WorldWideScience

Sample records for patients children heard

  1. Voices of minor children heard and unheard in judicial divorce proceedings in the Netherlands

    NARCIS (Netherlands)

    Coenraad, L.M.

    2014-01-01

    Under Dutch divorce law, children in theory have ample opportunity to make their voices heard: the petition for divorce must state how the children have been involved in preparing a parenting plan; all children aged 12 or 16 (depending on the context) or older have the right to be heard by the

  2. Seen and Heard: Children's Rights in Early Childhood Education. Early Childhood Education Series

    Science.gov (United States)

    Hall, Ellen Lynn; Rudkin, Jennifer Kofkin

    2011-01-01

    Using examples from a Reggio-inspired school with children from ages 6 weeks to 6 years, the authors emphasize the importance of children's rights and our responsibility as adults to hear their voices. "Seen and Heard" summarizes research and theory pertaining to young children's rights in the United States, and offers strategies educators can use…

  3. Characteristics of epilepsy patients and caregivers who either have or have not heard of SUDEP.

    Science.gov (United States)

    Kroner, Barbara L; Wright, Cyndi; Friedman, Daniel; Macher, Kim; Preiss, Liliana; Misajon, Jade; Devinsky, Orrin

    2014-10-01

    Describe the characteristics of persons with epilepsy (PWEs) and caregivers that have or have not heard of sudden unexpected death in epilepsy (SUDEP) prior to completing a survey through the Internet or in the clinical setting. An online survey for adult PWEs and caregivers was solicited by e-mail and newsletter to Epilepsy Therapy Project members. A similar survey was implemented in a clinic setting of a community hospital. The survey asked about seizure characteristics, epilepsy management, fear of death, and familiarity with the term SUDEP. Respondents that never heard of SUDEP read a definition and responded to questions about their initial reactions. Surveys from 1,392 PWEs and 611 caregivers recruited through an epilepsy Website and a clinic demonstrated that Internet respondents were much more likely to have heard about SUDEP than the clinic population (71.1% vs. 38.8%; p vs. 65.2%; p fear, anxiety, and sadness after first hearing of SUDEP, they wanted to discuss it with their doctor. Persons with epilepsy, and especially their caregivers, often worry that the PWEs may die of epilepsy or seizures. This worry escalated with knowledge of SUDEP and increased epilepsy severity. Approximately half of PWEs and caregivers believed that knowledge about SUDEP would influence their epilepsy management. Our results may help epilepsy care providers determine when to facilitate a discussion about epilepsy-related mortality and SUDEP among patients and caregivers, and to educate those at high risk about the importance of seizure control as well as reduce fears about death in patients with well-controlled and nonconvulsive epilepsies. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  4. The adolescent patient: parental responsibility, the right to be informed and the right to be heard.

    Science.gov (United States)

    Delbon, P; Dianiskova, S; Laffranchi, L; Conti, A

    2015-12-01

    The increasing emphasis placed on patients' rights, in dentistry as well as in other areas, is also having repercussions on the structure of the relationship between health care staff, the under-age patient and his /her parents. The authors reflect about the decision-making process when the patient is a minor in the field of dentistry and underline the role of the parties involved (dentist, parents, under-age patient) in different circumstances (e.g. ordinary care or non-routine care; urgent situations; conflict between parents; refusal of the parents; disagreement between the parents and the child, refusal of the under-age patient; etc.). The Law must first ensure that the minors' needs for protection are met by awarding their parents the power and duty to care for them and, thus, also to take health care decisions in their interest. At the same time, domestic legislation and international legislation supports the need to give greater weight to minors' opinions as they approach the age of majority and, therefore, as they acquire a certain degree of maturity. The rights of under-age patients are safeguarded by actively involving them in the decision-making process, with particular reference to their right to information and right to be heard, to the extent that their age and understanding allow, with due consideration to the specific situation.

  5. Making Oneself Heard--Children's Experiences of Empowerment in Swedish Preschools

    Science.gov (United States)

    Almqvist, Anna-Lena; Almqvist, Lena

    2015-01-01

    Children's experiences of empowerment in relation to preschool peers and in child-adult interactions were studied, involving 25 four- to six-year-olds from four Swedish preschools. Group interviews using puppets comprised pre-constructed scenarios to examine preschools' activities. Children took photos of indoor and outdoor preschool environments,…

  6. Children and U.S. federal policy on health and health care: seen but not heard.

    Science.gov (United States)

    Flores, Glenn; Lesley, Bruce

    2014-12-01

    Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation's investments in children's health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation.

  7. Feeling Heard & Understood in the Hospital Environment: Benchmarking Communication Quality Among Patients with Advanced Cancer Before and After Palliative Care Consultation.

    Science.gov (United States)

    Ingersoll, Luke T; Saeed, Fahad; Ladwig, Susan; Norton, Sally A; Anderson, Wendy; Alexander, Stewart C; Gramling, Robert

    2018-05-02

    Maximizing value in palliative care requires continued development and standardization of communication quality indicators. To describe the basic epidemiology of a newly-adopted patient-centered communication quality indicator for hospitalized palliative care patie9nts with advanced cancer. Cross-sectional analysis of 207 advanced cancer patients who received palliative care consultation at two medical centers in the United States. Participants completed the Heard & Understood quality indicator immediately before and the day following the initial palliative care consultation: "Over the past two days ["24 hours" for the post-consultation version], how much have you felt heard and understood by the doctors, nurses and hospital staff? Completely/Quite a Bit/Moderately/Slightly/Not at All". We categorized "Completely" as indicating ideal quality. Approximately one-third indicated ideal Heard & Understood quality before palliative care consultation. Age, financial security, emotional distress, preferences for comfort-longevity tradeoffs at end-of-life, and prognosis expectations were associated with pre-consultation quality. Among those with less-than-ideal quality at baseline, 56% rated feeling more Heard & Understood the day following palliative care consultation. The greatest pre-post improvement was among people who had unformed end-of-life treatment preferences or who reported having "no idea" about their prognosis at baseline. Most patients felt incompletely heard and understood at the time of referral to palliative care consultation and more than half improved following consultation. Feeling heard and understood is an important quality indicator sensitive to interventions to improve care and key variations in the patient experience. Copyright © 2018. Published by Elsevier Inc.

  8. Seen But Not Heard? Focusing on the Needs of Children of Divorced Parents in Gaborone and Surrounding Areas, Botswana.

    Science.gov (United States)

    Maundeni, Tapologo

    2002-01-01

    Examined extent to which children's expressed needs for information were met by their mothers in study of parental separation and divorce in Botswana. Found that most children were dissatisfied with informational support received from their mothers. Mothers' ability to meet children's communication needs were influenced by their perceptions of…

  9. The Right to Be Heard: Australian Children's Views about Their Involvement in Decision-Making Following Parental Separation

    Science.gov (United States)

    Campbell, Alan

    2008-01-01

    This article describes the findings from a qualitative study that explored the views of a small group of Australian children about their involvement in decision-making processes following their parents' separation. Sixteen children, aged between seven and 17 years, participated in in-depth interviews that focused on their understandings of the…

  10. Seen but not heard: School-based professionals’ oversight of autism in children from ethnic minority groups

    NARCIS (Netherlands)

    Burke, D.A.; Koot, H.M.; Begeer, S.M.

    2015-01-01

    Previous studies have shown that ethnic background hinders clinician detection of autistic features in children from non-western minority groups. The use of a structured instrument during evaluation of these children can reduce the risk of hindered detection. The aims of the current studies were to

  11. PSTT... Have You Heard?

    Science.gov (United States)

    Schofield, Kathy

    2014-01-01

    Kathy Schofield explains how the Primary Science Teaching Trust (PSTT) came into being and how it continues to enhance science for primary teachers and children. The Primary Science Teaching Trust provides financial assistance to help improve the learning and teaching of science in the U.K. The Trust was established in April 1997 as an independent…

  12. Are patients' preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations

    NARCIS (Netherlands)

    Victoor, A.; Noordman, J.; Sonderkamp, J.A.; Delnoij, D.M.; Friele, R.D.; Dulmen, S. van; Rademakers, J.J.

    2013-01-01

    BACKGROUND: Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients

  13. Are patients' preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations.

    Science.gov (United States)

    Victoor, Aafke; Noordman, Janneke; Sonderkamp, Johan A; Delnoij, Diana M J; Friele, Roland D; van Dulmen, Sandra; Rademakers, Jany J D J M

    2013-12-10

    Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provider. We aim to investigate whether policy on patient choice is reflected in practice, i.e. what the role of the patient is in their choices of healthcare providers at the point of referral and to what extent GPs' and patients' healthcare paths influence the role that patients play in the referral decision. In 2007-2008, we videotaped Dutch GP-patient consultations. For this study, we selected, at random, 72 videotaped consultations between 72 patients and 39 GPs in which the patient was referred to a healthcare provider. These were analysed using an observation protocol developed by the researchers. The majority of the patients had little or no input into the choice of a healthcare provider at the point of referral by their GP. Their GPs did not support them in actively choosing a provider and the patients often agreed with the provider that the GP proposed. Patients who were referred for diagnostic purposes seem to have had even less input into their choice of a provider than patients who were referred for treatment. We found that the GP chooses a healthcare provider on behalf of the patient in most consultations, even though policy on patient choice expects from patients that they choose, actively, a provider. On the one hand, this could indicate that the policy needs adjustments. On the other hand, adjustments may be needed to practice. For instance, GPs could help patients to make an active choice of provider. However, certain patients prefer to let their GP decide as their agent. Even then, GPs need to know patients' preferences, because in a principal-agent relationship, it is necessary that the agent is fully

  14. "Seen but Not Heard." Practitioners Work with Poverty and the Organising out of Disadvantaged Children's Voices and Participation in the Early Years

    Science.gov (United States)

    Simpson, Donald; Loughran, Sandra; Lumsden, Eunice; Mazzocco, Philip; Clark, Rory McDowall; Winterbottom, Christian

    2017-01-01

    Living in poverty disadvantages young children reducing school readiness. "Pedagogy of listening" can potentially support resilience remediating against poverty's negative effects. Little, though, is known about how early childhood education and care (ECEC) practitioners work with children in poverty and the attainment gap between such…

  15. Have You Heard of GERD? (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Español Have You Heard of GERD? KidsHealth / For Kids / Have You Heard of GERD? What's in this ...

  16. Are patients’ preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations.

    NARCIS (Netherlands)

    Victoor, A.; Noordman, J.; Sonderkamp, J.A.; Delnoij, D.M.J.; Friele, R.D.; Dulmen, S. van; Rademakers, J.J.D.J.M.

    2013-01-01

    Background: Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to

  17. Are patients’ preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations

    Science.gov (United States)

    2013-01-01

    Background Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provider. We aim to investigate whether policy on patient choice is reflected in practice, i.e. what the role of the patient is in their choices of healthcare providers at the point of referral and to what extent GPs’ and patients’ healthcare paths influence the role that patients play in the referral decision. Methods In 2007–2008, we videotaped Dutch GP-patient consultations. For this study, we selected, at random, 72 videotaped consultations between 72 patients and 39 GPs in which the patient was referred to a healthcare provider. These were analysed using an observation protocol developed by the researchers. Results The majority of the patients had little or no input into the choice of a healthcare provider at the point of referral by their GP. Their GPs did not support them in actively choosing a provider and the patients often agreed with the provider that the GP proposed. Patients who were referred for diagnostic purposes seem to have had even less input into their choice of a provider than patients who were referred for treatment. Conclusions We found that the GP chooses a healthcare provider on behalf of the patient in most consultations, even though policy on patient choice expects from patients that they choose, actively, a provider. On the one hand, this could indicate that the policy needs adjustments. On the other hand, adjustments may be needed to practice. For instance, GPs could help patients to make an active choice of provider. However, certain patients prefer to let their GP decide as their agent. Even then, GPs need to know patients’ preferences, because in a principal-agent relationship

  18. The Right to Be Heard.

    Science.gov (United States)

    Nix, Gary W.

    1981-01-01

    The author cites research that casts doubt upon the use of total communication as a means of facilitating speech, communication between parent and child, academic achievement, and vocabulary development in hearing-impaired children. He states that the Alexander Graham Bell Association is not antimanual communication, but rather prospeech. (CL)

  19. Voices that may not otherwise be heard: a qualitative exploration into the perspectives of primary care patients living with chronic pain

    Directory of Open Access Journals (Sweden)

    Wallace LS

    2014-06-01

    Full Text Available Lorraine S Wallace,1 Randell K Wexler,1 Leon McDougle,1 W Frederick Miser,1 J David Haddox2,3 1Department of Family Medicine, the Ohio State University, Columbus, OH, USA; 2Health Policy, Purdue Pharma L.P., Stamford, CT, USA; 3Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA Background: Although psychometrically sound pain assessment tools are available, there is a paucity of research that comprehensively defines chronic pain from the perspective of patients. The purpose of this study was to examine the utility of a combination of qualitative methods (Photovoice, one-on-one interviews, and focus groups in examining the daily experiences of primary care patients living with chronic pain. Methods: A sample of English-speaking primary care patients aged 30 years or older, who had been prescribed an opioid for long-term, noncancer pain management, participated in the study. Each patient took photographs that best reflected both his/her experiences with chronic pain and what he/she would like his/her life to be without chronic pain. Results: Patients submitted an average of 20.2±3.1 photographs (range =8–27 photographs. Analysis of one-on-one interviews illuminated five dominant themes: daily need for multiple medications, including opioids; difficulties climbing a flight of stairs; struggling to get out of bed in the morning; extreme challenges with participating in day-to-day life activities; and experiencing feelings of hopelessness and helplessness on a regular basis. Seven themes emerged from the focus groups: undesired effects/burdens of medications, loss of/striving for independence, effect on social interactions/relationships, pain effect on activities of daily living, constant search for convenience/a better situation, interactions with physicians, and frustration/depression with pain. Conclusion: The qualitative methods employed in this study provide deep insight into perceptions

  20. Speaking up, being heard: registered nurses' perceptions of workplace communication.

    Science.gov (United States)

    Garon, Maryanne

    2012-04-01

    The aim of the present study was to explore nurses' perceptions of their own ability to speak up and be heard in the workplace. Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction, team work as well as patient safety. The present study utilized a qualitative approach, consisting of focus group interviews of 33 registered nurses (RNs), in staff or management positions from a variety of healthcare settings in California, USA. Data were analysed using thematic content analysis. Findings were organized into three categories: influences on speaking up, transmission and reception of a message and outcomes or results. The present study supported the importance of the manager in setting the culture of open communication. It is anticipated that findings from the present study may increase understandings of nurse views of communication within healthcare settings. The study highlights the importance of nurse managers in creating the communication culture that will allow nurses to speak up and be heard. These open communication cultures lead to better patient care, increased safety and better staff satisfaction. © 2011 Blackwell Publishing Ltd.

  1. Predictors of having heard about human papillomavirus vaccination: Critical aspects for cervical cancer prevention among Colombian women.

    Science.gov (United States)

    Bermedo-Carrasco, Silvia; Feng, Cindy Xin; Peña-Sánchez, Juan Nicolás; Lepnurm, Rein

    2015-01-01

    To determine whether the probability of having heard about human papillomavirus (HPV) vaccination differs by socio-demographic characteristics among Colombian women; and whether the effect of predictors of having heard about HPV vaccination varies by educational levels and rural/urban area of residence. Data of 53,521 women aged 13-49 years were drawn from the 2010 Colombian National Demographic and Health Survey. Women were asked about aspects of their health and their socio-demographic characteristics. A logistic regression model was used to identify factors associated with having heard about HPV vaccination. Educational level and rural/urban area of residence of the women were tested as modifier effects of predictors. 26.8% of the women had heard about HPV vaccination. The odds of having heard about HPV vaccination were lower among women: in low wealth quintiles, without health insurance, with subsidized health insurance, and those who had children (p<0.001). Although women in older age groups and with better education had higher probabilities of having heard about HPV vaccination, differences in these probabilities by age group were more evident among educated women compared to non-educated ones. Probability gaps between non-educated and highly educated women were wider in the Eastern region. Living in rural areas decreased the probability of having heard about HPV vaccination, although narrower rural/urban gaps were observed in the Atlantic and Amazon-Orinoquía regions. Almost three quarters of the Colombian women had not heard about HPV vaccination, with variations by socio-demographic characteristics. Women in disadvantaged groups were less likely to have heard about HPV vaccination. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. The Power of Talk: Who Gets Heard and Why.

    Science.gov (United States)

    Tannen, Deborah

    1995-01-01

    Conversational style often overrides what is said, affecting who gets heard and what gets done. Women's linguistic styles often make them seem less competent and self-assured than they are. Better understanding of speech styles will make managers better listeners and communicators. (SK)

  3. Children's experiences as hospital in-patients: voice, competence and work. Messages for nursing from a critical ethnographic study.

    Science.gov (United States)

    Livesley, Joan; Long, Tony

    2013-10-01

    There is growing evidence that children's subjective interpretations of events may differ significantly from those of adults; yet children's and young people's voices and children's knowledge regarding hospital care remain relatively unexplored. To develop insight into children's subjective interpretations and knowledge of being hospital in-patients. Critical ethnography. A nephro-urology ward in a tertiary referral children's hospital in the north of England. A purposive sample was employed of 15 children over 2 phases: six (9-15 years) at home in a reconnaissance first phase, and nine (5-14 years) in hospital in phase 2. A raft of child-friendly, age-appropriate strategies was used to engage children in phase 1. Phase 2 involved over 100 h of field-work with hospitalised children over 6 months, with observation, interview, play and craft activities as prominent methods. Data were analysed using constant comparative methods. The study ward was a place in which children struggled to find a space for their competence to be recognised and their voice heard. Children's voice became manifest in what they said but also through the non-verbal mechanisms of resisting, turning away and being silent. While all the children shared the experience of being in trouble, recognition of their competence was fluid and contingent on their relationships with the nurses alongside other structural and material factors. The children worked hard to maintain their position as knowledgeable individuals. When they could not do so they relied on supportive adults, and in the absence of supportive adults they became marooned and received bare minimum care. The hospital ward was a place for children in which there was little space for children's voices. When their voices were heard, they were often seen as a challenge. Quiet, sick and shy children who were alone were the most likely to have their needs overlooked and become subject to standardised nursing care. A more inclusive and

  4. Children of home dialysis patients.

    Science.gov (United States)

    Tsaltas, M O

    1976-12-13

    Fifteen children of six families in which one parent was undergoing home dialysis were examined by the Minnesota Multiphasic Personality Inventory, human figure drawings, and family interviews. All the children were found to be clinically depressed, and two thirds had a history of being referred by teachers to school counselors and psychiatrists for behavioral problems in school. Of these referred children, all showed disorders of psychomotor activity and reduced academic achievement. There was no clear-cut evidence that these children were depressed because of exposure to home dialysis per se. The most disturbed children seemed to be responding to depressed parents or to partial object loss. A controlled, prospective study is planned to clarify this question.

  5. Cow's milk and children

    Science.gov (United States)

    Milk and children; Cow's milk allergy - children; Lactose intolerance - children ... You may have heard that cow's milk should not be given to babies younger than 1 year old. This is because cow's milk doesn't provide enough ...

  6. Mixing on the Heard Island Plateau during HEOBI

    Science.gov (United States)

    Robertson, R.

    2016-12-01

    On the plateau near Heard and McDonald Islands, the water column was nearly always well mixed. Typically, temperature differences between the surface and the bottom, 100-200 m, were less than 0.2oC and often less that 0.1oC. Surface stratification developed through insolation and deep primarily through a combination of upwelling from canyons and over the edge of the plateau and tidal advection. This stratification was primarily removed by a combination of wind and tidal mixing. Persistent winds of 30 knots mixed the upper 20-50 m. Strong wind events, 40-60 knots, mixed the water column to 100-200 m depth, which over the plateau, was often the entire water column. Benthic tidal friction mixed the bottom 30-50 m. Although the water column was unstratified at the two plume sites intensively investigated, tidal velocities were baroclinic, probably due to topographic controls. Tidal advection changed the bottom temperatures by 0.5oC within 8 hours, more than doubling the prior stratification. Wind mixing quickly homogenized the water column, resulting in the surface often showing the deeper upwelling and advective events. Although acoustic plumes with bubbles were observed in the water column, there was no evidence of geothermal vents or geothermal influence on temperatures. Mixing by bubbles rising in the water column was indistinguishable from the wind and tidal mixing, although the strongest upward vertical velocities were observed at the sites of these acoustic/bubble plumes.

  7. LHC? Of course we’ve heard of the LHC!

    CERN Multimedia

    2009-01-01

    Well, more or less. After its first outing in Meyrin (see last Bulletin issue), our street poll hits the streets of Divonne-les-Bains and the corridors of the University of Geneva. While many have heard of the LHC, the raison d’être of this "scientific whatsit" often remains a mystery.On first questioning, the "man-in-the-street" always pleads ignorance. "Lausanne Hockey Club?" The acronym LHC is not yet imprinted on people’s minds. "Erm, Left-Handed thingamajig?" But as soon as we mention the word "CERN", the accelerator pops straight into people’s minds. Variously referred to as "the circle" or "the ring", it makes you wonder whether people would have been so aware of the LHC if it had been shaped like a square. Size is another thing people remember: "It’s the world’s biggest. Up to now…" As for its purpose, well that’s another kettle of fish. &...

  8. 800 Fellows at CERN: Make your voice heard!

    CERN Multimedia

    Staff Association

    2018-01-01

    The financial and social conditions of the CERN personnel are determined in agreement between the CERN Management and the Staff Association (SA), the statutory body representing the personnel. The Staff Association is mandated to serve and defend the economic, social, professional and moral interests of its members and the entire CERN personnel. Fellows are members of the personnel employed by CERN (MPE), and should be listened to and heard during discussions that concern their financial and social conditions and, more widely, their working and employment conditions. The Staff Association wants to hear from you! At the end of 2017, 50 delegates were elected to the Staff Council, including four fellows. These delegates are your spokespersons within the Staff Association and, as such, they represent you in relations with the Management and the Member States. How can you make a difference? In 2015, during the latest five-yearly review, the aim of which was to review the financial and social conditions of the mem...

  9. Two-and 3-Year-Olds Know What Others Have and Have Not Heard

    Science.gov (United States)

    Moll, Henrike; Carpenter, Malinda; Tomasello, Michael

    2014-01-01

    Recent studies have established that even infants can determine what others know based on previous visual experience. In the current study, we investigated whether 2-and 3-year-olds know what others know based on previous auditory experience. A child and an adult heard the sound of one object together, but only the child heard the sound of another…

  10. Respect for nursing professional: Silence must be heard

    Directory of Open Access Journals (Sweden)

    Sundeep Mishra

    2015-09-01

    Full Text Available The value of care giving seems to be at an all-time low. whether it is clinical (bedside or for children and elderly at home (homemakers. Currently, individuals who pass away any opportunity (for themselves to care for another individual instead are considered weak and/or unmotivated. Thus, it is not surprising that modern society often fails to respect the nursing professionals to the extent of underplaying their strengths, skills, and even clinical abilities. While qualities such as kindness, team spirit, and willingness to get their hands dirty are the core of this profession, nursing professionals have a complex variety of set duties, involving drug dosage, trouble-shooting, ongoing patient monitoring, and providing holistic comfort and support to the sick and needy. Beyond classical role, the nursing professional has currently ventured into other roles as well, as a nurse practitioner, administrator, researcher, or even an educator. Thus, considering the wide spectrum of duties performed by nursing professionals, they do deserve more status and power rather than be treated like “ward housewives.”

  11. Seldom Heard Voices--Child Prostitutes in Ethiopia

    Science.gov (United States)

    Abdella, Rahmet; Hoot, James; Tadesse, Selamawit

    2006-01-01

    OMEP has a long history of advocating for the maximal development of the world's children. A plethora of recent natural disasters such as the Tsunami in Asia, hurricanes in the United States, and an earthquake in Pakistan have been major threats to the wellbeing of millions of children. Seemingly endless media reports of homeless, injured, and…

  12. The power to dismiss and the right to be heard under the common ...

    African Journals Online (AJOL)

    The power to dismiss and the right to be heard under the common law of Ghana: a need for satutory intervention. ... Journal of Business Research ... Based on the examination of selected Supreme Court cases, the paper demonstrates that, ...

  13. Afraid To Be Heard: The Selectively Mute Child.

    Science.gov (United States)

    Longo, Sharon L.

    2001-01-01

    Presents facts about selective mutism, an anxiety disorder believed to be caused by low levels of serotonin in the brain, discussing its effects on school children, explaining how to get the necessary help (e.g., talking to health professionals and becoming educated about the disorder), and noting what parents can do (e.g., help raise the child's…

  14. Let Their Voices Be Heard! Building a Multicultural Audio Collection.

    Science.gov (United States)

    Tucker, Judith Cook

    1992-01-01

    Discusses building a multicultural audio collection for a library. Gives some guidelines about selecting materials that really represent different cultures. Audio materials that are considered fall roughly into the categories of children's stories, didactic materials, oral histories, poetry and folktales, and music. The goal is an authentic…

  15. Long-term outcome in children of patients after stroke

    NARCIS (Netherlands)

    van de Port, Ingrid G. L.; Visser-Meily, Anne M. A.; Post, Marcel W. M.; Lindeman, Eline

    2007-01-01

    Objective: To investigate the long-term effects on children of parental stroke, with respect to care-giving tasks, children's behavioural problems and stress, and to study the relationship between stress and child, patient and partner characteristics. Subjects: A total of 44 children (age range

  16. Have You Heard of Schistosomiasis? Knowledge, Attitudes and Practices in Nampula Province, Mozambique.

    Science.gov (United States)

    Rassi, Christian; Kajungu, Dan; Martin, Sandrine; Arroz, Jorge; Tallant, Jamie; Zegers de Beyl, Celine; Counihan, Helen; Newell, James N; Phillips, Anna; Whitton, Jane; Muloliwa, Artur Manuel; Graham, Kirstie

    2016-03-01

    Schistosomiasis is a parasitic disease which affects almost 300 million people worldwide each year. It is highly endemic in Mozambique. Prevention and control of schistosomiasis relies mainly on mass drug administration (MDA), as well as adoption of basic sanitation practices. Individual and community perceptions of schistosomiasis are likely to have a significant effect on prevention and control efforts. In order to establish a baseline to evaluate a community engagement intervention with a focus on schistosomiasis, a survey to determine knowledge, attitudes and practices relating to the disease was conducted. A representative cross-sectional household survey was carried out in four districts of Nampula province, Mozambique. Interviews were conducted in a total of 791 households, using a structured questionnaire. While awareness of schistosomiasis was high (91%), correct knowledge of how it is acquired (18%), transmitted (26%) and prevented (13%) was low among those who had heard of the disease. Misconceptions, such as the belief that schistosomiasis is transmitted through sexual contact (27%), were common. Only about a third of those who were aware of the disease stated that they practiced a protective behaviour and only a minority of those (39%) reported an effective behaviour. Despite several rounds of MDA for schistosomiasis in the recent past, only a small minority of households with children reported that at least one of them had received a drug to treat the disease (9%). Poor knowledge of the causes of schistosomiasis and how to prevent it, coupled with persisting misconceptions, continue to pose barriers to effective disease prevention and control. To achieve high levels of uptake of MDA and adoption of protective behaviours, it will be essential to engage individuals and communities, improving their understanding of the causes and symptoms of schistosomiasis, recommended prevention mechanisms and the rationale behind MDA.

  17. Hydrothermal venting on the flanks of Heard and McDonald islands, southern Indian Ocean

    Science.gov (United States)

    Lupton, J. E.; Arculus, R. J.; Coffin, M.; Bradney, A.; Baumberger, T.; Wilkinson, C.

    2017-12-01

    Heard Island and the nearby McDonald Islands are two sites of active volcanism associated with the so-called Kerguelen mantle plume or hot spot. In fact, it has been proposed that the Kerguelen hot spot is currently located beneath Heard Island. During its maiden maximum endurance voyage (IN2016_V01), the recently commissioned Australian R/V Investigator conducted a detailed bathymetric and water column survey of the waters around Heard Island and the McDonald Islands as well as other sites on the Kerguelen Plateau. Some 50 hydrographic profiles were completed using the CTD/rosette system equipped with trace metal sampling and a nephelometer for suspended particle concentrations. In addition to the hydrographic profiles, 244 bubble plumes were detected in the vicinity of the Heard and McDonald Islands using the ship's multibeam system. It is thought that the bubble plumes observed on sea knolls and other seafloor surrounding the McDonald Islands are likely hydrothermal in origin, while plumes northeast of Heard Island may be biogenic methane from cold seeps. At 29 of the hydrographic stations water samples for helium isotope measurements were drawn from the CTD rosette and hermetically sealed into copper tubing for subsequent shorebased mass spectrometer and gas chromatograph analysis. In this paper we report results for 3He/4He ratios and CO2 and CH4 concentrations in water samples collected with the CTD/rosette, and discuss how these results are correlated with suspended particle concentrations and temperature anomalies.

  18. [What do psychiatrists know about the children of their patients?].

    Science.gov (United States)

    Franz, Michael; Kettemann, Beate; Jäger, Karin; Hanewald, Bernd; Gallhofer, Bernd

    2012-07-01

    Psychiatry could be a good starting point for preventive work for children of mentally ill parents by detecting children who are potentially at risk and connecting affected families with preventive services. However, it is unclear how much attention clinical psychiatrists pay for children of their patients. Therefore, this study examines the knowledge of german psychiatrists about the children of their patients and their attitude towards the youth welfare and prevention system. Seven psychiatric hospitals of one federal state in Germany participated in a questionnaire survey. The majority of the psychiatrists know whether their patients have children or not, but they can not answer differentiate questions of the children's life circumstances or name preventive programs for children and their families. Furthermore, psychiatrists potentially could forestall preventive programs because of a lack of knowledge about the youth welfare. Psychiatrists need more information about the children of their patients and about the general possibilities of prevention as well as more knowledge of supportive offers of the youth welfare. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Echo, Not Quotation: What Conversation Analysis Reveals about Classroom Responses to Heard Poetry

    Science.gov (United States)

    Gordon, John

    2012-01-01

    This article applies conversation analysis to classroom talk-in-interaction where pupils respond to poetry they have heard. The phenomenon of repeating in discussion details from the poem, including patterns of delivery, is considered and named echo to distinguish it from quotation in writing. The phenomenon is significant to the pedagogy of…

  20. Submarine geology and geomorphology of active Sub-Antarctic volcanoes: Heard and McDonald Islands

    Science.gov (United States)

    Watson, S. J.; Coffin, M. F.; Whittaker, J. M.; Lucieer, V.; Fox, J. M.; Carey, R.; Arculus, R. J.; Bowie, A. R.; Chase, Z.; Robertson, R.; Martin, T.; Cooke, F.

    2016-12-01

    Heard and McDonald Islands (HIMI) are World Heritage listed sub-Antarctic active volcanic islands in the Southern Indian Ocean. Built atop the Kerguelen Plateau by Neogene-Quaternary volcanism, HIMI represent subaerial exposures of the second largest submarine Large Igneous Province globally. Onshore, processes influencing island evolution include glaciers, weathering, volcanism, vertical tectonics and mass-wasting (Duncan et al. 2016). Waters surrounding HIMI are largely uncharted, due to their remote location. Hence, the extent to which these same processes shape the submarine environment around HIMI has not been investigated. In early 2016, we conducted marine geophysical and geologic surveys around HIMI aboard RV Investigator (IN2016_V01). Results show that volcanic and sedimentary features prominently trend east-west, likely a result of erosion by the eastward flowing Antarctic Circumpolar Current and tidal currents. However, spatial patterns of submarine volcanism and sediment distribution differ substantially between the islands. >70 sea knolls surround McDonald Island suggesting substantial submarine volcanism. Geophysical data reveals hard volcanic seafloor around McDonald Island, whereas Heard Island is characterised by sedimentary sequences tens of meters or more thick and iceberg scours - indicative of glacial processes. Differences in submarine geomorphology are likely due to the active glaciation of Heard Island and differing rock types (Heard: alkali basalt, McDonald: phonolite), and dominant products (clastics vs. lava). Variations may also reflect different magmatic plumbing systems beneath the two active volcanoes (Heard produces larger volumes of more focused lava, whilst McDonald extrudes smaller volumes of more evolved lavas from multiple vents across the edifice). Using geophysical data, corroborated with new and existing geologic data, we present the first geomorphic map revealing the processes that shape the submarine environment around HIMI.

  1. Disease representation in children and its mediating role in the therapeutic work with patient children

    Directory of Open Access Journals (Sweden)

    Arkady N. Kharkovskiy

    2015-09-01

    Full Text Available In the course of treating a serious illness, a person is faced with questions related not only to the medical side of treatment, but also with the realizing the sense of the events. This is equally true for both oncology adults and for children. The paper researches the disease representation in children who suffer from severe diseases. General psychological aspects of the disease situation and the understanding of patient children and the ability to use these concepts in practical psychological help are considered. The study hypothesizes, first of all, the semantic structure of representation in this group of children having specific characteristics that distinguish them from healthy children. Secondly, data representation having a therapeutic potential can be used as a psychological tool. Mediating function of the psychological tools mentioned is justified in this paper from the perspective of cultural historical approach and the concept of mental health levels. The experimental study was conducted in the specialized pediatric clinics in Moscow, Russia. Control group include students of one of Moscow schools. The study included organization of the experimental situation, criteria for obtaining data, comparative analysis and evaluation. The hypothesis is confirmed. The characteristic structure of disease representations in patient children reflecting some vector of the disease course is outlined. This makes the study an important practical value as the results may provide a solution to practical issues of medical psychology in assisting patient children. The research offers further studying the semantic sphere of patient children.

  2. Retreat of Stephenson Glacier, Heard Island, from Remote Sensing and Field Observations

    Science.gov (United States)

    Mitchell, W.; Schmieder, R.

    2017-12-01

    Heard Island (Australian sub-Antarctic territory, 53 S, 73.5 E) is a volcanic island mantled in glaciers, and a UNESCO World Heritage Site both for its geology and ecology. Lying to the south of the Antarctic Convergence, the changes in response to climate seen on Heard Island are likely to be a bellwether for areas further south. Beginning in 1999, American satellites (Landsat 7, EO-1, and Landsat 8) have produced images of the island on a roughly weekly basis. Although the island is often shrouded in clouds, clear images of at least portions of the island are plentiful enough to create a nearly-annual record of the toe of Stephenson Glacier. During this period, Stephenson Glacier retreated by nearly 5 km, and lost 50% of its area. As a result of this retreat, a portion of the glacier now could be classified as a separate glacier. Additionally, in 2016, terrestrial photographs of Stephenson Glacier were taken during a three-week expedition to Heard Island, which accessed the Stephenson Glacier area by boat via the proglacial Stephenson Lagoon. During that work, sonar indicated some depths in the lagoon exceeding 100 m. Much of the loss in glacier length and area occurred during the mid- and late-2000s, with retreat rates slowing toward 2017. At this time, the glacier has retreated so that the main toe is not far from the base of a tall ice falls, while another toe—perhaps now a separate glacier—is land-based. This type of retreat pattern, fast over water and slower on land, is typical of other tidewater glaciers. Further monitoring of Stephenson Glacier and other glaciers on Heard Island will continue using Landsat 8.

  3. Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage

    Science.gov (United States)

    Cleary, Sonja R.; Doyle, Kerrie E.

    2016-01-01

    Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies’ editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the ‘deaf effect’ prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage . PMID:26673652

  4. Meningitis in Children: Evaluation of 197 Patients

    Directory of Open Access Journals (Sweden)

    Ali Gunes

    2016-01-01

    Full Text Available Aim: The aim of our study was to evaluate the epidemiologic, clinic and laboratory results and the answers to treatment of meningitis cases. Material and Method: In this study, the epidemiologic, clinic and laboratory results of 197 patients hospitalized with central nervous system infection diagnosis in the Department of Pediatric Health and Diseases of the Faculty of Medicine of Dicle University between 1st of January 2003 and 1st of January 2006 have been studied retrospectively. The files have been studied in details for age, sex, complaints, and results of physical examination, laboratory results, radiological results and treatments applied. Results: 118 of the patients were male, 79 were women and the mean age calculated was 62,2±47,3 months.137, 27 and 33 patients have been respectively considered as ABM, AM and TM. The most frequent complaints of application to hospital were fever (95,4%, vomiting (82,7%, headache (45,6% and change of consciousness (21,3%. The presence of many risks about meningitis has been observed. The most frequent risk factors were head trauma history, parenchymal lung tuberculosis, military tuberculosis, presence of V-P shunt, meningocele, varicella history, having mumps, and the presence of purulent ear discharge. BOS has developed in 7 patients and for five patients, reproduction occurred in blood culture. The most important central nervous system sequels or complications were in order of frequency hydrocephalies requiring the installation of V-P shunt, brain edema, epilepsies, subdural effusions, tuberculoma, retention of head pair, and brain apses. The rate of mortality was (% 13,1. Discussion: During the period of execution of the study, the mortality and morbidity of central nervous system diseases were still at high risk. But this may be associated to the absence of vaccination programs for frequent meningitis factors such as pneumococcus and H. influenza were not in routine vaccination program in our

  5. Volcanism, Iron, and Phytoplankton in the Heard and McDonald Islands Region, Southern Indian Ocean

    Science.gov (United States)

    Coffin, M. F.; Arculus, R. J.; Bowie, A. R.; Chase, Z.; Robertson, R.; Trull, T. W.; Heobi in2016 v01 Shipboard Party, T.

    2016-12-01

    Phytoplankton supply approximately half of the oxygen in Earth's atmosphere, and iron supply limits the growth of phytoplankton in the anemic Southern Ocean. Situated entirely within the Indian Ocean sector of the Southern Ocean are Australia's only active subaerial volcanoes, Heard and McDonald islands (HIMI) on the central Kerguelen Plateau, a large igneous province. Widespread fields of submarine volcanoes, some of which may be active, extend for distances of up to several hundred kilometers from the islands. The predominantly eastward-flowing Antarctic Circumpolar Current sweeps across the central Kerguelen Plateau, and extensive blooms of phytoplankton are observed on the Plateau down-current of HIMI. The goal of RV Investigator voyage IN2016_V01, conducted in January/February 2016, is to test the hypothesis that hydrothermal fluids, which cool active submarine volcanoes in the HIMI region, ascend from the seafloor and fertilise surface waters with iron, thereby enhancing biological productivity beginning with phytoplankton. Significant initial shipboard results include: Documentation, for the first time, of the role of active HIMI and nearby submarine volcanoes in supplying iron to the Southern Ocean. Nearshore waters had elevated dissolved iron levels. Although biomass was not correspondingly elevated, fluorescence induction data indicated highly productive resident phytoplankton. Discovery of >200 acoustic plumes emanating from the seafloor and ascending up to tens of meters into the water column near HIMI. Deep tow camera footage shows bubbles rising from the seafloor in an acoustic plume field north of Heard Island. Mapping 1,000 km2 of uncharted seafloor around HIMI. Submarine volcanic edifices punctuate the adjacent seafloor, and yielded iron-rich rocks similar to those found on HIMI, respectively. Acoustic plumes emanating from some of these features suggest active seafloor hydrothermal systems.

  6. Optimizing patient management and adherence for children receiving growth hormone

    DEFF Research Database (Denmark)

    Acerini, Carlo L.; Wac, Katarzyna; Bang, Peter

    2017-01-01

    © 2017 Acerini, Wac, Bang and Lehwalder. Poor adherence with growth hormone (GH) therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The "360° GH in Europe" meeting, held in Lisbon, Portugal, in June...... and are reported as a manuscript, authored by the speakers. Reported here is a summary of the proceedings of the second session, which reviewed the determinants of GH therapy response, factors affecting GH therapy adherence and the development of innovative technologies to improve GH treatment in children....... Response to GH therapy varies widely, particularly in regard to the underlying diagnosis, although there is little consensus on the definition of a poor response. If the growth response is seen to be less than expected, the possible reasons should be discussed with patients and their parents, including...

  7. The Voice of the Turtle is Heard Programs to Develop Military Writers in the Field of Strategy

    Science.gov (United States)

    1966-04-08

    BENEFIT TO THE USER AS MAY ACCRUE. 8 April 1966 "THE VOICE OF THE TURTLE IS HEARD" PROGRAMS TO DEVELOP MILITARY WRITERS IN THE FIELD OF STRATEGY By...U USAWC RESEARCH ELEMENT (Research Paper) L’The Voice of the Turtle is Heard" Programs to Develop Military Writers in the Field of Strategy by Lt Col...extensively their own "original sources" of information. Such information as published is often nebulous , however, and as often fanciful as it is true

  8. [Prescription of olanzapine in children and adolescent psychiatric patients].

    Science.gov (United States)

    Frémaux, T; Reymann, J-M; Chevreuil, C; Bentué-Ferrer, D

    2007-01-01

    A review of the literature from 1996-2004 on the indications and adverse reactions concerning the use of olanzapine, a second generation antipsychotic agent, in children and adolescents with psychiatric illness is made in this article. Studies lasted for 2 to 3 months and a few had a follow up period up to a year. Olanzapine, dosed from 2.5 to 20 mg/day, is shown to be a useful drug in the treatment of child and adolescent onset schizophrenia, bipolar disorder, anorexia nervosa with delusions, pervasive developmental disorder, tic disorders, and aggression. OPEN AND DOUBLE-BLIND STUDIES: In 4 open labeled studies (26, 34, 39, 43) and 2 case reports (25), 53 patients, aged from 6-18 years old, afflicted by child onset schizophrenia, were treated with olanzapine for 1 1/2 weeks to one year; 19 had treatment resistant childhood schizophrenia and 34 a first episode. In the first group 13/19 showed improvement whereas, in the second group 27/34 were considered responders. Four patients in the first group who had responded to clozapine (stopped because of adverse events) did less well on olanzapine. In 5 studies, 4 open labeled (15, 20, 44) and 1 double blind (27), 59 adolescent onset schizophrenic patients were treated by olanzapine from 8 to 26 weeks; 50/59 patients were considered responders. In the open label study (20) comparing 43 adolescents treated by olanzapine (19 patients), risperidone (17 patients), or haloperidol (7 patients), improvement was significant in the three groups after 4 weeks of treatment and continued after 8 weeks. It is most interesting to mention that 2 months after the end of the study 71% (12/17) of the olanzapine group that had completed the study, 10/15 (67%) of the risperidone group, and 43% (3/7) of the haloperidol group had continued their treatment. Dropouts were for inefficacy and non-compliance in the olanzapine and risperidone groups whereas they were also for adverse events in the haloperidol group (2/4). A final double blind

  9. Clinical analysis of three children patients with MELAS

    Directory of Open Access Journals (Sweden)

    Xiao-jun LIU

    2016-05-01

    Full Text Available This study aims to investigate the clinical manifestations, laboratory and imaging features, pathological and genetic testing, diagnosis and treatment in 3 children patients with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS. Focal refractory epileptic seizures were the main clinical manifestations of 3 children, at the same time with stroke-like episodes, exercise intolerance, short stature, paroxysmal headache, vomiting, cognitive impairment, visual impairment, increased blood lactic acid (LA level and metabolic acidosis. Head MRI showed the lesions were located in temporo-parieto-occipital lobes, and EEG showed slow-wave background, bilateral asymmetry and interictal epileptiform discharges of occiput. Mitochondrial DNA (mtDNA A3243G mutation was found in the peripheral blood samples of 2 cases. The mutation was not detected in the other case, however, the muscle biopsy revealed pathological changes of mitochondrial myopathy. All 3 cases were treated by antiepileptic drugs (AEDs including topiramate, levetiracetam and oxcarbazepine, and cocktail therapy. One case died of status epilepticus (SE after 46 months of follow-up, one case had stroke-like episodes for 2-3 times per year during the follow-up of 40 months, and one case was lost. The clinical manifestations, laboratory and imaging characteristics, pathological and genetic testing in children of MELAS have certain features, which will be helpful for early identification and definite diagnosis, and thus may reduce misdiagnosis and mistreatment. DOI: 10.3969/j.issn.1672-6731.2016.05.009

  10. Optimizing Patient Management and Adherence for Children Receiving Growth Hormone.

    Science.gov (United States)

    Acerini, Carlo L; Wac, Katarzyna; Bang, Peter; Lehwalder, Dagmar

    2017-01-01

    Poor adherence with growth hormone (GH) therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The "360° GH in Europe" meeting, held in Lisbon, Portugal, in June 2016 and funded by Merck KGaA (Germany), examined many aspects of GH diseases. The three sessions, entitled " Short Stature Diagnosis and Referral ," " Optimizing Patient Management ," and " Managing Transition ," each benefited from three guest speaker presentations, followed by an open discussion and are reported as a manuscript, authored by the speakers. Reported here is a summary of the proceedings of the second session, which reviewed the determinants of GH therapy response, factors affecting GH therapy adherence and the development of innovative technologies to improve GH treatment in children. Response to GH therapy varies widely, particularly in regard to the underlying diagnosis, although there is little consensus on the definition of a poor response. If the growth response is seen to be less than expected, the possible reasons should be discussed with patients and their parents, including compliance with the therapy regimen. Understanding and addressing the multiple factors that influence adherence, in order to optimize GH therapy, requires a multi-disciplinary approach. Because therapy continues over many years, various healthcare professionals will be involved at different periods of the patient's journey. The role of the injection device for GH therapy, frequent monitoring of response, and patient support are all important for maintaining adherence. New injection devices are incorporating electronic technologies for automated monitoring and recording of clinically relevant information on injections. Study results are indicating that such devices can at least maintain GH adherence; however, acceptance of novel devices needs to be assessed and there remains an on-going need for innovations.

  11. FWPA was heard in the Parliament in connection to the new Electricity Market Act

    International Nuclear Information System (INIS)

    Holttinen, E.

    1998-01-01

    The new Electricity Market Act now under preparation will give the private consumers the opportunity to choose their electricity supplier. In principle, this has already been possible before, but the need for an expensive household metering has made it unfeasible. In the new proposal the pricing will be based on so called 'consumer type load curves', and no extra metering is needed. Finnish Wind Power Association was heard in the Economy Committee of the Parliament in connection to the preparation of the new Act. The Association expressed its concern on the unequal market position of small electricity producers connected to medium voltage grid, compared to large producers connected to high voltage grid. At present, the benefits of so called embedded generation are often not reflected in the transfer prices of small scale production, and the prices vary remarkably depending on the grid company. Some of the grid companies effectively prohibit the installations of wind turbines - or any other small scale production plants - in their area, by applying unreasonably high transfer prices. The resources of the electricity market supervisory authorities have shown to be completely inadequate to guarantee fair competition in the Finnish electricity market. (author)

  12. Hip arthrodesis in children: A review of 28 patients

    Directory of Open Access Journals (Sweden)

    Banskota Ashok

    2009-01-01

    Full Text Available Background: The best method of treating intractable hip pain in an unsalvageable hip joint in a child is still a subject open to debate. We believe that hip arthrodesis in such patients provides a painless and stable hip for most activities of daily living in our challenging rural terrain. Therefore, we conducted this study to assess the functional ability of children with painful hip arthrosis treated by arthrodesis of the hip. Materials and Methods: A retrospective evaluation of 28 children (out of 35 who had an arthrodesis of the hip performed between 1994 and 2008 was carried out. The average age was 14 years, with 12 males and 16 females. There was involvement of the right hip in 13 and left in 15 cases. The average duration of follow-up was 4.87 years. The preferred position of the hip for arthrodesis was 20-30° of flexion, neutral abduction-adduction, and neutral rotation, irrespective of the method of fixation. Results: The average duration of clinical and radiological arthrodesis was found to be 4 months (2-6 months. At the last follow-up, all patients were painfree and had good ambulatory capacity. The average Modified Harris Hip Score increased from 53 to 84 and the average post-surgical limb length discrepancy was 1.3 cm, which was well tolerated in all cases. Patients, however, had difficulty in squatting and had to modify their posture for foot care, putting on shoes, etc. Also, some patients complained of ipsilateral knee, contralateral hip, or low back pain with prolonged activity, but this was not severe enough to restrict activity except in one case that was known to have juvenile rheumatoid arthritis and needed ambulatory aid. Conclusion: In an environment where pathology generally presents very late and often in a dramatic manner, where the patient′s socioeconomic status, understanding, compliance, and the logistics of follow-up are consistently a challenge in management, hip arthrodesis has been an important procedure for

  13. Optimizing Patient Management and Adherence for Children Receiving Growth Hormone

    Directory of Open Access Journals (Sweden)

    Carlo L. Acerini

    2017-11-01

    Full Text Available Poor adherence with growth hormone (GH therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The “360° GH in Europe” meeting, held in Lisbon, Portugal, in June 2016 and funded by Merck KGaA (Germany, examined many aspects of GH diseases. The three sessions, entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management,” and “Managing Transition,” each benefited from three guest speaker presentations, followed by an open discussion and are reported as a manuscript, authored by the speakers. Reported here is a summary of the proceedings of the second session, which reviewed the determinants of GH therapy response, factors affecting GH therapy adherence and the development of innovative technologies to improve GH treatment in children. Response to GH therapy varies widely, particularly in regard to the underlying diagnosis, although there is little consensus on the definition of a poor response. If the growth response is seen to be less than expected, the possible reasons should be discussed with patients and their parents, including compliance with the therapy regimen. Understanding and addressing the multiple factors that influence adherence, in order to optimize GH therapy, requires a multi-disciplinary approach. Because therapy continues over many years, various healthcare professionals will be involved at different periods of the patient’s journey. The role of the injection device for GH therapy, frequent monitoring of response, and patient support are all important for maintaining adherence. New injection devices are incorporating electronic technologies for automated monitoring and recording of clinically relevant information on injections. Study results are indicating that such devices can at least maintain GH adherence; however, acceptance of novel devices needs to be assessed and there remains an on

  14. Brain stem tumors in children - therapeutic results in patients of the University Children's Hospital of Cracow in Poland

    International Nuclear Information System (INIS)

    Korab-Chrzanowska, E.; Bartoszewska, J.; Kwiatkowski, S.

    2005-01-01

    To analyse the treatment results achieved in children treated for brain stem tumours at one institution between the years 1990 and 2004. Material. 20 patients (10 girls, 10 boys) aged 2.8-15.6 years were treated for brain stem tumors at the University Children's Hospital of Cracow (UCHC) in the years 1990-2004. The tumour type was defined basing on imaging studies (CT, MRI), and, in the case of 7 patients, additionally basing on histopathological results. In the collected material the predominant tumor type was benign glioma, detected in 17 patients. Malignant gliomas were diagnosed in 3 children. 7 children were treated by radiotherapy only. Surgical procedures and adjuvant radiotherapy were employed in 3 patients. 6 children underwent radiotherapy and chemotherapy. Combined surgical treatment followed by radiotherapy and chemotherapy was employed in 4 patients. Of the 20 patients 6 have died (30%). The surviving group (70%) includes 1 patient with tumor progression (5%), 5 - with stable tumors (25%), and 8 (40%) - with tumor regression. The probability of three-year overall survival for the entire group as calculated by the Kaplan-Meier method was 70% while the probability of three-year progression-free survival was 65%. Conclusions. Diffuse brain stem tumors, mostly those involving the pons, and malignant gliomas have poor prognosis. In the presented material we achieved the best treatment results in patients with exophytic or focal tumors, treated surgically with adjuvant therapy. (author)

  15. Oncofertility: A New Medical Specialty Helping Young Cancer Patients Have Children

    Science.gov (United States)

    ... Oncofertility: A New Medical Specialty Helping Young Cancer Patients Have Children Past Issues / Fall 2014 Table of ... old problem: the fertility needs of young cancer patients. The word itself was coined through NIH-sponsored ...

  16. Choroid plexus carcinomas in children: MRI features and patient outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Steven P. [University of Rochester School of Medicine, Strong Memorial Hospital, Department of Radiology, Rochester, NY (United States); University of Rochester Medical Center, Department of Radiology, 601 Elmwood Avenue, P.O. Box 648, Rochester, NY (United States); Khademian, Zarir P.; Zimmerman, Robert A. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Chuang, Sylvester H. [Hospital for Sick Children, Department of Radiology, Toronto, ON (Canada); Pollack, Ian F. [Children' s Hospital of Pittsburgh, Department of Pediatric Neurosurgery, Pittsburgh, PA (United States); Korones, David N. [University of Rochester School of Medicine, Strong Memorial Hospital, Department of Pediatrics, Rochester, NY (United States)

    2004-09-01

    Choroid plexus carcinomas (CPC) are rare malignant intracranial neoplasms usually occurring in young children. The objectives of this study were to characterize the preoperative MRI features of CPC, determine the frequency of disseminated disease in the CNS at diagnosis, and assess patient outcomes. The preoperative cranial MR images of 11 patients with CPC were retrospectively reviewed for lesion location, lesion size, un-enhanced and enhanced MRI signal characteristics, and presence of disseminated intracranial tumor. Postoperative cranial and spinal MRI images were reviewed for residual, recurrent, and/or disseminated tumor. The study group included six male and five female patients ranging in age from 5 months to 5.3 years (median=1.8 years). CPC were located in the lateral (n=8), fourth (n=1), and third (n=1) ventricles, and foramen of Luschka (n=1). Mean tumor size was 5.2cm x 4.9cm x 5.0 cm. On short-TR images, CPC had heterogeneous, predominantly intermediate signal with foci of high signal in 45% of lesions from areas of hemorrhage. On long-TR/long-TE images, solid portions of CPC typically had heterogeneous, intermediate-to-slightly-high signal. Small zones of low signal on long-TR/long-TE images were seen in 55% of the lesions secondary to areas of hemorrhage and/or calcifications. Tubular flow voids representing blood vessels were seen in 55% of the lesions. Zones of high signal comparable to CSF were seen in 64% of CPC secondary to cystic/necrotic zones. All CPC showed prominent contrast enhancement. Irregular enhancing margins suggesting subependymal invasion were seen in 73% of the lesions. Findings consistent with edema in the brain adjacent to the enhancing lesions were seen in 73% of CPC. CPC caused hydrocephalus in 82% of patients at diagnosis. Two patients died from hemorrhagic complications from surgical biopsies. Disseminated tumor in the leptomeninges was present in 45% of patients at diagnosis and was associated with a poor prognosis. The 1

  17. [Acute ethanol intoxication among children and adolescents. A retrospective analysis of 173 patients admitted to a university children hospital].

    Science.gov (United States)

    Schöberl, S; Nickel, P; Schmutzer, G; Siekmeyer, W; Kiess, W

    2008-01-01

    In the last time the alcohol consumption among children and adolescents is a big theme in all kind of media. The ethanol consumption among children and adolescents has risen during the last years, but also new hazardous drinking patterns like "binge-drinking" are increasing. These drinking episodes are responsible for many hospital presentations of children and adolescents with acute ethanol intoxication. This study is a retrospective analysis of 173 patients admitted to the university children hospital of Leipzig due to acute ethanol intoxication during the period 1998-2004. Investigated parameters were: socio-demographic factors, clinical presentation and management as well as quantity and type of alcohol. During the years 1998-2004 the rate of alcohol intoxicated patients in this study increased, from 1998-2003 at about 171.4%. Totally 173 patients with an average age of 14.5 years were admitted to the university children hospital. There were significantly more boys than girls. The mean blood alcohol concentration of these patients was 1.77%. Some of the patients had severe symptoms. 62 were unconscious, 2 were in coma and at least 3 patients had to be ventilated. A difference between socioeconomic groups could be observed by comparing the different school types. 44.8% of the patients went to the middle school. Furthermore 17 patients of this study had mental disorders or psychosocial problems and were therefore in psychological or psychiatric treatment. In this study a significant influence of social classes or psychosocial problems on alcohol consumption such as binge-drinking leading to acute ethanol intoxication could not be found. Alarming is the increasing number of ethanol intoxicated patients, the young age, the high measured blood ethanol concentrations and the severe symptoms of these patients. This is the reason why early and intensive prevention strategies are required.

  18. The attitudes of mental health professionals towards patients' desire for children.

    Science.gov (United States)

    Krumm, Silvia; Checchia, Carmen; Badura-Lotter, Gisela; Kilian, Reinhold; Becker, Thomas

    2014-03-02

    When a patient with a serious mental illness expresses a desire for children, mental health professionals are faced with an ethical dilemma. To date, little research has been conducted into their strategies for dealing with these issues. Seven focus groups with a total of 49 participants from all professional groups active in mental health (nurses, psychologists, social workers and psychiatrists) were conducted in a 330-bed psychiatric hospital. Group discussions were transcribed verbatim and analysed by the documentary method described by Bohnsack. Mental health professionals did not feel that their patients' desire for children was as important in daily practice as were parenting issues. When discussing the desire for children on the part of patients, the following themes emerged: "the patient's own decision", "neutrality", "the patient's well-being", "issues affecting the children of mentally ill parents" and "appropriate parenthood". In order to cope with what they perceived as conflicting norms, mental health professionals developed the following (discursive) strategies: "subordination of child welfare", "de-professionalisation", "giving rational advice" and "resignation". The theme of "reproductive autonomy" dominated mental health professionals' discourse on the desire for children among psychiatric patients. "Reproductive autonomy" stood in conflict with another important theme (patient's children). Treating reproductive issues as taboo is the result of the gap between MHPs' perceptions of (conflicting) norms when dealing with a patient's desire for children and the limited opportunities to cope with them appropriately.In order to support both patients with a desire for children and mental health professionals who are charged with providing counselling for such patients, there is a need to encourage ethical reflection and to focus on clinical recommendations in this important area.

  19. Hereditary hemorrhagic telangiectasia in children: endovascular treatment of neurovascular malformations. Results in 31 patients

    International Nuclear Information System (INIS)

    Krings, T.; Chng, S.M.; Ozanne, A.; Alvarez, H.; Lasjaunias, P.L.; Rodesch, G.

    2005-01-01

    Hereditary hemorrhagic telangiectasia (HHT) is a heterogeneous disease that can present with a variety of clinical manifestations. The neurovascular complications of this disease, especially in children, may be potentially devastating. The purpose of this article was to review the therapeutic results of endovascular treatment of neurovascular malformations in children. A total of 31 patients under the age of 16 were included in this retrospective analysis. All children were treated in a single center. Twenty children presented with 28 arteriovenous (AV) fistulae, including seven children with spinal AV fistulae and 14 children with cerebral AV fistulae (one child had both a spinal and cerebral fistulae). Eleven children had small nidus-type AV malformations. All embolizations were performed employing superselective glue injection. Follow-up ranged between 3 and 168 months (mean 66 months). A total of 115 feeding vessels were embolized in 81 single sessions, resulting in a mean overall occlusion rate of the malformation of 77.4% (ranging from 30 to 100%). Two of 31 patients (6.5%) died as a direct complication of the embolization procedure; two patients (6.5%) had a persistent new neurological deficit; eight patients (26.7%) were clinically unchanged following the procedure; in 13 patients (41.9%) an amelioration of symptoms but no cure could be achieved; and six patients (19.4%) were completely asymptomatic following the endovascular procedure. (orig.)

  20. Regional circulation around Heard and McDonald Islands and through the Fawn Trough, central Kerguelen Plateau

    Science.gov (United States)

    van Wijk, Esmee M.; Rintoul, Stephen R.; Ronai, Belinda M.; Williams, Guy D.

    2010-05-01

    The fine-scale circulation around the Heard and McDonald Islands and through the Fawn Trough, Kerguelen Plateau, is described using data from three high-resolution CTD sections, Argo floats and satellite maps of chlorophyll a, sea surface temperature (SST) and absolute sea surface height (SSH). We confirm that the Polar Front (PF) is split into two branches over the Kerguelen Plateau, with the NPF crossing the north-eastern limits of our survey carrying 25 Sv to the southeast. The SPF was associated with a strong eastward-flowing jet carrying 12 Sv of baroclinic transport through the deepest part of Fawn Trough (relative to the bottom). As the section was terminated midway through the trough this estimate is very likely to be a lower bound for the total transport. We demonstrate that the SPF contributes to the Fawn Trough Current identified by previous studies. After exiting the Fawn Trough, the SPF crossed Chun Spur and continued as a strong north-westward flowing jet along the eastern flank of the Kerguelen Plateau before turning offshore between 50°S and 51.5°S. Measured bottom water temperatures suggest a deep water connection between the northern and southern parts of the eastern Kerguelen Plateau indicating that the deep western boundary current continues at least as far north as 50.5°S. Analysis of satellite altimetry derived SSH streamlines demonstrates a southward shift of both the northern and southern branches of the Polar Front from 1994 to 2004. In the direct vicinity of the Heard and McDonald islands, cool waters of southern origin flow along the Heard Island slope and through the Eastern Trough bringing cold Winter Water (WW) onto the plateau. Complex topography funnels flow through canyons, deepens the mixed layer and increases productivity, resulting in this area being the preferred foraging region for a number of satellite-tracked land-based predators.

  1. "Make Your Voice Heard": Communism in the High School Curriculum, 1958-1968

    Science.gov (United States)

    Scribner, Campbell F.

    2012-01-01

    The launch of "Sputnik" in 1957 sparked a crisis in American education. Suddenly threatened by superior Soviet technology, progressive educators' concern for children's preferences, health, and adjustment in school yielded to public demands for more basic learning and academic skills. Congress soon passed the National Defense Education Act,…

  2. Cost of inpatient care for HIVpositive patients at Red Cross Children ...

    African Journals Online (AJOL)

    There is anecdotal evidence that certain categories of patients at Red Cross War Memorial Children\\'s Hospital (RCH) are thought to be utilising more resources than others. Faced with an ever-increasing demand for care, shrinking budgets and tough measures by government to force health managers to operate within ...

  3. From the children's point of view : power, pragmatism and rights in children's lives in Buganda

    OpenAIRE

    Baarøy, Jan Olav

    1999-01-01

    I left for Uganda in 1996 with two issues I wanted to consider: One, people's comprehension of children's rights; and two, children's perspective of their daily life. As Redd Barna had been working in this particular area of Uganda since the early 1990's I had heard that almost everybody knew about children's rights - or eddembe ly'abaana in Luganda (a translation which literally could mean, and often understood as children's freedom or liberty, and even children's peace). Now, when sumarizin...

  4. Where to Look First for Suggestibility in Young Children.

    Science.gov (United States)

    Newcombe, Peter A.; Siegal, Michael

    1996-01-01

    Investigated preschool children's suggestibility following exposure to biased information. Children heard a story followed the next day by either biased, unbiased, or no information. Found that children were able to identify the original story details six days later when the questions were phrased in an explicit manner that referred to the time of…

  5. Possibilities and limitations of children's participation in inclusion ...

    African Journals Online (AJOL)

    Beyond realising the right of children and young people to be heard in routine interactions, there is much scope for research with (rather than on) children. This is particularly pertinent in the field of inclusive education where there is potential for the voice of children and young people to be a lever for change and to promote ...

  6. [The situation of pediatric patients' rights in the Transylvanian healthcare].

    Science.gov (United States)

    Albert-Lőrincz, Csanád

    2018-03-01

    This study summarizes the results of the author's PhD thesis presenting the research process and the most important findings regarding the situation of Transylvanian healthcare. Our data are based on the knowledge and compliance of pediatric patients' rights as they are seen by healthcare specialists, parents and children. A number of 751 persons were involved in the research: 200 healthcare specialists, 200 parents, 200 children aged from 7 to 17 years who have been experiencing health services at least three times over the past year and a control group of 151 children who did not have this kind of experience. Based on our data, it was possible to highlight the major problems encountered in children's healthcare. We found that children are treated by obsolete principles of medical practice despite the fact that the rights of pediatric patients are well known to doctors. Neither the parents nor the children themselves are sufficiently aware of their rights. Healthcare professionals are not prepared to overcome communication difficulties due to the age-specific characteristics of children, so the fundamental rights of children are just partially enforced: children are usually heard, but not properly informed, their medical decisions are usually not taken into account violating the right to self-determination. The chances to access adequate health services are lower for vulnerable children living in poverty. Orv Hetil. 2018; 159(11): 423-429.

  7. Management of the pediatric nuclear medicine patient (or children are not small adults)

    International Nuclear Information System (INIS)

    Kieffer, C.T.; Suto, P.A.

    1983-01-01

    The first of a four-part continuing education series on pediatric nuclear medicine is presented. Included are: (1) clinical indications for performing nuclear medicine studies in children; (2) comparison of nuclear medicine procedures for adult and pedicatric patients; (3) appropriate radiopharmaceuticals for performing pediatric studies; (4) radiation protection techniques (5) the principles of pediatric radiopharmaceutical dose calculation and common calculation methods; (6) possible injection sites and administration methods (7) radiopharmaceutical clearance times and imaging times in adults and children; (8) the collimators of choice for most procedures performed in children; (9) certain behaviors exhibited by children according to their stage of emotional development and children's response to the hospital setting; and (10) patient immobilization techniques and advantages of physical restraint over sedation

  8. Radiogenic enteritis in children: study in a series of 63 patients

    International Nuclear Information System (INIS)

    Alert Silva, J.; Longchong Ramos, M.; Castillo Otero, E.; Valdes Zamora, M.

    1981-01-01

    In children, the abdominal irradiation being part of multidisciplinary therapeutical treatment for various malignant neoplasias, inferred radiogenic enteritis onset. In a group of 63 patients treated at the Institute of Oncology and Radiobiology, in Havana City, who presented intraabdominal located no Hodgkin's linfomas, Wilms' tumors, neuroblastomas, intraabdominal sarcomas and ovarium malignant neoplasias, incidence for this complication was 63,5%; in 34 children showed up during radiant treatment (early enteritis) and in eleven children after it was finished (late enteritis). Extended surgical exeresis accounted to clinical picture onset. Hygienicdietetic treatment improves patient's clinical evolution. (author)

  9. Submarine glacial landforms and interactions with volcanism around Sub-Antarctic Heard and McDonald Islands

    Science.gov (United States)

    Picard, K.; Watson, S. J.; Fox, J. M.; Post, A.; Whittaker, J. M.; Lucieer, V.; Carey, R.; Coffin, M. F.; Hodgson, D.; Hogan, K.; Graham, A. G. C.

    2017-12-01

    Unravelling the glacial history of Sub-Antarctic islands can provide clues to past climate and Antarctic ice sheet stability. The glacial history of many sub-Antarctic islands is poorly understood, including the Heard and McDonald Islands (HIMI) located on the Kerguelen Plateau in the southern Indian Ocean. The geomorphologic development of HIMI has involved a combination of construction via hotspot volcanism and mechanical erosion caused by waves, weather, and glaciers. Today, the 2.5 km2 McDonald Islands are not glacierised; in contrast, the 368 km2 Heard Island has 12 major glaciers, some extending from the summit of 2813 m to sea level. Historical accounts from Heard Island suggest that the glaciers were more extensive in the 1850s to 1870s, and have retreated at least 12% (33.89 km2) since 1997. However, surrounding bathymetry suggests a much more extensive previous glaciation of the HIMI region that encompassed 9,585 km2, likely dating back at least to the Last Glacial Maximum (LGM) ca. 26.5 -19 ka. We present analyses of multibeam bathymetry and backscatter data, acquired aboard RV Investigator in early 2016, that support the previous existence of an extensive icecap. These data reveal widespread ice-marginal and subglacial features including moraines, over-deepened troughs, drumlins and crag-and-tails. Glacial landforms suggest paleo-ice flow directions and a glacial extent that are consistent with previously documented broad scale morphological features. We identify >660 iceberg keel scours in water depths ranging from 150 - 530 m. The orientations of the iceberg keel scours reflect the predominantly east-flowing Antarctic Circumpolar Current and westerly winds in the region. 40Ar/39Ar dating of volcanic rocks from submarine volcanoes around McDonald Islands suggests that volcanism and glaciation coincided. The flat-topped morphology of these volcanoes may result from lava-ice interaction or erosion by glaciers post eruption during a time of extensive ice

  10. Age-related postoperative morphine requirements in children following major surgery--an assessment using patient-controlled analgesia (PCA)

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Henneberg, Steen Winther; Hole, P

    1996-01-01

    To investigate if small children require less morphine for postoperative analgesia than do older children and adolescents we analysed the morphine consumption pattern of 28 consecutive children on intravenous patient-controlled analgesia (PCA) following major surgery. The median age-specific morp......To investigate if small children require less morphine for postoperative analgesia than do older children and adolescents we analysed the morphine consumption pattern of 28 consecutive children on intravenous patient-controlled analgesia (PCA) following major surgery. The median age...

  11. Are validated patient-reported outcomes used on children in pediatric otolaryngology? A systematic review.

    Science.gov (United States)

    Wong, Kevin; Piraquive, Jacquelyn; Troiano, Chelsea A; Sulibhavi, Anita; Grundfast, Kenneth M; Levi, Jessica R

    2018-02-01

    Review the pediatric otolaryngology literature to 1) identify studies in which children completed patient-reported outcome (PRO) measures and 2) appraise the psychometric quality and validity of these PROs as they apply to pediatrics. In October 2016, a systematic review was performed by two reviewers on PubMed/MEDLINE and EMBASE for all otolaryngology-related studies that utilized PROs in children. Inclusion criteria included articles that required children (ageotolaryngology and some studies utilized PROs that were not validated or not validated for use in this age group. Future efforts to design and validate more instruments may be warranted. Copyright © 2017. Published by Elsevier B.V.

  12. Heard Island and McDonald Islands Acoustic Plumes: Split-beam Echo sounder and Deep Tow Camera Observations of Gas Seeps on the Central Kerguelen Plateau

    Science.gov (United States)

    Watson, S. J.; Spain, E. A.; Coffin, M. F.; Whittaker, J. M.; Fox, J. M.; Bowie, A. R.

    2016-12-01

    Heard and McDonald islands (HIMI) are two active volcanic edifices on the Central Kerguelen Plateau. Scientists aboard the Heard Earth-Ocean-Biosphere Interactions voyage in early 2016 explored how this volcanic activity manifests itself near HIMI. Using Simrad EK60 split-beam echo sounder and deep tow camera data from RV Investigator, we recorded the distribution of seafloor emissions, providing the first direct evidence of seabed discharge around HIMI, mapping >244 acoustic plume signals. Northeast of Heard, three distinct plume clusters are associated with bubbles (towed camera) and the largest directly overlies a sub-seafloor opaque zone (sub-bottom profiler) with >140 zones observed within 6.5 km. Large temperature anomalies did not characterize any of the acoustic plumes where temperature data were recorded. We therefore suggest that these plumes are cold methane seeps. Acoustic properties - mean volume backscattering and target strength - and morphology - height, width, depth to surface - of plumes around McDonald resembled those northeast of Heard, also suggesting gas bubbles. We observed no bubbles on extremely limited towed camera data around McDonald; however, visibility was poor. The acoustic response of the plumes at different frequencies (120 kHz vs. 18 kHz), a technique used to classify water column scatterers, differed between HIMI, suggestiing dissimilar target size (bubble radii) distributions. Environmental context and temporal characteristics of the plumes differed between HIMI. Heard plumes were concentrated on flat, sediment rich plains, whereas around McDonald plumes emanated from sea knolls and mounds with hard volcanic seafloor. The Heard plumes were consistent temporally, while the McDonald plumes varied temporally possibly related to tides or subsurface processes. Our data and analyses suggest that HIMI acoustic plumes were likely caused by gas bubbles; however, the bubbles may originate from two or more distinct processes.

  13. Etiology of acute scrotal pain in children and adolescent patients ...

    African Journals Online (AJOL)

    Purpose Acute scrotum is an emergency condition requiring rapid intervention. The aim of this study was to evaluate the clinical and epidemiological specifications of acute scrotum. Patients and methods This retrospective study was carried out on patients less than 21 years admitted with a diagnosis of acute scrotum in the ...

  14. Myasthenia gravis in children: analysis of 18 patients

    Directory of Open Access Journals (Sweden)

    Morita Maria da Penha A.

    2001-01-01

    Full Text Available Myasthenia gravis (MG in childhood is rare comprising 10 to 20 % of all myasthenic patients. We studied 18 patients with MG whose first symptoms started from 1 to 12 years of age, followed at the Department of Neurology of the UNIFESP-EPM, from January 1983 to August 1997. There were 10 girls and 8 boys (1.2:1. Eleven patients (61% presented moderate or severe generalized disease and 4 (22% had at least one myasthenic crisis. EMG with supramaximal repetitive nerve stimulation was diagnostic in 8 (47% out of 17 patients, and chest CT was normal in 14 patients. Seropositivity to acetylcholine receptor antibodies was found in 81.6% (9 out of 11 tested and the levels had no relation to clinical severity. Nine out of 16 patients (56% worsened with pyridostigmine alone and were treated with prednisone. Four out of those nine continued worsening despite steroids and were subjected to thymectomy (all showed thymic lymphoid follicular hyperplasia. Three patients (75% improved markedly after thymectomy and one (25% worsened, eventually getting better with intravenous immunoglobulin and oral azathioprine. MG treatment, using all resources available, has to be individualized for each child.

  15. Cultural respect encompassing simulation training: being heard about health through broadband

    Directory of Open Access Journals (Sweden)

    Phyllis Min-yu Lau

    2016-04-01

    Full Text Available Background. Cultural Respect Encompassing Simulation Training (CREST is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity – defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire – of the streamed simulations. Design and Methods. In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. Results. Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05. Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. Conclusions. Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals’ learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training.

  16. Lipids and Protein Peroxidation in Children and Teenager Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Yu.V. Poliakova

    2015-09-01

    Full Text Available A review of literature about the study of lipid and protein peroxidation in children and teenagers with pulmonary tuberculosis nowadays was carried out. It was established that there is a great number works dedicated to the lipid peroxidation and antioxidant protective system in various pathological conditions of the respiratory system, including pulmonary tuberculosis in children and teenagers today. Oxidative modification proteins products are the earliest markers of oxidative stress in patients. There is no information on the oxidative modification of proteins in children and teenagers suffering from pulmonary tuberculosis in the literature. The study of oxidative modification of proteins will facilitate the development of more efficient new diagnosis methods and pathogenetic treatment of children and teenagers with pulmonary tuberculosis, that will increase the treatment effectiveness.

  17. Living and Dying: A Window on (Christian) Children's Spirituality

    Science.gov (United States)

    Champagne, Elaine

    2008-01-01

    Faith and beliefs about living and dying are fundamental constituents of spiritual development. However, children are seldom asked to talk about their experiences of life and death. This article has a twofold purpose. It first describes children's expressions on living and dying, as heard during a newly developed programme which encourages…

  18. Involving seldom-heard groups in a PPI process to inform the design of a proposed trial on the use of probiotics to prevent preterm birth: a case study.

    Science.gov (United States)

    Rayment, Juliet; Lanlehin, Rosemary; McCourt, Christine; Husain, Shahid M

    2017-01-01

    public consultation exercise in a socially disadvantaged and ethnically diverse community. The consultation aimed to meet and engage local service users in considering the acceptability of the proposed protocol, and to encourage their participation in future and ongoing patient and public involvement activities. Four discussion groups were held in the community with mothers of young children within the proposed trial region, using an inclusive approach that incorporated a modified version of the Nominal Group Technique (NGT). Bringing the consultation to the community supported the involvement of often seldom-heard participants, such as those from minority ethnic groups. Results The women involved expressed a number of concerns about the proposed protocol, including adherence to the probiotic supplement regimen and randomisation. The proposal for the RCT in itself was perceived as confirmation that probiotic supplements had potentially beneficial effects, but also that they had potentially harmful side-effects. The complexity of the women's responses provided greater insights into the challenges of even quite simple trial designs and enabled the research team to take these concerns into account while planning the pilot trial. Conclusions The use of the NGT method allowed for a consultation of a population traditionally less likely to participate in medical research. A carefully facilitated PPI exercise can allow members to express unanticipated concerns that may not have been elicited by a survey method. Findings from such exercises can be utilised to improve clinical trial design, provide insight into the feasibility of trials, and enable engagement of often excluded population groups.

  19. Subclinical nephritic syndrome in children cohabiting with pediatric patients, Presenting acute nephritic syndrome

    OpenAIRE

    Guerrero-Tinoco Gustavo Adolfo; Julio-Barrios Emil

    2012-01-01

    Introduction: subclinical nephritic syndrome is the presence of hematuria, hypocomplementemiaand/or proteinuria without the presence of signs and/or symptoms.Objective: to determine the incidence of subclinical nephritic syndrome in childrenliving with pediatric patients diagnosed with acute nephritic syndrome.Methods: family visit to identify children living together in the two previous months, with pediatric patients hospitalized with acute nephritic syndrome, at Hospital InfantilNapoleon F...

  20. Splenic abscess in children: A report of three patients | Rattan ...

    African Journals Online (AJOL)

    Splenic abscess is uncommon in paediatric age group. It usually occurs in conditions of disseminated infective focus. Conventional treatment of abscess is incision and drainage, although splenectomy or splenic conservation is alternative. In this report, we are presenting case summaries of three patients suffering from ...

  1. Intussusception in children: Experience with 105 patients in a ...

    African Journals Online (AJOL)

    Aim. The aim of this study was to present our experience in patients with intussusception (IN). Materials and methods. One hundred and five cases of IN treated between 1991 and 2007 were analysed. Age, gender, symptoms, signs, diagnostic and treatment methods, types of IN including leading point, and postoperative ...

  2. Variation in use of Internet-based patient portals by parents of children with chronic disease.

    Science.gov (United States)

    Byczkowski, Terri L; Munafo, Jennifer K; Britto, Maria T

    2011-05-01

    To assess the use of Internet-based portals among families of children with chronic diseases and to describe characteristics of portal registrants and users. Retrospective observational study. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, using data from September 1, 2003, through February 29, 2008. Patients/ Parents of children with diabetes mellitus, juvenile idiopathic arthritis, or cystic fibrosis. Parents of children with a chronic disease were given the opportunity to access health-related information for their children via an Internet-based portal. Percentage of families who obtained a portal account (registered), used the portal for the first time within 3 months and again 3 to 6 months after registration, number of times logged in, and session length. Of 1900 families, 27.9% obtained a portal account. Of those, 47.8% used the portal within 3 months of registration and 15.9% continued to use the portal 3 to 6 months after registration. Families of African American patients and of patients insured by Medicaid were less likely to obtain a portal account. More outpatient visits and having private health insurance coverage were associated with increased portal registration and use. Understanding the feasibility of portal use by parents is an important first step to using portals for improving self-management, patient-provider interactions, and outcomes for children with chronic diseases. Subsequent studies should address parent perceptions of the value portals add to the management of the chronic disease of their child and ways to increase that value. Barriers to using portals among racial minorities and publicly insured families should also be studied to address disparities.

  3. The Deafening Silence: Discussing Children's Drawings for Understanding and Addressing Marginalization

    Science.gov (United States)

    Angelides, Panayiotis; Michaelidou, Antonia

    2009-01-01

    Researchers who deal with inclusive education have made great efforts to listen to the voices of children in order to understand marginalization. Despite the fact that these efforts take place, the voices of many children fail to be heard and hence many children continue to be marginalized. In this article we will develop and implement a technique…

  4. When the Happy Victimizer Says Sorry: Children's Understanding of Apology and Emotion

    Science.gov (United States)

    Smith, Craig E.; Chen, Diyu; Harris, Paul L.

    2010-01-01

    Previous research suggests that children gradually understand the mitigating effects of apology on damage to a transgressor's reputation. However, little is known about young children's insights into the central emotional implications of apology. In two studies, children ages 4-9 heard stories about moral transgressions in which the wrongdoers…

  5. Child's Voice, Child's Right: Is Philosophy for Children in Africa the Answer?

    Science.gov (United States)

    Ndofirepi, Amasa; Cross, Michael

    2015-01-01

    In this concept paper, we explore the notion of the child's right to be heard, starting in the classroom. The idea that children have unique needs has paved the way for the admission that children have a similar spectrum of rights as adults do. The notion that children are valued as citizens, and have significant contributions to make now and in…

  6. Using electronic storybooks to support word learning in children with severe language impairments

    NARCIS (Netherlands)

    Smeets, Daisy J. H.; van Dijken, Marianne J.; Bus, Adriana G

    2012-01-01

    Novel word learning is reported to be problematic for children with severe language impairments (SLI). In this study, we tested electronic storybooks as a tool to support vocabulary acquisition in SLI children. In Experiment 1, 29 kindergarten SLI children heard four e-books each four times: (a) two

  7. Medulloblastoma subgroup-specific outcomes in irradiated children: who are the true high-risk patients?

    Science.gov (United States)

    Ramaswamy, Vijay; Remke, Marc; Adamski, Jennifer; Bartels, Ute; Tabori, Uri; Wang, Xin; Huang, Annie; Hawkins, Cynthia; Mabbott, Donald; Laperriere, Normand; Taylor, Michael D; Bouffet, Eric

    2016-02-01

    The advent of integrated genomics has fundamentally changed our understanding of medulloblastoma. Although survival differences exist among the 4 principal subgroups, this has yet to be elucidated in a North American cohort of irradiated patients. Ninety-two consecutive patients between the ages of 3 and 17 treated with surgery, craniospinal irradiation, and chemotherapy were identified at the Hospital for Sick Children. Molecular subgrouping was performed using nanoString. Two treatment periods were identified: prior to 2006 as per the protocols of the Children's Oncology Group, and after 2006 per the St Jude Medulloblastoma 03 protocol. Five-year progression-free survival (PFS) over the entire cohort was 0.801 (95% CI: 0.692-0.875) with no significant difference between treatment protocols. Strikingly, we found that Group 4 patients had excellent 5-year PFS of 0.959 (95% CI: 0.744-0.994) for average risk and 0.887 (95% CI: 0.727-0.956) across all Group 4 patients. Group 3 patients had 5-year PFS of 0.733 (95% CI: 0.436-0.891). Sonic hedgehog patients did poorly across both treatment protocols, with 5-year PFS of 0.613 (95% CI: 0.333-0.804), likely owing to a high proportion of TP53 mutated patients in this age group. In a cohort of irradiated patients over 3 years of age, PFS for Group 4 patients was significantly improved compared with initial reports. The impact of subgroup affiliation in these children needs to be assessed in large prospectively treated cooperative protocols to determine if more than just WNT patients can be safely selected for de-escalation of therapy. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Children's Hospitals' Solutions for Patient Safety Collaborative Impact on Hospital-Acquired Harm.

    Science.gov (United States)

    Lyren, Anne; Brilli, Richard J; Zieker, Karen; Marino, Miguel; Muething, Stephen; Sharek, Paul J

    2017-09-01

    To determine if an improvement collaborative of 33 children's hospitals focused on reliable best practice implementation and culture of safety improvements can reduce hospital-acquired conditions (HACs) and serious safety events (SSEs). A 3-year prospective cohort study design with a 12-month historical control population was completed by the Children's Hospitals' Solutions for Patient Safety collaborative. Identification and dissemination of best practices related to 9 HACs and SSE reduction focused on key process and culture of safety improvements. Individual hospital improvement teams leveraged the resources of a large, structured children's hospital collaborative using electronic, virtual, and in-person interactions. Thirty-three children's hospitals from across the United States volunteered to be part of the Children's Hospitals' Solutions for Patient Safety collaborative. Thirty-two met all the data submission eligibility requirements for the HAC improvement objective of this study, and 21 participated in the high-reliability culture work aimed at reducing SSEs. Significant harm reduction occurred in 8 of 9 common HACs (range 9%-71%; P collaborative dedicated to implementing HAC-related best-practice prevention bundles and culture of safety interventions designed to increase the use of high-reliability organization practices resulted in significant HAC and SSE reductions. Structured collaboration and rapid sharing of evidence-based practices and tools are effective approaches to decreasing hospital-acquired harm. Copyright © 2017 by the American Academy of Pediatrics.

  9. Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

    Science.gov (United States)

    2015-12-01

    Pediatric  ICU  with  severe  sepsis/shock...traumatic  brain  injury  and  pulmonary  embolus   and  in  both  adult  and   pediatric  patients.  CDS  can  be  a...record,   pediatric  critical  care,  neonatal  intensive  care,  severe  sepsis,  septic  shock   16. SECURITY CLASSIFICATION

  10. Have You Heard?

    Centers for Disease Control (CDC) Podcasts

    2009-08-12

    Pre-teens, adolescents, and college freshmen who live in dorms are at an increased risk for meningococcal disease. This podcast discusses routine vaccination recommendations for 11-18 year olds.  Created: 8/12/2009 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 8/12/2009.

  11. Hearing devices for children with unilateral hearing loss: Patient- and parent-reported perspectives.

    Science.gov (United States)

    Purcell, Patricia L; Jones-Goodrich, Rose; Wisneski, Meghan; Edwards, Todd C; Sie, Kathleen C Y

    2016-11-01

    Management of children with unilateral hearing loss is not standardized. The primary goal of this study was to elicit patient- and parent-reported perspectives regarding usage of hearing devices in pediatric UHL and to suggest a basic algorithmic approach to management. Our tertiary care center recruited families of youth ages 5-19 years with unilateral hearing loss from January 2014 through October 2015. Parents of all youths completed a 36-item survey, and some youth ages 11-19 years participated in hour-long interviews. We assessed patterns of hearing device usage among participants, and performed qualitative data analysis to understand factors considered by youths when deciding whether or not to use a hearing device. Survey information was collected for 50 patients. Distribution of hearing loss severity in affected ear was mild 14%, moderate 26%, severe 22%, and profound 38%. The majority of children had sensorineural hearing loss (57%), followed by mixed (32%), and then conductive (11%). 34 children (68%) had tried a hearing device; 20 continued to use the device. Retention rates were similar among children with different degrees of hearing loss: mild 66%, moderate 50%, severe 60%, profound 64%. Sixteen children tried a wireless contralateral routing of signal (CROS) device, and 15 tried a behind-the-ear (BTE) hearing aid. Retention rates for CROS and BTE devices were 69% and 47%, respectively. The most common reason for cessation of use was discomfort, followed by lack of benefit. A majority of children with unilateral hearing loss who tried a hearing device continued to use it, and retention rates were similar across all degrees of hearing loss. These findings suggest that personal hearing devices should be included in management protocols. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. A qualitative study of doctors' and nurses' barriers to communicating with seriously ill patients about their dependent children

    DEFF Research Database (Denmark)

    Dencker, Annemarie; Rix, Bo Andreassen; Bøge, Per

    2017-01-01

    OBJECTIVE: Research indicates that health personnel caring for seriously ill patients with dependent children aged 0 to 18 years often avoid discussing with them the challenges of being a family with a parent in treatment. Children of seriously ill patients risk serious trauma and emotional...... difficulty later in life and depend on adult support to minimize these consequences. Patients suffer anxiety about supporting their children during their illness. Because of their potentially pivotal role in supporting patients in enabling parent-child communication, we examined HP's structural and emotional...... barriers to communicating with patients about their children. METHODS: The study was based on 49 semi-structured, in-depth interviews with doctors and nurses working with haematology, gynaecological cancer, and neurointensive care. Both interviews and analysis addressed emotional and structural barriers...

  13. [Genotypes of rhinoviruses in children and adults patients with acute respiratory tract infections].

    Science.gov (United States)

    Demirkan, Eda; Kırdar, Sevin; Ceylan, Emel; Yenigün, Ayşe; Kurt Ömürlü, İmran

    2017-10-01

    Rhinovirus (RV) is one of the most frequent causative agent of acute respiratory tract infections in the world. The virus may cause a mild cold, as well as more serious clinical symptoms in patients with immune system deficiency or comorbidities. Rhinoviruses have been identified by molecular methods under three types: RV-A, RV-B and RV-C. In most of the cases, it was reported that RV-A and RV-C were related with lower respiratory tract infections and asthma exacerbations, while RV-B was rarely reported in lower respiratory tract infections. The main objective of this study was to investigate RV species by sequence analysis in nasopharyngeal samples in pediatric and adult patients who were admitted to hospital with acute respiratory tract infections and to establish the relationship between species and age, gender and clinical diagnosis of the patients. Secondly, it was planned to emphasize the efficiency of the sequence analysis method in the determination of RV species. One hundred twenty seven patients (children and adults) who were followed up with acute respiratory tract infections in our university hospital were evaluated between January 2014 and January 2016. Viral loads were determined by quantitative real-time PCR in RV positive patients detected by a commercial kit in nasopharyngeal swab specimens. Thirty-one samples whose viral loads could not be determined were excluded from the study. The remaining 96 samples (50 children and 46 adults) were retested by conventional PCR using the target of VP4/VP2 gene region. A total of 65 samples (32 adults and 33 children) with the bands (549 bp) corresponding to the VP4/VP2 gene regions after the conventional PCR were analyzed by DNA sequencing. A phylogenetic tree was constructed using the neighbour-joining method. After sequence analysis it was determined that 28 (43.07%) were RV-A, 7 (10.76%) were RV-B and 28 (43.07%) were RV-C; and moreover one of each enterovirus (EV) species EV-D68 (1.53%) and EV-C (1

  14. [THE IMPLEMENTATION OF THE RIGHTS OF CHILDREN-PATIENTS IN THE PROVISION OF MEDICAL CARE IN UKRAINE].

    Science.gov (United States)

    Vilenskyi, A B

    2015-01-01

    The author found that legal regulation of medical care of children in Ukraine need to improve the effectiveness. The key of efficiency of this process is the establishing the principle of providing of the rights of children-patients in the provision of medical care in Ukraine with the special attention to the best interests of the child.

  15. Autoantibodies to IL-1 alpha in sera from umbilical cords, children, and adults, and from patients with juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Müller, K; Hansen, M B; Zak, M

    1996-01-01

    umbilical cords (n = 11), children (n = 45), and adults (n = 20), as well as in 51 patients with juvenile chronic arthritis (JCA) of pauciarticular (n = 34), polyarticular (n = 8), or systemic onset type (n = 9). RESULTS. The frequency of positive sera was significantly lower in children than in cord blood...

  16. Serum LH and FSH Responses to Synthetic LH-RH in Normal Infants, Children and Patients With Turner's Syndrome

    Science.gov (United States)

    Suwa, Seizo; And Others

    1974-01-01

    Effects of luteinizing hormone-releasing hormone (LH-RH) on LH and follicle-stimulating hormone (FSH) release were studied in 26 normal children and six patients (from 1-to 14-years-old) with Turner's syndrome. (Author)

  17. Mini buffy coat photopheresis for children and critically ill patients with extracorporeal photopheresis contraindications.

    Science.gov (United States)

    Hackstein, Holger; Misterek, Joachim; Nockher, Angelika; Reiter, Alfred; Bein, Gregor; Woessmann, Willi

    2009-11-01

    Conventional extracorporeal photopheresis (ECP) has proven efficacy for the treatment of several diseases but is limited to patients with sufficient body weight. A novel simplified mini buffy coat ECP technique that allows treatment of small children and patients with apheresis contraindications has been developed. White blood cell (WBC)-rich buffy coat fractions were prepared from 5 to 8 mL/kg whole blood in a closed system, diluted, and ultraviolet A (UVA)-irradiated after addition of 8-methoxypsoralen (8-MOP). Apoptosis and cell death were analyzed by annexin V and 7-aminoactinomycin staining. Lymphocyte proliferation was measured after CD3/CD28 and phytohemagglutinin (PHA) stimulation. Autologous residual blood and UVA-irradiated buffy coat were returned to the patients. Fifty-six mini buffy coat ECP procedures were applied to three children with acute steroid-refractory skin graft-versus-host disease and apheresis contraindications. Mean whole blood and buffy coat volumes were 166 (+/-61.8) and 8 (+/-1.6) mL, respectively, and resulted in a hematocrit of 2.2% (+/-0.4) after saline dilution (median +/- SD). UVA irradiation of 8-MOP buffy coat preparations resulted in significant induction of WBC apoptosis at 48-72 hours (p laboratory side effects were observed during mini ECP procedures and the three patients responded to the therapy. Mini buffy coat ECP induces apoptosis and lymphocyte proliferation inhibition, both of which occur after standard ECP. This study proposes that mini buffy coat ECP be used as a simple and inexpensive alternative to classical ECP in children and adult patients with apheresis contraindications.

  18. [Ankle injuries without fracture in children. Prospective study with magnetic resonance in 116 patients].

    Science.gov (United States)

    Launay, F; Barrau, K; Petit, P; Jouve, J-L; Auquier, P; Bollini, G

    2008-09-01

    Appropriate assessment of ankle injuries in children and adolescents is a common emergency room problem. Many imaging techniques have been proposed, but with no consensus on the reality of anatomic lesions in ankles free of fractures, complicating the therapeutic decision. We analyzed the lesions observed with magnetic resonance imaging (MRI) in a large number of acute ankles in children. This prospective study was conducted in a pediatric emergency room. The study population included all children aged eight to 15 years who presented an isolated injury of the ankle without fracture on the plain x-ray. History taking and physical examination were standardized. MRI was performed within three days of the initial physical examination. All the radiographic documents were examined by an experienced radiologist blinded to the results of the physical examination. During the study period, 116 patients were included. One hundred two MRI series were examined. Minor ligament injury was noted in 20 patients and ligament tear in five, including three with a closed distal tibial growth plate. Minor bone injury was noted in 42 patients and fracture in seven. None of these fractures were visible on the plain x-ray, even after knowledge of the MRI. Injuries were more frequent in boys. Injuries were more frequent when the pain was localized on the lateral aspect of the ankle and when there was an edema. Despite an abundant literature on ankle sprains, prospective studies are scarce in the pediatric population. We have found that MRI is particularly well-adapted for children because it allows a complete examination of anatomic lesions involving the bone or ligaments without the inconveniences of injections, pain, or radiation. Our clinical and imaging findings show that ankle sprains are real in children. We were however unable to identify any clinical factors predictive of ligament and/or bone injury. Other studies should be conducted to better understand the nosological context of

  19. INFECTIOUS MONONUCLEOSIS IN CHILDREN AND WAYS OF IMPROVEMENT THE TREATMENT OF PATIENTS

    Directory of Open Access Journals (Sweden)

    Olkhovska O.M.

    2015-05-01

    Full Text Available Introduction. The beginning of this century is characterized by an epidemic of herpesvirus infections, whose frequency and spread continue to rise. Infection by the herpes virus group occurs mainly during the first five years of life and leads to life-long persistence. Despite the similarity of clinical features of the syndrome of infectious mononucleosis (IM caused by cytomegalovirus, human herpes virus type 6 and Epstein-Barr virus (EBV, pathogenic differences occurring in the body should be realized. Despite the presence of specific antiviral drugs up to the date, scientists haven’t managed to reduce pathogen circulation in the human population and to achieve absolute elimination of the virus from the body of an infected person. Questions about the use of nonspecific antiviral and «immunomodulatory» drugs against herpes virus infections get a mixed response. The purpose of the study was to examine the efficacy of interferon in the treatment of children with ІМ. Materials and methods. At the Regional Children's Hospital of Infectious Diseases, Kharkiv the comparison of the dynamics of clinical and laboratory parameters of 102 children in the age 1-5 years with moderate tonsillarglandular form of IM was conducted. The diseases were caused by EBV. The control group consisted of 58 children whose treatment was performed in accordance with generally accepted schemes of existing protocols for diagnosis and treatment of infectious diseases in children. The main group contained 44 patients, which had a complex therapy with the combination of recombinant interferon alpha-2 Viferon-Fearon at doses of 500 000 IU, 2 times a day during 5 days. Our choice of this particular drug was due to the form of drug release - suppositories. In addition, the product contains ascorbic acid and tocopherol acetate, which are powerful antioxidants and membranestabilizing factors. Results and discussion. In the majority of children the disease started acutely with

  20. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Mai E.; Valdehueza, Zaldy D.; Wiarda, Bart M. [Medical Centre Alkmaar, Department of Radiology, Alkmaar (Netherlands); Leeuwenburgh, Marjolein M.N. [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre Amsterdam, Department of Surgery, Amsterdam (Netherlands); Bouman, Donald E. [Medical Spectrum Twente, Department of Radiology, Enschede (Netherlands); Bruin, Ivar G.J.M. de; Schreurs, W.H.; Houdijk, Alexander P.J. [Medical Centre Alkmaar, Department of Surgery, Alkmaar (Netherlands); Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2014-03-15

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100 % (95 % confidence interval 92-100), that of ultrasound was significantly lower (76 %; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89 % (77-95), conditional MRI 80 % (67-89), MRI only 89 % (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. (orig.)

  1. An intervention to decrease patient identification band errors in a children's hospital.

    Science.gov (United States)

    Hain, Paul D; Joers, B; Rush, M; Slayton, J; Throop, P; Hoagg, S; Allen, L; Grantham, J; Deshpande, J K

    2010-06-01

    Patient misidentification continues to be a quality and safety issue. There is a paucity of US data describing interventions to reduce identification band error rates. Monroe Carell Jr Children's Hospital at Vanderbilt. Percentage of patients with defective identification bands. Web-based surveys were sent, asking hospital personnel to anonymously identify perceived barriers to reaching zero defects with identification bands. Corrective action plans were created and implemented with ideas from leadership, front-line staff and the online survey. Data from unannounced audits of patient identification bands were plotted on statistical process control charts and shared monthly with staff. All hospital personnel were expected to "stop the line" if there were any patient identification questions. The first audit showed a defect rate of 20.4%. The original mean defect rate was 6.5%. After interventions and education, the new mean defect rate was 2.6%. (a) The initial rate of patient identification band errors in the hospital was higher than expected. (b) The action resulting in most significant improvement was staff awareness of the problem, with clear expectations to immediately stop the line if a patient identification error was present. (c) Staff surveys are an excellent source of suggestions for combating patient identification issues. (d) Continued audit and data collection is necessary for sustainable staff focus and continued improvement. (e) Statistical process control charts are both an effective method to track results and an easily understood tool for sharing data with staff.

  2. Acceptance of New Medicaid Patients by Primary Care Physicians and Experiences with Physician Availability among Children on Medicaid or the Children's Health Insurance Program

    Science.gov (United States)

    Decker, Sandra L

    2015-01-01

    Objective To estimate the relationship between physicians' acceptance of new Medicaid patients and access to health care. Data Sources The National Ambulatory Medical Care Survey (NAMCS) Electronic Health Records Survey and the National Health Interview Survey (NHIS) 2011/2012. Study Design Linear probability models estimated the relationship between measures of experiences with physician availability among children on Medicaid or the Children's Health Insurance Program (CHIP) from the NHIS and state-level estimates of the percent of primary care physicians accepting new Medicaid patients from the NAMCS, controlling for other factors. Principal Findings Nearly 16 percent of children with a significant health condition or development delay had a doctor's office or clinic indicate that the child's health insurance was not accepted in states with less than 60 percent of physicians accepting new Medicaid patients, compared to less than 4 percent in states with at least 75 percent of physicians accepting new Medicaid patients. Adjusted estimates and estimates for other measures of access to care were similar. Conclusions Measures of experiences with physician availability for children on Medicaid/CHIP were generally good, though better in states where more primary care physicians accepted new Medicaid patients. PMID:25683869

  3. How Do Children Who Understand Mixed Emotion Represent Them in Freehand Drawings of Themselves and Others?

    Science.gov (United States)

    Burkitt, Esther; Watling, Dawn

    2016-01-01

    This research is the first to assess children's representation of mixed emotion using a freehand drawing task. Two hundred and forty-one 5--11-year olds completed a drawing and a colour preference task. Children heard a condition appropriate vignette about themselves or a protagonist designed to evoke mixed emotion, and were asked to draw the self…

  4. "I Already Know What I Learned": Young Children's Perspectives on Learning through Play

    Science.gov (United States)

    Colliver, Yeshe; Fleer, Marilyn

    2016-01-01

    Around the world, if and how young children learn through their play in early childhood education and care contexts has been the subject of much debate. Yet rarely has the debate heard from the young children themselves, often due to the pervasive belief that they do not understand learning. To redress this, a qualitative case study was conducted…

  5. Rediscovering and Reconnecting Funds of Knowledge of Immigrant Children, Families, and Teachers

    Science.gov (United States)

    McDevitt, Seung Eun

    2016-01-01

    In the United States, one in four children under the age of 6 attending preschool has at least one immigrant parent and speaks a language other than English. Despite this increasing population of immigrant children in U.S. preschool settings, their stories have rarely been heard. The author shares three stories of her students and their families…

  6. Video-Stimulated Accounts: Young Children Accounting for Interactional Matters in Front of Peers

    Science.gov (United States)

    Theobald, Maryanne

    2012-01-01

    Research in the early years places increasing importance on participatory methods to engage children. The playback of video-recording to stimulate conversation is a research method that enables children's accounts to be heard and attends to a participatory view. During video-stimulated sessions, participants watch an extract of video-recording of…

  7. A Scoping Review of Qualitative Studies about Children Experiencing Parental Separation

    Science.gov (United States)

    Birnbaum, Rachel; Saini, Michael

    2013-01-01

    This article explores a scoping review of qualitative studies about children's experiences and feelings during times of parental separation. The purpose of the review was to explore children's feelings and attitudes about their parents' separation and how their voices are heard during times of parental separation. The scoping review examined 44…

  8. DNA Repair Alterations in Children With Pediatric Malignancies: Novel Opportunities to Identify Patients at Risk for High-Grade Toxicities

    International Nuclear Information System (INIS)

    Ruebe, Claudia E.; Fricke, Andreas; Schneider, Ruth; Simon, Karin; Kuehne, Martin; Fleckenstein, Jochen; Graeber, Stefan; Graf, Norbert; Ruebe, Christian

    2010-01-01

    Purpose: To evaluate, in a pilot study, the phosphorylated H2AX (γH2AX) foci approach for identifying patients with double-strand break (DSB) repair deficiencies, who may overreact to DNA-damaging cancer therapy. Methods and Materials: The DSB repair capacity of children with solid cancers was analyzed compared with that of age-matched control children and correlated with treatment-related normal-tissue responses (n = 47). Double-strand break repair was investigated by counting γH2AX foci in blood lymphocytes at defined time points after irradiation of blood samples. Results: Whereas all healthy control children exhibited proficient DSB repair, 3 children with tumors revealed clearly impaired DSB repair capacities, and 2 of these repair-deficient children developed life-threatening or even lethal normal-tissue toxicities. The underlying mutations affecting regulatory factors involved in DNA repair pathways were identified. Moreover, significant differences in mean DSB repair capacity were observed between children with tumors and control children, suggesting that childhood cancer is based on genetic alterations affecting DSB repair function. Conclusions: Double-strand break repair alteration in children may predispose to cancer formation and may affect children's susceptibility to normal-tissue toxicities. Phosphorylated H2AX analysis of blood samples allows one to detect DSB repair deficiencies and thus enables identification of children at risk for high-grade toxicities.

  9. The clinical pattern of primary hyperoxaluria in pediatric patient at Queen Rania Abdulla Children Hospital.

    Science.gov (United States)

    Almardini, Reham I; Alfarah, Mahdi G; Salaita, Ghazi M

    2014-05-01

    Hyperoxaluria is a metabolic disorder that can lead to end stage renal disease (ESRD). It can be either inherited or acquired. Primary hyperoxaluria (PHO) is more common and characterized by an excessive production of oxalate leading to recurrent urolithiasis and progressive nephrocalcinosis. Due to the high rate of consanguineous marriage in Jordan this disease is commonly diagnosed in pediatric nephrology clinics. We aimed to demonstrate the clinical pattern and progression to ESRD in pediatric patients with hyperoxaluria at Queen Rania Abdulla Children Hospital. Medical records of all patients followed up in the pediatric nephrology clinic with the diagnosis of PHO during the period between September 2007 and March 2013 were reviewed. There were 70 patients with the diagnosis of PHO, 52.9% were males. The median age at presentation was 3 years ± 3 months with the youngest child being two months old. Diagnosis was made in the first year of life in 15.7% of patients. The most common presenting symptom was hematuria, while 14% of patients were asymptomatic and detected by family screening after the diagnosis of an index case. At the time of initial presentation, 15.7% of patients had ESRD and 25% had impaired renal function. Kidney stones were found in 57% of cases and nephrocalcinosis was found in 37%. High index of suspicion is needed to diagnose PHO in children presenting with kidney stone or unexplained hematuria. Twenty-four hour urine collection for oxalate are required to make the proper diagnosis. Family screening, when appropriate, is indicated for early detection of PHO.

  10. [Synostosis and tarsal coalitions in children. A study of 68 cases in 47 patients].

    Science.gov (United States)

    Rouvreau, P; Pouliquen, J C; Langlais, J; Glorion, C; de Cerqueira Daltro, G

    1994-01-01

    The authors report their experience with tarsal coalitions in children. The purpose of this study was to discuss the origins of the of the calcaneum, and to propose a simple therapeutic strategy for diagnosis and treatment. The study included 47 children (68 feet), with one or more idiopathic tarsal coalitions. All patients had physical examinations to record symptoms, morphology of the foot, mobility of the foot, gait analysis, standard radiographs, and in some cases CT scans or MRI. The average age of the patients was 11.5 years old, 7 patients had a positive family history for tarsal coalitions. 66 per cent of the patients had mild tarsal pain or a history of repeated ankle sprains. The conservative treatment concerned 28 feet: 3 casts, 2 injections of corticosteroids into the subtalar joint, insole-shoes in 3 cases, and abstention in 20 cases. The operative treatment (40 feet) consisted of resection of calcaneonavicular coalitions (24 feet) resection of talocalcaneal coalitions (3 feet), mediotarsal and subtalar arthrodesis (8 feet), resection of calcaneonavicular coalition combined with the "Cavalier'' procedure described by Judet (3 feet), calcaneal osteotomy (2 feet). The mean follow-up was 42 months. The morphology of the involved foot was normal in 33 cases, flat foot was seen in 24 cases (4 peroneal spastic flat feet), pes cavus in 3 cases, club foot in 2 cases, pes varus in 4 cases, "Z'' shaped feet in 2 cases. The radiological examination was demonstrative of tarsal coalition in 61 feet. 7 tarsal coalitions were seen during operative procedures. The location or the coalition was calcaneonavicular (57), talocalcaneal (16), talo-navicular (8), calcaneo-cuboid (7), naviculo-cuneiform (4). The secondary radiographic signs were studied for each foot. In the conservative group, 2 patients degraded their clinical status, one developed a spastic flat foot. In the surgical group, all except 2 patients had good clinical and functional results. One patient had

  11. Evolution of GH secretion in urine during an in-patient slimming course in obese children.

    Science.gov (United States)

    Lehingue, Y; Locard, E; Vivant, J F; Mounier, A; Serban, A; Remontet, L; Porquet, D; Joly, M O; Mamelle, N

    2000-03-01

    To estimate the change in GH excretion in urine (GH-U) during a slimming course, and if increased, to assess the components of the course related to the increase in obese children. Observational follow-up study of patients admitted for primary obesity to an in-patient slimming course lasting at least 10 weeks. 48 complete observations out of 54 consecutive pre-pubertal patients admitted to a paediatric centre for treatment of primary obesity (BMI greater than the 90th percentile of the national reference curves). GH excretion in urine by immunoradiometric assay, at entry and after 10 weeks, various anthropometric measurements, nutritional intake and departure from the prescribed diet, time spent in physical activity, sleep duration. A mean decrease of 0.90 standard deviations for BMI was accompanied by a 34% increase of GH-U. Time spent in physical activity was the only component of the course found to be related to the magnitude of GH-U increase. The results of this observational study confirm that GH-U is increased after a slimming course in children, and suggest that physical activity is a major contributor to the restoration of normal GH-U levels.

  12. Vertebral anomalies in children with Alagille syndrome: an analysis of 50 consecutive patients

    International Nuclear Information System (INIS)

    Sanderson, Evelyn; Newman, Vanessa; Haigh, Susan F.; Sidhu, Paul S.; Baker, Alastair

    2002-01-01

    Background: Vertebral anomalies may help differentiate Alagille syndrome from other causes of chronic cholestasis. We suspect significant under-reporting of vertebral anomalies in children with Alagille syndrome. Objective: To compare the vertebral anomalies in Alagille syndrome with those in patients with chronic cholestasis due to other causes. The accuracy of original radiographic reporting was evaluated. Materials and methods: Spinal radiographs of 50 patients with Alagille syndrome and 31 non-Alagille syndrome cholestatic patients were evaluated retrospectively by four trained radiologists. The number, site and type of vertebral anomaly were noted. The consensus evaluation was then compared to the original report. Results: Vertebral anomalies were found in 66% of patients with Alagille syndrome and 9.7% of cholestatic control subjects (P<0.0005). In the patients with Alagille syndrome, incomplete fusion of the anterior arch, most frequently at the D6-9 level, accounted for 123 of 126 anomalies. Multiple vertebral anomalies occurred in 48% of patients with Alagille syndrome (mean 2.5 anomalies). Vertebral anomalies were misreported in 54% of cases of Alagille syndrome. Conclusions: Vertebral anomalies are significantly more common in Alagille syndrome than in chronic cholestasis of other causes and are frequently overlooked. Reporting should be undertaken by a radiologist familiar with the appearance and location of these vertebral anomalies. (orig.)

  13. Test tools of physics radiography children as a support for safety radiation and safety patients

    International Nuclear Information System (INIS)

    Siti Masrochah; Yeti Kartikasari; Ardi Soesilo Wibowo

    2013-01-01

    Radiographic examination of the thorax children aged 1-3 years have a high sufficiently failure. This failure is caused by the movement and difficulty positioning the patient, resulting in the risk of repeat radiographs to patient safety particularly unnecessary radiation risks. It is therefore necessary to develop research on children design fixation devices. This research aims to create a design tool fixation on radiographs children to support radiation safety and patient safety. This research is a descriptive exploratory approach to tool design. The independent variables were the design tools, variable tool function test results, and radiographic variables controlled thorax. The procedure is done by designing data collection tools, further trials with 20 samples. Processing and analysis of data is done by calculating the performance assessment tool scores with range 1-3. The results showed that the design tool of fixation in the form of standard radiographic cassette equipped with chairs and some form of seat belt fixation. The procedure uses a tool fixation is routine radiographic follow thorax child in an upright position. Function test results aids fixation is to have an average score of 2.66, which means good. While the test results for each component, the majority of respondents stated that the reliability of the device is quite good with a score of 2.45 (60 %), convenience tool with a score of 2.60 (70 %), quality of the radiographs did not incontinence of the thorax radiograph with a score 2.55 (85 %), the child protection (security) with a score of 2.70 (70 %), good design aesthetic design with a score of 2.80 (80 %), addition of radiation from the others on the use of these tools do not need with a score of 2.80 (80 %), and there is no additional radiation due to repetitions with a score of 2.85 (90 %). (author)

  14. Children Adopt the Traits of Characters in a Narrative

    Science.gov (United States)

    Dore, Rebecca A.; Smith, Eric D.; Lillard, Angeline S.

    2017-01-01

    Adults adopt the traits of characters in narratives, but little is known about whether children do so. In Study 1, 7- and 10-year-olds (N = 96) heard a 2.5-minute recording about a professor or cheerleader. Reporting higher engagement in the professor narrative related to more time playing with an analytical toy (a Rubik's cube), whereas reporting…

  15. The levels of liver enzymes and atypical lymphocytes are higher in youth patients with infectious mononucleosis than in preschool children.

    Science.gov (United States)

    Wang, Yan; Li, Jun; Ren, Yuan-Yuan; Zhao, Hong

    2013-12-01

    Infectious mononucleosis (IM) is the clinical presentation of primary infection with Epstein-Barr virus. Although the literature contains a massive amount of information on IM, most of this is related specifically to only children or adults separately. In order to distinguish any differences between preschool children and youth patients, we retrospectively analyzed their demographic and clinical features. Records of patients hospitalized from December 2001 to September 2011 with a diagnosis of IM were retrieved from Peking University First Hospital, which is a tertiary teaching hospital in Beijing. The demographic data and clinical characteristics were collected. IM was diagnosed in 287 patients during this 10-year period, with incidence peaks among preschool children (≤7 years old, 130/287, 45.3%) and youth patients (>15 and <24 years old, 101/287, 35.2%). Although the complaints at admission did not differ between these two patient groups, the incidence of clinical signs (tonsillopharyngitis, lymphadenopathy, hepatomegaly, and edema of the eyelids) was much higher in preschool children. The incidence of liver lesion and percentage of atypical lymphocytes were significantly higher in the youth group (P<0.001), and the average hospital stay was longer in this group. Pneumonia was the most common complication, and there was no case of mortality. The incidence of IM peaks among preschool children and youth patients in Beijing, China. The levels of liver enzymes and atypical lymphocytes increase with age.

  16. The levels of liver enzymes and atypical lymphocytes are higher in youth patients with infectious mononucleosis than in preschool children

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2013-12-01

    Full Text Available Background/AimsInfectious mononucleosis (IM is the clinical presentation of primary infection with Epstein-Barr virus. Although the literature contains a massive amount of information on IM, most of this is related specifically to only children or adults separately. In order to distinguish any differences between preschool children and youth patients, we retrospectively analyzed their demographic and clinical features.MethodsRecords of patients hospitalized from December 2001 to September 2011 with a diagnosis of IM were retrieved from Peking University First Hospital, which is a tertiary teaching hospital in Beijing. The demographic data and clinical characteristics were collected.ResultsIM was diagnosed in 287 patients during this 10-year period, with incidence peaks among preschool children (≤7 years old, 130/287, 45.3% and youth patients (>15 and <24 years old, 101/287, 35.2%. Although the complaints at admission did not differ between these two patient groups, the incidence of clinical signs (tonsillopharyngitis, lymphadenopathy, hepatomegaly, and edema of the eyelids was much higher in preschool children. The incidence of liver lesion and percentage of atypical lymphocytes were significantly higher in the youth group (P<0.001, and the average hospital stay was longer in this group. Pneumonia was the most common complication, and there was no case of mortality.ConclusionsThe incidence of IM peaks among preschool children and youth patients in Beijing, China. The levels of liver enzymes and atypical lymphocytes increase with age.

  17. Late summer distribution and stoichiometry of dissolved N, Si and P in the Southern Ocean near Heard and McDonald Islands on the Kerguelen Plateau

    Science.gov (United States)

    Chase, Z.; Bowie, A. R.; Blain, S.; Holmes, T.; Rayner, M.; Sherrin, K.; Tonnard, M.; Trull, T. W.

    2016-12-01

    The Kerguelen plateau in the Southern Indian Ocean is a naturally iron-fertilised region surrounded by iron-limited, High Nutrient Low Chlorophyll waters. The Heard Earth Ocean Biosphere Interaction (HEOBI) project sampled waters south of the Polar Front in the vicinity of Heard and McDonald Islands (HIMI) in January and February 2016. Fe fertilised waters over the plateau generally exhibited high phytoplankton biomass and photosynthetic competency (as in previous studies and satellite observations), but interestingly, phytoplankton biomass was low near HIMI, though photosynthetic competency was high. In plateau waters away from HIMI, silicic acid (Si) concentrations were strongly depleted in surface waters, averaging 3 μM, while nitrate concentrations were close to 25 μM. Relative to the remnant winter water, this represents an average seasonal drawdown of 32 μM Si and only 8 μM nitrate. Though absolute drawdown was lower at an HNLC reference site south of Heard Island, the drawdown ratio was similarly high (ΔSi: ΔN 4-5). The average N:P drawdown ratio was 12, typical for a diatom-dominated system (Weber and Deutsch 2010). N:P drawdown was positively correlated with Si drawdown, perhaps indicative of an impact of Fe on both seasonal Si drawdown and diatom N:P uptake (Price 2005). In the well-mixed, shallow waters (McDonald Islands, despite the apparent lack of nutrient drawdown or biomass accumulation. Mixed layers deeper than the euphotic zone are one mechanism that retains these remineralization signatures and near the islands, tidal mixing also contributes.

  18. Enteric Duplication Cysts in Children: A Single-Institution Series with Forty Patients in Twenty-Six Years.

    Science.gov (United States)

    Erginel, Basak; Soysal, Feryal Gun; Ozbey, Huseyin; Keskin, Erbug; Celik, Alaattin; Karadag, Aslıhan; Salman, Tansu

    2017-02-01

    The purpose of the study was to evaluate our experience with enteric duplication cysts in 40 children during the past 26 years, while assessing the variability of their presentations and to propose an algorithm for surgical management. We retrospectively analysed sex, age, clinical presentations, duplication site, surgical treatment, presence of ectopic tissue, complications, associated anomalies, and prognosis of 40 patients with gastrointestinal tract duplications who were surgically treated in our clinic. Overall, there was a predominance of boys (28 males, 70 %; 12 females, 30 %). The presenting symptom was vomiting in 23 patients, rectal bleeding in 11 patients, abdominal mass in 10 patients, abdominal pain in 9 patients, constipation in 6 patients, cough in 2 patients, and respiratory distress in 2 patients. In 30 patients, a complete excision of the cyst with additional segmental intestinal resection and anastomosis was performed. Cystectomy was performed in seven patients, while complete excision of the cyst with additional wedge resection was performed in two. A Wrenn procedure (mucosectomy) was performed in one patient. Due to the variability in the site of enteric duplications, a wide range of presenting symptoms can exist, which is challenging for diagnosis. In children with a diagnosis of acute abdomen, enteric duplication cysts should be considered, and these children should be further investigated for additional skeletal, urogenital, and gastrointestinal system pathologies. Surgical treatment depends on the site and type of the cyst.

  19. Adrenal carcinoma and adenoma in children: A review of 17 patients

    International Nuclear Information System (INIS)

    Daneman, A.; Martin, J.; Toronto Univ., Ontario; Chan, H.S.L.; Toronto Univ., Ontario

    1983-01-01

    Seventeen children with adrenocortical neoplasms (13 carcinomas: four adenomas) are reviewed and attention is focused on the value of the newer imaging modalities in the management of these children. All the lesions were functioning tumors. CT is the single most important modality in assessing primary and metastatic disease at diagnosis and during follow-up. In children suspected of having an adrenal lesion, high resolution CT will promptly localize the lesion to an adrenal. Since the only curative treatment is complete surgical removal CT plays an important role in defining the extent of the primary lesion pre-operatively. Large carcinomas have an inhomogeneous density on CT and a complex echo pattern on ultrasound reflecting the areas of hemorrhage nd necrosis seen macroscopically in these lesions. Smaller lesions have a more homogeneous density on CT but benign and malignant disease could not be differentiated by this modality. Ultrasound is usefull in screening the adrenal area in those patients in whom there is a low clinical index of suspicion for an adrenal tumor and also in the post-operative period. (orig.)

  20. Quality of Life in Caregivers of ADHD Children and Diabetes Patients.

    Science.gov (United States)

    Andrade, Elisa Meirelles; Geha, Laysa Minella; Duran, Paula; Suwwan, Raphael; Machado, Felipe; do Rosário, Maria Conceição

    2016-01-01

    Studies have shown that the presence of attention-deficit hyperactivity disorder (ADHD) causes great impairment in academic, social, and professional activities as well as in the quality of life (QoL) of its patients. Similarly, the impact caused by other chronic disorders, such as diabetes, in the patient's QoL has been emphasized in many studies. Despite its relevance, no study has yet investigated whether ADHD caregivers and diabetic patients would have similar QoL impairment. This study was conducted in order to compare the QoL scores among ADHD caregivers and diabetic patients. We evaluated 63 caregivers of ADHD children treated at the Child and Adolescent Psychiatric Unit at the Federal University of São Paulo (UPIA-UNIFESP) and 52 adult diabetic patients. Subjects were assessed with the World Health Organization quality of Life-Bref Version (WHOQOL-BREF), the Beck and Hamilton depression scales, and the Adult Self-Report Scale. When compared to the Brazilian normative data, ADHD caregivers had significantly lower scores in the social relations and environment WHOQOL domains. ADHD caregivers and diabetic patients had similar impairment in all WHOQOL domains except for the physical domain. ADHD affects the QoL of the patient's caregiver, with similar impairment, when compared to the QoL of diabetic patients. These results emphasize the need for assessing QoL of the caregivers as part of the treatment strategies. They also emphasize the need for future studies with larger sample sizes comparing how the QOL is impacted in different chronic disorders.

  1. Indications for cone beam computed tomography in children and young patients in a Turkish subpopulation.

    Science.gov (United States)

    İşman, Özlem; Yılmaz, Hasan Hüseyin; Aktan, Ali Murat; Yilmaz, Büşra

    2017-05-01

    Cone beam computed tomography (CBCT) imaging is widely used in children; however, it remains controversial because of the health effects of radiation. This retrospective study investigated the indications for CBCT and dentomaxillofacial pathologies in paediatric patients. CBCT images of 329 paediatric patients (i.e., aged anomalies (38.5%), followed by the localisation of impacted teeth (33.1%). There was no relationship between sex and indications. There were significant associations between age groups and malocclusion and dentomaxillofacial anomalies, localisation of impacted teeth, and trauma. The face was the most frequently imaged region, followed by the jaws (maxilla and mandible). The most common indication for CBCT was malocclusion and dentomaxillofacial anomalies in the primary and permanent dentition age groups, whereas the localisation of impacted teeth was the most common indication in the mixed dentition age group. Generally, CBCT was indicated in orthodontics and surgery. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Patient-centered outcomes research in appendicitis in children: Bridging the knowledge gap.

    Science.gov (United States)

    Chau, Danielle B; Ciullo, Sean S; Watson-Smith, Debra; Chun, Thomas H; Kurkchubasche, Arlet G; Luks, Francois I

    2016-01-01

    Patient-centered outcomes research (PCOR) aims to give patients a better understanding of the treatment options to enable optimal decision-making. As nonoperative alternatives are now being evaluated in children for acute appendicitis, we surveyed patients and their families regarding their knowledge of appendicitis and evaluated whether providing basic medical information would affect their perception of the disease and allow them to more rationally consider the treatment alternatives. Families of children aged 5-18 presenting to the Emergency Department with suspected appendicitis were recruited for a tablet-based interactive educational survey. One hundred subjects (caregivers and patients ≥ 15 years) were questioned before and after an education session about their understanding of appendicitis, including questions on three hypothetical treatment options: urgent appendectomy, antibiotics alone, or initial antibiotics followed by elective appendectomy. Subjects were clearly informed that urgent appendectomy is currently the standard of care. Only 14% of respondents correctly identified the mortality rate of appendicitis (17 deaths/year according to the 2010 US census) when compared with other extremely rare causes of death. Fifty-four and 31% thought it was more common than death from lightning (40/year) and hunting-associated deaths (44/year), respectively. Eighty-two percent of respondents believed it "likely" or "very likely" that the appendix would rupture if operation was at all delayed, and 81% believed that rupture of the appendix would rapidly lead to severe complications and death. In univariate analysis, this perception was significantly more prevalent for mothers (odds ratio, (OR) 5.19, confidence interval (CI) 1.33-21.15), and subjects who knew at least one friend or relative who had a negative experience with appendicitis (OR 5.53, CI 1.40-25.47). Following education, these perceptions changed significantly (53% still believed that immediate

  3. Surgical correction of scoliosis in children with spastic quadriplegia: benefits, adverse effects, and patient selection.

    Science.gov (United States)

    Legg, Julian; Davies, Evan; Raich, Annie L; Dettori, Joseph R; Sherry, Ned

    2014-04-01

    Cerebral palsy (CP) is a group of nonprogressive syndromes of posture and motor impairment associated with lesions of the immature brain. Spastic quadriplegia is the most severe form with a high incidence of scoliosis, back pain, respiratory compromise, pelvic obliquity, and poor sitting balance. Surgical stabilization of the spine is an effective technique for correcting deformity and restoring sitting posture. The decision to operate in this group of patients is challenging. The aim of this study is to determine the benefits of surgical correction of scoliosis in children with spastic quadriplegia, the adverse effects of this treatment, and what preoperative factors affect patient outcome after surgical correction. A systematic review was undertaken to identify studies describing benefits and adverse effects of surgery in spastic quadriplegia. Factors affecting patient outcome following surgical correction of scoliosis were assessed. Studies involving adults and nonspastic quadriplegia were excluded. A total of 10 case series and 1 prospective and 3 retrospective cohort studies met inclusion criteria. There was significant variation in the overall risk of complications (range, 10.9-70.9%), mortality (range, 2.8-19%), respiratory/pulmonary complications (range, 26.9-57.1%), and infection (range, 2.5-56.8%). Factors associated with a worse outcome were a significant degree of thoracic kyphosis, days in the intensive care unit, and poor nutritional status. Caregivers report a high degree of satisfaction with scoliosis surgery for children with spastic quadriplegia. There is limited evidence of preoperative factors that can predict patient outcome after scoliosis. There is a need for well-designed prospective studies of scoliosis surgery in spastic quadriplegia.

  4. Inhalation of sevoflurane in the removal of post-labioplasty and palatoplasty stitches in uncooperative children patients

    Directory of Open Access Journals (Sweden)

    Ediyana Nuryadi

    2007-11-01

    Full Text Available The technique of behaviour management in medical treatment, especially in dental treatment, is needed to eliminate uncooperative children behaviour. The main factor influencing children behaviour is fear of painful that usually related to dental treatment. Children patients who will have their post­labioplasty and palatoplasty stitches removed have more sensitive condition, they cry when the dentist gives treatment. Using general anesthesia is a method to manage uncooperative children behaviour. Inhalational anesthesia is often used in general anesthesia and sevoflurane is a drug of choice. Sevoflurane has low solubility in blood, pleasant odor, nonirritating airway, and has a rapid induction of and recovery from anesthesia. Some researches indicate that sevoflurane gives more calm condition and can be used as a sufficiently ideal induction and maintenance of anesthesia in children. Sevoflurane can therefore made as alternative procedure in the removal of post-labioplasty and palatoplasty stitches.

  5. Heard and valued: the development of a model to meaningfully engage marginalized populations in health services planning.

    Science.gov (United States)

    Snow, M Elizabeth; Tweedie, Katherine; Pederson, Ann

    2018-03-15

    Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, "one-size-fits-all" approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges-highly gendered health and social experiences. The project's purpose was to develop a heuristic model to assist planners to engage patients who are not traditionally included in healthcare planning. Using a qualitative research approach, we reviewed literature and conducted interviews with patients and healthcare planners regarding engaging marginalized populations in health services planning. From these inputs, we created a model and planning manual to assist healthcare planners to engage marginalized patients in health services planning, which we piloted in two clinical programs undergoing health services design. The findings from the pilots were used to refine the model. The analysis of the interviews and literature identified power and gender as barriers to participation, and generated suggestions to support diverse populations both to attend patient engagement events and to participate meaningfully. Engaging marginalized populations cannot be reduced to a single defined process, but instead needs to be understood as an iterative process of fitting engagement methods to a particular situation. Underlying this process are principles for meaningfully engaging marginalized people in healthcare planning. A one-size-fits-all approach to patient engagement is not appropriate given patients' diverse barriers to meaningful participation in healthcare planning. Instead, planners need a

  6. Feasibility of using a handheld electronic device for the collection of patient reported outcomes data from children

    OpenAIRE

    Vinney, Lisa A.; Grade, John; Connor, Nadine P.

    2011-01-01

    The manner in which a communication disorder affects health-related quality of life (QOL) in children is not known. Unfortunately, collection of quality of life data via traditional paper measures is labor intensive and has several other limitations, which hinder the investigation of pediatric quality of life in children. Currently, there is not sufficient research regarding the use of electronic devices to collect pediatric patient reported outcomes in order to address such limitations. Thus...

  7. Quality of life in caregivers of ADHD children and Diabetes patients

    Directory of Open Access Journals (Sweden)

    Maria Conceição do Rosario

    2016-07-01

    Full Text Available Introduction: Studies have shown that the presence of ADHD causes great impairment in academic, social and professional activities, as well as in the quality of life (QoL of its patients. Similarly, the impact caused by other chronic disorders, such as diabetes, in the patient´s QoL has been emphasized in many studies. Despite its relevance, no study has yet investigated whether ADHD caregivers and diabetic patients would have similar QoL impairment. Objectives: This study was conducted in order to compare the QoL scores among ADHD caregivers and diabetic patients. Methods: We evaluated 63 caregivers of ADHD children treated at the Child and Adolescent Psychiatric Unit at the Federal University of São Paulo (UPIA-UNIFESP and 52 adult diabetic patients. Subjects were assessed with the World Health Organization quality of Life-Breef Version (WHOQOL-BREEF, the Beck and Hamilton depression scales, and the Adult Self-Report Scale. Results: When compared to the Brazilian normative data, ADHD caregivers had significantly lower scores in the social relations and environment WHOQOL domains. ADHD caregivers and diabetic patients had similar impairment in all WHOQOL domains, except for the physical domain. Conclusion: ADHD affects the QoL of the patient’s caregiver, with similar impairment when compared to the QoL of diabetic patients. These results emphasize the need for assessing QoL of the caregivers as part of the treatment strategies. They also emphasize the need for future studies with larger sample sizes comparing how the Qol is impacted in different chronic disorders.

  8. Seen but not heard: injuries and deaths from landmines and unexploded ordnance in Chechnya, 1994-2005.

    Science.gov (United States)

    Bilukha, Oleg O; Brennan, Muireann; Anderson, Mark; Tsitsaev, Zaur; Murtazaeva, Eliza; Ibragimov, Ramzan

    2007-01-01

    Due to more than a decade of armed conflict and civil unrest, Chechnya is among the regions most affected by landmines and unexploded ordnance worldwide. The study was performed to assess the magnitude of injuries and deaths due to landmines and unexploded ordnance in Chechnya between 1994 and 2005 and to describe epidemiologic patterns and risk factors for these events. Surveillance data that included 3,021 civilian non-combatants injured by landmines and unexploded ordnance in Chechnya during 1994-2005 were analyzed. Local non-governmental organizations in collaboration with the United Nations Children's Fund conducted victim data collection using trained staff to interview victims or their families. Surveillance data were used to describe injury trends, victim demographics, injury types, risk behaviors, and types of explosives related to landmine and unexploded ordnance events. The largest number of injuries occurred in 2000 (716, injury rate 6.6 per 10,000) and 2001 (640, injury rate 5.9 per 10,000). One-quarter of all victims were younger than 18 years, and 19% were females. The case-fatality rate was 23%. Approximately 40% of victims were injured by landmines, 30% by unexploded ordnance, and 7% by booby traps. A large proportion of children and adults were injured while traveling or performing activities of economic necessity; 29% of children were injured while tampering with explosives or playing in a contaminated area. The proportion of victims with lower limb amputations was similar among children and adults (14% and 17%, respectively), whereas the proportion ofvictims with upper limb amputations was three times higher in children than in adults (12% and 4%, respectively). Most accidents that occurred while the victim was traveling or performing activities of economic necessity were caused by landmines, while most accidents that occurred while the victim was playing near an explosive device or tampering with it were caused by unexploded ordnance. Civilians

  9. A comprehensive database of Duchenne and Becker muscular dystrophy patients in Children's Hospital of Fudan University

    Directory of Open Access Journals (Sweden)

    Xi-hua LI

    2015-05-01

    Full Text Available Background China is one of the countries that have the largest number of patients suffering from Duchenne and Becker muscular dystrophy (DMD/BMD. Although the building of international DMD/BMD databases has laid a foundation for clinical drug development and clinical trials, it has not yet been carried out in China. In this study, a modified registry form of Remudy was applied to 229 DMD/BMD patients in order to establish a comprehensive database, which will lay the groundwork for international cooperation.  Methods A total of 229 DMD/BMD patients diagnosed by genetic testing or muscle biopsy admitted in Children's Hospital of Fudan University (CHFU during the period of August 2011 to December 2013 were enrolled in this study. The data included sex, age, age at diagnosis, geographic distribution of patients, DMD gene mutation types, family history, walking capability, cardiac and respiratory function, steroid treatment and rehabilitation intervention.  Results There were 194 DMD and 35 BMD male patients who were diagnosed at the age of 0-18 years, and among them, most patients were diagnosed at the age of > 3-4 (16.59%, 38/229 and > 7-8 (14.85%, 34/229 years. Exon deletion was the most frequent genetic mutations for DMD/BMD [65.46% (127/194 and 74.29% (26/35], respectively. Patients with a family history accounted for 23.14% (53/229. The rate of DMD registrants losing walking capability was 17.53% (34/194, and all the BMD registrants were able to walk. Cardiac functions were examined in 46.29% (106/229 DMD/BMD boys and respiratory functions were examined in 17.90% (41/229 DMD/BMD boys. The proportion of DMD patients receiving prednisone with dosage of 0.75 mg/(kg·d was 26.29% (51/194.  Conclusions This database describes in detail the genotype, clinical manifestation, diagnosis and treatment and rehabilitation status of 229 DMD/BMD patients in China. The database not only provides comprehensive information for DMD/BMD patient management

  10. Alternative processing of renographic data for use in children and agitated adult patients

    International Nuclear Information System (INIS)

    Carlsen, Ove

    2002-01-01

    The purpose of this study was to describe an alternative method for processing [99mTc]-diethylene-triamine pentaacetate ([99mTc]-DTPA) renographic data which is unaffected by patient movement and which only requires the patient to be on the imaging table during the early and late examination phases. Methods: The analysis is based on early image series (0-2 min postinjection) and late image series (the last 5 min). Regions of interest (ROIs) over the kidneys, renal parenchyma and renal backgrounds were created in both sets of images. A robust method for determination without deconvolution of mean transit time indices for the whole kidney and renal parenchyma was established. Estimation of renal volume was possible using a geometrical method. Results: Simulation studies and studies in patients showed a close relationship between the mean transit times using deconvolution and the corresponding mean transit time indices. Conclusions: The alternative method is recommended to be applied in those agitated patients, children in particular, where sedation is either contraindicated or not relevant and in cases where the effective acquisition time should be kept at a minimum (Au)

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

    Science.gov (United States)

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

    2010-04-01

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

  12. Understanding the Psychology of a Trickster Tale: 5-Year-Old Japanese Kindergarten Children Collaboratively Retelling a "Kitsune" Story

    Science.gov (United States)

    Oshiro, Aiko; Pihl, Agneta; Peterson, Louise; Pramling, Niklas

    2017-01-01

    How children understand the psychology of a story (i.e., the intentions and experiences of its characters) is pivotal to comprehending its point. In this study we investigate empirically how 5-year-old children in a Japanese kindergarten manage mental state verbs and adjectives when collaboratively retelling a tale heard. The tale, an example of a…

  13. Hydrocephalus treatment in children: long-term outcome in 975 consecutive patients.

    Science.gov (United States)

    Beuriat, Pierre-Aurelien; Puget, Stephanie; Cinalli, Giuseppe; Blauwblomme, Thomas; Beccaria, Kevin; Zerah, Michel; Sainte-Rose, Christian

    2017-07-01

    OBJECTIVE Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgical units. Endoscopic third ventriculostomy (ETV) has an advantage over ventriculoperitoneal shunting as it enables patients to remain device free. Multiple shunt devices with various valve designs exist, with no one valve proven to be superior to another. The aim of this study was to describe the management of hydrocephalus and its long-term outcome. METHODS The authors retrospectively reviewed the medical records of all patients who had been treated for hydrocephalus at the Hôpital Necker-Enfants Malades in the period from 1985 to 1995. RESULTS Nine hundred seventy-five children had been treated for hydrocephalus. The mean follow-up was 11 ± 7.4 years (mean ± standard deviation). The most common cause of hydrocephalus was tumor related (32.3%), followed by malformative (24.5%) and inflammatory (20.9%) causes. Two hundred eighty patients underwent ETV as the first-line treatment. The procedure was effective in controlling hydrocephalus due to posterior fossa tumors and aqueductal stenosis. Six hundred ninety-five children had initial shunt insertion, with the majority receiving an Orbis-Sigma valve (OSV). The overall OSV shunt survival was 70% at 1 year, 58% at 10 years, and 49% at 20 years. The most common cause for mechanical shunt failure was obstruction (50.7%). Overall shunt survival was statistically different between the OSV and the differential-pressure valve (p = 0.009). CONCLUSIONS Endoscopic third ventriculostomy is effective in the management of childhood hydrocephalus. Its success is directly related to the underlying pathology. In the long term, the OSV has significantly higher event-free shunt survival than the classic differential-pressure valve systems.

  14. A qualitative study of doctors' and nurses' barriers to communicating with seriously ill patients about their dependent children.

    Science.gov (United States)

    Dencker, Annemarie; Rix, Bo Andreassen; Bøge, Per; Tjørnhøj-Thomsen, Tine

    2017-12-01

    Research indicates that health personnel caring for seriously ill patients with dependent children aged 0 to 18 years often avoid discussing with them the challenges of being a family with a parent in treatment. Children of seriously ill patients risk serious trauma and emotional difficulty later in life and depend on adult support to minimize these consequences. Patients suffer anxiety about supporting their children during their illness. Because of their potentially pivotal role in supporting patients in enabling parent-child communication, we examined HP's structural and emotional barriers to communicating with patients about their children. The study was based on 49 semi-structured, in-depth interviews with doctors and nurses working with haematology, gynaecological cancer, and neurointensive care. Both interviews and analysis addressed emotional and structural barriers, drawing on the theoretical framework of Maturana's domains. The study found structural barriers (eg, lack of space in the medical recording system, professional code, time pressure, and lack of training) and emotional barriers (eg, the painful nature of the situation and the perceived need of keeping professional distance). We found that emotional barriers tended to grow when structural barriers were not addressed. Our study indicates (1) the need to use templates and manual procedures to gather and process information about children in medical records; (2) the need for managerial backing for addressing children of seriously ill patients and time spent on it; and (3) the need for future HP training programmes to include how to implement procedures and how to address all barriers. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Quality of life and wishes in Duchenne Muscular Dystrophy: the perception of children and their parents

    Directory of Open Access Journals (Sweden)

    Benito Arias Martínez

    2009-12-01

    Full Text Available Objective: To assess the agreement between children with Duchenne Muscular Dystrophy (DMD and their parents regarding the perception of quality of life (QOL and the wishes expressed by children. Methods: The study involved 14 patients (median age = 9.9 yearsold followed up in Sarah Rehabilitation Center – Fortaleza, Brazil and their parents. The following instruments were used: AUQEI questionnaire (Autoquestionnaire Qualité de Vie Enfant Imagé and Three Wishes Projective Technique, this being analyzed by Nereo & Hinton’s system of categories (2003. Results: The analysis of AUQEI showed a good agreement with ICC (intraclass correlation coefficient = 0,699 and a positive and significant correlation between scores of both children and their parents (rho = 0.54, p < 0.05. The Three Wishes also showed a good agreement, mainly in the categories of Material Goods and Activities. Conclusions: Despite children with DMD and their parents exhibited similar perceptions of the QOL and wishes, we suggest that both be heard in respect to aspects of the rehabilitation program. This study provides additional data concerning the need for child QOL assessment instruments that include parallel versions directed to the children and their parents.

  16. Feasibility of using a handheld electronic device for the collection of patient reported outcomes data from children.

    Science.gov (United States)

    Vinney, Lisa A; Grade, John D; Connor, Nadine P

    2012-01-01

    The manner in which a communication disorder affects health-related quality of life (QOL) in children is not known. Unfortunately, collection of quality of life data via traditional paper measures is labor intensive and has several other limitations, which hinder the investigation of pediatric quality of life in children. Currently, there is not sufficient research regarding the use of electronic devices to collect pediatric patient reported outcomes in order to address such limitations. Thus, we used a cross-over design to compare responses to a pediatric health quality of life instrument (PedsQL 4.0) delivered using a handheld electronic device to those from a traditional paper form. Respondents were children with (n=9) and without (n=10) a speech or voice disorder. For paper versus the electronic format, we examined time to completion, number of incomplete or inaccurate question responses, intra-rater reliability, ease of use, and child and parent preference. There were no significant differences between children's scores, time to complete the measure, or ratings related to ease of answering questions. The percentage of children who made answering errors or omissions with paper and pencil was significantly greater than the percentage of children who made such errors using the device. This preliminary study demonstrated that use of an electronic device to collect QOL or patient-reported outcomes (PRO) data from children is more efficient than and just as feasible, reliable, and acceptable as using paper forms. The development of hardware and software applications for the collection of QOL and/or PRO data in children with speech disorders is likely warranted. The reader will be able to understand: (1) The potential benefits of using electronic data capture via handheld devices for collecting pediatric patient reported outcomes; (2) The Pediatric Quality of Life Inventory 4.0 is a measure of the perception of general health quality that has distinguished between

  17. Study on children patient dose in single-detector and multi-detector row helical computed tomography

    International Nuclear Information System (INIS)

    Lu Heqing; Zhu Guoying; Zhuo Weihai; Liu Haikuan; Guo Changyi

    2008-01-01

    Objective: To study and evaluate the radiation dose of children patient in single-detector and multi-detector row helical CT scan. Methods: The head and body CT dose index of 21 CT scanners were tested. Then the values of CTDI w , CTDI vol and DLP were calculated combining with the parameters of routine head and chest scan for children of 0-1 year old group, 5 years old group, 10 years old group and adults. The effective doses of children of every age group and adults in routine head and chest scan were subsequently estimated from effective dose per DLP by age and the calculated values of DLP. Results: CTDI per mAs is greater in the head than that in the body. In head routine scan, the effective doses of 0-1 year old group,5 years old group and 10 year old group were 2.2, 1.3 and 1.1 mSv, respectively. In chest routine scan, the effective doses of 0-1 year old group,5 years old group and 10 years old group were 5.3, 3.1 and 3.4 mSv, respectively. Effective doses to children per mAs are equally 1.8 times higher than corresponding values for adults. The CTDI vol , DLP and effective dose to children in head routine scan for MDCT were greater those that for single-detector CT and dual- detector CT. The CTDI vol , DLP and effective dose to children in chest routine scan for MDCT and dual-detector row CT were smaller than that for single-detector row CT. Conclusions: Children me more radiation risk in CT examination as compared with adults. So we should strictly abide by justification of children CT examination, and optimize the parameters of CT scan rationally in order to reduce the radiation dose to children patient as much as possible. (authors)

  18. The role of punishment in the in-patient treatment of psychiatrically disturbed children.

    Science.gov (United States)

    Alderton, H R

    1967-02-01

    The role of punishment in the psychiatric in-patient treatment of nonpsychotic latency-age children with behaviourdisorders is discussed. Punishment is defined as the removal of previously existing positive reinforcers or the administration of aversive stimuli. Ways in which appropriate social behaviour may be acquired are briefly considered. These include reinforcement of desirable responses, non-reinforcement of undesirable responses, reinforcement of incompatible responses and imitative learning. The reported effects of punishment on behaviour are reviewed and the psychological functions necessary before punishment can have the intended effects considered. For seriously disturbed children punishment is ineffective as a treatment technique. It reinforces pathological perceptions of self and adults even if it successfully suppresses behaviour. The frame of reference of the seriously disturbed child contraindicates the removal of positive reinforcers and verbal as well as physical aversive stimuli. Controls and punishments must be clearly distinguished. Controls continue only as long as the behaviour towards which they are directed. They do not include the deliberate establishment of an unpleasant state by the adult as a result of particular behaviour. Control techniques such as removal from a group may be necessary but when possible should be avoided in favour of techniques less likely to be misinterpreted. Avoidance of punishment in treatment makes even more important explicit expectations and provision of realistic controls. Natural laws may result in unpleasant experiences as an unavoidable result of certain behaviour. By definition such results can never be imposed by the adult. Treatment considerations may necessitate that the child be protected from the results of his actions. Avoidance of punishment requires a higher staff/child ratio, more mature and better trained staff. Sometimes children have previously been deterred from serious community acting out

  19. Bone-anchored hearing devices in children with unilateral conductive hearing loss: a patient-carer perspective.

    Science.gov (United States)

    Banga, Rupan; Doshi, Jayesh; Child, Anne; Pendleton, Elizabeth; Reid, Andrew; McDermott, Ann-Louise

    2013-09-01

    We sought to determine the outcome of implantation of a bone-anchored hearing device in children with unilateral conductive hearing loss. A retrospective case note analysis was used in a tertiary referral pediatric hospital to study 17 consecutive cases of pediatric patients with unilateral conductive hearing loss who were fitted with a bone-anchored hearing device between 2005 and 2010. The average age of the patients at the time of bone-anchored hearing device fitting was 10 years 6 months (range, 6 years 3 months to 16 years). Qualitative subjective outcome measures demonstrated benefit. The vast majority of patients reported improved social and physical functioning and improved quality of life. All 17 patients are currently using their bone-anchored hearing device on a daily basis after a follow-up of 6 months. This study has shown improved quality of life in children with unilateral hearing loss after implantation of their bone-anchored hearing device. There was a high degree of patient satisfaction and improvement in health status reported by children and/or carers. Bone-anchored hearing devices have an important role in the management of children with symptomatic unilateral hearing loss. Perhaps earlier consideration of a bone-anchored hearing device would be appropriate in selected cases.

  20. Tuberculosis of the hip in children: A retrospective analysis of 27 patients.

    Science.gov (United States)

    Agarwal, Anil; Suri, Tarun; Verma, Indereshwar; Kumar, Shashi Kant; Gupta, Neeraj; Shaharyar, Abbas

    2014-09-01

    We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon's criteria. The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10). The average age was 7.37 years (range, 2-12 years). In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae). There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed). There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial "triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.

  1. Tuberculosis of the hip in children a retrospective analysis of 27 patients

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2014-01-01

    Full Text Available Background: We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. Materials and Methods: We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon′s criteria. Results: The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10. The average age was 7.37 years (range, 2-12 years. In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae. There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed. There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial ′"triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. Conclusions: The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.

  2. Noise Hampers Children's Expressive Word Learning

    Science.gov (United States)

    Riley, Kristine Grohne; McGregor, Karla K.

    2012-01-01

    Purpose: To determine the effects of noise and speech style on word learning in typically developing school-age children. Method: Thirty-one participants ages 9;0 (years;months) to 10;11 attempted to learn 2 sets of 8 novel words and their referents. They heard all of the words 13 times each within meaningful narrative discourse. Signal-to-noise…

  3. A comparison with result of normalized image to different template image on statistical parametric mapping of ADHD children patients

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Dong Ho [Kyonggi University, Suwon (Korea, Republic of); Park, Soung Ock; Kwon, Soo Il [Dongnam Health College, Suwon (Korea, Republic of); Joh, Chol Woo; Yoon, Seok Nam [Medical College, Ajou University, Suwon (Korea, Republic of)

    2003-06-15

    We studied 64 ADHD children patients group (4 {approx} 15 ys, mean age: 8 {+-} 2.6 ys. M/F: 52/12) and 12 normal group (6 {approx} 7 ys, mean age: 9.4 {+-} 3.4 ys, M/F: 8/4) of the brain had been used to analysis of blood flow between normal and ADHD group. For analysis of Children ADHD, we used 12 children's mean brain images and made Template image of SPM99 program. In crease of blood flow (P-value 0.05), the result of normalized images to Template image to offer from SPM99 program, showed significant cluster in inter-Hemispheric and occipital Lobe, in the case of normalized images to children template image, showed inter-hemispheric and parietal lobe.

  4. A comparison with result of normalized image to different template image on statistical parametric mapping of ADHD children patients

    International Nuclear Information System (INIS)

    Shin, Dong Ho; Park, Soung Ock; Kwon, Soo Il; Joh, Chol Woo; Yoon, Seok Nam

    2003-01-01

    We studied 64 ADHD children patients group (4 ∼ 15 ys, mean age: 8 ± 2.6 ys. M/F: 52/12) and 12 normal group (6 ∼ 7 ys, mean age: 9.4 ± 3.4 ys, M/F: 8/4) of the brain had been used to analysis of blood flow between normal and ADHD group. For analysis of Children ADHD, we used 12 children's mean brain images and made Template image of SPM99 program. In crease of blood flow (P-value 0.05), the result of normalized images to Template image to offer from SPM99 program, showed significant cluster in inter-Hemispheric and occipital Lobe, in the case of normalized images to children template image, showed inter-hemispheric and parietal lobe

  5. Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis.

    Science.gov (United States)

    Boonacker, Chantal W B; Rovers, Maroeska M; Browning, George G; Hoes, Arno W; Schilder, Anne G M; Burton, Martin J

    2014-01-01

    Otitis media (OM) is a leading cause of medical consultations, antibiotic prescription and surgery in children. The surgical procedures offered to children with recurrent or persistent OM are insertion of grommets, adenoidectomy or a combination of the two. There is clear National Institute for Health and Care Excellence guidance for the use of grommets in subgroups of children with persistent OM with effusion (OME), but similar guidance is not available for adenoidectomy, either in persistent OME or in recurrent acute OM (AOM). (1) To develop a model to predict the risk of children referred for adenoidectomy having a prolonged duration of their OM. Then, (2a) to evaluate the overall effect of adenoidectomy, with or without grommets, on OM using individual patient data (IPD) and (2b) to identify those subgroups of children who are most likely to benefit from adenoidectomy with or without grommets. A number of electronic databases were searched from their inception including the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), metaRegister of Current Controlled Trials (mRCT), ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), ClinicalStudyResults.org and Google. Studies eligible for inclusion in this IPD meta-analysis were randomised controlled trials (RCTs) in children up to 12 years of age diagnosed with recurrent AOM and/or persistent OME in which adenoidectomy (with or without grommets) was compared with non-surgical treatment or grommets alone. The final selection of eligible studies and the quality assessment were carried out according to standard methods and disagreement was resolved by discussion. A total of 503 articles were identified of which 10 trials were included in the meta-analysis; eight of these were at a low risk of bias and two were at moderate risk. The

  6. Fracture following lower limb lengthening in children: a series of 58 patients.

    Science.gov (United States)

    Launay, F; Younsi, R; Pithioux, M; Chabrand, P; Bollini, G; Jouve, J-L

    2013-02-01

    Fracture is one of the main complications following external fixator removal used in cases of progressive lower limb lengthening; rates as high as 50% are found in the literature. The aim of this study was to determine the factors influencing this complication. One hundred and eleven cases of lower limb lengthening were performed in 58 patients (40 femurs and 71 tibias). The mean age at surgery was 10.1years old. Lengthening was performed in all cases with an external fixator alone, associated in 39.6% of cases with intramedullary nailing. The patients were divided into three groups according to disease etiology (congenital, achondroplasia and other). The fractures were classified according to the Simpson classification. Twenty fractures were recorded (18%). Sixteen fractures were found in patients with congenital disease, four with achondroplasia and none in the group of other etiologies. The fracture was more often in the femur (27.5%) than in the tibia (12.7%). The rate of fracture is influenced by different factors depending on the etiology of disease. In congenital diseases, the fracture rate is higher when there is lengthening of more than 15% of the initial length and a delay between surgery and the beginning of lengthening of less than 7days. In patients with achondroplasia, the influence of a relative percentage of lengthening is less important than in those with congenital disease. However, to avoid fractures, lengthening should not be started in children under the age of nine. Moreover, lengthening should begin at least 7days after the fixator has been placed. Retrospective. Level IV. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. EEG in children, in the laboratory or at the patient's bedside.

    Science.gov (United States)

    Kaminska, A; Cheliout-Heraut, F; Eisermann, M; Touzery de Villepin, A; Lamblin, M D

    2015-03-01

    In pediatrics, EEG recordings are performed on patients from the neonatal period up to young adults. This means adapting techniques to many different conditions, concerning not only the patient's age, the need for asepsis and the patient's behavior, but also the environment (e.g. in the laboratory, at the patient's bedside, or in the neonatal intensive care unit [NICU]). Technical requirements depend on age, indication and the type of examination; in infancy, there should be a minimum of 12 EEG electrodes, ECG and respiration recording. In epileptology, surface EMG is also necessary to characterize the type of seizures and refine the diagnosis of epilepsy syndrome, on which physicians will base their treatment choice. The role of the EEG technician is essential because the quality of the recording, its analysis and conclusion will depend on the quality of the technical set-up and the interaction with the child. Sleep is a systematic part of the study up to the age of 5 years for several reasons: sleep EEG yields information on brain maturation; the EEG tracing during wakefulness can contain too many artefacts; and some grapho-elements, key to the diagnosis, only appear during sleep. The time of the examination must be chosen according to the child's usual nap times, possibly after sleep deprivation. Grapho-elements and spatio-temporal organization of the EEG vary with age, and normal variants and unusual aspects are quite wide for any given age; this is why a physician experienced in pediatric EEG should perform the interpretation. This chapter concerns EEG performed in infants, children and adolescents, its technical aspects according to age and indications (general pediatrics, emergency, epilepsy). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. A protective screen for persons assisting in X-ray examination of children and patients with severe diseases

    International Nuclear Information System (INIS)

    Krylov, N.V.

    1978-01-01

    To increase the radiation protection reliability when carrying out auxiliary actions by medical attendants or patient relatives during X-ray investigations of children and seriously ill patients, X-ray screen provided with self-installed supporting rolls, a window with secured lead glass and a hand port is suggested. A screen constructure is described. Using the screens improves the radiation protection of roentgenologist

  9. Chronic as salvation: Teaching journalism is taught to listen and tell clearly what is heard after checking that it is true

    Directory of Open Access Journals (Sweden)

    Alfonso Armada

    2015-03-01

    Full Text Available Teaching journalism is to teach listen and tell clearly what is heard after checking that it is true. After receiving all the opinions, and stupidly believing that all are equally valuable, we finish misleading the sense of reality. This is why the press has lost much credit, because many readers or former readers have come to the conclusion that everybody lies, that all newspapers twist reality so that it looks like their worldview, because, as ironically says a friend who tries not to lose entirely his faith in journalism: "reality is overrated". Because we mix facts and opinions, because we weaken the facts so that they say what we want them to say, and ultimately we do not know where reality ends and where fiction begins, where we practice the intellectual and moral decency or misrepresenting what we know to harm others and protect us.

  10. Exploring young patients' perspectives on rehabilitation care: methods and challenges of organizing focus groups for children and adolescents.

    NARCIS (Netherlands)

    Krol, M.; Sixma, H.; Meerdink, J.; Wiersma, H.; Rademakers, J.

    2014-01-01

    Background: In research on quality of care, the experiences of children and (pre)adolescents are usually assessed by asking their parents. However, these young patients may have preferences of their own, and their experiences do not necessarily concur with those of their parents. Therefore, our

  11. Shared Medical Appointments marginally enhance interaction between patients: an observational study on children and adolescents with type 1 diabetes.

    NARCIS (Netherlands)

    Noordman, J.; Dulmen, S. van

    2013-01-01

    Objective: To examine informational and emotional patient–provider and patient–patient communication sequences (i.e. cues and subsequent responses) during Shared Medical Appointments (SMAs) for children and adolescents with type 1 Diabetes Mellitus (T1DM) and their parents. Methods: 57

  12. The Effect of "Sad" and "Happy" Background Music on the Interpretation of a Story in 5 to 6-Year-Old Children

    Science.gov (United States)

    Ziv, Naomi; Goshen, Maya

    2006-01-01

    Children hear music in the background of a large variety of situations and activities. Throughout development, they acquire knowledge both about the syntactical norms of tonal music, and about the relationship between musical form and emotion. Five to six-year-old children heard a story, with a background "happy", "sad" or no…

  13. NIGHT HEMODYNAMIC DISORDER RISK FACTORS AND MARKERS FOR PATIENT-SPECIFIC APPROACH TO CARDIOVASCULAR DISEASE PREVENTION IN CHILDREN

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    Olga V. Kozhevnikova

    2017-01-01

    Full Text Available Background:  High mortality rates of cardiovascular disease request research revealing risk factors and early markers of cardiovascular dysfunction in children with chronic pathology.Objective:  to reveal the risk factors and early markers of night hemodynamic disorders for the development of personalized cardiovascular disease prevention in children based on the results of the combined daily monitoring of arterial pressure, ECG examination, and analysis of night sleep. Patients and methods:  Parents filled screeningquestionnaire of night sleep before the study onset. Combined monitoring and examination was performed  in 232  children aged 6–17 with different blood pressure disorders using Astrocard НS E2bp (Russia equipment in the outpatient setting.Results: 24-hour BP monitoring identified arterial hypotension 3.8 times more often than routine ambulance method. 21% of children or every fifth child with hypotension  had night hypertension  associated  with maximum (93% pathology  of ENT organs  with nasal obstruction. Differentiation of investigated groups by night PP and DBP show these marks of hemodynamics to be really important at the early period of pathology development in children. 62% of children had QT interval with bad adaptation to RR-interval at night. In the group with high BMI we found 1.6 times more often children with height more than 85th percentile of the norm. These children had night diastolic hypotension  5 times more often, children with obesity didn’t have normal 24-hour  BP dynamics, children with high BMI had longer QT-interval at night.Conclusions: We demonstrate the necessity of night sleep hemodynamics investigation in children for personalized cardiovascular disorder prevention. Children of early school age suffering from chronic ENT-pathology with nasal obstruction and/or high BMI, with high BMI, and with height ≥85th percentile of gender-age norm have risk of development of cardiovascular

  14. Primary non-refluxive megaureter in children: single-center experience and follow-up of 212 patients.

    Science.gov (United States)

    Rubenwolf, P; Herrmann-Nuber, J; Schreckenberger, M; Stein, R; Beetz, R

    2016-11-01

    Primary non-refluxing megaureter (pMU) is a multifaceted and challenging congenital pathology of the urinary tract. We report our 23-year experience with this anomaly in terms of presentation, diagnostic work-up and management. We retrospectively reviewed the medical records of 212 children diagnosed with pMU between 1986 and 2009 at our institution. Mean follow-up was 45.17 (0-192) months. Of the total, 168 (79 %) children presented with upper urinary tract dilation on perinatal ultrasound screening. In 44 (21 %) patients, the diagnosis was made following diagnostic work-up of a urinary tract infection (UTI, 18 %) or flank pain (3 %). In total, 203 of 254 pMUs (79.9 %) were successfully treated conservatively during the 23-year observation period. Forty-eight children (23 %) underwent ureteric reimplantation. UTIs occurred in 91 of 212 children (43 %). Of these, 41 (45 %) occurred despite antibacterial infection prophylaxis. Within the past three decades, there has been a marked shift from surgical toward conservative therapy at our institution. Neonatal renal ultrasound is the method of choice to timely identify children with pMU and, alongside dynamic renography, to monitor the clinical course. Nowadays, only a minor subset of children with asymptomatic course requires surgical correction. Antibacterial prophylaxis has the potential to reduce the risk of febrile UTIs. Prospective randomized studies are warranted to provide evidence of the beneficial effect of antibacterial prophylaxis.

  15. Features and Outcome of Autonomous Thyroid Nodules in Children: 31 Consecutive Patients Seen at a Single Center.

    Science.gov (United States)

    Ly, Samantha; Frates, Mary C; Benson, Carol B; Peters, Hope E; Grant, Frederick D; Drubach, Laura A; Voss, Stephan D; Feldman, Henry A; Smith, Jessica R; Barletta, Justine; Hollowell, Monica; Cibas, Edmund S; Moore, Francis D; Modi, Biren; Shamberger, Robert C; Huang, Stephen A

    2016-10-01

    Most thyroid nodules are benign and their accurate identification can avoid unnecessary procedures. In adult patients, documentation of nodule autonomy is accepted as reassurance of benign histology and as justification to forgo biopsy or thyroidectomy. In contrast, the negative predictive value of nodule autonomy in children is uncertain. Some recent publications recommend surgical resection as initial management, but few address the degree of TSH suppression or the specific scintigraphic criteria used to diagnose autonomy. The objective of the study was to study the presenting features and cancer risk of children with autonomous nodules. Medical records of all 31 children diagnosed with autonomous nodules at our center from 2003 to 2014 were retrospectively reviewed. All children met full diagnostic criteria for autonomous nodules, defined by both autonomous 123 I uptake into the nodule and the suppression of uptake in the normal thyroid parenchyma on scintigraphy performed during hypothyrotropinemia. The median age of presentation was 15 years (range 3-18 y) with a female to male ratio of 15:1. Fifty-eight percent of patients had solitary nodules and 42% had multiple nodules. The median size of each patient's largest autonomous nodule was 39 mm (range 18-67 mm). Most of the children in this series (68%) had diagnostic biopsies and/or operative pathology of their largest autonomous nodule, which showed benign cytology or histology in all cases. In this pediatric series, the cancer rate observed in biopsied or resected autonomous nodules was 0%. Whereas larger studies are needed to confirm our findings, these results agree with earlier reports suggesting that thyroid cancer is rare in rigorously defined autonomous nodules and support that conservative management may be offered to selected children who meet strict diagnostic criteria for autonomous nodules, deferring definitive therapies until adulthood when the risks of thyroidectomy and 131 I ablation are lower.

  16. Phase I study of temozolomide in paediatric patients with advanced cancer. United Kingdom Children's Cancer Study Group.

    Science.gov (United States)

    Estlin, E. J.; Lashford, L.; Ablett, S.; Price, L.; Gowing, R.; Gholkar, A.; Kohler, J.; Lewis, I. J.; Morland, B.; Pinkerton, C. R.; Stevens, M. C.; Mott, M.; Stevens, R.; Newell, D. R.; Walker, D.; Dicks-Mireaux, C.; McDowell, H.; Reidenberg, P.; Statkevich, P.; Marco, A.; Batra, V.; Dugan, M.; Pearson, A. D.

    1998-01-01

    A phase I study of temozolomide administered orally once a day, on 5 consecutive days, between 500 and 1200 mg m(-2) per 28-day cycle was performed. Children were stratified according to prior craniospinal irradiation or nitrosourea therapy. Sixteen of 20 patients who had not received prior craniospinal irradiation or nitrosourea therapy were evaluable. Myelosuppression was dose limiting, with Common Toxicity Criteria (CTC) grade 4 thrombocytopenia occurring in one of six patients receiving 1000 mg m(-2) per cycle, and two of four patients treated at 1200 mg m(-2) per cycle. Therefore, the maximum-tolerated dose (MTD) was 1000 mg m(-2) per cycle. The MTD was not defined for children with prior craniospinal irradiation because of poor recruitment. Plasma pharmacokinetic analyses showed temozolomide to be rapidly absorbed and eliminated, with linear increases in peak plasma concentrations and systemic exposure with increasing dose. Responses (CR and PR) were seen in two out of five patients with high-grade astrocytomas, and one patient had stable disease. One of ten patients with diffuse intrinsic brain stem glioma achieved a long-term partial response, and a further two patients had stable disease. Therefore, the dose recommended for phase II studies in patients who have not received prior craniospinal irradiation or nitrosoureas is 1000 mg m(-2) per cycle. Further evaluation in diffuse intrinsic brain stem gliomas and other high-grade astrocytomas is warranted. Images Figure 5 p658-b Figure 6 p659-b PMID:9744506

  17. Nasopharyngeal carcinoma in children and adolescents - a single institution experience of 158 patients

    International Nuclear Information System (INIS)

    Liu, Weixin; Tang, Yuan; Gao, Li; Huang, Xiaodong; Luo, Jingwei; Zhang, Shiping; Wang, Kai; Qu, Yuan; Xiao, Jianping; Xu, Guozhen; Yi, Junlin

    2014-01-01

    To evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents. Between January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient’s clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed. There were 9 (5.7%) patients in stage II, 60 (38.0%) in stage III and 89 (56.3%) in stage IV according to the UICC2002 staging system. Neck mass (32.3%), headache (21.5%) and nasal obstruction (15.2%) were the most common chief complaints. With a median follow-up time of 62.5 months (range 2.0-225.0 months), the 5-year overall survival (OS) rate, local-regional control (LRC) rate and distant metastasis-free survival (DMFS) rate were 82.6%, 94.9% and 76.4%, respectively. There were 43 (27.2%) patients failed during the follow up, with seven local-regional recurrences and 38 distant metastases. In univariate analysis, the 5-year OS of T4 and T1-3 were 75% and 87.9%, p = 0.01, stage IV and stage II-III were 77.1% and 90%, p = 0.04, respectively. In multivariate analysis, T4 (p = 0.02) and stage IV (p = 0.04) were the independent adverse prognostic factors for OS. Significant reduction in trismus (27.3% v 3.6%, p = 0.03) and G2 xerostomia (37.9% v 10.3%, p = 0.02) was observed in patients treated by IMRT. Most childhood and adolescence nasopharyngeal carcinoma patients were locally advanced diseases at first diagnosed. The treatment results of radiotherapy, with or without chemotherapy, are excellent in our institution. Reducing distant metastasis with new strategies and late toxicities with intensity-modulated radiotherapy are the future directions for the treatment of adolescent nasopharyngeal carcinoma

  18. Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

    Directory of Open Access Journals (Sweden)

    Zernikow Boris

    2012-05-01

    Full Text Available Abstract Background Prevalence of pain as a recurrent symptom in children is known to be high, but little is known about children with high impairment from chronic pain seeking specialized treatment. The purpose of this study was the precise description of children with high impairment from chronic pain referred to the German Paediatric Pain Centre over a 5-year period. Methods Demographic variables, pain characteristics and psychometric measures were assessed at the first evaluation. Subgroup analysis for sex, age and pain location was conducted and multivariate logistic regression applied to identify parameters associated with extremely high impairment. Results The retrospective study consisted of 2249 children assessed at the first evaluation. Tension type headache (48%, migraine (43% and functional abdominal pain (11% were the most common diagnoses with a high rate of co-occurrence; 18% had some form of musculoskeletal pain disease. Irrespective of pain location, chronic pain disorder with somatic and psychological factors was diagnosed frequently (43%. 55% of the children suffered from more than one distinct pain diagnosis. Clinically significant depression and general anxiety scores were expressed by 24% and 19% of the patients, respectively. Girls over the age of 13 were more likely to seek tertiary treatment compared to boys. Nearly half of children suffered from daily or constant pain with a mean pain value of 6/10. Extremely high pain-related impairment, operationalized as a comprehensive measure of pain duration, frequency, intensity, pain-related school absence and disability, was associated with older age, multiple locations of pain, increased depression and prior hospital stays. 43% of the children taking analgesics had no indication for pharmacological treatment. Conclusion Children with chronic pain are a diagnostic and therapeutic challenge as they often have two or more different pain diagnoses, are prone to misuse of

  19. Subglottic stenosis in short-statured children: a case for further investigation of airway symptoms in patients with skeletal dysplasias.

    Science.gov (United States)

    Lee, Jonathan H; Ellison, Jay W; Schears, Gregory J; Thompson, Dana M

    2006-01-01

    Clinical evaluation of children with skeletal dysplasias is often concentrated on morphologic and radiographic assessments, but many of these patients also have disease processes of the ear, nose, and throat. We report a case of an 11-month-old girl with an unknown short-limbed dwarfism, similar to acromicric dysplasia, with grade II subglottic stenosis. Laryngotracheoplasty with anterior autologous costal cartilage graft and posterior cricoid split was performed at age 13 months, with subsequent improvement of her airway status. In cases of children with skeletal dysplasias and obstructive airway symptoms, formal otolaryngologic evaluation is warranted for definitive diagnosis and treatment.

  20. Cardiac-vessels system violations of children moved from radiation polluted zones

    International Nuclear Information System (INIS)

    Bobovich, A.A.; Kokorina, N.V.

    2008-01-01

    In the work are presented results of circulation system status and heard pre-pathology processes of 60 children moved from radiation polluted zones. Some connections between cardiac-vessels system violation and neural system violations are ascertained. Role of neural system functions fallen down and non-adaptive cardiac-vessels system changes in pathogenesis are discussed. (authors)

  1. Children's Trait and Emotion Attributions in Socially Ambiguous and Unambiguous Situations

    Science.gov (United States)

    Boseovski, Janet J.; Lapan, Candace; Bosacki, Sandra

    2013-01-01

    Children's attributions about story characters in ambiguous and unambiguous social situations were assessed. One hundred and forty-four 6-7-year-olds and 10-11-year-olds heard about actors who slighted a recipient intentionally or for an undetermined reason and then made causal attributions about the events, an emotion attribution about the…

  2. Young children's use of contrast in word learning: the case of proper names

    NARCIS (Netherlands)

    Hall, D.G.; Rhemtulla, M.

    2014-01-01

    Recent research has established that contrast can exert a powerful effect on early word learning. This study examined the role of contrast in young children's ability to learn proper names. Preschoolers heard a novel word for an unfamiliar stuffed animal in the presence of a second stuffed animal of

  3. Minimally Invasive Surgery (MIS) in Children and Adolescents with Pheochromocytomas and Retroperitoneal Paragangliomas: Experiences in 42 Patients.

    Science.gov (United States)

    Walz, Martin K; Iova, Laura D; Deimel, Judith; Neumann, Hartmut P H; Bausch, Birke; Zschiedrich, Stefan; Groeben, Harald; Alesina, Pier F

    2018-04-01

    Pheochromocytomas (PH) and paragangliomas (PGL) are rare tumours in children accounting for about 1% of the paediatric hypertension. While minimally invasive surgical techniques are well established in adult patients with PH, the experience in children is extremely limited. To the best of our knowledge, we herewith present the largest series of young patients operated on chromaffin tumours by minimally invasive access. In the setting of a prospective study (1/2001-12/2016), 42 consecutive children and adolescents (33 m, 9 f) were operated on. Thirty-seven patients (88%) suffered from inherited diseases. Twenty-six patients had PH, 11 presented retroperitoneal PGL, and five patients suffered from both. Altogether, 70 tumours (mean size 2.7 cm) were removed (45 PH, 25 PGL). All operations were performed by a minimally invasive access (retroperitoneoscopic, laparoscopic, extraperitoneal). Partial adrenalectomy was the preferred procedure for PH (31 out of 39 patients). Twenty patients received α-receptor blockade preoperatively. One patient died after induction of anaesthesia due to cardiac arrest. All other complications were minor. Conversion to open surgery was necessary in two cases with PGL. Median operating time for unilateral PH was 55 min, in bilateral cases 125, 143 min in PGs, and 180 min in combined cases. Median blood loss was 20 ml (range 0-1000). Blood transfusion was necessary in two cases. Intraoperative, systolic peak pressure was 170 ± 39 mmHg with α-receptor blockade and 191 ± 33 mmHg without α-receptor blockade (p = 0.41). The median post-operative hospital stay was 3 days. After a mean follow-up of 8.5 years, two patients presented ipsilateral recurrence (after partial adrenalectomy). All patients with bilateral PH (n = 13) are steroid independent post-operatively. PH and PGL in children and adolescents should preferably be removed by minimally invasive surgery. Partial adrenalectomy provides long-term steroid independence

  4. Comparative effectiveness studies examining patient-reported outcomes among children with cleft lip and/or palate: a systematic review.

    Science.gov (United States)

    Ranganathan, Kavitha; Vercler, Christian J; Warschausky, Seth A; MacEachern, Mark P; Buchman, Steven R; Waljee, Jennifer F

    2015-01-01

    Health care policy makers are increasingly encouraging comparative effectiveness research. Little is known regarding comparative studies among children with cleft lip and/or palate. Cleft lip and/or palate profoundly influences self-perception and social functioning, and patient-reported outcomes provide a unique perspective on the success of reconstruction. The purpose of this study was to systematically review the literature regarding patient-reported outcomes among patients with cleft lip and/or palate. The authors reviewed articles from MEDLINE, Embase, and PsycInfo that examined the use of patient-reported outcome instruments for cleft lip and/or palate. Studies of patients with cleft lip and/or palate across any age that described the use of patient-completed measures in patient and control populations were included. A research librarian confirmed the search, and two independent, blinded reviewers performed full-text review. The authors identified 1979 articles and selected 30 for inclusion. Forty-two different assessment tools were used to analyze factors such as self-esteem, behavior, and social support. The Strengths and Difficulties Questionnaire was most commonly used (n = 7), followed by the Childhood Experience Questionnaire (n = 5), and the Satisfaction with Appearance survey (n = 4). Barriers to analysis included lack of standardization of survey administration, effect of publication bias, and variations in patient populations between individual studies. Comparative studies of patient-reported outcomes among patients with cleft lip and/or palate are infrequent. Many instruments exist to measure patient-reported outcomes in this population, but no specific standard exists. Identifying efficient and targeted forms of instrument selection and administration will enhance comparative studies among children with cleft lip and/or palate. Diagnostic, III.

  5. Children and their parents assessing the doctor-patient interaction: a rating system for doctors' communication skills.

    Science.gov (United States)

    Crossley, Jim; Eiser, Christine; Davies, Helena A

    2005-08-01

    Only a patient and his or her family can judge many of the most important aspects of the doctor-patient interaction. This study evaluates the feasibility and reliability of children and their families assessing the quality of paediatricians' interactions using a rating instrument developed specifically for this purpose. A reliability analysis using generalisability theory on the ratings from 352 doctor-patient interactions across different speciality clinics. Ratings were normally distributed. They were highest for 'overall' performance, and lowest for giving time to discuss the families' agenda. An appropriate sample of adults' ratings provided a reliable score (G = 0.7 with 15 raters), but children's ratings were too idiosyncratic to be reproducible (G = 0.36 with 15 raters). CONCLUSIONS AND FURTHER WORK: Accompanying adults can provide reliable ratings of doctors' interactions with children. Because an adult is usually present at the consultation their ratings provide a highly feasible and authentic approach. Sampling doctors' interactions from different clinics and with patients of both genders provides a universal picture of performance. The method is ideal to measure performance for in-training assessment or revalidation. Further work is in progress to evaluate the educational impact of feeding ratings back to the doctors being assessed, and their use in a range of clinical contexts.

  6. Observation-status patients in children's hospitals with and without dedicated observation units in 2011.

    Science.gov (United States)

    Macy, Michelle L; Hall, Matthew; Alpern, Elizabeth R; Fieldston, Evan S; Shanley, Leticia A; Hronek, Carla; Hain, Paul D; Shah, Samir S

    2015-06-01

    Pediatric observation units (OUs) have demonstrated reductions in lengths of stay (LOS) and costs of care. Hospital-level outcomes across all observation-status stays have not been evaluated in relation to the presence of a dedicated OU in the hospital. To compare observation-status stay outcomes in hospitals with and without a dedicated OU. Cross-sectional analysis of hospital administrative data. Observation-status stay outcomes were compared in hospitals with and without a dedicated OU across 4 categories: (1) LOS, (2) standardized costs, (3) conversion to inpatient status, and (4) return care. Observation-status stays in 31 free-standing children's hospitals contributing observation patient data to the Pediatric Health Information System database, 2011. Fifty-one percent of the 136,239 observation-status stays in 2011 occurred in 14 hospitals with a dedicated OU; the remainder were in 17 hospitals without. The percentage of observation-status same-day discharges was higher in hospitals with a dedicated OU compared with hospitals without (23.8 vs 22.1, P hospitals with a dedicated OU (11.06%) compared with hospitals without (9.63%, P hospital-level outcomes. Inclusion of location of care (eg, dedicated OU, inpatient unit, emergency department) in hospital administrative datasets would allow for more meaningful comparisons of models of hospital care. © 2015 Society of Hospital Medicine.

  7. SERUM ANALYSIS OF AMYLOID BETA-PROTEIN 1-40 IN HEALTHY SUBJECTS, AUTISTIC CHILDREN AND ALZHEIMER’S PATIENTS

    Directory of Open Access Journals (Sweden)

    Vijendra K. SINGH

    2008-06-01

    Full Text Available Amyloid beta-protein1-40 (AP40 is a low molecu­lar weight peptide produced throughout life during normal cell metabolism and neurodegenerative diseases. Owing to its neurotrophic and neurotoxic effects, the present study was conducted to evalu­ate serum levels of AP40 in healthy subjects, au­tistic children and Alzheimer’s disease patients. Serum AP40 was measured by enzyme-linked im­munosorbent assay (ELISA. AP40 was signifi­cantly higher in normal children compared to nor­mal older controls, in normal children compared to autistic children, and in autistic children compared to Alzheimer’s patients (p value was less than 0.05 for all groups. This finding suggests an age-re­lated decline of serum AP40 in normal aging, as well as in autism and Alzheimer’s disease. This decline may result from abnormal processing of amyloid beta-protein precursor (APP during nor­mal aging and age-related diseases such as autism in children and Alzheimer’s disease in elderly. Possible explanations for this decline may include age-related increased interactions of AP40 with cytoskeletal proteins for brain tissue deposition, increased serine proteases for APP metabolism or hyperimmune reaction (antibodies to AP40 for removal of circulating AP40. To conclude, the AP40 metabolism declines with normal aging and in addition to its role in Alzheimer’s disease this protein might also be a contributing factor in au­tism.

  8. Individualized Infliximab Treatment Guided by Patient-managed eHealth in Children and Adolescents with Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Carlsen, Katrine; Houen, Gunnar; Jakobsen, Christian

    2017-01-01

    BACKGROUND: To individualize timing of infliximab (IFX) treatment in children and adolescents with inflammatory bowel disease (IBD) using a patient-managed eHealth program. METHODS: Patients with IBD, 10 to 17 years old, treated with IFX were prospectively included. Starting 4 weeks after...... their last infusion, patients reported a weekly symptom score and provided a stool sample for fecal calprotectin analysis. Based on symptom scores and fecal calprotectin results, the eHealth program calculated a total inflammation burden score that determined the timing of the next IFX infusion (4-12 wk...... after the previous infusion). Quality of Life was scored by IMPACT III. A control group was included to compare trough levels of IFX antibodies and concentrations and treatment intervals. Patients and their parents evaluated the eHealth program. RESULTS: There were 29 patients with IBD in the eHealth...

  9. Inaccuracy of Wolff-Parkinson-white accessory pathway localization algorithms in children and patients with congenital heart defects.

    Science.gov (United States)

    Bar-Cohen, Yaniv; Khairy, Paul; Morwood, James; Alexander, Mark E; Cecchin, Frank; Berul, Charles I

    2006-07-01

    ECG algorithms used to localize accessory pathways (AP) in patients with Wolff-Parkinson-White (WPW) syndrome have been validated in adults, but less is known of their use in children, especially in patients with congenital heart disease (CHD). We hypothesize that these algorithms have low diagnostic accuracy in children and even lower in those with CHD. Pre-excited ECGs in 43 patients with WPW and CHD (median age 5.4 years [0.9-32 years]) were evaluated and compared to 43 consecutive WPW control patients without CHD (median age 14.5 years [1.8-18 years]). Two blinded observers predicted AP location using 2 adult and 1 pediatric WPW algorithms, and a third blinded observer served as a tiebreaker. Predicted locations were compared with ablation-verified AP location to identify (a) exact match for AP location and (b) match for laterality (left-sided vs right-sided AP). In control children, adult algorithms were accurate in only 56% and 60%, while the pediatric algorithm was correct in 77%. In 19 patients with Ebstein's anomaly, diagnostic accuracy was similar to controls with at times an even better ability to predict laterality. In non-Ebstein's CHD, however, the algorithms were markedly worse (29% for the adult algorithms and 42% for the pediatric algorithms). A relatively large degree of interobserver variability was seen (kappa values from 0.30 to 0.58). Adult localization algorithms have poor diagnostic accuracy in young patients with and without CHD. Both adult and pediatric algorithms are particularly misleading in non-Ebstein's CHD patients and should be interpreted with caution.

  10. Two Project Methods: Preliminary Observations on the Similarities and Differences between William Heard Kilpatrick's Project Method and John Dewey's Problem-Solving Method

    Science.gov (United States)

    Sutinen, Ari

    2013-01-01

    The project method became a famous teaching method when William Heard Kilpatrick published his article "Project Method" in 1918. The key idea in Kilpatrick's project method is to try to explain how pupils learn things when they work in projects toward different common objects. The same idea of pupils learning by work or action in an…

  11. Improving Care in Pediatric Neuro-oncology Patients: An Overview of the Unique Needs of Children With Brain Tumors.

    Science.gov (United States)

    Fischer, Cheryl; Petriccione, Mary; Donzelli, Maria; Pottenger, Elaine

    2016-03-01

    Brain tumors represent the most common solid tumors in childhood, accounting for almost 25% of all childhood cancer, second only to leukemia. Pediatric central nervous system tumors encompass a wide variety of diagnoses, from benign to malignant. Any brain tumor can be associated with significant morbidity, even when low grade, and mortality from pediatric central nervous system tumors is disproportionately high compared to other childhood malignancies. Management of children with central nervous system tumors requires knowledge of the unique aspects of care associated with this particular patient population, beyond general oncology care. Pediatric brain tumor patients have unique needs during treatment, as cancer survivors, and at end of life. A multidisciplinary team approach, including advanced practice nurses with a specialty in neuro-oncology, allows for better supportive care. Knowledge of the unique aspects of care for children with brain tumors, and the appropriate interventions required, allows for improved quality of life. © The Author(s) 2015.

  12. Merging Children's Oncology Group Data with an External Administrative Database Using Indirect Patient Identifiers: A Report from the Children's Oncology Group.

    Directory of Open Access Journals (Sweden)

    Yimei Li

    Full Text Available Clinical trials data from National Cancer Institute (NCI-funded cooperative oncology group trials could be enhanced by merging with external data sources. Merging without direct patient identifiers would provide additional patient privacy protections. We sought to develop and validate a matching algorithm that uses only indirect patient identifiers.We merged the data from two Phase III Children's Oncology Group (COG trials for de novo acute myeloid leukemia (AML with the Pediatric Health Information Systems (PHIS. We developed a stepwise matching algorithm that used indirect identifiers including treatment site, gender, birth year, birth month, enrollment year and enrollment month. Results from the stepwise algorithm were compared against the direct merge method that used date of birth, treatment site, and gender. The indirect merge algorithm was developed on AAML0531 and validated on AAML1031.Of 415 patients enrolled on the AAML0531 trial at PHIS centers, we successfully matched 378 (91.1% patients using the indirect stepwise algorithm. Comparison to the direct merge result suggested that 362 (95.7% matches identified by the indirect merge algorithm were concordant with the direct merge result. When validating the indirect stepwise algorithm using the AAML1031 trial, we successfully matched 157 out of 165 patients (95.2% and 150 (95.5% of the indirectly merged matches were concordant with the directly merged matches.These data demonstrate that patients enrolled on COG clinical trials can be successfully merged with PHIS administrative data using a stepwise algorithm based on indirect patient identifiers. The merged data sets can be used as a platform for comparative effectiveness and cost effectiveness studies.

  13. Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems.

    Science.gov (United States)

    2014-05-01

    Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals. This requirement of supporting coordination of care is generally true for health systems providing care for all children and youth but especially for those with special health care needs. At the foundation of an efficient and effective system of care delivery is the patient-/family-centered medical home. From its inception, the medical home has had care coordination as a core element. In general, optimal outcomes for children and youth, especially those with special health care needs, require interfacing among multiple care systems and individuals, including the following: medical, social, and behavioral professionals; the educational system; payers; medical equipment providers; home care agencies; advocacy groups; needed supportive therapies/services; and families. Coordination of care across settings permits an integration of services that is centered on the comprehensive needs of the patient and family, leading to decreased health care costs, reduction in fragmented care, and improvement in the patient/family experience of care. Copyright © 2014 by the American Academy of Pediatrics.

  14. Frequency of nocturnal symptoms in asthmatic children attending a hospital out-patient clinic

    NARCIS (Netherlands)

    Meijer, G. G.; Postma, D. S.; Wempe, J. B.; Gerritsen, J.; Knol, K.; van Aalderen, W. M.

    1995-01-01

    Since nocturnal symptoms indicate more severe asthma, we investigated their frequency in a hospital-based population of asthmatic children. Recognition of these symptoms offers the possibility to introduce appropriate treatment. We studied 796 consecutive children with asthma (mean (SD) age 9 (4)

  15. Hepatocellular carcinoma in children and young patients with chronic HBV infection and the usefulness of alpha-fetoprotein assessment.

    Science.gov (United States)

    Tajiri, Hitoshi; Takano, Tomoko; Tanaka, Hideo; Ushijima, Kosuke; Inui, Ayano; Miyoshi, Yoko; Ozono, Keiichi; Abukawa, Daiki; Endo, Takeshi; Brooks, Stephen; Tanaka, Yasuhito

    2016-11-01

    The aims of the study were to elucidate the clinical characteristics of patients who developed hepatocellular carcinoma (HCC) related to persistent HBV infection since childhood and to investigate usefulness of assessing alpha-fetoprotein (AFP) in this population. A nationwide multicenter survey of children with chronic HBV infection was performed. Among 548 patients, 15 patients developed HCC at the median age of 15 years (range 9-36), including 13 males and 2 females. A case-control comparison showed that HBeAg seroconversion and liver cirrhosis were associated with the occurrence of HCC. Of the 15 HCC patients, 5 were treated with interferon and none of them responded to interferon therapy as compared with 12 of the 17 responders in the control group. Of the 15 patients, 10 died and 9 of the 10 who died never visited any medical facilities until diagnosis of HCC, while the remaining 5 surviving patients never stopped their clinic visits. The usefulness of AFP assessment was shown by the findings that AFP levels were elevated in all HCC cases, that elevations in AFP levels were detected prior to the diagnosis in the surviving patients, and that sensitivity of AFP as a diagnostic test for HCC was very high among 40 patients including our 14 and an additional 26 collected from the literature. HBeAg seroconversion and liver cirrhosis are associated with the occurrence of HCC. Regular measurement of AFP might be helpful to watch for the occurrence of HCC when following children and young patients with chronic HBV infection since childhood. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  16. Clinical response to long term enzyme replacement treatment in children, adolescent and adult patients with Hunter syndrome.

    Science.gov (United States)

    Dalmau Serra, Jaime; Vitoria Miñana, Isidro; Calderón Fernández, Rafael; Cortell Aznar, Isidoro

    2015-11-06

    Since enzyme replacement treatment (ERT) with idursulfase is available for Hunter syndrome (HS; mucopolysaccharidosis type II), for the first time, disease progression can be limited and organ damage reduced or prevented. We described retrospectively the clinical evolution of eight HS males, treated with ERT and followed in routine clinical practice in Hospital Infantil La Fe (Valencia, Spain). We studied three children, three adolescents and two adults. Time from diagnosis to ERT ranged from 13.7 to 0.2 years, and duration of ERT ranged from 24 to 77.1 months. From the start of ERT, weight and height increased in children and adolescents and remained stable in adults. Glycosaminoglycans (GAG) decreased in all patients; in patient 5 (aged 23 years), we observed the highest reduction (86%) with recovery of carpal tunnel syndrome, splenomegaly and a decrease in nocturnal oxygen dependence. Our results show that ERT improve respiratory impairment and organomegalies and decrease GAGs levels in all patients including children, adolescent and adults. While cardiac manifestations and facial features stabilized, responses in other parameters were heterogeneous. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  17. Tuberculosis infection and disease in children living in households of Filipino patients with tuberculosis: a preliminary report.

    Science.gov (United States)

    Salazar-Vergara, R M L; Sia, I G; Tupasi, T E; Alcañeses, M R; Orillaza, R B; Co, V; Quelapio, M I D; Beltran, G; Legaspi, J D; Rostrata, M P C; Tecson, M E B; Corpuz, M L S B

    2003-12-01

    DOTS Clinic with a DOTS-Plus pilot project for the management of multidrug-resistant tuberculosis (MDR-TB) in a high burden country. To determine the prevalence of tuberculosis (TB) infection and disease among pediatric household contacts of patients with pulmonary TB (PTB). Cross-sectional study. One hundred and fifty-three children aged 0-15 years in the households of 62 bacteriologically confirmed PTB patients, including 44 with MDR-TB, were studied. BCG scars were noted, and tuberculin skin test (TST), screening chest radiography, and sputum or gastric aspirate smear and culture for Mycobacterium tuberculosis in those with radiographic findings suggestive of PTB were done. For children in this study, the prevalences of latent TB infection (LTBI), radiographically diagnosed pulmonary TB, and bacillary pulmonary TB were 69.2%, 3.3%, and 0.65%, respectively. Only age > or = 5 years was found to be a significant predictor of LTBI (OR 3.17, 95%CI 1.43-7.01). Contact investigation for active case-finding and early treatment of TB in children from households of patients with active PTB is essential for TB control. Further study on a more precise definition of TB infection and strategies for control in this population will be pursued.

  18. Action word Related to Walk Heard by the Ears Activates Visual Cortex and Superior Temporal Gyrus: An fMRI Study

    Directory of Open Access Journals (Sweden)

    Naoyuki Osaka

    2012-10-01

    Full Text Available Cognitive neuroscience of language of action processing is one of the interesting issues on the cortical “seat” of word meaning and related action (Pulvermueller, 1999 Behavioral Brain Sciences 22 253–336. For example, generation of action verbs referring to various arm or leg actions (e.g., pick or kick differentially activate areas along the motor strip that overlap with those areas activated by actual movement of the fingers or feet (Hauk et al., 2004 Neuron 41 301–307. Meanwhile, mimic words like onomatopoeia have the other potential to selectively and strongly stimulate specific brain regions having a specified “seat” of action meaning. In fact, mimic words highly suggestive of laughter and gaze significantly activated the extrastriate visual /premotor cortices and the frontal eye field, respectively (Osaka et al., 2003 Neuroscience Letters 340 127–130; 2009 Neuroscience Letters 461 65–68. However, the role of a mimic word related to walk on specific brain regions has not yet been investigated. The present study showed that a mimic word highly suggestive of human walking, heard by the ears with eyes closed, significantly activated the visual cortex located in extrastriate cortex and superior temporal gyrus while hearing non-sense words that did not imply walk under the same task did not activate these areas. These areas would be a critical region for generating visual images of walking and related action.

  19. Listened to, but not heard!

    DEFF Research Database (Denmark)

    Lassen, Jesper

    2018-01-01

    In the mid-1990s, a mismatch was addressed between European genetically modified food policy, which focused primarily on risks and economic prospects, and public anxieties, which also included other concerns, and there was a development in European food policy toward the inclusion of what were...... fundamental questions about genetically modified foods, and in particular their perceived unnaturalness, were not considered in the parliamentary debates. It is suggested that the failure of the parliament to represent the public may undermine the legitimacy of politicians and lead to disillusionment...

  20. Children as digital rights agents

    DEFF Research Database (Denmark)

    Stald, Gitte Bang

    2016-01-01

    This paper looks at children’s involvement and contribution to internet safety policy. In many respects, the research perspective on children and young people has also seen a shift towards the child as agent, as citizen (Livingstone 2002, 2009; Dahlgren 2007). With increasing attention given...... to children’s communication rights there is an acknowledgement that children’s voices should be heard in all matters that affect them (Hamelink 2008). We still, however, primarily discuss how adults could and should take responsibility in guarding children and young people from risk and harm, and what...... the role of the “adult world” is. We need to focus more on the active role that children and adolescents play, according to age, skills and various capacities, in identifying, reflecting upon and acting according to opportunities and challenges in relation to digital media and digital rights (Hartman et al...

  1. Care for children with special health care needs in a managed care system: a patient satisfaction survey.

    Science.gov (United States)

    Flynn, J M; Bravo, C J; Reyes, O

    2001-09-01

    In 1994 the government of Puerto Rico adopted a capitated managed health care system for the medically indigent. The new law has been implemented in most municipalities. A survey of children with special health care needs treated at a tertiary pediatric center under the capitated managed care system and the prior non-capitated system was analyzed using the Consumer Assessments of Health Plan Survey (CHAPS) instrument. One third of the patients who were under the new capitated managed care system were not satisfied with the medial care they were receiving. The parents of children with multidisciplinary conditions found it much more difficult to access care at the tertiary center. It took parents two years to learn to navigate within the capitated managed care system. Studies to measure outcome and health quality of children with special health care needs in capitated managed health care programs must be developed to learn how the potential benefits of managed care can be maximized and the potential harms minimized. The purpose of this study was to analyze the accessibility and satisfaction of caretakers of children with special health care needs under a capitated managed health care system.

  2. How social media meet patients’ questions: YouTube™ review for mouth sores in children.

    Science.gov (United States)

    Di Stasio, D; Romano, A; Paparella, R S; Gentile, C; Serpico, R; Minervini, G; Candotto, V; Laino, L

    2018-01-01

    Recurrent aphthous stomatitis (RAS) is one of the most common causes of mouth sores in children so the management of this condition is a matter of great importance. YouTube™ is increasingly being used by patients to obtain health-related information. The aim of this work is to examine the quality of information offered by YouTube™ about mouth sores in children (MSC). Searching the term ‘mouth sores in children’, (MSC) displayed 12.300 results. Of the top 60 videos analyzed, 31 were excluded following exclusion criteria. The major source of upload was from healthcare information channels (HC-41,38%), followed by individual users (HP-25.59%), healthcare professionals (IU-17.24%) and generalist information channels (HC-13.78%); 20.69% of them deal with predisposing factors, and related pathologies, the majority of these propose home remedies (60.72%) rather than topical analgesic drugs (21.43%), antimicrobials (7.14%) and topical steroids (3.57). Most of the videos analyzed were slightly useful (68.97%). Information about mouth sores in children on YouTube™ was poor regardless of the upload source. Analyzing health content on social platforms is a starting point for providing greater quality of health-related information.

  3. Children's Experiences of Social Exclusion--What is It Like Living in a Slum in Kampala?

    Science.gov (United States)

    Sims, Margaret; Nagaddya, Teddy; Nakaggwa, Florence; Kivunja, Charles; Ngungutse, David; Ayot, Evelyn

    2011-01-01

    The voices of young people are beginning to be heard, but rarely are children living in poverty included in this research (Ridge, 2002). In this study, the authors used an interpretive approach that is informed by the phenomenological underpinning of the new sociology of childhood (Conroy & Harcourt, 2009; Schiller & Einarsdottir, 2009).…

  4. Changes in plasma phosphate during in-patient treatment of children with severe acute malnutrition

    DEFF Research Database (Denmark)

    Namusoke, Hanifa; Nielsen, Anne-Louise Hother; Rytter, Maren Johanne Heilskov

    2016-01-01

    BACKGROUND: Children treated for severe acute malnutrition (SAM) are at risk of refeeding hypophosphatemia. Therapeutic diets have only recently become fortified with phosphorus to meet United Nations (UN) specifications, but to our knowledge no studies have investigated the effect. OBJECTIVE...

  5. The effect of fermented milk on interferon production in malnourished children and in anorexia nervosa patients undergoing nutritional care.

    Science.gov (United States)

    Solis, B; Nova, E; Gómez, S; Samartín, S; Mouane, N; Lemtouni, A; Belaoui, H; Marcos, A

    2002-12-01

    For several years cytokine production has been associated with infections but it was not suspected that some types of food could also induce cytokines, even in a state of non-infection. Lactic bacteria can induce interferon (IFN) production in human healthy subjects, thus, a better protection against infections would be expected. Therefore, we planned to evaluate the effect of two diets including yoghurt or milk on IFN-gamma production during nutritional recovery in two different situations of malnutrition: (1) children with diarrhoea; and (2) patients with anorexia nervosa (AN). Both the diet including yoghurt of that including milk seemed to increase IFN-gamma production at the end of nutritional recovery in the malnourished children with diarrhoea. The significance of interferon production and the lymphocyte subset increase should be explored to know if a better resistance against pathogens is related to them. Regulation of intestinal absorption and moderate stimulation of interferon production make the yoghurt-based diet a good choice in the nutritional care of children. In the same way, an increase in the IFN-gamma production was observed in AN patients consuming yoghurt. This increase of IFN-gamma production could be considered a biological marker to detect the effect of probiotics on the immune response, especially in the improvement of a deficient nutritional status.

  6. The dangers of involving children as family caregivers of palliative home-based-care to advanced HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    S M Kang′ethe

    2010-01-01

    Full Text Available The aim of this research paper is to explore the dangers of involving children as family caregivers of palliative care and home-based-care to advanced HIV/AIDS patients, while its objective is to discuss the dangers or perfidiousness that minors especially the girl children face as they handle care giving of advanced HIV/AIDS patients. The article has relied on eclectic data sources. The research has foundminors disadvantaged by the following: being engulfed by fear and denied rights through care giving; being emotionally and physiologically overwhelmed; being oppressed and suppressed by caring duties; being at risk of contracting HIV/AIDS; and having their education compromised by care giving. The paper recommends: (1 strengthening and emphasizing on children′s rights; (2 maintaining gender balance in care giving; (3 implementation and domestication of the United Nations conventions on the rights of children; (4 community awareness on equal gender co participation in care giving; (5 and fostering realization that relying on child care giving is a negative score in fulfilling global Millennium Development Goals.

  7. An investigation of school violence through Turkish children's drawings.

    Science.gov (United States)

    Yurtal, Filiz; Artut, Kazim

    2010-01-01

    This study investigates Turkish children's perception of violence in school as represented through drawings and narratives. In all, 66 students (12 to 13 years old) from the middle socioeconomic class participated. To elicit children's perception of violence, they were asked to draw a picture of a violent incident they had heard, experienced, or witnessed. Children mostly drew pictures of violent events among children (33 pictures). Also, there were pictures of violent incidents perpetrated by teachers and directors against children. It was observed that violence influenced children. Violence was mostly depicted in school gardens (38 pictures), but there were violent incidents everywhere, such as in classrooms, corridors, and school stores as well. Moreover, it was found that brute force was the most referred way of violence in the children's depictions (38 pictures). In conclusion, children clearly indicated that there was violence in schools and they were affected by it.

  8. Successful endoscopic third ventriculostomy in children depends on age and etiology of hydrocephalus: outcome analysis in 51 pediatric patients.

    Science.gov (United States)

    Duru, Soner; Peiro, Jose L; Oria, Marc; Aydin, Emrah; Subasi, Canan; Tuncer, Cengiz; Rekate, Harold L

    2018-04-25

    Endoscopic third ventriculostomy (ETV) has become the method of choice in the treatment of hydrocephalus. Age and etiology could determine success rates (SR) of ETV. The purpose of this study is to assess these factors in pediatric population. Retrospective study on 51 children with obstructive hydrocephalus that underwent ETV was performed. The patients were divided into three groups per their age at the time of the treatment:  24 months of age. All ETV procedures were performed by the same neurosurgeon. Overall SR of ETV was 80% (40/51) for all etiologies and ages. In patients age SR was 56.2% (9/16), while 6-24 months of age was 88.9% (16/18) and > 24 months was 94.1% (16/17) (p = 0.012). The highest SR was obtained on aqueductal stenosis. SR of posthemorrhagic, postinfectious, and spina bifida related hydrocephalus was 60% (3/5), 50% (1/2), and 14.3% (1/7), respectively. While SR rate at the first ETV attempt was 85.3%, it was 76.9% in patients with V-P shunt performed previously (p = 0.000). Factors indicating a potential failure of ETV were young age and etiology such as spina bifida, other than isolated aqueductal stenosis. ETV is the method of choice even in patients with former shunting. Fast healing, distensible skulls, and lower pressure gradient in younger children, all can play a role in ETV failure. Based on our experience, ETV could be the first method of choice for hydrocephalus even in children younger than 6 months of age.

  9. Individualized Infliximab Treatment Guided by Patient-managed eHealth in Children and Adolescents with Inflammatory Bowel Disease.

    Science.gov (United States)

    Carlsen, Katrine; Houen, Gunnar; Jakobsen, Christian; Kallemose, Thomas; Paerregaard, Anders; Riis, Lene B; Munkholm, Pia; Wewer, Vibeke

    2017-09-01

    To individualize timing of infliximab (IFX) treatment in children and adolescents with inflammatory bowel disease (IBD) using a patient-managed eHealth program. Patients with IBD, 10 to 17 years old, treated with IFX were prospectively included. Starting 4 weeks after their last infusion, patients reported a weekly symptom score and provided a stool sample for fecal calprotectin analysis. Based on symptom scores and fecal calprotectin results, the eHealth program calculated a total inflammation burden score that determined the timing of the next IFX infusion (4-12 wk after the previous infusion). Quality of Life was scored by IMPACT III. A control group was included to compare trough levels of IFX antibodies and concentrations and treatment intervals. Patients and their parents evaluated the eHealth program. There were 29 patients with IBD in the eHealth group and 21 patients with IBD in the control group. During the control period, 94 infusions were provided in the eHealth group (mean interval 9.5 wk; SD 2.3) versus 105 infusions in the control group (mean interval 6.9 wk; SD 1.4). Treatment intervals were longer in the eHealth group (P eHealth-individualized timing of IFX treatments, with treatment intervals of 4 to 12 weeks, was accompanied by no significant development of IFX antibodies. Patients reported better control and improved knowledge of their IBD.

  10. Endoscopic transnasal repair of cerebrospinal fluid leaks with and without an encephalocele in pediatric patients: from infants to children.

    Science.gov (United States)

    Ma, Jingying; Huang, Qian; Li, Xiaokui; Huang, Dongsheng; Xian, Junfang; Cui, Shunjiu; Li, Yunchuan; Zhou, Bing

    2015-09-01

    The diagnosis and management of pediatric cerebrospinal fluid (CSF) leak and encephalocele are challenging. The current study aimed to identify patient characteristics, review operative techniques, and evaluate the efficacy and safety of endoscopic endonasal repair in a pediatric population. We retrospectively reviewed the records of pediatric patients who underwent transnasal endoscopic repair of CSF leak with or without a meningocele or an encephalocele at Beijing Tongren Hospital, Capital Medical University, between July 2003 and May 2014. All patients had preoperative radiological evaluations and underwent endoscopic endonasal repair of their skull base defects. Altogether, 23 children (mean age 7.0 years) underwent the procedures. Sixteen cases were congenital, and 7 patients had trauma history. The herniations or defects included meningoencephaloceles in 15 cases, meningoceles in 4 cases, and CSF leak in 4 cases (2 patients had bilateral leaks). The leak or herniation sites were ethmoid roof in 10 patients (one was bilateral), cribriform plate in 5, lateral to the foramen cecum in 3, posterior wall of the frontal sinus in 1, sphenoid sinus in 2, lateral recess of the sphenoid sinus in 1, and sella turcica base in 2. All subjects had favorable clinical outcomes without recurrence during a follow-up of 6-123 months (mean 61.1 months). The endoscopic endonasal approach was the preferred method for repairing CSF leaks with or without an encephalocele in pediatric patients. Compared to traditional operations, this endoscopic procedure is minimally invasive, efficient, and safe.

  11. Chronic Pancreatitis in Children

    Science.gov (United States)

    ... E-News Sign-Up Home Patient Information Children/Pediatric Chronic Pancreatitis in Children Chronic Pancreatitis in Children What symptoms would my child have? Frequent or chronic abdominal pain is the most common symptom of pancreatitis. The ...

  12. Neurofibromatosis in children.

    Science.gov (United States)

    Crawford, A H

    1986-01-01

    The clinical diagnosis of neurofibromatosis in childhood will usually be based on the presence of numerous café-au-lait spots. Early diagnosis allows for continuing follow-up and appropriate counselling. Symptomatic therapy can be provided if necessary. The disorder has a tendency via its mesodermal route to affect almost every system in the body; however, few laymen have even heard of the disorder and, except for the "Elephant Man" notoriety, are totally unaware of it, whereas muscular dystrophy, cystic fibrosis, and Down syndrome although occurring less frequently are well known to the general public. The management of neurofibromatosis in children covers an extremely wide spectrum: at times the management appears to be simple, involving little more than clinical evaluation and simple investigations. However, in view of the protean manifestations of the condition, a complete history including family history is obligatory, and investigation must include radiographic studies of the abdomen, chest, spine, and skull, the latter to include special views of the orbits and optic foramina. My investigation of this disorder has been extremely frustrating because of the progressive character of the disease. Nothing seems to alter the natural course of the disease. I cannot say that my investigative efforts have revealed any breakthroughs in treatment. An aggressive surgical approach to the myriad of lesions associated with this disease, especially neuromata or segmental problems, is probably advisable. The early treatment of tibial pseudarthrosis by polyprophylene orthotic and pulsating electromagnetic fields shows encouraging results over the short course, although I am not so sure as to whether or not the patients would do as well with the custom fit orthotic with or without the electronics. Early stabilization of spinal deformity has proven to be more than moderately successful and is strongly recommended following appropriate intraspinal evaluation. The management of

  13. Therapeutic patient education and disclosure of status of HIV infected children in Yaounde, Cameroon Achievements and competence.

    Science.gov (United States)

    Njom Nlend, A E; Lyeb, A S; Moyo, S; Nsangou, D

    2016-08-01

    Psychosocial support and therapeutic patient education are recommended practices that are poorly reported. Our objective was to describe the main achievements after a patient therapeutic education program conducted for pre-adolescents and adolescents with HIV infection. This qualitative study of 37 children with a mean age of 11 years assessed the outcome of an educational program of 8 sessions that ended by the disclosure of their HIV status. Semistructured interviews that took place 8 weeks after the last session and lasted 20 minutes evaluated the following areas: knowledge of the disease, its treatment, its prevention, and their skills in managing their treatment and the secret. The level of knowledge was acceptable except about HIV transmission, and specifically, how they had acquired the disease. In all, 33/37 (89%) of the children were able to cite or write the name of their disease; 29/37 (78%) had acquired knowledge of their treatment (name of the drugs, objective, and daily treatment times); they were able to manage treatment intake away from home; and secrecy was the standard for all. However, many were unable to explain how they had acquired the virus. Therapeutic patient education for HIV status disclosure enables adolescents to acquire knowledge about their disease and the ability to manage it. The poor results observed for knowledge of transmission needs to be improved after disclosure in support groups.

  14. Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

    Directory of Open Access Journals (Sweden)

    Sonja R. Cleary

    2016-01-01

    Full Text Available Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies’ editorial on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations” asks the question whether whistleblowing ameliorates or exacerbates the ‘deaf effect’ prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage.

  15. Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage: Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations".

    Science.gov (United States)

    Cleary, Sonja R; Doyle, Kerrie E

    2015-09-29

    Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies' editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the 'deaf effect' prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage . © 2016 by Kerman University of Medical Sciences.

  16. A comparison of the emotional and behavioral problems of children of patients with cancer or a mental disorder and their association with parental quality of life.

    Science.gov (United States)

    Krattenmacher, Thomas; Kühne, Franziska; Halverscheid, Susanne; Wiegand-Grefe, Silke; Bergelt, Corinna; Romer, Georg; Möller, Birgit

    2014-03-01

    To compare the emotional and behavioral problems of children of patients suffering from cancer or a mental disorder and their association with parental quality of life. A total of 223 children from 136 families and their 160 parents were investigated from multiple perspectives in a cross-sectional study. The consistency of different adjustment reports between family members was examined. Through mixed models, the differences between parental HRQoL and the children's symptomatology were studied with regard to the type of parental illness. The prediction of children's adjustment through parental HRQoL was further examined. Additionally, gender and age of the children were considered. Half of the children exhibited psychosocial problems. Gender and age differences were independent of the type of parental disease. In families with parental cancer, the reports of children's adjustment were more consistent between family members than in families where a parental mental disorder was present. We found differences in HRQoL between families with mentally ill parents and those with parental cancer patients. Specifically, the healthy partners of mentally ill parents showed worse HRQoL compared with healthy partners of cancer patients. Healthy parents' reduced HRQoL was associated with worse adjustment in their children, regardless of the type of parental illness, but this result was not found for ill parents. Family members confronted with parental cancer or mental disorders are more burdened compared with those from the "normal" population, independently of the type of disease. Our results indicate that the type of a parental disease has no direct effect on children's adjustment. However, there are disease-specific effects on parental HRQoL, which are associated with children's adjustment. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Indicators of malnutrition in children with cancer: A study of 690 patients from a tertiary care cancer center.

    Science.gov (United States)

    Srivastava, R; Pushpam, D; Dhawan, D; Bakhshi, S

    2015-01-01

    Large data pertaining to indicators of malnutrition in children with cancer is lacking from India. In view of this, we prospectively analyzed consecutive de novo childhood patients with cancer presenting at a tertiary care center. Height and weight of each child (n = 690) were compared with World Health Organization child growth standards-2006 for that particular age and sex to get weight-for-age, height-for-age, and weight-for-height indices and below 2SD of the reference median on these indices were considered as underweight, stunted, and wasted, respectively. Body mass index (BMI) for age was also analyzed for thinness and obesity. Prevalence of malnutrition based on Z-score for weight-for-age, height-for-age, weight-for-height, and BMI-for-age was 30%, 31%, 35%, and 41%, respectively. Weight-for-age (underweight) was significantly associated (P = 0.018) with solid tumors. Height-for-age, weight-for-age, and BMI-for-age were significantly associated (P = 0.007, P = 0.016, and P ≤ 0.001, respectively) with rural community. Malnutrition was observed in approximately one-third of children with cancer. Malnutrition is associated with solid tumors and those coming from rural community. Wasting has a higher prevalence in children with cancer in <5 years of age group.

  18. How social media meet patients’ questions: YouTube™ review for children oral thrush.

    Science.gov (United States)

    Di Stasio, D; Romano, A N; Paparella, R S; Gentile, C; Minervini, G; Serpico, R; Candotto, V; Laino, L

    2018-01-01

    YouTube™ is increasingly being used by patients to obtain health-related information. No studies have evaluated the content of YouTube™ videos on children oral thrush. The aim of this work is to examine the quality of information offered by this platform about oral thrush in children. Searching term “oral thrush in children” (OTC) displayed a total of 2.790 results. Of the top 60 videos analyzed, 27 were excluded. The main source of upload was from generalist information YouTube® channels (GC) followed by healthcare professionals (HP), individual users (IU), and healthcare information channels (HC); usefulness of videos is successfully correlated with the number of visualization, number of likes and viewing rate and was interdependent with the number of visualizations, number of likes and VR. However, videos on the oral thrush do not have satisfactory quality information. HP themselves, along with HC, do not seem to provide more appropriate information on COT, than GC or IU.

  19. Clinical significance of measurement of plasma leptin and serum IL-6, IL-18 levels after treatment in patients with children nephrotic syndrome

    International Nuclear Information System (INIS)

    Wang Xiaoyan

    2011-01-01

    Objective: To explore the clinical significance of changes of plasma leptin and serum IL-6, IL-18 levels after treatment in patients with children nephrotic syndrome. Methods: Plasma leptin (with RIA) serum IL-6, IL-18 (with ELISA) levels were measured in 31 patients with children nephrotic syndrome both before and after treatment as well as in 30 controls. Results: Before treatment,the plasma leptin and serum IL-6, IL-18 levels were significantly higher than those in controls(P <0.01). After treatment for 3 months, the levels in patients though dropped markedly remained significantly higher than those in controls (P<0.05). Plasma leptin levels were positively correlated with IL-6, IL-18 levels (r=0.6138, 0.5784, P<0.01). Conclusion: Changes of plasma leptin and serum IL-6, IL-18 levels after treatment might be of prognostic importance in patients with children nephrotic syndrome. (authors)

  20. Characteristics of patients with influenza-like illness, severe acture respiratory illness, and laboratory-confirmed influenza at a major children's hospital in Angola, 2009-2011.

    Science.gov (United States)

    Cardoso, Yolanda; Oliveira, Erika; Vasconcelos, Jocelyne; Cohen, Adam L; Francisco, Moises

    2012-12-15

    There are no published data on influenza trends in Angola, where pneumonia is a leading cause of death among young children. This study aims to describe the seasonal trends, types, and subtypes of influenza virus recovered from patients with respiratory illness who were admitted to the major children's hospital in Angola from May 2009 through April 2011. Nasal and oral swabs were collected from patients seen in the outpatient clinic with influenza-like illness (ILI) or hospitalized with severe acute respiratory illness (SARI) and tested for influenza virus by polymerase chain reaction assays. Of 691 samples collected, 334 (48%) were from case patients with ILI, and 357 (52%) were from case patients with SARI. Most (86%) of these children were Angola.

  1. Evaluation of knowledge about epilepsy and attitudes towards patients with epilepsy among university students in Upper Egypt.

    Science.gov (United States)

    Thabit, Mohamed N; Sayed, Mohamed A; Ali, Magda M

    2018-05-05

    Epilepsy is a major public health problem worldwide. There are many misconceptions about people's knowledge and attitudes about epilepsy, which influence people's behavior towards patients with epilepsy. We conducted a cross-sectional study in Sohag University, a public Egyptian University, in Upper Egypt. We used an Arabic language designed questionnaire to assess people's knowledge about epilepsy and their attitudes towards patients with epilepsy. We included a total of 920 students in the study. 12.4% of study respondents had never heard of or read about epilepsy. Moreover, there was much misunderstanding about the etiology of epilepsy, as 68.2% of epileptic and 74.5% of nonepileptic respondents believe epilepsy is caused by evil spirits and evil eyes or due to psychiatric disorders. There were also many people who held negative attitudes towards patients with epilepsy in regards to major life milestones such as marriage and having children. Among nonepileptics, 54.5% believe epileptics should not marry and 49.9% believe they should not have children. Among patients with epilepsy, these percentages are 27.3% and 36.4% respectively. Knowledge about epilepsy is insufficient and should be increased. The attitudes towards patients with epilepsy are negative and should be changed in Upper Egypt. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. 'You give us rangoli, we give you talk': using an art-based activity to elicit data from a seldom heard group.

    Science.gov (United States)

    Redwood, Sabi; Gale, Nicola K; Greenfield, Sheila

    2012-01-30

    The exclusion from health research of groups most affected by poor health is an issue not only of poor science, but also of ethics and social justice. Even if exclusion is inadvertent and unplanned, policy makers will be uninformed by the data and experiences of these groups. The effect on the allocation of resources is likely to be an exacerbation of health inequalities. We subject to critical analysis the notion that certain groups, by virtue of sharing a particular identity, are inaccessible to researchers - a phenomenon often problematically referred to as 'hard to reach'. We use the term 'seldom heard' to move the emphasis from a perceived innate characteristic of these groups to a consideration of the methods we choose as researchers. Drawing on a study exploring the intersections of faith, culture, health and food, we describe a process of recruitment, data collection and analysis in which we sought to overcome barriers to participation. As we were interested in the voices of South Asian women, many of whom are largely invisible in public life, we adopted an approach to data collection which was culturally in tune with the women's lives and values. A collaborative activity mirroring food preparation provided a focus for talk and created an environment conducive to data collection. We discuss the importance of what we term 'shoe leather research' which involves visiting the local area, meeting potential gatekeepers, and attending public events in order to develop our profile as researchers in the community. We examine issues of ethics, data quality, management and analysis which were raised by our choice of method. In order to work towards a more theoretical understanding of how material, social and cultural factors are connected and influence each other in ways that have effects on health, researchers must attend to the quality of the data they collect to generate finely grained and contextually relevant findings. This in turn will inform the design of

  3. 'You give us rangoli, we give you talk': using an art-based activity to elicit data from a seldom heard group

    Directory of Open Access Journals (Sweden)

    Redwood Sabi

    2012-01-01

    Full Text Available Abstract Background The exclusion from health research of groups most affected by poor health is an issue not only of poor science, but also of ethics and social justice. Even if exclusion is inadvertent and unplanned, policy makers will be uninformed by the data and experiences of these groups. The effect on the allocation of resources is likely to be an exacerbation of health inequalities. Discussion We subject to critical analysis the notion that certain groups, by virtue of sharing a particular identity, are inaccessible to researchers - a phenomenon often problematically referred to as 'hard to reach'. We use the term 'seldom heard' to move the emphasis from a perceived innate characteristic of these groups to a consideration of the methods we choose as researchers. Drawing on a study exploring the intersections of faith, culture, health and food, we describe a process of recruitment, data collection and analysis in which we sought to overcome barriers to participation. As we were interested in the voices of South Asian women, many of whom are largely invisible in public life, we adopted an approach to data collection which was culturally in tune with the women's lives and values. A collaborative activity mirroring food preparation provided a focus for talk and created an environment conducive to data collection. We discuss the importance of what we term 'shoe leather research' which involves visiting the local area, meeting potential gatekeepers, and attending public events in order to develop our profile as researchers in the community. We examine issues of ethics, data quality, management and analysis which were raised by our choice of method. Summary In order to work towards a more theoretical understanding of how material, social and cultural factors are connected and influence each other in ways that have effects on health, researchers must attend to the quality of the data they collect to generate finely grained and contextually

  4. Treatment adherence with the easypod™ growth hormone electronic auto-injector and patient acceptance: survey results from 824 children and their parents

    Directory of Open Access Journals (Sweden)

    Larroque Sylvain

    2011-02-01

    Full Text Available Abstract Background Accurately monitoring adherence to treatment with recombinant human growth hormone (r-hGH enables appropriate intervention in cases of poor adherence. The electronic r-hGH auto-injector, easypod™, automatically records the patient's adherence to treatment. This study evaluated adherence to treatment of children who started using the auto-injector and assessed opinions about the device. Methods A multicentre, multinational, observational 3-month survey in which children received r-hGH as part of their normal care. Physicians reviewed the recorded dose history and children (with or without parental assistance completed a questionnaire-based survey. Children missing ≤2 injections per month (92% of injections given were considered adherent to treatment. Adherence was compared between GH treatment-naïve and treatment-experienced children. Results Of 834 recruited participants, 824 were evaluated. The median (range age was 11 (1-18 years. From the recorded dose history, 87.5% of children were adherent to treatment over the 3-month period. Recorded adherence was higher in treatment-naïve (89.7%, n = 445/496 than in treatment-experienced children (81.7%, n = 152/186 [Fisher's exact test FI(X = 7.577; p = 0.0062]. According to self-reported data, 90.2% (607/673 of children were adherent over 3 months; 51.5% (421/817 missed ≥1 injection over this period (mainly due to forgetfulness. Concordance between reported and recorded adherence was 84.3%, with a trend towards self-reported adherence being higher than recorded adherence. Most children liked the auto-injector: over 80% gave the top two responses from five options for ease of use (720/779, speed (684/805 and comfort (716/804. Although 38.5% (300/780 of children reported pain on injection, over half of children (210/363 considered the pain to be less or much less than expected. Given the choice, 91.8% (732/797 of children/parents would continue using the device. Conclusions

  5. Cancer immunotherapy in children

    Science.gov (United States)

    More often than not, cancer immunotherapies that work in adults are used in modified ways in children. Seldom are new therapies developed just for children, primarily because of the small number of pediatric patients relative to the adult cancer patient

  6. A Community-based Survey of the Awareness and Acceptability of Oral Rehydration Therapy (ORT) as a Treatment for Acute Diarrhoea in Children.

    Science.gov (United States)

    Ekanem, E. E.; Benebo, N. S.

    1988-01-01

    A total of 267 Nigerian mothers with children under the age of five years were investigated regarding the degree of their awareness and acceptance of oral rehydration therapy in the treatment of childhood diarrhea. Results indicate that only 39 percent of the mothers had heard of ORT in treating diarrhea. (RJC)

  7. Lifestyle in children and adolescents with obesity: results of the survey of patients and their parents

    Directory of Open Access Journals (Sweden)

    Alisa V. Vitebskaya

    2015-11-01

    Full Text Available Introduction. Growth of obesity prevalence in children and adolescents is a serious problem of modern medicine. To learn characteristics of patient’s behaviour, their dietary preference, feeding time and physical loads one can use specialized questionnaires. Aim. Evaluation of lifestyle, physical activity, dietary regimen and consumption of some meals according to results of questioning children and adolescents with obesity and their parents. Materials and methods. Hundreds of children and adolescents with obesity 10–17 years and their parents answered the questionnaire on age of obesity onset, its causes, physical activity and nutrition. Results and conclusion. Obesity develops more often at the age of 7–10 years. The most commonly insufficient physical activity and heredity. Specific characteristics of sedentary lifestyle and impared dietary regimen were identified. Comparison of patients’ and parents’ answers allowed to demonsrate the differense in attitude to the problem of obesity and to diminish the influence of not transparant answers on the results of investigation.

  8. Abdominal pain endpoints currently recommended by the FDA and EMA for adult patients with irritable bowel syndrome may not be reliable in children.

    Science.gov (United States)

    Saps, M; Lavigne, J V

    2015-06-01

    The Food and Drug Administration (FDA) recommended ≥30% decrease on patient-reported outcomes for pain be considered clinically significant in clinical trials for adults with irritable bowel syndrome. This percent change approach may not be appropriate for children. We compared three alternate approaches to determining clinically significant reductions in pain among children. 80 children with functional abdominal pain participated in a study of the efficacy of amitriptyline. Endpoints included patient-reported estimates of feeling better, and pain Visual Analog Scale (VAS). The minimum clinically important difference in pain report was calculated as (i) mean change in VAS score for children reporting being 'better'; (ii) percent changes in pain (≥30% and ≥50%) on the VAS; and (iii) statistically reliable changes on the VAS for 68% and 95% confidence intervals. There was poor agreement between the three approaches. 43.6% of the children who met the FDA ≥30% criterion for clinically significant change did not achieve a reliable level of improvement (95% confidence interval). Children's self-reported ratings of being better may not be statistically reliable. A combined approach in which children must report improvement as better and achieve a statistically significant change may be more appropriate for outcomes in clinical trials. © 2015 John Wiley & Sons Ltd.

  9. Children with monosymptomatic primary nocturnal enuresis – the clinical profile of patients during the first nephrological consultation

    Directory of Open Access Journals (Sweden)

    Anna Krakowska

    2017-12-01

    Full Text Available Introduction: Nocturnal enuresis can be diagnosed in a child older than 5 years of age who involuntarily discharges urine in the wrong time, i.e. at night, and in the wrong place, i.e. in bed. Aim: The aim of the study was to analyse the profile of patients who consult the specialist physician with monosymptomatic primary nocturnal enuresis. Material and methods: The data were collected from a questionnaire completed by guardians of children during the first nephrological consultation. The questions concerned the following: family history of nocturnal enuresis, bedwetting intensity, other urinary tract symptoms, a voiding chart and fluid intake record, number of nocturnal enuresis incidents in 14 days, episodes of nocturia, nocturnal diuresis volume, urinary urgency volume and constipation. Moreover, basic anthropometric measurements were taken. The data were analysed and the following values were calculated: average voided volumes, maximum voided volumes, voided volumes before 5 p.m. and 24-hour diuresis. An analogous analysis was conducted with respect to fluid intake. Results: Most patients were males. The family history of nocturnal enuresis was positive in ⅓ of patients. Approximately ⅓ of patients tended to drink fluids directly before bedtime. The number of patients with sporadic nocturnal enuresis (23–45% was comparable to the number of patients with frequent nocturnal enuresis (28–55%. Nocturnal diuresis suggested nocturnal polyuria in 11 patients (21.6%. Decreased functional bladder capacity was found in almost ¼ of patients (12–23.5%. Conclusions: Monosymptomatic nocturnal enuresis is more common in boys. The family history was positive in ⅓ of patients. Patients and their guardians are not aware of fluid intake restrictions at bedtime. The frequency of nocturnal polyuria and decreased functional bladder capacity is comparable in the investigated patients.

  10. Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

    International Nuclear Information System (INIS)

    Nusman, Charlotte M.; Hemke, Robert; Benninga, Marc A.; Kindermann, Angelika; Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W.; Rossum, Marion A.J. van; Maas, Mario

    2016-01-01

    To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

  11. Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

    Energy Technology Data Exchange (ETDEWEB)

    Nusman, Charlotte M.; Hemke, Robert [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Benninga, Marc A.; Kindermann, Angelika [University of Amsterdam, Department of Pediatric Gastroenterology, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Rossum, Marion A.J. van [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Maas, Mario [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

    2016-04-15

    To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

  12. Self-Reported Health Experiences of Children Living with Congenital Heart Defects: Including Patient-Reported Outcomes in a National Cohort Study.

    Science.gov (United States)

    Knowles, Rachel Louise; Tadic, Valerija; Hogan, Ailbhe; Bull, Catherine; Rahi, Jugnoo Sangeeta; Dezateux, Carol

    2016-01-01

    Understanding children's views about living with congenital heart defects (CHDs) is fundamental to supporting their successful participation in daily life, school and peer relationships. As an adjunct to a health and quality of life outcomes questionnaire, we asked school-age children who survived infant heart procedures to describe their experiences of living with CHDs. In a UK-wide cohort study, children aged 10 to 14 years with CHDs self-completed postal questionnaires that included an open question about having a 'heart problem'. We compared the characteristics of children with more and less severe cardiac diagnoses and, through collaborative inductive content analysis, investigated the subjective experiences and coping strategies described by children in both clinical severity groups. Text and/or drawings were returned by 436 children (246 boys [56%], mean age 12.1 years [SD 1.0; range 10-14]); 313 had less severe (LS) and 123 more severe (MS) cardiac diagnoses. At the most recent hospital visit, a higher proportion of the MS group were underweight (more than two standard deviations below the mean for age) or cyanosed (underweight: MS 20.0%, LS 9.9%; cyanosed: MS 26.2%, LS 3.5%). Children in the MS group described concerns about social isolation and feeling 'different', whereas children with less severe diagnoses often characterised their CHD as 'not a big thing'. Some coping strategies were common to both severity groups, including managing health information to avoid social exclusion, however only children in the LS group considered their CHD 'in the past' or experienced a sense of survivorship. Children's reported experiences were not dependent on their cardiac diagnosis, although there were clear qualitative differences by clinical severity group. Children's concerns emphasised social participation and our findings imply a need to shift the clinical focus from monitoring cardiac function to optimising participation. We highlight the potential for informing

  13. Frequency of isolation of polioviruses and non polio enteroviruses from patients with acute flaccid paralysis, enterovirus infection and children from groups at risk

    Directory of Open Access Journals (Sweden)

    N. I. Romanenkova

    2012-01-01

    Full Text Available The article describes the frequency of isolation of polioviruses and non polio enteroviruses from different categories of the investigated children. The percentage of detection of polioviruses from the patients with acute flaccid paralysis was lower than that from the children from groups at risk. Among the patients with the enterovirus infection the polioviruses were rarely revealed. The frequency of isolation of non polio enteroviruses from these patients was significantly higher than that from the other categories of investigated persons. The improvement of poliomyelitis surveillance and the reinforcement of virological surveillance of children from groups at risk and those with enterovirus infection will provide the important data for Global Polio Eradication Initiative and the maintenance of polio free status of the Russian Federation.

  14. Complementary therapy use by patients and parents of children with asthma and the implications for NHS care: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharp Debbie

    2006-06-01

    Full Text Available Abstract Background Patients are increasingly using complementary therapies, often for chronic conditions. Asthma is the most common chronic condition in the UK. Previous research indicates that some asthma patients experience gaps in their NHS care. However, little attention has been given to how and why patients and parents of children with asthma use complementary therapies and the implications for NHS care. Methods Qualitative study, comprising 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma (plus a parent, recruited from a range of NHS and non-NHS settings in Bristol, England. Data analysis was thematic, drawing on the principles of constant comparison. Results A range of complementary therapies were being used for asthma, most commonly Buteyko breathing and homeopathy. Most use took place outside of the NHS, comprising either self-treatment or consultation with private complementary therapists. Complementary therapies were usually used alongside not instead of conventional asthma treatment. A spectrum of complementary therapy users emerged, including "committed", "pragmatic" and "last resort" users. Motivating factors for complementary therapy use included concerns about conventional NHS care ("push factors" and attractive aspects of complementary therapies ("pull factors". While participants were often uncertain whether therapies had directly helped their asthma, breathing techniques such as the Buteyko Method were most notably reported to enhance symptom control and enable reduction in medication. Across the range of therapies, the process of seeking and using complementary therapies seemed to help patients in two broad ways: it empowered them to take greater personal control over their condition rather than feel dependant on medication, and enabled exploration of a broader range of possible causes of their asthma than commonly discussed within NHS settings. Conclusion Complementary therapy

  15. Watchlist on children and armed conflict

    Directory of Open Access Journals (Sweden)

    Julia Freedson

    2002-10-01

    Full Text Available My name is Wilmot, from Liberia. I am 16 years old. At age five, I fled from Liberia with my mother to Sierra Leone. I was too young at the time to really understand what was happening. I heard the sounds of guns. I saw people running. I saw people shooting. I saw people being killed. I saw people dying. People as young as I were dying... I saw families like mine, in the thousands, leave everything behind and run…The children of Liberia appeal to the Security Council of the United Nations to do everything possible to stop the fighting in Liberia.

  16. PHARMACO-ECONOMICAL ASPECTS OF IN-PATIENT TREATMENT OF CHILDREN WITH PERINATAL

    Directory of Open Access Journals (Sweden)

    N.M. Sudakova

    2012-01-01

    Full Text Available The results of expert analyses АВС–VEN of drugs, using in treatment of children with perinatal encephalopathy at the age of 7 days to 3 years in psycho-neurological department of MIH «Belgorod Municipal children hospital» are represented in this study. The research is performed accounting syndrome approach to the diagnosis. It was established, that in the groups with the most financial costs («A» and «B» almost half of the drugs were referred to «V» and «N» categories, and 67,6% of drugs of group «B» were referred to «E» category. According to expert VEN-analysis the predominant amount of drugs — 34 (51,5% of total used drugs consist group «E». There are irrational use of drugs in central nervous system excitation syndrome and autonomic-visceral disturbances treatment. In general it was established that there are certain reserves for medicine therapy optimization in treatment of each syndrome of perinatal encephalopathy. 

  17. Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

    Science.gov (United States)

    Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

    2013-06-01

    Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

  18. cost of inpatient care for hiv- positive patients at red cross children's

    African Journals Online (AJOL)

    Enrique

    2004-11-01

    Nov 1, 2004 ... budgets and the continued inability of these patients to pay for health services. The prevalence of ... pregnant women with HIV infection and their newborn ..... surgical procedures discrepancies need to be addressed. □ Some ...

  19. Novel Munc13–4 mutations in children and young adult patients with haemophagocytic lymphohistiocytosis

    Science.gov (United States)

    Santoro, A; Cannella, S; Bossi, G; Gallo, F; Trizzino, A; Pende, D; Dieli, F; Bruno, G; Stinchcombe, J C; Micalizzi, C; De Fusco, C; Danesino, C; Moretta, L; Notarangelo, L D; Griffiths, G M; Aricò, M

    2006-01-01

    Familial haemophagocytic lymphohistiocytosis (FHL) is a genetically heterogeneous disorder characterised by constitutive defects in cellular cytotoxicity resulting in fever, hepatosplenomegaly and cytopenia, and the outcome is fatal unless treated by chemoimmunotherapy followed by haematopoietic stem‐cell transplantation. Since 1999, mutations in the perforin gene giving rise to this disease have been identified; however, these account only for 40% of cases. Lack of a genetic marker hampers the diagnosis, suitability for transplantation, selection of familial donors, identification of carriers, genetic counselling and prenatal diagnosis. Mutations in the Munc13–4 gene have recently been described in patients with FHL. We sequenced the Munc13–4 gene in all patients with haemophagocytic lymphohistiocytosis not due to PRF1 mutations. In 15 of the 30 families studied, 12 novel and 4 known Munc13–4 mutations were found, spread throughout the gene. Among novel mutations, 2650C→T introduced a stop codon; 441del A, 532del C, 3082del C and 3226ins G caused a frameshift, and seven were mis sense mutations. Median age of diagnosis was 4 months, but six patients developed the disease after 5 years of age and one as a young adult of 18 years. Involvement of central nervous system was present in 9 of 15 patients, activity of natural killer cells was markedly reduced or absent in 13 of 13 tested patients. Chemo‐immunotherapy was effective in all patients. Munc13–4 mutations were found in 15 of 30 patients with FHL without PRF1 mutations. Because these patients may develop the disease during adolescence or even later, haematologists should include FHL2 and FHL3 in the differential diagnosis of young adults with fever, cytopenia, splenomegaly and hypercytokinaemia. PMID:16825436

  20. Craniofacial differences according to AHI scores of children with obstructive sleep apnoea syndrome: cephalometric study in 39 patients

    International Nuclear Information System (INIS)

    Oezdemir, Hueseyin; Mahmutyaziciglu, Kamran; Davsancimath, Halit; Guendogdu, Sadi; Altin, Remzi; Kart, Levent; Soeguet, Ayhan; Tomac, Nazan; Cinar, Fikret; Uzun, Lokman

    2004-01-01

    Cephalometry is useful as a screening test for anatomical abnormalities in patients with obstructive sleep apnoea syndrome (OSAS). To evaluate comprehensively the cephalo metric features of children with OSAS, with or without adenotonsillar hypertrophy, and to elucidate the relationship between cephalometric variables and apnoea-hypopnoea index (AHI) severity. The study population consisted of 39 children, aged 4-12 years, with OSAS. Cephalometry was analysed using 11 measurements of the bony structures, their relationships and the size of the airways. Additionally, adenoid and tonsillar hypertrophy were graded. Cranial base angles (BaSN and BaSPNS) were found to correlate with increasing levels of AHI scores (P 0.05). The length of the mandibular plane (GnGo) and the minimal posterior airway space (MPAS) were inversely correlated with AHI scores (P<0.001). There was positive correlation between MPAS and GnGo (r=0.740, P<0.001), and negative correlation between MPAS and gonial angle (ArGoGn) (r=-0.541, P<0.001). There was significant correlation between cephalometric data and adenotonsillar hypertrophy concerning BaSN, BaSPNS, ArGoGn, GnGoH, BaN-GnGo, MPAS, GnGO and MPH. (orig.)

  1. MANAGEMENT OF SPECIALIZED AUDIOLOGIC MEDICAL CARE AND SIMULTANEOUS MEDICAL AND EDUCATIONAL FOLLOW-UP OF PREMATURE CHILDREN IN THE OUT-PATIENT DEPARTMENT OF A LARGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    I. V. Rakhmanova

    2014-01-01

    Full Text Available Background: The authors set a goal to analyze the problem of management of simultaneous medical and educational follow-up of premature children during the 1st year of life under the conditions of out-patient department of a large hospital (by the example of consulting and diagnostic centre of Morozov Children Municipal Clinical Hospital. Patients and methods: Audiologic examination was performed in 293 premature children. Ninety three children with the consequences of perinatal central nervous system damage were included into the program of correctional diagnostic medical and educational rehabilitation (they were examined by otolaryngologist-audiologist, neurologist and logopedist. Results: Premature children even with normal hearing function at the age of 3 months have very high level of prespeech development retardation (from 75 to 96%, depending on their gestation age. Conclusion: Logopedics examination of premature children at the age of 3 months allows to reveal signs of their mental retardation (motor activity, aural perception, communicative, cognitive and emotional spheres, prespeech activity in the overwhelming majority of cases.

  2. The Early Prevention of Obesity in CHildren (EPOCH Collaboration - an Individual Patient Data Prospective Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Simes John

    2010-11-01

    Full Text Available Abstract Background Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD prospective meta-analysis (PMA. An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design The Early Prevention of Obesity in CHildren (EPOCH Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children's dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number ACTRN12610000789066

  3. Longitudinal growth in children with non-Hodgkin's lymphoma and children with acute lymphoblastic leukemia: Comparison between unirradiated and irradiated patients

    International Nuclear Information System (INIS)

    Marky, I.; Samuelsson, B.O.; Mellander, L.; Karlberg, J.

    1991-01-01

    Longitudinal growth was studied in children treated for non-Hodgkin's lymphoma (NHL). The aim of the study was to compare these children's growth velocity with findings in a previous study we performed on age-matched children with acute lymphoblastic leukemia (ALL) who received cranial irradiation. Nine children with NHL with an onset time of treatment between 4 and 9 years of age (mean 6.5 years) were studied with annual body measurements taken from the time of the diagnosis and thereafter annually during the following 4 years. None of the children received cranial irradiation. During the first treatment year a significantly low mean height velocity was observed (-1.4 standard deviation score [SDS]) for the NHL group. The consecutive two 1 year periods showed a normalization of the mean height velocity. For the group of children with ALL, there was a more prominent negative effect on height during the first 2 years of treatment than for the NHL group in the present study. After the cessation of therapy, the children with NHL showed a reduced catch-up growth compared with the children with ALL. The explanation offered is that cranial irradiation has a heavier impact on growth than chemotherapy during the first 2 years of treatment, but an intense chemotherapy during the maintenance period could have a considerable impact in blunting growth

  4. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult ...

  5. Outcome of patients with stage III or inoperable WT treated on the second United Kingdom WT protocol (UKWT2); a United Kingdom Children's Cancer Study Group (UKCCSG) study.

    Science.gov (United States)

    Grundy, R G; Hutton, C; Middleton, H; Imeson, J; Pritchard, J; Kelsey, A; Marsden, H B; Vujanic, G M; Taylor, R E

    2004-04-01

    The aims of UKWT2 included consolidating the results for stage III patients obtained in UKWT1 and improving the outcome for patients with inoperable tumours by giving vincristine, actinomycin-D and doxorubicin in an intensive schedule (Intensive AVA). The second UK WT trial (UKWT2) ran between July 1986 and September 1991 accruing 448 patients. One hundred and six patients were diagnosed and treated for stage III disease. Six had clear cell sarcoma of the kidney (CCSK) and seven had rhabdoid tumours of the kidney (RTK) and are analysed separately. One other patient was excluded from overall analysis. Ninety-two patients were followed for a median of 115 months. Seventy-five received standard chemotherapy and abdominal radiotherapy according to protocol. Seventeen had stage III disease at immediate nephrectomy, but radiotherapy was omitted by physician choice. Thirty-three patients had inoperable disease at diagnosis and received pre-nephrectomy chemotherapy. Overall survival (OS) at 4 years for stage III favourable histology (FH) patients receiving abdominal RT was 83% (CI: 73-89). For children with stage III disease in whom RT was omitted the OS was 82% (CI: 59-97) and for inoperable disease 94% (CI: 78-98). The overall and event-free survival (EFS) of children with stage III CCSK was 100% and was achieved with the majority of patients not receiving radiotherapy (CI: 48-100). Three of seven children with RTK are alive EFS and OS 43% (CI: 10-73). For patients treated by abdominal radiotherapy the overall local control rate was 94.4% (CI: 86.4-98.5*%), 96.7% (CI: 88.5-99.6%) for flank RT and 83.3% (51.6-98.0%) for whole abdominal radiotherapy (WRT). The outcome for stage III FH disease was similar to that reported for UKWT1 and NWTS-3. The combination of abdominal RT together with 3-drug chemotherapy achieves a high abdominal tumour control rate. Flank RT is probably sufficient for localised tumour rupture. The high cure rates for children in this trial with

  6. Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

    Directory of Open Access Journals (Sweden)

    Felipe Alckmin-Carvalho

    Full Text Available ABSTRACT Background International studies have demonstrated an increase in the prevalence of boys and a decrease of patients’ age at the beginning of outpatient treatment for eating disorders (ED. Objective To evaluate if these changes are also present in the Brazilian population participating in the PROTAD, a Brazilian ED program, and to discuss its clinical implication for treatment. Methods Cross-sectional study. We evaluated 150 medical records of patients under 18 years diagnosed with ED (DSM IV-TR. Patients were divided into two groups: G1 (2001-2007 (n = 77 and G2 (2008-2014 (n = 73. The girl/boy proportion and the mean age of patients were compared. Results In G1, six boys (7.8% were admitted (girl/boy proportion: 11.8:1, while in G2, 16 (22% boys were admitted (girl/boy proportion: 3.5:1 (p 0.05. Discussion The increase in the number of boys treated for EDs reported in international studies was also found at the PROTAD. Contrary to what has been reported in international studies, the mean age of patients at the PROTAD did not decrease significantly. Gender and sexual orientation issues, clinical presentation, prior overweight history and culture/media impact on boys should be addressed by the healthcare team to increase the therapeutic efficacy.

  7. Endocarditis - children

    Science.gov (United States)

    Valve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective ...

  8. Patients' Adherence in the Maintenance Therapy of Children and Adolescents with Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Kremeike, K; Juergens, C; Alz, H; Reinhardt, D

    2015-11-01

    Acute lymphoblastic leukemia (ALL) is the most common form of paediatric cancer. Maintenance therapy as last treatment phase includes oral chemotherapy with methotrexate (MTX) and mercaptopurine (6-MP), self- or parent-administered at home, given for about 1 ½ years, and qualified as decisive for an optimum therapy outcome. The aim of our study was to analyze factors influencing the adherence of patients with ALL undergoing maintenance therapy and their families. A multi-method study was undertaken between 11/2011 and 10/2014 with patients surveyed by the Hannover Medical School outpatient clinic, including a questionnaire survey and qualitative interviews with parents as well as blood samples of the patients. 33 questionnaires, 27 interviews and blood samples of 26 patients could be analyzed. Only one third of the blood samples showed concentrations of the 6-MP active metabolite within the therapeutic reference range. Parents named the clinical doctor as their main advisor on medication intake. 36% (12/33) of the participants stated that medication intake has not always occurred the way medication was prescribed. Drug formulation and drug intake information could be identified as determinants of adherence. Parents' problems to obtain information are partly caused by different study results concerning the correct timing of the drug intake and drug interactions with milk products. Parents' information on drug therapy should be more consistent and the pharmaceutical formulations have to be adapted to patients' needs to improve adherence and thereby the chance of long-term remission. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Perception of epilepsy among the urban secondary school children of Bareilly district

    Directory of Open Access Journals (Sweden)

    Hari Shanker Joshi

    2012-01-01

    Full Text Available Background: There is a lack of knowledge about epilepsy among the students and the population in general, with consequent prejudice and discrimination toward epileptic patients. Objectives: Knowledge, behavior, attitude and myth toward epilepsy among urban school children in Bareilly district was studied. Materials and Methods: A cross-sectional survey was conducted among students of 10 randomly selected secondary schools of the urban areas in Bareilly district. A structured, pretested questionnaire was used to collect data regarding sociodemographic characteristics and assess the subject′s knowledge, behavior, attitude and myth toward epilepsy. Results: Of the 798 students (533 boys and 265 girls studied, around 98.6% had heard of epilepsy. About 63.7% correctly thought that epilepsy is a brain disorder while 81.8% believed it to be a psychiatric disorder. Other prevalent misconceptions were that epilepsy is an inherited disorder (71.55% and that the disease is transmitted by eating a nonvegetarian diet (49%. Most of them thought that epilepsy can be cured (69.3 and that an epileptic patient needs lifelong treatment (77.2. On witnessing a seizure, about 51.5% of the students would take the person to the hospital. Majority (72.31% of the students thought that children with epilepsy should study in a special school. Conclusions: Although majority of the students had reasonable knowledge of epilepsy, myths and superstitions about the condition still prevail in a significant proportion of the urban school children. It may be worthwhile including awareness programs about epilepsy in school education to dispel misconceptions about epilepsy.

  10. Metabolic alkalosis in children: Study of patients admitted to pediatrics center

    OpenAIRE

    Sobhani A; Radmehr B; Raji AR

    2001-01-01

    Metabolic alkalosis is characterized by high HCO3- as it is seen in chronic respiratory acidosis, but PH differentiates the two disorders. There is no characteristic symptom or sign. Orthostatic hypotension may be encountered. Weakness and hyporeflexia occur if serum K+ is markerdly low. Tetany and neuromuscular irritability occur rarely. We report the results of retrospective data analysis of metabolic alkalosis in 15463 patients hospitalized Pediatric Medical Center in Tehran during years 1...

  11. Metabolic alkalosis in children: Study of patients admitted to pediatrics center

    Directory of Open Access Journals (Sweden)

    Sobhani A

    2001-07-01

    Full Text Available Metabolic alkalosis is characterized by high HCO3- as it is seen in chronic respiratory acidosis, but PH differentiates the two disorders. There is no characteristic symptom or sign. Orthostatic hypotension may be encountered. Weakness and hyporeflexia occur if serum K+ is markerdly low. Tetany and neuromuscular irritability occur rarely. We report the results of retrospective data analysis of metabolic alkalosis in 15463 patients hospitalized Pediatric Medical Center in Tehran during years 1995-1997. We found 50 cases of metabolic alkalosis (rate of 0.32 percent. 64 precent male and 36 percent female. Most of them had growth failure (40% were bellow 3 percentile of height by age, 44% bellow 5 percentile of weight by height. More than 60 percent had hypokalemia, hypocloremia and hyponatremia. The most common cause of Metabolic alkalosis was cystic fibrosis and pyloric stenosis. Fifty percent of cystic fibrosis patients and Bartter cases had metabolic alkalosis. Metabolic alkalosis should be considered in every pediatric patient presented with projectile vomitting.

  12. Metabolic alkalosis in children: Study of patients admitted to pediatrics center1

    Directory of Open Access Journals (Sweden)

    2000-07-01

    Full Text Available Metabolic alkalosis is characterized by high HCO3- as it is seen in chronic respiratory acidosis, but PH differentiates the two disorders. There is no characteristic symptom or sign. Orthostatic hypotension may be encountered. Weakness and hyporeflexia occur if serum K+ is markerdly low. Tetany and neuromuscular irritability occur rarely. We report the results of retrospective data analysis of metabolic alkalosis in 15463 patients hospitalized Pediatric Medical Center in Tehran during years 1995-1997. We found 50 cases of metabolic alkalosis (rate of 0.32 percent. 64 precent male and 36 percent female. Most of them had growth failure (40% were bellow 3 percentile of height by age, 44% bellow 5 percentile of weight by height. More than 60 percent had hypokalemia, hypocloremia and hyponatremia. The most common cause of Metabolic alkalosis was cystic fibrosis and pyloric stenosis. Fifty percent of cystic fibrosis patients and Bartter cases had metabolic alkalosis. Metabolic alkalosis should be considered in every pediatric patient presented with projectile vomitting.

  13. Improved functionality, health related quality of life and decreased burden of disease in patients with ADHD treated with OROS® MPH: is treatment response different between children and adolescents?

    Directory of Open Access Journals (Sweden)

    Rettig Klaus

    2011-07-01

    Full Text Available Abstract Background To compare clinical and health-related quality of life (HRQoL outcomes between children and adolescents with ADHD treated with OROS® MPH, using data from two large similarly-designed multicenter, prospective, open-label, single-arm, non-interventional studies. Methods Pooled analysis (42603ATT4037, 42603 - ATT - 4001 including patients (6 to 18 years with a confirmed diagnosis of ADHD. Patients were treated with OROS® MPH for 12 weeks; ADHD symptoms, functioning, HRQoL, safety and tolerability parameters were assessed. Results 822 patients (583 children [6-12 years], 239 adolescents [13-18 years] were included in the pooled analysis. Mean daily OROS® MPH starting doses in the child and adolescent subgroups were 29.0 ± 11.7 and 37.6 ± 15.6 mg, respectively (p ® MPH in 76.9%, 86.0% and 79.3% of children, adolescents and the total population, respectively, at study end (p = 0.029 between-age subgroups. 195 of 822 patients (23.7% experienced at least one treatment-emergent adverse event; most commonly reported AEs in the total group (≥4% were insomnia (7.2%, anorexia (4.3% and involuntary muscle contractions (4.1%. No clinically relevant changes in body weight or vital signs were observed. Conclusions Clinically relevant differences between children and adolescents with ADHD are present. Adolescents appeared to have a lower health related quality of life and functioning compared to children at baseline, however, they were able to reach comparable ratings at endpoint for most items. Similarly, burden of disease decreased in patients and their carers. OROS MPH was generally safe and well tolerated.

  14. Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital.

    Science.gov (United States)

    Menke, Jan; Kahl, Fritz

    2015-03-01

    In children with ileocolic intussusception sonography is increasingly being used for diagnosis, whereas fluoroscopy is frequently used for guiding non-invasive reduction. This study assessed the success rate of radiation-free sonography-guided hydrostatic reduction in children with ileocolic intussusception, using novel well-defined success rate indices. All children were evaluated who presented from 2005 to 2013 to the local university hospital with ileocolic intussusception. The patients were treated with sonography-guided hydrostatic reduction unless primary surgery was clinically indicated. The according success rate was determined by indices of Bekdash et al. They represent the ratio of persistently successful non-surgical reductions versus four different denominators, depending on including/excluding cases with primary surgery and including/excluding cases requiring bowel resection/intervention. Fifty-six consecutive patients were included (age, 3 months to 7.8 years). About 80% of the patients presented until 24 h and 20% until 48 h after the onset of symptoms. Seven patients underwent primary surgery, with bowel resection required in three cases. Hydrostatic reduction was attempted in 49 patients, being permanently successful in 41 cases (selective reduction rate 41/49 = 83.7%; crude reduction rate 41/56 = 73.2%). The remaining eight patients underwent secondary surgery, with just two patients not requiring surgical bowel resection/intervention (corrected selective reduction rate 41/43 = 95.3%). The composite reduction rate was 87.2% (successful/feasible reductions, 41/47). Radiation-free sonography-guided hydrostatic reduction has a good success rate in children with ileocolic intussusception. It may be particularly valuable in centers that are already experienced with using sonography for the diagnosis.

  15. Extraintestinal manifestations were common in children with coeliac disease and were more prevalent in patients with more severe clinical and histological presentation.

    Science.gov (United States)

    Nurminen, Samuli; Kivelä, Laura; Huhtala, Heini; Kaukinen, Katri; Kurppa, Kalle

    2018-03-22

    This study investigated the prevalence of extraintestinal manifestations (EIM) in paediatric coeliac disease and their associations with other disease features. Researchers at the University of Tampere, Finland, compared EIM in 511 children diagnosed with coeliac disease from 2003 to 2014 and 180 diagnosed with functional gastrointestinal disorders from 2007 to 2013. Disease severity and dietary responses were also compared between coeliac children diagnosed by screening (n = 146) or because of EIM (n = 116) or gastrointestinal symptoms (n = 249). Coeliac patients had more EIM (62%) than those with functional disorders (33%). The most common EIM in coeliac children were poor growth (27%) and anaemia (18%). Children with coeliac disease often showed fatigue (8%) and symptoms affecting the skin (15%), nervous system (9%) and joints (6%). Coeliac patients with EIM as their main clinical presentation had more severe symptoms and histological damage at diagnosis than those with gastrointestinal presentation and screen-detected cases. The subgroups did not differ with regard to other clinical and laboratory parameters and dietary adherence. Concomitant EIM were also common in children diagnosed because of gastrointestinal presentation (60%) and by screening (37%). EIM were common in coeliac disease and associated with more severe clinical and histological presentation. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  16. Monogenic diabetes in children and young adults: Challenges for researcher, clinician and patient

    Science.gov (United States)

    2006-01-01

    Monogenic diabetes results from one or more mutations in a single gene which might hence be rare but has great impact leading to diabetes at a very young age. It has resulted in great challenges for researchers elucidating the aetiology of diabetes and related features in other organ systems, for clinicians specifying a diagnosis that leads to improved genetic counselling, predicting of clinical course and changes in treatment, and for patients to altered treatment that has lead to coming off insulin and injections with no alternative (Glucokinase mutations), insulin injections being replaced by tablets (e.g. low dose in HNFα or high dose in potassium channel defects -Kir6.2 and SUR1) or with tablets in addition to insulin (e.g. metformin in insulin resistant syndromes). Genetic testing requires guidance to test for what gene especially given limited resources. Monogenic diabetes should be considered in any diabetic patient who has features inconsistent with their current diagnosis (unspecified neonatal diabetes, type 1 or type 2 diabetes) and clinical features of a specific subtype of monogenic diabetes (neonatal diabetes, familial diabetes, mild hyperglycaemia, syndromes). Guidance is given by clinical and physiological features in patient and family and the likelihood of the proposed mutation altering clinical care. In this article, I aimed to provide insight in the genes and mutations involved in insulin synthesis, secretion, and resistance, and to provide guidance for genetic testing by showing the clinical and physiological features and tests for each specified diagnosis as well as the opportunities for treatment. PMID:17186387

  17. Patient Outcomes in the Operative and Nonoperative Management of High-Grade Spondylolisthesis in Children

    DEFF Research Database (Denmark)

    Lundine, K. M.; Lewis, S. J.; Al-Aubaidi, Zaid

    2014-01-01

    Background:The optimal management of high-grade spondylolisthesis in the growing child is controversial. Some authors have advocated for surgery in all cases regardless of symptoms. Surgical intervention results in a >10% risk of complications with increased risk of neurological injury associated...... with slip reduction maneuvers. There is a paucity of literature regarding nonoperative management in this setting. This study sought to obtain outcome measures in pediatric patients with high-grade spondylolisthesis managed either operatively or nonoperatively.Methods:Database review was performed...

  18. Anesthetic management of minimally invasive intervention in children's oncohematology: preoperative patient management protocol

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2013-01-01

    Full Text Available Preoperative patient management protocol in the complex anesthetic support of minimally invasive interventions in pediatric oncology is described. Choice of general anesthesia method was determined by the specific clinical situation by analyzing all of the following factors: airway management, necessity and anticipated duration of unconsciousness, the need for analgesia, necessity and duration of immobilization, prevention of hypothermia, the presence and severity of disturbances in the hemostatic system, comfort for the child and his representatives (parents. Basic techniques of child preoperative examination, as well as the methodology for predicting the risk of perioperative adverse events are described.

  19. Anesthetic management of minimally invasive intervention in children's oncohematology: preoperative patient management protocol

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2014-07-01

    Full Text Available Preoperative patient management protocol in the complex anesthetic support of minimally invasive interventions in pediatric oncology is described. Choice of general anesthesia method was determined by the specific clinical situation by analyzing all of the following factors: airway management, necessity and anticipated duration of unconsciousness, the need for analgesia, necessity and duration of immobilization, prevention of hypothermia, the presence and severity of disturbances in the hemostatic system, comfort for the child and his representatives (parents. Basic techniques of child preoperative examination, as well as the methodology for predicting the risk of perioperative adverse events are described.

  20. Role of Tc99m-dimercaptosuccinic acid (DMSA) in diagnosis of acute urinary tract infection (UTI) in Sudanese children patients

    International Nuclear Information System (INIS)

    Abu baker, S. E. E.

    2003-01-01

    Pediatric nuclear medicine, in order to survive, must be innovative in finding ways of competing with other pediatric imaging studies for better health care. In this study a group of thirty-one patients with urinary tract infection confirmed by clinical investigation, (fever, pain, ....ect), laboratory investigation (RBC and pus cell)and urine culture, were evaluate by nuclear medicine study. The aim of the study was to compare the diagnostic value of cortical scintigraphy using Tc 99m dimercaptosuccinic acid (Tc 99m -DMSA), with two other routine investigations; the intravenous urographic (IVU), and ultrasonography (US), for diagnosis of renal parenchymal abnormality in children. The Tc 99m -DMSA renal scan was utilized as the gold standard test for renal involvement. All patients had Tc 99m -DMSA renal scan, and US, and only 22 patients had contrast IVU. The Tc 99m -DMSA renal scan showed abnormality renal scanning in about 94% of patients, US abnormalities were detected in about 81% of patient, while the IVU detected defects in about 87%. Because the prevalence of upper UTI in children is high, Tc 99m -DMSA renal scan is undoubtedly the available tool for pediatriacicians as a guide in giving appropriate antibiotic therapy and to prevent further renal damage. The study concludes that, the renal cortical scintigraphy with Tc 99m -DMSA has been reported to be a useful children diagnostic study of acute parenchymal renal infections, moreover, is presently the method of choice to detect acute parenchymal infection. (Author)

  1. Historical and contemporary perspectives on children's diets: is choice always in the patients' best interest?

    Science.gov (United States)

    Denny, G; Sundvall, P; Thornton, S J; Reinarz, J; Williams, A N

    2010-06-01

    On 29 March 1744, Thomasin Grace, a 13-year-old girl, was the first inpatient admitted to the Northampton General Infirmary (later the Northampton General Hospital). Inpatient hospital diets, then and now, are mainstays of effective patient treatment. In the mid-18th century there were four prescribed diets at Northampton: 'full', 'milk', 'dry' and 'low'. Previous opinions concerning these four diets were unfavourable, but had not been based upon an individual dietetic assessment. Thomasin would most likely have been given the milk diet, but use of the full diet cannot be excluded. 'Grace Everyman' is Thomasin's modern equivalent. Under current NHS guidelines Thomasin would be considered a paediatric patient, but in 1744 she would have been considered as an adult. This study undertakes a full dietetic analysis of all the prescribed diets available for Thomasin in 1744 and compares this against random choices for Grace from the 2009 inpatient menu from the paediatric (Paddington) ward, and the adult ward inpatient menu at the Northampton General Hospital. The results show that, for Thomasin, the 1744 milk and full diets met the current advised nutritional requirements for adequate dietary intake. However, for Grace, the present 2009 Paddington and adult ward menu, although generally meeting nutritional requirements, could, if Grace or her carer consistently chose poorly during a prolonged inpatient stay, lead to inadequate nutrition. This challenges assumptions that hospital diets were historically inadequate, and that choice in present day equates with satisfactory nutritional intake.

  2. Identifying patient- and family-centered outcomes relevant to inpatient versus at-home management of neutropenia in children with acute myeloid leukemia.

    Science.gov (United States)

    Szymczak, Julia E; Getz, Kelly D; Madding, Rachel; Fisher, Brian; Raetz, Elizabeth; Hijiya, Nobuko; Gramatges, Maria M; Henry, Meret; Mian, Amir; Arnold, Staci D; Aftandilian, Catherine; Collier, Anderson B; Aplenc, Richard

    2018-04-01

    Efficacy of therapeutic strategies relative to patient- and family-centered outcomes in pediatric oncology must be assessed. We sought to identify outcomes important to children with acute myeloid leukemia and their families related to inpatient versus at-home management of neutropenia. We conducted qualitative interviews with 32 children ≥8 years old and 54 parents. Analysis revealed the impact of neutropenia management strategy on siblings, parent anxiety, and child sleep quality as being outcomes of concern across respondents. These themes were used to inform the design of a questionnaire that is currently being used in a prospective, multiinstitutional comparative effectiveness trial. © 2017 Wiley Periodicals, Inc.

  3. Comparing Explicit and Implicit Learning of Emotional and Non-Emotional Words in Autistic Children

    Directory of Open Access Journals (Sweden)

    Vahid Nejati

    2013-02-01

    Full Text Available Background: Explicit and implicit memories have different cerebral origins and learning approaches. Defective emotional words processing in children with autism may affect the memory allocated to such words. The aim of this study was comparing two types of (explicit and implicit memories during processing the two types of (emotional and non-emotional words in autistic children and their healthy counterparts. Materials and Methods: The present cross sectional study was conducted on 14 autistic children, who had referred to Autism Medical Treatment Center on Tehran, and 14 healthy children in kindergartens and schools across Tehran. For the explicit memory, a list of words was presented to the subjects of our study and they were asked to repeat the words they heard one time immediately and one time with delay. For implicit memory, the subjects were asked to identify the heard words among the presented words. Statistical analysis was performed using two-way analysis of variance. Results: The results showed that the normal children have higher efficiency in explicit and implicit memory than the children with autism (p<0.01. The two-way analysis of memory type and word type showed that the former affects memory significantly (p<0.05 while word type had no significant effect. Conclusion: Autistic children suffer from impaired memory. This defect is higher in implicit memory than in the explicit memory. It is recommended to apply rehabilitation, training, learning approaches and also explicit memory for interventions of autistic children.

  4. Do cavies talk? The effect of anthropomorphic picture books on children's knowledge about animals.

    Science.gov (United States)

    Ganea, Patricia A; Canfield, Caitlin F; Simons-Ghafari, Kadria; Chou, Tommy

    2014-01-01

    Many books for young children present animals in fantastical and unrealistic ways, such as wearing clothes, talking and engaging in human-like activities. This research examined whether anthropomorphism in children's books affects children's learning and conceptions of animals, by specifically assessing the impact of depictions (a bird wearing clothes and reading a book) and language (bird described as talking and as having human intentions). In Study 1, 3-, 4-, and 5-year-old children saw picture books featuring realistic drawings of a novel animal. Half of the children also heard factual, realistic language, while the other half heard anthropomorphized language. In Study 2, we replicated the first study using anthropomorphic illustrations of real animals. The results show that the language used to describe animals in books has an effect on children's tendency to attribute human-like traits to animals, and that anthropomorphic storybooks affect younger children's learning of novel facts about animals. These results indicate that anthropomorphized animals in books may not only lead to less learning but also influence children's conceptual knowledge of animals.

  5. Determination of prevalence and causes of hyponatremia in patient's admitted in pediatric intensive care unit of the Children's Hospital Medical Center

    Directory of Open Access Journals (Sweden)

    Kadivar M

    1999-06-01

    Full Text Available Among the 708 patients who were admitted in the pediatric intensive care unit (PICU of the children's hospital medical center, there were 100 patients with hyponatermia (Na<130 mEq/L. 62% of these patients had hyponatermia at the beginning of admission and 38% during hospitalization in PICU. According to the classification of hyponatermia in comparison to body fluid, this study revealed 7% pseudohyponatermia, 40% euvolemic hyponatermia, 34% hypovolemic hyponatermia and 10% hypovolemic hyponatermia. In conclusion, the most perevalent causes of hyponatermia in this study were syndrome of inappropriate antidiuretic hormone secretion (SIADH (27%, water intoxication (22% and extrarenal losses (20%

  6. Street children of India -- a glimpse.

    Science.gov (United States)

    Nigam, S

    1994-01-01

    In India, 90% of street children are working children with regular family ties who live with their families, but are on the streets due to poverty and their parents' unemployment. The remaining 10% are either working children with few family ties who view the streets as their homes or abandoned and neglected children with no family ties. The National Policy for Children established in 1974 emphasizes the provision of equal opportunities for the development to all children during their growing years. Policy stresses programs to maintain, educate, and train destitute children and orphans. Policy is also to protect children against neglect, cruelty, and exploitation, but this is only on paper. An UNICEF study found that almost 40,000 children die every day in developing countries, 25% of whom are in India. Studies in some major cities indicate that the street children in India are of moderate health status, suffering from various chronic diseases and undernourishment. They are deprived of all health programs, but seem to prefer government hospitals in case of dire need. Street children often have to pay for water. Almost 97% in Calcutta, 99% in Bangalore, and 90% in Madras reported having no access to toilet and bathing facilities; 83% in Kanpur, however, had access to such facilities. Nothing has been heard in recent years of the National Children's Board established in 1975. Apparently the board has gradually waned. Various schemes were planned in 1992 by the Union Welfare Ministry in association with UNICEF. Extending extra health facilities, establishing nutrition programs, providing vocational training, protecting children from abuse, distributing dry-food polypacks, providing night shelters, providing ration cards, and creating bathing and toilet facilities would go far in improving the quality of life and the future of street children in India.

  7. A Comparative Evaluation of Normal Tissue Doses for Patients Receiving Radiation Therapy for Hodgkin Lymphoma on the Childhood Cancer Survivor Study and Recent Children's Oncology Group Trials

    International Nuclear Information System (INIS)

    Zhou, Rachel; Ng, Angela; Constine, Louis S.; Stovall, Marilyn; Armstrong, Gregory T.; Neglia, Joseph P.; Friedman, Debra L.; Kelly, Kara; FitzGerald, Thomas J.; Hodgson, David C.

    2016-01-01

    Purpose: Survivors of pediatric Hodgkin lymphoma (HL) are recognized to have an increased risk of delayed adverse health outcomes related to radiation therapy (RT). However, the necessary latency required to observe these late effects means that the estimated risks apply to outdated treatments. We sought to compare the normal tissue dose received by children treated for HL and enrolled in the Childhood Cancer Survivor Study (CCSS) (diagnosed 1970-1986) with that of patients treated in recent Children's Oncology Group (COG) trials (enrolled 2002-2012). Methods and Materials: RT planning data were obtained for 50 HL survivors randomly sampled from the CCSS cohort and applied to computed tomography planning data sets to reconstruct the normal tissue dosimetry. For comparison, the normal tissue dosimetry data were obtained for all 191 patients with full computed tomography–based volumetric RT planning on COG protocols AHOD0031 and AHOD0831. Results: For early-stage patients, the mean female breast dose in the COG patients was on average 83.5% lower than that for CCSS patients, with an absolute reduction of 15.5 Gy. For advanced-stage patients, the mean breast dose was decreased on average by 70% (11.6 Gy average absolute dose reduction). The mean heart dose decreased on average by 22.9 Gy (68.6%) and 17.6 Gy (56.8%) for early- and advanced-stage patients, respectively. All dose comparisons for breast, heart, lung, and thyroid were significantly lower for patients in the COG trials than for the CCSS participants. Reductions in the prescribed dose were a major contributor to these dose reductions. Conclusions: These are the first data quantifying the significant reduction in the normal tissue dose using actual, rather than hypothetical, treatment plans for children with HL. These findings provide useful information when counseling families regarding the risks of contemporary RT.

  8. Children's rights and school psychology: children's right to participation.

    Science.gov (United States)

    Lansdown, Gerison; Jimerson, Shane R; Shahroozi, Reza

    2014-02-01

    The Convention on the Rights of the Child detailed an international imperative to fulfilling, protecting, and respecting the rights of every child. In particular, the Convention set out a clear mandate for guaranteeing opportunities for children to be heard on all matters of concern to them. The attainment of these goals involves respecting and valuing children as active participants in the educational process. If fully implemented, the right of children to express views and have them taken seriously, throughout the school environment, would represent one of the most profound transformations in moving towards a culture of respect for children's rights, for their dignity and citizenship, and for their capacities to contribute significantly towards their own well-being. These values and principles are consistent with those of the school psychology profession, thus, school psychologists are encouraged to be at the Center of the process advocating and actualizing the Convention in schools throughout the world. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  9. Immune reconstitution after allogeneic hematopoietic stem cell transplantation in children: a single institution study of 59 patients

    Directory of Open Access Journals (Sweden)

    Hyun O Kim

    2013-01-01

    Full Text Available &lt;b&gt;Purpose:&lt;/b&gt; Lymphocyte subset recovery is an important factor that determines the success of hematopoietic stem cell transplantation (HSCT. Temporal differences in the recovery of lymphocyte subsets and the factors influencing this recovery are important variables that affect a patient's posttransplant immune reconstitution, and therefore require investigation. &lt;b&gt;Methods:&lt;/b&gt; The time taken to achieve lymphocyte subset recovery and the factors influencing this recovery were investigated in 59 children who had undergone HSCT at the Department of Pediatrics, The Catholic University of Korea Seoul St. Mary's Hospital, and who had an uneventful follow-up period of at least 1 year. Analyses were carried out at 3 and 12 months post-transplant. An additional study was performed 1 month post-transplant to evaluate natural killer (NK cell recovery. The impact of preand post-transplant variables, including diagnosis of Epstein-Barr virus (EBV DNAemia posttransplant,on lymphocyte recovery was evaluated. &lt;b&gt;Results:&lt;/b&gt; The lymphocyte subsets recovered in the following order: NK cells, cytotoxic T cells, B cells,and helper T cells. At 1 month post-transplant, acute graft-versus-host disease was found to contribute significantly to the delay of CD16+/56+ cell recovery. Younger patients showed delayed recovery of both CD3+/CD8+ and CD19+ cells. EBV DNAemia had a deleterious impact on the recovery of both CD3+ and CD3+/CD4+ lymphocytes at 1 year post-transplant. &lt;b&gt;Conclusion:&lt;/b&gt; In our pediatric allogeneic HSCT cohort, helper T cells were the last subset to recover. Younger age and EBV DNAemia had a negative impact on the post-transplant recovery of T cells and B cells.

  10. Developmental change in children's sensitivity to sound symbolism.

    Science.gov (United States)

    Tzeng, Christina Y; Nygaard, Lynne C; Namy, Laura L

    2017-08-01

    The current study examined developmental change in children's sensitivity to sound symbolism. Three-, five-, and seven-year-old children heard sound symbolic novel words and foreign words meaning round and pointy and chose which of two pictures (one round and one pointy) best corresponded to each word they heard. Task performance varied as a function of both word type and age group such that accuracy was greater for novel words than for foreign words, and task performance increased with age for both word types. For novel words, children in all age groups reliably chose the correct corresponding picture. For foreign words, 3-year-olds showed chance performance, whereas 5- and 7-year-olds showed reliably above-chance performance. Results suggest increased sensitivity to sound symbolic cues with development and imply that although sensitivity to sound symbolism may be available early and facilitate children's word-referent mappings, sensitivity to subtler sound symbolic cues requires greater language experience. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Molecular characterization of norovirus GII.17 detected in healthy adult, intussusception patient, and acute gastroenteritis children in Thailand.

    Science.gov (United States)

    Khamrin, Pattara; Kumthip, Kattareeya; Yodmeeklin, Arpaporn; Supadej, Kanittapon; Ukarapol, Nuthapong; Thongprachum, Aksara; Okitsu, Shoko; Hayakawa, Satoshi; Ushijima, Hiroshi; Maneekarn, Niwat

    2016-10-01

    Noroviruses (NoVs) have been recognized as a leading cause of sporadic cases and outbreaks of acute gastroenteritis in all age groups. During the surveillance of NoVs in Chiang Mai, Thailand, four cases of the novel GII.17 NoVs were sporadically detected by RT-PCR in 2014-2015. The first case of GII.17 was detected in a healthy adult who worked for a restaurant. The second case was found in a pediatric patient who admitted to the hospital with intussusception. The third and fourth cases were found in acute gastroenteritis children. Phylogenetic analysis clearly demonstrated that GII.17 NoVs detected in this study were genetically closely related with the novel GII.17 Kawasaki reference strains. These four GII.17 NoV positive specimens were also tested by two immunochromatographic test kits in order to evaluate the sensitivity for GII.17 NoV detection. The viral loads in those specimens were determined by real-time RT-PCR. The sensitivity of GII.17 NoV detection varies by individual test kits and also depending on the amount of the viruses contained in the fecal specimens. In summary, our study reported the detection of novel GII.17 NoVs in a wide range of subjects with and without diarrhea. Therefore, continued comprehensive screening and genetic molecular characterization of NoV strains circulating in this area need to be further investigated. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Misconceptions about children`s pain

    OpenAIRE

    Miloseva, Lence; Vukosavljevic-Gvozden, Tanja; Milosev, Vladimir

    2014-01-01

    Managing hospitalized children's pain is challenging for health care professionals. The ethical principles of the duty to benefit another and the duty to do no harm oblige health care professionals to provide pain management to all patients, including children, who are vulnerable because of their constant developmental changes, being ill, and being hospitalized. During the last 20 years, researchers started to show an interest in misconceptions about children`s pain. Literature review showed...

  13. Health-related quality of life in children and adolescents with celiac disease: from the perspectives of children and parents.

    Science.gov (United States)

    Byström, Ing-Marie; Hollén, Elisabet; Fälth-Magnusson, Karin; Johansson, Annakarin

    2012-01-01

    Aim. To examine how celiac children and adolescents on gluten-free diet valued their health-related quality of life, and if age and severity of the disease at onset affected the children's self-valuation later in life. We also assessed the parents' valuation of their child's quality of life. Methods. The DISABKIDS Chronic generic measure, short versions for both children and parents, was used on 160 families with celiac disease. A paediatric gastroenterologist classified manifestations of the disease at onset retrospectively. Results. Age or sex did not influence the outcome. Children diagnosed before the age of five scored higher than children diagnosed later. Children diagnosed more than eight years ago scored higher than more recently diagnosed children, and children who had the classical symptoms of the disease at onset scored higher than those who had atypical symptoms or were asymptomatic. The parents valuated their children's quality of life as lower than the children did. Conclusion. Health-related quality of life in treated celiac children and adolescents was influenced by age at diagnosis, disease severity at onset, and years on gluten-free diet. The disagreement between child-parent valuations highlights the importance of letting the children themselves be heard about their perceived quality of life.

  14. The influence of patient, caregiver, and family factors on symptoms of anxiety and depression in children and adolescents with intractable epilepsy.

    Science.gov (United States)

    Puka, Klajdi; Widjaja, Elysa; Smith, Mary Lou

    2017-02-01

    The objective was to evaluate the association of caregiver and family factors with symptoms of anxiety and depression in children and adolescents with medically refractory localization-related epilepsy (i.e., failed at least two epilepsy medications). Forty-four children (ages 6-11years) and 65 adolescents (ages 12-18years) and their parents participated in this multicentered, observational, cross-sectional study. Univariable and multivariable linear regressions were used to evaluate the influence of multiple patient, caregiver, and family characteristics on self-reported symptoms of anxiety and depression in the children and adolescents. Among children, depressive symptoms were associated with a lower proportion of life with seizures (β=.344, p=.022), caregiver depression (β=.462, p=.002), poorer family relationships (β=.384, p=.010), and poorer family mastery and social support (β=.337, p=.025); in multivariable analysis, proportion of life with epilepsy and parental depression remained significant. No significant predictors of anxiety were found among children. Among adolescents, depressive symptoms were associated with caregiver unemployment (β=.345, p=.005) and anxiety (β=.359, p=.003), low household income (β=.321, p=.012), poorer family mastery and social support (β=.334, p=.007), and greater family demands (β=.326, p=.008); in multivariable analysis, caregiver unemployment and anxiety remained significant. Greater anxiety symptoms among adolescents were associated with females (β=.320, p=.009) and caregiver depression (β=.246, p=.048) and anxiety (β=.392, p=.001) and poorer family mastery and social support (β=.247, p=.047); in multivariable analysis, female sex and caregiver anxiety remained significant. These findings highlight the central role of caregiver psychopathology, which is amenable to intervention, on children and adolescents' symptoms of anxiety and depression. Addressing caregiver psychopathology may improve children and

  15. Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

    Directory of Open Access Journals (Sweden)

    van Rhijn Lodewijk W

    2010-06-01

    Full Text Available Abstract Background Cerebral palsy (CP may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. Methods We performed an RF-DRG procedure in 17 consecutive CP patients with severe hip flexor/adductor spasms accompanied by pain or care-giving difficulties. Six children were systematically evaluated at baseline, and 1 month and 6 months after treatment by means of the Modified Ashworth Scale (MAS, Gross Motor Function Measure (GMFM and a self-made caregiver's questionnaire. Eleven subsequent children were evaluated using a Visual Analogue Scale (VAS for spasticity, pain and ease of care. Results A total of 19 RF-DRG treatments were performed in 17 patients. We found a small improvement in muscle tone measured by MAS, but no effect on the GMFM scale. Despite this, the caregivers of these six treated children unanimously stated that the quality of life of their children had indeed improved after the RF-DRG. In the subsequent 11 children we found improvements in all VAS scores, in a range comparable to the conventional treatment options. Conclusion RF-DRG is a promising new treatment option for severe spasticity in CP patients, and its definitive effectiveness remains to be defined in a randomised controlled trial.

  16. Clinical and programmatic considerations in the treatment of MDR-TB in children: a series of 16 patients from Lima, Peru.

    Science.gov (United States)

    Mukherjee, J S; Joseph, J K; Rich, M L; Shin, S S; Furin, J J; Seung, K J; Sloutsky, A; Socci, A R; Vanderwarker, C; Vasquez, L; Palacios, E; Guerra, D; Viru, F A; Farmer, P; Del Castillo, H E

    2003-07-01

    Since 2000, the directly observed treatment, short-course (DOTS) strategy has been expanded in several countries to include treatment of multidrug-resistant tuberculosis (MDR-TB). This strategy is known as DOTS-Plus. Tuberculosis is a common cause of morbidity and mortality for children throughout the developing world. Children may also be infected with MDR-TB, yet most developing countries do not specifically address pediatric MDR-TB. To present the intermediate outcomes of the first 16 children enrolled in the Peruvian DOTS-Plus program and to demonstrate the tolerability of second-line anti-tuberculosis drugs. Three children completed therapy and are cured, one child had bacteriologic and clinical failure after 12 months of therapy and died of respiratory insufficiency, and 12 have intermediate outcomes demonstrating favorable clinical, bacteriologic, and radiographic evidence of improvement after 9-19 months of therapy. Of the 16 pediatric DOTS-Plus patients, 15 have tolerated therapy well and have had favorable clinical evolution. However, the diagnosis of pediatric MDR-TB is often extremely delayed due to reliance on the adult case definition and should be changed to prevent progressive, chronic illness in such children. Programmatic changes could facilitate earlier diagnosis and treatment of pediatric MDR-TB in Peru and in other DOTS-Plus programs.

  17. The Effect of a Pilot Pediatric In-Patient Department-Based Smoking Cessation Intervention on Parental Smoking and Children's Secondhand Smoke (SHS) Exposure in Guangxi, China.

    Science.gov (United States)

    Huang, Kaiyong; Yang, Li; Winickoff, Jonathan P; Liao, Jing; Nong, Guangmin; Zhang, Zhiyong; Liang, Xia; Liang, Gang; Abdullah, Abu S

    2016-11-08

    Children's exposure to secondhand smoke (SHS) at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children's SHS exposure and encourage smoking cessation. A pre-post test design study was designed to assess the effectiveness of a telephone counseling intervention on household members of hospitalized children in pediatric departments. Data were collected with a standardized Chinese language questionnaire. At the three-month follow-up survey, the proportions of household members who reported adopting complete smoking restriction at home (55%), did not smoke at home at all (37%), did not allow others to smoke in the car (70%), or did not allow others to smoke around the child (57%) were significantly higher than the self-reported responses at the baseline survey. The proportions of household members who reported smoking at home (49%) and in the car (22%) were significantly lower than the baseline survey. Overall, 7% of the participants had reported quitting smoking after three months. Pediatric in-patient department-based telephone counseling for smoking cessation was found to be acceptable to Chinese parents. The intervention encouraged few parents to quit smoking, but encouraged more parents to take measures to reduce children's SHS exposure.

  18. Input Distribution Influences Degree of Auxiliary Use by Children with Specific Language Impairment.

    Science.gov (United States)

    Leonard, Laurence B; Deevy, Patricia

    2011-04-01

    Children with specific language impairment (SLI) show a protracted period of inconsistent use of tense/agreement morphemes. The purpose of this investigation was to determine whether this inconsistent use could be attributed to the children's misinterpretations of particular syntactic structures in the input. In Study 1, preschool-aged children with SLI and typically developing peers heard sentences containing novel verbs preceded by auxiliary was or sentences in which the novel verb formed part of a nonfinite subject-verb sequence within a larger syntactic structure (e.g., We saw the dog relling ). The children were then tested on their use of the novel verbs in contexts that obligated use of auxiliary is . The children with SLI were less accurate than their peers and more likely to produce the novel verb without is if the verb had been heard in a nonfinite subject-verb sequence. In Study 2, children with SLI and typically developing peers were tested on their comprehension of sentences such as The cow sees the horse eating. The children with SLI were less accurate than their peers and were disproportionately influenced by the nonfinite subject-verb clause at the end of the sentence. We interpret these findings within the framework of construction learning.

  19. Psychological distress of cancer patients with children under 18 years and their partners-a longitudinal study of family relationships using dyadic data analysis.

    Science.gov (United States)

    Götze, Heide; Friedrich, Michael; Brähler, Elmar; Romer, Georg; Mehnert, Anja; Ernst, Jochen

    2017-01-01

    With increasing age at pregnancy, the likelihood of cancer affecting a family with children under 18 is rising and the issue of parents with cancer is gaining importance. Here, we examined the level of anxiety and depression, social support, and partnership satisfaction of cancer patients with children under 18 years and their partners as well as the dyadic patient-partner relationship concerning psychological distress and predictor variables. We used a longitudinal survey, recruiting patients with children under legal age and their partners (t1 = post therapy, t2 = 6 months after t1, t3 = 12 months after t1). Patients and partners completed the Hospital Anxiety and Depression Scale (HADS), the Oslo 3-item Social Support Scale (OSS-3), and the Abbreviated Dyadic Adjustment Scale (ADAS). We surveyed 161 cancer patients and 115 partners by mail (t1). Anxiety and depression were compared to German normative data. Dyadic relationships of three variables (social support, partnership satisfaction, and employment) and the psychological distress of 81 patient-partner dyads were analyzed with a structural equation model to estimate the actor-partner interdependence model. After cancer therapy, 28.3 % of the patients and 46.2 % of their partners had moderate to high levels of anxiety and 17.9 % and 23.1 % had moderate to high levels of depression, respectively. Partners' levels of anxiety (p = 0.002) and depression (p = 0.018) had decreased significantly over the 1-year period post therapy. We found no changes in patients' anxiety (p = 0.444) and depression (p = 0.636) over time. Anxiety and depression did not differ on pair level (p = 0.120-0.928). The level of anxiety in patients and partners was significantly higher than that in the general population (p family is a large burden for both patients and partners, highlighting the high incidence of anxiety. The results indicate that couples coping with cancer tend to react as an emotional system rather than

  20. Assessment of children's nutritional attitudes before oral food challenges to identify patients at risk of food reintroduction failure: a prospective study.

    Science.gov (United States)

    Polloni, L; Ferruzza, E; Ronconi, L; Toniolo, A; Lazzarotto, F; Bonaguro, R; Celegato, N; Muraro, A

    2017-05-01

    Inappropriate dietary eliminations may impair quality of life, affect children's growth and unnecessarily impact on healthcare costs. Previous retrospective studies reported that around 25% of children continue a food-avoidance diet despite a negative oral food challenge (OFC). A definite pattern has not been found yet for patients not reintroducing the food. This study aimed to examine the role of child's nutritional attitudes and maternal anxiety in reintroducing food after a negative OFC. A prospective study was conducted involving 81 mothers of children with IgE-mediated food allergy. They completed a survey on nutritional behaviour and attitudes and the State-Trait Anxiety Inventory on the day of OFC and 6 months later. In total, 11.1% of children never or rarely ate the food after a negative OFC. Consumption of the reintroduced food is positively correlated to child's interest in tasting new foods before and after OFC and to changes in child's nutritional habits after OFC. It is negatively correlated to monotony of the diet after OFC. No correlations were found with other participants' characteristics or maternal anxiety. State anxiety significantly decreased after the OFC. A correlation was found between trait and state anxiety and the degree of change in nutritional habits after OFC. Evaluating child's approach towards food before the OFC is a promising approach to identify patients at risk of food reintroduction failure. Furthermore, it underlined the importance of reassessing food consumption in all patients after a negative OFC and supporting patients in the reintroduction of food. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Feasibility of Using a Handheld Electronic Device for the Collection of Patient Reported Outcomes Data from Children

    Science.gov (United States)

    Vinney, Lisa A.; Grade, John D.; Connor, Nadine P.

    2012-01-01

    The manner in which a communication disorder affects health-related quality of life (QOL) in children is not known. Unfortunately, collection of quality of life data via traditional paper measures is labor intensive and has several other limitations, which hinder the investigation of pediatric quality of life in children. Currently, there is not…

  2. Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis

    NARCIS (Netherlands)

    Boonacker, C.W.; Rovers, M.M.; Browning, G.G.; Hoes, A.W.; Schilder, A.G.M; Burton, M.J.

    2014-01-01

    BACKGROUND: Otitis media (OM) is a leading cause of medical consultations, antibiotic prescription and surgery in children. The surgical procedures offered to children with recurrent or persistent OM are insertion of grommets, adenoidectomy or a combination of the two. There is clear National

  3. Feasibility and Diagnostic Accuracy of Supersonic Shear-Wave Elastography for the Assessment of Liver Stiffness and Liver Fibrosis in Children: A Pilot Study of 96 Patients.

    Science.gov (United States)

    Franchi-Abella, Stéphanie; Corno, Lucie; Gonzales, Emmanuel; Antoni, Guillemette; Fabre, Monique; Ducot, Béatrice; Pariente, Danièle; Gennisson, Jean-Luc; Tanter, Mickael; Corréas, Jean-Michel

    2016-02-01

    To evaluate the feasibility of using supersonic shear-wave elastography (SSWE) in children and normal values of liver stiffness with the use of control patients of different ages (from neonates to teenagers) and the diagnostic accuracy of supersonic shear wave elastography for assessing liver fibrosis by using the histologic scoring system as the reference method in patients with liver disease, with a special concern for early stages of fibrosis. The institutional review board approved this prospective study. Informed consent was obtained from parents and children older than 7 years. First, 51 healthy children (from neonate to 15 years) were analyzed as the control group, and univariate and multivariate comparisons were performed to study the effect of age, transducer, breathing condition, probe, and position on elasticity values. Next, 45 children (from 1 month to 17.2 years old) who underwent liver biopsy were analyzed. SSWE measurements were obtained in the same region of the liver as the biopsy specimens. Biopsy specimens were reviewed in a blinded manner by a pathologist with the use of METAVIR criteria. The areas under the receiver operating characteristics curve (AUCs) were calculated for patients with fibrosis stage F0 versus those with stage F1-F2, F2 or higher, F3 or higher, and F4 or higher. A successful rate of SSWE measurement was 100% in 96 patients, including neonates. Liver stiffness values were significantly higher when an SC6-1 probe (Aixplorer; SuperSonic Imagine SA, Aix-enProvence, France) was used than when an SL15-4 probe (Aixplorer) was used (mean ± standard deviation, 6.94 kPa ± 1.42 vs 5.96 kPa ± 1.31; P = .006). There was no influence of sex, the location of measurement, or respiratory status on liver elasticity values (P = .41-.93), although the power to detect such a difference was low. According to the degree of liver fibrosis at liver biopsy, 88.5%-96.8% of patients were correctly classified, with AUCs of 0.90-0.98 (95% confidence

  4. Concurrent validity of persian version of wechsler intelligence scale for children - fourth edition and cognitive assessment system in patients with learning disorder.

    Science.gov (United States)

    Rostami, Reza; Sadeghi, Vahid; Zarei, Jamileh; Haddadi, Parvaneh; Mohazzab-Torabi, Saman; Salamati, Payman

    2013-04-01

    The aim of this study was to compare the Persian version of the wechsler intelligence scale for children - fourth edition (WISC-IV) and cognitive assessment system (CAS) tests, to determine the correlation between their scales and to evaluate the probable concurrent validity of these tests in patients with learning disorders. One-hundered-sixty-two children with learning disorder who were presented at Atieh Comprehensive Psychiatry Center were selected in a consecutive non-randomized order. All of the patients were assessed based on WISC-IV and CAS scores questionnaires. Pearson correlation coefficient was used to analyze the correlation between the data and to assess the concurrent validity of the two tests. Linear regression was used for statistical modeling. The type one error was considered 5% in maximum. There was a strong correlation between total score of WISC-IV test and total score of CAS test in the patients (r=0.75, Ptest in children with learning disorders. A concurrent validity is established between the two tests and their scales.

  5. Who are the children and adolescent patients of a national referral service of eating disorders in Brazil?: a cross-sectional study of a clinical sample

    OpenAIRE

    Pinzon,Vanessa Dentzien; Turkiewicz,Gizela; Monteiro,Denise Oliveira; Koritar,Priscila; Fleitlich-Bilyk,Bacy

    2013-01-01

    Objectives: To investigate the sociodemographic and clinical profile of patients receiving treatment at a specialized service for children and adolescents with eating disorders (ED) in São Paulo, Brazil, and to compare data with the relevant literature. Methods: This cross-sectional study assessed male and female patients with ED up to 18 years of age. All data were collected upon admission. Results: A total of 100 subjects were assessed. Mean age was 15.41±0.18 years, and mean age at ED onse...

  6. Hearing the voices of children and young people to develop and test a patient-reported experience measure in a specialist paediatric setting.

    Science.gov (United States)

    Wray, Jo; Hobden, Sylvie; Knibbs, Sarah; Oldham, Geralyn

    2018-03-01

    To develop and test patient-reported experience measures (PREMs) for children and young people in a specialist paediatric hospital setting. Six PREMs were developed and tested by children and young people for children and young people aged 8-11, 12-13 and 14-16 years in inpatient and outpatient settings. A week-long pilot was implemented across inpatient wards and outpatient clinics to identify facilitators and barriers to the routine use of PREMs in a real-time setting across our organisation. Tertiary paediatric hospital. Final PREMs; identified facilitators and barriers to implementation. 543 children and young people aged 8-16 years attending outpatient clinics or inpatient wards across a range of specialties. Three key themes about hospital experience were identified during focus groups: facilities, treatment and tests and people working at the hospital, and these provided the structure for the questionnaires. During cognitive testing the questionnaires were generally understood but some revisions to language and length of the questionnaires were required. Two designs were selected for the final PREMs. During acceptability and feasibility testing it was evident that children and young people liked the PREMs and wanted to give feedback on their hospital experience. Particular challenges for routine use of the PREMs focused on sustainability and resources. The new PREMs will provide children and young people receiving care in specialist paediatric hospitals with the opportunity to provide feedback on their experience. Sustainability and ensuring that feedback results in improvements need to be addressed in future work. © 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.

  7. "They don't really get heard": A qualitative study of sibling involvement across two forms of family-based treatment for adolescent anorexia nervosa.

    Science.gov (United States)

    van Langenberg, Tanja; Duncan, Rony E; Allen, J Sabura; Sawyer, Susan M; Le Grange, Daniel; Hughes, Elizabeth K

    2018-04-23

    Little is known about the involvement of siblings in family-based treatment (FBT) for anorexia nervosa (AN). To explore the experience of families, adolescents who had completed FBT, their siblings, and parents were interviewed. Siblings reported that involvement in FBT enhanced their understanding of anorexia and that they supported their family in various ways. While siblings often wished they had attended more sessions, there was no consensus among parents and patients regarding sibling attendance and many were concerned about potential negative impacts on siblings. Clinicians should discuss sibling roles and expectations early in FBT and work actively with families to address concerns.

  8. Piecing It Together: The Effect of Background Music on Children's Puzzle Assembly.

    Science.gov (United States)

    Koolidge, Louis; Holmes, Robyn M

    2018-04-01

    This study explored the effects of background music on cognitive (puzzle assembly) task performance in young children. Participants were 87 primarily European-American children (38 boys, 49 girls; mean age = 4.77 years) enrolled in early childhood classes in the northeastern United States. Children were given one minute to complete a 12-piece puzzle task in one of three background music conditions: music with lyrics, music without lyrics, and no music. The music selection was "You're Welcome" from the Disney movie "Moana." Results revealed that children who heard the music without lyrics completed more puzzle pieces than children in either the music with lyrics or no music condition. Background music without distracting lyrics may be beneficial and superior to background music with lyrics for young children's cognitive performance even when they are engaged independently in a nonverbal task.

  9. Interventions for promoting participation in shared decision-making for children with cancer.

    LENUS (Irish Health Repository)

    Coyne, Imelda

    2013-01-01

    Children\\'s rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions. There is considerable support for involving children in healthcare decision-making at a level commensurate with their experience, age and abilities. Thus healthcare professionals and parents need to know how they should involve children in decision-making and what interventions are most effective in promoting shared decision-making (SDM) for children with cancer.

  10. Comparison of the Simple Patient-Centric Atopic Dermatitis Scoring System PEST with SCORAD in Young Children Using a Ceramide Dominant Therapeutic Moisturizer.

    Science.gov (United States)

    Koh, Mark Jean-Ann; Giam, Yoke Chin; Liew, Hui Min; Foong, Alice Yee-Wah; Chong, Jin Ho; Wong, Sharon Mun Yee; Tang, Mark Boon Yang; Ho, Madeline Sheun Ling; Tan, Lucinda Siyun; Mason, James M; Cork, Michael J

    2017-09-01

    Patient eczema severity time (PEST) is a new atopic dermatitis (AD) scoring system based on patients' own perception of their disease. Conventional scales such as SCORing of atopic dermatitis (SCORAD) reflect the clinician's observations during the clinic visit. Instead, the PEST score captures eczema severity, relapse and recovery as experienced by the patient or caregiver on a daily basis, promoting patient engagement, compliance with treatment and improved outcomes. This study aims to determine the correlation between carer-assessed PEST and clinician-assessed SCORAD in paediatric AD patients after 12 weeks of treatment using a ceramide-dominant therapeutic moisturizer. Prospective, open-label, observational, multi-centre study in which children with AD aged 6 months to 6 years were treated with a ceramide dominant therapeutic moisturizer twice daily for 12 weeks; 58 children with mild-to-moderate AD were included. Correlation between the 7-day averaged PEST and SCORAD scores for assessment of AD severity was measured within a general linear model. PEST and SCORAD were compared in week 4 and week 12. At week 12, a moderate correlation was found between the SCORAD and PEST scores (r = 0.51). The mean change in SCORAD and PEST scores from baseline to week 12 was -11.46 [95% confidence interval (CI) -14.99 to -7.92, p PEST demonstrated greater responsiveness to change (33.3% of scale) compared to SCORAD (13.8% of scale). The PEST score correlates well with the SCORAD score and may have improved sensitivity when detecting changes in the severity of AD. The ceramide-dominant therapeutic moisturizer used was safe and effective in the management of AD in young children. Hyphens Pharma Pte Ltd. clinicaltrials.gov identifier, NCT02073591.

  11. Indian Child Welfare Act of 1978. S.1214 to Establish Standards for the Placement of Indian Children in Foster or Adoptive Homes, to Prevent the Breakup of Indian Families, and for Other Purposes. Hearings before the Subcommittee on Indian Affairs and Public Lands of the Committee on Interior and Insular Affairs. House of Representatives, Ninety-Fifth Congress, Second Session (February 9 and March 9, 1978).

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Interior and Insular Affairs.

    Testimonies were heard by the Subcommittee on Indian Affairs and Public Lands in reference to the Indian Child Welfare Act of 1978, which establishes standards for the placement of Indian children in foster or adoptive homes to prevent the breakup of Indian families. Representatives from the following organizations testified: Administration for…

  12. How to support patients with severe mental illness in their parenting role with children aged over 1 year? A systematic review of interventions.

    Science.gov (United States)

    Schrank, Beate; Moran, Katherine; Borghi, Cristiana; Priebe, Stefan

    2015-12-01

    There are well-established risks for parents with severe mental illness (i.e. psychotic and bipolar disorders), both for their children and themselves. Interventions to help parents fulfil their role should therefore be a public health objective, but their implementation needs to be underpinned by research evidence. This systematic review determines what is known about the nature and effectiveness of interventions for parents with severe mental illness. We conducted a narrative synthesis of controlled and uncontrolled studies reporting interventions for this patient group after the post-natal period (i.e. after the child has turned 1 year old). Eighteen publications reported data from 15 studies. All but two studies were rated as low quality studies. Interventions included home visiting programmes, complex community programmes, residential treatments, and online interventions. Interventions targeted diverse areas, with parenting skills and understanding the impact of mental illness on parenting most frequently addressed. Both parent and child-related outcomes improved, but children were only assessed via observers and follow-up times were short. Interventions were diverse with respect to their nature and effectiveness. Future interventions should combine different intervention strategies to target multiple areas in a flexible manner. The addition of positively focussed and resource-oriented components should be investigated. Trials should include direct assessments of both parents and children, outcomes that are relevant from a public health perspective, and establish the long-term effects ideally until children have reached 18 years of age.

  13. Insufficient fluconazole exposure in pediatric cancer patients and the need for therapeutic drug monitoring in critically ill children

    NARCIS (Netherlands)

    van der Elst, Kim CM; Pereboom, Marieke; van den Heuvel, Edwin R; Kosterink, Jos G W; Scholvinck, Elisabeth H.; Alffenaar, Jan-Willem C

    2014-01-01

    Background. Fluconazole is recommended as first-line treatment in invasive candidiasis in children and infants. Although timely achievement of adequate exposure of fluconazole improves outcome, therapeutic drug monitoring is currently not recommended. Methods. We conducted a retrospective study of

  14. Who are the children and adolescent patients of a national referral service of eating disorders in Brazil?: a cross-sectional study of a clinical sample.

    Science.gov (United States)

    Pinzon, Vanessa Dentzien; Turkiewicz, Gizela; Monteiro, Denise Oliveira; Koritar, Priscila; Fleitlich-Bilyk, Bacy

    2013-01-01

    To investigate the sociodemographic and clinical profile of patients receiving treatment at a specialized service for children and adolescents with eating disorders (ED) in São Paulo, Brazil, and to compare data with the relevant literature. This cross-sectional study assessed male and female patients with ED up to 18 years of age. All data were collected upon admission. A total of 100 subjects were assessed. Mean age was 15.41±0.18 years, and mean age at ED onset was 13.5±0.19 years. Mean disease duration was 21.06 ±1.67 months. Of the total sample, 82% of the patients were female, 84% were Caucasian, 64% came from A and B economic tiers. Moreover, in 60% ED started at 14 years of age or less, and 74% had psychiatric comorbidities. Anorexia nervosa was the most prevalent diagnosis (43%). Hospitalized patients had lower body mass index, longer ED duration, and more severe scores on the Children's Global Assessment Scale than outpatients (p studies and indicate greater ED severity.

  15. Prognostic factors in children and adolescents with acute myeloid leukemia (excluding children with Down syndrome and acute promyelocytic leukemia): univariate and recursive partitioning analysis of patients treated on Pediatric Oncology Group (POG) Study 8821.

    Science.gov (United States)

    Chang, M; Raimondi, S C; Ravindranath, Y; Carroll, A J; Camitta, B; Gresik, M V; Steuber, C P; Weinstein, H

    2000-07-01

    The purpose of the paper was to define clinical or biological features associated with the risk for treatment failure for children with acute myeloid leukemia. Data from 560 children and adolescents with newly diagnosed acute myeloid leukemia who entered the Pediatric Oncology Group Study 8821 from June 1988 to March 1993 were analyzed by univariate and recursive partitioning methods. Children with Down syndrome or acute promyelocytic leukemia were excluded from the study. Factors examined included age, number of leukocytes, sex, FAB morphologic subtype, cytogenetic findings, and extramedullary disease at the time of diagnosis. The overall event-free survival (EFS) rate at 4 years was 32.7% (s.e. = 2.2%). Age > or =2 years, fewer than 50 x 10(9)/I leukocytes, and t(8;21) or inv(16), and normal chromosomes were associated with higher rates of EFS (P value = 0.003, 0.049, 0.0003, 0.031, respectively), whereas the M5 subtype of AML (P value = 0.0003) and chromosome abnormalities other than t(8;21) and inv(16) were associated with lower rates of EFS (P value = 0.0001). Recursive partitioning analysis defined three groups of patients with widely varied prognoses: female patients with t(8;21), inv(16), or a normal karyotype (n = 89) had the best prognosis (4-year EFS = 55.1%, s.e. = 5.7%); male patients with t(8;21), inv(16) or normal chromosomes (n = 106) had an intermediate prognosis (4-year EFS = 38.1%, s.e. = 5.3%); patients with chromosome abnormalities other than t(8;21) and inv(16) (n = 233) had the worst prognosis (4-year EFS = 27.0%, s.e. = 3.2%). One hundred and thirty-two patients (24%) could not be grouped because of missing cytogenetic data, mainly due to inadequate marrow samples. The results suggest that pediatric patients with acute myeloid leukemia can be categorized into three potential risk groups for prognosis and that differences in sex and chromosomal abnormalities are associated with differences in estimates of EFS. These results are tentative and

  16. Health-Related Quality of Life in Children and Adolescents with Celiac Disease: From the Perspectives of Children and Parents

    Directory of Open Access Journals (Sweden)

    Ing-Marie Byström

    2012-01-01

    Full Text Available Aim. To examine how celiac children and adolescents on gluten-free diet valued their health-related quality of life, and if age and severity of the disease at onset affected the children’s self-valuation later in life. We also assessed the parents’ valuation of their child’s quality of life. Methods. The DISABKIDS Chronic generic measure, short versions for both children and parents, was used on 160 families with celiac disease. A paediatric gastroenterologist classified manifestations of the disease at onset retrospectively. Results. Age or sex did not influence the outcome. Children diagnosed before the age of five scored higher than children diagnosed later. Children diagnosed more than eight years ago scored higher than more recently diagnosed children, and children who had the classical symptoms of the disease at onset scored higher than those who had atypical symptoms or were asymptomatic. The parents valuated their children’s quality of life as lower than the children did. Conclusion. Health-related quality of life in treated celiac children and adolescents was influenced by age at diagnosis, disease severity at onset, and years on gluten-free diet. The disagreement between child-parent valuations highlights the importance of letting the children themselves be heard about their perceived quality of life.

  17. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for ...

  18. Outcome of pediatric patients with acute lymphoblastic leukemia/lymphoblastic lymphoma with hypersensitivity to pegaspargase treated with PEGylated Erwinia asparaginase, pegcrisantaspase: A report from the Children's Oncology Group

    Science.gov (United States)

    Rau, Rachel E.; Dreyer, ZoAnn; Choi, Mi Rim; Liang, Wei; Skowronski, Roman; Allamneni, Krishna P.; Devidas, Meenakshi; Raetz, Elizabeth A.; Adamson, Peter C.; Blaney, Susan M.; Loh, Mignon L; Hunger, Stephen P.

    2018-01-01

    Background Erwinia asparaginase is a Food and Drug Administration approved agent for the treatment of acute lymphoblastic leukemia (ALL) for patients who develop hypersensitivity to Escherichia coli derived asparaginases. Erwinia asparaginase is efficacious, but has a short half-life, requiring six doses to replace one dose of the most commonly used first-line asparaginase, pegaspargase, a polyethylene glycol (PEG) conjugated E. coli asparaginase. Pegcristantaspase, a recombinant PEGylated Erwinia asparaginase with improved pharmacokinetics, was developed for patients with hypersensitivity to pegaspargase. Here, we report a series of patients treated on a pediatric phase 2 trial of pegcrisantaspase. Procedure Pediatric patients with ALL or lymphoblastic lymphoma and hypersensitivity to pegaspargase enrolled on Children's Oncology Group trial AALL1421 (Jazz 13-011) and received intravenous pegcrisantaspase. Serum asparaginase activity (SAA) was monitored before and after dosing; immunogenicity assays were performed for antiasparaginase and anti-PEG antibodies and complement activation was evaluated. Results Three of the four treated patients experienced hypersensitivity to pegcrisantaspase manifested as clinical hypersensitivity reactions or rapid clearance of SAA. Immunogenicity assays demonstrated the presence of anti-PEG immunoglobulin G antibodies in all three hypersensitive patients, indicating a PEG-mediated immune response. Conclusions This small series of patients, nonetheless, provides data, suggesting preexisting immunogenicity against the PEG moiety of pegaspargase and poses the question as to whether PEGylation may be an effective strategy to optimize Erwinia asparaginase administration. Further study of larger cohorts is needed to determine the incidence of preexisting antibodies against PEG-mediated hypersensitivity to pegaspargase. PMID:29090524

  19. A comparative study of occupancy and patient care quality in four different types of intensive care units in a children's hospital.

    Science.gov (United States)

    Smith, Thomas J

    2012-01-01

    This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.

  20. "HPV? Never heard of it!": a systematic review of girls' and parents' information needs, views and preferences about human papillomavirus vaccination.

    Science.gov (United States)

    Hendry, Maggie; Lewis, Ruth; Clements, Alison; Damery, Sarah; Wilkinson, Clare

    2013-10-25

    Two human papillomavirus vaccines were licenced in 2006/2007 for cervical cancer prevention. National vaccination programmes for schoolgirls were subsequently introduced in some European countries, North America and Australia. To understand factors influencing vaccine uptake and to inform the development of appropriate UK educational materials, we aimed to synthesise evidence of girls' and parents' information needs, views and preferences regarding HPV vaccination. Systematic review and mixed method synthesis of qualitative and survey data. Twelve electronic databases; bibliographies of included studies 1980 to August 2011. Two reviewers independently screened papers and appraised study quality. Studies were synthesised collaboratively using framework methods for qualitative data, and survey results integrated where they supported, contrasted or added to the themes identified. Twenty-eight qualitative studies and 44 surveys were included. Where vaccination was offered, uptake was high. Intention to decline was related to a preference for vaccinating later to avoid appearing to condone early sexual activity, concerns about vaccine safety and low perception of risk of HPV infection. Knowledge was poor and there were many misconceptions; participants tried to assess the potential benefits and harms of vaccination but struggled to interpret limited information about HPV in the context of existing knowledge about sexually transmitted infections and cancer. Conclusion Many girls and their parents have limited understanding to an extent that impinges on their ability to make informed choices about HPV vaccination and could impact on future uptake of cervical screening. This is a considerable challenge to those who design and provide information, but getting the messages right for this programme could help in developing patient information about other HPV related cancers. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Improving the care of children with advanced cancer by using an electronic patient-reported feedback intervention: results from the PediQUEST randomized controlled trial.

    Science.gov (United States)

    Wolfe, Joanne; Orellana, Liliana; Cook, E Francis; Ullrich, Christina; Kang, Tammy; Geyer, Jeffrey Russell; Feudtner, Chris; Weeks, Jane C; Dussel, Veronica

    2014-04-10

    This study aimed to determine whether feeding back patient-reported outcomes (PROs) to providers and families of children with advanced cancer improves symptom distress and health-related quality of life (HRQoL). This study was a parallel, multicentered pilot randomized controlled trial. At most once per week, children age ≥ 2 years old with advanced cancer or their parent completed the computer-based Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) survey consisting of age- and respondent-adapted versions of the Memorial Symptom Assessment Scale (MSAS), Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL4.0), and an overall Sickness question. In the intervention group (n = 51), oncologists and families received printed reports summarizing PROs; e-mails were sent to oncologists and subspecialists when predetermined scores were exceeded. No feedback was provided in the control group (n = 53). Primary outcomes included linear trends of MSAS, PedsQL4.0 total and subscale scores, and Sickness scores during 20 weeks of follow-up, along with child, parent, and provider satisfaction with PediQUEST feedback. Feedback did not significantly affect average MSAS, PedsQL4.0, or Sickness score trends. Post hoc subgroup analyses among children age ≥ 8 years who survived 20 weeks showed that feedback improved PedsQL4.0 emotional (+8.1; 95% CI, 1.8 to 14.4) and Sickness (-8.2; 95% CI, -14.2 to -2.2) scores. PediQUEST reports were valued by children, parents, and providers and contributed at least sometimes to physician initiation of a psychosocial consult (56%). Although routine feedback of PROs did not significantly affect the child's symptoms or HRQoL, changes were in expected directions and improvements observed in emotional HRQoL through exploratory analyses were encouraging. Importantly, children, parents, and providers value PRO feedback.

  2. Children Exploring the World of Minerals and Plankton

    DEFF Research Database (Denmark)

    Ricard, Lykke Margot

    2003-01-01

    is called Nausicaä just like the heroine in Homer?s Odyssey. Abstract: How do we as adults actually know whether the children are getting anything out of such learning activities at a sea centre or museum? In my opinion it is very important that the children feel welcome at a museum, and are not constantly...... child fingers on the fine china would cause a heart attack. Children are stimulated only if they are both seen and heard, otherwise a visit to a museum will have quite the opposite effect. I don?t have enough fingers to list the many bad and boring experiences I had at museums when I was a child...

  3. The alteration of gray matter volume in children with mental retardation: the differences between the patients presented with operation deficit predominantly and those presented with language deficit mainly

    International Nuclear Information System (INIS)

    Yuan Xinyu; Jiang Xuexiang; Jin Chunhua; Zhang Yuanchao; Bai Zhenhua; Yi Xiaoli; Xiao Jiangxi

    2012-01-01

    Objective: To detect the differences of grey matter volume between the patients with mental retardation (MR) presented clinically as operation deficit (OD) or as language deficit (LD) and the children with typical normal development using optimal VBM. The developmental connections between brain gray matter and language or operation skills were examined. Methods: Magnetic resonance imaging was obtained from 9 children with mental retardation presented as OD predominantly and 11 children with mental retardation presented as LD mainly, as well as the age-matched control group (11 and 14 normal children,respectively) on a 1.5 T scanner. Voxel-based morphometry analysis with an optimization of spatial segmentation and normalization procedures was applied to compare the volume of grey matter between the two groups (OD VS.control; LD VS.control). Statistically, the total and local gray matter volumes were compared between the two groups with t test. Results: The total gray matter volume of OD group was [(1.030 ± 0.078) × 10 6 mm 3 ]. Compared to that of controls [(0.984 ± 0.058) × 10 6 mm 3 ], it was increased significantly (t=-2.6, P<0.05). And the gray matter volume in the posterior cingulated gyrus, left superior prefrontal gyrus, left cuneus, left middle prefrontal gyrus and the body of left caudate nucleus showed significantly increased. Meanwhile, the total gray matter volume of the MR children presented as LD [(1.002 ± 0.068) × 10 6 mm 3 ] showed significantly increased(t=-3.0, P<0.05) compared with that of control group [(0.957 ±0.057) × 10 6 mm 3 ]. The gray matter volume in bilateral thalami, the left inferior temporal gyrus,the left inferior frontal gyrus, and the left cerebellum of the LD group was more than that of normal children. Conclusion: As revealed by VBM, there are differences in alterations of gray matter volume between MR children presented with OD and with LD relative to control. (authors)

  4. The effect of unsuccessful retrieval on children's subsequent learning.

    Science.gov (United States)

    Carneiro, Paula; Lapa, Ana; Finn, Bridgid

    2018-02-01

    It is well known that successful retrieval enhances subsequent adults' learning by promoting long-term retention. Recent research has also found benefits from unsuccessful retrieval, but the evidence is not as clear-cut when the participants are children. In this study, we employed a methodology based on guessing-the weak associate paradigm-to test whether children can learn from generated errors or whether errors are harmful for learning. We tested second- and third-grade children in Experiment 1 and tested preschool and kindergarten children in Experiment 2. With slight differences in the method, in both experiments children heard the experimenter saying one word (cue) and were asked to guess an associate word (guess condition) or to listen to the correspondent target-associated word (study condition), followed by corrective feedback in both conditions. At the end of the guessing phase, the children undertook a cued-recall task in which they were presented with each cue and were asked to say the corrected target. Together, the results showed that older children-those in kindergarten and early elementary school-benefited from unsuccessful retrieval. Older children showed more correct responses and fewer errors in the guess condition. In contrast, preschoolers produced similar levels of correct and error responses in the two conditions. In conclusion, generating errors seems to be beneficial for future learning of children older than 5years. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Using electronic storybooks to support word learning in children with severe language impairments.

    Science.gov (United States)

    Smeets, Daisy J H; van Dijken, Marianne J; Bus, Adriana G

    2014-01-01

    Novel word learning is reported to be problematic for children with severe language impairments (SLI). In this study, we tested electronic storybooks as a tool to support vocabulary acquisition in SLI children. In Experiment 1, 29 kindergarten SLI children heard four e-books each four times: (a) two stories were presented as video books with motion pictures, music, and sounds, and (b) two stories included only static illustrations without music or sounds. Two other stories served as the control condition. Both static and video books were effective in increasing knowledge of unknown words, but static books were most effective. Experiment 2 was designed to examine which elements in video books interfere with word learning: video images or music or sounds. A total of 23 kindergarten SLI children heard 8 storybooks each four times: (a) two static stories without music or sounds, (b) two static stories with music or sounds, (c) two video stories without music or sounds, and (d) two video books with music or sounds. Video images and static illustrations were equally effective, but the presence of music or sounds moderated word learning. In children with severe SLI, background music interfered with learning. Problems with speech perception in noisy conditions may be an underlying factor of SLI and should be considered in selecting teaching aids and learning environments. © Hammill Institute on Disabilities 2012.

  6. A Survey on Awareness about the Role of Anesthesia and Anesthesiologists among the Patients Undergoing Surgeries in a Tertiary Care Teaching Women and Children Hospital.

    Science.gov (United States)

    Marulasiddappa, Vinay; Nethra, H N

    2017-01-01

    Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital. A prospective cross-sectional survey with a sample size of 100 patients. Patients scheduled to undergo elective surgery in the age group of 18-65 years with the American Society of Anesthesiologists (ASA) Grades 1 and 2, who are willing to participate and given written informed consent. Patients whose age 0.05) between those with previous surgery and those without previous surgery regarding their knowledge of anesthesiology and anesthesiologist. Ninety percent did not know the complications, types of anesthesia and 44% did not know that anesthesiologist is a doctor. Most of the participants were not aware of the role of anesthesia and anesthesiologists inside and outside OT. Although this could be attributed to their lower level of education, the fraternity of anesthesiologists has to educate patients and surgeons about the role of anesthesia.

  7. Evaluation of radioprotection conditions and patient dose in thorax exams carried out in a public children's hospital in Belo Horizonte, MG, Brazil

    International Nuclear Information System (INIS)

    Lacerda, Marco A.S.; Silva, Teogenes A. da; Guedes, Elton C.; Khoury, Helen J.; Azevedo, Ana C.P.

    2005-01-01

    We conducted a survey of the conditions of radiation protection, radiographic techniques, dose and risk for pediatric patients undergoing chest X-rays exams in a children's hospital in Belo Horizonte-MG, Brazil. From a total of 125 chest exams (projections AP and PA) were noted the patient data (gender, weight, and age) and parameters of radiographic technique (kV, mAs and distance focus-skin). I was also evaluated the working procedures and the conditions of radiation protection. The values of input air kerma (K a,e ) and effective dose (E) were determined using the DoseCal software developed by Radiological Protection Center of Saint Georges's Hospital in London. With respect to the procedures and conditions for radiation protection, many aspects of Portaria 453 are not considered. The use of radiographic techniques with high values of mAs and low voltage values are not according with the quality criteria adopted by the European Community (EC). The values of Ka for patients aged 1 to 5 years varied between 51 μGy and 64 μGy, below the reference levels proposed by the EC. For patients over 5 years old, the values of Ka were substantially higher than those for other patients. The results allow to conclude that there is a need for optimization of the procedures adopted in order to reduce the dose and the risk to patients

  8. Comparability of the Patient-Reported Outcomes Measurement Information System Pediatric short form symptom measures across culture: examination between Chinese and American children with cancer.

    Science.gov (United States)

    Liu, Yanyan; Yuan, Changrong; Wang, Jichuan; Brown, Jeanne Geiger; Zhou, Fen; Zhao, Xiufang; Shen, Min; Hinds, Pamela S

    2016-10-01

    Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric forms measure symptoms and function of pediatric patients experiencing chronic disease by using the same measures. Comparability is one of the most important purposes of the PROMIS initiative. This study aimed to test the factorial structures of four symptom measures (i.e., Anxiety, Depression, Fatigue, and Pain Interference) in the original English and the Chinese versions and examine the measurement invariance of the measures across two cultures. Four PROMIS Pediatric measures were used to assess symptoms, respectively, in Chinese (n = 232) and American (n = 200) children and adolescents (8-17 years old) in treatment for cancer or in survivorship. The categorical confirmatory factor analysis (CCFA) model was used to examine factorial structures, and multigroup CCFA was applied to test measurement invariance of these measures between the Chinese and American samples. The CCFA models of the four PROMIS Pediatric symptom measures fit the data well for both the Chinese and American children and adolescents. Minor partial measurement invariance was identified. Factor means and factor variances of the four PROMIS measures were not significantly different between the two populations. Our results provide evidence that the four PROMIS Pediatric symptom measures have valid factorial structures and a statistical property of measurement invariance across American and Chinese children and adolescents with cancer. This means that the items of these measures were interpreted in a conceptually similar manner by two groups. They could be readily used for meaningful cross-cultural comparisons involving pediatric oncology patients in these two countries.

  9. An investigation of vancomycin minimum inhibitory concentration creep among methicillin-resistant Staphylococcus aureus strains isolated from pediatric patients and healthy children in Northern Taiwan.

    Science.gov (United States)

    Chang, Chia-Ning; Lo, Wen-Tsung; Chan, Ming-Chin; Yu, Ching-Mei; Wang, Chih-Chien

    2017-06-01

    The phenomenon of vancomycin minimum inhibitory concentration (MIC) creep is an increasingly serious problem in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. In this study, we investigated the vancomycin and daptomycin MIC values of MRSA strains isolated from pediatric patients and MRSA colonized healthy children. Then, we assessed whether there was evidence of clonal dissemination for strains with an MIC to vancomycin of ≥ 1.5 μg/mL. We collected clinical MRSA isolates from pediatric patients and from healthy children colonized with MRSA during 2008-2012 at a tertiary medical center in northern Taiwan and obtained vancomycin and daptomycin MIC values using the Etest method. Pulse-field gel electrophoresis (PFGE) and staphylococcal cassette chromosome (SCCmec) typing were used to assess clonal dissemination for strains with an MIC to vancomycin of ≥ 1.5 μg/mL. A total 195 MRSA strains were included in this study; 87 were isolated patients with a clinical MRSA infection, and the other 108 strains from nasally colonized healthy children. Vancomycin MIC≥1.5 μg/mL was seen in more clinical isolates (60/87, 69%) than colonized isolates (32/108, 29.6%), p < 0.001. The PFGE typing of both strains revealed multiple pulsotypes. Vancomycin MIC creeps existed in both clinical MRSA isolates and colonized MRSA strains. Great diversity of PFGE typing was in both strains collected. There was no association between the clinical and colonized MRSA isolates with vancomycin MIC creep. Copyright © 2016. Published by Elsevier B.V.

  10. Flash visual evoked potentials in patients with periventricular leucomalacia in children less than 1 year of age

    Directory of Open Access Journals (Sweden)

    Jitendra Jethani

    2013-01-01

    Full Text Available Background and Aim: Children with periventricular leucomalacia (PVL are known to have visual impairment of various forms starting from reduced vision, field defects, congnitive problems, and problems with hand eye coordination. There is very scant data/literature on the visual evoked potentials (VEPs at an early age in children with PVL. We did a study to evaluate the flash visual evoked potentials (fVEPs in children with PVL less than 1 year of age. Materials and Methods: A total of nine children diagnosed as having PVL on magnetic resonance imaging were included in the study. The mean age was 9.7μ 3.5 months. All children underwent handheld fVEPs under sedation at two different flash frequencies 1.4 and 8 Hz. Results: The mean latency of N1 and P1 on stimulation with 1.4 Hz was 47.9μ 15.2 and 77.7μ 26.0 ms, respectively. However, on stimulation with 8 Hz the mean latency of N1 and P1 was 189.8μ 25.6 and 238.4μ 33.6 ms, respectively. The mean amplitude with 1.4 Hz and 8 stimulation frequency was 5.6μ 4.5 and 5.59μ 3 mV, respectively. Conclusion: We have found for the first time that there is a change in the latency and the delay occurs at 8 Hz frequency but not at 1.4 Hz. We also conclude that amplitudes by fVEPs may be normal even in presence of periventricular changes. The amplitudes of fVEPs are not reliable in children with PVL.

  11. A review of the efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in children and adult patients with common comorbidities

    Directory of Open Access Journals (Sweden)

    Clemow DB

    2017-02-01

    Full Text Available David B Clemow,1 Chris Bushe,2 Michele Mancini,3 Michael H Ossipov,4 Himanshu Upadhyaya1 1Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly, Windlesham, UK; 3Eli Lilly Italia S.p.A., Sesto Fiorentino, Italy; 4inVentiv Health Clinical, LLC, Blue Bell, PA, USA Abstract: Attention-deficit hyperactivity disorder (ADHD is a common neuropsychiatric disorder that is often diagnosed during childhood, but has also increasingly been recognized to occur in adults. Importantly, up to 52% of children (including adolescents and 87% of adults with ADHD also have a comorbid psychiatric disorder. The presence of a comorbid disorder has the potential to impact diagnosis and could affect treatment outcomes. Atomoxetine is a nonstimulant treatment for ADHD. Despite numerous published studies regarding efficacy of atomoxetine in the treatment of ADHD in patients with comorbid disorders, there is limited information about the impact of individual common comorbid disorders on the efficacy of atomoxetine for ADHD, especially with regard to adults. Moreover, a cumulative review and assessment of these studies has not been conducted. For this reason, we performed a literature review to find, identify, and cumulatively review clinical studies that examined the efficacy of atomoxetine in the treatment of patients with ADHD and comorbid psychiatric disorders. We found a total of 50 clinical studies (37 in children; 13 in adults that examined the efficacy of atomoxetine in patients with ADHD and a comorbid disorder. The comorbidities that were studied in children or in adults included anxiety, depression, and substance use disorder. Overall, the presence of comorbidity did not adversely impact the efficacy of atomoxetine in treatment of ADHD symptoms in both patient populations. In the studies identified and assessed in this review, atomoxetine did not appear to exacerbate any of the comorbid conditions and could, therefore, be an important therapy choice for the

  12. Who are the children and adolescent patients of a national referral service of eating disorders in Brazil?: a cross-sectional study of a clinical sample

    Directory of Open Access Journals (Sweden)

    Vanessa Dentzien Pinzon

    2013-01-01

    Full Text Available Objectives: To investigate the sociodemographic and clinical profile of patients receiving treatment at a specialized service for children and adolescents with eating disorders (ED in São Paulo, Brazil, and to compare data with the relevant literature. Methods: This cross-sectional study assessed male and female patients with ED up to 18 years of age. All data were collected upon admission. Results: A total of 100 subjects were assessed. Mean age was 15.41±0.18 years, and mean age at ED onset was 13.5±0.19 years. Mean disease duration was 21.06 ±1.67 months. Of the total sample, 82% of the patients were female, 84% were Caucasian, 64% came from A and B economic tiers. Moreover, in 60% ED started at 14 years of age or less, and 74% had psychiatric comorbidities. Anorexia nervosa was the most prevalent diagnosis (43%. Hospitalized patients had lower body mass index, longer ED duration, and more severe scores on the Children's Global Assessment Scale than outpatients (p < 0.05. Conclusions: Our young Brazilian patients with ED present epidemiological and symptomatic characteristics very similar to those found in the scientific literature, including a high prevalence of psychiatric comorbidities. The higher frequency of full syndrome ED, the predominance of cases with an early onset, the delay in beginning specialized treatment, and the more severe state of inpatients provide grounds for concern because these factors differ from what has been reported in reference studies and indicate greater ED severity.

  13. Lipoid pneumonia in children following aspiration of mineral oil used in the treatment of constipation: high-resolution CT findings in 17 patients

    International Nuclear Information System (INIS)

    Zanetti, Glaucia; Marchiori, Edson; Gasparetto, Taisa D.; Escuissato, Dante L.; Soares Souza, Arthur

    2007-01-01

    Exogenous lipoid pneumonia is a rare disorder caused by aspiration of mineral, vegetable and animal oils. High-resolution CT findings of lipoid pneumonia in children taking mineral oil for constipation have been rarely reported. To evaluate the high-resolution CT findings in 17 children with exogenous lipoid pneumonia following aspiration of mineral oil. The study included nine boys and eight girls, with ages ranging from 2 months to 9 years. All patients underwent high-resolution CT and the images were reviewed by two radiologists who reached decisions by consensus. The inclusion criteria were an abnormal radiograph, history of taking mineral oil and the presence of intrapulmonary lipids proved by bronchoalveolar lavage or open lung biopsy. The most common symptoms were cough (n = 13), mild fever (n = 11), and progressive dyspnea (n = 9). The main CT findings were air-space consolidations (100%), usually with areas of fatty attenuation (70.6%), areas of ground-glass attenuation (52.9%), and a crazy-paving pattern (17.6%), predominating bilaterally in the posterior and lower regions of the lungs. The high-resolution CT features in children with exogenous lipoid pneumonia are air-space consolidations and ground-glass attenuation, occasionally with a crazy-paving pattern, distributed bilaterally in the posterior and lower zones of the lungs. (orig.)

  14. Lipoid pneumonia in children following aspiration of mineral oil used in the treatment of constipation: high-resolution CT findings in 17 patients

    Energy Technology Data Exchange (ETDEWEB)

    Zanetti, Glaucia [University of Rio de Janeiro, Department of Radiology, Rio de Janeiro (Brazil); Marchiori, Edson [University of Rio de Janeiro, Department of Radiology, University Federal Fluminense, Rio de Janeiro (Brazil); Gasparetto, Taisa D. [University Federal Fluminense, Department of Radiology, Rio de Janeiro (Brazil); Escuissato, Dante L. [University of Parana, Department of Radiology, Curitiba (Brazil); Soares Souza, Arthur [School of Medicine of Sao Jose do Rio Preto (ASSJ), Department of Radiology, Sao Jose do Rio Preto (Brazil)

    2007-11-15

    Exogenous lipoid pneumonia is a rare disorder caused by aspiration of mineral, vegetable and animal oils. High-resolution CT findings of lipoid pneumonia in children taking mineral oil for constipation have been rarely reported. To evaluate the high-resolution CT findings in 17 children with exogenous lipoid pneumonia following aspiration of mineral oil. The study included nine boys and eight girls, with ages ranging from 2 months to 9 years. All patients underwent high-resolution CT and the images were reviewed by two radiologists who reached decisions by consensus. The inclusion criteria were an abnormal radiograph, history of taking mineral oil and the presence of intrapulmonary lipids proved by bronchoalveolar lavage or open lung biopsy. The most common symptoms were cough (n = 13), mild fever (n = 11), and progressive dyspnea (n = 9). The main CT findings were air-space consolidations (100%), usually with areas of fatty attenuation (70.6%), areas of ground-glass attenuation (52.9%), and a crazy-paving pattern (17.6%), predominating bilaterally in the posterior and lower regions of the lungs. The high-resolution CT features in children with exogenous lipoid pneumonia are air-space consolidations and ground-glass attenuation, occasionally with a crazy-paving pattern, distributed bilaterally in the posterior and lower zones of the lungs. (orig.)

  15. [Evaluation of the effectiveness of patient-controlled analgesia in children with sickle cell anemia from the perspective of healthcare professionals and parents].

    Science.gov (United States)

    Turaç, Ayşegül; Rumeli Atıcı, Şebnem

    2016-07-01

    This study evaluated the efficacy of patient-controlled analgesia (PCA) used by children with sickle cell anemia (SCA) based on the attitudes of parents and healthcare professionals. A total of 86 individuals were involved in the study: 54 parents of children with SCA who were receiving treatment and 32 healthcare providers (doctors, nurses). To evaluate the effectiveness of the PCA method, a questionnaire was prepared to determine the level of knowledge of the participants about the PCA method and their perception of its advantages and disadvantages. According to 65.6% (n=21) of the healthcare providers, PCA should be used during acute phase of pain. The great majority of the participants (93%; n=80) thought that pain was effectively controlled both during the day and at night. PCA reduced the fear of unavailability of analgesic drugs in 83.3% (n=45) of parents and in 87.5% (n=28) of healthcare providers. More parents (37%) reported a reduction in the fear of return of pain than healthcare providers (9.4%) (paddiction. Resolving machine alarms (48%; n=26) and the length of time required to refill the machine (48%; n=26) were reported as disadvantages of PCA method. In this study, parents and healthcare professionals found PCA to be effective in relieving pain in children with SCA; however, fears and biased knowledge of users about the analgesic drug are thought to inhibit reaching sufficient dosage. Educational courses for users about PCA and the drugs used may increase the effectiveness of PCA method.

  16. Prevalence and risk factors for renal scars in children with febrile UTI and/or VUR: a cross-sectional observational study of 565 consecutive patients.

    Science.gov (United States)

    Snodgrass, Warren T; Shah, Anjana; Yang, Mary; Kwon, Jeannie; Villanueva, Carlos; Traylor, Janelle; Pritzker, Karen; Nakonezny, Paul A; Haley, Robert W; Bush, Nicol Corbin

    2013-12-01

    To determine prevalence and risk factors for renal scar in children referred for urologic assessment of febrile UTI and/or VUR. Pre-determined risk factors for renal scar were prospectively recorded in consecutive patients referred for UTI/VUR. Age, gender, VUR grade, and reported number of febrile and non-febrile UTIs were analyzed with logistic regression to determine risk for focal cortical defects on non-acute DMSA. Of 565 consecutive children, 24 (4%) had congenital renal dysplasia and 84 (15.5%) had focal defect(s). VUR, especially grades IV-V, recurrent febrile UTI, and older age increased risk. For any age child with the same number of UTIs, VUR increased odds of renal defect 5.4-fold (OR = 5.4, 95% CI = 2.7-10.6, AUC = 0.759). Focal DMSA defects were present in 15.5% of 565 consecutive children referred for febrile UTI and/or VUR; 4% had presumed congenital reflux nephropathy without cortical defect. All VUR grades increased risk for these defects, as did recurrent febrile UTIs and older age. However, 43% with grades IV-V VUR and 76% with recurrent UTI had normal DMSA. Published by Elsevier Ltd.

  17. PELICAN: Content Evaluation of Patient-Centered Care for Children With Asthma Based on an Online Tool

    NARCIS (Netherlands)

    Bragt, S. van; Bemt, L. van den; Cretier, R.; Weel, C. van; Merkus, P.; Schermer, T.

    2016-01-01

    Background: We assessed the content of an intervention which integrates individual goals in outpatient clinic asthma management (based on self management principles) of children 6–12 years of age. Methods: This is a content evaluation study and was part of a randomized controlled multicenter trial

  18. PELICAN: Content evaluation of patient-centered care for children with asthma based on an online tool

    NARCIS (Netherlands)

    Bragt, S. van; Bemt, L. van den; Cretier, R.; Weel, C. van; Merkus, P.J.; Schermer, T.R.

    2016-01-01

    BACKGROUND: We assessed the content of an intervention which integrates individual goals in outpatient clinic asthma management (based on self management principles) of children 6-12 years of age. METHODS: This is a content evaluation study and was part of a randomized controlled multicenter trial

  19. Ownership and use of mobile phones among health workers, caregivers of sick children and adult patients in Kenya: cross-sectional national survey.

    Science.gov (United States)

    Zurovac, Dejan; Otieno, Gabriel; Kigen, Samuel; Mbithi, Agneta M; Muturi, Alex; Snow, Robert W; Nyandigisi, Andrew

    2013-05-14

    The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers' practices, patients' adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed. In 2012, a national, cross-sectional, cluster sample survey was undertaken at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed. The main outcomes were personal ownership of mobile phones and use of SMS among phone owners. The predictors analysis examined factors influencing phone ownership and SMS use. The analysis included 219 health workers and 1,177 patients' respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients' respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. The respondents who were male, more educated, literate and living in urban area were significantly more likely to own the phone and use SMS. The youngest respondents were less likely to own phones, however when the phones were owned, younger age groups were more likely to use SMS. Respondents living in wealthier areas were more likely to own phones; however when phones are owned no significant association between the poverty and SMS use was observed. Mobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector. Among patients they serve the coverage in phone ownership and SMS use is lower and disparities exist with respect to gender, age, education

  20. Accuracy of cystatin C for the detection of abnormal renal function in children undergoing chemotherapy for malignancy: a systematic review using individual patient data.

    Science.gov (United States)

    Whiting, Penny; Birnie, Kate; Sterne, Jonathan A C; Jameson, Catherine; Skinner, Rod; Phillips, Bob

    2018-05-01

    We conducted a systematic review and individual patient data (IPD) meta-analysis to examine the utility of cystatin C for evaluation of glomerular function in children with cancer. Eligible studies evaluated the accuracy of cystatin C for detecting poor renal function in children undergoing chemotherapy. Study quality was assessed using QUADAS-2. Authors of four studies shared IPD. We calculated the correlation between log cystatin C and GFR stratified by study and measure of cystatin C. We dichotomized the reference standard at GFR 80 ml/min/1.73m 2 and stratified cystatin C at 1 mg/l, to calculate sensitivity and specificity in each study and according to age group (0-4, 5-12, and ≥ 13 years). In sensitivity analyses, we investigated different GFR and cystatin C cut points. We used logistic regression to estimate the association of impaired renal function with log cystatin C and quantified diagnostic accuracy using the area under the ROC curve (AUC). Six studies, which used different test and reference standard thresholds, suggested that cystatin C has the potential to monitor renal function in children undergoing chemotherapy for malignancy. IPD data (504 samples, 209 children) showed that cystatin C has poor sensitivity (63%) and moderate specificity (89%), although use of a GFR cut point of C has better diagnostic accuracy than creatinine as a test for glomerular dysfunction in young people undergoing treatment for cancer. Diagnostic accuracy is not sufficient for it to replace current reference standards for predicting clinically relevant impairments that may alter dosing of important nephrotoxic agents.

  1. Lichens of sub-Antarctic Heard Island

    NARCIS (Netherlands)

    Øvstedal, D.O.; Gremmen, N.J.M.

    2006-01-01

    A tota1 of 71 lichen species in 42 genera are listed for the island. Three species are described as new: “Arctomia” latispora Øvstedal, Fellhaneropsis subantarctica Øvstedal and Stereocaulon heardii Øvstedal. More than half of the species are restricted to the southern cold zone (Antarctica and

  2. The shots heard 'round the world.

    Science.gov (United States)

    Marshall, E

    2000-07-28

    The massacre at Columbine High School last year unleashed a torrent of fresh concern over the threat that violence poses to society. It also energized a government research effort to understand and prevent violence. Ironically, this flurry of activity comes at a time when youth violence, as reflected in crime statistics, is in decline.

  3. Assertiveness: making yourself heard in district nursing.

    Science.gov (United States)

    Lawton, Sally; Stewart, Fiona

    2005-06-01

    Being assertive is not the same as being aggressive. Assertiveness is a tool for expressing ourselves confidently, and a way of saying 'yes' and 'no' in an appropriate way. This article explores issues concerned with assertiveness in district nurse settings. It outlines helpful techniques to develop assertiveness, such as the broken record, fogging, negative assertion and negative inquiry.

  4. Digital Media Creates Youth Voices Heard

    Directory of Open Access Journals (Sweden)

    Jeff Sallee

    2014-06-01

    Full Text Available Oklahoma 4-H clubs and military service centers partnered with the Adobe Youth Voices (AYV program to give youth opportunities to raise their voices through digital media. This program reached out to underrepresented youth and gave them the tools and technology to effectively express themselves. The intent of this project was for 4-H members to create videos to educate, help and raise awareness in their communities of topics that were important to the youth. These experiences help youth gain knowledge towards helping others solve farm, home, and community problems. Participating youth selected issues that were important to them and created a short video, educating others and sharing their convictions on the topics of horse therapy, citizenship, bullying, and distracted driving.

  5. Management of chronic immune thrombocytopenia in children and adolescents: lessons from an Austrian national cross-sectional study of 81 patients.

    Science.gov (United States)

    Sipurzynski, J; Fahrner, B; Kerbl, R; Crazzolara, R; Jones, N; Ebetsberger, G; Jauk, B; Strenger, V; Wohlmuther, B; Schwinger, W; Lackner, H; Urban, C; Holter, W; Minkov, M; Kager, L; Benesch, M; Seidel, M G

    2016-04-01

    Chronic immune thrombocytopenia (cITP) is often associated with an underlying predisposition towards autoimmunity, recognition of which is relevant to guide treatment. International recommendations on diagnostic steps and therapeutic measures of cITP in childhood exist. However, due to the low prevalence (1-2/100,000) and a variation of availability of immunological and hematological tests and treatments across pediatric units, we postulated that these guidelines are not uniformly adhered to and that immune dysregulation syndromes remained undiscovered. To delineate the current management of children and adolescents with cITP in Austria, we performed a nationwide cross-sectional study. Between 2011 and 2014, 81 children with cITP were seen at seven centers (median age 8.75 years; range 1-17; female:male ratio 47:34) at 641 visits during 180 patient years after diagnosis of cITP (>12 months ITP duration). Additional diagnoses were noted, most frequently immune or autoimmune disorders, hematologic diseases, or infections (in 37.3%, including Evans syndrome, autoimmune lymphoproliferative syndrome, systemic lupus erythematosus, and Fanconi anemia), or other symptoms like bi- or pancytopenia (n=9), lymphoproliferation or granulomatous inflammation (n = 3). Both decision to treat as well as choice of treatment varied: smaller centers tended to observe more frequently, larger centers applied a pattern of treatment modalities that appeared to depend less on bleeding tendency than on center policy. More than 50% of therapeutic interventions occurred in bleedings scores ≤2 (of 5), suggesting a strong psychosocial intention to treat. Platelet increment upon 479 therapeutic interventions of eight types was evaluated, with multiple treatment approaches being pursued sequentially in refractory patients. These data confirm the hypothesis of heterogeneous diagnostic and therapeutic management of cITP in Austrian children and corroborate the need for (1) a precise panel of

  6. One-sample determination of glomerular filtration rate (GFR) in children. An evaluation based on 75 consecutive patients

    DEFF Research Database (Denmark)

    Henriksen, Ulrik Lütken; Kanstrup, Inge-Lis; Henriksen, Jens Henrik Sahl

    2013-01-01

    the plasma radioactivity curve. The one-sample clearance was determined from a single plasma sample collected at 60, 90 or 120 min after injection according to the one-pool method. Results. The overall accuracy of one-sample clearance was excellent with mean numeric difference to the reference value of 0.......7-1.7 mL/min. In 64 children, the one-sample clearance was within ± 4 mL/min of the multiple-sample value. However, in 11 children the numeric difference exceeded 4 mL/min (4.4-19.5). Analysis of age, body size, distribution volume, indicator retention time, clearance level, curve fitting, and sampling...... fraction (15%) larger discrepancies are found. If an accurate clearance value is essential a multiple-sample determination should be performed....

  7. Improving postoperative tonsillectomy pain management in children--a double blinded randomised control trial of a patient analgesia information sheet.

    Science.gov (United States)

    Bailey, Lucas; Sun, Jing; Courtney, Mark; Murphy, Paul

    2015-05-01

    To evaluate paediatric post-tonsillectomy pain management using oxycodone when a specific analgesia information sheet is included with standard postoperative information. Oxycodone information sheets were randomly allocated to half the study children's post-tonsillectomy information pack. The trial was double-blinded to the surgeon, anaesthetist, nursing and administrative staff. Parents and children completed the pain assessment on day 3, 5 and 7. On day 10 the parents completed a questionnaire. A postoperative analgesia information sheet provides for higher satisfaction and knowledge for parents using oxycodone (psheet, most significantly at day 3 and 7 post operatively (psheets are useful in education and use of postoperative analgesia. The primary objective to explore the efficacy of the information sheet has proved to be successful in this setting. Given risks of opioid analgesia, it is recommended that postoperative information sheets be given to all parents, to provide for improved analgesia control and safe management of children in the postoperative period. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Urological results after fetal myelomeningocele repair in pre-MOMS trial patients at the Children's Hospital of Philadelphia.

    Science.gov (United States)

    Carr, Michael C

    2015-01-01

    Myelomeningocele patients deal with multiple medical issues, including lower extremity neurological deficits, bowel and bladder incontinence and the sequelae of hydrocephalus secondary to a Chiari II malformation. In utero intervention holds the promise of reversing some of the sequelae and improving outcome. Between 1998 and 2003 (preceding the formal Management of Myelomeningocele Study, MOMS), an initial group of 58 patients underwent in utero repair of their myelomeningocele between 21 and 25 weeks' gestation. Long-term (5-year) follow-up has occurred in this cohort of patients. Previous reports have documented decreased incidence of ventriculoperitoneal shunting and neuromotor functioning, showing improved outcomes compared with historical controls. Overall, 4 fetal deaths occurred, while the majority of patients returned for follow-up for up to 5 years after closure. Phone follow-up has also been conducted for those who could not return. To date, 10 patients (18.5%) have successfully toilet-trained, while 2 patients have bowel continence and 1 has bladder continence but requires enemas; 2 patients who successfully toilet-trained developed spinal dermoid cysts requiring surgical resection. Historically, in utero repair of myelomeningocele patients yields a greater percentage of patients who have achieved continence compared with those undergoing postnatal repair. The MOMS trial will compare contemporary urological outcomes of those patients undergoing either prenatal or postnatal repair in a randomized fashion. The results of this trial showed a decreased need for ventriculoperitoneal shunting in those patients who underwent in utero repair as well as an improvement in lower extremity function. © 2014 S. Karger AG, Basel.

  9. Achieving social justice for children: How can children's rights thinking make a difference?

    Science.gov (United States)

    Smith, Anne B

    2016-01-01

    This article draws on themes from the author's book, Children’s Rights: Toward Social Justice , that emerge from surveying children’s rights issues in different childhood contexts; the family, education, child protection, and health services. The author has selected five examples of application of children’s rights to a policy area and identified the implications for policy and practice. There are four core rights that cut across all children’s rights issues that are mentioned before discussing specific areas. First, children, regardless of race, sex, language, religion, disability, or class, are entitled to rights. In other words, all children should enjoy their rights and should not be discriminated against. Second, “the best interests of the child” should be “a primary consideration” in actions or decisions concerning children. Third, children have the right to survival and development. And fourth, children have the right to be consulted and have their views heard in matters that affect them. PsycINFO Database Record (c) 2016 APA, all rights reserved

  10. Preoperative bowel preparation in children: Polyethylene glycol ...

    African Journals Online (AJOL)

    Preoperative bowel preparation in children: Polyethylene glycol versus normal saline. ... In children, (is this standard of care?: this method is mostly followed) this is usually ... Patients and Methods: Thirty patients, admitted in the Department of ...

  11. Use of fat mass and fat free mass standard deviation scores obtained using simple measurement methods in healthy children and patients: comparison with the reference 4-component model.

    Science.gov (United States)

    Atherton, Rachel R; Williams, Jane E; Wells, Jonathan C K; Fewtrell, Mary S

    2013-01-01

    Clinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data. (1) To compare fat mass (FM) and fat free mass (FFM) standard deviation scores (SDS) generated using new body composition reference data and obtained using simple measurement methods in healthy children and patients with those obtained using the reference 4-component (4-C) model; (2) To determine the extent to which scores from simple methods agree with those from the 4-C model in identification of abnormal body composition. FM SDS were calculated for 4-C model, dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy), BMI and skinfold thicknesses (SFT); and FFM SDS for 4CM, DXA and bioelectrical impedance analysis (BIA; height(2)/Z)) in 927 subjects aged 3.8-22.0 y (211 healthy, 716 patients). DXA was the most accurate method for both FM and FFM SDS in healthy subjects and patients (mean bias (limits of agreement) FM SDS 0.03 (± 0.62); FFM SDS -0.04 (± 0.72)), and provided best agreement with the 4-C model in identifying abnormal BC (SDS ≤-2 or ≥ 2). BMI and SFTs were reasonable predictors of abnormal FM SDS, but poor in providing an absolute value. BIA was comparable to DXA for FFM SDS and in identifying abnormal subjects. DXA may be used both for research and clinically to determine FM and FFM SDS. BIA may be used to assess FFM SDS in place of DXA. BMI and SFTs can be used to measure adiposity for groups but not individuals. The performance of simpler techniques in monitoring longitudinal BC changes requires investigation. Ultimately, the most appropriate method should be determined by its predictive value for clinical outcome.

  12. Use of fat mass and fat free mass standard deviation scores obtained using simple measurement methods in healthy children and patients: comparison with the reference 4-component model.

    Directory of Open Access Journals (Sweden)

    Rachel R Atherton

    Full Text Available BACKGROUND: Clinical application of body composition (BC measurements for individual children has been limited by lack of appropriate reference data. OBJECTIVES: (1 To compare fat mass (FM and fat free mass (FFM standard deviation scores (SDS generated using new body composition reference data and obtained using simple measurement methods in healthy children and patients with those obtained using the reference 4-component (4-C model; (2 To determine the extent to which scores from simple methods agree with those from the 4-C model in identification of abnormal body composition. DESIGN: FM SDS were calculated for 4-C model, dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy, BMI and skinfold thicknesses (SFT; and FFM SDS for 4CM, DXA and bioelectrical impedance analysis (BIA; height(2/Z in 927 subjects aged 3.8-22.0 y (211 healthy, 716 patients. RESULTS: DXA was the most accurate method for both FM and FFM SDS in healthy subjects and patients (mean bias (limits of agreement FM SDS 0.03 (± 0.62; FFM SDS -0.04 (± 0.72, and provided best agreement with the 4-C model in identifying abnormal BC (SDS ≤-2 or ≥ 2. BMI and SFTs were reasonable predictors of abnormal FM SDS, but poor in providing an absolute value. BIA was comparable to DXA for FFM SDS and in identifying abnormal subjects. CONCLUSIONS: DXA may be used both for research and clinically to determine FM and FFM SDS. BIA may be used to assess FFM SDS in place of DXA. BMI and SFTs can be used to measure adiposity for groups but not individuals. The performance of simpler techniques in monitoring longitudinal BC changes requires investigation. Ultimately, the most appropriate method should be determined by its predictive value for clinical outcome.

  13. Project Baiterek: A Patient Access Program to Improve Clinical Outcomes and Quality of Life in Children with Type 1 Diabetes in Kazakhstan.

    Science.gov (United States)

    Muratalina, Aigul; Smith-Palmer, Jayne; Nurbekova, Akmaral; Abduakhassova, Gulmira; Zhubandykova, Leila; Roze, Stéphane; Karamalis, Manolis; Shamshatova, Gulzhakhan; Demessinov, Adi; D'Agostino, Nicola Dunne; Lynch, Peter; Yedigarova, Larisa; Klots, Motty; Valentine, William; Welsh, John; Kaufman, Francine

    2015-09-01

    Diabetes is a key driver in the rise of noncommunicable diseases globally. It causes expensive and burdensome short- and long-term complications, with both an economic and social impact. In many countries, however, access to care and disease management in type 1 diabetes is suboptimal, increasing the risk for complications. In 2011, Project Baiterek was initiated as a collaborative effort between the Kazakhstan Ministry of Health, industry (Medtronic Plc), local physicians, and the Diabetes Association of the Republic of Kazakhstan to enhance patient access to continuous subcutaneous insulin infusion (CSII) therapy. It was the first countrywide project to provide equity and universal access to insulin pump therapy among children with type 1 diabetes, increasing pump use from zero to two-thirds of this population in less than 3 years. The project also involved instigating longitudinal data collection, and long-term clinical outcomes continue to be monitored. Here, we provide an overview of the clinical, quality-of-life, and economic outcomes to date associated with providing CSII therapy to children with type 1 diabetes in Kazakhstan. Initial clinical data show that CSII therapy improved clinical outcomes and quality of life for patients entered into the program and that CSII therapy was cost-effective relative to multiple daily injection therapy. The positive outcomes of Project Baiterek provide a template for similar patient access programs in other settings, and its framework could be adapted to initiatives to change health care infrastructures and standards of care for other noncommunicable diseases. Copyright © 2015. Published by Elsevier Inc.

  14. The effect of visual and verbal modes of presentation on children's retention of images and words

    Science.gov (United States)

    Vasu, Ellen Storey; Howe, Ann C.

    This study tested the hypothesis that the use of two modes of presenting information to children has an additive memory effect for the retention of both images and words. Subjects were 22 first-grade and 22 fourth-grade children randomly assigned to visual and visual-verbal treatment groups. The visual-verbal group heard a description while observing an object; the visual group observed the same object but did not hear a description. Children were tested individually immediately after presentation of stimuli and two weeks later. They were asked to represent the information recalled through a drawing and an oral verbal description. In general, results supported the hypothesis and indicated, in addition, that children represent more information in iconic (pictorial) form than in symbolic (verbal) form. Strategies for using these results to enhance science learning at the elementary school level are discussed.

  15. Long-term follow-up of patients treated with primary radiotherapy for supradiaphragmatic Hodgkin's disease at St. Jude Children's Research Hospital

    International Nuclear Information System (INIS)

    Shah, Amit B.; Hudson, Melissa M.; Poquette, Catherine A.; Luo Xiaolong; Wilimas, Judith A.; Kun, Larry E.

    1999-01-01

    Objective: To assess disease control, patterns of relapse, factors predictive of relapse, and late effects of treatment, we reviewed all cases of supradiaphragmatic (SD) Hodgkin's disease (HD) treated with primary radiation therapy (RT) at our institution. Methods: We retrospectively reviewed the disease characteristics, treatment history, and long-term outcome of the 106 patients with Stage I and II supradiaphragmatic HD who received definitive irradiation at St. Jude Children's Research Hospital between 1970 and 1995. As of the date of analysis, 95 patients are alive, with a median follow-up of 13.3 years (range, 1.9-24.2 years). Results: The median age at diagnosis was 14.7 years (range, 3.7-22.7). Involved-field RT was given to 13 patients (12%), whereas 37 (35%) had mantle RT, 51 patients (48%) had subtotal nodal irradiation, and 5 (5%) had total nodal irradiation. Relapsed disease developed in 26 patients at a median of 1.8 years (range, 0.2-9.3 years). The 5- and 10-year estimated cumulative incidences of relapse were 20.9% ± 4.0% and 25.1% ± 4.3%, respectively. With a median dose of 36 Gy (range, 32-40), in-field failure rate was 6.2%, whereas subdiaphragmatic relapse in sites irradiated prophylactically was 1.5%. There was a trend toward an increased incidence of relapse with higher ESR (p 0.088) and greater number of sites of disease (p = 0.087). Age, stage, histology, nodal disease ≥6 cm, the presence of bulky mediastinal disease, and the method of staging did not affect the incidence of relapse. The pattern of failure could not be predicted based on the stage of disease, the extent of subdiaphragmatic staging, the extent of radiation therapy, or the sequence of RT fields - 'ping pong' vs. sequential. Subset analysis of Stage II patients revealed significantly more relapses in clinically staged patients. Excluding Stage IA patients with high cervical disease or peripheral nodal disease, nodal extension failures were more common for patients

  16. Comprehension of idiomatic expressions by Russian speaking typically developing children

    Directory of Open Access Journals (Sweden)

    Eliseeva N.N.

    2017-12-01

    Full Text Available Background. The ability to understand idiomatic expressions begins to develop at an early age. However, such skill is not achieved within the same age and at the same pace in children speaking di erent languages. Objective. This study assesses comprehension of idiomatic expressions by Russian-speaking monolingual children aged 4 to 12 and monitoring the age dynamics of gurative language understanding. Design. 80 children were split in 4 age groups balanced for gender and level of formal education. e participants were asked to identify the correct non-literal meaning of 10 idioms. For each idiomatic expression, children heard three potential interpretations (one correct, and two incorrect ones of which one was literal while the other was overtly wrong. Results. Age-related di erences were analysed by performing a series of univariate ANOVAs. ese analyses showed that already at preschool age children begin to understand some kinds of idiomatic expressions and that such ability slowly develops throughout childhood. Interestingly, until the age of 6 children predominantly interpreted idioms literally. By the age of 7 their ability to correctly understand the non-literal meanings of idiomatic expressions enhanced signi cantly until it reached a plateau around the age of 12. Conclusion. The results of the study are in line with those found for children speaking other languages. The findings are interpreted in light of recent theories of language and cognitive development. Potential limitations of the study are also discussed.

  17. Parents' discursive resources: analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1.

    Science.gov (United States)

    Boman, Ase; Borup, Ina; Povlsen, Lene; Dahlborg-Lyckhage, Elisabeth

    2012-06-01

    The incidence of diabetes type 1 in children, the most common metabolic disorder in childhood, increases worldwide, with highest incidence in Scandinavia. Having diabetes means demands in everyday life, and the outcome of the child's treatment highly depends on parents' engagement and involvement. The aim of this study was to explore and describe discourses in health care guidelines for children with diabetes type 1, in Sweden, Norway and Denmark during 2007-2010, with a focus on how parents were positioned. As method a Foucauldian approach to discourse analysis was applied, and a six-stage model was used to perform the analysis. The findings shows a Medical, a Pedagogic and a Public Health discourse embedded in the hegemonic Expert discourse. The Expert discourse positioned parents as dependent on expert knowledge, as recipients of education, as valuable and responsible for their child's health through practicing medical skills. This positioning may place parents on a continuum from being deprived of their own initiatives to being invited to take an active part and could result in feelings of guilt and uncertainty, but also of security and significance. From this study we conclude that guidelines rooted in the Expert discourse may reduce opportunities for parents' voices to be heard and may overlook their knowledge. By broadening the selection of authors of the guidelines to include patients and all professionals in the team, new discourses could emerge and the parents' voice might be more prominent. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  18. Ownership and use of mobile phones among health workers, caregivers of sick children and adult patients in Kenya: cross-sectional national survey

    Science.gov (United States)

    2013-01-01

    Background The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers’ practices, patients’ adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed. Methods In 2012, a national, cross-sectional, cluster sample survey was undertaken at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed. The main outcomes were personal ownership of mobile phones and use of SMS among phone owners. The predictors analysis examined factors influencing phone ownership and SMS use. Results The analysis included 219 health workers and 1,177 patients’ respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients’ respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. The respondents who were male, more educated, literate and living in urban area were significantly more likely to own the phone and use SMS. The youngest respondents were less likely to own phones, however when the phones were owned, younger age groups were more likely to use SMS. Respondents living in wealthier areas were more likely to own phones; however when phones are owned no significant association between the poverty and SMS use was observed. Conclusions Mobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector. Among patients they serve the coverage in phone ownership and SMS use is lower and

  19. Utilization of Children with Special Health Care Needs (CSHCN) Screener© by O'ahu's pediatricians.

    Science.gov (United States)

    Guo, Mary; Chock, Galen; Parlin, Leolinda; Yamashiroya, Vince; Rudoy, Raul

    2013-05-01

    O'ahu's primary care physicians are in the process of implementing the Patient-Centered Medical Home (PCMH) model. The Medical Home Task Force recommends the implementation of the Children with Special Health Care Needs (CSHCN) Screener© as one of the two quality improvement programs that must be completed by each participating physician. This study sought to find how many pediatricians practice population health management and to determine barriers for incorporating population health management and care registries into practices. An online survey of 55 pediatricians in Hawai'i was conducted between January 10, 2012 and March 10, 2012. The survey contained questions regarding knowledge and use of population health management and investigated the utilization rate of the Screener©. This survey provides baseline data on the implementation of this recommended screener, and informs the process that will be necessary to ensure maximal adoption of recommendations. Sixty percent of the survey participants have not incorporated population health management into their routine practice. Twenty three percent did not have knowledge of population health management and 85% did not use a chronic disease registry. As of August 2011, 95% had not screened their patients with the Screener©. Reasons included not having heard of the Screener© and never having considered using a systematic process to ask patients to assess their health. Based on results, there are important educational goals that need to be accomplished in order for Hawai'i's physicians to transform their practices into effective PCMHs. Physicians will likely need instructional and monetary support to effectively change their practices into PCMHs.

  20. Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy

    DEFF Research Database (Denmark)

    Dörffel, Wolfgang; Rühl, Ursula; Lüders, Heike

    2013-01-01

    1995 and 2001, 925 patients with classical HL (cHL) were registered from seven European countries in German Society of Pediatric Oncology and Hematology Hodgkin Lymphoma Trial 95. Patients in treatment group 1 (TG1; early stages) received two cycles of vincristine, prednisone, procarbazine......, and doxorubicin or vincristine, prednisone, etoposide, and doxorubicin chemotherapy; additional two or four cycles of cyclophosphamide, vincristine, prednisone, and procarbazine were added in TG2 (intermediate stages) or TG3 (advanced stages), respectively. Patients in CR (assessed by computed tomography...... results in TG3 (82.6% ± 5.4% v 88.7% ± 2.0%, P = .259). Reduction of the standard radiation dose from 25 to 20 Gy did not increase failure rate. CONCLUSION: RT can be omitted in early stage HL in so defined CR following this chemotherapy. RT with 20(-35) Gy proved to be sufficient in patients...

  1. The work experience of a patient affected by Williams Syndrome: a pilot project at the Bambino Gesù Children's Hospital.

    Science.gov (United States)

    De Lorenzo, Francesca; Macchiaiolo, Marina; Carlevaris, Carla Maria; Bartuli, Andrea

    2017-05-31

    A new approach has been designed at the Bambino Gesù Children's Hospital in Rome aimed at increasing empowerment in Williams Syndrome individuals through tutor-assisted work activities. Williams Syndrome is characterized by a combination of distinguishing physical traits, congenital anomalies, intellectual disabilities, and a specific developmental profile.This manuscript describes the case of a Williams Syndrome patient.There are only few papers in the scientific literature describing interventions targeting improvement in the quality of life of adult Williams Syndrome individuals. Therefore, this experience may prove useful to several patients, their families, and the experts helping them.We described an example of intervention aimed at guiding and facilitating a Williams Syndrome patient within a work environment, taking into consideration the peaks and valleys of these individuals' specific abilities.Based on our results, we also stressed the need to promote a set of projects and initiatives aimed at enhancing as much as possible self-sufficiency and psycho-affective balance in Williams Syndrome individuals, in order to protect their dignity and self-esteem.

  2. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, A; Holm, K; Kastrup, K W

    1997-01-01

    fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3......, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral...... determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed...

  3. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, A; Holm, K; Kastrup, K W

    1997-01-01

    fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3...... determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed......, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral...

  4. Patient-Reported Outcome Coordinator Did Not Improve Quality of Life Assessment Response Rates: A Report from the Children's Oncology Group.

    Directory of Open Access Journals (Sweden)

    Donna Johnston

    Full Text Available Health related quality of life (HRQL assessments during therapy for pediatric cancer provide valuable information to better understand the patient experience. Our objective was to determine the impact of a patient-reported outcome (PRO coordinator on HRQL questionnaire completion rates during a pediatric acute myeloid leukemia (AML trial.AAML1031 is a multicenter Children's Oncology Group therapeutic trial for de novo AML with a secondary aim to assess HRQL of children and adolescents treated with chemotherapy and hematopoietic stem cell transplantation (HSCT. Parents/guardians are the primary respondents and four questionnaires are administered at eight time points. The questionnaires are the PedsQL 4.0 Generic Core Scales, PedsQL 3.0 Acute Cancer Module, PedsQL Multidimensional Fatigue Scale, and the Pediatric Inventory for Parents. To improve response rates, a central PRO coordinator was instituted and reminded sites about upcoming and delinquent questionnaires. The proportion of HRQL questionnaires completed were compared prior to, and following institution of the PRO coordinator. This analysis evaluated the first five assessment time points.There were231 families who consented to participate in the HRQL aim. Overall response rates for all questionnaires were 73-83%. At time point 1, within 14 days of chemotherapy initiation, post-PRO coordinator completion rates were significantly higher for three of four questionnaires. However, the effect was not sustained and at time point 4, one month following last chemotherapy or HSCT, completion rates were significantly lower post-PRO coordinator for all four questionnaires.Addition of a central PRO coordinator did not result in sustained improvement in HRQL questionnaire completion rates. Efforts to improve response rates must consider other strategies.

  5. Functioning and disability in patients with Angelman syndrome: utility of the International Classification of functioning disability and health, children and youth adaptation framework.

    Science.gov (United States)

    Bonanni, Paolo; Gobbo, Annamaria; Nappi, Sara; Moret, Ornella; Nogarol, Anita; Santin, Michela; Randazzo, Giovanna; Martinuzzi, Andrea

    2009-01-01

    Angelman syndrome (AS) accounts for upto 6% of all cases with severe mental retardation and epilepsy. Clinical findings include developmental delay, severely impaired expressive language, ataxic gait, tremulousness of limbs and a typical behavioral profile including a happy demeanour, hyperactive behavior and low attention span. Seizures, abnormal electroencephalogram, microcephaly and scoliosis are observed in >80% of patients. Cognitive, language and orthopedic problems must be addressed with vigorous rehabilitation programs. Classification of functioning disability and health, children and youth adaptation (ICF-CY) can provide the most adequate framework to describe the condition of the persons towards whom rehabilitative efforts are concentrated. The aim of the study is to test whether the ICF-CY framework is effectively able to capture the various dimensions of health in AS. We applied the ICF-CY, to the detail of second level codes, to a cohort of 11 patients with AS of various ages. The coding was obtained by the multi-professional team following these children for the rehabilitation program. The functional profile obtained applying the ICF-CY is complete and comparable with the characteristics of the syndrome described in literature. The possibility of highlighting not only the problems but also the points of strength appears as very helpful. The second level codes may be too broad to provide insight in the clinical and rehabilitative peculiarities, and the use of the full power of the classification may be more advisable for clinical use. This prelimiary study shows that ICF-CY is a valid tool to frame the clinical characteristics of a complex syndrome as AS, and may give a strong foundation for the rehabilitation programming.

  6. Spectrum of thyroid function in children among the patients attending to examine thyroidal illness at CNMU, Dhaka - A retrospective Study

    International Nuclear Information System (INIS)

    Taslima Begum, D.A.; Afroz, S.

    2004-01-01

    Establishment of a standard range of thyroid hormones for Bangladesh younger population is very essential. Trials were conducted to standardize the normal range of thyroid hormones i.e. T 3 , T 4 and TSH level, at 95% confidence limit (2sd) of age ranging from 1 day to 12 yrs of Bangladesh children group, which were differ by sex. The ranges of different thyroid status were evaluated in the In vitro Laboratory of Centre for Nuclear Medicine and Ultrasound, Dhaka. Comparing three stages (Table 2,3, and 4) observed hormone ranges at euthyroid stage marked off for overlapping the higher level of hypo thyroidal stage by lower side and the lower level of hyper thyroidal stage by higher side. Present work calculated the mean values of thyroid hormones of both sexes, which were found not affected by the sex. (author)

  7. Do cavies talk?: The effect of anthropomorphic books on children's knowledge about animals

    Directory of Open Access Journals (Sweden)

    Patricia A Ganea

    2014-04-01

    Full Text Available Many books for young children present animals in fantastical and unrealistic ways, as wearing clothes, talking and engaging in human-like activities. This research examined whether anthropomorphism in children’s books affects children’s learning and conceptions of animals, by specifically assessing the impact of depictions (a bird wearing clothes and reading a book and language (bird described as talking and as having human intentions. In Study 1, 3-, 4-, and 5-year-old children saw picture books featuring realistic drawings of a novel animal. Half of the children also heard factual, realistic language, while the other half heard anthropomorphized language. In Study 2, we replicated the first study using anthropomorphic illustrations of real animals. The results show that the language used to describe animals in books has an effect on children’s tendency to attribute human-like traits to animals, and that anthropomorphic storybooks affect younger children’s learning of novel facts about animals. These results indicate that anthropomorphized animals in books may not only lead to less learning but also influence children’s conceptual knowledge of animals.

  8. Advancing the human rights of children with communication needs in school.

    Science.gov (United States)

    Gallagher, Aoife L; Tancredi, Haley; Graham, Linda J

    2018-02-01

    Article 19 of the Universal Declaration of Human Rights states that everyone has the right to freedom of opinion and expression. However, due to difficulties in communicating, children with speech, language and communication needs (SLCN) are at particular risk of not being heard. Although it is recommended that children with SLCN can and should be actively involved as equal partners in decision-making about their communication needs, speech-language pathologists (SLPs) can lose sight of the importance of supporting communication as a tool for the child to shape and influence choices available to them in their lives. Building these skills is particularly important for SLPs working in mainstream educational contexts. In this commentary, the authors argue the need for a shift in emphasis in current practice to a rights-based approach and for SLPs to take more of an active role in supporting children with SLCN to develop agency and be heard. We also present some concepts and frameworks that might guide SLPs to work in a right-based way in schools with this population.

  9. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshihara, Takao; Fujii, Noriko [Matsushita Memorial Hospital, Moriguchi, Osaka (Japan); Naya, Mayumi [and others

    1999-02-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m{sup 2} x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin`s lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  10. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    International Nuclear Information System (INIS)

    Yoshihara, Takao; Fujii, Noriko; Naya, Mayumi

    1999-01-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m 2 x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin's lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  11. [PK/PD breakpoints and clinical/bacteriological effects of cefcapene pivoxil fine granules for children at free drug concentrations in pediatric patients with respiratory infection].

    Science.gov (United States)

    Toyonaga, Yoshikiyo; Iwai, Naoichi; Motohiro, Takashi; Sunakawa, Keisuke; Fujii, Ryochi

    2008-06-01

    A post-marketing clinical study was previously conducted in pediatric patients with respiratory infection to evaluate the pharmacokinetics, efficacy and safety of cefcapene pivoxil (CFPN-PI) fine granules for children. Based on the results from this study, we evaluated PK/PD breakpoints and clinical/bacteriological effects of CFPN-PI at free drug concentrations in pediatric patients with respiratory infection to determine an effective and safe dosage regimen of CFPN-PI. The following results were obtained from 61 pediatric patients evaluated in our research. 1) The response rate of pediatric respiratory infection to CFPN-PI was 100% for laryngopharyngitis, 84.6% for acute bronchitis, 100% for tonsillitis, 100% for pneumonia and 95.8% for all. 2) The bacteriological response (eradication rate of Haemophilus influenzae, Streptococcus pyogenes, Moraxella catarrhalis, Streptococcus pneumoniae, etc.) of pediatric respiratory infection to CFPN-PI was 87.5% for laryngopharyngitis, 66.7% for acute bronchitis, 75.0% for tonsillitis, 63.6% for pneumonia and 73.8% for all. 3) The blood concentration simulation demonstrated that the PK/PD breakpoint exceeding the time above MIC (TAM) of 40% after administration of CFPN-PI 3 mg/kg three times daily was 0.27 microg/mL. 4) The pediatric patients with respiratory infection were stratified by the TAM (%) of CFPN-PI into 40% to 100% (TAM > or = 40% group) and 0% to 40% (TAM or = 40% group, and 88.9% and 62.5% in the TAM or = 40% group than in the TAM < 40% group, although the between-group difference was not statistically significant.

  12. Head circumference in untreated and IGF-I treated patients with Laron syndrome: comparison with untreated and hGH-treated children with isolated growth hormone deficiency.

    Science.gov (United States)

    Laron, Zvi; Iluz, Moshe; Kauli, Rivka

    2012-04-01

    Head circumference (HC) is a simple and practical measure of brain size, development and longitudinal measurements of the HC in childhood are an index of brain growth. To determine the effects of long IGF-I deficiency and treatment on HC in patients with Laron syndrome (LS). 20 untreated adult LS patients, aged 48.4±11.2 years and 13 LS patients treated between ages of 5.6±4 to 11.3±3 years were studied. 15 patients with congenital IGHD treated between age 6.1±4 and 13±4 by hGH served as controls. HC was expressed as standard deviation (SD) and Ht as SDS. HC was measured and plotted on Nellhaus charts. Linear height (Ht) was measured by a Harpenden Stadiometer. The mean HC deficit of the adult untreated LS males was -2.9±0.6 SD compared to a Ht deficit of -7.0±1.7 SDS. The HC of the LS adult females was -3.6±1 SD compared to a Ht SDS of -6.9±1.5 (pdeficit decreased only by 1.5 SDS. hGH treatment of cIGHD children increased the HC from -2.0±1.8 to 0.3±1.2 SD and the Ht SDS from -4.8±1.6 to 1.6±1.0. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Food insecurity, CD4 counts, and incomplete viral suppression among HIV+ patients from Texas Children's Hospital: A pilot study

    Science.gov (United States)

    Our goal was to determine the relationship between food insecurity and CD4 counts and viral suppression among pediatric HIV-positive patients. Food insecurity was assessed by validated survey. CD4 counts and viral load were abstracted from patients’ charts. We used linear regression for the dependen...

  14. Understanding Effective Delivery of Patient and Family Education in Pediatric Oncology: A Systematic Review from the Children's Oncology Group

    Science.gov (United States)

    Rodgers, Cheryl C.; Laing, Catherine M.; Herring, Ruth Anne; Tena, Nancy; Leonardelli, Adrianne; Hockenberry, Marilyn; Hendricks-Ferguson, Verna

    2016-01-01

    A diagnosis of childhood cancer is a life-changing event for the entire family. Parents must not only deal with the cancer diagnosis but also acquire new knowledge and skills to safely care for their child at home. Best practices for delivery of patient/family education after a new diagnosis of childhood cancer are currently unknown. The purpose of this systematic review was to evaluate the existing body of evidence to determine the current state of knowledge regarding the delivery of education to newly diagnosed pediatric oncology patients and families. Eighty-three articles regarding educational methods, content, influencing factors, and interventions for newly diagnosed pediatric patients with cancer or other chronic illnesses were systematically identified, summarized, and appraised according to the GRADE criteria. Based on the evidence, ten recommendations for practice were identified. These recommendations address delivery methods, content, influencing factors, and educational interventions for parents and siblings. Transferring these recommendations into practice may enhance the quality of education delivered by healthcare providers, and received by patients and families following a new diagnosis of childhood cancer. PMID:27450361

  15. Towards beneficence for young children in research: challenges for bioethics committees.

    Science.gov (United States)

    Farrell, Ann

    2010-09-01

    Bioethics committees are the focus of international scrutiny, particularly in relation to their application of the principle of beneficence, ensuring that risks incurred in research are outweighed by benefits to those involved directly and to the broader society. Beneficence, in turn, has become an international focus in research with young children, who hitherto had been rarely seen or heard in their own right in research. Twenty years ago, The United Nations Convention on the Rights of the Child 1989 raised global awareness of children's human rights to both participation and protection, and articulation of children's rights came to inform understandings of young children's rights in research. In the intervening period, countries such as Australia came to favour child protection and risk minimisation in research over the notion of children's bone fide participation in research. A key element of the protection regime was the theoretical understanding of young children as developmentally unable and, therefore, unfit to understand, consent to and fully participate as research participants. This understanding has been challenged in recent decades by new theoretical understandings of children's competence, where children can be seen to demonstrate competence, even at an early age, in consenting to, participating in and withdrawing from research. The paper draws on these understandings to provide insights for human research gatekeepers, such as bioethics committees, to deal with the challenges of research with young children and to realize the benefits that may accrue to children in research.

  16. IIAM (important information about me): a patient portability profile app for adults, children and families with neurodevelopmental disabilities.

    Science.gov (United States)

    Jiam, N T; Hoon, A H; Hostetter, C F; Khare, M M

    2017-08-01

    To describe the development of important information about me (IIAM), an application (app) used to communicate and organize healthcare information for people with neurodevelopmental disabilities (NDD). Prior to the development of IIAM version 1.0, households with NDD were selected to participate in a focus group. Respondents (n = 7) were parents of children with NDD. Participants were asked to use a beta version for at least 2 months in day-to-day applications and to complete a questionnaire at the end of the trial. Over half (57%) of the participants found the beta version to be useful. The greatest limitation in usability was the child's age and literacy level. All participants found the app to be visually appealing and easy to navigate. IIAM was commonly used to communicate information to caregivers, and to facilitate quality interactions between the child and others. Mobile technology has become ubiquitous and has emerged as an important tool in healthcare. New applications could potentially promote accessible, cost-effective and self-managed interventions for the disability community. IIAM is a user-friendly, well-accepted and useful app for people with NDD. The focus group feedback elicited from the beta testing was used to develop the IIAM app version 1.0. However, the sample size in this initial feasibility study is small, and warrants a prospective study that evaluates the overall benefits of this app in improving quality of life and helping individuals with developmental disabilities manage their day-to-day activities. Implications for Rehabilitation Mobile technology has been more ubiquitous in health care and has emerged as a tool in communicating healthcare needs. New applications could potentially promote accessible, cost-effective and self-managed interventions for the disability community. IIAM (important information about me) is a new iOS application that enables adults and children with neurodevelopmental disabilities to organize their medical

  17. Role of MRI in the management of children with diffuse pontine tumors: a study of 15 patients and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Kornreich, Liora; Schwarz, Michael; Karmazyn, Boaz; Horev, Gadi [Schneider Children' s Medical Center of Israel, Department of Imaging, Petah Tiqva (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Cohen, Ian J.; Shuper, Avinoam; Yaniv, Issac [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Schneider Children' s Medical Center of Israel, Department of Hematology-Oncology, Petah Tiqva (Israel); Michovitz, Shalom [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Schneider Children' s Medical Center of Israel, Department of Neurosurgery, Petah Tiqva (Israel); Fenig, Eyal [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Rabin Medical Center,Beilinson Campus, Institute of Oncology, Radiotherapy Unit, Petah Tiqva (Israel)

    2005-09-01

    Pontine tumors carry the worst prognosis of all brain tumors. In most cases, the diagnosis is based solely on MR imaging, without biopsy. To describe the MR findings of pontine tumors at diagnosis and during follow-up and correlate those with prognosis and to assess the value of MR imaging in patient management compared to clinical evaluation. Ninety-one MR scans of 15 children with diffuse pontine tumors were reviewed at diagnosis and during follow-up. The parameters analyzed were as follows: tumor extent, area, and volume; encasement of the basilar artery; presence of exophytic component; necrosis; cysts; hydrocephalus; and intensity and enhancement. Findings were correlated to length of progression-free and overall survival. Trends of amelioration or worsening on imaging were compared with the clinical findings. Median length of progression-free survival was 10 months, and median survival was 20 months. Only hydrocephalus at presentation was associated with shorter progression-free survival (P=0.02). On the last examination of each patient, the craniocaudal diameter was significantly greater than at diagnosis (P=0.03). The concordance between the imaging and the clinical findings was good. MR is the mainstay for the diagnosis and management of pontine tumors. Cranial growth seems to be an ominous sign. However, the prognostic value of MR is limited. MR findings correlate well with the clinical examination. (orig.)

  18. Comparison of allele frequency for HLA-DR and HLA-DQ between patients with ECC and caries-free children

    Directory of Open Access Journals (Sweden)

    Bagherian A

    2008-03-01

    Full Text Available Background: Early childhood caries (ECC is one of the most common diseases of childhood. The etiology of ECC is multifactorial and both genetic and environmental factors play important roles in the pathogenesis of the disease. Genetic variations in the hosts may contribute to changes in the risk for dental caries. Genetic factors such as human leukocyte antigen (HLA have recently been suggested as a predisposing factor. Aim: The aim of this study was to look for an association between HLA-DRB1 and HLA-DQB1 with ECC for developing new strategies for the diagnosis as well as the prevention of the disease. Design: In this study, we extracted the genomic DNAs from whole blood samples of 44 patients with ECC and 35 caries-free children by the salting-out method. We amplified the genomic DNA by PCR-SSP and then HLA-typing was performed for all alleles. Results: The results revealed a significant increase in the frequency of HLA-DRB1FNx0104 in the patient group (P = 0.019. The odds ratio for this allele was detected to be 10. The frequency of HLA-DQB1 alleles was not significantly different between the two groups. Conclusion: The above results suggest that HLA-DRB1FNx0104 is associated with the susceptibility to ECC. Thus HLA-DRB1FNx0104 detection as a molecular marker for early diagnosis of ECC may be recommended.

  19. Four-years experience with monitoring of persons at the treatment of children patients with neuroblastoma by 131I-MIBG combination with hyperbaric oxygen therapy

    International Nuclear Information System (INIS)

    Hermanska, J.; Zimak, J.; Paskova, Z.; Dosel, P.

    2001-01-01

    Treatment of children patients with neuroblastoma by 131 I-MIBG in combination with hyperbaric oxygen therapy (HBO) started in the Czech Republic in 1997. Estimation of radiation load from extemal irradiation plays very important role in the treatment scheme elaborated at the Department of Nuclear Medicine. According to this scheme, activities of 5.5 GBq and 3.7 GBq are administered at the first and repeated therapies,respectively. 3 rd , 4 th , 5 th and 6 th day after the administration patients undergo HBO in the Institute of Aviation Medicine Prague. Activity administration and following care are realised at the bed station of the Department of Nuclear Medicine, which is the workplace of III. category with unsealed radionuclide sources. Real dose equivalents were checked during the reported four-year period. Members of both groups were equipped by personal digital dosemeters STEPHEN 6000 for inspection. From the presented results, the following conclusions can be drawn: (1) Monitoring of family members has to be performed in spite of the fact that exceeding of equivalent dose of 5 mSv is non-realistic. Unexpected situation concerning behaviour of both parents and children cannot be excluded. Moreover, records of H-values have to be stored and analysed in the case of possible pregnancy. (2) A question arises in connection with the special limit 5 mSv: What is the whole time of the treatment? Is it possible to understand it, similarly as in the case of iodine therapy, as 5 mSv per year or is it necessary to take into account really the whole, often very long, time of the treatment? (3) Monitoring of the staff maintaining the hyperbaric chamber and ambulance drivers seems to be unnecessary. Under normal condition, the staff is outside the chamber and its contact with a patient is minimal. In unusual situation, the instructed nurse from the Department of Nuclear Medicine equipped by STEPHEN 6000 will estimate dose equivalent and contact responsible medical

  20. High-dose "1"3"1I-MIBG therapies in children: feasibility, patient dosimetry and radiation exposure to workers and family caregivers

    International Nuclear Information System (INIS)

    Cougnenc, Olivier; Defachelles, Anne-Sophie; Lervat, Cyril; Carpentier, Philippe; Oudoux, Aurore; Kolesnikov-Gauthier, Helene; Clisant, Stephanie

    2017-01-01

    The objective of the present multi-centric phase II study (MIITOP) was to determine the response rate, survival and toxicity of tandem infusions of "1"3"1I-meta-iodobenzylguanidine (mIBG) and topotecan in children with relapsed/refractory neuroblastoma. High-dose "1"3"1I-mIBG therapy programme requires a deal of planning, availability of hospital resources and the commitment of individuals with training and expertise in multiple disciplines. Here in the present study, procedures and the results of patient's dosimetry, as well as family and worker's exposures, were reported for the patients treated in Lille. A total of 15 children were treated with "1"3"1I-mIBG between 2009 and 2011 according to the MIITOP protocol. High activity of "1"3"1I-mIBG (444 MBq kg"-"1) was administered on Day 0. In vivo dosimetry was used to calculate a second activity, to be given on Day 21, to obtain a total whole body absorbed dose of 4 Gy. Family and worker's exposures were performed too. The injected activity by treatment was from 703 to 11470 MBq. Total whole body absorbed dose by patient ranged from 2.74 to 5.2 Gy. Concerning relatives, whole body exposure ranged from 0.018 to 2.8 mSv. The mean whole body exposure of the radio-pharmacist was 4.4 nSv MBq"-"1, and the mean exposure of fingers ranged from 0.18 to 0.24 μSv MBq"-"1 according to each finger. The mean whole body exposure was 33.6 and 20.2 μSv d"-"1 per person, for night nurses and day nurses, respectively. Exposure of doctors was less than 5 μSv d"-"1. Under strict radiation protection precautions, this study shows the feasibility of high-activity "1"3"1I-mIBG therapy in France. (authors)

  1. Benign pneumatosis in children

    International Nuclear Information System (INIS)

    Fenton, L.Z.; Buonomo, C.

    2000-01-01

    Background. In pediatrics, pneumatosis intestinalis (PI) is usually due to necrotizing enterocolitis in premature newborns. Beyond infancy, PI is uncommon. ''Benign pneumatosis'' is PI in patients with few or no symptoms that resolves with conservative management. Objective. Our goal was to better characterize benign PI in children. Our investigation focused on identifying underlying risk factors, symptoms at time of diagnosis, management and outcome. Materials and methods. Available medical records and radiographs of children with pneumatosis intestinalis from 1990 to 1998 were reviewed for underlying conditions, symptoms at time of radiographs, management and outcome. Results. Thirty-seven children (mean age 4 years) were included. Thirty-two children had identifiable risk factors. Twenty -five children were immunocompromised by their underlying conditions or therapeutic regimen. Thirty-five children were managed conservatively with resolution of PI. Two patients, however, required surgery and one patient died. Conclusion. Benign pneumatosis does occur in children. The majority have underlying risk factors, most commonly related to immunosuppression. Clinical deterioration is the most useful indicator for surgical intervention. In most patients PI resolves with conservative management. (orig.)

  2. Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children. Patient safety considerations

    International Nuclear Information System (INIS)

    Callahan, Michael J.; MacDougall, Robert D.; Bixby, Sarah D.; Voss, Stephan D.; Robertson, Richard L.; Cravero, Joseph P.

    2018-01-01

    In the context of health care, risk assessment is the identification, evaluation and estimation of risk related to a particular clinical situation or intervention compared to accepted medical practice standards. The goal of risk assessment is to determine an acceptable level of risk for a given clinical treatment or intervention in association with the provided clinical circumstances for a patient or group of patients. In spite of the inherent challenges related to risk assessment in pediatric cross-sectional imaging, the potential risks of ionizing radiation and sedation/anesthesia in the pediatric population are thought to be quite small. Nevertheless both issues continue to be topics of discussion concerning risk and generate significant anxiety and concern for patients, parents and practicing pediatricians. Recent advances in CT technology allow for more rapid imaging with substantially lower radiation exposures, obviating the need for anesthesia for many indications and potentially mitigating concerns related to radiation exposure. In this review, we compare and contrast the potential risks of CT without anesthesia against the potential risks of MRI with anesthesia, and discuss the implications of this analysis on exam selection, providing specific examples related to neuroblastoma surveillance imaging. (orig.)

  3. Clinical Predictors of Liver Fibrosis in Patients With Chronic Hepatitis B Virus Infection From Children to Adults.

    Science.gov (United States)

    Wu, Jia-Feng; Song, Shih-Hsi; Lee, Chee-Seng; Chen, Huey-Ling; Ni, Yen-Hsuan; Hsu, Hong-Yuan; Wu, Tzee-Chung; Chang, Mei-Hwei

    2018-04-11

    This study aimed to elucidate predictors of liver fibrosis in patients with chronic hepatitis B virus (HBV) infection. Transient elastography was performed to define liver stiffness in 533 patients with chronic HBV infection (mean age ± standard deviation, 30.72 ± 0.57 years). Protein array was performed on serum samples and lysates of Huh7 cells transfected with HBV mutants; the results were confirmed by enzyme-linked immunosorbent assay. Single-nucleotide polymorphisms in the gene encoding interleukin 1β (IL-1β) were examined in patients with chronic HBV infection with and without liver fibrosis. Male sex, age ≥18 years, and serum α-fetoprotein level >3.6 ng/mL were independent predictors of a liver stiffness measurement of ≥7 kPa (P = .005, .019, and rs16944 and the CC genotype at rs1143627 in the gene encoding IL-1β were associated with higher serum IL-1β levels and liver fibrosis. Male sex, age ≥18 years, elevated α-fetoprotein level, and HBeAg-negative hepatitis are risk factors for liver fibrosis. IL-1β is involved in the progression of liver fibrosis in subjects with HBeAg-negative hepatitis.

  4. Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children. Patient safety considerations

    Energy Technology Data Exchange (ETDEWEB)

    Callahan, Michael J.; MacDougall, Robert D.; Bixby, Sarah D.; Voss, Stephan D.; Robertson, Richard L.; Cravero, Joseph P. [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2018-01-15

    In the context of health care, risk assessment is the identification, evaluation and estimation of risk related to a particular clinical situation or intervention compared to accepted medical practice standards. The goal of risk assessment is to determine an acceptable level of risk for a given clinical treatment or intervention in association with the provided clinical circumstances for a patient or group of patients. In spite of the inherent challenges related to risk assessment in pediatric cross-sectional imaging, the potential risks of ionizing radiation and sedation/anesthesia in the pediatric population are thought to be quite small. Nevertheless both issues continue to be topics of discussion concerning risk and generate significant anxiety and concern for patients, parents and practicing pediatricians. Recent advances in CT technology allow for more rapid imaging with substantially lower radiation exposures, obviating the need for anesthesia for many indications and potentially mitigating concerns related to radiation exposure. In this review, we compare and contrast the potential risks of CT without anesthesia against the potential risks of MRI with anesthesia, and discuss the implications of this analysis on exam selection, providing specific examples related to neuroblastoma surveillance imaging. (orig.)

  5. Implementation of the Kids-CAT in clinical settings: a newly developed computer-adaptive test to facilitate the assessment of patient-reported outcomes of children and adolescents in clinical practice in Germany.

    Science.gov (United States)

    Barthel, D; Fischer, K I; Nolte, S; Otto, C; Meyrose, A-K; Reisinger, S; Dabs, M; Thyen, U; Klein, M; Muehlan, H; Ankermann, T; Walter, O; Rose, M; Ravens-Sieberer, U

    2016-03-01

    To describe the implementation process of a computer-adaptive test (CAT) for measuring health-related quality of life (HRQoL) of children and adolescents in two pediatric clinics in Germany. The study focuses on the feasibility and user experience with the Kids-CAT, particularly the patients' experience with the tool and the pediatricians' experience with the Kids-CAT Report. The Kids-CAT was completed by 312 children and adolescents with asthma, diabetes or rheumatoid arthritis. The test was applied during four clinical visits over a 1-year period. A feedback report with the test results was made available to the pediatricians. To assess both feasibility and acceptability, a multimethod research design was used. To assess the patients' experience with the tool, the children and adolescents completed a questionnaire. To assess the clinicians' experience, two focus groups were conducted with eight pediatricians. The children and adolescents indicated that the Kids-CAT was easy to complete. All pediatricians reported that the Kids-CAT was straightforward and easy to understand and integrate into clinical practice; they also expressed that routine implementation of the tool would be desirable and that the report was a valuable source of information, facilitating the assessment of self-reported HRQoL of their patients. The Kids-CAT was considered an efficient and valuable tool for assessing HRQoL in children and adolescents. The Kids-CAT Report promises to be a useful adjunct to standard clinical care with the potential to improve patient-physician communication, enabling pediatricians to evaluate and monitor their young patients' self-reported HRQoL.

  6. Clinical features of morphea patients with the pansclerotic subtype: a cross-sectional study from the Morphea in Adults and Children (MAC cohort)

    Science.gov (United States)

    Kim, A; Marinkovich, N; Vasquez, R; Jacobe, HT

    2017-01-01

    Introduction Pansclerotic morphea is a poorly described form of morphea with little information on prevalence, demographics, and clinical features. Classification criteria for this subtype varies and the distinction from other forms of morphea such as extensive generalized morphea and pansclerotic morphea is not always clear. The purpose of this study was to clarify classification criteria for pansclerotic morphea by identifying its prevalence in the morphea in adults and children (MAC) cohort and describing its demographic and clinical features as compared with generalized morphea. Methods Patients who met predefined criteria for generalized and pansclerotic morphea were identified using a modified Laxer and Zulian classification system. Baseline demographic and clinical features of the patients were compiled and then analyzed for traits characteristic of pansclerotic morphea versus those of generalized morphea. 113 met criteria for inclusion – 13 pansclerotic and 100 generalized morphea type. Results Pansclerotic patients were more frequently male (46.2% vs. 6%, p<0.0001); had a shorter time to diagnosis (mean difference of 10.4 months [95% CI: 0.8-19.9 months], p=0.0332); higher rates of functional impairment (61.5% vs. 16%, p=0.0046); higher rates of deep involvement (61.5% vs. 17%, p=0.004); and higher average mRSS (mean difference of 10.8 points [95% CI: 5-16.6], p=0.0018), LoSDI (mean difference 28.3 [95% CI: 9-47.6], p=0.009), and PGA-D scores (mean difference 25.1 [95% CI: 0.3-50], p=0.048). Conclusions Our results suggest demographic and clinical features are sufficient to define the pansclerotic subtype as they represent a distinct clinical phenotype with a more rapidly progressive and severe course commonly accompanied by disability. Presence of features of the pansclerotic phenotype should alert practitioners to the possibility of significant morbidity and the need for early aggressive treatment. PMID:24293577

  7. "Only God decides": young children's perceptions of divorce and the legal system.

    Science.gov (United States)

    Pruett, K D; Pruett, M K

    1999-12-01

    To describe research on perceptions of children aged 6 and younger from 21 families of their parents' divorce, of its impact on their families, and of legal officials. Semistructured play interviews were conducted during home visits as parents were conjointly interviewed as part of a larger study on divorce in legal context. Children had much mis-information about divorce as an event and process. What they did know was often inappropriate, frightening, and confusing. They resented how the process "ruined their parents' being friends any more" and proposed reforms based on their wishes and observations. Greater awareness is needed of the child's desire to be heard during the process, to feel safe and less lonely, and to stay in touch with both parents and extended families. Age-appropriate explanations of psychological and legal aspects of the divorce process are likely to support children's positive adjustment and mental health.

  8. Children's perceptions of emotion regulation strategy effectiveness: links with attachment security.

    Science.gov (United States)

    Waters, Sara F; Thompson, Ross A

    2016-08-01

    Six- and nine-year-old children (N = 97) heard illustrated stories evoking anger in a story character and provided evaluations of the effectiveness of eight anger regulation strategies. Half the stories involved the child's mother as social partner and the other half involved a peer. Attachment security was assessed via the Security Scale. Children reported greater effectiveness for seeking support from adults and peers in the peer context than the mother context, but perceived venting as more effective with mothers. Children with higher security scores were more likely to endorse problem solving and less likely to endorse aggression in both social contexts than those with lower security scores. Early evidence for gender differences was found in that boys endorsed the effectiveness of distraction while girls endorsed venting their emotion.

  9. Refugee reception and pedagogical work with asylum-seeking and refugee children in Denmark

    DEFF Research Database (Denmark)

    Moldenhawer, Bolette

    on family reunification, cuts to social benefits, and granting more temporary or subsidiary forms of protection, with fewer rights attached (ibid. 106). In this paper, the aim is to illuminate how this broad range of restrictive policies is informing the professional work with asylum-seeking and refugee...... children. Since children in the asylum system are regarded as part of the family's unity and are not heard independently in asylum cases, such as for example in Norway (Vitus 2011, 147), I argue that children – along with their families – are in a position of permanent temporality; a position that at all...... and immigration system is ambiguous because it officially does express a concern for preparing applicants for a life in Denmark, but in reality, “the more powerful and concerted political will is directed at keeping the applicants at a distance, socially disconnected, so as to facilitate their possible...

  10. Partial Red Blood Cell Exchange in Children and Young Patients with Sickle Cell Disease: Manual Versus Automated Procedure.

    Science.gov (United States)

    Escobar, Carlos; Moniz, Marta; Nunes, Pedro; Abadesso, Clara; Ferreira, Teresa; Barra, António; Lichtner, Anabela; Loureiro, Helena; Dias, Alexandra; Almeida, Helena

    2017-10-31

    The benefits of manual versus automated red blood cell exchange have rarely been documented and studies in young sickle cell disease patients are scarce. We aim to describe and compare our experience in these two procedures. Young patients (≤ 21 years old) who underwent manual- or automated-red blood cell exchange for prevention or treatment of sickle cell disease complications were included. Clinical, technical and hematological data were prospectively recorded and analyzed. Ninety-four red blood cell exchange sessions were performed over a period of 68 months, including 57 manual and 37 automated, 63 for chronic complications prevention, 30 for acute complications and one in the pre-operative setting. Mean decrease in sickle hemoglobin levels was higher in automated-red blood cell exchange (p exchange and access alarm on automated-red blood cell exchange. No major complication or alloimunization was recorded. Automated-red blood cell exchange decreased sickle hemoglobin levels more efficiently than manual procedure in the setting of acute and chronic complications of sickle cell disease, with minor technical concerns mainly due to vascular access. The threshold of sickle hemoglobin should be individualized for clinical and hematological goals. In our cohort of young patients, the need for an acceptable venous access was a limiting factor, but iron-overload was avoided. Automated red blood cell exchange is safe and well tolerated. It permits a higher sickle hemoglobin removal efficacy, better volume status control and iron-overload avoidance.

  11. Telephone Consultation as a Substitute for Routine Out-patient Face-to-face Consultation for Children With Inflammatory Bowel Disease: Randomised Controlled Trial and Economic Evaluation.

    Science.gov (United States)

    Akobeng, Anthony K; O'Leary, Neil; Vail, Andy; Brown, Nailah; Widiatmoko, Dono; Fagbemi, Andrew; Thomas, Adrian G

    2015-09-01

    routine outpatient follow-up of children and adolescents with IBD. Research for Patient Benefit Programme, UK National Institute for Health Research.

  12. First-hand sensory experience plays a limited role in children's early understanding of seeing and hearing as sources of knowledge: evidence from typically hearing and deaf children.

    Science.gov (United States)

    Schmidt, Ellyn; Pyers, Jennie

    2014-11-01

    One early-developing component of theory of mind is an understanding of the link between sensory perception and knowledge formation. We know little about the extent to which children's first-hand sensory experiences drive the development of this understanding, as most tasks capturing this early understanding target vision, with less attention paid to the other senses. In this study, 64 typically hearing children (Mage  = 4.0 years) and 21 orally educated deaf children (Mage  = 5.44 years) were asked to identify which of two informants knew the identity of a toy animal when each had differing perceptual access to the animal. In the 'seeing' condition, one informant saw the animal and the other did not; in the 'hearing' condition, one informant heard the animal and the other did not. For both hearing and deaf children, there was no difference between performance on hearing and seeing trials, but deaf children were delayed in both conditions. Further, within both the hearing and deaf groups, older children outperformed younger children on these tasks, indicating that there is a developmental progression. Taken together, the pattern of results suggests that experiences other than first-hand sensory experiences drive children's developing understanding that sensory perception is associated with knowledge. © 2014 The British Psychological Society.

  13. Oral health knowledge and sources of information among male Saudi school children.

    Science.gov (United States)

    Wyne, Amjad H; Chohan, Arham N; Al-Dosari, Khalid; Al-Dokheil, Majed

    2004-06-01

    The purpose of present study was to determine the oral health knowledge and sources of information in male Saudi school children. The required information was collected through a especially designed questionnaire. A total of 130 children completed the questionnaire with the mean age of 13.3 (SD 1.9) years. There was no significant difference in oral health knowledge or sources of information in relation to age and educational level. Less than half (44.6%) of the children actually had heard about fluoride, one-third (34.6%) correctly identified the action of fluoride as preventing tooth decay. Almost all (97.2%) the children thought that sweets (chocolates/candies) could cause tooth decay. However, a large number of children were not aware of cariogenic potential of soft drinks (31.5%). More than half (53.1%) of the children reported that their dentist taught them how to brush properly. However, 11.5% children were not taught by any one about proper tooth-brushing. A large number (40.0%) of children thought that one must visit the dentist only in case of pain in the teeth. Dentists were the most popular (61.5%) source of oral health information. It can be concluded that the children need further oral health education in areas of caries prevention, and there was a need to utilise parents, schoolteachers and media to enhance their oral health knowledge.

  14. The impact of generic language about ability on children's achievement motivation.

    Science.gov (United States)

    Cimpian, Andrei

    2010-09-01

    Nuances in how adults talk about ability may have important consequences for children's sustained involvement and success in an activity. In this study, I tested the hypothesis that children would be less motivated while performing a novel activity if they were told that boys or girls in general are good at this activity (generic language) than if they were told that a particular boy or girl is good at it (non-generic language). Generic language may be detrimental because it expresses normative societal expectations regarding performance. If these expectations are negative, they may cause children to worry about confirming them; if positive, they may cause worries about failing to meet them. Moreover, generic statements may be threatening because they imply that performance is the result of stable traits rather than effort. Ninety-seven 4- to 7-year-olds were asked to play a game in which they succeeded at first but then made a few mistakes. Since young children remain optimistic in achievement situations until the possibility of failure is made clear, I hypothesized that 4- and 5-year-olds would not be affected by the implications of generic language until after they made mistakes; 6- and 7-year-olds, however, may be susceptible earlier. As expected, the older children who heard that boys or girls are good at this game displayed lower motivation (e.g., more negative emotions, lower perceived competence) from the start, while they were still succeeding and receiving praise. Four- and 5-year-olds who heard these generic statements had a similar reaction, but only after they made mistakes. These findings demonstrate that exposure to generic language about ability can be an obstacle to children's motivation and, potentially, their success.

  15. Type 2 diabetes mellitus in children and adolescents is still a rare disease in Germany: a population-based assessment of the prevalence of type 2 diabetes and MODY in patients aged 0-20 years.

    Science.gov (United States)

    Neu, Andreas; Feldhahn, Lutz; Ehehalt, Stefan; Hub, Regine; Ranke, Michael B

    2009-11-01

    To assess the prevalence of type 2 diabetes mellitus (T2DM) and maturity onset diabetes of the young (MODY) in children and adolescents aged 0-20 yr in Baden-Württemberg (BW), Germany, and to compare our results with those from other European countries. Our study involved every children's hospital (n = 31), each diabetologist in private practice (n = 122), and every internal medicine unit (n = 164) in BW. A written questionnaire and a telephone survey were used to identify children with T2DM and MODY who had been examined at any of these institutions between 2004 and 2005. Population data were drawn from the national census of 1987 and the subsequent annual updates. The prevalence of T2DM for the age range from 0 to 20 yr is 2.30/100 000, whereas the prevalence of MODY in the same age range is 2.39/100 000. The median age of patients with T2DM was 15.8 yr, and 13.9 yr for MODY patients. The majority of patients with either T2DM or MODY were treated in children's hospitals and by consultant diabetologists. A molecular genetic analysis was done to substantiate the clinical diagnosis in less than half of the recruits (14.3% of T2DM and 44.8% of MODY patients). The prevalence of T2DM and MODY is considerably lower than the prevalence of type 1 diabetes. Type 2 diabetes thus continues to be a rare disease in children and adolescents in Germany, as is also the case in other European countries.

  16. Children's confession- and lying-related emotion expectancies: Developmental differences and connections to parent-reported confession behavior.

    Science.gov (United States)

    Smith, Craig E; Rizzo, Michael T

    2017-04-01

    Young children understand that lying is wrong, yet little is known about the emotions children connect to the acts of lying and confessing and how children's emotion expectancies relate to real-world behavior. In the current study, 4- to 9-year-old children (N=48) heard stories about protagonists (a) committing transgressions, (b) failing to disclose their misdeeds, and (c) subsequently lying or confessing. Younger children (4-5years) expected relatively positive feelings to follow self-serving transgressions, failure to disclose, and lying, and they often used gains-oriented and punishment-avoidance reasoning when justifying their responses. Older children (7-9years) had the opposite pattern of emotional responses (better feelings linked to confession compared with lying). Older children expected a more positive parental response to a confession than younger children. Furthermore, children who expected more positive parental responses to confession were reported by parents to confess more in real life than children who expected more negative parental responses to confession. Thus, the current research demonstrates a link between children's emotion expectancies and actual confession behavior. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A Comparative Evaluation of Normal Tissue Doses for Patients Receiving Radiation Therapy for Hodgkin Lymphoma on the Childhood Cancer Survivor Study and Recent Children's Oncology Group Trials

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Rachel; Ng, Angela [Department of Radiation Therapy, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Constine, Louis S. [Department of Radiation Oncology, University of Rochester, Rochester, New York (United States); Stovall, Marilyn [Division of Radiation Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Armstrong, Gregory T. [Epidemiology/Cancer Control Department, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Neglia, Joseph P. [Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota (United States); Friedman, Debra L. [Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Kelly, Kara [Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University Medical Center, New York, New York (United States); FitzGerald, Thomas J. [Department of Radiation Oncology, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Imaging and Radiation Oncology Core Group, Lincoln, Rhode Island (United States); Hodgson, David C., E-mail: David.hodgson@rmp.uhn.on.ca [Department of Radiation Oncology, University of Toronto, and Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada)

    2016-06-01

    Purpose: Survivors of pediatric Hodgkin lymphoma (HL) are recognized to have an increased risk of delayed adverse health outcomes related to radiation therapy (RT). However, the necessary latency required to observe these late effects means that the estimated risks apply to outdated treatments. We sought to compare the normal tissue dose received by children treated for HL and enrolled in the Childhood Cancer Survivor Study (CCSS) (diagnosed 1970-1986) with that of patients treated in recent Children's Oncology Group (COG) trials (enrolled 2002-2012). Methods and Materials: RT planning data were obtained for 50 HL survivors randomly sampled from the CCSS cohort and applied to computed tomography planning data sets to reconstruct the normal tissue dosimetry. For comparison, the normal tissue dosimetry data were obtained for all 191 patients with full computed tomography–based volumetric RT planning on COG protocols AHOD0031 and AHOD0831. Results: For early-stage patients, the mean female breast dose in the COG patients was on average 83.5% lower than that for CCSS patients, with an absolute reduction of 15.5 Gy. For advanced-stage patients, the mean breast dose was decreased on average by 70% (11.6 Gy average absolute dose reduction). The mean heart dose decreased on average by 22.9 Gy (68.6%) and 17.6 Gy (56.8%) for early- and advanced-stage patients, respectively. All dose comparisons for breast, heart, lung, and thyroid were significantly lower for patients in the COG trials than for the CCSS participants. Reductions in the prescribed dose were a major contributor to these dose reductions. Conclusions: These are the first data quantifying the significant reduction in the normal tissue dose using actual, rather than hypothetical, treatment plans for children with HL. These findings provide useful information when counseling families regarding the risks of contemporary RT.

  18. Emotional well-being in children and adolescents treated with atomoxetine for attention-deficit/hyperactivity disorder: Findings from a patient, parent and physician perspective using items from the pediatric adverse event rating scale (PAERS

    Directory of Open Access Journals (Sweden)

    Dittmann Ralf W

    2008-05-01

    Full Text Available Abstract Background The objective of this analysis was to measure changes in items on the Pediatric Adverse Event Rating Scale (PAERS that relate to emotional well-being of children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD during treatment with atomoxetine for up to 24 weeks from the perspective of the patient, the parent, and the physician. Methods Patients aged 6–17 years with ADHD were treated with atomoxetine (target dose 1.2 mg/kg/day. In the two studies on which this secondary analysis is based the PAERS was used to assess the tolerability of atomoxetine in children and adolescents. This scale has a total of 48 items. The ten items that reflect emotional well-being were selected to measure changes over time from a patient, parent, and physician perspective. Results 421 patients were treated with atomoxetine. 355 patients completed the 8-week treatment period, and 260 patients completed the 24-week treatment period. The ten items that reflect emotional well-being were grouped in five dimensions: depressed mood, self-harm, irritability/agitation, drowsiness, and euphoria. The scores of these dimensions decreased over time, both from a patient as well as from a parent and physician perspective. Only the dimension self-harm was extremely low at baseline and stayed low over time. The mean scores for the ten items depended on the rater perspective. Conclusion The emotional well-being of children and adolescents with ADHD improved in terms of depressed mood, irritability/agitation, drowsiness, and euphoria during treatment with atomoxetine for up to 24 weeks.

  19. Young children's beliefs about self-disclosure of performance failure and success.

    Science.gov (United States)

    Hicks, Catherine M; Liu, David; Heyman, Gail D

    2015-03-01

    Self-disclosure of performance information involves the balancing of instrumental, learning benefits (e.g., obtaining help) against social costs (e.g., diminished reputation). Little is known about young children's beliefs about performance self-disclosure. The present research investigates preschool- and early school-age children's expectations of self-disclosure in different contexts. In two experiments, 3- to 7-year-old children (total N = 252) heard vignettes about characters who succeeded or failed at solving a puzzle. Both experiments showed that children across all ages reasoned that people are more likely to self-disclose positive than negative performances, and Experiment 2 showed that children across all ages reasoned that people are more likely to self-disclose both positive and negative performances in a supportive than an unsupportive peer environment. Additionally, both experiments revealed changes with age - Younger children were less likely to expect people to withhold their performance information (of both failures and successes) than older children. These findings point to the preschool ages as a crucial beginning to children's developing recognition of people's reluctance to share performance information. © 2014 The British Psychological Society.

  20. Achieving a neutral cervical spine position in suspected spinal cord injury in children: analysing the use of a thoracic elevation device for imaging the cervical spine in paediatric patients.

    Science.gov (United States)

    Pandie, Zaahid; Shepherd, Mike; Lamont, Tony; Walsh, Mark; Phillips, Mark; Page, Colin

    2010-08-01

    Paediatric patients with suspected cervical spine injury (CSI) are routinely immobilised on a firm surface using a hard collar, which results in excessive flexion of the cervical spine due to the relatively large size of the occiput. The objective of this study was to determine whether the use of a thoracic elevation device (TED) results in a more neutral cervical spine position and reduces the occurrence of cervical spine hyperflexion. A prospective cohort study was conducted at two Emergency Departments (sites A and B) from January 2006 to May 2007. Children TED and those at site B did not. x-Rays from both sites were analysed for flexion, extension or neutrality of the cervical spine as defined by the Cobb angle. A total of 76 patients were identified at site A and site B. There were four exclusions at each site for poor quality images. 51 patients in the site A group were found to be in neutral position (71%), compared to 29 patients in the site B group (43%) (p=0.001). One patient (1%) who had a TED was found to be hyperflexed (>10 degrees), whereas 12 (18%) patients at site B were hyperflexed (p=0.001). The use of a TED appears to produce a greater proportion of neutral cervical spine films in children < or =10 years of age presenting for suspected CSI.

  1. Lawnmower injuries in children.

    LENUS (Irish Health Repository)

    Nugent, Nora

    2012-02-03

    OBJECTIVE: Power lawnmowers can pose significant danger of injury to both the operator and the bystander, from direct contact with the rotary blades or missile injury. Our objective was to review our experience with paediatric lawnmower-associated trauma, and the safety recommendations available to operators of power lawnmowers. METHODS: The patient cohort comprised paediatric (<16 years of age) patients treated for lawnmower-associated trauma, by the plastic surgery service, between 1996 and 2003. These patients were identified retrospectively. Age at the time of injury, location and extent of bony and soft tissue injuries sustained, treatment instituted and clinical outcome were recorded. Brochures and instruction manuals of six lawnmower manufacturers were reviewed, and safety recommendations noted. RESULTS: Fifteen patients were identified. The majority of injuries occurred from direct contact with the rotary blades (93%); the remaining child sustained a burn injury. Fourteen children (93%) required operative intervention. Seven patients (46%) sustained injuries resulting in amputation, two of whom had major limb amputations. All children, except the burns patient, underwent wound debridement and received antibiotic therapy. Reconstructive methods ranged from primary closure to free tissue transfer. Many patients required multiple procedures. In all instruction manuals, instructions to keep children and pets indoors or out of the yard when mowing were found. CONCLUSIONS: Lawnmower injuries can be devastating, particularly in children. Many victims have lasting deformities as a result of their injuries. Awareness of and stringent adherence to safety precautions during use of power lawnmowers can prevent many of these accidents.

  2. Binaural Fusion and Listening Effort in Children Who Use Bilateral Cochlear Implants: A Psychoacoustic and Pupillometric Study

    Science.gov (United States)

    Steel, Morrison M.; Papsin, Blake C.; Gordon, Karen A.

    2015-01-01

    Bilateral cochlear implants aim to provide hearing to both ears for children who are deaf and promote binaural/spatial hearing. Benefits are limited by mismatched devices and unilaterally-driven development which could compromise the normal integration of left and right ear input. We thus asked whether children hear a fused image (ie. 1 vs 2 sounds) from their bilateral implants and if this “binaural fusion” reduces listening effort. Binaural fusion was assessed by asking 25 deaf children with cochlear implants and 24 peers with normal hearing whether they heard one or two sounds when listening to bilaterally presented acoustic click-trains/electric pulses (250 Hz trains of 36 ms presented at 1 Hz). Reaction times and pupillary changes were recorded simultaneously to measure listening effort. Bilaterally implanted children heard one image of bilateral input less frequently than normal hearing peers, particularly when intensity levels on each side were balanced. Binaural fusion declined as brainstem asymmetries increased and age at implantation decreased. Children implanted later had access to acoustic input prior to implantation due to progressive deterioration of hearing. Increases in both pupil diameter and reaction time occurred as perception of binaural fusion decreased. Results indicate that, without binaural level cues, children have difficulty fusing input from their bilateral implants to perceive one sound which costs them increased listening effort. Brainstem asymmetries exacerbate this issue. By contrast, later implantation, reflecting longer access to bilateral acoustic hearing, may have supported development of auditory pathways underlying binaural fusion. Improved integration of bilateral cochlear implant signals for children is required to improve their binaural hearing. PMID:25668423

  3. Binaural fusion and listening effort in children who use bilateral cochlear implants: a psychoacoustic and pupillometric study.

    Directory of Open Access Journals (Sweden)

    Morrison M Steel

    Full Text Available Bilateral cochlear implants aim to provide hearing to both ears for children who are deaf and promote binaural/spatial hearing. Benefits are limited by mismatched devices and unilaterally-driven development which could compromise the normal integration of left and right ear input. We thus asked whether children hear a fused image (ie. 1 vs 2 sounds from their bilateral implants and if this "binaural fusion" reduces listening effort. Binaural fusion was assessed by asking 25 deaf children with cochlear implants and 24 peers with normal hearing whether they heard one or two sounds when listening to bilaterally presented acoustic click-trains/electric pulses (250 Hz trains of 36 ms presented at 1 Hz. Reaction times and pupillary changes were recorded simultaneously to measure listening effort. Bilaterally implanted children heard one image of bilateral input less frequently than normal hearing peers, particularly when intensity levels on each side were balanced. Binaural fusion declined as brainstem asymmetries increased and age at implantation decreased. Children implanted later had access to acoustic input prior to implantation due to progressive deterioration of hearing. Increases in both pupil diameter and reaction time occurred as perception of binaural fusion decreased. Results indicate that, without binaural level cues, children have difficulty fusing input from their bilateral implants to perceive one sound which costs them increased listening effort. Brainstem asymmetries exacerbate this issue. By contrast, later implantation, reflecting longer access to bilateral acoustic hearing, may have supported development of auditory pathways underlying binaural fusion. Improved integration of bilateral cochlear implant signals for children is required to improve their binaural hearing.

  4. Binaural fusion and listening effort in children who use bilateral cochlear implants: a psychoacoustic and pupillometric study.

    Science.gov (United States)

    Steel, Morrison M; Papsin, Blake C; Gordon, Karen A

    2015-01-01

    Bilateral cochlear implants aim to provide hearing to both ears for children who are deaf and promote binaural/spatial hearing. Benefits are limited by mismatched devices and unilaterally-driven development which could compromise the normal integration of left and right ear input. We thus asked whether children hear a fused image (ie. 1 vs 2 sounds) from their bilateral implants and if this "binaural fusion" reduces listening effort. Binaural fusion was assessed by asking 25 deaf children with cochlear implants and 24 peers with normal hearing whether they heard one or two sounds when listening to bilaterally presented acoustic click-trains/electric pulses (250 Hz trains of 36 ms presented at 1 Hz). Reaction times and pupillary changes were recorded simultaneously to measure listening effort. Bilaterally implanted children heard one image of bilateral input less frequently than normal hearing peers, particularly when intensity levels on each side were balanced. Binaural fusion declined as brainstem asymmetries increased and age at implantation decreased. Children implanted later had access to acoustic input prior to implantation due to progressive deterioration of hearing. Increases in both pupil diameter and reaction time occurred as perception of binaural fusion decreased. Results indicate that, without binaural level cues, children have difficulty fusing input from their bilateral implants to perceive one sound which costs them increased listening effort. Brainstem asymmetries exacerbate this issue. By contrast, later implantation, reflecting longer access to bilateral acoustic hearing, may have supported development of auditory pathways underlying binaural fusion. Improved integration of bilateral cochlear implant signals for children is required to improve their binaural hearing.

  5. Brain SPECT in children

    International Nuclear Information System (INIS)

    Guyot, M.; Baulieu, J.L.

    1996-01-01

    Brain SPECT in child involves specific trends regarding the patient cooperation, irradiation, resolution and especially interpretation because of the rapid scintigraphic modifications related to the brain maturation. In a general nuclear medicine department, child brain SPECT represents about 2 % of the activity. The choice indications are the perfusion children: thallium and MIBI in brain tumours, pharmacological and neuropsychological interventions. In the future, brain dedicated detectors and new radiopharmaceuticals will promote the development of brain SPECT in children. (author)

  6. A Visual Analog Scale to assess anxiety in children during anesthesia induction (VAS-I): Results supporting its validity in a sample of day care surgery patients.

    Science.gov (United States)

    Berghmans, Johan M; Poley, Marten J; van der Ende, Jan; Weber, Frank; Van de Velde, Marc; Adriaenssens, Peter; Himpe, Dirk; Verhulst, Frank C; Utens, Elisabeth

    2017-09-01

    The modified Yale Preoperative Anxiety Scale is widely used to assess children's anxiety during induction of anesthesia, but requires training and its administration is time-consuming. A Visual Analog Scale, in contrast, requires no training, is easy-to-use and quickly completed. The aim of this study was to evaluate a Visual Analog Scale as a tool to assess anxiety during induction of anesthesia and to determine cut-offs to distinguish between anxious and nonanxious children. Four hundred and one children (1.5-16 years) scheduled for daytime surgery were included. Children's anxiety during induction was rated by parents and anesthesiologists on a Visual Analog Scale and by a trained observer on the modified Yale Preoperative Anxiety Scale. Psychometric properties assessed were: (i) concurrent validity (correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores); (ii) construct validity (differences between subgroups according to the children's age and the parents' anxiety as assessed by the State-Trait Anxiety Inventory); (iii) cross-informant agreement using Bland-Altman analysis; (iv) cut-offs to distinguish between anxious and nonanxious children (reference: modified Yale Preoperative Anxiety Scale ≥30). Correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores were strong (0.68 and 0.73, respectively). Visual Analog Scale scores were higher for children ≤5 years compared to children aged ≥6. Visual Analog Scale scores of children of high-anxious parents were higher than those of low-anxious parents. The mean difference between parents' and anesthesiologists' Visual Analog Scale scores was 3.6, with 95% limits of agreement (-56.1 to 63.3). To classify anxious children, cut-offs for parents (≥37 mm) and anesthesiologists (≥30 mm) were established. The present data provide preliminary data for the validity of a Visual

  7. Children's Learning

    Science.gov (United States)

    Siegler, Robert S.

    2005-01-01

    A new field of children's learning is emerging. This new field differs from the old in recognizing that children's learning includes active as well as passive mechanisms and qualitative as well as quantitative changes. Children's learning involves substantial variability of representations and strategies within individual children as well as…

  8. Children's Places

    DEFF Research Database (Denmark)

    Using a cross-cultural approach the book investigates children's places in different societies. "Children's Places" examines the ways in which children and adults, from their different vantage-points in society, negotiate proper places of children in both social and spatial terms. It looks at some...

  9. Heelys injuries in children.

    Science.gov (United States)

    Oh, D; Arjandas, M; Lim, K B L; Lee, E H

    2006-05-01

    Heelys, a type of shoes with stealth wheels, are extremely popular among children in Singapore. The widespread availability of cheap imitations has led to a proliferation of young users. Coupled with a total lack of safety equipment and instructions, these shoes can lead to significant injuries. The purpose of this study was to examine the incidence and type of injuries sustained by children using Heelys. During a seven-month period from February to August 2004, all children treated at the Paediatric Orthopaedic Department of the KK Women's and Children's Hospital, were asked if the injury was sustained while "heeling". All the patients were reviewed by the authors. A total of 37 patients with significant injuries sustained while "heeling" were identified. Their radiographs and clinical charts were reviewed. The patients and/or their parents were also interviewed to obtain additional information. Upper limb injuries were by far the most common. Distal radius fractures and elbow injuries predominated. None of the children used safety gear. "Heeling" can lead to serious injuries despite the relatively low velocity involved. Children and their parents need to be educated on the use of safety gear.

  10. Young children's knowledge of the "determiner" and "adjective" categories.

    Science.gov (United States)

    Kemp, Nenagh; Lieven, Elena; Tomasello, Michael

    2005-06-01

    Children's understanding of the grammatical categories of "determiner" and "adjective" was examined using 2 different methodologies. In Experiment 1, children heard novel nouns combined with either a or the. Few 2-year-olds, but nearly all 3- and 4-year-olds, subsequently produced the novel nouns with a different determiner from the modeled combination. Experiment 2 used a priming methodology. Children age 2, 3, 4, and 6 years repeated descriptions of pictures, before describing target pictures themselves. When the primes consisted of a varied determiner + noun, all age groups produced more determiner + noun descriptions. When the primes consisted of a determiner + adjective + noun, 2-year-olds showed no priming. Three- to 6-year-olds showed item-specific priming, but only 6-year-olds (and to a limited extent 4-year-olds) showed both item-specific and structural priming. These results suggest that children build an understanding of determiners and adjectives gradually, perhaps from individual lexical items, over a number of years, and that pragmatic correctness may be attained particularly late.

  11. A systematic review of generic multidimensional patient-reported outcome measures for children, part II: evaluation of psychometric performance of English-language versions in a general population.

    Science.gov (United States)

    Janssens, Astrid; Rogers, Morwenna; Thompson Coon, Jo; Allen, Karen; Green, Colin; Jenkinson, Crispin; Tennant, Alan; Logan, Stuart; Morris, Christopher

    2015-03-01

    The objectives of this systematic review were 1) to identify studies that assess the psychometric performance of the English-language version of 35 generic multidimensional patient-reported outcome measures (PROMs) for children and young people in general populations and evaluate their quality and 2) to summarize the psychometric properties of each PROM. MEDLINE, EMBASE, and PsycINFO were searched. The methodological quality of the articles was assessed using the COnsensus-based Standards for selection of health Measurement INstruments checklist. For each PROM, extracted evidence of content validity, construct validity, internal consistency, test-retest reliability, proxy reliability, responsiveness, and precision was judged against standardized reference criteria. We found no evidence for 14 PROMs. For the remaining 21 PROMs, 90 studies were identified. The methodological quality of most studies was fair. Quality was generally rated higher in more recent studies. Not reporting how missing data were handled was the most common reason for downgrading the quality. None of the 21 PROMs has had all psychometric properties evaluated; data on construct validity and internal consistency were most frequently reported. Overall, consistent positive findings for at least five psychometric properties were found for Child Health and Illness Profile, Healthy Pathways, KIDSCREEN, and Multi-dimensional Student Life Satisfaction Scale. None of the PROMs had been evaluated for responsiveness to detect change in general populations. Further well-designed studies with transparent reporting of methods and results are required. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. [Pediatric anesthesia: little children, big problems].

    Science.gov (United States)

    Grosjean, V; Veyckemans, F; Seghaye, M C; Hallet, C; Jastrowicz, J; Brichant, J F

    2011-03-01

    Infants and children are patients who are the most susceptible to benefit from a procedure in the ambulatory setting. However, some of these patients are at risk. They include infants, especially if premature, and children with sleep apnea syndrome or with current or recent upper respiratory infection. The present paper gives advices for an optimal anesthesic management of these young patients.

  14. Learning from childhood: children tell us who they are through online dialogical interaction

    Directory of Open Access Journals (Sweden)

    Saracco Susanna

    2016-07-01

    Full Text Available Philosophy of childhood is a field of inquiry in which the protagonists are adults, who are trying to understand children, and children, who are trying to be understood by adults. These two operating agents must find a common ground that renders their communication possible. This piece develops and illustrates the notion that no theorisation can exist if the authors of the theories do not know the subjects of their study, and thus that philosophers of childhood cannot contribute to knowledge about childhood unless they create occasions for the voices of children to be heard. Therefore, when activities are devised for the free expression of childhood, they cannot meaningfully be categorised as separate from philosophy of childhood. The latter cannot exist without the former. Philosophy of childhood and philosophy for children are interlaced in their work with children. Once the nature of childhood is understood through what children tell about themselves, instead of narrated through the interpretive frameworks of adults, the rights of the children can be effectively protected.

  15. The Voice of the Child in Social Work Assessments: Age-Appropriate Communication with Children.

    Science.gov (United States)

    O'Reilly, Lisa; Dolan, Pat

    2016-07-01

    This article describes a child-centred method for engaging with children involved in the child protection and welfare system. One of the primary arguments underpinning this research is that social workers need to be skilled communicators to engage with children about deeply personal and painful issues. There is a wide range of research that maintains play is the language of children and the most effective way to learn about children is through their play. Considering this, the overarching aim of this study was to investigate the role of play skills in supporting communication between children and social workers during child protection and welfare assessments . The data collection was designed to establish the thoughts and/or experiences of participants in relation to a Play Skills Training (PST) programme designed by the authors. The key findings of the study reveal that the majority of social work participants rate the use of play skills in social work assessments as a key factor to effective engagement with children. Of particular importance, these messages address how social work services can ensure in a child-centred manner that the voice of children is heard and represented in all assessments of their well-being and future care options.

  16. Expertise in Everyday Nurse–Patient Conversations

    Directory of Open Access Journals (Sweden)

    Lindsay M. Macdonald

    2016-04-01

    Full Text Available A great deal of nursing activity is embedded in what is considered to be everyday conversation. These conversations are important to health professionals because communication can affect health outcomes, and they are important to patients who want to know they are being heard and cared for. How do nurses talk with patients and what are the features of effective communication in practice? In this exploratory study, two expert nurses recorded conversations with patients during domiciliary visits. Linguistic discourse analysis, informed by contextual knowledge of domiciliary nursing shows the nurses skillfully used small talk to support their clinical work. In their conversations, nurses elicit specific information, normalize unpleasant procedures, manage the flow of the interaction, and strengthen the therapeutic relationship. Small talk can be big talk in achieving nursing goals. Critically reflecting on recorded clinical interactions can be a useful method of professional development and a way of demonstrating nursing expertise.

  17. Coblation adenotonsillectomy in children.

    Science.gov (United States)

    Shakeel, Muhammad; Trinidade, Aaron; Al-Adhami, Ahmed; Supriya, Mrinal; Kubba, Haytham

    2012-09-01

    To determine re-admission rate for post-tonsillectomy pain; the primary and secondary post-tonsillectomy bleeding rate; the percentage requiring control of post-tonsillectomy bleeding in children undergoing coblation tonsillectomy. A descriptive study. Royal Hospital for Sick Children (Yorkhill Hospital) between 2004 and 2006. All patients who underwent tonsillectomy with or without adenoidectomy by coblation technique. Patients were identified from operation theatre log book and electronic data base of theatre activity. The hospital case notes were reviewed retrospectively to collect data, regarding demographics, indication and type of surgery, grade of operating surgeon, duration of hospital stay, re-attendance and re-admission, and management of complications. A total of 106 children; males (n = 53, 50%), females (n = 53, 50%) with a mean age 6.3 years underwent surgery using coblation technique. Thirty-one percent had a tonsillectomy while 69% underwent an adenotonsillectomy. Of these, 48% had history of recurrent tonsillitis, 43% had obstructive sleep apnoea and 9% suffered predominantly from obstructive symptoms. Eighty-two percent of patients were discharged on the first postoperative day. Only one patient had primary bleeding requiring re-operation. After discharge, 7 patients (6.7%) were re-admitted with secondary bleeding, 3 (2.8%) of whom were taken back to theatre to control the bleeding under general anaesthesia. Coblation tonsillectomy is a useful technique in having a low primary and secondary bleeding rates in children undergoing tonsillectomy and adenotonsillectomy.

  18. Optimal screening of children with acute malnutrition requires a change in current WHO guidelines as MUAC and WHZ identify different patient groups

    DEFF Research Database (Denmark)

    Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard

    2014-01-01

    BACKGROUND: Timely treatment of acute malnutrition in children 500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm...... Circumference (MUAC) of malnutrition (SAM). However, it is currently unclear how MUAC relates to the other indicator used to define acute malnutrition: weight-for-height Z-score (WHZ). METHODS: Secondary data from >11,000 Cambodian children, obtained by different surveys between...... 2010 and 2012, was used to calculate sensitivity and ROC curves for MUAC and WHZ. FINDINGS: The secondary analysis showed that using the current WHO cut-off of 115 mm for screening for severe acute malnutrition over 90% of children with a weight-for-height z-score (WHZ)

  19. Identification of children and adolescents at risk for renal scarring after a first urinary tract infection: a meta-analysis with individual patient data

    NARCIS (Netherlands)

    Shaikh, N.; Craig, J.C.; Rovers, M.M.; Dalt, L. Da; Gardikis, S.; Hoberman, A.; Montini, G.; Rodrigo, C.; Taskinen, S.; Tuerlinckx, D.; Shope, T.

    2014-01-01

    IMPORTANCE: No studies have systematically examined the accuracy of clinical, laboratory, and imaging variables in detecting renal scarring in children and adolescents with a first urinary tract infection. OBJECTIVES: To identify independent prognostic factors for the development of renal scarring

  20. Likeable children, uneasy children

    DEFF Research Database (Denmark)

    Anderson, Sally Dean

    2014-01-01

    Drawing on fieldwork in small-town schools with children of Muslim background whose families came to Denmark as United Nation refugees, the chapter explores how pedagogical ideologies of school-based peer sociability inflect children’s experiences of ‘being Muslim.’ Danish provincial schools, wit...... a child’s personal religiosity, whereas not participating conjures up images of really religious families....

  1. Global impression of perceived difficulties in children and adolescents with attention-deficit/hyperactivity disorder: Reliability and validity of a new instrument assessing perceived difficulties from a patient, parent and physician perspective over the day

    Directory of Open Access Journals (Sweden)

    Dittmann Ralf W

    2008-05-01

    Full Text Available Abstract Background The objective of this analysis was to evaluate the psychometric properties of a brief scale developed to assess the degree of difficulties in children with Attention-Deficit/Hyperactivity Disorder (ADHD. The Global Impression of Perceived Difficulties (GIPD scale reflects overall impairment, psychosocial functioning and Quality of Life (QoL as rated by patient, parents and physician at various times of the day. Methods In two open-label studies, ADHD-patients aged 6–17 years were treated with atomoxetine (target-dose 0.5–1.2 mg/kg/day. ADHD-related difficulties were assessed up to week 24 using the GIPD. Data from both studies were combined to validate the scale. Results Overall, 421 patients received atomoxetine. GIPD scores improved over time. All three GIPD-versions (patient, parent, physician were internally consistent; all items showed at least moderate item-total correlation. The scale showed good test-retest reliability over a two-week period from all three perspectives. Good convergent and discriminant validity was shown. Conclusion GIPD is an internally consistent, reliable and valid measure to assess difficulties in children with ADHD at various times of the day and can be used as indicator for psychosocial impairment and QoL. The scale is sensitive to treatment-related change.

  2. Psoriasis in children: An insight

    Directory of Open Access Journals (Sweden)

    Sandipan Dhar

    2011-01-01

    Full Text Available Onset of psoriasis in childhood is quite common. Chronicity, inflammation and hyperproliferation are the cardinal features by which the condition establishes its uniqueness. Clearance of disease may be farfetched in most patients and relapse is frequent. Early recognition and management of psoriasis in children and adolescents is vital in therapy in children.

  3. Bowel management in children: how to keep children clean

    African Journals Online (AJOL)

    as it has a big social and psychological impact on patients and also their .... The underlying diseases were in most cases spina .... teen children were complaining of mild-to-moderate ..... established early in childhood to avoid social isolation in.

  4. Optimal screening of children with acute malnutrition requires a change in current WHO guidelines as MUAC and WHZ identify different patient groups.

    Science.gov (United States)

    Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard; Whitney, Sophie; Conkle, Joel; Horton, Lindsey; Un, Sam Oeurn; Dijkhuizen, Marjoleine A; Wieringa, Frank T

    2014-01-01

    Timely treatment of acute malnutrition in children 500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm Circumference (MUAC) of malnutrition (SAM). However, it is currently unclear how MUAC relates to the other indicator used to define acute malnutrition: weight-for-height Z-score (WHZ). Secondary data from >11,000 Cambodian children, obtained by different surveys between 2010 and 2012, was used to calculate sensitivity and ROC curves for MUAC and WHZ. The secondary analysis showed that using the current WHO cut-off of 115 mm for screening for severe acute malnutrition over 90% of children with a weight-for-height z-score (WHZ) children with a MUAC65% of children with a WHZchildren with acute malnutrition, therefore these 2 indicators should be regarded as independent from each other. We suggest a 2-step model with MUAC used a screening at community level, followed by MUAC and WHZ measured at a primary health care unit, with both indicators used independently to diagnose severe acute malnutrition. Current guidelines should be changed to reflect this, with treatment initiated when either MUAC <115 mm or WHZ<-3.

  5. Children's Health

    Science.gov (United States)

    Your child's health includes physical, mental and social well-being. Most parents know the basics of keeping children healthy, like offering ... for children to get regular checkups with their health care provider. These visits are a chance to ...

  6. Epilepsy - children

    Science.gov (United States)

    ... the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, ... Prognosis) Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or ...

  7. Dirt bikes injuries in children.

    Science.gov (United States)

    Abdelgawad, A A; Maxfield, D; Tran, S; Mclean, S; Kanlic, E M

    2013-12-01

    Dirt bike riding is becoming a more popular recreational activity among children. Injuries associated with this recreational activity did not gain attention in the medical literature. The purpose of this study is to assess orthopedic injuries associated with dirt bike riding. We retrospectively studied injuries occurring in children less than 18 years old, while riding dirt bikes, that required admission to the trauma department in our level one trauma center during the period 2000-2010. There were 24 admissions (23 patients). The mean age was 13. Fourteen patients had brain injuries. Six patients had abdominal injuries. One patient died shortly after arriving to the emergency department. Fourteen patients had face and neck injuries. The average injury severity score was 8.5. Thirteen patients' admissions (54 %) had orthopedic fractures. Five of 13 patients (38 %) suffered more than one fracture. Eight patients needed orthopedic intervention (seven of these were in operating room under general anesthesia and one in the emergency department under conscious sedation). Femur fracture was the most common cause for performing surgery in this group of patients. Riding dirt bikes is not a safe recreational activity. Orthopedic injuries constitute a major component of the injuries affecting children riding dirt bikes. Orthopedic surgeons (being responsible for treating most of these children) have the obligation to warn the community against the possible dangers facing children who ride dirt bikes.

  8. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... may find the taste mildly unpleasant even if mixed with soda or juice; however, most patients can ... Sometimes ultrasound is substituted for CT as a method of imaging in these procedures in children. A ...

  9. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's ( ...

  10. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local ... Related Articles and Media Catheter Angiography Magnetic Resonance, Functional (fMRI) - Brain Children's (Pediatric) CT (Computed Tomography) Magnetic ...

  11. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) ...

  12. [Xifeng zhidong tablet and the placebo control treatment of tic disorder children patients of internal disturbance of Gan-wind with phlegm syndrome: a clinical study].

    Science.gov (United States)

    Ma, Rong; Hu, Si-Yuan; Tian, Tian; Wei, Xiao-Wei; Xiang, Xi-Xiong; Ding, Ying; Wang, Xue-Feng; Chen, Yu-Yan

    2014-04-01

    To assess the efficacy and safety of Xifeng Zhidong Tablet (XZT) in treating tic disorder children patients of internal disturbance of Gan-wind with phlegm syndrome (IDGWPS). A stratified randomized, double-blinded, parallel control of placebo, multi-center trial was conducted in 160 subjects from 5 hospitals in China. They were randomly assigned to 2 groups, the test group and the control group, 80 in each group. Those in the test group were treated with XZT, while those in the control group were treated with placebos. The therapeutic course was 4 weeks for all. The effectiveness indicators covered main indicators and secondary indicators. Yale global tic severity scale (YGTSS) was taken as the main indicators. The amelioration of social function impairment, efficacy, single index of Chinese medical syndromes, Chinese medical syndrome efficacy as well as disappearance rate of single Chinese medical symptoms were evaluated as secondary indicators. The safety indicators included clinical adverse events, vital signs, blood/urine/stool routines, renal and liver functions, and electrocardiogram (ECG). As for main indicators, the score of YGTSS decreased from 22.10 +/- 6.38 to 11.34 +/- 6.58 in the test group, while it decreased from 22.65 +/- 6.70 to 16.82 +/- 6.53 in the control group, showing statistical difference when compared with the same group before treatment (P tics, irritability, dreaminess, abnormal tongue proper,abnormal tongue fur, and abnormal tongue pulse condition was 78.67%, 34.72%, 62.26%, 34.62%, 58.97%, and 39.74%, respectively in the test group, while they were 34.67%, 13.11%, 21.82%, 15.58%, 25.97%, and 19.48%, respectively in the control group. Better results were shown in the test group (P < 0.05). Totally 5 adverse events occurred. The incidence of adverse events was 3.75% in the test group and 2.53% in the control group. After 4 weeks of XZT treatment, the integral of YGTSS could be obviously reduced, the degree of social function impairment

  13. Efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in patients with common comorbidities in children, adolescents and adults: a review

    Science.gov (United States)

    Hutchison, Shari L.; Ghuman, Jaswinder K.; Ghuman, Harinder S.; Karpov, Irina; Schuster, James M.

    2016-01-01

    Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental health disorders and is associated with higher incidence of comorbid oppositional or conduct, mood, anxiety, pervasive developmental, and substance-use disorders. Comorbid mental health conditions may alter the presence of symptoms and treatment of ADHD. Atomoxetine (ATX), a nonstimulant medication for the treatment of ADHD, may be prescribed for individuals with ADHD and comorbid conditions despite some risk for certain undesirable side effects and lower effectiveness for the treatment of ADHD than stimulants. In this paper, we review studies utilizing randomized, placebo-controlled trials (RCTs) as well as within-subject designs to determine the effectiveness of ATX in the treatment of children and adults with ADHD and comorbid conditions. The current review uses an expanded methodology beyond systematic review of randomized controlled trials in order to improve generalizability of results to real-world practice. A total of 24 articles published from 2007 to 2015 were reviewed, including 14 RCTs: n = 1348 ATX, and n = 832 placebo. The majority of studies show that ATX is effective in the treatment of ADHD symptoms for individuals with ADHD and comorbid disorders. Cohen’s d effect sizes (ES) for improvement in ADHD symptoms and behaviors range from 0.47 to 2.21. The effectiveness of ATX to improve symptoms specific to comorbidity varied by type but appeared to be most effective for diminishing the presence of symptoms for those with comorbid anxiety, ES range of 0.40 to 1.51, and oppositional defiant disorder, ES range of 0.52 to 1.10. There are mixed or limited results for individuals with ADHD and comorbid substance-use disorders, autism spectrum disorders, dyslexia or reading disorder, depression, bipolar disorder, and Tourette syndrome. Results from this review suggest that ATX is effective in the treatment of some youth and adults with ADHD and comorbid disorders

  14. Mutilating lawn mower injuries in children.

    Science.gov (United States)

    Ross, P M; Schwentker, E P; Bryan, H

    1976-08-02

    Serious injuries from riding power mowers were sustained by 18 children. Eleven children were passangers on the mower and fell into its path. The injuries required an extensive number of hospitalizations and reconstructive procedures. Fifteen patients suffered considerable residual deformities. Operating riding power mowers in the vicinity of children must be actively discouraged.

  15. REHABILITATION OF CHILDREN WITH FUNCTIONAL (OBSTIPATIONAL) ENCOPRESIS

    OpenAIRE

    M.Yu. Denisov

    2010-01-01

    Author describes peculiarities of functional (obstipational) encopresis in children with prolonged chronic constipation. Disease relates to many predisposing factors; the most significant ones are perinatal pathology, disorders of nutritional behavior, psychological traumatic experience and social disadaptation of patient. Complex rehabilitation program of children with functional encopresis allows provision of optimal medical care. Key words: children, functional ecopresis, fecal incontinenc...

  16. Radiation injuries in children with lymphogranulomatosis

    International Nuclear Information System (INIS)

    Grulich, M.; Schoentube, M.; Doerffel, W.

    1990-01-01

    37 children with M. Hodgkin received radiotherapy to the involved cervical lymph nodes. Localized growth disturbances and muscle atrophies were observed as late effects. 12 children had severe sequelae and 19 patients moderate late effects. The effects were stronger the younger the children were at the time of irradiation. (author)

  17. Treatment of diabetes in children

    OpenAIRE

    GAO, YI-QING; GAO, MIN; XUE, YING

    2016-01-01

    Type 1 diabetes mellitus (T1D) and type 2 diabetes (T2D) mellitus are on the increase in children and adolescents. An increase in T2D is linked to the increasing rates of obesity in children. Usually, in both children and adults, T1D is treated with insulin while T2D is treated with metformin. There are other classes of drugs that are under assessment for their safety and efficacy in relation to pediatric patients. Most of these new drugs, however, have not been studied in children. Thus, the...

  18. 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.

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine ...

  20. Gastroesophageal scintiscanning in children

    International Nuclear Information System (INIS)

    Piepsz, A.; Georges, B.; Rodesch, P.; Cadranel, S.

    1982-01-01

    Four patients' positions were tested in search of increased sensitivity of gastroesophageal scintiscanning for the detection of reflux in children: supine, prone, left lateral, and 30 degrees right posterior oblique. The sensitivity was highest when the child was placed in supine position. A 60-min recording period increased the sensitivity of the technique, and is thus preferred to a shorter recording time

  1. Fingertip replantation in children.

    Science.gov (United States)

    Dautel, G

    2000-11-01

    Despite common unfavorable mechanisms, fingertip replantation is a rewarding procedure in children. Cosmetic final results are usually better than those obtained by local or pedicled flaps. The success rate and the sensory reinnervation are also better than what can be expected in adult patients.

  2. The impact of dual-source parallel radiofrequency transmission with patient-adaptive shimming on the cardiac magnetic resonance in children at 3.0 T.

    Science.gov (United States)

    Wang, Haipeng; Qiu, Liyun; Wang, Guangbin; Gao, Fei; Jia, Haipeng; Zhao, Junyu; Chen, Weibo; Wang, Cuiyan; Zhao, Bin

    2017-06-01

    The cardiac magnetic resonance (CMR) of children at 3.0 T presents a unique set of technical challenges because of their small cardiac anatomical structures, fast heart rates, and the limited ability to keep motionless and hold breathe, which could cause problems associated with field inhomogeneity and degrade the image quality. The aim of our study was to evaluate the effect of dual-source parallel radiofrequency (RF) transmission on the B1 homogeneity and image quality in children with CMR at 3.0 T. The study was approved by the institutional ethics committee and written informed consent was obtained. A total of 30 free-breathing children and 30 breath-hold children performed CMR examinations with dual-source and single-source RF transmission. The B1 homogeneity, contrast ratio (CR) of cine images, and off-resonance artifacts in cine images between dual-source and single-source RF transmission were assessed in free-breathing and breath-hold groups, respectively. In both free-breathing and breath-hold groups, higher mean percentage of flip angle (free-breathing group: 104.2 ± 4.6 vs 95.5 ± 6.3, P 3.0 T. This technology could be taken into account in CMR for children with cardiac diseases.

  3. Optimal Screening of Children with Acute Malnutrition Requires a Change in Current WHO Guidelines as MUAC and WHZ Identify Different Patient Groups

    Science.gov (United States)

    Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard; Whitney, Sophie; Conkle, Joel; Horton, Lindsey; Un, Sam Oeurn; Dijkhuizen, Marjoleine A.; Wieringa, Frank T.

    2014-01-01

    Background Timely treatment of acute malnutrition in children 500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm Circumference (MUAC) of malnutrition (SAM). However, it is currently unclear how MUAC relates to the other indicator used to define acute malnutrition: weight-for-height Z-score (WHZ). Methods Secondary data from >11,000 Cambodian children, obtained by different surveys between 2010 and 2012, was used to calculate sensitivity and ROC curves for MUAC and WHZ. Findings The secondary analysis showed that using the current WHO cut-off of 115 mm for screening for severe acute malnutrition over 90% of children with a weight-for-height z-score (WHZ) 65% of children with a WHZmalnutrition, therefore these 2 indicators should be regarded as independent from each other. We suggest a 2-step model with MUAC used a screening at community level, followed by MUAC and WHZ measured at a primary health care unit, with both indicators used independently to diagnose severe acute malnutrition. Current guidelines should be changed to reflect this, with treatment initiated when either MUAC <115 mm or WHZ<−3. PMID:24983995

  4. Patients particularly exposed: first results of two studies on the premature babies and the children/adolescents suffering of cystic fibrosis;Des patients particulierement exposes: premiers resultats de deux etudes sur les prematures et les enfants/adolescents atteints de mucoviscidose

    Energy Technology Data Exchange (ETDEWEB)

    Donadieu, J.; Roudier, C.; Pirard, Ph. [Institut de veille sanitaire, Saint-Maurice (France); Jarreau, P.H. [Hopital Cochin, Assistance publique, 75 - Paris (France); Chiron, R. [Centre de Ressources et de Competences de la Mucoviscidose, 34 - Montpellier (France); Maccia, C. [Centre d' Assurance de Qualite des Applications Technologiques dans le Domaine de la Sante, 92 - Bourg-la-Reine (France)

    2006-04-15

    We report two studies that have explored a particular health situation among children. These studies were concerned for one of preterm infants admitted to a neonatal intensive care unit, and for other patients with cystic fibrosis. These studies were limited to a dosimetry evaluation of a existing practice. It is worth noting that such studies are exceptional in literature. They aim to provide a missing information for radiation protection of populations not in good health, but suffering from diseases. (N.C.)

  5. VACCINATION OF CHILDREN WITH MALIGNANCIES

    Directory of Open Access Journals (Sweden)

    D.Yu. Kachanov

    2010-01-01

    Full Text Available Children suffering from oncological diseases fall into the group of immunocompromised patients. They are more at risk of severe children’s banal infections. Development of safe and efficient methods for immunological prevention of preventable infections diseases in this group of children is one of priorities for modern medicine. It is also important to properly organise the process of vaccinating the persons surrounding the patient to eliminate the risk of postvaccinal complications in the sick (non-vaccinated child. The article provides a detailed overview of the global experience in vaccinating children with malignant neoplasms. It describes modern principles of immunological prevention in children both being administered the standard anticancer therapy and those have undergone transplantation of hemopoietic stem cells. Key words: children, malignancy, vaccination.(Pediatric Pharmacology. – 2010; 7(3:28-34

  6. Urinary tract infection - children

    Science.gov (United States)

    UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children ... Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev . 2011;(3):CD001534. PMID: ...

  7. Gastroesophageal reflux disease - children

    Science.gov (United States)

    Peptic esophagitis - children; Reflux esophagitis - children; GERD - children; Heartburn - chronic - children; Dyspepsia - GERD - children ... GERD. Certain factors can lead to GERD in children, including: Birth defects, such as hiatal hernia , a ...

  8. Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study.

    Science.gov (United States)

    Nejašmić, Danijel; Miošić, Ivana; Vrdoljak, Davorka; Permozer Hajdarović, Snježana; Tomičić, Marion; Gmajnić, Rudika; Diminić Lisica, Ines; Sironić Hreljanović, Jelena; Pleh, Vlatka; Cerovečki, Venija; Tomljenović, Anita; Bekić, Sanja; Jerčić, Minka; Tuđa, Karla; Puljak, Livia

    2017-08-31

    To determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia. A cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n=496) and rural (n=482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics. Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician's opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P<0.001 for both). Our finding that patients consider a physician's opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary.

  9. Caries in Portuguese children with Down syndrome

    OpenAIRE

    Areias, Cristina Maria; Sampaio-Maia, Benedita; Guimaraes, Hercilia; Melo, Paulo; Andrade, David

    2011-01-01

    OBJECTIVES: Oral health in Down syndrome children has some peculiar aspects that must be considered in the follow-up of these patients. This study focuses on characterizing the environmental and host factors associated with dental caries in Portuguese children with and without Down syndrome. METHODS: A sibling-matched, population-based, cross-sectional survey was performed. RESULTS: Down syndrome children presented a significantly greater percentage of children without caries, 78% vs. 58% of ...

  10. Fertility Preservation for Children Diagnosed with Cancer

    Science.gov (United States)

    ... Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu ... with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for ...

  11. Exposure to gun violence and asthma among children in Puerto Rico.

    Science.gov (United States)

    Ramratnam, Sima K; Han, Yueh-Ying; Rosas-Salazar, Christian; Forno, Erick; Brehm, John M; Rosser, Franziska; Marsland, Anna L; Colón-Semidey, Angel; Alvarez, María; Miller, Gregory E; Acosta-Pérez, Edna; Canino, Glorisa; Celedón, Juan C

    2015-08-01

    Although community violence may influence asthma morbidity by increasing stress, no study has assessed exposure to gun violence and childhood asthma. We examined whether exposure to gun violence is associated with asthma in children, particularly in those reporting fear of leaving their home. Case-control study of 466 children aged 9-14 years with (n = 234) and without (n = 232) asthma in San Juan, Puerto Rico. Lifetime exposure to gun violence was defined as hearing a gunshot more than once. We also assessed whether the child was afraid to leave his/her home because of violence. Asthma was defined as physician-diagnosed asthma and wheeze in the prior year. We used logistic regression for the statistical analysis. All multivariate models were adjusted for age, gender, household income, parental asthma, environmental tobacco smoke, prematurity and residential distance from a major road. Cases were more likely to have heard a gunshot more than once than control subjects (n = 156 or 67.2% vs. n = 122 or 52.1%, P violence, those who had heard a gunshot more than once and were afraid to leave their home due to violence had 3.2 times greater odds of asthma (95% CI for OR = 2.2-4.4, P violence is associated with asthma in Puerto Rican children, particularly in those afraid to leave their home. Stress from such violence may contribute to the high burden of asthma in Puerto Ricans. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Complications of the surgical treatment early and tardy of supracondylar fractures of the humerus in children: a retrospective study of 111 patients treated at the Hospital Nacional de Ninos Carlos Saenz Herrera in the period January 2010 to January 2011

    International Nuclear Information System (INIS)

    Zuniga Blanco, Adrian

    2012-01-01

    Supracondylar fractures of the humerus up much of the emergency consultation of any pediatric orthopedic service, of them, Gartland III fractures are usually treated by closed reduction and percutaneous fixation with nails smooth. Often treatment has been delayed by factors such as the unavailability of an orthopedic specialist or local anesthesia or an operating room. At other times, the patient has come belatedly to consult. This retrospective study has analyzed whether a delay greater than 12 hours in the surgical treatment of supracondylar fractures of the humerus in children is associated with an increased risk of perioperative complications. Of 111 children who have been treated surgical in national children's hospital, underwent 59 surgeries before 12 hours from the trauma and 52 underwent surgery after 12 hours of trauma. The groups have developed without significant differences in terms of iatrogenic neurological injury, tract infection of the nails, vascular complications and compartment syndrome. Surgical time and hospital stay neither have had differences. In 2 cases of the tardy treatment group has been necessary to perform a opened reduction. As for the bad union, 9 cases (8%) have been of elbow varus radiological and clinical, of these 5 cases (4.5%) have occurred in the tardy treatment group and 4 cases (3,5) in the group early treatment. Findings of similar studies are confirmed in which the rate of perioperative complications is significantly unchanged if the surgical treatment is carried out before 12 hours or after 12 hours after the trauma. (author) [es

  13. An Analysis of Patient Adherence to Treatment during a 1-Year, Open-Label Study of OROS[R] Methylphenidate in Children with ADHD

    Science.gov (United States)

    Faraone, Stephen V.; Biederman, Joseph; Zimmerman, Brenda

    2007-01-01

    Objective: Treatment adherence is an important aspect of ADHD symptom management, but there are many factors that may influence adherence. Method: This analysis assessed adherence to OROS methylphenidate during a 1-year, open-label study in children. Adherence was defined as the number of days medication was taken divided by the number of days in…

  14. Psychosocial interventions for children exposed to traumatic events in low- and middle-income countries: study protocol of an individual patient data meta-analysis

    NARCIS (Netherlands)

    Purgato, M.; Gross, A.L.; Jordans, M.J.D.; de Jong, J.T.V.M.; Barbui, C.; Tol, W.

    2014-01-01

    Background: The burden of mental health and psychosocial problems in children exposed to traumatic events in humanitarian settings in low- and middle-income countries is substantial. An increasing number of randomized studies has shown promising effects of psychosocial interventions, but this

  15. Pain prevalence in hospitalized children

    DEFF Research Database (Denmark)

    Walther-Larsen, S; Pedersen, M T; Friis, S M

    2017-01-01

    admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. CONCLUSION: This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority......BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...

  16. Achalasia: Outcome in children.

    Science.gov (United States)

    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.

  17. Improving Care for Children With Complex Needs

    Science.gov (United States)

    2017-10-10

    Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

  18. Assessment of Knowledge Regarding Oral Hygiene among Parents of Pre-School Children Attending Pediatric Out Patient Department in Dhulikhel Hospital.

    Science.gov (United States)

    Khanal, K; Shrestha, D; Ghimire, N; Younjan, R; Sanjel, S

    2015-01-01

    Level of knowledge regarding oral hygiene among the parents of pre-school children plays an important role on maintaining the good oral hygiene of their children. In Nepal, sufficient research has not been carried out on this area. Objective of this study is to assess the level of knowledge on oral hygiene of preschool children's parents attending pediatric outpatient department in Dhulikhel Hospital. A descriptive study was conducted from November 2012 to January 2013 among one hundred parents of preschool children visiting pediatrics outpatient department of Dhulikhel Hospital. Paper and pencil based semi structured questionnaire was used for collecting data. Questions related to demographic information and knowledge were asked. Thirty questions were used for assessing knowledge level. Knowledge score was calculated by allocating one point for each correct answer and zero point for each wrong answer. Analyzed data were presented in terms of numbers and percentages. Total knowledge scores were categorized based on percentage. Knowledge score was categorized on four group - exclusive intervals - namely-poor (0-40%), moderate (40-60%), good (60-80%) and excellent (80-100%). Mann-Whitney U test and Kruskal-Wallis test were applied to check significance difference and chisquare test was used to check association among different background characteristic. It was found that 81% had moderate knowledge, 15% had poor knowledge and 4% had good knowledge about oral hygiene. Median knowledge score was found to be 15 with range 10 to 21. Following variables were found to be significant difference on knowledge category: Education status (poral health problem (p = 0.008), Further significant association was found between knowledge category and educational status (pknowledge category and past experience (pKnowledge regarding oral hygiene was found satisfactory among the parents of preschool children visiting pediatric OPD of Dhulikhel Hospital.

  19. Federal Act Amending Law Relating to Children (Children's Law Amendment Act), 15 March 1989.

    Science.gov (United States)

    1989-01-01

    , request joint custody, and such custody would not be detrimental to the child; 11) upon separation, either of these parents can be given custody of the child; 12) an unmarried father has a right to have a personal relationship with his child and to be heard with respect to important measures taken relating to the child; 13) the minority of a child ends at age 18, but can be extended to age 21 by a court because of the delayed development of the child; 14) custody can be withdrawn from parents who endanger the well-being of their child; 15) if no relatives or other appropriate close persons can be given custody, a court is to give custody to the youth welfare services, which are to transfer custody to 3rd persons; and 16) the opinion of children is to be heard in procedures relating to their care and custody. Further provisions of the Act deal with the rights of parents with respect to children who have been withdrawn from their custody, the role of the youth welfare services, the duties of foster parents, and guardianship. When the legal representative of the child agrees in writing, the youth welfare services can be authorized to act as attorney in matters of establishing paternity and implementing support claims.

  20. Effects of irrelevant speech and traffic noise on speech perception and cognitive performance in elementary school children.

    Science.gov (United States)

    Klatte, Maria; Meis, Markus; Sukowski, Helga; Schick, August

    2007-01-01

    The effects of background noise of moderate intensity on short-term storage and processing of verbal information were analyzed in 6 to 8 year old children. In line with adult studies on "irrelevant sound effect" (ISE), serial recall of visually presented digits was severely disrupted by background speech that the children did not understand. Train noises of equal Intensity however, had no effect. Similar results were demonstrated with tasks requiring storage and processing of heard information. Memory for nonwords, execution of oral instructions and categorizing speech sounds were significantly disrupted by irrelevant speech. The affected functions play a fundamental role in the acquisition of spoken and written language. Implications concerning current models of the ISE and the acoustic conditions in schools and kindergardens are discussed.

  1. Bereaved children.

    OpenAIRE

    Schultz, K.

    1999-01-01

    OBJECTIVE: To describe the unique aspects of childhood grief. To provide a framework for family physicians to use in assisting children to grieve. QUALITY OF EVIDENCE: A MEDLINE search from 1966 to 1999 using the key words children, childhood, grief, mourning, and bereavement revealed mainly expert opinion articles, some non-randomized observational studies, and retrospective case-control studies. MAIN MESSAGE: Although children are influenced by similar factors and need to work through the s...

  2. Precocious Puberty in Children

    International Nuclear Information System (INIS)

    Atta, I.; Laghari, T. M.; Khan, N. Y.; Lone, W. S.; Ibrahim, M.; Raza, J.

    2015-01-01

    Objective: To determine the etiology of precocious puberty in children and to compare the clinical and laboratory parameters of central and peripheral precocious puberty. Study Design: Cross-sectional study. Place and Duration of Study: Endocrine Clinic at National Institute of Child Health, Karachi, from January 2009 to December 2011. Methodology: Children presenting with precocious puberty were included. The age of onset of puberty was documented. Clinical evaluation, Tanner staging, height, height SDS, weight, weight SDS, body mass index, bone age, pelvic USG, plasma estradiol level and GnRH stimulation were done. Ultrasound of adrenal glands, serum level of 17 hydroxyprogesterone, ACTH, Renin, aldosterone and testosterone were performed in children with peripheral precocious puberty. MRI of adrenal glands and gonads was done in patients with suspected tumor of that organ and MRI of brain was done in patients with central precocious puberty. Skeletal survey was done in patients with Mc Cune-Albright syndrome. Results: CAH (81.8%) indentified as a main cause in peripheral percocious puberty and idiopathic (67.74%) in central precocious puberty. Eighty five patients were registered during this period. The conditions causing precocious puberty were central precocious puberty (36.47%), peripheral precocious puberty (38.82%), premature pubarche (10.58%) and premature thelarche (14.11%). There was a difference in the age of onset of puberty in case of central precocious puberty (mean=3, 2-6 years) versus peripheral precocious puberty (mean=5.25; 3.62 - 7.0 years). Children with central precocious puberty showed higher height SDS, weight SDS, FSH, LH than those with peripheral precocious puberty. Conclusion: Etiology in majority of cases with peripheral precocious puberty was congenital adrenal hyperplasia and idiopathic in central precocious puberty. Central precocious puberty children showed higher height SDS, weight SDS, FSH, LH than peripheral precocious puberty

  3. Headache in children's drawings.

    Science.gov (United States)

    Wojaczyńska-Stanek, Katarzyna; Koprowski, Robert; Wróbel, Zygmunt; Gola, Małgorzata

    2008-02-01

    Headache is a common health problem in childhood. Children's drawings are helpful in the diagnosis of headache type. Children, especially younger ones, communicate better through pictures than verbally. The aim of the present study is to evaluate the usefulness of drawings of the child's headache in the diagnostic process carried out by a pediatrician and a pediatric neurologist. At the beginning of a visit in a neurological clinic, or on the first day of hospitalization, the child was asked, "Please draw your headache," or "How do you feel your headache?" without any additional explanations or suggestions. Clinical diagnosis of headache type was made on the basis of the standard diagnostic evaluation. For the purpose of this study, children's headaches were categorized as migraine, tension-type headache, or "the others." One hundred twenty-four drawings of children with headaches were analyzed by 8 pediatricians and 8 pediatric neurologists. The analysts were unaware of the clinical history, age, sex, and diagnosis of the patients. The clinical diagnosis was considered the "gold standard" to which the headache drawing diagnosis was compared. There were 68 girls 5-18 years of age and 56 boys 7-18 years of age. Of the 124 children, 40 were clinically diagnosed with migraine (32.2%), 47 with tension-type headache (37.9%), and 37 (29.8%) as the others. Children with migraine most frequently draw sharp elements. Children with tension-type headache mainly drew compression elements and pressing elements. In the group of "the other" headaches, 21 children were diagnosed with somatoform disorders. The most frequent element in this group's drawings was a whirl in the head. Colors used most frequently were black and red, which signify severe pain. There was no difference in sensitivity of diagnoses between neurologists and pediatricians. Because the evaluation of drawings by children with headaches done both by pediatricians and pediatric neurologists was correct for

  4. Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support.

    Science.gov (United States)

    Saadatmand, Vahid; Rejeh, Nahid; Heravi-Karimooi, Majideh; Tadrisi, Sayed Davood; Vaismoradi, Mojtaba; Jordan, Sue

    2015-08-01

    Nonpharmacologic pain management in patients receiving mechanical ventilation support in critical care units is under investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients. The aim of this study was to examine the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support, using a pragmatic parallel-arm, randomized controlled trial. The study was conducted in a general adult intensive care unit of a high-turnover teaching hospital, in Tehran, Iran. Between October 2011 and June 2012, we recruited 60 patients receiving mechanical ventilation support to the intervention (n = 30) and control arms (n = 30) of a pragmatic parallel-group, randomized controlled trial. Participants in both arms wore headphones for 90 minutes. Those in the intervention arm heard pleasant, natural sounds, whereas those in the control arm heard nothing. Outcome measures included the self-reported visual analog scale for pain at baseline; 30, 60, and 90 minutes into the intervention; and 30 minutes post-intervention. All patients approached agreed to participate. The trial arms were similar at baseline. Pain scores in the intervention arm fell and were significantly lower than in the control arm at each time point (p natural sounds via headphones is a simple, safe, nonpharmacologic nursing intervention that may be used to allay pain for up to 120 minutes in patients receiving mechanical ventilation support. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  5. Characterization of Courtesy Stigma Perceived by Parents of Overweight Children with Bardet-Biedl Syndrome.

    Science.gov (United States)

    Hamlington, Barbara; Ivey, Lauren E; Brenna, Ethan; Biesecker, Leslie G; Biesecker, Barbara B; Sapp, Julie C

    2015-01-01

    A child's obesity is generally perceived by the public to be under the control of the child's parents. While the health consequences of childhood obesity are well understood, less is known about psychological and social effects of having an obese child on parents. We set out to characterize stigma and courtesy stigma experiences surrounding obesity among children with Bardet-Biedl syndrome (BBS), a multisystem genetic disorder, and their parents. Twenty-eight parents of children with BBS participated in semi-structured interviews informed by social stigmatization theory, which describes courtesy stigma as parental perception of stigmatization by association with a stigmatized child. Parents were asked to describe such experiences. Parents of children with BBS reported the child's obesity as the most frequent target of stigmatization. They perceived health care providers as the predominant source of courtesy stigma, describing interactions that resulted in feeling devalued and judged as incompetent parents. Parents of children with BBS feel blamed by others for their child's obesity and described experiences that suggest health care providers may contribute to courtesy stigma and thus impede effective communication about managing obesity. Health care providers may reinforce parental feelings of guilt and responsibility by repeating information parents may have previously heard and ignoring extremely challenging barriers to weight management, such as a genetic predisposition to obesity. Strategies to understand and incorporate parents' perceptions and causal attributions of their children's weight may improve communication about weight control.

  6. Characterization of Courtesy Stigma Perceived by Parents of Overweight Children with Bardet-Biedl Syndrome.

    Directory of Open Access Journals (Sweden)

    Barbara Hamlington

    Full Text Available A child's obesity is generally perceived by the public to be under the control of the child's parents. While the health consequences of childhood obesity are well understood, less is known about psychological and social effects of having an obese child on parents. We set out to characterize stigma and courtesy stigma experiences surrounding obesity among children with Bardet-Biedl syndrome (BBS, a multisystem genetic disorder, and their parents.Twenty-eight parents of children with BBS participated in semi-structured interviews informed by social stigmatization theory, which describes courtesy stigma as parental perception of stigmatization by association with a stigmatized child. Parents were asked to describe such experiences.Parents of children with BBS reported the child's obesity as the most frequent target of stigmatization. They perceived health care providers as the predominant source of courtesy stigma, describing interactions that resulted in feeling devalued and judged as incompetent parents.Parents of children with BBS feel blamed by others for their child's obesity and described experiences that suggest health care providers may contribute to courtesy stigma and thus impede effective communication about managing obesity. Health care providers may reinforce parental feelings of guilt and responsibility by repeating information parents may have previously heard and ignoring extremely challenging barriers to weight management, such as a genetic predisposition to obesity. Strategies to understand and incorporate parents' perceptions and causal attributions of their children's weight may improve communication about weight control.

  7. Clinical effectiveness and patient perspectives of different treatment strategies for tics in children and adolescents with Tourette syndrome: a systematic review and qualitative analysis.

    Science.gov (United States)

    Hollis, Chris; Pennant, Mary; Cuenca, José; Glazebrook, Cris; Kendall, Tim; Whittington, Craig; Stockton, Sarah; Larsson, Linnéa; Bunton, Penny; Dobson, Suzanne; Groom, Madeleine; Hedderly, Tammy; Heyman, Isobel; Jackson, Georgina M; Jackson, Stephen; Murphy, Tara; Rickards, Hugh; Robertson, Mary; Stern, Jeremy

    2016-01-01

    Tourette syndrome (TS) is a neurodevelopmental condition characterised by chronic motor and vocal tics affecting up to 1% of school-age children and young people and is associated with significant distress and psychosocial impairment. To conduct a systematic review of the benefits and risks of pharmacological, behavioural and physical interventions for tics in children and young people with TS (part 1) and to explore the experience of treatment and services from the perspective of young people with TS and their parents (part 2). For the systematic reviews (parts 1 and 2), mainstream bibliographic databases, The Cochrane Library, education, social care and grey literature databases were searched using subject headings and text words for tic* and Tourette* from database inception to January 2013. For part 1, randomised controlled trials and controlled before-and-after studies of pharmacological, behavioural or physical interventions in children or young people (aged tic disorder were included. Mixed studies and studies in adults were considered as supporting evidence. Risk of bias associated with each study was evaluated using the Cochrane tool. When there was sufficient data, random-effects meta-analysis was used to synthesize the evidence and the quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. For part 2, qualitative studies and survey literature conducted in populations of children/young people with TS or their carers or in health professionals with experience of treating TS were included in the qualitative review. Results were synthesized narratively. In addition, a national parent/carer survey was conducted via the Tourettes Action website. Participants included parents of children and young people with TS aged under 18 years. Participants (young people with TS aged 10-17 years) for the in-depth interviews were recruited via a national survey and specialist Tourettes clinics

  8. Percutaneous ultrasound-guided renal biopsy in children: The need for renal biopsy in pediatric patients with persistent asymptomatic microscopic hematuria

    Directory of Open Access Journals (Sweden)

    Mei-Ching Yu

    2014-12-01

    Full Text Available Background: Percutaneous renal biopsy (PRB is essential for the diagnosis, prognosis, and management of children with unknown kidney disease. In this study, the safety and efficacy of PRB is investigated, and also the common etiologies of childhood kidney disease, based on histological findings. In addition, we explored the role of PRBs in the diagnosis of children who presented with persistent asymptomatic hematuria. Methods: By chart review, from July 2005 to July 2009, a total of 99 PRBs were performed on 91 children (43 girls and 48 boys; mean age, 10.9 ± 4.4 years under ultrasound (US guidance, by a doctor, using an automated 18-gauge biopsy needle following the same protocol, at a medical center in northern Taiwan. Results: The accuracy of the histological diagnosis was excellent. The most common post-biopsy complications were perirenal hematoma (11.1% and asymptomatic gross hematuria (3.0%, respectively. Nevertheless, these complications resolved spontaneously, and none had major bleeding episodes. Histological results showed that lupus nephritis, minimal change disease, and IgA nephropathy (IgAN could be the current leading causes of childhood kidney diseases in Taiwan. Conclusions: Automated ultrasound (US-guided PRB is a safe and reliable method of assessing childhood renal disease. A recent study shows that the presence of persistent asymptomatic isolated microhematuria in adolescents is a predictive marker of future end-stage renal disease. Hence, the emphasis of renal biopsy on children with persistent asymptomatic hematuria is beneficial for the early diagnosis of IgAN or other glomerulonephritis (GN, which tends toward progressive kidney disease in adulthood without prompt therapeutic intervention.

  9. Bowel vaginoplasty in children

    Directory of Open Access Journals (Sweden)

    Sarin Yogesh

    2006-01-01

    Full Text Available OBJECTIVES: To describe our experience with bowel vaginoplasty done in children. MATERIALS AND METHODS: This is a retrospective study of eight children aged 10 months to 8 years, who underwent bowel vaginoplasty over a period of 5 years (2000-2005. The indications of bowel vaginoplasty included anorectovestibular fistula (ARVF associated with Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome (n=6 and cloaca (n=2. The bowel segment used for vaginoplasty included colon (n=3, ileum (n=2 and duplicated rectum (n=1. In two patients of ARVF associated with uterovaginal agenesis, the distal- most part of ARVF was transected at the level of peritoneal reflection and left as neovagina, whereas the proximal bowel was pulled through at the proposed neo-anal site. All the patients were advised daily home dilatation of the neo vaginal orifice with Hegar′s dilators, for a period of six weeks. RESULTS: Bowel vaginoplasty was done in eight patients. None had any significant per-operative complication. Two patients had abdominal wound dehiscence, requiring secondary suturing. Two patients had mucosal prolapse of the neovagina, which required trimming. One patient died two months after discharge, because of meningitis. Out of the eight patients, seven are in regular follow-up. Six patients have neovagina, cosmetically acceptable to the parents; all have been radiologically proven to have adequate length. One patient had unacceptable perineal appearance with nipple-like vaginal orifice and scarred perineal wound, that merits a revision. None of the patients had vaginal stenosis and excessive mucus discharge, during follow-up visits. Although post surgical results are acceptable to the parents cosmetically, the sexual and psychological outcome is yet to be assessed. Conclusions: Bowel vaginoplasty is a safe and acceptable procedure to treat the pediatric patients of uterovaginal agenesis and cloaca.

  10. Poverty, race and skin color: Perceptions and relationships among children at school

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Salum Moreira

    2015-11-01

    Full Text Available Here are presented the results of a research whose objective was to analyze what were saying and how were acting poor and/or black boy(s and girl(s about unequal treatment, shaped by discrimination through mockery, swearing, derogatory nicknames, separations, among other things, experienced in school. These children were students from the 5th year of primary school, in a public school located in a mid-sized city in the interior of São Paulo, Brazil. It was intended to undertake an analysis of the practices of class and racial differentiation that hierarchize, discriminate and exclude certain children, performed by adults and/or by children themselves. The ethnographic study made use of their stories, a questionnaire about denomination and classification of color/race, answered by children in the classroom, socio-economic survey, observations of children in different school environments and semi-structured interview with children and teacher. Among other results, it was confirmed that, children that were black, black and brown, poor and with a history of educational failure, suffer bigger discrimination at school from teachers and other children. In addition it was found that even among those who are poor and or black, it takes place the building of borders for the distinction that each one makes of themselves in relation to others. Therefore, the research provided the acknowledgement of the diversity of positions related to the recognition that they make regarding their identification of race and class. When verifying how children's actions are mediated by school educational practices, we support that in such spaces it should be granted the conditions of possibilities for them to speak - and be heard - about their doubts and desires, about what they do and why they do it, in the relations between them. Finally, provide the emergence of their curiosities, imagination and inventiveness to, maybe, see the burst of something new in our world that

  11. Oral health knowledge, behaviour and practices among school children in Qatar.

    Science.gov (United States)

    Al-Darwish, Mohammed Sultan

    2016-01-01

    The aim of this study was to assess the oral health knowledge behaviour and practices among school children in Qatar. A cross-sectional study was carried out in Qatar from October 2011 to April 2012. A total of 2200 school children aged 12-14 years were approached from 16 schools of different areas. The information about oral health knowledge and sources of information was obtained through a self-administrated questionnaire. Data analyses were performed. The overall response rate was (96%). Only (25.8%) of children reported a high level of oral health knowledge. After each meal, tooth brushing was observed by a very low percentage of children (3.7%). About 44.6% of children recognized dental floss as a cleaning device for between the teeth. A large number of children (32.5%) thought incorrectly that one must visit the dentist only in case of pain. A great majority was not aware of cariogenic potential of soft drinks (39%) and sweetened milk (97.8%). Less than half (38.9%) of children actually had heard about fluoride. Only (16.8%) correctly answered the question about sign of tooth decay. Slightly, less than half (48.4%) could not define the meaning of plaque. Parents were the most popular (69.1%), source of oral health information for the children. The oral health knowledge in Qatar is below the satisfactory level. Parents were the most popular source of oral health knowledge for the children followed by dentists, school teachers, and media.

  12. Bangladeshi school-age children's experiences and perceptions on child maltreatment: A qualitative interview study.

    Science.gov (United States)

    Atiqul Haque, M; Janson, S; Moniruzzaman, S; Rahman, A K M F; Mashreky, S R; Eriksson, U-B

    2017-11-01

    Child maltreatment (CM) is a public health problem and is recognized as a huge barrier for child development. Most of the research and definitions on CM are from the perspective of high-income western countries. Because no major studies have been conducted on CM in Bangladesh, the aim of the current study was to explore the experiences of and perceptions on CM in school-age children in rural and urban Bangladesh in order to understand maltreatment in a local context and from a child perspective. Semistructured individual interviews with 24 children (13 boys and 11 girls), between the ages of 9 and 13 years of which 11 were schoolgoing and 13 non-schoolgoing, were conducted during July 2013 and analysed according to qualitative content analysis. CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were especially young children, girls, and poor children. The children's voices were not heard due to their low status and low position in their families, schools, and working places. The main theme that emerged in the analysis was children's subordination, which permeated the five categories: (a) perception of children's situation in society, (b) understanding children's development and needs, (c) CM associated to school achievement, (d) negative impact of CM, and (e) emotional responses. Different kinds of abuse are obviously common in Bangladesh, and the schools do not follow the law from 2011 prohibiting corporal punishment at school. The society has to take further steps to live up to the UN Convention on the Rights of the Child, which was ratified already in 1990, to protect the Bangladeshi children from CM. © 2017 John Wiley & Sons Ltd.

  13. Idiopathic megarectum in children.

    Science.gov (United States)

    Godbole, P P; Pinfield, A; Stringer, M D

    2001-02-01

    There is scant information about the management of idiopathic megarectum in childhood. Children with idiopathic megarectum referred to a single institution between 1994 and 1998 were identified prospectively. Those with Hirschsprung's disease or an anorectal malformation were excluded. The remaining patient group, 22 boys and 7 girls, had a median age of 8.0 years (range 3.5-14.0 y). Median duration of symptoms prior to referral was 2.0 years (range 0.4-11 y). Chronic soiling was the dominant complaint in 28/29 (97%) cases. 23 children had received regular stimulant laxatives for periods ranging from 1 month to 11 years, and 9 children had been treated with regular enemas. The degree of megarectum assessed by both abdominal palpation and plain radiography was: grade 1 (below umbilical level) n=6; grade 2 (at umbilical level) n=15; and grade 3 (above umbilical level) n=8. Hirschsprung's disease was specifically excluded by rectal biopsy in all cases and no patient had evidence of spinal dysraphism. Three boys with massive megarectums and intractable symptoms were treated by a staged Duhamel sigmoid pull-through with excellent functional results. Fifteen patients (52%) were treated by a single manual evacuation under general anaesthesia followed by a daily Bisacodyl 5-10 mg suppository. After a median follow-up of 16 months, 13 continue to respond well with a daily bowel action and no soiling (4 of the 13 have discontinued treatment and remain well). The remaining 11 patients (38%) have continued conventional treatment with oral laxatives but with limited success. Idiopathic megarectum is poorly described in children. It is more common in boys and is often resistant to laxative therapy alone. After appropriate preparation, treatment with stimulant suppositories can be effective. Surgery has a valuable role in selected patients with a massive megarectum.

  14. Pediatric patient-reported outcome instruments for research to support medical product labeling: report of the ISPOR PRO good research practices for the assessment of children and adolescents task force.

    Science.gov (United States)

    Matza, Louis S; Patrick, Donald L; Riley, Anne W; Alexander, John J; Rajmil, Luis; Pleil, Andreas M; Bullinger, Monika

    2013-06-01

    Patient-reported outcome (PRO) instruments for children and adolescents are often included in clinical trials with the intention of collecting data to support claims in a medical product label. The purpose of the current task force report is to recommend good practices for pediatric PRO research that is conducted to inform regulatory decision making and support claims made in medical product labeling. The recommendations are based on the consensus of an interdisciplinary group of researchers who were assembled for a task force associated with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). In those areas in which supporting evidence is limited or in which general principles may not apply to every situation, this task force report identifies factors to consider when making decisions about the design and use of pediatric PRO instruments, while highlighting issues that require further research. Five good research practices are discussed: 1) Consider developmental differences and determine age-based criteria for PRO administration: Four age groups are discussed on the basis of previous research (<5 years old, 5-7 years, 8-11 years, and 12-18 years). These age groups are recommended as a starting point when making decisions, but they will not fit all PRO instruments or the developmental stage of every child. Specific age ranges should be determined individually for each population and PRO instrument. 2) Establish content validity of pediatric PRO instruments: This section discusses the advantages of using children as content experts, as well as strategies for concept elicitation and cognitive interviews with children. 3) Determine whether an informant-reported outcome instrument is necessary: The distinction between two types of informant-reported measures (proxy vs. observational) is discussed, and recommendations are provided. 4) Ensure that the instrument is designed and formatted appropriately for the target age group. Factors to

  15. Brain tumor - children

    Science.gov (United States)

    ... children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children) ... The cause of primary brain tumors is unknown. Primary brain tumors may ... (spread to nearby areas) Cancerous (malignant) Brain tumors ...

  16. Hepatitis B - children

    Science.gov (United States)

    ... B children; HBV children; Pregnancy - hepatitis B children; Maternal transmission - hepatitis B children ... growth and development. Regular monitoring plays an important role in managing the disease in children. You should ...

  17. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu Reprotopia_Main_Menu ... Cancer Fertility Preservation for Children Diagnosed with Cancer Patient Pocket Guides Patient Pocket Guides Patient Guides Fertility ...

  18. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

    Full Text Available Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011. The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

  19. Acute epidural hematoma in children

    International Nuclear Information System (INIS)

    Kusunose, Mutsuo; Nishijima, Michiharu; Fukuda, Osamu; Saito, Tetsugen; Takaku, Akira; Horie, Yukio.

    1992-01-01

    The clinical features and sequential changes of CT findings in children with acute epidural hematoma were correlated with the patient's age. Of the 373 children admitted for head injury during the past 8 years, 61 had an acute traumatic intra-cranial hematoma, and 38 of these had acute epidural hematoma. None of the patients with acute epidural hematoma was under 2 years of age, 15 were 2-6 years old, and 23 were 7-15 years old. In the pre-school group, the numbers of boys and girls were approximately equal, but in the older group boys outnumbered girls. Epidural hematoma was most often parietal (12 patients). Nine patients had posterior fossa hematomas; 30 (78.9%) had skull fractures, and the incidence was not related to the patient's age. In 28 of the 38 patients, CT scans were examined repeatedly for 24 hours. In 15 of them (53.6%), the size of the hematoma increased. In school-aged children, the hematoma tended to be larger than in pre-school children. In four patients with pneumocephalus, the hematoma increased in size. Eleven of the 13, whose hematomas did not increase in size, had skull fractures. (author)

  20. [Asthenic disorders in children].

    Science.gov (United States)

    Chutko, L S; Surushkina, S Iu; Nikishena, I S; Iakovenko, E A; Anisimova, T I; Kuzovenkova, M P

    2010-01-01

    The present study comprised two parts. In the first part, authors attempted to work out the systematics of asthenic disorders based on our own observations of 189 children aged 7-14 years. The following clinical variants of asthenic states in children were singled out: cerebrogenic asthenia (14.3%), somatogenic (13.8%), residual (16.4%), dysontogenetic (20.1%) and neurasthenia (35.4%). In the second part, we summarized the results of treatment of neurasthenia with adaptol (32 patients) compared to pantoham (30 patients). The efficacy of adaptol was higher: the improvement was seen in 71.9% of cases compared to pantoham (56.7%). The good tolerability of adaptol which clinical efficacy is confirmed by neurophysiological and psychological studies is discussed.

  1. Autoimmune hepatitis in children.

    Science.gov (United States)

    Mieli-Vergani, Giorgina; Vergani, Diego

    2002-08-01

    AIH, ASC, and de novo AIH after liver transplantation are childhood liver diseases of an autoimmune nature. The mode of presentation of AIH in childhood is variable, and the disease should be suspected and excluded in all children presenting with symptoms and signs of prolonged or severe acute liver disease. Although corticosteroids are effective in all types of childhood AIH, patients with LKM1 have a higher frequency of acute hepatic failure and relapse after corticosteroid withdrawal than do patients with ANA/SMA. ASC occurs commonly in the absence of inflammatory bowel disease, requires cholangiography for diagnosis, and improves during corticosteroid therapy. The development of AIH de novo in children who undergo liver transplantation for nonautoimmune liver disease may reflect interference with the maturation of T cells by immunosuppressive drugs.

  2. Eosinophilic cystitis in children

    International Nuclear Information System (INIS)

    Liu Ming; Zhang Yuzhen; Li Yuhua; Wang Qiuyan; Xie Hua

    2006-01-01

    Objective: To discuss the clinical manifestations and CT findings of eosinophilic cystitis in children. Methods: Nine cases including Six boys and 3 girls, three to 13 years old, mean age of 8.3- year, have symptoms of hematuria, irritative voiding, dysuria and abdominal pain. The eosinophilic cystitis was pathologically proved in 7 patients and eosinophilic granulomatous cystitis in 2 patients, which based on cystoscopic tissue biopsy or surgery retrospectively. Results: Local thickened bladder walls or nodular and sessile masses along the bladder dome showed in four cases with eosinophilic granulomatous cystitis, and the diffusely irregularly thickened bladder wails showed on CT scans in the rest 5 cases with eosinophilic cystitis. Conclusion: CT findings are helpful to reveal the site, size and other features of eosinophilic cystitis in children. But biopsy of the lesion is necessary to rule out other bladder tumor and selecting the proper management. (authors)

  3. Introduction of peanuts in younger siblings of children with peanut allergy: a prospective, double-blinded assessment of risk, of diagnostic tests, and an analysis of patient preferences.

    Science.gov (United States)

    Bégin, P; Graham, F; Killer, K; Paradis, J; Paradis, L; Des Roches, A

    2016-12-01

    The prevalence of peanut allergy in younger siblings of children with peanut allergy has been reported between 7% and 8.5%, but the anaphylactic risk at the time of introduction is currently unknown, which limits our ability to best counsel parents on this issue. To determine the risk of anaphylaxis and working parameters of allergy testing in this context. One hundred and fifty-four peanut-naïve younger siblings of peanut-allergic children underwent double-blinded skin testing, followed by parent-led peanut introduction. Questionnaires were dispensed to parents to investigate preferences with regard to peanut introduction in this subgroup. Eight participants (5.2%) presented unequivocal IgE-mediated reactions to peanut upon introduction, including five anaphylaxes. These participants were significantly older compared to the rest of the cohort (median 4.0 vs 1.9 years, P = 0.04). The negative predictive value of skin prick test with peanut extract and peanut butter and of specific IgE was 99%, 100%, and 100%, respectively. Six peanut-tolerant participants had positive peanut allergy tests. The option of introducing at home without prior skin testing was associated with high levels of anxiety (median 8.4 on 10-point Likert scale) when compared to supervised introduction (median 3.8, P siblings of children with peanut allergy, and parents are reluctant to introduce at home without testing. Allergy testing prior to introduction is negative in over 90% of cases and carries a high negative predictive value. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Myocardial dysfunction in malnourished children

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    Faddan Nagla Hassan

    2010-01-01

    Full Text Available Background : Malnourished children suffer several alterations in body composition that could produce cardiac abnormalities. Aim : The aim of the present study was to detect the frequency of myocardial damage in malnourished children as shown by echocardiography and cardiac troponin T (cTnT level. Methods : Forty-five malnourished infants and young children (mean±SD of age was 11.24 ±7.88 months were matched with 25 apparently healthy controls (mean±SD of age was 10.78±6.29 months. Blood sample was taken for complete blood picture, liver and kidney function tests, serum sodium, potassium, calcium levels and cTnT. All the malnourished children were subjected to echocardiographic evaluation. Results : Malnourished children showed a significantly lower left ventricular (LV mass than the control group. The LV systolic functions were significantly impaired in patients with severe malnutrition. The cTnT level was higher than the upper reference limits in 11 (24.44% of the studied malnourished children and all of them had a severe degree of malnutrition. The cTnT level was significantly higher in patients with anemia, sepsis and electrolyte abnormalities and it correlated negatively with LV ejection fraction (EF. Six of the studied children with high cTnT levels (54.5% died within 21 days of treatment while only one case (2.9% with normal level of cTnT died within the same period. Conclusions: LV mass is reduced in malnourished children. Children with severe malnutrition have a significant decrease in LV systolic functions. Elevated cTnT levels in malnourished children has both diagnostic and prognostic significance for cardiomyocyte damage.

  5. Street children

    Directory of Open Access Journals (Sweden)

    Rončević Nevenka

    2013-01-01

    Full Text Available According to UNICEF, street child is any child under the age of 18 for whom the street has become home and/or source of income and which is not adequately protected or supervised by adult, responsible person. It has been estimated that there are between 100 and 150 million street children worldwide. Life and work on the street have long term and far-reaching consequences for development and health of these children. By living and working in the street, these children face the highest level of risk. Street children more often suffer from the acute illness, injuries, infection, especially gastrointestinal, acute respiratory infections and sexually transmitted diseases, inadequate nutrition, mental disorders, and drug abuse. They are more often victims of abuse, sexual exploitation, trafficking; they have higher rate of adolescent pregnancy than their peers from poor families. Street children and youth have higher rates of hospitalization and longer hospital stay due to seriousness of illness and delayed health care. Street children/youth are reluctant to seek health care, and when they try, they face many barriers. Street children are invisible to the state and their number in Serbia is unknown. Recently, some non­governmental organizations from Belgrade, Novi Sad and Nis have recognized this problem and tried to offer some help to street children, by opening drop­in centers, but this is not enough. To solve this problem, an engagement of the state and the whole community is necessary, and primary responsibility lies in health, social and educational sector. The best interests of the child must serve as a basic guideline in all activities aimed at improving health, quality of life and rights of children involved in the life and work in the street.

  6. Transcranial Direct Current Stimulation Improves Audioverbal Memory in Stroke Patients.

    Science.gov (United States)

    Kazuta, Toshinari; Takeda, Kotaro; Osu, Rieko; Tanaka, Satoshi; Oishi, Ayako; Kondo, Kunitsugu; Liu, Meigen

    2017-08-01

    The aim of this study was to investigate whether anodal transcranial direct current stimulation over the left temporoparietal area improved audioverbal memory performance in stroke patients. Twelve stroke patients with audioverbal memory impairment participated in a single-masked, crossover, and sham-controlled experiment. The anodal or sham transcranial direct current stimulation was applied during the Rey Auditory Verbal Learning Test, which evaluates the ability to recall a list of 15 heard words over five trials. The number of correctly recalled words was compared between the anodal and sham conditions and the influence of transcranial direct current stimulation on serial position effect of the 15 words was also examined. The increase in the number of correctly recalled words from the first to the fifth trial was significantly greater in the anodal condition than in the sham condition (P transcranial direct current stimulation over the left temporoparietal area improved audioverbal memory performance and induced the primacy effect in stroke patients.

  7. Mycoplasmal pneumonia in children

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, H.; Lengerke, H.J. v.

    1987-10-01

    Roentgenographic findings of bilateral interstitial pneumonia without segmental consolidation and with regional lymphadenitis, which occurs after infancy, are always suggestive of pneumonia from Mycoplasma pneumoniae, as this is one of the most frequent types of pneumonia in children. M. pneumonia can be presumed by the discrepancy between the extensive roentgenographic findings and the generally good condition of the patient. Before therapy is decided upon it is important to know what the etiology is.

  8. Branchial anomalies in children.

    Science.gov (United States)

    Bajaj, Y; Ifeacho, S; Tweedie, D; Jephson, C G; Albert, D M; Cochrane, L A; Wyatt, M E; Jonas, N; Hartley, B E J

    2011-08-01

    Branchial cleft anomalies are the second most common head and neck congenital lesions seen in children. Amongst the branchial cleft malformations, second cleft lesions account for 95% of the branchial anomalies. This article analyzes all the cases of branchial cleft anomalies operated on at Great Ormond Street Hospital over the past 10 years. All children who underwent surgery for branchial cleft sinus or fistula from January 2000 to December 2010 were included in this study. In this series, we had 80 patients (38 female and 42 male). The age at the time of operation varied from 1 year to 14 years. Amongst this group, 15 patients had first branchial cleft anomaly, 62 had second branchial cleft anomaly and 3 had fourth branchial pouch anomaly. All the first cleft cases were operated on by a superficial parotidectomy approach with facial nerve identification. Complete excision was achieved in all these first cleft cases. In this series of first cleft anomalies, we had one complication (temporary marginal mandibular nerve weakness. In the 62 children with second branchial cleft anomalies, 50 were unilateral and 12 were bilateral. In the vast majority, the tract extended through the carotid bifurcation and extended up to pharyngeal constrictor muscles. Majority of these cases were operated on through an elliptical incision around the external opening. Complete excision was achieved in all second cleft cases except one who required a repeat excision. In this subgroup, we had two complications one patient developed a seroma and one had incomplete excision. The three patients with fourth pouch anomaly were treated with endoscopic assisted monopolar diathermy to the sinus opening with good outcome. Branchial anomalies are relatively common in children. There are three distinct types, first cleft, second cleft and fourth pouch anomaly. Correct diagnosis is essential to avoid inadequate surgery and multiple procedures. The surgical approach needs to be tailored to the type

  9. Melatonin Treatment Reduces Oxidative Damage and Normalizes Plasma Pro-Inflammatory Cytokines in Patients Suffering from Charcot-Marie-Tooth Neuropathy: A Pilot Study in Three Children.

    Science.gov (United States)

    Chahbouni, Mariam; López, María Del Señor; Molina-Carballo, Antonio; de Haro, Tomás; Muñoz-Hoyos, Antonio; Fernández-Ortiz, Marisol; Guerra-Librero, Ana; Acuña-Castroviejo, Darío

    2017-10-14

    Charcot-Marie-Tooth neuropathy (CMT) is a motor and sensory neuropathy comprising a heterogeneous group of inherited diseases. The CMT1A phenotype is predominant in the 70% of CMT patients, with nerve conduction velocity reduction and hypertrophic demyelination. These patients have elevated oxidative stress and chronic inflammation. Currently, there is no effective cure for CMT; herein, we investigated whether melatonin treatment may reduce the inflammatory and oxidative damage in CMT1A patients. Three patients, aged 8-10 years, were treated with melatonin (60 mg at 21:00 h plus 10 mg at 09:00 h), and plasma levels of lipid peroxidation (LPO), nitrites (NOx), IL-1β, IL-2, IL-6, TNF-α, INF-γ, oxidized to reduced glutathione (GSSG/GSH) ratio, and the activities of superoxide dismutase (SOD), glutathione-S transferase (GST), glutathione peroxidase (GPx), and reductase (GRd), were determined in erythrocytes at 3 and 6 months of treatment. Healthy age- and sex-matched subjects were used as controls. The results showed increased activities of SOD, GST, GPx, and GRd in CMT1A patients, which were reduced at 3 and 6 months of treatment. The GSSG/GSH ratio significantly increased in the patients, returning to control values after melatonin treatment. The inflammatory process was confirmed by the elevation of all proinflammatory cytokines measured, which were also normalized by melatonin. LPO and NOx, which also were elevated in the patients, were normalized by melatonin. The results document beneficial effects of the use of melatonin in CMT1A patients to reduce the hyperoxidative and inflammatory condition, which may correlate with a reduction of the degenerative process.

  10. Diagnóstico de laboratorio en pacientes ingresados por infección urinaria en un hospital pediátrico Laboratory diagnosis in patients admitted due to urinary infection in a children hospital

    Directory of Open Access Journals (Sweden)

    Margarita Isabel Chávez Isla

    2012-01-01

    Full Text Available Se realizó un estudio descriptivo, longitudinal y retrospectivo de 64 pacientes con infección urinaria, ingresados en el Hospital Infantil Sur de Santiago de Cuba desde enero hasta diciembre del 2010, con vistas a determinar algunos aspectos clínicos diagnósticos. En la mayoría de los niños hospitalizados prevalecieron: anemia, leucocitosis, eritrosedimentación acelerada, así como leucocituria ligera; y entre los microorganismos: Escherichia coli, Proteus mirabilis y Enterobacteriaceae. Para verificar la presencia de esas alteraciones, deben indicarse los exámenes complementarios: hemograma completo, eritrosedimentación, cituria y urocultivo, cuyos resultados posibilitan establecer un diagnóstico concluyente.A descriptive, longitudinal and retrospective study of 64 patients with urinary infection, admitted at the Southern Children Hospital in Santiago de Cuba was carried out from January to December, 2010, with the objective of determining some clinical and diagnostic aspects. In most of the hospitalized children, anemia, leucocytosis, accelerated erytrosedimentation, as well as mild leucocyturia prevailed; and among the organisms: Escherichia coli, Proteus mirabilis and Enterobacteriaceae. To verify the presence of these changes, additional tests such as complete blood count, erytrosedimentation, cyturia and urine culture should be indicated as their results facilitate to establish a conclusive diagnosis.

  11. Children's Bureau

    Science.gov (United States)

    ... of adoptions, and strengthen foster care. Watch the Centennial Video News Views and Experiences of Low-Income ... Welfare Capacity Building Collaborative CB Express Children's Bureau Centennial Home About What We Do Our Organization History ...

  12. Do we understand children's restlessness? Constructing ecologically valid understandings through reflexive cooperation

    Directory of Open Access Journals (Sweden)

    Anna Helle-Valle

    2015-12-01

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is the most widely used children's mental health diagnosis today, but the validity of the diagnosis is controversial, for instance, because it might conceal relational and ecological dimensions of restlessness. We invited parents and professionals from one local community in western Norway to participate in cooperative group discussions on how to conceptualize and understand children's restlessness. We carried out a thematic and reflexive analysis of the cooperative group discussions on ADHD and children's restlessness, and present findings related to three ecological levels inspired by Bronfenbrenner's ecological systems model. At the level of the individual, restlessness was discussed as individual trait, as the expectation to be seen and heard, and as a result of traumatization. At the level of dyad, group or family, restlessness was discussed as a relational phenomenon and as parents' problems. At the level of community, restlessness was discussed as lack of cooperation and lack of structures or resources. Our findings show how contextualized and cooperative reflexivity can contribute to more valid understandings of children's restlessness, and how cooperative inquiry can stimulate reflections about solidarity and sustainability in relation to adult's actions.

  13. False rumors and true belief: memory processes underlying children's errant reports of rumored events.

    Science.gov (United States)

    Principe, Gabrielle F; Haines, Brooke; Adkins, Amber; Guiliano, Stephanie

    2010-12-01

    Previous research has shown that overhearing an errant rumor--either from an adult or from peers--about an earlier experience can lead children to make detailed false reports. This study investigates the extent to which such accounts are driven by changes in children's memory representations or merely social demands that encourage the reporting of rumored information. This was accomplished by (a) using a warning manipulation that eliminated social pressures to report an earlier heard rumor and (b) examining the qualitative characteristics of children's false narratives of a rumored-but-nonexperienced event. Findings indicated that overheard rumors can induce sensory and contextual characteristics in memory that can lead children to develop genuine false beliefs in seeing rumored-but-nonexperienced occurrences. Such constructive tendencies were especially likely among 3- and 4-year-olds (relative to 5- and 6-year-olds) and when rumors were picked up from peers during natural social interactions (relative to when they were planted by an adult). (c) 2010 Elsevier Inc. All rights reserved.

  14. The importance the pharmacist for rational use of drugs in children and teenagers

    Directory of Open Access Journals (Sweden)

    Regiane Cristina dos Santos Moreira Borges

    2013-01-01

    Full Text Available Medication use without orientation can cause damage, especially among children and teenagers. The World Health Organization (WHO recommends actions to encourage the rational drug use and the Pharmacist is pointed as an important health educator. The goal was to identify the profile of medication use in children and adolescents and discuss the role of pharmacists to promote the rational drug use. A cross-sectional epidemiological study was conducted in three schools in the urban area of Extrema-MG, Brazil. The study included 525 children and adolescents between 0 and 18 years who completed a questionnaire about drug use with their parents or guardians. Children and adolescents who participated in the study, 58.5% reported using drugs in the last 6 months. Most understood the indications of the drugs used. The main causes for the purchase of non-prescription drugs were headache, colds and flu, sore throat and cough. Only a small proportion (7.0% said they do not use "drugs" without prescription. Most have heard about the rational use of medicines (57.5% and seeks the help of the pharmacist for the purchase of OTC drugs ever (57.3% or sometimes (25.1%. The importance of the pharmacist to rational drug use was confirmed by the usage profile observed. Only a minority used only with prescription drugs and most calls for help from the pharmacist to buy non-prescription medicines.

  15. THE IMPORTANCE THE PHARMACIST FOR RATIONAL USE OF DRUGS IN CHILDREN AND TEENAGERS

    Directory of Open Access Journals (Sweden)

    Regiane Cristina dos Santos Moreira Borges

    2013-05-01

    Full Text Available Medication use without orientation can cause damage, especially among children and teenagers. The World Health Organization (WHO recommends actions to encourage the rational drug use and the Pharmacist is pointed as an important health educator. The goal was to identify the profile of medication use in children and adolescents and discuss the role of pharmacists to promote the rational drug use. A cross-sectional epidemiological study was conducted in three schools in the urban area of Extrema-MG, Brazil. The study included 525 children and adolescents between 0 and 18 years who completed a questionnaire about drug use with their parents or guardians. Children and adolescents who participated in the study, 58.5% reported using drugs in the last 6 months. Most understood the indications of the drugs used. The main causes for the purchase of non-prescription drugs were headache, colds and flu, sore throat and cough. Only a small proportion (7.0% said they do not use "drugs" without prescription. Most have heard about the rational use of medicines (57.5% and seeks the help of the pharmacist for the purchase of OTC drugs ever (57.3% or sometimes (25.1%. The importance of the pharmacist to rational drug use was confirmed by the usage profile observed. Only a minority used only with prescription drugs and most calls for help from the pharmacist to buy nonprescription medicines.

  16. Characterization of Courtesy Stigma Perceived by Parents of Overweight Children with Bardet-Biedl Syndrome

    Science.gov (United States)

    Hamlington, Barbara; Ivey, Lauren E.; Brenna, Ethan; Biesecker, Leslie G.; Biesecker, Barbara B.; Sapp, Julie C.

    2015-01-01

    Background A child’s obesity is generally perceived by the public to be under the control of the child’s parents. While the health consequences of childhood obesity are well understood, less is known about psychological and social effects of having an obese child on parents. We set out to characterize stigma and courtesy stigma experiences surrounding obesity among children with Bardet-Biedl syndrome (BBS), a multisystem genetic disorder, and their parents. Methods Twenty-eight parents of children with BBS participated in semi-structured interviews informed by social stigmatization theory, which describes courtesy stigma as parental perception of stigmatization by association with a stigmatized child. Parents were asked to describe such experiences. Results Parents of children with BBS reported the child’s obesity as the most frequent target of stigmatization. They perceived health care providers as the predominant source of courtesy stigma, describing interactions that resulted in feeling devalued and judged as incompetent parents. Conclusions Parents of children with BBS feel blamed by others for their child’s obesity and described experiences that suggest health care providers may contribute to courtesy stigma and thus impede effective communication about managing obesity. Health care providers may reinforce parental feelings of guilt and responsibility by repeating information parents may have previously heard and ignoring extremely challenging barriers to weight management, such as a genetic predisposition to obesity. Strategies to understand and incorporate parents’ perceptions and causal attributions of their children’s weight may improve communication about weight control. PMID:26473736

  17. Children's success at detecting circular explanations and their interest in future learning.

    Science.gov (United States)

    Mills, Candice M; Danovitch, Judith H; Rowles, Sydney P; Campbell, Ian L

    2017-10-01

    These studies explore elementary-school-aged children's ability to evaluate circular explanations and whether they respond to receiving weak explanations by expressing interest in additional learning. In the first study, 6-, 8-, and 10-year-olds (n = 53) heard why questions about unfamiliar animals. For each question, they rated the quality of single explanations and later selected the best explanation between pairs of circular and noncircular explanations. When judging single explanations, 8- and 10-year-olds, and to some extent 6-year-olds, provided higher ratings for noncircular explanations compared to circular ones. When selecting between pairs of explanations, all age groups preferred noncircular explanations to circular ones, but older children did so more consistently than 6-year-olds. Children who recognized the weakness of the single circular explanations were more interested in receiving additional information about the question topics. In Study 2, all three age groups (n = 87) provided higher ratings for noncircular explanations compared to circular ones when listening to responses to how questions, but older children showed a greater distinction in their ratings than 6-year-olds. Moreover, the link between recognizing circular explanations as weak and interest in future learning could not be accounted for solely by individual differences in verbal intelligence. These findings illustrate the developmental trajectory of explanation evaluation and support that recognition of weak explanations is linked to interest in future learning across the elementary years. Implications for education are discussed.

  18. Power imbalance and consumerism in the doctor-patient relationship: health care providers' experiences of patient encounters in a rural district in India.

    Science.gov (United States)

    Fochsen, Grethe; Deshpande, Kirti; Thorson, Anna

    2006-11-01

    The aim of this study is to explore health care providers' experiences and perceptions of their encounters with male and female patients in a rural district in India with special reference to tuberculosis (TB) care. The authors conducted semistructured interviews with 22 health care providers, 17 men and 5 women, from the public and private health care sectors. Findings reveal that doctors adopted an authoritarian as well as a consumerist approach in the medical encounter, indicating that power imbalances in the doctor-patient relationship are negotiable and subject to change. Gender was identified as an influencing factor of the doctor's dominance. A patient-centered approach, acknowledging patients' own experiences and shared decision making, is called for and should be included in TB control activities. This seems to be especially important for female patients, whose voices were not heard in the medical encounter.

  19. [Community acquired pneumonia in children: Treatment of complicated cases and risk patients. Consensus statement by the Spanish Society of Paediatric Infectious Diseases (SEIP) and the Spanish Society of Paediatric Chest Diseases (SENP)].

    Science.gov (United States)

    Moreno-Pérez, D; Andrés Martín, A; Tagarro García, A; Escribano Montaner, A; Figuerola Mulet, J; García García, J J; Moreno-Galdó, A; Rodrigo Gonzalo de Lliria, C; Saavedra Lozano, J

    2015-09-01

    The incidence of community-acquired pneumonia complications has increased during the last decade. According to the records from several countries, empyema and necrotizing pneumonia became more frequent during the last few years. The optimal therapeutic approach for such conditions is still controversial. Both pharmacological management (antimicrobials and fibrinolysis), and surgical management (pleural drainage and video-assisted thoracoscopic surgery), are the subject of continuous assessment. In this paper, the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases have reviewed the available evidence. Consensus treatment guidelines are proposed for complications of community-acquired pneumonia in children, focusing on parapneumonic pleural effusion. Recommendations are also provided for the increasing population of patients with underlying diseases and immunosuppression. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  20. Characteristic of x-ray picture of urolithiasis in children and juveniles

    International Nuclear Information System (INIS)

    Kramnij, Yi.O.; Bortnij, M.O.; Voron'zhev, Yi.O.; Ul'yanchenko, Yi.M.

    1999-01-01

    More exactly the characteristics of urolithiasis x-ray picture in children and juveniles was defined. X-ray study of 42 patients. Mainly x-ray positive calculi localized in the pelvis and ureters occur in children patients

  1. Children Hospitalized With Varicella in Denmark

    DEFF Research Database (Denmark)

    Glode Helmuth, Ida; Broccia, Marcella Ditte; Glenthøj, Jonathan Peter

    2017-01-01

    is not part of the national immunization program and there is no national surveillance of varicella. The primary aim of the study was to describe the epidemiology and clinical characteristics of children hospitalized with varicella in Denmark. The secondary aim was to validate the sensitivity and completeness...... of the Danish National Patient Register. METHODS: Active surveillance of children hospitalized with varicella was carried out at 4 pediatric departments. In the Danish National Patient Register, we identified all children discharged with an International Classification of Diseases, 10th revision code...... of varicella from the 4 departments. We used a capture-recapture analysis to estimate the "true" number of hospitalized children with varicella. RESULTS: By active surveillance, we identified 86 children eligible for clinical description. In 87% of cases, the children were 0-4 years of age. Complications were...

  2. 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)

  3. Patellofemoral instability in children: T2 relaxation times of the patellar cartilage in patients with and without patellofemoral instability and correlation with morphological grading of cartilage damage.

    Science.gov (United States)

    Kang, Chang Ho; Kim, Hee Kyung; Shiraj, Sahar; Anton, Christopher; Kim, Dong Hoon; Horn, Paul S

    2016-07-01

    Patellofemoral instability is one of the most common causes of cartilage damage in teenagers. To quantitatively evaluate the patellar cartilage in patients with patellofemoral instability using T2 relaxation time maps (T2 maps), compare the values to those in patients without patellofemoral instability and correlate them with morphological grades in patients with patellofemoral instability. Fifty-three patients with patellofemoral instability (mean age: 15.9 ± 2.4 years) and 53 age- and gender-matched patients without patellofemoral instability were included. Knee MR with axial T2 map was performed. Mean T2 relaxation times were obtained at the medial, central and lateral zones of the patellar cartilage and compared between the two groups. In the patellofemoral instability group, morphological grading of the patellar cartilage (0-4) was performed and correlated with T2 relaxation times. Mean T2 relaxation times were significantly longer in the group with patellofemoral instability as compared to those of the control group across the patellar cartilage (Student's t-test, Ppatellofemoral instability, patellar cartilage damage occurs across the entire cartilage with the highest T2 values at the apex. T2 relaxation times directly reflect the severity in low-grade cartilage damage, which implies an important role for T2 maps in differentiating between normal and low-grade cartilage damage.

  4. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  5. Balloon Eustachian Tuboplasty in children.

    Science.gov (United States)

    Leichtle, A; Hollfelder, D; Wollenberg, B; Bruchhage, K-L

    2017-06-01

    Endonasal ballon dilatation of the Eustachian tube (BET) is a promising treatment for Eustachian tube dysfunction with encouraging results over the last years in adults. In addition, in children, single studies demonstrated promising results, but revealed the necessity for broader and additional studies. Our retrospective analysis presents outcomes with BET in children with chronic obstructive dysfunction of the Eustachian tube, showing resistance to the conventional therapy after adenotomy with paracentesis or grommets (ventilation tubes). The data of 52 children, having undergone BET from April 2011 to April 2016, were retrospectively evaluated. Most children in our study presented middle ear effusion (47%), adhesive (21%), chronic otitis media (13%), or recurrent acute otitis media (11%). In 24 (37%) children, we combined BET with a paracentesis, in 5 (8%) patients with a tympanoplasty type I and in 3 (5%) patients with a type III. All children were assessed using an audiogram, tympanometry, and tubomanometry (50 mbar) before and after BET. In addition, we evaluated the results of the Lübecker questionnaire, which we performed before and after BET. The childrens' ear-related and quality of life-related symptoms, such as pressure equalization, ear pressure, hearing loss, pain and limitation in daily life, and satisfaction pre- and postoperatively, were analyzed. In the majority of patients, we could see an improvement in the ear pressure, hearing loss, limitation in daily life, and satisfaction with recurrent inflammations, underlined by better outcomes in the tubomanometry and the tympanogram. BET in children is a safe, efficient, and promising method to treat chronic tube dysfunction, especially as a second line treatment, when adenotomy, paracentesis, or grommets failed before.

  6. Management of severe constipation in children.

    Science.gov (United States)

    Noviello, C; Romano, M; Zangari, A; Papparella, A; Martino, A; Cobellis, G

    2013-04-01

    Constipation is a common pediatric problem. Sometimes the hospitalization is necessary and in these patients the organic cause should be verified. The authors report their experience in the management of children with severe constipation. Anorectal manometry (ARM) was performed after a careful examination of perineum and bowel disimpaction. Once organic cause had be excluded, the patient got medical therapy. If recto-anal inhibitory reflex (RAIR) was absent, not collaborative patient or medical treatment failed, the child underwent contrast enema (CE) and rectal suction biopsies (RSB). Local anesthetics were used for anal fissures or internal anal sphincter (IAS) hypertonia. Anal malformations and Hirschsprung's disease (HD) were surgically treated. Posterior sagittal anorectoplasty was performed for anal malformations. In 5 years 98 children (63 males) were observed (mean age 6 years). 5 children were premature for gestational age, 4 presented failure to thrive, 5 anal malformations and 45 anal fissures. ARM was performed in 87 children and 74 of them showed normal RAIR. Hypertonia of the IAS was recorded in 38 patients. RAIR was absent/unclear in 13 patients. Follow-up revealed 6 patients (negative to ARM) with poor results without oral laxative. CE was performed in 19 children (2 positive cases) and RBS in 25 patients (2 cases of HD). Children with severe constipation must be carefully observed and studied because of not negligible incidence of organic cause. The first step in the management of these patients is the evacuation of the fecaloma.

  7. External beam orbital radiotherapy (EBORT) in patients with retinoblastoma: a Saudi-Arabian experience with 120 children from 1976 to 1993

    International Nuclear Information System (INIS)

    Pradhan, D.G.; Sandridge, A.; Kandil, A.; Mullaney, P.; Abboud, EB.; Gray, A.J.

    1996-01-01

    Purpose/Objective: To characterize the patient population and treatment options for patients with Retinoblastoma (RB) diagnosed at KKESH and referred for radiation therapy (RT) to KFSH and RC, Riyadh, Saudi Arabia from 1976 to 1993 and to record the treatment outcomes. Material/Methods: A retrospective study of 120 patients (a total of 193 affected eyes) referred for RT. 75% of the eyes were staged Reese-Ellsworth (RE) Stage Va or Vb disease. In 75% family history was available, and showed consanguineous marriages in 65%, (42% first cousins). A familial history of RB was present in 15%. Male:Female ratio 1.8:1.0. Patients were divided into three groups. Group A, 60 patients (64 eyes) were treated with EBORT to the intact eye to preserve vision. 55 of these patients (92%) had bilateral disease and 5 had unilateral disease. 49 patients had one eye already removed as primary treatment. Mean age at diagnosis was 20 months (standard deviation (SD) 24.88), range 0-148. Major presenting symptom was leukokoria in 75% and poor vision in 24%. RE staging was I:12%, II:10%, III:12%, IV:23% and V:43%. 28 of 60 patients (47%) also received chemotherapy (CT) with vincristine, adriamycin and cyclophosphamide (VAC), 7% before, 10% during and 30% after EBORT. Mean follow-up was 48 months, (SD 43.85 months), range was 0-14 years. 4 patients received EBORT to both eyes. Standard treatment until 1992 was 45Gy in 12 fractions of 3.75Gy each, three times a week over 18 days with 6 or 8MV Photons or Cobalt-60. Assuming the (α(β)) ratio for tumor control at 10, Tk = 21 days, Tpot = 5 days then the Biological Equivalent Dose (BED) for this regime 62Gy 10 for early effect and 101Gy 3 for late effects. Since 1992 this has been reduced and is currently BED (early) 54Gy 10 and BED (late) 76Gy 3 (44Gy in 20 fractions in 26 days). Group B consisted of 23 patients (28 eyes) referred for RT to control local disease in the orbit usually after enucleation (23 eyes) and treated with curative intent

  8. REHABILITATION OF CHILDREN WITH FUNCTIONAL (OBSTIPATIONAL ENCOPRESIS

    Directory of Open Access Journals (Sweden)

    M.Yu. Denisov

    2010-01-01

    Full Text Available Author describes peculiarities of functional (obstipational encopresis in children with prolonged chronic constipation. Disease relates to many predisposing factors; the most significant ones are perinatal pathology, disorders of nutritional behavior, psychological traumatic experience and social disadaptation of patient. Complex rehabilitation program of children with functional encopresis allows provision of optimal medical care. Key words: children, functional ecopresis, fecal incontinence, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5:121-126

  9. Dysphagia in children with repaired oesophageal atresia

    OpenAIRE

    Coppens, C.H.; Engel-Hoek, L. van den; Scharbatke, H.E.; Groot, S.A. de; Draaisma, J.M.T.

    2016-01-01

    Dysphagia is a common problem in children with repaired oesophageal atresia (OA). Abnormalities in the oropharyngeal and oesophageal phase have hardly been studied. The aims of this study were to assess the prevalence of dysphagia in children with repaired OA and to identify and differentiate oral and pharyngeal dysphagia based on videofluoroscopic swallow study (VFSS) findings in a limited number of children in this cohort. Medical records of 111 patients, born between January 1996 and July ...

  10. Camera Traps Can Be Heard and Seen by Animals

    Science.gov (United States)

    Meek, Paul D.; Ballard, Guy-Anthony; Fleming, Peter J. S.; Schaefer, Michael; Williams, Warwick; Falzon, Greg

    2014-01-01

    Camera traps are electrical instruments that emit sounds and light. In recent decades they have become a tool of choice in wildlife research and monitoring. The variability between camera trap models and the methods used are considerable, and little is known about how animals respond to camera trap emissions. It has been reported that some animals show a response to camera traps, and in research this is often undesirable so it is important to understand why the animals are disturbed. We conducted laboratory based investigations to test the audio and infrared optical outputs of 12 camera trap models. Camera traps were measured for audio outputs in an anechoic chamber; we also measured ultrasonic (n = 5) and infrared illumination outputs (n = 7) of a subset of the camera trap models. We then compared the perceptive hearing range (n = 21) and assessed the vision ranges (n = 3) of mammals species (where data existed) to determine if animals can see and hear camera traps. We report that camera traps produce sounds that are well within the perceptive range of most mammals’ hearing and produce illumination that can be seen by many species. PMID:25354356

  11. How age and linguistic competence affect memory for heard information

    Directory of Open Access Journals (Sweden)

    Bruce A Schneider

    2016-05-01

    Full Text Available The short-term memory performance of a group of younger adults, for whom English was a second language (young EL2 listeners, was compared to that of younger and older adults for whom English was their first language (EL1 listeners. To-be-remembered words were presented in noise and in quiet. When presented in noise, the listening situation was adjusted to insure that the likelihood of recognizing the individual words was comparable for all groups. Previous studies which used the same paradigm found memory performance of older EL1 adults on this paired-associate task to be poorer than that of their younger EL1 counterparts both in quiet and in a background of babble. The purpose of the present study was to investigate whether the less well-established semantic and linguistic skills of EL2 listeners would also lead to memory deficits even after equating for word recognition as was done for the younger and older EL1 listeners. No significant differences in memory performance were found between young EL1 and EL2 listeners after equating for word recognition, indicating that the EL2 listeners’ poorer semantic and linguistic skills had little effect on their ability to memorize and recall paired associates. This result is consistent with the hypothesis that age-related declines in memory are primarily due to age-related declines in the perceptual and attentional processes required for extracting the word pairs from a background babble of voices. Such declines are likely to increase the load on higher-order (possibly limited cognitive processes supporting memory. The problems that these results pose for the comprehension of spoken language in these three groups are discussed.

  12. Heard the One About the Principal Who Painted the Door?

    Science.gov (United States)

    Noe, Laurie R.

    2002-01-01

    Describes how school leaders can harness the power of stories to help maintain or create a positive school environment, explaining the role of the storyteller, how to choose the story, where to find meaningful stories, how to recognize people by name in a story, how to shape the message, and how to appeal to the audience's intellect and emotions.…

  13. Inferior Blueberries and Other Excuses I've Heard

    Science.gov (United States)

    Van Winkle, David

    2005-01-01

    In this article, the author relates the blueberry story, as one of many excuses for barely advancing the status quo, and suggests a workable framework that is common to both education and business. Unfortunately, many business and education leaders seem intent on fixing specific issues and fail to acquire a systemic perspective. These isolated…

  14. Making the "Minority" Voice Heard: Critical Communication Pedagogy and Dissent

    Science.gov (United States)

    Lawless, Brandi

    2018-01-01

    Courses: Intercultural Communication, Argumentation and Advocacy, Communication and Education. Objectives: This activity is designed to help students to problem-pose and think critically about policies/laws that influence education. Students will be exposed to U.S. policy and will be able to articulate a critical dissent of such documents.

  15. Women Are Seen More than Heard in Online Newspapers

    Science.gov (United States)

    Jia, Sen; Lansdall-Welfare, Thomas; Sudhahar, Saatviga; Carter, Cynthia; Cristianini, Nello

    2016-01-01

    Feminist news media researchers have long contended that masculine news values shape journalists’ quotidian decisions about what is newsworthy. As a result, it is argued, topics and issues traditionally regarded as primarily of interest and relevance to women are routinely marginalised in the news, while men’s views and voices are given privileged space. When women do show up in the news, it is often as “eye candy,” thus reinforcing women’s value as sources of visual pleasure rather than residing in the content of their views. To date, evidence to support such claims has tended to be based on small-scale, manual analyses of news content. In this article, we report on findings from our large-scale, data-driven study of gender representation in online English language news media. We analysed both words and images so as to give a broader picture of how gender is represented in online news. The corpus of news content examined consists of 2,353,652 articles collected over a period of six months from more than 950 different news outlets. From this initial dataset, we extracted 2,171,239 references to named persons and 1,376,824 images resolving the gender of names and faces using automated computational methods. We found that males were represented more often than females in both images and text, but in proportions that changed across topics, news outlets and mode. Moreover, the proportion of females was consistently higher in images than in text, for virtually all topics and news outlets; women were more likely to be represented visually than they were mentioned as a news actor or source. Our large-scale, data-driven analysis offers important empirical evidence of macroscopic patterns in news content concerning the way men and women are represented. PMID:26840432

  16. Heard it through the grapevine: indirect networks and employee creativity.

    Science.gov (United States)

    Hirst, Giles; Van Knippenberg, Daan; Zhou, Jing; Quintane, Eric; Zhu, Cherrie

    2015-03-01

    Social networks can be important sources of information and insights that may spark employee creativity. The cross-fertilization of ideas depends not just on access to information and insights through one's direct network-the people one actually interacts with--but at least as much on access to the indirect network one's direct ties connect one to (i.e., people one does not interact with directly, but with whom one's direct ties interact). We propose that the reach efficiency of this indirect network--its nonredundancy in terms of interconnections--is positively related to individual creativity. To help specify the boundaries of this positive influence of the indirect network, we also explore how many steps removed the indirect network still adds to creativity. In addition, we propose that the efficiency (nonredundancy) of one's direct network is important here, because more efficient direct networks give one access to indirect networks with greater reach efficiency. Our hypotheses were supported in a multilevel analysis of multisource survey data from 223 sales representatives nested within 11 divisions of a Chinese pharmaceutical company. This analysis also showed that the creative benefits of reach efficiency were evident for 3 and 4 degrees of separation but were greatest for indirect ties that depend only on one's direct ties. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  17. Hey! Have You Heard about Herds? Science Safari.

    Science.gov (United States)

    Sheldon, Louisa; And Others

    This is the second program in the Science Safari series produced by the Fairfax Network of the Fairfax County Public Schools. The series and the accompanying print materials are designed to show students a broad spectrum of animal life, introduce students to a variety of people who work with animals, and help students become aware of the important…

  18. Have you heard?… again in 2016!

    CERN Multimedia

    HSE Unit

    2016-01-01

    10 March 2016 will be the 19th national day of hearing in France, an information and prevention campaign with “A noisy world… what about our ears?” as this year’s theme. CERN will be participating in the day’s events in order to raise awareness of the effects of noise and its impact on our health.    All types of people… all ages… all the time… Today we live in increasingly noisy environments due to television, headphones, transport, machines at work, leisure activities, etc.  Health specialists confirm that all this regular noise exposure is linked to a rise in the early onset of noise-related conditions (tinnitus, deafness, etc.). This hazard affects people young and old, at work as well as at home. Noise is part of our daily lives and yet we hardly notice it anymore! Our ears… a fragile mechanism… Our ability to hear rests on a fragile m...

  19. Camera traps can be heard and seen by animals.

    Directory of Open Access Journals (Sweden)

    Paul D Meek

    Full Text Available Camera traps are electrical instruments that emit sounds and light. In recent decades they have become a tool of choice in wildlife research and monitoring. The variability between camera trap models and the methods used are considerable, and little is known about how animals respond to camera trap emissions. It has been reported that some animals show a response to camera traps, and in research this is often undesirable so it is important to understand why the animals are disturbed. We conducted laboratory based investigations to test the audio and infrared optical outputs of 12 camera trap models. Camera traps were measured for audio outputs in an anechoic chamber; we also measured ultrasonic (n = 5 and infrared illumination outputs (n = 7 of a subset of the camera trap models. We then compared the perceptive hearing range (n = 21 and assessed the vision ranges (n = 3 of mammals species (where data existed to determine if animals can see and hear camera traps. We report that camera traps produce sounds that are well within the perceptive range of most mammals' hearing and produce illumination that can be seen by many species.

  20. Rumblings in the forests heard loudly on the Web...

    OpenAIRE

    Patrick O. Waeber; Lucienne Wilmé

    2010-01-01

    This, the first issue in 2010 of the Journal of Madagascar Conservation & Development (MCD), deals with illegal and destructive selective logging activities within the supposedly protected National Parks of Madagascar. Accounts of these multifaceted crimes and their impacts began circulating in the Malagasy forests and have since come to the attention of the global community courtesy of the World Wide Web. In this issue, through the incredible efforts of numerous authors, reviewers, editors a...

  1. How Age and Linguistic Competence Affect Memory for Heard Information.

    Science.gov (United States)

    Schneider, Bruce A; Avivi-Reich, Meital; Leung, Caterina; Heinrich, Antje

    2016-01-01

    The short-term memory performance of a group of younger adults, for whom English was a second language (young EL2 listeners), was compared to that of younger and older adults for whom English was their first language (EL1 listeners). To-be-remembered words were presented in noise and in quiet. When presented in noise, the listening situation was adjusted to ensure that the likelihood of recognizing the individual words was comparable for all groups. Previous studies which used the same paradigm found memory performance of older EL1 adults on this paired-associate task to be poorer than that of their younger EL1 counterparts both in quiet and in a background of babble. The purpose of the present study was to investigate whether the less well-established semantic and linguistic skills of EL2 listeners would also lead to memory deficits even after equating for word recognition as was done for the younger and older EL1 listeners. No significant differences in memory performance were found between young EL1 and EL2 listeners after equating for word recognition, indicating that the EL2 listeners' poorer semantic and linguistic skills had little effect on their ability to memorize and recall paired associates. This result is consistent with the hypothesis that age-related declines in memory are primarily due to age-related declines in higher-order processes supporting stream segregation and episodic memory. Such declines are likely to increase the load on higher-order (possibly limited) cognitive processes supporting memory. The problems that these results pose for the comprehension of spoken language in these three groups are discussed.

  2. Have You Heard This? Designing Mobile Social Software

    Directory of Open Access Journals (Sweden)

    Jørn Georg Sannes Knutsen

    2010-07-01

    Full Text Available ‘Desktop’ social networking services are migrating to mobile devices. Research into the design of mobile social software (MoSoSo, especially its communication design, is emerging. The case we present is from a collaborative, interdisciplinary research project into communicative design innovation concerning these technologies. In focus is the design of what we label the communicative prototype for an interaction and media centred view of social software development. This view is applied to an exploratory design research case that extends an established online social service to the iPhone/iPod platform. The conceptual design in the case is intended to enable the discovery of independent, non-commercial music. The projected service was developed in consultation with a national public service broadcaster. We frame the design and analysis within a sociocultural approach to mediated communication and research by design. We employ mixed methods both in design and in research. We argue that a communicative stance in early concept development offers valuable insights on the ongoing design of social software. The communication expertise of interaction designers is central to this.

  3. Stroke in Saudi children

    International Nuclear Information System (INIS)

    Salih, Mustafa A.; Al-Jarallah, Ahmed A.; Kentab, Anal Y.; Al-Nasser, Mohammad N.; Bahakim, Hassan M.; Kurban, Khadija M.; Zahraa, Jihad N.; Nasir, Ali A.; Abdel-Gader, Abdel-Galil M.; Alorainy, Ibrahim A.; Hassan, Hamdy H.; Kabiraj, Mohammad M.; Khoja, Waleed A.

    2006-01-01

    To describe the epidemiology and clinical features of stroke in a prospective and retrospective cohort of Saudi children and ascertain the causes, pathogenesis, and risk factors. The Retrospective Study Group (RSG) included children with stroke who were evaluated at the Division of Pediatric Neurology, or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the period July 1992 to February 2001. The Prospective Study Group (PSG) included those seen between February 2001 and March 2003. During the combined study periods of 10 years and 7 months, 117 children (61 males and 56 females, aged one month-12 years) were evaluated; the majority (89%) of these were Saudis. The calculated annual hospital frequency rate of stroke was 27.1/100,000 of the pediatric (1month-12 years) population The mean age at onset of the initial stroke in the 104 Saudi children was 27.1 months (SD=39.3 months) median and median was 6 months. Ischemic strokes accounted for the majority of cases (76%). Large-vessel infarcts (LVI, 51.9%) were more common than small-vessel lacunar lesions (SVLL, 19.2%). Five patients (4.8%) had combined LVI and SVLL. Intracranial hemorrhage was less common (18.2%), whereas sinovenous thrombosis was diagnosed in 6 (5.8%) patients. A major risk factor was identified in 94 of 104 (89.4%) Saudi children. Significantly more hematologic disorders and coagulopathies were identified in the PSG compared to the RSG (p=0.001), reflecting a better yield following introduction of more comprehensive hematologic and cogulation laboratory tests during the prospective study period. Hematologic disorders were the most common risk factor (46.2%); presumed perinatal ischemic cerebral injury was risk factor in 23 children (22.1) and infectious and inflammatory disorders of the circulatory system in 18 (17.3%). Congenital and genetic cerebrovascular anomalies were the underlying cause in 7 patients (6.7%) and

  4. 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.

  5. Awareness of rhythm patterns in speech and music in children with specific language impairments

    Directory of Open Access Journals (Sweden)

    Ruth eCumming

    2015-12-01

    Full Text Available Children with specific language impairments (SLIs show impaired perception and production of language, and also show impairments in perceiving auditory cues to rhythm (amplitude rise time [ART] and sound duration and in tapping to a rhythmic beat. Here we explore potential links between language development and rhythm perception in 45 children with SLI and 50 age-matched controls. We administered three rhythmic tasks, a musical beat detection task, a tapping-to-music task, and a novel music/speech task, which varied rhythm and pitch cues independently or together in both speech and music. Via low-pass filtering, the music sounded as though it was played from a low-quality radio and the speech sounded as though it was muffled (heard behind the door. We report data for all of the SLI children (N = 45, IQ varying, as well as for two independent subgroupings with intact IQ. One subgroup, Pure SLI, had intact phonology and reading (N=16, the other, SLI PPR (N=15, had impaired phonology and reading. When IQ varied (all SLI children, we found significant group differences in all the rhythmic tasks. For the Pure SLI group, there were rhythmic impairments in the tapping task only. For children with SLI and poor phonology (SLI PPR, group differences were found in all of the filtered speech/music AXB tasks. We conclude that difficulties with rhythmic cues in both speech and music are present in children with SLIs, but that some rhythmic measures are more sensitive than others. The data are interpreted within a ‘prosodic phrasing’ hypothesis, and we discuss the potential utility of rhythmic and musical interventions in remediating speech and language difficulties in children.

  6. Children diagnosed with congenital cardiac malformations at the national university departments of pediatric cardiology: positive predictive values of data in the Danish National Patient Registry

    Directory of Open Access Journals (Sweden)

    Peter Agergaard

    2011-02-01

    Full Text Available Peter Agergaard1, Anders Hebert2, Jesper Bjerre3, Karina Meden Sørensen4, Charlotte Olesen3, John Rosendal Østergaard31Department of Pediatrics, Viborg Hospital, Viborg, Denmark; 2Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Denmark; 3Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark; 4Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, DenmarkIntroduction: The present study was conducted to establish the positive predictive value of congenital cardiac malformation diagnoses registered in the Danish National Patient Registry (NPR, thereby exploring whether the NPR can serve as a valid tool for epidemiologic studies of congenital cardiac malformations.Materials and methods: The study population comprised every individual born from 2000 to 2008 who was registered in the NPR with a congenital cardiac malformation diagnosis and treated at one of the two national departments of pediatric cardiology. Positive predictive values were established comparing NPR information with the clinical record of each individual.Results: A total of 2952 patients with a total of 3536 diagnoses were eligible for validation. Review of their clinical records unveiled no patient without cardiac malformation. In 98% (98%–99% of the cases, the NPR diagnosis could be found as the discharge diagnosis in the patient's clinical record, and in 90% (89%–91% of the cases the NPR diagnosis was considered a true reflection of the patient's actual malformation.Conclusions: Our study verifies that the present study population retrieved from the NPR is a valid tool for epidemiological research within the topic of congenital cardiac malformations, given that the research question is not dependent on a fully established sensitivity of the NPR. Precautions should be made regarding cardiac malformations characterized by low prevalence or poor predictive values, and the reported validity should not be

  7. Patellofemoral instability in children: T2 relaxation times of the patellar cartilage in patients with and without patellofemoral instability and correlation with morphological grading of cartilage damage

    International Nuclear Information System (INIS)

    Kang, Chang Ho; Kim, Hee Kyung; Shiraj, Sahar; Anton, Christopher; Kim, Dong Hoon; Horn, Paul S.

    2016-01-01

    Patellofemoral instability is one of the most common causes of cartilage damage in teenagers. To quantitatively evaluate the patellar cartilage in patients with patellofemoral instability using T2 relaxation time maps (T2 maps), compare the values to those in patients without patellofemoral instability and correlate them with morphological grades in patients with patellofemoral instability. Fifty-three patients with patellofemoral instability (mean age: 15.9 ± 2.4 years) and 53 age- and gender-matched patients without patellofemoral instability were included. Knee MR with axial T2 map was performed. Mean T2 relaxation times were obtained at the medial, central and lateral zones of the patellar cartilage and compared between the two groups. In the patellofemoral instability group, morphological grading of the patellar cartilage (0-4) was performed and correlated with T2 relaxation times. Mean T2 relaxation times were significantly longer in the group with patellofemoral instability as compared to those of the control group across the patellar cartilage (Student's t-test, P<0.05) with the longest time at the central area. Positive correlation was seen between mean T2 relaxation time and morphological grading (Pearson correlation coefficiency, P<0.001). T2 increased with severity of morphological grading from 0 to 3 (mixed model, P<0.001), but no statistical difference was seen between grades 3 and 4. In patellofemoral instability, patellar cartilage damage occurs across the entire cartilage with the highest T2 values at the apex. T2 relaxation times directly reflect the severity in low-grade cartilage damage, which implies an important role for T2 maps in differentiating between normal and low-grade cartilage damage. (orig.)

  8. A prospective study on oral manifestations in selective IgA deficient patients in children medical center of Tehran University of Medical Sciences (2000- 2001

    Directory of Open Access Journals (Sweden)

    Pourpak Z.

    2001-09-01

    Full Text Available "nAbstract: IgA selective deficiency is the most common immunodeficiency. The prevalence of it in different races varies from  to . Since secretary IgA has has a defensive role in the mucosal surfaces, supposing is thought that IgA deficiency will be accompanied by oral manifestations. The previous studies showed controversial results about that. The aim of this cohort study was to finding out oral manifestations in IgA- deficient individuals. As s result oral specialists can find the patients in early stages. 11 IgA- deficient patients (with IgA level < 10 mg/dl in serum and 11 normal volunteers with the same age and sex were compared. The ages of the people were between 3 and 18 years old and 5 girls and 6 boys were in each group. Their oral examination included DMFT (Decayed, Missed and Filled Teeth, periodontal condition, Plaque accumulation and oral mucosal lesions. Saliva immunoglobulin and secretary component levels were detected by enzyme- linked immunosorbent assay (ELISA and serum immunoglobulin levels were detected by single radial immunodiffusion (SRID methods. All of the IgA- deficient patients had the serum IgA level < 10 mg/dl and their immunoglobulin levels were normal.  of these patients didn't have SIgA and the rest of them had a little SIgA in their saliva(<  SIgA levels in sex and age matched normal group. IgA deficient patients showed no statistical significant difference about oral manifestations in comparison with normal group. It may be related to the increase of compensatory SIgM or assistance of other non- immunological defense factors in saliva, phagocytosis and cellular immunity. Thus IgA- deficiency cannot produce any oral manifestations as a criteria to diagnose it.

  9. Patient notes

    Directory of Open Access Journals (Sweden)

    Pádraig Ó Tuama

    2017-05-01

    Full Text Available Here’s the thing. While I have my asthma under control and my sleeping is no worse than usual, I am still near the uaigh. That’s the word for grave in Irish, and it’s also part of the word for loneliness. I’m near one or the other, or both. There was a time when my health was the only thing I talked about, and my friends from that time ask me now, and I remember that that was the p