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The SIMPOC Philippine Survey of Children 2001: a data source for analyzing occupational injuries to children.

Child labor is a global issue that exists in both industrialized and developing countries. With the unanimous adoption of International Labour Organization (ILO) Convention No. 182 in 1999 calling for the immediate elimination of the worst forms of child labor, ratifying member countries have committed themselves to identifying hazardous work for children in the context of their respective legislative frameworks. Part of tackling the problem of child labor is knowing what types of occupational activities children are engaged in, what types of work environments they are under, and what risks of injuries and illnesses they are exposed to while working. Using the Philippines as a country example, this study introduces a promising data source on children's work and presents a methodology for examining hazardous work to children through the examination of injury rates. Data for this study rely primarily on a nationally representative dataset from the Survey of Children 2001 carried out by the Philippine National Statistics Office, covering the months of October 2001 to September 2002.

Accidents, Occupational↗

Sources of energy and six nutrients in diets of low-income Hispanic-American women and their children: quantitative data from HHANES, 1982-1984.

OBJECTIVE: Identification of important food sources of energy, protein, fat, vitamin A, vitamin C, calcium, and iron for low-income Hispanic women and their children. DESIGN: A subset of 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES), a sample representing 76% of the Hispanic-origin population, provides the most comprehensive examination of Hispanic food habits in the United States. SUBJECTS/SAMPLES: The sample, which approximates the population of the Special Supplemental Food Program for Women, Infants, and Children (WIC), included 1,046 17- to 34-year-old women with household income less than 185% of poverty level and their 1- to 5-year-old children (n = 1,063). MAIN OUTCOME MEASURES: Tables show the percentage that each food contributes to total intake of energy and six nutrients for women and for children and percentage of persons who reported consuming each food during a 24-hour period. RESULTS: Cultural foods contributed less to the energy and nutrient intake of the population than expected, with few exceptions, notably beans, rice, tortillas, and salsa. Major sources of energy and nutrients were similar to those seen for blacks and whites in the second National Health and Nutrition Examination Survey (1976-1980). APPLICATIONS: The data presented should be useful to researchers designing dietary assessment instruments and to nutrition educators designing or adapting educational materials. The data may be of particular interest to WIC staff who work with low-income Hispanic populations.

Adolescent↗

[Epidemiology of community-acquired pneumonia in children. Current data].

Viruses, particularly syncitial respiratory virus, are the main aetiology of community-acquired lower respiratory tract infections in infants, while bacterial agents are more frequently responsible in children older than 3 years. Antimicrobial therapy must take into account the development of reduced susceptibility of penicillin to strains of Streptoccocus pneumoniae and Haemophilus influenzae with beta-lactamase, and high frequency of Mycoplasma pneumoniae and Chlamydia pneumoniae infections. Although the mortality rate has remained low in France, the morbidity appeared to increase in recent years.

Anti-Bacterial Agents↗

A Danish adaptation of the Pain Coping Questionnaire for children: preliminary data concerning reliability and validity.

The aim of this study was to determine the reliability and validity of a Danish translation of the Pain Coping Questionnaire (PCQ) for children in Danish children. The PCQ was translated using a translation-back-translation method. The subjects were 352 healthy children and 40 children with juvenile arthritis (JA), aged 8-17 y. Sixteen of the JA children were divided into a high-pain group (n = 7) and a low-pain group (n = 9). The results were factor analysed using principal component analysis with varimax rotation. Clinical pain intensity was measured using visual analogue scales (VAS) from the Varni/Thompson Pediatric Pain Questionnaire. Experimental pain was induced using a cold pressor pain paradigm and outcome measures were pain intensity, pain discomfort and tolerance to cold pressor pain. A seven-factor solution emerged as the most consistent factor structure. Four subscales, Seeking Social Support (SSS), Cognitive Distraction (CD), Externalizing (EXT) and Internalizing/Catastrophizing (INT), corresponded with the parallel subscales proposed by Reid et al. (Pain 1998; 76: 83-96). Two subscales, Positive Self-Statements (PSS) and Behavioral Distraction (BD), were composed of four of the five items from the previously proposed subscales. One subscale, Information Seeking/Problem Solving (IP), consisted of items from two subscales proposed by Reid et al., i.e. Information Seeking and Problem Solving. Internal consistencies of the subscales were acceptable, with reliability coefficients ranging from 0.60 (BD) to 0.83 (IP) and with test-retest reliabilities between 0.59 and 0.78. Low-pain JA patients showed significantly higher levels of BD than High-pain JA patients (p<0.05). Greater utilization of PSS and BD was associated with less patient-reported present pain and less average everyday pain (p<0.05-0.01), and greater utilization of INT was significantly associated with higher experimental pain intensity (p<0.01). These preliminary findings provide support for the reliability and validity of the Danish modification of the PCQ in a Danish population and for the hypothesis that paediatric pain-coping strategies are associated with the intensity of clinical and experimental pain.

Adaptation, Psychological↗

[Analysis of vitamin and mineral sufficiency in children using data of consumption with food and urinary excretion].

It has been shown that vitamin C and B2, calcium and phosphorus daily intake strongly correlated with their urinary excretion in children 5-8 years old (Moscow) from the decreased bone mineral density risk group. Hour urinary calcium, phosphorus, creatinine excretion values for adequately supplied children has been determined. Vitamin and mineral status evaluation by means of estimation of vitamins and minerals consumption and urinary level (except vitamin B2) give relatively coincided results. Difference between these methods of nutritive status assessment attains 8-25 per cent. Thus these methods are substituted for group nutritive status evaluation.

Ascorbic Acid↗

Agility, gnosis, and graphaesthesia for the toes and fingers in children: normative data (ages 7-14 years).

The differential representation of the toes/feet and fingers/hands along the medial and lateral surfaces of the cerebral cortices, respectively, may have diagnostic utility. Normative data for errors for toe and finger graphaesthesia and gnosis, as well as foot and finger agility, were collected for 86 children (ages 7 to 14). The fingers were more agile than the feet, and the right side of the body was more agile than the left side, regardless of age. A marked improvement in toe gnosis, but not in finger gnosis occurred in children after 11-12 years of age. A statistically significant interaction between laterality and gender was due to the greater numbers of errors for both toe and finger gnosis, displayed by girls for the left sides of their bodies compared to their right sides. This discrepancy was not significant for boys.

Adolescent↗

Antioxidants and protein carbonyls in bronchoalveolar lavage fluid of children: normal data.

Antioxidant-oxidant imbalances in bronchoalveolar lavage fluid (BAL) are thought to contribute to oxidative stress in respiratory disease. However, normal reference ranges for BAL antioxidants and oxidized proteins in children are not available. In this study, we recruited 124 children attending for elective surgery for a noninflammatory condition; 83 were nonasthmatic, nonatopic (N) and 41 were nonasthmatic, atopic (NA). A nonbronchoscopic lavage was performed and ascorbate, uric acid, alpha-tocopherol, and protein carbonyl (as a measure of oxidative damage) concentrations were determined in BAL fluid. The 95% reference range was 0.112-1.897 micromol/L for ascorbate, 0.149-2.163 micromol/L for urate, 0.0029-0.066 micromol/L for alpha-tocopherol, and 0.280-4.529 nmol/mg for protein carbonyls in BAL fluid. Age, gender, and exposure to environmental tobacco smoke did not affect the concentration of ascorbate, urate, alpha-tocopherol, or protein carbonyls. However, in multiple linear regression analyses, the type of home heating (glass-fronted fires or oil-fired central heating) was found to influence ascorbate and urate concentrations in the BAL fluid (ss-coefficient for ascorbate: 0.445, p = 0.031; for urate: 0.114, p = 0.001). There was no significant difference between the N and NA group in BAL fluid concentrations of ascorbate, urate, or protein carbonyls. The alpha-tocopherol concentration was significantly increased in the NA group (p = 0.037). Uric acid and alpha-tocopherol concentrations in BAL fluid and serum were not correlated. Intriguingly, serum and BAL ascorbate concentrations were significantly correlated (r = 0.297, p = 0.018, n = 63), which may offer an explanation for why supplementing the diet with vitamin C can improve asthma symptoms. Further studies will investigate the role of BAL antioxidant concentrations in children with inflammatory respiratory diseases.

Antioxidants↗

Optimal treatment intensity in children with Down syndrome and myeloid leukaemia: data from 56 children treated on NOPHO-AML protocols and a review of the literature.

Children with Down syndrome (DS) and myeloid leukaemia have a significantly higher survival rate than other children, but they also experience considerable treatment-related toxicity. We analysed data on 56 children with DS who were treated on the Nordic Society for Paediatric Haematology and Oncology-acute myeloid leukaemia (NOPHO-AML)88 and NOPHO-AML93 protocols and reviewed the literature. In the dose-intensive NOPHO-AML88 protocol, 8 out of 15 patients (53%) experienced an event. In the less dose-intensive NOPHO-AML93 protocol, 7 out of 41 patients (17%) had an event. Therapy was reduced in 29 patients (52%) with in average 75% and 67% of the scheduled dose of anthracycline and cytarabine, respectively. Treatment-related death occurred in seven who all received full treatment. Relapse and resistant disease occurred at a similar rate in those receiving full and reduced treatment. Review of major series of myeloid leukaemia of DS showed no clear relationship between dose and survival; however, it appears that both a reduction in treatment dose and a less intensively timed treatment regimen improved the outcome. Further studies are needed to define the optimal regimen for treating myeloid leukaemia of DS.

Anthracyclines↗

Comparison of EAP thresholds with MAP levels in the nucleus 24 cochlear implant: data from children.

OBJECTIVE: The purpose of this study is to examine the relationship between the electrically evoked compound action potential (EAP) thresholds and the MAP thresholds (T-levels) and maximum comfort levels (C-levels) in children implanted with the Nucleus 24 device. DESIGN: EAP thresholds were measured using the Neural Response Telemetry system of the Nucleus 24 device. Twenty children implanted with the Nucleus 24 cochlear implant participated in this study. EAP thresholds were compared with the behavioral measures of T- and C-level used to construct the MAP these children used on a daily basis. For these subjects, both EAP and MAP T- and C-levels were obtained the same visit, which occurred at 3 to 5 mo postconnection. RESULTS: EAP thresholds were shown to fall between MAP T- and C-level for 18 of 20 subjects tested; however, considerable variability across subjects was noted. On average, EAP thresholds fell at 53% of the MAP dynamic range. Correlations between EAP threshold and MAP T- and C-level improved substantially when combined with behavioral measures obtained from one electrode in the array. CONCLUSIONS: Moderate correlations were found between EAP thresholds and MAP T- and C-levels for the children participating in this study. However, a technique is described for improving the accuracy of predictions of MAP T- and C-levels based on EAP data combined with a small amount of behavioral information.

Acoustic Stimulation↗

Epidemiologic, bacteriologic, and long-term follow-up data of children with acute hematogenous osteomyelitis and septic arthritis: a ten-year review.

A total of 69 children with acute hematogenous osteomyelitis and 48 with septic arthritis admitted in the period 1978 through 1987 were included in a retrospective review. Epidemiologic and bacteriologic data were analyzed and compared with those of an earlier study (1965 through 1975), confined to the same geographic area. Long-term outcome was evaluated by a questionnaire and clinical and radiographic follow-up. A significant increase in the admission rate for both disorders was observed. The long-term outcome was favorable: major sequelae were found in three patients (3%), minor sequelae in two patients (2%). The benign long-term outcome may well be related to rapid hospital admission and appropriate long-lasting antibiotic treatment.

Adolescent↗

Postoperative extradural infusions in children: preliminary data from a comparison of bupivacaine/diamorphine with plain ropivacaine.

To try to decrease the incidence of side-effects associated with postoperative extradural infusions of local anaesthetics in combination with opioids, we have used plain ropivacaine solutions in 200 children. The first 72 children received an infusion of bupivacaine 0.125% + diamorphine 20 microg x ml-1, then 200 children received plain ropivacaine solutions. The children who received ropivacaine were found to have lower incidences of nausea, pruritus, urinary retention, and were less sedated, despite comparable analgesia. The management of plain ropivacaine for extradural analgesia is discussed.

Amides↗

Correlation of serum fatty acid composition with dietary intake data in children and young adults.

The percentage compositions of fatty acids in serum cholesteryl esters and phospholipids were analysed with gas chromatography in 759 nine- to 24-year-old Finns. The correlations of serum fatty acids with dietary fat intake data were calculated from a 48-h recall survey. The dietary P/S ratio had correlations of r = 0.50 and r = 0.40 with linoleate (18:2) in serum cholesteryl esters and phospholipids, respectively. The intake of fish and fish products correlated positively with the percentages of eicosapentaenoate (20:5 n-3) and docosahexaenoate (22:6 n-3) in both cholesteryl esters and phospholipids. Dietary intake of saturated fat correlated positively with the percentages of all saturated fatty acids in cholesteryl esters and with myristate (14:0) in phospholipids. The intake of monounsaturated fats did not correlate positively with serum monoenes. In conclusion, the dietary P/S ratio is well reflected in the fatty acid composition of serum cholesteryl esters and phospholipids, the intake of saturated fats less well, and the intake of monounsaturated fats not at all.

Adolescent↗

Office-based laser assisted tympanic membrane fenestration in adults and children: pilot data to support an alternative to traditional approaches to otitis media.

OBJECTIVES: To determine the role of intermediate duration ( approximately 3 weeks) middle ear ventilation using office-based laser assisted tympanic membrane fenestration in resolving an episode of otitis media with effusion in adults and children who otherwise would have been treated with insertion of pressure equalization tubes. METHODS: A retrospective chart review of 92 patients (162 ears) was conducted to identify the utility and technical challenges associated with laser assisted tympanic membrane fenestration in an office setting. Clinical characteristics reviewed included: age, gender, duration of effusion, season performed, and hearing and health status of middle ear upon healing of the fenestration. RESULTS: 69% of all patients were effusion free upon closure of the fenestration; 68% of those <3 years; 70% of those 3-7 years; and 70% of those 25-80 years. Some episodes recurred and at final follow-up 64% had normal middle ear structure and function (range of follow-up =1-18 months, mean 2.5 months, median 2.0). Shorter duration of effusion pre-fenestration was more often associated with return to normal middle ear structure and function (P<0.01). Season performed, number of previous episodes of otitis media and pre-treatment tympanometry were not predictive of result. No significant complications were observed. CONCLUSIONS: The use of office-based laser assisted tympanic membrane fenestration is a reasonably safe and effective procedure for the treatment of otitis media in most adults and children. As a minimally invasive otologic procedure, laser assisted tympanic membrane fenestration has great potential to decrease the rates of both antibiotic usage and insertion of ear tubes.

Acoustic Impedance Tests↗

CHIP: Defining a dimension of the vulnerability to attention deficit hyperactivity disorder (ADHD) using sibling and individual data of children in a community-based sample.

We are taking a quantitative trait approach to the molecular genetic study of attention deficit hyperactivity disorder (ADHD) using a truncated case-control association design. An epidemiological sample of children aged 5 to 15 years was evaluated for symptoms of ADHD using a parent rating scale. Individuals scoring high or low on this scale were selected for further investigation with additional questionnaires and DNA analysis. Data in studies like this are typically complicated. In the study reported on here, individuals have from 1 to 4 questionnaires completed on them and the sample is composed of a mixture of singletons and siblings. In this paper, we describe how we used a genetic hierarchical model to fit our data, together with a twin dataset, in order to estimate genetic factor loadings. Correlation matrices were estimated for our data using a maximum likelihood approach to account for missing data. We describe how we used these results to create a composite score, the heritability of which was estimated to be acceptably high using the twin dataset. This score measures a quantitative dimension onto which molecular genetic data will be mapped.

Adolescent↗

Long-term results of early cochlear implantation in congenitally and prelingually deafened children.

Cochlear implants have been shown to improve the speech perception and production skills in children. Data are available on congenitally and prelingually deafened children who were implanted at an older age, but data on children implanted below the age of 3 years are scarce. The present study examines the benefits obtained with early implantation of the young deaf child. Fourteen congenitally or prelingually profoundly hearing-impaired children were implanted before the age of 3 years, with the Nucleus multichannel cochlear prosthesis, and followed for 2-5 years. Results indicate an overall improvement in the perception of all aspects of the speech signal in the auditory-only condition with the cochlear implant. All the children use oral language as their primary mode of communication and attend regular schools. Based on the results of this investigation, the authors conclude that implantation of the young deaf child is beneficial to the development of auditory perceptual skills.

Age of Onset↗