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Sample records for risk stratify children

  1. Modified STOP-Bang Tool for Stratifying Obstructive Sleep Apnea Risk in Adolescent Children.

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    Daniel Combs

    Full Text Available Obstructive sleep apnea (OSA is prevalent in children and diagnostic polysomnography is costly and not readily available in all areas. We developed a pediatric modification of a commonly used adult clinical prediction tool for stratifying the risk of OSA and the need for polysomnography.A total of 312 children (age 9-17 years from phase 2 of the Tucson Children's Assessment of Sleep Apnea cohort study, with complete anthropomorphic data, parent questionnaires, and home polysomnograms were included. An adolescent modification of STOP-Bang (teen STOP-Bang was developed and included snoring, tired, observed apnea, blood pressure ≥ 95th percentile, BMI > 95th percentile, academic problems, neck circumference >95th percentile for age, and male gender. An apnea-hypopnea index ≥ 1.5 events/hour was considered diagnostic of OSA.Receiver Operator Characteristic (ROC curves for parent-reported STOP-Bang scores were generated for teenage and pre-teen children. A STOP-Bang score of < 3 in teenagers was associated with a negative predictive value of 0.96. ROC curves were also generated based upon child-reported sexual maturity rating (SMR; n = 291. The ability of teen STOP-Bang to discriminate the presence or absence of OSA as measured by the AUC for children with SMR ≥ 4 (0.83; 95%CI 0.71-0.95 was better than children with SMR < 4 (0.63; 95%CI 0.46-0.81; p = 0.048.In community dwelling adolescents, teen STOP-Bang may be useful in stratifying the risk of OSA.

  2. Biomarkers to Stratify Risk Groups among Children with Malnutrition in Resource-Limited Settings and to Monitor Response to Intervention.

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    McGrath, Christine J; Arndt, Michael B; Walson, Judd L

    2017-01-01

    Despite global efforts to reduce childhood undernutrition, current interventions have had little impact on stunting and wasting, and the mechanisms underlying growth faltering are poorly understood. There is a clear need to distinguish populations of children most likely to benefit from any given intervention and to develop tools to monitor response to therapy prior to the development of morbid sequelae. In resource-limited settings, environmental enteric dysfunction (EED) is common among children, contributing to malnutrition and increasing childhood morbidity and mortality risk. In addition to EED, early alterations in the gut microbiota can adversely affect growth through nutrient malabsorption, altered metabolism, gut inflammation, and dysregulation of the growth hormone axis. We examined the evidence linking EED and the gut microbiome to growth faltering and explored novel biomarkers to identify subgroups of children at risk of malnutrition due to underlying pathology. These and other biomarkers could be used to identify specific groups of children at risk of malnutrition and monitor response to targeted interventions. © 2017 S. Karger AG, Basel.

  3. Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6–59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey

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    Tchoubi, Sébastien; Sobngwi-Tambekou, Joëlle; Noubiap, Jean Jacques N.; Asangbeh, Serra Lem; Nkoum, Benjamin Alexandre; Sobngwi, Eugene

    2015-01-01

    Background Childhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011. Methods Four thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity. Results The prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13–24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25–36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion. Conclusion This study underlines a high prevalence of early childhood overweight with significant disparities between ecological areas of Cameroon. Risk factors of overweight included high maternal BMI, high

  4. Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6-59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey.

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    Tchoubi, Sébastien; Sobngwi-Tambekou, Joëlle; Noubiap, Jean Jacques N; Asangbeh, Serra Lem; Nkoum, Benjamin Alexandre; Sobngwi, Eugene

    2015-01-01

    Childhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011. Four thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity. The prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13-24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25-36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion. This study underlines a high prevalence of early childhood overweight with significant disparities between ecological areas of Cameroon. Risk factors of overweight included high maternal BMI, high birth weight, male gender, low birth rank

  5. Risk of type 1 diabetes progression in islet autoantibody-positive children can be further stratified using expression patterns of multiple genes implicated in peripheral blood lymphocyte activation and function.

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    Jin, Yulan; Sharma, Ashok; Bai, Shan; Davis, Colleen; Liu, Haitao; Hopkins, Diane; Barriga, Kathy; Rewers, Marian; She, Jin-Xiong

    2014-07-01

    There is tremendous scientific and clinical value to further improving the predictive power of autoantibodies because autoantibody-positive (AbP) children have heterogeneous rates of progression to clinical diabetes. This study explored the potential of gene expression profiles as biomarkers for risk stratification among 104 AbP subjects from the Diabetes Autoimmunity Study in the Young (DAISY) using a discovery data set based on microarray and a validation data set based on real-time RT-PCR. The microarray data identified 454 candidate genes with expression levels associated with various type 1 diabetes (T1D) progression rates. RT-PCR analyses of the top-27 candidate genes confirmed 5 genes (BACH2, IGLL3, EIF3A, CDC20, and TXNDC5) associated with differential progression and implicated in lymphocyte activation and function. Multivariate analyses of these five genes in the discovery and validation data sets identified and confirmed four multigene models (BI, ICE, BICE, and BITE, with each letter representing a gene) that consistently stratify high- and low-risk subsets of AbP subjects with hazard ratios >6 (P < 0.01). The results suggest that these genes may be involved in T1D pathogenesis and potentially serve as excellent gene expression biomarkers to predict the risk of progression to clinical diabetes for AbP subjects. © 2014 by the American Diabetes Association.

  6. Stratifying the Risk of Venous Thromboembolism in Otolaryngology

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    Shuman, Andrew G.; Hu, Hsou Mei; Pannucci, Christopher J.; Jackson, Christopher R.; Bradford, Carol R.; Bahl, Vinita

    2015-01-01

    Objective The consequences of perioperative venous thromboembolism (VTE) are devastating; identifying patients at risk is an essential step in reducing morbidity and mortality. The utility of perioperative VTE risk assessment in otolaryngology is unknown. This study was designed to risk-stratify a diverse population of otolaryngology patients for VTE events. Study Design Retrospective cohort study. Setting Single-institution academic tertiary care medical center. Subjects and Methods Adult patients presenting for otolaryngologic surgery requiring hospital admission from 2003 to 2010 who did not receive VTE chemoprophylaxis were included. The Caprini risk assessment was retrospectively scored via a validated method of electronic chart abstraction. Primary study variables were Caprini risk scores and the incidence of perioperative venous thromboembolic outcomes. Results A total of 2016 patients were identified. The overall 30-day rate of VTE was 1.3%. The incidence of VTE in patients with a Caprini risk score of 6 or less was 0.5%. For patients with scores of 7 or 8, the incidence was 2.4%. Patients with a Caprini risk score greater than 8 had an 18.3% incidence of VTE and were significantly more likely to develop a VTE when compared to patients with a Caprini risk score less than 8 (P otolaryngology patients for 30-day VTE events and allows otolaryngologists to identify patient subgroups who have a higher risk of VTE in the absence of chemoprophylaxis. PMID:22261490

  7. The Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Holmberg, Teresa; Rothmann, Mette Juel

    2015-01-01

    The risk-stratified osteoporosis strategy evaluation study (ROSE) is a randomized prospective population-based study investigating the effectiveness of a two-step screening program for osteoporosis in women. This paper reports the study design and baseline characteristics of the study population....... 35,000 women aged 65-80 years were selected at random from the population in the Region of Southern Denmark and-before inclusion-randomized to either a screening group or a control group. As first step, a self-administered questionnaire regarding risk factors for osteoporosis based on FRAX......(®) was issued to both groups. As second step, subjects in the screening group with a 10-year probability of major osteoporotic fractures ≥15 % were offered a DXA scan. Patients diagnosed with osteoporosis from the DXA scan were advised to see their GP and discuss pharmaceutical treatment according to Danish...

  8. Stratifying a Risk for an Increased Variation of Airway Caliber among the Clinically Stable Asthma

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    Atsushi Hayata

    2013-01-01

    Conclusions: These results indicate that ACQ, %FEV1 and FENO can stratify the risk for increased variation in airway caliber among patients with stable asthma. This may help identify subjects in whom further monitoring of lung function fluctuations is indicated.

  9. Cervical mucus properties stratify risk for preterm birth.

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    Agatha S Critchfield

    Full Text Available Ascending infection from the colonized vagina to the normally sterile intrauterine cavity is a well-documented cause of preterm birth. The primary physical barrier to microbial ascension is the cervical canal, which is filled with a dense and protective mucus plug. Despite its central role in separating the vaginal from the intrauterine tract, the barrier properties of cervical mucus have not been studied in preterm birth.To study the protective function of the cervical mucus in preterm birth we performed a pilot case-control study to measure the viscoelasticity and permeability properties of mucus obtained from pregnant women at high-risk and low-risk for preterm birth. Using extensional and shear rheology we found that cervical mucus from women at high-risk for preterm birth was more extensible and forms significantly weaker gels compared to cervical mucus from women at low-risk of preterm birth. Moreover, permeability measurements using fluorescent microbeads show that high-risk mucus was more permeable compared with low-risk mucus.Our findings suggest that critical biophysical barrier properties of cervical mucus in women at high-risk for preterm birth are compromised compared to women with healthy pregnancy. We hypothesize that impaired barrier properties of cervical mucus could contribute to increased rates of intrauterine infection seen in women with preterm birth. We furthermore suggest that a robust association of spinnbarkeit and preterm birth could be an effectively exploited biomarker for preterm birth prediction.

  10. Network Analysis to Risk Stratify Patients With Exercise Intolerance.

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    Oldham, William M; Oliveira, Rudolf K F; Wang, Rui-Sheng; Opotowsky, Alexander R; Rubins, David M; Hainer, Jon; Wertheim, Bradley M; Alba, George A; Choudhary, Gaurav; Tornyos, Adrienn; MacRae, Calum A; Loscalzo, Joseph; Leopold, Jane A; Waxman, Aaron B; Olschewski, Horst; Kovacs, Gabor; Systrom, David M; Maron, Bradley A

    2018-03-16

    Current methods assessing clinical risk because of exercise intolerance in patients with cardiopulmonary disease rely on a small subset of traditional variables. Alternative strategies incorporating the spectrum of factors underlying prognosis in at-risk patients may be useful clinically, but are lacking. Use unbiased analyses to identify variables that correspond to clinical risk in patients with exercise intolerance. Data from 738 consecutive patients referred for invasive cardiopulmonary exercise testing at a single center (2011-2015) were analyzed retrospectively (derivation cohort). A correlation network of invasive cardiopulmonary exercise testing parameters was assembled using |r|>0.5. From an exercise network of 39 variables (ie, nodes) and 98 correlations (ie, edges) corresponding to P 5e -46 for each correlation, we focused on a subnetwork containing peak volume of oxygen consumption (pVo 2 ) and 9 linked nodes. K-mean clustering based on these 10 variables identified 4 novel patient clusters characterized by significant differences in 44 of 45 exercise measurements ( P model, including 23 independent predictors of pVo 2 and pVo 2 itself, the network model was less redundant and identified clusters that were more distinct. Cluster assignment from the network model was predictive of subsequent clinical events. For example, a 4.3-fold ( P <0.0001; 95% CI, 2.2-8.1) and 2.8-fold ( P =0.0018; 95% CI, 1.5-5.2) increase in hazard for age- and pVo 2 -adjusted all-cause 3-year hospitalization, respectively, were observed between the highest versus lowest risk clusters. Using these data, we developed the first risk-stratification calculator for patients with exercise intolerance. When applying the risk calculator to patients in 2 independent invasive cardiopulmonary exercise testing cohorts (Boston and Graz, Austria), we observed a clinical risk profile that paralleled the derivation cohort. Network analyses were used to identify novel exercise groups and develop a

  11. Modification of Measures of Acute Kidney Injury to Risk Stratify Combat Casualties

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    2017-08-26

    REPORT TYPE 08/26/2017 Poster 4. TJTLE AND SUBTITLE t\\.1odification of l’vfeasures,of Acute Kidney Injury to Risk Stratify Cotnbat Casualties 6...profiles and potential future conflicts , identifying acute kidney injury (AKI) early can help us determine the need for rapidity of evacuation

  12. Mortality in perforated peptic ulcer patients after selective management of stratified poor risk cases.

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    Rahman, M Mizanur; Islam, M Saiful; Flora, Sabrina; Akhter, S Fariduddin; Hossain, Shahid; Karim, Fazlul

    2007-12-01

    Perforated peptic ulcer disease continues to inflict high morbidity and mortality. Although patients can be stratified according to their surgical risk, optimal management has yet to be described. In this study we demonstrate a treatment option that improves the mortality among critically ill, poor risk patients with perforated peptic ulcer disease. In our study, two series were retrospectively reviewed: group A patients (n = 522) were treated in a single surgical unit at the Dhaka Medical College Hospital, Dhaka, Bangladesh during the 1980s. Among them, 124 patients were stratified as poor risk based on age, delayed presentation, peritoneal contamination, and coexisting medical problems. These criteria were the basis for selecting a group of poor risk patients (n = 84) for minimal surgical intervention (percutaneous peritoneal drainage) out of a larger group of patients, group B (n = 785) treated at Khulna Medical College Hospital during the 1990s. In group A, 479 patients underwent conventional operative management with an operative mortality of 8.97%. Among the 43 deaths, 24 patients were >60 years of age (55.8%), 12 patients had delayed presentation (27.9%), and 7 patients were in shock or had multiple coexisting medical problems (16.2%). In group B, 626 underwent conventional operative management, with 26 deaths at a mortality rate of 4.15%. Altogether, 84 patients were stratified as poor risk and were managed with minimal surgical intervention (percutaneous peritoneal drainage) followed by conservative treatment. Three of these patients died with an operative mortality of 3.5%. Minimal surgical intervention (percutaneous peritoneal drainage) can significantly lower the mortality rate among a selected group of critically ill, poor risk patients with perforated peptic ulcer disease.

  13. Exploring the salivary microbiome of children stratified by the oral hygiene index

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    Mashima, Izumi; Theodorea, Citra F.; Thaweboon, Boonyanit; Thaweboon, Sroisiri; Scannapieco, Frank A.

    2017-01-01

    Poor oral hygiene often leads to chronic diseases such as periodontitis and dental caries resulting in substantial economic costs and diminished quality of life in not only adults but also in children. In this study, the salivary microbiome was characterized in a group of children stratified by the Simplified Oral Hygiene Index (OHI-S). Illumina MiSeq high-throughput sequencing based on the 16S rRNA was utilized to analyze 90 salivary samples (24 Good, 31 Moderate and 35 Poor oral hygiene) from a cohort of Thai children. A total of 38,521 OTUs (Operational Taxonomic Units) with a 97% similarity were characterized in all of the salivary samples. Twenty taxonomic groups (Seventeen genera, two families and one class; Streptococcus, Veillonella, Gemellaceae, Prevotella, Rothia, Porphyromonas, Granulicatella, Actinomyces, TM-7-3, Leptotrichia, Haemophilus, Selenomonas, Neisseria, Megasphaera, Capnocytophaga, Oribacterium, Abiotrophia, Lachnospiraceae, Peptostreptococcus, and Atopobium) were found in all subjects and constituted 94.5–96.5% of the microbiome. Of these twenty genera, the proportion of Streptococcus decreased while Veillonella increased with poor oral hygiene status (P oral hygiene group. This is the first study demonstrating an important association between increase of Veillonella and poor oral hygiene status in children. However, further studies are required to identify the majority of Veillonella at species level in salivary microbiome of the Poor oral hygiene group. PMID:28934367

  14. Stratified premedication strategy for the prevention of contrast media hypersensitivity in high-risk patients.

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    Lee, Suh-Young; Yang, Min Suk; Choi, Young-Hoon; Park, Chang Min; Park, Heung-Woo; Cho, Sang Heon; Kang, Hye-Ryun

    2017-03-01

    Although the severity of hypersensitivity reactions to iodinated contrast media varies, it is well correlated with the severity of recurrent reactions; however, prophylaxis protocols are not severity-stratified. To assess the outcomes of tailored prophylaxis according to the severity of hypersensitivity reactions to iodinated contrast media. Our premedication protocols were stratified based on the severity of previous reactions: (1) 4 mg of chlorpheniramine for mild reactions, (2) adding 40 mg of methylprednisolone for moderate reactions, and (3) adding multiple doses of 40 mg of methylprednisolone for severe index reactions. Cases of reexposure in patients with a history of hypersensitivity reactions were routinely monitored and mandatorily recorded. Among a total of 850 patients who underwent enhanced computed tomography after severity-tailored prophylaxis, breakthrough reactions occurred in 17.1%, but most breakthrough reactions (89.0%) were mild and did not require medical treatment. Additional corticosteroid use did not reduce the breakthrough reaction rate in cases with a mild index reaction (16.8% vs 17.2%, P = .70). However, underpremedication with a single dose of corticosteroid revealed significantly higher rates of breakthrough reaction than did double doses of corticosteroid in cases with a severe index reaction (55.6% vs 17.4%, P = .02). Changing the iodinated contrast media resulted in an additional reduction of the breakthrough reaction rate overall (14.9% vs 32.1%, P = .001). In a total severity-based stratified prophylaxis regimens and changing iodinated contrast media can be considered in patients with a history of previous hypersensitivity reaction to iodinated contrast media to reduce the risk of breakthrough reactions. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. Elevated manganese exposure and school-aged children's behavior: a gender-stratified analysis.

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    Menezes-Filho, José A; de Carvalho-Vivas, Chrissie F; Viana, Gustavo F S; Ferreira, Junia R D; Nunes, Lorena S; Mergler, Donna; Abreu, Neander

    2014-12-01

    High levels of waterborne manganese have been associated with problematic behavior in school-aged children, however to date this has not been reported for children exposed to airborne manganese. The objective of the present study was to examine behavioral traits among children with exposure to airborne manganese from a ferro-manganese alloy plant, located in the metropolitan region of Salvador, Brazil. The study included 34 boys and 36 girls, aged 7-12 years, living in two communities within a 3-km radius from the plant. For each child, hair manganese levels (MnH) and blood lead (PbB) levels were analyzed by graphite furnace atomic absorption spectrometry. The Children's Behavior Check List (CBCL) (Portuguese version validated in Brazil) was administered to parents or caregivers, providing scale scores of internalizing (withdrawn, somatic complaints, and anxious/depressed scales), externalizing (disruptive and aggressive) behaviors and a separate scale for attention problems. Median and range for MnH and PbB were 11.48 μg/g (range: 0.52-55.74); 1.1 μg/dL (range: 0.5-6.1), respectively. Spearman correlation analyses showed that several behavioral indices were significantly correlated with MnH levels for girls, but not for boys: total externalizing behavior (rho=0.484 vs rho=0.041) and attention problem scores (rho=0.542 vs rho=0.003) coefficients were significantly at pMnH stratified by sex, adjusting for age and maternal IQ. Total externalizing behaviors and attention problem scores were significantly associated with girls' MnH levels but not with boys'. Adjusting for maternal IQ, the β-coefficients for LogMnH associations with total externalizing and attention problems are 8.85 (95%CI 2.44-15.24) and 4.03 (95%CI 1.50-6.56) for girls. For boys, after adjusting for age, the β-coefficients are 0.08 (95%CI 11.51-11.66) and -0.05 (95%CI 4.34-4.25), respectively. The findings of this study suggest a positive association between elevated Mn exposure and externalizing

  16. Limitations of the Parsonnet score for measuring risk stratified mortality in the north west of England

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    Wynne-Jones, K; Jackson, M; Grotte, G; Bridgewater, B; North, W

    2000-01-01

    OBJECTIVE—To study the use of the Parsonnet score to predict mortality following adult cardiac surgery.
DESIGN—Prospective study.
SETTING—All centres performing adult cardiac surgery in the north west of England.
SUBJECTS—8210 patients undergoing surgery between April 1997 and March 1999.
MAIN OUTCOME MEASURES—Risk factors and in-hospital mortality were recorded according to agreed definitions. Ten per cent of cases from each centre were selected at random for validation. A Parsonnet score was derived for each patient and its predictive ability was studied.
RESULTS—Data collection was complete. The operative mortality was 3.5% (95% confidence interval 3.1% to 3.9%), ranging from 2.7% to 3.8% across the centres. On validation, the incidence of discrepancies ranged from 0% to 13% for the different risk factors. The predictive ability of the Parsonnet score measured by area under the receiver operating characteristic curve was 0.74. The mean Parsonnet score for the region was 7.0, giving an observed to expected mortality ratio of 0.51 (range 0.4 to 0.64 across the centres). A new predictive model was derived from the data by multivariate analysis which includes nine objective risk factors, all with a significant association with mortality, which highlights some of the deficits of the Parsonnet score.
CONCLUSIONS—Risk stratified mortality data were collected on 100% of patients undergoing adult cardiac surgery in two years within a defined geographical region and were used to set an audit standard. Problems with the Parsonnet score of subjectivity, inclusion of many items not associated with mortality, and the overprediction of mortality have been highlighted.


Keywords: risk stratification; cardiac surgery; Parsonnet score; audit PMID:10862595

  17. Risk of falling among hospitalized patients with high modified Morse scores could be further Stratified.

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    Gringauz, Irina; Shemesh, Yael; Dagan, Amir; Israelov, Irina; Feldman, Dana; Pelz-Sinvani, Naama; Justo, Dan; Segal, Gad

    2017-11-13

    Falls during hospitalization harbor both clinical and financial outcomes. The modified Morse fall scale [MMFS] is widely used for an in-hospital risk-of-fall assessment. Nevertheless, the majority of patients at risk of falling, i.e. with high MMFS, do not fall. The aim of this study was to ascertain our study hypothesis that certain patients' characteristics (e.g. serum electrolytes, usage of a walking device etc.) could further stratify the risk of falls among hospitalized patients with MMFS. This was a retrospective cohort analysis of adult patients hospitalized in Internal Medicine departments. The final cohort included 428 patients aged 76.8±14.0 years. All patients had high (9 or more) MMFS upon admission, and their mean MMFS was 16.2±6.1. A group of 139 (32.5%) patients who fell during their hospitalization was compared with a control group of 289 (67.5%) patients who did not fall. The fallers had higher MMFS, a higher prevalence of mild dependence, and a greater use of a cane or no walking device. Regression analysis showed the following patients' characteristics to be independently associated with an increased risk of falling: mild dependence (OR=3.99, 95% CI 1.97-8.08; pfalling (OR=0.3, 95% CI 0.13-0.69; p=0.005 and OR=0.25, 95% CI 0.11-0.59; p= 0.002). Further risk stratification of hospitalized patients, already known to have a high MMFS, which would take into account the characteristics pointed out in this study, should be attained.

  18. Risk of falling among hospitalized patients with high modified Morse scores could be further Stratified

    Directory of Open Access Journals (Sweden)

    Irina Gringauz

    2017-11-01

    Full Text Available Abstract Background Falls during hospitalization harbor both clinical and financial outcomes. The modified Morse fall scale [MMFS] is widely used for an in-hospital risk-of-fall assessment. Nevertheless, the majority of patients at risk of falling, i.e. with high MMFS, do not fall. The aim of this study was to ascertain our study hypothesis that certain patients' characteristics (e.g. serum electrolytes, usage of a walking device etc. could further stratify the risk of falls among hospitalized patients with MMFS. Methods This was a retrospective cohort analysis of adult patients hospitalized in Internal Medicine departments. Results The final cohort included 428 patients aged 76.8±14.0 years. All patients had high (9 or more MMFS upon admission, and their mean MMFS was 16.2±6.1. A group of 139 (32.5% patients who fell during their hospitalization was compared with a control group of 289 (67.5% patients who did not fall. The fallers had higher MMFS, a higher prevalence of mild dependence, and a greater use of a cane or no walking device. Regression analysis showed the following patients' characteristics to be independently associated with an increased risk of falling: mild dependence (OR=3.99, 95% CI 1.97-8.08; p<0.0001, treatment by anti-epileptics (OR=3.9, 95% CI 1.36-11.18; p=0.011, treatment by hypoglycemic agents (OR=2.64, 95% CI 1.08-6.45; p= 0.033, and hypothyroidism (OR=3.66, 05%CI 1.62-8.30; p=0.002. In contrast to their role in the MMFS, the use of a walker or a wheelchair was found to decrease the risk of falling (OR=0.3, 95% CI 0.13-0.69; p=0.005 and OR=0.25, 95% CI 0.11-0.59; p= 0.002. Conclusions Further risk stratification of hospitalized patients, already known to have a high MMFS, which would take into account the characteristics pointed out in this study, should be attained.

  19. Implementing risk-stratified screening for common cancers: a review of potential ethical, legal and social issues.

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    Hall, A E; Chowdhury, S; Hallowell, N; Pashayan, N; Dent, T; Pharoah, P; Burton, H

    2014-06-01

    The identification of common genetic variants associated with common cancers including breast, prostate and ovarian cancers would allow population stratification by genotype to effectively target screening and treatment. As scientific, clinical and economic evidence mounts there will be increasing pressure for risk-stratified screening programmes to be implemented. This paper reviews some of the main ethical, legal and social issues (ELSI) raised by the introduction of genotyping into risk-stratified screening programmes, in terms of Beauchamp and Childress's four principles of biomedical ethics--respect for autonomy, non-maleficence, beneficence and justice. Two alternative approaches to data collection, storage, communication and consent are used to exemplify the ELSI issues that are likely to be raised. Ultimately, the provision of risk-stratified screening using genotyping raises fundamental questions about respective roles of individuals, healthcare providers and the state in organizing or mandating such programmes, and the principles, which underpin their provision, particularly the requirement for distributive justice. The scope and breadth of these issues suggest that ELSI relating to risk-stratified screening will become increasingly important for policy-makers, healthcare professionals and a wide diversity of stakeholders. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

  20. The Ross classification for heart failure in children after 25 years: a review and an age-stratified revision.

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    Ross, Robert D

    2012-12-01

    Accurate grading of the presence and severity of heart failure (HF) signs and symptoms in infants and children remains challenging. It has been 25 years since the Ross classification was first used for this purpose. Since then, several modifications of the system have been used and others proposed. New evidence has shown that in addition to signs and symptoms, data from echocardiography, exercise testing, and biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP) all are useful in stratifying outcomes for children with HF. It also is apparent that grading of signs and symptoms in children is dependent on age because infants manifest HF differently than toddlers and older children. This review culminates in a proposed new age-based Ross classification for HF in children that incorporates the most useful data from the last two decades. Testing of this new system will be important to determine whether an age-stratified scoring system can unify the way communication of HF severity and research on HF in children is performed in the future.

  1. Decision tree analysis to stratify risk of de novo non-melanoma skin cancer following liver transplantation.

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    Tanaka, Tomohiro; Voigt, Michael D

    2018-03-01

    Non-melanoma skin cancer (NMSC) is the most common de novo malignancy in liver transplant (LT) recipients; it behaves more aggressively and it increases mortality. We used decision tree analysis to develop a tool to stratify and quantify risk of NMSC in LT recipients. We performed Cox regression analysis to identify which predictive variables to enter into the decision tree analysis. Data were from the Organ Procurement Transplant Network (OPTN) STAR files of September 2016 (n = 102984). NMSC developed in 4556 of the 105984 recipients, a mean of 5.6 years after transplant. The 5/10/20-year rates of NMSC were 2.9/6.3/13.5%, respectively. Cox regression identified male gender, Caucasian race, age, body mass index (BMI) at LT, and sirolimus use as key predictive or protective factors for NMSC. These factors were entered into a decision tree analysis. The final tree stratified non-Caucasians as low risk (0.8%), and Caucasian males > 47 years, BMI decision tree model accurately stratifies the risk of developing NMSC in the long-term after LT.

  2. Can a Modified Bosniak Classification System Risk Stratify Pediatric Cystic Renal Masses?

    Science.gov (United States)

    Saltzman, Amanda F; Carrasco, Alonso; Colvin, Alexandra N; Meyers, Mariana L; Cost, Nicholas G

    2018-03-20

    We characterize and apply the modified Bosniak classification system to a cohort of children with cystic renal lesions and known surgical pathology. We identified all patients at our institution with cystic renal masses who also underwent surgery for these lesions. Patients without available preoperative imaging or pathology were excluded. All radiological imaging was independently reviewed by a pediatric radiologist blinded to pathological findings. Imaging characteristics (size, border, septations, calcifications, solid components, vascularity) were recorded from the most recent preoperative ultrasounds and computerized tomograms. The modified Bosniak classification system was applied to these scans and then correlated with final pathology. A total of 22 patients met study criteria. Median age at surgery was 6.1 years (range 11 months to 16.8 years). Of the patients 12 (54.5%) underwent open nephrectomy, 6 (27.3%) open partial nephrectomy, 2 (9.1%) laparoscopic cyst decortication, 1 (4.5%) open renal biopsy and 1 (4.5%) laparoscopic partial nephrectomy. Final pathology was benign in 9 cases (41%), intermediate in 6 (27%) and malignant in 7 (32%). All malignant lesions were modified Bosniak class 4, all intermediate lesions were modified class 3 or 4 and 8 of 9 benign lesions (89%) were modified class 1 or 2. Cystic renal lesions in children with a modified Bosniak class of 1 or 2 were most often benign, while class 3 or 4 lesions warranted surgical excision since more than 90% of masses harbored intermediate or malignant pathology. The modified Bosniak classification system appears to allow for a reasonable clinical risk stratification of pediatric cystic renal masses. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Evaluation of the health status of preschool children stratified based on the weight-length index (WLI).

    Science.gov (United States)

    Shin, Kyung-Ok; Chung, Keun-Hee; Park, Hyun-Suh

    2010-10-01

    This study was conducted to prepare basic materials and offer advice regarding dietary habits to prevent and cure childhood obesity by comparing and analyzing dietary habit, nutritional status, blood factors, and mineral contents of hair. All subjects were stratified by their weight-length index (WLI). According to the standard WLI values, 64.9% of children were within the normal value, 13.5% of children were underweight, and 21.6% of children were overweight and obese (WLI ≥ 110%). Overall, the score assessed dietary habit for all children was 21.32 ± 2.55 point (921 subjects), with 5.1% of children having excellent dietary habits and 3.1% having poor dietary habits. Additionally, 37.9% of underweight children, 37.6% of normal weight children, and 43.2% of overweight and obese children consumed higher amounts of protein than underweight children did (meat, fish, eggs, and soy products) (P < 0.05). Overweight and obese children consumed more fried foods than underweight or normal weight children (P < 0.05). Moreover, 38.0% of the children had hemoglobin levels of 12 g/dl, while 7.6% were anemic (11.1 g/dl). When a hematocrit level of 33% was taken as the standard, 11.0% of children were anemic. The plasma transferrin content was 263.76 ± 54.52 mg/dl in overweight and obese children. The mean values of Fe, Cu, Ca, Cr, Mn, Se, Na, K, Li, V, Co, and Mo were within the reference values, but the Zn concentrations of underweight, normal weight, and overweight and obese children were 67.97 ± 28.51 ppm, 70.09 ± 30.81 ppm, and 73.99 ± 30.36 ppm, respectively. The Zn concentration of overweight and obese children (73.99 ± 30.36 ppm) was lower than that of the standard value (180~220 ppm). Therefore, a nutritional education program and new guidance for dietary pattern should be developed to reduce the number of underweight and overweight and obese children.

  4. Children at health risks.

    Science.gov (United States)

    Sekar, H R

    1992-01-01

    In India, 69% of the children of the working class die, most of whom are child laborers. Economic pressure forces parents to make their children work. Employers want child workers because they can manipulate them and pay them low wages, thereby ensuring their viability. The caste system induces social inequality, inheritance invokes cultural inequality, and patriarchal socialization is responsible for gender inequality, all of which perpetuates exploitation of children by employers. In Sivakasi, an estimated 125,000 children make up the child labor force, comprising 30% of the entire labor force. 75% are from the lowest castes. 90% of child workers are girls because they are more obedient and accept even lower wages than boys, and girls need to save for their dowry. Girls often suffer verbal and physical abuse. Like their parents who were also child workers, child workers are illiterate and work long hours. A small rich elite in Sivakasi controls most of the trading and industrial capital, educational institutions, and voluntary organizations. Employers' agents give parents a loan and use their children's labor as security. Each day, they bring child workers to Sivakasi in factory buses from villages to work at least 12 hour days. They work under hazardous conditions, e.g., working with toxic chemicals. Coughing, sore throat, dizziness, methemoglobinemia, and anemia are common effects of ingestion or inhalation of chlorate dust. Inhalation of sulphur dust causes respiratory infections, eye infections, and chronic lung diseases (e.g., asthma). Fires and explosions are common risks for working children. Factory management seldom undertake fire prevention measures. An extensive survey of the problem of child labor is needed in Sivakasi before systematic planning to protect children could be done. Overall development, especially agricultural development, is needed. Parents, employers, enforcement authorities, trade unions, and social groups need to be sensitized to the

  5. Risk Factors for Emergency Department Short Time Readmission in Stratified Population

    Directory of Open Access Journals (Sweden)

    Ariadna Besga

    2015-01-01

    Full Text Available Background. Emergency department (ED readmissions are considered an indicator of healthcare quality that is particularly relevant in older adults. The primary objective of this study was to identify key factors for predicting patients returning to the ED within 30 days of being discharged. Methods. We analysed patients who attended our ED in June 2014, stratified into four groups based on the Kaiser pyramid. We collected data on more than 100 variables per case including demographic and clinical characteristics and drug treatments. We identified the variables with the highest discriminating power to predict ED readmission and constructed classifiers using machine learning methods to provide predictions. Results. Classifier performance distinguishing between patients who were and were not readmitted (within 30 days, in terms of average accuracy (AC. The variables with the greatest discriminating power were age, comorbidity, reasons for consultation, social factors, and drug treatments. Conclusions. It is possible to predict readmissions in stratified groups with high accuracy and to identify the most important factors influencing the event. Therefore, it will be possible to develop interventions to improve the quality of care provided to ED patients.

  6. Cross-cultural adaptation of the STRATIFY tool in detecting and predicting risk of falling.

    Science.gov (United States)

    Enríquez de Luna-Rodríguez, Margarita; Aranda-Gallardo, Marta; Canca-Sánchez, José Carlos; Vazquez-Blanco, M José; Moya-Suárez, Ana Belén; Morales-Asencio, José Miguel

    To adapt to Spanish language the STRATIFY tool for clinical use in the Spanish-speaking World. A multicenter, 2 care settings cross-sectional study cultural adaptation study in acute care hospitals and nursing homes was performed in Andalusia during 2014. The adaptation process was divided into 4 stages: translation, back-translation, equivalence between the 2 back-translations and piloting of the Spanish version, thus obtaining the final version. The validity of appearance, content validity and the time required to complete the scale were taken into account. For analysis, the median, central tendency and dispersion of scores, the interquartile range, and the interquartile deviation for the possible variability in responses it was calculated. Content validity measured by content validity index reached a profit of 1. For the validity aspect the clarity and comprehensibility of the questions were taken into account. Of the 5 questions of the instrument, 2 had a small disagreement solved with the introduction of an explanatory phrase to achieve conceptual equivalence. Median both questions were equal or superior to 5. The average time for completion of the scale was less than 3 minutes. The process of adaptation to Spanish of STRATIFY has led to a semantic version and culturally equivalent to the original for easy filling and understanding for use in the Spanish-speaking world. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. Stratifying empiric risk of schizophrenia among first degree relatives using multiple predictors in two independent Indian samples.

    Science.gov (United States)

    Bhatia, Triptish; Gettig, Elizabeth A; Gottesman, Irving I; Berliner, Jonathan; Mishra, N N; Nimgaonkar, Vishwajit L; Deshpande, Smita N

    2016-12-01

    Schizophrenia (SZ) has an estimated heritability of 64-88%, with the higher values based on twin studies. Conventionally, family history of psychosis is the best individual-level predictor of risk, but reliable risk estimates are unavailable for Indian populations. Genetic, environmental, and epigenetic factors are equally important and should be considered when predicting risk in 'at risk' individuals. To estimate risk based on an Indian schizophrenia participant's family history combined with selected demographic factors. To incorporate variables in addition to family history, and to stratify risk, we constructed a regression equation that included demographic variables in addition to family history. The equation was tested in two independent Indian samples: (i) an initial sample of SZ participants (N=128) with one sibling or offspring; (ii) a second, independent sample consisting of multiply affected families (N=138 families, with two or more sibs/offspring affected with SZ). The overall estimated risk was 4.31±0.27 (mean±standard deviation). There were 19 (14.8%) individuals in the high risk group, 75 (58.6%) in the moderate risk and 34 (26.6%) in the above average risk (in Sample A). In the validation sample, risks were distributed as: high (45%), moderate (38%) and above average (17%). Consistent risk estimates were obtained from both samples using the regression equation. Familial risk can be combined with demographic factors to estimate risk for SZ in India. If replicated, the proposed stratification of risk may be easier and more realistic for family members. Copyright © 2016. Published by Elsevier B.V.

  8. Predictors of depressive symptoms in older Japanese primiparas at 1 month post-partum: A risk-stratified analysis.

    Science.gov (United States)

    Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Tamakoshi, Koji

    2016-01-01

    Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum. Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression. Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group. These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care. © 2015 Japan Academy of Nursing Science.

  9. Risk-stratifying capacity of PET/CT metabolic tumor volume in stage IIIA non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Finkle, Joshua H.; Jo, Stephanie Y.; Yuan, Cindy; Pu, Yonglin [University of Chicago, Department of Radiology, Chicago, IL (United States); Ferguson, Mark K. [University of Chicago, Department of Surgery, Chicago, IL (United States); Liu, Hai-Yan [First Hospital of Shanxi Medical University, Department of Nuclear Medicine, Taiyuan, Shanxi (China); Zhang, Chenpeng [Shanghai Jiao Tong University, Department of Nuclear Medicine, RenJi Hospital, School of Medicine, Shanghai (China); Zhu, Xuee [Nanjing Medical University, Department of Radiology, BenQ Medical Center, Nanjing, Jiangsu Province (China)

    2017-08-15

    Stage IIIA non-small cell lung cancer (NSCLC) is heterogeneous in tumor burden, and its treatment is variable. Whole-body metabolic tumor volume (MTV{sub WB}) has been shown to be an independent prognostic index for overall survival (OS). However, the potential of MTV{sub WB} to risk-stratify stage IIIA NSCLC has previously been unknown. If we can identify subgroups within the stage exhibiting significant OS differences using MTV{sub WB}, MTV{sub WB} may lead to adjustments in patients' risk profile evaluations and may, therefore, influence clinical decision making regarding treatment. We estimated the risk-stratifying capacity of MTV{sub WB} in stage IIIA by comparing OS of stratified stage IIIA with stage IIB and IIIB NSCLC. We performed a retrospective review of 330 patients with clinical stage IIB, IIIA, and IIIB NSCLC diagnosed between 2004 and 2014. The patients' clinical TNM stage, initial MTV{sub WB}, and long-term survival data were collected. Patients with TNM stage IIIA disease were stratified by MTV{sub WB}. The optimal MTV{sub WB} cutoff value for stage IIIA patients was calculated using sequential log-rank tests. Univariate and multivariate cox regression analyses and Kaplan-Meier OS analysis with log-rank tests were performed. The optimal MTV{sub WB} cut-point was 29.2 mL for the risk-stratification of stage IIIA. We identified statistically significant differences in OS between stage IIB and IIIA patients (p < 0.01), between IIIA and IIIB patients (p < 0.01), and between the stage IIIA patients with low MTV{sub WB} (below 29.2 mL) and the stage IIIA patients with high MTV{sub WB} (above 29.2 mL) (p < 0.01). There was no OS difference between the low MTV{sub WB} stage IIIA and the cohort of stage IIB patients (p = 0.485), or between the high MTV{sub WB} stage IIIA patients and the cohort of stage IIIB patients (p = 0.459). Similar risk-stratification capacity of MTV{sub WB} was observed in a large range of cutoff values from 15 to 55 mL in

  10. Data linkage and statistical modelling to provide stratified risk assessment for HAI

    Directory of Open Access Journals (Sweden)

    Kim Kavanagh

    2017-04-01

    Despite limitations to current application in practice,(paucity of patient level in-hospital prescribing data and constraints of the timeliness of the data, when fully developed this system will enable risk classification to identify patients most at risk of HAI and adverse outcomes to aid clinical decision making.

  11. Women’s perspectives and experiences on screening for osteoporosis (Risk-stratified Osteoporosis Strategy Evaluation, ROSE)

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Huniche, Lotte; Ammentorp, Jette

    2014-01-01

    main themes: knowledge about osteoporosis, psychological aspects of screening, and moral duty. The women viewed the program in the context of their everyday life and life trajectories. Age, lifestyle, and knowledge about osteoporosis were important to how women ascribed meaning to the program, how......This study aimed to investigate women's perspectives and experiences with screening for osteoporosis. Focus groups and individual interviews were conducted. Three main themes emerged: knowledge about osteoporosis, psychological aspects of screening, and moral duty. Generally, screening was accepted...... due to life experiences, self-perceived risk, and the preventive nature of screening. PURPOSE: The risk-stratified osteoporosis strategy evaluation (ROSE) study is a randomized prospective population-based trial investigating the efficacy of a screening program to prevent fractures in women aged 65...

  12. A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study

    DEFF Research Database (Denmark)

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela

    2013-01-01

    OBJECTIVES: An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. DESIGN: The design was an observational prospective study of risk factors embedded in a randomised controlled study. SETTING: Acute whiplash...... patients from units, general practitioners in four Danish counties were referred to two research centres. PARTICIPANTS: During a 2-year inclusion period, acute consecutive whiplash-injured (age 18-70 years, rear-end or frontal-end car accident and WAD (whiplash-associated disorders) grades I-III, symptoms...... and examined by a study nurse after 5 days; 605 were completed after 1 year. A risk score which included items of initial neck pain/headache intensity, a number of non-painful complaints and active neck mobility was applied. The primary outcome parameter was 1-year work disability. RESULTS: The risk score...

  13. Developing and evaluating polygenic risk prediction models for stratified disease prevention.

    Science.gov (United States)

    Chatterjee, Nilanjan; Shi, Jianxin; García-Closas, Montserrat

    2016-07-01

    Knowledge of genetics and its implications for human health is rapidly evolving in accordance with recent events, such as discoveries of large numbers of disease susceptibility loci from genome-wide association studies, the US Supreme Court ruling of the non-patentability of human genes, and the development of a regulatory framework for commercial genetic tests. In anticipation of the increasing relevance of genetic testing for the assessment of disease risks, this Review provides a summary of the methodologies used for building, evaluating and applying risk prediction models that include information from genetic testing and environmental risk factors. Potential applications of models for primary and secondary disease prevention are illustrated through several case studies, and future challenges and opportunities are discussed.

  14. A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study

    Science.gov (United States)

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela; Bach, Flemming W; Bendix, Tom; Jensen, Troels Staehelin

    2013-01-01

    Objectives An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. Design The design was an observational prospective study of risk factors embedded in a randomised controlled study. Setting Acute whiplash patients from units, general practitioners in four Danish counties were referred to two research centres. Participants During a 2-year inclusion period, acute consecutive whiplash-injured (age 18–70 years, rear-end or frontal-end car accident and WAD (whiplash-associated disorders) grades I–III, symptoms within 72 h, examination prior to 10 days postinjury, capable of written/spoken Danish, without other injuries/fractures, pre-existing significant somatic/psychiatric disorder, drug/alcohol abuse and previous significant pain/headache). 688 (438 women and 250 men) participants were interviewed and examined by a study nurse after 5 days; 605 were completed after 1 year. A risk score which included items of initial neck pain/headache intensity, a number of non-painful complaints and active neck mobility was applied. The primary outcome parameter was 1-year work disability. Results The risk score and number of sick-listing days were related (Kruskal-Wallis, pwhiplash. Neck-mobility was a strong predictor in this study; however, it was a more inconsistent predictor in other studies. Conclusions Application of the risk assessment score and use of the risk strata system may be beneficial in future studies and may be considered as a valuable tool to assess return-to-work following injuries; however, further studies are needed. PMID:23370009

  15. A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study

    DEFF Research Database (Denmark)

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela

    2013-01-01

    within 72 h, examination prior to 10 days postinjury, capable of written/spoken Danish, without other injuries/fractures, pre-existing significant somatic/psychiatric disorder, drug/alcohol abuse and previous significant pain/headache). 688 (438 women and 250 men) participants were interviewed......OBJECTIVES: An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. DESIGN: The design was an observational prospective study of risk factors embedded in a randomised controlled study. SETTING: Acute whiplash...... and number of sick-listing days were related (Kruskal-Wallis, p

  16. Advanced echocardiography and clinical surrogates to risk stratify and manage patients with structural heart disease

    NARCIS (Netherlands)

    Debonnaire, Philippe Jean Marc Rita

    2016-01-01

    Part I focuses on the potential role of 3-dimensional echocardiography. At first a clinical risk score model for prediction of outcome in patients undergoing TAVI is presented (Chapter 2). Second the role of 3D-echocardiography is explored in depth in patients with mitral valve disease. Different

  17. Stratifying the risks of oral anticoagulation in patients with liver disease.

    Science.gov (United States)

    Efird, Lydia M; Mishkin, Daniel S; Berlowitz, Dan R; Ash, Arlene S; Hylek, Elaine M; Ozonoff, Al; Reisman, Joel I; Zhao, Shibei; Jasuja, Guneet K; Rose, Adam J

    2014-05-01

    Chronic liver disease presents a relative contraindication to warfarin therapy, but some patients with liver disease nevertheless require long-term anticoagulation. The goal is to identify which patients with liver disease might safely receive warfarin. Among 102 134 patients who received warfarin from the Veterans Affairs from 2007 to 2008, International Classification of Diseases-Ninth Revision codes identified 1763 patients with chronic liver disease. Specific diagnoses and laboratory values (albumin, aspartate aminotransferase, alanine aminotransferase, creatinine, and cholesterol) were examined to identify risk of adverse outcomes, while controlling for available bleeding risk factors. Outcomes included percent time in therapeutic range, a measure of anticoagulation control, and major hemorrhagic events, by International Classification of Diseases-Ninth Revision codes. Patients with liver disease had lower mean time in therapeutic range (53.5%) when compared with patients without (61.7%; P<0.001) and more hemorrhages (hazard ratio, 2.02; P<0.001). Among patients with liver disease, serum albumin and creatinine levels were the strongest predictors of both outcomes. We created a 4-point score system: patients received 1 point each for albumin (2.5-3.49 g/dL) or creatinine (1.01-1.99 mg/dL), and 2 points each for albumin (<2.5 g/dL) or creatinine (≥2 mg/dL). This score predicted both anticoagulation control and hemorrhage. When compared with patients without liver disease, those with a score of zero had modestly lower time in therapeutic range (56.7%) and no increase in hemorrhages (hazard ratio, 1.16; P=0.59), whereas those with the worst score (4) had poor control (29.4%) and high hazard of hemorrhage (hazard ratio, 8.53; P<0.001). Patients with liver disease receiving warfarin have poorer anticoagulation control and more hemorrhages. A simple 4-point scoring system using albumin and creatinine identifies those at risk for poor outcomes. © 2014 American

  18. Parenting style and obesity risk in children.

    Science.gov (United States)

    Kakinami, Lisa; Barnett, Tracie A; Séguin, Louise; Paradis, Gilles

    2015-06-01

    Parents play a critical role in their children's lifestyle habits. The objective was to assess the effect of parenting style on the risk of childhood obesity, and to determine whether poverty was a moderator of the association. Participants were from the 1994-2008 cross-sectional samples of the National Longitudinal Survey of Children and Youth (NLSCY), a nationally representative survey of Canadian youth. Factor and cluster analyses identified four parenting styles consistent with Baumrind's parenting style prototypes. Multivariable logistic regression assessed the risk of obesity based on parenting style after adjusting for covariates. Analyses were stratified by age (preschool: 2-5years of age, n=19,026; school-age: 6-11years of age, n=18,551) and the moderating effect of poverty (household incomeauthoritative parenting, preschool- and school-age children with authoritarian parents were 35% (95% CI: 1.2-1.5) and 41% (CI: 1.1-1.8) more likely to be obese, respectively. In preschool children, poverty moderated this association: authoritarian and negligent parenting was associated with 44% (CI: 1.3-1.7) and 26% (CI: 1.1-1.4) increased likelihood of obesity, respectively, but only among the children not living in poverty. In school-age children, poverty was not a moderator. Parenting style is associated with childhood obesity, but may be moderated by poverty. Successful strategies to combat childhood obesity should reflect the independent and interactive associations of sociodemographic and social-familial influences on health especially in early childhood. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care.

    Science.gov (United States)

    Xaverius, Pamela; Alman, Cameron; Holtz, Lori; Yarber, Laura

    2016-03-01

    This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p < .0001). The distribution of risk factors differed between adequate and inadequate PNC regarding Black race (36.4 vs. 79.0 %, p < .0001), age under 20 (13.0 vs. 33.6 %, p < .0001), <13 years of education (35.9 vs. 77.9 %, p < .0001), Medicaid status (35.7 vs. 74.9, p < .0001), primiparity (41.6 vs. 31.4 %, p < .0001), smoking (9.7 vs. 24.5 %, p < .0001), and diabetes (4.0 vs. 2.4 %, p < .0001), respectively. Black race, advanced maternal age, primiparity and gestational hypertension were significant predictors of VLBW, regardless of adequate or inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563-0.803; PAR -32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.

  20. Predictors of electrical storm in patients with idiopathic dilated cardiomyopathy--how to stratify the risk of electrical storm.

    Science.gov (United States)

    Takigawa, Masateru; Noda, Takashi; Kurita, Takashi; Aihara, Naohiko; Yamada, Yuko; Okamura, Hideo; Satomi, Kazuhiro; Suyama, Kazuhiro; Shimizu, Wataru; Kamakura, Shiro

    2010-09-01

    Electrical storm (ES) is a serious problem in patients with an implantable cardioverter defibrillator (ICD). However, insufficient reports have indicated the predictors of ES in ICD patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this study was to clarify the predictors of ES for risk stratification in DCM patients with an ICD. Of 446 ICD patients, 53 DCM patients were included in this study. During a mean follow-up of 55+/-36 months, ES (> or =3 times appropriate ICD therapy within 24 h) occurred in 18/53 (34%) patients. According to multivariate Cox proportional hazard regression analysis, a duration of the terminal low amplitude signals of <40 microV (LAS40) (HR 1.4/10 ms increase, 95% confidence interval (CI) 1.1-2.1; P=0.0049) or root mean square voltage of the last 40 ms of the QRS complex (RMS40) (HR 0.88/1 microV, 95%CI 0.77-0.96; P=0.001) on the signal averaged electrocardiogram, and a history of atrial fibrillation (AF) before ICD implantation (HR 2.3, 95%CI 1.2-5.0; P=0.013) were independently associated with an increased risk of ES. Our data indicated that a longer LAS40, lower RMS40 and history of AF before ICD implantation could strongly predict ES, and the combination of those parameters could effectively stratify the risk of ES in DCM patients.

  1. Risk stratifying asymptomatic aortic stenosis: role of the resting 12-lead ECG.

    Science.gov (United States)

    Greve, Anders M

    2014-02-01

    Despite being routinely performed in the clinical follow-up of asymptomatic AS patients, little or no evidence describes the prognostic value of ECG findings in asymptomatic AS populations. This PhD thesis examined the correlates of resting 12-lead ECG variables with echocardiographic measures of AS severity and cardiovascular outcomes in the till date largest cohort (n=1,563) of asymptomatic patients with mild-to-moderate AS. Most importantly, this PhD thesis demonstrated that QRS-duration adds independent predictive value of sudden cardiac death and that the additional presence of ECG LVH/strain for fixed AS severity represents a lethal risk attribute. Finally, ECG abnormalities displayed low/moderate concordance with echocardiographic parameters. This argues that the ECG should be regarded as a separate tool for obtaining prognostically important information. Treatment was not randomized by ECG findings, future studies should therefore examine if and which ECG variables should elicit closer follow-up and/or earlier intervention to improve prognosis in asymptomatic AS populations.

  2. A novel clinically relevant segmentation method and corresponding maximal ischemia score to risk-stratify patients undergoing myocardial perfusion scintigraphy.

    Science.gov (United States)

    Nudi, Francesco; Pinto, Annamaria; Procaccini, Enrica; Neri, Giandomenico; Vetere, Maurizio; Tomai, Fabrizio; Gaspardone, Achille; Biondi-Zoccai, Giuseppe; Schillaci, Orazio

    2014-08-01

    Myocardial perfusion scintigraphy (MPS) represents a key prognostic tool, but its predictive yield is far from perfect. We developed a novel clinically relevant segmentation method and a corresponding maximal ischemia score (MIS) in order to risk-stratify patients undergoing MPS. Patients referred for MPS were identified, excluding those with evidence of myocardial necrosis or prior revascularization. A seven-region segmentation approach was adopted for left ventricular myocardium, with a corresponding MIS distinguishing five groups (no, minimal, mild, moderate, or severe ischemia). The association between MIS and clinical events was assessed at 1 year and at long-term follow-up. A total of 8,714 patients were included, with a clinical follow-up of 31 ± 20 months. Unadjusted analyses showed that subjects with a higher MIS were significantly different for several baseline and test data, being older, having lower ejection fraction, and achieving lower workloads (P < .05 for all). Adverse outcomes were also more frequent in patients with higher levels of ischemia, including cardiac death, myocardial infarction (MI), and their composites (P < .05 for all). Differences in adverse events remained significant even after extensive multivariable adjustment (hazard ratio for each MIS increment = 1.57 [1.29-1.90], P < .001 for cardiac death; 1.19 [1.04-1.36], P = .013 for MI; 1.23 [1.09-1.39], P = .001 for cardiac death/MI). Our novel segmentation method and corresponding MIS efficiently yield satisfactory prognostic information.

  3. Philippines: street children, children at risk.

    Science.gov (United States)

    Tantoco, F G

    1993-01-01

    Almost 2 million of Manila's 2.5 million children younger than 15 years old live on or below the poverty line. 75,000 of these children live on the streets after having run away from home or being abandoned. They beg, steal, scavenge for food, and sell newspapers, cigarettes, and leis. About 20,000 of the street children prostitute themselves. It is these latter children and adolescents who are at particular risk of HIV infection. Studies in the Philippines indicate that 91% of reported HIV infections are among individuals aged 15-44, the male/female infection ratio is one to one, the transmission rate is 45%, and the most common mode of transmission is through heterosexual intercourse. The high incidence of child sexual abuse and child prostitution in the Philippines would suggest that there are a significant number of children and adolescents under age 15 who are infected with HIV. Caritas Manila has developed an information, education, and communication program for HIV/AIDS prevention focusing upon individuals who have direct influence upon and are in direct contact with people: clergy, religious and civic associations, educators, and social and health workers. Caritas has also to a limited extent reached out directly to populations at risk, while collaborating with human rights advocacy groups and networking with other children-oriented agencies in the interest of providing resources to street children. Efforts must be made to protect the rights of children and provide them with an environment conducive to their growth and development. The author notes how off-duty policemen in Manila help real estate developers forcibly eject the poor from their shelters to clear the way for the construction of new infrastructure without concern for the legal processes and requirements in the humane and peaceful relocation of the homeless poor. Many women and children are hurt and killed in the process. It has also been reported that off-duty policemen in Rio de Janeiro

  4. Prevalence and Risk Factors of Dengue Infection in Khanh Hoa Province, Viet Nam: A Stratified Cluster Sampling Survey.

    Science.gov (United States)

    Mai, Vien Quang; Mai, Trịnh Thị Xuan; Tam, Ngo Le Minh; Nghia, Le Trung; Komada, Kenichi; Murakami, Hitoshi

    2018-05-19

    Dengue is a clinically important arthropod-borne viral disease with increasing global incidence. Here we aimed to estimate the prevalence of dengue infections in Khanh Hoa Province, central Viet Nam, and to identify risk factors for infection. We performed a stratified cluster sampling survey including residents of 3-60 years of age in Nha Trang City, Ninh Hoa District and Dien Khanh District, Khanh Hoa Province, in October 2011. Immunoglobulin G (IgG) and immunoglobulin M (IgM) against dengue were analyzed using a rapid test kit. Participants completed a questionnaire exploring clinical dengue incidence, socio-economic status, and individual behavior. A household checklist was used to examine environment, mosquito larvae presence, and exposure to public health interventions. IgG positivity was 20.5% (urban, 16.3%; rural, 23.0%), IgM positivity was 6.7% (urban, 6.4%; rural, 6.9%), and incidence of clinically compatible dengue during the prior 3 months was 2.8 per 1,000 persons (urban, 1.7; rural, 3.4). For IgG positivity, the adjusted odds ratio (AOR) was 2.68 (95% confidence interval [CI], 1.24-5.81) for mosquito larvae presence in water pooled in old tires and was 3.09 (95% CI, 1.75-5.46) for proximity to a densely inhabited area. For IgM positivity, the AOR was 3.06 (95% CI, 1.50-6.23) for proximity to a densely inhabited area. Our results indicated rural penetration of dengue infections. Control measures should target densely inhabited areas, and may include clean-up of discarded tires and water-collecting waste.

  5. Caries risk assessment in children

    DEFF Research Database (Denmark)

    Twetman, S

    2016-01-01

    PURPOSE: To summarise the findings of recent systematic reviews (SR) covering caries risk assessment in children, updated with recent primary studies. METHODS: A search for relevant papers published 2012-2014 was conducted in electronic databases. The systematic reviews were quality assessed...... displayed a high risk of bias. CONCLUSIONS: Based on the present summary of literature, it may be concluded: (1) a caries risk assessment should be carried out at the child's first dental visit and reassessments should be done during childhood (D); (2) multivariate models display a better accuracy than...... the use of single predictors and this is especially true for preschool children (C); (3) there is no clearly superior method to predict future caries and no evidence to support the use of one model, program, or technology before the other (C); and (4) the risk category should be linked to appropriate...

  6. Chubby children; weighing the risk

    NARCIS (Netherlands)

    Vliet, M. van

    2010-01-01

    The present thesis aimed to describe the prevalence of cardiometabolic risk factors, (which are predictive for the development of type 2 diabetes (T2DM) and cardiovascular disease) among overweight/obese children with or without type 1 diabetes (T1DM). Also, we aimed to assess the prevalence of the

  7. Impact of a decision aid about stratified ovarian cancer risk-management on women's knowledge and intentions: a randomised online experimental survey study.

    Science.gov (United States)

    Meisel, Susanne F; Freeman, Maddie; Waller, Jo; Fraser, Lindsay; Gessler, Sue; Jacobs, Ian; Kalsi, Jatinderpal; Manchanda, Ranjit; Rahman, Belinda; Side, Lucy; Wardle, Jane; Lanceley, Anne; Sanderson, Saskia C

    2017-11-16

    Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs. extended) of a decision aid about stratified ovarian cancer risk-management. This was an experimental survey study comparing the effects of brief (gist) information with lengthier, more detailed (extended) information on cognitions relevant to informed decision-making about participating in risk-stratified ovarian cancer screening. Women with no personal history of ovarian cancer were recruited through an online survey company and randomised to view the gist (n = 512) or extended (n = 519) version of a website-based decision aid and completed an online survey. Primary outcomes were knowledge and intentions. Secondary outcomes included attitudes (values) and decisional conflict. There were no significant differences between the gist and extended conditions in knowledge about ovarian cancer (time*group interaction: F = 0.20, p = 0.66) or intention to participate in ovarian cancer screening based on genetic risk assessment (t(1029) = 0.43, p = 0.67). There were also no between-groups differences in secondary outcomes. In the sample overall (n = 1031), knowledge about ovarian cancer increased from before to after exposure to the decision aid (from 5.71 to 6.77 out of a possible 10: t = 19.04, p type of content for decision aids about stratified ovarian cancer risk-management. This study was registered with the ISRCTN registry; registration number: ISRCTN48627877 .

  8. Impact of a decision aid about stratified ovarian cancer risk-management on women’s knowledge and intentions: a randomised online experimental survey study

    Directory of Open Access Journals (Sweden)

    Susanne F. Meisel

    2017-11-01

    Full Text Available Abstract Background Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs. extended of a decision aid about stratified ovarian cancer risk-management. Methods This was an experimental survey study comparing the effects of brief (gist information with lengthier, more detailed (extended information on cognitions relevant to informed decision-making about participating in risk-stratified ovarian cancer screening. Women with no personal history of ovarian cancer were recruited through an online survey company and randomised to view the gist (n = 512 or extended (n = 519 version of a website-based decision aid and completed an online survey. Primary outcomes were knowledge and intentions. Secondary outcomes included attitudes (values and decisional conflict. Results There were no significant differences between the gist and extended conditions in knowledge about ovarian cancer (time*group interaction: F = 0.20, p = 0.66 or intention to participate in ovarian cancer screening based on genetic risk assessment (t(1029 = 0.43, p = 0.67. There were also no between-groups differences in secondary outcomes. In the sample overall (n = 1031, knowledge about ovarian cancer increased from before to after exposure to the decision aid (from 5.71 to 6.77 out of a possible 10: t = 19.04, p < 0.001, and 74% of participants said that they would participate in ovarian cancer screening based on genetic risk assessment. Conclusions No differences in knowledge or

  9. Can Non-HLA Single Nucleotide Polymorphisms Help Stratify Risk in TrialNet Relatives at Risk for Type 1 Diabetes?

    Science.gov (United States)

    Steck, Andrea K; Xu, Ping; Geyer, Susan; Redondo, Maria J; Antinozzi, Peter; Wentworth, John M; Sosenko, Jay; Onengut-Gumuscu, Suna; Chen, Wei-Min; Rich, Stephen S; Pugliese, Alberto

    2017-08-01

    Genome-wide association studies identified >50 type 1 diabetes (T1D) associated non-human leukocyte antigens (non-HLA) loci. The purpose of this study was to assess the contribution of non-HLA single nucleotide polymorphisms (SNPs) to risk of disease progression. The TrialNet Pathway to Prevention Study follows relatives of T1D patients for development of autoantibodies (Abs) and T1D. Using the Immunochip, we analyzed 53 diabetes-associated, non-HLA SNPs in 1016 Ab-positive, at-risk non-Hispanic white relatives. Effect of SNPs on the development of multiple Abs and T1D. Cox proportional analyses included all substantial non-HLA SNPs, HLA genotypes, relationship to proband, sex, age at initial screening, initial Ab type, and number. Factors involved in progression from single to multiple Abs included age at screening, relationship to proband, HLA genotypes, and rs3087243 (cytotoxic T lymphocyte antigen-4). Significant factors for diabetes progression included age at screening, Ab number, HLA genotypes, rs6476839 [GLIS family zinc finger 3 (GLIS3)], and rs3184504 [SH2B adaptor protein 3 (SH2B3)]. When glucose area under the curve (AUC) was included, factors involved in disease progression included glucose AUC, age at screening, Ab number, relationship to proband, HLA genotypes, rs6476839 (GLIS3), and rs7221109 (CCR7). In stratified analyses by age, glucose AUC, age at screening, sibling, HLA genotypes, rs6476839 (GLIS3), and rs4900384 (C14orf64) were significantly associated with progression to diabetes in participants <12 years old, whereas glucose AUC, sibling, rs3184504 (SH2B3), and rs4900384 (C14orf64) were significant in those ≥12. In conclusion, we identified five non-HLA SNPs associated with increased risk of progression from Ab positivity to disease that may improve risk stratification for prevention trials. Copyright © 2017 by the Endocrine Society

  10. Community vulnerability and stratified risk: Hegemonic masculinity, socioeconomic status, and HIV/AIDS in a sex work community in Kampala, Uganda.

    Science.gov (United States)

    Schmidt-Sane, Megan M

    2018-01-29

    This article examines the social patterning of health, economic uncertainty, hegemonic masculinity, and vulnerability among men who live and work in a low-income sex work community in Kampala, Uganda. This problematises the notion that vulnerable communities are homogenous, in demographics, economic status, and risk. This article draws on ethnographic data collected in 2016, including semi-structured interviews and participant observation. This article uses a stratified risk framework to describe the central finding of this study, which is that men's experience in Kataba is characterised by a struggle to fulfil the provider role that constitutes a core aspect of their socially ascribed gender role. In a context of economic scarcity, men's lives are fraught with strain and this intersects with other forms of risk. Finally, by focusing on community vulnerability rather than individual risk, this work contributes to theories of gender and sex work, and informs HIV/AIDS praxis.

  11. Study of the therapeutic effects of a hippotherapy simulator in children with cerebral palsy: a stratified single-blind randomized controlled trial.

    Science.gov (United States)

    Herrero, Pablo; Gómez-Trullén, Eva M; Asensio, Angel; García, Elena; Casas, Roberto; Monserrat, Esther; Pandyan, Anand

    2012-12-01

    To investigate whether hippotherapy (when applied by a simulator) improves postural control and balance in children with cerebral palsy. Stratified single-blind randomized controlled trial with an independent assessor. Stratification was made by gross motor function classification system levels, and allocation was concealed. Children between 4 and 18 years old with cerebral palsy. Participants were randomized to an intervention (simulator ON) or control (simulator OFF) group after getting informed consent. Treatment was provided once a week (15 minutes) for 10 weeks. Gross Motor Function Measure (dimension B for balance and the Total Score) and Sitting Assessment Scale were carried out at baseline (prior to randomization), end of intervention and 12 weeks after completing the intervention. Thirty-eight children participated. The groups were balanced at baseline. Sitting balance (measured by dimension B of the Gross Motor Function Measure) improved significantly in the treatment group (effect size = 0.36; 95% CI 0.01-0.71) and the effect size was greater in the severely disabled group (effect size = 0.80; 95% CI 0.13-1.47). The improvements in sitting balance were not maintained over the follow-up period. Changes in the total score of the Gross Motor Function Measure and the Sitting Assessment Scale were not significant. Hippotherapy with a simulator can improve sitting balance in cerebral palsy children who have higher levels of disability. However, this did not lead to a change in the overall function of these children (Gross Motor Function Classification System level V).

  12. Cardiovascular risk factors in children.

    Science.gov (United States)

    Fraporti, Marisete Inês; Scherer Adami, Fernanda; Dutra Rosolen, Michele

    2017-10-01

    Systemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes. To investigate the relationship of diastolic (DBP) and systolic blood pressure (SBP) with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state, Brazil. This is a cross-sectional study of 709 children between six and nine years of age. Blood pressure, weight, height and waist circumference (WC) were measured. Statistical tests had a maximum significance level of 5% (p≤0.05) and the software used was SPSS version 13.0. Obesity was significantly associated with pre-hypertension, and stage 1 and 2 hypertension as assessed by DBP and SBP (≤0.05); high WC was significantly associated with a classification of pre-hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP (≤0.01). Children living in urban areas had significantly higher mean SBP than those living in rural areas. Those with high WC presented higher SBP and DBP compared to children with normal WC. Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Data on plasma levels of apolipoprotein E, correlations with lipids and lipoproteins stratified by APOE genotype, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Rasmussen, Katrine L.; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2016-01-01

    Data on correlations of plasma apoE with levels of lipids and lipoproteins stratified by APOE genotypes as well as data exploring the association between plasma levels of apoE and risk of ischemic heart disease (IHD) are wanted. The present data on 91,695 individuals from the general population...... provides correlations between plasma levels of apoE and lipids and lipoproteins for the three APOE genotypes ε33, ε44 and ε22, representing each of the three apoE isoforms. Further, data on extreme groups of plasma apoE (highest 5%) versus lower levels of apoE at enrollment explores risk of IHD...... and myocardial infarction (MI) and is given as hazard ratios. In addition, IHD and MI as a function of apoE/high-density lipoprotein (HDL) cholesterol ratio, as well as data on lipids, lipoproteins and apolipoproteins are given as hazard ratios. Data is stratified by gender and presented for the Copenhagen...

  14. An emergency department intervention to protect an overlooked group of children at risk of significant harm.

    LENUS (Irish Health Repository)

    Kaye, P

    2012-02-01

    BACKGROUND: Parental psychiatric disorder, especially depression, personality disorder and deliberate self-harm, is known to put children at greater risk of mental illness, neglect or physical, emotional and sexual abuse. Without a reliable procedure to identify children of parents presenting with these mental health problems, children at high risk of significant harm can be easily overlooked. Although deliberate self-harm constitutes a significant proportion of emergency presentations, there are no guidelines which address the emergency physician\\'s role in identifying and assessing risk to children of these patients. METHODS: A robust system was jointly developed with the local social services child protection team to identify and risk-stratify children of parents with mental illness. This allows us to intervene when we identify children at immediate risk of harm and to ensure that social services are aware of potential risk to all children in this group. The referral process was audited repeatedly to refine the agreed protocol. RESULTS: The proportion of patients asked by the emergency department personnel about dependent children increased and the quality of information received by the social services child protection team improved. CONCLUSIONS: All emergency departments should acknowledge the inadequacy of information available to them regarding patients\\' children and consider a policy of referral to social services for all children of parents with mental health presentations. This process can only be developed through close liaison within the multidisciplinary child protection team.

  15. A comparison of perinatal outcomes in singletons and multiples born after IVF or ICSI, stratified for neonatal risk criteria

    NARCIS (Netherlands)

    van Heesch, Mirjam M. J.; Evers, Johannes L. H.; Dumoulin, John C. M.; van der Hoeven, Mark A. H. B. M.; van Beijsterveldt, Catharina E. M.; Bonsel, Gouke J.; Dykgraaf, Ramon H. M.; van Goudoever, Johannes B.; Koopman-Esseboom, Corine; Nelen, Willianne L. D. M.; Steiner, Katerina; Tamminga, Pieter; Tonch, Nino; van Zonneveld, Piet; Dirksen, Carmen D.

    2014-01-01

    To compare perinatal singleton and multiple outcomes in a large Dutch in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital malformation.

  16. Red blood cell transfusion and mortality in trauma patients: risk-stratified analysis of an observational study.

    Directory of Open Access Journals (Sweden)

    Pablo Perel

    2014-06-01

    Full Text Available Haemorrhage is a common cause of death in trauma patients. Although transfusions are extensively used in the care of bleeding trauma patients, there is uncertainty about the balance of risks and benefits and how this balance depends on the baseline risk of death. Our objective was to evaluate the association of red blood cell (RBC transfusion with mortality according to the predicted risk of death.A secondary analysis of the CRASH-2 trial (which originally evaluated the effect of tranexamic acid on mortality in trauma patients was conducted. The trial included 20,127 trauma patients with significant bleeding from 274 hospitals in 40 countries. We evaluated the association of RBC transfusion with mortality in four strata of predicted risk of death: 50%. For this analysis the exposure considered was RBC transfusion, and the main outcome was death from all causes at 28 days. A total of 10,227 patients (50.8% received at least one transfusion. We found strong evidence that the association of transfusion with all-cause mortality varied according to the predicted risk of death (p-value for interaction 50% predicted risk of death (OR 0.59, 95% CI 0.47-0.74, p<0.0001. Transfusion was associated with an increase in fatal and non-fatal vascular events (OR 2.58, 95% CI 2.05-3.24, p<0.0001. The risk associated with RBC transfusion was significantly increased for all the predicted risk of death categories, but the relative increase was higher for those with the lowest (<6% predicted risk of death (p-value for interaction <0.0001. As this was an observational study, the results could have been affected by different types of confounding. In addition, we could not consider haemoglobin in our analysis. In sensitivity analyses, excluding patients who died early; conducting propensity score analysis adjusting by use of platelets, fresh frozen plasma, and cryoprecipitate; and adjusting for country produced results that were similar.The association of transfusion

  17. Cardiovascular event-free survival after adjuvant radiation therapy in breast cancer patients stratified by cardiovascular risk

    International Nuclear Information System (INIS)

    Onwudiwe, Nneka C; Kwok, Young; Onukwugha, Eberechukwu; Sorkin, John D; Zuckerman, Ilene H; Shaya, Fadia T; Daniel Mullins, C

    2014-01-01

    The objective of this study was to estimate the risk of a cardiovascular event or death associated with modern radiation in a population of elderly female breast cancer patients with varying baseline cardiovascular risk. The data used for this analysis are from the linked Surveillance, Epidemiology, and End-Results (SEER)-Medicare database. The retrospective cohort study included women aged 66 years and older with stage 0–III breast cancer diagnosed between 2000 and 2005. Women were grouped as low, intermediate, or high cardiovascular risk based on the presence of certain clinical diagnoses. The risk for the combined outcome of a hospitalization for a cardiovascular event or death within 6 months and 24 months of diagnosis was estimated using a multivariable Cox model. The median follow-up time was 24 months. Among the 91,612 women with American Joint Committee on Cancer (AJCC) stage 0–III breast cancer: 39,555 (43.2%) were treated with radiation therapy and 52,057 (56.8%) were not. The receipt of radiation therapy in the first 6 months was associated with a statistically significant increased risk for the combined outcome in women categorized as high risk (HR = 1.510; 95% CI, 1.396–1.634) or intermediate risk (HR = 1.415; 95% CI, 1.188–1.686) but not low risk (HR = 1.027; 95% CI, 0.798–1.321). Women with a prior medical history of cardiovascular disease treated with radiation therapy are at increased risk for an event and should be monitored for at least 6 months following treatment with radiation therapy

  18. Age-stratified 5-year risks of cervical precancer among women with enrollment and newly detected HPV infection.

    Science.gov (United States)

    Gage, Julia C; Katki, Hormuzd A; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Castle, Philip E; Kinney, Walter K

    2015-04-01

    It is unclear whether a woman's age influences her risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) upon detection of HPV. A large change in risk as women age would influence vaccination and screening policies. Among 972,029 women age 30-64 undergoing screening with Pap and HPV testing (Hybrid Capture 2, Qiagen, Germantown, MD) at Kaiser Permanente Northern California (KPNC), we calculated age-specific 5-year CIN3+ risks among women with HPV infections detected at enrollment, and among women with "newly detected" HPV infections at their second screening visit. Women (57,899, 6.0%) had an enrollment HPV infection. Among the women testing HPV negative at enrollment with a second screening visit, 16,724 (3.3%) had a newly detected HPV infection at their second visit. Both enrollment and newly detected HPV rates declined with age (p < 0.001). Women with enrollment versus newly detected HPV infection had higher 5-year CIN3+ risks: 8.5% versus 3.9%, (p < 0.0001). Risks did not increase with age but declined slightly from 30-34 years to 60-64 years: 9.4% versus 7.4% (p = 0.017) for enrollment HPV and 5.1% versus 3.5% (p = 0.014) for newly detected HPV. Among women age 30-64 in an established screening program, women with newly detected HPV infections were at lower risk than women with enrollment infections, suggesting reduced benefit vaccinating women at older ages. Although the rates of HPV infection declined dramatically with age, the subsequent CIN3+ risks associated with HPV infection declined only slightly. The CIN3+ risks among older women are sufficiently elevated to warrant continued screening through age 65. © 2014 UICC.

  19. Can subsyndromal manifestations of major depression be identified in children at risk?

    Science.gov (United States)

    Uchida, M; Fitzgerald, M; Lin, K; Carrellas, N; Woodworth, H; Biederman, J

    2017-02-01

    Children of parents with major depression are at significantly increased risk for developing major depression themselves; however, not all children at genetic risk will develop major depressive disorder (MDD). We investigated the utility of subsyndromal scores on the Child Behavior Checklist (CBCL) Anxiety/Depression scale in identifying children at the highest risk for pediatric MDD from among the pool of children of parents with MDD or bipolar disorder. The sample was derived from two previously conducted longitudinal case-control family studies of psychiatrically and pediatrically referred youth and their families. For this study, probands were stratified based on the presence or absence of a parental mood disorder. Subsyndromal scores on the CBCL Anxiety/Depression scale significantly separated the children at high risk for pediatric MDD from those at low risk in a variety of functional areas, including social and academic functioning. Additionally, children at genetic risk without elevated CBCL Anxiety/Depression scale scores were largely indistinguishable from controls. These results suggest that the CBCL Anxiety/Depression scale can help identify children at highest risk for pediatric MDD. If implemented clinically, this scale would cost-effectively screen children and identify those most in need of early intervention resources to impede the progression of depression. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Stratifying risk in chronic kidney disease: an observational study of UK guidelines for measuring total proteinuria and albuminuria.

    Science.gov (United States)

    Methven, S; Traynor, J P; Hair, M D; St J O'Reilly, D; Deighan, C J; MacGregor, M S

    2011-08-01

    Proteinuria predicts poor renal and cardiovascular outcomes. Some guidelines recommend measuring proteinuria using albumin:creatinine ratio (ACR), while others recommend total protein:creatinine ratio (TPCR). To compare renal outcomes and mortality in the populations identified by these different recommendations. Retrospective longitudinal cohort study. Baseline ACR and TPCR measurements were obtained from 5586 patients with chronic kidney disease (CKD) attending a Scottish hospital nephrology clinic. The cohort was divided into three groups with concordant results by ACR and TPCR (no proteinuria; low proteinuria; significant proteinuria) and one group with discordant results (significant proteinuria with TPCR, but not ACR). Outcomes were assessed using Kaplan-Meier plots and Cox proportional hazards models. Median follow-up was 3.5 years [interquartile range (IQR) 2.1-6.0]; 844 (15%) died at 3.0 years (IQR 1.8-4.7) and 468 (8%) started renal replacement therapy (RRT) at 1.7 years (IQR 0.6-3.4). Proteinuria was associated with a substantially increased risk of RRT and death. Patients with significant proteinuria by TPCR, but not ACR (n = 231) had high renal risk, and the highest all-cause mortality (log-rank P < 0.001). With multivariate analysis the risk fell below those with significant proteinuria with concordant results by ACR and TPCR but remained considerably higher than those without significant proteinuria. Proteinuria screening with TPCR identifies an additional 16% of patients with significant proteinuria, not identified using ACR. This subgroup has high renal risk, and high risk of all-cause mortality and therefore warrant identification. Guideline recommendations on proteinuria screening in CKD should be reconsidered.

  1. Has the Time Come to Stratify and Score SUDEP Risk to Inform People With Epilepsy of Their Changes in Safety?

    Directory of Open Access Journals (Sweden)

    Rohit Shankar

    2018-04-01

    Full Text Available Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation. Shared decision-making with an emphasis on delivering person-centered communication to foster self-management strategies is increasingly recognized as the ideal model of patient–clinician communication in chronic diseases such as epilepsy. The tension between delivering evidence-based risk information, yet, tailoring it to the individual is complex. It needs to incorporate the potential for change not only in seizure factors but also other health and social factors. Safety advice needs to be dynamic and situation sensitive as opposed to a “one off” discussion. As a significant minority of people with epilepsy have drug-resistant seizures, the importance of keeping the advice contextual at different intervals of the person’s life cannot be overstated as many of them are managed in primary care. We present some exploratory work, which identifies the need to improve communication at a primary care level and to review risks regularly. Regular reviews using a structured risk factor checklist as a screening tool could identify, sooner, people who’s health issues are worsening and justify referrals to specialists.

  2. Effectiveness of a two-step population-based osteoporosis screening program using FRAX: the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study.

    Science.gov (United States)

    Rubin, K H; Rothmann, M J; Holmberg, T; Høiberg, M; Möller, S; Barkmann, R; Glüer, C C; Hermann, A P; Bech, M; Gram, J; Brixen, K

    2018-03-01

    The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion took place from February 2010 to November 2011. Participants received a self-administered questionnaire, and women in the screening group with a FRAX score ≥ 15% (major osteoporotic fractures) were invited to a DXA scan. Primary outcome was incident clinical fractures. Intention-to-treat analysis and two per-protocol analyses were performed. A total of 3416 fractures were observed during a median follow-up of 5 years. No significant differences were found in the intention-to-treat analyses with 34,229 women included aged 65-80 years. The per-protocol analyses showed a risk reduction in the group that underwent DXA scanning compared to women in the control group with a FRAX ≥ 15%, in regard to major osteoporotic fractures, hip fractures, and all fractures. The risk reduction was most pronounced for hip fractures (adjusted SHR 0.741, p = 0.007). Compared to an office-based case-finding strategy, the two-step systematic screening strategy had no overall effect on fracture incidence. The two-step strategy seemed, however, to be beneficial in the group of women who were

  3. Stroke rehabilitation and risk of mortality: a population-based cohort study stratified by age and gender.

    Science.gov (United States)

    Hou, Wen-Hsuan; Ni, Cheng-Hua; Li, Chung-Yi; Tsai, Pei-Shan; Lin, Li-Fong; Shen, Hsiu-Nien

    2015-06-01

    To determine the survival of patients with stroke for up to 10 years after a first-time stroke and to investigate whether stroke rehabilitation within the first 3 months reduced long-term mortality in these patients. We used the medical claims data for a random sample of 1 million insured Taiwanese registered in the year 2000. A total of 7767 patients admitted for a first-time stroke between 2000 and 2005; 1285 (16.7%) received rehabilitation within the first 3 months after stroke admission. The other 83.3% of patients served as a comparison cohort. A Cox proportional hazards model was used to estimate the relative risk of mortality in relation to the rehabilitation intervention. In all, 181 patients with rehabilitation and 1123 controls died, representing respective mortality rates of 25.0 and 32.7 per 1000 person-years. Rehabilitation was significantly associated with a lower risk of mortality (hazard ratio .68, 95% confidence interval .58-.79). Such a beneficial effect tended to be more obvious as the frequency of rehabilitation increased (P for the trend Stroke rehabilitation initiated in the first 3 months after a stroke admission may significantly reduce the risk of mortality for 10 years after the stroke. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI

    Directory of Open Access Journals (Sweden)

    Vargha-Khadem Faraneh

    2011-10-01

    Full Text Available Abstract Background The MRC UKALLXI trial tested the efficacy of different central nervous system (CNS directed therapies in childhood acute lymphoblastic leukaemia (ALL. To evaluate morbidity 555/1826 randomised children underwent prospective psychological evaluations. Full Scale, verbal and performance IQs were measured at 5 months, 3 years and 5 years. Scores were compared in; (1 all patients (n = 555 versus related controls (n = 311, (2 low-risk children (presenting white cell count (WCC 9/l randomised to intrathecal methotrexate (n = 197 versus intrathecal and high-dose intravenous methotrexate (HDM (n = 202, and (3 high-risk children (WCC ≥ 50 × 109/l, age ≥ 2 years randomised to HDM (n = 79 versus cranial irradiation (n = 77. Results There were no significant differences in IQ scores between the treatment arms in either low- or high-risk groups. Despite similar scores at baseline, results at 3 and 5 years showed a significant reduction of between 3.6 and 7.3 points in all three IQ scores in all patient groups compared to controls (P Conclusion Children with ALL are at risk of CNS morbidity, regardless of the mode of CNS-directed therapy. Further work needs to identify individuals at high-risk of adverse CNS outcomes. Trial registration ISRCTN: ISRCTN16757172

  5. Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey.

    Science.gov (United States)

    Tang, Xianyan; Geater, Alan; McNeil, Edward; Zhou, Hongxia; Deng, Qiuyun; Dong, Aihu

    2017-07-01

    Large-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV). This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18-54 months in rural Guangxi. Based on quartiles of measles incidence during 2011-2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs) were calculated. Weighted Kaplan-Meier analyses were used to estimate the median delay periods for the first (MCV1) and second (MCV2) doses of the vaccine. A total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%-62.0%) for MCV1, and 76.9% (95% CI, 73.6%-80.0%) for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%-51.0%). The median delay period was 32 (95% CI, 27-38) days for MCV1, and 159 (95% CI, 118-195) days for MCV2. The timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  6. Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey

    Directory of Open Access Journals (Sweden)

    Xianyan Tang

    2017-07-01

    Full Text Available Background: Large-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV. This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18–54 months in rural Guangxi. Methods: Based on quartiles of measles incidence during 2011–2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs were calculated. Weighted Kaplan–Meier analyses were used to estimate the median delay periods for the first (MCV1 and second (MCV2 doses of the vaccine. Results: A total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%–62.0% for MCV1, and 76.9% (95% CI, 73.6%–80.0% for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%–51.0%. The median delay period was 32 (95% CI, 27–38 days for MCV1, and 159 (95% CI, 118–195 days for MCV2. Conclusions: The timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China.

  7. Metabolic risk profiles in diabetes stratified according to age at onset, islet autoimmunity and fasting C-peptide

    DEFF Research Database (Denmark)

    Wod, Mette; Yderstræde, Knud B; Halekoh, Ulrich

    2017-01-01

    OBJECTIVE: Islet autoimmunity, age at onset and time to insulin treatment are often used to define subgroups of diabetes. However, the latter criterion is not clinical useful. Here, we examined whether an unbiased stratification of diabetes according to age at onset, fasting C-peptide and GAD......, fasting C-peptide above or below 300 pmol/l (CPEPhigh or CPEPlow), and presence or absence of GADab (GADpos or GADneg). HbA1c, BMI, blood pressure (BP), lipid profile, alanine aminotransferase (ALT) and creatinine were evaluated. RESULTS: GADab were present in 13% of the cohort. Age at onset...... as GADposCPEPhigh; n=327) and patients with type 2 diabetes (GADnegCPEPhigh; n=3,544). Patients with LADA defined an intermediate group with higher HbA1c but otherwise lower cardiometabolic risk than patients with type 2 diabetes. CONCLUSIONS: Our results demonstrate that fasting C-peptide and GADab status...

  8. Children of Alcoholics/Addicts: Children at Risk.

    Science.gov (United States)

    Gover, F. Jill

    Children of alcoholics/addicts (COAs) are at a greater risk to develop alcohol and drug dependency, eating disorders, attention deficit disorders, stress-related illness, and suicidal behavior. Children become part of a conspiracy of silence by being told not to talk about the drug problem. The family members assume different roles which…

  9. Children neglected: Where cumulative risk theory fails.

    Science.gov (United States)

    O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

    2015-07-01

    Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Association between parents' attitudes and behaviors toward children's visual care and myopia risk in school-aged children.

    Science.gov (United States)

    Zhou, Shuang; Yang, Lihua; Lu, Benlin; Wang, Hexin; Xu, Ting; Du, Dandan; Wu, Shiqing; Li, Xiuxiu; Lu, Meixia

    2017-12-01

    The purpose of this survey was to determine the association of parents' attitudes and behaviors toward children's visual care with myopia risk in school-aged children.A total of 894 parents of school-aged children were investigated in primary and middle schools in the central and noncentral urban area in Wuhan through stratified cluster random sampling on July, 2015. We analyzed the association by the generalized linear mixed model.The results indicated that children with parents' high expectations of 1.5 or higher on their vision exhibited a decreased risk of myopia compared with 1.0 and 0.5 or lower (OR = 0.49, 95%CI = 0.36-0.67). Children whose parents only paid attention to their vision in junior and senior school and in primary school had an increased myopia risk than that in preschool (OR = 2.12, 95%CI = 1.01-4.45, and OR = 3.11, 95%CI = 1.28-7.58, respectively). Children whose parents ensured for their sufficient sleep had a decreased myopia risk (OR = 0.45, 95%CI = 0.24-0.85). Compared with children whose parents who never adjusted electronic devices' parameters, the odds ratio of sometimes was 0.49 (95%CI = 0.31-0.79), often 0.53 (95%CI = 0.33-0.85), and always 0.44 (95%CI = 0.26-0.75), respectively.Parents' attitudes and behaviors toward children's visual care are significantly associated with the myopia risk in school-aged children. Consequently, efforts should be made to educate parents on how they protect children's vision and reduce their risk of myopia. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  11. Risk of community-acquired pneumonia in chronic obstructive pulmonary disease stratified by smoking status: a population-based cohort study in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Braeken DCW

    2017-08-01

    Full Text Available Dionne CW Braeken,1–3 Gernot GU Rohde,2 Frits ME Franssen,1,2 Johanna HM Driessen,3–5 Tjeerd P van Staa,3,6 Patrick C Souverein,3 Emiel FM Wouters,1,2 Frank de Vries3,4,7 1Department of Research and Education, CIRO, Horn, 2Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+, Maastricht, 3Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, 4Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre (MUMC+, Maastricht, 5Department of Epidemiology, Care and Public Health Research Institute (CAPHRI, Maastricht, the Netherlands; 6Department of Health eResearch, University of Manchester, Manchester, 7MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK Background: Smoking increases the risk of community-acquired pneumonia (CAP and is associated with the development of COPD. Until now, it is unclear whether CAP in COPD is due to smoking-related effects, or due to COPD pathophysiology itself. Objective: To evaluate the association between COPD and CAP by smoking status. Methods: In total, 62,621 COPD and 191,654 control subjects, matched by year of birth, gender and primary care practice, were extracted from the Clinical Practice Research Datalink (2005–2014. Incidence rates (IRs were estimated by dividing the total number of CAP cases by the cumulative person-time at risk. Time-varying Cox proportional hazard models were used to estimate the hazard ratios (HRs for CAP in COPD patients versus controls. HRs of CAP by smoking status were calculated by stratified analyses in COPD patients versus controls and within both subgroups with never smoking as reference. Results: IRs of CAP in COPD patients (32.00/1,000 person-years and controls (6.75/1,000 person-years increased with age and female gender. The risk of CAP in COPD patients was higher than in controls (HR 4.51, 95% CI: 4.27–4.77. Current smoking

  12. Cancer risk in children born after donor ART.

    Science.gov (United States)

    Williams, C L; Bunch, K J; Murphy, M F G; Stiller, C A; Botting, B J; Wallace, W H; Davies, M C; Sutcliffe, A G

    2018-01-01

    Do children born after donor ART have an increased risk of developing childhood cancer in comparison to the general population? This study showed no overall increased risk of childhood cancer in individuals born after donor ART. Most large population-based studies have shown no increase in overall childhood cancer incidence after non-donor ART; however, other studies have suggested small increased risks in specific cancer types, including haematological cancers. Cancer risk specifically in children born after donor ART has not been investigated to date. This retrospective cohort study utilized record linkage to determine the outcome status of all children born in Great Britain (1992-2008) after donor ART. The cohort included 12 137 members who contributed 95 389 person-years of follow-up (average follow-up 7.86 years). Records of all children born in Great Britain (England, Wales, Scotland) after all forms of donor ART (1992-2008) were linked to the UK National Registry of Childhood Tumours (NRCT) to determine the number who subsequently developed cancer by 15 years of age, by the end of 2008. Rates of overall and type specific cancer (selected a priori) were compared with age, sex and calendar year standardized population-based rates, stratifying for potential mediating/moderating factors including sex, age at diagnosis, birth weight, multiple births, maternal previous live births, assisted conception type and fresh/ cryopreserved cycles. In our cohort of 12 137 children born after donor ART (52% male, 55% singleton births), no overall increased risk of cancer was identified. There were 12 cancers detected compared to 14.4 expected (standardized incidence ratio (SIR) 0.83; 95% CI 0.43-1.45; P = 0.50). A small, significant increased risk of hepatoblastoma was found, but the numbers and absolute risks were small (ART, the rarity of specific diagnostic subgroups of childhood cancer results in few cases and therefore wide CIs for such outcomes. As this is an

  13. [Risk factors for anorexia in children].

    Science.gov (United States)

    Liu, Wei-Xiao; Lang, Jun-Feng; Zhang, Qin-Feng

    2016-11-01

    To investigate the risk factors for anorexia in children, and to reduce the prevalence of anorexia in children. A questionnaire survey and a case-control study were used to collect the general information of 150 children with anorexia (case group) and 150 normal children (control group). Univariate analysis and multivariate logistic stepwise regression analysis were performed to identify the risk factors for anorexia in children. The results of the univariate analysis showed significant differences between the case and control groups in the age in months when supplementary food were added, feeding pattern, whether they liked meat, vegetables and salty food, whether they often took snacks and beverages, whether they liked to play while eating, and whether their parents asked them to eat food on time (Panorexia in children. Liking of meat (OR=0.093) and vegetables (OR=0.272) and eating on time required by parents (OR=0.079) were protective factors against anorexia in children. Timely addition of supplementary food, a proper diet, and development of children's proper eating and living habits can reduce the incidence of anorexia in children.

  14. Risk of congenital malformations among children of construction painters in Denmark

    DEFF Research Database (Denmark)

    Tougaard, Ninna Hahn; Bonde, Jens Peter; Hougaard, Karin Sørig

    2015-01-01

    OBJECTIVES: Painters' occupational exposure is classified as a group 1 carcinogen by the International Agency for Research on Cancer (IARC). Previous studies have shown increased risk of congenital malformations among children of women exposed to organic solvents and paint emissions during...... pregnancy. In Denmark, women comprise half of those enrolled in vocational paint training. We investigated the association between maternal and paternal occupational painting, respectively, and the risk of congenital malformations among children. METHODS: National register data were used to link childbirths...... diagnoses within the first 10 years of life, when stratifying by maternal age, birth year, and sex, or for paternal construction painters. CONCLUSIONS: This nationwide cohort study is reassuring with no indications of increased risk of congenital malformations among children of male or of female...

  15. [Risk assessment expanded accident insurance for children].

    Science.gov (United States)

    Sittaro, N A

    1998-08-01

    Disability is a well known and tragic event for children. While adults are an established group for specific disability insurance cover, children were often neglected in the past. Although parents, organizations and paediatricans are aware of the risk, children specific incidence rates for disability are hardly available. The only sufficient source for some statistical data are the accident statistics because they represent a substantial group of specific cause related disability for children. Incidence rates for disease related chronic severe impairment or disability in children are either derived by single disease research or actuarial calculation of the German Social Disability Registration. Based on this statistical background, an extended accident insurance for children was introduced in Germany covering both accidents and disabling diseases. The key limitation for all variations of this insurance are exclusion clauses for congential diseases and mental disorders. This insurance requires a new approach in underwriting of the health risks. Because of the substantial number of impaired children, a simple decline of substandard cases are unacceptable. The early experience or medical underwriting shows predominantly health impairments of the following types: allergies, bronchial asthma, ectopic eczema (neurodermitis), disorders of speech and articulation, vision disorders and mental impairments. The suggested solution for underwriting of substandard risks is the predetermination of the possible future maximum degree of disability. The need for underwriting guidelines is supported by the market impact of the new disability cover with thousands of insurance policies issued in the first month after introduction.

  16. Anti - microbial resistance stratified by risk factor among Escherichia coli strains isolated from the urinary tract at a rural clinic in Central India

    Directory of Open Access Journals (Sweden)

    Chatterjee B

    2009-01-01

    Full Text Available Background: The failure of empirical therapy is frequently observed, even in community-acquired urinary tract infections. We, therefore, conducted a prospective, clinic-based study in 2004-2005 to document anti-microbial resistance rates and correlate them with possible risk factors to assist empirical decision-making. Materials and Methods: Symptomatic patients with pyuria underwent urine culture. Isolates were identified using standard methods and anti-microbial resistance was determined by disk-diffusion. Ultrasonography was used to detect complicating factors. Patients were stratified by the presence of complicating factors and history of invasive procedures for comparison of resistance rates. Statistical Method Used: Chi-square or Fisher exact tests, as appropriate. Results: There were 156 E. coli isolates, of which 105 were community-acquired. Twenty-three community-acquired isolates were from patients with complicating factors while 82 were from patients without any. Fifty-one isolates were from patients who had recently undergone invasive procedures on the urinary tract. Thirty-two community-acquired isolates from reproductive-age women without apparent complicating factors had resistance rates of 50% or above against tetracyclines, Co-trimoxazole, aminopenicillins, Nalidixic acid, Ciprofloxacin and 1 st generation cephalosporins. Resistance rates were significantly higher among isolates from patients subjected to invasive procedures, except against Co-trimoxazole, tetracyclines and Amikacin. Conclusion: High rates of anti-microbial resistance in community-acquired uropathogens have made antimicrobial sensitivity testing necessary even in a rural, primary-care setting.

  17. Risk for tuberculosis among children

    DEFF Research Database (Denmark)

    Nakaoka, Hiroshi; Lawson, Lovett; Squire, S Bertel

    2006-01-01

    Contacts of adults with tuberculosis (TB) are at risk for infection. Tests based on interferon-gamma (IFN-gamma) expression in response to Mycobacterium tuberculosis antigens may be more sensitive than the tuberculin skin test (TST). Risk for infection was assessed by using TST and an IFN...

  18. Hourly differences in air pollution and risk of respiratory disease in the elderly: a time-stratified case-crossover study.

    Science.gov (United States)

    Yorifuji, Takashi; Suzuki, Etsuji; Kashima, Saori

    2014-08-13

    Epidemiological studies have shown adverse effects of short-term exposure to air pollution on respiratory disease outcomes; however, few studies examined this association on an hourly time scale. We evaluated the associations between hourly changes in air pollution and the risk of respiratory disease in the elderly, using the time of the emergency call as the disease onset for each case. We used a time-stratified case-crossover design. Study participants were 6,925 residents of the city of Okayama, Japan, aged 65 or above who were taken to hospital emergency rooms between January 2006 and December 2010 for onset of respiratory disease. We calculated city-representative hourly average concentrations of air pollutants from several monitoring stations. By using conditional logistic regression models, we estimated odds ratios per interquartile-range increase in each pollutant by exposure period prior to emergency call, adjusting for hourly ambient temperature, hourly relative humidity, and weekly numbers of reported influenza cases aged ≥60. Suspended particulate matter (SPM) exposure 24 to respiratory disease. For example, following one interquartile-range increase, odds ratios were 1.05 (95% confidence interval: 1.01, 1.09) for SPM exposure 24 to respiratory disease of SPM or ozone. Overall, the effect estimates for chronic obstructive pulmonary disease and allied conditions were equivocal. This study provides further evidence that hourly changes in air pollution exposure increase the risks of respiratory disease, and that SO2 may be related with more immediate onset of the disease than other pollutants.

  19. Risk behaviour of street children in Colombo.

    Science.gov (United States)

    Senaratna, B C V; Wijewardana, B V N

    2012-09-01

    Sri Lankan street children live in insecure and disadvantaged environments and have disrupted and poorly functioning families resulting in their poor socialisation. In this backdrop they are at high risk of adopting delinquent and antisocial behaviour and becoming victims of abuse. Despite recognition of this as a social problem, an in-depth exploration of their behaviour and its correlates has not been attempted. To describe risk behaviour among street children in Colombo city and the determinants of such behaviour. A cross sectional qualitative study in Colombo Fort, Pettah, Slave Island, and Maradana areas was conducted using focus group discussions (FGDs) with street children and semi-structured interviews (SSIs) with street children and key informants in their environment. Data generated were used to profile 283 children identified through referral sampling. An observation study was conducted to validate data generated through FGDs and SSIs. Semi-structured questionnaires, a moderator guide, an interviewer-administered questionnaire, and an observational checklist were used for SSIs, FGDs, profiling, and observational study, respectively. Majority of street children were boys and were aged 14 years or less. Nearly 18% lived alone without a guardian. Two thirds had never enrolled in a school. Many children were used for begging, neglecting their health vulnerabilities. Occupational risk behaviour included heavy manual labour, transportation and sale of illicit alcohol and narcotics, robbing/pick-pocketing, commercial sex work, and pimping. Recreational risk behaviour included abuse of alcohol/narcotics, smoking, sexual promiscuity, and patronising commercial sex workers. Increased awareness and strategies are required to minimise threats to street children and society.

  20. Children and war: risk, resilience, and recovery.

    Science.gov (United States)

    Werner, Emmy E

    2012-05-01

    This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.

  1. FeNO and Exercise Testing in Children at Risk of Asthma

    DEFF Research Database (Denmark)

    Schoos, Ann-Marie Malby; Christiansen, Christina Figgé; Stokholm, Jakob

    2017-01-01

    completed in 224 seven-year-old children from the at-risk Copenhagen Prospective Studies on Asthma in Childhood2000 birth cohort. The associations between FeNO, exercise test results, and reported respiratory symptoms during exercise were analyzed adjusting for gender, respiratory infections, and inhaled....... OBJECTIVE: The objective of this study was to investigate the relationship between FeNO, exercise test results, and a history of respiratory symptoms during exercise in children at risk of asthma. METHODS: FeNO measurement, exercise testing, and interview about respiratory symptoms during exercise were...... corticosteroid treatment. The associations were also analyzed stratified by asthma and atopic status. RESULTS: Of the 224 children, 28 (13%) had an established asthma diagnosis and 58 (26%) had a positive exercise test (≥15% drop in forced expiratory volume in 1 second [FEV1] from baseline). FeNO and bronchial...

  2. Risk factors of poor anthropometric status in children under five ...

    African Journals Online (AJOL)

    2010-06-25

    Jun 25, 2010 ... 35% of the total South African population.10 In 1995, the South ... is likely to provide better estimates of child malnutrition levels. Both the EC and KZN provinces had an average breastfeeding rate of 78% ... In the original study, a stratified random sample of 4 000 children ..... For attainment of optimal.

  3. Primary surgery results in no survival benefit compared to primary radiation for oropharyngeal cancer patients stratified by high-risk human papilloma virus status.

    Science.gov (United States)

    Lybak, Stein; Ljøkjel, Borghild; Haave, Hilde; Karlsdottir, Àsa; Vintermyr, Olav K; Aarstad, Hans Jørgen

    2017-01-01

    We changed the primary oropharynx squamous cell carcinoma (OPSCC) treatment recommendation from primary radiation therapy (RT) to tumor surgery and neck dissection, followed by RT around the year 2000 with apparently improved survival. However, high-risk human papilloma virus (hr-HPV)-16-caused OPSCCs have increased during this period. Furthermore, hr-HPV+ OPSCC carry a better prognosis than hr-HPV-negative patients. We have, therefore, evaluated the 5-year survival in the period from 1992 to 1999 versus 2000 to 2008 stratified by hr-HPV tumor infection status. Ninety-six OPSCC patients were treated from 1992 to 1999 compared with 136 patients from 2000 to 2008. The 5-year disease-specific survival (DDS) and overall survival (OS) were recorded, while the health-related quality of life (HRQoL) scores were obtained from some of the cured patients. Thirty-eight (40 %) in the first period and 86 OPSCCs (63 %) in the second period were hr-HPV+. In the first period, 16 versus 62 patients in the last period were treated by neck dissection, primary tumor surgery, and RT. DSS among all the hr-HPV-negative patients in the first period was 51 versus 55 % in the second period, and the corresponding OS was 33 versus 31 %, respectively. The DSS among all the hr-HPV+ patients was 78 % in the first period versus 77 % in the second period, while the OS was 71 versus 69 %, respectively. The HRQoL scores among successfully treated patients were worse following surgery, plus RT than RT only. The hr-HPV-adjusted 5-year survival in OPSCC patients was similar between the two time periods. A decreased HRQoL was associated with surgical therapy, which indicates that hr-HPV+ OPSCC patients may be treated by primary RT followed by major surgery only if RT treatment fails.

  4. Stratifying type 2 diabetes cases by BMI identifies genetic risk variants in LAMA1 and enrichment for risk variants in lean compared to obese cases

    NARCIS (Netherlands)

    J.R.B. Perry (John); B.F. Voight (Benjamin); L. Yengo (Loic); N. Amin (Najaf); J. Dupuis (Josée); M. Ganser (Martha); H. Grallert (Harald); P. Navarro (Pau); M. Li (Man); L. Qi (Lu); V. Steinthorsdottir (Valgerdur); R.A. Scott (Robert); P. Almgren (Peter); D.E. Arking (Dan); Y.S. Aulchenko (Yurii); B. Balkau (Beverley); R. Benediktsson (Rafn); R.N. Bergman (Richard); E.A. Boerwinkle (Eric); L.L. Bonnycastle (Lori); N.P. Burtt (Noël); H. Campbell (Harry); G. Charpentier (Guillaume); F.S. Collins (Francis); C. Gieger (Christian); T. Green (Todd); S. Hadjadj (Samy); A.T. Hattersley (Andrew); C. Herder (Christian); A. Hofman (Albert); A.D. Johnson (Andrew); A. Köttgen (Anna); P. Kraft (Peter); Y. Labrune (Yann); C. Langenberg (Claudia); A.K. Manning (Alisa); K.L. Mohlke (Karen); A.P. Morris (Andrew); B.A. Oostra (Ben); J.S. Pankow (James); A.K. Petersen; P.P. Pramstaller (Peter Paul); I. Prokopenko (Inga); W. Rathmann (Wolfgang); N.W. Rayner (Nigel William); M. Roden (Michael); I. Rudan (Igor); D. Rybin (Denis); L.J. Scott (Laura); G. Sigurdsson (Gunnar); R. Sladek (Rob); G. Thorleifsson (Gudmar); U. Thorsteinsdottir (Unnur); J. Tuomilehto (Jaakko); A.G. Uitterlinden (André); S. Vivequin (Sidonie); M.N. Weedon (Michael); A.F. Wright (Alan); F.B. Hu (Frank); T. Illig (Thomas); W.H.L. Kao (Wen); J.B. Meigs (James); J.F. Wilson (James); J-A. Zwart (John-Anker); C.M. van Duijn (Cornelia); D. Altshuler (David); A.D. Morris (Andrew); M. Boehnke (Michael); M.I. McCarthy (Mark); P. Froguel (Philippe); C.N.A. Palmer (Colin); N.J. Wareham (Nick); L. Groop (Leif); T.M. Frayling (Timothy); S. Cauchi (Stephane)

    2012-01-01

    textabstractCommon diseases such as type 2 diabetes are phenotypically heterogeneous. Obesity is a major risk factor for type 2 diabetes, but patients vary appreciably in body mass index. We hypothesized that the genetic predisposition to the disease may be different in lean (BMI<25 Kg/m2) compared

  5. Fetal programming of children's obesity risk.

    Science.gov (United States)

    Stout, Stephanie A; Espel, Emma V; Sandman, Curt A; Glynn, Laura M; Davis, Elysia Poggi

    2015-03-01

    Childhood obesity affects nearly 17% of children and adolescents in the United States. Increasing evidence indicates that prenatal maternal stress signals influence fetal growth, child obesity, and metabolic risk. Children exhibiting catch-up growth, a rapid and dramatic increase in body size, within the first two years of life are also at an increased risk for developing metabolic disorder and obesity. We evaluate the potential role of the maternal hypothalamic-pituitary-adrenal (HPA) and placental axis in programming risk for child obesity. This prospective longitudinal study measured placental corticotropin-releasing hormone (pCRH) and maternal plasma cortisol at 15, 19, 25, 30, and 37 gestational weeks and collected child body mass index (BMI) at birth, 3, 6, 12, and 24 months. Participants included 246 mothers and their healthy children born full term. Each child's BMI percentile (BMIP) was determined using World Health Organization (WHO) standards based on age and sex. Child BMIP profiles from birth to two years of age were characterized using general growth mixture modeling (GGMM). We evaluated whether fetal exposure to placental CRH and maternal cortisol are associated with BMIP profiles. Placental CRH at 30 gestational weeks was highly associated with both BMIP (pfetal programming of obesity risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Fungal infection risk groups among school children

    Directory of Open Access Journals (Sweden)

    Elżbieta Ejdas

    2014-08-01

    Full Text Available The aim of the study was to evaluate the relationship between ocurrence of fungi in children and living environment (city - countryside, sex, age, diet, undergone diseases therapy with antibiotics and exposure to hospital environment, and to indicate children potentially vulnerable to fungal infections. The material was consisted of swabs collected from the oral cavily, the throat and the nose of healthy children, aged 6-9 and 10-15, from both urban and rural environmens. Candida albicans, the basic aetiological factor in thc majority of mycoses recorded in humans, unquestionably prevailed in the group of the 13 speciec of yeast-like fungi and yeasts isolated. Records of C. glabrata and C. krusei increasing numbers of whose strains show resistance to basic antimycoties, as well as relatively frequent records of Trichosporon beigelii, Saccharomycopsis capsularis and Saccharomyces sp., fungi whose expansiveness and enzymatic activity have been growing, may be considered disconcerting. Vulnerability to fungal infection increases following anti-bacterial antibiotic therapy in the majority of subjects regardless season or age. This is particularly true primarily of the most stable ontocoenosis of the throat. Younger children, on the other hand, are the most vulnerable foUowing infection of the respiratory system. Fungi are likely to colonise the nose in this case. Children living in the countryside who had been ll immediately prior to the collection of the material constitute the highest risk group of the occurrence of fungi in any of the ontocoenoses studied. A greater number of positive inoculations were recorded in these children in comparison to the children from the city. It may be indicative of a more extensive spectrum of natural reservoirs of fungi and the vectors of their transmission in rural areas than those in the city, lower health hygiene and lower immunity or of a more common carriage of fungi among rural children.

  7. Risk Factors in Divorce: Perceptions by the Children Involved.

    Science.gov (United States)

    Moxnes, Kari

    2003-01-01

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

  8. Risk factors for Mycobacterium tuberculosis infection among children in Greenland

    DEFF Research Database (Denmark)

    Søborg, Bolette; Andersen, Aase Bengaard; Melbye, Mads

    2011-01-01

    To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection.......To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection....

  9. Risk-benefit analysis of restricting antimicrobial prescribing in children: what do we really know?

    Science.gov (United States)

    Keith, Tamara; Saxena, Sonia; Murray, Joanna; Sharland, Mike

    2010-06-01

    Most childhood respiratory infections including acute otitis media (AOM), sore throat, upper respiratory tract infections (URTIs) and sinusitis are self-limiting illnesses. Yet, despite extensive guidance discouraging routine use of antibiotics to limit side-effects and combat antimicrobial resistance, antibiotic prescribing for these conditions remains high in many developed countries, fuelled by the fear of rare but serious bacterial complications including mastoiditis, quinsy, pneumonia and brain abscess. This review summarizes evidence for the role of antibiotics in preventing serious complications of URTIs in children. From a key observational study reporting antibiotic use in children, the calculated excess risk of suppurative complications of respiratory tract infections in children who did not receive an antibiotic was 3.8 per 10 000. Despite extensive searches of the literature, no data were found to assess the affect of antibiotics upon the risk of brain abscess after sinusitis in children. New information from observational studies suggests antibiotics show little benefit in preventing complications of mastoiditis following AOM, quinsy following sore throat and pneumonia following URTI/bronchitis. Further research should focus on stratifying the key risk factors for such complications and optimizing long-term monitoring strategies to detect any future changes in the risk-benefit analysis for antibiotic prescription.

  10. Risk Factors For Epilepsy In Children With Cerebral Palsy | Lagunju ...

    African Journals Online (AJOL)

    Epilepsy is said to occur in 15-90% of children with cerebral palsy and this poses additional economic and psychological stress on affected children and their families. Objectives To describe the risk factors for epilepsy in children with cerebral palsy. Methods One hundred and seventy six children with cerebral palsy seen at ...

  11. Risk Profiles of Children Entering Residential Care: A Cluster Analysis

    Science.gov (United States)

    Hagaman, Jessica L.; Trout, Alexandra L.; Chmelka, M. Beth; Thompson, Ronald W.; Reid, Robert

    2010-01-01

    Children in residential care are a heterogeneous population, presenting various combinations of risks. Existing studies on these children suggest high variability across multiple domains (e.g., academics, behavior). Given this heterogeneity, it is important to begin to identify the combinations and patterns of multiple risks, or risk profiles,…

  12. IA-2 autoantibody affinity in children at risk for type 1 diabetes.

    Science.gov (United States)

    Krause, Stephanie; Chmiel, Ruth; Bonifacio, Ezio; Scholz, Marlon; Powell, Michael; Furmaniak, Jadwiga; Rees Smith, Bernard; Ziegler, Anette-G; Achenbach, Peter

    2012-12-01

    Autoantibodies to insulinoma-associated protein 2 (IA-2A) are associated with increased risk for type 1 diabetes. Here we examined IA-2A affinity and epitope specificity to assess heterogeneity in response intensity in relation to pathogenesis and diabetes risk in 50 children who were prospectively followed from birth. At first IA-2A appearance, affinity ranged from 10(7) to 10(11)L/mol and was high (>1.0×10(9)L/mol) in 41 (82%) children. IA-2A affinity was not associated with epitope specificity or HLA class II haplotype. On follow-up, affinity increased or remained high, and IA-2A were commonly against epitopes within the protein tyrosine phosphatase-like IA-2 domain and the homologue protein IA-2β. IA-2A were preceded or accompanied by other islet autoantibodies in 49 (98%) children, of which 34 progressed to diabetes. IA-2A affinity did not stratify diabetes risk. In conclusion, the IA-2A response in children is intense with rapid maturation against immunogenic epitopes and a strong association with diabetes development. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Risk factors of ophthalmic disorders in children with developmental delay

    DEFF Research Database (Denmark)

    Sandfeld, L.N.; Jensen, H.; Skov, L.

    2008-01-01

    PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12......PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12...

  14. The stratified Boycott effect

    Science.gov (United States)

    Peacock, Tom; Blanchette, Francois; Bush, John W. M.

    2005-04-01

    We present the results of an experimental investigation of the flows generated by monodisperse particles settling at low Reynolds number in a stably stratified ambient with an inclined sidewall. In this configuration, upwelling beneath the inclined wall associated with the Boycott effect is opposed by the ambient density stratification. The evolution of the system is determined by the relative magnitudes of the container depth, h, and the neutral buoyancy height, hn = c0(ρp-ρf)/|dρ/dz|, where c0 is the particle concentration, ρp the particle density, ρf the mean fluid density and dρ/dz Boycott layer transports dense fluid from the bottom to the top of the system; subsequently, the upper clear layer of dense saline fluid is mixed by convection. For sufficiently strong stratification, h > hn, layering occurs. The lowermost layer is created by clear fluid transported from the base to its neutral buoyancy height, and has a vertical extent hn; subsequently, smaller overlying layers develop. Within each layer, convection erodes the initially linear density gradient, generating a step-like density profile throughout the system that persists after all the particles have settled. Particles are transported across the discrete density jumps between layers by plumes of particle-laden fluid.

  15. Caries Risk Assessment in School Children Using Reduced Cariogram Model

    OpenAIRE

    Taqi, Muhammad; Razak, Ishak Abdul; Ab-Murat, Norintan

    2017-01-01

    Objective: To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children. Methods: Subjects’ caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a t...

  16. Regional variations in risk factors for asthma in school children.

    Science.gov (United States)

    Lawson, Joshua A; Rennie, Donna C; Senthilselvan, Ambikaipakan; Cockcroft, Donald W; McDuffie, Helen H

    2005-09-01

    The authors have previously reported an increased prevalence of asthma in Estevan, Saskatchewan (21.4%) compared with Swift Current, Saskatchewan (16.2%). To determine the association between asthma and personal and indoor environmental risk factors in these communities. A population-based cross-sectional study was conducted in January 2000. A questionnaire was distributed to school children in grades 1 to 6 for completion by a parent. Multivariate logistic regression was used to examine associations between various risk factors and physician-diagnosed asthma. Asthma was associated with respiratory allergy (adjusted OR [adjOR]=8.85, 95% CI 6.79 to 11.54), early respiratory illness (adjOR=2.81, 95% CI 1.96 to 4.03) and family history of asthma (adjOR=2.37, 95% CI 1.67 to 3.36). Several environmental factors varied with asthma by town. In Estevan, asthma was associated with home mould or dampness (adjOR=1.82, 95% CI 1.23 to 2.69) and was inversely associated with air conditioning (adjOR=0.56, 95% CI 0.37 to 0.85). The risk of asthma was increased if the child had previous exposure to environmental tobacco smoke from the mother in both communities (Swift Current: OR=1.87, 95% CI 1.06 to 3.30; Estevan: OR=2.00, 95% CI 1.17 to 3.43), and there was an inverse association with current exposure to environmental tobacco smoke from the mother in Estevan (OR=0.64, 95% CI 0.40 to 1.00). When multivariate analyses were stratified by sex, the relationship between home mould or dampness and asthma was most prominent in girls in Estevan. Despite a similar regional location, different risk factors for asthma were identified in each community. Local environmental factors are important to consider when interpreting findings and planning asthma care.

  17. Children of Incarcerated Parents: Cumulative Risk and Children's Living Arrangements. JCPR Working Paper.

    Science.gov (United States)

    Johnson, Elizabeth Inez; Waldfogel, Jane

    This paper examines risk factors that exist in the lives of incarcerated parents and their children, focusing on the living arrangements of the children. It uses data from the 1997 Survey of Inmates in State and Federal Correctional Facilities to address three issues: risk factors present in the lives of incarcerated parents and their children,…

  18. Mother-child interactions in depressed children and children at high risk and low risk for future depression.

    Science.gov (United States)

    Dietz, Laura J; Birmaher, Boris; Williamson, Douglas E; Silk, Jennifer S; Dahl, Ronald E; Axelson, David A; Ehmann, Mary; Ryan, Neal D

    2008-05-01

    To compare mother-child interactions and parenting styles in families of children with major depressive disorder, youths at high risk for depression, and healthy controls. Currently depressed (n = 43), high-risk (n = 28), and healthy control (n = 41) youths and their mothers engaged in a standardized videotaped problem-solving interaction. Measures of affect and behavior for both mothers and children were obtained, in addition to global measures of parenting. Depressed children demonstrated more negativity and less positivity in dyadic interactions than did children at high risk and control children. Mothers of depressed children were more disengaged than control mothers. Exploratory repeated-measures analyses in a subgroup of depressed children (n = 16) suggested mother-child interactions do not significantly change when children recover from depression. Children at high risk demonstrated less positivity in dyadic interactions than did controls. Mothers with a history of major depressive disorder and mothers with higher current depressive symptoms demonstrated patterns of disengagement and low control in interactions with children. Mother-child interactions in depressed youths are marked by maternal disengagement and low child positivity that may not improve when children recover. The bidirectional effects of maternal disengagement and low levels of child positivity may precede onset of major depressive disorder in children and serve as risk factors for recurrent depression in youths.

  19. Father-Child Interactions and Children's Risk of Injury

    Science.gov (United States)

    StGeorge, Jennifer; Fletcher, Richard; Freeman, Emily; Paquette, Daniel; Dumont, Caroline

    2015-01-01

    Unintentional injury is an important cause of infant and child hospitalisation and parents play a key role in reducing children's risk-taking behaviour. Studies show that maternal and paternal parenting and supervision of children differ, but there is little research showing how fathers' parenting may influence children's tendency to engage in…

  20. Cumulative Risks of Foster Care Placement for Danish Children

    DEFF Research Database (Denmark)

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children...

  1. A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

    NARCIS (Netherlands)

    van Heesch, M.M.J.; Evers, J.L.H.; Dumoulin, J.C.M.; van der Hoeven, M.A.H.B.; van Beijsterveldt, C.E.M.; Bonsel, G.J.; Dykgraaf, R.H.M.; van Goudoever, J.B.; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; van Zonneveld, P.; Dirksen, C.D.

    2014-01-01

    Objective To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

  2. A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

    NARCIS (Netherlands)

    Heesch, M.M. van; Evers, J.L.H.; Dumoulin, J.C.; Hoeven, M.A. van der; Beijsterveldt, C.E. van; Bonsel, G.J.; Dykgraaf, R.H.; Goudoever, J.B. van; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; Zonneveld, P. van; Dirksen, C.D.

    2014-01-01

    OBJECTIVE: To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

  3. Risk Factors, Comorbid Conditions, and Epidemiology of Autism in Children

    Science.gov (United States)

    2014-10-01

    of children with ASD vs. 3.3% in controls). The most common micronutrient deficiency was iron deficiency anemia (3.6% of the children with ASD vs...Epidemiology of Autism in Children PRINCIPAL INVESTIGATOR: Major Cade Nylund, MC USAF CONTRACTING ORGANIZATION: HENRY M JACKSON...REPORT TYPE ANNUAL 3. DATES COVERED 4. TITLE AND SUBTITLE Risk Factors, Comorbid Conditions, and Epidemiology of Autism in Children 5a. CONTRACT

  4. Screening for nutritional risk in hospitalized children with liver disease.

    Science.gov (United States)

    Song, Tiantian; Mu, Ying; Gong, Xue; Ma, Wenyan; Li, Li

    2017-01-01

    Malnutrition is a major contributor to morbidity and mortality from pediatric liver disease. We investigated the prevalence of both malnutrition and high nutritional risk in hospitalized children with liver disease as well as the rate of in-hospital nutritional support. A total of 2,874 hospitalized children and adolescents with liver disease aged 1 to 17 years (inclusive) were enrolled. Malnutrition was screened by anthropometric measures (height-for-age, weight-for-height, weight-for-age, and BMI- for-age z-scores). The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) was used to evaluate nutritional risk status. Nutrition markers in blood, rate of nutritional support, length of hospital stay, and hospital fees were compared among nutritional risk groups. The overall prevalence of malnutrition was 38.6%. About 20.0% of children had high nutritional risk, and prevalence of malnutrition was markedly greater in the high nutritional risk group compared with the moderate risk group (67.9% vs 31.3%). Serum albumin and prealbumin differed significantly between high and moderate risk groups (pnutritional risk and 3.5% with moderate nutritional risk received nutrition support during hospitalization. Children with high nutritional risk had longer hospital stays and greater hospital costs (pnutritional risk is also prevalent at admission. Albumin and prealbumin are sensitive markers for distinguishing nutritional risk groups. High nutritional risk prolongs length of stay and increases hospital costs. The nutritional support rate is still low and requires standardization.

  5. Cerebral Palsy in Children as a Risk Factor for Malnutrition.

    Science.gov (United States)

    Perenc, Lidia; Przysada, Grzegorz; Trzeciak, Jadwiga

    2015-01-01

    The main aim of this study was to determine some malnutrition risk factors among children with cerebral palsy (CP). Children with CP often require the assistance of physical therapy centers. Experience suggests that, apart from physical disabilities, this group often suffers from malnutrition. Data were gathered in the hospital among 128 children aged 3-18 years who were suffering from CP. The children were admitted from 2011 to 2013 to the Center for Neurological Physical Therapy for children in the Regional Hospital No. 2. St. Queen Jadwiga in Rzeszow (RORE). Statistical analyses were conducted for data on gender, age, type of CP, motor function level according to Gross Motor Function Classification Scale (GMFCS), body mass index (BMI) and hemoglobin levels in blood. The risk of anemia differs based on gender--the risk is 6 times greater among boys than among girls (p = 0.0398). Risk of malnutrition is 3.5 times higher in children with tetraplegia than in children with diplegia or hemiplegia (p = 0.0043). Higher GMFCS scores are connected to greater proportions of malnourished children (for BMI z-score children with CP, malnourishment risk factors are male gender for anemia and tetraplegia and high GMFCS values. 2015 S. Karger AG, Basel.

  6. Risk of Cancer in Children Conceived by Assisted Reproductive Technology.

    Science.gov (United States)

    Reigstad, Marte Myhre; Larsen, Inger Kristin; Myklebust, Tor Åge; Robsahm, Trude Eid; Oldereid, Nan Birgitte; Brinton, Louise A; Storeng, Ritsa

    2016-03-01

    An increasing number of children are born after assisted reproductive technology (ART), and monitoring their long-term health effects is of interest. This study compares cancer risk in children conceived by ART to that in children conceived without. The Medical Birth Registry of Norway contains individual information on all children born in Norway (including information of ART conceptions). All children born between 1984 and 2011 constituted the study cohort, and cancer data were obtained from the Cancer Registry of Norway. Follow-up started at date of birth and ended on the date of the first cancer diagnosis, death, emigration, or December 31, 2011. A Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) of overall cancer risk between children conceived by ART and those not. Cancer risk was also assessed separately for all childhood cancer types. The study cohort comprised 1 628 658 children, of which 25 782 were conceived by ART. Of the total 4554 cancers, 51 occurred in ART-conceived children. Risk of overall cancer was not significantly elevated (HR 1.21; 95% CI 0.90-1.63). However, increased risk of leukemia was observed for children conceived by ART compared with those who were not (HR 1.67; 95% CI 1.02-2.73). Elevated risk of Hodgkin's lymphoma was also found for ART-conceived children (HR 3.63; 95% CI 1.12-11.72), although this was based on small numbers. This population-based cohort study found elevated risks of leukemia and Hodgkin's lymphoma in children conceived by ART. Copyright © 2016 by the American Academy of Pediatrics.

  7. Suicide risk among young children after the Great East Japan Earthquake: A follow-up study.

    Science.gov (United States)

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

    2017-07-01

    On 11 March 2011, the Great East Japan Earthquake and subsequent tsunami hit East Japan. We aim to investigate the impact of trauma experiences related to the earthquake on suicide risk among young children, stratified by child sex. Participants at baseline were children who were exposed to the 2011 disaster at preschool age (affected area, n=198; unaffected area, n=82, total n=280). From July 2013 to May 2014, suicide risk was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a follow-up interview conducted by a child psychiatrist or psychologist (N=210, follow-up rate: 75%). Among young girls in the affected area, 12 out of 65 (18.5%) showed suicidal ideation, which is significantly higher than girls in the unaffected area (4.7%, p for chi-square=0.036). In the multivariate model adjusted for potential confounders and mediators, the odds ratio for 4 or more trauma experiences related to the earthquake was 5.74 (95% confidence interval: 0.83-39.6, p=0.076) compared to no trauma experience related to the earthquake. Among young boys, trauma exposure was not associated with suicidal ideation. Our findings showed that young girls who experienced earthquake-related trauma at preschool age had a higher suicidal ideation 3 years after the earthquake. Copyright © 2017. Published by Elsevier B.V.

  8. Dental erosion prevalence and associated risk indicators among preschool children in Athens, Greece.

    Science.gov (United States)

    Mantonanaki, Magdalini; Koletsi-Kounari, Haroula; Mamai-Homata, Eleni; Papaioannou, William

    2013-03-01

    The aims of the study were to investigate dental erosion prevalence, distribution and severity in Greek preschool children attending public kindergartens in the prefecture of Attica, Greece and to determine the effect of dental caries, oral hygiene level, socio-economic factors, dental behavior, erosion related medication and chronic illness. A random and stratified sample of 605 Greek preschool children was clinically examined for dental erosion using the Basic Erosive Wear Examination Index (ΒΕWE). Dental caries (dmfs) and Simplified Debris Index were also recorded. The data concerning possible risk indicators were derived by a questionnaire. Zero-inflated Poisson regression was generated to test the predictive effects of the independent variables on dental erosion. The prevalence of dental erosion was 78.8 %, and the mean and SE of BEWE index was 3.64 ± 0.15. High monthly family income was positively related to ΒΕWE cumulative scores [RR = 1.204 (1.016-1.427)], while high maternal education level [RR = 0.872 (0.771-0.986)] and poor oral hygiene level [DI-s, RR = 0.584 (0.450-0.756)] showed a negative association. Dental erosion is a common oral disease in Greek preschool children in Attica, related to oral hygiene and socio-economic factors. Programs aimed at erosion prevention should begin at an early age for all children.

  9. Children at Risk: Global Views on Challenges Facing Children

    Science.gov (United States)

    Neugebauer, Roger

    2011-01-01

    Members of the World Forum community were invited to respond to the question: "What is the most urgent challenge facing young children in your country?" Here are some of their responses. Jamils Richard Achunji Anguaseh mentions that in Cameroon, young children face lots of insecurity, both from health hazards and poor parenting practices. There…

  10. Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Saez, Noemi [Miguel Hernandez University, Public Health, History of Science and Ginecology Department, Alicante (Spain); Hernandez-Aguado, Ildefonso; Pastor Valero, Maria; Parker, Lucy Anne; Lumbreras, Blanca [Miguel Hernandez University, Public Health, History of Science and Ginecology Department, Alicante (Spain); CIBER en Epidemiologia y Salud Publica, Madrid (Spain); Vilar, Jose; Domingo, Maria Luisa [Peset Hospital, Radiodiagnostic Department, Valencia (Spain); Gonzalez-Alvarez, Isabel; Lorente, Maria Fermina [San Juan Hospital, Radiodiagnostic Department, San Juan de Alicante (Spain)

    2015-12-15

    To assess the risk of lung cancer and specific mortality rate in patients with and without solitary pulmonary nodules (SPN) on chest radiograph and CT. This prospective study included 16,078 patients ≥35 years old (893 of them had an SPN detected with either chest radiograph or CT) and 15,185 without SPN. Patients were followed up for 18 months or until being diagnosed with lung cancer. Risk and mortality lung cancer were calculated in both groups with Poisson regression. In patients with SPN, incidence of lung cancer was 8.3 % (95 % CI 6.0-11.2) on radiograph and 12.4 % (95 % CI 9.3-15.9) on CT. A chronic obstructive pulmonary disease in patients with radiographs (odds ratio 2.62; 95 % CI 1.03, 6.67) and smoking habit (odds ratio 20.63; 95 % CI 3.84, 110.77) in patients with CT were associated with a higher probability of lung cancer. Large nodule size and spiculated edge were associated with lung cancer on both CT and radiograph. Lung cancer-specific mortality was lower in patients with SPN than in those without SPN (1.73/1000 person-years, 95 % CI 1.08-2.88 vs. 2.15/1000 person-years, 95 % CI 1.25-3.96). The risk of lung cancer for patients with SPN is higher in clinical populations than in screening studies. Moreover, patients with SPN showed lower mortality than those without SPN. (orig.)

  11. Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study

    International Nuclear Information System (INIS)

    Gomez-Saez, Noemi; Hernandez-Aguado, Ildefonso; Pastor Valero, Maria; Parker, Lucy Anne; Lumbreras, Blanca; Vilar, Jose; Domingo, Maria Luisa; Gonzalez-Alvarez, Isabel; Lorente, Maria Fermina

    2015-01-01

    To assess the risk of lung cancer and specific mortality rate in patients with and without solitary pulmonary nodules (SPN) on chest radiograph and CT. This prospective study included 16,078 patients ≥35 years old (893 of them had an SPN detected with either chest radiograph or CT) and 15,185 without SPN. Patients were followed up for 18 months or until being diagnosed with lung cancer. Risk and mortality lung cancer were calculated in both groups with Poisson regression. In patients with SPN, incidence of lung cancer was 8.3 % (95 % CI 6.0-11.2) on radiograph and 12.4 % (95 % CI 9.3-15.9) on CT. A chronic obstructive pulmonary disease in patients with radiographs (odds ratio 2.62; 95 % CI 1.03, 6.67) and smoking habit (odds ratio 20.63; 95 % CI 3.84, 110.77) in patients with CT were associated with a higher probability of lung cancer. Large nodule size and spiculated edge were associated with lung cancer on both CT and radiograph. Lung cancer-specific mortality was lower in patients with SPN than in those without SPN (1.73/1000 person-years, 95 % CI 1.08-2.88 vs. 2.15/1000 person-years, 95 % CI 1.25-3.96). The risk of lung cancer for patients with SPN is higher in clinical populations than in screening studies. Moreover, patients with SPN showed lower mortality than those without SPN. (orig.)

  12. PATHOS: a phase II/III trial of risk-stratified, reduced intensity adjuvant treatment in patients undergoing transoral surgery for Human papillomavirus (HPV) positive oropharyngeal cancer

    International Nuclear Information System (INIS)

    Owadally, Waheeda; Hurt, Chris; Timmins, Hayley; Parsons, Emma; Townsend, Sarah; Patterson, Joanne; Hutcheson, Katherine; Powell, Ned; Beasley, Matthew; Palaniappan, Nachi; Robinson, Max; Jones, Terence M.; Evans, Mererid

    2015-01-01

    Human papillomavirus-positive oropharyngeal squamous cell carcinoma is increasing in incidence worldwide. Current treatments are associated with high survival rates but often result in significant long-term toxicities. In particular, long-term dysphagia has a negative impact on patient quality of life and health. The aim of PATHOS is to determine whether reducing the intensity of adjuvant treatment after minimally invasive transoral surgery in this favourable prognosis disease will result in better long-term swallowing function whilst maintaining excellent disease-specific survival outcomes. The study is a multicentre phase II/III randomised controlled trial for patients with biopsy-proven Human papillomavirus-positive oropharyngeal squamous cell cancer staged T1-T3 N0-N2b with a primary tumour that is resectable via a transoral approach. Following transoral surgery and neck dissection, patients are allocated into three groups based on pathological risk factors for recurrence. Patients in the low-risk pathology group will receive no adjuvant treatment, as in standard practice. Patients in the intermediate-risk pathology group will be randomised to receive either standard dose post-operative radiotherapy (control) or reduced dose radiotherapy. Patients in the high-risk pathology group will be randomised to receive either post-operative chemoradiotherapy (control) or radiotherapy alone. The primary outcome of the phase II study is patient reported swallowing function measured using the MD Anderson Dysphagia Inventory score at 12 months post-treatment. If the phase II study is successful, PATHOS will proceed to a phase III non-inferiority trial with overall survival as the primary endpoint. PATHOS is a prospective, randomised trial for Human papillomavirus-positive oropharyngeal cancer, which represents a different disease entity compared with other head and neck cancers. The trial aims to demonstrate that long-term dysphagia can be lessened by reducing the intensity

  13. Meta-Analysis: Reduced Risk of Anxiety with Psychostimulant Treatment in Children with Attention-Deficit/Hyperactivity Disorder.

    Science.gov (United States)

    Coughlin, Catherine G; Cohen, Stephanie C; Mulqueen, Jilian M; Ferracioli-Oda, Eduardo; Stuckelman, Zachary D; Bloch, Michael H

    2015-10-01

    Anxiety is a commonly reported side-effect of psychostimulant treatment. Our goal was to quantify the risk of anxiety as a side effect of psychostimulant treatment for attention-deficit/hyperactivity disorder (ADHD). We conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of psychostimulant medications in the treatment of children with ADHD. We used a fixed-effects meta-analysis to examine the risk ratio of anxiety reported as a side effect in children treated with psychostimulants compared with those treated with placebo. We used stratified subgroup analysis and meta-regression to examine the effects of stimulant type, dosage, duration of use, and trial design on the measured risk of anxiety. We identified 23 studies involving 2959 children with ADHD for inclusion in our meta-analysis. The risk of anxiety associated with psychostimulant treatment was significantly lower than that experienced with placebo (relative risk [RR] = 0.86 [95% CI: 0.77, 0.95], z = -2.90, p anxiety of psychostimulants when compared with placebo (β = -0.0039 [95% CI: -0.00718, -0.00064], z = -2.34, p = 0.019). Meta-analysis suggests that treatment with psychostimulants significantly reduced the risk of anxiety when compared with placebo. This finding does not rule out the possibility that some children experience increased anxiety when treated with psychostimulants, but suggests that those risks are outweighed by the number of children who experience improvement in anxiety symptoms (possibly as a secondary effect of improved control of ADHD symptoms). Clinicians should consider rechallenging children with ADHD who report new-onset or worsening anxiety with psychostimulants, as these symptoms are much more likely to be coincidental rather than caused by psychostimulants.

  14. Environmental lead exposure among preschool children in Shanghai, China: blood lead levels and risk factors.

    Directory of Open Access Journals (Sweden)

    Jia Cao

    Full Text Available OBJECTIVE: To determine blood lead levels and to identify related risk factors among children in Shanghai; to explore the lead change trend of children after industrial transformation and to provide data for policy development to control environmental lead pollution in Shanghai. METHODS: A stratified-clustered-random sampling method was used. A tungsten atomizer absorption spectrophotometer was employed to determine blood lead levels. RESULTS: The arithmetic mean, geometric mean and median of blood lead levels of 0- to 6-year-old children from Shanghai were 22.49 µg/L, 19.65 µg/L and 19.5 µg/L, including 0.26% (6/2291 with concentrations ≥100 µg/L and 2.7% (61/2291 with concentrations ≥50 µg/L. Boys' levels (23.57 µg/L were greater than those of girls (21.2 µg/L. The blood lead levels increased with age. This survey showed that the Chongming district was the highest and Yangpu district was the lowest, this result is completely opposite with the earlier survey in Shanghai. Risk factors for lead contamination included housing environment, parents' education levels, social status, hobbies, and children's nutritional status. CONCLUSIONS: The blood lead levels of children in Shanghai were lower than the earlier data of Shanghai and those of published studies in China, but higher than the blood lead levels of developed countries. The blood lead levels of urban districts are higher than the central districts with the industrial transformation. Society and the government should take an active interest in childhood lead poisoning of urban areas.

  15. China's community-based strategy of universal preconception care in rural areas at a population level using a novel risk classification system for stratifying couples´ preconception health status.

    Science.gov (United States)

    Zhou, Qiongjie; Zhang, Shikun; Wang, Qiaomei; Shen, Haiping; Tian, Weidong; Chen, Jingqi; Acharya, Ganesh; Li, Xiaotian

    2016-12-28

    Preconception care (PCC) is recommended for optimizing a woman's health prior to pregnancy to minimize the risk of adverse pregnancy and birth outcomes. We aimed to evaluate the impact of strategy and a novel risk classification model of China´s "National Preconception Health Care Project" (NPHCP) in identifying risk factors and stratifying couples' preconception health status. We performed a secondary analysis of data collected by NPHCP during April 2010 to December 2012 in 220 selected counties in China. All couples enrolled in the project accepted free preconception health examination, risk evaluation, health education and medical advice. Risk factors were categorized into five preconception risk classes based on their amenability to prevention and treatment: A-avoidable risk factors, B- benefiting from targeted medical intervention, C-controllable but requiring close monitoring and treatment during pregnancy, D-diagnosable prenatally but not modifiable preconceptionally, X-pregnancy not advisable. Information on each couple´s socio-demographic and health status was recorded and further analyzed. Among the 2,142,849 couples who were enrolled to this study, the majority (92.36%) were from rural areas with low education levels (89.2% women and 88.3% men had education below university level). A total of 1463266 (68.29%) couples had one or more preconception risk factors mainly of category A, B and C, among which 46.25% were women and 51.92% were men. Category A risk factors were more common among men compared with women (38.13% versus 11.24%; P = 0.000). This project provided new insights into preconception health of Chinese couples of reproductive age. More than half of the male partners planning to father a child, were exposed to risk factors during the preconception period, suggesting that an integrated approach to PCC including both women and men is justified. Stratification based on the new risk classification model demonstrated that a majority of the

  16. Aligning the Economic Value of Companion Diagnostics and Stratified Medicines

    Directory of Open Access Journals (Sweden)

    Edward D. Blair

    2012-11-01

    Full Text Available The twin forces of payors seeking fair pricing and the rising costs of developing new medicines has driven a closer relationship between pharmaceutical companies and diagnostics companies, because stratified medicines, guided by companion diagnostics, offer better commercial, as well as clinical, outcomes. Stratified medicines have created clinical success and provided rapid product approvals, particularly in oncology, and indeed have changed the dynamic between drug and diagnostic developers. The commercial payback for such partnerships offered by stratified medicines has been less well articulated, but this has shifted as the benefits in risk management, pricing and value creation for all stakeholders become clearer. In this larger healthcare setting, stratified medicine provides both physicians and patients with greater insight on the disease and provides rationale for providers to understand cost-effectiveness of treatment. This article considers how the economic value of stratified medicine relationships can be recognized and translated into better outcomes for all healthcare stakeholders.

  17. Risk factors for stress in children after parental stroke

    NARCIS (Netherlands)

    Sieh, D.S.; Meijer, A.M.; Visser-Meily, J.M.

    2010-01-01

    Objectives: To assess risk factors for stress in children 3 years after parental stroke. Participants: Questionnaires were filled in by 44 children aged 7-18 years, parents who suffered a stroke and healthy spouses from 29 families recruited in 9 participating rehabilitation centers across the

  18. Young Children and Sports--Weighing the Risks and Benefits.

    Science.gov (United States)

    Elkind, David

    2000-01-01

    Examines the contemporary rationales of parents placing their preschool children in organized sports, including: (1) earlier is better; (2) parent peer pressure; (3) contemporary dangers; and (4) learning of self confidence, self esteem, cooperation and competition. Finds little value and much risk in engaging children at an early age in organized…

  19. Risk for Death among Children with Pneumonia, Afghanistan.

    Science.gov (United States)

    Zabihullah, Rahmani; Dhoubhadel, Bhim G; Rauf, Ferogh A; Shafiq, Sahab A; Suzuki, Motoi; Watanabe, Kiwao; Yoshida, Lay M; Yasunami, Michio; Zabihullah, Salihi; Parry, Christopher M; Mirwais, Rabi; Ariyoshi, Koya

    2017-08-01

    In Afghanistan, childhood deaths from pneumonia are high. Among 639 children at 1 hospital, the case-fatality rate was 12.1%, and 46.8% of pneumococcal serotypes detected were covered by the 13-valent vaccine. Most deaths occurred within 2 days of hospitalization; newborns and malnourished children were at risk. Vaccination could reduce pneumonia and deaths.

  20. Risk and Protective Factors in Gifted Children with Dyslexia

    Science.gov (United States)

    van Viersen, Sietske; de Bree, Elise H.; Kroesbergen, Evelyn H.; Slot, Esther M.; de Jong, Peter F.

    2015-01-01

    This study investigated risk and protective factors associated with dyslexia and literacy development, both at the group and individual level, to gain more insight in underlying cognitive profiles and possibilities for compensation in high-IQ children. A sample of 73 Dutch primary school children included a dyslexic group, a gifted-dyslexic group,…

  1. Risk and protective factors in gifted children with dyslexia

    NARCIS (Netherlands)

    van Viersen, S.; de Bree, E.H.; Kroesbergen, E.H.; Slot, E.M.; de Jong, P.F.

    2015-01-01

    This study investigated risk and protective factors associated with dyslexia and literacy development, both at the group and individual level, to gain more insight in underlying cognitive profiles and possibilities for compensation in high-IQ children. A sample of 73 Dutch primary school children

  2. Risk factors for anaemia among HIV infected children attending care ...

    African Journals Online (AJOL)

    There is paucity of data describing the risk factors for anaemia among HIV infected children in Tanzania. This cross sectional study was carried out to determine the contributing factors for anaemia among HIV-infected children attending Muhimbili National Hospital in Dar es Salaam. Both univariate and multivariate logistic ...

  3. Cost-effectiveness of a risk-stratified approach to cardiac resynchronisation therapy defibrillators (high versus low) at the time of generator change.

    Science.gov (United States)

    Claridge, Simon; Sebag, Frederic A; Fearn, Steven; Behar, Jonathan M; Porter, Bradley; Jackson, Tom; Sieniewicz, Benjamin; Gould, Justin; Webb, Jessica; Chen, Zhong; O'Neill, Mark; Gill, Jaswinder; Leclercq, Christophe; Rinaldi, Christopher A

    2018-03-01

    Responders to cardiac resynchronisation therapy whose device has a defibrillator component and who do not receive a therapy in the lifetime of the first generator have a very low incidence of appropriate therapy after box change. We investigated the cost implications of using a risk stratification tool at the time of generator change resulting in these patients being reimplanted with a resynchronisation pacemaker. A decision tree was created using previously published data which had demonstrated an annualised appropriate defibrillator therapy risk of 2.33%. Costs were calculated at National Health Service (NHS) national tariff rates (2016-2017). EQ-5D utility values were applied to device reimplantations, admissions and mortality data, which were then used to estimate quality-adjusted life-years (QALYs) over 5 years. At 5 years, the incremental cost of replacing a resynchronisation defibrillator device with a second resynchronisation defibrillator versus resynchronisation pacemaker was £5045 per patient. Incremental QALY gained was 0.0165 (defibrillator vs pacemaker), resulting in an incremental cost-effectiveness ratio (ICER) of £305 712 per QALYs gained. Probabilistic sensitivity analysis resulted in an ICER of £313 612 (defibrillator vs pacemaker). For reimplantation of all patients with a defibrillator rather than a pacemaker to yield an ICER of less than £30 000 per QALY gained (current NHS cut-off for approval of treatment), the annual arrhythmic event rate would need to be 9.3%. The budget impact of selective replacement was a saving of £2 133 985 per year. Implanting low-risk patients with a resynchronisation defibrillator with the same device at the time of generator change is not cost-effective by current NHS criteria. Further research is required to understand the impact of these findings on individual patients at the time of generator change. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018

  4. Risk assessment of chemicals: What about children?

    NARCIS (Netherlands)

    Wolterink G; Piersma AH; Engelen JGM van; CSR; LEO

    2003-01-01

    In regulatory toxicology there is increased awareness and concern that children and adults may differ in their susceptibility to xenobiotics. In this report a concise overview of the relevant data on the differences between adults and children with respect to the kinetics, dynamics and exposure to

  5. DETERMINING CARDIOVASCULAR DISEASE RISK IN ELEMENTARY SCHOOL CHILDREN:

    Directory of Open Access Journals (Sweden)

    Kate E. Reed

    2007-03-01

    Full Text Available At least 50% of children have one or more cardiovascular disease (CVD risk factor. We aimed to 1 determine the prevalence of CVD risk factors in a sample of Canadian children, and 2 create a Healthy Heart Score that could be used in a school setting, to identify children with a greater number and severity of CVD risk factors. Children (n = 242, 122M, 120F, aged 9-11 years were assessed for cardiovascular fitness, physical activity, systolic/diastolic blood pressure, and body mass index (BMI. Biological values were converted to age and sex specific percentiles and allocated a score. Healthy Heart Scores could range between 5 and 18, with lower scores suggesting a healthier cardiovascular profile. Seventy-seven children volunteered for blood samples in order to assess the relationship between the Healthy Heart Score and (total cholesterol (TC, high and low-density lipoprotein cholesterol (HDL, LDL and triglycerides (TG. Fifty eight percent of children had elevated scores for at least 1 risk factor. The group mean Healthy Heart Score was 8 (2.2. The mean score was significantly higher in boys (9 (2.2 compared with girls (8 (2.1, p < 0.01. A high score was significantly associated with a low serum HDL, a high TC:HDL and a high TG concentration. Our results support other studies showing a high prevalence of CVD risk factors in children. Our method of allocation of risk score, according to percentile, allows for creation of an age and sex specific CVD risk profile in children, which takes into account the severity of the elevated risk factor

  6. Are all risks equal? Early experiences of poverty-related risk and children's functioning.

    Science.gov (United States)

    Roy, Amanda L; Raver, C Cybele

    2014-06-01

    Using cumulative risk and latent class analysis (LCA) models, we examined how exposure to deep poverty (income-to-needs ratio risks (i.e., single-parent household, residential crowding, caregiver depression, and multiple life stressors) in preschool is related to children's future difficulty in school in a longitudinal sample of 602 Head Start-enrolled, low-income families. Results from the LCA revealed 4 risk profiles: low risk, deep poverty and single, single and stressed, and deep poverty and crowded household. Tests of measurement invariance across racial/ethnic groups established that, although patterns of risk are similar across groups (i.e., risks covary in the same way), the prevalence of risk profiles differs. African American families were overrepresented in the "deep poverty and single" profile while Latino and White families were overrepresented in the "deep poverty and crowded" profile. Finally, children's third grade functioning in 3 domains (i.e., academic performance, behavior problems, and self-regulatory skills) was predicted using a cumulative risk index and LCA-identified risk profiles. Both approaches demonstrated that children who experienced higher levels of risk in preschool had worse school performance than children with low levels of risk. However, LCA also revealed that children who experienced "single and stressed" family settings had more behavior problems than low-risk children while children who experienced "deep poverty and crowded" family settings had worse academic performance. The results indicate that all risks are not equal for children's development and highlight the utility of LCA for tailoring intervention efforts to best meet the needs of target populations. PsycINFO Database Record (c) 2014 APA, all rights reserved

  7. Electromagnetic waves in stratified media

    CERN Document Server

    Wait, James R; Fock, V A; Wait, J R

    2013-01-01

    International Series of Monographs in Electromagnetic Waves, Volume 3: Electromagnetic Waves in Stratified Media provides information pertinent to the electromagnetic waves in media whose properties differ in one particular direction. This book discusses the important feature of the waves that enables communications at global distances. Organized into 13 chapters, this volume begins with an overview of the general analysis for the electromagnetic response of a plane stratified medium comprising of any number of parallel homogeneous layers. This text then explains the reflection of electromagne

  8. Children capacity in disaster risk reduction: A call for action

    Directory of Open Access Journals (Sweden)

    Leila Mohammadinia

    2017-01-01

    Full Text Available Disasters have various physical, psychological, social and economical effects on all age group, particularly children who are more vulnerable than adults. In the aftermath of disasters, children like pregnant women, elderly and handicaps are special group with special needs. This is because they are at greater risk based on their specific physiological and psychological characteristics. Moreover,, according to the Sendai document, children need more attention in Disaster Risk Reduction (DRRprograms design, policies implementation with a proactive approach in Disaster Risk Reduction (1. In the Sendai document it is emphasized that policies regarding disaster risk reduction, cognition and risk perception about the risk property should be considered based upon the hazards and the environment in terms of vulnerability, capacity and exposure (2.Hyogo framework for action was also already have been focused on child priority on the legislation program (3. Accordingly, it is necessary to involve children in disaster risk reduction programs actively in order to overcome their needs and their problems (4. As children are more affected groups in various aspects of disasters in most countries, their potential utilization, the conditions and space should be provided based on laws, national policies, training and capacity. Although after disaster children required particular needs and attention(5-6, they should be considered as an active group who could participate in DRR program and help their family and also the community.(4, 7 Some evidences suggest on value of children team working for community preparedness. Iran had a successful experience for using adolescence capacity as a pillar in activation of early warning; including notification announced while observing the rising sea levels for local community in order to reduce the risk of flood disaster at a local area in the North of Iran. According to the Hyogo and the Sendai documents, it seems that using

  9. Risk factors for mortality in burn children

    Directory of Open Access Journals (Sweden)

    Maria Teresa Rosanova

    2014-03-01

    Conclusions: In this series of burn children age ≤ 4 years, Garces index score 4, colistin use in documented multiresistant infections, mechanical ventilation and graft requirement were identified as independent variables related with mortality.

  10. Risk Factors of Attention Deficit Hyperactivity Disorder in Children

    Directory of Open Access Journals (Sweden)

    Katayoun Khoushabi

    2006-10-01

    Full Text Available Objective: Regarding to ADHD is believed to the most common behavioral disorder in children, the purpose of this study was to investigate the risk factors of Attention Deficit Hyperactivity Disorder in children. This study compared ADHD children and normal children. Materials & Methods: In this comparative study, subjects were 192 children with ADHD who referred to pediatric psychiatric clinic in two years therapeutic period. The children were diagnosed as ADHD according to DSM-IV by two pediatric psychiatrists (experimental group and 210 normal children who were chosen from schools and day-care centers in Tehran (control group. Research variables were matched with experimental group. Data were analyzed with descriptive methods such as: Q Square test.  Results: Findings showed that 79.3% of ADHD-positive subjects and 54.3% of their controls were boy. Consanguinity of parents, history of ADHD and psychiatric disorders in parents and their relatives and being the first or second child of family were associated with greater risk of ADHD in children and showed significant difference between two groups (P<0.001. Conclusion: Male, Consanguinity marriage, history of ADHD and psychiatric disorders in parents and relatives and the first or second child are risk factors of ADHD.

  11. {sup 18}F-FDG PET/CT to assess response and guide risk-stratified follow-up after chemoradiotherapy for oropharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Thomas; Lei, Mary; Guerrero Urbano, Teresa [Guy' s and St Thomas' NHS Foundation Trust, Department of Clinical Oncology, London (United Kingdom); Barrington, Sally [King' s College, PET Imaging Centre at St Thomas' Hospital, London (United Kingdom); Thavaraj, Selvam [Guy' s and St Thomas' NHS Foundation Trust, Head and Neck Pathology Department, London (United Kingdom); Jeannon, Jean-Pierre; Lyons, Andrew; Oakley, Richard; Simo, Ricard [Guy' s and St Thomas' NHS Foundation Trust, Department of Head and Neck Surgery, London (United Kingdom)

    2016-07-15

    To evaluate the use of {sup 18}F-FDG PET/CT as the principal investigation to assess tumour response, to determine the need for further surgery and to guide follow-up following radical chemoradiotherapy for stage III/IV oropharyngeal squamous cell carcinoma (OPSCC). A retrospective analysis was undertaken in 146 patients treated at our centre with radical chemoradiotherapy for OPSCC and who had a PET/CT scan to assess response. According to the PET/CT findings, patients were divided into four groups and recommendations: (1) complete metabolic response (enter clinical follow-up); (2) low-level uptake only (follow-up PET/CT scan in 12 weeks); (3) residual uptake suspicious for residual disease (further investigation with or without neck dissection); and (4) new diagnosis of distant metastatic disease (palliative treatment options). The initial PET/CT scan was performed at a median of 12.4 weeks (range 4.3 - 21.7 weeks) following treatment. Overall sensitivity and specificity rates were 92.0 % (74.0 - 99.0 %) and 85 % (77.5 - 90.9 %). Of the 146 patients, 90 (62 %) had a complete response and had estimated 3-year overall and disease-free survival rates of 91.9 % (85.6 - 98.2 %) and 85.6 % (78.0 - 93.2 %), respectively, 17 (12 %) had residual low-level uptake only (with two having confirmed residual disease on subsequent PET/CT, both surgically salvaged), 30 (21 %) had suspicious residual uptake (12 proceeded to neck dissection; true positive rate at surgery 33 %). HPV-positive patients with reassuring PET/CT findings had an estimated 3-year progression-free survival rate of 91.7 % (85.2 - 98.2 %), compared with 66.2 % (41.5 - 90.9 %) of HPV-negative patients. A strategy of using PET/CT results alongside clinical examination to help select patients for salvage surgery appears successful. Despite a complete response on the 12-week PET/CT scan, HPV-negative patients have a significant risk of disease relapse in the following 2 years and further studies to assess whether

  12. Stratified medicine and reimbursement issues

    NARCIS (Netherlands)

    Fugel, Hans-Joerg; Nuijten, Mark; Postma, Maarten

    2012-01-01

    Stratified Medicine (SM) has the potential to target patient populations who will most benefit from a therapy while reducing unnecessary health interventions associated with side effects. The link between clinical biomarkers/diagnostics and therapies provides new opportunities for value creation to

  13. Biobehavioral Risk Factors in Children of Schizophrenic Parents.

    Science.gov (United States)

    Erlenmeyer-Kimling, L.; Cornblatt, Barbara

    1984-01-01

    Research on risk factors for schizophrenia is reviewed with emphasis on children of schizophrenic parents. Four areas of biobehavioral functioning that have been examined in high-risk research are discussed. Three of these are considered compatible with hypothesis neurointegrative defect underlying schizophrenic-proneness. (Author/CL)

  14. Prevalence and risk factors of anemia in children

    Directory of Open Access Journals (Sweden)

    Cristie Regine Klotz Zuffo

    2016-07-01

    Full Text Available Objective: To identify the prevalence and factors associated with anemia in children attending Municipal Early Childhood Education Day Care Center (Centros Municipais de Educação Infantil [CMEI] nurseries in Colombo-PR. Methods: Analytical, cross-sectional study with a representative sample of 334 children obtained by stratified cluster sampling, with random selection of 26 nurseries. Data collection was conducted through interviews with parents, assessment of iron intake by direct food weighing, and hemoglobin measurement using the finger-stick test. Bivariate association tests were performed followed by multiple logistic regression adjustment. Results: The prevalence of anemia was 34.7%. Factors associated with anemia were: maternal age younger than 28 years old (p = 0.03, male children (p = 0.02, children younger than 24 months (p = 0.01, and children who did not consume iron food sources (meat + beans + dark green leafy vegetables (p = 0.02. There was no association between anemia and iron food intake in CMEI. However, iron intake was well below the recommended levels according to the National Education Development Fund resolution, higher prevalence of anemia was observed in children whose intake of iron, heme iron, and nonheme iron was below the median. Conclusions: In terms of public health, the prevalence of anemia is characterized as a moderate problem in the studied population and demonstrates the need for coordination of interdisciplinary actions for its reduction in CMEI nurseries. Resumo: Objetivo: Identificar a prevalência e os fatores associados à anemia em crianças que frequentam berçários de Centros Municipais de Educação Infantil (CMEI de Colombo-PR. Métodos: Estudo analítico, de caráter transversal, com amostra representativa de 334 crianças obtida por amostragem estratificada por conglomerados, com seleção aleatória de 26 berçários. A coleta de dados foi realizada por meio de entrevista com os

  15. [Comparison of the present and previously used protocol of risk stratification in children with acute lymphoblastic leukemia].

    Science.gov (United States)

    Glodkowska, Eliza; Bialas, Agnieszka; Jackowska, Teresa

    2007-01-01

    Acute lymphoblastic leukaemia (ALL) is one of the most common cancers in children. In Poland, since November 2002 a new protocol of risk stratification has been recommended for assessment of risk factors and for choosing therapy regimens. assessment of accuracy of protocol ALL-IC 2002 in comparison to previously used risk stratification protocols. ALL was diagnosed in 100 children (44 girls, 56 boys; 1-18 years of age) in the Department of Pediatric Hematology and Oncology, Warsaw Medical University, over the period from November 2002 to November 2006. According to the ALL-IC 2002 protocol the patients were divided into three risk groups: SR-standard, IR-intermediate and HR-high. The stratification was by age, leukocyte count, cytogenetic changes, early response to prednisone therapy and bone marrow remission. In the previously used risk stratification protocols-BFM-90, only hepatosplenomegaly and the number of blasts in peripheral blood (PB) were considered, and the patients were divided into three risk groups: low (LRG1.2). out of the 100 patients qualified for treatment regimens according to the ALL-IC 2002 protocol, 97 entered remission, 11 died and 3 had a relapse. Under the ALL-IC 2002 protocol these children were stratified into the following groups: SR-31%, IR-44% and HR-25%. In the previously used stratification, there would be 26% children in low, 46% in the medium and 28% in the high risk group. According to the BFM-90 protocol 18/31 (58%) and 16/44 (36%) patients from the SR and IR groups respectively would be given more intensive treatment. On the other hand 11/44 (25%) and 14/25 (56%) patients from the IR and HR groups respectively would be given less intensive treatment. 1. ALL-IC 2002 protocol in comparison with the previously used protocol BFM-90, changes the qualification of children with ALL for the SR, IR and HR risk groups. This is linked to basic change of treatment protocol, adequate to severity of disease. 2. Children with ALL qualified

  16. Cytokines and clustered cardiovascular risk factors in children

    DEFF Research Database (Denmark)

    Andersen, Lars Bo; Müller, Klaus; Eiberg, Stig

    2010-01-01

    pronounced in fat and unfit children based on the association with CRP levels. The association between fitness and fatness variables, insulin resistance, and clustered risk could be caused by other mechanisms related to these exposures. The role of IL-6 remains unclear.......The aim was to evaluate the possible role of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), C-reactive protein (CRP), low fitness, and fatness in the early development of clustering of cardiovascular disease (CVD) risk factors and insulin resistance. Subjects for this cross......-sectional study were obtained from 18 schools near Copenhagen, Denmark. Two hundred ten 9-year-old children were selected for cytokine analysis from 434 third-grade children with complete CVD risk profiles. The subgroup was selected according to the CVD risk factor profile (upper and lower quartile of a composite...

  17. Risk Assessment and Clinical Risk Management for Young Antisocial Children: The Forgotten Group

    OpenAIRE

    Augimeri, Leena; Child Development Institute; Walsh, Margaret; Child Development Institute; Woods, Sarah; Child Development Institute; Jiang, Depeng; University of Manitoba

    2012-01-01

    Centre for Children Committing Offences (CCCO), at Child Development Institute (CDI) in Toronto, Canada, developed Early Assessment Risk Lists (EARL-20B for boys; EARL-21G for girls), for young children at-risk for future criminality. In this first EARL prospective longitudinal study, 573 boys and 294 girls who participated in SNAP®, a gender-specific evidencebased model for at-risk children (6-11 years), 8.2% of boys and 3.1% of girls had registered criminal offences at follow up (mean age 1...

  18. Sideropenic anemia in preschool children and risk factors

    Directory of Open Access Journals (Sweden)

    Stojanović Dušica

    2006-01-01

    Full Text Available INTRODUCTION: Sideropenic anemia is one of the most common nutritional disorders in the world. The children are at higher risk of iron deficiency than adults due to their rapid growth during infancy and relatively higher requirements of iron. OBJECTIVE: The objective of our study was to investigate the prevalence of sideropenic anemia in pre-school children and relevant risk factors. METHOD: Study on sideropenic anemia of preschool children was performed in Zaječar Municipality in 2003. Subjects: all children, age 6-7 years, who lived in the Zaječar Municipality (554 children. The investigation included: interview of children's parents and laboratory analysis of blood. RESULTS: The frequency of sideropenic anemia was 5.23% in tested children (hemoglobin level less than 11g/dl. Sex and place of residence had no significant impact on hemoglobin concentration in blood of children. Likewise, social status and education of parents had no significant impact on iron deficiency anemia. Higher incidence of infections was found in children with lower hemoglobin concentration in blood (p<0.05. It made no difference if children attended the kindergarten or not. Nutrition of children in kindergarten does not correct domestic nutrition, which should be one of its basic roles. CONCLUSION: Since sideropenic anemia gives rise to serious health problems, such as poor cognitive and motor development and behavioral problems, it is important to take corrective measures regarding domestic and social nutrition of children. Therefore, it is necessary to take action in preventing the sideropenic anemia and provide normal growth and development.

  19. Children's health and their mothers' risk of divorce or separation.

    Science.gov (United States)

    Joesch, J M; Smith, K R

    1997-01-01

    The purpose of this study is to determine how children's health conditions are related to their mothers' risk of divorce or separation. The study is based on data from over 7,000 children born to once-married mothers identified in the 1988 Child Health Supplement to the National Health Interview Survey. The effects of 15 childhood health conditions on the mothers' risk of divorce are estimated with Cox's proportional hazard models. Controlling for demographic, marital, and reproductive measures, we find that mothers' prospects for divorce are affected both positively or negatively by their children's health status, depending on the type of childhood condition and, in the case of low birth weight children, timing within the marriage. Women whose children have congenital heart disease, cerebral palsy, are blind, or had low birth weight appear to have higher risks of marital disruption than mothers of healthy children. In contrast, mothers whose children have migraines, learning disabilities, respiratory allergies, missing/deformed digits or limbs, or asthma have somewhat lower rates of divorce.

  20. Risk Factors of Learning Disabilities in Chinese Children in Wuhan

    Institute of Scientific and Technical Information of China (English)

    BIN YAO; HAN-RONG WU

    2003-01-01

    Objective To investigate prevalence rate of learning disabilities (LD) in Chinese children, and to explore related risk factors, and to provide theoretical basis for preventing such disabilities.Methods One thousand and one hundred fifty one children were randomly selected in primary schools. According to criteria set by ICD-10, 118 children diagnosed as LD were classified into the study group. Four hundred and ninety one children were classified into the normal control group. Five hundred and forty two children were classified into the excellent control group. The study instruments included PRS (The pupil rating scale revised screening for learning disabilities), Conners' children behavior check-list taken by parents and YG-WR character check-list. Results The prevalence rate of LD in Chinese children was 10.3%. Significant differences were observed between LD and normally learning children, and between the LD group and the excellent group, in terms of scores of Conners' behavior check-list (P<0.05). The study further showed that individual differences in character between the LD group and the control groups still existed even after controlling individual differences in age, IQ, and gender. Some possible causal explanations contributing to LD were improper teaching by parents, low educational level of the parents, and children's characteristics and social relationships. Conclusion These data underscore the fact that LD is a serious national public health problem in China. LD is resulted from a number of factors. Good studying and living environments should be created for LD children.

  1. Nematode Infections Are Risk Factors for Staphylococcal Infection in Children

    Directory of Open Access Journals (Sweden)

    Sandra F Moreira-Silva

    2002-04-01

    Full Text Available Nematode infection may be a risk factor for pyogenic liver abscess in children and we hypothesized that the immunomodulation induced by those parasites would be a risk factor for any staphylococcal infection in children. The present study was designed to compare, within the same hospital, the frequency of intestinal nematodes and Toxocara infection in children with and without staphylococcal infections. From October 1997 to February 1998, 80 children with staphylococcal infection and 110 children with other diseases were submitted to fecal examination, serology for Toxocara sp., evaluation of plasma immunoglobulin levels, and eosinophil counts. Mean age, gender distribution, birthplace, and socioeconomic conditions did not differ significantly between the two groups. Frequency of intestinal nematodes and positive serology for Toxocara, were remarkably higher in children with staphylococcal infections than in the non-staphylococcal group. There was a significant correlation between intestinal nematodes or Toxocara infection and staphylococcal infection in children, reinforced by higher eosinophil counts and higher IgE levels in these children than in the control group. One possible explanation for this association would be the enhancement of bacterial infection by the immunomodulation induced by helminth infections, due to strong activation of the Th2 subset of lymphocytes by antigens from larvae and adult worms.

  2. [Nutritional status and risk in hospitalized children].

    Science.gov (United States)

    Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

    2001-11-01

    A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

  3. The Stratified Legitimacy of Abortions.

    Science.gov (United States)

    Kimport, Katrina; Weitz, Tracy A; Freedman, Lori

    2016-12-01

    Roe v. Wade was heralded as an end to unequal access to abortion care in the United States. However, today, despite being common and safe, abortion is performed only selectively in hospitals and private practices. Drawing on 61 interviews with obstetrician-gynecologists in these settings, we examine how they determine which abortions to perform. We find that they distinguish between more and less legitimate abortions, producing a narrative of stratified legitimacy that privileges abortions for intended pregnancies, when the fetus is unhealthy, and when women perform normative gendered sexuality, including distress about the abortion, guilt about failure to contracept, and desire for motherhood. This stratified legitimacy can perpetuate socially-inflected inequality of access and normative gendered sexuality. Additionally, we argue that the practice by physicians of distinguishing among abortions can legitimate legislative practices that regulate and restrict some kinds of abortion, further constraining abortion access. © American Sociological Association 2016.

  4. A study of cardiovascular risk factors and its knowledge among school children of Delhi

    Directory of Open Access Journals (Sweden)

    Grace Mary George

    2014-05-01

    Conclusion: Cardiovascular risk factors are highly prevalent among school children. Importantly, school children lack adequate knowledge regarding cardiovascular risk factors. School based interventions are required for cardiovascular risk reduction in childhood.

  5. RADIAL STABILITY IN STRATIFIED STARS

    International Nuclear Information System (INIS)

    Pereira, Jonas P.; Rueda, Jorge A.

    2015-01-01

    We formulate within a generalized distributional approach the treatment of the stability against radial perturbations for both neutral and charged stratified stars in Newtonian and Einstein's gravity. We obtain from this approach the boundary conditions connecting any two phases within a star and underline its relevance for realistic models of compact stars with phase transitions, owing to the modification of the star's set of eigenmodes with respect to the continuous case

  6. [Epidemiological survey and risk factor analysis of asthma in children in urban districts of Zhengzhou, China].

    Science.gov (United States)

    Zhao, Kun; Song, Gui-Hua; Gu, Hua-Qian; Liu, Shuang; Zhang, Yan; Guo, Yan-Rong

    2014-12-01

    To study the epidemiological features, treatment status, and risk factors for asthma in children in Zhengzhou, China. Questionnaires for primary screening were issued using the method of multi-stage stratified sampling. Suspected asthmatic children were given a second questionnaire, physical examination, medical history review, and auxiliary examination to confirm the diagnosis. Age- and sex-matched non-asthmatic children were randomly recruited to the control group. The number of valid questionnaires was 10 616 (5 444 males and 5 172 females). There were 308 confirmed asthma cases and the overall prevalence was 2.90%. The prevalence in boys was higher than that in girls (3.4% vs 2.4%). The prevalence in children under 3 years of age was 10.2%, which was higher than that in other age groups. The top three triggers for asthma attack in children were respiratory infection (94.2%), weather changes (89.0%), and exercise (35.1%). The most common asthma attack was moderate (71.8%), followed by mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (280 cases) of all patients, respectively. Multivariate logistic regression analysis indicated the following major risk factors for asthma: history of allergic rhinitis (OR=150.285, 95% CI: 31.934-707.264), history of eczema (OR=10.600, 95% CI: 1.054-106.624), history of atopic dermatitis (OR=31.368, 95% CI: 3.339-294.683), food allergies (OR=27.373, 95% CI: 2.670-280.621), method of birth (OR=2.853, 95% CI: 1.311-6.208), age of first antibiotic use (OR=0.384, 95% CI: 0.172-0.857), frequency of antibiotic use within 1 year of age (OR=9.940, 95% CI: 6.246-15.820), use of wall decorating materials (OR=2.108, 95% CI: 1.464-3.036), and use of heat supply in winter (OR=6.046, 95% CI: 1.034-35.362). The prevalence of childhood asthma is associated with age and gender in Zhengzhou. Most asthma attacks are moderate, often triggered by

  7. The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children

    Directory of Open Access Journals (Sweden)

    Dunger David B

    2010-03-01

    Full Text Available Abstract Background Low- to middle-income countries are undergoing a health transition with non-communicable diseases contributing substantially to disease burden, despite persistence of undernutrition and infectious diseases. This study aimed to investigate the prevalence and patterns of stunting and overweight/obesity, and hence risk for metabolic disease, in a group of children and adolescents in rural South Africa. Methods A cross-sectional growth survey was conducted involving 3511 children and adolescents 1-20 years, selected through stratified random sampling from a previously enumerated population living in Agincourt sub-district, Mpumalanga Province, South Africa. Anthropometric measurements including height, weight and waist circumference were taken using standard procedures. Tanner pubertal assessment was conducted among adolescents 9-20 years. Growth z-scores were generated using 2006 WHO standards for children up to five years and 1977 NCHS/WHO reference for older children. Overweight and obesity for those 2 for overweight and obesity respectively were used for those ≥ 18 years. Waist circumference cut-offs of ≥ 94 cm for males and ≥ 80 cm for females and waist-to-height ratio of 0.5 for both sexes were used to determine metabolic disease risk in adolescents. Results About one in five children aged 1-4 years was stunted; one in three of those aged one year. Concurrently, the prevalence of combined overweight and obesity, almost non-existent in boys, was substantial among adolescent girls, increasing with age and reaching approximately 20-25% in late adolescence. Central obesity was prevalent among adolescent girls, increasing with sexual maturation and reaching a peak of 35% at Tanner Stage 5, indicating increased risk for metabolic disease. Conclusions The study highlights that in transitional societies, early stunting and adolescent obesity may co-exist in the same socio-geographic population. It is likely that this profile

  8. Cancer risks following diagnostic and therapeutic radiation exposure in children

    Energy Technology Data Exchange (ETDEWEB)

    Kleinerman, Ruth A. [National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS 7044, Rockville, MD (United States)

    2006-09-15

    The growing use of interventional and fluoroscopic imaging in children represents a tremendous benefit for the diagnosis and treatment of benign conditions. Along with the increasing use and complexity of these procedures comes concern about the cancer risk associated with ionizing radiation exposure to children. Children are considerably more sensitive to the carcinogenic effects of ionizing radiation than adults, and children have a longer life expectancy in which to express risk. Numerous epidemiologic cohort studies of childhood exposure to radiation for treatment of benign diseases have demonstrated radiation-related risks of cancer of the thyroid, breast, brain and skin, as well as leukemia. Many fewer studies have evaluated cancer risk following diagnostic radiation exposure in children. Although radiation dose for a single procedure might be low, pediatric patients often receive repeated examinations over time to evaluate their conditions, which could result in relatively high cumulative doses. Several cohort studies of girls and young women subjected to multiple diagnostic radiation exposures have been informative about increased mortality from breast cancer with increasing radiation dose, and case-control studies of childhood leukemia and postnatal diagnostic radiation exposure have suggested increased risks with an increasing number of examinations. Only two long-term follow-up studies of cancer following cardiac catheterization in childhood have been conducted, and neither reported an overall increased risk of cancer. Most cancers can be induced by radiation, and a linear dose-response has been noted for most solid cancers. Risks of radiation-related cancer are greatest for those exposed early in life, and these risks appear to persist throughout life. (orig.)

  9. Cancer risks following diagnostic and therapeutic radiation exposure in children

    International Nuclear Information System (INIS)

    Kleinerman, Ruth A.

    2006-01-01

    The growing use of interventional and fluoroscopic imaging in children represents a tremendous benefit for the diagnosis and treatment of benign conditions. Along with the increasing use and complexity of these procedures comes concern about the cancer risk associated with ionizing radiation exposure to children. Children are considerably more sensitive to the carcinogenic effects of ionizing radiation than adults, and children have a longer life expectancy in which to express risk. Numerous epidemiologic cohort studies of childhood exposure to radiation for treatment of benign diseases have demonstrated radiation-related risks of cancer of the thyroid, breast, brain and skin, as well as leukemia. Many fewer studies have evaluated cancer risk following diagnostic radiation exposure in children. Although radiation dose for a single procedure might be low, pediatric patients often receive repeated examinations over time to evaluate their conditions, which could result in relatively high cumulative doses. Several cohort studies of girls and young women subjected to multiple diagnostic radiation exposures have been informative about increased mortality from breast cancer with increasing radiation dose, and case-control studies of childhood leukemia and postnatal diagnostic radiation exposure have suggested increased risks with an increasing number of examinations. Only two long-term follow-up studies of cancer following cardiac catheterization in childhood have been conducted, and neither reported an overall increased risk of cancer. Most cancers can be induced by radiation, and a linear dose-response has been noted for most solid cancers. Risks of radiation-related cancer are greatest for those exposed early in life, and these risks appear to persist throughout life. (orig.)

  10. Added Sugars and Cardiovascular Disease Risk in Children

    Science.gov (United States)

    Vos, Miriam B.; Kaar, Jill L.; Welsh, Jean A.; Van Horn, Linda V.; Feig, Daniel I.; Anderson, Cheryl A.M.; Patel, Mahesh J.; Munos, Jessica Cruz; Krebs, Nancy F.; Xanthakos, Stavra A.; Johnson, Rachel K.

    2017-01-01

    BACKGROUND Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. METHODS AND RESULTS For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. CONCLUSIONS Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target. PMID:27550974

  11. The Oncogenic Risks of Diagnostic CT Scam Studies in Children

    International Nuclear Information System (INIS)

    Brent, R.

    2004-01-01

    Brenner et al (2001) reported that estimates of the exposure to children from CT scans indicates that the exposures are both higher than from conventional radiographic studies and higher than is necessary to obtain quality examinations. utilizing the oncogenic risk data from the RERF study in Japan, Brenner et al estimated that the oncogenic risk in this population of CT exposed children exposed each year would result in an additional 500 cases of cancer. This risk estimate is supported by the RERF epidemiological data obtained from the populations exposed in Hiroshima and Nagasaki. the increased risks associated with the increased exposure from CT scans have raised concern and stimulated discussion. Although there is little doubt about the benefits of CT scans in improving the health care of children, there is concern about the estimated oncogenic risk, especially since the frequency of CT studies has been increasing. Applying the oncogenic risks of ionizing radiation from the RERF data may not be appropriate for all types of radiation exposure for accurately predicting the incidence of cancer in exposed children because of the impact of 1) partial versus whole-body irradiation, and 2) the protraction of the exposure. Other population of children who have been exposed to radiation and whose incidence of cancer has been studied will be presented and those studies indicate that the risk of cancer is much lower or not increased at all with exposures in the diagnostic range. finally, the dramatic impact of the use of CT scans in clinical pediatric practice saves lives and improves diagnostic accuracy. Therefore, it is crucial that a scholarly evaluation of the risks and benefits should be initiated. The radiology community and the manufacturers have already initiated programs to decrease the exposure significantly. But it is essential that well-planned, retrospective and prospective epidemiology studies should be initiated to study the oncogenic risks. If you want to

  12. Cancer risk in siblings of children with congenital malformations

    DEFF Research Database (Denmark)

    Sun, Yuelian; Wu, Chunsen; Arah, Onyebuchi A

    2016-01-01

    PURPOSE: Cancer and birth defects cluster in families more often than expected by chance, but the reasons are neither well known nor well studied. METHODS: From singletons born alive in Denmark between 1 January 1977 and 31 December 2007, we identified children who had no congenital malformations...... but had a full or half sibling with a congenital malformation (CM) diagnosed in the first year of life; this constituted the exposed group, while children whose siblings had no such condition constituted a reference group. We estimated cancer risks for children who had a full sibling or a half sibling...

  13. HIV INFECTION AS A RISK FACTOR OF TUBERCULOSIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E. P. Eremenko

    2017-01-01

    Full Text Available The article presents the results of three year follow-up over 96 HIV positive children registered in the AIDS Center. During 3 year follow up the infection with tuberculous mycobacteria was diagnosed in 27.3% (n = 23 of HIV positive children from the followed up group. The leading risk factor of tuberculosis is family exposure to a tuberculosis patient – 22.6% (n = 19. Compliance to follow-up and treatment, timely prescribed preventive anti-tuberculosis chemotherapy and highly active antiretroviral therapy enhanced prevention of development of local forms of tuberculosis in the followed up group of children.

  14. Are distinctive risk indicators associated with different stages of caries in children? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Maria Grazia Cagetti

    2016-12-01

    Full Text Available Abstract Background Actual caries figures emphasize the need to identify the risk indicators involved in the disease’s development. The hypothesis that certain risk indicators might affect the dynamic evolution of the caries process was assessed; to clarify this premise, a cross-sectional survey was performed in school children. Methods A total of 390 subjects aged 6–8 years old were randomly selected. Caries was assessed, and the subjects were stratified as follows: i highest caries score; ii most prevalent caries score; and iii number of affected teeth. Parents/guardians completed a questionnaire regarding vital statistics, socio-economic indicators, dietary habits, oral hygiene habits and oral health behaviours. Results Caries was detected in 42.31% of the subjects. Maternal nationality, parental education level, use of a sweetened pacifier at night, intake of lactose-free milk and toothbrushing frequency were statistically significant associated (p < 0.05 with subjects stratified according to the highest caries score. Parental educational level, maternal occupational status and use of a sweetened pacifier at night were associated (p < 0.05 with affected children stratified according to the most prevalent caries score. Maternal educational level and intake of lactose-free milk were associated with subjects with moderate caries stages compared to being caries-free (p = 0.01 and p = 0.02, respectively. Maternal nationality (p < 0.01 and toothbrushing frequency (p = 0.01 were associated with subjects affected by extensive lesions compared to caries-free children. In subjects affected by initial lesions as the most prevalent figure, gender (male and paternal occupation status (unemployed were statistically significant associated (p = 0.03 and p = 0.04, respectively compared to those affected by highest prevalence of extensive caries lesions. In children with the highest prevalence of moderate caries lesions

  15. Relation of Cardiometabolic Risk Factors between Parents and Children.

    Science.gov (United States)

    Halvorsen, Tanya; Moran, Antoinette; Jacobs, David R; Steffen, Lyn M; Sinaiko, Alan R; Zhou, Xia; Steinberger, Julia

    2015-11-01

    To explore the relations of parent-child cardiometabolic risk factors and assess the influence of adiposity on these associations. Associations of adiposity, blood pressure (BP), lipids, fasting insulin and glucose, and a risk factor cluster score (CS) were evaluated in a cross-sectional study of 179 parents and their children (6-18 years, N = 255). Insulin resistance was assessed by euglycemic clamp in parents and children aged 10 years or older. Metabolic syndrome in parents was defined by National Cholesterol Education Program's Adult Treatment Panel III criteria. CSs of the risk factors were created based on age-specific z-scores. Analyses included Pearson correlation and linear regression, adjusted for parent and child age, sex, race, and body mass index (BMI), accounting for within-family correlation. We found positive parent-child correlations for measures of adiposity (BMI, BMI percentile, waist, subcutaneous fat, and visceral fat; r = 0.22-0.34, all P ≤ .003), systolic BP (r = 0.20, P = .002), total cholesterol (r = 0.39, P parent-child correlations, except systolic BP, remained significant. Although adiposity is strongly correlated between parents and children, many cardiometabolic risk factors correlate independent of parent and child BMI. Adverse parental cardiometabolic profiles may identify at-risk children independent of the child's adiposity status. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Trampoline related injuries in children: risk factors and radiographic findings.

    Science.gov (United States)

    Klimek, Peter Michael; Juen, David; Stranzinger, Enno; Wolf, Rainer; Slongo, Theddy

    2013-05-01

    Backyard trampolines are immensely popular among children, but are associated with an increase of trampoline-related injuries. The aim of this study was to evaluate radiographs of children with trampoline related injuries and to determine the risk factors. Between 2003 and 2009, 286 children under the age of 16 with backyard trampoline injuries were included in the study. The number of injuries increased from 13 patients in 2003 to 86 in 2009. The median age of the 286 patients was 7 years (range: 1-15 years). Totally 140 (49%) patients were males, and 146 (51%) females. Medical records and all available diagnostic imaging were reviewed. A questionnaire was sent to the parents to evaluate the circumstances of each injury, the type of trampoline, the protection equipment and the experience of the children using the trampoline. The study was approved by the Institutional Ethics Committee of the University Hospital of Bern. The questionnaires and radiographs of the 104 patients were available for evaluation. A fracture was sustained in 51 of the 104 patients. More than 75% of all patients sustaining injuries and in 90% of patients with fractures were jumping on the trampoline with other children at the time of the accident. The most common fractures were supracondylar humeral fractures (29%) and forearm fractures (25%). Fractures of the proximal tibia occurred especially in younger children between 2-5 years of age. Children younger than 5 years old are at risk for specific proximal tibia fractures ("Trampoline Fracture"). A child jumping simultaneously with other children has a higher risk of suffering from a fracture.

  17. The impact of children on divorce risks of Swedish women.

    Science.gov (United States)

    Andersson, G

    1997-06-01

    "The purpose of this paper is to study the impact of children on divorce risks in 1971-1994 for first-married Swedish women. This impact is examined using two measures of family composition, namely the number of children and the age of the youngest child, and we find an independent effect from each of these factors on the propensity to divorce. There is an additional impact of births prior to marriage on the subsequent divorce risk.... The general picture of Swedish divorce-risk trends shows a strong increase in 1974, mostly among childless women, in response to a reform of the divorce legislation. Since the beginning of the 1980s, the risks have increased steadily, mostly among mothers." (EXCERPT)

  18. High blood pressure in school children: prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Rivers Patrick A

    2006-11-01

    Full Text Available Abstract Background The purpose of this study was to determine the prevalence of high blood pressure (HBP and associated risk factors in school children 8 to 13 years of age. Methods Elementary school children (n = 1,066 were examined. Associations between HBP, body mass index (BMI, gender, ethnicity, and acanthosis nigricans (AN were investigated using a school based cross-sectional study. Blood pressure was measured and the 95th percentile was used to determine HBP. Comparisons between children with and without HBP were utilized. The crude and multiple logistic regression adjusted odds ratios were used as measures of association. Results Females, Hispanics, overweight children, and children with AN had an increased likelihood of HBP. Overweight children (BMI ≥ 85th percentile and those with AN were at least twice as likely to present with HBP after controlling for confounding factors. Conclusion Twenty one percent of school children had HBP, especially the prevalence was higher among the overweight and Hispanic group. The association identified here can be used as independent markers for increased likelihood of HBP in children.

  19. Alternative Certified Teachers and Children at Risk

    Science.gov (United States)

    Tissington, Laura D.; Grow, Amani

    2007-01-01

    Special education programs that serve at-risk students are facing very real personnel needs that colleges and universities alone cannot meet. Alternative certification programs (ACP) may help meet these needs. Effective university-school district partnership programs that include critical teaching training components may offer an attractive…

  20. Blood Lead Levels and Risk Factors among Preschool Children in a Lead Polluted Area in Taizhou, China

    Directory of Open Access Journals (Sweden)

    Zhenyan Gao

    2017-01-01

    Full Text Available Objective. To determine the blood lead levels and identify related risk factors among preschool children in a lead polluted area (Taizhou, China and provide theoretical support for prevention of lead pollution. Methods. A stratified-clustered-random sampling method was used to determine the survey sample. Blood lead levels were determined by the tungsten atomizer absorption spectrophotometer. Results. A total of 2,018 subjects (average age of 59 months; 1,087 boys and 931 girls were included. The arithmetic mean, geometric mean, and median blood lead levels of the preschool children were 56.4 μg/L, 48.9 μg/L, and 46 μg/L. A total of 8.8% children had blood lead levels >100 μg/L and 43.9% had blood lead levels >50 μg/L. Mother’s education level, father’s occupation, decorative tableware, exposure to makeup, and the residential floor were all risk factors for elevated blood lead levels (odds ratios of 1.42, 1.21, 1.11, 1.19, and 1.27, resp., while hand washing before eating food was a protective factor (odds ratio of 0.88. Conclusions. The blood lead levels of preschool children in Taizhou were higher than in other areas in China and in developed countries. Therefore, policies ensuring lead-based industries are not placed in close proximity to residential areas are required.

  1. Risk assessment in fever and neutropenia in children with cancer : What did we learn?

    NARCIS (Netherlands)

    Poele, Esther M. te; Tissing, Wim J. E.; Kamps, Willem A.; de Bont, Eveline S. J. M.

    2009-01-01

    Children with cancer treated with chemotherapy are susceptible to bacterial infections and serious infectious complications. However, fever and neutropenia can also result from other causes, for which no antibiotic treatment is needed. In the past decades attempts have been made to stratify the

  2. Risk factors for cefotaxime resistance in children with pneumonia

    OpenAIRE

    A. A. Made Sucipta; Ida Bagus Subanada; Samik Wahab

    2012-01-01

    Background Pneumonia is a health problem in developing countries, often caused by bacterial agents. The widespread use of cefotaxime, a third-generation of cephalosporin to increased incidence of resistance to this antibiotic. Several studies have reported on risk factors associated with resistance to cefotaxime. Objective To oidentify risk factors for cefoxime resistence in children with pneumonia. Methods We performed a case-control study at Sanglah Hospital between January 2006-Dec...

  3. Profile and Risk Factor Analysis of Unintentional Injuries in Children.

    Science.gov (United States)

    Bhamkar, Rahul; Seth, Bageshree; Setia, Maninder Singh

    2016-10-01

    To study the profile and various risk factors associated with unintentional injuries in children. The study is a cross sectional analysis of data collected from 351 children presenting with unintentional injury to a tertiary care hospital in Navi Mumbai, India. Data were collected about variables based on Haddon Phase Factor Matrix - host, environment and agent factors. Proportions for categorical variables across various groups were compared using Chi square test or Fisher's exact test. Logistic regression model was used to evaluate the factors. Falls (36 %) were the most common injuries followed by bites (23 %). Majority of children were school going children (38 %) followed by preschool children (29 %). Forty-seven percent were from lower socioeconomic class. Commonest place of injury was home (48 %) and the commonest time was evening (49 %). Though there was male predominance in injuries, the difference across gender did not vary significantly (p = 0.15). Poisonings were significantly more common in infants and toddlers and in rural population (p risk of bites compared to urban (p Profile of injuries varies widely as per the variations in agent, host and environmental factors. Socio-environmental, economic conditions and infancy-toddler age groups are predisposing risk factors for bites and poisoning. Although rural areas and lower socioeconomic class population are more vulnerable to serious types of injuries, they still lack essential basic medical care.

  4. Comorbidities in preschool children at family risk of dyslexia

    Science.gov (United States)

    Gooch, Debbie; Hulme, Charles; Nash, Hannah M; Snowling, Margaret J

    2015-01-01

    Background Comorbidity among developmental disorders such as dyslexia, language impairment, attention deficit/hyperactivity disorder and developmental coordination disorder is common. This study explores comorbid weaknesses in preschool children at family risk of dyslexia with and without language impairment and considers the role that comorbidity plays in determining children’s outcomes. Method The preschool attention, executive function and motor skills of 112 children at family risk for dyslexia, 29 of whom also met criteria for language impairment, were assessed at ages 3 ½ and 4 ½. The performance of these children was compared to the performance of children with language impairment and typically developing controls. Results Weaknesses in attention, executive function and motor skills were associated with language impairment rather than family risk status. Individual differences in language and executive function are strongly related in the preschool period and preschool motor skills predicted unique variance (4%) in early reading skills over and above children’s language ability. Conclusion Comorbidity between developmental disorders can be observed in the preschool years: children with language impairment have significant and persistent weaknesses in motor skills and executive function compared to those without language impairment. Children’s early language and motor skills are predictors of children’s later reading skills. PMID:24117483

  5. [Risk factors for asthma in children in Hefei, China].

    Science.gov (United States)

    Xiong, Mei; Ni, Chen; Pan, Jia-Hua; Wang, Qiang; Zheng, Li-Lin

    2013-05-01

    To investigate the risk factors for asthma in children in Hefei, China and to provide a strategy for asthma control in this region. A total of 400 children with a confirmed diagnosis of asthma, as well as 400 children of comparable age, sex, living environment, and family background, who had no respiratory diseases, were selected for a case-control study. A survey questionnaire survey was completed for all children. The obtained data were subjected to univariate and multivariate logistic regression analysis to determine the risk factors for asthma. The logistic regression analysis showed that a family history of allergy, allergic rhinitis, infantile eczema, no breastfeeding, air-conditioning and passive smoking were the risk factors for asthma in children, with odds ratios of 9.63, 7.56, 4.58, 2.16, 1.73, and 1.55 respectively. In order to reduce the incidence of asthma, we should advocate breast feeding, promote outdoor activities, keep ventilation natural, prevent passive smoking and cure allergic rhinitis.

  6. Accident frequency and unrealistic optimism: Children's assessment of risk.

    Science.gov (United States)

    Joshi, Mary Sissons; Maclean, Morag; Stevens, Claire

    2018-02-01

    Accidental injury is a major cause of mortality and morbidity among children, warranting research on their risk perceptions. Three hundred and seven children aged 10-11 years assessed the frequency, danger and personal risk likelihood of 8 accidents. Two social-cognitive biases were manifested. The frequency of rare accidents (e.g. drowning) was overestimated, and the frequency of common accidents (e.g. bike accidents) underestimated; and the majority of children showed unrealistic optimism tending to see themselves as less likely to suffer these accidents in comparison to their peers, offering superior skills or parental control of the environment as an explanation. In the case of pedestrian accidents, children recognised their seriousness, underestimated the frequency of this risk and regarded their own road crossing skill as protection. These findings highlight the challenging task facing safety educators who, when teaching conventional safety knowledge and routines, also need to alert children to the danger of over-confidence without disabling them though fear. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Risk factors for invasive reptile-associated salmonellosis in children.

    Science.gov (United States)

    Meyer Sauteur, Patrick M; Relly, Christa; Hug, Martina; Wittenbrink, Max M; Berger, Christoph

    2013-06-01

    Reptile-associated salmonellosis (RAS) in children has been reported primarily due to direct contact with turtles, but recently also due to indirect contact with more exotic reptiles, causing disease in infants. To evaluate risk factors for RAS, we reviewed the RAS cases published in the literature since 1965. A case was defined as a child ≤18 years of age with an epidemiological link by identification of Salmonella enterica in cultures from both the affected child and the exposed reptile. We identified a total of 177 otherwise healthy children (median age 1.0 years, range 2 days to 17.0 years). RAS manifested mainly with gastrointestinal disease, but 15% presented with invasive RAS, including septicemia, meningitis, and bone and joint infection. The children with invasive RAS were significantly younger than children with noninvasive disease (median age 0.17 and 2.0 years, preptiles other than turtles, including iguanas, bearded dragons, snakes, chameleons, and geckos. Children exposed to those latter reptiles usually kept indoors were younger than children exposed to turtles mostly kept outdoors (preptiles, other than turtles, kept indoors is associated with RAS at younger age and more invasive disease. This finding is helpful for recognizing or even preventing invasive RAS in young infants that are at highest risk.

  8. Risk factors for mortality in children with abusive head trauma.

    Science.gov (United States)

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

    2012-10-01

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

  9. Cardiovascular Risk Factors in Parents of Food-Allergic Children.

    Science.gov (United States)

    Walker, Sheila Ohlsson; Mao, Guangyun; Caruso, Deanna; Hong, Xiumei; Pongracic, Jacqueline A; Wang, Xiaobin

    2016-04-01

    Previous studies suggest that chronic stress may induce immune system malfunction and a broad range of adverse health outcomes; however, the underlying pathways for this relationship are unclear. Our study aimed to elucidate this question by examining the relationship between parental cardiovascular risk factors including systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist-to-hip ratio (WHR) and maternal psychological stress score (MPSS) relative to the severity of the child's food allergy (FA) and number of affected children. SBP, DBP, BMI, and WHR were measured and calculated at the time of recruitment by trained nurses. MPSS was obtained based on self-report questionnaires covering lifestyle adjustments, perceived chronic stress, and quality of life. General linear models examined whether caregiver chronic stress was associated with FA. For mothers with children under age 5 years, SBP, DBP and number of affected children had strong and graded relationships with severity of the child's FA. MPSS was also significantly and positively associated with child FA severity (P parent. This was also the case for paternal SBP, DBP, and number of affected children of any age. There is a strong and graded link between cardiovascular risk and perceived stress in mothers of food-allergic children under age 5. Findings may have important implications for family-centered care of FA, may generalize to caregivers of children with chronic conditions, and extend the literature on allostatic load.

  10. Aerobic fitness related to cardiovascular risk factors in young children

    DEFF Research Database (Denmark)

    Dencker, Magnus; Thorsson, Ola; Karlsson, Magnus K

    2012-01-01

    Low aerobic fitness (maximum oxygen uptake (VO(2PEAK))) is predictive for poor health in adults. In a cross-sectional study, we assessed if VO(2PEAK) is related to a composite risk factor score for cardiovascular disease (CVD) in 243 children (136 boys and 107 girls) aged 8 to 11 years. VO(2PEAK...

  11. Risks of intestinal helminthiasis in children living in orphanages in ...

    African Journals Online (AJOL)

    Risks of intestinal helminthiasis in children living in orphanages in Benin city, Nigeria. ... of intestinal helminthiasis (p = 0.016). Conclusion: Behavioural modification, good personal hygiene and provision of towels for each child living in the orphanage should be integral part of intestinal helminths control in orphanages.

  12. Risk Factors, Clinical Features and Management Of Children With ...

    African Journals Online (AJOL)

    In spite of the diarrhoeal disease control Programme of WHO and campaign efforts of the Nigerian government in the prevention and management ofdiarrhoea, the disease still remains a major causes of death among children under 5 years in Nigerian. Hence this study was aimed at assessing the risk factors, clinical ...

  13. Comorbidities in Preschool Children at Family Risk of Dyslexia

    Science.gov (United States)

    Gooch, Debbie; Hulme, Charles; Nash, Hannah M.; Snowling, Margaret J.

    2014-01-01

    Background: Comorbidity among developmental disorders such as dyslexia, language impairment, attention deficit/hyperactivity disorder and developmental coordination disorder is common. This study explores comorbid weaknesses in preschool children at family risk of dyslexia with and without language impairment and considers the role that…

  14. Prevalence and Risk Factors for Enuresis in Children | Adekanmbi ...

    African Journals Online (AJOL)

    Using logistic regression, maternal history, sibling history of bedwetting, snoring and heavy supper are strong determinants of bedwetting. Enuresis is a common problem among primary school pupils. Intensive public enlightenment is needed. Key words: Enuresis, risk factors, prevalence, children, social-stigma ...

  15. Free Falling in Stratified Fluids

    Science.gov (United States)

    Lam, Try; Vincent, Lionel; Kanso, Eva

    2017-11-01

    Leaves falling in air and discs falling in water are examples of unsteady descents due to complex interaction between gravitational and aerodynamic forces. Understanding these descent modes is relevant to many branches of engineering and science such as estimating the behavior of re-entry space vehicles to studying biomechanics of seed dispersion. For regularly shaped objects falling in homogenous fluids, the motion is relatively well understood. However, less is known about how density stratification of the fluid medium affects the falling behavior. Here, we experimentally investigate the descent of discs in both pure water and in stable linearly stratified fluids for Froude numbers Fr 1 and Reynolds numbers Re between 1000 -2000. We found that stable stratification (1) enhances the radial dispersion of the disc at landing, (2) increases the descent time, (3) decreases the inclination (or nutation) angle, and (4) decreases the fluttering amplitude while falling. We conclude by commenting on how the corresponding information can be used as a predictive model for objects free falling in stratified fluids.

  16. Stratified Medicine and Reimbursement Issues

    Directory of Open Access Journals (Sweden)

    Hans-Joerg eFugel

    2012-10-01

    Full Text Available Stratified Medicine (SM has the potential to target patient populations who will most benefit from a therapy while reducing unnecessary health interventions associated with side effects. The link between clinical biomarkers/diagnostics and therapies provides new opportunities for value creation to strengthen the value proposition to pricing and reimbursement (P&R authorities. However, the introduction of SM challenges current reimbursement schemes in many EU countries and the US as different P&R policies have been adopted for drugs and diagnostics. Also, there is a lack of a consistent process for value assessment of more complex diagnostics in these markets. New, innovative approaches and more flexible P&R systems are needed to reflect the added value of diagnostic tests and to stimulate investments in new technologies. Yet, the framework for access of diagnostic–based therapies still requires further development while setting the right incentives and appropriate align stakeholders interests when realizing long- term patient benefits. This article addresses the reimbursement challenges of SM approaches in several EU countries and the US outlining some options to overcome existing reimbursement barriers for stratified medicine.

  17. Childhood vaccinations and risk of acute lymphoblastic leukaemia in children

    DEFF Research Database (Denmark)

    Søegaard, Signe Holst; Rostgaard, Klaus; Schmiegelow, Kjeld

    2017-01-01

    information on ALL subtypes. Using Cox regression, we estimated hazard ratios (HRs) comparing vaccinated with unvaccinated children.Results: Childhood ALL was diagnosed in 490 children during 10 829 194 person-years of follow-up. Neither the total number of vaccine doses received nor exposure to each......Background: It has been proposed that childhood vaccinations protect against acute lymphoblastic leukaemia (ALL) in children by modulation of future responses to common infections in childhood. However, the available studies provide inconsistent findings, and population-based cohort studies...... with longitudinal information on vaccinations are lacking.Methods: In a register-based cohort of all children born in Denmark from 1 January 1990 to 31 December 2008, followed up until age 15 years or 31 December 2009 (n=1 225 404), we evaluated exposure to childhood vaccination and risk of childhood ALL, including...

  18. Design of dry sand soil stratified sampler

    Science.gov (United States)

    Li, Erkang; Chen, Wei; Feng, Xiao; Liao, Hongbo; Liang, Xiaodong

    2018-04-01

    This paper presents a design of a stratified sampler for dry sand soil, which can be used for stratified sampling of loose sand under certain conditions. Our group designed the mechanical structure of a portable, single - person, dry sandy soil stratified sampler. We have set up a mathematical model for the sampler. It lays the foundation for further development of design research.

  19. Decision-making Under Risk in Children, Adolescents, and Adults

    Directory of Open Access Journals (Sweden)

    David ePaulsen

    2011-04-01

    Full Text Available Adolescents often make risky and impulsive decisions. Such behavior has led to the common assumption that a dysfunction in risk-related decision-making peaks during this age. Differences in how risk has been defined across studies, however, make it difficult to draw conclusions about developmental changes in risky decision-making. Here, we developed a non-symbolic economic decision-making task that can be used across a wide age span and that uses coefficient of variation (CV in reward as an index of risk. We found that young children showed the strongest preference for risky compared to sure bet options of equal expected value, adolescents were intermediate in their risk preference, and young adults showed the strongest risk aversion. Furthermore, children’s preference for the risky option increased for larger CVs, while adolescents and young adults showed the opposite pattern, favoring the sure bet more often as CV increased. Finally, when faced with two gambles in a risk-return tradeoff, all three age groups exhibited a greater preference for the option with the lower risk and return as the disparity in risk between the two options increased. These findings demonstrate clear age-related differences in economic risk preferences that vary with choice set and risk. Importantly, adolescence appears to represent an intermediate decision-making phenotype along the transition from childhood to adulthood, rather than an age of heightened preference for economic risk.

  20. Risk factors of abuse of parents by their ADHD children.

    Science.gov (United States)

    Ghanizadeh, Ahmad; Jafari, Peyman

    2010-01-01

    It is interesting that there is scant research of abuse of parents by their children and no study was found on the abuse of parents by their attention deficit hyperactivity disorder (ADHD) children. Seventy-four children and adolescents suffering from ADHD and their parents were interviewed. The diagnoses were made according to DSM-IV diagnostic criteria. A questionnaire was developed to assess the children's abuse toward parents. More than half of the parents are suffering from at least one of the forms of abuse by their ADHD children. Scores of parental abuse were not related to gender. Different types of abuse correlated with oppositional defiant disorder (ODD), tic, and separation anxiety disorder (SAD). Fathers' and mothers' age, the level of education, and type of occupation were not risk factors of the abuse scores. ODD and mother's major depressive disorder were predictors of the abuse. There was a very disturbing high rate of abuse by children against parents. There is an interrelation of different forms of abuse. This study contributes to increasing awareness on the abuse of parents by their ADHD children.

  1. Sickle cell children traveling abroad: primary risk is infection.

    Science.gov (United States)

    Runel-Belliard, Camille; Lesprit, Emmanuelle; Quinet, Béatrice; Grimprel, Emmanuel

    2009-01-01

    Pediatricians taking care of sickle cell children in France are concerned about giving travel advice. Very few articles are published and no study has been done about it. A lot of pediatricians are using their own experience to decide if sickle cell children can travel abroad. Studying the consequences of such travel for sickle cell children is important to discuss common recommendations. We conducted a prospective study from June 2006 to December 2007 on desires to travel expressed during our consultations with sickle cell children. We studied notable events that occurred during travel and at least 2 months after return. Of 52 desires to travel, 10 were cancelled. All of the 42 trips were to Africa. Median duration of travel was 1.29 months (0.5-3). Median age at travel was 7.6 years (0.2-17.7). Events during travel were two hospitalizations (4.8%), a transfusion (2.4%), and four paramedical or medical examinations (9.6%). After return, four events occurred: two SS children had Plasmodium falciparum malaria (4.8%) and two had digestive bacteremia (4.8%) in SC and Sbeta+ children. No event occurred during plane travel. None of our patients died. The primary risk for sickle cell children traveling to Africa is infection: malaria first and digestive septicemia second. These risks are increased by long travel and poor sanitary conditions. Each travel should be prepared a long time before departure, and each pediatrician should insist on malaria prophylaxis and sanitary conditions, especially for young children. Trips should be shorter than 1 month when possible. A longer prospective study will be done to confirm these results.

  2. Decision-making under risk of loss in children.

    Science.gov (United States)

    Steelandt, Sophie; Broihanne, Marie-Hélène; Romain, Amélie; Thierry, Bernard; Dufour, Valérie

    2013-01-01

    In human adults, judgment errors are known to often lead to irrational decision-making in risky contexts. While these errors can affect the accuracy of profit evaluation, they may have once enhanced survival in dangerous contexts following a "better be safe than sorry" rule of thumb. Such a rule can be critical for children, and it could develop early on. Here, we investigated the rationality of choices and the possible occurrence of judgment errors in children aged 3 to 9 years when exposed to a risky trade. Children were allocated with a piece of cookie that they could either keep or risk in exchange of the content of one cup among 6, visible in front of them. In the cups, cookies could be of larger, equal or smaller sizes than the initial allocation. Chances of losing or winning were manipulated by presenting different combinations of cookie sizes in the cups (for example 3 large, 2 equal and 1 small cookie). We investigated the rationality of children's response using the theoretical models of Expected Utility Theory (EUT) and Cumulative Prospect Theory. Children aged 3 to 4 years old were unable to discriminate the profitability of exchanging in the different combinations. From 5 years, children were better at maximizing their benefit in each combination, their decisions were negatively induced by the probability of losing, and they exhibited a framing effect, a judgment error found in adults. Confronting data to the EUT indicated that children aged over 5 were risk-seekers but also revealed inconsistencies in their choices. According to a complementary model, the Cumulative Prospect Theory (CPT), they exhibited loss aversion, a pattern also found in adults. These findings confirm that adult-like judgment errors occur in children, which suggests that they possess a survival value.

  3. Decision-making under risk of loss in children.

    Directory of Open Access Journals (Sweden)

    Sophie Steelandt

    Full Text Available In human adults, judgment errors are known to often lead to irrational decision-making in risky contexts. While these errors can affect the accuracy of profit evaluation, they may have once enhanced survival in dangerous contexts following a "better be safe than sorry" rule of thumb. Such a rule can be critical for children, and it could develop early on. Here, we investigated the rationality of choices and the possible occurrence of judgment errors in children aged 3 to 9 years when exposed to a risky trade. Children were allocated with a piece of cookie that they could either keep or risk in exchange of the content of one cup among 6, visible in front of them. In the cups, cookies could be of larger, equal or smaller sizes than the initial allocation. Chances of losing or winning were manipulated by presenting different combinations of cookie sizes in the cups (for example 3 large, 2 equal and 1 small cookie. We investigated the rationality of children's response using the theoretical models of Expected Utility Theory (EUT and Cumulative Prospect Theory. Children aged 3 to 4 years old were unable to discriminate the profitability of exchanging in the different combinations. From 5 years, children were better at maximizing their benefit in each combination, their decisions were negatively induced by the probability of losing, and they exhibited a framing effect, a judgment error found in adults. Confronting data to the EUT indicated that children aged over 5 were risk-seekers but also revealed inconsistencies in their choices. According to a complementary model, the Cumulative Prospect Theory (CPT, they exhibited loss aversion, a pattern also found in adults. These findings confirm that adult-like judgment errors occur in children, which suggests that they possess a survival value.

  4. Decision-Making under Risk of Loss in Children

    Science.gov (United States)

    Steelandt, Sophie; Broihanne, Marie-Hélène; Romain, Amélie; Thierry, Bernard; Dufour, Valérie

    2013-01-01

    In human adults, judgment errors are known to often lead to irrational decision-making in risky contexts. While these errors can affect the accuracy of profit evaluation, they may have once enhanced survival in dangerous contexts following a “better be safe than sorry” rule of thumb. Such a rule can be critical for children, and it could develop early on. Here, we investigated the rationality of choices and the possible occurrence of judgment errors in children aged 3 to 9 years when exposed to a risky trade. Children were allocated with a piece of cookie that they could either keep or risk in exchange of the content of one cup among 6, visible in front of them. In the cups, cookies could be of larger, equal or smaller sizes than the initial allocation. Chances of losing or winning were manipulated by presenting different combinations of cookie sizes in the cups (for example 3 large, 2 equal and 1 small cookie). We investigated the rationality of children's response using the theoretical models of Expected Utility Theory (EUT) and Cumulative Prospect Theory. Children aged 3 to 4 years old were unable to discriminate the profitability of exchanging in the different combinations. From 5 years, children were better at maximizing their benefit in each combination, their decisions were negatively induced by the probability of losing, and they exhibited a framing effect, a judgment error found in adults. Confronting data to the EUT indicated that children aged over 5 were risk-seekers but also revealed inconsistencies in their choices. According to a complementary model, the Cumulative Prospect Theory (CPT), they exhibited loss aversion, a pattern also found in adults. These findings confirm that adult-like judgment errors occur in children, which suggests that they possess a survival value. PMID:23349682

  5. Comparison of risk of local-regional recurrence after mastectomy or breast conservation therapy for patients treated with neoadjuvant chemotherapy and radiation stratified according to a prognostic index score

    International Nuclear Information System (INIS)

    Huang, Eugene H.; Strom, Eric A.; Perkins, George H.; Oh, Julia L.; Chen, Allen M.; Meric-Bernstam, Funda; Hunt, Kelly K.; Sahin, Aysegul A.; Hortobagyi, Gabriel N.; Buchholz, Thomas A.

    2006-01-01

    Purpose: We previously developed a prognostic index that stratified patients treated with breast conservation therapy (BCT) after neoadjuvant chemotherapy into groups with different risks for local-regional recurrence (LRR). The purpose of this study was to compare the rates of LRR as a function of prognostic index score for patients treated with BCT or mastectomy plus radiation after neoadjuvant chemotherapy. Methods and Materials: We retrospectively analyzed 815 patients treated with neoadjuvant chemotherapy, surgery, and radiation. Patients were assigned an index score from 0 to 4 and given 1 point for the presence of each factor: clinical N2 to N3 disease, lymphovascular invasion, pathologic size >2 cm, and multifocal residual disease. Results: The 10-year LRR rates were very low and similar between the mastectomy and BCT groups for patients with an index score of 0 or 1. For patients with a score of 2, LRR trended lower for those treated with mastectomy vs. BCT (12% vs. 28%, p = 0.28). For patients with a score of 3 to 4, LRR was significantly lower for those treated with mastectomy vs. BCT (19% vs. 61%, p = 0.009). Conclusions: This analysis suggests that BCT can provide excellent local-regional treatment for the vast majority of patients after neoadjuvant chemotherapy. For the few patients with a score of 3 to 4, LRR was >60% after BCT and was <20% with mastectomy. If these findings are confirmed in larger randomized studies, the prognostic index may be useful in helping to select the type of surgical treatment for patients treated with neoadjuvant chemotherapy, surgery, and radiation

  6. Prevalence and risk factors of dental erosion in American children.

    Science.gov (United States)

    Habib, Mariam; Hottel, Timothy L; Hong, Liang

    2013-01-01

    The purpose of this study was to assess the prevalence and characteristics of dental erosion in children aged 2-4 years old and 12 years old. 243 subjects were recruited from daycare centers, preschools, and grade schools; they received dental examinations assessing their condition of dental erosion, including both depth and area of tooth surface loss on four maxillary incisors. Questionnaires were given to the subjects to obtain socio-demographic, oral health behaviors at home, and access to dental care. Dental erosion was analyzed and risk factors were assessed using Chi-Square and logistic regression analysis. The subjects were 60% Caucasians, 31% Black, 7% Hispanic and others were 2%. 34% of children could not get the dental care they needed within the past 12 months and 61% of all children brushed their teeth twice or more daily. Overall, 12% of study children had dental erosion with 13% for 2-4 years old and 10% for 12 years old, with the majority of erosive lesions within enamel. Family income (OR 3.98, p = 0.021) and acidic fruit juice consumption (OR 2.38, p = 0.038) were significant risk factors for dental erosion, even after controlling for other factors, such as source of drinking water and oral hygiene using logistic regression analysis. Dental erosion is a relatively common problem among the children in this study and it is seen as a multi-factorial process.

  7. Can statistical data qualify assessments of children at risk?

    DEFF Research Database (Denmark)

    Søbjerg, Lene Mosegaard; Villumsen, Anne Marie Anker; Klitbjerg-Nielsen, Christina

    and parents that are already registered in the municipality such as home address and school records. A similar tool is being developed in a social work research project in Denmark. The idea is to include risk and protection factors such as information about health, school absenteeism and family circumstances......Every day municipalities across Europe (and beyond) receive notifications about children at risk. The notifications come from teachers, health professionals, social workers, neighbors, or anyone else who sees a child, which appears not to thrive. The assessment and validation of whether the child...... significantly from case to case. Third, the relative importance of the different risk and protection factors is complex and difficult to assess – especially when the social worker has to assess both immediate danger as well as risk of long term failure-to-thrive. Internationally, different risk assessment tools...

  8. Suppression of stratified explosive interactions

    Energy Technology Data Exchange (ETDEWEB)

    Meeks, M.K.; Shamoun, B.I.; Bonazza, R.; Corradini, M.L. [Wisconsin Univ., Madison, WI (United States). Dept. of Nuclear Engineering and Engineering Physics

    1998-01-01

    Stratified Fuel-Coolant Interaction (FCI) experiments with Refrigerant-134a and water were performed in a large-scale system. Air was uniformly injected into the coolant pool to establish a pre-existing void which could suppress the explosion. Two competing effects due to the variation of the air flow rate seem to influence the intensity of the explosion in this geometrical configuration. At low flow rates, although the injected air increases the void fraction, the concurrent agitation and mixing increases the intensity of the interaction. At higher flow rates, the increase in void fraction tends to attenuate the propagated pressure wave generated by the explosion. Experimental results show a complete suppression of the vapor explosion at high rates of air injection, corresponding to an average void fraction of larger than 30%. (author)

  9. Bronchitis and Its Associated Risk Factors in First Nations Children

    Directory of Open Access Journals (Sweden)

    Chandima P. Karunanayake

    2017-11-01

    Full Text Available Respiratory diseases, such as bronchitis and pneumonia, are common in First Nations children in Canada. The objectives are to determine prevalence and associated risk factors of bronchitis in children 6–17 years old residing in two reserve communities. The cross-sectional study was conducted in 2013 and children from two First Nations reserve communities participated. The outcome was ever presence/absence of bronchitis. Logistic regression analysis was conducted to examine the relationship between bronchitis and the individual and environmental factors. A total of 351 First Nations children participated in the study. The prevalence of bronchitis was 17.9%. While 86.6% had at least one parent who smoked, smoking inside home was 43.9%. Signs of mold and mildew in homes were high. Prevalence of houses with any damage caused by dampness was 42.2%, with 44.2% of homes showing signs of mold or mildew. Significant predictors of increased risk of bronchitis were: being obese; having respiratory allergies; exposed to parental cigarette smoking; and signs of mold and mildew in the home. There are several modifiable risk factors that should be considered when examining preventive interventions for bronchitis including obesity, smoking exposure, and home mold or dampness.

  10. Cardiorespiratory Fitness, Metabolic Risk, and Inflammation in Children

    Directory of Open Access Journals (Sweden)

    Antonios D. Christodoulos

    2012-01-01

    Full Text Available The aim of this study was to investigate the independent associations among cardiorespiratory fitness, metabolic syndrome (MetS, and C-reactive protein (CRP in children. The sample consisted of 112 children (11.4  ±  0.4 years. Data was obtained for children’s anthropometry, cardiorespiratory fitness, MetS components, and CRP levels. MetS was defined using criteria analogous to the Adult Treatment Panel III definition. A MetS risk score was also computed. Prevalence of the MetS was 5.4%, without gender differences. Subjects with low fitness showed significantly higher MetS risk (<0.001 and CRP (<0.007, compared to the high-fitness pupils. However, differences in MetS risk, and CRP between fitness groups decreased when adjusted for waist circumference. These data indicate that the mechanisms linking cardiorespiratory fitness, MetS risk and inflammation in children are extensively affected by obesity. Intervention strategies aiming at reducing obesity and improving cardiorespiratory fitness in childhood might contribute to the prevention of the MetS in adulthood.

  11. Radiation dose and cancer risk to children undergoing skull radiography

    International Nuclear Information System (INIS)

    Mazonakis, Michael; Damilakis, John; Raissaki, Maria; Gourtsoyiannis, Nicholas

    2004-01-01

    Background: Limited data exist in the literature concerning the patient-effective dose from paediatric skull radiography. No information has been provided regarding organ doses, patient dose during PA skull projection, risk of cancer induction and dose to comforters, i.e. individuals supporting children during exposure. Objective: To estimate patient-effective dose, organ doses, lifetime cancer mortality risk to children and radiation dose to comforters associated with skull radiography. Materials and methods: Data were collected from 136 paediatric examinations, including AP, PA and lateral skull radiographs. Entrance-surface dose (ESD) and dose to comforters were measured using thermoluminescent dosimeters. Patients were divided into the following age groups: 0.5-2, 3-7, 8-12 and 13-18 years. The patient-effective dose and corresponding organ doses were calculated using data from the NRPB and Monte Carlo techniques. The risk for fatal cancer induction was assessed using appropriate risk coefficients. Results: For AP, PA and lateral skull radiography, effective dose ranges were 8.8-25.4, 8.2-27.3 and 8.4-22.7 μSv respectively, depending upon the age of the child. For each skull projection, the organs receiving doses above 10 μGy are presented. The number of fatal cancers was found to be less than or equal to 2 per 1 million children undergoing a skull radiograph. The mean radiation dose absorbed by the hands of comforters was 13.4 μGy. Conclusions: The current study provides detailed tabular and graphical data on ESD, effective dose, organ doses and lifetime cancer mortality risk to children associated with AP, PA and lateral skull projections at all patient ages. (orig.)

  12. Attentional bias to threat in children at-risk for emotional disorders: role of gender and type of maternal emotional disorder.

    Science.gov (United States)

    Montagner, Rachel; Mogg, Karin; Bradley, Brendan P; Pine, Daniel S; Czykiel, Marcelo S; Miguel, Euripedes Constantino; Rohde, Luis A; Manfro, Gisele G; Salum, Giovanni A

    2016-07-01

    Previous studies suggested that threat biases underlie familial risk for emotional disorders in children. However, major questions remain concerning the moderating role of the offspring gender and the type of parental emotional disorder on this association. This study addresses these questions in a large sample of boys and girls. Participants were 6-12 years old (at screening) typically developing children participating in the High Risk Cohort Study for Psychiatric Disorders (n = 1280; 606 girls, 674 boys). Children were stratified according to maternal emotional disorder (none; mood disorder; anxiety disorder; comorbid anxiety/mood disorder) and gender. Attention biases were assessed using a dot-probe paradigm with threat, happy and neutral faces. A significant gender-by-parental emotional disorder interaction predicted threat bias, independent of anxiety and depression symptoms in children. Daughters of mothers with an emotional disorder showed increased attention to threat compared with daughters of disorder-free mothers, irrespective of the type of maternal emotion disorder. In contrast, attention bias to threat in boys only occurred in mothers with a non-comorbid mood disorder. No group differences were found for biases for happy-face cues. Gender and type of maternal emotional disorder predict attention bias in disorder-free children. This highlights the need for longitudinal research to clarify whether this pattern of threat-attention bias in children relates to the risk of developing anxiety and mood disorders later in life.

  13. Perinatal stroke in Saudi children: clinical features and risk factors

    International Nuclear Information System (INIS)

    Salih, Mustafa A.; Al-Jarallah, Ahmed A.; Kentab, Anal Y.; Al-Nasser, Mohammad N.; Abdel-Gader, Abdel-Galil M.; Alorainy, Ibrahim A.; Hassan, Hamdy H.

    2006-01-01

    To describe the clinical features and presentations of perinatal stroke in a prospective and retrospective cohort of Saudi children and ascertain the risk factors. Patients with perinatal stroke were identified from within a cohort of 104 Saudi children who were evaluated at the Division of Pediatric Neurology at King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia from July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Neuroimaging for suspected cases of stroke consisted of cranial CT, MRI, or both. During the study period, 23 (22%) of 104 children (aged one months to 12 years) were diagnosed to have had perinatal stroke. The male: female ratio was 1.6:1. Ten (67%) of the 15 children who had unilateral ischemic involvement had their lesion in the left hemisphere. The presentation of the ischemic result was within 24-72 hours of life in 13 (57%) patients, and in 6 children (26%), motor impairment was recognized at or after the age of 4 months. Nine children (39%) had seizures at presentation. Pregnancy, labor, and delivery risk factors were ascertained in 18 (78%) cases. The most common of these included emergency cesarean section in 5 cases, and instrumental delivery in other 5. Screening for prothrombotic risk factors detected abnormalities in 6 (26%) patients on at least one test carried out between 2 months and 9 years of age. Four children (17%) had low protein C, which was associated low protein S and raised anticardiolipin antibodies (ACA) in one patient, and low antithrombin III in another. Low proteins S was detected in a 42-month-old boy. The abnormality in the sixth child was confined to raised ACA. The present study highlights the non-specific features by which stroke presents during the neonatal period. The data are in keeping with the potential role for inherited and acquired thrombophilia as being the underlying cause. However, the high prevalence of

  14. Mothers' guilt responses to children's obesity risk feedback.

    Science.gov (United States)

    Persky, Susan; McBride, Colleen M; Faith, Myles S; Wagner, Laura K; Ward, Dianne S

    2015-05-01

    This study explored the influence of family health history-based obesity risk feedback for their child on 147 overweight mothers' guilt related to children's lifestyle behaviors and passing down a genetic propensity for overweight. Mothers were randomized to receive, or not, obesity risk feedback for their 4- to 5-year-old child and then made food choices for them using a virtual reality-based buffet. Receipt of risk information increased lifestyle- and genetics-related guilt. Choosing fewer unhealthful foods for the child attenuated both types of guilt. Work in this area may aid in development of obesity risk feedback strategies that enhance child feeding. © The Author(s) 2015.

  15. Sleep and cardiometabolic risk in children and adolescents

    DEFF Research Database (Denmark)

    Quist, Jonas Salling; Sjödin, Anders Mikael; Chaput, Jean-Philippe

    2016-01-01

    The evidence for a link between sleep and cardiometabolic risk factors in children and adolescents is accumulating; however, the literature has not yet been reviewed. Seventy-five studies investigating associations between sleep variables and measures of abdominal adiposity, glucose homeostasis......, blood lipids, blood pressure (BP), and inflammatory markers were included in the present review. The current evidence indicates that inadequate sleep may play a role in cardiometabolic risk at a later age for children and adolescents. Most compelling is the evidence for an association between inadequate...... sleep and abdominal adiposity, decreased insulin sensitivity as well as high BP, whereas the evidence for potential links between sleep and blood lipids as well as inflammatory markers is less convincing. It should, however, be noted that the majority of studies linking sleep with cardiometabolic...

  16. Thematic Synthesis of Cardiovascular Risk Predictors in Children

    Directory of Open Access Journals (Sweden)

    Merlin Garí Llanes

    2012-12-01

    Full Text Available In recent decades, there has been an increased interest in the identification of cardiovascular disease and the factors that predispose its development in children and adolescents. In this sense, significant risk predictors have been cited, such as the presence of family and personal medical history, genetic predisposition, and the alteration of anthropometric and biochemical markers. The understanding of these factors is crucial to prevent the early onset of cardiovascular disease.

  17. Cardiovascular Risk Factors in Children and Adolescents with Subclinical Hypothyroidism.

    Science.gov (United States)

    Yadav, Yogesh; Saikia, Uma Kaimal; Sarma, Dipti; Hazarika, Manoj

    2017-01-01

    Subclinical hypothyroidism (SCH) is a commonly encountered entity in day-to-day clinical practice and has been associated with adverse cardiovascular risk profile in adults and children. Data on children and adolescents with SCH, from India, are limited. This study was a cross-sectional case-control study, conducted at a tertiary care center in Northeast India. Twenty-seven children and adolescents aged 11 ± 2.4 years with SCH and thyroid-stimulating hormone >7.5 mIU/L were included in the study along with 20 age-, gender-, and height-matched controls. Multiple clinical, biochemical, and radiological cardiovascular risk factors were assessed and compared between the two groups. Body mass index (BMI) ( P = 0.048), waist circumference ( P = 0.008), waist to height ratio ( P = 0.007), low-density lipoprotein cholesterol ( P = 0.04), triglycerides (TGs) ( P = 0.038), TGs to high-density lipoprotein (HDL) cholesterol ratio ( P = 0.005), non-HDL cholesterol ( P = 0.019), fasting insulin ( P = 0.006), and homeostasis model assessment of insulin resistance ( P = 0.007) were found to be significantly higher while free T4 ( P = 0.002) and HDL cholesterol ( P = 0.019) were found to be significantly lower in SCH subjects compared to controls. On multiple regression analysis, BMI was found to have significant association with multiple cardiovascular risk factors. Children and adolescents with SCH were found to have adverse cardiovascular risk profile. Long-term follow-up studies are required to assess the clinical significance of these findings and requirement for therapy.

  18. Improving Asthma Communication in High-Risk Children

    OpenAIRE

    Butz, Arlene M.; Walker, Jennifer; Land, Cassia Lewis; Vibbert, Carrie; Winkelstein, Marilyn

    2007-01-01

    Few child asthma studies address the specific content and techniques needed to enhance child communication during asthma preventive care visits. This study examined the content of child and parent communications regarding their asthma management during a medical encounter with their primary care provider (PCP). The majority of parents and children required prompting to communicate symptom information to the PCP during the clinic visit. Some high-risk families may require an asthma advocate to...

  19. Cardiovascular risk factors in children and adolescents with subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Yogesh Yadav

    2017-01-01

    Full Text Available Background: Subclinical hypothyroidism (SCH is a commonly encountered entity in day-to-day clinical practice and has been associated with adverse cardiovascular risk profile in adults and children. Data on children and adolescents with SCH, from India, are limited. Materials and Methods: This study was a cross-sectional case–control study, conducted at a tertiary care center in Northeast India. Twenty-seven children and adolescents aged 11 ± 2.4 years with SCH and thyroid-stimulating hormone >7.5 mIU/L were included in the study along with 20 age-, gender-, and height-matched controls. Multiple clinical, biochemical, and radiological cardiovascular risk factors were assessed and compared between the two groups. Results: Body mass index (BMI (P = 0.048, waist circumference (P = 0.008, waist to height ratio (P = 0.007, low-density lipoprotein cholesterol (P = 0.04, triglycerides (TGs (P = 0.038, TGs to high-density lipoprotein (HDL cholesterol ratio (P = 0.005, non-HDL cholesterol (P = 0.019, fasting insulin (P = 0.006, and homeostasis model assessment of insulin resistance (P = 0.007 were found to be significantly higher while free T4 (P = 0.002 and HDL cholesterol (P = 0.019 were found to be significantly lower in SCH subjects compared to controls. On multiple regression analysis, BMI was found to have significant association with multiple cardiovascular risk factors. Conclusion: Children and adolescents with SCH were found to have adverse cardiovascular risk profile. Long-term follow-up studies are required to assess the clinical significance of these findings and requirement for therapy.

  20. PHOTOSPHERIC EMISSION FROM STRATIFIED JETS

    International Nuclear Information System (INIS)

    Ito, Hirotaka; Nagataki, Shigehiro; Ono, Masaomi; Lee, Shiu-Hang; Mao, Jirong; Yamada, Shoichi; Pe'er, Asaf; Mizuta, Akira; Harikae, Seiji

    2013-01-01

    We explore photospheric emissions from stratified two-component jets, wherein a highly relativistic spine outflow is surrounded by a wider and less relativistic sheath outflow. Thermal photons are injected in regions of high optical depth and propagated until the photons escape at the photosphere. Because of the presence of shear in velocity (Lorentz factor) at the boundary of the spine and sheath region, a fraction of the injected photons are accelerated using a Fermi-like acceleration mechanism such that a high-energy power-law tail is formed in the resultant spectrum. We show, in particular, that if a velocity shear with a considerable variance in the bulk Lorentz factor is present, the high-energy part of observed gamma-ray bursts (GRBs) photon spectrum can be explained by this photon acceleration mechanism. We also show that the accelerated photons might also account for the origin of the extra-hard power-law component above the bump of the thermal-like peak seen in some peculiar bursts (e.g., GRB 090510, 090902B, 090926A). We demonstrate that time-integrated spectra can also reproduce the low-energy spectrum of GRBs consistently using a multi-temperature effect when time evolution of the outflow is considered. Last, we show that the empirical E p -L p relation can be explained by differences in the outflow properties of individual sources

  1. [Videogame addiction: a danger for only at-risk children or for all children].

    Science.gov (United States)

    Le Heuzey, Marie-France; Mouren, Marie-Christine

    2012-01-01

    With the rapid growth in the number of children and adolescents having access to videogames, there is a risk of addictive behavior, especially among those with underlying mental illnesses. Yet there is no consensual definition of videogame addiction. Depression, anxiety disorders and hostility are all associated with overuse, but attention-deficit hyperactivity disorder (ADHD) is the most significant predictor.

  2. NEUROLOGICAL DEVELOPMENT DURING TODDLING AGE IN NORMAL-CHILDREN AND CHILDREN AT RISK OF DEVELOPMENTAL DISORDERS

    NARCIS (Netherlands)

    HEMPEL, MS

    Toddling age (1.5-4 years) is a period in which the quality rather than the quantity of motor functions changes. We examined 305 normal and 43 so called 'risk' children with an examination technique which concentrates on observations of motor functions (grasping, sitting, crawling, standing and

  3. Risk factors and outcome of Shigella encephalopathy in Bangladeshi children.

    Directory of Open Access Journals (Sweden)

    Farzana Afroze

    2017-04-01

    Full Text Available Although, Shigella encephalopathy, a serious extra-intestinal complication of shigellosis, significantly increases the risks of death, data are very limited on predicting factors particularly related to electrolyte profiles in children below five years of age with Shigella encephalopathy. Our objective was to determine the clinical as well as laboratory predicting factors and outcome of children with Shigella encephalopathy.In this unmatched case-control design, children aged 2-59 months having a positive stool culture for Shigella and who had their serum electrolytes been done from July 2012 to June 2015 were studied. Children with Shigella encephalopathy, defined as having abnormal mentation, constituted the cases, and those without encephalopathy constituted the controls. During the study period, we identified a total of 541 children less than five years of age, who had Shigella in their stool culture. Only 139 children fulfilled the study criteria and among them 69 were cases and 70 were controls. The cases more often had fatal outcome compared to the controls (7% vs. 0%, P = 0.02. In logistic regression analysis, the cases were independently associated with shorter duration (1.2 ± 0.4 days of diarrhea prior to admission, dehydrating diarrhea, sepsis and hyponatremia (p<0.05 for all. Among 139 Shigella isolates, S. flexneri (88/139, 63% and S. sonnei(34/139, 24% were the dominant species. S. dysenteriae was not isolated throughout the study period. S.sonnei was more frequently isolated from the cases (24/69, 35% than the controls (10/70, 14%, whereas the isolation of S. flexneri was comparable between the groups (40/69, 58% vs 48/70, 69%. A total of 94 (67.6% isolates were resistant to trimethoprim-sulphamethoxazole, 84 (60.4% to ciprofloxacin, 66/138 (48% to ampicillin, 5 (3.5% to ceftriaxone, 17 (12.2% to mecillinum and 35 (25% to azithromycin.The case-fatality-rate was significantly higher among the children with Shigella encephalopathy

  4. Hematologic risk factors for stroke in Saudi children

    International Nuclear Information System (INIS)

    Salih, Mustafa S.; Al-Jarallah, Ahmad A.; Alorainy, Ibrahim A.

    2006-01-01

    Objective was to explore the hematologic risk factors for stroke in cohort of Saudi children. We evaluated children at the Division of Pediatric Neurology at King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, during the periods July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Investigations for suspected cases included neuroimaging, transcranial Dopppler (TCD) for cases of sickle cell diseases (SCD), and Duplex scan. Hemostatic assays included coagulation screening tests, tests of thrombin generation and fibrinolysis, coagulation inhibitors, and activated protein C resistance. During the study period, 104 Saudi children (aged one month to 12 years) with stroke were seen. The mean age of the cohort was 27.1 months (SD=39.3 months) and median was 6 months. Ischemic strokes accounted for the majority of cases (76%). A major risk factor was identified in 93 of 104 cases of stroke (89.4%). Hematologic disorders were the most common (46.2%), followed by prothrombic disorders (31.7%); microcystic hypochromic anemia (26%); sickle cell disease (SCD), or SCB-thalassemia, (11.5%), and factor IX deficiency (2.9%). Raised anticardiolipin antibodies (13/49, 26.5%) was the most frequent abnormality. Deficiencies of the natural anticoagulants (protein S, protein C and antithrombin III) were as follows: protein S (15/70, 21.4%); protein C (15/70,21.4%) and combined deficiency of 2 or more inhibitors (9/70, 12.9%). Activated protein C resistance has not been detected. Contrary to the findings of previous studies from Saudi Arabia, SCD is a common risk factor and is severe, as it resulted in multiple strokes. Moyamoya syndrome was diagnosed in 2 patients with SCD, one of whom had revascularization surgery (encephaldoduroarteriosynangiosis). Assessment of children with SCD at a risk of stroke was helped by the introduction of TCD followed by neuroimaging, using MRI and magnetic resonanceangiography

  5. Risk factors for postural tachycardia syndrome in children and adolescents.

    Directory of Open Access Journals (Sweden)

    Jing Lin

    Full Text Available BACKGROUND: Postural tachycardia syndrome (POTS is prevalent in children and adolescents and has a great impact on health. But its risk factors have not been fully understood. This study aimed to explore possible risk factors for children and adolescents with POTS. METHODS AND FINDINGS: 600 children and adolescents (test group aged 7-18 (11.9 ± 3.0 years old, 259 males and 341 females, were recruited for identifying its risk factors. Another 197 subjects aged from 7 to 18 (11.3 ± 2.3 years old were enrolled in the validation group. Heart rate (HR and blood pressure (BP were monitored during upright test. Risk factors were analyzed and sensitivity and specificity for predicting POTS were tested via receiver operating characteristic curve. Among 600 subjects, 41 were confirmed with POTS patients (6.8% based on clinical manifestation and upright test. The results showed a significant difference in daily water intake, the daily sleeping hours, supine HR, HR increment and maximum HR during upright test between POTS and the unaffected children (P<0.05. Likelihood of POTS would increase by 1.583 times if supine HR was increased by 10 beats/min (95%CI 1.184 to 2.116, P<0.01, by 3.877 times if a child's water intake was less than 800 ml/day (95%CI 1.937 to 7.760, P<0.001, or by 5.905 times (95%CI 2.972 to 11.733, P<0.001 if sleeping hours were less than 8 hours/day. Supine HR, daily water intake and sleeping hours showed the capability of predicting POTS in children and adolescents with an AUC of 83.9% (95% CI: 78.6%-89.1%, sensitivity of 80.5% and specificity of 75%. Furthermore, in validation group, predictive sensitivity and specificity were 73.3% and 72.5%. CONCLUSION: Faster supine HR, less water intake and shorter sleeping hours were identified as risk factors for POTS.

  6. Individual Differences in Children's Risk Perception and Appraisals in Outdoor Play Environments

    Science.gov (United States)

    Little, Helen; Wyver, Shirley

    2010-01-01

    Child characteristics including age, gender, risk-taking behaviour and sensation seeking are thought to influence children's ability to appraise risks. The present study investigated children's risk perceptions and appraisals in the context of common outdoor physical play activities. Risk perceptions and appraisal of four- and five-year olds were…

  7. Stratified Outcome Evaluation of Peritonitis

    African Journals Online (AJOL)

    Risk evaluation in secondary peritonitis can direct treatment planning, predict ... ulcer (22.9%) and ileum (18.6%). Patients who complicated .... Frequency Percentage. Appendicitis. 22. 31.4%. Duodenal perforation. 16. 22.9%. Ileal. 13. 18.6%.

  8. [Diagnostic evaluation of the developmental level in children identified at risk of delay through the Child Development Evaluation Test].

    Science.gov (United States)

    Rizzoli-Córdoba, Antonio; Campos-Maldonado, Martha Carmen; Vélez-Andrade, Víctor Hugo; Delgado-Ginebra, Ismael; Baqueiro-Hernández, César Iván; Villasís-Keever, Miguel Ángel; Reyes-Morales, Hortensia; Ojeda-Lara, Lucía; Davis-Martínez, Erika Berenice; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Sidonio-Aguayo, Beatriz; Palma-Tavera, Josuha Alexander; Muñoz-Hernández, Onofre

    The Child Development Evaluation (or CDE Test) was developed in Mexico as a screening tool for child developmental problems. It yields three possible results: normal, slow development or risk of delay. The modified version was elaborated using the information obtained during the validation study but its properties according to the base population are not known. The objective of this work was to establish diagnostic confirmation of developmental delay in children 16- to 59-months of age previously identified as having risk of delay through the CDE Test in primary care facilities. A population-based cross-sectional study was conducted in one Mexican state. CDE test was administered to 11,455 children 16- to 59-months of age from December/2013 to March/2014. The eligible population represented the 6.2% of the children (n=714) who were identified at risk of delay through the CDE Test. For inclusion in the study, a block randomization stratified by sex and age group was performed. Each participant included in the study had a diagnostic evaluation using the Battelle Development Inventory, 2 nd edition. From the 355 participants included with risk of delay, 65.9% were male and 80.2% were from rural areas; 6.5% were false positives (Total Development Quotient ˃90) and 6.8% did not have any domain with delay (Domain Developmental Quotient <80). The proportion of delay for each domain was as follows: communication 82.5%; cognitive 80.8%; social-personal 33.8%; motor 55.5%; and adaptive 41.7%. There were significant differences in the percentages of delay both by age and by domain/subdomain evaluated. In 93.2% of the participants, developmental delay was corroborated in at least one domain evaluated. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  9. The Relative Risk of Divorce in Parents of Children With Developmental Disabilities: Impacts of Lifelong Parenting.

    Science.gov (United States)

    Namkung, Eun Ha; Song, Jieun; Greenberg, Jan S; Mailick, Marsha R; Floyd, Frank J

    2015-11-01

    We prospectively examined the risk of divorce in 190 parents of children with developmental disabilities compared to 7,251 parents of children without disabilities based on a random sample drawn from the community and followed longitudinally for over 50 years. A significant interaction between the parental group status and number of children was found: In the comparison group, having a larger number of children was related to an increased risk of divorce, whereas the number of children did not increase divorce risk among parents of children with developmental disabilities.

  10. The Relative Risk of Divorce in Parents of Children with Developmental Disabilities: Impacts of Lifelong Parenting

    Science.gov (United States)

    Song, Jieun; Greenberg, Jan S.; Mailick, Marsha R.; Floyd, Frank J.

    2015-01-01

    We examined prospectively the risk of divorce in 190 parents of children with developmental disabilities compared to 7,251 parents of children without disabilities based on a random sample drawn from the community and followed longitudinally for over 50 years. A significant interaction between the parental group status and number of children was found: In the comparison group, having a larger number of children was related to an increased risk of divorce, whereas the number of children did not increase divorce risk among parents of children with developmental disabilities. PMID:26505872

  11. [Nutritional risk screening and its clinical significance in 706 children hospitalized in the surgical department].

    Science.gov (United States)

    Peng, Lu-Ting; Li, Rong; Zhao, Wei-Hua; Chen, Yin-Hua; Li, Xiao-Mei; Chen, Meng-Ying; Cao, Jia; Li, Xiao-Nan

    2013-10-01

    To investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management. Nutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded. Of the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (Pnutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (Pnutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (Pnutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.

  12. Brooding Rumination and Risk for Depressive Disorders in Children of Depressed Mothers

    Science.gov (United States)

    Gibb, Brandon E.; Grassia, Marie; Stone, Lindsey B.; Uhrlass, Dorothy J.; McGeary, John E.

    2012-01-01

    The goal of the current study was to examine the role of brooding rumination in children at risk for depression. We found that children of mothers with a history of major depression exhibited higher levels of brooding rumination than did children of mothers with no depression history. Examining potential mechanisms of this risk, we found no…

  13. Preschool Language Profiles of Children at Family Risk of Dyslexia: Continuities with Specific Language Impairment

    Science.gov (United States)

    Nash, Hannah M.; Hulme, Charles; Gooch, Debbie; Snowling, Margaret J.

    2013-01-01

    Background: Children at family risk of dyslexia have been reported to show phonological deficits as well as broader language delays in the preschool years. Method: The preschool language skills of 112 children at family risk of dyslexia (FR) at ages 3½ and 4½ were compared with those of children with SLI and typically developing (TD) controls.…

  14. [Risk factors associated with the development of leukemia in children].

    Science.gov (United States)

    Fajardo-Gutiérrez, A; Garduño-Espinosa, J; Yamamoto-Kimura, L; Hernández-Hernández, D M; Mejía-Aranguré, M; Gómez-Delgado, A; Farfán-Canto, J M; Ortiz-Fernández, A; Martínez-García, M C

    1993-04-01

    Leukemia is the most frequent neoplasia in children; in our country it is the main cause of medical attention in children with cancer. The are different risk factors associated with the development of this kind of cancer. To identify which of the already known factors described in the literature associated with the development of leukemia are most frequent in the pediatric population of Mexico City. A protective case-control study was carried out using prevalent and incident cases. In two third level hospitals of Mexico City, a total of 81 children who had been diagnosed as suffering from different kind of leukemia, confirmed by biopsy of bone marrow, were select and studied. The control were 154 children from two different sources: 77 of them came from the same hospital where the cases received medical care, the selection criteria was not to have any kind of neoplasia; and 77 came from the same community where those diagnosed children cases lived, the selection criteria for this group was that they were healthy children. Both cases and community controls were visited at home and interview to complete precoded questionnaire with the different variables of the study. The information from the hospital controls was obtained during the time they stayed in the hospital. Odds ratio (OR's) for the different associations were calculated, as well as its confidence intervals at 95% (IC) accord to Cornfield and unconditioned logistic regression was carried out to control confounding variables. OR greater than 1 was found in those with familiar cancer background 1.93 (1.2-3.63); the mother being exposed to X-ray during pregnancy 1.89 (0.84-4.22); previous abortions before the child with leukemia was born 2.44 (1-06-5.68); being born from full term birth 2.42 (0.47-16.65); being born with weight greater that 3500 g 2.21 (1.04-4.33); being exposed to fertilizers 4.73 (1.04-24.14) and insecticides 1.93 (1.05-3.56). OR smaller than 1 was found in those who have been in a hospital

  15. Chronic acetaminophen overdosing in children: risk assessment and management.

    Science.gov (United States)

    Sztajnkrycer, M J; Bond, G R

    2001-04-01

    Acetaminophen is currently the pediatric analgesic and antipyretic of choice. Although children appear to tolerate single, high-dose ingestions well, the literature is replete with reports of significant morbidity and mortality after repeated supra-therapeutic dosing. Proposed risk factors for injury with chronic use include age, total dose, duration, presence of intercurrent febrile illness, starvation, co-administration of cytochrome P450-inducing drugs, underlying hepatic disease, and unique genetic makeup. Evaluation of these children should include serum acetaminophen concentration, prothrombin time, and serum bilirubin and transaminase concentrations. The Rumack-Mathew nomogram should not be used to estimate the risk of hepatotoxicity in cases of chronic ingestion. Based on history, clinical examination, and laboratory findings, patients may be placed in three categories: those without hepatic injury and with no residual acetaminophen to be metabolized, those without injury but with some acetaminophen to be metabolized, and those with hepatotoxicity. Those without injury and no residual acetaminophen need not be treated or followed. Patients with hepatotoxicity or potential for hepatotoxicity based on residual acetaminophen should be treated with N-acetylcysteine. Most importantly, because so many parents are unaware of the potential risk of inappropriate dosing, education is the key to preventing future cases.

  16. Risk-adjusted hospital outcomes for children's surgery.

    Science.gov (United States)

    Saito, Jacqueline M; Chen, Li Ern; Hall, Bruce L; Kraemer, Kari; Barnhart, Douglas C; Byrd, Claudia; Cohen, Mark E; Fei, Chunyuan; Heiss, Kurt F; Huffman, Kristopher; Ko, Clifford Y; Latus, Melissa; Meara, John G; Oldham, Keith T; Raval, Mehul V; Richards, Karen E; Shah, Rahul K; Sutton, Laura C; Vinocur, Charles D; Moss, R Lawrence

    2013-09-01

    BACKGROUND The American College of Surgeons National Surgical Quality Improvement Program-Pediatric was initiated in 2008 to drive quality improvement in children's surgery. Low mortality and morbidity in previous analyses limited differentiation of hospital performance. Participating institutions included children's units within general hospitals and free-standing children's hospitals. Cases selected by Current Procedural Terminology codes encompassed procedures within pediatric general, otolaryngologic, orthopedic, urologic, plastic, neurologic, thoracic, and gynecologic surgery. Trained personnel abstracted demographic, surgical profile, preoperative, intraoperative, and postoperative variables. Incorporating procedure-specific risk, hierarchical models for 30-day mortality and morbidities were developed with significant predictors identified by stepwise logistic regression. Reliability was estimated to assess the balance of information versus error within models. In 2011, 46 281 patients from 43 hospitals were accrued; 1467 codes were aggregated into 226 groupings. Overall mortality was 0.3%, composite morbidity 5.8%, and surgical site infection (SSI) 1.8%. Hierarchical models revealed outlier hospitals with above or below expected performance for composite morbidity in the entire cohort, pediatric abdominal subgroup, and spine subgroup; SSI in the entire cohort and pediatric abdominal subgroup; and urinary tract infection in the entire cohort. Based on reliability estimates, mortality discriminates performance poorly due to very low event rate; however, reliable model construction for composite morbidity and SSI that differentiate institutions is feasible. The National Surgical Quality Improvement Program-Pediatric expansion has yielded risk-adjusted models to differentiate hospital performance in composite and specific morbidities. However, mortality has low utility as a children's surgery performance indicator. Programmatic improvements have resulted in

  17. Antenatal risk factors for peanut allergy in children

    Directory of Open Access Journals (Sweden)

    Binkley Karen E

    2011-10-01

    Full Text Available Abstract Background Prenatal factors may contribute to the development of peanut allergy. We evaluated the risk of childhood peanut allergy in association with pregnancy exposure to Rh immune globulin, folic acid and ingestion of peanut-containing foods. Methods We conducted a web-based case-control survey using the Anaphylaxis Canada Registry, a pre-existing database of persons with a history of anaphylaxis. A total of 1300 case children with reported peanut allergy were compared to 113 control children with shellfish allergy. All were evaluated for maternal exposure in pregnancy to Rh immune globulin and folic acid tablet supplements, as well as maternal avoidance of dietary peanut intake in pregnancy. Results Receipt of Rh immune globulin in pregnancy was not associated with a higher risk of peanut allergy (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.51 to 1.45, nor was initiation of folic acid tablet supplements before or after conception (OR 0.53, 95% CI 0.19 to 1.48. Complete avoidance of peanut-containing products in pregnancy was associated with a non-significantly lower risk of peanut allergy (OR 0.53, 95% CI 0.27 to 1.03. Conclusion The risk of childhood peanut allergy was not modified by the following common maternal exposures in pregnancy: Rh immune globulin, folic acid or peanut-containing foods. Clinical implications Rh immune globulin, folic acid supplement use and peanut avoidance in pregnancy have yet to be proven to modulate the risk of childhood anaphylaxis to peanuts. Capsule Summary Identification of prenatal factors that contribute to peanut allergy might allow for prevention of this life-threatening condition. This article explores the role of three such factors.

  18. Quantifying risk of transfusion in children undergoing spine surgery.

    Science.gov (United States)

    Vitale, Michael G; Levy, Douglas E; Park, Maxwell C; Choi, Hyunok; Choe, Julie C; Roye, David P

    2002-01-01

    The risks and costs of transfusion are a great concern in the area of pediatric spine surgery, because it is a blood-intensive procedure with a high risk for transfusion. Therefore, determining the predictors of transfusion in this patient population is an important first step and has the potential to improve upon the current approaches to reducing transfusion rates. In this study, we reveal several predictors of transfusion in a pediatric patient population undergoing spine surgery. In turn, we present a general rule of thumb ("rule of two's") for gauging transfusion risk, thus enhancing the surgeon's approach to avoiding transfusion in certain clinical scenarios. This study was conducted to determine the main factors of transfusion in a population of pediatric patients undergoing scoliosis surgery. The goal was to present an algorithm for quantifying the true risk of transfusion for various patient groups that would highlight patients "at high risk" for transfusion. This is especially important in light of the various risks associated with undergoing a transfusion, as well as the costs involved in maintaining and disposing of exogenous blood materials. This is a retrospective review of a group of children who underwent scoliosis surgery between 1988 and 1995 at an academic institution. A total of 290 patients were analyzed in this study, of which 63 were transfused and 227 were not. No outcomes measures were used in this study. A retrospective review of 290 patients presenting to our institution for scoliosis surgery was conducted, with a focus on socioclinical data related to transfusion risk. Univariate analysis and logistic regression were used to quantify the determinants of transfusion risk. Univariate analysis identified many factors that were associated with the risk of transfusion. However, it is clear that several of these factors are dependent on each other, obscuring the true issues driving transfusion need. We used multivariate analysis to control for

  19. Incorporating pharmacokinetic differences between children and adults in assessing children's risks to environmental toxicants

    International Nuclear Information System (INIS)

    Ginsberg, Gary; Hattis, Dale; Sonawane, Babasaheb

    2004-01-01

    Children's risks from environmental toxicant exposure can be affected by pharmacokinetic factors that affect the internal dose of parent chemical or active metabolite. There are numerous physiologic differences between neonates and adults that affect pharmacokinetics including size of lipid, and tissue compartments, organ blood flows, protein binding capacity, and immature function of renal and hepatic systems. These factors combine to decrease the clearance of many therapeutic drugs, which can also be expected to occur with environmental toxicants in neonates. The net effect may be greater or lesser internal dose of active toxicant depending upon how the agent is distributed, metabolized, and eliminated. Child/adult pharmacokinetic differences decrease with increasing postnatal age, but these factors should still be considered in any children's age group, birth through adolescence, for which there is toxicant exposure. Physiologically based pharmacokinetic (PBPK) models can simulate the absorption, distribution, metabolism, and excretion of xenobiotics in both children and adults, allowing for a direct comparison of internal dose and risk across age groups. This review provides special focus on the development of hepatic cytochrome P-450 enzymes (CYPs) in early life and how this information, along with many factors unique to children, can be applied to PBPK models for this receptor population. This review describes a case study involving the development of neonatal PBPK models for the CYP1A2 substrates caffeine and theophylline. These models were calibrated with pharmacokinetic data in neonates and used to help understand key metabolic differences between neonates and adults across these two drugs

  20. Acculturation, Dietary Practices and Risk for Childhood Obesity in an Ethnically Heterogeneous Population of Latino School Children in the San Francisco Bay Area

    Science.gov (United States)

    Schwartz, Norah; Jiménez-Cruz, Arturo; Bacardi-Gascon, Montserrat; Heyman, Melvin B.

    2015-01-01

    Previous studies have found increased acculturation to the US lifestyle increases risk for obesity in Latinos. However, methodologies differ, and results in children are inconsistent. Moreover, previous studies have not evaluated risk factors within the heterogeneous US population. We recruited 144 self-identified Latino school children and their mother or father in grades 4–6 in San Francisco parochial schools and South San Francisco public schools using an information letter distributed to all students. Children and parents had weights, heights, demographic information, dietary patterns and lifestyle variables collected in English or Spanish through an interview format. A high percentage of our children were overweight [≥85th percentile body mass index (BMI)] (62.5%) and obese (≥95th percentile BMI) (45.2%). Correspondingly parents also had a high percentage of overweight (BMI ≥ 25 & obesity (BMI ≥ 30) (45.3%). Mexico was the country of origin for 62.2% of parents, and 26.6% were from Central or South America. In multivariate logistic analysis, speaking Spanish at home was an independent risk factor for obesity [odds ratio (OR) 2.97, 95% confidence interval (CI) 1.28–6.86]. Eating breakfast daily (OR 0.34, 95% CI 0.15–0.78) and consumption of tortas (a Mexican fast food sandwich) (OR 0.45, 95% CI 0.21–1.00) were associated with decreased risk. In stratified analysis, significant differences in risk factors existed between Mexican origin versus Central/South American Latino children. The processes of acculturation likely impact eating and lifestyle practices differentially among Latino groups. Interventions should focus on ensuring that all children eat a nutritious breakfast and take into consideration ethnicity when working with Latino populations. PMID:22101726

  1. Pneumococcal Vaccination Recommendations for Children and Adults by Age and/or Risk Factor

    Science.gov (United States)

    Pneumococcal Vaccination Recommendations for Children 1 and Adults by Age and/or Risk Factor Routine Recommendations for Pneumococcal Conjugate Vaccine (PCV13) and Pneumococcal Polysaccharide Vaccine (PPSV23) For children Administer PCV13 ...

  2. Dutch Children at Family Risk of Dyslexia: Precursors, Reading Development, and Parental Effects

    Science.gov (United States)

    van Bergen, Elsje; de Jong, Peter F.; Regtvoort, Anne; Oort, Frans; van Otterloo, Sandra; van der Leij, Aryan

    2011-01-01

    The study concerns reading development and its precursors in a transparent orthography. Dutch children differing in family risk for dyslexia were followed from kindergarten through fifth grade. In fifth grade, at-risk dyslexic (n = 22), at-risk non-dyslexic (n = 45), and control children (n = 12) were distinguished. In kindergarten, the at-risk…

  3. Precursors of Language Ability and Academic Performance: An Intergenerational, Longitudinal Study of At-Risk Children

    Science.gov (United States)

    Campisi, Lisa; Serbin, Lisa A.; Stack, Dale M.; Schwartzman, Alex E.; Ledingham, Jane E.

    2009-01-01

    The current investigation examined whether inter-generational transfer of risk could be revealed through mothers' and preschool-aged children's expressive language, and whether continuity of risk persisted in these children's academic abilities, 3 years later. Participating families were drawn from the Concordia Longitudinal Risk Project, a…

  4. Risk factors for scoliosis in children with neuroblastoma

    International Nuclear Information System (INIS)

    Paulino, Arnold C.; Fowler, B. Zach

    2005-01-01

    Purpose: To determine the risk factors for scoliosis in children treated for neuroblastoma. Methods and materials: From 1957 to 1997, 58 children with neuroblastoma were treated at one institution and have survived a minimum of 5 years. There were 35 boys and 23 girls with a median age of 6 months (range, 2 weeks to 15 years) at initial diagnosis. Primary site was located in the adrenal gland in 25 (43.1%), abdominal/nonadrenal in 16 (27.6%), thoracic in 12 (20.7%), cervical in 3 (5.3%), and pelvic region in 2 (3.5%). The International Neuroblastoma Staging System (INSS) stage was Stage 1 in 10 (17.2%), Stage 2A in 7 (12.1%), Stage 2B in 5 (8.6%), Stage 3 in 22 (37.9%), Stage 4 in 4 (6.9%), and Stage 4S in 10 (17.2%). Thirty-three (56.9%) received chemotherapy whereas 5 (8.6%) had a laminectomy as part of the surgical procedure. Twenty-seven (46.6%) received radiotherapy (RT). Beam energy was 1.25 MV in 11 (41%), 250 kV in 10 (37%), 4 MV in 4 (15%), and 6-MV photons in 1 patient. One patient received 300 cGy in 1 fraction total skin RT using 6-MeV electrons. For the remaining patients, fraction size was 100 cGy in 6 (22%), 150-180 cGy in 11 (41%), 200 cGy in 4 (15%), and 250-300 cGy in 3. Three patients had total body irradiation at 333 cGy for 3 fractions. For all children who received RT, median total dose was 2000 cGy (range, 300-3900 cGy). Patients who were treated with RT had plain films of the irradiated area every 1 to 2 years until at least the age of puberty. Median follow-up was 10 years (range, 5-46 years). Results: The overall 5-, 10-, and 15-year scoliosis-free rates were 87.6%, 79.0%, and 76.0% respectively. Twelve (21%) developed scoliosis at a median time of 51 months (range, 8-137 months). The degree of scoliosis was mild (≤20 deg ) in 8 (67%). Four had scoliosis ranging from 30 deg to 66 deg ; 3 of these patients required surgical intervention, whereas 1 had an underlying Duchenne muscular dystrophy which manifested itself 8 years after

  5. Lipoprotein (a and cardiovascular risk factors in children and adolescents

    Directory of Open Access Journals (Sweden)

    Ástrid Camêlo Palmeira

    2013-12-01

    Full Text Available OBJECTIVE: To review the relationship between lipoprotein (a [Lp(a] and other risk factors for cardiovascular disease (CVD in children and adolescents. DATA SOURCES: This systematic review included studies from 2001 to 2011, a ten-year time period. Epidemiological studies with children and/or adolescents published in English, Portuguese or Spanish and fully available online were included. The searches were performed in Science Direct, PubMed/Medline, BVS (Biblioteca Virtual em Saúde and Cochrane Library databases, using the following combination of key-words: "lipoprotein a" and "cardiovascular diseases" and "obesity". DATA SYNTHESIS: Overall, 672 studies were obtained but only seven were included. Some studies assessed the family history for CVD. In all of them, Lp(a levels were increased in patients with family history for CVD. There was also a positive correlation between Lp(a and LDL-cholesterol, total cholesterol, and apolipoprotein B levels, suggesting an association between Lp(a levels and the lipid profile. CONCLUSIONS: The evidence that CVD may originate in childhood and adolescence leads to the need for investigating the risk factors during this period in order to propose earlier and possibly more effective interventions to reduce morbidity and mortality rates.

  6. Lipoprotein (a) and cardiovascular risk factors in children and adolescents.

    Science.gov (United States)

    Palmeira, Ástrid Camêlo; Leal, Adriana Amorim de F; Ramos, Nathaly de Medeiros N; Neto, José de Alencar F; Simões, Mônica Oliveira da S; Medeiros, Carla Campos M

    2013-12-01

    To review the relationship between lipoprotein (a) [Lp(a)] and other risk factors for cardiovascular disease (CVD) in children and adolescents. This systematic review included studies from 2001 to 2011, a ten-year time period. Epidemiological studies with children and/or adolescents published in English, Portuguese or Spanish and fully available online were included. The searches were performed in Science Direct, PubMed/Medline, BVS (Biblioteca Virtual em Saúde) and Cochrane Library databases, using the following combination of key-words: "lipoprotein a" and "cardiovascular diseases" and "obesity". Overall, 672 studies were obtained but only seven were included. Some studies assessed the family history for CVD. In all of them, Lp(a) levels were increased in patients with family history for CVD. There was also a positive correlation between Lp(a) and LDL-cholesterol, total cholesterol, and apolipoprotein B levels, suggesting an association between Lp(a) levels and the lipid profile. The evidence that CVD may originate in childhood and adolescence leads to the need for investigating the risk factors during this period in order to propose earlier and possibly more effective interventions to reduce morbidity and mortality rates.

  7. CARDIOVASCULAR RISK FACTORS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Z ABDEYASDAN

    2003-12-01

    Full Text Available Introduction: Diabetes melliuts is a chronic, metabolic disease that involves the macro and micro vascular complications and one of its maer ascular cowplications is the cardio vascular disease, as ,the risk of cardiovascular disease is 2-4 folds in diabetic patients in comparison with non diabetic individuals. The researches have demonstrated that the risk factors of the cardio vascular disease are formed at childhood. Therefore the preventive measures must begin from early childhood. So the present study was planned with the goals to determine and compare the cardia-vascular risk factors in the diabetic children with type 1 of diabetes mellitus. Method: This was an analytic, cross sectional study that has been done in two groups (case-control. In this research, 148 children, suffering from the typel diabetes mellitus being supported by the metabolism and endocrine research center, were chosen in the continues case manner and for the control group, 148 children, matched with the study group (according to the age and the sex, at 6-18 years old from the schools in Isfahan city randomly and at 2-6 years from the neiborhoods of the case group. The data-gathering tool was the questionnaires includes lipid profile, blood pressure, weight and height. To analyze the data we used the analytic (t student and logistic regression and descriptive (mean and standard deviation statistic methods and SPSS. Results: Findings revealed that the means of Lipid profile, systolic blood pressure and body mass index had not statistically significant differences in the two groups. But the mean of diastolic blood pressure and the mean arterial blood pressure in the control group were more than the case group and this difference was significant. The mean, 75 and 95 percentiles for cholesterol and LDL in all the age groups, mean, 75 and 95 percentile for triglyceride in all the age groups except the age group of 1-4 years in the diabetic and non diabetic groups were

  8. Combined impact of negative lifestyle factors on cardiovascular risk in children: a randomized prospective study

    OpenAIRE

    Meyer, Ursina; Schindler, Christian; Bloesch, Tamara; Schmocker, Eliane; Zahner, Lukas; Puder, Jardena J; Kriemler, Susi

    2014-01-01

    PURPOSE: Negative lifestyle factors are known to be associated with increased cardiovascular risk (CVR) in children, but research on their combined impact on a general population of children is sparse. Therefore, we aimed to quantify the combined impact of easily assessable negative lifestyle factors on the CVR scores of randomly selected children after 4 years. METHODS: Of the 540 randomly selected 6- to 13-year-old children, 502 children participated in a baseline health assessment, and ...

  9. Orphans and at-risk children in Haiti: vulnerabilities and human rights issues postearthquake.

    Science.gov (United States)

    Nicholas, Patrice K; George, Erin K; Raymond, Nadia; Lewis-OʼConnor, Annie; Victoria, Stephanie; Lucien, Sergeline; Peters-Lewis, Angelleen; Hickey, Nancy; Corless, Inge B; Tyer-Viola, Lynda; Davis, Sheila M; Barry, Donna; Marcelin, Naomie; Valcourt, Roodeline

    2012-01-01

    The vulnerability of children in Haiti has increased dramatically since the earthquake in January 2010. Prior to the earthquake, the prevalence of orphans and at-risk children was high but since the earthquake, more than 1 million people-with more than 380,000 children remaining displaced and living in over 1200 displacement sites. These existing conditions leave orphans and at-risk children vulnerable to exploitation, abuse, and increased risk of HIV/AIDS. This article will focus on the complex issues affecting orphans and at-risk children and the intersection with HIV/AIDS and human rights. Specific recommendations by United Nations Children's Fund are discussed. Nursing in Haiti must address the policy-related and population-specific approaches for the care of children living with or affected by HIV/AIDS.

  10. Obesity and cardiovascular risk in children and adolescents

    Directory of Open Access Journals (Sweden)

    Manu Raj

    2012-01-01

    Full Text Available The global prevalence of overweight and obesity in children and adolescents has increased substantially over the past several decades. These trends are also visible in developing economies like India. Childhood obesity impacts all the major organ systems of the body and is well known to result in significant morbidity and mortality. Obesity in childhood and adolescence is associated with established risk factors for cardiovascular diseases and accelerated atherosclerotic processes, including elevated blood pressure (BP, atherogenic dyslipidemia, atherosclerosis, metabolic syndrome, type II diabetes mellitus, cardiac structural and functional changes and obstructive sleep apnea. Probable mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system and altered vascular function. Adiposity promotes cardiovascular risk clustering during childhood and adolescence. Insulin resistance has a strong association with childhood obesity. A variety of proinflammatory mediators that are associated with cardiometabolic dysfunction are also known to be influenced by obesity levels. Obesity in early life promotes atherosclerotic disease in vascular structures such as the aorta and the coronary arteries. Childhood and adolescent adiposity has strong influences on the structure and function of the heart, predominantly of the left ventricle. Obesity compromises pulmonary function and increases the risk of sleep-disordered breathing and obstructive sleep apnea. Neglecting childhood and adolescent obesity will compromise the cardiovascular health of the pediatric population and is likely to result in a serious public health crisis in future.

  11. Suboptimal decision making by children with ADHD in the face of risk: Poor risk adjustment and delay aversion rather than general proneness to taking risks.

    Science.gov (United States)

    Sørensen, Lin; Sonuga-Barke, Edmund; Eichele, Heike; van Wageningen, Heidi; Wollschlaeger, Daniel; Plessen, Kerstin Jessica

    2017-02-01

    Suboptimal decision making in the face of risk (DMR) in children with attention-deficit hyperactivity disorder (ADHD) may be mediated by deficits in a number of different neuropsychological processes. We investigated DMR in children with ADHD using the Cambridge Gambling Task (CGT) to distinguish difficulties in adjusting to changing probabilities of choice outcomes (so-called risk adjustment) from general risk proneness, and to distinguish these 2 processes from delay aversion (the tendency to choose the least delayed option) and impairments in the ability to reflect on choice options. Based on previous research, we predicted that suboptimal performance on this task in children with ADHD would be primarily relate to problems with risk adjustment and delay aversion rather than general risk proneness. Drug naïve children with ADHD (n = 36), 8 to 12 years, and an age-matched group of typically developing children (n = 34) performed the CGT. As predicted, children with ADHD were not more prone to making risky choices (i.e., risk proneness). However, they had difficulty adjusting to changing risk levels and were more delay aversive-with these 2 effects being correlated. Our findings add to the growing body of evidence that children with ADHD do not favor risk taking per se when performing gambling tasks, but rather may lack the cognitive skills or motivational style to appraise changing patterns of risk effectively. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Caries Risk Assessment Among School Children in Davangere City Using Cariogram

    Directory of Open Access Journals (Sweden)

    Umesh Kemparaj

    2014-01-01

    Conclusions: Cariogram can be a reliable tool in caries prediction. It can aid in identifying different risk groups in a community and developing preventive strategies for reducing caries risk in children.

  13. Parental Incarceration as a Risk Factor for Children in Homeless Families

    Science.gov (United States)

    Casey, Erin C.; Shlafer, Rebecca J.; Masten, Ann S.

    2015-01-01

    The current study aimed to describe the prevalence of children of incarcerated parents (COIP) in a sample of homeless/highly mobile children, examine the relationship between parental incarceration and other risk factors, and investigate the effect of parental incarceration on child academic and mental health outcomes. The authors compared COIP (n = 45) to children whose parents were never incarcerated (n = 93) within a sample of 138, 4- to 7-year-old ethnically diverse children residing in emergency homeless shelters. Children's caregivers provided information about children's history of parental incarceration and other family experiences. Children's teachers reported academic and mental health outcomes in the subsequent school year. Compared to children with no history of parental incarceration, COIP experienced more negative life events. Regression models revealed that a history of parental incarceration was a significant predictor of teacher-reported internalizing problems. These results have implications for the identification and treatment of the highest risk homeless/highly mobile children. PMID:26478648

  14. Risk Factors for Malnutrition Among Children With Cerebral Palsy in Botswana.

    Science.gov (United States)

    Johnson, Allison; Gambrah-Sampaney, Claudia; Khurana, Esha; Baier, James; Baranov, Esther; Monokwane, Baphaleng; Bearden, David R

    2017-05-01

    Children with cerebral palsy in low-resource settings are at high risk of malnutrition, which further increases their risk of poor health outcomes. However, there are few available data on specific risk factors for malnutrition among children with cerebral palsy in the developing world. We performed a case-control study among children with cerebral palsy receiving care at a tertiary care hospital in Gaborone, Botswana. Children with cerebral palsy and malnutrition were identified according to World Health Organization growth curves and compared with subjects with cerebral palsy without malnutrition. Risk factors for malnutrition were identified using multivariable logistic regression models. These risk factors were then used to generate a Malnutrition Risk Score, and Receiver Operating Characteristic curves were used to identify optimal cutoffs to identify subjects at high risk of malnutrition. We identified 61 children with cerebral palsy, 26 of whom (43%) met criteria for malnutrition. Nonambulatory status (odds ratio 13.8, 95% confidence interval [CI] 3.8-50.1, P malnutrition. A Malnutrition Risk Score was constructed based on these risk factors, and receiver operating characteristic curve analysis demonstrated excellent performance characteristics of this score (area under the curve 0.92, 95% CI 0.89-0.94). Malnutrition is common among children with cerebral palsy in Botswana, and a simple risk score may help identify children with the highest risk. Further studies are needed to validate this screening tool and to determine optimal nutritional interventions in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Validation of an age-modified caries risk assessment program (Cariogram) in preschool children

    DEFF Research Database (Denmark)

    Holgerson, Pernilla Lif; Twetman, Svante; Stecksèn-Blicks, Christina

    2009-01-01

    OBJECTIVES: (i) To validate caries risk profiles assessed with a computer program against actual caries development in preschool children, (ii) to study the possible impact of a preventive program on the risk profiles, and (iii) to compare the individual risk profiles longitudinally. MATERIAL...... of sugar. The majority of the children who changed category displayed a lowered risk at 7 years. The intervention program seemed to impair the predictive abilities of Cariogram. CONCLUSION: A modified Cariogram applied on preschool children was not particularly useful in identifying high caries risk...

  16. Risk factors for death in children with visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Márcia Jaqueline Alves de Queiroz Sampaio

    Full Text Available BACKGROUND: Despite the major public health importance of visceral leishmaniasis (VL in Latin America, well-designed studies to inform diagnosis, treatment and control interventions are scarce. Few observational studies address prognostic assessment in patients with VL. This study aimed to identify risk factors for death in children aged less than 15 years admitted for VL treatment in a referral center in northeast Brazil. METHODOLOGY/PRINCIPAL FINDINGS: In a retrospective cohort, we reviewed 546 records of patients younger than 15 years admitted with the diagnosis of VL at the Instituto de Medicina Integral Professor Fernando Figueira between May 1996 and June 2006. Age ranged from 4 months to 13.7 years, and 275 (50% were male. There were 57 deaths, with a case-fatality rate of 10%. In multivariate logistic regression, the independent predictors of risk of dying from VL were (adjusted OR, 95% CI: mucosal bleeding (4.1, 1.3-13.4, jaundice (4.4, 1.7-11.2, dyspnea (2.8, 1.2-6.1, suspected or confirmed bacterial infections (2.7, 1.2-6.1, neutrophil count <500/mm³ (3.1, 1.4-6.9 and platelet count <50,000/mm³ (11.7, 5.4-25.1. A prognostic score was proposed and had satisfactory sensitivity (88.7% and specificity (78.5%. CONCLUSIONS/SIGNIFICANCE: Prognostic and severity markers can be useful to inform clinical decisions such as whether a child with VL can be safely treated in the local healthcare facility or would potentially benefit from transfer to referral centers where advanced life support facilities are available. High risk patients may benefit from interventions such as early use of extended-spectrum antibiotics or transfusion of blood products. These baseline risk-based supportive interventions should be assessed in clinical trials.

  17. A Preliminary Study of Screening for Risk of Autism in Children with Fragile X Syndrome: Testing Two Risk Cut-Offs for the Checklist for Autism in Toddlers

    Science.gov (United States)

    Scambler, D. J.; Hepburn, S. L.; Hagerman, R. J.; Rogers, S. J.

    2007-01-01

    Objective: Risk criteria for the Checklist for Autism in Toddlers (CHAT) and modified risk criteria (i.e. the Denver Criteria) were compared in a group of children with fragile X syndrome (FXS) and autism. Method: Participants were 17 children aged 2-4 years with DNA confirmation of FXS. Four children had autism and 13 children did not. Results:…

  18. [Incidence and risk factors for mental abnormalities in children of psychiatric inpatients].

    Science.gov (United States)

    Stelzig-Schöler, Renate; Hasselbring, Laura; Yazdi, Kurosch; Thun-Hohenstein, Leonhard; Stuppäck, Christoph; Aichhorn, Wolfgang

    2011-01-01

    Children of mentally ill parents are exposed to a variety of stress- and harmful life events. To which extent the mental illness of one or both parents affects their children's mental development is barely studied. Therefore, over a period of 6 months 142 patients with children below the age of 18 (n=237 children), who were admitted to the Dept. for Psychiatry and Psychotherapy 1 of the Paracelsus Medical University Salzburg, were questioned for abnormalities in their children's mental development. Additionally all these patients were assessed for their family situation, demographic data and psychiatric disorder. 38.4% (n=91) of the children showed mental abnormalities. The most common one were emotional (n=41), social (n=41) and learning (n=34) disabilities. Parental duration of the illness (p=0.001), age of the children (p=0.044), illness of both parents (p=0.008), longlasting family conflicts (p=0.003) and living with only one parent (p=0.012) were correlated significantly with mental abnormalities in children. The results confirm an increase risk for mental abnormalities in children of psychiatric patients. This risk varies with existing risk and protective factors, which can be partially influenced. Therefore children of mentally ill parents with problems in their mental development should be detected early. Even if genetic risk factors cannot be changed reducing known psychosocial risk factors and promotion protective factors can significantly influence a healthy development of these vulnerable children.

  19. Parental Attachment for At-Risk Children's Antisocial Behaviour: A Case of Malaysia

    Science.gov (United States)

    Abu Bakar, Siti Hajar; Wahab, Haris Abd.; Rezaul Islam, M.

    2016-01-01

    The aim of this study was twofold: to explore the influential factors of parents' attachment for at-risk children's antisocial behaviour, and to know the types of children's antisocial behaviour caused by being a single-parent family. The sample comprised 1,434 secondary school children from the state of Johore, Malaysia. Results from the…

  20. Exploring Young Children's Understanding of Risks Associated with Internet Usage and Their Concepts of Management Strategies

    Science.gov (United States)

    Ey, Lesley-Anne; Cupit, C. Glenn

    2011-01-01

    The Internet provides remarkable opportunities for children's learning and development. Nevertheless, it is unregulated and hard to control, which potentially places children at risk of exploitation. This study examined five-eight-year-old children's understanding of dangers associated with the Internet, management strategies and sources of their…

  1. Developmental Risk and Young Children's Regulatory Strategies: Predicting Behavior Problems at Age Five

    Science.gov (United States)

    Gerstein, Emily D.; Pedersen y Arbona, Anita; Crnic, Keith A.; Ryu, Ehri; Baker, Bruce L.; Blacher, Jan

    2011-01-01

    Children with early developmental delays are at heightened risk for behavior problems and comorbid psychopathology. This study examined the trajectories of regulatory capabilities and their potentially mediating role in the development of behavior problems for children with and without early developmental delays. A sample of 231 children comprised…

  2. Identifying Children at Risk for Language Impairment or Dyslexia with Group-Administered Measures

    Science.gov (United States)

    Adlof, Suzanne M.; Scoggins, Joanna; Brazendale, Allison; Babb, Spencer; Petscher, Yaacov

    2017-01-01

    Purpose: The study aims to determine whether brief, group-administered screening measures can reliably identify second-grade children at risk for language impairment (LI) or dyslexia and to examine the degree to which parents of affected children were aware of their children's difficulties. Method: Participants (N = 381) completed screening tasks…

  3. Student-Teacher Relationships for Young Children with Autism Spectrum Disorder: Risk and Protective Factors

    Science.gov (United States)

    Caplan, Barbara; Feldman, Melanie; Eisenhower, Abbey; Blacher, Jan

    2016-01-01

    The quality of early student-teacher relationships (STRs) has been shown to predict children's school adjustment, and children with autism spectrum disorder (ASD) are at risk for poor quality STRs. The present study examined 162 children with ASD (ages 4-7) and their teachers to evaluate student, teacher, and classroom characteristics that…

  4. Literacy Skill Development of Children with Familial Risk for Dyslexia through Grades 2, 3, and 8

    Science.gov (United States)

    Eklund, Kenneth; Torppa, Minna; Aro, Mikko; Leppänen, Paavo H. T.; Lyytinen, Heikki

    2015-01-01

    This study followed the development of reading speed, reading accuracy, and spelling in transparent Finnish orthography in children through Grades 2, 3, and 8. We compared 2 groups of children with familial risk for dyslexia--1 group with dyslexia (Dys _FR, n = 35) and 1 group without (NoDys_FR, n = 66) in Grade 2--with a group of children without…

  5. Grain distinct stratified nanolayers in aluminium alloys

    Energy Technology Data Exchange (ETDEWEB)

    Donatus, U., E-mail: uyimedonatus@yahoo.com [School of Materials, The University of Manchester, Manchester, M13 9PL, England (United Kingdom); Thompson, G.E.; Zhou, X.; Alias, J. [School of Materials, The University of Manchester, Manchester, M13 9PL, England (United Kingdom); Tsai, I.-L. [Oxford Instruments NanoAnalysis, HP12 2SE, High Wycombe (United Kingdom)

    2017-02-15

    The grains of aluminium alloys have stratified nanolayers which determine their mechanical and chemical responses. In this study, the nanolayers were revealed in the grains of AA6082 (T6 and T7 conditions), AA5083-O and AA2024-T3 alloys by etching the alloys in a solution comprising 20 g Cr{sub 2}O{sub 3} + 30 ml HPO{sub 3} in 1 L H{sub 2}O. Microstructural examination was conducted on selected grains of interest using scanning electron microscopy and electron backscatter diffraction technique. It was observed that the nanolayers are orientation dependent and are parallel to the {100} planes. They have ordered and repeated tunnel squares that are flawed at the sides which are aligned in the <100> directions. These flawed tunnel squares dictate the tunnelling corrosion morphology as well as appearing to have an affect on the arrangement and sizes of the precipitation hardening particles. The inclination of the stratified nanolayers, their interpacing, and the groove sizes have significant influence on the corrosion behaviour and seeming influence on the strengthening mechanism of the investigated aluminium alloys. - Highlights: • Stratified nanolayers in aluminium alloy grains. • Relationship of the stratified nanolayers with grain orientation. • Influence of the inclinations of the stratified nanolayers on corrosion. • Influence of the nanolayers interspacing and groove sizes on hardness and corrosion.

  6. Risk Diagnosis for the Development of Social Behaviour Disorders in Pre-school Children.

    Science.gov (United States)

    Butollo, W.

    This paper is a summary of a study concerned with identification of risk variables which affect the development of social and emotional behavior in young children. Families with pre-schoolers responded to a questionnaire designed to screen children who might be considered high risk. The screening results were validated with behavior observations…

  7. Risk factors for renal injury in children with a solitary functioning kidney.

    NARCIS (Netherlands)

    Westland, R.; Kurvers, R.A.; Wijk, J.A. van; Schreuder, M.F.

    2013-01-01

    OBJECTIVE: The hyperfiltration hypothesis implies that children with a solitary functioning kidney are at risk to develop hypertension, proteinuria, and chronic kidney disease. We sought to determine the presenting age of renal injury and identify risk factors for children with a solitary

  8. Dutch home-based pre-reading intervention with children at familial risk of dyslexia

    NARCIS (Netherlands)

    van Otterloo, S.G.; van der Leij, A.

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected

  9. Dutch Home-Based Pre-Reading Intervention with Children at Familial Risk of Dyslexia

    Science.gov (United States)

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…

  10. Risks/Needs of Children/Youth with Behavior Disorders in Correctional Institutions in Croatia

    Science.gov (United States)

    Ratkajec, Gabrijela; Jedud, Ivana

    2010-01-01

    Previous research and experience in Croatia show that interventions are not matched with the risk level and intervention needs of children with behavior disorders. As a result of that, the situation in Croatia requires actuarial approach to the risks and needs assessment of children and youth. The purpose of the current research is to put stronger…

  11. Identifying Learning Patterns of Children at Risk for Specific Reading Disability

    Science.gov (United States)

    Barbot, Baptiste; Krivulskaya, Suzanna; Hein, Sascha; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

    2016-01-01

    Differences in learning patterns of vocabulary acquisition in children at risk (+SRD) and not at risk (-SRD) for Specific Reading Disability (SRD) were examined using a microdevelopmental paradigm applied to the multi-trial Foreign Language Learning Task (FLLT; Baddeley et al., 1995). The FLLT was administered to 905 children from rural…

  12. Effects of Lactobacillus casei Shirota intake on caries risk in children

    Directory of Open Access Journals (Sweden)

    Yng-Tzer Joseph Lin

    2017-06-01

    Conclusion: There may be a potential cariostatic effect of short-term Yakult intake in reducing functional biofilm acidogenicity in children with certain oral biofilm and risk profile. Further studies may be needed to validate this probiotic effect. Quality risk assessment may be critical prior to prescribing/recommending Yakult as an adjunct caries-preventive treatment for children.

  13. Features and risk factors of nonfatal injury among the rural children: a survey of seven schools in a mountain area in Southwest China.

    Directory of Open Access Journals (Sweden)

    Xiu-Quan Shi

    Full Text Available We aimed to investigate the patterns and risk factors of nonfatal injuries among rural mountain-area children in southwest China.A stratified sampling method was used to recruit rural children aged 8 to 17 years (mainly 9-14 years from 7 schools. Self-reported injuries during the past 12 months and relevant concerns were collected from June to December 2012 by using a structured questionnaire in a class interview.The mean age of the 2,854 children was 12.2 ± 1.5 years. The probability of annual injury was 16.7% (95% confidence interval [95% CI] 15.3-18.1%, with slightly higher injury risk for boys than girls (17.7% vs. 16.0%; P>0.05. The top 3 causes of injuries were falls (37.3%, animal-related incidents (20.6%, and burns (14.9%. The main injury risk factors included being involved in a violent episode (odds ratio [OR] 1.34, 95% CI 1.08-1.66, P = 0.007, maltreatment by parents or guardians (1.42, 1.17-1.72, P<0.001, and being from a single-child family (1.30, 1.10-1.66, P = 0.039. Older age was a protective factor (0.81, 0.76-0.87, P<0.001.The incidence of nonfatal injury among rural children was high, and falls were the leading cause. Younger children and boys from poor-care and poor-living environments were at increased risk of injury, which requires urgent attention. Injury prevention programs targeting these issues are needed in this mountain area and similar rural regions of China.

  14. Abdominal fat and metabolic risk in obese children and adolescents.

    Science.gov (United States)

    Revenga-Frauca, J; González-Gil, E M; Bueno-Lozano, G; De Miguel-Etayo, P; Velasco-Martínez, P; Rey-López, J P; Bueno-Lozano, O; Moreno, L A

    2009-12-01

    The aim of this study was to investigate fat distribution, mainly abdominal fat, and its relationship with metabolic risk variables in a group of 126 children and adolescents (60 males and 66 females) aged 5.0 to 14.9. According to IOTF criteria, 46 were classified as normal weight, 28 overweight and 52 obese. Weight, height, waist (WC) and hip circumferences were measured. The body mass index (BMI) was calculated. Total body fat, trunkal and abdominal fat were also assessed by dual energy x-ray absorptiometry (DXA). Glucose, insulin, HDL-Cholesterol, triglycerides (TG), ferritine, homocystein and C-reactive protein (CRP) were measured. Obesity status was related with insulin concentrations, CRP, TG and HDL. Obese patients had higher abdominal fat and higher CRP values than overweight and normal subjects. All markers of central body adiposity were related with insulin and lipid metabolism; however, they were not related with homocystein or ferritin. A simple anthropometric measurement, like waist circumference, seems to be a good predictor of the majority of the obesity related metabolic risk variables.

  15. Risk factors for lower respiratory tract infections in children

    International Nuclear Information System (INIS)

    Silfeler, I.; Tanidir, I.C.

    2012-01-01

    Objectives: Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Methodology: Hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Results: Lack of vaccination, duration of breast feeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Conclusion: Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of Respiratory Infections. (author)

  16. Clinical and Surgical Factors Associated With Increased Epilepsy Risk in Children With Hydrocephalus.

    Science.gov (United States)

    Tully, Hannah M; Kukull, Walter A; Mueller, Beth A

    2016-06-01

    Children with hydrocephalus are at risk for epilepsy both due to their underlying condition and as a consequence of surgical treatment; however, the relative contributions of these factors remain unknown. The authors sought to characterize epilepsy among children with infancy-onset hydrocephalus and to examine the risks of epilepsy associated with hydrocephalus subtype and with factors related to surgical treatment. We conducted a longitudinal cohort study of all children with infancy-onset hydrocephalus treated at a major regional children's hospital during 2002 to 2012, with follow-up to ascertain risk factors and epilepsy outcome through April 2015. Poisson regression was used to calculate adjusted risk ratios and 95% confidence intervals for associations. Among 379 children with hydrocephalus, 86 (23%) developed epilepsy (mean onset age = 2.7 years), almost one fifth of whom had a history of infantile spasms. Relative to spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes had fourfold higher risks of developing epilepsy. Among children who underwent surgery, surgical infection doubled the risk of epilepsy (risk ratio = 2.0, 95% confidence interval = 1.4 to 3.0). Epilepsy was associated with surgical failure for intracranial reasons but not extracranial reasons (risk ratio = 1.7, 95% confidence interval = 1.1 to 2.7; risk ratio = 1.1, 95% confidence interval = 0.7 to 1.9, respectively). Epilepsy is common among children with hydrocephalus. Compared with children with spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes have a markedly increased risk of epilepsy. Surgical infection doubles the risk of epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Kansas Action for Children, Inc., Topeka.

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

  18. The association between creatinine versus cystatin C-based eGFR and cardiovascular risk in children with chronic kidney disease using a modified PDAY risk score.

    Science.gov (United States)

    Sharma, Sheena; Denburg, Michelle R; Furth, Susan L

    2017-08-01

    Children with chronic kidney disease (CKD) have a high prevalence of cardiovascular disease (CVD) risk factors which may contribute to the development of cardiovascular events in adulthood. Among adults with CKD, cystatin C-based estimates of glomerular filtration rate (eGFR) demonstrate a stronger predictive value for cardiovascular events than creatinine-based eGFR. The PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score is a validated tool used to estimate the probability of advanced coronary atherosclerotic lesions in young adults. To assess the association between cystatin C-based versus creatinine-based eGFR (eGFR cystatin C and eGFR creatinine, respectively) and cardiovascular risk using a modified PDAY risk score as a proxy for CVD in children and young adults. We performed a cross-sectional study of 71 participants with CKD [median age 15.5 years; inter-quartile range (IQR) 13, 17], and 33 healthy controls (median age 15.1 years; IQR 13, 17). eGFR was calculated using age-appropriate creatinine- and cystatin C-based formulas. Median eGFR creatinine and eGFR cystatin C for CKD participants were 50 (IQR 30, 75) and 53 (32, 74) mL/min/1.73 m 2 , respectively. For the healthy controls, median eGFR creatinine and eGFR cystatin were 112 (IQR 85, 128) and 106 mL/min/1.73m 2 (95, 123) mL/min/1.73 m 2 , respectively. A modified PDAY risk score was calculated based on sex, age, serum lipoprotein concentrations, obesity, smoking status, hypertension, and hyperglycemia. Modified PDAY scores ranged from -2 to 20. The Spearman's correlations of eGFR creatinine and eGFR cystatin C with coronary artery PDAY scores were -0.23 (p = 0.02) and -0.28 (p = 0.004), respectively. Ordinal logistic regression also showed a similar association of higher eGFR creatinine and higher eGFR cystatin C with lower PDAY scores. When stratified by age creatinine and eGFR cystatin C with PDAY score were modest and similar in children [-0.29 (p = 0.008) vs. -0.32 (p = 0

  19. Assessing the validity of western measurement of online risks to children in an Asian context

    OpenAIRE

    Teimouri, M; Hassan, MS; Griffiths, M; Benrazavi, SR; Bolong, J; Daud, A; Adzharuddin, NA

    2016-01-01

    Before the advent of the Internet, television with limited channels was the only media choice that most children were exposed to, and took place under family supervision. Children’s television viewing was controllable and the risks were limited to watching sexual and violent content. Nowadays, children are surrounded by a variety of digital media and are exposed to many different risks, many of which are still unknown and under-researched. For many children, the Internet is fully integrated i...

  20. Suboptimal decision making by children with ADHD in the face of risk

    DEFF Research Database (Denmark)

    Sørensen, Lin; Sonuga-Barke, Edmund; Eichele, Heike

    2017-01-01

    Objective: Suboptimal decision making in the face of risk (DMR) in children with attention-deficit hyperactivity disorder (ADHD) may be mediated by deficits in a number of different neuropsychological processes. We investigated DMR in children with ADHD using the Cambridge Gambling Task (CGT......-matched group of typically developing children (n = 34) performed the CGT. Results: As predicted, children with ADHD were not more prone to making risky choices (i.e., risk proneness). However, they had difficulty adjusting to changing risk levels and were more delay aversive-with these 2 effects being...... correlated. Conclusions: Our findings add to the growing body of evidence that children with ADHD do not favor risk taking per se when performing gambling tasks, but rather may lack the cognitive skills or motivational style to appraise changing patterns of risk effectively....

  1. Prevalence of fall injuries and risk factors for fall among hospitalized children in a specialized childrens hospital in Saudi Arabia.

    Science.gov (United States)

    AlSowailmi, Banan Abdullah; AlAkeely, Maha Heshaam; AlJutaily, Hayat Ibrahim; Alhasoon, Mohammad Abdulaziz; Omair, Amir; AlKhalaf, Hamad Abdullah

    2018-01-01

    Fall injuries among children during hospital stay is a major patient safety issue. Inpatient pediatric falls can lead to numerous negative consequences. In contrast to adults, there is a paucity of information on the prevalence and risk factors associated with children's falls during hospitalization. Identify the prevalence of fall injuries among hospital.ized children and describe the demographic and environmental factors that could predict a higher risk of severe outcomes of fall. Descriptive, cross-sectional prevalence study. Specialized children's hospital. Data was obtained through the electronic Safety Reporting System (SRS). All reported fall events during hospitalization in children less than or equal 14 years of age for the period from 1 April 2015 to 30 April 2016 were included. Fall events that occurred in the day care unit and the outpatient clinic were excluded. Prevalence and possible risk factors for fall events. 48. The prevalence of falls among the 4860 admitted children was 9.9 (95% CI=7.5, 13.1) per 1000 patients (48/4860). A majority of the falls were among boys (n=26, 54%), in the age group from 1-5 years old (n=22, 46%), in children at high risk of falling (n=35, 73%), with normal mobility status (n=21, 44%), and with no history of previ.ous falls (n=33, 69%). Severe injuries accounted for 25% of falls (n=12). However, falls among the moderate risk category (n=9, 69%) were more often severe than falls among the high risk category of children (n=12, 34%) (P=.03). Risk factor identification is required to prevent falls and their severe outcomes. Underreporting and single-centered study. None.

  2. Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children.

    Science.gov (United States)

    Wu, Yelena P; Parsons, Bridget G; Mooney, Ryan; Aspinwall, Lisa G; Cloyes, Kristin; Hay, Jennifer L; Kohlmann, Wendy; Grossman, Douglas; Leachman, Sancy A

    2018-04-06

    Melanoma prevention is essential for children who are at elevated risk for the disease due to family history. However, children who carry a familial risk for the disease do not optimally adhere to recommended melanoma preventive behaviors. The current study sought to identify perceived barriers to and facilitators of children's engagement in melanoma preventive behaviors among children at elevated risk for melanoma due to family history of the disease (i.e., having a parent with a history of melanoma) from both parents' and childrens' perspectives. Qualitative methods were employed and consisted of separate focus group discussions with children (ages 8-17 years, n = 37) and their parents (n = 39). Focus group transcripts were coded using content analysis. Parents and children reported a number of barriers and facilitators, including on the individual (e.g., knowledge and awareness, preferences), social (e.g., peer influences, family modeling and communication), and contextual (e.g., healthcare provider communication) levels. The identified categories of barriers and facilitators both confirm and extend the literature documenting the reasons children who are at elevated risk for melanoma do not engage in melanoma prevention and control behaviors. Programs aiming to decrease melanoma risk among children of melanoma survivors could help families address their barriers to preventive behavior implementation and build on facilitators. Melanoma survivors and their children could benefit from support on their interactions with healthcare providers, schools, peers, and other caregivers about melanoma prevention.

  3. Overweight and obesity in children with congenital heart disease: combination of risks for the future?

    OpenAIRE

    Barbiero, Sandra Mari; D?Azevedo Sica, Caroline; Schuh, Daniela Schneid; Cesa, Claudia Ciceri; de Oliveira Petkowicz, Rosemary; Pellanda, Lucia Campos

    2014-01-01

    Background Children who have unhealthy lifestyles are predisposed to develop hypertension, dyslipidemia and other complications. The epidemic of obesity is also affecting children with congenital heart disease. The aim of this study is to estimate the prevalence of obesity and describe associated risk factors, including family history in children with congenital heart disease. Methods A cross-sectional study with 316 children and adolescents with congenital heart disease seen in an outpatient...

  4. Brominated flame retardants in children's toys: concentration, composition, and children's exposure and risk assessment.

    Science.gov (United States)

    Chen, She-Jun; Ma, Yun-Juan; Wang, Jing; Chen, Da; Luo, Xiao-Jun; Mai, Bi-Xian

    2009-06-01

    Brominated flame retardants (BFRs), including polybrominated diphenyl ethers (PBDEs), 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE), decabromodiphenyl ethane (DBDPE), and polybrominated biphenyls (PBBs) were found in children's toys purchased from South China. The median BFR concentrations in the hard plastic toys were 53,000, 5540 ng/g, 101.1 ng/g, and 27.9 ng/g, fortotal PBDEs, DBDPE, BTBPE, and PBBs, respectively,which were notably higher than values in other toys. The PBDE concentrations were below the threshold limit (1000 ppm) required bythe European Commission's Restriction of Hazardous Substances (RoHS) and Waste Electrical and Electronic Equipment (WEEE) directives in all of the toys, except for one hard plastic toy with a total PBDE concentration of 5,344,000 ng/g. The BFR profiles in the toys were consistent with the patterns of their current production and consumption in China, where PBDEs, specifically decaBDE product, were the dominant BFR, followed by the emerging DBDPE. The relatively high concentrations of octa- and nonaBDEs in the foam toys and the results of principal component analysis (PCA) may suggest the decomposition of highly brominated BDEs during the manufacturing processes of the toys. Daily total PBDE exposures associated with toys via inhalation, mouthing, dermal contact, and oral ingestion ranged from 82.6 to 8992 pg/kg bw-day for children of 3 months to 14 years of age. Higher exposures, predominantly contributed through the mouthing pathway, were observed for infants and toddlers than for the other subgroups. In most cases, children's BFR exposure via the toys likely accounts for a small proportion of their daily BFR exposure, and the hazard quotients for noncancer risk evaluation were far below 1. To the author's knowledge, this is the first study to examine the concentrations of BFRs in toys, and the potential exposures to children.

  5. Stratified charge rotary engine for general aviation

    Science.gov (United States)

    Mount, R. E.; Parente, A. M.; Hady, W. F.

    1986-01-01

    A development history, a current development status assessment, and a design feature and performance capabilities account are given for stratified-charge rotary engines applicable to aircraft propulsion. Such engines are capable of operating on Jet-A fuel with substantial cost savings, improved altitude capability, and lower fuel consumption by comparison with gas turbine powerplants. Attention is given to the current development program of a 400-hp engine scheduled for initial operations in early 1990. Stratified charge rotary engines are also applicable to ground power units, airborne APUs, shipboard generators, and vehicular engines.

  6. Association of TSH With Cardiovascular Disease Risk in Overweight and Obese Children During Lifestyle Intervention.

    Science.gov (United States)

    Rijks, Jesse M; Plat, Jogchum; Dorenbos, Elke; Penders, Bas; Gerver, Willem-Jan M; Vreugdenhil, Anita C E

    2017-06-01

    Overweight and obese children have an increased risk to develop cardiovascular diseases (CVDs) in which thyroid-stimulating hormone (TSH) has been suggested as an intermediary factor. However, results of cross-sectional studies are inconclusive, and intervention studies investigating changes in TSH concentrations in association with changes in cardiovascular risk parameters in overweight and obese children are scarce. To gain insight in associations of circulating TSH concentrations and cardiovascular risk parameters in overweight and obese children. Nonrandomized lifestyle intervention. Centre for Overweight Adolescent and Children's Healthcare. Three hundred thirty euthyroid overweight and obese children. Long-term lifestyle intervention. TSH concentrations, pituitary TSH release in response to thyrotropin-releasing hormone (TRH), and cardiovascular risk parameters. At baseline, serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TAG), and monocyte chemotactic protein 1 concentrations were significantly associated with serum TSH concentrations. TSH release by the pituitary in response to exogenous TRH was not associated with cardiovascular risk parameters. During lifestyle intervention, several cardiovascular risk parameters significantly improved. In children whose body mass index z score improved, changes in TSH concentrations were significantly associated with changes in TC, LDL-C, and TAG concentrations. In euthyroid overweight and obese children, circulating TSH concentrations are positively associated with markers representing increased CVD risk. Changes in TSH concentrations are also associated with changes in lipid concentrations in children with successful weight loss, which is consistent with TSH being an intermediary factor in modulating lipid and lipoprotein metabolism. Copyright © 2017 Endocrine Society

  7. Daycare attendance and risk for respiratory morbidity among young very low birth weight children.

    Science.gov (United States)

    Hagen, Erika W; Sadek-Badawi, Mona; Palta, Mari

    2009-11-01

    Daycare attendance and very low birth weight (VLBW, < or =1,500 g) are associated with respiratory morbidity during childhood. The objective of this study was to evaluate whether daycare attendance is associated with even higher risk for respiratory problems among VLBW children. We hypothesized that VLBW children attending daycare, in a private home or daycare center, are at higher risk for respiratory problems than VLBW children not attending daycare. We also investigated whether the effect of daycare is independent or synergistic with respiratory risk resulting from being VLBW, as indicated by having bronchopulmonary dysplasia (BPD) as a neonate. We conducted a prospective study of VLBW children followed from birth to age 2-3 (N = 715). Logistic regression was used to evaluate the relationship between daycare attendance and respiratory problems, adjusting for known neonatal risk factors for poor respiratory outcomes. Attending daycare in either a private home or in a daycare center was significantly associated with higher risk of lower respiratory infections than never attending. Attending a daycare center was also associated with higher risk for wheezy chest, cough without a cold, and respiratory medication use. While having BPD was associated with increased risk for respiratory problems, daycare attendance and BPD were not found to be synergistic risk factors for respiratory problems among VLBW children, but acted independently to increase risk. This implies that the increase in risk for respiratory problems associated with daycare attendance may be similar among VLBW children and those of normal birth weight.

  8. Interpretation of food risks by mothers of kindergarten children in St.Petersburg, Russia, and their strategies of risk handling

    NARCIS (Netherlands)

    Gromasheva, O.

    2012-01-01

    This study discusses different types of food risks and different strategies of risk handling as conceived by mothers of kindergarten children in Russia. The research includes an analysis of Internet forum discussions and semi-structured interviews; it mainly used data from well-educated,

  9. The optimism trap: Migrants' educational choices in stratified education systems.

    Science.gov (United States)

    Tjaden, Jasper Dag; Hunkler, Christian

    2017-09-01

    Immigrant children's ambitious educational choices have often been linked to their families' high level of optimism and motivation for upward mobility. However, previous research has mostly neglected alternative explanations such as information asymmetries or anticipated discrimination. Moreover, immigrant children's higher dropout rates at the higher secondary and university level suggest that low performing migrant students could have benefitted more from pursuing less ambitious tracks, especially in countries that offer viable vocational alternatives. We examine ethnic minority's educational choices using a sample of academically low performing, lower secondary school students in Germany's highly stratified education system. We find that their families' optimism diverts migrant students from viable vocational alternatives. Information asymmetries and anticipated discrimination do not explain their high educational ambitions. While our findings further support the immigrant optimism hypothesis, we discuss how its effect may have different implications depending on the education system. Copyright © 2017. Published by Elsevier Inc.

  10. Androgen Deprivation Therapy Use in the Setting of High-dose Radiation Therapy and the Risk of Prostate Cancer–Specific Mortality Stratified by the Extent of Competing Mortality

    Energy Technology Data Exchange (ETDEWEB)

    Rose, Brent S., E-mail: brose44@gmail.com [Harvard Radiation Oncology Program, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Chen, Ming-Hui; Wu, Jing [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Braccioforte, Michelle H.; Moran, Brian J. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); Doseretz, Daniel E.; Katin, Michael J.; Ross, Rudolf H.; Salenius, Sharon A. [21st Century Oncology, Inc, Fort Myers, Florida (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2016-11-15

    Purpose: The addition of androgen deprivation therapy (ADT) to radiation therapy (RT) is the standard of care for men with intermediate- and high-risk prostate cancer (PC). However, whether competing mortality (CM) affects the ability of ADT to improve, survival remains unanswered. Methods and Materials: We calculated a CM risk score using a Fine-Gray semiparametric model that included age and cardiometabolic comorbidities from a cohort of 17,669 men treated with high-dose RT with or without supplemental ADT for nonmetastatic PC. Fine and Gray competing risk regression analysis was used to assess whether ADT reduced the risk of PC-specific mortality for men with a low versus a high risk of CM among the 4550 patients within the intermediate- and high-risk cohort after adjustment for established PC prognostic factors, year of treatment, site, and ADT propensity score. Results: After a median follow-up of 8.4 years, 1065 men had died, 89 (8.36%) of PC. Among the men with a low CM score, ADT use was associated with a significant reduction in the risk of PC-specific mortality (adjusted hazard ratio 0.35, 95% confidence interval 0.14-0.87, P=.02) but was not for men with high CM (adjusted hazard ratio 1.33, 95% confidence interval 0.77-2.30, P=.30). Conclusions: Adding ADT to high-dose RT appears to be associated with decreased PC-specific mortality risk in men with a low but not a high CM score. These data should serve to heighten awareness about the importance of considering competing risks when determining whether to add ADT to RT for older men with intermediate- or high-risk PC.

  11. Androgen Deprivation Therapy Use in the Setting of High-dose Radiation Therapy and the Risk of Prostate Cancer–Specific Mortality Stratified by the Extent of Competing Mortality

    International Nuclear Information System (INIS)

    Rose, Brent S.; Chen, Ming-Hui; Wu, Jing; Braccioforte, Michelle H.; Moran, Brian J.; Doseretz, Daniel E.; Katin, Michael J.; Ross, Rudolf H.; Salenius, Sharon A.; D'Amico, Anthony V.

    2016-01-01

    Purpose: The addition of androgen deprivation therapy (ADT) to radiation therapy (RT) is the standard of care for men with intermediate- and high-risk prostate cancer (PC). However, whether competing mortality (CM) affects the ability of ADT to improve, survival remains unanswered. Methods and Materials: We calculated a CM risk score using a Fine-Gray semiparametric model that included age and cardiometabolic comorbidities from a cohort of 17,669 men treated with high-dose RT with or without supplemental ADT for nonmetastatic PC. Fine and Gray competing risk regression analysis was used to assess whether ADT reduced the risk of PC-specific mortality for men with a low versus a high risk of CM among the 4550 patients within the intermediate- and high-risk cohort after adjustment for established PC prognostic factors, year of treatment, site, and ADT propensity score. Results: After a median follow-up of 8.4 years, 1065 men had died, 89 (8.36%) of PC. Among the men with a low CM score, ADT use was associated with a significant reduction in the risk of PC-specific mortality (adjusted hazard ratio 0.35, 95% confidence interval 0.14-0.87, P=.02) but was not for men with high CM (adjusted hazard ratio 1.33, 95% confidence interval 0.77-2.30, P=.30). Conclusions: Adding ADT to high-dose RT appears to be associated with decreased PC-specific mortality risk in men with a low but not a high CM score. These data should serve to heighten awareness about the importance of considering competing risks when determining whether to add ADT to RT for older men with intermediate- or high-risk PC.

  12. Risks and benefits of antireflux operations in neurologically impaired children

    NARCIS (Netherlands)

    Borgstein, E. S.; Heij, H. A.; Beugelaar, J. D.; Ekkelkamp, S.; Vos, A.

    1994-01-01

    Gastro-oesophageal reflux (GER) in neurologically impaired children often causes feeding problems and complications of oesophagitis and is frequently resistant to medical treatment. Fifty neurologically impaired children underwent anterior gastropexy as anti-reflux operation, combined with

  13. Workshop: Valuing Environmental Health Risk Reductions to Children (2003)

    Science.gov (United States)

    This two-day workshop on children's health valuation was co-sponsored by EPA's National Center for Environmental Economics, Office of Children's Health Protection, and National Center for Environmental Research as well as the University of Central Florida.

  14. Vigilance and iconic memory in children at high risk for alcoholism.

    Science.gov (United States)

    Steinhauer, S R; Locke, J; Hill, S Y

    1997-07-01

    Previous studies report reduced visual event-related potential (ERP) amplitudes in young males at high risk for alcoholism. These findings could involve difficulties at several stages of visual processing. This study was aimed at examining vigilance performance and iconic memory functions in children at high risk or low risk for alcoholism. Sustained vigilance and retrieval from iconic memory were evaluated in 54 (29 male) white children at high risk and 47 (25 male) white children at low risk for developing alcoholism. Children were also grouped according to gender and age (younger: 8-12 years; older: 13-18 years). No differences is visual sensitivity, response criterion or reaction time were associated with risk status on the degraded visual stimulus version of the Continuous Performance Test. For the Span of Apprehension, no differences were found due to risk status when only 1 or 5 distractors were presented, although with 9 distractors a significant effect of risk status was found when it was tested as an interaction with gender and age (decreased accuracy for older high-risk boys compared to older low-risk boys). These findings suggest that ERP deviations are not attributable to stages of visual processing deficits, but represent difficulty involving more complex utilization of information. Implications of these results are that the differences between high- and low-risk children that have been reported previously for visual ERP components (e.g., P300) are not attributable to deficits of attentional or iconic memory mechanisms.

  15. Playground slide-related injuries in preschool children: increased risk of lower extremity injuries when riding on laps.

    Science.gov (United States)

    Jennissen, Charles A; Koos, Maggie; Denning, Gerene

    2018-04-10

    The purpose of this study was to better understand the factors associated with playground slide-related injuries in preschool children and to test the hypothesis that riding on laps increases the likelihood of lower extremity injuries. Playground slide-related injuries (product code 1242) in children ≤5 years of age treated in emergency departments from 2002 to 2015 were identified (N = 12,686) using the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Descriptive and comparative analyses, including chi-square testing and binary logistic regression, were performed. Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015. Overall, 59% of the children were male, and 65% were white. Almost 60% of injuries occurred in parks or other public areas. The most frequent diagnosis was a fracture (36%); lacerations were 19% of the injuries. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3-5 years of age (p < 0.001). Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person's lap at the time of injury. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0-58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7-77.4). Decreasing age was associated with a higher likelihood of being identified as sliding down on another person's lap and a higher likelihood of lower extremity injuries. Healthcare providers should be mindful of the potential for these slide-related injuries as they can result in a toddler's fracture of

  16. Nitrogen transformations in stratified aquatic microbial ecosystems

    DEFF Research Database (Denmark)

    Revsbech, N. P.; Risgaard-Petersen, N.; Schramm, A.

    2006-01-01

    Abstract  New analytical methods such as advanced molecular techniques and microsensors have resulted in new insights about how nitrogen transformations in stratified microbial systems such as sediments and biofilms are regulated at a µm-mm scale. A large and ever-expanding knowledge base about n...

  17. Increased Risk of Tics in Children Infected with Enterovirus: A Nationwide Population-Based Study.

    Science.gov (United States)

    Lin, Jiun-Nong; Lin, Cheng-Li; Yen, Hung-Rong; Yang, Chi-Hui; Lai, Chung-Hsu; Lin, Hsi-Hsun; Kao, Chia-Hung

    2017-05-01

    Both tics and enterovirus (EV) infections are common in children. The association between EV infections and tics has been seldom evaluated. The aim of this study was to evaluate the risk of diagnosed tics after EV infections in children. A nationwide retrospective cohort study was conducted to determine the risk of tics after EV infections by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged tics, death, loss to follow-up, withdrawal from the insurance system, or December 31, 2008. A total of 282,321 EV-infected and 282,317 non-EV-infected children were included in this study. The mean age was 2.39 years in both cohorts. The overall incidences of tics were 9.12 and 6.21 per 10,000 person-years in the EV-infected and non-EV-infected cohorts, respectively. Children with EV infection were significantly associated with an increased risk of tics compared with those without EV infection (adjusted hazard ratio, 1.38; 95% confidence interval, 1.27-1.5). Multivariable analyses showed that boys, children living in urbanized areas, children whose parents had white-collar jobs, and children with allergic rhinitis or bronchial asthma exhibited a significantly increased risk of tics. This study revealed an increased risk of tics after EV infection in children.

  18. Cross sectional study of childhood obesity and prevalence of risk factors for cardiovascular disease and diabetes in children aged 11–13

    Directory of Open Access Journals (Sweden)

    Brophy Sinead

    2009-03-01

    Full Text Available Abstract Background Childhood obesity levels are rising with estimates suggesting that around one in three children in Western countries are overweight. People from lower socioeconomic status and ethnic minority backgrounds are at higher risk of obesity and subsequent CVD and diabetes. Within this study we examine the prevalence of risk factors for CVD and diabetes (obesity, hypercholesterolemia, hypertension and examine factors associated with the presence of these risk factors in school children aged 11–13. Methods and design Participants will be recruited from schools across South Wales. Schools will be selected based on catchment area, recruiting those with high ethnic minority or deprived catchment areas. Data collection will take place during the PE lessons and on school premises. Data will include: anthropometrical variables (height, weight, waist, hip and neck circumferences, skinfold thickness at 4 sites, physiological variables (blood pressure and aerobic fitness (20 metre multi stage fitness test (20 MSFT, diet (self-reported seven-day food diary, physical activity (Physical Activity Questionnire for Adolescents (PAQ-A, accelerometery and blood tests (fasting glucose, insulin, lipids, fibrinogen (Fg, adiponectin (high molecular weight, C-reactive protein (CRP and interleukin-6 (IL-6. Deprivation at the school level will be measured via information on the number of children receiving free school meals. Townsend deprivation scores will be calculated based on the individual childs postcode and self assigned ethnicity for each participating child will be collected. It is anticipated 800 children will be recruited. Multilevel modeling will be used to examine shared and individual factors associated with obesity, stratified by ethnic background, deprivation level and school. Discussion This study is part of a larger project which includes interviews with older children regarding health behaviours and analysis of existing cohort studies

  19. Environmental lead exposure risks associated with children's outdoor playgrounds

    International Nuclear Information System (INIS)

    Taylor, Mark Patrick; Camenzuli, Danielle; Kristensen, Louise Jane; Forbes, Miriam; Zahran, Sammy

    2013-01-01

    This study examines exposure risks associated with lead smelter emissions at children's public playgrounds in Port Pirie, South Australia. Lead and other metal values were measured in air, soil, surface dust and on pre- and post-play hand wipes. Playgrounds closest to the smelter were significantly more lead contaminated compared to those further away (t(27.545) = 3.76; p = .001). Port Pirie post-play hand wipes contained significantly higher lead loadings (maximum hand lead value of 49,432 μg/m 2 ) than pre-play hand wipes (t(27) = 3.57, p = .001). A 1% increase in air lead (μg/m 3 ) was related to a 0.713% increase in lead dust on play surfaces (95% CI, 0.253–1.174), and a 0.612% increase in post-play wipe lead (95% CI, 0.257–0.970). Contaminated dust from smelter emissions is determined as the source and cause of childhood lead poisoning at a rate of approximately one child every third day. -- Highlights: •Spatial and temporal variations in lead exposure due to smelter emissions is examined. •Exposure to lead and other metals is evaluated using pre and post-play hand wipe measures. •The relationship of smelter emissions to surface and hand lead exposures is modelled. •A 1% increase in air lead (μg/m 3 ) was related to a 0.713% increase in lead dust on play surfaces. -- Playgrounds in Port Pirie are seriously contaminated by smelter emissions, with levels of surface dust and hand dust that pose a significant risk of harm to human health

  20. [Characteristics of growth and development in children from families at social risk].

    Science.gov (United States)

    Stojadinović, A

    2001-01-01

    Body height and weight are important indicators of children's health status. There are many evidences that children from disadvantaged families have lower height and weight than children of the same age from families without social risk. The aim of this study was to investigate characteristics of growth and development of children from economically disadvantaged families. The study was partly retrospective and partly prospective. The retrospective study included 509 children from disadvantaged families hospitalized at the Institute of Child and Adolescent Health Care in Novi Sad, during a five-year period. The prospective study included 90 children from disadvantaged families (experimental group) and 132 children from families without social risk (control group) hospitalized at the Institute during a six month period. Height/length, weight, head circumference, and psychomotor/intellectual development have been examined. In the retrospective study results were compared with theoretically expected values, whereas the prospective study results of experimental and control group were compared. In the retrospective study that included only children from disadvantaged families, 136 (26.7%) children had height/length, 173 (34%) had weight, and 86 (16.9%) children had head circumference below 10th percentile. Delay in psychomotor/intellectual development was established in 177 (34.8%) children. Children from families with social risk have significantly more often height/length, weight, head circumference and developmental delay than theoretically expected. In the prospective study 40 (44.4%) children from experimental group had height/length, 29 (32.2%) had weight, 20 (22.2%) children had head circumference below 10th percentile, and 17 (26.2%) had delay in psychomotor/intellectual development. Children from disadvantaged families (experimental group) significantly more often had delay in growth and development comparing with children from families without social risk

  1. Type 1 diabetes risk in children born to women with fertility problems

    DEFF Research Database (Denmark)

    Hargreave, Marie; Kjaer, Susanne K; Jørgensen, Marit E

    2016-01-01

    INTRODUCTION: While some studies have indicated that children born following fertility treatment are at an increased risk for insulin resistance and higher blood glucose levels, no study to date has investigated the risk of type 1 diabetes. In this large population-based cohort study we aim...... to assess the association between maternal fertility problems and the risk of type 1 diabetes in children. MATERIAL AND METHODS: Information on all children, born in Denmark from 1987 to 2010, was extracted from the Civil Registration System and linked with the Danish Infertility Cohort to identify maternal......%) were born to women with fertility problems. In all, 313 children born to women with fertility problems (0.36%) and 5176 children born to women without fertility problems (0.28%) were diagnosed with type 1 diabetes. The risk of type 1 diabetes was not affected by maternal fertility status (hazard ratio...

  2. Caries Risk Profiles amongst Preschool Aged Children Living in the Sleman District of Yogyakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Elastria Widita

    2017-04-01

    Full Text Available Objective: To assess the caries risk factors of preschool aged children. Methods: Data was collected from a sample of 85 preschool children and their mothers. An interview, and a clinical and microbiology assessment was included in this study. Clinical examinations were performed to measure the dental caries experience and plaque visibility of the children and mothers. The presence and levels of Mutans Streptococci (MS in the saliva was measured using a commercial kit by Dentocult SM and evaluated using the manufacturer’s chart. Results: Sixty-five children had a high risk of caries (76.5%, 12.9% had a low risk, and 10.6% had a moderate risk of caries. Active cavities were found in more than half of the mothers and children. The majority of the child subjects had a snacking habit between meals (85.9%. High risk scores of 2 and 3, indicating salivary levels of MS, was found in 41.1% of children. Fluoride exposure experienced by the study population was very limited. Conclusion: Results suggest that the majority of the population had a high caries risk. There was a high occurrence of teeth with cavities in children and active carious lesions in the mothers. There was a high frequency in snacking habits, the presence of plaque and bleeding gums, high levels of salivary MS, and low protective factors for the children. Results suggest that management of caries related factors are needed in order to prevent caries in the future. 

  3. Violence in Children's Television Programming: Assessing the Risks.

    Science.gov (United States)

    Wilson, Barbara J.; Smith, Stacy L.; Potter, W. James; Kunkel, Dale; Linz, Daniel; Colvin, Carolyn M.; Donnerstein, Edward

    2002-01-01

    Investigates the nature and extent of violence contained in television programming that targets children aged 12 and younger. Notes that the violence itself is just as likely to be glamorized in children's as in nonchildren's shows, but it is even more sanitized and more likely to be trivialized. Documents five subgenres of children's programming…

  4. Risk factors for children's receptive vocabulary development from four to eight years in the longitudinal study of Australian children.

    Directory of Open Access Journals (Sweden)

    Catherine L Taylor

    Full Text Available Receptive vocabulary develops rapidly in early childhood and builds the foundation for language acquisition and literacy. Variation in receptive vocabulary ability is associated with variation in children's school achievement, and low receptive vocabulary ability is a risk factor for under-achievement at school. In this study, bivariate and multivariate growth curve modelling was used to estimate trajectories of receptive vocabulary development in relation to a wide range of candidate child, maternal and family level influences on receptive vocabulary development from 4-8 years. The study sample comprised 4332 children from the first nationally representative Longitudinal Study of Australian Children (LSAC. Predictors were modeled as risk variables with the lowest level of risk as the reference category. In the multivariate model, risks for receptive vocabulary delay at 4 years, in order of magnitude, were: Maternal Non- English Speaking Background (NESB, low school readiness, child not read to at home, four or more siblings, low family income, low birthweight, low maternal education, maternal mental health distress, low maternal parenting consistency, and high child temperament reactivity. None of these risks were associated with a lower rate of growth from 4-8 years. Instead, maternal NESB, low school readiness and maternal mental health distress were associated with a higher rate of growth, although not sufficient to close the receptive vocabulary gap for children with and without these risks at 8 years. Socio-economic area disadvantage, was not a risk for low receptive vocabulary ability at 4 years but was the only risk associated with a lower rate of growth in receptive vocabulary ability. At 8 years, the gap between children with and without socio-economic area disadvantage was equivalent to eight months of receptive vocabulary growth. These results are consistent with other studies that have shown that social gradients in children

  5. Risk factors for children's receptive vocabulary development from four to eight years in the longitudinal study of Australian children.

    Science.gov (United States)

    Taylor, Catherine L; Christensen, Daniel; Lawrence, David; Mitrou, Francis; Zubrick, Stephen R

    2013-01-01

    Receptive vocabulary develops rapidly in early childhood and builds the foundation for language acquisition and literacy. Variation in receptive vocabulary ability is associated with variation in children's school achievement, and low receptive vocabulary ability is a risk factor for under-achievement at school. In this study, bivariate and multivariate growth curve modelling was used to estimate trajectories of receptive vocabulary development in relation to a wide range of candidate child, maternal and family level influences on receptive vocabulary development from 4-8 years. The study sample comprised 4332 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Predictors were modeled as risk variables with the lowest level of risk as the reference category. In the multivariate model, risks for receptive vocabulary delay at 4 years, in order of magnitude, were: Maternal Non- English Speaking Background (NESB), low school readiness, child not read to at home, four or more siblings, low family income, low birthweight, low maternal education, maternal mental health distress, low maternal parenting consistency, and high child temperament reactivity. None of these risks were associated with a lower rate of growth from 4-8 years. Instead, maternal NESB, low school readiness and maternal mental health distress were associated with a higher rate of growth, although not sufficient to close the receptive vocabulary gap for children with and without these risks at 8 years. Socio-economic area disadvantage, was not a risk for low receptive vocabulary ability at 4 years but was the only risk associated with a lower rate of growth in receptive vocabulary ability. At 8 years, the gap between children with and without socio-economic area disadvantage was equivalent to eight months of receptive vocabulary growth. These results are consistent with other studies that have shown that social gradients in children's developmental outcomes

  6. Type 2 diabetes in children: Clinical aspects and risk factors

    Directory of Open Access Journals (Sweden)

    P V Rao

    2015-01-01

    Full Text Available A strong link between obesity, insulin resistance, and metabolic syndrome has been reported with development of a new paradigm to type 2 diabetes mellitus (T2DM, with some evidence suggesting that beta-cell dysfunction is present before the onset of impaired glucose tolerance. Differentiating type 1 diabetes mellitus (T1DM from T2DM is actually not very easy and there exists a number of overlapping characteristics. The autoantibody frequencies of seven antigens in T1DM patients may turn out to be actually having T2DM patients (pre-T2DM. T2DM patients generally have increased C-peptide levels (may be normal at time of diagnosis, usually no auto-antibodies, strong family history of diabetes, obese and show signs of insulin resistance (hypertension, acanthosis, PCOS. The American Academy of Paediatrics recommends lifestyle modifications ± metformin when blood glucose is 126-200 mg/dL and hemoglobin A1c (HbA1c 200 mg/dL and HbA1c >8.5, with or without ketosis. Metformin is not recommended if the patient is ketotic, because this increases the risk of lactic acidosis. Metformin is currently the only oral hypoglycemic that has been approved for use in children. Knowing these subtle differences in mechanism, and knowing how to test patients for which mechanism (s are causing their diabetes mellitus, may help us eventually tailor treatment programs on an individual basis.

  7. Firm maternal parenting associated with decreased risk of excessive snacking in overweight children.

    Science.gov (United States)

    Rhee, Kyung E; Boutelle, Kerri N; Jelalian, Elissa; Barnes, Richard; Dickstein, Susan; Wing, Rena R

    2015-06-01

    To examine the relationship between parent feeding practices (restriction, monitoring, pressure to eat), general parenting behaviors (acceptance, psychological control, firm control), and aberrant child eating behaviors (emotional eating and excessive snacking) among overweight and normal weight children. Overweight and normal weight children between 8 and 12 years old and their mothers (n = 79, parent-child dyads) participated in this study. Mothers completed surveys on parent feeding practices (Child Feeding Questionnaire) and child eating behaviors (Family Eating and Activity Habits Questionnaire). Children reported on their mothers' general parenting behaviors (Child Report of Parent Behavior Inventory). Parent and child height and weight were measured and demographic characteristics assessed. Logistic regression models, stratified by child weight status and adjusting for parent BMI, were used to determine which parenting dimensions and feeding practices were associated with child emotional eating and snacking behavior. Overweight children displayed significantly more emotional eating and excessive snacking behavior than normal weight children. Mothers of overweight children used more restrictive feeding practices and psychological control. Restrictive feeding practices were associated with emotional eating in the overweight group (OR = 1.26, 95 % CI, 1.02, 1.56) and excessive snacking behavior in the normal weight group (OR = 1.13, 95 % CI, 1.01, 1.26). When examining general parenting, firm control was associated with decreased odds of excessive snacking in the overweight group (OR = 0.51, 95 % CI, 0.28, 0.93). Restrictive feeding practices were associated with aberrant child eating behaviors in both normal weight and overweight children. Firm general parenting however, was associated with decreased snacking behavior among overweight children. Longitudinal studies following children from infancy are needed to better understand the direction of these

  8. Parents' Attitudes to Risk and Injury to Children and Young People on Farms.

    Science.gov (United States)

    Nilsson, Kerstin

    2016-01-01

    Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents' attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground. Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically. The analysis pursued four themes: i) the most dangerous places and situations on the farm; ii) children's tasks on the farm; iii) children as a safety risk on the farm; and iv) farm risk education for children. Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children's friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes 'blind' to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion.

  9. Parents' Attitudes to Risk and Injury to Children and Young People on Farms.

    Directory of Open Access Journals (Sweden)

    Kerstin Nilsson

    Full Text Available Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents' attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground.Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically.The analysis pursued four themes: i the most dangerous places and situations on the farm; ii children's tasks on the farm; iii children as a safety risk on the farm; and iv farm risk education for children.Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children's friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes 'blind' to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion.

  10. Evaluation of a Stratified National Breast Screening Program in the United Kingdom : An Early Model-Based Cost-Effectiveness Analysis

    NARCIS (Netherlands)

    Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla; Evans, D. Gareth R.; Astley, Sue; Payne, Katherine

    Objectives: To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. Methods: A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1,

  11. Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis

    NARCIS (Netherlands)

    Gray, E.; Donten, A.; Karssemeijer, N.; Gils, C. van; Evans, D.G.; Astley, S.; Payne, K.

    2017-01-01

    OBJECTIVES: To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. METHODS: A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1,

  12. Serum galactomannan screening for diagnosis of invasive pulmonary aspergillosis in children after stem cell transplantation or with high-risk leukemia.

    Science.gov (United States)

    Gefen, Aharon; Zaidman, Irina; Shachor-Meyouhas, Yael; Avidor, Israela; Hakim, Fahed; Weyl Ben-Arush, Myriam; Kassis, Imad

    2015-03-01

    Both transplanted and leukemia patients are at high risk (HR) for invasive pulmonary aspergillosis (IPA). Methods for rapid diagnosis are crucial. Our objective was to investigate the impact of serial serum galactomannan assay (GMA) screening on IPA diagnosis in children. Between January 2010 and December 2011, all children following stem cell transplantation (SCT) or with HR leukemia were prospectively included. Serum samples for GMA were taken once-twice weekly. Results >.5 were considered positive. Patients suspected of having IPA were stratified as possible, probable, and definite. Forty-six children (median age, 8 years) were included, 38 after SCT (32 allogeneic), 8 with HR leukemia. A total of 510 samples were taken; screening period was 1-6 months for 34 patients. GMA was negative in 28 patients, all but one without suspicion of IPA. Eighteen patients had positive GMA: while four (22%) were upgraded to probable IPA, fourteen (78%) were considered as false positives (FP), some associated with piperacillin-tazobactam treatment. GMA sensitivity and specificity were 0.8 and 0.66, respectively; positive- and negative-predictive values (PPV, NPV) were 0.22 and 0.96, respectively. GMA may have a role in evaluating HR children for IPA. Both NPV and FP rates are high. The cost benefit of early detection versus over-diagnosis should be further studied.

  13. Parent-child communication processes: preventing children's health-risk behavior.

    Science.gov (United States)

    Riesch, Susan K; Anderson, Lori S; Krueger, Heather A

    2006-01-01

    Review individual, family, and environmental factors that predict health-risk behavior among children and to propose parent-child communication processes as a mechanism to mediate them. Improving parent-child communication processes may: reduce individual risk factors, such as poor academic achievement or self-esteem; modify parenting practices such as providing regulation and structure and acting as models of health behavior; and facilitate discussion about factors that lead to involvement in health-risk behaviors. Assessment strategies to identify youth at risk for health-risk behavior are recommended and community-based strategies to improve communication among parents and children need development.

  14. Language Delay in Severely Neglected Children: A Cumulative or Specific Effect of Risk Factors?

    Science.gov (United States)

    Sylvestre, Audette; Merette, Chantal

    2010-01-01

    Objectives: This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and…

  15. Risky-Play at School. Facilitating Risk Perception and Competence in Young Children

    Science.gov (United States)

    Lavrysen, Ann; Bertrands, Els; Leyssen, Leene; Smets, Lieve; Vanderspikken, Anja; De Graef, Peter

    2017-01-01

    Recent research indicates that risk competence and perception can be improved through the learning environment. The project "Riscki" examined how risk perception and risk competence in young children between three and eight years of age can be observed and measured within the classroom and school context. An intensive package of…

  16. [Homocystein serum levels and lipid parameters in children with atherosclerosis risk factors].

    Science.gov (United States)

    Sierakowska-Fijałek, Anna; Kaczmarek, Piotr; Pokoca, Lech; Smorag, Ireneusz; Wosik-Erenbek, Marzenna; Baj, Zbigniew

    2007-02-01

    Atherosclerosis is a disease of adult patients, however, it begins in childhood and progresses from fatty streaks to raised lesions in arteries in adolescence and young adults. Clinical manifestation of atherosclerosis in adulthood depends on the risk factors such as: lipid disorders, obesity, hypertension, smoking habits and family history of CHD. High serum homocysteine concentration is increasingly recognised as a new risk factor for atherosclerosis and other vascular diseases. Atherogenic effect of homocystein is related to cytotoxin action on the endothelial cells and their function. The aim of this study was to estimate relations between the homocysteine serum concentration and the lipid levels in children with atherosclerosis risk factors. The study was carried out on 48 children with atherosclerosis risk factors. The control group consisted of 25 healthy childrens. Total cholesterol (TC), Triglycerides (TG), HDL-C, LDL-C were determined by enzymatic method. Concentration of homocysteine was estimated by immunoenzymatic method (ELISA). Obesity, lipid disorders, and hypertension were the most frequent risk factors in the investigated children. Statistically significant higher concentration of TC, LDL-C, TG and lower HDL-C were observed in children with atherosclerosis risk factors. No significant differences in homocystein concentration were observed in the investigated groups, but homocystein concentration was significantly higher in group of children with atherosclerosis risk factors. We observed that increased number of the risk factors is followed by high homocystein concentration in the serum.

  17. Genetic Testing for Type 2 Diabetes in High-Risk Children: the Case for Primordial Prevention

    Directory of Open Access Journals (Sweden)

    Jennifer Wessel

    2017-09-01

    Full Text Available Extensive research now demonstrates that lifestyle modification can significantly lower risk of developing type 2 diabetes (T2D in high-risk adults. In children, the evidence for lifestyle modification is not as robust, but the rapidly rising rate of obesity in children coupled with the substantial difficulty in changing behaviors later in life illuminates the need to implement prevention efforts early in the life course of children. Genetic data can now be used early in the life course to identify children at high-risk of developing T2D before traditional clinical measures can detect the presence of prediabetes; a metabolic condition associated with obesity that significantly increases risk for developing T2D.  Such early detection of risk may enable the promotion of “primordial prevention” in which parents implement behavior change for their at risk children.  Young children with genetic risk are a novel target population.  Here we review the literature on genetic testing for prevention as it relates to chronic diseases and specifically use T2D as a model. We discuss the history of primordial prevention, the need for primordial prevention of T2D and the role genetic testing has in primordial prevention of high-risk families.

  18. Expressed Emotion-Criticism and Risk of Depression Onset in Children

    Science.gov (United States)

    Burkhouse, Katie L.; Uhrlass, Dorothy J.; Stone, Lindsey B.; Knopik, Valerie S.; Gibb, Brandon E.

    2012-01-01

    Objective The primary goal of the current study was to examine the impact of maternal criticism (expressed emotion-criticism; EE-Crit) on the prospective development of depressive episodes in children. In addition to examining baseline levels of EE-Crit, we also sought to determine whether distinct subgroups (latent classes) of mothers could be identified based on the levels of EE-Crit they exhibited over a multi-wave assessment and whether that latent class membership would predict depression onset in children. Finally, we examined whether EE-Crit and maternal depression would independently predict children's depression risk or whether EE-Crit would moderate the link between maternal depression and children's depression onset. Method Children of mothers with or without a history of major depression (N=100) were assessed five times over 20 months. Children completed the Children's Depression Inventory (CDI) and mothers completed the Five Minute Speech Sample and the Beck Depression Inventory (BDI) at the baseline assessment, and at 2, 4, and 6 month follow-up assessments. Children and mothers completed diagnostic interviews assessing children's onsets of depressive episodes at the 20 month follow-up. Results Latent class analysis of the 4 waves of EE-Crit assessments revealed two distinct groups, exhibiting relatively lower versus higher levels of EE-Crit across the first 6 months of follow-up. EE-Crit latent class membership predicted children's depression onset over the subsequent 14 months. This finding was maintained after controlling for mother's and children's depressive symptoms during the initial 6 months of follow-up. Finally, maternal depression did not moderate the link between EE-Crit and childhood depression onset. Conclusions Continued exposure to maternal criticism appears to be an important risk factor for depression in children, risk that is at least partially independent of the risk conveyed by maternal depression. These results highlight the

  19. Parental incarceration and multiple risk experiences: effects on family dynamics and children's delinquency.

    Science.gov (United States)

    Aaron, Lauren; Dallaire, Danielle H

    2010-12-01

    Children of incarcerated parents are exposed to factors that place them at risk for delinquency. Few studies have examined the effects of having an incarcerated parent after controlling for other experiences such as contextual risk factors and family processes. Past studies have also not examined effects of recent, but not current, parental incarceration on children. The present study examines an archival dataset, in which children aged 10-14 years and their parents/guardians reported children's risk experiences (e.g., exposure to poverty, parental substance use), family processes (e.g., level of family victimization, family conflict), and children's delinquent behaviors at two time points. Parents also reported their recent and past incarceration history. Hierarchical linear regression analyses show that a history of parental incarceration predicted family victimization, delinquent behaviors of children's older siblings, and delinquent behaviors of the child participants, over and above children's demographic characteristics and other risk experiences. Recent parental incarceration predicted family conflict, family victimization, and parent-reports of children's delinquency after also controlling for previous parental incarceration. The role of family processes in research and intervention directions involving children of incarcerated parents is discussed.

  20. Obesity-risk behaviours and their associations with body mass index (BMI) in Korean American children.

    Science.gov (United States)

    Jang, Myoungock; Grey, Margaret; Sadler, Lois; Jeon, Sangchoon; Nam, Soohyun; Song, Hee-Jung; Whittemore, Robin

    2017-08-03

    To describe obesity-risk behaviours (diet, physical activity and sedentary behaviour) and examine the relationships of the obesity-risk behaviours with body mass index (BMI) in school-aged Korean American children. Korean American children have a risk of becoming overweight or obese and developing obesity-related complications; however, there is limited research about obesity-risk behaviours in Korean American children. A cross-sectional study. Obesity-risk behaviours of children were assessed with well-validated self-report questionnaires (i.e., Elementary-level School-based Nutrition Monitoring Questionnaire) from children and their mothers. Height and weight of children were measured. Data were analysed with bivariate and multivariate analyses using mixed effects models to incorporate the correlation within siblings. A total of 170 Korean American children (mean age 10.9 [2.0] years; 52.4% girls; mean BMI 19.3 [3.2]; 28.7% ≥85 percentiles) participated in the study. Only 38.3% of Korean American children met established recommendations of five fruits/vegetables per day; 56.5% met recommendations for more than 3 days per week of vigorous physical activity; and 40.8% met recommendations for obesity in Korean American children and initiate clinical interventions to improve obesity-risk behaviours, especially sedentary behaviour, in Korean American children. Clinical assessment and management of the risk of developing overweight and obesity as well as obesity-related behaviours are important to improve obesity-related complications in overall Korean Americans. © 2017 John Wiley & Sons Ltd.

  1. Pediatric reference value distributions and covariate-stratified reference intervals for 29 endocrine and special chemistry biomarkers on the Beckman Coulter Immunoassay Systems: a CALIPER study of healthy community children.

    Science.gov (United States)

    Karbasy, Kimiya; Lin, Danny C C; Stoianov, Alexandra; Chan, Man Khun; Bevilacqua, Victoria; Chen, Yunqi; Adeli, Khosrow

    2016-04-01

    The CALIPER program is a national research initiative aimed at closing the gaps in pediatric reference intervals. CALIPER previously reported reference intervals for endocrine and special chemistry markers on Abbott immunoassays. We now report new pediatric reference intervals for immunoassays on the Beckman Coulter Immunoassay Systems and assess platform-specific differences in reference values. A total of 711 healthy children and adolescents from birth to reference intervals calculated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. Complex profiles were observed for all 29 analytes, necessitating unique age and/or sex-specific partitions. Overall, changes in analyte concentrations observed over the course of development were similar to trends previously reported, and are consistent with biochemical and physiological changes that occur during childhood. Marked differences were observed for some assays including progesterone, luteinizing hormone and follicle-stimulating hormone where reference intervals were higher than those reported on Abbott immunoassays and parathyroid hormone where intervals were lower. This study highlights the importance of determining reference intervals specific for each analytical platform. The CALIPER Pediatric Reference Interval database will enable accurate diagnosis and laboratory assessment of children monitored by Beckman Coulter Immunoassay Systems in health care institutions worldwide. These reference intervals must however be validated by individual labs for the local pediatric population as recommended by CLSI.

  2. The Joint Effects of Risk Status, Gender, Early Literacy and Cognitive Skills on the Presence of Dyslexia among a Group of High-Risk Chinese Children

    Science.gov (United States)

    Wong, Simpson W. L.; McBride-Chang, Catherine; Lam, Catherine; Chan, Becky; Lam, Fanny W. F.; Doo, Sylvia

    2012-01-01

    This study sought to examine factors that are predictive of future developmental dyslexia among a group of 5-year-old Chinese children at risk for dyslexia, including 62 children with a sibling who had been previously diagnosed with dyslexia and 52 children who manifested clinical at-risk factors in aspects of language according to testing by…

  3. MC3D modelling of stratified explosion

    International Nuclear Information System (INIS)

    Picchi, S.; Berthoud, G.

    1999-01-01

    It is known that a steam explosion can occur in a stratified geometry and that the observed yields are lower than in the case of explosion in a premixture configuration. However, very few models are available to quantify the amount of melt which can be involved and the pressure peak that can be developed. In the stratified application of the MC3D code, mixing and fragmentation of the melt are explained by the growth of Kelvin Helmholtz instabilities due to the shear flow of the two phase coolant above the melt. Such a model is then used to recalculate the Frost-Ciccarelli tin-water experiment. Pressure peak, speed of propagation, bubble shape and erosion height are well reproduced as well as the influence of the inertial constraint (height of the water pool). (author)

  4. MC3D modelling of stratified explosion

    Energy Technology Data Exchange (ETDEWEB)

    Picchi, S.; Berthoud, G. [DTP/SMTH/LM2, CEA, 38 - Grenoble (France)

    1999-07-01

    It is known that a steam explosion can occur in a stratified geometry and that the observed yields are lower than in the case of explosion in a premixture configuration. However, very few models are available to quantify the amount of melt which can be involved and the pressure peak that can be developed. In the stratified application of the MC3D code, mixing and fragmentation of the melt are explained by the growth of Kelvin Helmholtz instabilities due to the shear flow of the two phase coolant above the melt. Such a model is then used to recalculate the Frost-Ciccarelli tin-water experiment. Pressure peak, speed of propagation, bubble shape and erosion height are well reproduced as well as the influence of the inertial constraint (height of the water pool). (author)

  5. Burden of separation and suicide risk of prisoners with minor children.

    Science.gov (United States)

    Krüger, Sinja; Priebe, Stefan; Fritsch, Rosemarie; Mundt, Adrian P

    The present study aimed to explore the burden of separation from children and its relationship with suicide risk in prisoners with minor children at the moment of admission into the penal justice system. Suicide risk was assessed using the Mini International Neuropsychiatric Interview in newly admitted female (n=198) and male (n=229) prisoners in Santiago de Chile. The burden of separation from minor children was rated on a numeric rating scale. Both genders showed high burden of separation from children at imprisonment. Mothers had significantly lower suicide risk than women without children. The relative risk was 0.31 (95% CI [0.16-0.6], psuicide risk'. There was no difference of suicide risk between imprisoned fathers and male prisoners without children. Within the group of fathers, the suicide risk associated with the burden of separation. Our study indicates that strengthening the parent role and facilitating parent-child contacts during imprisonment could be an important element of suicide prevention interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders.

    Science.gov (United States)

    Emerson, Eric; Blacher, Jan; Einfeld, Stewart; Hatton, Chris; Robertson, Janet; Stancliffe, Roger J

    2014-12-01

    We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Equipment for extracting and conveying stratified minerals

    Energy Technology Data Exchange (ETDEWEB)

    Blumenthal, G.; Kunzer, H.; Plaga, K.

    1991-08-14

    This invention relates to equipment for extracting stratified minerals and conveying the said minerals along the working face, comprising a trough shaped conveyor run assembled from lengths, a troughed extraction run in lengths matching the lengths of conveyor troughing, which is linked to the top edge of the working face side of the conveyor troughing with freedom to swivel vertically, and a positively guided chain carrying extraction tools and scrapers along the conveyor and extraction runs.

  8. Inviscid incompressible limits of strongly stratified fluids

    Czech Academy of Sciences Publication Activity Database

    Feireisl, Eduard; Jin, B.J.; Novotný, A.

    2014-01-01

    Roč. 89, 3-4 (2014), s. 307-329 ISSN 0921-7134 R&D Projects: GA ČR GA201/09/0917 Institutional support: RVO:67985840 Keywords : compressible Navier-Stokes system * anelastic approximation * stratified fluid Subject RIV: BA - General Mathematics Impact factor: 0.528, year: 2014 http://iospress.metapress.com/content/d71255745tl50125/?p=969b60ae82634854ab8bd25505ce1f71&pi=3

  9. Balancing participation and risks in children's Internet use: the role of internet literacy and parental mediation.

    Science.gov (United States)

    Lee, Sook-Jung; Chae, Young-Gil

    2012-05-01

    This study analyzed the survey data from 566 Korean children between the ages of 10 and 15 to examine the role of Internet literacy and parental mediation in solving the dilemma of children's Internet use. According to the findings, children's online participation was associated with increased exposure to online risks. The association was moderated by Internet skills and parental restrictive mediation; that is, for children with a high level of Internet skills and for children who received more restrictive mediation, the positive association between online participation and online risks weakened, but was still significant. The limited roles of Internet skills and parental restrictive mediation in children's Internet use were discussed in the context of media education.

  10. Children With Disability Are More at Risk of Violence Victimization: Evidence From a Study of School-Aged Chinese Children.

    Science.gov (United States)

    Chan, Ko Ling; Emery, Clifton R; Ip, Patrick

    2016-03-01

    Although research tends to focus on whether children with disability are more at risk of violence victimization, conclusive evidence on the association, especially in non-Western settings, is lacking. Using a large and representative sample of school-aged children in Hong Kong (N = 5,841, aged 9-18 years), this study aims to fill the research gap by providing reliable estimates of the prevalence of disability and the direct and indirect experiences of violence among children with disability. The study also compares the prevalence of child maltreatment, parental intimate partner violence (IPV), and in-law conflict to explore the factors related to the association between disability and violence victimization. The prevalence of disability among children was about 6%. Children with disability were more likely to report victimization than those without disability: 32% to 60% of the former had experienced child maltreatment, and 12% to 46% of them had witnessed IPV between parents or in-law conflict. The results of a logistic regression showed that disability increased the risk of lifetime physical maltreatment by 1.6 times. Furthermore, low levels of parental education and paternal unemployment were risk factors for lifetime child maltreatment. The risk of child maltreatment could have an almost sixfold increase when the child had also witnessed other types of family violence. Possible explanations and implications of the findings are discussed. © The Author(s) 2014.

  11. Risk factors for obesity and high blood pressure in Chinese American children: maternal acculturation and children's food choices.

    Science.gov (United States)

    Chen, Jyu-Lin; Weiss, Sandra; Heyman, Melvin B; Lustig, Robert

    2011-04-01

    The objective of this study is to explore risk factors associated with overweight and high blood pressure in Chinese American children. Students and their parents were recruited from Chinese language schools in the San Francisco Bay Area. Data were collected on 67 children and their mothers, and included children's weight, height, waist and hip circumferences, blood pressure, level of physical activity, dietary intake, usual food choice, knowledge about nutrition and physical activity, and self-efficacy regarding diet and physical activity. Mothers completed questionnaires on demographic data and acculturation. About 46% of children had a body mass index exceeding the 85th percentile. Lower level of maternal acculturation is a risk factor for overweight and higher waist to hip ratio. Children's unhealthy food choices were predictive of high body mass index and high systolic blood pressure, whereas older age and less physical activity in children were predictors of high diastolic blood pressure. Developing culturally sensitive and developmentally appropriate interventions to reduce overweight and high blood pressure is critical to reduce health disparities among minority children.

  12. Nitrogen transformations in stratified aquatic microbial ecosystems

    DEFF Research Database (Denmark)

    Revsbech, Niels Peter; Risgaard-Petersen, N.; Schramm, Andreas

    2006-01-01

    Abstract  New analytical methods such as advanced molecular techniques and microsensors have resulted in new insights about how nitrogen transformations in stratified microbial systems such as sediments and biofilms are regulated at a µm-mm scale. A large and ever-expanding knowledge base about n...... performing dissimilatory reduction of nitrate to ammonium have given new dimensions to the understanding of nitrogen cycling in nature, and the occurrence of these organisms and processes in stratified microbial communities will be described in detail.......Abstract  New analytical methods such as advanced molecular techniques and microsensors have resulted in new insights about how nitrogen transformations in stratified microbial systems such as sediments and biofilms are regulated at a µm-mm scale. A large and ever-expanding knowledge base about...... nitrogen fixation, nitrification, denitrification, and dissimilatory reduction of nitrate to ammonium, and about the microorganisms performing the processes, has been produced by use of these techniques. During the last decade the discovery of anammmox bacteria and migrating, nitrate accumulating bacteria...

  13. Large eddy simulation of stably stratified turbulence

    International Nuclear Information System (INIS)

    Shen Zhi; Zhang Zhaoshun; Cui Guixiang; Xu Chunxiao

    2011-01-01

    Stably stratified turbulence is a common phenomenon in atmosphere and ocean. In this paper the large eddy simulation is utilized for investigating homogeneous stably stratified turbulence numerically at Reynolds number Re = uL/v = 10 2 ∼10 3 and Froude number Fr = u/NL = 10 −2 ∼10 0 in which u is root mean square of velocity fluctuations, L is integral scale and N is Brunt-Vaïsälä frequency. Three sets of computation cases are designed with different initial conditions, namely isotropic turbulence, Taylor Green vortex and internal waves, to investigate the statistical properties from different origins. The computed horizontal and vertical energy spectra are consistent with observation in atmosphere and ocean when the composite parameter ReFr 2 is greater than O(1). It has also been found in this paper that the stratification turbulence can be developed under different initial velocity conditions and the internal wave energy is dominated in the developed stably stratified turbulence.

  14. Serum Asymmetric Dimethylarginine, and Adiponectin as Predictors of Atherosclerotic Risk among Obese Egyptian Children

    Directory of Open Access Journals (Sweden)

    Enas R. Abdel Hameed

    2014-06-01

    CONCLUSIONS: Our results revealed that ADMA, Adiponectin and lipid profile can be considered as predictive biomarkers in prediction and prevention of atherosclerotic risk in the future among overweight and obese Egyptian children.

  15. Investigating Contingency Risk Factors of Brain Tumor in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    A Nazemi

    2014-12-01

    Conclusion: According to research results, several preventable and predictable factors are linked to pediatric brain tumors. Therefore, children prone to brain tumors are recommended to be examined and screened for these risk factors.

  16. Prevalence of risk factors for cardiovascular and kidney disease in Brazilian healthy preschool children

    OpenAIRE

    da Silva, Adriana C?ndida; de Sousa Tavares, Marcelo; Penido, Maria Goretti Moreira Guimar?es

    2016-01-01

    AIM To investigate the prevalence of nutritional parameters of risk for cardiovascular disease (CVD) and kidney diseases in healthy preschool children. METHODS This is an observational cross-sectional study with 60 healthy children, of both genders, aged two to six years old and 56 mothers, in Belo Horizonte, Minas Gerais, Brazil. Preschool children and their families with regular activities at public schools were invited to paticipate in the study. The following characteristics were assessed...

  17. Perinatal Risk Factors for Feeding and Eating Disorders in Children Aged 0 to 3 Years

    DEFF Research Database (Denmark)

    Hvelplund, Carolina; Hansen, Bo Mølholm; Koch, Susanne Vinkel

    2016-01-01

    OBJECTIVE: To describe the incidence, age at diagnosis, and associations between perinatal risk factors of feeding and eating disorders (FED) diagnosed at hospital in children aged 0 to 3 years. METHODS: A nationwide cohort of 901 227 children was followed until 48 months of age in the national...... in the clinical management of young children with persistent problems of feeding, eating, and weight faltering....

  18. Clustering of Multiple Lifestyle Behaviours and Its Association to Cardiovascular Risk Factors in Children

    DEFF Research Database (Denmark)

    Bel-Serrat, Silvia; Mouratidou, Theodora; Santaliestra-Pasías, Alba María

    2013-01-01

    ratio, triglycerides, sum of two skinfolds and systolic blood pressure (SBP) z-scores were summed to compute a CVD risk score. Cluster analyses stratified by sex and age groups (2 to ...) consumption, PA performance and television video/DVD viewing. RESULTS: Five clusters were identified. Associations between CVD risk factors and score, and clusters were obtained by multiple linear regression using cluster 5 (‘low beverages consumption and low sedentary’) as the reference cluster. SBP...... association was observed between CVD risk score and clusters 2 (β=0.60; 95% CI: 0.20, 1.01), 3 (β=0.55; 95% CI: 0.14, 0.97) and 4 (β=0.60, 95% CI: 0.18, 1.02) in older boys. CONCLUSIONS: Low television/video/DVD viewing levels and low SSB consumption may result in a healthier CVD profile rather than having...

  19. Respiratory syncytial viral infections in young children : risk assessment and prevention

    NARCIS (Netherlands)

    E. Rietveld (Edwin)

    2003-01-01

    textabstractRespiratory syncytial virus is the main cause of lower respiratory tract infections in infants and young children. Although almost all children are infected before the age of two years, less than 2% develop severe disease necessitating hospitalisation. Risk factors for severe RSV

  20. Reducing the Risk of Posttraumatic Stress Disorder in Children Following Natural Disasters

    Science.gov (United States)

    Mohay, Heather; Forbes, Nicole

    2009-01-01

    A significant number of children suffer long-term psychological disturbance following exposure to a natural disaster. Evidence suggests that a dose-response relationship exists, so that children and adolescents who experience the most intense or extensive exposure to the risk factors for posttraumatic stress disorder (PTSD) are likely to develop…

  1. Epileptiform discharges in EEG and seizure risk in adolescent children of women with epilepsy.

    Science.gov (United States)

    Samuel, Joseph; Jose, Manna; Nandini, V S; Thomas, Sanjeev V

    2017-09-01

    We aimed to study the epileptiform discharges (ED) and seizure risk in EEG of 12-18-year-old children of women with epilepsy (WWE). Children of WWE who were prospectively followed up in the Kerala registry of epilepsy and pregnancy (KREP), aged 12-16years (n=92; males 48, females 44) underwent clinical evaluation and a 30-min digital 18-channel EEG. The EEG showed epileptiform discharges in 13 children (5 males and 8 females). The EDs were generalized in 9 and focal in 4 (occipital 2, frontal 1, and centroparietal 1). They had significantly higher risk of ED (odds ratio 4.02, 95% CI 1.04-15.51) when compared to published prevalence of ED in healthy children. There were 2 children with epilepsy (one with localization-related epilepsy and the other generalized epilepsy). The children under study had a trend towards higher prevalence of epilepsy (odds ratio 3.39, 95% CI 0.82-13.77) when compared to age specific prevalence of epilepsy from community surveys in same region. Children of WWE showed increased risk of ED in EEG and trend towards increased seizure risk when compared to healthy children. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Risk Factors Associated with Obesity in Children of Different Racial Backgrounds

    Science.gov (United States)

    Urrutia-Rojas, Ximena; Ahmad, Naveed; Bayona, Manuel; Bae, Sejong; Rivers, Patrick A; Singh, Karan P

    2008-01-01

    Objective: The purpose of this study is to determine specific risk factors associated with obesity among African American, Hispanic and Caucasian children. Design: This is a cross-sectional study conducted on 1076 fifth grade children from 17 elementary schools at Fort Worth, Texas. Data were collected through questionnaires and physical…

  3. Delayed Early Vocabulary Development in Children at Family Risk of Dyslexia

    Science.gov (United States)

    van Viersen, Sietske; de Bree, Elise H.; Verdam, Mathilde; Krikhaar, Evelien; Maassen, Ben; van der Leij, Aryan; de Jong, Peter F.

    2017-01-01

    Purpose: This study aimed to gain more insight into the relation between vocabulary and reading acquisition by examining early growth trajectories in the vocabulary of children at family risk (FR) of dyslexia longitudinally. Method: The sample included 212 children from the Dutch Dyslexia Program with and without an FR. Parents reported on their…

  4. Children with Disabilities in Disability-Inclusive Disaster Risk Reduction: Focussing on School Settings

    Science.gov (United States)

    Ronoh, Steve; Gaillard, J. C.; Marlowe, Jay

    2017-01-01

    Every year, worldwide, disasters affect approximately seven million children with disabilities, highlighting their potential vulnerability. Although there is a growing move internationally to promote the rights of children with disabilities, they still receive little attention from disaster risk reduction (DRR) researchers and policy makers. They…

  5. Cardiometabolic risk factors and quality of life in severely obese children and adolescents in The Netherlands

    NARCIS (Netherlands)

    Makkes, Sabine; Renders, Carry M; Bosmans, Judith E; van der Baan-Slootweg, Olga H; Seidell, Jacob C

    2013-01-01

    BACKGROUND: The prevalence of severe obesity in children and adolescents is increasing. However, little is known about cardiometabolic risk factors and quality of life of children with severe obesity.Therefore, the aim of this study was to assess the demographic characteristics and the prevalence of

  6. Maternal Pre-Pregnancy Obesity and Risk for Inattention and Negative Emotionality in Children

    Science.gov (United States)

    Rodriguez, Alina

    2010-01-01

    Objective: This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children. Methods: A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714).…

  7. Cumulative Risk Disparities in Children's Neurocognitive Functioning: A Developmental Cascade Model

    Science.gov (United States)

    Wade, Mark; Browne, Dillon T.; Plamondon, Andre; Daniel, Ella; Jenkins, Jennifer M.

    2016-01-01

    The current longitudinal study examined the role of cumulative social risk on children's theory of mind (ToM) and executive functioning (EF) across early development. Further, we also tested a cascade model of development in which children's social cognition at 18 months was hypothesized to predict ToM and EF at age 4.5 through intermediary…

  8. Divorce Transitions: Identifying Risk and Promoting Resilience for Children and Their Parental Relationships.

    Science.gov (United States)

    Barnes, Gill Gorrell

    1999-01-01

    Discusses qualitative research linked to clinical work relating to some of the short-term effects of divorce on children within a British perspective. Describes clinical intervention into family relationships in divorcing and post-divorce families and suggests some high-risk issues for children. Some interactions that may promote resilience in…

  9. Risk Factors Associated with Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders

    Science.gov (United States)

    Duerden, Emma G.; Oatley, Hannah K.; Mak-Fan, Kathleen M.; McGrath, Patricia A.; Taylor, Margot J.; Szatmari, Peter; Roberts, S. Wendy

    2012-01-01

    While self-injurious behaviors (SIB) can cause significant morbidity for children with autism spectrum disorders (ASD), little is known about its associated risk factors. We assessed 7 factors that may influence self-injury in a large cohort of children with ASD: (a) atypical sensory processing; (b) impaired cognitive ability; (c) abnormal…

  10. Arts Enrichment and Preschool Emotions for Low-Income Children at Risk

    Science.gov (United States)

    Brown, Eleanor D.; Sax, Kacey L.

    2013-01-01

    No studies to date examine the impact of arts-integrated preschool programming on the emotional functioning of low-income children at risk for school problems. The present study examines observed emotion expression and teacher-rated emotion regulation for low-income children attending Settlement Music School's Kaleidoscope Preschool Arts…

  11. Philanthropic networks for children at risk in nineteenth-century Europe

    NARCIS (Netherlands)

    Dekker, Jeroen J. H.

    In the first half of nineteenth-century Europe, the founding fathers of the philanthropic network developed a specific network for the care of children at risk. This network eventually resulted in institutionalized solutions for the care of these children. In this article, three topics are looked

  12. Multilevel Mediation: Cumulative Contextual Risk, Maternal Differential Treatment, and Children's Behavior within Families

    Science.gov (United States)

    Meunier, Jean Christophe; Boyle, Michael; O'Connor, Thomas G.; Jenkins, Jennifer M.

    2013-01-01

    This study tests the hypothesis that links between contextual risk and children's outcomes are partially explained by differential parenting. Using multi-informant measurement and including up to four children per family (M[subscript age] = 3.51, SD = 2.38) in a sample of 397 families, indirect effects (through maternal differential…

  13. Mortality risk in children with epilepsy : The Dutch Study of Epilepsy in Childhood

    NARCIS (Netherlands)

    Callenbach, PMC; Westendorp, RGJ; Geerts, AT; Arts, WFM; Peeters, EAJ; van Donselaar, VA; Stroink, H; Brouwer, O.F.

    Objective. Long-term follow-up studies of patients with epilepsy have revealed an increased mortality risk compared with the general population. Mortality of children who have epilepsy in modern times is as yet unknown. Therefore, the objective of this study was to determine mortality of children

  14. Risk factors of severe pneumonia among children aged 2-59 months ...

    African Journals Online (AJOL)

    Introduction Globally, pneumonia is the leading cause of death in children under the age of 5 years. In Kenya, it is the second leading cause of mortality, accounting for greater than 30,000 deaths in this age group annually. This study sought to identify risk factors for severe pneumonia in children under the age of five years.

  15. Is Privacy at Risk when Commercial Websites Target Primary School Children? A Case Study in Korea

    Science.gov (United States)

    Kim, Sora; Yi, Soon-Hyung

    2010-01-01

    This study discusses privacy risk factors when commercial web sites target primary school children in Korea. Specifically, the authors examined types of personal information required for membership subscriptions and whether privacy policies at commercial sites for children abide by privacy guidelines. A total of 159 commercial sites targeting…

  16. Studying use and risks of medicines in children: a European approach

    NARCIS (Netherlands)

    S. de Bie (Sandra)

    2013-01-01

    textabstractIn recent years there has been increasing awareness on the gap in knowledge on the safety and efficacy of medicines used in children. The work as described in this thesis is based on large observational studies across Europe and aimed to study the use and risks of medicines in children

  17. Risk Factors of Anaemia Among Rural School Children in Kenitra ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of anaemia and factors associated with iron deficiency among school children in rural Kenitra, Morocco. Methods: 295 students between 6 and 16 years old composed the study group. The level of haemoglobin was measured in a group of 295 school children. The iron status was ...

  18. Aggression and the Risk for Suicidal Behaviors among Children

    Science.gov (United States)

    Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron; Fite, Paula J.

    2010-01-01

    Two subtypes of aggression--reactive and proactive--were examined to see how they relate to suicidal behaviors among young children admitted for acute psychiatric inpatient care. The children and their parents completed self-report questionnaires/interviews. Regression analyses revealed that depressed girls who scored higher on reactive aggression…

  19. Malnutrition among children in Southern Ethiopia: Levels and risk ...

    African Journals Online (AJOL)

    Using data collected in the Community and Family Survey of the Southern Nations Nationalities and Peoples Region, this study estimates the level of child malnutrition and identifies the factors associated with chronic malnutrition among children in the five densely populated zones of the Region. A total of 850 children aged ...

  20. Preschool language profiles of children at family risk of dyslexia: continuities with specific language impairment

    Science.gov (United States)

    Nash, Hannah M.; Hulme, Charles; Gooch, Debbie; Snowling, Margaret J.

    2015-01-01

    Background Children at family risk of dyslexia have been reported to show phonological deficits as well as broader language delays in the preschool years. Method The preschool language skills of 112 children at family risk of dyslexia (FR) at ages 3½ and 4½ were compared with those of children with SLI and typically developing (TD) controls. Results Children at FR showed two different profiles: one third of the group resembled the children with SLI and scored poorly across multiple domains of language including phonology. As a group, the remaining children had difficulties on tasks tapping phonological skills at T1 and T2. At the individual level, we confirmed that some FR children had both phonological and broader oral language difficulties (compared with TD controls), some had only phonological difficulties and some appeared to be developing typically. Conclusions We have highlighted the early overlap between family risk of dyslexia and SLI. A family history of dyslexia carries an increased risk for SLI and the two disorders both show an increased incidence of phonological deficits which appear to a proximal risk factor for developing a reading impairment. PMID:23772651

  1. Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children.

    Science.gov (United States)

    Becker, Stephen P; Withrow, Amanda R; Stoppelbein, Laura; Luebbe, Aaron M; Fite, Paula J; Greening, Leilani

    2016-12-01

    Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology. © 2016 Association for Child and Adolescent Mental Health.

  2. Otitis media in Indigenous Australian children: review of epidemiology and risk factors.

    Science.gov (United States)

    Jervis-Bardy, Jake; Sanchez, L; Carney, A S

    2014-01-01

    Otitis media represents a major health concern in Australian Indigenous children ('Indigenous children'), which has persisted, despite public health measures, for over 30 years. Global searches were performed to retrieve peer-reviewed and 'grey' literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012. In Indigenous children, the prevalence of otitis media subtypes is 7.1-12.8 per cent for acute otitis media, 10.5-30.3 per cent for active chronic otitis media and 31-50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media. Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

  3. Separation from children as a specific risk factor to fathers' health and lifestyles.

    Science.gov (United States)

    Grill, E; Weitkunat, R; Crispin, A

    2001-01-01

    The study was to examine whether fathers living apart from their children following divorce or separation ("fathers without children") differ in their health-related lifestyles and attitudes, and in their health status, from fathers in intact family settings ("fathers with children"). Data was acquired by means of a self-administered questionnaire within an exploratory cross-sectional survey. Fathers without children differed in their lifestyle patterns, parameters of satisfaction, health, and health related orientations from fathers with children. Negative lifestyles could be observed in fathers who had a low income and saw their children only rarely. Separation from their children is a major life crisis for fathers. Subgroups could be identified who had significant health risks. Due to study design, conclusions on causation are not possible. Longitudinal studies are necessary to yield more detailed impact for prevention.

  4. [Children with Multiple Risk Factor Exposition Benefit from the German "Strengthening Families Program"].

    Science.gov (United States)

    Bröning, Sonja; Sack, Peter-Michael; Thomsen, Monika; Thomasius, Rainer

    2016-09-01

    Children with Multiple Risk Factor Exposition Benefit from the German "Strengthening Families Program" The German adaptation of the substance use-preventive family-based Strengthening Families Program 10-14 (SFP, Iowa version) was evaluated in a longitudinal two-year follow-up trial. Participants were N = 292 children with a mean age of twelve years at baseline, and N = 292 parents. We employed a multi-centric, randomized-controlled, two-armed (SFP vs. minimal control condition) study design. Following a "risk moderation hypothesis", we assumed that children with an elevated risk-exposition R(+) would benefit more than children with a low risk-exposition R(-) irrespective of the preventive intervention, and that R(+) under SFP would benefit more than R(+) under the minimal control condition. "Risk-exposition" was measured in correspondence with the Communities That Care Youth Survey-questionnaire. A total of 28 % of children were classified with an elevated risk level. Children's reports confirmed our hypothesis: R(+) report a total of eleven improvements, four of these being significantly more distinct than in the other groups (Anxiety-Depressivity, Punitive Parenting of mother, Punitive Parenting of father, Unbalanced family functioning). In three measures an improvement appears solely in R(+) under SFP (Satisfaction with family functioning, School Attachment and Peer Relationship Quality, Quality of Life). Parents' reports showed a similar tendency, but were less pronounced.

  5. Clostridium difficile infection is associated with increased risk of death and prolonged hospitalization in children.

    Science.gov (United States)

    Sammons, Julia Shaklee; Localio, Russell; Xiao, Rui; Coffin, Susan E; Zaoutis, Theoklis

    2013-07-01

    Clostridium difficile infection (CDI) is associated with significant morbidity and mortality among adults. However, outcomes are poorly defined among children. A retrospective cohort study was performed among hospitalized children at 41 children's hospitals between January 2006 and August 2011. Patients with CDI (exposed) were matched 1:2 to patients without CDI (unexposed) based on the probability of developing CDI (propensity score derived from patient characteristics). Exposed subjects were stratified by C. difficile test date, suggestive of community-onset (CO) versus hospital-onset (HO) CDI. Outcomes were analyzed for matched subjects. We identified 5107 exposed and 693 409 unexposed subjects. Median age was 6 years (interquartile range [IQR], 2-13 years) for exposed and 8 years (IQR, 3-14 years) for unexposed subjects. Of these, 4474 exposed were successfully matched to 8821 unexposed by propensity score. In-hospital mortality differed significantly (CDI, 1.43% vs matched unexposed, 0.66%; P cost were significant: 5.55 days (95% CI, 4.54-6.56 days) and $18 900 (95% CI, $15 100-$22 700) for CO-CDI, and 21.60 days (95% CI, 19.29-23.90 days) and $93 600 (95% CI, $80 000-$107 200) for HO-CDI. Pediatric CDI is associated with increased mortality, longer LOS, and higher costs. These findings underscore the importance of antibiotic stewardship and infection control programs to prevent this disease in children.

  6. Adherence to treatment guidelines: the association between stroke risk stratified comparing CHADS2 and CHA2DS2-VASc score levels and warfarin prescription for adult patients with atrial fibrillation.

    Science.gov (United States)

    Chapman, Scott A; St Hill, Catherine A; Little, Meg M; Swanoski, Michael T; Scheiner, Shellina R; Ware, Kenric B; Lutfiyya, M Nawal

    2017-02-11

    Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS 2 , and more recently the CHA 2 DS 2 -VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy. Warfarin, for stroke prevention in AF, is the most commonly prescribed anticoagulant in North America. The purpose of this study was to examine the utility of using the CHADS 2 score levels (low and high) in contrast to the CHA 2 DS 2 -VASc when examining the outcome of warfarin prescriptions for adult patients with AF. The CHA 2 DS 2 -VASc tool was not widely used in 2010, when the data analyzed were collected. It has only been since 2014 that CHA 2 DS 2 -VASc criteria has been recommended to guide anticoagulant treatment in updated AF treatment guidelines. Bivariate and multivariate data analysis strategies were used to analyze 2010 National Ambulatory Care Survey (NAMCS) data. NAMCS is designed to collect data on the use and provision of ambulatory care services nationwide. The study population for this research was US adults with a diagnosis of AF. Warfarin prescription was the dependent variable for this study. The study population was 7,669,844 AF patients. Bivariate analysis revealed that of those AF patients with a high CHADS 2 score, 25.1% had received a warfarin prescription and 18.8 for those with a high CHA 2 DS 2 -VASc score. Logistic regression analysis yielded that patients with AF had higher odds of having a warfarin prescription if they had a high CHADS 2 score, were Caucasian, lived in a zip code where guideline adherence in alignment with risk stratification for stroke prevention. Interprofessional health care teams can provide improved medical management of

  7. [Morbidity rate of obesity in children in ukraine. Overweight as noncontagious disease risk factor].

    Science.gov (United States)

    Заболотна, Ірина Е

    The upsurge of prevalence rate of obesity and overweight that in the majority of cases traces back to childhood is a risk factor of the most common noncontagious diseases in adults. The aim was to analyze prevalence of obesity in children in Ukraine and to conduct the pilot study of medical condition of overweight children. Official state statistics of prevalence rate of obesity in kids and screening data of anthropometric characteristics, arterial tension levels, physical performance decrement and medical condition of children (boys - 50, girls - 90, average age - 15,1±0,1 years) was used in research. Data calculation performed by Statistica v. 6.0 software. Over the past few decades, the morbidity rate of obesity in children in Ukraine has greatly increased, especially in year class 15-17. Insufficient diagnosis of obesity in children is the consequence of the inadequacy of the existing system of preventive care and monitoring survey of decease risk factors. Children with body mass index (BMI) above normal have a risk of work decrement in 5,2 times (odds ratio, OR=5,2, CI95%: 1,7-10,6). Such children have higher risk of development of the diseases of the respiratory system (OR=8,1; CI95%: 3,9-13,6) and allergic dermatitis (OR=7,7; CI95%: 3,7-12,9). The odds ratio of arterial hypertension in such children is equal to 3,46±0,3 (95%CI: 2,0-5,9). According to prediction calculations, the situation with the increase of prevalence rate of obesity in children in Ukraine is unfavorable. The introduction of measures aimed at finding children with obesity, their registration and monitoring of patients' health with due regard to decease risk factors at the primary care level would conduce to improving prevention of obesity and prevention of alimentary diseases progression.

  8. "What exactly is a paedophile?" Children talking about Internet risk

    Directory of Open Access Journals (Sweden)

    Andrew Burn

    2017-09-01

    Full Text Available Reports tell us that the internet is opening new dangers to children, including online grooming, exposure to pornography and financial scams (Carr 2004; Gardner 2003; UK Home Office 2001; O'Connell 2003. The result has been various initiatives which attempt to teach children safe surfing habits. The UK Home Office "ThinkUKnow" campaign featured advertisements on the radio, internet and cinemas, targeting teens and preteens with the message that the person they are chatting to "may not be who you think they are". There are indications that such campaigns have had an impact on children's awareness of "stranger danger" on the internet (Livingstone/Bober 2003. However, many organisations are still struggling with the question of how best to prevent internet-related harm to children. Children are exposed not only to advertising campaigns about stranger danger but also sensationalist stories about, for example, what happens to girls who enter chat rooms. When a teenage girl goes missing, police investigations routinely include looking at the girls' online activities, and tabloid media frequently make the connection between missing school girls and chat room activities. These connections are firmly embedded in the minds of the children we interviewed for the study we will be discussing. Alongside the very rational and prohibitive discourse coming from campaigns which warn children against any chat with strangers, sit the folkloric stories about girls meeting up and getting killed by paedophiles. The challenge to educators is to find an approach which will engage with both sets of discourses.

  9. Diet Quality during Infancy and Early Childhood in Children with and without Risk of Type 1 Diabetes: A DEDIPAC Study

    Directory of Open Access Journals (Sweden)

    Stefanie Schoen

    2017-01-01

    Full Text Available Previous studies have indicated that mothers of children at increased risk of type 1 diabetes (T1D may modify their child’s diet following risk notification. Our aim was to investigate the diet quality after notified of T1D risk in at-risk children compared to not-at-risk children. The quality of nutrient intake (PANDiet score and food intake (analyzed by a newly developed score and the HuSKY score were assessed using three-day dietary records collected for at-risk children (BABYDIET study, n = 109 and a matched sample of not-at-risk children (DONALD study, n = 205 at nine and 24 months of age. Nutrient and food intake quality were lower at nine months of age and food intake quality was lower at 24 months of age in at-risk than in not-at-risk children (p = 0.01 and p < 0.0001, respectively. The amount of added sugar was higher in at-risk children at both ages (p < 0.0001. In at-risk children, dietary quality was similar between children who were first exposed to gluten at six or 12 months of age. Despite being notified about their child’s risk of T1D, the child’s mother did not switch to healthier diets compared with not-at-risk mothers.

  10. Asthma in Children: Risk Factors, Clinical Features and Prevention

    Directory of Open Access Journals (Sweden)

    Serap Balci

    2010-02-01

    Full Text Available Asthma is the most common chronic disease of childhood. It is known that asthma prevalence has increased significantly especially in children in last 20 years. To stop this increase in asthma, causes and prevention measures should be known better. For the management of the illness, control of environmental and trigger factors causing asthma attack are extremely important. Asthmatic children and family should be informed by health staff about changes in their life and measures to prevent the attacks. Through this information asthmatic children and their families can be supported for a better quality of life. [TAF Prev Med Bull 2010; 9(1.000: 79-86

  11. The risks and alternatives to physical punishment use with children.

    Science.gov (United States)

    Ateah, Christine A; Secco, M Loretta; Woodgate, Roberta L

    2003-01-01

    Despite strong evidence of negative developmental outcomes resulting from the use of physical (or corporal) punishment with children, its use by parents and other caregivers is common. Such negative outcomes include child aggression, mental health issues, and physical abuse. Health care providers have a responsibility to promote disciplinary strategies that facilitate positive parent-children relationships and keep children's self-esteem and bodies healthy and intact. The incidence, factors, and outcomes associated with parental use of physical punishment are reviewed and useful advice for parents and age-appropriate disciplinary strategies and resources are outlined for the various stages of child development from infancy to school age.

  12. Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh.

    Science.gov (United States)

    Borse, N N; Hyder, A A; Bishai, D; Baker, T; Arifeen, S E

    2011-11-01

    Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning. The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index. A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results. The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662. Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Functional and structural brain correlates of risk for major depression in children with familial depression

    Directory of Open Access Journals (Sweden)

    Xiaoqian J. Chai

    2015-01-01

    Full Text Available Despite growing evidence for atypical amygdala function and structure in major depression, it remains uncertain as to whether these brain differences reflect the clinical state of depression or neurobiological traits that predispose individuals to major depression. We examined function and structure of the amygdala and associated areas in a group of unaffected children of depressed parents (at-risk group and a group of children of parents without a history of major depression (control group. Compared to the control group, the at-risk group showed increased activation to fearful relative to neutral facial expressions in the amygdala and multiple cortical regions, and decreased activation to happy relative to neutral facial expressions in the anterior cingulate cortex and supramarginal gyrus. At-risk children also exhibited reduced amygdala volume. The extensive hyperactivation to negative facial expressions and hypoactivation to positive facial expressions in at-risk children are consistent with behavioral evidence that risk for major depression involves a bias to attend to negative information. These functional and structural brain differences between at-risk children and controls suggest that there are trait neurobiological underpinnings of risk for major depression.

  14. Identifying children at risk for being bullies in the United States.

    Science.gov (United States)

    Shetgiri, Rashmi; Lin, Hua; Flores, Glenn

    2012-01-01

    To identify risk factors associated with the greatest and lowest prevalence of bullying perpetration among U.S. children. Using the 2001-2002 Health Behavior in School-Aged Children, a nationally representative survey of U.S. children in 6th-10th grades, bivariate analyses were conducted to identify factors associated with any (once or twice or more), moderate (two to three times/month or more), and frequent (weekly or more) bullying. Stepwise multivariable analyses identified risk factors associated with bullying. Recursive partitioning analysis (RPA) identified risk factors which, in combination, identify students with the highest and lowest bullying prevalence. The prevalence of any bullying in the 13,710 students was 37.3%, moderate bullying was 12.6%, and frequent bullying was 6.6%. Characteristics associated with bullying were similar in the multivariable analyses and RPA clusters. In RPA, the highest prevalence of any bullying (67%) accrued in children with a combination of fighting and weapon-carrying. Students who carry weapons, smoke, and drink alcohol more than 5 to 6 days/week were at greatest risk for moderate bullying (61%). Those who carry weapons, smoke, have more than one alcoholic drink per day, have above-average academic performance, moderate/high family affluence, and feel irritable or bad-tempered daily were at greatest risk for frequent bullying (68%). Risk clusters for any, moderate, and frequent bullying differ. Children who fight and carry weapons are at greatest risk of any bullying. Weapon-carrying, smoking, and alcohol use are included in the greatest risk clusters for moderate and frequent bullying. Risk-group categories may be useful to providers in identifying children at the greatest risk for bullying and in targeting interventions. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  15. Risk of leukemia in susceptible children exposed to preconception, in utero, and postnatal radiation

    International Nuclear Information System (INIS)

    Bross, I.D.J.; Natarajan, N.

    1974-01-01

    Further statistical analysis has clarified the hypothesis that there exists a susceptible subgroup of children who are prone to develop leukemia after exposure to low doses of diagnostic radiation which have no effect on normal insusceptible children. The susceptible group does not show marked increase in relative risk when there is no report of exposure. The risk of developing leukemia among the susceptible children with any of the three types of radiation exposure is markedly increased in the appropriate age groups. The data are concordant with a latent period of 4 to 7 years. (auth)

  16. Understanding the Cognitive and Affective Mechanisms that Underlie Proxy Risk Perceptions among Caregivers of Asthmatic Children.

    Science.gov (United States)

    Shepperd, James A; Lipsey, Nikolette P; Pachur, Thorsten; Waters, Erika A

    2018-07-01

    Medical decisions made on behalf of another person-particularly those made by adult caregivers for their minor children-are often informed by the decision maker's beliefs about the treatment's risks and benefits. However, we know little about the cognitive and affective mechanisms influencing such "proxy" risk perceptions and about how proxy risk perceptions are related to prominent judgment phenomena. Adult caregivers of minor children with asthma ( N = 132) completed an online, cross-sectional survey assessing 1) cognitions and affects that form the basis of the availability, representativeness, and affect heuristics; 2) endorsement of the absent-exempt and the better-than-average effect; and 3) proxy perceived risk and unrealistic comparative optimism of an asthma exacerbation. We used the Pediatric Asthma Control and Communication Instrument (PACCI) to assess asthma severity. Respondents with higher scores on availability, representativeness, and negative affect indicated higher proxy risk perceptions and (for representativeness only) lower unrealistic optimism, irrespective of asthma severity. Conversely, respondents who showed a stronger display of the better-than-average effect indicated lower proxy risk perceptions but did not differ in unrealistic optimism. The absent-exempt effect was unrelated to proxy risk perceptions and unrealistic optimism. Heuristic judgment processes appear to contribute to caregivers' proxy risk perceptions of their child's asthma exacerbation risk. Moreover, the display of other, possibly erroneous, judgment phenomena is associated with lower caregiver risk perceptions. Designing interventions that target these mechanisms may help caregivers work with their children to reduce exacerbation risk.

  17. Incidence and risk factors for Malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: A retrospective study

    Directory of Open Access Journals (Sweden)

    Hershey Christine L

    2011-10-01

    Full Text Available Abstract Background United Nations High Commissioner for Refugees (UNHCR refugee camps are located predominantly in rural areas of Africa and Asia in protracted or post-emergency contexts. Recognizing the importance of malaria, pneumonia and diarrheal diseases as major causes of child morbidity and mortality in refugee camps, we analyzed data from the UNHCR Health Information System (HIS to estimate incidence and risk factors for these diseases in refugee children younger than five years of age. Methods Data from 90 UNHCR camps in 16 countries, including morbidity, mortality, health services and refugee health status, were obtained from the UNHCR HIS for the period January 2006 to February 2010. Monthly camp-level data were aggregated to yearly estimates for analysis and stratified by location in Africa (including Yemen or Asia. Poisson regression models with random effects were constructed to identify factors associated with malaria, pneumonia and diarrheal diseases. Spatial patterns in the incidence of malaria, pneumonia and diarrheal diseases were mapped to identify regional heterogeneities. Results Malaria and pneumonia were the two most common causes of mortality, with confirmed malaria and pneumonia each accounting for 20% of child deaths. Suspected and confirmed malaria accounted for 23% of child morbidity and pneumonia accounted for 17% of child morbidity. Diarrheal diseases were the cause of 7% of deaths and 10% of morbidity in children under five. Mean under-five incidence rates across all refugee camps by region were: malaria [Africa 84.7 cases/1000 U5 population/month (95% CI 67.5-102.0, Asia 2.2/1000/month (95% CI 1.4-3.0]; pneumonia [Africa 59.2/1000/month (95% CI 49.8-68.7, Asia 254.5/1000/month (95% CI 207.1-301.8]; and diarrheal disease [Africa 35.5/1000/month (95% CI 28.7-42.4, Asia 69.2/1000/month (95% CI 61.0-77.5]. Measles was infrequent and accounted for a small proportion of child morbidity (503 cases, Conclusions As in

  18. Guide to Considering Children's Health When Developing EPA Actions: Implementing Executive Order 13045 and EPA's Policy on Evaluating Health Risks to Children

    Science.gov (United States)

    Recommendations on integrating children's health considerations into EPA's Action Development Process (ADP). Also how to identify economically significant actions, disproportionate risk, and developing the Analytical Blueprint.

  19. Importance of Android/Gynoid Fat Ratio in Predicting Metabolic and Cardiovascular Disease Risk in Normal Weight as well as Overweight and Obese Children

    Science.gov (United States)

    Regier, Michael

    2014-01-01

    Numerous studies have shown that android or truncal obesity is associated with a risk for metabolic and cardiovascular disease, yet there is evidence that gynoid fat distribution may be protective. However, these studies have focused on adults and obese children. The purpose of our study was to determine if the android/gynoid fat ratio is positively correlated with insulin resistance, HOMA2-IR, and dislipidemia in a child sample of varying body sizes. In 7–13-year-old children with BMI percentiles ranging from 0.1 to 99.6, the android/gynoid ratio was closely associated with insulin resistance and combined LDL + VLDL-cholesterol. When separated by sex, it became clear that these relationships were stronger in boys than in girls. Subjects were stratified into BMI percentile based tertiles. For boys, the android/gynoid ratio was significantly related to insulin resistance regardless of BMI tertile with and LDL + VLDL in tertiles 1 and 3. For girls, only LDL + VLDL showed any significance with android/gynoid ratio and only in tertile 2. We conclude that the android/gynoid fat ratio is closely associated with insulin resistance and LDL + VLDL-, “bad,” cholesterol in normal weight boys and may provide a measurement of metabolic and cardiovascular disease risk in that population. PMID:25302115

  20. Importance of android/gynoid fat ratio in predicting metabolic and cardiovascular disease risk in normal weight as well as overweight and obese children.

    Science.gov (United States)

    Samsell, Lennie; Regier, Michael; Walton, Cheryl; Cottrell, Lesley

    2014-01-01

    Numerous studies have shown that android or truncal obesity is associated with a risk for metabolic and cardiovascular disease, yet there is evidence that gynoid fat distribution may be protective. However, these studies have focused on adults and obese children. The purpose of our study was to determine if the android/gynoid fat ratio is positively correlated with insulin resistance, HOMA2-IR, and dislipidemia in a child sample of varying body sizes. In 7-13-year-old children with BMI percentiles ranging from 0.1 to 99.6, the android/gynoid ratio was closely associated with insulin resistance and combined LDL + VLDL-cholesterol. When separated by sex, it became clear that these relationships were stronger in boys than in girls. Subjects were stratified into BMI percentile based tertiles. For boys, the android/gynoid ratio was significantly related to insulin resistance regardless of BMI tertile with and LDL + VLDL in tertiles 1 and 3. For girls, only LDL + VLDL showed any significance with android/gynoid ratio and only in tertile 2. We conclude that the android/gynoid fat ratio is closely associated with insulin resistance and LDL + VLDL-, "bad," cholesterol in normal weight boys and may provide a measurement of metabolic and cardiovascular disease risk in that population.

  1. Oral health and oral health risk behaviour in children with and without externalising behaviour problems.

    Science.gov (United States)

    Staberg, M; Norén, J G; Gahnberg, L; Ghaderi, A; Kadesjö, C; Robertson, A

    2018-05-15

    This was to study children with early detected externalising behaviour problems compared to matched controls regarding oral health, oral health risk behaviour and the parental evaluation of the child's oral health and dental care. Children aged 10-13 years and with externalising behaviour problems, were compared to matched controls. Behavioural characteristics were based on the Strength and Difficulties Questionnaire. The children and their parents completed questionnaires regarding dental fear, tooth brushing, dietary habits and evaluation of oral health and dental care. Data on dental caries risk assessments, caries, behaviour management problems and dental trauma were obtained from dental files. There were no differences in caries prevalence in children with early detected externalising behaviour problems, compared to controls. However, the former group consumed more sweet drinks when thirsty and brushed their teeth fewer than twice daily; they also had more dental trauma in both dentitions and a higher risk range for dental fear, compared to controls. This study points out potential oral health risk factors in children with early-detected externalising behaviour problems. Although no difference in caries prevalence was observed, externalising behaviour may affect oral health. Therefore, dental professionals should support the families and the children to preserve dental health by offering increased prophylactic measures. There were no differences between children with externalising behaviour problems, compared with controls, regarding the parent evaluation of their child's dental health. However, more parents in the study group evaluated the dental care as poor or not functioning.

  2. Relation between family history, obesity and risk for diabetes and heart disease in Pakistani children

    International Nuclear Information System (INIS)

    Basit, A.; Hakeem, R.; Hydrie, M.Z.; Ahmadani, M.Y.; Masood, Q.

    2004-01-01

    Objective: To assess the differences in relative risk of developing diabetes and CHD, obesity, fasting blood glucose, insulin and lipids of children having family history of diabetes or heart disease in first or second degree relatives as compared to control group. Design: Children were given a questionnaire to collect demographic data and to assess their dietary habits and family history. Anthropometric measurements and blood samples for fasting blood glucose, insulin and lipids of 8-10 years old children from 4 schools was taken. Subjects: Children having positive family history of diabetes (n=44) or heart disease (n=16) in first or second degree relatives were compared with a control group (n=39). Results: Children having positive family history for diabetes had slightly higher mean values for BMI, waist circumference, arm fat % as compared to the controls but the differences were not statistically significant. Overweight children (>85th Percentile of BMI for age) did not differ significantly in terms of various risk indicators however those who were in the uppermost tertile of arm fat % had significantly higher total Cholesterol, Triglycerides, LDL-C, LDL:HDL and Insulin levels (P<0.05 in each case). Conclusion: Diabetes and CVD risks from positive family history for the disease are probably mediated through increased body fat percentage. Thus even when information about family history of disease is lacking, arm-fat-percentage could be used as an important screening tool for determining the risk status of children. (author)

  3. [Causes of emergency dizziness stratified by etiology].

    Science.gov (United States)

    Qiao, Wenying; Liu, Jianguo; Zeng, Hong; Liu, Yugeng; Jia, Weihua; Wang, Honghong; Liu, Bo; Tan, Jing; Li, Changqing

    2014-06-03

    To explore the causes of emergency dizziness stratified to improve the diagnostic efficiency. A total of 1 857 cases of dizziness at our emergency department were collected and their etiologies stratified by age and gender. The top three diagnoses were benign paroxysmal positional vertigo (BPPV, 31.7%), hypertension (24.0%) and posterior circulation ischemia (PCI, 20.5%). Stratified by age, the main causes of dizziness included BPPV (n = 6), migraine-associated vertigo (n = 2), unknown cause (n = 1) for the group of vertigo (14.5%) and neurosis (7.3%) for 18-44 years; BPPV (36.8%), hypertension (22.4%) and migraine-associated vertigo (11.2%) for 45-59 years; hypertension (30.8%), PCI (29.8%) and BPPV (22.9%) for 60-74 years; PCI (30.7%), hypertension (28.6%) and BPPV (25.5%) for 75-92 years. BPPV, migraine and neurosis were more common in females while hypertension and PCI predominated in males (all P hypertension, neurosis and migraine showed the following significant demographic features: BPPV, PCI, hypertension, neurosis and migraine may be the main causes of dizziness. BPPV should be considered initially when vertigo was triggered repeatedly by positional change, especially for young and middle-aged women. And the other common causes of dizziness were migraine-associated vertigo, neurosis and Meniere's disease.Hypertension should be screened firstly in middle-aged and elderly patients presenting mainly with head heaviness and stretching. In elders with dizziness, BPPV is second in constituent ratio to PCI and hypertension.In middle-aged and elderly patients with dizziness, psychological factors should be considered and diagnosis and treatment should be offered timely.

  4. "What exactly is a paedophile?" Children talking about Internet risk

    OpenAIRE

    Andrew Burn; Rebekah Willett

    2017-01-01

    Reports tell us that the internet is opening new dangers to children, including online grooming, exposure to pornography and financial scams (Carr 2004; Gardner 2003; UK Home Office 2001; O'Connell 2003). The result has been various initiatives which attempt to teach children safe surfing habits. The UK Home Office "ThinkUKnow" campaign featured advertisements on the radio, internet and cinemas, targeting teens and preteens with the message that the person they are chatting to "may not be who...

  5. Predicting the risk of newborn children to become overweight later in childhood : The PIAMA birth cohort study

    NARCIS (Netherlands)

    Steur, Marinka; Smit, Henriette A.; Schipper, C. Maarten A.; Scholtens, Salome; Kerkhof, Marjan; De Jongste, Johan C.; Haveman-Nies, Annemien; Brunekreef, Bert; Wijga, Alet H.

    Objective. To develop a decision rule by which children with a high risk to develop overweight can be distinguished at birth from children at low risk. Design, setting and participants. Data of 1 687 Dutch children born in 1996/1997 who participated in the Prevention and Incidence of Asthma and Mite

  6. Predicting the risk of newborn children to become overweight later in childhood: the PIAMA birth cohort study

    NARCIS (Netherlands)

    Steur, M.; Smit, H.A.; Schipper, C.M.A.; Scholtens, S.; Kerkhof, van de M.; Jongste, de J.C.; Haveman-Nies, A.; Brunekreef, B.; Wijga, A.H.

    2011-01-01

    Objective. To develop a decision rule by which children with a high risk to develop overweight can be distinguished at birth from children at low risk. Design, setting and participants. Data of 1 687 Dutch children born in 1996/1997 who participated in the Prevention and Incidence of Asthma and Mite

  7. Distribution of risk factors among children with febrile convulsions in ...

    African Journals Online (AJOL)

    The proximal risk factors are male gender, age < 2 years, 2nd birth order and positive family nd history. The social status of families is a distal risk factor. The second year of life and 2 birth order are the strongest predisposing factors to the development of FC. Key words: Febrile convulsions, Risk factors, Benin City, Nigeria ...

  8. Children and the risks of using the Internet

    NARCIS (Netherlands)

    Nathalie Sonck; Jos de Haan

    2011-01-01

    Original title: Kinderen en internetrisico's As well as benefits, Internet use carries risks. This report looks at the online risks to which 9-16 year-olds in the Netherlands expose themselves. How often do they come into contact with online risks and how often do they themselves find this

  9. White dwarf stars with chemically stratified atmospheres

    Science.gov (United States)

    Muchmore, D.

    1982-01-01

    Recent observations and theory suggest that some white dwarfs may have chemically stratified atmospheres - thin layers of hydrogen lying above helium-rich envelopes. Models of such atmospheres show that a discontinuous temperature inversion can occur at the boundary between the layers. Model spectra for layered atmospheres at 30,000 K and 50,000 K tend to have smaller decrements at 912 A, 504 A, and 228 A than uniform atmospheres would have. On the basis of their continuous extreme ultraviolet spectra, it is possible to distinguish observationally between uniform and layered atmospheres for hot white dwarfs.

  10. Bayesian stratified sampling to assess corpus utility

    Energy Technology Data Exchange (ETDEWEB)

    Hochberg, J.; Scovel, C.; Thomas, T.; Hall, S.

    1998-12-01

    This paper describes a method for asking statistical questions about a large text corpus. The authors exemplify the method by addressing the question, ``What percentage of Federal Register documents are real documents, of possible interest to a text researcher or analyst?`` They estimate an answer to this question by evaluating 200 documents selected from a corpus of 45,820 Federal Register documents. Bayesian analysis and stratified sampling are used to reduce the sampling uncertainty of the estimate from over 3,100 documents to fewer than 1,000. A possible application of the method is to establish baseline statistics used to estimate recall rates for information retrieval systems.

  11. Stratified B-trees and versioning dictionaries

    OpenAIRE

    Twigg, Andy; Byde, Andrew; Milos, Grzegorz; Moreton, Tim; Wilkes, John; Wilkie, Tom

    2011-01-01

    A classic versioned data structure in storage and computer science is the copy-on-write (CoW) B-tree -- it underlies many of today's file systems and databases, including WAFL, ZFS, Btrfs and more. Unfortunately, it doesn't inherit the B-tree's optimality properties; it has poor space utilization, cannot offer fast updates, and relies on random IO to scale. Yet, nothing better has been developed since. We describe the `stratified B-tree', which beats all known semi-external memory versioned B...

  12. Does Head Start differentially benefit children with risks targeted by the program's service model?

    Science.gov (United States)

    Miller, Elizabeth B; Farkas, George; Duncan, Greg J

    Data from the Head Start Impact Study ( N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program's comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children's pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed.

  13. Disability as a risk factor? Development of psychopathology in children with disabilities

    DEFF Research Database (Denmark)

    Bøttcher, Louise; Dammeyer, Jesper Herup

    2013-01-01

    and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone......Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental...... psychopathological models that conceptualise the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability...

  14. Word Decoding Development during Phonics Instruction in Children at Risk for Dyslexia.

    Science.gov (United States)

    Schaars, Moniek M H; Segers, Eliane; Verhoeven, Ludo

    2017-05-01

    In the present study, we examined the early word decoding development of 73 children at genetic risk of dyslexia and 73 matched controls. We conducted monthly curriculum-embedded word decoding measures during the first 5 months of phonics-based reading instruction followed by standardized word decoding measures halfway and by the end of first grade. In kindergarten, vocabulary, phonological awareness, lexical retrieval, and verbal and visual short-term memory were assessed. The results showed that the children at risk were less skilled in phonemic awareness in kindergarten. During the first 5 months of reading instruction, children at risk were less efficient in word decoding and the discrepancy increased over the months. In subsequent months, the discrepancy prevailed for simple words but increased for more complex words. Phonemic awareness and lexical retrieval predicted the reading development in children at risk and controls to the same extent. It is concluded that children at risk are behind their typical peers in word decoding development starting from the very beginning. Furthermore, it is concluded that the disadvantage increased during phonics instruction and that the same predictors underlie the development of word decoding in the two groups of children. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Socialization in the Context of Risk and Psychopathology: Maternal Emotion Socialization in Children of Incarcerated Mothers.

    Science.gov (United States)

    Zeman, Janice; Dallaire, Danielle; Borowski, Sarah

    2016-02-01

    Children of incarcerated mothers are at increased risk for psychological, social, and emotional maladaptation. This research investigates whether perceived maternal socialization of sadness and anger may moderate these outcomes in a sample of 154 children (53.9% boys, 61.7% Black, M age = 9.38, range: 6 - 12), their 118 mothers (64.1% Black), and 118 caregivers (74.8% female, 61.9% grandparents, 63.2% Black). Using mother, caregiver, and child report, seven maternal socialization strategies were assessed in their interaction with incarceration-specific risk experiences predicting children's adjustment. For sadness socialization, the results indicated that among children reporting maternal emotion-focused responses, incarceration-specific risk predicted increases in psychological problems, depressive symptoms, increased emotional lability, and poorer emotion regulation. For children who perceived a problem-focused response, incarceration-specific risk did not predict outcomes. There were no significant interactions with incarceration-specific risk and perceived maternal anger socialization strategies. These results indicate a critical need to examine how socialization processes may operate differently for children raised in atypical socializing contexts.

  16. [Overweight in primary school-age children. Prevalence and risk factors].

    Science.gov (United States)

    Funk, M B; Bausback-Schomakers, S; Hanschmann, K M; Gerhards, B; Kuhn, K; Krackhardt, B

    2015-10-01

    Various studies show that pre-school age is a sensitive period for the development of overweight and obesity. During a longitudinal study between 2010 and 2013, the municipal health authority (city of Frankfurt) in cooperation with the university children's hospital investigated the development of weight in children aged 5 to 8. The weight and height of a collective of 5720 children were measured (2010/11). In addition, nutritional and exercise habits, as well as media consumption was documented for 4758 children through a questionnaire during the school enrolment procedure. The weight and height of 3481 children were measured again in the second grade (2012/13). Over a period of 24 months, the percentage of overweight (not obese) children increased from 7.5 to 9.4 % and that of obese children from 4.5 to 5.0 %. 164 of 2818 children with a normal initial weight (5.8 %) changed to percentile class overweight or obese. 79 of 260 children who were initially overweight, not obese (30 %), changed to the group of normal weight, but only 4 out of 156 obese children (3 %). Increased TV consumption (> 1 h per day), availability of their own television, lack of physical activity, and consumption of high-calorie drinks were risk factors for the development of overweight during the primary school age. 72 % of parents of overweight children and 22 % of obese children falsely classified their children as normal weight. Targeted education about the risk of obesity in the primary school age and offers for early intervention should be established in the healthcare services concerned.

  17. Adverse metabolic risk profiles in Greenlandic Inuit children compared to Danish children.

    Science.gov (United States)

    Munch-Andersen, T; Sorensen, K; Andersen, L B; Aachmann-Andersen, N J; Aksglaede, L; Juul, A; Helge, J W

    2013-06-01

    During recent decades, the prevalence of metabolic morbidity has increased rapidly in adult Greenlandic Inuit. To what extent this is also reflected in the juvenile Inuit population is unknown. The objective was, therefore, in the comparison with Danish children, to evaluate metabolic profiles in Greenlandic Inuit children from the capital in the southern and from the northern most villages 187 Inuit and 132 Danish children were examined with anthropometrics, pubertal staging, fasting blood samples, and a maximal aerobic test. Both Inuit children living in Nuuk and the northern villages had significantly higher glucose, total cholesterol, apolipoprotein A1 levels, and diastolic blood pressure compared with Danish children after adjustment for differences in adiposity and aerobic fitness levels. The Inuit children living in Nuuk had significantly higher BMI, body fat %, HbA1 c, and significantly lower aerobic fitness and ApoA1 levels than northern living Inuit children. Greenlandic Inuit children had adverse metabolic health profile compared to the Danish children, the differences where more pronounced in Inuit children living in Nuuk. The tendencies toward higher prevalence of diabetes and metabolic morbidity in the adult Greenlandic Inuit population may also be present in the Inuit children population. Copyright © 2013 The Obesity Society.

  18. Lipid profiles of vegetarian and non-vegetarian children at risk of overweight or obesity

    Directory of Open Access Journals (Sweden)

    Arie Purwana

    2010-10-01

    Full Text Available Background The type, amount, and composition of a diet may affect the levels of cholesterol in blood. Itis believed that children adhering to a vegetarian diet have lower total cholesterol levels and lower body mass indexes compared to children with non-vegetarian (omnivorous diets. We wish to compare cholesterol levels of vegetarian and non-vegetarian Indonesian children who are at risk of overweight or obesity. Objective To compare lipid profiles of vegetarian and no-vegetarian children who are at risk for overweight or obesity. Methods We performed a cross-sectional study in January and February 2010. Subjects for this study came from Denpasar, Bali. Subjects filled questionnaires as well as underwent history-taking, anthropometric measurements, and blood testing. We performed lipid profile analyses on their blood samples. We used the independent t test and Mann-Whitney test for statistical analysis of the data. The level of significance was set at P <0.05. Results Our study included forty-four children at risk for overweight or obesity with a vegetarian or non-vegetarian diet. We found that vegetarian children had lower mean total cholesterol (144 mg/dL than that of non-vegetarian children (171 mg/dL, a statistically significant difference of P=0.014. In addition, vegetarian children had lower mean triglyceride levels (150 mg/dL than those of nonvegetarian children (264 mg/dL, a statistically significant difference of P =0 .025. Conclusion Among Balinese children at risk of overweight or obesity, vegetarians have significantly lower mean total cholesterol and triglyceride levels than non-vegetarians.

  19. Early home-based intervention in the Netherlands for children at familial risk of dyslexia

    NARCIS (Netherlands)

    van Otterloo, S.G.; van der Leij, A.; Henrichs, L.F.

    2009-01-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and

  20. Early Home-Based Intervention in the Netherlands for Children at Familial Risk of Dyslexia

    Science.gov (United States)

    van Otterloo, Sandra G.; van der Leij, Aryan; Henrichs, Lotte F.

    2009-01-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n = 23) received a specific training in phoneme awareness and letter knowledge. A control group (n = 25) received…

  1. Sex of prior children and risk of stillbirth in subsequent pregnancies

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Mortensen, Laust Hvas; Nygaard, Ulrikka

    2010-01-01

    (singleton) between 1980 and 1998 (n = 499,731) using the Danish Birth Registry. These women had subsequent singleton births through 2004 (n = 558,314). We assessed the risk of stillbirth conditional on sex of prior children. RESULTS: The risk of stillbirth was increased by 12% after deliver of boys compared...

  2. Parental Bonds in Children at High and Low Familial Risk for Panic Disorder

    Science.gov (United States)

    Koszycki, Diana; Bilodeau, Cynthia; Zwanzger, Peter; Schneider, Barry H.; Flament, Martine F.; Bradwejn, Jacques

    2013-01-01

    A rejecting and overprotective parenting style is considered to be an important risk factor for the development of anxiety disorders. This study examined the role of perceived parental bonding as a potential environmental risk factor for panic disorder (PD) in unaffected offspring with parental PD. Children with a biological parent with PD (n =…

  3. Early Markers of Language Delay in Children with and without Family Risk for Dyslexia

    Science.gov (United States)

    Unhjem, Astrid; Eklund, Kenneth; Nergård-Nilssen, Trude

    2015-01-01

    This study examined the extent to which receptive and productive vocabulary between ages 12 and 18 months predicted language skills at age 24 months in children born with family risk for dyslexia (FR) and a control group born without that risk. The aim was to identify possible markers of early language delay. The authors monitored vocabulary…

  4. Parental Incarceration and Multiple Risk Experiences: Effects on Family Dynamics and Children's Delinquency

    Science.gov (United States)

    Aaron, Lauren; Dallaire, Danielle H.

    2010-01-01

    Children of incarcerated parents are exposed to factors that place them at risk for delinquency. Few studies have examined the effects of having an incarcerated parent after controlling for other experiences such as contextual risk factors and family processes. Past studies have also not examined effects of recent, but not current, parental…

  5. Transracial Mothering and Maltreatment: Are Black/White Biracial Children at Higher Risk?

    Science.gov (United States)

    Fusco, Rachel A.; Rautkis, Mary E.

    2012-01-01

    The number of people identifying as biracial is rapidly growing, though little is known about the experiences of interracial families. Previous work indicates that biracial children may be at elevated risk of entering the child welfare system. This could underscore additional risks faced by these families. This document includes data from the…

  6. Associations between Early Family Risk, Children's Behavioral Regulation, and Academic Achievement in Portugal

    Science.gov (United States)

    Cadima, Joana; Gamelas, Ana M.; McClelland, Megan; Peixoto, Carla

    2015-01-01

    Research Findings: This study examined concurrent associations between family sociodemographic risk, self-regulation, and early literacy and mathematics in young children from Azores, Portugal (N = 186). Family sociodemographic risk was indexed by low maternal education, low family income, and low occupational status. Behavioral aspects of…

  7. Risk Factors for Conduct Problems and Depressive Symptoms in a Cohort of Ukrainian Children

    Science.gov (United States)

    Drabick, Deborah A. G.; Beauchaine, Theodore P.; Gadow, Kenneth D.; Carlson, Gabrielle A.; Bromet, Evelyn J.

    2006-01-01

    Potential risk factors for conduct problems and depressive symptoms were tested in a cohort of 10- to 12-year-old Ukrainian children (N = 544, 47.6% male). Risk factors examined were child emotional lability, child attention problems, poor mother-child communication, coercive maternal discipline, maternal depression, and low marital satisfaction.…

  8. Early identification and intervention in children at risk for reading difficulties

    NARCIS (Netherlands)

    Regtvoort, A.G.F.M.

    2014-01-01

    In pre-readers, a familial background of dyslexia and/or delayed emergent literacy should be considered a not-to-ignore risk signalling problems with learning to read. This thesis aims to study early identification and intervention in at-risk children shortly before or after the start of formal

  9. Schizophrenia in High-Risk Children: Sex Differences in Predisposing Factors.

    Science.gov (United States)

    Mednick, Sarnoff A.; And Others

    Reported is a research program to observe children at high risk for schizophrenia and explore possibilities of prevention. Characteristics of the high risk group (n=207) observed during 1962 are discussed, and a theory which suggests that schizophrenia is an evasion of life is explained. Among results of a diagnostic assessment conducted 10 years…

  10. The Association between Cardiovascular Disease Risk and Parental Educational Level in Portuguese Children

    Directory of Open Access Journals (Sweden)

    Michael J. Duncan

    2012-11-01

    Full Text Available The aim of this study was to examine any differences in cardiovascular disease (CVD risk in Portuguese children split by parental educational level. A cross-sectional school-based study was conducted in 2011 on 359 Portuguese children (202 girls and 157 boys aged 10 to 17 years (mean age ± SD = 13.9 ± 1.98 years. Height and body mass were assessed to determine body mass index (BMI. Parental education level (PEL was used as a surrogate for socioeconomic status (SES. Capillary blood sampling was used to determine: Total Cholesterol (TC, Triglycerides (TG, Fasting Glucos (GLUC, High and Low Density Lipoprotein (HDL/LDL. These measurements were combined with measures of systolic blood pressure and cardiorespiratory fitness as z-scores. CVD risk was constructed by summing the z-scores. Analysis of covariance, controlling for BMI, indicated that CVD risk was significantly different across PEL groups (p = 0.01, with CVD risk score being significantly lower in low (p = 0.04 and middle (p = 0.008 PEL groups, compared to high PEL. Moreover, the covariate, BMI was also significant (p = 0.0001, β = 0.023, evidencing a significant positive association between BMI and CVD risk, with higher BMI associated with greater CVD risk. In Portuguese children, significantly greater CVD risk was found for children of high PEL, while higher BMI was associated with greater CVD risk.

  11. Risk and protective factors in children adopted from the former Soviet Union.

    Science.gov (United States)

    McGuinness, T M; McGuinness, J P; Dyer, J G

    2000-01-01

    The former Soviet Union (including the present independent republics of Russia, Ukraine, Latvia, Belarus, Lithuania, and Georgia) is the leading source of children adopted from overseas by persons in the United States (US Department of State, 1998). This study sought to (a) characterize the current social, academic, and conduct competencies of 6- to 9-year-old children adopted from the former Soviet Union who have resided in the United States for at least 2 years and (b) evaluate both risks and protective influences of adoptive families and their relationships to competence via a structural equation model. Telephone interviews and a postal survey of children were drawn from a US community sample of 105 children. Measures included (a) Child Behavior Checklist, (b) Teacher Report Form, (c) Vineland Adaptive Behavior Scales, (c) Family Environment Scale, and (d) demographic information. Many children had experienced abuse, abandonment, or neglect between birth and entry to the institution. Their mean birth weight was 2637 g, and alcohol abuse by the birth mother was common (41%). Although the children scored below average in competence, adoptive family environments were positive and served as buffers between the risks experienced by the children and the subsequent development of competence within the adoptive family. Children's abilities ranged from severely challenged to developmentally normal. The high rate of fetal alcohol exposure in the children may portend future challenges for families.

  12. Postprandial changes in cardiometabolic disease risk in young Chinese men following isocaloric high or low protein diets, stratified by either high or low meal frequency - a randomized controlled crossover trial.

    Science.gov (United States)

    Mok, Alexander; Haldar, Sumanto; Lee, Jetty Chung-Yung; Leow, Melvin Khee-Shing; Henry, Christiani Jeyakumar

    2016-03-15

    Cardio-Metabolic Disease (CMD) is the leading cause of death globally and particularly in Asia. Postprandial elevation of glycaemia, insulinaemia, triglyceridaemia are associated with an increased risk of CMD. While studies have shown that higher protein intake or increased meal frequency may benefit postprandial metabolism, their combined effect has rarely been investigated using composite mixed meals. We therefore examined the combined effects of increasing meal frequency (2-large vs 6-smaller meals), with high or low-protein (40 % vs 10 % energy from protein respectively) isocaloric mixed meals on a range of postprandial CMD risk markers. In a randomized crossover study, 10 healthy Chinese males (Age: 29 ± 7 years; BMI: 21.9 ± 1.7 kg/m(2)) underwent 4 dietary treatments: CON-2 (2 large Low-Protein meals), CON-6 (6 Small Low-Protein meals), PRO-2 (2 Large High-Protein meals) and PRO-6 (6 Small High-Protein meals). Subjects wore a continuous glucose monitor (CGM) and venous blood samples were obtained at baseline and at regular intervals for 8.5 h to monitor postprandial changes in glucose, insulin, triglycerides and high sensitivity C-reactive protein (hsCRP). Blood pressure was measured at regular intervals pre- and post- meal consumption. Urine was collected to measure excretion of creatinine and F2-isoprostanes and its metabolites over the 8.5 h postprandial period. The high-protein meals, irrespective of meal frequency were beneficial for glycaemic health since glucose incremental area under the curve (iAUC) for PRO-2 (185 ± 166 mmol.min.L(-1)) and PRO-6 (214 ± 188 mmol.min.L(-1)) were 66 and 60 % lower respectively (both p meals with higher protein content, irrespective of meal frequency appears to be beneficial for postprandial glycemic and insulinemic responses in young, healthy Chinese males. Implications of this study may be useful in the Asian context where the consumption of high glycemic index, carbohydrate meals is prevalent. NCT02529228 .

  13. Portal hypertension in children: High-risk varices, primary prophylaxis and consequences of bleeding.

    Science.gov (United States)

    Duché, Mathieu; Ducot, Béatrice; Ackermann, Oanez; Guérin, Florent; Jacquemin, Emmanuel; Bernard, Olivier

    2017-02-01

    Primary prophylaxis of bleeding is debated for children with portal hypertension because of the limited number of studies on its safety and efficacy, the lack of a known endoscopic pattern carrying a high-risk of bleeding for all causes, and the assumption that the mortality of a first bleed is low. We report our experience with these issues. From 1989 to 2014, we managed 1300 children with portal hypertension. Endoscopic features were recorded; high-risk varices were defined as: grade 3 esophageal varices, grade 2 varices with red wale markings, or gastric varices. Two hundred forty-six children bled spontaneously and 182 underwent primary prophylaxis. The results of primary prophylaxis were reviewed as well as bleed-free survival, overall survival and life-threatening complications of bleeding. High-risk varices were found in 96% of children who bled spontaneously and in 11% of children who did not bleed without primary prophylaxis (pportal hypertension. Life-threatening complications of bleeding were recorded in 19% of children with cirrhosis and high-risk varices who bled spontaneously. Ten-year probabilities of bleed-free survival after primary prophylaxis in children with high-risk varices were 96% and 72% for non-cirrhotic causes and cirrhosis respectively. Ten-year probabilities of overall survival after primary prophylaxis were 100% and 93% in children with non-cirrhotic causes and cirrhosis respectively. In children with portal hypertension, bleeding is linked to the high-risk endoscopic pattern reported here. Primary prophylaxis of bleeding based on this pattern is fairly effective and safe. In children with liver disease, the risk of bleeding from varices in the esophagus is linked to their large size, the presence of congestion on their surface and their expansion into the stomach but not to the child's age nor to the cause of portal hypertension. Prevention of the first bleed in children with high-risk varices can be achieved by surgery or endoscopic

  14. Estimation of transient increases in bleeding risk associated with physical activity in children with haemophilia

    Directory of Open Access Journals (Sweden)

    Latimer Jane

    2008-06-01

    Full Text Available Abstract Background Although it is widely appreciated that vigorous physical activity can increase the risk of bleeding episodes in children with haemophilia, the magnitude of the increase in risk is not known. Accurate risk estimates could inform decisions made by children with haemophilia and their parents about participation in physical activity and aid the development of optimal prophylactic schedules. The aim of this study is to provide an accurate estimate of the risks of bleeding associated with vigorous physical activity in children with haemophilia. Methods/Design The study will be a case-crossover study nested within a prospective cohort study. Children with moderate or severe haemophilia A or B, recruited from two paediatric haematology departments in Australia, will participate in the study. The child, or the child's parent or guardian, will report bleeding episodes experienced over a 12-month period. Following a bleeding episode, the participant will be interviewed by telephone about exposures to physical activity in the case period (8 hours before the bleed and 2 control periods (an 8 hour period at the same time on the day preceding the bleed and an 8 hour period two days preceding the bleed. Conditional logistic regression will be used to estimate the risk of participating in vigorous physical activity from measures of exposure to physical activity in the case and control periods. Discussion This case-control study will provide estimates of the risk of participation in vigorous physical activity in children with haemophilia.

  15. The differences of movement between children at risk of developmental coordination disorder and those not at risk

    Directory of Open Access Journals (Sweden)

    Adrián Agricola

    2015-09-01

    Full Text Available Background: Developmental coordination disorder (DCD is a syndrome unexplained by medical condition, which is marked by defects in the development of motor coordination. Children with this impairment are more dependent on visual information to perform movements than their typically developing (TD peers. Objective: The main aim of the research was to create a checklist for the evaluation of the head and limb movement while walking. After that, based on this tool, to find differences in the movement of various body segments in children at risk of DCD (DCDr compared to typically developing children under different visual conditions. Methods: A total of 32 children aged 8.7 ± 1.1 years participated in this study. The Movement Assessment Battery for Children - 2nd edition (MABC-2 was used to make a classification of motor competence level of the participants. PLATO goggles were used to make four different visual conditions. All trials were recorded. Based on the video analysis we completed a qualitative checklist. Results: The analysis between the children from the DCDr group and TD children showed significant differences in the head (p = .023 and the arm (p = .005 movements, in body position (p = .002 and total summary score (p = .001. The main effects of visual conditions showed significant differences in all cases; in the head (p = .015, with the arm (p = .006, trunk (p =  .009, leg (p = .001 movements, in body position (p = .001 and also in the total summary score (p = .001. The interaction between groups and visual conditions was significant in leg movements (p = .007 and body position (p = .002. Conclusions: This study has shown which movements of body segments are most affected by different visual conditions and how children at risk of DCD are dependent on visual perception.

  16. Body fat, abdominal fat and body fat distribution related to cardiovascular risk factors in prepubertal children

    DEFF Research Database (Denmark)

    Dencker, Magnus; Wollmer, Per; Karlsson, Magnus K

    2012-01-01

    Aim:  We analysed whether total body fat (TBF), abdominal fat and body fat distribution are associated with higher composite risk factor scores for cardiovascular disease (CVD) in young children. Methods:  Cross-sectional study of 238 children aged 8-11 years. TBF and abdominal fat mass (AFM) wer......, separately, and used as composite risk factor score. Results:  Pearson correlations between ln BF%, ln AFM and AFM/TBF versus composite risk factor score for boys were r = 0.56, r = 0.59 and r = 0.48, all p ...

  17. Visual and auditory perception in preschool children at risk for dyslexia.

    Science.gov (United States)

    Ortiz, Rosario; Estévez, Adelina; Muñetón, Mercedes; Domínguez, Carolina

    2014-11-01

    Recently, there has been renewed interest in perceptive problems of dyslexics. A polemic research issue in this area has been the nature of the perception deficit. Another issue is the causal role of this deficit in dyslexia. Most studies have been carried out in adult and child literates; consequently, the observed deficits may be the result rather than the cause of dyslexia. This study addresses these issues by examining visual and auditory perception in children at risk for dyslexia. We compared children from preschool with and without risk for dyslexia in auditory and visual temporal order judgment tasks and same-different discrimination tasks. Identical visual and auditory, linguistic and nonlinguistic stimuli were presented in both tasks. The results revealed that the visual as well as the auditory perception of children at risk for dyslexia is impaired. The comparison between groups in auditory and visual perception shows that the achievement of children at risk was lower than children without risk for dyslexia in the temporal tasks. There were no differences between groups in auditory discrimination tasks. The difficulties of children at risk in visual and auditory perceptive processing affected both linguistic and nonlinguistic stimuli. Our conclusions are that children at risk for dyslexia show auditory and visual perceptive deficits for linguistic and nonlinguistic stimuli. The auditory impairment may be explained by temporal processing problems and these problems are more serious for processing language than for processing other auditory stimuli. These visual and auditory perceptive deficits are not the consequence of failing to learn to read, thus, these findings support the theory of temporal processing deficit. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Exposure to an Indoor Cooking Fire and Risk of Trachoma in Children of Kongwa, Tanzania.

    Directory of Open Access Journals (Sweden)

    Andrea I Zambrano

    Full Text Available Elimination of blinding trachoma by 2020 can only be achieved if affected areas have effective control programs in place before the target date. Identifying risk factors for active disease that are amenable to intervention is important to successfully design such programs. Previous studies have linked sleeping by a cooking fire to trachoma in children, but not fully explored the mechanism and risks. We propose to determine the risk for active trachoma in children with exposure to cooking fires by severity of trachoma, adjusting for other known risk factors.Complete census of 52 communities in Kongwa, Tanzania, was conducted to collect basic household characteristics and demographic information on each family member. Information on exposure to indoor cooking fires while the mother was cooking and while sleeping for each child was collected. 6656 randomly selected children ages 1-9 yrs were invited to a survey where both eyelids were graded for follicular (TF and intense trachoma (TI using the WHO simplified grading scheme. Ocular swab were taken to assess the presence of Chlamydia trachomatis.5240 (79% of the invited children participated in the study. Overall prevalence for trachoma was 6·1%. Odds for trachoma and increased severity were higher in children sleeping without ventilation and a cooking fire in their room (TF OR = 1·81, 1·00-3·27 and TI OR 4·06, 1·96-8·42. Children with TF or TI who were exposed were more likely to have infection than children with TF or TI who were not exposed. There was no increased risk with exposure to a cooking fire while the mother was cooking.In addition to known risk factors for trachoma, sleeping by an indoor cooking fire in a room without ventilation was associated with active trachoma and appears to substantially increase the risk of intense inflammation.

  19. Exposure to an Indoor Cooking Fire and Risk of Trachoma in Children of Kongwa, Tanzania.

    Science.gov (United States)

    Zambrano, Andrea I; Muñoz, Beatriz E; Mkocha, Harran; West, Sheila K

    2015-01-01

    Elimination of blinding trachoma by 2020 can only be achieved if affected areas have effective control programs in place before the target date. Identifying risk factors for active disease that are amenable to intervention is important to successfully design such programs. Previous studies have linked sleeping by a cooking fire to trachoma in children, but not fully explored the mechanism and risks. We propose to determine the risk for active trachoma in children with exposure to cooking fires by severity of trachoma, adjusting for other known risk factors. Complete census of 52 communities in Kongwa, Tanzania, was conducted to collect basic household characteristics and demographic information on each family member. Information on exposure to indoor cooking fires while the mother was cooking and while sleeping for each child was collected. 6656 randomly selected children ages 1-9 yrs were invited to a survey where both eyelids were graded for follicular (TF) and intense trachoma (TI) using the WHO simplified grading scheme. Ocular swab were taken to assess the presence of Chlamydia trachomatis. 5240 (79%) of the invited children participated in the study. Overall prevalence for trachoma was 6·1%. Odds for trachoma and increased severity were higher in children sleeping without ventilation and a cooking fire in their room (TF OR = 1·81, 1·00-3·27 and TI OR 4·06, 1·96-8·42). Children with TF or TI who were exposed were more likely to have infection than children with TF or TI who were not exposed. There was no increased risk with exposure to a cooking fire while the mother was cooking. In addition to known risk factors for trachoma, sleeping by an indoor cooking fire in a room without ventilation was associated with active trachoma and appears to substantially increase the risk of intense inflammation.

  20. Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity.

    Science.gov (United States)

    Firk, Christine; Konrad, Kerstin; Herpertz-Dahlmann, Beate; Scharke, Wolfgang; Dahmen, Brigitte

    2018-02-01

    Adolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children's developmental outcome. Therefore, the aim of the current study was to investigate differences in children's cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers. Adolescent mothers (25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months). Children of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children's cognitive development. The present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors. Copyright

  1. Soil mixing of stratified contaminated sands.

    Science.gov (United States)

    Al-Tabba, A; Ayotamuno, M J; Martin, R J

    2000-02-01

    Validation of soil mixing for the treatment of contaminated ground is needed in a wide range of site conditions to widen the application of the technology and to understand the mechanisms involved. Since very limited work has been carried out in heterogeneous ground conditions, this paper investigates the effectiveness of soil mixing in stratified sands using laboratory-scale augers. This enabled a low cost investigation of factors such as grout type and form, auger design, installation procedure, mixing mode, curing period, thickness of soil layers and natural moisture content on the unconfined compressive strength, leachability and leachate pH of the soil-grout mixes. The results showed that the auger design plays a very important part in the mixing process in heterogeneous sands. The variability of the properties measured in the stratified soils and the measurable variations caused by the various factors considered, highlighted the importance of duplicating appropriate in situ conditions, the usefulness of laboratory-scale modelling of in situ conditions and the importance of modelling soil and contaminant heterogeneities at the treatability study stage.

  2. Stratified coastal ocean interactions with tropical cyclones

    Science.gov (United States)

    Glenn, S. M.; Miles, T. N.; Seroka, G. N.; Xu, Y.; Forney, R. K.; Yu, F.; Roarty, H.; Schofield, O.; Kohut, J.

    2016-01-01

    Hurricane-intensity forecast improvements currently lag the progress achieved for hurricane tracks. Integrated ocean observations and simulations during hurricane Irene (2011) reveal that the wind-forced two-layer circulation of the stratified coastal ocean, and resultant shear-induced mixing, led to significant and rapid ahead-of-eye-centre cooling (at least 6 °C and up to 11 °C) over a wide swath of the continental shelf. Atmospheric simulations establish this cooling as the missing contribution required to reproduce Irene's accelerated intensity reduction. Historical buoys from 1985 to 2015 show that ahead-of-eye-centre cooling occurred beneath all 11 tropical cyclones that traversed the Mid-Atlantic Bight continental shelf during stratified summer conditions. A Yellow Sea buoy similarly revealed significant and rapid ahead-of-eye-centre cooling during Typhoon Muifa (2011). These findings establish that including realistic coastal baroclinic processes in forecasts of storm intensity and impacts will be increasingly critical to mid-latitude population centres as sea levels rise and tropical cyclone maximum intensities migrate poleward. PMID:26953963

  3. Stratified Simulations of Collisionless Accretion Disks

    Energy Technology Data Exchange (ETDEWEB)

    Hirabayashi, Kota; Hoshino, Masahiro, E-mail: hirabayashi-k@eps.s.u-tokyo.ac.jp [Department of Earth and Planetary Science, The University of Tokyo, Tokyo, 113-0033 (Japan)

    2017-06-10

    This paper presents a series of stratified-shearing-box simulations of collisionless accretion disks in the recently developed framework of kinetic magnetohydrodynamics (MHD), which can handle finite non-gyrotropy of a pressure tensor. Although a fully kinetic simulation predicted a more efficient angular-momentum transport in collisionless disks than in the standard MHD regime, the enhanced transport has not been observed in past kinetic-MHD approaches to gyrotropic pressure anisotropy. For the purpose of investigating this missing link between the fully kinetic and MHD treatments, this paper explores the role of non-gyrotropic pressure and makes the first attempt to incorporate certain collisionless effects into disk-scale, stratified disk simulations. When the timescale of gyrotropization was longer than, or comparable to, the disk-rotation frequency of the orbit, we found that the finite non-gyrotropy selectively remaining in the vicinity of current sheets contributes to suppressing magnetic reconnection in the shearing-box system. This leads to increases both in the saturated amplitude of the MHD turbulence driven by magnetorotational instabilities and in the resultant efficiency of angular-momentum transport. Our results seem to favor the fast advection of magnetic fields toward the rotation axis of a central object, which is required to launch an ultra-relativistic jet from a black hole accretion system in, for example, a magnetically arrested disk state.

  4. Cognitive stimulation in children at social risk: its transference to school performance

    Directory of Open Access Journals (Sweden)

    Celina Korzeniowski

    2017-07-01

    Full Text Available The present study set out to evaluate the effectiveness of a group cognitive intervention aimed at promoting executive functions in children at social risk. The quasi-experimental, pretest-posttest design included a control group. The sample was made up of 178 children (52% boys, aged 6-10. The children were evaluated by means of a battery of neuropsychological EF tests and a teacher-rated behavioral EF scale. The intervention program included 30 group cognitive stimulation sessions that increased in difficulty and were embedded into school curr´ıcula. Trained children performed better in terms of cognitive flexibility, planning, metacognition and inhibitory control, as compared to their baseline values and to children in the control group. This study provides new evidence of the effectiveness of cognitive interventions for children and of children’s capability to transfer cognitive improvements to daily school activities.

  5. Divorce transitions: identifying risk and promoting resilience for children and their parental relationships.

    Science.gov (United States)

    Barnes, G G

    1999-10-01

    This paper gives an account of qualitative research linked to clinical work relating to some of the short-term effects of divorce on children within a British perspective. The transitions that accompany divorce and family reordering are shown by many studies in the United States, Australia, and New Zealand as well as in the United Kingdom to have stressful effects for children that can lead to long-term negative outcomes. Other studies have focused on the differential social and family factors that may contribute to the "differences that make a difference" to whether divorce has harmful effects on children. This paper describes clinical intervention into family relationships in divorcing and postdivorce families and suggests some high-risk issues for children. The focus of the work is one promoting long-term connections between parents and children in reordered+ families. Some interactions that may promote resilience in children as well as in their parents are alluded to briefly.

  6. Exploring the Relationship between Adiposity and Fitness in Young Children

    DEFF Research Database (Denmark)

    Fairchild, Timothy John; Klakk, Heidi; Heidemann, Malene Søborg

    2016-01-01

    PURPOSE: High levels of cardiorespiratory fitness (CRF) may attenuate the association between the excessive adiposity and the risks of cardiovascular and metabolic disease. The purpose of this study was to stratify children according to their body mass index (BMI) and adiposity (body fat percentage...

  7. Risk of oral clefts in children born to mothers taking Topamax (topiramate)Risk of Oral Clefts (Cleft Lip and/or ...

    Science.gov (United States)

    ... Drug Safety and Availability FDA Drug Safety Communication: Risk of oral clefts in children born to mothers ... data that show that there is an increased risk for the development of cleft lip and/or ...

  8. Risk of Nephrotic Syndrome following Enteroviral Infection in Children: A Nationwide Retrospective Cohort Study.

    Science.gov (United States)

    Lin, Jiun-Nong; Lin, Cheng-Li; Yang, Chi-Hui; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Kao, Chia-Hung

    2016-01-01

    Nephrotic syndrome is a common chronic illness encountered during childhood. Infections have been identified as a cause of nephrotic syndrome. The aim of this study was to evaluate the association between enteroviral infection and nephrotic syndrome. A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged children were randomly selected as the comparison cohort. The primary endpoint was the occurrence of nephrotic syndrome. This study included 280,087 enterovirus-infected children and 280,085 non-enterovirus-infected children. The mean age of the enterovirus-infected children was 2.38 years, and 53.7% of these children were boys. The overall incidence densities of nephrotic syndrome for enterovirus- and non-enterovirus-infected children were 2.65 and 2.21 per 10,000 person-years, respectively. The enterovirus-infected cohort had a higher cumulative incidence of nephrotic syndrome than did the non-enterovirus-infected cohort (log-rank test, p = 0.01). Multivariable analyses revealed that children with enteroviral infection were significantly associated with an increased risk of nephrotic syndrome compared with those without enteroviral infection (adjusted hazard ratio, 1.20; 95% confidence interval, 1.04-1.39; p = 0.01), particularly in children infected with coxsackievirus. Subgroup analyses revealed that enterovirus-infected girls, children of blue-collar workers, and children without allergies had a higher risk of nephrotic syndrome than did children in the non-enterovirus-infected cohort. This study revealed a significant association between enteroviral infection and nephrotic syndrome. Additional studies elucidating the role and pathogenesis of enterovirus in nephrotic syndrome are warranted.

  9. OBESITY AND METABOLIC SYNDROME IN CHILDREN AND YOUTH: A HEALTH RISK WE CANNOT AFFORD

    OpenAIRE

    Serge P. von Duvillard

    2012-01-01

    Ample observational and empirical evidence has been provided that indicates that childhood metabolic syndrome risk factors inevitably lead to significantly more profound health risk factors of developing potent adulthood metabolic syndrome. Much of these data has been provided from medical, nutritional, health, pediatric, physical education and associated communities. Perhaps the most visible and observable health risk factor among children (here referred to as youth) is the childhood obesit...

  10. Anxiety and Attentional Bias to Threat in Children at Increased Familial Risk for Autism Spectrum Disorder

    Science.gov (United States)

    Milosavljevic, Bosiljka; Shephard, Elizabeth; Happé, Francesca G.; Johnson, Mark H.; Charman, Tony

    2017-01-01

    Anxiety and threat bias were examined in 6-8-year-old children at familial-risk for Autism Spectrum Disorder (ASD) and low-risk (LR, n = 37) controls. The high-risk (HR) group was divided into those who met diagnostic criteria for ASD (HR-ASD, n = 15) and those who did not (HR-non ASD, n = 24). The HR-ASD group had highest levels of…

  11. Language profiles of monolingual and bilingual Finnish preschool children at risk for language impairment.

    Science.gov (United States)

    Westman, Martin; Korkman, Marit; Mickos, Annika; Byring, Roger

    2008-01-01

    A large proportion of children are exposed to more than one language, yet research on simultaneous bilingualism has been relatively sparse. Traditionally, there has been concern that bilingualism may aggravate language difficulties of children with language impairment. However, recent studies have not found specific language impairment (SLI) or language-related problems to be increased by bilingualism. The topic of bilingualism and its effects has high actuality in Finland, where increasing numbers of children in the country's 6% Swedish-speaking minority grow up in bilingual families, where one parent's primary language is Swedish and the other's Finnish. The present study aimed at exploring the influence of such bilingualism on the language profiles of children from this population at risk for language impairment (LI). Participants were recruited from a language screening of 339 children from kindergartens with instruction only in Swedish, from the Swedish-speaking parts of Finland. Of these children, 33 (9.7%) were defined as a Risk Group for LI, whereas 48 non-risk children were randomly selected to form a control group. When subdividing the children according to home language, 35 were found to be monolingual, Swedish-speaking, and 46 were Swedish-Finnish bilingual. The children underwent neuropsychological assessment during their preschool year. Assessment methods included subtests from the Wechsler Primary and Preschool Scale of Intelligence - Revised and the NEPSY Developmental Neuropsychological Assessment. A repeated-measures multiple analysis of covariance (MANCOVA) showed a significant effect of risk of LI on the NEPSY language scores. The effect of home language was not significant and there was no interaction between home language and risk for LI. Non-verbal IQ was controlled for. Across groups, bilingual children scored lower than monolingual children only on measures of vocabulary and sentence repetition. Although a slight general cost of

  12. Maternal perception of sickness as a risk factor of stunting in children aged 2-5 years

    Directory of Open Access Journals (Sweden)

    Maria Fatima Dete Dellu

    2016-11-01

    Maternal perception of sickness was the most dominant risk factor of stunting in children 2-5 years of age. A multidisciplinary approach is needed to address the range of raised issues and so combat stunting in children.

  13. Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

    Directory of Open Access Journals (Sweden)

    Jeanne Teixeira Bessa Fuly

    2014-01-01

    Conclusions: Overweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.

  14. Physical activity and cardiovascular risk factors in children

    DEFF Research Database (Denmark)

    Andersen, Lars Bo; Riddoch, Chris; Kriemler, Susi

    2011-01-01

    A number of recent systematic reviews have resulted in changes in international recommendations for children's participation in physical activity (PA) for health. The World Health Authority (WHO) has recently released new recommendations. The WHO still recommends 60 min of moderate to vigorous...... physical activity (MVPA), but also emphasises that these minutes should be on top of everyday physical activities. Everyday physical activities total around 30 min of MVPA in the quintile of the least active children, which means that the new recommendations constitute more activity in total compared...

  15. Risk factors for small pharyngeal airway dimensions in preorthodontic children

    DEFF Research Database (Denmark)

    Anandarajah, Seerone; Dudhia, Raahib; Sandham, Andrew

    2017-01-01

    Objective: To analyze which parameters, gathered from standard orthodontic diagnostic material, were most relevant for identifying small pharyngeal airway dimensions in preorthodontic children. Materials and Methods: The sample was composed of 105 cone beam computed tomography scans of healthy......, skeletal maturity and gender significant associations were found between pharyngeal airway dimensions and craniofacial morphology. Airway volume was positively associated with maxillary and mandibular width (P ... and sagittal jaw relationship were the most relevant factors for minimal cross-sectional area (r2 = 0.16). Conclusion: Pharyngeal airway dimensions were significantly associated with age, skeletal maturity, and craniofacial morphology in all three planes. Children with a reduced mandibular width and increased...

  16. Self-Management Training for Chinese Obese Children at Risk for Metabolic Syndrome: Effectiveness and Implications for School Health

    Science.gov (United States)

    Ling, Jiying; Anderson, Laura M.; Ji, Hong

    2015-01-01

    This article reviews the results of a school-based self-management intervention for Chinese obese children at risk for metabolic syndrome. Twenty-eight Chinese obese children (M age?=?10 years) and their parents participated in the study. Metabolic syndrome risk factors were measured pre- and post-intervention. The risk factors included Body Mass…

  17. Adaptive Behavior in Adopted Children: Predictors from Early Risk, Collaboration in Relationships within the Adoptive Kinship Network, and Openness Arrangements.

    Science.gov (United States)

    Grotevant, Harold D.; Ross, Nicole M.; Marchel, Mary Ann; McRoy, Ruth G.

    1999-01-01

    Examined links between early risk and problematic developmental outcomes in adopted children during middle childhood. Found no direct relation between prenatal, perinatal, or preplacement risk factors and problematic socioemotional adjustment. With 12 high-risk children, proactive cooperation among the child's adoptive and birth family members on…

  18. Patterns of aeroallergen sensitization predicting risk for asthma in preschool children with atopic dermatitis.

    Science.gov (United States)

    Calamelli, Elisabetta; Ricci, Giampaolo; Neri, Iria; Ricci, Lorenza; Rondelli, Roberto; Pession, Andrea; Patrizi, Annalisa

    2015-06-01

    Atopic dermatitis (AD) is a chronic inflammatory skin disorder mostly affecting young children. Although several studies aimed to identify the risk factors for asthma in AD children, many aspects still need to be clarified. The aim of this study was to investigate the possible risk factors for asthma at school age in 99 children with early-onset and IgE-mediated AD. All children performed clinical evaluation and total and specific IgE assay for a panel of inhalant and food allergens at two different times (t1 and t2) during preschool, and asthma diagnosis was assessed at one follow-up visit (t3) at school age. At t3, 39% of children had developed asthma. Of the variables compared, the sensitization to more than one class of inhalant allergens at t2 (mean age = 30 months) was associated with asthma, with grass (OR = 3.24, p = 0.020) and cat sensitization (OR = 2.74, p = 0.043) as independent risk factors. The sensitization pattern of a child with early-onset AD, also within the first 2-3 years of life, can reflect his risk to develop asthma. Therefore, testing these children for the more common allergens during this time frame should be recommended to predict the evolution of atopic diseases.

  19. Cesarean section may increase the risk of both overweight and obesity in preschool children.

    Science.gov (United States)

    Rutayisire, Erigene; Wu, Xiaoyan; Huang, Kun; Tao, Shuman; Chen, Yunxiao; Tao, Fangbiao

    2016-11-03

    The increase rates of cesarean section (CS) occurred at the same period as the dramatic increase of childhood overweight/obesity. In China, cesarean section rates have exponentially increased in the last 20 years and they now exceed World Health Organization (WHO) recommendation. Such high rates demand an understanding to the long-term consequences on child health. We aim to examine the association between CS and risk of overweight and obesity among preschool children. We recruited 9103 children from 35 kindergartens in 4 cities located in East China. Children anthropometric measurements were taken in person by trained personnel. The mode of delivery was classified as vaginal or CS, in sub-analyses we divided cesarean delivery into elective or non-elective. The mode of delivery and other parental information were self-reported by parents. Multivariate logistic regression analysis was used to examine the associations. In our cross-sectional study of 8900 preschool children aged 3-6 years, 67.3 % were born via CS, of whom 15.7 % were obese. Cesarean delivery was significantly associated with the risk of overweight [OR 1.24; (95 % CI 1.07-1.44); p = 0.003], and the risk of obesity [OR 1.29; (95 % CI 1.13-1.49); p children. After adjusted for child characteristics, parental factors and family income, the odd of overweight was 1.35 and of obesity was 1.25 in children delivered by elective CS. The associations between CS and overweight/obesity in preschool children are influenced by potential confounders. Both children delivered by elective or non-elective CS are at increased risk of overweight/obesity. Potential consequences of CS on the health of the children should be discussed among both health care professionals and childbearing women.

  20. Weight patterns in children with higher risk ALL: A report from the Children's Oncology Group (COG) for CCG 1961.

    Science.gov (United States)

    Withycombe, Janice S; Post-White, Janice E; Meza, Jane L; Hawks, Ria G; Smith, Lynette M; Sacks, Nancy; Seibel, Nita L

    2009-12-15

    This retrospective analysis defined and described patterns and predictors of weight change during treatment in children with acute lymphocytic leukemia (ALL) with high-risk features who received treatment on Children's Cancer Group protocol CCG 1961. Patients (1,638) were enrolled in CCG 1961 from November 1996 to May 2002. Weight was measured as BMI percent (%), specific for age and gender, and defined as 100 x ln(BMI/median BMI). By the end of treatment, 23% of children were obese (BMI >or=95%), compared with 14% at diagnosis. Children who received post-induction intensified therapy (arms C, D, SER with Doxorubicin or Idarubicin) had higher gastrointestinal toxicities and lower BMI% from consolidation through interim maintenance 1. BMI% then increased for all arms between delayed intensification and maintenance 1 or 2. Children who were of Black or Hispanic race, obese at diagnosis, or who had grade 3 or 4 pancreatitis/glucose toxicities during induction had higher BMI% throughout treatment. Children were more likely to be obese at the end of the study if they were aged 5-9 years at diagnosis or female gender. Cranial radiation was not a predictor of obesity. Successful treatment of higher risk childhood ALL was associated with obesity, independent of cranial irradiation. The beginning of maintenance therapy may be the best time to intervene with nutritional and behavioral interventions, particularly for children who are obese or aged 5-9 years at diagnosis, female, Black or Hispanic, or those with metabolic toxicities during induction. (c) 2009 Wiley-Liss, Inc.

  1. Risk Perception in Smokers with Children with Asthma

    Science.gov (United States)

    Wagener, Theodore L.; Gregor, Kristin L.; Busch, Andrew M.; McQuaid, Elizabeth L.; Borrelli, Belinda

    2010-01-01

    Objective: No studies have examined the relationship between caregiver beliefs about the risks of smoking to their own health and caregiver beliefs about the effect of their smoking on their child's health. In the current study, we investigated our proposed "risk congruence hypothesis" among caregivers who smoke. Specifically, we investigated…

  2. Understanding Risk for Reading Difficulties in Children with Language Impairment

    Science.gov (United States)

    Murphy, Kimberly A.; Justice, Laura M.; O'Connell, Ann A.; Pentimonti, Jill M.; Kaderavek, Joan N.

    2016-01-01

    Purpose: The purpose of this study was to retrospectively examine the preschool language and early literacy skills of kindergarten good and poor readers, and to determine the extent to which these skills predict reading status. Method: Participants were 136 children with language impairment enrolled in early childhood special education classrooms.…

  3. Cardiovascular risk assessment of dyslipidemic children: analysis of biomarkers to identify monogenic dyslipidemia[S

    Science.gov (United States)

    Medeiros, Ana Margarida; Alves, Ana Catarina; Aguiar, Pedro; Bourbon, Mafalda

    2014-01-01

    The distinction between a monogenic dyslipidemia and a polygenic/environmental dyslipidemia is important for the cardiovascular risk assessment, counseling, and treatment of these patients. The present work aims to perform the cardiovascular risk assessment of dyslipidemic children to identify useful biomarkers for clinical criteria improvement in clinical settings. Main cardiovascular risk factors were analyzed in a cohort of 237 unrelated children with clinical diagnosis of familial hypercholesterolemia (FH). About 40% carried at least two cardiovascular risk factors and 37.6% had FH, presenting mutations in LDLR and APOB. FH children showed significant elevated atherogenic markers and lower concentration of antiatherogenic particles. Children without a molecular diagnosis of FH had higher levels of TGs, apoC2, apoC3, and higher frequency of BMI and overweight/obesity, suggesting that environmental factors can be the underlying cause of their hypercholesterolem≥ia. An apoB/apoA1 ratio ≥0.68 was identified as the best biomarker (area under the curve = 0.835) to differentiate FH from other dyslipidemias. The inclusion in clinical criteria of a higher cut-off point for LDL cholesterol or an apoB/apoA1 ratio ≥0.68 optimized the criteria sensitivity and specificity. The correct identification, at an early age, of all children at-risk is of great importance so that specific interventions can be implemented. apoB/apoA1 can improve the identification of FH patients. PMID:24627126

  4. Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review.

    Science.gov (United States)

    Goudet, Sophie; Griffiths, Paula; Bogin, Barry; Madise, Nyovani

    2017-02-01

    Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children's malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children's health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.

  5. Asian dust storm elevates children's respiratory health risks: a spatiotemporal analysis of children's clinic visits across Taipei (Taiwan.

    Directory of Open Access Journals (Sweden)

    Hwa-Lung Yu

    Full Text Available Concerns have been raised about the adverse impact of Asian dust storms (ADS on human health; however, few studies have examined the effect of these events on children's health. Using databases from the Taiwan National Health Insurance and Taiwan Environmental Protection Agency, this study investigates the documented daily visits of children to respiratory clinics during and after ADS that occurred from 1997 to 2007 among 12 districts across Taipei City by applying a Bayesian structural additive regressive model controlled for spatial and temporal patterns. This study finds that the significantly impact of elevated children's respiratory clinic visits happened after ADS. Five of the seven lagged days had increasing percentages of relative rate, which was consecutively elevated from a 2-day to a 5-day lag by 0.63%∼2.19% for preschool children (i.e., 0∼6 years of age and 0.72%∼3.17% for school children (i.e., 7∼14 years of age. The spatial pattern of clinic visits indicated that geographical heterogeneity was possibly associated with the clinic's location and accessibility. Moreover, day-of-week effects were elevated on Monday, Friday, and Saturday. We concluded that ADS may significantly increase the risks of respiratory diseases consecutively in the week after exposure, especially in school children.

  6. Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia Study (NIM Study.

    Directory of Open Access Journals (Sweden)

    Rohit Saxena

    Full Text Available Assess prevalence of myopia and identify associated risk factors in urban school children.This was a cross-sectional study screening children for sub-normal vision and refractive errors in Delhi. Vision was tested by trained health workers using ETDRS charts. Risk factor questionnaire was filled for children with vision 11 years children (p 5 hours per day (p 2 hours / day (p 2 hours in a day.Myopia is a major health problem in Indian school children. It is important to identify modifiable risk factors associated with its development and try to develop cost effective intervention strategies.

  7. Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia Study (NIM Study).

    Science.gov (United States)

    Saxena, Rohit; Vashist, Praveen; Tandon, Radhika; Pandey, R M; Bhardawaj, Amit; Menon, Vimala; Mani, Kalaivani

    2015-01-01

    Assess prevalence of myopia and identify associated risk factors in urban school children. This was a cross-sectional study screening children for sub-normal vision and refractive errors in Delhi. Vision was tested by trained health workers using ETDRS charts. Risk factor questionnaire was filled for children with vision 11 years) children (phistory (p 5 hours per day (p 2 hours / day (p video/mobile games (p 2 hours in a day. Myopia is a major health problem in Indian school children. It is important to identify modifiable risk factors associated with its development and try to develop cost effective intervention strategies.

  8. Cardiometabolic risk factors and insulin resistance in obese children and adolescents: relation to puberty.

    Science.gov (United States)

    Tobisch, B; Blatniczky, L; Barkai, L

    2015-02-01

    The prevalence of obesity with concomitant increasing risk for having cardiometabolic diseases is rising in the childhood population. Insulin resistance has a key role in metabolic changes in these children. Insulin levels elevate as puberty commences in every individual. Children with increased risk for cardiometabolic diseases show significant differences in insulin levels even before the onset of puberty compared with those without risks. The pattern of appearance of dyslipidaemia also varies in children with risk factors even in the pre-pubertal group from those without risk. Children with metabolic syndrome display considerably pronounced changes in their metabolic parameters before the onset of puberty, which become more pronounced as puberty passes. Insulin resistance (IR) has a key role in the metabolic changes in obese children. In commencing puberty, the insulin levels elevate. It is not clear, however, how insulin levels develop if the metabolic syndrome appears. Metabolic changes were assessed in obese children before, during and after puberty to analyse the relationship between IR and puberty in subjects with and without metabolic syndrome. Three hundred thirty-four obese children (5-19 years) attended the study. The criteria of the International Diabetes Federation were used to assess the presence of cardiometabolic risks (CMRs). Subjects with increased CMR were compared with those without risk (nCMR). Pubertal staging, lipid levels, plasma glucose and insulin levels during oral glucose tolerance test were determined in each participant. IR was expressed by homeostasis model assessment (HOMA-IR) and the ratio of glucose and insulin areas under the curve (AUC-IR). Significantly higher AUC-IR were found in pre-pubertal CMR children compared with nCMR subjects (11.84 ± 1.03 vs. 8.00 ± 0.69; P puberty. HOMA-IR differs between CMR and nCMR only in post-puberty (6.03 ± 1.26 vs. 2.54 ± 0.23; P puberty. CMR is associated with increased

  9. High-dose anti-histamine use and risk factors in children with urticaria.

    Science.gov (United States)

    Uysal, Pınar; Avcil, Sibelnur; Erge, Duygu

    2016-12-01

    The drugs of choice in the treatment of urticaria in children are H1-antihistamines. The aim of the study was to evaluate children with urticaria and define risk factors for requirement of high-dose H1-antihistamines in children with urticaria. The medical data of children who were diagnosed as having urticaria admitted to our outpatient clinic between January 2014 and January 2016 were searched. The medical histories, concomitant atopic diseases, parental atopy histories, medications, treatment responses, blood eosinophil and basophil counts, and serum total IgE levels were recorded. In addition, the urticaria activity score for seven days, autoimmune antibody tests, and skin prick test results were evaluated in children with chronic urticaria. The numbers of the children with acute and chronic urticaria were 138 and 92, respectively. The age of the children with chronic urticaria was higher than that of those with acute urticaria (p0.05). There was a negative correlation between blood eosinophil count and the UAS7 score in children with chronic urticaria (r=-0.276, p=0.011). Chronic urticaria and requirement of high dose H1-antihistamines were significant in children aged ≥10 years (p<0.001, p=0.015). High UAS7 score (OR: 1.09; CI 95%: [1.03-1.15]) and basopenia (OR: 6.77; CI 95%: [2.01-22.75]) were associated with the requirement of high-dose H1-AH in children with chronic urticaria. The requirement of high-dose H1-antihistamines was higher with children's increasing age. Disease severity and basopenia were risk factors for the requirement of high-dose H1-antihistamines.

  10. Monte Carlo stratified source-sampling

    International Nuclear Information System (INIS)

    Blomquist, R.N.; Gelbard, E.M.

    1997-01-01

    In 1995, at a conference on criticality safety, a special session was devoted to the Monte Carlo open-quotes eigenvalue of the worldclose quotes problem. Argonne presented a paper, at that session, in which the anomalies originally observed in that problem were reproduced in a much simplified model-problem configuration, and removed by a version of stratified source-sampling. The original test-problem was treated by a special code designed specifically for that purpose. Recently ANL started work on a method for dealing with more realistic eigenvalue of the world configurations, and has been incorporating this method into VIM. The original method has been modified to take into account real-world statistical noise sources not included in the model problem. This paper constitutes a status report on work still in progress

  11. Ecosystem metabolism in a stratified lake

    DEFF Research Database (Denmark)

    Stæhr, Peter Anton; Christensen, Jesper Philip Aagaard; Batt, Ryan D.

    2012-01-01

    , differences were not significant. During stratification, daily variability in epilimnetic DO was dominated by metabolism (46%) and air-water gas exchange (44%). Fluxes related to mixed-layer deepening dominated in meta- and hypolimnic waters (49% and 64%), while eddy diffusion (1% and 14%) was less important....... Although air-water gas exchange rates differed among the three formulations of gas-transfer velocity, this had no significant effect on metabolic rates....... that integrates rates across the entire depth profile and includes DO exchange between depth layers driven by mixed-layer deepening and eddy diffusivity. During full mixing, NEP was close to zero throughout the water column, and GPP and R were reduced 2-10 times compared to stratified periods. When present...

  12. Stratified growth in Pseudomonas aeruginosa biofilms

    DEFF Research Database (Denmark)

    Werner, E.; Roe, F.; Bugnicourt, A.

    2004-01-01

    In this study, stratified patterns of protein synthesis and growth were demonstrated in Pseudomonas aeruginosa biofilms. Spatial patterns of protein synthetic activity inside biofilms were characterized by the use of two green fluorescent protein (GFP) reporter gene constructs. One construct...... synthesis was restricted to a narrow band in the part of the biofilm adjacent to the source of oxygen. The zone of active GFP expression was approximately 60 Am wide in colony biofilms and 30 Am wide in flow cell biofilms. The region of the biofilm in which cells were capable of elongation was mapped...... by treating colony biofilms with carbenicillin, which blocks cell division, and then measuring individual cell lengths by transmission electron microscopy. Cell elongation was localized at the air interface of the biofilm. The heterogeneous anabolic patterns measured inside these biofilms were likely a result...

  13. Thermal instability in a stratified plasma

    International Nuclear Information System (INIS)

    Hermanns, D.F.M.; Priest, E.R.

    1989-01-01

    The thermal instability mechansism has been studied in connection to observed coronal features, like, e.g. prominences or cool cores in loops. Although these features show a lot of structure, most studies concern the thermal instability in an uniform medium. In this paper, we investigate the thermal instability and the interaction between thermal modes and the slow magneto-acoustic subspectrum for a stratified plasma slab. We fomulate the relevant system of equations and give some straightforward properties of the linear spectrum of a non-uniform plasma slab, i.e. the existence of continuous parts in the spectrum. We present a numerical scheme with which we can investigate the linear spectrum for equilibrium states with stratification. The slow and thermal subspectra of a crude coronal model are given as a preliminary result. (author). 6 refs.; 1 fig

  14. Decision-making under risk in children, adolescents, and young adults.

    Science.gov (United States)

    Paulsen, David J; Platt, Michael L; Huettel, Scott A; Brannon, Elizabeth M

    2011-01-01

    Adolescents often make risky and impulsive decisions. Such behavior has led to the common assumption that a dysfunction in risk-related decision-making peaks during this age. Differences in how risk has been defined across studies, however, make it difficult to draw conclusions about developmental changes in risky decision-making. Here, we developed a non-symbolic economic decision-making task that can be used across a wide age span and that uses coefficient of variation (CV) in reward as an index of risk. We found that young children showed the strongest preference for risky compared to sure bet options of equal expected value, adolescents were intermediate in their risk preference, and young adults showed the strongest risk aversion. Furthermore, children's preference for the risky option increased for larger CVs, while adolescents and young adults showed the opposite pattern, favoring the sure bet more often as CV increased. Finally, when faced with two gambles in a risk-return tradeoff, all three age groups exhibited a greater preference for the option with the lower risk and return as the disparity in risk between the two options increased. These findings demonstrate clear age-related differences in economic risk preferences that vary with choice set and risk. Importantly, adolescence appears to represent an intermediate decision-making phenotype along the transition from childhood to adulthood, rather than an age of heightened preference for economic risk.

  15. Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: a case control study.

    Science.gov (United States)

    Wee, Bee S; Poh, Bee K; Bulgiba, Awang; Ismail, Mohd N; Ruzita, Abdul T; Hills, Andrew P

    2011-05-18

    With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs. A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome. Participants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC ≥90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C≤1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic

  16. Information content of household-stratified epidemics

    Directory of Open Access Journals (Sweden)

    T.M. Kinyanjui

    2016-09-01

    Full Text Available Household structure is a key driver of many infectious diseases, as well as a natural target for interventions such as vaccination programs. Many theoretical and conceptual advances on household-stratified epidemic models are relatively recent, but have successfully managed to increase the applicability of such models to practical problems. To be of maximum realism and hence benefit, they require parameterisation from epidemiological data, and while household-stratified final size data has been the traditional source, increasingly time-series infection data from households are becoming available. This paper is concerned with the design of studies aimed at collecting time-series epidemic data in order to maximize the amount of information available to calibrate household models. A design decision involves a trade-off between the number of households to enrol and the sampling frequency. Two commonly used epidemiological study designs are considered: cross-sectional, where different households are sampled at every time point, and cohort, where the same households are followed over the course of the study period. The search for an optimal design uses Bayesian computationally intensive methods to explore the joint parameter-design space combined with the Shannon entropy of the posteriors to estimate the amount of information in each design. For the cross-sectional design, the amount of information increases with the sampling intensity, i.e., the designs with the highest number of time points have the most information. On the other hand, the cohort design often exhibits a trade-off between the number of households sampled and the intensity of follow-up. Our results broadly support the choices made in existing epidemiological data collection studies. Prospective problem-specific use of our computational methods can bring significant benefits in guiding future study designs.

  17. Information content of household-stratified epidemics.

    Science.gov (United States)

    Kinyanjui, T M; Pellis, L; House, T

    2016-09-01

    Household structure is a key driver of many infectious diseases, as well as a natural target for interventions such as vaccination programs. Many theoretical and conceptual advances on household-stratified epidemic models are relatively recent, but have successfully managed to increase the applicability of such models to practical problems. To be of maximum realism and hence benefit, they require parameterisation from epidemiological data, and while household-stratified final size data has been the traditional source, increasingly time-series infection data from households are becoming available. This paper is concerned with the design of studies aimed at collecting time-series epidemic data in order to maximize the amount of information available to calibrate household models. A design decision involves a trade-off between the number of households to enrol and the sampling frequency. Two commonly used epidemiological study designs are considered: cross-sectional, where different households are sampled at every time point, and cohort, where the same households are followed over the course of the study period. The search for an optimal design uses Bayesian computationally intensive methods to explore the joint parameter-design space combined with the Shannon entropy of the posteriors to estimate the amount of information in each design. For the cross-sectional design, the amount of information increases with the sampling intensity, i.e., the designs with the highest number of time points have the most information. On the other hand, the cohort design often exhibits a trade-off between the number of households sampled and the intensity of follow-up. Our results broadly support the choices made in existing epidemiological data collection studies. Prospective problem-specific use of our computational methods can bring significant benefits in guiding future study designs. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Stratified sampling design based on data mining.

    Science.gov (United States)

    Kim, Yeonkook J; Oh, Yoonhwan; Park, Sunghoon; Cho, Sungzoon; Park, Hayoung

    2013-09-01

    To explore classification rules based on data mining methodologies which are to be used in defining strata in stratified sampling of healthcare providers with improved sampling efficiency. We performed k-means clustering to group providers with similar characteristics, then, constructed decision trees on cluster labels to generate stratification rules. We assessed the variance explained by the stratification proposed in this study and by conventional stratification to evaluate the performance of the sampling design. We constructed a study database from health insurance claims data and providers' profile data made available to this study by the Health Insurance Review and Assessment Service of South Korea, and population data from Statistics Korea. From our database, we used the data for single specialty clinics or hospitals in two specialties, general surgery and ophthalmology, for the year 2011 in this study. Data mining resulted in five strata in general surgery with two stratification variables, the number of inpatients per specialist and population density of provider location, and five strata in ophthalmology with two stratification variables, the number of inpatients per specialist and number of beds. The percentages of variance in annual changes in the productivity of specialists explained by the stratification in general surgery and ophthalmology were 22% and 8%, respectively, whereas conventional stratification by the type of provider location and number of beds explained 2% and 0.2% of variance, respectively. This study demonstrated that data mining methods can be used in designing efficient stratified sampling with variables readily available to the insurer and government; it offers an alternative to the existing stratification method that is widely used in healthcare provider surveys in South Korea.

  19. Stratified charge rotary engine combustion studies

    Science.gov (United States)

    Shock, H.; Hamady, F.; Somerton, C.; Stuecken, T.; Chouinard, E.; Rachal, T.; Kosterman, J.; Lambeth, M.; Olbrich, C.

    1989-07-01

    Analytical and experimental studies of the combustion process in a stratified charge rotary engine (SCRE) continue to be the subject of active research in recent years. Specifically to meet the demand for more sophisticated products, a detailed understanding of the engine system of interest is warranted. With this in mind the objective of this work is to develop an understanding of the controlling factors that affect the SCRE combustion process so that an efficient power dense rotary engine can be designed. The influence of the induction-exhaust systems and the rotor geometry are believed to have a significant effect on combustion chamber flow characteristics. In this report, emphasis is centered on Laser Doppler Velocimetry (LDV) measurements and on qualitative flow visualizations in the combustion chamber of the motored rotary engine assembly. This will provide a basic understanding of the flow process in the RCE and serve as a data base for verification of numerical simulations. Understanding fuel injection provisions is also important to the successful operation of the stratified charge rotary engine. Toward this end, flow visualizations depicting the development of high speed, high pressure fuel jets are described. Friction is an important consideration in an engine from the standpoint of lost work, durability and reliability. MSU Engine Research Laboratory efforts in accessing the frictional losses associated with the rotary engine are described. This includes work which describes losses in bearing, seal and auxillary components. Finally, a computer controlled mapping system under development is described. This system can be used to map shapes such as combustion chamber, intake manifolds or turbine blades accurately.

  20. Children at Risk for Suicide Attempt and Attempt-related Injuries: Findings from the 2007 Youth Risk Behavior Survey

    Directory of Open Access Journals (Sweden)

    West, Bethany A

    2010-08-01

    Full Text Available Purpose: The current study examines the associations between a range of risk factors and reports of suicide attempts, and attempts requiring medical care in a nationally representative study of high school students. The goal is to examine sex differences in the risk factors that are associated with suicide attempts and attempt-related injuries requiring treatment by a health-care provider. Methods: Data from the 2007 Youth Risk Behavior Survey for students in grades 9-12 were used to assess the prevalence and risk factors for suicidal behavior as well as differences in these for boys and girls. Cross-sectional multivariate logistic regression analyses were computed to determine the most important risk factors for suicide attempts and for suicide attempts requiring medical care for the sample overall and also stratified for boys and for girls. Results: Overall, 6.9% of adolescents attempted suicide (9.3% of girls versus 4.6% of boys. Girls were more likely than boys to report a suicide attempt in the past year (Adj.OR=2.89. Among girls, sadness (Adj.OR=5.74, weapon carrying (Adj.OR=1.48, dating violence (Adj.OR=1.60, forced sex (Adj.OR=1.72, and huffing glue (Adj.OR=2.04 were significantly associated with suicide attempts. Among boys, sadness (Adj.OR=10.96, weapon carrying (Adj.OR=1.66, forced sex (Adj.OR=2.60, huffing glue (OR=1.63, hard drug use (Adj.OR=2.18, and sports involvement (Adj.OR=1.52 were significantly associated with suicide attempts. Conclusions: These findings demonstrate similarities and differences in terms of the modifiable risk factors that increase risk for suicide attempts among boys and girls. In terms of the differences between boys and girls, hard drug use and sports involvement may be important factors for suicide prevention strategies that are directed specifically towards boys, while dating violence victimization may be an important risk factor to address for girls. Overall, these findings can help guide prevention

  1. Prenatal stress and risk of febrile seizures in children: a nationwide longitudinal study in Denmark

    DEFF Research Database (Denmark)

    Li, Jiong; Olsen, Jørn; Obel, Carsten

    2009-01-01

    We aimed to examine whether exposure to prenatal stress following maternal bereavement is associated with an increased risk of febrile seizures. In a longitudinal population-based cohort study, we followed 1,431,175 children born in Denmark. A total of 34,777 children were born to women who lost...... a close relative during pregnancy or within 1 year before the pregnancy and they were included in the exposed group. The exposed children had a risk of febrile seizures similar to that of the unexposed children (hazard ratio (HR) 1.00, 95% CI 0.94-1.06). The HRs did not differ according to the nature...... or timing of bereavement. Our data do not suggest any causal link between exposure to prenatal stress and febrile seizures in childhood....

  2. Fracture risk by HIV infection status in perinatally HIV-exposed children.

    Science.gov (United States)

    Siberry, George K; Li, Hong; Jacobson, Denise

    2012-03-01

    The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate ratio was 1.1 (95% CI 0.2, 5.5). There was no evidence of a substantially increased risk of fracture in HIV-infected compared to HEU children.

  3. An Exploratory Study Examining Risk Communication among Adolescent Children, Their Incarcerated Mothers, and Their Caregivers.

    Science.gov (United States)

    Robillard, Alyssa G; Holliday, Rhonda C; DeHart, Dana D; Lewis, Kaleea; Rutherford, Yamisha; Amutah, Ndidi N

    2016-01-01

    Adolescent children of incarcerated mothers (ACIM) are typically left in the care of adults (primary caregivers) who play a crucial role in children's care and guidance, as well as in the facilitation of contact and communication with incarcerated mothers. The purpose of this study was to explore the nature of relationships and communication among adolescent children of incarcerated mothers, primary caregivers, and incarcerated mothers using pilot data. Semi-structured individual interviews were conducted with youth aged 12-17 (n=7) and caregivers (n=6) recruited through a non-profit organization working with incarcerated mothers and their children. Incarcerated mothers and primary caregivers represent an important family unit for ACIMs and may play a role in preventing risk behavior. A conceptual framework is offered for further consideration of mother and caregiver communication with youth and youth risk.

  4. Giardia duodenalis infection: risk factors for children living in sub-standard settlements in Brazil

    Directory of Open Access Journals (Sweden)

    Júlio César Teixeira

    2007-06-01

    Full Text Available The objective of the present study was to characterize Giardia duodenalis infection among children living in sub-standard settlement areas in the municipality of Juiz de Fora, Minas Gerais State, Brazil. The cross-sectional epidemiological study included 590 children from 1 to 5 years of age. Data were collected from one child per selected family through home interviews with the parent or guardian and parasitological examination of stool samples. Thirty-one putative risk factors concerning family structure, socioeconomic status, and environmental factors were analyzed by multivariate logistic regression. Prevalence of G. duodenalis infection was 18% (106 children. Four potential risk factors were heavily associated with G. duodenalis infection: number of under-five children in the same household, index child's birth order, existence of a bathroom in the home, and drinking water source.

  5. The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering.

    Science.gov (United States)

    Magge, Sheela N; Goodman, Elizabeth; Armstrong, Sarah C

    2017-07-24

    Metabolic syndrome (MetS) was developed by the National Cholesterol Education Program Adult Treatment Panel III, identifying adults with at least 3 of 5 cardiometabolic risk factors (hyperglycemia, increased central adiposity, elevated triglycerides, decreased high-density lipoprotein cholesterol, and elevated blood pressure) who are at increased risk of diabetes and cardiovascular disease. The constellation of MetS component risk factors has a shared pathophysiology and many common treatment approaches grounded in lifestyle modification. Several attempts have been made to define MetS in the pediatric population. However, in children, the construct is difficult to define and has unclear implications for clinical care. In this Clinical Report, we focus on the importance of screening for and treating the individual risk factor components of MetS. Focusing attention on children with cardiometabolic risk factor clustering is emphasized over the need to define a pediatric MetS. Copyright © 2017 by the American Academy of Pediatrics.

  6. A Systematic Review of Sleep, Hypertension, and Cardiovascular Risk in Children and Adolescents.

    Science.gov (United States)

    Fobian, Aaron D; Elliott, Lindsey; Louie, Tinnie

    2018-05-01

    Many of the risk factors for heart disease have recently been shown to develop during childhood such as left ventricular hypertrophy and fibrous plaque lesions. As risk for cardiovascular disease in children and adolescents has risen, sleep duration has decreased, and inadequate sleep in children and adolescents has been found to be associated with cardiovascular disease risk. The aims of this manuscript are to provide an updated systematic review of the literature assessing sleep, hypertension, and cardiovascular risk and evaluate the strength of the evidence based on the available research. A systematic review was conducted using six databases from January 1, 2015 through March 9, 2018. We sought studies which looked at the relationship between sleep duration, sleep timing, or sleep quality and outcome variables of hypertension, inflammation, obesity, glucose or insulin, and lipids in children and adolescents. We found 24 studies which met our criteria. Nine studies included hypertension as an outcome variable; fifteen included obesity; thirteen included glucose or insulin; eight included lipids; and three included measures of inflammation. The existing literature on sleep and cardiovascular disease in children and adolescents is limited and relatively weak. Only one RCT was identified, and the overwhelming majority of studies had a high risk of bias. The strongest evidence of an association with sleep is with obesity, hypertension, and insulin sensitivity. Further research using more standardized methods and objective measures is needed to determine if a causal relationship truly exists between sleep and cardiovascular risk.

  7. [Value of nutritional risk screening in evaluating adverse clinical outcomes in children with severe pneumonia].

    Science.gov (United States)

    Guo, Xiao-Hui; Sun, Yan-Feng; Wang, Jiang-Bo; Han, Shu-Zhen; Miao, Jing; Cui, Min

    2017-03-01

    To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes. According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53). Fasting blood samples were collected to measure the levels of insulin-like growth factor-1 (IGF-1), adiponectin, leptin, non-esterified fatty acid (NEFA), albumin, transferrin, prealbumin, and retinol binding protein (RBP). The adverse clinical outcomes were recorded. Compared with the MR and LR groups, the HR group had significantly lower serum levels of IGF-1, leptin, adiponectin, prealbumin, and RBP, as well as a significantly higher serum level of NEFA (Prisk screening has an important value in evaluating the clinical outcome of children with severe pneumonia, and children at a higher nutritional risk tend to have more adverse clinical outcomes.

  8. The acquired preparedness risk model applied to smoking in 5th grade children.

    Science.gov (United States)

    Combs, Jessica L; Spillane, Nichea S; Caudill, Leann; Stark, Brittany; Smith, Gregory T

    2012-03-01

    The very early onset of smoking predicts numerous health problems. The authors conducted the first test of one risk model for elementary school age smoking, known as the acquired preparedness (AP) model of risk, in a cross-sectional sample of 309 5th grade children. The model posits that (a) impulsivity-related personality traits contribute to risk for a variety of risky, maladaptive behaviors; (b) smoking expectancies confer risk only for smoking; and (c) the personality traits contribute to the formation of high risk expectancies for reinforcement from smoking, which in turn increases the likelihood of early onset smoking. The model was supported: the high-risk personality traits distinguished children engaging in any risky, maladaptive behavior from other children, and the smoking expectancies differentiated smokers from all other children. The relationship between personality tendencies to act rashly when experiencing intense positive or negative emotions and smoker status was partially mediated by expectancies for reinforcement from smoking. This model should be investigated longitudinally. Copyright © 2011. Published by Elsevier Ltd.

  9. Risk factors for mercury exposure of children in a rural mining town in northern Chile.

    Directory of Open Access Journals (Sweden)

    Johan Ohlander

    Full Text Available Traditional gold mining is associated with mercury exposure. Especially vulnerable to its neurotoxic effects is the developing nervous system of a child. We aimed to investigate risk factors of mercury exposure among children in a rural mining town in Chile.Using a validated questionnaire distributed to the parents of the children, a priori mercury risk factors, potential exposure pathways and demographics of the children were obtained. Mercury levels were measured through analyzing fingernail samples. Logistic regression modeling the effect of risk factors on mercury levels above the 75(th percentile were made, adjusted for potential confounders.The 288 children had a mean age of 9.6 years (SD = 1.9. The mean mercury level in the study population was 0.13 µg/g (SD 0.11, median 0.10, range 0.001-0.86 µg/g. The strongest risk factor for children's odds of high mercury levels (>75(th percentile, 0.165 µg/g was to play inside a house where a family member worked with mercury (OR adjusted 3.49 95% CI 1.23-9.89. Additionally, children whose parents worked in industrial gold mining had higher odds of high mercury levels than children whose parents worked in industrial copper mining or outside mining activities.Mercury exposure through small-scale gold mining might affect children in their home environments. These results may further help to convince the local population of banning mercury burning inside the households.

  10. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

    Directory of Open Access Journals (Sweden)

    Tunde-Ayinmode Mosunmola

    2012-07-01

    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

  11. Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms.

    Science.gov (United States)

    Vyles, David; Adams, Juan; Chiu, Asriani; Simpson, Pippa; Nimmer, Mark; Brousseau, David C

    2017-08-01

    Penicillin allergy is commonly reported in the pediatric emergency department (ED). True penicillin allergy is rare, yet the diagnosis results from the denial of first-line antibiotics. We hypothesize that all children presenting to the pediatric ED with symptoms deemed to be low-risk for immunoglobulin E-mediated hypersensitivity will return negative results for true penicillin allergy. Parents of children aged 4 to 18 years old presenting to the pediatric ED with a history of parent-reported penicillin allergy completed an allergy questionnaire. A prespecified 100 children categorized as low-risk on the basis of reported symptoms completed penicillin allergy testing by using a standard 3-tier testing process. The percent of children with negative allergy testing results was calculated with a 95% confidence interval. Five hundred ninety-seven parents completed the questionnaire describing their child's reported allergy symptoms. Three hundred two (51%) children had low-risk symptoms and were eligible for testing. Of those, 100 children were tested for penicillin allergy. The median (interquartile range) age at testing was 9 years (5-12). The median (interquartile range) age at allergy diagnosis was 1 year (9 months-3 years). Rash (97 [97%]) and itching (63 [63%]) were the most commonly reported allergy symptoms. Overall, 100 children (100%; 95% confidence interval 96.4%-100%) were found to have negative results for penicillin allergy and had their labeled penicillin allergy removed from their medical record. All children categorized as low-risk by our penicillin allergy questionnaire were found to have negative results for true penicillin allergy. The utilization of this questionnaire in the pediatric ED may facilitate increased use of first-line penicillin antibiotics. Copyright © 2017 by the American Academy of Pediatrics.

  12. Risk Factors for Knee Injuries in Children 8 to 15 Years: The CHAMPS Study DK.

    Science.gov (United States)

    Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit; Wedderkopp, Niels

    2016-04-01

    Knee injuries are frequent in children, with most studies reporting traumatic knee injuries. Evidence of risk factors for knee injuries in children is sparse. The purpose of this study was to report the extent of traumatic and overuse knee injuries in children and to evaluate intrinsic and extrinsic factors for risk of these injuries. Weekly musculoskeletal pain, sport participation, and sports type were reported by 1326 school children (8-15 yr). Knee injuries were classified as traumatic or overuse. Multinomial logistic regression was used for analyses. During the study period, 952 (15% traumatic and 85% overuse) knee injuries were diagnosed. Period prevalence for traumatic and overuse knee injuries were 0.8/1000 and 5.4/1000 sport participations, respectively. Participation in tumbling gymnastics was a risk factor for traumatic knee injuries (OR, 2.14). For overuse knee injuries, intrinsic risk factors were sex (girls OR, 1.38) and previous knee injury (OR, 1.78), whereas participation in soccer (OR, 1.64), handball (OR, 1.95), basket (OR, 2.07), rhythmic (OR, 1.98), and tumbling gymnastics (OR, 1.74) were additional risk factors. For both injury types, sport participation above two times per week increased odds (OR, 1.46-2.40). Overuse knee injuries were the most frequent injury type. For traumatic knee injuries, participation in tumbling gymnastics was a risk factor. Risk factors for overuse knee injuries were being a girl; previous knee injury; and participation in soccer, handball, basket, and rhythmic and tumbling gymnastics. Further risk factors for both types of injury were participation in sports above two times per week. Although growth-related overuse knee injuries are a self-limiting condition, a major part of children are affected by these injuries with unknown short- and long-term consequences.

  13. Risk factors for unsuccessful lumbar puncture in children

    African Journals Online (AJOL)

    paediatric emergency medicine departments to diagnose or exclude ... Several studies have examined risk factors for unsuccessful or traumatic ... 4 Department of Anaesthesia, Faculty of Health Sciences, University of Cape Town, South Africa.

  14. Early life exposures and risk of atopy among Danish children

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Porsbjerg, C

    2006-01-01

    A large proportion of atopy develops in childhood and early life exposures are suspected to play a considerable role in the inception. The aim of this study was to examine the association between early life exposures and development of atopic disease in children. We performed a case-cohort study...... to be independent of familial predisposition to atopic disease and significantly increases the likelihood for development of atopy in genetically susceptible individuals. Parental knowledge of atopic heredity significantly influences smoking and breast-feeding habits....... of a random population-based sample of children (n = 480) 7-17 years of age, living in urban Copenhagen, Denmark. Information on breast-feeding, supplementation, wheezy bronchitis, use of antibiotics, and parental smoking during pregnancy and in early life was obtained retrospectively by questionnaire. Skin...

  15. Cognitive and Behavioral Risk Factors for Unintentional Drowning Among Rural Chinese Children.

    Science.gov (United States)

    Shen, Jiabin; Pang, Shulan; Schwebel, David C

    2016-04-01

    Unintentional drowning is among the top causes of pediatric death worldwide and the leading cause of death for children under age 14 in China. Environmental factors such as abundant bodies of water and psychosocial factors such as lack of parental supervision contribute to heightened risk of pediatric drowning in rural China, but little is known about the role of individual characteristics such as knowledge and perceived vulnerability in the drowning risk of rural Chinese children. The present study aimed to explore the cognitive and behavioral risk factors for unintentional drowning among school-aged rural Chinese children. Two hundred and eighty children (mean age = 10.03 years, range 8-13) enrolled at an elementary school in rural Zhejiang Province, China completed self-report assessments of knowledge about drowning prevention, perceived vulnerability toward drowning, and history of non-fatal drowning experiences, as well as demographic information. A simulation task using a dollhouse assessed children's anticipated behaviors with water. Fifty-two percent of the sample reported exposure to water sources at least once daily, and 21 % of the sample reported at least one non-fatal drowning experience in their lifetime. Regression analysis showed that male gender, better swimming ability, less safety knowledge, and lower levels of perceived vulnerability were associated with more self-reported risky practice in/near water. More safety knowledge also predicted safer behaviors in the dollhouse simulation task. None of the risk factors predicted self-reported history of non-fatal drowning incidents. High exposure to water sources and non-fatal drowning experiences were found among school-aged children in rural China. Drowning risk factors included demographic, cognitive, and behavioral characteristics of children. Results offer evidence for developing interventions in both Zhejiang Province and other regions with similar geographic and population characteristics.

  16. Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact

    Directory of Open Access Journals (Sweden)

    Nora Hajarsjah

    2018-04-01

    Full Text Available Background Children in household contact of adults with smear-positive tuberculosis (TB are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB. Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients. Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests. Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%] or the control group [TB score <6; 84 subjects (58.0%]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively. Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.

  17. Cognitive and motor abilities of young children and risk of injuries in the home.

    Science.gov (United States)

    Ehrhardt, Jennifer; Xu, Yingying; Khoury, Jane; Yolton, Kimberly; Lanphear, Bruce; Phelan, Kieran

    2017-02-01

    Residential injury is a leading cause of morbidity and mortality in US children. Rates and types of injury vary by child age but little is known about injury risk based on child cognitive and motor abilities. The objective of this study was to determine whether cognitive or motor development in young children is associated with residential injury. We employed data from Health Outcomes and Measures of the Environment (HOME) Study. Parent report of medically attended injury was obtained at regular intervals from 0 to 42 months. Child development was assessed at 12, 24 and 36 months using Bayley Scales of Infant and Toddler Development, 2nd edition, which generates both mental developmental index (MDI) and a psychomotor developmental index (PDI). Injury risk was modelled using multivariable logistic regression as function of child's MDI or PDI. Effects of MDI and PDI on injury risk were examined separately and jointly, adjusting for important covariates. Children with cognitive delay (MDI cognitive delay (OR=3.7, 95% CI 1.4 to 10.5, p=0.012). There was no significant association of PDI with injury. There was, however, significant interaction of MDI and PDI (p=0.02); children with cognitive delay but normal motor development were at significantly higher risk of injury than children with normal cognitive and motor development (OR=9.6, 95% CI 2.6 to 35.8, p=0.001). Children with cognitive delays, especially those with normal motor development, are at elevated risk for residential injuries. Injury prevention efforts should target children with developmental delays. NCT00129324; post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

    Science.gov (United States)

    Kramer, Gregory M; Luxton, David D

    2016-04-01

    The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

  19. PROPHYLACTIС DIET OF ALLERGIC DISEASES IN CHILDREN WITH HIGH RISK OF ATOPY

    Directory of Open Access Journals (Sweden)

    V.A. Revyakina

    2007-01-01

    Full Text Available The preventive efficiency of various kinds of feedings in children of the first year of life with high risk of an allergic pathology is studied. Under observation there were 87 children from group of high risk of an allergic pathology (from birth up to 18 months. The results of this study have confirmed the importance of breast feeding for prophylaxis of an allergic pathology in children with high risk of atopy. If it is impossible, the transclation of the child on artificial feeding by an dairy admixture based on a partial hydrolysate of serumal protein, which procvides physiological needs of a growing organism, assists physiological dynamics of parameters of weight and height, allows to increase frequency of early manifestation of atopy and prevents a sensibilization to proteins of the cow milk.Key words: allergic diseases, prevention, feeding, hydrolysate of protein of the cow milk, infants.

  20. Childhood asthma exacerbations and the Arg16 β2-receptor polymorphism: A meta-analysis stratified by treatment.

    Science.gov (United States)

    Turner, Steve; Francis, Ben; Vijverberg, Susanne; Pino-Yanes, Maria; Maitland-van der Zee, Anke H; Basu, Kaninika; Bignell, Lauren; Mukhopadhyay, Somnath; Tavendale, Roger; Palmer, Colin; Hawcutt, Daniel; Pirmohamed, Munir; Burchard, Esteban G; Lipworth, Brian

    2016-07-01

    The Gly-to-Arg substitution at the 16 position (rs1042713) in the β2-adrenoceptor gene (ADRB2) is associated with enhanced downregulation and uncoupling of β2-receptors. We sought to undertake a meta-analysis to test the hypothesis that there is an interaction between the A allele of rs1042713 (Arg16 amino acid) and long-acting β-agonist (LABA) exposure for asthma exacerbations in children. Children with diagnosed asthma were recruited in 5 populations (BREATHE, Genes-Environments and Admixture in Latino Americans II, PACMAN, the Paediatric Asthma Gene Environment Study, and the Pharmacogenetics of Adrenal Suppression with Inhaled Steroid Study). A history of recent exacerbation and asthma treatment was determined from questionnaire data. DNA was extracted, and the Gly16Arg genotype was determined. Data from 4226 children of white Northern European and Latino origin were analyzed, and the odds ratio for exacerbation increased by 1.52 (95% CI, 1.17-1.99; P = .0021) for each copy of the A allele among the 637 children treated with inhaled corticosteroids (ICSs) plus LABAs but not for treatment with ICSs alone (n = 1758) or ICSs plus leukotriene receptor antagonist (LTRAs; n = 354) or ICSs plus LABAs plus LTRAs (n = 569). The use of a LABA but not an LTRA as an "add-on controller" is associated with increased risk of asthma exacerbation in children carrying 1 or 2 A alleles at rs1042713. Prospective genotype-stratified clinical trials are now required to explore the potential role of rs1042713 genotyping for personalized asthma therapy in children. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  1. Risk factors that affect metabolic health status in obese children.

    Science.gov (United States)

    Elmaogullari, Selin; Demirel, Fatma; Hatipoglu, Nihal

    2017-01-01

    While some obese children are metabolically healthy (MHO), some have additional health problems, such as hypertension, dyslipidemia, insulin resistance, and hepatosteatosis, which increase mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. These children are metabolically unhealthy obese (MUO) children. In this study we assessed the factors that affect metabolic health in obesity and the clinical and laboratory findings that distinguish between MHO and MUO children. In total, 1085 patients aged 6-18 years, with age- and sex-matched BMI exceeding the 95th percentile were included in the study (mean 11.1±2.9 years, 57.6% female, 59.7% pubertal). Patients without dyslipidemia, insulin resistance, hepatosteatosis, or hypertension were considered as MHO. Dyslipidemia was defined as total cholesterol level over 200 mg/dL, triglyceride over 150 mg/dL, LDL over 130 mg/dL, or HDL under 40 mg/dL. Insulin resistance was calculated using the homeostasis model of assesment for insulin resistance (HOMA-IR) index. Hepatosteatosis was evaluated with abdominal ultrasound. Duration of obesity, physical activity and nutritional habits, screen time, and parental obesity were questioned. Thyroid and liver function tests were performed. Six hundred and forty-two cases (59.2%) were MUO. Older age, male sex, increased BMI-SDS, and sedentary lifestyle were associated with MUO. Excessive junk food consumption was associated with MUO particularly among the prepubertal obese patients. Our results revealed that the most important factors that affect metabolic health in obesity are age and BMI. Positive effects of an active lifestyle and healthy eating habits are prominent in the prepubertal period and these habits should be formed earlier in life.

  2. A Clinical Prediction Algorithm to Stratify Pediatric Musculoskeletal Infection by Severity

    Science.gov (United States)

    Benvenuti, Michael A; An, Thomas J; Mignemi, Megan E; Martus, Jeffrey E; Mencio, Gregory A; Lovejoy, Stephen A; Thomsen, Isaac P; Schoenecker, Jonathan G; Williams, Derek J

    2016-01-01

    Objective There are currently no algorithms for early stratification of pediatric musculoskeletal infection (MSKI) severity that are applicable to all types of tissue involvement. In this study, the authors sought to develop a clinical prediction algorithm that accurately stratifies infection severity based on clinical and laboratory data at presentation to the emergency department. Methods An IRB-approved retrospective review was conducted to identify patients aged 0–18 who presented to the pediatric emergency department at a tertiary care children’s hospital with concern for acute MSKI over a five-year period (2008–2013). Qualifying records were reviewed to obtain clinical and laboratory data and to classify in-hospital outcomes using a three-tiered severity stratification system. Ordinal regression was used to estimate risk for each outcome. Candidate predictors included age, temperature, respiratory rate, heart rate, C-reactive protein, and peripheral white blood cell count. We fit fully specified (all predictors) and reduced models (retaining predictors with a p-value ≤ 0.2). Discriminatory power of the models was assessed using the concordance (c)-index. Results Of the 273 identified children, 191 (70%) met inclusion criteria. Median age was 5.8 years. Outcomes included 47 (25%) children with inflammation only, 41 (21%) with local infection, and 103 (54%) with disseminated infection. Both the full and reduced models accurately demonstrated excellent performance (full model c-index 0.83, 95% CI [0.79–0.88]; reduced model 0.83, 95% CI [0.78–0.87]). Model fit was also similar, indicating preference for the reduced model. Variables in this model included C-reactive protein, pulse, temperature, and an interaction term for pulse and temperature. The odds of a more severe outcome increased by 30% for every 10-unit increase in C-reactive protein. Conclusions Clinical and laboratory data obtained in the emergency department may be used to accurately

  3. Cancer Risks for Relatives of Children with Cancer

    International Nuclear Information System (INIS)

    Heath, J. A.; Smibert, E.; Algar, E. M.; Heath, J. A.; Dite, G. S.; Hopper, J. L.; Algar, E. M.

    2014-01-01

    We determined the extent and distribution of cancers in relatives of 379 children newly diagnosed with cancer. Family history was collected from 1,337 first-degree and 3,399 second-degree relatives and incidence compared with national age- and gender-specific rates. Overall, 14 children (3.7%) had a relative with a history of childhood cancer and 26 children (6.9%) had a first-degree relative with a history of cancer, with only one of these having an identifiable familial cancer syndrome. There was a higher than expected incidence of childhood cancer among first-degree relatives (parents and siblings) (standardized incidence ratio (SIR) 1.43; 95% CI 0.54-5.08). There was also a higher than expected incidence of adult cancers among first-degree relatives (SIR 1.45; 95% CI 0.93-2.21), particularly in females (SIR 1.82; 95% CI 1.26-3.39). The increased family cancer history in first-degree females was largely attributable to an effect in mothers (SIR 1.78; 95% CI 1.27-3.33). The gender-specific association was reflected in higher than expected incidence rates of breast cancer in both mothers (SIR 1.92; 95% CI 0.72-6.83) and aunts (SIR 1.64; 95% CI 0.98-2.94). These findings support the hypothesis that previously undetected familial cancer syndromes contribute to childhood cancer.

  4. FACTORS ASSOCIATED WITH INDISCRIMINATE FRIENDLINESS IN HIGH-RISK CHILDREN.

    Science.gov (United States)

    Love, Leighanne; Minnis, Helen; O'connor, Suzy

    2015-01-01

    Indiscriminate friendliness (IF) refers to a lack of reticence with strangers and is well-documented in neglected children. This risky behavior is distinct from attachment insecurity, and persists when parenting/caregiving improves. A previous review has suggested that caregiving quality is not associated with IF. This review aimed to explore factors associated with IF and whether quality of caregiving is important. Ten articles were reviewed using the S.H. Downs and N. Black (1998) Checklist for randomized and nonrandomized studies. Overall quality was high. Results showed that IF is present in fostered populations and postinstitutionalized children. Attachment security was not associated with IF. Length of time in institution and inhibitory control were associated with IF. Inhibitory control moderated the association between IF and number of caregivers. Genetic factors predispose children to IF and may impact on persistence. Quality of caregiving was associated with IF. Emotional availability (i.e., the degree to which carer and child are able to respond to each other's emotional signals) predicted IF. Limitations across studies included heterogeneity in IF measurement and unreliable measures of preadoptive care. Parenting may be a useful target for intervention. Future research should focus on developing a standardized measure of IF as well as evaluating a parental intervention. © 2015 Michigan Association for Infant Mental Health.

  5. Oral hygiene risk indicators among 6- to 9-year-old Taiwanese aboriginal children.

    Science.gov (United States)

    Hsieh, Hui-Ju; Huang, Shun-Te; Tsai, Chi-Cheng; Chiou, Meng-Jao; Liao, Cheng-Ta

    2014-05-01

    This study investigated the dental health status, dietary habits, oral hygiene levels, and caretaker risk indicators among Taiwanese children. This cross-sectional purposive sampling study included 256 aboriginal children, 6 to 9 years old, living in remote regions in southern Taiwan. Participants received dental examinations, and questionnaires were completed by caretakers. Data were analyzed using the χ(2) test, t test, and multiple logistic regressions. The deft (sum of decayed, extracted, and filled primary teeth) and defs (sum of the decayed, extracted, and filled primary dentition surfaces) indices were affected by the frequencies of drinking sweetened beverages (P = .0006) and daily toothbrushing (P = .0032). Caretakers' toothbrushing frequency was a significant predictor of children's oral hygiene status (P oral hygiene was 2.04 (P = .0184). Oral hygiene among aboriginal children in this study was inadequate. Caretakers' toothbrushing frequency and betel quid habit were significant predictors of poor children's oral hygiene. © 2012 APJPH.

  6. Risk factors for death in children during inpatient treatment of severe acute malnutrition

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Babirekere-Iriso, Esther; Namusoke, Hanifa

    2017-01-01

    BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective...... observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants......% CI: 1.9, 13.3), which was an association that remained after adjustment for potential confounders (HR: 69.5; 95% CI: 7.0, 694.6). CONCLUSIONS: Refeeding syndrome may occur in children who are treated for malnutrition, even with moderately low plasma phosphate, and, in particular, in children...

  7. Symptoms of Anxiety and Associated Risk and Protective Factors in Young Asian American Children

    Science.gov (United States)

    Cheng, Sabrina; Calzada, Esther; Brotman, Laurie Miller

    2014-01-01

    Anxiety is one of the most prevalent mental health problems in young children but there has been a dearth of studies focusing on Asian American children. This study examines the patterns and the predictors of childhood anxiety and related symptoms in young children in a diverse Asian American (ASA) sample (n = 101). Findings indicate that ASA children are at higher risk for anxiety, somatization, and depressive problems than their peers. Parents’ level of acculturation (i.e., American identity, English competence), parental negative emotion socialization, conflicted parent–child relationship, child emotional knowledge and adaptive skills, as well as teachers’ ethnic background and school class types were all associated with ASA children’s anxiety. A combination of cultural, family, and school factors explained from 17 to 39 % of the variance in anxiety symptoms. Findings inform prevention services for young ASA children. PMID:22410755

  8. Risk Factors on Health-Related Quality of Life in Children With Epilepsy.

    Science.gov (United States)

    Liu, Xinjie; Han, Qizheng

    2015-12-01

    The goal of this study was to evaluate how epilepsy affected the health-related quality of life (HRQOL) in children with epilepsy, as well as the risk factors for poor HRQOL. Parents of epileptic children (n = 223) and parents of healthy children (n = 216) were enrolled. The Child Epilepsy Questionnaire-Parental form was given to all parents. Children with epilepsy had significantly lower HRQOL scores for overall QOL and all subscales. Seizure types were not associated with HRQOL, but the age of the child with epilepsy, disease courses and seizure frequency did influence the quality of life. Epilepsy has a severe impact on children's HRQOL, and age, increased seizure frequency and longer duration of epilepsy are associated with poor HRQOL. © The Author(s) 2015.

  9. Risk Factors of Obesity in Children 5-15 Years Old

    Directory of Open Access Journals (Sweden)

    Ratu Ayu Dewi Sartika

    2011-06-01

    Full Text Available Obesity is the result of positive energy balance for long periods of time. The problem of obesity can occur at the age of children, teens to adults. The purpose of this study is to identify the most dominant factor of obesity in children (5-15 years using Basic Health Research in 2007. The proportion of obesity (percentile >95 in children (5-15 years old was 8.3%. The risk factor which mostly associated with obesity was the level of education after being controlled by sex, father's obesity, exercise and smoking habits and intake of protein. To overcome obesity problem in children (5-15 years old, it is needed to provide health education for children from an early age through enhanced IEC (Information, Education and Communication such as anti smoking program, love of fiber (vegetables and fruits and develop a culture of sport activities.

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

    Science.gov (United States)

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

    2016-03-01

    Preterm and former preterm children frequently require sedation/anesthesia for diagnostic and therapeutic procedures. Our objective was to determine the age at which children who are born risk for sedation/anesthesia adverse events. Our secondary objective was to describe the nature and incidence of adverse events. This is a prospective observational study of children receiving sedation/anesthesia for diagnostic and/or therapeutic procedures outside of the operating room by the Pediatric Sedation Research Consortium. A total of 57,227 patients 0 to 22 years of age were eligible for this study. All adverse events and descriptive terms were predefined. Logistic regression and locally weighted scatterplot regression were used for analysis. Preterm and former preterm children had higher adverse event rates (14.7% vs 8.5%) compared with children born at term. Our analysis revealed a biphasic pattern for the development of adverse sedation/anesthesia events. Airway and respiratory adverse events were most commonly reported. MRI scans were the most commonly performed procedures in both categories of patients. Patients born preterm are nearly twice as likely to develop sedation/anesthesia adverse events, and this risk continues up to 23 years of age. We recommend obtaining birth history during the formulation of an anesthetic/sedation plan, with heightened awareness that preterm and former preterm children may be at increased risk. Further prospective studies focusing on the etiology and prevention of adverse events in former preterm patients are warranted. Copyright © 2016 by the American Academy of Pediatrics.

  11. Physical Activity, Sedentary Behavior and the Risk of Overweight and Obesity in School-Aged Children.

    Science.gov (United States)

    Keane, Eimear; Li, Xia; Harrington, Janas M; Fitzgerald, Anthony P; Perry, Ivan J; Kearney, Patricia M

    2017-08-01

    Globally, public health policies are targeting modifiable lifestyle behaviors. We explore the independent association of moderate-to-vigorous physical activity (MVPA) and sedentary behavior on the risk of childhood overweight/obesity. A cross-sectional survey of children aged 8-11 years (N = 826). Objective body mass index was used to classify children as normal weight or overweight/obese. Children wore wrist-worn Geneactiv accelerometers for 7-days and thresholds were applied to categorize MVPA and sedentary time. Screen time (ST) was parent reported. Poisson regression examined the independent association of (1) MVPA (2), objective sedentary time and (3) ST on the risk of overweight/obesity. Overall, 23.7% (95% CI, 20.8-26.6%) of children were overweight/obese. On average, children spent 10.8% of waking time at MVPA and 61.3% sedentary. One-fifth (22.1%, 95% CI, 19.3-25.0%) of children achieved MVPA recommendations (≥ 60 min each day) and 17.5% (95% CI, 14.9-20.1%) met ST recommendations (overweight/obese independent of total sedentary time. Total time spent sedentary was not associated with overweight/obese independent of MVPA. ST was associated with an increased risk of overweight/obese independent of physical activity. Few schoolchildren met physical activity and screen time recommendations suggesting population based measures are needed.

  12. Cardiometabolic risk is associated with the severity of sleep-disordered breathing in children with obesity.

    Science.gov (United States)

    Isacco, Laurie; Roche, Johanna; Quinart, Sylvain; Thivel, David; Gillet, Valérie; Nègre, Véronique; Mougin, Fabienne

    2017-03-01

    The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean±SD, age: 10.7±2.7years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScore BMI and MetScore WC ). Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScore BMI and MetScore WC (pobese children. There is no association between SDB and PAL. In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Vos, Miriam B; Kaar, Jill L; Welsh, Jean A; Van Horn, Linda V; Feig, Daniel I; Anderson, Cheryl A M; Patel, Mahesh J; Cruz Munos, Jessica; Krebs, Nancy F; Xanthakos, Stavra A; Johnson, Rachel K

    2017-05-09

    Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target. © 2017 American Heart Association, Inc.

  14. [Severe trampoline injuries and their risk factors among children and the young].

    Science.gov (United States)

    Sinikumpu, Juha-Jaakko; Salokorpi, Niina; Suo-Palosaari, Maria; Pesälä, Juha; Serlo, Willy

    2016-01-01

    Although the majority of trampoline injuries in children are minor, severe injuries occur as well. We have analyzed the risk factors, treatment and outcome of severe trampoline injuries treated in the Oulu University Hospital in children and the young between April and November 2105. There was a total of eight severe injuries. Five injuries involved a danger of death. Almost all severe trampoline injuries resulted from an unsuccessful trick. A safety net was in use in half of the cases. All cervical spine injuries would have been avoided provided that the children would have refrained from doing a somersault on the trampoline.

  15. Affective empathy, cognitive empathy and social attention in children at high risk of criminal behaviour.

    Science.gov (United States)

    van Zonneveld, Lisette; Platje, Evelien; de Sonneville, Leo; van Goozen, Stephanie; Swaab, Hanna

    2017-08-01

    Empathy deficits are hypothesized to underlie impairments in social interaction exhibited by those who engage in antisocial behaviour. Social attention is an essential precursor to empathy; however, no studies have yet examined social attention in relation to cognitive and affective empathy in those exhibiting antisocial behaviour. Participants were 8- to 12-year-old children at high risk of developing criminal behaviour (N = 114, 80.7% boys) and typically developing controls (N = 43, 72.1% boys). The high-risk children were recruited through an ongoing early identification and intervention project of the city of Amsterdam, focusing on the underage siblings or children of delinquents and those failing primary school. Video clips with neutral and emotional content (fear, happiness and pain) were shown, while heart rate (HR), skin conductance level (SCL) and skin conductance responses (SCRs) were recorded to measure affective empathy. Answers to questions about emotions in the clips were coded to measure cognitive empathy. Eye-tracking was used to evaluate visual scanning patterns towards social relevant cues (eyes and face) in the clips. The high-risk group did not differ from the control group in social attention and cognitive empathy, but showed reduced HR to pain and fear, and reduced SCL and SCRs to pain. Children at high risk of developing criminal behaviour show impaired affective empathy but unimpaired social attention and cognitive empathy. The implications for early identification and intervention studies with antisocial children are discussed. © 2017 Association for Child and Adolescent Mental Health.

  16. Identification of Risk Factors for Intravenous Infiltration among Hospitalized Children: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Soon Mi Park

    Full Text Available This retrospective study was aimed to identify risk factors of intravenous (IV infiltration for hospitalized children. The participants were 1,174 children admitted to a general hospital, who received peripheral intravenous injection therapy at least once, and had complete records. Data were analyzed with frequency and percentage or mean and standard deviation were calculated, and odds ratio (OR from univariate and multiple logistic regressions. The number and % of infiltrations were 92 and 7.8%, respectively. IV infiltration risk factors were lower limb (OR = 1.72, phenytoin (OR = 11.03, 10% dextrose (OR = 6.55, steroids (OR = 6.21, vancomycin (OR = 4.10, high-concentration electrolytes (OR = 3.49, and ampicillin/sulbactam combination (OR = 3.37. Nurses working at children's hospitals should consider the risk of IV infiltration for children receiving IV infusion therapy and make a preventive effort to identify IV infiltration in high-risk children at an early stage.

  17. Clostridium difficile Infection Is Associated With Increased Risk of Death and Prolonged Hospitalization in Children

    Science.gov (United States)

    Sammons, Julia Shaklee; Localio, Russell; Xiao, Rui; Coffin, Susan E.; Zaoutis, Theoklis

    2013-01-01

    Background Clostridium difficile infection (CDI) is associated with significant morbidity and mortality among adults. However, outcomes are poorly defined among children. Methods A retrospective cohort study was performed among hospitalized children at 41 children's hospitals between January 2006 and August 2011. Patients with CDI (exposed) were matched 1:2 to patients without CDI (unexposed) based on the probability of developing CDI (propensity score derived from patient characteristics). Exposed subjects were stratified by C. difficile test date, suggestive of community-onset (CO) versus hospital-onset (HO) CDI. Outcomes were analyzed for matched subjects. Results We identified 5107 exposed and 693 409 unexposed subjects. Median age was 6 years (interquartile range [IQR], 2–13 years) for exposed and 8 years (IQR, 3–14 years) for unexposed subjects. Of these, 4474 exposed were successfully matched to 8821 unexposed by propensity score. In-hospital mortality differed significantly (CDI, 1.43% vs matched unexposed, 0.66%; P cost were significant: 5.55 days (95% CI, 4.54–6.56 days) and $18 900 (95% CI, $15 100–$22 700) for CO-CDI, and 21.60 days (95% CI, 19.29–23.90 days) and $93 600 (95% CI, $80 000–$107 200) for HO-CDI. Conclusions Pediatric CDI is associated with increased mortality, longer LOS, and higher costs. These findings underscore the importance of antibiotic stewardship and infection control programs to prevent this disease in children. PMID:23532470

  18. Parental psychological symptoms and familial risk factors of children and adolescents who exhibit school refusal.

    Science.gov (United States)

    Bahali, K; Tahiroglu, A Y; Avci, A; Seydaoglu, G

    2011-12-01

    To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process.

  19. Morphology and Spelling in French: A Comparison of At-Risk Readers and Typically Developing Children.

    Science.gov (United States)

    Koh, Poh Wee; Shakory, Sharry; Chen, Xi; Deacon, S Hélène

    2017-11-01

    We present two studies that examine the role of morphology in French spelling. In Study 1, we examined the concurrent and longitudinal relationships between inflectional awareness and derivational awareness and spelling within a sample of 77 children in a French immersion programme in Canada. Children completed a non-verbal reasoning measure and French measures of phonological awareness, word reading, vocabulary, morphological awareness, and spelling. Results showed that inflectional morphological awareness in Grade 3 was a predictor of spelling in the same grade. Inflectional awareness in Grade 2 predicted Grade 3 spelling, controlling for reading-related skills and spelling at Grade 2. These analyses support the role of inflectional morphological awareness in the development of spelling of children of a range of reading and spelling abilities. In contrast, derivational awareness in Grades 2 and 3 did not predict spelling concurrently in both grades respectively. Study 2 contrasted the morphological errors in the spellings of six children at risk for reading difficulties with those of six chronological age-matched and six reading level-matched children. Analyses showed that at-risk children exhibited more difficulties with spelling roots and suffixes in words as compared with their age-matched peers, although they performed similarly to children matched on reading level. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  20. The prevalence and risk factors of stunting among primary school children in North Sumatera, Indonesia

    Science.gov (United States)

    Lestari, S.; Fujiati, I. I.; Keumalasari, D.; Daulay, M.

    2018-03-01

    Stunting in primary school-aged children is a kind of health and nutrition problem in Indonesia which has an impact on the human quality resources degradation. This research aimed to determine the stunting prevalence and the risk factors associated with stunting in primary school children in North Sumatra Province. This research is an analysis of cross-sectional approach. The total sampleis 400 children aged 8-13 years old were in the study from the Medan city and Langkat regency in July - October 2017. Data collected by using questionnaire and anthropometric assessment. Stunting (<-2 SD of height-for-age Z-score) were defined by using the World Health Organization reference 2007. Chi-square analysis and logistic regression were used toassess the association between risk factors and stunting. The prevalence of stunting in primary school children was 38.87%. The factors associated with stunting school children were theeducation of mother (OR=1.53), income (OR=2.27), work of mother (OR=1.39), energy intake (OR=2.66) and protein intake (OR=2.02). The dominant factor that influences stunting in school children was energy intake. The conclusion of this study is stunting prevalence in school children in NorthSumatra higher.

  1. The risk and protective factors in the development of childhood social anxiety symptoms among Chinese children.

    Science.gov (United States)

    Wu, Yi-Le; Zhao, Xue; Li, Yi-Feng; Ding, Xiu-Xiu; Yang, Hui-Yun; Bi, Peng; Sun, Ye-Huan

    2016-06-30

    The aim of this study was to explore the change and associated risk and protective factors of social anxiety symptoms among Chinese children. A 2-year longitudinal study was performed in a general primary and secondary school population in Anhui Province, China including 816 children in grades 3, 4, and 7. Children's social anxiety symptoms were assessed using the Social Anxiety Scales for Children (SASC) at three assessments. The overall prevalence of children's elevated social anxiety symptoms ranged from 15.2% to 16.4% across three assessments. Children's overall mean SASC scores were 5.6 (SD =3.7), 5.3 (SD =3.8), and 5.3 (SD =4.1) at three assessments, respectively, but the difference was not statistically significant. However, children's social anxiety symptom levels and change among different subgroups was not stable across 2-year follow-up. Multivariable logistic regression analysis indicated that age, severe family dysfunction, quality of life, positive coping, negative coping, depressive symptoms and self-esteem were predictive factors for childhood elevated social anxiety symptoms. The findings suggested that the overall social anxiety symptoms showed a relatively stable pattern over time. The identified risk and protective factors may provide scientific evidence for school, family, and health authorities to conduct necessary intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Ethnic Kawasaki Disease Risk Associated with Blood Mercury and Cadmium in U.S. Children

    Science.gov (United States)

    Yeter, Deniz; Portman, Michael A.; Aschner, Michael; Farina, Marcelo; Chan, Wen-Ching; Hsieh, Kai-Sheng; Kuo, Ho-Chang

    2016-01-01

    Kawasaki disease (KD) primarily affects children <5 years of age (75%–80%) and is currently the leading cause of acquired heart disease in developed nations. Even when residing in the West, East Asian children are 10 to 20 times more likely to develop KD. We hypothesized cultural variations influencing pediatric mercury (Hg) exposure from seafood consumption may mediate ethnic KD risk among children in the United States. Hospitalization rates of KD in US children aged 0–4 years (n = 10,880) and blood Hg levels in US children aged 1–5 years (n = 713) were determined using separate US federal datasets. Our cohort primarily presented with blood Hg levels <0.1 micrograms (µg) per kg bodyweight (96.5%) that are considered normal and subtoxic. Increased ethnic KD risk was significantly associated with both increasing levels and detection rates of blood Hg or cadmium (Cd) in a linear dose-responsive manner between ethnic African, Asian, Caucasian, and Hispanic children in the US (p ≤ 0.05). Increasing low-dose exposure to Hg or Cd may induce KD or contribute to its later development in susceptible children. However, our preliminary results require further replication in other ethnic populations, in addition to more in-depth examination of metal exposure and toxicokinetics. PMID:26742052

  3. Endothelial function in pre-pubertal children at risk of developing cardiomyopathy: a new frontier

    Directory of Open Access Journals (Sweden)

    Aline Cristina Tavares

    2012-01-01

    Full Text Available Although it is known that obesity, diabetes, and Kawasaki's disease play important roles in systemic inflammation and in the development of both endothelial dysfunction and cardiomyopathy, there is a lack of data regarding the endothelial function of pre-pubertal children suffering from cardiomyopathy. In this study, we performed a systematic review of the literature on pre-pubertal children at risk of developing cardiomyopathy to assess the endothelial function of pre-pubertal children at risk of developing cardiomyopathy. We searched the published literature indexed in PubMed, Bireme and SciELO using the keywords 'endothelial', 'children', 'pediatric' and 'infant' and then compiled a systematic review. The end points were age, the pubertal stage, sex differences, the method used for the endothelial evaluation and the endothelial values themselves. No studies on children with cardiomyopathy were found. Only 11 papers were selected for our complete analysis, where these included reports on the flow-mediated percentage dilatation, the values of which were 9.80±1.80, 5.90±1.29, 4.50±0.70, and 7.10±1.27 for healthy, obese, diabetic and pre-pubertal children with Kawasaki's disease, respectively. There was no significant difference in the dilatation, independent of the endothelium, either among the groups or between the genders for both of the measurements in children; similar results have been found in adolescents and adults. The endothelial function in cardiomyopathic children remains unclear because of the lack of data; nevertheless, the known dysfunctions in children with obesity, type 1 diabetes and Kawasaki's disease may influence the severity of the cardiovascular symptoms, the prognosis, and the mortality rate. The results of this study encourage future research into the consequences of endothelial dysfunction in pre-pubertal children.

  4. Dutch home-based pre-reading intervention with children at familial risk of dyslexia

    OpenAIRE

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small effect on a composite score of phoneme awareness (d = 0.29) and a large effect on receptive letter knowledge (d  = 0.88). In first grade, however, t...

  5. Estimation of stochastic effects risk in children from areas affected by the Chernobyl accident

    International Nuclear Information System (INIS)

    Jova S, L.; Garcia L, O.; Valdes R, M.

    1996-01-01

    Radiation risk estimation of stochastic effect was evaluated in a group of children assisted in the Cuba Republic as part of the program for medical attention with children from areas affected by the Chernobyl accident . Doses, received from different sources, were estimated for risk evaluation. The study shows total detrimental effects between 0,02 - 0,01% for different groups; values lower than expected for developed country (17-20%). Fatal thyroid cancer increased up to 0,07% in one of the studied groups. (authors). 8 refs., 4 tabs

  6. Sugar-Sweetened Beverages and Obesity Risk in Children and Adolescents

    DEFF Research Database (Denmark)

    Bucher Della Torre, Sophie; Keller, Amélie; Laure Depeyre, Jocelyne

    2016-01-01

    studies published until December 2013 in peer-reviewed journals was performed on Medline, CINAHL, Web of Knowledge, and ClinicalTrials.gov. Studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents were included, and methodological quality......: The aim of this review was to systematically analyze the methodology of studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents, and the studies' ability to answer this research question. METHODS: A systematic review of cohort and experimental...

  7. Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review

    OpenAIRE

    Strina, Agostino; Barreto, Mauricio L; Cooper, Philip J; Rodrigues, Laura C

    2014-01-01

    BACKGROUND: The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings.\\ud \\ud OBJECTIVE: To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents.\\ud \\ud METHODS: A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE.\\u...

  8. Risk assessment of bronchial asthma development in children with atopic dermatitis

    Science.gov (United States)

    Vуsotska, Olena V.; Klymenko, Viktoriia A.; Trubitcin, Alexei A.; Pecherska, Anna I.; Savchuk, Tamara O.; Kolimoldayev, Maksat; Wójcik, Waldemar; Szatkowska, Małgorzata; Burlibay, Aron

    2017-08-01

    This article offers a risk assessment of bronchial asthma development in children with atopic dermatitis by applying fuzzy-set theory to accumulated statistical data. It is shown that with a view to executing the said task one should exercise a complex approach involving factors such as "IgE level", "existence of obstructions" and "burdened bronchial asthma heredity of immediate relatives". The obtained results will assist in making adequate and well-informed medical decisions as well as facilitate the decrease of the risk of developing bronchial asthma in children with atopic dermatitis.

  9. Vascular risks and management of obesity in children and adolescents

    Directory of Open Access Journals (Sweden)

    Courtney J Jolliffe

    2006-06-01

    Full Text Available Courtney J Jolliffe1, Ian Janssen1,21School of Physical and Health Education, 2Department of Community Health and Epidemiology, Queen’s University, Kingston, Ontario, CanadaAbstract: Childhood obesity has reached epidemic proportions in many countries. Pediatric obesity is associated with the development of cardiovascular (CV risk factors including type 2 diabetes, hypertension, dyslipidemia, and the metabolic syndrome. It is also associated with an increased risk of CV disease (CVD in adulthood. Moreover, obesity and CVD risk factors in obese youth tend to track into adulthood, further increasing the risk of adult CVD. Consequently, the treatment and prevention of childhood overweight and obesity has become a public health priority. Proper nutrition and increased physical activity are the main focus of these efforts; however, few studies have shown positive results. Treatment options for obesity in youth also include pharmacotherapy and surgery. While pharmacotherapy appears promising, additional evidence is needed, especially with respect to the long-term impact, before it becomes a widespread treatment option in the pediatric population.Keywords: childhood, obesity, overweight, cardiovascular risk factors, prevention, treatment

  10. The New York High-Risk Project: social and general intelligence in children at risk for schizophrenia.

    Science.gov (United States)

    Ott, S L; Spinelli, S; Rock, D; Roberts, S; Amminger, G P; Erlenmeyer-Kimling, L

    1998-05-04

    Social deficits, as well as low performance on intelligence tests, are known early symptoms of schizophrenia. We studied whether impairment of social intelligence can be detected before the outbreak of the disorder. In the New York High-Risk Project, children at risk for schizophrenia (HRSz) or affective disorder (HRAff) and a normal control group (NC) were studied over the past 26 years. The children are now in mid-adulthood, with known psychiatric outcomes. Developmental and clinical data from childhood can now be related to adulthood diagnoses. We compared mean WISC (or WISC-R) and WAIS (or WAIS-R) scores from childhood and adolescence, and change of IQ, between the risk groups, as well as between the adulthood outcomes. We were specifically interested in the development of social intelligence (the Picture Arrangement and Comprehension subtests). We used logistic regression analyses to generate a model predicting adulthood schizophrenia. IQ at age 9,7 was lower in children with HRSz than with HRAff. Adulthood schizophrenia, compared with major depressive disorder and no psychiatric diagnosis could not be related conclusively to low IQ. This may be a result of the study design, since children with IQ below 70 or behavioral problems were not eligible as study subjects. There was no evidence of lower scores or more decline in social intelligence related to age or group membership (risk or outcome). Subtest-Scatter, a nondirectional measure of the differences between all subtests and Vocabulary, reflecting a lesser difference between crystallized and fluid intelligence, was identified as a significant predictor of adulthood schizophrenia, in the whole group as well as in the HRSz group alone.

  11. Risk assessment for furan contamination through the food chain in Belgian children.

    Science.gov (United States)

    Scholl, Georges; Huybrechts, Inge; Humblet, Marie-France; Scippo, Marie-Louise; De Pauw, Edwin; Eppe, Gauthier; Saegerman, Claude

    2012-08-01

    Young, old, pregnant and immuno-compromised persons are of great concern for risk assessors as they represent the sub-populations most at risk. The present paper focuses on risk assessment linked to furan exposure in children. Only the Belgian population was considered because individual contamination and consumption data that are required for accurate risk assessment were available for Belgian children only. Two risk assessment approaches, the so-called deterministic and probabilistic, were applied and the results were compared for the estimation of daily intake. A significant difference between the average Estimated Daily Intake (EDI) was underlined between the deterministic (419 ng kg⁻¹ body weight (bw) day⁻¹) and the probabilistic (583 ng kg⁻¹ bw day⁻¹) approaches, which results from the mathematical treatment of the null consumption and contamination data. The risk was characterised by two ways: (1) the classical approach by comparison of the EDI to a reference dose (RfD(chronic-oral)) and (2) the most recent approach, namely the Margin of Exposure (MoE) approach. Both reached similar conclusions: the risk level is not of a major concern, but is neither negligible. In the first approach, only 2.7 or 6.6% (respectively in the deterministic and in the probabilistic way) of the studied population presented an EDI above the RfD(chronic-oral). In the second approach, the percentage of children displaying a MoE above 10,000 and below 100 is 3-0% and 20-0.01% in the deterministic and probabilistic modes, respectively. In addition, children were compared to adults and significant differences between the contamination patterns were highlighted. While major contamination was linked to coffee consumption in adults (55%), no item predominantly contributed to the contamination in children. The most important were soups (19%), dairy products (17%), pasta and rice (11%), fruit and potatoes (9% each).

  12. Cumulative risk exposure moderates the association between parasympathetic reactivity and inhibitory control in preschool-age children.

    Science.gov (United States)

    Giuliano, Ryan J; Roos, Leslie E; Farrar, Jessica D; Skowron, Elizabeth A

    2018-04-01

    A child's cumulative risk for early exposure to stress has been linked to alterations of self-regulation outcomes, including neurobiological correlates of inhibitory control (IC). We examined whether children's ability to engage the parasympathetic nervous system impacts how risk affects IC. Children ages 3-5 years completed two laboratory measures of IC while respiratory sinus arrhythmia (RSA) was measured, indexing parasympathetic activity. Children with greater risk demonstrated lower IC; risk also moderated associations between RSA reactivity and IC. For children with less risk, greater RSA withdrawal during IC tasks was associated with better IC. In contrast, greater risk was associated with poor IC, regardless of RSA withdrawal. Effects of risk were more pronounced for cumulative than individual measures. Results suggest that cumulative risk exposure disrupts connectivity between physiological and behavioral components of self-regulation in early childhood. Parasympathetic withdrawal to cognitive tasks may be less relevant for performance in developmental samples experiencing greater life stress. © 2018 Wiley Periodicals, Inc.

  13. Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention.

    Science.gov (United States)

    Miovský, Michal; Vonkova, Hana; Čablová, Lenka; Gabrhelík, Roman

    2015-11-01

    To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles. A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups. The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children. We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Protective and risk factors for toxocariasis in children from two different social classes of Brazil.

    Science.gov (United States)

    Santarém, Vamilton Alvares; Leli, Flávia Noris Chagas; Rubinsky-Elefant, Guita; Giuffrida, Rogério

    2011-01-01

    The aim of this study was to analyze the prevalence of Toxocara spp. antibodies in children from two different socioeconomic classes in the Presidente Prudente municipality, São Paulo State, Brazil, and the protective and risk factors associated with toxocariasis. One hundred and twenty-six middle-class (MC) and 126 disadvantaged children (DC) were included in this study. Anti-Toxocara ELISA test was performed in order to evaluate seroprevalence. A survey was applied to the children's guardians/parents in order to analyze the protective and risk factors. The overall prevalence was 11.1%, and of 9.5% (12/126) and 12.7% (16/126) for MC and DC subgroups, respectively. Toxocara seropositivity was inversely proportional to the family income. A high household income was considered a protective factor for toxocariasis in the total population and in both MC and DC subgroups. Being a girl was considered a protective factor for the total population and for both subgroups. Whilst being an owner of cat was a risk factor for children belonging to the total and for both MC and DC subgroups, having dog was considered as a risk factor for only the MC. Epidemiologic protective/factor risks can be distinct depending on the strata of the same population. Thus, it is relevant to evaluate these factors independently for different socioeconomic classes in order to design future investigations and programs for preventing the infection of human beings by Toxocara spp. and other geohelminths.

  15. AWARENESS OF NON COMMUNICABLE DISEASES AND THEIR RISK FACTORS AMONG RURAL SCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    Siddharudha Shivalli

    2012-12-01

    Full Text Available Introduction: Behavioral interventions for Non Communicable Diseases (NCD abeyance would profit the most, if initiated at an early age. Major risk factors of NCDs are changing life style and behavior pattern which are largely due to practices adopted in younger age. Students' awareness about NCDs and their risk factors is an important part of population based prevention strategy. Objective: To assess the awareness of NCDs and their risk factors among rural intermediate school children. Methodology: A School based cross sectional study was conducted in Chiraigaon Community Development Block of Varanasi from July - Aug 2010. Intermediate school children from eight inter-colleges of Chiraigaon development block were the study subjects. Pretested questionnaire was used in the study and frequency and proportions were used to analyze the data. Results: Less than one third of the children were aware about Diabetes and Hypertension (27% and 31% respectively. Only 18% knew about Body Mass Index (BMI as an indicator of obesity. In general awareness of NCDs was more in boys than girl. Conclusion: Over all awareness of NCDs and their risk factors among students was not satisfactory. There is a need and scope for health education activity regarding NCDs and their risk factors to promote healthy life style among these school children.

  16. Prevalence and risk factors of intestinal helminth infection among rural malay children.

    Science.gov (United States)

    Huat, Lim Boon; Mitra, Amal K; Jamil, Noor Izani Noor; Dam, Pim Chau; Mohamed, Hamid Jan Jan; Muda, Wan Abdul Manan Wan

    2012-01-01

    Soil-transmitted intestinal helminth infection is prevalent in rural communities of Malaysia. Risk factors contributing to helminth infections are largely unknown in the country. To determine the prevalence and risk factors of intestinal helminth infections among children in Beris Lalang, a rural Muslim community of Malaysia. In this cross-sectional study, children aged 7-9 yea