new SINA guidelines include updates of acute and chronic asthma management, with more emphasis on the use of asthma control in the management of asthma in adults and children, inclusion of a new medication appendix, and keeping consistency on the management at different age groups. The section on asthma in children is rewritten and expanded where the approach is stratified based on the age. The guidelines are constructed based on the available evidence, local literature, and the current situation in Saudi Arabia. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan. PMID:26933455

Setting up pre-admission visits for children undergoing day surgery: a practice development initiative.

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O'Shea, Maria; Cummins, Ann; Kelleher, Ann

2010-06-01

The hospital experience can bring about a range of negative emotions for children. The literature clearly states that children who are prepared for surgery recover faster and have fewer negative effects. Pre-admission programmes seek to prepare children (and their parents) for surgery. This paper describes in detail how a pre-admission programme was established for children and their families who were scheduled for day case surgery.

School-Based Health Promotion Initiative Increases Children's Physical Activity

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Cluss, Patricia; Lorigan, Devin; Kinsky, Suzanne; Nikolajski, Cara; McDermott, Anne; Bhat, Kiran B.

2016-01-01

Background: Childhood obesity increases health risk, and modest physical activity can impact that risk. Schools have an opportunity to help children become more active. Purpose: This study implemented a program offering extra school-day activity opportunities in a rural school district where 37% of students were obese or overweight in 2005 and…

Early efficacy of the ketogenic diet is not affected by initial body mass index percentile.

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Shull, Shastin; Diaz-Medina, Gloria; Wong-Kisiel, Lily; Nickels, Katherine; Eckert, Susan; Wirrell, Elaine

2014-05-01

Predictors of the ketogenic diet's success in treating pediatric intractable epilepsy are not well understood. The aim of this study was to determine whether initial body mass index and weight percentile impact early efficacy of the traditional ketogenic diet in children initiating therapy for intractable epilepsy. This retrospective study included all children initiating the ketogenic diet at Mayo Clinic, Rochester from January 2001 to December 2010 who had body mass index (children ≥2 years of age) or weight percentile (those diet initiation and seizure frequency recorded at diet initiation and one month. Responders were defined as achieving a >50% seizure reduction from baseline. Our cohort consisted of 48 patients (20 male) with a median age of 3.1 years. There was no significant correlation between initial body mass index or weight percentile and seizure frequency reduction at one month (P = 0.72, r = 0.26 and P = 0.91, r = 0.03). There was no significant association between body mass index or weight percentile quartile and responder rates (P = 0.21 and P = 0.57). Children considered overweight or obese at diet initiation (body mass index or weight percentile ≥85) did not have lower responder rates than those with body mass index or weight percentiles ketogenic diet. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of Age at Antiretroviral Therapy Initiation on Catch-up Growth Within the First 24 Months Among HIV-infected Children in the IeDEA West African Pediatric Cohort

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Jesson, Julie; Koumakpaï, Sikiratou; Diagne, Ndeye R

2015-01-01

BACKGROUND: We described malnutrition and the effect of age at antiretroviral therapy (ART) initiation on catch-up growth over 24 months among HIV-infected children enrolled in the International epidemiologic Databases to Evaluate Aids West African paediatric cohort. METHODS: Malnutrition...

An initial look at sibling reports on children's behavior: comparisons with children's self-reports and relations with siblings' self-reports and sibling relationships.

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Epkins, C C; Dedmon, A M

1999-10-01

The authors examined siblings' reports of children's depression, anxiety, and aggression, and their reports of the sibling relationship, and compared them with children's self-reports. In two samples, including 169 sibling pairs (age M = 9.98 years, SD = 1.51), no significant differences emerged in the levels of depression and anxiety found in siblings' reports of children's behavior and children's self-reports, although siblings reported children to have significantly higher levels of aggression than the children self-reported. Age, the difference in ages between siblings, sex, and sibling sex were not related to siblings' reports of children's behavior. The relations between children's and siblings' reports of children's behavior were significant, yet moderate (average r = .22). Both siblings' self-reports of internalizing behavior and their perceptions of aspects of the sibling relationship (affection, rivalry, hostility, and satisfaction with the sibling relationship) explained significant, and unique, variance in siblings' reports of children's internalizing behavior. The findings for aggressive behavior were similar, although siblings' perceptions of affection in the sibling relationship were not significantly related to their reports of children's aggression. The potential uses and benefits of sibling reports of children's behavior, and sibling and family relationships, are discussed.

Quality Improvement Initiative to Increase the Use of Nasogastric Hydration in Infants With Bronchiolitis.

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Srinivasan, Mythili; Pruitt, Cassandra; Casey, Erin; Dhaliwal, Keerat; DeSanto, Cori; Markus, Richard; Rosen, Ayelet

2017-08-01

Intravenous (IV) hydration is used primarily in children with bronchiolitis at our institution. Because nasogastric (NG) hydration can provide better nutrition, the goal of our quality improvement (QI) initiative was to increase the rate of NG hydration in eligible children 1 to 23 months old with bronchiolitis by 20% over 6 months. We used Plan-Do-Study-Act cycles to increase the use of NG hydration in eligible children. Interventions included educational and system-based changes and sharing parental feedback with providers. Chart reviews were performed to identify the rates of NG hydration, which were plotted over time in a statistical process control p chart. The balancing measure was the rate of complications in children with NG versus IV hydration. Two hundred and ninety-three children who were hospitalized with bronchiolitis needed supplemental hydration during the QI initiative (January 2016-April 2016). Ninety-one children were candidates for NG hydration, and 53 (58%) received NG hydration. The rates of NG hydration increased from a baseline of 0% pre-QI bronchiolitis season (January 2015-April 2015) to 58% during the initiative. There was no aspiration and no accidental placement of the NG tube into a child's airway. Nine patients (17%) in the NG group had a progression of disease requiring nil per os status, and 6 of these were transferred to the PICU whereas none of those in the IV group were transferred to the PICU. Post-QI initiative, the majority of nurses (63%) and physicians (95%) stated that they are more likely to consider NG hydration in children with bronchiolitis. We successfully increased the rates of NG hydration in eligible children with bronchiolitis by using educational and system-based interventions. Copyright © 2017 by the American Academy of Pediatrics.

Quantitative pulmonary perfusion imaging at 3.0 T of 2-year-old children after congenital diaphragmatic hernia repair: initial results

International Nuclear Information System (INIS)

Zoellner, F.G.; Schad, L.R.; Zahn, K.; Schaible, T.; Schoenberg, S.O.; Neff, K.W.

2012-01-01

To investigate whether dynamic contrast-enhanced MR imaging of the lung following congenital diaphragmatic hernia repair is feasible at 3.0 T in 2-year-old children and whether associated lung hypoplasia (reflected in reduced pulmonary microcirculation) can be demonstrated in MRI. Twelve children with a mean age 2.0 ± 0.2 years after hernia repair underwent DCE-MRI at 3.0 T using a time-resolved angiography with stochastic trajectories sequence. Quantification of lung perfusion was performed using a pixel-by-pixel deconvolution approach. Six regions of interest were placed (upper, middle and lower parts of right and left lung) to assess differences in pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) while avoiding the inclusion of larger pulmonary arteries and veins. The difference in PBF and PBV between ipsilateral and contralateral lung was significant (P < 0.5). No significant differences could be detected for the MTT (P = 0.5). DCE-MRI in 2-year-old patients is feasible at 3.0 T. Reduced perfusion in the ipsilateral lung is reflected by significantly lower PBF values compared with the contralateral lung. DCE-MRI of the lung in congenital diaphragmatic hernia can help to characterise lung hypoplasia initially and in the long-term follow-up of children after diaphragmatic repair. (orig.)

Antihistamine medication may alleviate negative effects of prenatal exposure to polycyclic aromatic hydrocarbons (PAH) on lung function in children. Birth cohort prospective study.

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Jedrychowski, Wieslaw A; Perera, Frederica P; Maugeri, Umberto; Majewska, Renata; Spengler, Jack; Mroz, Elzbieta; Flak, Elzbieta; Klimaszewska-Rembiasz, Maria; Camman, David

2015-05-01

The main purpose of the present study was to test the hypothesis that the depressed lung growth attributable to prenatal exposure to polycyclic aromatic hydrocarbons (PAH) may be modified by the intake of antihistamine medications. Individual prenatal PAH exposure was assessed by personal air monitoring in 176 children who were followed over nine years, in the course of which outdoor residential air monitoring, allergic skin tests for indoor allergens, lung function tests (FVC, FEV(1), FEV(05), and FEF(25-75)) were performed. The analysis with the General Estimated Equation (GEE) showed no association between prenatal PAH exposure and lung function in the group of children who were reported to be antihistamine users. However, in the group of antihistamine non-users all lung function tests except for FEF(25-75) were significantly and inversely associated with prenatal airborne PAH exposure. The results of the study suggest that the intake of antihistamine medications in early childhood may inhibit the negative effect of fetal PAH exposure on lung growth and provides additional indirect evidence for the hypothesis that lung alterations in young children resulting from PAH exposure may be caused by the allergic inflammation within lung. © 2014 Wiley Periodicals, Inc.

Predictors of smoking initiation among schoolchildren in Tunisia: a 4 ...

African Journals Online (AJOL)

Objective: To identify predictors of smoking initiation among non smoking Tunisian school children; and to propose efficient antismoking strategies in order to prevent smoking initiation. Methods: It was a cohort study surveying prospectively for four years pupils attending schools in Sousse city in Tunisia. 441 non smoking ...

Industry self-regulation of food marketing to children: reading the fine print.

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Hebden, Lana; King, Lesley; Kelly, Bridget; Chapman, Kathy; Innes-Hughes, Christine

2010-12-01

despite the evidence showing the negative influences of food marketing on children's dietary beliefs and behaviours, and risk of adiposity, regulatory action to limit unhealthy food marketing has made little progress within Australia. Our aim was to describe and critically examine the Australian Food and Grocery Council's (AFGC) approach to self-regulate food marketing to Australian children through the Responsible Marketing to Children Initiative (Initiative). the Initiative's core principles and the commitments of the 16 signatory companies (as at December 2009) were assessed in terms of their capacity to limit unhealthy food advertising in media accessed by children. All information was publicly available from AFGC and signatory company websites (September- December 2009). limitations of the Initiative included inadequate definitions for when and where food marketing to children can occur, and permissive definitions of foods considered appropriate for advertising. The study also identified numerous examples of ongoing food marketing to children by AFGC companies that illustrate these limitations. until one reads the fine print, the self-regulatory commitments of companies signed to the AFGC Initiative may appear to be responsible. However, this study shows that the commitments are permissive and allow companies to circumvent the stated intent of the Initiative.

Parent Scaffolding in Children's Oral Reading.

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Evans, Mary Ann; Moretti, Shelley; Shaw, Deborah; Fox, Maureen

2003-01-01

Examined parental coaching strategies during shared book reading between parents and their first-grade children. Found that parents provided more feedback clues when their child was unsuccessful in rereading a word after initial feedback, causing children's success levels to rise. Children with weaker word recognition skill were offered feedback…

Parental practice of child car safety in Enugu, Southeast Nigeria.

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Ndu, K I; Ekwochi, U; Osuorah, D C; Ifediora, O C; Amadi, F O; Asinobi, I N; Okenwa, O W; Orjioke, J C; Ogbuka, F N; Ulasi, T O

2016-01-01

Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs) among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated ( r =-0.121, P =0.310). Only respondent's use of seat belt during driving ( P =0.001) and having being cautioned for non-use of CCRs ( P =0.005) maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%); restraints not being important, 53 (26%), and restraints being too expensive, 32 (15%). Similarly, for irregular users, exceptions for non-use included the child being asleep (29%), inadequate number of CCRs (22%), and the child being sick (18%). There is a need for a strategy change to enforce the use of CCRs in Nigeria.

Achalasia: Outcome in children.

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Meyer, Anell; Catto-Smith, Anthony; Crameri, Joe; Simpson, Di; Alex, George; Hardikar, Winita; Cameron, Donald; Oliver, Mark

2017-02-01

Oesophageal achalasia is well-recognized but relatively rare in children, occasionally appearing as the "triple A" syndrome (with adrenal insufficiency and alacrima). Treatment modalities, as in adult practice, are not curative, often needing further interventions and spurring the search for better management. The outcome for syndromic variants is unknown. We sought to define the efficacy of treatments for children with achalasia with and without triple A syndrome. We conducted a retrospective analysis of presentation and outcomes for 42 children with achalasia presenting over three decades to a major pediatric referral center. Long term impact of the diagnosis was assessed by questionnaire. We identified 42 children including six with triple A syndrome. The median overall age at diagnosis was 10.8 years and median follow-up 1593 days. Initial Heller myotomy in 17 required further interventions in 11 (65%), while initial treatment with botulinum toxin (n = 20) was ultimately followed by myotomy in 17 (85%). Ten out of 35 patients who underwent myotomy required a repeat myotomy (29%). Patients with triple A syndrome developed symptoms earlier, but had delayed diagnosis, were more underweight at diagnosis and at last follow up. Questionnaire results suggested a significant long term deleterious impact on the quality of life of children and their families. Many children with achalasia relapse after initial treatment, undergoing multiple, different procedures, despite which symptoms persist and impact on quality of life. Symptoms develop earlier in patients with triple A syndrome, but the diagnosis is delayed and this has substantial nutritional impact. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Use of the Mitrofanoff principle in urinary tract reconstruction: Experience with 122 children

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Sinha Shalini

2006-01-01

Full Text Available Purpose: Use of the Mitrofanoff principle is a valuable adjunct to many reconstructive urological procedures in the pediatric age group requiring clean intermittent catheterization (CIC especially if the urethra is not easily catheterizable. We present our experience with 122 children and analyze the results of this operation. Materials and Methods: 133 Mitrofanoff channels (100 appendicular, 31 ureteric and 2 Monti were constructed in 122 children (93 boys and 29 girls of mean age 6.3 years over the period from 1997 to 2005. The procedure was part of the reconstructive procedure in patients of neurogenic bladder (n=44, exstrophy-epispadias (n=40, posterior Urethral valve (n=30, and other diseases (n=8. Additional procedures included augmentation cystoplasty (n=90 and bladder neck procedure (n=46. Results: Mean follow-up was 2.6 years in 109 patients. Overall results were satisfactory. Major complication rates with the Mitrofanoff conduit using appendicular and ureteric channels were 7.4 % in and 25.8%, respectively, most of the ureteric channels due to non-use, there being alternate channels for catheterization. Only six (4.5% children required re-operation for significant problems with the Mitrofanoff conduit: revision of stoma due to stenosis or kinking (n=4 and closure of stoma due to troublesome leak (n=2. Children and parents were satisfied with the results of the operation and the majority was compliant with regular CIC. All children were socially well accepted and those above 6 years of age were attending regular school. Conclusions: The Mitrofanoff procedure is a feasible and acceptable option, with a low complication rate, for use as part of complex urinary reconstruction in a developing country. Patient education, family motivation, and cost reduction are important factors for success.

Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study.

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Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Wells, Helene; Legosz, Margot; Kemp, Robert

2013-10-01

To examine prospectively the contribution of the recreational social environment to ecstasy initiation. Population-based retrospective/prospective cohort study. Data from screening an Australian young adult population to obtain samples of users and non-users of ecstasy. A sample of 204 ecstasy-naive participants aged 19-23 years was obtained, and a 6-month follow-up identified those who initiated ecstasy use. We assessed a range of predictors of ecstasy initiation, including elements of participants' social environment, such as ecstasy-using social contacts and involvement in recreational settings. More than 40% of ecstasy-naive young adults reported ever receiving ecstasy offers. Ecstasy initiation after 6 months was predicted independently by having, at recruitment, many ecstasy-using social contacts [adjusted relative risk (ARR) 3.15, 95% confidence interval (CI): 1.57, 6.34], attending electronic/dance music events (ARR 6.97, 95% CI: 1.99, 24.37), receiving an ecstasy offer (ARR 4.02, 95% CI: 1.23, 13.10), early cannabis use (ARR 4.04, 95% CI: 1.78, 9.17) and psychological distress (ARR 5.34, 95% CI: 2.31, 12.33). Adjusted population-attributable fractions were highest for ecstasy-using social contacts (17.7%) and event attendance (15.1%). In Australia, ecstasy initiation in early adulthood is associated predominantly with social environmental factors, including ecstasy-using social contacts and attendance at dance music events, and is associated less commonly with psychological distress and early cannabis use, respectively. A combination of universal and targeted education programmes may be appropriate for reducing rates of ecstasy initiation and associated harms. © 2013 Society for the Study of Addiction.

Attention-getting skills of deaf children using American Sign Language in a preschool classroom.

Science.gov (United States)

Lieberman, Amy M

2015-07-01

Visual attention is a necessary prerequisite to successful communication in sign language. The current study investigated the development of attention-getting skills in deaf native-signing children during interactions with peers and teachers. Seven deaf children (aged 21-39 months) and five adults were videotaped during classroom activities for approximately 30 hr. Interactions were analyzed in depth to determine how children obtained and maintained attention. Contrary to previous reports, children were found to possess a high level of communicative competence from an early age. Analysis of peer interactions revealed that children used a range of behaviors to obtain attention with peers, including taps, waves, objects, and signs. Initiations were successful approximately 65% of the time. Children followed up failed initiation attempts by repeating the initiation, using a new initiation, or terminating the interaction. Older children engaged in longer and more complex interactions than younger children. Children's early exposure to and proficiency in American Sign Language is proposed as a likely mechanism that facilitated their communicative competence.

Different Backgrounds--Different Priorities? Student Perceptions of a Technology Initiative

Science.gov (United States)

Eriksson, Miikka J.; Vuojärvi, Hanna

2014-01-01

A multitude of studies has assessed the success of different technology initiatives but rarely has the focus been on special groups. This paper examines whether university students with children and those without have different perceptions of a technology initiative where students were able to acquire university sponsored laptops and were provided…

Fluoroscopic and CT enteroclysis in children: initial experience, technical feasibility, and utility

International Nuclear Information System (INIS)

Brown, Shanaree; Applegate, Kimberly E.; Sandrasegaran, Kumar; Jennings, S.G.; Garrett, Joshua; Maglinte, Dean T.; Skantharajah, Arunan

2008-01-01

Partial small-bowel obstruction can be difficult to diagnose on clinical examination. These obstructions might not be detected on routine abdominal/pelvic CT. To evaluate the feasibility, safety, and techniques of fluoroscopic enteroclysis (FE) and CT enteroclysis (CTE), and to review their indications and findings in children. We retrospectively reviewed all enteroclysis studies in children younger than 18 years performed between January 2002 and March 2007. We correlated the results with other abdominal imaging and surgical and pathological findings. The review revealed 112 FE and 74 CTE studies performed in 175 children (mean age 14 years, range 3-18 years). FE and CTE studies were performed most commonly for evaluation of known Crohn disease (FE 38%, CTE 29%) and abdominal pain (FE 26%, CTE 26%). One FE study was terminated because of patient anxiety, and one CTE study was terminated because of patient discomfort. No complications of FE or CTE were reported. The findings were normal in 54% of the FE studies and 46% of the CTE studies. The most common small bowel diagnoses were Crohn disease (FE 34%, CTE 28%) and partial small bowel obstruction (FE 3%, CTE 10%). Two FE studies (2%) and 14 CTE studies (19%) showed abnormalities outside the small bowel. In 54 patients with inflammatory bowel disease, 11 FE studies and 25 CTE studies showed additional bowel abnormalities. Overall, 14 and 21 patients had surgery as a result of the findings of FE and CTE, respectively. FE and CTE are safe, feasible, and accurate in depicting small-bowel pathology in children. These techniques can be particularly useful in children with Crohn disease involving the small bowel. (orig.)

The (Non-)Use of Configurative Reviews in Education

OpenAIRE

Levinsson, Magnus; Prøitz, Tine Sophie

2017-01-01

The push for evidence-based practice in education has led to a range of initiatives aimed at bridging the gap between research, policy and practice. Among these are the establishment of brokerage agencies with a mission to synthesise the findings of educational research. This development has been the subject of extensive controversy over the last decades. Critics emphasise that brokerage agencies in most fields prioritise experimental designs that measure the impact of interventions. However,...

Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation

DEFF Research Database (Denmark)

Guedes, Renata S; Piovesan, Chaiana; Floriano, Isabela

2016-01-01

AIM: To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children. DESIGN: A cohort study was designed with 639 children (12-59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years......, 469 children were re-examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were...

Initial Treatment for Nonsyndromic Early-Life Epilepsy: An Unexpected Consensus.

Science.gov (United States)

Shellhaas, Renée A; Berg, Anne T; Grinspan, Zachary M; Wusthoff, Courtney J; Millichap, John J; Loddenkemper, Tobias; Coryell, Jason; Saneto, Russell P; Chu, Catherine J; Joshi, Sucheta M; Sullivan, Joseph E; Knupp, Kelly G; Kossoff, Eric H; Keator, Cynthia; Wirrell, Elaine C; Mytinger, John R; Valencia, Ignacio; Massey, Shavonne; Gaillard, William D

2017-10-01

There are no evidence-based guidelines on the preferred approach to treating early-life epilepsy. We examined initial therapy selection in a contemporary US cohort of children with newly diagnosed, nonsyndromic, early-life epilepsy (onset before age three years). Seventeen pediatric epilepsy centers participated in a prospective cohort study of children with newly diagnosed epilepsy with onset under 36 months of age. Details regarding demographics, seizure types, and initial medication selections were obtained from medical records. About half of the 495 enrolled children with new-onset, nonsyndromic epilepsy were less than 12 months old at the time of diagnosis (n = 263, 53%) and about half (n = 260, 52%) had epilepsy with focal features. Of 464 who were treated with monotherapy, 95% received one of five drugs: levetiracetam (n = 291, 63%), oxcarbazepine (n = 67, 14%), phenobarbital (n = 57, 12%), topiramate (n = 16, 3.4%), and zonisamide (n = 13, 2.8%). Phenobarbital was prescribed first for 50 of 163 (31%) infants less than six months old versus seven of 300 (2.3%) of children six months or older (P epilepsy presentation (focal, generalized, mixed/uncertain). Between the first and second treatment choices, 367 (74%) of children received levetiracetam within the first year after diagnosis. Without any specific effort, the pediatric epilepsy community has developed an unexpectedly consistent approach to initial treatment selection for early-life epilepsy. This suggests that a standard practice is emerging and could be utilized as a widely acceptable basis of comparison in future drug studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Harmony or Discord? Understanding Children's Valuations of a Sistema-Inspired Initiative

Science.gov (United States)

Rimmer, Mark

2018-01-01

This article explores children's reflections on the value of their participation in "In Harmony," a social and music education programme whose approach and philosophy derives from the Venezuelan 'El Sistema' ('The System') model. More specifically, through an analysis of participating children's accounts (n = 111) and an exploration of…

Optimization of initial propofol bolus dose for EEG Narcotrend Index-guided transition from sevoflurane induction to intravenous anesthesia in children.

Science.gov (United States)

Dennhardt, Nils; Boethig, Dietmar; Beck, Christiane; Heiderich, Sebastian; Boehne, Martin; Leffler, Andreas; Schultz, Barbara; Sümpelmann, Robert

2017-04-01

Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI). Fifty children aged 1-8 years scheduled for elective pediatric surgery were studied. After sevoflurane induction and establishing of an intravenous access, a propofol bolus dose range 0-5 mg·kg -1 was administered at the attending anesthetist's discretion to maintain a NI between 20 and 64, and sevoflurane was stopped. Anesthesia was continued as TIVA with a propofol infusion dose of 15 mg·kg -1 ·h -1 for the first 15 min, followed by stepwise reduction according to McFarlan's pediatric infusion regime, and remifentanil 0.25 μg·kg -1 ·min -1 . Endtidal concentration of sevoflurane, NI, and hemodynamic data were recorded during the whole study period using a standardized case report form. Propofol plasma concentrations were calculated using the paedfusor dataset and a TIVA simulation program. Median endtidal concentration of sevoflurane at the time of administration of the propofol bolus was 5.1 [IQR 4.7-5.9] Vol%. The median propofol bolus dose was 1.2 [IQR 0.9-2.5] mg·kg -1 and median NI thereafter was 33 [IQR 23-40]. Nine children presented with a NI 13-20 and three children with burst suppression in the EEG (NI 0-12); all of them received an initial propofol bolus dose >2 mg·kg -1 . Regression equation demonstrated that NI 20-64 was achieved with a 95% probability when using a propofol bolus dose of 1 mg·kg -1 after

Adopt a Care Home: An intergenerational initiative bringing children into care homes.

Science.gov (United States)

Di Bona, Laura; Kennedy, Sheila; Mountain, Gail

2017-01-01

Dementia friendly communities, in which people living with dementia actively participate and those around them are educated about dementia, may improve the wellbeing of those living with dementia and reduce the associated stigma. The Adopt a Care Home scheme aims to contribute towards this by teaching schoolchildren about dementia and linking them with people living with dementia in a local care home. Forty-one children, 10 people living with dementia and 8 school/care home staff participated in a mixed methods (questionnaires, observations, interviews and focus groups) evaluation to assess the scheme's feasibility and impact. Data were analysed statistically and thematically. The scheme was successfully implemented, increased children's dementia awareness and appeared enjoyable for most participants. Findings, therefore, demonstrate the scheme's potential to contribute towards dementia friendly communities by increasing children's knowledge and understanding of dementia and engaging people living with dementia in an enjoyable activity, increasing their social inclusion.

Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis

Directory of Open Access Journals (Sweden)

Constantine I. Vardavas

2017-08-01

Our study highlighted parameters related to e-cigarette exposure incidents in 10 EU MS, the results of which indicate that consideration should be given to the design features which may mitigate risks, thereby protecting users, non-users and especially children.

Validation of the Physical Activity Questionnaire for Older Children (PAQ-C) among Chinese Children *

OpenAIRE

Wang, Jing Jing.; Baranowski, Tom.; Lau, W C Patrick.; Chen, Tzu An.; Pitkethly, Amanda Jane.

2016-01-01

Objective This study initially validates the Chinese version of the Physical Activity Questionnaire for Older Children (PAQ-C), which has been identified as a potentially valid instrument to assess moderate-to-vigorous physical activity (MVPA) in children among diverse racial groups. Methods The psychometric properties of the PAQ-C with 742 Hong Kong Chinese children were assessed with the scale's internal consistency, reliability, test-retest reliability, confirmatory factory analysis (CFA) ...

The Tennessee Children's Respiratory Initiative: Objectives, design and recruitment results of a prospective cohort study investigating infant viral respiratory illness and the development of asthma and allergic diseases.

Science.gov (United States)

Hartert, Tina V; Carroll, Kecia; Gebretsadik, Tebeb; Woodward, Kimberly; Minton, Patricia

2010-05-01

The 'attack rate' of asthma following viral lower respiratory tract infections (LRTI) is about 3-4 fold higher than that of the general population; however, the majority of children who develop viral LRTI during infancy do not develop asthma, and asthma incidence has been observed to continuously decrease with age. Thus, we do not understand how viral LRTI either predispose or serve as a marker of children to develop asthma. The Tennessee Children's Respiratory Initiative has been established as a longitudinal prospective investigation of infants and their biological mothers. The primary goals are to investigate both the acute and the long-term health consequences of varying severity and aetiology of clinically significant viral respiratory tract infections on early childhood outcomes. Over four respiratory viral seasons, 2004–2008, term, predominantly non-low weight previously healthy infants and their biological mothers were enrolled during an infant's acute viral respiratory illness.Longitudinal follow up to age 6 years is ongoing [corrected]. This report describes the study objectives, design and recruitment results of the over 650 families enrolled in this longitudinal investigation. The Tennessee Children's Respiratory Initiative is additionally unique because it is designed in parallel with a large retrospective birth cohort of over 95,000 mother-infant dyads with similar objectives to investigate the role of respiratory viral infection severity and aetiology in the development of asthma. Future reports from this cohort will help to clarify the complex relationship between infant respiratory viral infection severity, aetiology, atopic predisposition and the subsequent development of early childhood asthma and atopic diseases.

Initiating Nutritional Support Before 72 Hours Is Associated With Favorable Outcome After Severe Traumatic Brain Injury in Children: A Secondary Analysis of a Randomized, Controlled Trial of Therapeutic Hypothermia.

Science.gov (United States)

Meinert, Elizabeth; Bell, Michael J; Buttram, Sandra; Kochanek, Patrick M; Balasubramani, Goundappa K; Wisniewski, Stephen R; Adelson, P David

2018-04-01

To understand the relationship between the timing of initiation of nutritional support in children with severe traumatic brain injury and outcomes. Secondary analysis of a randomized, controlled trial of therapeutic hypothermia (Pediatric Traumatic Brain Injury Consortium: Hypothermia, also known as "the Cool Kids Trial" (NCT 00222742). Fifteen clinical sites in the United States, Australia, and New Zealand. Inclusion criteria included 1) age less than 18 years, 2) postresuscitation Glasgow Coma Scale less than or equal to 8, 3) Glasgow Coma Scale motor score less than 6, and 4) available to be randomized within 6 hours after injury. Exclusion criteria included normal head CT, Glasgow Coma Scale equals to 3, hypotension for greater than 10 minutes ( 30 min), pregnancy, penetrating injury, and unavailability of a parent or guardian to consent at centers without emergency waiver of consent. Therapeutic hypothermia (32-33°C for 48 hr) followed by slow rewarming for the primary study. For this analysis, the only intervention was the extraction of data regarding nutritional support from the existing database. Timing of initiation of nutritional support was determined and patients stratified into four groups (group 1-no nutritional support over first 7 d; group 2-nutritional support initiated group 3-nutritional support initiated 48 to group 4-nutritional support initiated 72-168 hr after injury). Outcomes were also stratified (mortality and Glasgow Outcomes Scale-Extended for Pediatrics; 1-4, 5-7, 8) at 6 and 12 months. Mixed-effects models were performed to define the relationship between nutrition and outcome. Children (n = 90, 77 randomized, 13 run-in) were enrolled (mean Glasgow Coma Scale = 5.8); the mortality rate was 13.3%. 57.8% of subjects received hypothermia Initiation of nutrition before 72 hours was associated with survival (p = 0.01), favorable 6 months Glasgow Outcomes Scale-Extended for Pediatrics (p = 0.03), and favorable 12 months Glasgow

WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010

NARCIS (Netherlands)

Wijnhoven, T.M.A.; Raaij, van J.M.A.; Spinelli, A.; Starc, G.; Hassapidou, M.; Spiroski, I.; Rutter, H.; Martos, E.; Rito, A.I.; Hovengen, R.; Perez-Farinos, N.; Petrauskiene, A.; Eldin, N.; Braeckevelt, L.; Pudule, I.; Kunesova, M.; Breda, J.

2014-01-01

Background: The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009/2010)

Health care utilization of refugee children after resettlement.

Science.gov (United States)

Watts, Delma-Jean; Friedman, Jennifer F; Vivier, Patrick M; Tompkins, Christine E A; Alario, Anthony J

2012-08-01

Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months from arrival were recorded. The sample included 198 refugees, many with positive initial screening tests. After arrival, 21% had an emergency department visit, 40% had a primary care sick visit, and 71% had a primary care follow-up. Mean number of visits ranged from 0.3 for emergency department to 1.9 for follow-up. Fifty-seven percent were referred to at least one subspecialist. Refugee children had substantial disease burden at arrival. Most had primary care follow-up visits and subspecialty referral after resettlement. These visits were largely for problems identified on initial screening and for general pediatric illnesses.

Children using Day Nurseries' Facilities can be Associated with more Risk to Nonnutritive Sucking Habits.

Science.gov (United States)

Alves, Fabiana Bt; Wambier, Denise S; Alvarez, Jenny Ha; da Rocha, José Cf; Kummer, Thais R; de Castro, Vanessa C; Cabral, Howard; Kozlowski, Vitoldo A

2016-09-01

This study evaluated the expression of nonnutritive sucking habits and the presence of malocclusion in children using day nurseries' facilities. The 195 children (7-40 months) attending 18 public day nurseries were evaluated clinically in Ponta Grossa, Brazil. Statistical package software was used for descriptive, univariate, bivariate, and multiple logistic regressions of the data about the socioeconomic condition, educational family status, malocclusions, and prevalence of nonnutritive sucking habits among the children. The pacifier users had a statistically significant, explanatory association with open bite [odds ratio (OR) = 10.97; 95% confidence interval (CI): 4.95, 24.31; p < 0.0001]. The children older than 25 months had more open bite than younger children (OR = 6.07; 95% CI: 2.81, 13.11; p < 0.0001). Of the children examined, 35.4% had an anterior open bite, 0.51% had posterior cross-bite, and 1.03% showed finger-sucking habits. A high frequency of pacifier-sucking habits was found (52%), with a significant association between this habit and anterior open bite (p < 0.0001, OR = 7.49; 95% CI: 3.71, 15.15). The 126 children without open bite (36.5%) were pacifier users. There was suggestive, though nonsignificant, evidence of a difference in pacifier use by gender (males, 34%; females, 46%; p = 0.07). The 69 children with open bite (81.16%) were pacifier users and (18.84%) nonusers. The boys showed a slightly greater association with open bite (OR = 21.33; 95% CI: 6.12, 74.40; p < 0.0001) than girls (OR = 5.03; 95% CI: 1.26, 20.00; p = 0.02) in the age group of 25 to 40 months; however, it was not observed in younger children. Pacifier use is a predictor for open bite in children from the lower socioeconomic classes using day nurseries' facilities. The parents, guardians, and caregivers working in public day nurseries should be advised to monitor nonnutritive sucking habits in order to avoid or minimize the occurrence of malocclusion. It demonstrates that

Vesicoureteric reflux in children

Directory of Open Access Journals (Sweden)

Jameela A Kari

2013-01-01

Full Text Available Aim: This study aimed to identify the differences between primary and secondary vesicoureteric reflux (VUR and the effect of associated bladder abnormalities on kidney function. Patients and Methods: We retrospectively reviewed the medical records of children with VUR who were followed up at King Abdulaziz University Hospital from January 2005 to December 2010. The review included results of radiological investigations and kidney function tests. We used Chi-square test for statistical analysis and paired t-test to compare group means for initial and last creatinine levels. Results: Ninety-nine children were included in this study. Twenty (20.2% had primary VUR, 11 had high-grade VUR, while 9 had low-grade reflux. All children with low-grade VUR had normal dimercaptosuccinic acid (DMSA. Renal scars were present in 72% of the children with high-grade VUR. The mean creatinine levels (initial and last for both groups were normal. Seventy-nine (79.8% children had secondary VUR, which was due to posterior urethral valves (PUV (46.8%, neurogenic bladder caused by meningomyelocele (25.3%, non-neurogenic neurogenic bladder (NNB (21.5%, or neurogenic bladder associated with prune belly syndrome (6.3%. Children with NNB, meningomyelocele and PUV had high creatinine at presentation with no considerable worsening of their kidney functions during the last visit. Renal scars were present in 49.4% of the children with secondary VUR. Conclusion: Children with primary VUR and normal bladder had good-functioning kidneys, while those with secondary VUR associated with abnormal bladder caused by NNB, spina bifida or PUV had abnormal kidney functions. DMSA scans were useful in predicting higher grades of VUR in children with primary reflux.

Is the igeneration a 'we' generation? Social networking use among 9- to 13-year-olds and belonging.

Science.gov (United States)

Quinn, Sally; Oldmeadow, Julian A

2013-03-01

Research suggests that online communication is associated with increased closeness to friends and friendship quality. Children under 13 years of age are increasingly using social networking sites (SNSs), but research with this younger age group is scarce. This study examined the relationship between SNS use and feelings of belonging among children aged 9-13 years. A self-report questionnaire was administered to 443 children (48.98% boys), asking about their SNS use and their sense of belonging to their friendship group. SNS users reported a stronger sense of belonging to their friendship group than non-users, but this was found only among older boys. Furthermore, among boy SNS users, a positive linear relationship was found between the intensity of usage and feelings of belonging. No significant relationships were found for girls. These findings suggest that boys who use these sites are gaining friendship benefits over and above those boys who are non-users or low-intensity users. Longitudinal studies should investigate the causal relationships between SNS use and social effects within this age group. © 2012 The British Psychological Society.

WHO European Childhood Obesity Surveillance Initiative in Serbia: a prevalence of overweight and obesity among 6-9-year-old school children.

Science.gov (United States)

Djordjic, Visnja; Radisavljevic, Snezana; Milanovic, Ivana; Bozic, Predrag; Grbic, Miljana; Jorga, Jagoda; Ostojic, Sergej M

2016-09-01

The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) is a public health program established in order to understand the progress of the obesity epidemic in young populations and gain inter-country comparisons within the European region, yet the data from a number of East European countries, including Serbia, were not available then. Therefore, the main aim of this cross-sectional study was to collect data about the prevalence of overweight and obesity among 6-9-year-old school children in Serbia according to the standardized protocol during the Fourth COSI Implementation Round. From September 2015 to November 2015, 5102 first- and second-grade primary-school children (age 7.7±0.6 years) were assessed for weight, height, and body mass index (BMI) in 14 Serbian school districts. The prevalence rates of obesity, as calculated using the International Obesity Task Force (IOTF) cut-off points, vary across different age groups, with the lowest obesity rates reported in 7-year-old boys (6.2%), while the highest obesity prevalence rates were observed in 6-year-old boys (9.7%). In addition, being overweight was strongly associated with poor local community development and lower level of urbanization. The overall prevalence of overweight (23.1%, including obesity) and obesity (6.9%) in Serbian primary-school children seem to be comparable to rather high rates previously reported in other countries participating in the COSI program, indicating an obesity epidemic in Serbian children. This surveillance system should be regularly implemented throughout Europe, providing comparable data on rates of overweight/obesity in primary schools that might drive prudent actions to reverse the pandemic trend of childhood obesity.

Self-perceived competence and social acceptance of young children who stutter: Initial findings.

Science.gov (United States)

Hertsberg, Naomi; Zebrowski, Patricia M

The goals of this study were to determine whether young children who stutter (CWS) perceive their own competence and social acceptance differently than young children who do not stutter (CWNS), and to identify the predictors of perceived competence and social acceptance in young speakers. We administered the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA; Harter & Pike, 1984) to 13 CWS and 14 CWNS and examined group differences. We also collected information on the children's genders, temperaments, stuttering frequencies, language abilities, and phonological skills to identify which of these factors predicted PSPCSA scores. CWS, as a group, did not differ from CWNS in their perceived general competence or social acceptance. Gender predicted scores of perceived general competence, and stuttering frequency predicted perceived social acceptance. Temperament, language abilities, and phonological skills were not significant predictors of perceived competence or social acceptance in our sample. While CWS did not significantly differ from CWNS in terms of perceived competence and social acceptance, when both talker groups were considered together, girls self-reported greater perceived competence than boys. Further, lower stuttering frequency was associated with greater perceived social acceptance. These preliminary findings provide motivation for further empirical study of the psychosocial components of childhood stuttering. Readers will be able to describe the constructs of perceived competence and social acceptance in young children, and whether early stuttering plays a role in the development of these constructs. Copyright © 2016 Elsevier Inc. All rights reserved.

Incidence of colorectal cancer in new users and non-users of low-dose aspirin without existing cardiovascular disease: A cohort study using The Health Improvement Network.

Science.gov (United States)

Cea Soriano, Lucía; Soriano-Gabarró, Montse; García Rodríguez, Luis A

2017-12-01

Evidence regarding the chemo-protective effects of aspirin has influenced expert opinion in favour of low-dose aspirin use in certain patient populations without cardiovascular disease (CVD). The effects of aspirin in reducing the incidence of colorectal cancer (CRC) may be a large contributor to this favourable risk-benefit profile of low-dose aspirin in primary CVD prevention. Using The Health Improvement Network, we estimated the incidence of CRC in individuals free of CVD and either prescribed or not prescribed prophylactic low-dose aspirin. Two cohorts - new-users of low-dose aspirin (N=109,426) and a comparator cohort of non-users (N=154,056) at start of follow-up - were followed (maximum 13years) to identify incident CRC cases. Individuals with a record of CVD, cancer or low-dose aspirin prescription before start of follow-up were excluded. 2330 incident cases of CRC occurred; 885 in the aspirin cohort and 1445 in the comparator cohort, after mean follow-ups of 5.43years and 5.17years, respectively. Incidence rates of CRC per 10,000 person-years (95% confidence interval) were 14.90 (13.95-15.92) in the aspirin cohort and 18.15 (17.24-19.12) in the comparator cohort; incidence rate ratio 0.82 (0.76-0.89) adjusted for age, sex and primary care practitioner (PCP) visits in the previous year. Lower incidence rates were seen in the aspirin cohort for all strata evaluated (gender, age group and number of PCP visits in the previous year) except those aged ≥80years. Among most individuals without established CVD, initiation of low-dose aspirin is associated with a reduced incidence of CRC. Copyright © 2017 Elsevier B.V. All rights reserved.

[Nineteen cases of school-aged children with degenerative or metabolic neurological disorders initially presenting with learning difficulty and/or behavior disturbance].

Science.gov (United States)

Honzawa, Shiho; Sugai, Kenji; Akaike, Hiroto; Nakayama, Tojo; Fujikawa, Yoshinao; Komaki, Hirofumi; Nakagawa, Eiji; Sasaki, Masayuki

2012-07-01

We reported 19 cases of school-aged children. They were initially judged to have learning difficulty or school maladaptation because of attention deficits, hyperactive behaviors or poor school performance, followed by the diagnosis such as degenerative or metabolic neurological diseases. The patients consisted of 4 cases of adrenoleukodystrophy, 5 cases of dentatorubral-pallidoluysian atrophy, 3 cases of Sanfilippo syndrome, 3 cases of subacute sclerosing panencephalitis, and each one case of juvenile Gaucher disease, juvenile Huntington disease, juvenile metachromatic leukodystrophy and Leigh disease. They had markedly poor school performance, and/or abnormal behaviors, followed by seizures, character disorders or psychomotor regression. The diagnostic clues included brain CT scan and/or MRI, peculiar facial appearance and notable family histories. When the children were indicated to have learning difficulty or maladjustment to school life, we should make deliberate differential diagnoses before concluding that they have a learning disorder and/or attention-deficit/hyperactivity disorder. Instead they should be recommended to visit child neurologists, when they present with any problems as aforesaid.

[Initial experiences with a new painless vascular approach in hemodialysis in children].

Science.gov (United States)

Klare, B; Kemkes, B M

1982-09-09

The necessity of hemodialysis in children is pointed out to be treated at specialized pediatric dialysis centers. In this connection a new vascular access is presented. The device is made from vitreous carbon and is mounted on a PTFE vascular prosthesis. By means of disposable connectors it can be dialysed without puncturing the implant. The device was implanted for the first time in the world in a small boy of 19 kg bodyweight. Our conclusion is that the biocarbon device is a welcome alleviation and an alternative for angio-access in children.

Myths and Realities for Children of Divorce.

Science.gov (United States)

Kelly, Joan B.

1980-01-01

The author examines seven myths, such as: divorce is preferable to an unhappy home; children anticipate divorce; turmoil ends with separation; and divorce damages children. She concludes that divorce initiates a prolonged and often difficult transition for children, which may benefit or harm them depending on how parents handle it. (SJL)

Four-Dimensional CT of the Diaphragm in Children: Initial Experience

Science.gov (United States)

2018-01-01

Objective To evaluate the technical feasibility of four-dimensional (4D) CT for the functional evaluation of the pediatric diaphragm. Materials and Methods In 22 consecutive children (median age 3.5 months, age range 3 days–3 years), 4D CT was performed to assess diaphragm motion. Diaphragm abnormalities were qualitatively evaluated and diaphragm motion was quantitatively measured on 4D CT. Lung density changes between peak inspiration and expiration were measured in the basal lung parenchyma. The diaphragm motions and lung density changes measured on 4D CT were compared between various diaphragm conditions. In 11 of the 22 children, chest sonography was available for comparison. Results Four-dimensional CT demonstrated normal diaphragm (n = 8), paralysis (n = 10), eventration (n = 3), and diffusely decreased motion (n = 1). Chest sonography demonstrated normal diaphragm (n = 2), paralysis (n = 6), eventration (n = 2), and right pleural effusion (n = 1). The sonographic findings were concordant with the 4D CT findings in 90.9% (10/11) of the patients. In diaphragm paralysis, the affected diaphragm motion was significantly decreased compared with the contralateral normal diaphragm motion (−1.1 ± 2.2 mm vs. 7.6 ± 3.8 mm, p = 0.005). The normal diaphragms showed significantly greater motion than the paralyzed diaphragms (4.5 ± 2.1 mm vs. −1.1 ± 2.2 mm, p Hounsfield units [HU] vs. 180 ± 71 HU, p = 0.03), while no significant differences were found between the normal diaphragms and the paralyzed diaphragms (136 ± 66 HU vs. 89 ± 73 HU, p = 0.1) or between the normal diaphragms and the contralateral normal diaphragms in paralysis (136 ± 66 HU vs. 180 ± 71 HU, p = 0.1). Conclusion The functional evaluation of the pediatric diaphragm is feasible with 4D CT in select children. PMID:29354007

Children?s Health in Latin America: The Influence of Environmental Exposures

OpenAIRE

Laborde, Amalia; Tomasina, Fernando; Bianchi, Fabrizio; Brun?, Marie-Noel; Buka, Irena; Comba, Pietro; Corra, Lilian; Cori, Liliana; Duffert, Christin Maria; Harari, Raul; Iavarone, Ivano; McDiarmid, Melissa A.; Gray, Kimberly A.; Sly, Peter D.; Soares, Agnes

2014-01-01

Background Chronic diseases are increasing among children in Latin America. Objective and Methods To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data. Results Industrial development and urbanization are pr...

Risk factors for mortality in children with abusive head trauma.

Science.gov (United States)

Shein, Steven L; Bell, Michael J; Kochanek, Patrick M; Tyler-Kabara, Elizabeth C; Wisniewski, Stephen R; Feldman, Kenneth; Makoroff, Kathi; Scribano, Philip V; Berger, Rachel P

2012-10-01

We sought to identify risk factors for mortality in a large clinical cohort of children with abusive head trauma. Bivariate analysis and multivariable logistic regression models identified demographic, physical examination, and radiologic findings associated with in-hospital mortality of children with abusive head trauma at 4 pediatric centers. An initial Glasgow Coma Scale (GCS) ≤ 8 defined severe abusive head trauma. Data are shown as OR (95% CI). Analysis included 386 children with abusive head trauma. Multivariable analysis showed children with initial GCS either 3 or 4-5 had increased mortality vs children with GCS 12-15 (OR = 57.8; 95% CI, 12.1-277.6 and OR = 15.6; 95% CI, 2.6-95.1, respectively, P < .001). Additionally, retinal hemorrhage (RH), intraparenchymal hemorrhage, and cerebral edema were independently associated with mortality. In the subgroup with severe abusive head trauma and RH (n = 117), cerebral edema and initial GCS of 3 or 4-5 were independently associated with mortality. Chronic subdural hematoma was independently associated with survival. Low initial GCS score, RH, intraparenchymal hemorrhage, and cerebral edema are independently associated with mortality in abusive head trauma. Knowledge of these risk factors may enable researchers and clinicians to improve the care of these vulnerable children. Copyright © 2012 Mosby, Inc. All rights reserved.

Follow-up of a cohort of children and adolescents with gastro-esophageal reflux disease who were free of reflux esophagitis at initial diagnosis.

Science.gov (United States)

Ruigómez, Ana; Lundborg, Per; Johansson, Saga; Wallander, Mari-Ann; García Rodríguez, Luis A

2010-08-01

Few studies have examined the incidence of complications from gastro-esophageal reflux disease (GERD) in children and adolescents in primary care. Here we aimed to describe the natural history of GERD in a pediatric population with no reflux esophagitis at initial diagnosis, assessing diagnoses of new esophageal complications and extra-esophageal conditions. We used The Health Improvement Network UK primary care database (which includes data on more than 2 million patients) to identify individuals aged 1-17 years with a first diagnosis of gastro-esophageal reflux or heartburn in the period 2000-2005, via a computerized search followed by a manual review of the patient records. This search identified 1242 individuals with an incident diagnosis of GERD but no record of esophagitis. This cohort was followed-up to detect new diagnoses of esophageal complications and extra-esophageal conditions. During a mean follow-up period of almost 4 years, 40 children and adolescents had a confirmed new diagnosis of reflux esophagitis (incidence: 10.9 per 1000 person-years). No cases of Barrett's esophagus, esophageal stricture or esophageal ulcer were reported. Individuals with GERD had double the risk of an extra-esophageal condition such as asthma, pneumonia, cough or chest pain compared with children and adolescents with no diagnosis of GERD. Children and adolescents with GERD may be at risk of developing reflux esophagitis and a range of other extra-esophageal conditions, but more severe esophageal complications are rare.

Characterization of heavy users of skin care products among Norwegian women from 2003 to 2011.

Science.gov (United States)

Aniansson, Boel; Veierød, Marit B; Rylander, Charlotta; Lund, Eiliv; Sandanger, Torkjel M

2016-01-01

Several ingredients in personal care products (PCPs) have been classified as endocrine disruptors (EDs) and concern has been raised whether use of PCPs can affect human health. We aimed to characterize Norwegian female users of skin care products and compare life style characteristics between heavy users and non-users. This cross-sectional study consisted of 114 202 women (age 41-76 years) participating in the Norwegian Women and Cancer study, a large population-based prospective cohort study. Based on self-reported questionnaire data, we classified the study subjects into five groups according to a calculated percentage of skin area creamed per day. Life-style characteristics were then compared between heavy users (using body lotion twice a day) and non-users. Change in use from 2003 to 2011 was assessed through repeated measurements ( n  = 8484). Heavy users of skin care products had a significantly lower BMI, higher level of physical activity, higher income, higher alcohol consumption, fewer children and a shorter total time of breastfeeding than non-users ( p  skin care products was, to a moderate extent (weighted kappa 0.52), consistent over time from 2003 to 2011, and as many as 91.5% of the women were classified into the same user group ±1 category in 2003 and 2011. Heavy users of skin care products differ significantly from non-users on BMI, degree of daily physical activity, income, number of children, use of hormonal pharmaceuticals, smoking and alcohol consumption. Use of skin care products is common among women aged 41-76 years in Norway, and the use is consistent over time.

77 FR 45471 - White House Initiative on Educational Excellence for African Americans

Science.gov (United States)

2012-08-01

... programs and services that enable early learning and development of children from birth through age 5; (iii...: (1) the development, implementation, and coordination of educational programs and initiatives at the... House Initiative on Educational Excellence for African Americans By the authority vested in me as...

Self-reports of executive dysfunction in current ecstasy/polydrug Users.

Science.gov (United States)

Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Bridges, Nikola

2012-09-01

Ecstasy/polydrug users have exhibited deficits in executive functioning in laboratory tests. We sought to extend these findings by investigating the extent to which ecstasy/polydrug users manifest executive deficits in everyday life. Forty-two current ecstasy/polydrug users, 18 previous (abstinent for at least 6 months) ecstasy/polydrug users, and 50 non-users of ecstasy (including both non-users of any illicit drug and some cannabis-only users) completed the self-report Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) measure. Current ecstasy/polydrug users performed significantly worse than previous users and non-users on subscales measuring inhibition, self-monitoring, initiating action, working memory, planning, monitoring ongoing task performance, and organizational ability. Previous ecstasy/polydrug users did not differ significantly from non-users. In regression analyses, although the current frequency of ecstasy use accounted for statistically significant unique variance on 3 of the 9 BRIEF-A subscales, daily cigarette consumption was the main predictor in 6 of the subscales. Current ecstasy/polydrug users report more executive dysfunction than do previous users and non-users. This finding appears to relate to some aspect of ongoing ecstasy use and seems largely unrelated to the use of other illicit drugs. An unexpected finding was the association of current nicotine consumption with executive dysfunction.

Features of tennis methods of teaching 5-6 years old children in the initial stages

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E.V. Kurmaeva

2014-06-01

Full Text Available Purpose : theoretical and methodological justification for the existing teaching methods tennis of 5-6 years old children. Material : 17 special analysis and scientific and methodological sources. Results : the features of the existing methods of teaching children at an early stage of training. The main theses of the existing methods: 1 the training process is carried out in the form of games; 2 the level of general physical preparedness level exceeds special; 3 The first two years of the children do not participate in official competitions; 4 education of children begins with " School Ball ", with a gradual transition to employment with racket and ball; 5 training is built on two levels: theoretical - each " part" in the form of pre- formation of a mental model of rational behavior, and practical - the formation of the ability to perform motor actions. Conclusions : it was found that the existing methods of constructing the training process for children 5-6 years do not account for their physiological characteristics, therefore proposed to use computer technology and animation, that will shorten the formation of motor skills of children.

The influence of parental education and other socio-economic factors on child car seat use.

Science.gov (United States)

Rok Simon, Mateja; Korošec, Aleš; Bilban, Marjan

2017-03-01

The behaviour of parents in ensuring car passenger safety for their children is associated with socio-economic (SE) status of the family; however, the influence of parental education has rarely been researched and the findings are contradictory. The aim of the study was to clarify whether parental education influences the use of a child car seat during short rides. A cross-sectional survey was carried out in outpatient clinics for children's healthcare across Slovenia. 904 parents of 3-year-old children participated in the study; the response rate was 95.9%. A self-administered questionnaire was used. A binary multiple logistic regression was applied to assess the association between parental unsafe behaviour as dependent variable, and education and other SE factors as independent variables. 14.6% of parents did not use a child car seat during short rides. Families where mother had low or college education had higher odds of the non-use of a child car seat than families where mother had a university education. Single-parent families and those who lived in areas with low or medium SE status also had higher odds of the non-use of a child car seat. Low educational attainment influences parents' behaviour regarding the non-use of a child car seat. Low parental education is not the only risk factor since some highly educated parents also have high odds of unsafe behaviour. All parents should therefore be included in individually tailored safety counselling programmes. SE inequalities could be further reduced with provision of free child car seats for eligible families.

Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services.

Science.gov (United States)

Hansen, Matthew; O'Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

2016-07-01

Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children's Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. 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/

Not All Clefts Are Created Equal: Patterns of Hospital-Based Care Use among Children with Cleft Lip and Palate within 4 Years of Initial Surgery.

Science.gov (United States)

Ligh, Cassandra A; Fox, Justin P; Swanson, Jordan; Yu, Jason W; Taylor, Jesse A

2016-06-01

This study compares hospital-based care and associated charges among children with cleft lip, cleft palate, or both, and identifies subgroups generating the greatest cumulative hospital charges. The authors conducted a retrospective cohort study of cleft lip, cleft palate, or cleft lip and palate who underwent initial surgery from 2006 to 2008 in four U.S. states. Primary outcome was hospital-based care-emergency, outpatient, inpatient-within 4 years of surgery. Regression models compared outcomes and classification tree analysis identified patients at risk for being in the highest quartile of cumulative hospital charges. The authors identified 4571 children with cleft lip (18.2 percent), cleft palate (39.2 percent), or cleft lip and palate (42.6 percent). Medical comorbidity was frequent across all groups, with feeding difficulty (cleft lip, 2.4 percent; cleft palate, 13.4 percent; cleft lip and palate, 6.0 percent; p cleft lip, 1.8 percent; cleft palate, 9.4 percent; cleft lip and palate, 3.6 percent; p cleft palate were most likely to return to the hospital (p cleft lip group, yet comparable among those with cleft palate and cleft lip and palate (p cleft palate cohort (cleft lip, $56,966; cleft palate, $106,090; cleft lip and palate, $91,263; p cleft lip versus cleft palate with or without cleft lip), and age at initial surgery were the most important factors associated with the highest quartile of cumulative hospital charges. Cleft lip and palate children experience a high rate of hospital-based care early in life, with degree of medical comorbidity being a significant burden. Understanding this relationship and associated needs may help deliver more efficient, patient-centered care.

Individual differences in the cortisol responses of neglected and comparison children.

Science.gov (United States)

Sullivan, Margaret Wolan; Bennett, David S; Lewis, Michael

2013-02-01

Neglected children's acute hypothalamic-pituitary-adrenal axis (HPA axis) reactivity in response to a laboratory visit was contrasted with that of a comparison group. The authors examined initial salivary cortisol response upon entering the laboratory and its trajectory following a set of tasks designed to elicit negative self-evaluation in 64 children (30 with a history of neglect and 34 demographically matched comparison children). Neglected, but not comparison, children showed higher initial cortisol responses. The cortisol response of both groups showed a decline from the sample taken at lab entry, with neglected children's cortisol exhibiting steeper decline. The groups, however, did not differ in their mean cortisol levels at 20 and 35 min post-task. The results are interpreted in terms of the meaning of initial responses as a "baseline" and as evidence for neglected children's heightened HPA-axis reactivity as either a reflection of differences in home levels or the consequence of stress/anxiety associated with arrival at the laboratory.

Emotion knowledge in young neglected children.

Science.gov (United States)

Sullivan, Margaret W; Bennett, David S; Carpenter, Kim; Lewis, Michael

2008-08-01

Young neglected children may be at risk for emotion knowledge deficits. Children with histories of neglect or with no maltreatment were initially seen at age 4 and again 1 year later to assess their emotion knowledge. Higher IQ was associated with better emotion knowledge, but neglected children had consistently poorer emotion knowledge over time compared to non-neglected children after controlling for IQ. Because both neglected status and IQ may contribute to deficits in emotional knowledge, both should be assessed when evaluating these children to appropriately design and pace emotion knowledge interventions.

Changes in urine albumin to creatinine ratio with the initiation of hydroxyurea therapy among children and adolescents with sickle cell disease.

Science.gov (United States)

Tehseen, Sarah; Joiner, Clinton H; Lane, Peter A; Yee, Marianne E

2017-12-01

Renal damage is a progressive complication of sickle cell disease (SCD) that begins in childhood and may progress to renal failure and early mortality in 12% of adults with hemoglobin SS (HbSS) SCD. Early sickle nephropathy is characterized by hyperfiltration and microalbuminuria; therefore, urine albumin to creatinine ratio (ACR) is an effective screening tool for its detection. This study investigated the effect of hydroxyurea (HU) therapy on urine ACR levels among children with SCD. A retrospective review was conducted to identify all patients with HbSS or HbSβ 0 thalassemia of age 7-18 years who began HU therapy in 2011-2013; a control group of patients not on HU were matched by age and baseline hemoglobin. All urine ACR measurements ≤24 months prior to and ≥24 months after HU initiation were recorded. There were 63 eligible patients on HU and 13 (25%) with albuminuria prior to HU initiation. Among those with baseline albuminuria, the median ACR was 96 mg/g prior to HU, 39 mg/g at 1 year (P = 0.02), and 25 mg/g at 2 years (P = 0.03). Albuminuria normalized in 37.5% (6/16) after 1 year and 61% (8/13) after 2 years of HU therapy. Among those without albuminuria prior to HU, 13% (6/47) developed albuminuria during HU therapy. Sixteen percent (13/80) of control patients had albuminuria in the beginning of study period, which normalized in 15% (two of 13) of patients at 1-year follow up. Introduction of HU is associated with significant decreases in urine ACR in children with SCD and albuminuria. © 2017 Wiley Periodicals, Inc.

Immune reconstitution inflammatory syndrome in children | Rabie ...

African Journals Online (AJOL)

IRIS) occurs in up to 21% of children initiating antiretroviral therapy. Mycobacterial diseases are the most common, with BCG-vaccine adenitis predominating in infants and Mycobacterium tuberculosis (TB) in older children. The difficulty of ...

Experience of parents of children with autism on YouTube: are there educationally useful videos?

Science.gov (United States)

Azer, Samy A; Bokhari, Raghad A; AlSaleh, Ghadah S; Alabdulaaly, May M; Ateeq, Khawlah I; Guerrero, Anthony P S; Azer, Sarah

2018-09-01

The aims of this study were to determine the following: first, are there educationally useful videos of parents of children with autism sharing their experiences? Second, do any of the data related to videos help in identifying useful videos? And third, what do posted comments tell us? YouTube was searched for videos of parents sharing their experiences. The following parameters were collected: title, creator, URL, duration, number of viewers, likes, dislikes, comments, days on YouTube, and country. Based on agreed-upon criteria, videos were divided independently into educationally useful and non-useful categories. A critical thematic analysis of comments was conducted. A total of 180 videos were finally identified, of which 106 (59%) provided useful information, scoring 15.3 ± 0.7 (mean ± SD); 74 (41%) were determined to be not educationally useful, scoring 8.6 ± 2.1. The differences in scores were significant (p YouTube in sharing experiences.

Music therapy CD creation for initial pediatric radiation therapy: a mixed methods analysis.

Science.gov (United States)

Barry, Philippa; O'Callaghan, Clare; Wheeler, Greg; Grocke, Denise

2010-01-01

A mixed methods research design was used to investigate the effects of a music therapy CD (MTCD) creation intervention on pediatric oncology patients' distress and coping during their first radiation therapy treatment. The music therapy method involved children creating a music CD using interactive computer-based music software, which was "remixed" by the music therapist-researcher to extend the musical material. Eleven pediatric radiation therapy outpatients aged 6 to 13 years were randomly assigned to either an experimental group, in which they could create a music CD prior to their initial treatment to listen to during radiation therapy, or to a standard care group. Quantitative and qualitative analyses generated multiple perceptions from the pediatric patients, parents, radiation therapy staff, and music therapist-researcher. Ratings of distress during initial radiation therapy treatment were low for all children. The comparison between the two groups found that 67% of the children in the standard care group used social withdrawal as a coping strategy, compared to 0% of the children in the music therapy group; this trend approached significance (p = 0.076). MTCD creation was a fun, engaging, and developmentally appropriate intervention for pediatric patients, which offered a positive experience and aided their use of effective coping strategies to meet the demands of their initial radiation therapy treatment.

[Basic and advanced resuscitation of children

DEFF Research Database (Denmark)

Lauritsen, T.L.; Jensen, Tim; Greisen, G.

2008-01-01

The ERC Guidelines 2005 regarding the resuscitation of children and neonates recommend changes in treatment algorithms. Cardiac arrest in children is most often caused or worsened by hypoxic conditions. On confirmation of cardiac arrest in a child, treatment is initiated with 5 ventilations and c...

Prevalence and geographic variation of abdominal obesity in 7- and 9-year-old children in Greece; World Health Organization Childhood Obesity Surveillance Initiative 2010.

Science.gov (United States)

Hassapidou, Maria; Tzotzas, Themistoklis; Makri, Evangelia; Pagkalos, Ioannis; Kaklamanos, Ioannis; Kapantais, Efthymios; Abrahamian, Annet; Polymeris, Antonis; Tziomalos, Konstantinos

2017-01-28

In children, abdominal obesity is a better predictor of the presence of cardiovascular risk factors than body mass index (BMI)-defined obesity. We aimed to evaluate the prevalence of abdominal obesity in the Greek pediatric population and to assess the impact of residence on the prevalence of both BMI-defined and abdominal obesity. In the context of the Childhood Obesity Surveillance Initiative of the World Health Organization (WHO) Regional Office for Europe, a national representative sample of 7.0-7.9 and 9.0-9.9-year-old children was evaluated (n = 2,531 and 2,700, respectively). Overweight and obesity according to BMI were estimated using both the WHO and International Obesity Task Force cut-off points. Abdominal obesity was defined as waist circumference/height ratio >0.5. The prevalence of abdominal obesity did not differ between 7-year-old boys and girls (25.2 and 25.3%, respectively; p = NS). Among 9-year-old children, abdominal obesity was more prevalent in boys than in girls (33.2 and 28.2%, respectively; p = 0.005). Among normal weight and overweight children, the prevalence of abdominal obesity was 1.6-6.8 and 21.8-49.1%, respectively. The prevalence of abdominal and BMI-defined obesity did not differ between children living in the mainland, in Crete and in other islands except in 7-year-old girls, where the prevalence of BMI-defined obesity was highest in those living in Crete, intermediate in those living in other islands and lowest in those living in the mainland. In 9-year-old boys and in 7- and 9-year-old girls, the prevalence of abdominal obesity was highest in children living in Athens and lowest in children living in Thessaloniki, whereas children living in other cities and in villages showed intermediate rates. The prevalence of abdominal obesity in 7-year-old boys and the prevalence of BMI-defined obesity did not differ between children living in cities and villages. The prevalence of pediatric abdominal obesity in Greece is among

Early diagnosis of HIV in children below 18 months using DNA PCR test--assessment of the effectiveness of PMTCT interventions and challenges in early initiation of ART in a resource-limited setting.

Science.gov (United States)

Gupta, Anil; Singh, Girraj; Kaushik, Pratap; Joshi, Bipin; Kalra, Kamlesh; Chakraborty, Sabyasachi

2013-04-01

This study was conducted to assess efficacy of the current Indian Prevention of Mother-to-Child Transmission (PMTCT) protocol in 217 HIV-exposed infants, and to assess challenges in the early initiation of antiretroviral treatment (ART) in 18 (8.3%) infants with HIV, as determined by the HIV-1 DNA polymerase chain reaction (PCR) test at ≥ 6 weeks to ART was initiated in 10 (55.6%) HIV-infected children at a mean ± standard deviation (SD) age of 10.45 ± 4.9 (range: 4-17.5) months; delay resulted in opportunistic infections in one-third of the children. A single-dose nevirapine PMTCT regimen should be replaced by a triple antiretroviral regimen; DBS DNA PCR-positive infants may be given ART, and simultaneously a whole blood specimen should be taken to determine whether ART should be continued.

Amphetamines, atomoxetine and the risk of serious cardiovascular events in adults.

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Hedi Schelleman

Full Text Available To compare the incidence rates of serious cardiovascular events in adult initiators of amphetamines or atomoxetine to rates in non-users.This was a retrospective cohort study of new amphetamines (n=38,586 or atomoxetine (n=20,995 users. Each medication user was matched to up to four non-users on age, gender, data source, and state (n=238,183. The following events were primary outcomes of interest 1 sudden death or ventricular arrhythmia, 2 stroke, 3 myocardial infarction, 4 a composite endpoint of stroke or myocardial infarction. Cox proportional hazard regression was used to calculate propensity-adjusted hazard ratios for amphetamines versus matched non-users and atomoxetine versus matched non-users, with intracluster dependence within matched sets accounted for using a robust sandwich estimator.The propensity-score adjusted hazard ratio for amphetamines use versus non-use was 1.18 (95% CI: 0.55-2.54 for sudden death/ventricular arrhythmia, 0.80 (95% CI: 0.44-1.47 for stroke, 0.75 (95% CI: 0.42-1.35 for myocardial infarction, and 0.78 (95% CI: 0.51-1.19 for stroke/myocardial infarction. The propensity-score adjusted hazard ratio for atomoxetine use versus non-use was 0.41 (95% CI: 0.10-1.75 for sudden death/ventricular arrhythmia, 1.30 (95% CI: 0.52-3.29 for stroke, 0.56 (95% CI: 0.16-2.00 for myocardial infarction, and 0.92 (95% CI: 0.44-1.92 for stroke/myocardial infarction.Initiation of amphetamines or atomoxetine was not associated with an elevated risk of serious cardiovascular events. However, some of the confidence intervals do not exclude modest elevated risks, e.g. for sudden death/ventricular arrhythmia.

Age of Parental Concern, Diagnosis, and Service Initiation among Children with Autism Spectrum Disorder

Science.gov (United States)

Zablotsky, Benjamin; Colpe, Lisa J.; Pringle, Beverly A.; Kogan, Michael D.; Rice, Catherine; Blumberg, Stephen J.

2017-01-01

Children with autism spectrum disorder (ASD) require substantial support to address the core symptoms of ASD and co-occurring behavioral/developmental conditions. This study explores the early diagnostic experiences of school-aged children with ASD using survey data from a large probability-based national sample. Multivariate linear regressions…

The influence of children's pain memories on subsequent pain experience.

Science.gov (United States)

Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

2012-08-01

Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Medication use among children 0-14 years old: population baseline study

Directory of Open Access Journals (Sweden)

Maria J.B. Cruz

2014-12-01

Full Text Available OBJECTIVE: Determine the prevalence of medication use in children and adolescents in 20 municipalities of Vale do Jequitinhonha, Minas Gerais-Brazil, showing the main groups and variables that may have influenced use. METHODS: Descriptive population-based survey sample of 555 interviews, selected by simple random cluster sampling of 137 census tracts. Inclusion criteria were age ≤ 14 years, mandatory interview with the legal guardians, and regardless of having received medications. Regarding the usage pattern, participants were divided into two groups: consumption and non-consumption of drugs. A descriptive analysis of the variables and tests of association were performed. RESULTS: The prevalence of drug consumption was 56.57%, and 42.43% showed no consumption. The use of medicinal plants was 72.9% for drug users and 74.3% for non-users. The health conditions for consumption were cough, common cold, flu, nasal congestion or bronchospasm (49.7%, fever (5.4%, headache (5.4%, diarrhea, indigestion, and abdominal colic (6.7%. In cases of self-medication, 30.57% of the drugs were given by the mother, and 69.42% were prescription drugs. Self-medication was prevalent using paracetamol (30.2%, dipyrone (20.8%, and cold medicine (18.8%. There was increased use of analgesics/antipyretics, followed by respiratory medications, systemic antibiotics, histamine H1 antagonists, and vitamins/antianemics. CONCLUSIONS: The prevalence of drugs use in children was high, indicating the need for formulating educational programs aiming at the awareness of caregivers regarding rational use.

After the honeymoon comes divorce: long-term use of the antegrade continence enema procedure.

Science.gov (United States)

Yardley, Iain E; Pauniaho, Satu-Liisa; Baillie, Colin T; Turnock, Rick R; Coldicutt, Pat; Lamont, Graham L; Kenny, Simon E

2009-06-01

Having reported that 18% of children discontinue use of the antegrade continence enema (ACE) after 5 years, we aimed to determine long-term use after an ACE procedure. A postal/telephone questionnaire was conducted. Subjects were consecutive children undergoing an ACE between 1993 and 1999. Outcome measures were use of ACE, reasons for nonuse, complications, and overall satisfaction. Of 84 eligible subjects, data were available on 61 (73%) aged 22.4 years (15.5-35.1 years). Underlying diagnoses included spina bifida (n = 27), anorectal malformations (n = 18), constipation (n = 11), Hirschsprung's disease (n = 1), sacral agenesis (n = 2), and trauma/tumor (n = 2). Follow-up was 11.02 years (8.34-14.39 years). Thirty-six (59%) of 61 patients were still using their ACE. Reasons for nonuse were lack of effectiveness (n = 14), complications (n = 5), psychologic issues (n = 2), and poor compliance (n = 2). There was no association between diagnosis and nonuse (chi(2), P = .63). In those still using ACE, the overall satisfaction score was 4.1 (1-5). Several individuals reported feeling abandoned on becoming adults and losing the support they had in childhood. There is a late "failure" rate for the ACE procedure. However, satisfaction was high among those still using the ACE. This study further emphasizes the need for robust transitional care arrangements.

Young children consider individual authority and collective agreement when deciding who can change rules.

Science.gov (United States)

Zhao, Xin; Kushnir, Tamar

2018-01-01

Young children demonstrate awareness of normativity in various domains of social learning. It is unclear, however, whether children recognize that rules can be changed in certain contexts and by certain people or groups. Across three studies, we provided empirical evidence that children consider individual authority and collective agreement when reasoning about who can change rules. In Study 1, children aged 4-7years watched videos of children playing simply sorting and stacking games in groups or alone. Across conditions, the group game was initiated (a) by one child, (b) by collaborative agreement, or (c) by an adult authority figure. In the group games with a rule initiated by one child, children attributed ability to change rules only to that individual and not his or her friends, and they mentioned ownership and authority in their explanations. When the rule was initiated collaboratively, older children said that no individual could change the rule, whereas younger children said that either individual could do so. When an adult initiated the rule, children stated that only the adult could change it. In contrast, children always endorsed a child's decision to change his or her own solitary rule and never endorsed any child's ability to change moral and conventional rules in daily life. Age differences corresponded to beliefs about friendship and agreement in peer play (Study 2) and disappeared when the decision process behind and normative force of collaboratively initiated rules were clarified (Study 3). These results show important connections between normativity and considerations of authority and collaboration during early childhood. Copyright © 2017 Elsevier Inc. All rights reserved.

Rules regarding Marijuana and Its Use in Personal Residences: Findings from Marijuana Users and Nonusers Recruited through Social Media

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Carla J. Berg

2015-01-01

Full Text Available Recent changes in policy and social norms related to marijuana use have increased its use and concern about how/where marijuana should be used. We aimed to characterize rules regarding marijuana and its use in homes. We recruited 1,567 US adults aged 18–34 years through Facebook advertisements to complete an online survey assessing marijuana use, social factors, perceptions of marijuana, and rules regarding marijuana and its use in the home, targeting tobacco and marijuana users to ensure the relevance of this topic. Overall, 648 (41.6% were current marijuana users; 46.0% of participants reported that “marijuana of any type is not allowed in their home or on their property.” Of those allowing marijuana on their property, 6.4% prohibited use of marijuana in their home. Of the remainder, 29.2% prohibited smoking marijuana, and 11.0% prohibited vaping, eating, or drinking marijuana. Correlates of more restrictive rules included younger age, being female, having nonuser (p’s <.05. Attitudes and subjective norms regarding marijuana are correlates of allowing marijuana in residential settings. Future work should examine areas of risk regarding household marijuana rules.

More than teacher directed or child initiated: Preschool curriculum type, parent involvement, and children's outcomes in the child-parent centers.

Directory of Open Access Journals (Sweden)

Elizabeth Graue

2004-12-01

Full Text Available This study investigated the contributions of curriculum approach and parent involvement to the short- and long-term effects of preschool participation in the Title I Chicago Child-Parent Centers. Data came from the complete cohort of 989 low-income children (93% African American in the Chicago Longitudinal Study, who attended preschool in the 20 Child-Parent Centers in 1983-1985 and kindergarten in 1985-1986. We found that implementation of an instructional approach rated high by Head Teachers in teacher-directed and child-initiated activities was most consistently associated with children’s outcomes, including school readiness at kindergarten entry, reading achievement in third and eighth grades, and avoidance of grade retention. Parent involvement in school activities, as rated by teachers and by parents, was independently associated with child outcomes from school readiness at kindergarten entry to eighth grade reading achievement and grade retention above and beyond the influence of curriculum approach. Findings indicate that instructional approaches that blend a teacher-directed focus with child-initiated activities and parental school involvement are origins of the long-term effects of participation in the Child-Parent Centers.

First-line antiretroviral drug discontinuations in children.

Directory of Open Access Journals (Sweden)

Melony Fortuin-de Smidt

Full Text Available There are a limited number of paediatric antiretroviral drug options. Characterising the long term safety and durability of different antiretrovirals in children is important to optimise management of HIV infected children and to determine the estimated need for alternative drugs in paediatric regimens. We describe first-line antiretroviral therapy (ART durability and reasons for discontinuations in children at two South African ART programmes, where lopinavir/ritonavir has been recommended for children <3 years old since 2004, and abacavir replaced stavudine as the preferred nucleoside reverse transcriptase inhibitor in 2010.We included children (<16 years at ART initiation who initiated ≥3 antiretrovirals between 2004-2014 with ≥1 follow-up visit on ART. We estimated the incidence of first antiretroviral discontinuation using Kaplan-Meier analysis. We determined the reasons for antiretroviral discontinuations using competing risks analysis. We used Cox regression to identify factors associated with treatment-limiting toxicity.We included 3579 children with median follow-up duration of 41 months (IQR 14-72. At ART initiation, median age was 44 months (IQR 13-89 and median CD4 percent was 15% (IQR 9-21%. At three and five years on ART, 72% and 26% of children respectively remained on their initial regimen. By five years on ART, the most common reasons for discontinuations were toxicity (32%, treatment failure (18%, treatment simplification (5%, drug interactions (3%, and other or unspecified reasons (18%. The incidences of treatment limiting toxicity were 50.6 (95% CI 46.2-55.4, 1.6 (0.5-4.8, 2.0 (1.2-3.3, and 1.3 (0.6-2.8 per 1000 patient years for stavudine, abacavir, efavirenz and lopinavir/ritonavir respectively.While stavudine was associated with a high risk of treatment-limiting toxicity, abacavir, lopinavir/ritonavir and efavirenz were well-tolerated. This supports the World Health Organization recommendation to replace stavudine with

Lyme disease in children.

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Sood, Sunil K

2015-06-01

The diagnosis and management of Lyme disease in children is similar to that in adults with a few clinically relevant exceptions. The use of doxycycline as an initial empiric choice is to be avoided for children 8 years old and younger. Children may present with insidious onset of elevated intracranial pressure during acute disseminated Lyme disease; prompt diagnosis and treatment of this condition is important to prevent loss of vision. Children who acquire Lyme disease have an excellent prognosis even when they present with the late disseminated manifestation of Lyme arthritis. Guidance on the judicious use of serologic tests is provided. Pediatricians and family practitioners should be familiar with the prevention and management of tick bites, which are common in children. Copyright © 2015 Elsevier Inc. All rights reserved.

Caregiver preferences regarding Personal Health Records in the management of ADHD

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Ronis, Sarah D; Baldwin, Constance D; McIntosh, Scott; McConnochie, Kenneth; Szilagyi, Peter G; Dolan, James

2015-01-01

Objective PHRs may address the needs of children with ADHD. Among parents, we assessed acceptance, barriers, and intentions regarding use of PHR for their children with ADHD. Methods Survey of parents from three practices in Rochester NY. Stepwise logistic regression analysis explored factors predicting respondents’ intentions for future use of PHR, accounting for care coordination needs, caregiver education, SES and satisfaction with providers. Results Of 184 respondents, 23% had used the PHR for their child, 82% intended future use. No difference was observed between users and non-users regarding gender, age, race, or education. Users were more likely than non-users to reside in the suburbs (p=0.03). Caregivers were more likely to plan future use of the PHR if they felt engaged as partners in their child’s care (AOR 2.3, 95%CI 1.2, 4.5). Conclusions Parents are enthusiastic about PHRs. Future work should focus on engaging them as members of the healthcare team. PMID:25567294

Relationship between social interaction bids and language in late talking children.

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Vuksanovic, Jasmina R

2015-03-28

The aim of this paper is to explore the relationship between language development and the frequency of social interaction (SI) behaviours during language acquisition in late-talking (LT) children who exhibit delays in expressive vocabulary development but have age-appropriate cognitive skills. The research consists of a longitudinal study with a first test followed by two re-tests 5 months apart, in which LT children were compared to 5-months-younger typically-developing (TD) children. Data showed that LT children performed significantly fewer initiation of SI behaviours, but no differences between groups in responding to SI behaviours were observed. Furthermore, LT children who have lower language comprehension scores initiate social interaction more frequently. The results showed that LT children seem to be less active in starting social interaction and participation, but, once they get involved, they respond similarly to TD children of comparable expressive language competence. Additionally, the correlation pattern between the frequency of SI behaviours and language functions showed that LT toddlers with more prominent receptive language delay are more interested in initiating interaction with their partner, thus suggesting that they need a partner's "scaffolding" to overcome this lack.

Differential Diagnosis of Selective Mutism in Bilingual Children

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Toppelberg, Claudio O.; Tabors, Patton; Coggins, Alissa; Lum, Kirk; Burger, Claudia

2005-01-01

Early diagnosis of selective mutism (SM) is an important concern. SM prevalence is higher than initially thought and at least three times higher in immigrant language minority children. Although the DSM-IV precludes diagnosing SM in immigrant children with limited language proficiency (as children acquiring a second language may normally undergo a…

Are Children with Autism Spectrum Disorder Initially Attuned to Object Function Rather than Shape for Word Learning?

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Field, Charlotte; Allen, Melissa L.; Lewis, Charlie

2016-01-01

We investigate the function bias--generalising words to objects with the same function--in typically developing (TD) children, children with autism spectrum disorder (ASD) and children with other developmental disorders. Across four trials, a novel object was named and its function was described and demonstrated. Children then selected the other…

Asthma Severity in patients initiating controller monotherapy versus combination therapy.

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Diette, Gregory B; Fuhlbrigge, Anne L; Allen-Ramey, Felicia; Hopper, April; Sajjan, Shiva G; Markson, Leona E

2011-04-01

Asthma treatment guidelines recommend medications based on the level of asthma control. To evaluate differences in asthma control between patients who initiated asthma controller monotherapy versus combination therapy. Children (5-16 years; n = 488) and adults (17-80 years; n = 530) with asthma and no controller therapy in the prior 6 months were included. Telephone surveys were conducted within 5 days of filling a new asthma controller prescription with either the caregiver of children or the adult patient. Demographics, asthma control before therapy, and asthma-related resource use were assessed for patients initiating monotherapy (filling one asthma controller prescription) and combination therapy (filling more than one controller medication or a fixed-dose combination). Mean pediatric age was 10 years; 53% were male. Mean adult age was 47 years; 25% were male. There were no significant differences in asthma control score between patients receiving monotherapy and combination therapy. Children on combination therapy did not have more nighttime awakening or short-acting β-agonist use but were more likely to have been hospitalized due to asthma attack (p = .05) and have more unscheduled (p = .0374) and scheduled (p = .009) physician visits. Adults on combination therapy were more likely to have been hospitalized due to asthma attack (p asthma (p asthma control scores in the 4 weeks before index medication suggests that asthma severity during a treatment-free period did not differ significantly for patients initiating controller monotherapy versus combination therapy. From these findings, it appears that although physicians may not focus on asthma control when choosing the intensity of initial controller therapy, the intensity of health-care encounters may be an influence.

The Initial Response To Corticosteroid Therapy in Childhood ...

African Journals Online (AJOL)

Background: Nephrotic syndrome (NS) in African children is associated with poor response to corticosteroids. There is disparity in treatment response on the African continent. The aim of this present study was to describe the initial response to corticosteroid therapy of childhood NS in Côte d'ivoire. Materials and methods: ...

Nutrition therapy during initiation of refeeding in underweight children and adolescent inpatients with anorexia nervosa: a systematic review of the evidence.

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Rocks, Tetyana; Pelly, Fiona; Wilkinson, Paul

2014-06-01

Restoration of weight and nutritional rehabilitation are recognized as fundamental steps in the therapeutic treatment of children and adolescent inpatients with anorexia nervosa (AN). However, current recommendations on initial energy requirements for this population are inconsistent, with a clear lack of empirical evidence. Thus, the aim of our study was to systematically review, assess, and summarize the available evidence on the effect of differing nutrition therapies prescribed during refeeding on weight restoration in hospitalized children and adolescents (aged 19 years and younger) with diagnosed AN. Searches were conducted in Scopus, Web of Science, Global Health (CABI), PubMed, and the Cochrane database for articles published in English up to May 2012, and complemented by a search of the reference lists of key publications. Seven observational studies investigating a total of 403 inpatients satisfied the inclusion criteria. The range of prescribed energy intakes varied from 1,000 kcal to >1,900 kcal/day with a progressive increase during the course of hospitalization. It appeared that additional tube feeding increased the maximum energy intake and led to greater interim or discharge weight; however, this was also associated with a higher incidence of adverse effects. Overall, the level of available evidence was poor, and therefore consensus on the most effective and safe treatment for weight restoration in inpatient children and adolescents with AN is not currently feasible. Further research on refeeding methods is crucial to establish the best practice approach to treatment of this population. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A Robotic Exoskeleton for Treatment of Crouch Gait in Children With Cerebral Palsy: Design and Initial Application.

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Lerner, Zachary F; Damiano, Diane L; Park, Hyung-Soon; Gravunder, Andrew J; Bulea, Thomas C

2017-06-01

Crouch gait, a pathological pattern of walking characterized by excessive knee flexion, is one of the most common gait disorders observed in children with cerebral palsy (CP). Effective treatment of crouch during childhood is critical to maintain mobility into adulthood, yet current interventions do not adequately alleviate crouch in most individuals. Powered exoskeletons provide an untapped opportunity for intervention. The multiple contributors to crouch, including spasticity, contracture, muscle weakness, and poor motor control make design and control of such devices challenging in this population. To our knowledge, no evidence exists regarding the feasibility or efficacy of utilizing motorized assistance to alleviate knee flexion in crouch gait. Here, we present the design of and first results from a powered exoskeleton for extension assistance as a treatment for crouch gait in children with CP. Our exoskeleton, based on the architecture of a knee-ankle-foot orthosis, is lightweight (3.2 kg) and modular. On board sensors enable knee extension assistance to be provided during distinct phases of the gait cycle. We tested our device on one six-year-old male participant with spastic diplegia from CP. Our results show that the powered exoskeleton improved knee extension during stance by 18.1° while total knee range of motion improved 21.0°. Importantly, we observed no significant decrease in knee extensor muscle activity, indicating the user did not rely solely on the exoskeleton to extend the limb. These results establish the initial feasibility of robotic exoskeletons for treatment of crouch and provide impetus for continued investigation of these devices with the aim of deployment for long term gait training in this population.

Assessing Joint Attention Responding and Initiation in Children with Angelman Syndrome

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Summers, Jane; Impey, Julie

2011-01-01

Background: Angelman syndrome (AS) is a rare neurogenetic disorder that overlaps with autism and is associated with severe cognitive, speech and motor impairments. Communication and social deficits are found among children with AS, both of which may be linked to impairments in joint attention. Methods: The participants in this study were four…

Excel Initiative: Excellence in Youth Programming

Directory of Open Access Journals (Sweden)

Lynne M. Borden

2015-06-01

Full Text Available The Excellence in Youth Programming (Excel Initiative strives to support youth programs in delivering high quality programs. The backbone of Excel is the Youth Development Observational Tool (YDOT which allows for the virtual assessment of program staff who work with children and youth ages 9-18 years. The YDOT also allows Excel to provide structured feedback to programs. Excel has several unique features, including a virtual platform and a focus on the relationships between adults and youth participating in after-school programs. Offering structured assessment and interaction online eliminates expenses, provides convenient access for programs around the globe, and allows for unobtrusive assessment of worker-youth interactions. Excel is also integrated into a broader network of resources, tools, and research for those working with children and youth ages 9-18.

Association between secure patient-clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study.

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Meng, Di; Palen, Ted E; Tsai, Joanne; McLeod, Melanie; Garrido, Terhilda; Qian, Heather

2015-11-09

To assess associations between secure patient-clinician email use and clinical services utilisation over time. Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient-clinician email users and non-users for utilisation 1-12 months before and 7-18 months after first email (users) or a randomly assigned index date (non-users). US integrated healthcare delivery system. 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88-237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI -0.3 to -0.1), from a mean of 4.1 calls per person 1-12 months before first use to a mean of 3.8 calls per person 7-18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI -0.2 to 0.0), from a mean of 4.2 calls per person 1-12 months before the index date to mean of 4.1 calls per person 7-18 months after the index date. Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7-18 months after first use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

Initial 2-year results of CardioCel® patch implantation in children.

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Pavy, Carine; Michielon, Guido; Robertus, Jan Lukas; Lacour-Gayet, François; Ghez, Olivier

2018-03-01

We present the initial 2-year results of CardioCel® patch (Admedus Regen Pty Ltd, Perth, WA, Australia) implantation in paediatric patients with congenital heart diseases. This was a single-centre retrospective study with prospectively collected data of all patients aged 18 years and under operated for congenital heart disease. The patch was introduced in 2014, with clinical practice committee approval and a special consent in case of an Ozaki procedure. Standard follow-up was performed with systematic clinical exams and echocardiograms. In case of reoperation or graft failure, the patch was removed and sent for a histological examination. Between March 2014 and April 2016, 101 patients had surgical repair using a CardioCel patch. The mean age was 22 (±36.3) months, and the mean weight was 9.7 (±10.3) kg. No infections and no intraoperative implantation difficulties were associated with the patch. The median follow-up period was 212 (range 4-726) days. The overall 30-day postoperative mortality was 3.8% (n = 4), none of which were related to graft failure. Five children were reoperated because of graft failure, 4 of whom had the patch implanted for aortic and were aged less than 10 days. The indications for patch implantation in the aortic position were aortopulmonary window, truncus arteriosus, coarctation and aortic arch hypoplasia repair. The median time between the first and the second operation for graft failure was 245 (range 5-480) days. Our experience shows that the patch is well tolerated in the septal, valvar and pulmonary artery positions. However, we experienced graft failures in infants in the aortic position. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Family time, parental behaviour model and the initiation of smoking and alcohol use by ten-year-old children: an epidemiological study in Kaunas, Lithuania

Directory of Open Access Journals (Sweden)

Zaborskis Apolinaras

2006-11-01

Full Text Available Abstract Background Family is considered to be the first and the most important child development and socialization bond. Nevertheless, parental behaviour model importance for the children, as well as family time for shared activity amount influence upon the child's health-related behaviour habit development has not been yet thoroughly examined. The aim of this paper is to indicate the advanced health-hazardous behaviour modelling possibilities in the families, as well as time spent for joint family activities, and to examine the importance of time spent for joint family activities for the smoking and alcohol use habit initiation among children. Methods This research was carried out in Kaunas, Lithuania, during the school year 2004–2005. The research population consisted of 369 fifth-grade schoolchildren (211 (57.2% boys and 158 (42.8% girls and 565 parents: 323 (57.2% mothers and 242 (48.2% fathers. The response rate was 80.7% for children; 96.1% and 90.6% for mothers and fathers correspondingly. Results Eating a meal together was the most frequent joint family activity, whereas visiting friends or relatives together, going for a walk, or playing sports were the most infrequent joint family activities. More than two thirds (81.5% of parents (248 (77.0% mothers and 207 (85.9% fathers (p Conclusion Joint family activity time deficit together with frequent parental examples of smoking and alcohol use underlie the development of alcohol and smoking addictions in children to some extent. The above-mentioned issues are suggested to be widely addressed in the comprehensive family health education programs.

Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM).

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Cabbage, Kathryn; Brinkley, Shara; Gray, Shelley; Alt, Mary; Cowan, Nelson; Green, Samuel; Kuo, Trudy; Hogan, Tiffany P

2017-06-12

The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of working memory in young school-age children. Working memory deficits have been identified in children with language-based learning disabilities, including dyslexia 1 , 2 and language impairment 3 , 4 , but it is not clear whether these children exhibit deficits in subcomponents of working memory, such as visuospatial or phonological working memory. The CABC-WM is administered on a desktop computer with a touchscreen interface and was specifically developed to be engaging and motivating for children. Although the long-term goal of the CABC-WM is to provide individualized working memory profiles in children, the present study focuses on the initial success and utility of the CABC-WM for measuring central executive, visuospatial, phonological loop, and binding constructs in children with typical development. Immediate next steps are to administer the CABC-WM to children with specific language impairment, dyslexia, and comorbid specific language impairment and dyslexia.

Industry self-regulation and TV advertising of foods to Australian children.

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Smithers, Lisa G; Lynch, John W; Merlin, Tracy

2014-05-01

The aim of this study is to examine the amount of non-core (unhealthy) food advertising currently on Australian television (i) during children's programmes and viewing times; (ii) since the introduction of food industry self-regulatory initiatives in 2009; and (iii) whether advertising differs according to signatory status to industry initiatives. We systematically searched PubMed, Embase.com and JSTOR (media/marketing) databases; grey literature; and reference lists of relevant articles for studies published since 2009 that reported on food advertising on Australian television. The title and abstract of 316 articles were screened, yielding 25 articles considered potentially eligible, of which eight met the pre-defined selection criteria. Meta-analysis was not possible because of temporal and methodological differences across studies. The advertising of non-core foods was found to be negligible during programmes with a C-(children's) classification but ranged from 1.5 to 6.5/h during children's peak viewing times. From 2006 to 2011, non-core food advertising decreased by 0.18 advertisements per hour every year, whereas fast food advertising increased by 0.09/h; however, these analyses are based on one study with only five time points. During children's viewing times, signatories to industry initiatives advertise non-core foods at higher rates than non-signatories. Although it is not possible to determine whether advertising has changed since the industry initiatives were introduced, signatories to the initiatives continue to advertise non-core foods at times when many children watch television. Future efforts to reduce children's exposure to food advertising should be focused on advertising during children's peak viewing times rather than by programme classifications. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Dinosaurs and fossils living without dangerous tools: Social representations of computers and the Internet by elderly Finnish and American non-users

Directory of Open Access Journals (Sweden)

Päivi Rasi (previously Hakkarainen

2014-11-01

Full Text Available This study compares the computer- and Internet-related conceptions of Finnish and American elderly people who deliberately refuse to use the Internet. It seeks to answer the following questions based on various social representations: Are there similarities and differences in the way the Finnish and American respondents classify the computer and the Internet? Are there similarities and differences in the images the Finnish and American respondents use to depict the computer and the Internet? How do the social representations of the computer and the Internet express the respondents’ distinct identities, history and culture? An analysis of written accounts provided by elderly Finnish and American people showed that both groups expressed an understanding of the computer and the Internet as a ‘Tool and Thing’ and ‘Danger’. However, differences existed between their understanding of the computer as a ‘Depriver of Freedom’ and ‘Marker of Differences’. The study concludes that their distinct identities, interests, history and culture may be some of the factors that limit their motivation and capacity to welcome and use the computer. To promote digital inclusion, the elderly should be provided with Internet-related information, training and support. At the same time, however, digital inclusion policies should also encompass a choice for Internet non-use.

More Chemotherapy May Help after Initial Treatment for Childhood Leukemia Fails

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A study suggests that at least some children diagnosed with acute lymphoblastic leukemia who respond poorly to initial chemotherapy may do better if they receive additional chemotherapy rather than a stem cell transplant.

Foreign body in children?s airways

Directory of Open Access Journals (Sweden)

Cassol Vitor

2003-01-01

Full Text Available OBJECTIVE: To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. METHOD: Time series of children who underwent bronchoscopies for foreign bodies aspirated into the airway between March 1993 and July 2002. Each patient was analyzed for age, sex, initial clinical diagnosis, nature and location of the foreign body, duration of symptoms between aspiration and bronchoscopy, radiological findings, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. RESULTS: Thirty-four children, 20 (59% boys, ages ranging from nine months to nine years (median = 23 months. In 32 (94% children the foreign body was removed by rigid bronchoscope, and two resulted in thoracotomy. Foreign bodies were more frequent in children under three years of age (66%. A clinical history of foreign body inhalation was obtained in 27 (80% cases. Most of the foreign bodies removed were organic (65% and more frequently found in the right bronchial tree (59%. Foreign bodies were removed within 24 hours in 18 (53% cases. The most frequent radiographic findings were: unilateral air trapping, atelectasis and radiopac foreign body. Major bronchoscopy complications occurred in seven children (22%, and there were no deaths. CONCLUSIONS: More attention is necessary to the respiratory symptoms of aspirations, mainly in boys at early ages, with clinical history and compatible radiological findings. Most foreign bodies removed were of organic nature. In this case series, therapeutic rigid bronchoscopy was effective with few complications.

The relationship between Plasmodium infection, anaemia and nutritional status in asymptomatic children aged under five years living in stable transmission zones in Kinshasa, Democratic Republic of Congo.

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Maketa, Vivi; Mavoko, Hypolite Muhindo; da Luz, Raquel Inocêncio; Zanga, Josué; Lubiba, Joachim; Kalonji, Albert; Lutumba, Pascal; Van Geertruyden, Jean-Pierre

2015-02-18

Malaria is preventable and treatable when recommended interventions are properly implemented. Thus, diagnosis and treatment focus on symptomatic individuals while asymptomatic Plasmodium infection (PI) plays a role in the sustainability of the transmission and may also have an impact on the morbidity of the disease in terms of anaemia, nutritional status and even cognitive development of children. The objective of this study was to assess PI prevalence and its relationship with known morbidity factors in a vulnerable but asymptomatic stratum of the population. A simple random sample, household survey in asymptomatic children under the age of five was conducted from April to September 2012 in two health areas of the health zone of Mont Ngafula 1, Kinshasa, Democratic Republic of Congo. The PI prevalence were 30.9% (95% CI: 26.5-35.9) and 14.3% (95% CI: 10.5-18.1) in Cité Pumbu and Kindele health areas, respectively, (OR: 2.7; p <0.001). All were Plasmodium falciparum infected and 4% were co-infected with Plasmodium malariae. In Cité Pumbu and Kindele, the prevalence of anaemia (haemoglobin <11 g/dL) was 61.6% (95% CI: 56.6-66.5) and 39.3% (95% CI: 34.0-44.6), respectively, (OR: 2.5; p <0.001). The health area of Cité Pumbu had 32% (95% CI: 27.5-37.0) of chronic malnutrition (HAZ score ≤ -2SD) compared to 5.1% (95% CI: 2.8-7.6) in Kindele. PI was predictor factor for anaemia (aOR: 3.5, p =0.01) and within infected children, there was an inverse relationship between parasite density and haemoglobin level (β = -5*10(-5), p <0.001). Age older than 12 months (aOR: 3.8, p = 0.01), presence of anaemia (aOR: 3.4, p =0.001), chronic malnutrition (aOR: 1.8, p = 0.01), having a single parent/guardian (aOR: 1.6, p =0.04), and the non-use of insecticide-treated nets (aOR: 1.7, p = 0.04) were all predictors for PI in the overall population. PI in asymptomatic children was correlated with anaemia and chronic malnutrition and was thus a harmful condition in the study

78 FR 13350 - Proposed Collection; Comment Request Healthy Communities Study: How Communities Shape Children's...

Science.gov (United States)

2013-02-27

... community-based initiatives; community characteristics (e.g., school environment); measurements of children... used for the development of future research initiatives targeting childhood obesity. Frequency of... Request Healthy Communities Study: How Communities Shape Children's Health (HCS) Summary: Under the...

Correlation between Colon Transit Time Test Value and Initial Maintenance Dose of Laxative in Children with Chronic Functional Constipation

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Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung; Lee, Ran

2016-01-01

Purpose To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation. PMID:27738600

Use of Predictive Text in Text Messaging over the Course of a Year and Its Relationship with Spelling, Orthographic Processing and Grammar

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Waldron, Sam; Wood, Clare; Kemp, Nenagh

2017-01-01

An investigation into the impact of predictive text use upon the literacy skills of primary school, secondary school and university cohorts was conducted over the course of a year. No differences in use of text abbreviations ("textisms") were found between predictive text users and nonusers. However, secondary school children who used…

Community-based study of Contraceptive Behaviour in Nigeria | Oye ...

African Journals Online (AJOL)

Contraceptive prevalence among sexually active respondents was 14.8% for all methods, 10.1% for modern methods and only 0.8% for emergency contraceptives. The most frequently stated reasons for non-use of contraceptives, among those who had never used any contraceptives but who did not want more children ...

78 FR 37821 - Tribal Self-Governance Program, Negotiation Cooperative Agreement, Announcement Type: New-Limited...

Science.gov (United States)

2013-06-24

... planning phase to the satisfaction of the Tribe. The planning phase must include legal and budgetary... as attachments to email messages addressed to IHS employees or offices. If an applicant receives a... workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children...

Hydroxyurea effectiveness in children and adolescents with sickle cell anemia: A large retrospective, population-based cohort.

Science.gov (United States)

Quarmyne, Maa-Ohui; Dong, Wei; Theodore, Rodney; Anand, Sonia; Barry, Vaughn; Adisa, Olufolake; Buchanan, Iris D; Bost, James; Brown, Robert C; Joiner, Clinton H; Lane, Peter A

2017-01-01

The clinical efficacy of hydroxyurea in patients with sickle cell anemia (SCA) has been well established. However, data about its clinical effectiveness in practice is limited. We evaluated the clinical effectiveness of hydroxyurea in a large pediatric population using a retrospective cohort, pre-post treatment study design to control for disease severity selection bias. The cohort included children with SCA (SS, Sβ 0 thalassemia) who received care at Children's Healthcare of Atlanta (CHOA) and who initiated hydroxyurea in 2009-2011. Children on chronic transfusions, or children with inadequate follow up data and/or children who had taken hydroxyurea in the 3 years prior were excluded. For each patient healthcare utilization, laboratory values, and clinical outcomes for the 2-year period prior to hydroxyurea initiation were compared to those 2 years after initiation. Of 211 children with SCA who initiated hydroxyurea in 2009-2011, 134 met eligibility criteria. After initiation of hydroxyurea, rates of hospitalizations, pain encounters, and emergency department visits were reduced by 47% (Hydroxyurea effectiveness was similar across gender, insurance types and age, although there was a slightly greater reduction in hospitalizations in younger children. Am. J. Hematol. 92:77-81, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

474 Science Activities for Young Children.

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Green, Moira D.

This book uses a child-initiated, whole language approach to help children have fun while exploring the world of science. The activities are divided into 23 units. Each unit begins with an "Attention Getter," the purpose of which is to introduce the unit to children in a way that grabs their attention, stimulates their interest, and creates…

Implementing Children's Human Rights Education in Schools

Science.gov (United States)

Covell, Katherine; Howe, R. Brian; McNeil, Justin K.

2010-01-01

Evaluations of a children's rights education initiative in schools in Hampshire, England--consistent with previous research findings--demonstrate the effectiveness of a framework of rights for school policy, practice, and teaching, for promoting rights-respecting attitudes and behaviors among children, and for improving the school ethos. The value…

Osteoporosis in the Women's Health Initiative: Another Treatment Gap?

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Sattari, Maryam; Cauley, Jane A; Garvan, Cynthia; Johnson, Karen C; LaMonte, Michael J; Li, Wenjun; Limacher, Marian; Manini, Todd; Sarto, Gloria E; Sullivan, Shannon D; Wactawski-Wende, Jean; Beyth, Rebecca J

2017-08-01

Osteoporotic fractures are associated with high morbidity, mortality, and cost. We performed a post hoc analysis of the Women's Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis were evaluated for medication use. A full logistic regression model was used to identify factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years. Among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, 21.6% reported taking an osteoporosis medication other than estrogen. Higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with White/Caucasian), higher income, and hormone therapy use (past or present) were associated with significantly higher likelihood of osteoporosis pharmacotherapy. Women with Black/African American race/ethnicity (compared with White/Caucasian), body mass index ≥30 (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and history of arthritis were less likely to use osteoporosis treatment. Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study. Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. Specific attention needs to be paid to

Development and Evaluation of an Educational Initiative to Improve Hospital Personnel Preparedness to Care for Children with Autism Spectrum Disorder.

Science.gov (United States)

Lucarelli, Jennifer; Welchons, Leah; Sideridis, Georgios; Sullivan, Nancy R; Chan, Eugenia; Weissman, Laura

2018-06-01

To evaluate the effectiveness of a multimodal educational curriculum on increasing hospital personnel's awareness of successful strategies and comfort in caring for children with autism spectrum disorder (ASD). We developed a 3-part training for front-line staff (i.e., front desk, clinical assistants, and phlebotomists) in 8 outpatient hospital departments frequented by patients with ASD. Following a needs assessment, participants completed an online educational module and then attended an in-person seminar tailored to each department. To evaluate training effectiveness, we administered pre-, immediate post-, and 1 month post-training surveys assessing personnel attitudes, comfort, perceived knowledge, and behaviors around caring for patients with ASD. We trained 168 staff members from 8 departments. On the needs assessment, participants (N = 129) reported a mean 2.5 behavioral incidents involving patients with ASD over the previous 3 months; 92% believed that the training would be helpful for their work. Across pre-, immediate- and 1-month post-training surveys, scores improved on all questions related to personnel attitudes about the importance of ASD-friendly care, comfort interacting with patients with ASD, perceived knowledge about ASD, and self-reported frequency of behaviors intended to help children with ASD adjust to the hospital setting (p initiative led to improvement in attitudes, comfort level, perceived knowledge, and self-reported behaviors of hospital personnel working with patients with ASD, which was maintained over 1 month.

Evacuation of Children

DEFF Research Database (Denmark)

Larusdottir, Aldis Run

is to provide new data and information on children’s evacuation, which is a step towards including children in evacuation models and calculations. Little is known about children’s evacuation characteristics in fire compared to other parts of the population. In recent years there has been more focus on children’s...... evacuation which is reflected in a rising number of publications on the topic. This thesis comprises evacuation experiments in daycares for children 0-6 years old and elementary schools for children aged 6-15 years. Full scale evacuations were filmed allowing detailed data analysis. Findings and results...... to isolate single factors and findings. Although an engineering approach fits best to the measurable parameters, the other areas are at least equally important when investigating or predicting children’s evacuation. The key findings of the thesis are: Children are very dependent on adults for initiating...

Treating Children as Individuals

Science.gov (United States)

... her own style and needs, initially because of birth order and inborn traits, and later because of experiences. ... appropriately for their child's developmental age and needs. Birth order and family size also influence your children's development. ...

Early constipation and toilet training in children with encopresis.

Science.gov (United States)

Fishman, Laurie; Rappaport, Leonard; Cousineau, Dominique; Nurko, Samuel

2002-04-01

To evaluate the frequency of predisposing factors for encopresis before and during toilet training, comparing children with primary and secondary encopresis. In this retrospective study, questionnaires from the initial evaluation at an encopresis clinic at a tertiary care pediatric hospital were reviewed for the presence or absence of factors in the first 2 years of life, for toilet training practices, and for disruptive events during the training process. Children younger than 48 months or those with organic defecation disorders were excluded. In 411 children with encopresis, the reported frequency of predisposing factors included constipation in 35%, and previous treatment for constipation in 24%. Toilet training was initiated before age 2 years in 26% and after age 3 years in 14%. Interruption of toilet training and punishment were seen more in primary encopresis than in secondary encopresis (50% versus 23%; P encopresis as was fear of the toilet (47% versus 10%; P encopresis, early difficult defecation, previous treatment for constipation, and early initiation of toilet training were less common than expected. Children with primary encopresis did not have an increased incidence of early constipation or invasive treatments compared with those with secondary encopresis. However, children with primary encopresis did have more difficult and disruptive toilet training experiences.

Helicobacter pylori infection in children.

Science.gov (United States)

Kalach, Nicolas; Bontems, Patrick; Raymond, Josette

2017-09-01

Helicobacter pylori infection in children differs from that in adults, from the point of view of epidemiology, host response, clinical features, related diseases, and diagnosis, as well as treatment strategies. The prevalence of H. pylori infection, in both children and adults, is decreasing in the Western World as well as in some developing countries, which contrasts with the increase in childhood asthma and allergic diseases. Recurrent abdominal pain is not specific during H. pylori infection in children. The role of H. pylori infection and failure to thrive, children's growth, type I diabetes mellitus (T1DM) and celiac disease remains controversial. The main initial diagnosis is based on upper digestive endoscopy with biopsy-based methods. Nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. The infection eradication control is based on validated noninvasive tests. The main cause of treatment failure of H. pylori infection is its clarithromycin resistance. We recommend standard antibiotic susceptibility testing of H. pylori in pediatric patients prior to the initiation of eradication therapy. H. pylori treatment in children should be based on an evaluation of the rate of eradication in the local population, a systematic use of a treatment adapted to the susceptibility profile and a treatment compliance greater than 90%. The last meta-analysis in children did not show an advantage for sequential therapy when compared to a 14-day triple therapy. Finally, the high rate of antibiotic resistance responsible for therapy failure in recent years justifies the necessity of a novel vaccine to prevent H. pylori infection in children. © 2017 John Wiley & Sons Ltd.

What Play Means to Us: Exploring Children's Perspectives on Play in an English Year 1 Classroom

Science.gov (United States)

Howe, Sally

2016-01-01

Opportunities for play and self-initiated activity, considered to be an important part of children's learning in early childhood settings, diminish as children progress into school. Previous studies suggest that losing time for play/self-initiated activity can impact negatively on children's attitudes to school learning. This article discusses the…

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

Science.gov (United States)

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

2015-05-01

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

A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children.

Science.gov (United States)

Morano, Milena; Rutigliano, Irene; Rago, Alfonso; Pettoello-Mantovani, Massimo; Campanozzi, Angelo

2016-10-01

In the context of a 6-mo obesity program, incorporating school- and family-based components, nutritional education, fun-type skill-learning physical activities, and exercise training, this study examined relationships among changes in nutritional status, physical fitness, and some psychosocial and behavioral treatment-related outcomes, using a before and after comparison. Eighteen obese and overweight children ages 10 to 12 y were assessed with respect to body weight, height, circumferences, skinfold thickness, and fat mass. Health-related fitness tests, and self-reported physical activity enjoyment and perceived physical ability also were administered. Health-related quality of life (HRQoL) was evaluated using the Pediatric Quality of Life Inventory; dietary habits were collected using a 7-d food diary. The WinFood software was used for the estimation of nutrient and caloric intake. After treatment, children showed decreases in body mass index z-score (P = 0.001), body fat percentage (P children, and place emphasis on directing such interventions toward improving perceived physical competence that could lead to increased exercise adherence and promotion of the health benefits associated with it. Copyright © 2016 Elsevier Inc. All rights reserved.

Langerhans cell scarcoma in two young children: Imaging findings on initial presentation and recurrence

Energy Technology Data Exchange (ETDEWEB)

Chung, Woong Do; Im, Soo Ah; Chung, Nak Gyun; Park, Gyeong Sin [Seoul St. Mary' s Hospital, Callege of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2013-06-15

Langerhans cell sarcoma (LCS) is a neoplastic proliferation of Langerhans cells with malignant cytological features and multi-organ involvement that typically has a poor prognosis. We experienced 2 cases of LCS in children less than 2 years of age and report them based primarily on CT and MR findings. Both children had findings of hepatosplenomegaly with low-attenuation nodular lesions, had multiple lymphadenopathy, and had shown recurrent lesions invading the skull during follow-up after chemotherapy.

World Federation of Pediatric Intensive Care and Critical Care Societies: Global Sepsis Initiative.

Science.gov (United States)

Kissoon, Niranjan; Carcillo, Joseph A; Espinosa, Victor; Argent, Andrew; Devictor, Denis; Madden, Maureen; Singhi, Sunit; van der Voort, Edwin; Latour, Jos

2011-09-01

According to World Health Organization estimates, sepsis accounts for 60%-80% of lost lives per year in childhood. Measures appropriate for resource-scarce and resource-abundant settings alike can reduce sepsis deaths. In this regard, the World Federation of Pediatric Intensive Care and Critical Care Societies Board of Directors announces the Global Pediatric Sepsis Initiative, a quality improvement program designed to improve quality of care for children with sepsis. To announce the global sepsis initiative; to justify some of the bundles that are included; and to show some preliminary data and encourage participation. The Global Pediatric Sepsis Initiative is developed as a Web-based education, demonstration, and pyramid bundles/checklist tool (http://www.pediatricsepsis.org or http://www.wfpiccs.org). Four health resource categories are included. Category A involves a nonindustrialized setting with mortality rate 30 of 1,000 children. Category B involves a nonindustrialized setting with mortality rate children. Category C involves a developing industrialized nation. In category D, developed industrialized nation are determined and separate accompanying administrative and clinical parameters bundles or checklist quality improvement recommendations are provided, requiring greater resources and tasks as resource allocation increased from groups A to D, respectively. In the vanguard phase, data for 361 children (category A, n = 34; category B, n = 12; category C, n = 84; category D, n = 231) were successfully entered, and quality-assurance reports were sent to the 23 participating international centers. Analysis of bundles for categories C and D showed that reduction in mortality was associated with compliance with the resuscitation (odds ratio, 0.369; 95% confidence interval, 0.188-0.724; p Initiative is online. Success in reducing pediatric mortality and morbidity, evaluated yearly as a measure of global child health care quality improvement, requires ongoing

Vaccination of School Children With Live Mumps Virus Vaccine

Science.gov (United States)

Furesz, J.; Nagler, F. P.

1970-01-01

Live, attenuated mumps virus vaccine (Mumpsvax) was administered to 146 school children 6 to 9 years of age. One child developed clinical mumps nine days after vaccination; epidemiological and serological data strongly suggest that this child had become infected before vaccination. Apart from this single instance there were no apparent clinical reactions that could be ascribed to the administration of the vaccine. Sixty-three of the 146 children with no clinical history of mumps had an initial serum neutralizing antibody titre of less than 1:2. Specific antibodies to mumps virus were detected in 93.5% of the sera of the susceptible children 28 days after vaccination, and the geometric mean antibody titre of these sera was low (1:6). Of the 80 initially seropositive children 21 (26.2%) showed a significant antibody response to the vaccine and this was influenced by the pre-existing antibody level. These data have further demonstrated the safety and efficacy of the live mumps vaccine in children. PMID:5420994

Factors Associated with Breastfeeding Initiation: A Comparison between France and French-Speaking Canada.

Directory of Open Access Journals (Sweden)

Lisa-Christine Girard

Full Text Available Breastfeeding is associated with multiple domains of health for both mothers and children. Nevertheless, breastfeeding initiation is low within certain developed countries. Furthermore, comparative studies of initiation rates using harmonised data across multiple regions is scarce.The aim of the present study was to investigate and compare individual-level determinants of breastfeeding initiation using two French-speaking cohorts.Participants included ~ 3,900 mothers enrolled in two cohort studies in Canada and France. Interviews, questionnaires, and medical records were utilised to collect information on maternal, family, and medical factors associated with breastfeeding initiation.Rates of breastfeeding initiation were similar across cohorts, slightly above 70%. Women in both Canada and France who had higher levels of maternal education, were born outside of their respective countries and who did not smoke during pregnancy were more likely to initiate breastfeeding with the cohort infant. Notably, cohort effects of maternal education at the university level were found, whereby having 'some university' was not statistically significant for mothers in France. Further, younger mothers in Canada, who delivered by caesarean section and who had previous children, had reduced odds of breastfeeding initiation. These results were not found for mothers in France.While some similar determinants were observed, programming efforts to increase breastfeeding initiation should be tailored to the characteristics of specific geographical regions which may be heavily impacted by the social, cultural and political climate of the region, in addition to individual and family level factors.

Spectral Analysis of Word-Initial Alveolar and Velar Plosives Produced by Iranian Children with Cleft Lip and Palate

Science.gov (United States)

Eshghi, Marziye; Zajac, David J.; Bijankhan, Mahmood; Shirazi, Mohsen

2013-01-01

Spectral moment analysis (SMA) was used to describe voiceless alveolar and velar stop-plosive production in Persian-speaking children with repaired cleft lip and palate (CLP). Participants included 11 children with bilateral CLP who were undergoing maxillary expansion and 20 children without any type of orofacial clefts. Four of the children with…

Parental smoking and children's attention to smoking cues

NARCIS (Netherlands)

Lochbühler, K.C.; Otten, R.; Voogd, H.F.J.M.; Engels, R.C.M.E.

2012-01-01

Research has shown that children with smoking parents are more likely to initiate smoking than children with non-smoking parents. So far, these effects have been explained through genetic factors, modelling and norm-setting processes. However, it is also possible that parental smoking affects

Sleep disorders in children with attention-deficit/hyperactivity disorder

Directory of Open Access Journals (Sweden)

Medina Permatawati

2018-03-01

Conclusion The proportion of sleep disorder in children with ADHD is relatively high, with the majority having a disorder of initiating and maintaining sleep. Children with combined type ADHD experience a higher amount of sleep disorder than those with either the inattention or hyperactive-impulsive types of ADHD. Children with poor sleep hygiene have significantly more severe sleep disorders.

[Basic and advanced resuscitation of children

DEFF Research Database (Denmark)

Lauritsen, T.L.; Jensen, Tim; Greisen, G.

2008-01-01

The ERC Guidelines 2005 regarding the resuscitation of children and neonates recommend changes in treatment algorithms. Cardiac arrest in children is most often caused or worsened by hypoxic conditions. On confirmation of cardiac arrest in a child, treatment is initiated with 5 ventilations and c...... of basic life support, i.e. before a new attempt of defibrillation Udgivelsesdato: 2008/11/17...

The Regional Asthma Disease Management Program (RADMP) for low income underserved children in rural western North Carolina: a National Asthma Control Initiative Demonstration Project.

Science.gov (United States)

Shuler, Melinda S; Yeatts, Karin B; Russell, Donald W; Trees, Amy S; Sutherland, Susan E

2015-01-01

A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI). This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management. Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month pre-intervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p < 0.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25-75 increased by 7.2%, 13.2% and 21.1%, respectively (all p < 0.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882,021. The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

Initial evaluation of children admitted on the Paediatric Intensive Care Unit

Directory of Open Access Journals (Sweden)

Esperanza Arce Delgado

2007-09-01

Full Text Available The initial evaluation of the child, when admitted on the Paediatric Intensive Unit, is a essential tool and key piece as a starting point on the development of a specific Care Plan for each child. Therefore, it is necessary the existence of a protocol, according to a rigorous methodology, so that cares will have quality and thus, it will be avoided that each nursing professional will act in a different way, according to his intuition, beliefs or improvisation capacity.The initial evaluation of the child will allow us not only to coordinate the interventions, but also to give continuity to the cares.The initial evaluation of the child document is a nursing register that is part of the clinical register of the paediatric patient. Nursing registers turn to be the best approximation of what nowadays is our job’s practice, and they are, therefore, necessary for us to be judged by a professional perspective and to make it possible to classify the services we carry out to the society.

Pre-K Physical Education: Universal Initiatives and Teacher Preparation Recommendations

Science.gov (United States)

Ross, Susan M.

2013-01-01

The "National Physical Activity Plan", as well as professional and government agencies (NASPE, 2008a; US Department of Health and Human Services, 2000) acknowledge pre-kindergarten (pre-K) children should be part of comprehensive school physical activity initiatives anchored in quality physical education programming. These…

Scintigraphic diagnosis of spiral fracture in young children

International Nuclear Information System (INIS)

Hossein-Foucher, C.; Venel, H.; Legouffe, P.; Ythier, H.; Legghe, R.; Marchandise, X.

1988-01-01

The authors report 8 cases of unsuspected bone fracture in children, identified at bone scan. Common features were the children's young age (1 to 3 years), the absence of clinical suspicion, the initially normal X-rays, the fracture type (sprial fracture of the tibia undisplaced), and the uniform of appearance the bone scan. These data confirm the value of the bone scan in limping children and suggest that spiral fracture of the tibia is a frequent and underdiagnosed condition in children [fr

Scintigraphic diagnosis of spiral fracture in young children

International Nuclear Information System (INIS)

Hossein-Foucher, C.; Venel, H.; Lecouffe, P.; Ythier, H.; Legghe, R.; Marchandise, X.

1988-01-01

8 cases of unsuspected bone fracture in children, identified at bone scan are reported. Common features were the children's young age (1 to 3 years), the absence of clinical suspicion, the initially normal X-rays, the fracture type (spiral fracture of the tibia undisplaced), and the uniform appearance of the bone scan. These data confim the value of bone scan in limping children and suggest that spiral fracture of the tibia is a frequent and underdiagnosed condition in children [fr

CT-guided percutaneous cryoablation of osteoid osteoma in children: an initial study

International Nuclear Information System (INIS)

Wu, Bin; Xiao, Yue-Yong; Zhang, Xiao; Zhao, Lei; Carrino, John A.

2011-01-01

The purpose of this study was to evaluate the safety and efficacy of CT-guided percutaneous cryoablation for osteoid osteoma in children. This study was approved by the institutional ethics committee. From January 2007 to July 2008, six children (four boys, two girls, mean age 12.6 years old) with osteoid osteoma were treated with CT-guided percutaneous cryoablation. The procedures were carried out under conscious sedation and local anesthesia. CT guidance was used for procedural planning, instrument guidance, and monitoring. An argon-based cryoablation system was used. Each cryoablation included two freezing-thawing cycles. Follow-up was performed to assess technical and clinical outcome for a minimum of 12 months. A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure, and mean VAS for the group was compared pre- and post-procedure with a t-test. The mean clinical follow-up period was 28.7 months (ranging from 18 to 36 months). Cryoablation was technically and clinically successful for all patients. No major immediate or delayed complications were observed. Significant pain relief (P <0.05) was observed in all patients after operation. Mean VAS were 6.57 ± 0.55 pre-procedure and 0.57 ± 0.10 1 month post-procedure. Patients were allowed to fully bear their weight and function without limitation within 3 days after the procedure. Pain recurrence was not observed in any patient. Percutaneous cryoablation is safe and effective for the treatment of osteoid osteomas in children. Notably, this procedure can be accomplished without general anesthesia. (orig.)

Traumatic dental injury research: on children or with children?

Science.gov (United States)

Wallace, Ann; Rogers, Helen J; Zaitoun, Halla; Rodd, Helen D; Gilchrist, Fiona; Marshman, Zoe

2017-06-01

It is widely acknowledged that children should participate in healthcare decisions, service development and even setting research agendas. Dental traumatology is a major component of paediatric dentistry practice and research. However, little is known about young patients' contribution to new knowledge in this field. The aim of the study was to establish the extent to which children are involved in contemporary dental trauma research and to evaluate the quality of the related literature. A systematic review of the dental trauma literature was conducted from 2006 to 2014. The electronic databases, MEDLINE and Scopus, were used to identify relevant studies. The selected papers were independently examined by five calibrated reviewers. Studies were categorized by the degree of children's involvement and appraised using a validated quality assessment tool. The initial search yielded 4374 papers. After application of the inclusion and exclusion criteria, only 96 studies remained. Research on children accounted for 87.5% of papers, and a proxy was involved in 4.2%. Children were engaged to some degree in only 8.3% of studies, and there were no studies where children were active research participants. In the quality assessment exercise, papers scored, on average, 57% (range = 14-86%). There is scope to encourage more active participation of children in dental trauma research in the future. Furthermore, there are some areas where the quality of research could be improved overall. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Efficiency of occlusion therapy for management of amblyopia in older children

Directory of Open Access Journals (Sweden)

Brar Gagandeep

2006-01-01

Full Text Available Materials and Methods: This was a retrospective consecutive case series analysis of children treated for amblyopia at a tertiary care center. All children received full time occlusion (FTO for the dominant eye. Results: Eighty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 20 years (9.45 ± 3.11 years. Forty-two children (47.7% had strabismic amblyopia, 37 (42.0% had anisometropic amblyopia and 9 (10.2% had a combination of strabismic and anisometropic amblyopia. Eighty out of 88 eyes (90.0% had improvement in visual acuity following FTO. Visual acuity (VA improved from 0.82 ± 0.34 at presentation to 0.42 ± 0.34 ( P < 0.001 after FTO. In children with strabismic amblyopia, VA improved from 0.81 ± 0.42 to 0.42 ± 0.39 ( P < 0.001. In children with anisometropic amblyopia, visual acuity of the amblyopic eye improved from 0.82 ± 0.24 to 0.36 ± 0.29 ( P < 0.001 following FTO. Out of 13 children older than 12 years, only 6 children (46.1% had improvement in VA. Mean follow-up after complete stoppage of occlusion was 8.37 ± 1.78 months. Conclusion: Occlusion therapy yields favorable results in strabismic and/or anisometropic amblyopia, even when initiated for the first time after 6 years of age. After 12 years of age, some children may still respond to occlusion of the dominant eye.

Use, non-use and perceived unmet needs of assistive technology among Swedish people in the third age.

Science.gov (United States)

Löfqvist, Charlotte; Slaug, Björn; Ekström, Henrik; Kylberg, Marianne; Haak, Maria

2016-01-01

To describe the most prominent use of or perceived unmet need of assistive technology (AT) and to compare the characteristics of users, non-users and those expressing perceived unmet need with respect to overall health, independence in everyday life, environmental barriers and socio-demographic features. The study is based on data collected in the "Home and Health in the Third Age Project". In all, 371 individuals participated and data were collected during home visits in southern Sweden by interviewers trained specifically for this project. The data collection comprised well-proven self-report scales and observational formats on the home environment and health indicators as well as questions about basic demographics and socio-structural data. The proportion of users constituted almost half of the total sample. The most common types of AT used were for furnishing/adaptation (35%) and the highest perceived unmet need concerned AT for communication, in total 8%. Those cohabiting were to a higher extent users of AT for furnishing/adaptation, compared to those who lived alone. A higher perceived unmet need was seen among those who lived alone compared with cohabiting people. These findings are of importance for future planning and development of policy to improve health services for the new generation of elderly. Implications for Rehabilitation In order to support the ageing process, the need for assistive technology has to be monitored in the third age. Assistive technology for furnishings and adaptation are frequently used by individuals in their third age and are important to support ageing in the home. Not only do health aspects impact the use of assistive technology, but gender, living conditions and social situation also matter - older men especially need to be monitored thoroughly according to their perceived unmet needs as well as do older persons living alone.

Development of the Indigenous Child-Initiated Pretend Play Assessment: Selection of play materials and administration.

Science.gov (United States)

Dender, Alma; Stagnitti, Karen

2011-02-01

There is a need for culturally appropriate assessments for Australian Indigenous children. This article reports the selection of culturally appropriate and gender-neutral play materials, and changes in administration identified to develop further the Indigenous Child-Initiated Pretend Play Assessment (I-ChIPPA). Twenty-three typically developing children aged four to six years from the Pilbara region in Western Australia participated in the study. Children were presented with four sets of play materials and frequency counts were recorded for each time the child used one of the play materials in a pretend play action. Twelve of the 23 children came to play in pairs. Both boys and girls used the Pilbara toy set including the dark coloured dolls and Pilbara region animals, more frequently than the standardised play materials from the Child-Initiated Pretend Play Assessment (ChIPPA). This study reports the first steps in the development of the I-ChIPPA. Future development will include the refinement of the administration and scoring with pairs of children, and then validity testing the assessment. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

Efficiency of occlusion therapy for management of amblyopia in older children.

Science.gov (United States)

Brar, Gagandeep S; Bandyopadhyay, Supratik; Kaushik, Sushmita; Raj, Surishti

2006-12-01

To analyse results of full time occlusion therapy for amblyopia in children older than 6 years. This was a retrospective consecutive case series analysis of children treated for amblyopia at a tertiary care center. All children received full time occlusion (FTO) for the dominant eye. Eighty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 20 years (9.45 +/- 3.11 years). Forty-two children (47.7%) had strabismic amblyopia, 37 (42.0%) had anisometropic amblyopia and 9 (10.2%) had a combination of strabismic and anisometropic amblyopia. Eighty out of 88 eyes (90.0%) had improvement in visual acuity following FTO. Visual acuity (VA) improved from 0.82 +/- 0.34 at presentation to 0.42 +/- 0.34 (P amblyopia, VA improved from 0.81 +/- 0.42 to 0.42 +/- 0.39 (P amblyopia, visual acuity of the amblyopic eye improved fron 0.82 +/- 0.24 to 0.36 +/- 0.29 (Pocclusion was 8.37 +/- 1.78 months. Occlusion therapy yields favorable results in strabismic and/or anisometropic amblyopia, even when initiated for the first time after 6 years of age. After 12 years of age, some children may still respond to occlusion of the dominant eye.

Demographic and Clinical Characteristics Associated with Engagement in Behavioral Health Treatment among Children with Autism Spectrum Disorders

Science.gov (United States)

Croen, Lisa A.; Shankute, Naomi; Davignon, Meghan; Massolo, Maria L.; Yoshida, Cathleen

2017-01-01

This study investigates demographic and clinical factors associated with initiation, continuation, and adherence to behavioral health treatment (BHT) among children with autism spectrum disorder. Among 293 insured children referred for applied behavior analysis (ABA) based BHT, 23% never initiated treatment. Among those initiating treatment, 31%…

Research Paper Xhosa male initiation: Freedom of choice versus ...

African Journals Online (AJOL)

Conclusion: Questions were raised regarding the role of children and women in general in a patriarchal society. As an example of culture and religion as influencing factors in a group's reality, Xhosa male initiation was discussed. These arguments call for the raising of questions and identifying themes and discourse in the ...

OPTICA: Our Path Together Initiating Cultural Access. Final Report.

Science.gov (United States)

Jackson, Susan, Comp.

This final report describes the activities and outcomes of OPTICA (Our Path Together Initiating Cultural Access) programs. For each program an information sheet indicates the goal, total participation, status of the goal, and activities of the program. Programs included: (1) Hands On: ASL Creative Story Telling, a program that used children's…

Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

Science.gov (United States)

Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

2017-10-27

Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

CT evaluation of severe renal inflammatory disease in children

International Nuclear Information System (INIS)

Montgomery, P.; Kuhn, J.P.; Afshani, E.

1987-01-01

We have performed CT scans on 15 children and 2 young adults with severe renal inflammatory disease. Most children with urinary tract infections do not require such evaluation. We have, however, found CT helpful in defining the nature of renal abnormality and in defining the extent of disease in selected patients who either presented as diagnostic dilemmas or who did not respond initially to proper medical treatment. We therefore use CT scanning as our initial examination in such problem patients. (orig.)

Test-Enhanced Learning in Third-Grade Children

Science.gov (United States)

Jaeger, Antonio; Eisenkraemer, Raquel Eloísa; Stein, Lilian Milnitsky

2015-01-01

Several recent studies have shown that retrieval is more efficient than restudy in enhancing the long-term retention of memories. However, studies investigating this effect in children are still rare. Here, we report an experiment in which third-grade children initially read a brief encyclopaedic text twice and then either performed a cued recall…

Maternal identification of dental caries lesions in their children aged 1-3 years.

Science.gov (United States)

Fernandes, I B; Sá-Pinto, A C; Silva Marques, L; Ramos-Jorge, J; Ramos-Jorge, M L

2017-06-01

To analyse the maternal identification of different stages of dental caries in children aged 1-3 years. A cross-sectional study was conducted with 274 children and their mothers. The mothers answered a questionnaire on the occurrence of dental caries in their children and completed questions addressing their demographic/socio-economic status. The oral examination of the children was performed using the International Caries Detection and Assessment System. Descriptive, Chi square test and Poisson regression statistical analyses were performed. The prevalence of initial and established/severe dental caries lesions by age were: 1 year (23.2 and 24.2%), 2 years (17.9 and 55.7%) and 3 years (23.3 and 60.3%) respectively. Significant associations between clinical examinations and the mothers' reports were observed among children aged 1 year old who had initial stage caries lesions (p = 0.006) and in children aged 1, 2 and 3 years old who had established/severe stage caries lesions (p dental caries both at initial (PR 4.01, 95% CI 1.35-11.94) and established/severe stages (PR 9.14, 95% CI 2.49-33.56) in children aged 1 year old. In children aged 2 and 3 years, this identification was more evident in the established/severe stage (2 years, PR 2.98, 95% CI 1.42-6.26; 3 years, PR 2.75, 95% CI 1.09-6.93). Mothers of children aged 1 year old identified dental caries at initial and established/severe stages. Mothers of children aged 2 and 3 years identified dental caries only at established/severe stages.

Acute meningococcal disease in children and adolescents

DEFF Research Database (Denmark)

Nygaard, Ulrikka; Vissing, Nadja Hawwa; Steensen, Morten

2017-01-01

Meningococcal disease is a rapidly progressing infection, which continues to cause deaths among children and adolescents. In this review, clinical signs and initial treatment of acute childhood meningococcal disease is described. Operational flow charts have been developed for assessment of non......-blanching rash and initial treatment of meningococcal disease....

Serum albumin level predicts initial intravenous immunoglobulin treatment failure in Kawasaki disease.

Science.gov (United States)

Kuo, Ho-Chang; Liang, Chi-Di; Wang, Chih-Lu; Yu, Hong-Ren; Hwang, Kao-Pin; Yang, Kuender D

2010-10-01

Kawasaki disease (KD) is a systemic vasculitis primarily affecting children who are initial IVIG treatment. This study was conducted to investigate the risk factors for initial IVIG treatment failure in KD. Children who met KD diagnosis criteria and were admitted for IVIG treatment were retrospectively enrolled for analysis. Patients were divided into IVIG-responsive and IVIG-resistant groups. Initial laboratory data before IVIG treatment were collected for analysis. A total of 131 patients were enrolled during the study period. At 48 h after completion of initial IVIG treatment, 20 patients (15.3%) had an elevated body temperature. Univariate analysis showed that patients who had initial findings of high neutrophil count, abnormal liver function, low serum albumin level (≤2.9 g/dL) and pericardial effusion were at risk for IVIG treatment failure. Multivariate analysis with a logistic regression procedure showed that serum albumin level was considered the independent predicting factor of IVIG resistance in patients with KD (p = 0.006, OR = 40, 95% CI: 52.8-562). There was no significant correlation between age, gender, fever duration before IVIG treatment, haemoglobin level, total leucocyte and platelet counts, C-reactive protein level, or sterile pyuria and initial IVIG treatment failure. The specificity and sensitivity for prediction of IVIG treatment failure in this study were 96% and 34%, respectively. Pre-IVIG treatment serum albumin levels are a useful predictor of IVIG resistance in patients with KD. © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

Guardian availability in children evaluated in the emergency department for blunt head trauma.

Science.gov (United States)

Holmes, James F; Holubkov, Richard; Kuppermann, Nathan

2009-01-01

Enrolling children in research studies in the emergency department (ED) is typically dependent on the presence of a guardian to provide written informed consent. The objectives were to determine the rate of guardian availability during the initial ED evaluation of children with nontrivial blunt head trauma, to identify the reasons why a guardian is unavailable, and to compare clinical factors in patients with and without a guardian present during initial ED evaluation. This was a prospective study of children (guardian during the initial ED evaluation. For those children for whom the guardian was not available during the initial ED evaluation, the physicians completing the data forms documented the reasons for the absence. The authors enrolled 602 patients, of whom 271 (45%, 95% confidence interval [CI] = 41% to 49%) did not have a guardian available during the initial ED evaluation. In these 271 patients, 261 had reasons documented for lack of guardian availability, 43 of whom had multiple reasons. The most common of these was that the guardian did not ride in the ambulance (51%). Those patients without a guardian available were more likely to be older (mean age, 11.4 years vs. 7.6 years; p guardian presence. Nearly one-half of children with nontrivial blunt head trauma evaluated in the ED may not have a guardian available during their initial ED evaluation. Patients whose guardians are not available at the time of initial ED evaluation are older and have more severe mechanisms of injury and more serious head trauma. ED research studies of pediatric trauma patients that require written informed consent from a guardian at the time of initial ED evaluation and treatment may have difficulty enrolling targeted sample size numbers and will likely be limited by enrollment bias.

A qualitative analysis of the barriers to antiretroviral therapy initiation ...

African Journals Online (AJOL)

A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland. Charisse V Ahmed, Pauline Jolly, Luz Padilla, Musa Malinga, Chantal Harris, Nobuhle Mthethwa, Inessa Ba, Amy Styles, Sarah Perry, Raina Brooks, Florence Naluyinda-Kitabire, Makhosini Mamba, ...

Switching Between Antibiotics Among Danish Children 0-4 Years of Age

DEFF Research Database (Denmark)

Reilev, Mette; Thomsen, Reimar W; Aabenhus, Rune

2018-01-01

BACKGROUND: In Denmark, the use of amoxicillin is widespread among children, despite phenoxymethylpenicillin being recommended as first-line therapy. The reason for this apparent discrepancy is not fully understood. We aimed at evaluating prescribing patterns of antibiotics among Danish children...... aged 0-4 years, with emphasis on incidence of treatment episodes, choice of initial antibiotic treatment and switching patterns between different types of antibiotics. METHODS: We identified all children ≤4 years who filled a prescription of antibiotics from 2000-2015 according to the nationwide Danish...... National Prescription Registry. We estimated the incidence rate of episodes treated with antibiotics and the choice of initial antibiotic treatment over time. Further, we assessed the cumulative risk of switching within 0-3 days after initiating therapy. RESULTS: We identified 3,481,684 antibiotic...

Hematogenous osteomyelitis in children

DEFF Research Database (Denmark)

Rud, B; Halken, S; Damholt, V

1986-01-01

approach. At follow-up after 5 (1-12) years, 3 neonates had developed severe growth disturbances despite optimal initial treatment. Acceptable results were obtained with antibiotic therapy for 6 weeks or more. We recommend ampicillin and a penicillinase-resistant penicillin, unless bacterial resistance......In a 10-year period, 31 children, including 9 infants, were treated for hematogenous osteomyelitis. Fifteen children were treated closed and 16 open. Thirteen of 14 positive cultures were Staphylococcus aureus. Three recurrences could possibly have been prevented by a more aggressive primary...

Poor quality of life among untreated Thai and Cambodian children without severe HIV symptoms.

Science.gov (United States)

Bunupuradah, Torsak; Puthanakit, Thanyawee; Kosalaraksa, Pope; Kerr, Stephen J; Kariminia, Azar; Hansudewechakul, Rawiwan; Kanjanavanit, Suparat; Ngampiyaskul, Chaiwat; Wongsawat, Jurai; Luesomboon, Wicharn; Chuenyam, Theshinee; Vonthanak, Saphonn; Vun, Mean Chhi; Vibol, Ung; Vannary, Bun; Ruxrungtham, Kiat; Ananworanich, Jintanat

2012-01-01

There are limited data on quality of life (QOL) 1 in untreated HIV-infected children who do not have severe HIV symptoms. Moreover, such data do not exist for Asian children. Poor QOL could be a factor in deciding if antiretroviral therapy (ART) should be initiated. Thai and Cambodian children (n=294), aged 1-11 years, naïve to ART, with mild to moderate HIV symptoms and CD4 15-24% were enrolled. Their caregivers completed the Pediatric AIDS Clinical Trials Group QOL questionnaire prior to ART commencement. Six QOL domains were assessed using transformed scores that ranged from 0 to 100. Higher QOL scores indicated better health. Mean age was 6.1 (SD 2.8) years, mean CD4 was 723 (SD 369) cells/mm(3), 57% was female, and%CDC N:A:B was 2:63:35%. One-third knew their HIV diagnosis. Mean (SD) scores were 69.9 (17.6) for health perception, 64.5 (16.2) for physical resilience, 84.2 (15.6) for physical functioning, 77.9 (16.3) for psychosocial well-being, 74.7 (28.7) for social and role functioning, 90.0 (12.1) for health care utilization, and 87.4 (11.3) for symptoms domains. Children with CD4 counts above the 2008 World Health Organization (WHO) ART-initiation criteria (n=53) had higher scores in health perception and health care utilization than those with lower CD4 values. Younger children had poorer QOL than older children despite having similar mean CD4%. In conclusion, untreated Asian children without severe HIV symptoms had relatively low QOL scores compared to published reports in Western countries. Therapy initiation criteria by the WHO identified children with lower QOL scores to start ART; however, children who did not fit ART-initiation criteria and those who were younger also displayed poor QOL. QOL assessment should be considered in untreated children to inform decisions about when to initiate ART.

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

Science.gov (United States)

Buller, Y; Sims, C

2016-01-01

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

The School Meals Initiative Implementation Study. First Year Report.

Science.gov (United States)

Abraham, Sameer; Chattopadhyay, Manas; Sullivan, Colleen; Mallory, Larry; Steiger, Darby Miller; Daft, Lynn; Arcos, Alyssa; Wilbraham, Brooke

This report, authorized by the Food and Nutrition Service of the U.S. Department of Agriculture, contains information on the School Meals Initiative for Healthy Children (SMI), a reform of school-meals programs aimed at upgrading the nutritional content of school meals. The purpose of the study was to describe and evaluate: (1) overall…

Parental practice of child car safety in Enugu, Southeast Nigeria

Directory of Open Access Journals (Sweden)

Ndu KI

2016-11-01

Full Text Available KI Ndu,1,* U Ekwochi,1,* DC Osuorah,2,* OC Ifediora,3 FO Amadi,1 IN Asinobi,1 OW Okenwa,1 JC Orjioke,1 FN Ogbuka,1 TO Ulasi4 1Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria; 2Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia; 3Griffiths University Medical School, Gold Coast, QLD, Australia; 4Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria *These authors contributed equally to this work Abstract: Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=–0.121, P=0.310. Only respondent’s use of seat belt during driving (P=0.001 and having being cautioned for non-use of CCRs (P=0.005 maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%; restraints not being important, 53 (26%, and restraints being too expensive, 32 (15%. Similarly, for irregular users, exceptions for non-use included the child being asleep (29%, inadequate number of CCRs (22%, and the child being sick (18

Caregiver Preferences Regarding Personal Health Records in the Management of ADHD.

Science.gov (United States)

Ronis, Sarah D; Baldwin, Constance D; McIntosh, Scott; McConnochie, Kenneth; Szilagyi, Peter G; Dolan, James

2015-07-01

Personal health records (PHRs) may address the needs of children with attention deficit hyperactivity disorder. Among parents, we assessed acceptance, barriers, and intentions regarding use of PHR for their children with attention deficit hyperactivity disorder. Survey of parents from 3 practices in Rochester, NY. Stepwise logistic regression analysis explored factors predicting respondents' intentions for future use of PHR, accounting for care coordination needs, caregiver education, socioeconomic status, and satisfaction with providers. Of 184 respondents, 23% had used the PHR for their child, 82% intended future use. No difference was observed between users and nonusers regarding gender, age, race, or education. Users were more likely than nonusers to reside in the suburbs (P = .03). Caregivers were more likely to plan future use of the PHR if they felt engaged as partners in their child's care (adjusted odds ratio = 2.3, 95% confidence interval = 1.2, 4.5). Parents are enthusiastic about PHRs. Future work should focus on engaging them as members of the health care team. © The Author(s) 2015.

Can children with sickle cell disease undergo open splenectomy ...

African Journals Online (AJOL)

We report three children with sickle cell anaemia presenting with chronic massive splenomegaly and hypersplenism. The children were initially denied surgery because of extremely low haemoglobin levels and the inefficacy of transfusion. Subsequently, they underwent successful open abdominal splenectomy without any ...

Inculcating the ergonomic culture in developing countries: national healthy schoolbag initiative in Sri Lanka.

Science.gov (United States)

Jayaratne, Kapila

2012-12-01

The aim of this article is to describe a survey on ergonomic factors of classroom environments of school children, their influence on health, and use of research outcomes to launch a healthy schoolbag initiative. Ergonomics have not yet well penetrated relevant fields in industrially developing countries, such as Sri Lanka. One of the crucial parameters of the school environment is ergonomics. Available evidence suggests ergonomic mismatches in classroom settings. Good practice examples in child ergonomic interventions are few in resource-poor contexts. A school-based cross-sectional study was conducted in a district in Sri Lanka with a sample of 1,607 children in Grades 6 to 8 with the use of a stratified multistage cluster sampling method. Many children did experience discomfort related to substandard seating arrangements in the classroom. A significant proportion had to turn their necks to see the blackboard. For many children, seating locations were not changed. There were widespread incompatibilities of classroom furniture with anthropometric dimensions of children. A majority of children perceived discomfort contributed by mismatched classroom furniture. Carriage of school materials was not healthy. Deficiencies were noted in weight, model, ergonomic features, and carrying behavior of bags. Children experienced several negative effects, in part attributable to mismatched ergonomic factors. The schoolbag was considered a priority issue. Findings were disseminated to stakeholders and to media. Solutions were contemplated on bag weight reduction, healthy schoolbag introduction, and behavior change in a collaborative initiative with the Education Ministry. Political, administrative, and business stakeholders were successfully engaged to inculcate an ergonomic culture in an industrially developing country.

The Development of Enemy Images in Dutch Children: Measurement and Initial Findings

Science.gov (United States)

Oppenheimer, Louis

2005-01-01

While there is ample evidence that enemies and enemy images are prerequisites in preparedness for war, little information is available about children's understanding of enemies or the presence of enemy images. Based on a pilot study in which assessment instruments were developed and validated, the present study examined the understanding of…

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

BNCT for malignant brain tumors in children

International Nuclear Information System (INIS)

Kageji, T.; Mizobuchi, Y.; Nagahiro, S.; Nakagawa, Y.; Kumada, Hiroaki

2006-01-01

BSH-based intra-operative BNCT as an initial treatment underwent in 4 children with malignant brain tumors since 1998. There were 2 glioblastomas, one primitive neuroectodermal tumor (PNET) and one anaplastic ependymoma patient. They included two children under 3-year-old. All GBM patients were died of CSF dissemination without tumor regrowth in the primary site. Another PNET and anaplastic ependymoma patients are still alive without tumor recurrence. We can consider BNCT is optimal treatment modality for malignant brain tumor in children. (author)

The Engineering 4 Health Challenge - an interdisciplinary and intercultural initiative to foster student engagement in B.C. and improve health care for children in under-serviced communities.

Science.gov (United States)

Price, Morgan; Weber-Jahnke, Jens H

2009-01-01

This paper describes the Engineering 4 Health (E4H) Challenge, an interdisciplinary and intercultural initiative that, on the one hand, seeks to improve health education of children in under-serviced communities and, on the other, seeks to attract students in British Columbia to professions in engineering and health. The E4H Challenge engages high school and university students in BC to cooperatively design and develop health information and communication technology (ICT) to educate children living in under-serviced communities. The E4H Challenge works with the One Laptop Per Child (OLPC) program to integrate applications for health awareness into the school programs of communities in developing countries. Although applications developed by the E4H Challenge use the low-cost, innovative XO laptop (the "$100 laptop" developed by the OLPC foundation) the software can also be used with other inexpensive hardware.

The Adolescent-Parent Career Congruence Scale: Development and Initial Validation

Science.gov (United States)

Sawitri, Dian R.; Creed, Peter A.; Zimmer-Gembeck, Melanie J.

2013-01-01

Although there is a growing interest in the discrepancy between parents and their adolescent children in relation to career expectations, there is no existing, psychometrically sound scale that directly measures adolescent-parent career congruence or incongruence. This study reports the development and initial validation of the Adolescent-Parent…

WHO European Childhood Obesity Surveillance Initiative: impact of type of clothing worn during anthropometric measurements and timing of the survey on weight and body mass index outcome measures in 6–9-year-old children

NARCIS (Netherlands)

Wijnhoven, T.M.A.; Raaij, van J.M.A.; Spinelli, A.; Yngve, Agneta; Lissner, L.; Spiroski, I.; Farrugia Sant Angelo, V.; Pérez-Farinós, Napoleon; Martos, E.; Heinen, M.; Kunesova, M.; Rito, A.I.; Hovengen, R.; Starc, G.; Duleva, Vesselka; Pudule, I.; Petrauskiene, Ausra; Braeckevelt, L.; Hassapidou, M.; Breda, João; Veer, van 't P.

2016-01-01

The World Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other

Kinematic analysis of jaw function in children following traumatic brain injury.

Science.gov (United States)

Loh, E W L; Goozée, J V; Murdoch, B E

2005-07-01

To investigate jaw movements in children following traumatic brain injury (TBI) during speech using electromagnetic articulography (EMA). Jaw movements of two non-dysarthric children (aged 12.75 and 13.08 years) who had sustained a TBI were recorded using the AG-100 EMA system (Carstens Medizineletronik) during word-initial consonant productions. Mean quantitative kinematic parameters and coefficient of variation (variability) values were calculated and individually compared to the mean values obtained by a group of six control children (mean age 12.57 years, SD 1.52). The two children with TBI exhibited word-initial consonant jaw movement durations that were comparable to the control children, with sub-clinical reductions in speed being offset by reduced distances. Differences were observed between the two children in jaw kinematic variability, with one child exhibiting increased variability, while the other child demonstrated reduced or comparable variability compared to the control group. Possible sub-clinical impairments of jaw movement for speech were exhibited by two children who had sustained a TBI, providing insight into the consequences of TBI on speech motor control development.

Corporal punishment and the growth trajectory of children's antisocial behavior.

Science.gov (United States)

Grogan-Kaylor, Andrew

2005-08-01

Despite considerable research, the relationship between corporal punishment and antisocial behavior is unclear. This analysis examined (a) the functional form of this relationship, (b) the correlation of initial antisocial behavior and changes in antisocial behavior, (c) differences in the relationship of corporal punishment and antisocial behavior by race, and (d) whether this relationship could be accounted for by unmeasured characteristics of children and their families. Data from 6,912 children in the National Longitudinal Survey of Youth were analyzed using hierarchical linear models. Findings suggested that corporal punishment has a relationship with children's initial antisocial behavior and with changes in antisocial behavior. No evidence was found for differences in the effect of corporal punishment across racial groups. The relationship between corporal punishment and antisocial behavior persists even when accounting for unmeasured time invariant characteristics of children and families. The findings suggest that corporal punishment is not a preferable technique for disciplining children.

The young and adolescents: Initiating change in children’s eating behavior

Science.gov (United States)

Limited success in existing interventions for initiating dietary behavior change among children is forcing a more detailed analysis of how to promote change. The mediating variable model provides a conceptual framework for understanding how behavior change interventions work and integrates more basi...

Factors affecting the survival of HIV-infected children after ART ...

African Journals Online (AJOL)

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Factors affecting the survival of HIV-infected children after. ART initiation ... balance between treating the disease and maintaining quality of life must be weighed carefully. An evaluation .... children were forced to work in early life, especially in.

Teaching Traumatic History to Young Children: The Case of Holocaust Studies in Israeli Kindergartens

Science.gov (United States)

Ziv, Yair; Golden, Deborah; Goldberg, Tsafrir

2015-01-01

Recently, the Israeli Ministry of Education initiated a mandatory nationwide curriculum for Jewish kindergarten children focusing on the study of the Holocaust. This initiative raises general questions regarding the inclusion of sensitive historical issues in curricula for young children. In this article, we use the new Holocaust curriculum as an…

Initiative Games in Physical Education: A Practical Approach for Teaching Critical Thinking Skills--Part 1

Science.gov (United States)

Maina, Michael P.; Maina, Julie Schlegel; Hunt, Kevin

2016-01-01

As teachers prepare children for the future, the need for developing critical thinking skills in students becomes clearly evident. One way to promote this process is through initiative games. Initiative games are clearly defined problems that a group must find a solution to through cooperation, physical effort and cognitive functioning. The…

Renin-angiotensin II-aldosterone system blockers and time to renal replacement therapy in children with CKD.

Science.gov (United States)

Abraham, Alison G; Betoko, Aisha; Fadrowski, Jeffrey J; Pierce, Christopher; Furth, Susan L; Warady, Bradley A; Muñoz, Alvaro

2017-04-01

Clinical care decisions to treat chronic kidney disease (CKD) in a growing child must often be made without the benefit of evidence from clinical trials. We used observational data from the Chronic Kidney Disease in Children cohort to estimate the effectiveness of renin-angiotensin II-aldosterone system blockade (RAAS) to delay renal replacement therapy (RRT) in children with CKD. A total of 851 participants (median age: 11 years, median glomerular filtration rate [GFR]: 52 ml/min/1.73 m 2 , median urine protein to creatinine ratio: 0.35 mg/mg) were included. RAAS use was reported at annual study visits. Both Cox proportional hazards models with time-varying RAAS exposure and Cox marginal structural models (MSM) were used to evaluate the effect of RAAS use on time to RRT. Analyses were adjusted or weighted to control for age, male sex, glomerular diagnosis, GFR, nephrotic range proteinuria, anemia, elevated blood pressure, acidosis, elevated phosphate and elevated potassium. There were 217 RRT events over a 4.1-year median follow-up. At baseline, 472 children (55 %) were prevalent RAAS users, who were more likely to be older, have a glomerular etiology, have higher urine protein, be anemic, have elevated serum phosphate and potassium, take more medications, but less likely to have elevated blood pressure, compared with non-users. RAAS use was found to reduce the risk of RRT by 21 % (hazard ratio: 0.79) to 37 % (hazard ratio: 0.63) from standard regression adjustment and MSM models, respectively. These results support inferences from adult studies of a substantial benefit of RAAS use in pediatric CKD patients.

Comparison of Initial Response of Nebulized Salbutamol and Adrenaline in Infants and young Children Admitted with Acute Bronchiolitis.

Science.gov (United States)

Adhikari, S; Thapa, P; Rao, K S; Bk, G

2016-01-01

Background Acute bronchiolitis is common cause of hospitalization in infants and young children. There are widespread variations in the diagnosis and management. Despite the use of bronchodilators for decades, there is lack of consensus for the benefit of one above another. Objective To compare initial response of nebulized adrenaline and salbutamol. Method Children aged two months to two years admitted with acute bronchiolitis in the department of Paediatrics of Manipal teaching hospital, Pokhara, Nepal, from 1st March 2014 to 28th February 2015 were enrolled. Patients fulfilling inclusion criteria received either adrenaline or salbutamol nebulization. Data were collected in a predesigned proforma. Respiratory distress assessment instrument (RDAI) scores were considered primary outcome measure and respiratory rate at 48 hours, duration of hospital stay, requirement of supplemental oxygen and intravenous fluid were considered secondary outcome measure. Result A total of 40 patients were enrolled in each study group. Mean RDAI scores at admission was in 9.75 with (CI- 9.01, 10.49) in adrenaline and 9.77 (CI- 9.05, 10.50) in salbutamol group. There was gradual decline in mean RDAI scores in both the groups over 48 hours to 4.15 (CI- 3.57,4.73) and 4.13 (CI- 3.69,4.56) in adrenaline and salbutamol group respectively. Hospital stay was 5.32 days in adrenaline and 5.68 days in salbutamol group. Patients nebulized with adrenaline required oxygen for 33.30 hours compared with 36.45 hours in salbutamol. Intravenous fluid duration was also less in adrenaline group compared to salbutamol group (33.15 vs 37.80 hours). Conclusion Patients of acute bronchiolitis nebulized with either salbutamol or adrenaline experienced similar decline in RDAI scores in the first 48 hours. Duration of supplementary oxygen and intravenous fluid was less in adrenaline group compared with salbutamol group.

The Tobacco Industry and Children's Rights.

Science.gov (United States)

van der Eijk, Yvette; Bialous, Stella A; Glantz, Stanton

2018-05-01

The manufacture, use, and marketing of tobacco present a serious threat to children's right to health. This makes the Convention on the Rights of the Child a potentially powerful tobacco-control tool and the United Nations Children's Fund (UNICEF), which oversees the convention's implementation, a potential leader in tobacco control. UNICEF actively supported tobacco control initiatives in the late 1990s, but since the early 2000s UNICEF's role in tobacco control has been minimal. Using the Truth Tobacco Industry Documents library, an online collection of previously secret tobacco industry documents, we sought to uncover information on the tobacco industry's ties with UNICEF. We found that from 1997 to 2000, when UNICEF was actively promoting tobacco control to support children's rights, the tobacco industry saw children's rights and UNICEF as potentially powerful threats to business that needed to be closely monitored and neutralized. The industry then positioned itself as a partner with UNICEF on youth smoking prevention initiatives as a way to avoid meaningful tobacco control measures that could save children's lives. After UNICEF's corporate engagement guidelines were loosened in 2003, tobacco companies successfully engaged with UNICEF directly and via front groups, including the Eliminating Child Labour in Tobacco Growing Foundation. This was part of an overall tobacco industry strategy to improve its corporate image, infiltrate the United Nations, and weaken global tobacco-control efforts. As part of its mission to protect children's rights, UNICEF should end all partnerships with the tobacco industry and its front groups. Copyright © 2018 by the American Academy of Pediatrics.

Active versus Passive Screen Time for Young Children

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Sweetser, Penelope; Johnson, Daniel; Ozdowska, Anne; Wyeth, Peta

2012-01-01

In this paper we report some initial findings from our investigations into the Australian Government's Longitudinal Study of Australian Children dataset. It is revealed that the majority of Australian children are exceeding the government's Screen Time recommendations and that most of their screen time is spent as TV viewing, as opposed to video…

How Much Do Mothers Love Their Children?

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Cameron, Paul

A total of 225 mothers, ages 19 to 64, were asked how they felt about their children (N=309): (1) upon knowledge of pregnancy, (2) at the quickening, (3) at birth, and (4) at the time of the interview. Results contradict some of the rationale behind the current liberalized abortion arguments by showing that initially unwanted children are loved as…

Intellectual development in preschool children with early treated congenital hypothyroidism.

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Seo, Min Kyoung; Yoon, Jong Seo; So, Chul Hwan; Lee, Hae Sang; Hwang, Jin Soon

2017-06-01

Delayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH. We retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence. The patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ) of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76-126). None had intellectual disability (defined as an IQ scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis. IQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

Can simple mobile phone applications provide reliable counts of respiratory rates in sick infants and children? An initial evaluation of three new applications.

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Black, James; Gerdtz, Marie; Nicholson, Pat; Crellin, Dianne; Browning, Laura; Simpson, Julie; Bell, Lauren; Santamaria, Nick

2015-05-01

Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates. The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants. Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants. There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the

Associations Between Peer Counseling and Breastfeeding Initiation and Duration: An Analysis of Minnesota Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

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McCoy, Marcia Burton; Geppert, Joni; Dech, Linda; Richardson, Michaela

2018-01-01

Background Peer counseling (PC) has been associated with increased breastfeeding initiation and duration, but few analyses have examined the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) model for peer counseling or the continuation of breastfeeding from birth through 12 months postpartum. Objectives Identify associations between Minnesota WIC Peer Breastfeeding Support Program services and breastfeeding initiation and continuation. Methods Retrospective analysis of observational data from the Minnesota WIC program's administrative database of women who gave birth in 2012 and accepted a PC program referral prenatally (n = 2219). Multivariate logistic regression and Cox regression models examined associations between peer services and breastfeeding initiation and continuation of any breastfeeding. Results Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19-2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33-0.61; months two through twelve: 0.33; 95% CI 0.18-0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother's country of origin. Conclusion for practice Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.

The pediatric studies initiative: after 15 years have we reached the limits of the law?

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Milne, Christopher-Paul; Davis, Jonathan

2014-02-01

Despite considerable disincentives for conducting drug studies in children, 15 years ago the Food and Drug Administration, pediatric health advocates and congressional sponsors created a carrot-and-stick policy approach of voluntary and mandatory programs to encourage the pharmaceutical industry to include children in the drug development process. After several rounds of reauthorization of the laws on a temporary basis, the enabling statutes have been made permanent. The purpose of this analysis is to review the advances that resulted from the law and the areas where further progress is needed. A brief review of the history and results of the pediatric studies initiative was conducted by the authors and a determination made about the accomplishments of the law and remaining challenges. Indicators of the changes that resulted from this pediatric studies initiative are both indirect, such as the increase in the number of indication supplements for new populations, and direct, such as the decrease in the percentage of medicines used off-label in children. Although the pediatric studies initiative has significantly improved therapeutic options for children, concern still exists that drug companies are reluctant to include children in drug development unless continuously incentivized, whether positively or negatively. Two challenges are particularly problematic: neonatal studies and child-friendly formulations. Although the latest round of legislation should provide opportunities to address these problems, significantly more effort will be needed to achieve real culture change. Ultimately, the solution will require full program implementation by the Food and Drug Administration and close collaboration by many key stakeholders to ensure that pediatric studies become a routine part of the drug development process. © 2013 Elsevier HS Journals, Inc. All rights reserved.

Young Children's Understanding of Conflicting Mental Representation Predicts Suggestibility.

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Welch-Ross, Melissa K.; And Others

1997-01-01

Examined the relation between developmental suggestibility effects and preschoolers' emerging ability to reason about conflicting mental representations. Subjects were 42 three- to five-year-olds. Found in the children significant initial encoding and ability to retrieve event details. Also found an integration between children's theory of mind…

Clinical characteristics of central diabetes insipidus in Taiwanese children

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Shih-Yao Liu

2013-10-01

Conclusion: Because a delayed diagnosis of CDI is common in Taiwanese children, a high index of suspicion is important. The underlying etiology of CDI in children may not initially be obvious. Long-term surveillance is therefore necessary, especially for the early detection of evolving treatable intracranial lesions.

Effect of provider-initiated testing and counselling and integration of ART services on access to HIV diagnosis and treatment for children in Lilongwe, Malawi: a pre- post comparison

Directory of Open Access Journals (Sweden)

Phiri Sam

2009-12-01

Full Text Available Abstract Background The HIV prevalence in Malawi is 12% and Kamuzu Central Hospital (KCH, in the capital Lilongwe, is the main provider of adult and paediatric HIV services in the central region. The Lighthouse at KCH offers opt-in HIV testing and counselling (HTC for adults and children. In June 2004, Lighthouse was the first clinic to provide free antiretroviral treatment (ART in the public sector, but few children accessed the services. In response, provider-initiated HIV testing and counselling (PITC and an ART clinic were introduced at the paediatric department at KCH in Quarter 4 (Q4 2004. Methods We analysed prospectively collected, aggregated data of quarterly reports from Q1 2003 to Q4 2006 from HTC centre registers, ART registers and clinic registrations at the ART clinics of both Lighthouse and the paediatric department. By comparing data of both facilities before (Q1 2003 to Q3 2004, and after the introduction of the services at the paediatric department (Q4 2004 to Q4 2006, we assessed the effect of this intervention on the uptake of HIV services for children at KCH. Results Overall, 3971 children were tested for HIV, 2428 HIV-infected children were registered for care and 1218 started ART. Between the two periods, the median (IQR number of children being tested, registered and starting ART per quarter rose from 101 (53-109 to 358 (318-440, 56 (50-82 to 226 (192-234 and 18 (8-23 to 139 (115-150, respectively. The median proportion of tested clients per quarter that were children rose from 3.8% (2.7-4.3 to 9.6% (8.8 to 10.0 (p = 0.0009 and the proportion of ART starters that were children rose from 6.9% (4.9-9.3 to 21.1% (19.2-24.2 (p = 0.0036. The proportion of registered children and adults starting ART each quarter increased similarly, from 26% to 53%, and 20% to 52%, respectively. Conclusions Implementation of PITC and integration of ART services within the paediatric ward are likely to be the main reasons for improved access to

Emotional congruence with children and sexual offending against children: a meta-analytic review.

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McPhail, Ian V; Hermann, Chantal A; Nunes, Kevin L

2013-08-01

Emotional congruence with children is an exaggerated affective and cognitive affiliation with children that is posited to be involved in the initiation and maintenance of sexual offending against children. The current meta-analysis examined the relationship between emotional congruence with children and sexual offending against children, sexual recidivism, and change following sexual offender treatment. A systematic literature review of online academic databases, conference proceedings, governmental agency websites, and article, book chapter, and book reference lists was performed. Thirty studies on emotional congruence with children in sexual offenders against children (SOC) were included in a random-effects meta-analysis. Extrafamilial SOC-especially those with male victims--evidenced higher emotional congruence with children than most non--SOC comparison groups and intrafamilial SOC. In contrast, intrafamilial SOC evidenced less emotional congruence with children than many of the non-SOC comparison groups. Higher levels of emotional congruence with children were associated with moderately higher rates of sexual recidivism. The association between emotional congruence with children and sexual recidivism was significantly stronger in extrafamilial SOC samples (d = 0.58, 95% CI [0.31, 0.85]) compared with intrafamilial SOC samples (d = -0.15, 95% CI [-0.58, 0.27]). Similarly, emotional congruence with children showed a significant reduction from pre- to posttreatment for extrafamilial SOC (d = 0.41, 95% CI [0.33, 0.85]), but not for intrafamilial SOC (d = 0.06, 95% CI [-0.10, 0.22]). Emotional congruence with children is a characteristic of extrafamilial SOC, is moderately predictive of sexual recidivism, and is potentially amenable through treatment efforts. PsycINFO Database Record (c) 2013 APA, all rights reserved.

How does graphotactic knowledge influence children's learning of new spellings?

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Pacton, Sébastien; Sobaco, Amélie; Fayol, Michel; Treiman, Rebecca

2013-01-01

TWO EXPERIMENTS INVESTIGATED WHETHER AND HOW THE LEARNING OF SPELLINGS BY FRENCH THIRD GRADERS IS INFLUENCED BY TWO GRAPHOTACTIC PATTERNS: consonants cannot double in word-initial position (Experiment 1) and consonants cannot double after single consonants (Experiment 2). Children silently read meaningful texts that contained three types of novel spellings: no doublet (e.g., mupile, guprane), doublet in a legal position (e.g., muppile, gupprane), and doublet in an illegal position (e.g., mmupile, guprrane). Orthographic learning was assessed with a task of spelling to dictation. In both experiments, children recalled items without doublets better than items with doublets. In Experiment 1, children recalled spellings with a doublet in illegal word-initial position better than spellings with a doublet in legal word-medial position, and almost all misspellings involved the omission of the doublet. The fact that the graphotactic violation in an item like mmupile was in the salient initial position may explain why children often remembered both the presence and the position of the doublet. In Experiment 2, children recalled non-words with a doublet before a single consonant (legal, e.g., gupprane) better than those with a doublet after a single consonant (illegal, e.g., guprrane). Omission of the doublet was the most frequent error for both types of items. Children also made some transposition errors on items with a doublet after a single consonant, recalling for example gupprane instead of guprrane. These results suggest that, when a doublet is in the hard-to-remember medial position, children sometimes remember that an item contains a doublet but not which letter is doubled. Their knowledge that double consonants can occur before but not after single consonants leads to transposition errors on items like guprrane. These results shed new light on the conditions under which children use general knowledge about the graphotactic patterns of their writing system to

Maternal involvement in children's leisure activities in rural China: Relations with adjustment outcomes.

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Zhao, Siman; Chen, Xinyin

2018-02-01

This 1-year longitudinal study examined maternal involvement in children's leisure activities and its relations with children's adjustment in rural China. Participants included 184 children (93 boys and 91 girls) initially in third grade (mean age = 9.31 years). Children were asked to report the frequencies of mothers' involvement in leisure activities. Information on children's social, school, and psychological adjustment were collected from multiple sources including peer evaluations, teacher ratings, self-reports, and school records. The results showed that children's perceptions of maternal involvement in leisure activities positively predicted later social and school adjustment, particularly in boys. Furthermore, child initial adjustment status moderated the relations between maternal leisure activity involvement and child outcomes. The results suggest that maternal involvement in children's leisure activities, which has traditionally been neglected in the society, is a significant factor in contributing to child development in today's rural China. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Production and Perception of Distortion in Word-Initial Friction Duration

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Jovicic, Slobodan T.; Kasic, Zorca; Punisic, Silvana

2010-01-01

The purpose of the present study was to investigate (a) the distortion in production of word-initial friction duration in fricative /[esh]/, and (b) the perceptual discrimination between typical (normal) and atypical (prolonged or lengthened) friction duration. In the first experiment 80 school aged children pronounced word /[esh]uma/, 40 of them…

[Prevalence of helmet use in children and adolescents in Germany and preventable bicycle-related head injuries].

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Gutsche, J; Hintzpeter, B; Neuhauser, H; Schlaud, M

2011-08-01

Head injuries are the main cause of death in bicycle-related accidents among children and adolescents. According to a Cochrane Review, the risk of head injury (OR 0.31; 95% CI 0.26-0.37) or brain injury (OR 0.31; 95% CI 0.23-0.42) decreases by 69% if a helmet is worn. This study presents the prevalence of helmet use in cycling children and adolescents in Germany and the proportion of head injuries that could be prevented by wearing helmets. The potential effects of increased helmet wearing rates on the population attributable risk percentage for head injuries (PAR%) are demonstrated. The prevalence of helmet use in children aged 3-17 years was analysed using data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The percentage of head injuries preventable by helmet use in this group is estimated by calculating PAR%. Prevalence rates of helmet use and odds ratios from a Cochrane Review about the effectiveness of bicycle helmets for the prevention of head injuries were used for analysis. The potential effect of increased helmet use is shown in 3 scenarios by means of differences of PAR% values in the most relevant age groups. The older the children, the less likely they are to wear a helmet: 89.5% (95% CI 88.0%-90.8%) of the 3- to 6-year-old children wear a helmet when cycling but only 11.0% (95% CI 9.3%-12.9%) of 14- to 17-year-old adolescents do. In the youngest group (3-6 years) 19% of bicycle-related head injuries are attributable to the non-use of helmets, but this proportion rises to 67% in the oldest group (14-17 years). The PAR% of head injuries associated with not wearing a helmet may be reduced by more than a third by increasing the helmet wearing rate to 67% (2 out of 3) among adolescents, and may be reduced to half if 75% of adolescents wore a helmet. Particularly older children and adolescents hardly use bicycle helmets, hence the rate of preventable head injury is high. Efforts towards increasing helmet use

Toward smoke-free homes: A community-based study on initiatives of rural Indian women.

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Mittal, Srabani; Das, Samiran

2011-05-01

Since the home is the primary source of exposure of children to second-hand smoke (SHS), measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children's exposure to SHS at home. A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7%) was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Women's initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

Fostering young children's interest in numeracy through demonstration of its value: the Footsteps Study

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Colliver, Yeshe

2017-07-01

Children's early mathematical abilities are fundamental to their later academic achievement. An interest in mathematics in the early years is likely to establish a positive attitude to later mathematical learning, hopefully sustaining continued interest in mathematics and mathematical learning. Approaches to early mathematics teaching in the early years, however, are typically adult-initiated, which may fail to capture children's interest. Given the importance of children's motivation and sustained interest, the study described here strove to spark children's interests in mathematical problems in everyday life. The study sought to determine if children would incorporate more numeracy-related concepts into their free play if exposed to adult demonstrations of age-appropriate numeracy activities such as patterning. For at least 15 min three times weekly, participating children's parents and educators demonstrated numeracy problem-solving nearby, while children engaged in other activities. Demonstrations were thought to ascribe social value to the problem-solving activities. If children became interested in participating, adults told them to wait until the demonstrations finished, further indicating social value. Results show these children chose to play with numeracy-related activities in their free play time at preschool significantly more than children in a control group. These results suggest that seeking to foster children's interest in mathematics through child-initiated play, rather than prescribing adult-initiated mathematics activities, may be an important means of laying the foundation for lifelong mathematics learning. Ascribing social value to numeracy applications is proposed as a new approach to teaching mathematics in the early years.

The Design and Development of Staff Wellbeing Initiatives: Staff Stressors, Burnout and Emotional Exhaustion at Children and Young People's Mental Health in Australia.

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Coates, Dominiek D; Howe, Deborah

2015-11-01

Mental health work presents problems for staff over and above those encountered in other organisations, including other areas of healthcare. Healthcare workers, in particular mental health workers, have poorer job satisfaction and higher job burnout and turnover compared with established norms for other occupational groups. To make sense of why healthcare workers experience high levels of burnout, a strong body of literature points to the emotionally demanding nature of people-work. The negative effects of mental health work on employee health can be mitigated by the provision of appropriate job resources and wellbeing initiatives. As to develop initiatives that appropriately target staff sources of stress and needs, it is important to engage staff in this process. As such, Children and Young People's Mental Health (CYPMH) and headspace Gosford, in Australia, New South Wales (NSW), developed a survey to identify how staff experience and manage the emotional demands of mental health work, what they identify as key stressors and which initiatives they would like to see implemented. Fifty-five staff (response rate of 73 %) completed the survey, and the results suggest that while staff find the work emotionally demanding, they do not appear to be emotionally exhausted and report administrative rather than client issues as their primary concerns. While a strong body of literature identifies the management of emotions in the workplace as a significant cause of stress, organisational stressors such as working in a bureaucratic environment are also important to understanding staff wellbeing.