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Sample records for undernourished children utilizing

  1. Nutrition rehabilitation of undernourished children utilizing Spiruline and Misola

    Directory of Open Access Journals (Sweden)

    Biondi Daniela M

    2006-01-01

    Full Text Available Abstract Background Malnutrition constitutes a public health problem throughout the world and particularly in developing countries. Aims The objective of the study is to assess the impact of an elementary integrator composed of Spiruline (Spirulina platensis and Misola (millet, soja, peanut produced at the Centre Medical St Camille (CMSC of Ouagadougou, Burkina Faso, on the nutritional status of undernourished children. Materials and methods 550 undernourished children of less than 5 years old were enrolled in this study, 455 showed severe marasma, 57 marasma of medium severity and 38 kwashiorkor plus marasma. We divided the children randomly into four groups: 170 were given Misola (731 ± 7 kcal/day, 170 were given Spiruline plus traditional meals (748 ± 6 kcal/day, 170 were given Spiruline plus Misola (767 ± 5 kcal/day. Forty children received only traditional meals (722 ± 8 kcal/day and functioned as the control group. The duration of this study was eight weeks. Results and Discussion Anthropometrics and haematological parameters allowed us to appreciate both the nutritional and biological evolution of these children. The rehabilitation with Spiruline plus Misola (this association gave an energy intake of 767 ± 5 kcal/day with a protein assumption of 33.3 ± 1.2 g a day, both greater than Misola or Spiruline alone, seems to correct weight loss more quickly. Conclusion Our results indicate that Misola, Spiruline plus traditional meals or Spiruline plus Misola are all a good food supplement for undernourished children, but the rehabilitation by Spiruline plus Misola seems synergically favour the nutrition rehabilitation better than the simple addition of protein and energy intake.

  2. Undernourished Children and Milk Lactose.

    Science.gov (United States)

    Grenov, Benedikte; Briend, André; Sangild, Per T; Thymann, Thomas; Rytter, Maren H; Hother, Anne-Louise; Mølgaard, Christian; Michaelsen, Kim F

    2016-03-01

    Lactose is an important energy source in young mammals, and in fully breast-fed human infants, it constitutes around 40% of the total daily energy intake. The role of lactose in feeding of undernourished infants and young children is not well described. A narrative review of the potential positive and negative effects of lactose in the treatment of undernourished children. Searches were conducted using PUBMED and Web of Science up to July 2015. Relevant references in the retrieved articles were included. Lactose may exhibit several health benefits in young children, including a prebiotic effect on the gut microbiota and a positive effect on mineral absorption. Studies in piglets suggest there might also be a stimulating effect on growth, relative to other carbohydrates. Lactose intolerance is a potential concern for undernourished children. Most undernourished children seem to tolerate the currently recommended (low lactose level) therapeutic foods well. However, a subgroup of severely undernourished children with secondary lactase deficiency due to severe diarrhea or severe enteropathy may benefit from products with even more restricted lactose content. At limited extra costs, lactose or lactose-containing milk ingredients may have beneficial effects if added to food products for undernourished children. Lactose may be an overlooked beneficial nutrient for young and undernourished children. Research is needed to define the balance between beneficial and detrimental effects of lactose in undernourished children at different ages and with different degrees of diarrhea and intestinal integrity. © The Author(s) 2016.

  3. Undernourished children and milk lactose

    DEFF Research Database (Denmark)

    Grenov, Benedikte; Briend, André; Sangild, Per Torp

    2016-01-01

    BACKGROUND: Lactose is an important energy source in young mammals, and in fully breast-fed human infants, it constitutes around 40% of the total daily energy intake. The role of lactose in feeding of undernourished infants and young children is not well described. OBJECTIVE: A narrative review...... of the potential positive and negative effects of lactose in the treatment of undernourished children. METHODS: Searches were conducted using PUBMED and Web of Science up to July 2015. Relevant references in the retrieved articles were included. RESULTS: Lactose may exhibit several health benefits in young...... children, including a prebiotic effect on the gut microbiota and a positive effect on mineral absorption. Studies in piglets suggest there might also be a stimulating effect on growth, relative to other carbohydrates. Lactose intolerance is a potential concern for undernourished children. Most...

  4. The clinical and anthropometric profile of undernourished children ...

    African Journals Online (AJOL)

    To determine the clinical profile and the severity of anthropometric failure of undernourished children aged under 5 admitted to. Nyangabgwe Referral ..... Signs and symptoms of the children on admission (N=113). Age group. (months). Oedema n (%). Fever n (%). Vomiting n (%). Diarrhoea n (%). Coughing n (%). Anaemia.

  5. The clinical and anthropometric profile of undernourished children ...

    African Journals Online (AJOL)

    Background. Although Botswana is a middle-income country, undernutrition among children younger than 5 years of age is still seen in various parts of the country. There is little information on the clinical and anthropometric profile of undernourished children in this age group admitted to hospitals in Francistown, Botswana.

  6. Low postprandial circulating inactive ghrelin: role of early satiety in undernourished children.

    Science.gov (United States)

    Najib, Khadijehsadat; Moghtaderi, Mozhgan; Farjadian, Shirin; Falahzadeh, Ebrahim

    2014-11-01

    To determine difference in the levels of circulating inactive ghrelin between undernourished and healthy children. The present cross-sectional study was conducted in undernourished children from southwestern Iran, from July 2011 through July 2012. Postprandial inactive ghrelin levels were measured in 40 undernourished children and sex- and age-matched healthy controls by enzyme immunoassay. The levels of postprandial inactive ghrelin were considerably lower in undernourished compared to the healthy children (6.4 vs. 12.9, P < 0.001). Among the undernourished children, the level of inactive ghrelin was significantly lower in girls than in boys (5.8 vs. 7.1, P = 0.032). Thus, the levels of inactive ghrelin was found to be low in undernourished children compared to healthy children. Early loss of appetite might be a result of low circulating inactive ghrelin levels in the postprandial state in undernourished children.

  7. Feasibility of integrating early stimulation into primary care for undernourished Jamaican children: cluster randomised controlled trial.

    Science.gov (United States)

    Powell, Christine; Baker-Henningham, Helen; Walker, Susan; Gernay, Jacqueline; Grantham-McGregor, Sally

    2004-07-10

    To assess the feasibility of integrating early psychosocial stimulation into primary care for undernourished children and to determine the effect on children's development and mothers' knowledge and practices of childrearing. Cluster randomised controlled trial. 18 clinics in three Jamaican parishes. 139 undernourished children aged 9 to 30 months and their mothers enrolled in intervention or control clinics. Weekly home visits by community health aides for one year in addition to usual duties. Parenting issues were discussed with the mothers and play activities were demonstrated with the children using homemade materials. Children's scores on the Griffiths mental development scales and mothers' knowledge and practices of childrearing measured by questionnaires. Children from the intervention group showed significant improvements in development: developmental quotient, 7.8 points (95% confidence interval 4.5 to 11.1); hearing and speech, 10.7 (5.9 to 15.4 points); hand and eye coordination, 6.8 (3.4 to 10.1 points); and performance subscale, 11.0 (5.6 to 16.4 points). No improvements were shown on the locomotor subscale. The mothers from the intervention group showed improved knowledge and practices of childrearing. Change in children's body mass index and height independently affected change in development. Integrating parenting skills and early psychosocial stimulation for undernourished children into primary care was feasible and effective in improving the children's development and mothers' knowledge and practices of childrearing.

  8. Evaluation of oral microbiota in undernourished and eutrophic children using checkerboard DNA-DNA hybridization.

    Science.gov (United States)

    Testa, M; Erbiti, S; Delgado, A; Cardenas, I L

    2016-12-01

    The aim of this study was to evaluate the relationship among nutritional status, gingival health and the composition of oral microbiota in children of a public school from a very poor area of San Miguel de Tucuman. Forty-five children ranging in age from 6 to 14 years old, 13 males and 32 females were studied. Twenty of these children were undernourished (Lejarraga-Morasso Table) and twenty-five were eutrophic. A clinical study that included DMF and dmf indexes, Löe Silness Plaque Index and bleeding on probing was performed. For microbiological study, saliva samples without stimulation were taken; aliquots of them were immediately placed in TAE buffer pH 7.6, adding NaOH (N and keeping at -70 °C until processed by checkerboard DNA-DNA hybridization method to check the presence of 40 oral microorganism species. Positive bleeding on probing was present in more than 80% of children, without significant differences between eutrophic and undernourished groups. Same result were obtain for the other clinical indexes (p > 0.05, Two Way ANOVA). Significant differences were found for some oral microorganism species, with a higher percentage of undernourished children harboring them. That was the case of S. gordonii (p Gingivitis and bleeding on probing would not be related to nutritional status in the groups of children studied. There were significant differences for the presence of some of the main periodontal pathogen species between eutrophic and undernourished children. It would be important to study the meaning of significant differences found for the other microorganisms more deeply. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Psychosocial stimulation improves the development of undernourished children in rural Bangladesh.

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    Hamadani, Jena D; Huda, Syed N; Khatun, Fahmida; Grantham-McGregor, Sally M

    2006-10-01

    Undernutrition in early childhood is associated with poor mental development and affects 45% of children in Bangladesh. Although limited evidence shows that psychosocial stimulation can reduce the deficits, no such interventions have been reported from Bangladesh. The Bangladesh Integrated Nutrition Program (BINP) has provided nutrition supplementation to undernourished children through community nutrition centers (CNCs). We added psychosocial stimulation to the treatment of undernourished children in a randomized controlled trial to assess the effects on children's development and growth and mothers' knowledge. Twenty CNCs were randomly assigned to intervention or control groups with 107 children in each group. We also studied 107 nonintervened better-nourished children from the same villages. Pre- and postintervention measurements included children's height, weight, development assessed on Bayley Scales, behavior ratings during the test, and a questionnaire on mothers' knowledge of childrearing. The intervention comprised home visits and group meetings with mothers and children for 12 mo. Intervention benefited children's mental development (4.6 +/- 2.0, P = 0.02), vocalization (0.48 +/- 0.23, P = 0.04), cooperation (0.45 +/- 0.16, P = 0.005), response-to-examiner (0.50 +/- 0.15, P = 0.001), emotional tone (0.33 +/- 0.15, P = 0.03), and mothers' knowledge (3.5 +/- 0.49, P < 0.001). At the end, undernourished controls had poorer mental (-4.6 +/- 2.0, P = 0.02) and motor (-6.6 +/- 2.2, P = 0.003) development, were more inhibited (-0.35 +/- 0.16, P = 0.03), fussier (-0.57 +/- 0.16, P < 0.001), less cooperative (-0.48 +/- 0.17, P = 0.005), and less vocal (-0.76 +/- 0.23, P = 0.001) than better-nourished children. Intervened children scored lower only in motor development (-4.4 +/- 2.3, P = 0.049). Neither group of undernourished children improved in nutritional status, indicating that treatment had no effect. In conclusion, adding child development activities to the

  10. Follow-up Assessment of Under-nourished Children Under Integrated Child Development Services Scheme in Tapi District, India.

    Science.gov (United States)

    Desai, Kanan T; Nayak, Sunil N; Patel, Prakash B; Modi, Bhautik P; Gharat, Vaibhav V; Bansal, Rajkumar

    2014-06-01

    India shares the largest burden of under-nutrition in world. The aim of this study was to conduct follow-up assessment of under-nourished children attending anganwadi center (AWC). This was a retrospective cohort study conducted in 50 AWC of Tapi district. Total 529 children aged 1-6 years diagnosed as under-nourished before 1 year were included. Pre-structured questionnaire was used for present day assessment of these children followed by Epi-info mediated analysis. Children of literate mothers had higher weight gain. Ninety percent of children attended anganwadi regularly, however 25% of children dropped out for more than 1 month. In 1 year, growth had faltered in 20% children and was stagnant in 63% of them. Children who were treated for under-nutrition; that completed course at Child Development and Nutrition Center; and whose parents were counseled about the under-nourished status of child had higher weight gain than their counterparts. Parents of under-nourished children must be counseled about the nutritional status of their child. In cases of under-nourished child, referral to higher center must be ensured by health worker. Supplementary feeding as a long-term solution to country's under-nutrition problem should be studied in detail with the alternative solutions.

  11. Cryptosporidium infection in undernourished children with HIV/AIDS ...

    African Journals Online (AJOL)

    Background: AIDS and Protein energy malnutrition (PEM) severely impair the immune system Cryptosporidium has over the last two decades emerged as a life threatening disease. The study attempts to determine the prevalence of Cryptosporidium infection in malnourished children with HIV/AIDS. Method: Blood and stool ...

  12. Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi.

    Science.gov (United States)

    Flax, Valerie L; Thakwalakwa, Chrissie; Ashorn, Ulla

    2016-12-01

    Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children. © The Author(s) 2015.

  13. Body composition and physical fitness of undernourished South African rural primary school children.

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    Monyeki, M A; Koppes, L L J; Kemper, H C G; Monyeki, K D; Toriola, A L; Pienaar, A E; Twisk, J W R

    2005-07-01

    The purpose of this study was to determine the relationships between the body composition characteristics, body mass index (BMI), sum of skinfolds (SSF), % body fat (%BF), fat-free mass (FFM) and waist-to-hip ratio (WHR), and nine physical fitness items in undernourished rural primary school children in Ellisras, South Africa. A cross-sectional study. The study consisted of 462 boys and 393 girls who were aged 7-14 y. Five body composition measures were assessed: BMI, SSF, %BF, FFM and WHR. Nine physical fitness test items were assessed: standing long jump, bent arm hang, sit-ups, 10 x 5 m shuttle run, 50 m sprint, 1600 m run, flamingo balance, sit and reach, plate tapping. BMI was highly correlated with FFM (r = 0.7, P sit and reach (B = -7.48, P = 0.01). In contrast, significant relationships were found between BMI and standing long jump (B = 0.74, P = 0.04), sit and reach (B = 0.51, P sit and reach (B = 0.04, P = 0.03). Significant inverse associations were found between FFM and bent arm hang (girls, B = -0.06, P = 0.05), 1600 m run (girls, B = -2.33, P = 0.003) and 50 m run (boys, B = -0.11, P = 0.006). FFM was significantly associated with standing long jump (boys, B = 0.99, P sit and reach (boys, B = 0.59, P = 0.03). In the present study in undernourished children, body composition was significantly related to physical fitness, but not always in the expected direction. It is therefore important to note that in this population, BMI should not be interpreted as a measure of fatness/overweight, but rather as an indicator of muscle mass.

  14. Head growth of undernourished children in rural Nepal: association with demographics, health and diet.

    Science.gov (United States)

    Miller, Laurie C; Joshi, Neena; Lohani, Mahendra; Singh, Rupa; Bhatta, Nisha; Rogers, Beatrice; Griffiths, Jeffrey K; Ghosh, Shibani; Mahato, Shubh; Singh, Padma; Webb, Patrick

    2016-05-01

    Brain development in early childhood is a key determinant of later cognition, social achievement and educational success. Head circumference (HC) measurements are a simple method to assess brain growth, yet reports of these measurements are uncommon in nutritional surveys of undernourished children. To evaluate HC measurements in a population of rural Nepali children and relate these measurements to demographics, health and diet. An observational study of head growth was nested within a longitudinal evaluation of a livestock-based agricultural intervention in rural Nepal. Between 538 and 689 children (aged 6 months to 8 years) were measured (height, weight, HC) at each of six survey visits. A total of 3652 HC measurements were obtained. Results were converted to Z-scores (WHO Anthro). Mean head circumference Z-scores (HCZ) diminished progressively over the first 4 years of life; a decline of 30% occurred between 3 and 4 years of age (-1.73 to -2.45, P children children was explained by WAZ and ASF consumption. HCs reflect brain size in young children; brain size is linked to cognitive function. Poor head growth represents another facet of the 'silent emergency' of child undernutrition. Routine HCZ assessments may contribute to better understanding of the links between poverty and cognitive development.

  15. Contribution of radioimmunological techniques on the management of undernourished children in Senegal

    International Nuclear Information System (INIS)

    Mbodj, M.; Gassama, S.S.; Sow, H.T.; Ndoye, O.; Ndong, B.; Diarra, M.; Sarr, M.; Diagne, I.; Diouf, S.

    2007-01-01

    Malnutrition in children continues to be a major health burden in Senegal. The main objective of this study was to discuss the existence of a thyroid disease induced by the various deficiencies, among which iodine, in these children and to assess the effects of the treatment on the thyroid function. Materials and methods Sixty eight children divided in a random way in two groups according to the addition or not of marine algae Hypnea to the traditional nutritional supplementation were included in the study. To appreciate at the same time the nutritional and biological state and to follow the evolution under treatment, the anthropometric parameters were the ratios: weight/age, weight/size, and height/age. Radioimmunoassays of free T3, free T4 and immunoradiometric assays of TSH were carried out in undernourished children before and after supplementation enriched or not in algae. Other blood parameters were measured among them protides, magnesium, and hemoglobin. Results They showed two types of biological abnormalities: low T3 syndrome (8.6%), compensated functional hypothyroidism (9%). The treatment induced neither iodine overload, nor thyroid disease. Conclusion In the program of nutritional rehabilitation, the isotopic techniques allow us to establish the low prevalence (17.6%) of the disturbances of the thyroid function (low T3 syndrome and compensated functional hypothyroidism, thus providing the differential diagnosis), and to confirm the absence of any thyroid disease induced by the iodine supply of the marine algae Hypnea. (authors)

  16. Chronic undernourishment in school-aged children: itineraries of nutritional neglect and official programs in indigenous communities of Guerrero, Mexico

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    Paul Hersch-Martínez

    2016-12-01

    Full Text Available Through the analysis of different elements of the nutritional dynamics in a predominantly indigenous municipality in Guerrero, Mexico, we explore the relevance of the concept of itineraries of nutritional neglect in order to broaden the understanding of avoidable health damage. In the framework of a process of accompaniment of the Health Commission of the Regional Coordination of Community Authorities - Community Police, the following methodological strategies were applied throughout the year 2015: a a review of official programs by means of the analysis of technical documents and interviews with health personnel; b the compilation of local narratives from families of undernourished children through interviews and participatory observation; c the somatometric measurement of 151 children in three elementary schools. We highlight the technical and cultural inadequacy of official nutrition programs and the existence of different scales (individual, familial, community, state, structural and dimensions (economic, environmental, cultural, institutional, affective-emotional of neglect, materialized in high rates of chronic undernourishment.

  17. Body Composition, Muscular Strength and Bone Status among Undernourished Children in Malaysia

    International Nuclear Information System (INIS)

    Chong, Kar Hau; Poh, Bee Koon

    2014-01-01

    Full text: Despite significant advances in social and economic development, undernutrition remains a devastating public health problem that affects millions of children across the globe, particularly in developing nations. It is important to understand how changes in nutritional status affect physical health and function, so that undernutrition-related alterations can be identified and interpreted correctly. This paper aimed to determine the impact of undernutrition in children through the assessment of three nutrition-related indicators: body composition, muscular strength and bone status. This study is part of the Nutrition Survey of Malaysian Children, which is part of the four-country South East Asian Nutrition Surveys (SEANUTS). A total of 208 school children (102 boys, 106 girls) in the age range of 7 to 10 years were included in this analysis, of which 104 were underweight (WAZ<-2SD) and 104 were normal-weight group (-2SD≤WAZ≤+2SD), individually-matched for sex, age, and ethnicity. Anthropometric measurements included weight and height; and body composition was measured by bioelectrical impedance analysis. Muscular strength of both hands was assessed independently by hand-held dynamometer. Bone status was evaluated using a radial quantitative ultrasound system at one-third distal radius of the non-dominant hand. Anthropometric measurements and bone status were not significantly different between the sexes. Boys had significantly higher muscular strength and lean mass (p<0.05), but lower fat mass when compared to the girls (p<0.01). In both sexes, the undernourished group presented significantly lower anthropometric and body composition measurements and muscular strength than their normal-weight counterparts (p<0.001). However, no significant differences were observed for bone status between the two weight groups in boys (p = 0.09) and girls (p = 0.98). These findings imply that undernutrition can have profound negative impact on body composition as well

  18. Body composition and physical fitness of undernourished South African rural primary school children

    NARCIS (Netherlands)

    Monyeki, M.A.; Koppes, L.L.J.; Kemper, H.C.G.; Monyeki, K.D.; Toriola, A.L.; Pienaar, A.E.; Twisk, J.W.R.

    2005-01-01

    Objective: The purpose of this study was to determine the relationships between the body composition characteristics, body mass index (BMI), sum of skinfolds (SSF), % body fat (%BF), fat-free mass (FFM) and waist-to-hip ratio (WHR), and nine physical fitness items in undernourished rural primary

  19. Using the Uganda National Panel Survey to analyze the effect of staple food consumption on undernourishment in Ugandan children

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    Michelle M. Amaral

    2017-07-01

    Full Text Available Abstract Background The United Nations’ Millennium Development Goals Report, 2015, documents that, since 1990, the number of stunted children in sub-Saharan Africa has increased by 33% even though it has fallen in all other world regions. Recognizing this, in 2011 the Government of Uganda implemented a 5-year Nutrition Action Plan. One important tenet of the Plan is to lessen malnutrition in young children by discouraging over-consumption of nutritionally deficient, but plentiful, staple foods, which it defines as a type of food insecurity. Methods We use a sample of 6101 observations on 3427 children age five or less compiled from three annual waves of the Uganda National Panel Survey to measure undernourishment. We also use the World Health Organization’s Child Growth Standards to create a binary variable indicating stunting and another indicating wasting for each child in each year. We then use random effects to estimate binary logistic regressions that show that greater staple food concentrations affect the probability of stunting and wasting. Results The estimated coefficients are used to compute adjusted odds ratios (OR that estimate the effect of greater staple food concentration on the likelihood of stunting and the likelihood of wasting. Controlling for other relevant covariates, these odds ratios show that a greater proportion of staple foods in a child’s diet increases the likelihood of stunting (OR = 1.007, p = 0.005 as well as wasting (OR = 1.011, p = 0.034. Stunting is confirmed with subsamples of males only (OR = 1.006, p = 0.05 and females only (OR = 1.008, p = 0.027, suggesting that the finding is not gender specific. Another subsample of children aged 12 months or less, most of whom do not yet consume solid food, shows no statistically significant relationship, thus supporting the validity of the other findings. Conclusion Diets containing larger proportions of staple foods are associated with greater

  20. Using the Uganda National Panel Survey to analyze the effect of staple food consumption on undernourishment in Ugandan children.

    Science.gov (United States)

    Amaral, Michelle M; Herrin, William E; Gulere, Grace Bulenzi

    2017-07-19

    The United Nations' Millennium Development Goals Report, 2015, documents that, since 1990, the number of stunted children in sub-Saharan Africa has increased by 33% even though it has fallen in all other world regions. Recognizing this, in 2011 the Government of Uganda implemented a 5-year Nutrition Action Plan. One important tenet of the Plan is to lessen malnutrition in young children by discouraging over-consumption of nutritionally deficient, but plentiful, staple foods, which it defines as a type of food insecurity. We use a sample of 6101 observations on 3427 children age five or less compiled from three annual waves of the Uganda National Panel Survey to measure undernourishment. We also use the World Health Organization's Child Growth Standards to create a binary variable indicating stunting and another indicating wasting for each child in each year. We then use random effects to estimate binary logistic regressions that show that greater staple food concentrations affect the probability of stunting and wasting. The estimated coefficients are used to compute adjusted odds ratios (OR) that estimate the effect of greater staple food concentration on the likelihood of stunting and the likelihood of wasting. Controlling for other relevant covariates, these odds ratios show that a greater proportion of staple foods in a child's diet increases the likelihood of stunting (OR = 1.007, p = 0.005) as well as wasting (OR = 1.011, p = 0.034). Stunting is confirmed with subsamples of males only (OR = 1.006, p = 0.05) and females only (OR = 1.008, p = 0.027), suggesting that the finding is not gender specific. Another subsample of children aged 12 months or less, most of whom do not yet consume solid food, shows no statistically significant relationship, thus supporting the validity of the other findings. Diets containing larger proportions of staple foods are associated with greater likelihoods of both stunting and wasting in Ugandan children. Other

  1. Spirulina Supplements Improved the Nutritional Status of Undernourished Children Quickly and Significantly: Experience from Kisantu, the Democratic Republic of the Congo

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    Féfé Khuabi Matondo

    2016-01-01

    Full Text Available Aim. Despite high levels of malnutrition, there is still very little information on the nutritional benefits of Spirulina, a natural alga that provides essential amino acids, rare essential lipids, and numerous minerals and vitamins, to undernourished children in the world. Methods. We carried out a prospective study of 50 children aged between six and 60 months. The intervention group consisted of 16 children who received 10 g of Spirulina daily, as well as the local diet administered by the nutritional centre, and the control group of 34 children who just received the local diet. Both groups of children were assessed on day zero, day 15, and day 30. Results. After treatment, the weight-for-age Z scores and weight-for-height Z scores increased significantly in the intervention group. At day 15, there was a statistically significant difference between the mean corpuscular volume, total proteins, and albumin (p<0.05 in both groups, in favour of the intervention group, and at day 30, this difference extended to all of the studied parameters (p<0.05. Conclusion. This study found that the nutritional status of undernourished children who received Spirulina supplements as well as the local diet administered by the nutritional centre improved quickly and significantly.

  2. Nutritional Status and Infectious Disease of Undernourished Children under five in Desa Cipacing, Jatinangor Subdistrict, West Java, from April to December 2012

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    Palomina Caesarea Nurhasanah

    2015-09-01

    Full Text Available Background: Undernutrition frequently occurs in children under five. If not treated, it will cause acute health effects and affect on cognitive development, social, physical work capacity and productivity. Undernutrition can be accompanied by the presence of infectious disease that can worsen the children’s nutritional status. This study aimed to describe the nutritional status and infectious disease of undernutrition children under five in Jatinangor Subdistrict. Methods: A qualitative study was carried out to 7 parents and undernourished children under five, in Desa Cipacing, Jatinangor. It was conducted from April to December 2012. The inclusion criterias were undernourished children under five with a history of infectious disease in the previous year, and the parents were willing to participate in this study. Exclusion criteria were parents and/or the children who were not at home when the collection of the data was conducted.. Data collection was conducted using measurement of nutritional status, in depth interview and environmental observation. The data were presented in tables, figures and narration. Results: Three subjects with undernutrition (-3SD to -2SD and four subjects with severe undernutrition (<-3SD. Factors affecting poor nutritional status were weight loss, no significant weight gain, diet and eating habit, and onset of disease. Commonly occurred infectious diseases were common cold, diarrhea, fever and cough. Some factors affecting infectious diseases were family member transmission, immunization, and treatment behavior. Conclusions: Poor nutritional status and infectious diseases contribute to undernutrition in children under five.

  3. Evaluation of the impact of a nutritional program for undernourished children in Brazil

    NARCIS (Netherlands)

    Santos, Iná S; Gigante, Denise P; Coitinho, Denise C; Haisma, Hinke; Valle, Neiva C J; Valente, Gicele

    2005-01-01

    To assess the effectiveness on child growth and body composition of a supplementary feeding program (Milk Supplement Program), a prospective, controlled study was conducted in Northeast Brazil. When entering the Program, children from 10 municipalities with the highest coverage rates in the Program

  4. Beneficial effect of cyproheptadine on body mass index in undernourished children: a randomized controlled trial.

    Science.gov (United States)

    Najib, Khadijehsadat; Moghtaderi, Mozhgan; Karamizadeh, Zohreh; Fallahzadeh, Ebrahim

    2014-12-01

    Cyproheptadine hydrochloride (CH) is a first-generation antihistamine which is used as an appetite stimulant. This study was designed to identify the role of CH therapy on weight gain, linear growth and body mass index in children with mild to moderate undernutrition. Eighty-nine patients were enrolled. The present randomized, double-blinded controlled trial included 77 evaluable patients, aged 24-64 months with undernutrition. The patients were randomized to receive cyproheptadine with multivitamin, or multivitamin over a period of four weeks. The weight, height and body mass index were measured at the baseline, four weeks after intervention and four weeks after discontinuation. A significant higher body mass index was observed among CH-treated patients after 8 weeks intervention with cyproheptadine compared with the control group (P<0.041). Mean weight gain after eight weeks was 0.11 kg in the control group and 0.60 kg in the CH group. There were no significant differences in changes of weight and height velocity across the study between CH-treated and control group at the end of study. In our study, cyproheptadine promotes increase in body mass index in children with mild to moderate undernutrition after four weeks treatment.

  5. [Nutritional rehabilitation of undernourished and nutritionally at-risk children admitted to a supplementary food program in Mogi das Cruzes, São Paulo, Brazil].

    Science.gov (United States)

    Goulart, Rita Maria Monteiro; França Junior, Ivan; Souza, Maria de Fátima Marinho

    2007-01-01

    This study aimed to evaluate the nutritional rehabilitation of undernourished children admitted to a program entitled Incentives to Fight Nutritional Deficiencies (ICCN) in Mogi das Cruzes, São Paulo, Brazil. The study included 724 children (6 to 24 months old) from July 1999 to July 2001. The indices used to evaluate baseline nutritional status were weight-for-age, weight-for-length, and length-for-age, defining normal as z score > or = -1, at-risk as > or = -2 and -3, and severe malnutrition as age index, and the results were analyzed considering the average z score variation at the end of the 12-month program. After 12 months, nutritional status had improved in all categories, while the best results were in children with more intense baseline nutritional deficiency. Gains in length were 1.12, 0.82, 0.57, and 0.45 z scores for the severe and moderate malnutrition, nutritional risk, and normal categories, respectively. The ICCN in Mogi das Cruzes thus demonstrated effective nutritional improvement for program beneficiaries.

  6. Beneficial effect of nutritional supportive plan among under-nourished children in poor families in Iran with collaborating Ministry of Health and Emam Khomeini

    International Nuclear Information System (INIS)

    Minaei, Mina; Zarei, Maryam; Araste, Razieh; Kamali, Behroo

    2014-01-01

    Full text: Malnutrition in the form of Protein – Energy Malnutrition (PEM) and micro nutrient deficiencies, is one of the most important health problems in developing countries, Iran included. The purpose of this study was to improve nutritional status among under-nourished children in poor families. Methods: A total of 50,000 children under 5 (girls and boys) in 30 provinces in Iran which suffered by moderate and severe malnutrition participated (<-2SD weight for age) in this program. Malnourished children belong to poor families were determined; weights and heights were measured and anthropometric indicators were determined based on WHO, 2007. Then, these malnourished children were introduced to Imam Khomeini Foundation. Khomeini Foundation as one of the biggest NGO in Iran which supports poor families since 1979. This study collaborated with Ministry of Welfare, Ministry of Health and Emam Khomeini. They have started to receive monthly supportive food basket which could support their daily nutritional requirements. This basket included (meat, egg, cheese, legumes, milk, tuna fish, chicken, liquid oil). Along with food support community health workers were actively involved with counseling of mothers on the nutritional requirements of children. Nutritional support cut for whoever has been improved nutritional status. However, nutritional education still had continued. Results: The results of monitoring & evaluation (according to anthropometric indicators) of this plan have shown around more than 45% of children that received food basket had consistently improved nutritional status. Conclusion: Likewise other intervention nutrition programs in developing countries this project showed that inter sector collaboration have been the best way for decreasing malnutrition in children. (author)

  7. Effects of a Cereal and Soy Dietary Formula on Rehabilitation of Undernourished Children at Ouagadougou, in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Zoenabo Douamba

    2012-01-01

    Full Text Available The New Misola consists of millet soybean, peanut, vitamins, minerals, and industrial amylase. Our objective is to demonstrate that porridge made from local grains and legumes restores the nutritional balance of malnourished children. The study was carried on 304 malnourished children aged 6–48 months including 172 girls and 132 boys from Saint Camille Medical Centre. At the beginning, these malnourished children had a WHZ z-score of −3.10 and a WAZ z-score of −3.85, which reflected, according to WHO, a severe malnutrition. After eight weeks of nutritional rehabilitation, a normal WHZ of −1.41 was obtained. These children recovered more than those in a similar study performed in 2006 with the old formula of Misola. This study shows that malnutrition remains a public health problem in Burkina Faso. It should be necessary that public health services and the epidemiologists work in synergy with nutritionists and “nutrigenetics” in order to combat malnutrition efficiently.

  8. Undernourishment and Public Policy in India | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Scientists, donors, and Indian policymakers are puzzled why India has the highest percentage of undernourished children in the world. This project explores the reasons why the country's high economic growth rate has not translated into better nutrition for its people, particularly poor women and children. It aims to shape ...

  9. The impact of public expenditure on undernourishment distribution in Mexico.

    Science.gov (United States)

    Moreno-Macías, Lidia; Palma-Solís, Marco; Zapata-Vázquez, Rita E

    2013-09-01

    The status of undernourishment in children under the age of five in Mexico is open to debate. Linked to poverty, underweight and stunting, the rates of undernourishment are reported to be diminishing, although poverty remains an incessant problem. This study was done to determine whether there is an association between public expenditure and underweight and stunting distribution in Mexico based on data from the 2006 health and population census and from macroeconomic, social, and demographic variables. We used principal component analysis to reduce the number of variables and analyze their behavior. Multiple regressions showed that underweight and stunting are significantly associated with the marginalization index, support from the Sistema Nacional para el Desarrollo Integral de la Familia (DIF) supplies and breakfast program, the gross domestic product per capita, and expenditure from the Opportunities program. Further, public expenditure aimed to combat undernourishment is inadequately oriented to address the needs of the poor.

  10. Corn-soy-blend fortified with phosphorus to prevent refeeding hypophosphatemia in undernourished piglets

    DEFF Research Database (Denmark)

    Hother Nielsen, Anne-Louise; Lykke Jensen, Mikkel; Martinussen, Torben

    2017-01-01

    BACKGROUND: Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soy-blends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified...

  11. The nutritional quality of an infant food from quinoa and its effect on the plasma level of insulin-like growth factor-1 (IGF-1) in undernourished children.

    Science.gov (United States)

    Ruales, Jenny; de Grijalva, Yolanda; Lopez-Jaramillo, Patricio; Nair, Baboo M

    2002-03-01

    An infant food product was manufactured by drum drying a pre-cooked slurry of quinoa (Chenopodium quinoa, Willd) flour. The chemical composition shows that the product is a potential source of valuable nutrients, like protein (16%), vitamin E (19 mg/kg), thiamine (0.7 mg/100 g), iron (70 mg/kg), zinc (48 mg/kg) and magnesium (1.8 g/kg), all the values expressed on dry basis, to pre-school children (of 5 years of age). The animal feeding experiments with rats showed a net protein utilisation (NPU) of 68, digestibility (TD) 95 and biological value (BV) 71. The level of insulin-like growth factor-1 (IGF-1) in the plasma of the children who consumed a supplementary portion of 2 x 100 g of the above infant food product showed an increase after a period of 15 days, while the plasma level of IGF-1 in the children of the control group as well as the reference group did not show any significant increase.

  12. [Body mass index and tri-ponderal mass index of 1,453 healthy non-obese, non-undernourished millennial children. The Barcelona longitudinal growth study].

    Science.gov (United States)

    Carrascosa, Antonio; Yeste, Diego; Moreno-Galdó, Antonio; Gussinyé, Miquel; Ferrández, Ángel; Clemente, María; Fernández-Cancio, Mónica

    2018-02-22

    Body mass index-for age (BMI) and tri-ponderal mass index-for-age (TMI) values of healthy non-underweight, non-obese millennial children have not been reported until now. We aimed to obtain these values. Longitudinal growth study (1995-2017) of 1,453 healthy non-underweight, non-obese millennial children, from birth (n = 477) or from 4 years of age (n = 976) to 18 years in girls and 19 years in boys (25,851 anthropometric measurements). In each sex, mean BMI-for-age values increased from birth to one year, declined until 5and increased from then onwards. Mean TMI-for-age values decreased abruptly during the first 6years of age and slowly thereafter, in both sexes. Although, at some ages, mean BMI-for age values differed statistically between sexes, differences were scant and of poor clinical significance. The same occurred for TMI-for-age values. BMI-for-age cut-off values to define underweight status (-2 SD) were similar to those proposed by Cole and the WHO for both sexes. However, BMI-for-age cut-off values to define obesity (+2 SD) were lower in both sexes (1.0-5.3) than those proposed by Cole and similar to those proposed by the WHO until 12 in girls and 14 in boys and lower (1.0-4.8) from these ages onwards. BMI-for-age and TMI-for-age values of healthy non-underweight, non-obese millennial children are provided. No clinically relevant differences were observed between sexes. These values may be used to measure underweight status and obesity in present pediatric populations and to evaluate the relationship between BMI-for-age and TMI-for-age in a clinical setting. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  13. ‘Urmitella timonensis’ gen. nov., sp. nov., ‘Blautia marasmi’ sp. nov., ‘Lachnoclostridium pacaense’ sp. nov., ‘Bacillus marasmi’ sp. nov. and ‘Anaerotruncus rubiinfantis’ sp. nov., isolated from stool samples of undernourished African children

    Directory of Open Access Journals (Sweden)

    T.-P.-T. Pham

    2017-05-01

    Full Text Available We report here the main characteristics of five new species ‘Urmitella timonensis’ strain Marseille-P2918T (CSUR P2918, ‘Blautia marasmi’ strain Marseille-P2377T (CSUR P2377, ‘Lachnoclostridium pacaense’ strain Marseille-P3100T (CSUR P3100, ‘Bacillus marasmi’ strain Marseille-P3556T (CSUR P3556 and ‘Anaerotruncus rubiinfantis’ strain MT15T (CSUR P2276, which were isolated recently from stool samples taken from undernourished children in Niger and Senegal using microbial culturomics.

  14. Evaluation of the impact of a nutritional program for undernourished children in Brazil Avaliação do impacto de um programa de suplementação alimentar para crianças desnutridas no Brasil

    Directory of Open Access Journals (Sweden)

    Iná S. Santos

    2005-06-01

    Full Text Available To assess the effectiveness on child growth and body composition of a supplementary feeding program (Milk Supplement Program, a prospective, controlled study was conducted in Northeast Brazil. When entering the Program, children from 10 municipalities with the highest coverage rates in the Program (intervention group were compared to non-beneficiary children from 10 municipalities with the lowest coverage rates (control group. A total of 219 children aged 6-18 months were enrolled. At entry, both groups were comparable in terms of age, sex, and nutritional status. There were frequent gaps in delivery of the supplement, no extra milk was provided to siblings less than 5 years of age, intra-household redistribution of milk was high, and maternal compliance with recommendations was low. Adjusted analyses by multilevel modelling showed average changes in weight, length, weight-age and length-age Z-scores, and % body water (deuterium method, at 6 months, of 1.53kg, 6.34cm, 0.33, 0.05, and 1.11% respectively among supplemented children as compared to 1.54kg, 6.5cm, 0.26, 0.07, and 4.10% among controls, with no statistically significant difference between groups. Thus, the Program failed to compensate for nutritional deficiencies in undernourished children in Northeast Brazil.Um estudo prospectivo, controlado foi realizado no Nordeste do Brasil para avaliar a efetividade de um programa de suplementação alimentar (Programa do Leite sobre crescimento infantil e composição corporal. Ao ingressar no programa, crianças de dez municípios com as maiores taxas de cobertura do programa (intervenção foram comparadas a crianças não-beneficiárias de dez municípios com as menores taxas de cobertura (controle. Um total de 219 crianças de 6-18 meses de idade foram arroladas. Ao entrar no estudo, ambos os grupos eram comparáveis quanto a sexo, idade e estado nutricional. Houve freqüentes falhas na entrega do suplemento, não foi fornecido leite para os

  15. Children with intellectual disability and hospice utilization.

    Science.gov (United States)

    Lindley, Lisa C; Colman, Mari Beth; Meadows, John T

    2017-02-01

    Over 42,000 children die each year in the United States, including those with intellectual disability (ID). Survival is often reduced when children with intellectual disability also suffer from significant motor dysfunction, progressive congenital conditions, and comorbidities. Yet, little is known about hospice care for children with intellectual disability. The purpose of this study was to explore the relationship between intellectual disability and hospice utilization. Additionally, we explored whether intellectual disability combined with motor dysfunction, progressive congenital conditions, and comorbidities influenced pediatric hospice utilization. Using a retrospective cohort design and data from the 2009 to 2010 California Medicaid claims files, we conducted a multivariate analysis of hospice utilization. This study shows that intellectual disability was negatively related to hospice enrollment and length of stay. We also found that when children had both intellectual disability and comorbidities, there was a positive association with enrolling in hospice care. A number of clinical implications can be drawn from the study findings that hospice and palliative care nurses use to improve their clinical practice of caring for children with ID and their families at end of life.

  16. Zinc treatment ameliorates diarrhea and intestinal inflammation in undernourished rats

    OpenAIRE

    de Queiroz, Camila AA; Fonseca, Said Gonçalves C; Frota, Priscila B; Figueiredo, Ítalo L; Aragão, Karoline S; Magalhães, Carlos Emanuel C; de Carvalho, Cibele BM; Lima, Aldo Ângelo M; Ribeiro, Ronaldo A; Guerrant, Richard L; Moore, Sean R; Oriá, Reinaldo B

    2014-01-01

    Background WHO guidelines recommend zinc supplementation as a key adjunct therapy for childhood diarrhea in developing countries, however zinc’s anti-diarrheal effects remain only partially understood. Recently, it has been recognized that low-grade inflammation may influence stunting. In this study, we examined whether oral zinc supplementation could improve weight, intestinal inflammation, and diarrhea in undernourished weanling rats. Methods Rats were undernourished using a northeastern Br...

  17. Research utilization among children's mental health providers.

    Science.gov (United States)

    Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

    2008-04-09

    Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

  18. Corn-Soy-Blend Fortified with Phosphorus to Prevent Refeeding Hypophosphatemia in Undernourished Piglets

    DEFF Research Database (Denmark)

    Hother, Anne-Louise; Lykke, Mikkel; Martinussen, Torben

    2017-01-01

    product (CSB+) and a product further fortified with skim milk powder (CBS++). Methods Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age...... in the CSB++ and CSB+/wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding. Conclusion We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant...

  19. Gut bacteria that prevent growth impairments transmitted by microbiota from malnourished children

    Science.gov (United States)

    Undernourished children exhibit impaired development of their gut microbiota. Transplanting microbiota from 6- and 18-month-old healthy or undernourished Malawian donors into young germ-free mice that were fed a Malawian diet revealed that immature microbiota from undernourished infants and children...

  20. Recuperação nutricional de crianças desnutridas e em risco nutricional em programa de suplementação alimentar no Município de Mogi das Cruzes, São Paulo, Brasil Nutritional rehabilitation of undernourished and nutritionally at-risk children admitted to a supplementary food program in Mogi das Cruzes, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Rita Maria Monteiro Goulart

    2007-01-01

    Full Text Available Este estudo teve como objetivo avaliar a recuperação nutricional de crianças inscritas no programa Incentivo ao Combate às Carências Nutricionais (ICCN no Município de Mogi das Cruzes, São Paulo, Brasil. Foram estudadas 724 crianças de 6 a 24 meses inscritas no ICCN, no período de julho de 1999 a julho de 2001. Para avaliar o estado nutricional inicial, utilizaram-se os índices peso/idade, peso/comprimento e comprimento/idade, sendo considerada eutrófica crianças com escore z > -1; em risco > -2 e -3 e desnutrida grave This study aimed to evaluate the nutritional rehabilitation of undernourished children admitted to a program entitled Incentives to Fight Nutritional Deficiencies (ICCN in Mogi das Cruzes, São Paulo, Brazil. The study included 724 children (6 to 24 months old from July 1999 to July 2001. The indices used to evaluate baseline nutritional status were weight-for-age, weight-for-length, and length-for-age, defining normal as z score > -1, at-risk as > -2 and -3, and severe malnutrition as < -3. Nutritional evolution was evaluated using the length-for-age index, and the results were analyzed considering the average z score variation at the end of the 12-month program. After 12 months, nutritional status had improved in all categories, while the best results were in children with more intense baseline nutritional deficiency. Gains in length were 1.12, 0.82, 0.57, and 0.45 z scores for the severe and moderate malnutrition, nutritional risk, and normal categories, respectively. The ICCN in Mogi das Cruzes thus demonstrated effective nutritional improvement for program beneficiaries.

  1. Representações sociais da equipe de enfermagem sobre a criança desnutrida e sua família Representaciones sociales del equipo de enfermeros sobre el niño desnutrido y su familia Social representations of a nursing team about undernourished children and their families

    Directory of Open Access Journals (Sweden)

    Maria Helena Ciampone

    1999-07-01

    in nursing practice with the undernourished children and their families. Our objectives were: to understand the social representations of the nursing team about undernourished children and their families and to analyze how these representations can interfere in the process of taking care. Based on qualitative research principles, authors adopted the social representations theoretical method. For data collection and analysis, authors used the projective techniques and speech subject analysis, respectively. Results showed an innocent conception by nursing professionals, that reproduces in the practical field a strong moral code and hygienic habits to the family and it does not propitiate the formation of a critical conscience about their citizenship rights.

  2. Zinc treatment ameliorates diarrhea and intestinal inflammation in undernourished rats.

    Science.gov (United States)

    de Queiroz, Camila A A; Fonseca, Said Gonçalves C; Frota, Priscila B; Figueiredo, Italo L; Aragão, Karoline S; Magalhães, Carlos Emanuel C; de Carvalho, Cibele B M; Lima, Aldo Ângelo M; Ribeiro, Ronaldo A; Guerrant, Richard L; Moore, Sean R; Oriá, Reinaldo B

    2014-08-05

    WHO guidelines recommend zinc supplementation as a key adjunct therapy for childhood diarrhea in developing countries, however zinc's anti-diarrheal effects remain only partially understood. Recently, it has been recognized that low-grade inflammation may influence stunting. In this study, we examined whether oral zinc supplementation could improve weight, intestinal inflammation, and diarrhea in undernourished weanling rats. Rats were undernourished using a northeastern Brazil regional diet (RBD) for two weeks, followed by oral gavage with a saturated lactose solution (30 g/kg) in the last 7 days to induce osmotic diarrhea. Animals were checked for diarrhea daily after lactose intake. Blood was drawn in order to measure serum zinc levels by atomic absorption spectroscopy. Rats were euthanized to harvest jejunal tissue for histology and cytokine profiles by ELISA. In a subset of animals, spleen samples were harvested under aseptic conditions to quantify bacterial translocation. Oral zinc supplementation increased serum zinc levels following lactose-induced osmotic diarrhea. In undernourished rats, zinc improved weight gain following osmotic diarrhea and significantly reduced diarrheal scores by the third day of lactose intake (p diarrhea and undernutrition and support the use of zinc to prevent the vicious cycle of malnutrition and diarrhea.

  3. Pediatric dentist density and preventive care utilization for Medicaid children

    Science.gov (United States)

    Heidenreich, James F.; Kim, Amy S.; Scott, JoAnna M.; Chi, Donald L.

    2014-01-01

    Purpose This study evaluates the relationship between county-level pediatric dentist density and dental care utilization for Medicaid-enrolled children in Washington State. Methods This is a cross-sectional analysis of 604,885 children ages 0-17 enrolled in the Washington State Medicaid Program for ≥11 months in 2012. The relationship between county-level pediatric dentist density, defined as the number of pediatric dentists per 10,000 Medicaid-enrolled children, and preventive dental care utilization was evaluated using linear regression models. Results In 2012, 179 pediatric dentists practiced in 16 of the 39 counties in Washington. County-level pediatric dentist density varied from zero to 5.98 pediatric dentists per 10,000 Medicaid-enrolled children. County-level preventive dental care utilization ranged from 32 percent to 81 percent, with 62 percent of Medicaid-enrolled children in Washington utilizing preventive dental services. After adjusting for confounders, county-level density was significantly associated with county-level dental care utilization (β=1.67, 95 percent CI=0.02, 3.32, p=0.047). Conclusions There is a significant relationship between pediatric dentist density and the proportion of Medicaid-enrolled children who utilize preventive dental care services. Policies aimed at improving pediatric oral health disparities should include strategies to increase the number of oral health care providers, including pediatric dentists, in geographic areas with large proportions of Medicaid-enrolled children. PMID:26314606

  4. Clinical utility of antinuclear antibody tests in children

    Directory of Open Access Journals (Sweden)

    Kickingbird Lauren M

    2004-07-01

    Full Text Available Abstract Background Antinuclear antibody (ANA tests are frequently used to screen children for chronic inflammatory diseases such as systemic lupus erythematosus (SLE. However, the diagnostic utility of this test is limited because of the large number of healthy children who have low-titer positive tests. We sought to determine the clinical utility of ANA tests in screening children for rheumatic disease and to determine whether there are specific signs or symptoms that enhance the clinical utility of ANA tests in children. Methods We undertook a retrospective analysis of 509 new patient referrals. Charts of patients referred because of results of ANA testing were selected for further analysis. Children with JRA, SLE, and other conditions were compared using demographic data, chief complaints at the time of presentation, and ANA titers. Results One hundred ten patients were referred because of an ANA test interpreted as positive. Ten patients were subsequently diagnosed with SLE. In addition, we identified one patient with mixed connective tissue disease, and an additional child with idiopathic Raynaud's phenomenon. Eighteen children of the children referred for a positive ANA test had juvenile rheumatoid arthritis (JRA. Another 80 children with positive ANA tests were identified, the majority of whom (n = 39, 49% had musculoskeletal pain syndromes. Neither the presence nor the titer of ANA served to distinguish children with JRA from children with other musculoskeletal conditions. Children with JRA were readily identified on the basis of the history and physical examination. Children with SLE were therefore compared with children with positive ANA tests who did not have JRA, designated the "comparison group." Non-urticarial rash was more common in children with SLE than in children without chronic inflammatory disease (p = 0.007. Children with SLE were also older (mean ± sd = 14.2 ± 2.5 years than the comparison group (11.0 ± 3.6 years; p

  5. Premature exfoliation of the teeth in a hypocalcemic undernourished African girl

    Directory of Open Access Journals (Sweden)

    Ibrahim Aliyu

    2014-01-01

    Full Text Available Premature exfoliation of the primary dentition is a rare phenomenon which may be associated with local disorders of the teeth and systemic diseases; however its association with hypocalcemia and malnutrition is uncommon. Nutritional rickets occurs mostly in developing countries despite some of these countries being sunny. Therefore, emphasis is now shifting toward the role of hypocalcemia as the predominant cause of nutritional rickets. Rickets is often described as a disease of growing bones; hence, it should ordinarily not be seen in malnourished children. This, however, has been refuted over the years. Therefore, a case of an undernourished hypocalcemic Nigerian child is reported who presented with premature exfoliation of the central lower incisors with delayed eruption of other primary dentition.

  6. Utilization of Dental General Anaesthesia for Children

    Science.gov (United States)

    Karim, Zarina Abdul; Musa, Normaizura; Noor, Siti Noor Fazliah Mohd

    2008-01-01

    Dental treatment under general anaesthesia may be needed for some children and adolescents due to medical or behaviour problem. The objective of the study is to identify the type of treatment that has been carried out under GA in Hospital Universiti Sains Malaysia (HUSM). A retrospective record review study from hospital records of dental patients (under 18 years old) receiving dental treatment under GA from 2003 until 2007 were retrieved from the database. Information such as the reason for GA, and the type of treatment provided was recorded in data sheet. The data were analyzed using SPSS 12.0.1 for Windows. It was checked and verified for errors. A total of 349 cases were treated of which 43.6% had medical problems. Patients were mostly diagnosed to have rampant caries (77.1%) and some of them have behavioural problems (34.4%). Treatment pattern in deciduous dentition revealed more extraction (97.8%) as compared to restoration (75.7%) whereas in permanent dentition more restoration was done (24.3%) as compared to extraction (2.2%). Majority of the restorations were done using Glass Ionomer Cements (47.5%). Biopsy (4.3%) contributed mainly to the surgery (24.1%) done during GA. General anesthesia is necessary when dental disease is interfering with health and general well-being of patient and it can facilitated dental treatment allowing dentists to benefit from improved treatment conditions and provide a higher quality of care. PMID:22570587

  7. Growth of children receiving a dehydrated potato-soy protein ...

    African Journals Online (AJOL)

    Rations distributed by food aid programs are intended to improve the growth of undernourished children. In practice, food programs target individual children and provide a supplement to the family that is intended to increase the energy and nutrient intake of undernourished children. Multiple food rations are available yet ...

  8. Predicting Health Utilities for Children with Autism Spectrum Disorders

    Science.gov (United States)

    Payakachat, Nalin; Tilford, J. Mick; Kuhlthau, Karen A.; van Exel, N. Job; Kovacs, Erica; Bellando, Jayne; Pyne, Jeffrey M.; Brouwer, Werner BF

    2014-01-01

    Scientific Abstract Comparative effectiveness of interventions for children with ASDs that incorporates costs is lacking due to the scarcity of information on health utility scores or preference-weighted outcomes typically used for calculating quality-adjusted life years (QALYs). This study created algorithms for mapping clinical and behavioral measures for children with ASDs to health utility scores. The algorithms could be useful for estimating the value of different interventions and treatments used in the care of children with ASDs. Participants were recruited from two Autism Treatment Network sites. Health utility data based on the HUI3 for the child was obtained from the primary caregiver (proxy-reported) through a survey (N=224). During the initial clinic visit, proxy-reported measures of the Child Behavior Checklist, Vineland II Adaptive Behavior Scales, and the PedsQL 4.0 (start measures) were obtained and then merged with the survey data. Nine mapping algorithms were developed using the HUI3 scores as dependent variables in ordinary least squares regressions along with the start measures, the Autism Diagnostic Observation Schedule to measure severity, child age, and cognitive ability as independent predictors. In-sample cross-validation was conducted to evaluate predictive accuracy. Multiple imputation techniques were used for missing data. The average age for children with ASDs in this study was 8.4 (SD=3.5) years. Almost half of the children (47%) had cognitive impairment (IQ<=70). Total scores for all of the outcome measures were significantly associated with the HUI3 score. The algorithms can be applied to clinical studies containing start measures of children with ASDs to predict QALYs gained from interventions. PMID:25255789

  9. A metabolomics approach to evaluate the effects of shiitake mushroom (Lentinula edodes) treatment in undernourished young rats

    Energy Technology Data Exchange (ETDEWEB)

    Molz, Patrícia [Nutrition Course, Department of Physical Education and Health, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Ellwanger, Joel Henrique [Biological Sciences Course, Department of Biology and Pharmacy, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Eliete Iochims dos Santos, Carla; Dias, Johnny Ferraz [Ion Implantation Laboratory, Physics Institute, Federal University of Rio Grande do Sul, Porto Alegre, RS (Brazil); Campos, Deivis de [Biological Sciences Course, Department of Biology and Pharmacy, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Corbellini, Valeriano Antonio [Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Prá, Daniel [Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Biological Sciences Course, Department of Biology and Pharmacy, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Putzke, Marisa Terezinha Lopes [Biological Sciences Course, Department of Biology and Pharmacy, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Franke, Silvia Isabel Rech, E-mail: silviafr@unisc.br [Nutrition Course, Department of Physical Education and Health, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil); Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS (Brazil)

    2014-01-01

    Undernourishment is characterized by a decrease of the metabolic rate as a result of lack of nutrients important to life. Shiitake mushroom (Lentinula edodes) can be an alternative to reverse undernourishment. The aim of this study was to explore the metabolic changes and consequent elemental concentrations found in undernourished rats and undernourished rats treated with shiitake mushroom (n = 12 rats each group). To determine the elemental concentration, blood samples were analyzed by Particle Induced X-ray Emission (PIXE). For metabolomics, blood samples were tested under Fourier Transform Infrared Spectroscopy (FT-IR). The results indicated that the supplementation with shiitake mushroom in undernourished rats altered the composition of blood proteins, elements and volume. Several strong correlations were observed between the elemental concentrations and metabolic parameters.

  10. Factors Influencing Utilization of Physiotherapy Service among Children with Cerebral Palsy in Jalandhar District of Punjab

    OpenAIRE

    Sinha, Akhoury Gourang; Sharma, Raju

    2017-01-01

    Background: Physiotherapy plays a central role in the management of children with cerebral palsy (CP); however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. Aims and Objectives: To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punj...

  11. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

    Directory of Open Access Journals (Sweden)

    Aymen N Naguib

    2015-01-01

    Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

  12. Phototherapy improves healing of cutaneous wounds in nourished and undernourished Wistar rats.

    Science.gov (United States)

    Pinheiro, Antonio Luiz Barbosa; Meireles, Gyselle Cynthia Silva; de Barros Vieira, Alessandro Leonardo; Almeida, Darcy; Carvalho, Carolina Montagn; dos Santos, Jean Nunes

    2004-01-01

    A wound represents the interruption of the continuity of tissue that is followed by damage or cellular death. Wound healing occurs due to a competitive mechanism between the synthesis and lysis of collagen. Any factor that increases collagen lysis or reduces its synthesis may result in changes in the healing process, i.e., nutritional deficiencies. Phototherapies have been suggested as an effective method to improve wound healing. This study evaluated, histologically, the differences in the healing of cutaneous wounds in nourished and undernourished rats following laser therapy or illumination by polarized light. Fifty nourished or undernourished Wistar rats had a standardized wound created on the dorsum and were divided into 6 subgroups: Group 1--Control (Standard diet; n=5); Group 2--Control (DBR; n=5); Group 3--Standard diet + laser therapy (lambda635nm; 20J/cm2, n=5; or 40J/cm2, n=5); Group 4--Standard diet + Bioptron (lambda400-2000nm; 20J/cm2, n=5; or 40 J/cm2, n=5); Group 5--DBR + laser therapy (lambda635nm; 20J/cm2, n=5; or 40J/cm2, n=5); Group 6--DBR + Bioptron (lambda400-2000nm; 20J/cm2, n=5; or 40 J/cm2, n=5). The first application of the treatment was carried out immediately after surgery and repeated every 24 h during 7 days. Specimens were routinely processed (wax, cut and stained with H&E and Picrosirius stain) and analyzed under light microscopy. Analysis included re-epithelization, inflammatory infiltrate, and fibroblastic proliferation. Picrosirius stained slides were used to perform descriptive analysis of the collagen fibers. The results showed the best results for nourished and undernourished groups treated with polarized light at a dose of 20J/cm2 and the undernourished groups irradiated with the laser light. It is concluded that the nutritional status influenced the progression of the healing process as well as the quality of the healed tissue and that the use of both modalities of phototherapy resulted in a positive biomodulatory effect in

  13. Studies on protein turnover and energy expenditure in chronically undernourished adults during stress of infection

    International Nuclear Information System (INIS)

    Kurpad, A.V.; Shetty, P.S.; Reeds, P.J.

    1994-01-01

    Chronic undernutrition in man leads to adaptive responses which could reduce the requirements for dietary energy and protein. It is also possible that these adaptive responses, which are economical in nature, could lead to a decreased capacity for combating stress. Undernourished people are more susceptible to infections, and during these stresses, show different patterns of protein and energy metabolism from well-nourished subjects. Animal models have clearly shown a diminished response to tissue injury, in terms of the anabolic acute phase response. It is proposed to study the effect of prior nutritional status on the degree to which an infective stress stimulates the acute phase protein synthesis by the liver. In addition, the supply of amino acids to the liver in conditions of stress could come from the breakdown of body tissue proteins, particularly muscle. It is intended to study muscle protein turnover by the use of 13 C-leucine in undernourished subjects under conditions of stress. Since whole body protein turnover can be measured by two methods, using 15 N-glycine and 13 C-leucine, a comparison of these two methods will initially be made in chronically undernourished subjects. It is also intended to study daily energy expenditure in the subject by an isotopic method, i.e. the appearance of 13 CO 2 in the breath after the administration of 13 C-bicarbonate. (author). 8 refs

  14. An explanatory model of the dental care utilization of low-income children.

    Science.gov (United States)

    Milgrom, P; Mancl, L; King, B; Weinstein, P; Wells, N; Jeffcott, E

    1998-04-01

    Factors related to the utilization of dental care by 5- to 11-year-old children from low-income households were investigated using a comprehensive multivariate model that assessed the contribution of structure, history, cognition, and expectations. The influence of dentist-patient interactions, psychosocial and health beliefs, particularly fear of the dentist, on utilization were investigated. Children were chosen randomly from public schools, and 895 mothers were surveyed and their children were interviewed in the home. Utilization was studied during the 1991-1992 school year, including a 6-month follow-up period after the interview. The overall utilization rate was 63.2%, and the rate for nonemergent (preventive) visits was 59.9%. Utilization was unrelated to actual oral health status. Race and years the guardian lived in the United States were predictive of an episode of care. Preventive medical visits and perceived need were strong predictors of a visit to the dentist, as were beliefs in the efficacy of dental care. Mothers who were satisfied with their own care and oral health and whose children were covered by insurance were more likely to utilize children's dental care. In contrast, child dental fear and absences from school for family problems were associated with lower rates of utilization. Mutable factors that govern the use of care in this population were identified. These findings have implications for the design of dental care delivery systems for children and their families.

  15. Utility of the Spelling Sensitivity Score to Analyze Spellings of Children with Specific Language Impairment

    Science.gov (United States)

    Werfel, Krystal L.; Krimm, Hannah

    2015-01-01

    The purpose of this study was to examine the utility of the Spelling Sensitivity Score (SSS) beyond percentage correct scoring in analysing the spellings of children with specific language impairment (SLI). Participants were 31 children with SLI and 28 children with typical language in grades 2 through 4. Spellings of individual words were scored using two methods: (a) percentage correct and (b) SSS. Children with SLI scored lower than children with typical language when spelling was analysed with percentage correct scoring and with SSS scoring. Additionally, SSS scoring highlighted group differences in the nature of spelling errors. Children with SLI were more likely than children with typical language to omit elements and to represent elements with an illegal grapheme in words, whereas children with typical language were more likely than children with SLI to represent all elements with correct letters. PMID:26413194

  16. Cyclosporine utilization in Idiopathic Nephrotic Syndrome in children

    International Nuclear Information System (INIS)

    Saeed, B.; Sheriff, S.; Ossman, Mohd Imad

    2006-01-01

    The treatment of steroid-resistant focal segmental glomerulosclerosis (FSGS) imposes one the most perplexing and frustrating problems on nephrologists. Cyclosporine A (CsA) is widely considered as the treatment of choice for steroid-resistant or dependent nephrotic children. We reviewed the clinical outcome in children with idiopathic nephrotic syndrome (INS) under CsA treatment. A total of 22 children presented with either steroid resistant nephrotic syndrome (SRNS) (14 children), or steroid-dependent nephrotic syndrome (SDNS) (8 children) during the period from August 2002 to February 2005; the mean age for both groups was 7.6 years (range: 23 months-15 years). Renal histology showed FSGS in 14 (63%) patients, minimal change disease (MCD) in 4(18%), diffuse mesangial glomerulonphritis (MesGN) in three (13.6%), and membranous glomerulonephritis (MGN) in two (6.8%). Treatment with CsA in combination with alternate-day prednisolone induced remission in 15(68%) patients; 9(60%) patients had complete remission and six (40%) partial remission. Seven (50%) patients in SRNS group responded to CsA treatment; two (14.2%) patients had complete remission and 5 (35.7%) had partial remission. Seven ( 87.5%) children in SDNS group had complete remission and one (13.5%) had partial remission. We conclude that this study demonstrates the efficacy of CsA in inducing remission in the steroid dependent is higher than in the steroid resistant nephrotic children. We believe that CsA is probably a good alternative therapy in this population. (author)

  17. Children with paralytic poliomyelitis: utilization of physiotherapy services in Zamfara State, Nigeria.

    Science.gov (United States)

    Ogwumike, Omoyemi O; Kaka, Bashir; Adeniyi, Ade F

    2013-02-01

    Physiotherapy is usually indicated for health promotion and the rehabilitation of individuals with paralytic poliomyelitis. The endemic nature of this condition in children in Zamfara State, Nigeria necessitated investigation into the utilization of physiotherapy services by parents or primary caregivers of children affected with polio in this sub-region. Parents and primary caregivers of children with paralytic poliomyelitis were recruited using a purposive multi-stage sampling procedure in a cross-sectional survey. Factors associated with the utilization of physiotherapy services were assessed based on questions extracted from a 4-part, 52-item structured questionnaire originally designed for a study which investigated knowledge, attitude, and beliefs of parents of children with paralytic poliomyelitis. A total of 217 participants were included in this study. The mean age was 32.29 ± 9.89 years and the mean knowledge of polio score was 62.0 ± 17.3%. The mean age of the children with paralytic poliomyelitis was 6.41 ± 2.50 years. Only 27.2% of the parents or primary caregivers had utilized physiotherapy service for their children at some point. No association existed between utilization of physiotherapy service and 'knowledge of paralytic poliomyelitis', 'employment status', and 'family income' of respondents. Explanations for low utilization of physiotherapy services for children with paralytic poliomyelitis by parents or primary caregivers are discussed.

  18. Impact of Chronic Condition Status and Severity on Dental Utilization for Iowa Medicaid-Enrolled Children

    Science.gov (United States)

    Chi, Donald L.; Momany, Elizabeth T.; Neff, John; Jones, Michael P.; Warren, John J.; Slayton, Rebecca L.; Weber-Gasparoni, Karin; Damiano, Peter C.

    2011-01-01

    Background Although Medicaid-enrolled children with a chronic condition (CC) may be less likely to use dental care because of factors related to their CC, dental utilization for this population is poorly understood. Objective To assess the relationship between CC status and CC severity, respectively, on dental utilization for Iowa Medicaid-enrolled children. Research Design Retrospective cohort study of Iowa Medicaid data (January 1, 2003 to December 31, 2006). Subjects Medicaid-enrolled children aged 3 to 14 (N = 71,115) years. Measures The 3M Corporation Clinical Risk Grouping methods were used to assess CC status (no/yes) and CC severity (episodic/life-long/malignancy/complex). The outcome variable was any dental utilization in 2006. Secondary outcomes included use of diagnostic, preventive, routine restorative, or complex restorative dental care. Results After adjusting for model covariates, Iowa Medicaid-enrolled children with a CC were significantly more likely to use each type of dental care except routine restorative care (P = 0.86) than those without a CC, although the differences in the odds were small (4%–6%). Compared with Medicaid-enrolled children with an episodic CC, children with a life-long CC were less likely to use routine restorative care (P children with a malignancy were more likely to use complex restorative care (P children with a complex CC were less likely to use each type of dental care except complex restorative care (P = 0.97). Conclusions There were differences in dental utilization for Iowa Medicaid-enrolled children by CC status and CC severity. Children with complex CCs were the least likely to use dental care. Future research efforts should seek to understand why subgroups of Medicaid-enrolled children with a CC exhibit lower dental utilization. PMID:21150799

  19. Primary sclerosing cholangitis in children: utility of magnetic resonance cholangiopancreatography

    Energy Technology Data Exchange (ETDEWEB)

    Chavhan, Govind B.; Babyn, Paul S.; Manson, David E. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Roberts, Eve [The Hospital for Sick Children, Department of Gastroenterology, Toronto (Canada); Moineddin, Rahim [University of Toronto, Department of Family and Community Medicine, Toronto (Canada)

    2008-08-15

    Even when histologic findings are highly suggestive of primary sclerosing cholangitis (PSC), cholangiographic correlation is required for the diagnosis. The present gold standard, endoscopic retrograde cholangiopancreatography (ERCP), is invasive and associated with complications. To evaluate the usefulness of magnetic resonance cholangiopancreatography (MRCP) in diagnosing PSC in children. MRCP studies were retrospectively reviewed in 20 children with clinical suspicion of PSC and who had undergone liver biopsy. MRCP studies were considered positive or negative for PSC depending on the presence or absence of dilatation, irregularity, multifocal strictures and beading of the bile ducts. Twenty children (14 boys, 6 girls) with an average age of 13 years qualified for the study. Of 19 diagnostic MRCP studies, 16 were called positive and 3 were called negative. An overall diagnosis of PSC-positive was assigned to all 19 patients based on clinical and laboratory findings, biopsy results and cholangiographic data. Based on this overall diagnosis, MRCP was 84% sensitive and accurate to diagnose PSC in children. MRCP can be a valuable tool in diagnosing pediatric PSC that can demonstrate major intra- and extrahepatic ducts in most cases. An unequivocally positive MRCP study should not be followed by ERCP for diagnosing PSC in children. (orig.)

  20. Health Service Utilization of Children in Delaware Foster Care, 2013-2014.

    Science.gov (United States)

    Knight, Erin K; McDuffie, May Joan; Gifford, Katie; Zorc, Catherine

    2016-02-01

    Children in foster care represent some of the most vulnerable children in the U.S. Their higher prevalence of a range of physical and behavioral health problems can lead to greater health care utilization and higher costs. However, many children in foster care have undiagnosed conditions and unmet needs. The purpose of this study was to provide a description of health services accessed by children in foster care in Delaware. The data serves as a baseline and informs current efforts to improve the health care of children in foster care. We analyzed rates of emergency room visits, behavioral health visits, hospitalizations, and costs of care for children in foster care and made comparisons with other children participating in Medicaid. We also looked at utilization before and after entry into care and assessed rates of appropriate medical screening for children on entering foster care. This study was conducted as part of a larger analysis guided by the Delaware Task Force on the Health of Children in Foster Care with funding appropriated by the Delaware General Assembly. Using a unique identification number, we linked Medicaid claims data with demographic information and characteristics associated with foster care from the Delaware Department of Services for Children, Youth and Their Families. We examined diagnoses, patterns of utilization, and costs for children in foster care (n = 1,458) and a comparable cohort of other children in Medicaid (n = 124,667) during fiscal years 2013 and 2014. Compared with other children in Medicaid, children in foster care had similar rates of emergency department utilization, but relatively high rates of outpatient behavioral health visits. Similarly, compared with other children in Medicaid, those in foster care had particularly high rates of psychotropic drug utilization. Entry into foster care was associated with increased utilization of overall health care services, including receipt of well-child care. However, just 31 percent

  1. Utilization of oral health services by mothers of preschool children in ...

    African Journals Online (AJOL)

    Objective: To determine oral health services utilization by mothers of pre school children in Jos North Local Government Area, Plateau State, Nigeria Design: Cross-sectional study. Setting: Four Primary Health Care (PHC) Clinics in Jos North Local Government Area Participants: 200 mothers of pre school children

  2. Utilization of Media in Upbringing of Children and Risks of Media Usage

    OpenAIRE

    BOUŠOVÁ, Jana

    2007-01-01

    The graduation thesis discusses positive and negative utilization of media, particularly computers, computer games and the internet, by children. The objective of this thesis is to propose how to attend to the risks of excessive usage of computers and the internet by children.

  3. Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

    Science.gov (United States)

    Piovesan, Chaiana; Ardenghi, Thiago Machado; Mendes, Fausto Medeiros; Agostini, Bernardo Antonio; Michel-Crosato, Edgard

    2017-03-30

    The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

  4. Utility of the PASS Theory and Cognitive Assessment System for Dutch Children with and without ADHD

    Science.gov (United States)

    Van Luit, Johannes E. H.; Kroesbergen, Evelyn H.; Naglieri, Jack A.

    2005-01-01

    This study examined the utility of the Planning, Attention, Simultaneous, Successive (PASS) theory of intelligence as measured by the "Cognitive Assessment System" (CAS) for evaluation of children with attention-deficit/hyperactivity disorder (ADHD). The CAS scores of 51 Dutch children without ADHD were compared to the scores of a group…

  5. Serum vitamin A levels among malnourished children aged 6 - 59 ...

    African Journals Online (AJOL)

    control hospital-based descriptive study carried out at the Institute of Child. Health (ICH) Banzazzau, Zaria. Systematic sampling method was adopted to select undernourished children aged 6-59 months for the study. Serum vitamin A level was.

  6. Enhancing Children's Sense of Self and Community through Utilizing Computers.

    Science.gov (United States)

    Haugland, Susan

    1996-01-01

    Argues that computers in early childhood classrooms serve to raise young children's self-esteem, self-concept, and place in the classroom community. Provides examples of specific computer exercises including storytelling, journals, autobiographies, classroom data collection and recording, and classroom activities. Notes that these computer…

  7. Evaluation of access and utilization of EPI services amongst children ...

    African Journals Online (AJOL)

    Introduction: High vaccination coverage is required to successfully control, eliminate and eradicate vaccine preventable diseases (VPDs). In Ghana, access and utilization of vaccination services is generally good with complete vaccination coverage of 77%. However, sustaining high coverages in island communities such ...

  8. Health Care of Latino Children with Autism and Other Developmental Disabilities: Quality of Provider Interaction Mediates Utilization

    Science.gov (United States)

    Parish, Susan; Magana, Sandra; Rose, Roderick; Timberlake, Maria; Swaine, Jamie G.

    2012-01-01

    This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N = 4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with…

  9. Nationwide Healthcare utilization among children with epilepsy in the United States: 2003-2014.

    Science.gov (United States)

    Lekoubou, Alain; Bishu, Kinfe G; Ovbiagele, Bruce

    2018-02-27

    Epilepsy is particularly frequent among children, yet updated and nationwide healthcare utilization estimates are scanty in the United States. To analyze healthcare utilization among children with epilepsy. Data on children (≤17-year-old) were extracted from the Medical Expenditure Panel Survey (MEPS) 2003-2014. Epilepsy was identified using the clinical classification code 83. Healthcare utilization (Inpatient admission, outpatient visits, prescription medication including refill, emergency room visits, and home health provider visits) was compared between children with epilepsy and those without epilepsy. A negative binomial model was used to assess the relationship between epilepsy and healthcare utilizations accounting for the influence of extraneous factors. In all, a weighted 457,873 children (0.84%) had epilepsy in United States. The unadjusted proportion and the mean annual number of health care service utilization were higher in children with epilepsy compared to those without epilepsy. Children with epilepsy had almost 3.3 more outpatient visits (95% CI: 2.281-4.274), 7.9 more medication prescriptions including refills (95% CI: 6.058-9.662), nearly 0.4 more emergency department visits (95% CI: 0.278-0.438) and nearly 12 more home health provider visits (95% CI: 1.988-21.756) than those without epilepsy. The adjusted marginal effect of epilepsy on inpatient admission was not statistically significant. unadjusted and adjusted healthcare utilization is considerably higher in children with epilepsy compared to those without epilepsy in the United States with heterogeneity across individual services. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Effect of exogenous melatonin on embryo viability and uterine environment in undernourished ewes.

    Science.gov (United States)

    Vázquez, M I; Forcada, F; Sosa, C; Casao, A; Sartore, I; Fernández-Foren, A; Meikle, A; Abecia, J A

    2013-09-01

    The effect of exogenous melatonin on embryo viability in undernourished ewes was investigated. At lambing, 24 ewes were treated (+MEL) or not (-MEL) with a melatonin implant. After 45 days, both groups were fed to provide 1.5 (Control, C) or 0.5 (Low, L) times daily maintenance requirements, so that experimental groups were: C-MEL, C+MEL, L-MEL and L+MEL. Ewes were mated (Day 0) and on Day 5 embryos were recovered and classified according to their developmental stage and morphology. Ovaries were used for in vitro fertilization and uterine horns were processed to study progesterone and oestrogen receptor (PR and ERα) expression by inmunohistochemistry. After 21 days, groups L-MEL and L+MEL had an average weight loss of 10kg (Pmelatonin effect was particularly evident in undernourished ewes, increasing both viability (L+MEL: 65%; L-MEL: 25%; Ppregnancy rates (L+MEL: 66.6%; L-MEL: 16.6%; Pmelatonin nor their interaction had a significant effect on the in vitro oocyte development. Melatonin treatment tended to increase the percentage of positive cells to PR in deep glandular epithelium, independently of diet (P=0.09), and the greatest staining intensity of PR was observed in the luminal and superficial glandular epithelia (Pmelatonin implants at lambing during the breeding season improve the viability of embryos recovered from undernourished ewes, although this effect seems not to be mediated at the oocyte competence level. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Programming of intermediate metabolism in young lambs affected by late gestational maternal undernourishment

    DEFF Research Database (Denmark)

    Husted, Sanne; Nielsen, Mette Olaf; Tygesen, Malin Plumhoff

    2007-01-01

    Effects of moderate maternal undernourishment during late gestation on the intermediary metabolism and maturational changes in young lambs were investigated. 20 twin-bearing sheep, bred to two different rams, were randomly allocated the last 6 wk of gestation to either a NORM diet [barley, protein...... wk) programming effects of late prenatal malnutrition on the glucose-insulin homeostasis and metabolism were manifested: LOW lambs had less insulin-secretory capacity, but this was apparently compensated for by increased target tissue sensitivity for insulin, and adipose lipolytic capacity increased...... during fasting. Thereby, glucose may be spared throguh increased lipid oxidationn, but overall energetic efficiency is apparently deteriorated rather than improved....

  12. Secondhand smoke and asthma: what are the effects on healthcare utilization among children?

    Science.gov (United States)

    Jin, Yue; Seiber, Eric E; Ferketich, Amy K

    2013-08-01

    This study aims to examine the associations between asthma, secondhand smoke exposure and healthcare utilization in a nationally representative sample of children. Data from 5686 children aged 0-11 years were analyzed. Healthcare utilization, asthma diagnosis and demographic information came from the 2001 and 2006 Medical Expenditure Panel Surveys. Secondhand smoke exposure was measured during the 2000 and 2005 National Health Interview Surveys. Multivariable regression models were used to determine the association between secondhand smoke exposure, asthma diagnosis and healthcare utilization (hospitalizations, emergency department visits, outpatient visits and prescription medication use). Asthma modified the relationship between secondhand smoke exposure and hospitalizations, as exposure more than doubled the odds of hospitalization among children with asthma but had no effect on children without asthma. Secondhand smoke exposure increased the odds by 37% of emergency room visits (PSecondhand smoke exposure was associated with a greater utilization of hospitals and emergency departments, and the effect on hospitalizations was most pronounced among children with asthma. Reducing secondhand smoke exposure would help to reduce the burden on the healthcare system, especially among children with asthma. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Emergency Department Utilization and Determinants of Use by 0- to 6-Year-Old Children with Disabilities in Taipei

    Science.gov (United States)

    Hsu, Shang-Wei; Lin, Ya-Wen; Chwo, Miao-Ju; Huang, Hui-Chi; Yen, Chia-Feng; Lin, Lan-Ping; Wu, Jia-Ling; Lin, Jin-Ding

    2009-01-01

    Although many studies have explored emergency services for children, there are few published reports of the utilization of emergency services by children with disabilities. The present study attempts to provide data regarding the utilization of, and factors affecting, emergency department visits by disabled children in Taipei. A general census of…

  14. A Decade in Dental Care Utilization among Adults and Children (2001–2010)

    Science.gov (United States)

    Vujicic, Marko; Nasseh, Kamyar

    2014-01-01

    Objective To decompose the change in pediatric and adult dental care utilization over the last decade. Data 2001 through 2010 Medical Expenditure Panel Survey. Study Design The Blinder-Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care utilization were attributed to changes in explained covariates and changes due to movements in estimated coefficients. Controlling for demographics, overall health status, and dental benefits variables, we estimated year-specific logistic regression models. Outputs from these models were used to compute the Blinder-Oaxaca decomposition. Principal Findings Dental care utilization decreased from 40.5 percent in 2001 to 37.0 percent in 2010 for adults and increased from 43.2 percent in 2001 to 46.3 percent in 2010 for children (p dental care utilization (−0.018, p children, changes in controlled factors did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences. Conclusions Dental care utilization for adults has declined, especially among the poor and uninsured. Without further policy intervention, disadvantaged adults face increasing barriers to dental care. PMID:24299620

  15. Healthcare Utilization and Spending for Constipation in Children With Versus Without Complex Chronic Conditions.

    Science.gov (United States)

    Stephens, John R; Steiner, Michael J; DeJong, Neal; Rodean, Jonathan; Hall, Matt; Richardson, Troy; Berry, Jay G

    2017-01-01

    The aim of the study was to examine the prevalence of diagnosis and treatment for constipation among children receiving Medicaid and to compare healthcare utilization and spending for constipation among children based on number of complex chronic conditions (CCCs). Retrospective cohort study of 4.9 million children ages 1 to 17 years enrolled in Medicaid from 2009 to 2011 in 10 states in the Truven Marketscan Database. Constipation was identified using International Classification of Disease, 9th revision codes for constipation (564.0x), intestinal impaction (560.3x), or encopresis (307.7). Outpatient and inpatient utilization and spending for constipation were assessed. CCC status was identified using validated methodology. A total of 267,188 children (5.4%) were diagnosed with constipation. Total constipation spending was $79.5 million. Outpatient constipation spending was $66.8 million (84.1%) during 406,814 visits, mean spending $120/visit. Among children with constipation, 1363 (0.5%) received inpatient treatment, accounting for $12.2 million (15.4%) of constipation spending, mean spending $7815/hospitalization. Of children hospitalized for constipation, 552 (40.5%) did not have an outpatient visit for constipation before admission. Approximately 6.8% of children in the study had ≥1 CCC; these children accounted for 33.5% of total constipation spending, 70.3% of inpatient constipation spending, and 19.8% of emergency department constipation spending. Constipation prevalence was 11.0% for children with 1 CCC, 16.6% with 2 CCCs, and 27.1% with ≥3 CCCs. Although the majority of pediatric constipation treatment occurs in the outpatient setting, inpatient care accounts for a sizable percentage of spending. Children with CCCs have a higher prevalence of constipation and account for a disproportionate amount of constipation healthcare utilization and spending.

  16. Barriers to utilization of dental services for children among low-income families in Alberta.

    Science.gov (United States)

    Amin, Maryam S; Perez, Arnaldo; Nyachhyon, Pawan

    2014-01-01

    To explore reasons for underutilization of dental services covered by a governmental funded program in Alberta. A survey questionnaire was sent to 4,000 randomly selected clients of Alberta Health Benefit program. Only respondents with children were included in the analysis. Reasons were explored among those who indicated that their children did not receive any dental services in the year prior to the survey (non-users). Difficulties faced by those who reported receiving at least one dental service (users) were also collected. Among 795 returned surveys, 597 had at least one child. A total of 1,303 children aged 1 to 19 years (mean age = 11.79 years, SD = 4.2) were included in the analysis. Of the 1,303 children, 443 (34%) did not receive any covered dental services (non-users); the most common reason (50.7%) was 'no perceived need' labeled for the replies 'my child was too young or had no dental problems' followed by perceived insufficient coverage (38.6%). The most common challenge reported by the dental care users was also insufficient coverage (44.9%). About 57% of parents were aware of the covered yearly fluoride application; however, only 34.3% of their children received fluoride and 14.2% had sealants. Low-income families underutilized available dental benefits for children. Perceived need seemed to be the primary determinant of utilization. Parental awareness about the coverage did not seem to promote the utilization of preventive measures for young children.

  17. Music Therapy with Children: A Review of Clinical Utility and Application to Special Populations.

    Science.gov (United States)

    Yeaw, John David Andrew

    This paper reviews the effectiveness of music therapy in treating children with psychiatric and developmental problems. The clinical utility of music therapy is first evaluated by examining the foundational effects of music on affect and behavior. Next, the two broad approaches to music therapy, active and passive music therapy, are discussed.…

  18. The Utility of Thin Slice Ratings for Predicting Language Growth in Children with Autism Spectrum Disorder

    Science.gov (United States)

    Walton, Katherine M.; Ingersoll, Brooke R.

    2016-01-01

    Literature on "Thin Slice" ratings indicates that a number of personality characteristics and behaviors can be accurately predicted by ratings of very short segments (of behavior. This study examined the utility of Thin Slice ratings of young children with autism spectrum disorder for predicting developmental skills and…

  19. The use of protein hydrolysate improves the protein intestinal absorption in undernourished mice infected with Schistosoma mansoni

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    Coutinho Eridan M.

    2002-01-01

    Full Text Available Patients residing in endemic areas for schistosomiasis in Brazil are usually undernourished and when they develop the hepatosplenic clinical form of the disease should usually receive hospital care, many of them being in need of nutritional rehabilitation before specific treatment can be undertaken. In the mouse model, investigations carried out in our laboratory detected a reduced aminoacid uptake in undernourished animals which is aggravated by a superimposed infection with Schistosoma mansoni. However, in well-nourished infected mice no dysfunction occurs. In this study, we tried to improve the absorptive intestinal performance of undernourished mice infected with S. mansoni by feeding them with hydrolysed casein instead of whole casein. The values obtained for the coefficient of protein intestinal absorption (cpia among well-nourished mice were above 90% (either hydrolysed or whole protein. In undernourished infected mice, however, the cpia improved significantly after feeding them with hydrolysed casein, animals reaching values close to those obtained in well-nourished infected mice.

  20. Factors influencing utilization of physiotherapy service among children with cerebral palsy in Jalandhar District of Punjab

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    Akhoury Gourang Sinha

    2017-01-01

    Full Text Available Background: Physiotherapy plays a central role in the management of children with cerebral palsy (CP; however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. Aims and Objectives: To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punjab. Methodology: During June 2009 to March 2012 interview of family members of 248 children with CP (male = 159; female = 89 was conducted using a schedule focusing on demography, constraints of resources, expectations, beliefs, awareness, and service utilization. Cross tabulation with Chi-square, univariate, and multivariate logistic regression analysis were the tools of statistical analysis. Results: 44.4% children had not received any physiotherapy in their life time. In univariate analysis exposure to physiotherapy was found significantly associated with age of diagnosis (odds ratio [OR] = 2.47, finance constraint (OR = 2.27, personal constraint (OR = 2.54, transportation constraint (OR = 3.01, lack of advice for rehabilitation (OR = 2.36, ignorance about condition (OR = 11.94, and rehabilitation services (OR = 2.88. Multivariate model (χ2 = 57.16, df = 15, P < 0.001, pseudo R2 Cox and Snell = 0.22, Nagelkerke = 0.27 identified two main predictor variables of nonexposure to physiotherapy-ignorance about condition (OR = 7.3 and expectation of normalcy (OR = 0.43. Conclusion: The main drivers for the use of physiotherapy among children with CP in Jalandhar district of Punjab were awareness about the condition of CP and expectation of normalcy which demonstrated a complex relationship with sociodemographic factors.

  1. Factors Influencing Utilization of Physiotherapy Service among Children with Cerebral Palsy in Jalandhar District of Punjab.

    Science.gov (United States)

    Sinha, Akhoury Gourang; Sharma, Raju

    2017-01-01

    Physiotherapy plays a central role in the management of children with cerebral palsy (CP); however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punjab. During June 2009 to March 2012 interview of family members of 248 children with CP (male = 159; female = 89) was conducted using a schedule focusing on demography, constraints of resources, expectations, beliefs, awareness, and service utilization. Cross tabulation with Chi-square, univariate, and multivariate logistic regression analysis were the tools of statistical analysis. 44.4% children had not received any physiotherapy in their life time. In univariate analysis exposure to physiotherapy was found significantly associated with age of diagnosis (odds ratio [OR] = 2.47), finance constraint (OR = 2.27), personal constraint (OR = 2.54), transportation constraint (OR = 3.01), lack of advice for rehabilitation (OR = 2.36), ignorance about condition (OR = 11.94), and rehabilitation services (OR = 2.88). Multivariate model (χ 2 = 57.16, df = 15, P physiotherapy-ignorance about condition (OR = 7.3) and expectation of normalcy (OR = 0.43). The main drivers for the use of physiotherapy among children with CP in Jalandhar district of Punjab were awareness about the condition of CP and expectation of normalcy which demonstrated a complex relationship with sociodemographic factors.

  2. Allergic Rhinitis in Preschool Children and the Clinical Utility of FeNO.

    Science.gov (United States)

    Yoon, Jisun; Choi, Yean Jung; Lee, Eun; Cho, Hyun Ju; Yang, Song I; Kim, Young Ho; Jung, Young Ho; Seo, Ju Hee; Kwon, Ji Won; Kim, Hyo Bin; Lee, So Yeon; Kim, Bong Seong; Shim, Jung Yeon; Kim, Eun Jin; Lee, Joo Shil; Hong, Soo Jong

    2017-07-01

    The nature of allergic rhinitis (AR) in preschool aged children remains incompletely characterized. This study aimed to investigate the prevalence of AR and its associated risk factors in preschool-aged children and to assess the clinical utility of fractional exhaled nitric oxide (FeNO). This general population-based, cross-sectional survey included 933 preschool-aged (3- to 7-year-old) children from Korea. Current AR was defined as having nasal symptoms within the last 12 months and physician-diagnosed AR. The prevalence of current AR in preschool children was 17.0% (156/919). Mold exposure (adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.15-2.43) and the use of antibiotics (aOR, 1.97; 95% CI, 1.33-2.90) during infancy were associated with an increased risk of current AR, whereas having an older sibling (aOR, 0.52; 95% CI, 0.35-0.75) reduced the risk. Children with current atopic AR had significantly higher geometric mean levels of FeNO compared to those with non-atopic rhinitis (12.43; range of 1standard deviation [SD], 7.31-21.14 vs 8.25; range of 1SD, 5.62-12.10, P=0.001) or non-atopic healthy children (8.58; range of 1SD, 5.51-13.38, Ppreschool children.

  3. Annual Report on Children's Health Care: Dental and Orthodontic Utilization and Expenditures for Children, 2010-2012.

    Science.gov (United States)

    Berdahl, Terceira; Hudson, Julie; Simpson, Lisa; McCormick, Marie C

    2016-01-01

    To examine general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. Nationally representative data from the Medical Expenditure Panel Survey (2010-2012) provided data on insurance status, public health insurance eligibility, and visits to dental providers for both general dental care and orthodontic care. Overall, 41.9% of US children reported an annual dental office-based visit for general (nonorthodontic) dental care. Fewer Hispanic (34.7%) and non-Latino black children (34.8%) received dental care compared to non-Hispanic whites (47.3%) and Asians (40.3%). Children living in families with the lowest income were also the least likely to have a visit (32.9%) compared to children in the highest-income families (54.7%). Among children eligible for public coverage, Medicaid-eligible children had the lowest percentage of preventive dental visits (29.2%). Socioeconomic and racial/ethnic disparities in use and expenditures for orthodontic care are much greater than those for general and preventive dental care. Average expenditures for orthodontic care were $1,823, of which 56% ($1,023) was paid out of pocket by families. Our findings provide a baseline assessment for examining trends in the future, especially as coverage patterns for children may change as the Affordable Care Act is implemented and the future of the State Child Health Insurance Program remains uncertain beyond 2017. Published by Elsevier Inc.

  4. WISC-III cognitive profiles in children with developmental dyslexia: specific cognitive disability and diagnostic utility.

    Science.gov (United States)

    Moura, Octávio; Simões, Mário R; Pereira, Marcelino

    2014-02-01

    This study analysed the usefulness of the Wechsler Intelligence Scale for Children-Third Edition in identifying specific cognitive impairments that are linked to developmental dyslexia (DD) and the diagnostic utility of the most common profiles in a sample of 100 Portuguese children (50 dyslexic and 50 normal readers) between the ages of 8 and 12 years. Children with DD exhibited significantly lower scores in the Verbal Comprehension Index (except the Vocabulary subtest), Freedom from Distractibility Index (FDI) and Processing Speed Index subtests, with larger effect sizes than normal readers in Information, Arithmetic and Digit Span. The Verbal-Performance IQs discrepancies, Bannatyne pattern and the presence of FDI; Arithmetic, Coding, Information and Digit Span subtests (ACID) and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profiles (full or partial) in the lowest subtests revealed a low diagnostic utility. However, the receiver operating characteristic curve and the optimal cut-off score analyses of the composite ACID; FDI and SCAD profiles scores showed moderate accuracy in correctly discriminating dyslexic readers from normal ones. These results suggested that in the context of a comprehensive assessment, the Wechsler Intelligence Scale for Children-Third Edition provides some useful information about the presence of specific cognitive disabilities in DD. Practitioner Points. Children with developmental dyslexia revealed significant deficits in the Wechsler Intelligence Scale for Children-Third Edition subtests that rely on verbal abilities, processing speed and working memory. The composite Arithmetic, Coding, Information and Digit Span subtests (ACID); Freedom from Distractibility Index and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profile scores showed moderate accuracy in correctly discriminating dyslexics from normal readers. Wechsler Intelligence Scale for Children-Third Edition may provide some useful

  5. Measuring Health Utilities in Children and Adolescents: A Systematic Review of the Literature.

    Directory of Open Access Journals (Sweden)

    Dominic Thorrington

    Full Text Available The objective of this review was to evaluate the use of all direct and indirect methods used to estimate health utilities in both children and adolescents. Utilities measured pre- and post-intervention are combined with the time over which health states are experienced to calculate quality-adjusted life years (QALYs. Cost-utility analyses (CUAs estimate the cost-effectiveness of health technologies based on their costs and benefits using QALYs as a measure of benefit. The accurate measurement of QALYs is dependent on using appropriate methods to elicit health utilities.We sought studies that measured health utilities directly from patients or their proxies. We did not exclude those studies that also included adults in the analysis, but excluded those studies focused only on adults.We evaluated 90 studies from a total of 1,780 selected from the databases. 47 (52% studies were CUAs incorporated into randomised clinical trials; 23 (26% were health-state utility assessments; 8 (9% validated methods and 12 (13% compared existing or new methods. 22 unique direct or indirect calculation methods were used a total of 137 times. Direct calculation through standard gamble, time trade-off and visual analogue scale was used 32 times. The EuroQol EQ-5D was the most frequently-used single method, selected for 41 studies. 15 of the methods used were generic methods and the remaining 7 were disease-specific. 48 of the 90 studies (53% used some form of proxy, with 26 (29% using proxies exclusively to estimate health utilities.Several child- and adolescent-specific methods are still being developed and validated, leaving many studies using methods that have not been designed or validated for use in children or adolescents. Several studies failed to justify using proxy respondents rather than administering the methods directly to the patients. Only two studies examined missing responses to the methods administered with respect to the patients' ages.

  6. Children With Intellectual Disability and Hospice Utilization: The Moderating Effect of Residential Care.

    Science.gov (United States)

    Lindley, Lisa C

    2017-01-01

    Children with intellectual disability commonly lack access to pediatric hospice care services. Residential care may be a critical component in providing access to hospice care for children with intellectual disability. This research tested whether residential care intensifies the relationship between intellectual disability and hospice utilization (ie, hospice enrollment, hospice length of stay), while controlling for demographic characteristics. Multivariate regression analyses were conducted using 2008 to 2010 California Medicaid claims data. The odds of children with intellectual disability in residential care enrolling in hospice care were 3 times higher than their counterparts in their last year of life, when controlling for demographics. Residential care promoted hospice enrollment among children with intellectual disability. The interaction between intellectual disability and residential care was not related to hospice length of stay. Residential care did not attenuate or intensify the relationship between intellectual disability and hospice length of stay. The findings highlight the important role of residential care in facilitating hospice enrollment for children with intellectual disability. More research is needed to understand the capability of residential care staff to identify children with intellectual disability earlier in their end-of-life trajectory and initiate longer hospice length of stays.

  7. Health care utilization and symptom severity in Ghanaian children--a cross-sectional study.

    Science.gov (United States)

    Krumkamp, Ralf; Sarpong, Nimako; Kreuels, Benno; Ehlkes, Lutz; Loag, Wibke; Schwarz, Norbert Georg; Zeeb, Hajo; Adu-Sarkodie, Yaw; May, Jürgen

    2013-01-01

    The aim of this study was to identify factors influencing health care utilization behavior for children with mild or severe disease symptoms in rural Ghana. Between March and September 2008 a cross-sectional health care utilization survey was conducted and 8,715 caregivers were interviewed regarding their intended behavior in case their children had mild or severe fever or diarrhea. To show associations between hospital attendance and further independent factors (e.g. travel distance or socio-economic status) prevalence ratios were calculated for the four disease symptoms. A Poisson regression model was used to control for potential confounding. Frequency of hospital attendance decreased constantly with increasing distance to the health facility. Being enrolled in the national health insurance scheme increased the intention to attend a hospital. The effect of the other factors diminished in the Poisson regression if modeled together with travel distance. The observed associations weakened with increasing severity of symptoms, which indicates that barriers to visit a hospital are less important if children experience a more serious illness. As shown in other studies, travel distance to a health care provider had the strongest effect on health care utilization. Studies to identify local barriers to access health care services are important to inform health policy making as they identify deprived populations with low access to health services and to early treatment.

  8. Health care utilization and symptom severity in Ghanaian children--a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Ralf Krumkamp

    Full Text Available The aim of this study was to identify factors influencing health care utilization behavior for children with mild or severe disease symptoms in rural Ghana. Between March and September 2008 a cross-sectional health care utilization survey was conducted and 8,715 caregivers were interviewed regarding their intended behavior in case their children had mild or severe fever or diarrhea. To show associations between hospital attendance and further independent factors (e.g. travel distance or socio-economic status prevalence ratios were calculated for the four disease symptoms. A Poisson regression model was used to control for potential confounding. Frequency of hospital attendance decreased constantly with increasing distance to the health facility. Being enrolled in the national health insurance scheme increased the intention to attend a hospital. The effect of the other factors diminished in the Poisson regression if modeled together with travel distance. The observed associations weakened with increasing severity of symptoms, which indicates that barriers to visit a hospital are less important if children experience a more serious illness. As shown in other studies, travel distance to a health care provider had the strongest effect on health care utilization. Studies to identify local barriers to access health care services are important to inform health policy making as they identify deprived populations with low access to health services and to early treatment.

  9. Vocalization patterns in young children with Down syndrome: Utilizing the language environment analysis (LENA) to inform behavioral phenotypes.

    Science.gov (United States)

    Parikh, Chandni; Mastergeorge, Ann M

    2017-01-01

    Children with Down syndrome (DS) are at higher risk for both delayed expressive language and poor speech intelligibility. The current study utilized the quantitative automated language environment analysis (LENA) to depict mother and child vocalizations and conversational patterns in the home of 43 children with DS, chronologically aged 24-64 months. Children with DS displayed fewer utterances than typically developing children; however, there was wide variability. Furthermore, children with DS did not show increased vocalization counts across their chronological ages. In contrast to previous findings, this study found that the mothers of children with DS had a reduced number of vocalizations. However, the vocalizations increased with age in comparison to mothers of typically developing children. Implications for targeted interventions that facilitate learning opportunities in bidirectional contexts for children with DS and their parents are discussed, with particular attention to quantify behavioral phenotypes utilizing a novel expressive language assessment tool.

  10. An assessment of schoolyard features and behavior patterns in children's utilization and physical activity.

    Science.gov (United States)

    Anthamatten, Peter; Brink, Lois; Kingston, Beverly; Kutchman, Eve; Lampe, Sarah; Nigg, Claudio

    2014-03-01

    Careful research that elucidates how behavior relates to design in the context of elementary school grounds can serve to guide cost-efficient design with the goal of encouraging physical activity (PA). This work explores patterns in children's PA behavior within playground spaces with the specific goal of guiding healthy playground design. Data on children's utilization and PA behavior in 6 playgrounds divided into 106 observation zones were collected in 2005 and 2006 at Denver elementary school playgrounds using the System for Observing Play and Leisure Activity in Youth. Analyses of variance and t tests determined whether there were differences in utilization and behavior patterns across observations zones and between genders. This study provides evidence that children prefer to use certain types of playground zones and that they are more likely to practice moderate-to-vigorous physical activity (MVPA) in some zones. The authors observed statistically significant differences between genders. Boys were more likely to engage in MVPA in zones without equipment, girls were more likely to use zones with equipment. This work suggests that the inclusion or omission of specific playground features may have an impact on the way that children use the spaces.

  11. Melatonin improves placental efficiency and birth weight and increases the placental expression of antioxidant enzymes in undernourished pregnancy.

    Science.gov (United States)

    Richter, Hans G; Hansell, Jeremy A; Raut, Shruti; Giussani, Dino A

    2009-05-01

    Melatonin participates in circadian, seasonal and reproductive physiology. Melatonin also acts as a potent endogenous antioxidant by scavenging free radicals and upregulating antioxidant pathways. The placenta expresses melatonin receptors and melatonin protects against oxidative damage induced in rat placenta by ischemia-reperfusion. One of the most common complications in pregnancy is a reduction in fetal nutrient delivery, which is known to promote oxidative stress. However, whether melatonin protects placental function and fetal development in undernourished pregnancy is unknown. Here, we investigated the effects of maternal treatment with melatonin on placental efficiency, fetal growth, birth weight and protein expression of placental oxidative stress markers in undernourished pregnancy. On day 15 of pregnancy, rats were divided into control and undernourished pregnancy (35% reduction in food intake), with and without melatonin treatment (5 microg/mL drinking water). On day 20 of gestation, fetal biometry was carried out, the placenta was weighed and subsequently analyzed by Western blot for xanthine oxidase, heat shock protein (HSP) 27 and 70, catalase, manganese superoxide dismutase (Mn-SOD) and glutathione peroxidase 1 (GPx-1). A separate cohort was allowed to deliver to assess effects on birth weight. Maternal undernutrition led to a fall in placental efficiency, disproportionate intrauterine growth retardation and a reduction in birth weight. Maternal treatment with melatonin in undernourished pregnancy improved placental efficiency and restored birth weight, and it increased the expression of placental Mn-SOD and catalase. The data show that in pregnancy complicated by undernutrition, melatonin may improve placental efficiency and birth weight by upregulating placental antioxidant enzymes.

  12. Utility of combined hip abduction angle for hip surveillance in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Akshay Divecha

    2011-01-01

    Full Text Available Background: Spontaneous hip lateralization complicates the management of non-ambulatory children with cerebral palsy (CP. It can be diagnosed early using radiographs, but it involves standardization of positioning and exposure to radiation. Hence, the aim of this study was to assess the utility of Combined hip abduction angle (CHAA in the clinical setting to identify those children with CP who were at greater risk to develop spontaneous progressive hip lateralization. Materials and Methods: One hundred and three children (206 hips with CP formed our study population. There were 48 boys and 55 girls aged 2-11 years (mean 5.03 years. 61 children were Gross Motor Function Classification System (GMFCS level 5, while 42 were GMFCS level 4. Clinical measurements of CHAA were statistically correlated with radiographic measurements of Reimer′s migration percentage (MP for bivariate associations using c2 and t tests. Results: CHAA is evaluated against MP which is considered as a reliable measure of hip subluxation. Thus, for CHAA, sensitivity was 74.07% and specificity was 67.35%. False-positive rate was 32.65% and false-negative rate was 25.93%. Conclusions: Our study shows that correlation exists between CHAA and MP, which has been proved to be useful for hip screening in CP children at risk of hip dislocation. CHAA is an easy, rapid, cost-effective clinical test which can be performed by paraclinical health practitioners (physiotherapists and orthopedic surgeons.

  13. Psychiatric symptoms and service utilization among refugee children referred to a child psychiatry department: a retrospective comparative case note study.

    Science.gov (United States)

    Vaage, Aina Basilier; Garløv, Ida; Hauff, Edvard; Thomsen, Per Hove

    2007-09-01

    Refugee children may encounter barriers to accessing mental health services. We conducted a case-control study based on a systematic review of clinic records to compare psychopathology and service utilization in refugee and Norwegian children referred to a child psychiatry department in a county in southern Norway. Sixty-one refugee children were compared with 61 Norwegian-born children matched for gender, age and time of referral to the clinic. There was no significant difference in rates of referral or level of service utilization, which were proportional to the population. Compared with Norwegian children, refugee children were diagnosed more frequently with post-traumatic stress disorder and other affective and emotional disorders, and less often with pervasive developmental disorders and attention deficit hyperactivity disorder. The results are discussed in terms of referral pathways and the need for culturally competent care for refugee children.

  14. Incremental health care utilization and costs for acute otitis media in children.

    Science.gov (United States)

    Ahmed, Sameer; Shapiro, Nina L; Bhattacharyya, Neil

    2014-01-01

    Determine the incremental health care costs associated with the diagnosis and treatment of acute otitis media (AOM) in children. Cross-sectional analysis of a national health-care cost database. Pediatric patients (age children with and without a diagnosis of AOM, adjusting for age, sex, region, race, ethnicity, insurance coverage, and Charlson comorbidity Index. A total of 8.7 ± 0.4 million children were diagnosed with AOM (10.7 ± 0.4% annually, mean age 5.3 years, 51.3% male) among 81.5 ± 2.3 million children sampled (mean age 8.9 years, 51.3% male). Children with AOM manifested an additional +2.0 office visits, +0.2 emergency department visits, and +1.6 prescription fills (all P <0.001) per year versus those without AOM, adjusting for demographics and medical comorbidities. Similarly, AOM was associated with an incremental increase in outpatient health care costs of $314 per child annually (P <0.001) and an increase of $17 in patient medication costs (P <0.001), but was not associated with an increase in total prescription expenses ($13, P = 0.766). The diagnosis of AOM confers a significant incremental health-care utilization burden on both patients and the health care system. With its high prevalence across the United States, pediatric AOM accounts for approximately $2.88 billion in added health care expense annually and is a significant health-care utilization concern. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil.

    Science.gov (United States)

    Maia, Carlos R; Stella, Steffan F; Wagner, Flavia; Pianca, Thiago G; Krieger, Fernanda V; Cruz, Luciane N; Polanczyk, Guilherme V; Rohde, Luís A; Polanczyk, Carísi A

    2016-03-01

    To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. NCT01705613.

  16. Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

    Directory of Open Access Journals (Sweden)

    Carlos R. Maia

    2015-01-01

    Full Text Available Objective:To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD with methylphenidate immediate-release (MPH-IR in children and adolescents from Brazil.Method:A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY, and costs reported in 2014 international dollars (I$. The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years.Results:Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530 as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy.Discussion:MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy.Trial registration number:NCT01705613.

  17. Potential utility of MRI in the evaluation of children at risk of renal scarring

    International Nuclear Information System (INIS)

    Chan Yuleung; Chan Kamwing; Roebuck, D.J.; Chu, W.C.W.; Metreweli, C.; Yeung Chungkwong; Lee Kimhung

    1999-01-01

    Background. Gadolinium-enhanced MRI has recently been employed in the diagnosis of acute pyelonephritis. Its potential utility in the diagnosis of renal scars in children is unknown. Objective. To evaluate the potential utility of MRI using fat-saturated T1-weighted (T1-W) and post-gadolinium, short-tau inversion-recovery (STIR) sequences in detecting renal scarring by comparison with technetium dimercaptosuccinic acid ( 99 m Tc-DMSA) renal scintigraphy in children at risk of renal scarring. Materials and methods. A group of 24 children with spina bifida and neurogenic bladder or anorectal anomaly was studied. No patient had a history of acute pyelonephritis. Documented urinary tract infection (UTI) was present in 10 children (42 %). The remaining 14 (58 %) children had a history of asymptomatic bacteriuria. None had clinical signs or symptoms of acute UTI at the time of the study. 99 m Tc-DMSA and MRI were performed to detect renal scarring. 99 m Tc-DMSA scans were supplemented with pinhole imaging. MRI of the kidneys employed a fat-saturated T1-W sequence and a post-gadolinium STIR sequence employing a short echo time. Results. Of the kidneys studied, 33 % (n = 16) had evidence of a renal parenchymal defect suggestive of scarring on 99 m Tc-DMSA. The concordance in the detection of a scarred kidney by post-gadolinium STIR sequence and 99 m Tc-DMSA is 94 %; that by fat-saturated T1-W sequence and 99 m Tc-DMSA is 82 %; that by both sequences (positive result on either sequence) and 99 m Tc-DMSA is 100 %. Using 99 m Tc-DMSA as the gold standard, MRI had a sensitivity of 100 % and a specificity of 78 % in the diagnosis of a scarred kidney. The concordance in the detection of a scarred zone by post-gadolinium STIR sequence and 99 m Tc-DMSA is 68 %; that by fat-saturated T1-W sequence and DMSA is 44 %; that by both sequences (positive result on either sequence) and 99 m Tc-DMSA is 84 %. MRI had a sensitivity of 84 % and a specificity of 86 % in the diagnosis of a

  18. Barriers of dental care utilization for children living in military and civilian areas

    Directory of Open Access Journals (Sweden)

    Amrita Sujlana

    2016-01-01

    Full Text Available Aim: We planned our study to assess whether easy access to dental care facilities result in improved oral health and increased utilization of dental services by children. Materials and Methods: Four hundred child-parent pairs, 200 each from the military and civilian areas, were randomly selected (children aged 5 years. Prior to the clinical examination of their wards, parents were asked to complete a questionnaire regarding their sociodemographic details, family structure, dental care utilization, and attitudinal variables toward oral health. Dental caries prevalence and treatment needs were assessed using the World Health Organization (WHO criteria (1997. Statistical Analysis Used: Students′ t-test and chi-square test were used to assess the significance of difference between the two groups. Multivariate regression analysis was performed for all covariates associated with the child′s dental attendance pattern. Results: The percentage prevalence of children affected by dental caries was observed to be statistically higher in the civilian area. The mean decayed, missing, and filled teeth (DMFT score was 2.35 ± 2.92 and 3.26 ± 3.35 in the military and civilian areas, respectively (t stat = 2.78, P = 0.002. The percentage of teeth requiring treatment was observed to be 22.5% and 27.6% in the military and civilian areas, respectively (χ2 = 16.77, P < 0.0001. Covariates significantly associated with increased child′s dental attendance were identified as: High level of the mother′s education, regularity of dental visits by the parents, the child′s increased brushing frequency, and past caries experience. Conclusion: Despite the adequate availability of dental facilities in military areas, untreated dental problems are prevalent. Our finding confirms that dental care utilization is not solely access-related, and other barriers need to be investigated.

  19. Children with neurodevelopmental disorders and disabilities: a population-based study of healthcare service utilization using administrative data.

    Science.gov (United States)

    Arim, Rubab G; Miller, Anton R; Guèvremont, Anne; Lach, Lucyna M; Brehaut, Jamie C; Kohen, Dafna E

    2017-12-01

    The aim of this study was to identify children with neurodevelopmental disorders and disabilities (NDD/D) and compare their healthcare service utilization to children without NDD/D using provincial linked administrative data. The sample included children aged 6 to 10 years (n=183 041), who were registered with the British Columbia Medical Services Plan. Diagnostic information was used for the identification and classification of NDD/D in six functional domains. Healthcare service utilization included outcomes based on physician claims, prescription medication use, and hospitalization. Overall, 8.3% of children were identified with NDD/D. Children with NDD/D had higher healthcare service utilization rates than those without NDD/D. Effect sizes were: very large for the number of days a prescription medication was dispensed; large for the number of prescriptions; medium for the number of physician visits, different specialists visited, number of different prescription medications, and ever hospitalized; and small for the number of laboratory visits, X-ray visits, and number of days hospitalized. The findings have policy implications for service and resource planning. Given the high use of psychostimulants, specialized services for both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D. Future studies may examine patterns of physician behaviours and costs attributable to healthcare service utilization for children with NDD/D. Children with neurodevelopmental disorders and disabilities (NDD/D) have higher healthcare service utilization than those without. Based on provincial population-based linked administrative health data, a sizeable number of children are living with NDD/D. Given the high use of psychostimulants, specialized services for children with both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D. © 2017 Mac Keith Press.

  20. Effects of continuity of care on emergency department utilization in children with asthma.

    Science.gov (United States)

    Huang, Shu-Tzu; Wu, Shiao-Chi; Hung, Yen-Ni; Lin, I-Po

    2016-01-01

    To examine whether continuity of ambulatory asthma care can lower asthma-specific emergency department (ED) utilization by children with asthma in Taiwan. Retrospective cohort study based on claims data. We used the Taiwan National Health Insurance Dataset, 2006 to 2009. The study population was new asthma patients aged 0 to 17 years in 2007, and every case was observed for 2 years. We used the Continuity of Care Index (COCI) to calculate the continuity of ambulatory asthma care in the first year, and estimated the asthma-specific ED utilization in the second year. Two-part hurdle regression was used for statistical analysis. The 29,277 patients in our study had an average COCI of 0.68 (± 0.31), and 42.3% of patients had an index of 1. More than 1 in 20 patients-1641 (5.61%)-had at least 1 asthma ED visit, and the mean number of visits per user was 1.46 (± 0.99). After controlling for covariates, the groups with medium and low continuity of ambulatory asthma care had 21% (odds ratio [OR], 1.21; 95% CI, 1.06-1.39) and 38% (OR, 1.38; 95% CI, 1.21-1.58) higher asthma-related ED utilization, respectively, than the group with high COCI. However, among users, the number of ED visits was not statistically correlated to the continuity of ambulatory asthma care. High continuity of ambulatory asthma care can decrease asthma-specific ED utilization risk in children with newly diagnosed asthma in Taiwan. We suggest that providers and the government reinforce the use of follow-up care and education for high-risk groups to improve the continuity of ambulatory asthma care.

  1. The Predictive Utility of Narcissism among Children and Adolescents: Evidence for a Distinction between Adaptive and Maladaptive Narcissism

    Science.gov (United States)

    Barry, Christopher T.; Frick, Paul J.; Adler, Kristy K.; Grafeman, Sarah J.

    2007-01-01

    We examined the predictive utility of narcissism among a community sample of children and adolescents (N=98) longitudinally. Analyses focused on the differential utility between maladaptive and adaptive narcissism for predicting later delinquency. Maladaptive narcissism significantly predicted self-reported delinquency at one-, two-, and…

  2. Clinical utility of raltegravir for the treatment of HIV infection in children and adolescents

    Directory of Open Access Journals (Sweden)

    Nuttall J

    2013-08-01

    Full Text Available James Nuttall,1 Tammy Meyers,2 Brian Eley11Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital and Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa; 2Department of Paediatrics, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaAbstract: Raltegravir (RAL is the first integrase strand transfer inhibitor and has been shown to provide potent antiretroviral (ARV activity against human immunodeficiency virus type 1 (HIV-1 in both ARV treatment-naïve and treatment-experienced individuals. Following initial US Food and Drug Administration (FDA approval of RAL for treatment of HIV-1-infected adults in 2007, an ongoing pharmacokinetic, safety, and efficacy study in ARV-experienced children and adolescents led to extension of FDA approval to children and adolescents aged 2–18 years in 2011. Availability of chewable tablets for children aged 2–11 years is a significant advantage, and twice-daily dosing is recommended based on pharmacokinetic parameters. Granules for oral suspension in children 4 weeks to 2 years of age are currently under evaluation and clinical trials in neonates are imminent. Coadministration of RAL and the anti-tuberculosis drug rifampin (RIF results in reduced RAL exposure. Evaluation of a double RAL dosing strategy in children requiring cotreatment with RIF is planned. RAL is generally well tolerated and has a good overall safety profile. Further data is required for children before RAL can be recommended in first-line ARV treatment regimens. RAL is also under investigation for use in preventing mother-to-child transmission both during pregnancy and in the HIV-exposed neonate. Currently, the main therapeutic role for RAL in children is for treatment failure and multi-drug resistant cases where the inclusion of RAL in combination with optimal background therapy has demonstrated successful

  3. Utility of positron emission tomography for tumour surveillance in children with neurofibromatosis type 1

    International Nuclear Information System (INIS)

    Moharir, Mahendranath; London, Kevin; Howman-Giles, Robert; North, Kathryn

    2010-01-01

    There is little consensus regarding optimal surveillance of optic pathway glioma (OPG) and plexiform neurofibroma (PNF) in childhood neurofibromatosis type 1 (NF1). 18 F-2-Fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) is employed in the surveillance of adult PNFs; but its utility has neither been specifically studied in children with PNFs nor in children with OPG. Review of PET/CT studies was performed in NF1 children with OPG or PNF. FDG-avidity of tumours was semi-quantitatively analysed and graded by calculating the maximum standardised uptake value (SUV max ) [grade 1: 3- 4 (intense)]. Eighteen children (ten girls; median age: 8.5-years) had PET/CT. Nineteen OPGs were imaged. The SUV max could be measured in 16. Ten were grade 1 and three each were grade 2 and grade 3. FDG-avidity reduced from grade 3 to grade 1 in two symptomatic OPGs following chemotherapy and this was associated with clinical improvement. PET/CT diagnosed symptomatic OPGs with a sensitivity of 0.625 [95% confidence interval (CI): 0.259-0.897] and specificity of 0.875 (95% CI: 0.466-0.993). Sixteen PNFs were imaged. Twelve were grade 1 and two each were grade 2 and grade 3. The two grade 3 PNFs were confirmed malignant peripheral nerve sheath tumours. PET/CT diagnosed malignant transformation with a sensitivity of 1.0 (95% CI: 0.197-1.0) and specificity of 0.857 (95% CI: 0.561-0.974). PET/CT may contribute useful information to the surveillance of OPG in childhood NF1 - particularly to identify progressive, symptomatic tumours. As in adults, PET/CT is useful for the detection of malignant transformation in PNFs in children with NF1. (orig.)

  4. Utility of positron emission tomography for tumour surveillance in children with neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    Moharir, Mahendranath [Hospital for Sick Children, Division of Neurology, Ontario (Canada); London, Kevin [Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney (Australia); Howman-Giles, Robert [University of Sydney, Discipline of Imaging, Faculty of Medicine, Sydney (Australia); North, Kathryn [Children' s Hospital at Westmead, Institute for Neuroscience and Muscle Research, Sydney, NSW (Australia)

    2010-07-15

    There is little consensus regarding optimal surveillance of optic pathway glioma (OPG) and plexiform neurofibroma (PNF) in childhood neurofibromatosis type 1 (NF1). {sup 18}F-2-Fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) is employed in the surveillance of adult PNFs; but its utility has neither been specifically studied in children with PNFs nor in children with OPG. Review of PET/CT studies was performed in NF1 children with OPG or PNF. FDG-avidity of tumours was semi-quantitatively analysed and graded by calculating the maximum standardised uptake value (SUV{sub max}) [grade 1: <3 (low), grade 2: >3-<4 (intermediate), grade 3: >4 (intense)]. Eighteen children (ten girls; median age: 8.5-years) had PET/CT. Nineteen OPGs were imaged. The SUV{sub max} could be measured in 16. Ten were grade 1 and three each were grade 2 and grade 3. FDG-avidity reduced from grade 3 to grade 1 in two symptomatic OPGs following chemotherapy and this was associated with clinical improvement. PET/CT diagnosed symptomatic OPGs with a sensitivity of 0.625 [95% confidence interval (CI): 0.259-0.897] and specificity of 0.875 (95% CI: 0.466-0.993). Sixteen PNFs were imaged. Twelve were grade 1 and two each were grade 2 and grade 3. The two grade 3 PNFs were confirmed malignant peripheral nerve sheath tumours. PET/CT diagnosed malignant transformation with a sensitivity of 1.0 (95% CI: 0.197-1.0) and specificity of 0.857 (95% CI: 0.561-0.974). PET/CT may contribute useful information to the surveillance of OPG in childhood NF1 - particularly to identify progressive, symptomatic tumours. As in adults, PET/CT is useful for the detection of malignant transformation in PNFs in children with NF1. (orig.)

  5. Prevalence of Food Insecurity and Utilization of Food Assistance Program: An Exploratory Survey of a Vermont Middle School

    Science.gov (United States)

    Khan, Shamima; Pinckney, Richard G.; Keeney, Dorigen; Frankowski, Barbara; Carney, Jan K.

    2011-01-01

    Background: Access to sufficient food--in terms of both quality and quantity--is especially critical for children. Undernourishment during childhood and adolescence can have health implications, both short and long term. The prevalence of food insecurity was assessed in a sample of Vermont school children, as well as the relationship between food…

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

    Directory of Open Access Journals (Sweden)

    Sulaimon T Adedokun

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

  7. Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

    Science.gov (United States)

    Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

    2017-05-01

    Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

  8. Constipation-Related Health Care Utilization in Children Before and After Hospitalization for Constipation.

    Science.gov (United States)

    Stephens, John R; Steiner, Michael J; DeJong, Neal; Rodean, Jonathan; Hall, Matt; Richardson, Troy; Berry, Jay G

    2018-01-01

    We studied constipation-related health care among children before and after constipation admission. Index admissions for constipation in 2010-2011 were identified in the Truven Marketscan Database, which includes children receiving Medicaid in 10 states. We measured number of and spending for outpatient constipation visits 12 months before and after index hospitalizations. We also measured spending for constipation hospitalizations and rehospitalization rate. There were 780 index constipation admissions. The median number of outpatient constipation visits was 1 (interquartile range [IQR] = 0, 3) in the 12 months before and 2 (IQR [0, 4]) after admission ( P = .001). Median outpatient spending for constipation was $110 (IQR [0, 429]) before and $132 (IQR [0, 431]) after admission ( P = .2). Median spending for index constipation admissions was $5295 (IQR [2756, 8267]); 78 children (10%) were rehospitalized for constipation within 12 months. Constipation-related health care utilization increased after constipation admission. Median spending for one constipation admission was 50 times the median spending for 12 months of outpatient constipation visits.

  9. The effect of testosterone and a nutritional supplement on hospital admissions in under-nourished, older people

    Directory of Open Access Journals (Sweden)

    Cameron Ian D

    2011-10-01

    Full Text Available Abstract Background Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentially important finding (NHMRC project grant number 627178. Methods/Design One year randomized control trial where subjects are allocated to either oral testosterone undecanoate and high calorie oral nutritional supplement or placebo medication and low calorie oral nutritional supplementation. 200 older community-dwelling, undernourished people [Mini Nutritional Assessment score 2: 7.5% over 3 months]. Hospital admissions, quality-adjusted life years, functional status, nutritional health, muscle strength, body composition and other variables will be assessed. Discussion The pilot study showed that combined treatment with an oral testosterone and a supplement drink was well tolerated and safe, and reduced the number of people hospitalised and duration of hospital admissions in undernourished, community dwelling older people. This is an exciting finding, as it identifies a treatment which may be of substantial benefit to many older people in our community. We now propose to conduct a multi-centre study to test these findings in a substantially larger subject group, and to determine the cost effectiveness of this treatment. Trial registration Australian Clinical Trial Registry: ACTRN 12610000356066

  10. Utilization of dental sealants by Alabama Medicaid children: barriers in meeting the year 2010 objectives.

    Science.gov (United States)

    Dasanayake, A P; Li, Y; Philip, S; Kirk, K; Bronstein, J; Childers, N K

    2001-01-01

    As a national objective, 50% of US children are expected to have dental sealants on at least one permanent molar by the age of 14 years. The present study was conducted to estimate the prevalence of dental sealants among Alabama Medicaid children and to evaluate the characteristics of the sealant users and non-users so the potential barriers in meeting the year 2000/2010 sealant objectives can be identified. Alabama Medicaid 1990-1997 claims for children (N = 3,683,842) were analyzed using basic descriptive statistics, likelihood ratio, Chi-Square and t-tests, and ANOVA. Logistic regression analysis was used in identifying the predictors of dental sealant utilization. Nearly 22 percent of children had at least one sealant claim by 12 to 14 years of age (white = 28.3%; Black = 19.8%; OR = 1.6, 95% CI = 1.4-1.8; female = 23.6%; male = 19.7%; OR = 1.3, 95% CI = 1.1-1.4). 5- to 9-year-olds were more likely to have sealants compared to 11- to 14-year-olds (OR = 4.1, 95% CI = 2.7-6.1). The availability of a Medicaid accepting dentist within the county of residence was a significant predictor (OR = 1.5, 95% CI = 1.1-2.2). Less than 2% of the annual amount claimed for total dental services in Alabama was related to sealants and the providers were reimbursed only for 50% to 70% of the amount claimed for sealant procedures. Racial and gender disparities in obtaining care, non-availability of a Medicaid-participating dentist within the county, and lower payment/claim ratio may make the national sealant objective difficult to achieve in Alabama.

  11. Health service utilization and access to medicines among Syrian refugee children in Jordan.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Weiss, William

    2016-01-01

    With over one million Syrian refugee children in the region, we undertook this study to characterize care-seeking behaviors and health service utilization for child refugees with the aim of informing humanitarian programming for non-camp settings in Jordan. A survey of Syrian refugees living outside of camps in Jordan was conducted using a 125 × 12 cluster design with probability proportional to size sampling to obtain a representative sample. The questionnaire focused on access to health services, including a module on care seeking for children. Care seeking was high with 90.9% of households with a child less than 18 years seeking medical care the last time it was needed. Households most often sought care for children in the public sector (54.6%), followed by private (36.5%) and charity sectors (8.9%). Among child care seekers, 88.6% were prescribed medication during the most recent visit, 90.6% of which obtained the medication. Overall, 49.4% of households reported out-of-pocket expenditures for either the consultation or prescribed medications at the most recent visit (mean $US21.1 and median $US0). Syrian refugees had good access to care for their sick children at the time of the survey; however, this has likely deteriorated since the survey because of the withdrawal of free access for refugees. The number of refugees in Jordan and relative accessibility of care has resulted in a large burden on the health system; the Jordanian government will require additional support if current levels of health access are to be maintained for Syrian refugees. © 2016 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

  12. Potential utility of MRI in the evaluation of children at risk of renal scarring

    Energy Technology Data Exchange (ETDEWEB)

    Chan Yuleung; Chan Kamwing; Roebuck, D.J.; Chu, W.C.W.; Metreweli, C. [Dept. of Diagnostic Radiology and Organ Imaging, Chinese Univ. of Hong Kong, Shatin (China); Yeung Chungkwong; Lee Kimhung [Dept. of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong (China)

    1999-11-01

    Background. Gadolinium-enhanced MRI has recently been employed in the diagnosis of acute pyelonephritis. Its potential utility in the diagnosis of renal scars in children is unknown. Objective. To evaluate the potential utility of MRI using fat-saturated T1-weighted (T1-W) and post-gadolinium, short-tau inversion-recovery (STIR) sequences in detecting renal scarring by comparison with technetium dimercaptosuccinic acid ({sup 99} {sup m}Tc-DMSA) renal scintigraphy in children at risk of renal scarring. Materials and methods. A group of 24 children with spina bifida and neurogenic bladder or anorectal anomaly was studied. No patient had a history of acute pyelonephritis. Documented urinary tract infection (UTI) was present in 10 children (42 %). The remaining 14 (58 %) children had a history of asymptomatic bacteriuria. None had clinical signs or symptoms of acute UTI at the time of the study. {sup 99} {sup m}Tc-DMSA and MRI were performed to detect renal scarring. {sup 99} {sup m}Tc-DMSA scans were supplemented with pinhole imaging. MRI of the kidneys employed a fat-saturated T1-W sequence and a post-gadolinium STIR sequence employing a short echo time. Results. Of the kidneys studied, 33 % (n = 16) had evidence of a renal parenchymal defect suggestive of scarring on {sup 99} {sup m}Tc-DMSA. The concordance in the detection of a scarred kidney by post-gadolinium STIR sequence and {sup 99} {sup m}Tc-DMSA is 94 %; that by fat-saturated T1-W sequence and {sup 99} {sup m}Tc-DMSA is 82 %; that by both sequences (positive result on either sequence) and {sup 99} {sup m}Tc-DMSA is 100 %. Using {sup 99} {sup m}Tc-DMSA as the gold standard, MRI had a sensitivity of 100 % and a specificity of 78 % in the diagnosis of a scarred kidney. The concordance in the detection of a scarred zone by post-gadolinium STIR sequence and {sup 99} {sup m}Tc-DMSA is 68 %; that by fat-saturated T1-W sequence and DMSA is 44 %; that by both sequences (positive result on either sequence) and {sup 99

  13. Substrate utilization during submaximal exercise in children with a severely obese parent

    Directory of Open Access Journals (Sweden)

    Eaves Audrey D

    2012-05-01

    Full Text Available Abstract Background We have reported a reduction in fatty acid oxidation (FAO at the whole-body level and in skeletal muscle in severely obese (BMI ≥ 40 kg/m2 individuals; this defect is retained in cell culture suggesting an inherent component. The purpose of the current study was to determine if an impairment in whole-body fatty acid oxidation (FAO was also evident in children with a severely obese parent. Methods Substrate utilization during submaximal exercise (cycle ergometer was determined in children ages 8–12 y with a severely obese parent (OP, n = 13 or two lean/non-obese (BMI range of 18 to 28 kg/m2 parents (LP, n = 13. A subgroup of subjects (n = 3/group performed 4 weeks of exercise training with substrate utilization measured after the intervention. Results The children did not differ in age (LP vs. OP, respectively (10.7 ± 0.5 vs. 10.2 ± 0.5 y, BMI percentile (65.3 ± 5.2 vs. 75.9 ± 7, Tanner Stage (1.4 ± 0.2 vs. 1.5 ± 0.2, VO2peak (40.3 ± 2.7 vs. 35.6 ± 2.6 ml/kg/min or physical activity levels (accelerometer. At the same absolute workload of 15 W (~38% VO2peak, RER was significantly (P ≤ 0.05 lower in LP vs. OP (0.83 ± 0.02 vs. 0.87 ± 0.01 which was reflected in a reduced reliance on FAO for energy production in the OP group (58.6 ± 5.1 vs. 43.1 ± 4.0% of energy needs during exercise from FAO. At a higher exercise intensity (~65% VO2peak there were no differences in substrate utilization between LP and OP. After exercise training RER tended to decrease (P = 0.06 at the 15 W workload, suggesting an increased reliance on FAO regardless of group. Conclusions These findings suggest that the decrement in FAO with severe obesity has an inherent component that may be overcome with exercise training.

  14. Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions

    Directory of Open Access Journals (Sweden)

    Singh DKA

    2014-08-01

    Full Text Available Devinder KA Singh,1 Zahara A Manaf,2 Noor Aini M Yusoff,3 Nur A Muhammad,2 Mei Fang Phan,1 Suzana Shahar2 1Physiotherapy Program, School of Rehabilitation Sciences, 2Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 3ASIA Metropolitan University, Cheras, Malaysia Purpose: The consequences of combined undernourishment and decreased physical ­performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions.Methods: Forty-seven older adults (26 males, 21 females aged ≥60 (69.23±8.63 years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test, biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels, and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered.Results: The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL, and 21.7% were at risk of protein energy malnutrition with prealbumin level (100–170 mg/L. A significant

  15. Impact of fee increases on dental utilization rates for children living in Connecticut and enrolled in Medicaid.

    Science.gov (United States)

    Beazoglou, Tryfon; Douglass, Joanna; Myne-Joslin, Veronica; Baker, Patricia; Bailit, Howard

    2015-01-01

    In 2008, Connecticut's Medicaid program administration increased children's dental fees to match approximately the 70th percentile of what the market fees were for dental care in 2005. These Medicaid program changes occurred at the same time as a national economic recession, which took place from 2007 through 2009. The authors obtained Medicaid eligibility, claims, and provider data before and after the fee increase, in 2006 and 2009 through 2012, respectively. Their analysis examined changes in utilization rates, service mix, expenditures, and dentists' participation. The authors qualitatively assessed the general impact of the recession on utilization rate changes. The Medicaid fee increase, program improvements, and the recession resulted in a dramatic increase in utilization rates. For children continuously enrolled in Medicaid, utilization rates increased from 45.9% in 2006 to 71.6% in 2012. Rates increased across sex, race, ethnicity, and geographic areas. These increased utilization rates eliminated the disparities in access to dental services between children with private insurance and children receiving Medicaid benefits. Children enrolled in Medicaid now have utilization rates that are similar to or higher than privately insured children. Expenditures increased $62 million; this represents less than 1% of 2012 State Medicaid expenditures. Dentist participation increased by 72%. These results suggest that dentists will participate in the Medicaid program if adequately compensated, and low-income families will seek dental services. The Medicaid fee increase, program improvements, and the recession had a dramatic impact on reducing disparities in children's access to dental care in Connecticut. One solution to the substantial disparities in access to dental care is to increase Medicaid fees to competitive levels. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  16. Esquistossomose mansônica em camundongos experimentalmente subnutridos Mansoni schistosomiasis in experimentally undernourished mice

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Magalhães

    1986-10-01

    Full Text Available Realizou-se estudo sobre o desenvolvimento da esquistossomose mansônica em camundongos submetidos à dieta hipoprotéica. Foram constituídos 4 grupos de Mus musculus "Swiss" da seguinte forma: 1 não infectados, normoprotéicos; 2 infectados, normoprotéicos; 3 não infectados, hipoprotéicos e 4 infectados, hipoprotéicos. Os animais foram sacrificados com 60 dias de infecção, aos 90 dias de idade. Verificou-se que os esquistossomos sofreram os efeitos da subnutrição do hospedeiro, principalmente os vermes machos, que além de terem seu desenvolvimento prejudicado, tiveram seu número reduzido aproximadamente pela metade. O número de granulomas foi menor nos roedores subnutridos e o tamanho da lesão foi reduzido. Houve acentuada leucopenia nos animais submetidos à dieta hipoprotéica, principalmente nos infectados subnutridos. A linfopenia e a eosinopenia acentuadas sugeriram que o sistema imunológico do hospedeiro foi afetado pela subnutrição. A taxa de mortalidade foi muito mais elevada nos animais infectados submetidos à dieta hipoprotéica. Concluiu-se que os camundongos subnutridos resistiram menos à infecção esquistossomótica apesar de terem apresentado menor número de lesões granulomatosas.Mansoni schistosomiasis was studied in mice fed on a low protein diet. Four groups of the Swiss breed Mus musculus were used in an experiment with two factors, each with two levels: 1-non-infected, normal diet; 2 - infected, normal diet ; 3 - non-infected, low protein diet; 4 - infected, low protein diet. The mice were killed for observation at age 90 days, after 60 days of infection, for those infected. It was found that the worms suffered the effects of malnutrition, mainly males, whose population count was cut by half, in addition to poor individual growth. The hepatic granuloma count was found to be smaller in the undernourished group; while the corresponding lesions were also generally smaller. There was a marked leukopenia in

  17. English Proficiency, Threshold Language Policy and Mental Health Service Utilization among Asian-American Children.

    Science.gov (United States)

    Aratani, Yumiko; Liu, Cindy H

    2015-10-01

    This paper explores the role of English proficiency, ethnicity, and California's threshold language policy in the rates of discontinuing mental health services among Asian-American children. We used data from the 2001-2006 Client and Services Information (CSI) System, which contains county-level information about service users in public mental health systems. Our data included 59,218 service users under the age of 18. We used logistic regression to determine the likelihood of discontinuing services, while controlling for sociodemographic and clinical characteristics. English-speaking Asians were 11% more likely than English-speaking Whites to discontinue mental health services. Non-English-speaking Asians were 50% significantly more likely to stay in services. The results also revealed some inter-ethnic variations in the discontinuation patterns; however, the patterns of mental health service utilization appear to be driven by the availability of mental health services in Asian-ethnic languages in county of residence. Further research is needed to understand the intake and referral processes that Asian children go through within the mental health service system. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  19. Pediatric cancer gone viral. Part I: strategies for utilizing oncolytic herpes simplex virus-1 in children

    Directory of Open Access Journals (Sweden)

    Timothy P Cripe

    Full Text Available Progress for improving outcomes in pediatric patients with solid tumors remains slow. In addition, currently available therapies are fraught with numerous side effects, often causing significant life-long morbidity for long-term survivors. The use of viruses to kill tumor cells based on their increased vulnerability to infection is gaining traction, with several viruses moving through early and advanced phase clinical testing. The prospect of increased efficacy and decreased toxicity with these agents is thus attractive for pediatric cancer. In part I of this two-part review, we focus on strategies for utilizing oncolytic engineered herpes simplex virus (HSV to target pediatric malignancies. We discuss mechanisms of action, routes of delivery, and the role of preexisting immunity on antitumor efficacy. Challenges to maximizing oncolytic HSV in children are examined, and we highlight how these may be overcome through various arming strategies. We review the preclinical and clinical evidence demonstrating safety of a variety of oncolytic HSVs. In Part II, we focus on the antitumor efficacy of oncolytic HSV in pediatric tumor types, pediatric clinical advances made to date, and future prospects for utilizing HSV in pediatric patients with solid tumors.

  20. User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica.

    Science.gov (United States)

    Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

    2017-06-01

    The impact of user-fee policies on the equity of health care utilization and households' financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper-middle-income countries. This paper assesses the short- and long-term impacts of Jamaica's user-fee-removal for children in 2007. This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user-fee-removal policy on children's health care utilization and households' financial burdens, as well as the impact in the medium- to long-term. Immediately following the implementation of user-fee-removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P  = 0.018). In the short-term (2007-2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium- to long-term. The household's financial burden (health expenditure as a share of household's non-food expenditures) reduced by 6 percentage points (95% CI: -11 to -1, P  = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. User-fee-removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short-term and the medium- to long-term results have different indications: In the short-term, the policy deteriorated the equity of

  1. Utilization of free dental health care services provided to the perinatally infected human immunodeficiency virus children in Bangalore: Longitudinal study

    OpenAIRE

    Beena Javaregowda Parvathy

    2014-01-01

    Background: Use of Highly active anti-retroviral therapy have increased the life expectancy of human immunodeficiency virus (HIV) infected patients and hence it is imperative that all efforts have to be made by Pediatric dentists to provide a better oral health for these children. Aim: The aim of this study was to evaluate the rate of utilization of free dental treatment provided to these perinatally infected HIV positive children who were previously screened as a part of oral health survey. ...

  2. Computed tomography in the evaluation of abdominal fat distribution associated with a hyperlipidic diet in previously undernourished rats

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Carlos Alberto Soares da [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Ciencias Medicas. Program of Post-graduation in Clinical and Experimental Physiopathology; Alves, Erika Gomes; Gonzalez, Gabriele Paula; Barbosa, Thais Barcellos Cortez; Lima, Veronica Demarco; Nascimento, Renata; Moura, Egberto Gaspar de; Saba, Celly Cristina Alves do Nascimento [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Dept. of Physiological Sciences]. E-mail: cellysaba@terra.com.br; Monteiro, Alexandra Maria Vieira [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Ciencias Medicas

    2007-09-15

    Objective: To study, by means of computed tomography, the repercussion of post-weaning dietary supplementation with soy oil or canola oil on the abdominal fat distribution in previously undernourished rats. Materials and methods: Dams submitted to 50% food restriction (FR) compared with dams receiving a standard diet (C). After weaning, undernourished rats received a diet supplemented with 19% soy oil (19% FR-soy) or 19% canola oil (19% FR-canola). Rats in the control group received a diet with 7% soy oil (7% C-soy) until the end of the experimental period. At the age of 60 days old, the rats were submitted to computed tomography for evaluation of total abdominal and visceral fat area. The rats' length and body mass were evaluated and, after their sacrifice, the abdominal fat depots were excised weighted. The data are reported as mean {+-} mean standard error, with p < 0.05 considered as significance level. Results: Rats in the group 19% FR presented similar length, body weight and visceral fat mass. As a whole, the evaluations have shower results significantly lower in relation to the control group (7% C-soy). However, computed tomography has found significant differences in abdominal fat distribution for the groups 19% FR-soy and 19% FR-canola. Conclusion: Computed tomography has demonstrated that the abdominal fat distribution may be dependent on the type of vegetable oil included in the diet. (author)

  3. [Nutritional condition and serum protein concentration in children (6-12 years old) of Chacopata Sucre State, Venezuela (December--January, 1997)].

    Science.gov (United States)

    Vásquez, Solange; García, Andrés Gerardi; Lugo, Raquel Salazar

    2004-01-01

    A biochemical and anthropometrical study of 175 children (6-12 years old) from Chacopata, Sucre State was done (December--January, 1997). The children were evaluated by combined anthropometrical indicators (OMS), clinical, nutritional and biochemical tests. The results showed 81.71% well-nourished children, 4.57% obese children and 13.72% with some degree of undernutrition: 3.43% acute undernourished and 10.29% chronic undernourished. Total seric proteins including fractions: albumin, alfa-1 alfa-2, beta and gamma globulins as well as total globulins and albumin/globulin indexes were at the normal reference range for children (6-12 years old). A significative increase in alfa-1 globulin (0.18+/-0.08 g/dl; 8-9 years old group) and decrease of alfa-2 globulin (0.71+/-0.11 g/dl; 10-12 year old group) was observed. Biochemical results associated with nutritional condition showed normal values, moreover, this biochemical index decreased in the undernourished group. A significant decrease of the seric beta globulin in the undernourished children (0.72+/-0,12 g/dl) with respect to the well-nourished children (0.79+/-0.15) was found. In children (6-12 years old) from Chacopata, compensated chronic undernourishement is prevalent.

  4. Diagnostic and therapeutic utility of double-balloon enteroscopy in children.

    Science.gov (United States)

    Urs, Arun N; Martinelli, Massimo; Rao, Prithviraj; Thomson, Mike A

    2014-02-01

    Diagnostic and therapeutic benefits of double-balloon enteroscopy (DBE) have been documented in adults, with few data available on pediatric patients. We evaluated the diagnostic and therapeutic utility of DBE in children. A prospective assessment of 113 DBE procedures in 58 consecutive children younger than 18 years (36 boys, 22 girls; median age 12.7 years, range 1-18 years) was performed for a variety of suspected small bowel (SB) disorders from January 2008 to August 2012 in a tertiary referral center for pediatric patients. All of the children had undergone upper gastrointestinal endoscopy and ileocolonoscopy. A total of 19 patients had undergone radiological investigations for SB (n = 11 magnetic resonance imaging; n = 5 barium enterography; n = 3 computed tomography) and 54 patients had undergone wireless capsule endoscopy (WCE). The overall median (range) examination time was 92.5 (45-275) minutes. The median (range) estimated insertion length of SB distal to pylorus was 230 (80-450) cm and proximal to ileocecal valve was 80 (5-275) cm. The common indications for DBE were polyposis syndromes (n = 21) and obscure gastrointestinal bleeding (n = 16). The findings included polyps (n = 19), mucosal ulcers and erosions (n = 8), submucosal elevations with white nodules (n = 4), and angioma/angiodysplasia (n = 2). The overall diagnostic yield for SB lesions using DBE was 70.7% (41/58) and for WCE was 77.7% (42/54). Endotherapeutic intervention was successfully used in 46.5% (n = 27/58). The endoscopic, medical, and surgical contributions to change in management by DBE were 72.4% (n = 42/58). Three complications (5.2%) were noted with uneventful recovery. The diagnostic yield of DBE was comparable to WCE, but with the addition of therapeutic possibility and histological yield. We believe this technique could be a valuable addition to existing endoscopic techniques, complementary to WCE, and may be considered as an alternative diagnostic and therapeutic option in the

  5. Behavioral Assessment of the Dysexecutive Syndrome for Children: an examination of clinical utility for children with attention-deficit hyperactivity disorder (ADHD).

    Science.gov (United States)

    Siu, Angela F Y; Zhou, Ya

    2014-05-01

    The present study evaluated the utility of the Behavioral Assessment of Dysexecutive Syndrome for Children for discerning differences in executive functioning between attention-deficit hyperactivity disorder (ADHD) children and normal controls and examined its associations with real-life executive function as rated by parent reports on the Dysexecutive Questionnaire for Children. Sixty-three children diagnosed with ADHD and 60 normal healthy peers were recruited for this study. All participants completed the Behavioral Assessment of Dysexecutive Syndrome for Children, while their parents completed the Dysexecutive Questionnaire for Children. Results revealed that the ADHD group exhibited significantly poorer performance than the controls on 3 subtests of the Behavioral Assessment of Dysexecutive Syndrome for Children (ie, Playing Cards Test, Water Test, and Zoo Map Test 2), as well as on the total Dysexecutive Questionnaire for Children. Significant correlation was found between the total Dysexecutive Questionnaire for Children and the 6-Part Test. Findings suggested that some subtests of the Behavioral Assessment of Dysexecutive Syndrome for Children were particularly useful for detecting real-life executive dysfunction in ADHD. Yet, further studies are needed to provide extended validity data.

  6. The Impact of Medicaid Reform on Children?s Dental Care Utilization in Connecticut, Maryland, and Texas

    OpenAIRE

    Nasseh, Kamyar; Vujicic, Marko

    2014-01-01

    Objective To measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children. Data 2007 and 2011?2012 National Survey of Children?s Health. Study Design Difference-in-differences and triple differences models were used to measure the impact of reforms. Principal Findings Relative to Medicaid-ineligible children and all children from a group of control states, preventive denta...

  7. [Serum levels of Zn in children with different degress of nutritional deficiency].

    Science.gov (United States)

    Amesty-Valbuena, Alis; Pereira-Medero, Nayda; Núñez-González, José Rafael de Jesús; García, Doris; de Villaroel, Monserrat Vicente; Granadillo, Víctor; Manzanilla, José; Fernández, Denny

    2006-12-01

    The importance of Zinc (Zn) as a necessary oligoclement for human nutrition begins in the first three decades of life. At the moment, the role that Zn plays in the infantile nutrition is very well-known, acquiring a special connotation in children with proteic-energetics malnutrition (PEM). In this study the daily ingestion and the serum measuremets of Zn were determined in 64 undernourished children (light, mild and severe) and in 25 eutrophic children with ages between 1 to 5 years, belonging to families of the strata IV and V according to the Graffar scale corrected by age. The results of the serum values of Zn were for the light undernourished of 39.73 +/- 14.97 microg/dL (30.38 microg/dL-44.56 microg/dL), for the mild undernourished of 35.07 +/- 28.13 microg/dL (27.76 microg/dL-65.80 microg/dL) and for the severe undernourished of 15.48 +/- 10.44 microg/dL (5.57 microg/dL-28.56 microg/dL), which were diminished in relation with the control group, 76.71 +/- 33.29 microg/dL (45.75 microg/dL - 78.27 microg/dL) with p < 0.0001. Equally, there were significant differences (p < 0.001) among the group of severe undernourished with the light undernourished and normal subjects. In relation with the daily ingestion of Zn, a statistically significant difference was observed only (p < 0.001) in the severe undernourished, 1.87 +/- 0.54 mg/día (1.20 mg/día-2.87 mg/día) when comparing them with the light undernourished, 5.48 +/- 0.98 mg/día (3.50 mg/día-7.87 mg/día), the mild undernourished, 4.99 +/- 1.24 mg/día (4.10 mg/día-11.42 mg/día) ) and the normal subjects, 6.22 +/- 0.98 mg/día (4.8 mg/día-8.02 mg/día). There was a positive correlation between ingestion and seric values of Zn when the 3 undernourished groups were studied. These results allow to conclude that both the seric values of Zn and its ingestion show modifications in relation with the degree of nutritional deficiency.

  8. Utility of language comprehension tests for unintelligible or non-speaking children with cerebral palsy: a systematic review

    NARCIS (Netherlands)

    Geytenbeek, J.J.M.; Harlaar, L.; Stam, M.; Ket, H.; Becher, J.G.; Oostrom, K.J.; Vermeulen, R.J.

    2010-01-01

    Aim To identify the use and utility of language comprehension tests for unintelligible or non-speaking children with severe cerebral palsy (CP).Method Severe CP was defined as severe dysarthria (unintelligible speech) or anarthria (absence of speech) combined with severe limited mobility,

  9. Utility of Language Comprehension Tests for Unintelligible or Non-Speaking Children with Cerebral Palsy: A Systematic Review

    Science.gov (United States)

    Geytenbeek, Joke; Harlaar, Laurike; Stam, Marloes; Ket, Hans; Becher, Jules G.; Oostrom, Kim; Vermeulen, Jeroen

    2010-01-01

    Aim: To identify the use and utility of language comprehension tests for unintelligible or non-speaking children with severe cerebral palsy (CP). Method: Severe CP was defined as severe dysarthria (unintelligible speech) or anarthria (absence of speech) combined with severe limited mobility, corresponding to Gross Motor Function Classification…

  10. Utility of screening questionnaire and polysomnography to predict postoperative outcomes in children.

    Science.gov (United States)

    Kako, Hiromi; Tripi, Jennifer; Walia, Hina; Tumin, Dmitry; Splaingard, Mark; Jatana, Kris R; Tobias, Joseph D; Raman, Vidya T

    2017-11-01

    The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire. Procedures within 1 year of PSG were included in the analysis. Questionnaires were scored according to a cutoff previously deemed optimal for predicting OSA (apnea-hypopnea index ≥ 5) on the sleep study. Postoperative outcomes included prolonged (>60 min) length of stay (LOS) in the post-anesthesia care unit (PACU) and oxygen requirement in the PACU. The study cohort included 185 patients (100/85 male/female) age 8 ± 4 years, undergoing adenotonsillectomy (n = 109), other ear, nose, and throat (ENT) procedures (n = 18), or non-ENT procedures (n = 58). There were 45 patients with OSA documented by PSG and 122 patients identified as likely to have OSA according to questionnaire responses (89% sensitivity, 41% specificity). PACU LOS was prolonged in 55/181 (30%) cases and supplemental oxygen was used in the PACU in 29/181 (16%) cases. In separate multivariable models, supplemental oxygen use in the PACU was more common if a patient scored ≥2/6 points on the short questionnaire scale (OR = 5.0; 95% CI: 1.3, 19.9; p = 0.023) or if the patient was diagnosed with OSA on PSG (OR = 4.6; 95% CI: 1.6, 13.5; p = 0.005). Neither OSA on PSG nor questionnaire score ≥2/6 were associated with prolonged PACU stay. Both OSA diagnosis based on the AHI and the questionnaire scale achieved comparable predictive value for the need for oxygen use in the PACU. The utility of the questionnaire in predicting rare adverse events (e.g., unplanned admission or rapid response team activation) remains to be determined

  11. Service utilization by children with conduct disorders: findings from the 2004 Great Britain child mental health survey.

    Science.gov (United States)

    Shivram, Raghuram; Bankart, John; Meltzer, Howard; Ford, Tamsin; Vostanis, Panos; Goodman, Robert

    2009-09-01

    Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity.

  12. Evaluation and Utility of a Family Information Table to Identify and Test Children at Risk for HIV in Kenya

    Directory of Open Access Journals (Sweden)

    Michelle Meyer, BA

    2014-09-01

    Full Text Available Background: Effective strategies to identify and screen children at risk for HIV are needed. The objectives of this study were to evaluate the utilization of a family information table (FIT to identify and test at-risk children in Kenya and identify factors associated with child testing. Methods: A cross-sectional study was conducted among HIV-infected adults with children at five Kenyan clinics. HIV testing status for children aged ≤18 years was gathered from the patients’ FITs and compared to reports from in-person clinic visits as the gold standard. Generalized estimating equations were used to assess predictors for HIV testing of children adjusted for confounders and within parent correlation. Results: Our sample included 384 HIV-infected adults enrolled in care with 933 reported children. Overall, 323 FITs (84% correctly listed all children in the family and 340 (89% documented an HIV testing status (including untested for all children. Seventy-five percent of parents verbally reported all children tested, compared to only 46% of FITs (OR=13.5, 95% CI 6.5-27.8. Verbal reports identified 739 (79% children tested, with 55 (7.4% HIV-positive and 17 (2.3% HIV-exposed infants (HEI. Of 63 adults with HIV-positive children or HEI, 60 (95% reported enrolling children into care. Likelihood that children had been tested was higher for younger children (≤4y vs. > 4y, aOR=2.0; 95% CI 1.4-2.9 and lower if the partner’s serostatus was unknown vs. seropositive (aOR=0.3; 95% CI: 0.1-0.8. Conclusions: Although the FIT may be a useful tool to identify children at risk for HIV, this study found underutilization by providers. To maximize impact of this tool, documentation of follow-up for untested and positive children is essential. Global Health Implications: Through early documentation of at-risk children and follow up of untested and infected children, the FIT may serve as an effective resource for improving HIV testing and linkage to care.

  13. Utility of Inferior Turbinoplasty for the Treatment of Nasal Obstruction in Children: A 10-Year Review.

    Science.gov (United States)

    Arganbright, Jill M; Jensen, Emily L; Mattingly, Jameson; Gao, Dexiang; Chan, Kenny H

    2015-10-01

    Inferior turbinoplasty (IT) in pediatric patients is a common procedure used to treat childhood nasal obstruction. Most of the published IT studies in this population did not control for concurrent airway procedures. To assess postoperative outcomes in pediatric patients undergoing isolated IT. Ten-year retrospective review of the medical records of 1770 children (aged point Likert scale of parental perception of their child’s ability to breathe through the nose (nasal patency) preoperatively and currently (1 indicates extremely poor; 5, extremely well) and their overall satisfaction rating for the procedure (1 indicates extremely dissatisfied; 5, extremely satisfied). Of the 1770 children, 107 underwent isolated IT. The mean age of the cohort was 10.5 (range, 1.2-17.9) years. The IT procedures included radiofrequency ablation (72 [67.3%]), microdebridement (19 [17.8%]), and partial turbinate resection (21 [19.6%]). No major complications were observed. Eight revision ITs for persistent nasal symptoms were performed independently of the initial surgical procedure, including 4 of 72 radiofrequency ablations (5.6%), 1 of 19 microdebridements (5.3%), and 3 of 21 partial turbinate resections (14.3%), with no difference among the 3 techniques (P = .10). The parents of 63 patients completed the telephone questionnaire with a mean follow-up of 4.55 (range, 0.63-10.68) years. The combined parental satisfaction on a 5-point Likert scale for the extremely satisfied and satisfied categories was 44 (69.8%), and the nasal patency score improved significantly from 2.0 to 3.4 (95% CI, 1.03-1.65; P four patients (54.0%) continued to require medical management owing to persistent nasal symptoms. Patients with a history of allergic rhinitis had a greater improvement of nasal patency (2.1 to 3.9; P = .02) and a higher postoperative use of medical therapy (13 of 34 patients [38.2%] vs 21 of 73 [28.8%]; P = .01). Inferior turbinoplasty showed overall utility and was safe and

  14. Treatment planning for children with attention-deficit/hyperactivity disorder: treatment utilization and family preferences

    Directory of Open Access Journals (Sweden)

    William B Brinkman

    2011-01-01

    Full Text Available William B Brinkman, Jeffery N EpsteinDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USABackground: Attention-deficit/hyperactivity disorder (ADHD is a common condition that often results in child and family functional impairments. Although there are evidence-based treatment modalities available, implementation of and persistence with treatment plans vary with patients. Family preferences also vary and may contribute to variability in treatment utilization.Objective: The objective of this study is to describe the evidence-based treatments available for ADHD, identify patterns of use for each modality, and examine patient and parent treatment preferences.Method: Literature review.Results: Treatment options differ on benefits and risks/costs. Therefore, treatment decisions are preference sensitive and depend on how an informed patient/parent values the tradeoffs between options. Literature on patient and parent ADHD treatment preferences is based on quantitative research assessing the construct of treatment acceptability and qualitative and quantitative research that assesses preferences from a broader perspective. After a child is diagnosed with ADHD, a variety of factors influence the initial selection of treatment modalities that are utilized. Initial parent and child preferences are shaped by their beliefs about the nature of the child's problems and by information (and misinformation received from a variety of sources, including social networks, the media, and health care providers. Subsequently, preferences become further informed by personal experience with various treatment modalities. Over time, treatment plans are revisited and revised as families work with their health care team to establish a treatment plan that helps their child achieve goals while minimizing harms and costs.Conclusions: Studies have not been able to determine the extent to which

  15. Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization

    Directory of Open Access Journals (Sweden)

    Classi Peter

    2012-10-01

    Full Text Available Abstract Background The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD. Methods Data were from the 2007 U.S. National Health Interview Survey (NHIS and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ. Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics. Results Of the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3% had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP, and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4. Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4. Conclusions In children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.

  16. Utility of the QuantiFERON-TB Gold In-Tube assay for the diagnosis of tuberculosis in Moroccan children.

    Science.gov (United States)

    El Azbaoui, S; Sabri, A; Ouraini, S; Hassani, A; Asermouh, A; Agadr, A; Abilkassem, R; Dini, N; Kmari, M; Akhaddar, A; Laktati, Z; Aieche, S; El Hafidi, N; Ben Brahim, F; Bousfiha, A A; Ailal, F; Deswarte, C; Schurr, E; Amar, L; Bustamante, J; Boisson-Dupuis, S; Casanova, J L; Abel, L; El Baghdadi, J

    2016-12-01

    The utility of interferon-gamma release assays (IGRAs), such as the QuantiFERON-TB Gold In-Tube (QFT-GIT) test, in diagnosing active tuberculosis (TB) in children is unclear and depends on the epidemiological setting. To evaluate the performance of QFT-GIT for TB diagnosis in children living in Morocco, an intermediate TB incidence country with high bacille Calmette-Gurin vaccination coverage. We prospectively recruited 109 Moroccan children hospitalised for clinically suspected TB, all of whom were tested using QFT-GIT. For 81 of the 109 children, the final diagnosis was TB. The remaining 28 children did not have TB. QFT-GIT had a sensitivity of 66% (95%CI 5277) for the diagnosis of TB, and a specificity of 100% (95%CI 88100). The tuberculin skin test (TST) had lower sensitivity, at 46% (95%CI 3360), and its concordance with QFT-GIT was limited (69%). Combining QFT-GIT and TST results increased sensitivity to 83% (95%CI 6992). In epidemiological settings such as those found in Morocco, QFT-GIT is more sensitive than the TST for active TB diagnosis in children. Combining the TST and QFT-GIT would be useful for the diagnosis of active TB in children, in combination with clinical, radiological and laboratory data.

  17. An examination of family functioning utilizing the circumplex model in psychiatrically hospitalized children with depression.

    Science.gov (United States)

    Kashani, J H; Allan, W D; Dahlmeier, J M; Rezvani, M; Reid, J C

    1995-10-09

    The purpose of the current study was to explore the relationship between childhood depression and family functioning. 11 children with depression and 11 children without depression were compared via scores on the adaptability and cohesion dimensions of the FACES-III-K. Children with depression reported significantly less cohesive and more disengaged (displaying emotional separateness and lack of closeness) families than children without depression. Cohesion (the emotional bonding and individual autonomy of family members), but not adaptability, appears to be an important factor in the relationship between family functioning and childhood depression. Clinicians are advised to use treatments designed to help alleviate low family cohesion for children with depression.

  18. Comparing the convergent validity and clinical utility of the Behavior Assessment System for Children-Parent Rating Scales and Child Behavior Checklist in children with epilepsy.

    Science.gov (United States)

    Allison Bender, H; Auciello, Dominick; Morrison, Chris E; MacAllister, William S; Zaroff, Charles M

    2008-07-01

    The convergent validity and clinical utility of two parent-report child behavior rating scales, the Behavior Assessment System for Children-Parent Rating Scales (BASC-PRS) and Child Behavior Checklist/Ages 6-18 (CBCL), in children with epilepsy were examined. Analogous broadband and narrowband behavior rating scales were evaluated in 60 subjects aged 6-17 years (mean=11.0, SD=3.4) with Full Scale IQ >70. Correlations for each similarly labeled scale were statistically significant (Passessing behavior problems in pediatric epilepsy.

  19. Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy.

    Science.gov (United States)

    Dey, Michelle; Wang, Jen; Jorm, Anthony Francis; Mohler-Kuo, Meichun

    2015-03-01

    To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Mental health problems were perceived as being more severe (p physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p literacy.

  20. A Cost-Utility Analysis of 5 Strategies for the Management of Acute Otitis Media in Children.

    Science.gov (United States)

    Shaikh, Nader; Dando, Emily E; Dunleavy, Mark L; Curran, Dorothy L; Martin, Judith M; Hoberman, Alejandro; Smith, Kenneth J

    2017-10-01

    To assess whether antimicrobial therapy in young children with acute otitis media reduces time to resolution of symptoms, overall symptom burden, and persistence of otoscopic evidence of infection. We used a cost-utility model to evaluate whether immediate antimicrobial treatment seems to be worthwhile, and if so, which antimicrobial agent is most cost effective. We compared the cost per quality-adjusted life-day of 5 treatment regimens in children younger than 2 years of age with acute otitis media: immediate amoxicillin/clavulanate, immediate amoxicillin, immediate cefdinir, watchful waiting, and delayed prescription (DP) for antibiotic. The 5 treatment regimens, listed in order from least effective to most effective were DP, watchful waiting, immediate cefdinir, immediate amoxicillin, and immediate amoxicillin/clavulanate. Listed in order from least costly to most costly, the regimens were DP, immediate amoxicillin, watchful waiting, immediate amoxicillin/clavulanate, and immediate cefdinir. The incremental cost-utility ratio of immediate amoxicillin compared with DP was $101.07 per quality-adjusted life-day gained. The incremental cost-utility ratio of immediate amoxicillin/clavulanate compared with amoxicillin was $2331.28 per quality-adjusted life-day gained. In children younger than 2 years of age with acute otitis media and no recent antibiotic exposure, immediate amoxicillin seems to be the most cost-effective initial treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The upper arm muscle and fat area of Santal children: an evaluation of nutritional status.

    Science.gov (United States)

    Chowdhury, Sutanu Dutta; Ghosh, Tusharkanti

    2009-01-01

    The purpose of this study is to determine the growth pattern of upper arm muscle area (UAMA), upper arm fat area (UAFA) and upper arm muscle area by height (UAMAH) and assessment of magnitude of undernutrition on the basis of these parameters in Santal children. UAMA and UAFA of 890 (473 boys and 417 girls) Santal children aged 5-12 years were calculated from mid-upper arm circumference and triceps skinfold. Growth curves of UAFA-for-age and UAMA by height in Santal boys and girls are placed at lower level of reference curve indicating severe undernutrition. The growth curves of UAMA-for-age in Santal children of both sexes do not indicate severe undernutrition. 17.13% Santal boys and 20.63% girls were truly undernourished on the basis of three Z-scores of height-for-age, weight-for-height and UAMAH of each subject. Santal children have more UAMA and less UAFA compared to similar undernourished children of Sugalis. Growth curves of UAFA-for-age and UAMA by height are good indicators of nutritional status in Santal children. UAMA and UAFA may not be similarly affected in undernourished children of every community. A comprehensive approach to identify the truly undernourished child has been suggested from this study.

  2. Associations of the type of childcare with reported preventive medical and dental care utilization for 1- to 5-year-old children in the United States.

    Science.gov (United States)

    Kim, Juhee; Kaste, Linda M

    2013-10-01

    Despite that the majority of US children use nonparental childcare (NPC), research examining its effects on children's preventive healthcare utilization is lacking. Our aim was to contrast NPC against parental childcare in terms of preventive medical and dental care utilization. Associations of childcare and healthcare utilization were evaluated using the 2007 National Survey of Children's Health, a telephone interview of parent-reported children's health (22,773 children ages 1- to 5-year old). The type of childcare was categorized as parental care, center-based care (CBC), nonrelative home care (NRHC), relative care (RCC), and mixed care (MCC). The outcome measures were preventive medical care (≥ 1 physical examination/well child check-up visit) and preventive dental care (≥ 1 check-ups/dental cleanings visit) during the past 12 months. Overall, 94.7% of 1- to 5-year-old children received preventive medical care, while only 53.6% received preventive dental care. The highest odds for preventive medical care was for 1- to 2-year-old children utilizing CBC [Odds Ratio (OR) = 2.85, 95% CI = 1.11-7.30] and for 3- to 5-year-old children utilizing MCC (OR = 2.00, 95% CI = 1.23-3.26) followed by CBC (OR = 1.66, 95% CI = 1.13-2.42). Considering preventive dental care, a statistically significant increase occurred for 1- to 2-year-old children with CBC (OR = 1.93, 95% CI = 1.62-2.30), and none occurred for any NPC above the parental childcare rates for 3- to 5-year-old children. Childcare use, particularly center-based care, may provide a means to raise preventive healthcare utilization for young children. Future regulations, as well as policy and program development, should consider promoting childcare settings as a means to improve preventive health care utilization. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Utility of Accelerometers to Measure Physical Activity in Children Attending an Obesity Treatment Intervention

    Directory of Open Access Journals (Sweden)

    Wendy Robertson

    2011-01-01

    Full Text Available Objectives. To investigate the use of accelerometers to monitor change in physical activity in a childhood obesity treatment intervention. Methods. 28 children aged 7–13 taking part in “Families for Health” were asked to wear an accelerometer (Actigraph for 7-days, and complete an accompanying activity diary, at baseline, 3-months and 9-months. Interviews with 12 parents asked about research measurements. Results. Over 90% of children provided 4 days of accelerometer data, and around half of children provided 7 days. Adequately completed diaries were collected from 60% of children. Children partake in a wide range of physical activity which uniaxial monitors may undermonitor (cycling, nonmotorised scootering or overmonitor (trampolining. Two different cutoffs (4 METS or 3200 counts⋅min-1 for minutes spent in moderate and vigorous physical activity (MVPA yielded very different results, although reached the same conclusion regarding a lack of change in MVPA after the intervention. Some children were unwilling to wear accelerometers at school and during sport because they felt they put them at risk of stigma and bullying. Conclusion. Accelerometers are acceptable to a majority of children, although their use at school is problematic for some, but they may underestimate children's physical activity.

  4. Association Between Body Weight at Weaning and Remodeling in the Subcutaneous Adipose Tissue of Obese Adult Mice With Undernourishment In Utero

    Science.gov (United States)

    Kohmura, Yukiko Kobayashi; Kanayama, Naohiro; Muramatsu, Keiko; Tamura, Naoaki; Yaguchi, Chizuko; Uchida, Toshiyuki; Suzuki, Kazunao; Sugihara, Kazuhiro; Aoe, Seiichiro; Sasaki, Takeshi; Suganami, Takayoshi; Ogawa, Yoshihiro

    2013-01-01

    Rapid growth in infancy considerably increases the risk of obesity and metabolic disorders in adulthood especially among neonates born small. To investigate the mechanism involved, we developed an animal model of undernourishment in utero by maternal caloric restriction, in which the Z scores of body weight at weaning (19.5 days) positively correlated with parameters of obesity, metabolic disorders, and remodeling of subcutaneous adipose tissue, such as numbers of macrophages in adipose tissue, the ratio of inflammatory M1 to anti-inflammatory M2 macrophages, estimated by gene expression of specific antigens, and the relative ratio of small adipocytes less than 30 μm in diameter, on a high-fat diet at 17 weeks of age. To our knowledge, this is the first report of a possible connection between infantile body weight and adipose tissue remodeling in obesity after undernourishment in utero. PMID:23296035

  5. Utilization of free dental health care services provided to the perinatally infected human immunodeficiency virus children in Bangalore: longitudinal study.

    Science.gov (United States)

    Parvathy, Beena Javaregowda

    2014-01-01

    Use of Highly active anti-retroviral therapy have increased the life expectancy of human immunodeficiency virus (HIV) infected patients and hence it is imperative that all efforts have to be made by Pediatric dentists to provide a better oral health for these children. The aim of this study was to evaluate the rate of utilization of free dental treatment provided to these perinatally infected HIV positive children who were previously screened as a part of oral health survey. Purposive sampling was used. Perinatally infected HIV children screened for oral health status. Patients not screened during the oral health survey. Attendance records of 319 perinatally HIV infected children consisting of 178 males and 141 females attending a specialized pediatric outpatient clinic at Indira Gandhi Institute of Child Health were examined to compare treatment compliance rates. The number of patients in the severe category who completed treatment was significantly less compared with mild and advanced categories (P patients who completed treatment between mild and advanced group was not statistically significant (P > 0.05). The results show that children with HIV have significantly lower compliance. Even though all dental treatment provided to them was free of the cost it still had no impetus to encourage them to go through with the treatment.

  6. Utilization of free dental health care services provided to the perinatally infected human immunodeficiency virus children in Bangalore: Longitudinal study

    Directory of Open Access Journals (Sweden)

    Beena Javaregowda Parvathy

    2014-01-01

    Full Text Available Background: Use of Highly active anti-retroviral therapy have increased the life expectancy of human immunodeficiency virus (HIV infected patients and hence it is imperative that all efforts have to be made by Pediatric dentists to provide a better oral health for these children. Aim: The aim of this study was to evaluate the rate of utilization of free dental treatment provided to these perinatally infected HIV positive children who were previously screened as a part of oral health survey. Design: Purposive sampling was used. Inclusion criteria: Perinatally infected HIV children screened for oral health status. Exclusion criteria: Patients not screened during the oral health survey. Materials and Methods: Attendance records of 319 perinatally HIV infected children consisting of 178 males and 141 females attending a specialized pediatric outpatient clinic at Indira Gandhi Institute of Child Health were examined to compare treatment compliance rates. Results: The number of patients in the severe category who completed treatment was significantly less compared with mild and advanced categories (P 0.05. Conclusion: The results show that children with HIV have significantly lower compliance. Even though all dental treatment provided to them was free of the cost it still had no impetus to encourage them to go through with the treatment.

  7. Utility of Dermatoglyphic Pattern in Prediction of Caries in Children of Telangana Region, India.

    Science.gov (United States)

    Asif, Shaik M; Babu, Dara Bg; Naheeda, Shaik

    2017-06-01

    Dermatoglyphics is an extremely useful tool as a preliminary investigation method for diagnosing suspected genetic disorders. Caries being a multifactorial disease with the influence of genetic pattern, early identification of caries risk children with dermatoglyphics can help in using effective and efficient caries preventive measures. The study was undertaken to record and know the frequency of occurrence of fingerprint patterns among children with caries and in children without caries. A total of 400 schoolchildren in the age group of 5 to 12 years were selected from a private school, Warangal, Telangana, India. Of 400 schoolchildren, 200 children were with caries group and 200 children were in caries-free group. Children with dental caries in five or more teeth based on the decayed, missing, filled teeth index performed were considered as study group, and the control group was normal healthy children without any dental caries. The fingerprints of each child were recorded using stamp pad method, and type of dermatoglyphic pattern of each digit was recorded based on Cummins and Midlo method. Data obtained were put for statistical analysis; p Dermatoglyphics could be an appropriate method to explore the possibility of a noninvasive and an early predictor for dental caries. Dermatoglyphics has a future role in identifying people with or at increased risk for dental caries so that risk reduction measures or earlier therapy may be instituted.

  8. A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.

    Science.gov (United States)

    Jonassaint, Charles R; Jones, Victor L; Leong, Sharlene; Frierson, Georita M

    2016-07-01

    Patients with sickle cell disease (SCD) experience a disproportionately high use of health care resources. Several studies have examined depression and other negative mood states as risk factors for increased health care utilization; however, there have been no systematic reviews examining and summarizing this evidence in SCD. The aim of this systematic review, therefore, was to determine whether depression or depressive symptoms are associated with health care utilization among children and adults with SCD. We followed a quantitative systematic review protocol based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines and performed a literature search of records from January 1980 to April 2014 using six databases. Empirical studies were eligible if the sample was primarily composed of patients with SCD and included data on depression, mood disorder diagnosis or depressive symptoms and health care utilization. We included 12 studies involving 54 036 unique participants. The prevalence estimates for depression ranged from 2-57%. Seven studies found a significant, or marginally significant, association between depression and utilization while five did not. Patients reporting depression had an estimated 2·8 times greater relative risk of being a high utilizer, and 2·9 versus 1·8 hospitalizations per year on average compared to patients without depression. Overall, depressive symptoms are common in SCD and may increase risk for poor outcomes including health care utilization. The available studies on depression in SCD, however, are limited by small sample sizes, retrospective designs or short follow-up. This systematic review found a modest association between depression and health care utilization in SCD. © 2016 John Wiley & Sons Ltd.

  9. Trends in the utilization of computed tomography and cardiac catheterization among children with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Justin Cheng-Ta Yang

    2015-11-01

    Conclusion: The use of noninvasive CT in children with selected heart conditions might reduce the use of diagnostic cardiac catheterization. This may release time and facilities within the catheterization laboratory to meet the increasing demand for cardiac interventions.

  10. Guía de atención integral al paciente desnutrido en el Servicio de Urgencias Guide of comprehensive care to undernourished patient at an emergency service

    Directory of Open Access Journals (Sweden)

    Lázaro Rodolfo Alfonso Novo

    2007-06-01

    Full Text Available Se define una estrategia secuencial de conductas con el niño desnutrido que acude al Servicio de Urgencia del policlínico o del hospital. Esta estrategia está basada en la necesidad de estandarizar la atención al paciente que es remitido por el Médico de Familia al escalón superior de atención de salud y que es recibido de inicio por un personal médico y paramédico en un servicio de urgencias. Se hace muy necesario elevar el conocimiento y el nivel de desempeño respecto a este tipo de paciente, cuyo seguimiento es en extremo importante, ya que de él depende en muchos casos el pronóstico de vida. La aplicación consecuente de esta atención integral asegura la buena evolución del paciente. Se concluye en que el desnutrido, por sus características muy especiales, necesita una atención de emergencia de elevada calidad que consiga la disminución del riesgo de morbilidad y mortalidad.This paper described a sequential strategy of behaviours that should be followed in the case of an undernourished child that goes to the Emergency Service at the polyclinics or hospital. This strategy is based on the need of standardizing the care to a patient who has been referred by the family physician to the upper level of health care and initially received by a medical and paramedical staff in an emergency room. It is indispensable to raise the level of knowledge and performance in treating this kind of patient whose follow-up is extremely important, since most of the time life prognosis depends on it. The implementation of this comprehensive care assures the good course of recovery of the patient. It was concluded that the undernourished children, because of their very special characteristics, need a high quality care at the emergency service that leads to reduction in morbidity and mortality risks.

  11. Validation and clinical utility of a bowel habit questionnaire in school-age children.

    Science.gov (United States)

    Wald, Ellen R; Jagodzinski, Tanya D; Moyer, Stacey C L; Wald, Arnold; Eickhoff, Jens C; Edmonson, M Bruce

    2011-11-01

    The aim of the study was to validate a brief Bowel Habit Questionnaire (BHQ) with prospectively obtained data from a 14-day diary and to determine whether the BHQ predicts the development of medically significant constipation (MSC) during the following year. The BHQ was distributed to parents of children ages 5 to 8 years during health supervision visits. Both the BHQ and subsequent diary were scored to indicate constipation if at least 2 of the following were reported: infrequent bowel movements, stool accidents, straining, avoidance, discomfort with defecation, or passing large stools >25% of the time. One year later, the BHQ was repeated to assess for MSC, defined as medical encounters about constipation or use of enemas, suppositories, laxatives, or stool softeners. MSC was reported for 57 (13.7%) of 416 children on the first BHQ. Paired BHQ and diary data were obtained for 269 children; 54 (20.1%) had diary scores indicating constipation. BHQ had a sensitivity of 59.6% (95% confidence interval [CI] 46.7%-71.4%) and a specificity of 82.6% (95% CI 77.0%-87.1%). One year later, 11 children (5.2%) had developed new-onset MSC; 7 (63.6%) of these children had initial BHQ scores of at least 2. Positive and negative predictive values for MSC were 19.4% (95% CI 9.8%-35.0%) and 97.7% (94.2%-99.1%), respectively. Parents often do not recognize constipation in young school-age children and most constipated children remain untreated. A brief screening questionnaire in this population proved to be valid but only moderately sensitive; efforts to improve sensitivity are needed before recommending it for routine use.

  12. Utility of laboratory studies in seizures of children older than one month of age.

    Science.gov (United States)

    Karbasi, S Akhavan; Mosadegh, M Modares; Fallah, R

    2009-08-01

    Seizure is the most common paediatric neurological disease which occurs in ten percent of children. In approaching a convulsive patient, finding the causes of seizure is essential, and the patient's history as well as the physical examination are important. The role of routine laboratory tests for children's seizures (except neonates) is undetermined, but checking for serum sodium, glucose, calcium and urea routinely has been advised. The purpose of this study was to determine the diagnostic efficacy of these serum chemistry tests in the seizures of children older than one month of age. In this descriptive, retrospective study, medical records of 302 hospitalised children with seizure were reviewed. Results of laboratory tests, like sodium, calcium, blood glucose and urea levels, pertinent history and physical examination, and the change in patient management based on serum chemistry test results, were analysed. All the children in the study were classified as having seizure with or without fever. In 302 hospitalised children with seizure, about ten percent of 938 tests were abnormal. 27.7 percent of these abnormal results were seen in 1-12-month-old infants. Only 11 percent of abnormal tests (1.3 percent of total tests) might have caused a seizure. Also, 0.2 percent of the results could not be predicted from the history or physical examination, which was conducted in patients younger than one year of age. Routine determination of serum chemistry values in seizures of children does not contribute to therapy, and are costly and time-consuming. It may not be helpful and informative unless the patient is less than one year of age.

  13. Differences in utilization of dental procedures by children enrolled in Wisconsin Medicaid and Delta Dental insurance plans.

    Science.gov (United States)

    Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Okunseri, Christopher

    2017-12-01

    Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008. Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received. Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group. DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees. © 2016 American Association of Public Health Dentistry.

  14. Effects of welfare and maternal work on recommended preventive care utilization among low-income children.

    Science.gov (United States)

    Holl, Jane L; Oh, Elissa H; Yoo, Joan; Amsden, Laura B; Sohn, Min-Woong

    2012-12-01

    We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. We identified American Academy of Pediatrics-recommended preventive care visits from medical records of children in the 1999-2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.

  15. Utility of Octreotide in Advancing Enteral Feeds in Children with Chronic Intestinal Pseudo-Obstruction.

    Science.gov (United States)

    Ambartsumyan, Lusine; Flores, Alejandro; Nurko, Samuel; Rodriguez, Leonel

    2016-10-01

    Chronic intestinal pseudo-obstruction (CIPO) is a challenging disorder with high morbidity and mortality due to limited effective therapies that improve enteral tolerance. We aimed to present our experience using octreotide in children with CIPO and evaluate factors predicting therapy response. The study population included total parenteral nutrition (TPN)-dependent children with CIPO receiving octreotide at a tertiary care center. Octreotide response was defined as an enteral feeding increase of ≥10 cc/kg/day. A total of 16 children were included (median age 5 years, range 1-18; 88 % female). We observed an overall feed increase in 11/16 (69 %) subjects and 7/16 (44 %) were considered responders: three tolerated >65 cc/kg/day (discontinued TPN), one tolerated >30 cc/kg/day (decreased TPN) and three patients tolerated 10-12 cc/kg/day. We found an association between therapeutic octreotide response and both the presence of octreotide-induced intestinal phase III of the migrating motor complex (MMC) as well as a higher median increase in intestinal motility index after octreotide challenge during the antroduodenal manometry (p = 0.03 and children with CIPO and the antroduodenal manometry may be helpful in predicting octreotide response. Prospective studies are needed to evaluate the safety and efficacy of octreotide in children with CIPO.

  16. Utility of CT-compatible EEG electrodes in critically ill children

    International Nuclear Information System (INIS)

    Abend, Nicholas S.; Dlugos, Dennis J.; Zhu, Xiaowei; Schwartz, Erin S.

    2015-01-01

    Electroencephalographic monitoring is being used with increasing frequency in critically ill children who may require frequent and sometimes urgent brain CT scans. Standard metallic disk EEG electrodes commonly produce substantial imaging artifact, and they must be removed and later reapplied when CT scans are indicated. To determine whether conductive plastic electrodes caused artifact that limited CT interpretation. We describe a retrospective cohort of 13 consecutive critically ill children who underwent 17 CT scans with conductive plastic electrodes during 1 year. CT images were evaluated by a pediatric neuroradiologist for artifact presence, type and severity. All CT scans had excellent quality images without artifact that impaired CT interpretation except for one scan in which improper wire placement resulted in artifact. Conductive plastic electrodes do not cause artifact limiting CT scan interpretation and may be used in critically ill children to permit concurrent electroencephalographic monitoring and CT imaging. (orig.)

  17. The effect of health and dental insurance on US children's dental care utilization for urgent and non-urgent dental problems - 2008.

    Science.gov (United States)

    Naavaal, Shillpa; Barker, Laurie K; Griffin, Susan O

    2017-12-01

    We examined the association between utilization of care for a dental problem (utilization-DP) and parent-reported dental problem (DP) urgency among children with DP by type of health care insurance coverage. We used weighted 2008 National Health Interview Survey data from 2,834 children, aged 2-17 years with at least one DP within the 6 months preceding survey. Explanatory variables were selected based on Andersen's model of healthcare utilization. Need was considered urgent if DP included toothache, bleeding gums, broken or missing teeth, broken or missing filling, or decayed teeth and otherwise as non-urgent. The primary enabling variable, insurance, had four categories: none, private health no dental coverage (PHND), private health and dental (PHD), or Medicaid/State Children's Health Insurance Program (SCHIP). Predisposing variables included sociodemographic characteristics. We used bivariate and multivariate analyses to identify explanatory variables' association with utilization-DP. Using logistic regression, we obtained adjusted estimates of utilization-DP by urgency for each insurance category. In bivariate analyses, utilization-DP was associated with both insurance and urgency. In multivariate analyses, the difference in percent utilizing care for an urgent versus non-urgent DP among children covered by Medicaid/SCHIP was 32 percentage points; PHD, 25 percentage points; PHND, 12 percentage points; and no insurance, 14 percentage points. The difference in utilization by DP urgency was higher for children with Medicaid/SCHIP compared with either PHND or uninsured children. Expansion of Medicaid/SCHIP may permit children to receive care for urgent DPs who otherwise may not, due to lack of dental insurance. © 2016 American Association of Public Health Dentistry.

  18. Growth patterns reflect response to antiretroviral therapy in HIV-positive infants: potential utility in resource-poor settings.

    Science.gov (United States)

    Benjamin, D K; Miller, W C; Ryder, R W; Weber, D J; Walter, E; McKinney, R E

    2004-01-01

    Laboratory monitoring of HIV-infected children is the current standard of care in the United States to guide the appropriate use of antiretroviral therapy (ART). Although ART is becoming a reality in some developing countries, laboratory monitoring of ART is costly, necessitating creative approaches to monitoring. As an initial step to guide monitoring of HIV progression in low resource settings, we assessed the utility of the physical examination to predict clinical progression of HIV. We conducted a retrospective cohort study of HIV-infected children using data from Pediatric AIDS Clinical Trials Group Protocol 300. We developed a clinical predictive model, and compared the utility of the clinical model to the change in HIV RNA viral load as diagnostic tests of ART failure. The clinical model incorporated treatment regimen, age, and height velocity: a three-level clinical predictive model provided likelihood ratios of 0.3, 3.9, and 14. For decline in RNA the likelihood ratios were 0.2 (> 1 log decline), 1.4, and 3.5 (> log increase). We developed a simple clinical predictive model that was able to predict clinical progression of HIV after initiation of new ART. The clinical model performed similarly to using changes in HIV RNA viral load. These data should be validated internationally and prospectively, because the test subjects were from a resource rich environment and growth patterns in undernourished children may be impacted differently by HIV and its treatment. The model was most pertinent to children 36 months of age or younger, and was conducted in children receiving monotherapy and dual therapy.

  19. Access to and utilization of oral health care by homeless children/families.

    Science.gov (United States)

    DiMarco, Marguerite Ann; Ludington, Susan M; Menke, Edna M

    2010-05-01

    The Surgeon General called dental caries the silent epidemic, suffered disproportionately by the poor. Homeless mothers/children are especially vulnerable as they lack access to dental care. This prospective study elucidated predictors of access, oral health, and the effectiveness of shelter-based care. A convenience sample of 120 homeless families (children n=236) provided predictor factors at intake and one month later. Nearly half the children (n=98) had dental caries. Ten independent variables explained 33% of the variance of access barriers; the most influential were mental health (B=-.426), oral health beliefs (B=.243), and victimization (B=.185). Ten independent variables explained 24.3% of the variance of oral health: mother's age (B5.351), number of children at the shelter (B=.337), and race (B=.154) had the most influence. Shelter-based care was effective in improving access: 43% of families secured dental appointments and perceived access barriers decreased after shelter-based care (t=4.695; p=<.001).

  20. Lessons from healthcare utilization in children with obstructive sleep apnoea syndrome.

    Science.gov (United States)

    Martinez-Beneyto, Paz; Soria Checa, Cristina E; Botella-Rocamora, Paloma; Rincon-Piedrahita, Inés; Garcia Callejo, Francisco J; Algarra, Jaime Marco

    Paediatric Obstructive Sleep Apnoea-Hypopnoea Syndrome (OSAS) is a multisystemic condition affecting child's health status that may be investigated analyzing demand for healthcare. to quantify the frequency of medical consultations in children with OSAS over a 5-year period, compared to a healthy population. A longitudinal, case-control, ambispective study was conducted at a hospital pertaining to the national public health system. 69 consecutive children referred for OSAS were recruited with no diseases other than OSAS so that healthcare demand was purely attributed to this condition. Matched healthy control children were selected to compare these data. Data regarding frequency of the medical consultations were obtained over 5 years: the year of the treatment ("Year0"), 1 and 2 years before ("Year -1" and "Year -2" respectively), and 1 and 2 years after treatment ("Year+1" and "Year+2") RESULTS: Frequentation Index (FI), as ratio between the use of health services by OSAS children and healthy controls was 1.89 during Year-2, and 2.15 during Year-1 (Pde Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  1. Exercise-induced bronchospasm diagnosis in children. Utility of combined lung function tests.

    Science.gov (United States)

    Sánchez-García, Silvia; Rodríguez del Río, Pablo; Escudero, Carmelo; García-Fernández, Cristina; Ibáñez, Maria Dolores

    2015-02-01

    The diagnosis of exercise-induced asthma or bronchospasm (EIB) is a complex dare in daily clinical practice. The consensus is that if bronchial hyper-responsiveness (BHR) is demonstrated in a patient with symptoms consistent with EIB, then that patient can be diagnosed with exercise-induced bronchospasm. The aim of this study was to determine which BHR test is the most efficient to diagnose EIB. Children under 16, without previous asthma diagnosis, or with stable asthma, complaining of asthma-like symptoms triggered by exercise were included. Bronchodilator, methacholine, mannitol, and exercise tests were performed on all patients, following established protocols. The performance of single and combined tests was determined. Of 46 patients (median age: 12 yr, ranged 8-16 y.o.) were recruited, 30 (70%) previously diagnosed of asthma. BHR was detected in 93.47% of the children. The exercise challenge test detected BHR in 11 of 46 (23.90%) patients, bronchodilator test in 10 of 46 (21.70%), mannitol in 36 of 45 (80%) and methacholine in 41 of 45 (91.11%). The total number of patients with BHR was detected using a combination of the methacholine and mannitol tests. A combination of the methacholine test performed first, followed by the mannitol test, was able to diagnose BHR in 100% of children with lower number of tests (n = 45) than if the order was reversed (n = 50). Methacholine and mannitol tests detect BHR in most children with suspected EIB. Bronchodilator and exercise tests show a low positivity rate. A combination of the methacholine test, followed by the mannitol test, gives the highest return to identify BHR in children for the diagnosis of EIB. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  3. Patterns on the utilization of oral healthcare for children with HIV ...

    African Journals Online (AJOL)

    More than two-thirds (66.3%) of caregivers whose child experienced dental pain and/or or swelling sought treatment from the dental professional, 16.3% of them bought medicine from the chemist whilst 15.2% of caregivers utilized home remedy. However, only 11% of caregivers sought treatment in a timely manner, within ...

  4. Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool.

    Science.gov (United States)

    Ojha, A R; Aryal, U R

    2014-01-01

    Urinary tract infection is a common problem in children and its early diagnosis and treatment is important to prevent long-term complications. Urine dipstick can be an important tool in this respect. The aim of this study is to look at the utility of urine dipstick as a diagnostic tool for UTI and will also see the clinical profile of children with UTI and sensitivity pattern of antibiotics among the isolates of urine culture. Urine samples of all children below 14 years of age who were suspected of urinary tract infection were sent for routine microscopic examination and dipstick testing. Urine culture and sensitivity were sent for those samples that were tested positive for nitrite, leucocyte esterase activity or both. For every fifth sample, which is dipstick negative, a culture and sensitivity testing was done. Among 110 children enrolled, 32(29%) cases had significant bacteriuria. Out of 32 culture positive cases 18(56%) were female. Fever was the main complaint (62.5%)). Escherichia Coli was isolated in 81.25% of cases. Amikacin was sensitive in 93% and amoxicillinwas resistant in 82%. The sensitivity, specificity, positive predictive value, negative predictive value of nitrite test was 65%, 80%, 58%, 85% respectively; those of leucocyte esterase are 84%, 55%, 43%, 89% respectively; those for significant microscopic pyuria >10/hpf were 65%, 74%, 51%, 84% respectively. E. Coli is the commonest uropathogen in children with UTI. Amikacin is the most sensitive antibiotic against all the isolates. A positive dipstick both for nitrite and leucocyte esterase is associated with high sensitivity and specificity for urinary tract infection as compared to either of them positive alone. In addition, urine WBC ≥10/hpf is associated with high probability of UTI.

  5. Healthcare utilization and costs of children with attention deficit/hyperactivity disorder initiating atomoxetine versus extended-release guanfacine.

    Science.gov (United States)

    Molife, Cliff; Haynes, Virginia S; Nyhuis, Allen; Faries, Douglas E; Gelwicks, Steve; Kelsey, Douglas K; Alatorre, Carlos I

    2018-04-01

    To compare 1-year direct healthcare costs and utilization among children and adolescents initiating non-stimulant medications atomoxetine (ATX) or extended-release guanfacine (GXR). In this retrospective, observational cohort study, children and adolescents aged 6-17 years with attention deficit/hyperactivity disorder (ADHD) who had ≥1 prescription claim for ATX or GXR between December 31, 2009 and January 1, 2011 were identified in the MarketScan Commercial or Multi-State Medicaid claims databases. The first claim was set as the index. Patients with no claims for other ADHD medications that overlapped with the days' supply for the index therapy during the post-period were classified as initiating monotherapy. All-cause and ADHD-related utilization and costs (2011 US$) and treatment patterns (adherence and persistence) were evaluated during the 12 months following index. Propensity score adjustment accounted for differences in patient characteristics, and bootstrapping was used for comparisons. A total of 13,239 children and adolescents with ADHD met the study criteria (4,411 ATX initiators and 8,828 GXR initiators). There were 2,699 ATX monotherapy patients. In propensity-score-adjusted analyses, mean all-cause total costs were significantly less for monotherapy ATX initiators than for GXR initiators ($7,553 vs $10,639; difference = -$3,086, p < .0001), as were mean ADHD-related total costs ($3,213 vs $4,544; difference = -$1,330, p < .0001). Monotherapy ATX initiators had significantly fewer all-cause and ADHD-related total medical visits and ∼22 days shorter persistence to index therapy (p < .0001). Results were similar for secondary analyses comparing all ATX with all GXR initiators, regardless of monotherapy or combination regimen, and comparing only monotherapy initiators. Children and adolescents with ADHD who initiated ATX monotherapy incurred lower all-cause and ADHD-related total healthcare costs than patients who initiated GXR

  6. Utilization of genetic testing among children with developmental disabilities in the United States

    Directory of Open Access Journals (Sweden)

    Kiely B

    2016-07-01

    Full Text Available Bridget Kiely, Sujit Vettam, Andrew Adesman Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children’s Medical Center of New York, New Hyde Park, NY, USA Purpose: Several professional societies recommend that genetic testing be routinely included in the etiologic workup of children with developmental disabilities. The aim of this study was to determine the rate at which genetic testing is performed in this population, based on data from a nationally representative survey.Methods: Data were analyzed from the Survey of Pathways to Diagnosis and Services, a telephone-based survey of parents and guardians of US school-age children with current or past developmental conditions. This study included 3,371 respondents who indicated that their child had an autism spectrum disorder (ASD, intellectual disability (ID, and/or developmental delay (DD at the time of survey administration. History of genetic testing was assessed based on report by the parent/s. Children were divided into the following five mutually exclusive condition groups: ASD with ID; ASD with DD, without ID; ASD only, without ID or DD; ID without ASD; and DD only, without ID or ASD. Logistic regression was used to assess the demographic correlates of genetic testing, to compare the rates of genetic testing across groups, and to examine associations between genetic testing and use of other health-care services.Results: Overall, 32% of this sample had a history of genetic testing, including 34% of all children with ASD and 43% of those with ID. After adjusting for demographics, children with ASD + ID were more than seven times as likely as those with ASD only, and more than twice as likely as those who had ID without ASD, to have undergone genetic testing. Prior specialist care (developmental pediatrician or neurologist and access to all needed providers within the previous year were associated with higher odds of genetic testing

  7. Prognostic Utility of Clinical Epilepsy Severity Score Versus Pretreatment Hypsarrhythmia Scoring in Children With West Syndrome.

    Science.gov (United States)

    Sehgal, Rachna; Gulati, Sheffali; Sapra, Savita; Tripathi, Manjari; Pandey, Ravinder Mohan; Kabra, Madhulika

    2017-07-01

    This cross-sectional study assessed the impact of clinical epilepsy severity and pretreatment hypsarrhythmia severity on epilepsy and cognitive outcomes in treated children with West syndrome. Thirty-three children, aged 1 to 5 years, with infantile spasms were enrolled if pretreatment EEG records were available, after completion of ≥1 year of onset of spasms. Neurodevelopment was assessed by Development Profile 3 and Gross Motor Function Classification System. Epilepsy severity in the past 1 year was determined by the Early Childhood Epilepsy Severity Score (E-Chess). Kramer Global Score of hypsarrhythmia severity was computed. Kramer Global Score (≤8) and E-Chess (≤9) in the past 1 year were associated with favorable epilepsy outcome but not neurodevelopmental or motor outcome.

  8. Gestational Undernourishment Modifies the Composition of Skeletal Muscle Transverse Tubule Membranes and the Mechanical Properties of Muscles in Newborn Rats

    Directory of Open Access Journals (Sweden)

    Ricardo Tonathiu Ramírez-Oseguera

    2013-10-01

    Full Text Available Backgroud/Aims: Skeletal muscle (SM constitutes more than 40% of the body weight in adulthood. Transports dietary glucose mainly through the insulin-dependent glucose transporter (Glut-4 located in the Transverse tubule membrane system (TT. The TT development ends shortly after birth. The TT membrane hosts the proteins involved in excitation-contraction coupling and glucose uptake. Glycaemic regulation through movement is a key function of fully developed skeletal muscle. In this study, we aimed to characterize the effect of gestational undernourishment (GUN in rats GLUT-4 expression and on the protein/lipid content of the TT membranes. We also examined the effect of GUN on the mechanical properties of muscles as an indication of the metabolic condition of the SM at birth. Methods: Isolated TT membrane from SM of GUN rats were used to study lipid/protein content and protein stability by differential scanning calorimetry. The effect of GUN on the SM mechanical properties was determined in isolated Extensor Digitorum Longus (EDL muscle. Results: We demonstrate that compared to control, GUN in the new-born produces; i decreases body weight; ii diminution in SM mass; iii decreases the formation of TT membranes; iv expresses TT membrane proteins with higher thermal stability. The TT membrane expression of GLUT-4 in GUN offspring was twice that of controls. The isolated EDL of GUN offspring was 20% stronger as measured by contractile force and more resistant to fatigue relative to controls. Conclusion; These results provide the first evidence of adaptive changes of the SM in new-borns exposed to severe gestational food restriction. The effects of GUN on muscle at birth are the first step toward detrimental SM metabolic function, contributing to the physiopathology of metabolic diseases in adulthood.

  9. [Utilization of Occupational Therapy in Children - Results from the KiGGS Basis Survey].

    Science.gov (United States)

    Weber, A; Karch, D; Thyen, U; Rommel, A; Schlack, R; Hölling, H; von Kries, R

    2016-03-01

    A population-based analysis on use of occupational therapy by child's parentally reported health restrictions and socio-demographic determinants is missing. The basis KiGGS survey (2003 to 2006) reports on health in 17 641 children aged 0 to 17 years. The use of occupational therapy in the last 12 months could be ticked as other therapies with a free text field to name occupational therapy or others. Health restrictions potentially relevant for the use of occupational therapy and sociodemographic factors were assessed. The proportion of use of occupational therapy explained by the health restrictions was estimated by the population attributable risk fraction. The average use of occupational therapy for 3 to 13-year-olds was 2.4%. There was no association with the socioeconomic status; Children with immigration background used occupational therapy less often (e. g. age group 3 to 6 years: ORadjusted 0.2 [95-% KI: 0.1-1.0]). The proportion of occupational therapy explainable by the health restrictions considered ranged from 45% (3 to 6 years) to 65% (11 to 13 years). The lower use of occupational therapy in the KiGGS survey compared to health insurance reports may be explained by the ascertainment method. A lower use of occupational therapy related to immigration background matches lower use for physician visits. The causes for the low proportion of explained occupational therapy in young children and the lower use in children with immigration background warrant further research. © Georg Thieme Verlag KG Stuttgart · New York.

  10. The clinical utility of testicular prosthesis placement in children with genital and testicular disorders

    Science.gov (United States)

    2014-01-01

    Testicular prosthesis placement is a useful important adjunctive reconstructive therapy for managing children with testicular loss or absence. Though these prostheses are functionless, experience has shown that they are extremely helpful in creating a more normal male body image and in preventing/relieving psychological stress in males with a missing testicle. With attention to details of implant technique, excellent cosmetic results can be anticipated in simulating a normal appearing scrotum. PMID:26816795

  11. Cognitive Modules Utilized for Narrative Comprehension in Children: A Functional Magnetic Resonance Imaging Study

    OpenAIRE

    Schmithorst, Vincent J.; Holland, Scott K.; Plante, Elena

    2005-01-01

    The ability to comprehend narratives constitutes an important component of human development and experience. The neural correlates of auditory narrative comprehension in children were investigated in a large-scale functional magnetic resonance imaging (fMRI) study involving 313 subjects ages 5–18. Using group Independent Component Analysis (ICA), bilateral task-related components were found comprising the primary auditory cortex, the mid-superior temporal gyrus, the hippocampus, the angular g...

  12. Numerical processing efficiency improved in children using mental abacus: ERP evidence utilizing a numerical Stroop task

    Directory of Open Access Journals (Sweden)

    Yuan eYao

    2015-05-01

    Full Text Available This study examined whether long-term abacus-based mental calculation (AMC training improved numerical processing efficiency and at what stage of information processing the effect appeard. Thirty-three children participated in the study and were randomly assigned to two groups at primary school entry, matched for age, gender and IQ. All children went through the same curriculum except that the abacus group received a 2-hour/per week AMC training, while the control group did traditional numerical practice for a similar amount of time. After a two-year training, they were tested with a numerical Stroop task. Electroencephalographic (EEG and event related potential (ERP recording techniques were used to monitor the temporal dynamics during the task. Children were required to determine the numerical magnitude (NC task or the physical size (PC task of two numbers presented simultaneously. In the NC task, the AMC group showed faster response times but similar accuracy compared to the control group. In the PC task, the two groups exhibited the same speed and accuracy. The saliency of numerical information relative to physical information was greater in AMC group. With regards to ERP results, the AMC group displayed congruity effects both in the earlier (N1 and later (N2 and LPC (late positive component time domain, while the control group only displayed congruity effects for LPC. In the left parietal region, LPC amplitudes were larger for the AMC than the control group. Individual differences for LPC amplitudes over left parietal area showed a positive correlation with RTs in the NC task in both congruent and neutral conditions. After controlling for the N2 amplitude, this correlation also became significant in the incongruent condition. Our results suggest that AMC training can strengthen the relationship between symbolic representation and numerical magnitude so that numerical information processing becomes quicker and automatic in AMC children.

  13. Numerical processing efficiency improved in children using mental abacus: ERP evidence utilizing a numerical Stroop task.

    Science.gov (United States)

    Yao, Yuan; Du, Fenglei; Wang, Chunjie; Liu, Yuqiu; Weng, Jian; Chen, Feiyan

    2015-01-01

    This study examined whether long-term abacus-based mental calculation (AMC) training improved numerical processing efficiency and at what stage of information processing the effect appeard. Thirty-three children participated in the study and were randomly assigned to two groups at primary school entry, matched for age, gender and IQ. All children went through the same curriculum except that the abacus group received a 2-h/per week AMC training, while the control group did traditional numerical practice for a similar amount of time. After a 2-year training, they were tested with a numerical Stroop task. Electroencephalographic (EEG) and event related potential (ERP) recording techniques were used to monitor the temporal dynamics during the task. Children were required to determine the numerical magnitude (NC) (NC task) or the physical size (PC task) of two numbers presented simultaneously. In the NC task, the AMC group showed faster response times but similar accuracy compared to the control group. In the PC task, the two groups exhibited the same speed and accuracy. The saliency of numerical information relative to physical information was greater in AMC group. With regards to ERP results, the AMC group displayed congruity effects both in the earlier (N1) and later (N2 and LPC (late positive component) time domain, while the control group only displayed congruity effects for LPC. In the left parietal region, LPC amplitudes were larger for the AMC than the control group. Individual differences for LPC amplitudes over left parietal area showed a positive correlation with RTs in the NC task in both congruent and neutral conditions. After controlling for the N2 amplitude, this correlation also became significant in the incongruent condition. Our results suggest that AMC training can strengthen the relationship between symbolic representation and numerical magnitude so that numerical information processing becomes quicker and automatic in AMC children.

  14. Medication utilization for targeted symptoms in children and adults with fragile X syndrome: US survey.

    Science.gov (United States)

    Bailey, Donald B; Raspa, Melissa; Bishop, Ellen; Olmsted, Murrey; Mallya, Usha G; Berry-Kravis, Elizabeth

    2012-01-01

    To identify the most common neurological and behavioral symptoms treated by medications in individuals with fragile X syndrome (FXS), factors associated with treatment variability, and difficulty in swallowing a pill. A total of 1019 caregivers provided information about 1064 sons and 299 daughters with FXS in a US national survey. Caregivers reported (a) current use of medications for attention, anxiety, hyperactivity, mood swings, anger, depression, seizures, self-injury, or sleep; (b) perceived efficacy; and (c) difficulty in swallowing a pill. Sixty-one percent of males and 38% of females were currently taking medication for at least 1 symptom. The most common symptoms were anxiety, attention, and hyperactivity. Treatments for attention and hyperactivity were common in childhood but declined substantially after the age of 18 years; anxiety treatment remained high in adults. Children perceived to be more impaired and children diagnosed or treated for autism were more likely to be taking medications. Caregivers considered most medications somewhat effective, but less than one-third rated current medication as "a lot" effective. Many children had difficulty swallowing a pill, but only 11% of adult males and 2% of adult females had a lot of difficulty. Symptom-based medication use is common in FXS, although response is incomplete and there is clearly an unmet need for medications with improved efficacy. The persistent use of medications to treat anxiety, mood, and behavior problems throughout adolescence and into the adult years suggests important outcomes when evaluating the efficacy of new medications.

  15. Utility of Subjective Sleep Assessment Tools for Healthy Preschool Children: A Comparative Study Between Sleep Logs, Questionnaires, and Actigraphy

    Science.gov (United States)

    Iwasaki, Mizue; Iwata, Sachiko; Iemura, Akiko; Yamashita, Natsumi; Tomino, Yasushi; Anme, Tokie; Yamagata, Zentaro; Iwata, Osuke; Matsuishi, Toyojiro

    2010-01-01

    Background Sleep pattern is an important factor in a child’s mental, behavioural and physical status. To evaluate the sleep patterns of children, subjective tools such as sleep logs and questionnaires are still widely used in addition to objective methods of sleep assessment. Despite the established correlation between subjective and objective sleep variables, the characteristic features of subjective assessment have not been elucidated. Methods To investigate the characteristics of parental sleep assessment (daily sleep log and brief questionnaire) in preschool children, a 7-day actigraphic sleep study was conducted in 48 healthy 5-year-old children. Results Sleep schedule variables in the parental reports generally correlated well with actigraphic assessment of sleep patterns; however, sleep periods were longer in parental reports than in actigraphic recordings. Although the daily sleep log was better correlated with actigraphy, the brief questionnaire showed a good correlation with sleep pattern on weekday actigraphic assessments. Parental reports recorded fewer than 10% of the night wakings recorded by actigraphy. Conclusions Subjective sleep assessments remain useful, although their utility depends on the purpose and size of the study in question. However, knowledge of the potential biases and characteristics of such assessments is essential for correct interpretation of the data. PMID:20139658

  16. Nutritional Status of Children as an Indicator of Bushmeat Utilization in Western Serengeti

    OpenAIRE

    Peter Mramba, Rosemary

    2011-01-01

    Serengeti ecosystem supports great number of large mammals ranging from grazers, browsers and carnivores. Some of these animals migrate between seasonal water sources and grasslands. The human population in the western boundary of the park is currently high and increases at the rate of 4% per annum. Majority of local communities are subsistence farmers who derive their needs such as bush meat from the park. The purpose of the study was to test if bush meat utilization contributes to nutrition...

  17. Survival and medical utilization of children and adolescents with prolonged ventilator-dependent and associated factors.

    Directory of Open Access Journals (Sweden)

    Szu-Chi Pai

    Full Text Available Over the course of a year, more than 20,000 patients in Taiwan require prolonged mechanical ventilation (PMV. Data from the National Health Insurance Research Database for patients between 2005 and 2011 were used to conduct a retrospective analysis on ventilator dependence. The study subjects were PMV patients aged <17 years in Taiwan. A multiple regression model employing general estimating equations was applied to investigate the factors affecting the use of medical resources by children and adolescent PMV patients. A Cox proportional hazard model was incorporated to explore the factors affecting the survival of these patients. Data were collected for a total of 1,019 children and adolescent PMV patients in Taiwan. The results revealed that the average number of outpatient visits per subject was 32.1 times per year, whereas emergency treatments averaged 1.56 times per year per subject and hospitalizations averaged 160.8 days per year per subject. Regarding average annual medical costs, hospitalizations accounted for the largest portion at NT$821,703 per year per subject, followed by outpatient care at NT$123,136 per year per subject and emergency care at NT$3,806 per year per subject. The demographic results indicated that the patients were predominately male (61.24%, with those under 1 year of age accounting for the highest percentage (36.38%. According to the Kaplan-Meier curve, the 1-year and 5-year mortality rates of the patients were approximately 32% and 47%, respectively. The following factors affecting the survival rate were considered: age, the Charlson Comorbidity Index (CCI, diagnosis type necessitating ventilator use, and whether an invasive ventilator was used. This study investigated the use of medical resources and the survival rates of children and adolescent PMV patients. The findings of this study can serve as a reference for the National Health Insurance Administration in promoting its future integrated pilot projects on

  18. Utility of sedation for young children undergoing dimercaptosuccinic acid renal scans.

    Science.gov (United States)

    Shaikh, Nader; Hoberman, Alejandro; Keren, Ron; Ivanova, Anastasia; Ziessman, Harvey A; Cui, Gang; Mattoo, Tej K; Bhatnagar, Sonika; Nadkarni, Milan D; Moxey-Mims, Marva; Primack, William A

    2016-10-01

    No studies have examined whether use of sedation during a Tc-99 m dimercaptosuccinic acid (DMSA) renal scan reduces patient discomfort. To compare discomfort level during a DMSA scan to the discomfort level during other frequently performed uroradiologic tests, and to determine whether use of sedation during a DMSA scan modifies the level of discomfort. We examined the discomfort level in 798 children enrolled in the Randomized Intervention for children with Vesicoureteral Reflux (RIVUR) and Careful Urinary Tract Infection Evaluation (CUTIE) studies by asking parents to rate their child's discomfort level with each procedure on a scale from 0 to 10. We compared discomfort during the DMSA scan and the DMSA image quality between centers in which sedation was used >90% of the time (sedation centers), centers in which sedation was used <10% of the time (non-sedation centers), and centers in which sedation was used on a case-by-case basis (selective centers). Mean discomfort level was highest for voiding cystourethrogram (6.4), followed by DMSA (4.0), followed by ultrasound (2.4; P<0.0001). Mean discomfort level during the DMSA scan was significantly higher at non-sedation centers than at selective centers (P<0.001). No difference was apparent in discomfort level during the DMSA scan between sedation centers and selective centers (P=0.12), or between the sedation centers and non-sedation centers (P=0.80). There were no differences in the proportion with uninterpretable DMSA scans according to sedation use. Selective use of sedation in children 12-36 months of age can reduce the discomfort level experienced during a DMSA scan.

  19. Caregiver perceptions and utilization of oral rehydration solution and other treatments for diarrhea among young children in Burkina Faso.

    Science.gov (United States)

    Digre, Peder; Simpson, Evan; Cali, Shannon; Lartey, Belinda; Moodley, Melissa; Diop, Ndack

    2016-12-01

    More than 500 000 young children die from dehydration caused by severe diarrhea each year, globally. Although routine use of oral rehydration solution (ORS) could prevent almost all of these deaths, ORS utilization remains low in many low-income countries. Previous research has suggested that misperceptions among caregivers may be an obstacle to wider use of ORS. To better understand the extent of ORS utilization and the reasons for use or non-use in low-resource settings, the project team conducted a semi-structured, quantitative survey of 400 caregivers in Burkina Faso in 2014. All caregivers had a child below the age of five who had diarrhea lasting 2 days or more in the previous 2 months. Although more than 80% of caregivers were aware of ORS, less than half reported using it to treat their child's diarrhea. Replacing fluids lost due to diarrhea was considered a low priority by most caregivers, and many said they considered antibiotics more effective for treating diarrhea. Users and non-users of ORS held substantially different perceptions of the product, though all caregivers tended to follow recommendations of health care workers. A significant proportion of users reported difficulty in getting a child to drink ORS. Costs and access to ORS were not found to be significant barriers to use. Misperceptions among caregivers and health workers contribute to low utilization of ORS. Better caregiver understanding of diarrheal disease and the importance of rehydration, as well as increased recommendation by health workers, will help to increase ORS utilization. Improving product presentation and taste will also help to increase use.

  20. Utilization of oral health services network among children and adolescents with leukemia.

    Science.gov (United States)

    Curi, Davi Silva Carvalho; Gondim, Ihana Thaís Guerra de Oliveira; Figueiredo, Andréia Cristina Leal; Jamelli, Silvia Regina

    2018-03-26

    To evaluate the use of the network of oral health services by children and adolescents with leukemia, according to the phase of cancer treatment, type of dental treatment received, and access barriers. An exploratory cross-sectional study carried out in a referral hospital in cancer in northeast of Brazil, with all children and adolescents (3-16 years old) with leukemia who used dental services and who attended the medical consultation in the outpatient clinic between March and August 2016. The analysis of the medical records and a structured interview with caregivers were performed. The majority who used only the specialized network were in a single phase of cancer treatment (49.1%), had oral mucositis treatment (79.2%), and had a time of displacement for oral health services greater than 40 minutes (92.6%). In addition, dental care was centered in the specialized network (76.8%) and during hospitalization (37.7%). The findings suggest that the oral health care of these individuals is centered on tertiary care, reflecting a deficiency in communication between the network services, as well as the nonrecognition of the basic network as a caregiver source by its users. Despite this, more research is needed. © 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.

  1. Utility of Modeling End-Stage Liver Disease in Children with Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Hamid Reza Kianifar

    2014-01-01

    Full Text Available Introduction: Chronic liver diseases consist of wide spectrum disorders that may be complicated by cirrhosis and therefore need to transplantation. The pediatric end-stage liver disease (PELD score and model of end-stage liver disease (MELD score has been used as predictors of mortality chronic liver diseases listed for liver transplantation. The aim of this study is evaluation of relation between PELDMELD score and evidence of cirrhosis in children with choronic liver disease.   Materials and Method: This cross-sectional study conducted on 106 patients of chronic liver disease referred to Ghaem Haspital, Mashhad University of Medical Science, Iran during 24 months period (2010-2013. PELD and MELD score were calculated for all patients. Clincal and patholoogical findings of cirrhosis were recorded.   Results: Mean age of patients was 68/3 ± 41.8 months. Mean PELDMELD score was -1/59± 9/64. There was significant correlation between PELDMELD score and clinical icter, spelenomegaly, evidence of hepatopulminary syndrome, esophageal varices, evidence of cirrhosis in tissue specimences.   Conclusion: PELDMELD score appear to be benefit for detection of cirrhotic children among paients with choronic liver disease.

  2. 10. Utilization of Narrative Approach in Art Therapy in Children with Behavioural Problems

    Directory of Open Access Journals (Sweden)

    Hutyrová Miluše

    2016-03-01

    Full Text Available The article deals with the possibilities of applying narrative approach in art therapy context and focuses on the situation of problems in social and cultural contexts, the development of alternative stories, and externalization as one of the basic techniques of narrative therapy. Along with looking for dominant, alternative and preferred stories, externalization develops potential for therapeutic and education intervention in individuals of various target groups. The article focuses, in particular, on children exhibiting problematic behaviour and disordered behaviour. The objective is to find the points interconnecting narrative therapy and art therapy in the creative potential and artistic anchorage, which, along with expression, embody a challenge of new opportunities to find new ways, methods and approaches.

  3. Helicobacter pylori-related gastroduodenal disease in children. Diagnostic utility of enzyme-linked immunosorbent assay.

    Science.gov (United States)

    Glassman, M S; Dallal, S; Berezin, S H; Bostwick, H E; Newman, L J; Perez-Perez, G I; Blaser, M J

    1990-08-01

    To evaluate the accuracy of IgG and IgA serological tests in establishing a diagnosis of Helicobacter (Campylobacter) pylori gastric infection, 60 children presenting with chronic abdominal pain were prospectively studied. Endoscopic antral biopsies were obtained and analyzed for the presence of H. pylori using three standard methods: culture and identification of bacterial isolates, microscopic examination for morphologically characteristic bacteria, and urease production by the biopsy specimen. Concomitantly obtained serum samples were analyzed for the presence of IgG and IgA antibodies against H. pylori surface antigens using enzyme-linked immunosorbent assay (ELISA). Thirty-four of 60 (56.6%) had histological evidence of chronic active gastritis, eight of whom (13.3%) also had evidence of H. pylori infection by at least one criteria. Six of the eight infected patients had H. pylori demonstrated by all three methods. Of the eight infected patients, seven had IgG antibodies against H. pylori (sensitivity of 87%) and six had IgA antibodies (sensitivity of 75%). Among the six patients who had H. pylori infection confirmed by all three methods, all had IgG antibodies (sensitivity of 100%). In the patients without evidence of H. pylori infection, the IgG ELISA had a specificity of 96% (50/52), and the IgA ELISA had a specificity of 100% (52/52). Our data suggest that serological testing for the presence of antibodies against H. pylori may be a useful diagnostic tool in screening children with chronic abdominal pain for the presence of gastric infection with H. pylori.

  4. The Utilization of Traditional Medicine to Treat Fever in Children in Western Javanese Culture.

    Science.gov (United States)

    Maulida, Tiany Futihat; Wanda, Dessie

    2017-01-01

    Fever regularly affects toddlers and may make their parents uneasy. This study aimed to identify common traditional medicines used by parents to treat their children's fever at home. The study was conducted in Karyasari, Leuwiliang, Bogor District. It was descriptive in design, and the instrument used was a questionnaire developed by the authors. A group of 106 respondents was selected through the cluster sampling method. All respondents were female; the youngest was 20 years old, and the oldest was 53 years old. The majority of respondents had graduated from elementary and junior high school (93%), were currently unemployed (95%), and had a household income of less than Bogor's regional minimum wage (RMW) (91%). The majority of mothers (90.6%) identified fever through tactile perception. The most common traditional medicines used by respondents were onion (86.8%) mixed with oil (64.2%) and applied to the body (86.8%). The results of this study suggested the need for health education concerning the use of traditional medicine to treat fever.

  5. Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents

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    Bello NT

    2015-06-01

    Full Text Available Nicholas T Bello Department of Animal Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA Abstract: Attention deficit hyperactivity disorder (ADHD is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR. As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. Keywords: Intuniv, norepinephrine, prefrontal cortex, locus coeruleus, impulsivity, inattentive

  6. Morphological aspects of Schistosoma mansoni adult worms isolated from nourished and undernourished mice: a comparative analysis by confocal laser scanning microscopy

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    Neves Renata Heisler

    2001-01-01

    Full Text Available Malnutrition hampers the course of schistosomiasis mansoni infection just as normal growth of adult worms. A comparative morphometric study on adult specimens (male and female recovered from undernourished (fed with a low protein diet - regional basic diet and nourished (rodent commercial laboratory food, NUVILAB white mice was performed. Tomographic images and morphometric analysis of the oral and ventral suckers, reproductive system and tegument were obtained by means of confocal laser scanning microscopy. Undernourished male specimens presented smaller morphometric values (length and width of the reproductive system (first, third and last testicular lobes and thickness of the tegument than controls. Besides that, it was demonstrated that the dorsal surface of the male worms bears large tubercles unevenly distributed, but kept grouped and flat. At the subtegumental region, vacuolated areas were detected. It was concluded that the inadequate nutritional status of the vertebrate host has a negative influence mainly in the reproductive system and topographical somatic development of male adult Schistosoma mansoni, inducing some alterations on the structure of the parasite.

  7. Perioperative oral nutritional supplements in normally or mildly undernourished geriatric patients submitted to surgery for hip fracture: a randomized clinical trial.

    Science.gov (United States)

    Botella-Carretero, José I; Iglesias, Borja; Balsa, José A; Arrieta, Francisco; Zamarrón, Isabel; Vázquez, Clotilde

    2010-10-01

    Oral nutritional supplements have been recommended after orthopedic surgery in geriatric patients. This has been shown to be effective even in normally nourished or mildly undernourished geriatric patients. Whether perioperative administration of these products is also effective and suitable is not known. Randomized, controlled, open, paralleled two-arms clinical trial, comparing energy-protein supplements (40 g of protein and 400 kcal per day), with no intervention in normally nourished or mildly undernourished patients. Outcomes were serum proteins, body mass index, postoperative complications among others. 60 Elderly patients were included. Patients in the intervention group (n = 30) ingested 52.2 ± 12.1% of the prescribed supplements per day for 5.8 ± 1.8 days before surgery and until hospital discharge. There was a significant change in serum albumin at follow-up (F = 22.536, P supplemented proteins per day (OR[95%CI] = 0.925[0.869-0.985]) were associated with less postoperative complications (R(2) = 0.323, χ(2) = 11.541, P = 0.003). Perioperative supplements in geriatric patients with hip fracture submitted to surgery showed better recovery of plasma proteins. Higher daily protein intakes were associated with less postoperative complications. Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. The relationship between body system-based chronic conditions and dental utilization for Medicaid-enrolled children: a retrospective cohort study

    Science.gov (United States)

    2012-01-01

    Background Dental care is the most common unmet health care need for children with chronic conditions. However, anecdotal evidence suggests that not all children with chronic conditions encounter difficulties accessing dental care. The goals of this study are to evaluate dental care use for Medicaid-enrolled children with chronic conditions and to identify the subgroups of children with chronic conditions that are the least likely to use dental care services. Methods This study focused on children with chronic conditions ages 3-14 enrolled in the Iowa Medicaid Program in 2005 and 2006. The independent variables were whether a child had each of the following 10 body system-based chronic conditions (no/yes): hematologic; cardiovascular; craniofacial; diabetes; endocrine; digestive; ear/nose/throat; respiratory; catastrophic neurological; or musculoskeletal. The primary outcome measure was use of any dental care in 2006. Secondary outcomes, also measured in 2006, were use of diagnostic dental care, preventive dental care, routine restorative dental care, and complex restorative dental care. We used Poisson regression models to estimate the relative risk (RR) associated with each of the five outcome measures across the 10 chronic conditions. Results Across the 10 chronic condition subgroups, unadjusted dental utilization rates ranged from 44.3% (children with catastrophic neurological conditions) to 60.2% (children with musculoskeletal conditions). After adjusting for model covariates, children with catastrophic neurological conditions were significantly less likely to use most types of dental care (RR: 0.48 to 0.73). When there were differences, children with endocrine or craniofacial conditions were less likely to use dental care whereas children with hematologic or digestive conditions were more likely to use dental care. Children with respiratory, musculoskeletal, or ear/nose/throat conditions were more likely to use most types of dental care compared to other

  9. The relationship between body system-based chronic conditions and dental utilization for Medicaid-enrolled children: a retrospective cohort study.

    Science.gov (United States)

    Chi, Donald L; Raklios, Nicholas A

    2012-08-07

    Dental care is the most common unmet health care need for children with chronic conditions. However, anecdotal evidence suggests that not all children with chronic conditions encounter difficulties accessing dental care. The goals of this study are to evaluate dental care use for Medicaid-enrolled children with chronic conditions and to identify the subgroups of children with chronic conditions that are the least likely to use dental care services. This study focused on children with chronic conditions ages 3-14 enrolled in the Iowa Medicaid Program in 2005 and 2006. The independent variables were whether a child had each of the following 10 body system-based chronic conditions (no/yes): hematologic; cardiovascular; craniofacial; diabetes; endocrine; digestive; ear/nose/throat; respiratory; catastrophic neurological; or musculoskeletal. The primary outcome measure was use of any dental care in 2006. Secondary outcomes, also measured in 2006, were use of diagnostic dental care, preventive dental care, routine restorative dental care, and complex restorative dental care. We used Poisson regression models to estimate the relative risk (RR) associated with each of the five outcome measures across the 10 chronic conditions. Across the 10 chronic condition subgroups, unadjusted dental utilization rates ranged from 44.3% (children with catastrophic neurological conditions) to 60.2% (children with musculoskeletal conditions). After adjusting for model covariates, children with catastrophic neurological conditions were significantly less likely to use most types of dental care (RR: 0.48 to 0.73). When there were differences, children with endocrine or craniofacial conditions were less likely to use dental care whereas children with hematologic or digestive conditions were more likely to use dental care. Children with respiratory, musculoskeletal, or ear/nose/throat conditions were more likely to use most types of dental care compared to other children with chronic

  10. Trends in resource utilization by children with neurological impairment in the United States inpatient health care system: a repeat cross-sectional study.

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    Jay G Berry

    2012-01-01

    Full Text Available Care advances in the United States (US have led to improved survival of children with neurological impairment (NI. Children with NI may account for an increasing proportion of hospital resources. However, this assumption has not been tested at a national level.We conducted a study of 25,747,016 US hospitalizations of children recorded in the Kids' Inpatient Database (years 1997, 2000, 2003, and 2006. Children with NI were identified with International Classification of Diseases, 9th Revision, Clinical Modification diagnoses resulting in functional and/or intellectual impairment. We assessed trends in inpatient resource utilization for children with NI with a Mantel-Haenszel chi-square test using all 4 y of data combined. Across the 4 y combined, children with NI accounted for 5.2% (1,338,590 of all hospitalizations. Epilepsy (52.2% [n = 538,978] and cerebral palsy (15.9% [n = 164,665] were the most prevalent NI diagnoses. The proportion of hospitalizations attributable to children with NI did not change significantly (p = 0.32 over time. In 2006, children with NI accounted for 5.3% (n = 345,621 of all hospitalizations, 13.9% (n = 3.4 million of bed days, and 21.6% (US$17.7 billion of all hospital charges within all hospitals. Over time, the proportion of hospitalizations attributable to children with NI decreased within non-children's hospitals (3.0% [n = 146,324] in 1997 to 2.5% [n = 113,097] in 2006, p<.001 and increased within children's hospitals (11.7% [n = 179,324] in 1997 to 13.5% [n = 209,708] in 2006, p<0.001. In 2006, children with NI accounted for 24.7% (2.1 million of bed days and 29.0% (US$12.0 billion of hospital charges within children's hospitals.Children with NI account for a substantial proportion of inpatient resources utilized in the US. Their impact is growing within children's hospitals. We must ensure that the current health care system is staffed, educated, and equipped to serve this growing segment of vulnerable children.

  11. Psychometrics and utility of Psycho-Educational Profile-Revised as a developmental quotient measure among children with the dual disability of intellectual disability and autism.

    Science.gov (United States)

    Alwinesh, Merlin Thanka Jemi; Joseph, Rachel Beulah Jansirani; Daniel, Anna; Abel, Julie Sandra; Shankar, Satya Raj; Mammen, Priya; Russell, Sushila; Russell, Paul Swamidhas Sudhakar

    2012-09-01

    There is no agreement about the measure to quantify the intellectual/developmental level in children with the dual disability of intellectual disability and autism. Therefore, we studied the psychometric properties and utility of Psycho-Educational Profile-Revised (PEP-R) as a developmental test in this population. We identified 116 children with dual disability from the day care and inpatient database of a specialised Autism Clinic. Scale and domain level scores of PEP-R were collected and analyzed. We examined the internal consistency, domain-total correlation of PEP-R and concurrent validity of PEP-R against Gesell's Developmental Schedule, inter-rater and test-retest reliability and utility of PEP-R among children with dual disability in different ages, functional level and severity of autism. Besides the adequate face and content validity, PEP-R demonstrates a good internal consistency (Cronbach's α ranging from 0.91 to 0.93) and domain-total correlation (ranging from 0.75 to 0.90). The inter-rater reliability (intraclass correlation coefficient, ICC = 0.96) and test-retest reliability (ICC = 0.87) for PEP-R is good. There is moderate-to-high concurrent validity with GDS (r ranging from 0.61 to 0.82; all Ps = 0.001). The utility of PEP-R as a developmental measure was good with infants, toddlers, pre-school and primary school children. The ability of PEP-R to measure the developmental age was good, irrespective of the severity of autism but was better with high-functioning children. The PEP-R as an intellectual/developmental test has strong psychometric properties in children with dual disability. It could be used in children with different age groups and severity of autism. PEP-R should be used with caution as a developmental test in children with dual disability who are low functioning.

  12. The utility of screen for child anxiety related emotional disorders (SCARED) as a tool for identifying children at high risk for prevalent anxiety disorders

    NARCIS (Netherlands)

    Muris, P.; Merckelbach, H.; Kindt, M.; Bögels, S.; Dreessen, L.; van Dorp, C.; Habets, A.; Rosmuller, S.; Snieder, N.

    2001-01-01

    The current study examined the utility of the Screen for Child Anxiety Related Emotional Disorders (SCARED) as a screening tool for the identification of children at high risk for prevalent childhood anxiety disorders. The child version of the Structured Clinical Interview for DSM (KSCID) was used

  13. Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children.

    Science.gov (United States)

    Powell, C A; Walker, S P; Chang, S M; Grantham-McGregor, S M

    1998-10-01

    Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programs, few programs have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age -1 SD). Both groups were stratified by class and school, then randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for 1 school year. Children in the control group were given one-quarter of an orange and the same amount of attention as children in the breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the schools' registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast group. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children's nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programs including health and educational inputs as well as school meals.

  14. A study on the awareness, beliefs, and service utilization among families of children with cerebral palsy in Jalandhar District of Punjab

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    Raju Sharma

    2014-01-01

    Full Text Available Introduction: Cerebral palsy (CP is emerging as one of the main causes of childhood disability in India. Care provided to children with disability largely depends on the awareness, beliefs, and socioeconomic status of the community. This study examines the influence of awareness, beliefs, concerns, and socioeconomic status of the families having children with cerebral palsy in Jalandhar District as one of the cities of state Punjab, Northern India, on the service utilization pattern. Materials and Methods: The study has been approved by BPSAR, Punjabi university, Patiala. Personal interview of 248 families of the children with cerebral palsy using semi structured questionnaire has been the tool for data collection. Results: The awareness of key legislative acts on disability has been nil, though 16.1% parents know about Right to Education (RTE act and have some knowledge of disability certificate, travelling concession, and benefits and tax rebates available to parents of children with disability. Close to 70% families believe that the condition of the child is so because of the deeds of parents in their previous life and almost an equal number accuse the mother for present condition of her child. Care of child after the demise of parents and the scattered facilities of rehabilitation were the main concerns. Massage has been the most common service utilized by 57.6% followed by physiotherapy (55.6% and orthoses (38.70%. Speech therapy and special education has been utilized for just 4% of the children belonging to upper and middle classes only and none of the children of any class has received occupational therapy. Conclusion: The awareness level and pattern of service utilization was significantly (P < 0.05 associated with the socio-economical status of family and awareness of rehab services requirements. The findings of the study reinforce that it is essential that concrete steps should be taken to sensitize the community and medical

  15. Parental immigration status is associated with children's health care utilization: findings from the 2003 new immigrant survey of US legal permanent residents.

    Science.gov (United States)

    Yun, Katherine; Fuentes-Afflick, Elena; Curry, Leslie A; Krumholz, Harlan M; Desai, Mayur M

    2013-12-01

    Our objective was to examine the association between parental immigration status and child health and health care utilization. Using data from a national sample of immigrant adults who had recently become legal permanent residents (LPR), children (n = 2,170) were categorized according to their parents' immigration status prior to LPR: legalized, mixed-status, refugee, temporary resident, or undocumented. Logistic regression with generalized estimating equations was used to compare child health and health care utilization by parental immigration status over the prior 12 months. Nearly all children in the sample were reported to be in good to excellent health. Children whose parents had been undocumented were least likely to have had an illness that was reported to have required medical attention (5.4 %). Children whose parents had been either undocumented or temporary residents were most likely to have a delayed preventive annual exam (18.2 and 18.7 %, respectively). Delayed dental care was most common among children whose parents had come to the US as refugees (29.1 %). Differences in the preventive annual exam remained significant after adjusting for socioeconomic characteristics. Parental immigration status before LPR was not associated with large differences in reported child health status. Parental immigration status before LPR was associated with the use of preventive annual exams and dental services. However, no group of children was consistently disadvantaged with respect to all measures.

  16. Utilization of formal health services for children aged 1-5 in Aceh after the 2004 tsunami: Which children did not receive the health care they needed? Implications for other natural disaster relief efforts.

    Science.gov (United States)

    Rassekh, Bahie Mary; Santosham, Mathuram

    2014-01-01

    Aceh, Indonesia, was the hardest-hit area in the December 26, 2004 Indian Ocean earthquake and tsunami, with more than 500,000 people displaced, 120,000 people dead, and total damages and losses estimated at $4.5 billion. The relief effort following the tsunami was also immense, with billions of dollars of aid pledged to this province alone. Since then, there have been several natural disasters, including Typhoon Haiyan, which have caused great loss of life and displacement and for which these results are applicable. This study aimed to determine and assess utilization patterns of health services for children under the age of five with diarrhea, cough and difficulty breathing, fever, or skin disease and to identify determinants of formal and non-formal healthcare usage. A household survey of 1439 households was administered to caretakers of children aged 1-5 years. A sample of clusters within Banda Aceh and Aceh Besar were selected and those caretakers within the cluster who fit the inclusion criteria were interviewed. In the two weeks prior to the survey, 78.3% of respondents utilized formal health services as the first line of care for their child's illness episode. Factors significantly associated with decreased formal healthcare usage for the sick children were if the children were living in a displaced household, if the children's mother or father were not living, and if the children's caretaker was not the mother. Although utilization of formal health services for children was quite high after the tsunami, there were certain children who received significantly less care, including those who were displaced, those who were being cared for by someone other than their mother, and those for whom one or both parents had died. Among the recommendations are suggestions to target these children to ensure that they receive the health care they need.

  17. Comparison of Health Service Utilization for Febrile Children Before and After Introduction of Malaria Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy in Rural Papua New Guinea

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    Takahiro Tsukahara

    2018-03-01

    Full Text Available BackgroundIn Papua New Guinea (PNG, a malaria treatment policy using rapid diagnostic tests (RDTs plus artemisinin-based combination therapy (ACT was widely introduced to rural communities in 2012. The objectives of the study were to evaluate the effect of this RDT/ACT introduction to a rural PNG population on health service utilization and to compare factors associated with health service utilization before and after the RDT/ACT introduction.MethodsHousehold surveys with structured questionnaires were conducted before and after the introduction of RDT/ACT in a catchment area of a health center in East Sepik Province, PNG. We interviewed caregivers with children less than 15 years of age and collected data on fever episodes in the preceding 2 weeks. Using propensity score matching, febrile children before the introduction of RDT/ACT were matched to febrile children after the introduction. Then, the adjusted difference in the proportion of health service utilization [i.e., the average treatment effect (ATE of the introduction of RDT/ACT on health service utilization] was estimated. We also employed a multilevel Poisson regression model to investigate factors influencing the use of health services.ResultsOf 4,690 children, 911 (19% were reported to have a fever episode. The unadjusted proportion of health service utilization was 51.7 and 57.2% before and after the RDT/ACT introduction, respectively. After matching, no significant difference in the health service utilization was observed before and after the introduction of RDT/ACT (ATE: 0.063, 95% confidence interval −0.024 to 0.150. Multilevel regression analysis showed that the consistent factors associated with a higher utilization of health services were severe illness and being female.ConclusionThe utilization of health services was not significantly different before and after the introduction of RDT/ACT. Villagers may have neither sufficient informations on the new protocol nor high

  18. Transcriptional, translational, and physiological signatures of undernourished honey bees (Apis mellifera) suggest a role for hormonal factors in hypopharyngeal gland degradation.

    Science.gov (United States)

    Corby-Harris, Vanessa; Meador, Charlotte A D; Snyder, Lucy A; Schwan, Melissa R; Maes, Patrick; Jones, Beryl M; Walton, Alexander; Anderson, Kirk E

    2016-02-01

    Honey bee colonies function as a superorganism, where facultatively sterile female workers perform various tasks that support the hive. Nurse workers undergo numerous anatomical and physiological changes in preparation for brood rearing, including the growth of hypopharyngeal glands (HGs). These glands produce the major protein fraction of a protein- and lipid-rich jelly used to sustain developing larvae. Pollen intake is positively correlated with HG growth, but growth in the first three days is similar regardless of diet, suggesting that initial growth is a pre-determined process while later HG development depends on nutrient availability during a critical window in early adulthood (>3 d). It is unclear whether the resultant size differences in nurse HG are simply due to growth arrest or active degradation of the tissue. To determine what processes cause such differences in HG size, we catalogued the differential expression of both gene transcripts and proteins in the HGs of 8 d old bees that were fed diets containing pollen or no pollen. 3438 genes and 367 proteins were differentially regulated due to nutrition. Of the genes and proteins differentially expressed, undernourished bees exhibited more gene and protein up-regulation compared to well-nourished bees, with the affected processes including salivary gland apoptosis, oogenesis, and hormone signaling. Protein secretion was virtually the only process up-regulated in well-nourished bees. Further assays demonstrated that inhibition of ultraspiracle, one component of the ecdysteroid receptor, in the fat body caused larger HGs. Undernourished bees also had higher acid phosphatase activity, a physiological marker of cell death, compared to well-nourished bees. These results support a connection between poor nutrition, hormonal signaling, and HG degradation. Published by Elsevier Ltd.

  19. Effect of subchronic and chronic exposure to 5-hydroxytryptophan (5-HTP) on the aggressive behavior induced by food competition in undernourished dominant and submissive pigeons (Columba livia).

    Science.gov (United States)

    Fachinelli, C; Ison, M; Rodríguez Echandía, E L

    1996-02-01

    The acute administration of 5-HTP was reported to block in undernourished dominant pigeons the aggressive attacks induced in a submissive partner by food competition. In the present study, undernourished pigeons with previously consolidated dominance were submitted to subchronic and chronic 5-HTP treatment. Adult males (n = 28) were kept at 80% of their body weight by a restricted diet. These were divided in pairs made of a previously ranked dominant subject (total time spent in aggression higher than 200 s/20 min) and a submissive one of similar body weight (time spent in aggression between 90 and 150 s/20 min). The same pairs were exposed to a daily 20 min interaction during each experiment in an observation chamber bearing a central feeder. The time spent in aggressive behavior, feeder control behavior and eating behavior was recorded. Intratest body weight gain was also recorded. In Experiment 1, 8 pairs of pigeons were exposed to a daily trial for 4 successive days (pretreatment-scores). The dominant subjects were then injected subcutaneously, 30 min. before trials, with 7.5 mg/kg 5-HTP from day 5 to day 8 (Treatment scores). The Recovery scores were obtained through a 4-trial post-treatment schedule. In Experiment 2 different pigeons were used. The pretreatment and recovery scores were obtained according to a 16-trial schedule (16 days). Both 4-day (subchronic) and 16-day (chronic) 5-HTP treatments attenuated aggression by the dominant subjects and reduced their intra-test body weight gain but did not decrease dominance for feeder control. The recovery scores of total aggression in subchronic experiments returned to pretreatment scores. In chronic experiments, instead, the recovery scores of aggression remained lower than pretreatment scores, whereas body-weight-gain scores came back to pretreatment values. This suggests that dominant subjects submitted to chronic 5-HTP might have learned to maintain dominance and feeder control in a virtual absence of

  20. Effects of oral nutritional supplements in normally nourished or mildly undernourished geriatric patients after surgery for hip fracture: a randomized clinical trial.

    Science.gov (United States)

    Botella-Carretero, José I; Iglesias, Borja; Balsa, José A; Zamarrón, Isabel; Arrieta, Francisco; Vázquez, Clotilde

    2008-01-01

    Oral nutritional supplements have been recommended after orthopedic surgery in geriatric patients to reduce postoperative complications. However, tolerability of supplements could be a limitation, and their universal use is not supported by the heterogeneity of previous studies, especially in patients without malnutrition. This study is a randomized, controlled, open, parallel, 3-arm clinical trial comparing supplementation with protein powder dissolved in liquids to aim at 36 g of protein per day, energy and protein supplements to aim at 37.6 g of protein and 500 kcal per day, or no intervention in normally nourished or mildly undernourished patients. Outcomes were serum albumin, prealbumin, retinol-binding globulin, and body mass index, among others. Postoperative complications were also recorded. Ninety patients aged 83.8 +/- 6.6 years were included. The mean ingested amount of supplements was 41.1% +/- 20.6% in the protein powder supplement group and 51.4% +/- 13.2% in the energy protein supplement group (t = 2.278, P = .027). Postoperative supplements had no effect on the nutrition status during in-hospital follow-up, as assessed by serum albumin (P = .251), prealbumin (P = .530), retinol-binding globulin (P = .552), or body mass index (P = .582). Multivariate analysis showed that length of hospital stay with an established complication until its resolution (beta = .230, P = .031), total hospital stay (beta = .450, P Oral nutritional supplements in normally nourished or only mildly undernourished geriatric patients with hip fracture submitted to surgery may be of interest for patients with postoperative complications and long hospital stays.

  1. The Clinical and Classroom Utility of the Inventory of Reading Occupations: An Assessment Tool of Children ’s Reading Participation

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    Lenin Grajo

    2018-04-01

    Full Text Available Background: The aim of this study was to determine the initial clinical and classroom utility of the Inventory of Reading Occupations (IRO, a new tool to assess children’s reading participation. Method: The study used phenomenological qualitative and descriptive methods. The participants included 38 occupational therapists, speech-language pathologists, classroom teachers, and parents who completed or reviewed responses of children on the IRO. To provide triangulation, 20 of the children who completed the IRO were interviewed. Data were thematically analyzed and then categorized using a central StrengthsWeaknesses-Opportunities-Threats premise. Results: The majority of the participants indicated favorable response to the clinical and classroom utility of the tool. Common themes were (a the IRO is a user-friendly and engaging assessment that allows students to reflect on their reading participation; (b the IRO is more suitable for children who engage in more structured reading; (c the IRO can be adapted for older children; and (d there is a need to identify whether the IRO is better as a screening or a full assessment tool. Conclusion: The study provided useful perspectives on how the tool can be further improved as a measure of the reading participation of school-aged children.

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

    Science.gov (United States)

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

    2013-05-01

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

  3. Marketing active transportation to school to improve children's health: Utilizing parental perspectives from an inner-city environment.

    Science.gov (United States)

    Royne, Marla B; Ivey, Stephanie S; Levy, Marian; Fox, Alexa K; Roakes, Susan L

    2016-01-01

    Thirty years ago, nearly half of the children in the United States walked or rode their bikes to school. Today, less than 15% of children actively commute to school. With the growing obesity epidemic, encouraging children to walk or bike to school has become a national priority. This research examines factors that influence parental decisions allowing their children to walk to school in an urban environment to identify effective marketing and communication strategies to reach those parents. Results indicate differences in parental perspectives across populations; suggestions for effectively marketing the Safe Routes to School program to minority populations are provided.

  4. Self-report measures in the study of comorbidity in children and adolescents with social phobia: research and clinical utility.

    Science.gov (United States)

    Viana, Andres G; Rabian, Brian; Beidel, Deborah C

    2008-06-01

    We examined differences in self-reported anxiety and depression according to the number and pattern of DSM-IV comorbid diagnoses in 172 children and adolescents (mean age=11.87, S.D.=2.67; range=7-17) with a primary diagnosis of social phobia. Three hypotheses were tested: (1) children with comorbid anxiety disorders would show significantly higher scores than children with social phobia-only on self-report measures, (2) self-report measures would significantly differentiate between children with social phobia and comorbid internalizing versus externalizing disorders, and (3) self-report measures would significantly differentiate children according to the type of anxiety comorbidities present. Multinomial logistic regressions showed that children with three anxiety disorders scored significantly higher than children with one and two diagnoses on two of three self-report measures used. Logistic regressions revealed that children's scores on measures did not differ according to the nature of the comorbid diagnoses (internalizing vs. externalizing). Finally, ROC curves showed that the MASC and the SPAI-C accurately classified children with additional diagnoses of SAD and GAD, respectively. The potential of self-report measures to further our understanding of childhood anxiety comorbidity and the clinical implications of their use to screen for comorbidity are discussed along with suggestions for further study.

  5. Breeding of a leopard gecko in a kindergarden and it's utilization for awakening and intensifying children's interest in nature

    OpenAIRE

    Kovalová, Marie

    2016-01-01

    This thesis is focused on the theme of the reciprocal action of animals and pre-school children. It introduces us to the breeding of leopard geckos in kindergartens (with its benefits and disadvantages). Based on case studies, it describes a leopard gecko's influence on preschool children's personalities in kindergarten. The main method of research involves observing individual children as well as a group of children in a one- room kindergarten, Lísteček. Kindergarten Lísteček enrolls childre...

  6. Nutritional Status And Its Association With Diabetes Mellitus In School Children, India

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    Muninarayana C

    2012-03-01

    Full Text Available Background: Poor health and nutrition may impair both the growth and intellectual development of school children. Incidence of malnutrition related childhood diabetes mellitus has increased and continues to be on the rise.Objectives: To assess the nutritional status by anthropometry and to screen for diabetes by capillary blood examination of school children. Design: Longitudinal study Setting: The study was carried out at Sri R.L.Jalappa Central School, Kolar from August 2008 to December 2009. Methods: All the school children were interviewed with pre-designed and pre-tested proforma. Height, Weight was measured by standard procedures. The nutritional status was analysed by Body Mass Index (BMI for age. The school children were also screened for diabetes mellitus by Finger stick capillary random plasma glucose testing. The children were followed up for any major medical problems during the study period.Participants: All the students studying in the school during study period.Results: Mean height and weight of children were found comparable to the ICMR pooled data. However, compared to NCHS standards and affluent Indian children the mean height and weight were found to be much inferior at all ages. According to BMI for age as per NCHS most of the children were undernourished (79.2% and 3 children (0.6% were overweight. Out of 495 children screened for diabetes 14 children had hyperglycaemia (>160mg/dl. These 14 children were further tested by oral glucose tolerance test and found to have normal blood sugars levels. During the follow up two undernourished children developed diabetes mellitus. Conclusion: The magnitude of malnutrition among school going children was found to be 79%. During the follow up two undernourished children developed diabetes mellitus, hence under nutrition was associated with diabetes mellitus.

  7. A NATIONAL DEMONSTRATION PROJECT UTILIZING TELEVISED MATERIALS FOR THE FORMAL EDUCATION OF CULTURALLY DISADVANTAGED PRESCHOOL CHILDREN. FINAL REPORT.

    Science.gov (United States)

    MUKERJI, ROSE; AND OTHERS

    TO SUPPLY DISADVANTAGED PRESCHOOL CHILDREN WITH CULTURALLY STIMULATING EXPERIENCES, A TV SERIES, "ROUNDABOUT," WAS DESIGNED TO BE USED IN WASHINGTON, D.C. INNER-CITY PRESCHOOL AND DAY CARE CENTERS. THE 15-MINUTE PROGRAMS WERE TO INTRODUCE NEW EXPERIENCES AND SUPPLEMENT REGULAR ACTIVITIES. IT WAS HOPED THAT THE CHILDREN WOULD IDENTIFY…

  8. Exploring the utility of cardiorespiratory fitness as a population health surveillance indicator for children and youth: An international analysis of results from the 20-m shuttle run test.

    Science.gov (United States)

    Lang, Justin J

    2018-02-01

    Emerging evidence has demonstrated the strong link between cardiorespiratory fitness and multiple aspects of health (i.e., physiological, physical, psychosocial, cognitive), independent of physical activity, among school-aged children and youth. Cardiorespiratory fitness is a trait that does not vary substantially from day-to-day, and provides an indication of recent physical activity levels, making it an important possible indicator of population health. Thus, the objective of this dissertation was to investigate the utility of cardiorespiratory fitness, measured using the 20-m shuttle run test, as a broad, holistic health indicator for population health surveillance among children and youth. To achieve this objective we completed 7 manuscripts, all prepared for submission to peer-reviewed, scientific journals: (1) Systematic review of the relationship between 20-m shuttle run performance and health indicators among children and youth. (2) Review of criterion-referenced standards for cardiorespiratory fitness: what percentage of 1 142 026 international children and youth are apparently healthy? (3) Cardiorespiratory fitness is associated with physical literacy in a large sample of Canadian children aged 8 to 12 years. (4) International variability in 20-m shuttle run performance in children and youth: Who are the fittest from a 50-country comparison? A systematic review with pooling of aggregate results. (5) Making a case for cardiorespiratory fitness surveillance among children and youth. (6) International normative 20-m shuttle run values from 1 142 026 children and youth representing 50 countries. (7) Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014. Combined, this dissertation provides support for the importance of cardiorespiratory fitness for health surveillance among school-aged children and youth. Results from the international analysis

  9. Evaluation of the utility of video-urodynamics in children with urinary tract infection and voiding dysfunction.

    Science.gov (United States)

    Glazier, D B; Murphy, D P; Fleisher, M H; Cummings, K B; Barone, J G

    1997-11-01

    To assess the use of video-urodynamic studies (VUDS) in children with urinary tract infection (UTI) and symptoms of voiding dysfunction (frequency, urgency, incontinence), to ascertain whether VUDS significantly assists in diagnosis and deciding treatment. Over a 16-month period, all children seen at our centre with a UTI in conjunction with previous symptoms suggestive of voiding dysfunction underwent free and pressure-flow VUDS. Forty-two children underwent VUDS and 38 (mean age 9 years, range 4-16, 15 male, 23 female) had sufficient information to be included in the study. All children had a prior history of voiding dysfunction (mean 55 months). Only five patients were found to have reflux and three of these had associated detrusor instability. In addition, 24 of 33 patients who did not have reflux had abnormalities on urodynamic study, the most common problem being detrusor instability in 17 of 24 patients. Other abnormalities included sphincter dyssynergia (five patients), poor bladder compliance (two) and hypersensitivity on bladder filling (three). VUDS can provide information about the aetiology of UTI and voiding dysfunction in children that cannot be obtained from any other source. The results of VUDS can be used to select specific treatments, to avoid inappropriate therapy and to identify children who may benefit from follow-up studies despite normal findings on voiding cystourethrography. From these results, we believe that VUDS should be considered for children with UTI and voiding dysfunction.

  10. The rate of antibiotic utilization in Iranian under 5-year-old children with acute respiratory tract illness: A nationwide community-based study

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    Nasser Mostafavi

    2015-01-01

    Full Text Available Background: To investigate the prevalence of antibiotic usage in children aged <5 years with acute respiratory tract illness (ARTI in Iran. Materials and Methods: Data were collected from a national health survey conducted in 2010 (Iran′s Multiple Indicator Demographic and Health Survey. Participants of this cross-sectional study were selected by multistage stratified cluster-random sampling from 31 provinces of Iran. Parents of children with <5 years of age responded to questions about the occurrence of any cough during the previous 2 weeks, referral to private/governmental/other health care systems, and utilization of any oral/injection form of antibiotics. Data were analyzed using SPSS software18. The chi-square test was used to determine antibiotic consumption in various gender and residency groups and also a place of residence with the referral health care system. Results: Of the 9345 children under 5 years who participated in the study, 1506 cases (16.2% had ARTI during 2 weeks prior to the interview, in whom 1143 (75.9% were referred to urban or rural health care centers (43.4 vs. 30.4%; P < 0.001. Antibiotics were utilized by 715 (62.6% of affected children. Injection formulations were used for 150 (13.1% patients. The frequency of receiving antibiotics was higher in urban than in rural inhabitants (66.0% vs. 57.7%; P < 0.05. Conclusion: The prevalence of total and injection antibiotics usage in children <5 years with ARTI is alarmingly high in Iran. Therefore, interventions to reduce antibiotic use are urgently needed.

  11. Prevalence of vaccine preventable diseases and utilization of routine immunizations services by parents of under‐one children in a semi‐urban community of Sokoto State, Nigeria

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    Kaoje AU

    2017-01-01

    Full Text Available Introduction Vaccine preventable diseases are categories of diseases that could be prevented by immunization. They affect children of less than five years of age. This study was conducted to determine the prevalence of vaccine preventable diseases and utilization of routine immunization services among parents/caregivers of under‐one children in Bodinga town of Sokoto State, Nigeria. Methods The study was community based and a descriptive cross sectional epidemiological study design was used. Four hundred households participated in the survey and were selected using a two stage sampling technique. A structured interviewer administered questionnaire with closed and some open‐ ended questions was used to collect the survey data through face‐to‐face interview. Data collected were entered into computer and analyzed using the SPSS version 23. Results were presented in simple tables for clarity. Results Measles was found to be the most prevalent vaccine preventable diseases in the community, while Hepatitis B has the least prevalence and mortality from these diseases was found to be 3%. Majority of the respondent were aware of Poliomyelitis as vaccine preventable disease and only few were aware of Hepatitis B vaccination. The percentage of fully vaccinated children was very low (4.75% while about one‐third of the children were not immunized at all. The socio‐cultural factors found to affect the utilization of routine immunization services includes: place of delivery (more for the hospital delivery, educational level and occupation of child’s parent affect positively more especially the mother. The major reason for not taking the children for immunization was Father’s refusal. Conclusion The study revealed that measles is the most prevalent vaccine preventable disease in the study area. The awareness of vaccine preventable diseases was found to be low except for poliomyelitis. Strengthening routine immunization including demand creation

  12. Health care utilization and cost among children with asthma who were enrolled in a health maintenance organization.

    Science.gov (United States)

    Lozano, P; Fishman, P; VonKorff, M; Hecht, J

    1997-06-01

    To measure the impact of asthma on the use and cost of health care by children in a managed care organization. Population-based historical cohort study. A medium-sized staff model health maintenance organization in western Washington state. All 71 818 children, between age 1 to 17 years, who were enrolled and used services during 1992. Children were identified with one or more asthma diagnoses during 1992 using automated encounter data. Nonurgent outpatient visits, pharmacy fills, urgent care visits, and hospital days, as well as associated costs were measured. All services were categorized as asthma care or nonasthma care. Multivariate regression analysis was used to compute marginal cost for asthma (difference in total cost between children with asthma and other children using services, adjusted for covariates). Treated prevalence of asthma was 4.9%. Children with asthma incurred 88% more costs ($1060.32 vs $563. 81/yr), filled 2.77 times as many prescriptions (11.59 vs 4.19/yr), made 65% more nonurgent outpatient visits (5.75 vs 3.48/yr), and had twice as many inpatient days (.23 vs .11/yr) compared with the general population of children using services. Asthma care represented 37% of all health care received by children with asthma, while the remaining 63% were for nonasthma services. Almost two-thirds of asthma-related costs were attributable to nonurgent outpatient care and prescriptions; only one third was attributable to urgent care and hospitalizations. Controlling for age, sex, and comorbidities, the marginal cost of asthma was $615.17/yr (95% confidence interval $502.73, $727.61), which includes asthma as well as nonasthma services. This marginal cost represents 58% of all health care costs for children with asthma. Children with asthma use significantly more health services (and incur significantly more costs) than other children using services, attributable largely to asthma care. The majority of all health care costs for children with asthma were for

  13. Access, acceptability and utilization of community health workers using diagnostics for case management of fever in Ugandan children: a cross-sectional study

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    Mukanga David

    2012-05-01

    Full Text Available Abstract Background Use of diagnostics in integrated community case management (iCCM of fever is recognized as an important step in improving rational use of drugs and quality of care for febrile under-five children. This study assessed household access, acceptability and utilization of community health workers (CHWs trained and provided with malaria rapid diagnostic tests (RDTs and respiratory rate timers (RRTs to practice iCCM. Methods A total of 423 households with under-five children were enrolled into the study in Iganga district, Uganda. Households were selected from seven villages in Namungalwe sub-county using probability proportionate to size sampling. A semi-structured questionnaire was administered to caregivers in selected households. Data were entered into Epidata statistical software, and analysed using SPSS Statistics 17.0, and STATA version 10. Results Most (86%, 365/423 households resided within a kilometre of a CHW’s home, compared to 26% (111/423 residing within 1 km of a health facility (p  Fifty-seven percent (243/423 of caregivers took their febrile children to a CHW at least once in the three month period preceding the survey. Households located 1–3 km from a health facility were 72% (AOR 1.72; 95% CI 1.11–2.68 more likely to utilize CHW services compared to households within 1 km of a health facility. Households located 1–3 km from a CHW were 81% (AOR 0.19; 95% CI 0.10–0.36 less likely to utilize CHW services compared to those households residing within 1 km of a CHW. A majority (79%, 336/423 of respondents thought CHWs services were better with RDTs, and 89% (375/423 approved CHWs’ continued use of RDTs. Eighty-six percent (209/243 of respondents who visited a CHW thought RRTs were useful. Conclusion ICCM with diagnostics is acceptable, increases access, and is the first choice for caregivers of febrile children. More than half of caregivers of febrile children utilized CHW services over a three

  14. Diagnostic Utility of the ADI-R and DSM-5 in the Assessment of Latino Children and Adolescents.

    Science.gov (United States)

    Magaña, Sandy; Vanegas, Sandra B

    2017-05-01

    Latino children in the US are systematically underdiagnosed with Autism Spectrum Disorder (ASD); therefore, it is important that recent changes to the diagnostic process do not exacerbate this pattern of under-identification. Previous research has found that the Autism Diagnostic Interview-Revised (ADI-R) algorithm, based on the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition, Text Revision (DSM-IV-TR), has limitations with Latino children of Spanish speaking parents. We evaluated whether an ADI-R algorithm based on the new DSM-5 classification for ASD would be more sensitive in identifying Latino children of Spanish speaking parents who have a clinical diagnosis of ASD. Findings suggest that the DSM-5 algorithm shows better sensitivity than the DSM-IV-TR algorithm for Latino children.

  15. A study of acute phase and transport protein synthesis in undernourished men using simulated infection and uniformly 15N-labelled Spirulina Platenses

    International Nuclear Information System (INIS)

    Kurpad, A.V.; Soares, M.J.; Sekhar, R.V.; Reeds, P.J.; Fjeld, C.R.

    1994-01-01

    This study was conducted to test the hypothesis that acute phase protein synthesis is accelerated and transport protein synthesis is decelerated in adult men in whom the stress of infection is superimposed upon undernutrition. As a pilot study, four chronically undernourished men and two well-nourished controls were studied on two occasions separated by four days; the second session was conducted 24 hours after the administration of typhoid vaccine. Basal urine and blood samples were collected and then subjects were given priming oral doses of 15 N-Spirulina (13.5mg/kg body weight) and oral doses (3.5mg/kg body weight) every 30 min for the next six hours. Meals were aliquoted during the dosing period. Blood samples were collected at four, five and six hours. 15 N enrichment in different fractions of plasma i.e., albumin, non-albumin and amino acids, was measured by combustion GC-IRMS. Total urinary nitrogen was measured by Kjeldahl. 5 refs, 2 figs, 3 tabs

  16. Low transformation growth factor-β1 production and collagen synthesis correlate with the lack of hepatic periportal fibrosis development in undernourished mice infected with Schistosoma mansoni

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    Andreia Ferreira Barros

    2014-04-01

    Full Text Available Undernourished mice infected (UI submitted to low and long-lasting infections by Schistosoma mansoni are unable to develop the hepatic periportal fibrosis that is equivalent to Symmers’ fibrosis in humans. In this report, the effects of the host’s nutritional status on parasite (worm load, egg viability and maturation and host (growth curves, biology, collagen synthesis and characteristics of the immunological response were studied and these are considered as interdependent factors influencing the amount and distribution of fibrous tissue in hepatic periovular granulomas and portal spaces. The nutritional status of the host influenced the low body weight and low parasite burden detected in UI mice as well as the number, viability and maturation of released eggs. The reduced oviposition and increased number of degenerated or dead eggs were associated with low protein synthesis detected in deficient hosts, which likely induced the observed decrease in transformation growth factor (TGF-β1 and liver collagen. Despite the reduced number of mature eggs in UI mice, the activation of TGF-β1 and hepatic stellate cells occurred regardless of the unviability of most miracidia, due to stimulation by fibrogenic proteins and eggshell glycoproteins. However, changes in the repair mechanisms influenced by the nutritional status in deficient animals may account for the decreased liver collagen detected in the present study.

  17. Utility of an abbreviated version of the stanford-binet intelligence scales (5thed.) in estimating 'full scale' IQ for young children with autism spectrum disorder.

    Science.gov (United States)

    Twomey, Conal; O'Connell, Helen; Lillis, Mary; Tarpey, Sarah Louise; O'Reilly, Gary

    2018-03-01

    The fifth edition of the Stanford-Binet Intelligence scales allows 'full scale' IQ (FSIQ) to be estimated using an abridged version of the test-the abbreviated battery IQ (ABIQ). Set within a public early intervention team service, the current cross-sectional study investigated the utility of the ABIQ in estimating FSIQ for 40 children with autism spectrum disorder (ASD) aged 3-5 years. A strong ABIQ-FSIQ association was yielded (r = 0.89; r 2  = 0.808) and the ABIQ did not over-estimate mean FSIQ above a clinically-relevant threshold; however, clinically significant over-estimation occurred in 17.5% of individual cases. While the findings provide support for the utility of the ABIQ in estimating FSIQ for young children with ASD, caution relating to the over-estimation of FSIQ is warranted. Careful clinical judgment-ideally based on examination of previous cognitive assessment results (if available), thorough interactional observations, and close multi-disciplinary consultation-is necessary to determine the applicability of the ABIQ to individual cases. Autism Res 2018, 11: 503-508. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. We investigated the utility of a shortened version of the Stanford-Binet Intelligence Scales in estimating IQ for 40 young children with autism spectrum disorder (ASD). The findings provide qualified support for the instrument: acceptably accurate IQ estimation was achieved for most cases; but not so for a sizeable minority (17.5%). Careful clinical judgment is necessary to determine the applicability of the ABIQ to individual cases. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

  18. Drawing on resilience: piloting the utility of the Kinetic Family Drawing to measure resilience in children of HIV-positive mothers

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    L Ebersöhn

    2012-01-01

    Full Text Available In this article we describe how using a visual, child-friendly measure of resilience in a randomised control trial (RCT, the Kgolo Mmogo (KM project, resulted in representative insights on resilience in a mother-child relationship where the mother is HIV-positive. We used the existing psychological method Kinetic Family Drawing (KFD to measure resilience of young children in the qualitative phase of the concurrent mixed method RCT as the children represent cultural groups for whom standardized measures have not been developed. We use the case example of baseline KM assessment data of 6 year olds (n = 11; 3 female, 8 male. The results of the study demonstrate that the visual and qualitative data from children (KFD added to quantitative information obtained from mothers (Vineland Adaptive Behavior Scale, VABS. Additional information from the KFD had interpretation value for VABS scores and provided a child's perspective regarding resilience. Contrasting information from the KFD problematized mothers' perspectives as indicated in the VABS. The absence of significant information in KFD results regarding VABS sub-domains indicates differences in the cultural/contextual conceptualization of resilience. This exploratory study indicates initial support for the cross-cultural utility of the KFD to measure resilience in young children faced with adversity.

  19. Utility of a summative scale based on the Children with Special Health Care Needs (CSHCN) Screener to identify CSHCN with special dental care needs.

    Science.gov (United States)

    Iida, Hiroko; Lewis, Charlotte W

    2012-08-01

    Our objective was to determine if a summative scale reflecting the number of positive criteria on the Children with Special Health Care Needs (CSHCN) Screener is useful in identifying subgroups of CSHCN at risk for poorer oral health and unmet dental care needs and who should be considered to have special dental care needs. Data were analyzed for a population-based sample of 91,642 US children needs in the past 12 months. Descriptive and multivariable logistic regression analyses were performed for each outcome using the survey command in Stata to account for the sampling design. A summative scale based on the number of positive CSHCN Screener criteria was independently associated with various parent-perceived poorer oral health outcomes in children. CSHCN who met 4 or 5 screener criteria had 4 and 4.5 times, respectively, the odds of having fair-poor condition of teeth and bleeding gums relative to non-CSHCN. They also had 87% higher odds for parent-perceived toothache and 2 and 2.5 times the odds of having recent broken teeth and unmet dental care needs relative to non-CSHCN, respectively. There was no dose-dependent association between summative number of positive CSHCN Screener criteria and reported cavities in children. Application of a summative score based on the CSHCN Screener has utility in identifying the CSHCN subgroup with special dental care needs.

  20. Utility of adjunctive macrolide therapy in treatment of children with asthma: a systematic review and meta-analysis

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    Mikailov A

    2013-01-01

    Full Text Available Anar Mikailov,1 Ilona Kane,2 Stephen C Aronoff,3 Raemma Luck,3,† Michael T DelVecchio31Beth Israel Deaconess Medical Center, Boston, MA, 2St Christopher's Hospital for Children, Philadelphia, PA, 3Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA†Raemma Luck is now deceasedBackground: The purpose of this study was to investigate macrolides as an adjunct to an asthma controller regimen in children with asthma.Methods: Prospective clinical trials of macrolide therapy in children with asthma using outcome measures of change in forced expiratory volume in one second (FEV1 and/or oral corticosteroid requirement were searched for in PubMed up to December 2009. The reference lists of studies were also included in the analysis, as well as those listed in published meta-analyses.Results: The literature search yielded 116 studies, six of which were included in this meta-analysis. The change in FEV1 from baseline with adjunctive use of macrolide therapy in all children was not significant (0.25% predicted; 95% confidence interval [CI] −0.37, 0.86 predicted, P = 0.43; however, the change in FEV1 among children receiving daily oral corticosteroids was significant (3.89% predicted; 95% CI −0.01, 7.79, P = 0.05. Addition of macrolide therapy to the treatment of children with oral corticosteroid-dependent asthma resulted in a statistically significant decrease in daily corticosteroid dosage (−3.45 mg/day; 95% CI −5.79, −1.09 mg/day, P = 0.004. This reduction in daily corticosteroid dosage was directly proportional to the duration of macrolide therapy (−0.17 mg methylprednisolone per week of macrolide therapy; 95% CI −0.33, −0.021, P = 0.025.Conclusion: Addition of macrolides to the treatment regimen of children with oral corticosteroid-dependent asthma improves FEV1 and decreases the daily dosage of corticosteroids required for control in these children. The degree of dose reduction is directly related to

  1. The trichotillomania impact project in young children (TIP-YC): clinical characteristics, comorbidity, functional impairment and treatment utilization.

    Science.gov (United States)

    Walther, Michael R; Snorrason, Ivar; Flessner, Christopher A; Franklin, Martin E; Burkel, Rachel; Woods, Douglas W

    2014-02-01

    The aim was to investigate clinical characteristics of young children with a hair pulling problem. Parents/caregivers of young children (0-10 years old) with a hair pulling problem (N = 110) completed an online survey. The majority reported that their child experienced mild to moderate impairment/distress due to hair pulling, and overall clinical characteristics were similar to adult samples, although some differences were noted (e.g., less awareness of pulling). We also compared preschool-aged and school-aged children within the sample. Symptom severity, pleasure during pulling and gender ratio remained stable across the age groups. The preschool-aged children demonstrated less impairment/distress, comorbidity, and treatment seeking; pulled from fewer body areas; and were less likely to be aware of the act or experience tension prior to pulling. In conclusion, clinical characteristics of childhood hair pulling are largely similar to adult/adolescent hair pulling problems, but there are some notable differences, particularly among pre-school aged children.

  2. Symptom screening scales for detecting major depressive disorder in children and adolescents: a systematic review and meta-analysis of reliability, validity and diagnostic utility.

    Science.gov (United States)

    Stockings, Emily; Degenhardt, Louisa; Lee, Yong Yi; Mihalopoulos, Cathrine; Liu, Angus; Hobbs, Megan; Patton, George

    2015-03-15

    Depression symptom screening scales are often used to determine a clinical diagnosis of major depressive disorder (MDD) in prevention research. The aim of this review is to systematically examine the reliability, validity and diagnostic utility of commonly used screening scales in depression prevention research among children and adolescents. We conducted a systematic review of the electronic databases PsycINFO, PsycEXTRA and Medline examining the reliability, validity and diagnostic utility of four commonly used depression symptom rating scales among children and adolescents: the Children׳s Depression Inventory (CDI), Beck Depression Inventory (BDI), Center for Epidemiologic Studies - Depression Scale (CES-D) and the Reynolds Adolescent Depression Scale (RADS). We used univariate and bivariate random effects models to pool data and conducted metaregression to identify and explain causes of heterogeneity. We identified 54 studies (66 data points, 34,542 participants). Across the four scales, internal reliability was 'good' (pooled estimate: 0.89, 95% Confidence Interval (CI): 0.86-0.92). Sensitivity and specificity were 'moderate' (sensitivity: 0.80, 95% CI: 0.76-0.84; specificity: 0.78, 95% CI: 0.74-0.83). For studies that used a diagnostic interview to determine a diagnosis of MDD, positive predictive power for identifying true cases was mostly poor. Psychometric properties did not differ on the basis of study quality, sample type (clinical vs. nonclinical) or sample age (child vs. adolescent). Some analyses may have been underpowered to identify conditions in which test performance may vary, due to low numbers of studies with adequate data. Commonly used depression symptom rating scales are reliable measures of depressive symptoms among adolescents; however, using cutoff scores to indicate clinical levels of depression may result in many false positives. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Assessing the Quality of Life Using the Health Utilities Index Questionnaire in Children With Severe Persistent Asthma During the Treatment With Omalizumab

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    Leyla S. Namazova-Baranova

    2017-01-01

    Full Text Available Background. Quality of life (QoL is an important parameter that provides additional information about changes in health status. Objective. Our aim was to study the change in QoL of patients with severe persistent bronchial asthma (BA during the treatment with genetically engineered biological preparation (GIBP omalizumab in addition to daily background therapy. Methods. The QoL assessment was conducted using the Health Utilities Index Mark 3 and Mark 2 (HUI3, HUI2 questionnaires at two points (1st point and 2nd point — in 6 months in 47 children with severe BA at the age of 13 (7; 17 years, 72% of them are boys. At the same points, QoL was evaluated using the PAQLQ (S specialized pediatric questionnaire (Standardized Pediatric Asthma Quality of Life Questionnaire. Results. Depending on the duration of omalizumab therapy, all children were divided into 5 groups: 1st group — children who did not receive treatment with monoclonal antibodies at the 1st point; in 2, 3, 4, 5-th groups, the QoL assessment was performed on GIBP treatment for different time. In children of the 1st group whose QoL was evaluated before starting GIBP therapy and in 6 months, a statistically significant change in scores on the Health Utilities Index questionnaire was noted: the multi-attribute indices HUI2 and HUI3 improved, respectively, by 21.3 and 10.71% (p = 0.041 and 0.086. According to the HUI2 classification system, a significant improvement in the emotion attribute was revealed, which positively correlated with the overall indicator and the emotion indicator of the PAQLQ (S questionnaire. In the remaining groups, the indicators of the Health Utilities Index questionnaire did not change significantly. Conclusion. The study results showed that the dynamics of the quality of life in children with severe persistent BA is an important additional criterion in a comprehensive assessment of the efficacy of targeted bioengineering therapy. 

  4. Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015

    Directory of Open Access Journals (Sweden)

    Célina Lichtl

    2017-11-01

    Full Text Available Abstract Background Hospitalizations for ambulatory care sensitive (ACS conditions are established indicators for the availability and quality of ambulatory care. We aimed to assess the differences between asylum-seeking children and children of the general population in a German city with respect to (i the prevalence of ACS hospitalizations, and (ii the utilization of emergency outpatient services for ACS conditions. Methods Using anonymous account data, all children admitted to the University Hospital Heidelberg in 2015 were included in our study. A unique cost unit distinguished asylum seekers residing in a nearby reception center (exposed from the children of the general population. We adapted international lists of ACS conditions and calculated the prevalence of ACS hospitalizations and the utilization of emergency outpatient services for ACS conditions, attributable fractions among the exposed (Afe and the population attributable fraction among total admissions (PAF for each outcome. Differences in the prevalence of each outcome between exposed and controls were analyzed in logistic regression models adjusted for sex, age group and quarterly admission. Results Of the 32,015 admissions in 2015, 19.9% (6287 were from inpatient and 80.1% (25,638 from outpatient care. In inpatient care, 9.8% (622 of all admissions were hospitalizations for ACS conditions. The Afe of ACS hospitalizations was 46.57%, the PAF was 1.12%. Emergency service use for ACS conditions could be identified in 8.3% (3088 of all admissions (Afe: 79.57%, PAF: 5.08%. The odds ratio (OR of asylum-seeking children being hospitalized for ACS conditions in comparison to the control group was 1.81 [95% confidence interval, CI: 1.02; 3.2]. The OR of the asylumseeking population compared to the general population for the utilization of emergency service use for ACS conditions was 4.93 [95% CI: 4.11; 5.91]. Conclusions Asylum-seeking children had significantly higher odds of ACS

  5. Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015).

    Science.gov (United States)

    Lichtl, Célina; Lutz, Thomas; Szecsenyi, Joachim; Bozorgmehr, Kayvan

    2017-11-15

    Hospitalizations for ambulatory care sensitive (ACS) conditions are established indicators for the availability and quality of ambulatory care. We aimed to assess the differences between asylum-seeking children and children of the general population in a German city with respect to (i) the prevalence of ACS hospitalizations, and (ii) the utilization of emergency outpatient services for ACS conditions. Using anonymous account data, all children admitted to the University Hospital Heidelberg in 2015 were included in our study. A unique cost unit distinguished asylum seekers residing in a nearby reception center (exposed) from the children of the general population. We adapted international lists of ACS conditions and calculated the prevalence of ACS hospitalizations and the utilization of emergency outpatient services for ACS conditions, attributable fractions among the exposed (Afe) and the population attributable fraction among total admissions (PAF) for each outcome. Differences in the prevalence of each outcome between exposed and controls were analyzed in logistic regression models adjusted for sex, age group and quarterly admission. Of the 32,015 admissions in 2015, 19.9% (6287) were from inpatient and 80.1% (25,638) from outpatient care. In inpatient care, 9.8% (622) of all admissions were hospitalizations for ACS conditions. The Afe of ACS hospitalizations was 46.57%, the PAF was 1.12%. Emergency service use for ACS conditions could be identified in 8.3% (3088) of all admissions (Afe: 79.57%, PAF: 5.08%). The odds ratio (OR) of asylum-seeking children being hospitalized for ACS conditions in comparison to the control group was 1.81 [95% confidence interval, CI: 1.02; 3.2]. The OR of the asylumseeking population compared to the general population for the utilization of emergency service use for ACS conditions was 4.93 [95% CI: 4.11; 5.91]. Asylum-seeking children had significantly higher odds of ACS hospitalization and of utilization of emergency outpatient

  6. Lack of utility of repeat monitoring of hemoglobin and hematocrit following blunt solid organ injury in children.

    Science.gov (United States)

    Acker, Shannon N; Petrun, Branden; Partrick, David A; Roosevelt, Genie E; Bensard, Denis D

    2015-12-01

    Current management protocols for children with blunt solid organ injury to the liver and spleen call for serial monitoring of the child's hemoglobin and hematocrit every 6, 12, or 24 hours, depending on the injury grade. We hypothesized that children who require emergent intervention in the form of laparotomy, angioembolization, or packed red blood cell (PRBC) transfusion because of bleeding from a solid organ injury will have changes in their vital signs that alert the clinician to the need for intervention, making scheduled laboratory evaluation unnecessary. We performed a retrospective review of all children admitted to either of two pediatric trauma centers following blunt trauma with any grade liver or spleen injury from January 2009 to December 2013. Data evaluated include a need for intervention, indication for intervention, and timing of intervention. A total of 245 children were admitted with blunt liver or spleen injury. Six patients (2.5%) underwent emergent exploratory laparotomy for hypotension a median of 4 hours after injury (range, 2-4 hours), four of who required splenectomy. No child required laparotomy for delayed bleeding from a solid organ injury. One child (0.4%) underwent angioembolization for blunt splenic injury. Forty-one children (16.7%) received a PRBC transfusion during hospitalization, 32 of whom did not undergo laparotomy or angioembolization. Children who underwent an intervention had a lower nadir hematocrit (median, 22.9 vs. 32.8; p hematocrit (median, 35.5 vs. 16 hours; p hemoglobin and hematocrit monitoring (median, 20 vs. 5; p hemoglobin and hematocrit values may not be necessary. Retrospective study with no negative criteria, prognostic study, level III.

  7. The utility of ultrasonography in the the diagnostics and monitoring of treatment of acute abdominal pain in children with neoplasms

    International Nuclear Information System (INIS)

    Zaleska-Dorobisz, U.; Jankowski, B.; Maciaszek, A.; Moron, K.

    2005-01-01

    The aim of this study was to estimate the results of the diagnostic imaging modalities, especially ultrasonography (US) in children during the oncological therapy with the acute abdominal symptoms. Acute abdominal symptoms in children with neoplasms causing a very difficult clinical and diagnostic problems and can occur in any stage of disease. The high-resolution ultrasound has a very important role in diagnosis in all patients with acute abdominal pain and with neoplasms. The authors consider that the US should be the first imaging method in the differential diagnosis of the abdominal changes in children with neutropenia and oncological disease. Proper diagnosis should be established only with clinical information. We analyzed 249 ultrasounds examinations of the abdominal cavity in 144 girls and 105 boys aged from 1 to 18 years (mean age 10, 3 years). The more important indication for the US exam in 133 cases was acute abdominal symptoms. We took exams during pre- and postoperative chemotherapy, radiotherapy and after the hematopoietic stem cell transplantation. All the patients were under routine hematological control. Based on the clinical symptoms and the laboratory tests we analysed two groups of children with oncological disease and acute abdomen: I group - 111 children with neutropenia, II group - 22 children without neutropenia. In the patients who underwent operation procedure the final diagnosis was established on histopathology. In the other cases diagnosis was based on clinical, laboratory and radiological exams, especially ultrasonography. We analyzed clinical picture of disease, the results of therapy and the US changes in examined patients using statistic parameters as: sensitivity, specificity and efficiency. In the group of 133 children with acute abdominal symptoms the most (92- 69,1%) patients suffer from ALL (acute lymphoblastic leukaemia) and 16(12%) - from AML (acute lymphoblastic leukaemia), Ewing sarcoma-3(2,2%), osteosarcoma - 3(2,2%), NHL

  8. Utilizing Storytelling to Promote Emotional Well-Being of Children With a Distinct Physical Appearance: The Case of Children Who Wear Eyeglasses

    Directory of Open Access Journals (Sweden)

    Andreas Brouzos

    2016-03-01

    Full Text Available This study explored the effectiveness of storytelling in supporting children with unusual physical traits. Participants were forty-eight children, aged 9 – 12 who, due to various eye diseases, wear eyeglasses. They completed various standardized self-report measures, both before and after participation, in one of the six intervention groups. The measures assessed shyness and social anxiety symptoms, loneliness and social dissatisfaction, perception of negative evaluation, satisfaction with one’s appearance, and anxiety regarding physical appearance. The intervention consisted of six 90-min group sessions and included both individual and group activities. The results lend support to the hypothesis that storytelling can significantly contribute to the emotional well-being of children, with a distinct physical appearance.

  9. Chest health surveillance utility in the early detection of bronchiolitis obliterans syndrome in children after allo-SCT.

    Science.gov (United States)

    Gassas, A; Craig-Barnes, H; Dell, S; Doyle, J; Schechter, T; Sung, L; Egeler, M; Palaniyar, N

    2013-06-01

    To prospectively assess whether periodic chest health surveillance is beneficial for the early detection of bronchiolitis obliterans syndrome (BOS) in children after allo-SCT. Children up to 18 years of age receiving allo-SCT from September 2009 to September 2011 were included. Surveillance consisted of the following: a 7-item respiratory system questionnaire of cough, wheeze and shortness of breath; focused physical examination; and pulmonary function test (PFT) conducted before SCT and at 1, 3, 6, 9, 12, 18 and 24 months after SCT. Thirty-nine patients were enrolled. Five children developed BOS at a median time of 192 days (range 94-282). Positive response comparisons between the BOS group vs the non-BOS group were NS for history questionnaire (P=0.2), heart rate (P=0.3), respiratory rate (P=0.3) and oxygen saturation monitoring (P=0.8). Differences between the two groups for chest auscultation and PFT were statistically significant (P=0.03 and P=0.01, respectively). However, chest auscultation in the BOS group was only positive after BOS diagnosis. PFT reduction was evident in the asymptomatic phase (BOS group 33%; non-BOS group 4.5%, P=0.01). Changes in PFT, but not history/physical examination, allow the early detection of BOS in children after SCT. Our study is limited by the small sample size.

  10. Diagnostic Utility of the ADI-R and DSM-5 in the Assessment of Latino Children and Adolescents

    Science.gov (United States)

    Magaña, Sandy; Vanegas, Sandra B.

    2017-01-01

    Latino children in the US are systematically underdiagnosed with Autism Spectrum Disorder (ASD); therefore, it is important that recent changes to the diagnostic process do not exacerbate this pattern of under-identification. Previous research has found that the Autism Diagnostic Interview-Revised (ADI-R) algorithm, based on the Diagnostic and…

  11. Diagnostic Utility of WISC-IV General Abilities Index and Cognitive Proficiency Index Difference Scores among Children with ADHD

    Science.gov (United States)

    Devena, Sarah E.; Watkins, Marley W.

    2012-01-01

    The Wechsler Intelligence Scale for Children-Fourth Edition General Abilities Index and Cognitive Proficiency Index have been advanced as possible diagnostic markers of attention deficit hyperactivity disorder. This hypothesis was tested with a hospital sample with attention deficit hyperactivity disorder (n = 78), a referred but nondiagnosed…

  12. Let's Draw: Utilizing Interactive White Board to Support Kindergarten Children's Visual Art Learning Practice

    Science.gov (United States)

    Chou, Pao-Nan; Chang, Chi-Cheng; Chen, Mei-Yin

    2017-01-01

    Compared to other academic disciplines, interactive white board (IWB) research in early childhood education is still in its infancy. To add more knowledge base regarding the instructional effectiveness of IWB for young children, this study aimed to investigate educational phenomenon of using an IWB to teach visual art to kindergarten students. The…

  13. Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care.

    Science.gov (United States)

    Milgrom, Peter; Sutherland, Marilynn; Shirtcliff, R Mike; Ludwig, Sharity; Smolen, Darlene

    2010-02-18

    A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid) in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93). The mean (SD) number of teeth with any decay was .75 (2.5) in the test population and 1.6 (2.5) in the comparison population (t = 2.08, p = .04). The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

  14. Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care

    Directory of Open Access Journals (Sweden)

    Shirtcliff R Mike

    2010-02-01

    Full Text Available Abstract Background A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. Methods As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Results Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93. The mean (SD number of teeth with any decay was .75 (2.5 in the test population and 1.6 (2.5 in the comparison population (t = 2.08, p = .04. Conclusions The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

  15. An evaluation of nutritional status of children in Anganwadi Centre of Hyderabad district of Andhra Pradesh stateusing WHO z- score technique

    Directory of Open Access Journals (Sweden)

    Shanawaz

    2013-01-01

    Full Text Available BACKGROUND In India the nationwide Integrated Child Development Services (ICDS uses the I.A.P criteria to grade under nutrition. The current WHO recommendation is to use Z score or the standard deviation system to grade under nutrition. Although widely recommended the z scores have not been widely used in India, especially in community based studies. AIMS & OBJECTIVES 1. To assess the socio-demographic profile of 0-72 months age group of children. 2. To find out the nutritional status of children using WHO z- score technique. METHODOLOGY A cross sectional, community-based was done in ICDS Anganwadi centers among the 400 ICDS children (0-6 years RESULTS There are (47.5% undernourished and (16.5% severely malnourished children according to WHO z score technique. Males (49.5% are comparatively more under nourished than females (45.5%. Female infants (31.2% are less undernourished when compared to male infants (50%. Literacy of mother had significance over the nutritional status of their children (p˂0.05. CONCLUSION The present study shows that there are still many children who are undernourished and severely malnourished in our country, even after 36 years of ICDS services. There is need to use WHO standards at the grass route levels to correctly identify the burden of under nutrition. Z score technique is simple to use, reliable and easy to understand at grass route level by health workers.

  16. Gender Disparities in Sciences: The Question of Parental Influence on Children's Self-Concept and Utility-Value

    Science.gov (United States)

    Makwinya, Noel M.; Hofman, Roelande H.

    2015-01-01

    Self-concept and utility-values are thought to influence differences in choices, participation and performance in schools-careers between students of different genders and ages. This study was investigating existence of gender differences in such constructs regarding science. Further, the study investigated whether development of such constructs…

  17. Gender Disparaties in Sciences : the Question of Parental Influence on Children's Self-Concept and Utility-Value

    NARCIS (Netherlands)

    Makwinya, N.M.; Hofman, R. H.

    2015-01-01

    Self-concept and utility-values are thought to influence differences in choices, participation and performance in schools-careers between students of different genders and ages. This study was investigating existence of gender differences in such constructs regarding science. Further, the study

  18. Single and Cumulative Relations of Social Risk Factors with Children's Dental Health and Care-Utilization Within Regions of the United States.

    Science.gov (United States)

    Yang, Alyssa J; Gromoske, Andrea N; Olson, Melissa A; Chaffin, Jeffrey G

    2016-03-01

    The purpose is to examine the relation of social risk factors, and the cumulative burden of social risk factors, on parent-reported dental health and dental care-seeking behavior. National Survey of Children's Health data (2011-2012) were analyzed for US children by Title V Block Grant regions. Multivariate logistic regressions were estimated for ten social risk factors, as well as a cumulative risk index, to find any associations with poor condition of teeth, presence of dental caries, and no dental care visits. Almost all of the risk factors were significantly associated with poor condition of teeth and presence of dental caries for the US. Models associating no dental care visits suggested that low family income (OR 1.58), poor maternal mental health (OR 1.54), high school education or less (OR 1.34), and multi-racial/other race (OR 1.18) were significant factors for the US. Regional variation existed for those risk factors and their association with the outcomes, but income, education, and poor maternal mental health consistently played a significant role in adverse outcomes. The cumulative risk index was strongly related to poor oral health outcomes, with a weaker relationship to dental care utilization. US children experiencing certain social risk factors, such as low family income, high school education or less, and poor maternal mental health, are likely to be at greater risk for poor dental health and low levels of dental-care seeking behavior. Children experiencing multiple social risks are at greater risk for poor oral outcomes than children who experience fewer social risks. An approach that involves the social determinants of health is needed to address these issues.

  19. A Developmental Examination of the Psychometric Properties and Predictive Utility of a Revised Psychological Self-Concept Measure for Preschool-Aged Children

    Science.gov (United States)

    Jia, Rongfang; Lang, Sarah N.; Schoppe-Sullivan, Sarah J.

    2015-01-01

    Accurate assessment of psychological self-concept in early childhood relies on the development of psychometrically sound instruments. From a developmental perspective, the current study revised an existing measure of young children's psychological self-concepts, the Child Self-View Questionnaire (CSVQ, Eder, 1990), and examined its psychometric properties using a sample of preschool-aged children assessed at approximately 4 years old with a follow-up at age 5 (N = 111). The item compositions of lower-order dimensions were revised, leading to improved internal consistency. Factor Analysis revealed three latent psychological self-concept factors (i.e., Sociability, Control, and Assurance) from the lower-order dimensions. Measurement invariance by gender was supported for Sociability and Assurance, not for Control. Test-retest reliability was supported by stability of the psychological self-concept measurement model during the preschool years, although some evidence of increasing differentiation was obtained. Validity of children's scores on the three latent psychological self-concept factors was tested by investigating their concurrent associations with teacher-reported behavioral adjustment on the Social Competence and Behavior Evaluation Scale – Short Form (SCBE-SF, LaFreniere & Dumas, 1996). Children who perceived themselves as higher in Sociability at 5 years old displayed less internalizing behavior and more social competence; boys who perceived themselves as higher in Control at age 4 exhibited lower externalizing behavior; children higher in Assurance had greater social competence at age 4, but displayed more externalizing behavior at age 5. Implications relevant to the utility of the revised psychological self-concept measure are discussed. PMID:26098231

  20. A developmental examination of the psychometric properties and predictive utility of a revised psychological self-concept measure for preschool-age children.

    Science.gov (United States)

    Jia, Rongfang; Lang, Sarah N; Schoppe-Sullivan, Sarah J

    2016-02-01

    Accurate assessment of psychological self-concept in early childhood relies on the development of psychometrically sound instruments. From a developmental perspective, the current study revised an existing measure of young children's psychological self-concepts, the Child Self-View Questionnaire (CSVQ; Eder, 1990), and examined its psychometric properties using a sample of preschool-age children assessed at approximately 4 years old with a follow-up at age 5 (N = 111). The item compositions of lower order dimensions were revised, leading to improved internal consistency. Factor analysis revealed 3 latent psychological self-concept factors (i.e., sociability, control, and assurance) from the lower order dimensions. Measurement invariance by gender was supported for sociability and assurance, not for control. Test-retest reliability was supported by stability of the psychological self-concept measurement model during the preschool years, although some evidence of increasing differentiation was obtained. Validity of children's scores on the 3 latent psychological self-concept factors was tested by investigating their concurrent associations with teacher-reported behavioral adjustment on the Social Competence and Behavior Evaluation Scale-Short Form (SCBE-SF; LaFreniere & Dumas, 1996). Children who perceived themselves as higher in sociability at 5 years old displayed less internalizing behavior and more social competence; boys who perceived themselves as higher in control at age 4 exhibited lower externalizing behavior; children higher in assurance had greater social competence at age 4, but displayed more externalizing behavior at age 5. Implications relevant to the utility of the revised psychological self-concept measure are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration

    Energy Technology Data Exchange (ETDEWEB)

    Adaletli, Ibrahim; Kurugoglu, Sebuh; Ulus, Sila; Ozer, Harun; Kantarci, Fatih; Mihmanli, Ismail; Akman, Canan [Istanbul University, Department of Radiology, Cerrahpasa Medical Faculty, Istanbul (Turkey); Elicevik, Mehmet [Istanbul University, Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul (Turkey)

    2007-01-15

    Foreign body aspiration is common in children, especially those under 3 years of age. Chest radiography and CT are the main imaging modalities for the evaluation of these children. Management of children with suspected foreign body aspiration (SFBA) mainly depends on radiological findings. To investigate the potential use of low-dose multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation and management of SFBA in children. Included in the study were 37 children (17 girls, 20 boys; age 4 months to 10 years, mean 32 months) with SFBA. Chest radiographs were obtained prior to MDCT in all patients. MDCT was performed using a low-dose technique. VB images were obtained in the same session. Conventional bronchoscopy (CB) was performed within 24 h on patients in whom an obstructive abnormality had been found by MDCT and VB. Obstructive pathology was found in 16 (43.25%) of the 37 patients using MDCT and VB. In 13 of these patients, foreign bodies were detected and removed via CB. The foreign bodies were located in the right main bronchus (n = 5), in the bronchus intermedius (n = 6), in the medial segment of the middle lobe bronchus (n = 1), and in the left main bronchus (n = 1). In the remaining three patients, the diagnosis was false-positive for an obstructive pathology by MDCT and VB; the final diagnoses were secretions (n = 2) and schwannoma (n = 1), as demonstrated by CB. In 21 patients in whom no obstructive pathology was detected by MDCT and VB, CB was not performed. These patients were followed for 5-20 months without any recurrent obstructive symptomatology. Low-dose MDCT and VB are non-invasive radiological modalities that can be used easily in the investigation of SFBA in children. MDCT and VB provide the exact location of the obstructive pathology prior to CB. If obstructive pathology is depicted with MDCT and VB, CB should be performed either for confirmation of the diagnosis or for the diagnosis of an alternative cause for the obstruction

  2. Test of memory malingering with children: The utility of Trial 1 and TOMMe10 as screeners of test validity.

    Science.gov (United States)

    Loughan, Ashlee R; Perna, Robert; Le, Jessica

    2016-01-01

    There is a growing body of research suggesting that the shorter versions of the Test of Memory Malingering (TOMM) may provide an accurate assessment of effort in children. During neuropsychological evaluations, some circumstances result in only one completed trial of the TOMM or partial completion of a trial. Research suggests that a cut-score of 40 or 41 on Trial1 is highly predictive of passing the TOMM overall. In the current study, 194 school-age children with academic and/or behavioral problems were used to compare the accuracy of TOMM1 and TOMMe10 (errors on the first 10 items of TOMM1) in predicting passing/failing of TOMM2. For the children in this sample, a score of performance on the TOMM2 (sensitivity = .80, specificity = .91) with a Negative Predictive Value = .98 at the malingering base rate of 7% (TOMM2 failure in our sample). A score of 2 errors (8 items correct) on the TOMMe10 was slightly less sensitive than that of the TOMM1 (specificity = .96, sensitivity = .53) but with a similar Negative Predictive Value (.96). Consistent with the research from adult populations, TOMM1 and TOMMe10 appear to be quite accurate in predicting performance on the standard administration of the TOMM and may be useful screeners. However, compared to that found in adult samples, slight differences in suggested cutoffs for TOMM1 and TOMMe10 may be warranted for children.

  3. Utility of Subjective Sleep Assessment Tools for Healthy Preschool Children: A Comparative Study Between Sleep Logs, Questionnaires, and Actigraphy

    OpenAIRE

    Iwasaki, Mizue; Iwata, Sachiko; Iemura, Akiko; Yamashita, Natsumi; Tomino, Yasushi; Anme, Tokie; Yamagata, Zentaro; Iwata, Osuke; Matsuishi, Toyojiro

    2010-01-01

    Background: Sleep pattern is an important factor in a child's mental, behavioural and physical status. To evaluate the sleep patterns of children, subjective tools such as sleep logs and questionnaires are still widely used in addition to objective methods of sleep assessment. Despite the established correlation between subjective and objective sleep variables, the characteristic features of subjective assessment have not been elucidated.Methods: To investigate the characteristics of parental...

  4. Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin resistance in overweight children and adolescents: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Agarwalla Vipin

    2007-02-01

    Full Text Available Abstract Background The rising prevalence of obesity and metabolic syndrome (MetS has received increased attention since both place individuals at risk for Type II diabetes and cardiovascular disease. Insulin resistance (IR has been implicated in the pathogenesis of obesity and MetS in both children and adults and is a known independent cardiovascular risk factor. However measures of IR are not routinely performed in children while MetS or severe obesity when present, are considered as clinical markers for IR. Objective The study was undertaken to assess the utility of ATPIII defined metabolic syndrome (MetS and severe obesity as predictors of insulin resistance (IR in a group of 576 overweight children and adolescents attending a pediatric obesity clinic in Brooklyn. Methods Inclusion criteria were children ages 3–19, and body mass index > 95th percentile for age. MetS was defined using ATP III criteria, modified for age. IR was defined as upper tertile of homeostasis model assessment (HOMA within 3 age groups (3–8, n = 122; 9–11, n = 164; 12–19, n = 290. Sensitivity, specificity, positive predictive values and odds ratios (OR with 95% confidence intervals (CI were calculated within age groups for predicting IR using MetS and severe obesity respectively. Results MetS was present in 45%, 48% and 42% of the respective age groups and significantly predicted IR only in the oldest group (OR = 2.0, 95% CI 1.2, 3.4; p = .006. Sensitivities were Conclusion The expression of IR in overweight children and adolescents is heterogeneous and MetS or severe obesity may not be sufficiently sensitive and specific indicators of insulin resistance. In addition to screening for MetS in overweight children markers for IR should be routinely performed. Further research is needed to establish threshold values of insulin measures in overweight children who may be at greater associated risk of adverse outcomes whether or not MetS is present.

  5. Clinical utility of spot urine protein-to-creatinine ratio modified by estimated daily creatinine excretion in children.

    Science.gov (United States)

    Yang, Eun Mi; Yoon, Bo Ae; Kim, Soo Wan; Kim, Chan Jong

    2017-06-01

    The spot urine protein-to-creatinine ratio (UPCR) is widely used to predict 24-h urine protein (24-h UP) excretion. In patients with low daily urine creatinine excretion (UCr), however, the UPCR may overestimate 24-h UP. The aim of this study was to predict 24-h UP using UPCR adjusted by estimated 24-h UCr in children. This study included 442 children whose 24-h UP and spot UPCR were measured concomitantly. Estimated 24-h UCr was calculated using three previously existing equations. We estimated the 24-h UP excretion from UPCR by multiplying the estimated UCr. The results were compared with the measured 24-h UP. There was a strong correlation between UPCR and 24-h UP (r = 0.801, P < 0.001), and the correlation improved after multiplying the UPCR by the measured UCr (r = 0.847, P < 0.001). Using the estimated UCr rather than the measured UCr, there was high accuracy and strong correlation between the estimated UPCR weighted by the Cockcroft-Gault equation and 24-h UP. Improvement was also observed in the subgroup (proteinuria vs. non-proteinuria) analysis, particularly in the proteinuria group. The spot UPCR multiplied by the estimated UCr improved the accuracy of prediction of the 24-h UP in children.

  6. Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation.

    Science.gov (United States)

    Rathod, Rahul H; Jurgen, Brittney; Hamershock, Rose A; Friedman, Kevin G; Marshall, Audrey C; Samnaliev, Mihail; Graham, Dionne A; Jenkins, Kathy; Lock, James E; Powell, Andrew J

    2017-12-01

    Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs. All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into "younger" (stress tests (P = .01), and a 14% total reduction in costs. The total cost savings of the ASO SCAMP was $216 649 in the first 6 years of the SCAMP. There was no difference in clinical outcomes between the historical and SCAMP cohorts. SCAMPs can improve resource utilization and reduce costs after the ASO operation while maintaining quality of care. © 2017 Wiley Periodicals, Inc.

  7. Study on the Status of Health Service Utilization among Caregivers of Left-Behind Children in Poor Rural Areas of Hunan Province: A Baseline Survey.

    Science.gov (United States)

    Ji, Meimei; Zhang, Yefu; Zou, Jiaojiao; Yuan, Tong; Tang, Amber; Deng, Jing; Yang, Lina; Li, Mingzhi; Chen, Jihua; Qin, Hong; Lin, Qian

    2017-08-12

    The caregivers of left-behind children (CLBC) in China's poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their health service utilization and to provide a scientific basis for guiding effective implementation of health policy in rural Hunan. Random cluster sampling was used to survey CLBC in two rural counties. Face-to-face interviews and questionnaires were used to collect data, including socioeconomic status and health service utilization. The two-week prevalence rate was used to reflect health service needs, while the two-week visiting rate, annual hospitalization rate and participation in basic public health services were used to evaluate health service utilization. Of the 518 respondents in the study, 95.9% were farmers and 88.4% were over 40 years old. The two-week prevalence rate was 36.1%. Furthermore, 40.1% of ill caregivers' activities were partly restricted by illness and 3.7% needed to be on bed rest. The two-week visiting rate was 21.0%. The main reasons for not seeing a doctor were "self-medication" (39.1%) or "financial difficulties" (32.6%). The annual hospitalization rate of the CLBC was 22.6% and the non-hospitalization rate of those who needed hospitalization was 41.5%. "Lack of time" (22.3%) and "financial difficulties" (50.5%) were the major factors affecting the utilization of hospitalization services. In terms of participation in basic public health services, only 35.1% CLBC clearly knew that township hospitals have established health records for them. Only 50.6% of caregivers received free health examinations in village clinics or township hospitals and 81.3% of the caregivers did not participate in health education or lectures organized by local health institutions in 2014. The utilization rate of health services was extremely low, which may affect the quality of care for left-behind children

  8. A strategy to optimize CT use in children with mild blunt head trauma utilizing clinical risk stratification; could we improve CT use in children with mild head injury?

    Science.gov (United States)

    Kocyigit, Ali; Serinken, Mustafa; Ceven, Zumrut; Yılmaz, Atakan; Kaya, Furkan; Hatipoglu, Celile; Yaylacı, Serpil; Karabulut, Nevzat

    2014-01-01

    The purpose of our study was to investigate the impact of clinical risk classification on optimization of the rationale of CT scanning in children with mild blunt head trauma. Exposed effective radiation dose values of CT scanning were also evaluated. Children with isolated pediatric mild head trauma admitted in a single center over a 5-year period (n=3102, >2 years and trauma were significantly different between low (n=10) 1.9% and high (n=90) 29.8% risk groups. Certain predefined signs and symptoms (e.g., vomiting, suspected skull fracture and loss of consciousness) were related significantly with pathologic CT findings attributed to trauma. Estimated mean effective dose values were 3.91±0.38mSv for 2-6 year old (n=557), and 3.33±0.12mSv for 7-16 year old patients (n=349). The pediatric victims of mild head trauma patients within high risk group and those with vomiting, suspected skull fracture and loss of consciousness should undergo head CT scanning. The manufacturer settings on the CT scanners for children should be revised to alleviate untoward radiation exposure. © 2014.

  9. The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults.

    Science.gov (United States)

    Barni, Simona; Mori, Francesca; Valleriani, Claudia; Mangone, Giusi; Testi, Sergio; Saretta, Francesca; Sarti, Lucrezia; Pucci, Neri; de Martino, Maurizio; Azzari, Chiara; Novembre, Elio

    2017-04-21

    The basophil activation test (BAT), has been proposed as a possible assay for the diagnosis of immediate-type allergy to beta-lactams (BLs). The aim of this study was to assess the utility of BAT in the diagnosis of amoxicillin (AMX) or AMX-clavulanate (AMX-C) IgE-mediated hypersensitivity in children and adults. Eighteen children and 21 adults, with clinical history of immediate reactions to AMX or AMX-C, were referred to Anna Meyer Children's Hospital and San Giovanni di Dio Hospital, respectively. They underwent in vivo tests (skin prick test and intradermal test). Moreover, BAT with AMX or AMX-C was performed within 6 months from the reaction. In the pediatric group, the concordance between the skin tests (ST) and BAT results was 83.3%. Upon comparing the symptom grades and ST results to the BAT results, we found that the reaction severity and ST positivity did not correlate with BAT results in children. In the adult group, the concordance between the ST and BAT results was 61.9%. Upon comparing patients with severe reactions and patients with mild reactions in terms of BAT results, we found a BAT sensitivity of 38.5% and a specificity of 100%. When comparing the symptom grades to the BAT results, we found that no patients with mild symptoms had a positive BAT result, whereas 38.5% of patients with severe symptoms had a positive BAT result. BAT does not seem to be a useful tool to increase the sensitivity of an allergy work-up to diagnose immediate hypersensitivity to AMX or AMX-C.

  10. Utility of CT after sonography for suspected appendicitis in children: integration of a clinical scoring system with a staged imaging protocol.

    Science.gov (United States)

    Srinivasan, Abhay; Servaes, Sabah; Peña, Andrès; Darge, Kassa

    2015-02-01

    To improve diagnosis of pediatric appendicitis, many institutions have implemented a staged imaging protocol utilizing ultrasonography (US) first and then computed tomography (CT). A substantial number of children with suspected appendicitis undergo CT after US, and the efficient and accurate diagnosis of pediatric appendicitis continues to be challenging. The objective of the study is to characterize the utility of CT following US for diagnosis of pediatric appendicitis, in conjunction with a clinical appendicitis score (AS). Imaging studies of children with suspected appendicitis who underwent CT after US in an imaging protocol were retrospectively reviewed by three radiologists in consensus. Chart review derived the AS (range 0-10) and obtained the patient diagnosis and disposition, and an AS was applied to each patient. Clinical and radiologic data were analyzed to assess the yield of CT after US. Studies of 211 children (mean age 11.3 years) were included. The positive threshold for AS was determined to be 6 out of 10. When AS and US were concordant (N = 140), the sensitivity and specificity of US were similar to CT. When AS and US were discordant (N = 71) and also when AS ≥ 6 (N = 84), subsequent CT showed superior sensitivity and specificity to US alone. In the subset where US showed neither the appendix nor inflammatory change in the right lower quadrant (126/211, 60 % of scans), when AS 6 (kg/year, P < 0.001) and after-hours (1700 -0730 hours) performance of US (P < 0.001). Results suggest that the appendicitis score has utility in guiding an imaging protocol and support the contention that non-visualization of the appendix on US is not intrinsically non-diagnostic. There was little benefit to additional CT when AS < 6 and US did not show the appendix or evidence of inflammation; this would have avoided CT in 140/211 (66 %) patients. CT demonstrated benefit when AS ≥ 6, suggesting that cases with AS ≥ 6 and

  11. A comparison of the upper limb movement kinematics utilized by children playing virtual and real table tennis.

    Science.gov (United States)

    Bufton, Amy; Campbell, Amity; Howie, Erin; Straker, Leon

    2014-12-01

    Active virtual games (AVG) may facilitate gross motor skill development, depending on their fidelity. This study compared the movement patterns of nineteen 10-12 yr old children, while playing table tennis on three AVG consoles (Nintendo Wii, Xbox Kinect, Sony Move) and as a real world task. Wrist and elbow joint angles and hand path distance and speed were captured. Children playing real table tennis had significantly smaller (e.g. Wrist Angle Forehand Real-Kinect: Mean Difference (MD): -18.2°, 95% Confidence Interval (CI): -26.15 to -10.26) and slower (e.g. Average Speed Forehand Real-Kinect: MD: -1.98 ms(-1), 95% CI: -2.35 to -1.61) movements than when using all three AVGs. Hand path distance was smaller in forehand and backhand strokes (e.g. Kinect-Wii: MD: 0.46 m, 95% CI: 0.13-0.79) during playing with Kinect than Move and Wii. The movement patterns when playing real and virtual table tennis were different and this may impede the development of real world gross motor skills. Several elements, including display, input and task characteristics, may have contributed to the differences in movement patterns observed. Understanding the interface components for AVGs may help development of higher fidelity games to potentially enhance the development of gross motor skill and thus participation in PA. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Stevens, Briony; Buettner, Petra; Watt, Kerrianne; Clough, Alan; Brimblecombe, Julie; Judd, Jenni

    2015-10-01

    The beneficial effect of balanced protein energy supplementation during pregnancy on subsequent child growth is unclear and may depend upon the mother entering pregnancy adequately nourished or undernourished. Systematic reviews to-date have included studies from high-, middle- and low-income countries. However, the effect of balanced protein energy supplementation should not be generalised. This review assesses the effect of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries on child growth. A systematic review of articles published in English (1970-2015) was conducted via MEDLINE, Scopus, the Cochrane Register and hand searching. Only peer-reviewed experimental studies analysing the effects of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries with measures of physical growth as the primary outcome were included. Two reviewers independently assessed full-text articles against inclusion criteria. Validity of eligible studies was ascertained using the Quality Assessment Tool for Quantitative Studies (EPHPP QAT). In total, seven studies met the inclusion criteria. All studies reported on birthweight, five on birth length, three on birth head circumference, and one on longer-term growth. Standardised mean differences were calculated using a random-effects meta-analysis. Balanced protein energy supplementation significantly improved birthweight (seven randomised controlled trials, n = 2367; d = 0.20, 95% confidence interval, 0.03-0.38, P = 0.02). No significant benefit was observed on birth length or birth head circumference. Impact of intervention could not be determined for longer-term physical growth due to limited evidence. Additional research is required in low- and middle-income countries to identify impacts on longer-term infant growth. © 2015 John Wiley & Sons Ltd.

  13. Identifying Low pH Active and Lactate-Utilizing Taxa within Oral Microbiome Communities from Healthy Children Using Stable Isotope Probing Techniques

    Energy Technology Data Exchange (ETDEWEB)

    McLean, Jeffrey S.; Fansler, Sarah J.; Majors, Paul D.; Mcateer, Kathleen; Allen, Lisa Z.; Shirtliff, Mark E.; Lux, Renate; Shi, Wenyuan

    2012-03-05

    Many human microbial infectious diseases including dental caries are polymicrobial in nature and how these complex multi-species communities evolve from a healthy to a diseased state is not well understood. Although many health- or disease-associated oral microbes have been characterized in vitro, their physiology in vivo in the presence of the complex oral microbiome is difficult to determine with current approaches. In addition, about half of these oral species remain uncultivated to date and little is known except their 16S rRNA sequence. Lacking culture-based physiological analyses, the functional roles of uncultivated microorganisms will remain enigmatic despite their apparent disease correlation. To start addressing these knowledge gaps, we applied a novel combination of in vivo Magnetic Resonance Spectroscopy (MRS) with RNA and DNA based Stable Isotope Probing (SIP) to oral plaque communities from healthy children for temporal monitoring of carbohydrate utilization, organic acid production and identification of metabolically active and inactive bacterial species.

  14. Utility of additional dedicated high-resolution 3T MRI in children with medically refractory focal epilepsy.

    Science.gov (United States)

    Ahmed, Raheel; Rubinger, Luc; Go, Cristina; Drake, James M; Rutka, James T; Carter Snead, O; Widjaja, Elysa

    2018-02-02

    In patients with medically refractory epilepsy and normal magnetic resonance imaging (MRI), high-resolution dedicated MRI may identify cryptic lesions. The aim of this study was to assess improvement in lesion detection and its impact on clinical management, using additional high-resolution dedicated 3T MRI in children with medically refractory epilepsy who had normal 3T epilepsy protocol MRI. Children who had resective epilepsy surgery and suspected focal cortical dysplasia (FCD) or normal 3T epilepsy protocol MRI were included. Those with other diagnosis on MRI including tumor and hippocampal sclerosis were excluded. Patients who had normal MRI on 3T epilepsy protocol underwent dedicated high-resolution 3T MRI through the epileptogenic zone, guided by video EEG, Magnetoencephalography and FDG-PET data. 101 patients with at least 1 year follow-up were included. Twenty-nine of 44 (66%) patients who had normal epilepsy protocol MRI had a lesion identified on dedicated high-resolution MRI. The addition of dedicated high-resolution MRI to standard epilepsy protocol increased sensitivity from 53.1% (95%CI: 40%-66%) to 85.9% (95%CI: 75%-93%). Identified lesions were concordant to surgical resection in all patients and guided depth/strip electrode insertion in 20/25 (80%) patients who underwent staged resection. Dedicated MRI detected small deep seated lesions in 10/20 (50%), and guided depth electrodes placement, without which it would not be feasible, as the lobar location of epileptogenic zone from other non-invasive tests were not sufficiently precise. Patients with non-lesional epilepsy on standard epilepsy protocol MR may benefit from high-resolution dedicated MRI to aid identification of an underlying lesion, which could impact surgical management and improve seizure control. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Pareto utility

    NARCIS (Netherlands)

    Ikefuji, M.; Laeven, R.J.A.; Magnus, J.R.; Muris, C.H.M.

    2013-01-01

    In searching for an appropriate utility function in the expected utility framework, we formulate four properties that we want the utility function to satisfy. We conduct a search for such a function, and we identify Pareto utility as a function satisfying all four desired properties. Pareto utility

  16. Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and U.S.-Origin Children.

    Science.gov (United States)

    Betancourt, Theresa S; Newnham, Elizabeth A; Birman, Dina; Lee, Robert; Ellis, B Heidi; Layne, Christopher M

    2017-06-01

    Most mental health services for trauma-exposed children and adolescents were not originally developed for refugees. Information is needed to help clinicians design services to address the consequences of trauma in refugee populations. We compared trauma exposure, psychological distress, and mental health service utilization among children and adolescents of refugee-origin, immigrant-origin, and U.S.-origin referred for assessment and treatment by U.S. providers in the National Child Traumatic Stress Network (NCTSN). We used propensity score matching to compare trauma profiles, mental health needs, and service use across three groups. Our sample comprised refugee-origin youth (n = 60, 48.3% female, mean age = 13.07 years) and propensity-matched samples of immigrant-origin youth (n = 143, 60.8% female, mean age = 13.26 years), and U.S.-origin youth (n = 140, 56.1% female, mean age = 12.11 years). On average, there were significantly more types of trauma exposure among refugee youth than either U.S.-origin youth (p refugee youth had higher rates of community violence exposure, dissociative symptoms, traumatic grief, somatization, and phobic disorder.  In contrast, the refugee group had comparably lower rates of substance abuse and oppositional defiant disorder (ps ranging from .030 to refugee-origin youth presented with distinct patterns of trauma exposure, distress symptoms, and service needs that merit consideration in services planning. Copyright © 2017 International Society for Traumatic Stress Studies.

  17. Nutritional status of children in two districts of the mountain region of Nepal.

    Science.gov (United States)

    Thapa, M; Neopane, A K; Singh, U K; Aryal, N; Agrawal, K; Shrestha, B

    2013-09-01

    Nutritional status is a prime indicator of health. Generally, three anthropometric indicators are often used to assess nutritional status during childhood and adolescence: underweight (weight-for-age), stunting (height- for-age) and thinness (BMI-for-age). Malnutrition in children is a major public health problem in many developing countries. This study was conducted to assess nutritional status among children attending health camps in two mountainous districts in Nepal. Five hundred and seventy five children below 15 years of age attending the medical camp in Humla and Mugu districts in October 2011 were assessed for nutritional status. For children less than five years, weight for age, weight for height and height for age as per WHO classification, and for children between five to 15 years age specific values of height, weight and Body Mass Index (BMI) were calculated. In Humla district, 28.2% children were undernourished, 8.8% wasted and 22.4% stunted in less than five years. In the same age group, 31.7% children were undernourished, 9.4% wasted and 29.4% stunted in Mugu district. In the age group five to 15 years, thinness was seen in 22.4% and 29.4% children in Humla and Mugu respectively. Malnutrition (underweight, stunting, wasting and thinness) still constitutes a major health problem among Nepalese children, particularly in mountainous regions.

  18. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia.

    Science.gov (United States)

    Rautenberg, Tamlyn Anne; Zerwes, Ute; Lee, Way Seah

    2018-01-01

    To perform cost utility (CU) and budget impact (BI) analyses augmented by scenario analyses of critical model structure components to evaluate racecadotril as adjuvant to oral rehydration solution (ORS) for children under 5 years with acute diarrhea in Malaysia. A CU model was adapted to evaluate racecadotril plus ORS vs ORS alone for acute diarrhea in children younger than 5 years from a Malaysian public payer's perspective. A bespoke BI analysis was undertaken in addition to detailed scenario analyses with respect to critical model structure components. According to the CU model, the intervention is less costly and more effective than comparator for the base case with a dominant incremental cost-effectiveness ratio of -RM 1,272,833/quality-adjusted life year (USD -312,726/quality-adjusted life year) in favor of the intervention. According to the BI analysis (assuming an increase of 5% market share per year for racecadotril+ORS for 5 years), the total cumulative incremental percentage reduction in health care expenditure for diarrhea in children is 0.136578%, resulting in a total potential cumulative cost savings of -RM 73,193,603 (USD -17,983,595) over a 5-year period. Results hold true across a range of plausible scenarios focused on critical model components. Adjuvant racecadotril vs ORS alone is potentially cost-effective from a Malaysian public payer perspective subject to the assumptions and limitations of the model. BI analysis shows that this translates into potential cost savings for the Malaysian public health care system. Results hold true at evidence-based base case values and over a range of alternate scenarios.

  19. Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys

    Directory of Open Access Journals (Sweden)

    Dong Hee Ryu

    2016-03-01

    Full Text Available Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only (‘I’-only and of fixed amount+indemnity-type (‘F+I’ increased, whereas the proportion of holders with fixed amount-type only (‘F’-only decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with ‘F’-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69, whereas subjects with ‘I’-only PMI or ‘F+I’ PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for ‘I’-only: 1.39, 1.63, and 1.38, respectively; ORs for ‘F+I’: 1.67, 2.09, and 1.37, respectively. Conclusions: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

  20. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia

    Directory of Open Access Journals (Sweden)

    Rautenberg TA

    2018-03-01

    Full Text Available Tamlyn Anne Rautenberg,1,2 Ute Zerwes,3 Way Seah Lee4 1IGES Institut GmbH, Berlin, Germany; 2Health Economics and HIV/AIDS Research Division (HEARD, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; 3Assessment in Medicine GmbH, Lörrach, Germany; 4Department of Pediatrics, University Malaya, Kuala Lumpur, Malaysia Objective: To perform cost utility (CU and budget impact (BI analyses augmented by scenario analyses of critical model structure components to evaluate racecadotril as adjuvant to oral rehydration solution (ORS for children under 5 years with acute diarrhea in Malaysia.Methods: A CU model was adapted to evaluate racecadotril plus ORS vs ORS alone for acute diarrhea in children younger than 5 years from a Malaysian public payer’s perspective. A bespoke BI analysis was undertaken in addition to detailed scenario analyses with respect to critical model structure components.Results: According to the CU model, the intervention is less costly and more effective than comparator for the base case with a dominant incremental cost-effectiveness ratio of –RM 1,272,833/quality-adjusted life year (USD –312,726/quality-adjusted life year in favor of the intervention. According to the BI analysis (assuming an increase of 5% market share per year for racecadotril+ORS for 5 years, the total cumulative incremental percentage reduction in health care expenditure for diarrhea in children is 0.136578%, resulting in a total potential cumulative cost savings of –RM 73,193,603 (USD –17,983,595 over a 5-year period. Results hold true across a range of plausible scenarios focused on critical model components.Conclusion: Adjuvant racecadotril vs ORS alone is potentially cost-effective from a Malaysian public payer perspective subject to the assumptions and limitations of the model. BI analysis shows that this translates into potential cost savings for the Malaysian public health care system. Results hold true at evidence-based base

  1. Communication for behavioural impact in enhancing utilization of insecticide-treated bed nets among mothers of under-five children in rural North Sudan: an experimental study.

    Science.gov (United States)

    Elmosaad, Yousif Mohammed; Elhadi, Magda; Khan, Asif; Malik, Elfatih Mohamed; Mahmud, Ilias

    2016-10-18

    Malaria is the leading cause of morbidity and mortality in Sudan. The entire population is at risk of contracting malaria to different levels. This study aimed to assess the effectiveness of communication for behavioural impact (COMBI) strategy in enhancing the utilization of long-lasting insecticidal nets (LLINs) among mothers of under-five children in rural areas. A randomized community trial was conducted in rural area of Kosti locality, White Nile State, Sudan, among mothers of under-five children, from January 2013 to February 2014. A total of 761 mothers from 12 villages were randomly selected, 412 mothers from intervention villages and 349 were from comparison villages. The knowledge of mothers, in intervention villages, about malaria vector, personal protective measures (PPM) against malaria, and efficacy of LLINs was significantly increased from 86.9 to 97.3 %; 45.9 to 92 % and 77.7 to 96.1 % respectively. Knowledge about usefulness of PPM, types of mosquito nets and efficacy of LLINs was significantly higher in intervention villages compared to comparison villages (p < 0.05), (η 2  = 0.64). Mothers in intervention villages increasingly perceived, post-intervention, that malaria was a serious disease (99.3 %), a preventable disease (98.8 %) and also LLINs as an effective intervention in malaria prevention (92.2 %). This resulted in an increase in the utilization rate of LLINs from 19.2 to 82.8 % in intervention villages compared to comparison villages (p < 0.05) [OR = 4.6, 95 %, CI = (3.72-5.72)], (η 2  = 0.64). The average of mothers' knowledge about malaria was increased by 64 % (η 2  = 0.64), the use of LLINs was increased by 79 % (η 2  = 0.79) and a positive attitude towards malaria was 2.25 times higher in intervention villages than among mothers in the comparison villages. These results established the usefulness of COMBI strategy for increasing awareness about malaria, developing a positive perception towards malaria

  2. Utility of a multiplex reverse transcriptasepolymerase chain reaction assay (HemaVision in the evaluation of genetic abnormalities in Korean children with acute leukemia: a single institution study

    Directory of Open Access Journals (Sweden)

    Hye-Jin kim

    2013-06-01

    Full Text Available &lt;b&gt;Purpose:&lt;/b&gt; In children with acute leukemia, bone marrow genetic abnormalities (GA have prognostic significance, and may be the basis for minimal residual disease monitoring. Since April 2007, we have used a multiplex reverse transcriptase-polymerase chain reaction tool (HemaVision to detect of GA. &lt;b&gt;Methods:&lt;/b&gt; In this study, we reviewed the results of HemaVision screening in 270 children with acute leukemia, newly diagnosed at The Catholic University of Korea from April 2007 to December 2011, and compared the results with those of fluorescence in situ hybridization (FISH, and G-band karyotyping. &lt;b&gt;Results:&lt;/b&gt; Among the 270 children (153 males, 117 females, 187 acute lymphoblastic leukemia and 74 acute myeloid leukemia patients were identified. Overall, GA was detected in 230 patients (85.2%. HemaVision, FISH, and G-band karyotyping identified GA in 125 (46.3%, 126 (46.7%, and 215 patients (79.6%, respectively. TEL-AML1 (20.9%, 39/187 and AML1-ETO (27%, 20/74 were the most common GA in ALL and AML, respectively. Overall sensitivity of HemaVision was 98.4%, with false-negative results in 2 instances: 1 each for TEL-AML1 and MLL-AF4 . An aggregate of diseasesspecific FISH showed 100% sensitivity in detection of GA covered by HemaVision for actual probes utilized. G-band karyotype revealed GA other than those covered by HemaVison screening in 133 patients (49.3%. Except for hyperdiplody and hypodiploidy, recurrent GA as defined by the World Health Organizationthat were not screened by HemaVision, were absent in the karyotype. &lt;b&gt;Conclusion:&lt;/b&gt; HemaVision, supported by an aggregate of FISH tests for important translocations, may allow for accurate diagnosis of GA in Korean children with acute leukemia.

  3. LOCOMOTOR DEVELOPMENT IN UNDERNOURISHED RATS

    NARCIS (Netherlands)

    GRAMSBERGEN, A; WESTERGA, J

    1992-01-01

    The effects of undernutrition on the development of locomotion were studied in fourteen rats. Mothers received about 40% of normal quantities of standard laboratory food from the 5th day of gestation until weaning at the 21st day after birth. Qualitative as well as quantitative aspects of locomotion

  4. Profiles of the Most Preferred and the Most Effective Music Therapy Approaches Being Utilized with Children with Autism Spectrum Disorders According to the Opinions of Music Therapists in the U.S.

    Science.gov (United States)

    Eren, Bilgehan

    2017-01-01

    The purpose of this study was to identify and analyze opinions of music therapists practicing in the United States, regarding various music therapy approaches currently being utilized with children diagnosed with Autism Spectrum Disorder. Music therapy approaches were analyzed for possible correlations between music therapists' preferences, and…

  5. Astronomy4Kids: Utilizing online video forums to teach basic planetary concepts to children (pre-K to 2nd-grade)

    Science.gov (United States)

    Pearson, Richard L.

    2016-10-01

    We have developed Astronomy4Kids to help cultivate the next generation of scientists by using technology to reach every interested child in both formal and informal learning environments. This online video series fills the void of effective STEM education tools for children under the age of 8. Our first collection of videos discuss many planetary topics, including the following: planet and moon formation theories, solar and lunar eclipses, and the seasonal effect of the Earth's tilt. As education and outreach become a larger focus of groups such as AAS and NASA, it is imperative to include programs such as Astronomy4Kids to extend these initiatives to younger age groups.Traditionally, this age group has been viewed as too young to be introduced to physics and astronomy concepts. However, child development research is consistently demonstrating the amazing plasticity of a young child's mind: the younger one is introduced to a complex concept, the easier it is to grasp later on. Following the philosophies of Fred Rogers, we present children with a real, relatable, instructor allowing them to focus on the concepts being presented.The format of Astronomy4Kids includes short instruction video clips that usually include a hands-on activity that is easily reproduced at home or in the classroom. This permits flexibility in how the video series is utilized. Within formal classroom or after-school situations, teachers and instructors can lead the discussion and activity with help from the video and supplemental materials (e.g. worksheets, concept outlines, etc.). Informal environments permit the viewer to complete the tasks on their own or simply enjoy the presentation. The video series can be found on YouTube (under "Astronomy 4 Kids") or Facebook (at www.facebook.com/astronomy4kids); we have also expanded to Instagram (www.instragram.com/astronomy4kids) and Pinterest (www.pinterest.com/astronomy4kids).

  6. Morphoquantitative effects on striated skeletal muscle of Wistar rats (Rattus norvegicus subjected to a diet utilized in young children from rural Mozambique

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    Catarina Tivane Nhamposse

    2016-12-01

    Full Text Available Mozambique is a country of sub-Saharan Africa where about 55% of the population lives below the absolute poverty line with less than one meal a day hardly surviving based on by donations. Food insecurity and precarious nutrition, especially in children, are factors that induce to levels of 44% of chronic malnutrition (CD in infants. The CD is responsible for one third of deaths in children under five years. The aim of this study was to evaluate the morphoquantitative effects in gastrocnemius muscle of Wistar rats fed with a diet utilized by people from rural areas of Mozambique. We used 75 Wistar rats weighing approximately 300 g divided in three groups: nourished or control (N, malnourished (D, and Mozambique or experimental group (M, measured at birth and at weaning. The animals were kept under the same housing conditions, temperature, humidity and light, but with different diets depending on the group: Group N with normal protein diet (20% casein, Group D with hypo-proteic diet (5% casein, and Group M with Mozambique diet. In all groups we evaluated the body mass at birth and weaning, and collected the right gastrocnemius muscle of male pups at weaning for analysis. Serial sections of 10 μm were performed in a cryostat prior to histology techniques of hematoxylin and eosin, picrosirius, NADH-tr and analysis in transmission electron microscope. Statistical evaluation was determined by analysis of variance (ANOVA and Tukey tests. Significant differences were found between groups N, D and M. In group M were observed a great variation of body mass that was approximately similar to group D; Group M also showed the same changes in muscle fiber which exhibited round-shaped contours, and predominance of type III collagen, similarly to malnourished group (D. Ultra-structurally, animals from Mozambique displayed a disorganization of the Z lines of sarcomeres, myofibrils disruption, decreased cross-sectional area and a smaller proportion of

  7. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: The Bogalusa Heart Study

    Directory of Open Access Journals (Sweden)

    Xu Jihua

    2010-10-01

    Full Text Available Abstract Background Body Mass Index (BMI is widely used to assess the impact of obesity on cardiometabolic risk in children but it does not always relate to central obesity and varies with growth and maturation. Waist-to-Height Ratio (WHtR is a relatively constant anthropometric index of abdominal obesity across different age, sex or racial groups. However, information is scant on the utility of WHtR in assessing the status of abdominal obesity and related cardiometabolic risk profile among normal weight and overweight/obese children, categorized according to the accepted BMI threshold values. Methods Cross-sectional cardiometabolic risk factor variables on 3091 black and white children (56% white, 50% male, 4-18 years of age were used. Based on the age-, race- and sex-specific percentiles of BMI, the children were classified as normal weight (5th - 85th percentiles and overweight/obese (≥ 85th percentile. The risk profiles of each group based on the WHtR ( Results 9.2% of the children in the normal weight group were centrally obese (WHtR ≥0.5 and 19.8% among the overweight/obese were not (WHtR Conclusion WHtR not only detects central obesity and related adverse cardiometabolic risk among normal weight children, but also identifies those without such conditions among the overweight/obese children, which has implications for pediatric primary care practice.

  8. Success of a comprehensive school-based asthma intervention on clinical markers and resource utilization for inner-city children with asthma in Chicago: the Mobile C.A.R.E. Foundation's asthma management program.

    Science.gov (United States)

    Patel, Bina; Sheridan, Phil; Detjen, Paul; Donnersberger, David; Gluck, Eric; Malamut, Karen; Whyte, Stephanie; Miller, Amy; Qing, Harshaw

    2007-03-01

    Children with asthma in low-income households in Chicago were participants in a school-based mobile van clinic, Mobile C.A.R.E. Our objective was to investigate whether long-term follow-up changed clinical markers and resource utilization. Children were evaluated by a pediatrician in a mobile allergy clinic and classified and treated based on National Asthma Education and Prevention Program (NAEPP) guidelines. Intervention consisted of assessment of allergic environment with avoidance recommendations, institution of appropriate controller therapy and inhaler technique, education on asthma and asthma management, and expectations for asthma control. Over 20,000 children were screened, 2041 were examined at least once, and 677 children had four follow-up visits. With follow-up, there was a decrease in hospitalizations and emergency room visits. Symptomatic markers (daytime and nighttime cough, wheezing, and dyspnea symptoms), frequency of rescue inhaler use, and a quality-of-life score improved from baseline. These findings suggest that ongoing school interventions may reduce resource utilization and improve clinical symptoms. Primary care physicians may be able to deliver specialized care to large numbers of inner-city children with asthma.

  9. Undernutrition in children with profound intellectual and multiple disabilities (PIMD): its prevalence and influence on quality of life.

    Science.gov (United States)

    Holenweg-Gross, C; Newman, C J; Faouzi, M; Poirot-Hodgkinson, I; Bérard, C; Roulet-Perez, E

    2014-07-01

    To estimate the prevalence of undernutrition among children with profound intellectual and multiple disabilities (PIMD) and to explore its influence on quality of life. Seventy-two children with PIMD (47 male; 25 female; age range 2 to 15 years 4 months; mean age 8.6, SD 3.6) underwent an anthropometric assessment, including body weight, triceps skinfold thickness, segmental measures and recumbent length. Undernutrition was determined using tricipital skinfold percentile and z-scores of weight-for-height and height-for-age. The quality of life of each child was evaluated using the QUALIN questionnaire adapted for profoundly disabled children. Twenty-five children (34.7%) were undernourished and seven (9.7%) were obese. Among undernourished children only eight (32 %) were receiving food supplements and two (8%) had a gastrostomy, of which one was still on a refeeding programme. On multivariate analysis, undernutrition was one of the independent predictors of lower quality of life. Undernutrition remains a matter of concern in children with PIMD. There is a need to better train professionals in systematically assessing the nutritional status of profoundly disabled children in order to start nutritional management when necessary. © 2013 John Wiley & Sons Ltd.

  10. Assessment of undernutrition among children below 5, using Composite Index of Anthropometric Failure (CIAF

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    Garima Gupta

    2017-03-01

    Full Text Available Background: SDG 2.2 aims to end all forms of malnutrition by 2030. Weight for age estimate misses out chronic and acute on chronic malnutrition. An aggregate indicator-the Composite Index of Anthropometric Failure (CIAF can help in addressing this concern. Aim & Objective: To assess the nutritional status of under five children using CIAF and compare it with other indices. Material & Methods: A cross-sectional, descriptive study was conducted in a resettlement colony of Delhi, between June to July 2015. Anthropometric measurements were taken using standard operative procedures. Mothers of the study children were interviewed to obtain relevant information. Z scores were calculated using WHO-ANTHRO software. Nutritional status indicators were determined as per the World Health Organization 2006 child growth standards. Results: A total of 100 under-5 children were assessed. The prevalence of CIAF was 62% in our study. 35% of children were found to be underweight, 25% were wasted and 43% stunted. Mid Upper Arm Circumference detected 58.5% as undernourished. Using weight-for-age criterion for identifying undernourished children led to underestimation of the prevalence by 27%. Conclusion: CIAF can be used to provide a single, aggregated assessment of undernutrition. Use of this tool by field level workers will improve the diagnosis of undernutrition and help in early initiation of treatment.

  11. Disparities in Healthcare Access and Utilization among Children with Autism Spectrum Disorder from Immigrant Non-English Primary Language Households in the United States

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    Sue C. Lin, MS

    2015-09-01

    Full Text Available Background: The prevalence of autism spectrum disorder (ASD in United State (US has surged from 1 in 150 children in 2007 to 1 in 88 children in 2012 with substantial increase in immigrant minority groups including Hispanic and Somali children. Our study objective is to examine the associations between household language among children with ASD and national health quality indicators attainment. Methods: We conducted bivariate and multivariate logistic regression analyses using cross-sectional data from the publicly-available 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN to investigate the association between household language use and quality indicators of medical home, adequate insurance, and early and continuous screening. Results: Approximately, 28% of parents of children with ASD from non-English primary language (NEPL households reported their child having severe ASD as compared with 13% of parents from English primary language (EPL households. Older children were more likely to have care that met the early and continuous screening quality indicator, while lower income children and uninsured children were less likely to have met this indicator. Conclusions and Global Health Implications: Despite the lack of differences in the attainment of quality indicators by household language, the higher severity found in children in NEPL households suggests that they are exceptionally vulnerable. Enhanced early screening and identification for these children and supporting their parents in navigating the complex US health care delivery system would increase their participation in early intervention services. Immigration of children with special health care needs from around the world to the US has been increasing from countries with diverse healthcare systems. Our findings will help to inform policies and interventions to reduce health disparities for children with ASD from immigrant populations. As the prevalence of

  12. Estimating Utility

    DEFF Research Database (Denmark)

    Arndt, Channing; Simler, Kenneth R.

    2010-01-01

    A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes...... an information-theoretic approach to estimating cost-of-basic-needs (CBN) poverty lines that are utility consistent. Applications to date illustrate that utility-consistent poverty measurements derived from the proposed approach and those derived from current CBN best practices often differ substantially......, with the current approach tending to systematically overestimate (underestimate) poverty in urban (rural) zones....

  13. Describing normal development in an African setting : The utility of the Kilifi Developmental Inventory among young children at the Kenyan coast

    NARCIS (Netherlands)

    Kitsao-Wekulo, Patricia; Holding, Penny; Abubakar, Amina; Kvalsvig, Jane; Taylor, H. Gerry; King, Christopher L.

    The Kilifi Developmental Inventory (KDI) is a tool developed in Kenya for the assessment of psychomotor development in infants and young children. We developed age-appropriate standards against which the developmental progress of individual children could be tracked. The current report is based on

  14. Beliefs and cultural values of the undernourished child's family Creencias y valores culturales de la familia del niño desnutrido Crenças e valores culturais da família da criança desnutrida

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    Mirna Albuquerque Frota

    2008-03-01

    Full Text Available OBJECTIVE: To identify and analyze the meanings of the mothers' participation in looking after their undernourished child. METHODS: An ethnographic approach was adopted, focusing on group dynamics within the family. RESULTS: Family influence in undernourished child care and the prevention of current and future practices related to the factors impede quality care. CONCLUSION: The cultural meanings that guide mothers, in terms of care, support, education and culture, are sustained by the social structure and have direct effects on the quality of people's life, as individuals and as social groups.OBJETIVO: Identificar y analizar el significado de la participación de las madres en el cuidado del niño desnutrido. MÉTODOS: Fue utilizado el abordaje etnográfico, focalizando en la dinámica de grupo dentro de la familia. RESULTADOS: Fue evidenciado que la familia influye en el cuidado al niño desnutrido y la prevención de las actuales y futuras prácticas relacionadas a los factores culturales que impiden la calidad del cuidado. CONCLUSIÓN: El significado que conduce la madre, en relación al cuidado y soporte, educación y cultura son sustentados por una estructura social y tiene efectos directos en la calidad de vida de las personas, como individuos y también como grupo social.OBJETIVO: Identificar e analisar o significado da participação das mães no cuidado da criança desnutrida. MÉTODOS: Foi utilizada uma abordagem etnográfica, focalizando na dinâmica de grupo dentro da família. RESULTADOS: Foi evidenciado que a família influencia no cuidado à criança desnutrida e a prevenção das atuais e futuras práticas relacionadas aos fatores culturais impedem a qualidade do cuidado. CONCLUSÃO: O significado que conduz a mãe, em relação ao cuidado e suporte, educação e cultura são sustentados por uma estrutura social e tem efeitos diretos na qualidade de vida das pessoas, como indivíduos e também como grupo social.

  15. [Association between nutritional status and physical abilities in children aged 6 to 18 years in Medellin (Colombia)].

    Science.gov (United States)

    García Cruz, A; Figueroa Suárez, J; Osorio Ciro, J; Rodríguez Chavarro, N; Gallo Villegas, J

    2014-12-01

    Nutritional disorders in childhood may cause a decline in motor abilities and increased morbidity and mortality in adulthood. To assess the association between nutritional status and motor abilities. A cross-sectional study was performed that included 12,872 children aged between 6 and 18 years who underwent a clinical evaluation and various physical tests. Among the children, 66% had a Tanner maturation stage 1 and 2, 6% were under-nourished, and 12.2% were at risk of overweight and obesity. The obese children had a decrease in aerobic power (in 2.72 mL O2 kg(-1)·min(-1); 95%CI: 1.89 to 3.56; Pchildren showed a decrease in speed (0.13 m·sec; 95%CI: 0.06 to 0.20; Pnutritional status and motor abilities in the children included in this study. Obese children showed the worst results in physical tests, and the under-nourished ones showed a decrease in speed, explosive strength and strength endurance. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. COMPARISON OF WHO GROWTH STANDARDS WITH INDIAN ACADEMY OF PEDIATRICS STANDARDS OF UNDER FIVE CHILDREN IN AN URBAN SLUM

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    Anjali B Dhone

    2013-12-01

    Full Text Available Background: Child undernutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Prevalence of under nutrition is very high in India; especially in urban slums. Objective: To compare the prevalence of under nutrition among underfive children using WHO growth standards with IAP standards.Methods: Community based cross sectional study was done during November-2008 to December-2009 in urban field practice area of Medical College Pune, India. All the underfive children (336 were enumerated by house to house survey. Parents were informed about the objectives of the study and their written consent was obtained. Anthropometric measurements of the children who were available during the study period were carried out as per WHO guidelines and IAP standards. Various indices of nutritional status were expressed in standard deviation units (z scores from the reference median. Epi-Info 2002 and Primer of Bio-statistics software package was used for statistical analysis.Results: Total 336 children were enumerated by house to house visit. Only 319 children were available during the study. Weights were recorded according to WHO and IAP standards. It was found that boys were more undernourished than girls by using WHO standards (P<0.005. When weights of girls were compared according to these two standards the girls were found to be more undernourished by WHO standards but difference was not statically significant.

  17. Effects of secondhand smoke exposure on asthma morbidity and health care utilization in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Zhen; May, Sara M; Charoenlap, Suvanee; Pyle, Regan; Ott, Nancy L; Mohammed, Khaled; Joshi, Avni Y

    2015-11-01

    Secondhand smoke (SHS) exposure can trigger asthma exacerbations in children. Different studies have linked increased asthma symptoms, health care use, and deaths in children exposed to SHS, but the risk has not been quantified uniformly across studies. To perform a systematic review and meta-analysis to evaluate and quantify asthma severity and health care use from SHS exposure in children. A systematic review was undertaken to assess the association between asthma severity and SHS in children. Inclusion criteria included studies that evaluated children with SHS exposure and reported outcomes of interest with asthma severity including exacerbations. Random effect models were used to combine the outcomes of interest (hospitalization, emergency department or urgent care visits, severe asthma symptoms, wheeze symptoms, and pulmonary function test results) from the included studies. A total of 1,945 studies were identified and 25 studies met the inclusion criteria. Children with asthma and SHS exposure were twice as likely to be hospitalized for asthma (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.20-2.86, P = .01) than children with asthma but without SHS exposure. SHS exposure also was significantly associated with emergency department or urgent care visits (OR 1.66, 95% CI 1.02-2.69, P = 0.04), wheeze symptoms (OR 1.32, 95% CI 1.24, 1.41, P < .001), and lower ratio of forced expiratory volume in 1 second to forced vital capacity (OR -3.34, 95% CI -5.35 to -1.33, P = .001). Children with asthma and SHS exposure are nearly twice as likely to be hospitalized with asthma exacerbation and are more likely to have lower pulmonary function test results. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Utility of unenhanced fat-suppressed T1-weighted MRI in children with sickle cell disease - can it differentiate bone infarcts from acute osteomyelitis?

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, Jorge; Bedoya, Maria A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Green, Abby M. [The Children' s Hospital of Philadelphia, Division of Oncology, Philadelphia, PA (United States); Jaramillo, Diego; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA (United States)

    2015-12-15

    Children with sickle cell disease (SCD) are at risk of bone infarcts and acute osteomyelitis. The clinical differentiation between a bone infarct and acute osteomyelitis is a diagnostic challenge. Unenhanced T1-W fat-saturated MR images have been proposed as a potential tool to differentiate bone infarcts from osteomyelitis. To evaluate the reliability of unenhanced T1-W fat-saturated MRI for differentiation between bone infarcts and acute osteomyelitis in children with SCD. We retrospectively reviewed the records of 31 children (20 boys, 11 girls; mean age 10.6 years, range 1.1-17.9 years) with SCD and acute bone pain who underwent MR imaging including unenhanced T1-W fat-saturated images from 2005 to 2010. Complete clinical charts were reviewed by a pediatric hematologist with training in infectious diseases to determine a clinical standard to define the presence or absence of osteomyelitis. A pediatric radiologist reviewed all MR imaging and was blinded to clinical information. Based on the signal intensity in T1-W fat-saturated images, the children were further classified as positive for osteomyelitis (low bone marrow signal intensity) or positive for bone infarct (high bone marrow signal intensity). Based on the clinical standard, 5 children were classified as positive for osteomyelitis and 26 children as positive for bone infarct (negative for osteomyelitis). The bone marrow signal intensity on T1-W fat-saturated imaging was not significant for the differentiation between bone infarct and osteomyelitis (P = 0.56). None of the additional evaluated imaging parameters on unenhanced MRI proved reliable in differentiating these diagnoses. The bone marrow signal intensity on unenhanced T1-W fat-saturated MR images is not a reliable criterion to differentiate bone infarcts from osteomyelitis in children. (orig.)

  19. Asthma-Like Symptoms in Homeless Children in the Greater Paris Area in 2013: Prevalence, Associated Factors and Utilization of Healthcare Services in the ENFAMS Survey.

    Directory of Open Access Journals (Sweden)

    Delphine Lefeuvre

    Full Text Available Asthma remains poorly studied in homeless children. We sought to estimate the prevalence of asthma-like symptoms (ALS and to identify the factors associated with ALS and healthcare service utilisation.A cross-sectional survey of a random sample of sheltered homeless families was conducted by interviewing 801 parents of children (0-12 years in 17 languages. ALS were defined as wheezing or night cough without fever during the previous year. Poisson regression models with robust error variance were used to compute prevalence ratios (PR for factors associated with ALS and healthcare service utilisation for ALS.The prevalence of ALS among the children was 19.9%. Poor housing sanitation was significantly associated with ALS, as being born in the European Union. Most of the children with ALS had used healthcare services (85.4%. The main barriers to accessing such services were having lived in France for less than 49 months, having difficulties in French and living in poor housing conditions.ALS prevalence seemed lower than in the general child population, possibly because of the children's origins. Environmental factors associated with ALS point to the need to improve the indoor environment of family shelters. The relatively high rate of healthcare service utilisation should not overshadow existing barriers.

  20. Utility of knowledge, attitude, and practice survey, and prevalence of dental caries among 11- to 13-year-old children in an urban community in India

    Directory of Open Access Journals (Sweden)

    Sanskriti Khanal

    2013-04-01

    Full Text Available Background: The school oral health education program is believed to be a cost-effective method for promoting oral health. The KAP (knowledge–attitude–practice model of oral health education is often the foundation of most health education programs. Objectives: To assess the existing knowledge, attitude, and oral health care practices among 11- to 13-year-old children and the association of knowledge with attitude, oral health care practices, and dental caries prevalence. Design: Cross-sectional design, involving 858 children studying in class seven at various schools in the city of Mangalore, India. The children were selected using stratified random sampling method. Prevalence of dental caries was determined using decayed, missing, and filled permanent teeth (DMFT index. A self-administered questionnaire on self-care practices in oral health, knowledge, and attitude toward oral health care was filled by children. The association of different variables with knowledge was analyzed using binary logistic regression analysis. Results: The dental caries prevalence was 59.4%, and 54.5% had low knowledge. They lacked knowledge regarding use of fluoridated toothpaste and did not use them. Children with low knowledge had significantly higher odds of having DMFT ≥ 1, not using fluoridated toothpaste, and being afraid of going to the dentist due to possible pain. There was no association of other oral health care practices and attitudes with knowledge. Conclusion: Oral health care practices and attitudes are not fully explained by knowledge, and other models of health education need to be considered.

  1. Lymphatic filariasis elimination efforts in Rufiji, southeastern Tanzania: decline in circulating filarial antigen prevalence in young school children after twelve rounds of mass drug administration and utilization of long-lasting insecticide-treated nets.

    Science.gov (United States)

    Jones, Clarer; Ngasalla, Billy; Derua, Yahya A; Tarimo, Donath; Malecela, Mwelecele N

    2017-08-01

    Lymphatic filariasis (LF) is a parasitic infection transmitted by mosquito vectors, and in Sub-Saharan Africa it is caused by the nematode Wuchereria bancrofti. The disease has been targeted for global elimination with the annual mass drug administration (MDA) strategy. Vector control is known to play an important complementary role to MDA in reducing the transmission of LF. The effects of an MDA and insecticide-treated net intervention implemented in an endemic area of southeastern Tanzania are reported here. A cross-sectional study assessing W. bancrofti circulating filarial antigen (CFA) was conducted in five primary schools in five different villages. Standard one pupils aged 6-9 years were screened for CFA using immunochromatographic test cards (ICT), with a total of 413 screened in 2012 and 659 in 2015. Just after CFA testing, the children were interviewed on their participation in the MDA campaign. Moreover, 246 heads of households in 2012 and 868 in 2015 were interviewed on their participation in MDA and utilization of long-lasting insecticide-treated nets (LLINs). The prevalence of CFA for the 413 children tested in 2012 was 14.3%, while it was 0.0% for the 659 children tested in 2015. The Tanzanian National Lymphatic Filariasis Elimination Programme reported annual treatment coverage for Rufiji District ranging from 54.3% to 94.0% during the years 2002-2014. The surveyed treatment was 51.6% in 2011 and 57.4% in 2014. With regard to LLINs, possession and utilization increased from 63.4% and 59.2%, respectively, in 2012, to 92.5% and 75.4%, respectively, in 2015. The findings suggest that 12 rounds of MDA complemented with vector control through the use of insecticide-treated nets resulted in a marked reduction in W. bancrofti CFA in young school children. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Reduced expressions of calmodulin genes and protein and reduced ability of calmodulin to activate plasma membrane Ca(2+)-ATPase in the brain of protein undernourished rats: modulatory roles of selenium and zinc supplementation.

    Science.gov (United States)

    Adebayo, Olusegun L; Khera, Alka; Sandhir, Rajat; Adenuga, Gbenga A

    2016-03-01

    The roles of protein undernutrition as well as selenium (Se) and zinc (Zn) supplementation on the ability of calmodulin (CaM) to activate erythrocyte ghost membrane (EGM) Ca(2+)-ATPase and the calmodulin genes and protein expressions in rat's cortex and cerebellum were investigated. Rats on adequate protein diet and protein-undernourished (PU) rats were fed with diet containing 16% and 5% casein, respectively, for a period of 10 weeks. The rats were then supplemented with Se and Zn at a concentration of 0.15 and 227 mg l(-1), respectively, in drinking water for 3 weeks. The results obtained from the study showed significant reductions in synaptosomal plasma membrane Ca(2+)-ATPase (PMCA) activity, Ca(2+)/CaM activated EGM Ca(2+) ATPase activity and calmodulin genes and protein expressions in PU rats. Se or Zn supplementation improved the ability of Ca(2+)/CaM to activate EGM Ca(2+)-ATPase and protein expressions. Se or Zn supplementation improved gene expression in the cerebellum but not in the cortex. Also, the activity of PMCA was significantly improved by Zn. In conclusion, it is postulated that Se and Zn might be beneficial antioxidants in protecting against neuronal dysfunction resulting from reduced level of calmodulin such as present in protein undernutrition. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales

    Directory of Open Access Journals (Sweden)

    Burwinkle Tasha M

    2007-07-01

    Full Text Available Abstract Background Advances in biomedical science and technology have resulted in dramatic improvements in the healthcare of pediatric chronic conditions. With enhanced survival, health-related quality of life (HRQOL issues have become more salient. The objectives of this study were to compare generic HRQOL across ten chronic disease clusters and 33 disease categories/severities from the perspectives of patients and parents. Comparisons were also benchmarked with healthy children data. Methods The analyses were based on over 2,500 pediatric patients from 10 physician-diagnosed disease clusters and 33 disease categories/severities and over 9,500 healthy children utilizing the PedsQL™ 4.0 Generic Core Scales. Patients were recruited from general pediatric clinics, subspecialty clinics, and hospitals. Results Pediatric patients with diabetes, gastrointestinal conditions, cardiac conditions, asthma, obesity, end stage renal disease, psychiatric disorders, cancer, rheumatologic conditions, and cerebral palsy self-reported progressively more impaired overall HRQOL than healthy children, respectively, with medium to large effect sizes. Patients with cerebral palsy self-reported the most impaired HRQOL, while patients with diabetes self-reported the best HRQOL. Parent proxy-reports generally paralleled patient self-report, with several notable differences. Conclusion The results demonstrate differential effects of pediatric chronic conditions on patient HRQOL across diseases clusters, categories, and severities utilizing the PedsQL™ 4.0 Generic Core Scales from the perspectives of pediatric patients and parents. The data contained within this study represents a larger and more diverse population of pediatric patients with chronic conditions than previously reported in the extant literature. The findings contribute important information on the differential effects of pediatric chronic conditions on generic HRQOL from the perspectives of children and

  4. Reproducibility and utility of an overnight 0.25 mg dexamethasone suppression test as a marker for glucocorticoid sensitivity in children with asthma

    NARCIS (Netherlands)

    R.H. Willemsen (Ruben); L. van Leeuwen; T.A.S. Voorend-Van Bergen; Y.B. de Rijke (Yolanda); M.W.H. Pijnenburg (Mariëlle); E.L.T. van den Akker (Erica)

    2016-01-01

    textabstractPurpose: Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment in children. However, there is considerable inter-individual variation in glucocorticoid sensitivity, leading to over- as well as undertreatment. A simple and fast test to predict glucocorticoid sensitivity

  5. Health-Related Quality of Life and Cognitive Functioning from the Perspective of Parents of School-Aged Children with Asperger's Syndrome Utilizing the PedsQL[TM

    Science.gov (United States)

    Limbers, Christine A.; Heffer, Robert W.; Varni, James W.

    2009-01-01

    HRQOL as a multidimensional construct has not been previously investigated in children with Asperger's Syndrome. The objective of the present study was to examine the initial feasibility, reliability, and validity of the PedsQL[TM] 4.0 Generic Core Scales and PedsQL[TM] Cognitive Functioning Scale parent proxy-report versions in school-aged…

  6. The Potential Utility and Technical Feasibility of a Computer-Based Tracking System for Birth through Five Year Old Children with Handicaps in Illinois.

    Science.gov (United States)

    Luick, Anthony H.

    A plan for a long term tracking system for handicapped children (birth to 5 years old) in Illinois is considered. The plan, based on agreements among five state agencies, could be used in a variety of ways, including for direct client care, statistical recordkeeping, and service evaluation. Advantages of an interactive system are identified, and…

  7. A Study of the Relationship between Virtual Reality (Perceived Realism) and the Ability of Children To Create, Manipulate and Utilize Mental Images for Spatially Related Problem Solving.

    Science.gov (United States)

    Merickel, Mark L.

    The premise of the Creative Technology Project, a collaboration by Autodesk, Inc., the School of Education at Oregon State University, and Novato Unified School District in the San Francisco Bay Area, was that children's cognitive abilities could be enhanced by having them develop, displace, transform, and interact with 2D and 3D…

  8. Does school breakfast benefit children's educational performance?

    Science.gov (United States)

    Fernald, L; Ani, C C; Grantham-mcgregor, S

    1997-09-01

    This article reviews several research studies on the impact of the lack of breakfast among students. Recent data reveal that about 20% of Nigerian children were wasted or had weight-for-height measurements under the 5th percentile of the US National Center for Health Statistics (NCHS) standard. In Ghana, 41% of children were underweight or had a weight-for-age under -2 standard deviations of the NCHS standards. In Tanzania, about 34% of children were underweight. Many more students in Africa are attending school, but many are leaving primary school early or failing secondary school examinations. It is argued that poor nutritional status affects children's ability to learn. Research reveals several hypotheses about how breakfast affects children's cognition, behavior, and school performance. Children may not attend school at all due to the inability to purchase food to eat at school, or insufficient food resources at home to provide sufficient energy to walk long distances to school. In four studies, two in the USA and the others in Peru and Jamaica, findings reveal that when undernourished children missed breakfast, they performed worse in tests of cognition. Adequately nourished children's performance was unaffected by missing breakfast. A study in four Jamaican schools found that children had more creative ideas when they received a breakfast for 2 weeks than when they did not receive breakfast. Two Swedish studies found that children with a high-calorie breakfast improved in cognition compared to those receiving a low-calorie breakfast. One study found that children in well-equipped classrooms paid more attention in class after having breakfast. Children in overcrowded classes and poorly equipped schools were less likely to pay attention after breakfast. Long-term effects are less well studied, but findings clearly support the benefits of breakfast.

  9. Utilization of Western and Traditional Korean Medicine for Children and Adolescents with Mental Disorders: a Nationwide Population-based Study from 2010 to 2012.

    Science.gov (United States)

    Kim, Su Jin; Kim, Bongseog; Lee, Young Sik; Bahn, Geon Ho

    2016-05-01

    When in need of medical treatment, Korean citizens have a choice of practitioners of western medicine (WM) or Traditional Korean Medicine (TKM). However, the two branches frequently conflict with one another, particularly with regard to mental disorders. This study was designed to compare the utilization of WM and TKM, focusing on child/adolescent patients with mental disorders. We analyzed F-code (Mental and behavioral disorders) claims from the Korean Health Insurance Review and Assessment Service, including data from 0-18-year-old patients from 2010 to 2012. Slightly more men than women utilized WM, while TKM use was almost evenly balanced. WM claims increased with advancing age, whereas utilization of TKM was common for the 0-6 age group. In WM and TKM, the total number of claims relying on the National Health Insurance Service (NHIS) was 331,154 (92.78%) and 73,282 (97.85%), respectively, and the number of claims relying on medical aid was 25,753 (7.22%) and 1,610 (2.15%), respectively. The most frequent F-coded claim in WM was F90 (Hyperkinetic disorders), with 64,088 claims (17.96%), and that in TKM was F45 (Somatoform disorders), with 28,852 claims (38.52%). The prevalence of a single disorder without comorbidities was 168,764 (47.29%) in WM and 52,615 (70.25%) in TKM. From these data, we conclude that WM takes prevalence over TKM in cases of attention deficit/hyperactivity disorder (ADHD), as well as in psychological problems such as depression and anxiety. On the other hand, patients utilizing TKM more commonly present with physical health problems including somatoform problems, sleep, and eating disorders.

  10. Village health volunteers' individual social capital and caretakers' health service utilization for febrile children in Malaria-endemic villages in Papua New Guinea.

    Science.gov (United States)

    Inoue, Yosuke; Takahashi, Daichi; Kondo, Naoki; Yoshii, Akiko; Sekihara, Makoto; Hombhanje, Francis W; Tsukahara, Takahiro

    2017-11-01

    Little is known about the association between the social capital of village health volunteers (VHVs) and their performance in relation to malarial care. Data came from 337 children and 13 VHVs working in Dagua, Papua New Guinea. The outcome variable was whether caretakers brought their children to health care services on the incidence of a febrile episode. The social capital of VHVs was assessed by inquiring about relationships with people in 25 social positions/roles. Caretakers were more likely to bring their febrile children to health care services when they lived in a village whose VHVs frequently discussed their activities with people in positions/roles outside their village (prevalence ratio [PR]=1.47 [95% confidence interval {CI} 1.22 to 1.78]). On the other hand, caretakers were less likely to do so when their VHVs had known people in informal positions/roles inside their village (PR=0.85 [95% CI 0.77 to 0.93]) and when they discussed their activities with people in formal positions/roles inside their village (PR=0.76 [95% CI 0.61 to 0.95]). Our results suggest that the social interactions of VHVs with people in positions/roles outside the village may benefit residents while those with people in positions/roles inside the village might not necessarily benefit them. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Utilization of teledentistry as a tool to screen for dental caries among 12-year-old school children in a rural region of India.

    Science.gov (United States)

    Purohit, Bharathi M; Singh, Abhinav; Dwivedi, Ashish

    2017-03-01

    The study aims to assess the reliability of video-graphic method as a tool to screen the dental caries among 12-year-old school children in a rural region of India. A total of 139 school children participated in the study. Visual tactile examinations were conducted using the Decayed, Missing, and Filled Teeth (DMFT) index. Simultaneously, standardized video recording of the oral cavity was performed. Sensitivity and specificity values were calculated for video-graphic assessment of dental caries. Bland-Altman plot was used to assess agreement between the two methods of caries assessment. Likelihood ratio (LR) and receiver-operating characteristic (ROC) curve were used to assess the predictive accuracy of the video-graphic method. Mean DMFT for the study population was 2.47 ± 2.01 and 2.46 ± 1.91 by visual tactile and video-graphic assessment (P = 0.76; > 0.05). Sensitivity and specificity values of 0.86 and 0.58 were established for video-graphic assessment. A fair degree of agreement was noted between the two methods with Intraclass correlation coefficient (ICC) value of 0.56. LR for video-graphic assessment was 2.05. Bland-Altman plot confirmed the level of agreement between the two assessment methods. The area under curve was 0.69 (CI 0.57, 0.80, P = 0.001). Teledentistry examination is comparable to clinical examination when screening for dental caries among school children. This study provides evidence that teledentistry may be used as an alternative screening tool for assessment of dental caries and is viable for remote consultation and treatment planning. Teledentistry offers to change the dynamics of dental care delivery and may effectively bridge the rural-urban oral health divide. © 2016 American Association of Public Health Dentistry.

  12. Environmental correlates of undernutrition among children of 3–6 years of age, Rajkot, Gujarat, India

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    Zalak Rameshbhai Matariya

    2016-01-01

    Full Text Available Introduction: There are lots of studies focusing on the role of reproductive and child health factors and dietary factors on the nutrition status of the child. The present study is an attempt to highlight the role of macro- and micro-environmental factors in predicting the occurrence of undernutrition in children. Methods: This was a cross-sectional study conducted in field practice area of Community Medicine Department, PDU Medical College, Rajkot. The nutrition status of children was assessed using the weight for age WHO reference standards, 2006. Children below two standard deviation of the reference median (weight for age were considered as malnourished. Data were collected for sociodemographic factors, sanitation, hygiene, and attitude of mother toward her child, etc., Data were entered in MS excel, and logistic regression was used. Results: Analysis of 495 selected children showed 24% prevalence of undernutrition. Employment status of mothers (adjusted odds ratio [AOR] 1.65, drinking water quality (AOR 1.53, and cleanliness of mother's hands and clothes (AOR 1.91 significantly affected the nutrition status of the child. Children classified in fair or poor category for Briscoe's sanitation scale had 1.34 and1.92 times higher odds of being undernourished (P > 0.05, respectively. Children classified in fair or poor category for Elizabeth's microenvironment scale had 2.05 and 2.41 times higher odds of being undernourished (P < 0.05, respectively. Conclusions: Water, sanitation, and hygiene-related factors, as well as microenvironmental factors, significantly affected the nutrition status of the children.

  13. Prevalence of severe acute malnutrition and associated sociodemographic factors among children aged 6 months–5 years in rural population of Northern India: A population-based survey

    Directory of Open Access Journals (Sweden)

    Ajeet Singh Bhadoria

    2017-01-01

    Full Text Available Introduction: National Family Health Survey (NFHS-3 documented that nearly 57 million children are undernourished in India, which is one-third of the world's share. We planned a study to identify the prevalence of severe acute malnutrition (SAM among children aged <5 years in a rural population of Northern India. Materials and Methods: A cross-sectional study was conducted at 2 blocks of District Meerut during 2012–2014. A total of 70 villages were identified and all children in the age group 6–60 months were approached through house-to-house visits. Data on sociodemographic profile and anthropometry were collected utilizing standards methods and equipment. The Z-scores for weight-for-age, height-for-age, and weight-for-height (WHZ were calculated using the World Health Organization (WHO reference data as standard. SAM (severe wasting was defined as per the WHO criteria (WHZ score −3 standard deviation or severe visible wasting or bipedal edema. Results: A total of 19,449 children were screened and 18,463 children (age, 32.6 ± 15.4 years, and 53.4% males were enrolled, and 466 were excluded due to erroneous age estimation and physical deformities. The prevalence of SAM was 2.2%, 95% confidence interval (CI 2.02–2.44%, (409/18,463. Multivariate logistic regression documented age (odds ratio [OR]: 0.97, 95% CI 0.96–0.98, nuclear family (OR: 1.25, 95% CI 1.01–1.54, lower occupation of head of family (OR: 1.29, 95% CI 1.05–1.59, and lower paternal education (OR: 1.49, 95% CI 1.16–1.91 as independent predictor of SAM. Conclusion: The prevalence of SAM was lower (2.2% in this Northern district of India as compared to national prevalence (7.9%. Younger age, nuclear family, lower parental education, and poor occupation of the head of the family predispose a child to SAM.

  14. A Tale of Smoking Cessation Promotion: The Utilization of a Children's Book to Increase Screening and Counseling in the Pediatric Clinic.

    Science.gov (United States)

    Thomas, Katharine E H; Kisely, Steve; Urrego, Fernando

    2017-10-01

    The rate at which pediatricians promote smoking cessation in clinical settings is low. The literature demonstrates that interventions paired with tangible health promotion materials may significantly increase screening rates to the pediatric office. The aim of this study was to investigate whether the addition of a children's book in the pediatric clinic could result in an increase in the rate in which pediatricians screened for secondhand smoke exposure (SHSe) and counseled caregivers to stop smoking. This randomized controlled study was performed at 7 pediatric clinics. Seven pediatric clinic sites were randomly assigned to either an intervention or control group. Pediatricians in the intervention group were given children's books about SHSe to distribute to their patients while the control group did not receive any materials. At baseline, there was no difference between the control group and intervention group in rates at which pediatricians screened for SHSe ( P = .8728) and counseled caregivers to stop smoking ( P = .29). After the intervention, screening for SHSe and counseling caregivers to stop smoking were statistically significantly greater in the intervention group, when compared to controls ( P book in the pediatric setting can increase the rate at which pediatricians screen for SHSe and counsel caregivers to stop smoking. Future research should examine the effect of the storybook on various parameters of smoking cessation and future smoking behaviors.

  15. Clinical utility of bronchoalveolar lavage and respiratory tract biopsies in diagnosis and management of suspected invasive respiratory fungal infections in children.

    Science.gov (United States)

    Batra, Surabhi; Li, Betty; Underhill, Nicole; Maloney, Rebekah; Katz, Ben Z; Hijiya, Nobuko

    2015-09-01

    Bronchoscopy with bronchoalveolar lavage (BAL) and respiratory tract biopsies are important tools for diagnosing fungal infections in children with cancer and hematopoietic stem cell transplant (HSCT) recipients. Our objective was to evaluate the impact of BAL and respiratory tract biopsies on the management of suspected fungal infections in oncology and HSCT patients. We retrospectively reviewed the medical records of oncology and HSCT patients with possible, probable, or proven fungal infection of the respiratory tract and determined whether BAL or biopsy following computed tomography (CT) prompted a change in management. Among 101 patients (0.5-29 years of age), 24 underwent a BAL and 31 had biopsies (27 lung and 4 sinus). The remaining 46 patients had CT scans only. Of these, there were radiographic findings suggestive of a fungal infection in 38 patients (83%). Thirty of these 38 patients (79%) had a change in management. BAL provided a diagnosis in 6 of 24 patients (25%). There was a change in management in 2 of the 6 (33%). Respiratory tract biopsy provided a diagnosis in 12 of 31 patients (39%). Biopsy results led to a change in management in 4 of the 12 patients (33%). Significant postoperative morbidity attributed to biopsy occurred in 3 of 31 patients (10%); 2 patients had pneumothorax requiring chest tube and intubation and a patient had prolonged intubation. BAL and biopsy in children with an oncological diagnosis or those undergoing HSCT only infrequently lead to changes in management in the era of empiric therapy with broad-spectrum anti-fungal agents. © 2015 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2009-01-01

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

  17. Dyslipidaemia and Undernutrition in Children from Impoverished Areas of Maceió, State of Alagoas, Brazil

    Directory of Open Access Journals (Sweden)

    Telma M. M. T. Florêncio

    2010-11-01

    Full Text Available Chronic undernutrition causes reduced growth and endocrine adaptations in order to maintain basic life processes. In the present study, the biochemical profiles of chronically undernourished children were determined in order to test the hypothesis that chronic undernutrition also causes changes in lipid profile in pre-school children. The study population comprised 80 children aged between 12 and 71 months, including 60 with moderate undernutrition [height-for-age Z (HAZ scores ≤ −2 and > −3] and 20 with severe undernutrition (HAZ scores ≤ −3. Socioeconomic, demographic and environmental data were obtained by application of a questionnaire, and anthropometric measurements and information relating to sex, age and feeding habits were collected by a trained nutritionist. Blood samples were analysed for haemoglobin, vitamin A, insulin-like growth factor 1 (IGF-1 and serum lipids, while cortisol was assayed in the saliva. Faecal samples were submitted to parasitological investigation. Analysis of variance and χ2 methods were employed in order to select the variables that participated in the multivariate logistic regression analysis. The study population was socioeconomically homogeneous, while the lack of a treated water supply was clearly associated with the degree of malnutrition. Most children were parasitised and anaemia was significantly more prevalent among the severely undernourished. Levels of IGF-1 decreased significantly with increasing severity of undernutrition. Lipid analysis revealed that almost all of the children had dyslipidemia, while low levels of high-density lipoprotein were associated with the degree of undernutrition. It is concluded that chronic malnutrition causes endocrine changes that give rise to alterations in the metabolic profile of pre-school children.

  18. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children

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    Jambert Elodie

    2010-10-01

    Full Text Available Abstract Background Important advances in the development and production of quality-certified pediatric antiretroviral (ARV formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. Methods We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Results Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs in solid and dispersible forms have been quality-certified since 2005. Most (67% of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Conclusion Pediatric ARV markets are more fragile than

  19. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children.

    Science.gov (United States)

    Waning, Brenda; Diedrichsen, Ellen; Jambert, Elodie; Bärnighausen, Till; Li, Yun; Pouw, Mieke; Moon, Suerie

    2010-10-17

    Important advances in the development and production of quality-certified pediatric antiretroviral (ARV) formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs) in solid and dispersible forms have been quality-certified since 2005. Most (67%) of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Pediatric ARV markets are more fragile than adult markets. Ensuring a long-term supply of quality, well

  20. Effect of 22q11.2 deletion on bleeding and transfusion utilization in children with congenital heart disease undergoing cardiac surgery

    Science.gov (United States)

    Brenner, Michelle K.; Clarke, Shanelle; Mahnke, Donna K.; Simpson, Pippa; Bercovitz, Rachel S.; Tomita-Mitchell, Aoy; Mitchell, Michael E.; Newman, Debra K.

    2016-01-01

    Background Post-surgical bleeding causes significant morbidity and mortality in children undergoing surgery for congenital heart defects (CHD). 22q11.2 deletion syndrome (DS) is the second most common genetic risk factor for CHD. The deleted segment of chromosome 22q11.2 encompasses the gene encoding glycoprotein (GP) Ibβ, which is required for expression of the GPIb-V-IX complex on the platelet surface, where it functions as the receptor for von Willebrand factor (VWF). Binding of GPIb-V-IX to VWF is important for platelets to initiate hemostasis. It is not known whether hemizygosity for the gene encoding GPIbβ increases the risk for bleeding following cardiac surgery for patients with 22q11.2 DS. Methods We performed a case-control study of 91 pediatric patients who underwent cardiac surgery with cardiopulmonary bypass from 2004–2012 at Children’s Hospital of Wisconsin. Results Patients with 22q11.2 DS had larger platelets and lower platelet counts, bled more excessively and received more transfusion support with packed red blood cells in the early post-operative period relative to control patients. Conclusions Pre-surgical genetic testing for 22q11.2 DS may help to identify a subset of pediatric cardiac surgery patients who are at increased risk for excessive bleeding and who may require more transfusion support in the post-operative period. PMID:26492284

  1. Morbilidad bucal: Su relación con el estado nutricional en niños de 2 a 5 años de la Consulta de Nutrición del Hospital Pediátrico Docente de Centro Habana Oral morbidity and its relationship with the nutritional status of 2-5 years-old children

    Directory of Open Access Journals (Sweden)

    María Elena Quiñónez Ybarra

    2004-04-01

    Full Text Available En el presente trabajo se describe la morbilidad de las principales afecciones bucales y su relación con el estado nutricional y peso al nacer en niños de 2 a 5 años de edad. Se realizó un estudio descriptivo transversal donde se evaluaron 230 niños, de ellos 115 eutróficos y 115 desnutridos, según tablas de referencia cubana de peso y talla, exámenes bioquímicos y exámenes clínicos, utilizándose como variables: estado nutricional, peso al nacer, índice coe-d, retardo del brote dentario, lesiones de esmalte, maloclusión e índice PMA. Para su procesamiento estadístico se aplicaron pruebas Chi cuadrado con un nivel de confiabilidad del 95 % (alfa 0,05. Se concluye que el índice coe-d fue de 0,14 para los eutróficos y de 0,71 para los desnutridos. El brote dentario estuvo retardado en el 2,63 % en los eutróficos, mientras que los desnutridos fue del 39,4 % y estuvo más retardado en los bajo peso al nacer, desnutridos, con el 75 %. Solo aparecieron lesiones de esmalte en el grupo de desnutridos (22,60 % y se incrementó en los bajo peso de este grupo (34,61 %. El porcentaje de maloclusión en el grupo eutrófico fue de 36,52 %, en los desnutridos 62,6 % y aumentó en los de bajo peso, con el 84,61 %. Se apreció como trastorno periodontal el 26,92 % de gingivitis moderada en niños desnutridos de bajo peso.The present paper describes the morbidity of the main oral diseases and their relationship with nutritional status and low birthweight in 2-5 years-old children. A cross-sectional descriptive study was conducted to evaluate 230 children - 115 eutrophic and 115 undernourished- according to the Cuban weight-size reference tables, biochemical and clinical examinations, using variables such as nutritional status, birthweight, coe-d index, dental eruption retardation, dental enamel lesions, malocclusion, and PMA index. For statistical processing, Chi-square test with a 95% confidence interval (alpha 0,05 was applied. It was

  2. The effects of breakfast on behavior and academic performance in children and adolescents.

    Science.gov (United States)

    Adolphus, Katie; Lawton, Clare L; Dye, Louise

    2013-01-01

    Breakfast consumption is associated with positive outcomes for diet quality, micronutrient intake, weight status and lifestyle factors. Breakfast has been suggested to positively affect learning in children in terms of behavior, cognitive, and school performance. However, these assertions are largely based on evidence which demonstrates acute effects of breakfast on cognitive performance. Less research which examines the effects of breakfast on the ecologically valid outcomes of academic performance or in-class behavior is available. The literature was searched for articles published between 1950-2013 indexed in Ovid MEDLINE, Pubmed, Web of Science, the Cochrane Library, EMBASE databases, and PsychINFO. Thirty-six articles examining the effects of breakfast on in-class behavior and academic performance in children and adolescents were included. The effects of breakfast in different populations were considered, including undernourished or well-nourished children and adolescents from differing socio-economic status (SES) backgrounds. The habitual and acute effects of breakfast and the effects of school breakfast programs (SBPs) were considered. The evidence indicated a mainly positive effect of breakfast on on-task behavior in the classroom. There was suggestive evidence that habitual breakfast (frequency and quality) and SBPs have a positive effect on children's academic performance with clearest effects on mathematic and arithmetic grades in undernourished children. Increased frequency of habitual breakfast was consistently positively associated with academic performance. Some evidence suggested that quality of habitual breakfast, in terms of providing a greater variety of food groups and adequate energy, was positively related to school performance. However, these associations can be attributed, in part, to confounders such as SES and to methodological weaknesses such as the subjective nature of the observations of behavior in class.

  3. Differences in Health Care Needs, Health Care Utilization, and Health Care Outcomes Among Children With Special Health Care Needs in Ohio: A Comparative Analysis Between Medicaid and Private Insurance.

    Science.gov (United States)

    Sarkar, Madhurima; Earley, Elizabeth R; Asti, Lindsey; Chisolm, Deena J

    This study explores comparative differentials in health care needs, health care utilization, and health status between Medicaid and private/employer-sponsored insurance (ESI) among a statewide population of children with special health care needs (CSHCN) in Ohio. We used data from the 2012 Ohio Medicaid Assessment Survey to examine CSHCN's health care needs, utilization, status, and health outcomes by insurance type. Adjusted multivariable logistic regression models were used to explore associations between public and private health insurance, as well as the utilization and health outcome variables. Bivariate analyses indicate that the Medicaid population had higher care coordination needs (odds ratio [OR] = 1.6; 95% confidence interval [CI], 1.1-2.2) as well as need for mental/educational health care services (OR = 1.5; 95% CI; 1.1-2.0). They also reported higher unmet dental care needs (OR = 2.2; 95% CI, 1.2-4.0), higher emergency department (ED) utilization (OR = 2.3; 95% CI, 1.7-3.2), and worse overall health (OR = 0.6; 95% CI, 0.4-0.7), oral health (OR = 0.4; 95% CI, 0.3-0.5), and vision health (OR = 0.4; 95% CI, 0.2-0.6). After controlling for demographic variables, CSHCN with Medicaid insurance coverage were more likely to need mental health and education services (adjusted odds ratio [AOR] = 1.8; 95% CI; 1.2-2.6), had significantly more ED visits (AOR = 2.3; 95% CI, 1.5-3.5), and were less likely to have excellent overall health (AOR = 0.64; 95% CI, 0.4-0.9), oral health (AOR = 0.43; 95% CI, 0.3-0.7), and vision health (AOR = 0.38; 95% CI, 0.2-0.6) than those with private insurance/ESI. The CSHCN population is a highly vulnerable population. While Ohio's Medicaid provides greater coverage to CSHCN, disparities continue to exist within access and services that Medicaid provides versus the ones provided by private insurance/ESI.

  4. Assessment of growth and feeding practices in children with cleft lip and palate.

    Science.gov (United States)

    Gopinath, V K; Muda, Wan Abdul Manan Wan

    2005-01-01

    Feeding difficulties in cleft lip and palate (CLP) infants is commonly observed and is the most traumatic experience the family has to face. These infants are undernourished and have compromised growth. The purpose of this study was to 1) assess general health and growth parameters in children with CLP and in normal children; and 2) investigate the feeding methods of CLP infants and normal infants. A total of 221 children from birth to six years of both sexes, with CLP (60 children) and normal (161 children) were selected. The CLP and normal children were divided into three subgroups by age. The practice of feeding the infants in subgroup I was assessed using standard piloted questionnaires. The assessment of growth was done at baseline and at six months in all the subgroups.The general well being of the children was assessed by noting the number of common infections. Results showed that a significantly higher percentage of mothers with normal babies (p < 0.01) had a positive attitude towards breast feeding. When compared to normal children, CLP children were more susceptible to infections (p < 0.05) and measured significantly lower on the height growth curve(p < 0.05). Hence, height can be used to monitor growth in CLP children.

  5. Acute Dehydrating Gastro-enteritis Undernourished Infants

    African Journals Online (AJOL)

    1974-08-03

    Aug 3, 1974 ... The use of half-strength. Oarrow's solution in 2;5% dextrose water, with supple- mentary intravenous sodium bicarbonate and oral potas- sium, rapidly corrected the electrolyte and acid-base dis- turbances. No significant difference resulted when this regimen was modified by variations in the rate, volume or.

  6. Efficacy of supplementation in Filipino children

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    Charisse Marie S Tayao

    2015-01-01

    Full Text Available Introduction: At present, in the absence of an anemia prevention and screening program in Barangay Vasra, this will aid in the formation of programs that would teach about this health related issue, with an intervention that could be used efficiently by the health workers at the non-government organization run center. Objective: The aim of the following study is to establish the efficacy of iron supplementation alone versus iron and ascorbic acid supplementation in improving the hemoglobin (Hgb, hematocrit (Hct, reticulocyte count and red cell indices of anemic undernourished children 5-10 years of age at Lingap Center, Barangay Vasra, Quezon City. Methodology: Anemic undernourished male and female children 5-10 years of age enrolled in the Supplementary Feeding Program of Lingap Center, Barangay Vasra, Quezon City. Study Design: Prospective, experimental trial comparing two interventions-iron supplementation alone versus iron and ascorbic acid supplementation. Results: A total of 25 children participated in this study, with a majority being female at 52% (13/25 of the total. Those who received iron supplementation alone for 6 months, while there were 50% (6/12 of either sex, whereas subjects who took iron and ascorbic acid supplementation for 6 months were predominantly female at 53.85% (7/13. Data obtained before and after iron supplementation alone revealed that there was an increase among the levels of Hgb, Hct, mean corpuscular volume (MCV, mean corpuscular hemoglobin (MCH, mean corpuscular hemoglobin concentration (MCHC and reticulocyte count, with the rise statistically significant. Hematological values gained before and after iron and ascorbic acid supplementation uncovered that there was an augmentation among the levels of Hct, MCV, MCH, MCHC and reticulocyte count, with the improvement statistically significant. Encompassing both interventions, the differences in findings were statistically significant in red blood cell (RBC count

  7. Efficacy of supplementation in filipino children.

    Science.gov (United States)

    Tayao, Charisse Marie S

    2015-01-01

    At present, in the absence of an anemia prevention and screening program in Barangay Vasra, this will aid in the formation of programs that would teach about this health related issue, with an intervention that could be used efficiently by the health workers at the non-government organization run center. The aim of the following study is to establish the efficacy of iron supplementation alone versus iron and ascorbic acid supplementation in improving the hemoglobin (Hgb), hematocrit (Hct), reticulocyte count and red cell indices of anemic undernourished children 5-10 years of age at Lingap Center, Barangay Vasra, Quezon City. Anemic undernourished male and female children 5-10 years of age enrolled in the Supplementary Feeding Program of Lingap Center, Barangay Vasra, Quezon City. Prospective, experimental trial comparing two interventions-iron supplementation alone versus iron and ascorbic acid supplementation. A total of 25 children participated in this study, with a majority being female at 52% (13/25) of the total. Those who received iron supplementation alone for 6 months, while there were 50% (6/12) of either sex, whereas subjects who took iron and ascorbic acid supplementation for 6 months were predominantly female at 53.85% (7/13). Data obtained before and after iron supplementation alone revealed that there was an increase among the levels of Hgb, Hct, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and reticulocyte count, with the rise statistically significant. Hematological values gained before and after iron and ascorbic acid supplementation uncovered that there was an augmentation among the levels of Hct, MCV, MCH, MCHC and reticulocyte count, with the improvement statistically significant. Encompassing both interventions, the differences in findings were statistically significant in red blood cell (RBC) count, with the level progression statistically significant. Overall, the results

  8. The effects of breakfast on behaviour and academic performance in children and adolescents

    Directory of Open Access Journals (Sweden)

    Katie eAdolphus

    2013-08-01

    Full Text Available Breakfast consumption is associated with positive outcomes for diet quality, micronutrient intake, weight status and lifestyle factors. Breakfast has been suggested to positively affect learning in children in terms of behaviour, cognitive and school performance. However, these assertions are largely based on evidence which demonstrates acute effects of breakfast on cognitive performance. Less research which examines the effects of breakfast on the ecologically valid outcomes of academic performance or in-class behaviour is available. The literature was searched for articles published between 1950-2013 indexed in Ovid MEDLINE, Pubmed, Web of Science, the Cochrane Library, EMBASE databases and PsychINFO. Thirty-six articles examining the effects of breakfast on in-class behaviour and academic performance in children and adolescents were included. The effects of breakfast in different populations were considered, including undernourished or well-nourished children and adolescents from differing socio-economic status (SES backgrounds. The habitual and acute effects of breakfast and the effects of school breakfast programs (SBPs were considered. The evidence indicated a mainly positive effect of breakfast on on-task behaviour in the classroom. There was suggestive evidence that habitual breakfast (frequency and quality and SBPs have a positive effect on children’s academic performance with clearest effects on mathematic and arithmetic grades in undernourished children. Increased frequency of habitual breakfast was consistently positively associated with academic performance. Some evidence suggested that quality of habitual breakfast, in terms of providing a greater variety of food groups and adequate energy, was positively related to school performance. However, these associations can be attributed, in part, to confounders such as SES and to methodological weaknesses such as the subjective nature of the observations of behaviour in class.

  9. A Comparative Analysis of Health-Related Quality of Life and Family Impact between Children with ADHD Treated in a General Pediatric Clinic and a Psychiatric Clinic Utilizing the PedsQL

    Science.gov (United States)

    Limbers, Christine A.; Ripperger-Suhler, Jane; Boutton, Kelly; Ransom, Daniel; Varni, James W.

    2011-01-01

    Objective: To evaluate health-related quality of life (HRQOL) from the perspective of children with ADHD and their parents being seen in a Pediatric Clinic in comparison to healthy children and children with ADHD being seen in a Psychiatric Clinic. Method: Participants were children with a physician diagnosis of ADHD ages 5-18 years and their…

  10. Utilization of Ig heavy chain variable, diversity, and joining gene segments in children with B-lineage acute lymphoblastic leukemia: implications for the mechanisms of VDJ recombination and for pathogenesis.

    Science.gov (United States)

    Li, Aihong; Rue, Montse; Zhou, Jianbiao; Wang, Hongjun; Goldwasser, Meredith A; Neuberg, Donna; Dalton, Virginia; Zuckerman, David; Lyons, Cheryl; Silverman, Lewis B; Sallan, Stephen E; Gribben, John G

    2004-06-15

    Sequence analysis of the immunoglobulin heavy chain genes (IgH) has demonstrated preferential usage of specific variable (V), diversity (D), and joining (J) genes at different stages of B-cell development and in B-cell malignancies, and this has provided insight into B-cell maturation and selection. Knowledge of the association between rearrangement patterns based on updated databases and clinical characteristics of pediatric acute lymphoblastic leukemia (ALL) is limited. We analyzed 381 IgH sequences identified at presentation in 317 children with B-lineage ALL and assessed the V(H)D(H)J(H) gene utilization profiles. The D(H)J(H)-proximal V(H) segments and the D(H)2 gene family were significantly overrepresented. Only 21% of V(H)-J(H) joinings were potentially productive, a finding associated with a trend toward an increased risk of relapse. These results suggest that physical location at the V(H) locus is involved in preferential usage of D(H)J(H)-proximal V(H) segments whereas D(H) and J(H) segment usage is governed by position-independent molecular mechanisms. Molecular pathophysiology appears relevant to clinical outcome in patients who have only productive rearrangements, and specific rearrangement patterns are associated with differences in the tumor biology of childhood ALL.

  11. Conventional nutritional indices and Composite Index of Anthropometric Failure: which seems more appropriate for assessing under-nutrition among children? A cross-sectional study among school children of the Bengalee Muslim Population of North Bengal,Indi

    Directory of Open Access Journals (Sweden)

    Jaydip Sen

    2011-06-01

    Full Text Available

    Background: Stunting, wasting and under-weight have been conventionally utilized to assess the prevalence of under-nutrition among children. As these indices grossly underestimate this prevalence mainly due to overlapping of the children into multiple categories of anthropometric failure, there is a need for an appropriate single measure to assess this prevalence and identify the more susceptible individuals. The present study tries to ascertain whether the use of the Composite Index of Anthropometric Failure (CIAF is more appropriate than the conventional indices for the estimation of under-nutrition among children.

    Methods: The present cross-sectional study was undertaken to compare the prevalence of under-nutrition using both the conventional indices and the CIAF among 1143 children aged between 5 years to 11 years (565 boys; 578 girls belonging to the Bengalee Muslim Population (BMP, and residing in the district of Darjeeling, West Bengal, India. The children were selected using a multi-stage stratified random sampling procedure. The data was collected during the period from February 2009 to May 2010. Height and weight of the children were recorded using standard procedures. The conventional anthropometric indices and the CIAF were compared with the National Center for Health Statistics reference data to determine the prevalence of under-nutrition. A child having a value 2SD’s below that of the reference median in any of these indices was classified as suffering from under-nutrition. All the necessary approvals and consents were obtained from the Gram Panchayets and school authorities, and the study was conducted in accordance with the ethical guidelines for human experiments as laid down in the Helsinki Declaration of 2000.

    Results: Using the conventional indices, the prevalence of under-nutrition was observed to be 17.4% (wasting, 38.5% (stunting and 47.0% (under

  12. [Classification of Colombian children with malnutrition according to NCHS reference or WHO standard].

    Science.gov (United States)

    Velásquez, Claudia; Bermúdez, Juliana; Echeverri, Claudia; Estrada, Alejandro

    2011-12-01

    A descriptive study was conducted to evaluate the concordance of National Center for Health Statistics reference (NCHS) used to classify undernourished children from Colombia with the WHO Child Growth Standards. We used data from children aged 6 to 59 months with acute malnutrition (Z Infantil" nutrition program in Colombia. Indicators height-for-age, weight for-height were analyzed when they were admitted to the hospital and weight for-height leaving the hospital. A statistical method used to compare means was T-student. Correlation coefficient intraclass (CCI) and Kappa index evaluated the concordance between NCHS and OMS; McNemar method evaluated the changes on the nutritional classification for children according to growth devices used. Of the total number of children classified as normal by NCHS, 10.4% were classified as stunted by WHO. 64% of the children admitted to the hospital presented acute malnutrition according to NCHS, of these 44,8% presented severe emaciation according to OMS, indeed severe emaciation increased of 36,0% to 63,3% using OMS. 5% of children leaving the hospital could need to stay more days if they had been evaluated with OMS. Growth devices shown high concordance in height-for-age (CCI = 0,988; k= 0,866) and weight for-height (CCI = 0,901; k = 0,578). Concluded that OMS growth standards classified more malnourished children and more severe states, in addition more malnourished children could be hospitalized and they could stay more days.

  13. Endocarditis - children

    Science.gov (United States)

    ... children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective endocarditis - children; Congenital heart disease - endocarditis - ...

  14. Predictors of Service Utilization among Youth Diagnosed with Mood Disorders

    Science.gov (United States)

    Mendenhall, Amy N.

    2012-01-01

    In this study, I investigated patterns and predictors of service utilization for children with mood disorders. The Behavioral Model for Health Care Utilization was used as an organizing framework for identifying predictors of the number and quality of services utilized. Hierarchical regression was used in secondary data analyses of the…

  15. Utility usage forecasting

    Science.gov (United States)

    Hosking, Jonathan R. M.; Natarajan, Ramesh

    2017-08-22

    The computer creates a utility demand forecast model for weather parameters by receiving a plurality of utility parameter values, wherein each received utility parameter value corresponds to a weather parameter value. Determining that a range of weather parameter values lacks a sufficient amount of corresponding received utility parameter values. Determining one or more utility parameter values that corresponds to the range of weather parameter values. Creating a model which correlates the received and the determined utility parameter values with the corresponding weather parameters values.

  16. Entrez Programming Utilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Entrez Programming Utilities (E-utilities) are a set of eight server-side programs that provide a stable interface into the Entrez query and database system at...

  17. Research Utilization in Rehabilitation.

    Science.gov (United States)

    Rogers, Everett M.

    In terms of its attention to research utilization, vocational rehabilitation today may be where agriculture was in 1913. One reason for this is an inadequate understanding of the process of research utilization. Scattered studies of research utilization have occurred, but suffer from a lack of integration. Among propositions that may be postulated…

  18. Nutritional status of pavement dweller children of Calcutta City.

    Science.gov (United States)

    Ray, S K; Mishra, R; Biswas, R; Kumar, S; Halder, A; Chatterjee, T

    1999-01-01

    Pavement dwelling is likely to aggravate malnutrition among its residents due to extreme poverty, lack of dwelling and access to food and their exposure to polluted environment. Paucity of information about nutritional status of street children compared to that among urban slum dwellers, squatters or rural/tribal population is quite evident. The present study revealed the magnitude of Protein Energy Malnutrition (PEM) and few associated factors among a sample of 435 underfives belonging to pavement dweller families and selected randomly from clusters of such families, from each of the five geographical sectors of Calcutta city. Overall prevalence of PEM was found almost similar (about 70%) to that among other 'urban poor' children viz. slum dwellers etc., but about 16% of them were found severely undernourished (Grade III & V of IAP classification of PEM). About 35% and 70% of street dweller children had wasting and stunting respectively. Severe PEM (Grade III & IV) was more prevalent among 12-23 months old, girl child, those belonged to illiterate parents and housewife mothers rather than wage earners. It also did increase with increase of birth rate of decrease of birth interval.

  19. Adaptive Calibration of Children's Physiological Responses to Family Stress: The Utility of Evolutionary Developmental Theory--Comment on Del Giudice et al. (2012) and Sturge-Apple et al. (2012)

    Science.gov (United States)

    Bugental, Daphne Blunt

    2012-01-01

    Children's physiological reactions to stress are presented from the broader theoretical perspective of adaptive calibration to the environment, as rooted in life history theory. Del Giudice, Hinnant, Ellis, and El-Sheikh (2012) focus on children's physiological responses to a stressful task as a consequence of their history of family stress.…

  20. Imaging utilization commentary: a radiology perspective

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Martin H. [University of Manitoba, Diagnostic Imaging, Children' s Hospital, Health Sciences Centre, Winnipeg (Canada); Children' s Hospital, Department of Radiology, Winnipeg, Manitoba (Canada)

    2008-11-15

    To adhere to the ALARA concept, imaging should be limited to studies that actually contribute to the management of the patient. For example, by applying the Ottawa Ankle Rule and the Ottawa Knee Rule, fewer radiographs are required to evaluate ankle and knee trauma in children. Chest radiographs usually do not contribute to the management of children presenting with typical acute bronchiolitis or asthma, and they can be detrimental because consolidation resulting from retained secretions is interpreted as pneumonia and the child is started on antibiotics unnecessarily. Moreover, a radiograph of the abdomen has poor validity and reproducibility for the diagnosis of constipation. The Pediatric Emergency Care Applied Research Network (PECARN) and the Pediatric Emergency Research in Canada (PERC) are currently developing decision rules for the use of CT in the assessment of minor head injuries in children, which should reduce its utilization in this condition. PECARN is also developing a decision rule for the use of CT in the assessment of abdominal trauma in children. CT is frequently used for the diagnosis of appendicitis in children, but appendicitis can be diagnosed clinically. If imaging is required, appendicitis can often be diagnosed with US, and CT need only be used in the minority of cases where the diagnosis is still in doubt. Utilization guidelines for pediatric imaging studies obtained in children in the emergency setting can improve yield and help in the more efficient management of often scarce health care resources. (orig.)

  1. Imaging utilization commentary: a radiology perspective

    International Nuclear Information System (INIS)

    Reed, Martin H.

    2008-01-01

    To adhere to the ALARA concept, imaging should be limited to studies that actually contribute to the management of the patient. For example, by applying the Ottawa Ankle Rule and the Ottawa Knee Rule, fewer radiographs are required to evaluate ankle and knee trauma in children. Chest radiographs usually do not contribute to the management of children presenting with typical acute bronchiolitis or asthma, and they can be detrimental because consolidation resulting from retained secretions is interpreted as pneumonia and the child is started on antibiotics unnecessarily. Moreover, a radiograph of the abdomen has poor validity and reproducibility for the diagnosis of constipation. The Pediatric Emergency Care Applied Research Network (PECARN) and the Pediatric Emergency Research in Canada (PERC) are currently developing decision rules for the use of CT in the assessment of minor head injuries in children, which should reduce its utilization in this condition. PECARN is also developing a decision rule for the use of CT in the assessment of abdominal trauma in children. CT is frequently used for the diagnosis of appendicitis in children, but appendicitis can be diagnosed clinically. If imaging is required, appendicitis can often be diagnosed with US, and CT need only be used in the minority of cases where the diagnosis is still in doubt. Utilization guidelines for pediatric imaging studies obtained in children in the emergency setting can improve yield and help in the more efficient management of often scarce health care resources. (orig.)

  2. An epidemiological study of urban and rural children in Pakistan: examining the relationship between delayed psychomotor development, low birth weight and postnatal growth failure.

    Science.gov (United States)

    Avan, Bilal I; Raza, Syed A; Kirkwood, Betty R

    2015-03-01

    Low birth weight is known to be associated with postnatal growth failure. It is not yet established that both conditions are determinants of psychomotor development. The study investigated whether or not low birth weight leads to delayed psychomotor development of a child, and whether it can be mitigated by adequate postnatal growth. A cross-sectional study was conducted in 2002 in 15 rural and 11 urban communities of Sindh province, Pakistan. Assessment of 1234 children less than 3 years of age included Bayley's Scale of Infant Development II, socioeconomic questionnaire and anthropometry; WHO standards were used to calculate z-scores of height-for-age, weight-for-height and weight-for-age. The underlying study hypotheses were tested through multiple regression modelling. Out of 1219 children, 283 (23.2%) had delayed psychomotor development and 639 (52.4%) were undernourished according to the composite index of anthropometric failure. Strong negative associations with the psychomotor development index were detected between stunting and being underweight, with a larger magnitude of effect for stunting (ppsychomotor index increased by 2.07 points with every unit increase in height-for-age z-score. The relationship between low birth weight and psychomotor development appears to be mediated largely by postnatal growth and nutritional status. This association suggests that among undernourished children there is significant likelihood of a group that is developmentally delayed. It is important to emphasize developmental needs in programmes that target underprivileged children. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Complementary Feeding Practices of Mothers and Their Perceived Impacts on Young Children: Findings from KEEA District of Ghana.

    Science.gov (United States)

    Egyir, Bridget K; Ramsay, Samantha A; Bilderback, Barry; Safaii, SeAnne

    2016-09-01

    Objective Appropriate and timely complementary feeding practices are fundamental to a child's growth, health, and development during the first 2 years of life. This study aimed to understand (1) Ghanaian mother's complementary feeding practices, and (2) their perceived and observed impacts of complementary feeding on their children. Methods Ghanaian mothers with children 4-24 months of age were recruited from four communities in the Komenda Edina Eguafo Abrem district in the Central Region of Ghana (n = 99). A qualitative methodological approach with focus group interview discussions was used. Eleven focus group interviews were conducted, and were audio recorded and transcribed. The audio transcriptions were coded and analyzed into pertinent themes, meta-themes, and theoretical concepts. Results Over 80 % (85) of mothers reported poor knowledge about the effects of complementary feeding on their children and 45 % (45) of the children were undernourished, indicating inappropriate complementary feeding practices. Some mothers held misconceptions about the effect of food on children's health. Four overarching themes were identified: (1) mothers' background knowledge about food, child health and growth outcomes, (2) mothers' motivation in feeding their children, (3) barriers to feeding, (4) foods mothers offered their children. Conclusion for Practice Nutrition education on complementary feeding is needed for Ghanaian mothers. Health facilities and community outreach programs could be a venue to provide education to mothers regarding infant and young child feeding practices in Ghana.

  4. Relationship between water compartments, body composition assessed by bioelectrical impedance analysis and blood pressure in school children.

    Science.gov (United States)

    Łątka, Monika; Wójtowicz, Kinga; Drożdż, Tomasz; Dąbrowska, Ewelina; Kwinta, Przemko; Pietrzyk, Jacek Antoni; Drożdż, Dorota

    2016-01-01

    Electrical bioimpedance analysis (BIA) is becoming more widely used in clinical practice as a method of body composition analysis. In healthy children blood pressure (BP) changes with age, body mass and height. Until now the relation between water compartments and BP in healthy children has not been evaluated. The aim of this study was to evaluate the relationship between body composition as well as water compartments (measured by electrical bioimpedance) and BP. The study was performed in 72 children (32 girls and 40 boys) aged: 6-7 and 12-13 years. BIA measurements were taken using Nutriguard Data Input device with Bianostic electrodes and following parameters were calculated: total body water (TBW), lean body mass (LBM), fat mass (FM), intra- and extracellular water (ICW, ECW) and phase angle alpha. BP was measured twice using the oscillometric method. Elevated BP > 95th percentile for gender, age and height were observed in 9 children. A significant correlation between systolic (S)BP and TBW (R = 0.4023, p obesity (BMI > 95th percentile). Growth disorders were found in 6 children (5 of them being undernourished). In the studied children SBP and DBP correlated with water compartments, lean body and fat masses derived from BIA. The problem of unrecognized hypertension and malnutrition in children and adolescents is still underestimated in the Polish population.

  5. US utility partnerships

    International Nuclear Information System (INIS)

    Worthington, B.

    1995-01-01

    Activities of the United States Energy Association were reviewed, as well as the manner in which its members are benefitting from the Association's programs. The principal cooperative program set up is the Utility Partnership Program, which was described. Through this program the Association is matching US companies, both electric utilities and gas utilities, with counterparts in Eastern Europe or the former Soviet Union. So far, about 25 partnerships were signed, e.g. in the Czech Republic, in Kazakhstan, in Poland, and in Slovakia. It was estimated that the return to the United States from the investments made by the American government in these Utility Partnership Programs has been well over 100-fold

  6. Tomografia computadorizada na avaliação da distribuição do tecido adiposo abdominal de ratos alimentados com rações hiperlipídicas após desnutrição neonatal Computed tomography in the evaluation of abdominal fat distribution associated with a hyperlipidic diet in previously undernourished rats

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Soares da Costa

    2007-10-01

    Full Text Available OBJETIVO: Descrever repercussões da ração suplementada com óleo de soja ou óleo de canola, por meio da tomografia computadorizada, na distribuição do tecido adiposo abdominal, após desmame de ratos desnutridos durante a lactação. MATERIAIS E MÉTODOS: Ratas lactantes submetidas a restrição alimentar (RA em 50%, de acordo com o consumo das lactantes controles (C. Após o desmame, filhotes desnutridos receberam ração contendo 19% de óleo de soja (RA-soja 19% ou óleo de canola (RA-canola 19%. Os filhotes do grupo controle receberam ração contendo 7% de óleo de soja (C-soja 7%. Aos 60 dias de idade, foram realizadas medidas corporais e das áreas de tecido adiposo abdominal por meio de tomografia computadorizada. Após sacrifício, tecido adiposo abdominal foi excisado e pesado. Os dados foram expressos como média ± erro-padrão da média, considerando o nível de significância de p OBJECTIVE: To study, by means of computed tomography, the repercussion of post-weaning dietary supplementation with soy oil or canola oil on the abdominal fat distribution in previously undernourished rats. MATERIALS AND METHODS: Dams submitted to 50% food restriction (FR compared with dams receiving a standard diet (C. After weaning, undernourished rats received a diet supplemented with 19% soy oil (19% FR-soy or 19% canola oil (19% FR-canola. Rats in the control group received a diet with 7% soy oil (7% C-soy until the end of the experimental period. At the age of 60 days old, the rats were submitted to computed tomography for evaluation of total abdominal and visceral fat area. The rats' length and body mass were evaluated and, after their sacrifice, the abdominal fat depots were excised weighted. The data are reported as mean ± mean standard error, with p < 0.05 considered as significance level. RESULTS: Rats in the group 19% FR presented similar length, body weight and visceral fat mass. As a whole, the evaluations have shower results

  7. Desnutrición infantil, coeficiente de desarrollo y su relación con el medio ambiente: un estudio piloto Desnutrição infantil, coeficiente do desenvolvimento e sua relação com o meio ambiente: um estudo piloto Infant undernourishment, the development coefficient and its relation to the environment: a pilot study

    Directory of Open Access Journals (Sweden)

    M. de la Luz Alvarez

    1991-08-01

    Full Text Available Fueron estudiados los factores socioculturales que podrían estar influyendo en el desarrollo psicomotor normal del lactante desnutrido. La muestra consistió en 32 díadas madrelactante: 16 tenían CD normal (Grupo A y 16 CD bajo lo normal (Grupo B según el Test de Bailey aplicado a los lactantes recién ingresados a un Centro de Recuperación Nutricional. Los resultados muestran que había algunas diferencias en los antecedentes de los lactantes: Los lactantes del Grupo A eran producto de un embarazo deseado (pEstudam-se os fatores sócio-culturais que poderiam estar influenciando no desenvolvimento psicomotor normal do lactente desnutrido. A amostra consistiu de 32 pares mãe-criança: 16 com coeficiente de desenvolvimento (CD normal (grupo A e 16 com CD abaixo do normal (grupo B de acordo com o teste de Bailey aplicado a lactentes que ingressavam a um centro de recuperação nutricional. Havia diferenças nos antecedentes das crianças: os lactentes do grupo A eram fruto de gravidez desejada (p The socio-cultural factors that might be influencing the normal psychomotor development of the undernourished infant are studied. The sample consisted of 32 mother-infant dyads: 16 having normal DQ (Group A and 16 having a below normal DQ (Group B according to Bailey's Test applied to infants who entered a Nutritional Recuperation Center. Results showed that there were some differences in the infants' backgrounds: infants of Group A were the product of a wished-for pregnancy (p < .05, and were separated less from their mother's side (p < .007 than was the case in Group B. No differences were found in the socio-cultural and demographic background of the mothers. The infants' external environment was different in aspects observed within the neighborhood: there were fewer negative aspects in Group A than in Group B (p < .003 and more positive in Group A than in B (p < .001. The infant's internal environment as related to the mother was also different

  8. Fertility Desire and Contraceptive Utilization among People Living ...

    African Journals Online (AJOL)

    HIV positive individuals may or may not have intention to have children. They could also have different degrees of utilization and demand for contraception. The desire of HIV infected persons to have children in the future has implication for the transmission of HIV to sexual partners or newborns. The study was designed to ...

  9. UTILITY OF VOWEL DIGRAPH GENERALIZATIONS IN GRADES ONE THROUGH SIX.

    Science.gov (United States)

    BAILEY, MILDRED HART

    SOME VOWEL DIGRAPH GENERALIZATIONS PRESENTLY TAUGHT WERE INVESTIGATED TO DETERMINE THE OVERALL UTILITY OF THE GENERALIZATIONS WHEN APPLIED TO A LIST OF REPRESENTATIVE WORDS MET BY CHILDREN IN READING INSTRUCTION IN GRADES 1 THROUGH 6, TO DETERMINE THE UTILITY OF ALL POSSIBLE SUBGROUPS OF ADJACENT VOWELS, AND TO EVOLVE NEW DIGRAPH GENERALIZATIONS…

  10. To assess the awareness, utilization and perception of healthcare ...

    African Journals Online (AJOL)

    2017-10-03

    Oct 3, 2017 ... Methods: A cross-sectional descriptive study among healthcare workers in a tertiary health institution in ... utilization not very encouraging. The study concluded that gender, marital status, having children and educational level were not significantly associated with awareness, perception and utilization of ...

  11. Utilization of healthcare services among children members of Medical Insurance for a New Generation Utilización de servicios de atención a la salud en niños afiliados al Seguro Médico para una Nueva Generación

    Directory of Open Access Journals (Sweden)

    Ricardo Pérez-Cuevas

    2012-01-01

    Full Text Available OBJECTIVE: To describe the utilization and associated factors for preventive and curative care utilization among children affiliated to the Medical Insurance for a New Generation (SMNG. MATERIALS AND METHODS: Data from the 2009 National Survey of SMNG was analyzed. RESULTS: The analysis represented 1 316 867 children; 25% of urban and 37.5% of rural mothers that took their children to well-child visits. Covariates associated with preventive care utilization were children 35 years, mother's literacy level of bachelor degree, housewife, attendance at >7 antenatal care visits, and living in a rural area. Curative care: 12% attended emergency room services, 5.4% were hospitalized and 66% received ambulatory care. Covariates associated with curative care utilization: child history of frequent diseases, mother living with husband/partner, mother's literacy level of bachelor degree, attendance >7 antenatal care visits and having paid work. CONCLUSION: It is needed to reinforce the programs encouraging mothers to seek preventive care regularly.OBJETIVO: Describir el uso y factores asociados para la atención preventiva y curativa de niños afiliados al Seguro Médico para una Nueva Generación (SMNG. MATERIAL Y MÉTODOS: Análisis de la información de la Encuesta Nacional SMNG 2009. RESULTADOS: El análisis representó 1316867 niños; 25% de madres urbanas y 37,5% de rurales que llevaron a sus hijos para atención preventiva. Variables asociadas con atención preventiva regular: niños 35 años, escolaridad licenciatura, ama de casa, asistencia a >7 visitas de atención prenatal y vivienda en zona rural. 12% acudió a servicios de urgencias, 5,4% fueron hospitalizados y 66% recibió atención ambulatoria. Antecedentes de enfermedades infecciosas, madre que vive con su esposo o pareja, escolaridad licenciatura, asistencia a >7 visitas prenatales y tener un trabajo remunerado se asociaron con la utilización de servicios curativos. CONCLUSIÓN: Es

  12. Development of norms for executive functions in typically-developing Indian urban preschool children and its association with nutritional status.

    Science.gov (United States)

    Selvam, Sumithra; Thomas, Tinku; Shetty, Priya; Thennarasu, K; Raman, Vijaya; Khanna, Deepti; Mehra, Ruchika; Kurpad, Anura V; Srinivasan, Krishnamachari

    2018-02-01

    Executive functions (EFs) are essential and important for achieving success in children's everyday lives and play a fundamental role in children's cognitive, academic, social, emotional and behavioral functioning. A cross-sectional study was carried out to develop age- and sex-specific norms for EFs using the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P) among 2- to 5-year-olds from urban Bangalore, India. In addition, the association between EFs and anthropometric measures, a marker of nutritional status, is also examined. Primary caregivers of 412 children, equally distributed by age and sex, participated. Raw scores for each domain and indices were converted to standard t-scores and percentiles were computed. A t-score at or above 63 corresponding to the 90th percentile was considered as the cutoff for executive dysfunction in this sample. The prevalence of executive dysfunction is 10% based on the Global Executive Composite score of the BRIEF-P. The cutoff score for identifying executive dysfunction using existing United States (US) norms is higher compared to the cutoff score obtained in the current study. Therefore, using US norms for Indian children could result in the prevalence of executive dysfunction been underestimated. Multiple linear regression analysis revealed that stunted and underweight children have significantly elevated EF scores after adjusting for age, sex and socioeconomic status (SES; p executive dysfunction and implementing interventions to improve their future prospects. This study also shows that undernourished children are more likely to have executive dysfunction.

  13. The prevalence of undernutrition upon hospitalization in children in a developing country: A single hospital study from Malaysia.

    Science.gov (United States)

    Lee, Way-Seah; Ahmad, Zulfadly

    2017-10-01

    Undernourished children who require hospital care have a longer duration of hospitalization and respond poorly to modern medical therapy. The objective of the present study was to ascertain the nutritional status of children admitted to a pediatric tertiary center in Malaysia and the risk factors leading to undernutrition upon admission. In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) standard deviation (S.D.), respectively. Underweight was defined as weight-for-age definition for acute undernutrition (HFA definition of acute undernutrition, an additional eight patients were noted to have acute undernutrition (n = 40, 14%). No significant risk factors associated with undernutrition were identified. The prevalence of undernutrition among children admitted to a tertiary hospital in Malaysia was 14%. Strategies for systematic screening and provision of nutritional support in children at risk of undernutrition as well as treatment of undernutrition in children requiring hospitalization are needed. Copyright © 2017. Published by Elsevier B.V.

  14. Tuberculosis in human immunodeficiency virus-infected children starting antiretroviral therapy in Côte d'Ivoire.

    Science.gov (United States)

    Auld, A F; Tuho, M Z; Ekra, K A; Kouakou, J; Shiraishi, R W; Adjorlolo-Johnson, G; Marlink, R; Ellerbrock, T V

    2014-04-01

    In Côte d'Ivoire, more than 2000 human immunodeficiency virus (HIV) infected children aged tuberculosis (TB) incidence and determinants among ART enrollees. A nationally representative retrospective cohort study among 2110 children starting ART during 2004-2008 at 29 facilities. At ART initiation, the median age was 5.1 years; 82% had World Health Organization Stage III/IV, median CD4% was 11%, 42% were severely undernourished (weight-for-age Z-score [WAZ] tuberculosis treatment. Documentation of TB screening before ART declined from 63% to 46% during 2004-2008. Children taking anti-tuberculosis treatment at ART enrollment had a lower median CD4% (9.0% vs. 11.0%, P = 0.037) and a higher prevalence of WAZ children considered TB-free at ART enrollment, TB incidence was 6.28/100 child-years during days 0-90 of ART, declining to 0.56/100 child-years after 180 days. Children with one unit higher WAZ at ART enrollment had 13% lower TB incidence (adjusted HR 0.87, 95%CI 0.77-1.00, P= 0.047). Ensuring clinician compliance with TB screening before ART and ensuring earlier ART initiation before children suffer from advanced HIV disease and nutritional compromise might reduce TB morbidity during ART.

  15. The importance of milk and other animal-source foods for children in low-income countries.

    Science.gov (United States)

    Dror, Daphna K; Allen, Lindsay H

    2011-09-01

    Milk and other animal-source foods are concentrated dietary sources of macro- and micronutrients. Despite a global increase in milk production and consumption over the past decades, milk and other animal-source foods are often lacking in the diets of children in developing countries. To evaluate the importance of milk and other animal-source food intake in promoting the growth, development, and health of children in low-income countries. Original research articles describing observational and intervention studies with unfortified milk, fortified milk, and other animal-source foods in children were identified by searching the PubMed database. Consumption of milk and other animal-source foods by undernourished children improves anthropometric indices and cognitive function and reduces the prevalence of biochemical and functional nutritional deficiencies, reducing morbidity and mortality. Unfortified and fortified milk used in supplementation trials has been well tolerated and widely accepted by parents and children. To improve the dietary quality of children in low-income countries and further the effort to eradicate extreme poverty and hunger in accordance with the United Nations Millennium Development Goals, additional research is necessary to identify and implement programs and policy supporting increased intake of milk and other animal-source foods.

  16. Factors associated With the development of motor proficiency in school children of Kolkata: A cross-sectional study to assess the role of chronic nutritional and socio-economic status.

    Science.gov (United States)

    Ghosh, Satabdi; Ghosh, Tusharkanti; Dutta Chowdhury, Sutanu; Wrotniak, Brian H; Chandra, Ananga Mohan

    2016-09-01

    Development of coordinated movements is determined among others by individual growth and environmental factors, but the dynamic relationship between motor proficiency and potential contributing factors such as chronic nutritional status and socio-economic status (SES) is not known in school children of Kolkata. To characterize the motor proficiency in school children of Kolkata and to investigate association of chronic nutritional and SES on motor proficiency. Motor proficiency in 843 school children of Kolkata aged 5-12 years was assessed by the Bruininks-Oseretsky Test of Motor-Proficiency-Second Edition-Short Form (BOT-2 SF). Chronic nutritional status was determined from height-for-age Z-scores (HAZ) using WHO reference and SES was measured using the updated Kuppuswamy's scale. Children's motor proficiency was poor compared with the reference values. Children classified as severely undernourished and children of lower SES were found to be "below average" and "well-below average" in motor proficiency categories compared with normal nourished groups and children of upper SES. Children's BOT-2 SF standardized scores decreased incrementally with the severity of chronic undernutrition and lower grades of SES. Chronic undernutrition and lower SES are associated with poorer motor proficiency in children. Understanding the complex interrelationships that shape childen's motor skills can help inform the development of health promotion programs and tailored interventions to help children reach their full potential. © 2016 Wiley Periodicals, Inc. Dev Psychobiol 58:734-744, 2016. © 2016 Wiley Periodicals, Inc.

  17. Utility portfolio diversification

    International Nuclear Information System (INIS)

    Griffes, P.H.

    1990-01-01

    This paper discusses portfolio analysis as a method to evaluate utility supply decisions. Specifically a utility is assumed to increase the value of its portfolio of assets whenever it invests in a new supply technology. This increase in value occurs because the new asset either enhances the return or diversifies the risks of the firm's portfolio of assets. This evaluation method is applied to two supply innovations in the electric utility industry: jointly-owned generating plants and supply contracts with independent power producers (IPPs)

  18. MSIS Drug Utilization Datamart

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page provides background needed to take advantage of the capabilities of the MSIS Drug Utilization Datamart. This mart allows the user to develop high-level...

  19. Chemical Search Web Utility

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Chemical Search Web Utility is an intuitive web application that allows the public to easily find the chemical that they are interested in using, and which...

  20. Utility requirements for HTGRs

    International Nuclear Information System (INIS)

    Nicholls, D.R.

    1997-01-01

    Eskom, the state utility of South Africa, is currently evaluating the technical and economic feasibility of the helium cooled Pebble Bed Modular Reactor with a closed cycle gas turbine power conversion system for future power generating additions to its electric system. This paper provides an overview of the Eskom system including the needs of the utility for future generation capacity and the key performance requirements necessary for incorporation of this gas cooled reactor plant. (author)

  1. Utility requirements for fusion

    International Nuclear Information System (INIS)

    Vondrasek, R.J.

    1982-02-01

    This report describes work done and results obtained during performance of Task 1 of a study of Utility Requirements and Criteria for Fusion Options. The work consisted of developing a list of utility requirements for fusion optics containing definition of the requirements and showing their relative importance to the utility industry. The project team members developed a preliminary list which was refined by discussions and literature searches. The refined list was recast as a questionnaire which was sent to a substantial portion of the utility industry in this country. Forty-three questionnaire recipients responded including thirty-two utilities. A workshop was held to develop a revised requirements list using the survey responses as a major input. The list prepared by the workshop was further refined by a panel consisting of vice presidents of the three project team firms. The results of the study indicate that in addition to considering the cost of energy for a power plant, utilities consider twenty-three other requirements. Four of the requirements were judged to be vital to plant acceptability: Plant Capital Cost, Financial Liability, Plant Safety and Licensability

  2. Pediatric Emergency Department Utilization and Reliance by Insurance Coverage in the United States.

    Science.gov (United States)

    Schlichting, Lauren E; Rogers, Michelle L; Gjelsvik, Annie; Linakis, James G; Vivier, Patrick M

    2017-12-01

    For many children, the emergency department (ED) serves as the main destination for health care, whether it be for emergent or nonurgent reasons. Through examination of repeat utilization and ED reliance (EDR), in addition to overall ED utilization, we can identify subpopulations dependent on the ED as their primary source of health care. Nationally representative data from the 2010 to 2014 Medical Expenditure Panel Survey were used to examine the annual ED utilization of children age 0 to 17 years by insurance coverage. Overall utilization, repeat utilization (two or more ED visits), and EDR (percentage of all health care visits that occur in the ED) were examined using multivariate models, accounting for weighting and the complex survey design. High EDR was defined as having > 33% of outpatient visits in a year being ED visits. A total of 47,926 children were included in the study. Approximately 12% of children visited an ED within a 1-year period. A greater number of children with public insurance (15.2%) visited an ED at least once, compared to privately insured (10.1%) and uninsured (6.4%) children. Controlling for covariates, children with public insurance were more likely to visit the ED (adjusted odds ratio [aOR] = 1.55, 95% confidence interval [CI] = 1.40-1.73) than children with private insurance, whereas uninsured children were less likely (aOR = 0.64, 95% CI = 0.51-0.81). Children age 3 and under were significantly more likely to visit the ED than children age 15 to 17, whereas female children and Hispanic and non-Hispanic other race children were significantly less likely to visit the ED than male children and non-Hispanic white children. Among children with ED visits, 21% had two or more visits to the ED in a 1-year period. Children with public insurance were more likely to have two or more visits to the ED (aOR = 1.53, 95% CI = 1.19-1.98) than children with private insurance whereas there was no significant difference in repeat ED utilization for

  3. Utility planning for decommissioning

    International Nuclear Information System (INIS)

    Williams, D.H.

    1982-01-01

    Though the biggest impact on a utility of nuclear power plant decommissioning may occur many years from now, procrastination of efforts to be prepared for that time is unwarranted. Foresight put into action through planning can significantly affect that impact. Financial planning can assure the recovery of decommissioning costs in a manner equitable to customers. Decision-making planning can minimize adverse affects of current decisions on later decommissioning impacts and prepare a utility to be equipped to make later decommissioning decisions. Technological knowledge base planning can support all other planning aspects for decommissioning and prepare a utility for decommissioning decisions. Informed project planning can ward off potentially significant pitfalls during decommissioning and optimize the effectiveness of the actual decommissioning efforts

  4. Electric utility report '80

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    A collection of brief atricles describes the trends and developments in Canada's electric utilities for the 1980's. Generating stations planned or under construction are listed. The trends in technology discused at a recent Canadian Electrical Association meeting are summarized in such areas as turbine stability control, power line vibration control, system reliability, substations and transformer specifications. Developments in nuclear generation are discussed and compared on the world scale where Japan, for example, has the world's largest nuclear program. Progress on fusion is discussed. In Canada the electric utilities are receiving the support of the comprehensive nuclear R and D program of Atomic Energy of Canada Ltd. New innovations in utility technology such as street lighting contactors, superconductive fault limiters and demand profile analyzers are discussed. (T.I.)

  5. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... are important, but that economics cannot alone explain the differences in health care utilization....

  6. Dor na criança desnutrida: percepção da mãe Dolor en el niño malnutrido: percepción de la madre Pain in undenourished children: the mother's perception

    Directory of Open Access Journals (Sweden)

    Larissa Coelho Barbosa

    2005-08-01

    Full Text Available O objetivo foi identificar a percepção da mãe quanto a dor no seu filho desnutrido. Pesquisa de natureza qualitativa, utilizando entrevistas semi-estruturadas no Instituto de Prevenção à Desnutrição e a Excepcionalidade - IPREDE (Fortaleza-Ceará. As informantes foram mães que acompanhavam seus filhos desnutridos. De acordo com a análise surgiram as categorias: Busca à Instituição; Descrição da dor e Como cuidar da dor. Conclui-se, a necessidade de um trabalho da sociedade, respeitando os direitos do cidadão e sua cultura, com o intuito de reverter a dor na criança desnutrida.El objetivo de esa investigación cualitativa era identificar la opinión de madres respecto al dolor de su hijo malnutrido. Se realizó entrevistas semiestructuradas en el Instituto para la Prevención a la Desnutrición y Excepcionalidad - IPREDE (Fortaleza-Ceará-Brasil. Los participantes fueron las madres que acompañaban a sus hijos malnutridos. El análisis reveló las siguientes categorías: Búsqueda de la institución; Descripción del dolor y Cómo cuidar del dolor. Se concluye que es necesario un trabajo de la sociedad, respetando los derechos del ciudadano y su cultura, con objeto de revertir el dolor del niño malnutrido.This qualitative study aimed to identify how mothers perceive pain in their undernourished children. Semistructured interviews were realized at the Institute for the Prevention of Malnutrition and Exceptionality - IPREDE (Fortaleza-Ceará-Brazil. Participants were mothers who accompanied their undernourished children. Data analysis revealed the following categories: Coming to the Institution; Pain description and How to take care of the pain. Society needs to take actions, in respect of citizens' rights and culture, with a view to reverting this picture of pain in undernourished children.

  7. Electric utilities in Illinois

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    Although the conference dealt specifically with concerns of the electric utilities in Illinois, the issues were dealt with in the national context as well. A separate abstract was prepared for each of the 5 sections of this proceeding. A total of 25 papers were presented. Section titles are: Forecasting, Planning and Siting, Reliability, Rates and Financing, and Future Developments.

  8. Male Adolescent Contraceptive Utilization.

    Science.gov (United States)

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  9. Nontransferable Utility Bankruptcy Games

    NARCIS (Netherlands)

    Estevez, A.; Borm, P.E.M.; Fiestras-Janeiro, G.

    2014-01-01

    In this paper, we analyze bankruptcy problems with nontransferable utility (NTU) from a game theoretical perspective by redefining corresponding NTU-bankruptcy games in a tailor-made way. It is shown that NTU-bankruptcy games are both coalitional merge convex and ordinal convex. Generalizing the

  10. The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review.

    Science.gov (United States)

    Adolphus, Katie; Lawton, Clare L; Champ, Claire L; Dye, Louise

    2016-05-01

    Breakfast is thought to be beneficial for cognitive and academic performance in school children. However, breakfast is the most frequently skipped meal, especially among adolescents. The aim of the current article was to systematically review the evidence from intervention studies for the effects of breakfast on cognitive performance in children and adolescents. The effects of breakfast were evaluated by cognitive domain and breakfast manipulation. A total of 45 studies reported in 43 articles were included in the review. Most studies considered the acute effect of a single breakfast (n = 34). The acute studies looked at breakfast compared with no breakfast (n = 24) and/or comparisons of breakfast type (n = 15). The effects of chronic school breakfast program interventions were evaluated in 11 studies. The findings suggest that breakfast consumption relative to fasting has a short-term (same morning) positive domain-specific effect on cognition. Tasks requiring attention, executive function, and memory were facilitated more reliably by breakfast consumption relative to fasting, with effects more apparent in undernourished children. Firm conclusions cannot be made about the acute effects of breakfast composition and the effects of chronic breakfast interventions because there are too few studies and these largely report inconsistent findings. This review also highlights methodologic limitations of the existing research. These include a lack of research on adolescents, few naturalistic breakfast manipulations or testing environments, small samples, and insensitive cognitive tests. © 2016 American Society for Nutrition.

  11. Moderated Mediation Effect of Self-esteem on the Relationship Between Parenting Stress and Depression According to Employment Status in Married Women: A Longitudinal Study Utilizing Data from Panel Study on Korean Children.

    Science.gov (United States)

    Han, Jeong-Won; Kim, Ju Hee

    2017-06-01

    This study was to examined the moderated mediation effect of self-esteem on the relationship between parenting stress and depression among married women with children using longitudinal data from the 3rd to 6th Panel Studies on Korean. The data from the Panel Study of Korean Children (Korea Institute of Child Care and Education) was collected as part of a longitudinal inquiry of babies born in 2008, their parents and their community environments. Only the data collected from the married women over the age of 20 who participated in the maternal survey was used for this study. The initial level of married women's parenting stress affects the initial level and the rate of change in self-esteem; the initial level of self-esteem, the initial level and rate of change in depression; and the initial level of parenting stress, the initial level of depression. However, the impact of the rate of change in parenting stress on that of self-esteem was significant only in employed women while the impact of the rate of change in self-esteem on that of depression was significant only in unemployed women. It is necessary to manage parenting stress among married women through various programs and education that increase self-esteem in order to reduce their level of depression. Copyright © 2017. Published by Elsevier B.V.

  12. Biomass ash utilization

    Energy Technology Data Exchange (ETDEWEB)

    Bristol, D.R.; Noel, D.J.; O`Brien, B. [HYDRA-CO Operations, Inc., Syracuse, NY (United States); Parker, B. [US Energy Corp., Fort Fairfield, ME (United States)

    1993-12-31

    This paper demonstrates that with careful analysis of ash from multiple biomass and waste wood fired power plants that most of the ash can serve a useful purpose. Some applications require higher levels of consistency than others. Examples of ash spreading for agricultural purposes as a lime supplement for soil enhancement in Maine and North Carolina, as well as a roadbase material in Maine are discussed. Use of ash as a horticultural additive is explored, as well as in composting as a filtering media and as cover material for landfills. The ash utilization is evaluated in a framework of environmental responsibility, regulations, handling and cost. Depending on the chemical and physical properties of the biomass derived fly ash and bottom ash, it can be used in one or more applications. Developing a program that utilizes ash produced in biomass facilities is environmentally and socially sound and can be financially attractive.

  13. Industrial coal utilization

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-01-01

    The effects of the National Energy Act on the use of coal in US industrial and utility power plants are considered. Innovative methods of using coal in an environmentally acceptable way are discussed: furnace types, fluidized-bed combustion, coal-oil-mixtures, coal firing in kilns and combustion of synthetic gas and liquid fuels. Fuel use in various industries is discussed with trends brought about by uncertain availability and price of natural gas and fuel oils: steel, chemical, cement, pulp and paper, glass and bricks. The symposium on Industrial Coal Utilization was sponsored by the US DOE, Pittsburgh Energy Technology Center, April 3 to 4, 1979. Twenty-one papers have been entered individually into the EDB. (LTN)

  14. Utilization of research reactors

    International Nuclear Information System (INIS)

    1962-01-01

    About 200 research reactors are now in operation in different parts of the world, and at least 70 such facilities, which are in advanced stages of planning and construction, should be critical within the next two or three years. In the process of this development a multitude of problems are being encountered in formulating and carrying out programs for the proper utilization of these facilities, especially in countries which have just begun or are starting their atomic energy work. An opportunity for scientific personnel from different Member States to discuss research reactor problems was given at an international symposium on the Programing and Utilization of Research Reactors organized by the Agency almost immediately after the General Conference session. Two hundred scientists from 35 countries, as well as from the European Nuclear Energy Agency and EURATOM, attended the meeting which was held in Vienna from 16 to 21 October 1961

  15. Utility customer issues

    International Nuclear Information System (INIS)

    Downey, W.H.

    1997-01-01

    Customer issues affected by the restructuring of the $250 billion US electric power industry were discussed. In the past the industry's vertically integrated utilities conducted their business in protected geographic markets. With deregulation and greater competition, that industry structure will change. This presentation highlighted the strategies that Unicom is using to react to the restructuring of the electric power industry. The underlying principle is for the utility to reinvent itself to change its market orientation and focus on customer services, such as reliability, responsiveness, custom tailored solutions, and guaranteed savings over time. Attempting to become total energy providers and delivering integrated solutions to meet the needs of large industrial and commercial consumers, intensive market research, improved service and installation, and sophisticated customer retention initiatives will also have to be high on the agenda

  16. UTILITY OF SIMPLIFIED LABANOTATION

    Directory of Open Access Journals (Sweden)

    Maria del Pilar Naranjo

    2016-02-01

    Full Text Available After using simplified Labanotation as a didactic tool for some years, the author can conclude that it accomplishes at least three main functions: efficiency of rehearsing time, social recognition and broadening of the choreographic consciousness of the dancer. The doubts of the dancing community about the issue of ‘to write or not to write’ are highly determined by the contexts and their own choreographic evolution, but the utility of Labanotation, as a tool for knowledge, is undeniable.

  17. NASA's Technology Utilization Program.

    Science.gov (United States)

    Farley, C. F.

    1972-01-01

    NASA's Technology Utilization Program is described, illustrating how it can be useful in achieving improved productivity, providing more jobs, solving public sector challenges, and strengthening the international competitive situation. Underlying the program is the fact that research and development conducted in NASA's aeronautics and space programs have generated much technical information concerning processes, products, or techniques which may be useful to engineers, doctors, or to others. The program is based on acquisition and publication, working with the user, and applications engineering.

  18. Debating Clinical Utility

    OpenAIRE

    Burke, W.; Laberge, A.-M.; Press, N.

    2010-01-01

    The clinical utility of genetic tests is determined by the outcomes following test use. Like other measures of value, it is often contested. Stakeholders may have different views about benefits and risks and about the importance of social versus health outcomes. They also commonly disagree about the evidence needed to determine whether a test is effective in achieving a specific outcome. Questions may be presented as factual disagreements, when they are actually debates about what information...

  19. Role of the utility

    International Nuclear Information System (INIS)

    Bellin, A.

    1986-03-01

    It is common to say that a nuclear programme needs basic infrastructures such as an appropriate educational system, governmental organizations for regulation, decision and inspection, engineering organizations for design and implementation, industrial infrastructures for manufacturing, erection and commissioning, operation organizations for running and maintaining power plants. This schematic organization is not sufficient to succeed in a nuclear programme: one has to consider very carefully the attribution of responsibilities. It appears, that, among all the different systems which exist in the world for the organization of a nuclear project, it is always the utility which bears the overall responsibility for the implementation of the project. It defines objectives such as production capacity, schedule, price; it takes part in the definition of a national policy for energy supply, for the choice of a type of reactor, for the implementation of a national nuclear industry; it selects sites and conducts feasibility studies including a preliminary project; it participates in the definition of organization charts and selects contractors; it calls for and obtains authorizations from regulatory bodies; it manages the project, coordinates contractors and permanently ensures that goals are attained as regards safety, quality, schedule, costs. The French utility has directly taken charge of all these basic responsibilities and this is commonly considered as a major reason of the success of the French nuclear programme. Depending on its capacities, the utility may delegate some of these responsibilities - mainly concerning engineering and project management - to experienced firms. Nevertheless, one has to remember that the utility bears the final responsibility and that it is probably the organization most fully aware of the fact that the final goal is not the construction of a nuclear power station but the production of nuclear electricity in the best and safest conditions

  20. Electric utilities in 2007

    Energy Technology Data Exchange (ETDEWEB)

    Hyman, L.S. [Smith Barney Inc., New York, NY (United States)

    1998-10-01

    A century ago--in the year J.J. Thomson discovered the electron--electricity, gas and traction companies battled for markets, and corrupt city councils demanded their fair share of the take. One tycoon became so disgusted with the confusion and dishonesty that he decided to bribe the legislature to set up an honest, state-run regulatory agency that would bring order to chaos. But he was found out. The scandal set back the cause of regulation until 1907, the year in which the electric washing machine and the vacuum cleaner were invented. By then, electricity sales had septupled from 1897 levels, and three states had established utility regulation. In the coming decade, 1997 to 2007, the utility business could undergo similar dramatic change, but it will move toward less regulation and more competition during a period of slow growth. Management will have to work harder to achieve success, however, because much of the profits will have to come not from a growing market but from the pockets of competitors. By 2007, electricity will constitute a component of a larger energy and utility services industry that sells electricity, natural gas and possibly water, propane and telecommunications. Customized service will meet the needs of consumers of all sizes. The dominant firm in the industry, the virtual utility, may look more like a financial organization or a mass marketer than the traditional converter of raw material to energy. Emphasis on market-based pricing should lead to more efficient use of resources. If the process works right, the consumer wins.

  1. Clean energy utilization technology

    International Nuclear Information System (INIS)

    Honma, Takuya

    1992-01-01

    The technical development of clean energy including the utilization of solar energy was begun in 1973 at the time of the oil crisis, and about 20 years elapsed. Also in Japan, the electric power buying system by electric power companies for solar light electric power and wind electric power has been started in 1992, namely their value as a merchandise was recognized. As for these two technologies, the works of making the international standards and JIS were begun. The range of clean energy or natural energy is wide, and its kinds are many. The utilization of solar heat and the electric power generation utilizing waves, tide and geotherm already reached the stage of practical use. Generally in order to practically use new energy, the problem of price must be solved, but the price is largely dependent on the degree of spread. Also the reliability, durability and safety must be ensured, and the easiness of use, effectiveness and trouble-saving maintenance and operation are required. For the purpose, it is important to packaging those skillfully in a system. The cases of intelligent natural energy systems are shown. Solar light and wind electric power generation systems and the technology of transporting clean energy are described. (K.I.)

  2. The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS.

    Directory of Open Access Journals (Sweden)

    Samba O Sow

    2016-05-01

    Full Text Available The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized.Data from the Global Enteric Multicenter Study (GEMS, a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD] were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated.Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9% and C. parvum in 9.9% (95% CI, 7.1%-13.6%; 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67 and 3.18 (95% CI, 1.85-4.52 per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08 and 1.36 (95% CI, 0.66-2.05 per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01 and 4.88 (95% CI, 0.82-8.92 in infants and 4.04 (95% CI, 0.56-7.51 and 4.71 (95% CI, 0.24-9.18 in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deaths (regions combined. ~59

  3. The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)

    Science.gov (United States)

    Nasrin, Dilruba; Blackwelder, William C.; Wu, Yukun; Farag, Tamer H.; Panchalingam, Sandra; Sur, Dipika; Zaidi, Anita K. M.; Faruque, Abu S. G.; Saha, Debasish; Adegbola, Richard; Alonso, Pedro L.; Breiman, Robert F.; Bassat, Quique; Tamboura, Boubou; Sanogo, Doh; Onwuchekwa, Uma; Manna, Byomkesh; Ramamurthy, Thandavarayan; Kanungo, Suman; Ahmed, Shahnawaz; Qureshi, Shahida; Quadri, Farheen; Hossain, Anowar; Das, Sumon K.; Antonio, Martin; Hossain, M. Jahangir; Mandomando, Inacio; Nhampossa, Tacilta; Acácio, Sozinho; Omore, Richard; Oundo, Joseph O.; Ochieng, John B.; Mintz, Eric D.; O’Reilly, Ciara E.; Berkeley, Lynette Y.; Livio, Sofie; Tennant, Sharon M.; Sommerfelt, Halvor; Nataro, James P.; Ziv-Baran, Tomer; Robins-Browne, Roy M.; Mishcherkin, Vladimir; Zhang, Jixian; Liu, Jie; Houpt, Eric R.; Kotloff, Karen L.; Levine, Myron M.

    2016-01-01

    Background The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized. Methods Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged Cryptosporidium diarrhea were estimated. Findings Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27–4.67) and 3.18 (95% CI, 1.85–4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73–2.08) and 1.36 (95% CI, 0.66–2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33–5.01) and 4.88 (95% CI, 0.82–8.92) in infants and 4.04 (95% CI, 0.56–7.51) and 4.71 (95% CI, 0.24–9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged Cryptosporidium-attributable deaths (regions combined). ~59,000 excess deaths occurred among Cryptosporidium-attributable diarrhea cases over expected if cases had been Cryptosporidium-negative. Conclusions The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies. PMID:27219054

  4. Market research for electric utilities

    International Nuclear Information System (INIS)

    Shippee, G.

    1999-01-01

    Marketing research is increasing in importance as utilities become more marketing oriented. Marketing research managers need to maintain autonomy from the marketing director or ad agency and make sure their work is relevant to the utility's operation. This article will outline a model marketing research program for an electric utility. While a utility may not conduct each and every type of research described, the programs presented offer a smorgasbord of activities which successful electric utility marketers often use or have access to

  5. Time Functions as Utilities

    Science.gov (United States)

    Minguzzi, E.

    2010-09-01

    Every time function on spacetime gives a (continuous) total preordering of the spacetime events which respects the notion of causal precedence. The problem of the existence of a (semi-)time function on spacetime and the problem of recovering the causal structure starting from the set of time functions are studied. It is pointed out that these problems have an analog in the field of microeconomics known as utility theory. In a chronological spacetime the semi-time functions correspond to the utilities for the chronological relation, while in a K-causal (stably causal) spacetime the time functions correspond to the utilities for the K + relation (Seifert’s relation). By exploiting this analogy, we are able to import some mathematical results, most notably Peleg’s and Levin’s theorems, to the spacetime framework. As a consequence, we prove that a K-causal (i.e. stably causal) spacetime admits a time function and that the time or temporal functions can be used to recover the K + (or Seifert) relation which indeed turns out to be the intersection of the time or temporal orderings. This result tells us in which circumstances it is possible to recover the chronological or causal relation starting from the set of time or temporal functions allowed by the spacetime. Moreover, it is proved that a chronological spacetime in which the closure of the causal relation is transitive (for instance a reflective spacetime) admits a semi-time function. Along the way a new proof avoiding smoothing techniques is given that the existence of a time function implies stable causality, and a new short proof of the equivalence between K-causality and stable causality is given which takes advantage of Levin’s theorem and smoothing techniques.

  6. Growth & development of Indian children adopted in Sweden.

    Science.gov (United States)

    Proos, Lemm A

    2009-11-01

    More than 6800 children from India have been adopted in Sweden over the last four decades. At arrival many were undernourished and suffered from infectious diseases. Catch-up growth was common. Unexpectedly, cases of early pubertal development were subsequently reported. In order to investigate the growth and development of adopted children more in detail we studied 114 children adopted from India prospectively during two years. The majority were stunted at arrival and caught up in height and weight after two years. Psychomotor retardation and common infections diminished fairly soon. Those that were stunted did not attain the higher catch-up levels of those not stunted at arrival. Low birthweight also limited the degree of catch-up growth. 107 girls were analysed retrospectively in another study. The median menarcheal age was 11.6 yr (range 7.3-14.6 yr) which is significantly earlier than the mean in Swedish and privileged Indian girls (13.0 and 12.4-12.9 yr, respectively). The pubertal linear growth component was normal in duration and magnitude but likewise started 1.5 yr earlier. The final height/age was 154 cm (-1.4 SDS) and the weight/age 46.9 kg (-1.1 SDS) 8 per cent were 145 cm or shorter. Stunting limited catch-up growth and final height. Those that were most stunted at arrival, and had the fastest catch-up growth, had the earliest menarche. Good maternal and child nutrition is necessary for full expression of a child's growth potential. What is lost in growth early in life can only partially be recovered by catch-up growth. Such growth is associated with risk for early pubertal development which abbreviates the childhood growth period and limits final height. The mechanism underlying the early pubertal development, and the optimal management of nutrition rehabilitation after chronic malnutrition, need to be clarified by further studies.

  7. Protocol investigating the clinical utility of an objective measure of attention, impulsivity and activity (QbTest) for optimising medication management in children and young people with ADHD 'QbTest Utility for Optimising Treatment in ADHD' (QUOTA): a feasibility randomised controlled trial.

    Science.gov (United States)

    Hall, Charlotte L; James, Marilyn; Brown, Sue; Martin, Jennifer L; Brown, Nikki; Selby, Kim; Clarke, Julie; Vijayan, Hena; Guo, Boliang; Sayal, Kapil; Hollis, Chris; Groom, Madeleine J

    2018-02-15

    Attention-deficit hyperactivity disorder (ADHD) is characterised by symptoms of inattention, hyperactivity and impulsivity. To improve outcomes, the National Institute for Health and Care Excellence ADHD guidelines recommend regular monitoring of symptoms when children commence medication. However, research suggests that routine monitoring rarely happens, and clinicians often rely on subjective information such as reports from parents and teachers to ascertain improvement. These sources can be unreliable and difficult to obtain. The addition of an objective test of attention and activity (QbTest) may improve the objectivity, reliability and speed of clinical decision-making and so reduce the time to identify the optimal medication dose. This study aims to assess the feasibility and acceptability of a QbTest medication management protocol delivered in routine healthcare services for children with ADHD. This multisite feasibility randomised controlled trial (RCT) will recruit 60 young people (aged 6-17 years old), diagnosed with ADHD, and starting stimulant medication who are seen by Child and Adolescent Mental Health Services or Community Paediatric services. Participants will be randomised into one of two arms. In the experimental arm (QbTest protocol), the participant will complete a QbTest at baseline (prior to medication initiation), and two follow-up QbTests on medication (2-4 weeks and 8-10 weeks later). In the control arm, participants will receive treatment as usual, with at least two follow-up consultations. Measures of parent-, teacher- and clinician-rated symptoms and global functioning will be completed at each time point. Health economic measures will be completed. Clinicians will record treatment decision-making. Acceptability and feasibility of the protocol will be assessed alongside outcome measure completion rates. Qualitative interviews will be conducted. The findings will be used to inform the development of a fully powered RCT. The results will

  8. Social group utility maximization

    CERN Document Server

    Gong, Xiaowen; Yang, Lei; Zhang, Junshan

    2014-01-01

    This SpringerBrief explains how to leverage mobile users' social relationships to improve the interactions of mobile devices in mobile networks. It develops a social group utility maximization (SGUM) framework that captures diverse social ties of mobile users and diverse physical coupling of mobile devices. Key topics include random access control, power control, spectrum access, and location privacy.This brief also investigates SGUM-based power control game and random access control game, for which it establishes the socially-aware Nash equilibrium (SNE). It then examines the critical SGUM-b

  9. Energy utilization in Canada

    International Nuclear Information System (INIS)

    Klassen, J.

    1976-04-01

    The situation of the energy supply of Canada is characterized by its geographic location and by the dispersal of the energy consumers over a wide area. At present, the energy supply leaving the successful CANDU nuclear energy programme out of account, is based mainly on crude oil, natural gas, and electricity as well as on coal imported from the USA. The targets of Canadian enery policies and energy research are stated as follows: a) Reducing and optimizing energy consumption, b) introducing district heating, and c) utilizing the extensive local coal deposits. (GG) [de

  10. Managing the nuclear utility

    International Nuclear Information System (INIS)

    Williams, J.W. Jr.

    1985-01-01

    The Florida Power and Light Company (FP and L) is the fifth largest investor-owned utility in the country. The success of nuclear power generation at the St. Lucie Units 1 and 2 and Turkey Point Units 3 and 4 has resulted from a continuing management commitment to the nuclear program. The management of the power plants rely strongly on teamwork for most large projects and activities whether they entail plant operation, construction, or maintenance. Various examples of how teamwork has been used to realize the successful completion of projects or solutions to problems are given

  11. Tribal Utility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Engel, R. A.; Zoellick, J. J.

    2007-06-30

    The Schatz Energy Research Center (SERC) assisted the Yurok Tribe in investigating the feasibility of creating a permanent energy services program for the Tribe. The original purpose of the DOE grant that funded this project was to determine the feasibility of creating a full-blown Yurok Tribal electric utility to buy and sell electric power and own and maintain all electric power infrastructure on the Reservation. The original project consultant found this opportunity to be infeasible for the Tribe. When SERC took over as project consultant, we took a different approach. We explored opportunities for the Tribe to develop its own renewable energy resources for use on the Reservation and/or off-Reservation sales as a means of generating revenue for the Tribe. We also looked at ways the Tribe can provide energy services to its members and how to fund such efforts. We identified opportunities for the development of renewable energy resources and energy services on the Yurok Reservation that fall into five basic categories: • Demand-side management – This refers to efforts to reduce energy use through energy efficiency and conservation measures. • Off-grid, facility and household scale renewable energy systems – These systems can provide electricity to individual homes and Tribal facilities in areas of the Reservation that do not currently have access to the electric utility grid. • Village scale, micro-grid renewable energy systems - These are larger scale systems that can provide electricity to interconnected groups of homes and Tribal facilities in areas of the Reservation that do not have access to the conventional electric grid. This will require the development of miniature electric grids to serve these interconnected facilities. • Medium to large scale renewable energy development for sale to the grid – In areas where viable renewable energy resources exist and there is access to the conventional electric utility grid, these resources can be

  12. COLOUR LEARNING IN RETARDED CHILDREN*

    African Journals Online (AJOL)

    Tt has been observed' that mentally retarded children have. :olour preferences, preferring, for example, to pick red and yellow sweets from a multicoloured supply. Among normal nursery-school children the same 2 colours feature in tests for preference, and it has been suggested' that it might be useful to utilize these ...

  13. Geothermal Resource Utilization

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, Paul J.

    1998-01-03

    Man has utilized the natural heat of the earth for centuries. Worldwide direct use of geothermal currently amounts to about 7,000 MWt, as compared to 1,500 MWe, now being used for the generation of electricity. Since the early 1970s, dwindling domestic reservoirs of oil and gas, continued price escalation of oil on the world market and environmental concerns associated with coal and nuclear energy have created a growing interest in the use of geothermal energy in the United States. The Department of Energy goals for hydrothermal resources utilization in the United States, expressed in barrels of oil equivalent, is 50 to 90 million bbl/yr by 1985 and 350 to 900 million bbl/yr by the year 2000. This relatively clean and highly versatile resource is now being used in a multitude of diverse applications (e.g., space heating and cooling, vegetable dehydration, agriculture, aquaculture, light manufacturing), and other applications requiring a reliable and economic source of heat.

  14. Utilization of coalbed methane

    Energy Technology Data Exchange (ETDEWEB)

    Gustavson, J.B. [Gustavson Associates Inc., Boulder, CO (United States)

    1996-02-01

    Substantial progress has been made in capturing coalbed methane (CBM gas), which constitutes a valuable source of clean burning energy. It is of importance to study the various potential uses of coalbed methane and to understand the various technologies required, as well as their economics and any institutional constraints. In industrialised countries, the uses of coalbed methane are almost solely dependent on microeconomics; coalbed methane must compete for a market against natural gas and other energy sources - and frequently, coalbed methane is not competitive against other energy sources. In developing countries, on the other hand, particularly where other sources of energy are in short supply, coalbed methane economics yield positive results. Here, constraints to development of CBM utilization are mainly lack of technology and investment capital. Sociological aspects such as attitude and cultural habits, may also have a strong negative influence. This paper outlines the economics of coalbed methane utilization, particularly its competition with natural gas, and touches upon the many different uses to which coalbed methane may be applied. 24 refs., 4 figs.

  15. Aspectos culturais no cuidado familiar à criança com desnutrição - DOI: 10.4025/actascihealthsci.v31i1.4519 Cultural aspects in family care for children with malnutrition - DOI: 10.4025/actascihealthsci.v31i1.4519

    Directory of Open Access Journals (Sweden)

    Conceição de Maria de Albuquerque

    2009-05-01

    Full Text Available Objetivou-se identificar o fator cultural que interfere no cuidado do filho desnutrido e propor ações de Educação Popular em Saúde na assistência à criança desnutrida. Trata-se de uma pesquisa-ação desenvolvida no Núcleo de Atenção Médica Integrada – NAMI, realizada no período de janeiro a julho de 2008. Participaram deste estudo oito mães e um pai, cujas idades variavam de 20 a 48 anos. A coleta de dados realizou-se mediante entrevistas semi-estruturadas e oficinas educativas, em que se utilizou análise de conteúdo de Bardin. Após organização dos resultados, foram identificadas as categorias: uma desnutrição desconhecida; oficinas educativas e saber popular; consciência do cuidado. O resultado aponta para uma nova consciência no cuidado com o filho desnutrido na cultura da comunidade. Recomendam-se intervenções de Educação Popular em Saúde adequadas para grupos culturalmente distintos. Nesta perspectiva, há de se considerar o conjunto de propostas, viabilizando e incentivando a Educação Popular, para buscar mudanças na constituição de novos sujeitos e práticas comprometidas com o rompimento das barreiras sociais, econômicas e políticas.This study aimed to identify the cultural factor that interferes with the care of undernourished children and to propose actions of Popular Health Education in the assistance of undernourished children. It regards an action research developed at the Nucleus of Integrated Medical Attention – NAMI, performed between January and July 2008. Eight mothers and one father took part in the study, with ages varying from 20 to 48 years old. The data collection took place by means of semi-structured interviews and educational workshops, which were used in the Bardin content analysis. After organizing the result, the following categories were identified: unknown malnutrition; educative workshops and popular knowledge; conscience of care. The results point to a new conscience at the

  16. A review of health utilities across conditions common in paediatric and adult populations

    Directory of Open Access Journals (Sweden)

    Hopkins Robert B

    2010-01-01

    Full Text Available Abstract Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI or EuroQoL-5Dimensions (EQ-5D questionnaires or using time trade off (TTO or standard gamble (SG techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL. Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25, cancer (n = 23, diabetes mellitus (n = 11, skin diseases (n = 19 or chronic diseases (n = 2, with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33, EQ-5D (n = 26, TTO (n = 12, and SG (n = 14, with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin

  17. Utilities in UNIX

    International Nuclear Information System (INIS)

    Perez, L.

    2002-01-01

    This manual goes to the users with some or much experience in the unix operating system. In such manner that they can get more efficiency using the unix of the most vendors. Include the majority of UNIX commands, shell built-in functions to create scripts, and a brief explication of the variables in several environments. In addition, other products are included, more and more integrated in the most of the unix operating systems. For example: the scanning and processing language awk, the print server LPRng, GNU Utilities, batch subsystem, etc. The manual was initially based in an specific unix. But it and been written for use of the most unix that exist: Tru64 unix, aix, iris, hpux. solaris y linux. In this way, many examples in the chapter had been included. The purpose of this manual is to provide an UNIX reference for advanced users in any of the unix operating systems family. (Author)

  18. Treatment of children with Helicobacter pylori infection and malabsorption syndromes with probiotics: Comparison with conventional methods

    International Nuclear Information System (INIS)

    Ghoos, Y.; Brunser, O.; Lawson, F.; Muzeke, A.; Ndjaye, M.F.

    2000-01-01

    It is stated that in developing countries a high rate of Helicobacter pylori infection among newborns and young children occurs. It is further assumed that this incidence may lead to inhibition of defense mechanism (inhibition of acid secretion) against bacteria, per orally ingested. This may result in excessive colonisation of the small intestine by bacteria. This situation may become a major cause for chronic malnutrition and diarrhoea syndrome with failure to thrive. This project aims at determining the occurrence of Helicobacter pylori infection in children at young age. It is aimed also at tracing the relationship between the Helicobacter pylori infection and the state of undernourishment. Finally it is aimed at comparing the usefulness of pre-/probiotics as anti-infection treatment. The methods used to demonstrate above mentioned parameters are based on stable isotopes, 13 CO 2 and H 2 breath tests mainly. To assess nutritional status and progress in growth conventional anthropometric techniques will be used, complementary to the results obtained by stable isotopes. It is put forward that the use of pre-/probiotics, instead of antibiotics, will suppress upper gastrointestinal infection and restore the intestinal cell capacity to assimilate all food ingredients. (author)

  19. Energy utilities and the Internet

    International Nuclear Information System (INIS)

    2000-01-01

    The chances for energy utilities in the Netherlands to present themselves on the Internet are briefly outlined. It appears that other businesses are ahead of the Dutch utilities in offering electronic services with respect to energy

  20. Anthropometric Profile of Children Attending Anganwadi Centers under Integrated Child Development Sevices (ICDS Scheme in Doiwala Block

    Directory of Open Access Journals (Sweden)

    Gagan Deep Kaur

    2014-12-01

    Full Text Available Introduction In any community, Mothers and Children constitutes not only priority group, but they are also a “Vulnerable” or “Special-risk Group”. Similarly in India our biggest problem is malnutrition among under five year old children. To break the vicious cycle of malnutrition, morbidity reduced learning capacity and mortality India launched the Integrated Child Development Services (ICDS Scheme in 1975. It is the foremost symbol of India’s commitment to her children Rationale: Forty percent of the world's severely under-nourished under-five children live in India so the present study was conducted to assess the nutritional status of children availing the services under Integrated Child Development Service Scheme in Uttarakhand. Objective: To estimate the level of nutrition in children attending Anganwadi centers of Doiwala block. Methods: Out of these Seven ICDS project areas, Doiwala Block was chosen for the study purpose since it is also the field practice area of Department of Community Medicine, HIMS. 19 AWC was selected by using Simple Random Sampling technique in Doiwala block. All the children aged between 3- 6years attending Anganwadi centers were included in community based, cross sectional study. Predesigned pretested anthropometric survey tool with local adaptability and minor modification for local suitability was adopted to collect information pertaining to growth monitoring of the children [Adopted from WHO child growth standard 2006]. Children were weighed, and their height and MUAC were recorded. Weight for age, height for age and MUAC for age was calculated using WHO growth references .Nutritional status according to the WHO Child Growth Standards was analysed using WHO Anthro statistical software. Results: 200 children were surveyed. From the total population 110 are males and 90 are females. After the analysis of weight for age with anthro software it was found that 20.9% of children lie within -2 SD with a mean

  1. Protocol investigating the clinical utility of an objective measure of activity and attention (QbTest) on diagnostic and treatment decision-making in children and young people with ADHD-'Assessing QbTest Utility in ADHD' (AQUA): a randomised controlled trial.

    Science.gov (United States)

    Hall, Charlotte L; Walker, Gemma M; Valentine, Althea Z; Guo, Boliang; Kaylor-Hughes, Catherine; James, Marilyn; Daley, David; Sayal, Kapil; Hollis, Chris

    2014-12-01

    The National Institute for Health and Care Excellence (NICE) guidelines for attention deficit/hyperactivity disorder (ADHD) state that young people need to have access to the best evidence-based care to improve outcome. The current 'gold standard' ADHD diagnostic assessment combines clinical observation with subjective parent, teacher and self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading to diagnostic uncertainty and delay. The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes. This trial investigates whether providing clinicians with an objective report of levels of attention, impulsivity and activity can lead to an earlier, and more accurate, clinical diagnosis and improved patient outcome. This multisite randomised controlled trial will recruit young people (aged 6-17 years old) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services (CAMHS) and Community Paediatric clinics across England. Routine clinical assessment will be augmented by the QbTest, incorporating a continuous performance test (CPT) and infrared motion tracking of activity. The participant will be randomised into one of two study arms: QbOpen (clinician has immediate access to a QbTest report): QbBlind (report is withheld until the study end). Primary outcomes are time to diagnosis and diagnostic accuracy. Secondary outcomes include clinician's diagnostic confidence and routine clinical outcome measures. Cost-effective analysis will be conducted, alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice. The findings from the study will inform commissioners, clinicians and managers about the feasibility, acceptability, clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young

  2. utilization of insecticide treated nets among pregnant women and ...

    African Journals Online (AJOL)

    results showed that the prevalent harsh and dry weather condition was the major barrier to utilization of ITN in the ... explored as a remedy for promoting consistent use of ITN by pregnant women and under five children in this community. KEYWORDS: Insecticide treated nets, pregnant women, mothers, Ikot Omin, Nigeria.

  3. The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review123

    Science.gov (United States)

    Champ, Claire L

    2016-01-01

    Breakfast is thought to be beneficial for cognitive and academic performance in school children. However, breakfast is the most frequently skipped meal, especially among adolescents. The aim of the current article was to systematically review the evidence from intervention studies for the effects of breakfast on cognitive performance in children and adolescents. The effects of breakfast were evaluated by cognitive domain and breakfast manipulation. A total of 45 studies reported in 43 articles were included in the review. Most studies considered the acute effect of a single breakfast (n = 34). The acute studies looked at breakfast compared with no breakfast (n = 24) and/or comparisons of breakfast type (n = 15). The effects of chronic school breakfast program interventions were evaluated in 11 studies. The findings suggest that breakfast consumption relative to fasting has a short-term (same morning) positive domain-specific effect on cognition. Tasks requiring attention, executive function, and memory were facilitated more reliably by breakfast consumption relative to fasting, with effects more apparent in undernourished children. Firm conclusions cannot be made about the acute effects of breakfast composition and the effects of chronic breakfast interventions because there are too few studies and these largely report inconsistent findings. This review also highlights methodologic limitations of the existing research. These include a lack of research on adolescents, few naturalistic breakfast manipulations or testing environments, small samples, and insensitive cognitive tests. PMID:27184287

  4. [Health services' utilization patterns in Catalonia, Spain].

    Science.gov (United States)

    Medina, Carmen; Salvador, Xavier; Faixedas, M Teresa; Gallo, Pedro

    2011-12-01

    The purpose of this article is disclose services utilization patterns among the Catalan population with particular emphasis on primary care, specialised care, hospital care and emergency care. A number of logistic regression models were used to explain the utilization of the various types of services. Variables in the analysis included self-perceived need, lifestyles, and sociodemographic variables. Separate analyses were performed for male, female, adults, and children as well as for the general population. Women use all types of services more often than men. Children and people over 64 are more frequent users of primary care. Primary care is also associated to lower socioeconomic conditions. Young adults and the migrant population in general are found to be under users of services, except of emergency care services. The use of specialised care is associated to the better-off, to those with university level education attainment, individual private insurance, and those living in the city of Barcelona. Hospital care is largely associated to need variables. The use of health services is explained by self-perceived need as well as by demographic, socioeconomic and geographical factors. Copyright © 2011 Elsevier España S.L. All rights reserved.

  5. YEAR 2 BIOMASS UTILIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Christopher J. Zygarlicke

    2004-11-01

    This Energy & Environmental Research Center (EERC) Year 2 Biomass Utilization Final Technical Report summarizes multiple projects in biopower or bioenergy, transportation biofuels, and bioproducts. A prototype of a novel advanced power system, termed the high-temperature air furnace (HITAF), was tested for performance while converting biomass and coal blends to energy. Three biomass fuels--wood residue or hog fuel, corn stover, and switchgrass--and Wyoming subbituminous coal were acquired for combustion tests in the 3-million-Btu/hr system. Blend levels were 20% biomass--80% coal on a heat basis. Hog fuel was prepared for the upcoming combustion test by air-drying and processing through a hammer mill and screen. A K-Tron biomass feeder capable of operating in both gravimetric and volumetric modes was selected as the HITAF feed system. Two oxide dispersion-strengthened (ODS) alloys that would be used in the HITAF high-temperature heat exchanger were tested for slag corrosion rates. An alumina layer formed on one particular alloy, which was more corrosion-resistant than a chromia layer that formed on the other alloy. Research activities were completed in the development of an atmospheric pressure, fluidized-bed pyrolysis-type system called the controlled spontaneous reactor (CSR), which is used to process and condition biomass. Tree trimmings were physically and chemically altered by the CSR process, resulting in a fuel that was very suitable for feeding into a coal combustion or gasification system with little or no feed system modifications required. Experimental procedures were successful for producing hydrogen from biomass using the bacteria Thermotoga, a deep-ocean thermal vent organism. Analytical procedures for hydrogen were evaluated, a gas chromatography (GC) method was derived for measuring hydrogen yields, and adaptation culturing and protocols for mutagenesis were initiated to better develop strains that can use biomass cellulose. Fly ash derived from

  6. Utilization management in anatomic pathology.

    Science.gov (United States)

    Lewandrowski, Kent; Black-Schaffer, Steven

    2014-01-01

    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management. © 2013.

  7. Utility service entrance in boreholes

    International Nuclear Information System (INIS)

    1987-08-01

    This study evaluates alternatives for utility service entrances to the repository. We determined the requirements for a repository utility supply. These requirements were defined as safety, maintainability, flexibility, reliability, cost efficiency, voltage regulation, and simplicity of operation. The study showed that repository shafts can best satisfy all requirements for location of the utility supply without the use of borehole penetrations into the repository. It is recommended that the shafts be utilized for utility distribution to the repository, and that the current NWTS program position to minimize the number of boreholes penetrating the repository horizon be maintained. 42 refs., 2 figs., 3 tabs

  8. National Utility Rate Database: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Ong, S.; McKeel, R.

    2012-08-01

    When modeling solar energy technologies and other distributed energy systems, using high-quality expansive electricity rates is essential. The National Renewable Energy Laboratory (NREL) developed a utility rate platform for entering, storing, updating, and accessing a large collection of utility rates from around the United States. This utility rate platform lives on the Open Energy Information (OpenEI) website, OpenEI.org, allowing the data to be programmatically accessed from a web browser, using an application programming interface (API). The semantic-based utility rate platform currently has record of 1,885 utility rates and covers over 85% of the electricity consumption in the United States.

  9. Gas utilization technologies

    International Nuclear Information System (INIS)

    Biljetina, R.

    1994-01-01

    One of the constant challenges facing the research community is the identification of technology needs 5 to 15 years from now. A look back into history indicates that the forces driving natural gas research have changed from decade to decade. In the 1970s research was driven by concerns for adequate supply; in the 1980s research was aimed at creating new markets for natural gas. What then are the driving forces for the 1990s? Recent reports from the natural gas industry have helped define a new direction driven primarily by market demand for natural gas. A study prepared by the Interstate Natural Gas Association of America Foundation entitled ''Survey of Natural Research, Development, and Demonstration RD ampersand D Priorities'' indicated that in the 1990s the highest research priority should be for natural gas utilization and that technology development efforts should not only address efficiency and cost, but environmental and regulatory issues as well. This study and others, such as the report by the American Gas Association (A.G.A.) entitled ''Strategic Vision for Natural Gas Through the Year 2000,'' clearly identify the market sectors driving today's technology development needs. The biggest driver is the power generation market followed by the industrial, transportation, appliance, and gas cooling markets. This is best illustrated by the GRI 1994 Baseline Projection on market growth in various sectors between the year 1992 and 2010. This paper highlights some of the recent technology developments in each one of these sectors

  10. Knowledge-based utility

    International Nuclear Information System (INIS)

    Chwalowski, M.

    1997-01-01

    This presentation provides industry examples of successful marketing practices by companies facing deregulation and competition. The common thread through the examples is that long term survival of today's utility structure is dependent on the strategic role of knowledge. As opposed to regulated monopolies which usually own huge physical assets and have very little intelligence about their customers, unregulated enterprises tend to be knowledge-based, characterized by higher market value than book value. A knowledge-based enterprise gathers data, creates information and develops knowledge by leveraging it as a competitive weapon. It institutionalizes human knowledge as a corporate asset for use over and over again by the use of databases, computer networks, patents, billing, collection and customer services (BCCS), branded interfaces and management capabilities. Activities to become knowledge-based such as replacing inventory/fixed assets with information about material usage to reduce expenditure and achieve more efficient operations, and by focusing on integration and value-adding delivery capabilities, were reviewed

  11. Debating clinical utility.

    Science.gov (United States)

    Burke, Wylie; Laberge, A-M; Press, N

    2010-01-01

    The clinical utility of genetic tests is determined by the outcomes following test use. Like other measures of value, it is often contested. Stakeholders may have different views about benefits and risks and about the importance of social versus health outcomes. They also commonly disagree about the evidence needed to determine whether a test is effective in achieving a specific outcome. Questions may be presented as factual disagreements, when they are actually debates about what information matters or how facts should be interpreted and used in clinical decision-making. Defining the different issues at stake is therefore an important element of policy-making. Key issues include evidence standards for test use, and in particular, the circumstances under which prospective controlled data should be required, as well as evidence on feasibility, cost and equitable delivery of testing; the goals of population-based screening programs, and in particular, the role of social outcomes in evaluating test value; and the appropriate uses and funding of tests that inform non-medical actions. Addressing each of these issues requires attention to stakeholder values and methods for effective deliberation that incorporate consumer as well as health professional perspectives. Copyright 2010 S. Karger AG, Basel.

  12. Gnuastro: GNU Astronomy Utilities

    Science.gov (United States)

    Akhlaghi, Mohammad

    2018-01-01

    Gnuastro (GNU Astronomy Utilities) manipulates and analyzes astronomical data. It is an official GNU package of a large collection of programs and C/C++ library functions. Command-line programs perform arithmetic operations on images, convert FITS images to common types like JPG or PDF, convolve an image with a given kernel or matching of kernels, perform cosmological calculations, crop parts of large images (possibly in multiple files), manipulate FITS extensions and keywords, and perform statistical operations. In addition, it contains programs to make catalogs from detection maps, add noise, make mock profiles with a variety of radial functions using monte-carlo integration for their centers, match catalogs, and detect objects in an image among many other operations. The command-line programs share the same basic command-line user interface for the comfort of both the users and developers. Gnuastro is written to comply fully with the GNU coding standards and integrates well with all Unix-like operating systems. This enables astronomers to expect a fully familiar experience in the source code, building, installing and command-line user interaction that they have seen in all the other GNU software that they use. Gnuastro's extensive library is included for users who want to build their own unique programs.

  13. Automated ISS Flight Utilities

    Science.gov (United States)

    Offermann, Jan Tuzlic

    2016-01-01

    During my internship at NASA Johnson Space Center, I worked in the Space Radiation Analysis Group (SRAG), where I was tasked with a number of projects focused on the automation of tasks and activities related to the operation of the International Space Station (ISS). As I worked on a number of projects, I have written short sections below to give a description for each, followed by more general remarks on the internship experience. My first project is titled "General Exposure Representation EVADOSE", also known as "GEnEVADOSE". This project involved the design and development of a C++/ ROOT framework focused on radiation exposure for extravehicular activity (EVA) planning for the ISS. The utility helps mission managers plan EVAs by displaying information on the cumulative radiation doses that crew will receive during an EVA as a function of the egress time and duration of the activity. SRAG uses a utility called EVADOSE, employing a model of the space radiation environment in low Earth orbit to predict these doses, as while outside the ISS the astronauts will have less shielding from charged particles such as electrons and protons. However, EVADOSE output is cumbersome to work with, and prior to GEnEVADOSE, querying data and producing graphs of ISS trajectories and cumulative doses versus egress time required manual work in Microsoft Excel. GEnEVADOSE automates all this work, reading in EVADOSE output file(s) along with a plaintext file input by the user providing input parameters. GEnEVADOSE will output a text file containing all the necessary dosimetry for each proposed EVA egress time, for each specified EVADOSE file. It also plots cumulative dose versus egress time and the ISS trajectory, and displays all of this information in an auto-generated presentation made in LaTeX. New features have also been added, such as best-case scenarios (egress times corresponding to the least dose), interpolated curves for trajectories, and the ability to query any time in the

  14. Growth in Children with Cerebral Palsy during five years after Selective Dorsal Rhizotomy: a practice-based study

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2010-07-01

    Full Text Available Abstract Background Overweight is reported as a side effect of SDR. The aims were to study the development of weight, height and body mass index (BMI during five years after SDR. Methods This prospective, longitudinal and practice-based study included all 56 children with CP spastic diplegia undergoing SDR from the start in March 1993 to April 2003 in our hospital. The preoperative Gross Motor Function Classification System (GMFCS levels were I-II in 17, III in 15, IV-V in 24 children. Median age at SDR was 4.3 years (range 2.4-7.4 years. Weight and height/recumbent length were measured. Swedish growth charts for typically developing children generated weight, height and BMI z-scores for age and gender. Results The preoperative median z-scores were for height -1.92 and for body mass index (BMI -0.22. Five years later, the median BMI z-score was increased by + 0.57 (p + 2 SD increased (p The individual growth was highly variable, but a tendency towards increasing stunting with age was seen in severe gross motor dysfunction (GMFCS levels IV-V and the opposite, a slight catch-up of height in children with walking ability (GMFCS levels I-III. Conclusions These are the first available subtype- and GMFCS-specific longitudinal growth data for children with CP spastic diplegia. Their growth potential according to these data should be regarded as a minimum, as some children were undernourished. It is unknown whether the spasticity reduction through SDR increased the weight gain velocity, or if the relative weight increase was part of the general "obesity epidemic". For some children the weight increase was highly desirable. In others, it resulted in overweight and obesity with risk of negative health effects. Weight and height should be monitored to enable early prevention of weight aberrations also causing problems with mobility, activity and participation.

  15. Washington state foster care: dental utilization and expenditures.

    Science.gov (United States)

    Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David

    2014-01-01

    To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population Care [$28.57 95% CI($14.00, $43.15)]. Most children enrolled in WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.

  16. Undernourishment and Public Policy in India | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Those articles will feed into policy development through briefs, website content for the Institute of Development Studies, other online platforms, and the publication of an edited book and/or journal issue. A symposium in India will share research results with key policymakers, researchers, civil society, and the media in order ...

  17. Altered placental development in undernourished rats: role of maternal glucocorticoids

    Directory of Open Access Journals (Sweden)

    Chen Chun-Hung

    2011-08-01

    Full Text Available Abstract Maternal undernutrition (MUN during pregnancy may lead to fetal intrauterine growth restriction (IUGR, which itself predisposes to adult risk of obesity, hypertension, and diabetes. IUGR may stem from insufficient maternal nutrient supply or reduced placental nutrient transfer. In addition, a critical role for maternal stress-induced glucocorticoids (GCs has been suggested to contribute to both IUGR and the ensuing risk of adult metabolic syndrome. While GC-induced fetal organ defects have been examined, there have been few studies on placental responses to MUN-induced maternal stress. Therefore, we hypothesize that 50% MUN associates with increased maternal GC levels and decreased placental HSD11B. This in turn leads to decreased placental and fetal growth, hence the need to investigate nutrient transporters. We measured maternal serum levels of corticosterone, and the placental basal and labyrinth zone expression of glucocorticoid receptor (NR3C1, 11-hydroxysteroid dehydrogenase B 1 (HSD11B-1 predominantly activates cortisone to cortisol and 11-dehydrocorticosterone (11-DHC to corticosterone, although can sometimes drive the opposing (inactivating reaction, and HSD11B-2 (only inactivates and converts corticosterone to 11-DHC in rodents in control and MUN rats at embryonic day 20 (E20. Moreover, we evaluated the expression of nutrient transporters for glucose (SLC2A1, SLC2A3 and amino acids (SLC38A1, 2, and 4. Our results show that MUN dams displayed significantly increased plasma corticosterone levels compared to control dams. Further, a reduction in fetal and placental weights was observed in both the mid-horn and proximal-horn positions. Notably, the placental labyrinth zone, the site of feto-maternal exchange, showed decreased expression of HSD11B1-2 in both horns, and increased HSD11B-1 in proximal-horn placentas, but no change in NR3C1. The reduced placental GCs catabolic capacity was accompanied by downregulation of SLC2A3, SLC38A1, and SLC38A2 expression, and by increased SLC38A4 expression, in labyrinth zones from the mid- and proximal-horns. In marked contrast to the labyrinth zone, the basal zone, which is the site of hormone production, did not show significant changes in any of these enzymes or transporters. These results suggest that dysregulation of the labyrinth zone GC "barrier", and more importantly decreased nutrient supply resulting from downregulation of some of the amino acid system A transporters, may contribute to suboptimal fetal growth under MUN.

  18. The Dynamics of Food Supply and Undernourishment in Sub ...

    African Journals Online (AJOL)

    Saharan Africa (SSA). This paper examines the dynamics of food supply in SSA for a panel of 42 countries over the period 1994-2009. Ordinal measures of national food supply status of SSA countries are generated from daily calorie supply per ...

  19. Passive stiffness of rat skeletal muscle undernourished during fetal development

    Directory of Open Access Journals (Sweden)

    Ana Elisa Toscano

    2010-01-01

    Full Text Available OBJECTIVES: The aim of the study was to investigate the effect of fetal undernutrition on the passive mechanical properties of skeletal muscle of weaned and young adult rats. INTRODUCTION: A poor nutrition supply during fetal development affects physiological functions of the fetus. From a mechanical point of view, skeletal muscle can be also characterized by its resistance to passive stretch. METHODS: Male Wistar rats were divided into two groups according to their mother's diet during pregnancy: a control group (mothers fed a 17% protein diet and an isocaloric low-protein group (mothers fed a 7.8% protein diet. At birth, all mothers received a standardized meal ad libitum. At the age of 25 and 90 days, the soleus muscle and extensor digitorum longus (EDL muscles were removed in order to test the passive mechanical properties. A first mechanical test consisted of an incremental stepwise extension test using fast velocity stretching (500 mm/s enabling us to measure, for each extension stepwise, the dynamic stress (σd and the steady stress (σs. A second test consisted of a slow velocity stretch in order to calculate normalized stiffness and tangent modulus from the stress-strain relationship. RESULTS: The results for the mechanical properties showed an important increase in passive stiffness in both the soleus and EDL muscles in weaned rat. In contrast, no modification was observed in young adult rats. CONCLUSIONS: The increase in passive stiffness in skeletal muscle of weaned rat submitted to intrauterine undernutrition it is most likely due to changes in muscle passive stiffness.

  20. Acute dehydrating gastro-enteritis in undernourished infants | Beatty ...

    African Journals Online (AJOL)

    The use of half-strength Oarrow's solution in 2;5% dextrose water, with supplementary intravenous sodium bicarbonate and oral potassium, rapidly corrected the electrolyte and acid-base disturbances. No significant difference resulted when this regimen was modified by variations in the rate, volume or type of intravenous ...

  1. Undernourishment and Public Policy in India | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    It aims to shape policies underlying the development of India's proposed National Food Security Act. As well, it will help restructure the public food distribution system and the delivery of social welfare programs that affect food and nutritional security. The project's two streams are led by the National Council for Applied ...

  2. Buprenorphine transdermal system utilization.

    Science.gov (United States)

    Wallace, Laura; Kadakia, Aditi

    2017-01-01

    To evaluate utilization patterns in patients initiating buprenorphine transdermal system (BTDS), CIII, and estimate the proportion decreasing their total opioid dose over time. This retrospective cohort study used data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database from 1 January 2011 through 31 December 2015. Eligible individuals were adults aged 18-64 years newly dispensed BTDS (index prescription) who had at least six months of insurance coverage prior to (baseline period) and following (study period) the index prescription. Back and neck pain was the most common pain condition in the study population (n = 31,533) and 88% were dispensed opioids in the baseline period. Nearly half (48%) received BTDS in a strength of 10 mcg/hour as their index prescription. Most (80%) patients prescribed BTDS had concomitant prescriptions for other opioids, chiefly immediate-release (IR) opioids (77%). During the baseline period, median opioid dose among patients prescribed opioids was 50 morphine-equivalent doses (MED), with 33% of patients using nonsteroidal anti-inflammatory drugs and 44% adjuvant analgesics. During the study period, BTDS use lasted a median 30 days and mean 100 days. Median dose of BTDS remained largely constant, and median dose of all opioids during continuous use of BTDS was 65.6 units MED. However, 24% of patients reduced total units MED from the baseline period (median mean dose, 74.5 units MED) until the end of the study period (42.8). Most patients initiating treatment with BTDS had a history of treatment with IR opioids. Though the average change in total opioid daily dose after patients were prescribed BTDS was modest, an important subpopulation of approximately one-quarter of patients were able to markedly reduce their total units MED compared with prior opioid therapy. BTDS should be investigated as an option to help patients step down from higher opioid doses.

  3. wssa_utils: WSSA 12 micron dust map utilities

    Science.gov (United States)

    Meisner, Aaron M.; Finkbeiner, Douglas P.

    2014-02-01

    wssa_utils contains utilities for accessing the full-sky, high-resolution maps of the WSSA 12 micron data release. Implementations in both Python and IDL are included. The code allows users to sample values at (longitude, latitude) coordinates of interest with ease, transparently mapping coordinates to WSSA tiles and performing interpolation. The wssa_utils software also serves to define a unique WSSA 12 micron flux at every location on the sky.

  4. Increase in utilization of dental sealants.

    Science.gov (United States)

    Lam, Anty

    2008-03-01

    The purpose of this review is to explore how to increase utilization of dental sealants to reach the national 50% sealant objective as stated in the Healthy People 2010 document. Dental decay is the most common chronic childhood disease. A simple, cost-effective preventive measure to manage this disease is through sealant application. Although dental sealants are effective in reducing the risk of having dental decay, their rate of utilization among children and adolescents is below the objective set forth by the Healthy People 2010 document. This is related to the lack of public awareness, patient education, and inadequate reimbursement for sealants served by third-party insurers. Dental decay is the most common chronic childhood disease. Dental sealants are a simple, cost-effective preventive measure to manage this disease. In order to meet the national 50% sealant objective of the Healthy People 2010 document, public awareness and the education of consumers about the benefit of having dental sealants must be improved. Third-party insurers must improve the benefits for subscribers seeking dental sealant services. Using these approaches, the utilization of dental sealants will improve the oral health among the next generation of Americans.

  5. The Utility and Consequences of Using Impressed Child Soldiers in Africa's Contemporary Wars

    National Research Council Canada - National Science Library

    Woguwale, Jasom

    2000-01-01

    .... The purpose of this paper titled, "The Utility and Consequences of Using Impressed Child Soldiers in Africa's Contemporary Wars," is to examine the practice of using children as soldiers by various...

  6. Facility Utilization Reports - FAA Aviation Information Utilization Reports

    Data.gov (United States)

    Department of Transportation — Provides: (1) Space management and planning, including area calculations, tracking space by organization and employee, and monitoring space utilization information....

  7. Privatization of municipal electrical utilities

    International Nuclear Information System (INIS)

    Carr, J.

    1998-01-01

    The challenges and special issues which arise through the sale of a municipal electric utility were discussed. The recent sales of two utilities, the Kentville Electric Commission in Nova Scotia and Cornwall Electric in Ontario, were used as examples to show how the sale of an electric utility differs from the sale of most business enterprises. Municipal utilities are integral parts of the communities they serve which introduces several complexities into the sale. Factors that require special attention in the sale of the utilities, including electricity rates, local accountability, treatment of employees and local economic development, and the need for a comprehensive communication program to deal with the substantial public interest that sale of a municipal utility will engender, were reviewed

  8. Mox fuel utilization in ATR

    OpenAIRE

    下村 和生; 川太 徳夫

    1987-01-01

    ATR, a heavy-water moderated boiling-light-water cooled reactor developed in Japan, is a unique reactor with out-standing flexibility regarding nuclear fuel utilization, because it has superior properties concerning the utilization of plutonium, recovered uranium and depleted uranium. The development of this type of reactor is expected to contribute both to the stable supply of energy and to the establishment of plutonium utilization in Japan. Much effort has been and will be made on the deve...

  9. Utility deregulation and AMR technology

    International Nuclear Information System (INIS)

    Moore, G.

    1991-01-01

    This article reviews the effects of deregulation on other utilities and services and examines how the electric utilities can avoid the worst of these effects and capitalize of the best aspects of competition in achieving marketing excellence. The article presents deregulation as a customer service and underscores the need for utilities to learn to compete aggressively and intelligently and provide additional services available through technology such as automated meter reading

  10. VT Electric Utility Franchise Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) ELCFRANCHISE includes Vermont's Electric Utility Franchise boundaries. It is a compilation of many data sources. The boundaries are approximate...

  11. Cumulative Contextual Risk and Behavior Problems among Children with Substance Using Mothers: The Mediating Role of Mothers? and Children?s Coping Strategies

    OpenAIRE

    Zhang, Jing; Slesnick, Natasha

    2016-01-01

    Substance using mothers vary in their exposure to an accumulation of contextual risks associated with their drug-using life styles, likely leading to variability in their children?s behavioral outcomes. The present study examined a mediation model interrelating mothers? cumulative risk exposure, children?s behavior problems, and coping strategies of both mothers and children. Findings showed that mothers? greater exposure to cumulative risk was associated with lower utilization of task-orient...

  12. Comparison of measles complications in well-nourished and mal-nourished children.

    Science.gov (United States)

    Qaisar, Imran; Ahmad, Ameer; Ahmad, Fiaz; ullah Mazhar, Atta

    2009-01-01

    Measles is the most common and the most infectious of the viral infections of childhood. It can cause severe pneumonia, diarrhoea, encephalitis, and death. A significant proportion of deaths due to measles in young children worldwide are attributable to low weight for age To compare the measles complications in well-nourished and mal-nourished children, this cross-sectional study was conducted at Paediatric out-patient department and paediatric unit 1 Bahawal Victoria Hospital Bahawalpur. Total 120 patients were included in the study. All patients presented with signs and symptoms suggestive of measles according to WHO criteria. These patients were divided into well-nourished and malnourished according to the modified Gomez classification. Both groups were evaluated for measles complications like pneumonia, diarrhoea, encephalitis, corneal ulceration, thrombocytopenia, otitis media and myocarditis by detailed history and complete physical examination, and statistically analysed. In the studied patients, 75 were males and 45 were females. Mean age was 23 months. Fifty-nine (49.2%) patients were well-nourished and 61 (50.8%) were undernourished. Fifty-two (43.3%) patients were having pneumonia. Fifty-three (44.2%) patients were having diarrhoea. Twenty-six (21.7%) patients were having encephalitis. Corneal ulceration was found in 9 (7.5%) patients. Thrombocytopenia and otitis media was present in 1 patient in each group. Fourteen patients expired. Measles is a global epidemic problem having many serious complications, including pneumonia, diarrhoea, encephalitis, corneal ulcerations etc. Moreover these complications are more frequent in under nourished children. Efforts should be made to improve the nutritional status of the children and to eradicate this disease by effective vaccination.

  13. Mortality after Inpatient Treatment for Severe Pneumonia in Children: a Cohort Study.

    Science.gov (United States)

    Ngari, Moses M; Fegan, Greg; Mwangome, Martha K; Ngama, Mwanajuma J; Mturi, Neema; Scott, John Anthony Gerard; Bauni, Evasius; Nokes, David James; Berkley, James A

    2017-05-01

    Although pneumonia is a leading cause of inpatient mortality, deaths may also occur after discharge from hospital. However, prior studies have been small, in selected groups or did not fully evaluate risk factors, particularly malnutrition and HIV. We determined 1-year post-discharge mortality and risk factors among children diagnosed with severe pneumonia. A cohort study of children aged 1-59 months admitted to Kilifi County Hospital with severe pneumonia (2007-12). The primary outcome was death pneumonia, 1041 (25%) had severe acute malnutrition (SAM), 267 (6.4%) had a positive HIV antibody test, and 364 (8.7%) died in hospital. After discharge, 2279 KHDSS-resident children were followed up; 70 (3.1%) died during 2163 child-years: 32 (95% confidence interval (CI) 26, 41) deaths per 1000 child years. Post-discharge mortality was greater after admission for severe pneumonia than for other diagnoses, hazard ratio 2.5 (95% CI 1.2, 5.3). Malnutrition, HIV status, age and prolonged hospitalisation, but not signs of pneumonia severity, were associated with post-discharge mortality. Fifty-two per cent (95% CI 37%, 63%) of post-discharge deaths were attributable to low mid-upper arm circumference and 11% (95% CI 3.3%, 18%) to a positive HIV test. Admission with severe pneumonia is an important marker of vulnerability. Risk stratification and better understanding of the mechanisms underlying post-discharge mortality, especially for undernourished children, are needed to reduce mortality after treatment for pneumonia. © 2017 The Authors. Paediatric and Perinatal Epidemiology Published by John Wiley & Sons Ltd.

  14. Comparison of measles complications in well nourished and mal-nourished children

    International Nuclear Information System (INIS)

    Qaisar, I.; Ahmad, A.; Ahmad, A.

    2009-01-01

    Measles is the most common and the most infectious of the viral infections of childhood. It can cause severe pneumonia, diarrhoea, encephalitis, and death. A significant proportion of deaths due to measles in young children worldwide are attributable to low weight for age. To compare the measles complications in well-nourished and mal-nourished children, this cross-sectional study was conducted at Paediatric out-patient department and paediatric unit 1 Bahawal Victoria Hospital Bahawalpur. Total 120 patients were included in the study. All patients presented with signs and symptoms suggestive of measles according to WHO criteria. These patients were divided into well nourished and malnourished according to the modified Gomez classification. Both groups were evaluated for measles complications like pneumonia, diarrhoea, encephalitis, corneal ulceration, thrombocytopenia, otitis media and myocarditis by detailed history and complete physical examination, and statistically analysed. In the studied patients, 75 were males and 45 were females. Mean age was 23 months. Fifty-nine (49.2%) patients were well-nourished and 61 (50.8%) were undernourished. Fifty-two (43.3%) patients were having pneumonia. Fifty-three (44.2%) patients were having diarrhoea. Twenty-six (21.7%) patients were having encephalitis. Corneal ulceration was found in 9 (7.5%) patients. Thrombocytopenia and otitis media was present in 1 patient in each group. Fourteen patients expired. Measles is a global epidemic problem having many serious complications, including pneumonia, diarrhoea, encephalitis, corneal ulcerations etc. Moreover these complications are more frequent in under nourished children. Efforts should be made to improve the nutritional status of the children and to eradicate this disease by effective vaccination. (author)

  15. Utility of the Koppitz norms for the Bender Gestalt Test performance ...

    African Journals Online (AJOL)

    Objective: This study investigated the utility of the Koppitz administration, scoring and norms for the Bender Gestalt Test (BGT) as a neurocognitive screening instrument for Sesotho-speaking children. Method: The BGT protocols of 671 Sesotho-speaking children between the ages of seven and nine were reviewed.

  16. Medical Service Utilization among Youth with School-Identified Disabilities in Residential Care

    Science.gov (United States)

    Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald

    2016-01-01

    Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with…

  17. The utility target market model

    International Nuclear Information System (INIS)

    Leng, G.J.; Martin, J.

    1994-01-01

    A new model (the Utility Target Market Model) is used to evaluate the economic benefits of photovoltaic (PV) power systems located at the electrical utility customer site. These distributed PV demand-side generation systems can be evaluated in a similar manner to other demand-side management technologies. The energy and capacity values of an actual PV system located in the service area of the New England Electrical System (NEES) are the two utility benefits evaluated. The annual stream of energy and capacity benefits calculated for the utility are converted to the installed cost per watt that the utility should be willing to invest to receive this benefit stream. Different discount rates are used to show the sensitivity of the allowable installed cost of the PV systems to a utility's average cost of capital. Capturing both the energy and capacity benefits of these relatively environmentally friendly distributed generators, NEES should be willing to invest in this technology when the installed cost per watt declines to ca $2.40 using NEES' rated cost of capital (8.78%). If a social discount rate of 3% is used, installation should be considered when installed cost approaches $4.70/W. Since recent installations in the Sacramento Municipal Utility District have cost between $7-8/W, cost-effective utility applications of PV are close. 22 refs., 1 fig., 2 tabs

  18. Utility strategies - affiliated power marketers

    Energy Technology Data Exchange (ETDEWEB)

    Coffey, J.F. [Aquila Energy Corp., Omaha, NE (United States)

    1994-12-31

    The regulation of affiliated power marketers (APM) is discussed. Any electric utility affiliates that own or control generation must not have market power in the relevant market, which is defined as the utility`s first-tier markets. One can prove that its affiliates do not have generation dominance by: (a) showing that its entire generating capacity is committed under long term contract, (b) showing that its affiliates already are authorized to sell at market-based rates, or (c) submitting a market analysis which demonstrates that the affiliates do not possess generation market power. The electric utility affiliates must have a transmission tariff on file which provides for comparable transmission services. The APM must agree not to buy power from, or sell power to its electric utility affiliate without prior approval by the Federal Energy Regulatory Commission (FERC). The APM must notify FERC if it sells power to, buys power from, or obtains transmission service from a utility that has any business relationship with any affiliates. Any non-sales services provided by the utility affiliates must not be priced below market value. Procedures must ensure that market information is not shared between the utility and the APM, or shared on a comparable basis with non-affiliates. A continuing obligation exists for the APM to notify FERC of any change in these criteria occurring after approval is granted. Concerns with these provisions and suggested improvements are discussed.

  19. Therapeutic Utilities of Pediatric Cardiac Catheterization

    Science.gov (United States)

    Moustafa, Giannis A.; Kolokythas, Argyrios; Charitakis, Konstantinos; Avgerinos, Dimitrios 
V.

    2016-01-01

    In an era when less invasive techniques are favored, therapeutic cardiac catheterization constantly evolves and widens its spectrum of usage in the pediatric population. The advent of sophisticated devices and well-designed equipment has made the management of many congenital cardiac lesions more efficient and safer, while providing more comfort to the patient. Nowadays, a large variety of heart diseases are managed with transcatheter techniques, such as patent foramen ovale, atrial and ventricular septal defects, valve stenosis, patent ductus arteriosus, aortic coarctation, pulmonary artery and vein stenosis and arteriovenous malformations. Moreover, hybrid procedures and catheter ablation have opened new paths in the treatment of complex cardiac lesions and arrhythmias, respectively. In this article, the main therapeutic utilities of cardiac catheterization in children are discussed. PMID:26926291

  20. Hualapai Tribal Utility Development Project

    Energy Technology Data Exchange (ETDEWEB)

    Hualapai Tribal Nation

    2008-05-25

    The first phase of the Hualapai Tribal Utility Development Project (Project) studied the feasibility of establishing a tribally operated utility to provide electric service to tribal customers at Grand Canyon West (see objective 1 below). The project was successful in completing the analysis of the energy production from the solar power systems at Grand Canyon West and developing a financial model, based on rates to be charged to Grand Canyon West customers connected to the solar systems, that would provide sufficient revenue for a Tribal Utility Authority to operate and maintain those systems. The objective to establish a central power grid over which the TUA would have authority and responsibility had to be modified because the construction schedule of GCW facilities, specifically the new air terminal, did not match up with the construction schedule for the solar power system. Therefore, two distributed systems were constructed instead of one central system with a high voltage distribution network. The Hualapai Tribal Council has not taken the action necessary to establish the Tribal Utility Authority that could be responsible for the electric service at GCW. The creation of a Tribal Utility Authority (TUA) was the subject of the second objective of the project. The second phase of the project examined the feasibility and strategy for establishing a tribal utility to serve the remainder of the Hualapai Reservation and the feasibility of including wind energy from a tribal wind generator in the energy resource portfolio of the tribal utility (see objective 2 below). It is currently unknown when the Tribal Council will consider the implementation of the results of the study. Objective 1 - Develop the basic organizational structure and operational strategy for a tribally controlled utility to operate at the Tribe’s tourism enterprise district, Grand Canyon West. Coordinate the development of the Tribal Utility structure with the development of the Grand Canyon

  1. Low Fertility Preservation Utilization Among Transgender Youth.

    Science.gov (United States)

    Nahata, Leena; Tishelman, Amy C; Caltabellotta, Nicole M; Quinn, Gwendolyn P

    2017-07-01

    Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy. The purpose of this study was to examine the rates of fertility counseling and utilization of FP among a cohort of adolescents with gender dysphoria seen at a large gender clinic. An Institutional Review Board-approved retrospective review of electronic medical records was conducted of all patients with ICD-9/10 codes for gender dysphoria referred to Pediatric Endocrinology for hormone therapy (puberty suppression and/or cross-sex hormones) from January 2014 to August 2016. Seventy-eight patients met inclusion criteria. Five children were prepubertal, no hormone therapy was considered, and they were therefore excluded. Of the remaining 73 patients, 72 had documented fertility counseling prior to initiation of hormone therapy and 2 subjects attempted FP; 45% of subjects mentioned a desire or plan to adopt, and 21% said they had never wanted to have children. Utilization rates of FP are low among transgender adolescents. More research is needed to understand parenthood goals among transgender youth at different ages and developmental stages and to explore the impact of gender dysphoria on decision-making about FP and parenthood. Discussions about infertility risk, FP, and other family building options should be prioritized in this vulnerable adolescent population. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Rising utilization of inpatient pediatric asthma pathways.

    Science.gov (United States)

    Kaiser, Sunitha V; Rodean, Jonathan; Bekmezian, Arpi; Hall, Matt; Shah, Samir S; Mahant, Sanjay; Parikh, Kavita; Morse, Rustin; Puls, Henry; Cabana, Michael D

    2018-02-01

    Clinical pathways are detailed care plans that operationalize evidence-based guidelines into an accessible format for health providers. Their goal is to link evidence to practice to optimize patient outcomes and delivery efficiency. It is unknown to what extent inpatient pediatric asthma pathways are being utilized nationally. (1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network. (2) Compare characteristics of hospitals with and without pathways. We conducted a descriptive, cross-sectional, survey study of hospitals in the Pediatric Research in Inpatient Settings Network (75% children's hospitals, 25% community hospitals). Our survey determined if each hospital used a pathway and pathway characteristics (e.g. pathway elements, implementation methods). Hospitals with and without pathways were compared using Chi-square tests (categorical variables) and Student's t-tests (continuous variables). Surveys were distributed to 3-5 potential participants from each hospital and 302 (74%) participants responded, representing 86% (106/123) of surveyed hospitals. From 2005-2015, the proportion of hospitals utilizing inpatient asthma pathways increased from 27% to 86%. We found variation in pathway elements, implementation strategies, electronic medical record integration, and compliance monitoring across hospitals. Hospitals with pathways had larger inpatient pediatric programs [mean 12.1 versus 6.1 full-time equivalents, p = 0.04] and were more commonly free-standing children's hospitals (52% versus 23%, p = 0.05). From 2005-2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. We found variation in many aspects of pathway design and implementation. Future studies should determine optimal implementation strategies to better support hospital-level efforts in improving pediatric asthma care and outcomes.

  3. Utility of spinal MRI in children with anorectal malformation

    Energy Technology Data Exchange (ETDEWEB)

    Miyasaka, Mikiko; Nosaka, Shunsuke; Tsutsumi, Yoshiyuki [National Centre for Child Health and Development, Radiology, Tokyo (Japan); Kitano, Yoshihiro [Saitama Children' s Medical Centre, Paediatric Surgery, Saitama (Japan); Ueoka, Katsuhiko [National Centre for Child Health and Development, Paediatric Urology, Tokyo (Japan); Kuroda, Tatsuo; Honna, Toshiroh [National Centre for Child Health and Development, Paediatric Surgery, Tokyo (Japan)

    2009-08-15

    The association between spinal cord anomalies and imperforate anus is well recognized. Until now, the incidence of tethered cord has been assumed to be higher in patients with high-type imperforate anus. However, recent reports suggest that tethered cord is as common in patients with a low lesion as in those with a high lesion. To review the incidence of spinal cord anomalies in those with a low lesion and those with a high (including intermediate) anorectal malformation (ARM), and to determine the best diagnostic imaging strategy. A group of 50 consecutive patients with postoperative ARM and in whom spinal MRI had been performed were identified retrospectively. We reviewed and compared the following factors between those with a high lesion and those with a low lesion: (1) clinical symptoms, (2) spinal cord anomalies, and (3) vertebral anomalies. The incidence of spinal cord anomalies was no different between those with a high lesion and those with a low lesion, and spinal cord anomalies were present regardless of the presence of vertebral anomalies or symptoms. Owing to the high incidence of spinal cord anomalies in patients with imperforate anus, MRI is the best imaging tool for detecting such anomalies regardless of the level of the lesion. (orig.)

  4. Dealing with the difficult utility

    International Nuclear Information System (INIS)

    Keats, D.E.; Sundquist, M.J.; Cross, J.P.

    1991-01-01

    STS HydroPower, Ltd. (STS) is an independent hydroelectric power developer involved in the full scope of hydroelectric activities. This includes the permitting, design, financing, turbine design and manufacturing, site construction and operation of small to mid-sized hydroelectric sites across the United States. At the present time, STS owns and operates nine sites in four states with a combined capacity of 20 megawatts. In dealing with the implementation of these sites, STS has dealt with five different utilities. In addition, in pursuing additional development opportunities throughout the United States, STS has had contact with numerous other utilities. During this time it would be fair to conclude that each of these utilities has exhibited its own personality with respect to dealing with independent developers. To the credit of the utility industry, the majority of these utilities have been helpful and supportive of independent projects, but a small number of utilities have approached projects from an initial and continuing adversarial position. The purpose of this paper is to examine those options and procedures available to the developer when a utility is encountered with a negative predisposition

  5. Public utility economics and finance

    Energy Technology Data Exchange (ETDEWEB)

    Howe, K.M.; Rasmussen, E.F.

    1982-01-01

    Students will find this presentation of the economic and institutional arrangements that surround the area of public utilities helpful in understanding current regulations and possibly suggesting solutions for future problems. The eight sections of the text cover: (1) an introduction to the nature and types of services provided by public utilities; (2) economic characteristics; (3) legal concepts; (4) traditional issues in regulation; (5) independent regulatory commissions; (6) a critique of public-utility regulation; (7) pricing and the regulation of consumer demand; and (8) capital budgeting and finance. 490 references, 37 figures, 38 tables. (DCK)

  6. Life-Cycle Consumption and Children

    DEFF Research Database (Denmark)

    Jørgensen, Thomas Høgholm

    2017-01-01

    I estimate by maximum likelihood a dynamic model of optimal intertemporal allocation of consumption in the presence of children using high-quality Danish longitudinal data. The number and age of all children can affect the marginal utility of consumption while income uncertainty, credit constrain...... in explaining the observed consumption age profile.......I estimate by maximum likelihood a dynamic model of optimal intertemporal allocation of consumption in the presence of children using high-quality Danish longitudinal data. The number and age of all children can affect the marginal utility of consumption while income uncertainty, credit constraints...... and postretirement motives also influence household behaviour. While I estimate that children have a surprisingly small effect on the marginal utility of non-durable consumption, data simulated from the estimated model replicates similar correlations between log consumption growth and changing household composition...

  7. Protective effect of Bacillus Calmette-Guerin (BCG) vaccination in children with extra-pulmonary tuberculosis, but not the pulmonary disease. A case-control study in Rosario, Argentina.

    Science.gov (United States)

    Bonifachich, Elena; Chort, Monica; Astigarraga, Ana; Diaz, Nora; Brunet, Beatriz; Pezzotto, Stella Maris; Bottasso, Oscar

    2006-04-05

    A hospital-based case-control study was carried out at the Vilela Children's Hospital in Rosario, Argentina, to measure the protection conferred by BCG vaccination against tuberculosis (TB). The study included 148 newly diagnosed cases of TB (75 males and 73 females, mean age 3.34+/-2.97 years, S.D.), 134 of them with pulmonary TB and 14 cases with extra-pulmonary disease. Controls (425 males and 357 females, 3.39+/-2.98 years) were selected randomly among children who attended to the Hospital showing, neither respiratory diseases nor any other infectious illnesses. Information on BCG vaccination history was assessed from scars or immunisation records. All participants were negative to human immunodeficiency virus and belonged to the lower and upper-lower socioeconomic status, being similar in place of residence and ethnic characteristics. Rate of vaccinated children was 92.6% of cases and 94.5% of controls (3.4 and 3.9% of them without scars, respectively). Regarding the total cases, the protective association between BCG and TB was statistically insignificant, as was for the pulmonary form. Among cases with extra-pulmonary disease, vaccine effectiveness attained significance [79% (95% CI=26-94)], no matter their age, sex or nutritional status. BCG vaccination exerted a beneficial role in extra-pulmonary TB, even in children not seriously undernourished.

  8. Pediatric liver transplantation: predictors of survival and resource utilization.

    Science.gov (United States)

    Wagenaar, Amy E; Tashiro, Jun; Sola, Juan E; Ekwenna, Obi; Tekin, Akin; Perez, Eduardo A

    2016-05-01

    We sought to identify factors associated with increased resource utilization and in-hospital mortality for pediatric liver transplantation (LT). Kids' Inpatient Database (1997-2009) was used to identify cases of LT in patients liver disease was the most common (75 %). Logistic regression found higher mortality in children undergoing LT for malignant conditions (odds ratio: 4.8) and acute hepatic failure (OR 3.4). Cases complicated by renal failure (OR 7.7) and complications of LT (OR 2.7) had higher mortality rates. Resource utilization increased for children with renal failure and those with hemorrhage as a complication of LT, p failure and complications related to LT. Admission length was sensitive to payer status, hospital characteristics, and UNOS region, whereas total costs were unaffected by payer status or hospital type.

  9. Aspectos culturais no cuidado familiar à criança com desnutrição = Cultural aspects in family care for children with malnutrition

    Directory of Open Access Journals (Sweden)

    Mirna Albuquerque Frota

    2009-01-01

    Full Text Available Objetivou-se identificar o fator cultural que interfere no cuidado do filho desnutrido e propor ações de Educação Popular em Saúde na assistência à criança desnutrida. Trata-se de uma pesquisa-ação desenvolvida no Núcleo de Atenção Médica Integrada – NAMI, realizada no período de janeiro a julho de 2008. Participaram deste estudo oito mães e um pai, cujas idades variavam de 20 a 48 anos. A coleta de dados realizou-se mediante entrevistas semi-estruturadas e oficinas educativas, em que se utilizou análise de conteúdo de Bardin. Após organização dos resultados, foram identificadas as categorias: uma desnutrição desconhecida; oficinas educativas e saber popular; consciência do cuidado. O resultado aponta para uma nova consciência no cuidado com o filho desnutrido na cultura da comunidade. Recomendam-se intervenções de Educação Popular em Saúde adequadas para grupos culturalmente distintos. Nesta perspectiva, há de seconsiderar o conjunto de propostas, viabilizando e incentivando a Educação Popular, para buscar mudanças na constituição de novos sujeitos e práticas comprometidas com o rompimento das barreiras sociais, econômicas e políticas.This study aimed to identify the cultural factor that interferes with the care of undernourished children and to propose actions of Popular Health Education in the assistance of undernourished children. It regards an action research developed at the Nucleus of Integrated Medical Attention – NAMI, performed between January and July 2008. Eight mothers and one father took part in the study, with ages varying from 20 to 48 years old. The data collection took place by means of semi-structured interviews and educational workshops, which were used in the Bardin content analysis. After organizing the result, the following categories were identified: unknown malnutrition; educative workshops and popular knowledge; conscience of care. The results point to a new conscience at the

  10. State Drug Utilization Data 2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  11. State Drug Utilization Data 1996

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  12. State Drug Utilization Data 1993

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  13. State Drug Utilization Data 1995

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  14. State Drug Utilization Data 1997

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  15. State Drug Utilization Data 2015

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  16. State Drug Utilization Data 1998

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  17. State Drug Utilization Data 1991

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  18. State Drug Utilization Data 1992

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  19. State Drug Utilization Data 1994

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  20. State Drug Utilization Data 2001

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  1. State Drug Utilization Data 2005

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  2. State Drug Utilization Data 2011

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  3. State Drug Utilization Data 2006

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  4. State Drug Utilization Data 2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  5. State Drug Utilization Data 2012

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  6. State Drug Utilization Data 2009

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  7. State Drug Utilization Data 2004

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  8. State Drug Utilization Data 2008

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  9. State Drug Utilization Data 2002

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  10. Growth of hydrocarbon utilizing microorganisms

    Digital Repository Service at National Institute of Oceanography (India)

    Bhosle, N.B.; Mavinkurve, S.

    Two isolates from marine mud having broad spectrum hydrocarbon utilizing profile were identified as Arthrobacter simplex and Candida tropicalis.Both the organisms grew exponentially on crude oil. The cell yield of the organisms was influenced...

  11. Decentralized method for utility regulation

    Energy Technology Data Exchange (ETDEWEB)

    Loeb, M. (North Carolina State Univ., Raleigh); Magat, W.A.

    1979-10-01

    A new institutional arrangement for regulating utilities is suggested that minimizes the costs of natural monopolies. A mixture of regulation and franchising, the plan draws on the advantages of each and eliminates many of the problems. The proposal allows utilities to set their own price on the basis of demand and marginal-cost projections. Subsidies are provided by the regulatory agency if there is a consumer surplus. The system encourages the utility to select a competitive price and to produce only the amount of service needed. Operating efficiency is encouraged by rewarding cost reductions and discouraging cost overstatement at the rate review. The regulatory agency would not need to take action to bring price and marginal costs into equality. The franchise sale can be made by competitive bidding, in which the bidders would capitalize part or all of the subsidy or the regulatory agency could recover the subsidy in a lump-sum tax on the utility.

  12. Medicare Utilization for Part B

    Data.gov (United States)

    U.S. Department of Health & Human Services — This link takes you to the Medicare utilization statistics for Part B (Supplementary Medical Insurance SMI) which includes the Medicare Part B Physician and Supplier...

  13. State Drug Utilization Data 2017

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  14. State Drug Utilization Data 2016

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  15. State Drug Utilization Data 2000

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  16. State Drug Utilization Data 2007

    Data.gov (United States)

    U.S. Department of Health & Human Services — Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate...

  17. Build Resilience at Your Utility

    Science.gov (United States)

    CREAT allows users to evaluate potential impacts of climate change on their utility and to evaluate adaptation options to address them using both traditional risk assessment and scenario-based decision making.

  18. Children's Learning

    Science.gov (United States)

    Siegler, Robert S.

    2005-01-01

    A new field of children's learning is emerging. This new field differs from the old in recognizing that children's learning includes active as well as passive mechanisms and qualitative as well as quantitative changes. Children's learning involves substantial variability of representations and strategies within individual children as well as…

  19. Photovoltaics: New opportunities for utilities

    Energy Technology Data Exchange (ETDEWEB)

    1991-07-01

    This publication presents information on photovoltaics. The following topics are discussed: Residential Photovoltaics: The New England Experience Builds Confidence in PV; Austin's 300-kW Photovoltaic Power Station: Evaluating the Breakeven Costs; Residential Photovoltaics: The Lessons Learned; Photovoltaics for Electric Utility Use; Least-Cost Planning: The Environmental Link; Photovoltaics in the Distribution System; Photovoltaic Systems for the Rural Consumer; The Issues of Utility-Intertied Photovoltaics; and Photovoltaics for Large-Scale Use: Costs Ready to Drop Again.

  20. The 1990 utility tax conference

    International Nuclear Information System (INIS)

    Norris, J.E.

    1990-01-01

    This article reports on the Sixth Annual Utility Tax Conference held in Washington, D.C. in October. Topics of the conference concerned tax issues associated with depreciable assets, employee benefits plans, valuation on utility property, pollution control, and restructuring and reorganization. Also discussed briefly were the tax changes being considered at that time as part of the negotiation of the details of the Omnibus Budget Reconciliation Act

  1. Strategies for the plutonium utilization

    International Nuclear Information System (INIS)

    Zouain, D.M.; Lima, J.O.V.; Sakamoto, L.H.

    1981-11-01

    A review of the activities involving plutonium (its recycle, utilization and technological status and perspectives) is done. These informations are useful for an economic viability study for the plutonium utilization in thermal reactors (recycling) and in fast breeders reactor (FBR), trying to collect the major number of informations about these subjects. The initial phase describes the present status and projections of plutonium accumulation and requirements. Then, the technological process are described and some strategies are analyzed. (E.G.) [pt

  2. Critical paths to coal utilization

    Energy Technology Data Exchange (ETDEWEB)

    Hill, G.R.

    1977-01-01

    The present dilemma of energy producers, converters, and policy decision makers is presented. The consequences of environmental control regulations, coupled with the need for conservation and energy, and of energy resources on the increased utilization of coal, are discussed. Several recent technical accomplishments that make possible increased utilization of coal for power generation are described. Groundwork is laid for discussion of the technical development that must occur if the United States is to retain its energy viability.

  3. Aerobic fitness, micronutrient status, and academic achievement in Indian school-aged children.

    Directory of Open Access Journals (Sweden)

    Ishaan K Desai

    Full Text Available Aerobic fitness has been shown to have several beneficial effects on child health. However, research on its relationship with academic performance has been limited, particularly in developing countries and among undernourished populations. This study examined the association between aerobic fitness and academic achievement in clinically healthy but nutritionally compromised Indian school-aged children and assessed whether micronutrient status affects this association. 273 participants, aged 7 to 10.5 years, were enrolled from three primary schools in Bangalore, India. Data on participants' aerobic fitness (20-m shuttle test, demographics, anthropometry, diet, physical activity, and micronutrient status were abstracted. School-wide exam scores in mathematics and Kannada language served as indicators of academic performance and were standardized by grade level. The strength of the fitness/achievement association was analyzed using Spearman's rank correlation, multiple variable logistic regression, and multi-level models. Significant positive correlations between aerobic capacity (VO2 peak and academic scores in math and Kannada were observed (P < 0.05. After standardizing scores across grade levels and adjusting for school, gender, socioeconomic status, and weight status (BMI Z-score, children with greater aerobic capacities (mL * kg(-1 * min(-1 had greater odds of scoring above average on math and Kannada exams (OR=1.08, 95% CI: 1.02 to 1.15 and OR=1.11, 95% CI: 1.04 to 1.18, respectively. This association remained significant after adjusting for micronutrient deficiencies. These findings provide preliminary evidence of a fitness/achievement association in Indian children. While the mechanisms by which aerobic fitness may be linked to academic achievement require further investigation, the results suggest that educators and policymakers should consider the adequacy of opportunities for physical activity and fitness in schools for both their

  4. A survey of undernutrition in children under three years of age in rural Western China.

    Science.gov (United States)

    Pei, Leilei; Ren, Lin; Yan, Hong

    2014-02-05

    Childhood undernutrition adversely impacts child health and is one of China's largest health burdens. However, there is limited information on the current rate of childhood undernutrition in rural Western China. The purpose of this study was to investigate the prevalence of childhood undernutrition and explore its association with socio-economic characteristics in Western China. A total of 13,532 children of 0 ~ 36 months of age were recruited as subjects from 45 counties and 10 provinces in Western China with a 3-stage probability proportion to size sampling. The composite index of anthropometric failure (CIAF) was used to assess the childhood undernutrition. The association between socio-economic characteristics and childhood undernutrition was analyzed using a two-level logistic regression. Based on CIAF, the prevalence of undernutrition among children under three years of age in rural Western China in 2005 was 21.7%. The two-level logistic analysis presented a large difference in undernutrition among the 10 provinces with the highest odds ratio in Guizhou (OR: 2.15, 95%CI: 1.50, 3.08). Older children had a higher prevalence of undernutrition. As compared to girls, boys were more likely to be undernourished (OR 1.27, 95% CI: 1.16, 1.39). The likelihood of undernutrition was lower in subjects of Han ethnicity as opposed to subjects of minority ethnicities (OR 0.77, 95%CI: 0.65, 0.90). In addition, the education levels of the mother as well as wealth index were both negatively associated with childhood undernutrition. Childhood undernutrition still remains a large health challenge in rural Western China. This study has important policy implications for the Chinese government to improve childhood undernutrition in the surveyed areas.

  5. Underdiagnosis of malnutrition in infants and young children in Rwanda: implications for attainment of the Millennium Development Goal to end poverty and hunger.

    Science.gov (United States)

    Binagwaho, Agnès; Agbonyitor, Mawuena; Rukundo, Alphonse; Ratnayake, Niloo; Ngabo, Fidel; Kayumba, Josephine; Dowdle, Bridget; Chopyak, Elena; Smith Fawzi, Mary C

    2011-12-29

    Progress towards the first Millennium Development Goal (MDG1) to end poverty and hunger has lagged behind attainment of other MDGs due to chronic poverty and worldwide inequity in access to adequate health care, food, clean water, and sanitation. Despite ongoing challenges, Rwanda has experienced economic progress and the expansion of the national public health system during the past 20 years. However, protein-energy malnutrition in children under five is still a major concern for physicians and government officials in Rwanda. Approximately 45% of children under the age of five in Rwanda suffer from chronic malnutrition, and one in four is undernourished. For years, health facilities in Rwanda have used incorrect growth references for measuring nutritional status of children despite the adoption of new standards by the World Health Organization in 2006. Under incorrect growth references used in Rwanda, a number of children under five who were severely underweight were not identified, and therefore were not treated for malnutrition, thus potentially contributing to the under five mortality rate. Given that one in ten children suffer from malnutrition worldwide, it is imperative that all countries with a burden of malnutrition adopt the most up-to-date international standards for measuring malnutrition, and that the problem is brought to the forefront of international public health initiatives. For low income countries in the process of improving economic conditions, as Rwanda is, increasing the identification and treatment of malnutrition can promote the advancement of MDG1 as well as physical and cognitive development in children, which is imperative for advancing future economic progress.

  6. Underdiagnosis of malnutrition in infants and young children in Rwanda: implications for attainment of the Millennium Development Goal to end poverty and hunger

    Directory of Open Access Journals (Sweden)

    Binagwaho Agnès

    2011-12-01

    Full Text Available Abstract Progress towards the first Millennium Development Goal (MDG1 to end poverty and hunger has lagged behind attainment of other MDGs due to chronic poverty and worldwide inequity in access to adequate health care, food, clean water, and sanitation. Despite ongoing challenges, Rwanda has experienced economic progress and the expansion of the national public health system during the past 20 years. However, protein-energy malnutrition in children under five is still a major concern for physicians and government officials in Rwanda. Approximately 45% of children under the age of five in Rwanda suffer from chronic malnutrition, and one in four is undernourished. For years, health facilities in Rwanda have used incorrect growth references for measuring nutritional status of children despite the adoption of new standards by the World Health Organization in 2006. Under incorrect growth references used in Rwanda, a number of children under five who were severely underweight were not identified, and therefore were not treated for malnutrition, thus potentially contributing to the under five mortality rate. Given that one in ten children suffer from malnutrition worldwide, it is imperative that all countries with a burden of malnutrition adopt the most up-to-date international standards for measuring malnutrition, and that the problem is brought to the forefront of international public health initiatives. For low income countries in the process of improving economic conditions, as Rwanda is, increasing the identification and treatment of malnutrition can promote the advancement of MDG1 as well as physical and cognitive development in children, which is imperative for advancing future economic progress.

  7. Uso de medicamentos em crianças de zero a seis anos matriculadas em creches de Tubarão, Santa Catarina Drug utilization among children aged zero to six enrolled in day care centers of Tubarão, Santa Catarina, Brazil

    Directory of Open Access Journals (Sweden)

    Diélly Cunha de Carvalho

    2008-09-01

    Full Text Available OBJETIVO: Identificar o padrão de utilização de medicamentos, nos últimos seis meses, em crianças entre zero e seis anos, em quatro creches de Tubarão, Santa Catarina, no ano de 2007. MÉTODOS: Estudo transversal realizado por meio de questionário semi-estruturado, aplicado aos pais ou responsáveis pelas 413 crianças incluídas na pesquisa, após consentimento informado. Foram coletados dados sobre utilização de medicamentos e informações de saúde. A análise estatística foi feita com auxílio do programa Statistical Package for the Social Sciences 15.0. RESULTADOS: A média de idade das crianças foi 3,7±1,3 anos, sendo 195 (47% meninas e 218 (53% meninos. Dentre os adultos que responderam ao questionário, 75% eram mães e 43% tinham oito anos de estudo. Diante de situação de doença, 47% forneciam os medicamentos que tinham em casa. Das crianças pesquisadas, 82 (20% apresentavam doença crônica e 75 (18% portavam doença aguda no momento da pesquisa. Houve histórico de reações adversas aos medicamentos em 82 (20% crianças, sendo a mais freqüente a alergia. A classe de medicamentos mais utilizada foi a dos analgésicos e antitérmicos (45% e o motivo de uso principal foi febre (32%. Nos últimos seis meses, haviam sido utilizados 763 medicamentos, com média de 1,8 medicamentos por criança, sendo 41% com prescrição médica e 59% por automedicação. CONCLUSÕES: A prática freqüente de automedicação em crianças é um fenômeno potencialmente nocivo à saúde. Esse estudo mostrou que a maioria dos pais ou responsáveis segue essa prática, podendo mascarar doenças graves, gerar quadros de reações adversas e desenvolver resistência bacteriana, além de outras complicações.OBJECTIVE: Identify the pattern of drug utilization in a six-month period among children aged zero to six years old, in Tubarão, Santa Catarina, Brazil, during 2007. METHODS: This cross-sectional study was carried out using a semi

  8. Cross-Language Nonword Repetition by Bilingual and Monolingual Children

    Science.gov (United States)

    Windsor, Jennifer; Kohnert, Kathryn; Lobitz, Kelann F.; Pham, Giang T.

    2010-01-01

    Purpose: Identifying children with primary or specific language impairment (LI) in languages other than English continues to present a diagnostic challenge. This study examined the utility of English and Spanish nonword repetition (NWR) to identify children known to have LI. Method: Participants were 4 groups of school-age children (N = 187).…

  9. Calculating utility prudency issue costs

    International Nuclear Information System (INIS)

    Nielsen, K.R.

    1985-01-01

    The nuclear industry, particularly utilities and their construction, engineering and vendor agents, is faced with a surging increase in prudency management audits. What started as primarily a nuclear project-oriented requirement has spread to encompass most significant utility capital construction projects. Such audits are often a precedent condition to commencement of rate hearings. The cost engineer, a primary major capital construction project participant, is required to develop or critique ''prudency issue'' costs as part of such audits. Although utility costs in the broadest sense are potentially at issue, this paper concentrates on the typical project/construction management costs. The costs of design, procurement and construction are all subject to the calculation process

  10. Ethanolamine utilization in Vibrio alginolyticus

    Science.gov (United States)

    2012-01-01

    Abstract Ethanolamine is used as an energy source by phylogenetically diverse bacteria including pathogens, by the concerted action of proteins from the eut-operon. Previous studies have revealed the presence of eutBC genes encoding ethanolamine-ammonia lyase, a key enzyme that breaks ethanolamine into acetaldehyde and ammonia, in about 100 bacterial genomes including members of gamma-proteobacteria. However, ethanolamine utilization has not been reported for any member of the Vibrio genus. Our comparative genomics study reveals the presence of genes that are involved in ethanolamine utilization in several Vibrio species. Using Vibrio alginolyticus as a model system we demonstrate that ethanolamine is better utilized as a nitrogen source than as a carbon source. Reviewers This article was reviewed by Dr. Lakshminarayan Iyer and Dr. Vivek Anantharaman (nominated by Dr. L Aravind). PMID:23234435

  11. The European Utility Requirement Document

    International Nuclear Information System (INIS)

    Roche, I.I.

    1999-01-01

    The major European electricity producers work on a common requirement document for future LWR plants since 1992. They aim at requirements acceptable together by the owners, the public and the authorities. Thus the designers can develop standard LWR designs acceptable everywhere in Europe and the utilities can open their consultations to vendors on common bases. Such a standardisation promotes an improvement of generation costs and of safety : public and authorities acceptance should be improved as well ; significant savings are expected in development and construction costs. Since the early stages of the project, the EUR group has grown significantly. It now includes utilities from nine European countries. Utilities from two other European countries are joining the group. Specific cooperation agreements are also in progress with a few extra-European partners

  12. The NRC and utility finances

    International Nuclear Information System (INIS)

    Byus, L.C.

    1992-01-01

    In a speech before the National Association of Regulatory Utility Commissioners in November 1991, Nuclear Regulatory Commission Chairman Ivan Selin presented what he called an open-quotes expansion of the concept of safety beyond our previous narrow bounds.close quotes He went on to explain, open-quotes To be seen as successful and safe operators of nuclear facilities, utilities must have safe and predictable cash flows.close quotes While there is little disagreement that the concepts of successful plant operations and financial strength go hand in hand, the relationship between the two is not clear. Which came first, successful operation of generating plants or financial strength? Selin's views on NRC involvement in financial aspects of utility operation in the United States are sure to stimulate debate on the issue

  13. Utilization trend of wood species utilized in furniture industry in ...

    African Journals Online (AJOL)

    The utilization trend of four commonly used wood species and two lesser used wood species that are used for furniture making was examined. The wood species are Mansonia altissima (Mansonia), Khaya ivorensis (Khaya), Cordia millenii (Cordia) and Tectona grandis (Teak) as commonly used wood species; Aningeria ...

  14. 24 CFR 5.632 - Utility reimbursements.

    Science.gov (United States)

    2010-04-01

    ... Section 8 Project-Based Assistance Family Payment § 5.632 Utility reimbursements. (a) Applicability. This... the utility supplier to pay the utility bill on behalf of the family. If the PHA elects to pay the utility supplier, the PHA must notify the family of the amount paid to the utility supplier. (3) In the...

  15. 'Utility marketing' as an oxymoron

    International Nuclear Information System (INIS)

    Gedge, P.

    1996-01-01

    Electricity industry restructuring through the elimination of monopolies and the introduction of competition was examined. A distinction was made between marketing a product and brand marketing, emphasizing the customer loyalty, customer confidence and high profitability associated with brand names. The meaning of 'brand' in general and particularly in relation to electric power was explained. The old and the new utilities world were contrasted, and the place and importance of marketing in the deregulated, customer choice-based, market-driven new utilities world was described

  16. E-Commerce for utilities

    Energy Technology Data Exchange (ETDEWEB)

    Malicky, M. [Metzler and Associates, Deerfield, IL (United States)

    1999-07-01

    The use of E-Commerce by energy utility and service companies was discussed. E-Commerce was described as being all communication via the web including Internet, Intranet and Extranet. E-Commerce communication includes the exchange of information, data, money services, products, ideas, conversations, knowledge, inventory and events. E-Commerce can be applied to electric and gas utilities to enhance energy marketing, delivery, retail energy, energy services, retail services and customer satisfaction. This means of communication is quickly becoming an essential part of customer care strategy. It reduces costs and improves performance. It was forecasted that E-Commerce will more than double from 1998 to 2001. 15 refs.

  17. Essential fats: how do they affect growth and development of infants and young children in developing countries? A literature review.

    Science.gov (United States)

    Huffman, Sandra L; Harika, Rajwinder K; Eilander, Ans; Osendarp, Saskia J M

    2011-10-01

    Omega-3 and omega-6 fatty acids, particularly docosahexaenoic acid (DHA), are known to play an essential role in the development of the brain and retina. Intakes in pregnancy and early life affect growth and cognitive performance later in childhood. However, total fat intake, alpha-linolenic acid (ALA) and DHA intakes are often low among pregnant and lactating women, infants and young children in developing countries. As breast milk is one of the best sources of ALA and DHA, breastfed infants are less likely to be at risk of insufficient intakes than those not breastfed. Enhancing intake of ALA through plant food products (soy beans and oil, canola oil, and foods containing these products such as lipid-based nutrient supplements) has been shown to be feasible. However, because of the low conversion rates of ALA to DHA, it may be more efficient to increase DHA status through increasing fish consumption or DHA fortification, but these approaches may be more costly. In addition, breastfeeding up to 2 years and beyond is recommended to ensure an adequate essential fat intake in early life. Data from developing countries have shown that a higher omega-3 fatty acid intake or supplementation during pregnancy may result in small improvements in birthweight, length and gestational age based on two randomized controlled trials and one cross-sectional study. More rigorous randomized controlled trials are needed to confirm this effect. Limited data from developing countries suggest that ALA or DHA supplementation during lactation and in infants may be beneficial for growth and development of young children 6-24 months of age in these settings. These benefits are more pronounced in undernourished children. However, there is no evidence for improvements in growth following omega-3 fatty acid supplementation in children >2 years of age. © 2011 Blackwell Publishing Ltd.

  18. Pancreatitis - children

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007679.htm Pancreatitis - children To use the sharing features on this page, please enable JavaScript. Pancreatitis in children occurs when the pancreas becomes swollen ...

  19. Intussusception - children

    Science.gov (United States)

    ... Viral infection Englarged lymph node in the intestine Polyp or tumor The reason for the problem is more likely to be found in older children. Intussusception can affect both children and adults. However, ...

  20. Children's Health

    Science.gov (United States)

    Your child's health includes physical, mental and social well-being. Most parents know the basics of keeping children healthy, like offering ... for children to get regular checkups with their health care provider. These visits are a chance to ...

  1. Utility Energy Services Contracts: Enabling Documents

    Energy Technology Data Exchange (ETDEWEB)

    None

    2009-05-01

    Utility Energy Services Contracts: Enabling Documents provides materials that clarify the authority for Federal agencies to enter into utility energy services contracts (UESCs), as well as sample documents and resources to ease utility partnership contracting.

  2. Waste heat utilization in agriculture

    International Nuclear Information System (INIS)

    Horacek, P.

    1983-01-01

    The Proceedings contain 17 papers presented at meetings of the Working Group for Waste Heat Utilization of the Committee of the European Society of Nuclear Methods in Agriculture of which 7 fall under the INIS scope. The working group met in May 1980 in Brno, Czechoslovakia, in October 1981 in Aberdeen, Scotland and in September 1982 in Brno. (Z.M.)

  3. Introduction to drug utilization research

    DEFF Research Database (Denmark)

    Wettermark, Björn; Elseviers, Monique; Almarsdóttir, Anna Birna

    2016-01-01

    Qualitative research methods derive from the social sciences. Their use in drug utilization research is increasingly widespread, especially in understanding patient and prescriber perspectives. The main focus in qualitative research is exploration of a given phenomenon in order to get a wider...

  4. Production and utilization of radioisotopes

    Energy Technology Data Exchange (ETDEWEB)

    Sekine, Toshiaki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Matsuoka, Hiromitsu

    1999-03-01

    A plan of developing radioisotopes with a high power proton accelerator of the Neutron Science Project is presented. The status of production and utilization of radioisotopes in Japan is briefly discussed. The radioisotopes to be produced for biomedical use are discussed together with the facility for production of those radioisotopes and for research with the products. (author)

  5. Expected utility with lower probabilities

    DEFF Research Database (Denmark)

    Hendon, Ebbe; Jacobsen, Hans Jørgen; Sloth, Birgitte

    1994-01-01

    An uncertain and not just risky situation may be modeled using so-called belief functions assigning lower probabilities to subsets of outcomes. In this article we extend the von Neumann-Morgenstern expected utility theory from probability measures to belief functions. We use this theory...

  6. Utilities practices toward sustainable development

    International Nuclear Information System (INIS)

    2008-01-01

    The strategy toward a Sustainable Development is not standardised and it is useful to compare approaches of companies. WG C3.03 analysed a number of Sustainability Reports or Environmental Reports, published by Utilities, exposing their current approaches to the three 'Pillars': environmental aspects, society development and economical performances. Case studies, relevant to the three 'Pillars', show examples of practices

  7. Utilization and management of alder.

    Science.gov (United States)

    David G. Briggs; Dean S. DeBell; William A. Atkinson

    1978-01-01

    In the Pacific Northwest and British Columbia, red alder often grows on forest lands following natural or man-caused disturbances. Frequently ignored as a pest or weed, many alder stands have developed to the point where important utilization and management questions are being asked. It is recognized that alder is a fast growing species, and that its rapid early growth...

  8. Utility impact on STARFIRE design

    International Nuclear Information System (INIS)

    DeFreece, D.A.; Waganer, L.M.; Woklenhauer, W.C.

    1981-01-01

    A primary objective of STARFIRE has been to design a tokamak fusion power plant that was attractive to the utilities. To achieve this goal, several utility representatives were directly involved in the decision-making processes as the design evolved. An initial step was to establish the relative importance to the utilities for an extensive list of economic, performance, safety and environmental issues. The top twenty issues were ranked. Cost of electricity was clearly most important with very little spread in the ratings of individual evaluators. Licensing is a go/no-go factor and must be accomplished for the other factors to have meaning. The top nine factors were judged to be very important by all evaluators, as was shown by the spread of ratings from 5 to 10. There is considerably more spread in the bottom eleven, which reflects a lack of consensus as to the relative importance of the evaluation factors. This evaluation was utilized in establishing the initial design concept

  9. Utilizing Twitter for Concept Learning

    Science.gov (United States)

    Buzzelli, Armand; Holdan, E. Gregory; Rota, Daniel; McCarthy, John

    2016-01-01

    Despite the perception that face-to-face classrooms provide speaking opportunities, studies by Fassinger (1995), Nunn (1996), and Weimer (2013) have conveyed that there is limited interaction in a traditional college lecture setting. Social media networks such as Twitter provide an opportunity for instructors to utilize popular mobile technology…

  10. Thorium utilization in power reactors

    International Nuclear Information System (INIS)

    Saraceno; Marcos.

    1978-10-01

    In this work the recent (prior to Aug, 1976) literature on thorium utilization is reviewed briefly and the available information is updated. After reviewing the nuclear properties relevant to the thorium fuel cycle we describe briefly the reactor systems that have been proposed using thorium as a fertile material. (author) [es

  11. Manpower Utilization in Social Welfare.

    Science.gov (United States)

    Teare, Robert J.; McPheeters, Harold L.

    To study the problems of developing a useful conceptual framework for utilizing workers in the field of social welfare who received training at less than the highest professional level, four 2-day symposium sessions were held during the fall of 1968, Approximately 13 participants, predominanatly social workers and representatives from the fields…

  12. Wind energy utilization: A bibliography

    Science.gov (United States)

    1975-01-01

    Bibliography cites documents published to and including 1974 with abstracts and references, and is indexed by topic, author, organization, title, and keywords. Topics include: Wind Energy Potential and Economic Feasibility, Utilization, Wind Power Plants and Generators, Wind Machines, Wind Data and Properties, Energy Storage, and related topics.

  13. Bankruptcy games with nontransferable utility

    NARCIS (Netherlands)

    Dietzenbacher, Bas

    This paper analyzes bankruptcy games with nontransferable utility as a generalization of bankruptcy games with monetary payoffs. Following the game theoretic approach to NTU-bankruptcy problems, we study some appropriate properties and the core of NTU-bankruptcy games. Generalizing the core cover

  14. Bankruptcy Games with Nontransferable Utility

    NARCIS (Netherlands)

    Dietzenbacher, Bas

    2017-01-01

    This paper analyzes bankruptcy games with nontransferable utility as a generalization of bankruptcy games with monetary payoffs. Following the game theoretic approach to NTU-bankruptcy problems, we study some appropriate properties and the core of NTU-bankruptcy games. Generalizing the core cover

  15. Acute necrotising gingivitis in young children